healthy relationships

Becoming Accountable – Exercise

To begin the process of Taking Accountability for an addiction there are some specific and concrete methods in getting there. An individual can begin by writing a complete “Personal Use History” through documenting impact statements for each age range and each major life area (MLA). MLA’s include family, friends, work /school, financial, legal, physical, psychological/emotional, and spiritual.

Appropriate age-range parameters could include 10-16, 17-20, 21-30, 31-40, 41-50, 51-60, and 61-70. As such, you would have a statement for every age range as it relates to every MLA. This exercise will produce a very clear impact analysis, which permits an individual to see this disorder in its entirety versus small “justifiable” events.

A relationship with substance use may go back a long time. Learning how substances fit into someone’s life can help. In addition to a “Personal Use History”, an individual can take time to write about their answers to the following:

1. What do you notice about how substance use affects you?
2. What will it take you to learn to live without substances?
3. How much is substance use a part of your family and lifestyle?
4. How often do you use substances to celebrate?
5. How often do you use substances to cope with negative feelings?
6. How often do you use substances to provide a sense of belonging (e.g. in a social gathering)?
7. When did you begin using? What did it mean to you then? What does it mean to you now?
8. How could stopping substances change your work performance or work patterns?
9. If you stopped, what things would you have that you do not have now?
10. How do you think you would feel if you were not depending on substances?
11. What relationships might you have or might you improve if you were not using?

Answers to these questions and others engage an addict in a manner that is unfamiliar to most— seeing the totality of their behavior and actions. Addicts are very good at rationalizing and justifying events as one-offs; it is when they explore the whole picture that this exercise in rationalization becomes extremely difficult to perform.


Accountability – Case Example

John came to see me after a referral from his workplace. While assessing John, it became clear that he was over-complaint to this process for someone who was attending an assessment under duress. However this behavioral stance became clearer as our time together passed; he had believed that there would be no other diagnosis then someone who had made “one bad” decision and thus clearly non-dependent. He additionally believed that he could convince me of this belief and that we would spend a pleasant two-hours together. However, things altered at about the 1.5-hour mark when it was clear that this man was experiencing a full-blown dependency disorder that would require intensive treatment. At this point, he became agitated and stated that he would launch a full formal complaint with both his company and my professional association regarding such egregious conduct on my part. In exploring options within his company, he discovered that the assessment recommendations would stand and that he was provided with an option to follow these or seek other employment. To say the least he was appalled at the company’s decision in not providing greater support to one of their most senior employees.

Regardless of his disdain for the process, John contacted an inpatient treatment facility and began the process of following the recommendations as identified in the assessment process. When he entered treatment, he was very clear with the staff that he was there against his better judgment but was required to complete this for his employer; this stance was met with an immediate discharge, as the treatment facility will not admit people who do not believe they have a problem. John was now in a bit of a conundrum as he needed treatment to keep his job yet he had already told the treatment team that he did not believe he had a problem and he had further complained about my professionalism to anyone who was within ear shot for over a week (this information always has a funny way of making it back). Now backed into a corner, he called my office to see if he could have another appointment–which was immediately granted. He was surprised that I was willing to see him again after his original conduct. I informed him that I had seen this type of reaction many times over the course of my career and did not take it personal in any manner.

His first focus in the session was on the unprofessional conduct of the treatment team that discharged him and how they needed to be “as understanding as I was”. John was again under the belief that his smooth talking complimentary behaviour was fooling everyone around him until I brought forward the comments made about me just a few short days earlier that were now being directed at the treatment team and I enquired as to who would be the next focus of his attacks. It become evident that John did not believe he had a problem and that everyone else was accountable for why his life was as miserable as it was… including everyone now trying to assist him. He was looking for someone who would respond negatively to his criticisms as an excuse to state that he made every attempt but he was turned away at every opportunity for care. To disprove this stance I was able to work with the treatment team to have him fast-tracked into the system in order to clearly display everyone’s willingness to assist him and that should this go sideways it would be due to his own decision-making.

