Dear GoodTherapy.org,

Some people masturbate to thoughts of faceless figures. Some people masturbate to porn. Some people have fantasies about characters from fan fiction.

Me? I tend to masturbate to thoughts of people I actually know, ranging from friends to coworkers to professors to the guy next door to my boss’ husband and everyone in between. Is that healthy? I mean, in most cases I would never actually have sex with these people (it would usually be taboo or inappropriate), so I wonder if it’s healthy to even imagine it or if I should be trying to redirect my fantasies elsewhere.

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I personally would be flattered to know that a friend or coworker or whoever was masturbating with me in mind, but I feel a little guilty about it sometimes, like I’m using someone’s image for my sexual gratification without their knowledge or consent. When I’m around these people I don’t act any different; I don’t get weird or creepy or anything. So is there any harm in what I’m doing? Is this normal and healthy? Am I some sort of deviant? —Thinking of You

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Dear Thinking,

Thanks for your question. First, a quick remark regarding your question of whether this is “normal.” I gently discourage people from using this word in therapy, though I understand why they do. Perhaps because I tend to work within an existential-humanistic viewpoint, I have discovered there is no normal. I mean this within the context of understanding a specific person’s psychological and emotional life. So many behaviors or emotions are confusing from a distance, but then make sense as you understand them empathically.

Often the word “normal” often gets conflated with “rational,” or within the bounds of acceptable socio-cultural definition. Thus, it is defined by social norms, which change over time.

But consider that it is not necessarily “rational” to watch a pretend series of moving images on a screen, with actors dressed in costume and special effects generated by computer, in such a way that emotionally involves us with the characters and story we’re seeing (even when that story is called Star Wars or Wonder Woman). It is not rational to be engrossed or frightened by an obviously “fake” science-fiction novel or TV series. All of this is, however, quite human in our need for narratives and fantasies that serve a variety of emotional and psychological purposes. Certainly, sexual fantasies can go beyond the bounds of “rational”—and wouldn’t life be boring if they didn’t?

It seems to me fantasies, even dreams themselves, are often closer to the emotional or psychological truth of our existence than logic or rationality. Rationality is necessary, but too much of it becomes constricting; it’s the non-rational, creative, or unbounded energy that brings color and, frankly, gets the party started (so to speak). It’s hard to imagine a line of people lining up to see a movie about lives which remain rational or “normal” throughout.

Were you in the therapy room with me, I would be curious to hear more about these fantasies of yours, as a window into what might be happening on an unconscious or soulful level.

On the face of it, your fantasies and masturbation, even wondering about the social ethics therein, don’t strike me as unusual or alarming. Having said that, you don’t mention the frequency or intensity of said behaviors. It’s hard to tell whether they happen enough to warrant being considered compulsive. When a compulsion is present, a person often feels they ought to “get a handle” on things, and may feel guilty the behavior (or set of feelings driving the behavior) is hard to manage.

Hard to say, in other words, whether this behavior is relatively harmless (to yourself or others), a way of blowing off some sexual steam, or if it is somehow getting in the way of real-life relationships.

We all sometimes wonder about our own private habits, of course, and may secretly want validation we are not “beyond the bounds” of normalcy (whatever that is), or wonder, “Is this a problem or isn’t it?” Your question does intimate danger or risk in such self-pleasuring, since these fantasy scenarios are possibly “taboo or inappropriate.” This makes me especially curious.

What is the taboo you might be breaking? You don’t mention the specific content of your fantasies, which I am guessing are compelling or captivating in some way. In many cases, the intensity of sexual scenarios relates to some emotional intensity—pain, desire, fear—in our psyche that has not been fully explored or understood, or relationally shared, but which can create turbulence, even shame, until better understood. (That’s not a bad description of the purpose of psychotherapy, incidentally.)

You may know the content of sexual fantasies and desires so often symbolizes or “disguises” a person’s deepest wishes, hopes, and fears. Sexual fantasies are dream-like, and can be interpreted as such, much as Sigmund Freud hinted (though he stubbornly insisted on only one valid interpretation). These fantasy and dream images become a kind of “map” of yearnings or deeper desires not easily expressed consciously, for all manner of reasons.

Sometimes such needs become “eroticized” or take sexual form. The person who feels they are never noticed or truly seen may have exhibitionist-type fantasies in which they are finally “noticed” by others; the “nudity” in this scenario may correspond to a desire to feel unbounded, spontaneous—as young children are often unabashed about their own nudity.

I would suggest paying attention to the emotional hopes or wishes suggested by your imagined scenarios. The only true “taboo” I can imagine is stifling further exploration toward listening to or observing more closely the needs, wants, or hopes your psyche may be trying to communicate.

Within such scenarios, we may see or be “seen” in the most unencumbered and exciting ways. Urges or impulses that are usually kept in “storage” are free to roam. Pushing and playing with boundaries is part of the excitement, in whatever form that takes. This holds true, of course, for both masturbatory and shared sexual activity.

As another example, S&M scenarios are commonly enjoyed by those who (for instance) struggle with feeling overly compliant during their “real” life, but are then empowered to dominate in the bedroom. Meanwhile, those who enjoy being tied up or submissive might struggle with a sense of over-responsibility in “real” life.

Is it possible your fantasies are a way of asserting yourself and your needs in a way that feels elusive in your actual relationships? Are there needs or emotions that are hard to share or communicate in your interactions with others?

Clearly there is an aftermath here of guilt or self-doubt. Again, in what way is this activity “taboo” or possibly “deviant” (a strong word)? Is it that you are somehow “exploiting” these folks without their awareness? In what way might it be wrong to do so? Have you ever felt exploited in any parallel way? Are you concerned such fantasizing might somehow lead to taking action (if there is anything “edgy” or dangerous about your fantasies)? Is there something shameful about the desires symbolized by the fantasies themselves?

I can’t escape the feeling that, at the bottom of all of this, there is something emotional and very human hoping to be more deeply understood.

There is a rather significant detail left out of your note: you don’t mention if you are single. If you are, does it mean your partner would be hurt or offended?

I’m imagining for a moment you are single. Is the “taboo” an offense against yourself, in not seeking an actual sex partner and depriving yourself of an intimacy that may be overwhelming or anxiety-provoking? Or in “permitting” some (possibly sexualized) desires or needs to take shape and find expression, even if privately?

Or, if you are partnered, is there a sense of guilt or “forbidden-ness” around attraction toward others? People are often surprised to learn one can be married or monogamous and still be attracted to others. How far to take such an attraction does subjectively and culturally vary, of course. (There are cultures or traditions, for instance, which allow bigamy, and there has been quite a bit of discussion lately in social and mainstream media about open relationships.)

In short, your question is a provocative one and is worthy of further exploration in therapy. I would suggest paying attention to the emotional hopes or wishes suggested by your imagined scenarios. The only true “taboo” I can imagine is stifling further exploration toward listening to or observing more closely the needs, wants, or hopes your psyche may be trying to communicate.

Kind regards,

Darren Haber, MFT, PsyD

Dear GoodTherapy.org,

Everyone I know goes bonkers when they see a kid under the age of, say, 6. “Oh, what a sweet-faced little angel!” they’ll say. All I see, meanwhile, is a snot-nosed germ factory and life/financial drain whose parents, in the prime of their lives, surrendered their freedom to raise.

