Therapist Tips

IMG_1400Vincent Fitzgerald,
NFSB Clinician, MSW Fordham University, LCSW, is a member of the mental health community for 20 years during which he has worked with the mentally ill/chemically addicted (MICA) population, served as a school social worker, and psychiatric screener/mobile crisis outreach worker.

Therapist Viewpoint For The Holidays – Relationship Triangles and Defining A Self

(Originally posted on
Thanksgiving is often idealized as an occasion during which family and friends gather around an outsized meal, and give thanks for health, achievements, and each other, but for some families, members wait until the end of the night when they can give thanks for getting away from each other and old familial tensions. It’s no secret holidays can resurrect old dysfunction, regress individuals to familiar roles, and create anxiety. Although I wasn’t surprised when these phenomena appeared at a Thanksgiving hosted by my youngest brother, I was surprised their catalyst was my foray into turkey carving.

I had never been one to embrace patriarchal tradition, but I was honored when Brian allowed me to carve our turkey as a guest in his home. Because anxiety is woven into my DNA, much of which is rooted in fear of my father’s criticism, his eyes weighed heavy on me the moment I accepted the knife from my brother. Although I am 49 years-old, educated, and somewhat successful, my childhood need for my father’s approval resurfaced, and I believed I could somehow fail at the menial task of slicing meat.

One of the patterns in my family is our tendency to launch derisive comments at each other in an attempt at humor. Ironically, as much as we all like to cut each other up, we are all highly sensitive to derision, and only recently have I understood my attempts at humor often came at the expense of someone’s feelings. Because Brian is aware of my sensitivity, he instinctively aligned with me, and walked me through the steps of turkey carving, rooting me on with every slice, and unbeknownst to him, becoming the third member of a triangle.

In Bowen theory, a triangle is the smallest stable relationship system. Triangles consists of three people, one of whom either jumps in, or is incorporated by a member of the previously existing dyad to ease tension transmitted between my father and me. It was not rooted in malice, just a perpetuation of my childhood need for approval, and my dad’s desire to feel his own elevated sense of importance. As I work towards defining a self, resolving this attachment issue with my father will liberate me from tension born of misconceptions of myself as solely an extension of him. Brian’s anxiety stemmed from fear of conflict in his home during Thanksgiving, and motivated him to insulate me, and his guests from tension.

Triangles typically consist of two insiders and one outsider who craves connection to the insiders. In our case, Brian and I held the inside positions while our father lingered outside. Tension was transmitted through the triangle as my father’s anxiety about diminished physical skills morphed into criticism of me, my fear of being scrutinized was transmitted to Brian through his awareness of my sensitivity, and Brian’s anxiety about tension was transmitted throughout the room through his reassurances of me in preservation of holiday harmony.

My father sensed some struggle when I slammed into a stubborn breast bone, and bellowed, “I see you’re having a hard time there, Vin.” When it comes to my dad, it’s not his words, but his tone that triggers my anxiety. When Brian heard this, he jumped in on my behalf and reassured the room I was doing fine, and anyone’s first time carving a turkey could be daunting. In that moment he stabilized the relationship between me and my dad by absorbing the tension, but if change was going to happen, I needed to temper my reactivity to perceived criticism, not cave to scrutiny, and not allow someone else to bail me out by surrendering the knife.

A cornerstone of defining a self is not allowing tension in the moment to create an imbalance between emotional reactivity and thoughtful response, as people function optimally when feeling and thought are balanced. With that in mind I acknowledged my struggle, and carved the bird to completion. Later on, my 75 year-old father who struggles with pain, fought to get a knife through a chocolate cake. A less mature version of myself would have sought revenge by underscoring his challenge, but only through allowing the moment to pass would change occur.

When I was finished, Brian congratulated me as if the turkey and I got engaged, and we sat to eat. When I reflect on defining a self, I acknowledge there was a time when I might have held a grudge against my father for perceived ridicule, or would have evened the score with him through some kind of verbal retaliation. Having done so would not only have laid unfair blame on my father for a generations old pattern of derision, but would have sullied the fact that he complimented me on Facebook the next day, a validation that might seem trite to some, but meant everything to me.

It is too often the case family gatherings are strained by emotional reactivity in place of thoughtful response. Such reactivity will taint family gatherings, and are hard behaviors to shake, but they are a matter of choice. In the face of old family patterns, we can choose to allow our defensiveness to rule, or we can think the problem through, and give a response that is neutral, and more likely to extinguish a spark before it becomes a brush fire.

