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

A version of the Serenity Prayer that I like is:

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

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

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

[fat_widget_relationships_right]

So how does all this happen?

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

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

It is helpful to say:

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

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

“Can I recover from depression without antidepressants?”

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

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

[fat_widget_depression_right]

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

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

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

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

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

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

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

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

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

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

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

References:

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

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

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

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

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

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

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

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

Fashion magazines may seem like little more than a diversion from the stress of everyday life, but research has repeatedly demonstrated that reading these periodicals makes women feel terrible. One study found that just three minutes spent paging through a fashion magazine left 70% of women feeling guilty, ashamed, and depressed. Another found that, regardless of the women’s size or physical appearance, women were equally negatively affected by viewing images of very thin models in fashion magazines. Yet women continue to buy millions of fashion magazines every year. A new study suggests that some women might be seeking inspiration to look like the models.

Fashion Magazines and “Thinspiration”

To understand why women buy magazines that harm them, researchers recruited 51 female college students to look at fashion magazines. Unlike previous studies that evaluated the effects of reviewing fashion magazines, participants in this study viewed a variety of ads and articles over the course of five days, rather than in a brief burst. Prior to the students’ participation, researchers compiled data on the young women’s magazine reading habits, their body image, body mass index, and how frequently the women compared their bodies with the bodies of others.

After the women viewed 16 pages of fashion magazines, researchers asked them a host of questions about how they felt about the magazines and their bodies. Unsurprisingly, women who compared themselves to the models felt worse about themselves, and were more likely to have dieted during the five days of the study. But some women saw the models as a source of what researchers termed “thinspiration.” They wanted to look more like the models, and viewed this as possible.  [fat_widget_left]

Silvia Knobloch-Westerwick, professor of communication at The Ohio State University and the study’s author, notes that previous studies have only looked at women’s reactions when the women viewed advertisements only, not text. Women may develop an affinity for models in such a context, viewing the models as relatable and a source of thinspiration. Of course, looking like a model is unrealistic for the overwhelming majority of women, and with the rampant use of photo editing tools, even the models themselves don’t always look like the finished images we see in magazines.

Knobloch-Westerwick argues that when women understand the effects fashion magazines have, rather than just seeing these periodicals as entertainment, they may be better equipped to combat the magazines’ negative effects.

References:

1. The Body Project: Facilitator fact sheet [PDF]. (n.d.). Retrieved from http://www.bodyprojectsupport.org/assets/pdf/materials/facilitator_fact_sheet.pdf
2. Why women buy magazines that promote impossible body images. (2014, November 9). Retrieved from http://www.medicalnewstoday.com/releases/285020.php
3. Women of all sizes feel badly about their bodies after seeing models. (2007, March 27). Retrieved from http://www.sciencedaily.com/releases/2007/03/070326152704.htm

Feeling empty from time to time may be a normal part of the human condition. But if you experience persistent feelings of emptiness, there may be something you can do about it.

What does emptiness feel like?

• You don’t have a sense of purpose.
• You perceive a lack of meaning in your life.
• You’re not happy, but you’re not particularly sad, either.
• If someone were to ask you how you feel, you might say, “I don’t know.”

What causes feelings of emptiness? No one knows for sure, and there may be more than one cause. A common reason you might feel empty is self-alienation—feeling like a stranger to yourself. This sensation develops over time, usually as a result of pushing away unwanted emotions.

Our emotions are an important aspect of our experience of ourselves and our quality of life, yet most of us have some degree of trouble allowing ourselves to have certain feelings. Anger is one emotion that many people try not to experience, for example.

What happens to our feelings when we refuse to acknowledge them? They stick around in the shadows of our minds, gumming up the emotional works and, eventually, cutting us off from ourselves altogether.

[fat_widget_right]

The result? We feel empty. We have a pulse, but we’re not really alive.

Life is an emotional experience.

If you come from a family that didn’t “do” certain (or any) emotions, you’re at increased risk of feeling empty.

