Family Therapy Can Improve Depression in Parents Which Benefits Children

Posted on May 14, 2012 by

Parenting can be a wonderful experience much of the time, but there is no doubt that it is often stressful and difficult at many times. If a parent has a mental health issue, the task of parenting is that much harder. Mental health issues in the parents can have negative effects on the children. I see families together as part of my San Francisco Family Therapy practice, and experience first hand how the mental health issues of parents affect the children in the family.

I want to focus on a recent blog post in the New York Times discussing how depression in parents has negative effects on the children, written by Perri Klass, MD. [well.blogs.nytimes.com/2012/05/07/parents-depression-linked-to-problems-in-children/]. The post notes that one in five Americans will become depressed during their lifetime. Untreated depression has several negative effects on children. Children may have poor performance in school. They may also have increased visits to the emergency room, difficulties relating to their peers, and develop depression as teenagers. Depressed parents have difficulty maintaining positive interactions with their children. The routines and traditions of the family, which are very important to maintain a strong bond within the family, are often disrupted.

Fortunately, depression in parents can be recognized and treated by primary care providers and mental health professionals. Individual psychotherapy, provided by a professional mental health provider like a psychologist or Marriage and Family Therapist, is effective at treating depression. In some cases, medical doctors will need to prescribe antidepressant medication. The combination of medication and psychotherapy can provide a good outcome in treating depression for many people.

I do not want you to be reluctant to seek help if you feel like you have depression that is interfering with your job as a parent. Symptoms like poor energy, irritability, change in sleep habits, feelings of sadness or guilt, or lack of desire to do activities you previously found enjoyable are common symptoms of depression.

If you feel that you have depression and it is affecting your relationship with your children, please contact San Francisco Family Therapist Patricia Hecht, MFT at (415) 354-4718 to get help now.

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Family Therapy Topic: Communication at the Dinner Table

Posted on May 7, 2012 by

In this day and age with all the texting, emailing, friending and twittering the true role of face to face communication can be lost. Problems with communication between family members can produce tension within the family and prevent the effective resolution of conflicts, which I see commonly in my San Francisco Family Therapy practice.

An American institution that many families share is the dinner table conversion, where all members of the family meet over a meal. There is such a wide variation what goes on at the dinner table from family to family. I recently found a very interesting article in the New York Times [www.nytimes.com/2012/04/29/fashion/at-family-meals-children-encouraged-to-take-part-in-the-conversation.html?pagewanted=all]  describing the family meal traditions of a number of prominent people. The traditions these families followed ranged from very unstructured with the only requirement that everyone come to the meal, to a mealtime that involved math quizzes for all the children. The common thread is that the family was together, and that they communicated. The communication establishes a bond between the family members, parents and children, and reinforces the emotional connections within the family.

I would encourage all families to use a mealtime to gather and discuss various issues both important and small. The important concept is that the family joins together, no matter how you decide to structure the meal or what is discussed at the table.

Establishing lines of communication is an important part of family therapy. The dinner table conversation is one method to start to make connections. If you need help making connections in your family, or you need to start regaining connections that have been broken through trauma, help from a professional family therapist can be highly effective.

For help in family therapy and communication issues, contact San Francisco Family Therapist Patricia Hecht, MFT, today at (415) 354-4718.

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Divorce Counseling Can Help Ease the Transition When Couples Separate

Posted on April 25, 2012 by

The goal of my San Francisco Marriage Therapy practice is to work together with married couples to strengthen their bond.  Most often I am able to work with couples to energize and strengthen their relationship. However, it is a fact that there are many marriages which are unable to continue for a variety of factors. For those cases, it is very important to undergo divorce counseling which can help ease the transition from being a married couple to two formerly married and now separated people.

Almost 50% of marriages now end in divorce. There is a clear role for counseling in easing the negative feelings associated with the separation. During the process of a divorce, counseling for both people can help strengthen the skills for negotiation and communication between them so they both can move through the process of divorce more smoothly. The presence of children in the marriage is an important factor that increases the need for counseling. A therapist working with the children can help them accept the finality of the divorce, and prevent them from having feelings of blame because they were unable to prevent the divorce of their parents.

