Dr. Mary Gresham

Therapy in your 20′s and 30′s

Dr. Mary Gresham — Mon, 07 May 2012 01:39:20 +0000

One of the most important times in your life to seek therapy is in your 20′s and 30′s.This is the time that you are making those life decisions that will impact the course of your future. Here are just some of the questions that you are busy answering:
Should I get married and to whom?
Do I want children?
What should I do for work and an income?
Where should I live?
Why is my marriage such hard work? Is this the way it is supposed to be?
How close do I want to be to my parents?How much should I stand up to them?

As you can see, these are the questions without easy answers.They will define your life for decades. And for many of us, the answers may be that part of me wants to do X while the other part of me wants to do Y. It can lead to a war within the self. Looking at the what you did in the past that lead to a good decision can help. This period of life is more about developing a process to use to make good decisions than about each particular decision. If you are torn inside or cannot develop a good decision-making process, this is a time in life to consider therapy.

The Secret Legacy of Male Depression

Dr. Mary Gresham — Thu, 03 May 2012 01:17:28 +0000

Whenever a successful man takes his own life, it comes as a shock to all who saw him as a success. Men who are deemed to be accomplished in life are seen as having it all. There is little room left for that man to have feelings that don’t fit the outward picture. Far too many men are suppressing feelings and needs that are simply human. It is easy for an accomplished man to feel as though he exists primarily to care for others and to deny as long as possible that he himself is in trouble emotionally.
Research on socialization of emotions, much of it done at Emory University, shows that little boys are generally steered to one feeling, the feeling of anger. When they tell a story to their parents, the parents often interpret the story of being upset to mean that the boy was angry. Meanwhile little girls are steered away from anger and towards sadness. No wonder the rates of depression are higher in women and the rates of addiction and outbursts are higher in men. This happens in educated well-meaning families without their awareness of directing their children by gender to interpret feelings in a certain way.
Traditionally men are also socialized to deny negative feelings in the presence of other men, where the typical interaction is one of teasing, humor and superficial talk about business or sports.This means that a man must have a supportive female partner who is interested in his feelings and is willing to work to try to draw him out. Men who do not have partners tend to have higher rates of depression as well, since they have little outlet to share their emotions. And many times men become depressed and don’t really know what is wrong..just that they are having trouble sleeping, are drinking too much or are escaping into television.
On the positive side, I see that younger men ( in Gen X and Y) do seem to have more access to their inner worlds and are more open than men brought up in the 50′s and 60′s. Younger men seem to be more accepting of treatment and seek out therapy on their own, not brought in by a female partner or a relationship loss as is more common with older more traditional men. Just as women now have more permission to direct their lives into either career success or motherhood or both, men eventually will have more permission to be authentic instead of feeling that they must measure their lives by how well they provided for others or by the image they projected. Books by Terence Real and David Wexler can help the process along, as can therapy. Being depressed means that something is not working in your life and is not a shameful or unacceptable situation. Seeking treatment is a healthy action that takes courage, not a sign of weakness.

For Singles in a Coupled World

Dr. Mary Gresham — Tue, 14 Feb 2012 17:17:07 +0000

Today is Valentine’s Day, a hard time for many single people because the world seems to be coupled. My single patients tend to have difficulties and distress at this time of year, feeling shame that they are still single. Most of them express that they feel no one has ever chosen them (never married singles) and have no validation of their lovability that they can show to others. Many feel discouraged with the quest to find a partner in love. Other patients (divorced/widowed) feel a lot of sadness that their primary relationship is gone but do not seem to have as much difficulty with the lack of validation.
Being single is a challenge in this culture where it is socially inappropriate to talk about loneliness and longing. Friends kind- heartedly try to soothe with words like “when you least expect it, it will happen” but singles experience these remarks as empty reassurance. Still other friends come up with advice, dating strategies and stories of friends who found someone but these comments are generally upsetting to a single person who is struggling to accept himself/herself as being alone.
It is so easy to compare oneself to others and ask “what is wrong with me that I am still single?” This is not a useful line of self-interrogation. It makes more sense to ask “how have I maintained my single status over the years?”There are many answers to this question; each answer will be unique to the person who is asking. Some push people away without realizing it because their parents had a bad marriage or got divorced. Some make no effort to meet other singles, wanting it to happen naturally without extending energy. There are plenty of staying-single behaviors that are not obvious to the person who says he/she wants a relationship.
It is hard to put yourself out there and be vulnerable and to show someone that you like them. The best stance is to keep looking for the special one and staying open while at the same time being happy with your life. This is easier to describe than to do but it means keeping the joy of life while at the same time seeking to change your life. That is where the paradox comes in. People you meet will be able to sense if you are desperate and you hate your life and that will be a turn off for them. They will also be able to tell whether you have a protective wall up and don’t want to risk letting anyone in and will move on. Wanting something and being okay with whether or not you are able to obtain it will keep you open while reducing your suffering about not having something that you want in life.

