Starting the day with fibromyalgia pain made Vera angry

Fibromyalgia made it hard for 46 year old Vera to get her legs out of bed in the morning. As she moved toward the bathroom and began her toilette, the pangs of pain moved to her hands, head and neck. It brought tears to her eyes. It made her angry to think that Kurt hadn’t even thought of organizing things around the house to make life a little easier for her. Vera remembered the arguments about accompanying her on doctor appointments and got even angrier. But she never said anything to him. She turned her mind to the support group she would attend later that day, although it wasn’t successful in easing her physical discomfort.

Vera found it easier to focus on the fibromyalgia pain than her scary emotions

As she ate breakfast, flashbacks of her early family file flooded Vera’s vision. She relived the tension she used to feel coming home from school wondering if her parents would fight out loud or give each other the cold shoulder. Her mother would take out her frustration on Vera the oldest and quietest of her kids. Her muscles tightened up as she recalled the fear of uncertainty and not knowing how to speak about her worries. It was the same thing now. She didn’t know how to talk about the anxiety of not being able to take care of herself. Vera had no words for the anger at her father for not making her mother happy, and at Kurt for being equally insensitive and uncaring. What she did have was body pain that ranged from dull aches to excruciating pain for which no specific organic cause had been found. Fibromyalgia was the diagnosis. It came with fatigue, slowing down of actions and restricting her life. It was making Vera dependent on pain medication and on a husband who let her down, repeating the cycle of her childhood. (more…)

“For years it lay in an iron box buried so deep inside me that I was never sure just what it was. I knew it carried slippery, combustible things more secret than sex and more dangerous than any shadow or ghost. … I saw things I knew no little girl should see. Blood and shattered glass. Piles of skeletons and blackened barbed wire with bits of flesh stuck to it…The iron box contained a special room for my mother and father, warm and moist as a greenhouse. They lived there inside me, rare and separate from other beings. … I knew my parents had crossed over a chasm … The box became a vault, collecting in darkness, always collecting; pictures, words, my parent’s glances, becoming loaded with weight. It sank deeper as I grew older, so packed with undigested things that finally it became impossible to ignore.”
-Helen Epstein, Children of the Holocaust

(more…)

Temper tantrums can be very frustrating to deal with. All children have a temper tantrum at one point in time or another. They can happen in the home, school, in grocery stores, although they may not necessarily happen when the child is at another person’s house.

Temper tantrums are a child’s way of expressing anger and frustration at not getting what he or she desires, when there is difficulty expressing feelings, or when he or she know that the tantrum will result in getting what he or she wants.

Parents can be easily frustrated because the tantrums are not always easily dealt with, especially when the tantrum happens in the grocery store. That seems to be more like the child egging on the parents to actually follow through with what the parents say they will do.

Are tantrums a test from the child to the parent? It could be. When a parent is telling a child that he or she can’t do something if he or she has a tantrum, a child will definitely test that theory. When the tantrums happen, the child is looking at the parent to see if the parent is going to follow through with what is said. When the tantrum is “successful” and the parent gives in, then the child knows that tantrums result in getting his or her way.

When the tantrum is not successful the parents don’t give in, they follow through with what was said and the child learns that the tantrum is not the way to deal with things. That’s a hard thing, mostly for the parent. The child can whine, scream, yell and go on for what seems like hours. At the point that the child continues with the tantrum behavior and does not appear to give up, is when the parent tends to give in which only reinforces that the tantrum is the way to go.

Helpful hints:

1. Don’t give in. When the tantrum is not given the attention that is needed to work, the tantrum will fade. As a parent, you will still want to observe your child so they don’t get hurt, or hurt others from their tantrum, but still do not give in.
2. Stay calm. It is difficult to stay calm when a child is having a tantrum but you are the parent, the adult, and still know what’s best for your child. If you have your spouse around, and you are getting frustrated, then do a “tag out” but still both parents stay calm.
3. Speak calmly to your child: that helps to keep you in control of the situation. The child could get louder, but speaking calmly can help shorten the behavior. You can say that when the tantrum is done, then we can talk about the situation.
4. Let your child know what is expected of him or her when they go into the grocery store or other place or activity. You can also let them know that if there is a tantrum then they will not be able to do something later. This is where the follow through needs to happen, so when you say this, make sure the action can be followed through.
5. Validate feelings. When the tantrum is done, tell your child that you knew he was able to regain control.
6. When a child does not have a tantrum where her or she normally would, provide praise for that. That will help increase improved behavior and her own confidence that she does not need to have a tantrum and will be alright when she doesn’t have one.

