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  • Jim Piffath

    Counseling for Individuals, Couples & Families

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    How to Set Healthy Boundaries

    March 20, 2020

    Relationships can only be healthy when both people have the space to be themselves and maintain their personal integrity. Sadly, many people find themselves in relationships, romantic and otherwise, with people who do not respect boundaries and feel entitled to have their needs met regardless of the other person’s. These people most likely grew up […]

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    How to Set Healthy Boundaries

    Relationships can only be healthy when both people have the space to be themselves and maintain their personal integrity. Sadly, many people find themselves in relationships, romantic and otherwise, with people who do not respect boundaries and feel entitled to have their needs met regardless of the other person’s. These people most likely grew up in households that were unsafe and unstable, and where there was a constant invasion of personal boundaries.

    If you can relate, chances are you have a hard time creating healthy boundaries to create the life experience you wish to have. Here are some ways you can begin to do so:

    Identify Your Limits

    You can’t set boundaries unless you discover where it is you personally stand. You’ll need to take a bit of time to recognize what you can and cannot tolerate. What makes you happy and what makes you feel uncomfortable and stressed? Only until you have made these discoveries can you move on to the next steps.

    Don’t Be Shy

    People who have similar communication styles are easy to engage with. These people will quickly understand what your new barriers are. But people who have a different cultural background or personality may not easily understand your boundaries. With these people, it’s important to be very clear and direct.

    Pay Attention to Your Feelings

    People who have a hard time setting boundaries don’t often allow themselves to acknowledge their own feelings because they’re usually too busy worrying about everyone else’s.

    You’ll need to start recognizing how people make you feel in order to know whether your new boundaries are being crossed or not. When you’re with someone, make mental notes, or even jot down in a journal how that interaction made you feel.

    If, after spending time with someone, you feel anger or resentment, this is a sign that the person may be overstepping your boundaries. Reiterate to this person what your boundaries are. If they continue to disrespect you and them, you will want to cut yourself away from further interactions.

    Make Self-Care a Priority

    Put yourself and your needs first. This may feel strange and even somehow wrong if you’ve spent your entire life taking care of others. Give yourself permission to feel your feelings and get what you need to feel happy and well.

    Speak with Someone

    If you’ve spent an entire life with a sense of low self-worth, you may find setting boundaries quite difficult. In this case, it’s important to speak with a therapist that can help you discover where these feelings are coming from and how to change your thought patterns and behavior.

    If you’d like to explore therapy, please get in touch with me. I would be happy to help you on your journey toward self-care.

    Filed Under: Women's Issues

    Why Every Man Should See a Therapist

    March 7, 2020

    While women are often the ones who seek therapy, typically making up nearly two-thirds of therapy patients, multiple studies have shown that men benefit more from the process. But men rarely seek therapy because they just don’t like the idea of opening up to a stranger and sharing their feelings. Therapy, then, isn’t a very […]

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    Why Every Man Should See a Therapist

    While women are often the ones who seek therapy, typically making up nearly two-thirds of therapy patients, multiple studies have shown that men benefit more from the process. But men rarely seek therapy because they just don’t like the idea of opening up to a stranger and sharing their feelings.

    Therapy, then, isn’t a very naturally masculine process. But I want to encourage men to push past their discomfort and seek therapy anyway because it can really help in so many areas of their life.

    Here are some of the reasons why every man should see a therapist:

    Men Often Struggle with Their Identity

    Many men today struggle with what it means to be a man. Decades ago, the definition was more clearly defined, but nowadays a man can get completely lost. Should they be masculine or is masculinity somehow toxic? Should they show their emotions or not? Should they protect women or is that somehow belittling women?

    It is entirely confusing for men, and many have had to grow up without a father figure in the home, or fathers who were there but emotionally absent. And so men look to media and advertising to find clues about who they should be, and this can be incredibly damaging.

    Therapy can be a space where men can learn to define themselves on their own terms.

    Gain Understanding and Tools for Your Relationships

    Men are from Mars, Women are from Venus? That’s putting it mildly!

    In their day-to-day interactions, men tend to live on a logical plane of existence whereas women live on an emotional one. No one plane of existence is right and no one is wrong, it is simply how the two sexes are wired.

    But, since men tend to struggle to express their feelings and express themselves in a way their female partner can relate to, the relationship can take a hit and the two can grow apart.

