When trauma is “the norm”: About CPTSD

May 18, 2021

Complex post-traumatic stress disorder, or CPTSD is not a formal mental health diagnosis, but this term describes a mental health condition related to the exposure of repeated and chronic traumatic experiences. “Complex PTSD comes in response to chronic traumatization over the course of months or, more often, years. This includes emotional, physical, and/or sexual abuses, domestic violence, living in a war zone, being held captive, human trafficking and other organized rings of abuse, and more. While there are exceptional circumstances where adults develop C-PTSD, it is most often seen in those whose trauma occurred in childhood.” Definition retrieved from https://www.beautyafterbruises.org/what-is-cptsd.

The difference between PTSD and CPTSD

When we think of trauma, we think of physical abuse, sexual abuse, witnessing death, experiencing a natural disaster, or being in a life-threatening situation. These are “big traumas”, or “big T’s”. Post-traumatic Stress Disorder, or PTSD is a formal diagnosis that describes the distressing symptoms and impacts of big T traumas. While more rare, a chronic or repeated exposure to big T traumas would fit the CPTSD criteria. These big T experiences of trauma are often recognizable as a root cause of distress, as opposed to emotional or psychological trauma. These types of trauma are “little traumas”, or “little t’s”. The main difference between PTSD and CPTSD is the recurring exposure to trauma for a long period of time that is associated with CPTSD.

Little traumas are distressing experiences that aren’t in the big T category, and can be more challenging to see. These include, but are not limited to: being insulted, invalidated, humiliated, shamed, made to feel unsafe, made to feel incapable, made to feel less than or unworthy, neglected, violated, etc… Often, CPTSD develops when children experience repeated and chronic little t’s by caregivers or other prominent individuals in their lives.

What this looks like in childhood

Here’s an example of complex trauma in childhood from little t’s: A 10-year-old boy works hard at school to get good grades because he was told for years by his parents that he won’t amount to anything unless he’s a straight-A student. He starts struggling with test anxiety, and even though he studies for hours every day, he gets B’s and C’s. When his grades come in, his parents often say things like: “This isn’t hard, why aren’t you getting this?” “You’re not trying hard enough.” “You’re lazy.” “You must be dumb if you can’t do any better.” Eventually, the boy stops trying to get good grades and starts spending his time doing other things besides his school work. He starts to believe that he won’t amount to anything and feel that life is pointless.

Children who experience repeated insults, shame, or humiliation, such as in the example above, start to believe what they are told about themselves. More so, the mind and body start to try and cope with the trauma by disconnecting from the experience and body, which can lead to chronic psychological, physiological, and emotional issues and difficulties. These difficulties can impair a person’s overall functioning in childhood and adulthood.

What this looks like in adulthood

If we continue with the example above, how this person functions as an adult could look like this: he’s now 25 and works part-time at a tech store and lives alone. He wants a long-term committed relationship, but has a dating pattern of frequent short-term relationships. His relationships often end with him screaming at his partner after he’s asked what he wants to do with his life, which triggers the trauma of his parents saying that he wouldn’t amount to anything. After his break-ups, he secludes himself in his bedroom for days, sometimes missing work because he can’t get out of bed. He struggles with depression, anxiety, low self-esteem, and emotional regulation issues.

Adults who experience CPTSD may not be aware they have experienced trauma. They may feel something is wrong or “off”, but not know what is making them feel that way. Even more so, the way they feel may be so long-standing, that it’s their “normal”, making it difficult to recognize and address.

Common signs of CPTSD:

Anxiety
Depression
Difficulty managing anger
Low self-esteem
Suicidal ideation
Feelings of hopelessness
Impulse issues
insomnia
Quick mood changes
Difficulty maintaining relationships

Recovering from CPTSD

While CPTSD can be difficult to uncover, there are ways to recover. Different types of therapies, such as EMDR, somatic experiencing, trauma-focused cognitive behavioral therapy (TF-CBT), trauma-focused emotion-focused therapy (TF-EFT), brainspotting, and others specifically address and help people work through their trauma. For more information on different types of trauma-focused therapies, visit the links in Resources below.

What if this is you?

