“Happy birthday!”

Colorful balloons are carefully tied to the picnic table as giggling 8-year-olds play hide-and-seek in the backyard. The pink and white frosted cake is about to be cut, but the birthday girl isn’t in sight. Her mom eventually finds her quietly playing alone in her room and gently asks, “What’s going on?”

Normally outgoing, the girl, adopted at birth, had been excited in the days leading to her celebration, helping with the plans and decorating invitations. Today, however, she awoke visibly upset and announced to her parents, “I don’t want a birthday party anymore!”

A member of a group I facilitate for adopted teens explains, “My birthday is an extremely hard day for me. It’s really bad. I feel sad and angry and just bad.”

“Me too!” another teen chimes in. “I’ve never liked my birthday, and Mother’s Day is sometimes hard, too.”

It’s not uncommon for adopted children, teens, and even adults to have conflicting feelings about birthdays and other dates of note. Small children may not even understand why and may need the adults in their lives to help put words to their complex feelings.

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Birthdays are often the day infants are separated from their biological mothers. This separation, an undeniably traumatic event, is stored in the brain and body as an implicit memory because the separation takes place before language develops. The memory becomes embodied and can later be triggered without conscious knowledge.

Mother’s Day can be difficult because while one mother is celebrated, the other may not be mentioned. Other holidays may be challenging as an adopted person thinks about his or her biological family. A 16-year-old adoptee shares, “I think about my [biological mom] a lot during Christmas. I hope she’s doing OK and celebrating. I wonder what her traditions are and I wonder if she’s thinking about me? I miss her even though I don’t know her.”

Difficulty navigating holidays and birthdays may be compounded for children and teens who have been in multiple placements or foster homes before they were adopted. Each year may mark a different memory and an additional loss.

Adoptive parents should be sensitive to their child’s experience and remember that their child’s history began before they became a family. This is also true for children adopted at birth or in early infancy. They, too, had a history prior to being adopted.

Parents can help put language to the felt experience for their child. They can empathically respond to a child who is visibly struggling by reminding themselves that their child is likely experiencing implicit feelings. They can make the implicit explicit by expressing curiosity and naming the feelings, which may include sadness, anger, and grief and loss. Parents might say something like, “Your birthday is the day you were born, and I wonder if part of you remembers this is also the day your birthmother made the difficult decision to have someone else raise you?”

On Mother’s Day and other holidays, parents can “say” what is not being said by celebrating and acknowledging their child’s birth mom and genetic relatives. They can ask their child about what they are experiencing and validate any and all feelings. Families might decide together to incorporate customs, traditions, and special foods of a child’s country of origin into their existing traditions. If the adoption is an open one, parents can make contact with their child’s biological family.

It’s OK for parents to give themselves permission to get creative and think outside the box. Most importantly, parents should strive to see the world from their child’s point of view and imagine how difficult it may be for the child to integrate the inherent split adoption creates. Adopted children and teens want and need their parents to be their advocates at birthdays, holidays, and every day, and to lead the conversations until they feel comfortable doing so.

Being unable to speak up at work can have long-lasting negative consequences. It can lead to stress, burnout, or render you almost invisible in a setting where promotions and raises depend on visibility.

When you’re assertive, you ask for what you need, you talk openly about what you want, and you recognize when someone is taking advantage of you. You can approach the things you do with confidence and make a direct impact on your environment. But this does not come easily for everyone.

There are two important components to becoming more assertive: (1) learning to treat yourself with respect, and (2) building communication skills.

1. Recognize Your Value

The first step toward becoming more assertive is nurturing a realistic and respectful perspective on your value as a person. Many people struggle with attribution problems—attributing their failures to internal flaws (“I’m just no good at this, no matter how hard I try”) and their successes to luck (“That went well because it was easier than everyone thought it would be”), contributing to gnawing self-doubt and potentially a sense of worthlessness.

Take a step back and think about what you contribute to your workplace. For now, try to quiet any internal criticism that wants to scrutinize your flaws, mistakes, and failures; those thoughts can evoke shame and cloud your ability to see your positive attributes. Take a balanced inventory of who you’ve been at work, noting both good things that you’ve done and anything you might want to improve.

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2. Know Your Rights

Educate yourself on the things you’re entitled to in your workplace. The big wall of posted notices in your lunchroom, your employee policy manual, your job description—you might not know what’s in all of that available material, despite it having important information.

Learning to be assertive in your workplace includes learning the legal and ethical boundaries of what you can expect from your work environment. For example, if you find that you’re frustrated by being expected to work through lunch four times a week, this material can tell you if that expectation violates laws in your state, which can support your desire to stand up for what you need. If you are being harassed or subjected to mistreatment, there may be protections in place to help you. Knowledge can help empower you to seek what you need.

3. Know Your Boundaries

Learning and respecting your personal boundaries is an important step toward regulating stress and frustration. Taking on extra projects despite missing important family events, or continuing to answer work emails from your bed despite the interference with a proper night’s rest—burnout is made of these ingredients. Think about what you can realistically expect of yourself and respect your limitations. We are all bound by our humanness and by time; there is no getting around those things, even if deadlines are looming.

Everyone benefits from your direct communication. Being exhausted or resentful is not only miserable, it keeps you from performing at your best.

4. Prepare and Practice

First, prepare for being assertive at work in the safety of your journal, your therapy, or your close relationships. Imagine what it might be like to communicate something difficult to your coworker or your boss. Ask yourself the following questions: What is my goal? What do I want to say? How would I like to say it?

Act it out in your mind, playing out both the ideal scenario and the scenario that scares you the most. Try talking it through with a loved one who would be open to role playing. Say aloud what you would like to communicate at work. If you don’t, when the moment comes, your nerves might get you tongue-tied and it can feel easier to give up. Consider the things that are often difficult for you to say (for example, “No, I can’t,” or, “That makes me uncomfortable”) and rehearse them for future use.

5. Learn the Difference Between Assertive and Aggressive

Many people quiet their voices because they have come to believe that speaking up is synonymous to being bossy, pushy, or disrespectful of other people. Being assertive does not have to be any of those things; it only means to value your own thoughts, feelings, and voice as well as those of others.

You can continue to be a kind, likable person while communicating directly. Assertive communication doesn’t look to bulldoze over other people (that would be aggressive communication). Its goal is to create the best outcome for you in cooperation with the others in your workplace. “I disagree with that” is assertive and honest, and it opens up further conversation to move toward resolution. “What kind of stupid idea is that?” is aggressive and minimizing, and it shuts down conversation.

