Dear GoodTherapy.org,

I am under 18 and live with my dad and stepmom. I’ve been cutting for almost a year from depression and anxiety and basically not feeling like I want to be here. I HATE the idea of seeing a therapist and “talking about my feelings,” but apparently the school counselor told my dad I needed to see someone outside the school for help. The school counselor doesn’t know about the cutting, but I’ve talked to him a bit because apparently I have “anger issues.”

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So now my dad and stepmother are looking up therapists for me to go see. I really don’t want to talk to anyone about my “issues,” but it’s getting hard to cover the marks on my arms and legs and I don’t know how to stop cutting. And also I know they’re just going to keep me in therapy longer if I refuse to talk. But I REALLY don’t want my parents to know about me cutting myself or the suicidal thoughts I sometimes have. Can I get through counseling without my parents finding out about it? How much is the counselor going to tell my parents about what I say in therapy? —Under Rage

Dear Under Rage,

These are good questions to ask any therapist you see. Find out from them what their policies are regarding confidentiality with people in therapy under 18. Much of what they say will depend on legal and ethical guidelines based on where they live and what kind of license they have. When I work with people under the age of 18, I discuss in great detail with both the young person and the parents what those guidelines are. That allows everyone to have the same understanding and expectation about how the process works. It also allows the young person to decide how much to share with me and to be aware of what my responsibilities to report are.

Most professionals are obligated to report when a person in therapy, regardless of age, is in imminent danger. That danger could be significant risk of suicide or conditions of abuse/neglect. Thoughts of suicide alone, however, do not necessarily trigger a mandated report—it depends on the circumstances. There are many people who have such thoughts but no intention or plan on following through. What is essential, however, is that anyone who is struggling with thoughts of suicide finds sources of support with whom they can talk. A trusted therapist is a great option. There are also national hotlines where you can reach out for support 24/7.

I hear the frustration in your message about all that the adults in your world “apparently” believe to be true for you. Instead, look at what YOU can get out of this experience. You can have a voice and share your truth with someone.

I’ve worked with a number of people who also HATED the idea of talking about their feelings. Usually that stems from a place of fearing they would be judged, a massive discomfort with feeling vulnerable and exposed, and a reluctance to trust someone they don’t know well. All of those feelings are natural. I can share with you that all of those people, in their own time, came to trust me and the process. When you find a therapist you can work with, who allows you to share at your own pace, who offers you a safe place to speak your truth without fear of being judged, counseling can be an amazing experience.

If I can offer you a suggestion, don’t reject therapy completely because it feels like something being “done” to you. I hear the frustration in your message about all that the adults in your world “apparently” believe to be true for you. Instead, look at what YOU can get out of this experience. You can have a voice and share your truth with someone. You can get support for the anger, anxiety, and depression you say you’ve been feeling for a year now. You can have support in finding alternative strategies beyond cutting to cope with the intensity of the feelings you have. You can be seen. You can be heard.

Nobody can make you share what you aren’t willing to share. You are right, though, that refusing to talk or engage will likely limit your choices and your control over your situation. So, how can you engage in ways that work for you? Ask your potential therapist the tough questions about confidentiality and how they manage those issues. Find out if your parents are willing to let you take part in the process of choosing a therapist. Many professionals have directory profiles and websites that can tell you a bit about what they might be like to work with. I’ve had people meet me first before deciding to work with me. Many therapists are very willing to meet to assess fit, as we know a good fit leads to more positive outcomes. You might just find someone you can open up to who can offer relief from what you’ve been feeling.

Best of luck,

Erika

Emotional abuse can be every bit as devastating to individuals and relationships as physical and sexual abuse. And the pain of experiencing emotional abuse can be heightened when you feel unsure whether what you are experiencing is normal or okay. You may feel something is wrong but be unable to identify what it is. You may find yourself spending a great deal of time trying to put yourself in the other person’s shoes and understand where they are coming from. You may notice you are altering your behavior in order to keep the peace or avoid conflict.

Emotional abuse occurs when one person—intentionally or otherwise, consciously or unconsciously—engages in behavior that insults, threatens, rejects, neglects, blames, manipulates, isolates, degrades, punishes, humiliates, or exerts control over another. Fear, guilt, and shame are among common responses to, and goals of, emotional abuse.

Although it is most often thought of in terms of intimate partner relationships, emotional abuse can occur in other types of relationships as well. Parent-child relationships, for example, can be marked by emotional abuse, sometimes continuing well into adulthood.

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Although physical and sexual abuse can also be considered forms of emotional abuse, the latter tends to be more subtle. Physical or sexual abuse may be easier to identify, as they often have physical evidence and a clear incident to reference. Emotional abuse is more often characterized by a pattern or collection of behaviors over time that can be difficult to recognize. Some of these behaviors, when taken on their own, might not necessarily be thought of as abusive. It is the systematic application of these behaviors, with an intention to change the way another responds, that is destructive.

A few examples of emotionally abusive behaviors include: putting you down or calling you names, cutting you off from other sources of connection and support, demanding to know your whereabouts at all times, limiting your access to finances or financial decision making, making threats to harm you or damage property, making you feel constantly unsettled or wary, or leading you to doubt reality.

People who are emotionally abusive can be expert manipulators. They may be very intentional about choosing behaviors that cannot be proven or that come close to crossing lines while retaining deniability.

