Help us congratulate Jordan Langley, our former intern and recent graduate from the National University MFT program. She is now employed at Healing Reflections Therapy: Diversity, Trauma and Wellness Services and is accepting news clients as she is pursuing her license as a Marriage and Family Therapist. Feel free to send folks her way! Private pay or Aetna insurance. She has afternoon and evening availability, both virtual and in-person in South City St. Louis.
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The level of social support is the number one predictor of outcomes after trauma. Having support from a loved one came be a critical step in the healing process. Many family members ache when they see their loved one's suffer and are desperate to help them find relief, and to find relief for themselves of the anxiety and distress the helpless creates.

Seeking mental health support from a family member has some pros and cons. In general, seeking out therapy can be helpful, however not everyone is ready to take that step for themself. This can become a point of distress as family members get desperate for change with ongoing worry. 

Here are some things that therapists want you to know when you reach out on their behalf.

1)Reaching out to therapists on behalf of someone else takes away their sense of agency/responsibility for their therapy process and can be a sign of patterns of enabling or codependence.
All too often  well meaning loved ones reach out on someone else's behalf for therapy, but more often than not those individuals have little motivation to participate in the process. When you make the call for them, it takes away their ownership of the issue. Well meaning family members can become enablers by allowing these individuals to not have to take the role of responsible adults. Women often complain that they get cast in the role of mother to their spouses, but they often enable the very problem they are frustrated with by continuing to make the calls for doctors visits and setting up the appointments for them.

2) Lack of motivation to reach out to a therapist is often predictive of one's motivation to participate in the treatment process.
Often therapists find that when someone else makes the arrangement for someone to attend therapy, the person making the call is more distressed and ready for change than the client is. As much as you want them to change, they may not be ready to. Part of the process of reaching otu to a therapist, filling out the intake forms, and coming to the first session is all part of someone's preparation for change. It involves accepting there is a problem, that you need help, and that you are willing to take steps to make change. When people are just "visiting" therapy and not ready to make change, they usually do not attend past the intake sessions, if they bother to show up for the intake at all. Prochaska & Diclemente (1983) developed the stages of change model that highlights the cycle and one's readiness to change, particularly as it applies to addiction, though this pattern is applicable to the overall therapy process.
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3) Confidentiality is a barrier for us.
While you may want to advocate for them, your advocacy can only go so far when we are dealing with another adult who is their own guardian. Therapists are required to maintain confidentiality with their clients, so once they make contact, we cannot really communicate with you about them without a release. 

What about when your family member is too ill or depressed to advocate for themself or is a poor reporter/historian?

If someone is in a mental health crisis situation there a few options to consider. This situation is different than a situation where someone is enabling, but more occurs when the client is in such a poor state, they lack the capacity to take the steps for themself. For example, someone who is experiencing psychosis and cannot distinguish reality from a delusion, someone that is so depressed they are near catatonic and bed ridden, someone whose OCD has lead to a hazardous hoarding situation, or someone who is experiencing a manic episode and is engaging in high risk behavior, or someone who has been abusing substances or has been having a reaction to medication and they are seemingly not themself. In each of these scenarios, these folks likely need immediate help. Going to an ER or the nearest psychiatric facility may be the best option to immediately manage the crisis. If a person already has a psychiatrist or therapist, reaching out to them to let the know what is going on can be a tremendous help.

Generally, you can send mental health professionals information, but we cannot acknowledge it or send anything back to you without a consent to release information from the client. Exceptions to this rule may apply if there is an imminent threat to the life of the client or someone else.

As much as I encourage clients to take responsibility for their mental health and challenge when folks are enabling, there have been many times over the years that I have encouraged family members to write letters to their loved one's doctor or to call the office and leave a message to inform them if a crisis has developed or if there are significant pieces of information about symptoms necessary for the clinician to make an adequate diagnosis and appropriate treatment plan, and for their doctor to be able to prescribe the appropriate medications. These methods, when necessary can be absolute game changers in the trajectory of a client's mental health outcomes. 

