The Family Dynamics of a Psychiatric Crisis -- Part Five: The Professional Perspective

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[00:01:28] Welcome to our award-winning podcast, Mental Health, Hope and Recovery. I'm Helen Sneed. And I'm Valerie Milburn. We both have fought and overcome severe chronic mental illnesses. Our podcast offers a unique approach to mental health conditions. We use practical skills and inspirational true stories of recovery. Our knowledge is up close and personal.

[00:01:58] Helen and I are your peers. We're not doctors, therapists, or social workers. We're not professionals, but we are experts. We are experts in our own lived experience with multiple mental health diagnoses and symptoms. Please join us on our journey. We live in recovery. So can you.

[00:02:41] Welcome to episode 52. The Family Dynamics of a Psychiatric Crisis, Part 5. The Family Therapist, A Professional Perspective. Today marks the fifth and final episode of our series, The Family Dynamics of a Psychiatric Crisis.

[00:03:03] Valerie and I encourage you to visit the first four episodes where we made an in-depth exploration of the many challenges and numerous roles in a family where a member has mental health issues. Now, throughout the series, we've had spouses, siblings, parents, children, caregivers, people with mental health conditions, all providing their point of view in response to our probing questions.

[00:03:31] Now, our overall goal has been to define and demystify the impact of mental illness on the family and to enlighten and strengthen the impact of the family on mental illness. Now, today will be an episode filled with invaluable professional advice as we talk with our guest, Lisa Powell Watts, a seasoned psychotherapist of 40 years. It's my great pleasure to tell you something of her distinguished career.

[00:04:01] Lisa received her master's degree in education with a focus on counseling and guidance from Texas State University in 1984. Since then, she has received her professional counselor license, her marriage and family therapist license, and her chemical dependency counselor license. It's Lisa's extensive experience in family counseling that we will particularly call on today.

[00:04:26] For these past 40 years, Lisa has been a practicing psychotherapist in both inpatient and outpatient settings. Over the years, she has seen individuals, couples, and families in counseling and has also led numerous trainings. Lisa met and trained with Dr. Brenda Davies, British psychiatrist and author, over 25 years ago. With Dr. Davies, she began utilizing mind-body approaches to healing with her clients.

[00:04:56] From 2008 to 2018, she had a healing school in which she taught other helping professionals these mind-body healing techniques. Now, I can personally attest that Lisa is gifted in the technique of chakra healing. Lisa is a healer. In 2019, she wrote a wonderful book, Chakra Healing, A New Path Forward in Treating Addictions and Other Issues. It was a very helpful book for me.

[00:05:24] Today, Lisa is semi-retired and mainly offers phone sessions to her clients. Her contact information will be in our show notes so that you can contact Lisa with any questions you may have. Now, I have to share this. Lisa is not only a dear friend of 45 years, she is an emotional rock for me. And with our friend Kelly, Lisa is the third side of a triangle that makes up one of the most meaningful relationships in my life.

[00:05:55] Lisa, thank you for being with us today. Thank you for having me. I'm really excited about sharing what I know about family therapy and just feel so honored to get to be a part of this. Well, we're happy you're here. And let's just jump right in. Well, what drew you to a family practice? Well, I had started working on my master's degree in counseling.

[00:06:22] And this was back in the 80s. And my class had the opportunity to see Dr. Virginia Satir. And she was one of the pioneers in family therapy. And so when I saw her, it was just one of those magical moments. Her whole approach was about building the nurturing family, how to build a nurturing family.

[00:06:49] And I was just hooked after I saw Virginia Satir. And it wasn't long after that, that people like John Bradshaw, Pia Melody, those therapists and authors were talking about the roles and the rules of addicted families. And I came from an alcoholic family.

[00:07:11] So I really, really resonated with what they said about the roles in those families and how they get affected by the members' alcoholism or addiction. So I've just always integrated, trying to get in as many members of the family as I can when I'm working with an individual. Well, I think we want to hear more about that as our conversation goes on.

[00:07:40] But I'm going to start with a quote that I'm sure you've heard, but that is one of my favorites. And it's from Leo Tolstoy. He said, all happy families are alike. Each unhappy family is unhappy in its own way. Now, we are wrapping up a five-part series on family dynamics when there is a psychiatric crisis, as I said earlier.

