Counselor writes notes on person in treatmentThough I wish it weren’t so, many therapies get “stuck” at some point, leading to premature termination or a less-than-ideal outcome. Here are three of the many possible patterns that could lead you to feel stuck in therapy. If any of these feels familiar, be sure to bring this up with your therapist right away. Hopefully you can put your efforts together to overcome the factors keeping you from making the progress you envision.

1. Waiting for the Therapist to Heal You

When we take our experience or difficulties to a helping professional, many of us harbor a wish, secretly or not-so-secretly, that the professional’s advice, explanations, or prescriptions alone will be enough to heal us. We wind up in a passive, dependent stance in therapy, approaching therapy as though it will be like surgery: I’ll lie back, and the doctor will diagnose my ailment and cut it out of me. Therapies can go on for years with the person expectantly waiting for a piece of advice or interpretation that will finally part the clouds. Meanwhile, the therapist is left puzzled, wondering why change has not occurred despite all the good ideas that have been discussed.

The omnipotent and powerful therapist is a nice fantasy, one that therapists (myself included) can accidentally participate in by overworking—providing unnecessary or unhelpful advice, explanations, or instructions, or taking full responsibility for therapeutic progress. Those of us who have managed to get out of such an entanglement, where the therapist is overworking and the person in therapy is passively waiting, have learned an important lesson: no therapist has ever changed anyone. Change cannot result from a therapist “doing something” to us; it comes from us doing something differently with ourselves.

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Infants and children are completely dependent on others for survival, and the passive/dependent stance that many people approach therapy with may be a remnant of that need. My clinical experience suggests the yearning for a powerful, magical caregiver who will come along and make it all better often sticks around because it was not fulfilled at the time it was supposed to be—childhood. However, part of growing up is learning to think and solve problems for ourselves, and developing the ability to mobilize our own resources in the face of a challenge.

A good therapist will help you create the optimal conditions for you to do this but simply cannot do it for you. If you are waiting around for your therapist to do this, and if you have a sense that your therapist is not aware of this pattern or is reinforcing it somehow, the passive/dependent stance in therapy could be keeping you stuck. Talk to your therapist about what is going on.

2. Fighting Against Reality

Just as therapists cannot change people (a difficult reality for many to accept), therapy cannot change reality. Many of us come to therapy with a secret agenda: I want to change reality so that my anxiety-provoking feelings about reality will go away. We ask our therapist for “effective communication strategies” that might help us be more persuasive to a distant father, or detoxify a toxic spouse. We burden our therapy with fixing someone else’s problems.

There is, of course, a time and place for learning such communication strategies in therapy; however, if the goal of this learning is to change or control an unchangeable person or situation, the therapy will inevitably fail because the goal is unrealistic.

Believe me, if I could change reality, I would—reality can stimulate all kinds of uncomfortable, anxiety-producing reactions in us. I don’t like those feelings, either! But we’re all probably better off learning to accept and cope with the thoughts and emotions that reality tends to stir up in us, rather than continuing to chase after the fantasy of a perfect reality that we can control and change. After all, so many of our problems are a result of the difficulties we have in coping with reality and our feelings about it.

If your therapy has become focused on changing or controlling someone else, or a situation that is beyond your control, your “stuck-ness” may continue until you refocus on the things you do have some control over; namely, your inner reactions to outer realities.

3. Chasing Someone Else’s Goals

Many people, when asked why they are seeking therapy, reply: “Well, my wife/husband/partner/friend says …” They have not necessarily come to therapy of their own free will, but at least in part to meet the needs of another person. This can also be the case for people who come for court-mandated treatment and for adolescents. And it can limit the efficacy of therapy in a number of ways.

If your therapy has become focused on changing or controlling someone else, or a situation that is beyond your control, your “stuck-ness” may continue until you refocus on the things you do have some control over; namely, your inner reactions to outer realities.

First, because they are not internally motivated to achieve their therapy goals, people who are compelled into therapy by others may not put in the necessary amount of effort and energy that change requires. They may not even see themselves as having a problem or a goal to work toward.

They may submit to the will of the referring person and pursue goals that are not truly their own. They may decide to change themselves to make the other person happy, and their behavior may even change as a result. This kind of change can be quite transient, though, ending with a complete reversal and the refrain, “I only did it to make you happy!”

On the flipside of that coin are people who say, “I’ll be damned before I change,” and perpetuate their life problems out of stubbornness against the person who compelled them into therapy. This defiance, while sometimes pleasurable in the moment, can be quite self-defeating, as the person in therapy is intentionally perpetuating problems just to “stick it” to the other person.

Therapists can get caught up in this, too, pursuing outside parties’ goals rather than those of the person in therapy. Many of us learn the hard way that if someone’s will and desire for change are not on line, the therapy will inevitably get stuck. If you’re not in therapy of your own free will, complying with or defying someone else’s goals for you, or feeling like therapy is going nowhere, make sure to bring this up with your therapist. Together, you can develop goals that will help you get unstuck and lead to the outcomes you desire.

Mother and worried daughter sit on grassWhile new parents frequently seek the “right way” to parent, there is no one rule book. Rather, there are many, often contradictory, guides to parenting. The lack of certainty about how to raise and care for a child can create intense anxiety for a new parent. Some learn, soon enough, that they will figure out how to be good enough parents. Others never lose an overwhelming anxiety that each decision could have life-or-death consequences. The communication of high levels of parental anxiety frequently results in children whose anxiety controls, limits, and shapes their relationships to the world.

Anxiety is an internal state that is communicated in a variety of ways. The anxious mother holding her baby can unconsciously communicate her inner agitation through her body tension and facial expressions. The young child may sense a parent’s anxiety in the parent’s frantic behavior or speech.

Eventually the child becomes old enough to be the recipient of clear expressions of anxiety in the parent’s verbal communications. The child can experience the parent’s anxiety when told, “No, honey, you’re not old enough for play dates,” or, “I don’t care if your friends can stay out until 9. It’s not safe out there,” or in the parent’s intake of anxious breath every time the child goes down the slide or falls and bruises a knee.

Repeated exposure to parental expressions of anxiety teaches children to expect that they will be vulnerable in a risky world. These lessons are not simply intellectual. They are emotional communications which often have an unconscious component: the lesson to be learned is transmitted and received unconsciously. It is a very powerful communication.