When we have a release and family therapy or coordination of care is part of the treatment
As family therapists, especially when working with children it is very difficult to make changes with the child if the rest of the family is not on board and participating in the treatment. Some of the best results I have ever seen as trauma therapist have come immediately after sessions using Trauma Focused Cognitive Behavioral Therapy (TF-CBT) when parents are brought into the session to help process/witness the trauma of their child. Secrets are eliminated and parents are coached on how to be effective supporters in the present. The shame the child was experiencing dissipates and healing takes place in the family system.

Although interventions with loved one's have long been used in substance abuse recovery, there are mixed reviews of the efficacy of these attempts.


What about if it's a Britney situation and we think we need to become guardians or conservators in order to help our family member?

Sometimes a person is not well enough to take care of themself. They refuse treatment. They struggle with having the capacity to recognize the risk to themselves. In some cases, a person can apply for a conservatorship or guardianship with the courts. The court determines if this is appropriate.

Sometimes, when a family member is severely chronically ill and it no longer feels like there is another way to get them help to save their life, this step can be helpful.

However, it can also come with a large price. Family members have the burden of assuming medical and financial responsibility for their impaired family member, which is often a thankless, tiring, and exhausting job. The task and the subsequent blowback of resentment and fight for control from the client can result in major conflicts, and sometimes complete dissolution in the relationship between family members. As they say, no good deed goes unpunished. As we all saw with what happened with Britney Spears and her family over the conservatorship and when it was lifted, the process and outcome were complicated in their impact.

So, should you help a family member? Absolutely! But before you take those next steps, carefully consider your role, expectations of them, ask yourself whether it is possible they can do this for themself and how your involvement may help or hurt. Consider the impact that your helping may have on your own mental health.

Remember local resources like the 988 mental health crisis line as well as NAMI, AA, Al-Anon,  SAMHSA, and Psychology Today  are all excellent ways to help for yourself or to send the information to a loved one to encourage them to take steps for their own mental well being. If you think that maybe you are struggling with codependence with a family member, you can look into a CODA group for yourself.

Author
~Megan Garza, MA, LMFT

We hope to see you all join us for a day of therapeutic and relaxation related activities at this year's Tower Grove Pride Festival in St. Louis City. The festival is all weekend, but we are just there on Sunday. Whether you want therapy dog cuddles, need a quiet moment to color, want to learn some new guided relaxation skills, or want to make some fun stress balls or make a packet of coping skills, we are here to help! Sign-up today. Free events all day!

Therapy has become increasingly accepted as a norm for health treatment, especially since covid. As historical barriers of stigma and shame fall away, more and more people are embracing hope and change and looking for therapists to help them facilitate healing, but sometimes struggle with where to start.

One option for finding a good therapist or mental health treatment center is to ask your family, friends, or colleagues for recommendations. High praise from someone you know can go a long way in building trust with your provider.

Another option is to check with your insurance company. If you check the back of your insurance card, there is usually a number you can call and they can help with referrals for providers in your network. Better yet, go to the insurance companies Doc Find on their website, which usually allows you to add in filters for your selection and find providers nearest you.

A third recommended option is using Psychology Today's search field at www.psychologytoday.com
Many reputable clinicians use this for their marketing. You can read about each clinician in detail, view their fees, insurances taken, and specialty areas, and even watch video snapshots of them.

Of course Google can also locate someone near you, but that may be driven more by sponsoring ads than who is the best fitting provider near you.

Alternatively, crisis lines like BHR can also help link you to social service organizations, psychiatrists, and mental health facilities.

You don't have to go through this alone. Many people are available to help. 
A word to the wise, be patient, sometimes places may have long wait lists or be slow to return calls, if at all. It may be beneficial to reach out to multiple providers initially and see who is most responsive to your needs.

How to know if the therapist is a good fit?

An important quality is competence, does the therapist have specialized training or certifications in the area, symptom, or diagnosis that you need help with? How long have they been working in that area to develop a solid set of skills for complicated needs? 

Do they do in-person, virtual, or a combination of both that may make them more accessible or easier for you connect with or be vulnerable.

Does the therapist specialize in Christian counseling or are they general, non-religiously focused? Choosing a therapist that works within a framework you are comfortable with can be helpful.

