I hear your love and concern for your sister. There is nothing more painful than watching someone you love make choices you believe are harmful. Unfortunately, they are her choices. You will not get anywhere with your sister if you lecture her about the choices she is making. Letting her know (directly or indirectly) you think her boyfriend is a “loser” will most likely only serve to distance her from you and strengthen her bond to him. It also makes it less likely she would confide in you if she did have misgivings about her relationship or her choices; nobody wants to hear “I told you so” from anyone, particularly family.

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At 19, your sister is technically an adult. You characterize her behavior as stubborn. That feeling may be contributing to a dynamic that makes her believe you and your parents don’t respect her, don’t see her as a capable adult, and don’t understand her needs. Given that dynamic, of course she isn’t going to listen to you. She may insist on sticking to her (destructive) choices just to prove her independence. As long as you continue to approach her with opposition, little is likely to improve. Also, even if you were successful in “getting rid” of the boyfriend, that is no guarantee her life choices would improve.

May I suggest you reach out to her from a different place? Listen to her. Find out from her what works for her in her relationship. What draws her to her boyfriend?

May I suggest you reach out to her from a different place? Listen to her. Find out from her what works for her in her relationship. What draws her to her boyfriend? Let her know you aren’t trying to “meddle”; you are just trying to understand her choices. Lead from a place of love and compassion, not judgment and fear. You can also ask her if she’d be willing to engage in family therapy with you and your parents to see about changing your family dynamic, independent of the boyfriend.

The drug use is absolutely a concern. Not only are there potential physical, financial, and legal ramifications for what she is doing, but emotionally, it is likely distancing her more from you and your parents and connecting her more to her boyfriend as well as impacting her ability to make effective choices. Working with a family therapist and an addiction specialist (with or without your sister) can help you identify some effective intervention strategies. Attending a Nar-Anon meeting could also shed some light (again, with or without your sister).

Best of luck,
Erika

At least 30% of Americans have a fear of spiders, or arachnophobia. According to a new study published in Biological Psychiatry, just two minutes of therapy could eradicate that fear.

For most people, arachnophobia does not interfere with everyday life. In most natural habitats, however, people are usually not farther than a few feet from a spider. This means that for some people with arachnophobia, intrusive thoughts of spiders can become a chronic source of distraction and fear.

Treating Arachnophobia with Therapy

Lead researchers Marieke Soeter and Merel Kindt, of the University of Amsterdam in the Netherlands, wanted to explore whether memory reconsolidation, a treatment originally developed by neuroscientist Joseph LeDoux for the treatment of posttraumatic stress, could treat arachnophobia. The concept behind reconsolidation is to change the way the brain processes memories that may be upsetting, thereby altering trauma-related thoughts and behaviors.

Soeter and Kindt recruited 45 subjects with arachnophobia. Each group was exposed to a tarantula for two minutes, resulting in a predicted fearful response. After being exposed to the spider, half of participants received a 40-milligram dose of propanolol. The other half received a placebo. Propanolol is a beta-blocker but has also been shown to have amnesic properties.

[fat_widget_right]LeDoux’s idea of reconsolidation theorizes that fearful memories require protein synthesis in the brain’s amygdala. After these memories are retrieved, this protein synthesis makes the memories more susceptible to change, but only for a few hours. Thus treatment that occurs immediately after triggering the fear—as was the case with the people exposed to the tarantula—could help extinguish it.

As predicted, participants who received the beta-blocker experienced significant reduction in fear-related avoidance behavior. They were also more willing to approach spiders, even a year after the study.

Treatment Options for People with Phobias

Scientists have multiple approaches to treating fear. Some providers use cognitive behavioral therapy and medication, but this can require numerous sessions. Others offer a form of treatment called exposure therapy, which gradually exposes someone to a frightening stimulus. Though usually effective, these treatment options can be time-consuming and stressful.

The new study could offer a more cost-effective option for people seeking relief from phobias. More research is necessary to assess whether this treatment works with other phobias.

References:

1. Buddle, C. (2012, June 5). You are always within three feet of a spider: Fact or Fiction? Retrieved from http://arthropodecology.com/2012/06/05/you-are-always-within-three-feet-of-a-spider-fact-or-fiction/
2. Kaplan, J. S., PhD, & Toplin, D. F., PhD. (n.d.). Exposure therapy for anxiety disorders. Retrieved from http://www.psychiatrictimes.com/anxiety/exposure-therapy-anxiety-disorders
3. LeDoux, J. E. (2015). Anxious: Using the brain to understand and treat fear and anxiety. New York, NY: Viking.
4. Whiteman, H. (2015, December 14). How a 2-minute therapy could help cure fear of spiders. Retrieved from http://www.medicalnewstoday.com/articles/304048.php

Effective and meaningful communication is vital to human growth and function. However, the 21st century’s emphasis on speed has often produced quick results at the expense of quality and durability. These days we want our food faster and our coffee in an instant. Communication, like many other facets of human life, has been affected by our need for speed. The push for instant gratification has seen the rise of instant messaging. While getting the word out quickly does have its benefits, too often we focus solely on what we say rather than what we hear.

Why Listening Well Is So Important

A poll of 100 mental health professionals revealed communication problems is the most often cited contributing factor for divorce (65%). When considering divorce, 56% of women said their husband’s lack of listening was among their top communication complaints.

[fat_widget_right]Good listening skills can foster good communication and minimize misunderstandings. While other common relationship concerns—such as lack of emotional support, inability to resolve conflict, financial stress, and unfulfilled expectations—are serious issues within their own right, the application of good listening skills often means that many interpersonal conflicts may either be resolved more easily or avoided completely.

There are occasions when some conflicts become explosive and the situation may progress far more quickly than expected. In these circumstances, it may be important to slow down and listen. Listening well allows you to accurately gauge the situation from the other party’s perspective, discover the other party’s true concerns or needs, and respond in a manner that may quell the emotionally heated exchange. Poor listening skills, however, often contribute to poor communication.

Types of Listening Skills

In an effort to become a better communicator, learning and practicing different types of listening skills may be necessary. In many cases, we listen in order to learn facts, uncover emotions, or analyze a particular issue. Of course, the type of listening skill you choose to employ at a particular time will depend greatly on the setting, the audience, and your communication goals. After considering your circumstances closely, you may decide to use one of these types of listening:

Active listening – This skill encourages the listener to focus his or her full attention on the speaker. It involves repeating what the listener believes the speaker said, but in the listener’s own words. The listener may also express his or her understanding of the speaker’s psychological response to the situation. For example, an active listener may say “I understand you are upset that I borrowed your notes without asking.” The speaker may then confirm or clarify the listener’s understanding.

When listening, you may sometimes become distracted by your own thoughts. Perhaps you may be overly concerned about what you are going to say in response, or you may believe you already know what the speaker is about to say. However, active listening involves setting aside judgment during the listening process and using nonverbal communication—such as facial expressions, gestures, and other forms of body language—to show the speaker that complete attention is being paid to his or her message.

