When Your Partner Won’t Go to Therapy


What do you do when you’ve done all you can? Despite repeated promises to stop having affairs or talking in chat rooms or sexting with a coworker, your partner continues. There’s a pattern—what seems like an addiction. Your partner says, no, everything’s fine. Or that this is normal in a marriage, even though the two of you made a commitment to be exclusive. If your partner refuses to go to therapy, what do you? What’s the next step?

The next step is to begin with yourself. I know that statement may sound strange or blaming, but that’s not the intent. You can’t force your partner to change; you can only change yourself. And the best next step at this point is to stop pressuring your partner into therapy, and instead find your own therapist. You need someone with the right training who can help you think through the options—to help you understand boundaries and accountability and addiction. If you’re having trouble setting boundaries, the therapist can help you look at why it’s difficult for you. Boundaries can be complicated. Besides, you can really miss important opportunities if you don’t have the right person to assist you in thinking things through.

For example, suppose you give your partner an ultimatum that he must attend 12-step group meetings every day for a month. It sounds reasonable enough, but you may have just inadvertently shot yourself in the foot. What’s going to happen? Well, after a month of attending meetings, the partner may very well say, “Okay, I did what you asked me to do. Now I’m done. And I’m not going back.” Or what if the partner attends 20 meetings but not the 30 meetings that you asked for? Are you really prepared to leave the relationship because work or family obligations interfered?

You see my point? The next step is most likely to begin with yourself. “Get thee to a therapist!” And if the partner’s problem has anything to do with sex and porn addiction, you definitely need a Certified Sex Addiction Therapist (CSAT). Other therapists may be great with other issues, but most are not trained in sex addiction. Having the right therapist will make all the difference. I promise you.

At Bull City Psychotherapy, we would be honored to work with you and help you on your journey. Take the first step. Begin with yourself. Do it now.

To schedule an appointment with Tim, please call his direct line at 919-533-7907. Or you can e-mail him at tim@bullcitypsychotherapy.com.

Transgender: Really though, WTH does transgender mean?

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Quick Hits:

  • If you don’t know something, that doesn’t make you a bad person.
  • Anatomy, identity, expression, sexuality – are four distinct components of our lives that deal with gender.  
  • These four components, like most things in life, exist on a spectrum, which is to say, they are non-binary or have more than two possible outcomes.
  • To be transgender is defined by each individual, but basically refers to the extent to which a person’s gender identity, role, or expression is different from the cultural norms prescribed for people of a particular sex.  For example – a person could have the anatomy of a female but identify and/or express themselves in a way that is less feminine, or more masculine, than cultural norms.
  • Transgender / Gender nonconforming people have been around forever.  The way cultures have responded to them has changed. For example, indigenous cultures referred to GNC people as “Two Spirited”, and they were revered as healers and visionaries.
  • Gender nonconforming (GNC) folks are not dangerous.  Tragically, GNC folks are much more likely to be the targets of violent crimes than to be perpetrators.  

First off – not knowing something is nothing to be ashamed of.  If you’re confused about some aspect of identifying as transgender, there is nothing wrong with you!  This post is designed to help. My goal is to provide some basic factual information on this topic. My hope is that this information will help you be more comfortable and feel better informed when you interact with folks who identify as transgender, or gender nonconforming (GNC).  

Let’s dive in!

What helped me most as I was learning about gender non-conforming (GNC) folks was to understand that anatomy, identity, expression, and sexuality are different things.  So, let’s cover that real quick.

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Anatomy – as humans, our anatomy develops in predictable ways. We are assigned a gender at birth based on our external sex organs (like a penis).  This can differ from our internal sex organs (like a uterus). It’s rare, but sometimes our internal and external sex organs do not align with the same gender.  This is called “ambiguous genitalia”. This is NOT the same thing as being transgender or GNC. Main point: there are more than two possible combinations of our gender anatomy, so the description is non-binary (has more than two possible outcomes), and our biological make-up is different from our expression, identity, and sexuality.  You can learn more about ambiguous genitalia here: http://www.mayoclinic.org/diseases-conditions/ambiguous-genitalia/basics/definition/con-20026345

Identity – deep in our brains, in the same area that informs you that you love pizza and hate anchovies, this is where your identity lives.  It tells you what feels right. Our cultural norms tell us that men hold doors open and love football, but our brains tell us what feels right.  Maybe you love hitting things. Maybe you love ballet dancing. Your brain is informing your preference. Your culture is naming it with a gender.  The things your brain tells you to like may be more masculine or feminine when compared to cultural norms. I, for example, love football, hitting things, and steak, as much as I love musical theater, romantic comedies, and the color purple.  Main point: there are more than two possible combinations of our identities, so the description is non-binary (has more than two possible outcomes), and our identity is different than our anatomy, expression, and sexuality.

