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My favorite way of describing the meaning of codependency is the concept of “if you’re good, I’m good” meaning if your emotional state is positive, so is mine. If emotionally you are angry, upset, or sad- then I am not okay either. Codependency is when stability comes from outside of ourselves. Oftentimes, codependency is a pattern of losing ourselves in others. Codependency is not unique to romantic relationships and can be formed alongside addictions, platonic or familial relationships, parent/child relationships, etc. To understand how to begin to conquer codependency is first to understand how codependency shows up in our lives. Oftentimes those of us who are codependent struggle with low self-worth and an overall minimal understanding of ourselves. I hear people who struggle with codependency often state feeling out of touch with their instincts and gut feelings, that they often seek that security outside of themselves. There is little trust in that inner voice because frankly, we don’t understand what it is even saying. This looks like relying heavily on others for advice, often sharing and replaying your exact predicament with each person and getting confirmation of which choice is the right choice. I think alongside the premise of the definition of codependency is “if you’re okay, I’m okay” is this belief that: if you make the decision and it turns out to be wrong, it was you that was wrong, not me. Sometimes it’s easier to live with mistakes regarding us being made by other people. People who struggle with codependency also tend to experience behavioral addiction. With addiction to substances, we see this commitment to a substance of choice, regardless of consequences. With emotional addiction, we often put our true needs on the back burner in order to make sure the other person is pleased with us, at whatever cost to us that may come. This often looks like people-pleasing, caretaking, and attempting to save or rescue others. This requires us to repress our needs and feelings which chronically, puts us very out of touch with ourselves. Now that we’ve got a bit of a better understanding of what codependency means and what it looks like, I’m going to outline a few steps to conquering codependency and reclaiming your identity. Identity Work: The first step to recovery is to begin to get to know yourself. I need to be able to know who my authentic self is in order to fully step into that. To put it simply, we can’t trust people that we do not know. To do this identity work, we have to start learning what feels good for us. Not what the people around us enjoy that we do to please them, but what feels good and effortless for us. A good way of gauging this is checking in with yourself and your energy levels. Do you feel depleted after doing this thing, do you feel resentful after doing this thing? Does this thing give you energy, boost your mood, and motivate you for the future? More of what is authentic to our wants and desires, leaves us feeling good after. Spending Time Alone: This isn’t typically at the top of a codependents list of things they enjoy doing, but this goes hand in hand with the identity work. How do you want to spend your days? When you’re old and gray, what do you want to be able to say you did or accomplished? Practice intrinsic motivation. Practice refraining from asking your loved ones what to do but instead- lean into the last time you felt a sensation of warmth and fulfillment. What was that thing that you were doing, or where were you? Some ideas could be: getting food from your favorite restaurant: alone. This could mean dining in or if you’re not ready yet, getting takeaway. Eat it in your car, drive by the ocean or your favorite park, and eat it there. The key here is that you are alone. Phone and distractions away- just you with you. Finding the Middle Ground: Recovery is stepping out of the black and white extremes and searching for what exists in the middle. This comes with a lot of discomforts. The work is showing up even though it feels painful. Every time we show up, we teach ourselves we can be trusted. Back to my analogy before of being unable to trust someone we don’t know. If someone is entirely new to us or even betrays us, it takes time to trust them. The saying “actions mean more than words” definitely applies here. A great way to find the middle ground, in the beginning, is to write out the two extremes you can easily think of. An easy example: Socializing. I can socialize with everyone all of the time or I can isolate myself entirely and socialize with no one. What exists in the middle? Self-Care: The priority shifts and is now centered on you. This might feel a bit weird and uncomfortable, that’s how you know you are growing. I refer to these commonly as growing pains. Self-care allows you to prioritize the things that are for YOU that you know feel good or gives you a chance to learn what you enjoy in the absence of others. If you thought of taking a painting class in the past and someone told you it was silly, now is the time. For some people, self-care is a warm bath and a face mask and for others, it’s pushing themselves to go out for a 5-minute mental health walk. The key here is starting small and working your way up. If you are interested in conquering codependency and are ready to be supported in your journey, we invite you to contact Alex Steiner today at 954-391-5305 for your complimentary consultation. If you would like to learn more about Alex and her services, you can find her bio here. Alex provides counseling for adults at our beautiful office located in Fort Lauderdale, Florida, and online via our secure telehealth platform for those who live in the state of Florida.

Do you ever feel stuck or overwhelmed because you cannot meet the everyday demands of life? Do you find yourself looking at others and questioning how they are able to juggle so much with ease? Does the idea of having an organized home or office seem completely unrealistic for you? Are you struggling with poor memory, focus, and concentration? Are your relationships and/or friendships suffering from your inability to keep up with commitments? Do you thrive in a world of controlled chaos but then feel easily upset at the same time? Perhaps people have jokingly said to you that you must have ADHD! Well, maybe it’s true. If you found yourself saying, YES to the above questions I hope you find relief knowing you are not alone! According to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, (DSM-5), the essential feature of Attention Deficit Hyperactivity Disorder is a persistent pattern of inattention and/or hyperactivity-impulsivity that interferes with functioning or development. To further understand if this applies to you please keep reading to learn more about how this neurological condition impacts our executive functioning. In the past six months have you experienced difficulties related to inattention at work, home or in your social setting because of any of the following? Are you careless? Overlooking or missing important details? Failing to submit or turn in inaccurate work? Do you have trouble staying focused throughout meetings or conversations? Do you read a paragraph and then need to read it again because your mind was elsewhere? Are you easily distracted during a conversation, even when being spoken to directly? Do you start tasks and then lose your focus; perhaps you rarely finish? Are you easily sidetracked? Are you disorganized and messy? Do you miss deadlines? Do you avoid tasks that require sustained mental effort like paperwork or reviewing lengthy reports? Are you frequently searching for everyday items like your phone, glasses, or keys? Are you easily distracted by random things (movement, sound, voices)? Does your mind frequently wander? Do you find yourself forgetful in daily activities like returning calls, keeping appointments, or paying bills? If you said, YES, YES, YES to several of those questions, let's keep going to see if you relate to any associated hyperactive or impulsive qualities too. Do you find it difficult to be still? Are you often fidgeting, or taping your hands or feet? Maybe you squirm in your chair a bunch? Is it hard to stay seated when you are expected to during class or meetings? Do you feel restless or on edge most of the time? Are quiet activities like sitting through presentations or movies painful for you? Are you always on the go? Does being still for extended periods of time make you feel uncomfortable? Have you been told you talk too much or even at inappropriate times? Perhaps you ignore or miss normal social cues and interrupt others? Is it difficult for you to wait your turn while inline or in traffic? Are you intrusive? Do you insert yourself into conversations or activities otherwise not related to you? If you continued answering YES to all my questions, keep reading for a better understanding of ADHD. Guess what, if you only related to one segment of questions keep reading because you might be in for a surprise. If this article does not apply to you I am fairly confident you’ve thought of two or three people in your life that fit this description to a tee! So what exactly is Attention Deficit Hyperactivity Disorder? The American Psychiatric Association released its newest edition of the Diagnostic and Statistical Manual of Mental Disorders in 2013, (DSM-5) which identifies three types of Attention Deficit Hyperactivity Disorder. ADHD, inattentive type: This is often referred to as Attention Deficit Disorder or ADD (no hyperactivity included). If you were screaming, “YES, this is ME” to the first set of questions but not the second, you could possibly be experiencing this presentation of ADHD. These individuals typically present as very forgetful, easily distracted, and have a hard time paying attention. ADHD, Hyperactivity and Impulsivity type: If you felt like someone finally understands what it feels like to be in your skin while you were reading the second question set there is a good chance this applies to you. These individuals typically struggle to finish tasks and perhaps find themselves distracted by meaningless projects that consume their entire day while important deadlines are quickly approaching. They have poor focus, frequently daydream, and often lose things. They also need to MOVE! ADHD combined type: If BOTH question sets apply to you, guess what……. this could be you! Okay… so now what? Now that we have an understanding of what ADHD really is and the undesirable effect it can have on one’s work, home, and social life, what can we do about it? Seeking proper diagnosis is key. If you suspect Attention Deficit Hyperactivity Disorder is preventing you from thriving please see a qualified medical professional (psychiatrist, psychologist, psychiatric mental health nurse practitioner, primary care physician) for an evaluation. The evaluation should include a clinical interview, a