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Masterclass 39

[ "I would look at  getting engaged with a support network of individuals who may also have autistic children.  They will understand some of the things that you are experiencing at home and you may also find someone who feels that same way as you. If you have not sought professional counseling for the abusive relationship I would seek out a therapist who can help you process through it so you do not repeat similar choices in your next relationship.", "Unfortunately I think most of us have heard this, so you are not alone.  If you are still under her roof she has leverage as to what her expectations are while you are living there.  I would consider therapy for the both of you to see if there could be a middle ground that could be agreed upon.  Often times a 3rd party can help with conflict.  If there is no resolution then I would look to get creative in finding a place of your own.", "Blaming others is one of our greatest coping mechanisms.  It is not just for addiction, and often we blame the ones closest to us.  You can not stop them from blaming you, you can stop yourself for taking on the burden.  We are all in charge of the choices we make.  No one makes us do something other than our self.  We choose how we internalize and react to situations.  I would find a good therapist who understands family dynamics and addiction to help you cope with your current environment and help you move forward.", "First I am so sorry for your loss.  Most people go through the grieving process.  I would get a better understanding of what that process is.  Everyone has their own way of handling loss.  You are taking the first step in realizing that you are having a difficult time coping with it.  I would reach out to a therapist that has experience treatment patients with loss. I would also recognize that drinking and smoking are both substances that will not make depression or depressive thoughts any better.", "It can be very frustrating being lied to.  The one thing that struck me was the sentence he had a alcohol addiction \"in the past.\"  Addiction is not something that comes and goes.  Once you have addict tendencies they are here to stay.  You may be able to fight them off for awhile but the will enviably rear their ugly head again.  Some of the things that we would suggest is taking the access away.  If the alcohol is not conveniently in the house he would have to go seek it out elsewhere.  You can think about it in other terms.  If chocolate cake was your favorite food and you were a diabetic, you would not have chocolate cake lying around all the time because you know you would eventually eat it.  Remember there are no temporary addicts.", "It can be challenging to quite anything once we set our mind to it.  We often crave the things more that we know we can not or should not have.  With that being said I would encourage you to become aware of the chemical dependency part that cigarettes have on your brain and your body.  Then make yourself aware of the mental part the habit part.  Often times people will engage in smoking again just from the mere social aspect of it.  Make yourself aware of these and devise a plan of the things you will do instead of going out on smoke breaks, or the ritual of smoking in the car on on the back porch.  There are plenty of support groups out there to help with this as well.  Smoking cessation is a good resource.", "Speaking with a licensed therapist will help you figure out if indeed you have a problem or not.  I would say the first question you should ask yourself is why you are drinking? The second would be why you feel the need to drink in excess? It may be due to a life event or the crowd you are running with.  Either way a therapist will be able to help you through this as you already made the first step in admitting you are having a difficult time.", "I would suggest having a conversation with your dad and then having a conversation as a family with your stepmom.  Usually there are other signs of use that can often be missed.  Be aware of behavior changes and mood swings.  Be supportive and ready to listen often times individuals suffering from addiction will deny use until they are ready for help.", "Wikipedia states, Alcoholism In a medical context, alcoholism is said to exist when two or more of the following conditions is present: a person drinks large amounts over a long time period, has difficulty cutting down, acquiring and drinking alcohol takes up a great deal of time, alcohol is strongly desired, usage results in not fulfilling responsibilities, usage results in social problems, usage results in health problems, usage results in risky situations, withdrawal occurs when stopping, and alcohol tolerance has occurred with use.  Hope that helps.", "Your dad needs to be aware that he has a problem and be willing to make some changes in order for him to be motivated to stop.  Often times individuals will be forced to stop when they were not ready.  Remember we can not ever make someone do something they do not want to do.  There needs to be at least a little willingness on the other party to make some changes.  I would encourage you to reach out to your family or other loved ones and have a conversation with your dad regarding your concerns.", "Studies have proven that addiction affects the brain, there are many coping skills that addicts use to enable their addiction as well.  I would recommend that you speak with someone abut your relationship and your concerns.  Not only so you can have more clarity in the situation but we often tend to gravitate around or toward the same types of individuals.  Being more aware of your relationship will help you in the future when re-engaging in personal relationships.", "Your friend needs to admit they have a problem.  If not no matter how many pills you take they will find a way to get more.  It is also a federal offense to take someone else's medication so if you did take it she could have you arrested.  In other instances it can be more dangerous to take medication away than slowly tapering off of them.  Like anything we put into our system our tolerance builds up and can effect us in different ways.  I would listen to her and discuss why she feels that she needs to be on the medications rather than playing bad cop in this situation.  Encourage her to get help and let her know you re there for her.", "I think the best thing for you is to speak with someone on how you can best cope with the situation.  It can be challenging living in a household with someone who is currently addicted.  It is also important that you realize that you can only work on yourself.  Other individuals need to take the same accountability.  Enabling often happens in households with addiction. It can be a challenging environment to live in.", "You are not hopeless, as you can see there are many people who care about your well being and believe you can overcome this.  I would suggest that you first get evaluated for your alcohol consumption.  Alcohol is one of the addictions that you may need to seek inpatient treatment for.  If not inpatient then be monitored by a doctor.  Once you are evaluated and or complete inpatient treatment I would suggest you participate in a form of outpatient therapy on a consistent basis.", "There are plenty of online providers within the mental health field that would me more than happy to speak with you immediately.  Many of them provide treatment on a sliding scale fee.  I would google online mental health treatment providers and that should lead you to a list of providers that can help you.", "I would first suggest you sitting down with him and voicing your concerns about how distant he has been, or more importantly you have felt that he is.  This will give clarification to the situation as we need to remember that everyone's perception can be different. Remember that relationships take work and take communication.", "Acknowledgment from your husband and wiling to make changes is essential first.  We often try to force people to make changes hoping that they will see that we are right, even when they may not be ready.  Having a willingness to work together and be supportive is fundamental in recovery.  If he is not quite there yet I would snuggest individual therapy for yourself where you have an outlet and can also gain suggestions on what the next steps might be. If he is ready I would suggest you engage in therapy together and be ready to listen to him and what his needs might be.", "I am so sorry for your loss.  Generally therapists only have a duty to report self harm to ones self or others if it is expressed to them.  Often times they will not report relapses due to the fact that proper releases were not signed or patient has specifically asked them not to for fear of shaming or failure again.  I understand this may not be the answer you were hoping for.  I would encourage the family to seek therapy themselves for help coping with such a loss.", "I think it is important that you are able to convey what you are looking for in a therapist even if that changes over time.  You need to look at it like you are interviewing the counselor and that they will be able to provide you with the therapy you need.  To many times we do not know and it ends up not being a good fit and then people are left with a bad experience and do not want to re-engage.  Remembering you are basically hiring someone to help you so I would treat it as such. Do some research and be clear as to why you are coming to therapy and ask questions as how they will be able to help you.", "A good therapist will discuss what brought you to therapy in the first place and devise a therapy plan with you on some of the things that you may want to work on.  The plan is not set in stone as things may arise during your therapy sessions. You also agree on how often and when you would like to meet." ]

[ "I am so impressed to hear that despite all that you have endured, you're open to and asking about therapy! That. Is. Incredible.I don't believe there is a person who has \"too many\" struggles or is \"too far gone\" for therapy. Often, our numerous struggles are like the roots that grow from a plant bulb. They're are a lot, but they all lead back to the bulb. That is, we can have many symptoms and experiences that are often rooted from a few deep, primary issues that, once addressed, can resolve more than one symptom/experience like the image below illustrates.", "Short answer: YES.Feelings of worthlessness can have many sources. Some examples: feeling like you don't measure up; repeated experiences where you were told you were worthless; abrupt life changes; and depression. Once those thoughts start, we often latch onto them for dear life because they serve a purpose and actually help us in some way. A big key to starting the journey to self-acceptance and self-worth is to understand why you feel worthless. Where the heck did these thoughts come from? Get curious about it. Once you start to understand where these invalid thoughts are coming (I know these thoughts are invalid for a fact because I, a random therapist on the internet, cares for you and knows your worthy. So, take the jump and start exploring that intricate noggin' of yours. You've got this!", "This is a great question! When you look forward to sessions because you feel calm, comforted, supported, and growth -- that's how you know you found the right therapist. Therapy can be uncomfortable simply because you start looking at parts of your life and yourself that you've been avoiding or hiding. BUT, a therapist shouldn't make you feel attacked, judged, dependent, or weak.A good therapist will \"train\" themselves to best suit you and your needs. I truly hope you find your match!", "YES. Absolutely it is appropriate to cry during a therapy session (or all of them). Crying is a physical representation of acknowledging, expressing, and releasing emotion. Our bodies are very smart and often know what we need to heal. The urge to cry is our body telling us it may be time to let some stuff out." ]

[ "Hi, This sounds like a very challenging and upsetting problem - good for you for reaching out! My first thought is, these two adults may have a sleep disorder that could be contributing to the urination in inappropriate places. Since they are adults, and you can't force them to seek treatment,  you might be able to suggest that there could be an underlying medical issue and advise they speak with a medical provider. . As far as what to do for yourself - set some firm boundaries. Be clear about the expectations of your home. Also include the positive and negative consequences should they decide to address or avoid this issue. I hope this helps you, your family members, and the pets!", "Hi. It can be difficult to handle such a transition on your own. I work with clients to understand their needs and wants. This can involve how to communicate effectively with friends, family, and other loved ones; or, learning how to have self-acceptance. I strongly recommend speaking with a licensed clinician one on one to help facilitate the change you are looking for." ]

[ "Participating in therapy can be incredibly vulnerable at times, and can evoke lots of emotions that may or may not lead to tears. It is okay to experience these emotions in and outside of the therapy space.  Therapy should be a safe place for you to be yourself, be in the moment, and give freedom toward healing and personal growth." ]

[ "Not at all! Whatever issues you might have you can bring to the therapy room. Remember therapy is about YOU, not your therapist. You bring whatever you need to bring to the table. Keep in mind these issues are likely related. Remember you are a holistic being, more than just the sum of the parts. Just like any system, when you move something in one area, things start changing in other areas as well. Talk to your therapist to decide goals for counseling and establish priorities, and ENJOY THE RIDE! Growing, flourishing, and finally letting go of what hurts can be a beautiful and exciting process.", "You can, for sure... and the first step is to believe you are worthy TO YOURSELF. Recognizing you are in a quest is already a big first step. Taking the time to start figuring out who you are is definitely the next... do so with SELF COMPASSION and kindness. Know this is a process and just look forward for what you might find.  I do recommend you find someone to talk to (there are many options out there that can fit the situation you are in), and I also recommend you start by giving yourself the importance to invest some time and effort in this quest. YOU DESERVE IT. There are some excellent TED Talks you can google, great books you can read, or even joining a yoga practice, team or some kind of hobby may help. Anything that shows yourself you are worthy of this effort. Have patience and start!!!! the answer is out there waiting for you. Asking these questions already set you on the right path." ]

[ "Yes, it is normal to cry in therapy. When opening up and talking about uncomfortable feelings or experiences that a person has been holding onto, there is a lot of emotion that is being released whether during a therapy session, close friend or family member.We all have painful memories and feelings. Talking about things brings up a lot and tears sometimes will follow. If you cry during a session, it just means that you have been holding onto difficult thoughts/feelings that you finally are ready to look at and talk about.In the beginning of working with a therapist, lot of people feel uncomfortable when they cry. Often they will apologize for their tears, question why they are crying now or try to dehumanize their feelings by labeling them ( i.e. as silly, stupid, annoying). There is no need to apologize or use labels, as therapists know that with therapy comes healing. Sometimes healing needs tears.Life at times is difficult and the stories behind one's emotions can be moving for both a client and therapist. As a therapist, I sometimes find myself wiping a few tears away too. That's when you know someone is really listening to what you are sharing and understands the road you've walked.-Adrienne Licari - http://www.positivetherapyservices.com" ]

[ "It is completely understandable that you are struggling to forgive and forget this betrayal, and I'd like to echo the sentiment of Danielle Alvarez: infidelity takes time to heal from, so allow yourself to grieve and find the support you need. I'd highly suggest going to couples therapy and addressing all the issues that Danielle raised, especially whether he has expressed genuine remorse and is being completely transparent with you and is taking responsibility for the choice he made, including acknowledging the immense impact it had on you, your relationship, and your ability to trust him. If you have doubts about being able to trust him, he needs to be willing to earn back your trust and do whatever it takes to do so. If he accepts this challenge, then that is a good sign you are on the path toward healing your relationship. Also, please don't ever forget that regardless of what led him to cheat, it was his decision to take that action rather than addressing whatever issues he was having in your relationship. Couples affected by betrayal typically have some underlying issue(s), whether it is a lack of connection or intimacy or another factor, and it is possible to heal and grow even stronger as a couple after betrayal. Because you are grieving, though, allow yourself to acknowledge and accept your feelings of hurt and pain, as they will likely come in waves, but the pain will lessen over time and with supportive therapy, along with the commitment to repair your relationship-from both you and your husband. Also, in regards to your concern about hurting your children, keep in mind that parents model healthy relationship behavior for their children. If your relationship with your husband remains disconnected, untrusting, or bitter, your children will see that and not only feel sad that their parents are both suffering, but also grow up feeling that experiencing such ongoing pain is tolerable or even normal in a relationship. Having parents who learn to handle conflict or heal deep wounds in healthy ways is crucial for children's emotional and psychological development. Whether they see you heal together as a married couple or heal separately as loving but divorced co-parents, they will learn what it is like to expect healthy communication and boundaries in relationships, which I'm sure you want for your children! Take care of yourself, and I wish you much peace and healing. Also, here is a good book I would recommend, along with books by Gottman, as Rebecca Wong suggested:Private Lies: Infidelity and the Betrayal of Intimacy", "Hi there! It sounds like you have already started to answer\nyour own question by stating that you love cross dressing very much, and I am\nglad you enjoy it! Cross dressing is something many people enjoy, and there is\nno harm in it whatsoever. My question to you would be: What is making you feel torn\nabout it? There is unfortunately still a lot of negative stigma associated with\npeople who express their gender or sexuality in ways that differ from the\nmajority. (And sometimes certain sexual interests are actually very common or\neven in the majority, but because people carry shame about being different when\nit comes to gender and sexuality we assume we are all alone!)Being a sexual or gender minority or someone who\nparticipates in kink or expresses their sexuality or gender identity in a\nunique and personal way often means suffering from something called\n\"internalized oppression\". We grow up being exposed to certain\nassumptions and beliefs about what is \"acceptable\" behavior and even\nface consequences sometimes if we don't \"fit in\" the way others tell\nus to. Even if those assumptions are harmful and wrong, we still internalize\nthem and feel guilty about who we are. There is nothing wrong with us, but\nfeeling stigmatized and isolated can lead to feelings of shame, embarrassment,\nor like something is \"wrong\" with us.But there is absolutely nothing wrong with you, so be proud\nof who you are and what you enjoy. You can continue to simply enjoy it\nprivately, or maybe you'd eventually like to share it with a partner or maybe\neven join a community with similar interests. I'll leave you with a quote from\ncomedian Eddie Izzard, who identifies as, in his own words, a \"straight\ntransvestite\": \"They’re not women’s clothes. They’re my clothes. I\nbought them!\" Take care, and thanks for your question!", "Hi there, and thanks for your question! To answer your question, I'm going to point you to a link from Dara Hoffman-Fox's blog. Dara is a gender therapist like myself, and everything Dara says is very accurate! Ask a Gender Therapist: “I Want to Transition – Do I Have to See a Therapist?”Also, since you asked specifically about hormones, it really depends on where you live, how accessible transgender friendly medical providers/endocrinologists are in your area, and also whether you feel you would benefit from counseling-regardless of whether a counselor's letter of referral is required from your medical provider. I hope this information helps!" ]

[ "Sounds like you have a high achieving daughter! That's something to be proud of! Yet, as you're aware, your daughter's efforts to maintain such a high level of achievement is causing her to experience high levels of stress. I can only imagine how this is impacting her overall wellbeing and quality of life. And I agree how this may not feel normal - because truthfully, why would anyone want to accept this as normal? It's hard to see someone you care about suffering - and it's really natural for you to worry and question her behaviors. And just like it is natural for you to care and worry about someone that matters to you, it's quite natural for your daughter to worry and stress out about something that matters to her - in this case, her schoolwork. It's important to understand more about what she is going through and providing her the space to openly talk about her issues, concerns, and stress. This open and honest conversation can lead to opportunities to support her in navigating the terrains of her challenges. Some stress is good for us - but chronic stress can be detrimental.  It's vital that your daughter is developing and enhancing her survival skills with coping tools to effectively manage her stress so that she can continue achieving her target goals. And, as a parent, you are not alone. Supporting and raising a child is no easy task. There's a huge gap in our society when it comes to parenting - so please also give yourself a break and know that there is support for you as well." ]

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[ "It is great that you are noticing these changes with your daughter. I can’t offer advice without knowing much more about your particular situation but some things to think about:Has something else happen recently that has been stressful, upsetting?Is your daughter trying to communicate something to you and if so what might that be?Have you discussed these recent changes with her? (Without being too serious or accusatory)There is so much changing for her (and you) now-communication and connection are crucial. I hope you both can talk to a supportive person about all these changes.", "Self-doubt and self-hatred are such common and unpleasant experiences and really worth  understanding! Therapy with the right person can really help. When in your life do you feel the most confident? What gets in the way of you accepting and loving yourself (big question!). You can and will uncover that confident self!" ]

[ "Hello! Emotions run high in \"crush\" situations and when emotions run high it's not uncommon for us to have emotion-based instead of fact-based thoughts. After reading your question, I wondered how you went from \"making out\" to \"nothing happened?\" I wondered if this happened because of an emotion-based thought that sounded like \"If he liked me, he would make something happen.\" A truer and more empowering thought might be \"I want something different to happen with him and I want to take a different action to see if that can happen.\" This thought focuses more on the one thing you can control: YOU.  Hopefully, the thought also empowers you to think through what you can do to gauge interest/talk with him about his feelings on the matter. I hope this helps and good luck to you!" ]

[ "Fear is a part of life. In fact, our five main emotions are joy, fear, sadness, shame, and anger. We tend to spend a lot of time and energy running away from or trying to get rid of most of those emotions and the more we do that, the more we set ourselves up for failure and disappointment. As a result of viewing our human emotions as \"bad\" or \"wrong,\" we often get caught up in a trap of thinking we have to overcome them or get rid of them before we can do what matters to us. In reality, you can do what is important to you while having your fears! My question for you is, what would you do if this fear was completely gone? What behaviors would you have if you were the ideal you? What skills, knowledge, or personal qualities would you develop? What kind of relationships would you have?I imagine your fear has kept you from achieving those goals because your mind tells you you can't do it until the fear is gone. I challenge you to do the following exercise:What is a goal you would like to achieve? Example: I would like to change careersWhat actions are necessary to complete this goal? Example: see a career counselor to determine my ideal career, go back to school/get a certification, network with others in my desired industryWhat thoughts, feelings, or urges might get in my way? Example: thoughts of \"What if I fail? I'm not smart enough. I can't do it. I'm too busy to put energy into this.\" Feelings of fear, shame, excitement. Urges to distract myself through drinking or watch tv instead of taking action.It would be helpful to remind myself that: example: It is natural to have these thoughts, feelings, and urges but I can take action anyway. I deserve to have a fulfilling life.The smallest and easiest step I can take now: example: research career counselors in my area and write down their phone numbersThe time, day and date that I will take that first step, is: example: Tonight at 7pm At least think through these answers but it is most beneficial to write them down. I hope this helps!", "Hi there,I first want to let you know that having these thoughts is completely normal. Studies have been done that show that 80% of human thoughts are \"negative\" so you are not alone. I like to think of thoughts as a tornado... if you are in a tornado, you are completely consumed by it and it is nearly impossible to do anything beneficial. However, when you are, let's say, a mile away from a tornado, it is still scary but you have the option to do something that is important to you such as get shelter or make sure your family and friends are safe. When unhelpful or scary thoughts arise, we tend to start a \"war\" with them, which is the equivalent of jumping into the tornado. This makes the thoughts and emotions bigger and intensifies the feelings that go with them. So the question I imagine you have is \"how do I get out of the tornado?\" There are 3 steps to doing this:Get distance from your thoughts by adding \"I am noticing I'm having the thought that....\" to the front of them. For example, \"I am noticing I am having the thought that something bad is going to happen to me.\"   The purpose of this is not to decrease your fear or get rid of the thought. These thoughts might always be there and that is okay because that is how the mind naturally works so struggling with that is a waste of time and energy. The purpose is to gain some distance from the thoughts so you don't get swept away by them. You can imagine them floating along like leaves in a stream or clouds in the sky (and often the same thought will come back again and again but that's okay... just continue to notice it with curiosity). I imagine the thoughts get in your way of doing what really matters to you so if you can get a little bit of distance, you can do things that are fulfilling and meaningful to you. Tune into your body and notice what sensations come up and where you feel them most intensely. Then breathe into them and make room for them. Our 5 main emotions are: joy, sadness, fear/anxiety, shame, and anger. ALL of these emotions are part of being human and there is no escaping them. So again, struggling with them ends up intensifying them. Instead, let them be and make a little bit of room for them. Often a side effect of this is the intensity will decrease but it might not. The purpose is to keep them from becoming more intense. Contact the present moment. Notice what is happening here and now. One way of doing this is tuning into the five senses. What are some things you hear, see, taste, smell, and feel? Another way is to notice what is happening in your body (without trying to change it). How deep are your breaths, what is happening with your heart rate, are you cold/warm, etc?Implementing these three steps can help you to refrain from getting caught up in your unhelpful thoughts. Unfortunately there is no way to get rid of thoughts or feelings completely. So the only option that works in the long run is to accept them while continuing to do what matters to you and what is fulfilling to you.I hope this helps!" ]

[ "I am so sorry to hear that you are experiencing this.  It can be really hard to deal with our family dynamics, especially when you feel this way and are being told these things.  I would encourage you to keep in touch with people who support you, whether that is friends, a group or club you are involved in or even extended family (if that is an option).  I would also encourage you to seek out support in a professional sense, whether an individual therapist or even in a group therapy setting.The things you are saying to yourself is negative self-talk and it is being fueled by the things others are saying to you.  It can be really difficult sometimes to see the positive in ourselves, and it can definitely take some digging and searching to find it.  But you have it within you somewhere and it is waiting to be let out.  I hope you find therapeutic help that works for you and helps you to see how incredible you are.", "I am truly sorry to hear about your loss, as well as your previous horrible experience with therapy.I agree with what Laura wrote about this, she makes great points.  However, I also want to add a few points.  It seems as though you are at a point where you want to speak to someone.  Honestly, you might not find the correct therapist for you right away.  It can be difficult to find someone who fits with you, who helps you feel comfortable and speaks to you completely unbiased and without judgement.  That being said, those kinds of therapists do exist.  Many therapists offer free consultations, perhaps not the first session like Laura, but a phone call where you can speak with them.  That can give you a good idea of what they are like and if you \"fit\" with them.Alternatively, have you considered going to a group?  This can take a lot of pressure off of you, because there are a lot of grief groups and many are for those who lost loved ones to drug use.  These can be something you do weekly, bi-weekly or even monthly and could be a stepping stone for you to get to the point where you feel ready to see an individual therapist.  It is also helpful to speak with others who have gone through a similar situation.  Check out psychologytoday.com or even google \"grief groups near me\" to see what pops up.  I hope this is helpful to you, again I am so sorry for your loss and I wish you the best.", "I am so sorry to here about what you are experiencing.  Your question is kind of difficult to answer, because there are a lot of things that go into what caused you to develop PTSD in the first place.  You could work on developing ways to work on decreasing the negative responses you are having, such as panic attacks or anger.  This could be done using coping skills, mindfulness and thought reframing.  This could help you to not experience the panic attacks or anger in such intensity.You could also perhaps join an outpatient mental health group, because they help to teach basic coping skills and provide other helpful resources.  If you want to go this route, look at local behavioral health hospitals or even a local hospital, NAMI.org to find more information about groups or even look on psychologytoday.com to see what you can find near you.  Lastly, you could work with a therapist if these don't appeal to you.  I know this isn't exactly you fixing it by yourself, but hear me out.  Therapy is a lot of work, but it is also a lot of self-introspection and self-care.  While you go to see someone, you also have to do a lot of work on your own.  A therapist isn't going to make the changes for you, they just give you the tools and skills you need to get to where you want to go.I hope this helps you and I wish you the best.", "This sounds like a pretty difficult dynamic and I am sorry to hear how it is impacting you.I would encourage you to try and observe the relationship from an outside perspective to begin with.  Try to see what it is that causes your mom to be upset (such as you responding in a tone of voice she doesn't like) and see if there is something you could change on your end.  If you are able to change something, like your tone of voice, start there.  You could also try asking what you could do to help, perhaps she is frustrated that the trash wasn't taken out.  You could also sit down and try to hash things out with her, if you feel like that could be beneficial.Ultimately, you are only in charge of you.  The things you say, your behaviors, are all controlled by you.  So it is important to recognize that no matter what, you can't control what she says or does.  Obviously the things we say or do can impact others, which is why you are frustrated over her behavior.  But remember that you are able to only control yourself.  Seeking therapeutic intervention could also be beneficial for you, and even having her join in to help.  I hope you are able to figure something out and I wish you well." ]

[ "Lots of people do cry in session, but your therapist won't be uneasy with this.  Crying is a natural response and it also releases toxins, so some might say it's necessary!  Remember that you can be in charge of what you talk about in your session and if there's something that feels too uncomfortable, just say, \"I'm not ready to talk about that.\"  Your counselor wants  you to feel at ease and will probably not push you right away to a very uncomfortable place.  As you get to know your therapist, you will feel more relaxed and even not worry so much about how you appear to them.  It's normal to be anxious going into a new situation especially when you might not feel in control of uncomfortable emotions.  Don't give up, go and put your best effort in! Hope that helps, Allison", "Initially, everything is a reminder because there is a trace of that other person present in everything in your life. When we lose someone, we're saying goodbye to what we thought our future was going to be.  Accepting that's changed and allowing ourselves to envision a new future is necessary to \"move on\". Start learning something new or try a new activity that you've always wanted to do.  Find whatever is \"good\" about being out of the relationship and focus on those things.  This can be an exciting time of transformation for you.   As time goes by, you'll add new things in your life that aren't entwined with this relationship and those things will begin to crowd out those things associated with the relationship.  Give yourself a little empathy, no one goes through a breakup without being sad.  It's ok to be sad.  It's even ok to feel devastated.  Loss of a relationship touches a primal need we have to belong.  It makes us feel insecure, unanchored.  In truth, we are ok, safe even.  This experience will open different perspectives for you.  There are lessons you'll take from it that will add another facet to you as a person.  Maybe in time, you'll even appreciate this experience.  I'm sorry you're hurting right now.  Best wishes to you, Allison", "You are right that his insecurities are at the root of the issue.  You cannot change that for him.  He will have to do the work to handle those emotions on his own.  What you can do is reassure him in whatever ways possible, but always recognizing that you can't \"fix\" this for him.  When I work with people who struggle with their partner's past experiences, I always frame it like this:  Everything that you've experienced has resulted in you being the person you are today.  The person they claim to love.  If you had not gone through some of those experiences, you would not be in the position you're in now, ready to commit to him and know that you're satisfied with that.  Just as when bad things happen to us, we have to find a way to appreciate the lessons learned your fiance has to accept that you're the person you are today because of what you have gone through.  Celebrate that you have moved through that and have landed in this perfect position with him!Hope that helps, Allison", "While this might not be the first thing you want to discuss when you meet someone, it is important for you to be yourself.  It's better to weed out 10 people who can't accept you to find that one who can.", "While you can't be responsible for your boyfriend's feelings, relationships do come with expectations.  Both people in a relationship bring their own expectations into it.  These expectations are usually unspoken, but result in conflict as you are experiencing here!  Your boyfriend expects you not to spend the weekend with this guy.  He may expect you not to spend the weekend with any guy at all.  He may expect you to spend every single weekend with him!  You'll have to decide if his expectations are ones you can live with.  Relationships do require some compromise out of concern for our partner, but you get to choose how much you compromise. We get upset about things that make us feel insecure.  You spending the weekend with an ex makes your boyfriend feel insecure.  That doesn't mean you did anything wrong.  It just means that you have to decide if it's more important for you to maintain your freedom to spend weekends with whomever you wish, or to help your boyfriend feel secure in your relationship. Good luck!  Hope that helps,Allison", "Each counselor may have a different process, so I'm not the end all authority here.  For myself, I review policies and confidentiality concerns with people first and answer any questions they have. Then I'll let them know I'll be writing a lot in this session and I have an assessment form that I like to get completed, but I want to have a conversation and I'll ask questions as we go.  My first question is usually, \"How do you feel I can best help you today?\"  Some people are very at ease and tell me many details.  Others are a bit more reserved and I have to demonstrate more curiosity.  Even people who have been very apprehensive are usually feeling very relaxed by the time the session is over.  Usually, when we get close to end of session time, I'll summarize what I think are the biggest concerns from what I've heard and confirm whether or not the person wants to work on those things.  I also try to give an exercise targetting my biggest concern for them to work on in between sessions.  For instance, a relaxation method if they are very anxious.  Counselors are just humans as well, so it does take a bit of time to really get to know another person.  I always tell people that are apprehensive to give the counselor 3 or 4 sessions to determine if they really connect with them.  I hope that helps, Allison" ]

[ "Usually people who struggle with depression also have symptoms of anxiety. These symptoms come about as a result of underlying causes. The obstacles you have been overcoming such as abuse, cancer and insomnia likely bring about similar feelings and emotions in you which affect your self-esteem. Counseling is meant to support people who have layers of difficulties. We see the difficulties as layers to an onion, peeling away the many layers.", "When you feel the frustration and anger building inside you have that be a trigger for you to remember a feeling that you want to experience instead of anger, frustration and guilt, for example understanding. Then say that word to yourself as you take deep breaths. But know that this is normal for caregivers/family members to have these reactions because it is also an emotional roller coaster for you. Even though it is normal it is still good to try to respond differentyl and I commend you for doing that. You also may want to look for a Caregiver Support group which will help you hear from others who also respond this way.", "It is important to set boundaries with those that stress you out. I encourage people to validate the other persons feelings by saying \"I am sorry you are going through this.\" Then, to set the boundary bye stating what you need from them or what you are trying to do with your life to destress and that you can't be a listening ear right now. This will need to be a repeated conversation, but over time you will notice less stress." ]