Here are some ideas for getting out from under this uncomfortable state:

• Stop looking “out there” for a sense of purpose. Your purpose springs forth from your uniqueness. It’s not something that floats around the earth independently like a cloud, waiting for you to find it. If you don’t have a strong sense of who you are, it’s can be hard to feel in touch with your purpose. You are someone in particular. You have a story, of which you’re the star.
• Think about this question: “Who is the person experiencing this feeling of emptiness?” Your authentic self is the person who cries when you’re sad, and laughs when you’re tickled. It’s your authentic self who wants to inhabit the void, filling you with meaning, purpose, and connection. Start where you are: Someone is feeling empty. Who is it?
• Ask yourself how you might feel if you weren’t feeling empty. Look at your life—past, present, and/or future. What comes up as you think about it? Any so-called negative emotions such as anger, disappointment, or despair are showing you what might be hiding under a numbing blanket of emptiness. Are you protecting yourself from something you’d rather not know? Be curious, not judgmental. Compassionate, not accusing.
• Embrace your emotions, whatever they are. This is the same as embracing yourself. Although emotions aren’t literally a part of you, they’re a reliable reflection of you in this moment. How you feel in any given moment is the road that connects you with your authentic self. Try a little constructive wallowing in any emotions you have, and remember: curiosity and compassion, not judgment, is the goal.
• Be a joiner. There’s meaning in connection with other people. Consider sharing your sense of emptiness with another person. If there’s no one in your life you trust with that information, a support group could be valuable. A grief support group might be a good choice. Many of us have endured enough loss in our lives to fit right in. You can’t be closer to another than you are to yourself. Be honest and kind to yourself, rather than looking to other people to fill you up.
• Root out shame. There is nothing inherently wrong with you. It’s hard to be close to someone you despise, and shame encourages you to reject yourself.
• Try therapy. A good therapist holds up a metaphorical mirror, helping you see and appreciate who you are. If you need a little help, find a therapist in your area.

You don’t have to live your life feeling empty if you don’t want to. You deserve a good relationship with yourself and a meaningful, purposeful life. Let this article reach that part of you that’s there under the surface, waiting to reconnect and dispel those feelings of emptiness.

Ask any parent which sex is more verbal, and you’ll likely get a confident assertion that girls are just better with language. Pop psychology tells us that this is a fundamental difference between men and women, but new research sheds light on how this phenomenon could actually be a product of parenting and environment. According to a study just published in Pediatrics, mothers may spend more time talking to girls than they do talking to boys.

Sex-Based Differences in Communication

The frequency with which a parent talks to his or her child is a major predictor of language development, with children of frequent talkers talking earlier and developing larger vocabularies more quickly. To study the effects of parent-child communications, researchers evaluated 33 late pre-term babies and their parents, ultimately amassing 3,000 hours of recordings.

Researchers found that, regardless of a baby’s sex, mothers talked to their infants more frequently than fathers. While dads only respond to an infant’s cooing and babbling 27% to 30% of the time, moms respond 88% to 94% of the time. Unsurprisingly, then, babies showed signs of preferring their mothers’ voices over their dads’ voices. [fat_widget_left]

While dads responded slightly more frequently to boy babies than girl babies, the difference was not statistically significant. Mothers, however, were more likely to respond to and initiate communications with daughters than with sons. Researchers speculate that this may be because baby girls tend to engage in joint attention and make eye contact more frequently.

Previous research has suggested that a father’s degree of communicativeness has a strong effect on a child’s eventual language development. Thus the discrepancy in communication between moms and dads is a problem for boosting communication skills. Likewise, the tendency of mothers to communicate more frequently with daughters might help explain differences in vocabulary between male and female children.