If you’ve experienced the impacts of CPTSD, there is hope and help for recovery. The therapists at Fuller Life Family Therapy are qualified and trained to help you heal. To schedule an appointment, call (855) 245-5433 or email info@fullerlifefamilytherapy.org.

Resources:

EMDR

Somatic experiencing

Trauma-focused cognitive behavioral therapy (TFCBT)

Trauma-focused emotionally focused therapy (TFEFT)

Brainspotting

What is CPTSD?

Contributed by Lindsay Perry, LPC Associate

Clinical supervision by Amy Fuller, PhD, LMFT-S, LPC-S

Categories : Anxiety & Panic, Anxiety Issues, Child Abuse (Safety), Counseling, Depression, Depression, Bipolar, EMDR, Emotions and Relationships, Mental Health, Self-Awareness, Self-Esteem, Suicide Awareness (Crisis Info), The Human Brain, Trauma and Loss

Tags : anxiety, childhood abuse, counseling, depression, Emotional Abuse, emotional regulation, self-awareness, self-esteem, trauma

Are you “HEALING” or “DERAILING” your grief process?

Posted by 1-Stephanie Jordan on

March 23, 2021

· No Comments

Grief is an equal opportunity offender and impacts everyone, especially during the era of COVID-19. However, how we understand grief varies from person-to-person. Many understand grief through “stages” but realistically a human being’s emotions don’t occur in sequential order. They do not unfold in a predictable way but contains a fluctuating mix of psychological experiences including thoughts, feelings, behaviors, and physical changes. These vary erratically and unpredictably in the short-term, and can evolve over a variable period of time. Grief is different for each individual and each loss is also different and can depend upon who the loved one is, how they died, and the stage of life before their death, etc. Grief can reflect a form of love when a loved one dies.

Columbia University’s Center for Complicated Grief offers two unique acronyms to understand grief: “HEALING milestones” and “DERAILERS.”

“Healing Milestones” allow individuals to adapt to changed circumstances, accept reality, restore well-being and integrate grief into one’s life experiences.

H – Honor your loved one and yourself, reconnect with your own interests and values

E – Ease your emotional pain, allow emotions in your life, both painful and pleasant

A – Accept grief and let it find a place in your life

L – Learn to live with reminders of your loss

I – Integrate memories of your loved one into your life; let them help you learn and grow

N – Narrate stories of the death so that you can understand and accept the reality of your loss

G – Gather friends and loved ones and let them into your life. Let them support you

Likewise, the journey through healing grief, can become blocked. Consider these “DERAILERS” to help see when the progress is hindered which can lead to prolonged or complicated grief.

D – Doubt that you did enough for the person who died (caregiver self-blame)

E – Embracing the idea that intense grief is the only way to honor the person who died

R – Repeatedly imagining scenarios, “if only” thinking

A – Anger and bitterness you can’t resolve or let go of

I – Insistent belief that this death was unfair, wrong, or should not have happened

L – Lack of faith in the possibility of adapting to the loss and having a promising future

E – Excessive avoidance of reminders of the loss

R – Rejecting support from others, unable to let others help, feeling hurt and alone

S – Survivor guilt that is stopping you from experiencing joy and satisfaction

There is no “true north,” on life’s internal emotional compass, to finding one’s way out of grief. Likewise, there are no fixed stages to go through to finalize one’s grief process. Learn to integrate healing milestones into your heart and avoid derailers that hinder your progress forward. Learn to tolerate the unpredictable shifts in your mood, and the directional shifts in your emotions. Grief is done, when it’s done.

If you would like to learn more about HEALING milestones and DERAILERS and how grief has impacted the African American community during COVID-19 click on the link below and watch this free webinar.

Reference:

Loss & grief in real time: The African American experience with COVID-19. (n.d.). Social Work Action Lab for Social Justice. https://actionlab.socialwork.columbia.edu/content/loss-grief-real-time-african-american-experience-covid-19

Categories : Counseling

Tags : acceptance, African American Grief, grief, Grief and COVID-19

When African Americans Grieve

Posted by 1-Stephanie Jordan on

October 19, 2020

· No Comments

This summer, the nation and the world grieved the loss of George Floyd and other victims of police violence. The sting of racial injustice combined with police brutality continues to cause outrage and incalculable grief among African Americans; a “conscious nightmare” if you are black in America. Grief as a function of ethnicity is not widely researched within the bereavement scientific community; particularly grief experiences of African Americans. However, the grief process for African Americans differs from Eurocentric culture and has distinct factors and features which contribute to their grieving process.