[ "There is no such thing as too many issues for counseling.  Many people come in with a variety of issues and sometimes we discover other underlying issues.  As you begin therapy, you will be able to explore your history with your therapist and come up with what you would like to focus on first or what appears to be most important.  This is your therapy and you get to decide what is focused on in it.", "That is great that he shared this information with you, that you were tested (and hopefully everything was okay), and that he continues to answer your questions about the event.  It sounds like you are still having some trouble with what happened, and that is okay, and normal/natural.  The question I want you to focus on is why you want to know if he had sex with a prostitute?  I want you to think about what this information would do for you, how you would use it, what-if anything would change in your relationship because of this information.  I also want to ask yourself if you feel like you trust your husband?  Has he done anything like this in the past or since he shared this information with you?  I don't have an answer for you and you may never know, because it sounds like he might not even know.  He did share this information with you, he did make sure to care for you and make sure you were tested for stds, and he does continue to try to answer your questions.  I'm sure he feels a lot of shame and guilt about this experience and understand that you are still feeling hurt and confused by his actions.  I think it is important to explore the event, how you are both feeling about it, and even discuss ways to feel safe when he travels again if that is something that is causing stress and anxiety.", "How do you feel when you meet with your therapist?  Are you comfortable?  Do you feel safe?  Do you feel like you are gaining something from the experience?  Therapy has its ups and downs, it is hard, and sometimes it won't feel good- that is when you are growing and learning the most.  If you feel comfortable, safe, like you can tell your therapist anything (after getting to know her/him- not in the first session), and that you are getting help with what brought you in; then you might have found the right therapist for you.  I always say, its just a feeling- you'll know." ]

[ "Counselors want to help you process whatever you come into therapy with! They can help guide you with where to start and how to start. Their intake paperwork will ask you questions about your life history so they can help you walk through each area. Don't be afraid to share these things upfront with your therapist so they can set goals with you and help you feel comfortable as you get started. It may take some time to explore the different areas, but that is normal! :)" ]

[ "Depression has many different signs and symptoms and looks different for every person.  Often times people think depression is more about feeling \"sad,\" but depression can, in fact, express itself through irritability (or bad mood as you say) and lack of energy.  According to the DSM-V (Diagnostic and Statistical Manual of Mental Disorders), depression includes the following symptoms:-Depressed mood-Irritable mood-Decreased interest or pleasure in activities you usually participate in or enjoy-Significant weight change or change in appetite-Change in sleep (insomnia or hypersomnia)-Psychomotor aggitation or retardation-Fatigue or loss in energy -Feelings of worthlessness or excessive guilt-Diminished ability to concentrate or indecisiveness-Thoughts of suicide or plan The great news is that there are many ways to improve depressive symptoms.  If you are up for it, perhaps the best place to start is by seeing a physician or a therapist who can help determine how severe the depression is and can suggest methods of addressing the depression that fit your lifestyle, values, and capabilities.  Good luck!", "For some people, it really is about \"learning\" to love and like yourself.  Learning this often starts with understanding what gets in the way of you liking or loving yourself.  And more often than not, it is the messages our brain sends that have an extremely powerful affect on how we view ourselves.  The brain is very powerful in tricking us that we are ugly, or dumb, or not worthy, and so on.  But what is amazing and beautiful, is that our brain has great capacity to be re-wired to no longer accept the negative messages but instead replace them with more realistic and more loving messages.  Seeing a therapist/counselor can be a great resource to help you learn to fight those messages.", "For some people, it really is about \"learning\" to love and like yourself.  Learning this often starts with understanding what gets in the way of you liking or loving yourself.  And more often than not, it is the messages our brain sends that have an extremely powerful affect on how we view ourselves.  The brain is very powerful in tricking us that we are ugly, or dumb, or not worthy, and so on.  But what is amazing and beautiful, is that our brain has great capacity to be re-wired to no longer accept the negative messages but instead replace them with more realistic and more loving messages.  Seeing a therapist/counselor can be a great resource to help you learn to fight those messages." ]

[ "I've been in this situation before and have some insight to share with you.  In my experience, he was lying and trying to cover it up. By pushing you to std testing, he's distracting you so he can shift the guilt he feels and blame it on you. In a guilty man's mind I believe he's thinking-...if I cheated...you must have as well....but you're much worse than I because it's okay for me to cheat...but not you...now you're a cheating dirty slut...just like that prostitute Men believe they're entitled to treat women and children like property. Often they use intimidation and violence to control us.  He'll never admit to cheating, he'll never apologize and he'll do it again and again. Truly they don't think it's a big deal, it's just their way of being social. They desperately want us to accept it, perhaps join in the act." ]

[ "No, you do not have too many issues to address in counseling. A lot of people present with multiple issues they want to address, and that shows good insight. Usually in therapy you find that everything is connected together, and the issues are more intertwined than previous thought." ]

[ "Hello, and let me say first, what a great question! There are so many people putting forth their 100% everyday and often times, do not get the credit they deserve. Without being able to fully understand where you're question is coming from, I think there are a couple of different ways to look at this question.First, I think it's important for us to consider the message being sent by those in your life stating that you're \"not good enough.\" Is that ACTUALLY what they said, or is this just what you heard? Sometimes, because of our own self-doubts and fears, we skew and misinterpret the messages we receive from others. Again, listen to the message being sent and attempt to remain objective. Is the message being sent coming from a place of love or concern? If so, have an honest and open communication with that individual about what your concerns are regarding the amount of energy and time you're spending on being \"good enough.\" Explore with them how you feel you'r already giving your best.If the person is unwilling to work at understanding this concern you have, then it may be time to explore the relationship. Some relationships we engage in can be toxic, especially if the other person is toxic. It may be they have their own \"stuff\" going on and they feel the need to constantly put others down to make themselves feel better. If you're in the direct path of this individual, then it serves to reason you will probably be in the direct fire, as well. Explore whether or not you want this relationship to continue in your life. If it's a relationship that MUST continue, then work on what you will do to distance yourself from their toxicity or their problems. Until they're willing to work on these issues for themselves, then it may be necessary to find an exit strategy, such as leaving the room or simply refusing to engage in the conversation. Another perspective of this question is exploring the reason why it's important for YOU to satisfy the expectations of these other individuals? NO ONE will ever be 100% \"good enough\" for EVERYONE. Every single person has their own set of expectations in themselves and expectations in others. It would be impossible to satisfy all of those expectations for every single person in our lives. The question becomes, what is it WITHIN you that feels the need to meet these expectations? There is most likely a part of you, yourself, as an individual that feels \"less than\" and feels as if you, yourself, are not good enough. It then becomes impossible to every feel \"good enough\" for others, because it's really YOU you're trying to feel good enough for. If you already feel as if you're doing everything you can do to be at your best version of yourself, then really work on LETTING GO of the rest. No one is perfect, and striving for perfection in our lives only creates more anxiety and stress. Find a middle ground in which you are happy with your accomplishments and your daily goals, and learn to let go of what's left. After all, tomorrow is a new day and you can work on more of your goals tomorrow!I recommend doing this by finding a mantra, a statement or phrase you can repeat to yourself anytime you start to feel that sense of stress and pressure from striving for perfection. The mantra can remind you to let go of this expectation you have for yourself or that others have for you so you can also let go of the stress and anxiety surrounding the expectation. I leave you with one of my favorite quotes that perhaps you can use as your mantra, \"No one can make you feel inferior without your consent. \" - Eleanor Roosevelt.", "Hello,This question describes a very typical setup of what is called the  Binge, Repent, Repeat cycle. This means that typically after you binge, you experience emotions as you described \"shame and disappointment\" and then because of these emotions you \"repent\" (i.e. vow to never binge again, promise to \"do better,\" go to the gym, etc.) and then ultimately end up bingeing again. There are many coping mechanisms for binge eating and one of the best is actually attempting to NORMALIZE eating. Meaning you need to attempt to eat normally, eating appropriately portioned meals 3 times a day, with snacks in between. IF you binge, then it may be helpful to remind yourself that when you attempt to compensate for your bingeing behaviors, and you end up feeling restricted from over exercising or undereating, then this actually leads to a binge again. Thus, reverting you back to the cycle. If you binge, it will be helpful to try and get back on a normal schedule of eating instead of trying to compensate for the binge. Although it may feel counterproductive, getting back on a normal eating schedule will prevent you from entering into the restrictive cycle. It can also be helpful to remind yourself that the binge has already occurred, it is in the past and the goal is to move forward without focusing on the past. Focus on what you can do differently next time. What emotions or situations led up to the binge? What can you to do prevent or change the circumstances that led to the binge, or the way that you handled the situation? Lastly, if you're struggling with \"normalizing\" eating, it can be helpful to work with a professional that can provide counseling and coaching to help you learn how to eating normally, mindfully and without feeling the guilt and other harmful emotions sometimes associated with disordered eating. I would be more than happy to assist you if you ever have any questions or want to reach out to somebody. You can contact me via my website: http://www.maddenwellnessky.com/", "Hello! I'm so glad you decided to write in today. This is such a great question and I'm sure many others will relate to exactly what you're describing. There are a few different ways we can look at in understanding your concern. First, I think it's important to understand food is just food. Food is meant to nourish our bodies, provide us with energy and yes, sometimes reserved for special occasions and celebrations. But in many cultures, we place a LOT of emphasis on food. We have food at every gathering and every celebration. What's more people have come to almost EXPECT food to be present at any and every get-together. And if it's not? Well, then forget about it! I see this time and time again with my clients. Donuts appear in the office, and it's almost like donuts have never been there before! Must eat one (or two)! However, we need to remind ourselves that this occurrence, or similar ones, will not be the last time we can enjoy this particular food. It is likely the office donuts have happened before, and they will be there again on another day. During these moments, I like to have my clients employ a Stop-and-Think method. Stop-and-Think about your goals before you eat. Is this donut getting you where you want to be? Also, I have my clients ask themselves how special is this donut? If the donut really is a special donut (from the best bakery in town and you've never been there before) then now might be a time to have the donut. But if not, it would be wise to pass and wait until that \"special\" donut. Another aspect we need to remember about food, is to think about what we're getting from overindulging or overeating. Are you trying to drown out other emotions? Are you trying to feel better and the food gives you that feeling for a brief moment? What ELSE is going on? This can be determined by utilizing what we describe as a Thought Record. A Thought Record involves tracking and identifying thoughts and feelings associated with food triggers. By targeting the emotions, we can then determine where they're coming from, as well as how to decipher them. A therapist can also help you with understanding your emotions related to food and will be helpful in assisting you with the Thought Record.The most important thing to remember is that \"food addiction\" can be a real problem for a lot of people. If food is taking over your life and you are preoccupied and overwhelmed with knowing where to start, please seek out help. Binge eating is the most common eating disorder and impacts the lives of thousands. There are lots of free resources and information on my website at www.maddenwellnessky.com. In addition, I offer individual coaching and counseling through my website and I would love to help!- Amber", "Hello, I do not live in the California area. However, perhaps I could make some suggestions as to where you might look for free counseling. First, I must mention that most insurances now cover for many different types of issues, including family issues. If your girlfriend lives with you, most insurances now cover \"live-in partners,\" as well. If you have insurance, contact your policy provider and ask whether or not couples counseling is included.Aside from insurance, the next place that comes to mind is a religious affiliation. Do you belong to a church or other religious organization? Many of the pastors or leaders in these disciplines have significant training in counseling, as well as assisting with marriage and couples counseling. These services are ordinarily offered free of charge to members.Another option might be to explore support groups within the area. There may be a group in the form of a couples support group that brings couples together to explore their relationships in the safety of the group. If you find there are no such groups in your area, there are anonymous, support groups online. Here is one such site: http://relationship.supportgroups.com/" ]

[ "Hello! You may have heard the saying that counseling is like peeling the layers of an onion. Whether a person comes to therapy with many issues on their heart and mind or whether he/she comes with something specific, one issue leads to another. Please don't feel as though you have too many issues. You are important and worthy. On the plus side,  you are a breast cancer survivor and have a wonderful marriage! Seek the help that you deserve.", "Hello, you sound like you have so much on your mind! I am relieved to hear that you have never tried or have contemplated suicide, but not being able to sleep, feeling worthless, and like you shouldn't be here are big issues that need addressing.Please get around to counseling.  Having someone to listen to you is a gift to yourself. You deserve the help of someone helping you change your feelings of worthlessness. You have not been able to do this alone. It's time to reach out for help.  You can do this! Best to you!", "Hi! I'm Amelia. Oh, that is so frustrating! Have you ever heard of social anxiety? Sounds like you may be suffering from it. Here is a link to a quiz... https://www.psycom.net/social-anxiety-test/.Besides being a therapist, I am a Mom to 10 kids. A couple of my kids are very uncomfortable with crowds and become very anxious. Find yourself a therapist who can assess you and spend time with you to address these issues and to help you learn tools to help you navigate these emotions.I am wishing you the best!", "Hello, I am sorry to hear about you feeling verbally abused, trapped without an escape, and emotionally drained. Sounds to me like you are being treated more like a child than an adult.  It's time to learn about healthy boundaries and being treated like an adult. This process will take time, but beyond elevating your self-esteem and worth, you will be modeling to your children a healthy adult. Model to them an empowered, confident, and person that is worthy of respect. Please invest in yourself. Find yourself a therapist that encourages and empowers you to have a voice and not feel invisible. You'll be so glad you did!", "Hi, I'm Amelia! Oh, this is a common problem, unfortunately! Let me say first of all, that doing more, giving more, loving more, performing more will never provide you with a sense of worth. Nor will it satisfy those that are critical and judgmental. I am so sorry to hear that this is what you've heard all your life! You are a human BEING not a human DOING.If you can get yourself in counseling with a trusted therapist who will accept you, encourage you, hear you and support you, you can begin to work on what truth worth is.  My best to you!", "I am so sorry to hear about your loss. He must have been very special to you and it definitely makes sense that you are having a hard time with it. Counseling may be an option if you have a university near you with a graduate marriage and family therapist program. Graduate students provide counseling at a very low cost as part of their traineeship.  Here is an example... http://www.clucounseling.org/.  Another possibility is a support group for bereavement and loss. Many are free. I wish you the best towards healing your heart.", "Hi, I'm Amelia! You know, it does sounds like you have imagined a motherly comfort figure for yourself. Sometimes, when I have a person in my office that is very self-critical, I have him/her speak to his or herself as though he/she were speaking to a loved one. Isn't it sad that we speak to others more lovingly than we do ourselves?If you have not received empathy, nurturing, or comfort from a caregiver, it is hard to internalize empathy, nurture or comfort from the inside. There is a saying that \"We have been hurt in relationships and we can heal in relationships.\" Healing and growth are best provided in the context of healthy relationship. How about going the next step and finding a compassionate therapist or loving mentor that could actually provide you with the comfort that you need. You deserve to be seen, heard, noticed, and valued. I am wishing my very best to you!" ]

[ "Hello and thanks for your question! It's important to have the right therapist. I encourage you to start by checking out the website of the therapist. Their blog articles will reflect the kind of work they do and the approach they may take while working with you. If there's an email listed, go ahead and reach out. Ask the particular questions that are on your mind. Share a little of what you are looking for in a therapist. Are you a goal-direct, solution-focused individual who is looking for someone to listen and ask questions? Are you less self-directive and desire a therapist who can give you the consistent push to move forward? Are you interested in intertwining certain theory approaches? Maybe a cognitive-base or experiential? Art therapy or engaging in exercise while talking? Your therapist is out there. It's OK to try out a therapist for a session or two. Interview them as they interview you. It's also OK to change therapists; ask your present therapist for a referral. He or she should be willing to provide you with names of other providers and there's no shame in asking for it. You deserve to work with someone who fits your style!I imagine there's already enough things happening in your life if you are searching for a therapist. Do you really want to \"train\" your therapist? After all, you are paying them for their knowledge and expertise. It does take time to develop a relationship and developing one with your therapist is vital to your growth and satisfaction. Participating in therapy, for the most part, should be a time you anticipate and not avoid. Can you be honest with them? Are you trusting of the confidentiality they provide? Has this person clearly shared with you the limits of confidentiality if using insurance versus paying privately? Is there any part of you that \"just isn't sure\"? It's okay to assert yourself in therapy. As a therapist, I invite you to assert yourself as it's a way to develop self-confidence and resiliency. Not everyone thrives in therapy by sitting in an office or lounging on a couch. Some folks benefit by challenging themselves in various environments, or are more comfortable in their homes, online, in the community, at a retreat, etc. Give yourself a gift of spending some time finding the person that can work with you towards what you are searching. Although there's the convenience of the local non-profit agency in your area, it may not be what you need. Also, limiting yourself to the names of providers listed on your insurance may not lead to the \"right one\". There are many forms of therapy that insurances refuse to cover. When this happens, many times you can be reimbursed for your expenses by your insurance or you can use a Health Savings Card or Flexible Spending Card, there are many, many options. Therapy is about exploring yourself. Go ahead and feel free!If you feel as if you need to \"train\" your therapist, it seems that person is not the right fit for you. Engaging in treatment should be quite comfortable from the outset of treatment. Many independent practitioners or small group providers offer a free consultation to start the relationship. Perhaps that's a place for you to begin? Good luck and I wish you well!" ]

[ "Hey! Sounds like the part of you that knows the RIGHT thing to do won here! I am so proud of you for admitting that you lied to your Mom! Sometimes lies come out of our mouths before we can even catch them because we are trying to say what the other person wants to hear. I bet that, as you begin to show her that you are not going to lie any more, she will begin to gain trust in you again! Be open with your feelings with you Mom - she is there to support you, guide you and love you! Give her lots of hugs - and give yourself one too for being so brave! Be Wise!", "Hey!  I am so impressed with your efforts to ask questions, to figure out how to change the messages that you hear (and say to yourself), and to get support!  And it sounds like you want to make some changes in your life!  Take a walk over to the counseling office at school, the school nurse or consider reaching out to your Pediatrician’s office. You don’t have to have your parent’s permission to seek support for yourself!  And maybe taking control of your support network will give you the strength to make even bigger decisions about your health!  I am rooting for you!  Be Wise!", "Hey!  It takes a lot of courage to share your feelings with someone!  And it sounds like you have been lucky to meet someone who makes you feel safe enough to explore some of your more painful feelings.  A big part of the process, however, of strengthening your self-concept is learning how to tell yourself those positive messages that you heard from your friend!  Leaving for college may also be contributing to your feelings of unsteadiness.  Try this - Make a list of all of the positive things that you know are true about yourself.  Ask your friends and family to contribute to the list.  Then carry it with you in your wallet - and when you need a self-esteem boost, take a look at it!  You are in a season of life that presents lots of challenges and opportunities.  Reach out to your long-distance friend when you need support - and take a walk over to the campus counseling center and check out what they might have to offer.  Be Wise!" ]

[ "So amazing that you are aware of your social anxiety and distress with others you are in relationships with. You have taken the first step toward a journey of healing! Secondly, make an appointment with a therapist who specializes in neurofeedback and biofeedback treatment. A test is needed to determine which areas of your brain are ‘on’ and which areas of your brain are ‘off’. Then it will be focused treatment which will speed your healing.", "Social Anxiety is scary. You don’t feel safe in relationships and prefer to isolate yourself from the outside world. Is it something you can talk to your parents about? A school counselor could help you. The counselor could possibly order an evaluation to determine how to help.Build your self confidence - Start slow with your family and identify a subject you are familiar with and add to a general conversation. It’s important to start finding things in common with others. You don’t need to carry the conversations, just add a phrase or two. Have an exit strategy if you get too uncomfortable. Keep notes of what worked and what didn’t work so you’ll be prepared for your next opportunity. Carpe Diem!", "It may be helpful to register for a class you can take together. I would recommend mindful meditation or yoga, just the two of you. Something you find time for in a weekly basis. Yoga is amazing in learning mindfulness and reducing stress. I use yoga and mindful techniques when working with children and recommend it to parents to engage with their children. Hope this helps.", "Contact your daughter’s school and ask for an occupational therapy evaluation. An occupational therapist can determine if your daughter struggles with eye-hand coordination, visual processing or sensory motor difficulties. The therapist will develop a plan of care if your daughter demonstrates delays or difficulties in learning. OTontheGo.org mobile therapy that comes to you! Accepting most insurance.", "The answer lies in what the outcome will be. How will things end if you find out he had sex with a prostitute? Will you leave? Will you try to work things out? The multiple versions are concerning. He seems unable to be truthful and this is damaging your relationship. Before considering marital therapy, please find a counselor for yourself. The right therapist can help you uncover what is right for you.", "Be lighthearted, this toddler may not be a morning person! He is most likely wanting to connect with either parent when he arises in the morning. It could be helpful to talk with his parents and establish a routine that he would be comfortable with." ]

[ "A good way to start is the language or \"self talk\" that is happening inside your mind.  Looking at your question, when it is said that the presentations \"make me feel stress\" you are giving the responsibility of the stress to the presentations and taking that away from your self.  The presentations cannot give or take away your stress, that's something only you can do and you can do it!   What language can you change in your self talk?  For example, are you saying \"I can't speak in front of an audience! I'll fail?\"  That sounds a lot different than \"I studied my butt off and if I practice speaking out loud, I can ace this presentation!\"  Although this is a short answer, I do believe that counseling will help you overcome these stressful feelings and bring out your inner confidence.", "Change can be uncomfortable, but sometimes those uncomfortable moments are the opportunity for us to be the person we feel we really are.  It sounds like you like to spend the time in your head anticipating the worst, why not be in the present and encourage yourself that you can talk to people and it will be okay.  By telling yourself it will not be okay, or that it will go wrong you are hurting your confidence to do what you want.  Give yourself some credit for being awesome and tell yourself you can build new friendships...it may be the motivation you need to move past this fear.", "It sounds like you are no longer committed to track emotionally.  It can be hard to talk to your dad about this, but he may think you love track and may not know you are getting so upset the days of meets.  An idea would be to first write a letter to your dad to see what feelings come out and then preparing to speak with him.  I think he will appreciate your honesty and maybe this conversation will bring you relief and also time to find something you really will enjoy.", "Trust is at the top of what makes a healthy relationship.  It sounds like you may benefit from personal counseling to explore where this jealousy comes from and what keeps you from having complete trust in your boyfriend.  This is not stupid, this is your mind telling you that there is something that needs to be worked through.  Sometimes we need to talk to someone like a counselor who is disconnected from our life to understand our feelings and what they mean in our relationships.", "Use this time to explore who you are...imagine what your life would be like if you were gay and not, ask yourself what is different? What scenario do you find yourself gravitating to?  What is important is that you are happy. My message to you is that you do not need to define yourself with your sexual preference or feel the need to label yourself, especially if you are confused and exploring what your sexual preference is." ]

[ "A person never has \"too many\" issues to address in counseling. Participating in counseling with a licensed professional offers a safe place and therapeutic relationship where healing can occur. A trained therapist can help a person unpack and process past and/or current wounds (or events) which may  negatively impact day to day living. They can also help make sense of thoughts and emotions that sometimes feel overwhelming and confusing.  If you want to experience more emotional freedom and gain some tools to help understand and cope with depression and anxiety, I'd encourage you to schedule an appointment with a therapist in your area.", "I'm so sorry you had that horrible experience! It's common for those who've experienced childhood trauma(s) to not disclose the events until later in life. Sometimes it doesn't feel safe enough to share the information until the person who hurt them is far away, or even dead.  Trusting and vulnerability are difficult, especially when we've been hurt. So, it's not uncommon for clients to share that their desire to be close to their loved one (emotionally, physically and/or sexually) doesn't match the reality of what they are able to actually experience.But, there is hope!You have met a loving and caring man, and you have a self-awareness that you did not experience before. I am confident that the help of a licensed professional counselor (preferably trained in trauma recovery) can help you navigate this healing journey and help you gain the tools needed for the life you want." ]

[ "I have had these many cases, but in situations like this.... If it does get out of hand, the police do need to be involved. Sit down and talk to your husband when he is calm and collective.", "In situations like this, in most cases, he probably will not fill anytime soon. It's more of the fact that he isn't ready to give that life yet... Now if you probably pressured him about it then yes, he would probably give in.. But if it hasn't been a big issue anymore or something you guys aren't talking about, then right now.. Everything is on a hold." ]

[ "It sounds as though your daughter is struggling to manage her anxiety and she is having really big reactions to what you view as small problems or issues. What have you tried with her in the past? As exhausting as it might be, a good first step is to empathize and validate her feelings." ]

[ "Hello,I'm very sorry to hear about the loss of your grandpa. My suggestion would be to look into community mental health agencies in your area. Sometimes they can offer low-fee counseling. You can also check the hospitals in your area because they may offer free or low-fee bereavement support groups, which can be very helpful. Lastly, you may want to look into reading some books about grief as they can help you understand the general effects of grief and feel comforted that you are not alone. Lastly, some therapists offer sliding scale, or reduced fee so it doesn't hurt to call some local therapists to see if they offer could offer a very low-fee. I hope this helps! Please take good care of yourself. Grief is so difficult but please know the pain will ease up over time. Warmly,Angela Topcu, MFT" ]

[ "Being a caretaker can be very rewarding and demanding. This is not easy work, particularly when the person you are caring for is experiencing significant changes in behavior functioning. In your mom's case, it appears that her personality has drastically changed, and not just toward you. The first thing is to keep in mind that this is not personal to you. Your mom is experiencing cognitive degeneration, which impacts how a person perceives the world around them and how they respond to it. Educating yourself about Alzheimer's and how to take care of yourself as a caregiver may be very helpful.  It is so important that you have support. It is challenging to take on the task of caring for a person. The adage, \"it takes a village to raise a child,\" is no different in this case. Maybe have breaks for caring for your mom and have someone else help. In those times, you get away, engaging in tasks and activities that are fun and exciting to you. It also may be beneficial to reach out to support groups of caregivers of those with dementia or Alzheimer's.Lastly, individual counseling for you will be so helpful. Talk through these experiences and develop coping strategies such as deep breathing, self-validation, wise mind, or safe/calm place.", "Finding the right therapist is a lot like looking for a primary care doctor or family physician. You may have more than one in your life and also, if it does not work out, you can find a provider that is a better fit. You want to find someone who you believe will respond to your needs and help you accomplish your goals. That being said, it is very helpful to know what are you trying to accomplish in counseling. Therapists will open up the floor for you to discuss and will set treatment goals with you to move towards what you are accomplishing. This becomes the road map. The map keeps both the clinician and client on course. In addition, being very honest about your needs and providing feedback about sessions can be helpful. If you did not like something, make sure to speak up about it, so that it does not negatively impact the therapy relationship. If something works, make sure you speak up about that too. This can help the therapist to know if therapeutic changes need to be made. Similar to a doctor, if a medication is not working, it would be important to let them know so that adjustments can be made.  Therapy is a journey that is unique to each person. Talking about the therapy relationship is a part of that journey.", "Therapy is a safe place where we address a host of different issues. Many times things come up that we may have been too busy to address or we have become skilled in avoiding. We usually avoid or push away painful experiences. When we open ourselves to the healing process of therapy these painful things can be brought forward. Humans cry for many reasons. Commonly we cry when something touches us deeply and is related to a strong emotion of sadness, hurt, confusion, happiness, relief, or some other emotion. It would be natural for the body to respond to these emotions through crying. As a side note: we keep kleenex in every room of our office, lobby, and common areas. http://www.liferebirthed.com" ]

[ "This can certainly be a side effect of some medications. If the voices are so powerful that you can not sleep or they are constantly present, you shouldn't wait any time, but go and see your doctor straight away.", "Although we all want (or wish) that our partner is also our best friend, in reality this doesn't always happen. There may be issues, of course and there are many things to consider there, such as \"why do we need\" another person to confide in, or are we actually attracted to this \"best friend\" but because we know we can't have them we put this thought behind etc. etc. Is this friend and old friend, an old flame or a new acquired friend; the latter is complicated and probably the most questionable, in my view. So, many things to think about and there is no one answer fits all.", "It all depends how old you are and what a particular situation is.  You may be feeling very close to this friend and mistake that feeling for sexual feeling, or the feelings may be real. This is something you will find out for yourself, however, it definitely doesn't mean that you are a lesbian just because you have those feelings for this particular person. Time will tell, but if you need to discuss this, you could see your school councelor (if you are at school/university) or find a LGBT group with meetings and discuss this with them. I hope this is helpful.", "Remember, the past no longer exists and the future is just an illusion as we don't know what will happen tomorrow, so take the present as your guide. That is all we can do, so keep saying this to yourself and try to help someone each day.  The happiness is helping others to feel a bit better." ]

[]

