Goodbye 2020

As we get ready to ring in the New Year, we begin to look back on this crazy year of the COVID pandemic.  I, like the rest, have begun to look back on my year and have noticed I had to change my perspective to see that some pretty spectacular things have happened!  I remember being touched when I read a quote that stated 2020 was the year we stopped taking things for granted and instead began seeing the things we are grateful for.  Let’s take a look at my new perspective on what I can be grateful for. 

•  For many years now my life has been routinely chaotic with working two jobs.  I never felt as though I got to spend much time at home.  2020 was the year I can no longer say that!

•  I was, and still am, fortunate to still have the ability to work two jobs as technology has been very helpful in this department.

• I was able to learn a whole new way of connecting with people through the telephone and video chat (although it’s not the same as human interaction!).

• I learned there is a plethora of fun internet activities to keep children entertained and found new ways to share books with children. 

• I am very grateful for my healthy immune system as I have not tested positive for COVID (so keep your mask on and social distance!!!).

• I am grateful for my loved ones as they too have been able to stay healthy.  I also recognized that I may have taken our time together for granted as I was not able to enjoy spending the holidays with every family member!

• Lastly, I am very grateful for the opportunity to begin sharing my life with my partner as we start to build our future together!

There are so many other things to be grateful for as well!  As we go in to 2021, I work on not setting my expectations too high as it may be somewhat of a repeat of 2020.  However, I will go into the New Year with a new perspective and will continue counting the things I am grateful for and open my eyes to no longer take things for granted!  As you review your year of 2020, I challenge you to change your perspective and find things you are grateful for! 

Marriage is Hard Work

As my wedding anniversary nears, I can remember one particular response I received when sharing the news that I was getting married.  A lady that worked in the same building as me asked, “Are you sure?” She dipped her head back and rolled her eyes regretfully as she described how marriage is a ball and chain.  I understood she meant no malice but instead was offering me portentous advice based on her own experiences.  Looking back, I’m glad I didn’t take her seriously, but it certainly opened my eyes to how some people feel about marriage. 

This November marks 22 years with my husband.  In being together this length of time, we have had our share of ups and downs.  And one thing I know for sure is marriage is hard work!  But when you hear that marriage is hard work, because I’m sure you’ve heard this pretty often, what comes to mind? And just how difficult should you expect it to be? 

Hard work means so many things.  It means not taking your relationship for granted.  It means attuning to your partner intentionally.  It means taking your partner into consideration when making big decisions and maybe even the small ones.  It means letting him or her know how much you care and appreciate them.  It means trying over and over to understand each other.

Putting in the effort to your marriage can be so rewarding.  The best way I can describe it is like getting through a tough physical workout.  At first it feels a little daunting, then you’re right in the middle of it all and gaining momentum, and when it’s over you feel proud for getting to the other side of it.  Maybe you hurt a little but you know that you’ll be stronger because of it.  So essentially what I’m saying is the kind of hard work you put into a relationship should make you feel good. 

Each partner has to be an active participant in the marriage.  I read somewhere that in successful relationships a partner must be willing to put in 100% without the expectation to receive something back.  Sound crazy?  Just think about it.  No tit for tat.  No more he said, she said.  No need to keep count. Each of you share the responsibility for the relationship fairly.  But 50/50 is no such thing!  It’s all in!

Ready to give it a real shot? Call your local therapist today!

Give Life Meaning

We’re heading into the last few months of 2020 and this year feels a whole lot different! For many years we may have relied on the upcoming months to be the season of joy and full of festivities around the holidays. Instead as this holiday season approaches, I have felt the heaviness, difficulty, and uncertainty of how the next few months will unfold. I for one can say that this is completely understandable! After all we have had to experience the many changes and stress influenced by the COVID-19 pandemic. In addition, the news constantly reminds us of the additional challenges that are taking place socially, politically, and economically.