Distinct Factors That Contribute to the African American Grieving Process

There are many factors that contribute to a distinct grief process for African Americans. These include losses to homicides, a diminished lifespan, a history of sociological disadvantages, poverty, racism, oppression, police brutality, civil injustices, incarceration, and drug and alcohol abuse.

The Centers for Disease Control (CDC) data shows the homicide rate among African Americans is eight times higher than that of Caucasians. Thus, African Americans are likely to experience premature loss of a loved one to homicide. They live approximately six to seven years fewer than Caucasians. Moreover, socioeconomic disadvantages persist across multiple generations of African American families. These life-long, and lingering stressors contribute to how African Americans experience grief and is commonly referred to among mental health professionals as complicated or prolonged grief experiences.

Distinctive Features of African American Grief

There are inherent strengths and distinct features that show how grief differs in the African American culture in contrast to the Eurocentric culture. Continuing bonds, changes in self-identity, kinship bonds, professional and social support, and religious coping are a few of these features.

Continuing Bonds: African Americans are likely to maintain ongoing spiritual connections with deceased loved ones, mark birth and death occasions, connect to loved ones through dreams or sense their loved one’s presence or have conversations with them, and make frequent visits to the cemetery.
Change in Self-Identity: Likewise, in this close-knit culture, there is an interconnectedness within “the village” that affects one’s sense of self in the African American community more so than in other groups.
Kinship: A loss to an extended family member or close friend, in the African American community, is just as significant as a loss in one’s nuclear family. It profoundly affects “the village” regardless of formal kinship.
Professional/post social support: African Americans are also less likely to use professional therapy services and embody stoicism to a fault. Researchers suggests African Americans believe that sorrow and suffering are to be expected and difficult circumstances tolerated rather than seek help to address the situation. Family support helps, unless members are emotionally preoccupied and have limited capacity to help others through loss.
Religious Coping: African Americans that do seek help, turn to religious coping and rely on faith, spirituality, and prayer with some seeking informal counseling with church pastors.

When African Americans Grieve

When it comes to grief and African Americans, there is no one-size-fits all approach. Important cultural differences and grief variations that are in relationship to – and as a result of – external environmental, structural, and social factors must be considered by mental health professionals in order to understand, and not pathologize, the African American grief experience. While some members in “the village” may stigmatize counseling and therapy services, getting help for grief, loss, and trauma can be cathartic and restorative.

References:

Laurie, A., & Neimeyer, R. A. (2008). African Americans in bereavement: Grief as a function of ethnicity. OMEGA – Journal of Death and Dying, 57(2), 173-193.

Boulware, D. L., & Bui, N. H. (2015). Bereaved African American adults: The role of social support, religious coping, and continuing bonds. Journal of Loss and Trauma, 21(3), 192-202.

Rosenblatt, P. C. (2017). Researching grief: Cultural, relational, and individual possibilities. Journal of Loss and Trauma, 22(8), 617-630.

Jarosz, B. (2020, April 16). Disadvantage for Black families compounded by economic circumstances of Kin – Population reference bureau. Population Reference Bureau – Inform, Empower, Advance. https://www.prb.org/disadvantage-for-black-families-compounded-by-economic-circumstances-of-kin/#

Categories : Counseling, Depression, Grief, Mental Health, Trauma and Loss

Tags : African Americans, Black in America, counseling, Cultural Differences, depression, George Floyd, grief, mental health, Racism and Grief, trauma

Teletherapy, Is It Right For Me?

Posted by Angela Blocker on

August 3, 2020

· No Comments

Since the outbreak of COVID19, many healthcare professionals have switched to telehealth platforms, including counselors and therapists! Called Telemental health or teletherapy, it is the use of telemedicine to provide mental health assessment and treatment from a distance, such as online or through the phone. For those of us more accustomed to traditional face-to-face therapy sessions, it is normal to feel hesitant, uncomfortable, or even skeptical. However, teletherapy does have its benefits and can be very effective.

