Blog - Gitu Bhatia Psy.D.

New Year Resolutions to Enhance Relationships

Every New Year presents us with a fresh opportunity to refocus our intentions for the upcoming months, as well as to make changes to those aspects of our lives that have not been fully satisfying for us. Oftentimes, even despite our initial determination, we get caught in the business of everyday life and fail to nurture our connection with those we love and care for.

I’d like to share a few simple practices to help you maintain a healthy relationship with your spouse, partner, or loved one. My hope is that with these various “instruments,” you can start creating a toolkit that can serve to achieve greater intimacy, increase communication, and improve the quality of your physical and emotional bonds.

I hope you can make the time to do some (or all) of these, as the more you implement them, the more likely you are to feel connected.

1. Come up with traditions around holidays, birthdays, or special occasions; these should be specific to this relationship and enjoyable by both parties. For example, knitting each other scarves at the beginning of winter; having a birthday picnic, participating in a yearly race together.
2. Put aside about 10 mins each day to do a “check in” with each other. I recommend taking turns (3-5) minutes each, telling your loved one relevant experiences or observations from the day. When you are done, it is the other person’s turn. Very important: remember that there is no responding or interrupting, only listening.
3. Have a date night at least once per week. Just the 2 of you- make it something fun, enjoyable, and not so expensive that it becomes stressful.
4. Individually, keep a “gratitude journal.” Either at the beginning or at the end of each day, write down something you are grateful for; it can be as specific or as general as you wish. You do not necessarily have to share it with one another, but you may if you so desire.
5. Write a description of what you want your relationship to look like at the end of next year. If 2017 is transformational and it brings you everything you ever wanted in your marriage- how would things be different? Take a trip to the future and describe what you see/fee/experience in your ideal relationship. *This is to be done individually by each partner; you can choose to discuss your vision at any time- either now or in the future.

Lastly, enjoy one another! Remember what brought you together and the deep love that holds you. Speak up, let each other know what you need, and keep in mind that you are pretty terrible mind-readers ;)

Best Wishes for 2017!

Karyn Maczka, MA, MFTI

Integrating Spirituality Into Clinical Practice

Politics. Money. Religion. We are often discouraged to bring up these three topics in everyday conversation, as they are considered highly controversial issues in our society. Despite the fact that religion, faith, and/or spirituality are an important part of most Americans’ lives, religion has not always been viewed in a positive light within the field of psychology, and key figures in the field have expressed differing opinions about spirituality. Freud and Skinner, for example, questioned the value of religion or criticized it as harmful, while others like James and Jung held more positive, hopeful views. In recent decades, more contemporary psychologists have valued the role of religion in people’s lives, and the interest in the relationship between spirituality and psychotherapy has grown rapidly in the last 20 years. This shift is consistent with current research, which indicates a positive association between religious practice and mental health, recovery from mental and physical illness, subjective well being, and marital satisfaction.

Moreover, psychology professionals have begun to consider the ability to work with client’s religious and spiritual beliefs a form of cultural competency. Not only is it important to learn about client’s ethnicity, language, race, age, sexuality, and past history, it is equally valuable to understand an individual’s relationship with religion and how she/he experiences spirituality. Unfortunately, studies show a trend indicating that many clinicians are not comfortable exploring such areas while conducting therapy, since therapists receive no or minimal training, supervision, and coursework that present spirituality as an important element in therapy. Spirituality can manifest in people’s lives, and hence in the therapy room, in a variety of ways. Many people who seek help for physical, emotional/psychological, or interpersonal problems are also experiencing spiritual distress. In some cases, devastating events can bring one’s faith into question and even alienate some from their faith. In yet other instances, religious values can become too rigid, resulting in a punitive, harmful experience by the believer. However, spirituality can also be a source of incredible healing power form which individuals draw strength, inspiration, and meaning. As others in the field have suggested, most people across faiths consider their spiritual beliefs to bring them closer to loved ones, solve problems, respect themselves and others, refrain from doing undesirable things, help others in need, and find healing. Spirituality offers options for solutions to clients’ struggles. It also facilitates finding meaning in the human experience, as well as offers answers to often difficult conundrums. In addition, studies have asserted that spirituality provides motivation to remain committed to love in the face of a partner’s flaws; it gives purpose and significance to the passing of a loved one; and that spirituality offers a consistent morality that can serve as a stabilizing guide to those facing difficult circumstances.

