Conversion therapy—sometimes called reparative therapy and other names—is a widely discredited form of therapy that attempts to change people’s sexual orientation or gender identity. In recent years, a number of states have moved to ban the practice for minors, and dozens of mental health advocacy and professional organizations have produced statements against it. In spite of research showing that conversion therapy can be harmful, an Oklahoma state House committee in February 2015 approved legislation designed to protect the practice.

Concerns with Conversion Therapy

Mainstream mental health organizations and the American Psychiatric Association’s Diagnostic and Statistical Manual have long accepted that homosexuality is not a mental health diagnosis, yet conversion therapy typically focuses on changing one’s sexual orientation to heterosexual. According to the American Academy of Pediatrics, “therapy directed specifically at changing sexual orientation is contraindicated, since it can provoke guilt and anxiety while having little or no potential for achieving changes in orientation.”

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Though there are many ways to approach therapy, ethical therapy works to increase self-awareness and self-acceptance while offering judgment-free treatment in the context of a safe therapeutic relationship. Conversion therapy can include a range of approaches such as talk therapy, prayer, re-education, or aversion therapy. In some cases, techniques used in conversion therapy may be abusive and/or dangerous. For instance, a therapist might electrically shock the person every time he or she expresses interest in a person of the same sex. A group of people who experienced abusive conversion therapy recently sued their therapist, claiming he forced them to strip naked in front of him and engage in other questionable practices.

For some people, conversion therapy is an involuntary form of treatment. Parents of gay children (or children who display behavior culturally associated with the opposite sex) sometimes force their children to undergo conversion therapy, though conversion therapists may decline to work with children who do not want the treatment. Leelah Alcorn, a 17-year-old transgender girl, sparked national outrage in late 2014 when she committed suicide after being exposed to conversion therapy.

Legal Issues Regarding Conversion Therapy

California, New Jersey, and Washington, D.C. have banned conversion therapy for minors, and states such as Arizona, Colorado, Florida, Iowa, Ohio, Oregon, Washington, and West Virginia have taken preliminary legislative measures to eliminate the practice or methods associated with it. In 1997, the American Psychological Association passed a resolution disavowing conversion therapy, and since then, many leading mental health governing bodies have come out against the practice.

Nevertheless, Oklahoma legislators are diligently working to protect conversion therapy. Republican Rep. Sally Kern introduced the bill to “protect” parents’ ability to pursue such treatment for their children; the bill was later amended to prohibit “physical pain, such as electroshock or electroconvulsive therapy, touch therapy, pornography exposure, or vomit-induction therapy,” controversial tactics which not all therapists who practice conversion therapy use. Kern argues that the freedom to pursue conversion therapy for minors is a parents’ rights issue.

A host of professional organizations in the field of mental health and social work have spoken out against the bill. On March 4, 2015, GoodTherapy.org affirmed its opposition to conversion therapy, and declines to list in its therapist directory mental health professionals who advertise conversion therapy as a service they offer.

References:

1. APA resolution on “reparative therapy” (1997). Retrieved from http://psychology.ucdavis.edu/faculty_sites/rainbow/html/resolution97.html
2. Fox, F. (2015, January 8). Leelah Alcorn’s suicide: Conversion therapy is child abuse. Retrieved from http://time.com/3655718/leelah-alcorn-suicide-transgender-therapy/
3. Gay conversion therapy bill clears Oklahoma House committee. (2015, February 24). Retrieved from http://newsok.com/gay-conversion-therapy-bill-clears-oklahoma-house-committee/article/5396127
4. Homosexuality and adolescence. (1993). Retrieved from http://pediatrics.aappublications.org/content/92/4/631.full.pdf
5. Iowa senate panel approves ban on conversion therapy. (2015, February 17). Retrieved from http://stlouis.cbslocal.com/2015/02/17/iowa-senate-panel-approves-ban-on-conversion-therapy/
6. Michael Ferguson, et al. v. Jonah, et al. (n.d.). Retrieved from http://www.splcenter.org/get-informed/case-docket/michael-ferguson-et-al-v-jonah-et-al
7. Steinmetz, Katy. (2014, June 30). California Ban on Gay Conversion Therapy Stands. Time. Retrieved from http://time.com/2940790/california-ban-on-gay-conversion-therapy-stands/

While it’s true that working with a good trauma therapist enhances healing, not all trauma work happens in the therapy room. Even when a person regularly sees a therapist, the trauma work does not stop because a therapy session has ended. On the contrary, the brain keeps working and sorting through traumatic material in an effort to heal and move forward.

The brain is incredible in its resiliency and natural tendency toward healing. The brain wants to heal, but in doing so, sometimes distress happens. For example, when the brain has nightmares or flashbacks after experiencing a traumatic event, it is in fact attempting to heal by trying to bring forth information related to the trauma. But the distress and anxiety from experiencing these intrusions and related trauma symptoms can cause a person to want to (understandably) push away the memories and other intrusive symptoms related to the trauma.

It is not uncommon for intrusive symptoms to sometimes increase at the beginning of trauma therapy. As much as trauma therapy helps, it can also cause discomfort and intense emotions as a person faces and works through the traumatic memories. Therefore, having effective coping skills to use between therapy sessions is imperative. Below are three skills that can be used in or out of therapy sessions.

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1. Body Scan

The body often tenses as it prepares to fight, flee, or freeze due to continued trauma symptoms, even long after the traumatic event has ended. The body holds onto trauma, which can cause it stay on “high alert” status. This is exhausting and can take a toll on your health. Body scan is an exercise during which you pay attention to parts of your body without changing anything you notice. The objective of this exercise is not to relax. It is simply to be aware of what is happening in a particular moment.