If this sounds challenging, it’s because it is, but the fact that something is a challenge does not mean it’s impossible. Any shift in family dynamics begins with one person’s willingness to change a behavior. When ground is stuck, and efforts are consistent, the rest of the family tends to fall in line, and new dynamics are born.

Think about your own family gatherings this holiday season; try to be aware of triangles, your emotional reactivity, and the reactivity of others, and see if you can be the person in your family whose thoughtful response in the face of stress eases tension, and moves your family toward change, growth, and emotional maturity.

IMG_1400Vincent Fitzgerald,
NFSB Clinician, MSW Fordham University, LCSW, is a member of the mental health community for 20 years during which he has worked with the mentally ill/chemically addicted (MICA) population, served as a school social worker, and psychiatric screener/mobile crisis outreach worker.

The Deaths of Kate Spade and Anthony Bourdain Remind Us Hopelessness Disregards Wealth and Fame

(Originally posted on TapInto Nutley)
When Anthony Bourdain died by suicide three days after Kate Spade, I read social media grumblings by people insulted the rich and famous would choose to “leave it all behind,” and I was reminded we often confuse affording anything with having everything. Perhaps we believe money and fame overpowers loss and hopelessness, when in truth, hopelessness shrugs at fame, and spits in the face of wealth. Scarier still, maybe we remain imbued with belief suicide indicates weakness.

Aside from professional experience, I have had personal struggles with depression and agoraphobia. Hopelessness permeated at times, as did vague thoughts about the option of death, but I was never touched by despair that divides those who commit suicide from those who don’t.

Whether acute or chronic, hopelessness is indiscriminate in choice of victim, and celebrities whose hopelessness leads to attempted suicide are not weak or ungrateful. They have endured biological sickness that assaults thoughts the way diabetes attacks insulin production. I have yet to read about celebrities whose wealth and fame cured their diabetes.

Though separated from Spade and Bourdain by economics, we share human capacity for emotional pain. The wealthy experience lost love and personal failure like all others. How foolish are we to suggest wealth and fame heals profound emotional pain.

While severe depression drains hope from people suffering from stress both acute and chronic, other sufferers are clueless as to the source of their pain. The unfair facts of depression are that it need not be circumstantial, and while stress serves to amplify, fortune offers no abatement.

To assume wealth could insulate Kate Spade and Anthony Bourdain from hopelessness minimizes the gravitas of mental illness, and perpetuates an awful stigma that suicide is about weakness. To believe such fallacy serves only to perpetuate passivity toward the suffering. Suicide is the only cause of death in the top ten with annual increases, and we must all do what we can to ensure passivity allows no one to fall through cracks.

If you know anyone who even vaguely mentions suicide, stay connected, have local police conduct a wellness visit, or call your local psychiatric screening center. When crisis abates, you may also remember Nutley Family Service Bureau houses a team of therapists and a supportive admin staff ready to help any person who desires high quality psychotherapy.

IMG_1400Vincent Fitzgerald,
NFSB Clinician, MSW Fordham University, LCSW, is a member of the mental health community for 20 years during which he has worked with the mentally ill/chemically addicted (MICA) population, served as a school social worker, and psychiatric screener/mobile crisis outreach worker.

Why “CAN’T” is Not Allowed in My Therapy Room

(Originally posted on TapInto Nutley)
Many of us enter therapy struggling with external locus of control. We blame partners for dysfunctional relationships, accuse the universe of conspiring against us, or suggest demons assume command of our behavior. When these premises arise in therapy, I strive to help clients accept responsibility for their behaviors. Finding the word “Can’t” most often used by clients to avoid responsibility for undesirable behavior, I now seldom accept it in treatment.

A client with whom I have a deep relationship recently demanded she“Can’t” stop her binge/purge cycle. In prior sessions, I sympathized with her perceived powerlessness while we resolved childhood trauma, and disproved negative self-perceptions. Although she had gained insight, her bingeing endured, replacing relationships, and serving as a conduit to self-loathing. It was then I made the radical choice to put “Can’t” under a microscope. Hoping to underscore choice, and awaken her latent ability to be self-guided, I suggested she replace “can’t” with won’t.

When she denied bingeing was a choice, I suggested it must then be true she was also not responsible for several previous stints of remission. Because she was unwilling to credit another entity for her choice to periodically cease bingeing, she accepted responsibility for the choice to engage in such behavior, and an in-road was made.

The removal of can’t is also useful in couples therapy where blame fills the room. It always shocks each individual when I underscore their own contributions to the dysfunctional dynamic. When I suggest alternative courses of action, “I can’t”! is a frequent response, but I am quick to suggest the removal of can’t, and subsequent insertion of “won’t.” Once personal responsibility is acknowledged, change becomes possible.