Here Are Six Things to Know:

Your Confidentiality is a Priority

Confidentiality is the foundation therapy builds upon and is crucial to a trustworthy relationship between therapist and client. For this reason, counselors take extra precaution to protect you when offering services through the phone or online. Information transmitted online offers more opportunities for privacy leaks and hacks. Counselors are required to use HIPAA approved online platforms that protect your personal information each step of the way. These platforms reduce the risks of breaches occurring over the internet and your private information being compromised.

Teletherapy Increases Access to Treatment

Physically traveling to and from a therapy office can be cumbersome or even impossible for some, especially for those who are sick or disabled. Telemental health extends care to those physically unable to come in for treatment. It also allows you and your therapist to continue care if either is ill but well enough to engage in the session. Telemental health also provides a safe alternative when severe weather prevents travel or during times of social distancing, as we are experiencing now with COVID-19.

TeleMental Health Increases Options in Type of Treatment and Therapist

Finding therapists with specific areas of expertise such as trauma, marriage, grief, or a certain mental health disorder may otherwise be limited by physical traveling distance; but, telemental health extends access to therapists across your state. Teletherapy also makes it easier to find a therapist who speaks the same language or is more experienced working with a specific cultural group.

The Quality of In-Person Therapy is Not Lost

The rapport between you and your counselor is important. Many are concerned that the screen or phone will create a barrier that makes the therapeutic process too impersonal. However, compared to face-to-face therapy, there is no significant difference between the perception of the working relationship between the client and the teletherapist. There was also no significant difference in overall satisfaction with services. When one study controlled for technological difficulty, the study indicated that session smoothness and depth were not significantly different from in-person treatment either.

Your Safety is Important

Since teletherapists are physically distant from you, responding to a crisis is more tricky than being in the room with you. However, your teletherapist will create a safety plan with you before the first session begins just in case! This helps to ensure safety in the event of an emergency.

Teletherapy is Effective for Kids, too!

One qualitative study showed that kids and teens tend to feel more comfortable with technology than adults when in therapy remotely. Children also felt they had more choice in the process of therapy. In some cases, telemental health has been shown and hypothesized to be better for some kids than in-person care, like those with some autism spectrum disorders. Some children with ADHD had a higher satisfaction rate when using teletherapy as opposed to traditional therapy.

Telemental health can be a new and exciting way to experience therapy during this time. At the same time, teletherapy is not for everyone and it is important to share any concerns with your therapist who has expertise in navigating telehealth benefits and challenges. We work with you to help you choose the best course of treatment for you! For more tips on creating a confidential space for teletherapy, frequently asked questions about telehealth, or information on getting started with teletherapy at Fuller Life, you can read more here or to ask a question feel free to email us at info@fullerlifefamilytherapy.org.

Self-Care in the Time of Corona

Posted by Manet Castaneda on

June 22, 2020

· No Comments

Difficult Times

As our nation and world around us is surrounded by news of the COVID 19 epidemic, it can be very easy to neglect self-care due to the different struggles that can arise from this unique situation. It is not uncommon to experience feelings of anxiety, depression, loneliness, confusion, and even anger during this difficult time. Because of this, it is important to deal with these emotions in ways that are helpful and healing. Self- care is one way in which we can deal with difficult emotions and situations. Keep in mind that self-care is what we do (or stop doing) to take care of and improve our mental, physical and spiritual lives. Below are a few ways in which you can practice self-care during this particular situation that we are all facing as a community.

Practice Gratitude

Practicing gratitude has been found to have a positive impact on how our bodies and minds feel. When we practice gratitude, this stimulates oxytocin in our brains, and this helps relax the nervous system. There are two ways in which we can practice gratitude. The first is to practice gratitude for within, that is to say, being grateful for your life, body, breath, mind, strengths, etc. The second way we can practice gratitude is outwardly by being grateful for others, our pets, nature, resources, and other elements outside of us.

Seek Social Connections

During the quarantine, it can be difficult to maintain in touch with others, however it is still important to seek out those connections for support. Having a community or a tribe of people that you can count on can help reduce the feelings of loneliness and isolation. Some ways we can keep in touch during this time is via video phone calls, writing text messages, writing letters, or social media. With any relationship, it is important to be intentional about the type of communication you have, so find ways to be creative with your communication during the time of Corona.