Spiritual expression can be seen in many different forms, through religious as well as secular practices. Personal faith may involve belief in a higher power, a divine spirit dwelling in all things living, or an ultimate human connection for which we strive. While religious spirituality may involve attending a church/temple/sanctuary, praying, ceremonial milestones, rituals, etc., atheist/agnostic practices often include meditation, creative arts, chanting, a connection with nature, social activism, and interpersonal bonds.

While incorporating spirituality into clinical practice can enhance therapy, there are some precautions of which therapists who wish to do so must be aware, such as exploring our own spirituality and creating an open and safe space for spiritual discussions. Also, it is important to refer clients when appropriate, and to be careful about imposing one’s own beliefs and values or simply ignoring the client’s beliefs. In addition to respecting every client’s particular ethnic, cultural, and religious practices, we as therapists can expand our own knowledge by seeking training and doing further research. These steps will be key in assuring an adequate level of competence. It is critical not to make assumptions about clients’ spirituality, religious identification, upbringing, or community affiliation. Instead, we ought to strive to understand the individual experience of a client’s spirituality. In doing so, studies have suggested some guidelines: to respectfully inquire about the meaning of spiritual practices in clients’ lives, particularly as they relate to the presenting problem(s); explore religious/spiritual beliefs that may contribute to an individual’s suffering; facilitate understanding and mutual respect among families and couples facing spiritual conflicts; and identify different resources to increase resilience and facilitate healing.

Research demonstrates that secular, as well as religious counselors are integrating a spiritual element into therapy. The approaches can range form implicit to explicit integration. Implicit integration may occur when a counselor’s views and interventions are influenced by her own spiritual beliefs, yet they are not discussed with the client. A clinician may also engage in prayer and/or meditation prior to sessions. During explicit integration, on the other hand, the clinician may openly address a client’s spiritual beliefs, discuss spirituality as an element in the therapeutic process, or use overt spiritual tools such as prayer and meditation with her client.

Given the new trends, social changes, and increasing openness of both clients and therapists to integrate religious/spirituality elements into the therapeutic process, the field of mental health must continue to adapt and incorporate spiritual elements into both therapeutic interventions, as well as clinical training programs. While many clinicians recognize the need to delve into issues of spirituality and religion as part of clients’ presenting circumstances, we don’t always know how to do so in a way that is supportive and nonjudgmental. In light of widespread racism, faith intolerance, and mass discrimination inside and outside our country, it is imperative that we as clinicians equip ourselves with the tools and skills to engage in courageous conversations about such issues that affect all of us. Mental health professionals face an ongoing responsibility to make clinically appropriate decisions that serve our clients and enhance the therapeutic process. However, clinicians may struggle to balance our clinical judgment with newly emerging ethical, social, and moral responsibilities that arise as society continues to become segmented by ideological differences.

Karyn Maczka, MA, MFTI.
Registered Marriage and Family Therapist Intern #81717
[email protected] Ph: (858) 761-7121

Spiritual Healing after Divorce

Divorce and separation have all kinds of legal, financial and emotional consequences. One aspect of divorce that is not often talked about is the spiritual consequence experienced by the family members. It is safe to say that for many, divorce is a legal dissolution of a religious or a spiritual contract. For many people, raised with strong religious beliefs, the decision to divorce brings up feelings of guilt, shame, and a sense of failure.

Of late, many distinctions are made between religion and spirituality. Generally speaking, spirituality is described as a more personally chosen and an individual experience compared to religion. Religion may or may not be chosen by one, and tends to be a more collective experience that is guided by texts or leaders. While religion and spirituality bring up inner conflicts and question your faith, these beliefs and values can also be helpful in getting through one of the most difficult times in people’s lives. Although in this country we support the separation of church and state, in reality, religion often frames our view of right and wrong and a sense of fairness and justice, and needs to be addressed for healing and growth for all members of the family.

