To recover from the emotional abuse caused by a parent with narcissistic tendencies, you must repair your reality—a reality that has been skewed and damaged by your experience of parenting. You are recovering from a serious interpersonal trauma. The repair process has nothing to do with (1) self-improvement, (2) fixing your parent, or (3) working on the relationship with your parent.

When you grow up around a parent with narcissistic qualities, you may be conditioned to believe that only the voice of that person matters. You may learn that only that person is allowed to have and express feelings and opinions. You may shut off your voice and needs in order to meet your parent’s needs. You may watch your other parent abide or acquiesce, and without thinking, the entire family may follow suit.

After all of this childhood conditioning, it can be difficult to adopt healthier ways of being in adulthood. This article provides some suggestions on how to heal from this type of abuse, but it is by no means exhaustive. Partnering with a qualified therapist can help you determine the best way to address your specific needs and circumstances.

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Learning to Love Yourself

In order to heal, it is time to start focusing on what it means to experience self-value. Here are four strategies you can incorporate in your life from this day forward to “rewire” your brain and encourage self-value:

1. Develop Self-Compassion

Developing self-compassion can prove quite challenging for some people. It can trigger emotional flashbacks in some individuals who have been exposed to cyclical abuse where compassion was part of the setup for the next attack. It can also be difficult for those who grew up in emotionally neglectful homes and rarely or never received compassion (Germer and Neff, 2014).

Realize that compassion may be absent in a relationship with a person with narcissism, and since parents are so essential for demonstrating empathy to their children, the kids may grow up underdeveloped in this area, particularly when it comes to compassion toward the self.

Be patient as you learn to create kindheartedness toward yourself. Consider what you would say to someone else in similar circumstances, or what benevolent friends have said to you in the past to bring you comfort; learn to say these same words to yourself (Germer and Neff, 2014).

2. Eliminate Your Inner Critic and Toxic Shame

Your “inner child” holds on to the hope that if it becomes smart, helpful, talented, and flawless enough, your parent will finally love it. The continued failure to win the approval of the parent leads the inner child to conclude that it is defective and unlovable. Thus, the child learns through this self-reflection process to self-criticize (Neff, n.d.).

Your “inner child” holds on to the hope that if it becomes smart, helpful, talented, and flawless enough, your parent will finally love it. The continued failure to win the approval of the parent leads the inner child to conclude that it is defective and unlovable.

Because of the constant projection and implication of failure on the part of your parent, you not only have a hurt inner child, but you likely also have an internalized “inner parent” in the form of a punitive voice and inner critic. Hearing the internalized voice of the inner critic continues the experience of toxic shame.

You can eliminate shame by learning to be vulnerable with safe people. As you begin to make connections with safe people, start telling them your story (Brown, 2010).

3. Build Self-Trust

Visualize your traumatized inner child and start developing a relationship with it that is comforting, accepting, strong, secure, and safe. The best way to learn self-trust is to start treating yourself well.

Since you have been in a close interpersonal relationship with a parent with narcissism, you have missed out on the role modeling and mirroring of healthy nurturing. Because of this, you may experience attachment trauma, a faulty inner working model for relationships, and an inaccurate belief system about yourself in relationship to others (Courtois and Ford, 2013).

This needs repair. Stop rejecting yourself and start repairing the damage your parent has caused. You can do this. Embrace your inner child with warmth and acceptance (Walker, 2013).

4. Exercise Self-Care

Because your parent with narcissism has trained you to focus only on their reactions, you may be conditioned to focus outside of yourself and may have no idea how to look internally at your own needs.

Begin to embark on a journey of self-care. Develop an “inner nurturer” and let it have a strong presence in your life. Write a list of happy, healthy things you can do with and for yourself each day.

Conclusion

Please realize that this article only touches the surface of what can happen with a person raised with a parent with narcissistic tendencies and is just a beginning point for what is needed to heal. Recovery from any type of abuse is a process, one that may take a lifetime. Allow yourself the gifts of time, grace, and unhurried, relaxed baby steps. Do not rush the process. Learn to enjoy each day as it comes and be mindful of what you are experiencing and learning. Work to eliminate the critic that resides inside your head. Ultimately, the recovery process involves developing a healthy relationship with self and others. Seek support from a therapist as needed.

