Mental Health Articles
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 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
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 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  We spoke in an earlier post about the important elements for success in therapy, one of which was finding a therapist that was a good fit. With the rise of mental health platforms run by tech corporations that have a wide social media presence, there has been a new vogue of treating your therapist like online dating, the minute something is uncomfortable you should get out, swipe left, keep shopping, there’s always another one ready to pop up and take their place. Wait! Hold on just a minute. There may be some valid reasons to terminate your relationship with your therapist, but there may also be some good reasons to stay that you may not have considered. When to go As therapists, we frequently hear horror stories of past therapists- be it unethical practices, unorthodox practices, or interventions that did more harm than good. A therapist that crosses boundaries to have sex with a client, or exploits the therapeutic relationship for their own gain, or abuses their power are all serious causes for concern. If a therapist is displaying overtly unethical or illegal behavior, then the relationship needs to end. Ruptures in rapport: A Forgivable Offense? Most complaints about a prior therapists usually arise not because the therapist is inherently bad, but because of differing perspectives/worldviews, cultures, generational differences that lead to feeling, hurt, invalidated and misunderstood. For example, a client not liking the words chosen or boundaries set, or feeling uncomfortable with being held accountable in session, the therapist breaching trust by fulfilling their legal obligation to make a hotline report, or recommending medication or hospitalization; or a therapist making a human error in scheduling, missing an email or call, looking sleepy, forgetting something client previously said, being distracted, conflict over a billing error, snacking during session, seeming too casual or not casual enough, or perceiving the therapist as not on their side enough. These slights, however unintentional can hurt, but whether or not it is worth ending the therapeutic relationship over may be complicated. Ruptures in rapport are common, especially as the relationship deepens and therapy reaches newer levels of trust and patterns of earlier relationships begin to play out in the therapeutic relationship. While most licensed therapists are well meaning and do their best to serve their clients with the tools they have, they are also human and have their flaws. Some are wounded healers who are still in the middle of their own journeys, others come from a place of privilege or have not sufficiently done their deconstruction and decolonizing work. Both may inadvertently harm the client. Ideally, therapists should spend some time in their own therapy as well as supervision and consultation doing self-of-therapist work prior to seeing clients, if not on an ongoing basis. Ruptures as Opportunities for Corrective Emotional Experience Therapy is a microcosm of the rest of the world, meaning that problems that play out in the external world often find a way to play themselves out in the therapy room as well. Challenges in the therapeutic relationship are opportunities for a corrective emotional experience that one may not otherwise have had with others in their life. For example, if you are upset with you therapist for something they said or how they handled a situation, your ability to confront them can be the first time you may feel able to use your voice and challenge someone who has hurt you, but in a safe way (hopefully). In this way, addressing conflict and dissatisfaction with your therapist is both courageous and encouraged, and can be an empowering and healing, and deeply transformative process with breaking patterns in the clients’ life. Political Betrayal by Your Therapist There are times when a therapeutic relationship just isn’t the right fit, for example there is a recent discussion about folks leaving their therapist after learning their therapist voted in a way that went against their rights. Essentially, the therapist has violated the clients' trust with their betrayal and failure to protect their rights. Traditionally, therapists are trained to be neutral and not bring their stuff into the room and not share much about themselves personally- but arguably anyone who works with marginalized populations and sexual or religious trauma survivors needs to NOT be neutral about protecting the folks they serve. They have a fiduciary responsibility to care about their clients not just in the therapy room, but who they are as people. In this way, the political is very personal, so sometimes a political/cultural/gender/racial/religious match may be necessary for building trust and eliminating harmful bias. When To Pause before a break-up-When Attachment Wounds Run the Show The "swipe left" method for choosing/leaving a therapist is particularly problematic if the client has concerns with attachment. What do we mean by that? Healthy attachment develops from our early caregivers. When we feel safe and our needs lovingly cared for, we develop a secure attachment, which enables us to have healthy, secure trusting relationships in adulthood. When our needs are not met, or we grow up in unsafe/traumatic, unpredictable, or chaotic environments we may develop anxious, avoidant, disorganized or insecure attachment styles that hinder our brain development and adult relationships. In children, they may be given a diagnosis known as RAD, Reactive Attachment Disorder, commonly seen among foster and adopted kids where there is a disruption to the early attachment relationships. This article talks more in-depth about the disastrous consequences of early attachment wounds and the impact it has on one's ability to attach to future care-givers. https://www.theatlantic.com/magazine/archive/2020/07/can-an-unloved-child-learn-to-love/612253/ . Mary Ainsworth, Margaret Mahler, Harry Harlow, and John Bowlby were among the early pioneers of attachment theory and more modern books by Dr. Bruce Perry have talked about this concept. At the end of this article there are some videos that talk about these foundational attachment studies and why early attachment relationships are so fundamental to development. Carl Rogers, famous for developing the Humanistic client-centered psychotherapy treatment