Divorce counseling can be helpful in setting rules that allow the couples to communicate. These can include agreements between on how to handle issues that arise during the process of divorce. The rules can affect things as mundane as cooking and cleaning chores, to other larger issues such as employment and financial issues. Counseling can help the divorcing couple ease the divorce process for their children as well. For example, the counselor can help them learn to avoid having fights and arguments in front of the children, which would emotionally traumatize them.

Divorce counseling can also help people when they move onto their next marriage. If people have a positive experience with counseling while they are going through their divorce, they will carry these positive feelings with them into their next marriages. Also, divorce counseling can help some couples preserve their relationship even through their marriage is ending. Carrying on an effective relationship with an ex-spouse is especially important when there are children in the marriage.

I hope that you work with a couples therapist to preserve and strengthen your marriage. However, if you or your partner have decided to divorce, an experienced couples therapist can help you transition through the divorce more easily.

When considering divorce, you can get help from San Francisco Couples Counselor Patricia Hecht by calling (415) 354-4718.

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Stress and Depression Accelerate Aging

Posted on April 23, 2012 by

One of the main focal points of my San Francisco Individual Psychotherapy practice is the treatment of stress and depression, so I am always looking for interesting articles published on these psychological problems. There is a recent article in the Wall Street Journal discussing a new study looking at the relationship between stress and depression, and accelerated aging [online.wsj.com/article/SB10001424052702304587704577333941351135910.html].

The article discussed the results of a study done at UC San Francisco which links the psychological conditions of stress and depression with physical illnesses. According to the article, people with long term psychological stresses, depression and post-traumatic stress disorder have earlier onset of physical illnesses that usually affect older people, like heart disease, stroke, dementia and diabetes. Researchers found 20 years ago that the brains of older people with depression shrink faster than those of older people without depression.

In the article, the WSJ said that the UCSF study found that there were shortened telomeres in people affected with depression, childhood trauma and post-traumatic stress disorder. The telomeres are protective coverings at the ends of the chromosomes that protect the genetic material from being damaged. They get shorter as people get older, and shortened telomeres are associated with an increased chance to develop diseases. The WSJ article also mentions a study from Sweden with similar results.

The article states that the scientists do not yet know the mechanism by which depression shortens telomeres. They also do not know how much psychological trauma is necessary to have an affect on the telomeres. Also, not everyone under psychological stress have shortened telomeres. Some people might have innate protective factors in their body, such as higher levels of anti-oxidants and anti-inflammatory proteins.  Researchers also think that it might take a long time (months or years) of stress and depression to start affecting the telomeres. However measurements of a protective enzyme that lengthens telomeres show that the enzyme increases in the blood after improved lifestyle changes and reduction psychological stress, according to research done by Dr. Dean Ornish and UCSF.

For me it is very interesting that scientists are starting to understand the links between psychological stress, depression and physical ailments. No matter how the mechanism works, I think these results reinforce the idea that managing stress and depression will help people live happier and healthier lives. As part of a treatment plan for stress and depression, cognitive behavioral therapy techniques and individual psychotherapy can be very helpful. The best way to get effective psychological treatment for stress and depression is to get help from an experienced professional psychotherapist.

You can get help to improve your problems with stress and depression by contacting San Francisco Individual Psychotherapist Patricia Hecht, MFT, at (415) 354-4718.

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Living Together Before Marriage May Not Increase Divorce Rate

Posted on April 16, 2012 by

I often counsel people in my San Francisco Couples Counseling practice who are considering moving in together or cohabiting. One issue that they might be concerned about is whether living together before marriage will prevent them from having a stable, intact marriage in the future.