When sex addiction surfaces in a relationship, the focus tends to revolve around addressing the symptoms and causes of the addiction and the steps toward healing for the person with the addiction. In the process, the well-being of that person’s partner or spouse may be overlooked. The partner is likely to feel betrayal upon discovering the addictive behaviors of his or her partner. Although there may be times when a spouse suspects or feels something is amiss, many times, spouses are caught totally off-guard, they may feel alone, and it can be hard to consider how to take the next step. It is important for partners and spouses of those with sex addiction to take care of themselves and try to avoid the downward spiral that can threaten them.

[fat_widget_right]

Seek Support and Self-Care

It is not uncommon for the betrayed partner to feel pity for his or her partner and focus attention on him or her. When people feel betrayed, it’s important that they take time to care for themselves first so as to build a plan to create structure, reduce anxiety, and get some much needed encouragement and support. A good counselor can be instrumental in providing that support because the counselor functions as an advocate, providing validation, compassion, and clear direction. Some may benefit from joining a support group of other spouses that are going through the same thing. Dependable friends and family can also provide support, especially on those very tough days. Incorporating a healthy lifestyle by getting plenty of rest, eating properly, finding some time for exercise, and scheduling times for fun will give the partner’s body, mind, and spirit the energy it needs to cope with daily stress.

Experience Emotions Fully

The person feeling betrayed may experience a sense of shame that results in the temptation to shut down, or to numb the pain by suppressing the painful feelings. The feelings are there and they are very strong, and it will cause more harm, eventually, than good by stuffing them or hiding them. That is why finding a counselor, having supportive friends, and being a part of a group are extremely important in providing a safe outlet for the partner’s full expression. Whether it’s anger, fear, abandonment, or any number of emotions, sharing those feelings in a safe and healthy way helps work through the grieving process and generate some hope. The hope may not be focused necessarily on the relationship, but on the person’s recognition that he or she can face these feelings of betrayal and survive, even thrive. The feelings are very real, and when handled appropriately, openly, and with care, some of the intense weight may be lifted.

Set Boundaries

The critical time to establish boundaries with a partner who has sex addiction is when the other partner is most hurt and vulnerable. This will help establish a place of safety for the person who feels hurt. Boundaries may include removing Internet access, changing what comes through the TV, establishing a bank account to insure bills are covered, and removing any offensive material from the home. If consequences are tied to the boundaries, it’s important that they are followed through with or they will not be taken seriously. This can be vital in creating some order to what feels like chaos.

There is no magical formula for healing a person’s experience of betrayal by a partner experiencing sex addiction, and every day is a new battle that can feel out of control if specific steps are not taken to handle the overwhelming feelings. The good news is that if these steps are followed, one can find that they are developing strength they never knew they had. The combination of empathy, compassion, and some tough love are necessary to guide a person down a path of healing and then to hope.

As much as indulging in “retail therapy” can trigger a short-term giddy feeling, new research shows that some products actually work in the opposite manner: we buy them because they make us feel bad. A new study finds that beauty product marketing, in particular, makes female shoppers feel bad about their appearance by suggesting to women that without the product, they are not as attractive as they should be. The unrealistic appearance of air-brushed models has already been shown to have a negative affect on female self-esteem. But this study found that even packaging and advertisements without humans in the imagery had a negative psychological impact on female viewers.

Why do so many men sabotage relationships and careers? Current cultural stereotypes of men range from bumbling incompetence to aggressive, macho insensitivity. I’ve worked with men in therapy and personal growth workshops for over 25 years, and I’ve identified a type of adult man I call the LATE Men, Lost, Angry Teens, and they are often stuck in an adolescent level of development – literally, LATE to grow into full adult functioning.

We all have four primary internal parts: An Inner Child, a Teenager, an Inner Critic, and a loving, responsible Adult. The Teenager seeks independence, identity, and acceptance with peers. Teens may also become rebellious, angry, confused and withdrawn. Adjustment problems are more likely to occur in distressed or dysfunctional families, where adolescents do not receive the guidance, emotional support, and other resources necessary for healthy maturation and individuation. (more…)

Last month we looked at why it’s important to let ourselves “wallow” in our feelings; it helps us know ourselves better and get over difficult patches faster. It also helps us to reintegrate the parts of us that had to be cut off in order not to hurt so much. Once we’re whole, we can enjoy the self-esteem that comes from knowing and respecting ourselves.

