Suicide Crisis – An Update

Since the early 1990’s suicide rates in the US have steadily increased. This increase has created a suicide crisis. Rates in 2022 were 3% higher than in 2021, and 2023 data looks to add to that increase. This is a crisis that receives little attention. As a mental health provider, I want to inform my networks about the issues around suicide in the hopes that we, as a larger community, can prevent needless deaths. Below is a graph of the suicide rate per 100,000 population from 2001 – 2021.

Suicide rate per 100,000 population in the US

This highest year was 2018 with a rate of 14.79 per 100,000 population. There was a small decline in 2019 and 2020 during the pandemic. But rates rose again in 2022, and 2023 seem to be on par with 2021, quite possibly trending higher. Currently, unofficial data for 2022 shows a 2.79% increase over 2021, making it the highest year yet (possibly 14.93 per 1000,000 population). 2023 data is incomplete and hard to predict since some months have not been reported.

A first question many ask, is what might be contributing to increase rates of suicide. A Colorado University study has analyzed that data and found two recent developments that are likely contributing to the suicide increase.

  1. Increased access to powerful opioids has contributed to a rise of suicide among women.
  2. The decrease in the federal safety net has led to increased financial stress for all adults.

Easy access to a particular lethal method can make suicide much easier to accomplish. Malcolm Gladwell in his book Talking to Strangers illustrated how suicide rates plummetted in the United Kingdom in the 1960s as the country switched from “town gas” to natural gas. Town Gas had a much higher concentration of carbon monoxide and lethal limits were reached much more quickly than natural gas. This information has bearing on our conversations about guns, and now the opioid crisis. Easy access to lethal methods is a danger. It is important to consider the methods available to those suffering from suicidal ideation. As a therapist, I often ask about weapons in the home, and now medications in the home. And as a larger community, we need to be talking about gun restrictions because these regulations will save lives by limiting access.

We know that men are more often more likely to kill themselves with an attempt because they often choose more violent methods such as guns or hanging. Suicide attempts by women are on the rise, and especially by younger generations. Though women choose less violent methods, the very powerful effects of medication can have deadly results, thus raising their overall rate of actual suicides. Opioids were involved in more than 80,000 overdose deaths in 2021, which was 10 times the number of opioid overdose deaths in 1999. Our communal value of human life should lead us to support all efforts to eradicate the flow of deadly opioids into our communities.

Stress, and specifically economic stress, can be a major contributor to suicide. Currently, the high rates of inflation are impacting many lower-income families in a disproportionately negative way. When we look at state-by-state rates of suicide, the highest rates seem to occur in rural farming communities. The economic uncertainties of an agricultural world, access to means (usually guns), and social isolation are all contributors to higher rates. Not only can we be only the look out for our “neighbor” and their economic stresses, but we can advocate or vote for policies that lead to safety net supports being implemented to reduce economic losses for the most vulnerable in our communities.

There is HOPE, because we can all play a part in the prevention of suicide. Relationships are the key to suicide prevention. Let me give you a few ideas for what you can do.

  1. Show you care about others. Check in on your neighbors if you have not seen them for some time. Inquire about the grief’s and even economic challenges you know family and friends might be experiencing. Ask them how they are doing and be a bit persistent if they just blow off the question with a dismissive, “Fine.” Take care of those closest to you first.
  2. Don’t be afraid to ask the question, “Have your thought about dying, killing yourself?”, “Are you wishing you were not here or were not alive right now?”
    You might be a bit afraid to ask, but research is really clear that our best prevention is to ask this questions. If your gut tells you that you need to ask the question, then don’t be afraid. It often opens a dialogue and can help facilitate a plan to save a life.
  3. Develop a safety plan. Don’t leave anyone that is actively suicidal alone. Suicidal ideation does not necessarily mean there needs to be a rush to a psychiatric hospital or the ER. Call the National Suicide Hotline, which is available 24:7 with professionals who can help with a plan. You can contact the National Suicide Hotline by calling or texting 988. It is that simple. Maybe they have a therapist they can contact who can help them develop a safety plan. Telehealth has made mental health far more accessible.
  4. The QPR Institute has developed a well-researched intervention method for helping prevent suicide. It is a three-step model: Question—Persuade—Refer. Just like CPR can save a life, this model can prevent suicide. They offer numerous training opportunities to learn the model, including online and in-person training. If you are a decision-maker for your company or church, why don’t you pursue bringing a trainer into your organization to teach these prevention tools to everyone?
988 - Suicide Hotline - Call or Text

30 Day Gratitude Journal

Gratitude is an essential ingredient for personal mental health and relational stability. This month, Dr. DeYoung wants to offer you a 30-day prompt for gratitude in your marriage. Each prompt is meant to generate a thought or feeling of gratitude. Don’t be too alarmed by the word “Journal” because the writing expectations are minimal. Each day of this activity, you would not be required to write more than one or two sentences. In fact, each prompt is written in a way that you will just need to complete the thought. If you do this journal as a couple, you can discuss them at the end of each week or the end of the month. Directly below you can click to downlad a PDF of the Gratitude Journal and print for easy access.