[00:08:06] Lisa, if you could pinpoint a couple of things that are imperative to healthy family dynamics during such times, what would they be? Okay. There's so many parts to this. But the two main ones, I would say, is for the family members to have open communication, to talk about it. It's just so important.

[00:08:33] And so many times, family members will isolate. And I've heard y'all talk about the stigma with addiction. And it just kills me that it's still prevalent in some areas. But it is. And so a lot of times, family members will not reach out to other people or talk to each other about it. I think they feel so helpless in making a change with the person that is struggling with a mental illness.

[00:09:00] But the open communication, the talking to each other. And then the second thing I would say is reaching out for help. Yes. You know, reading all that you can about it, finding some professionals that you feel comfortable with, seeing. Those are probably the two most important things, the communication, the talking to each other, and finding some good help and support.

[00:09:25] I'm so glad to hear you say that because we, you know, Helen and I really hammer on that, that isolation is so deadly and that education and help are just imperative. So, so glad those are things that you find important as well. Well, and in the role of families, we have a question that, you know, Helen and I have kicked this around too.

[00:09:48] Have you found that the family dynamic inevitably plays a definitive role in a family member developing a mental health condition? Well, yes and no. I mean, because there are some mental health disorders that are genetic and neurotransmitters are affected. Right. So this is kind of also the nature versus. Yes. Versus. Yes. Okay.

[00:10:18] Yes, absolutely. Absolutely. So the family, maybe there aren't dynamics in the family that cause the mental health disturbance, but the family still needs help in learning how to deal with it. Absolutely. Sometimes, you know, and sometimes there are disorders that, a lot of times, that skip a generation.

[00:10:40] So if, if a child, a teenager maybe develops a thought disorder, you know, one of the forms of schizophrenia, well, if mom or dad don't relate, cannot relate to that because neither one had a thought disorder. One of them may remember that one of their parents did or an uncle did. It just skipped a generation. Addiction does that a lot. You know, it will, maybe mom or dad don't become addicted, but maybe a grandparent had it and it skipped a generation.

[00:11:10] And then one of the children inherits that genetic component. So it's funny. It's interesting because sometimes families will want to spend a lot of time in trying to figure out. Sometimes it's about to put blame on where these disorders come from. So it's, it's interesting and we'll talk about that, but really the thing that is most salient is how to treat it and how to support everybody in the, in the family.

[00:11:40] Yeah. That's a tall order, I think. I do remember one. As you know, far better than we do. Yeah. I do remember once my mom saying, I wonder where you got this. Yeah. It's like, oh, I'm not going there with you. Yeah. Because, well, this, this really does lead to the next question, which is, Lisa, as you know, in many therapeutic approaches over many, many years, the family is blamed for making the person sick. Now, what is your own experience taught you?

[00:12:09] And can you promote understanding rather than blame? Is that possible? Absolutely. You know, sometimes I felt like a detective, a kind detective, kind caring detective with the family, because I want to understand and I don't want to judge. And I am not the expert on their family. They are.

[00:12:35] And so I ask questions for them to teach me about their family. And, and it's kind of like we're in this together. And so I try to join with the family by not judging them and not acting like I think I know more than them, because I really don't. They're teaching me. So I hope that I'm modeling, promoting understanding as opposed to blaming them.

[00:13:04] You know, it's, you know, when Valerie was saying a while ago, when her mother was saying, when were you got this? You know, I notice with families and with individuals, too, you can ask a question that will shut them down and you won't get any further. So you don't want to blame. You don't want to be judgmental.

[00:13:25] You, I'm always saying with the families I see, the thing that I start off with a lot is, I wonder, you know, I'm wondering if blah, blah, blah. And I ask a question because I don't know. And I want them to help me understand. I don't want to go in like I think I'm the expert because I'll lose them every time. Yeah. And I want to keep them engaged. I want to and I do want to understand them.

[00:13:52] Well, that's the communication that you're very good at. And you would want to go back to what I want to go back to what you said earlier about communication being, you know, the foundation of helping your family member heal. And so how do you counsel a family with communication issues and poor communication skills? Can they learn a common language? Absolutely. Absolutely. They can. And, you know, communication is not something that we're taught a lot of times.

[00:14:21] So we don't know how to do it well. And so I hope that I model that for them. All I know is it was very helpful in my graduate program to learn active listening. So when they are talking, the first thing that I'm thinking is not how I'm going to respond. I want to elicit more information from them. You know, I'm into what they're saying. And like I said, I'm kind of a detective. I feel like a detective.