Spiritual healing can take many forms. Here are a few ways of making room for the spiritual and emotional healing after divorce:

1. Finding support of a religious leader/guide who understands your situation may be helpful in getting through this difficult part of your lives with compassion, forgiveness, and room for healing…

Read the article:

7 Ways to Make Room for Spiritual Healing after Divorce

by Gitu Bhatia Pys.D. on Divorce Magazine

5 Tips for Keeping Your Emotional Thermometer Cool While Co-Parenting During the Holidays

Going through a divorce brings up intense emotions in families, but going through a divorce during the holidays brings up even more intense feelings of sadness, guilt, regret, and anger. The true spirit of the holidays of love and kindness can easily be lost while one is flooded with negative emotions. It is really important to remember what holidays mean to children and to extended members of the family…

Read the article: 5 Tips for Keeping Your Emotional Thermometer Cool While Co-Parenting During the Holidays http://www.divorcemag.com/blog/emotional-thermometer-cool-co-parenting-during-holidays

What Time Is It?

We usually find ourselves asking this question when planning some portion of the day ahead. We need to reach our destination by a certain time or finish an assignment prior to its deadline. Perhaps we ask ourselves this question rhetorically after spending hours doing “nothing,” only to begin hurriedly arranging the time we have left in the hope of shortening our to-do lists. Undoubtedly, we have all devoted innumerable hours to reminiscing about past experiences (both comforting and regrettable); and likewise, we both wonder and worry how the future ahead of us will unfold. So many times each day do we check the time: Two o’clock? Half past five? Quarter ’til? We find these among myriad other responses to our question, and yet all of them are quite misleading!

Certainly scheduling our time according to days, hours, minutes, etc. enables us be productive, efficient, and make sense of the sequence of events we expect to happen in the coming moments. However, viewing time through this lens obscures the most fundamental answer to our question: What time is it? The time is… Now. If you imagine a watch without hands or marks and in their place the word “now,” that watch will always be correct—regardless of time zone, hemisphere, or position of the sun. It is always now. Now is here, and it has been now every moment of your life.

Beyond calling into question the appeal of upscale timepieces, the reality of now offers a renewed perspective on the reminiscing and worrying we do. Dwelling on misfortunes of days past and fearing future catastrophe often leave us feeling helpless and afraid, as they prevent us from being truly present and taking action in the only moment that matters—now. Likewise, many of us avoid such emotions, albeit temporarily, through obsessing, day dreaming, procrastinating, and a host of other strategies. Eventually, this vicious cycle can lead to feeling overwhelmed, depressed, and powerless to handle tasks that once seemed easy—prompting many to seek professional help. What remedy can we offer our clients? Better yet, what can we
do for ourselves?

It is my view that Mindful living and regular meditation offer a wonderful method of remaining in the now, confronting uncomfortable feelings, and tackling life’s challenges effectively. Simply put, mindfulness is paying attention to the present moment, on purpose, and without judgment.

It emphasizes an awareness and acceptance of this moment, of now, whether it brings discomfort, gratification, pain, joy, or anything in between. This may seem counterintuitive, and yet those who practice mindful living describe a renewed sense of presence and a willingness to engage with the ups and downs of life. One might say living in the now fosters resilience, a sense of wellbeing, and openness to life. So the next time you find yourself glancing at your watch, check in with yourself; remember that you are, and always will be, right here right now.
– Kenneth S. Skale, M.A.

Befriending Technology… and making it work for you!

It is not just kids who are constantly plugged into their devices anymore. We all have replaced so many things in our lives with smart phones and tablets. Not only does technology let us access the world wide web, it helps us navigate geographically, make and maintain connections through social media, and keep our hectic social and professional lives in order. People are now more likely to get news and information via technology than books and newspapers. Divorceworks App

My colleague, Dr. Linda Bortell, and I have joined the 21^st century movement and have developed an app for people going through divorce.

As many of you know, I have spent the last 30 years working with families going through this painful transition, and in the process I have learned a lot about how to help soothe and manage the negative feelings and teach those involved how to care for themselves and their children.

Many people never seek the help of a therapist, but instead suffer in isolation and subsequently find it hard to navigate this difficult journey alone. This app is a private self-help tool to help individuals understand, monitor and manage the wide range of emotions that people find themselves feeling during divorce. We have found that therapists and attorneys are making it a vital tool they recommend to help their clients through the process. We called it DIVORCEWORKS because you CAN make divorce work!

Remember to recommend it to people who may need some hand holding through technology…

Why do we procrastinate?

