HEATHER N. LETTOW, MA., LPC., LMFT
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#SurvivorsSpeak, #WhyIStayed and Dating Violence

10/14/2019

 


October is Domestic Violence Awareness Month

Domestic Violence is one of the most common ways women suffer at the hands of men. It is a topic less openly discussed as domestic violence victims often have safety concerns that keep them from sharing publicly. The #MeToo movement has sparked more conversation and the National Domestic Violence hotline in 2018 reported a 30% spike in calls and other forms of contact quite possibly due to the confidential nature of discussing a history of or current domestic violence. In sharing that one has been a victim/survivor of domestic abuse it not only identifies them and their story but also exposes the other person as the abuser. Often many choose to not speak about the abuse due to victim blaming as the abuse may happen over many months or years and the victims are often asked the question “why didn’t you leave?” Blaming the victim vs holding the abuser accountable is another reason why many chose to not speak up.
While domestic violence may conjure up different pictures from reach life and movies, one form of domestic violence I want to highlight is dating violence. Teen Dating Violence Awareness Month is actually in February but as one form of Domestic Violence I wanted to write about it during Domestic October. One in three young women and girls are victims of dating violence. According to the website ‘Love Is Respect. Org’  dating violence is very common. Stats from the site include:
  • “Nearly 1.5 million high school students nationwide experience physical abuse from a dating partner in a single year.
  • One in three adolescents in the U.S. is a victim of physical, sexual, emotional or verbal abuse from a dating partner, a figure that far exceeds rates of other types of youth violence.
  • One in 10 high school students has been purposefully hit, slapped or physically hurt by a boyfriend or girlfriend.”
  • “Girls and young women between the ages of 16 and 24 experience the highest rate of intimate partner violence — almost triple the national average.
  • Among female victims of intimate partner violence, 94% of those age 16-19 and 70% of those age 20-24 were victimized by a current or former boyfriend or girlfriend.
  • Violent behavior typically begins between the ages of 12 and 18.
  • The severity of intimate partner violence is often greater in cases where the pattern of abuse was established in adolescence.”
The CDC states that there are four types of dating violence:
  • Physical violence is when a person hurts or tries to hurt a partner by hitting, kicking, or using another type of physical force.
  • Sexual violence is forcing or attempting to force a partner to take part in a sex act, sexual touching, or a non-physical sexual event (e.g., sexting) when the partner does not or cannot consent.
  • Psychological aggression is the use of verbal and non-verbal communication with the intent to harm another person mentally or emotionally and/or exert control over another person.
  • Stalking is a pattern of repeated, unwanted attention and contact by a partner that causes fear or concern for one’s own safety or the safety of someone close to the victim.
“Dating Violence may also include controlling behavior such as not letting you hang out with your friends, calling you frequently to find out where you are, whom you’re with, and what you’re doing, telling you what to wear or having to be with you all the time.”
It is also stated that long term effects of dating violence may include:
  • Experience symptoms of anxiety and depression
  • Victims are at higher risk for substance abuse, eating disorders, risky sexual behavior and further domestic violence.
  • Being physically or sexually abused makes teen girls six times more likely to become pregnant and twice as likely to get a STI.
  • Half of youth who have been victims of both dating violence and rape attempt suicide, compared to 12.5% of non-abused girls and 5.4% of non-abused boys.
  • Dating violence can negatively influence the development of healthy sexuality, intimacy, and identity as youth grow into adulthood (4)
  • Dating violence can increase the risk of physical injury, poor academic performance, negative body image and self-esteem, and violence in future relationships.(5)
Prevention includes identifying risk factors such as experience in stressful life events/symptoms of trauma (including history of past sexual abuse), poverty, exposure to violence, dating at an early age, sexual activity prior to age 16, low self-esteem or depressed mood, etc. Prevention also includes identifying safe and healthy relationship skills, engagement of influential adults and peers, creative a protective environment at home and school and strengthening supports are some ways take an active role in prevention (7). It is critical to learn to develop health coping, mood management and communication skills as well as boundary setting in younger years (2).
Domestic Violence takes many forms and effects adults and youth. I have included at the end of this blog some resources for our readers to explore for more information. What is important to take away from this is the need for supportive, positive and healthy relationships with peers and adults, to model healthy relationships, to identify risk factors and to address possible dating violence behaviors no matter how insignificant they seem. One third of dating violence victims share their experience with a peer or adult; that does not mean that one third receive support or get help. Although this statistic seems appalling, in a culture where victims are blamed for their abuse or criticized for coming out it is not surprising.
If you are a victim of dating violence or another form of domestic violence please tell a trusted adult, friend, police officer, mental health clinician or medical provider. You may also call the National Domestic Violence Hotline at 7-800-799-7233 or explore resources and information at www.thehotline.org.