Day One

There are many qualities that I love or appreciate about my partner. When I think of one of those qualities I am most grateful for it is…

Day Two

There are many qualities that I love or appreciate about my partner. If I were to list a second quality that I am thankful for, it is…

Day Three

Reflecting on the last month, think of a time your partner gave you emotional support. I am grateful for my partner’s emotional support when I was dealing with…

Day Four

You have probably had some trips or vacations with your partner. One memory from our trips together that I am grateful for is…

Day Five

Change happens in marriages. The change can be good. One change that your partner has made is…

Day Six

Change happens in marriages. The change can be good. Another change that your partner has made is…

Day Seven

Conflict happens in marriages. Can you name a quality your partner has that helps you resolve conflicts? The quality you are thankful for is…

Day Eight

Conflict happens in marriages. Can you think of a recent conflict? What is one thing your partner did in that conflict that was helpful…?

Day Nine

Name one thing that you most admire about your partner…

Day Ten

Name the one favorite way your partner expresses love for you…

Day Eleven

Write down one of your dreams that you are most grateful to share with your partner…

Day Twelve

Write down another dream that you are most grateful to share with your partner…

Day Thirteen

Reflect back on your wedding day. What is one memory from that day that you are most thankful for…

Day Fourteen

Reflect back on your first date. What is one memory from that day that is most special…

Day Fifteen

If you are parenting together, what is one quality that your partner displays as a parent that you value…?
If you are not a parent, what quality do you imagine in your partner that would make them a good parent…?

Day Sixteen

What is one thing your partner did this last week that you are thankful for…?

Day Seventeen

What is one thing you and your spouse have accomplished that you feel proud of…?

Day Eighteen

What is another thing you and your spouse accomplished that you feel proud of…?

Day Nineteen

What is one value that you share…?

Day Twenty

What is a second value that you share…?

Day Twenty-one

Your partner has helped you grow and change. What is one change your partner has helped you make…?

Day Twenty-two

What is a second change your partner has helped you make…?

Day Twenty-three

What is one part of your sexual intimacy that you are thankful for…?

Day Twenty-four

Think of the last time you laughed really hard with your partner. What is your memory of this event…?

Day Twenty-five

What is the most attractive characteristic of your partner…?

Day Twenty-six

Do you have a favorite song, movie, TV show? Why are you thankful to share this with your partner…?

Day Twenty-seven

Sitting quietly, what is the first positive thing about your partner that comes to mind…?

Day Twenty-eight

When you have been married 50 years what is one thing you hope to still appreciate about your partner…?

Day Twenty-nine

Name the one thing that makes you want to come home to your partner every day…?

Day Thirty

Reflect over the past 29 days. What is the most surprising/exciting thing from this gratitude list that you are glad to have discovered…?

Nova the #TherapyCat

Nova has been a popular addition to the blogs. Her first offering was so well received that over 95% said they wanted her to write a regular contribution. So, after a restful holiday season, Nova has told me she has some new insights to share. She even said she was willing to talk about a bit of her trauma history.

Holidays are a time for giving and receiving gifts. But sometimes the best gifts are in the unexpected surprises of any celebration. Jumping in and out of a gift bag brings joy and surprise to everyone. Nova wants to encourage everyone to try and find joy in the unexpected.

After all the holiday celebrations, when all the decorations are put away and the house is cleaned, rest is important. Nova wants to remind everyone that scheduling in a good period of rest is healthy.

Nova became an orphan early in her life. She was born at a car dealership sales lot, and her mom was hit by a car only a few weeks into her life. She was quickly whisked away into an adoptive home. Nova still has periods of sadness when she thinks about her loss. But she wants to remind everyone that waves of grief are a normal part of coping with loss.

Hiding might be either good or bad. If we hide to bring surprise, that joy might be good. Of course, our impulsive leaps might scare someone and prompt an unexpected yell. This might cause the second type of hiding: covering up from shame. But if we hide out of shame, we must work on our vulnerability. Nova likes the work of Brene Brown, who suggests one of our tools for healing our shame is reaching out, “Are you owning and sharing your story? We cannot experience empathy if we are not connecting.”

