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Family Conflict

Family Conflict

Amanda Kotsura, LISW, from Carve Your Own Path, Inc. talks about setting boundaries with family and the hard, important work of getting along. Though originally pertaining to holiday gatherings, the wisdom from this episode of Ascend Health Show holds for maintaining warmth and trust in all relationships. We discuss conflict beyond the usual platitudes of “family is family.” The opposite approach is to “release what doesn’t serve you.” Cultures have different values, so we spend a hilarious moment or two discussing “white girl therapy.” How should we respond, if at all, when Uncle Jim doesn’t believe in COVID and Grandpa Oscar says things that weren’t appropriate in 1954 either? Transcript below.

I’m your host Nick Angeles I’m a nurse anesthetist and one of the owners of Ascend Health Center and I’m here with Amanda cotsura a psychotherapist and a friend of mine how are you doing today

I’m doing good thanks for having me Nick

you’re welcome so we had this great idea that we’re going to talk about ways during the holidays you can solve family conflicts or at least stay out of them but then I just realized right before we started Taping that the people who have made it I don’t know 15 seconds into the show already are probably the ones that are already solving the conflicts they’re not the ones causing them um maybe a good way to explain it to you all is so right now the fun thing to watch on the internet is fights at Waffle House but when Amanda and I were younger the thing was Jerry Springer where you just see people throwing chairs at each other and people would shout Jerry Jerry and that’s sort of because of the quality of people that are either in Waffle House sometimes at 3am or on the Jerry Springer Show so some of this is very dependent on what your family’s like if they’re the Jerry Springer Waffle House combo you have to realize that and maybe some of these therapeutic interventions that we’ll mention just it’s not going to be enough so I thought I’d start with that and also because I want to talk about the waffle house really quick

I don’t know about the Waffle House fights but as you talked I was thinking also uh not only Jerry Springer but also just throughout the years of holiday shopping and the chaos that happens people fighting and like trampling over people to get that toy right like you know Samsung makes more than one TV like if you don’t get this one there will be another one manufactured at some point yeah in all of those situations what I see is what I preach regularly is a lack of emotional regulation skills and a lack of coping skills right a lack of boundaries the things that you’re not taught in school or in society right and and so that’s the main first point is that I realize that this is challenging because again people watching or listening are those who often have the boundaries and the skills because

I’d mentioned we had tried to do the show before around Christmas time and you were a little under the weather because we did your podcast right before and I was thinking I don’t need ask Amanda if she’s fine she’s a therapist she’s got great boundaries she’ll let me know if she’s sick otherwise we’re just doing this show and then I realized well that’s kind of mean because even as a therapist she clocks us you know she’s off the clock or has her so I actually emailed you like hey do you want to reschedule how are you feeling and I realized oh that was like a really nice thing to do to actually ask you sure you want to do this especially since you know we know each other but you could have been like oh maybe he’s really dedicated and he’ll be really disappointed if I can’t do this TV show instead of what happened which is I think I convinced somebody to do two shows and it was perfectly fine yeah

I was actually glad that you asked because as a therapist it is challenging sometimes honestly and so to have you ask was an opportunity for me to practice the boundary right and and also I was very foggy and wasn’t really looking ahead at the next day so I was like oh yeah that’s probably a good idea to reschedule so I think that’s a good point that like again sometimes we have to ask people like uh one method is if someone says something awkward at a family gathering just ask them to repeat themselves and then they’ll either realize what they’re saying like oh that’s not appropriate or they’ll charge on ahead but at least you know at least they have that chance to back off I’ve started to develop some really unique responses not only for myself but for clients and a lot of them come from tick tock um but like oh that’s a really strange thing to say out loud or um when you said that it sounds like you were meaning this and kind of laying that out there for them is that what you meant and clarifying and then if it makes them look or feel bad they’re like oh no no that wasn’t what it was so really just kind of re putting it back on them to clarify and then they have to kind of say it again consciously and mindfully and then they’re like oh I don’t want to look like that so no what I meant is this okay and and it’s it’s not really slick either because it is a genuine like well that was a really strange thing to say so let’s make sure we’re all and that way too like if they want to be offensive they get their chance to be offensive that way there’s no like did they really mean it that way or my husband actually surprised me we were in a family setting and one of my family members said something that was definitely racist and my husband said um hey if you have to whisper those kind of things you probably shouldn’t be saying them at all right so just to give to give people like some skills because a lot of people are people are just caught off guard or shocked or hurt or whatever the thing is and they don’t know what to say so they don’t say anything right and I think especially in those situations it’s definitely our job to disrupt that and so giving people the tools to say sure and that’s a good question too because um and again

