Knowledge is a powerful resource for navigating life. We have endless internal dialogues that assist with interpretation of information and decision-making. Knowing why we think the way we think is the gold standard for healthy functioning. It affords us an opportunity to appreciate where we are in life and to choose where to go from there, a starting point for change.

Unhealthy thinking is, in large part, a function of negative belief systems, often installed by others and reinforced by our childhood experiences. Many people exhibit profound self-doubt, blame themselves, apologize profusely, and excuse their parents’ abusive behavior. This constellation of negative beliefs and behaviors presents in conjunction with stories of verbal and physical abuse that begins in childhood and follows people into adulthood. The longer we think a particular way, the harder it is to change our thoughts and beliefs.

I am a psychotherapist in private practice. Here is a hypothesis for consideration: Parents raise their children in their own image to fit into the world the way they see it. I ask people who come to me for therapy to stop and think about the developmental and environmental realties of their childhoods. I remind them that kids are captive learners who have no choice, no voice, and no mobility.

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There is a big difference between grieving that you didn’t get what you needed as a child and spending your life blaming parents for your life as an adult. A middle-aged man told me he had stomped out of a doctor’s office because his physician asked him how he felt about being hit by his father. He tearfully pointed his finger and said, “My dad was a good man, a hard worker, and I probably deserved what I got.” It was a clear message to me that the subject was off limits. It was a defensive response.

Interestingly, the man’s presenting issue was that he was “at his wit’s end” trying to cope with a 30-year-old son’s excessive pot smoking and slovenly behavior. The daily arguments were driving him and his wife crazy, but neither had successfully implemented and enforced boundaries in their own home.

Why did a middle-aged man protectively defend his deceased father when, as an adult, he never tolerated being hit by others? He relied on a system of justifying his dad’s abuse while blaming himself because it once worked. He learned to be a peacekeeper at a young age. It reduced the likelihood that his dad would get angry and violent. However, this role did not allow the man to honor his true feelings about being hit, berated, and shamed.

He was profoundly uncomfortable, consumed with constant doubt about his worth and ability. He’d worked for five companies but had been let go because he was “a loyal employee but an ineffective leader.” His home life was less than satisfying. The worse things got, the more he loved and the harder he tried to make peace. He parented his son from this place of low self-esteem. He was incapable of setting reasonable limits, highly deferential to the needs and wants of his wife and children. His coping system ceased to work, but he didn’t know how to change it.

We owe it to ourselves to identify why we do what we do. Then, we may decide whether we still want or need to stay with the program. Defensive responses are protective and serve a purpose. A great example of this is the use of avoidance. Most people who avoid refer to themselves as “lazy” or say “I’m a procrastinator.” Two significant things are successfully happening. One, they internalize the blame. It may not be pleasant to criticize oneself for being lazy, but it reduces the likelihood of argument. This is terrific for people who hate conflict. Two, it bypasses being angry with others and helps us feel in control.

Early coping strategies for dealing with life, especially for navigating interactions with others, are rooted in familiarity. People rely on and repeat these even when the results are painful and no longer work.

Anger gets a bad rap in our culture, which suggests that to be angry is to be out of control. It is an appropriate affect in certain situations. There are normal ranges for angry expression, as there are for all emotions. Anger is frequently role-modeled in extremes—demonstrations of screaming, verbal put-downs, and physical violence.

Early coping strategies for dealing with life, especially for navigating interactions with others, are rooted in familiarity. People rely on and repeat these even when the results are painful and no longer work. The human drive for consistency pulls dominance over curiosity for exploring new ways of coping. These methods worked well at some point in life, especially during childhood, when they were appropriate for emotional and physical survival.

Compartmentalization and detachment are subconscious coping mechanisms. The same man adamantly defends his father’s dictatorial parenting style but parents his children with a “marshmallow” approach—no rules or consequences. One part of him agrees with and condones his dad’s treatment of him. Another part parents in a diametrically opposed manner. It’s fascinating to observe these disconnects in action. People complain about feeling stuck. Change is challenging and often feared. Familiarity and years of reinforcement make moving from negative to positive thinking difficult. I guide people on a journey of awareness and choice. We nonjudgmentally search relevant files of experience to identify significant influences and resulting patterns of thinking. The pace of raising awareness is based on each person’s comfort level and learning style.

Awareness is a starting place. The brain does not have a delete button for experiential files, but it is possible to update and integrate files. The password for reprogramming? Choice.

Allison, 14, comes home from school and busts through the door. She slams her backpack against the wall in the family room and throws herself onto the sofa, only to ignore your demands to get her shoes off the furniture and put her backpack on the hook where she knows it is supposed to go.

Is this a familiar scene in your household?

As parents, our reactions to Allison’s behavior will mostly reflect an immediate request for correction. In response to Allison, many of us would be quick to say, “Get your shoes off the couch and go pick up that backpack!” With this reaction, however, we are ignoring the symptoms behind the disrespectful behavior.

But what if, instead of making demands for better behavior or offering reminders of family rules, you simply take a step back and notice the behavior? Moreover, what if you look for the emotions behind the behavior and place your request for compliance on the back burner for a bit? How might the interaction occur differently? These are some of the principles of a type of listening identified in the work of Carl Rogers, a 1950s psychologist known for his emphasis on helping people become self-aware through reflective listening.

[fat_widget_right]The acronym DEAR is a helpful way to remember the important components of reflectively listening to your child. If you follow this path, you may find that you are connecting with your child in a more meaningful way. DEAR works like this:

Detect

The first step in reflective listening is to become a detective of sorts. First, you must tamp down your own reactive, subjective emotions in order to focus on your child. This is hard to do because our role in parenting naturally consists of advising and telling our children based on our own judgments. Instead, try to observe your child’s demeanor, behaviors, tone, and words. In our example with Allison, we see anger and frustration, as well as defiance of the rules. If we practice our detection skills even more, we will likely discover some hurt underlying those emotions.

