Emotions connect us to each other. They are the barometers that we use throughout the day to determine our well-being and degree of happiness. When we feel sad or lonely, these feelings can lead us to seek out comfort and companionship from friends or family. When angry or hurt, these emotions can indicate that we need to try to change our circumstances in order to feel better. For some people, however, their emotional life tends to resemble more of a roller coaster than a barometer, with ups and downs that leave them feeling wiped out and drained. These feelings may cause them to act impulsively, without stopping to consider the consequences. They become so caught up in the waves of their emotions that they may do and say things they later regret. If you struggle at times with your emotional well-being and would like to learn to get your feelings under control, the following are some considerations and skills that may help:

1. Think before you act.

When we feel carried away by the strength of our emotions, we can sometimes throw caution to the wind and act in rash and irresponsible ways, especially if we are feeling angry or hurt. Taking a few deep breaths to calm down before responding to someone who has upset us can give us a chance to catch our breath and think through the situation.

2. Consider the bigger picture.

When we get caught up in our day-to-day dramas, we often forget that which is most meaningful to us. When we feel upset, trying to look at the situation from a different perspective can offer us an opportunity to gain insight, into either the other person’s point of view or the wider panorama of our lives. Is winning another argument more important in the long run than trying to maintain loving relationships with our partners?

3. Change your circumstances whenever possible.

If you are truly unhappy in your relationship or your job, consider the fact your emotions may be trying to give you a wake-up call. Tune into your heart and follow your inner calling. If your relationship has been having more downs than ups recently, couples counseling may be a good option to help you get back on track. If you feel as though your job has been causing you more heartache than fulfillment, looking for another one or seeking training in another field might be the best course of action.

4. Practice radical acceptance.

Regardless of how well we care for ourselves, there will always be situations that arise that are upsetting for us. Accepting those challenges as an integral part of life can assist us in creating a greater sense of peace.

5. Take up journaling.

If you experience a lot of emotional ups and downs throughout the day, journaling can be a helpful exercise. Writing down the struggles that you have been facing can help to get them off your chest and give you more peace of mind.

6. Learn to forgive.

Holding grudges and resentment toward another can be extremely toxic for our mental and physical health and well-being. By releasing our inner anger and bitterness, we can open ourselves up to greater compassion and love toward others, as well as toward ourselves.

7. Sit with your emotions.

When you experience a lot of emotional turmoil, try to spend a few moments sitting down and tuning into your feelings. Let go of your thoughts surrounding the emotions and focus on the actual sensations arising in your body. For example, if you are feeling angry, where are you feeling the anger? Does it manifest as a tight ball in your stomach or as tension or clenching in your jaw? Wherever you feel your body contracting around the sensation, spend a few moments just breathing into that feeling.

8. Practice mindfulness.

Our emotions can feel like a roller coaster ride when we allow our thoughts and fantasies to get the better of us. When we think negative thoughts, these affect our emotions in powerful and negative ways. Rather than imagining the worst-case scenario or replaying over and over again an unpleasant memory, practice being mindful of what is happening in the moment and letting go of any thoughts of the past or future.

9. Share your feelings with others.

Rather than stuffing your emotions inside, express them to others whenever you can. If you are feeling upset about an incident that occurred with a loved one, allow yourself some time to cool down and consider the situation more rationally. Then try to share your emotions to get them off your chest and reach a better understanding.

Reach out to one of our therapists in Dallas, TX or find a therapist closer to you. 

Learning to deal with our emotions in a healthy way, rather than letting them run our lives, can make a tremendous difference in our ability to maintain a sense of stability and inner peace. If you are still struggling with managing your emotional well-being after trying some or all of these skills, you may want to consider meeting with a compassionate therapist who can lead you on the road to a healthier and happier state of mind.

Children and teens with attention-deficit hyperactivity (ADHD) often have difficulty in social situations. They may frequently get into conflicts with peers, have trouble developing and sustaining friendships, or experience other social difficulties. In some instances, these difficulties may be due primarily to symptoms associated with ADHD, such as difficulty focusing, resisting impulses, or other self-regulation issues.

Difficulty focusing impedes individuals with ADHD in that they may not hear everything that is being said or otherwise communicated. As a result, they may miss social cues or relevant information to sustain conversations. In some instances, individuals may “zone out” and be perceived by peers as being uninterested. In other situations, children and teens may be focused on what they want to say and not allow peers to fully contribute to conversations and social interactions. Individuals who have trouble managing impulses to say something, trouble sitting still, or difficulty resisting other impulses often struggle in social situations because peers may find certain actions annoying or irritating.

ADHD does not always occur by itself. There are high comorbidities with anxiety, depression, learning issues, and other conditions. Thus, in some instances, symptoms from co-occurring conditions exacerbate the effect that ADHD symptoms have on social interactions.