Inner Critic Vs Inner Best Friend

12/12/2018

 

Over three years ago I became involved in my first mom group. A drama free group with positive, uplifting women who have the same shared goal; to raise our babies the best as we can, be the best mothers we can and have a village behind us for the good, the bad, the celebrations and the heartbreak. Every once in a while we would share some things that challenged us not just as mothers, but to dig deep in who we are as individuals. So, this blog is birthed from the work shared by my dear friends Ashley and Erica.
Last month, my friend shared the podcast episodes “Inner Critic Pt. 1” and “Inner Critic Pt. 2” in our mom group community by Rachel Brathen (Inner Heart: Conversations with Yoga Girl). If you are reading this, I promise this is not just a mom focused thing so don’t let me lose you. We discussed these shared podcasts from the lens of “what does your inner critic say?” and “what does your inner best friend say?” The results? Women poured their hearts out and later were able to see how similar they were to those around them but also women were able to see how other people see them… because of course our inner critic tells us a distorted reality.
As a mental health provider it was also eye opening for me. I don’t tend to use these terms; the critic vs the best friend. I have used textbook terms, buzz words, “positive/negative self talk” but nothing as clear and as simplified as this. This new view humanized those parts; the critic and best friend within all of us. Since this work, I have made it a mission to use these terms instead. Now I can’t share what others have shared but as a human first I can say that I was surprised at how much just looking at our negative thoughts vs positive thoughts from this re-frame challenged me, opened me up and made me come face to face with realities I didn’t know how to express previously.  It was hard! I also noticed that when I speak to other people I speak from my “inner best friend,” the kind helper… and how when it comes to me it is so hard to do the same.
As a therapist, I try very hard to practice what I preach but I will admit that the homework I assign to those I sit with isn’t always easy for me. It doesn’t come naturally even if the way I communicate it makes it seem seamless; I wish it were. Many of us question whether we are doing something right. Is it good enough? Am I setting my kid up for success? Is my child’s delay due to something I did? Am I lovable? Does my partner love me? Am I worthy of these relationships?  That, my friends, is the critic. Yes, I think that as humans we should evaluate our decisions and challenges some thoughts but when they become overwhelming to our day to day knowing of ourselves… that is when that critic is speaking. The critic is also the one that tells you things to make you feel less than… like an inner bully. “You suck. You’re worthless. Not good enough. You are a failure. You aren’t smart enough. No one cares”. The inner best friend is supportive and loving and kind- the encourager.
So, I have homework for you….
  • Take out a piece of paper.
  • Title one side of it “My Inner Critic”
  • Title the back of the paper “My Inner Best Friend”
  • Under each title, write what each part says. I prefer to start with the critic because my best friend is much kinder and much more of what I believe and know to be true.
  • What did you come up with?
*Please note, if this brings about tears or difficult emotions it is also bringing awareness to those areas. Seek counseling if the inner critic is loud and distressing days after the activity.
Speak to yourself from your inner best friend. Be kind to yourself.


You can find more information about “the inner critic vs the inner best friend” by exploring Rachel Brathen’s website,  her podcast, blog or one of her many books (Rachelbrathen.com).

Welcome to Winter: Identifying and Treating SAD

12/12/2018

 
 
Seasonal Effect Disorder (now referred to as Depressive Disorder with Seasonal Pattern)commonly effects about 5% of the population commonly beginning between the ages18-30; more common among women than men. While most of us in the northern region are effected by lessening of light (vitamin D) during the fall and winter months and change in our circadian rhythms due to the increase in darkness, SAD is different than “the winter blues.” Common symptoms of SAD include fatigue, even with too much sleep, and weight gain associated with overeating and carbohydrate cravings. SAD symptoms can vary from mild to severe and can include many symptoms similar to major depression, such as:
    Feeling of sadness or depressed mood
    Marked loss of interest or pleasure in activities once enjoyed
    Changes in appetite; usually eating more, craving carbohydrates
    Change in sleep; usually sleeping too much
    Loss of energy or increased fatigue despite increased sleep hours
    Increase in restless activity (e.g., hand-wringing or pacing) or slowed movements and speech
    Feeling worthless or guilty
    Trouble concentrating or making decisions
    Thoughts of death or suicide or attempts at suicide


The APA recommends diagnosis of SAD through the following criteria:
  • Depression and other symptoms that have occurred for at least two consecutive years, during the same season every year.
  • The periods of depression have been followed by periods without depression.
  • There are no other explanations for the changes in mood or behavior.