Why doesn’t the body scan encourage relaxing the tension or pain you find? Because sometimes just noticing the tension you find is enough. Also, releasing any expectation of what is supposed to happen during the exercise can relieve anxiety about the exercise itself and make it more effective. If you have the expectation that you are supposed to feel relaxed during the exercise and that is not what you experience, negative thoughts about “not doing it right” may come up, which can cause distress.

During this exercise, you can start at the head, feet, or any other part of the body, and then pay attention to each part or section of the body at a time, noticing any sensations that come up. You may notice tension, itching, discomfort, or no sensation at all. The key is to just pay attention and to be aware. If you get distracted, simply notice that you got distracted without criticizing yourself, and gently redirect your attention back to the part of your body you were focused on.

2. Containment

Containment is one of the skills I was taught early in my EMDR training and it has become one of the stabilization skills I teach most frequently. This exercise is effective in utilizing the brain’s natural ability to contain material. It involves imagery of a container of some type that can hold onto material that is distressing or disturbing, until the time you feel better able and prepared to deal with it.

To utilize this exercise, imagine a container of some type: a box, safe, vault, trunk, etc. Whatever the container is, it should have a door or lid that you can open and close as you please. The container needs to be big enough and strong enough to hold anything that is causing distress. When something distressing comes up and it is not possible or optimal to address whatever is coming up in that moment, imagine letting the traumatic material go into the container temporarily, until it can be addressed at a later time.

The objective of this exercise is not to disregard or ignore the important information that the brain is trying to communicate. Rather, it is meant to allow the brain to set aside distressing information for the time that it is optimal to address the material. This helps to prevent becoming too overwhelmed by trauma symptoms, which often include intrusive thoughts, images, and memories. It is beneficial to discuss with your therapist the thoughts/images/memories/etc. you contain between sessions so that he or she can help you sort through the material in the container, a little at a time.

3. Body Movement

Sometimes the body is our most underutilized resource. Recent research by Bessel van der Kolk, et al. (2013) found that a yoga practice as a supplementary treatment for posttraumatic stress (PTSD) dramatically decreased symptoms of PTSD in participants. The researchers in this study theorize that yoga practice may help individuals with trauma to learn to more effectively tolerate and cope with body and sensory sensations, in addition to helping them to learn to tolerate intense emotion.

It is my belief and experience that, whether it is yoga or some other form of exercise, moving the body has major benefits and enhances trauma healing. The exercise or body movement you choose does not have to take a great deal of time or money. Some people report that simply walking and stretching has positive benefits on their ability to cope between sessions. People often report that engaging in some form of exercise or body movement also is helpful in gaining self-appreciation and the ability to self-soothe and nurture.

I have found with the people I work with in therapy that, when used consistently, the above skills help to move trauma work forward as they begin to feel more confident in their ability to tolerate intense emotion and distress. Contact a qualified trauma therapist if you think you might benefit from some guidance.

Reference:

Van der Kolk, B. A., Stone, L., West, J., Rhodes, A., Emerson, D., Suvak, M., and Spinazzola, J. (2013). Yoga as an adjunctive treatment for posttraumatic stress disorder: A randomized controlled trail. Journal of Clinical Psychiatry, 75, e1-e7. Retreived from http://www.traumacenter.org/products/pdf_files/Yoga_Adjunctive_Treatment_PTSD_V0001.pdf

It should go without saying: conversion therapy is an outdated mode of treatment for an issue that is not, and has not been, a mental health diagnosis for quite some time. GoodTherapy.org does not endorse conversion therapy —also known as reparative therapy or sexual orientation change efforts (SOCE)—for homosexuality, nor does it permit mental health professionals to advertise those services to website visitors.

On March 3, 2015, The Huffington Post published an article in which Human Rights Campaign, a leading LGBT rights group, condemned Psychology Today, an online therapist directory, for allowing its therapist members to advertise conversion therapy on its profile pages. A representative of Psychology Today told The Huffington Post that the company did not intend to begin removing or refusing membership to therapists who offer conversion therapy. The backlash and criticism from health professionals, human rights advocates, and others was immediate.

Within 24 hours, Psychology Today had changed its position. In a statement issued March 4, the company asserted that it does not condone conversion therapy, and has notified therapist members that they would be de-listed if their profiles advertised this practice. Their updated stance is in line with what the majority of the mental health community has come to believe: conversion therapy has no place in mainstream mental health care.

Flaws in the Conversion Concept

Conversion therapy, also known as reparative therapy, is a controversial type of treatment aimed at changing a homosexual person’s sexual orientation on the assumption that homosexuality is an inherent flaw or disorder that must be altered. While homosexuality was once listed in the Diagnostic and Statistical Manual (DSM) as a mental health diagnosis, it was removed from the DSM by the time the third edition was published in 1980 with support from the professional mental health community.

In addition to rejecting conversion therapy as a useful treatment, GoodTherapy.org does not acknowledge homosexuality as a mental health disorder. The American Psychiatric Association (APA) agrees; a statement issued by the board of the APA in 1998 states: “The American Psychiatric Association opposes any psychiatric treatment, such as ‘reparative’ or ‘conversion’ therapy, which is based upon the assumption that homosexuality per se is a mental disorder, or based upon a prior assumption that the patient should change his/ her homosexual orientation.”

The APA isn’t the only organization to reject conversion therapy, as research over the course of years has affirmed concerns over conversion therapy as a treatment modality. The American Association for Marriage and Family Therapy, the National Association of Social Workers, the American Psychological Association, and the American Medical Association, among others, have issued statements against reparative therapy. Many cite research that suggests conversion therapy is likely to lead to harmful outcomes, such as contributing to anxiety, depression, relationship problems, self-loathing, and other issues. According to the Pan-American Health Organization (PAHO), “Services that purport to ‘cure’ people with non-heterosexual sexual orientation lack medical justification and represent a serious threat to the health and well-being of affected people.”

