In my introductory article on anger management, I introduced you to the notion that anger management per se often misses the mark. Spending all our time and energy handling our anger in more productive, pro-social ways can get tiring if we constantly have anger bubbling up that needs to be managed. Wouldn’t it be nice, for once, to be able to sit back and enjoy yourself rather than constantly spin inside your managerial role? It’s not too good to be true, but you must know going in that getting to this place will take considerable effort at first. Perseverance, patience, and kindness will serve you well in this endeavor.

To begin, we must understand the nature of anger. When not experienced as a secondary emotion (more on this shortly), anger occurs as a result of being a part of or witnessing a wrong. If we or a loved one are in harm’s way, the energy we call anger wells up, leading to two things: (1) an often laser-like focus on the wrong occurring and (2) increased energy to do something about it. We can view anger in this sense as organically pro-social. It occurs in relation to harm that we think must be prevented or averted. Barring any illegal, immoral, or self-harming act, expression of this type of anger can generally be viewed favorably. Sometimes called “righteous anger,” imagine Jesus routing out the bankers from the temple to get an image of what I’m referring to here.

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As you may have already guessed, the vast majority of the anger we experience on a regular basis does not fit into the first category described above. Rather, the anger we generally need to “manage” falls into the category described as a secondary emotion. In brief, a secondary emotion is one that emanates from a judgment about a primary emotion. They generally occur due to our unwillingness to fully accept and feel the primary emotion. The primary emotion is usually one that feels physically uncomfortable and might also have a social stigma attached that reinforces the tendency to keep it held in. Sadness, guilt, anxiety, and fear are most often the primary emotions that get transformed into anger. As a result of judging and therefore suppressing their full expression, their energy “becomes” anger.

In my next article, I will cover in greater detail how to work with fear and anxiety. In this article, I wish to focus on sadness. Sadness occurs when we have lost something significant. Losing a job or the death of a loved one are obvious causes of sadness, but all too often we do not catch the more subtle triggers. At its core, we experience sadness when we’ve lost something that supports our self-identity. The reason sadness hurts is because we’re experiencing the absence of a psychological part of ourselves, not unlike losing a limb.

Feeling our sadness is important because it sanctifies the thing lost. Sadness fully expressed allows us to honor the missing aspect in our lives. This process reinforces the importance of reengaging in life so that we may begin cultivating the missing value. Not feeling our sadness prevents us from accessing the importance of the thing lost. Once we inquire into our sadness with kind curiosity, we will find that some value or quality is missing.

So how do you put all of this information into practical use? We’re all fond of steps, and I’m not here to disappoint:

1. When you get angry, sit down and begin to feel the energy in your body. Rather than ranting and raving, start taking stock of your bodily tension. (Yes, this is very difficult at first. With practice you’ll get better, I promise.) Once some of the energy has subsided, ask yourself what you’re sad about. Usually something specific—and quite often completely unrelated to the thing that caused you to be angry in the first place—pops in.
2. Once you’ve accessed the trigger of your sadness, it’s time to feel sad. I can already hear you grumbling. I know, feeling sadness isn’t pleasant, and that’s why so many of us avoid the sensation. A little trick I learned, and teach, is to say “yes” or nod your head when the sensation of sadness is felt. Acknowledging our emotion in this way makes it easier to access. Now, fully feel the sadness without judging or commenting. (This part is a bit difficult as well. It takes much practice to learn to feel our physical sensations without any accompanying thoughts.)
3. Once the sadness has subsided—and it will subside—you can begin the process of inquiry. Ask yourself what was lost. If it’s not obvious, look to core values that you prize, such as kindness, fairness, support, etc. Often, we get angry when these core values aren’t experienced in ourselves or in our relationships.
4. Patience and honesty in this process will often lead you to the missing value. Now that you’ve found it, it’s simply a matter of going out into the world and cultivating the very quality that went missing in the first place. This might look like being kind to coworkers, patience with your children, or being gentle with yourself when you make a mistake. Regardless of the quality expressed, your sense of power and accomplishment will increase.

Although the above steps are simply laid out, it will take you a few goes before you really get a handle on the entire process. We’ve come a long way from talking about anger. To bring that aspect back, recognize now that underneath much of our anger is a sense of powerlessness in the face of losing something sacred. When we re-access that missing component, we reclaim our power and, ultimately, our sense of peace.

Every smoker knows that smoking poses serious health risks, but the prospect of quitting can be daunting. Nicotine withdrawals can last between three and 14 days, and some smokers find the depression and anxiety that may be associated with quitting smoking unbearable.

If you can ride out the first week or two of misery, though, it really does get better. Within a few weeks, you may be wondering why you ever craved a cigarette at all.

For smokers desperately craving just one more puff, these five tips can help quell the nicotine thirst.

Change Your Routine 

Nicotine is highly addictive, but it leaves your body within three days. By the fifth or sixth day, any cravings you feel are psychological, not physical. Changing your daily routine to remove common triggers for smoking can help you cope with these cravings. Try taking a day or two off of work, changing your working hours, or even going on a vacation. When you don’t have constant reminders that you used to smoke, you’re much less likely to miss puffing away your life.

[fat_widget_right]Get Moving

Even the healthiest smokers suffer cardiovascular consequences from their decision to smoke. But within a few hours of quitting, your body begins to repair itself. This makes exercise easier, and exercising without coughing and becoming exhausted can be a powerful reminder that quitting has immediate health benefits. Even better, though, aerobic exercise can help silence even the worst cravings. Try doing a few jumping jacks every time you get a nicotine pang, and aim for a slightly longer workout every day or every other day.

Drink Some Water

The desire to put a cigarette in your mouth can be overwhelming, but try replacing that habit with a healthier one. Sipping cold water through a straw can combat nicotine cravings. Try taking a few deep breaths as you drink, and visualize yourself as a happy, healthy nonsmoker.

Accept the Cravings

When a craving strikes and you need to be doing something else, the energy you need to fight the craving can undermine your ability to work, concentrate, or maintain a decent mood. Rather than fighting cravings, try accepting them. When you feel a craving, tell yourself you’re going to take five minutes to fully experience the craving. Breathe through it while thinking about all the reasons you want to be a nonsmoker. Then get back to what you were doing before the craving came on.

Make Cigarettes Your Enemy

Most smokers conceive of quitting smoking as a time of epic deprivation. If you think of cigarettes as your friend, though, you’ll miss them more when they’re not around. Before you quit smoking, concentrate on every problem cigarettes have caused you—from smoker’s cough to the inability to enjoy a meal without lighting up. When you smoke a cigarette that you don’t enjoy or that gives you a headache, dwell on it. Then, when you give up smoking for good, think of your cravings as nasty reminders of what cigarettes used to do to you.

The cravings aren’t a longing for a friend who helped you through tough times; they’re the voice of harmful nicotine trying to convince you to do something that’s terrible for your body. When you miss cigarettes, think to yourself, “Cigarettes have harmed me so much that I have managed to convince myself that something that tastes bad and is terrible for me is good.” When cigarettes become your enemy, you have little reason to smoke them—even when you get a craving.