[ "Thank you for your question. It's completely normal and natural to feel nervous before a therapy session. Many people report having felt this way. I can't say enough regarding the amount of courage it takes to reach out and attend a therapy session. For many people, it can take weeks, months, or even years of contemplating whether to see a therapist or not before actually contacting one and attending the first session. It takes courage to want to work through any struggles you may be having or personal growth you aspire toward. In your question, you mentioned that you've \"gone several times and are still feeling nervous and shaky.\" If you feel comfortable with your therapist and it's a good fit for you, I would suggest talking about this with your therapist. You don't have to struggle each time you have your appointment. Together, you and your therapist can work toward helping you have a different experience.", "Hello. Thank you for your question. Many couples that experience infidelity in their relationship face this important question - \"is it possible for us to get past the cheating, or should I just move on?\" Deciding to stay or leave is such a personal decision, one that only you can make.When an affair is disclosed or found out, it can have a traumatic impact on the betrayed partner. The betrayed partner might be overwhelmed by intrusive thoughts - Wanting answers to specific questions - Wanting details. And the partner that had the affair might be feeling overwhelm around \"Will their partner ever forgive them?\" \"Will they trust them again?\" \"How long will it take to regain their trust again?\" While it is possible for couples to get past the cheating, it does take a commitment from each partner to do the work needed. Because of the complexities cheating has on the bond couples have with each other, I would recommend seeing a couple therapist that specializes in working with the issue of infidelity. When infidelity happens, there are usually a number of secrets that accompany it, and this can be incredibly difficult for couples to work through on their own.", "Feeling alone in your marriage is one of the most painful feelings. Wanting connection with your spouse yet feeling the all too familiar distance that's keeping you apart can be so hurtful. But, change is possible. You might be able to move closer toward each other on your own but since there has been two years of distance, I would suggest looking into couples therapy with a trained couples therapist. They are trained in helping couples begin to examine what's been happening that has caused a drift in your marriage. I'm also curious if there was a significant event that occurred around the time you started feeling distant. If there was something that occurred during this time that is hard for you both to talk about, couples therapy can help with this also. It can provide a safe and supportive space for you both.", "When \"threats\" of leaving, such as what you described in your question (\"kicking you out, wanting divorce\") are continuous in your marriage, it can start to erode at the foundation of your relationship, impacting both partners. And, if you're concerned about the influence of another male in the relationship, and are unable to express your concerns or fears to your wife, it's extremely difficult to build a secure functioning relationship. From the information provided in your question, it seems as if there is some avoidance evident in your relationship. Avoidance of being able to express yourself and have honest communication about your relationship. If your wife is willing, I would recommend seeing a marriage counselor to help you both during this time. Or, for you to talk with an individual therapist, if marriage counseling isn't an option.", "It's hard when you feel as if you're the only one that's taking the time to listen to your spouse. But, I would look at this as an opportunity to see if you can become aware of what exactly is happening between you, when you try and talk with your husband. Sometimes, it can be in the way dialogue is approached. I would suggest paying attention to the way you begin dialogue with your husband. See if blame and criticism are present. When blame and criticism are included, bids for connection, can quickly go off track. This can sometimes start off with something like: \"why don't you...\" \"you aren't...\" \"you don't...\" Partners can quickly go into defensive mode if they feel they are being attacked and sometimes starting off like this can feel like an attack.  Also, become aware of the time of day or evening when you approach your husband. Sometimes, this can make a big difference for couples as far as when they can truly be present for one another.  If you find this pattern continues, you might consider seeking professional help through couples therapy. A trained couples therapist can help you both understand more about what's happening between you.", "A resource I think is helpful to learn more about \"what makes a good marriage\" and steps toward doing so is Dr. John Gottman's book: \"Seven Principles for Making Marriage Work.\" Dr. Gottman is a leader in this field and has done extensive studies with couples to determine what behaviors are key in making a marriage work and what behaviors could predict divorce. I think this book might be a good start if you're wanting to learn more about how to have a long lasting relationship.", "One key factor to consider is, are you able to repair after your arguments? It seems from your question that repair is lacking after any disagreement or argument. When couples are able to repair after an argument, they have an opportunity to learn more about each other's needs moving forward. I'm also curious if you're having the same type of arguments over and over? If you're stuck in a particular pattern, and can start recognizing what happens between you when this pattern happens, then you can start to name it. Once you name it, then you can take a break to cool off and come back to each after your nervous system has had a chance to calm down (about 30 minutes). The key here though is to make sure you have a plan in place - when things are good between you - an agreement between you that when you both start to get escalated, you'll name it or have an agreed upon code word to signal you don't want to continue this cycle, and then agree to cool off and come back together at a later time. That way, when this is enacted during an argument, nobody feels abandoned during the cool off time. Rather, both partners know they will return at a time when they can truly hear each other and hear their needs.", "Thank you for submitting this question. I think this type of situation can be common for many couples struggling with how to keep friendships with past relationships while being in a new relationship. For me, more information is needed here...but given the information provided, the way I interpret the question is...I'm assuming your boyfriend didn't know you were going to spend the weekend with your good friend?  Working off of this assumption, I would suggest beginning an open and honest dialogue with your boyfriend about what specifically upset him? And to talk about your point of view regarding spending the weekend with him. I would also suggest talking about how you both envision your relationship when it comes to spending time with others. If you feel like you can't have this conversation without it going off track, please consider seeing a couples therapist. They can help you begin these important conversations that can help shape and develop the relationship you and your boyfriend long for.", "For a therapist, deciding to end counseling sessions or terminate working with a client is a thoughtful and intentional decision. One that is not entered into lightly. While there are many considerations counselors take into account, to help answer this question, I'll offer an example of two areas that counselor's take into consideration when ending counseling sessions:Does the client need different or more specialized care than the current counselor can provide? This requires the counselor to determine whether referring the client to another therapist or health care provider is needed.And, has the therapeutic relationship reached treatment goal(s)? While this question is specific to the counselor, I'd like to also add that a client, at any time, can end counseling.", "Starting the counseling process can be daunting but here are some ways that hopefully help make the process a little less overwhelming. First,I'd start with finding a therapist through a therapist directory and searching for a therapist specifically in your area and with the expertise you're looking for. There are many reputable therapist directories online that offer specific information and links to therapist websites to learn more about how they can help.Next, I'd pick two or three of interest to contact directly. Have a list of questions that are important to you that you can ask to determine whether a particular therapist is a good fit. Many therapists offer a free phone consultation to allow you both to determine whether it is a good fit.Then, after you schedule, the next step is to see what it's like being in session to determine if the fit is still a match." ]

[ "It sounds like you may be struggling with depression. Depression can make you feel overwhelmed and paralyzed to change. I would suggest that you connect with a provider who can help you get to the root of where the worthlessness is coming from and help you develop a plan for recovery. In the meantime, small steps can go a long way. Self-care interventions such as journaling your feelings, mindfulness meditation, and regular exercise are all helpful to reconnecting with the present moment and gaining internal motivation. Focusing on one day at a time and bringing your thoughts back to the present can also be beneficial. There is hope!" ]

[ "It can be maddening when it seems like our partners or spouses are unwilling to hear us—especially when we have been trying for so long to be heard. Being cut off, shut down, or turned away from is very hurtful, particularly when it is a loved one who is doing the turning away.I’m sure you have found that the harder you try to make him hear you, the further away he seems. There are a few things at play here and the situation can be looked at from a few different angles—First, no one likes to hear that they “need to change”. Being confronted with something that someone feels we are doing wrong feels like being criticized and judged—and who responds perfectly to that? The hackles go up, the defenses start rearing their ugly heads, and we dig in our heels. So how do you deal with someone who puts up an instant wall when you are asking something important of them?Consider the tone of your “startup”. When you begin your ask of your husband, is it light and friendly? Is it approachable and warm? Or are you angry, fed-up, and anxiety-ridden from moment one? The way you start the conversation sets the tone for the rest of the conversation, so if you are hoping for a successful conversation, a harsh start up is a poor strategy. Try instead to begin in a way that sets a warmer tone for the conversation. There is no need for you and your husband to be adversaries, is there? You both probably want the same things in many of these interactions at the end of the day, after all. How would you want to be approached? How would you approach a good friend of yours or a work colleague? Is there any reason you should be speaking to him with any less warmth then you would a co-worker or friend?This by itself is not the whole story of course—you may have even tried this. Although, I must say it takes some persistence. Which brings me to the next point—it sounds like you and your husband have already established a push-pull pattern where you push for something and he pulls away and the more you push the more he pulls away. He is likely (as you might be too) already expecting this kind of interaction. This pattern has to be broken. Remaining calm and warm and empathetic to his position (that he is about to be criticized and judged and must therefore defend himself) throughout the entire conversation will help to break that pattern. Imagine his surprise when, where he was expecting an exasperated sigh or a raised voice you instead respond with a kind “yeah, I get that it’s hard to remember to pick up the dog every single time you get the door. I just worry about the dog, you know. I know you care about him too, so I just thought I’d remind you”. And then leave it at that. The next part can be very tough—you really leave it at that. In all likelihood, he is aware that your grandson needs to be looked after or the dog needs to be picked up at the door. Your telling him doesn’t make him any more aware. It only serves to frustrate you, and him, and drive a wedge between you. This is where you get to do the hard work of managing what you can control and what you can’t. You can’t make him pick up the dog any more than you can make the dog sit and stay at the door. But you can control yourself. You can control whether you drive that wedge further between you or let him be responsible for his own actions (or inactions as the case may be).Also, look out for the times when he does something that is “right”. You don’t have to throw a parade every time he remembers to be attentive to your grandson but a simple “thank you” or “that was really nice of you” can really enforce “good behavior” and strengthen your bond. If you find that it is difficult to find times like this right off the bat, look harder. Not only could this do something to brighten things between you from his perspective, it can also help you to feel a little better about things when you are searching for positives as opposed to negatives.Couples counseling can be very useful for understanding these patterns of relating, how to reset them, and gain control over what is available and empowering for you to control. Best of luck!" ]

[ "I commend you for taking such a brave step in talking about everything you have been through. No one ever has \"too many issues\" to seek therapy and I would be willing to bet that many of these concerns are intertwined and once unraveled great relief is to follow. Best of luck on your journey toward healing. Most times our wounds lead us to the best parts of ourselves.", "Being a parent is hard. Finding the balance between nurturing and guidance can be a difficult thing to do. I find that most of us seek validation and sometimes that can be the most helpful thing when experiencing stress and anxiety. Saying something like \"Gosh, it sounds like XYZ is really difficult to take on, I can't imagine what that is like for you.\" Allowing the space for your child to communicate their thoughts and feelings, seeking clarity and understanding can go miles in your daughter feeling heard and understood. Seeking professional help is also a good option. Therapy allows your child the space to work through, process, and find solutions to many of the struggles they are having. Because as we all know, being a kid is hard!", "I am curious, what makes you stay? Sometimes \"managing stress\" is only a band aid to a bigger problem. When you ask yourself \"what your life would look like without this stress,\" what do you see? We can easily talk about coping strategies for stress. Mindfulness, deep breathing, meditation, journaling, exercising etc. All of which may be things to help manage your stress. Hearing your sentiments above \"I am being overworked and underpaid for my contributions\" I wonder if the stress is more resentment and if \"managing\" is really the solution?", "The therapeutic relationship is such an important aspect of the process toward healing. Feeling comfortable enough to be vulnerable is a good starting place. Understanding your own goals for therapy, outcomes you hope to get from it, and the approach you need from your therapist. Each therapist is unique and have their individual styles and theoretical orientations they align with. Open and honest communication regarding what you are hoping to get out of therapy and asking questions from the start of therapist to better understand if their theoretical approach will be helpful to you is a good starting place. Knowing and trusting yourself that if it is not a good fit that it is okay to seek therapy from another provider.", "It is completely NORMAL and can be incredibly helpful. Some times we just need to let things out with a good cry. Having a non-judgmental open space to do that be so therapeutic. It sounds like you are really putting in the work you are in need of.", "The therapeutic relationship is such an important aspect of the process toward healing. Feeling comfortable enough to be vulnerable is a good starting place. Understanding your own goals for therapy, outcomes you hope to get from it, and the approach you need from your therapist. Each therapist is unique and have their individual styles and theoretical orientations they align with. Open and honest communication regarding what you are hoping to get out of therapy and asking questions from the start of therapist to better understand if their theoretical approach will be helpful to you is a good starting place. Knowing and trusting yourself that if it is not a good fit that it is okay to seek therapy from another provider.", "I think this question can vary based on the individual therapist, their style and theoretical orientation. Clients are always welcome to ask questions before and during the process to understand their care. When I am first meeting with a client I take a more formalized approach in our first session completing what is called a psychosocial assessment. Typically I explore what brought the client to therapy in the first place and I take a more direct approach asking a variety of questions related to the specific struggles, frequency, history, duration, etc. This is NOT how my normal therapy sessions are and I try to explain that to my clients so they understand that while my first initial sessions is a lot of information gathering, and me typing out their responses, on going therapy is very client focused and catered to the needs of the client." ]

[ "You will know when you have the right there is when you have been able to establish a trusting relationship with this person, there's a level of honesty and transparency within this relationship, and this person challenges you on different levels to come out of your comfort zone and to grow.", "It's normal to cry. Crying is a very healthy and cathartic process that allows for you to fully experience whatever emotion you feel, whether it be tears of joy or tears of sorrow. To cry in therapy is quite normal and there shouldn't be anything wrong with it. Crying is a part of being human. It's a part of expressing how we feel and it is a beautiful thing." ]

[ "If you are a people-pleaser type or a natural caretaker, you can slowly \"lose yourself\" over time if you are always tending to the needs of others and neglecting yourself.  If this sounds like a familiar pattern for you, this may have happened without you even realizing it if you were raised in a family where you had to pick up the slack alot.  Maybe your parents were addicts or they might have even just worked all the time and you learned to \"take care of everything\" because that is what you had to do to help the family run smoothly. Over time, a person who grows up in this type of environment learns that you put the needs of others before your own.  You might also be stuck in these types of patterns in intimate relationships as well; if you completely give yourself over to your significant other and you don't create a life for yourself with your own interests and supportive friends, you are at risk of losing what is unique and amazing about you.  If you grew up in a family where you learned this role out of survival or because it was needed to take care of your family, it's easy to re-create this in adult relationships.In both scenarios, if there is no awareness that this \"self sacrifice at the expense of others\" is going on, your identity is shaped around being a caretaker/enabler/people-pleaser and down the road it can lead to depression, low self esteem, and a confused sense of self.  Basically, you spend so much time helping other people that you don't make time for yourself or create a life of fulfillment.  Before you realize it, you have been living a life for others instead of yourself and you have no idea who YOU are.  Supporting loved ones and friends is important and certainly admirable, but if you are always that person that rescues, those that rely on you begin to take advantage of you and they will suck you dry if you let them.  In conclusion, learning to set boundaries with those in your life that are too needy becomes a really important part of the process when you begin to recognize that you are unhappy and unfulfilled in life.  It sounds like you may be at that crossroads right now.  Take one small step at at a time.  Identify the worst offenders in your life that suck time and energy, and limit your contact and/or set some strong boundaries with those people so you can refocus and do some soul-searching.  Meanwhile, engage in pleasurable activities with people you enjoy being with, get yourself outside in the fresh air, get some good sleep, and eat some nourishing food!", "I think there are many different directions we could go as far as answering your question.  I think the first and most important question you need to ask yourself is do you truly believe in your heart that you can forgive him and trust him again?  Once you answer that question honestly then you can move in one of two directions.  First, if you truly love this guy and see yourself being with him long term and for the \"long haul\", so to speak...and you genuinely want to forgive him and trust him again, that is completely do-able and possible if you both put in the work.  But, there's a greater issue here that needs to be addressed.  You say your relationship is \"good\", but there's been a sexual disconnect between the two of you and that usually indicates some type of emotional disconnect is at the core.  Would you agree with that, or what are your thoughts?  Were you giving him less sexual attention than you normally do or were you guys never on the same page about sexual needs and having compatible sex drives?  If you are more of an emotional person than he is, you may have been less interested sexually because he hasn't been meeting your emotional needs.  For instance, if you hadn't been feeling loved, cared about, validated, appreciated, cherished, and special to him than you may have felt less connected physically and been less interested.  This is a common issue with couples, and can easily be addressed if the communication in your relationship is strong and you can find a way to express to him your frustrations.  In essence, many women tend to have more emotional needs than men, this is the way we are hard-wired, and there are exceptions to this of course, but if you have been feeling neglected emotionally than your lack of interest in sex is actually completely understandable and NORMAL!  Until he understands this, and can learn to tune into your needs emotionally, you may struggle with feeling you are out of sync emotionally (and sexually).  This leads to you both being frustrated, but if all this is ringing true to you, he seriously probably has no clue what's going on and may not know how you're feeling.  You need to communicate your needs to him; if you are super lost with how to do that, there's an awesome book called The Five Love Languages.  It's not that long, and it's very approachable and easy to apply the concepts to your relationships. Invaluable resource for relationships and truly eye opening; really!!This is a long post, I'm sorry!  But this is such an important issue that is very common and many people feel lost about how to handle it.  So back to the second direction you can go....you feel very betrayed, you aren't sure if you can ever trust him again and you see yourself perhaps being paranoid forever and never being able to completely get over this.  For instance, if he says he is working late, or if he doesn't call or text right away when he usually does, you may immediately jump to the worst case scenario that he is cheating again.  Of course, it may not be true, he may have legit reasons for his behaviors, but the point is if you are going to be in paranoia-mode OR you just will always be unsure whether he loves you and is committed to you and only you, then the trust may not be able to be re-built.  You need to think long and hard about this, and if you decide you have the capacity to forgive him and rebuild your foundation of trust and honesty, then you need to let him know very explicitly what you need him to do to earn that trust back.  You can't just tell him vaguely \"I need to trust you again\"; if he wants his family back and he's willing to do the work, you need to line out exactly what he needs to do and he needs to do it.  But, be prepared that he might throw out there that he cheated because he felt you weren't attracted to him anymore (or he tries to put the blame on you somehow because he says you weren't meeting his physical needs)...if he throws that out there, but you weren't showing him the affection because you were frustrated emotionally, then it all starts with you communicating that to him.  Get that book!In conclusion, if you feel in your heart there is no way you will be able to trust him again and you will always wonder if he's cheating when his behavior isn't spot on, you will be a nervous wreck and perhaps cutting your losses now would spare you the continued heartache.  There is certainly a way to work through this, but you both have to be motivated and you have to get to the source of why the cheating happened in the first place.  Rebuilding trust can be a long process, maybe even years, and for some people, they may never be able to fully trust and let go of the past.  I truly recommend starting with the book, and then going from there.  If you decide you want to stay with him, you would really benefit from couples counseling, as it sounds like a professional could help you strengthen your communication and ability to trust again." ]

[ "You can never have too many issues to address I'm counseling!  In fact, I wish more people would come in sooner than later (or not at all) but I always say better late than never.  I think you will discover how everything you're experiencing makes sense when you connect the dots with your therapist.  Depression, anxiety, sleep disturbances, and low self esteem can all be symptoms of trauma/sexual abuse.  Your counselor will do an assessment and talk with you about your goals to develop a treatment plan.  Always make sure your therapist feels like a good fit, because research has shown that the therapeutic relationship is the most important factor regardless of the theoretical orientation or treatment modality.", "First of all, it’s a strength that you are openly seeking help for this problem.  As others have said, it would be best to get a therapist you can work with because as humans we heal in relationship with others.  Here are a few things I would explore and suggest working on:1.) Questions to explore:  When did you start feeling worthless?  Why do you feel worthless?  What does it mean to be worthwhile?  Where are these beliefs coming from?  How are you measuring your worth? 2.) Check the facts: are people TELLING you that you’re worthless or treating you like it?  If so, start setting some boundaries, communicating your feelings, and/or get those people out of your life.  Surround yourself with people who make you feel good.  If you believe you’re worthless even if you’re treated well by people you’re surrounded with then...3.) start to challenge the belief that you’re worthless.  Start to cultivate the belief that you’re worthwhile regardless.  Is there any part of you that can believe it, even just a little bit?  Spend time focusing on this each and every day. 4.) do things that help you build confidence and mastery.  Find something you enjoy and want to get better at or learn more about.  Invest time in learning a new skill and practice being patient with yourself.5.) practice mindfulness.  That involves being non-judgmental and curious rather than criticizing yourself or emotions.  6.) do something that makes you feel like you have a purpose- even if it’s small Iike visiting some lonely people at a nursing home or volunteering at an animal shelter.  It may seem small but it matters a great deal to the one you helped!I wish you all the hope, healing, and happiness you deserve!", "I'm so sorry you're going through this!  I think there is almost always someone in the family who becomes the scapegoat and ends up feeling this way sadly.  Please know that you are NOT the problem!  It sounds like you need to be heard and understood but maybe your family has their own stuff going on and don't know how to handle it so they end up taking it out on you, or maybe they just don't know how to listen and validate because they never learned.  Bottom line is there are many reasons they might be treating you this way that have nothing to do with you or your worth.  It's your parents' responsibility to love and care for you.  You are loveable and worthy regardless.  I hope you find a therapist that helps you work through this.  You deserve to be happy and loved.", "Wow, that's tough.  It's understandable to feel trapped when the people you depend on are mistreating you.  While you can't change your parents, fortunately you can work on changing yourself and your situation.Often, the clients I work with feel trapped when there are actually things they can do to change their situation.  The problem is, our emotions can be so powerful they can distort our perception of reality or prevent us from doing the things necessary to build a better life.  Work through this with a therapist to see if your emotions might be getting in the way and look outside the box for things that you can do to change your situation.  In the meantime, here are some other things you can work on.1.)  Assume the best and try not to take it personally.  Most likely your parents don't want to cause you harm, but they don't know any other way to cope with their emotions or communicate effectively.  For example, they may feel that they failed as parents somehow but they take their frustrations out on you.  Maybe their disappointment comes off as anger or frustration directed towards you.  Maybe they feel powerless and the abuse gives them an outlet or a sense of control (i.e., an unhealthy way of coping).  This doesn't excuse them for treating you that way but can help in understanding that this may be all they know and the abuse is the problem- not you.2.)  Communicate.  Relationships are transactional, meaning that what you do and say affects me, and what I do and say affects you.  One way we influence people is with the way we communicate (our words, body language, actions, tone of voice, etc.).  If you don't say or do anything, you are essentially communicating that it is acceptable.Instead, tell them clearly and respectfully every time their words or actions hurt you.  Sometimes people don't realize how their words and actions affect us (or they don't know how else to say things), but it is our responsibility to let them know and to set the boundaries.  Remember that while it is your parents' responsibilities to manage their own emotions and communication, it is your responsibility to take care of your own.You could say something like, \"when I hear you say that it really hurts,\" \"please don't say things like that to me,\" or even more clearly, \"it's not okay to talk to me that way.  Please find a more respectful way to say you need.\"  Each time you are correcting them and teaching them how to treat you.  I realize that this doesn't always work because ultimately people are gonna do do what they want, but these are ways that you can practice standing up for yourself.  You may have to say these things over and over again, but it's better than not saying anything at all.  Not only will it help your self esteem, but you will be modeling healthy boundaries and communication for your child.None of this is easy work and since people are so complex, there isn't a quick and easy fix.  I definitely recommend working with a therapist to explore what's keeping you stuck and how you can work through it.  It would be awesome if your parents would be on board with learning some healthier ways to communicate as well.  I hope this helps and things work out!", "Aside from seeing a therapist to help you work through the feelings and events that might have resulted in the self-hatred, I recommend a few things:1.)  Draw a line down the page in a journal to make two columns.  In the first column, write down your negative thoughts.  On the other side in the second column, write down a different statement to challenge that thought.  Pretend you are a judge trying to prove the negative thought wrong.  For example, you might change \"I wasn't good enough\" to \"it wasn't about me\" or \"I'm actually really good at x, y, and z.\"  2.)  Write down a new positive self statement each day and focus on each one on your list for 2-3 minutes (more if you can- the more the better).  Meditate on the truth of each of these statements.  This method has been proven to be effective in improving self esteem.3.)  Practice non-judgmental awareness.  Be curious about your experience.  Notice your emotions and where they are coming from.  My guess would be that if you're hating yourself then there is probably some shame, guilt, sadness, and/or anger that needs to be addressed.  These emotions might fit the facts or not.  If they do, here are some things you can do (if not, then practice the methods above):Shame: Fits the facts if a person or group of people you care about will reject you if they knew the truth.  Try talking to someone who will not reject you about what you're ashamed of.  Be VERY careful to pick someone who will validate you and not cause more shame (a therapist will help with this).Guilt: Fits the facts when you've done something that violates your own values or moral code.  Try making amends if you've hurt someone.  Practice self-validation (or talking with someone who will validate you) and forgiving yourself.  Use it as motivation to making a commitment to change your behavior if necessary.Sadness: Fits the facts when you lost or will be losing someone or something you care about.  Practice letting yourself feel sad and grieve.  Maybe process it with someone who supports you or through a creative outlet like art or writing.Anger:  Fits the facts when someone or something has threatened you or a loved one's life or well-being.  Anger motivates us to protect ourselves and our loved ones.  Practice setting boundaries and seeking justice if necessary.4.)  Practice self compassion.  Imagine someone you care about is going through the same thing.  What encouraging or loving words would you say to them?  Write that down.  Now read it back to yourself.5.)  Building mastery is a great skill for confidence and improving your mood.  That means doing things that give you a sense of confidence like learning or practicing a new skill.  6.)  Step out of your comfort zone and do things that you're afraid of that are not harmful, like participating in Toastmasters to practice public speaking.  Give yourself permission to suck and try not to judge yourself.These things can be very helpful, but there may be more work to do to really get to the root of the problem and heal.  This is pain trying to get your attention.  Don't ignore it.  Find support and give yourself grace.", "I'm sorry that you feel this way despite all you do and as hard as you try.  No wonder you're feeling worn out and hopeless!  If you're doing your best and it's still not good enough then it's reasonable to expect that you would end up feeling burnt out.  It's like there's no more fuel to keep your fire going!  I would encourage you to approach this with curiosity.  In what areas are you not feeling \"good enough?\"  What does \"good enough\" even mean?  How are you measuring your success?   Is it measured by what other people say, whether or not they approve, or what other people think?  Is it measured by your own expectations, expectations of a boss, a parent, or a partner?  Are they realistic and achievable expectations?  I once had a boss who always gave negative feedback and criticism.  I started to get to the point where I questioned my career and whether or not it was for me.  When I took a step back and checked the facts, I realized that the feeling of being \"not good enough\" was coming up mostly in my interactions with my boss.  When I found myself thinking of quitting, I realized that it might be helpful to try talking to her about it first.  As scary as it was, it made a huge difference.  I practiced the skills I teach my clients including constructive criticism and assertive communication.  I told her that as much as I appreciated her trying to help by giving me feedback, I found myself feeling very discouraged after our meetings.  I braced for her response, which actually came to me as a surprise.  She admitted that many people have told her the same thing, and that it wasn't me.  She said that it was her own \"stuff\" that she needed to work on.   After that I chose to focus on the evidence that I was doing well and that my job has meaning and value.  I realized that \"good enough\" is how I choose to define it.  I worked on letting myself be human and realizing that I am doing my best and that's good enough (and that doesn't mean I can't still learn and grow).  Giving yourself permission to be human and stop judging yourself so harshly creates space for learning and growing without burning out.  It also gives you a sense of peace because you're not trying to live up to unrealistic expectations.  It's saying \"I'm okay as I am, regardless of what anyone says or thinks.\"  It's also saying \"I'm doing my best and I can do better, try harder, and be more motivated to change.\"Bottom line is, if you check the facts, you're doing great in many ways.  So whether the \"not good enough\" message is coming from outside or within, try to replace it with another narrative.  Maybe something like, \"I'm okay as I am, even if I make mistakes and I'm always learning.\"  If you're getting criticism from others, try talking to them about it.  Let them know how they can best support you.  Maybe that means celebrating your accomplishments with you- no matter how small.  Most likely they want what's best for you and don't realize how their actions are affecting you.  If they don't want what's best for you, then you might want to consider how you can filter them out of your life or set healthy boundaries with them.  Keep your head up and stay focused on your strengths.  The fact that you are reaching out for help shows that you're proactive and open-minded; hang in there and it will get better!", "Since no one can prove that there is a higher power (meaning we cannot observe \"God\" with our senses), the decision to believe is a choice you make.  When something can't be proven true, you get to choose what belief system works best for you.  Some questions to reflect on might be:1.)  What does \"God\" even mean?  What are the experiences that have shaped your perception of \"God?\"  Are there any other ways to think of it?2.) What turns you on or off to the idea of God?  And remember that there is a difference between religion and spirituality.  You do not have to be religious to believe in God.3.) How might your life look if you truly believed there was a higher power/God?  How might that be beneficial?  Why wouldn't you believe (what is there to lose)?4.) How might your life look if you chose not to believe in any higher power?  Is there anything you might lose?  What would you gain?5.) How do you cope with things that are outside of your control and don't make sense?  How do you cope with the idea of death and tragedy?If you decide that you would like to cultivate a belief in God, then there are ways you can strengthen this belief (some doubt and questioning is always normal).  Something you could do to strengthen your belief is to look for ways that it fits into your life.  Look for things that have happened in your life that show you there is something/someone out there looking out for you.  Another way to think about God is to think about love.  Not in the emotional sense of the word, but in terms of good versus evil, light versus dark, love versus hate.  There are some things out there that are clearly evil acts (Christians refer to this as the enemy and sin), but many times something good can be found amidst the bad.  As Fred Rogers once said, whenever you see something terrible that happened on the news, \"Look for the helpers.  You will always find people who are helping.\"  And as one of my favorite verses from the Bible goes, \"Light always overcomes darkness.\"Remember the answers you're looking for come from within.  Just look for the answers you hope to find and they will come to you.", "I'm so sorry that you have been haunted by the past for so long.  It must have been incredibly difficult to open up about something so dark and vulnerable.  But by shedding light on it you have already taken the first step toward healing.  Trauma can wreak havoc on relationships if it isn't healed.  In fact, we are all reacting to things every day based on perceptions colored by our past experiences.  The good news is, you can heal by gaining an understanding of how trauma from the past is affecting you now, developing healthy coping skills, and working through those memories and emotions with a therapist.  This will require some \"rewiring of the brain,\" meaning that you will identify the negative thought patterns and beliefs, and replace them with something more helpful.  For example, if your negative reaction feels like \"I'm abandoned and alone,\" you might work on changing it to \"I can get my needs met, and I'll be okay regardless.\" Or if you find yourself feeling like \"I'm not worthy of love,\" you might change that to something like \"I deserve to be loved.\"Most likely, the reason you're pushing this man away is because something about this relationship is triggering negative beliefs and emotions from the past, and your reaction (by pushing him away) protects you in some way even though there may not be any real danger now.  You probably know this logically, but trauma gets stuck in our emotional mind which you can't reason with!  That's why you have to work through the emotions to be able to see things more clearly from a new and more helpful perspective.  I like to think of emotions like clouds that block the sun and make it difficult to see anything clearly.  If we ignore and avoid the clouds all the time then we will spend our lives looking at the ground.  If you can learn to safely weather the storm,  you'll find that before long it will pass and you'll be able to see things clearly again.I recommend working with a therapist who is trained in treating trauma and who you feel comfortable with because they will be able to tailor treatment to your specific needs.  You can have the happy life and healthy relationship you desire and deserve!", "I would look up therapists who speak to what you are going through on their website or directory listing and seem to align with your values (some people want a therapist of the similar faith, gender, or cultural background).  I'm not saying that they should have these traits but for some people that's important and helps them to feel more comfortable.  When you find one that seems to fit on their listing or website, try the free consultation that most therapists offer.  Ask them about their experience in treating your problems and how they might be able to help.  I would try them for a few sessions and see how well y'all mesh.  Ultimately if you don't feel like you're getting anything out of it then I would suggest either letting them know if you need something different or try a different therapist.  Your therapist needs to fit like a comfy pair of shoes!  Sometimes that does take a few sessions though as the first stage always involves getting to know each other and building rapport.", "I can't tell you how many times I've heard people talk about terrible things that have happened to them yet they don't shed a tear.  Is that normal?  Well, yes, but not exactly healthy.  It's normal because they've been conditioned this way.  If you feel shame around crying, then you most likely learned at some point in your life that it's not okay to cry.  Most people have been told at some point in their life, \"don't cry!\" or \"don't be sad!\"  But some people have had this message imprinted in their minds by negative experiences such as parent who shamed them or got mad at them for crying, or simply by cultural or societal messages.The truth is, whether you're male, female, black, white, asian, etc.- we're all humans and crying is a natural response that allows our bodies to express (i.e. release) pain.  It literally helps to get the emotional pain out.  If you don't express your sadness in a healthy way (writing or creating art to represent your emotions can be other healthy outlets) then it will find another way to get your attention, and that will likely not be healthy (self harm, inflicting harm on others, numbing/dissociating, anxiety, etc.).So to answer your question, it is normal and healthy to cry in therapy.  If you have no other place where you can allow yourself to cry with someone to witness and hold space for your pain, then you are already benefitting from therapy.  I would suggest exploring your beliefs around crying with your therapist if you feel ashamed of it.  This is all too common, but I believe that many people would start to feel better if they didn't judge themselves for crying or feeling sad.  Honor your pain and you will feel more at peace." ]

