This Saturday, I will be speaking in this women’s conference that seeks to inspire and empower ladies in Metro Cebu area.

https://www.facebook.com/ColourMeLadiesCon/?fref=nf

CBT Explanation of the Major Cause of Depression

This video you are about to watch is a testimony how David Burns the author of the best-selling book Feeling Good came to realize the importance of training people to stop their distorted thinking in order to feel better. Burns said in his TED talk that as a psychiatrist he was dispensing medication to people with depression, but found many of them still struggling with depression after months of medication. This led him to try Aaron Beck’s Cognitive Behavior Therapy (CBT). Later he developed his own manual for people who suffered from depression, anxiety and low self-esteem which became Feeling Good.

Today’s medications for depression have been improved and perhaps are more effective in controlling mood disorders, but as a psychotherapist seeing clients suffering from mood disorders, I agree completely that most people who struggle with depression and anxiety have one thing in common:  Their suffering is not primarily because of a certain event or what people have done to them, but because of how they perceive these people or circumstances. People become depressed from the story they tell themselves about these people or circumstances. They have a hard time thinking about reality without telling themselves these “stories.” No wonder the people who care for them sometimes have difficulty understanding what is happening to them. Their loved ones wonder why they cannot see the reality that there is a way out of their situation.  There is hope, and they have control over their lives.

To be able to get out of depression people need to change the way they think. They need to be able to be aware of their thoughts and identify the type of faulty thinking they are having. Then they must examine the evidence:  Is what they are thinking true? If they are having a hard time doing it by themselves, they might need to seek help from a counsellor who does Cognitive Behavioral Therapy or CBT. Many people believe that the circumstance, other people or something outside of a person produce the reaction or feelings that are labeled depression. CBT teaches that your thoughts produce your mood or your behavior. So changing the type of thoughts you are thinking is the way to change your feelings or behavior and this is a practical and very effective way to deal with what a lot of people experience as depression

Financial Considerations for becoming an OFW

ABS-CBN News Channel (ANC) with guest Susan Ople (President of Blas F. Ople Policy Center and Training Institute) produced this video On the Money: True Cost of Being an OFW to give an understanding of the cost for a Filipino going abroad.  According to Ople, the cause of Filipinos leaving for another country is not poverty but a salary differential.  Applying for a job overseas is a transaction between you and your employer not a favor given by a recruiter.   There is a great deal of fraud by fake agencies and recruiters so it is extremely important to do your research via the internet and asking referrals before paying any money to a “recruiter.”   Not infrequently, OFWs are victims of contract substitution:  meaning that as soon as the OFW arrives in their destination country, the nature of the contracted job and agreed upon salary change.  When this happens the OFW can report the situation to the Philippine Embassy and Philippine Labor.  However there are times when the Philippines government is unable to impose its law on the host country of the OFW. 

 

For those thinking of applying as an OFW, make sure you know:

• the specific nature of the job you are contracting
• how much the salary is
• the conversion rate of your salary into Filipino currency
• when your salary will be paid
• the cost of living (housing, transportation and food costs)
• the distance of travel to your job
• the exact nature of any benefits that are promised 

Here is a summary of the costs* incurred by an OFW:

• Placement fee (Should not exceed 1 month salary as approved by the POEA)
• Mandatory contributions to PAG-IBIG and PhilHealth which are set by law like (P1200 for 2014 and P2400 for next year 2015)
• Cost of Pre-departure Orientation Seminar: P100
• Passport fee: P950
• 2 Years Overseas Workers Welfare Administration (OWWA) membership US$25 (P1100)

*There are countries with hidden costs like Taiwan (requiring a broker’s fee between P60,000-P100,000)

You will be required to present a receipt for all of these expenses to the PHILIPPINE OVERSEAS EMPLOYMENT ADMINISTRATION (POEA) before leaving the Philippines. 

