Samaritan Insights

The current anxiety, fed here in Michigan by job loss, threat of more job loss, threat of loss of income, inability to get credit, fear of not being able to pay bills, buy food, heat my home for many of us keeps our anxiety level very high.  It is true that our mental and emotional and spiritual health and stability certainly is related to our personal sense of economic well being.  It is even further influenced by the economic climate in which we all live.  Being influenced by it does not necessarily mean we are overwhelmed by it.  Rather we can be challenged to find ways to take control of those parts of our lives we can make an impact on and shape what we can in our lives.

In seminary I did a field work experience in a church in a deeply poverty stricken neighborhood.  But the community of people in worship and in other church activities smiled, had an upbeat outlook and looked forward to getting up each day.  This made me think of a story a friend of mine recently shared with me.  A noted religious leader – a rabbi – and family therapist, Edwin Friedman – wrote a book called Friedman’s Fables.  One of his fables had to do with a string of dominos, precariously situated, particularly when one of them lost his balance began to fall, and in falling fell into another.  You can picture what began to happen; the entire string of dominoes, all vertically straight standing next to each other, began to fall also, doing so in sequence as the increased force of the dominoes, gained speed and more quickly and powerfully fell into the next domino.  Several dominoes, further down the line, wondered what they could do to prevent the fall; perhaps if many of them stood together they could withstand the pressure and stop the force of these dominoes.  They were nervous and worried about the impact that might occur.  One domino stepped out of the line.  The dominoes came crashing down and the entire line collapsed, except the one domino that stepped out of line and remained standing.  This one domino decided not to be influenced by the anxiety and fear of falling which pushed al the other dominos together and further influenced their fall.

We can be like this one domino, says Friedman; we can take charge of anxiety and use it to create at the minimum good coping skills, and at the best approaches to our situation which can provide us with a good enough outlook to help us move ahead positively.  What does this mean?  Look carefully at your own life situation: make wise decisions, surround yourself with people who support this idea and are trying to move ahead themselves.  But in the process care for yourself in some very significant ways.

Firstly, pay attention to feelings.  Be honest with yourself and loved ones about your anxiety or fear of loss of any or your entire current life situation.  When you welcome those feelings into your life and recognize them they will not have control and unduly drive your thoughts and actions.  Make honest steps to control your spending, save; cut back if you need to.  Keep fun in your life, whether through games with family, fun reading or other ways to help support a positive outlook.  If you are struggling to keep a job, see what you need to do to improve.  Maybe you need to start putting together a resume.  If you think you can’t find a job in this area look for a job.  If your family needs to split, with one spouse working at a distance, find others in this situation so you can receive support.  Pay attention to those spiritual truths from which you take comfort.  Look to your religious community for the caring and support it can provide.  Further, see where you may be able to reach out.  Many others have lived with less economic and personal wealth and possessions and may in more difficulty and rely on agencies for help.  They could use your help and you will benefit with the happiness of helping another.

If you need professional help look around.  Many mental health professionals, will try to work with you if you have no health insurance or less income, if only to help you sort out what is going on and identify things that if you can’t stay in therapy you might be able to do for yourself.  Finally, don’t withdraw.   The domino who stepped out of the crowd did so in order to reengage with the others in control of his anxiety.  Stay in contact with people to help stay in focus, fight against the competition that will arise from perceived scarcity and appreciate history as well.  There is a spirit, for many of us it lies in our faith, and for others they find something in the world around them, which allows them to move forward.  Find that spirit and stay with it.  And if you need mental, emotional, spiritual support , don’t withdraw; get help.  Even there you will not be alone.  Hang in!

The recent financial bailout bill passed by Congress has done a favor for the mental health care of Americans.  After 12 years Congress passed a bill that had long been advocated by Senator Pete Domenici of New Mexico and the late Senator Paul Wellstone of Minnesota.  This bill re casts the treatment of mental health care.

At its simplest this bill provides that as the New York Times reported fully one third of all Americans will receive better insurance coverage for mental health treatment; this law requires that there be equal coverage for both mental and physical illness.  For those who suffer from mental illness of many kinds and from many addiction disorders there will be more support for treatment for these conditions.

Up to now there were many employers as well as health plans that did not pay at the same rate for mental health care as they did for the treatment for conditions such as cancer, broken bones, heart problems, or other medical issues.  There were in place for many years higher co pays and steeper deductibles for mental health care as well as more strict limits on both inpatient and outpatient treatment for mental illness and addictions.

