When we think about figuring out our child’s needs, we think about their hunger, thirst, sleep, diaper changes, safety and other basic care. These aforementioned needs are the critical building blocks for developing a loving and connected relationship with our children. The next step beyond simply providing these building blocks, however, is learning to “attune” to your child.

What is Attunement?

Attunement is knowing how and when to deliver care to our children in order for them to feel safe, understood and prioritized. Attunement is expressed in “behaviors that reflect ‘the quality of feeling of a shared affect state without imitating the exact behavioral expression’”. This just means that your baby learns about their feelings by “observing themselves in the mirror of their mother’s [or father’s face]” (Booth, P.B., & Jernberg, A.M. 2010).

What Does Attunement Look Like?

Being attuned with your child means that you are responding to your child’s needs and learning each other’s rhythms. Our rhythms are how we interact and respond with people and objects around us. For instance, you establish a rhythm or pattern with your child based on how you respond to their cries or their yelling your name from two rooms away. Your child is able to predict how you will respond and know that you will be there to give a comforting hug or express concern when you hear their shout.

In fact, this set way of responding is developed the moment your child is born. Your baby cannot speak or understand the words you are using but they understand your non-verbal cues and ways of communicating. They are becoming aware of your gentle, crinkly eyes, your smile and laughter when they do something cute, and the tone of your voice while playing peek-a-boo.

• If you are still curious (or for those of us that are visual learners) what attunement looks like, watch the Still Face Experiment by Dr Edward Tronick. This video gives us a great visual representation of just how much our verbal and non-verbal communication expresses our interest or “attunement” in others.

Imagine that you go to a friend to share some exciting news. Perhaps you got a new job, a new house, or had a new partner to share about. If your friend responded with no outward expression, a straight face, how would you feel? You might leave feeling like your friend expressed no genuine interest in your excitement, that your friend was mis-attuned to your excitement, and perhaps you would walk away feeling not seen or heard. Children are looking for similar (though MORE!!) attunement from their attachment figures/parent(s) every time they are scared, hungry, happy, and more.

“Good Enough Parenting”

No matter how hard we may try, there is no way to be attuned to our child(ren) all the time. Dr Donald Winnicot, a British Psychoanalyst and Pediatrician, coined the term, “Good Enough Parenting”. Winnicot determined that parents need to be meeting their child’s needs “30% of the time to create happy, well attached children” (Johnson, P. 2021). It is also important to note that how much attunement or responsiveness we give our child decreases over time. We respond and react more frequently when our children are infants versus when they are teenagers due to your child’s need for independence.

How Can I Increase Attunement with my Child(ren)?

Here is a list of simple activities you can do with your child to enhance your relationship and attune to their needs:

• Read a book or tell a story: Pay attention to how your child responds verbally and non-verbally. Comment on how they reacted to better reflect your understanding.
• Reflect to your child if they had a hard day at school (do you need a minute of quiet? would you like a hug? etc).
• Draw or paint a picture together. Get creative and maybe a little bit messy!
• Play a simple game of Simon Says, Follow the Leader OR create your own game.

These moments of feeling seen and heard can happen while eating dinner, cleaning the dishes together, during bath time, bedtime, and more. You know your child best, so try to find a time where you can fill their “attunement meter”.

Sources:

Booth, P. B, Jernberg, A.M. (2010). Theraplay: Helping parents and children build better relationships through attachment-based play. Jossey-Bass.

Johnson, P. (2021, August 6) Good Enough Parenting. Forest Psychology.

Manela, M. (2014, February 10). Four Easy Activities to Enhance Attunement. Thrive Group.

Blog written by Sentier therapist, Bridgett Brye, MSW, LICSW

Autigender – What does it mean?

I was in my 20s when I consciously started to think about my gender. Why was I so uncomfortable being called a woman? I eventually realized that I lacked the ability to follow the rules that society laid out for me as someone who was assigned female at birth. I could force myself to show some traditionally feminine traits, and I do naturally have some feminine traits. But I could not force myself to follow all of the “rules” of being a woman. I do not have the skills to do my hair and makeup in a traditionally feminine way and I am unable to safely carry a pregnancy, for example.

Today, I identify as autigender and nonbinary because I cannot meet the expectations of being a woman or a man and I no longer want to. If I am going to be my genuine self, then neither woman or man fits for me.

What does autigender mean?

There are many words that can describe a person’s gender, but there are a few broader terms that are important to understand in relation to gender:

• Binary genders such as man and woman are genders that fit within these two traditional categories.
• Nonbinary is an umbrella term for people who identify with both genders, neither, or anywhere in between.
• Cisgender refers to a person whose gender identity matches with their assigned sex at birth.
• Transgender refers to a person whose gender identity does not match with their assigned sex at birth.

Autigender commonly falls under the nonbinary and transgender umbrellas; however, each person has a unique relationship with their gender and it is important not to assume which category a person identifies with.

Autigender is a gender identity that describes the relationship that an autistic person has with their gender. In other words, it is for autistics who see their gender as being intimately connected with their autism. It is not autism as a gender. All people who identify as autigender also identify as autistic or neurodivergent; however, not all autistic people identify as autigender.

Since autigender refers to a person’s relationship with their gender, people who idenitfy this way often include other words to describe their gender identity. An example is an autigender person identifying as nonbinary as well. The term nonbinary would be the word that describes their gender identity while autigender refers to how being autistic relates to and informs that gender identity.

Many people who identify as autigender use they/them or neopronouns. Neopronouns are any pronouns that are not the standard ones, such as xe/xem/xyr and ze/hir/hirs. It is important to remember that a person identifies with pronouns specific to them, not necessarily ones that usually go with a specific gender identity.

I use they/she pronouns.They/them feels most fitting, but I understand that I present as someone who was assigned female at birth and I’m not offended by people who unconsciously follow the societal constructs that they were taught throughout their entire lives.

Some people who use they/them or neopronouns can get gender dysphoria from being referred to by the wrong pronouns. Being misgendered can cause someone discomfort and pain which is why it is so important to learn and use a person’s correct pronouns.

