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Category: clincial social work

Posted on July 27, 2018 by Tanya Ruckstuhl LICSW · 1 Comment

The Genius of Anger


By Tanya Ruckstuhl LICSW

When I was a kid I loved magnifying glasses. They seemed like a magical portal to a secret world: like Alice in Wonderland drinking the elixir which made her shrink and grow, magnifying glasses changed everything. Ants went from simple black specks to armored warriors.  Grass became a complex, mysterious world of sharp edges and shadows. Sunlight went from general brightness to burning laser. I yearned to someday own an old fashioned, wooden handled magnifying glass.

I’ve come to think of anger as a type of magnifying glass. If that sounds random (and it probably does) bear with me. Anger offers—demands–we pay attention to our core values. We get angry when we believe that something or someone is threatening our core values. Anger magnifies our emotion to get us to pay attention to and protect our values.

Now there are folks out there who get mad at everything and everyone: the weatherman for predicting rain, the government for collecting taxes, the neighbor for taking too long to pull in their trashcans. To these folks I’d say get therapy (but not me, I don’t enjoy your kind). They also are responding to a perceived threat to their value system but like a rescue dog who bites when frightened, they lack the emotional wellbeing to tell when they should and should not feel safe.

I’m addressing this blog to the vast majority of us who are not constantly (and tediously!) angry, but who struggle with recognizing anger as a useful tool in navigating relationships.  Typically, we feel angry when we feel duped, taken advantage of, disrespected, or mistreated in some way. Likewise, we feel angry when these things happen to someone we care about. Anger holds in its flaming heart the certain knowledge that we are WORTH something, that we are precious and worth protecting. Healthy anger is the safeguard of self-esteem.

Seen through this lens, anger is a useful reaction to a threat to the safety of connection between people. Anger is fuel propelling us with courage to stand up for ourselves, to set boundaries, to name the thing that we cannot and should not ignore. Anger is a wicked cool sword that cuts through the bullshit of pandering and placating to show us our own raw truths.

Skillful communication of anger protects relationships by protecting boundaries. If I don’t allow myself to be mistreated, I can stay safely connected. If I let myself be mistreated I either have to give up my safety or I have to sever the relationship. Anger is the opposite of apathy, and apathy is the opposite of love. Anger and love are inextricably wound into all of the relationships we treasure because every deep, long term connection involves imperfect people. All of us make mistakes, have blind spots and character flaws, lack complete understanding and inevitably fail one another at different times.

So if you want love in your life, be prepared to sometimes be pissed off. Be prepared to piss off the ones you love. Allow the experience to slow you down, just like a magnifying glass in the hands of a curious kid. Anger springs from your deepest values and offers lessons about areas of yourself that you need to refine: your expectations, your boundaries, your capacity to hang in there and stay respectful. It teaches you how to meet the world without being a doormat. Anger gives insight into your own code of fairness. When you or the ones you love are angry, don’t run away, but rather magnify the moment. Be prepared to listen and to speak your truth.

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Photo by Pixabay on Pexels.com
Posted on April 19, 2018 by Tanya Ruckstuhl LICSW · 4 Comments

My Needs Are Too Much


by Tanya Ruckstuhl LICSW

I think most of us have this secret fear lurking in our core: that our needs are too much for the people around us. That our unvarnished self is a black hole of emptiness and nothing can fill us up. We hide our fear of emptiness/neediness in a variety of ways: by developing hyper-independence, or engaging in excessive care-taking of others, or by dissociating with food/alcohol/television/Facebook/tasks.

To understand where this near-universal fear comes from it helps to know two things:

One, the brain is a meaning-maker. It makes meaning by recognizing patterns and generalizing those patterns out to arrive at conclusions to help us navigate life. One major pattern we learn is simple cause and effect tracking: If I do X, Y will happen. This cause and effect pattern-recognition is half the battle of functioning in a given environment.  For example: If Harry consistently gets to work late (X), he will lose his job (Y). If I rinse my dishes before putting them in the sink (X), it’s easier to clean them (Y).

Two, just because a pattern is true at one point in time doesn’t make it true in present time. Therein lies 98% of the work of therapy.

