Dan Knoepfler, MC, LMHC
Individual, group, and family therapy
Thoughts for the Day
Links to the archives of previous months are at the bottom of the page.
One of my nieces announced she is having a kid in the spring, making me a great uncle to-be.   And my mom will be a great grandmother for the first time.  Apparently my mom is excited, because this is something she has wanted to be.  Funny the titles people want.   I wouldn't have guessed that it would be important to her, but you learn something new about people all the time, even about someone I have known 50+ years.

I was watching a rerun of "Maude" starring Bea Arthur.   The plot was about whether men and women can just be friends.    The conclusion of this episode was that maintaining Platonic friendships are difficult when you are attracted to the other person and in Maude's case she was more optimistic that she could than was true in real life.

Twice in the last week I have been told by people I am talking too loud.   Generally I am good at be mindful of the volume of my voice.  But there are people in my life who tend to make me more animated in my conversations, and when that occurs I get loud. 

I was talking with a person who said that recently she made a comment to someone and the person burst into tears and left the room.  When she described what she said and the context it was said, I was perplexed why the person had such a strong response to her comment.  She had some uneasiness about this occurring.   Not because there was anything inappropriate said, but because of the strong emotional reaction was something she didn't expect or particularly want to evoke.   At the end of the conversation she affirmed something very important, which is that she is not responsible for other people's emotions, although that doesn't give her permission to be intentionally hurtful.  

Today is my older brother's birthday.   Some days I wonder what I would have been like without his influence in my life.   As a kid he was such a jerk to me, and yet he grew up to be an amazing person.   There is a lot of research that human brains don't really fully develop until people are in their mid-20s.  And the part that controls our impulses develops last.    Funny how that works.   The gas pedal of the brain develops early, and we don't get our brakes until much later.     God help us all to survive our teens and early twenties.  It tends to be smoother sailing for most of us once we reach ~25.    Having said all this, what my brother taught me was how to stand up for myself and be assertive, and at times even be aggressive.   I think many people have a lot of negative associations with being aggressive.  And while it shouldn't be one's go-to response most of the time, it is a useful skill.   Just as passivity is.  Sometimes the best response is no response at all.   Anyway, happy birthday to my brother who taught me many of these lessons through life experiences. 

I was meeting with a client at the jail, and another person being detained was talking to a lawyer.   The lawyer wanted to know why this person keeps going back to heroin.   The person told the lawyer that heroin is the only thing that blocks out the horrible memories from the past.   The lawyer kept trying to get a commitment from the person to stop using.   I wanted to jump in and say that until the PTSD is treated that person will never stop using.  But I didn't since it wasn't my place.   But if I run into the lawyer in the next week or two I might suggest that he get his client some trauma-focused CBT therapy and perhaps that may help.

The lackluster Sounders looked so outplayed by Toronto yesterday.  I'm not sure why they played so poorly, but it was hard to watch.   They picked a bad time to have an off day.

For people in Washington, the long stretches of gray skies  during the winter can cause you to have very low Vitamin D levels.    When I was first tested my levels were so low I was put on a super mega-dose of Vitamin D for awhile to help my body get back within normal limits.   There was an amazing impact on my mood and energy level.   If you are feeling sluggish during the winter months, perhaps you are deficient in Vitamin D.    Your doctor can run a simple blood test for this and let you know.  Of course the other solution for low Vitamin D levels other than a supplement is to get some sun.   Perhaps a winter trip to Florida, California or Hawaii just might be the ticket.

Diabetes is a disease that profoundly impacts a person's life.  Not just because of the frequent testing, and need to use insulin.   But things like it can cause you to lose limbs, eyesight, sexual functioning, and put you at higher risk for kidney and heart disease.  Some of the medications that treat diabetes can actually cause people to gain weight, which is an unfortunate situation.   If you haven't had your blood sugar tested, maybe at your next physical get it checked.   Early intervention and management is key to avoiding some of the most harsh effects of diabetes.

This past weekend a retro-TV channel had a marathon of "Family" episodes.  I remember growing up with that show.  I did not remember how physically affectionate the family members were with one another. But it's actually nice to see people show non-sexualized affection on TV.

I was grumpy all day Saturday this past weekend.    What is a cure for that?  For me it is doing something, specifically cardio.     I had procrastinated doing my steps.   By about 9p.m. I was sick of being around myself and did my 10,000 steps.   After finishing I was in a better mood.   Wow, I may have enjoyed my Saturday a heck of a lot more if I had only motivated myself to do something earlier.

I'm getting excited about the Sounders playing again for the title on Sunday.   As a kid I hoped for a winning team, but never really had those dreams realized.   Seattle now has a team that may win back to back championships. 