Are you working on quitting smoking? You’re not alone—more and more people are getting help with nicotine addiction. Smoking isn’t just a physical habit; it’s a mental health issue. Finding a therapist who works with smoking cessation may help. You can look for a therapist for yourself or a loved one in the GoodTherapy.org directory.

References:

1. Withdrawals. (n.d.). Retrieved from http://www.quit.ie/en/inner/withdrawals
2. Withdrawal symptoms and how to cope. (n.d.). Retrieved from http://www.lung.ca/protect-protegez/tobacco-tabagisme/quitting-cesser/withdrawal-sevrage_e.php

We know that certain functions of the body shut down when a person is faced with a threatening situation. This allows other parts to become more active. Larger sets of muscles receive more blood as heart rate increases, allowing for the well-documented “fight-or-flight” response. While the body tenses and readies to “respond,” some areas of the brain become less active. Hence, the ability to process emotional responses and store memories during a traumatic event can be impaired while pre-programmed survival mechanisms kick in.

Posttraumatic Stress

For some, this will lead to a condition known as PTSD (posttraumatic stress). The intense emotions associated with an unintegrated traumatic memory can impair normal functioning in daily life for those experiencing PTSD. Read more about this here.

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Not everyone experiencing a traumatic event will go on to develop PTSD. However, for those that do, PTSD is treatable. Eventually, there can actually be benefits that result from a well-integrated traumatic event. This is called posttraumatic growth.

Posttraumatic Growth

Many people experience a meaningful improvement in their psychological outlook on life after a traumatic or life-altering event. For example, after a near-death experience, some report a renewed zest for living, an intense wonder at the beauty of the natural world that surrounds them, and a deeply felt sense of purpose not previously recognized.

In one study, Robert James Miller II and David Read Johnson noted an increased capacity for symbolic thinking in a group of 56 Vietnam War veterans who experienced PTSD. From the abstract: “Unexpectedly, subjects with PTSD in comparison to subjects without PTSD showed greater capacity for symbolic representation, and no difference in lexical capacity, raising new questions as to the mechanism by which trauma could increase the capacity for mental imagery.”

It’s possible that in order to avoid re-experiencing a traumatic event (because memories of the event have not been properly stored), some people unknowingly strengthen their ability to think symbolically as a coping mechanism. Since we know that symbolic thinking is a cornerstone of the creative process, can an unexpected benefit of trauma be an increase in creativity?

Surges in Creativity

There is compelling evidence that suggests surges in creativity could be linked to the experience of trauma. Dr. Marie Forgeard conducted an online study to investigate this idea. An online questionnaire was filled out by participants, whose answers were used to measure posttraumatic growth, rumination related to the event, and growth of creativity. Forgeard used two measures in the study: (1) scores on a measure of posttraumatic growth and depreciation and (2) scores on self-reported measures of creativity in the aftermath of adversity.

She found that “… adversity-induced distress predicted self-reported creative growth and breadth in a sample of online participants. Cognitive processing [intrusive/deliberative rumination] as well as domains of posttraumatic growth/depreciation—in particular, self-reported changes in interpersonal relationships and in the perception of new possibilities for one’s life—mediated the link between self-reported distress and creativity outcomes.”

It is important to note that intrusive rumination describes a process where the individual is primarily focused on the symptoms of the distress being experienced as opposed to solutions for these symptoms. On the other hand, deliberate rumination is a process by which an individual turns inward and engages in reflection along with contemplation about various problem-solving possibilities.

Creative Therapy and Deliberate Rumination

Given the links between trauma and creativity that are being uncovered, creative therapies such as art therapy or expressive writing, coupled with supported deliberate rumination practice, could be beneficial in the recovery process for individuals wishing to deal with the aftermath of traumatic, life-altering events and/or full-blown PTSD.

References:

1. Miller II, Robert James, and Johnson, David Read. Psychological Trauma: Theory, Research, Practice, and Policy. Vol. 4(1), Jan 2012, 112-116. doi: 10.1037/a0021580. Retrieved 3/21/14 from: http://psycnet.apa.org/journals/tra/4/1/112/
2. Thompson, Paula. The Traumatized Imagination: Creativity, Trauma, and the Neurobiology of the Resilient Spirit. Retrieved 3/21/14 from: http://www.healingresources.info/article_thomson1.htm
3. Forgeard, Marie J. C. Perceiving Benefits after Adversity: The Relationship Between Self-Reported Posttraumatic Growth and Creativity. Psychology of Aesthetics, Creativity, and the Arts. Vol. 7(3), Aug 2013, 245-264. doi: 10.1037/a0031223. Abstract retrieved on 3/21/14.

Cheating is an emotionally charged topic. When we hear of an affair, our immediate response can feel like a punch in the stomach. We empathize with what the betrayed partner must be going through. For most of us, in those moments, we feel aligned to that person because we either know from experience or can imagine what she or he must be feeling after such a revelation.

We may become triggered, wondering if our own relationship is vulnerable to an affair, and how we would get through such a traumatic experience. We may even decide we no longer want to associate with the partner who cheated, and cut off all ties or distance ourselves.

No relationship is immune to infidelity. Research has shown that oftentimes partners are not looking for affairs, but they gradually slide into one because the opportunity presents itself. Some relationships may be more susceptible than others, because of factors such as keeping separate social circles or having demanding careers that require travel or excessive time away from home.

An often-overlooked risk factor making a relationship vulnerable to infidelity is the presence of one or both partners having a “people pleasing” personality type.

[fat_widget_right]What does people-pleasing have to do with cheating?

Pleasers tend to share a commonly held set of assumptions:

• Who I am, what I think, how I feel, what I need or want, and what I care about are not as important as everyone else.
• My point of view isn’t valid or correct.
• Everyone else comes before me.
• If I speak up for myself or share my true self with others I may be rejected.
• Conflict is scary and should be avoided.
• I must be who others want or expect me to be—and do what others want or expect me to do.

In a relationship of any kind, these assumptions translate into behavior and feelings that look like this:

• Agreeing to things you may not agree with, and then possibly being upset with yourself for the incongruence
• Doing things for others you don’t want to do or have time to do, and then feeling resentful or taken for granted and taken advantage of
• Keeping thoughts and feelings to yourself or withholding your truth, and then ruminating about it, or expecting others to read your mind or body language
• Acquiescing or surrendering your position to your partner, and being upset you aren’t getting your needs met
• Withholding bits of the truth to avoid conflict
• Saying everything is fine, when your behavior clearly shows you are not fine (passive aggression or silent treatment)

Pleasers often end up in places they do not want to be: they marry the person their parents adore; they propose because that is the next logical step; they have babies because their spouse is ready for parenthood. Pleasers may stay in a relationship because that is what they feel they are supposed to do.

They live their lives by assumptions, and in the end do not really have a strong sense of who they are and what they want. They are often in a lot of emotional pain. Though they may feel hurt, resentment, and confusion, they do not actively acknowledge it within themselves.

