 It seems that the word “confrontation” is something we learned, or were taught, that is not acceptable. I see it as a form of communication - and an important one. It doesn’t have to be equated with conflict, though it seems we are inclined to make the two words synonymous. By definition, confrontation is a hostile or argumentative interaction. And conflict is an aspect of confrontation. But, confrontation does not have to be mean-spirited, aggressive, or overly intense. Most people don’t like expressing anger or having anger directed at them. This is understandable because anger is not a pleasant feeling. And, we tend to avoid feelings that don’t feel good.
I propose that we learn to tolerate, accept, and sit with all kinds of feelings and discomfort. When we allow ourselves to experience, to feel, a range of emotions, including the “bad” ones, we work through them much easier. When we avoid, or use other defense mechanisms to prevent feeling sad, mad, angry, etc. they still live within us; they just come out in different ways such as headaches, stomach aches, anxiety, depression, etc. or they could be displaced onto someone else who doesn’t deserve it. The intensity of feelings actually dissipates when we accept them, tolerate them, or actually express them. Sitting with the feelings is the first step. This allows us to not act impulsively. When we immediately respond to someone with the anger we feel, the desired communication does not make it over to the other person. It is intercepted by the tone in which it is delivered and the outcome is likely to be unpleasant. So, it’s quite hard to “sit” with the feelings. Often when we impulsively express our feelings, it creates some relief because now we are no longer sitting with them. But what we have done is dropped them on someone else. It’s not always fair, and it’s often not effective. Then, the other person receives it, and either feels badly by the way it was delivered or it’s not heard in the way we intended or wanted it to be received, or with the outcome we envision, and combative friction develops. When we are intensely affected by someone else’s actions, we can be prone to defend ourselves or go on the offense; "fight back”. And fighting back often leads to attacking behavior. On the other hand, those folks who are willing to let their hurt or anger slide, are not getting their needs met. What to do? Be intentional with your confrontation.
For more about this topic, tune in to What Would Dr. Meyers Do?, Episode #18.
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 This is such a big question! And since blogs are relatively short, I’m going to rise to the challenge of tackling this in a succinct way. There are many different types of therapy, and many different styles, and ways of working. Personally, I was trained in psychoanalysis which is based on Freudian theory and working with the unconscious. What that means is trying to help the client bring into awareness those things he/she may not be aware of. Sounds simple, but it’s very complex. If they aren’t aware of those “things”, how do they become conscious? Through a lot of talk and free association. When the client is free to talk without judgment or prompts, the idea is that they are able to get to underlying thoughts and feelings that they are not usually in touch with. There is also a lot of focus on transference. This means that we move through life relating to others how we have been related to and how we have been responded to, but again we aren’t usually aware of this. For example, if someone had an overly critical parent, that person may expect others to be critical as well, even though he/she may be dealing with some very different people who may not respond that way at all. Or, they may continue to find critical people and attach themselves to these “types” of people because it’s familiar. But are they aware that they do this? Most likely not. If the expectation is there, of facing criticism, this may impact the individual in many ways. Perhaps they don’t exercise their voice, and they remain introverted or socially isolated. Or maybe they don’t exert themselves at work for fear of judgment. On the other hand, attaching oneself to negative people may further reinforce their negative self-esteem. So it’s important to help that person understand their background, their past relationships, and how that may impact their current functioning. We tend to repeat what we know/what is familiar, and we are usually not aware of doing so.