There is some controversy around the term autigender. Some individuals feel that this term invalidates others who identify as nonbinary or otherwise gender diverse. However, autigender refers to an individual’s relationship to their own gender. It does not mean that other people cannot identify with the gender that fits for them. Part of this controversy may be because autistics can be blunt or more direct than others tend to be. The controversy around the term seems to be fueled by the ableism that is saturated throughout our society.

How could a gender be related to someone’s neurodiversity?

Autistics do not interpret societal expectations in the same way as an allistic (non-autistic) person. We (autistics) may not realize there is a societal expectation for a given situation or we may not understand why there would be a societal expectation in the first place.

This can relate to any topic that people may expect another person to act that would be socially acceptable. Examples of societal expectations are etiquette, how to treat others, how to express emotional reactions, when to let others talk in a conversation, and when to jump into a conversation. A specific example is not knowing when a person is expected to apologize.

Gender identity and expression also have specific societal expectations. In the United States, women are treated differently overall if they look or act masculine. The same is true for men who look or act feminine. The definitions of masculinity and femininity change with time and across cultures, which makes gender a social construct.

Autistics are more likely than allistics to experience their gender outside of traditional societal expectations. In a study of 641,860 participants conducted by Warrier et. al in 2020, those who identified themselves as transgender or gender-diverse on average scored higher than the cisgender participants on self-report measures of autistic traits and sensory sensitivity.

Social constructs have societal expectations. Therefore, gender is sometimes a concept that either doesn’t make sense to us or is something that we don’t feel in the same way as allistics.

Why is there a link between gender diversity and autism?

It is important to note that people can identify as a gender, not follow all of the rules, and never question their gender. Women can have short hair and choose not to be mothers. Men can wear makeup and be stay-at-home dads. Unfortunately, this doesn’t easily change the actual rules and expectations. I am still reminded daily of the rules I should be following as a “woman.” This can be in subtle ways that many people don’t notice — like when the car dealer didn’t look at me throughout the entire conversation with my partner and me, despite my name being the sole name on the title. It can be in more painful ways as well, like when I’m asked about when I’m going to get pregnant.

Autistics can have the tendency to logically deduce the rules of a societal expectation. We do this through consuming media (books, shows, movies, etc.), observing how others are acting, and even through being punished or shamed for not knowing the rules in the first place. It can feel like there is a book of rules for how to act around people that everyone else has read, but we haven’t had access to it.

Autistics can have a tendency to follow the rules that they know immaculately. Sometimes, we can’t make ourselves forget the details. Mental health uses terms like rigidity to describe these tendencies. When I have tried to identify as a woman, my brain can get stuck on the times that I clearly didn’t match expectations for the rest of the day. I identify as autigender and nonbinary, because I cannot meet the expectations of being a woman or a man and I no longer want to. If I am going to be my genuine self, then neither woman or man fit for me.

This is the reason why many people identify as autigender- they are allowing themselves to be their true selves. This can give our brains permission to move forward with our days without being constrained by expectations that fall under our assigned sex at birth.

Blog written by Sentier therapist, Mary Devorak, MS, LMFT

Warrier, V., Greenberg, D.M., Weir, E. et al. Elevated rates of autism, other neurodevelopmental and psychiatric diagnoses, and autistic traits in transgender and gender-diverse individuals. Nat Commun 11, 3959 (2020). https://doi.org/10.1038/s41467-020-17794-1

The new year is a time full of celebrating milestones from the previous year and looking ahead with hope for what’s to come in the next year. Many people make New Year’s resolutions in hopes of achieving a personal goal, making big changes, or finally kicking that bad habit. But often, people end up feeling anxious and stressed by the pressure to meet these goals and live up to unrealistic expectations. Even more, studies show that about 80% of Americans will not keep their New Year’s resolutions, which can lead to even more frustration, disappointment, and stress.

So how do we work towards real change in our lives? Lasting and meaningful change happens most effectively when we accept where we are, without judgment, and take a balanced approach towards our goals. Dialectical Behavior Therapy (DBT) can help us in making realistic New Year’s resolutions that stick. The foundation of DBT is the idea that two opposite things (such as acceptance and change) can exist together in harmony and help us achieve better outcomes when it comes to changing behavior. Using radical acceptance and a non-judgmental approach to assess where we are and where we want to be, is crucial to the change process.

What Is Radical Acceptance?

Radical Acceptance is a DBT skill used when life is not going the way we want or hope it would. Radical means “all the way, complete and total” (Linehan, 2015). It’s an acceptance that happens in the mind, body, and spirit. Radical acceptance means accepting reality, the way it really is and choosing to embrace rather than fight against what is happening. We cannot change our reality without first accepting it. Why bother accepting reality?

1. Rejecting reality does not change anything about our current circumstances.
2. Refusing to accept reality can keep us stuck in bitterness, anger, unhappiness, and other painful emotions.
3. True acceptance may lead to sadness at first but is usually followed by a deep calmness.
4. Changing reality requires first accepting reality.

(Linehan, 2015)

How do I practice acceptance in my life?

At first, we may not even realize that we aren’t practicing acceptance in our lives. I encourage you to pause, take inventory of your emotions and thoughts about what you’re hoping to change or make a resolution for. Notice if any tension arises in your body or any feelings of disgust or disapproval. You may need to practice some acceptance. Here are practical steps for doing so:

1. Notice your resistance as mentioned above. Many times, the ways we resist are unconscious and habitual.
2. Gently remind yourself that reality is just as it is and there are always causes for the reality of this very moment.
3. Practice acceptance with your whole self; mind, body, and spirit. This looks different for everyone but get creative with how you practice self-acceptance. You might journal, use a guided meditation on acceptance or self-compassion, prayer, imagery, or relaxation techniques.
4. Use a non-judgmental approach. Accept the facts and try not to judge yourself harshly or critically. Typically, when we are hard on ourselves it keeps us stuck rather than pushing us towards change. (Here is a great exercise to practice this.)
5. List specific behaviors you would do if you did accept reality, then act in accordance.
6. Imagine yourself coping in healthy ways with the area that you are struggling to accept. Rehearse in your mind what you would do if you accepted what seems unacceptable.
7. Allow for the painful emotions to arise within you (grief, sadness, disappointment). This will help you move through your experience towards acceptance.
8. Practice. Remember, acceptance is a skill, and takes time to learn.

How do I set realistic new year’s intentions and work towards change?