As a therapist, I often hear variations on the following from clients: “I’m sick to death of wallowing in my feelings. How do I let this go and move forward?”

Have you ever had a similar thought? Has it ever seemed to you that if you could just handle your emotions better, you wouldn’t feel so bad?

Do you sometimes consciously let yourself wallow, only to find you just feel worse? If so, you may not be wallowing constructively. Truly constructive wallowing always leads to relief.

The hardest part of wallowing is the part after the initial “w”: the allowing.

When you say you’re “wallowing,” are you allowing yourself to truly and simply just have your feelings? Are you avoiding self-criticism – avoiding kicking yourself when you’re already down?

Here are some behaviors that torpedo the healing power of wallowing:

• You set a timer, either literally or in your head, after which you think you should be done.
• You dislike yourself while doing it.
• You ruminate, turning thoughts about the problem over and over in your mind, instead of simply feeling.
• You try to figure out whether your feelings are justified.
• You act out your pain through destructive behaviors that only leave you feeling worse.

If you are wallowing constructively, you will feel better afterward. When your unedited, no-need-for-justification feelings are allowed to be inside you without interference, they will move through you smoothly of their own accord.

What a lot of people call wallowing is really either distraction or rumination.

Distraction comes in the form of using substances like food or alcohol or drugs, or performing obsessive behaviors like exercising or worrying, having sex, shopping, cutting, reading, or even doing housework instead of sitting with your feelings and tolerating them.

Whenever we “do” instead of “be,” we run the risk of shutting the door on feelings that need us to listen to them. Sitting with, and witnessing feelings is the only constructive way to wallow.

Rumination is a kind of repetitive thinking. Instead of having our feelings about something, we think about the situation, the other person or people involved, what happened or didn’t happen, etc. in an effort to make sense of, or talk ourselves out of our feelings – instead of just having them.

We turn the situation over and over again in our minds, concocting plans designed to shield us from further harm; the problem is, we haven’t acknowledge the actual harm done so far.

True wallowing, which is constructive and healing, is what’s left after we remove all distractions and all obsessive behaviors, and all rumination in our minds. There is nothing left but to feel our feelings in our hearts. To tolerate them patiently. And to do so with compassion for ourselves, rather than judgment.

If you have a big backlog of uncomfortable feelings to feel, it will take longer for them to dissipate. Have patience with yourself during this process. You may experience waves of uncomfortable feelings off and on over time. This is normal when you have a backlog of  feelings you haven’t felt yet. Embrace each feeling in your heart as it presents itself, and know you’re doing something positive for yourself.

Have you ever been in a relationship that challenged your assumptions and beliefs about yourself and the world around you? If so, then you know how powerful and life changing some relationships can be. Imagine then, forming a relationship with a professional who is trained to develop relationships that encourage self-exploration, insight and positive change. Carl Rogers, founder of person centered psychotherapy, outlined three essential ingredients of  a successful therapeutic relationship – unconditional positive regard, genuineness and empathy.

Therapy can be a difficult, and even painful, process, wherein clients explore the good, the bad and the ugly within themselves, perhaps for the very first time in their lives.  As clients explore, the therapist’s attitude towards them will either encourage them to continue the exploration, regardless of what comes up, or the therapist’s attitude will shame them into shutting down. Therapists who have unconditional positive regard for their clients accept them as they are without conditions or judgments. Unconditional positive regard is paramount in the therapeutic relationship; it not only allows, but encourages clients to explore parts of themselves that they have never been permitted to explore. Free from the fear of rejection, clients can fully and honestly explore themselves, past and present, and their desires for their future.

The concept of genuineness in the therapeutic relationship, simply put, calls for therapists to be themselves, and to interact authentically and sincerely with their clients. Genuineness requires therapists to have a high level of self awareness, coupled with a willingness to share the experiences of their clients in a way that is beneficial to the clients. For example, if a therapist is feeling disconnected from a client as he reports the events of his week, the therapist might say something like, “I’m feeling a little disconnected from you right now.  I hear the events you are reporting, but I’m not hearing anything about how you experienced them, how you felt about them, or how they impacted you.” Chances are if this is how the therapist experiences the client, this is also how other people in the client’s life experience him. However, people rarely provide such frank, insightful feedback to one another in everyday life. This genuine statement from his therapist may lead the client to develop some insight into why he feels a distance and lack of connection in his personal relationships.