If you are struggling to stay hopeful and positive right now, then this article is dedicated to you. I’m also struggling to stay hopeful and positive right now. It’s discouraging and frustrating to dig deep to find positivity when the next challenge or problem seems to be right around the corner. Recently, I walked into my office feeling a lack of confidence and worry on how I would share hope and positivity with my clients when everything outside of my office seemed so negative. Additionally, to be more vulnerable with you guys, that moment terrified me! For the last 5 years, Reconnecting Relationships Therapy has been my home away from home. It has been an honor to serve the Dallas Fort Worth area by working with my clients. All these years my heart has been filled with gratitude and excitement as clients have shared their stories and invited me to help them create positive changes. Although most stories that are shared with me in therapy are filled with suffering and conflict, I’ve known what my purpose has been all these years. Feeling those negative emotions as I walked into my office, forced me to pause and acknowledge my current predicament.  I’m struggling with sadness, fear, frustration, and hopelessness. Since I hadn’t been diligent in processing these negative emotions outside of work, they were now making me question my purpose.

According to the CDC, about 41% of the U.S. population reported experienced mental health issues as a result of the pandemic. Common mental health issues reported included anxiety, depression, trauma-related symptoms, and substance use disorders. If you are not experiencing one of these mental health issues, perhaps you have noticed other symptoms associated with the increase of stress and anxiety.

 So, what can we do? We may not be able to control many things about a pandemic. We definitely can’t bury our heads in the sand and pretend that life is not filled with various challenges right now. What we can do to gain some stability, is to find what is in our control. We can control how we use our time sheltering at home. We can control what decisions we make that care for our physical and mental health. We can decide to have a mindset and practice actions that remind us that our life still has meaning. We can choose to live a life that is meaningful and has purpose. The most valuable support we can have at this time is finding that our life still has meaning when we are attempting to cope, survive, and restructure during difficult times.

One of my favorite books is by Viktor Frankl, which I find always reminds me of man’s strength and resilience in the worst situations. In his book, Man’s Search for Meaning, he describes his experience while being held at a concentration camp during World War II. He reminds us of what helps people survive desperate circumstances, “The meaning of life is to give life meaning.” In times of uncertainty, crisis, or change we have the power to choose what will give us meaning or purpose. I may not like the changes and negative emotions that the pandemic has brought but I can choose to focus on what gives my life meaning. I’m committed to continue helping couples reduce conflict and to help my clients experience joy in their relationships! 

Back to School: Talking to Your Teen Student During Coronavirus

I can hardly believe it is August!  And while school is just around the corner, this year proves to be one full of uncertainty.  I have a teen attending a Fort Worth ISD school and another returning for her second year to a Texas university. Over the last few months, their schools have continued to send them updates on plans and ideas for the new school year, but it is apparent that anything can change suddenly.  And, this in itself can create anxiety and stress for both parent and student. 

As a Fort Worth mom, I understand my daughters each face some challenges with returning to school. Each will have to figure out ways to adjust with the ongoing changes the schools are likely to make as the academic year commences.  Some kids will be attending classes online while others return to an in-class setting.  And then there are some students who will be juggling both types of schooling.  Many schools are communicating a need to change course of action if COVID-19 becomes more problematic and are making parents and students aware of the possible interruptions to learning. 

So as a parent what can you do to help your student through the academic year? 

A lot can be offered by listening to your teen and sharing dialogue that feels collaborative and mutual.  Here are some helpful topics to cover before and throughout the school year. 

Talk openly about anxious feelings.  Express to your teen that it is okay to feel anxious and concerned, however assess your own feelings so that your kid does not take them on as his or her own.  As you share your own worries do allow your teen to ask questions and provide feedback.

Discuss expectations.  Ask your student what he or she might expect from their upcoming school year.  Your teen might have expectations about their online or in-class experience. Inquire how your teen might feel if those expectations do not play out. 

Offer support and understanding.  Validate your teen’s experience.  As parents we may have our own worries about the school year but our perspective can differ from the student.  While academics are certainly being affected, your teen might express more concern for the lack of social activity which is highly important at this age and should not be disregarded. 

