Are you tired of intense and destructive marital arguing and want it to stop? Do you need some space to think about things more clearly? Are you thinking about a separation but are not sure how to pull it off without making things worse? Do you feel like you just need a break from all the tension?

It might be time to separate—either formally, legally, or “in-house.” In an effort to save a troubled marriage, a separation can be useful if done with agreement between both spouses and a high degree of respect (even when you are angry). A separation does not signify that a divorce is inevitable. It is a time to get clarity about the direction your relationship should take.

In Lee Raffel’s book Should I Stay or Go?, she reviews specific steps couples can take that will enhance the probability that their marriage will be saved. She refers to this as a Controlled Separation. She tells stories of couples who have successfully separated in order to repair the relationship, learn new skills, and enter back into the relationship with a new mindset and optimism. Both partners need to be committed to change, compromise, and self examination. The reward is a much improved marriage and avoidance of painful and costly divorce.

This article is not about the legal or financial aspects of separation but is about the psychological and emotional issues and how to stay focused on getting a good outcome for an “in-house” separation. The two of you need to agree on why you are taking the separation and how long it will last. You need to both recognize that your marriage is on the brink and drastic changes are needed. Keep an open mind. Slow down the decision making. Other issues that need to be resolved—what part of the house is his or hers. Are you going to tell family or friends? Do you continue splitting chores up between the two of you in the same way. If the holidays are coming up, do you attend as a family? Are you going to be sexually intimate? Do you eat dinner together? Do you talk to each other when you pass each other in the house? This is not a license to see other people outside the relationship.

The following are some reasons that couples cite for taking a controlled, in-house separation:

• A stop to the fighting
• A time to cool off
• Time to determine your next course of action
• An opportunity to see how you feel about the relationship
• Time to reflect on your responsibility in making the marriage go sour
• You don’t have the money for a formal separation

If you think you would benefit from an in-house separation, both you and your spouse will need to act in good faith as you call this truce. Your first step is to establish some ground rules that the two of you can agree on. Establish a time frame—1 to 4 weeks—at which time the two of you will renegotiate. Make an attempt to understand the reasons your spouse wants a separation. If you do not want a separation, be clear about your concerns that things may get worse. These should all be written down which will help you stay focused. Get marriage counseling if you feel you can’t manage the details of a separation on your own. GoodTherapy.org offers lists of therapists in your area.

Separation is a serious thing not to be entered into lightly. It will not fix everything on its own. It is a tool to be used to bring healing to the relationship.

For those battling depression, both cognitive-behavioral therapy and interpersonal psychotherapy have long been recognized as very effective means of overcoming depression. A new study printed in the British Journal of Psychiatry and published on PsychiatryOnline.org shows that differing personality traits can affect how responsive people are to these two main types of therapy. The researchers wanted to know if certain personality traits made treatment less effective. Their conclusion: the success of interpersonal therapy seemed to vary based on the individual’s personality and temperament, while the success of cognitive-behavioral therapy showed no difference based on personality traits. This can help therapists further match clients with the best form of treatment not only for their struggles (e.g. depression), but their personality as well.

If you’ve done any channel surfing at all in the last year or so, you might have come across a couple of documentary shows (Hoarders on A&E; Hoarding, Buried Alive on TLC) featuring people who are living with massive amounts of clutter and/or trash in their homes. The piles of “stuff” often reach to the ceilings, and there is barely space to stand, much less walk across a room. The programs show professional organizers and psychotherapists working with people to clean out their homes. If you’ve seen either of these shows, then you know what I mean when I say it’s something you don’t forget easily. Although the people being featured on the shows are treated with respect and compassion, the images are shocking and disturbing. How does this happen? Why do people do this? Can they be helped?

Contrary to what you might think, people experiencing compulsive hoarding are not just being lazy or careless. They are experiencing an anxiety related condition; although, there is disagreement in the medical/psychiatric community as to whether hoarding is its own issue, or that compulsive hoarding is a subtype of obsessive compulsive disorder (OCD). Although many people experiencing OCD also exhibit hoarding behavior, not all people experiencing OCD also hoard, and many people who hoard have no other symptoms of OCD.

People who compulsively hoard do experience excessive extreme anxiety, doubting, checking, and reassurance seeking before discarding items, which does suggest a close relationship to OCD. However, recent research suggests that compulsive hoarding may also be associated with a range of other psychiatric conditions, in addition to OCD. Compulsive hoarding behavior has been reported in disorders including schizophrenia, social phobia, eating disorders, depression, and dementia. In studies of the brain, researchers compared neurochemical activity and patterns of blood flow in the brain of people who compulsively hoard and people who experience OCD who did not hoard. They found that the neurochemical activity and blood flow patterns in people who hoard were different than those in people with OCD, suggesting that compulsive hoarding is a separate symptom/condition from OCD.