Treatment:
While SAD symptoms can lessen without treatment with the change of seasons into spring treatments for SAD include light therapy using a UV light that simulates the sun. It is recommended to sit within 2 feet of the light in the morning from fall through winter months for min. 20 minutes per day. Therapy (especially CBT) can assist in identifying and managing symptoms. Use of SSRI medications(antidepressants). Spending time outside- fresh air! Eating healthfully. Other suggestions include taking supplements including multivitamins, vitamin D,B-Complex Vitamins, fish oil or use of essential oils including lemon, lavender, chamomile, rose, etc. While symptoms have the potential to last up40% of the year, the change in season into spring and later into summer can bring relief, increasing energy and boosting serotonin.

The Importance of Resilience

8/29/2018

 

It’s that time of year again.  Penciled are sharpened, backpacks are clean and empty, and you are about to send your child or children off to school for either the first or umpteenth time.  Every year around this time, I talk with my clients, their parents, and even my own children about the things they want to be intentional about for the upcoming school year.  Take a moment and reflect – What goals do you as a child, adolescent or parent want to accomplish this year– Increased organization, better grades or maybe just a peaceful school year?   While all of these aspects of school and life are quite important, they require an awful lot of hard work and at times can be difficult and stressful to manage in our day to day.   In this day and age, our children and adolescent face several stressors: grades, friends, parents, bullying, over scheduling, social media, school shootings, 24 hour news cycle etc.  So how do we foster resilience or the ability to bounce back and recover from adversity in life in our children and adolescents?
Dr. Kenneth Ginsburg with Martha Jablow in their book Building Resilience in Children and Teens identify resilience as “giving kids roots and wings” in their book subtitle.   At the core of this philosophy is the idea that the important adults, whether as a parent, aunt, grandparent, mentor, teacher or coach, affect a child’s resilience.  As parents, caregivers and loving adults we offer unconditional love and create security, we set and encourage our children to meet our expectations for better or worse, and we model behaviors on how to meet these expectations and manage the challenges along the way because according to Ginsberg and Jablow, (2011)“children watch what we do much more than they listen to what we say” (p.22).
Ginsberg and Jablow (2011) identify seven crucial C’s as the “ingredients of resilience”
  • Competence – the ability or manage situations effectively through the development of skills making healthy choices through actual life experience.
  • Confidence- the solid belief in one’s own abilities and is rooted in confidence
  • Connection- close ties with family, friends, school, and community that create a sense of security and produce strong values.
  • Character- fundamental sense of right and wrong that allows children to make wise choices, build self-worth, contribute to the world and become stable adults.
  • Contribution- the belief that the world is a better place because my child is in it and that each and every one of them has something to offer the world on a regular basis.
  • Coping- the ability to manage stress and overcome obstacles in life in a positive, healthy way.
  • Control- helping children to identify that they have the ability to impact their lives through their decisions and actions and there are some extenuating circumstances in his or her life that are out of his or her control (divorce, loss etc.). (Ginsberg & Jablow, 2011, p.24-30).
So Perhaps this year as you and your child head back to school for the 2018-2019 you can review the crucial C’s and identify intentional ways to build on each of these tenets of resilience.



Ginsberg, K.R. & Jablow, M.M. (2011).  Building Resilience in Children and Teens:         Giving Kids Roots and Wings (2nd ed.).  Elk Grove Village, IL: American   Academy of Pediatrics.