review of your psychiatric and medical history as well as your family history! ADHD is suggested to be genetic! There are a variety of rating scales that may be used to evaluate the severity of your symptoms. In some cases, your family, educators, and/or colleagues might be required to complete rating scales as well. It is important to note, that if you are seeking accommodations at work or school (especially at the collegiate level) you will most likely need to have a comprehensive neuropsychological evaluation by a trained psychologist who specializes in testing cognitive and behavioral functioning. Once I have been diagnosed with ADHD what can I expect? The treatment for Attention Deficit Hyperactivity Disorder is individualized to each person's needs. There is no “one size fits all” when it comes to ADHD treatment. It is important for you to have an idea of what you are comfortable with when discussing treatment options with your provider. Standard treatment of ADHD in adults includes medication, lifestyle modifications, and therapy. The two medication types to treat ADHD are stimulants and non-stimulants. Stimulants are the most frequently prescribed medications because they are fast-acting. They produce results by “stimulating” activity in the central nervous system by increasing the amount of dopamine and norepinephrine in the brain which in turn improves focus and decreases hyperactivity. Stimulant medication can be divided into three categories based on its duration of action short-acting, intermediating-acting, and long-acting. Adderall (Amphetamine and Dextroamphetamine) and Ritalin (Methylphenidate) are a few examples of stimulant medication. At this time the only FDA-approved ADHD-specific non-stimulant medication is Strattera (Atomoxetine). Strattera affects chemicals in the brain that contribute to hyperactivity and impulse control. It is approved for children, teenagers, and adults. Strattera builds up in your system over time so it is important to be consistent with taking this medication. The FDA has also approved Intuniv (Guanfacine) and Kapvay (Clonidine) and recently Qelbree (Viloxazine) for children ages 6 to 17. However, in some cases, adults who are intolerant of stimulant medications have achieved the benefit of ADHD symptoms with Guanfacine and Clonidine. These medications help by decreasing distractibility and improving attention and impulsive control. Wellbutrin XL (Bupropion) is an antidepressant that is sometimes used off-label to treat ADHD in adults. This norepinephrine dopamine reuptake inhibitor helps improve focus and concentration. The use of Wellbutrin XL is a great choice for people who cannot tolerate first-line treatment or for someone who suffers from both depression and attention deficit hyperactivity disorder. Finding the right medication and the right dose varies from person to person. It is important for you to work closely with your provider and have patience during the process. If your medication is not helping, don’t give up. Working with a therapist can help you understand the ways ADHD is negatively impacting your life and help you develop strategies to manage your life more effectively. Eating a well-balanced diet and getting regular exercise are additional ways you can improve how Attention Deficit Hyperactivity Disorder is impacting your life. If you made it to the end of this article and feel like you gained a new friend because someone finally understands what your life is like, please know you are not alone. Life is a balancing act for any adult but living with Attention Deficit Hyperactivity Disorder makes everything a bit more of a struggle. Take a moment now to forgive yourself for your disorganization, forgetfulness, and hyperactivity. Sometimes receiving a diagnosis of ADHD provides a sense of relief because it allows people to understand the reasons for their challenges. On the bright side, no matter how overwhelming living with ADHD feels, with treatment symptoms can become manageable. It is never too late to start living life more effectively. If you are concerned that you or a loved one might be living with Attention Deficit Hyperactivity Disorder, we invite you to contact us today for your complimentary consultation at 954-391-5305. Our psychiatric medication provider, Crystal Adkins, can help you gain clarity on whether you have ADHD and what you can do to better manage the symptoms. You deserve to live a healthy, happy life so let us help you get there. Our offices are located in Fort Lauderdale, Coral Springs, and Plantation, Florida (coming soon). We also provide online counseling via a secure telehealth platform for those living in the state of Florida. We look forward to speaking with you!

You ever wondered if anyone else in the room is as anxious and wrapped up in their own mind as you are in social settings? You find yourself completely drained of energy after what’s supposed to be a fun get-together because the entire time you’re just trying to survive it without fleeing the scene or letting on that you’re struggling in any way. The anxiousness doesn’t just set in when you’re around people, but you go through a whirlwind of emotions leading up to it. And that’s only when you can muster up the strength to put yourself in a social situation; a lot of times you avoid them altogether. The truth is that social anxiety is very common! It presents itself in varying degrees, but it is something that many people are dealing with. That may be comforting to know but surely you’re more interested in learning how to manage it better. What is Social Anxiety? It seems pretty self-explanatory that social anxiety is anxiety related to social situations, however, it’s a little deeper than that. We all get anxious at times; anxiety is a normal human emotion. But those with social anxiety are overflowing with fear that is disproportionate to the actual situation. Fear of what you might ask… Fear of scrutiny and judgment by others. Fear of being seen in a negative light. Fear of embarrassment and humiliation. Fear of being rejected by others. Fear of offending others. The list goes on. You can imagine how debilitating this must make a life for those with social anxiety. We are a social species. So much of our lives are in the view of and around other people. It’s nearly impossible to avoid contact with another human being, although those of you with social anxiety have probably become experts in avoidance. The Internet Age has given us the ability to do so much from the safety and security of our homes. You don’t have to go out into the world to survive anymore. You can order just about anything you need online. You can work online. You can stay up to date with the lives of family and friends online without having to talk to anyone. If you do choose to talk to someone, you can do it through text and email, using primarily emojis to convey expression. Although that still may be anxiety-provoking for some of the more serious cases of socially anxious people, it’s still less intense in comparison to in-person interaction. You can even get therapy online nowadays, and if it’s too overwhelming to show your face you can shut off your camera. So if we now have the technology set up that allows us to reduce human contact, then why do so many people seek help for social anxiety? Well, one simple reason is it’s really lonely! Imagine wanting to be around people but not feeling like you can do it without stress and anxiety. Imagine a desire to be an active participant in life outside your home but being trapped in an anxious web within you that constricts tighter and tighter the more you get outside your comfort zone. HOW AWFUL! It’s not an easy thing to overcome, but it is possible to manage it differently. Here are some strategies you can use to get started… Develop and Practice Grounding Techniques and Coping Strategies to Reduce the Symptoms of Anxiety As mentioned before, a lot of the struggle with social anxiety is the physiological symptoms that are triggered and the fear that others will notice. Learning ways to regulate your body when you get anxious can be a huge help. Two of the most common symptoms of anxiety are racing heart rate and shortened breaths. To address them both, you want to work on controlling your breathing. Oxygen or lack thereof is a major contributor to the onset of other symptoms in your body. If you practice breathing techniques to ensure a good flow of oxygen is coming in, you’ll notice a decrease in other symptoms. Try this breathing technique: Place one hand on your belly and the other on your chest. Breathe in through your nose, expanding your belly out and allowing the breath to fill up your abdomen. Try to breathe in for a count of 4. Now exhale through your mouth and let your body deflate. Try to extend your exhale to a count of 6 or 8; this will help your heart rate to slow down. Repeat this process until you feel relaxed and can get back into a normal breathing rhythm. Another important skill to develop is the ability to ground yourself. A lot of people become disoriented and overwhelmed when anxiety starts to flood in. A great way to get yourself back at the moment is to use your senses. Try this mindfulness technique: Notice your environment and become familiar with what’s around you. For some it’s easier to focus on what's right in front of you, like the table you’re sitting at or the inside of the car you’re in; and for others, it’s helpful to scan the space for things that would not typically be noticed, like the ceiling, the pattern on the carpet, or the plants around you outside. Now bring attention to what you hear and smell. Just become aware of the nuances of your environment. Now bring attention to things you can touch. It could be items around you like a chair, a menu, a pen, and paper, or it could be things that are on your person like your clothes, a piece of jewelry, or a bag you have with you. The last sense is taste. This one can be a bit tricky to tap into but can be incredibly grounding because it shifts your attention away from everything external to you and allows you to focus just on what’s in your mouth. Grab a drink and focus on the taste and sensation you get when you sip it. Or try bringing something with you like a piece of candy or gum that you can pop in without others really noticing. The goal of this technique is to simply get familiar with what’s going on in your immediate surroundings and be intentional with your focus. You are disengaging from the anxiety and allowing yourself to settle into the space. Challenge the Negative Thoughts That Fuel Your Fears Anxious and fear-based thoughts are a significant part of social anxiety, so you want to learn to challenge them. It’s really hard to engage in conversation with others when there’s a blaring dialogue of negative commentary happening in your mind. “You look ridiculous. That was the wrong thing to say. They totally don’t like you. You’re being weird.” You have