Here are a few strategies to help your child/teen with social skills:

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• Practice good social skills and behavior at home. If your child/teen is engaging in problematic behavior (i.e., interrupting others, doing something annoying on purpose, being unfocused when having a conversation with you), have a conversation about how these types of behaviors can make it difficult at school and socially. It is best to bring it up when an issue isn’t occurring in the moment. Once you have this initial conversation, figure out a way that is amenable to your child/teen to gently point out when problematic behavior is occurring. Over time, this will help your child or teen learn to recognize when he or she is doing something he/she shouldn’t be doing, and may ultimately lead to it not happening in the first place. You have to be careful, though, that you are pointing things out in a constructive way and that your child/teen views it that way. If the child/teen feels that you are hounding him or her about things, he/she may become upset and, in time, develop negative feelings toward you. Do not embarrass your child/teen; speak privately about problematic behavior that you observe. Don’t bring things up in front of friends or siblings.
• For certain behaviors, you could collaboratively develop a signal that you could use to convey to your child/teen that you are observing something problematic. For instance, if your child/teen chews with his or her mouth open, set up a signal where you hold up your hand and give a two-second gesture, signaling to him or her that he/she needs to chew with mouth closed. As another example, if your child/teen frequently interrupts conversations, set up a signal where you raise one finger when he or she interrupts, signaling to wait for an appropriate time to speak.
• Model good behavior for your child/teen. If you interrupt your child/teen, use foul language, do things intentionally that are annoying, or engage in other negative behaviors, chances are your child/teen will follow your example. It makes it much harder to explain and enforce to your child/teen that such behaviors are wrong if you continue to do them yourself.

Learning and using good social skills is a process, and having a safe environment to practice is important. At the same time, it is vital that any practicing or pointing out of negative behaviors is carried out in a constructive way to avoid any negative impact on your relationship with your child/teen or his or her self-esteem. If you feel that your child/teen is struggling significantly with social skills, seeking out a therapist or counselor or social skills therapy groups can greatly help your child/teen improve on these issues.

It sounds like there are two main issues for you right now: managing your feelings and hesitation about dating someone with a teenage daughter, and dealing with your fears about how your family will respond to your situation and the woman you love.

The fact is your girlfriend is a mom. Nothing is going to change that. You can wish it weren’t so, but that is a big part of who she is. It also may be that her experiences as a mom made her into the person you fell in love with.

I’m curious about where your resentment is coming from. Is it mostly coming from fears about how your family will react, or are there other issues at play? You knew she was a mother when you started dating her. You have been in a relationship with her for a year. If you are uncomfortable with the idea of moving in together, you owe it to her, yourself, and your relationship to have an honest conversation about that. Her feelings may get hurt, but avoiding the issue and letting these feelings fester in secret can do much more damage to your relationship. If you need support in how to have that kind of conversation, you may want to reach out to a therapist in your area for individual or couples work.

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Dating someone who has kids can be complicated. Something that makes your situation potentially even more complicated is the spread of ages. You are, in fact, closer in age to the daughter than the mother. How much of that is factoring in to your unease? Would you feel the same way if her daughter were 7 instead of 17?

As for how your family reacts to your relationship, you cannot control what your family thinks or feels. They may disapprove of your relationship. They may disapprove of your girlfriend. It is up to you how much importance you give to their feelings. At 26, you are an adult who can make his own decisions. If the way your family feels about your partner is a deal-breaker, then it is important to be honest about that. Her past is not going away. If, however, you choose to be in relationship with this woman, it is not fair of you to judge or condemn her for her past. Your family can choose to disapprove. Only you can choose to let that matter.

I hope this helps shed some light on your situation. I hope you can resolve your internal conflict and highly recommend seeking the support of a therapist to help guide you through it.

Best,
Erika

A broken heart has become synonymous with the pain of romantic rejection and bad relationships. According to a new Michigan State University study, though, a bad marriage could quite literally break your heart—especially if you’re female.

Can Your Relationship Affect Your Heart Health?

Researchers decided to look at the effects of a bad marriage in older couples, since most marriage counseling and research into marital quality focuses on young people. They analyzed five years of data from the National Social Life, Health and Aging project, looking at about 1,200 married women and men ranging in age from 57 to 85. Participants answered questions about the quality of their marriages, in addition to undergoing lab tests and reporting their symptoms of and risks for cardiovascular disease.

The researchers found that people in bad marriages were more likely to have cardiovascular problems. They also learned that a bad marriage affects heart health more than a good marriage, and that women in bad marriages suffer more negative cardiovascular effects than men in bad marriages. They speculate that this may be because women are more likely to internalize negative feelings and to become depressed. The negative effects of a bad marriage on heart health increase with advancing age. [fat_widget_relationships_right]

Researchers also found that heart disease itself could harm marriages, but only for women, not for men. They point out that previous research has found that women are more likely to care for sick spouses than to receive care when they are sick. Consequently, married women with heart disease may get less support and be subject to more stress than married men with heart disease.

Heart disease is the leading cause of death for people in the United States, and it kills more women than all forms of cancer combined, according to the American Heart Association.

References:

1. About heart disease in women. (n.d.). Retrieved from https://www.goredforwomen.org/home/about-heart-disease-in-women/
2. Bad marriage, broken heart? (2014, November 19). Retrieved from http://www.sciencedaily.com/releases/2014/11/141119204855.htm

Cognitive behavioral therapy (CBT) seeks to help people identify negative or unhealthy thoughts, replace those thoughts with healthier thoughts, and in so doing, change their behavior and feelings. People don’t have to spend endless sessions discussing painful childhood memories, and the formulaic nature of CBT offers some people reassurance.

