Em Dreiling, Ph.D.
Clinical Psychologist
Lic #: 0810005362
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Moms--You are setting the standard for your daughter's body image - be careful what messages you are sending

5/26/2016

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        My mother is beautiful.  She has gorgeous red hair, striking green eyes and great legs.  She has always been a force: smart, encouraging and kind.  As a little girl, like most little girls, I thought my mother was the most powerful and wonderful woman in the world, I still do. Yet, within all of this strength there was always a piece of kryptonite at play:  my mother was always on a diet.
       From the time I was little I knew what a ‘diet’ was –which is similar to the 80% of 10 year-olds who have dieted at least once in their very short lives. My experience was not different.  And if the idea of a 10 year-old on a diet appalls you, as well it should, we need to talk about where those ideas are coming from and take action – yes mothers, it is time to face your body image issues, for the sake of your daughters.  I have worked with many young women who struggle with the hell that is an eating disorder and the fear and disgust that are inherent in body image struggles.  Whenever we talk about where their earliest messages regarding the importance of weight and shape came from –they talk about their moms.  Their relationship to their body is often shaped by their mothers and is often a reflection of their mom’s relationship to her own body.  From the way they feel about their weight, to how they feel about aging.
       Body image disorders are transgenerational.  We learn to overestimate the value of weight and shape, not only from cultural influences but most importantly, from our caregivers.  Moms- your ‘stuff’ is harming your daughters.  I know that the vast majority of mothers would never intentionally set their little girl on a path laden with self-doubt, insecurity, unhealthy habits, fear and shame.  You want your girls to feel beautiful when they look in the mirror.  You want your daughters to appreciate, accept and love their bodies -- no matter what its shape. 
        To address the some of the critics of body acceptance who say ‘what about obesity?  What about the health risks?  I don’t want my child to become complacent and unhealthy!”  First, everyone gets to feel pretty.  EVERYONE.  Not just people who are thin or who can run a 5 minute mile or who are blonde etc.  Body acceptance is not body complacency.  I promise that it is easier to take care of something that you love and appreciate rather than something that you despise and are ashamed of--shame is a terrible motivator.  You can both love your body and be working to live a healthier lifestyle.  There should be no messages of “when I’m thin then I’ll be happy” – it is this type of illogical thinking that builds a fantasy around thinness and its powers – it is not real.  Thin does not equal happy—look on any eating disorder unit and you will see that. 
        So moms – what do you need to do?  Model body acceptance.  Talk about what you love about your body.  The power in your legs, your curves, your strength, your smile.  It is tragic when I ask young women if they have anyone in their life who loves their body and they say no – and 99% say no.  Being around people who love and accept their bodies give others permission to do the same.  In a culture that makes a tremendous amount of money off of the insecurities of women, we have been trained to focus on our flaws.  Set a different standard for your daughters.  Teach them that they do not have to buy into (both literally and figuratively) those ‘thin ideal’ messages.  Inspire acceptance and pride.  Girls who love their bodies demand respect for their bodies from others and that is a beautiful and empowering thing.  And moms- if this is difficult for you to do that is ok.  If demonstrating body acceptance feels like you are selling something you don’t believe, I understand—do it anyway and get help for yourself. You are as deserving of feeling joy and comfort in your body as anyone else.  Talk to a professional, address your fears and insecurities for you and all those young women that you influence.
        As for my mother’s influence on me, I watched her slowly step into acceptance and then embrace the body that has done and continues to do so much for her.  I see women sit up a little straighter and breathe a little easier when she is around and speaks joyously of her laugh lines and the ‘signs of aging’ which to her are beautiful reminders of a life well lived.  I’m not scared of wrinkles because I have this beautiful example of how to age gracefully and to be comfortable in my skin, smile lines and all.

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February 18th, 2016

2/18/2016

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Client: I don't need corporate America to tell me when to buy flowers for my wife. That is manipulative and I'm not buying into it.
Me: I can see your point. When was the last time that you bought flowers for your wife?
Client: Last Valentine's Day. I bought into their scheme.
Me: So you didn't get her flowers at any other time during the year?
Client: no.
Me: and your wife loves getting flowers.
Client: yes.
Me: Well it sounds like you might need a push from the Valentine's Day corporation to get flowers to your wife.
Client, thinking it over....considering....: ah hell doc, do you think Giant has sold out of roses by now?
Me: I think you can probably figure something out.

