The AAMFT Blog

CEO Statement on Children in U.S. Care

Marriage and family therapists are professionals who dedicate their lives to the well-being and health of families. As an association, AAMFT is committed to positive family policies that affirm the ability and responsibility for dependent care, responsible nurturing of children, and the ability to provide for dependents' basic needs. Recent reports of children in U.S. care being held in unsafe and potentially traumatizing conditions directly contradicts this commitment of our profession. Fundamental rights to basic needs, safety, and security for children is not a political issue but rather one that we as an association believe is a commitment that our society should strive for every day to support families as its most basic institutions.

AAMFT urges immediate action be taken to ensure that children and families in U.S. care be provided with these basic necessities essential to protecting their long-term well-being. As an association we will continue to seek out opportunities via our coalitions and partnerships with other mental health associations to honor our commitment to ameliorating challenges to relationships and emotional and mental health within the context of family and larger social systems.

 

Tracy Todd, PhD

CEO, AAMFT

Post-Traumatic Stress Disorder

Most of us have heard about Post-Traumatic Stress Disorder (PTSD).  Once referred to as shell shock and combat fatigue, PTSD is often associated with combat veterans. And while it is true that veterans are subject to both, it is something that can happen to anyone.

One is at risk of developing PTSD when exposed to one or more event(s) that involve or threaten death, serious injury, or sexual violation. You may experience an event directly when it happens to you or indirectly by witnessing it.  And in some cases, the trauma develops from repeated exposure to the details of a horrific event.

We live in a world where acts of terror and constant media happen, leaving us vulnerable to the paralyzing symptoms that come with PTSD. The anxiety that affects those who suffer is overwhelmingly stressful. It is an acute reaction to severe trauma. And, because we are wired to survive, any threat will activate the fight, flight or freeze response as a way to cope with it.

Effects of PTSD

PTSD can be a deeply distressing and disturbing experience, physically and emotionally. The statistics on PTSD show that 70% of adults in the U.S. have experienced some traumatic event at least once in their lives. Of these people, 20% go on to develop PTSD, and women are twice as likely to develop PTSD than men.

Those who have PTSD have deep, disturbing thoughts and feelings long after their traumatic experience or experiences have occurred. Many people living with PTSD, report having flashbacks, nightmares, sadness, fear, and anger. Some people become easily startled and feel on edge in response to loud noise or an unexpected gesture that can trigger trauma.

According to the American Psychiatric Association, symptoms of PTSD fall into four categories and can vary in frequency and intensity. The four types are:

1. Intrusive thoughts, such as repeated, involuntary memories, distressing dreams, or flashbacks of the traumatic event. Flashbacks may be so vivid that people feel they are re-living the traumatic experience or seeing it before their eyes.
2. Avoiding reminders of the traumatic event may include avoiding people, places, activities, objects, and situations that bring on distressing memories. People may try to avoid remembering or thinking about the traumatic event. They may resist talking about what happened or how they feel about it.
3. Negative thoughts and feelings may include ongoing and distorted beliefs about oneself or others (e.g., “I am bad,” “No one can be trusted”); constant fear, horror, anger, guilt or shame; much-reduced interest in activities previously enjoyed; or feelings of detachment or estrangement from others.
4. Arousal and reactive symptoms may include being irritable and having angry outbursts; behaving recklessly or in a self-destructive way; being easily startled, or having problems concentrating or sleeping.

The typical onset of symptoms is days after exposure to a traumatic event. PTSD can be tricky as many people may experience the most active symptoms months after the fact. The DSM-5 has a specific and lengthy diagnostic list of criteria, but one essential component is that the symptoms must last more than one month, sometimes persisting for months to years. Whether it is trauma one witnesses or is directly subject to, its impact is systemic. Family and friends of the sufferer will also endure the challenges that come in the aftermath of a traumatic event.

How a Marriage and Family Therapist Can Help

If you or someone you know is struggling with symptoms of PTSD, a marriage and family therapist (MFT) can help. As systemic therapists, MFTs have expertise in assessing, diagnosing, and treating a range of mental health disorders. MFTs work with individuals, couples, and families, offering the necessary support and treatment plan to the individual affected by PTSD and his or her family.

