Recession and Divorce
According to a 2010 survey conducted by the Institute for Divorce Financial Analysts, the recession appears to have affected the divorce rate in some interesting ways.
Thirty-eight percent of analysts report a decrease in the number of divorce cases they handle, with 25% reporting an increase.
Common reasons for the increase:
- desire to reduce the cost of their divorce (most common)
- economic climate is straining marriages
- people exploring options prior to hiring an attorney
Common reasons for the decrease:
- people are afraid to divorce while unemployed
- people cannot afford to live apart
- people cannot afford to divorce until economy improves
- not enough money to hire a financial expert
The housing market has also affected the behavior of splitting couples. Because it is more difficult to sell their homes, people are coming up with creative solutions:
- both stay in house and live in separate rooms (most common solution)
- renting house to third party
- renting apartment, and taking turns staying in apartment (kids stay in house)
- one stays in house and pays rent until market improves
What does all this mean? The general trend appears to be that couples are staying together longer; whether they are postponing divorce, or simply forced to continue living together due to finances and the housing market. Either way, couples could benefit from learning to communicate better, get a long better, and understand each other more. Couples therapy can help with all of that.
Couples therapy isn’t just for couples who want to stay together. Having an objective third party present can help couples learn how to communicate better and diffuse tension. Couples often have “blind spots”, things one or both partners cannot see because of past hurts or resentments. A couples counselor can gently point them out, to help the person gain a greater perspective on the situation.
As an experienced couples counselors, I have helped many couples communicate more effectively. Clients have reported that their relationship improved even though they ultimately decided to split up. An improved relationship can mean a less acrimonious split. So why not call and make an appointment today?
Barbara LoFrisco, LMHC
counselorbarb.com
(813) 404-9215
Female Sexual Pain and CBT
Female Sexual Pain is a prevalent, yet commonly misunderstood and misdiagnosed group of disorders. Let’s begin with some definitions. Sexual pain disorders are defined in the DSM-IV TR as either dyspareunia or vaginismus. Dyspareunia is pain associated with intercourse that is troublesome to the individual and not caused exclusively by medical conditions. Vaginismus is an involuntary spasm of the outer third of the vagina that prevents sexual intercourse, causes the individual distress, and is not due exclusively to a medical condition. Vulvodynia, pain in the vulvar, and its subtype, provoked vestibulodynia (also referred to as vulvar vestibulitis), pain in the vulvar vestibule area, are both types of dyspareunia. Clinically, it is difficult to separate dyspareunia and vaginismus, as they often occur together.
Female sexual pain disorders are prevalent and can have devastating effects on women’s health and happiness. Statistics vary, but most researchers estimate that the rate of dyspareunia is 20% in the general population. Vaginismus rates seem to be lower, with the National Institutes of Health reporting rates of 30% in a primary care setting and 1 – 5 % in the community. Because many researchers have found healthy, positive and satisfying sexual behavior to be important for women’s health and happiness, these statistics point to the importance of accurate diagnosis and effective treatment to women’s well-being. Yet, according to one research study, only 60% of pain sufferers seek treatment, and only 40% receive a diagnosis.
If these disorders are prevalent and can have such a negative effect on women’s health and happiness, why don’t clinicians have a better understanding of these disorders? One reason is that the research and clinical community can’t seem to agree on how to conceptualize these disorders. The main disagreement seems to center around whether or not these disorders should be classified, and therefore treated, simply as pain disorders; or if there is something “different” about them that warrants inclusion into their own unique category. Another reason could be the lack of research. Although recently there is renewed interest, historically there has been a dearth of information on the topic. Finally, there is confusion and misunderstanding about the etiology of the disorder.
Because it is thought that there are psychological elements to pain, many practitioners include psychological and behavioral elements when treating female sexual pain disorders. Researchers have reported that women with a sexual pain disorder can benefit from sexual education, improving sexual skills, improving communication, physical therapy (such as vaginal dilation or Kegel exercises), addressing cognitive disorders; and using behavioral interventions like sensate focus, visualization and relaxation exercises.