Nova asks, “Do you have a safe place?” Where do you go to process your experiences and feelings? Do you have a space, like a comfy bed, or do you go to a place in your mind? Nova recommends having a safe space. Nova’s is a comfy bed by the window, which is especially nice when the warm sun moves across it in the morning.

Have a happy February!

Breath – The Pause for Connection

In marriage therapy work, one of the listening and connection skills we practice is sharing our feelings/experiences and validating our partner’s experiences. This is a fundamental building block of relationships, and it can lead to significant communication complications when it breaks down. Let me give you some examples of how it can break down. 

Husband (H): I am upset and angry that you spent so much time on the phone with your mother when we had plans to go out with friends. It made us late. I hate being late. I guess you care about your mother more than me. 

Wife (W): I hear that you are angry. You just don’t get it. My mom needed me. You have never liked her anyway. 

H: Now you are just turning this on me. Always blaming me and never apologizing. 

W: I might try to apologize if you were nicer to my mother and me. Don’t you remember how you treated her last Christmas?

(The conflict escalates here as the couple no longer discusses the original problem). 


Here is a second example.

Wife (W): I felt alone and rejected last Tuesday when you got home so late. I had no idea that you planned to watch the game with friends. I had supper ready for us, and honestly, I was planning to watch the game with you after we ate. 

Husband (H): I can see being lonely. But what do you mean rejected? I am home with you every night. I have not been out with friends for over two months. It was Steve’s birthday. Maybe I should have texted you to remind you, but I told you about these plans on Sunday. It makes me angry that you are accusing me of rejecting you.

W: You never told me about these plans on Sunday. I was out with the kids most of the day, so we were never really together on Sunday. You think you communicate, but you don’t. 

H: You never listen to me. We were standing right there in the kitchen. You even told me to have a good time. Honestly, your accusations make me not want to spend any time with you because I can never get it right. 

(You can also imagine how this little exchange only gets worse). 


I want to present a model for how to have these conversations calmly, improve your connections, and reduce the intensity of conflict. In the example above, the couples do an excellent job of starting with sharing their feelings. These are good “I” statements. And the response of their spouses begins well. You might even say they were validating because they at least “parroted” back what their partner said. “I can see being lonely,” or “I hear that you are angry.” 

But each partner quickly switches into a defensive mode of blaming or playing the victim. These words of accusation and victimhood undo any sense of validation between the couple, and it severs their connections. At this point, it becomes a tit-for-tat explosion. 

Validation requires two components:

  1. Make sure your partner feels heard. Use your own words.
  2. Taking ownership of the problem or offense. Admit what you did that caused the offense. 

Let me show you a better validation from each of the examples above. In the first example, it could have sounded like this:

W: I know it made you mad for me to spend so much time on the phone with my mom. Being late has never been your favorite thing and it probably made you embarrassed that all our friends were there waiting on us when we arrived. (The wife has been on the phone for a long time, and she summarizes her partner’s feelings in her own words.)

In the second example, the husband could have started here:

H: I regret that you were lonely and even felt unimportant when I didn’t come home. I want to spend time together, too. I thought I had told you it was Steve’s birthday, but somehow, I failed to make sure you knew about these plans. It might have helped for me to text you during the day to make sure we were on the same page.  (Again, he used his own words but also offers a bit of what he wished he had done differently).

So these modifications are suitable, but often, in any problem, there are two perspectives. The partner who offers validation can end up asking in their mind, “Well, what about me? When does my partner understand me?” 

This is where the often missed step of “Taking a Breath” is omitted. If you look back to the original examples, the spouse who got defensive was using their failed validation as an attempt to present their viewpoint/feelings/perspective. This is a “cart before the horse” scenario. Breathing is the secret to reaching a point where both partners are heard. 

Here is how it works. Imagine that each partner in the examples above gives the improved “edited” validations I offered. After saying those validations, they want to get confirmation from their partner that they feel understood. They might say something like, “Yes, thank you.” Or “I appreciate your understanding.” There might be some nonverbal confirmation of a smile or relaxing sigh. If you are unsure if your partner feels you “get it,” you can always ask, “Do you think I understand?” If you receive confirmation, you can take a breath and offer your feelings/perspective.

Feelings – Breath Cycle

So, let’s rework the above conversations with the Validation-Breathe cycle and see how they improve and how both partners feel heard and respected. 


Example 1

Husband (H): I am upset and angry that you spent so much time on the phone with your mother when we had plans to go out with friends. It made us late. I hate being late. I guess you care about your mother more than me. (This last statement is a criticism and not appropriate. But if the spouse does the validation, it will help settle any anger).

Wife (W): I know it made you mad for me to spend so much time on the phone with my mom. Being late has never been your favorite thing and it probably made you embarrassed that all our friends were there waiting on us when we arrived. (The wife owns being on the phone for so long, and she summarizes her partner’s feelings in her own words).