Many, if not most, people have a certain amount of clutter in at least one part of their homes. Where is the line between average messiness and compulsive hoarding? Hoarding behavior includes:

• Acquiring and keeping, indefinitely, a large number of possessions which appear to be useless or of limited value
• Living in spaces so intensely cluttered as to preclude activities for which those spaces were designed
• Significant distress or impairment in functioning caused by the hoarding (e.g., health problems, inability to keep a job, difficult relationships or lack of relationships with other people)
• Reluctance or inability to return borrowed items; impulsiveness and compulsion to acquire more “things” sometimes leading to stealing or shoplifting

Why/how does a person cross the line from messiness to hoarding? There are several proposed explanations for the causes of hoarding behavior. Investigators have suggested that errant cognitive processing leads to hoarding. These include information processing deficits, meaning that people who hoard have substantial problems focusing and sustaining attention, difficulty categorizing and prioritizing their possessions, and difficulty in making decisions about their possessions.

Maladaptive beliefs about, and extreme emotional attachment to, possessions may also contribute to a person’s hoarding behavior. People who hoard have an exaggerated sense of responsibility for their possessions, and desire complete control over them. They experience intense emotional distress (anxiety, grief, or guilt) about the ideas of discarding or losing an object, leading to avoidance, and escape in the form of saving and acquiring.

There are also studies showing that difference in brain activity and /or brain injury can lead to hoarding behavior. Scientists have identified the areas of the brain involved in hoarding. One study showed reduced glucose metabolism in certain areas of the brains of compulsive hoarders. Some people with traumatic brain injury, stroke, and neurodegenerative diseases have also developed hoarding behavior.

In the past, clinicians have used the same treatment methods for compulsive hoarding that they used for OCD, with poor results. While medication, cognitive behavioral therapy for OCD, exposure and response prevention therapy have all been effective treatments for OCD, they have been shown to be of little benefit for compulsive hoarding. People with hoarding behavior have high instances of poor insight, refusal of treatment, lack of cooperation, and inability to recognize hoarding as a problem, all contributing to difficulty in effective treatment.

There is hope for people who hoard, though. In a recent study, researchers designed a new cognitive-behavioral treatment especially for treating compulsive hoarding. In this treatment, motivational interviewing (getting people excited about the seriousness of the hazards of hoarding and the benefits of clearing out their homes), skills training for organizing and problem solving, and modification of beliefs about possessions are emphasized. Also, treatment includes frequent off-site sessions in which therapists helped people to sort, discard, and learn to resist acquiring more items. People typically respond more positively when the therapists are at the home with them, assisting them with sorting and discarding.

The sight of such intense messiness and disarray is certainly disturbing to see, but knowing that hoarding is a symptom of a person who is possibly experiencing severe emotional distress, hopefully, helps to engender compassion and patience in friends and family members. Information about help for hoarding can be found online at www.ocfoundation.org/hoarding/.

This is a continuation of last month’s article, “Are You Your Own Worst Enemy?” After learning to identify self-destructive behavior in ourselves, we can explore why we do it and the possible motivations behind vicious cycles of attacking ourselves. It may come from past trauma, abuse, neglect, or a number of other things that may have caused low self-esteem. Below are seven reasons people attack themselves.

1. Imitating Parents
We all learn how to take care of ourselves from imitating how our parents or other caretakers take care of us. When parents or caretakers attack children emotionally, verbally, or physically, children learn to attack themselves like their parents do. Practicing over and over, people become good at self-attack and carry the skill into adulthood. It becomes an integral part of regular daily life, almost like breathing.

2. Method of Discipline
Often caretakers don’t teach children how to set limits, or boundaries, how to structure themselves, or reward themselves. These skills are needed for discipline (which is sticking with things that are hard in the present, in order to achieve a longer-term desire). If people do not learn these skills, their way of disciplining themselves can be to attack themselves, when they don’t do what they think they “should.” For example, “Stop being lazy and stupid and do your homework.” Or, “Don’t eat that pie, you’re a fat pig!” This method of shaming can provide some rudimentary support for getting through obstacles to something one wants, but it causes a great deal of destruction in the process, and often backfires—causing rebellion against the “discipline.”

3. Lack of Information about their Value
When children don’t feel valued by their caretakers, they naturally conclude they have no value. This conclusion colors the way they see themselves in every aspect of their lives. The message that they have no value becomes a pretty constant “voice” in their thoughts that follows them into adulthood. This conclusion that they have no value can come from caretakers overtly shaming kids.

But it can also come from neglect, or lack of love or attention. Children who don’t get what they need emotionally gather that they must not have deserved it. This can even happen when there is no abuse involved. For example, children who are adopted into a loving family may determine that they had no value to their birth parents, and therefore aren’t worthy of much from others they encounter.

4. Preserving Parents and Power
When caretakers are brutal, absent, or unable to meet the emotional, needs of their children, the children have a choice to conclude either that there is something wrong with the parent or caretaker who is causing pain the child experiences, or there is something wrong with “me” (the child) for causing the caretaker’s behavior. For the child to conclude it is the parent, generally means acknowledging that the parent isn’t competent to take good care of their children.

For a child, not having a competent caretaker is life-threatening. So children generally do anything to avoid believing that their parent is unable to take care of them. This leaves children with the only other conclusion they can come to, given their limited experience, and great need—that there is something wrong with themselves. This preserves the belief that the parent is safe to depend on, and has the added advantage of allowing children to believe they have some control in their painful circumstances.