If you were born into a compromised environment such as a family system where addiction or mental illness or poverty or disability affected the adult’s capacity to care for you, than your needs were too much.  At that time, and in that family system of diminished capacity, a growing child’s constant need for food, love, shelter, attention, explanation, comfort, sanitation, structure, stimulation, and consideration is too much for the parent(s) to meet. The parent, ashamed at their failure to meet the demands of this needy being grows angry at the child for putting them in this position and blames the child. The adults convert their own failure into blame and send the message to the child: Your needs are too much. The child’s meaning making looks like this: If I have needs (x), I make my mother angry (Y). The child then starts to hide his needs, first from his mother and ultimately from himself.

Of course we all have needs, and our adult selves need the very same things that our child selves needed. Some of those needs we can now meet directly (food, shelter, sanitation, structure) while others still must be met via relationship (love, attention, comfort, consideration).

If we are still in that child habit of hiding our needs from ourselves, we don’t know it’s okay to have needs and we don’t know what we really want. We may think we want a Rolex watch or watch ten hours of Netflix.

Here’s a handy way of telling if we are meeting a need or blotting ourselves out: when we meet a need, it goes away. We return to a state of calm. When we are blotting ourselves out, the need gets quiet for a short period of time and then resumes its shrill driving force.  When blotting out, we vacillate between distracted and restless.  When meeting a need, we feel relief and peace.

My wish for you, dear reader, is that you take the time to know your needs and value yourself enough to meet them.

Posted on January 30, 2018January 30, 2018 by Tanya Ruckstuhl LICSW · 2 Comments

SAD to Glad: Surviving Seasonal Affective Disorder


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Tanya Ruckstuhl LICSW

In the gloom of a Seattle January, it’s vital to keep our inner sun ignited. Seasonal Affective Disorder, with its attendant low levels of energy and flattening of enthusiasm, affects many to some degree.

Do you find yourself hitting the snooze button and rolling over? Do you look out the window and scowl?

People in Seattle, we need a whole battalion plan of fun to battle the winter meh’s. What is fun? I’m talking about tiny bits of delight, not the roller coaster of joy. Fun is subjective, subtle and easily attainable.

Visualize Picturing the golden sun in a clear blue sky is uplifting. Imagine a garden in the late spring; recall the delightful riot of blooming peonies and lily-scented hyacinths. Visualization is not just for woo-woos.  I know a clinical social worker working with professional athletes in Chicago. He has injured players picture themselves practicing and playing the game while in their hospital beds. Just by visualizing, these players are able to retain muscle tone and skill level. Think of visualization as the opposite of catastrophic thinking. Instead of using your imagination to freak yourself out, visualization is using your imagination to improve your reality. Conscious use of visualization is effective, free and has no unwanted side effects!

Progress The therapeutic value of a feeling of progress cannot be overstated. Sure we are all aging and the mortality rate is a solid hundred percent, but here you are, alive and able, so do something to make your life even a tiny bit better/prettier/healthier/more interesting. Each winter I repaint bits of the ceiling and walls that are marred. This weekend my boyfriend and I spent half a day making a week’s worth of healthy breakfasts and lunches from scratch to save time and money during the work week. Learning anything is a slam dunk for creating a sense of progress. With the internet, learning has never been so abundantly available. As an example, the DuoLingo app offers free daily language lessons that take just five minutes and allow you to choose from all the major world languages.  I’m currently working on my Spanish and will learn French next. And you don’t need Wi-Fi to learn: Find someone who knows something you don’t and ask them questions.

Travel Depending on destination and level of luxury, travel costs vary from modest to major.  If you can afford it, go to the sun midwinter for a blue sky break. Stay somewhere you can walk outside every day for an hour and get your vitamin D recharged. If that’s too much for your budget, take a weekend getaway with your partner or friends and go somewhere to connect with loved ones and shake up the routine. If you don’t want to commit to a whole weekend, get outside of the city and go east to the mountains for a day of snowshoeing or sledding or skiing.  Take in the beauty of snow blanketing the landscape and feel the refreshing chill of high altitude winter air.