6. Keep Growing

The more you learn and grow, the more connected you can feel to your skills and your knowledge. Confidence is rooted in knowing yourself, your value, and the things you can offer to the world around you. Continue to cultivate your career, and acknowledge how your efforts and strengths bring benefits to your work environment.

Have patience with yourself as you make these changes. You may stumble through difficult conversations or lose nerve at the last moment. That’s OK—many new things are hard at first, and building a direct communication style is a process.

If you find that being assertive is particularly difficult, you can also address the issue through assertiveness training programs, group psychotherapy, or individual psychotherapy.

What does a counselor say to a teen who just found out his or her best friend has died an unexpected death? I recently found myself facing that very challenge. I found myself asking, “What can I do or say to fill the space?”

Sometimes, there simply are no words. While adults often have strong opinions about what grief should look like, such as talking about feelings, teens often don’t want to talk and just want to be with their feelings. An important lesson I learned is that when a teen is grieving, he/she needs to be given the same respect, trust, and space that adults receive when they are grieving in order to process feelings in his/her own way. Initially, teens often don’t want to answer questions, do art therapy, journal about their feelings, etc.

As I sat with a teen in my office, wondering if I should implement the strategies stated above, I could almost hear the words, “Just let me have my feelings!” I began to realize that I was the one uncomfortable with the silence and with “just being there” as the teen tried to absorb and process an event that forever changed the teen’s life. This is not to say that, at some point, opportunities for the teen to express grief won’t be helpful and therapeutic; however, the process needs to happen on the teen’s timeline, not mine.

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There is no “right” way for teens to mourn the loss of a friend. I believe teens get through the mourning process in a more effective way if the adults in their lives walk that journey with them without trying to determine and/or tell them what they need and/or where they should be in the grieving process. Teens need to understand that they are in a grieving process and allow themselves to feel their feelings, which can be very scary. Initially, teens may resist allowing themselves to feel anger, sadness, confusion, the need for answers, and regret. They need to be given permission to “meet themselves where they are” and to understand that it is normal for their emotions to change frequently. At some point, opportunities for teens to express their grief through art, writing, talking, etc., will be helpful and therapeutic.

What is the best way for parents to “walk the journey” with a teen who has lost a friend to death? While each situation is different and individualized, parents can take the role of listener and learner and allow the teen to be the teacher. Parents need to follow their teen’s lead. Another way parents can walk beside their teen without being intrusive is by providing the support of outside resources that the teen can access as he/she feels the need to or when he/she feels ready to, before the teen has an opportunity to get stuck in the grief process.

Parents need to be mindful of their own grief issues, as they will influence the way they relate to their teen. Parents often fear that their teen will become suicidal or stuck in their grief and believe they need to monitor the teen at all times. While this belief comes from a spirit of caring, sometimes a teen will feel smothered and become resentful if the teen perceives that he/she doesn’t have the opportunity to grieve in his/her own way. While parents and other family members and friends should be nearby and available, a teen may need the opportunity to perceive that he/she has enough space to sob, yell, or scream without the fear that anyone can hear. Parents need to be careful of directing their teen’s grief process as opposed to being a companion and support.

While teens should not be judged for the way they grieve, clearly there are constructive behaviors as well as destructive behaviors teens may engage in while mourning. Behaviors that are considered constructive are those that encourage teens to face their grief, such as talking with trusted family members or friends and expressing emotion (along with creating art, journaling, etc.). Behaviors that are considered destructive are those that allow teens to “numb” their feelings, such as drugs, alcohol, reckless sexual behavior, antisocial behavior, academic problems, etc.

Grief is not something that ends. Without the intention of being offensive, many often say, “You need to move on,” but grief is not something one gets over. It is something that changes over time and is eventually accepted.

I find myself looking at this person; I feel for him, knowing that he is tormented by his anxiety and sense of isolation. While he has made amazing strides in therapy, especially through eye movement desensitization and reprocessing (EMDR), there is something that keeps “blocking” him from reaching the point of accepting that the past is truly “over.” There is something that pulls at him, drags him down into the murky depths of his sadness, telling him that he can’t reach that positive belief that he is “good enough.”

His story is not unique. He is like many of the people I work with in therapy who struggle to loosen themselves from the hold of trauma. He is like many who walk into my office wanting to feel free of the past, to fully integrate what they know “logically”—that they are “OK, lovable, worthy, safe, here now”—with their emotional selves, who are just not buying it.

As you are reading this, perhaps there is some aspect of your healing work that you feel “stuck” in. It’s a common theme; folks do amazing trauma healing work and perhaps might find that they have hit a wall. They want to feel healed, but on some level it just won’t budge. “I don’t know why” is a common statement. What we often find is that there is some next layer of the person’s experience that is revealing itself. In EMDR therapy, we call it a “blocking belief.”

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Why does this happen? Why is it that, on the one hand, we can know that the past is behind us, and yet there is also a sense that it is not? We can begin to explore this question not only through the perspective of trauma therapy, but specifically EMDR therapy.

A blocking belief essentially blocks us from shifting our core beliefs about ourselves. For example, in processing deep-rooted trauma through EMDR therapy, the person I described was working through a core belief (EMDR therapists call it a “negative cognition”) of “I’m not good enough” and then, right when it was getting to a decreased intensity, found another layer—a blocking belief that “I shouldn’t get over this.” That same blocking belief kept the trauma from decreasing in intensity from a 10 (most disturbance) to a zero (neutral/no disturbance). It wasn’t until we shifted that blocking belief—“I shouldn’t get over this”—that the core belief of “I’m not good enough” could release its hold as the trauma was processed.

Blocking beliefs can come up often in EMDR therapy when we ask about the SUDs (subjective units of disturbance scale). It’s a scale we use to find out how the person’s distress about the event has shifted. Keep in mind that it doesn’t mean that the event is not disturbing. That it’s disturbing doesn’t change. It will be a disturbing event as a trauma, by its nature of being a trauma. But the person doesn’t have to continue to feel disturbed by it.

When we start to explore our core beliefs about ourselves, and the traumas that have driven them, be sure to explore any blocking beliefs that may show up. It may just mean that you are that much closer to healing those traumas than you may have thought. It may just be that deepest layer waiting for you to discover it.

