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PCS Blog

Welcome to the PCS blog. Here you will find articles about our organization, our industry and reflections on every day topics. You can use the links below to quickly find those articles which most interest you.

PCS Blog Articles



May 2014: Ten Tips for Fair Arguing

Doug Stephens

"There are times when people just don’t agree, or as the saying goes, "we can agree to not agree," said Doug Stephens, Ed.D., M.S.W., LICSW, a licensed social worker at Pastoral Counseling Services (PCS), an independent, non-profit counseling and consulting center serving southern New Hampshire.

Stephens, author of The Couples' Survival Workbook, specializes in couple therapy and conflict resolution. "It’s important for both people to be prepared and work through the conflict without one or the other prolonging the fight, or in many situations, blindsiding the other person. Resolving conflicts can be done in a fair way with a few helpful tips to remember."

Ten Rules of Fair Arguing

  1. Schedule time for discussion: Don’t spring conflict on the other person when they have expectations for something pleasant and important to them.
  2. Give topic in advance when discussing conflict: Here is what we need to talk about. Expectations are very important at each stage.
  3. Keep each discussion to the critical topic: Limit discussion to those issues. No kitchen sinking.
  4. Don’t store up transgressions: Discuss problems as soon after they occur or are discovered as is feasible.
  5. Don’t prolong a fight needlessly: If you are getting nowhere, stop. Take a time-out and agree when you can continue the discussion. This is especially helpful when emotions have taken over. We need objectivity when we are trying to resolve conflicts.
  6. Don’t tell the other person what they are doing or feeling: Stick to “I” statements. “YOU statements are accusatory and set up for defensiveness.
  7. Don’t drop the A-Bomb to kill fire ants: Keep your response appropriate to the problem’s scope and urgency.
  8. Don’t hit below the belt: No name-calling, dredging up past sins to which the other confesses, or purposely-nasty remarks.
  9. Resolving a conflict requires you to look at what you can change, not what the other person can change.
  10. Make up after the conflict: Once someone has said that he/she made a mistake and will try to avoid its recurrence, how much more can you ask.

With over 37 years of experience, Doug brings an impressive and diverse knowledge of psychotherapy to PCS. Currently, he serves as the Training Coordinator at PCS in which he develops and implements a clinical training program in which graduate students and postgraduate residents can complete clinical training. Dr. Stephens serves in the role of Adjunct Consultant for the Samaritan Institute, Inc. based in Denver, CO. He currently holds several licenses and certifications, including: AAPC Fellow; AAMFT Clinical Member and Approved Supervisor; Board Certified Diplomat; Clinical Social Work; NH Independent Licensed Clinical Social Work; NY Licensed Clinical Social Work; and, NY Licensed Marriage and Family Therapist. In 2011 he co-authored with David Olsen, Ph.D. The Couples' Survival Workbook.

For more information or to schedule an appointment with Doug Stephens, call Pastoral Counseling Services at 603.627.2702. www.pcs-nh.org. Click here to download this press release.

March 2014: Interview with Dr. Carrie Doehring

by Dr. David Reynolds
Center Director
Pastoral Counseling Services

Carrie Doehring

How did you become interested the relationship between caring for self and caring for the world?

I became interested in the role of compassion in caring for self and caring for the world after interviewing Vietnam veterans using Buddhist practices to cope with military posttraumatic stress. Meditation helped them experience self-compassion, which was the turning point in integrating their traumatic experiences. Their stories reminded me of how spiritual practices that foster self-compassion can open up new ways of experiencing God or a sense of goodness in oneself and the world. Self-compassion makes people more resilient. Whereas empathic distress makes people more likely to withdraw when they encounter people who suffer, compassion activates concern and makes people reach out to others. I realized that helping people care for themselves by using spiritual practices that foster compassion is not only important for self-care; it is important in helping them care for the world.

Say more about "moral anxiety." It is an intriguing phrase.

Moral anxiety arises when our core values are in conflict. For example, parents might experience moral anxiety when their values about being good parents conflict with values of achievement related to work. Sorting out the conflicting values is complicated because sometimes the values we put into practice were formed in childhood and are no longer values we espouse as a high priority. Yet these embedded childhood values continue to exert an influence. We can clarify sources of moral anxiety by identifying which values are indeed high priorities, and which can be acknowledged as still influential but no longer meaningful. Addressing and resolving moral stress in whatever ways we can is important for self-care.

Why is it important for psychotherapists and religious leaders to be aware of these issues?