Experience Novelty Anything new and different wakes your brain up and makes you feel alive, which happens to be exactly the opposite of how Seasonal Affective Disorder makes you feel. Think of novelty as the umami flavoring that makes life delicious. Again, we’re talking little bits of newness here, not enter the witness protection program and move across the country. Discover a new show on Netflix or Amazon that makes you laugh, cry or think. Throw a party for a truly ridiculous reason (The Winter Olympics watch party! National Pie Day!). Spend an evening listening to a new album, or internet-stalk your favorite musician and listen to their side bands. Make a paper-mache mask. Take a class that you would have loved as a child.  I’ve taken classes on hip hop dancing, ceramics building, jewelry-making, mosaics, writing, interior decorating, cooking, and painting. Remember adults take recreational classes for fun, not to create an amazingly impressive product, so dump your perfectionism before you go.

Get Physical Attend to the mammalian needs of your body. The basic three are: sleep, exercise and food. It’s easy to have not enough of the first two and then try to make up for feeling lousy with way too much of the third. Make a plan to get to sleep earlier. Block out time on your schedule to get regular, healthy movement. Do a little prep each weekend by making or buying readymade meals for the work week so you can have food that sustains you without inflating you. Drink more water and less everything else liquid. Have sex. Really! Schedule it if need be. Sexual activity increases both self esteem and dopamine.

Finally, consider this general philosophy: Nibble on as many different sources of self care as you can dream up. Consider emotional nutrition akin to dietary needs for variety and enjoyment.

Posted on October 19, 2017 by Tanya Ruckstuhl LICSW

On Sparkly Skull Chandeliers and the Subjective Nature of Reality


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Tanya Ruckstuhl LICSW, MSW

One of the best things about being a therapist is also one of the best things about being a mom.  This year my teenagers were surprisingly enthusiastic about decorating for Halloween. After several years of their steadily diminishing interest in holiday decor, I had given away the moaning zombie head, the black foam tombstones, the light up snowman, the plywood Santa, and pared down our vast and tacky collection to our favorite things.

But I was wrong because October first, my sons were completely excited about decorating for Halloween.  We set about putting up the giant bat, the blinking bat lights, the sparkly spider, the witch, the Frankenstein treat holder, the rubber rats.  The boys put things in weird places: The “eye of newt potion” bottle was stuck in the door of the fridge, with the condiments. One of them put a giant rubber rat in the linen closet, just far back enough in the shadows to actually freak me out.

This is one thing I love about both parenting and therapy. It’s the delightful surprise of how people think differently. I think of decorations like art. I put them out where they are easy to see and enjoy. Meanwhile, the boys think of them as thematic: eye of newt would be a witch’s condiment, so it goes in the fridge with condiments.  Seeing a rat in a closet is scary, and Halloween is a holiday to scare people.

Years ago, when running a social skills group, participants were developing ground rules for group safety and cohesion. One of the women requested no swear words. She grew up in a religious household and felt uncomfortable with swearing. It was a revelation to me that someone might feel unsafe from salty language. As a result, I had to think about conveying enthusiasm and intensity and spontaneity without swearing which made me a more palatable public speaker.

These separations between how we interpret reality and how others do the same can be incredibly fertile growth areas. Which is therapist-code for “or it can really freakin’ suck.” (See how I didn’t swear there?) As we move into the holiday season my wish for you, dear reader is that you can notice and communicate those differences with compassion both for yourself (we are all works in progress) and others (because ditto).

Posted on August 19, 2017 by Tanya Ruckstuhl LICSW · 2 Comments

Shine On You (actually quite) Crazy Diamond


By Tanya Ruckstuhl LICSW

I’ve been thinking and talking with clients this week about connection and the importance of developing a tribe of people to get our needs met. For heterosexual men in particular, this is a huge challenge in our society and the lack of it impairs both their own quality of life and the lives of their partners. It’s a challenge because men are raised to compete with each other and to rank themselves hierarchically in regards to desirable and undesirable traits: intelligence, athleticism, attractiveness, charisma, awkwardness, clumsiness, etc…

When people are in competition mode the primary directive is to win and not be weak. This doesn’t lend itself to vulnerable disclosures of self doubt and the reassurance that everyone feels—and is—lacking in some important areas at some times.