method commonly seen as the foundation of most clinical practices wrote about his theory of change in “On Becoming a Person” where he compared the role of the therapist to that of a healthy soil for a tree to grow. In order for someone to grow and flourish, there needs to be a healthy, nurturing soil. Although the home/family environment might not have been provided enough sustenance for early growth, healing/growth in the therapeutic realm can be made through a secure attachment with the therapist by way of empathy, genuineness, and unconditional positive regard. So while for some people the task may be to find the “right fit” with the therapist, for others their challenge is deeper- to work through their attachment wound and allow themself to connect/share intimately in a therapeutic relationship, to not run away as the relationship deepens as a form of self-sabotage (i.e., I will leave them before then can leave me, So I won’t be hurt again), and to be able to appropriately address and work through conflict in order to make repairs to be able to have enduring relationships. This process of challenging patterns helps build new neural networks in the brain, to make repairs from earlier setbacks. Trust and Attachment Takes Time For some folks, the real work in therapy may not begin for 6 months to a year until they have worked with the therapist long enough to “test them” to ensure the therapist will not reject or abandon them, only then do they start to show their therapist their deeper wounds, pain, insecurities and problematic behaviors. Not surprisingly, this same pattern can emerge in romantic relationships, where the partnership seems like bliss, so they rush to marry or move-in together quickly. Once the partner has them on the hook, suddenly their personality and behavior shift. One begins to see an entirely different side of the person than they did before, and in some cases it may seem like a Dr. Jekyll/Mr. Hyde situation. The other partner often feels confused and betrayed. A Note About The Impact of Sexual Trauma on Attachment Wounds One common scenario where attachment wounds play out with women in romantic relationships is when there is a history of sexual trauma. In the wake of the trauma she may experience distorted beliefs in which she believes it is her fault, is damages, unloveable, unwanted, or not good enough. This leaves her feeling hurt, sad, lonely, and isolated. As a result she may end up hooking up with various people in a serial fashion combo of trauma re-enactment, maladaptive coping, attempts to reclaim power, and self-fulfilling prophecy. Eventually she ends up with a hook-up that turns into a situationship that turns into a relationship. It starts out hot, but once the relationship gets to a point of stability and safety, the sex life turns cold and avoidant. The couple starts fighting more as he is frustrated and hurt from the rejection and she is feeling pressured and coersed into unwanted and painful sexual activity which cause her to further lose interest and avoid any attempts at intimacy, for fear it will lead to demands/pressure for sex. This pressure is a trauma trigger that feeds back into her original negative beliefs about herself that she is damaged/unloveable/only good for sex. The antidote is recognizing those patterns, and encouraging the partner to create a safer space while the she works to challenge her distorted beliefs and anxiety about triggers. If the couple can work through this together, they can have a deeply satisfying, intimate relationship. If they cannot address it together, there is the risk that the pattern will be repeated with the next partner, and the next. The same can be said about the therapist, if conflicts in therapy room are not addressed, there is a risk that pattern will present with the next therapist and so on. So, before you fire off that email to break-up with your therapist, really sit and be curious. Ask yourself: Is this about them, or is this about Me? Is this similar to a pattern in your life with other providers, family members, friends, or romantic partners? Am I leaving to avoid conflict? Am I leaving to avoid connection? Have I done the work to give them the opportunity to change or demystify their process or apologize? Are they safe? Do they respect my dignity and autonomy? Is this therapeutic relationship doing more harm than good? Were they having an off day when something happened that hurt your feelings or do you feel hurt more often than not when meeting with them? Am I expecting perfection? Did they tell me something I did not want to hear, but maybe needed to hear? If I don’t trust them, do I feel I can trust anyone? Am I ready to make changes to myself and the patterns I am in? Barriers to Change, Lack of Readiness and Low Motivation While we are talking about reasons people stop therapy, sometimes it's because of the therapist, sometimes it's because of client attachment concerns, but sometimes it's lack of readiness or willingness to change. When people are at the pre-contemplative or contemplative stages of change, the might throw up all kinds of barriers to attending services, like needing things to be "perfect", requiring just the right time slot, location, proximity or services; or just the right therapist demographics of race, gender, religion, level of experience/certification/degree, or lived experience; minimal cost, and just the right modality. While all these things certainly can help as previously discussed, when folks are creating barriers that sometimes set it up to where no one can fulfill their needs, and they thus get to avoid the therapy process by escaping it but claiming no responsibility. They may also create further barriers to change by not thinking about their therapy after/between sessions, not doing homework, etc. We find that when people are really desperate and motivated for change, most those barriers fall away and all people are really left with is “Can you help me?” And “How Soon can I get in?” Research is clear that the number one predictor of positive outcomes in therapy is not the therapeutic modality, it is the alliance with the therapist. Attachment matters. Readiness to change matters. Attachment to your therapist matters. Take time to see if they are trustworthy. Decide if you are really ready. If they are trustworthy, and you are ready for change, take time to consider before you leave. Author: Megan Garza, MA, LMFT  A popular point of discussion on social media these days is narcissism. It seems like everyone's parent or ex has been deemed a narcissist.