Several states consider conversion therapy detrimental enough that they have enforced or are considering bans on it. California, New Jersey, and Washington, D.C. have banned the use of conversion therapy on minors. Other states that have pending legislation to ban reparative therapy include New York, Massachusetts, Illinois, Iowa, Minnesota, Michigan, Ohio, Vermont, Pennsylvania, Colorado, and Hawaii.

Given a lack of research that supports the effectiveness or safety of conversion therapy, the American Psychiatric Association “recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum to ‘First, do no harm.’ ”

GoodTherapy.org Philosophy of Membership

GoodTherapy.org is founded on a mission and vision to reduce harm in therapy by educating consumers so they can be equipped with resources and services that will help them achieve their mental and emotional health goals.

When mental health professionals sign up to be listed in the GoodTherapy.org therapist directory, applicants are required to certify that the services they provide accord in orientation and attitude to its Elements of Healthy Therapy Statement. A peer-review team verifies each clinician’s credentials and screens his or her profile content to ensure the person’s practice is in line with elements of good therapy. Profiles are reviewed for questionable content, such as homophobic, sexist, racist, or other discriminatory or harmful practices or beliefs. GoodTherapy.org does not list conversion therapy or reparative therapy as a type of therapy that members can select.

[fat_widget_left]Because the review process for inclusion in GoodTherapy.org’s therapist directory is done on a case-by-case basis by human beings, and because members are able to update their listings at any time, it is possible that an inappropriate listing could appear for a period of time in its directory. However, GoodTherapy.org addresses any such listing as soon as it becomes aware of it and takes action to remove the individual from its directory. Since GoodTherapy.org was founded in 2007, situations like this have been extremely rare.

It is important to note that there are people who seek therapy as part of an effort to change their sexual orientation. GoodTherapy.org’s position is in no way an invalidation of these individuals’ desires to work toward their chosen goals in therapy. GoodTherapy.org respects individuals’ rights to identify their treatment goals and choose treatment modalities that appeal to them for any reason.

It is perfectly acceptable for individuals to discuss, explore, and evaluate their sexual orientation in the context of a therapeutic relationship. Trained therapists should be equipped to support people in these efforts without prejudice or discrimination. GoodTherapy.org works to ensure that it offers people seeking treatment quality choices so they can find a therapist who meets their unique needs.

GoodTherapy.org was founded in 2007 with the mission of:

• Reducing harm in therapy
• Advocating healthy and ethical psychotherapy practices
• Encouraging therapists to work collaboratively and nonpathologically
• Depathologizing diagnostic-based language and therapy practices
• Educating consumers about the differences between healthy and unhealthy therapy practices

Toward this end, GoodTherapy.org makes every effort to avoid and remove from its site any content—including blog material and therapist listings—that contains a homophobic, sexist, racist, ableist, or otherwise discriminatory message. Dan Fajans, director of member services at GoodTherapy.org, explains, “Everything we do, from our therapist directory, to our Continuing Education Program, to The Good Therapy Blog, to our GoodCause program and beyond, is first and foremost an effort to put this mission into action. Providing an advertising platform for conversion therapy would be directly at odds with our mission.” GoodTherapy.org takes this stand based on mounting evidence that conversion therapy causes harm; leading mental health organizations do not view it as ethical; and it requires the therapist to operate from a fundamentally pathology-based understanding of the person who is seeking therapy.

Noah Rubinstein, GoodTherapy.org’s founder and CEO, stands behind GoodTherapy.org’s position on conversion therapy both professionally and personally. As a licensed marriage and family therapist who has worked in the mental health field for over 25 years, Rubinstein elaborates:

“In general, any psychotherapy that focuses on trying to depreciate, banish, or exile a psychological aspect of a person at the expense of curiosity, appreciation, and compassion is not in the best interest of the individual. Even with issues such as depression, anxiety, addiction, anger, self-criticism, and nearly every other symptom which motivates a person to seek help, the only agenda ever set by the therapist, in my opinion, should be to help the individual understand the purpose, function, and existence of such an aspect. The decision to help a person change some aspect of themselves should be made by the person in therapy only when he or she is in a psychological state of calm and self-compassion.

“I can only imagine how difficult it is in this culture for some individuals to recognize, accept, and explore their sexuality when it differs from the majority. I assume that those who want to change their sexual orientation are under enormous pressure internally and/or externally to assimilate and that any desire to alter their sexuality does not originate from self-compassion, unless their sexual practices are harmful to self and others—which homosexuality in and of itself is not. The only way to tell, I imagine, would be to first work with an individual to access the internal resources to transcend any internal or external pressures. At that point, one could reach a place of understanding, acceptance, and self-compassion for his or her own sexuality.”

As an organization, GoodTherapy.org reiterates its support for individuals experiencing any type of mental health challenge, in any stage of their mental health journeys. No person should be made to feel inadequate or broken because of a psychological concern, and all people are worthy of healing and love—especially self-love. If you feel discouraged or troubled, or if you feel you have been treated unfairly in therapy, there is hope and help available.

We invite you to share your thoughts or comments in the “Leave a Reply” section below.

References:

1. APA Board of Trustees. Position Statement on Issues Related to Homosexuality. March 2000. Retrieved from http://www.aglp.org/pages/LGBTPositionStatements.php#Anchor-55000
2. Herek, Gregory M. Facts about Homosexuality and Mental Health. Retrieved from http://psychology.ucdavis.edu/faculty_sites/rainbow/html/facts_mental_health.html
3. Millar, Katharine S. The Myth Buster. February 2011. Retrieved from http://www.apa.org/monitor/2011/02/myth-buster.aspx

The transition from being a wife or partner to being a mother with children can be a difficult one. Whereas before you could give all your time and attention to your partner or spouse, hobbies, work, and other pursuits, now there is a demanding baby to care for. Some women feel that during pregnancy they begin to experience “mommy brain” and have trouble with memory. In fact, research shows that women’s brains do shift during pregnancy. A study published in Behavioral Neuroscience showed that there was a small but significant level of growth in the amygdala, prefrontal cortex, and hypothalamus. These changes are associated with increased worry, obsessively thinking about and caring for the child, and placing a high emphasis on the baby’s needs. Well beyond birth, when the child is a little older and more independent, many women continue to have a difficult time shutting off obsessive thoughts about their child and focusing on being a wife or partner.

