Category: Therapy

Science Says You Should Go Outside

UK happiness researcher George MacKerron’s Mappiness Project is an app that allows users to track activities and feelings throughout their day. The results demonstrate that most of us are the least happy at work, more happy on vacation, with friends or listening to music and the most happy while outside.

When we’re outside most of our senses are engaged, taste is tricky but we’re at least seeing, smelling, hearing and feeling the world around us. That helps us to be more present and in the moment. When we're more mindful, amazing things can happen. Mindfulness allows us to recognize that we are not defined by our thoughts but are rather observers. This distinction is important because it allows us to be happier, more empathic and more secure.

Being outside also increases our exposure to direct sunlight and production of Vitamin D. Vitamin D is a steroid hormone that the Centers for Disease Control estimates 32% of children and adults are deficient in. Maintaining adequate levels of vitamin D lowers risk of cardiovascular disease and Type 2 diabetes while increasing bone density. Researchers recommend 10-minutes exposure to midday sun as a way of ensuring you don’t fall short.

Exposure to sunlight has also been shown to help maintain good eyesight by correcting the distance between the lens and the retina which can become distorted the more time one spends inside in front of a screen.

Simply living near parks and wooded areas has been shown to lead to decreased levels of anxiety and depression and several studies have demonstrated that patients in hospital rooms with views of nature require less pain medication and heal faster than patients in rooms without views of nature.

Walking outside at a natural gait has been shown to significantly enhance creativity. Individuals who walked outside were shown to present not only more ideas, but ideas that demonstrated an increase in novelty.

Nature walks have also been linked to significantly lower levels of depression, less perceived stress and enhanced mental health and well-being.

Here's a short video that hits on most of this:

For most people, the option to get outside is accessible. It costs nothing and the benefits far outweigh any inconvenience. There are not many easier ways to improve your physical and mental health.

If You'd Like To Learn About Other Ways To Improve Your Life, Let's Talk

6 Things Anxious Partners Can Do To Improve Their Relationships

Anxiety has a way of invading all aspects of life and can have a significant impact of romantic relationships. Those with anxiety feel misunderstood, invalidated and fearful of rejection while their partners feel alone, impatient and unsupported. If you struggle with anxiety, here are few things you can do to help lessen the impact.

Reality Checks. You might think you can read your partner’s mind; you can’t. Anxiety is great for creating a narrative but that narrative is rarely based in reality. So the next time you are making up a story about what your partner must be thinking, check it out. I’m a fan of something like, “Hey dear, I know this might sound weird but I’m worried you are _____________. Should I be worried?”

Be Vulnerable. I don’t know who first used the saying “name it to tame it” but Dr. Dan Siegel has popularized the idea that by naming our emotions we can reduce the degree to which they overwhelm us. It also helps put things in context for our partners. Knowing that you're upset about something at work and not at your partner will help them to respond with compassion rather than defensiveness.

Make Sacrifices. If you want to be in a relationship and you have anxiety, sometimes you're just going to have to do the thing that makes you anxious. If your partner is always the one doing the accommodating or altering plans they're going to eventually become bitter and resentful. Acknowledge your anxiety and then do it anyway.

Ask for Help. The National Institute of Mental Health estimates that up to 18% of adults in the United States suffer from some type of anxiety disorder. And while anxiety disorders are highly treatable, less than a third of those suffering seek out help. It’s important for your partner to see that you’re trying; so try.

Seek Reassurance (sometimes). “Are you ok?” “Is anything wrong?” “Do you love me?” “Are you sure you’re ok… How about now?” Get it? Dial it back a few notches. If you can't, it will only lead to your partner distancing from you which is exactly what you're trying to avoid. It’s not your partner’s job to relieve you of your anxious thoughts. That’s your work; most of the time.

Find Ways to be a Support. Relationships like balance. If your needs are taking up too much space in the relationship it doesn’t leave much room for the needs of your partner. Anxiety has a way of keeping you focused inward, making it easy to miss what’s going on with the person right next to you. Sit down and make a list of things you can do to make your partner’s life easier. If you need to, set reminders in your phone to ensure follow through.