[ "Hello there, first I'd like to say I think it's great that you are reaching out as a parent and wanting to help her. My first thought is whatever is going on with her is not silly to her, and is impacting her in a real way. She is responding the best she can right now. It does sound like she is struggling with managing her anxiety and stress. She might benefit from finding a therapist that she can trust to discuss her thoughts and feelings, learn coping skills, and learn how to better manage these overwhelming emotions.", "Absolutely. We talk about vulnerable things and crying is a human response. I encourage my clients to cry and let out whatever they were holding in. It's not just you. I cry with my therapist as well :)" ]

[ "According to research, one of the ways to manage imposter feelings is to explore the cognitive distortions that contribute to the negative emotions. Expert  Jessica Vanderland, Ph.D a clinical psychologist.  challenges individuals to examine the bigger picture and asked the question concerning  what fact supports that you deserve to be in your role? Vanderland said, \"it can help to zoom out and consider how where you are now compares to where you were last year or five years ago.\"  Vanderland recommended a simple exercise of exploring how you might help a friend who undermines their achievements and then apply the same supportive words to their your own narrative.", "One of the ways to decrease nightmares is to document your dreams. In addition to keeping a dream journal, it's important to work with the content of the dream and revise the ending.It's important for you to work with a therapist that is trained in dream work.  The researcher  Montangero (2009) pointed out that in  using the cognitive approach to dream analysis, the therapist follows the basic tenets of cognitive behavioral therapy and that they help the individual to enhance their cognitive skills in order to be able to alleviate their psychological distress .For example, in the treatment of nightmares one of the methods that is used with the cognitive approach is imagery rehearsal therapy. The basic premise of the approach is that those who have recurring nightmares and are experiencing insomnia, later come to understand that The insomnia is brought on by anxiety. Unlike cognitive experiential dream theory, the approach does not integrate other theoretical orientations.. The approach to nightmares and the treatment of them, is aligned with cognitive experiential dream approaches as the individual has the opportunity to revise their dream if they have an unpleasant dream. Although the scary dreams  may not disappear altogether, they may lessen in frequency." ]

[ "Since you have not had counseling for any of these issues, I would encourage you to do so. During your initial visit, a therapist will gather data about your presenting problem and symptoms, medical history, as well as any significant events that have occurred in your life such as abuse, parental separation or divorce  and so forth. During the sessions, a competent therapist will ask you what issue you want to address first. Part of your treatment plan will not only include your diagnosis but also other areas of your life that need clinical attention and that can be considered additional stressors. During the sessions, you will most likely explore the sources of your depression and anxiety as well as your trauma history. Sexual abuse is often challenging to discuss particularly if you have never talked to anyone about it.However,if the  therapist strives to create an emotionally safe environment, no matter how many issues you believe you have, you will feel supported to reveal your psychological distress layer by layer.", "A feeling of emptiness can cause depleting emotions to emerge. It would be important to identify the sources of emptiness.You may want to try to tap into more regenerating emotions. For example, you might want to think about what brings you joy or situations in which you experienced gratitude. Practicing mindful breathing can also help you take your attention away from distressing feelings.", "The sense of being worthless appears to certainly  be a limiting belief about yourself that you have been cultivating. One way to transform a limiting belief to a more adaptive and empowering belief would be to explore if there exists any evidence to support the limiting belief about worthlessness. First list all of your personal strengths,  or talk with a supportive friend who can give you feedback about the qualities you have that they love about you. You may soon discover that there is little evidence to support your limiting belief. You can also experiment with asking yourself- supposing I believed the opposite of my limiting belief? The theorist, Karen Horney used to say that each individual has a unique universal inner power which represents a fountain of the growth process. I encourage you to tap into that inner power and develop new, empowering ideas about who you truly are.", "It is to your credit that you reached out for help on this platform. How to find someone to talk to would depend upon your lifestyle and worldview. Many people reach out to their faith community and others to friends, family, or seek help from a psychotherapist. If you live in a large, metropolitan area you will have an abundance of options. However, if you live in a more rural area, options might be limited. Broadly speaking, if you have health insurance, you can make an inquiry about providers who deliver psychotherapy in your local area. You might also try exploring profiles  on Psychology Today to get a sense of therapists in your area available for a phone consultation. I wish you all the best in your search.", "It appears to me that you feel as if you have sacrificed your dreams and aspirations when you assumed the roles of wife and mother. Many women place all their energies into raising a family but like you, believe they have not self- actualized in the process. Your efforts and devotion appear to have paid off as you now have a loving family! I would encourage you to explore your passions and hence find your identity apart from mothering.The reality is that parenting involves years of work as it takes 18 years to reach adulthood! Perhaps you can look forward to evolving with your children as you discover what else you would like to do with your life.", "One of the ways a diagnosis is helpful has more to do with health providers having a \"common language\" with which to discuss their patients. Arriving at a diagnosis requires gathering quite a bit of data on an individual which includes observation. I would not recommend self-diagnosing as it could be challenging for an individual to be objective no matter how much research they have done. Further, I do not believe in pathologizing individuals nor would I recommend anyone pathologize themselves.", "You are having thoughts of an existential nature. I am wondering what could be activating these thoughts.Your thoughts remind me of what St. Katherine ( a Catholic saint)said about living in the now as if we were already in eternity. When thoughts seem to be overwhelming, it could be a sign to take a different perspective, or use reframing which can help alleviate your anxiety.", "It appears to me that you feel unmoored as a result of the break and the experience has triggered some self- doubt and anxiety. Your lack of self- belief seems to further propel you to seek validation from the person you are casually involved with.  One of the ways to find peace within yourself could be to engage in life and find fulfillment in healthy experiences.. Theorist  Karen  Horney considered  this approach a form of therapy.  She taught that most  individuals could thrive once their fears and anxieties had been alleviated. I hope that will practice self acceptance daily be using expressive writing to document the areas of your life you are thankful for and that bring you joy.", "It's understandable that you would experience anxiety as your job involves a long commute away from home. One of the ways to cope with this situation might be to think about all the good that will come out of the sacrifice you are making to  help support your family financially.There may be many other benefits you are drawing from working such as professional growth or other areas you can focus on. Doing a cost benefit analysis can also be helpful in identifying the advantages of this experience which may help decrease your worry. As a HeartMath Certified Practitioner, I would also recommend a deep breathing technique known as heart focused breathing. It is simple to do and will help you enjoy a sense of calm and ease whenever you feel you need it. All the very best to you.  Just click here:   Heart focused breathing", "That is unfortunate that you are being verbally abused and that the experience not only impacts you, but also your children.It is understandable that you would be overwhelmed as the stress you experience may trigger depleting emotions. Author, Victor Frankel advised others that in difficult situations that one cannot control, it is best to focus on controlling one's reactions to the situation. One way to approach this may be to think about the good that may emerge from the situation regardless of how tough it is.", "One of the ways that can help you practice acceptance  of self is by using self-compassion. Researcher, Kristin Neff recommends that taking a daily self-compassion break can be beneficial in that it can transform harboring feelings of isolation such as those hating yourself , to an experience of connection. A self-compassion break consists of placing your hand over your heart and acknowledging that you are having a difficult time believing in yourself but that you recognize you are not alone as suffering is ubiquitous so you are connecting with the rest of humanity. You can then say encouraging words to yourself either silently or out loud such as \"May I be led every day to recognize my strengths and to love myself\" or \"May I find peace within myself and strengthen my self-belief.\" Apart from self-compassion, I would encourage you to keep a self-esteem journal in order to engage in expressive writing and write about your strengths so that you can start to build self-acceptance.", "Just like when you were in school, mistakes are opportunities to learn and refine ourselves. Someone wise once said, mistakes are our teachers. None of us are  perfect, and we all make mistakes at one time or another. Don't be hard on yourself, and find a way to practice self-acceptance. Fallibility is part of being human.", "It is understandable that you are questioning whether to trust your husband as you learned that he was involved in an incestuous relationship with his sister ,and you believe he hid the information from you for years. I am sensing that you believe he may still be involved with her as they work together and see each other daily.In our society, incest is considered a taboo, and this might clearly have been the reason he could not share it with you. In addition, it is not clear whether the incest emerged as part of experimentation,or whether it was a traumatic experience for both siblings in which one of them played the role of the malevolent perpetrator and the other the victim. In any case, there is complexity around the dynamics  incest and it is often necessary for the individuals that participated in it to  undergo a healing process. In like manner, it must have been distressing for you to uncover this event in your husband's life. You may need to explore these issues in couples counseling with a professional who has training and experience in the family dynamics around incest that can shed further light for you. I hope that through that process, you may be able to figure out what direction to take, in terms of whether to preserve your marriage or not.", "The fact that he has several versions of the story, could indicate the presence of deception concerning the events that occurred.If he expressed that he may have had contact with a prostitute, there may be a likelihood he may have had sex, but you cannot be 100 percent certain. The suspicion alone would appear to be a source of distress for you. Having the STD screening will certainly be helpful in terms of your health since it appears that he may have been involved in an indiscretion that may also be interpreted as a breach of trust between you.", "My condolences to you. Dealing with the loss of a loved one is certainly an  emotionally devastating experience particularly in the early stages of grief. Healing from grief can include counseling, but also attending grief support groups can be helpful. Generally, there is no cost for attending a group apart from a voluntary donation.The universality of experience as well as the cohesion that happens between members contributes to healing in a significant way. During a pandemic, meetings may have been cancelled. However, you can also find support in attending online grief support groups. Compassionate Friends  is an organization which helps families deal with the death of a child, but their website provides excellent resources for related groups you might want to explore that may  lead you to an active online support group. All the best to you.", "I doubt that they believe they are wrong as individuals with Narcissistic\nPersonality Disorder   (NPD)   have the belief that they are special and they seek admiration from others. They are also grandiose with a sense of entitlement. As they are also arrogant, it is doubtful they would feel wrong or admit to being wrong.As far as healing, I believe it could be hard won. Personality disorders are difficult to treat, However, there are some approaches that might yield better outcomes than others.I have never heard of ignoring them as a way to deal with a narcissist. Researcher and psychologist  Bessel Van der Kolk recommended  that using  a person-centered approach in which\nunconditional positive regard is upheld can be helpful in the treatment of NPD as far therapeutic approaches are concerned. Approaches in which the individuals feels validated\nby their therapist usually works best with this population,if they agreed to participate in therapy. The nature of the disorder makes it tough for them to even be in therapy as it would be hard for them to admit they have psychological problems. They might also be distrustful of the therapist questioning their intentions and interpretations about them.They tend to behave this way with most of the people in their lives.", "Broadly speaking, assessment tools are used to measure the symptoms related to a variety of disorders.Gathering patient data also includes doing an intake interview usually at the first session. The intake interview is a valuable tool as it leads the way to a diagnosis along with other collected information associated with personal history and the presenting problem. Although counselors work toward arriving at an accurate diagnosis, at the same time, they aspire to not pathologize clients.", "The question about identifying the right therapist is a compelling one to be sure.  The therapeutic relationship is based on trust and confidentiality is the cornerstone of the profession. Therefore, it is essential to seek a therapist who practices ethically, is empathetic, and has the capacity to be objective as well as non-judgmental. It is also important to seek a therapist who specializes in your particular issue and has clinical  experience as well as a passion in striving for toward the best outcome. You will not need to train your therapist as a competent therapist will help you explore the sources of your distress, or limitations in your belief system and so forth. A competent therapist will be able to suggest a variety of treatment approaches and together you will decide which approach is best for you. However, you also have to decide what kind of therapist you envision being comfortable with. Some clients prefer a more directive approach and others a more collaborative one.Most therapists offer a consultation which is a good opportunity to ask questions and get a sense of the therapist's treatment approaches, training, credentials,  style, ideas and so forth. You may be able to gauge from the consultation whether or not you are a good fit.", "Counseling can be beneficial in many ways. For example, a counselor can help an individual identify the sources of their psychological distress and support them in using coping skills.In addition, counselors can collaborate with clients in developing a treatment plan that lays out goals and objectives to be realized during the process.The counselor's capacity to understand the underlying problems and also communicate the understanding to the client constitutes an important discussion to have that leads to helping the client alleviate symptoms.Most counselors use active listening and this intervention helps clients feel heard which in itself can be healing.", "Although many clients have the capacity to be engaged in the therapeutic process and express their thoughts and feelings in an articulate way, others may demonstrate resistance to treatment which can manifest in ways such as reflecting the desire to end therapy prematurely, cancelling appointments, or arriving late. A resistant client can also make the process of the therapist engaging the client, challenging.Once the therapist identifies the resistance, it is essential for the  therapist to address it with the the client and encourage the client to focus on the therapeutic goals.In my experience, I have observed that people have many reasons why they begin to show resistance. Some may believe the therapist is judgmental and they may not for one reason or another, feel  emotionally safe with the therapist. Others may not feel comfortable talking about their feelings, and it may appear that they never developed a rapport with the therapist.Sometimes a person may harbor feelings of distrust, or dislike for the therapist which eventually creates barriers to good treatment outcomes." ]

[ "It's not unusual for traumatic experiences that happened when we were younger to stay with us when we get older.  Traumatic experiences can become embedded in our bodies, as well as in our emotions.  If the issue doesn't get a chance to get resolved within, then external action doesn't necessarily take care of the problem.  Seek out a qualified trauma therapist so you can start to deal with the issues you're grappling with." ]

[ "From a behavioral standpoint you should refrain from punishing your son.  Instead of utilizing punishment when he wets himself provide contingencies prior to any accidents.  Sit down with your son and discuss the importance of utilizing the bathroom and responsibilities and inform him that if he chooses to wet his pants that his video games will not be available for use for him the next day(or your designated realistic time frame).  This way if an accident occurs, no heated words have to be exchanged because you have already laid the ground work.  Also allow him to clean up himself.  Gather cleaning supplies and and oversee cleaning operations without ridicule or negative feedback.  Since you have stated that you have an adolescent who is experiencing enuresis, you may want to check with your PCP and a licensed professional for underlying diagnosis that can be treated.   You can also call a local behavioral analyst.", "Hello Frostproof,Thinking about becoming transgender and being transgender are slightly different.  This is a topic that is best discussed with a therapist that specializes in LGBTQ issues.  From what you have written it sounds as if you still have some confusion as to where you fit in with the \"labeling system\".  While labels provide a means to quickly identify and classify, they can also feel restrictive or confining.  Instead of focusing on fitting into a specific classification, explore who you are as a person and celebrate your positive qualities and those things that make you uniquely you!  There are many options for you to find a therapist and e-therapy is also an option.  You can try Breakthrough an online service.   Here is some reading for refection that you may find helpful.  Yin Yang Woman Man http://dld.bz/ejVK2  What does it mean to be a woman or a man?", "Hello Largo, This is a great question.  There are several options when a therapist is transferring to a new practice.  If the practice is in the same general area and the therapist does not have a non compete agreement they can let clients know where they are going.  Generally if a therapist has a planned exit from an agency or practice they will inform their clients, and offer or provide  transition sessions or suggest new therapist options.  At times, unforeseen events arise and and there is no transition process with the therapist.  While this situation is not ideal for any client, it does provide an opportunity to utilize learned coping strategies and resilience." ]

[ "It sounds like you are noticing that you are drawn towards sad and negative content and it's hard to understand why. This may sound counter-intuitive, but sometimes we do things that on the surface may look problematic (or even cause us some real problems) because it serves us in some unseen way. A simple example would be somebody who is addicted to a substance; their addiction may be causing serious problems in their life, and they may even know it, but the addiction serves them by helping them to avoid painful feelings that they anticipate having if they quit using. Now I am not saying that what you describe is an addiction, it is just a really illustrative example of the unseen benefit.One thing I would be wondering about is what is the unseen benefit of seeking out sad and negative content? I'd also be wondering what your relationship is to other feelings. These are things you may benefit from exploring with a competent therapist.", "First of all, I can tell that you really care about your friend and I think it's great that you are reaching out with your concern. It's hard to determine whether your friend would meet the criteria for an official diagnosis of depression without working with him, however, whether he does or not, therapy may be beneficial for him in working through these difficult feelings and relational challenges. Unfortunately, you can't make your friend get help. He will ultimately need to make that decision for himself, however, you can talk to him about your concerns and your hopes that he will reach out for help.", "It sounds like you have been feeling pretty down, since the loss of a relationship, and you're wondering how to be happy by yourself. Intimacy is a very natural human desire and at the same time learning to enjoy ourselves, even when we are alone, can strengthen our ability to lead a satisfying life in and out of relationship. Working with a therapist, you may be able to gain insight into how you show up in your relationships with yourself and others and discover more fulfilling ways to do so.", "As far as the formal diagnosis of depression goes, it would be hard to determine without more information. It sounds like you are noticing that there is a significant difference between how you are feeling on the inside and how you express yourself outwardly. Part of you is quite distressed and yet it remains invisible to the outside world, almost as if it is trapped inside of your body. Many people who are depressed experience such things as intrusive thoughts, emotional numbness, difficulty expressing themselves, and bodily tension (caged animal?). In working with a competent therapist, you may be able to get more insight into what you are going through, the nature of the disconnect between you inner feelings and outer expression, and eventually gain relief from the distress as well as a greater sense of connection with yourself and personal freedom.", "It sounds like you have been thinking about how past hurts have influenced you, and when you try to talk about these hurts with people in your life, you are feeling invalidated. It also sounds like current conflicts are continuing to leave you feeling hurt and devalued. In working with a therapist, you may be able to get some clarity about your past, who you are, and what kinds of boundaries you want in your relationships, so that you can lead a life that is more satisfying to you.", "It sounds like you are feeling pretty overwhelmed and stuck between wanting to improve your work situation and worrying that you won't be able to. It is possible that the paralysis, uncertainty, and self-doubt that you describe are contributing to your difficulty in getting  and maintaining a satisfying job as employers generally like to see that a potential employee is confident and can think on his or her feet. With a competent therapist, you may be able to get more understanding of the roots of these feelings and learn how to move forward in your search for a better work life in a way that leaves you feeling confident and capable.", "It sounds like you are feeling pretty stuck, lonely, and hopeless; like you have a desire to be more connected to people and to find purpose in life, but are not sure what to do. I am glad to hear that you have at least one friend and I think it is great that you are reaching out for more connection. If you can, working with a therapist who is competent in treating depression may be a huge benefit to you and help you to regain a sense of meaning, motivation, and connection. Additionally, anything you can do to give yourself a little break from the feeling of pointlessness and any ruminating thoughts you may be having may be of help. I know it may sound pointless in the moment, and you may feel a great deal of inertia in doing so, but you may find that if you force yourself to do something small that is pleasurable, like taking a walk for example, there's a good chance you will be glad that you did so after the fact. Thank you for reaching out.", "It's sounds like you are feeling pretty overwhelmed with intrusive thoughts and are feeling very criticized by others as well. I think it is great that you are reaching out and I can tell that you want this to change. Working with a competent therapist may be a good option for getting some more clarity about what is going on, developing ways to cope, and eventually getting relief from these overwhelming experiences.", "Deciding whether or not psychiatric medicine is a good option can be complicated, as you have noticed, and only a person who is licensed to prescribe can give you medical advice regarding medications. While there is sometimes relief from symptoms from medication, as you have pointed out, there are often negative side effects as well. While I can't give you advice on whether or not to continue medication, I would urge you to take an inventory of the positive and negative effects that you have noticed and educate yourself as much as possible about the short and long-term costs and benefits of psychiatric medication. If you can find a doctor, psychiatrist, or ARNP who is competent in mental health, it may also benefit you to consult with them.One thing that I am wondering about is, what is your support system like, in regards to your fight against depression? Are you seeing a therapist or attending any therapeutic or supportive group? While there are many things that one can do on their own to work through challenges such as depression, psychotherapy has been shown time and again in research to be highly effective and sometimes having a relationship with a caring, competent professional who understands depression and ways of helping can make a huge difference.", "It sounds like you are feeling like things are hopeless and out of control and you're not sure what to do about it. If you can find a competent therapist to work with, together you may be able to come up with some strategies for alleviating the overwhelming distress that you are experiencing and gain some insight into what may be contributing to these challenges. Additionally, a therapist may be able to support you in getting back on your feet in regards to work, a place to live, and showing up with your partner in a way that will be more satisfying to you.", "It sounds like you are feeling very unsure and out of place and the prospect of continuing to feel as you do now for the remainder of schooling seems daunting. Without getting to know more about you and your experiences here and at home, it is hard to say what you should do, however, I think exploring these things with a competent therapist may help you to discover the answer.", "It sounds like you are feeling pretty overwhelmed with worry about being continuously monitored, with no privacy even in your own mind, and as if people are constantly saying things about you in whispers on in the media. It's hard to say from a post online what is at the root of this experience, but you may be able to get insight into that, as well as develop ways of coping with the distress of feeling this way, with the help of a good therapist. There is no pill or technique that can guarantee that this experience will go away, though it might, however, there are things that you can do so that you can understand it better and so that it does not have such an impact on your ability to lead a satisfy life.", "It sounds like you are having difficulty knowing if people are saying things to you, or if you only thought someone was talking to you, and this is anxiety producing. It's understandable that it could be confusing and/or a bit scary to be unsure if people are speaking to you or not. It's hard to say exactly what is going on from just this description, but if you can work with a competent therapist, you may be able to get more insight into what is happening, get clarity about your social interactions, and develop some ways to deal with the anxiety.", "What you are describing sounds like it may be a form of dissociation. Dissociation is our mind's way of disconnecting us from aspects of our experience in an attempt to protect us in overwhelming situations. It also sounds like you are noticing anxiety in certain situations. In working with a competent therapist, you may be able to gain insight into these experiences, learn skills for coping with anxiety and reconnecting with yourself, and alleviate these symptoms over time.", "There is no scientifically established formula for understanding dreams, that I know about, however, many people get a great deal of value from exploring what their dreams mean. It is believed by many that our dreams contain metaphors that represent meaningful patterns in our lives and relationships and if we pay attention to them we can learn important things about ourselves. One thing you might try, to see if you can get more insight into the dream and possibly begin remembering things, is to take note of whatever you do remember, any details about your experience, such as when do you wake up from the dream, how do you feel, both emotionally and physically, what are you thinking about when you wake up, is there any pattern in terms of what happens to you in your waking life around the time you have this dream... If you can keep a journal or a recording device to speak into by your bed, you can try to record whatever you do remember and notice as soon as you wake up. People seem to have more difficulty remembering dreams, the more time they let go by before attempting to record the dream, or if you go back to sleep before recording what you remember.", "Individual and/or group therapy can be a powerful antidote for social anxiety. Often in therapy, the things that tend to get in the way of our securing satisfying and lasting personal relationships will appear in some way in the therapy relationship and a competent therapist will be able to help you work through this anxiety, in a sensitive way, and eventually encourage you to seek out the personal relationships that you want. In group therapy, you have an opportunity to have a relationship not only with the therapist, but several other people who are all in the group in order to give and receive mutual support to one another.", "It sounds like a couple of things are going on here; you are noticing yourself feeling judged by the people around you and that you are avoiding social activities and in addition to this you have intrusive thoughts that you are being judged, even when alone. It sounds like these thoughts are pretty distressing and you are wondering what is happening to you. Many people who come to therapy experience intrusive and distressing thoughts of various kinds, which often influence their behavior in ways that they may not like, such as leading them to isolate. In therapy, you may be able to gain insight into the nature of your distress as well as learn ways to cope and eventually alleviate this distress so that you can have satisfaction and security in your life and relationships.", "It sounds like you are noticing yourself becoming overwhelmed with anxiety, feeling more irritable, and struggling to sleep consistently. There are many possibilities, in regards to what may be contributing to these things you are noticing, and a competent therapist may be able to help. In therapy, you may be able to gain insight into these experiences as well as develop strategies for coping with and eventually alleviating anxiety, irritability, and inconsistent sleep.", "It sounds like you have some insight into the cycle that you describe with your current relationship and at the same time you are still feeling stuck. It also sounds like the distressing feelings that you experience, when you imagine what will happen for you and your current partner, are pretty overwhelming. A competent therapist may be able to help you work through these difficult thoughts and feelings and find a resolution to this cycle that will feel right to you.", "If you are noticing that anxiety tends to be triggered around interactions with others, then you may have social anxiety. Working with a therapist, you may be able to gain insight into the nature of the anxiety, develop tools for coping with it, and take steps that may alleviate it over time, so that you can enjoy your interactions with others. If you are short on money, there still may be options for you to be able to see a therapist. Check with your insurance provider about your behavioral health coverage. If you have medicaid/apple care, there are some private practice therapists who accept this form of insurance, as well as community clinics which do. If you are not insured, some therapists and clinics will work on a sliding fee scale, and accept either low fee or may even work with you pro-bono (for free).", "It sounds like you have the perception that people are frequently disappointed in you, wish you were different or someone else, and ultimately reject you. One question I would have for you is what is your evidence that people feel this way? Is there anything in people's words or behaviors that gives you this impression? If your not sure, it may be useful for you to try to notice what people say and do in response to you, even though you perceive these attitudes within them. Additionally, working with a competent therapist may be a great way to get an answer to your question as well as developing ways to move forward with that answer and gain a sense of self-esteem and security in your relationships.One possibility that comes to mind, of which there may be more, is that as we grow up, we often develop relational templates, or sets of expectations about how people are and will relate to us, which influence our experiences and behavior in relationships. Sometimes the templates that we develop to stay connected growing up are not particularly adaptive for adult life and can hamper our self-esteem and capacity for comfortable intimacy as an adult. You ask a great question here, and one that can be very hard to see through, given the difficulty of feeling that people think of you in this way, and I hope that you will stay curious about this and consider working with a therapist who is trained to help you discover the answer.", "It sounds like you are feeling helpless and out of control, you are concerned about your behavior, and at the same time you feel compelled to continue it. In working with a therapist, you may be able to get insight into what is motivating these behaviors, develop strategies for taking care of yourself, and get a stronger sense of who you are motivated to be when you are your authentic self.", "It sounds like you had a very confusing and painful experience in this relationship, and now you feel hesitant to let yourself get close to people. It is understandable that when we are hurt in relationships, we may have trouble trusting and allowing ourselves to be vulnerable with others.Therapy is a great place to explore the roots of present difficulties in relationships, to unpack what happened in prior relationships, and to find new ways to show up in relationships so that we can have the relaxed intimacy that we want. Often, relationship difficulties represent patterns of relating that we learn early in life which we may feel compelled to act on outside of our awareness and therapy provides an opportunity to become more aware of these patterns so that we can change them, enabling us to feel secure and to seek out satisfying companionship.", "Therapy may be an effective way for you to get a stronger sense of who you are. A competent therapist will work to create a safe and curious therapeutic relationship in which you can explore your identity. There are also many different exercises which you can do in and out of therapy which you may find helpful in this area as well.", "First of all, I am very sorry for your loss, and I can understand the urge to drink and smoke to try and cope. As I'm sure you understand, alcohol and marijuana may take the edge off of the pain in the short run, but in the long run they may prevent you from being able to work through the thoughts and feelings that you have about the loss of your friend. Grieving is a process that is unique to each individual and each relationship that may involve difficult, confusing, and even contradictory seeming thoughts and feelings and a competent therapist can help you work through this process. It also may be useful for you to add other ways of coping, such as taking care of yourself through exercise, doing healthy activities that you love, and spending time with people that you love. Self care is often most difficult when we need it the most. Thank you for reaching out.", "Given your experience of being imposed upon against your will, and all the personal and professional loss that has come since, your fear of what will happen if you undergo treatment and trust a therapist is understandable. There is no technique or pill that can guarantee these thoughts will go away or be reversed, however, there are things that you can do which may help you to change your relationship to the thoughts and to the distress that they cause. I understand that working with a therapist sounds risky, given your experiences, and at the same time a good therapist may be a beneficial resource in helping you deal with the intrusive thoughts, cope with and alleviate the stress that they create, and perhaps even lead to the alleviation of the thoughts themselves. A therapist may also be able to help you discover strategies to work towards any goals you have around reconnecting with your children and working again. If therapy feels too unsafe at the moment, I would recommend looking into workbooks on how to deal with intrusive thoughts and coping with stress. Some popular approaches that you may want to look into are mindfulness techniques, Acceptance and Commitment Therapy, or Cognitive Behavioral Therapy. You may even be able to find some of these resources at a library, if affordability is an obstacle.", "Anger is a natural and healthy emotion, however, it can be difficult to deal with if it becomes overwhelming and depending on what we have been taught about it and how to express it. A competent therapist may be able to help you figure out ways to relate to your anger and your mother that will feel right to you.", "You’re noticing that as you lie down to go to sleep, there\nis quite a bit going on, which may be anxiety related. It sounds like the\ndreams and difficulty sleeping are reminiscent of previous experiences you had\naround the time of your break up, the difficulty with your father’s business,\nand your mother’s health issues. These connections to past events may be\nimportant insights to continue exploring in addition to finding out more about\nwhat your dreams may be trying to tell you. There is no exact science to\ndreams, but many people find it fruitful to explore the content as it relates to\nsignificant themes in their lives. I think that exploring these issues further with\na therapist could help you resolve whatever is causing you the stress, trouble sleeping, and frightening dreams.", "First of all, I am very sorry to hear about your loss, which must be very painful. It sounds like in addition to the loss, you are also feeling invalidated by your parents and alone with your grief. Grieving is a very personal and sometimes complex process which many people are ill equipped to support us through. If you can get the support of a competent therapist, this may be quite valuable in helping work through this process.", "It can be very difficult, when our parents do not approve of significant aspects of who we are. As children, we need our parents approval, and as adults, we often still desire it. Some things I am wondering about are, how do you feel about your sexuality and your relationship with your mother? Is there anything you would like to have different in your relationship with your mother? I don't know if these questions resonate with you or not, but if there are some conflicted feelings in regards to your mother, working with a competent therapist may be a good way of getting clarity about how you would like to move forward.", "It sounds like you are feeling pretty criticized by your cousin and at the same time you are wondering whether or not there is some truth in what she is saying. It also sounds like you would like to see if you can find a new way to relate to your cousin, so that your relationship can be more satisfying. If you can find a competent therapist to work with, there may be a great deal of opportunity to learn more about how you relate to people in the world and to learn strategies to show up in your relationship with your cousin in a way that feels right to you.", "It is completely understandable that you would like to find a way to make these intrusive thoughts go away, however, your feeling that you can't control having these thoughts is accurate. It's also understandable that you would feel helpless and guilty, given that you see how these thoughts are effecting your relationship, though I would encourage you to go easy on yourself and remember that you aren't choosing to have these thoughts. I'm sure that if there was a switch to turn them off, you would flip it.There is no magic technique or pill that can guarantee these thoughts will go away, however, therapy may still have a lot to offer. In working with a competent therapist, you may be able to gain insight into where these thoughts are coming from and develop new ways of relating to them so that they do not leave you feeling as helpless and guilty and can be more present with your partner. Though there is no guarantee that the thoughts will go away, this may also be a result of work with a therapist. Either way, you may be able to find a way to deal with the thoughts and show up in your relationship in a way that will be satisfying to you and your partner.", "It sounds like you have some ambivalent feelings towards your ex-boyfriend that are difficult to sort out. You notice that there are both desirable and undesirable things about him, and this is true of everyone to one degree or another. One question that I would have for you is, are you satisfied with your relationship with him as it currently stands? Are you happy with the boundaries between the two of you, or would you like them to be different? Negotiating through conflict and establishing different boundaries are definitely things you could work on with the help of a therapist. Another question I would have for you is, what would it mean for you to find out what motivates his behavior? Discovering the roots of such behavior is something that he would have to work on in his own therapy and not something that you and a therapist could discover without him.", "It sounds like you are experiencing a great deal of distress and you're wondering if it may meet a diagnosis of Bipolar disorder. There are a few different types of Bipolar diagnoses in the DSM (diagnositc and statistical manual) and the best way to find out if your experiences would meet that diagnosis would be to meet with a mental health professional. You can also look up the diagnosis online and see if what you are going through meets the criteria.One question that I would have for you is, what would it mean for you to find out that you meet the criteria for such a diagnosis? It sounds like whether or not you do, you are suffering and working with a therapist may help you get into a better place.", "It sounds like you would like to let other people get close to you and at the same time you are finding yourself compelled to keep people at a distance. Often times, when we have difficulty trusting others, it is because we have specific fears about what would happen if we get close or let our guard down. Such fears may be rooted in past experiences in relationships in which we were hurt and or disappointed. In working with a therapist, you can gain insight into what is underneath your compulsion to put walls around yourself and develop ways to form authentic, lasting, satisfying relationships with others." ]