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I never say this out loud, of course. But sometimes my dislike of kids inevitably comes out, as when the unwanted questions about my own situation come along: “Any kids?” “Don’t you want to have children?” “When are you having kids?” Nope. I sure don’t. Never! People stare at me like I have three heads when I say I don’t like or want kids.

I’m getting to the age where most of my friends are having kids, and this makes me feel increasingly isolated. I can’t help that I don’t like kids (at least, I don’t think I can?), but I also sometimes find myself wondering if there’s something wrong with me for not liking/wanting children. Your thoughts on this would be welcomed. —No Kidding

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Dear No Kidding,

I really appreciate this question. So many people struggle with this issue. Having children, like any other life decision, is not for everyone. Some people are certain they want to have children, others are certain they don’t want to have children, and still others are unsure. It sounds like you fall squarely in the category of being certain you do not want to have children. There is nothing wrong with you for making this decision.

Society seems to be at something of turning point on this issue. People of previous generations often got married and had children without giving it much thought, but rather because it was just “what you did.” These days, for many people, major life events—including marriage and having children—are not taken for granted, but rather thoughtful decisions based on the kind of lives they’d like to live. Still, there remain plenty of people who see these events as customary, desirable, traditional, or inevitable and therefore have no qualms about asking you when you are going to do them.

It sounds like you fall squarely in the category of being certain you do not want to have children. There is nothing wrong with you for making this decision.

I would imagine if you can do some work to get to a place where you accept this as a valid choice designed to give you the kind of life you are seeking, you may stop questioning what is “wrong” with you. You may feel more comfortable providing people with explanations when they inquire or, even better, you won’t feel a need to justify your choices. If you struggle to get to this place on your own, you might consider partnering with a therapist to help you explore this issue, come to terms with it, and decide how (or if) you want to talk about it with people.

Before closing, I’d like to end on a practical note. You mention feeling isolated as more and more of your friends begin to have children. People generally become friends with one another because of some commonalities or an experience that draws them together. This was probably the case for you and your friends when you met. As your friends move into parenthood, there can still be a place for you in their lives (and vice versa), but it may also be important for you to find some friends who are interested in the freedom a child-free life can provide.

Kind regards,

Sarah Noel, MS, LMHC

Dear GoodTherapy.org,

My biological parents gave me up for adoption when I was born. I’m sure they had their reasons, and I am probably better for it since I grew up in a very loving family and turned out as well as could be expected. I’ve never wanted for anything. I have a great life, a great career, and a great family of my own now. I’m 45 years old. I don’t feel traumatized. I’m actually relieved my birth parents made the decision they did. I’ve never asked my adoptive parents about them.

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As I have gotten older, though, I have had more and more thoughts about my biological parents. I find myself wondering about the circumstances that led them to give me up, whether they’re still alive, and if so, what they’re like today. I wonder if they think of me, too. And I wonder what it would be like to meet them. I had never felt compelled to go down this road until recently, so I’m not sure what’s bringing these feelings to the surface.

I guess I just don’t know if it’s wise, from the standpoint of my mental health, to pursue this. Like I said, my life is great without them in it. Also, while I wonder if my life could be enhanced by knowing more about the people who gave me life and connecting with them after all these years, I am mindful of the possibility I will only learn upsetting things. Who knows? Maybe they wouldn’t even want anything to do with me.

What do you think? —Left Wondering

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Dear Wondering,

It is only natural you would wonder about who your birth parents are, what they’re like, and why they decided to put you up for adoption. Who wouldn’t be curious? You write that your life, career, and family are satisfying, and perhaps you’d like them to know that. Maybe you also wonder what your life would have been like if you hadn’t been adopted. These days, there are numerous ways to look for people that may help you find your birth family—if you decide you want to.

Many years ago, adoption information was not recorded or, if it was, the records were closed, but since 1980 most adoptive records are open. If you decide to look for more information, you can use social media, genealogy websites, and open records that should give you access to your birth certificate and other information. I personally know one person who found her birth mother on Facebook.

You wonder what it might be like to meet your family of origin. Different people have different experiences, of course. You might find out you have siblings, for example. You might feel you have little in common with your birth family or, on the contrary, there is a lot you share. There is only one way to know the answer, but would the answer be worth the time and emotional energy you expend?

You are worried about how this would affect your mental health. That is a good question, and I suggest this is such a big question that you might want to work with a therapist or professional adoption adviser who could accompany you on your journey. You would be hunting down the past and bringing it into the present. Working out whether you really want to do that, and then how to proceed if you do, may be no simple task. Finding your birth parents and meeting them would likely necessitate a big adjustment on everyone’s part.

You may fear rejection. Many people do. You birth family may have the same fears about you, and you might also reject your birth family once you meet them; there’s no way to know. Your adoptive family could fear losing you. This delicate decision to find your birth parents requires a combination of wisdom and courage.

I don’t know if you ever watched the TV show This Is Us. It has many threads, but one of the important plot lines concerns looking for and finding a birth parent. You might want to watch the show and see what it brings up for you. Chances are, you have plenty of your own fodder.

I wonder if you know other people who have been adopted. If so, you might like to discuss your feelings with them and get to know how they understand their adoption. Talking to your partner is important, too.

It sounds like you never discussed this with your adoptive family. It may feel like a delicate issue to bring up, but they could be enormously helpful in your search and may even feel it is important for all of you.

You may fear rejection. Many people do. You birth family may have the same fears about you, and you might also reject your birth family once you meet them; there’s no way to know. Your adoptive family could fear losing you. This delicate decision to find your birth parents requires a combination of wisdom and courage.

Either decision—to know or not to know—is wise and brave. Only you can decide what is the right path for you. Whatever you choose, I admire your curiosity and your process. You are not taking this lightly, nor should you.

Good luck, and I hope you check back in and let me know what happens.

Take care,

Lynn Somerstein, PhD, E-RYT

Dear GoodTherapy.org,

I’m a 27-year-old dental student with no serious medical issues other than sports injuries. Over the past few years, I have developed these thoughts about getting/being sick. I am constantly paying attention to my body. Any little thing I notice, I freak out. I am frequently going to the doctor for one thing after another and can’t seem to control my brain immediately thinking the worst. And every time I go, I am perfectly healthy.

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I also think that because I am believing in these fake ailments, it’s causing my brain to create symptoms! It’s frustrating because I don’t know how to stop feeling like this even though I know it’s mostly in my head. At this point, my girlfriend and family are getting sick of me asking things like “This isn’t cancer, right?” or “I’m going to be okay, right? It’s not going to kill me or anything?”

My main question is why am I always thinking of the worst-case scenario with my health? Why can’t I just have a sore throat and think “I must have a cold” instead of “I must have a rare infection that’s going to eventually kill me”? Any help would be awesome because as of now I feel myself worrying about being sick more than actually enjoying my life. Thank you. —Worried Sick

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Dear Worried Sick,

You’ve asked a great question, and you are not alone in asking it: Why do you seem to always think of the worst-case scenario when it comes to your health, and what can you do differently so you are not immediately thinking the worst? The answer to this question is very much tied to understanding what may be behind this in the first place.