Empathize

By listening to your child reflectively, you are helping him or her define emotions and minimize acting out. This teaches your child that he or she can choose to control and manage emotions. Try to empathize with your child’s feelings without making it about you. What is their perspective? Though your child may have broken a house rule or even hurt your feelings by lashing out at you, try to be nonjudgmental for a moment. Connect with your child’s feelings. We can easily empathize with anger and frustration because we have all been in situations where we have those feelings. You might say, “Wow, Allison. You seem really angry,” or, “I can see your frustration.” These statements are more disarming in nature and send a signal to your child that you see him or her, not just the behavior.

Ask

Ask questions out of compassion. Keep the conversation focused more on your child’s emotions and story before moving forward to address the undesirable behavior or a solution. Paraphrase what you hear. Your questions shouldn’t be “why” they behaved in such a manner; your questions should come from a place of wanting more information. Again, using our example of Allison, ask her “Can I help?” or “Can you tell me what happened?” These types of questions may deactivate the power of her emotions and keep her from acting out further. It will also assure her that you want to listen.

Reflect

Reflecting on or summarizing what you hear from your child can help dampen the powerful emotions your child is feeling. When you restate or paraphrase what has been said, your child has an opportunity to step back and reevaluate their statements and feelings. With this practice, you are teaching your child how to regulate emotions through conversation and process feelings rather than behave as a result of the emotions.

Allison, for example, may share that she was being teased on the way home from school about her new hairstyle. She may tell you that even some of her friends joined in. In response to her story, reflection might sound like this: “What I am hearing is that you are hurt because you were made fun of.” Similarly, summarizing sounds like: “What a terrible end to your school day. It sounds like you’ve been hurt by people you thought were your friends.”

By listening to your child reflectively, you are helping them define emotions and minimize acting out. This teaches your child they can choose to control and manage emotions. At this point, you can move back into the role of advising and telling. You might end the fictional example with Allison by saying something along the lines of, “OK, well, why don’t you go put that backpack on its hook and let’s go find a movie for tonight?”

Some points to remember when using DEAR:

• Take a step back from your own emotions before reacting.
• Look underneath the behavior.
• Don’t use “why” when asking questions.
• Paraphrase and summarize what you hear.

If you are involved in a relationship with a person who has been diagnosed with autism spectrum disorder, you’re likely familiar with this scenario: You have a discussion with your partner. It turns oddly off course. You’re left confused. And then—slam!—you’re hit with something hurtful that takes the wind out of your sails.

This is different from other conversations that go off the rails. In this case, you have to struggle with the realization that your partner did not mean to hurt you. There was no intent to abuse, but you are reeling just the same.

So what do you do with the pain?

Do you deny it because you understand it was not inflicted intentionally? Or do you ignore it, hoping it will go away?

These are two time-honored methods used by many of the individuals who come to my office for counseling regarding this aspect of their relationships. The problem is that they backfire; by using them, you generally end up feeling more hurt. Then the ground is fertile for resentment and contempt, and—as relationship researcher John Gottman has repeatedly pointed out—once these emotions enter a relationship through what he calls the “Four Horsemen” patterns (criticism, contempt, defensiveness, and stonewalling), it is very difficult to retrieve mutual respect and rebuild.

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Besides, you already know these methods don’t work.

How do I know that you know? Because you likely don’t feel any relief.

Recent research has enhanced our understanding of communication between autistic and neurotypical partners. Studies supporting the “double empathy” framework show that communication challenges often arise from differences in social communication styles between autistic and neurotypical individuals, rather than deficits in either person. while autistic individuals face challenges in relationships including communication barriers, they also possess strengths such as pattern recognition and truthful communication.

If you are seeing a counselor, be certain that he or she understands the unique dynamics of being in a relationship in which one partner is on the autism spectrum. From an educational perspective, there are enormous implications that might make the difference between being helpful to a neurotypical partner in an autistic-neurotypical partnership and being not so helpful.

What may look like self-centeredness or even narcissism in your story is more likely to be your legitimate expression of not feeling heard by your autistic partner. , your experience of being lonely and hurt in your relationship is valid.

While it may not be the result of conscious disregard, your experience of being lonely and hurt in your relationship is valid.

] Contemporary research shows that autistic individuals report high levels of interest in pursuing and maintaining romantic relationships, and autistic people are involved in satisfying long-term relationships when understanding and accommodation are present.

If your partner is in counseling, or if you are in couples counseling together, it is equally important that your therapist have a specialized understanding of this unique relationship. Autism exists on a spectrum with great clinical heterogeneity, ranging from individuals who require significant support to those who can function independently with typical or above-average intellectual abilities. However, understanding the impact of the neurological differences and the arc of possibility upon which they can play out in an intimate relationship is essential for fair couples work, and certainly for providing substantive assistance to the person with the diagnosis.

A neurodiversity-affirming approach views autism as neurological differences to be understood and accommodated rather than deficits to be fixed. Recent developments in autism support emphasize helping neurotypical people learn autistic communication preferences rather than requiring autistic individuals to mask their natural communication styles.

If you suspect that your partner is on the spectrum but has no diagnosis, please bear in mind that a professional assessment is essential; there is no online quiz or self-help book that will help you to make that diagnosis on your own.

Still, you know your situation best. If your partner is hurting you emotionally and you can’t seem to get him or her to understand you when you talk about your pain, as a starting point, consider couples work with a counselor who understands autism spectrum disorder. The couples work will be helpful regardless of whether autism is a factor, and as is frequently the case with couples with whom I work, an assessment becomes part of our work together. Everyone wins. The person either has or does not have the diagnosis. It is a triaging tool in that it allows a couple to move forward knowing what they are dealing with in their interpersonal communication.

Research suggests that when both partners develop understanding of differing communication styles and consciously use strategies to bridge communication gaps, deeper connection and relationship satisfaction can result.