[ "Before I answer your question I want to cover some basics given that attempted suicide is very  serious. I don't mean to scare you but I do want to be realistic with you. If a person attempts suicide once it is more likely they will try again. Men also succeed more often than women because they typically use a means that is more fatal. Here are some signs you can watch for:Threatening to hurt or kill himself, or talking of wanting to hurt or kill himself; and or,Looking for ways to kill himself by seeking access to firearms, available pills, or other means; and/or,Talking or writing about death, dying or suicide, when these actions are out of the ordinary. Some other signs are:Increased substance (alcohol or drug) useNo reason for living; no sense of purpose in lifeAnxiety, agitation, unable to sleep or sleeping all of the timeFeeling trapped – like there’s no way outHopelessnessWithdrawal from friends, family and societyRage, uncontrolled anger, seeking revengeActing reckless or engaging in risky activities, seemingly without thinkingDramatic mood changesGiving away prized possessions or seeking long-term care for petsNow, in terms of ways you can help: 1. Ask if your husband is okay or if he is having thoughts of suicide2. Express your concern about what you are observing in his behavior3. Listen attentively and non-judgmentally4. Reflect what he shares and let him know that his is heard5. Tell him he is not alone6. Discuss treatments available that can help7. Guide them to additional professional help: National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255).A mental health professionalA hospital emergency departmentIf you are interested, I have more information on my website under \"Resources/Information\" and \"Suicide\". www.bbcounseling.net I wish you both the best!" ]

[ "It sounds like you have been through a lot, but in therapy there's no such thing as too many issues. That's what it is there for.  I want to normalize that a lot of people feel they are 'too much' but this isn't true.  A lot of the issues you mentioned are interrelated and may be affecting the other. We are a whole person, and our physical health affects our mental health and vice versa.  Sometimes when you work on one issue in therapy, it can help alleviate some of the other issues.  It is easy to feel overwhelmed with all you have going on but a therapist can also help prioritize some of that and find goals to focus on.", "Kids these days are facing a lot of pressure! Add to that COVID19 and pandemic related stress! Play therapy is a great way to learn coping skills and to help your daughter understand what she is going through. Usually there is an underlying issue that is bigger than something that seems silly on the surface. Remember what is silly to you may be a huge deal to her, so try re-stating and imagining how she may feel so she knows you care." ]

[ "The older I get, the more I believe that our real task isn't to 'find' ourselves. We're already 100% \"there.\" What we do have to do is become more mindful of the times when we feel the most alive, most happy, most creative, and most fully engaged with life. It is in those moments that we find ourselves.For example, I couldn't help loving the people or things I loved, no matter who tried to talk me out of them. All I needed to do was notice when my heart opened and I felt the most alive--not because I was afraid or addicted, but because in those moments, I was in contact with my highest self. On the flip side, I needed to recognize the people and activities that consistently brought out the worst in me--the ones that made me feel controlled, constricted, dishonest, resentful, or afraid--and be honest about them. Mindfulness of \"what already is\" is the key to finding yourself. Align yourself with the people and activities that matter most to you. Don't let old habits, crappy jobs, or mean-spirited people define you. Just stumble your way forward as best you can, with greater self-awareness followed by affirmative action..", "Imagine your best friend just told you that her husband lied to her all the time and that he had broken every promise he ever made to her. What would you tell her? If I were her best friend I'd tell her to run the other way. You may love this man. We don't choose who we love. But the evidence is pretty clear, isn't it? A healthy relationship cannot be built on a foundation of lies and broken promises. I believe that as adults, we are always treated as well as we insist on being treated by our partners. If you continue to accept unacceptable behavior, you are likely to see lots more of it." ]

[ "Not possible! Your therapist will help you prioritize your treatment goals and often, those \"issues\" are intertwined and as you address one problem, another may resolve or become less problematic.", "Telehealth has become very popular during the pandemic. One of the benefits of telehealth, is that you can see a therapist who may not be in your area at all (although depending on where you reside, they likely just need to be licensed in the state where you reside). Telehealth offers access to a much larger pool of mental health providers. Some therapists offer sliding scale fees (a reduced fee) for those who are unable to pay full rate.", "I encourage you to look at two things - what you can do (behaviors) to better manage anxiety and how can you change your thoughts (cognitions) that likely exacerbate anxiety. Behaviorally, it may benefit you to create more structure and improve your organization and time management skills. That might include the use of a planner, a consistent sleep wake-cycle, exercise and movement, and prioritizing activities of self-care. The second component take a little more self-reflection. What are some of your thoughts that are problematic? For example, catastrophic thinking is common amongst people who struggle with anxiety. Those thoughts might sounds something like, \"This is the worst day ever.\" Now, perhaps it was the worst day ever, but more than likely it wasn't. More than likely, it was a difficult day or a stressful day. By correcting that thought from \"worst day\" to \"a tough day\" you bring the intensity of the anxiety down a notch. Making those kinds of corrections to your thinking throughout the day will help your anxiety feel less debilitating and more manageable.", "Learning how to set healthy boundaries can be life changing! Assertiveness training will help you in all facets of your life. A therapist can help you figure out how much interaction is too much, how to say no and set healthy boundaries, and how to prioritize your needs so you don't become resentful or burned out." ]

[ "You have\n\nseveral things going on here. The sleep should be addressed with a primary care\n\nphysician to rule out any physical issues. Sleep is the big reset and allows us\n\nto function in the day. What happens during a depression is that our thoughts\n\nrace and it is as though our “brain won’t shut off.” Medication can help with\n\nthis. I also use a Pranayama yoga breathing technique called the four\n\nfold breath which has great usefulness for relaxing us  and often does work quite well with allowing\n\nus to sleep.. You can read about it here:    https://billleavitttherapy.com/breathing-techniques-the-four-fold-breath/Your\n\nthoughts on feeling worthless to everyone fall under a heading of thinking\n\nerror in Cognitive Behavioral Therapy (CBT) known as overgeneralization. In CBT\n\nthoughts lead to emotions, so we are going to pick the statement apart and then\n\nreframe it. First list\n\nthe evidence that contradicts the thought. Has anyone in the past made positive\n\ncomments toward you? This might be hard to recall if we are in a rut, but at\n\nsome point in life we frequently have had some positives expressed towards us\n\nby others.  “Everyone” is an absolute. The\n\nspecifics on why you are thinking this need to be addressed. How are you\n\narriving at this conclusion? There may be specific people that we want more\n\nvalidation from. Or specific people might have made offhand hurtful comments, (such\n\nas a family member, teacher or co-worker) but if I extrapolate that to a global\n\nand think that everyone thinks I am worthless, that thought is not rooted in\n\nfacts.  \nWhat are\n\nthe Pros and Cons of thinking this way? What are the Benefits and Costs? There\n\nare very little pros or benefits to thinking this way. It’s just going to\n\ncontinue to tear you down and make you feel bad. So can we reframe the thought\n\nabout the situation? Is there another way of looking at the situation? Again,\n\nwe need the specifics on how you are arriving at this conclusion, and a one on\n\none therapist can definitely help you with this, but the thinking that you are\n\nusing to arrive at the conclusion needs to be re-cast into a more helpful\n\nmindset." ]

[ "Most men believe that getting an erection is just a given. However, research shows that men, even in their 20's and 30's can start to lose an erection sometimes. Unfortunately, what tends to happen is that men don't know this and become extremely upset and fearful after losing an erection because they don't know that it is normal and happens sometimes. Anxiety, depression and stress are the biggest culprits to losing erections at an early age. Anxiety or nervousness constricts the blood vessels, decreasing the amount of blood flow to the penis, thus diminishing an erection. Other reasons may be possible also, especially, when this first happened. My assumption would be that anxiety and fear of being able to keep your erection is contributing to continued difficulty with erections, but the initial cause would need to be explored more deeply.Initial causes of losing an erection could be many things. Anxiety, depression, stress, tiredness, or any negative emotion can cause you to lose your arousal and thus lose an erection. Also, I would encourage you to make sure that you see a doctor to check off that their are no medical concerns. Diabetes or weight issues might contribute to the loss of erection and so can other medical concerns. If it is causing relationship difficulties, the last thing you and your wife need to do is argue about it or get angry or frustrated with each other. I would encourage marriage counseling to make sure your relationship and COMMUNICATION is strong, especially around the topic of sex. I good sex therapist can probably assess what the initial contributing factor could be. A doctor to do a full medical check-up to make sure there are no physical issues (especially testosterone levels). Finally, one thing I encourage is to get back to the basics. Make sure your relationship is strong, keep excitement and dating and spontaneity a large part of your relationship. Bring enjoyment back into your relationship everyday. And, don't stress about the erection. Focus more on ENJOYING your wife, her body, and the all the experiences that come with \"MAKING LOVE\" to her. I have known men that can't get an erection, but still enjoy sex with their wife. With that said, if their are no physical concerns, then it is all in your head. So, learning how to relax and ENJOY the action is key!", "Our actions unfortunately cannot be undone, and we all do things we regret. It is sometimes very hard for others to see past our worst behaviors and trying to force them to move forward or \"get over them\" doesn't usually work. Your fiance is probably grieving the losses and consequences that come with what have happened. I know that may be hard to understand, but desired a virgin for a wife, then he has to grieve the loss of that dream coming true. Also, if he is struggling with you having had sex with another person before, then he will need he may not be able to accept that. All of that to say, as a counselor who helps people everyday with sexual, relational and spiritual issues, I believe it may be helpful for you to help him grieve and connect with the tragedy of your past. Grieve with him. Let him know that you hurt too and wish you could have provided that for him. Listen to his heart and allow him to speak his pain. And after that, ask him to pray with you and do devotions with you. Encourage him to see a therapist. If ya'll are Christians, there are Christian therapists who can help him uncover the blocks that may be hindering him from moving forward.", "The short answer is, NO! It is not wrong for you to be attracted to your girlfriend. You are a perfectly healthy person. When puberty hits, hormones start changing and it is a natural to be interested and attracted to others. It may feel wrong, especially if you are a Christian and have grown up in that home due to the messages that are sometimes sent your way. But as a Christian myself and a counselor, I remind people that every human is made with a very similar biological make-up. If humans did not have an innate attraction to others, then the human race would not survive because we would not marry or have children. You are not a pedophile!", "I want to be short and brief about this. First, If you can achieve a good erection at anytime without your girlfriend, your penis is fine. However, erections work through getting enough blood flow to the penis. If you are having any sort of mental related concern (anxiety, depression, stress, etc) it can cause your blood vessels to constrict and keep your penis from becoming erect. After reading your concerns, my questions would be: What are you thinking about right before and during sex?\" \"Do you feel anxious or nervous during that time?\" Have you ever experienced not getting an erection before?\" I am assuming it has do to with what you are thinking and their is a certain amount of anxiety you are having during or right before sex. If you want to work this out, I would encourage you to work on your thought process and learn to relax your mind and your body (meditation/relaxation exercises). Focus more on enjoying the experience through your 5 senses. What do you smell, take it in and enjoy it. What do you hear, take it in and enjoy it. What do you see, take it in and enjoy it. What do you feel, take it in and enjoy it. Calm yourself! Not having an erection is not the end of the world and happens all the time to men. If you freak out about it, it will happen more. Just relax, believe it is normal and try again and ENJOY the beauty in front of you!", "I am sorry that you are struggling with this! I would love to help. I have a few questions first and I know you can't answer back unless you contact me. Do you use birth control? Is there pain during sex? Have you had sexual experiences before your husband? Have you ever experienced sexual abuse or trauma? Has their been any negative sexual experiences between you and your husband? Did you grow up in a Christian home? When you say you have low sex drive or you don't know what you are doing:Do you ever think about sex? Do you ever have the urge or desire? When ya'll have had sex, do you both enjoy it? Do you enjoy it? What are your priorities? Is your relationship good? Did you have sex before marriage and how much? Wow... So, it is hard to answer this question without knowing more information. I want you to be better connected with your husband too. If you don't want to seek other help, my best advice would be to intentionally initiate sex once per week, whether you feel like it or not. If something hurts, don't do it. Begin talking about sex regularly. Read more books on sex and build a knowledge about sex. I can give you some good resources if you would like. Please don't give up, but please work on this soon!", "I don't know that I should tell you to get a divorce. Some would, but I think there is something much deeper going on for you. I would be more concerned about figuring out the deeper reason you are having an affair. Do you have shame and guilt? Do you not like that you are doing this to your husband? Do you see yourself as a bad person, or do you just want more? All of this can be handled if you really want to fix it in your marriage.You can have more in your marriage with some help. You can stop having affairs if you get help. I would encourage you to seek help right away and find out what you are missing that is driving you to commit affairs. I actually believe that if you get a divorce, you will probably keep repeating the same behavior with another person. Let me know if you desire more help.", "Simply, Yes!Just because you argue, does not mean your marriage is not worth it. Couples disagree. They are different people from different worlds with different likes and dislikes. Trying to mesh these different worlds is tough, but does not mean you don’t need to not be married.There are reasons why couples don’t get along. Finding out why you cannot compromise and working towards similar goals can help. Talking about what you really want out of the marriage and relationship may show y’all how much your relationship goals are similar. Then you can build upon that.Learning communication skills, listening skills and ways to improve your ability to express self without anger can help." ]

[ "We have thousands of thoughts a day. Some thoughts we choose to think, and some thoughts are random as you describe. We can't control the first random thought but as soon as we become aware of it we can make a conscious choice to change the thought. Positive affirmations are messages we intentionally read to or tell ourselves to help us counteract negative thoughts. If you find yourself under stress on some days more than others you may notice an increase of these negative thoughts about yourself.  To help you neutralize your negative thoughts and make it more natural to randomly think positive thoughts about yourself you might find it helpful to work with a therapist who specializes in cognitive behavioral therapy. This professional can help you build insight into your errors in thinking, help you develop a stress management plan, and provide you with additional tools to boost your self-esteem." ]

[ "I think we all go through a period of time where we think we aren't worth anything. Sometimes these feelings are a result of low self esteem or because of shame. The most important part of dealing with this thought is to separate feelings from reality. \"I don't feel worth anything, but I know what I do is important, I know who I am matters to others. I know I am loved and cared about.\"When you find yourself having these thoughts, stop, take a few deep breaths and try to reframe what you're thinking." ]

[ "In short, no you do not have too many issues to address for counseling. You and your counselor should work closely together in order to prioritize. Typically anyone coming to therapy has more than one underlying issue. It’s rare that someone comes with just one concern to address. There are so many things throughout life that contribute to our current circumstances. Your therapist shall be prepared to address what you feel is most important and work from there. Hope this helps.", "Sometimes we can be our own toughest critic. Acceptance starts first with acknowledging the things that you currently do well, positive qualities, etc. Spend time with those in your life who are supportive of you. Ask them to also contribute to your list of positive qualities. Acknowledge those qualities as often as you can. Next start small with the things you’d like to see differently. Identify a small step you can start that will contribute in shifting how you view your physical and emotional self. Ex.) Identify a hobby that brings you joy.", "One question I have,  is how would this impact your relationship now if you were to know the answer? It sounds as though you may be experiencing issues with trust in your relationship. I believe the bigger issue here is not whether or he has had sex with someone else a few years ago, but more that you lack trust within your relationship. Are there other behaviors you’ve noticed that indicate untrustworthiness? It may be worth exploring sources of mistrust versus dwelling on a possible affair. Hope this helps.", "Creating healthy boundaries is very helpful but also very difficult at times. Especially, when we’re setting boundaries with family members. A good way to start is to hear your mother and validate her concerns. Let her know that you hear her complaints and can see why some of her concerns may be upsetting. By first validating gives her the opportunity to feel understood. It’s also could potentially help with setting boundaries. Communicate how you feel respectfully yet firmly. This will let her know that you respect her feelings and points of view. However, would prefer not to be in the middle of what’s sounds like a tough situation." ]

[ "It sounds really difficult to know that your daughter may be \"choosing\" her dad over you, perhaps I can help by saying her intense emotional reactions towards you actually acknowledge how much safer and connected she feels towards you. We tend to have big emotions around those we care for most. I would suggest to let her know how hard it is to hear that, and sad it make you feel at times, and that this is hard for everyone. Expressing your feelings to here, will allow her to express hers too.", "This relationship with your step dad sounds very challenging. It is hard to to be told over and over again how not good enough we are. Let me offer you this, frequently when we say harsh, mean, nasty things to others, we are simply projecting our own thoughts about ourself. I am not advocating that this is ok, it seems like your stepdad could also use some support. You get to make your own empowered choice around this, this is your life and if you find yourself in a situation that does not suit you make a change." ]

[ "First, I want to say how sorry I am for your loss. The grief of losing a parent can be very difficult to work through. When you lose someone you love, you are forever changed. The goal of working through any loss is to reach a \"new normal.\" Though you will never forget your mom, the grief processing is about learning to live in a different way, without her physical presence. One of the best things you can do is find a good support system. You need to talk about your loss, and talk about it a lot. Talking helps work through your emotions and reach a place of healing. Find friends you trust who can support you or find a good grief support group. They are hugely beneficial since the group will understand exactly how you feel. If you find you are still struggling, a good grief counselor will also help.", "Thank you for your question. Trust is a huge thing in relationships and when that is broken, or perceived as being broken, it takes a long time to repair. From what you shared, it sounds like your boyfriend took steps to correct the situation and has shown to be trustworthy since. Unfortunately, no matter how much we apologize for something we did or for something others perceive we did, there will always be those with hardened hearts and will not forgive. If you feel confident in your relationship, then trust your inner wisdom. We cannot control others but only ourselves. Respect your families wishes to remain in unforgiveness while at the same time, ask them to respect your wish to believe in him and be in this relationship. Good luck to you.", "Grief has a huge impact on us and everyone's reaction is different. The one common reaction however is to shut down and distance ourselves. Her relationship with her grandmother was close, given she took care of her up until she passed. It sounds like she is working through a difficult loss and her ability to connect with you, or anyone else, is likely low right now. Trust what she is telling you and try to be there for her as she works through it. If she finds it too difficult to connect again, a good grief counselor can help her get back on track." ]

[ "Many peope uffer from changes in mood when the winter time comes. The amount of daylight hours decreases significantly. Most times it is dark when you go to work and dark when you return home. There are special lights that can be used during the winter season to counteract the \"winter time blues.\" Also, paying attention to self care. Are you sleeping enough, attending to physical illness? Exercising and eating a balanced diet? Make sure to schedule fun activities and spend time with loved ones.", "Its understandable to have anxiety when transitioning to a new job/career or any other major life change. Doing some mindfulness activities such as deep breathing exercises, grounding, or mindfulness meditation can help center and calm yourself in moments of anxiety when being away from your family.It may also be helpful to make a list of your concerns or fears about being away from your family. What are you afraid will happen while you are away? Once you've identified those fears you can challenge them and determine whether they are based on fact or your emotions." ]

[ "Absolutely not. It's actually quite rare for someone to come in to therapy for \"just one thing.\" More often than not, even people who seek out therapy \"just for anxiety\" often find a host of other related things when they start peeling back the layers in therapy.When clients come to me with a list of things like this, our first step is to put it all out there and THEN to work on finding the \"constellation.\" All of these things tie together to form a more complete picture of who you are and how your experiences have impacted you and have led to other experiences. For example, many clients find it helpful to understand how a history of sexual abuse can increase the likelihood of developing insomnia. Seeing how everything ties together often helps people to slow down and take a step back from the tendency to take each of these struggles as a personal flaw or failure and to see how the whole picture fits. Plus, on the upside, once you've started to piece together the larger picture, you can use that to decide where to begin. Once you begin learning skills you can apply to one area, often times those same skills can be applied to other concerns with just a little variation. For example, the skills required to process through the beliefs you developed as a result of sexual abuse so that you can start shifting your mindset to more helpful perspectives is actually the same skills you can use to change the thought processes that maintain insomnia. So the skills can be generalized relatively easily!As long as you're still breathing, there's no such thing as too far gone.", "If the symptoms are to the extent that they are affecting your ability to function, you may want to consider seeking treatment. PTSD, anxiety, and depression all typically respond well to treatment if provided by a trained clinician. Common types of treatment for PTSD that you may want to look into include Cognitive Processing Therapy or EMDR. The nice things about Cognitive Processing Therapy is that it is time limited and only lasts 17 sessions typically.", "Imposted Syndrome is often linked to feelings of shame - shame about our own inadequacies, our imperfections, the limits of our knowledge or abilities. It's based on the belief that in order to be valuable, you must be perfect. Often times, the standards for this are so unrealistic, that when we really look at them, we can cognitively see that it's impossible to achieve. Here are a few of the common beliefs that typically underlie Imposter Syndrome:I must know everything there is to know about this and have no gaps in my knowledgeI must be perfect at every task the first time I tryI must never make mistakesI must always appear confident and never let on that I have any doubtsSo in order to appear valuable, you must hide your imperfections. The only problem is that this behavior does a few things that actually keeps you stuck in Imposter Syndrome. Hiding things you're ashamed of (such as your lack of knowledge in a new area) only reinforces the emotional feeling that this is \"bad\" or \"wrong\"It keeps you from having the experience of others knowing you're not perfect and still accepting and valuing you anywayIt keeps you from asking for help or information when you might need it, making it more likely your performance will actually sufferIt can cause you to come off as not needing support or guidance, so that will be given to others who acknowledge their imperfections and limitations openlyIn order to decrease the feeling of Imposter Syndrome, it can be helpful to take small steps such as asking for help, information, or clarification when you need it; acknowledging the limits of your experience of knowledge; and taking every practice as a learning experience rather than a test of whether or not you deserve to be there.", "It's common with social anxiety to replay or \"pre-play\" conversations in your mind - often focusing on how you believe it did or could go wrong. CBT can be helpful in pinpointing what's keeping this cycle of anxiety and avoidance going for you if it's something you wish to change. It's also important to note that adults who struggle with feeling nervous or scared in social situations often have similar experiences in childhood - namely being criticized by parents, siblings, or peers for how they speak, interact, appear, or express themselves. This often creates a pattern of becoming very self-conscious in an effort to avoid shame and embarrassment in social interactions. Working with a therapist to process through these thinking patterns and the behaviors that come from them can help to start decreasing anxiety and anger around social interactions and more importantly decreasing feelings of shame and anxiety about the way you express yourself.", "One reason may have to do with physical anxiety symptoms. This is common for people who experience panic attacks or physical anxiety symptoms. Often it begins with just avoiding certain places or activities where the symptoms happen. Over time, it's common for it to spread to more and more places and situations until many people get in the habit of not leaving their home at all in an effort to avoid the symptoms.", "A lot of times when you're experiencing nightmares and flashbacks, it can be a sign that you haven't fully processed what happened. Our brains tend to replay scenes in our life that we wish had turned out differently or  in an effort to desensitize us to it.  If you are comfortable with it, you may want to consider sharing what you're experiencing with your current partner so that he is able to understand what's going on. Also, you may want to consider  what parts of your past relationship you blame yourself for. This can be a difficult task to undertake on your own, and the help of the therapist may be necessary to sort through the memories in a safe way.  Typically however, flashbacks and nightmares are a sign that the trauma  of what you went through needs to be addressed.  it's a great thing that you were able to have the courage to get out of that relationship and you should be proud of yourself for that.  You may want to  begin therapy to address these traumatic memories and help you to sort through any conflicting emotions you have about it (i.e.  Feeling like it's your fault for not recognizing the abuse or getting out of the relationship sooner, blaming yourself for being  \" The kind of person who gets into an abusive relationship \",  or believing that you somehow caused your ex to abuse you in some way.)  These types of beliefs and feelings can prevent us from moving past traumatic experiences and a trained therapist can certainly help you sort through them.", "When it comes to trauma, especially in the event that it has caused you to develop PTSD, there can be a lot of difficulty in attempting to resolve these issues on your own simply because of how strong your urge to avoid it whenever thoughts of the traumatic experience come up. PTSD is best treated with the help of a mental health professional and if using the Cognitive Processing Approach can be treated in as few as 17 weeks. As for your other concerns, many of these can be treated independently if you have the motivation to manage your way through. Panic attacks and depression, specifically, often respond well to self-help treatment manuals. The Centre for Clinical Interventions is a great online resource for workbooks to help you learn to manage the depression and panic attacks. Whether you decide to work through these concerns on your own or in professional therapy, just know that your panic attacks must be managed prior to addressing your trauma. Hope this is helpful and if you have any other questions don't hesitate to ask.", "Depending on where you are located, you may want to consider calling 2-1-1. It is a resource hotline that can help provide you with referrals for therapists or clinics in your area who may offer pro-bono services. When going through the list of referrals they provide you with, you can call around and see what types of treatment they offer for PTSD and make a list so you can do your own research before deciding what you think will be the best fit for you. There are several different types of trauma therapy, but some of the most common include cognitive processing therapy and EMDR in case you'd like to research them and get more information.", "Sexual intimacy can be very triggering for survivors even when it is both wanted and consensual.  You may want to consider seeing a therapist who specializes in trauma to work through the abuse if you have not already done so. Often times triggers still hold such a powerful effect when the emotions related to the abuse  have not been fully processed.  In the meantime, you may want to consider coming up with a Safe Word to let your partner know that you are being triggered or to communicate your physical boundaries to him.  Often times, the experience of communicating  your physical boundaries to your partner, having those boundaries respected and validated, and having a partner who is understanding and  willing to engage in intimacy in such a way that does not violate your physical boundaries  can reinforce a sense of safety with him.", "Nightmare are actually very common for survivors of domestic violence. If they are affecting you the the point where you feel like you need to do something, you may want to consider processing your memories of the events with a trained trauma therapist. Another good option, may be to attend a support group for survivors where you could process your memories in a safe space where others will be able to provide support and understanding for what you went through as well as encouragement for the strength it took you to get out of that relationship. You may also want to consider completing a screening or assessment to rule out post-traumatic stress disorder as well.", "This sounds very hurtful for you to be on the receiving end of this. You can ask yourself \" what am I learning from the way I am being treated? \"  and consider whether or not this is in fact either (1)  A message or value that you agree with and believe will strengthen your relationship and help you to grow as a person or (2)  A message or value that is damaging to the relationship or  to your view of your self and others.  Once you've considered that and come to your own conclusion, you will likely know what you need to do.  If you're still stuck, you may want to consider seeing an individual therapist for yourself  to process your feelings about the relationship or a couples therapist with your partner to work on improving your communication with each other.", "Counselors should consider ending counseling sessions or terminating therapy under several different circumstances. Here are a few of the most common:If the client has developed the coping skills for which they came to therapy, counselors should encourage clients to decrease sessions to less often to begin practicing maintaining progress on their own. Clients are often nervous about decreasing sessions when they are doing well for fear of relapsing. This is a crucial step in helping clients to build confidence in their coping skills and decrease the feeling that they must forever continue therapy in order to be well. Most clients experience some difficulties and slip ups during this step down process, but these are important to identify and address while still in therapy where clients can get help coming up with a plan. This is also the point at which counselors should be helping clients come up with a relapse prevention plan so they can safely terminate therapy and maintain the progress on their own.If the counselor determines the client's needs are outside of their scope of practice, they should refer them out. For example, if the counselor determines that the client has an eating disorder and the counselor is not knowledgable or trained in the treatment of eating disorders, they should refer them to another provider who specializes in this issue.If the client is in need of a higher level of care, counselors should refer them to the lowest level that is likely to be effective for the client. Most of what we think of as \"therapy\" is often on session every week or two with a therapist at a local practice. For some clients, however, the therapist may find they are unable to manage their symptoms and emotions between sessions and need to be seen more frequently. For outpatient therapy, clients with more severe symptoms are typically seen twice a week. For clients who need more than that, counselors should refer them to other programs for more intensive treatment such as intensive outpatient (groups and individual therapy several times per week), partial hospitalization (groups and individual therapy several hours per day plus medication), or inpatient (residential treatment with groups, individual therapy, and medication for 30 days).If the client is in need of substance abuse treatment before therapy can be effective with other concerns, the counselor should refer clients for a substance abuse evaluation. People commonly use substances to cope with unwanted emotional pain and mental health symptoms. Over time, this pattern often develops into substance abuse. Research has shown therapy to be ineffective in treating mental health conditions without FIRST addressing any substance abuse. For example, someone with a history of trauma who is drinking to cope with unwanted memories would need to be able to maintain sobriety for a period of time before therapy for trauma can have any significant impact.My goal as a therapist is always to start people off with the lowest frequency of sessions possible for them to actually make progress (typically once a week or once every other week). Then we work to teach them the skills they came in for and encourage them to practice outside of sessions. Next, once they've gotten the hang of the skills and are feeling better, we start encouraging them to space out sessions and \"take the training wheels off\". Finally, we come up with a relapse prevention plan to make sure they can keep it going on their own and identify any impending relapses long before they get bad so they can course correct on their own.For more information about the process of CBT therapy, visit: \"From Start to Finish: What does cognitive behavioral therapy look like?\"" ]