Reflective listening – This strategy is often confused with active listening as it too involves giving the speaker undivided attention, using nonverbal cues, and asking questions in order to confirm ideas or provide further clarification. However, while active listening encourages the listener to express what he or she thinks the speaker says or feels, reflective listening encourages the listener to reflect or mirror the speaker’s psychology and emotions so the speaker feels as if he or she is being listened to.

The goal of reflective listening is to provide support while trying to understand the speaker’s perspective. This approach can be crucial to maintaining romantic, business, and social ties as it demonstrates sensitivity to the speaker’s emotions.

Key points to remember during reflective listening include:

• Step back from your own emotions
• Look past the speaker’s behavior for underlying causes of the behavior
• Empathize with the speaker and mirror the speaker’s emotions
• Avoid using the word “why” when asking questions as this may be misinterpreted as the listener passing judgment or imposing his or her own beliefs on the speaker

Critical listening – This listening strategy is often used when the aim of the listener is to evaluate and analyze what is being said. Critical listening is often employed in situations that involve decision-making or problem-solving. Unlike active listening and reflective listening, which are both non-judgmental listening skills, critical listening involves the use of personal judgment.

Critical listening can be an excellent tool in academic or business contexts in which the primary goal of communication is to garner accurate information, compare it to what is already known, and apply it to situations in which it may be beneficial. A critical listener will ask questions about whether the information being transmitted is credible, logical, or being used for manipulation. As critical listening is usually results-oriented, it may be best used when neither the speaker nor the listener is overly concerned about his or her emotions during communication.

Ways to Apply Listening Skills

While it can be important for good communicators to learn good listening skills, it may be equally important to learn how to apply these skills effectively. To facilitate meaningful communication, it is recommended that the listener face the speaker and maintain eye contact. Not only can this approach minimize possible distractions, it can give the speaker the impression that his or her message is being taken seriously.

Listening well allows you to accurately gauge the situation from the other party’s perspective, discover the other party’s true concerns or needs, and respond in a manner that may quell the emotionally heated exchange. Poor listening skills, however, often contribute to poor communication.A good communicator should also be relaxed during conversation. Though an effective listener may be mindful of interrupting the speaker and only ask clarifying questions when the speaker pauses, he or she may send nonverbal cues to the speaker that can significantly affect the flow of communication.

Good communicators are also encouraged to keep an open mind, picture what the speaker is saying, and give appropriate feedback at appropriate times. This practice may put the speaker at ease—particularly if he or she is relating a difficult issue—and may prompt the speaker to provide more information than expected.

As social beings our quality of life is often dependent on meaningful communication with others, and the application of effective listening skills can be a big part of that effort. When properly used, these techniques can help enhance our marriages, families, careers, and more.

If your goal is to become a better communicator as you carry out your role as parent, partner, teacher, supervisor, or friend, try applying these strategies to your life. You may discover improvements in your personal relationships in the process. Being a good speaker is commendable, but if you want to be a good communicator, you may want to stop talking for a moment and listen up!

References:

1. American Psychological Association. (2004). Marital education programs help keep couples together. Retrieved from http://www.apa.org/research/action/marital.aspx
2. Bernstein, E. (2015, January 12). How active listening makes both participants in a conversation feel better. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/how-active-listening-makes-both-sides-of-a-conversation-feel-better-1421082684
3. Conflict Research Consortium, University of Colorado. (n.d.). Active listening. Retrieved from http://www.colorado.edu/conflict/peace/treatment/activel.htm
4. Deutschendorf, H. (2014, September 3). 5 ways to improve your listening skills. Retrieved from http://www.fastcompany.com/3036026/how-to-be-a-success-at-everything/5-ways-to-improve-your-listening-skills
5. Doherty, W. H. (n.d.). How common is divorce and what are the reasons? Retrieved from http://www.divorce.usu.edu/files/uploads/lesson3.pdf
6. Kilpatrick, J. (2015, May 31). Types of listening skills. Retrieved from http://www.livestrong.com/article/82419-kinds-listening-skills/
7. Poor Communication is the #1 Reason Couples Split Up: Survey. (2013, November 20). Huffington Post: Divorce. Retrieved from http://www.huffingtonpost.com/2013/11/20/divorce-causes-_n_4304466.html
8. Scott, K. (2015, September 8). How to connect with your kid using reflective listening skills. Retrieved from https://www.goodtherapy.org/blog/how-to-connect-with-your-kid-using-reflective-listening-skills-0908154
9. Schilling, D. (2012, November 9). 10 steps to effective listening. Retrieved from http://www.forbes.com/sites/womensmedia/2012/11/09/10-steps-to-effective-listening/
10. Taft College. (n.d.). Active listening skills. Retrieved from http://www.taftcollege.edu/lrc/class/assignments/actlisten.html

Thank you for your question, which sounds like just about every parent’s nightmare—one that’s more common than you might think.

For me, the key to the answer is in your last two questions. You seem to assume that you did something “wrong,” leading to feelings of guilt, shame, anger (at yourselves or each other and/or your son), and say you want to get your son “back.” I assume you mean the way he was before he took on the appearance of a “rebel” from a bad 1950s movie.

He is still the kid you love, still good—just struggling with something beneath all of that strange and troubling behavior. I would hesitate to conclude he is definitely “ruining his life” because I would bet, in the larger context of his life, his behavior probably makes some sense. Most teens go through a rebellious phase, whose aim in part is to annoy or even frighten the living hell out of parents. So I wouldn’t take the bait completely. Of course this is very concerning and needs to be investigated, and consequences are crucial (provided they are communicated clearly and enforced consistently), but something tells me “tough love” or drawing a line in the sand may only alienate him. The trick is reaching to connect with the kid behind all this behavior (fighting, smoking) that also keeps his teenage need for individuation and autonomy in mind. Not the easiest relational dance by any means, which is why the teen years can be very difficult indeed, and why a good school counselor or family therapist can help.

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Seeing this as a family problem, not his problem or your problem, is key. Drawing in teachers and school counselors is good, as is including the parents of the other “troublemakers” he runs with. Something is attracting him to this crowd; what is it?

And again, what was happening before? Was he a good student? Fortunately, this is all happening now more or less under your roof, which tells me this is in part a communication to you—a rebellious, perhaps angry communication at that. As if he’s saying, “I’m making my own rules, got it?” But what might be happening in the family dynamic such that he feels compelled to “say” and do these things? And why isn’t he fearful of consequences? The compulsion to do these things, which includes numbing or distancing from certain thoughts and feelings, means whatever feelings he’s pushing away and expressing via behavior are more powerful than the fear of going off track in school and developing “shady” friends.

Why might he identify with these friends, incidentally? Try to really put yourself in his shoes and forget black/white, right-and-wrong thinking. The harder you push for “the right side” of the line, the more he’ll likely stand on the other side and dig in. Welcome to the teen years. But keep in mind this may be the only way he knows how to express whatever is happening inside him, probably inexpressible.