Preliminary studies of CBT showed impressive improvements in symptoms of conditions ranging from depression to personality disorders, leading to a surge in therapists who offered CBT. This type of therapy continues to be one of the most widely used evidence-based treatments available.

According to famed British psychologist Oliver James, though, CBT is a “scam” that does little to address underlying psychological issues. James, a psychodynamic therapist, argues that until people understand what led to their psychological troubles, those troubles are likely to reoccur.

GoodTherapy.org CEO and founder Noah Rubinstein, LMFT, LMHC, takes a similar stance with regards to addressing underlying issues in therapy.

“I am certainly not an expert on what research has shown about the efficacy of CBT, and I certainly don’t want to throw the baby out with the bathwater. CBT is an evidence-based, short-term therapy that has helped many people. However, on a theoretical level, I’ve always considered CBT to be a surface-level treatment rather than a method for lasting changes,” Rubinstein said. “In my experience, the only way to make lasting change is to help people tend compassionately to the more vulnerable feelings that protective functions, or defense mechanisms—such as depression, anxiety, self-criticism, anger, or addiction—are shielding us from.”

CBT’s Short-Term Effectiveness

There’s no question about CBT’s short-term effectiveness; even James admits that people receiving CBT can see remarkable improvements in a short period of time. So effective is CBT in the short term, in fact, that CBT self-help manuals such as David Burns’s The Feeling Good Handbook have become bestsellers. Because CBT teaches people how to detect and stop automatic negative thoughts, it’s especially popular for treating depression and anxiety. Some therapists, regardless of therapeutic modality, even insist that their clients use CBT principles to treat these conditions. 

Can Short-Term Behavioral Interventions Provide Lasting Results?

When researchers evaluate the long-term effects of CBT, the treatment looks less promising. James points out that psychodynamic psychotherapy yields better results in the long term because it helps people address the root causes of their distress. Several studies support this claim. For example, a 2003 meta-analysis that compared CBT and psychodynamic therapy for depression across several studies found that people who used psychodynamic therapy had larger improvements. Another study of marriage therapy evaluated the effects of behavioral versus insight-oriented marital interventions. CBT relies on behavioral interventions, while psychodynamic therapy is built on insight. Thirty-eight percent of couples who used the behavioral strategies were divorced four years later, compared to just 3% of couples who relied on insight-based approaches.

Rubinstein takes the view that conditions such as depression and anxiety protect us from the vulnerable feelings associated with the true source of our distress.

“For example,” Rubinstein said, “the man with depression who’s shut down, can’t get out of the bed in the morning, and has given up might be protecting himself from trying, failing, and once again feeling that terrible worthlessness he’s felt in the past.” Like James, Rubinstein sees CBT as a short-term fix that “helps to eliminate the problematic, surface-level protective behavior.”

Indeed, one of the selling points of CBT is that it doesn’t require a long-term commitment to therapy. Many CBT programs take only a few months, and some promise near-immediate results. A study published in Psychological Medicine in 2008, though, found that long-term approaches may be preferable. That study compared long-term psychodynamic therapy to two short-term therapies: short-term psychodynamic therapy and solution-focused therapy. While the short-term approaches produced more immediate results, those results faded over time. At the three-year mark, people who had undergone long-term therapy saw more improvements. Although this study didn’t evaluate CBT, it does suggest that dedicating more time to gaining insight can be valuable. [fat_widget_left]

Laura Reagan, LCSW-C, a GoodTherapy.org Topic Expert on trauma and posttraumatic stress, blends CBT with a variety of other techniques. She sees CBT techniques as effective and essential, though she acknowledges that CBT may not be best for addressing long-term issues.

“In my practice with trauma survivors, focusing only on changing thoughts and behaviors through CBT without using a more depth-oriented approach will result in only temporary improvement of symptoms which are likely to return, as the underlying problem has not been addressed. I use CBT skills as part of my work with clients to challenge negative cognitions about the traumatic events experienced.”

Rubinstein agrees that underlying problems need to be addressed for lasting change, “I don’t agree with everything Freud postulated, but he did believe that if you eliminate a defense mechanism, another will take its place, and I think that is the problem with CBT in terms of its long-term effectiveness. Therapies that help people to resolve the deeper and more vulnerable feelings that fuel defense mechanisms offer potential for long-lasting change.”

Is It a Scam?

While CBT doesn’t work for everyone, it’s far from a scam. James is a well-respected therapist, but he’s also a practitioner of psychodynamic therapy, so his opinion is by no means free of bias. While some studies have shown that psychodynamic therapy is more effective in the long term, others show that the two approaches are equally effective. Few studies show that CBT doesn’t work at all, and several studies suggest that CBT can work in the long term. A study that evaluated people who had been treated with CBT for social anxiety found that, even three years later, they were able to use what they had learned in CBT to more effectively cope with anxiety. A 2006 review of recent studies found that CBT may help reduce depression relapse rates, particularly when researchers compare the effects of CBT to the effects of medication alone.

Carey Heller, PsyD, a GoodTherapy.org ADHD Topic Expert who uses CBT as well as other forms of therapy in his practice, highlights the importance of a strong therapeutic alliance. He explains, “Many studies have shown that the quality of the relationship between the therapist and the patient/client is one of the best predictors of treatment outcome. Thus, the specific type of treatment, whether it is CBT, psychodynamic, or an integrative approach, is not the only determining factor in whether treatment will be successful for a specific individual. I feel it is more important to find a clinician who you feel comfortable with and can look at your unique needs in determining the best treatment approach to help you rather than just seeking out a specific type of treatment on your own.”