Expression – is completely external.  So far (with anatomy and identity) we’ve been discussing things that come from within our bodies.  Expression has everything to do with our external presentation to the world. Some of us prefer to wear baggy clothes.  Some prefer suits. Some prefer yoga pants. Some prefer make-up. Some prefer beards. Our expression can tell the world how we prefer to be seen.  Many times our preferences for gender expression conform with cultural norms. Sometimes they don’t. Main point: there are more than two possible combinations of gender expression, so the description is non-binary (has more than two possible outcomes), and is different than our anatomy, identity, and sexuality.  

Sexuality – this is who we love and who we want (or do not want) to have sex with.  As you may have guessed by now, these preferences live deep in our brains and are non-binary – or exist on a spectrum.  Some people are attracted to stereotypically masculine/feminine traits and only those traits. Some people like a little of this and a little of that.  The main point is that there are more than two combinations of sexuality, so the description is non-binary (has more than two possible outcomes), and is different than our anatomy, identity, and expression.  

Ok, so now we know what anatomy, identity, expression, and sexuality are in this conversation.  But, the question remains, WTH does it mean to be transgender?! Here’s the answer…

To be transgender most commonly means that your identity is not the same as your anatomy.  

An even better definition is that being transgender refers to the extent to which a person’s gender identity, role, or expression differs from the cultural norms prescribed for people of a particular sex.

However, there are two important points to consider when we are thinking about definitions.  

First, let a person tell you what they want to be called.  Just like you might prefer to be called “Italian” as opposed to “European”, we all have our own reactions to labels.  So, if you don’t know a person’s preference, simply ask, “what do you prefer to be called?” Another good question is, “what are your preferred gender pronouns?”  This will let you know if you should say “he/him/his” , “she/her/hers”, “they”, etc. when referring to this person.

Secondly, we’ve outlined four different components (anatomy, identity, expression, and sexuality) that deal with gender and established that each component exists on a spectrum (is non-binary).  So there are many, many combinations of ways these components could intersect for a person.

If you’re not sure what term to use, I suggest using the term “gender non-conforming” (GNC).  It respectfully covers the spectrums. Gender non-conformity (GNC) refers to the extent to which a person’s gender identity, role, or expression differs from the cultural norms prescribed for people of a particular sex.

Whew!  Now we know what “transgender” means!

I have one more important point I want to make on this topic.  It has to do with fear. You have interacted with many GNC folks without knowing it.  This fact may be confusing, and even scary, but this confusion and fear is a result of your natural reaction to that which is different – not factual human behavior.  Here’s what I mean…

GNC folks, as a population demographic, are less, not more, dangerous than just about any other demographic you could think of that deals with gender.    

In fact, recently (April 2016) the National Task Force to End Sexual and Domestic Violence Against Women, which is comprised of thousands of experts in the field, published a letter stating that GNC folks pose no inherent risk to others – particularly women.  You can read their statement here: http://4vawa.org/4vawa/2016/4/21/full-and-equal-access-for-the-transgender-community

Furthermore, of all the homicides in 2013 that were classified as hate crimes, 72% of the victims were transgender women – that likely means they were anatomically men who identified and/or expressed as feminine.  So, not only are GNC folks less likely to be violent, but they are more likely to be victims. These brothers, sisters, sons, daughters, and neighbors of ours are not to be feared. In fact, they have much more to fear than most of us.  

Final thought: Like anything else, when we find something to be confusing, our brain usually, automatically labels it as “less-than” and/or dangerous.  I am encouraging you to fight that urge. Fight that fear response. Rise above it. The fact is you’ve already interacted with many GNC folks – and they were pleasant, and respectful, and not scary.  Next time you get a chance to do so, be intentional about showing them the same love and respect you would anyone else. If you want to know something about them, respectfully ask them, just like you would anybody else.  The key term is “just like you would anybody else”. Asking “how do you prefer to be addressed?” or “how can I be a better ally to you?” are rooted in concern. Asking, “are you going to have the surgery?” or “does this make you gay?” are rooted in curiosity and are not questions you would typically ask of someone you just met.  Life is tough enough as it is. Let’s not let superficial differences make it tougher for ourselves or others. Please see the links below for more information.

transgender Bull city psychotherapy sex addiction therapySummary:

There’s nothing wrong with not knowing something.  Just be respectful with your questions.