Without certain knowledge that the pain of personal weakness is universal, that this very experience leads back to our humanity and (hopefully) the chance to be compassionate, men are cut off from connecting these dots, resulting in their being just a wee bit socially retarded less conscious when compared to women.

Where does male vulnerability go?  It is buried under shame, obscured by addiction, hidden behind unrealistic expectations to find a partner who makes them feel powerful and right all the time. It comes out as anger, blame, inability to apologize, conflict avoidance, contemptuous communication during conflict, and passive aggressive acts towards their partners.

It’s funny because where men are in terms of relationship naiveté is roughly equal to where women are in terms of employment naiveté: because we ladies are more recent arrivals in the world of careers, many women suffer from paralyzing and unrealistic expectation that they can and should find work that is important, well paid, emotionally rewarding, free-time respecting, and that anything less than luminous employment perfection represents a failure on their part to choose well.

I’m suggesting women should learn from men in terms of careers, and men should learn from women in terms of connections. Women have multiple friends and so can choose who to do what with. We don’t expect our intellectual friend to help us hang wall paper.  We don’t expect our athlete friend to join us on a ten day Vipassana meditation retreat. And we don’t expect our men to fit our every facet of interest because that would be ridiculous. Meanwhile, men take jobs expecting to enjoy some aspects of their work and hate others, to get paid and go home and have hobbies in order to have fun.

You are a diamond—multifaceted and incalculably precious. Don’t expect any one person or job to shine light into the whole of you.

 

Posted on March 23, 2017March 23, 2017 by Tanya Ruckstuhl LICSW

Spooked to Serene


 

By Tanya Ruckstuhl LICSWflower of life

I’ve been reading a good deal about the direction our current administration appears to be headed and major concerns folks have regarding its anticipated impact on the environment, immigrants, women, families in poverty, and people of color…basically every vulnerable human and carbon on the planet. The response to all of this unknown worry varies from productive to preposterous.  People have mentioned stockpiling gasoline and bullets ala The Walking Dead.

It’s easy to get caught up in dire predictions. The generalized and pervasive feelings of fear, powerlessness and anger so many of us feel create a breathless anticipation of disaster. Many are now living in a shared cultural trauma, similar to the aftermath of the 9-11 attacks when people around the country were terrified that they would be the next target of terrorist attacks. Friends of mine who work and hang out with immigrants and refugees report that men who used to play soccer are no longer showing up at the park, that families who used to use the library are too frightened to check out books. There is cause for concern. Agreements to slow the pace of environmental destruction are being overturned. Meals on Wheels, a program which allows low income seniors to age in place is at risk of losing all federal funding. PBS, long considered free preschool for the public, is also on the chopping block. (Check out this cheeky call for funding: http://whatstrending.com/video/23876-elmo-gets-fired)

It’s an uncertain time. And yet, we become less effective as humans: less empathic, less articulate, less focused when we fall into fear and hysteria. The human race is a story of struggle and survival. We impressive humans have harnessed fire, created agricultural surplus, made music and art, discovered penicillin, built machines that fly and drive, invented solar power grids and the internet. We are AMAZING creatures. And by many measures—current political administration aside—things are getting easier: we mostly no longer starve to death in developed countries. The national homicide rate has fallen 51% since 1991, per the Bookings Institute. According to the Guttmacher institute, 90% of sexually active women in the United States at risk of unintended pregnancy are using birth control. The Journal of Blacks in Higher Education reports that nearly 4.6 million African Americans now hold college degrees, as compared with just ten thousand in the 1920’s.

Staying calm and reminding our freaked out brains that the world is not about to come to a crashing halt allows us to maintain perspective and make contingency and response plans. And that makes us more effective humans. There is cause for celebration and unity. Even across the political/economic/gender/educational divide we have more in common than separate: we are all trying to make sense of the world around us—even if we come to different conclusions about what it all means and how to respond, we all spring from families who pass along good and bad ideas in the process of raising us, we all love our children and want them to grow up healthy, smart and capable. We all thrill to the sight of spring flowers bursting out of the ground. Almost everyone wants to do the right thing, to be proud of ourselves. None of us have all the answers and none of us are done growing into our best selves.