References:

1. Brown, B. (2010). The Gifts of Imperfection. New York, NY: Hazelden.
2. Connelly, S. (n.d.). Permission to Stop Beating Yourself Up. Retrieved from http://traumahealed.com/articles/permission-to-stop-beating-yourself-up/
3. Courtois, C.A., & Ford, J.D. (2013). Treatment of Complex Trauma. New York, NY: The Guilford Press.
4. Germer, C.K., & Neff, K. (2014). Cultivating Self-Compassion in Trauma Survivors. Retrieved from http://self-compassion.org/wp-content/uploads/2015/08/Germer.Neff_.Trauma.pdf
5. Neff, K. (n.d.). Self-Compassion. Retrieved from http://self-compassion.org/exercise-2-self-compassion-break/
6. Walker, P. (2013). Complex PTSD: From Surviving to Thriving. United States: Azure Coyote.

I’ve had the great fortune of being a therapist for the past 40 years. When I began this journey in grad school in 1974, I was told I would never make it in this field, nor should I, because I have cerebral palsy and use a wheelchair for mobility. This was my first real blast of bias and disrespect, encountered at age 22. Good that it happened then; I learned to navigate around such prejudice early and developed an informed emotional blueprint regarding that kind of experience that serves me to this day.

Over the past four decades I’ve had plenty of chances to put that blueprint to good use, both personally and professionally. Having worked with a wide variety of people with different life stories and sources of pain, I’ve come to realize that the experience of feeling deeply disrespected can lead to further disrespectful, if not abusive, patterns and be devastating for many.

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In fact, the issue of feeling disrespected (or not) is the primary theme that has sifted to the top of what I see as most salient in psychotherapy. In my experience, people who have endured trauma, abuse, conflicted relationships, and/or struggles with addiction or mental health conditions have encountered their fair share of disrespect. Some people feel robbed of respect in significant and deep ways, if they ever felt like they experienced genuine respect at all.

Respect-focused therapy (RFT) aims to address this by utilizing the therapeutic relationship to set the stage for respectful interaction in a way that allows a person to feel genuinely respected, maybe for the first time. This experiential learning—of being respected by another human being in such a profound and holistic way—can lead the process of therapy toward a healing outcome.

As the process of illuminating and honoring pain as something separate from a person’s identity unfolds, it becomes easier to concentrate on wellness from the standpoint of self-respect. This can happen with the infusion of affirmation and sincere validation of one’s core strengths and values.

The first step is to become fully aware of the pain one holds. In effect, this involves the therapist and person in therapy holding a flashlight together in the dark, allowing the pain to be better seen and understood. In bringing the pain out of hiding, its intensity is often diminished. The idea from that point forward is to find a way of carrying what remains of the pain that is not quite as burdensome as it was in the beginning.

As the process of illuminating and honoring pain as something separate from a person’s identity unfolds, it becomes easier to concentrate on wellness from the standpoint of self-respect. This can happen with the infusion of affirmation and sincere validation of one’s core strengths and values. The restoration of identity and integrity comes out of reclaiming one’s uniqueness as goodness.

Interpersonal respect, or respect with and for others, then comes into play. Is the severity of the pain endured such that it creates a pattern of disrespectful interactions with others throughout a lifetime? Many people who have been abused or otherwise traumatized tend to learn to expect more trauma from others, perhaps feeling that is what they deserve. In some cases, people may become so angry at the world that they inadvertently create more conflicts. In respect-focused therapy, the therapist and person in therapy reflect upon how respect is about looking again, or reconsidering, and how that empowers more constructive communication. It’s also about feeling more valued in the relationship and how that creates a stronger bond.

Finally, respect-focused therapy is about instilling a universal or global sense of respect—for those with whom we don’t personally identify, people of different cultures, races, nationalities, sexual orientations, faiths, abilities, socioeconomic backgrounds, and so on. It is about embracing “otherness” rather than rejecting it. Respect, in its truest sense, is the active framework that allows for optimal human interaction and well-being.