Because Cognitive Behavioral Therapy addresses the connection between thoughts, feelings and behaviors, many researchers think CBT may be a viable alternative in treating female sexual pain. The main idea behind using CBT is that by changing the thoughts around the pain we can actually change the pain experience.
Several research studies have shown that CBT (whether in group, individual, or bibliotherapy format) is initially somewhat effective in treating female sexual pain disorders. However, a few studies indicated that biofeedback, Supportive Psychotherapy and medication were equally or more effective. In fact, one study showed that vestibulectomy (excising a portion of the vulvar) was significantly more effective. However, both vestibulectomy and medication are considered more invasive treatment than CBT, making them less desirable.
CBT is not completely benign. One study showed that it decreased marital satisfaction. A possible reason for this is the lack of any type of couples’ therapy. And, not all studies showed lasting effects. Interestingly, non-randomized studies showed lasting effects, but randomized studies did not.
More research needs to be done with regard to the effectiveness of CBT for female sexual pain. In particular, there was a lack of information on individual treatment, and how the inclusion of couples’ therapy might affect the results.
It is my experience and opinion that many interpersonal and relationship factors are present in most sexual experiences for women. Sex does not occur in a vacuum. For most women, factors such as how the woman feels about herself, how she feels about her partner, her past experiences, how she perceives her partner feels about her, etc., are relevant in a woman’s sexual expression. Because female sexual pain is associated with the genitals, and is usually experienced during some form of sexual expression, it is my opinion that female sexual pain is tied to the sexual experience. Because sexual experiences are tied to relationship factors, therefore so is female sexual pain. Thus I disagree with the opinion that female sexual pain should be treated as any other pain disorder. Rather, it needs to be addressed both in a sexual and a relational context.
It is these unique features of female sexual pain that indicate the need for more comprehensive interventions. Treatment should include some form of assessing how the woman feels about herself as a sexual being, her body image, how desirable she feels she is, how she views sexual expression, her past sexual experiences and what her parents may have taught her about sex. There is a possibility that a woman’s negative view of herself as a sexual being could block good and positive sexual feeling and create tension, thus making the pain worse. This could create a vicious cycle: as the pain gets worse she thinks more negatively about her sexuality, which worsens the pain, and so on.
Relationship factors are also important to consider. Most women present because they cannot have sexual intercourse with their partners, which is negatively affecting their relationship because it is inhibiting intimacy. Some women present with not wanting their partner to touch them in a sexual way due to the fear of pain. Either way, it is inarguable that the couples’ intimacy is adversely affected. Once intimacy is reduced, it is much easier for the couple to begin building misunderstandings, hostility, and eventually, resentments. For the woman, once this happens it is likely she will blame herself, which will worsen the negative thoughts she has about her pain and her genitalia, thus worsening the condition. For the man, he may feel frustration but not communicate his feelings to his wife because he is afraid of making the situation worse. All of these negative dynamics are appropriately fodder for couples’ therapy.
In conclusion, female sexual pain is difficult to understand and treat due to differing clinical conceptualizations and the lack of research. Unfortunately, this condition is prevalent and can have deleterious effects on a woman’s well-being. Although initial results from CBT treatment appears to be positive, future research and study is necessary, particularly in the areas of individual CBT treatment and the inclusion of couples’ therapy.
Therapy more cost-effective than money for happiness
Think you can’t afford psychotherapy?
A recent study done by the University of Warwick and the University of Manchester (http://www2.warwick.ac.uk/newsandevents/pressreleases/therapy_32_times) shows that 4 months of psychotherapy is as effective at increasing happiness as a pay raise of 25,000 pounds ($37,500 in U.S. dollars with today’s exchange rate). These researchers studied thousands of subjects, comparing their happiness levels before and after 4 months of psychotherapy. What they found was that it would take 32 times an 800 pound ($1200 U.S. dollars) cost of therapy to achieve the same happiness levels.
This study has huge implications to our understanding of happiness, and also the cost/benefits of psychotherapy. The results from this study point to the fact that money does not make us happier, that happiness is originated from within ourselves. Therapy can address internal factors that inhibit happiness. Furthermore, although therapy is expensive, it is a much more effective investment in your well-being than obtaining (or holding onto) your money.