People who are emotionally abusive can be expert manipulators. They may be very intentional about choosing behaviors that cannot be proven or that come close to crossing lines while retaining deniability. They may manufacture or maintain a chaotic environment, so that it is hard to pin down or describe exactly what is happening. They may also lie about what has happened or rewrite history in order to avoid responsibility for their actions.

Individuals who behave in emotionally abusive ways typically do not respect boundaries. This can be problematic on many levels, but never more so than when you try to leave the relationship. Attempts to leave the relationship or to diminish contact may be met with an increase in abusive or manipulative behaviors intended to convince you to stay. These behaviors may be threatening or intended to induce guilt. However, they may also feel positive, like promises for change or admissions of responsibility for problems in the relationship. Unfortunately, promises for change and responsibility taking may be short-lived once you compromise your boundary and return.

Perhaps the most perplexing phenomenon of all is the ability of abusive individuals to be remarkably kind, caring, and generous at times. Few people would remain in relationships that always felt bad. Fewer would choose to begin relationships with people who treated them poorly all the time. The confusing fact of the matter is individuals who are capable of cruelty are also capable of kindness. They may be charming and generous at times. These instances of kindness or generosity may be good, but abuse is never okay. It cannot be offset.

Emotional abuse often comes packaged with trauma, and while your first priority in any emotionally abusive situation should be to seek a safer environment, therapeutic interventions can also help. Consider contacting a licensed therapist as you make sense of what has happened and begin the healing process. Therapy is a safe space for you to work through any unprocessed feelings and can guide you toward appropriate resources in your community.

A new year is under way, a time when people are reflecting on their lives and setting goals aimed at moving closer to long-term aspirations. If you recently experienced the death of a loved one, you may feel grateful just to have survived the first holiday season without them. Focusing on goals and aspirations while your grief still feels so present may seem paradoxical. But doing so is an essential part of your grief work, according to M. Katherine Shear, MD, founder and director of The Center for Complicated Grief at Columbia University.

While each grief process is unique, the loss of someone with whom you have shared a deep emotional and supportive relationship usually causes the most intense grief reaction. Someone who has held you up emotionally when you were in crisis, helped shape your sense of self, and/or encouraged you to reach for your dreams is physically removed from your life forever. So it makes sense that in the acute phase of grief, you may feel as though you have lost your sense of self or feel unsure of your life purpose.

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Grief is an expression of love that continues after death. You shouldn’t expect your grief to ever end completely. However, it is possible for your grief to become more integrated; painful emotions occur less frequently and with less intensity, and no longer interfere significantly with work, other relationships, or your experience of positive emotions.

The path to integrated grief requires three interrelated processes:

• Accepting the reality of your loved one’s death
• Finding new meaning or purpose in your life
• Continuing the bond with your deceased

Humans are innately motivated to search for meaning in living. However, if you are overwhelmed by sadness as you struggle to accept the reality of a loved one’s death, it may seem impossible to think about trying to find new meaning in your living without them. But after the first few months following your loved one’s death, if you can spend a short period, on as many days as possible, focused on redefining your goals and reimagining your life purpose, it can offer glimpses of joy—a welcome respite from your sadness. It may help you with acceptance on a deeper level of your loved one’s death. Greater acceptance of the death may help you to reconnect with your deceased loved one in memory. Reconnecting with your loved one may alleviate some of the longing and sadness you feel so you are more free to focus on redefining your goals and reimagining your life purpose.

Maladaptive thinking, such as the belief one doesn’t deserve to experience the joy that comes with a renewed life purpose after the death of a loved one, can serve as an obstacle, keeping an individual locked in the acute phase of grief. People are sometimes unable to focus on new goals or life purpose because they fear accepting their loved one’s death and “moving on” means they will or must “forget about” their loved one.

It is important to have a balanced focus on all three processes. Knowing when and being able to shift your focus from working on acceptance of the death to focusing on future goals, or to reconnecting to your loved one, can be challenging. While many individuals can navigate the path to integrated grief with the support of other loved ones, some people can get stuck along the way. One reason for this is on a societal level, death, dying, and bereavement are still taboo topics. Thus, many individuals aren’t educated about the grief process, particularly about the importance of finding new meaning or purpose in living after the death of a loved one.

Maladaptive thinking, such as the belief one doesn’t deserve to experience the joy that comes with a renewed life purpose after the death of a loved one, can serve as an obstacle, keeping an individual locked in the acute phase of grief. People are sometimes unable to focus on new goals or life purpose because they fear accepting their loved one’s death and “moving on” means they will or must “forget about” their loved one. Thus, they may become fixated on people, situations, and places that remind them of the loved one when they were alive, or avoid circumstances that remind them of the loved one’s death. Both fixation and avoidance serve as obstacles to accepting the reality of the death.

Even though grief is a normal response to the death of a loved one, and finding new meaning is a natural human tendency, the path to integrated grief can be a complicated one. If more than a few months have passed since your loved one died, and you are feeling overwhelmed or recognize your grief is interfering with your day-to-day functioning, it may be beneficial to work with a mental professional who specializes in grief work. They can work with you to help you remove obstacles in your path so you can balance the range of emotions that come with the struggle to accept your loved one’s death, the joy that can emanate from finding new meaning in your living, and the peace that flows from reconnecting with your deceased loved one.

