Mental Health Articles
|
|
 A Sign to Trust Yourself taken by Megan Garza at Burningman of an art exhibit Many problems in work, school, with roommates, relationships, friendships, and families come down to one issue- Boundaries. Boundaries are the invisible lines that define where you end and another person begins. They protect your physical space, emotional safety, and personal identity. Healthy boundaries allow closeness without losing individuality. Healthy Boundaries can sound like: “I am responsible for my own feelings, needs, and actions. Others are responsible for theirs.” Setting boundaries is an act of self respect, not selfishness. It communicates your worth and protects your peace. This table below provides an outline of what different forms of boundaries look like and how it can be problematic when boundaries in those areas are crossed.  Setting Boundaries with Family Members
Sometimes when folks are struggling with relationships with their family members they have a difficult time setting boundaries. You cannot control other people, you can only control yourself, but you can request that others be considerate of your feelings. Here are some important key point to consider when setting boundaries with Family Members:
Remember- A boundary without a follow-through becomes a wish, not a boundary. Examples: • If they continue yelling → “I’m going to step away now.” • If they push for personal details → “I’m not discussing that. Let’s change the subject.” Consistency teaches people how to treat you. Focus on What You Can Control You can’t control: •Their reactions •Their opinions •Whether they change You can control: •Your boundaries •Your emotional energy •Your responses •How much access they have to you If you are struggling with setting boundaries with someone in your life, consider working with a therapist to help you develop your skills. We have multiple therapists at Healing Reflections Therapy available to meet your needs. Author: Megan Garza, MA, LMFT Therapist & Co-Owner of Healing Reflections Therapy
0 Comments
 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. 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  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. There are low-fee sliding scale therapists available through memberships at Open Path Collective. What about the venture capital backed companies (VC) that you see the ads for a lot? These are usually the first 3-5 companies that pop on any any search result for a therapist now. There are many options for therapists available through them as well, but the controversy surrounding them is increasingly mounting, with more and more pressure to push back against the Walmart effect and risk of healthcare monopolies with conflicts of interest and how they impact your healthcare and your local community. You can read more about that here. 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? Do they primarily do individual or couple or family counseling? 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. Good 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.
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
Author: Megan Garza, MA, LMFT is a licensed Marriage and Family Therapist and Supervisor at Healing Reflections Therapy  Over the holiday season people often come together with families, sometimes to celebrate, sometimes to grieve losses that tend to congregate around these times of year. As is often the case when families get together, sometimes things are said or done that are hurtful. Sometimes painful truths of the past are unmasked. People are often forced to reconcile with these new harsh truths and realities and to cope with their hurt feelings or the way they have hurt others, sometimes intentionally, but more often than not inadvertently or unintentionally, yet the hurt remains.
Dealing with the aftermath, once problems surface, means that healing and reconciliation may be needed. Some may find that their friends or family members are distant, if not not cut off from them until they attempt to acknowledge the hurt or make amends. One of the biggest challenges relationships face is when the offending party refuses really to acknowledge the harm done. A good apology is more than just saying “sorry.” Effective apologies help repair relationships, build trust, and promote healing. Here are the key elements that make an apology meaningful and effective. 1. Acknowledge the Harm What it means: Recognize the specific behavior that caused harm or hurt.
validate the other person’s feelings. 2. Take Responsibility What it means: Own up to your role in the situation without excuses or shifting blame.
Why it matters: Shifting blame undermines trust. Apologies are meaningful when they come with accountability. 3. Express Regret and Empathy What it means: Show genuine remorse for the impact your behavior had on the other person.
wounds. 4. Offer a Plan to Make Amends What it means: Outline steps to fix the mistake or prevent it from happening again.
Why it matters: Offering amends signals that you’re committed to change, not just offering empty words. 5. Be Sincere and Timely What it means: Deliver your apology with sincerity, and don’t wait too long to do so.
Why it matters: A well-timed apology keeps emotions from festering and shows the other person you care about their feelings. 6. Avoid Repeating the Same Mistake What it means: After an apology, work on personal growth to avoid the same behavior in the future.