Reference:

Slay-Westbrook, S. (2016). Respect-Focused Therapy: Honoring Clients Through the Therapeutic Relationship and Process. New York, NY: Routledge.

I remember the first time I saw all the medication bottles in Mark’s cabinet. We hadn’t been together long, and I was curious to learn more about the medication he was taking. I asked him about them and he said they were for seizures. I didn’t quite understand what he meant by this, but he said “it” was under control, so I didn’t give it much more thought. I thought it was great he was willing to share such sensitive and personal information, considering it was early in our relationship.

Mark began to have seizures in his late 20s that did not respond to medication. Even though they are of the complex partial kind (e.g.,“smaller seizures”), when I witnessed one for the first time, it scared me. He wasn’t able to speak while it was happening, and he made strange sounds in addition to awkward movements with his hands.

Little did I know at that time the impact it would have on our lives. When epilepsy is under control, you don’t think about it. But when it is out of control, causing six or eight seizures a day, you can’t help but think about all the time.

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The Impact of Epilepsy on Our Lives

Gradually, the seizures got worse until it impacted his work, home, and personal life. At work, supervisors did not understand his behavior and, at one point, asked him to take a leave of absence. He missed opportunities for advancement due to his employer knowing he struggled so much with seizures, and because of this his focus was impacted. At one point, I even contacted an attorney who said nothing could be done unless Mark was fired for having seizures.

Mark could no longer drive, meaning I had to do it. This impacted me so profoundly that I became resentful, both with our relationship and with epilepsy. To me, it was the thief that took away my normally laid-back and smiling husband and took away parts of our relationship. He began to withdraw more and played video games for hours at a time, struggled to talk about “it” and his feelings, and lost the ability to focus on our relationship and look forward to our wedding and life after.

It became hard for me to cope. I had few friends and felt no one understood. How could they? No one I knew what I was going through. I didn’t want to go out much with him to social events, as I feared the embarrassing attention a seizure might attract. I hate to say that, but it’s how I felt at the time.

Once we moved out of state, Mark got better medication and his seizures have since been controlled.

Looking back, there is a lot I would have done differently. I waited too long to get Mark support from a therapist for his physical condition and for his emotional well-being, and waited too long to get couples counseling to help us manage the challenging realities of life with epilepsy, for both partners.

Recommendations for Caregivers for People with Epilepsy

I recommend caregivers seek support from as many friends, family, and neighbors as possible and reach out frequently. I wasn’t as willing to reach out to the few friends I had as I should have been, even though I felt isolated and alone.

I also think it’s helpful for caregivers to find some respite through social outings. Going out to dinner, a movie, or bowling can help you feel connected and replenish your emotional reserves.

Pursue local resources that may be available to you as well. For us, a support group for people with epilepsy and their loved ones would have made a world of difference. With the internet at our fingertips, resources including message boards and local support groups are much easier to find and participate in.

The Importance of Self-Care

I recommend caregivers take time for self-care: good eating habits, consistent exercise, plenty of restful sleep. I have learned that the more stressful the experience, the more self-care is needed to maintain good mental health. Find ways to relax through deep breathing, meditation, massage, and stretching. It can also be helpful to find a creative outlet through art, writing, or crafts.

Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times.

As a caregiver, it can be easy to allow resentment, guilt, or compassion fatigue to set in, but remind yourself that epilepsy impacts the whole family. It’s no one’s fault, and it’s no one individual’s problem. Like your loved one, you need to be cared for and supported through this difficult journey. The more you take care of yourself and get support, the better the caregiver you are able to be.

Lastly, maintaining a sense of humor through the experience is important. Epilepsy can take over your world like an unwelcome visitor and seemingly become the center of everything. Find what tickles your funny bone and come back to it as needed. Laughing reduces your stress response, relieves tension, improves your mood, and can make it easier to deal with difficult situations (Mayo Clinic Staff, 2016).

In closing, remember to keep the faith. Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times. Keep looking for support until you find it—from medical practitioners, from friends, from your community. Remember to support each other as well, because you’re in it together.