Please don’t try to swallow your pain. At the very least, recognize that if you feel hurt, it is because you ARE in pain, regardless of intent or circumstances. Your pain is real—and it deserves your attention.

Be kind to yourself.

*If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, contact the National Suicide Prevention Lifeline at 988 for free and confidential emotional support.*

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References:

1. Neu, B., et al. (2025). Autism in romantic relationships: A content analysis of challenges and strengths (2013–2024). Journal of Family Theory & Review. DOI: 10.1111/jftr.70001
2. Bottema-Beutel, K., et al. (2023). Autism spectrum disorder in 2023: A challenge still open. PMC. PMC10724724
3. Stokes, M. A., et al. (2023). Factors of relationship satisfaction for autistic and non-autistic partners in long-term relationships. Autism, 27(8), 2348-2360. DOI: 10.1177/13623613231160244
4. Khaw, J., & Vernon, T. (2025). Relationship satisfaction among autistic populations: How partner neurotype influences relationship satisfaction factors for autistic adults. Autism in Adulthood. DOI: 10.1089/aut.2024.0124
5. Jones, D. R., Botha, M., Ackerman, R. A., King, K., & Sasson, N. J. (2024). Non-autistic observers both detect and demonstrate the double empathy problem when evaluating interactions between autistic and non-autistic adults. Autism, 28(8), 2053-2065. DOI: 10.1177/13623613231219743
6. Crompton, C. J., et al. (2020). Autistic peer-to-peer information transfer is highly effective. Autism, 24(7), 1704-1712. DOI: 10.1177/1362361320919286
7. Haroon, R., & Dogar, F. (2025). NeuroBridge: AI tool to help neurotypical people learn how to better communicate with autistic people. Tufts Now. Retrieved from https://now.tufts.edu/2025/12/05/helping-neurotypicals-understand-autistic-communication
8. Wise, S. J. (2024). We’re all neurodiverse: How to build a neurodiversity-affirming future and challenge neuronormativity. London, UK: Jessica Kingsley Publishers.
9. Gottman, J. (2024). The four horsemen: Recognizing criticism, contempt, defensiveness, and stonewalling. The Gottman Institute. Retrieved from https://www.gottman.com/blog/the-four-horsemen-recognizing-criticism-contempt-defensiveness-and-stonewalling/
10. Lerner, M. D., Gurba, A. N., & Gassner, D. L. (2023). A framework for neurodiversity-affirming interventions for autistic individuals. Journal of Consulting and Clinical Psychology, 91(8), 503-515. DOI: 10.1037/ccp0000839

More than a quarter of Americans experience mental health issues each year, and the World Health Organization reports that depression is the leading cause of disability worldwide. However, many Americans think mental health care is both expensive and difficult to access, according to a study jointly sponsored by the National Action Alliance for Suicide Prevention, the Anxiety and Depression Association of America, and the American Foundation for Suicide Prevention.

In a survey of 2,000 adults, most (almost 90%) said they equally valued physical and mental health. One third reported that mental health care is hard to access, and 40% said high costs are a barrier to treatment. Forty-seven percent thought they had experienced a mental health issue, but only 38% of them had received treatment.

[fat_widget_right]Among those who sought treatment, therapy was the most popular option, with 82% pursuing psychotherapy and 78% taking medication. Eighty-six percent said that they knew mental health conditions such as depression increase the risk for suicide, but only 47% knew that anxiety-related conditions could also increase one’s suicide risk.

Though federal laws mandate equal coverage for mental and physical health, a number of recent reports suggest that many insurers continue to deny mental health claims.

64% of Psychology Experiments Fail Replication Test

In May, GoodTherapy.org reported on research suggesting that the majority of psychology studies could not be reproduced by subsequent researchers. Reproducibility is a hallmark of sound science. When a study’s results cannot be recreated, this suggests that the study could have been flawed, biased, or a fluke. Now, the results of that research have been published in Science, sparking debates about a so-called crisis in psychology. The research argues that the results of only a quarter of social psychology experiments and half of cognitive psychology experiments could subsequently be reproduced.

Living Small: The Psychology of Tiny Houses

Tiny houses are trending all over social media. For young people facing an expensive housing market, more economically sized homes can be enticing. These houses encourage people to reduce their carbon footprint by living simply, offer greater mobility because they can easily be moved by a trailer, and are much more affordable than standard-size homes. Moving into a tiny home may require significant downsizing of clothing, furniture, and belongings, but the advantages may include increased control over one’s housing experience, a private alternative to keeping costs down, and the ability to personalize design to fit one’s mood.

Health Buzz: Alcohol Education Should Begin at Age 9

Parents often delay talking to their kids about alcohol until the adolescent years, but a new survey published in the American Academy of Pediatrics suggests that these conversations should begin much earlier. The survey found that two thirds of teens had consumed alcohol by their high school graduation and that a quarter have had more than just a few sips before eighth grade. Researchers also found that children and teens drink more heavily than adults, raising concerns about alcohol poisoning and addiction. To give kids accurate and relevant information, the report recommends parents begin the alcohol conversation by the time their children are 9 years old.

Religion Rarely Part of ICU Conversation

Though three quarters of people charged with making health care decisions in an intensive care unit report that religion and spirituality are “fairly” or “very” important in their lives, less than 20% of family health care meetings involve discussion of religion or spirituality with doctors and other caregivers. Particularly when discussing end-of-life decisions, religion can be important, but it is usually the caregiver, not the doctor, who broaches the subject.

Japan’s Worst Day for Teen Suicides

September is National Suicide Prevention Month. For many Japanese parents, it may also be a time of increased concern about suicide among their teens. In Japan, more school students commit suicide on September 1 each year than on any other day. Though experts have posited various explanations—such as worries regarding bullying at school after a summer break free of emotional and physical attacks from peers—suicide remains common. Japan has one of the world’s highest suicide rates, and suicide is the leading cause of death among people aged 15 to 39. Figures from the Japanese government show that more than 18,000 adolescents under the age of 18 committed suicide between 1972 and 2013.