this is more the disclaimer part but Amanda is the expert in this I’ve got plenty of opinions and I think they’re amazing but if you hear something that I say and then she disagrees with me she’s probably right I’m probably wrong because a lot of a lot of the shows here it is almost like an infomercial like where we both know all about the mango squeezer but for in this particular case it is like well I’ve got really great opinions about how to solve family conflict but what’s more of like the research-based psychotherapist version of it and that’s regardless of people’s beliefs and that’s

for me that’s the most fascinating part of all this because a lot of these are religious holidays or you’re with people that you don’t always spend a lot of time with and it’s not your job to be a crusader for your personal beliefs or against their personal beliefs so what you said about racism that’s really interesting portion like so there’s this try not to be offensive but I can’t help it so it’s almost like um like a white person trying to save everyone sort of thing sometimes like the movies Dances with Wolves or Avatar there’s this theme of like okay the natives can’t help themselves until someone takes their size and champions for their justice but a lot of times you know when you talk to either indigenous groups or minorities or any marginalized Community it’s like well thank you for your help but that’s not really the issue here here’s what’s really going on so how can you keep your family from being racist or xenophobic or a bigot but at the same time not necessarily Champion people who aren’t there at the Gathering sorry that that was really long convolutely an explanation

yeah no it’s okay and yeah and I as a CIS white woman am not um I know you said you’re the expert I won’t claim to be the expert because I don’t live those experiences um I am an anti-oppression informed practitioner with the National Association of Social Workers and I do a lot of Justice work um and anti-oppression work uh however I won’t say that I’m an expert and now I already forgot the question that’s because I’ve talked for like three minutes about it

I’m saying where is that line between when we want to advocate for those who aren’t there to advocate for themselves oh and when you want to just be like you know what today I’m your cousin I’m not the psychotherapist who stands up for truth and Justice like how do you and there’s no perfect answer

yes it’s definitely a like situation by situation type thing we have that discussion a lot in those sort of platforms where I’m doing that work and it’s really save yourself first like if you’re exhausted you’re depleted and you know that having that just having that engagement is going to exhaust you more and tomorrow you’re not going to be able to fight because of that then maybe you kind of let it go you walk away you you get a safe space for yourself it really just depends on the situation if you know that no matter what you say that person is going to be toxic or abusive or um not you’re not going to be able to change their opinion right it just depends on the setting and the person that makes sense so it’s really more of like do I have a chance to change this conversation and some good sort of like we all know if we’d write a Facebook comment about something we disagree with no one’s going to be like you know what that was really insightful I was wrong you’re right but with families especially if there’s already a relationship there um which might be sort of the basis of this whole show like if you can form warm healthy relationships with your family members then you can have these discussions and even disagree but still see different points of views and it’s not this thing we’re like well Amanda started the yearly fight I guess we’ll all go back to our homes now

yeah that makes sense so uh for a little bit of a role play let’s say I’m like covert the conspiracy I shouldn’t get my shot and all you guys are fools for getting jabbed like that’s the one for me like how would you respond to something like that again you’re not like the CDC there’s you know Dr fauci would not cry if you just said well can you pass the potatoes so what would be like more of a better response than um getting into it that was a challenge for me I might say something you know