How you describe your concerns is consistent with what is conceptualized in the DSM-5 (the most recent version of the Diagnostic and Statistical Manual) as illness anxiety, as well as what prior to this would have been considered hypochondriasis (debilitating worry about having a serious illness). Regardless, please know there are things you can do to keep the worry from getting the better of you.

It’s worth stating this about anxiety more generally: some people are more prone to either anxiety or hypervigilance (heightened awareness about small sensations or possible threats, in this case health-related symptoms) than others. This can happen for any number of reasons, and it’s okay if you tend to be that way. What you are doing, essentially, is making sense of your experiences and protecting yourself from perceived threats of danger. While this can be adaptive—as doing so can tune you in to something that is wrong—it may become a problem when your interpretations are in overdrive. Furthermore, when you worry excessively, there is a negative filter operating on your thoughts which further intensifies and reinforces the worry.

You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.

The bottom line is thoughts are powerful. When we experience a symptom such as pain, fatigue, or bloating, many people try to better understand and make sense of the experience, and depending on our thoughts, this may work for us or it may signal our thoughts are in overdrive. Additionally, constantly paying attention to bodily symptoms—and perhaps even creating symptoms, as you indicated—is a pattern worth changing. When we think the worst, this sends us down a dark path leading to debilitating anxiety. Furthermore, the way we think significantly affects the way we feel. So it makes sense that if we are thinking the worst about our health, we will feel bad. We are focusing on even the slightest discomfort or sensation and then feeling distressed over the worry around what it could mean. Clearly, you have realized that health-related anxiety or worry can become extremely uncomfortable.

By modifying the thoughts you have around bodily sensations, you can change your level of comfort. You will, in fact, be able to do just as you want—to be able to enjoy your life. Imagine how powerful a small shift in a thought can be. Instead of “This means I have a rare infection that will kill me,” try something else. Perhaps, “It is possible this is something that warrants medical attention, but it is also possible this will go away on its own.” You can learn how to modify your thoughts through psychotherapy. By seeking help for this, you can learn and practice skills to help you reduce hypervigilance and significantly reduce the tendency to immediately think the worst.

Here are some other tips that are important to consider:

• Beware of conducting your own health-related research. Many individuals who experience illness anxiety find they spend a lot of time online researching suspected conditions or symptoms. I suspect you know this already, being a dental student, but sometimes reading about things that “could” happen serves as an unnecessary trigger for anxiety. Be mindful of the amount of time you spend conducting such research, as well as how you feel while reading information (especially compared to times when you are not reading about symptoms). I suspect such information may spike anxiety in you. If so, consider whether this is useful for you to do.
• Consider new ways of coping and reframing. You mentioned you gather that the people close to you are already getting annoyed by you regularly seeking reassurance. This is one mechanism you have developed as a pattern to manage anxiety. Another is to frequently make medical appointments for these symptoms, which is essentially doing the same thing. You want reassurance that everything is okay. Because neither of these practices is sustainable in the long run, you’ll have to learn additional coping and reframing skills so you can adequately assess when it may be appropriate to seek reassurance.
• Implement relaxation as a regular practice. What usually helps you reduce anxiety? Finding a healthy outlet for stress and anxiety can be a useful tool to have at your disposal, regardless of the stressors you face.

Glad you’ve reached out!

Best wishes,

Marni Amsellem, PhD

Dear GoodTherapy.org,

My mom and dad divorced when I was 14. I’m in my forties now. Neither of my parents is in the best of health, and I don’t know how much time left I have with them. They don’t talk to each other. I’m on good terms with both of them, though closer to my dad.

I was visiting my mom a couple of years ago when she told me a bombshell of a family secret: my dad had been sexually abused by a pastor as a child. This went on for years, apparently. It seems my mom is the only person in our family he has told about this—assuming she is to be believed. I add this qualifier because she has a history of creating drama. I have not known her to outright lie, however.

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I am inclined to believe her, as I know my dad was raised in a devout, church-going family and he has never been one to be very open with his feelings, emotions, or past experiences. If he was indeed abused as a child, I think it’s likely he’d hide it from his children, out of what I would imagine is a deep sense of shame.

It’s my empathy and compassion for that shame that has kept me from saying anything to him these past couple of years. One the one hand, I really want him to be able to talk about his past with me. Part of me thinks that by talking about it, he might be able to make peace with it (assuming he hasn’t already) and perhaps have fewer regrets as the end of his life approaches. On the other hand, I don’t want to push him into talking about something he doesn’t feel comfortable talking about. The one thing I am sure of is that he’ll take this to his grave if I don’t bring it up. If I do bring it up, I would not be surprised if he denied it.

What are your thoughts? Should I try to get him to talk to me about this? —Hurting for Him

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Dear Hurting,

What a fascinating question—and touching, since your empathy for your father is so obvious. I’m moved by how you want to help him find peace with what sounds like a pretty awful betrayal and abuse of trust. As the film Spotlight illustrated, it’s terribly painful when “God’s ambassadors” are the ones perpetuating such psychological and/or physical injury, which can leave scars for a lifetime.

I suppose my main question is: whose peace are you actually seeking? It sounds as if you are nagged by the question or impulse to help him. My question is, and I mean this in a deep sense: how come? This is not to sound skeptical; I just find it’s helpful to understand one’s own impulse to help. There are times when, in my own experience, the relief cuts two ways—one for the other person and two for ourselves, since we are troubled by such a disturbing disclosure.

Wanting to help our parents as they grow older is one way many of us want to “give back” for what we are just now beginning to appreciate. It sounds as though you have an intuitive sense of how this might be bothering your father. I also wonder if your mother told you because she either was tired of carrying such a secret herself all these years or was hoping you might find a way to approach him. Did she say this to you in confidence, or is she okay with you bringing it to him?

It’s impossible for me (and you, it sounds like) to know how your father has or hasn’t made peace with this. I have learned not to underestimate the ability of the human mind to compartmentalize. We have to, in order to adapt and move forward. Where adaptation becomes repression or dissociation can be ambiguous, since every person, every relationship, and every situation is different.

I would still advise you to pause a moment to gently reflect on your motives and feelings. What are you hoping might come of an honest conversation with your dad? If he has never really dealt with it, it’s unlikely one conversation will clear it up. It might—or it might stir up all kinds of complex feelings around what happened. He may feel anger at the perpetrator and those who failed to protect him as a boy. It’s also possible he doesn’t know how he feels, or harbors deeper feelings that may arise in a conversation and take time to process (which doesn’t mean “don’t do it,” just that he might say no before he says yes, or say no and want to reflect on it himself).

He may also have feelings about your mother disclosing this to you. Again, I don’t know anyone involved or the dynamics of the family, but sometimes there is an unspoken need among family members for a secret to come out in the open, and sometimes there is conflict around it. He may chuckle and say, “Oh, your mom …” or he may become angry about having his secret spilled.

It’s impossible for me (and you, it sounds like) to know how your father has or hasn’t made peace with this. I have learned not to underestimate the ability of the human mind to compartmentalize. We have to, in order to adapt and move forward. Where adaptation becomes repression or dissociation can be ambiguous, since every person, every relationship, and every situation is different.

Is it possible your mother wants your dad to discuss it while he is reluctant or outright disinterested? Are you then concerned about your mother’s distress? Is your mother enlisting you as a kind of stand-in for her own pursuit? The “drama” you allude to regarding your mom might be a way for her to attract attention while avoiding her own feelings or vulnerability.