H: You are right; I was embarrassed. Thank you for understanding.

W: BREATHE

W: I felt trapped that night. I knew we needed to be leaving, but my mom was really struggling with a serious problem. I know my mom is difficult, and I don’t even like dealing with her all the time, but she is my mom, and I am the only support she has right now. 

H: Trapped. Like you were feeling pressure from both me and your mom? 

W: Yes.

H: I can see that. I am not sure how we could have solved that situation better, but from now on I can try to be more understanding of how hard it might be to have to be the only source of support for you mom.

W: Thank you. 


Example 2

Wife (W): Last Tuesday, I felt alone and rejected when you got home so late. I had no idea that you planned to go watch the game with friends. I had supper ready for us, and honestly, I was making plans to watch the game with you after we ate. 

H: I regret that you were lonely and even felt unimportant when I didn’t come home. I want to spend time together, too. I thought I had told you that it was Steve’s birthday, but somehow, I failed to make sure you knew about these plans. It might have helped for me to text you during the day to make sure we were on the same page.

H: (a bit unsure of what his wife is feeling) Do you think I understand what you are trying to say?

W: Yes. I am sorry. I appreciate you hearing me. 

H: BREATHE

H: I was a bit confused today when you brought this up since I thought I had communicated with you. Again, I may have not give you the message clearly. I appreciate that you wanted to spend time together because I want the same thing. Can we try again and find a time to schedule?

W: I agree we somehow missed each other in communicating plans. Can we just plan for this next game night to be our time to watch the game together?

H: Yes, I cannot wait. 

Pausing and taking a breath are a couple of small ways to enhance validation and connection in your marriage. Those “little things” create a space of safety between the two of you. Pause and breathe, slow down the process, and keep you from rushing into sharing your feelings/experiences. Intimacy requires both partners to feel understood. Love chooses not to rush the process – “It [Love] does not insist on its own way.” (I Corinthians 13:5, NRSV) 

Being a Gift for Your Spouse

Gifts are the language of the holiday season. Meaningful gifts are often unexpected, meet a particular need, and communicate a message of value or importance. We love giving and receiving gifts because they are founded on love and sacrifice. The Christmas season celebrates God, offering himself as a gift in the incarnated Christ. In this gift-giving time, I am reminded of the marital union being bonded through the giving of self. I want to explore that idea in this blog and suggest ways you can be a meaningful gift for your spouse.

Marriage takes hard work. Many modern myths attempt to convince us that if we find the “right one,” marriage should work. But these myths make us lazy about the real work of marriage. Bono, the lead singer of U2, published a memoir titled Surrender in 2022. He reflects on his 41-year marriage to his high school sweetheart, Ali. 

“I’m sure that oneness is the direction of travel for all great loves, but I also accept that it does not happen on cue, at a ceremony, for example, like a wedding. It can happen in all kinds of different circumstances in the middle of the night or the middle of the day, when two lovers decide they want to be part of each other’s lives more than they desire their own independence, and in continuum they pledge their lives to each other…The universe may marvel at such perfectly imperfect love and the stars light your way, but back on earth, if you heed the statistics, it’s as if the world stands in the way of love. I’m sure the essence of romance is defiance, and what is more defiant than two young hearts, twenty-two and twenty-one, deciding to take on the odds, to challenge the dull-thud facts around an ancient ceremony in a modern world…Ali and I were moving in together, and now we were beginning to move together. On paper our marriage started that honeymoon week, but in truth it didn’t feel like that. We’d honored each other, made sacred vows, but the biggest moments in life may not be those we notice at the time. No fireworks, no explosions, no falling even more deeply in love now that we had time together. We were the playwrights and the play, the actors and the critics. Excited and nervous to begin our adventure together. No idea where we’d be in ten years. Twenty. Thirty. I raise you again. Forty years. We’ll eventually figure out what was going on in that moment.Rather than falling in love, we were climbing up toward it. We still are.”

In the memoir, each chapter is represented by one song selected from the U2 library. In this chapter about his wedding and marriage to Ali, the song chosen is “Two Hearts Beat as One.” In this song, Bono sings the lyric, “I said don’t stop the dance, maybe this is our last chance.” All marriages face “last chance” moments; survival depends on each partner staying in the dance, giving and receiving. In those moments, the power of “oneness” can save us if we do the work. The work requires communion between partners where each sacrifices to give themselves as a gift to the other consistently. 