Our religious values and beliefs along with spiritual practices form a spiritual orienting system or, as I call it, a lived theology that can be life-limiting or life-giving. Psychologist of religion Ken Pargament has pioneered ways to measure when religions and spirituality is helpful or harmful for people coping with stress. I am interested in how certain emotions like fear or anxiety can bring together childhood values, beliefs, and coping practices that are beneficial or harmful. I've been using research and case studies to explore what this might look like.

How have participants responded to your talks on this topic before?

Religious leaders who take my online self-care course choose practices they want to establish that pulls together core values and beliefs they want to put into practice. They keep journals where they track the cues that will prompt them to use the new coping and/or spiritual practice, and they pay attention to how rewarding their new practice is. They read each other's journals and offer compassionate encouragement. The changes that can happen over 3 or 4 weeks are really inspiring (Doehring, 2013).

How do you think the current climate of health care changes contributes to the "moral anxiety?"

I understand that health care professionals often work in cultures of scarcity, and are pressured to hurry appointments and see a quota of patients. This can make it harder to invite patients to tell their stories in their own way and be in charge of their treatment. A helpful approach to helping people that counteracts this top-down scarcity model is motivational interviewing, which I incorporate into teaching communication skills (Doehring, In preparation; Miller & Rollnick, 2012; Rollnick, Miller, & Butler, 2008).

What type of self-care practices have been mentioned in your previous seminars?

My interviews with Vietnam veterans explore the use of Buddhist meditation. In the self-care courses I teach, I encourage people to find whatever practice helps them live out core values. So, for example, one person made a habit of silence in the morning by turning off the radio and television. Another wanted to use her bicycle more because she was committed to ecology. She made biking into a spiritual practice. Many students use exercise and walking as a form of spiritual practice. For others, listening to music is spiritually meaningful. I enjoy seeing how creative people are in choosing these practices.

References

  • Doehring, C. (2013). New directions for clergy experiencing stress: Connecting spirit and body. Pastoral Psychology 62(5), 623-638. doi: 10.1007/s11089-013-0512-1
  • Doehring, C. (In preparation). The practice of pastoral care: A postmodern approach (Revised and expanded ed.). Louisville, KY: Westminster John Knox.
  • Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change (3rd ed.). New York, NY: Guilford Press.
  • Rollnick, S., Miller, W. R., & Butler, C. C. (2008). Motivational interviewing in health care: Helping patients change behavior. New York, NY: Guilford Press.


March 2014: Getting to Know Our Interns

Our students are expected to spend three days a week, during regular business hours here at PCS. Interns learn to provide intake and ongoing counseling or therapy for children, youth, and adults. Some basic skills are taught through regular supervision and seminars for individual as well as family therapy. Theoretical orientations that are taught include object relations, self psychology, and family systems.



Daniel Bush

Daniel Bush

Daniel Bush is a graduate student in mental health counseling at Springfield College. His special clinical interests are men's issues, couple relationships, and grief. Daniel has a Ph.D in anthropology and has coauthored the book "75 Habits for a Happy Marriage" with his wife, Ashley.



Aimee Hackett

Aimee Hackett

Aimee Hackett has been a clinical Intern at PCS since May. She works with adolescents, adults and families on a variety of topics. Aimee received her BA from Southern New Hampshire University, where she majored in Psychology. Currently studying at the Boston University School of Social Work, Aimee will graduate with a MSW this spring.



Marie Macedonia

Marie Macedonia

Marie Macedonia is completing her doctoral degree in clinical psychology at Antioch University of New England. She is currently completing her third year in the program while concurrently receiving training in psychotherapy at PCS. Marie possesses a strong background in neuropathology assessment and would like to work more closely with preteens, adolescents, young adults, and families. Marie is interested in the treatment of anxiety, depression, trauma, and eating disorders.


February 2014: Finding Ways to End Emotional Suffering

Carol Knieriem

Carol Knieriem is a Licensed Independent Social Worker. Who feels very fortunate to do my internship where the masters of Family Therapy, Cognitive Behavioral Therapy, Strategic and Systemic Therapy and various Brief Therapies came to teach.

Carol went into this field because of a driving interest to know what caused human beings, her self included, emotional suffering and what were the ways to end that suffering.

She believes what was common to all these methods was the focus on clients' strengths and their faith in their own ability to solve their problems. That is how she has structured her therapy.