I’m not in like you know I’m in the medical field not in the medical field so I might say something like oh well I hope that you’re finding other ways to stay safe or you know protect yourself from spreading it to other people or hey how did you know again it depends on the person like if someone’s really that gung-ho about that perspective I don’t know if I want to engage because it might just go down a rabbit hole so it is a little bit of almost like staying in our lanes for for example me as a nurse anesthetist I want to own that covet Lane I talk all about it I’m really passionate about it and at least I have some sort of background in it so it’s more like okay fine you can talk about it you’re a nurse and a nurse anesthetist but then if someone asks me about something that I really have opinions about but no expertise it’s the same thing of all right let’s pass the mashed potatoes because I think for that one too because I dealt with those I was really passionate about people getting their uh first immunization like at least have one coveted shot see what it does too and then after that no dog in the fight was like oh you don’t want a booster or you don’t want to do this or that well that’s fine that’s controversial so it would be nice if I guess you wouldn’t need the show if everything was so cut and dry like you’re wrong and here’s why yeah I think curiosity kind of comes to mind right like instead of judgment it’s like oh how did you come to that conclusion or what made you decide that or you know things like that like how are you staying safe or how are you preventing the spread or so it’s almost like instead of okay here’s my agenda for Thanksgiving so I’m like well I want to be curious to see how my relatives feel about things yeah I think that can go a long way actually just the this is a chance to because there used to be you know family members believe mostly the same things was Community but now the way the internet works were all fractured into these little tribes that’s almost the opposite that all of a sudden you’re forced to be with people who the algorithms never put you next to so it’s almost jarring to hear other people’s truth so to speak and that’s such I was just thinking that right it’s like when people say these things it can become such a visceral reaction in our survival response right that it’s fear right but we don’t recognize that we don’t recognize that it’s so Primal nor do most of us have the coping skills or emotional regulation to handle that and it can get really messy really fast right that’s where the fights can happen the police can get called you know people are getting kicked out type of thing so yeah I think if you come from a place of curiosity rather than judgment it really can help kind of diffuse that okay that makes sense so instead of something that’s written Forever on a Facebook wall it’s like this is a conversation we won’t even remember it a 100 accurate so I need to be clear and you know how but how do you find I’ve got so many questions today how do you find that way of like not being triggered where uh you know you don’t want to also just have this weird cold dismissive relationship with your parents and your cousins where it’s like oh okay interesting that you think that and you never get deep because that’s well it keeps you safe and keeps it from being triggered but it’s also makes for really lame Thanksgiving or Christmas which by the way we’re going to trot this video out every single Thanksgiving from now until like 20 33. yeah let’s have all the tips for all the houses right because because then they’ll suspect like well Amanda looks the same but isn’t Nick’s hair a little grayer than than he seems and so yeah 2033 is a cut off okay got it you can’t do it past that but how do you just make sure you still have a warm actual relationship instead of like well let’s not talk about that there is something I often I have a very small caseload I don’t take a lot of clients but something regularly that we teach clients is um you’re never gonna I don’t want to say never because that’s an absolute but rarely are you going to be able to fully control your environment to where you’re not going to be triggered right again that survival response is very visceral and depending on what your past life experiences are and what your current stressors are it could be easily activated so my thing is when I’m activated for whatever reason it’s