A good apology does not ask for forgiveness of the one that has been harmed. That only further burdens the victim with guilt and responsibility. Quick Recap:
While apologizing may be hard and requires the strength of being vulnerable and swallowing your pride, when done well, the reward is worth it. Keep in mind though, if you are only apologizing as a tactic to get more of YOUR OWN needs met, the other person may see this as a manipulation tactic and may not be willing to accept it. True apologies and amends come from your own desire to heal the person you hurt, sometimes out of a commitment to faith or justice to do right, and they acknowledge that when you attempt to heal others you also heal yourself. If you are still struggling and need help, our counselors at Healing Reflections Therapy are also available to help mend the broken divides. Check out our Meet Our Therapists page to find a clinician that best fits for you. Author: Megan Garza, MA, LMFT  First and foremost, it has been the case in our clinical practice that many Queer and Trans people who come to us for services are only hurt, angered, or feel cut off from their family members who choose to take actions such as not attending their weddings. As the person getting married did not choose and cannot change their sexual orientation or gender identity, family rejection does not send an actionable message to the person, just that family who object to their being out or in a marriage to a person of the same sex are incapable of seeing them for who they truly are and loving them as they are.
In our experience, people who may hold religious convictions that homosexuality is wrong or evil may feel as though they have the moral high ground in their family and social dynamics and may overlook the fact that LGBTQIA+ family members will object to their judgement and disdain and may cut them out of their lives as result. Just as we know there are correlations between Queer people not being able to be "out" as themselves or Trans people not being able to have their identified name and pronouns used and respected and the risk for depression and suicide, it stands to reason that parents of Queer and Trans children will cause often irreversible harm to their child's emotional well-being by choosing to put their own judgements in this area ahead of actions that communicate support and love. If you are someone who is not homophobic or disapproving of your Queer or Trans child, but simply feels less than comfortable due to lack of exposure to those communities, the concerns and values that your child likely holds, speaking from clinical experience, those adult children often just hope that their loved ones will do their best to communicate their love and support and be respectful and not say hateful/judgmental things or use dead names or incorrect pronouns. Many clients report that they are willing to accept that their family may not be capable of being completely open and affirming without reservation if their loved ones are willing to inform themselves, make an effort to see the world through their child's eyes, and not cut them off emotionally or financially when applicable. We recognize that, if you have an LGBTQIA+ child and are grappling with these questions, the likelihood that you would reject or disown them may be lower than the average, but we feel it is important to consider the impact that letting disrespect or even discomfort destroy one's most important relationships will often lead to sadness, loneliness, and regret. As therapists who support and align with the Queer and Trans communities, we are happy to meet with clients who may fall on either side of this dynamic and help them work through their feelings about the actions or identities of their loved ones in order to facilitate stronger individuals, families, and to continue to support the wonderful diverse nature and possibilities for the modern family. Author~Chris Scarberry, MA, LPC  As a family therapists we often run into clients or family of clients that are struggling with political and religious conflict with their family members from the LGBTQIA+ community, sometimes to the point where rejections, and cut offs are being considered. During the holiday season these conflicts tend to reach a fevered pitch, often being the driving force for many to begin/return to therapy. Adding another layer of complication, many individuals tend to get engaged over the holiday season, which prompts a flurry of spring weddings and pre-wedding angst. When the person getting married is your family member and the wedding is a gay/queer wedding, it may bring up a lot of emotions and turmoil over how to respond depending upon your level of acceptance of the entirety of who they are as a person. If you are someone who is struggling with determining what the best choice is for you, we've come up with some discussion points for the family of Queer loved ones to think about to help you gain clarity and hopefully some peace with your decision.
After taking time to read these questions, we suggest that you sit with yourself and notice your reactions. Did you notice any changes in your body as your reflected on them? Notice the questions that made you most uncomfortable and be curious and ask yourself why those questions brought on that reaction. Change is often uncomfortable, and we do a lot to resist change and return to homeostasis-where things were before and what we were most acclimated or used to. Sometimes discomfort shows up when we are at our learning edge, the place where we are challenged and struggle between our old beliefs and the introduction of new thoughts, feelings, or experiences that challenge them. We know sitting with your thoughts can be uncomfortable. One of the hardest things for folks during the pandemic was not having the usual distractions and being forced to sit with their thoughts (which had the unfortunate consequence of increasing substance abuse to re-bury these thoughts). Be kind to yourself. Let go of the judgment. Just notice and curious. If it helps, write down your thoughts to help you gain more clarity. Authors~Megan Garza, MA, LMFT & Chris Scarberry, MA, LPC |
AuthorSMegan Garza, MA, LMFT is a certified Specialist in Treating Trauma at a Supervisory level and is Licensed as a Marriage and Family Therapist. She specializes in work with complex trauma, sexual abuse survivors, and relational therapy. Archives
July 2026
Categories
All
|
RSS Feed