Many people believe that if you meet the right person and fall in love, you are meant to be with this person. That there won’t be anything you will ever want to change about them. That it should just work out.

There may be couples who do not struggle, but marriage counselors recognize that most relationships face challenges. If only it were easy, we would not have so many divorces or so many conflicts driving couples to counseling. Most people would agree that marriages and long-term relationships are hard work. There are many who resign themselves to sticking it out, thinking they can learn to live with, accept, and endure whatever arises, even though they may be miserable. That is not what most of us want. If we understood that there are stages to relationships and things we can do to make them better, more might work harder to make them last.

This article presents one clinical framework for understanding relationship development, drawing on Imago relationship therapy and longitudinal research, but other models exist, and couples may experience relationships differently.

Stage 1: Romantic Love

The theory of Imago relationship therapy explains that we tend to attract and be attracted to people who feel familiar. Romance happens unconsciously. At the time, we may not be consciously aware of how a person is like our childhood caretakers. We just experience the attraction and feel the chemistry. We discover all the things we have in common and minimize, if we even notice, the differences we have. We can’t take our hands off each other. We finish each other’s sentences. We merge with each other. It all seems amazing. We feel that this is the one person who will meet the unmet needs of childhood, but we are not consciously aware of feeling this. This stage is also referred to as the unconscious partnership.

Powerful neurochemicals fuel this early stage, with oxytocin playing a central role. Recent research shows that oxytocin levels are significantly higher in new lovers compared to singles, suggesting increased activity of the oxytocinergic system during the early stages of romantic attachment. These neurochemicals produce feelings of attachment and connection, a sense of well-being and belonging, with oxytocin particularly active during intimacy and caregiving moments. This phase can last anywhere from three months to two years, though recent research on college students shows this initial “flirtationship” stage involves the first sparks of attraction and exploration of common interests.

The purpose of this stage is to form a bond that provides a secure foundation for the journey forward.

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Stage 2: Power Struggle

At the beginning of a relationship, we generally do not see the things that will annoy us as the relationship progresses into the second stage. In the second stage, you start noticing each other’s differences. He likes to spend all Sunday afternoon in the fall watching football; you don’t. You have emotional needs; your partner has different wants and needs. You like to cuddle; your partner doesn’t want physical closeness.

You may find you feel frustrated in a similar way to your disappointments in childhood. Some of us are wounded and abused to the point of trauma, whereas others have minor hurts and disappointments.

In this stage, you may try to deny these differences in order to preserve the bliss of the first stage, or you may begin squabbling, trying to get back to the oneness that you previously experienced. The relationship may feel like a lose-win or win-lose. It may be experienced as competitive as to who is going to get his or her way.

Research shows that markers of the power struggle phase often include disillusionment, conflict, mutual blame, tension, anxiety, and doubt, with emotions running high and unresolved issues feeling overwhelming. Recent studies demonstrate that power struggles can be reduced through interventions that facilitate psychological distancing from reactive self-focus and redirect attention toward understanding the partner’s emotions, needs, and motivations, which interrupts the defensive cycles that fuel power dynamics.

Many couples can navigate disagreements with empathy and understanding, but if conflicts involve ongoing contempt, abuse, or safety concerns, seeking support from a qualified mental health professional can help keep everyone safe and supported.

When couples reach a power struggle stage, they often say it doesn’t feel like love. But if we care about a partner and the relationship, we become aware that love is more than a feeling—it is a behavior, a commitment to stay with your partner and do the work. As long as both are committed to the relationship and doing the work, a relationship can grow.

Most couples who go to marriage counseling have entered this stage. Research indicates there are five phases in romantic relationships—honeymoon, power struggle, stability, commitment, and co-creation—with the power struggle phase commonly showing up somewhere between two months and two years into a relationship. They feel stuck and don’t know what to do. There are also many who, at this stage, give up and separate or divorce.

The purpose of this stage is to learn the skills and tools to resolve differences without losing yourself. Once couples have worked through the power struggles and practiced healthy communication, they’re ready to enjoy the deeper closeness and stability of mature love.

Stage 3: Mature Love

Assuming that both parties are committed to growth and value the relationship, this stage reflects long-term, conscious love built on growth and mutual understanding. We are now aware that, together, we can heal our childhood wounds. We have learned the skills and tools of dialogue so that we can listen and hear each other. We understand that we have differences and how those differences make sense. We have compassion for our partner. We are less reactive and more intentional. We communicate our wants and needs more clearly. We allow ourselves to be influenced by our partner without losing ourselves because we care about his or her happiness. We recognize that to have a healthy, happy relationship, we both need to experience a sense of well-being. It becomes a win-win.

Research on mature love shows it thrives on transparency, with partners feeling safe sharing their innermost thoughts, fears, and desires, knowing they will be heard and respected. This level of communication builds a foundation of trust and deepens the connection between partners. Recent findings indicate that enduring connection in marriage results more from the intentional efforts of spouses than from spontaneous love and emotional spark, with high-connection marriages showing three times higher scores on proactive behaviors like spending meaningful time together, doing acts of kindness, and forgiving offenses.

Long-term research with couples married 40+ years identifies primary coping mechanisms that strengthen relationships: effective communication, drawing closer together, persevering together, prioritizing the relationship, and mutual sacrifice. Studies show 83% of successful coping mechanisms involve “together coping” that strengthens the attachment bond.

The purpose of this stage is to enjoy each other and feel the intimacy of connection with someone who gets you. We do this by using the skills and tools learned in the second stage when challenges arise.

References:

1. Bühler, J. L., & Orth, U. (2025). Terminal decline of satisfaction in romantic relationships: Evidence from four longitudinal studies. Journal of Personality and Social Psychology. Advance online publication. https://dx.doi.org/10.1037/pspp0000551
2. Dupuis, H. E., Girme, Y. U., Overall, N. C., Cross, E. J., & Sibley, C. G. (2025). Changes in well-being and relationship satisfaction in the years before and after marriage in a sample of New Zealand adults. Journal of Social and Personal Relationships, 42(2), 315-199. https://doi.org/10.1177/02654075251315199
3. Galovan, A. M., Carroll, J. S., & Schramm, D. G. (2024). Flourishing marriages are made, not found. Institute for Family Studies. https://ifstudies.org/blog/number-5-in-2024-flourishing-marriages-are-made-not-found
4. Grob, A., Weidmann, R., Wünsche, J., Burriss, R. P., Bühler, J. L., Traut, A. C., Uhlich, M., Arnold, K., & Gander, F. (2025). Personality change in the light of relationship transitions in partnered and single individuals: Study protocol of a prospective measurement burst design. Swiss Psychology Open, 5(1), 1-15. https://doi.org/10.5334/spo.90
5. Hoan, E., & MacDonald, G. (2025). Personality and well-being across and within relationship status. Journal of Personality and Social Psychology, 128(3), 430-450. https://doi.org/10.1177/01461672231225571
6. Muñoz, N., Abalorio, B., & Yang, Y. (2025). The role of perspective-taking training on reducing power struggles and increasing relational empathy. Research and Practice in Couple Therapy, 3(1), 1-11.
7. Ogolsky, B. G., Dobson, K., Rivas-Koehl, M., Kawas, G., & Hardesty, J. L. (2025). The progression of college student romantic relationship development: Stability and change over 10 years. Personal Relationships, 32(1). https://doi.org/10.1111/pere.12590
8. Schneiderman, I., Zagoory-Sharon, O., Leckman, J. F., & Feldman, R. (2012). Oxytocin during the initial stages of romantic attachment: Relations to couples’ interactive reciprocity. Psychoneuroendocrinology, 37(8), 1277-1285. https://doi.org/10.1016/j.psyneuen.2011.12.021
9. Snowdon-Farrell, A., Attal, C., Nikkheslat, N., Pariante, C., Young, A. H., & Zahn, R. (2025). How does neurochemistry affect attachment styles in humans? The role of oxytocin and the endogenous opioid system in sociotropy and autonomy – A systematic review. Neuroscience & Biobehavioral Reviews, 169, 105994. https://doi.org/10.1016/j.neubiorev.2024.105994

“I slept and dreamt that life was joy. I awoke and saw that life was service. I acted and behold, service was joy.” —Rabindranath Tagore

One of the ways we come into balance and connection with each other and life is by giving from the heart. When we give to others, whether it’s an act of kindness, generosity, or compassion, it helps us live from the heart instead of the ego.

Living from the ego is painful and exhausting. It’s like feeding a hungry monster that’s never satisfied. Ego craves, pursues, and clings to status, approval, material wealth, and control. It views the world through the eyes of fear—constantly evaluating, judging, and acting in ways that are self-centered, defensive, and protective. Ego is about getting more, which leaves little room for generosity or compassion.

In contrast, generosity requires that we open our hearts to the world and each other. We accept that in life there are challenges, and we meet these challenges with humility, patience, and compassion. This is the work of the spiritual warrior, to open our hearts and allow ourselves to be vulnerable. In doing this, we open ourselves fully to life, love, and relationships.

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The practice of generosity also helps us let go of striving and pursuing things. When we stop striving, we begin to see, value, and respond to what’s happening in the present moment in ways that are healthy and healing. This movement from striving, to be present and open to life, is what nourishes the heart. In responding and valuing our connection to others and the world, we let go of an “us-versus-them” mentality. Our priority shifts from attaining things to appreciating what we have and being open to share with others.

Greed vs. Generosity

“Thoughts rooted in greed, hatred and delusion lead to disharmony and suffering. Thoughts rooted in generosity, loving-friendliness, compassion and wisdom lead to harmony and peace.” —The Buddha

The opposite of generosity is greed. When we view life through the eyes of greed, our hearts are closed off and we suffer. We become small, fearful, and contracted, and view ourselves as lacking some elusive thing (material, spiritual, emotional, physical). This is much like the character Scrooge, who lived a lonely, bitter, and resentful life. On the outside, Scrooge appeared to be a grumpy, mean-spirited, and stingy man, but under this tough exterior was a fearful and vulnerable person who wanted connection but was afraid of it.

If we’re honest with ourselves, each of us has moments where we engage in Scrooge-like behavior. We get caught up in a “me, mine, I” mentality. We compare ourselves to others and either feel superior or inferior/inadequate. When we act in ways that feed the ego/greed, we lose our vital connection to the life around and within us. Generosity, which opens our hearts to each other and life, falls by the wayside.

Joy Arises from a Generous Heart

“There is no exercise better for the heart than reaching down and lifting people up.” —John Holmes

In the book The How of Happiness, author Sonja Lyubomirsky states that “being kind and generous leads us to perceive others more positively and more charitably. It fosters a heightened sense of interdependence and cooperation in our social community.”

Generosity is a quality of kindness, of living from a place of abundance. When we act with kindness and generosity, we see the world through a clear lens that isn’t clouded by fear, wanting, or clinging. Our eyes are open to see life as it is, instead of how we want it to be. When we interact with others, our connection is genuine and based on a sincere concern for each other’s well-being. We see people instead of judgments or labels.

This may sound confusing at first, but think about it. How many times do you interact with people without really seeing them? When you go to the grocery store, do you see a“person” or a “cashier”? What about your spouse/significant other? Do you see the living, feeling, vulnerable loved one, or do you see a “service provider”? Generosity allows us to cultivate a heart-to-heart connection.

Start a Generosity Movement and Watch What Happens

“To live a pure unselfish life, one must count nothing as one’s own in the midst of abundance.” —The Buddha

I’d love for us to start a generosity movement where the goal is to act from a place of goodwill and give without expecting anything back. I’m not advocating that we give up all our worldly goods, and it’s not about giving to the point of depriving ourselves. It’s about living a balanced life and sharing with others. Too often we live from the viewpoint of “me, mine, and I.” When we do something or give to others, we expect to get something in return. Sometimes we’re not even aware of this expectation. We only become aware of it when a feeling of resentment arises, or when we feel as if we’re taken for granted. If instead we offered time, care, a hug, etc., from place of generosity, we may experience a warm feeling inside and in the live connection that is present in the moment of sharing.

Being generous arises from the heart, not the wallet. We don’t need to have material wealth in order to be generous. The only requirement is a willingness to open our hearts, to see life as it is, and to interact with others from a place of compassion and love. Some examples of generous acts are:

• Do a household chore without being asked.
• Offer to buy lunch for someone.
• If someone is in need of emotional support, set aside what you’re doing and listen with compassion.
• Hold or open the door for someone (it doesn’t matter if they thank you; what matters is the intention to be kind and generous).
• Tell your loved ones what you appreciate about them (this is a beautiful gift, as you’re letting them know you value them).
• Spend time listening to your children and try to see the world through their eyes before offering advice.
• Take time out of your busy schedule to spend quality time with a loved one.
• Smile at a stranger.
• When you ask, “How are you?” look into the person’s eyes and take time to truly listen with an attitude of curiosity and compassion.

For this week, pick a few activities from the list above and be mindful of your experience. Remember that generosity awakens goodness in the heart and this helps us open to life, love, and relationships.

May you be well!