Oliver Sacks, Renowned Neurologist Who Wrote About His Cancer, Dies at 82

Famed author and neurologist Oliver Sacks died of cancer at his home on Sunday, August 30. Sacks wrote about unusual neurological conditions, often naming books after symptoms he saw in his clinical practice, such as The Man Who Mistook His Wife for a Hat. He was the inspiration for the doctor played by Robin Williams in the 1990 movie Awakenings, which is based on Sacks’ 1973 book of the same name.

Lack of Sleep Puts You at Higher Risk for Colds, First Experimental Study Finds

According to a study of 164 healthy people, inadequate sleep could increase the risk of developing a cold. Scientists monitored participants’ sleep patterns for a week, then quarantined them in a hotel for five days and exposed them to a cold virus. Researchers also checked the participants’ blood for an antibody that fights the common cold, then removed participants who had the antibody to make sure those participants would not bias the infection rates of the group.

At the end of the quarantine period, 45.2% of those who slept less than five hours a night exhibited at least one sign of illness—revolving around mucus production—and one other immune response. Of those who slept five to six hours, the cold rate was 30%, compared to 22.7% for those who slept six to seven hours. The rate was only 17.2% for those who got more than seven hours of sleep. At the end of the study, researchers determined that people who slept less than five hours per night were 4.5 times more likely to get sick than those who slept seven hours or more.

I am so sorry to hear about your situation, and cannot imagine the pain you and your wife must be experiencing as she fights her battle against cancer. Let’s get to the root of your questions.

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You love each other. You can’t help being what she needs you to be—she needs you to be you, loving her, and you clearly do. Yes, you will be optimistic if you can and if that helps. Yes, you can cry in front of her after she has had sufficient time to digest the news, and you can cry together to mourn the life that you will not have together, as well as to celebrate the life you have together now and have had to this point. You are grieving. Of course you are grieving. Please allow yourself to grieve in whatever way you need to. Although you say your wife is acclimating to the news better than you are, it’s possible she’s trying to stay “strong” for you, and is grieving inside every bit as much as you are. It’s OK to grieve together. In fact, it could be very helpful. Talk to your wife about what you are feeling and see how she feels about experiencing your grief as a team.

Four years may be a pittance of the time you wished you might have, but it’s also a treasure chest of breakfasts and dinners, fights and laughs, walks and longer journeys, complaints and compliments.

You describe your wife as a fighter, and you sound like you are one, too. You will find ways to be together and do the things you love best. And in those times when grieving in front of your wife doesn’t feel like the thing to do, when you need to scream and holler and let go, it’s absolutely OK to find a private place and do so. You can walk down a busy city street and yell your heart out (I’ve done this myself), or you can hide in the woods and do the same. You can lean on a good friend or family member who will help you mourn and be angry and be thankful, and break apart and heal and hold together.

You have time still to show your love, to enjoy the everyday-ness of being together. Four years may be a pittance of the time you wished you might have, but it’s also a treasure chest of breakfasts and dinners, fights and laughs, walks and longer journeys, complaints and compliments. You will be brave and cowardly, angry and loving, and express all the emotions that humans are capable of feeling, and you will do so both together and separately. All of it is OK. All of it is normal. All of it is whatever you make of it. Please let yourself feel what you feel.

Your wife needs help, yes, but don’t forget that you do, too. You need and deserve supportive people—family, friends, perhaps even groups who will help you through this. You can’t do it alone.

Many hospitals have support groups where people meet and help one another through difficult times. Are you members of a religious or spiritual group? Would you consider working privately with a therapist or counselor—someone just for you, or someone for you both? I highly recommend the empathic support of a therapist to help guide you through the range of emotions you’re feeling right now, especially a therapist who specializes in grief, loss, and bereavement.

I hope you can feel the love and peace that I wish you both.

Take care,
Lynn

Does the thought of sexual contact make you shudder? Do you tend to avoid or limit sexual activity? Do you find sexual touch or even romantic touch, such as hugging or kissing your partner, unappealing or even repulsive?

If this sounds like you or your partner, it may be a case of sexual aversion. Sexual aversion is your body’s heightened response to sexual anxiety. First, it’s helpful understand why you might be experiencing it. Then, you can explore how to begin resolving it.

Where Does My Sexual Aversion Come From?

Some individuals who experience sexual aversion may have experienced sexual trauma or another type of trauma. They may have had one or more experiences where sexual contact was forced. Especially in formative years, such as childhood and adolescence, the brain is creating pathways to understand sexuality. If a sexual trauma occurs during these years, the brain may link sexual arousal or sexual touch with threat, danger, anxiety, or pain.

[fat_widget_right]However, some individuals I work with who experience sexual aversion cannot pinpoint any trauma. For these people, the issue is even more confusing because they do not understand why they feel so anxious. Usually, when such individuals look into their past (especially childhood and adolescence, when sexual connections are beginning to formulate), they find small messages of guilt, shame, or blame associated with sexual arousal or touch. Perhaps small comments from parents or school institutions created an atmosphere of body shame or shame about sexual arousal.

How Sexual Aversion Can Influence Your Thoughts and Emotions

Sexual aversion may be experienced even if you have a great relationship and find your partner attractive. Some common thoughts and emotions associated with sexual aversion may include:

• You feel out of control.
  Control is an essential component of aversion. Remember, aversion is an extreme form of anxiety. It is your body’s way of saying, “I do not want that. I do not like that. Stay away.” It protects your body from harm. When you feel that someone wants sex, expects sex, or even has the “right” to sex because you are married, you are feeling out of control.