A new year is under way. Will you accept the invitation to allow it to be the beginning of a new life for yourself?

Reference:

Shear, M. K. (2015). Complicated Grief Treatment: A Handout for Patients, Friends, and Family Members. Columbia Center for Complicated Grief, The Trustees of Columbia University in the City of New York. Retrieved from https://complicatedgrief.columbia.edu/tools-and-resources/

It’s very common for couples to pursue counseling when communication issues begin to dominate their relationship. Does it ever feel like you and your partner keep missing each other on something? Or like your partner just doesn’t seem to get you anymore? Perhaps you feel you’ve been very clear about your perspective and it’s your partner’s problem that they just can’t seem to understand the issues from your point of view.

Blaming each other for what’s not working, although tempting, will not get you the satisfaction you so desperately desire. Whether you are struggling to navigate a difficult situation together or daily arguments have become the norm, everyone can benefit from improved communication. Here are five tips to help you get on a better track toward mutual understanding and a deeper connection:

1. Find an opportune time to talk calmly about the issues.

Preserving time to check in with each other can help you be more productive. Arrange a time in the near future when you are both likely to be calm and comfortable. Perhaps you find that morning tends to work best, or Sunday afternoon when you’re in a more relaxed mood. You may need to adjust your schedule slightly so you have some extra time.

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Too often, couples attempt to discuss an issue as it’s unfolding. While this may work some of the time, giving each other a heads-up to discuss something more in-depth may help you feel more relaxed and open with your partner. Take a moment to express your need and then follow up with a suggestion for a more opportune time. This communicates respect and consideration, which helps to promote an atmosphere of goodwill between two people.

2. Understand and communicate your partner’s perspective.

Listening can be tough, especially when the other person is saying something that triggers a defensive response in you. Remind yourself that you will also have a turn; right now it’s important to tune in and not interrupt. Make eye contact and be fully present with your partner. You can demonstrate being present by focusing exclusively on the conversation and what’s being said. It might be helpful to view the discussion as involving two subjective perspectives rather than one person being “right” or “wrong.”

If you’re not clear on something, ask a thoughtful question or two to make sure you really understand. You might even say, “Am I getting that right?” or, “I want to make sure I understand; tell me if I’m hearing you correctly …” Take turns talking and listening to each other. Spending just 10 minutes focused on the other person sharing their perspective can make a significant difference. If you find things are escalating, take a 5-minute break and come back.

3. Be mindful of your language and tone.

When you feel the urge to become accusatory or to begin a statement with “You always …” stop yourself. Ask yourself what you’re feeling in this moment.

It can be so easy to miss an important message when we don’t like the tone in which something is being said. Take inventory. When you feel the urge to become accusatory or to begin a statement with “You always …” stop yourself. Ask yourself what you’re feeling in this moment. Taking a minute to slow down before responding can help you say what you truly feel instead of becoming defensive or blaming. Perhaps you might try: “Talking about this always seems to lead us down a destructive path. I’d like to get to a better place with it, but I’m just not sure how.” This kind of statement might help to open up a more constructive dialogue.

If you find a particular topic is especially difficult, it may help to share your feelings surrounding the issue. For example, you might say, “I’d really like to talk about (the issue) with you, but I’m feeling anxious about it because I know this is an area we tend to struggle with.” Sometimes this sort of statement can relieve the pressure to get it right the first time. Be patient with yourself; with time and practice, communication with your partner can become more productive.

4. Think in terms of what you can give, not just what you can take.

While it’s certainly true good relationships involve both give and take, when both partners are focused on giving, they strengthen their ability to negotiate conflict more effectively. With some increased awareness, you can shift a problematic dynamic. Tune into your words and actions more carefully. Is there something you can say or do differently to yield different results? When we are kind, we send a caring message to our partner, and when we feel cared for, we can operate from a place of generosity and love.

What positive and unique qualities do you bring to your relationship? What makes you feel happy to provide to your partner? How can you contribute positively to the situation?

5. Notice and say out loud what you appreciate about your partner.

Everyone wants to feel appreciated and valued. It can be easy to fall into a thinking pattern of: “I feel like I do so much, but no one notices.” When we take the time to openly appreciate someone else’s positive qualities and good deeds, we foster an atmosphere of emotional generosity. Notice something about your partner that you feel grateful for? Share it! Be on the lookout for what you can appreciate and say it. Often, we tend to focus on what we don’t have or what’s not working in relationships. This critical shift in perspective to a focus on the positive can make all the difference. You might find your partner begins to share their appreciation for how awesome you are as well.

Taking the time to understand your partner’s perspective and to reflect back that you truly “get it” can have a significant impact on the quality of your relationship. The next time you find yourself a little stuck, try out the tips above to help you move toward a deeper, more satisfying connection.

I recently worked with someone who had his heart crushed by an individual who led him on for months, asked for his help with various tasks, accepted an invitation to go on an official date, and then ultimately, on the “date,” said she doesn’t date.

Knowing the timeline and details, I had been confident this relationship was headed in a positive direction and wound up feeling disappointed at how it had crumbled to pieces, leaving us both stunned and confused. This happened to somebody who has done so much work in terms of gaining self-confidence and developing interpersonal relationship skills. Having an important relationship dissolve in an instant was devastating.