And there are additional expenses: 

• National Bureau of Investigation (NBI) clearance
• Medical clearance
• Airfare
• Accommodation fees from agency while in Manila
• Travel costs to Manila before the international flight

**Domestic workers are exempted from placement fees.  However, there are many schemes created to extract money from domestic workers, like salary deduction so one must be very careful

Once you leave the Philippines you are on your own, so before leaving the Philippines:

1.  Make sure you have at least 3 copies of all your documents.  Keep one copy for yourself in case something will happen with others when you present them to authorities or your boss.
2.  Know the name of the Philippine ambassador, the address of the embassy, hotlines, emails, and websites for those who can help you if you are in need.
3.  Make a strategic plan with your family including your children and set clear goals:

• Know why you want to work overseas and communicate it clearly to your children.
• Clarify expectations and needs with your family and agree upon them together. 

4.  Develop a financial management plan

• Discuss the time table: how long you plan to stay
• Discuss savings and investments plans
• Discuss limits on purchases with your new income that will be much more than you are accustomed to making while in the Philippines
• Discuss how much to spend for priorities and needs.
• Discuss limits on what will be given or lent to friends who come asking for help once you are earning at a much higher rate
• MAKE A WRITTEN BUDGET

***Susan Ople recommends that you do NOT send all of your excess income to your family to protect yourself from severe disappointment when they do not follow through on your agreements

Choosing to work abroad is one of the biggest decisions you will make in your life and it should be made with as much accurate information as possible.  Many Filipinos put all of their hearts into an OFW job only to see their dreams come crashing down into reality because they have not carefully researched and weighed all of the factors that will affect them and their families.  

Psychological Impact of Overseas Filipino Worker on the Filipino Family

This video entitled The Trials and Triumphs of the Children of OFWs portrays the sacrifices of children growing up away from an OFW parent.  A parent going abroad begins with high hopes and dreams of alleviating their poverty and giving their children a better future, but often becomes the very thing that breaks the family apart.  The length of the separation, the confusing change of roles and the pain of loneliness are not compensated by the money being sent by an OFW parent.  To navigate this difficult emotional pain, children of OFWs need to be able to stay focused on the goal for which their parent went abroad and endure a the pain and loneliness, sacrificing their feelings for their family.   

ABS-CBN News of the Philippines produced this TAGALOG video entitled “Tragic OFW stories.”  Kabayan Special Patrol reporter Noli De Castro documents the tragic story of 2 OFWs: Maria Arlene Carbon fell to her death from the 43^rd story of her building in Hong Kong and her employers reported her death as suicide, but her family questions their version of the events. Albert Bautista worked as an engineer in Jeddah, Saudi Arabia.  He was killed in an accident, but there are conflicting details in the account of his death and they are still looking for his Filipino who was with him to give his account of the story or to know what happened to him.  OFWs leave the Philippines seeking good paying jobs, but there are hidden dangers and high risks in many of these situations. 

 

http://www.academia.edu/5241905/Overseas_Filipino_Workers_A_Risk_Society_Analysis

The link above is a short paper written by Leo Urrutia that talks about risk analysis for Overseas Filipino Workers (OFW).  The author describes the work of the OFWs as “3D jobs,” meaning dirty, difficult and/or dangerous.  The nature of their work, being out of their country and under the control of their employers makes OFWs quite vulnerable to oppression, abuse, and sometimes even death.  The paper challenges the Filipino notion that the OFW is a hero, and makes the reader wonder if many of them are not victims.  

Trust & Betrayal in Marriage

The success of marital relationships and other types of relationships whether business, community, or intimate relationships is based on trust.  Trust is what makes the relationship work.  Without trust, a relationship will deteriorate and eventually it will die.

Trust is one’s confidence in another person that what he or she says is true and that his or her intentions are for your best interest and the welfare of your relationship.

Betrayal by definition is a violation or breaking of a promise or agreement that erodes one’s confidence in the trustworthiness of the other person in a relationship. 

John Gottman, an expert in marital relationships, has studied the science of trust and betrayal and how to build trust in our relationship.  Gottman says that trust in another person slowly erodes any time there is a turning away from meeting the need of ATTUNEment to a loved one. 