There has been a long gap between my postings on this blog. I apologize to some of you who have encouraged me to write. Like many of my readers, I have been struggling with procrastination. I have decided to work through this personal challenge by learning more about it and sharing what I know, what I am learning, and how I plan to beat it.

There are many valid reasons for most of us to procrastinate and not all of us are chronic procrastinators. By definition, procrastination is a habit of putting off urgent tasks for less urgent, and perhaps more pleasurable, tasks. As a consequence, procrastinating leads to feeling disappointed, disappointing others, self-criticism, added stress, and feeling a sense of failure. It is not surprising that procrastination and the resulting feelings lead to more procrastination and more negative self-appraisal. This vicious cycle has a tendency to feed on itself and grow exponentially.

Personally I have used all the valid excuses for putting off things. The “I am so busy”, “I am not in the mood”, or “others need me” have been explanations that soothe some of the nagging negative feelings some of the time. However, it is hard to convince the inner, more knowing, self that there is a clear gap between the intention and action.

Eric Jaffe, in an article titled, “Why Wait? The Science Behind Procrastination”, explained some theories and research to better understand this concept. Most evidence shows that the consequences of choosing temporary pleasure over finishing important work costs us emotionally (sense of well being), physiologically (stress that translates to physical changes) and sometimes financially (work output and productivity). Intuitively we would think that suffering these consequences would teach us to do things differently. However, the reason we procrastinate, in the first place, is that we are drawn to avoiding pain in the form of boring, hard or demanding work, and tend to seek relief by playing Words with Friends or watching mindless TV (not necessarily pleasure). It turns out that the solution to overcoming these challenges is learning to tolerate negative feelings and having the skills to regulate our emotions rather than taking the easy way out.

To unlearn old patterns and learn new ones, we need to have a good talk with ourselves about our core values. Personally, I value the present time and feel grateful for the opportunities I have been afforded. Just articulating my values helps me view procrastination in a different light. “Procrastination is really a self-inflicted wound that gradually chips away at the most valuable resource in the world: time.”(Psychil, 2000). Clarifying our values is only the first step. An important next step is to have a plan that works and allows us to feel successful and motivated.

There are specific strategies to beat procrastination. Like with any behavior modification plan, we need to start with truly assessing the problem. Ask yourself the following questions: How big is this problem? When does it occur and what is most likely keeping it going? What has helped you overcome this problem in the past? What, and who, has helped you solve the problems in the past? BTW, I am a firm believer in engendering support of family and friends. Once you have these questions answered, set a goal for yourself that is relatively easy to accomplish and makes you feel successful. Remind yourself that you have the capacity to cope with the anxiety and discomfort that you had been avoiding. Reward yourself when you complete this task (pats on the back from your supporters always help) and set another goal. Before you know it, you would have reversed the vicious cycle of procrastination, like I did.

Lastly, to make any kind of changes in our lives and move forward, it is important to learn to forgive and not beat ourselves up. Putting yourself down for procrastinating is a waste of time!

Simplifying and Optimizing our lives with TLC:

Therapeutic Lifestyle Changes.

Most of us think of TLC as Tender Loving Care. These letters conjure up thoughts and feelings of nurturance towards our loved ones. However, most of us don’t always associate TLC with caring for ourselves. A recent edition of the American Psychologist, a reputed publication of the American Psychological Association, addresses this very issue in great detail.

Roger Walsh, Ph D, MD, did a comprehensive review of research, spanning the last few decades, and concluded that “Lifestyle changes can offer significant therapeutic advantages for patients, therapists, and societies, yet are insufficiently appreciated, taught or utilized,……….in the 21st century, therapeutic lifestyles may need to be a central focus of mental, medical and public health.”

The best part of these recommendations is that they are inexpensive, are known to treat multiple physical and emotional pathologies and preserve and optimize social, psychological and cognitive well-being (Walsh, 2011). The simplicity of these recommendations is contrasted by how difficult these are to implement in our lives. The tendency to use pills and rely on external sources of gratification is universal, specially, since we continue to be bombarded by commercials highlighting the values of these magical remedies. Unfortunately often medical and mental health professionals, also subject to the same socio-cultural influences of this fast paced and consumer driven society, underestimate and underutilize the following lifestyle treatments:

Exercise not only helps people feel better by reducing anxiety and depression. It can help children do better in school, improve cognitive performance in adults, reduce age-related memory loss in the elderly, and increase new neuron formation in the brain.