References:

1. Moms talk more to infants, especially girls, study finds. (2014, November 4). Retrieved from http://www.theglobeandmail.com/life/health-and-fitness/health/moms-talk-more-to-infants-especially-girls-study-finds/article21438411/
2. Raymond, J. (2014, November 3). The ‘baby talk’ gap? Moms may favor girls when talking to infants. Retrieved from http://www.today.com/parents/baby-talk-gap-moms-may-favor-girls-when-talking-infants-1D80257873

The matter of trust is always a burning issue, especially nowadays when technology has taken over the bigger part of our lives. With the development of social media, we forgot how to talk to each other, and replaced our real life communication with calls, chats, and videos. We think we have the company of friends and lovers, but when the Internet goes dark, we face the terrifying reality—our virtual worlds are just an excuse to avoid complete solitude.

One of the biggest problems we face while using the Internet is jealousy. It starts with simple comments, “likes,” and then progresses to messages and even calls. If there were a way to check your better half, would you do it? Does online chatting constitute cheating?

Many stories start with flowers and chocolate, mine was no different. I met my husband in college, where both of us were studying programming. It is not news that there are few girls in that field, and I was lucky to catch the best boy in our group.

Soon after graduation, we got married and moved to New York. Things were going pretty well except that we hardly saw each other. He joined an international company and was constantly away. Quite a common story, you might say, but it wasn’t just distance that set us apart—there was technology.

I could not stop thinking of what he was doing and with whom he was talking when he was not with me. One time I caught him chatting with another woman, and I was foolish enough to start spying on him. In reality, though, I had neither time nor money to hire a private detective to follow him to Japan, so I bought a spying pen, which indicated his GPS location and recorded his surroundings, but in practical terms, it was nothing but a waste of money.  I didn’t know how to make my husband carry it with him all the time; moreover, I couldn’t hear anything because of the wind. Eventually, the battery charge got so low that I had to ditch that idea. [fat_widget_left]

Next, I took my friend’s advice to use a mobile spying app. It was quite a simple thing to use: I downloaded the file and installed it on his iPhone, then I could track his messages, calls, his GPS location. I became obsessed, lost sleep, could hardly work, and was even admitted to a hospital.

You probably want to know if he was actually cheating. There was a girl—his coworker—I saw them taking pictures together, which he deleted before coming home. I could see those pics through my spying app; I tracked his messages, and I knew how many times he called her, but I could not prove that they were involved in an affair.

Spending all my money on shrinks, I got lost completely. I couldn’t sleep and one of the shrinks I went to told me I had neurosis—symptoms of anxiety, depression, and obsessive behavior. He told me to visit another doctor who gave me antidepressants. It’s easy to become addicted to those pills, though, and they don’t really cure the real problem. I felt better, but I knew that I felt so only because of the drugs, so I stopped using them, and then it all changed into a nightmare.

There was a time when I couldn’t even work, and my mom had to take me to my parents’ house where I stayed for a whole week while my husband was in Indonesia. I knew one thing: I needed help, real help that surprisingly came from no one else but my husband. He got back and called my mother. He pestered me for information, as he couldn’t understand the reason for my behavior. When suddenly I cracked and told him everything, he just started crying. He confessed that there was a crush and that on one occasion he had almost taken it too far. Nevertheless, I was the reason he was interested in her. My depression led me to neglect self-care, and I had no interest in making love or spending romantic time together. He thought there was no more love left from me, and he was also stressed because he was under risk of getting fired. I pushed him off and abandoned him when he needed me most. I was so wrapped up with thoughts of jealousy, I thought only about myself, when the person I loved the most was devastated.

I relied on technology to reveal the truth, when all I had to do was to talk with him upfront.  Eventually, we figured out a way to stay together—he quit his job and found a new one in the city. Surprisingly, we needed no recovery therapy, our main medicine was honesty and love.

Although my story has a happy ending, I really think that love and technology do not match. Because it is true, as the author Frank Crane wrote, “You may be deceived if you trust too much, but you will live in torment if you don’t trust anyone.”

Paula Green is an IT professional who currently works as a writer for a college writing service.

Editor’s note: DeAnza Spaulding, MA, LMHCA is a trauma therapist who takes a holistic, client-centered approach to therapy. Her continuing education presentation for GoodTherapy.org, titled Ethics in Spirituality in Therapy, is scheduled for 9 a.m. PDT on November 14, 2014. This event is available at no additional cost to GoodTherapy.org members and is good for two CE credits. For details, or to register, please click here.

