Tuesday, December 3, 2013

Relationship Issues

Are you having difficulty in your relationship? Are you feeling dissatisfied with how things are going? Establishing and maintaining a healthy relationship in life is possible. The cornerstone of any relationship is healthy communication. Being able to relate to one another in an open and honest way requires self-awareness, trust, and a sense of safety. If these components are not present, it can often result in hurt and anger, resentment, arguments, broken trust, and, ultimately, a broken relationship. In therapy, you will identify your communication style, you will identify the emotional needs you are trying to communicate, you will find effective ways of communicating those needs, and you will learn healthy ways of getting those needs met.

An additional challenge to maintaining healthy relationships may be unresolved issues from the past. Often these issues are rooted in pain experienced from family-of-origin that have resulted in unhealthy coping mechanisms and maladaptive patterns of relating to others. People who grow up in dysfunctional families often discover they've subconsciously recreated the same dynamic in their present-day relationship. Such occurrences are complex and are influenced by multiple factors that require deeper work to tease apart the past from the present, heal past wounds, learn healthier coping mechanisms, and identify more adaptive ways of relating in your current relationship.

Another difficulty in maintaining a healthy relationship is when one or both partners struggle with mental health challenges. Navigating through these issues can be difficult and exhausting until you learn healthy and adaptive ways of coping and managing the complexities of such challenges. With professional help, you can restore balance and stability in your relationship.

If you or someone you know is struggling in a relationship, you don't have to navigate it alone. Reaching out for professional help is a positive first step. If you would like help, please call me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LMFT


What is 'trauma'? Trauma involves a single experience, or an enduring or repeating event or events, that completely overwhelm an individual's ability to cope or integrate the ideas and emotions involved with that experience. The sense of being overwhelmed can be delayed by weeks, years or even decades, as the person struggles to cope with the immediate circumstances. Psychological trauma can lead to serious long-term negative consequences.

Trauma can be caused by a wide variety of events, but there are a few common aspects. There is frequently a violation of the person's familiar ideas about the world, putting the person in a state of extreme confusion and insecurity. This is also seen when people depended on for survival violate or betray  or disillusion the person in some unforeseen way.

Psychological trauma may accompany physical trauma or exist independently of it. Typical causes and dangers of psychological trauma are sexual abuse, verbal abuse, physical abuse, emotional abuse, domestic violence, bullying, and being the victim of an alcoholic parent. Catastrophic events such as earthquakes, war or other mass violence can also cause psychological trauma.

Different people will react differently to similar events. One person may experience an event as traumatic while another person might not. In other words, not all people who experience a potentially traumatic event will actually become psychologically traumatized.

Symptoms of Trauma:
People who go through these types of extremely traumatic experiences often have certain symptoms. How severe these symptoms are depends on the person, the type of trauma involved, and the emotional support they receive from others. Reactions to and symptoms of trauma can be wide and varied, and differ in severity from person to person.

After a traumatic experience, a person may re-experience the trauma mentally and physically, hence avoiding trauma reminders, also called triggers, as this can be uncomfortable and even painful. They may turn to drugs or alcohol to try to escape the feelings. Re-experiencing symptoms are a sign that the body and mind are actively struggling to cope with the traumatic experience.

Triggers and cues act as reminders of the trauma, and can cause anxiety and other associated emotions. Often the person can be completely unaware of what these triggers are. In many cases, this may lead a person suffering from traumatic disorders to engage in disruptive or self-destructive coping mechanisms, often without being fully aware of the nature or cause of their own actions. Panic attacks are an example of a psychosomatic response to such emotional triggers.
Consequently, intense feelings of anger may frequently surface, sometimes in inappropriate or unexpected situations, as danger may always seem to be present, as much as it is actually present and experienced from past events. Upsetting memories such as images, thoughts, or flashbacks may haunt the person, and nightmares may be frequent.  Insomnia may occur as lurking fears and insecurity keep the person vigilant and on the lookout for danger, both day and night.

One of the most effective and research-based treatments for trauma is Eye Movement Desensitization and Reprocessing (EMDR). As a certified trauma professional, I use EMDR  to help clients safely discharge the psychological, emotional, and physical hyperarousal that accompanies trauma (please read my blog on EMDR). When a traumatic event occurs, the memory of it gets encoded in our brain with the intense emotions experienced at the time of the trauma. Later, when recalling the trauma, individuals feel the same intensity of these negative emotions present-day. EMDR allows the brain to reprocess these experiences in a way that alleviates the intense emotions while re-encoding the now benign memory.

If you or someone you know suffers from a traumatic experience or post-traumatic stress disorder, recovery is possible. Reaching out for professional help is a positive first step. If you would like help, please call me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LMFT


Do you struggle with excessive worry? Do you find it difficult to manage your anxiety? We all live with a certain amount of anxiety in our lives that is adaptive for our survival. Often this adaptive form of anxiety is out of our awareness because we're so used to operating with it. Sometimes, however, anxiety and worry can reach levels that are maladaptive and unhealthy, and that interfere with healthy functioning academically, professionally, and/or socially. Certain symptoms of excessive worry or anxiety include muscle tension, irritability, restlessness or feeling on edge, difficulty concentrating, being easily fatigued, and difficulty falling or staying asleep. If you experience some of these symptoms, you may have an issue with anxiety. Because these symptoms can be so uncomfortable, people often turn to unhealthy coping mechanisms, such as food, drugs or alcohol, to control the anxiety. Unfortunately, these are only temporary solutions. Therapy can provide the necessary skills and tools to help you better manage anxiety and restore long-lasting balance to your life. In therapy, we can also explore if there are underlying fears or life experiences that produce and maintain such a high level of anxiety. Addressing such fears and collaboratively developing ways to manage them can restore a sense of peace and tranquility to your life. If you or someone you know struggles with anxiety, reaching out for professional help is a positive first step. If you would like help, please call me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LMFT