If any of this is true, keep in mind the risk of wading into a longstanding struggle; sometimes adult children are the “power brokers” or go-betweens in such situations. This has its benefits and risks, naturally. I recommend considering the downside of stepping in, along with the potential benefits. It’s also true any decision you make will have potential ups and downs, and there is often no easy choice. I sense you care deeply about both of your folks—and at the end of the day, provided you move with empathy for all involved (as best you can), this is what matters most.

Should you decide you’d like to try discussing this with him, I would broach the topic gently and see if he wants to discuss it before specifics are introduced. You can come from a place of your own concern, even curiosity, about his experience, and ask if talking would help him—rather than coming at him with a pre-decided or firm intent to help (which can be received as critical, if a person hasn’t asked for it).

I often encourage people to ask, “How can I help?” before deciding for the other person what’s needed or how it ought to play out. (Not that you’re doing this.) I often ask people in therapy (or even loved ones) if they want suggestions before offering my own advice. It surprises me how, so much of the time, people just want to be heard, validated, understood … so they don’t feel so alone in their struggle.

Of course, you may hit a wall with him. He may resist and then come around, or he might surprise you by being open right at the start.

If you decide to broach the topic, the key is to be honest with him about your love and concern for him. It’s a bit of a tightrope, wanting to be transparently honest without falling into “you need to do this, dad” when the motivation may be your own anxiety. One thing to consider is whether some of the shame and darkness you imagine he’s feeling is, possibly, what you are feeling. It’s painful and difficult to think of a person you love being harmed in such a way.

In short, the “lead” as they say in journalism is your love and concern for him, your empathy, in compassionately considering him and his (conscious or unconscious) struggle, and your wanting to lighten the load. One of the most loving things you can do is to ask if or how you can help with all this—if you decide to talk to him. (If this is a real hot button between your folks, it’s also okay to recuse yourself.) Let him decide whether he wants to open this door wider or at all, or would rather leave sleeping traumas be.

I hope, whatever happens, he will be proud of a son who cares enough about his dad to take a risk.

Finally, please know there is no “perfect decision” in such cases. Often, in the messiness and muddle of human affairs, we simply do the best we can. Sounds to me like you’re a good son trying to do just that.

Thanks so much for writing!

Darren Haber, MA, MFT

Dear GoodTherapy.org,

First, let me say I don’t think I’m a great parent, but I do try to be one. I know the way I parent is different than how a lot of people are with their kids. I just don’t know if that’s good or bad.

My kids are grown up. My son is 24 and lives with his girlfriend in an apartment a few miles away. My daughter is 25, lives halfway across the country, and recently graduated from college with a degree in anthropology. Neither is employed. I am retired and financially comfortable, so I am able to help them. And by help, I mean fully support them.

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I know a lot of parents would cut the cord completely and let their kids fend for themselves. I just don’t feel good about that. My kids had a rough childhood with their dad, who was an alcoholic (he killed himself in 2006). He was really hard on them. They didn’t deserve that.

When my kids ask for money or other assistance, I can’t bring myself to say no. They heard “no” too much as kids. On the flip side, I acknowledge this might mean they are becoming dependent on me. My friend tells me they are taking advantage of me and are less motivated to find work because I help them. She’s probably right, but I still can’t bring myself to say no to them. I love them very much, and I am able to help them, so what’s the harm?

I guess I am asking whether you think I’m wrong. It’s one thing to hear it from a friend; it’s another to hear it from a therapist. —Yes Ma’am

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Dear Yes Ma’am,

There is no “right” way to parent your children, even when they are grown. You, and only you, get to decide how you want to show up for them.

That said, I’m hearing a good bit of guilt behind some of your actions, and that may not be the healthiest framework for decision-making. Your kids may not have had the childhood you would have chosen for them, but that does not mean you owe them more because of it. No parent is ever able to meet all of their children’s needs—we do the best we can given our circumstances and abilities. I imagine you did the best you could with what you had available. For the record, hearing “no” as a child can sometimes be the best thing for us.

Often, when I work with new parents, I ask them what they want most for their kids. Almost every time, they answer, “I just want my kids to be happy.” I subsequently disappoint them when I suggest happiness is not the primary goal of parenting. Equipping our children to cope with the world, to manage their lives, and to develop resiliency are better goals. It is less outcome focused and more skills focused, and helps our children develop the tools they need to be able to experience happiness—competence, purpose, and confidence they can weather any storm. That means letting them struggle while being a soft place for them to land when they fall.

Often, when I work with new parents, I ask them what they want most for their kids. Almost every time, they answer, “I just want my kids to be happy.” I subsequently disappoint them when I suggest happiness is not the primary goal of parenting.

This does not mean you should yank your support in order to force your children to be resilient. It doesn’t have to be an all-or-nothing proposition. You may want to decide for yourself what you are willing to offer, and then have conversations with each of them as to what form that support might take. You might set a timeline and a budget that works for you—enough to help them until they get established, but not so much they can abdicate responsibility for their own lives. I’ve seen parents who decided they were willing to pay for car insurance, or half the rent, or a set amount each month. If you ask your kids what form of support would be most helpful, you can engage with them as the adults they are becoming while holding to limits that feel reasonable to you.

You may also want to talk with a therapist about any lingering feelings of guilt. There may be some emotional healing you and your kids need, but financial support has never been an adequate substitute for emotional support. It can even create barriers when the relationship becomes one of obligation and entitlement.

By setting a limit with your children, you would be letting them know you want to support and help them while also communicating you have confidence in their abilities to create their own lives.

Best of luck,

Erika Myers, MS, MEd, LPC, NCC

Dear GoodTherapy.org,

I’ll just say it: I hate my parents with every fiber of my being. I’m pretty sure they hate me, too. My dad beat me almost every day when I was little, and never had anything nice to say when I was growing up. He was always on drugs, burned me with his cigarettes, told me I was garbage. Which is exactly what I felt like. My mom stood by and let it happen. He hit her too. I watched it happen. She took it out on me. She wouldn’t even let me eat some nights. I wish I had reported them, but I never did. I was too afraid of what would happen to me.

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I am 27 now, and until last week I had not talked to either of my parents in years. Then, out of the blue, my mom calls me. I hung up right away. She’s called me twice since, leaving messages saying she hopes I’m happy. She said she thinks I should forgive them and doesn’t understand why I won’t talk to her. I’m like, “Really?”

I don’t know why she’s suddenly interested in my life, but I don’t care. I’m not one of those people who thinks just because you accidentally got pregnant and had a kid, your kid owes you something. I had terrible parents. I had the worst childhood you can imagine. I don’t want to be my parents’ son anymore. I don’t want anything to do with them. I don’t see that ever changing, either.

I know hate is an ugly word. Article after article says it’s “unhealthy” to hate and that it’s “healthy” to forgive. But I hate my parents. I can’t forgive them. And what’s worse is I hate that I hate my parents, which makes me hate myself. I don’t know what to do with that except what I’ve always done: nothing. —No Love Lost

Dear NLL,

I’m sorry to hear about what sounds like an awful childhood. In some ways, the blaming and emotional abuse you experienced may be even more impactful than the physical abuse; scars that remain invisible often take the longest to acknowledge and heal.