Now that we understand how acceptance impacts change, we   can more effectively set New Year’s resolutions. First, I recommend rethinking using the word resolution and trying to set intentions for yourself and the new year. Resolutions are firm, determined goals that are either achieved or broken. Intentions are broader, a willful direction, that help guide your actions and your life. Setting an intention for yourself considers the reality of where you are starting and the reality of the ups and downs of life. It is more about the process and the holistic change, rather than a very specific outcome. Other steps to take in setting realistic intentions for the new year:

1. Be realistic. Setting an intention that you can easily incorporate into your daily routine will make it more likely for you to continue.
2. Be mindful and stay present. When we practice mindfulness in our daily lives, we feel more fulfilled and purposeful, which will help us both enjoy and achieve our goals.
3. Talk about your intentions with a trusted person in your life. This will provide support and accountability, which only helps improve the likelihood of sticking to our plans for change.

If you are still feeling stuck and struggling with where to begin, you might try starting with just one word. Pick a word that represents your intention for the upcoming year. A word that inspires, challenges, or encourages you. You might ask yourself the following questions to help you decide upon your intention for the New Year:

1. What do I want to keep working on?
2. What is important to me?
3. What are things I still want to achieve?
4. What word or phrase lifts me up and gives me hope?
5. What feeling or ideal do I want more of in my life?

May you be filled with acceptance and compassion for yourself, right where you are in this moment. Happy New Year!

Blog written by Sentier therapist, Tana Welter, MSW, LICSW

Therapists love to ask clients to be open and “curious” about themselves and situations in their lives. It is convenient, then, that there’s a new buzzword in the wellness world: Sober Curious.

What is “Sober Curious”?

Being sober curious means examining one’s alcohol use in order to answer an important question: What is my relationship with alcohol? Sober curiosity is not the same as abstaining from alcohol use in other contexts – during pregnancy or for religious reasons, for example. It is also different than being in active recovery from an alcohol use disorder or addiction. Sober curious folks are eager to challenge their current use patterns and discover how their life feels when they drink less.

Reasons to be Sober Curious

Whether it’s drinking less after a wake up call following an embarrassing moment, or a month-long challenge like Dry January, or cutting back for health reasons, many people are trying drinking less alcohol on for size.

#SoberNotSomber

The reasons people try it are varied, but the result is unanimous: sober curious people seem to be enjoying life more. As Jen Gilhoi, co-founder of the Zero Proof Collective, points out with her hashtag #sobernotsomber, sober does not equal boring. Another sober curious writer backs up this point by saying that drinking less “isn’t about sacrifice – the lucidity I’m able to bring to my important moments now intensifies their brightness and hue.” Having fun without the hangover? That’s enough to pique many people’s interests. What can follow in terms of health benefits makes a lot of people stick with it.

Cutting Back for Health and A Clearer Mind

Alcohol is a chemical that directly affects the brain. According to the National Institute on Alcoholism and Alcohol Abuse (NIAAA), “Alcohol makes it harder for the areas controlling balance, memory, speech, and judgment.” Alcohol also makes the brain process information more slowly, and so brain fog is a major component of a hangover. Emotions can feel closer to the surface and mood swings are also common as people withdraw from alcohol. Cutting back can lead to a clearer mind and better emotional control while drinking and in the day(s) after.

Drinking alcohol is also directly linked to higher incidents of physical health risks including all types of cancer. The National Cancer Institute states that alcohol is a known carcinogen, which can lead to cancer. “Even those who have no more than one drink per day and binge drinkers (those who consume 4 or more drinks for women and 5 or more drinks for men in one sitting) have a modestly increased risk of some cancers.”

The health benefits of sober curiosity do not require being totally dry. People who even just cut back on how much they drink experience improved sleep, energy, skin clarity, and confidence.

Social Norms are Changing While Sober Bars are Popping Up

In the United States, the trend is toward drinking less in all age groups. Forty percent of legal drinkers report drinking less frequently and in lower quantities than they did a year ago. So do college students.

This may be a response to the major increase in sober options popping up. There are more non-alcoholic options available to us than ever, and the “U.S. Sales of non-alcoholic beverages rose 33.2% in the past year, with $331 million in total sales.” Locally, you may notice an increase in alcohol-free options at liquor stores and in specialty NA bottle shops like Marigold. Additionally, we are seeing non-alcoholic or sober bars popping up all over, including Sans Bar, Awake, and Sober Sally’s.

Get Curious

Ready to take a closer look at your own drinking? Great! It can help to keep a journal of your sober curious journey. Try tracking your mood, sleep, and energy levels while you change your drinking behaviors. If you’re already working with a therapist, they can help you explore how it feels to make a change. Again, this is all about exploring your relationship with alcohol and why you choose to drink – or not.

Blog written by Sentier therapist, Sarah Souder-Johnson, MEd, LPCC

Many people struggle with their relationship with food or their body image. Right now there are endless ads about getting a “beach body” or social media influencers showing what they eat in a day, which can really make people feel terrible about themselves and think they need to change the way they look. You are enough just the way you are! A lot of people have felt pressure to diet from messages they’ve gotten from friends, family, society, and sometimes doctors. Diets are not long-lasting for weight loss and can be gateways to eating disorders. The “anti-diet,” Intuitive Eating, is actually the way to make peace with food once and for all.

Here is an overview of the 10 principles of Intuitive Eating:

1. Reject the Diet MentalityDiets do not work long-term. People will inevitably gain the weight back at some point, if not end up at a heavier weight than they were prior to starting the diet. When people gain weight back, they often feel like a failure or like they do not have willpower, when in reality it has nothing to do with lack of willpower. When people diet, they end up in a state of deprivation and the body has many natural biological mechanisms to help you in this state. Your body cannot tell the difference between you choosing to restrict calories or there being an extreme scarcity of food.
2. Honor your HungerYour body gives you signals when it is hungry. Listening to your body when it gives these signals is important. If you do not listen to them, you will become excessively hungry and could overeat. Your body gives other signals, such as telling you when you have to go to the bathroom. You wouldn’t ignore those signals, so why ignore hunger cues?
3. Make Peace with FoodGive yourself permission to eat any foods. Having foods that are “off limits” leads to cravings and when you finally cave in to cravings you will feel out of control because your body does not know when you will be able to have this food again. If the food is always available your body does not need to binge on this food.
4. Challenge the Food PoliceThe food police is the negative self-talk you have about foods being “good” or “bad” or even you being “good” or “bad” for what you’ve eaten or how much. All food is guilt free because food is not a moral issue! It can take practice to “talk back” to these messages, but it is possible.
5. Discover the Satisfaction FactorEating can be an experience that brings joy if you allow it. Eating what you really want in a pleasant environment can be a truly pleasurable experience.
6. Feel Your FullnessBe mindful while you are eating and honor when you feel full. Some people were taught they have to finish what is on their plate or they eat until they are uncomfortably full. Listen to your body.
7. Cope with Your Emotions with KindnessSome people use food as a way to cope with emotions. This may soothe emotions in the short term, though it does not fix problems and can make people feel worse in the long run. Instead, find effective coping strategies that don’t lead to you feeling worse.
8. Respect Your BodyThere is body diversity in the world. Some people live in bigger bodies and some people live in smaller bodies. No matter your body size, your body deserves respect. You don’t necessarily have to love your body to respect it.
9. Movement-Feel the DifferenceLots of people exercise for the purpose of losing weight but this creates a negative association with exercise when your body is not changing in the ways you want. Instead, change your mindset about movement. Focus on how it decreases stress, helps you feel more energized, builds strength, etc. When movement is no longer tied to losing weight, it is more fun and enjoyable.
10. Honor Your Health with Gentle NutritionMake food choices that make your body feel good. You do not have to follow rigid food rules in order to be healthy. One meal or snack will not make or break you.This has just been a quick overview of intuitive eating. If you would like to learn more about it, I recommend the following books:
    

    Intuitive Eating: A Revolutionary Anti-Diet Approach, 4th ed.

    The Intuitive Eating Workbook for Teens: A Non-Diet, Body Positive Approach to Building a Healthy Relationship with Food

    If you need support around your relationship with food or body image, make an appointment with a therapist who is knowledgeable about eating disorders and intuitive eating.

Blog written by Sentier Psychotherapy Therapist, Andrea Schroeder, MS, LPCC.

Sentier Therapy at work and play

You park the car, enter the building, and open the door to the waiting room, where you are met with the calming whir of white noise machines.

Maybe you browse through a National Geographic or scroll through Instagram while you wait for your therapist, or maybe you make a cup of coffee or hot chocolate to sip on during your session.

Eventually, you walk into your therapist’s office and sink into the comfy chair of your choice.

Or, alternatively, you open your laptop, click the Doxy link, and wait for the ding that means your therapist is ready to begin.

What you may not realize once you leave the building or close the laptop is just how much your therapist is doing outside of your sessions. Here are just a few things that are part of your Sentier therapist’s job that you may not know about:

• Therapists complete a case note for each and every therapy session they do in order to monitor their clients’ progress and keep track of what is covered in sessions. If you’ve noticed your therapist writing or typing during a session, they were probably adding to the session’s case note. These aren’t extensive reports but rather a quick summary of what happened during the session. What was discussed and what topics did the client bring up? What was the client’s mood and demeanor? What changes occurred between this session and the last? What sorts of activities or exercises were done during the session? Was any homework or practice assigned for next time?
• Every day, each of the therapists at Sentier updates a massive spreadsheet with 18 tabs outlining everything from therapist availability for new clients to new client inquiries to important dates for the team to remember. Each time someone inquires about therapy at Sentier, it is carefully logged in this spreadsheet. The date and times of Sentier’s groups are outlined months in advance. The list goes on and on! This spreadsheet is a puzzle that keeps the clinic running smoothly and therapists maintaining each piece of it is crucial to the success of the clinic.
• Sentier is an out-of-network clinic which means that therapists submit claims for some clients sessions to insurance providers. By doing this step for our clients, we are trying to make it easier for folks to get reimbursed if possible. Submitting to insurance also means that therapists work with clients to troubleshoot with insurance companies if issues with claims or reimbursement arise.
• Therapists also monitor their sliding scale availability. By logging what sliding scale fees they have offered to clients, they are able to keep track of what they can offer to future individual and group clients.
• Your therapist also updates their waiting list, reaching out to people when availability opens up and communicating frequently with clients about scheduling. Therapy is in high demand, and keeping these waiting lists organized and updated is an important part of your therapist’s job.
• Sarah trains the team on HIPAA (Health Insurance Portability and Accountability Act) guidelines that keep your private health information safe.
• Andrea is the resident expert on Sentier’s Electronic Health Record (EHR). She fields your therapist’s questions about the software and updates a manual that therapists often refer to when they need help.
• Once a month, Sentier therapists gather in the Group Room of our office. We each do a brief check in, updating the team on both our personal and professional lives, and each share something we are grateful for, all while munching on breakfast provided by a rotating member of the team. These gratitudes are recorded in a journal so that your therapist can look back on them whenever they want. The team goes over big and small changes that may have come up in the past month, perhaps about our EHR or how our COVID policies continue to evolve. Therapists bring questions to the team about their approaches to client care and receive feedback and advice on how to proceed.

A few other things you might not know about what goes on at Sentier when you’re not in session:

• Megan can tell who is coming to hang out in her office before they arrive based on their footsteps and her door is always open for a chat or a question.
• Mailboxes fill with paperwork, and then are emptied, and then fill again, and sometimes chocolate or other treats appear in them from the Sunshine Committee. The Sunshine Committee is in charge of birthday gifts, handwritten messages of support and encouragement for therapists, and other random offerings that make our team a family.
• Ashley provides the team with an endless supply of fidgets and help with the printer when it inevitably decides to stop working.
• The thermostat is adjusted often, as half the therapists are always shivering and the other half are too warm.
• Andrea keeps the kitchen stocked with sweet snacks.
• Your therapists ponder the temperature of the lighting in the waiting rooms—too bright? Too warm?—and discuss how the furniture is arranged.
• Jenga, Sentier’s therapy dog, plops down at your therapist’s feet between sessions and looks expectantly at them for pets, love, and apple cores, his tail eternally wagging.

These little things make all of the difference in the way daily life is shaped here at Sentier.