Of course your concerns are understandable, given his behavior at school and his alarming drug/alcohol use. Yes, many teens experiment with booze and pot, but in this case 15 is pretty early for him to be using it in such a casual way (as opposed to sneaking a beer or joint with friends at a concert). Again, it’s as if he wants you to know about it, as it’s happening, right under your nose.

In some cases, children have tried to be “good” for so long that this goodness becomes a burden, often privately felt, leading to a swing in the opposite direction. Or there’s an anxiety or hurt that drugs and booze cover up. Could your son find some rebellious expression in arenas besides pot—such as music, drama, filmmaking, sports, etc.? Something assertively geeky or super cool where he can stand out and feel good about himself? Teens want to be cool and feel cool, in all ways, be it computer programming or punk rock. These other kids he hangs with make him feel cool, though I wonder why he has embraced this particular incarnation. Of course, many of our greatest innovators were rebels; the challenge is finding an outlet that is free from self-destruction and liberates/transcends rather than medicates the difficult emotions of adolescence. (It’s difficult for parents, too!) It’s likely that underneath all this tough-guy stuff is fear and/or anxiety. It sounds like you may be anxious also, which is why you need to be a role model of calm. Anxiety is contagious throughout a family “system.”

It’s good that he wants to feel cool and have friends; what’s not cool is that his current behavior will lead him nowhere positive in the long run.

Has your son demonstrated an interest in anything previously that might provide for his self-expression? Anything creative rather than destructive? Can you or a counselor or teacher help him find such a direction? Anything that can “hook” his interest can help him find a way back into engagement with school, such as a magnet school for music or technology, for instance. Volunteer work, too. Karate. Photography. Fly fishing. Think outside the box; offer him incentives for trying something new. Maybe his dad or grandpa or someone could even try doing it with him for the first time or two. I’d bet he has an untapped passion.

You and your husband ought to decide, first, what is and isn’t acceptable to you both. Make sure you’re both on the same page. The calmer you are in general, the safer he’ll feel bringing his troubles to you. I recommend tough love if and after the other ideas flop.

And now, consequences. I imagine you have leverage, since he’s 15 and, I’m presuming, approaching driving age. He’ll want driving lessons, need car insurance, and so on. Here’s where you get to be loving but firm parents and decide what is and isn’t acceptable. Anything less than a “B” average, for example, means no driving. Missing a curfew means no car (and possibly phone) for the next __ days. Drinking and driving means no car keys for the next __ months, minimum, and the loss of other privileges (social media, etc.).

You and your husband ought to decide, first, what is and isn’t acceptable to you both. Make sure you’re both on the same page. The calmer you are in general, the safer he’ll feel bringing his troubles to you. I recommend tough love if and after the other ideas flop.

Usually a child his age struggles with developmental challenges. He may not be completely comfortable talking to you about them, which isn’t your fault. Is there a school counselor or teacher who can get involved? What do these folks, probably seasoned observers of teens, think might be happening? What about the parents of his pals?

Does your son have an uncle or grandpa, some adult he trusts, who can spend some time with him and help him open up about what’s going on? Can they go to a movie or a ballgame? It takes a village, as they say, and parents are often the wrong messengers for the right message because of the rebellion factor. Also, children need to complain and gripe about their folks a bit; sometimes “delinquency” is a kind of grandiose, covered-up lament or expression of hurt feelings that they feel can’t be expressed any other way.

What do the parents of these “bad influences” have to say? The more communication among all of you, the better. You need to know where your son is, within reason, and to let him and his friends know that caring eyes are watching.

Also, what is your own attitude toward drinking and drug use (including pills)? That may have some bearing on your son, if you or your husband tip too far toward rigidity or looseness; at any rate, his drinking and smoking is a symptom of something deeper, but neither is helpful to his development if overdone.

It would be interesting to reflect upon how and when the “old version” of your son changed, and what may have been going on in the overall context of his life. We all change. But was there any big change? New neighborhood, new school, the loss of a girlfriend? If he is self-medicating with drugs and alcohol, why? What might be causing anxiety, worry, or other troublesome feelings? Is he worried about dating, college, becoming a man? I think it is important to remember he is still the boy you love, struggling as manhood fast approaches. It’s a confusing world, and teens are bombarded with all kinds of conflicting messages. Personal identity questions around freedom, autonomy, and self-expression are all being worked out, often awkwardly, as a new “family” of peers is developed. Again, the calmer you are—and the less your emotional security is dependent on his behavior—the better.

Also, what bothers you about this behavior? Are you concerned you or others will deem yourself a parental “failure”? Are you imagining the worst—i.e., he is headed for the penitentiary if this doesn’t stop yesterday? Are you already preparing the care package you’ll take to the visiting center, where he’ll be waiting in an orange jumpsuit? Try not to panic, as this may alienate him and scare him off. I know many productive, happy adults who went through a “dark period” in their teens. In fact, it’s better to get it out of the way now. He could also be testing you, to see how far he can go before losing (or not) your love of him. The trick as parents is loving the child without necessarily condoning certain behavior. Easier said than done. But he is and will always be your boy (even if he doesn’t express it that way). Often in the mid- to late twenties, there is a period of reconciliation where kids, now adults, realize how hard adult life really is.

Finally, the most important point of all, which may sound somewhat counterintuitive (but here goes): Take care of yourself. One thing parents forget, and I include myself here, is that we are most of all role models for our children, even when they act like we’re invisible (or annoying). Sometimes, our children will “counter-identify,” meaning they’ll take on the “reverse” identity of a parent, to distinguish themselves as different. Your son’s behavior is communicating something important to you, most likely unconsciously; it’s a good idea to try to “decode” what he’s trying to say. There’s no harm in some family therapy to seek some help in this.

Children often bridle at the implication that they are responsible for their parents’ emotional well-being. This only decreases and constrains the very freedom they’re itching to define. Of course parents get upset or angry or anxious when a child is in trouble—that’s normal—but I’m talking about something more profound, a core, existential sense of OK-ness. Parents who feel, consciously or not, that “my child’s ‘performance’ is a direct reflection of my own core worthiness” are setting themselves up for trouble.

I like the concept from recovery programs of “attraction, not promotion.” You want to provide an attraction to a peaceful sense of stability, calm, and strength which you personally embody. Not pounce and pick apart all of his behavior, which will only make him defensive and/or angry. In a way, you and his dad are the guardrails for safety, in deed and not just word. The guardrail needs to be flexible but not breakable, solid but not overly foreboding (or flimsy). Our children provoke our own need to grow and stretch as a person, and again there’s no shame in getting help. This might include therapy, Al-Anon, or a parents’ support group so you can learn from others—which would also be good role modeling for him. And any non-pressured family time, in whatever form (movies, ballgames, let him choose), will hopefully cultivate unity.

Finally, the National Institute on Drug Abuse has a page for parents on teens. There are other good resources for parents on the Internet also.