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The Inability to Self-Soothe

When parental anxiety is communicated, consciously or unconsciously, the child’s defenses are put on high alert. If parents are overwhelmed by their own anxieties and can’t soothe themselves, it can be difficult to calm and reassure their children. Without an experience of being calmed as infants, children may not develop an ability to self-soothe. They may develop anxiety, which paradoxically functions as a signal that they are in protective mode. It’s as if the anxiety is evidence of vigilance toward pending danger and thus has a calming influence.

It would be risky to let go of this essential feeling by using rational thoughts to challenge the basis of the anxiety. Instead, anxiety can be put on temporary hold with behavioral distractions that anesthetize against anxiety but don’t alleviate the feelings.

The Intergenerational Transmission of Anxiety

Kate initially came to see me two years ago because she was unhappy with her work life. She is a painter with a master’s degree in fine arts working as an administrator in an art gallery. She was doing little painting, hated her work, and felt clueless about what she wanted to do with herself professionally. She was married with a 17-year-old daughter.

Through our work, we learned about Kate’s lack of belief in her ability to be a good painter and her intense anxiety about showing her work publicly. She described a history of feeling tortured when she painted and had anxiety attacks when she had to submit work to her professors. She acknowledged that even though she won several prizes for her art and was considered very talented by the faculty, “Putting my work out there feels like I’m walking naked in the streets where everyone can see my private parts.” She never was able to initiate the showing of her work and became filled with dread the few times she was persuaded to allow her work to be seen in public.

Talking in therapy helped Kate to paint more at her small studio at home. She began to allow herself to enjoy the experience after she learned to slow down her anxious feelings and use her thoughts to calm herself. But she was clear that she thought it best to leave painting to her personal enjoyment and figure out what else she could do with her life. As we began to look further at Kate’s history, her narrative revealed her to be a person with intense anxiety about almost everything in her life:

“I’ve always had terrible separation anxiety. I went away to college, but it was less than two hours from home. I drank a lot and smoked pot from late middle school until midway through college. I over-ate, I still do. I know I’ve used these things to get rid of my feelings. I think when I started to paint and could get into a kind of Zen place and not worry about any audience, it calmed me down. That’s what probably helped with my drinking and pot smoking. But as soon as my painting was up for judgment, I would freak out. Sometimes I would skip classes or feel sick and go home for days.”

I asked how her parents dealt with her anxiety and her homecoming. Laughing ruefully, she told me, “They didn’t have a clue what to do. I made them, especially my mother, very anxious. She always seemed so agitated when I was conflicted and anxious. It was as if she didn’t want to address my issues because she didn’t know what to do, and that made her a ball of anxiety. I would feel so helpless and angry, and I think she did, too. I soon learned not to come home when I was upset. That only made things worse.”

Then Kate went silent and became tearful. I waited as she slowly began to speak. “You know, I’ve talked mostly about me and my work life in my therapy with you,” she said. “I know that my anxious mother is not news to either of us and how much that has influenced me. But I’ve been ashamed to bring up the fact I’m just like her. My daughter Erica just turned 19. She’s finishing her freshman year in college …”

Repeated exposure to parental expressions of anxiety teaches the child to expect that he or she will be vulnerable in a risky world. These lessons are not simply intellectual. They are emotional communications which often have an unconscious component: the lesson to be learned is transmitted and received unconsciously. It is a very powerful communication.

Kate paused, then started to sob and shake. “I see what’s happening,” she said. “Erica is just like me—a ball of anxiety. She calls home a lot to talk to me, not her father. I know she can feel how anxious I am about her being away at school. I don’t know if she’s calling to reassure me that she’s OK or to check in to see if I’m OK. … I’m an awful mother. I know I don’t help her and only make her more anxious. The problem is I really am scared for her. I didn’t give her the tools to take care of her feelings. Like me, she doesn’t know how to use her thoughts to find ways to counteract her anxious feelings. Worse is when she tells me her anxious feelings, I feel like the best I can do is not share my anxious feelings with her. I feel totally at a loss to offer any useful, thoughtful, soothing response.”

I was familiar with the phenomenon Kate was describing: the intergenerational transmission of anxiety. Like her mother and now her daughter, Kate’s anxiety always lurks at the edge of her emotional life. It is on call to alert her to danger and can be summoned consciously and unconsciously to send out the signal to a loved one that he or she, too, must be vigilant. What else can a good mother do? How can she not warn her child of impending danger? Kate’s mother couldn’t contain her dread and needed Kate to feel it so she could become part of the team to defend against harm. Kate needed to be sure that Erica would be able to function in the world and protect herself from all the dreadful possibilities she was at risk of encountering. While often unconscious, it is a relief for an anxious mother to know that her child is on alert and aware of the many possible threats to her well-being.

Unlike her mother, Kate had become aware of the disadvantages of being unable to manage anxiety. Her recognition that Erica’s anxiety was intensified in the presence of her own strongly contributed to her wish to disrupt this harmful intergenerational cycle. Talking with me helped her use the rational thought that “if I soothe myself and lessen my own anxiety, I will be better able to help Erica with hers.” She was determined not to perpetuate the cycle of anxiety.

Kate has begun to talk with Erica about what she has learned about the intergenerational transmission of anxiety. They have had some honest and painful discussions about the ways they each make the other anxious and have needed the other to mirror their anxiety so they could feel better. Erica has decided to begin her own therapy, and Kate continues to work with me on becoming more comfortable with all her feelings and the feelings she evokes in others. She is slowly developing a greater tolerance for her negative feelings and the negative responses she has been protecting herself from for so many years. When she experiences the anxieties of her mother and daughter, she has started to think thoughts that help her to remind herself that she is a separate person with her own feelings. She can say to herself, “I’m not the same as you. I see you are anxious and scared, but I don’t have to be. These anxieties are not rational, and I don’t have to be in that irrational-feeling space.”

This is hard work for Kate, but the strong wish for her daughter to be free from the same anxiety that has debilitated her is strong motivation for Kate to continue her struggle for change.

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

Family making snow angelsI used to have this goal for my life in which I would eventually get to a place where I loved school or my job so much that I didn’t desperately hope for a snow day during the long winter months. In the past, I would obsessively check the weather forecasts looking for signs of enough snow that school or work would be called off. I had difficulty sleeping the evening before a forecast indicating such a possibility. I would get up and look out the window throughout the night to check if the pace of accumulation was quick enough to cause administrators to foresee a “snowpocalypse,” make the right call, and cancel all school and work activities. My emotions felt as if they were at the mercy of the snow, which is indeed an unreasonable thing to allow oneself to be controlled by. Did I just hate school or work that much, or was there something less dramatic and more innocent going on?