Right from the start, psychology taught us to be suspect of processes involving spirituality, and this led us to divide spirituality from psychological treatment. In fact, Freud once coined religion and spirituality as “obsessional neurosis.” In his 1927 book Future of an Illusion, Freud stated, “Religious views are illusions, fulfillments of the oldest, strongest, and most urgent wishes of mankind.”

As therapeutic professionals, we’ve been trained to think that spirituality has no place within the tradition of psychotherapy and that there is no intersection between these two arenas. For decades we’ve been telling people that when addressing concerns about their psychological health, such as depression or anxiety, they should seek guidance from psychotherapists and counselors, and for questions regarding their spiritual health and faith, they should consult their priests, pastors, clergy, and imams.

This dichotomy fails to address how psychological well-being impacts spiritual health and spirituality, psychological health. People have been led to believe that spirituality is an inappropriate means to address their psychological health, so they are less likely to bring their spiritual selves to the counseling setting. Perhaps they internalized the message: leave the spirituality to your spiritual leaders and the psychological care to your therapists. 

Today’s clients, however, more frequently inquire where their spiritual identities might fit in therapy. In part this has to do with how clients see themselves—many acknowledge that their spirituality is a core component of their identities. In a 2012 Pew Research Center survey, for example, 85% of Americans stated that their spirituality is an essential part of their identities.

The diverse needs and expressions of clients require therapists to reexamine the divide. Our clients are changing and assessing their personal needs, and some may be saying, “My spiritual identity is a vital part of who I am—is there any way to incorporate that in therapy?” The “leave your spirituality at the door” perspective is no longer sufficient in assessment and treatment, yet many of us find ourselves ill equipped to address the client’s spiritual needs.

Therapists fielding questions about spirituality and therapy may find themselves asking, “How do we bridge this great divide?” This question stems from concerns about how to utilize spirituality in helpful and meaningful ways in therapy. Some therapists may question their qualifications to merge these areas, as spirituality is a broad spectrum. It isn’t uncommon to think that in order to effectively utilize spirituality, one must be experienced in the various expressions. It is certainly a daunting prospect to consider learning every religion and tradition. What’s more, some therapists link spirituality to religiosity when those are two different aspects. [fat_widget_right]

Spirituality refers to transcendence—a state where one is connected to something beyond self and imminence. The word spirit is derived from the Latin word spiritus, which means breath. Spirituality is commonly referred to as a fundamental component of a human’s sense of being and purpose—the breath that is the essence of life. Spirituality is often viewed as a connection beyond self, to nature, for example, or a Deity or higher power, as well as the ability to access that connection within self. Thus, spirituality is not about belief systems, dogma, or doctrine. This broader understanding and language allows the practitioner to explore each client’s personal meaning to spirituality.

For thousands of years people have relied on spiritual coping strategies. Spirituality aids individuals in dealing with grief, loss, transition, and change. A pilot study was conducted in 2010 on the efficacy of a multi-faith spirituality-based intervention (SBI) for generalized anxiety disorder (GAD) and found that SBI significantly reduced the baseline psychic and somatic symptoms of GAD. Similarly, a 2007 meta-analysis on the efficacy of spiritually oriented psychotherapy revealed the positive health outcomes for depression, anxiety, stress, and disordered eating. And research shows that cognitive behavioral therapy (CBT) techniques that incorporate spirituality enhance psychological outcomes for individuals in alcohol treatment (Hodge, 2011).

Therapy is a healing practice that opens pathways to hope, inspiration, and relief, and a holistic approach is a bridge to incorporating the whole person in therapy. Holistic therapies take into consideration the body-mind-spirit of the individual and honor all aspects of an individual’s identity. This approach does not require therapists have experiential knowledge in all spiritual practices. Holistic therapy allows the therapist to build on language and meaning that is derived from an individual’s experience.