Sex Therapy
You may wonder what exactly sex therapy is and whether or not it’s for you. Issues or questions about sex or intimacy are very common and nothing to be ashamed or embarrassed about. According to the Mayo Clinic, about 1/3 of all adults have a question or concern about their sexuality.
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lack of desire
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difficulty achieving orgasm
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premature ejaculation
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erectile dysfunction
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concern about sexual practice: “am I normal?”
Possible outcomes:
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increased intimacy
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more satisfying sex
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less anxiety about sex
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more positive self-image
Here is more information on sexual counseling/sex therapy from the Mayo Clinic:
http://www.mayoclinic.com/health/sex-therapy/MC00065
To find a provider, look for someone who is certified by a board of sexology, such as the American Board of Sexology (ABS) or the American Association of Sexuality Educators, Counselors and Therapists (AASECT), or someone who is legitimately advertising themselves as a “sex therapist” (can demonstrate that they have had the 120 hours of training required by the state, and 6 months of supervision).
For more information on the services that I provide, including sexual counseling, please visit:
Mental Health Disorders More Widespread Than Estimated
According to the October 2009, issue of ScienceNews, almost 60% of our population experiences either anxiety, depression or substance abuse by the age of 32. This was a result of a study done by psychologists Terrie Moffit and Avshalom Caspi of Duke University.
According to this study, anxiety is the most prevalent, at approx 33%, then depression, at approx 18%. Substance abuse was the least likely, at approx 5% for alcohol and 2.5% for cannabis (marijuana).
Fortunately, both anxiety and depression are among the disorders that re most easily treated.
How to Fight Fair
How to Fight Fair
Developed by CounselorBarb
Tampa, FL
1. Pick your battles. Decide what is really important, and what isn’t. This will take a bit of work but it will be worth it. Examine your values — what can you “give” on and what is “completely unacceptable?” Give in to your partner when appropriate, and negotiate the rest. Would you rather be right or be happy?
2. Pick your times. Think about the household schedule and what time might be best for an intense discussion. Think about your own, and your partner’s, temperament to determine what time of day might be best. Do not discuss or argue when either of you are tired, or after you have been drinking, or when you are on a “date night.” In fact, reserve a few hours once or twice week for a “business meeting” to discuss issues or logistical things like who is going to pick Johnny up after soccer practice. Let the rest of the time with your mate be fun and relaxed.
3. Be respectful. Do not raise your voice, use a sarcastic tone, or become silent as a way to punish your mate. Do not belittle or use profane language. Also be mindful of ways in which you may be communicating disrespect in non-verbal ways, such as sighing or rolling your eyes. Do use statements that describe your feelings (“I feel….”) and specifically what your partner has done to cause these feelings (“…when you…”).
4. Stay on topic. Do not air old grievances from the past. However tempting it may be, do not bring up unrelated issues. In fact, try to avoid bringing up old issues at all. When couples do this it is usually an indication that resentment has built up because the issue was never resolved. The goal is to discuss and resolve issues as they happen.
5. Show understanding. Listen to your partner sympathetically. Even if you do not agree with his or her point of view, try to understand it. Demonstrate that you are listening by paraphrasing what they are saying, for example, “You sound really angry. It must have been really frustrating for you when I…”
6. Do not argue when you are angry. If you are too upset to follow these guidelines, it is time to cool off until you are. My couples will often agree to call a “timeout,” where one of them goes to another room or for a walk for a specific period of time (usually about 20 minutes). Then, they promise to get back together to continue the discussion after they have cooled off. Do not argue when you are upset — you will be more likely to say something to hurt your partner and damage your relationship.
7. Develop a good repair strategy. Although at first glance it may seem a bit insensitive, a lot of partners will crack a joke when things get too heated. This can work if the other partner laughs, thus breaking the tension. Anything couples can do to calm the tension and reunite is considered a good repair strategy.
8. If you are still having trouble, enlist the help of an experienced relationship counselor.
Note: This list was developed by CounselorBarb, after consulting similar lists by Lambos, W.A., & Emener, W.G. (In press) Cognitive and Neuroscientific Aspects of Human Love: A Guide for Therapists and Researchers. Hauppauge, NY: Nova Science, Publisher; and Horton, Lee. Crumbling Commitment: Surviving a Marital Crisis.