Perfectionism is one of those things that carry both positive and negative qualities, making it a tricky and complicated issue to understand. If you are detail-oriented or want the best for yourself, are you perfectionist or just ambitious? I think the answer lies in (1) the way you feel about yourself and (2) whether the idea of perfection is an obsessive thought that won’t let go or, rather, a repetitive behavior done in an attempt to succeed.

Of course, some amount of ambition is a good thing, right? We all want to do our best, to look our best, and to have life go our way. In that way, striving is a positive quality. However, it becomes harmful and maladaptive when we attempt to reach an invisible goal. What is perfection, exactly? Doesn’t it depend on your definition? What might be perfection for some may not be for others.

In a quote by Anne Wilson Schaef, she writes, “Perfectionism is self-abuse of the highest order.” Self-abuse is a strong wording choice that defines the obsessive quality of the idea. Perfectionism can run rampant on your self-esteem, your confidence, and your motivation to do more. If your first thought when you start an exercise routine is that you want to look like a supermodel, you may be experiencing perfectionist thoughts. Even supermodels don’t look like supermodels in real life. If you lose weight, get fit, eat healthier, and yet don’t look like a magazine ad, have you failed? Perfection is a deep whisper in our souls that we, alone, are not enough. Its invasive quality can be quite destructive to a healthy outlook on life.

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Perfectionism is most apparent in three areas of our lives. First, we are perfectionists with our bodies and minds. Every commercial, every advertisement, every billboard reminds us that we are not “right” in some way. We’re expected to believe that we must have a toned body, the longest, sleekest hair, acne-free skin, and white teeth. Second, we are perfectionists in relationships and especially parenting. We read the books, get on the preschool mailing list before our children are out of diapers, and kill all germs immediately. This quest for perfection in parenting leads to perfection-driven children who may feel they cannot measure up. Third, we are perfectionists with our environment. We want our homes to be HGTV worthy while we bake like Martha Stewart. An entire home-design-and-improvement culture was created on the perfectionist ideal.

So, what to do when perfection is running our thoughts? Here’s how to get un-perfect and still be OK:

1. Check yourself. Are you thinking perfection all the time? What if you don’t reach perfection? Will you be happy, healthy, and alive? Will others still love you? Will you still be a good person? If you understand that thoughts can come and go, you will start to realize that perfectionist thoughts can be harmful and they can be released. Check to make sure that while your standards are being met, you are not preoccupied with perfection. Flawed people are great, too.
2. Focus out, not in. Focusing on ourselves too much can breed insecurity, which in turn breeds perfectionism. Instead of focusing inward, reach out to family, friends, and strangers to see what else the world has to offer. Take a class, help a friend, volunteer, teach, garden, or build something to give away. Perfectionism loves inwardly focused people. Open yourself up.
3. Fail. Try something new with the intention of being bad at it. Paint a picture and laugh at how ridiculous it is. Talk to a stranger with the understanding that if he or she ignores you, at least you tried! Failing is a vital step to get rid of perfectionism because you learn that failing isn’t as bad as you thought. In fact, it can be fun! If you are always trying to be perfect, it can paralyze you to never try anything. So go out there and fail!

If you believe you cannot get a grip on obsessive thoughts and behaviors, please contact a mental health specialist who can help guide you to feeling more balanced.

Have you ever busted out in good, hearty laughter for a couple of minutes and then felt a rush of blissful joy? You know the kind of laugh we’re talking about; the one where you have a tough time catching your breath, your stomach and cheeks hurt, and your eyes water like crazy. It is this kind of laugh that often leaves us feeling wonderful, and perhaps even a little exhausted afterward. But did you know that laughing like this is also great for your health? Want even more good news? So is smiling.

Smiles and laughter have been proven in multiple studies to benefit a person’s wellness, and these two simple actions can also dramatically change the way others perceive you. If it has been a while since you enjoyed a good chuckle or shared an ear-to-ear grin, it is time to turn that frown upside down and get busy doing things that make you smile and laugh.

Here are four reasons to get you started:

1. Laughter Is Medicine and Improves the Body’s Functioning Almost Like Exercise

[fat_widget_right]You may have heard from Reader’s Digest that laughter is the best medicine. Well, in many ways that old saying is true. Physiologically, we change as we laugh. When you bust out in laughter, your heart rate goes up and your breathing rate increases, which gets more oxygen flow to the cells and gives your muscles a big stretch.

Dr. William Fry, a leading researcher of the psychology of laughter at Stanford University, discovered that it took him 10 minutes of rowing to get his heart rate up to the level that hardcore laughter achieved in just one minute.

In other studies, people struggling with illness, depression, anxiety, and other conditions who incorporated more laughter into their lives reported drops in blood pressure rates, stronger immune systems, and less stress.

2. Laughter Releases Endorphins

Endorphins are the “feel good” chemicals that are released when you exercise, and research asserts that endorphins are also released during a good laugh. A 2006 study by Lee S. Berk of Loma Linda University demonstrated the mere anticipation of laughter was enough to release endorphins.

There is even a new type of yoga quickly gaining popularity called Laughter Yoga, in which participants are led through laughter exercises. Laughter Yoga emphasizes the benefits of increased endorphins and utilizes laughter to reduce stress, encourage a positive attitude, and improve a person’s health.

3. Smiling and Laughter Improve the Way Others See You

If you laugh and smile more, it improves your overall quality of life by changing the way people perceive you. A study that built on previous research about the effect smiling has on others (1994) found that smiling is a universal response that is understood among human beings. Smiling indicates happiness, which is one of six basic emotions universally presented and understood across cultures.

In this study, students were asked to evaluate slides of males and females smiling or displaying other facial expressions. The students were then asked to rate the slides on 12 adjectives: optimism, conciliation, calmness, reliability, leadership, happiness, intelligence, attractiveness, beauty, sympathy, sincerity, and kindness. The only trait that was not found to have a significant positive correlation to smiling was leadership, which seemed to be more affected by the manner in which the subject was smiling (head tilted, closed lip smile, etcetera).

4. Laughter and Smiling Can Help Relieve Pain

A study published in 2010 examined the therapeutic value of laughter in medicine. One of the pieces of research this study built on was that of Norman Cousins, who published an article titled “Anatomy of an Illness” in the New England Journal of Medicine in 1976. This article serves as the basis of most research concerning laughter and health care.

Cousins was diagnosed with a severe form of arthritis called ankylosing spondylitis. This condition primarily causes painful inflammation of the spinal joints, leading to chronic pain and discomfort. Cousins theorized that adding laughter to his health care routine would help and began introducing a heavy dose of “Candid Camera” and comedies into his regimen. He found that this daily serving of humor helped him sleep comfortably—more than he had been able to previously. He said, “It worked. I made the joyous discovery that 10 minutes of genuine belly laughter had an anesthetic effect and would give me at least two hours of pain-free sleep.”