Stay Active

Keeping an active lifestyle can keep improve your mood and boost your energy levels. During the quarantine it can be hard to find ways to exercise, so take some time to research various at home workouts that are available on the internet. Find ways to be creative with your workouts, try new forms of exercise that perhaps you have always been interested in. Make it a social activity by including your family members or roommates. Consider making a schedule that fits your daily activities so that you are more likely to stick with it.

Seek Help

Lastly, if you find yourself having a hard time with the isolation and the issues that have come up as a result of the quarantine, it is highly encouraged to seek professional help. Many organizations including our own (Fuller Life Family Therapy Institute) are offering telemental health services. If talking to someone about your struggles is something you are considering, now might be a good time.

Categories : Anxiety & Panic, Anxiety Issues, Covid-19, Depression, Gratitude, Lifestyle, Mental Health, Mindfulness Practice, Parenting, Relationships, Self-Care Practices, Stress Management

Tags : anxiety, depression, gratitude, physical well-being, self care

Vicarious trauma: When we feel the pain of someone else’s trauma

Posted by 1-Lindsay Perry on

May 21, 2020

Being on the front line in times of crisis can be difficult and draining. For those in helping fields, these kinds of crises can be an everyday experience. When does it become too much to carry? How do we know when the stress goes from what’s expected from the work we do to something that is significantly impacting our lives? If this feels familiar, you may be experiencing vicarious trauma or compassion fatigue.

During this time when the world is experiencing a health crisis, is it possible to feel someone else’s trauma from the news stories we see?

What is vicarious trauma?

Vicarious trauma can be described as the direct or indirect exposure to someone else’s trauma that impacts one’s own physical and/or psychological well-being. This is also known as compassion fatigue or secondary trauma. Those who are in a helping or rescuing role are at risk for experiencing vicarious trauma. You may be thinking this sounds like burnout, but burnout can be described as workplace stress that impacts one’s physical or psychological well-being. The important difference here is that, unlike burnout, compassion fatigue involves being exposed to someone else’s trauma. In being exposed to someone else’s trauma, your life can be negatively impacted by what you’ve seen or heard in those helping or rescuing experiences.

Signs of compassion fatigue

We can start to understand whether our experience is workplace burnout or vicarious trauma by being aware of how we think, feel, and behave in our everyday life. There are multiple signs of dealing with compassion fatigue. These include, but are not limited to:

Physical exhaustion
Mental and emotional exhaustion
Insomnia
Nightmares
Use of or dependence on alcohol, drugs, or addictive behaviors
Lack of ability to empathize with others
Workaholism
Hyper-vigilance (constantly being worried about the safety of yourself and others)
Cynicism (a belief that everyone is acting out of self-interest and outlook of the world is bleak)
Anxiety (often feeling nervous, scared, or constantly thinking of things that could go wrong)
Depression (feeling numb, unmotivated, and exhausted)
Anger (getting easily angry to a degree that is inappropriate to the situation)

What if this is you?

Experiencing vicarious trauma can take a toll on your overall well-being, but there are things you can do to prevent and cope with it.

Contact Fuller Life Family Therapy

Here at Fuller Life Family Therapy, we have a group of trained professionals who can help individuals who are dealing with vicarious trauma. For more information, or to schedule an appointment, please email us at info@fullerlifefamilytherapy.org or call our main number (855) 245-5433.

Resources

Good Therapy – Vicarious trauma

Psychology Today – Vicarious trauma and the professional interpreter

Psychology Today – When vicarious trauma victims suffer from PTSD

Psychology Today – Trauma workers at risk for compassion fatigue

Contributed by Lindsay Perry, LPC Intern

Clinical supervision by Amy Fuller, PhD, LMFT-S, LPC-S

Categories : Counseling, Mental Health, Self-Awareness, Sticky, Trauma and Loss

Tags : mental health, self-awareness, trauma

When Grief and Spirituality Intersect

Posted by 1-Stephanie Jordan on

March 30, 2020

· No Comments

In light of the recent global novel Coronavirus pandemic that spread and claimed the lives of hundreds of thousands of people in local communities, cities, states, and countries around the world, many individuals are experiencing grief in the midst of this calamity. Some have lost loved ones due to the virus, are unable to have or attend funerals for the deceased loved one, are personally suffering from or know someone suffering from the virus, are dealing with the psychological and emotional effects of “social (physical) distancing,” and are worried about meeting the most basic needs for their family’s survival and livelihood. These concerns, among others, have caused many to experience some form of personal grief, or an existential crisis in spirituality.