We processed the experience and the many questions that arose in our next session: Where did he go wrong? Why did she agree to the date in the first place? Did she not date in general or did she just not want to date him? Did her rejection not confirm his feelings of unworthiness?

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As much as we could speculate, analyze the chain of text messages, and try to make sense of what transpired in the relationship, the frustrating truth was there was no logical justification for what happened or why this person treated him the way she did. At least not one he was ever going to be privy to.

He reached out for some clarification, but her responses were arrogant, passive-aggressive, defensive, and left no explanation for how he could have possibly misread her signals. Further, they changed his view of who she was and left it nearly impossible to continue their friendship. He grieved the loss, missing the person he thought she was.

We spent a good amount of time discussing what he should do next. He wanted answers that made sense, but instead he was being ignored. A part of him wanted to contact her, lashing out with his anger, to let her know exactly what he now thought of her. A part of me wanted to support him in doing that. I was appalled by her callousness. I was angry for him.

He wanted closure. At the same time, we both knew it likely wouldn’t accomplish anything. She wouldn’t change, her responses wouldn’t become any more enlightening or helpful, and there was probably no realistic scenario that would lessen his hurt.

The knowledge you were the better or stronger person, or you were mature enough not to burn a bridge, doesn’t feel like much of a win amid the pain and anger. But resisting the temptation to lash out or search for answers you may never get forces you to face the pain head-on.

When this kind of thing happens—when a relationship ends in hurt and anger, when we feel like the rug has been pulled out from under us, or when life doesn’t go the way we were hoping—we want an immediate sense of closure or justification. The desire for closure might be the temporary satisfaction of telling off the person who hurt us, gaining an apology, having the person change their mind, or getting some type of definitive ending that seems clean and makes sense to us.

But the reality is these things generally don’t make us feel better in the long run. Typically, they simply never happen. So the search for closure is often futile and results in wasted energy, more frustration, and a delayed ability to begin healing and moving on.

It takes a lot of strength to be the “bigger person,” to walk away with your head held high, and to resist the urge to give someone who has hurt you a piece of your mind.

The knowledge you were the better or stronger person, that you were mature enough not to burn a bridge, doesn’t feel like much of a win amid the pain and anger. But resisting the temptation to lash out or search for answers you may never get forces you to face the pain head-on. While highly uncomfortable, the sooner you acknowledge and accept the disappointment and hurt, the sooner you can begin to move forward. It may involve coming to terms with the fact sometimes things aren’t logical or fair.

Having the strength to walk away from a negative experience with a sense of grace and your dignity intact will likely help you to feel good about yourself in the long run. With time and some distance, you may discover the experience taught you a valuable lesson or helped you grow in a way only the most challenging of experiences could.

Do you have a grievance you think about more than the positive things in your life? If so, do you think the same, repetitive thoughts about it? Do you seek out people who will listen to you tell the same painful story many times? Does this story have a villain?

If you recognize these patterns in yourself, maybe it is time to forgive.

Why Forgive?

When we hold on to hurt, we remain locked in an unhealthy bond that keeps the people in our lives from having all of who we are. Hurt also robs us of our personal strength. Left unresolved long enough, it can even develop into a victim story that becomes part of our identity.

Some research suggests forgiveness correlates with fewer health problems and less stress (Luskin, 2002).

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What Is Forgiveness?

Some question what forgiveness is and is not. According to Dr. Frederic Luskin, author of the 2002 book Forgive for Good: A Proven Prescription for Health and Happiness, forgiveness is:

• Taking back your power
• Taking responsibility for your feelings
• For you and your healing, not the offender
• A choice

Per Luskin, forgiveness is not:

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• Excusing bad behavior or unkindness
• Minimizing or denying your pain
• Forgetting a painful event happened
• Reconciling with the offender

Focus on the personal aspect of a hurt often comes from our beliefs and expectations that were not met. Luskin (2002) shares some common beliefs and expectations he refers to as “unenforceable rules”:

• My partner must be faithful.
• No one should ever lie to me.
• People must treat me the way I want to be treated.
• My life should be easier than it is.
• Life should be fair.
• My parents should have done a better job.

Challenge Unenforceable Rules

Forgiveness centers on giving back peace of mind. It prevents a past hurt from determining a negative future. Luskin (2002) offers the following steps to address unenforceable rules:

A big part of forgiveness is giving up the hope that the past could be anything other than what it was.

1. Acknowledge your feelings: confusion, anger, indignation, etc. Ask yourself if you are experiencing feelings in the present over events in the past.
2. Concede that you feel bad because your expectations were not met.
3. Give yourself the grace to challenge the unenforceable rule underlying your hurt.
4. Identify the unenforceable rule. What is the experience in your life that you demanded to be different?
5. Change the unenforceable rule you demanded into something you hoped to get. Express it in positive terms. “I wanted a partner who did not cheat on me” is different from “I wanted a monogamous partnership.” The latter is a positive expression.
6. Notice what changes for yourself when your demands change to hopes. Do you feel more peaceful?