You mention reading about how it’s “healthy” forgive one’s parents, let go of the past, etc. Whenever I’ve talked with people about some of their overwhelmingly toxic parents (yours appear to fit in that category, I’m afraid), I’ve had cause to doubt this maxim profoundly. In some cases, we may be unable to forgive until there has been some parental or caregiver recognition of the abuse and suffering inflicted upon us. Furthermore, an ongoing lack of recognition of abuse or neglect indicates the toxicity persists. Setting a boundary, as you have, is reasonable and may in fact be the safest way forward.

Whatever your mother’s reasons for wanting to connect with you, she cannot reasonably expect to set the terms of any relationship with you. The terms are yours to define, and she needs to respect them, even if it means no contact.

Emotional experience is subtle and complex. It’s possible—through therapy and other avenues— to simultaneously heal wounds of the past and set boundaries with toxic others. It is vital to acknowledge your emotional authenticity and experience, however painful or awkward. Otherwise, your psychological agency is in danger of becoming fractured, dissociated, or radically undermined.

This brings to mind a person I worked with many years ago whose mother actively intervened (starting in elementary school) to ruin her son’s friendships with others because she felt no one was “good” or “pure” enough. The way she “protected” him was to gossip behind his back to teachers and his friends’ parents about what a untrustworthy and generally nasty kid he was, going so far as to whisper in the ear of the local pastor to keep an eye on her “wayward” son. This awful behavior had the desired effect: the friends he wanted were told by their parents to stay away from him, and he grew up with insecurity issues that led to drug addiction.

When he grew older and entered therapy, the son fiercely resented his mother’s behavior (while struggling with guilt over “hating” her) and refused to comply with her demands that he write and call her regularly. He came to recognize her chief aim was to isolate him—a classic abuse technique—so he might become a surrogate “friend” and stop trying to have his own life. Her alcohol-addicted husband worked long hours, and when home he remained locked in his den watching television, sipping booze. Unable to address her husband, she directed her rage at her son and essentially held him hostage with her manipulations and subterfuge.

A couple of years ago, I had the good fortune of studying with a longtime psychoanalyst and mentor. I asked about forgiveness of one’s parents as a “must.” You see, I had inadvertently caused some controversy in one of my doctoral seminars after reading an article by a psychoanalyst who felt that forgiving one’s parents was a sign of maturity; I disagreed, as I felt there could be no global rule about forgiveness as it pertains to one’s parents, and clashed with my fellow students and instructors.

My mentor waved off this “doctrine” in no uncertain terms. “Why do you have to forgive your parents?” he wondered aloud. “I’ve never been a fan of that idea. Especially if they were horrible to their kids. Am I going to tell a woman who experienced incest with her dad, with a mom who denied such things ever happened, ‘get over it’ or ‘move on’? Of course not. And anyway, do we really want requirements of the people we help? What do we do if they can’t or won’t forgive? Refuse to see them? Give them moral instruction? That’s repeating the very abuse they’re trying so hard to escape.”

All of this is a way of saying this: Do what feels safe and right to you. Keep your boundary. The fact you took the time to write means there’s some part of you that treasures your own preservation and well-being; trust your instincts! Also, the fact you have set a boundary and had such a human, understandable, and honest reaction to your mother’s recent contact tells me you’re probably the healthiest person in your family. The healthiest person is often the first to seek therapy, as it turns out.

I have discovered over time that the kind of harsh and unspeakably cruel treatment you received may impact a person in a way that can be hard to assess without empathic observation and support.

Speaking of which, I would encourage you to seek a counselor, preferably one who can address the psychodynamics of such pernicious abuse. The damage can be very subtle. I discovered over time that the kind of harsh and unspeakably cruel treatment you received may impact a person in a way that can be hard to assess without empathic observation and support.

You might say the vulnerable part of us, which we have to hide or “put away” in an abusive context, inevitably emerges as we try to fulfill our hopes and goals for an authentic life, especially in regard to relationships with others (sexual/romantic, friendships, even educationally or professionally). Sustaining hope means remaining vulnerable. Some people end up sabotaging their own hopes, or withdrawing from life, due to the savagery of past suffering. Finding a competent healer might be the most loving thing you could do for yourself.

Hating your parents is one thing. Hating yourself for hating them is quite another. You clearly don’t deserve that burden. A competent therapist can help you recognize and have compassion for the forces at work in your self-directed misgivings.

One final note: Are there are any other family members you can talk to who “get” your experience and can validate it? A cousin, aunt or uncle, even close family friend? The son I spoke of earlier had an aunt who was far more balanced than his own mother, and he and his aunt developed a fairly close rapport. The aunt validated his experience as real, which was an important aspect of his coming to terms with his experience and moving forward.

I hope this has been helpful. I further hope you are able to find the peace so unfairly denied to you by your parents.

Kind regards,

Darren Haber, MA, MFT

Dear GoodTherapy.org,

I am hoping you can give me an honest answer here. I have been seeing a therapist for nearly three years now and I just don’t feel like it’s working for me. I don’t feel any different than when I started. In some ways, I feel even worse, because I am discouraged about therapy not helping. It makes me wonder what is wrong with me that I can’t get better. I have read that it is highly unusual for someone to be in therapy as long as I have.

I guess I should provide some background about my “issues.” As a kid, I was molested for years by an uncle, saw my parents die, and was bullied incessantly. I have been told I have major depression and have tried about half a dozen kinds of medication, none of which have made a shred of difference. I have self-esteem problems. I can’t seem to hold down a job. I haven’t been in a relationship for five years; women won’t even look at me, and I don’t blame them. I hate my life and I have no friends. Yes, I have considered suicide. No, I am not currently suicidal. I know that distinction is important to people who do what you do.

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Because therapy isn’t helping me and hasn’t helped in all the time I’ve been in it, I want to stop. I feel like I am throwing away money. I feel un-helpable. I must be one of the few cases out there for whom there is no relief, whose problems are just too many and too major. I might be a lost cause. But I do not want to be a fool. My therapist has encouraged me to continue with therapy and to not give up hope. She says she has seen signs of progress but cannot seem to articulate them in a way that allows me to see them too. Maybe that is my failing, but I am starting to feel like maybe I’m just a paycheck for her. I don’t think she is necessarily a bad therapist. She is a nice person and she tries. She seems to truly care. I just think she isn’t helping me, I think she knows she’s not helping me, and I no longer really think anyone can.

What are your thoughts? Is she just stringing me along? Are there other people like me who don’t seem to get any better, and if so, what do you recommend in those cases? Please answer these questions. Thank you. —Lost Cause

Dear Lost,

What a great question regarding a terribly painful situation. I’m glad to hear from you about this, while so sorry to hear about all you have endured. Let me first give you my impressions in a way that “cuts to the chase,” then flesh things out a bit.

First, it is not unusual for it to take a while to find the right medication or combination of medications. (For instance, some people respond better to an older generation of medications, while others respond to SSRIs.) Have you tried more than one psychiatrist? I would encourage you to keep trying, discouraging as it has been. I have worked with a few people in therapy who were as discouraged as you, but managed to find an effective medication plan that helped them enormously.