And as for the 2010 study that quoted Cousins’ finding? It concluded that there is “sufficient evidence to suggest that laughter has some positive, quantifiable effects on certain aspects of health … Add laughter to your working and daily life, remember to laugh regularly, share your laughs, and help others laugh too.”

When you feel down in the dumps, remember that you have an absolutely free, potent form of medicine available to help you relieve some of your symptoms. The acts of smiling and laughing can be healing, cathartic, and great for your health—even if you have to force it.

Smile and say hello to those you pass. Watch a comedy film or television show or attend a live stand-up comedy show. If you cannot shake the bad mood you are in, get around those that make you laugh. Laughter, after all, is contagious. As you become mindful of the positive effects of smiling and laughing, you may notice that your days feel lighter and a few laughs and smiles are aimed back at you.

References:

1. Griffin, R. (n.d.). Give your body a boost–with laughter. Retrieved October 7, 2014, from http://www.webmd.com/balance/features/give-your-body-boost-with-laughter
2. Mora-Ripoll, R. (2010). The therapeutic value of laughter in medicine. Alternative Therapies in Health and Medicine, 16(6), 56-64. Retrieved from http://search.proquest.com/docview/808403188?accountid=1229
3. Otta, E., Lira, B. B. P., Delevati, N. M., Cesar, O. P., & Pires, C. S. G. (1994). The effect of smiling and of head tilting on person perception. The Journal of Psychology, 128(3), 323-31. Retrieved from http://search.proquest.com/docview/213818302?accountid=1229
4. Psychophysiology: just the expectation of a mirthful laughter experience boosts endorphins. (n.d.). Retrieved October 1, 2014, from http://www.healinglaughter.org/blog/psychophysiology-just-the-expectation-of-a-mirthful-laughter-experience-boosts-endorphins

In the Showtime series Web Therapy, Lisa Kudrow plays a narcissistic therapist who administers questionable therapy over the Internet. Life often imitates art, and web-based therapy is no exception, though the therapists engaged in web therapy—also known as distance therapy—are nothing like Kudrow’s character. They’re qualified professionals who want to help people.

Several large and well-respected websites now offer web-based therapy or provide advertisements for therapists who do. The advent of online therapy raises important ethical issues that online therapists may not be fully ready to address.

Skype Therapy: Risks and Benefits

At first glance, online therapy might seem like little more than another way technology makes life easier and more convenient. After all, a therapist who doesn’t have to maintain a brick-and-mortar office can probably afford to charge less. People concerned about being seen going into and out of a therapist’s office may feel more comfortable with web-based therapy, and the easy accessibility of the service means that people can choose from therapists across the country rather than being limited to a specific geographic location.

The problem is that the technology has not caught up to the ethical and legal demands of therapy. Skype and similar technologies may retain records of conversations and calls, but therapists have little control over what happens to this information. The Health Insurance Portability and Accountability Act, better known as HIPAA, mandates that mental health professionals protect client privacy and data, but even the best therapists can’t guarantee that their Skype conversations are private or safe.

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The American Psychological Association weighed in on this issue in an April 2014 practice update. The APA explained that “liability for failure to comply with HIPAA is now shared equally by covered entities and business associates—third parties that provide services to covered entities and may have access to [protected health information]. So it is critical for practitioners to have business associate agreements in place. Yet Skype does not offer business associate agreements for health care professionals who want to use it for telehealth purposes.”

The ongoing controversy about government use of Internet records compounds the concern. The National Security Agency (NSA) may review Skype metadata, and some privacy advocates have expressed concern that government entities have access to everything a user does on the Internet—even web therapy.

At a time when it can be more challenging than ever to protect client privacy, ethical norms are placing an increasing premium on such privacy. The American Counseling Association’s 2014 Code of Ethics requires therapists to protect the privacy of both current and prospective clients. This means an email asking about therapy or a brief online conversation with a prospective client are now forms of health care data that professional ethics mandate must be protected.

Virtual therapy such as Skype poses some other, more tangential concerns as well. For example, it can be harder for a therapist to read body language over a video call, and the environment in which people seeking therapy conduct video chats could be anything but relaxing. Such challenges could reduce the effectiveness of therapy, particularly among therapists who don’t actively work to prevent these problems.

What Could Possibly Go Wrong?

We live in a world where video cameras can be seen on every corner and employers regularly snoop through employees’ email, so privacy can feel like an increasingly remote concept. But confidentiality is a cornerstone of ethical and effective therapy. Marlene Maheu, PhD, an expert in online therapy, has repeatedly argued that Skype can pose serious challenges to professional ethics. “Ultimately, my strong suggestion is that providers proceed with great caution when using Skype or similar non-HIPAA-compliant platforms,” Maheu told GoodTherapy.org.

Consider the following ways Skype therapy can compromise a client’s well-being:

• When the records of a Skype call remain on a person’s computer, it’s easy for the person’s spouse, children, or even employer to see he or she is going to therapy—and perhaps even see the contents of Skype chats.
• Skype does not offer a privacy policy that is compliant with HIPAA, which means no one really knows what Skype does or does not do with user data. A user’s therapeutic chats could conceivably be sold as marketing data to third parties.
• If the NSA or other government branches store Skype metadata, then people who utilize Skype therapy may be revealing that they talk to a therapist even if they don’t want to make such a revelation.
• It’s a very real risk that Skype chats can be hacked and intercepted. If a user feels safe with his or her therapist, he/she may reveal highly personal information that can then be used against him by a person with malicious intent.

Balancing Privacy and Convenience

The challenges posed by Skype don’t mean that mental health professionals have to give up on web-based therapy altogether. Maheu argues that there are other options. “The beauty of Skype is that it is easy and free,” she said. “The truth is that several HIPAA-compliant platforms are also free and/or low cost, as well as easy to use.” Maheu maintains a list of HIPAA-compliant platforms on her website.

People who want to give online therapy a shot should ask their therapists the following questions:

• What specific steps do you take to protect my privacy?
• Is the platform you use HIPAA compliant? Would you consider switching to a HIPAA-compliant platform?
• Are my conversations with you saved in any way? If so, how do you secure the files?
• Are our sessions encrypted?

There’s no denying the convenience offered by Skype, but the consequences of poor privacy standards can vastly outweigh the convenience of distance therapy. Both therapists and people seeking therapy should proceed with caution before sharing personal information via Skype.