I consider myself a psychodynamic psychotherapist. This means that I work with making the unconscious conscious as I described, and I work with transference. However, over the years I have shifted to also incorporating working from an interpersonal framework with some cognitive behavioral methods. I have observed that folks want results. They want interaction. And they want some tools to help them through the everyday while they are working on increasing self-awareness. An interpersonal approach focuses on building interpersonal skills and communication skills towards the goal of strengthening relationships. Since I also work from a psychodynamic perspective, I believe that this can also be addressed through the transference of the client-therapist relationship, practicing and modeling. A cognitive-behavioral approach addresses your thought processes (often negative, distorting, or overwhelming) and offers concrete adjustments or homework to address those faulty ways of thinking and develop coping skills. Now where does a psychiatrist, psychologist, and social worker come in? In short, a psychiatrist attends medical school and specializes in brain chemistry; the focus is on the use of medication to address symptoms. Some psychiatrists also conduct therapy, but it is important to question their training. Perhaps they have also been trained in therapy. If they have not, remember they are coming from a medical model, and therefore are likely to focus on medication as an intervention of treatment. A psychologist also works to understand thoughts, emotions, feelings and behavior. In addition, they are trained to make assessments and conduct psychological testing - often for diagnoses (ie: ADD) and learning disabilities. A social worker, depending on their focus of education, has many possible paths. A social worker has a broad understanding of resources, human dynamics, and development. A social worker can also be a therapist. However, in my opinion, it’s important that they have more than two years of graduate school to be trained as a therapist. A social worker considers context: not only how a person is functioning, and what may have led to stressors, crises, or difficulties but also the impact of the greater environment on said functioning. For example, culture, race, political climate, geographic location, poverty, etc. Each of these titles, psychiatrist, psychologist, and social worker can fall under the umbrella of therapist/psychotherapist. Are you looking for a therapist? It’s ok to ask questions! This doesn’t mean you are challenging the professionalism or credentials of the person; you have the right to know how the person is trained; their philosophy; their style of therapy. It’s important that you find what works for YOU. I get it, you may not know. But what is most important is that you feel you have found a good fit. It may take meeting a couple of therapists, and having an introductory session. It’s that important to take the time to do so. You are on what may be a long journey. You are on a path of self-discovery and healing. It can be frightening to begin therapy - you don’t know what is going to come up, and you don’t know what you may end up feeling. Not having that kind of control is scary! There may be times you leave feeling a bit down. But I strongly believe you have to work through your stuff in order to get past it. And there will be many times you leave encouraged, supported, validated, and having gained insight. Consider it a necessity like your morning cup of coffee. Or a luxury like getting your hair done, or getting a massage. Invest in yourself! We discuss more aspects of finding the right therapist on episode #78.  Our primary motivation is to feel a sense of connection to others. The root of all connectedness begins with mother-infant, yet siblings soon become a key source of emotional connection. When children lack nurturing relationships in their home, they search for that connection throughout their life. Families set a precedent for how its members understand closeness with another person; how they think about connectedness; and how they experience intimacy. Because victims of sibling abuse do not have a model for a “healthy” and satisfying connection, there is a tendency in adulthood to seek out relationships that repeat aspects of their previous experiences. Survivors of sibling abuse endure feelings of helplessness, powerlessness, and inferiority that erodes self-esteem. This ultimately influences the nature and quality of relationships to others. We learn so much from our sibling relationships: loyalty, friendship, conflict resolution, sharing, competition, tolerance, frustration, leadership and followership, sharing, assertiveness, cooperation, negotiation, love and support. When one’s most trusted peer – the sibling – betrays the sanctity of that relationship, the idea of closeness – and of intimacy - becomes fraught with danger. As a result, survivors develop defenses against and within intimate relationships as an attempt to self-protect from re-traumatization. Survivors of sibling abuse poignantly define “closeness,” in terms that demonstrates both their struggle to achieve intimacy and a desire to attain it (based on my research): Naked honesty bare-naked emotionally; unconditional acceptance but I’m not sure if that is possible; staying present to one’s own feelings and to another’s. A lot of caring --a lot of ‘unconditionality’. It’s about having similar values and beliefs that if I ever needed