Believe it or not, it is possible to get to a neutral or zero about traumatic events and the disturbance we feel about them, even for the most upsetting and distressing experiences. But there may be some reason we hold on. Unconsciously, perhaps we think we need to keep some fear, just enough, to help us feel safe and prepared for next time. Perhaps we think it’s “impossible” to heal from those experiences. Perhaps there’s a mistaken, unconscious belief that it’s not “something we should get over,” that it’s not OK that we heal this event: “It’s just too painful; if I feel neutral or no disturbance, then I am not honoring the experience(s) and the impact on my life.”

The fact is, and this comes up a lot for folks when they do EMDR, it is possible to heal trauma.

It is possible to feel differently about our lives, whether it be to feel safe, calm, or even feel and know that the past is over. Yes, it can change; I’ve seen it. I’ve also experienced it. That said, it can take time, even with EMDR therapy, especially with multiple of types of traumas, and when traumas span across the developmental stages of our lives.

Life is unfair! Why does he have more money than me? Why is she prettier? Why does that guy get away with everything?

Injustice is a bitter pill to swallow, and some people seem to choke on it on a regular basis. If you are very sensitive to injustice, you become aware of its existence all around you; the reckless driver speeding down the street, risking other people’s lives; the coffee shop barista, friendly to young hotties but dismissive of old fogies. Injustice can stir many painful feelings: anger, frustration, helplessness, sadness, vengeance.

Revenge is the desire for justice. It isn’t fair that they should get away with that; for it to be fair, they must feel the repercussions of their actions. So people fantasize about the driver getting a speeding ticket or humiliating the young barista with sharp wit. But the revenge fantasy doesn’t make the pain go away. In fact, it makes it last longer, feeds the anger and helplessness, keeps it alive, and adds shame and guilt to already unpleasant feelings. And if you were to actually enact revenge, the consequences for you would be far worse.

“He that studieth revenge keepeth his own wounds green, which otherwise would heal and do well.” —John Milton

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Many people experience this cycle of emotions: recognition of injustice, turning to rage, desire for revenge, shame, and then hopelessness, on an all-too-often basis.

Everyone experiences injustice, but why do some people suffer over it more than others? One reason may be that the people regularly plagued by injustice have experienced more extreme and blatant examples of injustice in their lives. They’ve been bullied, discriminated against, poor. However, not all people in similar situations share this painful obsession with injustice. In addition, people who have experienced relatively minor injustices can be just as sensitive to it.

One thing that people sensitive to injustice seem to have in common is a “me against them” attitude that can quickly stir them to anger; causing disruption in their relationships with other people and leading to isolation. It’s like you’re always in a fight with an invisible other person or group.

So what do you do if you’re a person whose feelings are painfully stirred by an encounter with injustice? Ask yourself the questions, “What am I feeling? What is my view of humanity? Is my anger a call to action or a cry of helplessness? Do I think that I, alone, experience injustice, whereas everyone else in the world is dealt with fairly?”

In other words, if you experience this injustice cycle frequently, it’s time to take your view off what is going on in the world and look inward at what is going on within you.

The fact of the matter is life is unfair. There is injustice in the world. We see it in the newspaper every day. Even as small children, we’re aware of this fact. From the first time some kid got an ice cream cone and you didn’t, or you were punished for something you didn’t do, you were dealing with it.

It may also be that you are unconsciously dealing with existential injustice; the aspects of life that we find difficult to accept—that we will all die someday, that there are no guarantees in life, and that we are ultimately responsible for our lives, regardless of the things we can’t control.

It may be helpful to remind yourself that there are a lot of wonderful things that people do to make the world a better place. Many people are out there striving to make a difference all the time. If a certain injustice becomes your call to action, you could be one of those people, doing your best to help those in need. But even if you choose to focus on helping yourself to become a happier, more peaceful, and more accepting person, that will make a much more positive impact on your life and the people around you than if you choose to spend your life angry and holding a grudge. Peace begins with you.

Problems that make their way to family therapy tend to involve self-reinforcing—or circular—dynamics and, as such, are commonly called “vicious cycles” or even “vicious circles.” When people become “stuck in a rut,” so to speak, a problem has morphed into a cycle of cause, effect, and attempted solutions.

In other words, even legitimate attempts to solve a problem seem to somehow perpetuate it.

By the time a person (or couple, or family) enters therapy, they are often aware on some level of the nature of the cycle they are stuck in, and motivated to try something new.

This is therapy’s opportunity.

People thoroughly entrenched in problems have underlying resiliency. Family therapist Carl Whitaker (1989) wrote, “Psychopathology is proof of psychological health. The individual who is distorted in his thinking is essentially carrying on an open war in himself rather than capitulating …”

Effective therapy need not reinvent a person; rather, systemic therapists wrestle with people in their care to stir their own latent creative energies to free themselves from being stuck in their quagmires. It is ultimately always the people in therapy who become free and responsible over their lives, not the therapist.

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Therapeutic experiencing invokes a kind of psychological immune response. In the best of cases, multiple interdependent systems experience simultaneous positive effect. In the course of therapeutic work, I utilize interventions that turn circular tailspin into dialectical liftoff.

I must credit these ideas, broadly, to the pioneering integrative systems theory of Gregory Bateson, to whom many of the founding mothers and fathers of our field owe their inspiration.

Isomorphism

The use of feedback to engage the parallel emotional process.

At every turn, I believe it is my responsibility to circle back around to mindful reflection of my therapeutic interaction with people. I tell them about my experience of them—what I have felt, wondered, observed, and thought, including my evolving hypotheses.

I sometimes go to great lengths to understand and cajole them to understand some of the basic relational dynamics taking place between us in therapy to stir perspective outside the therapy room.

Isomorphism as intervention is about intentionality as a therapist in cultivating emotional-relational transparency oriented toward therapeutic intimacy.

When built on openness, respect, and curiosity—and while maintaining a practice of accountability with people in therapy—engaging at this level has the potential to infuse transformative power into the therapy process.

Circumnavigation

The use of evaluative assessment to gain contextual perspective.

Recently the Rosetta space probe arrived at its destination after a 10-year journey of more than 600 million miles through our galaxy. When it arrived, it spent months carefully orbiting around comet 67P, aka Churyumov-Gerasimenko, in order to study it from afar. Rosetta first had to get a sense of the shapeliness of the mass, understand a bit of its terrain, and strategize where best to send its lander.

Philae, the landing module that Rosetta had brought along, eventually made its careful descent to the comet. Unfortunately, despite careful planning, the lander bounced at least twice after landing on the surface, and when it landed, it was in a shadow, near the bottom of a towering ridge, unable to absorb the sunlight necessary for its own battery and the continuity of the mission.