References:

1. Huggins, R., LPC, NCC. (2014, April 2). Initial client contact by email & the 2014 ACA Code of Ethics. Retrieved from http://www.personcenteredtech.com/2014/04/initial-client-contact-by-email-the-2014-aca-code-of-ethics-vs-hipaa-1st-in-a-series/
2. Maheu, M. M., and McMenamin, J. (2013, March 28). Telepsychiatry: The perils of using Skype. Retrieved from http://www.psychiatrictimes.com/blog/telepsychiatry-perils-using-skype
3. Practitioner pointer: Does the use of Skype raise HIPAA compliance issues? (2014, April 24). Retrieved from http://www.apapracticecentral.org/update/2014/04-24/skype-hipaa.aspx
4. Zur, O. (2014). Utilizing Skype and VSee to provide TeleMentalHealth, E-Counseling, or E-therapy. Retrieved from http://www.zurinstitute.com/skype_telehealth.html#debate

Opponents of gay marriage have periodically argued that gay marriage is fundamentally different and that gay couples are more likely to break up. According to a new study, though, gay marriage looks a lot like heterosexual marriage, with gay couples splitting at rates similar to those of straight couples.

Divorce Rates among Gay and Straight Couples

The study drew its data from the How Couples Meet and Stay Together survey and began tracking about 3,000 couples in 2009. They followed up with the couples every year through 2012. Because many states did not have legal gay marriage options at the time of the study, researchers looked at both legally married same-sex couples and same-sex couples who maintained long-term, marriage-like relationships. The study included almost 500 same-sex couples.

Researchers found that the rate of marriage breakup among same-sex couples was indistinguishable from that of straight couples. There was also no substantive difference in marriage breakup rates between lesbian and gay couples. Both straight and gay marriages had an annual breakup rate of less than 3%.

The study also found that legalized same-sex marriage tended to encourage marriage among same-sex couples. Forty-two percent of same-sex couples living in states where gay marriage was legal were married when the survey began, compared to just 28% of couples in states that did not legally recognize gay marriage. [fat_widget_left]

Michael Rosenfeld, an associate professor of sociology at Stanford University and the study’s lead author, explains in the study that same-sex couples are more likely to stay together in states that legalize same-sex marriage. He further emphasizes that the sex of partners plays a less significant role in predicting divorce than other factors. The study notes that some previous research found that gay couples are more likely to break up, but that data did not come from a nationally representative sample. For both gay and straight couples, the study says, factors such as commitment, the history of the relationship, and the length of the relationship all play more significant roles in keeping couples together.

References:

Marriage break-up rates similar for gay, straight couples — study. (2014, October 6). Retrieved from http://health.usnews.com/health-news/articles/2014/10/06/marriage-break-up-rates-similar-for-gay-straight-couples-study

Trust—the act of placing confidence in someone or something other than yourself—is social superglue. It is the binding for the deepest love, the strongest friendships, and the world’s communities. Modern society is built on trust, and in the absence of trust, fear rules.

With this in mind, it is easy to understand how people with trust issues might have difficulty engaging in certain social contexts and leading the most fulfilling life they can. Some of the most common settings in which individuals display a lack of trust are in interpersonal relationships (romantic or otherwise), business dealings, politics, and even the use of technology. And with these different facets of life becoming increasingly interconnected, mistrust could conceivably spread from one part of a person’s life to another.

Where Do Trust Issues Come From?

Trust can take years to develop, but it can be destroyed in an instant. People who have issues with trust have often had significant negative experiences in the past with individuals or organizations they initially deemed trustworthy. For example, studies show that children of divorced parents and those from abusive households are more likely to have intimacy, commitment, and trust issues in future relationships.

While trust issues sometimes develop from negative interactions experienced during early childhood, social rejection during adolescence or traumatic experiences during adulthood can also lead to trust issues for an individual. Betrayal in the form of infidelity in romantic relationships can cause trust issues throughout a person’s life. Significant loss of financial resources or perceived injustice at the hands of authority figures can even cause strong feelings of mistrust toward institutions rather than people. The fragile state of the nation’s economy, for example, has resulted in many people losing trust in the banking system and government organizations.

In short, when a person’s trust is repeatedly violated, his or her belief system can be affected profoundly, causing future concerns with placing trust in people or organizations.

Trust Issues: Psychology and Common Beliefs

A person with trust issues may harbor negative beliefs about trust and may find themselves thinking limiting thoughts, such as:

“I can never let my guard down.”
“If I open up I will only get hurt again.”
“Everybody is out to get me.”

A person with these kinds of thoughts may construct social barriers as a defense mechanism to ensure that trust is not lost again. These barriers are often a person’s way of avoiding the pain, rejection, or guilt associated with mistrust.[fat_widget_right]

A belief system marred by violations of trust can significantly burden an individual both mentally and physically. Overwhelming anxiety and stress can easily become everyday companions, facilitating the gradual erosion of both mind and body. Thankfully though, these shackles need not remain forever.

How to Regain Your Trust

Before any issue can be resolved, you must first recognize that there is an issue. That honest admission will serve as the bedrock for all your endeavors to re-establish trust in others.

Many types of therapy will help people regain the ability to trust others, and, in fact, the therapeutic relationship itself provides an exercise in trust. With a thorough understanding of a person’s initial development and psychology, a qualified mental health professional can help an individual understand where his or her trust issues come from, and develop effective ways to foster trust in relationships, interactions, or institutions. During therapy sessions, sources of mistrust can be identified and properly addressed so that people are able to dispel or cope with future fears. Group therapy for trust issues can also be particularly effective as people undergoing treatment for similar mental health concerns can learn to build trust with the therapist and other members of the group.

Trust is vital for internal harmony and positive social functioning. The ability to effectively trust others helps people live happy, rich lives. As mentioned before, trust is the foundation of most healthy relationships, but sometimes that foundation is shaky because of events in the past. If you’re interested in working through past wounds that shook your trust or increasing your capacity to trust, consider seeking the help of a therapist, spiritual leader, or other qualified mental health professional to begin rebuilding that important foundation.

References:

1. Bierhoff, H. & Vornefeld, B. (2004).The social psychology of trust with applications in the internet. Analyse and Kritik, 26(1) pp. 48–62
2. Covey, S.M.R. (2008). The speed of trust. New York City: Simon & Schuster.
3. Lewis, M. (2013). Trust issues among children of divorce. Retrieved from http://www.drspeg.com/research/2013/divorcetrust.pdf
4. Schaick, K. & Stolberg, A. (2001). The impact of parental involvement and parental divorce on young adults’ intimate relationships. Journal of Divorce and Remarriage, 36(1-2), 99-121. doi:10.1300/J087v36n01_06

Sex sells. Sex sells vacations, music, perfume, clothing, even salad dressing with both covert and overt sexual messages. Sex also sells products that will supposedly help us become sexier, such as exercise equipment. Even the medical community tries to offer us ways to be sexier and maybe have more sex.