• You do not feel relaxed in sexual encounters.
  Your body is almost in a state of “beyond anxiety” where you don’t necessarily feel nervous, but you feel repelled. Pay attention to your body. Do you feel nauseous or have stomach issues when you think about sex? Do you feel fluttery or nervous? Do you feel nothing at all and just sort of frozen?

• You do not feel aroused, yet you engage in sex anyway.
  Engaging in sexual activity when you are not aroused is harmful for your emotional well-being. If you are not aroused, your body is not connected with your mind during the act. You might do this because you feel guilty that you are never in the mood to be with your partner. However, it could be causing long-term damage.

5 Steps to Reduce Your Sexual Anxiety

It’s important to understand that sexual aversion is common, especially among women. You are not alone. To work on your sexual anxiety, follow these steps:

1. Assert your control over the situation by setting boundaries and ground rules.
2. Agree to limited sexual contact. If you experience sexual aversion, engage only in a type of sexual contact (hugging, holding hands, etc.) that you feel comfortable with. As you get more comfortable, increase the activities slowly over time. Take it week by week or month by month—whatever you’re comfortable with.
3. Practice mindfulness and relaxation techniques prior to and during a sexual encounter.
4. Stop engaging in intercourse until the aversion has subsided.
5. Consider finding a sex therapist, as this does not typically go away by continuing to engage in sex.

Understanding why you feel averse to sexual touch even if you love your partner is the first step in lowering your sexual anxiety. Work through the tips above to be more connected with your body and feel more comfortable when sexual contact occurs.

Transgender individuals and issues impacting them continue to gain mainstream attention. An increasing number of reality and scripted television shows include transgender individuals, and some prominent figures, such as Caitlyn Jenner, have come out.

Advocacy efforts for transgender individuals have also gained greater attention. In the United Kingdom, major psychological and medical associations noted the negative psychological consequences of conversion (reparative) therapy—psychotherapy aimed at changing an individual’s gender identity or sexual orientation—by signing a Memorandum of Understanding against conversion therapy. In the United States, President Obama became the first president to publically speak on transgender issues and also called for an end of conversion therapy practices with transgender youth.

The American Psychological Association (APA), the largest association of psychologists in the U.S., recently increased its transgender educative and advocacy efforts. On August 5, 2015, the APA adopted the Guidelines for Psychological Practice with Transgender and Gender Nonconforming People (hereafter Guidelines). The Guidelines are directly applicable to psychologists and other mental health professionals, transgender people, and the general population.

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Psychologists and Mental Health Professionals

Mental health professionals often lack adequate training in trans-affirmative service delivery. The Guidelines provide practice guidelines aimed at increasing mental health professionals’ ability to work effectively with transgender individuals. The Guidelines provide a clear rationale and applicability for affirmative services. Through adherence of principles in the Guidelines (and additional training and consultation), more psychologists are available to provide mental health services to transgender individuals.

As reported by the National Gay and Lesbian Task Force, 41% of transgender individuals report making at least one suicide attempt (suicide attempt rate for the general population is 1.6%). The 2015 report from the National Coalition of Anti-Violence Programs describes 2014 as a “deadly year for LGBTQ” communities, given the high homicide rate of transgender individuals. An increase in the number of psychologists providing affirmative therapy and transgender awareness education to the general public may be effective at decreasing the suicide rate among the transgender population and reducing instances of hate crimes and violence directed toward transgender individuals, thus saving many lives.

Transgender Individuals

The Guidelines may help transgender individuals seeking therapy become educated consumers. One of the most important contributors to a successful therapy experience is the relationship between the person in therapy and the therapist. A therapist who is informed on issues impacting transgender individuals and is skilled in providing appropriate interventions is likely to be a better fit than a therapist without these qualities.

A therapist who is informed on issues impacting transgender individuals and is skilled in providing appropriate interventions is likely to be a better fit than a therapist without these qualities.

The Guidelines highlight issues that competent therapists should consider, which can help transgender individuals develop interview questions for therapists. For example, as per the Guidelines, psychologists should view gender as a nonbinary construct (in other words, acknowledge that male and female are not the only genders), be able to distinguish the difference between gender and sexual orientation, recognize that stigma can negatively impact mental health, and understand that support can positively impact mental wellness. Affirmative therapy is most likely to come from a therapist who adopts these guidelines and who can speak to the relevance of the Guidelines.

General Public and Transgender Allies

The Guidelines are written to be readable and understood by a wide population. As much as possible, they are free from jargon and provide examples of more complicated concepts. As there is a rationale for each guideline, access to the Guidelines may be able to provide the general public with a strong understanding of both historical and current issues that impact the transgender community.

Additionally, although trans-related language is ever-evolving, the Guidelines provide a glossary of current definitions. Transgender allies can use the Guidelines to advance their advocacy efforts. Counseling centers that aspire to increase their support of the transgender population may wish to use information from the Guidelines to further research initiatives and develop educational workshops and trainings.

The U.S. mental health field may still have room for development in terms of education and advocacy for trans issues, as major psychological and medical professions in the U.S. have yet to come together to create their own version of the U.K.’s Memorandum of Understanding. However, the Guidelines provide an accompaniment to other trans-related mental health guidelines and competencies, furthering the existing information available on trans-affirmative psychotherapy services.

Often, I meet a mom who is on the verge of tears describing how her teen hates her. She can’t understand it, and she wants her baby back. The teen looks on sullenly, once again exasperated by a parent who just doesn’t understand.

As a nonparent but a therapist for many kids, teens, and families, I can easily understand what this teen is going through. I remember it well. I hated my mom, too, and she was a sobbing mess due to my abrupt withdrawal. All I wanted was independence and for her to get off my back. Looking back, I want to kiss my mom for being so annoying. She saved me from so many negative experiences by having rules and expectations, but she also pushed me away by being emotional and reactive to my teen antics.

The preteen and teen years are filled with intense emotions and conflict. Historically, this change has been attributed to hormones, which is certainly a large part of it. Through our entire adult lives, we wrestle with hormones surging in our bodies, but after our teenage years we have developed enough to manage most of the residual emotions. Teens, on the other hand, have not. They feel so many different and new things, and they don’t always have the ability to slow down their reactions.