After the mishap, scientists reassessed that the unthinkable position of the lander may have a serendipitous upside—as the comet nears the sun, the lander may find itself exposed to the beams of sun necessary to charge itself yet remain shielded enough to carry on for much longer than planned.

As we survey territory, I must be skilled enough to avoid major obstacles, and we must be joined well enough together to traverse through pummeling, disorienting space dust in order, ultimately, for people in therapy to gain an awesome, sometimes catalyzing, perspective of larger processes governing their lives. And we must roll with resistance in the process, reframing stumbles as opportunities.

Oh, and just in case it crossed your mind—yes, assessment is intervention!

Abduction

Analyzing perceptual alongside communicative patterns in order to disentangle them.

Bateson (1979) described how people become stuck in their own rigidity—how, for instance, presupposed ideas are supported by a social system which conversely supports the presupposed ideas because the social system itself is a vast recursion full of individuals with presupposed ideas.

The proverbial “chicken or the egg” really cannot do justice at this level of complexity.

Bateson commonly called abduction “the double description,” and he by this referred to extrapolating patterns of mental processes alongside patterns of adaptive processes. It is fascinating to consider—all forms of communication truly are adaptive; and perception is nearly inextricably tied into it.

We must move far beyond learning as insight-comprehension to a kind of learning-while-learning, with, for instance, communicative shifts occurring simultaneously alongside perceptual shifts and each reinforcing the other—Bateson (1972) called this “deutero-learning” or “Learning II.”

As people in therapy grasp shared aspects of the perceptual and communicative processes within themselves and their families, the possibility increases that as they decode interrelationships, they will learn to disembody the problem transfixed within them. In other words, they may learn increasingly to dissociate themselves in some way from their problem and thereby become disentangled from it.

Bateson (1977) once wrote, “As you become aware that you are doing it, you become in a curious way much closer to the world around you,” and this is its therapeutic power. This, Bateson (1991) argued, is because “meaning is not internal. It is between parts.”

Recapitulation

Practicing the problem in order to demystify and rend it less powerful.

Once people in therapy have come to experience a problem differently in-session, they will come to experience it differently in life. Experience will beget experience, as it nearly always does.

And so I find it of the highest necessity that the people I work with in therapy bring their problem(s) into therapy. This may seem to be stating the obvious. What I mean, though, is that for our therapeutic relationship to affect change in the lives of the people I help, we must somehow experience the problem together in vivo.

When people are tempted to go on recursively explaining problems, I let them know they can choose between carrying on, remaining in the safe position of knowing what they know already, or experientially exploring with me aspects of presence, emotion, or communication to risk gaining what they may have never known.

Summoning the spirit of the problem may necessarily come of its own accord, as its cajoling may constitute an ethical breach for the therapist, depending on the nature of the problem. Nonetheless, nearly inevitably, and often in the midst of a presumed period of improvement, the therapy room becomes proving ground.

Evocation

The spontaneous and creative stirring of images and feelings to energize positive changes.

When the positive end of one magnet is placed against the negative end of another, an invisible force pulls them together. Likewise, when the magnet’s positive end is placed against the positive end of another, they repel one another. Two pieces of uncharged metal neither attract nor repel.

There is magnetism in the emotional systems of families and, to greater or lesser degrees, between every family member. The force between two is skewed by an intervening third, and so on.

The challenge of therapy is of how to work therapeutically with processes that bind and unbind, generating flexibility and instilling resilience. To grow, people must experience freedom within the felt pushes and pulls of powerful self-perpetuating forces in which problems—and families—maintain themselves.

Bateson (1972) himself suggested that painting, poetry, music, dance, and other metaphoric art forms serve as a bridge between the conscious and the unconscious, a way of communicating outwardly what dwells inwardly, abductively and evocatively affording us opportunities to enter into the relationships they express.

Whitaker (1989) taught us that what is therapeutic is not necessarily the experience itself but the meaning the person in therapy attaches to it. Quite so, if the person is to change, then transformative experiencing must occur. Success is quantum leap from one state—or state of meaning—to another.

And who but the therapist must invoke it?

(Incidentally, these modes of intervention spell “I CARE.” You can credit the acronym to me.)

References:

1. Bateson, G. (1972). Steps to an ecology of mind. Chicago: University of Chicago Press.
2. Bateson, G. (1977). Afterword. In J. Brockman (Ed.). About Bateson: Essays on Gregory Bateson (pp. 235-247). New York: E. P. Dutton.
3. Bateson, G. (1979). Mind and nature: A necessary unity. New York: Bantam.
4. Bateson, G. (1991-published posthumously). A sacred unity: Further steps to an ecology of mind. New York: Harper/Collins.
5. Whitaker, C., and Ryan, M. (1989). Midnight musings of a family therapist. New York: Norton.

When I think of the people I work with in therapy, it is astonishing how many have had to grow up fearing a parent’s powerful responses if they fail to maintain their parent’s emotional equilibrium. Shame, anger, hurt, retaliation, and emotional and physical abandonment are just some of the serious consequences for children who attempt to be themselves in some families.

When subjected to these forms of physical and emotional mistreatment, children learn to protect themselves by becoming acutely sensitive to the feelings of their caregivers. To keep themselves safe, they quickly learn that they have the responsibility to soothe and get rid of their parent’s anger, hurt, uncertainty, confusion, and any other intolerable and unwanted feelings the parent may experience. If they can’t prevent unacceptable parental feelings, they must fix the parent’s feeling state through apology, soothing, or even acceptance of the parent’s lashing out with shaming, humiliating treatment.

If the child is unsuccessful at this, the parental assaults, sometimes subtle and other times powerful, convey many messages: “It’s your fault I’m hurt, upset, sad, etc.”; “You have failed in your responsibility to make me feel good”; “You are a bad person.” Most prominent is the message: “To safeguard my feelings, you must be who and what I need you to be.”

This has many repercussions for the development of the child’s identity, sense of self, and agency.