[ "The thing that confuses a child the most is for a parent to come and go from their life. Children have a way of making things their fault, even when they have done nothing wrong. Because of this, when parents cut off contact, the child thinks it's their fault. As hard as that already is for a child, it is even worse when a parent pops in and out of their life. This makes the belief even more strong for them. They start to think, \"why does dad keep leaving? What am I doing to keep making him go away?\"I believe a child needs both parents in their life. Whether she used you for a child or not, that child still exists and never asked for this. They didn't ask to be born into drama and two parents that can't make things work. You can move on and start over while still maintaining a relationship with your child. If you start over far away, this may mean less visits but you'll still be a part of their life. Just make sure when you make a commitment to this child to stick to it. Every child deserves that much. Good luck to you! :-)", "Absolutely not! It is never in a child's best interest to use humiliation as punishment. This can lead to issues in the relationship between parent and child as well as the child's social relationships. Kids have a hard enough time. To then go and cause them embarrassment is unconscionable. The entire job of a parent is to prepare their child to become a successful, healthy adult. You do this by using healthy ways to teach a child when they make a mistake. Discipline shouldn't be seen as punishment. It should be seen as a way to teach a lesson. What lesson could this possibility be teaching him? Absolutely nothing. Meanwhile, she is most likely damaging her relationship with him and causing great distress in his school day and peer interactions. She should be one of the people he can come to when he's hurting; not someone who causes him pain." ]

[ "It's absolutely normal.  Therapy provides a space where you can be free to express yourself and experience all of your emotions fully.  Crying is a form of release, and many people feel like they do not have any other space where they can let out their emotions.  Crying can be a healthy way to be present with your emotions.  While not everyone will cry during a therapy session, you're not the first, and definitely not the last." ]

[ "I am sorry you are feeling this way.  We all have narratives that we say to ourselves whether it is valid or not.  In your case it would be beneficial to explore when and how this belief began and rewrite your story.  There are different ways to explore and rewrite.  This process requires commitment, self-reflection and courage.", "Hi, your situation sounds very complicated and sensitive.  It is important to handle it with care as it involves your children.  When parents are attempting to co-parent, the clearer the boundaries and expectations are the easier it gets to effectively co-parent.  Parenting your child is not “living in the past”, allow me to reframe that approach and instead view it as an investment in your future.  Your child will forever be your child and deserves and active loving and caring father.  Staying away sends a different message to your child and leaves room for resentment.  Find a way to create an agreement between you and your ex-wife with the best interest of your child as the focus.  The courts are able to assist with this goal as well.", "I am so sorry you are experiencing this situation.  Considering that you mentioned not having a place to go, it may be best to address the problem as oppose to “just take all of it”. Confrontation can be done in a healthy and effective way.  Being able to communicate your feelings with the intent of improving the problem can be a great skill needed in multiple settings in life.  The therapy process can help build this skill set and goal plan to remove yourself from the home.  Good luck.", "This sounds very stressful.  Setting boundaries is important to maintaining a peace of mind.  If you have not communicated your feelings to your family member, that would be a good first step.  Communicate with the intent of simply expressing your feelings and your expectations going forward.  Do not blame or shame because that will blur your intent.  Going forward, consistently stick to your new boundaries.  That may mean not picking up your phone for each call.  Soon enough the message will be clear.  Good luck.", "Long distance relationships have the addition strain of being far away.  It sounds like you and your girlfriend overcame the initial challenges considering that you’ve been together for over a year and she was honest in telling you about her crush.  These are some clear strengths in your relationship.  Now moving forward, continuing to have honest conversations about your relationship will help ensure you two are on the same page.  Explore with her how this crush came about and what her feelings are about this relationship.  Be prepared for the answers and express your feelings as well.  You’ve invested over a year in this relationship, it may be worth figuring out how to mend it.  Ignoring this issue will potentially lead to other issues." ]

[ "In addition to academic stress, teens are facing multiple stressors in their lives, it can be social stress. Teens place a high value on their social lives. It’s part of their developmental stage. Finding friends, keeping their friendships can be stressful at times. World events such as school shootings, acts of terrorism, and natural disasters also worry teens. If there are major lifestyle changes or traumatic events that can also be overwhelming and confusing for the developing teens. As parents, it is important to show your emotional support for their struggles. Having open communications can also help them process distressed emotions. In many cases, it can be helpful to have a therapist they can talk to. By teaching them resilience and self-care, you’re teaching a toolbox for any stress they may face." ]

[ "The first step is realizing your value and establishing firm boundaries. When your parents cross that boundary and are verbally abusive, you have to have a plan to stand your ground and act upon it. That plan may include a better job to afford a place of your own, a domestic violence shelter if you are unable to provide for your needs, a firm talk with your parents about your parental authority, or other. Whatever you do has to be firm or consistent, a boundary that you allow someone to cross is no boundary. There is always a way, if you have no where to go, ask yourself why is that the case(which I am sure you have considered already) and what can I do about it. If you choose not to take any action then you are enabling your parents to remain abusive. Ask yourself too, why am I not acting on my situation. Am I too dependent on them? Do I not want to change? Is it easier just to let them provide for me? Be honest with yourself. You need to work on your self esteem, and things that empower you. Support groups in person or online, Church groups or organizations, friends, books, music, etc.... but think on things that will empower you. Are you stuck financially because of the need for a job? Do you need to go back to school? Do you need training in a new field? There are a myriad of possibilities and answers. Action, think action and Change, what can I change?" ]

[ "It sounds like your daughter may be experiencing heightened levels of anxiety based on her value system of wanting to ensure she is 'good enough' or 'doing all the right things.' Talking to a trained professional could help her to decompress some of those feelings as well as find ways to challenge negative thoughts that are leading to overwhelming amounts of stress. Please let me know if you have any further questions that I may be able to help in this area." ]

[ "Like with any helping professional, you need to feel comfortable and heard.  If the therapist is not the right one, you will definitely know during the first session.  There is no 'training\" a therapist.  I believe there has to be an openness in communication and a clear understanding of goals and treatment expectations." ]

[ "I am truly sorry for your loss.His passing has triggered some uneasy emotions. Do you know what these emotions are as you are trying to cope? Be aware, that \"coping\" is not processing. Coping means that the problem is always there, and you are \"managing\" rather than healing. And, as you know, that isn't working.Emotional pain comes in waves, which can also cause physical symptoms of anxiety, frustration, and sadness. Rather than coping (avoiding) your feelings, give yourself time to process them. Invite your feelings in when you feel the wave of emotions. Focus on what is going on physically in your body with compassion and curiosity. This will begin your healing process to bring you a sense of peace.Remember, emotions are messengers that help us develop insight into our psychological (and physiological) wellbeing.Please contact me with any questions or more information.~ Catherine", "Hi!This is a great question!The term you are looking for is alexithymia, the inability to identify and describe emotions in the self. However, just because you are not able to feel or express emotions, does not mean that you do not have emotions.After such a traumatic event that you experienced, your central nervous system goes into defensive mode (dorsal vagal nerves) that protect you from any further harm. What this means is if you were to feel your emotions related to your rape, you would have a sense of being overwhelmed, possibly re-experiencing the traumatic event.Not feeling emotions is your body's way of protecting you from any further trauma. Unfortunately, when the (parasympathetic) dorsal vagal system (shutting down feeling) is activated and suppresses your painful emotions (pain, shame, guilt, sadness, anger), it also shuts down your positive and relational emotions (love, joy, contentment, connectedness, happiness).I am very sorry that you had to go through such a traumatic experience as being raped. No one knows what is going on inside of you as a result. You don't know what is happening to your emotional wellbeing! The best (and at times, difficult and scary) thing is to process your emotions related to your trauma. This processing is done carefully, with a trained counselor, in a place that you feel safe, heard, and not judged. Although the thought of proceedings (addressing) emotions may be anxiety-inducing, it brings on a huge sense of relief and validation.What you are going through is normal, considering what happened to you! I hope you reach out for more help.If you have any questions feel free to contact me, Catherine at clevelandemotionalhealth.com", "This is a great question. PTSD can be very complex and debilitating. It must be very difficult for you at this time.When we feel complex emotions such as anger, frustration, and possibly low-self worth, the tendency is to try to avoid or suppress these emotions. The more you avoid them, the more these emotions will express themselves, and at the worst times. This may be why your PTSD symptoms are harming your relationships and your job status.To help you get your life back, it is important to process your emotions with a counselor that has specific training in trauma-informed interventions. To process emotions, you start by inviting them in, observe them with compassion and without judgment. When we observe our emotions, it starts the healing process because we separate ourselves from them. Remember, thoughts and emotions are constructed. You are not your thoughts, nor your emotions. They are messengers telling you to pay attention to them. The more we avoid the messengers, the louder they get, to the point that they are crippling you in more than one way.I hope this helps you begin your change process. For more information, please here is a link to a trauma post on my blog The Wisdom Room.Please reach out for help. And contact me with any questions.Sincerely~ Catherine ClevelandCleveland Emotional Health" ]

[ "This is actually more common then we often realize, and actually understandable, as he has gone through a trauma, an unresolved existential crisis.  He was taken care of by others and now is again left alone with his own internal, and rather horrific inner struggle.In my work with CCT, or Contextual Conceptual Therapy, (see www.suicidetherapy.com) I have learned how trapped suicidal people are in their own isolation, also called a \"mysterious isolation,\" a form of self protection which cuts the off from their Self, or spirit.  And unless they address this message from their soul, accompany a guide on a journey to discover their own missing information, that is to recognize how their own uncomforted emotional pain has resulted in a coping stategy which has effectively cut themselves off from their own beauty, their Self, and their ability to receive love from themselves and others. Their attempt to kill themselves is a cry from their soul or spirit that they cannot live the life they are living any longer.  They take this literally and try to end their life, when in fact what their soul or spirit is saying is they need to begin to live the life they came here to live.", "This is your experience, your feeling and you are wondering if it is normal, which means is this common or the rule. This question about how you feel about your third child leads me to believe you are dis- turbed [etymology: agitated or stirred up].  Feelings are messages from our soul or spirit that something is not right.  So, though  it might be normal [common, the rule]  to look forward to a one year olds nap time when you have a three year old a nine year old, the dis- turbance or stirring up in you, is important and requires your attention, your listening, if you will to your higher self." ]

[ "Yes, it is completely normal to feel anxious about therapy. Therapy often explores topics and feelings that are uncomfortable. The ultimate goal of therapy is to feel better but the process itself can be uncomfortable.", "First and foremost, be gentle and patient with yourself. It is normal to feel a range of emotions after a severe trauma including no emotions at all. Try not to push yourself to feel, just notice the lack of emotion you are experiencing right now. Maybe write about your emotions and the lack of them or talk about it with a safe person. Unfortunately recovering from trauma can take time and it's best done at your own pace. If you aren't feeling there may be a reason you aren't feeling. For severe trauma I always recommend working with a trained trauma professional who has the training to guide you on your path to healing fully.", "Yes, it is completely normal to experience a wide range of emotions after a major loss. Healing can occur in stages. Elisabeth Kübler-Ross proposed the concept of the five stages of grief:Denial - Unable to believe the reality of the loss.Anger - Wanting to blame somebody or something, having thoughts like \"this isn't fair!\" and \"why me?\"Bargaining - Hope that you can somehow avoid the cause of grief with a promise to compromise or change.Depression - Feeling sad, discouraged, and/or hopeless.Acceptance - Being able to remember with love rather than pain.The stages are not linear and not everyone experiences all five stages in this order. This 5-stage model is meant to help normalize the grieving process and educate individuals that you have to let yourself feel your way through your grief. It can help to work with a trained professional counselor to guide and support you on your path to healing. ​​", "Unfortunately you can't directly change another person's behavior. However, you can give him feedback on how his not listening impacts you. The best way to provide feedback is in 3 parts. The first part is telling him the emotion you are experiencing when he doesn't listen, such as hurt, sad, and unloved. I would stay away from feelings such as frustrated, angry and irritated and use a more vulnerable emotion. The second part is what he does specifically to make you feel that way, be specific! Example: when I get home and tell you about my day and you don't look away from the tv. Be objective as possible when you describe his behavior. And the last part is the most important, tell him what you want him to do, and again be specific! Example: I would rather you turn off the tv, give me eye contact and reassure me about my day. Here is an example with all 3 parts together: I feel hurt when you don't say anything to me when I tell you about my fight with my friend, I want you to hug me and tell me you understand how I feel. Hope that helps!!", "That is a difficult situation and there is no right or wrong. You both need to discuss it and come up with a solution that works for the both of you. You want to spend time with your friend but your boyfriend  may feel betrayed by you spending quality time with another man you have been intimate with. There may be a way for you both to get your needs met. Maybe you only spend short periods of time with your friend, not a whole weekend. Or you check in with your boyfriend  periodically when you see your friend. It really depends on the two of you. If it becomes too difficult, you may need a neutral party to help you establish appropriate boundaries around this issue. Good luck!", "Counseling ends when the client has received the maximum benefit from the therapist. Even if the therapist believes the client is not making progress, the client may feel they are improving and receiving a benefit. And the therapist may see a benefit and the client does not. It is best to have ongoing dialogue with the client to determine when termination is appropriate." ]

[ "Staying on the lower dose may give you more room to learn strategies for coping with your anxiety.  Medications are so helpful, and needed at times, but it's also important to have a variety of tools you use to manage your responses to stress.  If you are not already seeing a therapist, consider finding one who can help you learn some effective strategies, like replacing self-defeating thoughts with ones that work better for you, or mindfulness, relaxation, or other tools to keep your anxiety in the manageable range!", "The behaviors you describe are boundary violations.  You can not change your spouse, but you can respond to his behaviors in ways that protect your boundaries and ensure your safety.  This is very hard to do without support.  Finding a therapist who understands the dynamics of abusive relationships may be helpful.  If you are not ready to do this, I recommend the book \"Boundaries\" by Dr. Henry Cloud and Dr. John Townsend.  It's a great resource for helping one recognize boundary violations and learning how to respond to them in ways that are constructive!", "That does sound very confusing...and hurtful.  You do not have to tolerate someone treating you in a way that hurts you.  It may be helpful to decide where the boundaries are for you and to stay true to them in your interactions with him.  You teach other people how they are allowed to treat you." ]

[ "Have you spoken to your health care provider about your weight?  You may not have a medical issue.   A lot of times we try to have the \"perfect\" body when in reality we try to live up to social standards.  Please set up a FREE consultation with me!" ]

[ "Thank you for posting.  I'm interested to hear some more information; such as, if you live by yourself or family, if you go to school/employed/unemployed, and what kind of things do you like to do with friends or by yourself.  Often times, when we are experiencing a strong emotion that we interpret as negative, we put most of our focus on that negative emotion and struggle to see that we do not always feel that specific emotion.  There are typically points in the day (even if it is for only in 1 minute intervals) when we do not feel that negative emotion.  When we overgeneralize, we use words like \"always\" or \"never\" and when we use those words and it may not be totally true, we feel the negative emotion based on an inaccuracy which is not fair to you.  Ask yourself some of these questions: Am I being realistic when I'm overgeneralizing things? Have I ever noticed a short period of time that I wasn't feeling anxious?  What do I notice when I am feeling anxious? What am I thinking about?  When was the last time I felt empathy?  What was different when I was able to feel empathy?  Hopefully this helps get you started.", "Thanks for posting.  This is a significant issue for many people and can make us feel helpless; among other emotions due to the uncertainty.  You said that, at times, you feel like everyone is lying. Ask yourself some of these questions.  What is it that makes you feel so strongly that they are lying?  Where is the concrete evidence that they are lying? How could I test my thoughts about this? What if things are not what they seem on the surface? Am I any lesser of a person as a result of this person's behavior or opinion?  Our beliefs about ourselves and the people and our world  and how we interpret information and experiences have a significant effect on how we feel and how we behave.  It is important to objectively challenge the beliefs that contribute to negative emotions.  You can start this process by answering some of the above questions.  We are unfortunately influenced by what and who we associate with.  As it pertains to if God is a lie; be honest with yourself and question your beliefs that tell you that God is or is not real.  It may be helpful for you to speak to a preacher or chaplain of some sort and they can help you with a lot of that.  Hope this helps at least a little bit.", "It's very admirable that you are trying to stop smoking for the sake of your health and your child's health.  The mental aspect of quitting a drug can and usually is the hardest part.  First, it can be helpful to change the focus of your thinking so you are focusing on the healthy behaviors you will start/improve rather than only focusing on the behavior that you are trying to stop.  The reason for this is that our brains hear the main topic of our thoughts.  That is, when you tell yourself \"quit smoking, quit smoking, quit smoking\", your brain hears \"smoking, smoking, smoking\".  So we need to put together a self-care plan that addresses your thinking, emotions, and behaviors (nutrition, physical activity, and other stress reducing activities).  The idea is to have an effective plan in place to both prevent yourself from feeling intense stress (which increases cravings) and to have a well-placed plan for when the intense cravings inevitably present themselves.  And lastly, and possibly the most important; You have to believe you deserve to be the healthiest version of yourself.  Think about the times when you are most vulnerable to smoke (stressful situations, after meals, when drinking, social situations, etc.).  The use of affirmations is also an important resource as what we say to ourselves effects our mood.  Repeatedly telling yourself \"i am healthy, \"i am getting healthier, \"my lungs are becoming clear and healthy\" or other affirmations like this.  Even if you don't believe them at first, continue saying them.  This step is important to improve cognitive flexibility which trains your brain to be open to change.  Think about activities that you like to do or that you would like to try and replace smoking with those activities.  Any activity that can make you laugh (time with friends, watching comedies, etc.) will evoke a calming response because when we feel happy, we typically don't feel stressed out simultaneously." ]

[ "It must be painful to do this behavior. Something is causing your pain. I know that’s staring the obvious. But taking a step back. Taking some deep breaths might allow you to determine what’s underlying your need to self harm. If you feel you have to harm yourself then a technique is to hold an ice cube. The cold will divert your attention away from your emotional pain.", "It’s painful to want to be what you are actually. God loves you. Despite your religious beliefs you need to be tru to yourself. Talk to a common high that you can relate to. Be you.", "Your therapist will show up for you not only keeping your appointments but s/he will listen to you. S/he will use your language. Also s/he will respectfully confront you when appropriate.", "Are you crying because you are sad? Perhaps this is your heart breaking open ready to cope with your issues. When we are sad and we don't cry maybe it's because we are guarded and our ego is trying to protect us." ]

[ "It's absolutely normal to cry in therapy. I imagine that you are being vulnerable and open to exploring some deep seeded issues. Also, it may be a good sign that you feel safe and held with your therapist that you are able to freely express those strong emotions." ]

[ "It takes a lot of courage to go to therapy.  I have gone myself as a Counselor and know what that feeling is like. This is normal but hopefully you have become more comfortable with your therapist. This might be something to bring up to your Therapist and openly discuss (scary to do but its ok) this may even relieve some of your anxiety.  If it continues, you may want to consider trying another therapist as this one may not be the best fit for you.", "I will work with clients and continually review progress with them and determine if counseling is helping.  If a client appears to have less to talk about in sessions, appears more stable for a period of time and has reached therapeutic goals I will talk about termination.  Some clients however I may continue with on a monthly or bi monthly process to allow for check-ins to see how they are doing and if they need more help at that time.", "Counseling definitely helps people!  I have seen so many positive changes from those willing to engage in the counseling process.  Having a safe place to openly share concerns with an objective listener really is therapeutic and can make a huge difference in your life.    Many times people don't feel heard or validated by people in their lives, counseling call help validate your feelings and help you become more self-aware.  You can learn new skills to better manage your life as well.  I find the people who get the most out of it are the ones most willing to make changes." ]

[ "Grief can be confusing, and it can be hard to know who to talk to and how you are supposed to feel. It can be helpful to talk to a trusted adult to get support with talking to your family  about your need for counseling at this difficult time. You can find free resources and support online at:-https://whatsyourgrief.com-www.GriefNet.org-The Dougy Center at https://www.tdcschoolkit/org/teens" ]

[ "When I ask my couples why are you together, they often will say \"because we love each other!\" Well, that's great, but it's not enough. Love is what brings us together in the first place. It's that magical, hormonal glue that creates a powerful biological bond that ensures we get together, mate, and have kids. When that magic fades, the difficult work of making good marriage starts. It takes more than love. You have to have a shared purpose, a shared reason for being together. For many couples, it's about having kids, or self-actualization, or buying a house. It can be anything, but a good marriage is one in which both partners can answer the question in the same way, and have thought and talked about before. Another sign of a good, lasting marriage is one in which each partner takes an active role in helping the other through hard times. When they disagree, they spend more energy trying to understand the other person instead of proving their own point. They can quickly drop the sword, listen and reflect accurately, and demonstrate care and genuine concern. Finally, a good marriage is one where there is affection. Notice I didn't say sex. I've worked with couples who haven't had sex in years, and they were the happiest couple in my practice. Sex doesn't equal intimacy or affection. I'm talking about cuddling, holding, hugging. I'm talking about that deep relaxation feeling you get when you just let go into the arms of your partner. That kind of affection. It's crucial! You deserve this kind of relationship, and you have everything in you to make it happen. Sometimes we just need some support and guidance. Don't hesitate to reach out for help. It can make all the difference. Good luck!" ]

[ "Long distance relationships have their challenges, and I am wondering if part of the missing attraction is due to the distance. Has the relationship always been long-distance, or is this a change? How do you feel when you are visiting one another? Are you distracted by your lack of feelings of lust for him? Or do those thoughts mostly come up when he's not with you? And the men you find yourself lusting over--are they men you see in real life?  Perhaps you are experiencing moments of lust for these other men because it's too painful for you to experience them about someone who is far away and not physically accessible to you.It is normal for physical attraction to ebb and flow over time. And it is normal to be attracted to other people outside of your relationship. Being in love with one partner and building a life does not mean you stop having normal, human urges about other people you find attractive. Being in love does mean choosing that partner over others despite those urges of attraction.There are many reasons you might wake up and fall in love all over again. But I would offer that those reasons are harder to experience in a long distance situation. Physical attraction is \"easy\" because we can experience that reaction based on a picture. But the day-to-day things a partner might do to make you feel loved, secure, cared for, and honored (which could give the same falling in love all over again feeling) are harder to experience and trust when you aren't physically together.If the relationship is great and he's the ideal man in many ways, give some thought to what the next step for your relationship could be other than marriage. Is it possible to spend a significant amount of time together? If your potential marriage wouldn't be a long-distance relationship, then it might be worth exploring what it would be like to be in each other's life day in and day out." ]

[ "The most important action you can take here is validating her feelings and staying calm when she is crying and \"freaking out\".  It's equally important to do some self exploration regarding your own thoughts, feelings, and behaviors towards making mistakes and how you respond to your mistakes.   When she is calm, ask her what a mistake means to her.  Giving her examples of different kinds of mistakes and listening to her responses will give you an idea of how extreme her thoughts are.  Taking this opportunity to share with her your own struggles with perfectionism or some other area would help her feel more at ease.  Reminding her that she is enough just as she is would be helpful as well.  Encouraging her self care routine will help develop a greater sense of balance regarding her priorities.  The practice of mindfulness will be helpful in self awareness.  Creating a plan on what to do when the early signs of \"freaking out\" surface will strengthen her coping skills.    Your fears as a parent are completely understandable and this definitely needs to be addressed.  Your daughter cannot bring about change on her own and will need the family to work towards this change as well.  A therapist that specializes in anxiety/perfectionism would be a great resource.  They may also help you all have a greater understanding of what the root of this need for perfection is and how it plays a role in the family.  I suggest one or two sessions without your daughter would be helpful to develop a course of action.    I hope this was helpful.   It takes a lot of courage to seek help and guidance, I'm glad you posted.", "When you find the right therapist, you will feel understood on a deeper level.  You'll feel that they not only understood what you were saying, but that they were also able to catch the \"in between the lines\" part and put into words what you have not been able to.  The relationship with your therapist should be collaborative, there should be a fundamental element of safety and trust.  A strong relationship with your therapist takes time to cultivate, but by the second or third session, you'll know if that therapist genuinely see's the world from your perspective and has a plan to get on how they will support your growth through this journey." ]

[ "What you are experiencing is totally normal and these emotions mean you are human! Humans are social creatures who were created to be in connection with others, but sometimes our life experiences or genetics can make that more difficult for some of us. It is possible that these reactions are based on negative reactions you have had with others in the past, maybe your family, or other traumatic interactions with others. It is also possible that they are caused by an underlying condition such as anxiety or depression, which may cause you to be more uncomfortable around others or annoyed by others. Some people are also more bothered by crowded spaces, loud interactions, and the actions of others. Of course you prefer animals (me too!), they provide unconditional love and support, do not judge you, and do not require you to have conversations with them. The fact that you have conversations in your head at night tells me that although you say you do not like people, you are craving some social connection. What is probably the case is that you were never really taught how to interact and have those conversations. The good news is that there is nothing wrong with you, you just need a little help learning how to have these conversations and taking some healthy risks to initiate conversations and that is something that I help many of my clients with in therapy." ]

[ "No, it is natural for us to have a number of issues going on if we don't address the concerns we have in our lives. Seeking counseling can assist you in working on these issues individually as well as ways in which they intersect and impact each other.", "This is actually pretty common. When winter hits, we tend to find ourselves huddled inside from the cold. Not to mention the sun is out for a much shorter time. It will be helpful to get as much sunlight as possible. Get outside when you can. Open up the blinds and drapes. Use a sunlight if you want to (amazon has some for reasonable prices). Stay connected to friends and family. Try to engage in activities that make you feel positive, productive, and connected.", "It sounds like you may be putting yourself last. You wrote that you want to fix your issues but never get around to it. I wonder how you are spending your mental and physical energy. Are you spending time taking care of and doing for others? I also wonder where the thoughts and feelings of being worthless are coming from - are you around people who treat you poorly or are hurtful? Or do you feel it is more of a worry you have but aren't really sure how others feel? It may be helpful to talk to someone about your feelings - a counselor perhaps - to clarify your feelings and move forward from se that are hurting you.", "This can be a very difficult question to answer. Without knowing anything else about the situation - it makes me wonder - what makes you feel like you should break up with him? What brought up thinking about ending things? It will be important to decide if the relationship is safe, if it is healthy, and if it makes you both happy. Are there reasons you are staying in the relationship that don't make you feel good? It might be helpful to write things out or talk to a trusted friend about what each of your choices means. What would it be like to end things? What would it be like to stay? Are there issues that the two of you can work on to make the relationship better?", "It is really important for you to be comfortable with your identity. With that said, it is also so important for you to be safe. It may be helpful for you to find supports (in your life, community, or online) that you can talk about how you feel and potentially gain supportive persons if your family does not accept you. It will be really important to connect with others and even a counselor to help you.", "I am sorry for your loss. I understand the difficulty of needing help and not having financial resources. In some areas, you can dial 211 and find resources in the area that may be free of cost or low cost. In addition, often hospitals and community centers, churches, etc. have support groups. These are often free and many include grief and loss issues. Finally, there are some therapists who work on sliding scales and even sometimes offer pro bono sessions for clients. Hopefully some of these leads work out for you so that you can get the support that you need.", "It can really be difficult to listen to someone constantly complain and it can take a lot of emotional energy to be the listening ear to someone struggling. Perhaps having a conversation with your mother about making the communication more productive in nature. It seems like your mother is obviously having some difficulties and she is stuck, therefore making you stuck listening to complaints on repeat. Explain to her the impact it has on you to listen to the complaining and not working towards changing things or coming to a level of acceptance or even making the conversation mutual, such as her being there for you. This may or may not help her to come around, but at least it can open up the conversation and be an effort towards initiating a change.", "I am sorry to read that this happened to you. If your family is not supportive of you, this can be a huge challenge. Are you dependent on them in some way (financially, etc.)? This could affect choices you make at this point. Make sure you connect with a supportive community or people and organizations that are afforming of you and your identity. If you are unable to receive support from your family, you can lean on them if necessary. If you feel your family needs more information you can always refer them to appropriate websites and organizations that can help them to understand that this is natural and normal and learn the negative effects of non-affirming people in the life of LGBTQ+ individuals.", "Sexuality is fluid. It is possible to find yourself attracted sexually or affectionally to different types of people at different times in your life.", "There is nothing wrong with you! Sometimes we get intrusive thoughts that can be worrisome. One things that can be helpful is to identify if there is a trigger to these thoughts - something in your life that makes these thoughts more common (an experience, a person, a place, a situation, etc.). It will also be helpful to try and challenge this type of thinking by focusing on ways in which you are worthwhile as a person and have worth in your life. CBT (Cognitive Behavioral Therapy) may be particularly helpful with this, also. If you are open to seeing a therapist, find one that does CBT. You can also find resources on CBT online. It focuses on stopping and challenging unhelpful and harmful thinking patterns and replacing it with more helpful and healthy thinking patterns.", "You can certainly ask the therapist questions such as their style or issues they have experience working with. You can also determine whether a therapist is the right fit if you feel a connection or alliance and feel that you are working together toward your goals. It is important to be open and honest with your therapist about what you are looking for in counseling.", "Of course! There are some people who will never cry during sessions and some that always cry. In counseling you may be talking about very vulnerable topics and experiences and it may even be the first time you are talking to someone about your concerns, thoughts, or feelings. It is perfectly natural to cry if you are so moved." ]

[ "One way is to bring one's concerns or desires to the therapist directly, rather than trying to subtly 'train' them. Here's why I say that: One quite important healing factor in a psychotherapy is discovering that problems in the therapy and the therapeutic relationship can be solved together. It is a safety zone or bridge for practicing that. If it can be done with a trained, usually safe person (the therapist), the client might think, wow--what are the implications for my outside life and relations? Could I get what I want outside of therapy, too, even if it feels not as safe?If the therapist can deal with feedback (and any good therapist should be able to), this can be very productive. Cooperation in this way, in the moment, with a live person who is supposed to have authority and knowledge in these matters, can be profoundly healing.If the therapist can't take feedback or doesn't want to--or does nothing to act on it--maybe we could say the client has the wrong therapist." ]