Thanks for writing, and warmest wishes to you and your family.
Darren

As the holidays and end of the year approach, many experience the recurrence of grief as they remember happy times with a deceased loved one. Loss and grief are among the most powerful emotions we can experience. When grief recurs, particularly in relation to the pain of holidays, it can be confusing and overwhelming.

During the holiday season, symptoms of grief that have previously relented might suddenly return, and it can seem as though one is actively grieving again. This experience is known as an “anniversary reaction” or “anniversary grief.”

[fat_widget_grief_right]The first year following a loss is considered the most challenging as a griever faces many new experiences for the first time without the loved one. Psychologist Dr. Therese Rando (1993) describes six processes necessary for healthy grieving. Among these processes is the need for readjustment into the world without the lost loved one. This is, perhaps, the biggest challenge faced during the first year after a death.

It’s common for waves of grief to overwhelm and disrupt the process of adjustment, as described by Rando. Although anniversary reactions can occur for many years following a loved one’s death, they are usually felt most keenly during this first year as milestones are confronted. Holiday milestones can be particularly difficult as anticipation builds.

The deeper truth of loss is that we are never truly finished with grieving when someone significant to us dies. However, there are many ways to live with the loss without suffering from it.Symptoms can include anxiety, anger, and difficulty sleeping, including waking up early or falling asleep. Sadness, crying, fatigue, difficulty concentrating and focusing, and loss of interest in social activities can also be common. Additionally, symptoms may be more than emotional changes. Often, intrusive memories of the loss and memories of past celebrations return.

The deeper truth of loss is that we are never truly finished with grieving when someone significant to us dies. However, there are many ways to live with the loss without suffering from it. It is important to know the return of grief is a normal part of the healing process.

Here are some suggestions to manage the reactions to anniversary grief during the holidays:

• Change holiday gatherings to limit painful reminders. Gather for a breakfast meal instead of the traditional dinner and consider having another person host the holiday if you traditionally did so.
• Consider volunteering for a charity activity as a way of honoring the lost loved one.
• Use your support system and reach out to friends and loved ones to help you through. Tell them which memories may be most difficult and how you would prefer to handle them. Give yourself permission to limit participation in family or social gatherings as needed. Be mindful of your support system during these times, and remain connected.
• Reconnect with a counselor or bereavement support group.
• Be gentle toward yourself and handle your memories with care. You can choose which memories to focus on and decide to release particular memories if they create longing or hold you in the past in an unpleasant way.
• Calm your pain by focusing on both the sad and happy memories shared with your loved one. Recalling happy memories can help ease the pain of the loss.
• Create space to intentionally remember and grieve regularly. Use this time to consciously recall memories and set the memories aside. Some find it helpful to imagine a container for these memories, which can be opened and closed as needed.
• Rituals and memorials are helpful for acknowledging the anniversary while also containing the emotional intensity of the event. Draw on your culture, family traditions, and religious or spiritual beliefs to guide you in the creation of a meaningful remembrance.

References:

1. Corr, C. A., Nabe, C. M. and & Corr, D. M. (1997). Death and Dying, Life and Living, Pacific Grove, CA: Brooks/Cole Publishing Company.
2. Rando, T. A. (1993). Treatment of Complicated Mourning. Champaign, IL: Research Press.

It has been more than 30 years since Dr. Patrick Carnes published his book, Out of the Shadows: Understanding Sexual Addiction, which introduced the concept of sexual addiction. One working definition of sexual addiction is a pathological attachment to a mood-altering experience of sex.

At that time, the focus was almost entirely on males who were addicted to sex. But new ground was already being broken. When I first met Jennifer Schneider—an Arizona psychiatrist—in the early 90s, she and a colleague had recently completed a book about couples recovering from sexual addiction.

Schneider and her colleague obtained detailed information about married females who were addicted to sex. Twenty-four women and 17 husbands were interviewed by telephone; 7 of the male spouses declined to take part in the survey. The findings were provocative back then, but they are confirmed by my own clinical observations over the years.

Gender Differences in Sex Addiction

Unlike the majority of men with sex addiction, most women are aware of their codependency when they initially begin therapy with me—either alone or with a partner. Codependency can be briefly described as looking outside oneself to other people in order to define self-worth.

[fat_widget_sex_right]This makes the early stages of recovery particularly difficult for women who are sexually compulsive. Initially, a period of abstinence is important in order to learn to maintain sexual boundaries. But that requires being able to say no without it affecting self-worth. As one woman in therapy put it, “I don’t want to deprive him or drive him to look elsewhere for sex!”

I find that is rarely a problem for a man choosing a period of abstinence. Unfortunately, this culturally learned gender difference makes it much more difficult to rebuild marriages in which the wife is sexually compulsive. Females with sex addiction often feel alone and unsupported as they work toward recovery.

Steps for Women in Recovery

In order to appreciate the complicated nature of sex addiction for women, it’s important to recognize how terrifying psychological isolation can be. One woman told me, “I feel ashamed that I feel lonely even in my marriage, like something in me is broken and defective.”

Consequently, women in recovery benefit most from a combination of supportive individual therapy and group experience, both 12-step and therapist-led. In 12-step meetings such as Sex and Love Addicts Anonymous (SLAA), participants share experiences, strength, and hope. In her book, Ready to Heal: Women Facing Love, Sex, and Relationship Addiction, author Kelly McDaniel lists some of the numerous benefits:

• A sense of belonging
• Seeing and being seen
• Having a voice
• Supporting others when they have a turn to speak
• Giving and receiving comfort when life is painful

You may not be able to heal your brain alone, and the brain usually doesn’t function at its best capacity when you are isolated. Therapy can provide a trusting relationship and a healthy context for healing.Healing relationships requires healing the mind and the lifelong patterns that have shaped responses to the people closest to you. When your mind is fearful, you may have problems trusting or acting outside of your truest morals and values. Women with sex addiction may have difficulty being their best selves, and many of their sexual behaviors may have fallen outside their value system.

Healing your life also means healing your brain, and this may require professional support. Sexual addiction thrives in isolation. You may not be able to heal your brain alone, and the brain usually doesn’t function at its best capacity when you are isolated. Therapy can provide a trusting relationship and a healthy context for healing. McDaniel makes these suggestions for being a careful consumer when you’re ready to find a therapist:

• Consider finding a professional who understands brain chemistry, the effects of trauma, and the subsequent need for an addiction.
• Look for a therapist who understands sex addiction and can guide you through the process of designing a treatment plan that will best address your particular situation.
• Most important, your therapist must be able to facilitate a relationship with you that is collaborative and respectful. If you feel awkward in your first session, listen to your intuition. Trust your heart to be your guide in finding the right professional.

Women experiencing sex addiction today have a much greater chance of finding a caring and well-trained professional than their mothers may have had. You owe it to yourself to find the best help possible.

