For many folks across the US, the globe, and in marginalized communities this was a hard day.  At Healing Reflections Therapy, we see you. Your pain is valid. Sadness, anger, betrayal, shock, and frustration are all very real and may feel all the more acute when others are celebrating or otherwise blind or uncaring about what you are experiencing. You are allowed to grieve as you need to grieve. 

Grief
Grief occurs in separate and sometimes simultaneous cycles.  It may look like shock, numbness or shutting down.  It may look like anger and wanting to rage at those you believe hurt you and to cut ties with family and friends, it may look like sadness and wanting to cry or stay in bed and eat or drink your feelings.  It may look like bargaining and wanting to rationalize how you can make sense of it, thinking “if I just do x, maybe it won’t impact me”, it may look like denial and telling yourself it’s not over yet, maybe something may change it, or telling yourself or others to get over it.  

Next Steps
Focus on the now. Your brain may be spinning with sooo many possibilities: future fears of changes, loss of rights, concern for your safety and the safety of your loved ones, fears for the choices by lawmakers and the fate of democracy. Instead of focusing on external events that are much bigger than you and beyond your control, focus on what you can do for right now. Think about what you are able to control.
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The serenity prayer reminds us to ask, "Grant me the serenity to accept the things I cannot change, the courage to change the things I can and the wisdom to know the difference." This notion of radical acceptance is hard, but can help move you out of helplessness and hopelessness.

 Self-Care
Today is a good day for self-care. What does that mean? It means connect with your support communities, your trusted friends, family members, colleagues, and mental health workers- schedule a meeting, date, appointment, a get together. You could create a group text or join a social media group with like-minded individuals.

Please take some time for yourself. That may mean taking a day or two off of work. Give yourself grace for having to pick yourself off the floor or peel yourself out of bed after maybe having a night or two of less than ideal coping choices.  It happens. Try not to linger there too long. Focus on adaptive coping. Make choices for self-care that will make you feel proud of yourself later and allow you to feel better instead of worse. If you are someone who is in recovery, try to use positive coping skills rather than allow the current political climate to take your sobriety.
Find something that creates meaning in your life. 

Allow yourself to cry and feel your emotional response at times.  You need to get it out.  No one can hold in this much pain and live with it alone.  Rely on chosen family, friends, and community.  

Distraction
You might need to get out of your head for a little while and away from the media frenzy. Try unplugging and refocusing on other areas of your life, if you can, which we realize may be a privilege. Watch a favorite movie. Watch some stand-up comedians on netflix, watch funny pet videos on tiktok, put in your favorite movie- yes, you can go ahead and watch Twilight for the 100th time, throw yourself into some true crime, re-read your favorite YA book, spend time in nature, go thrift store shopping, go to a museum, create some art or play music.


Self-soothing
Self-soothing may look like connecting with your body and 5 senses to bring you peace. It may mean snuggling your fur babies and enjoying the texture of their soft fur, or hearing the relaxing sound of their purr or breathing, it may mean taking a hot bath or cold shower, it may mean making yourself some hot cocoa, putting on your favorite smelling lotion or cooking something that transports you to a childhood memory, cleaning your closet, walking around barefoot in the grass, buying yourself some fresh flowers to smell and look at, making a playlist of songs that bring your inspiration or peace or help channel your rage, enjoying some pumpkin spice whatever fall stuff has to offer, or maybe you put up your Christmas decorations early to surround yourself with things that bring you joy and calm your nervous system.  

Safety Planning
Are you a member of a marginalized group like LGBTQIA+ people or immigrants that is being targeted? Although some may try to minimize your concerns, you know what your experience has been and what you have endured, your fears are valid.  Does making a plan for safety give you a sense of control? For some folks, there may be talks with your loves ones about where in or outside the US you feel most safe and protected. Yes, I know lots of folks talk about leaving the country around elections, which just is not a real feasible for most. So there may be more practical solutions to consider. Are there legal documents that you need to arrange to protect the status of your relationship and/or your loved one? DO you want to work on getting your name change or gender-affirming surgery while that is still definitely possible?  Do you have a list of community spaces where you feel safe and people who you can trust? Don't allow people who do not see your pain or the situation accurately to deter you from doing what you need to do to be as safe and comfortable as possible.