If you are a member of a marginalized population, does the therapist understand those complexities or needs so that you feel safe? A therapist doesn't have to be a member of that population to be helpful, but they do need to have culturally competency or willingness to approach with openness and non-judgement.

Are you wanting only wanting validation or change? Therapy can feel really good if you are supported and the therapy gives lots of validation, but that doesn't always result in change. One major difference between a friend and a therapist is a therapist is specifically there to help you work on your goals to change, which may mean they tell you things that can be hard to hear and encourage you to do things you are uncomfortable with, for the sake of your recovery. If the therapist only validates you, it may feel good, but might not always result in the change you are seeking.

And lastly, what is the general vibe of the therapist? How do you feel about their demographics and personality?  Look over their website, their psychology today profiles and videos, do they seem like someone you could jive with?

Tempering your Expectations
Sometimes we hear about folks that therapist hop, looking for the "perfect fit," much like dating, it's not likely you will find the "perfect therapist". They are humans and can make mistakes, but are they open to learning and making change to meet your needs, or are you willing to accept that maybe they are telling you something you need to hear instead of what you want to hear? Therapists also encourage the client to do the hard work, not them. So if you are expecting them to do all the work, you may feel frustrated with long silences and delayed in progress. The more you modulate your expectations, the happier you may be about the result.

Sometimes when folks are not ready for therapy, they easily find barriers. It is a good idea to think about whether you are screening out providers who would otherwise be a fit for this reason.  When people strongly desire change and are ready to do the work, they may not overemphasize what certifications the therapist has, or how far away they are, or what times they offer, or what the cost is.  They will be willing to do anything to access the service they need at the moment and are also willing to do the hard work in the process.

Conversely, if a therapist makes you feel unsafe or judged, it makes sense to listen to your gut and move on.

Hopefully this helps and you can find your way to a clinician that helps you meet your needs. Goof luck, and good health!

Authors, Megan Garza, MA, LMFT & Chris Scarberry, MA, LPC

​A question that I often hear brought up in therapy is when is it appropriate to cut off my family members? This has become a popular topic these days as generational differences, awareness of trauma, and politics divides family.

As systemic marriage and family therapists, we are trained to study family ancestral trees called genograms and look for patterns of connection, attachment, abuse, substance abuse, and cutoffs. Whenever cutoffs show up in a genogram, it tells us something important about the family dynamic and signs of dysfunction.

Generally, we discourage folks from immediately considering cutoffs vs exploring alternate options.

What are the alternatives to cutoffs
Rather than black and white thinking, that things have to be "all this way" or "all that way" or we are a family unit or we have no connection, as family therapists we often encourage people to explore they gray areas. What about decreasing length of visits or frequency of contacts? Instead of going over every holiday, maybe only go to one, and don’t stay with them, limit your time there and stay at a hotel. Maybe instead of taking all their calls, you choose selectively when to respond or you just send them cards.

There are many times as people explore their development and really individuate from their parents and begin to develop their own sense of identity and beliefs, that they suddenly see problems in their relationship with their family members that were not fully realized prior. Or perhaps the parent is struggling with adapting to the new role of having an independent, adult child where they have less control. At that point, as growing awareness blooms into anger and contempt, sometimes prompted by an outsiders’ view of your family such as partner, teacher, friend, or therapist that the drive to cut-off a family member or make big changes in boundaries with family comes about.

When is a cutoff appropriate?
Sometimes folks have decided that the only way they can have some peace is to cut off their family members. This is especially true when family members have displayed long patterns of egregious, toxic, abusive, manipulative, or selfish behavior and are unlikely or unwilling to change, nor take accountability for their actions. 

• The narcissistic parent who keeps the focus on them and their needs and makes their children walk on eggshells and consequently develop ingrained patterns of hypervigilance and people pleasing
• The antisocial family member who physically, emotionally, sexually, and/or verbally abuses with no remorse or empathy, with pattens of lies, manipulation, and law breaking
• The chronically substance abusing parent or family member that ignores all boundaries, behaves erratic and puts your life or the life of those you care about at risk, betrays trust through lies and stealing, only initiates contact when they want something, and is a source of deep pain and shame
• The morally ambiguous, self-righteous family member who touts themself as a religious/ political/faith leader/follower, But fails to follow their teachings/preaching in favor of judgment or condemnation of people who are poor, suffering, are unlike them, immigrants, minorities, of a different faith, sexual orientation, or gender identity. E.g the parent that kicks out their child for being gay, or refuses to attend their gay child’s wedding because they “don’t believe that” or the parent that aligns themselves with white supremecist movements despite having biracial or immigrant family members (note these individuals often fall into the first two aforementioned categories).