Perhaps most central to the development and maintenance of the therapeutic relationship is the concept of empathy.  Empathy goes well beyond the more common notion of sympathy. Sympathy is simply feeling badly that someone is going through a difficult time. Empathy on the other hand is the ability to put yourself in another person’s shoes, and to view, feel and experience the world as that person does. Imagine, for example, how powerful it is to have a therapist take the time to actively listen to a client who has lost her mother.  The empathic therapist, who has worked hard to fully understand her client might say something like, “It sounds like your mom was the only person who ever made you feel taken care of, and now that she is gone you’re feeling very alone and scared.”  Until this point, people have probably told the client that they are “sorry for her loss.”  Through empathy, however, the therapist has offered something much deeper– something that makes the client feel understood and solidly connected to the therapeutic relationship.

Beginning therapy can be a very difficult step to take. You may be concerned that your interaction with the therapist will be cold and clinical, or that the therapist will judge you harshly. These concerns are quite common, but also quite contrary to the Rogerian therapeutic relationship. If you are considering therapy and believe you would thrive in the kind of relationship described in this article, consider seeking out a person centered therapist near you.

Experiencing a traumatic life event is horrific and terrifying, but this experience does not have to become your defining moment.

It is possible to grow through a traumatic event, or series of events, and there are loosely-structured phases of healing for that growth to follow. For a moment, stop and reflect on what it means for experts to have identified these patterns of healing: it means that you are not alone in having experienced trauma, and you are not alone on the healing journey.

The healing journey follows three loosely linear stages or phases. The rate of growth through each of the phases, as well as the details of what that growth looks like, will be unique to you. You will develop your own unique pattern of healing, which means that you will enter, exit, and revisit phases at various times in your life.

Always keep in mind that revisiting is not backwards movement. It is like the outer layers of a spiral: you pass by the same issues, but are in a different, deeper state of healing. As you near the end of your healing journey, you will be able to look back and notice an overarching progressive nature to your growth and healing.

[fat_widget_trauma_ptsd_left]This article will look at the first phase of healing, while future articles will address the second and third phases.

Understanding the Safety Phase

As you begin the first phase of healing, safety is both your main concern and the hardest task to achieve. Establishing safety—both within yourself and within your environment—can take days, weeks, or even years. The length of time required to develop genuine safety depends on your unique attributes, such as past life experiences, personality, and pretrauma baseline. The length of this phase also depends on how chronic the trauma. In general, the longer you were exposed to the trauma, the longer it will take to develop a sense of safety.

This is not an easy stage. Establishing safety requires a lot of hard work and may require that you, the survivor, dramatically change your life or lifestyle. While this is a difficult part of the healing journey, absolutely no survivor can skip this stage.

Safety Within

In order to truly have safety, you must establish safety within yourself. Focusing on your physical health lays the foundation for internal safety. Establishing internal safety requires you to tend to any ailments, as well as to eat healthy foods, exercise regularly, and sleep sufficiently. Self-harming behaviors preclude genuine safety, so cutting, burning, or addictions to drugs, alcohol, food, or sex, must be grown through and terminated.

Many self-harming behaviors are efforts at managing emotions or thoughts. Learning how to manage your thoughts and emotional world, including your trauma reactions (especially hyperarousal and intrusive reactions), is fundamental to being safe within yourself. Many people find it difficult to engage in this healing without the assistance, support, and guidance of a trained professional. Do not feel ashamed or hesitant to reach out for help.

Safety in the World

Safety within oneself is only half of the equation. No one can be fully safe unless the environment they live and interact in is also safe. Creating safety within your environment requires safety within your physical and relational spheres.

• Attaining a safe physical space includes your ability to move physically in society with a sense of safety and security. It may help to work on your ability to identify dangerous situations or individuals and, to the best of your ability, to get out of a dangerous situation if at all possible. Consider developing safety plans or learning self defense.

• Assess the physical and emotional safety of your social support network. It may be necessary to remove people from your life who are a potential source of physical or emotional danger, or to increase the number of people who can and do provide emotional support, protection, or practical help.