n the spirit of Valentine’s Day and a more heightened awareness of romance; I thought that a few words on this elusive concept would be appropriate.
So, here are 5 thoughts on romance
  1.  Romance looks different to everyone.  For some, putting gas in her car is as romantic as buying flowers.  For others, cooking a meal at home in your pajamas is as intimate as a candlelit dinner.  The important thing is to know what romance means to you and to your partner and step up accordingly.  There is no need to roll your eyes at him when he gets you a card with a sweet, perhaps, cheesy sentiment inside.  No need to act bothered when she requests that you go to a restaurant that requires a tie.  This is a time to be responsive to the romantic requests of others-go for it.
  2. Romance isn’t for just one day a year.  The beautiful thing about romance is that it includes effort and desire.  Two things that everyone wants to feel they are worth.  It does not need to be grand gestures all the time, but small gestures for your partner that remind him or her that you care about them and desire them are necessary throughout the year.
  3. Romance is about intimacy  -- this can include sex but doesn’t have to.  Intimacy is that feeling you have when you are seen by another person in the most accepting and honest way possible.  It is to be known by someone, understood and embraced.  The embodiment of intimacy can range from laughing with each other until it hurts, holding each other, a simple touch, seeing each other across a room and knowing what the other is thinking, cooking a meal together, sex (in whatever form you enjoy), pulling her close while waiting in line at the market…whatever it looks like it involves engagement with another person –it is dynamic.
  4. Passion and romance are two separate things.  Romance is deliberate, an effort to elicit a desired emotional response in someone.  Passion is less organized.  Both are important and both take different types of motivation to maintain.  Passion can be cultivated by having an openness and willingness to take advantage of opportunities to engage with each other in a heightened level of arousal.  Romance can be nurtured through efforts to send a clear message of desire and love.  It is has a layer beyond affection-a hint of vulnerability in revealing your desire for another person.
  5. Every relationship needs some romance – it does not matter if you have been together for 5 years or 50.  What romance in your relationship will look like will evolve and change – this is vital.  Romance can be familiar gestures or surprising efforts – all of it is good.  The most profound impact of romance is that it makes you feel wanted.  That loving you is a choice that your partner is making over and over again.  It is feeling wanted and desired that keeps a relationship alive.  So if you know what your partner finds romantic, do that. If you don’t, ask.  Romance does not lose its meaning because you talk about it.  I have told many many of my clients that you can either be surprised or satisfied when it comes to romance, but rarely both.  So ask for what you want.  Don’t expect for your partner to read your mind and don’t expect that his desires from 4 years ago are the same now.  Make the effort and recognize when an effort is made.  Show your partner they are worth it.  
 
 

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Choosing the Right Therapist-Things to Consider

9/29/2015

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First, let me note how exceptional the person is who seeks counseling.  It can be a daunting and frightening thing to do and above all the amazing qualities my clients possess - it is their courage in making that first appointment and coming into my office that I admire most.  Knowing, both personally and professionally, how difficult it can be to initiate therapy, I wanted to give a few ideas about how to find a good match in a therapist.  This list is by no means complete, but I feel that it is a good start when entering into a therapeutic relationship.

The Initial Preparations:
Identify your needs:  It is important to be able to first identify what you are looking for in therapy. To do that, here are a few questions to consider when looking at what you want to gain from therapy.
  • What are three areas in my life that I would like to change?  
  • How will I know that things are better? - What would I see/feel/experience?
  • When did I notice things starting to slip in my life and become more difficult?  What was happening at that time?
  • What is my push to seek help now?  
  • Am I willing to give therapy a chance to help?  How much effort do I feel I can put into therapy?
  • What behavioral changes do I think will be important to make to move toward my goals?
Personal Preferences:
It is good to consider if there are particular attributes you would like in your therapist.  Some people feel more comfortable talking to one gender over the other.  Some would like their therapist to share their same religious views or at least be able to converse about religion and/or spirituality.  Some are looking for a particular therapeutic technique or approach.  Cost, location and availability are also important considerations.  

The Office Space:
There are a few things to keep in mind when you arrive at your appointment - do you feel safe in the neighborhood? Is the waiting area neat and orderly?  Is the clinician's office comfortable?  I check out the books on the shelves to see where their interests are -- I like to see up-to-date psychology journals or a few newer looking books in the office--this makes me feel that they are invested in continuing to build on their skills and keep abreast of changes in the field.