If Anxiety is Impacting Your Relationship, Let's Talk

Can’t Sleep? Here’s Why It Happens And What To Do About It.

Most humans spend approximately 30% of their lives asleep yet 43% of Americans between the ages of 13 and 64 report they rarely or never get a good night's rest. Proper rest is a big deal when it comes to physical and mental health. Sleep deficient folks are more likely to suffer from chronic diseases like diabetes, hypertension and obesity as well as depression.

What's Messing Up Your Sleep

Stress at Night: engaging in stressful activities like watching the news, paying bills or having conflicts with others increases cortisol and adrenaline levels and interferes with sleep. Instead, deliberately engage in calming activities at night and save the stress for other times.

Racing Thoughts: it's unfortunate that the very things that help promote sleep - quiet and stillness - also makes it easy for our thoughts to go on a rampage. Rumination often accompanies anxiety and depression which are exacerbated when our sleep is disturbed, forming a loop that can easily spin out of control. When racing thoughts occur, one of the worst ways to deal with it is to try and force sleep. It seldom works and often can make matters worse.

Unhealthy Food Choices: eating spicy or acidic food before bedtime can increase risk for heartburn or acid reflux. Food high in fats can interfere with the production of orexin, a neurotransmitter that helps regulate the sleep/wake cycle. High protein foods require extra energy to digest which, when eaten close to bedtime, can interfere with sleep. In addition, it is well documented that sleep deprived individuals tend to snack more often and crave extra carbs and fatty foods, so on top of being tired you're probably going to be struggling with weight.

External Factors: these may seem obvious but factors like room temperature, outside light, street traffic or a snoring partner can be significant disruptions to getting a good night sleep. The more you wake up during the night, the harder it is for you to transition to the deeper stages of sleep.

How To Sleep Better

  • Keep to a Schedule: our brains and bodies like consistency. Try to stick to established bed and wake times.
  • Eliminate Napping: short naps can be refreshing but if you are having difficulty sleeping at night, push on through to bedtime.
  • Avoid Electronics: blue lights from LED screens can mimic sunlight and inhibit melatonin production which regulated our sleep-wake cycle. Give your eyes a break from electronic devices before bedtime to help your hormones.
  • Dim the Lights: similar to above. Help your body recognize nighttime by letting it get dark.
  • Avoid Clocks: clock watching only serves to increase anxiety about being awake when you should be asleep. If the alarm hasn't gone off it doesn't matter what time it is. Cover the clock if you can't help sneaking a glance.
  • Reduce Alcohol: alcohol can help you fall asleep faster and stay asleep longer but it gets in the way of REM sleep which makes you feel less rested.
  • Reduce Caffeine: stimulants = bad for sleep.
  • Avoid Nicotine: see above.
  • Exercise: studies show that sleep is significantly improved when people get 150 minutes of exercise each week.
  • Read Before Bed: reading before bed can help reduce cortisol levels and help separate your sleep time from your daily stresses.
  • Use Guided Imagery: there are plenty of apps out there. Experiment to find one that works for you.
  • Breathing Exercise: exhale through your mouth; close your mouth and inhale through your nose to a count of 4; hold the breath to a count of 7; exhale to a count of 8; repeat x3.

Sleep is a tricky matter because what helps can vary significantly from person to person. What works for me is taking a hike in my mind. If I'm having a difficult time falling asleep I'll pick a favorite trail to follow. If my thoughts start to wander, I'll get back on the trail. I seldom reach the end before falling asleep. Your strategy may be different.

The relationship between sleep and mental health can easily become circular and can spill over into virtually every area of life. Let's work together to get your life back in order.

If you are struggling with sleep-related issues, let's talk!

Dating Doesn’t Have To Suck

awkward dating austin tx

People love to hate dating. It makes sense if you've got the pressure of possibly screwing things up with a potential life partner with every swipe, text or email.  It's hard to be yourself and know what you truly want with that kind of stress hanging over you.