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Written by Vanessa Bradden, LMFT

MFTs on Capitol Hill: Amplify their Impact!

Starting this past Monday, June 10, several AAMFT Family TEAM members are meeting with their Members of Congress to advocate for MFTs in Medicare legislation, the Mental Health Access Improvement Act of 2019 (H.R. 945/S. 286). These meetings will continue through next week. Please amplify their impact by asking your Members of Congress to support the Mental Health Access Improvement Act of 2019!

TEAM members were flown from their home states to meet with Congressmembers on key congressional committees with jurisdiction over Medicare issues: the House Ways and Means Committee, the House Energy and Commerce Committee, and the Senate Finance Committee.

The MFTs in Medicare legislation was introduced in the House (H.R. 945) and the Senate (S. 286) on January 31, 2019, earlier in this Congressional session than the last. Already, for the Senate bill, there are 19 Senate cosponsors as of June 12, 2019, which surpasses the total number of cosponsors (17) who were on the prior version of this Senate bill in the last Congress (2017-2018). The House version of the bill currently stands at 43 cosponsors and growing. Four Representatives signed on since Monday, June 10! Help keep the momentum going by asking your Members of Congress to cosponsor H.R. 945/S. 286!

Emailing or calling your Senators and Representatives help to amplify the impact of the Family TEAM members in Washington, D.C. meeting with their Members of Congress in person. By having more constituents actively contacting congressional offices, it raises the profile of our issue. If you have a couple minutes to spare, call your legislators with these simple instructions in mind:

• Go to our Take Action pages and find your legislators under “Directory” and typing your address in.
• Click on your Representatives and Senators to find the phone number for their Capitol office. If you scroll down further on the page, it will tell you whether this Representative/Senator has cosponsored our bills yet.
• Call them! Since it’s a phone call, you’ll want to make your point quickly and concisely.
  • You’ll be speaking to a legislative assistant. If you can, ask to speak to the legislative assistant responsible for health policy/mental health policy.
  • Tell them your name and explain that you are a constituent.
  • Then get right to the point: “I am calling to encourage Representative/Senator (name) to support the Mental Health Access Improvement Act of 2019 (H.R. 945/S. 286)”

If you don’t have the extra minutes to spare for a phone call, please take action through this link. If you receive a response, or if you have any questions, please email us at [email protected].

Sensate Focus Mindful Touch: An Adjunct to Marital and Couples Therapy

Join the Couples and Intimate Relationships Network for a webinar presented by Linda Weiner, MSW, LCSW.

Date: Friday, June 21 from 3:00 PM - 4:30 PM Eastern

Register Here

Relationship therapists and others who work with couples acknowledge the importance of physical touch and sexual intimacy as foundational to satisfaction. Many of our clients report this as a primary goal in couple and sex therapy. While some couples are able to recapture lost physical affection and sexual interest on their own through traditional couples therapy as their relationship improves, sometimes more direction is needed. This workshop is designed to add a skillset to assist therapists in addressing couples' intimacy and sexuality difficulties through the addition of Sensate Focus touching experiences. These "at home" touching experiences, developed by Masters & Johnson form the foundation of sex therapy but Sensate Focus can be a useful technique to build emotional connection and trust even without the existence of a diagnosable sexual dysfunction.

The workshop will identify the conceptual underpinnings of Sensate Focus, its connection to mindfulness and somatic therapies and its integration with relational therapies such as EFT; describe in detail the general protocol for Sensate Focus touching; present modifications for a variety of common sexual difficulties; and illustrate modifications for diverse client populations. You'll get a chance to hear Linda giving the suggestions and processing client feedback, as well as her offering of interventions for commonly encountered problems clients may bring to the therapist. 