References:

1. Hope, Jenny. (2014, November 10). ‘CBT is a scam and a waste of money’: Popular talking therapy is not a long-term solution, says leading psychologist. Retrieved from http://www.dailymail.co.uk/health/article-2828509/CBT-scam-waste-money-Popular-talking-therapy-not-long-term-solution-says-leading-psychologist.html
2. Kendall, P. C., & Southam-Gerow, M. A. (1996). Long-term follow-up of a cognitive–behavioral therapy for anxiety-disordered youth. Journal of Consulting and Clinical Psychology, 64. Retrieved from http://dx.doi.org/10.1037/0022-006X.64.4.724
3. Knekt, P., Lindfors, O., Härkänen, T., Välikoski, M., Virtala, E., Laaksonen, M., . . . Renlund, C. (2008). Randomized trial on the effectiveness of long-and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up. Psychological Medicine, 38(05). doi: 10.1017/S003329170700164X
4. Leichsenring, F. (2003). The Effectiveness of Psychodynamic Therapy and Cognitive Behavior Therapy in the Treatment of Personality Disorders: A Meta-Analysis. American Journal of Psychiatry, 160(7), 1223-1232. doi: 10.1176/appi.ajp.160.7.1223
5. Snyder, D. K., Wills, R. M., & Grady-Fletcher, A. (1991). Long-term effectiveness of behavioral versus insight-oriented marital therapy: A 4-year follow-up study. Journal of Consulting and Clinical Psychology,59(1), 138-141. doi: 10.1037//0022-006X.59.1.138

Although I can’t know what is happening in your therapy and how this may pertain to your question, clearly this is an important issue, and I hope you will discuss it directly with your therapist. I can understand that perhaps you feel reluctant to bring it up, but the ensuing conversation might be very helpful, and it could move the work you are doing together toward a deeper understanding of your relationship with her and, most importantly, with yourself.

Any emotional reaction, especially one as pervasive as what you describe, contains clues that you want to identify and investigate. For example, at some stages of development obsession is quite natural, and your obsession might be pointing toward a difficult time in your life that needs work. Young children, for example, are obsessed with their caregivers, often their mothers. If this is the root of your issue, you might learn that there was a difficult experience in your childhood that needs to be looked at. Maybe when you were very young, a toddler or a baby, you had fears that your mother or another important person in your life might leave you, never to return—that you might be abandoned. Perhaps you did in fact lose someone you loved. Teenagers, even adults, are sometimes obsessed with someone they see as a role model. They are obsessed because that person is someone they want to be and knows things they need to learn.

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An interesting aspect of therapy is an experience called “transference.” Transference means that the feelings you have for someone important in your life are unconsciously transferred to another person—in this case the therapist. We all have feelings like that; it’s quite normal. For example, people at work often relate to the boss as if the boss was their father or mother, and they might not even know it. Or your irresponsible coworker might remind you of your younger brother or sister. It’s helpful when we become aware of such feelings and then take care to recognize and correct them rather than simply reacting. Therapy can help you do that.

Let’s talk about therapy, some of its general goals, and how they may apply to your situation.

1. Speak your mind to your therapist, without concern for feeling silly, looking stupid, being insulting, or whatever worries tend to stop you from speaking up. Honesty makes for a strong therapeutic relationship.
2. There are many different kinds of obsessions—obsession with the Internet, with sports, with movie stars, with teachers, even with one’s therapist. A therapist, after all, is someone who is trying to help. It makes sense that we become attached to kind and helpful people. Who wouldn’t? Maybe, for you, this is a rare experience of being truly understood, you can’t quite believe it’s real, and you don’t want to let it go.
3. The love and gratitude we feel when we are accepted and understood is boundless. Certainly, I feel greatly attached to my teachers, mentors, and therapists. The thought that these connections are partly real and partly transference is kind of sad. “What,” I might think, “you mean this isn’t real?”
4. It is real, the feelings are real, but they are not to be acted on—they are to be explored with words only. These feelings and the therapeutic relationship are on a different and special plane, apart from the everyday world in certain ways. That is the tragedy, glory, and power of any deep therapeutic relationship.

How lovely that you have such strong feelings about your therapist. It means that you have been reached at a deep level, which has given you and your therapist a strong energic ground from which to proceed.

I hope this has been helpful. Please let me know what you think. Take care!

Respectfully,
Lynn

In my first meeting with Nora and Jeff, Nora told me (actually, she was yelling and crying): “He’s so passive, he’s driving me crazy. Jeff never lets me know what he’s thinking. He doesn’t make clear what he wants; when we disagree, he doesn’t explain what he thinks or feels.” As I got to know Nora and Jeff, I could imagine that most people would describe Jeff as a passive person—not actively taking part, compliant, meek. But I have come to understand that, more accurately, Jeff is a person in hiding.

While both Nora and Jeff contributed to the difficulties in their relationship, I am going to focus on Jeff.