THE IMPORTANT STUFF

1.  The RELATIONSHIP between client and therapist
If you look at all the research on what makes therapy effective it all points to the quality of the therapeutic relationship.  More than technique or style.  More than any therapist attributes.  More than cost of treatment or years in practice.  This is what makes therapy work or not.  The connection you feel with your clinician will be the most important aspect in treatment.  Here are some statements that should resonate with you regarding your therapist.
  • I feel my therapist works hard to understand me
  • My therapist is on my side
  • I trust my therapist
  • I feel that my therapist cares about me and my well-being
  • I feel challenged by my therapist
  • I feel that my therapist has a plan for my treatment
  • My therapist checks in with me about how I feel treatment is progressing
  • I feel that I can talk to my therapist about our relationship
Note:  The relationship between client and clinician does not form instantly.  It is important to give the relationship a chance to develop.  Personally, I feel that you can get a pretty good gauge about a therapist within the first three sessions. You should at least feel some sort of connection at the initial session.  
Fallibility: Alas, therapists are not perfect.  We mess up.  We misread things, we have bad days, we get distracted, we have 'stuff' like anyone else and sometimes we don't do our jobs as well as we can or should.  Your therapist may fall victim to being human and it may impact your relationship.  That is a good thing!  Trust me, having a therapist that messes up can be amazing because you get to practice 'working through the rupture.' You get a chance to talk about the mess-up, how it felt and what you need and how to move forward.  So, I invite you to give your very human therapist a chance to make things better -- a good therapist is open to their own humanity and should willingly step into an open conversation about where things went wrong and how it impacted your relationship.
​
2.  Safety
You should feel safe with your therapist - both physically and emotionally. The space you are in should feel comforting, the dynamic with your therapist should feel caring and compassionate.  You need to be able to trust your therapist -- that is the only way that you can be vulnerable.  Most important, you should feel that your therapist is always working toward your best interests.  This is not to say that you should always like your therapist - because sometimes therapy is hard--and it should be. Beware of feeling too comfortable - therapy should present challenges.  Challenges to how you think and behave.  Challenges to how you view the world and yourself.  Challenges that push you out of your comfort zone - where growth happens. A good therapist can help you feel safe; a great therapist helps you feel safe taking risks.

3.  Feedback
A good clinician will always ask for feedback regarding your experience, progress and treatment planning.  You should feel comfortable asking questions about you treatment and the treatment process and your clinician should be able to answer your questions clearly.  A therapist should not get defensive if you speak up about something that you would like to change or address about therapy- it is YOUR therapy and a good therapist knows the benefits of client feedback.  

4.  Logistics
All of the logistics should be discussed at the initial session or within the first two sessions of treatment. You should know your therapist's policies around after hours contact, how to re-schedule, emergency procedures and attendance policies. You should know what your rights are as a client, what limits to confidentiality are in place, your therapist's theory and approach to treatment, costs and payment practices as well as what the clinician's expectations of his or her clients are.  Some clinicians ask that clients do 'homework' between sessions or try different behavioral experiments.  I am a big fan of between-session activities because it is very difficult for change to happen when you only devote an hour a week to it. However, it is also very important that you are honest with your clinician about what you are and are not willing to do. For example, I had a client who hated the idea of tracking her feelings every day in a journal but was willing to download an app to help her track her moods. Another client preferred to keep a music journal and downloaded songs to make a playlist of her emotions for the week.  Work with your therapist to find what fits for you.
Ethics:  A good therapist knows his or her limits.  It is unethical to 'practice outside your scope' - so, it is ok to ask your therapist what experience they have working with your types of concerns. You have every right to ask about any part of treatment from a specific intervention to a therapist's training in providing services for a particular disorder.  Your therapist should be able to provide you with their reasons for pursuing a particular type of treatment.Your therapist should be licensed - you can check on their license history through your state's board of professions. 

5.  Humor
This element is often left of the lists of important traits in the therapy room but I think it is vastly important.  
It is important to laugh.  It is important that your therapist be able to present ideas to you in a way that is engaging.  Humor should never be used at the expense of a client or their experience but it can be an excellent tool for finding insight, release and perspective.  Tears can be a means of catharsis but so can laughter.  
Finding the humor in one's situation is vital - not as a means of invalidating or dismissing the experience - but as a way to see it in its most whole form. I have found that using humor and laughter with my clients is a way to finding peace with difficult things.  While holding their experiences with compassion, laughter allows experiences to take on a new form. A form that can be easier to approach, to talk about, to understand and to accept. 

So there you have a quick guide for what to look for and look out for when choosing a therapist.  Remember, it is YOUR treatment and your comfort is important.  Trust your instincts and give therapy a chance to work for you--I absolutely believe that it can.  

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