Ways To Make Dating Survivable (and maybe even fun)

Keep Perspective: let it just be coffee, dinner or a walk around the lake. It is so easy to think about step 10 when you're only on step one. Be deliberate about enjoying the moment with another human, even if you know you won't be going on a second date.

Try Variety: the great thing about the internet is how it opens up our worlds to meeting people we would otherwise never cross paths with. Take the opportunity to spend some time with people you wouldn't ordinarily pursue. The risk is low and it will help you refine what you like and don't like.

Thicken Your Skin: rejection is part of the process. You are not going to feel it for everyone you go out with and, brace yourself... not everyone is going to feel it for you. That's ok, it's how it should be. There are 7.5 billion people in the world (2016), there is room to take your time and choose wisely.

Know When To Quit: not everyone communicates clearly. If you are operating in the absence of information from the other person it is probably time to take a step back. Don't expend energy towards someone if it isn't reciprocated.

Know When To Lean In: intimacy and connection can be scary at times, especially when a relationship is new and untested. Finding a balance between taking a risk and keeping yourself emotionally safe can be a fine line that doesn't always feel good.

Practice Vulnerability: if there is one thing I've come to realize it's that people are craving connection; they just don't do it very well. If you're tired of having the same date over and over again, shake things up by setting a rule of no small talk the next time you meet someone new. Need some help? Check out this article from the New York Times.

How Long Should I Wait To Date After A Breakup?

It depends on a number of things including the length of the previous relationship, the nature of the breakup and the goal of getting back into dating. There is really no magic length of time. Sometimes it may be appropriate to rediscover what makes you happy outside of being in a relationship. Other times it may be helpful to lean in and connect with someone new even when you don't feel quite ready.

Regardless, take time to process, mourn and integrate lessons; the end of a relationship has a lot to teach. If you have a pattern of jumping from relationship to relationship you are probably cheating yourself out of the opportunity for real growth and insight. Grief and loss are tough issues to confront but doing the work in the present can save you from heartache in the future.

What Do I Do Now?

Sometimes when you're in the middle of something it's hard to see your way out. Friends and family members may be important for support but they may not be the most objective source of feedback. Working with a counselor to identify fears and maladaptive patterns of behavior can help increase your chances of enjoying and maybe even finding success in dating.

If you want to have more success in the dating world, let's talk!

Differentiation: separate but connected

Do you struggle with feeling like you have lost your identity to you relationship? Do you have a long list of hobbies, interests or activities that you used to do before your relationship? Is resentment creeping in between you and your partner? If you can answer yes to any of these questions, keep reading.

To the best of my knowledge, Murray Bowen, M.D., the father of Family Systems Theory, was the first clinician to describe the concept of differentiation as it pertains to family systems. Bowen maintained that people with a poorly differentiated “self” depend so heavily on the acceptance and approval of others that either they quickly adjust what they think, say, and do to please others or they dogmatically proclaim what others should be like and pressure them to conform. In contrast, a person with a well-differentiated “self” recognizes his realistic dependence on others, but he can stay calm and clear headed enough in the face of conflict, criticism, and rejection to distinguish thinking rooted in a careful assessment of the facts from thinking clouded by emotionality.

David Schnarch, Ph.D. has focused Bowen’s concept of differentiation more specifically to sex and intimacy in his book Constructing the Sexual Crucible: An Integration of Sexual and Marital Therapy. Schnarch believes that learning how to be differentiated in romantic relationships leads to becoming more differentiated in the rest of your life. “ ‘It’s not that hard to be independent when you’re alone’, Schnarch observes. ‘But pursuing your own goals and standing up for your own beliefs, your personal likes and dislikes, in the midst of a relationship is a far tougher feat. Once achieved in the context of a relationship, differentiation becomes possible outside as well. If you can stand your ground with your partner, who means so much to you, you can defend your turf at the office and maintain your principles when pressured.’ ” In this way, making the decision to value differentiation in your relationship can have life-altering impacts.