Often, a snow day is a child’s dream come true. Depending on where you are in the world, it may be quite common, or it’s possible you’ve never even heard of a snow day if you live in a climate that is warm and mild. I grew up in Texas, where, unprepared for winter weather, school was called off for a bit of frost on the ground. When that happened, I’d spend my day in the front yard trying to scoop up ice particles from the driveway to make the world’s tiniest snowman (which was usually an epic fail). In much of the country, snow is commonplace during winter and schools build snow days into their calendars to account for bad weather or unsafe travel conditions.

[fat_widget_right]For those who live in states where snow is relatively common, does anyone other than me still experience the frenzied excitement of snow and, with it, the possibility of playing hooky?

I’m guessing I’m not alone here. Snow days are interruptions to our routines, which may be a rare occurrence for some. Although some may not appreciate the disruption, for many of us, the monotony of responsibilities, the “to-do” lists that never get done, the expectation that work comes first, and the pressure of being “on” at all times leaves us desperate for an unexpected reason to let it go. We go to work sick, or we stay up too late getting ahead on projects because our workloads exceed the 40 allotted hours. If we are sick and manage to stay home, we work from home because technology says we can.

Snow days provide a great opportunity for a break because we can’t control Mother Nature. It isn’t our failing immune system (somehow our fault) or the failing immune systems of our families. It isn’t our lack of being a “team player.” It isn’t a situation in which our colleagues question whether we drank too much last night and that’s the real reason we can’t come to work. We have something tangible that everyone can bear witness to. When a snow day is called, the city is frozen and we all know it. No one can reasonably leave home without significant risk, and it isn’t our fault.

We look forward to days like this because we need them. We need moments in which we aren’t in charge. We need moments where we can let go and allow something larger than ourselves to give us a break. As a population, we don’t do this enough. We work longer and longer hours, we multitask ourselves into the ground, we do chores on our days off, we engage in endless errands to help make our lives run more smoothly, and we make appointment after appointment after appointment.

We need moments where we can let go and allow something larger than ourselves to give us a break. As a population, we don’t do this enough. We work longer and longer hours, we multitask ourselves into the ground, we do chores on our days off, we engage in endless errands to help make our lives run more smoothly, and we make appointment after appointment after appointment.It can be difficult to take a break and do nothing, which is often forced when a snow day occurs. We may be sick from stress, but it doesn’t often make us quit doing. We may be exhausted and disconnected from those we love due to the demands of our busy schedules, but we may perceive that the world would fall apart if we don’t keep going. On the other hand, a snow day cannot be negotiated with. The blanket of white quiets the world and says, “Stop!” We can’t get out of the house to run errands, so we cook what we have in the cupboard, play board games if the cable goes out, and sleep when we’re tired. We are often forced to just relax.

If you’re like me, peeking out the window all night and imploring the sky to save you from your busy schedule tomorrow, maybe it isn’t so much that you’re being silly or that you hate your job or hate school or you can’t get a grip on your emotions. It could just be your body and mind telling you that you need a break. I don’t necessarily want to get to a place in my life where I don’t long for breaks in the form of an unexpected snow day. Days like that help us remain grounded, healthy, and sharp. We need days where we can relax, even if we’re forced, and allow the world to run without us. We need moments that allow us to reconnect with the feeling of quiet contentment and recognize that what we have around us in this moment is enough for this moment. It isn’t likely that everything will fall apart in our absence, but perhaps more likely that everything may fall back into place.

Let it snow.

Father and son reading togetherChildren with disabilities bring a unique set of challenges, and opportunities, to their families. Depending on the nature of the disability, the challenges can be quite significant. At the same time, though, they have the potential to deepen connection between parents as well as the parent-child bond.

Aside from the energy required to manage a child’s physical and emotional needs, there are often huge financial considerations. A child’s disability may require the family to retrofit their home, or obtain housing that is accessible. In addition, equipment, social services, and health care are often pricey and are not always covered by insurance or entitlement programs. Families able to get some or all of these expenses covered often have to advocate for them on their own, and navigating disorganized government programs associated with these benefits can be an extremely taxing process in its own right.

Because it can be quite time consuming to address these issues, many families are forced to give up large portions of their leisure time. Often, one parent takes on a primary caretaking role with the child, while the other parent becomes the primary provider, deeply involved in his or her work in order to help with the finances. Primary caretakers sometimes have to partially or completely forgo any job aspirations of their own.

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If these decisions are not talked about and processed carefully, they can lead to divisions within the family that may become deeply entrenched and long-lasting. Caretakers may feel as if they do an unfair amount of the work for the child, and may feel resentful about having to sacrifice their careers. Providers, meanwhile, may feel isolated within their families, as though everyone is against them, and may come to perceive the bond between the caretaking parent and the child as impenetrable.

The Importance of Communication

To help with this, I suggest that parents openly discuss how caretaking responsibilities are divided. Are there ways to make these responsibilities more evenly managed? What types of feelings does each person have about it? These are important considerations that should be discussed regularly.

Another consideration for parents is the emotional impact of having a child with a disability. Parents sometimes have to adjust their expectations regarding what their child can become, which is frequently experienced as loss and may be accompanied by a mourning process. The process of adjusting expectations to conform to the reality of the circumstances can be challenging and varied depending on the nature of the disability.

Regardless of the specific disability, the family has to come to accept that the child’s life may be limited in some way, and that additional care may be needed for the remainder of the child’s life. This process can be a loaded one and has potential to drive parents apart.

In general, the more ambiguity in the disability, the more difficult it is for the family to adjust. Degenerative diseases, which are less understood than more standard physical disabilities, can be among the most difficult to adjust to. The lack of information about how quickly the disease will develop and impact the child’s life can create enormous anxiety and stress. Cognitive disorders such as mental retardation are also difficult in that parents often cannot tell how much information their children take in.

Regardless of the specific disability, the family has to come to accept that the child’s life may be limited in some way, and that additional care may be needed for the remainder of the child’s life. This process can be a loaded one and has potential to drive parents apart. I suggest that couples set time aside regularly to discuss their feelings about their child’s disability, either in counseling or on their own.

Much is made of accomplishments in Western society, and children are too often measured by what they do instead of who they are. If couples keep an open line of communication and feelings regarding the challenges they face, the experience of parenting a child with a disability can bring them closer together and help them learn to accept and love their child for who they are.