As a couples therapist, I hear often how hard it is for women to transition from being constantly involved with their children to being a wife or partner again. It’s completely normal for most women to have some challenge making the transition. After all, just because your children are asleep does not mean that your “mommy” duties are fulfilled. You might have to prepare lunches or fill out permission slips for the next day.

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Just as the husbands and partners of mothers have to adjust to new roles and realities, women, too, have to come to some balance. Even in the throes of parenthood, it is essential to have time together with your partner independent from your children.

Here are some strategies for making the switch from “mommy mode” to “partner mode”:

1. Effectively manage your time. Think about cutting some obligations so you have more time in the evening. Schedule things if you have to, and stick to the schedule. If there’s a task that isn’t a “must-do,” let it go. Make time with your partner a priority, right alongside fixing those lunches. When you’re with your partner, try not to think about anything else and allow yourself to immerse yourself in the moment. A family is only as strong as the partnership.
2. Set aside one or two nights per week for intimacy. Make it a point to head to bed a little earlier than usual a couple of nights a week. (If you’re too tired at night, why not set the alarm for before the kids wake up?) If you set certain nights aside (and you know they are coming), you can train your mind and prepare yourself better. Oh, and just because you are not already in the mood does not mean you cannot get in the mood once you are physically close. Remember: desire does not always come before intimacy. Intimacy can generate desire.
3. Do relaxing activities before bed that don’t have to do with housework or child care. For example, take a hot shower or bath, read a chapter from a novel or peruse a magazine, have some red wine and chocolate, or watch a favorite television show (perhaps one you wouldn’t watch with the kids). These activities will ground you and help you transition to intimacy with your partner, in whatever form that may take.
4. Talk to your partner about your relationship or even “adult” things. Have an intellectual or emotional conversation about current events, work, your passions, or your relationship. Avoid discussing the kids, if possible.

Reference:

Kim, P., Leckman, J. F., Mayes, L. C., Feldman, R., Wang, X., and Swain, J. E. (2010). The Plasticity of Human Maternal Brain: Longitudinal Changes in Brain Anatomy During the Early Postpartum Period. Behavioral Neuroscience, Vol. 124, No. 5. 696-700

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Thanks for your question. I guess the simple and perhaps even smart-alecky answer would be, “Don’t talk about politics and stick to sports!” I have very good friends who disagree with me politically and we are so passionate about our respective views that we simply agree to disagree. With others, I find it a little easier to have a more moderately tempered exchange; for example, I have a college buddy on Facebook who has drifted to the opposite end of the spectrum as me, but he has a sense of humor and pokes fun at my “side” and we have a good-natured sparring relationship about it. I could not do that with everyone.

But on a broader and philosophical level, your question points to a very psychologically significant phenomenon—related to change and, perhaps, loss.

The sometimes jarring fact of the matter is people change. There are friends from my past, as I sit here in middle age, whom I would no longer recognize. Some I am happy to stay in touch with via Facebook, and some I just can’t find common ground with anymore. A lot of this is about the present: the ongoing, indestructible present moment, which creates a context around what remains in common today. And other than a shared past, there are some with whom we just don’t share much in common anymore. Sometimes a new place—geographically, emotionally—can change a person, which changes his or her relationships. Sounds like your friend has changed for reasons that, I’m guessing, have little to do with you, but do affect the friendship.

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We all exist in a particular context, often fleeting, ever shifting. (This would be related to what Buddhists call “groundlessness.”) In the case of your friend, you and he shared some very intense experiences in a common setting, but obviously things have changed in more complicated ways than can be assessed by the human eye. It sounds to me like you would have to make an adjustment to “fit” this new situation by listening to the “jibber jabber” of your friend’s politics. Perhaps these politics have become important to him for some reason that blocks more friendly relating. Could you ask him to drop this as a topic? Or is life too short to even bother at this point?

I was curious about the notion of an “obligation” to him, and I think that warrants further investigation. Why “obligation”? What are the risks of not following this new “requirement”? My sense is that not staying obligated might bring with it a loss of a kind that could be symbolic for you: for example, this friend was like a brother, and losing him might be related to experiencing a brotherly loss of a kind. Maybe you feel you’ve lost too many “friends” lately. Is there a loneliness losing him might touch on? Or perhaps there are people in your life like him, and for some reason you feel like you “owe” it to them to stay uncomfortable listening to opinions that seriously clash with yours. There is something abrasive about feeling “forced” to listen to political opinions that don’t jibe with yours; it sounds as if it might be more of a monologue than a conversation. “Fun for one,” as a friend likes to say. It does you no good to force yourself in such situations. I suppose you could try to “understand” his positions, if you’re interested, but that’s a lot of work on your part, and it may or may not be worth it.

More importantly, why hold on to this particular friendship if it’s no longer fun or friendly? It sounds like your college pal now wants your audience as more than a friend, from what you’ve said. Assuming he’s going to cling to his political points of view, what purpose does it serve by pretending a friendship is there that has changed or even faded away? I get a sad feeling while writing this, since people do come in and then out of our lives in a way that can spark specific feelings in us, depending on who we are and how we process these experiences.

In short, see if getting politics out of the equation helps, or if by continuing this friendship you are staving off inevitable feelings of loss that, unfortunately, are as difficult in life as connections are rewarding. You seem like a nice, considerate fellow, and I’m hoping there are people in your life whom you can spend more time with, rather than forcing a situation that no longer suits your particular context. Thank you for writing!