to get comfortable recognizing the voice of your anxiety and insecurity and differentiating that from your true self. Often the inner dialogue is critical, but in a sense, it’s trying to protect you from the embarrassment and rejection that you fear. When you can appreciate it for it is and know that it’s not rooted in facts, then you can separate yourself enough to choose what thoughts to engage and when to just let them pass through your mind. Try this externalizing technique: Start by giving the anxious part of you a name; make sure it’s different from your own. Doing this creates a separation in your mind between you and your anxiety. For example, let’s use the name Frank. You are in a conversation with friends and you begin to worry that you’re not saying enough to contribute. Frank steps in and starts to tell you “You have to say something or they are going to think you’re strange or not listening. They won’t invite you out again if you aren’t more outgoing. You are a bad friend. Something is wrong with you.” All of these statements are hurtful and may make you want to retreat to your safe zone. Instead, let’s challenge Frank. We know Frank just wants to protect you from being rejected in this scenario, so say to yourself “Frank, you’re anxious. Thank you for trying to help, but I’m ok right now. I will speak when I have something to say. I don’t have to force myself to be outgoing when it feels fake to me.” It might seem strange to have this back and forth conversation internally, but the reality is you’re already doing this, it’s just all happening from the same perspective. Differentiating yourself from Frank (your anxiety), helps you to challenge fear-based thinking and practice self-compassion and supportive self-talk. Prepare Yourself and GO! Now that you have some tools in your toolbox, prepare yourself to put them into practice. Although it may seem counterintuitive, putting yourself in a social situation even though it feels terrifying is going to help you. There’s only so much you can do from your safe zone to prepare. Practice these skills in spaces that you feel comfortable in so you can build some muscle memory, so to speak, around them. Repetition helps, so make them a part of your day-to-day routine. Practicing while you’re comfortable will make it easier for you to pull out these tools when you need them in uncomfortable situations. Start small. Rank different scenarios and experiences based on how anxious they make you feel. Maybe going out with 3 close friends for lunch is less scary than facilitating a meeting with a room full of people at your job. Pick something that you’ve ranked lower on the stress scale to start out with. Go to the event and put into practice the techniques you’ve learned and see how it goes. When you are able to get back to your safe zone, reflect a little on what worked for you and where you could benefit from more practice. Then implement those changes next time. The goal is to build a tolerance to the distress you feel in social settings in a slow and gradual way. Be patient with yourself! Social anxiety does not have to govern your life. It’s possible to decrease your anxiety symptoms. It’s possible to process and work through the fears you have. It’s possible to develop the confidence in yourself needed to feel freer in social settings. Therapy, of course, is a definite resource and recommendation for those with social anxiety because it helps you develop and practice skills to reduce your symptoms and it gives you a place to do the deeper work needed to improve your confidence. Nicole Ambrose, LCSW can provide this for you. If you’re interested in learning more about yourself and how to cope more effectively with anxiety, give her a call for a complimentary consultation. Therapy is not a one size fits all thing and Nicole will partner with you to come up with strategies that work best for your lifestyle, giving you the opportunity to grow and live with ease and authenticity. If you’re ready to set up your complimentary consultation with Nicole, call us at 954-391-5305 today. Nicole provides counseling and EMDR for adults in Coral Springs, Florida, and across the state of Florida through our secure online counseling (telehealth) platform.

Thanks to various social media platforms and high-profile celebrities speaking out about their mental health, many of us have heard of Bipolar Disorder in one way or another. For those of you that have not done so already, I encourage you to read my previous blog, (Riding the Emotional Roller Coaster: Is it Bipolar Disorder?) for an overview of what Bipolar Disorder is (and what it is not). As a follow-up, I wanted to refine this topic further and look at Bipolar Disorder in men, specifically. In my experience, men are commonly diagnosed with Bipolar Disorder based upon their initial complaint of “mood swings” only to find out there is a more widespread, maladaptive way of relating to the world indicative of a personality disorder. In general, a personality disorder is a longstanding and pervasive pattern of both internal experiences and behaviors that deviate from the person’s cultural norms with regard to how they perceive themselves, other people, and events; how they experience and express their emotions; how they function within social relationships; and their impulse control. Among the 10 personality disorders included in the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), Borderline Personality Disorder is one that is marked by a consistent pattern of instability and when individuals present upon intake with inconsistent mood, it is easy to see how clinicians can be fooled into diagnosing Bipolar Disorder if they aren’t proficient in assessing such symptoms further. What is Borderline Personality Disorder? Without going too far into a history lesson on the origin of this disorder and how it has progressed through the years, the term Borderline Personality was first proposed in the United States in 1938 to describe a group of patients that were neither psychotic nor neurotic, which were traditionally the only two camps of psychiatric disorders (compared to present day where we have over 200 classified forms of mental illness). These patients bordered between these two groups with an overarching pattern of instability. Such individuals were noted to fluctuate in their self-image, going between periods of confidence to utter self-despair, as well as experiencing rapid changes in mood with marked fears of abandonment and rejection. They were also observed to have a strong tendency towards suicidal thinking and self-harming behaviors. Fast forward several decades and while research has helped improve our understanding of Borderline Personality Disorder (BPD), it remains hallmarked by a pattern of instability in a number of areas, including mood, relationships, and self-image. BPD is one of the more common personality disorders, with estimates it affects at least 2% of adults in the United States. So how does one develop BPD? While there are several different theories established within the field, research continually relates the disorder back to early childhood attachments and certain adverse childhood events. Infants commonly form their first attachment with their mother but this primary attachment can occur with their father or other individuals who provide comfort, nurturance, and express an interest in the infant on a regular basis. Such nurturance and comfort are key to forming an attachment, providing a “home base” where the child feels safe to explore knowing there is a stable caregiver they retreat back to if they feel scared or overwhelmed. Experiences of abandonment, abuse, and rejection can prevent attachments from being formed or disrupt those that have already been established given how diametrically opposed they are to feelings of safety, stability, and nurturance. A similar effect can be seen for caregivers who are ambivalent; at times being protective and nurturing towards the child while abandoning and rejecting them at others. Such dynamics in early childhood set the stage for BPD, with a more detailed account of how the disorder shows up in men provided below. Gender Differences Among those Diagnosed with BPD: Gender can have a notable impact on the presentation of certain psychiatric conditions, which can be traced back to several behavioral differences commonly seen between boys and girls when they are younger, with boys typically viewed as more active and rough while girls are observed to be more focused on inward, imaginative, and relationship-based play. Despite these outer, behavioral differences between boys and girls, they do not equate to inner, personality-based differences and have contributed to gender stereotypes that boys are tough while girls are sensitive. Such stereotypes continue into adulthood where men are thought of as rugged and resilient while women are viewed as inherently delicate and sensitive. These stereotypes permeate so many aspects of our culture and infiltrate our expectations of people based on gender, both consciously and unconsciously. It is no surprise, then, to find out that traditional gender norms can affect the way psychiatric disorders present, with clinicians not impervious to their own gender biases when assessing and diagnosing their clients. Given men are believed to be less emotional, when they do come into treatment reporting mood fluctuations, it is not uncommon to first attribute their complaints to a more biologically based illness, such as Bipolar Disorder. After all, being emotional can’t be part of the personality of a man! While it was believed that women were diagnosed with BPD three times the rate of men, such prevalence rates were captured strictly within treatment centers, with females traditionally outnumbering men in such settings, skewing results. When research broadened their sample, results suggest men and women have similar prevalence rates. The settings in which men and women with BPD are found are largely influenced by the way the disorder shows up based on gender. On the surface, men with BPD are commonly observed to have substance use problems, anger management difficulties, and risk-taking behaviors that ignore the welfare of themselves and others. As such, they are commonly found in substance abuse or correctional facilities. Women, on the other hand, often present with more obvious symptoms of disordered eating, identity concerns, and post-traumatic stress disorder, contributing to their higher numbers within traditional mental health facilities. How do Bipolar Disorder and BPD Look Similar in Men? How Are They Different? A recent report in the Journal of Clinical Psychiatry found that 40% of individuals with BPD had been misdiagnosed with Bipolar Disorder. Why such a high number? Both conditions are marked by impulsivity, instability in mood, irritability/anger, depression, disrupted social relationships, and suicidality. Further, symptoms