Passivity as Protective Hiding

Several months into my work with the couple, this particular session was not the typical discussion of the vicious circle where Jeff’s passivity evokes Nora’s anger which makes Jeff more passive and around they go. Instead, Jeff started the session. Looking frightened but sounding more filled with feelings than usual, he told Nora: “I’m tired of this fighting. I’ve tried so hard to give you what you want, to be the good guy. All you do is criticize me and make me feel like the bad guy. You’re always screaming, but now I do feel like the bad one. This isn’t me. I’m always the good guy. I can’t stand that you don’t see me that way anymore. I don’t know what to do.”

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In my work with Jeff and Nora, I learned a lot about Jeff’s need to hide and came to understand his passivity as his way of hiding himself to stay safe. Jeff projected a self to the world that was easygoing, undemanding, and kind. In our sessions, Jeff slowly revealed how this was not how he felt about himself: “I can’t say I like myself very much or think very highly of myself. I don’t know. Maybe it has to do with having such critical parents. They were horrible. They always laughed about my appearance: look at his big ears; his voice is so squeaky; ooh, he’s so hairy. They made me feel ashamed. They didn’t like my friends, complained about how I ate, dressed, ugh, everything. I finally learned to tune them out. From the time I was, I guess, about 8 or 9, I stopped reacting. I suppose I do that with everyone now.”

Nora started to cry softly in response to Jeff: “I had no idea; you never told me any of this. I’m so sorry your parents were so mean to you.”

Jeff looked shocked by Nora’s tears and words: “I don’t want you to feel sorry for me. I hate that! I can’t stand it. Now you both are going to think there is something wrong with me. I never should have said anything.”

Jeff’s “saying something” was the start of expressing his “true self,” which his false self had kept hidden and safe from harm. His false self had been engaging with a world that could be emotionally destructive and dangerous. Consequently, Jeff wasn’t totally familiar with the Jeff who had been kept in hiding. He had done a good job of protecting his young self from intolerable feelings of shame, hurt, and rage. Unfortunately, with the “true self” in hiding, there was little opportunity for Jeff to grow and develop through relationships in the real world.

False-Self Interference with Good, ‘True-Self’ Feelings

The false self develops as an adaptation that protects the individual and makes it possible for the “true self” to go into hiding. Often, the development of the false self is unconscious, and the individual may not be aware that this defense is protecting him (or her) from intolerable feelings. Over time, awareness may develop that the “me” who is acting in the world is “not me.” As these “not me” feelings get stronger, the feelings of being loved, being successful, deserving of recognition, etc., cannot be felt as me, or as the “true self.” It is, after all, “not me” who is loved, admired, or successful. This leaves no room for good self-feelings and frequently results in increased hiding to diminish the risks of being seen and known.

As the individual becomes increasingly aware of the false self adaptation, he (or she) is also aware that he (or she) may not know what will appear when the “true self” begins to emerge. It feels risky to be vulnerable and speak one’s feelings. How the person will be responded to is an unknown. The false self emerged early in development and was successful in protecting the person from intolerable feelings. Now that the false self no longer protects so well, it takes courage to begin to allow the true self to emerge. There are no assurances that the old shaming ways that required the adaptation to a false self won’t be repeated. Jeff’s relating of his early experiences with his parents, his shame, and his negative self-feelings were a brave expression of his “true self.”

Interference with Intimacy

To be intimate with another assumes a personal closeness, familiarity, and a knowing of the other. Jeff and Nora had difficulty being intimate because Jeff was in hiding and Nora had no sense of a real other self to relate to. In one session, Nora turned to Jeff and described her struggle: “I think I love you, I want to love you, but sometimes I don’t know who you are. I want this to work, but I rarely feel I know what you want.”

Sadly, no matter what loving or affectionate feelings Nora might have been able to feel for Jeff, he felt it was “not me” who was being loved. As a false self, he had no way to experience that Nora’s loving feelings had anything to do with what was true or real about him. As Jeff became more interested in shedding his false self and developing his “true self,” he was handicapped in his ability to be intimate since he didn’t feel he was a person of substance with thoughts, feelings, needs, and desires with which he could relate to Nora. It takes a strong desire and a good deal of courage to overcome the anxiety of risking a repeat of the shame and hurt as one begins to let oneself know what they are feeling and then allow the vulnerability to share oneself with significant others and then ultimately the world. Jeff is working on this with Nora and is making slow but steady progress.

Interference with Self-Knowledge

Who am I? What do I want, think, need, believe? What do I like, hate, fear, love? These are only some of the basic questions we wrestle with as we grow and develop our identities. When we grow up in an environment that feels dangerous or destructive, we need to find a safe way to protect ourselves from mistreatment and intolerable feelings. But when we adapt to a false self, we frequently miss the opportunity to develop the answers to these questions.

Who we know ourselves to be is based on the accumulation of our continuing experiences of the interactions between ourselves and others. This relational dialogue—all these back-and-forth responses—are the building blocks of self-knowledge. We develop the ability to self-reflect and think about self and other. We discover what we want and don’t want. We learn how to get what we want and from whom. But we can’t do this when we keep ourselves hidden from the world. The “true self” must participate in these interactions if we are to come to know who we are.