These are all examples of family dynamics that are difficult, if not impossible to manage. Sometimes, for one’s own safety or sanity, there is no recourse but to put distance from the harmful family member. Note, a person is not put into these categories simply because you do not approve of them, or they are not who you want them to be or what you believe, they meet these criteria when they are actively inflicting harm on others through their behavior, the pattern is chronic, and there is a demonstrable unwillingness or inability to change.

Consequences of cutoffs
Sometimes I encounter clients who, at the advise of younger clinicians, have decided to cut-off their family members with formal letters, over more minor and typical family conflicts. Rather than attempting to work through the issue in family therapy, the family member unceremoniously receives a letter that that have been disowned or a list of their infractions and have been informed they are going no-contact. They problem with formally making these statements in a letter is 1) it gives the other person no opportunity to respond, clarify, ask questions, or make amends. And since many issues come down to problems with communication and understanding, this can only exacerbate the problem. 2) You cannot take back the harm inflicted by a formal pronunciation that you are cutting off a family member, thus creating or exacerbating a rejection wound.

Although many people experience family cut-offs for a time, rarely are they permanent. Most people end up reunifying with their family members within a few years. This is true for even the abusive, toxic family members, or the religiously based cut-offs.

Writing letters to harmful family members are very powerful tools in therapy for clarifying your hurt, exploring boundaries, and finding cathartic release. As a trauma counselor I have been witness to thousands of these letters over the years. However, a therapeutic exercise for the self is not the same thing as sending one of those letters to a family member and should be taken with great care and consideration. Sometimes folks who struggle with assertiveness or have fears/challenges with being communication/being heard by their family member may feel letter writing is the only option necessary, which may be true, but it’s also important to know that what is formally written may be hard to take back or make repairs from as well. There is also no guarantee they will read it.

Cautions of cut offs
If your attempt at a cut off is to get the person comply, to punish, to be more the way you want them to be, then you could be abusing the situation and using the cut-off as a tool for emotional manipulation.

If, by contrast, you are using the cut-off as a tool for safety when all methods of communication, family therapy, consultation with faith leaders, and boundary setting have failed, this is totally appropriate. This is especially true when there are no signs of positive change or willingness to change or willingness to take responsibility for the harm that has been caused, and they are in-fact doubling down on their behavior and blaming you for it. Red flags.

As a family therapist, I have witnessed the devastating impact of trauma and clients struggling to set limits with narcissistic parents who continue to ignore and cross boundaries. I have also seen the tragic result of when clients are unceremoniously cut-off by their family members and the pain, sadness, and confusion that results. Many times the person being cut-off genuinely does not recall the events they are being accused of and are shocked at the variation in perspectives. There is no easy path and the decisions you make today may impact generations to come. It's important to remember that small, consistent shifts in your behavior can change the larger family system functioning over time.

A note for parents:
Sometimes parents feel blamed a lot in the therapy process, and the fear of being blamed or judged can keep them away from participating in family therapy. This is a fair concern as parents do take a brunt of the impact when their is family dysfunction. It's important to remember that there are no perfect parents. And even the best parents are going to say or do something at some point that harms their child directly or indirectly. In family therapy we really stress the idea of a "good enough parent". In order for children to develop well, you just need a good enough parent. Most parents do many more good things than bad things. A bad choice does not automatically equate with a bad person/parent/child. Sometimes the positive contributions and the way the parent shows love is not readily recognized. For example, a child may say they did not feel love because dad did not hug them or say "I love you" or was overly strict or critical or said things that made them feel bad about themselves, but that same dad may have shown love through showing up all their sporting events, making sure to always have a job and steady income to support the family, by fixing things around the house to create a safe environment for them, by making sure they had a car to get to their job or college. How a person receives love may not be the same as how another expresses love.