of BPD may not present early on in males as they may come across quite stable in the more outer layers of their life, such as work and upon intakes for treatment. However, the deeper and more emotionally charged their relationships become, the more likely their BPD pathology comes to life. Such difficulties are commonly seen within their romantic relationships and close friendships, as well as with their children at times. As previously noted, BPD often co-occurs with other mental health conditions, such as anxiety and depression that tend to be at the forefront of the clinical picture, causing mental health professionals to miss the bigger picture and context of which such symptoms are occurring within. One of the hallmark differences between Bipolar Disorder and BPD is how long the various mood states last, as the male with BPD may cycle through mood states (depression, anger, contentment) within the span of a few hours or days while bipolar mood states last longer. It is also more likely that the mood fluctuations in BPD are triggered by external events/stressors while those occurring within Bipolar Disorder can appear more biologically based and unpredictable. Then there are the psychological conflicts that underlie the mood states within BPD that help delineate it from Bipolar Disorder. If we refer back to the disrupted attachments with caregivers in early childhood as a primary source of BPD, Dr. Nowinski details a subsequent feeling of insecurity in his book, Hard to Love: Understanding and Overcoming Male Borderline Personality Disorder. Dr. Nowinski defines such insecurity as a lingering feeling you cannot count on your loved ones, that somehow you will be let down, rejected, or abandoned by them. While this insecurity has its root in actual experiences from earlier in life, it is not necessarily representative of current relationships. Interpersonal conflicts arise when this emotional baggage gets erroneously applied to present-day relationships that by and large are healthy and stable. Men with BPD may also be observed with what Dr. Nowinski refers to as “free-floating anxiety”, or a vague but persistent fear that hovers over someone. While the male may label it as anxiety, they may have a difficult time elaborating on what they are anxious about. This is because the source of their anxiety has little to do with current stressors but stems from long-standing insecurity and distrust created in their early attachments. Men often cope with this anxiety by overeating, abusing alcohol, smoking marijuana, using other drugs (particularly downers), working excessive hours, over-exercising, and engaging in compulsive sex. In relation to unstable self-image, men with BPD often experience periods of self-hatred that stem from a common assumption by a child that if they are abused, rejected, or abandoned, it is their fault; they must be inherently bad, inferior, or unlovable. Such insecurity and self-hatred result in jealousy and possessiveness within relationships, particularly romantic ones. Sex can oftentimes be confused with intimacy because it becomes the way in which the man with BPD feels reassured he is still loved and provides a short-term fix for their anxiety. Lastly, relationships for men with BPD can be negatively impacted by poor boundaries. A relationship entails two separate people coming together to form an “us” and while many aspects of their lives begin to overlap as the relationship progresses, it is healthy for each person to maintain a certain level of individuality within the relationship, or separateness from the other. For men with BPD, large areas of individuality are experienced as threatening given they evoke feelings of insecurity and anxiety. As such, there is a tendency for their closest relationships (particularly romantic ones) to be intense and highly interconnected or inseparable. As you can see, symptoms of Bipolar Disorder and male BPD can overlap, particularly upon the first look and when focusing on a more surface-level complaint of mood irregularities. With true Bipolar Disorder, mood episodes are as far as it goes; however, with male BPD, changes in mood are just the tip of the iceberg with longstanding conflicts in self-image and relationships hiding beneath the surface. Given traditional gender roles within our society that hold women to be more emotionally unstable as part of their inherent personalities, borderline personality pathology has often been overlooked in men and misdiagnosed as Bipolar Disorder. In order for the proper treatment plan to be developed, it is important to meet with a qualified clinician who is able to assess whether such mood symptoms are part of a larger clinical picture and provide the most accurate diagnosis. Otherwise, treatment may be putting a bandaid on a wound that has an underlying infection. Without treating the infection, the injury is just going to keep coming back and getting worse. If you’re struggling with mood instability and would like to have more clarity about how to manage your mood or if you have questions about whether you could be struggling with Bipolar Disorder or Borderline Personality Disorder, contact us to schedule a session with Dr. Taylor Phillips. Dr. Taylor is a Licensed Psychologist located at our beautiful Coral Springs office who also provides online counseling across the state of Florida. Give us a call today at 954-391-5305 to schedule your complimentary consultation to see how Dr. Taylor can help you live your best life! ***Disclaimer, this article should not be used to diagnose yourself or someone else. If you have questions or concerns you or someone you love may be experiencing Bipolar Disorder or Borderline Personality Disorder, it is important you meet with a qualified expert. Resources: https://www.borderlinepersonalitytreatment.com/borderline-personality-disorder-misdiagnosis.html https://www.borderlinepersonalitytreatment.com/borderline-personality-disorder-bipolar-disorder-commonly-misdiagnosed.html

Parenting is challenging. Whether you are a new or experienced parent, each day brings something new. The ups and downs are similar to a rollercoaster: facing enormous challenges and embracing moments of immense love. The initial transition into parenthood can be overwhelming. Parents are expected to know how to anticipate their baby's needs and care for them upon leaving the hospital. Not only are they expected to care for a newborn baby, but life as they know it changes significantly. The primary focus of their relationship becomes their children. This includes ensuring developmental milestones, pushing social connection, and monitoring that their physical and emotional needs are met. With each age bringing growth, new skills, and more language; parents are forced to increase their toolbox of ways to best parent their children. Before you know it, your child is a toddler, then a child, then an adolescent, and finally a teenager. These life stages bring their own set of challenges. Fighting amongst partners increases upon bringing a child into the family as they learn to parent together. Each partner brings their own childhood experiences and expectations into making parenting decisions for their child. Meanwhile, mothers are told to trust their “mother’s intuition”. Grandparents attempt to provide support by reflecting on their own experiences as a parent. The stress level in the family tends to rise. All the while, there are signs from the media attempting to point parents in the right direction, with influential results. Social media feeds display children looking well behaved, nicely groomed, and following societal expectations. All around us people are telling parents how to parent and blaming parents when something isn’t working. All of this is happening, and much more, without any training or guidance from professionals. How can we expect parents to manage it all without any training? A way for parents to gain guidance and support exists. Parent Coaching provides parents with tools and training to effectively parent and is their best selves while doing it. Here are 3 Signs that Parent Coaching might be right for you: 1. You Sound Like a Broken Record - Are you constantly asking your children for things? Do you feel like you are not being heard? Pick up your clothes. Put away the dishes. Listen when I speak to you. This may later escalate to you feeling angry, screaming at your children, or using threats to get what you want. A parent coach will listen to you describe these scenarios and provide feedback regarding their effectiveness. Parent coaching can provide strategies and techniques to engage your child and get you out of the same old cycle of behavior. 2. You’re Burnt Out - Do you ever feel like you just can’t do it anymore? Are you exhausted, both physically and emotionally? If you are feeling burnt out, you are not alone. Escaping this feeling is not an impossible task: a parent coach can help you. Taking a break from parenting is not an option. Although it doesn’t always seem possible, one's mental health must remain a priority as a parent. In order to take care of others, we must take care of ourselves first. We can only be present, engaged, and involved parents when we are our best selves. A parent coach will help you learn how to prioritize yourself as a parent and find ways to improve your stress management. A parent coach will help you explore your self-care process, without judgment, and use your answers to make strides for yourself and your family. 3. You’re Worried About the Future - Does the behavior appear to be getting worse? Could the problem be intensifying? Could your child's behavior be a cry for help? Parents and caregivers are a child’s favorite person in the world. They would do anything for your love and attention. It is not their intention to behave this way or manipulate, as parents often see it. A parent coach can assist with behavior problems, sibling rivalry, aggression, defiance, changes in the family system, and life transitions. By participating in parent coaching, parents will have an additional perspective and lens to view their child’s behavior. They then can learn new ways to handle situations and increased confidence in making parenting decisions. This practice can hold the parent accountable for making these changes as they go. Parent coaching focuses on enhancing family relationships, improving family communication, strengthening problem-solving skills, and creating an overall calmer home environment. Are you wondering if a Parent Coach may be for you? Let me help guide you through the process. After we work together, you will truly feel like you’ve got this! I invite you to call me for a complimentary consultation at 954-391-5305. I offer to counsel children and coaching for parents at our beautiful Coral Springs office and via online counseling across the state of Florida. I look forward to speaking with you and helping you become the best version of yourself!

