Filtered by author: Jeremiah Gibson Clear Filter

Death and COVID-19

What I've noticed during the pandemic are regression, difficulty maintaining differentiation, and a return to unhelpful and undermining defenses. I've been exploring existentialism, object relations, and assumptive world theory in my clinical practice and here is what I've found.

Many of the family systems I work with have never explored their mortality. Death is also symbolic of socioeconomic ruin for many. The fear and grief of these potential realities is rarely shared with one's partner(s).

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Parenting during COVID-19

Parenting differences may be especially highlighted at this time because for many of us, there's no escape from the daily grind and everyone's emotions are heightened. Whether you are parenting teens or young kids, I want to provide some suggestions on how parents may better support one another.

Can you and your partner find value in one another's parenting styles or perspectives?  

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Peer Support Groups

When I read that NEAFAST is organizing a peer support group online, I was intrigued and excited. I thought, "This is exactly what I need at this moment."

My experience through the years with different support groups, both in the US and overseas, was positive and enriching. It helped further my clinical learning, combat professional isolation, and make friends. I could write on and on about how beneficial, on so many levels, peer support groups are, and also how challenging they can be to sustain.

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Space and COVID-19

Welcome to my new office!

I live with two roommates, one of whom is also working from home, and the confidentiality requirements for our work means that I am relegated to my bedroom. My queen size bed, which takes up the majority of my room, serves as my desk, my chair (or lounging space, as sitting without back support can be uncomfortable after awhile), and, well, my bed where I sleep.

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All the Grief That Hasn't Been Grieved

Following the Paris terrorist attack in 2015, I had a conversation with a group of colleagues about how public tragedies provide humanity with permission to grieve.

In these events, we collectively grieve our immediate losses, the collateral damage, and all that damn heartbreak—which may or may not be linked to the precipitating tragedy.

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Social Distance Birthdays

Today is my birthday.

And I'm celebrating it similar to the way soccer star Dele Alli, pictured left through his Instagram feed, celebrated his last month. Social distancing.

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Hope in the Time of COVID-19

NEAFAST member Ann Vasey sent this quote from Howard Zinn. May this give us hope and encouragement in the time of COVID-19.

"To be hopeful in bad times is not just foolishly romantic. It is based on the fact that human history is a history not only of cruelty, but also of compassion, sacrifice, courage, kindness.

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What Are You Noticing During COVID-19?

What are you noticing during COVID-19?

What is going on in the lives of your couples and families? What relational trends are you observing?

How are you noticing that the increase in teletherapy and trauma work during the time of COVID-19 is impacting your own relationships, both with others and yourself?

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Trauma Bingo

In response to the collective isolation of the pandemic, COVID-19 has inspired a different sort of community building. While physically separate, people are reaching out in new and creative ways.

Last week, I had a virtual reunion with my roommates from college, which we probably would not have organized during "real" life. I also have an active group text with several of my friends, in which we check on each other daily in order to provide as much support as possible during such a stressful time.

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Taking Charge: What Works

The following reflection on advocacy is written by Mary-Jane Beach, secretary of the NEAFAST Board. For more information about joining the NEAFAST Board of Directors, please email [email protected]

I remember that in the mid-1990’s, I was working with families, often after school and evenings. I had two children and never seemed to have enough time. Some of the families had various negative and pejorative labels: dysfunction, multi-stressed, multi-problem.

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The Value of Joining NEAFAST

The following is written by Mary-Jane Beach, secretary of the NEAFAST. For more information about joining the NEAFAST Board of Directors, please email [email protected]:

At this stage of my career, I realize that MFT’s from Massachusetts have been there for me. First it was SFTR (Society for Family Therapy and Research) in the 1970s in Boston. There were workshops, supervision groups, and training programs available. Later it was an MAMFT mentoring group where I had individual and group support to develop a practice and a niche. Then there was advocacy and a focus on licensure and eventually vendorship. I learned to advocate and testify at the Statehouse thanks to the leadership of the Massachusetts Chapter. Knowing it was important to give back, yet still challenged by children, travel, and time I joined the MAMFT Board, and naïve as I was, became Treasurer. I learned to use accounting software, began to understand how National Organizations and Chapters functioned, met colleagues from around the state, and participated in local networking activities. 

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Reflections on the Ambulatory Care 1

Last month, we wrote a blog post about the collaborative efforts of the Executive Office for Health and Human Services (EOHHS) as they help create processes that improve access to quality behavioral health care in our state. Quite a few NEAFAST members have attended these meetings and provided input, including Stuart Moskowitz, a licensed marriage and family therapist (LMFT) in the Worcester area. The following are his reflections from a listening session meeting in Worcester


 

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Improving Access to Therapy in Massachusetts

How do your clients find out about your practice? How do you receive information about your own therapists?

A Google search of "couples/family therapy" and (insert location here)? Psychology Today? Word of mouth?