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Living in Fear

Cynthia, 47, is married woman with an 11-year-old son, Jason. She describes herself as having been depressed and anxious for as long as she can remember. She attributes her severe anxiety to her relationship with her mother, who lives nearby. Cynthia explained why she decided to seek therapy:

“I have always been anxious and depressed. But I just can’t take it anymore. I’ve been careful around my mother my whole life. I’m so afraid to hurt her feelings or get her angry. I bend over backward to sound cheerful, never ask for anything, tell her how wonderful she is. Even when I don’t think I’ve done anything wrong, I always apologize. Now she is doing with my son what she has always done with me. She’s trying to run his life. She gets all weepy or angry and makes him feel like a bad person when he doesn’t go along with what she wants. My life goal has always been to keep my mother happy. I know I never let myself think about or go after what I wanted for myself. Now I can’t let her do that to my son. But it’s just so scary to try and protect him. She will tell me what a horrible mother I am and then get icy cold to me. I don’t think I can withstand that rejection. I probably am a terrible mother.”

Working with Cynthia, I soon discovered that her life was organized around her need to be vigilant. She rarely made a decision or undertook a meaningful action without obsessively worrying about how her mother would feel and respond:

“Jason has been begging Howard (her husband) and me to let him go to a travel camp this summer. His best friend is going, and they would mostly be going to some national parks out west. Howard thinks it’s a great idea. But I know my mom will think it’s dangerous and that he’s too young. If I don’t do what she thinks is best, my mom will be so hurt and upset. I’ll be the one who has made her an anxious mess. Then I will be a wreck. It scares me that I’m actually more worried about her feelings than about whether this is a good idea for Jason. I’m always thinking ahead about how everything will be seen by her. Her feelings rule my life. I know if I agree to let Jason go traveling, I will be attacked and then get the cold shoulder. It’s wrong that I’m more afraid of my mother making me feel so rejected and like such a bad person than I am about whether this is OK for Jason. I think I am even more afraid that if we send Jason to the camp, my mother will start on Jason like she has in the past. When he wants to do something that she doesn’t approve of, she gets that distant, frigid look and tells him that he is being mean to her and doesn’t love her. I don’t know what to do. I’m frightened all the time.”

In our therapeutic work, we began to realize how Cynthia’s vigilance was designed to protect her from the painful and frightening consequences of her mother’s behavior toward her. As we uncovered and explored Cynthia’s memories and associations, Cynthia became aware of how terrified she was of her mother. In one session, Cynthia began to cry and tremble as she recalled:

“I remember when I was in kindergarten—oh, it was so awful. I had peed in my pants, and the teacher was very kind. She called my mother to bring me some fresh clothes. All I can think of is my mother’s face when she showed up.”

Cynthia began to sob: “She looked so angry and scary. She took me into the bathroom at school and yanked my clothes off. She yelled at me and with a twisted face said something like, ‘How could you embarrass me like this? You are disgusting.’ I felt so ashamed and humiliated. I kept crying and saying, ‘I’m sorry, I’m sorry.’ ”

The more we talked and the more memories that Cynthia recalled, the clearer it was that Cynthia’s mother terrified her. Not only did Cynthia have to protect herself from repeated shaming, she always felt at risk of being abandoned by her mother emotionally and sometimes physically. Cynthia described how she knew she had to be good:

“One time, I must have been about 7 or 8; we had a housekeeper who gave me a present for my birthday. When my mother learned about it, she made me give it back. Then she screamed at me for taking something from someone who had no money. And yelled things like, ‘What kind of person are you?’ Then, as usual, she told me I had embarrassed her and that I didn’t deserve to have her for a mother. I think I remember being stunned. Then she slammed the door to my room and left the apartment. I was all alone. I don’t remember how long she was gone, but I was so frightened. I never knew what would set her off. But I soon understood that I was always in danger of being rejected or shamed and humiliated.”

Impact on Separation and Individuation

It is easy to understand how Cynthia’s fears necessitated compliance with her mother. The only means she had to protect herself was to live in her mother’s shoes and anticipate her wants, needs, and demands. Growing up, her emotional life was stunted. The constant need to be prepared to prevent or soothe her mother’s destructive behaviors had a huge mental and emotional cost.

Because Cynthia needed to be available for her mother’s use, her head was always preoccupied with anxieties about what her mother wanted and how to provide it. This left no emotional space to discover her own wishes and desires. Indeed, it would be dangerous to be too aware of being separate from her mother: to even know her own needs would run the risk of conflict and the painful consequences that would follow. This left Cynthia as a person who has no sense of herself as a person who knows who she is or what she wants.

As long as Cynthia succeeded in regulating her mother’s emotional state by keeping her feelings positive, Cynthia could stay safe. She could shield herself from the pain inflicted by her mother’s outbursts of terrifying feelings and reduce the risk of being rejected, as when her mother became cold and abandoned her emotionally or physically.

As Jason is getting older, it is becoming more difficult for Cynthia to maintain her disconnection from her own undeveloped self. While she has not had much opportunity to become a separate, individuated person, there are nascent wishes and dreams for herself that are beginning to emerge and grow. Her awareness of the destructiveness of her mother in relation to her son has helped her to emotionally understand what her own experience with her mother has been like and what the consequences have been. This has made it more difficult to ignore the steadily increasing volume of her own needs.

Cynthia is slowly becoming less afraid of her mother and of her own emerging, differentiated self. She wants something different for Jason: “I am going to try and fight for him. It is getting more scary to think that he is going to repeat my history than that I am going to be rejected by my mother.”

Cynthia understands that the power and hold of the early fears of her mother and the terror of shame and rejection are not easy to overcome. But the desire to help her son provides powerful motivation as she struggles to differentiate and separate. She knows that her challenge is to become less afraid so she can tolerate the feeling that she is harming her mother and will lose her if she asserts herself. Cynthia is committed to developing herself and learning who she is and what she wants.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

The intensity of your feelings is coming through loud and clear. And it is understandable. Being a full-time caretaker can be all-consuming and exhausting. You never get to leave your job. Doctors and nurses who work with high-needs populations get to go home at the end of their shifts, and they aren’t personally connected to their patients. Caretakers of family don’t have either of those luxuries, and it can take a significant toll on their health and well-being.

Before you can focus on being a more tolerant or compassionate caretaker to your husband, I think it might be wise to focus on taking care of yourself. Are you engaging in any self-care practices? Even simple practices such as going for walks, taking hot baths, reading a good book, or spending time with friends might allow you to cool off and help recharge you. Are any other family members, relatives, or friends in position to pitch in from time to time and give you a much-needed break?

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It sounds like you are dealing with a lot of anger toward your husband since he played a significant role in creating the situation you are both forced to live with now. You are absolutely entitled to your feelings of anger. Having said that, it seems like they are eating you up and morphing into bitterness. This does not feel good. You don’t deserve that.