[00:14:51] So I've got some questions. I want them to explain. The most important thing at that moment to me is what they're saying to me. Not what I have to respond to them, but what they're saying to me. So I hope I model active listening and staying with them. And, you know, sometimes in the beginning with a high conflict family, you have to kind of lay out rules. No, try not to interrupt.

[00:15:21] No yelling. Keeping it calm in the session. And, you know, most of the times they can do that. Sometimes things get heated. And when the energy picks up like that and it gets heated, I get very calm. I get very calm. I learned that in my family. Someone has to be. Someone has to be. To bring the energy down. To bring the reactivity down a little bit. Yeah.

[00:15:48] Well, this kind of leads to my next question, which is boundaries, which we all know are so important in all kinds of relationships. But for families, are there boundaries you recommend for family members to maintain for their own well-being while supporting their loved one? Oh, absolutely. And, Helen, that's so true. Boundaries are so super, super important.

[00:16:16] And that's one of the things that we'll talk about as I'm working with a family. And boundaries are important, whether there's been a huge psychiatric crisis or just in regular family therapy, in that the individual self-care of each of the members is very, very important. And I try to teach them, you know, what I'm learning now about what we feel in our bodies.

[00:16:42] We can feel in our bodies when somebody has transgressed our boundaries. And when they feel, I try to teach them when they feel that, that's the time to say something and say something very kind. Because a lot of times boundaries are stepped over and the person doing the stepping over didn't realize they did that. So they kind of need to be educated, you know, that I don't want to talk about an example. I don't want to talk about that right now.

[00:17:11] Or let's revisit that another time. Or if you're being asked to do something over what you feel comfortable doing, that you say, no, I don't feel comfortable doing that. But it takes really good self-knowledge and being in touch with your body to know if you can do that or not. Now, if you say yes and you do something against your boundaries, that feels awful. That feels awful.

[00:17:40] So you need to, you know, honor that. Yeah, I had to learn to do that. And I finally learned that I can say, this is a lot. I need to process this. I promise to get back with you. But, you know, and usually at this point I'm crying. But I can say, I cannot talk about this right now. But I do say, you know, I need to process this and I promise I will get back with you. But not right now. Oh, that's perfect.

[00:18:09] That is perfect. And one other thing I'd like to say there, there's something that we talk about in family therapy about rescuing. It's never a good thing. It is not a good thing. So if we go against our boundaries and we say, you know, we think, okay, they really need this. They're asking me to do this and I don't feel comfortable. But they really need me. I mean, you know, what are they going to do if I don't do this? If I don't, you know, bail them out or whatever again?

[00:18:38] That's not good. I mean, it's an insult to continually rescue family members because you're really kind of telling them you don't really have the ability to get out of this scrape. But I do. You know, it's a one-up situation where that's the thinking, I think. You know, I will rush in and rescue you. And it's usually an insult. That's not a good thing.

[00:19:03] It also seems like you would learn so much more by watching how they naturally communicate with each other rather than rescuing them. Yes. Do you know what I mean? Because that to me would be where you would learn so much about the family. Yes. Oh, I'm telling you, those sessions are so instructive. I mean, you know, for a while, I am just watching because the way they interact with each other, you know, who's in control.

[00:19:34] Sometimes people are in control in a strong, you know, an overpowering way. And sometimes there will be a family member that controls by silence. I'm not saying anything. You know, and if you want the truth of what's going on in a family, you bring in the teenagers because they're the truth tellers. You know, I think it's interesting, too.

[00:19:55] The other thing I've learned about kind of these invisible cords or connections that family members have, you know, a lot of times family members, parents will try to protect kids. Say there's an affair going on. They'll say the kids don't know about it and they'll try to protect kids. The kids always know something's going on. They may not know exactly what, but they know something is going on.

[00:20:17] So learning how to be honest in a developmentally correct way with what they can handle is really important. My kids said I communicated a lot in silence and they called it the power of the raised eyebrow. Right. Right. Oh, gosh. Yeah.

[00:20:41] So by all the watching and calmness and learning, what helps you determine that real progress is being made within the family? Are there signposts along the way? Yes, absolutely. Usually they're good about coming to all their appointments. They're taking advantage of all the help. So they'll come to their appointments and they come in and they work.