Parents do however have the responsibility, as the older person with more power and authority in the relational dynamics, of being the one to reach out to their children and initiate contact occasionally. It cannot be left just up to the child/adult child. The child also has a responsibility of returning the calls and checking back in occasionally as well if they both wish to maintain a relationship. Parents do have the burden of being the bigger person, because of child's need for unconditional love from the parent.

If you are considering a cut-off, try these steps first

• Practice reflective listening skills to make sure you understand the problem
• Spend time reflecting on your favorite memories with the other person and what you would miss by not having them in your life
• Practice perspective taking- imagine what the situation might feel like from the other person's perspective
• Consider the Context- rather than judge them for their behavior, consider what events contributed to why they acted that what. Consider the influences of their family, culture, prior trauma(s), and generation with kind eyes toward them.
• Consider how that person has shown love to you in their love language vs how you wanted to receive love
• Imagine what your life might look like 5, 10, 20, 30, 50 years in the future with or without them in it and explore any regrets or guilt you might have
• Convey adequate empathy - really put yourself in their shoes and reflect the appropriate emotion needed
• Seek individual therapy from someone who is not biased toward cut-offs
• Try Family Therapy from a skilled family therapist
• Try seeking a consult with your faith leaders
• Consider attending a support group like Al-anon or co-dependents anonymous or a related group such as one's for adult children of emotionally immature or narcissistic parents
• Be cautious of others that encourage you to cut-off your family or to ignore your boundaries/safety for the sake of the family, ask yourself if/how they might benefit or if they have a bias that keeps them from being an objective resource
• Set clear boundaries and stick to them
• Use clear, assertive communication with "I statements" about what your needs are
• Try a writing exercise for yourself to clarify your concerns
• Be curious about your own role in the problem
• Be willing to take accountability for the part you may have played in any hurt feelings that have impacted the relationship
• Listen to podcasts like The Estrangement Project Podcast, The Mend Project, or We Need to Talk about Estrangement, or this TikTok https://www.tiktok.com/t/ZP8rfppao/
• Check out Resources on Psychology Today on Estrangement or the website Rejected Parents
• Read books on family estrangement

Author: Megan Garza, MA, LMFT is a licensed Marriage and Family Therapist and Supervisor at Healing Reflections Therapy

3. Meditation: Happier
When I bring up meditation in sessions, I’m met with comments like, “I hate meditation, I get too distracted, and it’s impossible for my thoughts to be quiet.” The mainstream understanding of meditation is that it’s somehow supposed to teach you to be totally devoid of thoughts, but that is simply unrealistic and, in my opinion, not what meditation should be used for. Instead, meditation is a powerful way to process and feel emotions, relax and recenter ourselves when stressed and overwhelmed, and expand our capacity for skillful coping mechanisms. 

Happier, previously known as Ten Percent Happier, is an app that was recommended to me by another therapist. It is now a resource that I use regularly, personally and professionally, primarily because of the quality and variety of meditation practices and tools it provides. The app has free meditations available, but you may choose to purchase their yearly subscription, like I did, for full access. 

The meditations cover many different topics and guide you through many visualization and reflection options. They also do a good job of setting a pace that allows time for reflection and still calls your attention back to the practice in case your thoughts start to wander. Whether you are experienced or new to meditation, this app is one that my clients and I find helpful.
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Other:
Outside of apps, I recommend Self-Compassion Practices by Dr Kristin Neff. The meditations found on that webpage are geared towards compassion, loving-kindness, and grounding. Her website includes helpful exercises as well, which I suggest checking out.

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5. Couples: Paired
Lots of people struggle communicating with their partners, and that is normal, even in a healthy relationship. The Paired app is designed to facilitate conversations that you may not think to have. These conversations revolve around topics like sex, sharing responsibility, finances, quality time, communication, LGBTQ+, and more.

​Each conversation prompt or quiz starts with a bit of psychoeducation about relationship dynamics. The prompts and quizzes have thoughtful questions designed to make you think and reflect so that you share insightful information with your partner via the app. You can not see your partner's answers until you submit your own, which I feel helps with authenticity. After each of you has answered, you can continue to discuss in the app with messages and emoji reactions, or if you prefer, you can continue the conversations in person to build on your understanding of each other’s answers. 