John eventually completed his care; he even stayed longer than required in inpatient treatment as he discovered that his problems were much more significant then he would originally explore. A year to the date of his entry into treatment John called me and asked if he could come see me again which of course I obliged. He needed to see me face-face to thank me for “sticking” in with him through the insults, the complaints, and the bad-mouthing of my professionalism. I state this not as a pat on my own back but to show that when we work with the addict initial accountability is often elusive and we must see their story in the bigger picture if we are to help. Here is a man that was now over a year abstinent from mood-altering substances who when he first sought care did everything in his power to avoid that admittance and hoped to accomplish this by distancing the very people that could help him. I was not going to be just another justification in his long history of addiction!


Communication Skills

Communication skills are essential to healthy relationships!

That may seem like an obvious statement however, the number of relationships where this actually exists is rather limiting; follow along this week so you can decide whether your relationships have a healthy style or some unique variation upon this key skill set. For many of us we communicate based upon the stylings of our parental role models (some of you just began to worry a little, I know). Very few people will actually take a course in their lifetime related to healthy communication patterns and so we are left to the functionality or lack thereof from those early exposed models. If you came from a healthy communicative environment this is less of an issue as long as your friends and partner additionally had access to this type of style as it takes two to perform this intricate dance.

I remember hearing in a class back in my under-grad years on communication that “you cannot not communicate” (and not because it is a double negative). That statement stayed with me–we are always communicating! Our very existence is a form of communication; however, I will avoid the existential discussion surrounding this concept. I will instead focus upon the concrete examples of how this unfolds. When we enter a room with others present, we begin communication with our very body language–are we smiling, frowning, walking fast, looking up/down, etc. Our body language is essential to the communication process; what we do not verbally say will matter more to others than what we do say (I will illustrate this more later). When we open our mouths to talk, our speech is influenced by tone, pitch, intonation, and of course, the words that we choose to utilize in the discussion.

A portion of good communication centers upon these two areas (non-verbal and verbal) complimenting each other. Good communicators will intentionally make efforts to ensure that their verbal communication lines up with their non-verbal messaging. If you are angry yet you say to someone “I am not angry” whilst pounding your fist on a table which message do you think they will believe. This is but one example of where body language over-rules verbal messaging. Communication is a complex process of interpreting and re-interpreting the features contributing to the process. On a day-to-day basis, we generally perform this dance without a thought and without a glitch quite easily. This is because we typically allow others a large area of interpretation. Where it often becomes problematic is when the issue being discussed is important to both parties and where two people are operating from differing communication platforms. Later in the week, I will explore healthy communication platforms. For today, pay attention to the complexities of verbal and non-verbal messages in others and in yourself, you may find the “dance” more interesting.


Communiciation Skills: Talking

Research studies in the area of separation/divorce used to report that the major causes for divorce were money, sex, and issues with respect to children. What has become clearer is that those issues are simply “life” happening and the bigger issue is the way people deal with those concerns, often from a communicative stance. Our last blog left off on the requirement that it takes two to come to this “dance” we call communication. I would go further to state that it also takes two with the same rules or “playing field” for this process to be healthy. I have witnessed some very impressive communicators over the course of my career and one of the things I have discovered is that two people well trained in communication will experience similar issues to those with no training if they are operating from differing stances. It is important that couples communicate from the same framework to avoid escalation of conflict simply because of process issues.

Here is a framework for healthy communication–all messages need to contain the following pieces of information; Sensing Information(the facts of the event or issue), Meaning Information (our interpretation of those facts), Feeling Information (how we feel about the facts and our meaning), Consequential Information (what has been the consequence to us as a result of the issue), andBehavioral Information (what are we willing to do different or what are we requesting our partner do different because of this issue).

Example–I have asked you to talk to me about the kids before changing our rules (sensing). Since this did not occur, I question whether you are still interested in doing it (meaning), and I am frustrated (feeling) having to ask for this to occur again. The kids rarely take me seriously as a result (consequence), so I would like to see this pattern change as we move forward (behavioral consequence).

