Dr. Mary Gresham

Families with problem mothers

Dr. Mary Gresham — Wed, 23 Jun 2010 19:33:08 +0000

There is often denial in families about the emotional troubles of others in the family. This is particularly true when a mother is emotionally unstable and family members look the other way instead of stepping in and dealing with the issue. The problem with this kind of denial is that children are affected by a mother’s mood swings, alcohol use, rage, verbal put downs or neediness. The same woman that no one in the family can deal with is left in charge of the children. Often fathers have no idea what to do and avoid the situation by withdrawing and resigning themselves to a wife’s mental difficulties. Fathers are the adults who have the most impact and power to change the situation but many are afraid to rock the boat for fear of angry outbursts. Extended family members could also step in and insist that a mother get some help or could at least be willing to talk to the children about mom’s problems and let them know that it is not their fault. Many times daughters are left to try to care for and help their mothers with mental issues. We call this kind of child the “parentified” child since they are attempting to fill the role that a parent should undertake. Families do not have to remain helpless in the face of a mother’s refusal to seek treatment. There are a number of people who now specialize in doing interventions with emotionally unstable family members and even if it may be an upsetting experience, the problem now has a name and the children will know that someone cared about what happens to them. When the problem is brought out into the open and made clear, the children no longer have to wonder if they are bad and somehow caused it. If you cannot tolerate your family member’s emotional outbursts, imagine how her children might feel. It takes courage to bring out these types of problems and there can be some difficult fallout but the alternative is to continue to whisper and dance around the issue without really confronting it.

Helping young adults who are underfunctioning

Dr. Mary Gresham — Sun, 02 May 2010 19:26:40 +0000

Is there such a thing as a slacker young adult? Yes there is and they may be part of your own family or even living with you. I have recently been asked by 2 mothers who have children in their 20s living at home, how to help launch these grown children. First of all, not every child who lives in a multi-generational household is a slacker. Some are busy as students or full-time employees and it may be that these young adults are living at home to save money for something important or avoid student debt. In these cases, the children pay some of the living expenses of the house and do chores in the home to acknowledge that they are not guests but family members who have to contribute to the household. They are living in the home as adults and are able to negotiate and have some say over communal issues that arise in every household (i.e. how long can dishes go unwashed in this house?).
The young adult I am referring to as under-functioning is not in a healthy situation like the above but is living off his/her family. This child may be working part-time and having a perpetual summer, sleeping late and primarily interested in hanging out with friends. There is not a sense of moving forward in this young person’s life but more of a sense of being stuck. If you are the parent of such a child, you may be distressed but you keep allowing yourself to be persuaded by your child’s compelling arguments to keep things the way they are. If you take a step back and look at the situation you might begin to see how this is doing your child a true disservice. If your child has no inner drive to leave, you will need to become the motivating force if you are not happy with the situation. All young adults should pay some money for their upkeep. You can use this money to create a savings account for your child and then use the savings to help your child move out. You can also use the money they contribute to buy your child a service instead of free rent. Some young adults need counseling to develop the confidence to leave home or to begin to see the benefit of leaving. Sometimes they need the services of a career counselor or a financial advisor to help them develop the skills of independent living. Having them be responsible for some of the cleaning and cooking tasks is another way to send the message that they need to be learning the skills of living as adults. Sometimes it helps to ask them (with compassion) if they are afraid for some reason to grow up?
Many young people may initially resist changes that ask more of them but over time they will notice an improvement in their feelings about themselves. It does not feel good to know that you are not developing your potential as a person but many young people do not realize how their feelings of well-being can be improved by becoming a more highly functioning person. Remind your child that he/she will feel better if they are moving ahead in life even if that means paying rent to you. In addition, be sure to look at yourself and your life. Is there some way that you may be lonely or trying to fill a void in your life by allowing your child to hang around the house? Do you need to develop more of a life? Remember that if you decide that you like your child’s presence, you can change to healthier patterns of living together in lieu of eviction but be sure that you are not keeping your child from growing up.