Re-focusing your energy on Advocacy
For some people the best way to deal with this immense sense of lack of control is to look for ways to feel in control. This may look like volunteering for a cause or group that is important to you. It may mean joining your local political group and focusing on the next local election.  It may mean spending time supporting local marginalized communities. 

Hope
It is never wrong to hope. Do not be ashamed or mad at yourself for allowing yourself to hope. Sometimes that is all we have. If you are familiar with the Greek myth of "Pandora’s Box," then you know that when Pandora, the first woman on earth, was given a gift by Zeus, she was told not to open it. When Pandora gave in to her curiosity and opened the box, it was said she unleashed all the evils, sickness, disease, evil and horrors unto the world, but at the bottom of the box was HOPE.  

I often think about Red’s line in Shawshank Redemption “Hope is a good thing. Maybe the best of things.”

As crisis counselors we know that people die when they lose hope.
For those in power, we know that hope can be a threat to their power. In Hunger Games President Snow tried to stamp out hope in the districts, because he recognized hope could be dangerous.
From research on Learned helplessness, we know that it happens when we lose hope, people & animals give up opportunities for freedom from terrible situations even when presented to them...I won't tell you the story about the experiment because it will depress you even more (you can google Seligman's story if you really need to know more). 
Never be ashamed of having hope and choosing to believe in a better tomorrow. History repeatedly has shown us that the worst periods, the worst wars, the worst regimes do not endure, the human spirit does.

Remember, this is a marathon relay, not a sprint. You are not alone. He won't be the thing that breaks you.  Getting to the other side of this likely will mean a lot of pain and discomfort along the way. You may not look the same or feel the same when you come out of it. You may learn hard lessons along the way. You may be a different person on the other side of it all. The losses you suffer may not be fair or just. At times you may fall back and need someone else to tap in while you step back and allow yourself to rest for a while. Don't be afraid to ask for what you need and pause when you have to.  You have been though hard things before. You can do hard things. Throughout the world and history people have gone through enormous suffering, but humanity has endured...and generally moved toward progress. Have faith. Have hope. Have Courage. Have Endurance. Be Persistent. Have Heart. We are here to pass you back the baton when you are ready.

If you are needing help finding a good therapist, we are here for you . Or you can check out this article on how to Find a good Therapist https://www.hopehealreflect.com/mental-health-articles/how-to-find-a-good-therapist​

Authors: The Healing Reflections Therapy Team

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. 

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Author: Megan Garza, MA, LMFT

A common misunderstanding in the therapy realm has to do with all those confusing alphabet soup of letters after the providers name- LMFT, PsyD, PhD, MS, MSW, MD, NP, MFT, LPC, PLPC, LCSW... and so on. Even as someone who went through years of school, multiple graduations, and career highlights, admittedly my family still mislabel my title and don't understand the work I do.

So what do all these letters mean and why does it matter to you as a person seeking mental health services? Many people frequently get confused about whether they were seeing a psychologist or a psychiatrist, which can lead to a lot of frustration and disappointment when they are expecting an hour long psychotherapy session, but instead get a doctor's appointment that lasts 5 minutes and are given a prescription for antidepressants, or vice vera.

Well, for starters these letters are basically indicators of their years of education, specific degree, specialization. They may even tell you about the philosophy and values of that profession.

Your Medication Prescribers
MD- Your psychiatrist is usually and MD. They went to medical school and specialized in studying the brain and its impact on mental health. Visits with a Psychiatrist are usually 5-15 minutes once a month or every few months for adjusting medications based on symptoms. Occasionally you will find old school psychiatrists (think Fraser Crane, Dr. Freud, or the dad in Growing Pains) that still do psychotherapy on top of prescribing meds, but that is far less common these days.

GP -or general practitioner also has an MD and also frequently prescribes basic medications for anxiety for depression or anxiety in cases that are less complicated.