Working toward forgiveness may help in coping with this. People tend to think that forgiveness is for other people (the people who are being forgiven), but it is often more for the person who is doing the forgiving. It is certainly a process, but beginning the process might alleviate some of the anger and bitterness you are experiencing. You deserve that relief.

It sounds like you need more support than you are getting. There are a lot of caretaker support groups out there, and some of them are free. Ask your husband’s medical providers if they know of any local support groups you can join. You can also go to the American Diabetes Association website to get connected to an office in your community that will likely have caretaker resources available.

The bottom line is this: The better you are able to take care of yourself, the better you will be able to take care of your husband, and the more comfortable you will be while you are doing it.

Best wishes,
Sarah

Body image, your internalized sense of your physical shape and appearance, isn’t just about confidence, nor is it an issue reserved exclusively for teenagers. Negative body image affects people of all ages, genders, and races, and is intricately linked to a host of mental health concerns, including eating disorders, low self-esteem, shame, isolation, anxiety, and depression.

Although it’s quite normal to feel some dissatisfaction regarding aspects of your body or appearance, if such self-criticism dominates your thoughts, limits your overall life satisfaction, or otherwise affects your school, work, relationships, or ability to function in a healthy way on a day-to-day basis, seeking help is imperative. Persistent negative body image can set the stage for serious mental and physical health complications, including body dysmorphia (sometimes referred to as “imagined ugliness”), compulsions and avoidance behaviors, and even suicidal ideation.

Eating disorders are of particular concern among people with body image issues, as they can be life threatening if left untreated. Anorexia nervosa, in fact, has the highest mortality rate of any psychiatric condition. Widely misunderstood and mischaracterized as a phase or lifestyle choice, eating disorders—also including bulimia nervosa and binging and purging—are strongly linked to body dissatisfaction.

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When it comes to body image, the elephants in the room, of course, are the unavoidable media and advertising messages that permeate our culture. Television, movies, magazines, websites, and other forms of media peddle unrealistic and often unhealthy standards, and younger people can be especially susceptible to the suggestion that these images reflect an ideal. In one study, 69% of American elementary school girls who look at magazines said the images they contained influenced their concept of the ideal body, and 47% said the images made them want to lose weight.

Addressing body image issues is complicated, but seeking the help of a qualified therapist is a highly recommended step. For our part, we’ve compiled a list of the 10 best online resources for body image issues and support—GoodTherapy.org excluded—in 2014. Our selections are based on quality and depth of content, presentation, and functionality.

• Proud2Bme: Proud2Bme is a teen-focused online community that provides relevant coverage on fashion, beauty, culture, and entertainment while promoting healthy attitudes about weight and body image. Proud2Bme is a resource for information on eating disorders and recovery, expert advice, self-esteem for teens, and help for parents. Site visitors can find an active forum, personal stories from teens, and a helpline staffed with volunteers from the National Eating Disorders Association.
• Adios, Barbie: Adios, Barbie calls itself “the body image site for every body.” A lifestyle blog edited by two women, Adios, Barbie tackles body image issues among people of all genders, races, body types, sexual orientations, ages, and cultures. Adios, Barbie encourages people to think critically about the messages they receive from the media and shift from being consumers to active participants in the media culture critique. Site visitors can find blog posts, articles, campaigns, and information about events that work to redefine beauty and help everyone feel comfortable with themselves.
• About-Face: About-Face is one of the best-recognized nonprofit groups working to promote healthy self-esteem and body image in girls. Established in San Francisco in 1995 by Kathy Bruin, About-Face works to give girls and women the tools to recognize harmful media messages and resist their negative impact. About-Face puts on media-literacy workshops in schools, organizations, and communities, and site visitors can find a “Gallery of Offenders” and a “Gallery of Winners” wherein About-Face staff critique or cheer the latest in pop culture.
• Beauty Redefined: Lexie Kite, PhD, and Lindsay Kite, PhD, are identical twin sisters who, after receiving their doctorates in the study of media and body image, created Beauty Redefined—a nonprofit foundation to help women and girls recognize and reject harmful media messages. Beauty Redefined has an active social media presence and a well-read blog with smart, meaningful messages and societal critiques that encourage girls to rethink what “beauty” means.
• BodySense: BodySense specializes in promoting a positive body image culture among athletes and in sports. A program offered by the Canadian Centre for Ethics in Sport and the True Sport Foundation, BodySense has created a 10-point model for promoting healthy body image in sports designed for use by teams, clubs, and schools. The 10 “BodySense Basics” were developed by doctors, body image experts, and dieticians with the goal of building self-esteem, fostering healthy coping skills, and encouraging male and female athletes to love their bodies. Site visitors can find information about training programs, workshops, and a resource kit for parents, coaches, and teachers.
• The Body Image Project: The Body Image Project encourages women and girls to contribute their personal stories about challenges with self-esteem and body image; a frequently updated blog features these stories. All posts are anonymous (only a contributor’s age is listed) to encourage an honest conversation about the struggles some women and girls face every day. Note: Because of the openness of the stories, there may be some potentially triggering language.
• We Are the Real Deal: We Are the Real Deal is a program of Mental Fitness, Inc., a national nonprofit that uses arts and media programs to spread mental health awareness. We Are The Real Deal hosts a body image-focused blog featuring more than 40 contributors who offer unique perspectives on self-acceptance, healthy coping, and nutrition. Site visitors can find interviews with celebrities and athletes, insight from mental health professionals, and a library of information on eating issues and self-esteem.
• Association for Size Diversity and Health: The Association for Size Diversity and Health (ASDAH) is an international nonprofit that strives to promote an alternative to weight-centered body image and focuses on what it calls “Health at Every Size” principles. These principles emphasize health enhancement, respectful care, eating for well-being, and nutrition rather than dieting. Site visitors can access recorded webinars at no cost, an active blog, and other positive body image resources.
• The Body Image Movement: Taryn Brumfitt began The Body Image Movement when she decided to cancel her impending body-augmenting plastic surgery. She dedicated her life to learning how to live happily in her body, and is working toward her goal of reaching as many women around the world as she can with her message of fully embracing and loving the body you were given. The Body Image Movement emphasizes health, body diversity, and celebrating the aging process while working to combat media messages that erode women’s self-esteem.
• AnyBody: AnyBody is the UK chapter of the international initiative Bodies Endangered. AnyBody works to change the body image landscape by challenging the diet industry and defying physical representations of people in today’s media-fueled society. Blog contributors are activists, psychologists, doctors, and writers, all dedicated to refuting harmful norms in the fashion, food, and media industries. Site visitors can also find a forum for discussion and links to other Bodies Endangered resources.