    Therapy can help men safely explore their own feelings and learn how to relate to women in a language women understand.

    Become the Best Version of You

    Seeing a therapist doesn’t necessarily mean something is wrong with you. Often therapy can be a way to explore who you are, what you want, and how to reach your goals. In other words, therapy can be a means by which you become the best version of yourself. If you hit the gym x times per week to get into the best physical shape of your life, why not hit the therapist’s office each week to get into the best mental and emotional shape of your life and be a total package?

    Get Help for Substance Abuse

    Studies have shown that men are far more likely to abuse drugs and alcohol as a way to cope with the stress and depression in their life. Therapy can show you how to cope without the need for these substances.

    Lower Your Suicide Risk

    There has been a disturbing rise in instances of suicide among older American men. This is most likely a result of men not believing they have the right to seek help. When you’ve got to be the strong one all the time and fix other people’s problems, seeking outside help simply is not an option.

    But it IS an option. Men need to get help with their issues so they don’t turn to suicide.

    Help with Fatherhood

    As I mentioned earlier, many men grew up without proper role models. They then find themselves a father, unable to cope with the challenges and responsibilities. Therapy allows men to discover who they want to be for their children and come up with a game plan to develop this side of themselves.

    If you are a man struggling with these issues or any others and would like to explore treatment options, please be in touch. I would be more than happy to discuss how I may be able to help.

     

    References:

    • https://www.goodtherapy.org/learn-about-therapy/issues/men-issues
    • https://www.psychologytoday.com/us/blog/the-angry-therapist/201701/why-i-think-all-men-need-therapy

    Filed Under: Men's Issues

    Is Social Media Bad for Your Mental Health?

    February 25, 2020

    Have you been feeling a bit low lately, but you can’t quite put your finger on why? It may have something to do with your social media habits. According to a recent study, social media use can increase depression and loneliness. For years people have suspected that social media use might have an ability to […]

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    Is Social Media Bad for Your Mental Health?

    Have you been feeling a bit low lately, but you can’t quite put your finger on why? It may have something to do with your social media habits. According to a recent study, social media use can increase depression and loneliness.

    For years people have suspected that social media use might have an ability to negatively impact our mental well-being. After all, it’s hard not to feel inadequate or jealous when looking at photos of people whose lives seem so much more perfect than ours. But now research is actually making a definitive link between spending time on Instagram, Facebook and Twitter and a sense of loneliness and isolation.

    It May be Time for a Social Media Detox

    I encourage my clients to take a social media detox every now and then to gain a more positive sense of reality. They often report back to me that the detox offered some amazing and unexpected benefits such as:

    Improved Self-Esteem

    When you take a break from comparing yourself to other people, you can start to look at how great you and your own life really are.

    New Interests and Hobbies

    When you spend less time trying to get that social approval in the form of ‘likes’, ‘retweets’, and ‘upvotes’, you suddenly find you have a lot of time on your hands for other things.

    Improves Your Mood

    Trading in online friendships for real face-to-face ones makes us feel more grounded and connected to people. This can drastically improve our mood and sense of well-being.

    Better Sleep 

    Many people are on their mobile phone in bed, checking their social media accounts. The blue light from these devices disrupts our sleep pattern. When we put these devices away, we inevitably sleep better.

    Able to Enjoy the Moment More

    I am a big proponent of daily mindfulness. By being present in our lives, we feel an increased sense of peace and joy. That’s priceless.

    So how do you perform a social media detox?

    Follow these 4 steps:

    1. Temporarily deactivate your accounts. Don’t worry, you can reactivate them again in the future should you choose.
    2. Remove all Social Media Apps and notification pathways from your devices.
    3. Use a web filtering tool to block social media sites. (Why tempt yourself?)
    4. Be prepared for some withdrawal symptoms and have other activities ready to replace the void.

    If you follow these steps and take a break from social media, chances are you will find you feel a whole lot better!