Educate Yourself

[fat_widget_right]Learn more about what your teen is going through and try to develop an objective lens through which to look. This may help you make meaning of some of the wilder behavior your teenager exhibits. It won’t buffer the sting of hateful comments, but understanding where they come from may help you think rationally about it all and not question every parenting move you make. Read books, articles, and websites about teen development. An informative, easy-to-read book I recommend is The Teenage Brain: A Neuroscientist’s Survival Guide to Raising Adolescents and Young Adults by Dr. Frances E. Jensen.

Remain Calm

When the situation is tense, take three deep breaths before responding to your teen. Don’t respond impulsively, as doing so may fuel the fire and create a bigger rift in your relationship. Attempt to process your emotions with another adult if you need to, and present yourself as calm, cool, and collected when approaching your teen. When this is not possible, try your best not to engage in an argument and instead walk away. If you are losing your cool or crying, your message may not be as effective and may further contribute to your teen’s negative perception of you.

See It from Their Perspective

It may not be sensible to you, but there is usually some merit to your teen’s argument. Validate it. Let them know that you get it, and you want them to be happy.

Guide Them

Looking back, I want to kiss my mom for being so annoying. She saved me from so many negative experiences by having rules and expectations, but she also pushed me away by being emotional and reactive to my teen antics.Almost all teens need some major guidance. Many lack the ability to think far ahead and weigh all the consequences of their choices. Part of your job as a parent is to control impulses. Your teen may rail against you, but don’t give up! Letting your teen run wild will help neither you nor your teen. Teens can be harsh, hurtful, and even intimidating to their parents, but you are the adult in the relationship and it’s your job—not your teen’s—to stand strong and maintain boundaries.

Stay Strong

Forget the messy rooms, don’t worry so much about the heavy eyeliner, and simply focus on safety and love. You love your teen because they were once your baby, and even though they can seem cold, moody, and sometimes downright mean, your teen loves you underneath it all and they do NEED you.

Yes, middle school may be a time full of awkwardness and self-doubt, but it is also a time of incredible transformation and movement toward independence. With regard to its impact on human development, this period of life is second only to the period from infancy to age three.

Think about that for a minute.

Remember how much your child changed from birth to age three? That’s how much change, growth, and development will happen over these next three years as your teen navigates middle school! Get ready for a wild ride!

Many of the parents I work with feel lost, unsure of how much support to offer their middle school student. How much independence is enough? How much is too much? How do you support a child without being a helicopter parent?

I like to compare the situation to teaching a child to swim. Think about the stages we go through with swimming. When our kids are toddlers, we go in the pool with them and we never let go. Later, we let them swim farther and farther away from us, but we stay in the pool so we can rescue them at any moment. Eventually, when we are comfortable with their skills, we let them swim while we watch from our lounge chair. I think of parenting during middle school as that last stage. We are on the sidelines offering guidance and support. We are right there if they get into trouble, but, mostly, we let them do their thing.

In the spirit of parenting from the sidelines, here are some tips to help make your child’s transition to middle school successful:

1. Encourage self-advocacy.

[fat_widget_right]Self-advocacy is one of the most important skills your teen will learn over the next few years. Speaking up for himself or herself and knowing how to ask for what they need is a critical, lifelong skill. Your teen can only learn it if you make an intentional effort to back away and let him or her step up to the plate.

• When your teen has a question about homework, make sure he or she contacts the teacher, not you. Help your teen brainstorm what to say, and maybe even craft the email or conversation together. But let the message come from your teen.
• When your kid forgets to do homework, let him or her approach the teacher to work it out. Maybe your child will need to stay in for lunch. Maybe the assignment can’t be made up and your teen will have to deal with the zero. Either way, let the student work it out with the teacher.
• When your teen feels like another student wronged him or her, teach them to use the office as a resource. Help your teen report the incident to a counselor or dean, but let him or her take the lead.

Side note: With all of these examples, I encourage parents to follow up with teachers to make sure your child really did follow through and advocate for themselves. I have written many emails that simply say “I’m just checking to make sure my daughter talked to you about … ” This is very different from taking the lead and contacting teachers to solve it yourself.

2. Allow your teen to struggle.

This one is always hard for parents, and for good reasons. We don’t like to see our children struggle. Our instinct is to jump in and rescue. However, we all know that the greatest lessons in life come from learning from our mistakes, and if our goal is to raise children to become strong, independent adults, we need to learn to let them stumble.

• Our kids take their lead from our energy as parents. The attitude you project will be the attitude they absorb. These next three years will be an unbelievable transformation! Allow your child to suffer the “natural consequences” of being unprepared for class. Maybe he or she will serve a detention. Maybe your teen will receive a zero. It will sting and your child will be upset, but hopefully habits will start to change.
• Stop rescuing! Don’t bring the missing work to school for your teen. Don’t write the teacher a note about how busy your family was and why homework didn’t get finished. Let your teen learn to deal with the consequences.
• Focus on growth instead of grades. Your child won’t earn an A on every single assignment, and that’s okay. Focus your conversations on how hard he or she is working, what is being learned, what support is needed, and how skills are growing, rather than just what your teen’s grades are.

The most important thing parents can do at this age is learn to ask, “How can I help? What kind of support to do you need?” instead of “How can I fix this for you?”

3. Encourage positive risk-taking.

Middle school is the perfect time to try new things, and becoming comfortable with taking positive risks is another critical skill in teen development. Some ideas for middle school risk-taking include:

• Try a new sport.
• Join a club or start a new one.
• Volunteer or start a new charity drive at school.
• Expand your circle of friends.
• Try a music class.

There are so many ways your teen can learn to take a positive risk. The important part as a parent is to always acknowledge and praise the effort and courage it takes to try something new.