All of this reminds me of Pope John Paul’s words in his book, “A Theology of the Body,” in which he explores the marital union. He conducts a rich examination of the Genesis creation accounts of Adam and Eve. He reminds us of the moments when God parades all the animals of creation in front of Adam to explore whether one of them might be a suitable partner. Of course, none suffice, not even the dog. God had, through love, given the gift of life to Adam, and the Pope asks a poignant question as Adam stands alone in his humanity. “…we must ask ourselves whether this first “man” in his original solitude, “lived” the world truly as a gift, with an attitude that conforms to the actual condition of someone who has received a gift…?”

There has to be an “other” to exchange the gift with. This is what God meant when he said it is “not good for the human to be alone. (Gen 2:18)” Humans need relational companionship to realize their makeup as image bearers of God fully. As Pope John Paul says, “He [Adam] realizes it only by existing ‘With someone’—and put even more deeply and completely, by existing ‘for someone.’” It is through this communion with someone that we can experience the reciprocal giving of self as a gift to another. It is at the heart of God’s identity and was fully realized in the incarnation of Jesus Christ. God wants to live in reciprocal communion with each of us, and he created us to do the same with each other. 

The heart of the communion in marriage is being a gift to your spouse. You gave yourself to each other. But this was not a one-time event. It is an ongoing process of giving yourself continually, consistently. I want to tell you about three ways you can offer yourself as a gift to your spouse. You can give Unexpectedly, Meet their Need, and Communicate their Value.

Unexpected

Most everyone loves a surprise gift. Though I recommend the occasional unexpected gift for your spouse, being an unexpected “gift” for your spouse is much deeper and will require more work. 

The work involves your ongoing decision to offer unearned grace and forgiveness. I speak about this in the chapter called “Safe Marriage” in my book. Marriage is to be a safe place when couples consistently forgive. Forgiveness is the decision not to make your spouse pay for the injuries they cause. This makes marriage safe because it clears the battleground of retaliation. Many of us know when our choices hurt our partner. As humans, we expect punishment or retribution. But the unexpected response of pardon reconciles and restores. 

If you are still thinking that flowers, candy, or a dinner out at the right time is the formula for providing an unexpected gift, then you are missing out. These things are nice, but your partner needs more. They need your unexpected gift of grace. In those moments of peace, restoration, and intimacy explode. 

Meet a Need

There have always been jokes about the husband who gets their wife a vacuum cleaner or some other appliance for their birthday or Christmas. It is a joke because, though the gift meets a need, it falls short of meeting a deeper emotional need for connection and understanding. Intimacy is rarely practical. 

What does your spouse need right now? Just think about that. What have you heard them say that is on their heart or they are concerned about? If you could do one thing for them right now, what would help them? If you can answer that question clearly, then stop reading and go do what came to mind. Serve your partner and meet their need. 

If nothing is coming to mind, then you should listen and engage with them a bit more. In my chapter, “Stable Marriage,” I share a concept called “I am Present.” This is the willful act of being available, listening, and understanding my spouse through engagement and empathy. We are a gift for our spouse when we have taken the time to listen and truly hear their needs. Meeting those needs consistently builds stability in your marriage. It is those sacrifices of service (not your pocketbook) that ultimately strengthen your bond.

Communicate Value

Expensive gifts are nice. At their heart, they give a message of value to the recipient. Car companies with commercials of cars with bows on top are abundant in the holiday season. Many car companies would love to sell you a car in December to help their year-end bottom line and help you have a momentary romantic vision of the bow on the car in the snow-covered driveway (though the snow is unlikely in Texas, where I live). 

But again, giving your spouse an expensive gift is not the best way to communicate their true value. The best way to be a gift to your spouse is to see their value and share that value in the ways you speak to them, build them up, encourage and support them. Your words are powerful, and they have the very power of life for your spouse. I share thoughts about this idea in my chapter, “Successful Marriage.” Your marriage has the opportunity to participate in the life-giving resurrection work of God’s kingdom. This is done in the gift of your words to your spouse. 

When you speak kindness, encouragement, or value to your spouse, they are made alive. This world and the life we must live in is full of discouragement and death. Your marriage can be a restorative space. You are a gift when you speak healing to your partner’s hurts. You are a gift when you speak the truth about your spouse’s character. You are a gift when you encourage and support them to use their gift and talents.

These are the ways to be a gift. Unexpected grace, Meeting Needs, and Communicating Value. As you unwrap presents this holiday season, you can offer yourself as a gift in these ways. I pray God blesses your efforts. 

Marriage Therapy Outcomes

Dr. DeYoung did an analysis of all his work with couples for the past 10 years. It includes work with over 250 couples and just under 4000 hours of therapy with couples in that time. 

Couples who commit to therapy beyond three meetings with Dr. DeYoung have an 88% success rate for therapy. On average those couples participated in 18 hours of therapy. 