    Filed Under: Addiction, Adolescents/Teens, Depression

    Signs of Narcissistic Personality Disorder in Mothers

    February 18, 2020

    A heavy diet, The Great Depression, and jumbo shrimp are all examples of oxymorons that are often used. These terms, characterized by two conflicting ideas being presented side by side, are sometimes humorous. In other instances, such as that of the narcissistic mother, this juxtaposition paints a dark picture of the potential for harm that […]

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    Signs of Narcissistic Personality Disorder in Mothers

    A heavy diet, The Great Depression, and jumbo shrimp are all examples of oxymorons that are often used. These terms, characterized by two conflicting ideas being presented side by side, are sometimes humorous. In other instances, such as that of the narcissistic mother, this juxtaposition paints a dark picture of the potential for harm that these individuals possess.

    The description of Narcissistic Personality Disorder (NPD) in the 5thversion of the Diagnostic Statistical Manual (DSM-5) includes nine possible symptoms. Each of these symptoms is in direct opposition with traits that quality mothers possess.

    Self-Importance

    Someone with NPD exaggerates his or her achievements and talents and expects to be recognized as superior. A narcissistic mother may be unable to put her own child’s needs first because of this false belief about herself.

    Fantasies about self

    These fantasies can be related to unlimited success, power, brilliance, beauty, or ideal love. A mother who attempts to pursue domains related to these fantasies may forsake her children in this futile pursuit.

    Sees self as special

    This includes beliefs that someone can only be understood by, or should associate with, other special or high status people. A mother who exhibits this trait may refuse to associate with their children or others in their children’s lives (i.e., other parents, teachers, etc.)

    Requires excessive admiration

    As is often said, motherhood is a thankless job, and mothers who require admiration from their children may be sorely disappointed when this admiration never comes. The reaction to this can be as minor as resentment, but it may also lead to more serious reactions such as abuse or neglect, as these mothers eventually refuse to perform motherly duties.

    Sense of entitlement

    This symptom includes unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations. This trait can be passed on to children, who may also believe they are entitled to similar favorable treatment.

    Exploits others

    A person with NPD often takes advantage of others to achieve his or her own ends. A mother with NPD may be driven to use her child to achieve her own needs, despite the threat it may pose to the child.

    Lacks empathy

    Someone with NPD is unwilling to recognize or identify with the feelings and needs of others. This is concerning for mothers, as the identification of their children’s feelings is necessary to help them develop in a healthy way.

    Envious

    Individuals with NPD often envy others or believe that others are envious of them. This is another trait that is likely to be passed on to children, which can lead to future relational deficits.

    Arrogant

    Arrogance is another trait that may be modeled by narcissistic mothers. Children who observe an arrogant mother may believe this characteristic is normal and may themselves display it.

    In isolation, these symptoms may not present a clear danger to the child of a narcissistic mother, but when these traits are combined the potential deleterious effects become clear. It is important for clinicians to be aware of these dangers and keep a watchful eye on mothers who display these traits, as the effects of their narcissism can have lasting impacts on their children.

    If you were raised by a mother with Narcissistic Personality Disorder, or if you are concerned for your own children, therapy can help. Contact me today for an initial consultation.

    Filed Under: Family Therapy

    Keys to Successful Therapy

    February 11, 2020

    Cognitive therapy has been shown over the years to be incredibly effective at helping people recognize and change their behaviors. But, as much potential as therapy has for every individual, some people seem to have success with therapy while others don’t. Some of this stems from what the individuals’ expectations were going into therapy, some […]

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    Keys to Successful Therapy

    Cognitive therapy has been shown over the years to be incredibly effective at helping people recognize and change their behaviors. But, as much potential as therapy has for every individual, some people seem to have success with therapy while others don’t.

    Some of this stems from what the individuals’ expectations were going into therapy, some from how much effort they gave, and some from whether or not there was a good personality fit between patient and therapist.

    If you’re thinking of exploring therapy and want to ensure your journey is successful, here are some things to keep in mind:

    An Evidenced-Based Approach

    The American Psychological Association defines an evidence-based practitioner as someone who integrates their (1) clinical expertise with (2) available/relevant psychological science and (3a) the client’s values and (3b) cultural context to guide the intervention. This means your therapist should be using proven techniques in a way that jive with your values, preferences, and needs. It’s not about them and what they bring to the table, it’s about what they have to offer and how they can offer it so you might be positively impacted.

    A Solid Partnership

    It’s important to shop around to find the right therapist for you. Ideally, you want someone who you feel comfortable opening up to and someone you trust to listen and offer guidance. You also want to know your therapist is competent and has your best interests at heart. And finally, you’ll want to have open communication so you can always be sure you are on the same page as far as your “story” and how well the interventions are working.