[00:21:08] You know, it's in the beginning, sometimes there's a lot of work on my part. You know, you're establishing boundaries in the session, you know, being on time, paying your bill, you know, all that kind of stuff. But after a while, when they're really engaged, I say it's kind of easy. It flows. They're engaged. They're motivated. They're committed. And so they come in ready to work.

[00:21:35] And one of the things that I love, I so love this, and I think the AA and NA program is so wonderful about this, how people in recovery from addiction learn themselves so well they have to to know what their triggers are to keep from relapsing.

[00:21:56] So in mental health, when I have a client come in and instead of saying, this is what they did to me, you know, talking about another family member, when they come in and they say, this is what I did. This is how I feel. This is what I did. This is what I said. And they take ownership. Whoa, that's such a wonderful sign. Then we're off to the races. And what I tell people, too, and it's so important. And Valerie, you're such a good example of this.

[00:22:26] And Helen, I'm sure, too. There is a point, you know, in the very beginning of healing, it's kind of hard. You know, there's resistance and you're working against years of, you know, either blowing up or keeping everything in. But you go to enough sessions and there is a momentum that starts that never stops. It will go the rest of your life. And it will serve you later on when you're not in that therapist's office.

[00:22:54] When you are in a difficult situation, if you've had enough therapy and healing, those healthy things just kick in. And you don't need the therapist. It's all been internalized. And you know you. You know what to do when you're triggered. You know what triggers you. So that's what, to me, that's what I'm always working for is for, A, for the clients to come in and start right off the bat talking about themselves, not blaming.

[00:23:22] And also that they come long enough and are committed long enough that I can see that growth and healing in situations outside of the session, that it's taken on a life of its own. That they don't need the therapy so much that they're doing it. Are you ready to sprinkle a little extra magic, peace, and possibility into your life?

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[00:24:19] Well, that's a, I'm sorry, that can sound, I'm sure it can seem so magical depending on the family and the situation. But I'm thinking of some families I know where I think, man, she'd have to wave a wand, but that's okay. Something will work, right? It does take a while. It does. It can take a while, yes, to get to that point. Yeah. Yeah. Well, I find all of this so fascinating.

[00:24:47] Now, here's one that I think is really important, which is how can family members identify the line between being helpful and enabling unhealthy behaviors? Yeah. It's, well, one. It seems like you could really step in the hornet's nest if you got into this kind of thing. Yes. You know, on the one hand, it's about being in touch with yourself and your boundaries.

[00:25:15] So there is such a difference between being supportive and helping, but not rescuing and not going against your boundaries. And, you know, there may be times that I loved something that Bernadette said when she was talking, Valerie's sister, when she was talking about, you know, supporting Valerie during her crisis. You family members may be able to be supportive and be there for the children when there was a crisis going on.

[00:25:42] But there may be a time, there may be something going on internally with them, and they just have to say, okay, I need to back away for a little bit. Not forever, but for a little bit. I need to back away and take care of my own mental health, and I'll be back. But I love that she said something to Malcolm about it, too, that just a little heads up. There's some things going on with me. I want to be here for you and for the kids, but I need to just step away for a little bit. So it...

[00:26:11] Well, let me jump in for a second. Also, on that episode you were talking about that Bernadette was on, about the not doing for me what I could do for myself kind of thing. She said at some point she couldn't help me directly, but she could help me by taking care of the kids. She said at some point there was nothing she could directly do for me, that she couldn't rescue me. She had nothing... There was nothing. I was... She couldn't do anything for me, but take care of the kids.

[00:26:38] So that was her not crossing that line of trying to rescue me rather than supporting me. And so, yeah. Yeah, exactly. And you don't... Like, say, a person that's in recovery from an addiction, you don't want to ask about their program. You know, I know in the beginning there's a lot of fear about relapse and things like that, but their program is their program. And hopefully family members are going to Al-Anon or whatever, their own self-care.

[00:27:08] It's very important. So you want to be careful not to get into that role of having kind of their police or whatever, you know, to make sure they're doing recovery correctly or whatever. That's theirs really to do. And I guess another thing I'd like to say is that probably had to do... I should have said this long ago. It takes a village. Oh, my gosh.

[00:27:36] You know, listening to your family, Valerie, and, you know, Malcolm had his own therapist. You had a good psychiatrist. You all did couples therapy. It takes all of that. And as a family therapist, I can't do it all by myself either. You know, I have a network of psychiatrists and other therapists and definitely the NAAA community and people that I know that are affiliated with NAMI.