But what about better sex?

The word “better” is relative, of course. What is good or great sex to me isn’t necessarily good or great sex to you. Let’s keep those potential differences out of this discussion because what I want to talk about is highly individualistic, personal, and literally at your fingertips and at the end of your nose—your senses, which can play a big role in sensuality. “Sensual” is defined as relating to, devoted to, or producing physical or sexual pleasure. Even the dictionary sounds sexy with that definition!

This discussion is about the impact of our senses on sexual arousal. Accessing and becoming more attuned to our senses, and then incorporating that skill into sexual experience, either with another or on your own, is often an automatic or secondary component of sexual experiences. Still, we have an incredible opportunity to put our senses at the forefront of our sexual experiences.

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What the Science Says

Our senses contribute to the sexual arousal cycle. With some intention and perhaps experimentation, we can leverage what is sensual to each of us and our partners. Rachel S. Herz and Elizabeth D. Cahill (1997) found that men reported being aroused equally by visual and olfactory stimuli, while female olfactory sense was most powerful. In another study, 54% of men reported visual stimulation to be essential to their sexual arousal, while only 14% of women reported visual stimulation to be essential.

Touch is the most frequent method used to induce sexual stimulation. Skin is the largest organ in our body and has the most effective impact on sexual response. With practice, we can quiet the mind and listen to what the body is telling us about which types of touch are most arousing. We may think we know what touch is arousing based on previous experiences, but I challenge you to find new areas and methods of touch to add to your sexual experiences. As a simple example, we may recognize that having our calves massaged is pleasurable and relaxing; could this be added to your experience by asking a lover to massage your calves for the purpose of pleasure and eroticism?

The sense of taste as it relates to sexual response is a compelling but overlooked area of study. Obviously, we taste when we kiss and perform oral sex, but are we intentionally and mindfully tuning into this sense to explore a new dimension of our sexual experience? Consider this: phenylethlamine is a chemical believed to be produced during sexual acts and also released when we consume chocolate, cheese, and even salami! No wonder chocolate is a common part of Valentine’s Day—it’s sensuality in a box!

Incorporating the Senses into Daily Practice

A component of mindfulness is noticing what you are experiencing in the moment, which, of course, requires us to notice our senses. As I write this article, I am in a bustling, metropolitan coffee shop rife with opportunity for me to practice what my senses are detecting. Take a moment to practice this yourself. You may notice the lighting, the temperature of your environment, or the humming of traffic or conversation. I encourage people in therapy to sharpen their awareness to the information their senses are receiving by tuning in and detecting, just as I am asking of you.

Another daily practice is to take a moment and notice the thoughts, images, or memories each of the following words inspires. Now, no pressure here—I’m not suggesting you have to have a sexy thought, sexual image, or memory of a sexual experience. Set sex aside. Just take a breath, relax, and focus on each of the following words. Simply notice what you notice:

• Sight
• Sound
• Smell
• Touch
• Taste

Do two simple practices every day to enhance your sexual experience by tuning into your sensuality:

1. In everyday life, check in with your five senses. What are they detecting?
2. In sexual experiences, check in with your five senses. What are they detecting?

One final thought: As a sex therapist, I am often asked, “So, how do I spice up my sex life?” It is important to keep the first steps simple, use your senses, and remember which senses you and your partner are likely to respond to most!

A long time ago, my (much older) bachelor next-door neighbor confided in me that his pleasure in life was purely “sartorial.” Unfamiliar with the term, I ran to my dictionary and learned sartorial meant “pertaining to clothing, especially men’s.” But this distinguished college professor was—his clothes appeared unremarkable, plain, and masculine.

As we became better and better friends, he confessed to me that his sartorial interests were with feminine clothing, and that he had been wearing female lingerie under his tweed suits for many years. He lamented that he had lost his last girlfriend years before when “the allure of her panties reared its satin head.” What offered a sexual turn-on for him was a turn-off for her.

He wanted my help with shopping for dresses, but I was wearing work shirts and overalls—this was the early 1970s, and nobody condemned me for dressing like a male farm worker! Since I couldn’t offer shopping assistance, I spent time with him and listened.

Find a Therapist for Sex / Sexuality

Since that time, I’ve learned much more about cross-dressing, now more commonly referred to as gender expression that varies from societal expectations. Cross-dressing itself is simply a clinical term, and most people who cross-dress do not have transvestic disorder. [UPDATED: It’s important to distinguish between cross-dressing as personal expression and transvestic disorder as defined in clinical contexts].

Research shows that 87% of male cross-dressers describe themselves as heterosexual, and 60% were married at the time of survey. Rather than choosing “macho professions to hide,” many people simply work in various fields while managing their personal expression separately from their professional identity.

Current understanding recognizes that cross-dressing exists on a spectrum of gender expression, distinct from gender identity. Transvestic disorder occurs when cross-dressing causes significant distress or impairment to daily life, but this represents only a small subset of people who engage in cross-dressing behaviors.

I don’t know what happened to Henry. I know he yearned for a female partner who would understand. He especially hoped that one day he would marry a woman who could accept him with all his quirks and proclivities. Back then I don’t believe there was as much support available as there is now.

Individuals reading this while exploring their gender expression might be concerned about being discovered. This fear is shared by many people who cross-dress. Rather than outdated resources, current support includes professional therapy specifically trained in gender and sexuality issues, as well as evidence-based online communities and educational materials. Modern gender-affirming care emphasizes patient-centered approaches and coordination between providers to optimize outcomes.

but it can help you find peace with yourself, especially if your intimate relationships are being adversely affected. Support groups and psychotherapy aimed at self-acceptance and reducing risky behaviors can be particularly helpful.

So, what if you’re a wife or girlfriend discovering your partner’s gender expression? I recommend a 90-day “chill” period before taking any drastic measures.

Talk to them about what they do and why. Current research-based resources for partners include educational materials from professional organizations and evidence-based support groups]. Research shows that a quarter of women report at least occasional positive responses to their partner’s cross-dressing, and acceptance is often linked to discovering the behavior before marriage and having open communication about it.

Professional support organizations continue to provide resources for cross-dressers and their families, offering everything from education to community support]. Organizations like Tri-Ess (Society for the Second Self) serve as educational, social, and support groups for heterosexual cross-dressers, their partners, and their families.

One wife told me years ago that it would have been easier to accept her husband if he announced he was gay. She felt scared she would lose “the butch part of him—the manly part.” That didn’t happen. Over time, she came to terms with it: “There are worse things he could be doing, and I’ve found he’s the same guy I fell in love with before he broke out the Little Bo Peep outfit for Halloween. I don’t always condone his fashion statements, but I don’t need to divorce him, either.”

