The idea for the “Connections” group was sparked when a physician colleague approached Michelle about running a group for young women living with “emotional regulation” difficulties in their lives. This interest grew from the challenges of working with young women who were dealing with serious problems like depression, anxiety, eating disorders, addiction, cutting, and suicide. Our experience at CFT of working with young people who are struggling with eating disorders has taught us that the body and the mind can be so desperately at odds so as to create intense suffering for people.  So Michelle approached her colleague Sue Steindorf, a true believer in the power of yoga practice, to see what they could fashion together that might address the complexity of the problems these young women were having. 

The “Connections” group was structured to highlight both bodily awareness, through yoga, as well as the connections between experiences of the body and participants’ own developing identities as young women.  We didn’t want this experience to feel like therapy in a traditional sense, although we wanted the effects to be therapeutic and life changing. The yoga concepts we have focused on include breath, strength, ?exibility, balance, heart opening, and stillness to help create meaningful connections personally and interpersonally.  Focused conversations about what discoveries these bodily experiences connect to in regards to feelings and relationships take place at the beginning and ending of each meeting together.

We have held three “Connections” groups over the past year with women of all ages.  Michele Rizza, nurse and gifted yoga instructor, and I have teamed up with Sue Steindorf, pediatric physical therapist, and committed yoga instructor, to facilitate these groups.  Our collaboration has itself been another kind of rich connection as our different professional orientations have created a truly unique context in which wellness and healing occur. As a personal trainer and family therapist, this group births a dream I have held about creating ways to integrate mind, body, and spirit in the healing process. Here are just a few of the comments that group participants have made along the way:

I am able to be me now. I cry with happiness - everyone has noticed. This has helped me connect my body and my mind.

I’m so much happier now, before I was crying all the time because of how sad I was, now I’m able to let feelings go.

I am a more open person, which is not easy to do. I am more confident and aware of myself. I know myself better and I have opened up to people more. I know that it is okay if people don’t understand me.

Yoga has helped me respond to stress better and I can focus on my feelings. I am connecting my mind and body, and finding time with myself to do the poses at home. I let the emotions go and focus on breath, and then the emotions. This allows me to take a break. I do the poses before bed and sometimes during the day.

I envision my hands holding my heart, and see me for me. I don’t worry as much and I am happy with myself.

Our experience of these groups has been that by blending the arts of yoga and psychotherapy together, openings are created for change that are not possible in either discipline alone. Plans for the future are to offer “Connections” groups for couples and for men.

Kim Delaney

Licensed Family Therapist

This article is written in collaboration with Dr. Linda Warren of Bainbridge Pediatrics.

Two years ago, my mentor and colleague, Michelle Naden, invited me to join a team of therapists named Collaborative Family Therapy. It had been a dream of mine to work in a collaborative way with other therapists, health care professionals, and community resources to better serve families, so I felt honored to accept the invitation. Working openly with a team has created layers of meaningful support for me and the people I serve. One of these layers has been Bainbridge Pediatrics, a group of three pediatricians and their support staff. Our teams share the value of seeking and providing a network of resources that can “wrap around” the families that seek our assistance. This is for the purpose of minimizing isolation and maximizing communication between providers and patients, and between providers.

We decided to write a piece on family eating because it is a topic that crops up often in our work. Food can be a tricky issue for many young people and their parents. On the medical side, Michelle Bombardier, SLE, and Catherine Whiting, OT, approached Dr. Linda Warren at Bainbridge Pediatrics to discuss working together to address feeding problems developing in young children and their families on Bainbridge Island. These medical providers were seeing more families struggling with the challenges of feeding their kids, and on the mental health side, we at CFT were seeing more families struggling with eating disorders. Dr. Warren introduced us to several excellent books on the topic. She and her medical colleagues also began a monthly group for “Picky Eaters.” She initiated this piece that focuses on how to create a family environment that promotes healthy eating for all ages. Our teams work to help families decrease stress around eating and to increase communication and connection within the family. Some of the most useful resources that guide us in this area are the books written by Ellyn Satter, a licensed nutritionist and therapist, who has written extensively about children and food.