Death itself, whether untimely or anticipated, sometimes leaves unanswered questions. Dr. Mark Kellenman, author of the book, “God’s Healing For Life’s Losses” examines the complexities of life’s unanswered questions; in the midst of death and in the midst of human suffering. His book offers readers a perspective on grief, spirituality, and hope through the Divine Redeemer. Although the book is specifically written for individuals of Christian faith, the concepts and perspectives shared may be applicable to other religious faiths as well. This blog will share grief perspectives from the book on how to move from depression to hope on one’s grief journey.

Traditional Perspectives on Processing Grief

Many people are familiar with the five stages of grief model first introduced by psychiatrist Elizabeth Kübler-Ross. She speculated that an individual experiences denial (stage one), anger (stage two), bargaining (stage three), and depression (stage four), before coming to acceptance (stage five). The model suggested that grief occurs in a sequential process until they reach the final stage.

Dr. Kelleman, however, viewed the five stages of grief model as too one-dimensional. Noting that individuals tend to deal with their grief in separation from others which leads to feelings of spiritual abandonment, social betrayal, and feelings of shame and self-contempt. Dr. Kelleman believes this causes spiritual depression.

Spirituality Perspectives on Processing Grief

Dr. Kellenman’s grief model, which he describes as God’s Positioning System (GPS), explains grief as a multi-dimensional process, where individuals respond to grief by integrating spirituality into their grief process. The model introduces eight stages. Four stages address hurt and four stages address hope.

Four Stages of Hurt	Four Stages of Hope
Candor: Practice honesty with myself.	Waiting: Groaning with Hope.
Complaint: Honesty with God.	Wailing: Trusting with Faith.
Cry: Ask God for help.	Weaving: Perceiving with Grace.
Comfort: Receive God’s help.	Worshiping: Engaging with Love.

The eight stages describe how grievers can suffer a loss and come face-to-face with God. The traditional grief responses, introduced by Kübler Ross, are not to be minimized. Dr. Kellenman encourages grievers to learn how to move from denial to personal honesty, from anger to honesty with God, from bargaining to asking God for help, and from depression to receiving God’s help.

Moreover, the four stages of hope describe how grievers can take God’s hand and journey forward in life (acceptance) while facing the realities of their loss. Dr. Kelleman, calls this “creative suffering.” That is, creative suffering converts the suffering that batters and causes depression, into hope that, The Redeemer can bring healing to hurting hearts.

Journeying in Hope: An Alternative Perspective

Dr. Kelleman, explains the journey of grief can be emotional, complicated, and messy. It comes with hills and valleys and good days and bad days. It is normal to feel hurt and it is necessary to grieve. Remember that taking the journey with God places one’s trust and faith in His good character and his good heart that better days will come. Likewise, contemplating suffering from a grace perspective nurtures alternative ways to view life’s losses where hope can flourish, and spiritual growth can mature.

Reference:

Kellemen, R. W. (2010). God’s healing for life’s losses: How to find hope when you’re hurting. Winona Lake, IN: BMH Books.

Categories : Anxiety Issues, Counseling, Covid-19, Depression, Depression, Bipolar, Mental Health, Spirituality, Trauma and Loss, Unemployment

Tags : anxiety, death, depression, grief, Grief Models, healing, loss, mental health, spirituality, trauma and loss

Fuller Life Family Therapy: Covid-19 Update

Posted by AmyFullerPhD on

March 17, 2020

· No Comments

updated 3-31-20

A Letter to Our Clients

This message is to all our clients and potential clients at Fuller Life Family Therapy.