In the above example, there is limited room for the other person to misunderstand what the concern is and what is being requested as a result. This is one part to better communication–reducing miscommunication.

Here are some additional methods to improve your communication patterns;
• Think before you speak
• Check your non-verbal behavior
• Use “I” statements
• Seek to preserve the other person’s dignity
• Face the person you are speaking to squarely
• Maintain frequent but not fixed eye contact
• Nod your head to indicate you are listening to the other person
• Keep an open body stance or position
• Lean slightly forward
• Listen and watch for their non-verbal cues
• Become aware of your own biases with respect to statements, phrases, words, etc.
• Increase your vocabulary
• Above all, ask for clarification throughout the communication exchange

The next blog will explore the other key feature to communication—Listening!!


Being ‘Other Centred’

Our last discussion was on “spending time together”; this is a key ingredient to developing intimacy with one another. In the vast majority of assessments that I conduct with couples a common theme is related to men wanting more sex and women wanting to be loved. This confuses most males as they believe and associate sex as being synonymous with love and cannot understand why if their partners want more love yet they turn down sex! I will come back to this point.

There is a simplistic way that both sides can win in this issue. I will start with males; let me be very clear…if you do not spend time with your partner yet expect her to have sex with you, it is NOT going to happen. Women, if your spouse is meeting your needs (which I will speak to on how) and actively engaged in the relationship, sex is not a punishment tool…if you have an issue with your spouses behavior use good communication and conflict resolution skills to resolve these versus withholding sex.

Once you have re-engaged spending time together, the next hurdle is meeting each other’s needs in meaningful ways. Relationships’ cannot have true intimacy without the needs being met within the relationship–intimacy be it sexual, physical, emotional, spiritual, or intellectual is driven by people who understand and meet the needs of their partner. One way to accomplish the task is to simply ask! So many couples somehow believe that their partner should just be able to know what their needs are and will go years’ not telling them…this somehow does not make sense.

There are two ways to meet the needs of your partner and both are important. The first is becoming “other centered”. The best way to explain this concept goes back to the start of your relationship; if you reflect upon this time period, both of you spent an inordinate amount of time thinking about, talking about, and actively doing “nice” things for each other. You likely drove your friends and family nuts with all your talk about this new person–they likely didn’t want to hear their name again in any context or sentence because of how driven you were to focus upon this individual. If you think about where you are now in your relationship, when was the last time you spoke kindly about your partner? Interesting isn’t it?

To become “other centered” you need to answer and act upon one simply question everyday of your life–“what could I do today that would make my partners life better”? Then do it! You need to re-engage that behavior that says he or she is important to me and I am going to show it. This does not have to be “big” things; in fact, it should be the everyday small things that are attended to here. Our society has gone overboard on the concept of co-dependent relationships to the degree that if someone is “other centered” they are labeled as co-dependent–there is a huge difference between these two relational positions. Another part to being “other centered” is to make important decisions with your partner and imagine they can see everything you can do–would you still be doing it; if the answer is no, then stop it!

Somewhere in your relationship you likely went from asking, “What can I do for this person” to “What am I getting out of being here”—the day those questions switched is the day you began to grow apart and not together anymore. A healthy relationship is inter-dependentand a piece to this is treating your partner in ways that show they are important to you. More to come….


Focus Upon Needs

Today we will explore the second key task to meeting needs and thus intimacy development. We all have needs for love, respect, appreciation, acknowledgment, trust, safety, etc. Some of these needs overlap in their behavioral definitions. It is also important to highlight that these needs change over time; what was important in your 20’s changes in your 30’s, 40’s and onwards. Unfortunately, some people feel they are doing a great job meeting needs because they continue to act on old information; this is where telling your partner what you need will become critical. This exercise should be re-examined every five years.

Another important note is, do not do this exercise if you have no intent on following through; it sends a weird message if there is no follow through—“I now know what you need, I’m just not going to provide it”!

The exercise is this—take each area identified above and others that you would have and list at least three things (more if you have them) that if your partner did these things it would elicit the need identified.