Over time, the pleaser disappears in the relationship. They have been forsaken for the “should”. And when both partners are not showing up and representing themselves as two distinct individuals the, relationship can become ripe for an affair.

Which Partner Is at Risk for Cheating?

Well, that depends. The pleaser may cheat because she is extremely unhappy but doesn’t have the skills and sense of worth to speak up. Instead of using her voice to express her needs to the other partner, her pain may lead her into the arms of an attentive or exciting other. This may come after an awakening or realization that she is discontent or that her current partner is not a match for her after all.

Maybe the pleaser begins to assert himself, but the tracks are too deeply grooved and the other partner is not responsive to the pleasing partner’s new protests. He may be shut down and shut out more firmly than before, so any attempt to correct the imbalance leads him to the conclusion that he is stuck in an unchanging, painful dynamic. Turning away from his partner to fulfill his needs is much more appealing.

It can also be the non-pleasing partner who, over time, gets bored with the lack of challenge or resistance to being in relationship with a pleaser. There can be little push back or debate with a pleaser. The pleaser becomes invisible because who he or she is as a person is not adequately represented in the relationship.

The non-pleasing partner may feel suffocated by the needs and symbiotic pull (enmeshment) of the pleaser and can’t get enough time alone. An affair can be an act of defiance—a declaration of “I need some space.”

The Antidote

While there is no failsafe measure to protect against a breach of the marital walls, moving toward truth telling and away from pleasing will certainly help to minimize some of the risk. When both partners show up every day sharing the truth of who they really are, they create a strong, secure attachment to one another.

They acknowledge and are able to respond to each other’s separate and distinct needs. And this affirmation of both partners within the relationship keeps some of the holes filled so they are less likely to be filled outside the marriage.

There are four types of human beings, and I believe each is designed to attend to at least one of four critical areas of need in a functioning human society.

The tasks that each temperament is designed to attend to are so disparate that significant differences in perceptions, priorities, values, and meanings are required to attend to them. These automatically triggered differences are present at birth, identifiable at an early age and, like the degree to which each newborn is left-, right-, or mixed-handed, will not change much across time.

For instance, a naturally literal parent will not be able to get their naturally possibilities-oriented child to become more literal, any more than a naturally feel-response-oriented parent will be able to get their natural thinking-response-oriented child to experience emotions more like a feeling-oriented individuals does.

The temperament that each child is born with may be the same as, or different from,

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1. One or both parents.
2. One or more siblings.
3. One or more extended family members.
4. A teacher, coach, employer, friend, or therapist.

The nature of temperament-driven differences is such that four individuals with different temperaments can perceive, process, prioritize, and respond to the same reality in significantly different ways. Current models for making sense out of these differences treat them as matters of choice rather than of nature.

Consequently, when these differences lead to a disagreement over who is right and who is not, each assumes that the other is choosing to differ when they are not. Never-ending relationship-threatening debates can ensue driven by natural differences that neither is aware exist.

I have been providing my individual, couple, and family clients with information on natural differences in temperaments since 2000. Once most clients have realized that natural differences are at play, debilitating debates over who is right and who is not have come to an end. This allows for accommodation and compromise in areas that had not been possible before.

Taking a freeware version of the Myers-Briggs Type Indicator (MBTI) can identify an individual’s temperament. A two-letter code within the four-letter MBTI psychological type code identifies the temperament providing the driving force for that particular type. The method for identifying temperament codes is found at the end of this article.

 The Four Temperaments

1. Sensing-Judging (SJ): Approximately 45% of the population

People with the SJ temperament provide structure for human societies. From an early age they want to know what the rules are—the societal norms for acceptable behavior. They will then live their life according to those rules and expect others to do the same.

With regards to typological wiring, choice is not an option. An SJ person’s sense of self is connected to following the rules and honoring the traditions of their society and they will automatically be bothered when others do not. Without SJs, human beings would not have a functioning foundation, a social order.

• Extraverted SJs are wired to express disapproval immediately when someone is breaking a rule. That unacceptable behavior might be cutting in line, arriving late for a meeting, or making too much noise in a library.
• Introverted SJs are also automatically bothered by such behaviors, but may not be as direct in expressing their disapproval.

The four SJ-driven personality types are ESTJ, ESFJ, and ISTJ. SJs of note include George Washington, Mother Teresa, Andy Rooney, Desmond Tutu, and Barbara Walters.

2. Sensing-Perceiving (SP): Approximately 23% of the population

People with SP temperaments are designed to address the needs of immediate sensory experience. The common denominator for SPs that distinguishes them from the other three temperaments is their need for freedom to respond or create in the moment, as the moment dictates, without reference to others.

This independence of mind is innate, a derivative of nature’s design and an essential requirement for the purpose and function they are designed to attend to. SJs tend to take care of the structural needs of human societies, that which can be predicted and planned out. Meanwhile, SPs are attending to the needs of the moment, those aspects of human experience that are best served by in-the-moment innovation and ingenuity.

SPs adapt to the constantly changing variables of immediate sensory experience. This can be quite extraordinary; SPs are found among the most gifted practitioners of both the fine as well as the martial arts.

The four SP-driven personality types are ESFP, ESTP, ISTP, and ISFP. SPs of note include Barbra Streisand, Erwin “Magic” Johnson, George C. Patton, Meryl Streep (my guess here), and Michael J. Fox.

3. Intuitive-Thinking (NT): Approximately 15% of the population

Those with NT temperaments are designed to process information from a logical frame of reference. Their primary function is to make sure that what is said or done makes logical sense. NTs can often be found in leadership roles in science, business, government, sports, and the military, making sure that logic rules the decision-making process.

In order to attend to their role responsibilities in a functioning human society, NTs are designed to experience emotions within objective parameters of cause and effect. As with the other three temperaments, choice is not an option. If something said or done does not make logical sense, it is automatically rejected as invalid.

The four NT-driven personality types are ENTJ, ENTP, INTJ, and INTP. Well known NTs include Hilary Clinton, Steve Jobs, Albert Einstein, General Colin Powell, and Angela Lansbury.

4. Intuitive-Feeling (NF): Approximately 18% of the population

NFs are designed to facilitate harmony in the lives of other human beings. Nature assures that NFs attend to their role of responsibility by triggering feelings of guilt and blame disproportionate to objective reality when they upset or disappoint someone or do not help others when they know they can help but may not want to.

A rule of thumb for NFs is, “If is not said nicely, it is not nice.” No other temperament is designed with this degree of guilt and blame sensitivity in their wiring. Given this innate set of priorities for experiencing a sense of meaning and purpose in life, it is not surprising that as many as 75% of marriage and family therapists in private practice are NFs.

The four NF-driven personality types are ENFJ, ENFP, INFJ, and INFP. Well-known individuals with the NF wiring include Oprah Winfrey, Abraham Maslow, Nelson Mandela, Mahatma Gandhi, and Isabel Briggs-Myers.