Explore coping strategies.  Remind your teen of helpful ways to cope with stress and anxiety.  What has he or she practiced in the past that has been useful in getting through tough times?  Encourage your student to get plenty of rest, exercise, and maintain a healthy diet. 

Discuss appropriate safety measures.  Over the past few months, you and your family have probably learned some ways to stay safe by wearing masks, washing hands often, applying hand sanitizer when in public areas, etc.  Talk with your kids about how to translate those habits into the school environment if they are planning to attend classes or head back to college campus.     

Consider a backup plan. Prepare for the likelihood of a quarantine or shelter in place.  Discuss with your student how this event might alter plans and expectations. Talking ahead of time about how to make the transition can lessen anxiety and offer some stability and structure.

It’s important to acknowledge that our students are facing unique challenges during this time.  It’s okay that we don’t always have the answers.  Our teens don’t necessarily need us to have the answers.  What they need is for us to listen and offer support as we all work to getting on steadier ground.  Stay safe everyone!

When Your Partner Is Going Through Anxiety

Our world is dealing with a lot of uncertainty and change right now due to COVID-19. Along with this pandemic comes so much fear, panic, anxiety, sadness, and anger. For many of us in the DFW area, we have had to face the adjustment from a fast-paced life to an “in shelter” lifestyle with all sorts of emotions, thoughts, reactions, and new realities. For those who have coped by staying productive and are caring for your physical and emotional health, congrats! The other reality is that many people may not be ready to “sit with their feelings” or feel comfortable expressing their feelings. Some don’t even know what it is they are feeling. For a person with an anxiety disorder, the anxiety may have become worse by all the environmental changes we are currently facing. We all experience and express our emotions differently. I want to remind you that that’s ok, we are all different and deserve to be respected and supported as we navigate and adjust to change.

The idea that we all react differently to change and how we all thrive when we receive emotional support, led me to write this article. There are many people right now struggling with anxiety and on the other side of that many partners finding it challenging to provide emotional support during a stressful time. Here are a few tips on how to provide effective support when your partner is experiencing anxiety.

1.     Don’t Try to Fix Them

It may be your first reaction, as you’re seeing your partner get lost in their thoughts, beginning to isolate, or is displaying those symptoms you’ve seen before where you think “oh no, the anxiety is back.” Unfortunately, jumping in to solve the problem can be seen as dismissive or critical without truly listening to your partner. When your partner is struggling with anxiety, they cannot be well for you. Anxiety can be debilitating and the last thing someone who is experiencing this disorder needs, is the feeling that they have failed you or that your love will be conditional based on their symptoms. Instead, remind them that you want them to feel better soon because you love them and see how difficult it is for them to be experiencing anxiety.

2.     Avoid Proving to Them Why They Shouldn’t Be Afraid

Sure, anxiety is a normal body’s response to threatening situations some of which may be irrational or may not occur. For individuals struggling with anxiety, it is no longer about being afraid of something specific and weighing out the facts. Their anxiety has become too high where they are experiencing unpleasant physical, emotional, and cognitive symptoms. Instead of challenging their fears, ask them specifics of what is upsetting to them. Allowing your partner to talk about their deep fear openly can often neutralize it, making it less threatening.

3.     Help Calm Them Down

As often as you are able to, remind your partner that they are lovable and that their anxiety will not change that. Let them know, “you’re not alone, we’re in this together.” If your partner is experiencing a panic attack, help them interrupt the attack by offering a distraction. Helpful distractions can be as simple as breathing some fresh air outside or going for a walk. Learn more about breathing techniques specifically for anxiety, where you can practice them alongside with your partner. This will not only help alleviate your partner’s anxiety but will demonstrate your active support for your partner and your commitment to turn towards each other during difficult moments.

4.     Set Realistic Expectations

During times when your partner is struggling with their anxiety, they will not be themselves. Their energy, mood, demeanor will be different. You may be longing to share happy moments instead of evening talks about anxiety. Although it can be difficult to remain patient with your partner. Remember to set realistic expectations of what your dynamic will be like during this time. It’s ok to not be experiencing relational bliss in this moment. Consider setting the expectations that you both will practice behaviors that will provide you with rest, self-care, or professional support.