Best wishes,
Darren

It happened. You knew it would, but you didn’t think it would happen so quickly. In spite of any hope you had of slowing down the clock, you woke up one day to find that your child is not so childlike anymore. Suddenly, hormones are raging, romantic feelings are developing, and, of course, it doesn’t stop there. Before you know it, your teen may be entering the dating world.

For many, raising a teenager is the most intimidating chapter of parenthood. Discipline becomes increasingly difficult and may feel impossible to maintain. It’s tough to know when to set rules and when to give freedom, when to bend and when to stand firm, when to intervene and when to let live.

Communication is often one of the trickiest minefields to navigate. It’s a struggle to know what to say, when to say it, and how to say it. These conversations and decisions only become more challenging when the time comes for your teen to start dating. As we near the end of Teen Dating Violence Awareness Month, we want to remind parents how important it is to do their part to help prevent teen dating violence and promote healthy relationships.

If you are a parent to a blossoming teen, consider discussing these crucial aspects of relationships with your child before he or she enters into a relationship:

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1. Define a Healthy Relationship

Be sure to teach your teen about the foundations of a healthy relationship. Explain that a healthy relationship comes from respect, mutual understanding, trust, honesty, communication, and support.

A relationship should consist of healthy boundaries that are established and respected by both partners equally. A good partner will accept you as you are, support your personal choices, and praise you for your achievements. A healthy relationship also allows both partners to maintain outside interests and friendships, and does not hinder the personal freedom of either partner.

2. Describe the Different Types of Abuse and Associated Warning Signs

There are many different types of abuse your teen should be aware of before entering into a relationship. These include physical, emotional, sexual, financial, and digital abuse, as well as stalking.

• Physical abuse occurs when a person uses physical force to harm another, but need not result in visible injuries to qualify. Hitting, kicking, pushing, biting, choking, and using weapons are all forms of physical abuse.
• Emotional abuse can take the form of insults, humiliation, degradation, manipulation, and intimidation. Emotional abuse can involve forced isolation, coercion, or use of fear or guilt to control or belittle.
• Sexual abuse involves any act that directly or indirectly impacts a person’s ability to control their own sexual activity and the conditions surrounding it. It can take many forms, including forced sexual activity, using other means of abuse to pressure one into an activity, and restricting access to condoms or birth control.
• Financial abuse is a form of emotional abuse that uses money or material items as a means of power and control over another person.
• Digital abuse is any form of emotional abuse using technology. A person may use social media, texting, or other technological means to intimidate, manipulate, harass, or bully someone.
• Stalking is persistent harassment, monitoring, following, or watching of another person. These behaviors can be difficult for teens to recognize as abuse, as they may sometimes see it as flattering or believe the other person is engaging in such behaviors only out of love.

If you’re feeling unsure about how to teach your teen to distinguish between a healthy and unhealthy relationship, or if you would like additional resources on the warning signs of relationship abuse or promoting positive relationships, consider visiting loveisrespect.org.

Loveisrespect is a nonprofit organization that works to educate young people about healthy relationships and create a culture free of abuse. Its website offers a wealth of information for teens and parents and provides 24/7 support via phone, text, or chat.

3. Explain the Differences between Lust, Infatuation, and Love

Distinguishing between infatuation and love can be difficult for many adults; imagine how complicated it can be for a teenager who is experiencing many new feelings for the first time. Take a moment to explain to your teen that attraction and desire are physiological responses that can occur separately from emotions.

Make sure he or she understands that infatuation is not the same as love. Infatuation may give us butterflies, goose bumps, and that “can’t eat, can’t sleep” type of feeling, but it isn’t the same as love. Love takes time to grow, whereas infatuation may happen almost instantly.

4. Talk Realistically about Sex

While it may be tempting to skip this conversation, it’s in everyone’s best interests to talk to your teen about sex. Ask yourself whether you want your teen to hear this information from you or someone else.

On its website, the Mayo Clinic suggests turning the topic into a discussion rather than a presentation. Be sure to get your teen’s point of view and let your teen hear all sides from you. Discuss the pros and cons of sex honestly. Talk about questions of ethics, values, and responsibilities associated with personal or religious beliefs.

5. Set Expectations and Boundaries

It is important to set expectations and boundaries you have now regarding your teen dating rather than defining them through confrontation later. Let your teen know any rules you may have, such as curfews, restrictions on who or how they date, who will pay for dates, and any other stipulations you might have. Give your teen an opportunity to contribute to the discussion, which can help foster trust.

6. Offer Your Support

Be sure to let your teen know you support him or her in the dating process. Tell your teen you can drop off or pick up him or her, lend a compassionate and supportive ear when necessary, or help acquire birth control if that fits with your parenting and personal philosophies. However you intend to support your teen, make sure he or she knows that you are available.

7. Use Gender-Inclusive Language that Remains Neutral to Sexual Orientation

When you open the discussion with your teen about relationships and sexuality, consider using gender-inclusive language that remains neutral to sexual orientation. For example, you might say something like, “Are you interested in finding a boyfriend or girlfriend?” rather than automatically assuming your teen has a preference for the opposite sex. Deliver this language with genuine openness and love.

By opening up the possibility of being attracted to both genders right away, you will not only make it easier for your teen to be open with you about his or her sexual orientation, but you’ll likely make your teen feel more comfortable with his or her identity, regardless of who your teen chooses to date.

8. Be Respectful

Most importantly, be respectful when talking to your teen about dating and relationships. If you communicate with your teen in a gentle, nonobtrusive manner that respects his or her individuality, opinions, and beliefs, then your teen will be much more likely to do the same for you. This helps to create a healthy and open line of communication between you and your child and ultimately could improve your teen’s self-esteem.