• Bring home flowers
• Verbally tell me you love me
• Spend 30 minutes with me; just listening to my day

• Say thank you for the things I do-work, taking the kids places, etc
• Take over one of my typical house tasks and do it once in a while for me
• Cook me dinner

Let me be very clear, this list is not meant to be a demands list; it is a list that allows a partner the inside information on what they can do to meet your needs in a meaningful way. They may not be able to do everything on the list, which is why you were asked to provide three options under each area. Once you have the list, do not let a month pass where you have not attended to a few items off these lists.

I will now return to the statement I made in blog two related to this area; “This confuses most males as they believe and associate sex as being synonymous with love and cannot understand why if their partners want more love yet they turn down sex!”…. for most people sex is often an extension of intimacy and not the other way around. If people attend to the needs in the relationship, it will increase intimacy and thus sex.

Couples that meet each other’s needs have higher than average levels of intimacy across all the major areas; physical, sexual, emotional, spiritual, and intellectual. The greater the degree of intimacy the more connected a couple becomes.

To recap; the three key areas to relationships include spending meaningful fun interactive time together, being “other-centered”, and meeting each other’s needs in meaningful ways.

A note to this area that you may want to be attentive to is that females typically have a greater attention to needs for love and males typically have a higher degree of attention to their needs for respect. In other words, males should pay particular attention to their partners needs in the Love area and females should pay particular attention to their partners needs in the Respect area. In one piece of research performed, participants were asked, “if you were on an island what would you prefer–to be surrounded by many people who loved you but didn’t respect you or would you rather be alone”…men chose “be alone”! Whereas the women were ok in being with a group of people who loved them, even if they were not respected by them.


Lust and Attraction

As we enter the month of March, we begin our approach into Springtime—a time of endings and new beginnings. Many associate “Romantic Love” with springtime. Over the next few weeks, we will explore the many facets of “Romantic Love” and relationships including additional happenings like marriage, affairs, separation, and divorce. We have already covered areas associated with Healthy Relationships like being ‘Other Centered’ and methods for improved ‘Communication & Conflict Resolution’ styles—but we will back up a bit here into how/why we have relationships in the first place and what these have to do with Love.

Love is a concept/emotion that almost holds as many experiences and descriptors as there are people. Those that have studied love find this elusive experience very difficult to nail down; I believe part of the reason is the very personal nature to love. Love is akin to a spiritual experience; it is not something that can be imparted to others it can only be experienced and only within that experience can it be discussed…in other words only those that have been “in love” can discuss this with another as it is only understood at an experiential level. Another way to explain this is that a person that has never been in love would not be able to comprehend a description of love—for words alone cannot describe love—albeit that many a great poet has done an exceptional job at creating this image. Secondly, within love, there is both experience and learning. Those who have experienced love are able to comprehend another’s experience of love even though it is likely vastly different. Finally, it cannot be willed but we can be open to the experience and place ourselves in environments where it could be attained.

For most, love only occurs after a period of “attraction/lust”—as love is the deeper experience that envelopes care, concern, and true desire—all of which require time for development. Attraction/lust can be of a physical, psychological, emotional, and/or intellectual nature; however, most of us focus upon the physical piece as the main prerequisite to Romantic Love. Therefore, we can have “Lust” at first sight but not “Love” at first sight. Here is where the first problem can present for some people; they are unable to distinguish the difference between “true love” and “attraction/lust”. The state of attraction/lust has been shown through research to carry actual physical alterations within the human body—this is what drives that increase in energy, that overwhelming positive attitude (which sometimes blocks the true negatives about a prospective partner; lust is truly blind but not love), that non-sensible rambling that occurs related to the other person, and the incessant desire to see the other person 24 hours a day! “Lust” can last months to even a few years, which for those mistaking this feeling for love will find that it wanes at some point, and thus they end the relationship because they believe that they have “fallen out of love”. They were never “in love” to “fall out of it”…they base relationships on the shallow experiences of “lust”. True love goes beyond chemical bodily changes and immature evaluations of another person to extend into care, concern, and a true and complete desire for another person that allows for imperfection and celebrates difference.