5.     Take Good Care of Yourself First

Seeing your partner experience such dark moments can shift all the focus on their wellbeing. You may be tempted to refrain from sharing your personal stress from your partner in an attempt to not worry them further. Unfortunately, this creates a conflicting dynamic in the relationship where- they may end up feeling like a fragile child and you may end up feeling alone. Remember the idea is to turn towards one another despite the challenges you are both facing. If your partner is unable to do this because their anxiety is interfering, practice other strategies that help you cope with your individual experience. Practice journaling or talking to someone you trust. Allow yourself to do things that you enjoy or that don’t stress you out. Dedicating time to yourself will help you cope with your individual stress as well as re-energize you for those times when your partner needs support.

It’s hard work to turn towards each other during difficult moments. My hope is that these tips will be helpful in providing you with new strategies to help someone you love and help you feel supported too! One of my favorite quotes is by Dr. John Gottman, which I use in my work with couples. I especially believe it’s perfect for those of us wanting to be helpful to someone experiencing anxiety. Dr. Gottman says, “when you’re hurting, the world stops, and I listen.” 

Where Do You Wish To Meet?

Illustration by Sophia Schultz

Abraham Maslow was a humanistic psychologist who developed a theory describing what motivates individuals and how they move along the lines of getting their needs met.  His concept, Hierarchy of Needs, is most often depicted in a pyramid to delineate each level.  The bottom level, the foundation, represents the most basic necessities for human survival while the highest level demonstrates transcendent desires.  As a person reaches their goals in one level, he or she is able to move on to the next level.  If an individual has yet to satisfy the needs for food and shelter one can assume this person is less likely motivated to fulfill their needs in other levels.

The 5 Stage Model includes:   

  1.    Physiological Needs -  food, shelter, water, clothing

2.    Safety & Security -  health, employment, stability, security of  body

3.    Love & Belonging -  friendships, family, intimacy, connection

4.    Self-Esteem -  confidence, respect from others, achievement

5.    Self-Actualization -  spontaneity, creativity, lack of prejudice, realizing personal potential

While the hierarchy is depicted in an upward trajectory, it is not uncommon for people to fluctuate from one level to the next.  When changes arise such as divorce, death, breakups, or loss of employment individuals can find themselves moving back and forth through the hierarchy.  And when these needs to be loved, to feel safe, to feel confident become threatened, it is human nature to make attempts, even if ineffective, to gain or maintain them.  

In our practice, clients come to us from all different levels.  We do our best to listen to where our clients have been and discover where they wish to be.  Whichever level you find yourself, we will meet you there.   

The Dynamic Dr. Dixon

Brian Dixon, M.D.

As a therapist, I often find that clients are hesitant or skeptical about taking medications for mental health purposes.  Some individuals explain that medication in the past has not worked effectively while others share their distrust in psychiatrists or “pill pushers.”  So, I sat with Brian Dixon, M.D. recently to see if he could shed some light on his approach and process to psychiatry. 

What led you to practice psychiatry?  And how did you know it was right for you? 

I knew psychiatry was the ideal specialty after I completed a family medicine rotation in medical school and realized how mental health was a key component in treatment compliance. And when I learned that psychiatrists have more time to truly dig deeply, I knew it was the field for me.

What is your style or approach to working with your patients?

I fully believe in meeting patients where they are and helping them towards their best self; this only occurs when patients are ready for change so I establish people’s motivation for change early in the process.

What have you found to be the most difficult to treat?

My “waterloo” in psychiatry is likely eating disorders. I employ lots of behavioral techniques and though most eating disorders have a large behavioral component, the psychodynamics stretch me pretty thin and puts me at risk for compassion fatigue.

What is the biggest misconception about psychiatry that you have come across? 

That it’s fast and easy. Like a surgeon doing a Whipple procedure [a 10-hour delicate pancreas surgery] psychiatrists open up a person’s psyche and help them build insight into themselves. It’s a process that’s scary and complex and can’t be done in a session or two. Reminding the public that as physicians, psychiatrists are trained in all aspects of mental healthcare and building a comprehensive treatment plan takes training and patience and helping someone feel better is a process.