4. Keep your communication and connection strong.

Even with all of this new independence, your teen still needs you. In fact, I would argue that he or she needs a strong connection with you now more than ever. Your teen will most certainly start pushing you away, but rest assured he or she is craving connection. Some new twists on connecting at this age:

• Find some new, creative ways to ask how your teen’s day was. Encourage him or her to tell you fun stories from the day, not just list the details about homework and grades.
• Become involved in your teen’s social media. If you allow your teen to have social media accounts, use the apps as one more opportunity to engage with him or her. Send funny quotes you found, “like” pictures and videos, ask about celebrities your child is following. Engaging via social media gives you the double bonus of connecting and monitoring activity all at once.
• Let your bedtime routine evolve, but not disappear. Maybe he or she is too old for bedtime stories and songs, but you’re still needed. Ask how things are going with friends. Let you teen share a new favorite song with you (even if you hate it).
• Carve out time to spend together. Coffee dates, movie nights, watching your favorite show together—make one-on-one time a priority. Your teen is never, ever too old for that. I promise.

Middle school is hard. There’s no doubt about that, but it doesn’t have to be miserable. Be thoughtful about the messages you are sending your kids about this new adventure. Are you allowing your own biases to fill their heads with the idea that middle school is terrible and you just have to suffer through it and try to survive? Or are you letting your kids know that it’s going to be exciting, energizing, challenging, and new?

Our kids take their lead from our energy as parents. The attitude you project will be the attitude they absorb. These next three years will be an unbelievable transformation! Prepare for it, brace yourself for it, but most of all, enjoy it!

Just as the body works to maintain homeostasis on a physical, cellular level, I believe the mind strives to create balance emotionally. Both happen unconsciously, though you can accelerate the processes with various interventions. Just as physical wounds heal more quickly with antibiotic cream and a bandage, psychological injuries heal faster with rational self-talk, breathwork, journaling, therapy, good food, yoga nidra, plenty of sleep, and other supportive strategies.

How the Conscious and Unconscious Affect Emotional Balance

It’s hard to imagine that emotional homeostatic work can be accomplished unconsciously, but how else can sayings such as “Time heals all wounds” be explained? How does the simple passage of time assuage psychic pain? You may not notice incremental improvement, but suddenly, one day, you feel differently about something that previously disturbed you. That’s your unconscious mind processing change over time. Certain practices can support this growth and transformation.

[fat_widget_right]When you choose to pay attention to your thoughts, feelings, and bodily sensations, you will often speed up the emotional healing process. It does not have to be solely relegated to your unconscious mind. Practices like yoga, meditation, journaling, psychotherapy, yoga nidra, dreamwork, and breathwork can all help soothe the nervous system and make conscious what has been unconscious so it can be safely felt, dealt with, and transcended.

All these interventions may seem challenging or annoying at first because they are unfamiliar, require learning new skills, or bring up unpleasant memories or feelings from the past. With practice, the initial break-in period will pass quickly, and you will begin experiencing a feeling of mastery. These intervention can also serve as healthy tools for future times when you feel anxious, angry, sad, or overwhelmed.

Practices to Move You toward Emotional Homeostasis

Take a close look at your inner landscape. Where are the boulders blocking your path? Are they out in plain sight, or are your obstacles more like potholes, only noticeable when you’re right on top of them?

Some great ways to analyze your internal topography include:

• Journaling: Journaling can work show remarkably well for helping people feel more in touch with their emotional well-being and better able to navigate life’s slings and arrows.
• Daily check-ins: When you notice an uneasy feeling—a headache, stomach issue, weariness, muscle tension, or other physical pain—try breathing into that space and ask yourself what it is trying to tell you. Acknowledge it, monitor it, and then relax.
• Five minutes of breath meditation: The simplest (but not easiest) exercise to work toward emotional balance is watching your breathing. Notice the length of your inhalation and exhalation, its temperature, where you first feel it entering your body, and how it moves through your lungs.
• Virtual alternate breathing with counting: I am partial to this activity. It is wonderfully relaxing and focuses the mind while relieving it of most distractions. This calming breath work engages the parasympathetic nervous system, improves rest and digestion, and increases vagal tone. Here is how it’s done:

1. Take a deep, slow breath through both nostrils and exhale.
2. Take a close look at your inner landscape. Where are the boulders blocking your path? Are they out in plain sight, or are your obstacles more like potholes, only noticeable when you’re right on top of them?Now, without touching your nose, focus on inhaling through the left nostril and count ONE.
3. Exhale though the right and count ONE.
4. Inhale through the right. Count TWO.
5. Exhale through the left. Count TWO.
6. Inhale through the left. Count THREE.
7. Exhale through the right. Count THREE.
8. Inhale through the right. Count FOUR.
9. Exhale through the left. Count FOUR.
10. Inhale through both nostrils. Count FIVE.
11. Exhale through both nostrils. Count FIVE.
12. Inhale through the left. Count SIX.
13. Exhale through the right. Count SIX.

Continue in this manner and inhale and exhale through both nostrils on every multiple of five. If you lose count, go back to the beginning and start with one. If you would like a beautiful explanation and walkthrough of this technique, check out Swami Janakananda’s CD, Experience Yoga Nidra.

Like all good habits, the benefits from these practices accrue over time. In addition, doing yoga nidra, an ancient passive guided meditation, can strengthen your emotional resilience and nervous system, allowing for more easy switching from fight-flight-freeze mode to rest and digest.

Some other excellent yoga nidra sources I recommend:

• Amy Weintraub’s 40-minute yoga nidra
• Richard Miller’s book Yoga Nidra: The Meditative Heart of Yoga

Nope, this isn’t a strange riddle where someone is found in the desert in a scuba suit. The answer to the question posed above is actually pretty simple: brain integration.