If I, as the child, believe I caused the abuse, then I can also believe that changing my behavior will stop the abuse. If I am a helpless victim of my caretaker, there is very little hope for my life to improve. So, most children attack themselves when their parents are hurting them to preserve their positive image of their parents, and to give themselves an illusion of control over the hurt, abuse or neglect.

5. Guilt
Sometimes children blame themselves for anything that goes wrong in the family (illness, death, mental illness, accidents, injuries, divorce, etc.) for various reasons. Common motives for self-blame include misunderstanding, attempting to feel powerful, being blamed for the problem by someone else, or, on occasion, having something directly to do with what went wrong. Children can carry that guilt into adulthood, punishing themselves with self-attack about much more than the original problem.

6. Imitating Peers
Sometimes people are repeatedly shamed, but not by parents or caretakers. Instead, siblings, and/or peers may be responsible. This can also turn the child’s belief system into one that legitimizes the bad treatment. They take on the belief that they deserve it. When they come to this conclusion, they have learned to continue this attack inside themselves.

7. A Way of Coping
Children who are overwhelmed with their feelings and are not given any skills for handling them have to scramble to use whatever resources they have to deal with these feelings on their own. Sometimes one of these resources is self-attack. Rather than feeling sharp, intense or disorienting emotional pain, children can convert these overwhelming, confusing feelings into a focused activity.

In multiple cases, self attack presents itself as a way of coping that seems to bring matters under the child’s control. When this happens, there is actually some comfort associated with self-attacking thoughts, just as there can be comfort in starving or cutting oneself. This is one reason cognitive-behavioral therapy alone often doesn’t work—people can not afford to give up thoughts they depend on to comfort themselves.

People attack themselves as a method of self-defense, coping, or due to the fact that we all, especially as children, are hard-wired neurologically to imitate those around us. In therapy, we find the origins of the self-attack and the purposes we use it toward. We then look for ways to provide the same functions without the negative consequences self-attack brings with it.

In some cases of rewiring, Eye Movement Desensitization Reprocessing (EMDR) is a helpful option. In other cases, imitating the therapist offers a transitional alternative to the results of imitation of critical parents. However we get there, all of us ultimately have to become nurturing, compassionate parents to ourselves. That is the goal of childhood and good parenting, just as it is the badge of happiness and adulthood.

“All cruelty springs from weakness.” —Seneca, 4BC-AD65

There are those who say that bullying is behind all forms of violence, conflict, persecution, abuse, harassment, discrimination, and prejudice.

The death of Phoebe Prince in 2010, a 15-year-old Massachusetts girl who hanged herself after being harassed by a group of students from her school, puts a spotlight on bullying among teenagers. And in fact, there have been many notable cases of teen bullying, on and off the Internet (i.e., cyber-taunting on Facebook) that come to mind when we think of bullies.

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However, it isn’t just children and teenagers who bully. Although it may not be as obvious, or as easily identifiable, adult bullying may be more widespread. “Independent research suggests that bullying is happening to around 1 in 4 people” (from “Life After Adult Bullying”). Bullying impacts many of us, regardless of our age.

What Is Bullying?

Bullying is defined as “an act of repeated aggressive behavior in order to intentionally hurt another person, physically or mentally” (Wikipedia). It is characterized as behaving in a manner to gain power over another person. And it is a form of abuse. I would suggest that if you rephrase the descriptive action from “repeated aggressive behavior” to “taking frustrations out” on those who are weaker or different, bullying becomes a much more commonplace and identifiable act. In fact, it is pervasive.

There are different types of bullies and different environments in which they proliferate. There are verbal bullies, physical bullies, serial bullies, gang bullies, cyber bullies, subordinate bullies, unwitting bullies, work bullies, sadistic bullies, and psychotic and sociopathic bullies. There are bullies at work, at home, in schools, in governments, in religious organizations, on the Internet, and in social cliques.

What Kind of People Bully?

Usually people with low self-esteem and a certain amount of unconscious resentment (envy, jealously) that pushes the bully to project their own feelings of inadequacy onto you while denying that anything is wrong with them. Not all bullies are serial bullies. Sometimes the average person loses it under pressure and takes out their feelings in a bullying manner. But regardless of how or why it is happening to you, it is not acceptable.

What all bullies have in common is the use of power to satisfy one’s own psychological shortcomings. Each time a bully moves against someone weaker, he/she feels better about themselves for an instant. But because that feeling doesn’t last, they do it again and again. Sometimes the bully appears to lack insight into their own behavior (unwitting bully), but more often the bully does know yet elects to ignore the moral and ethical considerations by which the majority of people are bound. The rules don’t apply to them. Or they have projected so much self-hatred on the other that they truly believe that those they are bullying deserve exactly what they are getting.

Why Are There So Many Bullies in Society?

One of the reasons bullying is so prevalent is because most bullies commit non-arrestable offenses. And so bullying becomes unconsciously acceptable. It’s an outlet–a way to express–frustration and/or rage.

There are adult bullies we can easily identify. Hitler was a bully; racists are bullies. Parents and older siblings have been known to bully. Certainly, gang members bully. But what about those who threaten, shame, or intimidate you into doing things you don’t really want to do? It happens to most of us, and when it does, we are being bullied. Even when it comes from a person or institution that you love, respect, admire–your government, your church, your significant other, a family member, a professional colleague.