We are often tempted to perceive our own actions as beyond our control, but such surrender of our will perpetuates behaviors sure to stunt progress, and hinder growth. Consider this a challenge to replacecan’t with won’t, and assess how it feels to accept responsibility, and regain control. In the end, we are the authors of our own narratives, and are the only creatures on Earth with the ability to change our circumstances through force of will.

Ann GoldsteinAnn Goldstein,
LCSW, Nutley Family Service Bureau therapist, holds a post-graduate certificate from Fordham University in Child and Adolescent Therapy.

What to Say to Children When They Are Anxious

Anxiety has a way of making everyone feel helpless – the ones in the midst of an anxiety attack as well as the ones beside them who would do anything to make it better. It’s difficult to know exactly what to do when your little person is flooded with anxiety. Different things will work for different people, so don’t be afraid to experiment with what works best. READ FULL ARTICLE from “Hey Sigmund” by Karen Young.

NFSB offers Play Therapy for children working towards better socio-behavioral interactions, emotional regulation, and trauma resolution. The therapeutic model uses toys, art supplies, and games to elicit children’s thoughts and feelings. It is available to the youngest of children and provided by our staff specialist in child therapy, Ann Goldstien MSW, LCSW in conjunction with the family’s primary therapist to ensure an integrated healing process for all family members involved

Tricia Politi,Tricia Politi
LCSW, Nutley Family Service Bureau therapist, is also a wife, mother, daughter, sibling, friend and volunteer.

Happy New Year: Investment Strategies for 2017

For the year ahead, resolve to focus your time and energy in the following three investment strategies, which will pay off all year long:

Invest in yourself. Investing in yourself does not require a financial commitment, but rather is an act of love and self-care. Set aside time to do something that inspires you. Pursue an outlet that will bring meaning to your life. Say no to requests and demands on your time that leave you feeling depleted. If you want to make a major change in your life, break the process down into manageable steps and be patient with yourself as you make progress toward your goal. Forgive yourself when you encounter setbacks. Allow yourself to experience the journey with as much peacefulness as possible. Speak to yourself with the same loving words you would use with the person you care about most.

Invest in others. When the problems of the world seem too overwhelming, “double -down” on the people and relationships in your life that matter most to you. While it is impossible to shut out the often-harsh realities of modern life, instead of giving up, invest your time and energies on those you love and care about. If you have fallen out of touch with a friend, reach out and reconnect. If you are holding onto negative feelings with someone, find it in yourself to forgive and move ahead with a more positive attitude. No one has ever said, “I wish I had fewer friends!” Invest in your community. While we may feel powerless to effect change in the world, the place where we can make a significant difference is in our communities. Whether it is by volunteering at a soup kitchen, food pantry, or thrift shop, or fundraising for a local charity, or simply by routinely responding with kindness to those who are struggling – we can make a significant impact in the lives of our neighbors.

Investing in community, not only benefits others, but is good on a personal level as well because it creates empowerment. When we feel empowered, we cannot help but feel good. When we feel good about ourselves, we feel hopeful. When we have hope, wider horizons open to us.

By investing in ourselves, in others, and in our communities, we create meaning in our lives and make sense of the world around us. These investments can yield long term dividends if internalized and maintained throughout one’s life!


Holidays Stress

5 Tips To Reduce Stress During The Holidays
Family, friends, fun, and food: holidays can be the best of times. But they’re also stressful times, full of demands and deadlines. Here are 5 tips to help reduce stress during the holiday season and throughout the year from our clinicians at NFSB.

Couples Meditation Workshop

5 Questions To Ask If Someone You Know Expresses Suicidal Ideation
No expression of suicidality is to be underestimated. I served two of my 20 years in mental health as a psychiatric screener for a major New Jersey hospital where I gained experience and insight too valuable to not share with as many people as I can. In those two years I interviewed many people in the throes of anxiety, depression, and suicidality. Our lives intersected on their worst day, and my charge was to discern if they met the legal definition of mental illness.

Five Signs You Have Developed Panic Disorder
Panic launches relentless attacks on both mind and body. Anyone who has ever experienced such an assault is familiar with shallow breathing, nausea, sweating, rapid heart rate, and lesser known symptoms like derealization and depersonalization. Once symptoms subside, sufferers are exhausted, and require significant recovery time. Such is the result of our own bodies poisoning us with adrenaline for reasons known only to itself. Some people might experience an attack or maybe even two, and then never again feel consumed by dread and imminence of death, but others are not so fortunate. Those people whose brains are tattooed by panic attack experience life altering effects.