Increasingly it has been found that many mental illnesses can have a biological basis or be a contributing factor.  Mental Health is managed by companies with this as their specialty.  It is also true that employers report greater productivity in the work place for those who have been treated for mental health and addiction issues.  Parity has worked in many states and also in the federal employees health program; this is the program that covers members of Congress.  Perhaps, most importantly, as many members of the US armed forces have returned from Iraq and Afghanistan with serious mental problems more people are taking these issues more seriously; the stigma of having mental health problems is slowly eroding.

Part of the bill that was passed calls for better management of mental health care; at the same time treatment decisions are supposed to be able to be reviewed more easily and criteria for decisions can be appealed.  There will no longer be completely arbitrary decisions in these important healthcare decisions

The new law will be in place by 2010.  In the meantime this bills passage will hopefully continue the process of lessening the stigma of mental health treatment and even now encourage more people to take advantage of this important piece of heath care.

Dr. Paul Melrose is Executive Director of the Samaritan Counseling Center of SE Michigan.  He can be reached at www.paulmelrose.com or www.samaritancounselingmichigan.com., or through 248-474-4701.  The staff of the Center may be reached through www.samaritancounselingmichigan.com or 248-474-4701.

SCC is thrilled to announce that Dr. Peter Steinke will join us on  October 16.  You are invited to take advantage of this rare opportunity.

 Dr. Steinke’s powerful work, based on Systems Theory, has globally influenced leaders in church and business systems.

 Co-sponsored by Rochester College.

I have asked my colleague, Kathy Gleason, M.A., LMFT, to tell our readership a little bit about play therapy.  As you will see it is useful for children, to gain the necessary emotional or relational strength they often need but don’t know how to talk about to their parents.  So, Kathy, please explain what play therapy is all about. 

When many people hear the words “play therapy,” they envision taking their kids to play games with a therapist and aren’t too sure how that will help change their situation.  While parents likely believe it will be more fun for their children than standard talk therapy, many parents are wary of paying money “just to have their kids play.”  After all, they can do that at home, many parents will say.  What many people don’t realize is that they cannot play at home in the same manner as they can in a therapist’s office.  Most importantly, play is a much more natural mode of communication for children than talking, which is why it is the most fitting medium for working through emotional issues with children.

So, you may still be wondering exactly what play therapy is.  What does it look like in the room and specifically why does it work?  Play therapy is a unique growth experience in which a child develops an understanding of and respect for him or herself and others, develops appropriate coping skills, and learns how to set appropriate and healthy boundaries and to be accountable for his or her actions.  These goals probably sound a lot like those for adults seeking the more known talk therapy.  And as with adults, this process takes time.  Just as children don’t learn to swim or play baseball overnight, learning new life skills takes consistent practice over a period of time.  What’s different with play therapy is that instead of just talking about their struggles, children use some form of play to work through them.  This might include various types of games, pretend or dramatic play, sand tray use or different forms of artwork. 

Because play is understood to be children’s primary language, it is the

most natural way for them to work through difficult issues.   No child

wants to be or can be forced into thinking about something in a new way or into learning a new skill.  The play environment allows this process to occur at a pace that the child can monitor, giving him or her a needed sense of control when much in his or her life feels chaotic.

Further, the use of play and the resulting symbolism allows children to externalize their fears, sadness, anger, etc. and thereby work through difficult situations more safely.  Providing some symbolic distance through play allows scary or overwhelming emotions to surface in a safe manner.  This helps the child learn that he or she can in fact experience those feelings as well as experience being in true relationship with themselves and others without being “taken over” by strong emotions.  For these reasons, children’s play is not interpreted to them.  Further, only consistent themes are communicated to parents so they come to understand what’s happening with their child without compromising the safety and confidentiality of the therapeutic environment.

For any of the aforementioned to really occur in session, the child needs to feel connected to and trust his or her therapist.  For this reason, the therapeutic relationship is the basis and foundation of play therapy. Children are offered a safe and nurturing space in which they are free to express whatever feelings or thoughts they might have.  This occurs within boundaries that support the children’s well-being and without children needing to worry about whether they might offend or scare parents, other relatives or friends by this expression of emotion.

So, hopefully this sheds some light on the topic of play therapy.  It’s most commonly used with children ages 3-12 since children of these ages express themselves and their experiences of their world by using play more than conversation.  However, it can also be used very effectively with adolescents and adults, especially those who are creative or more action-oriented than verbal.  With these clients, focus tends to shift away from dramatic play and more toward using games, sand tray or various forms of artwork.

Dr. Paul J. Melrose, is Executive Director of the Samaritan Counseling Center of SE Michigan, where Katherine Gleason, M.A., LMFT, is on staff as a marriage, family and play therapist.  Both Dr. Melrose and Ms. Gleason can be reached at www.samaritancounselingmichigan.com or through 248-474-4701.