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6. Movement: Bend
Movement is another therapeutic tool! Moving our bodies, in whatever capacity, can have great mental and physical health benefits. Gentle movement, like stretching, is more accessible for some than going on a run or going to the gym, and Bend is a great way to guide yourself through that. The app has stretches categorized by body areas to stretch and by various intentions for stretching. It has guided routines that are as short as four minutes up to thirty minutes. You select a routine based on whether you’re looking for a wake-up stretch, a bedtime stretch, a mid-workday stretch, or you want to stretch your sore lower back, and it presents you with several options varying in length. You can pick according to the amount of time you have or the kinds of stretches it shows in the sequence, if you have a preference. 

Each option has an explanation of its specific focus. Before you start the stretch series, it shows you all the stretches in the order that they will be presented and the length of time intended to hold those stretches. Both before you start or if you need a refresher in the middle of stretching, each movement has a detailed description of how to get into the position (including a video demonstration showing you what it looks like), tips to help you find your footing and prevent injuries, modifications to accommodate movement restrictions, and the areas that benefit from that stretch.
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I personally love the way that the app guides you through the movements and provides ample support for executing each stretch. You can adjust the time that you hold each stretch if it is too long or too short, and you can pause any time if you need a break to adjust, reread the directions, or sip some water. The app will, of course, send you reminders to stretch if you set it up to, and as with most apps, there are more features available if you pay for the subscription. The unpaid version only does a full guided routine with the timer once a day, but it does not restrict your access to stretches or their instructions if you want to use them with your own timer or at your own pace. 

​Conclusion:
While they are not a fix for our mental health, nor a replacement for trained professionals and community support, apps are a great way to reinforce the things you are working on in therapy. The apps I recommend here may not work for you, and that is okay; they are just options to experiment with. If you find that these are not your vibe, that is just more information to help you determine what you do or do not need in terms of support. It’s all about finding what works for you!

​Author: McKayla Kagie Robinson, MS, PLMFT
McKayla is Provisionally licensed Marriage and Family Therapist with Healing Reflections Therapy, currently accepting new clients for individual, couple, or family therapy.

In doing counseling with clients who have substance abuse concerns and disorders, I
often draw from the world of 12-Step recovery. One of the concepts that comes out of
the wisdom of AA is the idea of People, Places, and Things. In order for someone who
abuses substances or things like food or sex to change their behavior and maintain their
progress, it is usually necessary to change the people with whom they associate, the
places they frequent, and items with which they regularly come in contact. The world
that someone in that situation has created is often filled with other people who abuse
substances, places the person goes to use those substances, and items that are
components of their use pattern.

The comedian Bill Hicks once said that the only things a man needs in order to be come
someone who has an alcohol use disorder are, “the right bar, the right girl, and the right
friends.” I have always liked that quote because it acknowledges that anyone can
become someone who abuses something or other given a few circumstances. While I
appreciate the wisdom of the disease model of addiction and also see people who
abuse substances as having a likely chemical imbalance and a genetic predisposition to
addictive behavior, there is also a role that habit, modeling, and circumstances play in
substance abuse and life in general.

I have always felt that in the “nature versus nurture” debate, the answer is both. As
such, people who abuse substances tend to think in such a way as to maintain the
addiction and the circumstances that give rise to it. Changing people may be the
hardest of the three. It may mean cutting off contact with family or close friends
temporarily or indefinitely. Sometimes new ways of interacting with them can be
negotiated, but sometimes not. When I quit smoking cigarettes many years ago, having
a romantic partner who believed I could and should do and did not smoke herself was a
huge factor in the longevity of my ability to cease and desist from using tobacco. If
someone has a problem with methamphetamine and chooses to stay with their partner
who abuses meth also, one can imagine all of the temptation and other challenges that
will continue to bring into their life while they try to pretend that they are quitting in a
vacuum.

I have seen some of the places people should consider avoiding be the route to the
liquor store they normally go to, places that are trauma triggers that may make them
want to use to self-medicate, childhood homes, their drug dealer’s house and so forth.
Sometimes if avoiding those things is not suggested by a peer or professional, it does
not occur to the user. I have seen numerous people with alcohol problems believe they
can/should work in a bar and have encouraged them to consider other options. There
are countless rituals and routines around using that the person will benefit from
breaking or at least interrupting.