Gottman’s colleague, Dan Yoshimoto has created an acronym to clarify the meaning of ATTUNE:

• Awareness of your partner’s emotion
• Turning toward the emotion
• Tolerance of two different viewpoints
• trying to Understand your partner
• Non-defensive responses to your partner
• and responding with Empathy

That slow erosion of trust from turning away from a partner's need for ATTUNEment can cause great damage over years, but individual events of turning away from needs of ATTUNEment do not define a relationship because everyone does it at some time or another.  When we fail to attune with our spouse or the person we love, we are allowing the basic building blocks of a strong and healthy relationship to erode.

For Gottman, betrayal begins after you have turned away from the need for ATTUNEment in your partner and then begin to distance yourself from your partner by saying to yourself, “I can do better.  Who needs this garbage?  I am always dealing with their negativity and I’m fed up.”  This ruminating on that idea that there is someone or something better is the initiation of betrayal. 

Many marital conflicts begin with small things such as forgetting to wash the dishes, coming late for dinner, forgetting to communicate, etc.  The offended person sends signals that something bothers him or her.  (Gottman calls this the sliding door)  These sliding doors, like a small reaction of sadness, a sudden silence or coldness are opportunities for the other person to ATTUNE to the person who is hurting or bothered.  When we choose to ignore sliding doors because we are tired or we don’t want to be sidetracked or distracted, we ended up destroying the trust that we could build by simply pausing and ATTUNE-ing  to our partner.

Lack of ATTUNE-ment turns to betrayal when we choose to believe that we can do better without them which usually leads to resentment, becoming uninterested and jaded.  Our level of commitment drops and we stop investing in and sacrificing for the relationship.  Without significant intervention, this relationship decline will lead to the ending of the relationship. 

Gottman created a “betrayal metric” where he defines the extent of the couples’ interaction.  When a relationship interaction is characterized by the thinking that I win when my partner loses known in game theory as “zero-sum game” trust erodes quickly.  During Gottman’s 20-year study,  many couples who engaged in this type of interaction dropped from the study.  When he started to investigate why, he discovered that many of them had died.  And it was usually the male partner who had died.  Creating a high trust relationship is very significant not only for the emotional wellbeing, but also for the physical health of the couple.

John Gottman explains how to build trust through ATTUNE-ment in this video:

Building and maintaining trust can be accomplished the paying attention to and investing the time to ATTUNE to our spouse or loved one.  This has tremendous emotional and physical benefits in the long run, both personally and relationally

Gottman’s full article and accompanying lecture videos can be seen here:

http://greatergood.berkeley.edu/article/item/john_gottman_on_trust_and_betrayal

Intercultural Marriage Counseling

    In my counseling practice, I work with intercultural couples (particularly Filipinas married to foreigners here in the Philippines).  Foundationally, we want to understand the couples’ cultural differences by clarifying the values of each culture and their impact in the budding intimate relationship.  The first thing we do in counseling is “Getting to know ‘me’ as a Filipina or a foreigner:  my values, my hopes and my dreams, as well as, my fears.”   I do psychoeducation on how differing values and cultural patterns will clash.  Then we work together to explore ways to proactively face them.  By understanding both cultures, the couple becomes aware and equipped to develop their own family culture, unique to their relationship.  This also provides the couple a framework to set limits and boundaries especially in dealing with cultural obligations and cultural values that cause them to see each other as rivals.   Secondly, I teach the couple how to bond and create an environment where feelings of falling in-love can be nourished and grow.  Thirdly, I teach Emotionally Healthy Skills (developed by my mentors Pete and Geri Scazzero) that will help make them feel listened to and loved.  We go over how to confide both positive and negative emotions; how to have a fair fight for change; and how to make a complaint and ask for what one needs.  These skills provide a point of reference when they are caught in the middle of these clashing and seemingly irreconcilable cultural differences.  They can use Emotionally Healthy Skills in order to lovingly communicate their struggles without hurting each other deeply from collateral damage.