9. Know When to Ask for Outside Help

There is help available if you’re struggling to talk to your teen about dating and sexuality. In addition to our advice, there are numerous resources available online to help you start a constructive conversation. Additionally, if your teen is experiencing relationship problems and/or your talks about relationships aren’t going well, consider finding a family therapist who can help mediate the conversations and promote emotional intelligence and healthy behaviors. Teaching your kids what it means to be in a healthy relationship is simply too important of a message to leave to chance and may even save his or her life someday.

References:

1. Sex education: Talking to your teen about sex. (2017, August 2). Mayo Clinic. Retrieved from http://www.mayoclinic.org/healthy-living/sexual-health/in-depth/sex-education/art-20044034
2. Types of abuse. Retrieved from http://www.loveisrespect.org/is-this-abuse/types-of-abuse

If you’re like most people, you spend some portion of every day stressed about time, obligations, and your ability to get everything done. In an increasingly fast-paced world, where everyone wants a response yesterday, it’s easy to feel overwhelmed by unceasing demands.

According to a study published in the Journal of Marketing Research, it’s not necessarily time constraints that lead to chronic stress. Instead, time constraints may affect how people spend their time, and these choices may lead to even more stress.

Understanding How Busy Schedules Cause Pressure

The study’s authors theorized that conflicting demands could be a significant source of stress. For instance, having to be two places at once or needing to complete two tasks that demand different emotional or intellectual resources could be more challenging.

To test this theory, researchers asked study participants to list tasks according to the amount of time they took, and to then picture themselves completing those tasks. They then asked participants to pretend the duties conflicted with one another. Some tasks were conflicted such that participants would be able to complete only one. Others involved emotional or financial conflicts. Participants reported more stress associated with conflicting tasks, regardless of the reason for the conflict.

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The study’s authors believe that the way we think about stress may affect how we deal with it. It doesn’t matter if tasks actually conflict with one another; when people think of them that way, they have more difficulties with time management. When people feel pressed for time, they may struggle to sleep, be willing to spend more money to save time, or experience depression. These issues can all lead to even more stress.

Simple Strategies for Coping With Time Pressures

Researchers suggest that two easy strategies may help people more effectively cope with stress. Slow breathing can help to refocus the mind and calm feelings of anxiety. When feelings of stress become unmanageable, researchers suggest, it may be better to express them in the form of intense emotions such as excitement. Both approaches helped study participants feel less pressed for time.

Reference:

Is your busy schedule affecting your health? Time might not be the problem. (2015, February 25). Retrieved from http://www.sciencedaily.com/releases/2015/02/150225094321.htm

A friend, loved one, or family member pulls you aside to talk. He or she is normally quiet and reserved; this seems out of the ordinary.

“I have something very important to tell you. It’s very hard for me to say,” the person admits. “I have been sexually abused.”

How do you respond?

Do you recognize how powerful this moment is for the person talking?

For mental health professionals and non-mental health folks alike, being in the position of listener may seem daunting. In my work as a therapist, I have encountered many survivors of sexual abuse at various stages of the healing process. Most often, such people describe abuse starting in childhood and reoccurring throughout life.

In addition to the trauma inflicted by the abuse itself, many survivors, if not all, describe a bad experience when they chose to disclose the abuse to someone they trusted. Disclosing abuse is an enormously important and highly stressful event that can mark a golden opportunity for the survivor to begin the healing process.

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If navigated poorly by the listener, however, it can easily be a step backward.

Many survivors of abuse hold on to memories of their abuse for years, typically denying, avoiding, or dissociating from them. It often takes an unthinkable amount of trust and vulnerability to motivate a survivor of abuse to disclose these events and make them “real.”

For those of us who have been on the listening end, it can be difficult to know what to do. The experience can be scary, and the unexpected and uncharted nature of the event may make us feel anxious. We may feel dismissive or defensive if the person identified as the abuser is a close friend, loved one, or family member. In some situations, inadvertently or otherwise, we may even shift blame to the victim by saying things like, “Why didn’t you say stop or call for help?” or, “Were you drunk when this happened?” or, “What were you dressed like?” These reactions are antithetical to the help that the survivor worked so hard to seek.

Before we cover what a person in the position of listener should do, let’s explore what may have prevented a survivor from disclosing abuse earlier. Sexual abuse, especially if perpetrated by someone the survivor knows and has an ongoing relationship with (family member, friend, friend of a friend, etc.), typically comes with threats if the survivor speaks up or alerts authorities. Aside from direct threats from the perpetrator, survivors will often harbor their own fears of consequences of disclosure, including:

• Threats that the abuser will harm nonabusing peers or loved ones
• Fear of judgment, embarrassment, alienation, and abandonment from nonabusing peers or loved ones
• Consequences to the survivor’s social structure and/or family, especially if the abuser is a valued person within his or her social or family structure
• Worry that because the events were so confusing to the survivor, he or she will not be able to properly communicate what happened
• Concern that because the trust of nonabusing adults or peers had previously been damaged, he or she cannot turn to them for protection or help
• In the event of childhood sexual abuse, the child may fear dissolving the only relationship he or she currently has

When someone tells you about his or her experience with sexual abuse, simply saying “I believe you” is the most valuable form of help you can offer. Validation is the first step in breaking the cycle of fear and isolation. Survivors of sexual abuse are often groomed or primed by their abusers to fear the revelation event, so feeling socially rewarded for it will introduce a much-needed new perspective and sense of safety. Additionally, feeling believed when disclosing abuse may also lead to breaking the person’s negative coping skills (denial, avoidance, dissociating). Once the abuse has been revealed and validated, the person may finally feel able to fully confront the reality of what happened and begin the healing process.

Abuse often leaves the survivor feeling powerless. An individual who has felt out of control of his or her body, emotions, and environment may feel a rush of empowerment and hope knowing that someone believes his or her truth. It might even be the impetus to the survivor going to the authorities or seeking legal protection.