Working towards change while remaining grounded in connection allows us to better deal with this world we live in. It allows us to be at peace with (or at least grudging acceptance of) the time/energy/money we have available to contribute. Maintaining our sense of calm and connectedness makes better individuals while we try to make the world better for all.

Posted on January 31, 2017 by Tanya Ruckstuhl LICSW · 1 Comment

I’m a Groupie


Tanya Ruckstuhl LICSW

I am a total groupie.  Not for musicians though—fame oriented people bore me. No I am a groupie for groups.  I am in a women’s group, a writing group, a meditation group, two professional consultation groups, and a book group.  This (among perhaps a million other things) makes me a bit of a weirdo, but as a result I have a deep appreciation for and understanding of group dynamics.

This weekend was group-a-rific. My writing group and my meditation group met, and in between I attended a movement workshop specifically for therapists. The workshop was a one-time group filled mostly with lovely, open-hearted women and men. There was just one woman there with a sour look on her face who I immediately felt myself recoil from. I work hard not to indulge the desire to judge people on first impressions (what if she had had a stroke or a facial tic or her dog just died or she was just having a really tough time?) so I made a point of smiling at her and introducing myself.  She barely grunted back to me.  My feelings were hurt. I reminded myself that not everyone needs to be friendly to be interesting or contribute to the world.  I took a seat far across the room from her.

At the end of the workshop everyone went around the circle, checking in. One man shared that during his meditation time he thought about the fact that Donald Trump is a human being.  This was a welcome reminder in a room full of liberals who were all freaking out about the implications of this particular president.  We smiled and nodded, except for the sour-faced woman who barked out, “Can we not talk about politics?” People looked away and fell silent. One person quietly said, “it’s not exactly political—“ and the woman loudly cut her off, “Well it’s hurting ME.” Silence reigned. The group disbanded. The expansive feelings of gratitude for the support we had just received turned into something more complicated, more deflated.

To be a good group member you have to have two opposite and equal orientations: one is for the good of the group and the other is towards meeting your own needs. People who only orient towards themselves come across as rude and selfish. People who only orient towards the group won’t enjoy them because group participation will be work without reward.

I’m starting up an Anxiety support group in March. It will meet at noon on the first and third Friday of the month and we will explore this magical mix of meeting our own needs while also serving the well being of the group.  We will create a safe space to talk about anxiety and ways to comfort and manage it. We will cheer each other on and get to know one another.  We will learn empirically validated techniques and exercises to decrease baseline anxiety and to deal with specific anxiety triggers. If you are interested please call me for an intake appointment at 206 375-7690.

Posted on October 18, 2016 by Tanya Ruckstuhl LICSW · 1 Comment

Seasonal Sanity


Tanya Ruckstuhl LICSW

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Goodbye Sunglasses!

The trees outside my office are turning to flame and every day I’m scooping tracked-in maple leaves off the kitchen and living room floors (dog doors are a wonderful opportunity for clean freaks to practice surrender).  It’s autumn, a time for homemade soup and hot baths and hanging twinkle lights against the darkness.  After nineteen years in Seattle, I’m finally getting the hang of coping with the long, wet winters here.  Here are my top seven tips for maintaining mental health over the fall and winter:

First of all, you gotta do something seasonal. Tacky Halloween décor is awesome. Ditto going to haunted houses or whatever autumnal offerings float your boat. Not into the whole Halloween thing? Throw a party or go see some live theatre.

Second, nourish yourself with food that is warm, creamy, salty and substantial. Our lizard brain needs reassurance that we will survive the coming winter and nothing says “I am safe from starvation” to the lizard brain like salted fat.

Third get swept up in a story. When the days are dark and cold it is delightful to travel in our imagination. This is a great time to read novels, watch a show or a movie.

Forth, have at least one warm and beautiful jacket and a seriously comfy pair of house slippers. Spend some money so that you have a delicious tactile experience every day.

Fifth, remember that creativity ignites your inner sunlight. Take a workshop or a class to learn how to make something, or pull out creative supplies you already have and spend a weekend afternoon playing with them.