Sometimes there is a fine line between harmless coercion and harmful bullying. But you can feel the difference. You know when you are truly ambivalent and open to being talked into something versus when you are being pressed against your better instincts, wishes, or values. And if you are being bullied by more than one person (i.e. an organization or group), it is even more difficult to stand up for yourself.

More insidious and pernicious is the type of bullying that has less to do about forcing you to do something and more to do with “putting you in your place”–minimizing or even destroying you in order to make someone else feel better about themselves. People do this consciously or unconsciously because of a hole inside of themselves that they try and fill by being better than someone else. It gives them a sense of power and authority in the world that they may not otherwise experience. It is a way to externalize their own feelings of insecurity, inferiority, and/or rage by putting those feelings on someone else and then attacking them.

Some bullying is so subtle that you really believe the bully. They make you feel unsure of yourself; bad about yourself. They can even do it in the guise of friendship or love. It becomes more of a mind game than an outright violation. But it is bullying just the same. We will not be able to rid the world of bullies, but we can learn how to stand up to them.

How Do You Stand Up for Yourself to Stop Bullying?

First and foremost, recognize what is happening and remember that it is the bully who has the problem, not you. Unless they are physically threatening you, bullies are “paper tigers.” If you stand up to them calmly and confront their behavior rationally while asserting your rights, they will back down. If you call them out on their actions, they usually have no place to go–especially if others are witness to these actions.

You don’t have to attack a bully; you simply have to calmly and self-assuredly stand up for yourself. You don’t want to give them reason to escalate by engaging in a heated or emotional manner. You may be thinking that this sounds easier than it would actually be. So start slowly. If you can’t immediately stand up to a bully, at least don’t play into their behavior by trying to appease them.

Let the bully know by your reaction that you are not cowed and quietly walk away. Think about what you want to say and either talk to them later or wait until the next time they behave that way and then call them out on it. Bullies don’t have any real power once they realize that you won’t engage in their game. Once you have exposed them; they will fade away.

As a Yoruba priest, I frequently make offerings to the Orishas (divine spirits who guide our lives) and my ancestors. The type of offering varies, with the simplest being a white candle, glass of water, white flowers, and a bowl of fruit on my ancestral altar. We Yoruba also make offerings we call “Ebo.” The expression is to “do Ebo” in order to ask for something we want or to give thanks for something we have received.

In this article, I’d like to expand the notion of “doing Ebo” to include those actions/offerings, perhaps not as obvious, that we all take and make in honor of the divine or the ancestors. To illustrate this, I’ll tell a personal story.

For the past year, I’ve been doing extensive research on my family of origin. As far as I can tell, just about all of them have passed on. They were never very forthcoming about family history when they were alive.

One person, however, my paternal uncle, loomed very large in the family constellation. Not much was said about him by my paternal grandmother or my father. To me there was also a great deal of mystery surrounding him. I never knew where he was buried, when and where he died, or who he really was. All I did know was that he had drowned when he was 22, allegedly after getting a cramp while swimming in a lake.

When she was alive, my grandmother continuously eulogized him. I believe she suffered from what can be called pathological mourning, which is when someone experiences a loss so devastating it haunts him/her throughout, and interferes with, his/her life. My father rarely talked about his brother who was clearly the favorite son. I was going to be named after him (but in the end I wasn’t). All I gathered from them was that he was a budding superstar, on his way to law school, brilliant, talented, and full of promise. In other words, a tough act to follow.

Through research and an off-hand conversation with my father’s second wife, I managed to find out where he died and was able to get a copy of his death certificate. The death certificate told me where he was buried. I visited his grave and did an Ebo, which consisted of some simple offerings and prayers. During the visit to the gravesite, I was struck by the powerful impact his death had on my grandmother and father (and, hence, on me). It was an overwhelming and, for me, life-changing experience.

Jump ahead to this past April. I’m taking my dog to a canine internist in West Caldwell, New Jersey. The plan is to continue on to my house, upstate. I ask for directions from the receptionist at the office who tells me to make a right, then take Route 46, which would then get me to Route 23. I follow her directions and take 46 West. I’m driving and driving, sensing that I’m going the wrong way. But thinking, at some point, I was going to be heading in the right direction. Lo and behold, after more than an hour, I see a sign that says Delaware 7 miles, and I know I’m way off track. I keep going hoping to see a highway heading north. Within minutes I see the sign and then drive past Budd Lake—the very lake my uncle drowned in 72 years ago! I don’t stop but clearly feel he has been calling me to that place to remember him, and to bear witness to what had happened to him. I also felt he wanted something from me.

One of my spiritual advisors suggested I go to a local church and have them say a mass for him. Since my ancestors were Jewish, that didn’t feel right. So I went to the local synagogue, near my house, and was told that they were going to have a Yiskor (a ceremony honoring the dead) on May 20, which seemed appropriate.