In true love a couple is passionate for the other, has intimacy (physical, emotional, psychological, intellectual, and spiritual) based upon the meeting of real needs, and is committed to the relationship. Even these terms are often misunderstood, which is likely why we still have a 50% divorce rate—people do not really know what the terms passion, intimacy and commitment involve. Next time we will focus upon the features to true love.


Mature Love

“Mature Love” is based upon a number of features; as we explored in the last blog, love has the features of being passionate for the other, has intimacy (physical, emotional, psychological, intellectual, and spiritual) based upon the meeting of real needs, and is committed to the relationship. What does all of this really mean?

To start with, couples that are passionate for each other discover that there is a shared emotionality of desire and interest in the other’s life.Passion is not simply a physical desire state; it includes physicality but is much larger than just “sex”. Passion is that deep-rooted emotional bonding that also brings forward a desire to be assisting in another’s development and their general well-being. Because it is an emotion, it is prone to ebbs— however, it never departs completely. Similarly, love as an emotion does not exist at a constant sustainable level for people—the type of emotional experience that one has in their phase of “lust/attraction” (if this is where they first discover that they “love” the other person) is likely to be at a heightened level. These levels will be in a constant state of flux over the course of a long-term relationship and this is normative which is why healthy relationships are based upon other features beyond emotional bonds.

Secondly, mature love consists of features of true intimacy. Intimacy is achieved through the action of meeting real needs in another’s life. Intimacy is not just having sex as some believe; it is an action requirement that means an individual is invested in knowing and then meeting the real needs of their partner across the realms of acknowledgement, safety, love, respect, appreciation, loyalty, etc—it is these actions that contribute to the various forms of intimacy (physical, psychological, emotional, intellectual, and spiritual).

The final piece to mature love is commitment. Here is where so many relationships fall short; part of the rationale for this is the limited understanding of what true commitment really means. I believe some of this is related to developmental realities in that young adults are generally not matured enough to “really” understand this concept which has been significantly influenced through societal stances with respect to delay of gratification and living in a disposable world. Many individuals are meaningfully influenced to believe that as soon as there is not enough in the relationship for them that it is time to depart. This is not to say that one should remain in a situation that is abusive or clearly one-sided over the long-term; however, it is also important to note that in long-standing relationships there is a 50-50 contribution that only occurs over time and rarely equitable at the same time. Immaturity demands instant gratification with limited tolerance for shortages and it is about “me”! A common thread to the many couples I see in psychotherapy is the internal messaging that begins (at the onset of the relationship) with “What can I do for this other person” which at some point changes to “What am I getting out of this relationship”? As soon as one begins to internally (or for some externally) message “What am I getting out of this relationship” they stop looking for ways to contribute and thus reduce their commitment levels in being in the relationship. Next time we will examine healthy commitment inclusive of “when is enough—enough” or alternatively “when do we put in 100% to keep this sustainable”?


Healthy Commitment

Healthy commitment in relationships embodies a number of areas and concepts. A few things about commitment are…

  • It is an action behavior based upon solid cognitive choice making: this implies that a person fully analyzes the relationship and the investability into said relationship. A healthy person will examine where their functioning is at and the functionality of the other person with respect to health and desirability across major life areas; physical health/appeal, emotional functioning, intellectual abilities, career and financial functioning and goals, spiritual belief systems, and psychological status in making a decision related to long-term commitment. We all evaluate prospective partners upon relationship inception; the difference is that the healthy person will do this in a meaningful and organized fashion. For the most part people end up in relationships with similar functioning partners; e.g., healthy people do not commit to unhealthy individuals.
  • It understands that emotion is ever changing and ever evolving: emotions do not drive decisions for healthy people; they understand the fluidity of emotion and thus make decisions based upon true realities and behavioral displays. One of the best books that I have come across in my career is “Love is Never Enough” (see links button for more info). In summation, this book explores many of the other key components to healthy relationships including good selection, communication/ conflict resolution skills, and general relational health.
  • It stands steady in difficult times and evaluates along the way: this implies that healthy people do not throw in the towel in difficult times. They work through the difficulties and re-evaluate once issues are resolved or at least negotiated to a place of stability.
  • It does not institute impulsively: healthy people do not make decisions of a commitment nature (moving in, marriage, having children, etc) without thorough analysis and processing.