A common reason for marriage therapy is affairs. Dr. DeYoung has worked with numerous couples attempting to overcome the challenges of betrayal from affairs. 78% of couples that have worked with Dr. DeYoung accomplish their therapy goals. This subset of couples participated in 21 hours of therapy on average. 

Couples can also be affected by problems from substance abuse. Dr. DeYoung has worked with numerous couples attempting to cope with problems caused by substance use. 74% of couples that have worked with Dr. DeYoung and also been dealing with substance abuse accomplish their therapy goals. 

This subset of couples participated in 21 hours of therapy on average. ​

Nova the #TherapyCat

Nova, the #TherapyCat 

Nova is the current pet resident (therapist) in our home. We have had many pets in our home through the years, but none have been more interested in the therapeutic happenings of our home than Nova. For many of you who have been in therapy sessions with Dr. DeYoung, you have sometimes witnessed her joining me for our sessions. Please know you have no worries about her breaking any confidence, and she is entirely HIPAA compliant. She has received all the necessary training and certifications to ensure the trustworthy handling of your stories. 

Nova is relatively young. As of this writing, she is only 18 months old, but she is a fast learner and has developed quite a few therapeutic insights that might be a bit wiser than her years. She asked if she could offer some occasional tidbits of wisdom about mental health on this blog, and I agreed to give her a shot. She is on a bit of a “short leash” (cats don’t like leashes), so if this first effort goes well, we might let her come back with a few more things to say.

So here she is, Nova, the #TherapyCat.


​Here is Nova observing her world from a perch high above. Nova says you sometimes need to rise above the chaos to see things more clearly. She also recommends waiting patiently in this new space before reacting. We all need time outs. 


Nova is a firm believer in getting her rest. There is nothing wrong with finding the most comfortable spot while you recharge. ​


Nova is a trauma survivor. She is not quite ready to share the details of her early life traumas; she has learned something about threats. Sometimes, when assessing a threat, it is essential to change your perspective, seek a new vantage point, and recognize from your new viewpoint that the danger is not so threatening. ​


Though Nova is an indoor cat only, she highly recommends the outdoors and getting exercise for your mental well-being. She soaks up the rays from the outdoors every chance she gets.  Nova says being in the sun and getting some Vitamin D is good for your emotional well-being.


Lastly, Nova recalls the work of the renowned psychologist Mihaly Csikszentmihalyi. She says play increases her experience of Flow. She encourages us to play more because it is good for our bodies and minds. 

Therapy in Bare Feet

We have developed a significant comfort level with telehealth options for our medical and mental health care. My private practice has shifted from providing in-home therapy to meeting with clients solely via encrypted and secure video. Following the pandemic, I found this method highly effective, convenient, safe, and practical for couples and families. 

Doing so much by video has changed many things. And one of those things is what we wear while conducting business by video. Since we only see each other from the chest up, this has lent itself to greater freedom in clothing options from the waist down. This may have created some rather embarrassing moments for some, but I can guarantee that I have consistently maintained a must-be-wearing “jeans” policy for all therapy sessions. But I do have a confession. I am barefoot for nearly 100% of therapy sessions. I even have a small heater for my feet in winter because cold toes can significantly distract me. 

Walking barefoot has many benefits. So many nerve endings in the bottom of the foot are stimulated when freed from shoes. Before you read any further, go outside and stand in the grass while you finish this blog. Imagine walking on the beach, splashing in the water, and enjoying the sand between your toes. When I walk outside to get the mail, my feet on the grass or pavement causes feelings to move up my entire body. If you are in the grass, notice that now. Those nerve endings activate and cause all manner of emotions. New sensations move from the bottom of our feet through our entire body. Feeling new phenomena in the grass, sand, or concrete often brings unique, heightened awareness. We might be more careful with our steps or slow down and experience the sensations deeply. The effect of the new feelings and heightened awareness is that we are more effectively attuned to our environment.

Another benefit to walking barefoot is loosening constraints. Taking your shoes off after a long day can feel so freeing. There is a bit of tension relief. Having your feet free can even be soothing. There is freedom in being barefoot. Now, I am confident the ladies understand this more than we guys do. You ladies have shoes that press and contort your feet in all manner of uncomfortable ways. We do many things for style and having the right image. We often want to “put the best foot forward” (sorry, I couldn’t help it). But all this foot dressing is also limiting. Something we need freedom from. Being barefoot frees us from the superficial coverings that bind and create discomfort.   

I never set out to do therapy in bare feet intentionally. The context of using a home office has made the choice a natural one. And the experience of doing therapy in bare feet has helped connect me with some important values for treatment. 