Diets rich in vegetables, fruits and fish may help school performance in children, maintain cognitive functions in adults, as well as reduce symptoms in affective and schizophrenic disorders.
Spending time in nature can promote cognitive functions and overall well-being.
Good relationships can reduce health risks ranging from the common cold to strokes as well as multiple mental illnesses, and can enhance psychological well-being dramatically.
Recreation and fun can reduce defensiveness and foster social skills.
Relaxation and stress management can treat a variety of anxiety, insomnia, and panic disorders.
Meditation has many benefits. It can improve empathy, sensitivity and emotional stability, reduce stress and burnout, and enhance cognitive function and even brain size.
Religious and spiritual involvement that focuses on love and forgiveness can reduce anxiety, depression and substance abuse, and foster well-being.
Contribution and service, or altruism, can enhance joy and generosity by producing a “helper’s high.” Altruism also benefits both physical and mental health, and perhaps even extends lifespan. A major exception the paper notes is “caretaker burnout experienced by overwhelmed family members caring for a demented spouse or parent.”

Aiming to implement all these changes can be overwhelming and time consuming. Perhaps tackling one change per week can be more realistic. However, inviting friends and family to join you in making these changes can address a few of the therapeutic lifestyle changes, ex, improving relationships and taking care of others.

Inspired by: Walsh(2011) Lifestyle and mental health. American Psychologist, 66(7), 579-592.

Web link to summary of the article: http://www.apa.org/news/press/releases/2011/02/beyond-tlc.aspx

Importance Of Play In Our Lives

Games and play have been a part of all cultures. Besides being a source of amusement and joy for young and old, they seem to have a significant role in socialization of young people and a means of social interaction for people of all ages. This was clearly evident during the recent frenzy of the World Cup. All boundaries of race, religion, class, caste and even political ideologies, were set aside to a common goal. Psychologists, educators and sociologists have long known that play is an essential way for children, and adults, to learn about themselves, their world, and the concept of rules in life. The use of play makes learning easier, transforms relationships, and creates a climate of mutuality.

Lullabies, nursery rhymes, peek-a-boo, bouncing on the knee, etc., make way for more imaginative and interactive play as a baby grows. Development of language, recognition of faces and facial expressions, and social skills are naturally developed through these activities. As the baby grows, the increasing cognitive and physical development allows for more complicated games that incorporate more complex rules and physical activity, from using gross motor skills to fine motor activities.

Bring to mind little children who take delight in playing with a string, an empty box, a noisy rattle, or just about anything. The reason we think of this activity as play is the delight visible on their faces. This kind of play does not need to involve another person. As the child grows older, he or she finds that delight in sharing activities with others. The developing brain allows imagination to bring even more choices to the use of the string, an empty box and a noisy rattle. Play becomes more complex and ingenious games are invented. Games and play become more complex and competitive as children get older.

While children are having fun, they are also learning about rules and order of things in the real world. Some games are about luck and chance while other games require strategizing. Some games require strength and endurance while other games require fine motor skills and finesse.

In the present times, physically challenging games and interactive play have been replaced, to a large extent, by more solitary play in the form of video games. Even when these games are interactive, the social interactions tend to lack some important ways of learning about feelings of others, i.e., reading the facial reactions of your opponents, sensing the emotional consequences of winning or losing. The greater loss, to children and adults playing these sedentary and solitary games, is the lack of physical activity and fewer opportunities to let off steam and engage with others in physical activities. There is growing recognition that a natural consequence of social networking and interacting on the internet may result in an impairment in empathy for others as evident in the increasing incidences of bullying in schools and cyber bullying.

Body image and a healthy sense of self

We live in a world that values appearance. Whether we like to admit it or not we form our first impressions based on very superficial features. Some of us are able to look past what is on the cover of the book and look inside for it’s true value. Others remain preoccupied with the cover and buy into the advertised message.

So when does this preoccupation with body image and appearance start? From a developmental perspective, until children are preschool age, a child’s self esteem is almost entirely based on how they are treated by their caregivers, or family and friends, with whom they come in contact. Even exposure to media at this age does not have the negative impact it has later on as children’s growing cognitive abilities expand to see themselves as separate individuals from others. In the magical early years of childhood, children may even believe, when they play dress-up, that they are truly transformed into the costume they adorn.