Rebuilding your life

Dr. Mary Gresham — Sun, 13 Nov 2011 22:40:43 +0000

There comes a time for each of us when we face the task of rebuilding an adult life from the ground up. It may be that losses are occurring in proximity to each other. Job loss, loss of a significant other, death of a family member, the emptying of the nest, or a change in economic circumstances are some the loss experiences that create the impetus to rebuild our lives. There are also many wonderful life experiences where we have to start over: a new job in a new city, graduating from school, leaving military service,retiring from a long term job and changing marital or parental status. It is hard to remember when we are feeling settled and comfortable that this state is temporary and at some point will come to an end. When the old life falls apart, it is easy to feel lost, alone and confused. The trite saying, “The only way out is through” is particularly true for these relaunching of ourselves.
Along with the stress of trying to make decisions and rebuild our worlds, there is also an opportunity to redefine ourselves and pursue other options that we may not have considered in the past. All of us also have unlived potentials inside of us that we can draw on to re-invent our new worlds.
The re-building task will confront us at a number of times in our adult lives and is part of the nature of how we live in the modern world. These transitions are distressing, challenging, and rewarding times in our lives and we need all the support we can get to keep depression and anxiety from overwhelming us. When you find yourself at this place in your life, don’t be afraid to ask others for help. By the time most of us have reached the age of 40, we have all hit some hard times and had to face disappointing re-definitions of what we thought our lives would become. This is a good time to turn to foundations of what has sustained us in past times: friendships, support groups, knowledge-seeking,time spent in natural settings,creative endeavors, religious beliefs, and a willingness to ask for help will help you stay the course until your new life has taken hold.

The double taboo: Money and death

Dr. Mary Gresham — Sun, 24 Jul 2011 18:16:28 +0000

It is hard to have an open, contained conversation about money that includes emotions and does not end up in a difficult interaction. This is a learned skill for most of us. It is even harder to have an open and contained discussion about money and death. Whether you want to know what is in your parents’ estates and how they plan to distribute or you want to deal with your own estate issues with your grown children, people in general are reluctant to address these topics.

The adults who are hesitant to ask information of their parents are afraid of being seen as greedy, in competition with their siblings or even of anticipating their parents’ deaths. This kind of avoidance generates anxiety and worry, often for years as they secretly wonder about the estate issues or dread dealing with their siblings.

It will take some courage and some skill to initiate this conversation but it could easily be that your parents are afraid to bring it up and would appreciate your initiating this conversation. It also helps to begin “softly” and with open ended questions such as “What you would most like to have happen in our family when you are at the end of your life?” ” How can all of us help you with that?” If your parent is in denial and will not discuss the topic, approach this indirectly by telling stories of your friends and their parents.

Parents tend to be blissfully unaware of the possibilities of sibling wars when they make inheritance decisions on their own and keep them private. The best outcome for your whole family may be to tell your adult children about your decisions and let them express their opinions and have some input as well. Emotions that truly should be part of the parent relationship can often be acted out on the siblings after the parents are deceased.

What gets in the way of parents calling a family meeting and reviewing estate concerns? Many do not know that it is important to do and it never occurs to them. Many parents perceive the assets to belong only to them and thus they have complete freedom to do as they wish. This ignores the next generation’s feelings that the assets belong to the whole family. In addition, as parents approach the last stage of their lives, they do not want to risk having a child upset with them or alienated from them and believe that keeping inheritance terms secret will preserve their own relationship with their children.