Some of the more unhealthy things that I have seen over the course of my career include…

  • Couples deciding to move in together after only knowing each other for a few weeks (you would be surprised at how many times I have seen this occur)
  • Couples that decide to have children as a means of repairing a problematic relationship (children are a blessing but they are also a stress; to a dysfunctional relationship they can take the stress point to a heightened degree).
  • Couples that access counseling one month into their “dating” relationship…if you need relationship counseling that soon into dating—it’s broken; get individual counseling to be a better partner and once you are in a healthier place re-enter the dating world.
  • Couples that get married to repair a broken dating or common-law relationship; marriage should be a celebration of two becoming one not a tool for reparation.
  • Individuals that go into commitments believing that they can change the other person and then everything will be all right.
  • Relationships that initiate based upon an affair; this has been shown to be very dysfunctional as the relationship begins upon a foundation of disloyalty and deceit.

Next week we will explore the dynamics to marriage; the culmination of ultimate commitment and the full expression of Love.


Today’s Marriages

We will begin this week looking at marriage—the history, some of the current realities, and the components needed to have the best chance at marriage being successful. Marriage is a term that goes well beyond the space that we have here for a full commentary; as such, we will be looking at a very small and culturally influenced perspective on this area.

From a historical perspective I have always found it interesting that when marriage first initiated as an institution the life expectancy levels were somewhere in the area of 35 years old—so the “till death do you part” really wasn’t likely to be a long time! Albeit that people were married at younger ages, it still was not likely to be a 60-year union. I bring this up as it relates to commitment (the topic addressed last week). Even a bad marriage could be tolerated for these lengths of time—however, with today’s current life expectancy rates, a bad marriage would be akin to a prison sentence if issues are not resolvable; all the more reason to select well, keep working on it, and understand the appropriate concepts of negotiation and acceptable compromise.

The place where we start with marriage is where we left off last week—commitment. Last week four premises were offered up in relation to what commitment is… It is an action behavior based upon solid cognitive choice making, it understands that emotion is ever changing and ever evolving, it stands steady in difficult times and evaluates along the way, and it does not institute impulsively.

Where the first roadblock presents with respect to marriage is in the area of maturation and development; in today’s environment of lengthy life spans, unfortunately many young people are not fully cognizant to the understanding of what this commitment really means. Since the 60’s I believe we have lived in a world that is much more selfishly focused, things are more disposable, and youth mature at a slower rate due to our attentions to the developmental phase of adolescence. These combinations and others have contributed significantly to an escalating divorce rate. Where people would have struggled and potentially worked through difficult times as a part of their relationship many today throw in the towel and look to start over believing next time it will be better—even though second marriages have a higher divorce rate than first marriages. These comments are based upon the belief that we are talking about reasonably equitable dysfunctional relationships not those where pervasive abuse is a feature. Where patterns of abuse exist, I can fully comprehend the rationale for separation/divorce. What I am referring to above is your garden-variety dysfunctional relationship that through some meaningful work could be agreeable to alteration and thus functionality and health; however, people are walking out before they even explore an option for resolution because “it’s too much work”, “I don’t love them”, “my life is no fun anymore”, and on and on infinitum. What these comments amount to is that this is solely about self (what am I getting out of being here), commitment is too much work (I did not know this would be work), and it is easy to dispose of this and just start new (ask the vast majority of divorcees and you will find it was not that easy and neither is beginning anew).

Where many of these issues initiate is based upon maturation; many young people do not understand or comprehend terms like life-long, commitment, and retention. This is not a statement of blame but a means of understanding why we have come to this place in the world of relationships. Until someone has lived a little, we cannot fully comprehend the above three terms. Next time we will explore the various features of a successful marriage— what are the key foundational pieces for a marriage to thrive?