You have been through hell and back. The fact you are still standing says something about your resilience. You have suffered enough trauma for several lifetimes, so it’s understandable you would feel this way. Your life experience has, I sadly observe, given you no tangible reason to hold onto hope. It does not mean there is none to be found, however; in fact, your letter indicates you are searching for it, itself is a glimmer of something positive.

As to your therapy question: Any therapist worth their salt would welcome any and all the feedback you have put forth here. My impression is it is time to have a blunt and honest conversation with your therapist regarding your feelings; if you’re still dissatisfied afterward, it may well be time to seek out someone new.

I would guess you had no source of true comfort after seeing your parents die. How unspeakably sad! I can hardly imagine a more hellish experience, in that the people you may have relied on most for comfort are the ones you lost. This, in addition to the other psychological injuries you experienced, leads to my amazement at your resilience. My great hope is you find, sooner rather than later, the kind of therapeutic “holding” and healing you deserve.

In the meantime, you seem to know intuitively you’re not getting what you need. I would be curious to know what keeps you in therapy with your current therapist. Have you tried telling her directly what you say in your letter? If not, why not? Is it possible she has helped as much as she can and now it’s time for a new approach? It is not uncommon, after all, to seek a second opinion medically; I believe this applies to psychotherapy also.

Sometimes people in therapy are afraid that, because they are not the “authority,” they do not have the last word on their own experience. You sound almost convinced it’s time to move on or ask directly that your therapist change her approach; I encourage you to follow your intuition. Whether or not it’s worth one last conversation with your therapist is obviously your call. Such a conversation could prove healing or just add fuel to frustration. If you feel you would benefit somehow from clearing the air, it’s worth a try. If, however, you feel it’s a foregone conclusion, you might want to move on.

Is it possible you doubt your own perceptions (not unusual with depression) in that she sees progress while you don’t, leading you to wonder if she is “right”? If the latter is true, she needs to find a way to convey her observations in a way that is meaningful to you. If your therapist insists you “hang in there” for no reason that feels solid, that’s simply not good enough; the direct experience of the person in therapy is, in my view, always front and center in therapeutic inquiry and exploration.

I don’t expect the people I work with in therapy to understand everything that flows from my lips. I have to learn a person’s language—and, to paraphrase Carl Jung, each of us speaks differently. I cannot insist on calling anything “progress” if the person in therapy feels or perceives otherwise. In the absence of mutual resonance regarding progress and therapeutic aims, the person in therapy feels dangerously alone.

Given your dwindling (or absent) faith in the process, it makes sense you are feeling alone in this relationship. It almost seems this alone-ness may even echo or parallel earlier suffering with the traumatic isolation and self-doubt you describe. I can’t shake the feeling you sense painful distance or discrepancy between you and your therapist, that she is missing something essential. I am not blaming her—nor you, for that matter. Do you somehow feel pressured to “live up to” her seeing progress? Are you concerned that if she feels disappointed or anxious about “progress,” it could be a bad sign?

Therapists seek a tricky balance between instilling hope and validating a person’s pain—mostly because, in so many cases, the latter has never been permitted or acknowledged by caregivers. Strangely, the more a pain is accepted as valid in the context of a person’s experience—with a safe other who can stay with you during and through that pain—the more healing the process becomes.

Therapists seek a tricky balance between instilling hope and validating a person’s pain—mostly because, in so many cases, the latter has never been permitted or acknowledged by caregivers. Strangely, the more a pain is accepted as valid in the context of a person’s experience—with a safe other who can stay with you during and through that pain—the more healing the process becomes. It’s when we begin to fear that emotional pain is “too much” for us or the other, or that it’s a sign of weakness on our part—that we need to “get over it already,” etc.—that it lingers like an unwelcome guest.

I believe people are entitled to all of their feelings, including and especially about therapy, because no one knows your experience better than you. I can’t imagine anything more important in your therapy than what you have bravely expressed in your letter. I am grateful you are not suicidal, but it sounds bad enough that an adjustment needs to happen, either within the current therapy or with someone new. (If thoughts of hurting yourself do resurface, please call 911 go to your nearest emergency room immediately.)

You sound very certain your therapist “knows she’s not helping me,” though I would urge you to not jump to the conclusion that no one can. The latter can be a hallmark or emotional symptom of depression—the sense one is cosmically alone in the universe, unable to connect with anyone. This feeling is, sadly, more common than many people realize. But this feeling is not objective “truth.” Your situation is not hopeless, and the fact you wrote your letter suggests you may leave room for hope, too. It is vital your therapist help you believe this more expansively.

When it comes to feedback, vital in any therapy, I try my best to listen nondefensively to where a person is or is not happy with me or how things are going with the two of us. My aim is to do no harm and be as helpful as possible. I do not assume I am always on the right track, or that no feedback means everything is fine and dandy.

There needs to be, more often than not, some mutually understood “map” of where we are going, and why—in your case, that would plainly include relief from traumatic anguish. The work can be difficult, even painful, at times, but for the sake of a treatment plan (ethically required), the “plan” needs to be something the person in therapy understands, endorses, and trusts as desirable.

Once a person begins to feel overly “protective” of the therapist’s feelings, which the therapist might tacitly encourage, the process is in danger of shutting down or becoming overly burdensome to the person, adding to their trauma and emotional isolation. Maybe the person has never had a chance to be fully honest with another, which can feel scary or even risky. The very act of sharing this disappointment can be healing, which is why I do my best to encourage it.

I would be curious to know if you are getting help with managing painful or traumatic emotions or emotional states between sessions. Do you need concrete help dealing with feelings of despair or low self-worth? There are cognitive behavioral approaches, dialectical behavior therapy (DBT), mindfulness, and other techniques to help with such moments.

Please do not give up. I wish you the best of luck in your pursuit of much-deserved relief.

Warmly,

Darren Haber, MA, MFT

Dear GoodTherapy.org,

I have been married to my husband for 12 years and I love him with all my heart. I would never dream of leaving him, so I want to get that out of the way right off the bat. But there is no question the spark in our marriage has faded over the years, and it leaves me wanting in some ways.

When we first got together, things were pretty hot and heavy. After we got married, and especially after we had kids, things cooled off considerably. I recognize that this pattern is probably typical. We still treat each other like best friends and do sometimes have sex (great sex, by the way), but the courting has stopped. That’s why I’m writing. I miss being courted. I am sure we both take it for granted that we are a couple and I’m sure day-to-day life saps opportunities for romance, but I miss the feeling of being wanted, the thrill of the chase, the sense that being together is not a given but rather a choice.

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I have mentioned a couple of times that I miss date nights, flowers, simple gestures, things like that, and while it’s usually met with a hug, a smile, and an “Aw, I love you, babe,” it hasn’t resulted in any meaningful attempts on his part to court me again. I feel like he’s not taking me very seriously. And I suppose I wonder just how serious I am, since I am very happily married even though I feel like things could be even better.

So I’m not sure what to do, basically. Should I just be happy that I am happy? Do I need to take initiative by courting him? Am I being stupid or selfish for wanting to be courted? Is courting even something I should expect at this stage of marriage? —In His Court

Dear Court,

No, you are absolutely not being stupid or selfish! It’s totally normal to miss the romance, passion, and excitement that typically exist in the early days of a relationship. It is also totally normal for it to have faded. Relationships, like most things, evolve and change over time. After 12 years of marriage and children, there are probably some aspects of your relationship that have deepened and grown—perhaps a sense of trust, commitment, and security.