References:

1. Crook-Lynn, R.E., O’Grady, K.A., Smith, T.B., Jensen, D.R., Golightly, T. and Potkar, K.A. (2012). Addressing religious and spiritual diversity in graduate training and multicultural education for professional psychologists. Psychology of Religion and Spirituality, 4(3), 169-181.

2. Hodge, D. R. (2011). Alcohol treatment and cognitive-behavioral therapy: Enhancing effectiveness by incorporating spirituality and religion. Social Work, 56(1), 21-31.

3. Koszycki, D., Raab, K., Aldosary, F., & Bradwejn, J. (2010). A multifaith spiritually based intervention for generalized anxiety disorder: A pilot randomized trial. Journal of Clinical Psychology, 66(4), 430-441.

4. Pew Research Center. (2012). Religion and the unaffiliated. Retrieved from http://www.pewforum.org/2012/10/09/nones-on-the-rise-religion/

The National Institutes of Health (NIH; 2011) reports that approximately 5 million American adults—or about 2% to 3% of the general population—are affected by fibromyalgia. Of those individuals, 80% to 90% are women. People experiencing fibromyalgia commonly report widespread chronic pain, anxiety, a lack of energy, and erratic sleep patterns. But as some doctors are focused on developing drugs and treatments for the condition, other medical professionals doubt its very existence.

Fibromyalgia is a hotly debated topic in the medical community. The primary issue is that although doctors do recognize the chronic pain experienced by people with the condition and acknowledge that therapeutic programs are needed to help affected persons find relief, some doctors do not recognize fibromyalgia as a categorical illness. It has even been suggested that the condition might all be psychosomatic, existing only as an illness in the affected individual’s head.

Is Fibromyalgia All in Your Head?

Some health care professionals claim fibromyalgia is psychosomatic because there are no X-ray images, blood tests, or biopsies that will definitively indicate the presence of fibromyalgia. The condition is not quantifiable. The debate is further heightened by the fact that Dr. Frederick Wolfe—a researcher who spearheaded a 1990 paper that presented the world with a diagnostic protocol for fibromyalgia—has since stated that “fibromyalgia exists as a continuum rather than a dichotomous diagnosis.” In other words, fibromyalgia exists on a spectrum and not as a black-and-white illness according to Wolfe.

Wolfe’s assertion and other research has led to several medical professionals calling for a reclassification of fibromyalgia from a categorical illness to a spectrum health condition. However, any such decision could have significant repercussions. Andrea M. Risi, LPC, a Denver-based counselor and Topic Expert in health, illness, and medical issues, said, “The problem with a spectrum diagnosis is that it can be unacknowledged in the medical community. Some doctors refuse to diagnose a condition that’s not quantifiable (such as the result of an X-ray or blood test). Therefore, it can be difficult for the patient to find and obtain the most effective treatment with a spectrum diagnosis.”

What Is Fibromyalgia?

Fibromyalgia is a chronic pain syndrome characterized by fatigue, sleep disturbances, and tenderness. Localized pain is felt when light pressure is applied to tender points throughout the body, and the pain can spread to other areas when light pressure is applied to fibromyalgia trigger points.

The Centers for Disease Prevention and Control (CDC) reports that individuals with fibromyalgia demonstrate abnormal pain perception processing. As a result, affected persons might react strongly to stimuli that others do not find painful, such as the sharp ridges on a paper bag or the feel of one’s clothes on the skin. Individuals with fibromyalgia are also 3.4 times more likely to experience major depression than persons who do not have the condition.

According to the CDC, other common fibromyalgia symptoms include:

• Frequent headaches
• Tingling sensations or numbness in the hands or feet
• Morning stiffness
• Irritable bowel syndrome (IBS)
• Problems with memory and thinking (also referred to as fibro fog)
• Painful menstrual periods

While risk factors such as stressful or traumatic events, repetitive injuries, viral infections, obesity, genetic predisposition, and certain diseases (such as chronic fatigue syndrome) have been linked with fibromyalgia, the CDC says there are no known fibromyalgia causes. Fibromyalgia might also occur on its own according to NIH. Additionally, the United States Food and Drug Administration (FDA) says people with lupus, rheumatoid arthritis, and spinal arthritis are at greater risk for developing the condition. Despite the debate that exists on whether fibromyalgia is a psychological or physical illness, researchers are making strides toward developing strategies for effective fibromyalgia treatment.