Procedure for Identifying Temperament

For a free short-form questionnaire to find your own temperament, you can go to www.NaturalPersonalityInstitute.com and download the freeware questionnaire (Natural Personality Questionnaire) based on the MBTI located there. Fill it in and score it. When done, you will have a four-letter psychological type code.

The first letter of that type’s temperament code is found on the Sensing-Intuition dichotomy. That is the second column from left on the questionnaire.

• If the first letter is S for Sensing, the second letter is found on the Judging-Perceiving dichotomy (the last, or fourth, column on the right).
  • If your letter code on the Judging-Perceiving dichotomy is J for Judging, your temperament is SJ (Sensing-Judging).
  • If your letter code is P for Perceiving, your temperament is SP (Sensing-Perceiving).

• If the first letter of your two letters temperament code is N for Intuition, the second letter is found on the Thinking-Feeling dichotomy (third column from left)
  • If your letter code is T for Thinking, your temperament is NT (Intuitive-Thinking).
  • If your letter is F for Feeling, your temperament is NF (Intuitive-Feeling).

For example, my four-letter MBTI psychological type code is INFP. The first letter of my temperament code is found on the Sensing-Intuition dichotomy which, in my case, is N for Intuition. When N is the first letter of a temperament code, the second letter is found on the Thinking-Feeling dichotomy which, in my case, is F for Feeling. Therefore my two-letter temperament code is NF for Intuitive-Feeling.

Between Temperament Communication

In order to maximize your effectiveness in navigating communication problems with temperaments that differ from your own it is helpful to remember the following:

1. SJs automatically prioritize rules of conduct, if others are behaving appropriately.
2. SPs automatically prioritize the dictates of immediate sensory experience.
3. NTs automatically prioritize the logical consequences of an act or intention.
4. NFs automatically prioritize how people may or will feel about what is said and done.

Choice is not an option. Like the degree to which each newborn is left, right, or mixed handed, the temperament in each newborn’s wiring is the temperament that will provide the perceptual frame of reference throughout their lifetime.

My mother and I provide a perfect example of this phenomenon. She was an ESTJ and I am an INFP, opposites on all four dichotomies. She was a thinking-response-oriented SJ and I am an NF. She was bluntly direct (and usually right!) in letting me know how I should be behaving.

I found her manner of communicating to be hurtful, leaving me feeling guilty, bad, and resentful. I kept her at an emotional distance most of my life. She was 93 and still cognitively sharp as a tack, before I got up the courage to tell her how her manner of communicating affected me.

She was genuinely surprised, stating, “Michael, I do not understand this guilt thing. I did not want you to feel bad about yourself; I just wanted you to do it right.” This comment helped me realize that thinking-oriented and feeling-oriented people naturally experience emotions very differently.

A Note of Caution

While the information on temperaments and temperament-specific psychological types tends to be accurate, it is general in nature, addressing response dynamics known to be common for individuals with each of the type profiles. The specifics of an individual’s self, separate from others, is far too complex to be captured by a temperament specific tendencies profile.

First of all, there are a near infinite number of degrees of response orientation that an individual may have on each of the four dichotomies known to determine an individual’s temperament and temperament specific psychological type. Birth order, degrees of visual, auditory, and kinesthetic perceptual processing, spirituality, aptitudes of mind, and a wide range of environmental influences, as well as an X factor to cover the inexplicable, also factor into the equation.

The complexity involved is such that true knowing of another has some very real limitations. Because of this, type profiles should be used for the gathering of general information about an individual, but most definitely not to define the person.

Many people have heard that anxiety medications can have some serious side effects, such as addiction, memory problems, impaired driving, and sleepiness. But a provocative new study claims that taking anti-anxiety medications leads to greater long-term mortality.

Anxiety is the most common mental health challenge; an estimated 40 million Americans every year experience anxiety. Although contemplating such a serious side effect can be frightening, is one study reason to give up on anti-anxiety medications altogether?

The Study

The study tracked 35,000 people prescribed anxiety medications and compared them to 70,000 people who did not take such drugs. Study participants were tracked for about seven years, on average. Even when the researchers controlled for variables such as socioeconomic class, medical conditions, and age, the group taking the anti-anxiety medications was more likely to die early.

The study’s authors argue that anti-anxiety medications cause four excess deaths per year for every hundred patients. Although the numbers may seem alarming, they’re relatively low. The numbers also reveal nothing about an individual patient’s personal risk of death.

Are Anti-Anxiety Drugs Dangerous?

[fat_widget_right]Every drug poses some risks, and anti-anxiety drugs are no exception. However, it’s important to note that the study tracked long-term use of anxiety medications. Doctors have known for a while that long-term use of certain anti-anxiety drugs carries risks such as cognitive impairments. Many people take anti-anxiety drugs for brief periods of time, and the effects could be different for short-term users.

Although the study’s authors controlled for several factors that could increase long-term mortality, they couldn’t control for everything. It could be that doctors are more likely to prescribe anti-anxiety medications to people with more severe anxiety or that people with severe anxiety are more likely to continue taking medication for years.

Anxiety itself is correlated with a host of health problems that may increase the likelihood of death. The study could simply be tracking the effects of severe, chronic anxiety.

If you take anti-anxiety medication and are worried about the drug’s effects, talk to your doctor. A variety of lifestyle and health factors can alter your relative risks. Your doctor can recommend specific steps to take to reduce your specific risk factors. Because anxiety itself can be damaging to your health, you may find that the risks of anti-anxiety medications don’t outweigh the benefits.

Options for Coping with Anxiety

Although medication can help you fight anxiety, drugs aren’t the only antidote. If you’re concerned about taking medication, consider therapy. Treatments such as cognitive behavioral therapy can aid you in detecting and reversing anxious, negative thoughts.

If you have specific fears, your therapist might use exposure therapy. Your therapist may also recommend other strategies to amplify the effects of therapy, such as meditation, exercise, a healthier diet, or a regular sleep schedule.

The study did not find that antidepressants increase the risk of death, and these drugs can be effective at treating anxiety. Selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Zoloft are popular options, but your doctor might also recommend a nontraditional antidepressant such as Bupropion.

No matter what treatment option you choose, be honest with your treatment provider about your concerns, as well as any specific medical risk factors you have. Only then can you and your doctor properly evaluate the right course of action.

References:

1. Facts & statistics. (n.d.). Retrieved from http://www.adaa.org/about-adaa/press-room/facts-statistics

2. Raison, C. (2010, March 23). What are the long-term brain effects of Xanax? Retrieved from http://www.cnn.com/2010/HEALTH/expert.q.a/03/23/xanax.long.term.use.raison/index.html?hpt=Mid

3. Salzman, C. (2000). Cognitive improvement after benzodiazepine discontinuation. Journal of Clinical Psychopharmacology, 20(1), 99. doi: 10.1097/00004714-200002000-00017

4. Weich, S., Pearce, H. L., Croft, P., Singh, S., Crome, I., Bashford, J., & Frisher, M. (2014). Effect of anxiolytic and hypnotic drug prescriptions on mortality hazards: Retrospective cohort study. BMJ, 348. doi: 10.1136/bmj.g1996

Thank you for your question. Boy, have you been on a roller coaster! In fact, this was my first response: Gee, does he really want to get back on? But then I reflected on it, and I began to see the question in a more positive light, thinking: Perhaps he really cares about her, loves her, and is willing to wait. Maybe he sees something worth waiting for. And what is nobler than that?