anybody, all I needed to do was pick up the phone and they would be there for me. There’s a lot of mutuality and a lot of openness. If they do something that makes me angry or vice versa, we talk about it. You know, and I never question that I care deeply about them or they care deeply about me. Intimacy is when I feel most vulnerable - when I share something about myself that I wouldn’t necessarily share with anyone. There is always a part of me that thinks ‘I wonder what that person thinks about me now that they know that. Or I’m like ‘oh no, what are they going to think now’? That’s what intimacy is to me- to trust someone with my feelings, my most delicate feelings and they will be like ‘I get you and I love you’. To be able to talk with someone and express how you feel emotionally--to be able to talk freely without any advice or condemnation or ridicule but with acceptance and listening. And still at the end of it I will be held. I don’t know because I can’t think of any person that I have gotten that from. It means understanding somebody and showing that you care about them. Or someone identifying how I feel; knowing when that person feels bad and being able to reach them and finding a way to help that person through; providing comfort to each other. Although desirous of closeness, survivors fear they would be hurt if they expose their feelings or appear vulnerable. This mirrors earlier incidents when they relied and trusted that their families were capable of providing support, but were severely disappointed. Survivors of sibling abuse are violated not only by a sibling but by the caregiver who failed to protect. Not only was abuse present, but neglect by the caregiver is also implied. The betrayal and violation inherent within a sibling abusive relationship forms survivors’ perceptions of how the world at large will relate to them and engenders the expectation of rejection. We are conditioned to take in our life experiences, make them our own, and project them onto subsequent relationships. This is called the internalization and externalization (or projection) of experience. And as a result, we expect others to relate to us as did our primary (familial) relationships. Survivors describe “closeness” as unconditional acceptance and a sense of unyielding support: something they did not experience with their families of origin. As adults, they fear pain if they expose their feelings or appear vulnerable. The betrayal and violation inherent within a sibling abusive relationship forms expectations of the world at large – a world where intimacy is to be feared. Intimacy requires trust. Trust requires risking that the world is not necessarily going to respond to survivors as did the family of origin. Humans are conditioned to perceive others through the lens from which they see the world growing up. The voice or perception of the abusive sibling makes its way deep within the victim/survivor’s soul. The good news is, that lens can change. Take risks; step outside of your comfort zone; allow yourself to hear/feel how others perceive you. Finding those who treat you the way you deserve to be treated will rebuild your ego and make the voice of your perpetrator diminish over time.  I saw a magnet that said “I’m sorry I slapped you, but you wouldn’t stop talking and I panicked”. Yikes. Sounds harsh, and certainly not subtle. But I want to speak to the subtle part of that message. Some people like to talk… a lot; and some people are listeners. But EVERYONE wants to be heard and understood.
It sounds so easy. Just let someone talk; air their thoughts; feel heard. But it’s not so easy! We want to show we get it, so what do we tend to do? We interrupt with our own thoughts; we cut off the person; we relate something we experienced that may be similar; and we try to comfort by offering a silver lining. All of this tends to fall flat, and leaves the person feeling deflated. Sitting with someone in their discomfort, their pain, their truth ain’t easy! Practice, practice, practice. Offering your silence is a gift like no other. So consider this: what gets in your way of simply sitting with the person, remaining attuned and attentive? Do you think the person expects something from you? Are you uncomfortable with what is being shared? Is it stirring up feelings in you - sadness, anger, identification? Is it hard to sit with their feelings? How are you at handling your own strong feelings? Holding - and I mean emotional holding - is so powerful. It requires sitting with our own discomfort in order to be there for the other person. So first, identify what’s uncomfortable for you - and then work on managing that. Check out this discussion in full on the WWDMD episode #14 entitled “The Art of Empathy and Silence” Working in the field of social work, or I suppose any helping profession comes with a bit of a burden: the sense of responsibility for someone else’s well-being. I say burden, because we tend to take this very seriously, and it’s scary! Especially at the beginning. In social work, we tend to feel that responsibility for someone’s emotional well-being. After my first few years fearing this, I came to see it as a luxury. Someone else is trusting me with his/her emotional life, and is revealing inner, often private, thoughts that perhaps no one else in their life is privy to. So, yes, this is scary, but it’s also a privilege. Perhaps if we shift our lens from feeling fearful to perceiving it as an honor, that can be a starting point to feeling more confident.