References:

1. Carnes, P. (2001). Out of the shadows: Understanding sexual addiction (3rd ed.). Center City, MN: Hazelden.
2. McDaniel, K. (2008). Ready to heal: Women facing love, sex, and relationship addiction (2nd ed.). Carefree AZ: Gentle Path Press.
3. Schneider, J., & Schneider, B. (1989). Rebuilding trust: For couples committed to recovery. Center City, MN: Hazelden.

In the face of our depressed moods, friends, loved ones, and even our therapists may say things like, “Stop doing that to yourself!” or “Get over it!” We may even say to ourselves, “Why can’t I just get over it?” These forms of “psychotherapy” usually come from a loving place but often turn out to be ineffective. But why? Why is it that we can stop ourselves from doing certain things (touching a hot stove, for instance), but when it comes to the low energy, hopelessness, helplessness, and self-attacking thoughts of depression, we can’t “just get over it”?

When ‘Get Over It’ Does Work

Believe it or not, as a therapist I spend a fair chunk of my day using a form of “Stop It!” therapy, often with success. When a person is (1) in conscious control of a behavior, (2) no longer wants to do it, and (3) wants my help to stop, challenge (Abbass, 2015) or response-prevention interventions can be quite effective.

“Get over it!” is a form of challenge or response prevention—it says, “Stop doing the thing that hurts you!” When you look at it that way, you can see the loving core of the comment. When someone asks me for help with a pattern they know is self-defeating, such as stubbornness or detachment, but they intentionally continue to do it, challenging them with a “don’t” intervention is one of the most compassionate, helpful things I can do.

When ‘Get Over It’ Doesn’t Work

When someone has conscious control over a behavior, “get over it”-type interventions can help, but my clinical work looks much different when the self-defeating pattern is unintended or unconscious, habitual, or automatic. Decades of clinical research in intensive short-term dynamic psychotherapy (e.g., Abbass, 2015) have shown that a portion of those experiencing depression have symptoms driven by an unconscious emotional process—a process that, at least at the start of therapy, occurs automatically and is entirely beyond their control.

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In ISTDP, we call this process “repression” or “instant repression”—the process by which mixed emotions toward another person are instantaneously and unintentionally shunted back against the self, either in the form of depression or somatic symptoms (this is a slightly different definition of repression than in psychoanalysis).

Often, people who experience repression-driven problems never recognize they were mad at someone else; instead, they are instantly overcome by a process of self-blame and self-torture that leaves them feeling fatigued and hopeless. At no point did they decide to do this. Before therapy, this is just how their brains are wired; they automatically say, “When I feel anger toward someone I love, I protect them by pointing it back at myself.” Considering the people we love most are the most likely to irritate us, this is a potentially dangerous state of affairs.

Saying ‘Get Over It’ to Someone with Repression

So what happens when we say “get over it” to someone with depression that is driven by unconscious repression? Here, the “get over it” confronts the depressed mind with an impossible task: (1) gain conscious control of an unconscious process that is currently operating out of your awareness, or (2) do a thing you simply can’t do (yet).

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self. Instead of lovingly reducing the person’s symptom burden, then, the “get over it” would actually make symptoms worse by activating anger that will be sucked back in via repression.

When people, especially people we love, challenge us to do something that is impossible, it triggers anger, and in the depressed mind where instant repression is still active, that anger will deflect right back onto the self.

‘Get Over It’ and Psychotherapies for Depression

Some therapies encourage us to challenge, question, or detach from our depressive thoughts and moods. Other therapies encourage us to get up and do something even when we have no energy. Sometimes, for some people, these approaches produce positive benefits.

My concern, however, is that for folks who have depression caused by unconscious repression processes, questioning their thoughts implies, “Don’t think that,” and encouraging different behaviors implies, “Don’t be like that.” These both sound a lot like saying “get over it” to someone who is not in conscious, intentional control of the symptom; asking them to do something different when they literally cannot. This could trigger anger toward the therapist that will get shunted into repression and lead to worsened therapy outcomes. No one wants that.

How ISTDP Can Be Useful

ISTDP is an ideal therapy for building the capacity to become consciously aware and tolerant of the mixed emotions that usually get deflected back on the self in repression-driven depression and somatization. When working with people with depression in ISTDP, the therapist is in a largely supportive mode, helping people self-reflect on and feel the feelings that were previously getting automatically and unintentionally converted into depression or somatic symptoms. This builds affect tolerance—the ability to feel feelings while still being able to think clearly and channel them in a satisfying way.

This process helps people with repression because, rather than telling them what not to do or what they should do, it gives them another option—it helps them become more comfortable with their emotional reactions so they can then decide how to channel their emotions. In ISTDP, what people wind up “getting over” is the destructive way their mind would unconsciously bury mixed emotions. Once they can think clearly while being in touch with their emotions, rather than being unconsciously overwhelmed by those emotions, they can then make wise, authentic decisions about what to do.

Reference:

Abbass, A. (2015). Reaching through resistance: Advanced psychotherapy techniques. Kansas City, MO: Seven Leaves Press.

So often when I ask people in my therapy office (mostly children and teens) to brainstorm strategies for coping with certain difficult situations, the initial answer I get is something along the lines of “I need to toughen up,” “I need to just deal with it,” or “I’ve got to be a man.” The difficult situation itself could be a disagreement with a sibling, a problem with a peer, or an uncomfortable issue with a teacher at school.

Children pick up these quick-fix mantras from a variety of places—television, school, peers, and parents among them. When a child gets emotional, often the quick, easy fix is to say, “toughen up,” especially when whatever caused the child to be upset seems minor. The message is clear: Let’s move on, kid, because we’ve got things to do and worrying about this doesn’t fit into my schedule.

Is there anything wrong with that? What, if any, damage is done when a child is told to “toughen up”? Let’s break down the ripple effect this type of response has on a child’s psyche over time.

• Five minutes later: The child feels minimized. The situation that caused the initial reaction has been left unresolved. The child may be thinking he or she is dumb or weak for bringing up the situation in the first place. He or she may also resent the person who instructed the child to “just deal with it” because that person doesn’t seem to care. [fat_widget_right]
• Five months later: The child hesitates to mention a problem when it occurs, fearing the reprimand of not being “tough enough.” This teaches the child to “stuff” emotions instead of verbalizing them and learning to process them. Acting out may increase as the uncomfortable emotions aren’t dealt with promptly. For their part, the adults in the child’s life may not understand what is causing the unwelcome behaviors. If an adult attempts to discuss the child’s emotions, the child may resist and have increasing difficulty sharing those emotions because he or she has been taught to ignore them.
• Five years later: The child—perhaps now a teenager or young adult—has a difficult time empathizing with others about their emotions because he or she expects others to “toughen up” or “deal with it” when something doesn’t go their way. The child may be more likely to perpetuate the belief that many emotionally difficult situations should be ignored.

The biggest problem with telling a child to toughen up is that it undermines true resilience, which is learned by experiencing adversity or uncomfortable feelings, processing why they occur, and learning new and more positive ways to reframe those situations.