The development of a sense of identity—this is who I am; this is what I know and feel about me—helps us to locate ourselves in the world. The sense of self that we carry with us, including feelings of confidence and self-esteem, are constantly evolving as we engage in our relationships in the world. When we sequester our “true self” to keep it safe, it loses the opportunity to have “true self” experiences, which are the building blocks of identity. The false self may have kept Jeff safe from intolerable feelings, but it deprived him of becoming a person who could see himself and be seen as a person with a large number of positive and negative attributes (valuable, funny, smart, stubborn, courageous, mean, loving, etc.).

Jeff and Nora have a lot of work to do individually and with each other if they are going to be able to develop a trusting, loving, intimate relationship. When our defenses no longer protect us, as when Jeff’s false self no longer protected him from intolerable feelings of shame, badness, and anger, we become more motivated to make changes in the way we think about ourselves as individuals and in relationships. Jeff’s growing awareness of how hiding himself was damaging not only to his relationship with Nora, but also to himself, became a driver of his openness to learning the ways in which hiding himself was having severe consequences in his life.

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

Popular wisdom suggests that a messy work space is the product of a creative and unique mind. At least one study has found support for this claim, noting that a messy space can be a source of creativity and inspiration. If you’re concerned about promoting an ethical environment, though, it might be time to rethink your work space. According to a collection of three different Rice University studies, the feelings of disgust associated with an unclean work space might give rise to unethical behavior.

How Disgust Changes Behavior

Disgust helps protect people from dangerous or questionable situations. The disgust you feel when looking at rotten food, for example, prevents you from eating a potentially toxic meal. The study’s authors speculated that disgust might make people more self-interested, decreasing their willingness to help or notice others. After all, disgust can be an overpowering emotion that provokes an immediate desire to escape the disgusting situation. 

Ethics and Disgust

To test their hypothesis about how disgust affects behavior, researchers induced disgust in nearly 600 participants. In one trial, participants contemplated “disgusting” products such as cat litter, incontinence products, and anti-diarrhea medication. Researchers asked a second group to write an essay about their most disgusting memory, and a third group watched a toilet scene from the movie Trainspotting.

After inducing feelings of disgust, researchers administered a series of tests to evaluate participants’ willingness to lie and cheat for financial benefit. Those who reported higher levels of disgust were also more likely to lie, cheat, and engage in other self-centered behaviors. [fat_widget_left]

In a second trial, researchers induced a state of disgust, then asked participants to contemplate various household cleaners. Participants who evaluated the cleaners were no more likely to engage in dishonest behavior than those who did not experience disgust.

The study’s authors believe their results point to the value of a clean environment. When people feel disgusted by their surroundings, they’re less likely to behave ethically. But when that disgust is “cleaned”—either metaphorically, by thinking about cleaning products, or literally, by removing the source of the disgust—people may behave more ethically.

A 2008 sociological experiment made a similar observation after evaluating the effects of urban disorder, such as litter and graffiti, on people’s behavior. Researchers found that passersby were more likely to participate in vandalism and other minor infractions in environments where these kinds of activities were already taking place. This study was based on the “broken windows theory,” introduced in the early 1980s by Dr. George Kelling to explain how dilapidated areas, like abandoned buildings with broken windows, inspire further vandalism.

Of course, an unclean environment that doesn’t promote disgust, such as a slightly disheveled desk, is unlikely to lead to unethical behavior. For managers, parents, and other people who perpetually ask others to clean up their mess, though, this study provides one more point in favor of a clean work space.

References:

1. Can the can. (2008, November 20). Retrieved from http://www.economist.com/node/12630201
2. Falk, J. (2014, November 13). Rice U. study: Disgust leads people to lie and cheat; cleanliness promotes ethical behavior. Retrieved from http://news.rice.edu/2014/11/13/rice-u-study-disgust-leads-people-to-lie-and-cheat-cleanliness-promotes-ethical-behavior/

There’s a broad assumption in our culture that women are just more emotionally intelligent than men. But women’s superior emotional intelligence is anything but a settled fact, in spite of claims of women everywhere to the contrary. Even if women do show more emotional awareness than men, a new study points toward environmental, rather than genetic, influences. According to that research, which was published in the British Journal of Developmental Psychology, mothers may teach girls more about emotions than they teach boys.

Do Boys Learn Less About Emotions Than Girls?

To evaluate differences in the ways parents talk to their children, researchers evaluated 65 Spanish parents of 4- and 6-year-old children. The parents told stories with their children and talked about previous experiences. Girls were more adept at using emotional words—such as happy, sad, and confused—than were boys. Researchers also found that mothers used more expressive words with their daughters than their sons, which might help explain why differences in emotional awareness emerge so early.

Undermining Boys’ Emotional Behavior

This isn’t the first study that has found that parents teach boys to be less emotionally astute than girls. In another study, a baby’s gender was concealed while he or she watched a jack-in-the-box. Observers were then asked to characterize the baby’s emotional reactions. When they thought the baby was a boy, they were more likely to call the reaction angry or aggressive, and girls were more likely to be labeled as fearful, potentially stigmatizing fear for boys. [fat_widget_left]

Some parents may even punish their boys for expressing their emotions, and boys receive intense peer pressure to conform to a masculine social norm that demands disconnection from emotions. The British Journal of Developmental Psychology is just one more piece of research suggesting the ability to feel and express emotions must be taught.