Start time for the Yiskor was 9:30. Turned out it was also a holiday (the day that God gave the Ten Commandments to Moses). Unbeknownst to me, that was going to be acknowledged first. So as a group we prayed, and prayed, and prayed and finally about 11:30 a.m. we got to the Yiskor. I prayed for my uncle and my family and touched his photo to the Torah. I cried at his loss and prayed for his elevation. I didn’t leave there until after noon. It was the longest time I had ever spent in a synagogue, certainly the longest time I had spent reciting Hebrew prayers (in English, of course).

When it was over, I genuinely felt that I had done an Ebo. The Ebo was not only finding out about the Yiskor, but also spending far more time than I had intended remembering my uncle. I know he appreciated it.

So think about those sacrifices/offerings you have made for others, living and dead, in your life and take comfort that in doing so, you have been blessed accordingly.

The “empty chair” technique is one of my favorite anger tools to use with clients. When I first explain the idea and how it works, I tend to hear people say, “I don’t want to look stupid.” Too often, we spend so much time worrying how we will look to others and what they will think of us—but I digress. In this technique, we want to imagine the person we are angry with and use our minds to essentially “put them” in a chair facing us. This is our opportunity to speak directly about what we feel, with absolutely no concern about how the absent target will respond.

Too often, clients will tell me they worry about the target’s response if they do share their feelings. They worry about possible retribution or intensifying the target’s response if they get too upset. Another concern for some people is that they will hurt the target’s feelings and push them away. For instance, a client wanting their parent’s approval may fear that if they express their anger with their parent, their parent will only reject them further or maybe totally disappear from their lives.

This exercise seems like it should be a piece of cake, and yet the resistance to it is amazing. Clients are embarrassed to share, concerned what I or others may think. I remind them that these fears may be related to the fact they are not used to sharing in the first place—so it makes sense that they might not be comfortable at first. Others will find themselves “stuck,” not knowing how to start or what to say. In these situations, I might help them start by taking a few of their past statements about the target and modeling the technique. I then ask the client what I am missing, allowing them to continue. In my “sharing” aloud, I might be loud and even boisterous, modeling that it is okay to express what they are truly feeling.

Once the client starts sharing, pent-up frustration seems to easily spurt out. Ironically, what I tend to hear is clients’ surprise that they had so much to say. I remind them that once they allow themselves to be comfortable sharing, they are allowing thoughts and feelings that have been stuffed for years to get their due and be released.

I will ask clients to continue this exercise as needed. For example, if you are in the car and thinking about a past frustration, it is okay to talk aloud as if directly to that person. “But what if someone sees me?” The fact is, other drivers will think you are just singing along to the radio. Of course, you can do this at home or while out alone on a walk. What tends to happen next is that clients will say how relieved, or even tired, they feel as the feelings are released. Furthermore, clients will often report finding it easier to share their thoughts and feelings later, with the person truly there.

When we use the empty chair technique, we can be as angry as we want. Don’t worry about how you say it; just get it out. After the steam clears, you may want to keep some of the core statements to later share in real life with the person—but now is not the time to have to worry about how it might come out later. Again, just get it out.

The onset of disabling illness or physical or sensory impairment is often accompanied by complicated grief processes, including depression and posttraumatic stress disorder. These grief processes are frequently developed in response to the concurrent losses people may experience when living with new abilities.

Most obviously, people who acquire a disability or disabling disease lose a part of their bodies and/or the functionality of parts of their bodies. Additionally, they may lose physical comfort, vigor, mobility, spontaneity, the ability to engage in certain activities, aspects of their previous lifestyles, privacy, a sense of dignity, a sense of control, a sense of efficacy/agency, a degree of independence, actual or perceived life roles, friends and other social supports, the ability to work, financial stability, their previous sense of identity and purpose, the ability to pursue previously established dreams, their previous body image, and, all in all, their previous sense of self as a whole. Therapists should be attuned to what a newly disabled person may have lost, or may perceive themselves to have lost, beyond the obvious loss of physical or sensory functionality.

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How well people adjust to this potentially staggering array of losses is usually much more closely correlated to who they have been prior to the disability, and what social, emotional, and financial resources they have available to them, than to how “severe” the impairment itself is. The huge importance of social support after a disabling event cannot be overstated; people with new-onset disabilities may realize how lucky they are to have loving people in their lives as they have never realized it before, or they may feel almost completely socially and emotionally isolated. The most difficult disabilities to deal with in regard to social support seem to be “disenfranchised” disabilities (e.g., those resulting from Fibromyalgia/Chronic Fatigue Syndrome) in which others do not quite believe.

Non-professionals wishing to support a newly disabled person can be most helpful by being available to him or her as a friend who is willing to listen and meet him or her where he or she is emotionally. Trying artificially to cheer the person up or suggest that the person does not, or will not, have losses is not helpful. Newly disabled people will “cheer up” once they have finished grieving their losses and reorienting themselves to their new situation, often with the assistance of a counselor or therapist.

Another key to successful adaptation to a new disabling condition seems to be successful identity reconstruction, a process in which therapists can be particularly helpful. This may often entail psychological, existential, and/or spiritual shifts in perspective toward valuing innate qualities (as opposed to physical or comparative ones), authenticity, and taking life slowly and savoring it. Identity reconstruction, it should be noted, is not necessarily a finite process, as some disabling conditions are progressive and require constant readjustment.