There is, of course, something to be said for “letting go” of certain minor situations that are upsetting. However, that needs to come from within the child and not from the belief that getting upset by something means there is something wrong with him or her.

Why ‘Being a Man’ Isn’t All It’s Cracked Up to Be

Finally, a note about boys who think they need to “be a man” when something doesn’t go their way: The children I see in my practice who use phrases such as this are, in my experience, more likely to be aggressive in the responses they give others.

Aside from what it suggests about being a woman, the phrase “be a man” has a sense of machismo associated with it that indicates a need to be strong and aggressive. In today’s world, acting on this impulse (at school, for example) may lead to discipline problems and resolves few. It perpetuates stereotypes many boys may not feel they fill as adults and reduces the likelihood they will seek help for emotional or mental health concerns because “being a man” means ignoring those feelings.

Many couples experience a surge in sexual excitement and activity when they begin to try for a baby. They may be suddenly free from hormonal birth control methods or the barrier sensation of condoms and often feel they have a closer and more intimate connection than before.

However, after a short time, if a baby has not been conceived, this heightened sense of intimacy and sexual excitement may fade. What typically replaces it is a sense of monotony and routine—sex by schedule, goal-oriented sex, sex under pressure—as well as anxiety, grief, and loss and lowered self-esteem. The emotional ups and downs can be hard for people to endure time and time again. Hope is erased by the first sight of your period, and then sadness and grief take over.

Sometimes, partners experience guilt on top of all these other emotions. Is it my fault we are not getting pregnant? Is it his fault we are not getting pregnant? Are we doing it wrong? Could we have done something differently? Is it because I did X, Y, or Z? Many people also feel guilty that they want sex only in order to conceive. What’s wrong with me that I don’t desire my partner sexually except to make a baby?

This can be an extremely difficult time for couples. They often feel alone, especially when they see “baby bumps” and strollers everywhere they go. The pressure to conceive often colors the mood and trajectory of the sexual relationship.

Here are some recommendations that may help you continue to enjoy sex while going through the process of trying to conceive:

1. Even if sex is planned or scheduled, don’t forget the foreplay, take your time to turn-on both you and your partner. Sex doesn’t have to be rushed just because you “have” to do it. Try setting a timer for 30 or 45 minutes and don’t begin intercourse until that timer goes off. This may help you focus on becoming aroused, touching each other, and enjoying one another. Take time for sexual arousal to set in explore your partner’s body and pay attention to all of your partner’s erogenous zones for a better sex experience.
2. Focus on pleasure and the female orgasm. Many women struggle to orgasm through penetrative sex alone and require clitoral stimulation. This is nothing to be ashamed of and most of the time can even highlight both partners’ sexual experiences. Though many assume the male ejaculation is all that’s really needed to create a baby, there are a lot of benefits to focusing on pleasure and even female orgasm. In one study, researchers R. Robin Baker and Mark Bellis found that female orgasms that happened between one minute before the male ejaculated up to 45 minutes afterward led to higher levels of sperm retention. Furthermore, getting into the habit of having sex only for procreation may bring about reduced interest in sex on the part of both parties. Once a couple gets into the habit of having sex as a matter of routine and without much arousal, it can be hard to get out of that habit.
3. Try something different. Many couples get in sexual ruts from time to time. Consider changing the environment. Even having sex in the shower, in another room, or adding some new lingerie or candles can enhance the experience and make it feel less routine. Consider adding sex toys such as a vibrator to enhance her sexual pleasure. Consider starting with a different sex position than you normally would new positions can take good sex, to great sex. Other ways you can make your sex life feel less routine are adding lube, roleplay, and even oral sex can help reawaken your partners sex drive.
4. Remember it can take time. It’s important to know that, for many couples, it can take several months to a year or more to conceive. Try not to get discouraged, exercise self-compassion, and give yourself the benefit of patience.
5. Talk to your partner about your experience and listen to your partner’s experience. Grieve together. Share feelings. Remember people experience loss differently. Although your partner may not cry in front of you, it does not mean he or she does not feel sadness. Share your feelings, but don’t expect your partner to feel the exact same way you do. Listen and be compassionate. Relating on this shared experience grows emotional intimacy, which will help you have greater sexual intimacy as well.
6. Consider taking a break from “trying.” Take a break from scheduled ovulation times and just have sex when the mood arises. Not only might this kindlesexual desire, it may relieve some of the pressure and anxiety you both feel.
7. Talk to someone in your support system outside of your partner. Be selective about who you talk to because some people may not be as helpful as you may like. Some people may give you all sorts of unwanted tips and “old wives’ tales” about what they heard will help you get pregnant. Some may be overly intrusive. Select a few trusted people to talk to, such as close friends, family members, or a therapist, who can help meet some of your emotional needs. Remember that your partner is also going through this difficult time and may not be able to fully support you the way you need because he or she is going through his or her own process as well.
8. Schedule date nights or other fun activities you enjoy outside the bedroom. Having more fun together may remind you that you’re not just “partners”—you really like and love each other. Those positive feelings may carry over into sexual activities. Be sure to take the time to cuddle and embrace each other afterward.

If you’re having difficulty conceiving, you are not alone. Reach out to your support system, get the medical attention and therapeutic support you need, and focus on what you love about your partner. Sustain emotional intimacy and focus on the pleasure of being together by not rushing to the male ejaculation. Extend foreplay and remember that just because sex may be scheduled does not mean you cannot also experience pleasure and even orgasm.

Reference:

Baker, M. M., & Bellis, M. (1993). Human Sperm Competition: Late Manipulation by Females and a Function for the Female Orgasm. Animal Behavior, Vol. 46, 887-909.

© Copyright 2015 GoodTherapy.org. All rights reserved. Permission to publish granted by Mieke Rivka Sidorsky, LCSW-C

We’ve all had moments where we felt completely spaced out. What is normal, and when do instances of mental escape become a cause for concern? Dissociation, or the feeling of being disconnected or separated from oneself, is a common experience, especially as a means for coping with or escaping from stressful situations.

I like to explain dissociation on a continuum. At one end there is “normal” dissociation, the kind we all do at times. A popular example to describe simple and typical dissociation is driving your car on autopilot and not really paying attention to the road ahead, yet managing to safely make it to your destination. Another example is when you are completely absorbed in a movie until the person next to you reaches for the popcorn and your awareness snaps back to the present moment. These moments of “escape” happen occasionally and are a normal part of the human experience.

A little further down the spectrum is the type of dissociation used as a defense mechanism to cope with stressful situations or feelings of being completely overwhelmed. People will sometimes describe themselves as detached, “out of it,” or even as if they are watching themselves from an out-of-body perspective.