Presented by: Linda Weiner, MSW, L.C.S.W As a therapist, Linda specializes in working with individuals and couples with a range of relational and sexual concerns. As an educator, workshop presenter and supervisor, she brings together many of the same qualities of insight, experience, connection, respect and humor characteristic of her therapeutic work. In recent years she has published numerous articles, a book chapter and a book on the use of Sensate Focus techniques, a foundational technique in sex therapy developed at Masters & Johnson Institute where she worked for five years before beginning a private practice. She and Dr. Avery-Clark are the authors of Sensate Focus in Sex Therapy: The Illustrated Manual, the first publication to detail both the updated sensate focus strategies of Masters & Johnson and to add the contributions of other clinicians and researchers involving more diverse clients. Linda taught at Washington University in St Louis Brown School for many years and has been a guest on numerous podcasts and media outlets, including CNN.

Why Pride Matters for Marriage and Family Therapists

June is celebrated by many as Pride month. The first Pride march was established through the courage of Brenda Howard, a bisexual woman reverently known as the "Mother of Pride." This was due to her work coordinating first a rally and then the Christopher Street Liberation Day March to commemorate the first anniversary of the Stonewall Riots, which happened on June 28, 1969. These riots were led by trans feminine people of color-such as Sylvia Rivera and Marsha P. Johnson- tired of being targeted and criminalized by the police because of their race, ethnicity, gender and sexuality. It is important to remember, now more than ever, that Pride was initially rooted in active resistance to pathology, criminalization, racism, transphobia and queerphobia. Pride, at its best, is about celebration of the wonderful and essential diversity of genders and sexualities, it is about community and the family that many of us find with one another when faced with rejection or misunderstanding by our families of origin.

For many trans and queer individual and families, Pride is a time to remember that we are not alone, to celebrate our survival and to come together. Pride is also complicated given that in many places corporations use it as yet another way to push capitalist consumption and many parades often have a police presence, which can make Pride feel unsafe for many trans and queer people, especially Black and Brown members of our communities who are too often impacted by systemic violence. Yet, every year since 1970 in this place we currently call the United States, Pride is celebrated, mostly during the month of June and many trans and queer people find safety, acceptance and community through Pride-related events.

As marriage and family therapists we know how important systems of support are, how essential families and relationships, and a sense of belonging to community are to our well-being. As systemic therapists we are uniquely located to support queer and trans families, as well as colleagues, not only during Pride month but all year long. For example, we know from research evidence that family support is a protective factor for trans, nonbinary and queer youth and we can have an instrumental role in this process. In alignment with our code of ethics and our commitment to health across communities, we can disrupt the ongoing systemic dynamics contributing to systemic oppression and violence against trans and queer people, especially trans feminine people of color.

May this Pride season remind us that our communities thrive when we can celebrate the wonderful gender and sexual diversity in our humanity and that we, as marriage and family therapists, have a unique role to play in the ongoing survival, resistance, celebration and support of gender and sexual minorities.

 

Alex Iantaffi, PhD, MS, SEP, CST, LMFT, is a Licensed Marriage and Family Therapist, Clinical Fellow and Approved Supervisor with the American Association for Marriage and Family Therapists, Certified Sex Therapist with the American Association of Sex Educators, Counselors, and Therapists, Somatic ExperiencingⓇ practitioner, writer and independent scholar. Alex co-owns a small group private practice, Edges Wellness Center LLC, and is passionate about healing justice and community-based scholarship. They are adjunct faculty at the University of Wisconsin-Stout, where they teach on the Graduate Certificate in Sex Therapy. They were the Editor-in-Chief for the Journal of Sexual and Relationship Therapy for eleven years and have researched, presented and published extensively on gender, disability, sexuality, bisexuality, polyamory, BDSM, Deafness, education, sexual health, HIV prevention, and transgender issues. Alex is the Chair Elect of the Queer and Trans Advocacy Network.

Anxiety and Panic Disorder

Anxiety is a feeling we all experience on occasion. It is a normal response to stressful situations.

Triggered by stress and fear, anxiety warns us that something is potentially harmful. Human beings are wired to survive, and anxiety’s intention is to protect us. In the right “doses,” we are positively motivated by anxiety. In fact, scientists have identified good stress, known as eustress, as necessary for our overall well-being. This is the kind of stress that gives us butterflies when we’re excited and keeps us motivated toward a specific goal.