[00:28:05] It takes a whole village. One person can't do it by themselves with a family. It takes a whole village to really help them and everybody kind of playing their part and getting released as signed so you can talk to each other. It's... That's the best way to do it in a perfect world.

[00:28:29] Well, talking about bringing everybody in and taking a village, when you're working with an individual in therapy, what persuades you to bring in their village? What persuades you to bring in the family and involve the family in their therapy and their treatment? Yeah. It's an interesting...

[00:28:49] That's an interesting question because it seems to me like you kind of have the mindset of a family systems therapist or, you know, I will always prefer to bring in as many other family members as I can. And in my own therapy, when I was in therapy, my therapist, she'd get in any family members of mine that she could. But my mother lived on the other side of Texas.

[00:29:15] And when my mother would come visit, my therapist would say, you want to bring your mother in next week? Yeah, I'll bring her in. So, and, you know, if things were going on with my husband, she'd be like, well, why don't you bring Craig in? So, okay, yeah, I'll bring him in. And it was so beneficial. I guess that's another thing that influenced me was her therapy with me. And it was interesting because she'd been working with me for a long time, but she was so kind and including when my mother and my husband would come in.

[00:29:44] And they did never seem to feel like she and I had this special relationship and they were like outsiders. She was masterful at wondering, you know, and being inclusive of everybody.

[00:29:58] So, I like, especially if it's a young person, if it's late teens or early 20s, and a lot of times with a thought disorder, one of the maybe forms of schizophrenia or something like that, those young people don't usually come in on their own. They're usually in a crisis and the family will bring them in.

[00:30:28] But there are young people that will have either one of the thought disorders, I mean, one of the mood disorders, I'm sorry, a form of anxiety or depression. They're having problems in college. And so, they are usually coming in on their own. And right off the bat, I'll let them know one of the things that I do is family therapy.

[00:30:50] And so, I used to kind of almost have a rule that when I saw these young people, I like to bring the family in once every four to six weeks, something like that. Because I've just seen too many young people find a good individual therapist and they grow and heal. But, you know, our issues don't start in a vacuum. It's very good to include the family.

[00:31:19] And a lot of times the family feels like they're on the outside. And so, this one member is getting all this work and they really need to be included. So, I'm a big proponent of that, you know, and I tell them right off the bat, like I said, right off the bat, I'm also a family therapist and I'd like to see your family. And then we kind of go from there. It's almost always helpful.

[00:31:41] Yeah, Malcolm talked about how, and I talked about how grateful I was that I signed that release so that my psychiatrist could talk to him. And he did come in, but even the ongoing communication when I was super sick that Malcolm was able to talk to my psychiatrist was, I knew it was imperative. And he talked about it on the podcast that he was so grateful to have that communication with him. I heard that. That was so, so good that that happened. I mean, it's so important to have it.

[00:32:11] One other thing I'd like to say about that, that as a family therapist, if you have an acting out young person, they're late teens, early 20s. And it's not really a thought disorder. They don't have schizophrenia or anything like that, but they're acting out either, you know, they're just not doing well. They're not functioning well in their life. I mean, a lot of times they're expressing a symptom in the family.

[00:32:41] And so, again, you know, if you just work with them and you don't involve the family, you can help them in some ways. I mean, you can, they can learn about communication and, you know, and develop a trusting relationship with you. And that's good. But if that symptom in the family, you know, if they take away that, if you don't help heal the family, the family will replace it with something else.

[00:33:07] I mean, it's just imperative that you include as many members of the family as you can. Well, that's, that's good to know. And I, I wonder how many people have the opportunity to actually do that. You know, people in therapy that, that, that don't have you. Yeah. Yeah. But here's a, here's a big one.

[00:33:30] And, you know, we're always, we like to get into the pragmatic side of things, but what skills, methods, pursuits, books, games, group activities can bring a family together? Promote understanding and provide an area of stability in difficult, volatile relationships. Okay. Let's see. Let's start with kind of family activities that could bring a family together.

[00:34:00] Rather, especially if it is a family that is disengaged. As a family therapist, I look for either enmeshed families. You know, they, they, they're too, they're, they're not bonded because you want them to have a bond, but they feel each other's feelings too much. There's not much individual being there. They're all kind of fused together. So there's that, or there's a disengaged family and every man is out for himself. You know, they're, they're not joined enough.