At the other end of the spectrum is a mental health diagnosis called dissociative identity disorder (DID). Previously known as multiple personality disorder, this condition involves dissociation so extensive that it results in a complete split, or compartmentalization, of memories and experiences that ultimately become separate and distinct personalities. Different personalities are often referred to as “alters,” while the main identity is typically called the “host” personality. Together, the various personalities make up a system that initially served to help an individual cope with experiences of extreme and repeated trauma, often including severe sexual or physical abuse at a young age.

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‘Alters’ and Dissociative Identity

DID is often difficult to comprehend, and the multiple personalities within a person with this diagnosis are sometimes hard to recognize or believe until a personality shift is witnessed within the person. Each personality serves some type of purpose for the host person. For example, one alter may be the “playful one,” while another is the “protector” or “helper.” Each alter has his or her own interpretation of events and, often, only certain alters will remember the details of the trauma that occurred.

Different alters typically have their own names and distinct traits. They may speak in different accents and tones, display different mannerisms and body postures, and dress differently from one another. They each have their own idea of how they look, and sometimes it’s vastly different from the host person’s actual appearance.

A person with DID often has alters of different genders than the host person’s true gender, and they may have personalities who are “stuck” at younger ages than the host personality’s actual age. For example, an adult experiencing DID might have an alter personality who is 5 years old and is interested in coloring or playing with dolls. Each alter may have a unique set of talents and hobbies, and some may even speak different languages.

DID After Surviving Trauma

While DID is initially a coping mechanism the brain employs to allow a person to survive extreme trauma, it can lead to difficulties as the host person grows up and tries to interact in a world where this level of dissociation is not widely understood. Individuals with DID are often misperceived and sometimes called liars because the stories or actions of different alters don’t add up.

Although the trauma may have ended, the barriers in the mind remain and can lead to confusion for the individual, who may also experience co-occurring symptoms of depression, anxiety, and posttraumatic stress. Sometimes, certain alters may develop self-destructive patterns, such as drinking excessively, behaving recklessly, and engaging in actions to sabotage the host personality’s efforts to stay healthy. Some alters may have suicidal thoughts or attempts.

A person experiencing DID who ends up in the hospital may often be misdiagnosed since hospital staff may only see a snapshot of the system and issues. Incorrect diagnoses often include major depressive episode, bipolar, substance abuse, and schizophrenia.

The following indicators are often displayed by individuals who experience DID:

• Gaps when recalling daily events
• Repeated mentions of losing time or blacking out
• Wearing clothing they don’t remember purchasing
• Finding themselves somewhere with no knowledge of how they got there
• Finding notes or drawings they don’t remember creating
• Not remembering conversations, events, or experiences with others

How Dissociative Identity Disorder Is Treated

Treatment for DID involves long-term, consistent therapy to break down the “walls” in the mind. This involves gaining an understanding of each alter and processing their various experiences, including those that involve the original trauma. Consistent treatment can sometimes be difficult because certain alters may be resistant or skeptical Some people with DID fear the loss that may occur from “curing” them of their personalities. Rather than getting rid of each personality, the goal is to assimilate the positive and functional aspects of each alter in a way that helps the person feel more balanced and less chaotic.of help. Also, dealing with arising crises within individual personalities may delay the course of trauma treatment. A good rapport between the person in therapy and therapist is essential.

The goal of treatment is often referred to as “integration,” which involves bringing together the fragmented and compartmentalized parts of the person’s memory. Some people with DID fear the loss that may occur from “curing” them of their personalities. Rather than getting rid of each personality, the goal is to assimilate the positive and functional aspects of each alter in a way that helps the person feel more balanced and less chaotic.

While DID can be a complicated and frustrating condition for individuals who live with it, it is important to remember that dissociation is a natural mechanism of the brain and can work as an extraordinary process for ultimately surviving horrific experiences.

Most of us take care of others at some point, sometimes putting their needs first or focusing on helping them out of tight situations. In the 1930s, the term “codependent” was introduced to describe the partner of someone who is addicted to alcohol. What constitutes codependency was later broadened to include a wide spectrum of behaviors, from substance use to compulsive gambling to sex addiction. Codependency also expanded to include relationships in which the other person’s needs are always put first, often to the complete exclusion of a person’s own needs. It may be believed that if this is done, self-sacrifice will be recognized, reciprocated, and rewarded by the other person.

In the following fairy tale, titled “The Wife Who Refused to Bury Her Husband,” consider how codependency often plays out:

There was once a woman who loved her husband very much. Her husband became ill, and after a long time he died. The woman didn’t know how she would carry on without him, and the thought of putting him into the cold ground, casting dirt down on top of him, and leaving him all alone in the graveyard seemed unbearable to her.

So she didn’t bury him. Instead, she kept him in their bed, where he had died. She continued to take care of him, bringing him bowls of good, warm broth (for which, of course, he never thanked her), and spending what little money she had on medicine for him (which he never took), and putting bandages on him (which did no good at all). Every night, she slept next to him.

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As you can imagine, the situation became challenging. Insects and other vermin came into the bed where the woman slept each night. As nature took its course, which nature will do, her own health was put at risk. Sometimes as she lay there, trying to sleep, she wept bitterly because it seemed her husband didn’t appreciate anything she did for him. But then she would rally herself: “I just need to take better care of him, that’s all. And besides, I couldn’t live without him.”

The tale opens with the woman’s husband having just died after a long illness. He’s no longer present in the relationship. People we love may become increasingly unavailable when practicing an addiction. Untreated, addictions also tend to get worse over time. William G. McCown and William A. Howatt, in Treating Gambling Problems, describe the phenomenon of “motivational toxicity,” which is the decreasing ability to be motivated by anything other than the addictive experience.

There’s another sense in which a partner or loved one can seem to be “dead.” One aspect of codependency is to always put the other person’s needs foremost and to expect that person to take care of our needs without having to mention them. When this doesn’t happen, people may perceive the other as ungrateful and unresponsive. Another aspect of codependency is the desire to manage and manipulate others. In this sense, one person becomes an object of another person’s management. Rather than experiencing that person as a subject, the way you might experience your own existence in the world, that person experiences the other as something to be controlled and arranged to best protect a sense of safety.

In the fairy tale, the woman is unwilling to bury her husband even though he’s dead. The idea of consigning him “into the cold ground” is unbearable to her.

Being buried is a natural consequence of having died, and so the woman is trying to protect her husband from this consequence. She appears to be confusing her own responses for his. The husband shows no fear or reaction to hot or cold, to loneliness, or company. Sometimes in addiction, nothing impacts the person who is addicted until that person bottoms out—in other words, the addiction no longer protects the person who is addicted from any painful feelings. Hitting bottom is how many people enter recovery.

Sometimes people with codependent patterns of behavior believe that the other person can’t live without them. In a domestic violence situation where an individual isn’t yet ready to exit, he or she might find grounds for staying with the idea: “I’m the only one who can really understand and help my partner.” This person might think he or she is a partner’s or loved one’s last and only chance for living a good life, or even staying alive. Paradoxically, this seems to make an individual feel very important, essential, almost as if the other person carries him or her as the reason for living.