For more information on CounselorBarb, visit www.counselorbarb.com
How Daily Hassles Can Affect Your Health
Multiple stress researchers have discovered that it is the small problems in our daily life that have a large effect on our psychological and physical well-being. Although major life changes such as death, divorce or job loss can certainly have a large impact, researchers have discovered that it is the sum total of life’s “daily hassles” that takes a larger toll.
Stress is defined by any demand placed on us that exceeds our ability to cope, or to solve the problem. Stress can have a huge negative effect on our emotional and physical health. Too much stress can eventually make us sick!
So, how about taking a look at your daily life? See what “daily hassles” you can eliminate. Think about time management. Maybe by simply re-arranging errands, or doing them on a different day, will mean much less hassle. Be aware of what stresses you out- maybe even keep a journal about what “daily hassles” really bother you. Awareness is the first step to problem solution.
Nutrition and Depression
Today’s Parade magazine contained an article titled “Can Diet Affect Depression?”. It got me to thinking about other articles I had found linking depression to diet or other lifestyle factors. It’s fascinating to know that there are many ways to alleviate mild depression that do not involve either psychotherapy or drugs! Of course, sometimes psychotherapy and/or psychotropic medication are indicated, so please visit your mental health professional to be sure.
According to today’s Parade magazine, a study in the British Journal of Psychiatry reports that people who regularly eat fish, fruits and vegetables reduce their chances of suffering from depression! And, as one might expect, fueling up on yummy junk such as fast food had the opposite effect. Meaning, your Big and Tasty along with a creamy milkshake could make depression worse, although it won’t actually cause it. Researchers think it’s probably due to the increased antioxidants and Omega 3 fatty acids in a healthy diet.
Speaking of Omega 3’s….
According to Dr. Mercola, ABC news on September 17, 2002 reported that studies have shown that people who eat a lot of fish suffer from less depression! In fact, some psychiatrists are recommending that their patients increase their Omega 3 intake.
How to get more Omega 3 in your diet? Dr. Mercola recommends taking fish oil. To read this article in it’s entirety, please visit http://articles.mercola.com/sites/articles/archive/2002/11/30/depression-part-nine.aspx.
There’s other evidence that diet can affect depression.
http://news.bbc.co.uk/2/hi/health/8334353.stm
According to a recent BBS News report, there is a link between processed foods and depression. Click on the link above to view a short video from a man who states that eliminating dairy also eliminated his depression. Scientists are unsure why, but think there might be a link between inflammation and depression.
There’s also a link between Vitamin D and depression.
According to Dayna Dye of Life Extension Magazine, low vitamin D levels are connected with depression. Dutch researchers found lower levels of vitamin D in people who were depressed. They also found higher concentrations of a blood serum compound which can indicate low vitamin D. As a side note, they also noticed that all subjects were somewhat low on vitamin D, indicating a widespread problem.
** To visit Life Extension’s website click on http://www.lef.org/magazine/
Another reason to eat a healthy diet: there is also a relationship between illness and depression.
According to the July 19, 2008 issue of Science News, there is a relationship between illness and depression. Although the connection between elevated cytokines and depression is relatively new, it is thought that being ill can make people somewhat depressed. Cytokines are proteins made by the body when it is fighting off infection, and they are also found in depressed and suicidal people. Cytokines serve a function because they help the body shut down physically so that it can rest when it is ill. Problems happen when these proteins are created by mistake. This link could offer hope for those 30% of people who don’t respond to antidepressants. For more information, please visit http://www.sciencenews.org/view/feature/id/33835/title/Sick_and_down (must be a subscriber).
Dr. David Williams agrees. According to the September 2008 issue of his Alternatives newsletter, cytokines can reduce level of serotonin, producing irritability, irregular appetite, a general lack of energy…all which serve to shut the body down so that it can deal more effectively with the illness. He goes on to state that depression is as much as 10 times more likely among people with a chronic illness. To learn more about Dr. David Williams, please visit his website http://www.drdavidwilliams.com/.