While acknowledging the positive changes in the marriage might offer valuable perspective, it certainly doesn’t mean you aren’t entitled to miss the thrill of being wanted and pursued. So the question becomes what can you do to try to get some of that fire back? You asked if you should take some initiative by courting him; I think that might be a great place to start. Show him what you want by giving it to him, in whatever way he is most likely to recognize its value and embrace it. Perhaps he will be excited by the spark to the marriage and follow suit.

You asked if you should take some initiative by courting him; I think that might be a great place to start.

You say you have mentioned a couple of times that you miss date nights, flowers, and simple gestures. This makes me wonder if you have mentioned this in passing … a couple of times. If this is the case, it seems quite possible your husband doesn’t have a real sense of how much this means to you. He might better understand how important this is to you if you sit down and have a full conversation about this, as opposed to a passing comment here and there.

If neither of the aforementioned approaches produces the change you are seeking, you might want to partner with a couples therapist. It might seem excessive to consider seeking therapy when you describe yourself as happy and loving your husband with all your heart. However, you also describe yourself as wanting. Couples therapy can be valuable during times when a marriage is in pretty good shape but there is a little hiccup or identifiable room for growth. At this stage, given the relatively happy state of your marriage, couples therapy can be quite effective in a short period of time.

Kind regards,

Sarah Noel, MS, LMHC

Dear GoodTherapy.org,

I have a close friend who comes to me with all his problems, and sometimes I don’t know how to help. Some small issues I can give advice on or help him out with. When he asks me about other, bigger things, such as work issues, relationship issues, or family issues, I often really don’t know what to do or say.

He seems to depend on my advice, and if I say “I’m sorry, I don’t know how I can help” or tell him I don’t have a lot of free time at the moment, he will often get irritated and say something like, “Whatever. It doesn’t matter anyway.” Then I find myself trying to reassure him and find a way to help him, even though this takes time and effort I sometimes don’t have.

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He also has a tendency to fixate on things. I’ll offer advice or a suggestion, and he seems to like it, but a few days later he will bring up the issue again, almost as if I said nothing at all. This is very frustrating. If my advice isn’t working out, why doesn’t he seek out someone else’s opinion? I’m only going to tell him the same thing again.

This happens frequently. We talk most days, and it seems as if a week can’t go by without him having some new problem he needs help with. I don’t mind doing what I can to help, of course, but (1) sometimes it seems like that’s all he wants to talk to me about and (2) I think he can solve most of his problems himself, if he would just give them a little more thought.

I don’t think this is worth losing our friendship over. We have come too far for that. I’ve tried to raise the issue, but he hasn’t seemed to hear what I’m saying. And if I encourage him, saying, “I’m really not sure because I don’t have a lot of experience in that. Try looking it up online!” or something similar, he might respond with “I’m too dumb to figure this out” or make other self-defeating remarks.

Do you have any suggestions as to how I can bring this up and be heard? —Frustrated Friend

Dear Frustrated Friend,

It sounds like you have tried to set some boundaries with your friend and he is unwilling to hear or respect them. That raises the question for me as to what you are getting out of this friendship. You say you’ve “come too far” to lose your friendship, but something in this relationship is not working for you. If your friend is not willing to hear you, or responds with what sounds like emotionally manipulative statements, it may be time to reevaluate just how important this relationship is to you and how staying in it is serving you.

Ultimately, if you choose to continue your friendship, it will be up to you to set and hold your boundaries; he is unlikely to change what he is asking of you. You mentioned that when you try to let him know you don’t have answers or it isn’t a good time, you wind up trying to reassure and help him anyhow. One way to stop having him asking for help you can’t or don’t want to give is to stop giving it. Hold firm to your boundary.

Setting and holding boundaries can be uncomfortable. It is clear you want to be a good friend. Being a good friend does not mean consistently ignoring your needs, however.

If the timing is an issue, let him know you aren’t available at the moment, and provide a time that would work for you. He can respond with frustration or anger, but you do not have to give in. You can gently hold your ground and respond with caring. Let him know you are sorry he is struggling and that you will be able to help at another time. If you feel you aren’t the one to help him, that the issues are beyond you, let him know that and then stick to it. If he makes self-deprecating remarks, you do not have to respond to them. When you have given him help and he returns with the same issues again and again, it’s okay to let him know you don’t have anything to add to what you’ve already discussed.

Setting and holding boundaries can be uncomfortable. It is clear you want to be a good friend. Being a good friend does not mean consistently ignoring your needs, however. Being a good friend means not letting resentment build or having frustrations get in the way of your friendship. Being a good friend also means setting limits and not expecting your friend to take full responsibility for holding them.

You will learn much about your friend and your friendship by how he responds to you when you do hold firm. It may open up a meaningful conversation about the kind of friendship you both want with each other and may even strengthen your friendship. If, however, he is unwilling to recognize your needs as legitimate or your boundaries as meaningful, if he responds to you in anger or with blame or manipulation, I would encourage you to reconsider if this relationship is serving you in a meaningful way.

As you consider all of this, you may want to get support from a counselor who can help you identify what is keeping you in this relationship; help you implement strategies to set your limits; or, if you should choose to step back from the friendship, help you grieve the loss of what has been an important relationship.

Best of luck,

Erika Myers, MS, MEd, LPC, NCC

Dear GoodTherapy.org,

We’ve been together about a year and a half, and from the beginning we established a mutual dedication to open communication and sharing as much with one another as possible. We weren’t together very long before that started to become challenged. Let me be clear: My girlfriend doesn’t lie to me, doesn’t cheat on me, and I don’t think she even intentionally keeps things from me. She just … doesn’t readily open the doors of communication and isn’t forthcoming with her thoughts or emotions. As someone who likes to talk about my feelings frequently and has heard her say things like “the more information, the better,” I find this incredibly frustrating.

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Just in the past month, we have had a significant discussion about how we agree it’s necessary to have difficult conversations, and the sooner the better when an issue or feeling comes up. And that discussion wasn’t even in reaction to any problem that had arisen—we were just positively reaffirming our dedication to such communication. But not two weeks later, she neglected to tell me about receiving a lengthy, heartfelt email from a mutual friend. It contained nothing that crossed boundaries for either of us, but was unusual and deserved attention. I heard about it from the mutual friend before I heard about it from her, however, and it took her a week for her to bring it up on her own. There was no special reason to keep it from me, she said, but she just thought maybe I already knew or she’d wait until she’d responded to let me know about it. She has also been quiet about hanging out with mutual friends when I wasn’t around, even though it’s not something I’m bothered by, and she knows that.

I’m just mystified as to why she continues to make an effort to assure me we have an understanding about mutual, honest, timely communication … and then leave me out of the loop when things happen in her life. It’s a strong disincentive to be open with her, too, and that saddens me. Is there anything we haven’t tried, or any new way I can bring this up to her that encourages her to trust me and talk to me more? —Deafening Silence

Dear Deafening,

I can just feel the intensity of your frustration—it comes through loud and clear in your letter. It sounds like you feel shut out by your girlfriend when all you want is to be deeply and profoundly connected. Beyond frustration, it seems like you feel quite hurt and maybe even alienated by your girlfriend’s lack of communication.