A large study has just been published by the Centers for Disease Control in Atlanta. An article published in the Christian Science Monitor discusses the research [www.csmonitor.com/The-Culture/Family/2012/0322/Cohabitation-before-marriage-It-s-no-greater-divorce-risk]. The researchers surveyed over 22,000 men and women. It appears that times have changed in that living together does not increase the divorce rate like it used to in the past. In any case, in this country there is an increasing trend for living together before marriage. The article states that in the 1960′s 10% of American couples moved in together before getting married, and that these people had an increased risk of having a divorce. However, today, about 60% of couples cohabit before they get married, and the divorce rate has since decreased with an increase in marriage stability.

The study found that people who were engaged to be married and living together had the same chance of having a stable marriage at 15 years as couples who had not lived together. If people were not engaged before moving in together, they had lower chance of remaining married at the 10 to 15 year mark. This result is similar to findings based on prior research. Potential explanations for this trend is that people who do not commit to each other may have more relaxed attitudes towards commitment. These people tended to also have lower levels of education and family histories with negative experiences toward marriage.

Different people have different experiences and attitudes toward cohabitation. Young people may be pursuing a college education and starting a career, and cohabitation for them is like a practice marriage without kids. These people often end up married. Other people, often those not on a college track, may move from one live in relationship to another, sometimes having children along the way. They may not wind up getting married, or if they do they have a higher chance of divorce.

Marriage and couples counseling with an experienced professional can be helpful to try to work through these issues when you are considering living together before marriage. Contact San Francsico Couples Therapist Patricia Hecht at (415) 354-4718 to make an appointment so you can get started exploring these complex issues.

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Anxiety and Depression Are Worsened By Excessive Self Criticism

Posted on March 27, 2012 by

In my San Francisco Anxiety Therapy Practice I see a lot of people who come in with levels of anxiety and depression that prevent them from functioning normally in their daily lives. I help them using cognitive-behavioral therapy techniques, which are based on the idea that changing the thoughts you tell yourself in reaction to an event will change your emotional feelings. In my experience, the negative feelings of anxiety and depression are worsened by excessive self criticism and negative self-talk.

It was interesting to see this very idea being discussed in a recent story in the Huffington Post by Ocean Robbins. [www.huffingtonpost.com/ocean-robbins/self-acceptance_b_1303190.html]. Robbins notes that people who tell themselves self-critical messages tend to have more problems with anxiety and depression. Conversely, people who send positive messages to themselves will increase their level of performance in both work and social situations.

He notes that self-criticism is very common, and that recognition of self-critical thoughts is the key to changing how to speak to yourself. He indicates people often attack themselves with self-criticism no matter what they do.   For example, self-critical messages will make you feel unworthy if you don’t stay up late working, and also cause you to blame yourself when you are tired the next day because you don’t get enough sleep. But, he also notes that you CHOOSE to listen to the messages you send yourself. You can choose mean and self-critical voices, or kind and compassionate voices. You are in control of the thoughts that you tell yourself in your internal voice.

Robbins clearly writes about how negative internal thoughts contribute to anxiety and depression, while positive messages are self-affirming and generate positive emotions. This concept underlies my own practice using cognitive-behavioral treatments for anxiety and depression. I help people understand and change their own internal messages to being self-supportive and positive, which leads to decreased levels of anxiety and depression and positive outcomes in life.

Please contact San Francisco Therapist Patricia Hecht, MFT, for help understanding your own internal messages and how you can change them to improve your own well being. Contact her at (415) 354-4718 to make an appointment.

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Anxiety Treatment Can Improve Your Relationships

Posted on March 19, 2012 by

Generalized anxiety disorder is a heightened sense of worry or tension that can be induced by any minor problem. Often the problems that people with anxiety worry about are not significant enough to cause the emotional reaction of severe anxiety, and people with anxiety disorder generally realize this fact. People with generalized anxiety disorder can have significant problems in their relationships with a partner or spouse. The anxiety makes both people in the relationship unhappy and can be a real source of conflict, and often drives couples to see me in my San Francisco Anxiety Therapy practice.

Anxiety can cause feelings of suspiciousness about the other person. Often, people with significant anxiety can worry whether their partner is being faithful to them. Alternatively, people might be concerned that their partners do not care as much as they do about a specific issue, even though rationally the issue is really quite minor and does not warrant a high level of anxiety. Even though people should trust their intuition during a relationship, people with generalized anxiety disorder might react to insignificant cues with a lot of stress and worry about whether their partner is committed to them or not. Sometimes, if you have a very understanding partner asking for reassurance from time to time might be helpful.