References:

  1. Boyse, K. (2009). Siblings of Kids with Special Needs. Retrieved from http://www.med.umich.edu/yourchild/topics/specneed.htm
  2. Reichman, N., Corman, H., & Noonan, K. (2008). The Impact of Child Disability on the Family. Retrieved from http://www.medscape.com/viewarticle/581577_2
  3. Solomon, A. (2013). Far From the Tree. New York, NY: Scribner.

GoodTherapy | Healing Complex Trauma, Part II: The Path to IntegrationEditor’s note: This article represents the second of two parts. The first part moves from disconnection to autopilot, then from autopilot to self-awareness.

“Until you make the unconscious conscious, it will direct your life and you will call it fate.” —Carl Jung

Complex trauma represents an expected response to ongoing and extreme interpersonal threats, revealing in its process the capacity of a core “Self” to preserve what matters most, even when it means separating from it. Part I of this article framed multiple selves as a natural adaptation to systems in which we must “fit” by placing parts of Self in storage, giving examples of potential self-containment strategies. Part II now moves toward reintegration of what was necessarily preserved while navigating the tunnel of childhood.

From Awareness to Attuned Self-Compassion

After years of automated disconnection and internal judgment, integration is often felt as an awakening, a softening toward what was once perceived as an enemy, a protective hesitance becoming a grateful encompassing. It is felt most profoundly in the surprising arrival of ownership and empathy for Self. The epiphany, or “aha” moment: a recognition that “I am not this intense emotion, nor the judgment of it.” It’s the point at which we realize this “part in exile” has been trying to get our attention, to elicit from us a response it never got from our caregivers. This gives us a chance to feel what it felt, to finally see it, to stop containing it as something evil and instead embrace it and feel with it.

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Likewise, the containing part ceases to be perceived as a bully when we realize it has been protecting us all these years, that some part of us believed our core to be so valuable and worthy of protection and preservation. It’s a simple moment of self-compassion (often with a response felt physically), telling Self: “Yes, this did happen. This present feeling is how you felt for so long. I feel it in my body. I get it. You did not deserve this pain nor create it, and I will not punish you or leave you.”

After years of automated disconnection and internal judgment, integration is often felt as an awakening, a softening toward what was once perceived as an enemy, a protective hesitance becoming a grateful encompassing.

“I am too much for others” becomes, for instance, “I have been judging myself as too much in order to contain myself and avoid re-creating the feeling of distance I felt from my father.”

One might realize: “I am afraid of others because I fear myself.” Or: “I depend on others because I have abandoned myself.” Or: “My emotions grow and overwhelm precisely because I try to diminish and dismiss them.”

In the experience of abuse and neglect, these are the missing ingredients: attunement and compassion, allowing a moment of empathy for that contained part, that child who was hurt, who reacted the only way a child could. And a recognition in that moment of empathy: “All of this pain is also me, and everything that matters most in me has been preserved.”

From Compassion to Integration

Healing comes through integration, balancing of extremes, an olive branch offered between “enemies,” an internal dialogue of acceptance and compassion. It requires access to some part of Self that can simply observe—some witness able to watch our thoughts and emotions without landing in them, without becoming them. (This is where mindfulness comes in.)

When we know each part—when we can observe without judgment and treat it with compassion—it has no reason to polarize or amplify. It calms and centers. It synchronizes. It trusts our own core.

Many people, when imagining some part of Self as a child outside of their body—experiencing that child’s life, feeling their feelings—notice an internal stirring, even a release, recognizing that as they are empathizing and speaking compassionately to a child outside of Self, they are also landing in their own child part, hearing their own words of compassion, and feeling accepted.

This internal love—acceptance and appreciation without judgment—changes the entire experience of living.

Intentional self-compassion offers release from all these arbitrary rules we’ve carried. It’s a chance to experience both freedom and connection simultaneously, internally, knowing that as we navigate the countless systems of the world, external integration echoes internal.

Ladder from dark room leading into lightOne of my favorite writers, fellow social worker Brené Brown, has dedicated years researching vulnerability and all those other seemingly ugly things—such as shame and fear—that get in our way of becoming our best selves. Vulnerability, in particular, gets a bad rap. Although it seems unappealing at best and hurts like hell at worst, vulnerability is a prerequisite when it comes to living a life of authenticity and intimacy.

As a writer, I often put myself “out there” at the risk of being rejected, criticized, and judged. (Surprise—three of my least favorite things!) As a therapist, I ask the people I work with in the therapy room to do the same—that is, if their goal is to create deeper intimacy in their lives. Brown’s work has forced me to turn the mirror on myself and find out how shame and the fear of being vulnerable are holding me back from being the best writer (and therapist, friend, sister, partner, etc.) I can be.

It’s important to note the difference between guilt, the feeling of regret for one’s actions, and its more pervasive counterpart, shame, the feeling that we, at our core, are not good enough, inadequate, less than, and undeserving.

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In her book Daring Greatly, Brown speaks of the little “gremlins,” or the negative messages we give ourselves (often external sources internalized), and how, in a twist of self-fulfilling fate, those negative gremlins sometimes end up showing up all around us. For example, the old friend you made back when you were in a dark place (when you could keep each other’s misery company) who expects you to be the same you and attacks you when you’re not. (Tip: It may be time to de-friend that friend.) Or the colleague who resents your achievements and thus feels the need to put you down to lift himself or herself up. (Reminder: It’s not you, it’s him/her!) And, finally, one of the worst creations to have come from modern technology—so-called Internet trolls. (What less courageous way to express yourself than to anonymously and publicly bully/shame someone brave enough to put themselves out there?)

The title of Brown’s book is inspired from Theodore Roosevelt’s “Citizenship in a Republic” speech, in which he states: “It’s not the critic who counts. … The credit belongs to the man who is actually in the arena, who if he fails, at least fails while daring greatly.” If you are going to criticize someone’s work or behavior, Brown suggests, you’d better be in the arena, bloody and sweaty and fighting right along with that person.

What sadder outcome than the shutting down of a voice that could possibly add something to the world, if only simply touching one life for the better?

I’d like to add that if you feel the need to criticize, do so openly and with respect. Or better yet, as my mother used to say, if you don’t have anything nice to say, don’t say anything at all.

What sadder outcome than the shutting down of a voice that could possibly add something to the world, if only simply touching one life for the better? How many voices and gifts would we have missed out on if those who were brave enough to dare allowed the naysayers to shut them down?

I speak to myself as I struggle to allow myself to even write this piece as, you can be sure, my own gremlins are hard at work. But, like Brown, I will walk the walk and put my words into the ether regardless of how vulnerable it may make me. Because ultimately, I do aspire to a life lived with authenticity and intimacy—no matter how much it may hurt. The alternative is just not an option. So, bring it on.