Satter, licensed nutritionist and therapist, says that it is the parents’ responsibility to provide good nutrition for their children. The what, how, and when to eat can become confusing and overwhelming questions for families. Some of the questions we hear are:  How much responsibility should a parent take when it comes to decisions about eating, and how much should be shared with the children? How does responsibility shift as children grow? Different messages bombard us through the media, and we have become a society that is conflicted about food and body image. Concerns about “healthy” body shape and size, food allergies, and the relationship between food and behavior are just a few of the topics that parents and children raise when they consult us.

We will begin to answer some of these questions with Ellyn Satter’s definition of the “division of responsibility” (1990) between parent and child. She refers to this division in the following way:

1. The parent’s job is to decide what, when and where to provide food, regular snacks, and meals. They are also responsible to offer a variety of foods.

2. The child’s job is to decide whether and how much to eat or not to eat. Control in this area is with the child.

In exploring the first part of the division of parents’ responsibility, Satter provides some helpful things for parents not to do. She says: Don’t become a short order cook, and don’t pressure your kids to eat (1987). This means no bribing, arguing, rewarding with dessert, or tricking kids into eating it.  She coaches parents to offer a child the food, and let them sit and decide if they want to eat. If they don’t eat, Satter says to wait until the next snack or mealtime to offer food, milk, or juice. The goal is to raise a competent and “intuitive eater,” (Tribole & Resch, 2003) one who knows what he or she wants to eat, knows when he or she is full, and who enjoys eating.

The second part of Satter’s division states that how much a child eats is his or her responsibility. Often parents become concerned about their child not eating enough, or too much. It is helpful to develop trust that a child will eat what he or she needs, and to know that this will fluctuate over time. It can be helpful to look at a larger time frame and to focus on what a child eats over the course of a month, rather than a day or week.  Satter (2005) believes that parents need to stay within their division of responsibility, which is to provide the structure and the food choices. When parents gravitate towards the children’s responsibility of how much to eat, a power struggle often ensues. The struggle can be fueled when parents continue to worry over their children’s eating habits. Satter says it is helpful for parents to keep these worries in check so children can learn how much is enough, a skill that is important to develop on the way to becoming “intuitive eaters” (Tribole and Resch, 2003).

The division of responsibility ideally shifts as children grow. For adolescents, autonomy and identity become central themes of their development, and they often become more self-conscious or struggle with self-confidence. With an influx of hormones, their bodies typically grow rapidly and they must adjust to internal and external changes daily. Adolescents need to make more choices for themselves, and parents need to let them explore these choices with food. Parents can still influence their growing children by offering healthy choices in the home and by eating meals together. The goal is for parents to support their children and to trust them to care for themselves. This will develop a healthy balance of responsibility between parents and teens.

Satter (1987) states:

• During the teen years, you continue teach and guide your child, building on the foundation of instruction and interaction that has gone before. The way you treat your child is the most powerful part of the instruction, as it has been at all previous times.  Your attitude of respect and interest and your willingness to play a supportive, rather than a controlling role, will have an enormous impact on the way you and your child feel about each other. (pp. 245-246)

Family meal times provide a great opportunity to create and nurture connections within families. These occasions offer parents the structure within which to live out the division of responsibility described by Satter. In order to provide more detail on the benefits of family meal time, we offer some interesting research findings that highlight some significant benefits of family meals:

A 1999 study from University of Michigan found that meal time at home was the single strongest predictor of better achievement scores and fewer behavioral problems with kids. Meal time proved more powerful than time spent in school, at church activities, studying, or playing sports.

A Harvard study in 2000 showed that eating family dinners together most or all days of the week is associated with eating more healthfully. These families consumed higher amounts of nutrients such as calcium, fiber, iron, B6 and B12, C and E.