Carol's practice has focused mainly on adult, individuals and couples. She works people on depression, anxiety, panic, trauma, grief, she works on parenting issues, Obsessive Compulsive Disorder, Bipolar Illness, Post Traumatic Stress Disorder, marital/couple issues, and medical issues. She uses all these methods listed above because people think and behave differently and one size doesn't fit all people. Carol also uses Eye Movement Desensitization Reprocessing (EMDR). When she feels it would be helpful. EMDR is a technique for helping people who have experienced PTSD trauma; but it also has uses in other areas. Read more about EMDR in our recent blog article EMDR Helps Ease Traumatic Memories.

Carol has studied Buddhism which has been proven to be a very useful and exciting addition to therapy and her own life. She teaches mindfulness meditation in individual sessions and also leads a mindfulness meditation group on the 1st and 3rd Monday nights of each month.


January 2014: Letter from the Director of Clinical Services

by Calvin Genzel, Ph.D, LP
Pastoral Counseling Services

Dr. Calvin Genzel

Dear friend of Pastoral Counseling Services:

As 2013 nears its end, we would like to thank you for your support of the many, varied services this organization offers to our local communities. We remain committed to our mission to "be a center of excellence and diversity that integrates psychological theory and spiritual sensitivity through psychotherapy, consultation, and education" while partnering with "social service, educational, faith and business agencies." Our estimates are that in 2013 PCS provided 8,600 hours of clinical service, Over 150 hours of consultation, and Over 100 hours of continuing education.

In 2014, PCS will celebrate its 35th anniversary. We will keep you apprised of the celebratory events that will be part of this special year. We also thought it is a good time for us to reflect upon how we can continue to develop and improve our services. To that end, we would like to secure some feedback from you. Please take a few moments to complete an online questionnaire. This questionnaire is just five short questions so will only take a few minutes to complete.

Thank you for your time, as well as your commitment to the work and mission of our organization.

Sincerely,

Calvin R. Genzel, Ph.D, LP
Director of Clinical Services


September 2013: My Child is Anxious

by Cynthia Hogan, M.S.W., LICSW
Pastoral Counseling Services

Cynthia Hogan

My name is Cynthia Hogan and I’m a licensed clinical social worker, coming to Pastoral Counseling with a background in work with children and families. My first six months have been a meaningful time of getting to know the caring folks at PCS, and meeting so many engaged parents who are committed to the best help they can get for their children.

It shouldn’t be surprising to me that the referral issue is frequently “my child is anxious”, but it does concern me that our youth feel under a kind of pressure that permeates through their home and school lives. I recall a much more carefree childhood and although I might wish the same for our kids, the fact is it’s a different world – one with very real concerns that we as the adults need to mediate for kids as best we can.

No, we can’t remove all the factors of life that create stress, nor would it be good for kids to grow up without facing obstacles that they need to wrestle through. But, we can be protective and try to minimize the extent to which adult size issues are on their minds.

I’m a proponent of children being made aware of the significance of events in family life. I wouldn’t want children to be ‘protected’ through secrecy. We know that children make up their own scenarios, and unfortunately they often put ‘blame’ on themselves for what’s occurring around them. I would advocate for kids being informed about losses, and changes, and events that will affect them. But, the key is that information be shared at a developmental level that enables the youth to integrate the news about ‘adult size’ matters. This is where an objective, professional voice can help a family navigate through family issues and be of assistance to all family members. This is work that Pastoral Counseling Services is positioned to do with families, with many experienced therapists who can accompany families on their journeys and who can bring a faith-based and spiritual perspective to that joining with the family system.

As NH kids are a month into their new classrooms there are steps parents can take to help children with the day to day stress of school life. Youth need to be ready to learn each day, meaning they need to be rested, and prepared, and open to new information. Good nutrition matters. Sleep matters. Play matters – carving out time to be outdoors. Being able to concentrate on tasks at hand rather than worrying about home life is key. Give kids responsibility, and help them to build organizational skills. Ask for help from teachers if each evening has become a homework battleground. Listen to your children and their classmates for information about what their days are like. Put yourselves in their shoes, helping you to recognize their day to day experiences and share thoughts and ideas with them. Model for your children what it means to approach each day with an attitude of ‘can-do’.

Lowering anxiety matters for all of us. It helps to be attuned to the sources of our stress. Help your kids identify what’s bothering them, and do it for yourself too. May the start of this school year be a source of excitement for your family!