Have a website you would like to see in our Top 10? Recommend it here.

References:

1. Body Dysmorphic Disorder. (n.d.). Retrieved from http://teenshealth.org/teen/your_mind/body_image/body_image_problem.html
2. Get the Facts on Eating Disorders. (n.d.). Retrieved from https://www.nationaleatingdisorders.org/get-facts-eating-disorders
3. Martin, J. B. (2010). The Development of Ideal Body Image Perceptions in the United States. Nutrition Today, 45(3), 98-100. Retrieved from http://www.nursingcenter.com/pdf.asp?AID=1023485
4. Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin, 128, 825-848.

Stress affects us all. From minor instances, such as experiencing a poor night of sleep or arriving a few minutes late to work, to major instances, such as divorce, severe illness, or injury, stressors large and small will plague us throughout life. Our personal and professional lives are impacted when we’re stressed—we may lash out at loved ones, for example, or withdraw from friends; we may resort to using food, alcohol, or other substances to mask the tension; or the stress may manifest as physical symptoms. Sometimes stress becomes part of a vicious circle in which feelings of stress are compounded. Perhaps we feel uneasy due to stress, and this affects our resilience and ability to manage daily stressors, which ultimately leaves us feeling more stressed and susceptible to illness or mental health challenges.

Some of the most common sources of stress in the United States include workplace stress, financial strain, chronic illness, relationship difficulties, sleep problems, or excessive media consumption, including social media, television, or Internet usage. Symptoms may include muscle tension, irritability, anxiety, headaches, nausea, fatigue, or feeling emotionally overwhelmed or weepy.

Recognizing stressors, managing symptoms, and employing self-care strategies are some of the most critical preventive steps we can take to keep from feeling overwhelmed by stress. To facilitate these efforts, we’ve compiled a list of the 10 best online resources for help with stress—GoodTherapy.org excluded—in 2014. Our selections are based on quality and depth of content, presentation, and functionality.

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• The American Institute of Stress: The American Institute of Stress is a nonprofit organization that provides information and resources about various causes and symptoms of stress, as well as materials for stress solutions and treatment. Site visitors can participate in online forums, watch lectures on stress and stress management, and explore academic publications related to stress research. Free site registration enables you to interact with others on the site and use the forums. Health care professionals can seek certification from AIS to indicate their expertise in the field of stress and stress relief.
• Stress Cure: Stress often arises because of workplace issues, relationship problems, and other challenges in life. While it’s usually impossible to anticipate and prepare for these challenges, it is possible to cope with them when they do arise. On the site, Dr. Morton C. Orman offers 18 in-depth tips and suggestions for dealing with unexpected changes. The majority of other content has been moved or re-created at OrmanStressRelief.com, which is a more up-to-date resource for handling life stress.
• Totally Stressed Out: Created primarily for students, Totally Stressed Out offers stress-management solutions that can help with productivity and managing nerves. Academic issues can be constant sources of anxiety for students, hindering their ability to get things done, be creative, and commit knowledge to memory. By addressing symptoms of stress in both body and mind, Totally Stressed Out coaches students through relaxation and developing healthy habits for efficient, stress-free work.
• Caregiver Stress: If you’re caring for an ill or injured partner, an aging parent, or another loved one, you might not be aware of the toll it’s taking until you’re overwhelmed, perhaps even experiencing health problems yourself.This site provides an online assessment to help caregivers understand how their mental and physical health is affected by their caregiving responsibilities. With a blog that covers issues such as end-of-life care, financial problems, family communication, and specific health concerns, Caregiver Stress can help caregivers gain wisdom about practicing self-care and reducing stress.
• Stress Directions: If you’re not sure your level of stress is taking a toll on your health and well-being, or if you simply would like to learn more about stress and its symptoms, Stress Directions provides information and assessments that can help. Their Personal Stress Navigator test has 246 items that evaluate one’s susceptibility to stress, the symptoms a person may be experiencing, and the source of the stress. Site visitors can learn about what stress does in the body, including neuromuscular, cognitive, hormonal, and immune symptoms.
• Stressed Teens: For many teens, the ability to slow down and be present often does not come easily or naturally. They are usually fairly new to stress, and may not know or understand the symptoms or ways to cope. Created by Gina M. Biegel, LMFT, Stressed Teens teaches mindfulness practices geared toward teens and adolescents. Resources include tips for disconnecting from technology to reduce stress, mindfulness exercises for teens and parents, and simple activities that can help manage symptoms.
• Stress Relief Exercises: Physical activity has been shown time and time again to reduce stress, but stress-relief exercises don’t have to require physical exertion. Simple stretches, brain exercises, meditation, and mindful breathing techniques can help eliminate symptoms of stress. This site includes tutorials on all of these methods and others, including information about how each technique can help reduce stress. Other articles touch on further ways of destressing by clearing clutter in your home or adopting a pet.
• Stress Fish: On the left sidebar of StressFish.com, you will find a link that randomly generates a helpful—and occasionally strange or offbeat—tip for reducing stress immediately. One tip involves singing “Tumbling Tumbleweeds” and watching a GIF of a tumbleweed rolling across the screen. The description explains, “The StressFish thinks it’s funny, and claims that this has helped him in the past to clear his mind of unwanted fears and stressful imaginings.” Stress Fish aims to help children, adults, and everyone in between find effective ways to manage stress in fun, unconventional ways. The techniques may be silly, but the intent is earnest and authentic.
• Stress Free Kids: Family dynamics and conflicts can put a strain on all family members, creating stress and anxiety for children and adults alike. Parents can use StressFreeKids.com to introduce children to basic mindfulness techniques, help boost their self-esteem, and make bedtime easier. On the site, you can find specific tips for military families and helping family members with autism, plus free downloadable resources such as guided relaxation audio clips for kids. The StressFreeKids blog also offers information related to seasonal stressors, like going back to school and the holidays.
• Foundation for Well Being: The Foundation for Well Being promotes relaxation and peace of mind through articles and informative slideshows. If you are a teacher, parent, or caregiver, or if you learn best with visual aids, the Foundation for Well Being slideshows are a great way to learn and share information. Hidden gems throughout the site include information about de-cluttering your living space and improving feng shui, a collection of inspirational quotes about happiness, and a series of GIFs depicting rotating shapes (meant to calm nerves).