Let’s talk about healing from the loss of a loved one… There is no roadmap for healing, no statute of limitations on grief. The journey of a broken heart is a highly variable and individual one. On some occasions, the natural medicine of time and a good support system will be sufficient, in others it will not. Different variables will affect how you grieve including your relationship to the deceased, how they died, current life circumstances, and even your age and gender. So how can you tell when your personal mourning process has exceeded what is considered a typical and common reaction to a painful loss and escalated to a clinical condition that may necessitate treatment? There are numerous types of bereavement and grief accepted by the mental health community. These can include anticipatory grief as when the loss is foretold like with long term illness, delayed grief when symptoms first arise far beyond the actual loss, cumulative grief which is the compound experience of multiple losses, traumatic grief when the death involves unexpected or violent circumstances, masked grief when the individual becomes stuck in the state of denial and no identifiable grief symptoms emerge, and many more. There are two different types of grief… Normal Grief: First, it is important to define what is considered a “normal” grief reaction. At first, this term can seem offensive as the devastation experienced from the tragic loss of a loved one feels anything but normal. But there are typical reactions that can be expected from nearly everyone who has a loss in their lives. These presentations include a longing for your loved one, tearfulness, dreams of the departed, anger, sadness, fatigue, hopelessness, insomnia, confusion, loss of appetite, even transient hallucinatory experiences (hearing their voice, seeing them out of the corner of your eye). As grief reactions vary so widely between individuals, it is difficult to assign a cookie-cutter definition of grief, but the aforementioned symptoms are considered well within the scope of what is to be expected from one who has lost someone dear to them. Complicated Grief: The term used for mourning that has surpassed the above scope of experiences is “Complicated Grief.” Complicated grief emotions tend to be debilitating, long-lasting, and significantly impair your ability to function. This type of anguish includes difficulty focusing on anything else besides the loss, the feeling that life is not worth living without your loved one, believe that you could have prevented the death or in some way caused it, inability to think back upon positive experiences with your loved one, and becoming preoccupied with the wish that you had died alongside them. It is important to remember that within the first few weeks or months after the loss, the symptoms of normal grief and complicated grief can be remarkably similar. The distinction comes with the evolution and duration of the reaction. The normal grief experience usually starts to fade or reduce overtime while complicated grief becomes an unending, intensified state of being that disallows healing. It is also imperative to acknowledge that the grieving process can both be exacerbated by preexisting depressive or anxious conditions and create further irritation of these states if they were already present which will confound the management of both. Grief is a journey… just as the sun rises and the world moves forward… so will you. These expectations and hopes for a new day will stir in you, memories of the past that will propel you towards your future. This understanding is what your lost loved one would want for you and will forever be part of the healing process. The job of a grief therapist is to walk this journey with you, to keep you focused on this new day ahead, and all the joy it will bring. Out of the ashes, you will rise to navigate the uncharted waters of mourning. You will have setbacks but always move forward to that new day awaiting. Having a safe place with a person dedicated to your support and recovery can assist you in easing the pain you are feeling and rediscovering the purpose of your life. You are not alone… We see you. We are inspired by you. Your courage, strength, and resilience are incredible. If you’re in need of a Licensed Therapist or Certified First Responder Counselor specially trained to walk beside you on your path of healing, we encourage you to reach out. On behalf of our entire team at Bayview Therapy, we are here to help. For more information about our services for those struggling with PTSD/Trauma, Grief and Loss, or specifically for First Responders, visit our website. We have offices in Fort Lauderdale, Coral Springs, and Plantation (coming soon). We also provide online counseling through our secure telehealth platform across the state of Florida.

Charlotte stares blankly out the kitchen window watching the trees become a hazy blur as last night’s dinner slid down the drain of the sink. She was too tired to care. This wasn’t the first time she had this apathetic reaction. Quite frankly, this had been going on for some time, off and on for months. She feels overwhelmed, anxious, impatient, and uninterested in parenting. Then it hit her as her 2-year-old was tugging at her leg screaming, “I want cookies!”; she was “burnt out.” She was toasted, literally like an old piece of bread left in the toaster oven burnt to a crisp. This startling realization offers little consolation and she knows she isn’t alone. She can remember vividly talking to a friend who described her current parenting experience as exhausting, overwhelming, and overall feeling emotionally dissatisfied and withdrawn. Numerous research articles, books, journals, and surveys exist supporting the evidence of these emotions. More and more women are finally discussing these feelings of motherhood that used to be taboo to admit, and even more, are realizing that these feelings are unfortunately quite normal. The official term for this is called “mommy burnout.” It is a real and potentially dangerous problem. Burnout makes you irritable, moody, unable to manage responsibilities, and disinterested in parenting. Ultimately, mommy burnout impairs your overall emotional and social functioning as well as the ability to care for yourself and your family. It can affect you and your entire family’s well-being. It’s a dark and lonely place that more and more moms are finding themselves lost in. The causes of mommy burnout are unrealistic expectations, whether self-imposed (“I’ve got to be SUPERMOM!”) or societal (You’re expected to be SUPERMOM!). It may be the result of an absence of familial support or hyper-involved parenting. The highest risk associated with mommy burnout is reaching an utter state of exhaustion which can lead to emotional detachment from yourself, your children, and your spouse. More importantly, this can lead to feeling like a failure as a parent and then can ultimately spill over to feeling like a failure at everything. The good news is that mommy burnout is preventable and curable. One solution is reaching out to a therapist, who specializes in maternal mental health. Here are some benefits of starting a therapy journey to combat mommy burnout. 1. A therapist can help you focus on yourSELF. The therapist may ask you a series of questions associated with your nutrition and sleep regimen, as well as the burnout symptoms you may be experiencing. Education is key and it's important to get a clear understanding of how mommy burnout can affect you. When a mom remains in a burnout state, there is more room for those headaches to turn to migraines, irritability can shift to rage, verbal aggression can intensify to physical aggression, sleep deprivation can transform into insomnia, and worry can lead to anxiety. All of these symptoms and a desire to de-stress can lead to an overall decline in functioning and can lead to substance use or self-medicating. When mom is struggling, the entire family unit suffers as well as our lives, our work, our relationships, our marriage, and our children. It’s important for a mom to PRIORITIZE herself so she can then prioritize her children. 2. A lot of women believe that there is no way out of this constant struggle of mommy burnout. Most of the time, women just need permission to say “no.” A therapist can teach you effective ways to say no and establish boundaries that protect your family and focus on your FAMILY VALUES. It’s important for mothers to realize that it is okay to say no to social invitations or extra-curricular activities that do not bring your family JOY. Determining your core values and prioritizing them is key. Setting up a schedule that promotes these values is important and can create less anxiety and in turn, mommy burnout. This may mean realizing that extra social support reinforcements are necessary such as a nanny or help from your mother-in-law or other family and friends. It's important to understand that parenting is not a “one size fits all” concept and realize what works for your family may look different than what works for others. 3. Prioritizing self-care is not selfish. It is necessary! It is a crucial component to maintain your mood, your decision-making, and your overall approach to your day. It is also necessary for your health. Continual stress increases inflammation and cortisol levels that can lower your immune system and damage vessels over time. A therapist can help you focus on SELF-CARE. Your therapist could help you identify what you need, what those needs look like for you personally, and help you to find ways to meet those needs on a daily basis. 4. Do you FIGHT, FLEE, or FREEZE in the face of stress? A therapist can help you determine your stress triggers and better understand how you respond to stressful situations. Knowing this can help you recognize and prevent these types of situations as much as possible. Your therapist can teach you self-awareness and help you create positive coping mechanisms to manage your REACTION to STRESS. 5. Your therapist can help you CREATE A PLAN to treat mommy burnout. Here are some components that your therapist may discuss with you and help you implement: Establishing a nutrition and sleep routine. Identifying your stress style. This was addressed above. Implementing coping mechanisms to be proactive with stress. Compartilizing your life by creating life-work boundaries. Finding positives in every situation. Stop the BLAME game. Staying connected with other women. Find women who you can talk to, vent to, and laugh with. Women need other women. Limiting social media usage. We’ve seen an increase in anxiety and depression associated with too much time being spent on social media for moms. 6. Is it burnout, depression, or anxiety? Mommy burnout can have serious ramifications. However, it is not genetic and medication is not required to treat it. This is different from anxiety and depression which are psychiatric disorders that may require medication and therapy for healing. All three can have serious implications if left untreated. If you need help determining if you are experiencing mommy burnout, postpartum depression, and/or anxiety, please reach out to a mental health professional. If you feel that you are struggling with “mommy burnout”, postpartum anxiety, and/ or depression, please reach out to me at 954.391.5305. My office is open for online counseling via phone or video across the state of Florida and in-person at our beautiful Fort Lauderdale office. I look forward to talking with you soon and helping you become the best version of yourself!