August 20, 2013: EMDR Helps Ease Traumatic Memories

by Audrey Watjen, M.S.W., LICSW,
Pastoral Counseling Services Psychotherapist

The mental health profession loves acronyms. “Eye Movement Desensitization and Reprocessing” is a mouthful so it is just referred to as EMDR. EMDR was developed by psychologist, Francine Shapiro, PhD, in 1987, following a walk in the park where she noticed that her rapid eye movements lessened her disturbing negative thoughts. When she began exploring this revelation, she found that other people also had the same response to eye movements. However, it seemed that eye movements alone did not have a lasting effect, but adding some structured thought process with it demonstrated significant improvement. She then developed structured EMDR techniques. Her research found that EMDR was particularly helpful for people with traumatic disturbing memories, especially individuals with post-traumatic stress disorder. EMDR has also shown some usefulness with individuals with other stress and anxiety disorders.

How does EMDR work?

Our memories are linked in networks that contain related thoughts, images, emotions, and sensations. We know that when a person is very upset, their brain cannot process information as it does ordinarily. Simple upsetting events are usually resolved through thinking about it as well as during the period of rapid eye movement (REM) sleep. With trauma, memory of the event is dysfunctionally stored with many elements still unprocessed. With EMDR eye movements, the brain makes the associations and connections needed to integrate and digest the disturbing memory. This allows our memory networks to take disturbing events and make the appropriate connections that allow a return of emotional equilibrium.

EMDR treatment is generally short term and may be used within standard "talking" therapy, in conjunction with “talking” therapy with a separate therapist, or as a treatment all by itself. It has been used with people with all kinds of traumas and anxieties, including someone who has been in an automobile accident, someone who has experienced physical or sexual abuse, someone who has been mauled by a vicious dog, and victims of natural disasters. To help demonstrate how EMDR works, below are two fictional examples.

Example 1:

Martha is a 68 year old woman who lives alone in a house on the corner of a very busy street which has had several car accidents. One lovely sunny day, as she sat on her porch another accident happened but this time the car came right through her porch into her house, barely missing her. Since then she had been afraid of leaving her house and avoided the corner of the house where the accident happened. After a few EMDR sessions, she still has some anxiety, but is able to leave her home and has the full use of her house again. She is also able to enjoy her front porch again.

Example 2:

Linda is a 37 year old married mother of a 12 year old daughter. Because of her anxiety going over bridges (even a short highway overpass), she was forced to avoid highways and major roads. She had to limit her visits to her mother who lives in the Boston area and took 45 minutes to get to her job which was only 10 minutes from her house. After three EMDR sessions, she was able to drive to work on the highway and had more time to spend with her husband and daughter.

Pastoral Counseling Services is fortunate to have three staff therapists who have been specially trained in this technique. If you think EMDR might help you or someone you love with a traumatic experience or anxiety, contact Dr. Cal Genzel, PCS Clinical Director, at 603.627.2702 ext.116.


June 4, 2013: Ready For a Full Nest?

by Dr. David Reynolds, Pastoral Counseling Services Center Director

Full NestIn early Summer, an interesting phenomenon happens. All of a sudden, children and teens are at home more when the school year ends and college students return home for the summer. Instead of the “empty nest,” many families are experiencing the “full nest.”

For some families, this is a joyful time of reconnecting and conversation, and for others, it is a time of struggle and conflict. For all, it is a time of transition! How do you navigate the changes? What about the dirty dishes left in a formerly pristine sink? Where did the piles of laundry come from and is the expectation really that they will be magically transported to the washing machine? Did you really expect to hear, “I’m bored!” the first week out of school? Do the family rules take the summer off? Does respecting people and property end when the last day of school or college is over?

The short answer is this: it is critical for parents to be clear about their expectations. Of course, these expectations will vary from family to family, but here are some suggestions to make the summer be more pleasant for all:

  • Clarify Timing: What are the designated times to be in the home (i.e. dinner, curfew, etc.)? How late is sleeping in allowed?
  • Summer Job: Are college students expected to have a summer job?
  • Household Tasks: How will household tasks be spread around so all can participate? State that each person picks up for her/himself.
  • Vehicle Privileges: For teens and college age students, what are the guidelines regarding use of a family vehicle?
  • Family Activities: Discuss common activities, such as meals, vacations, or family visits, that are considered required participation.

The key for a successful summer is for the parents to be clear about these expectations. Then communicate and discuss together with the family to insure everyone is on the same page. With older children, negotiation may be part of this discussion and is acceptable as a means to clarify obligations. However, these negotiations should not be a means of avoiding responsibilities as this will only foster opportunities for resentment. Finally, remember to include some fun together. Having a full nest is not just about rules, but enjoying each other!

The “full nest” provides a great opportunity for healthy family function. Conflict is normal, but the goal is to encourage healthy interaction when any conflict arises. If there is clarity from the start on expectations, the possibility for healthy communication is increased. In fact, setting expectations early may even enhance the overall family harmony levels so that summer the most peaceful and relaxing summer yet!