    An Appreciation for the Process of Change

    We live in an instant gratification society. We want what we want and we want it NOW. In many instances, we can get what we want quickly. But this isn’t true for real change.

    For therapy to be successful, you MUST be realistic about the process. It is not linear, and it is not quick. This is particularly true if you are dealing with complex, long-term problems. This doesn’t mean you can expect to be in therapy for the rest of your life or even many, many years. It simply means you must appreciate the reality of what you can expect and how quickly.

    If you are interested in exploring treatment options, please get in touch with me. I’d be happy to discuss how I may be able to help.

    Filed Under: General

    How to Boost Your Self-Esteem

    February 7, 2020

    What does it mean to have a healthy self-esteem? Some people think it means you are okay with how you look. Other people think you must accomplish something big in your life to have a good self-esteem. But the reality is, having a healthy self-esteem means you like and appreciate yourself faults and all. A […]

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    How to Boost Your Self-Esteem

    What does it mean to have a healthy self-esteem?

    Some people think it means you are okay with how you look. Other people think you must accomplish something big in your life to have a good self-esteem.

    But the reality is, having a healthy self-esteem means you like and appreciate yourself faults and all. A good self-esteem can be the difference between being a happy, resilient individual, able to face life’s challenges head on, and someone who suffers from depression and anxiety and is often overwhelmed with life.

    If you have struggled in the past with self-esteem issues, there are some things you can do to give it a much-needed boost:

    Face the REAL Reality

    Are you someone that generalizes your lack of self-esteem? By that I mean, do you make generalities about yourself such as, “I’m an idiot,” “I’m not pretty enough or smart enough?” The truth is, we all act like idiots from time-to-time, and most human beings on this planet can find someone who is smarter and more attractive than they are.

    If you’re going to work on your self-esteem, you need to first recognize that you often lie to yourself with these generalities. It may be a very convincing lie from your point of view, but it’s still a lie.

    To become familiar with reality, make a list of 10 of your strengths and 10 weaknesses. If you have a hard time coming up with your strengths, think about what others have said about you: you’re a good listener, you are thoughtful, you cook a mean burger.

    When you’re done making this list, you’ll see there are plenty of things you are really good at. And, some of the weaknesses may be things you can absolutely change over time and with some effort.

    Forget About Perfection

    Perfection doesn’t exist. Now you may think all of those Hollywood A-listers that are on the cover of magazines are the epitome of perfection, but even they are air-brushed, photoshopped and have a team of people following them around so their hair is never out of place.

    Stop spending your energy trying to have the perfect face, body, bank account, career, children or relationships. None of that exists. Focus your energy on achieving attainable goals like obtaining your degree and enjoying hobbies.

    Get to Know Your Authentic Self

    We spend so much of our lives comparing ourselves to others that we don’t really take the time to get to know ourselves. Beyond strengths and weaknesses, who are you as a person? What makes you happy or excites you? What hobbies do you enjoy? What kind of brother or sister are you?

    The more you know about yourself, the more chances that you’ll find things out you really like.

    If you would like to speak to someone about your self-esteem issues, please be in touch with me. I’d be happy to discuss how I may be able to help.

    Filed Under: Adolescents/Teens, Depression, Self-Esteem

    Are You Married to a Narcissist?

    February 4, 2020

    When you met your spouse, did it seem like love at first sight? Was there a familiarity to them and a feeling that you were somehow drawn to them? Soon after you said “I do,” did they begin to change? Were they giving you less attention and making everything about them? Did they show fits […]

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    Are You Married to a Narcissist?

    When you met your spouse, did it seem like love at first sight? Was there a familiarity to them and a feeling that you were somehow drawn to them? Soon after you said “I do,” did they begin to change? Were they giving you less attention and making everything about them? Did they show fits of rage or suddenly start giving you the silent treatment?

    If any (or most) of this sounds familiar, there’s a very good chance you married a narcissist. Still not sure? Here are some common warning signs:

    Unreasonable Expectations

    For narcissists, it’s all about THEM. This means your spouse may expect you to meet their needs 24/7 while your own are placed on the back burner. If you find you give and they take ALL of the time, you may be married to a narcissist.