Your early life experiences can impact how you see yourself, other people, and the world. When you experience hurt, betrayal, abandonment, and many other painful emotions from your past, it may be difficult to trust and feel safe in your current relationships. If you want to be present in your life, to react differently than you have in the past, and to be calmer, happier, and more positive about your relationships, then it is time you look within. You may need to explore how a lot of your current issues take you back to your childhood. You may see that your current feelings of abandonment, fear, anxiety, and unworthiness have been very familiar to you, and they can go back as far as you can feel and remember them. Here are some signs that your childhood trauma may be impacting your adult relationships… You Withdraw - In relationships, you may notice that you withdraw or shut down when you feel hurt. You may feel that you do not know how to manage your emotions, therefore, you engage in what seems normal or safe to you. You may engage in unhealthy behaviors such as drinking or doing drugs as an automatic way to numb what you are feeling. You end up disconnecting from yourself because it is too uncomfortable and painful to experience. You Lash Out - You may also lash out at your partner because that is how you learned to survive and defend yourself when you feel attacked. You may yell or say and do the same hurtful things you experienced in your early life. How many times have you said to yourself, “I do not want to be like…” your parents or anyone who may have hurt you as a child? You Constantly Feel On Edge - You may find yourself on edge all the time because feeling calm is too scary and unpredictable, so you need to feel “in control” by being ready for any type of threat. You may struggle to feel relaxed because of the anxiety that arises from trusting and letting things be in your life. Controlling gives you a sense of peace. Feeling vulnerable is not something you are comfortable doing and this stems from traumatic events you have not been able to deal with. You Feel Intense Loneliness - If you experienced abandonment as a child, you may feel a deep loneliness that never goes away, even when people are around you. You may experience a deep fear that your partner will eventually leave you, just like your father or mother did. Or that their feelings for you will change, just like you experienced before. You Feel Unloveable - You may also believe that you are unlovable because of a divorce or abuse you lived through as a child. If you have a parent who struggled with drugs and alcohol or was absent, you may experience fear of rejection. When your partner rejects you, the need for approval gets triggered, leading to unhealthy behaviors such as acting self-destructive or being vindictive trying to hurt them back however you can. You Struggle to Express Your Thoughts & Emotions - It is very common to feel unsafe expressing your thoughts and emotions. You may have been raised in an abusive environment or experienced physical, environmental, emotional, sexual, or medical trauma. When you experience a traumatic event, you may have a hard time expressing, identifying, and managing your emotions. Not knowing how to regulate your emotions can lead you to get stuck in a flight, fight or freeze response. Emotions can trigger protective responses of intense anger and fear. You will experience an automatic reaction to fight the pain in order to escape from the present situation and the memories from your past. It is important to learn how to give yourself permission to feel the good and the bad, so when you feel rage, anger, and pain, you do not identify those emotions with the hostile father or the unavailable mother, or the abusive parent. You Can Heal From The Past… You Deserve to Live a Full, Vibrant Life! When you embark on a healing process, the emotional wounds get reopened, and you will need to work on releasing the energy from them. The energy that you experience when facing trauma gets stored in your body, and this is the reason why you may shake, sweat, breath heavily, or feel tension and pressure in some parts of your body. It is important to receive guidance from a counselor who can help you resolve and process buried emotions. Allowing yourself to heal from the past will give you a better opportunity to move forward not only with your current partner but also with the most important person in your life, yourself. In relationships, you may find that you tend to re-create the patterns you experienced early in your life. If you do not get curious about what is moving within you, what you are trying to avoid will continue to show up in your life. If you are ready to work on healing your past trauma and improving your relationships, including the relationship with yourself, contact Tatiana St. Germain for your complimentary consultation at 954-391-5305. I provide counseling and Heart Centered Hypnosis/Hypnotherapy at our beautiful offices in Coral Springs, Florida, and online in the state of Florida. I look forward to working with you!

How Can A Psychological Evaluation Or Psychoeducational Evaluation Help My Child? Is your child struggling academically or behaviorally in school? Has your child received tutoring or specialized education and they still have a hard time learning? Do emotional or social challenges get in the way of your child developing friendships and enjoying childhood? If you answered yes to any of these questions, psychological testing could give you a clear understanding of your child’s strengths and identify opportunities for intervention. While psychological and psychoeducational evaluations often lead to a diagnosis, the most important aspect is getting a game plan with recommendations and referrals for services designed to help each child succeed. What Type of Services Are Often Suggested? There are a variety of services available to support children and parents depending on the present concerns. As part of the recommendations I make when evaluating a child, I often incorporate a variety of the services below. Individual and Family Therapy – The goals of therapy depend on the child’s needs. Common reasons I suggest therapy include managing emotions, difficulty with relationships, feelings of low self-esteem, and/or learning communication skills such as assertiveness. Family therapy can be helpful when parents would benefit from learning tools to support their child’s needs and/or to improve communication in the home. Art and Equine Therapy – Some children may respond better to addressing their personal challenges in creative ways such as art therapy or equine therapy. Typically these sessions occur outdoors and involve learning at the moment which can be great for children who are more hesitant to open up and share about personal matters. Art and/or horses offer a unique way to help children let their guard down. Also, for children with various emotional and physical limitations, therapeutic horseback riding can be tremendously healing and enhance self-esteem while also improving balance, strengthening the core, developing hand-eye coordination, and helping with sensory integration. Speech and Language Therapy – Speech and language therapy can help when there are language delays, however, this service is also beneficial for children with various Communication Disorders such as Stuttering, Language Disorder, Speech Sound Disorder, Social Pragmatic Communication Disorder, or Autism Spectrum Disorder. While speech and language therapists often help children with articulation difficulties, they can also focus on communication skills, understanding social cues to self-regulate the conversation, and the ability to express ideas, thoughts, and feelings. Occupational Therapy – Occupational therapists can help children improve their grasp, develop good handwriting, and help with their daily activities. For children with ADHD or Autism Spectrum Disorder, the focus may be on sensory integration or developing tools for self-regulation. Specialized Tutoring – While many adults offer tutoring services, to work with children with learning differences, they must have specialized training to know how to instruct these children. In addition, they utilize evidence-based programs and methods for teaching children with various learning disabilities such as dyslexia, dysgraphia, dyscalculia, nonverbal learning disorders, among others. Applied Behavior Analysis (ABA) – This is an approach often suggested when working with children who present with various behavioral and/or emotional problems in-home and/or school. The goals of ABA are tailored to each child and family but often aim to decrease problem behaviors, improve language and communication skills, provide children with self-monitoring and self-regulation techniques to reduce challenging or interfering behaviors, or focus on improving adaptive functioning and self-care activities. The ABA therapists often work in the home with the parents or even in the school setting. Psychiatry and other medical providers – There are many times when medications are appropriate. A psychiatrist or psychiatric nurse practitioner who specializes in children and adolescents can assess your child and discuss potential medication options. Other medical providers include: Audiologists – When a child has auditory processing difficulties or other challenges hearing or understanding what they hear, an audiological evaluation can provide helpful insights and recommendations for how to help a child thrive. Neurologists – When testing uncovers various concerns pointing to a possible neurological condition, this referral may be suggested to rule out any brain-based issues before finalizing a diagnosis. Developmental Optometrists – A Developmental Vision Evaluation performed by a Developmental Optometrist is designed to assess all the visual functioning required for reading, writing, and learning. This is very different from a routine eye exam. This may be a crucial recommendation when there is evidence of dyslexia or visual processing weaknesses. Social skills groups – This recommendation is often suggested for children who struggle to initiate, develop, or maintain friendships. Most groups last for 8 to 12 weeks and cover a curriculum of vital skills necessary to create relationships. These groups are led by licensed mental health professionals and typically include 6 to 8 peers which give opportunities to practice these skills. Nutritional counseling – Collaborating with a nutritionist is crucial for children coping with eating disorders such as anorexia, bulimia, or binge eating patterns. However, nutritionists can also work with children on the autism spectrum who may be very selective in their eating habits. Guidance for Schools – As part of my evaluations, I make recommendations for 504 Plans and Individualized Education Plans (IEPs) for children attending public schools or suggestions or accommodations in private schools. At times, I may also suggest connecting with an educational advocate to support parents in this process and to ensure their rights and needs are being met according to the Individual with Disabilities Education Act (IDEA). School Placement – Once a psychologist has a clear picture of a child’s strengths and challenges, they may suggest a different school based on that child’s unique needs. Other important recommendations that would be selected specifically to meet the needs of the child and their family may include: Resources such as applying for grants or services in the community Support groups for parents/families Bibliotherapy or reputable websites to help you learn more about your child Apps for parents and/or children that teach skills such as mindfulness, mood tracking, coping skills, organizational skills, or reminders and alarms to improve self-efficacy and independence. Other personalized recommendations such as ideas for parenting, sleep hygiene, managing test anxiety, creating a reward system in the home, among many others. With the number of services and resources available, there is no need to watch your child struggle with social, learning, emotional or developmental difficulties. But knowing what services you need, what is available, and where to access support can be tough. While a diagnosis may be an important outcome of getting your child evaluated, the diagnosis will lead to a roadmap of recommendations to help your child succeed personally, socially, or academically which I believe is the most important aspect of an evaluation. You and your child deserve to be happy. You also deserve to know where to go for help. What steps should I take if I want to have my child evaluated? Find a psychologist in your area who specializes in psychological testing and evaluations. I would suggest calling to ask questions about how they structure their testing, what their reports look like, and find out if they provide thorough recommendations and can connect you with services in your community. Dr. Heather Kuhl specializes in psychological evaluations with children, adolescents, and adults and is happy to answer questions you may have about how testing could help you or your child. Call Dr. Kuhl today at (954) 391-5303 to get started with your complimentary consultation today! She provides testing and psychological evaluations in Fort Lauderdale and Coral Springs, Florida.

