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Riversage Family Counseling
Specializing in treating complex issues with strength and compassion

Riversage Counseling's Blog Page

HAPPINESS for 2017?!

As 2017 rings in the new year, many are setting their new year affirmations and resolutions. Plenty of gym memberships, budgeting apps and activity planners are being tended to with vigor. Goals are being laid out to change what we want to improve, or perhaps to attend to work we’ve already done and want to maintain our results. 

Some goals to consider are mindful practices and social engagement in happiness. 

Yes, planned social engagements of happiness!

In the U.S., people are affected at a higher rate by anxiety as they are by headache or migraine (13%). In the US 18% of the population is affected by an anxiety related mental health disorder. Anxiety is developed through complex combination of risks in the biology, brain, personality and environment of a person. Anxiety increases doctor visits and increases the likelihood of being hospitalized for mental health issues. Mindful practices with a therapist can help decrease or eliminate these risks and issues. 

We can all agree the increase in mindfulness and mindful practice have become great resources for those experiencing anxiety, trauma, stress, or simply wanting to increase awareness. Mindful practices increase awareness so we can become aware of positive experience opportunities in our lives. Recognizing these positive experiences provide protective factors against the potentially negative effects of the chaos of modern societal pressures. Mindfulness powerfully concentrates our attention toward our focus and aspirations. Mindfulness increases happiness! Mindfulness is an individual self centered practice. While self is paramount important, this might be a great time to expand your practice of self awareness recognizing joy to others. 

So, about those “planned social engagements of happiness” I suggested in your resolutions? Well, happiness for an individual is known to be happiness for many when it is shared! Sharing experiences of joy and happiness exponentially increases positive effects for all those involved.  I’d like to invite you all to increase your happiness and share it! Intentionally share positive feelings with others. Share experiences of joy to increase the overall contentment and calm for your communities. From the community of family, to the community of work, and geographical communities. After 2016, we could all stand to be a part of increasing the overall well-being and contentment of all people with happiness.

**And if you have migraine, please call and let’s talk about EMDR Treatments for Headache and Migraine! Migraines can resolve in a single session!*

Joy to you all in 2017!

Gina MK Kramer




What to Expect During Your First Therapy Session

For someone who might not be used to sharing their problems with strangers, the first meeting with a therapist can be quite daunting. I remember my first therapy session was definitely intimidating. I had all sorts of thoughts going through my head about what to expect. I thought the therapist was going to judge me and after months of debilitating panic attacks I thought I was going crazy. My worries were unfounded. During my first session, the therapist and I just spent time getting to know each other. I also walked away with a few tools to help me start getting the anxiety under control.

Here are some things to expect for your first therapy session:

Why are you there?

During your first session, your therapist will ask what brings you to counseling. It’s helpful if you can write down some things beforehand to pinpoint what isn’t working in your life in the current moment. While some people may know exactly what the problem is, for others it’s not so easy. I had no idea what was causing my anxiety and panic attacks when I showed up to my first session. It took several more meetings to discover what had actually triggered me.

What is your background and current life like?

It’s helpful for your therapist to learn a little bit about your background. You don’t have to tell your whole life story during the first session (and there probably won’t be time if you’ve already lived a few decades), but if you come from an alcoholic, abusive background your therapist should know that. Likewise, if you’ve recently gone through a divorce or changed jobs, even if that might not the main reason you are there, it’s helpful for the therapist to know these things.

Are you experiencing any symptoms?

Your therapist will ask you during your first session if you are experiencing any current symptoms. This helps to target things to work on, as well as the possibility of needing medications.

How is your sleep? Are you able to enjoy activities that usually give you pleasure? Are you more fearful than usual?

With a checklist, your therapist can determine if you are experiencing anxiety, depression, or other issues.

Don’t let this scare you. Not everyone has a diagnosis and if there is one, it can be a blessing in disguise. Getting referred to a doctor and starting medications can be life changing.

There doesn’t have to be a crisis to see a therapist

One thing to remember is that your life doesn’t have to be in crisis to see a therapist. You may have a great life, but just need some help dealing with a difficult relationship or a hard challenge at work.

 Ask questions

 Don’t be afraid to ask questions. Your therapist is a person just like you.

And, if you don’t like your therapist it’s ok to move on to another. I do encourage giving the therapist a second chance if the first meeting doesn’t go well. When I first met my current therapist, I didn’t care for her at all. However, the more I got to know her, I found out she was a deeply caring individual and very good at what she does.

 A personal confidante

 One great thing about having a therapist is that she is your confidante. Unlike some friends or family members, you don’t have to worry about your therapist telling other people your business. She’s not allowed. Unless what you tell her will endanger your life or the lives of others, you can be assured  what you say will not leave her office.

 It’s a process

The last thing to remember is that therapy is a process. All your life problems will not be solved in one hour. Commit to that process and slowly you will start noticing your life changing for the better.

Paula Bostrom has written for the International Bipolar Association and Tiny Buddha among other websites and publications.