Heightened awareness of self and our other relationships is necessary for change in therapy. We have to learn to slow down and listen more. We tune into our feelings and reactions to understand their source better. Just as walking barefoot helps us feel new feelings and possibly feel them more deeply, participating in therapy can do the same. Feeling deep and connecting with our inside selves is a part of the therapeutic process. We call this process insight or gaining self-awareness. It requires us to observe, reflect, and draw inferences about our experiences, feelings, and emotions. When working with a couple, individual, or family, I find success in peeling past immediate problem-solving solutions and helping make insightful connections to our inner experiences and feelings. This process is not always comfortable, and it can even be painful. It is like stepping on an unexpected sharp stone when walking through the yard (or a Lego in a dark house). But it is often in these new spaces of awareness we can see, understand, and experience our problems in a way that can facilitate change. 

Just like removing our shoes loosens constraints, we must do similar things in therapy. We must push our boundaries, nudge outside our comfort zones, and challenge our conventional thinking. When we experience problems in life, they are often supported by assumptions, beliefs, and values that can bind us. We may feel compelled to live behind a mask or project a particular identity.  Change is at the center of therapy. Change means many things, including seeing, thinking, feeling, and behaving differently. To experience change, we have to get unstuck; successful therapy helps us to do that. Hopefully, working together in therapy creates a type of freedom. In this space, we can test, challenge, and change those constraints in our lives that have us trapped or stuck.

Therapy in bare feet is a good idea. I encourage you to do the same. Take your shoes off and walk in the grass. Feel new things. Feel them more deeply. Find the freedom to explore new feelings, test your assumptions, and challenge yourself to growth and change. Show your therapist your bare feet on the screen or take your shoes off in their office. Tell them you want to do therapy in your bare feet. I don’t think they will mind.

Listening

Listening is an essential skill in marriage, but it is also challenging. When we listen well to our spouse, we enhance the connection and overall well-being of the marriage. Unfortunately, we will likely need help with some bad habits in our listening. I want to identify six bad habits and offer you some antidotes to the bad habits.

Interrupting
This habit is self-explanatory. We cut off the statement or thought of our partner to share our thoughts or feelings. This makes our partner feel we don’t care what they say. We place more importance on our position.

Story-Topping
Story-topping is the choice to connect what your partner is saying with something about you. It often comes with the message that what you have experienced or think is more important than what your spouse says. It can create a one-up environment where you compete for importance.

Bright-Siding
When you are “bright-side,” you are trying to get your partner to move off the negative and focus on the good parts of their story. You might think this optimism is encouraging. But the truth is it can be invalidating of your spouse. It can make them feel like they are exaggerating their negative response and their feelings are unimportant.

Being Right
You can quickly escalate conflict when you must point out your position on a problem. This is a confrontation with what your spouse is saying and implies there is one correct position or perspective.

Being All-Knowing
The popular term for this tactic is “mansplaining.” This attitude of having an answer for everything can be off-putting. It can make a spouse feel like you think they are stupid or incapable.

Advice-Giving
Giving advice is another way to invalidate your partner. This behavior wraps up being right and all-knowing into one. It is an almost guaranteed way to create conflict. I think it is best to offer advice when directly asked.

Remedies for lousy listening habits

Patience
Listening cannot be done with speed. It takes time. The agenda needs to be set by your partner and their story. When you interrupt, you often rush a process that takes time. Before you respond or interrupt what your partner is saying – pause and take a breath. Could you slow the process down?

Prioritize your Partner
When your partner shares something with you, whether small or very significant, they are the most critical thing. They are your priority. Connecting their story to something about yourself elevates you when they should be the focus.  Don’t be Penelope from SNL.

Presence over positivity
This is probably the biggest struggle for someone like myself who sees the world in a “glass half-full” way. What our partners need is our presence. They need us to be with them and validate their feelings and concerns rather than just trying to put a positive spin on the situation. Sometimes, our response is unnecessary; they need us to say I am here and will stay with you.

Permit their perspective
Listening to our spouse often involves discussing a problem or potential conflict. We need to permit their perspective rather than engaging in a point-counterpoint debate. This usually means we must take ownership of our contribution to the problem.  Once we have validated their experience and taken ownership, we can share our perspective on the problem more successfully.

Practice Humility
Whether we are “mansplaining” or need an ego boost by trying to show how much we know, these behaviors are unnecessary in marriage. We should all know that we don’t “know it all.” And even if we are very knowledgeable about a topic, we need to have the humility to recognize that sharing our supposed wisdom negates the benefits of our spouse feeling heard.