When you notice a patient is worried or anxious about the idea of taking medication, how do you move forward?

First and foremost, the first option is always no medication. As one of my training psychiatrists taught me – no one is born with a Ritalin deficiency – meaning that we use medications currently to bridge people to a time when they are feeling better. If people are interested in medications, I then walk them through all options explaining common risks, benefits, and side effects so that they get to choose the option that works best for them and their situation.

I understand you also see adolescents and children.  How young is too young? 

There’s a field of infant psychiatry so I’d say no one’s too young! My youngest is 3 and since there are very few medications approved for that age, I blend mainly behavior modification into my treatment plans.

And how do you adjust from working with an adult to working with a minor?

Training. The best part of being a psychiatrist is that you go through an intense residency program for 4-5 years.  During that time, you learn to juggle complex treatment choices that come at you from all angles. Thus, it’s not tough to adjust when it’s literally built into our training.

What do you recommend to those who are searching for a psychiatrist?  What questions should people ask?  What should they be looking for?  Or steering away from?

The most important and first question is “Are you ready for change?” It’s okay if someone isn’t ready for change but [instead] reaching towards possible medication (which many psychiatrists tend to use as part of a treatment plan.) If you’re ready to ask, the next question is specialty and focus. I remind patients that orthopedic surgeons are surgeons and could remove your gallbladder but you’d likely want a general surgeon to do it. The same goes for psychiatry. There are generalists and subspecialists, and both genres have focuses so be sure to ask if they’re a good fit. Online reviews are notoriously inaccurate so I encourage everyone to steer clear of what reviews they read in regards to the quality of mental health services in Fort Worth; I know many of the providers and they’re quite good.

In your line of work, it can be very demanding and challenging.  So, how do you find balance between tending to patients and taking care of your own self-care needs?

The hardest balance, strangely, isn’t practicing psychiatry (this is where my amazing training kicks in.) Honestly, running a small business is the tougher of the two endeavors, and self-care tends to take a back seat when there’s work to be done until the wee hours. I’m blessed to sing in a great chorus in Dallas and have fantastic friends in Fort Worth to keep me sane.

Lastly, I want to say congratulations on your recent recognitions for 40 under 40 by the Fort Worth Business Press AND Top Doc in Psychiatry by Fort Worth Magazine.  How awesome!  So, what’s next for you?  Can you tell us what you plan to accomplish next?

Thanks!  It’s quite an honor to be acknowledged for building a successful private practice both business wise and clinically.  My goal for 2017 is to tackle healthcare reform.  Our current system is broken as it’s based on commercial insurance.  I have a novel solution that returns healthcare to the local level and power to the citizens and I’m sharing it far and wide through all public and social media outlets.  My goal is to get my idea into the common discourse so that we can change healthcare starting today.

Something that comes across loud and clear when hanging out with Dr. Dixon is his friendly, down-to-earth disposition.  After the interview, Dr. Dixon shared with me his desire to make improvements in how mental health is not only treated but also perceived.  He is a man interested in helping others, however he understands and respects his limits.  He often integrates the expertise of other professionals to enhance his mental health plan for his patients. 

Your mental health is essential in your day-to-day living and making the decision to seek a psychiatrist is not always easy.  Some people have preconceived notions about meds and doctors that make it difficult to embrace a consultation with a psychiatrist.  I hope today's Q&A helps you gain a better understanding of what to expect when seeking help from a psychiatrist.  Thank you, Dr. Dixon, for sharing with us what you do and how you do it!  

Brian J. Dixon, M.D. is a Board-Certified Adult, Child & Adolescent Psychiatrist with an active private practice in Fort Worth, TX.  He believes in treating the whole patient using a unique blend of behavior modification and therapy while minimizing medications.  His practice’s goal is to reintegrate mental health into our modern lifestyles.  www.progressivepsychiatry.org