breath maybe walking away now that it’s cold outside get outside and activate your vagus nerve in that cold air and get some calm and Clarity before you just readily and actively respond right that makes sense react versus being able to respond right so they might be asking me like Nick why are you massaging your carotid artery to stimulate your vagus and everything nothing it’s fine just that’s me over here tapping but actually that that might also be another technique so emotional release work and tapping or one reason I really even started talking about this with you was I had a lot of my patients over Thanksgiving say that went really well like that was the first time that me and my family got together and they were doing ketamine infusions so I realized oh some of these techniques and I’m not saying that everyone in the audience is a ketamine infusion before Christmas but it may help if you start some technique to give yourself some space the way we describe at the clinic is okay so depression and anxiety it’s sort of like a bear is chasing and you’re trying to do calculus if we can at least get the bear out of the picture like life still might be hard you might still have this disease or this problem but if you’re doing calculus at your own pace instead of also being triggered so whether it’s talking to a therapist like you of course or you know doing some sort of intervention that will just give you some space between you and your feelings and what you said like your body thinking oh this is a threat unless we spawn I think yeah I think modern or not matter but like the general public doesn’t necessarily understand how often that there’s a Tiger standing in front of us that feeling is and it’s so Primal and it was needed back then right but in modern society it’s activated every single day multiple times a day right I’m pulling in I know Nick like I know you I’ve talked to you I’ve done shows with you like on our podcast and still there’s this right like as if there’s a Tiger standing in front of me right and we’re not taught how to manage that and I think um if we can kind of get that information out there and teach people hey it’s okay we can we can regulate that and get on a more um stable ground to be able to move forward that’s that’s natural so is there almost like a good kind of anxiety like for me I’d like to play sports some of the treatments we do at Ascend Health Center that’s how they kind of work like it seems like it’s going to provoke more anxiety if you’re doing something like ketamine which really is difficult on the brain but the end result is less anxiety it’s almost like you have to prepare your brain for that for it to recognize like this is I run away from the tiger or this is a complex family situation that you know getting my adrenaline pumping isn’t going to do anything for me yeah I mean stress in general isn’t all bad right there’s good stress so I think the little bit of stress I was feeling today was excitement right um or if you’re going to see family and you enjoy most of them you might and get a little bit of excitedness right and so or you’re doing a big presentation for work right some of that can be good stress it’s just when it starts to become physical is kind of where I like to intervene are you starting to have chest pain are you you know getting clenching your jaw are you getting warm where it’s really escalating to the point of your body thinking that you’re gonna fight flight freeze situation so knowing your body is like really helpful for these family situations that makes sense because like I’ve always whenever I took a big test I’d try to think of it as an adventure or a way to prove that my brain works well like instead of like the negative side of it so it can be like oh I might learn some new things about my family or I don’t this might not be a great idea but you know even if there is some sort of argument or some altercation it might be really interesting for me to watch so is that one inappropriate because it’s kind of funny but I mean entertainment is great especially if it makes you laugh right so well it’s still the right approach like you’re distancing yourself from the triggering act the fear of it my my thing to look forward to at family gatherings is the food yes so if anything’s going chaotic at least I can enjoy the good food so so in that case it’s almost like a delayed reward kind of mindset like yes I do have to listen to Uncle Bill talk about how the birds are robots and what the 5G is doing but I also get Aunt Fran’s dessert so it’s just part of the equation of what I have to do today yeah and I think knowing your body like you said is I mean we talk about that all the time the Mind Body Connection so knowing your body truly is it so how much can I tolerate this I’m sitting there I’m eating my lasagna we’re Italian I’m sitting here eating my lasagna and so and so is talking about this stuff and I’m noticing that I’m starting to clench my toes and I’m starting to get real tense and I’m getting irritable I’m taking my breaths I’m ta I’m tapping publicly like under the table where people don’t know I’m doing all the things and I’m still just not able to regulate that’s where I need to get up and excuse myself and go to the bathroom maybe Splash cold water on my face or just distance myself because no situation in my opinion is worth getting that you know dysregulated over right unless you’re in a pure survival situation so when is it that we have to decide like okay my family’s too toxic for me so like with my Greek background it’s sort of like well they did try to murder me but they are family so it is what it is I’m not saying that’s a healthy cultural uh phenomenon when can you decide that you know what Christmas just isn’t worth it this is a challenging one um especially when you take into perspective different cultural backgrounds and approaches there’s a common intervention in a lot of like white therapists modes especially CBD and things like that where it’s like oh just set a boundary and cut them off and they’re toxic and don’t you know blah blah blah whereas other perspectives other cultures might say hey we’re more Collective and so we want to heal collectively how can we bring them in how can we heal that type of situation so again it’s something that’s very individualized depending on the person um I would offer that though like if I’m talking to a client and say what feels right for you what feels right for your family do you feel like this is anywhere that you could collectively kind of come together as a family and heal and work on this situation or is it is it just not going to go anywhere and you really need to separate yourself and it might not be a full cutting off it might just be a full like a distance where you rarely see them or communicate right because I’m because my background I’m biased on the like yeah sometimes life is hard and relationships are hard big deal just deal with it I realize it’s not always therapeutic yeah like what you’re saying is that it still is very individual decision Yeah so basically you shouldn’t decide based on watching this show yes yes yeah and it’s definitely something like if so I mean when people are having these issues and they come to therapy it’s not like a one-and-done session and then they’re like oh I know what to do now it’s something that we talk about and people there’s grief with that whether you decide to cut