Marriage counseling and couples therapy is highly important and successful treatment that can help repair, replenish, and restore your relationship to a healthy and thriving state. However, there is one major component that is essential to the efficacy of couples therapy and that is both partners’ willing participation. In a perfect world, both partners are on board and ready to put in the work together in couples therapy. Unfortunately, this isn’t always the case. It is normal for someone to have hesitancy and nerves about the process of starting marriage therapy or couples counseling, especially if this is one’s first time doing any type of therapy. The following tips can help make the process of communicating with your partner and starting therapy smoother. Find A Safe Space & Time - It is important to initiate the conversation about beginning couples counseling at a time when the conflict is low and you are both in a healthy headspace. Ask your partner if they are prepared to discuss the relationship to assure you are both ready to communicate. Pick a place where you and your partner best handle heavy conversations. If the conversation gets heated or your partner gets defensive, take a break and plan to have the conversation at a different time. Express Love & Affection - Reassure your partner that you love them, support them, and want to work together on overcoming any presenting problems. Don't hold back affection as any emotional connection you can express makes conversion go smoother. You want them to also feel heard, share that you want to remain a team, and be willing to listen to their own thoughts and opinions on the matter as well. Be Open & Honest - Sharing your true feelings about the situation is important, as transparency is essential in a healthy relationship. Use “I statements” to express your own emotions and minimize placing any blame on your partner. Be honest, but avoid criticism and remain as respectful as you can at all times. Discuss The Benefits - Couples therapy has many benefits for your relationship, mental health, and even life skills. Helping your partner see the upside of couples therapy can be an encouraging step to start your own counseling journey. Conflict resolution, communication skills, trauma recovery, deeper understanding, affair recovery, parenting support, improved intimacy, and strengthening trust are just a few possible benefits to couples counseling. Set Goals & Make a Plan - Propose to make a plan in choosing a therapist together if possible. Try discussing your goals for your relationship. It's positive to discuss the progress and future that you envision for your relationship and help you go into the couples therapy process with an optimistic mindset. Be proud of the decision to start marriage counseling or couples therapy. It is a common misconception that couples counseling means your relationship is failing or it is a “last resort”. Couples therapy is a fantastic option to work through struggles, grow closer, or even maintain an already strong and healthy relationship. By taking this step you are making a positive decision in prioritizing the relationship and having the bond you deserve. If you and your partner are ready to start the couple’s therapy process, contact us today at 954-391-5305 for your complimentary consultation. We look forward to helping you and your relationship thrive! For more information about Jamie Ratowski, LMFT, and her approach to therapy, click here. Jamie provides counseling for individuals and couples in Fort Lauderdale Florida and online across the state of Florida with our secure telehealth platform.

Conflict is something that comes up in almost every therapy session I have with couples. For many, conflict is one of those Boogeyman words that frighten, terrifies, and is something to be avoided and prevented at all costs. Based on how some clients speak of conflict, one would think that the outcome of the conflict would be the same as saying “Candyman” in the mirror 5 times! Horror story legends aside, I can understand why men and women try to avoid conflict. Although conflict is a natural part of relationships, it can be hurtful and damaging if mismanaged. As a well-seasoned couples therapist and relationship coach, I am fully aware of how unproductive methods of conflict management can lead to dreadful outcomes. Many couples find themselves going deep into the chaos of mismanaged conflict and it stands to reason how people connect conflict with pain and worst-case outcomes. However, what if the conflict can be viewed as a means of connecting instead of a means of suffering? First of all, what is conflict? For many couples, conflict is a tense conversation with two people yelling at each other and someone walking away with hurt feelings or worse. Some couples use conflict to demean and disrespect their partner; there is a winner and a loser and one person walks away from that interaction feeling hopeless, hurt, and resentful. Experiencing conflict this way would feel scary to most people, thereby connecting conflict to the demise of a relationship. This logic deduces that if we want to hold on to our relationship and our love, conflict must be avoided at all costs. I’ll admit that while some incidents of conflict may not feel great, conflict is a natural and potentially healthy part of a relationship, NOT the terrifying Booygeyman that some make it out to be! Let’s talk about what conflict could be if utilized constructively… Firstly, it should be noted that happy couples engage in conflict as much as unhappy couples and regarding similar issues. Conflict does not need to take away from the relationship. Conflict can be an opportunity for growth, evolving as a couple, deepened connection, and enhanced intimacy. Through conflict, we have the ability to learn about ourselves and our partner which is how we move forward in the relationship, in ways that lead to lasting connection versus pain and emotional disengagement. The goal of conflict is to UNDERSTAND, not necessarily agree. We do not want to persuade our partners that they should adopt our mindset in lieu of their own nor to crush them into submission but to be curious as to where they are coming from. We want to operate from a place of empathy, curiosity, validation, and compassion. I understand that this may seem difficult when strong emotions are involved, but emotions are allowed. Emotions are human and should be accepted and worked with instead of dismissed or avoided. The following guidelines are how to manage or resolve conflict discussions like “relationship ninjas”. Keep in mind that conflict management success has one rule that must be applied at all times: There must be a speaker and a listener. Listening is half of the communication regarding effective conflict management. Listen non-defensively and leave your judgments behind; they will only get in the way. After all, there are two sets of “realities” and both positions are likely to have validity to some extent. Try to hear your partner’s pain or emotions even if you don’t agree with the details of what is being said. Suspend your agenda/perspective just for a little while and try to see things through your partner’s eyes, not your own. This is not easy and takes a lot of practice. Ask open-ended questions for the purpose of gaining clarity and elaboration. Open-ended questions are designed to get someone talking and can open their heart to you. We want to ask questions like “How does this situation affect you?” or “What do you believe about what is happening?” or “What meaning are you assigning to this?” Another crucial aspect of listening is summarizing and reflecting back on what you hear. A powerful way to be present with your partner is to repeat back in your own words what you hear your partner saying to their satisfaction. Validate (even a small part of your partner’s position), express understanding, and communicate empathy. Say things like “I can see how you feel this way” or “it makes sense to me that you felt this and what your perceptions and needs were”. This does not mean that you agree, but that you can identify something reasonable about where your partner is coming from. When partners feel understood and heard, this diffuses negativity, reduces emotional charge, lowers defenses, and can be instrumental in navigating through conflict while maintaining love, respect, and connection. Speaking is the other half of conflict management and communication. When speaking, the goal is to speak in a manner that elicits understanding and if possible, works towards appropriate and realistic solutions as a team. The task of the speaker is to talk honestly about feelings, and beliefs on a given issue. Something I discuss with my couples is a tool called The Assumption of Similarity - If you attribute a positive trait in yourself, try to see some of that trait in your partner. If you attribute a negative trait to your partner, try to see some of that trait in yourself. As stated previously, the goal is not to persuade our partners that we are right and they are wrong. Do not argue for your point of view, as that is unlikely to work. Instead, focus on telling your partner how you are experiencing things, including thoughts and feelings on the issue. Oftentimes, it helps to go deeper into how you are seeing things that angle towards values, core beliefs, and the meaning assigned to things based on your philosophy of life. This develops a deeper understanding of our thoughts and gains insight into WHY this is happening versus WHAT is happening. Lastly, we always want to set our partner up for success by clearly stating what we want, need, or expect. One of my favorite teachings in the Gottman Method Couples Therapy approach is “within every complaint there is a longing. When that longing is expressed, a recipe for how to fulfill it may emerge”. When these guidelines are followed, couples report experiencing conflict with more respect, calmness, positive regard for each other, and more attunement to each other’s needs. Although it may seem difficult, even insurmountable to navigate through conflict in healthier ways, I promise that it is attainable! One thing to remember is that no one needs to be perfect to maintain a connection during the conflict. Listening and speaking in accordance with these strategies, will be helpful with maintaining a lasting connection amidst the chaotic emotional charge of conflict. If you and your partner are struggling with your conflict management styles and if the conflict is leading to more chaos than connection, I’d recommend working with a couples therapist. Relationship experts are a wonderful resource to help individuals and couples to learn the tools for better communication, conflict management, and connection in their relationships. If you’re ready to see how couples therapy can help your relationship, contact me at 954-391-5305 for your complimentary consultation. I provide counseling for individuals and couples in Fort Lauderdale and Coral Springs as well as across the state of Florida via our secure telehealth platform. For more information about my approach or services, click here.