A study in 2004 from the University of Minnesota found adolescents who ate with their families did better in school, were less likely to use drugs and alcohol, and were less likely to have low self-esteem and depression.

The information from these studies listed above reinforces the significance of family meal time as a way to help kids make positive choices in their lives. For more information about this topic we suggest the books below. We also invite you to contact us at CFT and Bainbridge Pediatrics to talk about your questions or concerns.

Recommended Reading:

How to Get Your Kid to Eat… But Not too Much, 1990, by Ellyn Satter. Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal, 1999, by Ellyn Satter.
Child of Mine: Feeding with Love and Good Sense, 2000, by Ellyn Satter
Intuitive Eating, a Revolutionary Program that Works, 2003, by Evelyn Tribole and Elyse Resch.
Your Child’s Weight: Helping without Harming, 2005, by Ellyn Satter.

The following is a paper written by a fellow colleague, Tony Stanton. He is a psychiatrist who has published extensively in his field, and holds years of experience working with troubled youth. This piece shares a summary of the values that Narrative Therapy embodies, and that we as practitioners working with this perspective commit to uphold in our work with clients and each other.

A Little Working Paper on Values in the Practice of Narrative Therapy

Underlying our mandate to help our clients is an affirmation of their inalienable right to experience safety, respect, and meaning in their lives. To uphold this mandate the following values are put forth as possible useful points of discussion.

1. We ask permission before we offer help and we keep a strict eye on confidentiality. The exception is when we feel that someone is not safe.

2. We value curiosity and inquiry towards all the factors that either impede or promote the heart of creativity in our clients. This means that we value questions more than quick answers and that we help our clients to be explorers in their own lives. It also means that we value descriptions of real life more than diagnostic categories.

3. We help our clients search towards the preferred stories of their lives so that these stories are revealed and honored over any limiting stories that may be restraining their lives in the present. This means that we help our clients become detectives towards their successful experiences and those people from their past who have supported them.

4. We take a stand against those stories that may be dominant in our culture which prevent our clients from knowing themselves and from experiencing themselves as capable of exercising choice towards their preferred values. Such stories may include subjects of race, physical appearance, or limiting ideas of what constitutes being a person.

5. We affirm that our own work will be based on a community of support for each other - and that this support will exemplify the same values that we promote for our clients i.e. respect and support for each other’s creativity. To this end we need to meet with each other regularly as well as make ourselves available to each other on a more casual basis.

6. Whenever it is useful we will help our clients to experience us as a larger community which is committed to the rights stated above. While we are not a 12 step program we should exemplify the same principles of support and sharing that are manifest in such a program. Clients may need to know that we are not isolated individual therapists - that we help each other and that we engage the larger world outside of our own practices.

7. We believe that the body and mind constitute an exquisite instrument for the discrimination of value and that this instrument can make precise decisions through what is known as “common sense” or intuition if we free it from the burden of external restraints. It is part of our job to return this “instrument of the discrimination” back to its proper functioning.

8. We promote the knowledge each of our clients can obtain of those gifts they hold towards their families and the larger community - gifts which ultimately enhance the lives of those they are in contact with. This might be called helping people to know their place in “the larger scheme of things” and experiencing themselves as “having meaning” in the lives of others.

T. Stanton

I invite readers to share a blog by two of my most trusted colleagues, Kurt Johns and Michelle Naden. They are both Licensed Marriage and Family Therapists at Collaborative Family Therapy on Bainbridge Island. You can find their blog at www.practicalnarrativetherapy.com

I would like to invite readers to meet a trusted and knowledgeable colleague, Joseph Shaub.  I am honored to have him share his wisdom and experience with you.  He is a collaborative family lawyer and mediator with offices in Seattle and Bellevue.  He is licensed as both an attorney and marriage and family therapist.  Joe has many more informative and helpful articles on a variety of topics in his website: www.josephshaub.com.  He has offered this informative article on the benefits of the collaborative law process.