Modern relationship research emphasizes that successful navigation of these issues requires open communication, education, and often professional support for both partners. Studies indicate that relationships can maintain quality and satisfaction when both partners engage in maintenance activities that buffer challenges and focus on relationship positives].

References:

1. Docter, R. F., & Prince, V. (1997). Transvestism: A survey of 1032 cross-dressers. Archives of Sexual Behavior, 26(6), 589-605. https://doi.org/10.1023/A:1024572209266
2. Psychology Today. (2024). Transvestic disorder. https://www.psychologytoday.com/us/conditions/transvestic-disorder
3. Bullough, V. L., & Weinberg, T. S. (1994). Women in relationships with cross-dressing men: A descriptive study from a nonclinical setting. Archives of Sexual Behavior, 23(5), 515-530.
4. Coleman, E., Radix, A. E., Bouman, W. P., Brown, G. R., de Vries, A. L. C., Deutsch, M. B., … & Arcelus, J. (2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. International Journal of Transgender Health, 23(sup1), S1-S259.
5. Moini, J., & Ahangari, R. (2024). Cross-dressers. In Foundations of the Mind, Brain, and Behavioral Relationships (pp. 285-290). Academic Press.
6. Tri-Ess (Society for the Second Self). (2024). Educational and support resources for cross-dressers and families. https://www.triess.org/
7. McCann, E., Brown, M., & McCormick, F. (2021). The quality and satisfaction of romantic relationships in transgender people: A systematic review of the literature. International Journal of Transgender Health, 22(1-2), 4-22.

Battle Hymn of the Tiger Mother, Amy Chua’s controversial 2011 book, advocates a highly controlling and often punitive style of parenting. A new study that looked specifically at this “tiger parent” style of parenting has found that it increases problem behaviors in children and may lead to mental health concerns.

How Punitive Parenting Affects Children

Previous research suggests that Chinese parenting styles differ from American parenting styles. Many Chinese parents believe that controlling their children’s behavior is a sign of support and love. Consequently, some Chinese parents show less affection toward their children while behaving in more controlling ways—a parenting style commonly known as authoritarian parenting.

Although past research has suggested that this parenting style is damaging to American children, cultural norms play a huge part in influencing the way parenting affects children. Cixin Wang, a professor at the Graduate School of Education at UC Riverside, grew up in China and wanted to examine whether authoritarian parenting styles were hard on Chinese children. [fat_widget_right]

The study surveyed 589 middle and high school students in Hangzhou, China. Children reported on their parents’ parenting style and behavior, as well as their own academic performance, self-esteem, and behavior. Children with punitive “tiger” parents had lower self-esteem and more difficulty adjusting to the demands of school. They also displayed more problem behaviors and were more likely to experience depression. Psychological control techniques, particularly withdrawing love, were especially problematic. These kinds of psychological control techniques are similar to those advocated by Chua in her book.

Which Parenting Style Is Best?

Though the study found that punitive parenting negatively affected children, excessive permissiveness by parents was also linked to negative outcomes for kids. Previous research on Western children has uncovered similar correlations. Child psychologists often measure parenting style by evaluating two factors: warmth and control. Parents deficient in either behavior tend to generate worse outcomes for kids. For example, parents who are low in warmth and control may tend to be neglectful.

While the latest study did not provide information about the “right” parenting style for Chinese children, it does suggest that Chinese children have similar needs to the American kids from other studies. Research on parenting demonstrates that authoritative parents who are high on both warmth and control get the best outcomes.

References:

1. Hold on, tiger mom: Punitive parenting may lead to mental health risks. (2014, September 23). Retrieved from http://www.sciencedaily.com/releases/2014/09/140922130745.htm
2. Parenting styles: A guide for the science-minded. (n.d.). Retrieved from http://www.parentingscience.com/parenting-styles.html

Fall and winter bring cooler nights and darker mornings. Along with the temperature and light changes, many people are also dealing with back-to-school changes for themselves or their children. There are changes in schedules, routines, expectations, and even relationships.

Though many people consider spring to be a time of new beginnings, autumn is that for many people. It is a time of reflection on the summer and the year thus far, as well as a time of preparation for the winter and upcoming holidays. As we enter the harvest season, consider the physical, emotional, and relational ways you may be affected by this transition.

The impact of light and temperature on the human body is profound. We all need some level of light and warmth for our bodies to survive and thrive. Autumn, for some parts of the world, marks a change in both light and warmth as we approach colder and darker days.

Consider the ideal temperature and amount of light that you physically desire. Do you love the bright sun and hot weather? Or do you prefer cooler temperatures with less intense sunlight? Are you more active now than you were two months ago? Or are you struggling to be physically active? Whatever your preference, the change in season will affect you. Understanding and responding to your needs will help you prepare for whatever season is approaching.

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Many people struggle with seasonal affective mood issues, commonly referred to as seasonal affective disorder (SAD)—a depression related to the change in seasons. For most, this begins in fall and continues through the winter months. It’s marked by moodiness, low energy, difficulty sleeping, a lack of interest in activities and relationships, feeling hopeless, and an overall sense of depression. Known more casually as “the winter blues,” SAD can have a significant impact on your mood and relationships. If you are more irritable, withdrawn, or moody during the winter months, the time to plan and prepare is now.

“Vanessa” called me at the beginning of August wanting therapy to plan for the winter. I was impressed that she was being so proactive. “I can’t do winter like that again,” she told me when I praised her. She wasn’t willing to experience another winter feeling as low as she did last year, so she wanted to do it differently this time.

To help you prepare for the upcoming season, ask yourself the following questions:

• Do you find yourself sleeping more? Are you struggling to get out of bed?
• Is it harder or easier to exercise now?
• Do you feel less patient? Are you easily annoyed or irritated?
• Do you feel more energized and productive?
• Has there been a shift or change in any of your relationships in recent weeks?
• Are you actively involved in your relationships?

Answering these questions could give you some insight about how the change in season may or may not be affecting you. Regardless of whether you are affected by SAD, there are three key points that will help you navigate and manage any seasonal changes.

1. Exercise, exercise, exercise. Moving your body on a regular basis has far-reaching, positive effects on your physical and emotional health. You don’t need to train for a marathon. Walking around your neighborhood, doing push-ups, running around outside with children—these all have the same benefit.
2. Get more light. Everyone needs to be exposed to sunlight on a daily basis. Since many jobs can be done indoors, this often takes effort. But the benefits are great, physically and emotionally. Our bodies absorb vitamin D, important to our health, from sunlight. And the energy and emotional boost that we get from a few minutes in the sun can be exceptional.
3. Talk it out. All transitions have their challenges, and it’s always easier when you’re talking to someone about it. Whether you’re talking to a friend, coworker, or therapist, let someone into your inner thoughts and experiences.