    Pfeil (2010) in her book, Counseling Intercultural Couples, highlights cultural values that cause gaps in intercultural marriage.  For instance, the Filipino cultural value of” Utang na Loob” (debt of gratitude) has very good aspects, but it brings a heavy load to children who are expected to provide for their parents and help their parents to raise the younger siblings as soon as they have income.   Pfeil (2006) stressed that the Filipino family system is bilateral with closely knit family ties, generational hierarchy, and respect for seniority.  Children owe their parents a debt of gratitude for giving them life and raising them.  Younger siblings owe their older siblings for having cared for them.  The failure to fulfil this obligation causes bitterness and broken trust.  The younger one who owes the debt will be incapable of expressing love and respect to parents and elder siblings if they ignore this debt of gratitude and the relationships will fracture.  This Filipino cultural value of financially supporting the Filipino family of origin is a big issue of marital conflict in a Filipino marriage and even more so if the Filipina is married to a Westerner who does not share that cultural value.

Here are some of the intercultural issues that I discuss in counselling Intercultural Couples:

• Punctuality
• Child rearing
• Organizational patterns
• Communication patterns
• Staple food preferences
• Personal Health Habits
• Ideas of loyalty
• Ways to ask and extend forgiveness
• Financial stability vs. Obligation to sharing financial resources to the extended family.
• Straightforwardness vs. Smooth Interpersonal Relationships (where it is ok to lie or make a cover-up story for the sake of saving someone from shame)
• The values of personal reward/enjoying the fruit of my labor vs.  The value of self-sacrifice for the sake of other’s happiness and well-being.
• Inner oriented vs. Other oriented (where I care so much about what people think or say, that most of what I do is motivated to do exactly what others expect of me or to prevent them from saying bad things about me)
• Personal responsibility vs. Group responsibility
• Respect as earned vs. Respect as ascribed (based on status)
• Group culture vs. Individualistic culture
• Nutritious diet vs. Cultural diet 

    The rising phenomenon of divorce is very alarming both in Christian and Non-Christian marriages.  The strength of society depends on the stability and emotional health of families.  A couple’s marital relationship deeply influences the couple’s emotional health and intimacy, as well as the self-esteem of their children.  When couples are in conflict, the children usually suffer as they are caught in the middle of warring parents.  When couples are unable to communicate about small annoyances, the frustration is usually repressed and eventually causes destructive emotional explosions or deep resentment expressed in passive aggressive tendencies.  The passive aggressive partner distances him or herself to avoid the struggles and pain of the relationship.  This will eventually lead to a loss of bonding in the relationship, which raises the risk of the partner seeking solace in an extramarital affair. 

    People do not get married hoping to divorce someday.  But when two people come together there is a great potential for conflict.  Conflict resolution and skillful communication are necessary in order to safely navigate these difficulties common to relationship.  Being married is one of the most difficult relationships, but it is also the most significant relationship where one can experience the deepest joy of what it means to be truly loved, cherished, and desired.  The marital vow provides boundaries and limits that protect the loving relationship, but often these boundaries are misunderstood and violated. 

    There are whole slew of marital issues that are common in both same-culture marriage and intercultural marriage.   Many divorced couples separated due to incompatibility.  That’s why instruments like PREPARE have been created to detect the differences between the prospective marriage partners in areas such as personality and personal values on finances, children, sex, and religious orientation (David Olson et al. 2000).  According to Gottman (1995) though compatibility is a significant issue in staying married, the most important thing is how the couple works out their differences.

Help Offered at Harner Marriage and Family Counseling Center:

Couples Counselling Intervention Program for engaged couples

For Pre-marital couples, I have designed a 10-session Counseling curriculum with specific inventories to identify major cultural value differences for discussion.   Even couples of the same culture find this enlightening and very helpful in preparation for their marriage. 