[ "No you can never have to many issues for counseling thatis why we have counseling around so we can help you with your problems", "Absolutely if your crying it means that you are releasing your emotions we counselors are trained to handle that kind of thing" ]

[ "There is a difference in someone agreeing to try something and agreeing to continue to do it. Have you ever been willing to try something and then decided you did not like it? A type of food? A sport? A new restaurant? A type of dance? So this does not mean that things have changed between you. It does mean that the two of you may need to spend some time to find out what you both like. Instead of looking at it as a rejection, look at it as a challenge, an adventure that the two of you can go on as explorers together. Some couples have even found it helpful to each write down ten things they would like the other person to try and then each person can pick three things from the other person's list to add into their life together when they chose to over the next few weeks.", "A car accident can be a traumatic event. Especially,  if it was serious, you could have feared for your life, felt everythingvwas out of control and had normal reactions to an abnormal situation afterwards. This may or may not be related to the traumas that you experienced in the military. If it is then it is possible that you will see a direct effect in triggering off PTSD symptoms. Even if it didn't, it is possible that the complexity of the two situations will interact inside you to be a combined response. Having already been diagnosed with PTSD, this might be a good time to reconnect with the help system you had around military experiences and explore it a little bit about the new experience. The right exploration does not have to make things worse and can be a good source of prevention.", "Depending on the source of your traumatic experience, there may be ways to get free treatment to help you. For example, if your experience was related to your military service, the VA may be able to assist you. If your experience is related to 9/11 and you meet certain criteria, there are ways to get free help. In many states, if you are the victim of a crime, there is a victim's assistance fund that may cover costs of this treatment. Basically, start with the traumatic event(s) you have experienced and move forward from there.", "There are different reasons why a counselor may seek to terminate with a client and these will each have different processes by which the counselor will come to that decision. Here are a few examples. The counselor may determine that the client's needs are outside what the counselor is competent to be able to work with. A person may have come to the counselor talking about a particular issue but either when they first met or as counseling progressed, it may become clear that the issue is in fact something different or that there is an additional related issue. If that issue is outside the competence of the counselor, the counselor should look for alternatives, the most common of which would be to terminate and refer. Beyond clinical issues, this could also come up around particular other related facts, such as the culture of the client or linguistic issues. This could also be the choice of the counselor if they know someone that they feel would be a better match for the client's issues. Another reason for discharge (and possible referral) would be if the relationship does not seem to be a good fit. No counselor is the right person to work with everyone. If the right level of connection is not happening, the counselor will often look first at what they are doing, might talk about it with the client and ultimately will admit that things don't seem to be working to allow the desired therapeutic process to work. A similar process would be followed if the counselor determined that the client might not yet be ready for counseling as evidenced by lack of engagement such as frequent cancellations, not doing any agreed on work between sessions, showing up late or being really guarded in session. The easiest situation to decide on is when a person has met their counseling goals and have nothing new that they are working on. While this is the easiest one to determine, it is also probably the hardest one for the counselor as they may be like the client in not wanting the relationship to come to an end. However, counselors know that this is part of the process. They will also determine this by regularly reviewing the treatment plan or by sending in the sessions that the work has come to an end. This type of termination maybe final or may be with the intent that the client will return later to address other things that have been identified but for which they are not ready to move into. All of these (and other) situations involves the counselor being open to the relationship ending, to monitoring how things are going, then engaging in self reflection, possibly talking with the client and then coming to a conclusion on which the counselor  follows through.", "There are multiple ways that counseling helps people. The most basic is that it gives you someone to talk to about and through what you are facing. It is better than a friend because this is a space for your stuff and you get to focus on what you need and don't have to worry about the other side. This is also a place where you do not have to worry about how else the other person is involved in the situation. Beyond this basic level, a counselor will have expertise they can bring in terms of how people, including you, can effectively deal with this kind of situation. The counselor may also be aware of connections that you would not otherwise see. A good counselor will also recognize if and when you need other help or support in the situation. Why wouldn't you benefit from having someone walk with you in your journey to peace and wholeness." ]

[ "I would suggest some holistic approaches, such as getting your Vitamin D and iron levels checked. Make sure you are eating well, exercising, and getting outside when you can. Take a trip to someplace warm if possible. Use a sun lamp in the morning for 30 minutes to simulate sunlight. Seek professional health to gain coping skills and other ways to manage symptoms." ]

[ "Seasonal Affective Disorder (S.A.D.) is a term that reflects how many people are affected by the changing seasons, especially fall to winter.  Everyone suffers with some form of this (lessened activity levels, increased isolation, etc.) while some find that this time of year can put them into a deeper depression. If you have noticed that this happens frequently, there are some ways you can definitely help yourself going forward:1. Attend therapy to learn strategies and tools to help you to manage your mood.  It's important to stay within the therapy until you feel you have mastered these tools. 2. Push yourself to interact more with your social groups and other positive activities. It's easy to go out and spend the day outside in the summer months, when the temperature is warm and the sun shines for long periods of the day, but it seems harder to find fun ways to spend your time when the temperature drops and darkness comes on so quickly.  Perhaps winter time could become the time of year where you and your friends have weekly board game nights, complete with hot chocolate and a fire?3. You may want to consider the purchase of a S.A.D. Light.  These are lights that expose you to additional ultra violet light to increase the vitamin D in our bodies, as well as the release of growth hormone (which releases when we wake up). There are mixed reviews of these products, however, and they can be expensive.", "I'm alway wary of assigning a term to a feeling, as often that term becomes more important than the feeling itself. From the very little that you have written, it is clear that you are going through something that has made you extremely low, affected your self-esteem and motivation, limits your enjoyment of formerly pleasurable activities and affects your feelings of self-worth. All of these are aspects of being depressed, though you can be depressed and still not have \"depression\". Counseling is definitely a place where you can go and sort out why you have had such a sudden a drastic change to your mood. Sometimes our mood can be effected by changes in our routine, losses or significant disappointments. Talking with someone will not only help you to better understand why you are feeling this way, but they will also help you to ground yourself and learn strategies and tools to help you to manage your mood and strategize for the future. I do hope that you will reach out. Feeling alone can be harmful over long periods of time, as it can stop us from seeking out the support we need.", "I couldn't help but notice that you did not specify your age, so I am unable to set the total chronological order and length that you have suffered in this way, but I want to start by commending you on seeking out additional coping techniques on your own.  Unfortunately, it sounds like you were offered some that were more dangerous than helpful, but be proud that you were able to curb those before they caused too much harm. From what you have written, stress has always been a difficult thing for you to manage.  Often, when I am working with those who offer the same concern, there is a degree of people pleasing that comes with that stress.  When we are trying to make others happy, especially when we are unable to distinguish the proper \"rules for success\", it can make even the simplest of tasks overwhelming. Stress management is just that, management; of our own anxieties about the needs of others, about our skills and the ability to complete a task and having multiple requests at any given time. Each of these aspects requires a separate sets of \"tools\" to manage them accordingly. For example, assertiveness communication training could aid in communicating with your colleagues to manage their expectations of your deadlines and abilities, but it will not assist you with managing your own anxieties. Try to separate the different areas of the problem, in order to help yourself to find a solution and work on them in their own time. Perhaps keeping a journal will help you to better understand why you are so easily overwhelmed by stress and help you track some of your less-helpful responses to stress. For example, does a certain person's style of communication always make you feel undervalued and therefore push you to finish their requests first? Is there a certain time of the day where you start to fall off in productivity?  Is that the time fo the day where you also tend to pile up your requirements?Try to ask yourself some of these harder questions and see where they lead you.", "It sounds like you have been struggling with this for quite some time, using many of the same coping techniques that feel tried and true to no avail. Often, we fall back on coping techniques that would be helpful in other problems (stress, social anxieties, etc.) for our depression, but the truth is that depression requires it's own little tool kit. Depression is all-encompassing, and, based on what you've written, the symptoms are already affecting work and your personal life in myriad ways.  The best route forward would be to seek out counselling, admittedly, but if your insurance deductible is too high, that can be very expensive. I would recommend contacting your Employee Assistance Program (EAP) if offered by your employer. If not, you can look into community centres for counselling options, check if your doctor will give you a referral or your local religious organization. If, however, you are motivated to get your depression under control, there are some great workbooks out there that you can use on your own or with your therapist (as long as your therapist is trained in Cognitive Behavioural Therapy, or CBT), such as \"Mind Over Mood\".", "As silly as it may sound, making sure that we are getting the right amount of *restful* sleep is very important when we are feeling low.  The reason for this is the lack of proper sleep significantly affects our ability to problem solve and critically evaluate our situation and can lead to a domino effect in our thinking.  I know you feel that you may be losing your friendships, but what are the facts that have led to this belief? Really ask yourself, \"are they facts?\" or are they your perspective on events.  In regards to your coping behaviours at night, it sounds very isolating and also very silenced.  As opposed to the sad music, why not try all music, allowing yourself to experience the wide breadth of emotions that are circling within you.  One of the other recommendations I would make would be to try and journal about some of those thoughts and fears in order to release them in a positively cathartic way. Some of the behaviours that you have mentioned are a bit more significant, though and I would recommend speaking with someone directly in the near future.", "Anxiety can cause such a feeling of discomfort in our bodies that it can seem unbearable. The concern that I can hear in what you have written is that the thought of having some anxiety has now left you uncomfortable with any anxiety at all - and that can become a problem, indeed. As opposed to thinking about your anxiety as something much bigger than you, it could be helpful to start breaking it down. What are the things specifically that cause you anxiety about this new job? Is it being away from your family? If so, why? Once you start breaking down what causes you to feel anxiety into smaller \"mouthfuls\", then we are far better able to understand what has led to discomfort and start to problem solve the issue.", "I think one of the first questions that springs to mind for me is, \"what's the rush?\"  Just because other people in your circle have had experiences that you are still warming up to does not mean that there's something wrong or something to be ashamed of.  If anything, I want to commend you on the self-respect you have in wanting to wait and share this most intimate of experiences with someone that will feel the same way about it.  One of the most common distortions in our thinking is when we try to directly compare ourselves to others; while these people and even those in your family share a level of closeness to you they are not exactly like you - they don't see or feel things in the exact same way as you nor do they share the exact same perspective. It's important to be making choices for you and for your own desires and life goals.  Once you stop comparing your happiness, you may find that you are already experiencing it and allow more of your guard to fall down.", "One of the greatest ways that we can promote ourselves s by learning how to assert ourselves.  Despite what most people think of when they hear the word assertive, assertive communication is one of the best ways to manage interpersonal conflict as well as maintain personal boundaries.  Once we become comfortable with acknowledging our boundaries, there is usually a follow-up whereby we realize that we have the right to those boundaries.  In effect, assertiveness communication becomes it's own self-motivating force in managing positive self-esteem. You may want to invest in a workbook that can help you to develop these skills on your own, or work directly with a therapist to develop them in a safe situation.   One of the Workbooks that I have found to be very helpful is, \"The Assertiveness Workbook: How to Express your Ideas and Stand Up for Yourself at Work and in Relationships\" by Randy J Paterson.", "Sometimes we let our insecurities get the best of us, causing us to make some interesting choices. Honesty is always the best policy, but honesty comes with risk.  Perhaps you may want to start with your family first, explaining to them what you have done and why.  Perhaps they can help you to practice talking about your insecurities with your friends. Another way is to start, slowly, to dress more and more like yourself and your true body shape. Some of your \"friends\" may make fun of you, true, but then you must ask yourself...why do you want to be friends with people like that?", "I'm so sorry to hear about your recent loss.  There is such a large feeling of uncertainty that befalls those of us left to sort through these emotions of such a loss, and it's never easy.  I think it's important to remember that there is no \"right\" or \"wrong\" way to deal with loss and the \"best way\" for you may not be the best way for someone else.  The fact that you are aware that you are smoking more marijuana and drinking more, and the fact that you can recognize that these may not be the best coping techniques, is a very good step towards giving yourself some better support at this time.  Marijuana and drinking are type of coping techniques that can numb us to our emotions, but they do not really help us to work through those emotions. When it comes to grief, often one of the most helpful ways to move through the phases of grief is to use your social supports; talk to your friends and family, see your mutual friends and commiserate with each other on the loss and the uncertainty.  The more we talk about our feelings, the more we are okay with them being ours. The more we express our loss, the better we become at accepting such a loss. In talking with your supports, you may also decide ways in which you may want to remember your friend; ways you can do so on a personal level (writing a poem, planting a tree, etc.) or ways you as a group can remember and memorialize them (a special day where you get together to share your memories, starting a charity, etc.) We never truly \"get over\" our losses, but we can learnt o accept the losses and what it means to us now...but that also takes time.", "Sexual desire seems to be straightforward - I like someone and I become aroused at the thoughts of being intimate with them - but that idea does not always take into account other factors. Stress can have a huge effect on our body and how it performs.  When we are overstressed, for example, we often find ourselves ill at the same time.  Can you think of any part of your world that may be causing you some additional stress? Additionally, focusing on your erection may also be increasing the level of stress you feel about being intimate, which could also effect your ability to get and maintain an erection.  While this may seem counter intuitive, it makes sense in the word of stress!Finally, it's never a bad idea to follow up with your doctor, as well. You did not mention your age or sexual history outside of this relationship, but it is always a good idea to check in with medical staff to make sure there is nothing physically responsible for changes in our body, as well.", "The best way to work on a relationship is for both people to engage with the problem and start communicating with each other more effectively.  One of the hardest things about this, however, is getting both people within the relationship to recognize that they are both responsible for the successes and failures within the relationship and remove all the all-or-nothing blame. The best style of communication is open and asking for clarification; why not try asking your mother why this particular fight/situation is eliciting such an angry response.  Often, the simple act of expressing that we don't understand the other person's point of view can open the doors to better levels of communication. The hardest part is trying to remain humble as we seek out that clarification and avoid the blaming language we are so used to using in such times.", "Often, communication is the key within relationships. When faced with our significant other telling us about a “crush”, it can create or highlight feelings or thoughts that can promote feelings of insecurity. Talk to your partner about their crush and use the conversation to strengthen your bond.", "I'm truly sorry to hear that your relationship is causing you such distress at this time. When we are in relationships, trust is so integral to our satisfaction within the relationship.  Often, when we feel we are required to prove ourselves, feelings of resentment can replace those feelings of wanting to be supportive.  In situations like this, I often recommend being open and honest in your communication with your partner.  Your fears about his response are valid, as he made an assumption which you cannot disprove because you cannot battle against a shadow fact. If you feel comfortable doing so, you can always ask him why he is so concerned you are unable to remain faithful and challenge those beliefs with the facts that disclaim them.  You can also ask your partner what it is that he needs from you to help you to help him trust in your responses.  In the end, these are issues that you cannot conquer for him - you can only guide him and show him the path towards trust.  You may suggest couples counselling or that he seek out a professional to talk to, as well.  But in terms of your question, only you can decide whether you feel you can remain in a relationship in which you defend yourself against an uncommitted offense.", "Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!", "Counselling offers a number of ways to help one to improve their situation.  For some, this process can take a very long, winding path of self-discovery, while, for others, they are seeking a purposeful, solution-based way to approach and manage a specific problem. It's important to remember that there are different styles of therapy, some of which will work great with some, but poorly with others, specifically to help those to decide how they wish to move forward. I often recommend speaking with a number of therapists before beginning treatment to find out more about how they practice, in order to make sure their style aligns with your goals. On a more specific note, there is myriad research out in the world that indicates both counselling and medication can have an affect on changing our moods and behaviours.  However, medication is not an effective way of treating the problem, as it treats the symptoms of that problem (increased anxiety, lowered mood, etc.) and research has shown that the most effective route for better mental health care comes from a combination of counselling and medication.", "Hello, There are many ways to approach a counselor and starting the process, however they all start with picking up the phone.  It's most definitely an uncomfortable feeling, but once that first step is taken it is often met with a wave of relief. My recommendation is always to call and speak with a therapist over the phone before scheduling an appointment. Listening to how they converse, use their tone and inflection, may give you a brief insight to how they will respond to you and increase your comfort right away. You may also discover, rather quickly, that this therapist is not the right match for you.Regardless of how you go about it, I like to remind all people who call, email, text or walk-in, therapists are a bit like pizzas - if you don't like the toppings, send it back! There are hundreds of therapists offering all kinds of styles of therapy - take the time to pick one that suits you." ]

[ "Let me begin by offering my condolences for your loss. I can understand how difficult this time maybe for you especially if you have several unanswered the questions due to the circumstances surrounding the death of your friend.  It's during this time, that you may experience the various stages of grief. This includes denial, anger, bargaining, depression and finally acceptance. In the bereavement process, there is so specific time frame or lengths of time for someone to work through each step. Its imperative to note  that one may express each stage with different levels of intensity. Also, the five stages do not necessarily occur in any specific order. We often move between stages before achieving a more peaceful acceptance of death. Just note that everyone greives differently, some internalize their feelings and emotions, others express it externally, while other avoid it all together.Coping with loss is ultimately a deeply personal and singular experience. Sometimes we feel that no one understands what we are feeling or going through, much less comprehend our emotional state of mind . What's important, is that you allow others to comfort you through the various stages. My recommendation is to allow yourself to go through the emotions and feel the grief. Avoiding or resisting may only delay the healing process. Reaching the acceptance stage of mourning is a gift not not everyone is awarded, but seeking the help of a Grief counselor may assist in deciphering your emotions and set you on a more positive path to achieve closer." ]

[ "As a past sufferer of anxiety myself, I have learned that it is a natural part of life, it is a natural part of us, the longer we try to run from it the more it entangles us in its clutches, if we deny certain parts of ourselves we will become depressed or even oppressed, the only way to deal with anxiety is to embrace it and accept it, and in fighting the fight without fighting we will eventually win, I would encourage you to look into Acceptance and Commitment Therapy, your answer I think lies in that area of research. Hope this helps,C", "Therapy does not work overnight, oftentimes it is a lifelong struggle, the therapists job is not to \"cure\" you or to remove something but rather to make you strong enough to live your life with your own peculiarities and struggles, remember we are human and constantly fallible. Another important thing to note is that although you go to therapy, that is just a room, most of the magic and work takes place in your real life outside of that room.", "Fears are not that difficult to deal with, first you need to train yourself to relax using some relaxation strategy, once you are able to employ that in your daily life, you then need to start facing your fear, for instance I'll use an example of a man who has a fear of driving over a bridge. We would build a hierarchy of fears, that is a list of fears ranging from least to most, for example the man may want to start by looking at a picture of a bridge while employing his relation technique, then he may want to see a real bridge from a distance while employing that same relaxation technique, then moving closer to the bridge, then maybe standing on a bridge, all the while moving closer to his fear while relaxing, until you come to most fearful proposition which is crossing that bridge, or you can also engage in flooding which is for example, if you were scared of an elevator, go into an elevator until you are not panicking anymore, in the movie Batman Begins, Bruce Wayne who has a great fear of bats, goes into this cave and allows himself to be surrounded by bats until he is no longer fearful of them. Secondly, look at your fears, do they even need to be worked on, some fears are healthy, for example if i was a therapist in New York City and someone came to me and said \"I'm scared of snakes\", I would probably say that is OK because there are very little snakes left in ManhattanHope that helps C", "Its hard to answer this question based on the information presented but I shall give it a go, Is it possible that your daughter is afraid of failing, I've seen many children and kids who get stressed out over grades or performance in sports, can you tell me \"what was your grade in fourth grade English? Or what was the score of the 7th game you played in football when you were a junior? Much of what happens to us is insignificant and we worry over things which really , in the long term don't matter much to us. But ask yourself this question, Is your daughters reaction to what is going grossly out of proportion with what would normally be expected, if the answer is yes, a visit to a psychotherapist might not be a bad idea to learn some coping skills and to alter our reaction to life.", "Humans are social creatures so this can be an alarming thing for a parent to deal with, just like adults children are not the same and some children are more social than others, if he plays alone at recess (all the time) it would worry myself as well, however recess is only one domain of life, does he have friends outside of school or daycare? Does he socialize in other situations or is it just at recess where this occurs? If this is a global problem occurring at other social times it may be indicative of something deeper going on, if perhaps it is occurring \"just during recess\" it could be something else altogether. I would request reports from all teachers and caregivers concerning socialization and make a choice on whether or not to evaluate further.Hope this helps,C", "My first reaction to this is that It sounds like you rely alot on the impressions and projections of the outside world, that you need validation from other people to compensate for a lack of something on the inside, build yourself up on the inside, work on yourself, use positive affirmations daily, it would be wise for you to research some self-construct theory and do some self-concept work.Hope this helps,C", "The way that I see it is that Humans have always been afraid of life and death, historically we have always tried to understand life, we try to organize it, categorize it, explore it, and we've built up this system, our system and societies system around us to help us define what life and (death) is, this system or way is not real but only a perception of our own value judgements, it is, no matter how you try to argue it, a false system of conditioning, humans have a finite mind and a finite mind cannot ever hope to understand an infinite mind of which a god would be. God has been developed over time as a security blanket for our child-like selves, the world is a beautifully brutal place and what is more reassuring than a master that will take care of us and show us the way. On Earth alone there are thousands of gods and even many more systems of thought, economics, societal structures and so on, it is almost as though it were a supermarket with so many choices, we have more choices in gods than we do flavors of ice cream at Baskin-Robbins, so then I ask you, \"which one is real?, and \"what is real?\"", "This suffering and clinging to the past, especially a troubled past or a past that we dont like, may be  amplified due to the Christian framework that may be built into your life. I am not averse to religion, i just think that many times it puts unreasonable expectations on us and helps us to form a guilt complex or perhaps even insecurities, we are humans and humans make mistakes. you mention the straight and narrow, this is a notion that you must give up on and let go, humans can never travel the straight and narrow for their whole lives there are bounds to be mistakes, we are the most fallible species on the planet and please tell your fiance to have some mercy on himself, he is not perfect. Here is a story about clinging on to things you may find useful to mediate on:Once\nthere lived a village of creatures along the bottom of a great crystal\nriver. The current of the river swept silently over them all -- young and\nold, rich and poor, good and evil -- the current going its own way, knowing\nonly its own crystal self.\nEach creature in its own\nmanner clung tightly to the twigs and rocks of the river bottom, for clinging\nwas their way of life, and resisting the current was what each had learned\nfrom birth.\nBut one creature said\nat last, \"I am tired of clinging. Though I cannot see it with my eyes,\nI trust that the current knows where it is going. I shall let go, and let\nit take me where it will. Clinging, I shall die of boredom.\"\nThe other creatures laughed\nand said, \"Fool! Let go, and that current you worship will throw you tumbled\nand smashed against the rocks, and you will die quicker than boredom!\"\nBut the one heeded them\nnot, and taking a breath did let go, and at once was tumbled and smashed\nby the current across the rocks.\nYet in time, as the creature\nrefused to cling again, the current lifted him free from the bottom, and\nhe was bruised and hurt no more.\nAnd the creatures downstream,\nto whom he was a stranger, cried, \"See a miracle! A creature like ourselves,\nyet he flies! See the messiah, come to save us all!\"\nAnd the one carried in\nthe current said, \"I am no more messiah than you. The river delights to\nlift us free, if only we dare let go. Our true work is this voyage, this\nadventure.\"\nBut they cried the more,\n\"Savior!\" all the while clinging to the rocks, and when they looked again\nhe was gone, and they were left alone making legends of a savior.", "This is perhaps the deepest question that one can ask of themselves and the answer is as elusive as the deepest enigma. We are fluid beings, we are never the same from day to day, we learn or unlearn, we evolve or some of us even devolve, we are in a state of constant flux, changing and adapting, like a cloud in the sky that has its shape changed by the wind, life whittles us away and carves us constantly, trying to understand this question is like trying to bite your own teeth, however we can have a sense of what we would call our core and to understand the core, we need to live and to experience, but also to think deeply, analytically, and critically, by engaging with life we get a sense that we are like the Earth itself, inside of us there is a core, just as there is inside our planet but our continents shift and change over time, like those continents so does our own nature shift throughout our lives.", "Suicide is not a natural way to pass from this Earth, so many times it can be EXTREMELY tough to deal with because of the \"unnatural-ness\" of the event. We may find ourselves feeling guilty that we did not see it or that we could've have done more or something to stop it, but often the fish in the fishbowl cannot see that which is closest to him. You are currently trying to numb your feelings, those feelings as nasty as they are, are meant to be felt, those feelings help us to process the event and also help us to pass through the situation. Your friend has a legacy, remember it, and honor that legacy everyday in some small or even grand way, perhaps committing or volunteering your time to help others in honor of your friend.Hope this helps, C", "This can be tough to do in this money-driven crazy world where many therapists are not taking cases pro-bono anymore and quite often charge exorbitant prices for sessions, however I would ask potential therapists if they do take any cases on pro-bono, I usually reserve some hours for people who simply have no finances but need help, there are still some that do, if your ex-military you can look at \"Give and Hour\" which is an hour a week for ex-service members, often times you can look to your local pastor, minister or priest (there are still some good ones out there) to help with finding or providing help to you, there are free hotlines you can call that are staffed by knowledgeable people that cost nothing, lastly you may look into getting state insurance which would enable someone to take you on.Hope this Helps, C", "It sounds like your in quite a rough place, my recommendation just based on what you type might warrant a visit to a psychotherapist to resolve what may be going on, I am not entirely sure but it sounds like he might have a bit of a sex addiction problem. One thing you need to ask yourself is \"Am I happy?\", \"Do I feel loved?\", these are deep questions, but the answers to those questions will give you a direction to travel in.", "First thing that you must realize is that most people only post the \"best parts\" of their lives on Facebook, some people even go so far as to make their lives seem better or more interesting and post mostly false views of their life. Facebook is watered down, candied version of our life, you put on there only what you want people to see. The questions you should ask is \"How have I grown from this?\", Is my marriage currently in a good place? I really wish there was some form of magic that could be performed to solve peoples issues and help them sort out their emotions and troubles, however there is not, the closest we can get is by using {time and insight} to heal our wounds.", "Let go of your ego, the ego tends to get in the way of things, be a man and listen, do not react so uch to life around you. life is not out to get you, just listen and work on how your reactive to people and sitations around you. C", "Best answer that I can give to you is that some level of de-personalization is quite normal for everyone, it will come and go throughout life, kind of like being on a roller-coaster, \"here it is, then it's gone not to return for quite some time\", like many things, the more that you fixate on it, the more stress it will cause you, consider it part of life, accept it, and move on, now if your having many, many ,many of these episodes or have some auditory or visual hallucination or disturbances or emotional unbalancing that accompany it than that is definitely something to look at, but for the most part nothing to worry about. Hope this helps,C", "In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C", "One thing I would ask is \"why are you still hanging with those {friends}?\" A relationship needs to be nurtured by both parties, it is a dynamic fluctuation between two people. I would ask you to question why you continue to remain together as friends, I always believed that a relationship should emit positivity towards all parties involved, if your in a relationship that is one-sided, it is inevitable that it will start to de-compensate. Never travel with the circus, never travel with fools, everything in life should have some positive payout, will things at times be negative, of course they will, but in order to keep something or someone in your life there should be more positivity than negativity.Hope this helps, C", "Yes, it is normal to cry during therapy, it is a time of catharsis, letting things out, shedding our skin, dropping our weights and just to let you know, even therapists sometimes feel like crying in sessions. Although people often cry or become upset, it is in no way a measure of \"good therapy\". C", "Counseling allows us to have a sacred space, a space that is set apart from the outside world, it is a space of non-judgement and exploration. Being that the universe is not made for us and that the the world tends to be a fairly untamed place at times, this sacred space allows us to explore ourselves. It allows for greater reflection upon our attitudes, our behaviors and our feelings. Imagine if you will a small goldfish swimming around the usual fish tank, although I dont attest to know what a goldfish thinks, I would imagine he does not see the world outside of him, he only sees the small fishbowl, oblivious to the outside world, when one comes into the counseling room, one is trying to gain insight that was not previously there. Remember the observer affect, one cannot truly act objectively with the world, we are in a dynamic relationship with life, it reacts to us and we to it, the time in the counseling room allows us to gain an understanding that is beyond the normal limits, allowing us to see what was before hidden, often times in plain sight.", "Usually people call me by phone, they introduce themselves, we chat for a bit, then we schedule a time for their appointment" ]

[ "Your comfort with a therapist is one of the most essential aspects of a quality therapeutic relationship.  Don’t be afraid to ask questions about the therapist’s approach and background.   Do you feel heard and understood?  Do you find the feedback helpful and directed toward achieving your goals.  Ensuring open communication with your therapist is primary to making sure you have the “right” therapist." ]

[ "Hello, I'm sorry that you experiencing a very low moment in life. Sometimes we all go through life circumstances that can be challenging, traumatizing and overwhelming. On reading this question, it sounds as though you have gone through some hardships that have  made you question what your sense of self in what  belief, value especially about yourself. It sounds as though you are emotionally overwhelmed and stuck and now you are overthinking. You may be depressed and you may need to talk to someone professional about your condition. Processing past hurts maybe somewhere to start especially identifying the pain, hurt, anger, loss among the other emotions you may be feeling. Again you may need to talk with someone so you do not feel defeated in your efforts.", "Reading this question makes me think of  melancholy and  phlegmatic temperaments. People with such a temperaments do not need to be in large crowds in order to feel included. They actually get so angry if they feel forced to be around people. They need small social settings to feel included and if they do not know this, they feel angry, scared and nervous because it is not their territory. They do not thrive well in big crowds and so they struggle. They also feel more comfortable in small social settings with people that are familiar to them. It's helpful if you can get a copy of your temperament results to help you identify your socializing needs so that you can meet them in a healthy way.The other tendencies melancholies have is that they are constantly thinking and have a fear of being rejected. These are stressful moments that needs to be managed. You can use cognitive behavioral therapy to ration your way of thinking.You may need to develop social and relationship skills so that you do not get overly stressed by relationships.The last thing is that allow yourself to choose the places and the time you can be around people so that you do not feel forced to be around people.", "You easily get angered because you haven't trained your mind to ration how your brain interprets the events you experience. As a result you act after an event happens because you do not ration and question to find out if your interpretations of events are rational and legitimate.Anger is an emotion that communicates to us that something is not right and we feel threatened and have to fight back in self defense. All it takes is one event to be trigged and the rest is history. Anger management can help you identify what triggers you so that you can train yourself to be able to interpret events in a rational way.Anger is not the problem, it is what we do when we get angry that is the problem.", "Absolutely crying is very normal in therapy for many reasons. Some people after a good cry feel better , in other words crying can be a stress reliever.  To other people who have never spoken about their pain, talking about it can trigger raw emotions and can lead to crying. To other people  who have never been heard, therapy can create an environment of being heard, which can be validating and healing.If your heart has experienced so much loss, it maybe grieving and the  tears are an expression of deep emotional pain.Sometimes your heart can experience so much joy and gratitude that crying maybe the way you express it.So if you find yourself crying in therapy, do not shame yourself. You are not being weak but expressing your emotions in a healthy way." ]