While in some ways the discussion can be helpful in recognizing abusive behaviors that can impact one’s own mental health, the overuse of the term has taken away some of its power and can lead to misunderstandings. Although it is common these days to toss around phrases like “my ex was such a narcissist” to such an extend that it seems like everyone dated a narcissist. However, the actual presence of Narcissistic Personality Disorder only occurs in 1% of the population. A person can exhibit moments of narcissism ( arguably all of us), but not be a Narcissist. So what does a Narcissist in clinical terms look like? The classic signs of NPD include:
Someone who may be very full of themselves, vain, or overly self-confident. They may have little insight into themselves. The may have little empathy for others and see themselves as the victim in situations where they are the offending party. Often people initially find them very amiable and “charming” is the word that repeatedly comes up in domestic violence circles. They have a way of drawing people to them with their charisma and enigmatic personality, but often their words and gestures are hollow with little sincerity, thoughtfulness, or follow-through. Because they make such a great first impression they can easily trick judges, police, family, and others in authority into believing that they are just a great, well meaning person and their counterpart is suffering from mental illness (enter gaslighting). Narcissism and its role in Domestic Violence Just because your significant other said you were exaggerating or doesn’t recall your side of the events does not mean they are gaslighting you. Gaslighting is a strategic way certain abusers systematically try to make their partner think themselves crazy. It is designed to break them down. Most relationships have couples that widely misperceive or misinterpret events, where one may be experiencing cognitive distortions and have a hard time separating feelings from facts or another may be bad at reading or responding to emotions non-defensively...that does not make them gaslighters or Narcissists. Gaslighting came from the old classic 1944 film “Gaslight” where the main character attempted to convince his wife she was crazy by stealing things from the home and accusing her of stealing or misplacing things, then telling her she had a poor memory, and climbing into the ceiling and adjusting the gas in the ceiling lights and acting like it wasn't happening to convince her she was going insane. It came to be known as a specific form of domestic violence, though can be used by anyone in power/authority, or looking to gain something from someone else for malevolent means. It essentially is intentionally saying/doing things to make someone believe they are going crazy…usually in effort to gain control over them/their things/or to just be antisocial and abusive and enjoy others suffering. Narcissists may use their charm and charisma to get others to align with them against their victim. The victim feels crazy and their self esteem and self-concept are eroded. They may exploit the victim's vulnerabilities to their own advantage physically, financially, or emotionally. Narcissists have more than average encounters with HR, police, civil and criminal suits, protection orders in which they see themselves as the wronged party. They may cry, pout, sulk, yell, namecall, deflect, project, deny, become puffed up, enraged, and incredulous if their behaviors are pointed out. One noted hallmark is the tendency to accuse others of the very behavior they themselves are exhibiting while admonishing it in the other person (kinda makes you feel crazy, right?). If they do admit what they have done wrong, it will be your fault because you “made them do X”, or you “made them feel Y”. Ultimately, they will usually take the stance of “it’s your fault.” I.e. "It’s your fault I cheated because you were not having sex with me enough.” Charming Narcissists may start out with lovebombing and seeming like the perfect person. When getting lovebombed it might feel like you are the main character in your favorite romcom and you likely will feel very special, but usually after 1 year or so of after they get their partner “on the hook” with marriage, housing, loans, or a child their veneer begins to fade and the other side starts to emerge- sometimes classically known as the Dr. Jekyl/Mr. Hyde personality. The victim tends to spend a lot of time in ever shortening cycles of domestic violence idealizing the perfect periods and struggling to see the holistic pattern that tells much more about the overall personality structure of their partner and the waning hope for change. Partners, employees, and children or narcissists tend to develop a lot of insecurity about themselves, are highly attuned to slight reactions from others in a “walking on eggshells” approach to maintain survival and avoidance of further pain. Gaslighting vs Perceptual differences By contrast, Most relationships involve 2 people disagreeing about something because of their own past experiences, internal thought processes/distorted views of the world, and resulting different perceptions of the experience. In most cases, people are not intentionally trying to convince someone they are crazy-though this may be the inadvertent result. Take for example the Michael Brown shooting. They had 64 witnesses and their perceptions and reports of their experience differed wildly. Sure, some may have been motivated by secondary gain to report the way they did, but they were by far not outliers (https://www.motherjones.com/politics/2014/11/inconsistencies-what-happened-during-michael-brown-shooting/) There are famous experiments in cognitive psychology where people can be engaged