[00:34:29] So I would say with some of those disengaged families, we'd start looking for family activities that they could do together. Where they have, just to be together, family movie night. Definitely that the parents are doing things together as a couple. There's a lot of different ways that you can do that. Are the parents involved in the kids' sports? You know, what are some local activities that they can go do together as a family?

[00:34:58] Hiking, being out in nature. You know, sometimes families get so busy working and, you know, they're just putting one foot in front of the other. They've got so much on their plate. Sometimes they don't think about some of these activities they could do. So fun activities. Oh, I always look for the families that look like they have fun together. And they can be a little lighthearted. Sometimes they're very serious and angry and it's just right below the surface.

[00:35:24] So how to increase fun in their lives. There's so much online help these days. I practice in a small town and we don't have as many support groups, but there are a lot that is offered online. And I think there's a lot of NAMI groups. A lot of NAMI groups online, yes. Online, yeah. So getting involved in some of those things.

[00:35:52] If there's an addiction in the family, going to Al-Anon, Alateen, AA, NA. You know, sometimes those support groups have their own communities. And I found them. And, you know, you want to be selective about the groups that you go to because some are better than others or some feel your needs better than others. But starting to build a community that you feel a part of. Let's see.

[00:36:21] Skills and methods. I mean, I'm always working on communication with the family members I see. I did a fun method with one of the families I saw years ago when I was learning about these energy centers in the body. I had a mom and a dad and they had three daughters. And I think it was the oldest daughter that was starting to have some problems. And they were real open to family therapy.

[00:36:48] So they came in and the oldest daughter was, you know, she was a pretty nature. She was a little surly and a little separate from everybody. And so I did an exercise with them where I taught them breathing and how to be grounded and how to open their hearts. And we did it together. And I saw them a couple of times not doing that exercise. And then it was probably like the third session I did that exercise.

[00:37:16] And just teaching them how to open their hearts while they were talking to each other. It was amazing. It was just amazing. So I'll try to think of little methods like that, that to me, utilize the body, get them out of their head and help them communicate better with each other. Oh, let's see. Books. Gosh, I was really hooked on all.

[00:37:44] This is back in the 90s, though. Pia Melody and John Bradshaw. I loved all of the books about adult children of alcoholics because my father died of alcoholism and my oldest sister died of addiction. So all those roles and rules, I really resonated to all that. But there's a lot of new family therapists that are so good.

[00:38:14] I heard of a new guy the other day, Gabor Mata. Oh, yeah. Yeah. Yeah. Excellent. People really respond to him. The Brene Brown information is really great. And I would say, too, when family members come in and there is a need for a psychiatrist and medication, I'll point them to some of the online resources like the American Psychiatric Association.

[00:38:43] Mayo Clinic has some good information. Duke University has some good information. But to be very careful about that. I find that the hospitals and the research hospitals are the best place for information. Like, say, if they're wanting to know some of the characteristics of bipolar disorder or fentanyl addiction or whatever. You know, be careful online. Don't just get it off of TikTok or wherever.

[00:39:14] Yeah. Go to one of the, you know, tried and true medical websites. Yeah. My doctor said, these are the ones you can go to. These are the only ones you can go to. And the three you just gave are the ones he said. Ah. Yeah. Yeah. And Harvard and other major research universities. But those are the ones he gave. And Helen and I rely on those as well for our own research. Yeah. What else can you, what else can I add to that that you'd like to know?

[00:39:43] Those were great. Can you think of any more? Yeah. I think that was really, really full of good advice. And ways, again, you know, it gets back to the communications question, I think, is so important. That a lot of these things I'm asking about, I think, can help foster better communications within the family and that kind of thing.

[00:40:06] So let me let me add one other thing, because I think it was your guest, Rebecca, that said something about this that I thought was so excellent. When we're talking about communication, I always tell my clients it's going to feel uncomfortable because for those people that kind of over remote, that are very emotional and maybe they get angry real quickly. I'm going to teach them how to pause, not to emote when they're triggered.

[00:40:36] How to pause, pause their communication. And it is the opposite with my clients that hold everything in. I'm going to teach them to speak up, you know, to let it come up and out. So it depends on the person about communication, but it's always uncomfortable. It doesn't feel like the natural thing because the natural thing to do when they're triggered is to do what they've always done, which, you know, I think that she was talking about learning how to pause when she was triggered.