Making mistakes is a natural “right” that should be bestowed on all of us when we come into this world. In fact, it is. We learn to walk, we fall down. We learn to talk, we make up bizarre sounding words. We learn to eat, we smear our food all over our face. So what happens after toddlerhood that activates this sense of dread when making mistakes? Sure, it can have to do with how these errors or mistakes were handled by our parents, our teachers, etc., but it is extremely curious to me that the majority of us have this ability to punish ourselves. And so, that raises questions about a much larger phenomenon - why this is such a common feeling. I don’t have the answer, but I do think that those of us who go into the profession of social work are somewhat “broken”. And I don’t mean that to be critical - I’m one of you! I mean that in the sense that whether we realize it or not, social work has drawn us in, has spoken to us, likely because of our own connection to needing help or living through some difficult times. That being said, somewhere along the line it’s like we got the message “get it right, or else”. I have tried to live my life with the words of Elbert Hubbard in mind. He was an American writer and philosopher, who said “The greatest mistake you can make in life is to be continually fearing you will make one.” I hope you too can adopt that philosophy. Remember:
So, as a social worker, we have the ability to consult - with a supervisor or a colleague. You don’t know of a resource your client needs? Ask someone. You think you may have said the wrong thing to a client? Go back the next time and address it. You are modeling very positive behaviors: asking the client how he/she felt about what you said or didn’t say; you are showing that you are able to self-reflect; you are showing that you want to build a positive relationship; and you are showing that you are human, and fallible… and it’s ok! What better model for human interaction?! If this topic "speaks" to you, hear more on Episode 13 of WWDMD.  None of us like to talk about difficult feelings or face challenging parts of ourselves before we are ready; before we choose. So what happens when you are confronted with doing that? That’s often the fear of being in therapy. Most folks want to control their own emotions. That’s normal! Being in therapy presents a level of vulnerability that we can’t control, unless of course we use our defenses to ward off the pain that may surface. Generally, we are conditioned to wanting to be able to know the outcome of our actions. That’s why so many of us fear taking risks or starting something new. We can have a sense of the outcome of the change being made, but we don’t always know for sure. That’s why making change can be quite scary. And being in therapy means that change is coming.
We get really comfortable with our discomfort. Because discomfort is familiar, it’s comfortable. Again, we know what to expect. So, being in therapy takes vulnerability, and risk. We can’t predict the outcome. What we can expect is change for the better. But first we have to be willing to come out of our comfort zones. We protect ourselves from that, understandably. It’s cozy there! No matter what, you will go at your own pace, because whether you know it or not, your defenses will protect you. This is why change is slow, and it won’t happen until you are truly ready. So many of us want to change things we don’t like. But it takes work. And if it took you your lifetime to be who you are, it’s going to take some time to make shifts. So be patient. And be kind to yourself. Put in the work, it will be worth it. But remember this: We can’t get past our feelings, discomfort, and pain unless we push through them. And you deserve to live your best life. To hear more tune in to my podcast "What Would Dr. Meyers Do": Episode 12 (release date: 1/10/23)  Sibling abuse is often overlooked as normative sibling rivalry. However, siblings can pose danger to each other either physically, emotionally, or both. The ramifications on the victim of an enduring aggressive and assaultive sibling relationship have both short-term and long-term repercussions. There are environmental factors outside of the family that may increase the likelihood of sibling on sibling aggression such as substance abuse, peer bullying, and low self-esteem. However, sibling abuse tends to develop from certain family conditions that create resentment and hostility between children. Most parents are upset to learn that sibling abuse occurs under their roof; they may be unable to manage the behavior; or they may feel helpless to address it. Additionally, parents may report that their child is also abusing them. There are steps that parents can take to minimize the development and perpetuation of sibling abuse.
1. Do not subject your child to your abusive partner. It is your responsibility to protect your children from all types of abuse within the household. Do not passively accept your partner’s maltreatment of your child. My study found that parent-child abuse occurred in 50% of homes where sibling abuse was present. 2. Model appropriate communication. Children learn how to manage conflict by observing disagreements and conflict between parents and through the interactions parents have with each child. Remember that acceptable behavior starts with you. Do not bring children into adult conflicts. 3. Pay attention to your child’s peer relationships. Children who have challenging peer relationships are apt to bring this behavior into the home. If your child is the target of peer bullying he may be prone to victimization in the home; likewise, your child may displace his anger at being victimized onto a sibling. If your child is demonstrating aggressive behavior at school, he/she may also be aggressive to a sibling. 