It sounds to me like there is a mismatch in each of your needs for communication. You seem to crave, and gain a sense of, intimacy from a high degree of communication, while your girlfriend is satisfied by a significantly lower degree of communication. Because you have stated there is no betrayal (i.e., infidelity, crossing boundaries, etc.), it doesn’t seem like the lack of communication on your girlfriend’s part is problematic in and of itself. It doesn’t seem to be rooted in trust issues. The issue seems to be the disparate needs you each have around communication.

Framing the issue as a disparate need for communication, as opposed to your girlfriend’s failure to communicate, doesn’t lay the blame at anyone’s feet. It’s just an acknowledgment you have different needs and doesn’t make anyone right or wrong.

Framing the issue as a disparate need for communication, as opposed to your girlfriend’s failure to communicate, doesn’t lay the blame at anyone’s feet. It’s just an acknowledgment you have different needs and doesn’t make anyone right or wrong. This can enable both of you to drop your defenses and try to really understand where the other person is coming from.

Much of how people communicate in intimate relationships is influenced by how they saw their parents communicate. Talking about each of your memories of your parents’ relationships might be a good place to start in trying to understand why each of you have the preferences you have around communication.

You also mentioned that your girlfriend’s lack of communication is a “strong disincentive” to be open with her. Why is that? There are hints of resentment in this statement, one of the biggest indicators there is work to be done to strengthen your relationship. However you proceed from here, I would encourage you not to let your girlfriend’s communication style dictate yours—especially since you both have expressed “the more, the better” when it comes to sharing.

You two might also find great value in working with a couples therapist on this issue. A therapist will likely be able to help you two understand each other on a much deeper level. This understanding could lead to a true sense of empathy for each other and quite possibly some movement toward the middle that could work for both of you.

Kindly,

Sarah

Dear GoodTherapy.org,

For years now, I’ve had a problem with grinding my teeth, and it only seems to be getting worse. I think it might be hereditary because my mom says she grinds her teeth, too. It used to only happen at night, but lately it’s almost constant, and I have to consciously stop myself from clenching my jaw even during normal daily tasks (like writing this letter, for example).

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I know things like biting cheeks and the skin on your lips can be linked to anxiety or other mental health issues. Is it the same with grinding teeth or jaw clenching? So far, amazingly, my dentist says my teeth haven’t been affected too much—but they always still try to sell me on expensive mouth guards. I’ve tried store-bought mouth guards and had a retainer for a while, but obviously they’re not really stopping the jaw tension even if they’re protecting my teeth. Sometimes I fall asleep biting my tongue and wake up with really pronounced indents from my molars. And I think sometimes the tension is related to how stressful my dreams are. But I don’t always remember my dreams, so I can’t say for sure.

Anyway, do you have any suggestions for things I can try? I wake up with a dull headache from this nearly every morning, and I’d really like to stop popping painkillers. I do think I have a more-stressful-than-average life, but honestly I prefer staying busy, and I don’t think my stress level is likely to change. Besides, I know people who lead lives with far more responsibilities and stress who don’t have this issue. Any ideas? —Ground Down

Dear Ground Down,

You’re not alone in this! Many people grind or clench their teeth, often in their sleep but also often in the daytime as well. Fortunately, there are many things you can try to help yourself overcome this issue and prevent more significant damage as a result of teeth grinding. I will provide some suggestions of things you can do, but first I’ll share a little more information about grinding teeth, how and why it happens and persists, and the role of anxiety in clenching or grinding teeth.

Clenching or grinding teeth without awareness, also known as bruxism, affects many (the incidence at any one time is around 10% of the population) and can range in severity from mild (no physical evidence of consequences) to severe. More notable effects of grinding or clenching include facial pain, tired jaw muscles or the development of jaw disorders, sensitive or damaged teeth, damage to tongue or inside of mouth walls, headaches, or earaches. It has been found to happen more frequently during periods of high stress, though it can become habitual and happen regardless of stress level. It also appears to have a hereditary link and happens more frequently in women than men.

Teeth Grinding and Anxiety

Does this mean you have anxiety? It’s hard to accurately assess that without information that can only be gleaned by talking to you in person. I recommend making an appointment with a therapist near you to discuss the issues you may be experiencing.

Certainly, grinding or clenching teeth can be one manifestation of holding tension and responding to stress, and many individuals who experience anxiety (and depression) do also grind their teeth. Grinding teeth does not necessarily mean you are experiencing anxiety (or depression), however. That said, one way to treat this is by using many of the same behavioral techniques you might use to help manage anxiety.

How Can Teeth Grinding Be Treated?

The first step in overcoming grinding or clenching teeth is to become aware of the issue. How did you discover you were doing this? Have you experienced headaches or tightness in your facial muscles? Has your dentist remarked about damaged teeth or suspect you might be grinding or clenching? Are you hearing from your partner that you are grinding teeth in your sleep? Ask yourself questions about the frequency and nature of this behavior. When are you grinding or clenching your teeth? Are you doing other activities at the same time (e.g., sleeping or working)? Do you notice you are feeling stressed when you are clenching your teeth? You may want to keep a journal for a period of time to track this behavior and when it occurs. This information can inform your strategies to help overcome these behaviors.

Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences. 

Essentially, a pattern has developed over time. For example, you have trained yourself to engage in teeth clenching if you automatically start clenching your jaw when doing things like typing on your keyboard or stepping out into the winter cold. Now is the time to break this habit, before you notice more significant consequences.

Be aware of your mouth position. Believe it or not, there is a correct way to position your jaw. With your lips closed, you want to keep a gap between your top and bottom jaw, which can he assisted by placing the tip of your tongue just behind your front teeth on top. This may take some practice and regularly checking in to modify your habit of how you typically position your mouth. If, as you are reading this, you notice you are clenching your jaw, start to make a change. Begin by opening your mouth as if you are about scream, which is a great stretch for these muscles, followed by adopting the correct mouth position. This correct position will likely reduce tension in the jaw.

Implementing Relaxation Is Key

How do you know whether you are holding tension in your body? It is not always obvious. One thing to do is to scan your body for tension. Deliberately think about every muscle group in your body. Are muscles in your back or shoulders holding tension? Muscles in your jaw? Take a deep breath in and exhale. Let go of the tension where you notice you are holding it. Various relaxation techniques, centered on mindful breathing, can be especially effective. You may want to end every day by scanning your body for tension. You may want to do some yoga stretches. Additionally, try placing a warm washcloth on the muscles of your jaw to relax them before bedtime.

There are some suggested “don’ts” as well. Because this is a habit, be mindful of nonfood items you may “chew” on. Chewing pencils, straws, toothpicks, etc. may increase your tendency to engage in that behavior when you are not aware of it. Be aware of your chewing all around. Also, some experts would recommend reducing caffeine, nicotine, or alcohol before bed.

Other strategies to consider are what your dentist has been suggesting to you. If relaxation strategies and retraining your behavioral patterns are not the approach you would like to try, many individuals do utilize bite plates and find that custom plates are useful. If you are reluctant to try this approach, first try the behavioral strategies suggested above.

Knowing potential damages or consequences can be enough to motivate many to try to make a change. It sounds like you are quite motivated to overcome this on your own. Good luck!

Kind regards,

Marni Amsellem, PhD