Reference:

Mayo Clinic Staff. (2016). Stress relief from laughter? It’s no joke. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

Do you consider yourself a people pleaser?

Do you find yourself saying “yes” to people only to regret it moments later?

Do you tend to put others’ needs before your own?

If you answered in the affirmative to any of the above questions, it may serve you to become better at saying “no.”

William Ury, in his book The Power of a Positive No: Save the Deal, Save the Relationship—and Still Say No, suggests the dilemma we encounter in saying “no” often stems from an internal struggle between plugging into our own sense of power and a simultaneous desire to cater to, or foster, a relationship. Ury says we often find ourselves doing one of three things in response to a request:

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1. Accommodate. We say yes when we really want to say no. This brings us a temporary, false sense of peace, later be replaced with apprehension and resentment. We defer to the relationship with no regard for our power and ironically end up undermining the relationship in the long run.
2. Attack. We often do this with those we love the most, the ones we take for granted. We say “no” aggressively, stepping strongly into our power, but with no regard or attention to the connection with the other person.
3. Avoid. We don’t prioritize our personal power OR the relationship; in other words, everybody loses. We dishonor ourselves and amp up our own discomfort by leaving something unresolved and disrespect the other person by not providing them with an answer.

It’s important to be able to say no so you feel empowered while still maintaining your relationships with others. Saying no helps you establish healthy boundaries and enables others to have clarity about what they can expect from you.

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Some people question what to do when they don’t have an immediate answer to an inquiry. It’s okay to take a little time to think about your response. To keep yourself from avoiding altogether, provide a deadline by which you need to decide what your answer will be. Tell the other person something like, “I need to give your request some thought. I will let you know by noon Friday.” This deadline keeps you accountable and ensures that you honor both the relationship and yourself by providing a concrete reply in a reasonable time frame.

Being able to say no may enable you to be more honest and authentic with others. You may be less likely to feel taken advantage of, and people may learn to come to you for the things to which you are more inclined to say yes.

A helpful strategy that can enable you to say no with greater ease is to gain clarity around the kinds of things to which you want to say yes. Make a list of your top three priorities (and understand that they may change). Post these priorities where you will see them all the time: your bathroom mirror, your nightstand, your laptop, your car’s dashboard. When someone asks something of you, check to see if it will serve any of the things you declared you wanted to put your time and energy toward. If the answer is yes, feel free to answer the inquiry affirmatively. If it is not in line with your objectives, say no.

Be clear, confident, consistent, and concise. It’s not necessary to offer a lot of information to explain your reasoning (in fact, sometimes it can invite challenges to your “no”). However, you can say something about the kinds of things you are willing to do, or the time frame in which you might be in a better position to say yes. Doing so lets others know you are acknowledging the request, and demonstrates respect for the person who asked. Communicating to others that they’ve been heard can go a long way toward strengthening a relationship, even when you say no.

Another helpful strategy suggested by Ury is to have an “anchor phrase.” Examples might be “I have a policy …” or “I’d rather say no to you now rather than disappoint you later” or “I only volunteer in connection with a particular cause.” Once you have your anchor phrase, you can practice it. As a result of being proactive and prepared, you may be able to say no more confidently so you can say yes to things that are truly important to you.

Being able to say no may enable you to be more honest and authentic with others. You may be less likely to feel taken advantage of, and people may learn to come to you for the things to which you are more inclined to say yes. People may learn to respect your yes rather than take it for granted, you may find that your resources are allocated more appropriately, and your connection to, and communication with, others may be healthier as well.

Reference:

Ury, W. (2007). The Power of a Positive No: Save the Deal, Save the Relationship—and Still Say No. New York, NY: Bantam Dell.

Within the past several decades, a shift has been observed in the relationship patterns of many mothers and daughters. Many seem to have abandoned the traditional hierarchy of parent and child for a relationship of equals, identifying with each other more as “best friends.” BFF (“best friends forever”) mothers embrace their daughters’ lives, sharing them and, at times, walking in their footsteps.