• For those who experienced trauma at the hands of other people, assess the degree of continuing threat and the potential for re-victimization or revenge, and develop appropriate precautions. Ensuring your safety is not 100% within your authority, since to live means to be vulnerable. But that does not mean it is 0% within your authority either.

Moving Through the First Phase

This phase of growth is gradual. It can have a sometimes halting stop-and-go pattern, and it can take a long time. However, if you continue to work on developing safety, and allow trustworthy others to help you, you will be able to grow through this phase.

Some indicators that you have grown through this phase include no longer feeling utterly vulnerable; having a degree of confidence in your ability to protect yourself physically and emotionally; knowing who to count on for safety and support, and being able to effectively manage most of your trauma reactions, including emotions, thoughts, and behaviors.

If learning about the tasks involved in this first phase of healing feels daunting, don’t give up. Reach out to a trained therapist and harness their skills and abilities in order to engage in this healing work. You have a right to reclaim the quality of life you deserve.

If this first phase of healing sounds like a review of work you have already completed, take a deep breath of congratulations and gratitude. You are on your way to continued and ever-deeper healing and growth.

It might seem absurd or counterintuitive to think of a two-person relationship as consisting of three parts. So why would someone suggest you consider it?

Developing a coherent sense of self and establishing a long-term relationship are two developmental tasks during emerging adulthood, and these dual needs continue throughout our lives. Think of your relationship like a three-legged table, where each leg must be strong: you, your partner, and your relationship with each other. To bloom a truly happy partnership with lasting strength, each piece is an integral part of the equation. If one person absorbs too much energy, the other gets left out. If not enough attention is paid to the relationship itself, your partnership suffers. Take away one piece, neglect one part, and you have a wobbly table.

A positive sign of marriage identity is when both partners maintain their individual interests, hobbies, and friendships while also valuing and prioritizing time spent together. This balance allows for personal growth and a strong couple bond.

Meeting Each Other’s Needs

Many people believe that the only thing they can work on in their relationship is their partner’s happiness. The problem with looking at relationships this way is that the person trying to make sure their mate is doing well runs the risk of neglecting themselves. This person may be sacrificing what they want or need in the relationship so their partner will feel good.

That might work for a while, but eventually the person doing all the giving can run out of energy and feel exhausted and depleted. If the pattern continues, those feelings can turn into anger and resentment. If one partner feels like they are the giver and don’t receive anything in return, they can end up feeling used and alone.

Researchers describe this balancing act as “risk regulation”: we weigh our desire for closeness against our fear of rejection, and it is confidence in a partner’s care and positive regard that makes it feel safe to depend on them. In couples work, an early warning sign that this balance has tipped is “relational accounting”—keeping score of who has done what for whom. Once partners are tallying contributions, the assumption of good faith between them has usually already begun to erode.

The receiver of this energy doesn’t get their needs met either, they may be happy for a while, but this constant state of receiving can become tiresome, too. There is no room for real bonding between the two because their positions are not equal. There is imbalance in the relationship. Balance is essential in a healthy relationship because both partners have individual needs, desires, and aspirations that must be acknowledged and met to sustain personal well-being.

Meeting Your Own Needs

I recommend that each person learn about themselves as individuals as an important part of improving their relationship. Part of self-knowledge is understanding what makes you happy. Do you know what makes you feel happy and fulfilled? If you think that being loved by your partner is all you need, that is not the answer I’m looking for. Your answer though, could be something like this: “I love to spend time working in the garden, and I like to volunteer my time with the humane society.” These are endeavors that could make a person feel whole and worthwhile. What about your job? Some people find their happiness through their profession—maybe this is your source of enrichment. By working to understand yourself as an individual, you will learn what you need to make your leg of the table strong.

Self-care means taking the time to do things that help you live well and improve both your physical health and mental health. Self-care ensures you have the emotional and physical energy for yourself and others. Balancing caregiving with self-care improves the overall quality of your life and the health of your relationship.

When we as individuals have attained knowledge about ourselves, we are in a better position to stay in balance. Knowing what makes you happy is the best contribution you can make to your relationship. When you understand yourself and you know how to keep yourself in a good state, you will be a contributing member to the relationship. Without this knowledge, you may depend on your partner to provide you your happiness—and that can lead to problems. If a couple places too much emphasis on the relationship, one or both partners may feel suffocated, lose a sense of individuality, or sacrifice personal goals. On the other hand, if individual needs consistently take precedence, the relationship itself may weaken, leading to emotional distance, resentment, or a loss of intimacy.