Approaches to Treating Fibromyalgia

“A diagnosis of fibromyalgia is based entirely on the self-report of a patient and the use of a sliding pain scale. Pain tolerance varies from person to person, so self-reports of different patients are difficult to compare,” Risi said. As such, doctors often have to approach fibromyalgia cases on both per person and per symptom bases.

Pharmacotherapy, or treatment with the administration of drugs, is a popular method by which fibromyalgia symptoms are treated. People experiencing fibromyalgia symptoms are typically given pain medication, muscle relaxants, sleep medication, and antidepressants to address specific symptoms.

There are beneficial approaches other than FDA-approved drugs used to treat fibromyalgia pain too. Risi explains, “A healthy lifestyle is particularly important for people living with fibromyalgia. Low-impact exercise, massage, nutrition, yoga, acupuncture, physical therapy, and chiropractic treatments can all help manage the symptoms. All of these options keep joints moving and muscles loose, which can help ease pain. Many people find supplements like omega-3 fatty acids, turmeric, ginger, magnesium, and calcium help ease the pain as well.”

Risi also suggests that affected individuals can benefit from speaking with a qualified therapist.

The Benefits of Psychotherapy in Fibromyalgia Treatment

There is a split between health care professionals as to whether fibromyalgia is best treated as a physical or mental condition. What is clear, however, is that in addition to medication and relaxation techniques, emotional support is crucial to finding relief. Such support is especially effective when it is regularly received from family members, friends, and an experienced therapist.

According to Risi, “If a person is depressed or anxious about the illness, there can be a greater frequency and intensity in pain and flare-ups. A therapist can help identify negative thoughts, feelings, and behaviors that are adding to the pain cycle and when the person uses coping skills, those flare-ups can diminish.”

If someone you love is affected by fibromyalgia, be a source of comfort by showing patience, affection, and understanding. Increase your understanding of the condition and, if appropriate, encourage your loved one to seek the help of a therapist. A qualified mental health professional can help alleviate symptoms and some conditions that may accompany fibromyalgia.

Fibromyalgia can severely affect a person’s quality of life. Even when an affected individual looks healthy, they might not feel healthy. Ongoing research is revealing more and more about fibromyalgia and the best way to treat it, and with dedicated doctors continuously testing new treatments and understanding the nature of the condition, the future is looking brighter for people experiencing fibromyalgia symptoms.

References:

1. Atzeni, F., Cassisi, G., Ceccherelli, F. & Sarzi-Puttini, P. (2013). Complementary and alternative medicine in fibromyalgia: A practical clinical debate of agreements and contrasts [Abstract].Clinical and Experimental Rheumatology, 31, Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24373372
2. Cashin-Garbutt, A. (2013, March 22). Fibromyalgia: An interview with dr. frederick wolfe, university of kansas school of medicine. News Medical. Retrieved from http://www.news-medical.net/news/20130322/Fibromyalgia-an-interview-with-Dr-Frederick-Wolfe-University-of-Kansas-School-of-Medicine.aspx
3. Centers for Disease Control and Prevention. (2012). Fibromyalgia. Retrieved from http://www.cdc.gov/arthritis/basics/fibromyalgia.htm
4. United States Food and Drug Administration. (2014). Living with fibromyalgia, drugs approved to manage pain. Retrieved from http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm107802.htm
5. National Institutes of Health. (2011). What is fibromyalgia? Fast facts: An easy-to-read series of publications for the public. Retrieved from http://www.niams.nih.gov/Health_Info/Fibromyalgia/fibromyalgia_ff.asp

For children, adolescents, and adults with attention-deficit hyperactivity (ADHD), difficulty maintaining focus is often the most prominent challenge. Although medication can lead to huge improvements in the ability to focus, some individuals cannot take medication, choose not to, and in some cases medication alone is not sufficient to fully address difficulties with attention.