Best practices in today’s modern family include an open family meeting about the future process that the children will go through, some input from them and an open discussion of why certain choices seem desirable and the contained expression of feelings about this.

American Psych Association Mental Health Blog Day: To the Caregivers

Dr. Mary Gresham — Thu, 19 May 2011 14:41:56 +0000

Today is mental health blog day for the American Psych Association and I am here today to extend compassion and understanding to all who are loving and caring for someone who has mental illness. There is still stigma involved in acknowledging that someone you are related to has symptoms of mental illness. Many adults who have family with mental problems feel as if it brings shame onto them because their family member has an illness. Feeling healthy inside means beginning to see yourself as a person separate from your loved one; a person who may be affected by your loved one’s behavior but did not cause it and should not be judged for it.
It is not always easy to tell your friends about your situation but it is a milestone when you can say in a matter of fact way…”Before I introduce you to my (mother, father, brother, sister, son, daughter), I should explain to you that my loved one has (addiction, bipolar, OCD,dementia, PTSD,depression,anxiety, etc. etc. ). Then go on in a matter of fact way to explain the situation and what can be expected. Talking openly about the issues lets others know how to relate to you and your family member and that there is nothing to feel embarrassed or awkward about. Open and honest discussion of the situation lets others know that they can discuss this with you, begin to gain an education on relating to others who may be different and learn about mental illness as well. For many of my clients, getting to this matter of fact acceptance of the situation is a therapeutic milestone in itself. Releasing shame and stigma is possible and relating to your family member with compassion, limits and boundaries begins to create a new stance from which to operate. My heart goes out to all of you who are caregivers today.

The Four Cornerstones of Happiness

Dr. Mary Gresham — Mon, 25 Apr 2011 15:47:24 +0000

Recently I read a theory of happiness ( based on research studies) that summarized and discussed the four most important areas that contribute to feeling happy. I have found this to be very useful in the therapy that I do and would like to share this with you. The four attributes that seemed to contribute most to feelings of satisfaction and well-being in life were the following: competence, autonomy, connection and security.

MASTERY: It is important to feel like a productive and competent person who has something to contribute in life. Having a talent or working hard to develop a skill brings a feeling of mastery that increases our good feelings about ourselves. When our abilities are noticed and appreciated by others, we feel even better. Watch a child who is working hard to learn to tie a shoe or throw a ball and then notice the excitement this child has when he or she accomplishes this. As adults we know how it feels to have and utilize a skill. We can forget how vulnerable we feel when we put ourselves in situations of trying to learn a new skill and we can also forget how rewarding and satisfying it is to master the skill and feel a renewed sense of competence.

AUTONOMY: Most of us also need to feel as though we are doing things of our own free will and by choice. There is a significant increase in happiness when a country increases civil liberties for its population. As humans, we want to feel free and self-sufficient. Autonomy means that we have a sense of choosing our lives and activities and doing things are meaningful to us. No one likes to feel controlled and even when we are performing assigned tasks in our work life or our home life, we can feel that we are doing these things because we have chosen them for the inner and outer rewards they bring us. In the movie “Invictus”, Nelson Mandela maintained his sense of freedom by reciting a poem with the following lines: I am the master of my fate:I am the captain of my soul.

CONNECTION: Because we are humans, we are basically social animals. Feeling connected to others is essential to our survival and well-being. When we are disconnected,lonely or feel alienated from others, we are unhappy. Human infants must have physical and emotional contact or they die of “failure to thrive.” It is easy to forget how important and fundamental connection is to our well-being if we are caught up in the belief that we should be able to do everything without depending on others.

SECURITY: A feeling of security comes when we feel we have enough resources to meet our needs. The increase in happiness that comes when one is lifted out of poverty is enormous. We cannot be happy when we feel our day to day survival needs might not be met. Why then can we feel insecure when we do have resources? Past traumas of not having enough or worries that we will lose what we do have can undermine our feelings of happiness and well-being. We need to understand how much is “enough” and what is truly secure and not secure in our worlds.