At the same time, it’s possible you are feeling some survivor guilt after all this intensity (i.e., a “horror film.”) Your girlfriend, while lovely in many ways, I’m sure, clearly has some posttraumatic stress-type abandonment terrors and, probably, some trauma or historical abuse to work through. This can take a while. It is hard to predict the course of therapy; my sense is that the more you give her space to really work on healing herself, the better. It is easy to find distraction when the hard road of recovery lies before you, especially in the early stages. Keep holding your ground, because many people in early treatment look for distractions or exits. In fact, I think the less talk of “we’ll give it another try,” the better. “Let’s see how it goes first” might be the more prudent approach.

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Even if you do decide to give love another try, she needs time to establish some emotional balance in her life, to withstand life’s inevitable volatility—which has proven so dangerously destabilizing to her. (She must have really been treated horribly at some point in her life; how lucky she has someone who cares for her so much now!) Treatment is very hard to predict. Based simply on what you describe, it sounds like she has some knotty psychological issues to untangle. Also, there are always relapses in the best of treatments, and the inevitable ups and downs. Be prepared for a long haul with—I hope—subtle but lasting changes along the way.

But let’s talk about you for a moment. You are in an existential dilemma in the sense that no one except you really knows what it is like in your own skin, to say nothing of what lies within your heart. Because of the complexity of what you are facing, and if I may be so bold, might I suggest some therapy for yourself? Your questions are actually about your girlfriend, but what lies within you? What do you need to be happy from this or any partner—what can and can’t you live with to feel safe? I suggest a cooling-off period where you spend time with friends or doing things you enjoy, getting on with life, seeing how it feels to live without the “horror film” and threats. Sad to say, but I wonder if your girlfriend is really available for a relationship, given the inevitable challenges of intimacy. (What does her therapist say about this?) Love is often given as “the answer” to life’s woes, but love, like life, is always subject to unpredictability.

You say you need “expert advice,” a wise observation given that you have been through trauma; though your tone is admirably stalwart, I can’t help but think it disturbing to have witnessed your beloved behaving so destructively, perhaps like someone you hardly even recognized. (Trauma states are often jarringly alien to friends and loved ones, even the person him/herself.)

No one can say, when all is said and done, whether your questions are reflective of love and devotion or so-called “codependence.” But counseling, even short-term, would probably help gain some perspective as the dust clears. You’re very smart, by the way, to hesitate before leaping back in. The fact you are hesitating to seek “expert advice” might indicate a need to explore the pain of your own recent experience as much as the possible return of the relationship. And yes, I do mean your pain, which counts just as much as hers—or should, if we’re talking about a romance between equals. Without something resembling equality-based thinking, where both partners’ needs “count”—a relationship between two committed, equally available and accountable partners—intimacy cannot thrive.

Best wishes,
Darren

Today’s world is filled with messages on how to date, but frankly, most of what we hear is creating heartache after heartache for women. After even one heartbreak, a woman might find herself distancing herself emotionally, having problems connecting, or experiencing trust issues.

The examples in pop culture are numerous. On this past season of ABC’s The Bachelor, for example, viewers watched as women became physically involved with the leading man. In the words of one participant, when they kissed, all the issues in her mind “disappeared.” Several women during the season described delving into a fast, physical relationship, while the emotional relationship was missing something.

What we are seeing is that many women are first looking for a physical connection and then asking themselves: Do I really like him? Are we really compatible? Do we really want the same things in life? Unfortunately, once we develop a strong physical or sexual connection and become infatuated, our brains start to convince many of us that the answers to the above questions are yes, when in fact they may be no.

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Why does this happen? According to researcher Helen E. Fisher, individuals who are “falling in love” experience elevated concentrations of central dopamine and norepinephrine along with lower levels of serotonin, which tends to mean they obsessively focus their thoughts and attentions on one another and, more importantly, on their partner’s positive attributes rather than the negative ones (p. 416). Once that “falling” feeling has diminished, as it generally does over the next few months, individuals begin to notice deficits more rapidly than before.

So now we have a situation where a woman is emotionally invested and connected with a man, but experiences confusion about whether they are actually compatible or share the same values or goals. To protect her heart, she tries to convince herself that they are a good match and that they want the same things in life. But she may still hear that “little voice” telling her that something is not right.

Ladies! Consider the following advice to protect your heart, make smart dating decisions, and more easily find the person you may be searching for:

1. Take the physical relationship slowly. Very slowly. Even kissing.
2. Get to know him deeply. Find out if you share the same life goals and values. What kind of lifestyle does he envision? What are his thoughts on marriage and commitment? (Hint: If he tells you he has commitment issues and you are looking for commitment, then back away now.) Do you share the same family values? Do you see eye to eye on religion and spirituality? These are the types of answers you want.
3. Believe that you can know whether you have chemistry with him before you are physical. Many people ask me, “But if we do not have a sexual relationship at first, how do I know if we will have sexual chemistry?” Do you long to kiss him? Do you want to reach out and hug him? Do you stare into each other’s eyes? If the answer to these questions is yes, then you can relax your anxiety because you do, in fact, have sexual chemistry. You can work on whatever sexual issues may arise once you have built a solid relationship.
4. If a little voice inside of you is telling you that it’s not right, pay attention to that voice and try to figure out why it feels that way. What is it saying? What are the red flags you are picking up? Why are you staying in a relationship if your gut is telling you it’s not right? Are you afraid of being alone? Do you wonder if you will ever find Mr. Right?
5. Be OK with being alone for a while. If you have a need to be in a relationship, you may settle or convince yourself that he is what you want out of fear of going without anyone. While you’re with Mr. Wrong, you won’t be emotionally available and open to meeting Mr. Right.

If we take care to protect our hearts and open ourselves up safely and slowly, we will reduce our possibility of getting hurt. Opening yourself up too much, too quickly may create a pattern of distrust or emotional guardedness with others, making it hard for you to find “the one,” even if he is standing right in front of you. Taking the time to open yourself up slowly and protecting your body and feelings will let you lead with your head so that your heart can follow.

Reference:

1. Fisher, H. E., Aron, A., Mashek, D., Li, H., and L. Brown (2002). Archives of Sexual Behavior. Vol. 31, No. 5. Pp. 413-419.

There’s a good reason why more than 16 million people have viewed Harvard professor Amy J. Cuddy’s TED Talk: “Your Body Language Shapes Who You Are.” In it, Dr. Cuddy describes findings that seem to be both commonsensical and revolutionary all at once; even two minutes of adopting a powerful stance can change both one’s physiology and behavior. Over time, acting as if one is confident and powerful can positively impact self-concept, or the way we view ourselves.