HEAL

Luskin (2002) further offers a HEAL (hope, educate, affirm, long-term) method to help forgive:

• Hope: Hope statements remind us of what we wished went our way. They remind us of life’s uncertainty. They are a statement of power when we understand not all our hopes manifest. They declare we will continue to hope for good things to happen.
• Educate: This is to remind us there are limits to what we control and we don’t always get what we want.
• Affirm: Affirm your positive intention. For example: “I want to use my experiences to be a more compassionate person.” This reminds us that we can grow from any hurtful experience. Consider repeating the intention to yourself.
• Long-Term: Make a long-term commitment to healing and well-being. Practice the HEAL steps. Set aside 15 minutes each day to mull over the grievance and write about your feelings for a period of time. Ask someone close to let you know if you slide into old habits and repeat the grievance story. What else could you do to take care of yourself? Would counseling, an exercise program, or parenting classes help?

A big part of forgiveness is giving up the hope that the past could be anything other than what it was. It is important to acknowledge the feelings that come with an injustice, but also to not remain locked in them. If you have tried to forgive and not been successful, a therapist can help you process a grievance.

Something happened that we did not want to happen, or something did not happen that we wanted to happen. Forgiveness is the power we receive as we assert that we have a well of resilience to draw upon. It gives us the chance to rewrite a story about a victim into a story about a hero (Luskin, 2002).

Reference:

Luskin, F. (2002). Forgive for Good. New York, NY: HarperCollins.

People with narcissism live in a self-constructed world of double standards and distortions. That is a key reason dealing with someone who has narcissistic characteristics can feel confusing, frustrating, and draining. One way to cope with a person with unhealthy narcissism is to recognize the “game” of narcissism.

Some key paradoxes in people with narcissism:

1. Hypersensitive, Yet Insensitive

People with narcissism may easily play the martyr or fume at the smallest perceived slight. They may sulk when they’re not the center of attention or don’t get their way.

Yet should someone around them have a crisis, that person’s hurt and needs are often ignored, minimized, or ridiculed. If someone makes requests of them, the person with narcissism may become irritable or label the other “selfish” or “demanding.” And though their narcissistic behavior inflicts pain on those around them, they often seem clueless about it, acting mystified or indignant when the consequences of their actions are pointed out.

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2. Oppositional, Yet Intolerant of Opposition

Many people with narcissism seem to derive energy from saying no or opposing things. They may take delight in ruining another’s mood or special occasion. They tend to blame others for relationship problems; it’s about what you did that made them act a certain way. They may need to have an enemy, a vendetta, pursue legal action, write inflammatory letters, or seek revenge.

Yet should someone question them or call them to account for wrongdoings, they can become incensed or full of disbelief that anyone would oppose them. They may turn to personal attacks or distractions when another challenges them.

3. Demanding of Attention, Yet Unwilling to Reciprocate

People with narcissism tend to be attention vacuums. If positive behavior doesn’t bring the spotlight, they will easily switch to negative behavior to remain dominant.

Despite their pursuit of affirmation and admiration, they rarely dole it out. They may listen impatiently to others, waiting to bring conversation back to them. They may one-up others or compete with loved ones, almost as if any good that comes a loved one’s way takes away from the person with narcissism.

4. Emotionally Entitled, Yet Lacking Emotional Intelligence

If a person with narcissism expresses emotions, those feelings are often presented as sacred and unquestionable, necessitating worship or a full stop by others.

Yet when those around them express emotions, people with narcissism tend to treat others’ feelings as things to be changed, avoided, or ridiculed.

5. Quick to Blame, Yet Slow to Own Their Part

People with narcissistic behavior seem to relish finding scapegoats. Their own personal challenges or shortcomings, if even acknowledged, are often blamed on others. If they fail, it is someone else’s fault. (Though when they succeed, it is entirely to their credit.) If their actions bring pain to others or have great cost, they seem allergic to the words “I was wrong” or “I am sorry.” They may glorify rules and insist others follow them, yet freely break the rules when it suits them.

6. Worshipful of Status and Appearance, Yet Myopic About Their Flaws

People with narcissism may be fixated on who they know, associating with only the “right people” and having contempt for those they see as inferior. They may compulsively need to look perfect and be the best.

Yet if their physical beauty fades or their status wanes, they may distract, deny, or redouble their efforts to feel special and connected. They feel entitled to admiration and respect, rather than acknowledging that respect is earned and that gaining admiration takes hard work.

7. Needy, Yet Depriving

People with narcissism seem driven to pursue success, admiration, material possessions, or other proxies for self-worth. They may pressure or manipulate others.

While you may have to relate to people with narcissism, you don’t have to play their “game” or follow their rules.

Yet to those close to them, people with narcissism may be cold and disinterested, demanding obedience and threatening to disown others for opposing their wishes. They may splurge on unneeded material goods while criticizing others for wanting more than the bare necessities.