Anatomy, identity, expression, and sexuality all exist on a spectrum (are non-binary) and are different from one another.

Being transgender or gender non-conforming (GNC) refers to the extent to which a person’s gender identity, role, or expression differs from the cultural norms prescribed for people of a particular sex.  

Individuals may prefer different terms to define their identities.  If you don’t know someone’s preference, simply ask, “how do you prefer to be addressed?”

GNC folks are not dangerous.  If you don’t believe me, just ask thousands of trained professionals working to protect women all over the country.  Their position is articulated here: http://4vawa.org/4vawa/2016/4/21/full-and-equal-access-for-the-transgender-community

GNC folks are a particularly vulnerable population as they are disproportionately targeted for hate crimes.  

Just like anyone else, GNC folks deserve our respect and love.

More information:

FAQ:  http://www.glaad.org/transgender/transfaq

The Genderbread Person (great resource!) – http://itspronouncedmetrosexual.com/genderbread-person/#sthash.5CiYYY2I.dpbs

World Professional Association for Transgender Health – www.wpath.org

Violence statistics: http://www.avp.org/storage/documents/ncavp_transhvfactsheet.pdf

Gender ambiguity: http://www.mayoclinic.org/diseases-conditions/ambiguous-genitalia/basics/definition/con-20026345

Are you in good shape? How physical fitness and psychological fitness interact.

mental health bull city psychotherapy

 

 

Quick hits:

  • Our physical health and psychological health are linked
  • They respond similarly to our efforts to improve them
  • Consistency and accountability are required for progress
  • Professional advice saves you lots of trouble

Disclaimer: these comparisons are consistent for many folks based upon my personal and professional experience.  There are outliers for whom these ideas do not ring true. You should consult a licensed professional before beginning any training plan – physical, psychological, or otherwise.

One of the consistent metaphors I use in sessions is relating our psychological goals to our physical goals.  Many people starting psychological training (therapy/counseling) are not sure what to expect, but they have experienced some form of physical training.  Whether it was a community softball league, professional sports, or just working out at the gym, most folks can relate to setting and pursuing physical goals.  

There are many similarities between making physical progress and making psychological progress.  This post is intended to highlight these similarities in order to find a new ways to connect you to your psychological goals so you may feel more comfortable starting, continuing, and getting the most out of your training time.

Consistency is key:

You probably know the cliché, “you get out what you put in”.  Like most clichés, this one is rooted in truth for many situations.  If you spend one hour/week or four hours/month in the gym you may feel a little better, but you’re not likely to make much physical progress.  The same is true for your psychological health.

This means that if you spend one hour/week in session with your psychotherapist and do not put any more effort into your psychological growth, then you are not likely to see much progress.  You may have specific assignments between sessions. Or you may just take what you learn in session and reflect on it or practice it throughout your week. Whatever you do, it must be consistent in order for anything to change.  You don’t lose weight staring at the treadmill, and you don’t improve your psychological health by staring at your therapist.

Along these lines, our skills and muscles atrophy if we don’t use them.  If you have a great experience at the gym working regularly with your trainer for a few months you may feel great and make great progress!  But, if you stop going, you will lose that progress. The same works for much of our psychological work. If you work diligently to develop skills around cultivating healthy relationships and taking good care of your psychological wellness you will feel great!  But if you stop practicing these skills you will fall into your old patterns that may not serve you as well. This doesn’t mean you need to be in therapy forever, just as you don’t need a physical trainer forever. However, you will need to practice your healthy habits in either part of your life in order to maintain the benefits.  

 

Problem Areas Suck:

Whether it’s stubborn love handles or a stubborn love of booze, if we don’t address our problem areas they will not improve.  Getting physically fit is not a mystical process. We need to burn more calories than we take in to lose weight. We need to bend our muscles to stretch and strengthen them.  Getting psychologically fit is not magical either. We need to change our ways of thinking in order to change our behaviors. We need to change the ways we relate to others in order to change our relationships.  If you don’t lift weights you are not likely to get any stronger. If you don’t talk about your issues, they are not likely to improve.

Along these lines, while the work may be hard, it doesn’t have to make you miserable.  If you’re working with a physical trainer and you hate running, a good physical trainer will help you find ways to meet your goals that don’t involve running.  Similarly, a good psychotherapist will help facilitate your psychological progress with tools and strategies that don’t make you miserable.