We know that there’s widespread concern in our community about the Coronavirus Disease 2019 (COVID-19), and we want you to know that your health is our top priority at Fuller Life Family Therapy Institute. Please refer to the CDC website and the World Health Organization website for up to date information.

We are available

During this unprecedented time, we are working hard to make sure access to therapy is available. At Fuller Life Family Therapy, telemental health therapy sessions are now in place through our HIPAA-compliant video conferencing tool. Existing clients will be contacted with details or can call the office for set-up instructions. New clients are encouraged to call and set an initial appointment which can be conducted through our telemental health platform. All clients will need to read and sign our Telemental Health Informed Consent.

For now, our physical offices are closed but our staff is still available. Please let us know what we can do to help you and yours during this difficult time.

Online Therapy is Effective and Secure

Research shows that technology assisted therapy can be just as effective as in-person appointments, and we can continue your care without interruption. The online therapy will be offered through a HIPAA compliant program. With many schools and companies going online, some of these programs are becoming overloaded and as we work through this transition, we may offer more than one online option as we try to find the best fit. Please accept our apology for unexpected technical difficulties for those we do see online.

No cancellation fees

All cancellation fees due to illness will be waived through April 30th, 2020 and may extend that date as needed. We will inform everyone of any additional changes and we hope to help each and every one of you get through this difficult time.

In order to utilize technology assisted services please read and sign the Consent form for Telemental Health. This consent is in addition to our current consent form. Please talk to your therapist if you have any questions or concerns about using technology assisted therapy services.

Refer your friends

If you know anyone that is having a difficult time, please have them reach out to us and we will do our best to help.

We’ve included some resources below to help you maintain your mental health during this challenging time.

Thank you from the therapists at Fuller Life Family Therapy.

Here are some articles you may find helpful during this time:

Categories : Counseling

The unexpected reality of intimate partner violence

Posted by Terry Hoisington on

February 16, 2020

· 2 Comments

Sometimes relationships are surprising – and perplexing. What begins as an ideal match in the eyes of others, can be a disappointing world of nightmares.

When this relationship with an intimate partner appears different in public than it is in private, it may be time to examine the direction that the relationship is growing into.

How do you know when it is time to examine your relationship? One red flag is when the “ideal” relationship only exists in public. Sometimes, the private relationship is very different than the one shown to others.

Is there reason for discomfort?

If examining the relationship brings definite feelings of discomfort, there may be valid reasons for that feeling. Consider the following points.

Does your partner:

try to control what you are doing, check your phone, e-mail or social media without your permission?
force you to have sex when you don’t want to?
attempt to control your birth control or perhaps insist that you become pregnant before you are ready?
decide what you wear or eat?
decide or how you spend money?
humiliate you in front of others?
prevent or discourage you from seeing or visiting with friends, or family.
unfairly accused you of being unfaithful?

If you can answer yes to any one of these questions, you are likely experiencing domestic or intimate partner violence (IPV).

IPV is sometimes difficult to identify. Many people have a reaction of “Whoa, not me, my husband/wife, boyfriend/girlfriend loves me.” Love is not just about romance though. It is about respect, and respect has no room for violence in any form.

IPV is about control and abuse in any part of a person’s life. This control or abuse may be experienced in social activity, finances, religion and even sexual activity. What is helpful to understand is that IPV is very subtle and progresses over time.

What is Intimate Partner Violence?

Society tends to think of violence as being solely physical abuse. However, emotional abuse can be just as, or even more, damaging. IPV is a physical episode of being hit, beat, or pushed. It may be a situation of being blamed for a partner’s violent outbursts. It is important to realize that IPV is not limited to physical violence. Statements such as “If I can’t have you, then no one can” also qualifies as IPV. Verbal insults, humiliation and put-downs are also forms of IPV. It can also involve hurting or threatening someone’s children or pets.

As defined by the Center for Disease Control and Prevention, Intimate Partner Violence is

“…violence or aggression that can vary in frequency and severity and occurs on a continuum ranging from one episode that might or might not have lasting impact, to chronic and severe episodes lasting over a period of years.”