At Sentier, we’re lucky. Having such a small group of therapists allows the team to get to know each other and develop a flow so that we can all help one another be successful.

These personal moments that your therapists share help them maintain the momentum to get all of the other things done. It is a privilege to work with our clients and with one another, and we help each other out so that we can better help you.

Blog written by Client Care Coordinator, Ellie Struewing.

How To Think Positive Thoughts

Has anyone ever told you to “just think positive?” This statement is a lot easier said than done, which can be very frustrating when it’s your parent, teacher, coach, or friend telling you to do so. They aren’t thinking about how your brain works (or they don’t know!) and they don’t know what it’s like to be you. However, the person saying this might actually be onto something. Research shows that thinking positively about ourselves and others, leads to increased self-esteem, increased self worth, and increased happiness.

It’s very common among teens to engage in a lot of what we therapists like to call “negative self-talk.” Statements like, “I’m not smart enough,” “I wish I was prettier,” or “why am I always screwing up?” are all examples of negative self-talk. Due to the strong influence of societal messages and social comparisons, negative self-talk among teens is more present today than ever before. Because of this (and other factors, of course), we are seeing an increase in depression, anxiety, and a variety of other mental health concerns. This is why it’s important that we work to change the way we “talk” to ourselves. Would you tell your good friend that they are not smart enough, pretty enough, or always screwing up? My guess is probably not. So why should what you tell yourself to be any different?

Here are some ways to practice thinking positive thoughts:

• Notice your negative self-talk. Start paying attention to your thoughts.
• When you notice yourself thinking negative thoughts such as “I’m not smart enough” don’t judge yourself.
• Try to find some evidence against your negative statement. For example, if you are thinking “I’m not smart enough” try to think of a time where you were smart enough, like when you got an A on a test or when you made a really whitty joke (intelligence is not just related to academics!). Then tell yourself “I am smart” or if you can’t connect with that statement because it doesn’t feel true, try something like “I am working hard in school.”
• Work on giving yourself compliments or thinking positive thoughts at random times throughout the day. For example, when you wake up in the morning, give yourself a compliment. When you go to bed at night, give yourself a compliment.
• Lastly, don’t get discouraged if this doesn’t come naturally at first. For some of us it doesn’t because we are so used to our negative self-talk and it has become such a habit. The more you practice positive self-talk and thinking positive thoughts, the more natural it will feel and the more automatic it will become.

Has thinking positive thoughts helped you to take a different perspective in any situation in your life?

Blog written by a therapist at Sentier Psychotherapy.

There has been an increase in LGBTQ+ visibility in television, music, schools, and social media. This increased visibility has helped young people find acceptance in their gender and sexuality. Increased acceptance does not mean that young people do not face discrimination and bullying every day in schools and their community, however. LGBTQ+ suicide continues to happen at an alarming rate. Students face discrimination at home, in their schools, and in the community.

There are places of refuge for young LGBTQ+ people, and many of them find community on social media and the internet as well as their school. While this is great for many young people, this can also be a place of isolation and loneliness especially for LGBTQ+ youth who do not have access to community spaces or struggle with anxiety/depression and are unable to interact with people “in real life.”

For LGBTQ+ young adults, the places of refuge and community tend to be bars and clubs where there is exposure to alcohol and drugs. There are not many safe and sober places for young adults to make supportive friends. This is especially difficult for young adults who are not yet 21, or for those who struggle with chemical use.

At Sentier Psychotherapy, we provide a safe space for LGBTQ+ youth and young adults to create community and find support as they come out and become more confident in themselves. Sentier currently offers two groups that run weekly. We have a support group for LGBTQ+ teens (ages 14-17) and a young adult LGBTQ+ support group for ages 18-24. Groups provide a safe and supportive space for young people who are in any stage of the coming out journey. Our groups provide resources and information as well as support and mentoring for young people who are a part of the LGBTQ+ community. Please check our website for dates and times of groups: www.sentiertherapy.com

If you would like more information about the LGBTQ+ groups at Sentier Psychotherapy please contact Ashley at agroshek@sentiertherapy.com 

Link to current Young Adult LGBTQ+ group: https://sentiertherapy.com/group-therapy/lgbtq-support-group-young-adults.html

Link to current Teen LGBTQ+ Support Group: https://www.sentiertherapy.com/group-therapy/teen-lgbtq-support-group.html

This year, 2019, marks the 50th anniversary of the Stonewall riots in New York. For those of you who do not know about the Stonewall riots, here is a brief description of the event:

In the early hours of June 28, 1969, New York City police raided the Stonewall Inn, a gay club located in Greenwich Village in New York City. The raid sparked a riot among bar patrons and neighborhood residents as police roughly hauled employees and patrons out of the bar, leading to six days of protests and violent clashes with law enforcement outside the bar on Christopher Street, in neighboring streets and in nearby Christopher Park. The Stonewall Riots served as a catalyst for the gay rights movement <https://www.history.com/topics/gay-rights/history-of-gay-rights> in the United States and around the world.

As we celebrate pride this year, it is it important to look back at the history of the LGBTQIA+ population, and to honor those who came before us.  They sacrificed SO much, and their sacrifice has resulted in the rights we have today. To celebrate PRIDE this year, let us take a minute to talk about what PRIDE means to the people around us. 

I asked several people what PRIDE means to them and here are their answers. Please feel free to include what it means to you in the comments section below.

• “Pride, to me, is remembering our history, and honoring everyone fighting for our community to just exist. Remembering Pride and who fought before us… The cafeteria riots and the Stonewall riots were just the beginning as we continue to fight. To learn, and continue to grow as our community evolves, also to love and accept the changes and evolution of our community.”
• “Pride means accepting and loving myself for who I am.  It means coming out to my family, friends, and others to show my true, authentic self.  It means honoring the people who came before me to bring more acceptance and love to our community.  It means being in community with my people and celebrating who we are and the progress we have made in society.”
• “It means I am the only one who defines who I am.self-acceptance”
• “Pride is joy and celebration of my full self and the beautiful rainbow of people in out LGBTQIA+ community! It’s shared experience and safety and love in a crowd of strangers and friends.”
• “Pride = life. The ability to live out loud with courage, vulnerability, and self acceptance.”
• “Pride means being yourself against all odds.”
• “Pride is not only a celebration of community, but it is also a reminder of our struggles, how far we have come and where we still need to go.”
• “Pride means I get to be my full self. And to have conversations with friends about the full spectrum of what it means to be queer.  I just had a conversation with a bi friend about privilege and being in relationship with cis het men, and how we can still express our queer love as a part of that. Pride means loving all my people, and celebrating who we are in community.”
• “Pride… It’s a feeling that you are who you are and that there are others like you. Chosen family and safety in community.”