References:

1. Kindlon, D. (n.d.). Raising Cain: Protecting the emotional life of boys [PDF]. City Leadership Research Project.
2. Mothers nurture emotions in girls over boys, new study finds. (2014, November 12). Retrieved from http://www.eurekalert.org/pub_releases/2014-11/uos-mne110914.php
3. Widen, S. C., & Russell, J. A. (2002). Gender and Preschoolers’ Perception of Emotion. Merrill-Palmer Quarterly, 48(3), 248-262. doi: 10.1353/mpq.2002.0013

Do you want to build a case about how your partner is wrong and defective or do you want to repair the relationship? So many people come to my office wanting to convince me how wrong and/or bad their partners are. They are so busy focused on their partners’ flaws that they don’t pause to look at themselves and what their part in the relationship might be.

A version of the Serenity Prayer that I like is:

God grant me the serenity to accept the people I can’t change,
The courage to change the one that I can,
And the wisdom to know that is me.

Emotional hurts or traumas experienced in early childhood—we’ve all been there to greater or lesser degrees—stay with us, but they can be overcome. Our opinions of ourselves and others are formed by these early experiences. These are what become familiar. Unconsciously, we are seeking the comfort of the familiar even though it may not be good for us. Often we deny and overlook these early experiences, as we don’t want to remember the hurt and bad feelings.

Unconsciously, we attract partners who feel familiar, and often they are more similar to our most unresolved relationship from childhood. Most of us aren’t consciously aware that this is what is happening.

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So how does all this happen?

I maintain that the best individual therapy happens in the context of couples therapy, where each partner holds up a mirror of sorts for the other, giving each partner the opportunity to see themselves more clearly. When we don’t like what we see, it becomes easier to blame our partners and point out that they are flawed. Bringing up these old feelings and looking at ourselves takes courage.

Rather than saying, “You did this or that wrong and therefore you are (insert negative label here),” we can focus on ourselves and what is going on within us.

It is helpful to say:

1. “When (whatever the situation that has caused upset) happens, I feel _______.” Ask yourself what your primary emotion is. Sometimes we think we are angry, but we may actually feel hurt, with anger as a secondary emotion. Try to identify your primary emotion. If someone scared me, I could get angry that they did this, but fear would be the primary emotion.
2. “What this reminds me of from childhood is _______.” Now you start to become aware of your childhood wounds and disappointments. As the old saying goes, if you can feel it, you can heal it. Don’t take too much time to figure this out; just notice the first thing that pops up—it’s usually the correct response.
3. “What I tend to do when I feel this way is _______.” Your response is likely to be what you did when you were a child to protect and defend yourself. It worked for you then, and you think it will work for you now, but it might not.
4. “I react this way to hide my fear of _______.” This is when you are likely to feel vulnerable, but it is the vulnerability that leads to intimacy. We all have fears, and we need to identify them so we can work to alleviate them at a conscious level. When we don’t, we tend to act them out defensively in an unconscious way. Once they are identified and labeled, we are better able to make conscious choices as to how we respond.
5. “What I want and need is _______.” What was it that you wanted and needed in childhood that you didn’t get? It is likely the same as or similar to what you want from your partner, but you might not even be conscious of wanting this from him or her.
6. And finally, to your partner: “Would you please _______?” Our emotional brain heals through experience. When we experience receiving what we truly need, we begin to heal. Hopefully, you have a partner who will do this for you, just as you would be willing to do it for him or her.

Emotional intimacy involves two people entering into a conscious relationship with an agreement to support each other in healing their childhood wounds. When we do this, we evolve into mature individuals and have healthier relationships. We are then able to blossom into expressing the fullness of who we are as individuals. A relationship at this level is an example of an interdependent relationship. The more the old issues resolve, the more enjoyable a relationship will become.

“Can I recover from depression without antidepressants?”

This is a question that many people ask me. They search the web, talk to their doctors, and seek alternative treatments, hoping that they can recover “on their own.” The answer to this question is both simple and very complicated. It often depends on the severity and persistence of depressive symptoms. Few people, in my experience, recover spontaneously and fully from depression entirely on their own. Reaching out for help is an important part of the recovery process. But getting help can take many forms, and what works for one person may not be the answer for another.

Studies show that psychotherapy can be as effective as medication in improving depressive symptoms, and the benefits tend to persist after treatment ends. Therapy addresses the root causes of depression, such as unresolved grief, anxiety, early childhood trauma, negative thinking, poor self-image, loss of meaning, and relationship difficulties. Therapy can also help to improve coping skills and resilience. But for severe or persistent depression, both therapy and medication may be needed for a complete recovery. This article will talk about what individuals should consider when deciding whether to take antidepressants for treatment of depression or whether another approach might work as well.

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1. Severe, debilitating depression warrants a consultation with a doctor.

When a person comes into my office complaining that he or she is depressed, it is important to assess the severity of the depression. Severe depression with suicidal thoughts needs to be taken much more seriously and warrants a consultation with a medical professional regarding possible medication. Severe depression is a life-threatening condition and should be treated as such.

In addition, depression with severe insomnia may require medication. Without adequate sleep, it is extremely difficult to recover from depression. There are strategies that can greatly improve sleep in some cases, but if sleep does not improve quickly, medication may be required to prevent a worsening of depressive symptoms.