Six: Do something for someone else. Look around you. There are needs everywhere and if you have a time or talent, share. Look for a non-profit addressing a problem you care about and volunteer. This is the fastest acting, side-effect-free antidepressant not on the market. Sorry Pfizer!

Seven: Exercise. It makes endorphins and keeps us healthy. We Americans are a fat lot because we love to eat and hate to move. This is especially problematic when the outside world is about as inviting as a bed of nails. If you don’t already have an exercise routine, make a sustainable, incremental plan to increase your movement. If you already do, switch things up by trying out a new class or dance or type of movement.

Lifestyle adjustments are not always enough. If you are doing all you can to take care of yourself and still suffering from depression and/or anxiety, get professional help. But here’s the other thing you should know: professional help will not be enough without positive lifestyle choices.  For instance, psychotropic medications (antidepressants for example) work as standalone treatments only 20% of the time.

I wish you all a happy fall!

Posted on August 29, 2016 by Tanya Ruckstuhl LICSW · 1 Comment

Should I Stay or Should I Go Now?


By Tanya Ruckstuhl LICSW

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Your Relationship Shouldn’t Feel Like a Wrestling Match

Certain life skills are baffling to many people.  How to keep a tidy home or cook a reasonable meatloaf or pick a flattering dress are all skills that come with practice and by practice I mean screwing up.  This is all well and good and in some ways the only justice in aging: we’re not as hot as we used to be, but we’re a heck of a lot more sensible and competent.  Twenty-somethings dinner parties suck, while fifty-somethings dinner parties are delicious AND interesting.

There are certain areas where screwing up costs a lot more emotional coin than a lousy diner or an ugly dress.  I’m talking about intimate relationships and the discernment it takes to decide whether to stay and invest or sever and heal. Most of us were never taught how to assess the quality of our love relationships and that makes it hard to decide when things are bad enough to leave.

Without a functional paradigm to make this assessment, we may find ourselves bouncing between distress and hope when our relationship is troubled, telling ourselves “maybe it will work” and “I hope it will work” and “I just don’t want to start all over again.”  Many good-hearted people with a lot to offer (as in folks who can find love again) will stay in preoccupying and damaging connections due to two factors of human nature: our universal reluctance to change and our universal fear of being alone.

Here’s how emotional attachments are supposed to work: we meet someone we feel a natural affinity for. They have enough qualities in common with us that we easily connect to them, and enough qualities different from us that they are interesting. We spend time getting to know them before becoming physically involved.  Why delay jumping into bed?  Not because our grandmothers would disapprove, but because good sex is so captivating—our very cellular biology is interested in the perpetuation of the species and doesn’t give a hoot about compatibility– that if we are having it we won’t pay attention to major incompatibility markers.

A healthy connection progresses over time from purely delightful to durable and real.  Along the way it loses some of its magic sparkle (wah!) but develops into a deeper and richer thing of mutual understanding and enjoyment, comfort, a shared history and vision for the future, and a sense of safety. There is conflict (always!) and it is managed in a way that allows both parties to tell their truth, to listen and learn from one another, and maintain their own dignity.  The most vital overriding emotion of a good relationship is mutual gratitude. Gratitude happens naturally when both parties value the connection, feel seen and loved by one another and know that the other doesn’t have to, but chooses to be there.

The opposite of gratitude is contempt. Contempt is the active expression of disrespect and stems from feelings of superiority and judgment (secretly the contemptuous party actually feels bad about him or herself but that’s for their therapist to deal with and not something their romantic partner can repair).

Contempt is a subtle but poisonous emotion.  It manifests in scornful communication, eye rolling, rejecting or disregarding reasonable requests, avoiding contact, saying cruel things, private rage and public politeness, and withholding information about why one is upset.  No one is contemptuous all the time and this makes things even more confusing.  A contemptuous partner is a Jekyll and Hyde routine and you never know who is going to show up.