When both people know themselves, they can spend time understanding their partners. When we learn what our mate loves, likes, wishes for, and enjoys, we become more adept at providing it to them. The Gottman Method calls this kind of ongoing curiosity building “Love Maps”—an intentional exploration of what makes your partner tick, what they worry about, and what they hope for. And when something is unclear, ask rather than assume: psychologist Carol Dweck describes hearing her husband say he “needed space” and, instead of interpreting it as distance, asking what he meant—he simply wanted to reposition his arm.

Meeting the Needs of Your Relationship

Building the relationship together is like solidifying the last leg of the table. What are your combined values, goals and dreams? What do the two of you as a unit stand for? What is your “mission statement?” In the Gottman Method, this is the work of “creating shared meaning”—the top level of the Sound Relationship House—where a couple names what is fun, uplifting, and purposeful about their life together and actively supports each other’s dreams.

Relationship researchers have a name for this sense of shared identity: “we-ness.” Across decades of studies, couples with a stronger sense of we-ness report greater satisfaction with, and commitment to, their relationship. Couples with a strong shared identity often refer to themselves as “we” or “us,” indicating a strong sense of being a team. They also likely use positive and affirming language when speaking to and about each other.

You have a chance to create something unique to the two of you. Understanding all the pieces of your three-legged table gives you the best opportunity to build a healthy, lasting relationship. Tending to this third leg may even pay physical dividends. In a 2022 study published in the Annals of Behavioral Medicine, couples who were more satisfied with their relationship also ate, slept, and exercised together more often—and both the satisfaction and the shared routines predicted better self-rated health and fewer depressive symptoms.

Please note: This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your mental health or relationships.

Find a therapist who can help you balance your individual and relationship needs.

References:

1. Auger, E., Thai, S., Birnie-Porter, C., & Lydon, J. E. (2025). On creating deeper relationship bonds: Felt understanding enhances relationship identification. Journal of Personality and Social Psychology, 128(3), 907-942. https://doi.org/10.1177/01461672241233419
2. Canevello, A., & Crocker, J. (2010). Creating good relationships: Responsiveness, relationship quality, and interpersonal goals. Journal of Personality and Social Psychology, 99(1), 78-106. https://doi.org/10.1037/a0018186
3. Cruwys, T., South, E. I., Halford, W. K., Murray, J. A., & Fladerer, M. P. (2023). Measuring “we‐ness” in couple relationships: A social identity approach. Family Process, 62, 795–817. https://doi.org/10.1111/famp.12811
4. Dover, C. R., Serrano, C., López-Madrigal, C., García-Manglano, J., & Willoughby, B. J. (2024). Relational identity and relationship functioning in emerging adulthood: A brief report. Emerging Adulthood, 12(2), 245-253. https://doi.org/10.1177/21676968241234953
5. McLean Hospital. (2024). How relationships impact mental health—and vice versa. https://www.mcleanhospital.org/essential/relationships
6. Meridian Counseling. (2024). Balancing individual and relationship needs for long-term happiness. https://www.meridian-counseling.com/blog/how-to-balance-individual-and-relationship-needs-for-a-happier-relationship
7. Murray, S. L., Holmes, J. G., & Collins, N. L. (2006). Optimizing assurance: The risk regulation system in relationships. Psychological Bulletin, 132(5), 641-666. https://doi.org/10.1037/0033-2909.132.5.641
8. National Institute of Mental Health. (2024). Caring for your mental health. U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/topics/caring-for-your-mental-health
9. Travers, M. (2024, May 31). 3 signs that a couple’s connection is bulletproof. Psychology Today. https://www.psychologytoday.com/us/blog/social-instincts/202405/3-signs-that-your-marriage-identity-is-bulletproof
10. Wilson, S. J., Stadler, G., Milek, A., Kamarck, T. W., Otero, M. C., & Novak, S. A. (2022). The implications of being “in it together”: Relationship satisfaction and joint health behaviors predict better health and stronger concordance between partners. Annals of Behavioral Medicine, 56(12), 1259-1273. https://doi.org/10.1093/abm/kaac043

I often say, when explaining eating disorders, that someday I’m going to invent the Eating Disorder Board Game. I certainly don’t mean to make light of eating disorders. They are serious conditions that cause tremendous pain to those  to have them and to their loved ones. I am a big believer in analogies’ abilities to explain thoughts and behaviors involved in eating disorders.