“Things,” can be paraphernalia, numbers in ones phone, the actual substance they use.
I have seen people hold onto a stash of tobacco, drugs, or alcohol because they say
they feel more comfortable still having it if they need it. While this may work as a form
of harm-reduction at first, it is likely not sustainable long-term. Initially keeping alcohol
around with hopes to one day drink in moderation also seems premature in my
experience. In short, every person who abuses substances or struggles with other
compulsive behavior has a list of people, places and things that they need to evaluate
and possibly partially or completely liquidate in order to best prevent relapses into old
behavior. These are always unique to each person.
​
Once someone is far enough along the stages of change to take action, they are more
likely to take this recommendation or see that this work needs to be done without
guidance. Sponsorship within AA/NA, counseling, or just some serious conversations
with concerned loved ones can also wake a substance abuser up to a lot of their
patterns of behavior and once they have this solid information, it is up to them to
personalize it and choose to take it from there.

Avoidance can cause prolonged grief, traumatic reactions and the like and, as such,
therapists typically advise clients to face their fears, explore underlying emotional
responses and the like. By contrast, avoiding people, places, and things is an adaptive
tool for people to use in recovery because they have likely already identified the
underlying emotion, have no sound reason to be around their substance of choice given
the corresponding cravings that may ensue, and are or will become aware that trying to
master regularly being tempted just isn’t worth it.

Author: Chris Scarberry, LPC
Chris is Therapist and CO-founder of Healing Reflections Therapy and is available to see clients in recovery.

A common theme that comes up in therapy is people holding the belief that rest is a bad thing and that they are somehow bad if they allow themselves to rest. relaxation is often seen as a luxury rather than a necessity. Many people equate being busy with being productive, often neglecting the essential need to rest. Whether it developed from messages passed down in their family, their church, the Puritan work ethic, capitalistic influences on productivity and self-worth, or other cultural influences, the impact is the same- Shame. Shame prohibits people from doing what it is in the very nature to do for their own survival. 

Rest is not a bad thing. 

Is this you? Have you shamed yourself for not working enough? Do you prohibit yourself from taking a day off? Do you force your day off of work to perpetually become days of cleaning and project days at home? Where do you think you got that perspective from? Ok, sure, if you spend weeks in bed, that's probably gonna make you feel worse and is likely a sign of depression, but a couple days here or there won't make the world stop.

Winter is a great time to give yourself permission to relax and have some downtime. Plants and tree go dormant in the winter. Bears, squirrels, turtles, and even the worker bee hibernates and rests in winter. After a period of rest, the world bursts back to life in the spring. If we allow ourselves permission to rest, we may 

Still not convinced? Scientific research strongly supports the idea that relaxation is not only beneficial but crucial for overall health and well-being. 

Psychological Perspective: The Mind Needs Downtime

Psychology has long recognized the importance of relaxation in maintaining mental health. Chronic stress and overwork can lead to burnout, anxiety, and depression. Research in cognitive psychology suggests that taking breaks and engaging in restful activities helps improve attention, creativity, and problem-solving abilities.

Popular Harvard psychiatrist Daniel Siegel proposed the Healthy Mind Platter (see diagram below) that outlines the various key areas for a healthy mind and body, which include not only time for work and physical activities and sleep, but also time for relaxation, social connection and play.

One key neuropsychological theory supporting relaxation is the Default Mode Network (DMN), a set of brain regions active when the mind is at rest. The DMN is crucial for self-reflection, memory consolidation, and emotional regulation. When we relax, our brain shifts into this mode, allowing for better cognitive processing and emotional well-being.

Additionally, relaxation plays a critical role in regulating the autonomic nervous system (ANS). The ANS consists of the sympathetic nervous system (responsible for the fight or flight response) and the parasympathetic nervous system (which promotes rest and digestion). Chronic stress keeps the sympathetic nervous system overactive, leading to anxiety, poor sleep, and even depression. Engaging in relaxation techniques such as mindfulness, deep breathing, or even simple leisure activities helps activate the parasympathetic nervous system, restoring balance and reducing stress-related mental health issues.