4. Take your child’s complaints seriously. If your child is complaining about a sibling’s behavior towards him/her, monitor the relationship. If your child is scared of being alone with his/her sibling or finds reasons to stall coming home from school, ask if he/she feels safe at home. Often, children who are abused by a sibling will seek refuge at a friend’s house or get involved in after-school activities as a way to avoid being home until parents arrive from work. 5. Give children child responsibilities. Children should not be in the position of caregiver. Sometimes parents are overwhelmed and need help with tasks. That is ok! However, children should not serve as a substitute spouse. Children, especially from single-parent homes, tend to be burdened with the care giving of younger siblings. This breeds resentment. While children may seek positive reinforcement – and are praised – for being a “mother’s helper”, they have the ability to grow up resentful of taking on that role. 6. Treat each child equally. Granted, each child cannot be treated the same all the time. However, it is important to recognize the strengths of each child. Favoritism can create hostile sibling relationships. As children, we learn that we are subordinate to parents: messages are conveyed that expressing anger at a parent is unacceptable. This anger is likely to be displaced onto a more subordinate figure (the sibling) who bears the brunt of the rage. When a child perceives that he/she is not being treated fairly by a parent, or is liked less than a sibling, he/she may react by mistreating the sibling. 7. Get help. If you feel unable to manage your child’s behavior, seek professional help. Parenting is not easy! There is nothing shameful in needing guidance or intervention. The best intervention is prevention! But parenting is the hardest job there is. If sibling relationships turn aggressive, obtain all the support you need. All parents struggle with parenting responsibilities. We pay so much attention to the influence of parents on children – and parents are powerful beings in the home environment. Siblings are too.  Sibling abuse has been identified as the most common form of family violence in the United States (Button, Parker, & Gealt, 2008; Reid & Donovan, 1990), occurring more frequently than parent-child abuse or spousal abuse (Graham-Bermann, Cutler, Litzenberger, & Schwartz, 1994). However, without current and national statistics to support this, sibling abuse continues to be under-recognized. No consistent national law exists regarding sibling abuse since many states do not have statutes that distinguish it as separate from incest. Parents who are not knowledgeable of the traumatic effects of abuse by a sibling may unintentionally perpetrate neglect, by failing to address the behavior. Longstanding societal oversight of sibling abuse contributes to survivors’ uncertainty in terming their relationship with their siblings as abusive. A common response to someone claiming to have been abused by a sibling is that it must be a dramatization of normative sibling rivalry. After all, doesn’t everyone have fights with their siblings growing up? The cultural lack of validation of the sibling abuse experience leads many victims to not report its occurrence. Parental emotional unavailability and unresponsiveness to their child leaves the victim feeling alone and isolated. Often, because of shame and embarrassment, victims keep outsiders at a distance. This poses challenges for community members or peers to recognize the need for intervention. Furthermore, literature on sibling aggression often uses the terms “conflict”, “aggression”, “violence”, “rivalry” and “abuse” interchangeably which tends to minimize the significance of sibling abuse.
Sibling abuse is NOT sibling rivalry! There are distinct differences between normative sibling rivalry and sibling abuse. With sibling rivalry, children have an equal opportunity for advantage or disadvantage. Sometimes, one sibling is hurtful to another; and another time the other sibling is hurtful. However, sibling abuse indicates pervasive, ongoing damaging behavior from one sibling to another in which there is intent to harm by the abusive sibling and an induced sense of fear, shame, and hopelessness in the victim. While sibling rivalry fosters skills of communication, negotiation, and competition, sibling abuse does not warrant any positive outcomes. Although a single act of violence may be deemed abusive, sibling abuse generally differs from sibling rivalry because the harmful acts are perpetual, consistent, and severe. Sexual abuse is the form of abuse most often assumed when sibling abuse is discussed. However, like with parent-child abuse, acts of violence between siblings can be of physical and/or emotional nature. Researchers have qualified physical sibling abuse as that which results in injuries such as bruises, welts, abrasions, lacerations, wounds, cuts, bone fractures, and other evidence of physical harm or injury (Wiehe, 1997; Hart, Germain, & Brassard, 1987). However, physical evidence of injury is not the only indicator of physical abuse, which could also include behavior that is physically intrusive, physically painful, and experienced as physically overwhelming. Emotional abuse involves active expressions of rejection and actions that deprecate the sibling, including verbal denigration and ridicule, actions or threats that cause a sibling extreme fear and anxiety. Another form of emotional abuse occurs when a sibling uses another for advantage or profit (Schneider, Ross, Graham, & Zielinski, 2005). Victims of sibling abuse feel terrified and powerless