Other research has shown that people who feel powerful tend to have a greater sense of agency, better cognitive function, adopt more expansive body language, and are more willing to take action than those who feel less powerful. People who feel disempowered tend to adopt more contractive or protective postures. During her talk, Cuddy shows photographs of the iconic Wonder Woman stance (i.e., hands on hips, feet apart, head erect, and gaze confident) as one example of a power pose. She contrasts this with images of protective postures (i.e., limbs in toward body or crossed, shoulders forward, chin tucked). In effect, feeling powerful leads one to take up more space, both literally and psychologically. Furthermore, powerful people tend to have higher baseline levels of testosterone, lower baseline levels of cortisol (a stress hormone), and reduced cortisol reactivity to stressors.

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In their study, Dr. Cuddy and colleagues hypothesized that adopting high-power poses would lead to increased testosterone, decreased cortisol, and higher risk tolerance. They randomized 42 men and women into two groups, where they would be posed in either high or low power positions by an experimenter for a total of two minutes. Power poses were characterized by expansiveness (taking up more space) and openness (limbs open versus closed or crossed; the specific poses used can be viewed in their article).

Cortisol and testosterone levels were measured before and after the poses. Participants’ willingness to engage in risk taking was measured via a gambling task, and subjective feelings of power were measured by self-report.

The team found that their hypotheses were confirmed: Just two minutes of high-power posing was associated with a statistically significant increase in testosterone and decrease in cortisol. High-power posers also reported feeling more powerful and “in charge” than low-power posers. Furthermore, they were more likely to view a game of risk as an opportunity to win rather than to lose. In contrast, those who had adopted low-power poses for two minutes had significant decreases in testosterone, increases in cortisol, reported feeling less powerful, and were more likely to avoid risk, viewing it as an opportunity to lose.

Why is this important?

Aside from the subject distress associated with feeling powerless, persistently elevated stress hormone levels are linked to increased incidence of stress-related illnesses, including immune issues and hypertension. In addition, if we feel chronically at a disadvantage, we are likely to act in accordance with this belief, avoiding situations because we view ourselves as less likely to navigate them successfully.

In her talk, Dr. Cuddy equated personal power with feeling more confident in one’s ability to “win,” and thus, greater willingness to take chances that may result in some reward. She also noted the difference between male and female business students’ body language and levels of class participation (men tend to participate more, and adopt power poses more frequently; women as a group participate less often, despite the fact their grades depend on participation). Cuddy attributed this difference at least in part to the fact women are socialized differently from men; my interpretation of this is that, in general, women are encouraged to be nice, and discouraged from taking up too much space, physically or otherwise.

It is intriguing to wonder what the long-term benefits could be of consciously adopting more powerful, self-confident body language, particularly if one feels stressed, discouraged, or down. It certainly seems worth trying. If you do this, please let me know what you think.

Be well!

Is the trauma children typically experience when divorce occurs in the family due to the divorce itself or other factors that surface around the divorce between the parents?

To a marriage and family therapist, this is an important question. If mental health professionals know specifically what it is about the process of divorce in the family that is traumatic for children, the trauma can be lessened to a great degree by addressing the specific factor(s) that children who experience divorce in the family are confronted with.

Many children experience the process of divorce in their families. During the 1970s and ’80s, the pop psychology was that parents should not stay together for the sake of the children. The theory was, “If the parents aren’t happy, the children will not be happy.” While that is most likely true, research has shown that there are, in fact, traumatizing effects that divorce can have on children.

However, the divorce itself does not appear to be the only factor that is traumatic for children when the divorce process takes place. Other factors, such as not seeing one of the parents as often, the parents transitioning into new relationships, changes in the socio-economic status of the family, and the constant transition from one parent’s house to the other parent’s house can also be difficult adjustments for children who experience divorce.

[fat_widget_child_counselor_right]Generally, children are very adaptable when they have enough support. When children who experience divorce do not have an appropriate amount of support and they reflect back on the situation, they often recall experiencing difficulty that they possibly did not realize they were experiencing at the time.

Some factors for parents to consider when children experience divorce in the family:

• There should be as little conflict as possible between the parents, especially in front of children. When children witness their parents in conflict, they often attribute the cause of the conflict to something they did wrong. Each parent should avoid criticizing the other.
• Parents must be extremely careful when entering into a new relationship. They must ensure that the person they are entering the relationship with is open to accepting the extended family, including both biological parents of the children. This would also mean accepting the ex-spouses. Whether the parents and the new partners in their relationships like it or not, they are, in fact, extended family. It is in the best interest of the child(ren) that everyone involved be accepting of one another while setting and respecting clear boundaries. This also models healthy boundaries for future relationships.
• The time each parent spends with the child(ren) needs to be as equitable as possible.
• When spending time with one of the parents, children should feel free to contact the other parent if desired, and to have their privacy respected.
• Parents must recognize that their relationship is not ending when they divorce; it is changing. They will always be in a parenting relationship and must collaborate as a team.
• Each parent should have a caring attitude toward the other biological parent. Children need to know that their parents care about each other, as it reflects that the parents also care about the child(ren), which increases the child(ren)’s self-esteem.
• Both parents should attend events such as parent/teacher conferences, school plays, sports activities, and other types of activities that the children are involved in as much as possible. Children need to know both parents are invested in supporting their success.
• Parents should ensure they live close enough geographically so that they are both easily accessible to the children; that being said, it is also important to have clear boundaries and show respect for the other parent’s personal life.
• Parents must be able to communicate consistently about their child(ren)’s emotional development, health issues, academic progress, etc., and be committed to supporting one another in their role as parents.
• Parents must be careful to avoid using the child(ren) as a messenger. They should communicate directly and avoid asking the child(ren) for information about the other parent’s personal life.
• The child(ren) should know that they can turn to both parents when/if they need to problem solve.
• Parents need to ensure that they have adequate and quality one-on-one time with their child(ren) and are as present in the moment as possible … in other words, children need to have a sense that they have a parent’s undivided attention when spending quality one-on-one time together.

When parents have appropriate support systems in place for each other and the children while maintaining clear boundaries, the process of divorce is much less traumatizing for children. Ideally, in time, both parents can move forward with their lives and into healthy relationships with the outcome being extended family relationships that are loving and supportive of one another. Ideally, the children should have the perspective that they did not lose their family, but that their family changed and that the parents have the children’s best interests at heart.

“David, tell Randy you’re sorry.”

“Sorry.”

The mother takes 7-year-old David to another part of the playground. By the sound of the “saaaaawry,” I’m guessing that David was being obedient, but he didn’t really know what he did, didn’t feel like it was his fault, and wasn’t sorry at all.

As adults, we hear (or even give) apologies such as, “I’m sorry you felt hurt.” “If I did something that hurt you, I’m sorry.” “I apologize, but I was really distracted by something else.” “I’m sorry, but you should know that I really love you and you shouldn’t take it so personally. It’s just the way I am.” “I’m sorry, but you are really making too big a deal of this. It is just a little thing.” “I apologize, but give me a break.” “I’m sorry for the problem you had. My assistant is normally on top of things.” When we give such apologies, we can say, as 7-year-old David did, “But I apologized!” However, when the apology (as in the examples above) is an inauthentic or inadequate apology, it doesn’t heal, doesn’t resolve, doesn’t soothe, and the hurt remains unmoved.