On being single :the paradox

Dr. Mary Gresham — Tue, 23 Feb 2010 21:47:35 +0000

We have just passed 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.

A Difficult Mother

Dr. Mary Gresham — Tue, 05 Jan 2010 20:46:49 +0000

What does it mean to have a difficult mother? All mothers go through difficult periods due to fatigue, stress and the demands of adult life and parenting. However a truly difficult mother is difficult all the time and presents a child with an unresolvable dilemma: you can either sacrifice yourself and have a relationship with me or be your true self and I will ridicule, disapprove of or reject you. The child’s dependency on the mother is then exploited and he/she will have difficulty trusting others and developing close relationships in adulthood. Some of the characterisitics of a difficult mother include erratic and intense outbursts of anger, rigid and inflelxible expectations of her child or chronic neediness and unhappiness. The child grows up to be the caretaker or the parent of the mother and even in adulthood can have great difficulty resisting a mother’s manipulations and control. Often a grown child will beg mom to please “accept me as I am and stop needing, controlling or being angry with me.” Truly learning that your mother is no longer in charge of you can be hard , even when you know in your head that it is true. Learning that others will not treat you as she did is also hard. Challenge the voices in you that predict everyone will treat you similarly and you will always have to placate others. Be sure that you are not drawn to relationships that feel like a repeat of your childhoood as there are other ways to be with people than the ways of your original family. If you have difficulty with these issues, ask for help if you need it.

Happiness Research

Dr. Mary Gresham — Tue, 15 Dec 2009 20:11:45 +0000

What should you spend your money on? How effective is therapy at increasing happiness? The latest research from the Journal of Health Economics, Policy and Law ( Boyce and Wood) has an article entitled Money or Mental Health: Alleviating Psychological Distress with Monetary Compensation versus Psychological Therapy. This research analyzed data sets where thousands of people gave reports on their well-being. They compared well-being ratings for subjects who got a 4 month course of psychotherapy to the ratings of those who had a sudden increase in income through winnings and pay raises. The increase in well-being from $1300 of therapy was equivalent in this study to the well-being obtained by an increase of $40,726 in pay. Dr. Boyce writes that the purpose of the study is to help people see that they may be overestimating the effect that money has on their well-being. We should be questioning whether our current spending patterns are having the best impact on our well-being and making our mental health a priority. Perhaps courts should consider awarding therapy visits instead of dollars to plaintiffs. Having material wealth is unlikely to improve mental health, contrary to common myths, and people might be better off spending money on psychological therapy which seems 32 times more effective than money at increasing feelings of well-being.

Health Insurance Reform

Dr. Mary Gresham — Sun, 13 Sep 2009 20:27:06 +0000

I believe that the majority of health insurance clients have little knowledge of how the industry works and the problems inherent in the current system until they have a serious medical situation and have to become an expert on the process. Most of my new clients are in the dark about their benefits and the situations behind the scenes that have an impact on their own financial lives. After being quite involved with the health insurance industry for 20 years, I finally had to give it up for the sake of my sanity. One of the main difficulties is the inherent conflict of interest in making payments from a pool of money designed to reward shareholders and executives. The companies make it quite difficult to get paid accurately and fairly in the hope that I ( or now my clients) will simply give up and take a smaller amount. And since most insureds have no idea of their benefits, they are often not in any position to challenge the jargon and system of payment. Over the years, here are some of the many abuses I have seen:

1. A client who uses mental health benefits decides to open his or her own business and must buy private insurance. If they answer the insurance questionnaire honestly,they will be denied private insurance for health, life and disability because they have seen a provider for depression..or they will be charged an exorbitant premium.

2. The legislature of Georgia decides to allow Blue Cross to be run as a for-profit business licensed to Wellpoint and the non-profit coop is dissolved. Over the years, the mental health side of the plan is targeted to lowered reimbursements for providers. Because mental health treatments can lead to stigma, the patients are afraid to fight this within their companies. The reimbursement for me as a doctoral level expert psychologist with 20 years of experience is dropped from July’s rate (112 per hour) to August’s rate (78 per hour) in 2007 and I have to leave the plan as I cannot pay overhead and earn a living at that rate. Meanwhile, the CEO of Wellpoint is the highest paid CEO in Indiana, earning 14 million in one year. The clients are the ones who are hit hardest as their costs rise for the treatment they need.