I dare and encourage you to do the same.

What are some things that shame and fear are preventing you from achieving?

Downcast girl sitting on fenceIf the title of this article threw you off a bit, it’s OK—I understand why it would. After all, forgiveness is quite the hot topic. Religious leaders, spiritual gurus, and even some mental health professionals emphasize the importance of forgiveness as a part of finding true happiness and freedom. I get where they are coming from. I can understand how forgiveness could be beneficial in some circumstances. For example, if a loved one says something uncharacteristically harsh in the heat of an argument, and you would like to keep that person in your life, it may be beneficial to understand that we all sometimes say things we don’t mean when we are upset and to forgive him or her in order to move forward in the relationship.

I work with people who have experienced horrific traumas at the hands of other people. These traumas include acts of sexual abuse, rape, exploitation, and physical and emotional abuse. Some of the perpetrators are relatives and some are not. Regardless, the degree of trauma in each of these cases is significant and has had a major impact on their lives and well-being.

The people I work with in the therapy room are resilient and courageous. They are able to work through their traumas, but many get caught up on one point: They believe they are supposed to forgive the perpetrator but can’t seem to get there.

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This is what I tell them: You don’t have to forgive in order to move on.

Understand that if a person comes in and finds that the word “forgiveness” resonates, I do not discourage it. We roll with it. But often people struggle with this word, and rightfully so. They do not want to imply what happened to them was in any way OK. They don’t want to excuse the perpetrator’s behavior. They feel the perpetrator is not deserving of forgiveness. The worst thing I can do as a therapist is to talk people out of the way they feel.

Emotions are important and automatic. When we can acknowledge and appreciate even the darkest, most negative-feeling emotions, they often soften and release. As soon as I say, “You don’t have to forgive,” the person usually breathes a sigh of relief.

Once we have determined that forgiveness is not necessary, we work on finding a word that will be more congruent for the person in his or her trauma work. I like the word unburdening.Once we have determined that forgiveness is not necessary, we work on finding a word that will be more congruent for the person in his or her trauma work. I like the word unburdening, which is something I first heard in Richard Schwartz’s book Internal Family Systems Therapy. I understand unburdening as a letting-go process. That is, letting go of the power the trauma has over a person, expressing and releasing anger and other strong emotions about what happened without criticism or expectation of what needs to come next. This includes allowing a person to have as much time as is needed to feel whatever he or she is feeling. This may include rage, hate, and resentment, among other emotions.

It is equally important for others to refrain from pushing someone into forgiving a perpetrator. Even if the intention is coming from a good place, trying to get someone who has been violated to forgive can feel like being victimized all over again. Instead, it is more helpful to validate that the person is entitled to his or her feelings. Being a listening ear instead of trying to fix the issue is much more supportive and healing. The person needs to be able to have a voice and express what he or she is feeling and thinking without the fear of judgment.

The brain and body are so intelligent. It is important to allow the natural process of working through trauma to happen and to remove any barriers that may get in the way. This includes the belief we aren’t supposed to feel “negative” emotions or that we have to forgive. Once we remove that expectation, the natural process moves through. Even if someone doesn’t get to a place of forgiveness, he or she can still move on, unburden themselves, and thrive.

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Editor’s note: This article represents the first of two parts. The second part, which appears here, moves from awareness to attuned self-compassion, then from compassion to integration.

“Do I contradict myself? Very well, then I contradict myself (I am large, I contain multitudes).” —Walt Whitman, Song of Myself

Those who seek therapy for complex trauma often do so unknowingly. They may first notice depression or anxiety, numbness, spaciness, lack of motivation, or a failure to connect or thrive. They might simply feel stuck, uncomfortable, or confused, either as an individual or in relationship.

Complex trauma refers to the way we organize our “Self” in the wake of ongoing or repeated exposure to interpersonal disconnections (sometimes overt abuse, oppression, or neglect; sometimes simple, unintended, unavoidable misattunements). At its base, complex trauma represents an ability to exist in pieces—an adaptive preservation of Self at any cost. While initially adaptive, this separation from parts of Self sometimes brings confusion in all relationships—internal versus external, Self versus Other, “what should be” versus “what is,” present versus past or future.

We stop cooperating with our “selves.”

Internally, we move from equality to hierarchy, subjugating the very parts we want to protect.

We adapt to each imperfect system (i.e., family of origin) by internalizing the system rulebook and policing ourselves to enforce the system rules. To maintain relationship with caregivers and preserve Self long enough to survive childhood, we contain parts that do not “fit” the system. We dis-integrate. Self organizes against Self, and we become walking dualities: the containing versus the contained, the rigid head versus the chaotic body. It happens automatically to all of us, with extreme reactions happening in extreme adaptations.

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This is the complexity of complex trauma: “missing experience” creates an inability to heal, yearning for unmet needs while protecting against them. Just as we internally separated parts that seek connection from parts that seek safety, we push externally against whatever we need most in life because there is no agreement.

At some level, we wait for the elusive experiential safety that will release us and reverse the process, bringing everything together.

From Disconnection to Autopilot

When ongoing threat remains familiar—when it lives within our homes, permeates the atmosphere, and becomes just another layer of everyday experience—we adapt to it. Assuming we come into the world with particular needs and dispositions, in the tunnel of childhood we often temper parts of Self. We fold and contain in order to fit.

Assuming we come into the world with particular needs and dispositions, in the tunnel of childhood we often temper parts of Self. We fold and contain in order to fit.

Even as infants, we track and respond to nonverbal cues of caregivers. We see their responses to various emotions, and we learn to contain whatever triggers them to fight, flee, or disappear. Often, this includes either particular emotions or emotions in general. We adapt to their system and separate from our bodies to avoid exiled, “unwanted” parts of Self. In this, we also separate from sensory information, becoming insulated against new input and trapped in the adaptation.

In order to adapt to the system, we become the system. We absorb and recreate our caregivers internally. If caregivers judged us, we judge ourselves. If they dismissed or diminished us, we do the same. If they did not know how to see us, we do not know how to see ourselves; we struggle to notice or articulate internal events. We often go into life not knowing how to regulate our bodies (or how to notice basic signals such as hunger). And while the dis-integration proves successfully adaptive, there remains a subtle knowing: a felt experience of disconnection, a subtle background noise, a gentle reminder that some part of us yearns to be remembered and reunited once safety is established.

These are our fragmented lives: parts of Self, surviving independently by turning against other parts Self, enforcing an embargo on that which would heal.