 

Accountability:  

The greatest physical trainer in the world can’t burn the calories for you.  A good trainer can help you feel motivated and make the work more fun, but ultimately, you’re the one going to the gym and sweating.  

Similarly, the best psychotherapist in the world can’t talk you into a healthier life.  You will have to do the work – which will likely include showing up regularly, making an effort in between sessions, and being honest with yourself and your therapist.  

The good news here is that the process doesn’t have to last forever.  If you are new to working out for physical fitness a trainer can help you learn the basics and accomplish your first set of goals a matter of weeks or months.  Once you have a solid grasp on the fundamentals you may not need to continue working with them until you have new goals in mind.

This concept applies directly to your psychological goals and training as well.  Most folks are able to learn some fundamental skills and realize satisfying results in around ten weeks.  After that, they may choose to stay in therapy and work on new goals, or they may not. Either way, while our health is a lifelong process, working with a professional doesn’t need to be.  

One benefits the other:

With all of these similarities between working on our physical and psychological health, it’s no wonder that these two parts of our lives impact each other.  Simply put: working on your physical fitness will have a great impact on your psychological health, and working on your psychological health will have a great impact on your physical health.  

When you are more psychologically well you will be in touch with your true motivations that help you eat healthier and get you to the gym.  Being psychologically well makes you a better athlete. When you are physically well you feel better psychologically, are more aware of your thoughts and feelings, and are more willing to honestly explore them.  This synergy is a beautiful thing!

 

Work with a professional that works for you:

You will benefit from working with a licensed professional.  When it comes down to it, we can only get so far working on our own.  However, working with a physical trainer is a personal thing. You need to feel comfortable looking vulnerable and sharing your strengths and weaknesses with them.  This is hard! As human beings we click better with some folks than others.

The same thing is true for your psychological training.  It is vulnerable, challenging work, and you must feel comfortable with your therapist in order to make progress.  You are putting in effort and deserve to see results! Do not settle for a trainer or therapist that is not a good fit for you.  

 

The “Musts” of Psychological and Physical Progress:

  1. Consistency – you get out what you put in
  2. Accountability – if you don’t work on it, it will not change
  3. Professional Input – you can teach yourself a new skill, but a professional will save you lots of time and frustration

In summary, if you have goals around feeling better and improving your overall wellness, I encourage you to pay attention to both your mind and your body.  They may be more similar than you realize and working on one will certainly help the other. Use these three tips and you will be thrilled by how quickly and effectively your situation improves.  

All the best as you make your progress,

Matt

 

A Better Way To Recovery Than Thunder Road

 

 

Okay, I admit it. I didn’t like it the first time I rode a roller coaster. It just wasn’t for me. I was a kid—maybe 12 years old—when I hopped aboard Thunder Road at Carowinds. The wooden roller coaster bumped along so jarringly that I thought my teeth were going to fall out. I “white-knuckled” it to hang on until the ride was over. A few years later, I found other roller coasters that I liked much better—ones that were faster but that weren’t so jarring.

Thunder Road has since been replaced by another ride, but some people experience the recovery process in much the same way. They white-knuckle it—holding on for dear life, thinking that if they can just muster up enough willpower, the bumpy ride of abstinence will quickly lead to success. But abstinence isn’t recovery. Stopping the behavior of an addiction is a good beginning, but if there isn’t genuine recovery, the familiar cravings will most likely come back. In 12-step groups, there is the old line about the chronic drinker, who says: “I can stop drinking anytime. In fact, I’ve stopped hundreds of times!”

What is true recovery? It can involve several facets, but put simply, it is doing the inner work. It is looking at our childhood and family-of-origin and seeing the patterns (or schemas) that we learned. For example, when you were a child, how did you learn to get what you wanted and needed? If you had an angry parent, did you learn to placate and be a people pleaser, or did you learn to withdraw and deny your feelings? Did you learn to do things as close to perfection as possible, or did you become ashamed of all your efforts?

These childhood patterns may be a bit daunting for us to look at, but if they are not addressed, we will continue repeating the same patterns as adults. We might rather avoid difficult emotions and challenging situations in our lives, but without learning to cope with them, we cannot experience true recovery. We must see the underlying emotional causes that perpetuate the addiction cycle.

White-knuckling it isn’t the answer. In the long run, you will save yourself and your loved ones much grief by doing the work of recovery and growth. Even better, you will find a richer, more fulfilling life when you seek a place of openness, authenticity, and resilience.

To schedule an appointment with Tim, please call his direct line at 919-533-7907. Or you can e-mail him at tim@bullcitypsychotherapy.com.