3. At the same time I get the notice of my change in payment, I also receive a threatening letter stating that I tend to see Blue Cross patients for 16 visits while the average number of visits should be 4. Because of my tendency to see patients for a longer time, I will be subject to in-office audits where the charts of my patients will be reviewed and assessed for the appropriateness of my treatment.

4. Approximately 50% of all claims paid directly to me are full of errors and the error always results in a lower payment than I am due. The errors are predictable: a visit in a series of visits is left off; the code is entered incorrectly; I am deemed to be in the network when I am not; the usual and customary fee for that service is not at all realistic, etc. I am rarely able to get the errors corrected without spending an hour on the phone or paying an assistant to do this.

I am clear that the health insurance industry is rife with abuses that harm clients and the providers but currently there is not another alternative. I would like to see a 3 tiered program for our needs: A private corporate option for those who are well-employed and can afford it; a set of non-profit cooperatives for the self-employed and those who cannot afford the private corporate tier; and a government safety net plan for those with life-changing medical problems, unemployed and unable to afford the others. There are numerous debates about health care and reform but the industry has created its own difficulties as they attempt to maximize profits and minimize care and reimbursements. Even with these caveats, it is better to use your benefit if this is the only way to afford treatment as the decision to forego mental health treatment has many negative effects.

ABC’s 20/20 program about Onsite

Dr. Mary Gresham — Wed, 05 Aug 2009 18:32:47 +0000

Last Friday night the Healing Money Issues program was featured on ABC’s 20/20. This is a 5 day live-in program at a retreat center in Tennessee that works with clients on money issues. I worked in this program as an assistant last november and learned a lot . Here is a link to the video if you would like to see it. Healing Money Issues

On another note, I am starting my women and money ongoing group this fall. This is a group for women only as all the research and my personal experience leads me to believe that women work best on subjects that are considered “Male-expert” (math, computers, finance) in small same sex groups. This is an ongoing group that follows after two years of offering one day workshops. I feel the one day workshop format does not work as well to sustain ongoing changes as the open-ended group. The group will meet 2 times monthly on wed evenings from 6:30 to 8:00 and is both educational and psychotherapeutic in nature. This is unusual but I think it will be a powerful combination and is modelled on the program at Onsite. The charge for the group is 65 per session and the initial committment is for 6 groups

. The group will be diverse in nature and is appropriate for a variety of issues and ages. Some referrals may be for younger women who want to prevent the problems they see in others; some will be women who have money but are afraid to invest it or use it; some may be for women who are afraid to negotiate or market on their own behalf; some may be for overspending problems, some may be for women who are in partnerships where there is severe conflict about money, etc. If you have a colleague, partner or client or client’s spouse that you believe is a good fit for this program, please have them contact me

Intimacy and chemicals

Dr. Mary Gresham — Mon, 25 May 2009 22:04:44 +0000

I have been aware for a number of years how using recreational chemicals can impede the development of closeness in couples. The last 2 weeks in the office have really brought this home. When you are high and your special one is not, he/she is likely to withdraw from you. You don’t see the changes in yourself or the relationship because your perceptions are altered. It only takes a few drinks or tokes to change the energy between you both. You feel that you are “more yourself” or more relaxed and are likely to deny that this is a problem. It is doesn’t meet the criteria for abuse/addiction but it does break the feeling of safety and closeness. Sometimes your loved one will join you in drinking or smoking so that he /she can be on the same wavelength . When the two of you are uninhibited you are more likely to get into a conflict with ugly words. Non-sober fights tend to go nowhere . Today might be a good day to ask your partner if he/she is ever bothered by your recreational activities and then carefully listen to the answer. Your partner might be unhappy about your using as it breaks the emotional connection and they sense that you are “different”. Checking it out can give you some valuable feedback.

If you are concerned about your or your partners use of substances, please feel free to call the office at 404-320-6510 for a consultation.