 

April 15, 2013: Common Themes in Couples Therapy

by Dr. David Reynolds, Pastoral Counseling Services Center Director

Couples TherapyIn today’s hectic society, couples often find that their bond can be affected by expected and unexpected challenges. They can even undergo severe alterations to the loving, symbiotic relationship they once knew. Therapists know that one of our most important roles is to help couples to recognize these external triggers and consider how they distress the dynamics within their relationship.

Certainly, every couple’s concerns and challenges are unique. However, we do find that similar themes tend to play a part in most couples state of crisis. Below are just a few of these common themes for your review and consideration, either as a professional, as a pastoral counselor, or as half of a couple!

  • Do not run from intimacy. One of the most important elements of a successful couple is for each individual to be aware of and to share their feelings, thoughts, dreams and aspirations with their other half. The first step is to spend introspective time recognizing one’s own perspective and consider how to verbalize this standpoint to your significant other. Then, embrace the intimacy of sharing these personal pieces with your partner.
  • Change self, not your partner. One of the most common fallacies among couples is that you can somehow transform your partner to meet your needs. In the end, you must remember that you are the only person that you can change. So spend that energy identifying how you can grow to best cultivate your relationship, and then trust your partner to do the same.
  • Accept your partner. The media has created the ideal image for just about every human role: from husband to wife, mom to daughter, neighbor to friend. Many individuals focus their energy on what they think their significant other should be in light of this ideal image. However, very rarely does that ideal image ring true. In many cases, that ideal which is sought after falls short of what is needed for a fulfilling, multi-dimensional life. Accept your partner for who they are, just as you need he or she to accept you for everything you are.

To explore this topic further, Pastoral Counseling Services invites you to register for our upcoming seminar The Fragile Pact: Couples in Treatment on May 17. From 8:45am-12:00pm, Dr. Doug Stephens will focus on a clinical model for therapists and cover engaging couples in conflict and creating and sustaining interactional change. This morning session is currently awaiting approval for 3 Category I Continuing Education Units. Then, from 1:00pm-4:00pm, the afternoon session will focus on exploring pastoral models for couples in treatment and is recommended for clergy participants. Please visit the PCS Upcoming Events for more details on the 4th Annual Conference on Spirituality and Psychotherapy.


March 6, 2013: PCS, ACA and You

by Dr. David Reynolds, Pastoral Counseling Services Center Director

What is Affordable Care Act (ACA)?

In healthcare, much discussion, speculation, and confusion is happening around healthcare reform. The Affordable Care Act (ACA) is making great changes in healthcare generally and in behavioral health specifically. The four major areas addressed by the ACA are insurance reform, coverage expansion, delivery system reform, and payment reform. New protections that are in effect have been welcomed by most consumers and providers: insurance companies cannot deny coverage; preexisting exclusions are banned; annual and lifetime limits on coverage are prohibited; and coverage has been extended for children up to age 26.

No one knows what the final product will look like as the Executive Branch, Congress, states, and the citizenry work on this major overhaul. The overall goals of the ACA are to improve quality and manage costs by focusing on and early intervention, improving the management of chronic health conditions and finally reducing errors and waste in the healthcare system. Few would argue with these laudable goals.

What Does This Mean To You?

What does this have to do with PCS, clients, providers, and our colleagues? I will comment on two areas. First, early intervention and preventative care are central to behavioral health. The relationship of medical issues such as heart disease, diabetes, stroke, ulcers, and other disorders often co-exist with mental health disorders such as depression, anxiety, and substance abuse. Often, the mental health disorders are not treated or undertreated. PCS clinical staff has seen what many studies have demonstrated that effective psychotherapy can have a positive effect on medical issues.

Second, you will hear much discussion about "healthcare homes" in the ongoing discussion. Since mental and medical health often interrelate, communication between multiple providers is essential. Healthcare homes will be a more intentional relationship between various providers. PCS clinical staff already consults with other healthcare providers when indicated and authorized by our clients. It appears more organic and official connections between mental and medical providers will be happening with the ACA.

The highest value is providing the highest quality of care to our clients. Escalating healthcare costs, the number of uninsured and underinsured, and the high incidence of "preventable deaths (e.g. heart disease, diabetes, etc.)" have initiated the major reforms that are coming down the pike. PCS will monitor the complex process of reform. We will also be working to position ourselves to be able to continue to provide the highest quality of mental healthcare available to our clients.

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