It is a paradox that stress is meant to help us—it is our fight, flight, or freeze response to dangerous situations—and yet is has the potential to impede our quality of life. What happens, then, when beneficial stress or “eustress” turns into distress? The downside of such anxious stress is that it can often lead to negative outcomes. Worry becomes excessive or chronic which can lead to dread and isolation for its sufferers. Because anxiety shows up in different ways, some people may not recognize its impact immediately and therefore live in distress for long periods of time. When anxiety become a chronic condition, it can keep us from enjoying life to the fullest.

Types of Anxiety

There are a number of subtypes of anxiety that are impairing including: panic disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Chronic anxiety is most often identified as General Anxiety Disorder (GAD) and is characterized by persistent and pervasive worry.  Over time, steady worry and negative thinking interfere with daily functioning and relationships. 

For those of us who worry about “everything” anxiety can be debilitating. Life is stressful and requires much from us.  Your environment, for example, asks that you adjust to the elements. You must endure weather, pollen, traffic, noise, and pollution. Additionally, there are such challenges as demands on time, competing priorities, interpersonal conflicts, financial problems, or perhaps the loss of a loved one. There are physiological and cognitive stressors that create tremendous anxiety for so many.

You may ask yourself where the worry comes from. In general, anxiety can be seen in childhood. Research demonstrates that nature (genetics) and nurture play a role in its development. While our DNA poses a potential risk factor for anxiety disorders, it does not necessarily mean that the condition is inevitable. Our environment plays a significant role and exposure to trauma at critical points in development can reset the brains normal fear-processing system to over react in non-threatening situations.

Panic Disorder is a type of anxiety marked by sudden and repeated panic attacks. Fear becomes so intense and uncomfortable that it manifests physically. Individuals often report chest pains, heart palpitations, shortness of breath, dizziness or vertigo, abdominal distress, loss of control and fear of dying.

How a Marriage and Family Therapist Can Help

If you find yourself struggling with anxiety and panic disorder, a marriage and family therapist (MFT) can be a valuable resource. Systemically trained, MFTs know how to assess and connect the environmental and genetic factors that may be contributing to your distress. In addition to effective treatment modalities like cognitive-behavioral therapy (CBT), MFTs have expertise in relational therapy. The combination of these skills provides an anxious client the opportunity to: 

• Connect thoughts, beliefs, and actions that maintain anxious symptoms
• Examine the impact of how major relationships and events shape thought patterns
• Build on existing strengths, while adding skills, like meditation and mindfulness to better manage stressors that trigger anxious thoughts and feelings of panic
• Increase awareness and understanding of the mechanics of anxiety through psychoeducation

We should all remember that no one chooses chronic anxiety. It is something that happens over time and can be treated effectively in therapy.

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Written by Vanessa Bradden, LMFT

Adolescents and Social Media

What does it mean to be an adolescent growing up in a world saturated with social media? This is a new and uncharted territory and parents have little data for understanding its impact – both negative and positive.

Adolescence is a time in lifespan development that brings about dramatic changes—physical, intellectual, emotional, and social.  While these changes occur throughout life, they can be particularly daunting during the tween and teen years. 

Social media has become part of this passage into adulthood and while there are benefits to its use, the pitfalls can cause emotional distress to individuals and their families. For parents and primary caregivers, who did not have this same rite of passage into adulthood, it is all the more necessary to understand new media’s impact in order to navigate its complexity.

The Impact of Social Media Use on Development

Social media is ubiquitous: for virtually all young people, it is the way they connect and communicate. In fact, 81% of adolescents report that the use of social media makes them feel more connected to their friends. This is an obvious benefit to the use of social media amongst adolescents.

Yet this is new terrain for many parents raising a generation of children who only know a world with social media. This is especially critical as teens feel tremendous pressure to "fit in" with peers as they leave childhood and move toward adulthood.

The Risks of Social Media

Mental Health -- Adolescence is a time of social pressure, identity formation, and emotional ups and downs. For those that are able to seamlessly develop and maintain friend groups and a sense of belonging, social media is a point of connection and positivity. However, we know that peer rejection and lack of close friendships increases the risk of developing depression and low self-esteem. Research shows that some teens who are excessive users of social media are often bored, unhappy, and tend to get into more trouble than their peers. The emotional toll of social media on young women’s and girls’ self-image can be especially high.