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Authentic and effective apology is the very core of healing, clarifying, and restoring relationships, from interpersonal to organizational to cross-cultural ones. A real and well-thought-out apology can, like forgiveness, cut the cycle of anger, revenge, and hatred. However, making a genuine apology causes the giver to be extremely vulnerable. You are admitting directly to another that you did something that caused harm. This is very humbling! Doing so is also challenging because it’s like leaping off a cliff into the unknown. You are not in charge of how your apology will be received. Your efforts could be harshly rejected, your hopes for healing thrown back in your face.

A client spent some months working with his shame about having abused his younger sister. From a most humble place, he wrote her an apology in the hope that this could be a first step in restoring their relationship. Several weeks later, the letter was returned to him, with “Rejected. You will not be forgiven.” written across his words. He was devastated. Over time he began to look at what he could do rather than grieving for the loss of his relationship with his sister.

His sister couldn’t accept his apology, but he could demonstrate that he had learned and changed by volunteering at a women’s crisis center. He also could be proud that he had broken many generations of family history by not abusing his own daughters. These actions, which he was proud of, had shifted his inner wound from the shame of feeling unforgivable to the fact of being unforgiven. He could now move on.

I asked a few of my friends to remember a time when they needed to and did offer someone an apology. Usually, we rightly focus on the feelings and needs of the hurt person, but I wondered what the apologizer got from the process. This is what I heard: “I got to let go of at least some of my guilt.” “The apology was accepted. It repaired the relationship, and the friendship actually got better.” “In the process of getting to being able to apologize, I went through all my defenses and finally got to see something about myself that I didn’t like and face the truth about a familiar and hurtful pattern I had been denying or at least had been unaware of. This was hard work. Once I got it, the apology was easy.” “Honestly, I don’t know if I got anything at all. It was really like just getting it out of the way.” “It was unbelievably relieving for me.” “It took such courage. I try so hard to be ‘good,’ and it was painful but freeing to be able not only to see but to take responsibility for doing a bad thing.” “I learned that it’s really OK to make mistakes. What isn’t OK is not to apologize for them and learn from them.”

Apologies open big doors. As John Kador puts it, “Apology is the bravest gesture we can make to the unknown. … Apologies unmask all the hopes, desires, and uncertainties that make us human because, at the moment of genuine apology, we confront our humanity most fully. At the point of apology we strip off a mask and face our limitations. No wonder we hesitate” (Kador, pp. 43-44).

What is the value of apology to the one who has been wounded? Opportunity for restoring relationship, deescalating conflict, rebalancing power, recovering dignity, letting go and moving on, stopping a cycle of resentment and revenge, and increasing trust in the human capacity for goodness and truth. This is a strong litany. From the biggest perspective, “quarrels often escalate into serious conflicts on the fulcrum of apology. … Throughout human history, endless cycles of revenge and untold suffering have resulted from the denial of effective apology. It’s a tragedy because apology has the power to defuse almost all human conflicts” (Kador, p. 45).

In my book Right Use of Power: The Heart of Ethics and in my ethics programs, I talk about resolving difficulties as one of the most important and challenging skills to learn as leaders and human beings. I describe five things that most people need to hear in order to for an injured relationship to be restored. Not all of these things will be essential in all situations, but at least one—and probably more—will be needed. Here they are (Barstow, p. 160):

1. Acknowledgement
2. Understanding
3. Regret
4. Learning
5. Repair

Making “a genuine apology or/and authentic expression of … regret” is the complete description of No. 3.

Effective Apologies

With a deep bow to Kador for his excellent book Effective Apology: Mending Fences, Building Bridges, and Restoring Trust, I want now to suggest how one can make an apology with greater wisdom and skill.

Kador also names five dimensions in making an effective apology (Kador, p. 124): recognition, responsibility, remorse, restitution, and repetition. Here’s more about each of these.

• Recognition. Apology requires recognition that what you did was wrong or harmful. The injured person needs to know that you understand your offense and that you are apologizing for the right thing. “I’m sorry I hurt you” is not sufficient because it is not sufficiently specific. “I’m sorry I spoke to you in a disrespectful way” is better. You need to face and name your offensive action. Doing so calls for humility and vulnerability. It is more effective when both parties agree on the facts of what happened, but sometimes when there is disagreement you need to give up your need for this aspect of closure. “Apology is basically giving up our struggle with history. Contested facts invariably lie at the heart of botched apologies” (Kador, p. 52).
• Responsibility. In this dimension, you take full responsibility for your offense without being defensive, making excuses, offering long explanations, or blaming anyone else. “You misunderstood me. What I meant was …” or, “And what’s your part in this?” won’t get you anywhere and might even make matters worse. “I take responsibility for being angry, using mean words, and hitting you” is clear and direct. In my program, dimension No. 2 is understanding (“They want to know what happened or what your intention was”). I personally have experienced times in which an explanation of my intention or my process was helpful. However, I agree with Kador that explanations can defuse an apology and that the best time for giving an explanation or stating your intention is later on, if at all. “In general, explanations burden apologies. … When victims first consider an apology, they don’t care about intentions. All they care about are consequences. Explanations have an unfortunate tendency to serve the needs of the wrongdoer more than the wronged” (Kador, p. 67).
• Remorse. Here you use the words “I’m sorry,” or “I apologize.” It seems there isn’t any substitute for these exact words accompanied by appropriate feeling. The little boy on the playground used the right words, but he didn’t accompany the words with the much-needed nonverbal cues that would have demonstrated genuine feelings of remorse, humility, vulnerability, and respect. “I wish it hadn’t happened,” or “I wish I could do it over again” just doesn’t have the needed effect at the moment when “I apologize” is needed.
• Restitution. You need to make amends. You need to offer an appropriate action. “I was careless with your bicycle, and I will take it to a bike shop tomorrow to get it fixed and tuned up,” for example. Restitution should be aimed at a repair that goes one step beyond the actual harm done. In this example, that would be having the bike tuned up in addition to simply having it fixed. In my program, I talk about the question, “What is needed here for relationship repair?” While this can be a useful, heartfelt question because it conveys a desire to reconnect and restore the relationship, in the apology process it is usually advisable not to ask the injured person what restitution he or she wants because the person may not know or may ask for something greater than what you can offer. It is most often best to make an offering yourself. So often we hear the words, “Don’t admit you made a mistake because it will be held against you in court.” Offering some restitution would seem dangerous because it clearly admits guilt. However, this understanding is not supported by facts. “An expression of regret combined with an offer of restitution actually reduces punitive measures and lowers the odds of litigation. Restitution is not cost-free, but it is almost always less costly and destructive to the relationship than protracted litigation” (Kador, p. 99). “The last thing a plaintiff’s lawyer wants to introduce in court is evidence of a contrite physician who issued an apology” (Kador, p. 219).
• Repetition. Here you say what you have learned, how you have changed, and how things will be different in the future. This action in my program is aspect No. 4, learning: “They [the injured party] want reassurance that you’ve learned something and will act differently in the future.” Repetition in making an effective apology goes further. It is a commitment to not repeat the offending action. For example, “I’ve learned that I have poor boundaries. I revealed confidential information about you. I will not do this again. I hope over time you will be able to trust me again.” This commitment to change is critically important to the success of the apology.