[00:41:04] And I loved, loved, loved that because for very emotionally reactive people, pausing is what they need to learn. Yeah. It's one of the things I read every morning. One of the lines, pause when agitated or doubtful and ask for the next right thought or action. I love that. Try to do that. Love that. I just want to throw in that NAMI's website is easy to remember. It's NAMI, N-A-M-I dot org, NAMI dot org.

[00:41:33] And we always wrap up, which I hate to do. I hate to wrap this conversation up. My gosh. But we always wrap up our conversations with guests with a question about hope. And here's yours, Lisa. What possibilities and changes can occur within a family dynamic that give you hope? Oh, there's so much reason to have hope. Sometimes that's all you got. That's all you got is hope.

[00:42:01] When you see family members working on their healing and you see them talking to each other in a way that they never did before, and you see changes in their lives, they're not just talking it, but you feel different with them. You hear differences in their stories. You see them taking responsibility. All that gives me hope.

[00:42:27] And I know, like I said, if I can help them get to a point in that trajectory where they won't go backwards. They just won't. If they do enough work, it's onward. It is onward. And this is what I was going to say to you, Valerie, and to Helen, too. These, I love to look at families from the big picture, you know, because families are timeless.

[00:42:54] There's always been families, and any one member of a family, all it takes is one that has done their work to heal, changes the trajectory of a family for generations, for generations. And I love family therapy because I like to kind of hear where, you know, maybe where did the grandparents come from? What were the struggles they had? Because then it will make that person sitting in front of me, it makes much more sense to me and to them.

[00:43:20] But their healing causes a trajectory, and it makes it more healthy for all the future people in that family. It just gives me the chills. I mean, this work is, you know, it never felt like a job to me. It always felt like a calling, and it's magical because you see people. Change is not easy, but it's so rewarding.

[00:43:45] And to be able to see that in front of your eyes, and I had to go through my own therapy and support groups, and, you know, I did all that because the family I came from, it helped me be a better therapist. But it's magical and wonderful, and there's a lot of hope for the future. The stigma is being taken away somewhat.

[00:44:07] The medications that are available now for, you know, for bipolar disorder, depression, and anxiety, and schizophrenia. I mean, there's a lot of stuff around that wasn't here when I started my practice 40 years ago. A lot of support, a lot of support groups, a lot of education. People know a lot more about mental illness and addiction, and, you know, it's in all families. There's something in all families.

[00:44:37] Yeah. Yeah. So hope is absolutely you want to keep the hope. Well, I think that in terms of looking at hope, which is something that we do every episode, is that to see that a change in one family member, as you said, can influence the trajectory of the family for generations to come. That's one of the most hopeful things that I've ever heard. Thank you for bringing that up.

[00:45:06] Ah, sure. Sure, sure. And this is, unfortunately, we don't want to do this, but this is sort of where we're bringing our topic to an end. And, Lisa, thank you for your expression of hope and the countless ways that you have enlightened us today. It's simply, I couldn't count it if I tried. And, you see, it enriches all of us to hear your professional perspective and wisdom.

[00:45:35] And thank you so much for being so forthcoming with it today. Thank you, my dear friend. Thank you. Thank you. So happy to be here. I'm happy I could help. It's, I like talking about this stuff. I, yeah, ask my family. Well, it's endlessly fascinating. And I wish, again, I wish that we had another, I don't know, day.

[00:45:58] But what we're going to do now is what we always do, and that is to turn to Valerie for a mindfulness exercise. Yes, we will close today's episode in our traditional way with a mindfulness exercise. And what is mindfulness? I always give a definition. Mindfulness is a mental state achieved by focusing one's awareness on the present moment,

[00:46:23] while calmly acknowledging and accepting one's feelings, thoughts, and bodily sensations without judgment. Today's mindfulness exercise introduces a new breathing technique. Now, here on the Mental Health Hope and Recovery podcast, we know the importance of our breathing as a part of successful meditation and mindfulness practices.

[00:46:49] How we breathe influences all sorts of things in our bodies. Most significantly, how we breathe directly influences our nervous system, which is responsible for how we feel and how we interpret the world around us. We have started every mindfulness exercise since our first episode with diaphragmatic breathing. And today, I'm going to lead us in a new type of breathing.

[00:47:18] The technique of box breathing. Now, listeners, you know that Helen and I do lots of research for each episode. So yes, I researched box breathing. And in my research about box breathing, I learned that it is used by U.S. Navy SEALs. They use it to help them stay calm and alert through any sort of situation. And they have some intense, stressful situations.