    Jealousy

    They talk a good game, but narcissists actually have low self-esteem. This also makes it very easy for them to become jealous – VERY jealous. And not just about anyone interested in your romantically, but ANYONE who can take focus off of them, including children, pets and other friends and family members. This jealousy will trigger intense rage.

    Projection

    Narcissists all have the same power play and that is to project their own behaviors onto others. You see politicians do this all of the time. Your spouse may say that you are needy or have anger issues, and in your head, you are thinking, “Wow, you are so describing YOU right now.” Yes, they are – they are projecting.

    No (or Fake) Apologies

    Narcissists have no empathy. That is, they truly don’t have the ability to look at something from another person’s perspective. You may be hurting or having a bad day, but your spouse seems completely uninterested. They ARE uninterested.

    No empathy also makes it hard for them to take any responsibility for their behaviors and actions. But they have enough awareness to know they should at least make it LOOK as if they care, so they will throw you a hollow apology every so often.

    Narcissistic abuse is very real, and if you have been the victim, you most likely feel exhausted and shell-shocked, lacking confidence and self-worth. If you would like to talk to someone about this, please be in touch with me. I would be happy to discuss how I may be able to help you heal from the abuse you’ve endured.

    Filed Under: Abuse/Neglect, Couples/Marriage, General, Issues for Women

    How to Control Your Anger

    January 28, 2020

    Someone slides into the parking spot you had your eye on. A coworker takes credit for your work. Your spouse runs up $200 on the credit card without discussing it first. These are things that are apt to make you angry. And that’s okay. Anger is a natural response to many life events. Like other […]

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    How to Control Your Anger

    Someone slides into the parking spot you had your eye on. A coworker takes credit for your work. Your spouse runs up $200 on the credit card without discussing it first. These are things that are apt to make you angry.

    And that’s okay.

    Anger is a natural response to many life events. Like other emotions, anger helps us understand our world and how we feel about it. When managed well, anger can provide a healthy release and be a motivator for transformation. But when we experience too much anger, to the point of becoming out of control, it can have lasting ramifications.

    Our Brain on Anger

    When anger reaches a very high level, our pre-frontal cortex, that is the part of the brain responsible for cognitive thought and reasoning, becomes hijacked. The amygdala, our primal emotional/instinctual part of the brain that induces the “fight or flight” response, takes over and we are no longer capable of rational thought.

    When aroused to anger, our brains can no longer take in new information. This means if our partner or loved one is trying to talk sense into us and explain something, we CANNOT hear them. All we are aware of is that we must defend ourselves as if our very life depends on it. We feel under extreme attack and are ready to fight back.

    How to Control Your Anger

    Now that you know how your brain responds, it’s time to learn some techniques to manage your extreme anger.

    Take a Breather

    You know that the hotter you get, the more your brain shuts down and becomes unable to process any information. There is no sense in you continuing to talk/argue with someone. Your best course of action is to put the fire out before it begins to rage by calling a time out and taking a breather.

    Exercise

    The body’s “fight or flight” response releases powerful hormones that are intended to help us fight or run. Without this physical release, they can linger in the body and cause health problems. Going for a walk, run or lifting weights can be a great way to burn through these hormones and release soothing endorphins.

    Seek Out Counseling

    Managing extreme anger can be very challenging, especially in the beginning. A mental health professional will be able to share coping strategies and techniques to control outbursts.

    If you or someone you love has anger management issues and would like to explore treatment options, please be in touch with me. I’d be more than happy to discuss how I may be able to help.

    Filed Under: Anger, General

    What is Mindfulness-Based Cognitive Therapy?

    December 31, 2019

    You’ve probably heard of mindfulness meditation, but what exactly is Mindfulness-Based Cognitive Therapy (MBCT)? This form of therapy uses mindfulness practices like breathing exercises and meditation to help clients break free of negative thought patterns. What Can MBCT Treat? MBCT was first developed to prevent individuals who were struggling with repeating episodes of depression and anxiety from […]

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    What is Mindfulness-Based Cognitive Therapy?

    You’ve probably heard of mindfulness meditation, but what exactly is Mindfulness-Based Cognitive Therapy (MBCT)? This form of therapy uses mindfulness practices like breathing exercises and meditation to help clients break free of negative thought patterns.

    What Can MBCT Treat?