to stop the onslaught. Despite its consistency, the acts are often unpredictable. There is no warning as to when it will occur, what will incite such anger in the perpetrator, and how the victim may prevent or avoid the next blow. It is interesting that as a society we have rallied to the cause of bullying: through media, anti-bullying legislation, and outraged parents. I would posit that bullying could be termed peer abuse. In much the same way that we distinguish teasing from bullying, we need to distinguish sibling rivalry or sibling aggression from sibling abuse. There are parallels between peer teasing and sibling rivalry: variability in roles; equality in power; playfulness; testing of boundaries; and, the aggressor can be remorseful and take responsibility when the target becomes upset. There are also similarities between bullying and sibling abuse: always the same target; intent to harm; the aggressor seeks control or power; and, there is no remorse. Rightfully, serious measures have been taken to protect children from peers in the realm of bullying - as a society we have acknowledged the destructive physical impact or emotional influence a peer can have on another child. We also need to pay attention to the devastating implications of siblings who abuse siblings. Learn more on this subject: Tune in to my podcast "What Would Dr. Meyers Do": Episode 11 "Sibling Abuse: It Hurts and It's Serious" (release date: 1/3/23)  “Who cares what others think!” Can we really live by this ideal? I am a middle-aged University Professor. I was bullied throughout my middle school and some high school years. I cried myself to sleep. I dreaded walking down the hallways. My ego was battered. I know what it feels like to be unseen, viewed in a negative light, ridiculed and tormented. I also now know what it feels like to be seen, admired, and sought after. It took years to achieve feeling liked, loved, valued for my positive attributes, and yes, I feel empowered. How did I get there? I actually listened to what others thought of me. I heard the statements that were made of appreciation. I saw the way people looked at me. And I took it in. On the one hand, we learn not to give others such power over us. That we have to build our confidence through believing in ourselves. This is not an easy task, particularly for the developing adolescent who is fraught with building an identity and to whom peer approval is everything. As an adult, especially as a woman, we are often conditioned to dismiss the positive accolades: to undo compliments. We all can relate to the retort to “you look so nice; I love your outfit” with “really? this is so old”; or “you’re so funny” with “I worry that I’m too sarcastic”. We must learn to acknowledge and take in the positive observations with “THANK YOU”. Care what others think, especially as an adult, and hopefully as a child and adolescent when it is affirming.
Take in what is liked about you; your strengths; views and perceptions that contradict those victimizing perceptions from youth.
 Receiving gifts from clients is often awkward…for me. How do you feel about it? Is it welcome? Is it deserving? Do you feel you know you shouldn’t accept it, but are not sure why? Does it depend on what it is? It sure is tempting to accept that gorgeous piece of jewelry! As I always ask, is there something we can learn from the gesture? Now, many may think I’m reading too much into it. But I believe, without “over”-analyzing, that gifts are meaningful. I see it as a form of communication. Can you inquire what the process was for the client in thinking through the choice of gift? Now, we have to be careful with this because we don’t want to reject or hurt the client. Assume it is well-intentioned! Don’t be suspicious. Be curious. You can even inquire with humor or playfulness. I would suggest that we can learn much about someone and his/her choices. What may the gift represent? Is it simply an act of gratitude? The client may want to show their appreciation for your good work. Could it be that he/she feels they owe you something? We don’t want to encourage that. And, if that’s the case, we may be able to learn that the client is showing you how they operate with others outside of the relationship with you. So rather than promote this sense of obligation, we want to help the client with that feeling that they have to “pay back” someone for what they may have received (in whatever form, ie: love, caring, empathy). What if it’s a silent collusion - I give you this gift, and in return, you don’t push me to address painful things. How can you now confront a client who has expressed their gratitude/love for you?! As long as you don’t let the gift get in the way of that, then let your conscience guide you.
An important question: can the client afford what they have presented to you? You want to be careful here. A small token is completely fine and acceptable. It’s the expensive gifts you should consider. Some clinicians may not be aware of how they themselves feel about gifts. Self-reflect. And, always consider your countertransference. Do you love to receive gifts? Will that draw you in to accepting one? Does it make you uncomfortable? Will that drive you to reject it? The answer?: Always know the meaning (as best you can) to the client if you accept or reject. Will accepting or rejecting do more harm than good? WHO is it serving? Let that be your guide! As with most interactions with clients, and interpretations to clients, know first its intent to the best of your ability. Want to learn more about this topic? Tune in to my podcast "What Would Dr. Meyers Do": Episode 9 "To Tell the Truth" (release date 12/20/22). |
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