Because of these double standards, being in a close relationship with someone with narcissism can be exhausting. If you wonder whether someone close to you has narcissism, the following experiences are commonly felt by those in relationships with someone behaving narcissistically:

• Feeling trapped
• Feeling blindsided
• Confusion as to why someone who loves you would show so little empathy
• Feeling used and manipulated, yet helpless to stop it
• Hypervigilance
• Feeling emotionally unsafe
• Frustration or anger
• Feeling small, isolated, helpless, or hopeless
• Feeling unaccepted
• A need to hide your true feelings so as not to upset the other person
• Fatigue, sluggishness, or heaviness
• Feeling over-scrutinized
• Feeling part of a command performance
• Feeling not good enough
• Feeling unseen or unheard

While you may have to relate to people with narcissism, you don’t have to play their “game” or follow their rules. Healthy self-care in relationships with people with narcissism means:

1. Recognizing unhealthy narcissistic behavior
2. Gaining distance from those behaviors through perspective and action
3. Asking yourself, “At what cost?” At what cost do you tolerate or accept narcissistic behavior? At what cost do you change your own behavior to avoid others’ reactions?

No matter how comfortable you may be with your sexuality, the idea of sex therapy can be intimidating. Many of the people I work with in sex therapy struggle with sexual functioning or desire, issues that often come loaded with complicated emotions such as anxiety. These things can be difficult to talk about, let alone try to do something about—even when it is understood that the person you’ve enlisted to help you is a compassionate and nonjudgmental professional.

For men in particular, socialization related to sexuality can add to these complexities. Although not uncommon, the experiences of premature ejaculation or erectile dysfunction can bring deep feelings of shame—even in committed relationships with partners who are understanding and patient. Many men are socialized to believe sex should be easily enjoyable and they should always be in control. When it doesn’t work out this way, some may feel intensely inadequate or weak. Men in these situations may question their worth as partners and even as human beings. If a partner isn’t understanding or patient, these feelings can be amplified.

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As a sex therapist, I am trained in specific techniques that men can utilize to resolve a variety of sexual concerns. However, these techniques are often insufficient in addressing premature ejaculation and erectile dysfunction. Given the complexity of these issues, holistic sex therapy can play an important role.

It’s natural to seek out strategies that focus on physical functioning—the most obvious symptoms of sexual issues—but sex is more complicated than that. There are thoughts, narratives, emotions, and processes associated with the act of sex. These elements can greatly affect desire and pleasure. They can also impact bodily control and responses.

Sensory issues must also be addressed. The body tells its own story. Sometimes this story matches up well with the mind’s story about a problem, other times not so much. In these situations, people can benefit from learning about the activation cycles of their bodies—knowledge they can then incorporate into their sex lives.

It’s natural to seek out strategies that focus on physical functioning—the most obvious symptoms of sexual issues—but sex is more complicated than that. There are thoughts, narratives, emotions, and processes associated with the act of sex.

Holistic sex therapy is also about identifying cultural and social narratives surrounding sex. Not only can this exploration help people understand some of the roots of what they experience, it can also help them learn about ways their sexuality has been impacted, and how their bodies respond to these ingrained stories. Through sharing and understanding, validation can lead to healing and growth. It can also lead to sexual confidence that reflects acceptance of these influences while also challenging them.

Religion and spirituality can also play a role. These two elements can be related, of course, but they can also be very different. In fact, they can even contradict each other. Certain forces of religion, when deeply embedded, can overtake a person’s ability to sexually express themselves. Meanwhile, spiritual meaning can be difficult to ascertain.

In holistic sex therapy, self-esteem work is also relevant. When people recognize the barriers that are leading to their sexual issues, they may have to rediscover what they value about themselves.

Certainly, relationship issues can be a factor as well. Many men masturbate with no problems but struggle with sexual function with partners. Sometimes, this can be related to feelings about partners and their expectations, which may or may not be based in reality. When men unpack this in therapy, they’re typically better able to see what’s getting in the way of arousal, control, and desire.

Sound like a lot? Well, that’s because it can be. Sex can be complex, especially when you delve beyond the presenting physical issues and explore emotions and cultural influences. It’s rarely just one thing. Although many people tend to think of sex as primarily a physical act, there’s a lot more to it. Therapy that doesn’t explore these often hidden aspects does a disservice to the people who seek it.

Dear GoodTherapy.org,

I’m afraid of everything. I seriously mean everything. Spiders, clowns, heights, germs, dying, dogs, small spaces, large crowds, undercooked meats, darkness, terrorist attacks, natural disasters … I could go on. These irrational fears have been affecting my life for as long as I can remember, and I never seem to get over them. If anything, I only find new things I’m afraid of.

I did a ton of research to find a place to live that was least risky—no hurricanes, no tornadoes, unlikely earthquakes, the least number of bugs, etc. I’ve insulated myself as much as humanly possible. I’m still miserable and afraid.

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Only a small number of these fears actually have roots in personal experiences. For instance, I was once bitten by a large dog, which explains my fear of dogs. But I have never been traumatized by a clown, never been caught in a violent attack, never experienced a natural disaster. I never had a negative experience in an elevator, but I have a panic attack almost every time I step foot in one.

Why do these things bother me so much? Is it possible to “cure” fears that have no basis in personal history? I want to live more freely and feel better about normal things and occurrences that should, at most, evoke minimal discomfort. Please help! —Dread Locked

Dear Dread Locked,

You write that you are scared of everything and there is no reason for most of your fears. I disagree. I think you do have reasons, even if you may not be fully aware of them, and these reasons can be worked with.

Sure, if you’ve been bitten by a dog, it makes logical sense you’d be afraid of dogs—there’s a reason for the saying “once bitten, twice shy,” after all. But you don’t have to have been in an elevator, necessarily, to be afraid of elevators—claustrophobia (fear of being trapped in small places) and agoraphobia (fear of situations that might cause panic and feelings of helplessness) are both pretty common.