Couples Counselling Intervention Program for married couples

For Filipino, Chinese and intercultural couples I have developed a 10-session culturally relevant Couple’s Counselling Program.  This program has been particularly effective for a Filipina married to a foreigner here in the Philippines.  During the counselling, the couples develop their own goals and together we work toward achieving those goals.   The counselling sessions provide a place for the couple to look at the factors affecting their relationship:  hidden expectations, differing visions for their marriage, creating boundaries, unlearning bad relational habits, learning emotionally healthy skills and appropriate language for communication in intimate relationships.  In the end, the goal is to establish a new norm for the couple that will enhance intimacy and maintain strong attachment.  After the 10^th session the couples decide where they will continue the counselling or stop and evaluate the impact of session after few months.

Your Role in Making a Difficult Person Difficult - When Dealing with Your Difficult Person, Don’t Overfunction

This is part 2 in my review of John Townsend’s Handling Difficult People:  What to do when people try to push your buttons.

My wife asks me to cook for her, massage her, and fetch her a drink.  If I don’t do what she asks, she will sulk for days.  I am feeling used and manipulated to do what she wants.  I feel like I have no choice.  To keep the peace, I yield to her constant demands for my time to do things for her.  I am concerned that if I stop doing these little things for her, we will fight and she will keep me at a distance for too long.  I feel lonely and in pain.  She is too strong for me to stop.  I am thinking of our 4 kids. I don’t want them to be exposed to heated discussions, bickering, and my wife running away from home.

When you hear this story, you might feel pity for the person sharing their problem and feel irritated with the difficult person who is taking advantage of them.  We might see the person as a victim who has no option in the relationship.   We might see the difficult person as the whole problem.  However, the difficult behavior of the difficult person does not exist in a vacuum and we must consider the whole system of relationships in order to understand why the difficult person continues to behave in this way.  There are things that we do that will reinforce the difficult behavior.  Many times the difficult person has people in their lives that are very “caring” and “loving” toward them and willing to sacrifice for themselves for the difficult person.  But they are also afraid of conflict and not willing to confront the difficult person strongly and allow him or her to feel the true consequences of their behavior “because they care too much.” 

But the only way that the person will begin to change is feel those consequences, and feel them for a long time to the point where they realize they are no longer going to be rescued by that “caring” individual.  Difficult people will not change their behavior on their own out of a good heart.  So if they will not change, who will change?  Whoever is uncomfortable is the one that needs to change and must seek to create healthy space for himself or herself. 

So when the difficult person displays toxic behavior, instead of being caught in an ambush of her mood swings and feeling out of control and angry about yourself or feeling guilty for giving in when this difficult person displays her toxic behavior, you need to be able to be aware of the discomfort you are experiencing and evaluate the situation.  Difficult people have the tendency to push you until you break, then blame you for victimizing them.  This is their strategy to make you feel responsible for their problem by making you reap what you did not sow.   We feel manipulated, guilty, angry, helpless and hopeless to change our situation. 

We have proven many times that when we do things to pacify the situation, it does not yield a good and lasting change.  Many times in our feelings of helplessness we simply deny our reality and hope that the problem will simply go away.  We try to understand, cover up or even lie for them, hoping that they will see our effort and in turn, they will consider our feelings.  But when our hope does not come true, we get angry and threaten them or we completely give up on them.  By doing this, we become part of the problem.

Townsend gives very good advice in dealing with this kind of situation: 

1.  Identify your inability to separate yourself from this difficult person.  His thoughts, feelings, and actions are his.  Since it is his, he is completely responsible for it and completely in control of it.  You and he are completely different persons even if you are twins or he is your spouse.

2.  Pause for a moment; evaluate the situation; differentiate yourself; identify you goal; and plan your course of action.

 

3.  Take a specific behavior & examine it:  How severe is the problematic behavior? Then rate it. 

• Not very severe (annoying but not damaging and only occurs sometimes)
• Moderately severe (happens often causing prolonged chaos)
• Extremely severe and urgent (Infrequent but violent; or the person is enraged much of the time)

4.  Evaluate the person’s sense of personal responsibility.  Then rate it:

• Minimal problem – the person response accepts and change the behavior
• More serious problem – when the person accepts but makes excuses or minimizes it. 
• Severe problem – when the person is unaware and blames others.