    MBCT was first developed to prevent individuals who were struggling with repeating episodes of depression and anxiety from relapsing. Studies have found MBCT to be very effective at helping people with major depressive disorder who have experienced at least 3 instances of depression in their life. This therapy approach may also be helpful in improving the symptoms of depression in those with disease and physical illness, such as cancer and traumatic brain injuries.

    How Does Mindfulness Help Depression?

    You may think that meditation is something only monks or yoga masters do, but everyday people are reaping the major mind and body benefits through mindfulness meditation. Depressed people suffer rumination, that is they become stuck in mental patterns. They often mistake their rumination for problem-solving, but in reality, rumination prolongs a negative mental state.

    Meditation works by disrupting the mental process of rumination. When you focus your mental attention on the present moment, you cannot ruminate. While it’s hard for any person to completely stop the mental process of rumination, it’s our choice whether or not we engage with it. Meditation helps us “just say no.”

    How to Find an MBCT Therapist

    MBCT is usually held in group sessions once weekly for 2-hours each. The meditations and breath work will be led by your therapist. He or she will not only lead you in these techniques but also the fundamentals of cognition, such as the relationship between your thoughts and how they make you feel. Your therapist will also most likely give you homework to practice the breathing and meditation techniques you’ve learned that week.

    An MBCT therapist is a cognitive behavioral therapist who will have had additional training in mindfulness-based practices and techniques and is able to teach these to others. Beyond looking for these specific credentials, you’ll also want to find a therapist you feel comfortable working with. After doing a bit of research for qualified therapists in your area, get on the phone and talk to a few to see who you may like working with the best.

    If you or someone you know may be interested in exploring MBCT, please reach out to me. I’d be happy to discuss how I may be able to help.

    Filed Under: Anxiety, Depression, General, Issues for Women, New Mother, Self-Esteem

    Coping with the Holidays After Loss

    December 26, 2019

    For many people, the holidays are about spending time with loved ones. But for those who have suffered a recent loss, the holidays can be painful and isolating. Here are some ways you can cope with the holidays after a loss: Recognize You are Not Alone It’s easy to feel as though you are the […]

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    Coping with the Holidays After Loss

    For many people, the holidays are about spending time with loved ones. But for those who have suffered a recent loss, the holidays can be painful and isolating.

    Here are some ways you can cope with the holidays after a loss:

    Recognize You are Not Alone

    It’s easy to feel as though you are the only one experiencing great pain during the holiday season. Everywhere you turn, people seem to be happy, putting up decorations, buying gifts and making holiday plans. It’s important to recognize the truth right now, and that is that you are not alone. There are people all over the world who have experienced loss, some perhaps very recently.

    Honor Your Pain

    No one expects you to feel joyful and in the holiday mood right now, so don’t feel as though you must pretend for others’ sake. It is very important that you honor whatever emotions you may be experiencing, whether it’s sadness, anger, regret or a combination.

    Take Your Time

    The holidays are usually a busy time for people. There is much to accomplish and many events to host and/or attend. You do not have to keep your normal schedule this year. You simply will not have the mental or emotional stamina for it. So take the time you need. If you don’t feel like attending many (or any) events this year, that is fine. People will understand.

    Help Others in Need

    One of the worst parts about losing a loved one is the feeling that we no longer have any control over our lives. Loss makes us feel helpless. One way to fight this feeling is to help others who are in need. As a bonus, connecting with others who are hurting can often be a salve on our hearts as well.

    When Don’t These Guidelines Apply?

    If you have children, it’s important to understand that they are looking to you right now to know what life will be like from now on. To a child, the loss of a parent or sibling can frighten them terribly. Though you may not at all feel like celebrating the holidays, doing so helps your child know that life does go on and that there is space in your life to feel joy along with sadness.

     

    If you have experienced loss and would like to explore grief counseling, please be in touch. You don’t have to suffer alone.

    Filed Under: Depression, General, Grief

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    3881 Ten Oaks Rd, Ste 2A
    Glenelg, MD 21737

    (443) 520-1005
    jpiffath.lcpc@gmail.com

    Convenient to Glenelg, Columbia,
    Ellicott City, & Western Howard County

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    Jim Piffath, LCPC
    jpiffath.lcpc@gmail.com | (443) 520-1005

    Counseling services in Glenelg, Columbia,
    Ellicott City, and Western Howard County

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