Some of the other fears you describe—fear of spiders (arachnophobia), fear of heights (acrophobia), fear of germs (mysophobia), fear of clowns (coulrophobia), fear of dying (thanatophobia), and fear of earthquakes (seismophobia)—are prevalent enough to have their own names, too.

You ask whether there is a cure. That’s a strong word, and while nothing is guaranteed, I feel confident in saying therapy can help you understand your fears better, which in turn may help you manage them in more effective and productive ways.

It’s telling to me that you describe your fears as irrational. If you look at these fears, you no doubt recognize they are about things and events that do sometimes happen or present problems in human experience, but remember: the brain is wired to protect itself. Consider your fear of dying, for instance. Would you agree most people fear death on some level? Fundamentally, fear of death is protective, as it is our brain telling us to make decisions that are in the best interests of its preservation. Your brain is in fact being rational, not irrational, when it tells you to, say, keep your distance from the edge of the cliff, or to slow down, or to not eat those two-week-old leftovers. (Thanks, brain!)

Some of these fears can also go along with emotional experiences—claustrophobia, for example, can be linked to early experiences. You may not have been stuck in an elevator at any point, but you may have a history of being stuck or trapped in other, perhaps figurative, more emotional ways. As a result, seeking and finding safety may have become paramount in your life. Based on the extent of your fears and the lengths to which you go to avoid feeling fearful, I imagine that being vulnerable—as we all are in one way or another—is not something that sits especially well with you.

Can you do anything about being fearful? Well, yes. I think your best bet would be to seek a therapist who specializes in helping people with anxiety, fear, and worry. Starting therapy can be scary too, of course, but working with someone who is grounded, accepting, and knowledgeable about how to help people in your situation is a fine step toward learning how to handle your feelings.

You say you’ve “insulated” yourself as much as “humanly possible,” but you are still afraid and “miserable.” Clearly, the actions you’ve taken to protect yourself, while well-intentioned, aren’t working for you. You yearn for some relief. You ask whether there is a cure. That’s a strong word, and while nothing is guaranteed, I feel confident in saying therapy can help you understand your fears better, which in turn may help you manage them in more effective and productive ways.

I salute you for identifying an issue that is blocking you. You’ve taken a fine first step by writing in and explaining your situation. I wish you well as you take the next step in addressing your fears by partnering with a qualified mental health professional.

Take care,

Lynn

People who feel rejected may engage in retaliatory aggression, according to a study published in the Journal of Personality and Social Psychology. The findings also showed exacting revenge can improve mood.

Many people who feel they have been wronged experience a natural desire for revenge as a way to seek justice. Understanding which experiences trigger a need for vengeance could help reduce violence and interpersonal cruelty.

Revenge: Pleasurable and Triggered by Rejection

The study sought to explore how rejection affects the desire for revenge. Previous research has found a link between seeking revenge and a desire for status and power. The new study supports previous findings, pointing to a role for revenge as a coping mechanism to avoid shame.

Researchers conducted six trials on 1,516 participants. In one study, 154 students took a placebo pill. Researchers told them it would make their mood stable and unchanging. The students then played a computer game in which they passed a ball back and forth with two other “players,” who were pre-programmed computer responses.

[fat_widget_right]One group was rejected by the other “players.” Compared to a group that received 15 of 30 passes, the rejection group received just three passes. Investigators asked participants to rate their rejection. Participants then had a chance to retaliate during a race to hit a buzzer. Faster participants could punish the slowest participant with a loud blast of noise. The loudest blast went up to 105 decibels—similar to the volume of a jackhammer.

To improve their mood, rejected players elected to expose other players to louder sound blasts. The rejected players who received the placebo pill believed nothing they did would improve their mood, so they predicted no benefit to seeking revenge. This trial also supports the notion that people seek revenge to feel better.

The study’s authors highlight the clear correlation in the trials between rejection and aggression, as well as a link between revenge and the desire to return to a more stable mood.

References:

1. Borreli, L. (2017, January 11). Why looking for revenge feels so good. Retrieved from http://www.medicaldaily.com/looking-revenge-soothes-social-rejection-bad-mood-complicated-psychology-why-408310
2. Chester, D. S., & Dewall, C. N. (2016). Combating the sting of rejection with the pleasure of revenge: A new look at how emotion shapes aggression. Journal of Personality and Social Psychology. doi:10.1037/pspi0000080

I like to think of therapy as a place to try on emotions. I’m not implying there are emotions we don’t have yet; we’re given the capacity for the spectrum. But fully expressing how one feels in a healthy manner is not always easy to do.

It’s not easy because it gets socialized out of us early on. As children, we quickly learn what is “appropriate.” This may differ at home, at school, and maybe even with different caregivers. At some point, we settle into how we generally express ourselves, whether it’s with anger, sadness, happiness, amusement, or some combination of emotions. This is part of how we identify our personality. Feelings big or small, held in or let loose, comprise an unconscious, growing sense of how we emotionally exist in the world.

Sometimes people seek therapy to learn to express these feelings. Anger management, for example, is meant to shift how anger is expressed. Likewise, grief and bereavement counseling following a loss can help with those emotional expressions.