If you are in a relationship with someone who treats you contemptuously, first check yourself: are you showing up respectfully?  Are you making requests and not demands? Contempt can be a (lousy) defensive strategy by people feeling attacked and judged. If you are communicating with respect and being met with contempt, ask your partner to get help.  If they are unwilling, ask yourself if you can tolerate living the rest of your life giving in to a bully while biting your tongue or enduring explosive conflict to stand up for yourself.

Intimate relationships require daily collaboration and decision making between two different people with separate agendas and experiences, differing skills and deficits, therefore relationships will always have problems to solve.  Conflicts arise from two people rubbing together through time and space and sometimes rubbing each other the wrong way.

If those inevitable conflicts can’t be discussed and solved in a manner that honors both parties’ legitimate human needs for dignity, that’s a good reason to go.

Posted on July 13, 2016July 13, 2016 by Tanya Ruckstuhl LICSW · 1 Comment

Repairing Trust: Why and How


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by Tanya Ruckstuhl LICSW

At birth our developmental “job” is to receive love and care. This systematically builds our capacity to trust on three levels:  first with our caretaker (the immediate, intimate relationship), then our environment (the larger world), and finally ourselves.  With this trust-skin in place we can show up in the world with discernment of who to trust and who to avoid, and confidence that we are worthy of receiving love.  Just like a good immune system, a healthy trust-skin allows us to protect ourselves when our emotional or physical safety is jeopardized.

A former client came in recently to show me her beautiful new baby. It was awesome to see the way she attended to her child, anticipating her needs, offering help but not interfering with the baby’s exploration.  Her baby was calm, curious and joyful. This child was getting her needs met and felt pure trust in her mother as well as the world around her.

Of course none of us received or can possibly provide perfect care all the time, so we all bear some wounds in our trust-skin. The size of our wounds varies due to family circumstances as well as individual temperament and mitigating influences. Children born to parents with addiction, depression, anxiety, abuse, poverty, and discrimination have caretakers only partially available. Imagine watching a toddler only half the time.

A child who grows up without a trustworthy caretaker and safe environment becomes an adult who cannot trust themselves. Mistrust of others is a healthy adaptation in a physically or emotionally dangerous environment.  But without repair, adaptation becomes mutation. The neglected or abused child might become the adult who shields themselves in isolation and cynicism in order to avoid the pain of relationship disappointments. They may become rigid and judgmental, striving to control people and situations around them so that they feel safe.  They may lack interpersonal boundaries and accept or perpetrate abuse.  They may compulsively people-please, taking care of the needs of everyone within a mile radius in order to feel likable.

These painful adaptations do not have to be life sentences. Our trust-skin is formed, damaged and repaired through the magic of relationships. Healing damaged trust happens naturally in stable and long term relationships where we feel safe, deeply known, and valued.  The best form of this is a healthy love relationship with a partner who can express their own as well as accept their beloved’s full range emotions (love/anger/sorrow/fear/joy/curiosity/etc.) without alarm or rejection.  Honestly, this is rarely seen. Typically women are emotional virtuosos able to indentify, describe and express emotions while men treat emotions like Shaggy and Scooby Do entering a dark cave: with mortal terror.  But men need repair of their trust-skin as much as, if not more than women.

And these generalities are not limited to heterosexual couples.  Gay and lesbian couples have the exact same patterns, with one party typically being more emotionally expressive and relationally oriented and the other being more emotion-avoidant.

Providing the safety to heal our trust-skin requires both members to value their connection above the familiarity of emotional withdrawal, above being better-than and above the moment’s convenience.

How do we value connection over the moment’s convenience? It means you stop playing on your computer or reading your book or watching your show when someone you love is talking to you. It means eye contact, listening, asking clarifying questions, responding thoughtfully and affirming your partner/child/best friend.  It means asking for time and space to meet your own needs so that you do not show up for your loved one filled with resentment.

Therapy is a venue for this type of repair as well. In therapy you are attended to in a safe, stable and predictable fashion by a person whose agenda is your wellbeing.  There are no distractions and the time is limited so the experience of being solely focused on is not too overwhelming.

People in therapy are then able to bring the experience of finally feeling valued into their larger life as a functional set of expectations for how they treat and are treated by those around them.

It’s never too late. We are never too old. And we are–every single of us–worth the work it takes to heal.

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