John Wayne Syndrome By Kate Niles So many times in therapy I find clients ashamed that they ever needed someone. This of course is a by-product of abuse, and is the very definition of neglect: Had there been someone there, perhaps the abuse would have stopped and certainly no neglect would have occurred. But being kids (usually) when these things occur, we internalize our utter aloneness as the norm: what was the matter with us that we “couldn’t handle it” or “felt like crying” or worse? The irony is that many people who shame their emotional neediness are the very ones Caretaking everyone else’s needs, maybe especially the abuser’s. Stereotypically, it is women who get assigned the Caretaker role in dysfunctional families, but I have seen plenty of men with this issue too. They believe their sole role on Earth is to help others, but the minute they turn to focus on helping themselves, on self-compassion, the “You’re Selfish” demon-voice rears its ugly head and tries to shut this process down. To care about oneself, to find those sad, hurt, and angry emotions and address them, is to be “weak,” “needy,” “not good enough,” etc and so forth. Those of you with awareness around abuse are nodding your heads and going, “Well, yeah, that’s how the abuse keeps being internalized and how the abuser gets away with their crimes.” There are probably others of you who recognize your own versions of those demons, and they are in actuality fantastic protectors -- guardians of our raped and pillaged souls, pre-emptive strikes against the self so we don’t have to feel the damage done by someone else. In further irony, it is easier to keep knifing ourselves willingly sometimes than to feel what others have done. Sadly, though, the effect of this is to simply dig the wound deeper and to continue to buy into the abuse. Those feelings then come out as rage toward others (in worst case scenarios, we abuse others), or toward the self (depression, self-harm, suicidal thoughts). Unfortunately, to get out of this mindset we often encounter mainstream white US culture, which is notoriously “hyperindividualistic” and – maybe especially in the West -- still in admiration of John Wayne underneath it all. (Sometimes not so underneath.) At some point in session, when my clients are learning to set boundaries and speak their truth, we run into Mr. Wayne. What helps here is to ask if my client would really want to be married to John Wayne. This stops people in their tracks. “Uh, no….” they say. And right they are! I can’t think of a dude less in touch with his emotional life than Mr. Wayne, and neither can they. Thus we (alas) lance the Cowboy Stereotype pretty quickly. Now don’t get me wrong – as a lifelong Westerner, I am a deep historian of its settlement by all peoples, Native, White, Hispanic, or other. I have come to find that the best Western movies are, ironically, superb psychological thrillers. (Check out the original Three Ten to Yuma with Glenn Ford. Yikes!) However, in healing our own wounds, we have to see the flaws in that cultural mirror so that we give ourselves permission to heal the trauma that happened in such isolation. When someone who has been trampled on first explores setting boundaries and speaking up, often that person is terrified of being “like the abuser” and cannot differentiate between simply saying “no” and being a total jerk. We explore how they can learn to do this in neutral, or even kind, ways. I differentiate between “kind” (being genuine) and “nice” (being that fakey Caretaker who puts on the smile and sucks it up). We explore what kind looks like and I remind clients that we teach people how to treat us. So until we are able to stop being a doormat and accept that we need to learn to ask for help and set up space for ourselves through setting boundaries, we will continue to feel run over. Sometimes, hiking way up high, or running across some godforsaken shack in the desert, I am reminded that for so long the United States had an escape valve in the form of westward expansion. We could run from terrible parents, religious persecution, awful economic conditions in the Old Country, or mental illness, by coming West and trying to make a go of it by mining some hole in the ground at 12,000 feet or ekeing out a homestead in some place like Pie Town, NM. My own family was some of the last to homestead, taking out a claim in extreme western Nebraska in the early 1900s. Native folk are right to see the spiritual sickness in this history, just as I am right to see to the curious pluck in making a go of it at all. Now, however, we are up against the limits of our ability to run. So we have to turn and face the flaws in the program, witness and hold space for our hurts, and learn to heal without the luxury of Manifest Destiny or a man called Wayne. It’s a tough job, but I have no doubt we are up to it. I am forever in such admiration of the courage of my clients – because that’s the true John Wayne: someone who stays with their tears, and listens to what they have to teach us.

Field Work

Margaret Mead once wrote that “the very core of field work [is] one person, all alone, face to face with a whole community.” I think this is very much like what a person does when they heal deep-seated family of origin trauma. It is field work with the self, and all the parts that are still scattered on the ground, waiting to be reunited with their siblings. It is the most difficult thing anyone does, but the extent to which you do it and then decide to help others heal is the extent to which you will be effective.

Then, as healer, to quote Mead again, “one must learn to do something correctly and not to become too absorbed in the doing. One must learn what makes people angry but one must not feel insulted oneself. One must live all day in a maze of relationships without being caught in the maze. And above all, one must wait for events to reveal much that must be learned.” So being a good psychotherapist is exactly the same as being a good anthropologist in a foreign village deep in some jungle far from home. You have to love this territory. And if you haven’t done your own internal field work “all alone, face to face” with the whole community of your soul, then you are likely to take people’s emotions as your own; you are likely to misunderstand where the right boundary is.

People think you need psychology degrees to do psychotherapy. Of course that is valid. But being able to participate-observe; being in love with the totality of the human condition, or in love at least with the curiosity of it – that’s anthropology. And so I think any good clinician is at heart an anthropologist.


Welcome to our new Riversage blog!  We hope to share new ideas, things we learn, tips for health and wellness, and other useful information for your benefit.  If you have something you feel would benefit the greater mental health community please see our one of our therapists to share your ideas.

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