Journal For Your Mental Health

5/23/2018

 
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(Image from: Medium.com)


As a therapist I suggest journaling often. Now before you roll your eyes… or if you have… I can wait…
Journaling in a tool for introspection. What is introspection? It is [the examination or observation of one’s own mental and emotional processes]. In short, it is how we examine ourselves emotionally. It’s how we perform our own analysis of the things we feel, the things we are wrestling with, and finding the meat of who we are and what we think. Journaling is a tool for reflection. It is a way of exploring the way we feel but truly… making the intangible thing… the thing we can’t feel with our hands or see with our own eyes, tangible. Journaling helps you process your emotions to help your mental and physical health- yes, physical health, because our emotions and our bodies are connected and influence each other.


According to Psychology Today, writing can strengthen your immune system, lower your blood pressure, and improve your lung and liver function. It can also reduce depression and improve your emotional health as you work through problems on paper. It can support recovery from addiction by providing a positive behavior and replacing the previous old or unhealthy behavior. It is a way for planning ahead, processing the past, having a conversation with yourself or exploring questions that are stumping progress or your ability to get to know yourself. It helps track patterns and growth over time. It is a way of getting in touch with your left brain to analyze and to allow for your right brain to create. It helps to get to know and understand yourself more, to process and understand and explore emotions better and deeper, reduce stress, clarify thoughts and feelings, problem solve, and is a step to resolving interpersonal conflicts with others. It is a place to be self aware, not self-critical.


Where Do I Start?


You don’t need to write in a classic journal or diary or notebook (although I find that this, the putting pen to paper, helps me process things better). There are online journal options where you can create a username and password or pull up your word or notes section on your computer. Whatever works best for YOU. There are other forms of journaling out there, including bullet journaling, art journaling, etc. Explore what feels best for you. If it’s a few words, great. If its bullet points, awesome. If it’s a stream of thoughts- way to go. Whatever works and feels best to you is the way to go.


Write for 10-20 minutes. Your journal should be a private place for you to write and not feel as if you need to sensor yourself. Write quickly- sort of like “word vomiting” onto a page. Just get it out. Don’t worry about whether you should or shouldn’t …. Your feelings are valid and are telling you something so allow for them to be there, explore them instead of ruminating on them.


Not sure what to write? No worries. Pinterest has loads of options for journal prompts for those just starting off. Anything from self-discovery questions, to journaling tips for anxiety, depression or self-esteem.


Ask. Dig. Explore.


If you are wrestling with something very specific but don’t know where to start, write out a question. “Why am I so angry with my best friend?” Answer it. Ask another question. Answer it. Write how that answer makes you feel. Why? Sometimes that’s all we need to unlock that stuckness. Ask more questions to open up more doors. Get deeper. What does this remind me of? Why is this a big deal to me? What am I afraid this will do for my future? Is this what I want? Why do I stay when I am so unhappy? What you may notice in journaling is that it feels almost circular. It goes back to the feeling or the starting point, but as you journal and get deeper the circle gets bigger and wider giving you a sense of what is really happening. Whether it’s more to the issue than what you thought or deeper issues that are arising from this event… explore it. It is a way of exploring your dreams, your interests, what you want for your future, where you are struggling in your marriage, where you find strength in yourself. It organizes the clutter of our thoughts and feelings by our sorting through the mess.


Journaling is one of the cheapest forms of therapy, which is why I ask people I sit with to journal. Because one hour of your life sitting with me isn’t going to get you to your goal alone. The work happens outside of therapy, whether it’s in behavior changes, self-exploration or self-care. Journaling helps maximize the benefits of therapy… I mean… we are already paying a fee, what if we could get more for our money? That’s exactly it. It extends therapy beyond the last session. More for your money. More opportunities for introspection and growth. FREE THERAPY! And as a therapist, it helps me help you better too.

Try it out for a few months- if not daily a couple times per week and explore the benefits you find in journaling.


Burn-Out Prevention

2/1/2018

 

Embracing Your Human-ness:  Balancing the Work, Home and Motherhood Gig.