The Center for Disease Control and Prevention tells us that IPV can be four types of behavior:

Physical violence is when a person hurts or even tries to hurt a partner by hitting, kicking or using any other type of physical force
Sexual violence is forcing or trying to force a partner to take part in a sex act, touching or sexting when a partner does not or cannot consent
Stalking is a pattern of repeated, unwanted attention/contact by that causes fear or concern for safety of self or someone close to the victim
Psychological/emotional abuse occurs when a person is verbally humiliated, shamed, controlled or isolated from family or friends

What is emotional abuse?

Emotional abuse often leads to any one of the other three types of IPV. It is far more subtle and less talked about since it leaves no scars on the outside. Emotional abuse can be just as damaging. Katie Ray-Jones, president of the National Domestic Violence Hotline (NDVH) stated in an interview with Cosmopolitan.com that one woman told her…

“I can still hear his voice in my head. Even though I’ve been out of the relationship for three years, I still feel like I’m sitting there.”

Another individual relayed a similar experience indicating that trauma from emotional abuse was evidenced 10 years after the event.

In many cases, the victim’s confidence, self-esteem and perception of their world are slowly undermined by the partner’s need to dominate or control. Counseling psychologist, Carmel O’Brien, Fellow of the Australian Psychological Society, says

“…what comes across again and again is that there’s someone in the relationship who thinks that their views are more important, their needs have to come first, and they basically should be making the decisions and the other person should be toeing the line.”

How does IPV impact its victim?

IPV does not discriminate! It can happen to anyone, anywhere, regardless of gender or sexual preference, economic status, religious, ethnic or cultural group. In whatever form it takes, IPV is never OK, and can result in consequences such as, but not limited to

poor physical health
depression and/or anxiety
trauma or posttraumatic stress
feelings of guilt or shame
low self-esteem or self-harm
an inability to trust others

It is important to understand what IPV looks and feels like. Resources are available to find help when discomfort in a relationship occurs. If you or a person you know is involved in Intimate Partner Violence, please reach out for help. A few resources, both national and local, can be found below.

Resources to find help

The resources below are good places to start reaching out for help or to receive guidance:

National Domestic Hotline – call 1-800-799-7233 or use the secure online chat in English or Spanish
ACF’s (Administration for Children & Families) Family Violence Prevention and Services Program administers the primary federal funding stream dedicated to the support of emergency shelter and related assistance for victims of domestic violence and their children.
National Coalition Against Domestic Violence: State Coalition List provides a directory of state offices that can help you find local support, shelter, and free or low-cost legal services. This includes all U.S. states, as well as the District of Columbia, Puerto Rico and the Virgin Islands.

Find help in the Houston area:

Bridge Over Troubled Waters (713)473-2801 in Pasadena, Texas – Provides residential shelter in a family atmosphere for women & children in crisis, as well as counseling and educational services
Family Time Crisis and Counseling Center (281)446-2615 in Tomball/Humble, Texas
Houston Area Women’s Center (713)528-2121 is a Hotline
Houston Area Women’s Center
Domestic Violence Hotline: (713)528-2121, Rape Crisis Hotline: (713)528-7273
The Montrose Center (713)529-0037 on 701 Richmond Avenue, Houston, Texas77006 – Population: Lesbian, Gay & Bisexual and Transgender survivors of domestic violence can call the Gay & Lesbian Switchboard (713)529-3211
The Montrose Counseling Center provides around the clock, scattered site emergency shelter for LGBT survivors of domestic violence, as well as transitional housing. Advocacy & counseling services also are available.
Bay Area Turning Point Webster, Texas(281)286-2525 – Provides emergency shelter for battered women and children
Fort Bend Women’s Center located in Richmond, Texas, (281)342-4357 Provides safe shelter for battered women and children (under 18 years of age). Counseling and referrals provided to shelter residents.
Houston Volunteer Lawyers (713)228-0732 Provides pro-bono civil legal services, including family law, for low-income residents of Harris County who meet eligibility requirements.
Legal Line (713)759-1133

Contributed by:

Terry Hoisington, LPC-Intern

Under Supervision of Amy Fuller PhD, LPC-S

Categories : Boundaries, Counseling, Couples, Domestic Violence, Marriage, Relationships, Trauma and Loss

Tags : abuse, boundaries, couples, Domestic Violence, intimate partner violence, trauma

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