Cyberbullying – While bullying has been going on for many generations, tech savvy or otherwise, the prevalence of social media as the primary medium of communication opens up what can be an abyss of emotional distress for teens. This is a new level of bullying that has potentially fatal consequences. It is especially daunting for LGBTQ teens, as well as young women as they are most often the targets of this kind of bullying.  And those who are victims of cyberbullying are likely in turn to perpetuate it. It is a vicious cycle and can happen to anyone in this age group, leading to outcomes such as depression, anxiety, isolation, and suicide. 

Text and Picture Messaging – One of the inherent problems with text messaging is the absence of visual cues. Text messaging (or video-gaming, e.g.) replacing face-to-face interactions creates a two-fold problem that can impact empathy and accountability. Teens are now, in a way, more deprived of visual cues than previous generations were, who could see the emotional impact of a certain type of communication. When a message is sent without seeing the recipient, it is easy for miscommunication to occur, which in turn diminishes accountability. Because of their still developing capacity for self-regulation and their susceptibility to peer pressure, children and adolescents are at some risk as they navigate and experiment with social media.

The exchange of photos and videos in this demographic is lightning quick. It is important that tweens and teens, and their parents, understand that any personal information put out into the ether can easily be misused by others. Young people need to understand the potentially damaging consequences of what they exchange with their peers. Messages, especially pictures and videos, can last longer and thus be more injurious than a face-to- face interaction or event. Sexting, for example, can leave a lasting negative impact on a young person’s life. It is estimated that 20% of teens have sent and received sexually explicit images or messages. Often teens engage in sexting without thinking about the consequences.

To sum up the risks, the adolescent brain is still developing and in one impulsive move, young lives can be greatly altered. Some of the emotional consequences include: bullying, embarrassment, humiliation, loss of friendships, feelings of guilt and shame, all of which increase risks for depression, anxiety and suicide.

The Benefits of Social Media

Socialization, Communication, and Enhanced Learning Opportunities -- Social Media is a primary source of connection among tweens and teens. Because most young people use these platforms to stay connected with friends and family, as well as a way to make new friends, the benefits that come from its use are systemic and extend to self-esteem, community and the world at large. Other benefits may include increased community engagement through fundraising and volunteering for local events.

Online exchanges can also help foster individual identity and creativity by building on social skills. Teens have the opportunity to learn from each other. By broadening online connections, teens have a chance to learn about differences. These types of communication can enhance respect, tolerance, and access to a broader understanding of different social and cultural backgrounds.

For many middle- and high school-aged children, social media is also a way to connect on homework and group projects. These platforms can be a wonderful tool for collaborating and sharing ideas about assignments. In some instances, schools have successfully used blogs as a method of enhancing writing skills as well as creativity.

Support and Comfort -- Social media can offer support in different ways. There are positives for those who want to explore romantic relationships, friendships and social status. Properly curated, such platforms can be especially helpful for marginalized groups, such as LGBTQ youth, those with chronic illness or disability, or teens with low self-esteem and social anxiety.

How a Marriage and Family Therapist can Help?

As we see, social media—as any complex part of life—has its pros and cons. And for tweens and teens the risks and benefits can often be intermingled. The negative consequences of social media are systemic in that they affect our most intimate relationships.

We know that cyberbullying, for example, can have a significant psychosocial impact on adolescents. Harmful outcomes include depression, anxiety, isolation, and tragically suicide. Everyone in the family unit feels the impact of such outcomes. A marriage and family therapist is a valuable resource for helping families navigate that challenging impact that social media can have on young people. If you find your family struggling to navigate the ins and outs of social media, a marriage and family therapist can help.

Some tips for parents:

• Set clear boundaries around the use of social media
• Be proactive and educate your children about the negative consequences associated with social media, especially when it comes to sexting, and cyber bullying
• Be mindful of how you use social media and set good examples for your kids
• Protect time for the family to be together without screens being part of the equation

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Written by Vanessa Bradden, LMFT