in a game of basketball and a man in a gorilla suit can walk straight through the court and when asked later about it, most players and witnesses of the game will not see it, because they are focused on the ball (https://www.youtube.com/watch?v=vJG698U2Mvo). A person could easily say “wow, did u see that gorilla?!” And the other person might be like “what are you talking about? There was no gorilla.” An argument ensues and one or both may feel crazy and this is where pop psych gets it wrong-someone might say-“you are gaslighting me.” This is not true, unless the person was intentionally trying to make the other person think they are crazy. And the added piece with cognitive psychology research by Elizabeth Loftus teaches us that people are especially bad historians. Our memories are very fallible and maleable to suggestion, which is why eyewitness testimony is considered the weakest/most unreliable form of evidence, despite people having the most confidence in it (https://www.science.org/content/article/how-reliable-eyewitness-testimony-scientists-weigh#:~:text=As%20Loftus%20puts%20it%2C%20%22just,that%20their%20memory%20of%20an). So, when thinking of gaslighting, ask yourself about the overall behaviors and intentions of this person. Do they generally mean you goodwill even when they are not trying to lovebomb or get something from you in a manipulative fashion? Do they try to help/support/lift you up/encourage your dreams and best version of yourself? Or do you usually feel bad/smaller/more out of control in ways that is usually inconsistent with how you view yourself/others/the world. Narcissists in Therapy Joseph Burgo in the book “The Narcissist you Know” talks about different types of Narcissists, the ones that want to be held in high esteem, famous, or revered and will happily step on anyone who gets in the way of achieving their goal. Dictators, politicians, and some actors and models have been known to fit this mold. Others have a veneer of wanting others to see them as great, but they are much more shallow and easily wounded and resort to lashing out when that is not validated. They are likely to throw a fit, use injurious words to cut down anyone that might see through the veneer and cut the person out of their life entirely. Some may be philanthropers or nurses, teachers, or ministers, or police , or even therapists where they are in the position of being admired and praised, but the people that are closest to them like their partner, parent or child may have a very different experience of them than their public persona. Narcissists are not historically known to show up for therapy unless court mandated or coming in with their partner for couple/family therapy. It is sometimes said that narcissists in therapy only become better at manipulation and therefore a clinician that recognizes the perils should proceed with caution. In these settings they tend to first focus on winning over the therapist by being a “good client” or they finger point all issues as originating with their partner/boss/family member/ex/etc and take no accountability for the work they need to do on their end to make repairs. Essentially, they take the stance of wanting the therapist to validate their concerns as the injured party and try to co-opt the therapist to get the other person to take the responsibility for the problems in the relationship. They may seem agreeable to homework, but have little follow through if the expectation is for them to focus on change within themselves, yet be simultaneously demanding of change and work from their partner. They usually do not see their hypocrisy and are emboldened by their narcissistic injury to overlook their injurious behaviors. Theories of what causes Narcissistic Personality Disorder Theories on the roots causes of NPD vary. Sometimes it develops because they grew up in entitled settings where they were pushed to be “the best” and likewise developed little empathy for anything/anyone that did not meet those standards. Conversely, some were treated so poorly from developmental/attachment trauma that they develop a false sense of self/veneer to convince themselves they were ok to steal themselves up from the outside threats. This is the narcissism that is much more fragile, because if they allow their guard to come down and see their own flaws, their core sense of self may be at threat. They may be vulnerable to experiencing the extreme pain of their early trauma, so they fight hard to allow those vulnerable feelings from being experienced. Traits vs personality disorder Maybe you have read this and thought you for sure know someone who is a Narcissist, but to be clear, the pervasiveness and chronicity and truly heinous impact of this abuse is what makes it unique. You likely have someone who treated you poorly, made you question yourself, did not validate your feelings, took advantage of you, or behaved poorly during an argument and did not share the same perspective as you, but it does not necessarily mean they are a Narcissist. If you reflect, maybe there are times you could say the same for yourself too. This popsych mislabeling is a disservice to real sufferers of narcissists, and gaslighting. Your ex- boyfriend may be a selfish ass, but probably isn’t an actual narcissist. We need to be kinder to one another and more magnanimous sometimes in how we interpret others actions. Fore more readings on the subject, you can read here: www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662 https://emedicine.medscape.com/article/1519417-overview?form=fpf Gaslight(1944).www.youtube.com/watch?v=QJtJsFdpRm8 The Narcissist You know by Joseph Burgo By 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
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