So how can we create relationships that have a healthy level of differentiation? Here are the four steps, according to Schnarch:

1. Maintain your own values and goals, even if your partner is pressuring you to do otherwise.

2. Learn how to soothe yourself when you’re feeling emotional or anxious. Don’t rely on your partner to calm you down.

3. Don’t shy away from confrontation. Stay calm in the face of difficult people or situations.

4. Keep going, even if you make mistakes. Don’t let one little setback prevent you from trying to grow.

One thing to keep in mind is that differentiation is a dynamic rather than a static concept. You never check the differentiated box and move on. Some times you will be able to hold onto yourself better than at other times. If you would like to learn more about differentiation and how to grow towards being separate but connected in your relationships contact me here.

Why You Should Read More Fiction

counseling austin tx bibliotherapyI come from a long line of readers. Growing up, my sister and I were allowed to stay up later at night if we were reading – a habit that I have mostly adhered to throughout of my adult life. My tastes are varied and include biographies, historical fiction and nonfiction, short stories, self help, professional development, best sellers and random picks from the bargain shelf at Goodwill. At the beginning of 2016 I set out to read one piece of fiction each week; I failed miserably but am well into double digits. I’m often asked for recommendations of “self help” type books for clients but more and more I find myself encouraging clients to read fictional works as a form of self care.

You should read more fiction because:

  • Reading fiction allows for an escape from the day to day pressures of life. It can reduce stress better than listening to music, going for a walk or playing video games.
  • Reading fiction puts our brains in a pleasurable trance-like state, similar to meditation, in which the heart rate slows and muscle tension decreases.
  • Regular readers tend to sleep better, experience higher levels of self esteem and lower rates of depression.
  • Regular reading can help to slow memory decline in later life.
  • Reading fiction can increase our ability to empathize with others as we explore different experiences and world views through different character lenses.
  • Reading fiction can provide an opportunity to practice interactions with others as we identify with characters without the risk of any lasting damage.

Reading fiction can open up our worlds that have been narrowed by anxiety, depression or day to day stresses. It can help challenge perspectives or it can quite simply give your brain a rest. Try reading more fiction over the next few weeks and see what impact it has.


What’s On My Bookshelf

austin-counseling-bookshelfI have my parents to thank for instilling a love of reading in me from a young age. I read a lot; print, preferably hard cover. Allowing for the fact that books mean different things to different people and even different things to the same people depending on where they are at in life, this list contains no “must reads.” It’s simply a catalogue of a few of the books I have read over the years that taught me something about myself or others or touched me in ways for which I am thankful.

Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships

I was first introduced to this book in 1995 during grad school. It is a dense, heady piece that is work to get through. That being said, chapter 2 is some of the best writing on the concept of differentiation that I know of. This is definitely a book that will take on new meaning with each reading.

Allies in Healing: When the Person You Love Was Sexually Abused as a Child 

Laura Davis has done an exceptional job in creating this resource for partners of victims of sexual abuse. Super tough subject that can be an extremely challenging dynamic to navigate. If you are faced with this issue, I highly recommend this book and also encourage you to reach out for help from a professional.

I Thought It Was Just Me: Telling The Truth About Perfectionism, Inadequacy and Power

If you haven’t read any of Brené Brown’s work start here; then go buy the rest. Brené is one of the leading experts on vulnerability and shame and her work has begun a movement of people striving to live more authentic lives. Her writing style is personal and engaging and I have yet to talk to anyone who has read the book and not benefitted from it.

Cinderella Ate My Daughter

This is a thought provoking piece from Peggy Orenstein for anyone parenting a girl. You may or may not agree with some of her conclusions but it is a good read for those concerned with the health, development and future of today’s girls.

Too Good To Leave, Too Bad To Stay

If you are struggling with ambivalence about a relationship this book is a great resource for sorting through conflicting feelings and hopefully gaining some clarity. It offers practical steps and is a relatively quick and easy read.

Seven Principles For Making Marriage Work

John Gottman, Ph.D. is one of the leading experts in long term relationship research. He’s got a lot of stuff out there – books, card games, weekend workshops – but his Seven Principles book is a good place to start. It is a pretty easy read and most chapters include specific tasks and exercises for you and your partner to complete.