The woman in the fairy tale cooks her husband nourishing meals and uses her money to buy him medicine and put bandages on him. Jennifer Sowle, in The Everything Guide to Codependency, notes, “If you are codependent, you are not powered from within; your quest for power is through controlling others.” We observe this in the woman in the fairy tale as she attempts to do just that. She tries to control something over which she has no control—trying to make her husband “get better,” although he’s in a state she can’t affect.

This may be reminiscent of some of the arrangements a person experiencing codependency might try to make, at great cost. Sometimes these arrangements are financial—bailing someone out of jail, paying a person’s debts, or providing someone with another stint in detox. Often, it’s in the form of energy someone expends and the wear and tear on his or her heart as the other person says they’ve changed and this was the last time they will strike him or her, or have an affair, or go out on a bender. But the promises an addicted loved one makes aren’t always reliable indicators of change. In the story, the husband is dead. Therefore, he’ll continue as he’s going, and the deterioration will continue as well.

As the woman keeps her dead husband in their bed, in the natural order of things, he begins to decompose. This places her at risk. Addiction often brings chaos, and things can fall apart. Consequences can include legal issues, or What could the woman in the fairy tale or anyone do in order to implement boundaries? She might begin by identifying the needs she has in her relationship and assess whether those needs are being met. She might take a moment to reflect on who she is apart from the relationship—what does she like, dislike, believe in, or do for enjoyment? having people present in the home and in a person’s life who aren’t wanted, from social workers to pushers to other people who are addicted to creditors of past-due debts. These natural consequences will affect the partner who is codependent or family members, as well as the person who is addicted. If the woman was going to do something effective, what would it be? Would it be to focus on her husband, trying to get him to respond and change, or would it be to focus on her own behaviors?

“And besides, I couldn’t live without him,” the wife says, which brings us to the heart of the matter. In Breaking Free of the Codependency Trap, Janae B. Weinhold and Barry K. Weinhold note, “You started out as a helpless infant who could not survive without the care of your parents.” As infants, people depend on their caregivers absolutely. It’s quite possible to love and cherish others, to love life in general, and to value your own life, but for those who experience codependency, the idea may be that their life somehow depends on their partner or loved one’s life, and that their partner or loved one’s life should therefore be responsive to their control, which indicates a confusion of boundaries.

What could the woman in the fairy tale or anyone do in order to implement boundaries? She might begin by identifying the needs she has in her relationship and assess whether those needs are being met. She might take a moment to reflect on who she is apart from the relationship—what does she like, dislike, believe in, or do for enjoyment? She might notice that her husband’s condition is just that—his—and that if she continues trying to rescue him from it, she’s depriving him of the chance to learn from his own life (or death, here).

As she becomes more aware of her own needs, she might notice what she doesn’t want around her. She might say to her husband, “If you’re not going to eat the soup I make for you, then I’m not going to make soup for you,” or, “If you’re going to be in our bed, you may not bring insects and vermin in. If you do, then you’re no longer welcome in our bed.” By setting these boundaries and enforcing the consequences, she may come to a place where she can assess whether she wants to continue with her husband the way things are, or whether she wants to implement change in the relationship.

Meanwhile, the hope is that the woman will begin her own inner work, wake up some morning soon, and realize what she’s in bed with.

We can’t do much about anyone’s addiction because it’s not ours to do anything with. Finally, recovery is a choice for the person who is addicted. It’s a choice that may not be selected, but we can choose a path for ourselves. We can choose to bury the past, mourn for what’s lost, and move on.

If you tend to isolate from others, you may notice it’s a double-edged sword: isolating can provide needed relief from anxiety (and other strong feelings), yet it can cause you to feel depressed, down about yourself, and reinforce the belief that you cannot handle life. It is an avoidance strategy and, like all such strategies, could create more problems than solutions over time.

I’d like to briefly explore isolation and its function, origination, and costs as a way to help people transition from habitual responses to their feelings to more dynamic responses.

What Constitutes Isolation?

Isolation can take many forms. You might isolate by being alone in your home and avoiding social contact. You might isolate by looking at your phone obsessively, watching television excessively, or overworking. You might isolate in relationships by fantasizing about other people. These are, of course, just a few ways.

Isolation is not necessarily a strictly physical act; it’s also a mental one. It is a state of mind in which you protect yourself from the uncomfortable feelings inside of you. Sigmund Freud described isolation as a mental process that creates a gap between unpleasant thoughts/feelings and other thoughts/feelings. As a result of this process, you may be more likely to be drawn to physical forms of isolation as well (staying home alone, for example).

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What Function Does Isolation Serve?

If you isolate, you may have a visceral response to the question above. Isolation may feel comfortable, a relief from the “craziness” of life, a reprieve from the judgment of others, a break from anxious thoughts.

It also might be a place where you feel more enlivened. Depending on what thoughts and feelings you are beset by, isolation can provide a sort of respite.

Where Does an Isolating Strategy Originate?

Isolation is a strategy you likely developed early in life to cope with emotional challenges you experienced in your family and the intense feelings those challenges evoked. A child’s inherent temperament and family conditions play a role.

If you tend to isolate, it is possible that your temperament is such that you emotionally pull back naturally when you feel anxious, fearful, or even angry. You may have withdrawn from your family as a child if you didn’t get essential emotional needs met: you likely felt unsafe, misunderstood, or ignored. Either way, isolating was your way to protect yourself from the pain (and rage) associated with those unmet needs.

Isolation is not necessarily a strictly physical act; it’s also a mental one. It is a state of mind in which you protect yourself from the uncomfortable feelings inside of you.

What Does It Take to Recover from Isolation?

Recovery from isolation takes time. There are strong, deeply held forces pulling toward isolation when you feel the feelings (anxiety, rage, fear, grief, etc.) that seemed intolerable as a child. Because isolation is a strategy that occurred in the context of relationship (to your parents), the safety, continuity, and framework provided by psychotherapy or psychoanalysis may be key to recovery.

In psychotherapy and psychoanalysis, many of the obstacles to observation are removed. A therapist/analyst, trained to observe and point out the elements of isolation as it occurs in a therapy office, can also point to its effects: the way it can cause you to feel alone, suspicious, and detached from the life-giving energy of your feelings.

Over time, through the process of studying your isolation, you may begin to feel how painful of a strategy it can be. Getting in touch with this pain is essential. In doing so, you may begin to see that you can, in fact, tolerate strong or unpleasant feelings. This has a cascading effect and may empower you to choose contact more and more, until you have internalized this new way of thinking and linking thoughts and feelings. You can then take this new capacity out into the world and feel more enlivened by relationships.

Reference:

Baumeister, R. F., Dale, K., & Sommer, K. L. (1998, December 1). Freudian Defense Mechanisms and Empirical Findings in Modern Social Psychology: Reaction Formation, Projection, Displacement, Undoing, Isolation, Sublimation, and Denial. Journal of Personality 66 (6): 1081-1124.