What does Pride mean to you? 

Blog written by therapist Ashley Groshek, LMFT. To read more or schedule with Ashley, please read her therapist bio.

Seasonal Affective Disorder: Light Therapy

Let’s talk about winter. Hot chocolate, sledding, and crackling fires can make us feel all warm and cozy, but having fewer and fewer daylight hours takes its toll. As Daylight Saving Time ends in early November, and our days become even shorter and darker, it is important to have tools in place to combat the downside of the season.

One such tool is called Light Therapy. Light therapy consists of indirect exposure to bright UV-free light. It is primarily used for the treatment of the winter blues and sleep problems. Clinically speaking, there is a type of depression known as Seasonal Affective Disorder (also called S.A.D. or Seasonal Depression; learn more here). The dramatic reduction in sunlight during Minnesota winter months causes our hormones, brain chemicals, and daily rhythms to get out of whack. All of those changes can lead to sleepiness, fatigue, and sad moods, which are symptoms of Seasonal Affective Disorder.

Spending time with a specially-designed light box can help reverse these symptoms by tricking our brains and bodies into thinking we are getting the sunlight we need. Research consistently shows that regular use improves energy and mood. https://www.mayoclinic.org/tests-procedures/light-therapy/about/pac-20384604

Light therapy boxes with 10,000 LUX, the optimal amount of cool blue light that looks and feels like the blue sky on a summer’s day, can trigger biochemical changes in your brain. The right amount of full-spectrum light helps regulate melatonin and boost serotonin, giving you a better chance at restful sleep and a happy (or happier!) mood all winter long.

Light therapy is most effective when used for 30 minute periods several days or every day of the week. When using the light box, sit 20-30 inches away from it, and go about your business–read, study, work at your computer, or eat dinner. The light is meant to enter your eyes indirectly. Just like the Sun, never look directly at the light!

Always follow the manufacturer’s directions for your specific light. Although side effects are rare, they can occur, so make sure to pay attention to how you feel when using your light.

Has light therapy been helpful for you? If not, what has helped during these long winter months?

Blog written by Sentier therapist, Sarah Souder Johnson.

We are living in an uncertain time. Today’s children will tell their grandchildren about the COVID-19 pandemic of 2020 and how everything stood still for a period of time: schools and libraries closed, store shelves emptied, and almost everyone stayed home. The purpose of this “social distancing” was to protect one another and stop the spread of disease. 

That’s where we are today, and putting space between us will work to flatten the curve if we all do it. With that said, there are some real downsides of staying apart even for relatively healthy people with safe homes, Internet access, and plenty of food.* Interpersonal connection is a key component to human wellbeing, and social isolation is a risk to mental health. At a time when it is absolutely necessary to socially distance, many more people than usual will experience the rippling effects of loneliness.

The good news is that there are ways to decrease the effects of social isolation. Here are some strategies for staying well while figuring out this (temporary) new normal. 

1. Ramp up your virtual communication with friends, family members, and co-workers. This is especially effective if you can see one another, so try using apps like Skype, Facetime, and Zoom for video calls and conferencing whenever possible. We are also seeing an increase in individual and group therapy sessions taking place online so that people can start or maintain mental health care. Here is a listing of virtual recovery meetings, for example: Online AA Meetings During COVID-19
2. Get outside. Interacting with others even from quite a distance is beneficial to our wellbeing. Waving to people across the street or when biking past them gives our brains the feeling that we are interacting and boosts mood. Try some Spring yard cleanup, pulling the bikes out of storage, or even some apartment building sing-a-longs like we have seen from our friends in Italy.
3. Create a schedule and shared objectives. It may go without saying that people do better with routines, but did you know that working toward common goals with others is also a protective factor for health? Work on a puzzle with your roommate. Play board games or trivia in teams via Google Hangouts. Create a solo workout plan that a friend will also follow and then check in on your mutual progress each day. Plan, start, and finish a project around the house. (Give an air high-five when you check it off your list!)

Most importantly, remember that this situation is new, and we are all just figuring it out as we go. Taking daily actions to stay connected will protect our individual and collective mental health. And then, perhaps, the ways we pulled together – from a distance – to prevent social isolation will also be part of the pandemic story for future generations. 

What are you going to do to take care of yourself during this hard time? 

Blog written by Sarah Souder Johnson, MEd, LPCC, therapist at Sentier Psychotherapy

*For local readers in the Twin Cities, here are some helpful links to food and safety resources:

Free meals for kids at local restaurants

Child care services division of Department of Human Services; hotline: 651-297-1304

Expanded hotspot capabilities for internet access

How to Stay Grounded During this Stressful Time

In the United States, we are in the midst of a nationwide response to the COVID-19 pandemic. Though necessary, being apart from others comes with a significant risk to mental health. Many people are also experiencing increased health anxiety in general. Others have new or continuing financial insecurity or even loss of jobs. Not leaving the house removes the ability to escape from problems at home when home isn’t a safe place. And the necessary “social distancing” we all have to do promotes withdrawal and the loneliness that can follow. (Read our other blog post about social connection.)

It is normal to feel out of sync with yourself at this time. Thankfully, there are some relatively simple ways to connect with yourself and start to feel better. One way to do so is through a practice called mindfulness. 

Mindfulness is the state of being aware. A leader in the field named Jon Kabat-Zinn says that mindfulness is awareness of the present moment without judgment. It is when we purposely pay attention to what is happening in the here and now without a determination that anything is right or wrong. It helps us respond wisely to things that are happening to us instead of just reacting blindly. Since a lot of things are currently happening to us that are not within our control, we can all benefit from starting – or increasing – our mindfulness practice. 