Promote their needs
The most important result of good listening must be meeting our partner’s needs. Sometimes, they will directly state their needs, but we might have to infer their need by listening well. We should always check and promote whatever our spouse needs. Giving advice does not meet their need. It is rather dismissive and can make a person feel as if you are blowing them off. When our spouse is hurting, they don’t need advice. Your spouse needs your ear, understanding, and intentional actions to meet their needs in the moment.

Mental Health and Gun Violence

In May 2023, there was another horrific act of evil in Allen, TX, when a gunman opened fire in a crowded mall parking lot. This was nearly one year after the shooting at Robb Elementary School in Uvalde, TX. In Allen, eight were killed, including three young children; in Uvalde, 19 children, and two teachers were killed. Two evil men committed these acts of violence. The result has been too many destroyed lives.

Following these events, Texas Governor Abbott spoke to the communities involved and said similar things in both cases. Here are his words:
In Uvalde, Governor Abbott said the shooter had “a mental health challenge.” “Anybody who shoots somebody else has a mental health challenge…We as a state, we as a society, need to do a better job with mental health.”
In Frisco, he echoed a similar refrain. “What Texas is doing in a big-time way, we are working to address that anger and violence but going to its root cause, which is addressing the mental health problems behind it…People want a quick solution. The long-term solution here is to address the mental health issue.”

The governor has it entirely backward. His words conflate evil with mental illness. This sends all the wrong messages. Mental illness is not evil. Mental illness is not the primary cause of violence. Numerous complex systemic factors contribute to violent acts, and to singularly blame mental illness and blindly ignore all the other potential contributors to violence is dismissive, neglectful, and irresponsible.

This makes the governor’s response backward because I believe the rise in gun violence contributes to a surge in mental health challenges. It is not the other way around. This is because mental illness has been with us since the dawn of time. It ebbs and flows with the impacts of life stresses and traumas. We know that mass events like famines, pandemics, wars, and other tragedies can have far-reaching implications for the mental health of nations. In other words, our mental health suffers as external stresses pile up. And these impacts can last for years. Gun violence is no exception, and it is one of those stresses. 

With the advent of the Information Age in the later 1900s, we have increasingly faster access to information. We have gone from the 24-hour news cycle of newspapers to instant news at any second we want to access. This has led to living in a culture of fear. With a world of information in our hands, we have no time to process or digest all the information that floods our minds. As a result, our mental health suffers.

And with the threat of constant gun violence in our faces, our fear escalates. We avoid public spaces, including what should be one of our safest public spaces–church. So isolation increases along with our fear. And to think our children have remained unaffected is naive. Our children are intensely aware of the dangers in their world and schools. As I wrote in the May 2023 blog, “Teenage Mental Health Crisis,” regular lockdown drills in our schools are practiced trauma.
We should make mental health resources available and eliminate stigma from seeking mental health support. We need to increase mental health support to help us cope with the threats of violence in our neighborhoods. But, more importantly, we need to restore a sense of order and peace in our communities.

Here are a few suggestions for accomplishing some of those goals.

  1. Set limits on the amount of information you consume. None of us needs a constant feed of news from our phones or televisions. We also need to limit how much we scroll on social media. We know that higher levels of information input only increase our anxiety and distract us from what is most important right in front of us — our family, friends, and neighbors, which leads me to my second suggestion.
  2. Focus on those closest to you. Spend conversation and face-to-face contact with your immediate family and friends. Notice their needs and work to meet those needs. Provide service and support. None of us can solve the world’s big problems, but we can do something about the people right before us. Love those close to you.
  3. Please do what you can to stop supporting our violent subculture. Examine your life and world. Do you do things or say things that explicitly or implicitly support violence? Do you use violent language when you talk about topics? When talking about political adversaries or those you disagree with, you use fighting-oriented language, like “going to battle” or “we are at war.” Do you need to advertise guns on your bumper stickers, flags, or living room wall if you own guns? Do you play violent video games? Maybe we could all curb our connections to these words, images, or activities. 
  4. We need to stop responding to gun violence as if it is a zero-sum game. If we keep responding like the goal is to beat the “bad guys,” then disagreement, conflict, and violence will only increase. Our goal should be to find ways to create safer, more peaceful communities for all of us, including the “bad guys.” If we do that, they may not be bad guys anymore. The focus is then on helping the community flourish and feel safe. Church leaders have many opportunities to implement programs, messages, and collaboration in this area, leading to my last point.
  5. We must make more significant strides in unifying with those different from us. Sadly, we often won’t share a meal or resources with the church down the street, let alone another community of faith. All faith communities can rally together around a message of peace and cooperation. We need to passionately pursue cooperative efforts with every faith community to find solutions for reducing violence in our streets and neighborhoods.