People with anxiety disorders might appear to be needy with respect to their partner. Often, anxious people will ask their partner for constant reassurance about their commitment. They will often demand that their partner regularly show their commitment with various forms of proof. Many times these demands are unreasonable and constant and can cause stress and tension in the relationship.

The emotions of anxiety are extremely uncomfortable and people want to relieve these feelings as much as possible. People under severe anxiety may be driven to act impulsively to reduce these feelings. This acts could include jumping to conclusions, having an emotional outburst, or doing self-destructive acts that only hurt the relationship and do not constructively solve any problems.

Fortunately, cognitive-behavioral psychotherapy is an effective way to learn to manage anxiety that is interfering with your relationship. Reduction of anxiety often improves both partner’s happiness and fulfillment together. You can get help for anxiety that is interfering with your relationship by contacting San Francisco Psychotherapist Patricia Hecht, MFT, at (415) 354-4718.

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Social Anxiety Disorder Causes Dating Anxiety And Can Be Helped By Cognitive Behavioral Therapy

Posted on March 16, 2012 by

Social anxiety disorder can be manifested as shyness, being overly focused on yourself, being overly concerned about other people judging you, and being overly concerned about what other people think. People often have a fear of rejection and being isolated. The anxiety can be severe enough to cause poor functioning in social situations and impairment in relationships with others. Dating can be a very anxious event for some people, and I often help people with dating anxiety in my San Francisco Anxiety Therapy practice.

Consider the following situation. A woman could meet an very accomplished man online. Perhaps he is a successful professional or businessman. Over email, they agree to meet for a first date. The woman goes into the restaurant where they plan to meet, and she sees the man at the bar the looking very uncomfortable. His shoulders are hunched and his eyes are on the floor instead of having a welcoming expression and making good eye contact. He has five bottles of beer as a social lubricant.  At the end of this miserable date, the woman of course never wants to see this man again.

This case is a good example of social anxiety disorder causing significant problems with dating. The man is experiencing anxious thoughts like worrying about what the woman is thinking about him, asking himself if she is going to go out on another date with him, and wondering if he is being witty enough during the conversation. The man is trying to self-medicate the anxiety with alcohol, which does not work. He is obviously not listening to the woman or interacting successfully because he is too concerned about his own anxious thoughts and feelings.

I would help this man’s social anxiety disorder with a cognitive-behavioral approach. First, I would try to identify what circumstances cause anxiety for this person, then I would find out what the man has done in the past to help himself with this anxiety. I would then find out what the man is afraid of when he goes on a date with a woman. For example, he might be afraid of blushing, or sweating excessively, or being humiliated by looking foolish. I then help the man by supportively encouraging him to keep going on dates, which desensitizes him to the anxious feelings. The man realizes that as he goes on dates, even if he does not feel very comfortable, it is not a catastrophe.

The other cognitive approach is make the person aware that he is telling himself negative thoughts. Then I help make him aware of what the negative thoughts are.  For example, the man may be telling himself he is going to say something dumb and because of that he is a worthless person. Then I will tell him “what is the worst thing that will happen?” I help the man accept that everything that comes out of his mouth does not have to be witty or perfect and that does not mean he deserves to be rejected. I also help him realize that even though he is not liked by everyone, it does not mean he is not likable.

Dating can be a very stressful and anxious experience for some people. If anxiety is interfering with your dating life, you can get help by contacting San Francisco Anxiety Therapist Patricia Hecht, MFT, at (415) 354-4718.

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Stress in The Workplace Can Hurt Your Career

Posted on March 14, 2012 by

I read an interesting article in Forbes magazine about stress in the workplace. Stress and anxiety arising from specific job situations can be very disturbing to people and hurt their functioning in their career. Workplace stress is a common problem for which people seek my help in my San Francisco Stress and Anxiety Management practice.