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More often, though, people’s reasons for coming to therapy are different. Feelings and emotions more typically come up with respect to movement toward another goal, such as improving relationships, work advancement, or assertiveness. Still, cruelly, it’s often the unhealthy expression of feelings and emotions that gets in the way of these presenting goals.

In therapy, we travel back in time to see how the ways we emotionally express ourselves were taught to us and subsequently internalized. With these insights, we can make new decisions going forward about how we want to show our feelings.

Being Taught How to Have Emotions

In therapy work with parents, one major focus tends to be modeling. This looks at how you’d like your child to act in different situations, of course, but also at teaching your child how to express their feelings in a healthy way.

In therapy, we travel back in time to see how the ways we emotionally express ourselves were taught to us and subsequently internalized.

You don’t have to be a parent to know kids tantrum. It’s how they express anger, exhaustion, fear, disappointment, excitement, and other emotions. By labeling emotions—“That uncomfortable feeling when your face gets all hot and you want to crawl into a hole? That’s embarrassment”—we slowly learn we don’t need to throw ourselves on the floor anymore. We come to understand the emotion, how it feels in our body, how it feels in our heart. We can express it and not let it control us.

Children watch their moms and dads be angry or sad, and in so doing they learn how to “have” these feelings. Parents who hide their tears or never argue (in a healthy way) in front of their children rob them of amazing learning opportunities. When these opportunities arise, with their kids watching, parents can model, “This is how people settle differences. It’s uncomfortable, but these emotions don’t have to be scary.”

Experimenting with Emotions in Therapy

Emotions are layered. Sometimes we have to go through a lot of anger to get to sadness. Sometimes we need to locate that anger under strata of sarcasm.

And this is what often keeps people from achieving those presenting goals, from making their relationships and work lives better. We spend time and energy protecting the expression of these feelings. We don’t peel back the layers.

The therapeutic relationship allows for a safe space—and I don’t use that term loosely—to express feelings and emotions, to peel them back, to study them, to see how they work. In daily life, it’s rare we show how we authentically feel, even in our most trusted relationships. Sometimes we think we’ve expressed a feeling because we expressed it the way we were socialized to do. Then we realize how our stomach still hurts, how we’re still replaying that moment with our boss over and over in our head, how we can’t sleep, how we’re eating way more than we need to.

In the therapy room, we can look deeper. We can unpack our feelings and emotions and see if there is more to express. We can take a chance and get really angry or really sad—or even really, unabashedly happy, if that’s difficult for us.

Therapy is a place to experiment with emotions we’ve always had but either didn’t know how to express or felt inhibited in expressing. We can try it all on. Because it’s all inside us.

Preschool-age children who frequently engage with superhero culture—by watching superhero movies or dressing like superheroes—may be more likely to behave aggressively, according to a study published in the Journal of Abnormal Child Psychology.

In movies and comics, superheroes are often defenders of the underdog. Parents may turn to superhero culture to encourage children to stand up to bullies. According to the study, this choice may be misguided. Findings showed children who invested in superhero culture were not more likely than their peers to stand up for bullied children, but they were more likely to act aggressively in general.

Does Superhero Culture Make Children Aggressive?

Researchers interviewed 240 preschoolers and their parents. Forty-nine percent of the participating children were male, and 51% were female.

Parents answered questions about their children’s engagement with superhero culture, including how frequently they watched superhero shows and whether they identified with superheroes. Parents also provided data about their children’s behavior. Interviewers asked the children to identify 10 superheroes. The children also identified their favorite superhero and explained why they chose that character.

[fat_widget_right]Children were more likely to list superhero merchandise (26%) than interpersonal characteristics (20%) as justification for liking a particular superhero. Ten percent of children who pointed to a superhero’s characteristics highlighted their defending skills, and 20% specifically listed superhero violence. Seventy percent listed non-violent characteristics, such as a superhero’s strength or skills.

A year after the initial analysis of a child’s identification with superhero culture, researchers assessed children’s aggression based on parental reports. Children who identified with superheroes were more likely to be relationally and physically aggressive. Compared to peers who were less invested in superheroes, the children did not show more prosocial behavior such as defending children against bullies.

Understanding the Effects of Superhero Culture

The study did not directly assess why children who like superheroes tend to exhibit more aggressive behavior, and did not establish a clear causal connection. However, its authors hypothesize that the complexity of superhero narratives might partially explain the violence. Superhero stories are often complex, but preschoolers may not understand the complexities behind the violence or aggression they witness. As a result, they may latch onto violence as the dominant theme of superhero narratives.

The study’s authors do not recommend forbidding access to superheroes. They suggest instead that parents adopt a moderate approach, finding ways to focus on more positive aspects of superhero culture and encouraging children to develop a wide range of interests.

References:

1. Coyne, S. M., Stockdale, L., Linder, J. R., Nelson, D. A., Collier, K. M., & Essig, L. W. (2017). Pow! Boom! Kablam! Effects of viewing superhero programs on aggressive, prosocial, and defending behaviors in preschool children. Journal of Abnormal Child Psychology. doi:10.1007/s10802-016-0253-6
2. Superhero culture magnifies aggressive, not defending behaviors. (2017, January 11). Retrieved from https://www.sciencedaily.com/releases/2017/01/170111131122.htm