What happens when we react with skepticism, blame, or defensiveness? The fears and paranoia nurtured and reinforced by the abuser are validated instead. Rather than seizing an opportunity for healing, the survivor may feel rejected and thus retreat into hiding. In psychotherapy, we call this retraumatizing. When a person feels retraumatized, it may stand as an obstacle for the person to seek help in the future.

If someone you know and love tells you that he or she has been sexually abused, remain calm, listen and speak with empathy, and leave the person no doubt that you are on his or her team. You may help the person take the first step out of a very dark place.

Reference:

Sanderson, C. (2006). Counseling adult survivors of child sexual abuse (3rd ed.). London; Philadelphia: Jessica Kingsley.

Trauma dysregulates the body. It moves energy levels away from baseline to extremes of hyperarousal (“too much,” panic, overwhelm) and sometimes hypoarousal (“low,” lethargy, emptiness), not only alternating but sometimes getting stuck in either extreme.

When we experience overwhelm in the body, one natural response to this dysregulation (and accompanying confusion or relational struggles) is to just get away—perhaps through drinking, sex, anxiety medication, working out, or power-watching television series online. For some, especially when trauma occurs early in life or when physical escape is not an option, dissociation (mentally drifting, wandering, “spacing out”) becomes the path to something that approximates peace or safety. Whatever route you take to numbness, it ultimately leads to separation from overwhelming sensory input coming through the body. Studies have shown that even when mental denial occurs, when we tell ourselves we are not upset, our body still shows all the standard symptoms of activation and overwhelm.

Big names in trauma, including Peter Levine and Bessel van der Kolk, advocate not for desensitization approaches that dull perception (repetitive reprocessing of trauma), but for practices that resensitize somatically to awareness of the present moment, the physical narrative, and an embodied experience of safety and control.

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“Traumatized people chronically feel unsafe inside their bodies: the past is alive in the form of gnawing interior discomfort. Their bodies are constantly bombarded by visceral warning signs, and, in an attempt to control these processes, they often become expert at ignoring their gut feelings and in numbing awareness of what is played out inside. They learn to hide from their selves.”
—Bessel van der Kolk, The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma

From Numbness

When we split from Self, we become our own enemy. We deem some core part of Self unacceptable or unsafe and expend huge amounts of energy in an effort to contain and subdue that part.

Sometimes the numbness soothes.

Sometimes it smothers.

Especially in trauma, we move to extremes.

Where we once sought freedom from overwhelming sensations, we eventually embody the separation: fully numb, divorced from life, split from Self, desperately seeking a way to feel real again, to feel connected to others and to life … to feel anything but the empty nothingness we sought and created.

The experience changes from one person to the next. For some, it may be less conscious or intentional. Maybe awareness of behaviors comes from the feedback of others as they accuse you of being irritable or irrational. Maybe they point out how analytical you’ve become, how rigid you’ve become in your rules and boundaries in some apparent quest to manufacture security.

Sometimes the extremes seem less extreme. Especially from a patterned “freeze” response or “learned helplessness,” the only noticing may be more of a familiar giving up, an acceptance of circumstance, buying in to the belief that this is all there is. From the perspective of onlookers—seeing your shoulders fall, your head drop slightly—it might look like a physical collapse.

Character development over the years, adapting around ongoing waves of trauma, commonly moves toward extremes of highly responsible or irresponsible behavior—rigid or chaotic. It might be a complex blend of both, creating artificial structure to protect and control, then engaging in high-risk behaviors to drown out or anesthetize the pain.

Sometimes there’s just the safety of the same old patterns.

Sometimes an anger rises against that monotony. That part contains screams out from inside of you.

Whether it feels safe or not, that unknown, incessant core part of Self keeps making itself known, keeps drawing your attention.

To Overwhelm

Coming back into your body often means a return to the original overwhelm.

Sometimes we can feel it coming. Other times, we are so split from our bodily senses that we don’t feel the pain until it’s too intense to ignore. It might feel like an instant move from “just fine” to overwhelm. What would it be like to drive a car with a speedometer that shows zero or 100 but nothing in between?

“Trauma changes the insula, the self-awareness systems. Traumatized people often become insensible to themselves. They find it difficult to sense pleasure and to feel engaged. These understandings force us to use methods to awaken the sensory modalities in the person.”
—Bessel van der Kolk

Sometimes the only way out is through … through the natural physical sequence of fight or flight—whatever motor pattern that represents in your body, whatever unfinished story it represents in your behavior. Sometimes this requires the help of a trauma therapist, including a therapeutic process of training and resourcing, developing a bond of trust and a mindful grounding in the present moment. The accessing of uncomfortable physical sensations (and state-dependent beliefs that come with the sensations) can become a healing experience rather than a confirmation of negative beliefs formed at a time when you felt incapable of meeting the occasion.

Some people find a grounding, resensitizing support in nature. Others find a necessary social/attachment support in structured groups. For some, it might be yoga or martial arts that return your body to a felt sense of control. Many therapists, particularly those trained in trauma or body-based experiential approaches, come equipped to help a person internalize (to gradually take in, to incorporate into his or her character) an experience and a knowing of safety and control with Self and with Other (the therapist). Whatever the method, for those who have separated from their bodily self, the move to incorporate bodily sensation into their awareness often proves to be a life-altering process.

To Manageable Pain

Sometimes it’s in the shower, cooking a meal, sitting in a garden, or “being” with a therapist. The nervous system drops to a calm hum, the physical containment ceases, and the memories process, unbidden, unstopped. And finally, in stillness, with internal safety and compassion, we observe, feel, accept, and integrate. Sometimes the body shakes—with or without tears. And after all the years of struggle, sometimes a gentle sadness lingers.

Once the overwhelm is past and underlying truths are part of present awareness, only grieving remains. Each new level of awareness brings with it a comparison between what was and what could have been—grieving for the time lost, missed opportunities in life, unmet wishes, past distractions from this centered place of living.