This article interviews Jonathan Berent, who is a psychotherapist and business consultant [www.forbes.com/sites/jennagoudreau/2011/02/08/do-you-suffer-from-workplace-anxiety-worry-stress-fear-office-most-common/]. He has just written a book called “Work Makes Me Nervous”. He notes that it is normal to have fears, anxiety or feel awkward from time to time in the workplace. However, when anxiety controls you, your productivity in your job can decline, careers can be hurt and you can develop problems with your mental health.

Berent thinks that the triggers for workplace stress are rooted in five basic issues:
- fear of public speaking
- fear of interacting with people in authority
- fear of new challenges
- fear of appearing nervous
- desire to be perfectionistic

Berent feels that public speaking anxiety is the most common anxiety disorder in the workplace. Unfortunately, speaking in public is a very common task professionals need to successfully accomplish. Berent advises that the best way to conquer stress in the workplace is to face your anxieties. Also, he advises taking care of your physical health such as eating well, sleeping enough, regular exercise and avoiding substances. He then advises that people use their sensations of anxiety to help them rather than using them to avoid situations that make them anxious. He suggests that people recognize these physical reactions as normal and be aware of them, and remind themselves to relax.He notes that after each challenge that produces anxiety is met successfully, then confidence will grow. As confidence grows, the sensation of anxiety will lessen and improve.

If you feel that you need help meeting stressful challenges in the workplace, and the anxiety that these challenges cause is hurting your job performance, career and happiness, contact San Francisco Stress and Anxiety Therapist Patricia Hecht, MFT, at (415) 354-4718.

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Treatment of Anxiety Disorders with Cognitive-Behavioral Therapy

Posted on March 12, 2012 by

In my last post I discussed the different types of anxiety disorders. These include panic attacks, obsessive-compulsive disorder, social anxiety disorder, specific phobias, post-traumatic stress disorder and generalized anxiety disorder. In this post I want to discuss a general approach to treatment of these problems and discuss what I provide in my San Francisco Anxiety Therapy practice. To begin with, I want to emphasize that there is no “one size fits all” approach, and the treatment of anxiety disorders must be individualized to the patient’s specific condition and circumstances.

In general, anxiety disorders are treated with medication, specific methods of psychotherapy, or a combination of both. Only a licensed medical professional (physician, nurse practitioner, or physician assistant) can make sure that the symptoms of anxiety are truly due to a mental health issue and not due to a medical problem. Only these professionals can prescribe medication, and I will not discuss medication treatment further.

Often, people have coexisting mental health conditions such as alcoholism, drug abuse, depression or other issues that have a strong impact on anxiety treatment. To effectively treat anxiety, these other problems must be brought under control first.

Psychotherapy is done by speaking with a trained mental health professional, such as a marriage and family therapist, to uncover the underlying causes of an anxiety disorder and provide guidance on how to deal with its symptoms.

Cognitive-behavioral therapy is a type of psychotherapy that is extremely helpful in dealing with anxiety disorders. The cognitive part helps people change erroneous or irrational thinking that provokes fear and anxiety. People then learn how to change their reactions or behavior in response to situations that generate anxiety. Cognitive-behavioral therapy can only be started when people decide they are ready to try it, and can only be done with direct cooperation by the patient.

In my anxiety treatment practice, I tailor my approach to the specific anxieties and needs of the patient. Sometimes people experience temporarily increased anxiety as treatment is progressing, but there are no other significant side effects. On average, 12 weeks is a reasonable duration for cognitive-behavioral therapy. There is some evidence that the helpful effect of cognitive-behavioral therapy lasts longer than that of medication. If the anxiety recurs in the future, then psychotherapy can be used again to treat it successfully.

For more information please review the National Institute of Mental Health website at [www.nimh.nih.gov/health/publications/anxiety-disorders/treatment-of-anxiety-disorders.shtml].

If you are having problems with anxiety disorders and need treatment for anxiety, please get started by contacting San Francisco Anxiety Therapist Patricia Hecht, MFT at (415) 354-4718.

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