In the absence of help from medication, here are several simple strategies to help improve focus:

[fat_widget_right]

Classroom Strategies

• Take frequent notes on class material.
• If possible and feasible, have the child or teen complete fill-in-the-blank notes provided by a teacher.
• Some children and teens sustain focus better by keeping their hands occupied with something small, such as a stress ball, eraser, or a similar item.
• Younger children may do well with using exercise hands on the legs of their chairs. Allowing them to push their legs against these will provide tension, reduce fidgeting, and in turn may improve concentration.
• For older children and teens, teaching them how to stretch subtly during class may help reduce fidgeting and improve focus.
• Use a vibrating watch to prompt the child or teen at specific time intervals to regain focus.

Homework-Completion Strategies

• Have the child or teen create an agenda each evening for which assignments will be completed and the order in which they will be completed. Encourage the child/teen to estimate how long each will take when creating the agenda. This will help the child/teen to mentally prepare to complete the assignments for a designated period of time and may help improve focus.
• For reading assignments, designate a chair for the child or teen to sit in. Let the child/teen sit in that chair only when reading for school. This will help train the child or teen to focus on reading when in that chair.
• Reduce distractions such as the availability of a cell phone, computer access not related to homework assignments, noise, etc. Using apps such as White Noise (to reduce background noise) and Interval Minder (to stay on task) may be helpful.

Work-Completion Strategies

• Create a daily to-do list and estimate how long each task will take.
• Block out time in your calendar to complete each task as if it were an appointment.
• As appropriate, schedule specific blocks of time to return phone calls, email, etc., instead of returning them as they come in. Obviously, this depends on your job responsibilities and the urgency of responding, but doing this will limit distractions that impede your ability to complete specific tasks in a timely manner.
• If getting to meetings on time is an issue, use countdown apps or reminders to prompt you 30 minutes, 15 minutes, and five minutes before you have to leave to attend the meeting. When the five-minute reminder goes off, stop what you are doing and go.
• When writing/editing a report, set realistic deadlines to finish writing/editing each paragraph, section, page, or other part of the document. If you get slowed down when editing and keep rereading the same lines or sections over again, try tapping your finger or hand on the desk as you read each word. This action may help you edit more quickly and keep you moving along.
• If having trouble editing carefully, try reading the text out loud. This may help improve the quality of your work.

The strategies above are likely to help improve focus. Obviously, the exact cause of the difficulty sustaining focus, and individual differences, will affect how helpful each of these strategies may be. I suggest you try the strategies that seem appropriate for your needs and work on developing your own. If needed, seeking out a therapist who specializes in this or an ADHD/executive functioning coach may be helpful. A trained professional can ensure that you are able to follow through in carrying out implementation of these types of techniques successfully.

In my view, self-esteem, the foundation for how we are in the world, is the most under-acknowledged component of mental health. One of our most important tasks as parents is to be sure the environment fosters in children perceptions of themselves as capable, effective human beings. Self-esteem is greatly impacted by how children feel about their ability to cope with life, a feeling that is largely developed by others. The way parents respond to their children communicates to them that they are loved, capable, and contributing people, which enhances their self-esteem. On the other hand, parents can unintentionally send negative messages to children that they are incapable and unloved, which contributes to low self-esteem.

A desirable self-esteem is likely being established if children perceive that they belong and that they are loved and respected within the family system. One way for parents to enhance that perception is to focus on their children’s strengths and accept their weaknesses. Children should be set up to be successful and learn how to embrace positive feedback from others, not discount it.

In order for children to understand how capable they really are, parents need to facilitate children reaching their full potential by demonstrating genuine interest and a desire to be productively involved with them. If an atmosphere of closeness and trust is created between children and their parents, children will grow increasingly interested in adult perceptions. All human beings, children in particular, have a basic need for potency, a sense of control over their environment, and an affirmation of their significance.