[00:47:48] So author and former Navy SEAL Mark Devine says it slows down his breathing rate and deepens his concentration in all sorts of situations. Box breathing has also been used as a treatment for insomnia because it allows us to calm our nervous system at night before bed.

[00:48:09] The Mayo Clinic reports the benefits of box breathing in addition to the powerful benefit of anxiety reduction include pain management and improved mood. So what is box breathing? How does it work? Box breathing is a repetitive breathing pattern of four equal length intervals. It has a pattern of inhale, hold, exhale, hold.

[00:48:38] An easy way to do it is to close your eyes and imagine a square. The pattern is to breathe in for four seconds as you start from the bottom left corner and move vertically up the square. Then you hold your breath with your lungs inflated for the next four seconds as you move to the right at the top of the square. From the top right corner, you move down the square and exhale for the next four seconds.

[00:49:03] Then finally, you move left along the bottom of the square as you hold your breath with your lungs deflated for the final four seconds. So you see you just moved around the square. Your lungs are inflating as you move up the square and deflating as you move down the square. And you're holding your breath as you move horizontally along the top and bottom of the square. Sounds confusing, but it's not. We're going to keep running through it.

[00:49:30] So you inhale up, hold across, exhale down, hold across. Breathing as you go around the square. Once again, before we run through it. Inhale up, hold across, exhale down, hold across. That's how you breathe as you go around the square. And remember to breathe through your nose and out through your mouth. Let's run through it again before we try it. Imagine a square.

[00:50:00] Inhale for four seconds, starting at the bottom left corner and move up the square. Hold your breath with your lungs inflated as you move to the right. From the top right, move down, exhaling for four seconds. Then you're going to move left, going along the bottom of the square as you hold your breath. Okay, let's try it.

[00:50:29] Close your eyes if you can. If you're walking or driving, please adapt this exercise so that it's safe for your surroundings. Imagine a square. Inhale. Inhale. Start from the bottom, the left corner. Go up the square. Hold your breath with your lungs inflated.

[00:50:57] Move to the right along the top of the square. From that right corner. Move downwards, exhaling. Now move left along the bottom line of the square, holding your breath. Let's do it again. Exhale. Still imagining the square. Inhale up the left side of the square.

[00:51:26] Hold your breath with your lungs inflated, moving to the right. Exhale down the right side of the square. Take a breath with your lever down the top.

[00:51:52] If you paling stand by Gazalak. Exhale down. Hold your breath going to the left. Hold your breath going to the right. Exhale down.

[00:52:24] Hold your breath going to the left. If your eyes are closed, please open them and gently bring yourself back to the room. When you feel anxiety or stress rising in your body, remember there are things that can be done to calm down those areas of the brain.

[00:52:52] Try picturing the box. Trace the edges. Inhale. Hold. Exhale. Hold. Inhale. Hold. Exhale. Hold. Try it. Use it. Thank you for doing this mindfulness exercise with me. Well, thank you, Valerie. I worked very hard to follow your directions for this because it's so refreshing to learn another method of breathing.

[00:53:20] I think I have a ways to go, but I've got a good start today. And Lisa, our deepest gratitude for the much-needed wisdom and insight that you gave us today. Thank you so much. And to our listeners, family members around the globe, thank you for joining us for the family series and for the terrific responses we've gotten from our worldwide audiences.

[00:53:45] Our next episode features a brilliant book with its co-author as our guest. The book is called When a Loved One Won't Seek Mental Health Treatment, and it deals with one of the biggest concerns that Valerie and I encounter in our work everywhere. We encourage all of you to join us. And now, I leave you with our favorite word, onward.

[00:54:09] I believe love never dies, even after someone has left the physical world. I'm spiritual medium Marilyn Kapp, and I want you to know that your loved ones on the other side share the need for love and connection.

[00:54:33] On the Past Yet Present podcast, I show you that communication can become collaboration. Join me for the show, part of the mindbodyspirit.fm podcast network and wherever you get your podcasts. Are you curious about why we're here on this planet? If you find yourself pondering big questions and you like exploring topics like near-death experiences, the spirit world, and reincarnation, join us on Closer to Venus.

[00:55:03] I'm Johnny Burke, and I talk with experiencers and researchers in the field each week to get insights into some of these questions. You can listen on the mindbodyspirit.fm podcast network or podcast directories everywhere.