Keep in mind that a large number of the losses with which a person with an acquired disability must learn to cope are not due to the physical impairment itself but rather to limitations imposed on the person by society. Therefore, therapists should not insist that people with disabilities “accept” their condition of disablement as theirs to adjust to, rather than, say, as an invitation to fight injustice.

Ultimately, it is much more helpful for therapists to view identity reconstruction, rather than “acceptance” of one’s disability, as the end-stage of grieving an acquired disability.

Unemployment is a downright monster. Most often, we see a lot of support for the unemployed person who is building his or her resume, interviewing, networking, staying busy, and being positive. I certainly hope and pray that our economy improves soon and each unemployed person finds work that is fulfilling in both meaning and income.

But how about support for the partners of unemployed people?

Ms. Y (not her real name) came in the other day and said, “My husband has been unemployed for over two years. Over two years. Over—two—years! I say it, dumbfounded, because at some point every day, I realize that I can’t believe how long it’s been. First it was an industry crisis. Then came his depression. Then there was his second wind, his revival. Then the revival turned into stagnation again. There were a number of short-term freelance gigs. There were rejections, interviews, and even jobs-in-hand that folded at the last minute  thanks to the tanking economy.

“During every rise and fall of this god-forsaken unemployment phase, I have been there to support my partner every step of the way. I’m exhausted. I’m tired of being the sole breadwinner. I’m especially tired of all those people who tell me what they think about my husband’s lack-of-work situation. During these years, I can’t tell you how many times I’ve been at some function where after a few drinks someone said to me, ‘I feel so bad for your partner. Your partner really needs support. Be patient, be supportive.’

“I think to myself, ‘Me, be patient? Me, be supportive? When haven’t I been?!’ I want to jump out of my skin and slap that person silly. Instead, I stuff my pride, and in my most polite tone, I tell the preacher-man to stick it. I want to hear what they have to say after they’ve supported their unemployed partner for over two years. I doubt it’ll be the same thing, I swear. Jerk.”

My heart goes out to Ms. Y and people like her. It is tough to be unemployed, but it is equally tough to be the partner watching and supporting the unemployed person. It is a terribly helpless position. Some have become involuntary breadwinners, straining to care for everyone and everything with one lone paycheck. All are forced to be passengers on the emotional roller coaster ride of a loved one’s bout with unemployment.

Some are the only people their unemployed partners will talk to about their suffering. Often, their emotional needs involuntarily get thrown aside because of the attitude that “unemployment isn’t happening to you, it’s happening to the unemployed.” Both the unemployed and partners of unemployed vacillate on the spectrum between the hope for the day of the “Great News” (“I start a new, real job on Monday and can help pay the bills now!”) and fear that their savings will be sucked dry and they’ll be forced to live in a shelter—or worse, their parents’ house.

I say unto you, dear partners: It is time.

Partners, it is indeed time to take care of you. You deserve it. You have done an amazing job of standing by your unemployed person’s side despite the mental, physical, and spiritual turmoil that unemployment puts everyone through. So first of all, do yourself a favor and give yourself—your mind, body, and soul—a break.

How can you possibly give yourself a break at a time like this? Well, if you don’t, you’re going to keel over, for one. The truth of the matter is that unemployment is not what defines you or your partner completely. In other words, each of you is a complex, multifaceted human being who remains healthy as long as your mental, physical, spiritual, and relationship states are receiving attention. At this moment, unemployment is taking a toll on these four realms; however, the trick to lessening unemployment’s severe control is self-care.

Self-care means honoring the other facets of your personality and life, thereby diminishing the attention given to the unemployment monster. Take a look at the following short lists of self-care ideas that honor these other parts of who you are. You’ll find that many ideas can cross multiple realms:

Mental: Attend individual and/or group therapy. Meditate, listen to music, take a vacation alone or with a friend or partner, spend time with loved ones, take a class, or escape through watching movies or reading.

Spiritual: Pray alone or with others. Choose to be silent, join a group on a spiritual practice that you enjoy, light a candle and reflect, journal your thoughts and feelings, or attend spiritual events and retreats.

Physical: Get a massage, exercise, go for a walk, take a hot bath, get regular sleep, dance, play sports, do yoga, paint, draw, sing, arrange flowers, color mandalas, play music, use relaxation techniques, or cook.

Relationship: Attend couples counseling. Create creative dates, like cooking from scratch together; do an activity together on a regular basis, like volunteering; take a week-long vacation from talking and thinking about unemployment; have sex.

Try any or all of these ideas, and keep adding to these lists. Find what works for you. You’ll see that given enough respite, you will have more energy to carry on your daily tasks until the “Great News” arrives. No one will be able to do this for you. You have to take care of yourself just as much as you take care of everyone and everything else. So, dear partners, be good to yourself and feed your mind, body, and soul. It is long overdue.

Lots of people hope for compromise in their relationship. Compromise is great when it happens; there is an easy flow, and both partners feel happy with the results. Nobody feels like they are losing, like they are being taken advantage of, or that their needs don’t matter. It doesn’t even feel like compromising—it’s just being happy together.

But what gets in the way of this delightful experience? Does it just happen naturally? Do you need to have logical conversations about it? Does it come from being forceful about getting your point across? Do you have to give up your needs?