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Narrative Therapy in Practice

The Narrative Therapy Initiative is hosting two separate trainings next weekend in Beverly. On Thursday, 4/25, Suzanne Gazzolo, PhD, and Matt Mooney, LICSW will give you a taste of the process and power of narrative therapy in their 6 hour workshop "What is Narrative Therapy?". On Friday and Saturday, 4/26 and 4/27, Suzanne and Matt will offer an intensive, skill-based training, "Narrative Therapy in Practice". For more information on these conferences, including cost and location, please check out the Narrative Therapy Initiative website.

NEAFAST had the honor of interviewing Suzanne and Matt about their experiences with narrative therapy.

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We Do: A Book Review (part 3)

This is the third of a four part series of Stan Tatkin's new book, We Do: Saying Yes to a Relationship of Depth, True Connection, and Enduring Love. This portion involves how Tatkin addresses sexuality, substance use, and infidelity. A special thanks goes to Peter Jones, EdD for writing this series.

In We Do, sex, with its intensity of contact and proximity, is presented as a potential psychobiological minefield, fueling the troublesome triad of communication, perception and memory. Because “in the psychobiological world partners repeat the same mistakes everywhere, regardless of the situation,” what goes wrong in sex is predictable from trouble in other areas.  

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We Do: A Book Review (part 4)

This is the fourth of a four part series of Stan Tatkin's new book, We Do: Saying Yes to a Relationship of Depth, True Connection, and Enduring Love. A special thanks goes to Peter Jones, EdD for writing this series.

Some users may object that Tatkin’s vision calls for relationship relentlessly up close. They may prefer a vision of relationship with more distance and independence.

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The Intersection of LGBTQ and Aging: An Interview with Jane Fleishman

The Massachusetts Society for a World Free of Sexual Harm by Youth (MASOC) is hosting its annual conference, Preventing Sexual Violence through Assessment, Treatment, and Safe Management, on April 3-5 in Marlborough. The MASOC Annual Conference is an NEAFAST-supported continuing education event; LMFTs in Massachusetts can use CEs from this conference toward their biannual continuing education requirements.

Jane Fleishman, PhD, is presenting a workshop called "Queering the Lens on Sexuality Education: How to Create a More LGBTQIA+ Inclusive Program". Jane is a certified sex educator and has her doctorate from the Center for Human Sexuality Studies at Widener University. Check out her Ted Talk: Is It Okay for Grandma to Have Sex? Lessons from an Aging Sexuality Educator.

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We Do: A Book Review (part 1)

This is the first of a four part series of Stan Tatkin's new book, We Do: Saying Yes to a Relationship of Depth, True Connection, and Enduring Love. A special thanks goes to Peter Jones, EdD for writing this series.

In We Do, Stan Tatkin sets out a conception of successful relationships, what gets in the way, and what couples need to know to prevent and repair trouble.

With no lack of books on the market seeking to help couples, We Do is a significant contribution for its solid grounding in current neuroscience and attachment research, and Tatkin’s flair for making that research accessible in fresh language while articulating a rich model of successful relationship.

Tatkin offers readers a binocular perspective on relationships: one lens focusing on agreements, principles and social justice; the other lens focusing on automatic psychobiological (body/brain) wiring that can undermine couples’ best intentions. The binocular depth that results sheds new light on key areas of couples’ difficulties such as sex, fighting, and betrayal, while generating new strategies solutions and tweaks to handle them.

Tatkin argues that couples’ best chance at enhancing their survival in a dangerous world, and from there to thrive, is to adopt a model of relationship as “secure functioning”. We Do is a thorough exploration of secure functioning, what it looks like across lifecycle phases in a couple relationship, and how it can be unintentionally undermined.

Simply put, secure functioning couples learn who they are, including how they are shaped by their earliest experiences, know what they are doing together, what they agree to, how to collaborate on making changes, and how to minister to each other when in distress.

To do this well Tatkin helps couples collaboratively create explicit, shared “principles of governance” based in values such as fairness, justice, sensitivity and reciprocity. A variety of clarification exercises support users in exploring what the explicit underpinnings of their relationship are and agreeing to what they should be.

Success in secure functioning may be based in agreements but requires a sharp eye on how implicit human psychobiological wiring, especially the nervous system, either supports or undermines their collaboration.

Tatkin’s skill as an educator and writer shines in his ability to set out the complexity of this neuroscience and attachment challenge in fresh language. He grounds his exploration in the importance of grasping the “troublesome triad” of memory, communication and perception.

Memory stemming from our prior relationships, beginning in childhood, is our main resource for managing the present, and without awareness and skill, history will repeat itself.

Communication is necessarily partial and easily misleading, leading to compounding errors in perception if uncorrected.