Exercise can also help depression.
According to an article in Science News by Bruce Bower, aerobic exercise can be as effective as antidepressants when it comes to dealing with depression. I am always telling my clients to exercise. Even if you aren’t suffering from depression, there are many incredible health benefits to exercise. So why not just get out there and try it? See if you don’t feel better!
For the full text of the article, please visit http://www.sciencenews.org/view/generic/id/9004/title/Exercise_steps_up_as_depression_buster (must be a subscriber).
So why not take better care of yourself? You have nothing to lose, except, maybe depression…
Climbing the Mountain of Life
Recently I was fortunate enough to find myself at the base of a mountain in Southern Utah. You may have heard of it: Angel’s Landing in Zion National Park. Breathtakingly beautiful. The weather was clear and bright with temperatures at a very comfortable 70 degrees.
The wonderful outside air was an ironic contrast to the nausea rising up in me when I saw what our guide was pointing at:
“This is where we will end up”, he said. He was pointing to a mountain that looked far away and very, very high. Worse, it appeared as if it actually turned on itself somehow; sort of like my stomach was doing at that very moment.
But I knew I couldn’t let my thoughts go down that pathway. It took a lot of money, effort and time to get out here, and I really didn’t know if I’d ever get the chance again.
It’s not like I wasn’t warned. “Oh some people just can’t make it to the top- what with the chains and all”, said the woman behind the register in the outfitter’s store. “Wh-wh-what?”, I managed to reply. Nobody told me chains would be involved! “Oh, it’s no big deal. You can always stop on the small ledge halfway to the top and wait for everyone to come back down.” More on that later.
Undeterred, we signed up for the trip. Now that it was reality, I did not want to be known as the woman who “almost made it”. I thought about how I would feel if I told people I went to this famous hiking place but didn’t make it to the top. Embarrassed, Ashamed. Humiliated.
So I did what I tell my clients to do: I put one foot in front of the other and I just kept doing it. I didn’t stop and think about how tall the mountain was, or how “twisty”, or the dreaded chains. I simply thought about where my feet were at that moment, and where the next step needed to go.
I did this over and over. It got a little more difficult when I surpassed the resting area, as it is loosely called. It is actually a very small area where the trail is slightly wider, say 5 feet across instead of 2. This allows people to line up plastered against the rocks so that others can pass.
I passed several men who were too scared to continue. I could have let this deter me. After all, if men are too scared then it must be really scary, right? No! Again, I followed the advice I give my clients: reframe. “I will be more powerful than all these wimpy men. Just because some men say something cannot be done doesn’t mean I cannot do it”, I told myself.
I turned a corner and saw this:
Part of the descent to Angel’s Landing. Scary but beautiful.
But there was no turning back. I ignored the rising bile in my throat and kept repeating to myself about the next step. What the next step would be, where I would put my feet, how I would not fall. I concentrated on how wonderful my body felt with all the great exercise and how strong my legs were getting from all this climbing. I looked down at my feet and NOT over the edge. I did not look up at the mountain, other than to see where my next step should go. I never thought about the final destination, I just kept focusing on getting to the next step.
It was in this way that I reached the summit:
Angel’s Landing, Zion National Park, Third Day, Trekker 2
You cannot tell from this picture, but this top ledge is only about 10 feet wide in any direction, with a sheer drop off that I cannot even think about as I am typing this. People have actually died from not paying attention once they got up here. So, none of the pictures show me standing at the summit. I literally never stood up. But I was OK with that. My goal was to make it to the top, and I did that. Once I got there I cut myself some slack and enjoyed my victory rather than criticize myself for not doing it perfectly. I am the woman who made it to the top of Angel’s Landing by doing it one step at a time.
Think about Angel’s Landing the next time you are faced with a situation or goal that seems overwhelming or impossible. Do not focus on that. Do not even really think about the final goal, other than to plan the little steps it will take to get there. Once you know your little steps, just focus on each and every one of them. Complete one and immediately move onto the next one. They will eventually all add up to your final goal. Then you can be the person who made it to the top of Angel’s Landing.
CounselorBarb 