CHOOSING COLLABORATIVE LAW

Divorce is such a hard road.  Sadly, lawyers can make that road so much harder.  They’re not bad people - most of them are truly lovely folks if you knew them socially.  However, their role is to protect their client.  “Protect them from what?” you might ask.  Well, protect them from being “ruined,” “screwed,” “wrecked” or “destroyed by their spouse,” if you asked them.  Lawyers, in their role as protectors are also dispensers of paranoia.  It’s part of the training.  It’s like a magical transformation, but rather than turning from an ugly duckling to a swan, or Clark Kent to Superman, the divorcing person enters the lawyers office wanting the “fair” outcome, not wanting to screw their spouse and emerges hyper-vigilant and hyper-protective of their “rights,” having heard for an hour or two what they are “entitled to.”

The good news is that there’s a large and growing group of lawyers in King County who want to help smooth the path of this otherwise rocky life transition.  They are “collaborative lawyers” and its important for anyone commencing this process to know about them.

Collaborative Law started in the early ‘90’s when a Minneapolis lawyer named Stu Webb decided he just wasn’t going to go to court any longer.  He asked all of his colleagues if any of them were willing to agree to forego the soul-rending process of divorce litigation and commit, with their clients, to working out all the details of a legal divorce by negotiated agreement.  He had a handful of takers… and the word got out.  Collaborative Law began to spread throughout the country.  To get an idea of its breadth and scope log onto the website of the International Academy of Collaborative Professionals at www.collaborativepractice.com.

This form of healing, supportive practice - in which lawyers make a paradigm shift from protecting the narrow interests of their clients no matter who else may be hurt in the process (the spouse or their children) to developing a broader view of what a client’s real interests are - is now being practiced by many professionals in Washington.  The lawyers in King County Collaborative Law understand that an adversarial divorce which locks people into years of animosity and children into a life of negotiation between enemy camps simply can’t be in anybody’s interests.

Collaborative Law, as practiced in Washington is a “team approach,” recognizing that there are many elements of a divorce - the legal, the financial, the parental and the emotional.  So, we have collaboratively trained lawyers to support, advise and advocate for their clients; collaboratively trained financial specialists to act as neutrals, assisting the couples in understanding their current and future financial needs - and resources - in a non-adversarial manner; collaboratively trained mental health professionals, who act as divorce coaches, assisting people in managing the most acute emotional reactions that come up during the divorce process and child specialists who support the children through this alien and utterly unwelcome change in their lives.

While the collaborative law team approach is certainly more costly than doing it yourself, or working with a mediator, only, it is no more expensive than a conventional adversarial divorce where lawyers run into court to win temporary orders on behalf of their clients, stressful and incredibly comprehensive information gathering is conducted through a “discovery” process and a costly (both financially and emotionally) settlement conference is conducted where both people are separated with their lawyers and a settlement official shuttles between the two rooms with offers and counter offers in an effort to pound out a settlement in a day.  This process leads to next-morning regret for at least one person as sure as the sun rise in the east.  This doesn’t even include trial, which virtually guarantees destruction of whatever is left of the relationship between two people who shared years of intimacy and often children that they both love.

Collaborative practice can expose people embarking on this awesomely challenging life journey to a group of professionals who are committed to helping both people identify and achieve high-end goals that will serve them for the ensuing days, months and years.  An image evoked by one collaborative professional often is that of the divorced husband and wife sitting side-by-side (with their new partners if that be the case) at their children’s graduations or weddings and experiencing the gratitude of these children in finding a way to end the marriage (if end it must) in a loving, respectful manner, mindful of the integrity of everyone involved.

It’s a challenge, to-be-sure.  Yet a challenge well worth taking.

For more information visit the Collaborative Law page of Joseph Shaub’s website: www.josephshaub.com and the website of King County Collaborative Law, www.kingcountycollab.org.