From Autopilot to Self-Awareness

This is just a lens, a way to begin observing our own internal conflicts, differentiating one side from another: one part judging, one part receiving that judgment and feeling it.

This automated containment system protects us from punishment (fight) or abandonment (flight) of others within our original family system(s).

Internal conflicts can look like this:

Sometimes the parts we try hardest to contain become most visible to others. We try to hide emotion, and it becomes bigger and louder. This is how we polarize. The containing side attempts to diminish because the other side is amplifying, because it is trapped and simply wants attention. The contained side amplifies because the containing part is attempting to diminish. And so goes the dance.

We land, sometimes, on either side of the conflict. Sometimes we’re the contained part, feeling our own unmet needs on top of feeling trapped. Other times we are that containing part, wanting to survive and meet needs, knowing that if the contained part escapes we will face punishment or abandonment. No matter where our consciousness lands, the other side becomes the villain.

Woman comforts a woman in distress

Having a mental health issue can be very isolating. You may feel like no one understands the pain and despair you experience. Because of this, you might keep your condition to yourself, confiding in no one. This is not uncommon.

The stigma surrounding mental health doesn’t help. Many people are hesitant to open up about their struggles out of concern for being judged and thus go to great lengths to hide their conditions from coworkers, friends, even family members.

People with depression and anxiety, among other issues, often isolate because of lack of energy or because they are unsure how to get support. Being open about a mental health condition constitutes taking a risk, which can feel scary. Not everyone may be supportive, some people don’t know how to help, and some people in your life may choose to remain ignorant.

A mental health condition has nothing to do with what kind of person you are. It doesn’t mean you overreact to things, that you’re “just” feeling down, that you’re incompetent, that you’re weak, or that you’re “crazy.” Just as people who struggle with a physical health issue need and deserve support, people with a mental health issue need and deserve the same.

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Contacting a therapist is a great step in the right direction, of course, as a professional is best positioned to help you understand the factors contributing to what you’re feeling and can point you toward helpful resources. He or she can’t replicate the compassion and empathy of close friends or family members, however.

So how can you find the support you need? Here are five considerations to help you get what you need when you need it most.

  1. Learn as much as you can about your condition so you can explain to others what you experience. Many people’s only source of information about mental health is what is portrayed in the media, which more often than not is inaccurate or even demeaning. But if you can describe what it’s like to live with bipolar, for example, you can inform others and help them understand how they can best support you. By educating yourself, you can educate others.
  2. Identify someone you think might be a support to you. Whether a friend or family member, this should be a person you trust, who has displayed compassionate tendencies in the past. Again, not everyone will understand, want to understand, or be able to help.
  3. Think about what you hope to get out of the conversation you will have with this person. Are you looking for someone to vent to (“Work was so rough today that I spent 30 minutes in the bathroom crying”), or would you like help solving a problem (“I’m so anxious that I need help getting to the grocery store”)? Be specific about what you need and why you need it: “I’m feeling really stressed right now and could really use someone to talk to,” or, “My depression is making it hard for me to get out of bed each day and take care of my house and family. Do you have any suggestions?” Practice asking for what you need.
  4. Recognize that some people may be better at supporting you than others. The first person you confide in may not understand. Keep sharing until you’ve found the person or people who can support you. If someone you asked for help cannot follow through, understand that it’s not something you’re doing wrong. They may be dealing with their own struggles and simply not have enough energy or wisdom to help you with yours.
  5. Don’t rely on just one person. Try to build a support network, one person at a time. This way, if one friend or your partner can’t talk right away, there are others you can reach out to.

It should not go unacknowledged that, for some people, finding support is exceedingly difficult. People whose pool of family and trusted friends is limited or nonexistent may feel like they have no one to turn to. However, there is always someone who not only will listen but wants to listen—whether it’s a therapist, a pastor or church member, or someone who volunteers for a crisis line. There is always support. The key is summoning the strength to ask for it, something everyone must do at one time or another.

Mental health conditions are very common, so keep sharing; chances are, sooner or later someone you confide in will have dealt with their own struggles. You shouldn’t have to go it alone. Each time you are open about your condition, you decrease the stigma and ignorance surrounding mental health issues. Little by little, we can change the world.

Vintage journal and fountain penWords have power, so it follows that the process of journaling does, too. It’s a tool I often recommend to the people who see me for therapy.

Some situations in which journaling might be helpful include:

Sometimes people share that they’ve thought about journaling but never moved forward with it. When I explore why that is, it’s often because they saw it as a chore or obligation, something that had to be done the “right” way.

However, there is no right way to journal. The key is to utilize this tool in the way that will work best for you.

You might choose to buy a beautiful book with empty pages, but you could just as easily grab a notecard, a yellow legal pad, or a piece of printer paper and begin.

You need not worry about writing regularly. There’s no rule that says you have to record things daily. Write when you believe it might serve you, not because of an arbitrary “should” that you or someone else has placed on you.

You have the option of sharing what you’ve journaled with others or keeping it private. You decide. You make the rules.

There is no requirement to write full sentences. You can jot down thoughts as they come to you. You can scribble them all over the page if you want and draw lines connecting those that are related to one another, literally connecting the dots of your thoughts in a deliberate way.

Another therapeutic way to journal is to vent on paper all that you are upset about so that you have a sense of expelling that negativity. Give yourself permission to be as “ugly” in these rants as you want so you have the opportunity to empty yourself of toxic thoughts and feelings. Many people resist this at first, fearing others might discover about them what they’ve been trying to hide. In that case, I suggest symbolically ridding yourself of those thoughts and feelings by ripping up the words or shredding them. This act alone can be a powerful one, a moment of triumph over something that was possibly poisoning you from within.

Sometimes people struggle to find the words to express themselves accurately. I encourage such people to draw or sketch what comes to mind. Scribble if need be. Let the pen flow over the paper in a way that mimics how you feel. Even choosing your writing tool might be telling—a pencil’s lead that can be erased as though it never was, a ballpoint that moves smoothly, a colorful marker, a thick, permanent Sharpie. You can grab what’s nearby or you can be more deliberate when selecting.

You have the option of sharing what you’ve journaled with others or keeping it private. You decide. You make the rules.

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I define an emotional affair as a relationship in which one or both parties are involved in another significant relationship where there is emotional intimacy, sexual chemistry, and romantic feelings, without the relationship having been consummated.