Compounded errors in perception lead to compromised affect and arousal states, with partners increasingly seeming threatening to each other without intending it. In conditions of even low-level threat, collaboration and alignment with agreements and shared visions is compromised.

Thus, the job for couples is two-fold, with a need to explore and develop explicitly their shared vision on one hand, and on the other to watch for how their minds, bodies, and brains can play tricks on them.





















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We Do: A Book Review (part 2)

This is the second of a four part series of Stan Tatkin's new book, We Do: Saying Yes to a Relationship of Depth, True Connection, and Enduring Love. A special thanks goes to Peter Jones, EdD for writing this series.

Drilling down to reveal how the troublesome triad of memory, communication, and perception plays tricks on us, Stan Tatkin devotes several chapters of We Do to our mostly implicit, mostly automatic psychobiological systems, which are by default expert at detecting threat and waging war.

Tatkin lays out the architecture of systems with a variety of simplifications, many familiar by now to therapists but less so to other users. Crucial to managing the war are emotional and arousal (energy) regulation, a spectrum of attachment styles, the nervous system’s fight, fight, freeze and collapse responses, the window of tolerance, and not least, the negativity bias, an overarching tendency for the brain to lean negative and store negative memories, weighting psychobiological systems towards ever finer perceptions of threat.

Tatkin shows how reliance on automatic functioning, on board since early childhood, can lead to partners attributing intentions to each other that are the residue of unreflected, memory-based functioning in real time.

Real time is too fast, Tatkin says, limiting error-correction of inaccurate perceptions by the higher cortical areas of the brain. Vignettes illustrate the functioning of these system in interactions couples are all too likely to recognize. Corrective vignettes show how couples might handle those situations in light of each other’s implicit wiring.

Crucial to error correction is coregulation, the capacity of partners to both take their partners’s nervous systems into account and make adjustments. Fast remediation of old responses, potentially rewiring for secure functioning, is possible with a renewed, better informed effort to coregulate. Failing to respond appropriately to the other’s state through coregulation, partners can easily spin out and begin to seem threatening and predatory to each other.

Tatkin offers secure functioning as the couple’s necessary antidote to the inevitable specter of threat, which all relationships must learn to manage. A relationship is secure functioning when couples can keep threat limited enough to support cooperation and collaboration on realizing their shared vision of relationship.    

The practical value of the binocular approach pays off in extended treatment of areas of perennial difficulty for couples such as sex, fighting, and betrayal.

For fighting, Tatkin leads with the secure-functioning directive that partners must learn to “take care of their partner and themselves at the same time.” This simplification is countered by the psychobiological limitations that come into play in a close relationship: the negativity bias coupled with attachment insecurities, each leading to coregulation difficulties.

The physiology of vision complicates matters and is crucial to understand; the depth of Tatkin’s approach is perhaps best exemplified in his treatment of the importance of visual coregulation during fighting.

We only see clearly out of the center of the eye, the fovea, which is the size of a pinprick; we are effectively legally blind to the side. Since we don’t have a clear visual stream coming from the side, if our partner is to the side  the amygdala will fire more often, prepping for threat. The brain, angling towards negativity and in the absence of eye-to-eye visual coregulation, will fill in the blanks of the visual stream based on memory.

If partners get into a difficult topic and don’t have a rich enough visual stream, while driving, for instance, they are more likely to misinterpret partner’s responses, introducing errors. Without crosschecking what they are hearing with clear and steady visual cues, which would allow them to respond to partner distress fast enough, couples may find these errors compounding, leading them to square off, undermining collaboration.

Difficult topics must therefore be worked through face to face and eye to eye, not pointed toward the TV, the wall, the road, or even the therapist. While face-to-face, couples are urged to focus on one difficult topic at a time, and to not hold the floor too long; with rising stress, the nervous system is undersupplying oxygen and glucose to the higher cortical areas of the brain, making it hard to stay in the listening position long. None of this allows couples to correct errors in perception quickly enough.

Couples may thus find that the knowledge of psychobiology supports their capacity to structure and manage better difficult discussions to fuel their partnership.























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Meet Our Board: Katherine Manners

NEAFAST is a professional organization with a volunteer board of directors. The Board of Directors provides guidance and vision for how NEAFAST meets its goals of supporting quality training and practice of family and systemic therapy. Our board members have a diverse set of professional and personal interests, which contributes to the development of an organization that seeks to systemically address the needs of therapists in Massachusetts. In the initial installment of our series Meet Our Board, we introduce you to Katherine Manners, LMFT.

For over 30 years, Katherine has worked in the field of victim services. She began her career as a volunteer in a domestic violence shelter, which led to many years working in the new field of victim advocacy for the Middlesex District Attorney’s office. From there she obtained her M.Ed. in MFT from UMass Boston and went to work providing traumatic bereavement therapy with family members of homicide, developing and leading several programs in Roxbury, Cambridge and Boston including hospital and community-based agencies.

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