Compromise Versus Conflict

Do you believe compromise should happen naturally? Do you think it means a relationship can’t work if it isn’t easy? Do you think about leaving relationships when they get difficult?

Let’s take a moment to look at this experience. Perhaps you feel really bad when conflict starts. You want to get away ASAP. You don’t like the feeling of someone being unhappy with you, criticizing you, wanting you to change. You have no experience of conflict being productive. Maybe conflict means someone is going to go crazy on you, demand something from you, or manipulate your feelings.

If that’s the case, it makes a lot of sense that you’d want to avoid conflict. When compromise doesn’t flow, you might conclude that this isn’t the relationship for you, or you become a stonewall and stop talking.

If there’s enough love present for you in the relationship you might want to think about your avoidance of conflict. Maybe it doesn’t have to be as bad as it has been in the past. If you acknowledge how it was and how you have come to protect yourself from these bad experiences—by heading out of town—you’re half way to a more mature, balanced approach to conflict.

Logic Versus Compromise

Does your mate get upset when you bring logic and rationality to the conversation? Do you say to yourself, “I’m just trying to solve the problem—why is he/she getting so upset?” Look at yourself honestly. Does your logical tone have an argumentative, forcing element to it?
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Maybe the conversation gave you an uncomfortable feeling—maybe your gut got tight and you got a brief, but powerful sinking feeling. In Internal Family Systems (IFS) that is called an Exile. It could be that you used logic as a way to try to make that feeling go away (in IFS that’s called a protector). Honesty might work better than logic. Consider saying, “When you said I wasn’t helping enough around the house, I felt bad, and part of me wants to fight you using logical sounding arguments.” Pure logic rarely leads to vital, mutually satisfying compromise.

Forcing Your Point Versus Compromise

We’ve all been there: the conversation is going smoothly, and all of a sudden we find ourselves trying to ram our points home. What happened just before you changed your tone? If you can be honest, you’ll probably find an Exile. Maybe an old feeling of no one listening or caring about your feelings came up. Or you felt an echo of an old feeling of not fitting in with the group, not measuring up.

If you notice a moment when you’ve started to force your point, you might be able to choose what you want to do, rather than charging forward with an attitude which you know will not help you get to compromise. Can you imagine yourself saying, “I don’t want to admit it, but a part of me feels just like I did when the other kids wouldn’t choose me for the team. And another part wants to force you to agree with me so I don’t have to feel that anymore.”

My Needs Versus Compromise

Do you find yourself defaulting to a subservient, submissive, surrendering position, and then getting resentful, depressed, or maybe angry? Do you think someone else’s reality is more valid than yours? Do you have Exiles (walled off parts of  yourself) who had this experience when you were young? Maybe powerful people made you agree with them, and the cost of fighting was too great.

You can acknowledge those young Exiles, find them in the rooms, porches, and yards where they live, re-playing their bad experiences. You can let them know you see them and understand them, and that they aren’t alone anymore. IFS teaches that direct contact between you and your parts opens up surprising, fresh possibilities. They may come to trust you, rely on you for help, and even stop flooding you with their bad feelings. If you can do that, you won’t have to rely on surrendering. You might find it safe and productive to speak up for what you believe, then watch to see how your partner responds.

Compromise Happens

Compromise happens naturally when you recognize the protectors that have come out to help you, and the Exiles behind them. It will be a fluid, fun, mutually supportive, brainstorming experience, and you’ll find solutions you never could have imagined beforehand.

The dreams we have for our families and children are full of deep expectations, some stated but many unspoken. This is true for families that have biological children and also for families who choose to foster and adopt. We want to make a difference in the world and love a child that needs us. We want to offer support, guidance, and opportunities to our children. The most frequent thing I hear from parents is, “I just want to help.” The best foster and adoptive parents know that helping a child involves more than just “wanting to”—it involves sticking in there when times get rough.

The Critical Point

In my experience, there tends to be a critical point in the journey of foster care and adoption when parents have to reconcile the difference between their initial expectations and their family’s current reality. I consider this the critical point because this is when placement disruption is likely to occur. Those of us that have experienced this firsthand understand that there is always a honeymoon period with a new placement. This time is filled with excitement and positive thoughts about the future. Though scared, the child may be on their best behavior: they are helpful with chores, follow the rules, attempt to build a relationship and may cheerfully fulfill their parent’s requests. For new parents, the placement may feel like bliss. The parents feel good about themselves and feel like they are making a difference.

Then comes the change—sometimes occurring slowly and sometimes what appears to be overnight. All of a sudden the sweet-natured child that you have grown to care about tells you that they hate you. They may leave the house unexpectedly and not tell you if they plan on returning, leaving you to worry and search through all hours of the night. They may refuse to follow the rules and start screaming hurtful remarks when you ask them to help with the dishes. They may tell you that you are an awful parent and that they want to move out. Some children may take this behavior to another level and resort to violence upon themselves or others. They may start attacking their siblings or getting aggressive with the family pets. They may make false allegations and tell their social worker that you are hurting them when you have done nothing of the sort.