NP - Your nurse practitioner is a nurse  (RN) with specialized clinical training that can often prescribe meds for mental health and usually works in conjunction with an MD.

Your Testers, Forensic Evaluators, High level Administrators, Psychotherapists
PhD- This is where you typically find Psychologists. These individuals have doctoral degrees usually in clinical psychology, Marriage and Family Therapy, Education, Social Work or a related field. They have typically 10+ years in academia after high school completing their education with  scientific research components, teaching, and writing/publication. Clinical Psychologists may provide psychotherapy, but often you find them doing a host of other jobs. They are highly trained in diagnosis, testing, and various forms of evaluation. There also other Cognitive Psychologists and Industrial/Organizational Psychologists who specialize in other areas of psychology, but do not usually provide therapy.

PsyD or EdD- These individuals also have a doctorate in either psychology or education, or counseling usually, but their programs were more clinical and less research focused. They have 10+ years in education, but their training was highly specialized to working with clients or students in the field rather than the research lab.

Your Master's level Therapists/Psychotherapists/Counselors
These folks make up the bulk of who is providing therapy today

MA means they have a Master of Arts degree
MS means they have a Master of Science degree

MSW- These folks have a Master's degree in Social Work- They have a 4 yr Bachelor's degree + 2-3 year Master's degree with a strong social justice component.
LCSW- These folks are Licensed Clinical Social Workers- They have a  4 yr Bachelor's degree + 2-3 year master's degree with a strong social justice component but they also have added clinical training and experience to work with clients and have passed their licensing exam. They usually are opposed to diagnosis, but in practice diagnosis is often required to billing purposes.


LMFT ( or MFT of FT in some states)- These folks are Licensed Marriage and Family Therapists. They have a a 4 yr Bachelor's degree + a 3 year Master's degree in therapy interventions with a specialization in relational and family system therapies. They have specialized clinical training and passed their licensing exam.
PLMFT- These folks are provisionally Licensed Marriage and Family Therapists. They have a 4 yr Bachelor's degree + a 3 year Master's degree with a specialization in relational and family system therapies. They have passed their licensing exam, but have not yet completed their required 2+ years of clinical training prior to being fully licensed. They work under the license of a supervisor.
SMFT- These folks are working toward their provisional License as a Marriage and Family Therapist. They have a 4 yr Bachelor's degree +a 3 year Master's degree with a specialization in relational and family system therapies. They have not taken/passed their licensing exam yet, and have yet to complete their required 2+ years of clinical training prior to being fully licensed. They work under the license of a supervisor.

LPC- These individuals are Licensed Professional Counselors with a 4 yr Bachelor's degree + 2-3 year Master's degrees in Counseling or a related field. They have very similar education requirements to MFTs, but they tend to focus more on the individual, so they don't usually have the additional specialized training for working with kids/couples and families unless they sought that out separately.
PLPC- is a Provisionally Licensed Professional counselor who has completed their Master's degree and have passed their licensing exam, but are working on completing their 2+ years of post-degree clinical experience.

Bachelor Level support workers
BA Bachelor of Arts- 4 year degree
BS Bachelor of Science- 4 year degree

Your Case Worker or Support worker or Tech usually will fall into this category. They don't have a license or any specialized clinical training beyond education and work experience. These are the "trench workers" who usually work very hard, for little pay, and see high volumes of clients.

Certificate holders
A Lifecoach is a person that helps direct a person to make important decisions in their life. They have no specialized education/degree requirements, no exams, nor is their a governing regulatory body that gives that a license or oversees them to guarantee ethical practice. They typically receive a certificate as a life coach and often train under another life coach. This area is often controversial because the lack of oversight and lack of public knowledge about the professional competencies of the lifecoach. There is a concern that people may be taken advantage of by individuals that label themselves lifecoaches, but may in fact be doing their clients harm due to their lack of training, skills, or boundaries outside of what that they believe themselves to have. Conversely, many licensed therapists also double over as lifecoaches and offer coaching as a separate part of their practice. Some people who find mental  health stigmatizing may shy away from "therapists" but may proudly seek out a "lifecoach." Lifecoaches should avoid diagnosis and attempting to provide therapy. Their work is usually skills and decision based (e.g. a career coach) and should not involve diagnosis, or attempts at therapy. 