Recent research indicates that 76% of Americans consider a secret emotional relationship to constitute a form of infidelity, highlighting just how seriously these connections are viewed. Frequently in emotional affairs, the partner who didn’t have the affair experiences the same degree of betrayal and breach of trust as he or she would if a spouse had a physical affair. Research shows that individuals often view emotional infidelities as more hurtful than sexual infidelities. At times, an emotional affair can feel even more damaging because someone else has met the partner’s emotional needs.

It can also be helpful to understand that an affair is often not only a discrete event, but a signal that something in the relationship system has broken down. While this does not excuse the betrayal or the pain it causes, emotional and physical affairs alike frequently emerge in relationships where partners feel unable, unsafe, or unequipped to address growing disconnection, unmet needs, or conflict directly.

Current studies show that roughly 60% to 75% of couples stay together after discovering an affair, and your relationship can most certainly survive and perhaps even become even closer than it was before the affair.

At the same time, recovery is not only about repairing the rupture caused by the affair itself. It also involves examining the underlying emotional, structural, and communication patterns that may have created the conditions in which the affair developed. In fact, recent research from 2023 found that nearly 46% of unfaithful partners and 36% of betrayed partners believed their relationship ultimately improved after working through the affair.

Here are some tips to get you back on track:

Tip 1: Be willing to look at the affair in the context of your relationship.

Emotional affairs often start because emotional needs are unmet, the person has low self-esteem, and connecting with others online is a very easy process. Many people in unhappy relationships feel unheard, disconnected and unwanted. If one person is looking outside the relationship to get emotional needs met, it may be likely that person’s needs aren’t being met within the primary relationship. Be willing to honestly consider what had been going on in your significant relationship prior to the beginning of the affair.

Find a Therapist for Relationships

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“Joanne” and “Jeff,” both teachers at an international school, recently came to see me for therapy because Jeff had an emotional affair with Eileen, another teacher at the school. When Eileen was in the process of separating from her husband, Jeff had become her confidant, and the relationship deepened from there.

When Joanne found out about the affair, she was furious, hurt, and felt out of control. She made going to therapy a condition of continuing the relationship. As we began to work together, it was revealed that Joanne had given birth to the couple’s first child a year ago. Since that time, Jeff reported feeling left out and uncared for as Joanne had been preoccupied with the baby’s needs. He was missing the easy companionship and enjoyable sex they had before. However, he never told this to Joanne, and she had no way of knowing how Jeff was feeling.

Here, the context of the relationship was the birth of the couple’s first child and Jeff’s feelings of isolation and exclusion when Joanne’s attention was diverted to their baby. Because he didn’t share this with Joanne, his emotional needs went unmet within their relationship. Once this came out in therapy, Joanne was able to acknowledge Jeff’s feelings, and together they came up with strategies for Joanne to meet Jeff’s emotional needs and vice versa.

In this way, the affair can be understood as disrupting an existing pattern that had already been fostering disconnection. While the behavior itself is harmful and must be addressed, it can also bring into focus the relationship habits, avoided conversations, and unmet needs that were present beforehand. Exploring these patterns allows couples to move beyond blame and toward a more complete understanding of their shared dynamic.

Tip 2: Talk about your feelings and needs with your partner without judgment or blame.

This is often easier said than done when strong feelings are present. Accusations can be flung, which rarely help couples resolve anything.

For many couples, these moments are especially difficult because they touch on long-standing fears, including fear of conflict, fear of rejection, or fear of destabilizing the relationship. As a result, important issues may have gone unspoken even before the affair. Developing clear boundaries and building the capacity to tolerate the discomfort of honest conversations are essential steps in changing this pattern.

When I work with couples, I teach a communication model called [nonviolent communication NVC, or compassionate communication as I prefer to call it. Recent research from 2024 shows that NVC training has improved interpersonal relationships among healthcare professionals, reduced workplace conflict, and promoted a culture of empathy and cooperation in high-stress environments.

Using this model, couples learn how to identify and express their feelings and needs to each other without blame, then to make a request of their partner, which can be answered yes or no. I find when people take responsibility for their own feelings and needs and communicate them directly to their partners, they can be heard in a non-defensive way because there is no judgment involved.

man and woman flirting

It is a very simple model that looks like this:

Observation: I make an observation about what I heard or saw the other person say or do, like a video camera recording the action. A video camera has no judgment or blame; it’s simply recording. The statement starts with, “When you do or say ________ …”

Feelings: I name the feeling I experienced as a result of the observation. An example would be, “When you say I don’t care about you, I feel hurt and misunderstood.”

Needs: This refers to common human needs that we all experience. Examples are needs for acceptance, love, understanding, collaboration, harmony, happiness, peace, etc. Now the model looks like, “When you say I don’t care about you, I feel hurt because I have a need for respect and understanding.”

Request: I then make a request of the other person that can be answered yes or no, using the phrase, “Would you be willing to ________?”

In Jeff and Joanne’s case, after the sentence in the third category of the model (needs), I would ask, “Would you be willing to talk with me more about this without blaming me so I can better understand what you mean?” This puts the whole conversation in a different light and can elicit a very different response than when I’m simply told, “You don’t care about me.”

When an emotional affair has occurred in a relationship, it’s essential that both partners learn to express delicate and vulnerable feelings without judgment so they can get past the accusation phase and arrive at some solutions.

This process is most effective when couples work to move away from rigid roles of villain and victim. While accountability remains crucial, lasting repair often depends on each partner’s willingness to examine both the impact of the affair and the broader relational context in which it occurred.

Tip 3: Be open to coming up with new strategies to solve the underlying problem.

couple fog walking

In Joanne and Jeff’s case, the underlying problem was that, since the birth of their son, Jeff had felt excluded and hurt by what he perceived to be Joanne’s inattentiveness. Because Jeff didn’t want to feel more vulnerable, he didn’t express his feelings to Joanne. They first needed to identify the problem and then communicate their feelings and needs to each other.

The rupture caused by an affair, while painful, can also serve as an opportunity to intentionally rebuild the relationship with a healthier framework. This may include redefining boundaries, clarifying expectations, and asking an important question: “What kind of relationship do we each want to create moving forward?” Answering this together can help shift the focus from simply repairing damage to actively designing a more connected and resilient partnership.

Research on trust rebuilding shows that it is a gradual process requiring patience and consistent effort, with both partners needing to feel internal “pro-relationship” motivation rooted in care for their partner.

This paved the way for them to strategize about effective solutions. Jeff might have said, “When I come home from work and tell you about my day and you don’t listen, I feel hurt and dismissed because I have a need to be heard. Would you be willing to tell me when would be a good time for us to talk if you’re busy with the baby?”