We wanted to share a few resources we often use in therapy and suggest for our clients at home: 

Here is a basic video describing mindfulness:

Why Mindfulness is a Superpower

Here is a brief video about mindfulness and meditation:

Headspace Meditation Tips

Your breath is one of the most important tools for achieving a calm state. Try this simple Breathing Box technique:

• Inhale for 4 counts
• Hold for 4 counts
• Exhale for 4 counts
• Hold for 4 counts
• Repeat

Yoga is a spiritual practice that promotes mindfulness and connection between the brain and body. Here are a few video sites we use:

Cosmic Kids Yoga

Yoga with Adrienne

Yoga Ed.

Dr. Dan Siegel is a leader in the field of neuroscience and the brain-body connection. His website is full of wonderful resources including Everyday Mindsight guided meditations.

Apps we like:

Headspace
Calm
Mindfulness Daily
Welzen – How Are You?
#Mindful
Insight Timer
Reflectly 

Some books we like:

The Gift of Awareness: Mindfulness Guide for Women (it applies to everyone!)
By Caroline Welch

Mindsight: The New Science of Personal Transformation
By Dan Siegel

I Am Peace
By Susan Verde

This one is great for children! Here it is read aloud by the author: https://www.youtube.com/watch?v=hXA3837uv3w

We hope you will build some mindfulness into each day as we face uncertain times ahead. A person’s body and mind are interconnected; you actually strengthen your immune systems when you use mindfulness, so it’s a win-win! What will you do to help yourself today?

Blog written by Sentier Psychotherapy therapist, Sarah Souder Johnson, MEd, LPCC

Home (from College) for the Holidays

Winter break is around the corner. You imagine having time to unwind, sleep in, and decompress after final exams. You want to reconnect with high school friends and maybe just hang out with the family pet. Maybe you’ll work at your old job a bit to make some extra spending money for next semester or stop by your old high school to say hello. It all sounds pretty dreamy, but being back at home can be more challenging than many anticipate, especially for first-year college students.

Although many students welcome the thought of spending some quality time with their family, parents can have a much different idea of how much time together constitutes a sufficient amount to be “quality.” The long and short of it is that they might expect things to go back to how they used to be before you moved out. This can be very frustrating for a college student who is in the throes of becoming an independent adult (and seems to be doing a pretty good job at it thankyouverymuch!)

Here are some common scenarios that you might encounter going back and tips for how to handle each one:

• You are exhausted after a difficult semester, and all you want is to catch up on your sleep. Parents may see this as laziness and wonder if all you do while at school is sleep. Obviously not—you work hard for school because you like it and it is important. Ask them not to come in and open the blinds at 8AM please—this is a VACATION after all—but you appreciate their hospitality and will of course help with some chores later.
• If you have siblings at home, the family structure might have to reconfigure. For example, the middle sibling is now used to being the eldest, and for them it may be more of a drag than a delight to have big brother or sister home again. Let them know not to worry, because you’ll be out of the house soon enough. A friendly game of Monopoly or a trip to the mall together might break the ice and make it fun to be around one another again.
• Be prepared to discuss money issues openly. Becoming financially independent is a process—a journey, really—with a lot of opportunities to learn and make mistakes. Maybe you bought 87 pizzas this semester when you only had enough money to buy 64. Budgeting is important—ask your parents to help you out or give you some pointers…not just more money.
• Again, time may be an issue. You may be grabbing your coat to leave as your flabbergasted parents were about to get in bed. As author Karen Coburn state in Letting Go: A Parent’s Guide to Understanding the College Years, “It’s tough on parents because even though they have grown used to not knowing what time their child comes back to her room when she’s away at college, parents can’t turn off their ‘worry button’ when it’s 2AM and the car isn’t back in the driveway. Parents don’t stop being parents. They worry about their child’s safety. It helps to come to an agreement that recognizes their child’s growing independence, as well as their own need not to worry.”
• Talk to your parents about your experiences in college. Parents err on the side of educational and professional progress (i.e. asking about grades, teachers, and goals), so tell them about your favorite subjects, books, performances, or pieces of music that changed your life. Tell them the highlights of your semester and how you’ve changed; it can be rewarding for both of you to acknowledge your accomplishments. 
• Try to make plans in advance. Family gatherings might interfere with social gatherings, so try to talk about things ahead of time so conflict is kept to a minimum.

Basically, the key is communication. Don’t be afraid to express how you like to do more things on your own now and to kindly request respect for your need to develop independence. That being said, try to also respect your parents’ necessity to be parents and to look out for your safety, success, and well-being. Do you feel equipped to head home for the holidays?! Good luck!

Blog was written by therapist Sarah Souder Johnson, MEd., LPCC 

DBT Therapy – What is it?

Everyone’s talking about DBT, but what is it, exactly?  

You tell your friend about the recent behavioral issues your teen has been having, and they tell you that their child was in DBT (Dialectical Behavior Therapy) and that it really worked!  They tell you that you should consider putting your child in DBT.  Your doctor refers your teen to DBT after he discover she has been cutting herself.  Your cousin, who is a therapist, suggests you look into DBT for your daughter after your daughter has an emotional outburst at the family reunion.  

You Google “DBT” online and find the same information over and over: It’s a cognitive behavioral treatment that was originally developed to treat borderline personality disorder and people who were chronically suicidal.  It’s now been shown to be effective in treating a wide range of mental health issues such as depression, anxiety, PTSD, eating disorders and substance use disorders.  It teaches mindfulness, emotion regulation, distress tolerance, and interpersonal effectiveness skills.  While all of the above is accurate and informative, chances are you still don’t have a clear understanding of what it is your teen will actually be getting out of DBT or how it will help your teen.  Let me try to help.   

DBT is a treatment approach meant to help those who might be more emotionally sensitive and reactive than the average person.  What do I mean by emotionally sensitive?  People who are emotionally sensitive tend to experience emotions more frequently and more intensely than others.  For example, when the average person gets cut off in traffic, they will likely feel frustrated or mad for a short time and then go back to thinking about what they were thinking about before they got cut off.   A person with high emotional sensitivity, however, may react by cursing, flicking the person off, and speeding up to pass and cut them off.  They may think about the event for hours after it happened. Another example is a person who plays the wrong key at their piano recital.  The average person would be embarrassed or disappointed in themselves, think about it for the evening, but sleep on it and move forward within the next couple of days. A person with high emotional sensitivity may become depressed, suicidal, and internalize this mistake by telling themselves that they are a screw up, a failure, and don’t deserve to be alive.  These intense feelings and thoughts may lead a person to engage in behaviors such as isolation, self-harm, substance use, or other unhealthy behaviors.  