Mental Illness and Violence

Dr. Mary Gresham — Mon, 17 Jan 2011 22:26:59 +0000

Our country is the only developed country that has mass murders perpetrated by young adults, college students, high school students and even some elementary school students. After one of these incidents such as the one in Tucson, there comes an outcry about mental illness and how the mentally ill need to be noticed, contained and treated in order to prevent violence. I agree that the mentally ill need to be treated but also feel the need to point out that the rates of violence in mentally ill populations are no higher than the rates of violence in non-mentally ill populations and are sometimes lower. The US has the same percentage of mentally ill as do the other developed countries yet they do not have the same kinds of murderous events that we experience. Why?
There are other factors besides the presence of untreated mentally ill young people. One is the easy access to very lethal automatic weapons. When one can enter a store and emerge with an arsenal, something is amiss. To drive a car one must prove that he or she is competent to handle this powerful machine and understands the laws involved by taking a written test. To require less than this for gun ownership seems foolhardy. There is also a media that is hungry for sensational stories and extreme rhetoric that excites and attracts viewers. This media has a powerful influence and ubiquitous presence, becoming embedded in the minds of those who are most vulnerable,the isolated person who consumes many hours daily of violent imagery and angry political arguments. It is time that we focused on looking at the factors that differentiate us from the other developed countries. Those factors do not include the number of mentally ill and alienated young people.

The Betrayal of Trust

Dr. Mary Gresham — Thu, 14 Oct 2010 14:28:48 +0000

One of the most painful experiences that we endure as humans is the experience of feeling as though our trust has been betrayed. The trust that is broken can be with another person, a relationship, a workplace or your an institution.
A break in trust first causes us to doubt our own abilities and perceptions. If we trusted and it did not work out, then what is wrong with our own ability to see reality and size up situations? How can we trust ourselves or another again? We go through a period of doubt and questioning that can be quite profound. Emotional responses can run the gamut of anger, panic, grief, hurt and shock. Our responses depend on many things:

- how important that relationship is to us
-whether we felt there was malicious intent behind the action
-if we have experienced other significant betrayals in our lives
-how much we self-attack and berate ourselves instead of taking this as a learning experience.

Many times we need to decide whether to try to repair this break or to cut our losses and leave. Much of this decision depends on our perception of the depth of the betrayal and the intention of the other. Sometimes when processed, the betrayal can be seen as a miscommunication in expectations. Other times it will be viewed as deeper than that. The attitude of the party who let you down is very significant as well. Does the other seem to acknowledge the problem or just become defensive? Do they take ownership and responsibility for their actions? Do they care how you feel? If you want to repair a break in trust you may wish to ask for the following actions of the other:

-take responsibility for their part in the trouble
-understand your feelings
-change course and maintain it over time
-issue a genuine apology and exhibit remorse.

Betrayal of trust is often a topic in my work. If you are concerned about this issue, please feel free to contact me at
mg@doctorgresham.com

Does self-help work?

Dr. Mary Gresham — Sun, 08 Aug 2010 20:42:11 +0000

Many people will engage in a period of self-help before they will consider calling for a therapy appointment.
Sometimes self-help works well and sometimes it is actually harmful. The current estimate is that about 5% of people who engage in self-help endeavors end up being harmed by them. The greatest harm is done because of the following:

1. Unrealistic expectations that do not function as promised. The best-seller “The Secret” could easily encourage someone to believe that all you have to do is visualize and it will come true. A positive vision is necessary but not sufficient by itself to produce results. It is only one of many factors that contribute to success.

2. The high cost of some self-help programs can lead you to spend excessively and create more stress. Read a book called “Helping Me Help Myself” to hear one writer’s experiences of seeking help over the course of a year and the costs of these programs. If you are going into debt for self-help you can end up in a difficult situation. If your resources are limited, stick to proven methods.

3. Most of my patients who come to therapy after a period of attempts at self-help have self-diagnosed and are working on the wrong problem with the wrong methods. Sexual problems are especially likely to create confusion and the majority of sexual help products and sexual advice is just incorrect ( such as:” Have a drink and relax and everything will be fine”).

The only self-help that I encourage is reading books. The cost is reasonable and learning, thinking and contemplating your problems is likely to be of benefit to you, even if it is not the whole solution. For this reason I have started a bookstore on my site so that you will have a chance to choose the best of the self-help genre out of the bewildering array of self-help material.