Medical Perspective: How Relaxation Benefits the Body

The impact of relaxation on physical health is well-documented in medical research. Chronic stress triggers the release of cortisol, the body's primary stress hormone. While cortisol is essential for survival, prolonged elevation can lead to numerous health issues, including:

•  Cardiovascular disease: High stress levels contribute to hypertension, heart disease, and stroke.
• Weakened immune function: Chronic stress suppresses immune responses, making individuals more susceptible to infections.
• Digestive disorders: Stress is linked to conditions such as irritable bowel syndrome (IBS) and acid reflux.
• Sleep disturbances: High cortisol levels interfere with the body's ability to fall and stay asleep, leading to insomnia.

Medical research has found that relaxation techniques such as meditation, yoga, progressive muscle relaxation, and deep breathing lower blood pressure, improve heart rate variability, reduce inflammation, and boost immune function. Studies in psychoneuroimmunology (the study of how the mind influences the immune system) show that people who engage in regular relaxation activities have stronger immune defenses and better overall health outcomes.

Anthropological Perspective: Rest as a Cultural and Evolutionary Necessity

From an anthropological standpoint, relaxation is not just a modern necessity but an ancient practice essential for survival. Human societies throughout history have recognized the importance of rest and leisure.

Hunter-gatherer societies, for example, structured their lives around periods of intense activity followed by extended rest. Anthropologists have noted that these populations spend significant portions of their day engaged in socializing, storytelling, and leisure activities. Unlike industrialized societies, where work dominates daily life, traditional cultures incorporate relaxation as an integral part of existence.

In many indigenous cultures, rest is tied to communal well-being. Practices such as siestas in Mediterranean societies, tea ceremonies in Japan, and mindfulness in Buddhist traditions highlight the value of structured relaxation. These traditions suggest that relaxation is not merely about physical recovery but also about fostering social bonds and mental clarity.

From an evolutionary perspective, downtime is necessary for learning and adaptation. The brain consolidates experiences, integrates new knowledge, and strengthens neural connections during rest periods. This ability to switch off has likely played a role in human survival by enabling problem-solving, creativity, and resilience in the face of challenges.

Practical Steps to Incorporate Relaxation Into Daily Life

Understanding the necessity of relaxation is the first step; the next is implementing it into daily life. Here are some evidence-based ways to cultivate relaxation:
1. Mindfulness and Meditation -Studies show that mindfulness reduces cortisol levels and enhances emotional regulation.
2. Physical Relaxation Technique -Practices like yoga, progressive muscle relaxation, and deep breathing help reduce stress and promote bodily relaxation.
3. Set Boundaries and say No to things that you do not need to do.
4. Give Yourself Permission- assure yourself you are a good person, doing good things for yourself, and will be able to do more good things for the world when you allow yourself intermittent periods of doing NOTHING.
5. Scheduled Downtime - Setting aside time for non-work-related activities, such as reading, painting, or spending time in nature, improves overall well-being.
6. Social Connection - Engaging in meaningful conversations and social interactions helps reduce stress and fosters a sense of belonging.
7. Quality Sleep - Prioritizing good sleep hygiene (such as limiting screen time before bed and maintaining a regular sleep schedule) allows the brain and body to recover.
8. Nature Exposure - Research shows that spending time in green spaces reduces stress and enhances mental clarity.

Relaxation as a Fundamental Human Need. Relaxation is not a sign of laziness, badness, or inefficiency; it is a scientifically supported necessity for both mental and physical well-being. From a psychological perspective, it enhances cognitive function and emotional resilience. Medically, it lowers stress-related health risks and strengthens the immune system. Anthropologically, relaxation is deeply embedded in human culture and survival. 

By embracing relaxation as a fundamental part of life, individuals can achieve better health, improved productivity, and greater overall happiness. In a world that constantly pushes for more, taking time to slow down is not just beneficial, it is essential. So go ahead, on the next snow or rainy day, listen to your body when it says it wants to stay in bed. Treat yoself! Your body will thank you later.

Author Megan Garza, MA, LMFT
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