the relationship or off or not because especially if it’s like a parent right that’s our core attachment those are people that we really want to stay connected to um so even if you don’t decide to cut them off just the grief of not having the relationship you thought that you would have or that you’ve maybe seen friends or other family have with their parents that can be really grief strict that’s freaking so you’re also saying that what to look at it objectively because you’re right there is that approach of like well if this doesn’t serve me but life isn’t all about being served like none of us are this the Galaxy isn’t meant to be this Smorgasbord of a buffet for us where okay like this I don’t want this in my life and I think we’ve both seen that in our clinics where like there’s people who try so hard to curate everything so that no negativity is in their lives and often those are you know the most miserable patients that we come across and that makes sense when you think about a survival approach right if you feel like you’re always in fight freezing everything is out of control many people then over correct right and have severe anxiety or maybe full-blown OCD because they’ve tried to control these situations that are so out of control but there really is you know the universe doesn’t allow us that level of control right and that kind of circles back to our first point like if you can picture your family members gathered around on Thanksgiving and that they’d fit really well in on a Jerry Springer Show or in a Waffle House throwing waffles at each other then maybe this isn’t something that you with your powers of being the one that tries to keep things together can actually fix if on the other hand they’re like nope we’re just people and the way the world works right now we’ve you know had different influences over the last year and now we’re all coming together and you know Uncle Jim has been listening to Tucker Carlson and I’ve been watching MSNBC and this person you know and it I don’t want to say it’s again one of those things we just have to avoid all these topics where you’re like those couples that are been married for 50 years and all they can talk about now is the weather but I guess again that’s an individual decision yeah and I think it is okay to say hey these are safe topics that we can talk about or hey I’d prefer if we didn’t bring this up when we’re around each other type thing like that’s an okay boundary to set hey I’d prefer you know we never we can never agree and we typically get in an argument when we bring this up so maybe we just don’t talk about this when we meet doesn’t mean that you only talk about the weather but right hey maybe kovid’s off the table when we’re at family gatherings or maybe politics you know like political party type things are off the table or um and then kind of back to your point like hey if your whole family is a little toxic and it doesn’t have the best coping skills and you’re the one constantly taking care of them just maybe reflecting and thinking how is that impacting my physical mental emotional spiritual social all the areas of health so I mean I can see myself actually saying like hey this time I’m not going to salvage this I’m actually gonna go get some more potatoes you all figure this out because I mean like the responsibility of the Peace here which I don’t I don’t have that responsibility in my family like I mean I’m kind of diplomatic but I also enjoy seeing things happen seeing it play out right right I was the social worker from like five on so it’s a constant battle to not fall into that role but that is something that even birth order and some of those kind of Dynamics and something to think of like being a middle child I’m more natural going to be the Diplomat so it’s like okay am I okay with this role am I getting some satisfaction or some purpose out of this role that’s unhealthy where I’m enabling others to take their role of you know the one who doesn’t have it together and What needs of mine aren’t getting met in the process you know people can feel kind of I don’t know if disgruntle is the best word it’s the best thing I can come up with right but like oftentimes when people are mad at other people or frustrated with other people are irritable with other people it’s because we’re not getting our own needs met so I’m really taking a moment to say like is this worth my energy and What needs do I need to get met first right and I think I mean we could talk about this all day but I do want to give you a chance to talk a little bit about carve your own path and what you guys do there because at Ascent Health Center we have ketamine and TMS and Psychiatry but we don’t want the message here to be like are you sad with your family come get Zoloft at Ascent Health Center a much more therapeutic and a much more gentler step is just talk to a therapist see if this is something that that would benefit that you’d benefit from so what do you all do there because it’s a lot yeah we do too a lot um so Carbone path is a non-profit organization we focus on preventative holistic mental health and wellness we offer traditional mental health counseling so talk therapy you just want to come talk out some situations and get perspective and see is this appropriate how can I cope with this but then we also offer art therapy yoga Reiki and then some Wellness workshops for the community to really get engaged if you’re not you know ready to dive full into therapy yet and you have the podcast too we do have our podcast it’s called grow your path to Wellness and you can find it on YouTube and then all the podcast streaming platforms and the two of us have done a few episodes together one was on psychedelics because that might come up at Thanksgiving too what do you think about psilocybin I mean that could be a very interesting conversation with your family um and also the one about self-care and self-pay versus Insurance based because that’s the challenge is there’s sometimes so many insurmountable barriers to getting Health that it’s a lot of patients that I come across they’re like well do I really have to like have this diagnosis and then I’m into the system forever because it’s not like here’s a pill and you’re done it’s more like oops I just signed up for a lifestyle of every few months I have to talk about you know my deepest problems with somebody so yeah I often do tell patients like how about during the holidays you come here more often and then when it’s warm here in Ohio you probably don’t need us as much yeah and I just try to normalize for people like we don’t require a diagnosis for you to be seen that’s one of the benefits of being self-pay but a lot of the things that people come to therapy for are just the stuff that you don’t learn to cope with in life and you just need some support with yeah absolutely well that’s great well I think that’s all the time we have for today again if we either want to reach out you’re in Copley I’m in Fairlawn and you do that guys do some Telehealth too I believe right yep Telehealth for the whole state of Ohio absolutely so thanks for watching the sand Health show remember to always pass the potatoes to your left and the next family gathering leave room for dessert and I think that’s all the wisdom I have for now but thanks for joining me on the show thank you for having me take care everyone

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