There may be decades of fighting the overwhelm of grieving, and then just the simple, natural, bodily directed process of grieving. No longer does one part of the body expend energy containing the “unwanted” energy of another part. No longer is it “too much” to bear. It just is. We are able to sit with the experience without reaction, without separation, with nonjudgmental presence. It might be less letting go and more letting be.

To Joy

Emerging on the other side of pain, many people find new connections. Many find that the quality of external integration echoes the quality of internal integration, and once Self is internally acceptable, we begin attracting others who also accept and value those parts of Self that we truly value, that perhaps we preserved in hiding so many years.

“If you are divided from your body, you are also divided from the body of the world, which then appears to be other than you or separate from you, rather than the living continuum to which you belong.”
—Philip Shepherd, author of New Self, New World

References:

1. Siegel, D. J. (2010). Mindsight: the new science of personal transformation. New York: Bantam Books.
2. Van der Kolk, B. (2014). The Body Keeps the Score. New York: Viking.

First, I want to tell you that you are absolutely entitled to all of your feelings—even the ones that seem to contradict each other. Relationships are very complex; there is room for many different emotions. You may be able to achieve a little bit of peace if you give yourself permission to end the war between hurt, helplessness, confusion, guilt, resentment, and fury. You don’t have to choose; you can have them all.

From what you have written about your mother, it seems like she is in considerable pain and struggling with a lot of her own issues. It is very possible that her intensely protective behavior toward you is indicative of her own deep wounds. She may be trying to protect you from sustaining the wounds that she has experienced in her own life. In other words, her behavior is not about you, but rather her own suffering. Sometimes realizing this, and constantly reminding yourself of it, can go a long way toward not taking her behavior personally.

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Her behavior is clearly taking a toll on her, you, your relationship with her, and probably many other relationships in her life—remember, this is about her, not you, so it certainly impacts her relationships with others. It sounds like she could really benefit from being in therapy, if she isn’t already. You may wish to encourage her to pursue this. That said, at the end of the day, your mom has to make her own choice about whether to get help. While you can suggest it, encourage it, and even offer to help her find it, you can’t make her do it.

In fact, the only thing you do have control over is your behavior. It sounds like your mom is behaving in some pretty self-destructive ways and she is really hurting you. While it can be tempting to try to find ways to control her—to make her get help, to make her see that you have sacrificed so much to be there for her, to make her know that she is loved—you simply cannot. Your mom is the only person in the world who can control what she does. Likewise, you can control what you do. So, it is probably time to shift the focus to yourself. Partnering with your own therapist to work through the hurt and pain, which likely lurks beneath the fury, can help you stop personalizing your mom’s behavior and develop more productive ways of coping.

In addition to therapy, I would suggest being compassionate and patient with yourself, and doing all that you can to make yourself as comfortable as possible. It can be very painful to have a parent like this. Everyone deserves to have a consistently loving, nurturing mom who makes them feel safe. While your mom was unable to provide this for you, maybe part of your healing will be learning how to provide it for yourself. Try to take good care of yourself—eat well, exercise, and get a good amount of sleep. Seek out friends and family members who you trust and feel safe with to support you. You’ve been so focused on your mom for so long, it’s time to keep the focus on you and your needs.

Kind regards,
Sarah

In a culture saturated with violent images, parents naturally worry about their children and the influence of these images on their behavior. The question of whether being exposed to violent images or interacting with violent computer or video games increases the level of violent or aggressive behavior in children is a subject of much research and debate.

Regardless of how children are affected by depictions of violence in media, it is important to remember that even children who are not exposed to violence on television and do not play violent computer or video games are often still aggressive. In fact, all children have the potential to act aggressively; it is part of our human endowment. As parents, it is our job to monitor and intervene in our children’s aggressive activity so that they (and those around them) remain safe. This can be a confusing and difficult task. However, it is made much easier if we ask ourselves a few basic questions and follow some basic guidelines:

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What Is the Difference Between Aggressive Play and Aggressive Behavior?

With aggressive play:

• No one intentionally hurts another physically or emotionally.
• The play between peers in mutual.
• The children playing understand the difference between fantasy and reality.

With aggressive behavior, one or more of the above guidelines is not followed by one or more of the children involved.

Why Do Children Engage in Aggressive Play?

• Children often feel powerless and frustrated by how little agency or control they have in their lives. Aggressive play gives children a sense of control and mastery over their environment.
• It gives children a way to express certain feelings and desires that they may not have access to or can’t yet put into words.
• It helps children work through their developing sense of right and wrong.

How Do I Handle Aggressive Play?

• Try to take a nonjudgmental attitude. Aggression is a normal part of the human condition and of your child’s emotional life.
• Make sure the situation is safe and mutual and that no one is hurt or scared.
• Keep an eye on the level of stimulation; if it gets too high and you worry it will get out of control, step in and stop/redirect the play.
• Take your own comfort into account; we each have a different tolerance level for aggression.

How Do I Handle Aggressive Behavior?

• Like with play, take a nonjudgmental attitude. We don’t want to shame our children with regard to their aggressive feelings (though we do have to intervene with their behavior).
• Point out to your child when play has become behavior. For example: “It looks like Tommy doesn’t want to play anymore,” or, “I am worried what you are doing is not safe.”
• Try to identify the stressor (if there is one) that is causing the behavior—too much stimulation, difficulty putting feelings into words, etc. If the child is old enough, point out the stressor to the child. Try to resolve stressors when possible (quiet time, giving words to feelings, etc.).
• Set limits! Your child may not be in control of their impulses and may need you to step in.

Some children who behave aggressively need more help feeling safe and in control. When you sense that your child’s aggressive behavior is interfering with the ability to function (at school, with peers or siblings, etc.) or is dangerous or out of control, it may be time to seek professional help from a child therapist or parenting expert. Your child might be struggling with a particularly difficult stressor or developmental challenge and need a bit more help getting back on track.