The examples above show how being emotionally sensitive can negatively impact a person’s life. However, being emotionally sensitive can also be a very positive quality.  Feelings such as love, happiness and joy are felt more often and more intensely.  People who have high emotional sensitivity often exhibit characteristics such as kindness, creativity and empathy.  The goal of DBT is not to get rid of a person’s emotional sensitivity, it is to help a person learn how to manage these extreme emotions.  

A full DBT-intensive outpatient program includes weekly individual therapy, phone coaching calls between client and therapist and a weekly skills training group.  Typically these programs are anywhere from 6 months to 14 months in length.  Some programs, however, adapt DBT to fit the population in which they are serving.  For example, there are DBT groups that have been developed specifically for people struggling with substance abuse.  Many eating disorders treatment programs have been incorporating DBT into their programming to address problems specific to eating disorders.  We have adapted DBT to be more teen-friendly and meet the needs of adolescents who don’t need an intensive DBT program. What this means is that we don’t do coaching calls, we only meet once per week, and the teen is not required to be in individual therapy to be in the group. Our model is less intensive, more user friendly for today’s busy teens, and focuses on learning skills. Click here for more information about our next Teen DBT group in St. Paul.

This blog was written by a therapist at Sentier Psychotherapy

So your spring break was cancelled. Possibly for the second time.

The first lockdown in Minnesota was in March 2020, right around spring break time. And experts still advise against travel. But you definitely deserve a break.

Here are some ideas to make the best of your spring break 2021:

Travel virtually

Here is a list of virtual tours that you can do of museums, landmarks, national parks, and more. https://www.globotreks.com/tips/best-virtual-tours-world/

If you virtually travel abroad, really get into the experience by cooking some of what would be local cuisine.

Download the World Walking app

Take a walk somewhere local but be transported to someplace else through virtual tours of places all around the world.

Do a scavenger hunt

Download the Let’s Roam app and do scavenger hunts in Minneapolis or St. Paul with friends.

Go on a staycation

Get creative here! You can create a paradise at home!

Get into your bathing suit, put up pictures of beaches, lay on a towel in your living room, decorate with seashells, play ocean sounds, light an ocean scented candle, and make tropical smoothies.

Find a local event

The Wintertime LED Light Show is happening through the end of March. https://www.exploreminnesota.com/event/wintertime-led-light-show/25017

Start planning your spring break for 2022

Just planning a vacation can bring joy. Create a vision board of your dream vacation on Pinterest. Gather ideas of places you would like to visit and what sights you would like to see!

We’ve said it before, and we’ll say it again: COVID-19 has taken so much from us.

So much that we were looking forward to, like trips, got cancelled. It’s okay to feel mad and disappointed about that.

And you can also make your spring break as fun and as relaxing as possible.

What will you do for spring break 2021? Connect with us and share on Sentier’s Instagram.

They say it’s the mother (or father) of all losses. Nothing can truly prepare you for it, no matter your age. But when you’re a teen and your parent dies, it can be very disruptive to an otherwise normal process.

In adolescence – that sweet spot between childhood and adulthood – one of the things you naturally do is separate yourself from your parents.

You want to explore your own interests, spend time with your friends, figure out what you believe about life, and make your own decisions. It’s part of human development to want independence and to rely less on your parents!

At the same time, parents are usually loosening the reins and giving you space in order to help you transition from the kid they’ve known into the adult you’ll be become.

If a parent dies, you are forced to do without them instead of slowly separating as you become an adult.

If you’ve been in conflict with your parent, which is also totally normal in adolescence, you likely have things left unsaid or undone.

Those “what ifs” and even regrets are all part of grief. It is important to know what normal grief looks like so that you can learn to live in a new way.

Disclaimer: We recognize not everyone has a healthy parent relationship. It’s natural to grieve whether or not you had a close bond with the parent who died.

So, what is “normal grief” for a teenager? There are four big things we tend to see in therapy:

1. Under Construction. The teen years are all about building, much like a construction project, but when you lose a parent, it can change the whole plan. The solid foundation your parent may have built for you can shatter. If you had an unhealthy or abusive parent relationship, it can feel devastating not to ever get that chance. You might feel like you aren’t sure where to start. Grief becomes part of the (re) building process.
2. Intense Emotions. Grief is a very complex process that is hard to control. Most teens feel confused and lost when their parent dies. It is common to have symptoms of depression, anxiety, hopelessness, and lots of crying. Anger is a very normal part of the grieving process as is disappointment. Parent loss can lead to uncertainty about who you are without your parent, and many grieving teens struggle with self esteem. It’s common to cycle through emotions, and they generally become less intense over time.
3. Isolation. Death is hard, and we don’t always do a very good job of talking about it “in public”. Adults can be some of the worst offenders. Some will believe you don’t want or need to talk to an adult about it. Others may try to keep your time together lighthearted since they assume you’re sad the rest of the time or need a “break” from your grief. Unless they have experienced grief themselves, some of your friends are likely so uncomfortable with the idea of death that they avoid it altogether and never bring it up. All of that can lead you to feel alone.
4. Academic Ups and Downs. It can be hard to focus on school work when you’re grieving. Afterall, you don’t get to choose when you are or aren’t grieving. If your parent had been really involved with your school, you might not yet know how to keep on top of your work on your own. Other teens pour themselves into school work as a distraction and actually perform better in school than before their parent died. Whatever it is for you, maintaining structure in your life by at least getting to school each day and interacting with peers will help in the long run.

While all normal, none of those things is easy. With support and understanding, you will learn how to function with the new normal in your life.

Peer support groups can be very helpful as can talking about it with a school counselor, clergy person, family member, or therapist.

Grief takes a winding course and it changes over time, just like being a teen, so the most important thing is to try and recognize when you’re grieving and be gentle with yourself.

Ask for what you need from others. While no one can replace your parent, you don’t have to do it alone.

What have you found to be helpful on your healing journey?

Blog written by therapist Sarah Souder-Johnson, MEd, LPCC