Have a website you would like to see in our Top 10? Recommend it here.

Historically, if a human being did not belong to a social group, he or she would more than likely die due to harsh conditions. It took a village to survive and you needed to be a part of that village. In an article titled The Pain of Social Rejection, written by Kirsten Weir for the American Psychological Association, she wrote that our need to belong, for acceptance, links back to our early survival skills.

Weir quotes Kipling Williams, PhD, at Purdue University as saying, “Evolutionarily speaking, if you’re socially isolated, you’re going to die and it’s important to feel that pain.” Weir also cites brain research which reveals that the areas of the brain that register pain due to physical injury, the dorsal anterior cingulate and the anterior insula, also register the emotional pains of rejection.

It’s quite smart of our bodies to create such a strong reaction to rejection. Due to our early programming, rejection—a lack of belonging, a lack of acceptance—meant death. So the brain sends us strong signals of pain to warn us that if we don’t try to reconnect, our lives are in jeopardy.

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Rather than value this warning sign, this important bodily communication, we fear it. The pain becomes unbearable. We attach all kinds of meanings to the pain, to rejection itself. We perceive rejection as an absolute truth about who we are or what we can achieve. Somehow, this primitive survival signal creates a slow, painful death—of our spirits.

We stop reaching out. We stop trying. We give up on finding the right partner, the right job, the right friends. While our modern-day culture allows us to survive in isolation, what quality does that bring to our life? We may not die physically, but what about mentally, emotionally, and spiritually?

Romantic relationships include various forms of rejection. You may reject your partner macro style, the total breakup, or micro style, such as the quiet zingers you launch over dinner. You may reject in obvious ways, such as sleeping in a separate room, or less direct ways, such as developing and feeding a sexual dysfunction.

As a result of these rejections, you may continue to coexist in your relationship but shut down connection. Or the whole relationship might break apart. This separation can wound so deeply that you may fear ever trying to form another relationship.

If you want to overcome your fears of rejection, here are five ways to transform how you respond to this difficult experience:

1. Rejection is not about you and it is about you. This tenet is twofold. On the one hand, rejection usually has more to do with the person rejecting and less to do with you. That person has his or her own history that influences the person’s ability to connect with and accept you. The person may have his or her own emotional obstacles to confront. At the same time, there may be threads of truth woven into the person’s perspective about you. It behooves you to try to learn what you can from the experience. It takes two to make a relationship work or to tear it apart. How does this rejection become a learning opportunity for you? How do you become constructive instead of destructive with these threads of truth?
2. Expect rejection SOME of the time. I have no idea where I heard this, but someone once said to me, “You see that gorgeous girl? Someone, somewhere, is sick of her [crap]!” Like that girl, you, too, will be rejected, no matter how attractive you are, how much money you have, or how nice you are—someone will “get sick of you” in some form. Not everyone is compatible, and you will not meet everyone’s needs at all times. If you can accept this, you can decrease the personalization of rejection, maintain faith, and keep trying.
3. Stop making rejection your whole life story. Assuming the identity of “victim” will not attract or keep a mate. The more you cling to the “rejected” role, the more you suffer. There is more to you than your rejection. Surround yourself with friends and family who support you. These people serve as a reminder of your worth. They are a part of your love story. To overcome rejection, you must connect with people who love you.
4. Vulnerability is a relationship requirement and a rejection target. If you fear rejection, you might hold up a bulb of garlic when you see the word “vulnerability.” Yet without this vital relationship skill, your mate cannot ever truly connect with you, and may, in turn, reject you. Real intimacy is possible only when both partners become vulnerable. If you can transform what you choose to do with rejection, vulnerability might not feel so scary.
5. Risk is necessary for your emotional growth. When you choose to love someone, you risk loss. Whether by death, divorce, or separation, the risk of rejection is present. Is it better to love and risk loss or rejection than to not love at all? The answer is yes, plain and simple. Science shows us that we are wired to seek connection, belonging, and acceptance. Avoiding rejection closes the doors to many potentially fulfilling relationships.

Destructive responses to rejection shut you down to all relationships. Constructive responses teach you about yourself and others. Rejection is not easy. Your response sets the stage for your relationship experiences. What do you choose?

Reference:

Weir, Kirsten (2014). The Pain of Social Rejection. American Psychological Association. Retrieved from: http://www.apa.org/monitor/2012/04/rejection.aspx

First, let me applaud your courage in seeking out therapy and for reaching out to GoodTherapy.org with your question. It is no small thing to acknowledge that one needs help, so bravo to you for taking those steps.

Your question of how to open up to a therapist is quite common. Many people feel overwhelmed at the possibility of sharing their deepest, darkest secrets and pain with a virtual stranger. It seems especially frustrating when you are paying for the services but still can’t seem to open up. However, this is perfectly normal, and many people find themselves in that position. There are a few things that might contribute to this: you may not have developed the level of trust you need to feel safe with the therapist you are working with, you may be fearful of being judged by the therapist, or maybe you are afraid that opening the pain of the past might be too much to handle. There are many reasons for people not opening up in therapy, so I will give you some ideas on how to get things going.

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If you’ve ever heard the saying, “If something scares you, you must do it immediately,” this will sound familiar. You have to build trust with your therapist AND with yourself—with your therapist, you need to know that he or she has the capacity to hold whatever pain you might share, and you need to know that you can handle sharing your past without falling apart, losing control, or being overtaken. The best way to do this is by taking small steps. First, I suggest talking with your therapist specifically about your inability to open up. This type of honest conversation can be a bridge to building trust in other areas. Second, after having that conversation, intentionally decide to take risks and share honestly in your therapy sessions. Even if you don’t want to share the trauma of the past, you can say, “I’m really anxious because I want to share, but I’m afraid of …” Simply naming the anxiety when it appears can help clear the way through it.

Finally, many people are concerned that the therapist will judge them when they share openly. While I can’t say that there aren’t therapists who judge, they are firmly in the minority. Therapists generally hold a genuine space of empathy and high regard for the people they work with, knowing that each individual has had a unique “pain journey” and that seeking help is not a sign of weakness, but rather of deep strength. Your therapist is a stranger only as long as you keep him or her that way. By taking small risks and building trust, you will deepen your relationship with your therapist, which will help your therapy progress.

You can make this therapeutic experience what you want it to be by taking ownership for how it has gone and making active choices in how to handle it going forward. I believe that you want this to work, and I believe that it will because you are willing to work. Best wishes in your journey!

Sincerely,
Lisa