[ "children and adolescents who have a desire to achieve high grade point averages often have the symptoms you are describing. It sounds like, your gut is telling you to help her find ways to de-stress. Listen to your gut-always; as her mom, you know her needs better than anyone else. She would probably benefit from seeing a therapist to help her deal with the stress of being a high achiever. I provided the following suggestion to another parent with a similar concern: First identify the three most stressful aspects of the day. Do this by creating a circle on a regular size paper. (do this three times); ask your daughter how much of that circle can she confidently say she has under control. shade that in. The remaining parts of the circle are then named by intensity. (for example, in the circle labeled school anxiety, the client identified that she felt she could handle school anxiety 1 out of 4 days. The circle was split into 1/4. 1/4 of the circle was shaded . the remaining parts were labeled with the challenges that caused the client school anxiety.(these were 1. walking to class during passing time. 2. not having the assignments completed or at all. 3. feeling fat. after labeling each part; and making note of the percentage of the stress associated with each concern, free form thinking takes place and a pile of unwanted behaviors and genetic responses are portrayed  around the circle in bright colors. Using note cards, create a tree of concern; the concerns can be written on note cards. a concern = the behavior that leads to more trouble.  For example, \"all i could do was think about that extra slice of pizza, I was unable to concentrate on the teacher's explanation of the assignment\" (the concern you would write on the note card is Inability to concentrate. Now, fill up the back of the notecard with all of the different factors causing this pattern. nack. (" ]

[ "First, let me say that you are a survivor and a warrior. Managing 1 child by yourself is difficult, but twins is a whole different ballgame. Anxiety can affect us at any time anywhere. This is the challenge, especially when we have so many things to manage each day. There are several methods and practices that help manage and even reduce symptoms of anxiety. It will depend on what works best for you. Talk with friends, a counselor, or a loved one who can offer you support and feedback as you navigate this process of learning what works for you. When all else fails; make sure you are in a safe place, pause for a deep, cleansing breath in, a long exhale out, and ask yourself, \"What do I want in this moment?\" Now you can begin again.", "Anxiety and Depression are challenging experiences to live with and to manage on a daily basis. I would say that both are challenges to overcome but solutions to living healthy and well exist. Step 1: Talk about it. With friends, family, partners, counselors, and other trusted people in your life. Step 2: Create a plan with a counselor to learn new skills that help you recognize and manage your symptoms. Step 3: Don't give up. Working on yourself can be difficult and hard at the beginning. Stick with it and you will be able to find exercises, tools, and resources that help you live well.", "Thinking about what others think of us is a natural tendency. Human beings are social creatures and rely on feedback from the outside world of people, places, and things to let us know more about ourselves. We also have an inner voice, dialogue, conscience, etc. that helps us to determine the path for us. Often, when someone is worried about the external feedback, and focuses on this as the sole source of information, it can create a dependency that can become problematic. Balance is key to so many things in life. Your own voice is powerful and has strength to provide you the enjoyment you seek. Don't discount it and rely only on the voices of others.", "Watching children go through challenges in their lives is difficult. On a very basic level, There exists a primal need to protect them from harm. The hard part for parents is letting them feel those challenges and working through them as they get older. At some point, there is a moment that occurs when the role as a parent shifts. Children no longer need the basics (food, shelter. water, safety) as much as when they were toddlers, but rather, their needs shift to wanting more support, encouragement, advice, and room to make mistakes. This is where the ability to communicate with them, letting them direct the sails to gather the wind needed to move, is so important. Keep the lines of communication open and be available to give feedback when they ask for it.", "Getting your first job is an exciting, terrifying, and challenging experience. It is something you will remember for a long time and it shapes how you begin to think about yourself as a worker. You are literally \"learning as you go\" in this completely new environment. You are going to make mistakes. You are not going to get it right the first time. It can be even more challenging if you are having a difficult time building relationships that are supportive at work. A couple of things to remember here: 1) You are there to do a job and you are getting paid to do it, 2) There is a reason or reasons for you wanting to be there and do that work, 3) you know best what you need in order to be successful. These three items can be helpful to remember, especially when we feel our emotions are taking over in a place where we do not feel safe to express them fully. If you feel like your supervisor is approachable, meaning someone you could talk to because they express confidence in you, let them know you are nervous about doing a good job. Also let them know how you learn new tasks, information, or expectations so they can deliver the message in a way that you understand. Becoming a successful worker doesn't happen overnight, but each day you can identify what works for you and what doesn't by communicating with your work team, the easier it will be for you. We all had a first job once, and were all worried about doing well. Hang in there, and call a counselor if you need more help." ]

[ "I'm sorry to hear that you are feeling as if you're in a slump. First of all, nothing is wrong with you. Many people report similar symptoms. Have you ever talked with a physician regarding your symptoms? Two extreme emotions such as feeling extremely happy and then feeling extremely low for a length of time may indicate a mood disorder. I think it would be best to talk with your doctor or a therapist to help pinpoint the issue causing them.It's possible that it could just be certain stressors in your life that are causing the two extremities but you definitely want to rule out any mental health issues. If it is in fact mental health related there are many medications or therapy choices that can help. Thanks for reaching out! I hope that you will feel back on track soon!", "It sounds as if you may be experiencing a bout of anxiety and/or depression. Sleeping difficulties, irritability and anxiety attacks all are correlated with these mood disorders. And it’s actually quite common for someone to deal encounter this during their lifetime. Also, keep in mind that just because you are experiencing this now does not mean that you will be dealing with it the rest of your life. Many times, it can be a single episode and if treatment is received, you can help prevent any recurrent episodes.However, you may want to first talk with your primary physician to rule out any medical issues that could be causing these problems. There may be a reason for the sudden onset of these symptoms that can be addressed quickly. On the other hand, if it is determined that you are experiencing anxiety and/or depression without a medical reason, there are two methods that are very helpful in your treatment:#1 Talk therapy with a certified therapistHe/She will be able to address the concerns you’re experiencing and discovering if there is an underlying issue that may be causing it.#2 MedicationThere are many medications that can assist you with the feelings that you are experiencing. Your doctor will be able to help you find the right one that works for you. If one doesn’t work, keep trying. There are many different options to address your specific needs.Also, a combination of these two options is extremely beneficial!Thank you for your question. I sincerely hope that you feel better soon!", "I'm sorry to hear that you are unable to get through to your parents. It sounds like you are experiencing a great deal of anxiety that needs to be addressed by a professional (despite the fact that you are unable to at the moment). I would recommend talking with another adult such as a school counselor that can offer you support in this area. Perhaps they can work with you on your anxiety issues and schedule a meeting with your parents so that he/she may help mediate the conversation with them.If you are unable to reach out to a school counselor maybe you can try a member of the family such as an aunt or an uncle that feels comfortable addressing the issue with your parents. Sometimes it helps hearing it from a third party before the situations is taken seriously enough.Good luck!", "I’m sorry to hear that you are currently experiencing panic attacks. I hope that the medication you have been prescribed has provided you with some relief. Unfortunately, I don’t feel that moving in with your girlfriend would alleviate your anxiety. Although you may feel very anxious about leaving her, your body is reacting to this stressful event in your life in an unhealthy manner. You may be able to render this particular situation but it’s likely that you may experience another panic attack when an additional stressful event arises. Therefore, it is essential that you address the reason for why you are experiencing panic attacks in the first place followed by practicing coping mechanisms in the case that one would arise in the future.Talk therapy has shown to be effective with those affected by anxiety along with breathing exercises and yoga. A trained therapist will be able to assist you in finding the right stress reducing method so that you can reduce the chance of another attack occurring.I wish you the best of luck! It sounds like you are very happy in your relationship and I hope you are able to reduce your anxiety so that you are able to enjoy one another.", "I can see why you are alarmed. That is a scary situation for a parent. Do you know if the child has been evaluated by a mental health professional? Early treatment is often the key. A professional will be able to help the child learn how to control their anger and mend the troublesome actions into more appropriate responses. Have you addressed your concerns with the child's other parent? There could be contributing factors in his life that could be causing these issues (exposure to violence, sexual/physical abuse, drug use, stressful events in his life, etc.). It is important that these factors are identified so that they can either be eliminated and/or reduced. I wouldn't hesitate to have him evaluated (if he hasn't been already) and to ensure that he is getting the help that he needs whether it be medication and/or therapy. Until then, I would make sure that he is always supervised under an adult's care.", "I think the best thing you can do is be respectful of each family member's wishes. Although everyone may not agree with one another, the most important thing you can do for each other is to respect their faith and beliefs instead of trying to sway them in a certain direction. There are many families that are united despite their differences. For example, a mother may be Catholic and the father Jewish. By introducing the children to each faith until they are ready to decide for themselves can be beneficial. Also, it's not uncommon for views to change as one ages or faces different life experiences. So don't get too discouraged if your child wants to explore different avenues. Creating a loving and accepting environment is most essential.", "I'm very sorry to hear this. Hypnosis can be a valuable tool that a trained therapist can use to bring back suppressed memories. However, keep in mind that hypnosis doesn't work for everyone. I think regardless, speaking with a therapist about your sexual issues would be beneficial. It seems like you have experienced some painful experiences in the past and may need help dealing with them in order to move forward. In addition, if past memories do resurface a trained therapist will be able to help you cope with them as they arise. I wish you the best of luck and I hope you receive the treatment that you deserve.", "It sounds like you are in a tough situation. You have to ask yourself why you don't want to leave her. Is it because of the child? Or is it because you want the relationship to work? You must consider that being in an abusive relationship is not healthy for you or your child. So if the abuse continues, it would be more beneficial for you and your child to move out.On the other hand, if you are just wanting the relationship to work out despite its current state, you need to evaluate whether the relationship is worth salvaging. It seems as though you are very unhappy and undervalued in this relationship. Although your question revealed just a short bit of information, I didn't read about any positives in the relationship. Sometimes it's extremely hard to leave a relationship even though you know that the relationship itself is harmful for you. However, with time and focus you can do it. Each day will get a little easier and you have to trust yourself that you are making the right situation for you and your child.However, if you really feel that you want to stay in the relationship, you have to be upfront with her. You need to tell her exactly how you feel and give her specific examples of how she is hurting you. This gives her a chance to render the situation. If after this there is no improvement, I suggest that you start reconsidering your decision to stay.I also think it would be valuable for you to start engaging in things outside of the home that make you happy. Are there any hobbies you enjoy? Are there any groups in the area that you can join such as playgroups that will allow you to engage with other parents? Start looking into these options and finding an avenue for you to do something for your own benefit.It is certainly not healthy for you to isolate yourself from friends and family. You need to have additional support networks besides the one with your girlfriend, especially since this has not been a healthy environment lately.Thank you for reaching out. I wish you the best of luck with your relationship.", "There are plenty of red flags that you have been presented with:Several breakups Not holding up his end of the bargain regarding workLack of empathy for your miscarriageLying about his involvement with another womanPhysical violence, which is of most concern. This seems to be a very unhealthy relationship. In my experience, relationships such as these rarely become positive ones. Violence is never okay and regardless of his reasoning (you looking through his phone), it is indefensible. You have to look at these red flags and ask yourself, “Is this really someone I want to marry? Is he an asset to my life?” I think you’ll realize he is not.Best of luck to you and please know that you deserve someone who treats you with kindness, dignity and respect.", "First of all, exercise is always beneficial for your physical and emotional health. That's great that you have added this in your routine. Have you also considered altering your diet? Certain foods are linked with poor sleep. For example, alcohol, caffeine, nicotine and high fat content foods do not bode well with quality sleep, especially right before bed time.  On the other hand, warm milk and foods high in carbohydrates have actually shown to positively impact sleep.Additionally, at bed time it's important to keep your room dim, cool and without distractions (i.e. TV, IPad, Phone). Stick to a sleep routine and avoid any activities close to bed time that demand a lot of attention and energy.As far as your nightmares, there could be many causes contributing to them. Certain foods (many of the ones mentioned) or medications could be the culprit. Doing a bit of research into the ones you are consuming may help you eliminate the offender. You may also benefit from talk therapy with a qualified therapist to discuss any underlying issues you are experiencing. Oftentimes, depression and anxiety can manifest themselves during sleep, causing nightmares. Finally, Yoga has shown to be very beneficial for quality sleep. There are many instructional videos available that can introduce you to the practice if you'd rather not join a class right away. Best of luck to you and I sincerely hope you are able to catch up on some well deserved Z's!", "I’m sorry to hear about your current situation. My heart goes out to you during this time.First of all, it is of vital importance that you discuss your symptoms with your doctor. Regardless of whether you are able to mend your relationship with your husband, you need to address the physical issues you are experiencing. More than likely he/she will be able to help you relieve some of these symptoms.Secondly, you must be upfront and honest with your husband. Intimacy is a large part of a relationship and it is unfair to your husband that you did not disclose how you were feeling. I think he would appreciate knowing that it was your medical problems causing the lack of sexual desire as opposed to the reason being him.If you explain to him that you are addressing your sexual issues with your doctor in order to enhance your relationship, he may be more willing to see that you are serious in wanting to mend the relationship. The conversation will be hard to explain to your doctor and your husband since it is of such a personal nature but it will be extremely beneficial. And please note that the reason for the feelings you were experiencing (or lack thereof), was not your fault.Best of luck to you and your husband!", "I am so sorry to hear of your boyfriend's passing. Grief is something that can take a long time to recover from. Have you considered speaking with a grief counselor? Being able to speak with someone that specializes in grief would be very beneficial. Do not get down on yourself for not recovering quickly. This is one of the hardest aspects to deal with in life but eventually you will be able to move forward. In the mean time, immerse yourself with positivity (i.e. Good friends, hobbies, exercise) and try to schedule a time with a counselor. Perhaps there will be a support group you could also join. Oftentimes, it is comforting to meet others who share the same experience as you.Good luck to you. I hope you will find peace and comfort soon.", "Try to think of his close relationship with his mother in a good way. It means that they have a positive family structure which can transfer down to your own family if you have one together in the future. Despite your boyfriend having a good relationship with his mother, it will never be equal to the relationship that you have with him. A love for a mother is a very different love than one with a girlfriend or wife. There are certain things that he may look towards his mother for and certain things that he may look toward you for. So, instead of comparing your relationship with him to the one he has with his mother, try viewing them as two separate entities. She can not replace you, and you cannot replace her. However, all together, you can have a positive, healthy family dynamic.", "I think it would be wise for you to call a hotline especially designed for children. It's called the Childhelp National Child Abuse Hotline. The number is 1-800-4-A-CHILD (1-800-422-4453). It is completely anonymous and a trained therapist will be able to provide you with guidance, confidentiality, and can also help you make a report of you want.The call is completely free and they are open 24 hours a day / 7 days a week. I'm glad that you are taking steps to improve your situation. You are a very brave and an intelligent child. Please remember to call 911 if you are in immediate danger.", "First of all, my heart goes out to you. Infidelity is an extremely challenging obstacle to overcome. There are some things that you should consider. First of all, did he seem truly remorseful? If you felt in his heart that he was truly sorry for what he had done, it will give you a piece of mind that it was a  mistake. Secondly, was he forthcoming with this information? How about with answering your questions after the truth was uncovered? If you found that he was still lying or not forthcoming, the sting is even more painful. He should be able to answer any question you have honestly and without hesitation.Thirdly, has he shown a positive difference after this experience? At this time, he should still be proving his faithfulness to the marriage, you and the children.Keep in mind that experiencing infidelity is a form of grief. It is not a quick process that can easily be overcome. What you are experiencing is 100% normal. My best suggestion would be to see a marriage therapist. Find out what drove your husband to cheat in the first place and decide if this aspect in his life has been resolved. I know its important for you to keep your family together but children can sense anger and frustration, this is not a healthy environment either. If you decide that you can no longer remain in the relationship, a therapist will also be able to help you cope with the separation along with addressing your children's needs.Please know that you are not alone and that unfortunately, many relationships have endured this very thing. It may also be helpful to reach out to people who have experienced similar obstacles. The web is a great resource to find groups whether online or in person to use as a support or sounding board.Best of luck to you and your family!", "How has your husband acted since then? Was he regretful? How did you find out? Did he confess? These are all things that you want to consider. Betrayal is very hard to get over so if it's taking you awhile to get over, know that this is normal.Hopefully you're husband has been very regretful and upfront and honest with you since this happened. It may take awhile to reestablish your trust with him and he should understand this. It's also very important to discuss WHY he cheated. You want to make sure that the reasoning behind this was not something that could arise again in the future. And if it can, there needs to be an action plan in place (i.e. being honest with how he's feeling) so that you both get a chance to rectify the situation.If the cheating has happened more than once, you may want to reevaluate your reasoning for staying in the marriage. It would be obvious that he did not truly regret what he had done or else he wouldn't repeat the same mistake. However, if it was a single event and he has shown you and continuously shows you that he genuinely loves you and is sorry for his mistake, I would give it a try. People do make mistakes and sometimes it takes an event like this to realize what you have.Know that it takes time and that you have the right to feel what you feel. If the relationship was a good, healthy relationship, it is worth saving. Ease back into it and be upfront with your feelings. In return, your husband should be patient and understanding of this. Also, marriage counselors are often a good go-to as they have a great deal of experience working with marriages in similar situations. Best of luck to you!", "It's hard to let go of the dreams you had regarding your wedding and engagement. This was something that you and most women think about for years, so it's understandable to be disappointed. But please be aware that it is rare that any wedding is perfect. You may envy your friends' weddings but more than likely they had a few mishaps of their own and/or it wasn't as perfect as they had planned it either. However, like you know, the marriage is the most important thing. How many women are envious that you are in a happy, stable relationship? I assure you that there are plenty. Try to live in the present considering that dwelling on the past can still not change how you were proposed to or how your wedding day transpired. Focus on what you can control NOW. Perhaps, you can plan an extravagant renewal of your vows or change the look of your ring?I would also be upfront with your husband and explain why you've been short lately. But after that, close that chapter and move on. It sounds like you have a wonderful companion and you certainly don't want to lose this due to a situation that is impossible to change.", "I'm sorry you are feeling uncared for. I'm sure there are plenty of people that care and love for you that you are not taking into consideration. Sometimes when we get upset we may think irrationally and see the world as all or nothing. However, take a deep breath, relax and start focusing on the positive relationships you have with others, regardless of how small or insignificant they may seem. I think you will quickly realize there are people out there that care a great deal about you.I also think it would help for you to surround yourself among people who you can identify with and share common interests with. Maybe you can attend a religious service, join an interest group (i.e. reading club, sports group, etc.) or start a group of your own. Most importantly, you need to tap into your interests and surround yourself with things that are beneficial for your own mental and physical health. From this, relationships will start to immerse. You may also like to talk with a therapist regarding your feelings of being unloved. This is an unhealthy way to think of yourself and I think with a little help, you can see that you are more than deserving of a great relationship. Thanks for reaching out and I wish you the best of luck moving forward.", "It is incredibly hard to let go of a relationship that was meaningful in your life. Even though you consider the relationship to be a hurtful one, I’m sure there are some aspects about it that are hard to let go of (i.e. time invested, mutual friends, positive memories, etc). So it is very understandable why it’s hard for you. However, the most important piece here is that you know that this relationship is harmful. That is great that you have recognized this. Unfortunately, some men and women do not realize the damaging and hurtful situation that that they are really in.Keep in mind that the longer you stay in this relationship, the longer it will be until you find the RIGHT person. You are doing this to better yourself and your future. Look at it this way, being in a destructive relationship is comparable to an illness or disease. You are simply, taking the correct measures to rid you of this sickness and to get well.It may also help to write down a list of negative aspects of the relationship and keep it close if times arise when you begin to question yourself or start to miss this person. Constant reminders of why you ended the relationship will be helpful to keep you on right track and in the right mind setting.It will be difficult, but it’s doable. Give your chance to start on your deserved happiness now.Best of luck!", "Thanks for your question. I'm glad you realize that you need extra support and are being proactive. Simply explain to your doctor the feelings you have been experiencing and how you feel that speaking with a mental health therapist would be beneficial. However, keep in mind that you do not have to go into detail about your personal feelings. You can simply state that you are feeling down, overwhelmed, stressed, or whatever it may be. I'm sure your doctor will be glad to direct you from there. Best of luck you you! I hope that you will be feeling better soon!", "It sounds like your confused as to why your friends would be calling you a hypocrite when they act in the same manner, correct? Communication is key to any relationship. I would recommend speaking with your friends face-to-face to address why they feel your behavior is concerning. In-person contact is the best method of sorting out differences considering texts, emails or any written response can be misconstrued. Be upfront with them and let them know that being accused of hypocrisy is hurtful and you feel it is unfounded. If after speaking with them you feel that they have valid reasons for the way they are feeling, maybe you can consider modifying your behavior accordingly. Especially if this friendship is valuable to you. However, make sure they are aware that there is a respectful way to address these issues and name calling is not one of them. On the other hand, if you feel that their reasons are indeed unfounded, it may be best to distance yourself from the relationship. Not all friendships are healthy ones. And it is important that you surround yourself with people who are an asset to your self esteem as opposed to those that hinder it.I hope you are able to get this matter sorted. Best of luck!", "Do you have any other form of identification? The first place to stop would be the Visitor’s Center or whichever department issues passes. They are located outside of the gate so you do not need a military ID to enter. If you have another form of identification it’s possible that they can give you a pass in order to go and obtain a new military ID. If you do not, you could always ask someone else to sponsor you on (a friend, coworker, etc.) that have military access. Depending on the threat level, they may not need your ID as long as you are with someone that has access. Keep in mind that currently (6/11/15) all military bases are on Bravo which unfortunately means you will need your own ID.Finally, if all else fails, call your doctor and explain your situation. I’m sure they would be more than willing to discuss your options.Also, it’s important to make sure that you report your wallet being stolen if you haven’t already. Security Forces on base can help you with this and to ensure your ID doesn’t get into the wrong hands. Good luck!" ]

[ "This is a great question! I personally don't believe that any client could ever have too many issues for counseling. In fact, that type of thinking may be stopping you from seeking counseling, so it may be hindering you from getting the help you need. In fact, all of what you described points to the importance of you seeking help in order to cope with the many challenges in your life. If you seek counseling, it will be important for you to understand that you may need to remain in counseling for a sustained period of time in order to work through each of these issues. All of these issues won't be able to be solved right away or in a brief period of time. Counseling will take commitment and hard work, but it is possible for you to recover and heal from all of the issues you described.Many clients come into counseling with numerous issues rather than just one particular thing. Most of the time, the issues relate to and exacerbate each other. We call these \"comorbid\" conditions, which means that two or more mental health problems exist at one time. A lot of the times, when you start to work on one issue, the other issues get better as a result.I encourage you to find a professional therapist that can help you learn how to cope with all of the mental health difficulties that you described. You deserve the help just as much as anyone else.", "Self love and self acceptance is something that many of my clients struggle with, so I can assure you that you are not alone. We are bombarded by media and advertisements everyday that try to sell us things to make us somehow better, thus leading us to believe that we are not enough. Unfortunately, I believe that low self esteem is a social epidemic.On a more personal level, do you have any sense of what types of messages you have received in your life that have led to these self defeating thoughts? For example, did a parent or another loved one criticize you or put you down often? Were you bulled in school? Has a romantic partner emotionally abused you? Usually, there are factors such as these which insidiously lead to low self esteem and self loathing. Once you can identify some of the factors that lead to your self hatred, you can make a decision to not let these things from your past have such power over you any more. You learn to take control of how you feel about yourself, rather than letting others dictate that for you. I do think it is possible to heal from self hatred. It doesn't happen over night, and it takes time and effort. It is about re-training your brain to focus on your strengths rather than on your weaknesses. None of us are ever going to be perfect, and if we look for a flaw we are bound to find one (or two, or three...). Try keeping a self esteem journal. Every night, write down three things that you were proud of that day about yourself. Try reciting positive affirmations every day (such as \"I am lovable and beautiful just the way that I am today\"), to re-program your mind into thinking highly of yourself, rather than poorly.", "The clinical term for alcoholism is “Alcohol Use Disorder,” which is defined by the American Psychological Association’s Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (known as the “DSM-5”). There are 11 symptoms that are described in this diagnostic tool to help health care providers determine whether their patients suffer from an alcohol use disorder. 11 Signs of an Alcohol Use DisorderYou drink more alcohol or you drink over a longer period of time than you intend to.You have persistently wanted to and/or tried to cut down the amount of alcohol that you drink or stop drinking completely, but you have been unsuccessful.You spend a great deal of time seeking out alcohol, using alcohol, and recovering from the effects of alcohol.You find yourself having strong cravings, desires, or urges to use alcohol.Your use of alcohol leads to your inability to fulfill your obligations at work, home, or school.You continue to use alcohol even after your drinking has caused problems in your social life or interpersonal relationships.Your use of alcohol leads to a reduction in or disengagement with important social, occupational, or recreational activities.You find yourself recurrently using alcohol in situations that are physically hazardous to you.You continue to use alcohol despite your awareness that your drinking has caused or exacerbates a physical or psychological problem.You have developed tolerance to alcohol, which is defined as needing larger amounts of alcohol to obtain the desired intoxication level or feeling a reduced effect when you drink the same amount of alcohol.You develop withdrawal symptoms when you don’t drink alcohol, or you use alcohol (or a closely related substance) in order to prevent withdrawal symptoms. Withdrawal symptoms include: sweating, fast pulse rate, hand tremor, insomnia, nausea or vomiting, hallucinations or illusions (visual, tactile, or auditory), psychomotor agitation, anxiety, generalized tonic-clonic seizures.A person who has 2 to 3 of the above symptoms is considered to have a “mild” alcohol use disorder.A person who has 4 to 5 of the above symptoms is considered to have a “moderate” alcohol use disorder.A person who has 6 or more of the above symptoms is considered to have a “severe” alcohol use disorder." ]

[ "There is no such thing as too much. Start where you're at today and move forward or backwards to figure out the rest. You don't need to be anything less or more than you are right now. It may be a longer journey, but it's one that can ideally lead to healing. I hope that happens for you.", "Perspective is everything. I know it is \"silly\" to you, but I can't help but wonder if it is much more for her. Sometimes when we \"overreact\" it is a manifestation of something much larger: a feeling that has been neglected or a worry that hasn't been addressed. It is healthy to learn how to effectively cope with stress. How do we handle life when it feels overwhelming? Developing coping tools to process emotions instead of dismissing them until they \"bubble up\" again.", "I think it would be helpful to process these emotions with a professional. You may find it helpful to discuss what it is you feel, where these emotions and thoughts may come from, and start looking into what ay be helpful in improving the way you think of and speak to yourself. One way many professionals do this is through the process of developing self-compassion.", "If you've found the \"right\" therapist for you, you probably feel comfortable being vulnerable with them. Ideally, you feel connected to them in a way that leads to you feeling understood. In order to get what you need out of your treatment, it's important to be open and honest with your therapist about what you are seeking. Are you looking for coping tools? What are your goals and how are you planning on reaching them? Those questions need to be talked about in therapy to make sure everyone is on the same page.", "It's normal to experience many intense emotions in therapy. Sometimes those emotions lead to tears- so, long story short... yes! It's also quite common for emotions like frustration and even anger to be felt during the therapeutic process. Change and processing is hard. Allow the emotions to come through naturally and discuss them if it seems like it would be helpful." ]

[ "Often times when an individual begins the counseling process it is revealed that there is more than one thing going on. When we think about how much is wrong, it can be overwhelming and we may not know where to even start. Counseling can provide guidance to help you to begin working toward healing in a way that is most helpful for you to reach your goals." ]

[ "What a great question. There is no one size fits all to the answer unfortunately because it is based solely on what draws a connection between the two of you. Deciding on a therapist is not an easy process just as deciding on a physical health practitioner. I would suggest first inquiring about areas of specialty and alining this with what you desire to obtain from therapy. Secondly, I would suggest requesting a consultation to engage in dialogue to aid you with getting a feel of your comfort level with speaking to him or her. Lastly, I would suggest asking their level of experience with whatever your presenting concern is. I hope that I have offered you some sense of direction. Good luck to you. Be safe, and don't forget to exercise some form of self-care routinely.", "Emotion is the most \"normal\" and human activity that any person has the freedom to exercise.  Therapy is a place to explore freely, the deepest most ignored, and often denied concerns. Often time this process will evoke responses that were unexpected, but perhaps needed. What better place to begin exploring this than with a trained, unbiased person? Crying speaks to the development of connection and is symbolic of acceptance, and freedom of what was being held on to, which may not have been beneficial." ]

[ "I can offer you hypnosis for confidence in presentations, via Skype, if you're in Cali.", "Write down your nightmares and discuss them with an analyst or psychotherapist who specializes in dreams, as I do. If you are hearing voices while awake, see a doctor right away.  If the voices are strictly in your dreams, do call for therapy and talk to your caring others about what's happening." ]

[ "First of all, I am sorry that you have been missing out on your childhood. It may help you to know that many of us feel that we have missed out on our childhoods, as well, and that despite such deprivations, for many of us, our adult lives have been extraordinarily fulfilling due to our opening up to trusted adults. I recommend that you find a trustworthy adult to talk to. This may be a teacher, a coach, a school counselor, a minister, a family member, or a friend's family member. If none of these are available, try out a professional counselor, social worker, psychiatric nurse practitioner, psychologist, or a psychiatrist. It is best to get a referral for such a professional from a peer who has had a positive and safe experience with a particular provider.", "Your challenge is called \"co-dependency.\" People seek approval from others in an obsessive way when they are failing to truly accept themselves. I encourage you to truly love yourself and know that you have every right to every sensation, emotion, thought, and inspiration that you may have. Best of luck on your journey.", "You are in an abusive relationship-not because of your boyfriend's silences but because he is comfortable being sarcastic and hurtful, never admits he is wrong and never apologizes. It is your choice to participate in an abusive relationship. You can not stop an abusive partner from being abusive no matter how wonderfully you treat your partner. You can either accept the terrible relationship as it is or reach out for the support that you need to leave the abusive relationship. I wish you well, always." ]

[ "I would recommend other providers who accept your insurance.  Once you choose, I would ask you to complete a release of information so I could discuss your child's case and send records so that the new therapist is aware of the general treatment issues." ]