Joanne, for her part, would have heard it was important to Jeff to talk about his day, and she may have been willing to make another time. When Jeff swallowed his feelings instead of expressing them, there was no way for Joanne to know there was a problem, so of course no solution could be reached.

Recent studies on relationship interventions show that most couples who receive evidence-based therapy obtain significant results in improving relationship satisfaction, with these effects often sustained at follow-up. Indeed, a relationship can survive an emotional affair if both partners are committed to finding a way past it.

Ultimately, healing from an emotional affair involves holding two truths at once: acknowledging and working through the real hurt and breach of trust, while also examining the relational patterns that made disconnection possible. When couples are able to do both, they are better positioned not only to recover, but to create a relationship that feels more secure, open, and intentional.

If you find this too difficult to do on your own, often just a few sessions of couples therapy can kick-start the process. Meta-analyses show that couples therapy is effective for improving relationship satisfaction, communication skills, and emotional intimacy.

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

References:

  1. Adriani, P. A., Hino, P., Taminato, M., Okuno, M. F. P., Santos, O. V., & Fernandes, H. (2024). Non-violent communication as a technology in interpersonal relationships in health work: A scoping review. BMC Health Services Research, 24, 289. https://doi.org/10.1186/s12913-024-10753-2
  2. Carr, A. (2025). Couple therapy and systemic interventions for adult-focused problems: The evidence base. Journal of Family Therapy, 47(1), 6-42. https://doi.org/10.1111/1467-6427.12481
  3. Fincham, F. D., & May, R. W. (2017). Infidelity in romantic relationships. Current Opinion in Psychology, 13, 70-74.
  4. Institute for Family Studies. (2020). What counts as ‘cheating’ in marriage? Emotional infidelity in a national sample. https://ifstudies.org/blog/what-counts-as-cheating-in-marriage-emotional-infidelity-in-a-national-sample
  5. Kernová, L., Halamová, J., & Deriglazov, D. (2025). Effectiveness of digital interventions on relationship satisfaction among couples: A systematic review and meta-analysis. BMC Psychology, 13, 1069. https://doi.org/10.1186/s40359-025-03444-y
  6. Knox, C., & Rempel, J. K. (2024). Rebuilding trust in romantic relationships [Poster presentation]. Society for Personality and Social Psychology Annual Convention, San Diego, CA, USA. https://doi.org/10.17605/OSF.IO/AP26D
  7. Neilson, E. C., & Maitland, D. W. M. (2025). Acceptance and commitment therapy for couples: A systematic review and meta-analysis. Journal of Contextual Behavioral Science, 36, 100892.
  8. Rosenberg, M. (2003). Nonviolent communication: A language of life. Encinitas, CA: Puddle Dancer.
  9. Weiser, D. A., & Weigel, D. J. (2024). Revisiting the charmed circle: A reflexive examination of unanswered questions in the infidelity literature. Social and Personality Psychology Compass, 18(7), e12983. https://doi.org/10.1111/spc3.12983

A man walks along a tree-lined pathStress is a state of physical, mental, and emotional strain or tension resulting from adverse or demanding circumstances. It can also be a reaction people experience as they encounter rather routine changes in life, if the changes are frequent and ongoing.

Stress is a normal reaction, but it can have a number of negative effects on the physical body. According to the National Institutes of Health, “long-term stress may contribute to or worsen a range of health problems including digestive disorders, headaches, sleep disorders, and other symptoms. Stress may worsen asthma and has been linked to depression, anxiety, and other mental [conditions].” In addition, stress is known to suppress the human immune system. For all these reasons, it is particularly important for people living with HIV and AIDS to manage the level of stress in their lives.

It’s important to note that the last sentence reads “manage” stress and not “eliminate” stress. For nearly all of us, experiencing a certain level of stress is a routine part of our daily lives. Stress often arises as a response to change, and change, for better or worse, is a constant in most of our lives. So rather than spend time and energy toward eliminating stress, people living with HIV/AIDS could benefit from reducing and managing their stress levels.

Decades of research has shown that both physical and emotional/mental stress suppresses the human immune system. This essay will not focus on how this happens, but it is worthwhile to note that stress reduces the production of T-cells in the body. These are cells that help fight infection. Unfortunately, it is also the class of cells that HIV attacks in infected people. An individual living with HIV/AIDS may have a lowered level of T-cells due to HIV. Ongoing physical and emotional/mental stress will only add to this deficit.

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In my years of experience working with the HIV/AIDS community, I’ve learned many individuals in this group live with additional life stressors and, thus, elevated levels of stress. A few of these stressors include:

Numerous HIV-positive people have come to me over the years, concerned that ongoing stressors in their lives are causing anxiety and depression. Many seek therapy to help support them with their stressors, but just as many are interested in learning how to relax in the hope of lessening their stress before it adversely affects their immune systems.

Fortunately, there are several easy, low-impact, and free forms of relaxation available, some of which can be taught and practiced during a therapy session. They include:

Massage and acupuncture are often considered complementary or alternative therapies. Both have been offered free of charge to HIV-positive individuals at numerous social service agencies in New York City, among other places. Many people, particularly those living with HIV/AIDS, report that therapeutic touch brings on a deep sense of relaxation and well-being. For those with relatively good physical health, moderate exercise, including walking and yoga, can be a big source of stress reduction. Many people over the years have reported that joining a gym or exercising in a park on a regular basis have helped reduce anxiety and depression symptoms.

Some individuals may find that their stress and tension has brought on anxiety that they feel unable to control despite many attempts to do so. They may seek treatment with psychotropic medications. There are numerous antianxiety psychotropic medications, many of which are widely known by the general public. They include Klonopin, Valium, and Xanax. These medications are all controlled substances and can be obtained only through a prescription.

For both mental and physical health, I have learned from experience to never underestimate the benefits of a good night’s sleep. One of the most common symptoms of stress I hear reported is insomnia. Feeling refreshed and fully awake helps make it easier to handle life’s daily stressors. Without a sufficient amount of sleep, many people experience an impaired ability to concentrate, regulate their emotions, digest food, and stay awake throughout the day.

References:

  1. Segerstrom, S. C., & Miller, G. E. (July 2004). Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry. Psychological Bulletin of the American Psychological Association, Vol. 130(4), pp. 601-630. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1361287/
  2. U.S. Department of Health & Human Services: National Institutes of Health. (n.d.). Stress. Retrieved from https://nccih.nih.gov/health/stress
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