2. There are effective non-drug treatment options for mild to moderate depression.

Many people with mild to moderate depression, where sleep is adequate, can recover from depression with talk therapy and adjunctive strategies such as exercise, improved nutrition, mindfulness techniques, sunlight or light therapy, support from friends, family or a support group, and lifestyle changes. All individuals with depression should rule out a medical issue which may contribute to their depressed mood. Many medical problems, including vitamin deficiencies and hormone imbalances, can contribute to depression. Getting a thorough physical exam to rule out a medical cause is important.

If there is no clear medical cause, psychotherapy which focuses on improving self-care, reengaging in pleasurable and meaningful activities, and managing negative thoughts can be helpful in many cases. Working on issues that are impacting relationships with friends, loved ones, and family can also greatly relieve depression in some individuals. And for some, exploring and resolving unresolved grief or early childhood trauma may be important. Other approaches that can contribute to recovery include bodywork, acupuncture or other alternative medical approaches, meditation, yoga, or spiritual exploration.

3. Taking medication for depression, when needed, should not be viewed as a failure.

However, it is important to recognize that depression is an issue as serious as diabetes, epilepsy, or even cancer. Because it involves mood, thoughts, and behavior, it can often be treated through those channels. But there are also genetic and environmental factors that make some individuals susceptible to depression and which may result in a more persistent condition that is more difficult to treat.

Just as other conditions sometimes require medication for their treatment, depression may also require medication to fully resolve. And it is important to recover fully rather than settle for persistent mild depression. Persistent depression can become chronic and more severe over time as the brain becomes accustomed to the depressed state. Therapy and medication combined have the highest success rate in terms of resolving depression, and when therapy alone is not sufficient, it may help to consult with a doctor or psychiatrist to discuss medication options.

It is important to remember that, when it comes to treating depression, there is no prize for recovering “better” than another person. Recovering without therapy, without medication—literally “on your own”—does not earn you any awards. The prize is being emotionally healthy. It’s important to recognize the impact that our society’s attitudes toward mental health conditions, psychotherapy, and psychotropic medications may have on your decision-making. How you recover is a personal choice, based on your own needs in consultation with trusted professionals. Your choice should be made from a place of compassion and self-love.

For help with depression, find a therapist in your area.

References:

1. De Jonghe, F., Kool, S., Aalst, G., et al (2001). Combining psychotherapy and antidepressants in the treatment of depression. Journal of Affective Disorders, 64, 217-229.
2. De Maat S, Dekker J, Schoevers R, De Jonghe F. Relative efficacy of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Psychother Res. 2006; 16(5): 562–572.
3. Spielmans, G. (2011, October 1). Antidepressants Versus Psychotherapy for Depression. Retrieved October 18, 2014, from http://pro.psychcentral.com/antidepressants-versus-psychotherapy-for-depression/004942.html

Just over three years ago I considered myself happily married and content to grow older gracefully. I was 46, working hard as a senior school teacher and raising two teenage girls. My husband, who is almost 10 years older than me, had been in poor health after an operation and had been off work for several months. Much of my life was about obligation—it was tedious and I was in a rut.

At the start of the academic year I was assigned, once a week, a 29-year-old trainee teacher. The first day I worked with him I thought what a nice young man he was and wished my daughters would meet someone like him one day. He had a gentle nature and such a non-confrontational approach to teaching that the students took to him immediately.

By week three I was hopelessly in love with him. We were relaxed with each other, could talk for hours and had such an intense connection. I could think of little else, day and night. I have never longed for someone, cried over someone, or been absolutely driven to distraction like I was with this man. I completely lost my perspective, and almost my sanity.

The thing is, unlikely as it may seem, he was obviously attracted to me. He paid me endless compliments, stared at me constantly in class, commented that my husband was lucky, described me to a colleague as ‘beautiful’ and ‘wondrous,’ blushed and stammered when we met around school and generally acted like someone with a teenage crush. The week of Valentine’s Day, he gave me a beautiful drawing of a heart that had obviously taken hours; another day, when I complimented him on his teaching, he responded with “There are just not enough superlatives in the world to describe how wonderful I think you are.” I was in heaven. [fat_widget_left]

Against this barrage of affection I consistently maintained a ‘you’re very sweet but I’m happily married and far too old for you’ response. It was agony but I couldn’t show him how I felt. What held me back was my devotion to him—a relationship between us could never have worked and the one thing I wanted in the world more than him was for him to be happy. When he left after a year I was heartbroken and went for counseling to make sense of it all, which really helped in several ways: I could talk my obsession through in safety and realize how impossible it was, I was able to explore what was missing in my marriage at that time and try to identify the positives, but moreover, my counselor helped me to address problems at home and improve the relationship with my husband.

Three years on and things are completely different—this infatuation, or whatever it was, is all but forgotten and hardly seems real. My husband is mostly back to good health and we are much happier. I’m also doing more things for me—I’ve reduced my working hours and enjoy a more balanced life. And the young teacher? We have stayed in touch, but inevitably he has moved on. When we occasionally meet I can’t honestly understand what I saw in him.

Karina is a senior school teacher, now aged 49. She lives in England, is married and has two daughters—one at college, one at university. The episode that she recounted happened three years ago.