At this time, it is incredibly important to make decisions about how to improve the situation and avoid a disruption in placement. Why do the children act like this? They are scared and lonely and testing whether you are going to love the “real them”—or kick them out like every other provider has in the past. Though it can be discouraging, all hope is not lost. Remember that there are peaks and valleys in behaviors and that these challenges will lessen over time given the appropriate support.

Before, during, or after this time of turmoil, it is common to have feelings of resentment toward the child you have chosen to bring into your home. You may feel exhausted and unable to manage their emotions in addition to yours. You may feel as though you are in over your head and are not skilled enough to manage what that child needs. Instead, you might feel as though this child screaming at you is not what you signed for and you worry about the impact on the rest of your family. It is also common to worry that your other children may pick up these behaviors and all of your hard work as a parent will be lost. You may realize that being a foster parent or adopting a child is not the same as what you expected it to be. You may think that you must be a glutton for punishment to do this work and you re-examine why you thought this would be a good idea. The worst part is that you are upset with yourself for thinking these things in the first place—all you wanted to do is “help,” right?

Working Through Resentment

The first step in working through the resentment is to acknowledge, truthfully, what your expectations were going into the process of becoming a foster/adoptive parent. Sit down and write out what your spoken and secret hopes and dreams were. Be honest about this because sometimes the secret and hidden expectations are the most important as they may reflect some core personal values that you hold about yourself, your family, and the world: What was the relationship you were hoping for? How did you envision the family dynamic?

Next, make a list of things that you felt blindsided by during this process: What has happened so far that you weren’t prepared for? What were you shocked by or scared of that you have seen your child do? What are your fears?

Third, you need to remind yourself why you are doing the work you do: What is your goal in becoming a therapeutic provider? How do you feel change is made?

Finally, re-examine your family goals with your revised understanding of your foster/adoptive child in mind and create steps you need to take in order to achieve your new and redefined vision of your family.

By doing these exercises you will gain insight into areas that you need help with in order to reconcile your feelings and get back on track with creating a therapeutic environment. You may identify areas or skills that could benefit from trainings, behavior coaching, support groups and/or therapy. You may also come to realize strengths in yourself that you never knew you had and may recognize your positive characteristics that led you to this challenging work in the first place. Remember that it is normal to feel resentment and that you are not alone. Most importantly, use these feelings to work toward being the therapeutic parent you are able to be.

The question often comes up among LGBT (lesbian, gay, bisexual, transgender) people: should they see a gay therapist, or would they would be comfortable with a gay-friendly therapist? This is a personal decision people need to make for themselves, but as in choosing any therapist, it is important to find a professional who has the education, the empathy, and the ability to understand your individual needs.

Although there are many gay-affirmative and gay-friendly therapists, sometimes it is important to find a therapist who is a member of the gay community. The process of therapy is a very personal one, and for many people it is vital that their therapist be someone who understands and can directly relate to their life experiences. For many LGBT people, there is an internal process that makes it important for them to work with a therapist who has direct knowledge of what it is like to live as a member of the gay community.

So what should you look for when choosing a therapist who specializes in LGBT issues? First off, if having a gay therapist is important to you as a client, then you should make sure you find a therapist who is open about his or her sexual orientation and is willing to openly discuss yours. A gay therapist who is comfortable with his or her own sexuality will be more open to discussing issues that you may be facing as an LGBT person.

But sexual orientation is not all that one should look for in a therapist. It is also important to ask questions about the therapist’s education, training, and understanding of the issues that can face LGBT clients. Your therapist should be familiar with issues of sexuality, coming out, internalized homophobia, HIV/AIDS, depression, and self-destructive behaviors, as well as more traditional issues like couples, dating, social skills, and relationships as they pertain to the LGBT population. Not all gay therapists will be experts on all of these topics, but you want to find the one who has the knowledge to address your personal needs.

Beware of therapists who promise to treat or “cure” homosexuality, as this type of therapy has been found to be unsuccessful. It can often be damaging and lead to low self-esteem, guilt, self-destructive behavior, and even suicide. A good therapist will assist you in finding your personal comfort with your sexuality and not try to “cure” or “fix” you.

Another issue that can come up for discussion in therapy is sex. For many gay people, it is important to have a forum where they can talk openly about sex and the myriad issues that surround intimacy. Ask your therapist whether he or she will be comfortable talking openly about sex and other personal issues that affect you as a client.

As much as it is important to learn about your therapist’s sexuality and commitment to working with LGBT clients, it is equally important to make sure that your therapist will maintain appropriate boundaries in regard to discussing his or her personal experiences. Under no circumstances should there be sexual contact or behavior between client and therapist.

An excellent way to find an LGBT therapist is to use the Advanced Search function here at GoodTherapy.org and enter the search term “LGBT Issues.” You can also check with your local gay and lesbian center, which will often have a resource list of local therapists who work with the LGBT community. Referrals from friends are another great resource in the search for a good therapist who can address your personal needs.

Finding the right therapist for you is vital in order to create the most beneficial outcome of your commitment to go into therapy. Take the time to interview your therapist, making sure that you find the right person who will be able to assist you in your rediscovery of yourself. Whether the therapist is gay or gay-friendly, the right match of therapist and client is the foundation for an exceptional therapeutic experience.