Big Magic: Creative Living Beyond Fear

Elizabeth Gilbert, of Eat, Pray, Love fame, offers a unique perspective about creativity and the fears and insecurities that prevent folks from connecting with and pursuing the things that bring them joy. This is a practical easy read full of good stuff.

Wired For Love

Stan Tatkin, Psy.D. is currently one of the leading experts in integrating neuroscience and psychology. He’s a pretty big deal. If you want to dive into attachment theory, emotional regulation and understanding your dynamics with your partner this is a great resource.

Broken Open: How Difficult Times Can Help Us Grow

I can’t count the times I have pulled this book out and read from it aloud to a client who was struggling with grief and heart ache. If you are struggling with how to emerge from suffering I think you will find this book helpful.




How To Pay For Counseling


A lot of folks think they can’t afford counseling. I frequently have inquiries asking about free or heavily discounted services and although I am empathetic towards financial struggles I also have to make sure I can pay the bills and support my family. I reserve 10% of my active caseload for reduced fee clients and usually have a waiting list for those spots. I do not see clients free of charge.

If you are concerned about the cost of counseling consider your options. Many employers offer Employee Assistance Programs that may include behavioral health services. Many health insurance plans offer behavioral health benefits. I always recommend calling your insurance provider prior to making an appointment to verify coverage and benefits including copay amount, deductible and limits of coverage. Using an Out-Of-Network provider may also be an option as many health insurance plans will reimburse you for a portion of the out-of-pocket costs.

A Few Money-related Things To Consider When Choosing A Counselor

  • Ask if the counselor can offer a reduced fee if you can meet during “off peak hours.”
  • Seek out a Counselor Intern. Interns are typically recent graduates working under the supervision of an experienced licensed clinician.
  • Review your budget and have a good idea of what you can realistically afford to spend on counseling in a given month. Depending on circumstances, it may be appropriate to meet with your counselor less frequently than the typical once a week.
  • You can also explore organizations that help members with the cost of counseling. In Austin there are services for musicians, attorneys, members of the LBGTQ community as well as others. This is where Google can be your friend.

If you still have concerns, please reach out. If I can’t help I will do my best to steer you in the right direction.


Choosing a Counselor

michael hilgers choosing a therapst

Choosing a counselor can be an intimidating task. Research suggests that selecting a counselor who is a good fit has a more significant impact on successful outcome than the counselor’s degree, licensure or theoretical orientation. What constitutes a good fit is a difficult thing to measure and often comes down to trusting your instincts.

If you can, ask friends, family or coworkers for referral options to help narrow the options down. Most counselors have an online presence. Check out their websites, reviews and written material before reaching out.

If you plan to use insurance benefits do your homework first. I always recommend calling an actual representative to verify coverage for mental/behavioral health benefits, copay amount, deductible amount and any restrictions. Don’t necessarily rely on the information you find online about your policy. I’ve seen several people be unpleasantly surprised when their claims are rejected.

Reach out to a few counselors either by phone or email. Most counselors I know have limited availability by phone so anticipate having to leave a message and provide them with some good times to call you back.

Here’s a few things to consider:

Location: it is not ideal to arrive for counseling completely stressed out after hustling across town through traffic. If possible, try to make going to counseling as convenient as possible.

Insurance: if you find a counselor but they are not in-network, explore what options you have for using an out-of-network provider. Many plans will reimburse a percentage of the cost making it much more affordable.

Questions: write down what questions you have before making the initial contact with a prospective counselor. That first call can be intimidating and it is easy to forget things that might be important.

Questions that you might want to ask include:

How long have you been in practice?

Do you have a specialty?

Do you have experience with _________?

What are your thoughts on psychotropic medications?

Do you take my insurance?

How much do you charge?

How is contact handled between appointments?

What is your cancellation policy?

At the end of the day trust your gut. It may take an appointment or two to truly get a good feel but a lot can be determined even in that initial contact.