[fat_widget_right]

Children need to have opportunities to experience success. Success breeds success, which will result in building self-esteem. Parents can encourage children to work toward developing a level of self-understanding, which is a powerful influence on human behavior and is a crucial component in children reaching their full potential.

In order to ensure that their children are developing a desirable self-esteem, parents can do the following:

• Set time aside to talk with your children and be fully present. Children need to feel they are being listened to.
• Encourage children to take care of themselves through modeling a healthy lifestyle by eating a balanced diet and getting enough exercise.
• Provide the opportunity for children to become involved in activities they enjoy. Allow children to have a voice in the activities they engage in to encourage their individuality and to develop their own interests and passions.
• Model a positive attitude toward yourself and others.
• Help children set goals, and celebrate when they reach them. If reaching their goal takes longer than expected, keep encouraging them. If plans need to be renegotiated, let children know it is OK in order to enhance their self-confidence.
• Encourage children to do their best and be proud of them for doing so. If they receive an A or a C in school, be proud of them for the effort they give.
• Despite the circumstances, let children know they deserve to be loved and accepted.
• Teach children that experiencing challenges and disappointments is a life skill and not a reflection of their worth or what they deserve.
• Let children know you will never give up on them and ensure that they are held accountable. Their self-esteem will be enhanced by taking responsibility for themselves and their behavior.

Even people who have happy relationships spend a lot of time having negative thoughts about their partner. Here’s why:

1. You have a fantasy about how your partner should be.
2. You are a person with high sensitivity, anxiety, or depression.
3. You think your partner should make you happy.
4. You are with someone who is not like you.
5. You don’t see your part in conflicts.

Fantasies Falling Short

Intimate relationships and marriages can be a dream come true but, for many, they can feel like a nightmare. Consciously or unconsciously, people go into marriage with expectations from their own parents’ marriage(s). Some people try to fashion the closeness or distance they observed between their parents, while others affirm desperately that they will never repeat what they saw. Either way, you may feel angry, anxious, and/or hopeless if your relationship falls short of your expectations.

Temperament and Mood Matters

If you are highly sensitive or prone to depression or anxiety, you might be intensely reactive to minor slights from your partner. Understanding how to work with, tolerate, and manage these feelings is crucial in avoiding chronic disagreements and misunderstandings. I once asked a friend how she could get married after being single so long. “Prozac,” she said. Don’t underestimate the power of your mood to create conflict in your relationship.

[fat_widget_relationships_right]

Happiness Is an Inside Job

While it would be great if your partner could make you happy, he or she can only enhance how you feel. Your spouse is a separate person who may not share your moods, interests, patience, empathy, or level of sexual interest. He or she should be respected for these differences. If your spouse makes you happy, realize that is a gift and not an entitlement.

Differences Are Enriching

Opposites may attract us initially but can later repel us. That joke-telling, life-of-the-party spouse suddenly isn’t so funny. That brilliant, charming guy is now draining to be around. So do you leave? Not necessarily. Stick around and learn to understand and accept your partner. Often, the masks that attracted you cover vulnerabilities that your partner didn’t want you to see. Show your significant other you love the “real” him/her and your relationship will move to a much deeper level. After all, you are your partner’s port in the storm and he/she is yours.

You Don’t See Your Part in Conflicts

Ever feel like you’d have a wonderful relationship if you just had another partner? When you become intimate on so many levels with another person, you are bound to conflict and disagree. It is much easier to point your finger at your spouse than to look in the mirror, but looking at yourself is the only way to change your relationship. When you look inside, you may discover that the person you really have trouble with isn’t your spouse.

In short, it is so much easier to hate or be disappointed in your partner than to take the time to appreciate him or her. If you open up and learn to accept and cherish your partner, your relationship may unfold in ways you never thought possible. In the words of Carl Rogers, a famous 20th-century psychologist, “The curious paradox is that when I accept myself as I am, then I can change.” So start accepting yourself as you are, your partner as he or she is, and then create a relationship together that you both love. And if you need help getting started, contact a therapist.