10/10/2017

 
Sound familiar? Whether you are a stay at home mom, work part or full time out of the house, you are working.  The amount of hours in the day are never enough, there’s always dishes to be done, laundry to be switched and folded and the never ending, ever growing list of to-do’s.
Ugh, I know that rumble very well at this stage in my personal life; a house, significant other, dog, two adorable little girls. What people don’t talk about is how much work it all is. SURE, you hear “it’s a lot of hard work” and then they finish the statement with something along the lines of “but it’s all worth it.” It so very much is, but being a mom, a professional, and a wife is really hard and we lose sight of ourselves. This brings me to why I am talking about this in a blog. The balancing of motherhood, work life (whatever work that may be) and home life is so delicate. I will admit I am NOT an expert in this. I struggle with this very real reality myself and often misplace my own personhood in the process; so yes, I stumble. I have read during the ages 0-5 parents are in the trenches. With a 2 year old and almost 1 year old in tow I’m very much in the trench area and learning. In this blog post I want to take off the “expert” or “therapist” hat and share what I do know and what I have found helpful. Let me embrace my humanness with you and share what I find as a human first.
  • Delegate tasks.
When I think about this area I think about home chores. Write out a list of chores to be done for the week and ask your significant other “Could you please accomplish these things by Saturday afternoon?” Maybe one person in the house is in charge of the dishes, the other is in charge of bath time. Ask if a co-worker can pick up a part of a project.  Delegate where you can.
  • Ask for help.
Even superman needs help- that’s why he has a side kick. So who can be your Robin? Reach out.  Grandparents or an aunt or uncle super excited to spend time with the little one? Great! Had them over w a diaper bag, a couple bottles and maybe those adorable PJ’s you plan to put him or her in and go have a couple hours to yourself or with your partner. Hire someone to help with house work. Trade off with a fellow mom where one will watch the kids for a couple hours while the other goes grocery shopping and to a hair appointment and then return the favor.
  • Give yourself permission to not do everything
There is only so much time in the day. Set the timer on the microwave for 15 mins and clean. When those 15 mins are up be done for the night. You can do this during a nap time and again at the end of the day. You can do this as a family too. I’m sure it’s comical to watch my husband, my oldest and I rush around for 15 mins picking up. But when that timer dings, I finish what I am doing and tell myself “this is good enough”
  • Place boundaries with the office
I would love to say “leave work at work” but sometimes it’s not that easy. Deadlines are daunting. Do all that you can at the office and if you absolutely MUST, again ABSOLUTELY MUST do work at home, schedule that time in where it does not hurt time with family (which may be after the kids go to sleep for an hour). When at the office and fresh first thing make a note of all the tasks you need to accomplish… then break it down to what you can accomplish in that day. When you write it out it takes all the intangible stuff that you are thinking about and ruminating over and puts it into something tangible. You can see it. It’s concrete. It is more manageable. I can’t tell you how reinforcing it is to check off a task and when you check off the 5 or so items you’ve given yourself that day to accomplish, stop.
  • Spend time with your partner
Grab a pint of Oberon, a glass of local wine or cup of hot tea and sit outside on your deck or porch. Heck, even on the couch- Use that time to talk. Even if it’s as long as it takes to savor that beverage of choice you are connecting. Date nights aren’t possible for everyone, so what do you do? Gym dates might be an option. Utilize your membership and the gym babysitting; you are working out, boosting feel good hormones and spending time with your love. A little “you time”, a little “we time” and utilizing one of the most underutilized anti-depressants- exercise.  Love to play games? Pick out a board game to play after the kids go to bed. Chess, checkers, Uno, Dominion, Settlers or if AGE on the computer or Halo is your jam- FANTASTIC! Do that!
  • You time is important
Scheduling time in when you have a list a mile long and a bunch of responsibilities is challenging. Steal a couple minutes for you. Whether that’s standing in the kitchen with the first cup of coffee when it’s still hot, standing under the shower head for an extra moment just enjoying the water or a hot cup of tea with a chapter in a book. Steal moments, not just chunks of time. Perhaps a struggle with time is figuring out what to cook during the week- meal plan on Sundays or dust off that crock pot. Maybe Mondays is “Brinner night” (you know… breakfast dinner), Tuesdays is tacos, Wednesday is left overs, Thursday is crock pot… whatever makes your life simpler.
  • Lastly, slow down
This is something that I struggle with personally and professionally. I want to do it all. But the reality is I can’t do it all. I have spent many years over stretching myself and since having my second child I have realized the importance of slowing down, enjoying moments and not worrying about accomplishing every task or desire I have.
This is just a snip it of the things I am exploring as I balance home, work and this motherhood gig. I am not the expert mom and am learning from my friends and colleagues who are veterans in comparison. It’s challenging but doing less allows for so much more… and that is worth it.

Embracing Your Human-ness: Vulnerability and Relationships

9/12/2017

 
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