General Considerations

• Ifs or buts: Don’t use them! “I apologize if I said anything offensive,” or “I’m really sorry, but I only said this because you said that” neutralize or worsen the injury by making the apology conditional and in effect denying responsibility (Kador, p. 203-204).
• Assumptions: You may be attempting to express your empathy, but “I know exactly how you feel” doesn’t really add to the process. It is much better to enter the dialogue by expressing interest in and concern about how the person is truly feeling. For example, “I wonder how I’d feel if …” is better than “If I were in your shoes, I’d …” (Kador, p. 209-210).
• Form: Begin your apology with “I.” This word makes it clear that this is a personal response from you. Don’t ramble on. Being simple, clear, and concise is more powerful and effective than an overly long apology (Kador, p. 211).
• Timing: When the offense is small, immediacy is best. A simple, “I’m sorry I stepped on your foot” will be enough. Without this simple apology, the relationship “bag” gets full of remembered incidents that can be interpreted as lack of awareness or respect on the part of the other party. This situation will then require a larger apology and more complex process for increasing trust. When the offense is great, however, time to think it through, cool off, or do some psychological processing is needed.
• Manner: Apologizing in person is usually the most successful. An email, which can be easily misunderstood, does not convey emotion very well. However, when a CEO or a government official needs to apologize, a written apology may be the only available way.

Accepting Apologies

The other side of offering an apology is accepting one. On the receiving side, you must discern whether the apology is genuine and whether it feels satisfactory. Accepting is just accepting. It doesn’t automatically include trusting or forgiving. Rebuilding trust happens over time. Forgiveness is a separate process.

When you do accept an apology, it is important to make an acknowledgment. Responses such as, “It was nothing,” or, “Don’t worry about it,” or, “You don’t need to apologize,” or, “It’s too late” have the effect of dismissing the intended communication. They trivialize a vulnerable moment. Before learning about the apology process, I had thought that when I said, “It was nothing,” I was being kind, generous, and forgiving. I now understand it to be disrespectful. When the apology is genuine, it is best to say, “I accept your apology.” The interaction needs to be complete and acknowledged. A friend’s “I’m sorry I’m late; I know that caused you some extra work” deserves my recognition of her humility and awareness of her negative impact. “Thank you, I accept your apology” as a response in this case works well.

Apology can move mountains. A half-hearted one can make things worse. A sincere and well-crafted apology can restore relationships.

Although grief is a part of life, it can be one of the hardest parts of life, and one of the most difficult to understand. At the end of the day, grief is a very lonely journey. People who are ensconced in the process of grieving often say they feel like they’re alone, like they’re going crazy, like the rest of the world is buzzing around them while they’re trapped in a bubble, and like they’ve lost themselves and wonder when they’ll be “normal” again. It’s a process that is very internal and confusing, and it can be difficult to feel a sense of connection in the world.

To be in an intimate relationship with someone who is in this space can feel just as lonely and confusing. You want to be there for your partner, but don’t know what he or she needs or wants. You want the person to feel better. You want the person to be him/herself again. You want the person to be able to support you on those days when your life feels hard. Or maybe, very simply, you just want that smile or playfulness back that used to be so fun.

When a person is grieving, his or her capacity for giving to a relationship is far less than normal. He or she is consumed with comprehending the loss experienced, and with coping with the multitude of feelings that accompany grief. In many cases, a person experiences depression alongside the grief, which can feel like another barrier to relating with him or her.

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I’ve seen many couples, of all lengths of relationships, struggle through these issues and wonder how their relationship can survive such a raw and inevitably difficult time in life. It would seem that the longer a couple has been together, the greater the ability of both people to stick through the hard times with each other, possibly because they have made a commitment to each other, or because there is more trust developed in the relationship. But what I’ve witnessed is the success of many of these couples, regardless of how long they have been together, as they have moved toward each other, rather than away from each other, during this hard time. If two people believe in their relationship AND feel that they can get their needs for connection met AND there is patience available in the partnership, the outcome is usually positive. How long they’ve been together is less of an influence if these pieces are present.

1. Get some of your needs met outside of your relationship. The simple truth is that your partner can’t be there as much as he or she could before the loss because the person is busy experiencing so many feelings and reactions to that loss. You may feel upset or angry that this is the case. If you do, talk with someone about it. If you’re judging yourself for feeling this way, talk with someone about that as well. And amid all of it, understand that your partner just can’t be there as much right now, and it’s OK for you to seek friendship and social connection with your friends or social spheres more regularly. You are experiencing something fundamentally different than your partner, and you cannot expect yourself or your partner to be in a different place.
2. Have patience. Your partner will return. The grief will integrate into his or her life and psyche, and be less of an overwhelming force that shrouds each day. Grief doesn’t ever go away; however, it does subside, and your partner’s “normal” personality will come back, albeit with more of a personal understanding of what life means to them. This is an opportunity for you to connect with the person in a very deep way. The things your partner will come through this experience with are incredibly important and will offer you not only a perspective on how grief feels, but also a perspective on your partner’s unique way of finding meaning in life. This could be an amazing source of connection for you both as you gain understanding about this deep and sacred aspect of your partner’s psyche.
3. Understand your own grief. Grief can beget grief. Seeing someone we love grieve often reminds us of our own grief, and can remind us in very visceral ways what it was like to lose someone—or a pet. In the grand scheme of things you do not have to put your experience on hold; in fact, this would be detrimental to your relationship and to yourself. In the moment, you may have to put aside what you’re feeling in order to be fully present for your partner, but please come back to it. Give your own experience the space it needs, whether by talking with someone, journaling, making art, taking a walk, or just sitting with it. When your partner is ready, he or she may even ask you about it.
4. Let your partner feel all of his or her feelings. For those of us who take our responsibilities seriously, the experience of watching someone in discomfort or distress can trigger a cascade of our own discomfort that we often assuage by trying to say the right thing or by trying to find a solution to the “problem.” If there is one thing you remember from this article, remember that feelings are not problems. Your partner must feel the entirety of his or her experience if he or she is going to get through the grief in one piece. This means that there is nothing “right” to say, there is nothing you can do to make the person feel better, and in fact when you try to make the person feel better you’re creating a dissonance between the two of you that will just make your relationship suffer. Your partner needs you to simply hear what this is like for him or her, and to accept it. Accept your partner’s feelings as his or her truth, and accept the fact there is nothing to do about it. The act of simply listening without rushing in to change anything will offer more than you can imagine.