Life Transitions

Are you making a life transition or contemplating one? Life transitions - getting married, deciding to have children, changing your career, getting a divorce, retirement - can be scary, anxiety-producing, and full of overwhelming decisions. One's ability to successfully navigate life transitions can be disrupted by fears, what-if thinking, and cognitive distortions that can keep one stuck in indecision. When working with individuals, couples and families who are facing such significant transitions, I will help you identify rational vs. irrational fears, alter what-if thinking, and work through any cognitive distortions in thinking so that you and your loved ones can successfully navigate the transition with balanced thinking and relative peace of mind. Life transitions can also signify the ending of a phase of life or relationship, and great care must be taken in the area of grief and loss. Therapy can be tremendously helpful at such times in processing through the loss, gently moving from a place of grief to a place of acceptance, being able to heal from any hurt and/or resentment, and, eventually, being able to transition into the next phase of life.

Life transitions can sometimes be exciting and positive, and sometimes painful and difficult. If you or someone you know is contemplating a life transition, or is feeling stuck in indecision, reaching out for help will be a positive first step.

Debbie Tessmer-Wagner, MA, LMFT

Post-Traumatic Stress

Have you witnessed or been exposed to actual or threatened death, serious injury, or sexual violence? Do you struggle with intrusive and involuntary distressing memories of the trauma? Do you avoid people, places or things in order to avoid reminders and feelings associated with the trauma? Do you have persistent negative beliefs about yourself as a result of the trauma? Do you feel detached from people? If you have these symptoms, you may have Post-Traumatic Stress Disorder (PTSD). PTSD can hinder one socially, occupationally, or academically, and can interfere with the ability to establish and maintain relationships. Having PTSD could result in poor concentration, sleep disturbance, hypervigilance, recklessness or self-destructive behaviors. If any of these sound familiar, professional help is necessary.

When trauma occurs, it gets stored in the central nervous system and it disrupts normal brain functioning. When such trauma results in PTSD, such symptoms will not resolve on their own, and will require professional help. Treatment is available and recovery is possible. One such treatment is eye-movement desensitization and reprocessing (EMDR). EMDR helps discharge the hyperarousal that's stored in the central nervous system, it helps reprocess memories that have been stored in a maladaptive way in the hippocampus so that the brain can re-store these memories in an adaptive way without the emotional charge connected to the memories. EMDR can also help to decrease and possibly eliminate flashbacks and nightmares, as well as decrease triggers to the flashbacks.

Recovery from trauma is possible, and stability and calm can be restored. If you or someone you know has PTSD, reaching out for professional help is a positive first step. If you would like to take that first step, please call me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LFMT


What is EMDR? EMDR stands for Eye-Movement Desensitization and Reprocessing. EMDR was discovered in 1987 by Dr. Francine Shapiro, and is the most researched of all treatment modalities. These studies have consistently found that EMDR effectively decrease/eliminate the symptoms of Post-Traumatic Stress Disorder (PTSD) for a majority of people with the diagnosis. Success has also been reported by clinicians in areas such as anxiety, phobias, OCD, addictions, eating disorders, panic attacks, performance anxiety, and sexual/physical abuse. As an EMDR-provider, I have seen countless lives transformed by this powerful psychotherapeutic approach.

How does it work? According to the EMDR Institute, no one knows how any psychotherapy works neurobiologically or in the brain. We do know that with extreme upset, normal brain functioning is disrupted in the areas of information processing, emotion regulation, memory encoding, and sensorium. EMDR seems to have a direct effect on these areas, and helps restore normal brain functioning.

How long does EMDR take? One or more sessions are required for me to understand the nature of the problem and to decide whether EMDR is an appropriate treatment. At that time, I will be able to discuss EMDR more fully and provide an opportunity to answer any questions about this treatment. A typical EMDR session lasts from 50- to 90-minutes. Tye type of problem, life circumstances and the amount of previous trauma will determine how many treatment sessions are necessary. EMDR can be used as a stand-alone treatment or in addition to standard "talk" therapy.

If you are interested in EMDR, please contact me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LMFT


Do you suffer from obsessional thinking? Do you find yourself involved in repetitive behaviors to relieve anxiety created by these obsessions or to prevent some dreaded event? If so, you may have OCD. Obsessive-Compulsive Disorder (OCD) is time-consuming (more than an hour per day), and can cause significant distress or impairment socially, occupationally, and in other important areas of functioning. OCD is an anxiety-based disorder, and in some cases, medication may be required to interrupt obsessionality and reduce anxiety. In addition to medication, treatment can include EMDR therapy (please read my blog on EMDR). If you or someone you know struggles with OCD, seeking professional help is a positive first step. If you would like to take that first step, please call me at 619-507-2936.

Debbie Tessmer-Wagner, MA, LMFT