5.  Be aware that there is a big difference between “I can’t” and “I won’t.”  Difficult people tend to confuse these.  They would say, “I can’t.” when they actually mean they won’t.

“I can’t” means the person really has no ability. 

“I won’t” means the person is simply resistant. 

6.  Empower them by teaching them what to do and how to do it once or twice.  Then let them do it themselves.  Be consistent and stand on your ground.  Do NOT do things for them because you are happy this time or because it makes them have a good attitude (That is manipulation and they will manipulate you back) Do not nag or remind the difficult person what to do – he knows what to do and how to do it right.  (You already showed him and taught him.  Also, he has already done it himself before when he was in the mood).

Examples: 

If your mother is staying in your house and constantly complains about your situation and change the way you run your house.  It is important that you consider the validity of her comments and concern.  She might be giving you better ideas about life and discipline.  Comparing you to your other siblings and accusing your husband of something he did not do is really not acceptable and must be confronted.  Be careful the way you do this because it will cause a heated argument.  This requires some communication skill and self-control not fall into the trap of guilt tripping.  Even when you approach it slowly difficult people has a hard-time accepting the possibility that they could be wrong….

If your 17-year-old daughter refuses to cook, then don’t cook for her so that she does not have a good cooked meal to eat.  If she did not clean her room, let her room stink.  Do not cover it up.  Do not be afraid of what other people say.  Do not clean it yourself or let the maid or helper clean for her. 

If your son is already 7 years old and refuses to feed himself, then let him go without eating.  When he is hungry, he will decide to feed himself.  (This is very common here in the Philippines because we spoon feed children even when they are older.) If he cries or pouts give him space for his emotion and let him deal with it.  But do not allow any tantrums or damaging of property. 

We might tend to nag because we believe that this difficult person needs to be reminded to do the right thing.  However the problem is, they don’t see what you are doing, instead they see you as controlling.  They may be reminded of an authority figure like their mom or dad that they did not function well with and regress into a childish state and rebel against your authority.  

Loving and enabling are not the same thing.  Love can be very kind and caring, but have zero tolerance toward irresponsibility, selfishness and manipulation.  On the other hand, enabling allows the person to get away with their misbehavior while protecting them from the pain that their misbehavior causes.  When you are enabling, you may do what they ask of you when you are in their presence, but deep inside you want them out of your life or may even have developed a hatred against them. 

The transformation of a difficult person requires the whole system to change.  It starts with you (the one who is bothered) restraining yourself from over-functioning and enabling their immature behavior.  When you choose to stop over-functioning, you will engage in a real battle for a while, but it is very important that you are consistent and do not over-function.  Instead allow this person to reap the consequence of his behavior.  The goal is not to punish them.  And you don’t want to quit on them.  Instead the goal is to help them develop a maturity that is appropriate for their age and expected developmental tasks.  If you over-function for them, you will cripple them and set them up for failure. 

For example:  A parent may really value the education of their child.  The parent always helps with homework and sometimes ends up taking over.  The student gets good grades on his projects, but is not learning how to be a good student.  When the students goes away to college, he may not have the perseverance necessary to finish difficult assignments because he never hard to before. 

In short, it takes a lot of hard-work and self-discipline to restrain yourself.  Be committed that you will not be a part of problem by separating yourself and holding this difficult person accountable to choose good behavior.  It is a temptation to jump back into the cycle when they are showing progress because you think the problem is over now.  Be sure to find ways to reward them fully with praise, appreciation and encouragement, but DO NOT begin to take on their responsibility again (this would sabotage their recovery).  This kind of discipline will bring about emotional health, personal growth and maturity.  If they are less than 18 years old, it is your responsibility to make them follow your household rules and the order of your home.  If they are above 18, they are already capable of feeding and supporting themselves and they can live on their own and have their own personal rules if they do not want to abide by your rules.

To be gracious and kind is what we desire, so as we wait and expect this difficult person to change we also provide space, time, and more affirmation when they achieve the desired behaviors.