What works best for you as you enter a new season? What tips or techniques do you have to share with others? Share your experiences with us. Let’s learn from each other!

When it was revealed that actor/comedian Robin Williams took his own life in early August 2014, millions of people were in shock. For Williams’ family, friends, and fans alike, the news was devastating, but perhaps one of the most startling realizations about the incident—despite Williams regularly appearing in front of people worldwide for nearly four decades—was that no one saw it coming.

The subject of suicide is often portrayed as taboo, making it an extremely difficult topic for many to discuss. But people of all ages, genders, sexual orientations, ethnicities, socioeconomic statuses, and physical capabilities are at risk for suicide. Suicide affects both the strong and the weak. It can touch anyone.

As family members, friends, and confidants, we have a responsibility to assist the people we care about. September is recognized as National Suicide Prevention Month, which presents an opportunity to learn as much as we can about this sensitive, yet urgent, issue. How can we discern if someone we love is having suicidal thoughts, and how can we take preventative action?

Where Do Suicidal Thoughts Come From?

For people who have never seriously contemplated ending their own lives, it is challenging to understand the mind-set of an individual with suicidal ideation. As the 10th-leading cause of death in the United States according to the Centers for Disease Control and Prevention (CDC), however, understanding where suicidal thoughts come from is necessary if we want to help individuals contemplating suicide.

[fat_widget_right]Dr. Kelly Baez, a therapist who worked for several years as a crisis intervention counselor for suicidal and homicidal children and adolescents, explains, “[Suicidal ideation] is the ultimate in lack of perception, gratitude, and hope. Someone who is suicidal has developed a sort of tunnel vision—it is impossible for them to imagine that their life could ever improve.”

People who are suicidal often do not know how to obtain help. While prolonged suffering is typical in suicide-related cases, it is important to remember that suicidal persons are not always merely trying to escape pain. Most genuinely believe that there is no good reason to continue living and that the world will be a better place without them.

Identifying Common Risk Factors for Suicide

According to the American Foundation for Suicide Prevention (AFSP), 90% of people who die by suicide are experiencing a mental health issue at the time of their deaths. Depression is one of the most common factors attached to suicidal ideation, but people who experience bipolar tendencies or other mood-altering conditions are also at higher risk. Psychosis, excessive alcohol consumption, and the use of mind-altering drugs are other factors which can increase impulsivity and heighten the risk of suicide.

The highest rates of suicide occur among adults between the ages of 45 and 64, followed closely by adults 85 and older. Children, too, can become suicidal; one in 65,000 children ages 10-14 dies by suicide each year in the U.S. Issues such as the death of a parent, divorce, bullying, sexual abuse, or social exclusion can increase the likelihood of suicide among preteens. The main concern in these cases is that parents and teachers often believe that young children will not attempt suicide.

Regarding the possibility of pre-adolescent suicide, Baez said, “I have seen children as young as six who attempt suicide—usually in an ineffective way at that age. However, the intent is there, and that’s what matters. That’s what we have to address.”

The Importance of Therapy in Suicide Prevention

Therapy is one of the best tools for suicide prevention. Mental health professionals usually approach the situation in one of two ways: by targeting the conditions underlying a person’s suicidal thoughts (depression, for example), or by targeting a person’s suicidal ideations directly.

Two prominent types of therapy for suicide prevention are dialectical behavior therapy (DBT) and cognitive behavioral therapy (CBT). Dialectical behavior therapy helps individuals make lifestyle changes that minimize suicidal thoughts and helps people maintain control over emotions. Cognitive behavioral therapy, meanwhile, teaches suicide prevention skills and encourages the application of learned skills even if the individual is in an activated state of suicidal ideation.

Suicide Prevention Strategies You Can Use

If a family member or friend expresses suicidal thoughts, do not ignore them. They might desperately need your help. Here are a few tactful steps you can take to help a loved one at risk for suicide:

• Ask questions in a mild and sincere manner.
• Explain why you are asking questions.
• Express that your loved one is not alone. Tell them you are there for them and will continue to be there.
• If the individual is not comfortable speaking with you, suggest a qualified third party such as a therapist, spiritual leader, or doctor.
• Do not passively tell the person to just call a hotline; lead the person to helpful resources such as suicide hotlines and local mental health associations.
• Help the person schedule and keep appointments with a mental health professional, even if the individual no longer feels suicidal.

With National Suicide Prevention Month in full swing, take full advantage of the many articles, seminars, webinars, and other programs on suicide prevention. Suicide can affect anyone, and being prepared can help save lives.

Where You Can Find Help

If you or someone you know is having suicidal thoughts, the suicide prevention hotline in the United States is 988. If you are outside the United States, visit suicide.org or iasp.info to get a helpline within your local area. GoodTherapy.org also has a page dedicated to help those in crisis.  Other online resources include:

• stopasuicide.org explains the warning signs of suicide so you can help prevent it from happening.
• https://chat.988lifeline.org/ allows people to call or chat online with a suicide prevention counselor.
• thetrevorproject.org offers life-affirming programs to members of the LGBTQ youth community at risk for suicide.

Working with a therapist or counselor allows a suicidal person confront and cope with intense emotional pain. Therapy is a leading suicide prevention method. You can find a therapist near you by searching online at GoodTherapy.org or calling us at 1-888-563-2112 ext. 1 during business hours.

References:

1. American Foundation for Suicide Prevention. (n.d.). Treatment. Retrieved from https://www.afsp.org/preventing-suicide/treatment
2. Brent, D. A., Kuramoto, S. J., Langstrom, N., Lichtenstein, P., Runeson, B. and Wilcox, H. C. (2010). Psychiatric morbidity, violent crime, and suicide among children and adolescents exposed to parental death. Journal of the American Academy of Child & Adolescent Psychiatry, 49(5), 514-523.
3. Pope, J. and Axelson, D. A. (2013, May 3). Warningsigns of suicide in teens and children. Retrieved from http://www.webmd.com/a-to-z-guides/warning-signs-of-suicide-in-children-and-teens-topic-overview
4. Price, M. (2010). Suicide among pre-adolescents. Monitor on Psychology, 41(10), 52. Retrieved from http://www.apa.org/monitor/2010/10/suicide.aspx
5. Sher, L. (2004). Preventing suicide. QJM: An International Journal of Medicine, 97 (10): 677-680. doi: 10.1093/qjmed/hch106. Retrieved from http://qjmed.oxfordjournals.org/content/97/10/677.full