Then children start kindergarten, and elementary school, and the feedback of others and socio-cultural biases reflected in the media start to impact self -esteem in positive or negative ways. Seeds of body dissatisfaction, disordered eating and full blown eating disorders get planted during these years. Although only a small percentage of people end up suffering from Anorexia or Bulimia or serious eating disorders, a large proportion of young girls and women, in this culture, suffer to some extent from dissatisfaction with their bodies, distorted body image and have disordered eating. Not surprisingly, but to a lesser degree, men are becoming increasingly dissatisfied with their bodies. A study in the British Journal of Health Psychology, on parental influence on dieting awareness in young children concluded, “The negative self comparisons to unrealistic images portrayed by media are not just a female issue anymore. A substantial proportion of young children have internalized societal beliefs concerning the ideal body shape and are well aware of dieting as a means for achieving this ideal. In particular, the desire for thinness emerges in girls at around age 6.

Although it seems alarming that most children are exposed to dieting parents and almost all children are exposed to popular media, there are a good number of children who seem to escape this pressure and grow to have a balanced and healthy sense of self that is not wrapped around their appearance alone. There are some protective qualities that can be encouraged in children, at a young age, to allow for development of a healthy self image.

As a society, we believe that increasing knowledge around any issue, helps prevent large scale problems like AIDS, drug abuse, drinking and driving etc. In reality these simple measures to educate have a very small impact on changing behaviors. It does not help build coping skills. It tells us what not to do without providing tools to cope with the pressures of real life. In building a healthy sense of self, “just say no”, does not seem to be a helpful approach.

On the other hand, helping children become better consumers of media is a very effective way of building resistance to societal pressures. Children can be taught critical thinking skills in simple every day situations like on their trip to the supermarket. The beautiful displays and packages communicate the glories of products, where as the product may or may not match up to the claims. Having children experience the “spin” first hand is a meaningful way of using their own instincts rather than “buy” into what is being “sold” to them. These messages can be brought to their attention with commercials, movies and even news sources. In all these small ways, children can learn that the vastly unachievable images projected by media are unrealistic and even harmful.

Another very important way for parents to be supportive of the healthy development of their children’s self esteem is to ensure that they are never teased for the way they look. People with eating disorders often report that the seed of body dissatisfaction was planted when they were teased or heard a devastating remark from someone significant in their lives, generally at a young age. Students of gymnastics and ballet are specially at a higher risk for weight and body size related remarks.

Unfortunately as a society, in placing such a high value on thinness we don’t honor the natural diversity in shapes, sizes and skin (and hair) color, on the other hand have one of the highest proportion of obese children and adults in the world. Perhaps some amount of education on healthy life style is needed at all ages.

A few things that parents can actively do to vaccinate their children against unhealthy body image:

Model a healthy and balanced emphasis to internal and external qualities by praising children for their work, effort and internal qualities with how they look. We have all heard comments that reflect the double standards of our socialization; girls hear “you look so pretty” and boys hear “you throw like a champ”.
Try to avoid social comparisons and judgements about others. It helps weaken peer pressure.
As much as possible, watch movies and TV shows with your children so you can use the teaching moments that invariably come up. It helps children know your values more explicitly.
Discuss their role models with them. Often parents are surprised that they are their children’s role models and not the popular movie or sports figures.
Avoid using terms “I was BAD” when you eat french fries or a decadent dessert. The terms “healthy” or “unhealthy” usually convey a sense of responsibility to self than “good or bad”.
Helping children expand their vocabulary of feeling words. Food often serves as an expression of emotion in the absence of open communication.

These are some warning signs that seeds, of destruction of a healthy body image, have set in:

Picky eating (obsessive concern about weight, calories, or a certain part of the body).
Possession of diet pills, laxatives, diuretics.
Excessive exercise or dieting.
Evidence of bingeing and/or vomiting.

Parents often feel the need to praise and compliment their children to foster a positive self esteem. In reality a healthy sense of self is only ultimately achieved by real accomplishments and not empty praise. Children, and adults, need opportunities to discover who they are and become aware of their strengths in a loving and supportive environment.