What is that? Excellent question; I am glad you asked. As you may know, we have two hemispheres of the brain. Neuroscience is a relatively young field, and we are continuing to learn more about the complexity of the brain and its function with time and as research evolves. We do know that there are different roles played by different sides and areas of the brain, and that integrating neural networks appears to be helpful in resolving traumatic memories.

The success of eye movement desensitization and reprocessing (EMDR) in treating trauma and mental health challenges teaches us that alternating right- and left-brain stimulation, via visual, auditory, or tactile experience, helps facilitate emotional processing. Through the simple act of holding something that buzzes between your right and left hand, or listening to something shifting from your right to left ear, a memory that was once charged with emotion can become less distressing. During the process, it is common for relevant associations to arise, for memories of thoughts and body sensations to arise. With support, this process can facilitate lasting and integrated healing.

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Right-left brain stimulation may sound like a scary, science fiction-like process, but I assure you there is no electricity involved in this type of therapy. Your body receives input in the form of sound, touch, or sight, without any added energy.

Along with helping us process emotions, EMDR can help build up positive memories, experience, thoughts, and feelings. We call this resourcing, and use imagined or real resources to cultivate feelings of peace, nurturing, protection, and wisdom. In addition to and as part of processing negative experiences, it is crucial to cultivate the positive, sometimes the opposite of what occurred in the experience of trauma.

Think about your life for a moment and ask yourself: when do I engage in an activity that engages my right and left brain in alternating rhythm? How do I feel before, during, and after the fact? How can I incorporate this information into my healing path?

How do walking, running, and drumming factor in? Think about it for a moment. When you walk, run, or drum, you are using your body in a rhythmic way, alternating the stimulation or use of your right and left brain throughout the activity. Have you ever gone on a hike or run and felt that you were sorting through your thoughts, developing new insights, or becoming less distressed about something? We know that exercise has many benefits; EMDR highlights for us some of the mental and emotional benefits.

There are a million ways to alternate right- and left-brain activation, including dance, yoga, and some tai chi moves. People have naturally gravitated toward right-left movements in many healing rituals across the world. Think of how many sacred rituals involve drums, movement, or voyages on foot. Understanding brain integration, plasticity, and resilience gives us some insight into why these rituals have been effective and why they continue to be passed down through generations.

Think about your life for a moment and ask yourself: when do I engage in an activity that engages my right and left brain in alternating rhythm? How do I feel before, during, and after the fact? How can I incorporate this information into my healing path?

If you are looking to heal from specific traumatic memories, I highly recommend working with a skilled EMDR professional who can provide structure and guide you toward health and resolution. Consider how your own choices outside of therapy can support your process as well. Perhaps you will choose to walk or bike to your therapist’s office this week, or do a little dance after your session. Whatever you choose, may it serve your healing and integration.

I’ve been a jerk many times in my life. But one time that stands out for me happened when I was 13. I had been invited to the bat mitzvah of a girl I barely knew. A bat mitzvah is a big event; at least 100 people were there. After singing “Happy Birthday,” some kid usually started chanting, “Skip around the room, skip around the room, we won’t shut up until you skip around the room.” Obviously, the intent was to make the birthday child … skip around the room.

On this occasion, I started the chant, but it fell flat on its face. Not a single person joined the chant with me.

It wasn’t until I was in college, recalling this embarrassing incident, that I finally realized my shameful behavior. The birthday girl, who appeared in class sporadically, sometimes showed up on crutches and sometimes arrived in a wheelchair. I had completely forgotten about her disability because she had put them aside for her bat mitzvah. Ignorantly, obliviously, I had thrown her illness in everyone’s face. What a horrible child!

It’s easier to forgive a child’s behavior than an adult’s. It’s also easier to forgive unintentional cruelty than intentional harm. But regardless, I will always feel a little ashamed that I hurt that girl and her family that day.

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Shame, that gut-wrenching, nauseating feeling, keeps people from acknowledging when they’ve been hurtful. So often, admitting that you’re guilty means being overcome with shame. We all want to be the good guy. It’s awful to discover that we’ve been the villain.

The other thing that stops people from admitting when they’ve been wrong is punishment. Often, the punishment is shame: “Shame on you!” If a person admits to a spouse that he or she has been overreactive or harsh toward the spouse, will the person be understood and forgiven or will he/she be punished and repeatedly shamed?

Being able to take responsibility for one’s bad behavior is in everyone’s best interest. Being condescending, being harshly critical, being explosive, being prejudiced—these behaviors and more may occur for all of us, but unacknowledged and unchecked, they can become a person’s identity, overshadowing higher qualities and damaging or destroying relationships.

What to do:

• Focus on learning about yourself, not punishing yourself
• Separate the behavior from your identity; you can overcome the behavior, and it doesn’t have to define who you are
• Be honest with yourself
• Breathe, calm yourself, and tolerate the unpleasant feelings
• Take responsibility for your behavior
• Apologize, if possible
• Commit to being the person you want to be

What not to do:
Twelve-step groups, support groups, and psychotherapy can assist individuals in regaining clarity and self-compassion in order to end abusive behaviors, including the abusive behavior of self-loathing and self-abuse.

• Lie to yourself
• Blame the victim
• Beat yourself up

These suggestions are sometimes easier said than done. It can take time, patience, and emotional support to work through these steps. A person may not get the understanding and forgiveness he or she desires. It’s important to do it anyway, regardless of the reaction. Just because someone becomes aware of his or her behavior doesn’t mean it won’t happen again. Hopefully, with repeated awareness and commitment, the person can learn to stop it faster.

In families that carry histories of substance abuse and/or physical abuse, the level of damage can be extreme, resulting in a greater need to justify, ignore, or suppress awareness of these behaviors. Twelve-step groups, support groups, and psychotherapy can assist individuals in regaining clarity and self-compassion in order to end abusive behaviors, including the abusive behavior of self-loathing and self-abuse.

No one is perfect. There is no shame in learning, growing, and striving to be your best self.