Or click here to send an email: mg@doctorgresham.com.

Dr. Mary Gresham

Relationship Skills

Dr. Mary Gresham — Wed, 18 Mar 2009 02:05:38 +0000

Most of my clients are either seeking to find a special love relationship or to improve the relationship that they are in. Relationship skills that are important for either seeking or improving a relationship are often learned in the family by watching our parents and how they treat each other. If we are fortunate enough to have parents in a strong marriage, then what we see and absorb will help us though we still must update some of it to work for our own generation. If our parents are single parents or are in unhappy relationships we either have a blank slate where the relationship modeling should be or we have an example that is the opposite of what we are seeking. Often the first step is to develop an idea of the skills we need to learn.

One possible source for this is the relationship research of Dr. John Gottman. He observed couples for 25 years and then noted the characteristics of happy and unhappy couples. His work has been published for the general public and is easily available in paperbacks. Knowing the skills we need is only the first step. The hardest part is learning to change old ways or develop the skills to begin with. This is the work …often uncomfortable and awkward at first…and without feedback hard to know if we have mastered it. If you are lucky enough to have a partner that you want to stay with, it would be best if both of you read the book and used the same theory. If you are still seeking a partner, you can practice these skills on close friendships and family relationships as they can apply to any intimate relationship.

Most of the skills have to do with how you talk to someone. If you have an issue with someone, learn how to bring it up “softly” rather than harshly. If you wait to bring up issues until you are furious and you use sarcasm and blame, this will be more difficult. You will not get a good response and are likely to get a defensive reaction, not a true listening and understanding. If you bring up issues based on your feelings and how you felt about something and are not acting in a superior manner in your presentation, you are likely to get a more positive response. It is hard to learn how to bring up things that are bothering you. Many people are afraid of hurting someone’s feelings.

There are different kinds of “hurt.” A negative type of hurt is done simply to punish someone or put them down..the useful kind of hurt is done to help the relationship, help someone become aware of themselves and helps them grow as a person. Try hard to practice what you want to say before you say it and imagine how you would feel if this were said to you. Then get your courage and arrange a special time to talk remembering that often the most feared words in a relationship are “we need to talk” and that sensitivities will be high. Assure your partner that you do not want to hurt them, you want to have a better relationship.

Then read Dr. Gottman again and again until it begins to feel more natural.

Seeking Happiness

Dr. Mary Gresham — Mon, 16 Feb 2009 02:11:08 +0000

Many of us want to feel better. This is often the reason people seek therapy.

Psychologists are finally beginning to study and do research on the experience of happiness. Happiness is defined as a feeling of “subjective well-being”, meaning that only we can decide if we are happy or not and that it will change from person to person. Most people would include in their definition of happiness being able to experience a number of positive emotions like joy, affection, contentment, hope, and gratitude. Is it possible to be too happy?

Yes it does seem that it is not good to be too happy. When the happiness scores of thousands of people from 1 to 10 were tabulated and followed over time, those who rated themselves about an 8 on the scale had better life outcomes that those who said they we 10 on the happiness scale. Chronic euphoria is not the best outcome. Negative emotions do serve a real purpose in life, especially in moderate doses. Occasional guilt,worry, anger and sadness are necessary to help us know what we need to change to improve our lives. Without them, the people in the studies seem to drift.

Another important aspect of happiness is a measure called life satisfaction. For most of us, life satisfaction depends on doing well in areas that are important to us….relationships, health, work, leisure, spirituality and income. We are operating in sync with our values and our goals. There is another factor in happiness that is called “flourishing”. This is the assessment that our lives have meaning and purpose, that we are good people, that we get the social support we need , that our everyday lives are interesting and that we have an absence of addictions.

The formula developed by Dr. Ed Diener, one of the foremost happiness researchers in psychology is as follow: Happiness = positive feelings minus negative feelings + life satisfaction + flourishing. If you are interested in learning more about the research on happiness, you may want to read Dr. Diener’s book, Happiness: Unlocking the Mysteries of Psychological Wealth.