How easy would parenting be if children naturally did everything they “should” be doing? However, setting an expectation as to what a child “should” be doing is a parent's first step down an unsettling path, especially when it comes to children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). It is important for all parents to know ADHD is a neurological disorder that impacts the parts of the brain responsible for focus, impulse control, and executing tasks. ADHD is a brain-based, biological disorder and not developed due to environmental factors or poor parenting. Parents must understand that ADHD is not a behavioral disorder, a mental illness, or a learning disability. Symptoms vary by individual, but the disorder cannot be “fixed.” If children with ADHD could do the things they “should” be doing, they likely would have already done them. A child must develop skills and tools to manage the disorder to be successful in school and in life. To increase a child's likelihood for success, parents will benefit from learning skills and tools alongside them. Here are 4 tips for parents of children with ADHD: Educate Yourself: Understanding an ADHD diagnosis is the first step in becoming an effective parent of a child with ADHD. Consult with a therapist, do research, or reach out to a fellow parent of a child with ADHD. By educating yourself, a parent can develop a greater understanding of the ways ADHD may reveal itself in your child and tasks that may be an added challenge. For example, children diagnosed with ADHD may hyperfocus on an activity. Hyper focusing means direct, intense attention to a singular task. When a child is hyper-focusing on a videogame and mom calls him for lunch, a parent's first instinct is to become frustrated and insulted that their child is not listening to them. When in reality, a child may not hear you when he is in a hyperfocused state. Learning about the symptoms of the disorder may change the way you approach your child and the situation. """In this scenario, a parent could learn alternative techniques to get their child to come to lunch without yelling at them. For example, using a timer to indicate videogame time is over gives the child autonomy over their actions and when completed successfully, builds self-esteem. """ Children with ADHD have a higher likelihood to develop low self-esteem due to being unable to complete tasks or follow through. Therefore, parents must learn ways to promote self-esteem rather than responding to their children in ways that may contribute to their low self-esteem. Becoming informed about an ADHD diagnosis will help a parent develop empathy for their child, even in the most frustrating moments. An ADHD diagnosis is often compared to a visualization of an iceberg. The majority of an iceberg sits above the surface, while more sits under the surface where we cannot see it. Picture the top of the iceberg includes the classic symptoms of hyperactivity, impulsivity, and inattention. While the unanticipated and undiscussed characteristics lie below the surface including poor-self esteem, low self-confidence, emotional sensitivity, and low frustration tolerance to start. Parents must educate themselves and look beneath the surface of their child's behaviors. In doing so, they can better understand the empathetic and nurturing parenting style their child needs. Build a Supportive Team: Assembling a team of professionals and community members that understand you and your child is essential. It is important to feel supported and understood by your child’s treatment team. Children with ADHD are often seen by psychiatrists and therapists who put together a treatment plan. Make sure your child's therapist and psychiatrist are the right fit, understand your child's needs, and that they include you in your child's care. It may take a few tries to find the best providers for your family. An executive functioning coach can also be a helpful resource. Include family members and supportive friends on your team. Make sure these people also understand the implications of your child’s ADHD diagnosis and how they can help when your child is struggling. It is key for everyone to be on the same page to best help your child. It may also be helping to find a support group. Speaking with other parents or caregivers who are experiencing the same stress or difficulties helps to validate and normalize your own feelings, as well as an opportunity to learn new techniques or ideas to improve your day-to-day. If you are in need of a supportive friend or parent with similar experience there are many online resources. Children and Adults with Attention-Deficit/Hyperactivity Disorder (CHADD) is an online community resource for parents with online support groups you can visit at chadd.org. Be Strengths-Focused: An ADHD diagnosis is identified within a child after parents, caregivers, or teachers identify a deficit or area of weakness in the child. Focusing on the negative can have dangerous implications including harming a child’s self-esteem, self-worth, and limiting their strengths and capabilities. It is critical to reframe this and focus on areas your child can succeed. Cue in on how you communicate about your child to others. Do you highlight his deficits rather than emphasize his strengths? Perhaps you empathize “Oh sorry, he never waits his turn!” or “He is so excited to play!”. Try focusing on the positive and the progress being made. Focusing on the negative impacts of how others receive your child, in addition to how he thinks about himself. Your statements become your child's internal voice. Lean on your child’s strengths. Share strategies that have worked in your home with teachers and other caregivers. By doing so, you increase your child’s likelihood for success and positive feelings about his success. Do not focus on negative events or your child’s unsuccessful attempts. Move on to allow your child to grow. Seeking therapy for yourself to discuss your own feelings surrounding your child’s ADHD diagnosis may also be helpful. Parents typically have certain expectations for their child or what they view as “normal”. This view is typically flawed as our child often has different interests, strengths, and needs than we initially thought. And with a child with ADHD, this is no different. Parents may need to grieve the loss of a typical child and change their expectations as to what a successful version of their child looks like. By changing our own perception, we can better support and be an authentic part of the parenting process. Be Kind To Yourself: In order to be a successful parent, we must take care of ourselves. This often sounds backward to parents as they think of all the things they must do for their children, to ensure their child's needs are met and they are happy. This false notion not only limits the number of time parents has to do something for themselves but is also faulty reasoning as there will always be endless things to do for your child. All parents need self-care, but when it comes to parenting a child with ADHD this could not be more imperative. Responding to the child’s needs can be exhausting and parents may feel a sense of helplessness at times. Parents need to reframe these thoughts and recognize the amount of time put into caring for themselves translates into a more patient, more caring, and more empathetic caregiver. Being a calm and empathetic parent is essential for a child with ADHD. Setting an intention for self-care goals at the beginning of the week can be helpful. This can include going for a walk, taking a nap, or even taking a long shower or bath with no interruptions. Practicing these habits alongside your child models the importance of taking care of ourselves and our own mental health. You don’t have to go through this alone! Parenting is hard! Don’t go through it alone. Let me (Jessica Califf, LMFT) be a part of your team. If you are looking for additional support as you parent your child with ADHD or parent a child with any challenges, contact me for your complimentary consultation at 954-391-5305. I’d be happy to answer any questions you have and discuss how I can help you. I offer to counsel for children, families, and coaching for parents at our beautiful Coral Springs office or via telehealth for teens and families across the state of Florida on our secure platform. For more information about what I do or how I can help your family, visit my bio here.