Hopefully after reading this you have a better sense of the kind of provider you are seeking or seeing (and maybe what label you should actually call your family member).  Sidenote, though it may seem like these words are interchangeable, it's actually illegal/unethical for these professionals to call themselves by a title that does not belong to them so as not to misrepresent themself. A psychologist cannot call themself a psychiatrist and a lifecoach cannot call themselves a therapist unless they have a Master's degree and clinical license. As you become a savvier consumer, the more likely you will ensure you have the satisfactory treatment experience you are expecting.

by Megan Garza, MA, LMFT

We want to welcome aboard a new clinician to our practice. Anne Marie Mathews, SMFT recently joined us at Healing Reflections Therapy: Diversity, Trauma, and Wellness Services as our newest Marriage and Family Therapist Supervisee.
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She graduated from St. Louis University for undergrad and recently graduated from Nova Southeastern University in FL for with her Master's degree in Marriage & Family Therapy. She is specially trained in relational therapy and play therapy, including sand tray work. She is available for working with individuals, couples, and families of all age ranges. She has flexible scheduling and hybrid in-person and in-office therapy service options.
Please welcome her as she settles back into the St. Louis community and keep her in mind for any referrals.
[email protected] www.hopehealreflect.com

We want to take a moment to welcome aboard our new intern Jordan Langley, BA, BS onto the Healing Reflections Therapy Team. She is completing her Master's degree in Marriage and Family Therapy and is ready to see clients. She is currently accepting spots for individuals, couples, and families virtually. A little down the road she will be able to see kids in-office. She is a great option for folks need lower fee accessible services. Feel free to send folks her way!

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:

1. Sense of self-importance
2. Preoccupation with power, beauty, or success 
3. Entitled
4. Can only be around people who are important or special
5. Interpersonally exploitative for their own gain
6. Arrogant
7. Lack empathy
8. Must be admired
9. Envious of others or believe that others are envious of them

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

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.

• How did you come to this decision?
• How do you tend to feel if you hear about someone's parents not attending their wedding?
• What values are you trying to demonstrate by not attending this wedding?
• Have you taken time to grieve the future you envisioned for your child when you believed they were heterosexual?
• Have you considered that, more so than ever, it is possible for a married gay person to have a fulfilling family life?
• What biblical references specifically forbid attending this wedding?
• Are there any biblical references or church teachings that you to do not strictly adhere to?
• Are there any people/figures that you usually look to for wisdom on this subject?
• Do you ever disagree or act in ways differently from these advisors?
• Do you believe witnessing a gay wedding will make you gay?
• Are you uncomfortable being around Queer or Trans people and might not know what to say?
• Is it possible that, on some level, you knew your child was gay from a very young age?
• Will anything bad happen to you if you attend this wedding?
• Will anything bad happen to you if you do not attend this wedding?
• Will anything bad happen to your child if you do not attend their wedding?
• Will any harm come to your child if you attend the wedding?
• Do you believe your refusal to attend will stop the wedding or change your child’s sexuality?
• How will you feel about yourself for making this decision?
• How do you think your decision will impact your child?
• How do you think your decision will impact your child’s partner?
• What might be the long-term impact of your decision?
• How might your relationship be impacted after the wedding?
• Are you prepared to possibly lose your relationship with your child/family member?
• What is more important, your principles and values or your love and support of your child/family member?
• How would you have felt if your parents refused to attend your wedding?
• How do you see your relationship with future grandchildren? What will you tell them when they ask why you didn’t attend their parents’ wedding?
• What do you think are the reasons why your child wants to get married/what they love and value about their fiancé?  
• Is there any way to make up for the hurt an injury like this could cause in a relationship? How?
• If you attend the wedding, could you make things worse by adding more shame/guilt/tension to the event or will you make things better by adding love/support/happiness to the day and create positive memories for years to come on the anniversary when they look back at their wedding photos?
• What biblical teachings would allow for you to attend this wedding?
• What would Jesus do?

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