The Eating Disorder Board Game is one that I use to illustrate one of the salient issues involved in an eating disorder. Arrested psychological development is common in young people who develop eating disorders. Imagine a board game that begins at birth. Each player starts with a given temperament, or set of genetic markers that give them certain characteristics, and a given degree of emotional sensitivity.

As they move around the board, they learn, via the spaces they land on and the cards they draw, about their family environment and life circumstances. They can receive what they need in order to move on to the next stage of development. Things required to move to new spaces or stages symbolize secure infant attachment, attunement, protection, unconditional love and acceptance, caregivers who put their children’s needs ahead of their want.

However, they may not get all of those things, or some are cancelled out by other factors, such as traumatic experiences. So they may have to go back several spaces or lose turns. Players with certain sets of factors are statistically more likely to develop eating disorders.

Eventually, players get to adolescence and then the launching phase of life, wherein they are ready to leave home and move out into the world. At this point on the board there is a special feature. You know those circles of spaces on some board games where you get stuck going round and round while the other players continue around the board, and you have to roll exactly a certain number in order to get out?

Well, in the Eating Disorder Board Game, the majority of players who acquire eating disorders get stuck in that circle. What this illustrates is one common function of an eating disorder: enabling a person who has been deprived of what they need to develop. It substitutes real emotional nourishment in order to navigate the rocky transition from childhood to adulthood to do the impossible: to continue to move forward in life while barely progressing to psychological and emotional maturity.

Eating disorders often emerge in middle and high school because one’s psychic infrastructure—a sense of self, competence, and worth, a toolbox of interpersonal and emotional coping skills —isn’t adequate to support the weight of the demands of this stage of development. At this juncture, life gets much bigger as peers take on greater importance and family takes on less.  Kids without a solid infrastructure are vulnerable to developing maladaptive coping mechanisms to help them organize the muddle around or within themselves.

Body and weight can become easy,  logical focal points for a tweener or teenager who hears self-deprecating talk about being “so fat” and stinging criticism from other kids who are something other than slender. The malleable teenage brain, still developing its frontal lobs, is at risk for making decisions that don’t align with wellness when under social pressure. Arrival at the conclusion that appearance is the ticket to being liked, and to be fat leads to becoming alone and unloved may ring truest for their circumstances at the time.

In the Eating Disorders Board Game, players whose nature is emotionally sensitive or whose genetic makeup predisposes them to anxiety, to poor self-esteem, to a high degree of sensitivity to perceived rejection, and to perfectionism are vulnerable to eating disorders. All other vulnerabilities are enhanced in children whose family provides, as the creator of Dialectical Behavioral Therapy (DBT) Marsha Linehan describes it, an “emotionally invalidating environment.”

An emotionally invalidating environment can comprise a variety of situations. Parents who are absorbed with chronic illness in the family, either of one parent or another sibling, may distribute attention unequally throughout the family or household. If both parents grew up in families that were emotionally invalidating, they may repeat the pattern of their childhood home. If neither parent was born with or developed a high level of emotional sensitivity, they may not see or understand the needs of the emotionally sensitive child.

An emotionally invalidating environment can also involve parents whose behavior is overtly harmful to their child. If one or both parents have problems with an addiction of some sort, life at home likely mirrors the chronic illness scenario with added accountability and security issues. If one of or both of the parents are verbally, physically and/or sexually abusive, and the child is left without a protective guardian between the two, this forms an emotionally invalidating environment as well. Addiction and abuse have a wide variety of relationships in families. They may combine in a variety of ways to create different degrees of safety and validation for children.

The range of factors that can make up an emotionally invalidating home environment is broad. The less obvious these factors, the more puzzling the origins and function of an eating disorder. But the presence of an eating disorder more often than not indicates the absence of some crucial ingredients in the child’s infrastructure.

Fortunately, in the Eating Disorder Board Game, when a player stuck in the circle at the border of adolescence and adulthood rolls the right number on the dice he or she exits the circle on the Road to Recovery. This road can be long and filled with setbacks. But is paved with lots of help from skilled professionals, and self-help programs and literature.