Someone I know is facing a crisis at their church.    It's one thing when you are facing a crisis.  But what does one do when the church is struggling?   My suggestion is to turn to people of faith for strength and support.  Remember that you also have a personal relationship with God that doesn't require a church.   If things are too "hot" at your church, maybe take a break and attend at another church on occasion to go to a place where there aren't distractions.  Most of the time crises will pass, and the dust will settle.  Time does tend to improve many situations, because it allows for solutions to arise. 

I went to an all day training yesterday about predicting violence.   Sadly, having a troubled childhood and coming from a broken home makes you more likely to be violent in the future.  

Adult live-in relationships tend to make you less risky for engaging in any type of criminal behavior, including violence, assuming you don't have a partner in crime.     Staying in school and not getting into trouble at school also improves your chances of a more positive future.   Only use alcohol in moderation, and drugs as they are prescribed to you, or recreationally (if they are legal in your area) in a responsible manner. 

Another interesting piece of information:  People who tend to have a lot of casual sex also appear to be at a higher risk for engaging in violent behavior in the future.  I'm not sure why, but it is something I noted.

However, generally the best predictor of future risk is a person's past behavior.  Which means if you have a long-standing history of violence, especially violence that has resulted in charges and/or convictions, it is more likely you will engage in violent behavior in the future.   Also being involved in non-violent criminal behavior makes one appear riskier for violence.     How does one deal with mitigating the risk for these factors?  There is no magic answer, it's simple:  Stay out of trouble, and specifically trouble relating to violence.   Your risk for engaging in violence tends to decrease the longer the amount of time that has passed since your last incident of violence.  It only counts if you aren't locked up in prison or other secure facilities. 

Therefore it is never to late to take a different path.  Because it does help.   Start today and move forward.

The place where I get my car serviced always details my car as part of the deal.   Even when it's as simple as an oil change.   I admire the owner's business practices for doing this.    He takes pride in his work, and wants you to take pride in your vehicle.   When I drive off in my immaculately cleaned car after it's been serviced, I know I treat my car better.  It's an interesting dynamic.  

Wednesday was a turbulent day at work.  More ups and downs than usual.  In some respects I have done this by design to myself.  I try not to schedule myself in a way so that there are multiple people at the same place in therapy with the same issues, back to back to back.  I find that if I don't mix things up a little over the course of my day, the first person gets my best work, and subsequent people do not always get me at my best.  But when my day is filled with people who are at different places in therapy and presenting with different issues, they get me at the top of my game.

Another powerful person is ousted for sexual harassment on the job.   It's interesting that an issue  can be ignored for a long time and then suddenly things reach critical mass and there is no longer any tolerance for it anymore.  It's refreshing that people (mostly women) will begin to feel safer on the job as a result of this shift.  

I had a turkey sandwich yesterday with stuffing and cranberry sauce on it.    I think I am done with turkey until Christmas.

We talked about the pros and cons of pornography in group tonight.   It's always interesting to discuss an issue when there is a perceived side of an issue people believe they should take.  Trying to get people to talk about the positive side of pornography is interesting.  

The pros discussed were things like: "You can always have it your way", "There's no risk of rejection", "You can fantasize about things you might never do in real life",  "It's not cheating, but something different",  "It can give you and your partner ideas about knew things to try", and "It's a form of sex education." 

The cons to porn included: "Most people don't look like that in real life",  "Many things people do in porn are things people don't like in real life". "It treats people like things not people", "Many people in porn wouldn't want to be in porn if they were given a real choice",  "It can cause relationship problems", "Sometimes people get addicted to it", and "You can do things (get certain kinds of porn) that are illegal."

Back to work after a long weekend.   There always seems to be a lot to catch up on when you've been gone longer than usual.   I did well in trying to catch up today.

And then there is everyone's favorite emotion that tends to paralyze people - anxiety.   What helps with anxiety:
1)  Having positive things handy that will soothe you in the moment
2)  Having people who are kind around you,  and have them  reassure you that everything will be OK
3)  Knowing your triggers and do your best to limit exposure to them.
4)  Do stress inoculating activities when you aren't overwhelmed so you are better prepared if anxiety arises.

Some types of blood pressure meds in low doses are also great anti-anxiety antidotes for people.   One of the things they do is short-circuit the anxiety loop.   So even if a person gets triggered their blood pressure won't rise as much, they  tend to get fewer racing thoughts, they  tend to sweat and shake less.  And guess what?   When your body doesn't reinforce the anxiety response people calm down faster.

Speaking of feeling stuck, one of the difficult parts of depression is that it can immobilize people.    One of the better antidotes for depression is to get people doing vs. thinking and feeling.    Many times people will stay stuck in their rut looking for the perfect solution, when there is no perfect solution and/or their depression is blinding them.   So the next time you see someone depressed and stuck, offer to DO something with them if you want to help.  You could be part of helping them to get back on track and moving forward.