The player is accompanied by many other pieces on the board: loving family, supportive friends, and other players making their way along. There are no losers in this game, and it doesn’t matter who arrives at the end of the Road to Recovery first. Players are all in the game together, and the only way to lose is to stop playing before reaching the end.

Elijah nicked a mole on his upper lip while shaving one morning. He covered it with tape and went on with his busy day. Managing his fine arts import company and finding distributors that would sell the fine porcelain gave him enormous pride and self-esteem. He enjoyed making a reality out of the unpredictable nature of the business. Rain or shine, sick or not Elijah never missed a day. He always had his finger on the pulse of every part of the trade, and that’s what helped him sleep at night.

Elijah Diagnosis

He didn’t sleep the night his dermatologist diagnosed malignant melanoma from that pesky mole he had found a few weeks ago. It had itched and oozed enough for him to appease his wife and go to the doctor. He had laughed and joked about it, just as he did about most things that may turn out to be bad news. Elijah had been making light of life’s curve balls since he was a kid. It made people laugh. It also made everyone take their eye off the ball and pay the price later. Elijah would just give them a huge slap on the back as if everything was a jest. He never acknowledged his feelings, and pretended to be a happy, humorous person with not a care in the world. He would change the subject when ever anyone talked about something serious, denying them and himself of empathy, comfort, and genuine support.

Pretending All Is Well

Elijah’s joking helped his mother cope when his father got drunk and lost jobs. The boisterous joviality was a great cover for his anger at his father which he refused to discuss. Marvin, on the other hand, was the opposite of his brother. He berated the memory of their father after his parents divorced and openly despised his mother’s helplessness. Elijah cheered her up and sacrificed his childhood to care for her. [fat_widget_left]Elijah ignored his emotions and ended up with malignant melanoma, while Marvin acknowledged his negative feelings and got help to process his traumatic childhood experiences, resulting in a healthier adult life.

Stress Builds

Elijah suffered long-term, constant stress from early in his life. That makes his stress chronic and toxic. It became so much a part of his life that he no longer recognized it as anything unusual. If you asked him about taking care of his mother when she was depressed, getting himself to school, and making sure the household bills were paid, he would probably say it was no big deal. He wasn’t consciously aware of the stress.

Stress Hormones and Melanoma

Elijah’s denial of his emotions is typical of individuals with melanoma. In a 1984 study reported in the Journal of Psychosomatic Research melanoma subjects had little or no awareness of their stress as measured by stress hormones and electrical skin reactions that reflect physiological stress. In contrast, cardiovascular patients and those with no illness were able to recognize and acknowledge their stress. This suggests that melanoma patients were repressing their conscious awareness of stress. As Gabor Mate says in his book When The Body Says No: Understanding The Stress-Disease Connection, “People can experience emotional stress with measurable physical effects on their systems—while managing to sequester their feelings in a place completely beyond conscious awareness.”

Chronic stress, such as that which Elijah experienced, triggers the growth of melanoma cells when skin is exposed to UV rays. The effects of the stress are cumulative over years, striking slowly over time, until that mole is visible. The Journal of the National Cancer Institute, 2010, indicates that the stress hormone norepinephrine increases the number of proteins responsible for accelerating tumor growth. Short pieces of RNA, which normally block these proteins, disrupt the normal cycle of protein production, leaving proteins to morph into oncogenes (cancer producing genes) causing metastatic melanoma. The disease has likely already spread by the time that one mole shows up and gets treated.

The Type C Personality

Many studies have found a series of common coping styles that have been described as “type C” or the “cancer personality.” The most important of these is dealing with negative emotions that trigger stress by suppressing and repressing them. In particular, the repression of anger while pretending to be happy. In order to deflect conflict and maintain relationships type C personalities show an easy going exterior, while living an inner hell. They are more likely to act in ways that are self-sacrificial, appeasing, patient, and accepting. The stress caused by suppression releases massive amounts of hormones that damage the natural cycle of cell growth and death, leading to cancer.

The American Cancer Society reports that there are 48,000 cases of melanoma diagnosed each year, and of those, 8,000 will die from metastatic melanoma. The repression of emotions, especially anger, appears to be a major factor that contributes to chronic stress which stimulates the production of cancer cells. Elijah may have lived his life as a type C person, but he still has a good chance of survival, if he chooses to express his childhood anger and reduces the stress in his body. Acknowledging and expressing his feelings can offer a healthier way of coping without having to pretend, putting his life at even greater risk.