A close, friendly mother-daughter relationship is not in itself a cause for concern. But when the boundaries of the relationship become blurred, this can lead to confusion regarding the distinct responsibilities and obligations, of both parent and child, over what behaviors are acceptable within the context of the relationship. This confusion may, in turn, may lead to behavior unrestricted by limits, on the part of either mother or daughter.

The New Mother-Daughter Relationship

Research has attempted to explain and explore the variables contributing to these mother-daughter best friend relationships. Authors Linda Perlman Gordon and Susan Morris Shaffer describe in their book, Too Close for Comfort: Questioning the Intimacy of Today’s New Mother-Daughter Relationship, what is referred to as a generation overlap, an intersection of lives that differs from anything seen in previous generations. Mothers and daughters today may shop at the same stores, utilize the same new technology, participate in the same social media apps (and possibly have some of the same friends or followers), and listen to the same music.  [fat_widget_right]

Some believe this generation overlap, and mother-daughter relationships in general, are made easier by a youth-fixated culture. In the article “My Mom Is My BFF,” Paige Williams writes of a stay-young revolution, where women are enticed and encouraged—some might say pressured—to think, act, and look young.  With the widespread availability and broad variety of technology and resources that promise to preserve youth, many mothers may find it fairly simple to recapture their years of young adulthood. And who better to morph with than a daughter, the one who likely most closely resembles their teenage selves?

Having their worlds so closely intertwined has made friendships between mothers and daughters more common than in generations past, something that is not necessarily harmful. After all, who doesn’t want a loving and caring relationship with their mother?

But these friendships may blur the distinctions between parent and child. If mother and daughter are best friends, what happens when the mother tries to parent, to speak out as a mother rather than a friend? Where do the lines get drawn? The danger of opting for the BFF route appears to lie in its potential to minimize, as well as distort, the parent-child relationship. When mothers and daughters are “besties” first and parent and child second, the maternal role—providing direction, support, and the tools needed to become a confident, self-sufficient adult—may be in jeopardy.

Mothers, Daughters, and Dating

Mothers and daughters who enjoy a close bond may share many details about their personal lives, dating details among them.

The dating world has always offered any number of challenges, among them the various rules, cultural norms, and aspects of etiquette often applied to dating individuals, particularly women. Some of these customs differ little from those of generations past, while others may be vastly different or newly established. In many cases, mothers may guide their daughters, using experience to navigate new challenges, as they also struggle with the unspoken rules of dating in a society that may encourage and expect them to balance a semblance of youth with the maternal role.

The current age of reality TV, smartphones, and social media give the term “being connected” a deeper level of meaning, in terms of dating. These technological advances have been shown to impact the development and progression of romantic relationships, but can they also contribute to the development of mother-daughter enmeshment?

Communication patterns between dating young adults today may in some cases differ significantly from those of the previous few decades, and parental involvement in teen and young adult relationships may be both more limited and more casual. Mothers who are friends with their daughters, or who want to be, may try to avoid setting strict rules, whether out of simple trust and support or in order to maintain their daughters’ good favor.

This may lead some mothers to work to become friends with their daughters’ dating partners. Some mothers may even come to act as “surrogate girlfriends,” displaying behavior that is friendly and supportive but may eventually cross the line into impropriety, even as it undermines the significance of their duties as a parent.

Mothers who assume a ‘surrogate girlfriend’ role may:

• Text their daughter’s significant other with random conversations (that go beyond asking for confirmation of whereabouts, etc.).
• Connect with their daughter’s partner on social media platforms regularly.
• Continue communicating with their daughter’s exes after breakups.
• Devote more attention to their daughter’s dating partner than to their adult relationships (their own partner or friends).

The Effects of an Enmeshed Relationship

When the roles of a mother and daughter become entangled, this is described as an enmeshed relationship. In an enmeshed relationship, a mother provides her daughter love and attention but tends to exploit the relationship, fortifying her own needs by living through her daughter. They both grow to depend on this type of arrangement, despite its dysfunction.

Susan Forward and Donna Frazier Glynn, authors of Mothers who Can’t Love: A Healing Guide for Daughters, explained this relationship as one where mothers depend on their daughters to fulfill all their needs for companionship, entertainment and a meaningful sense of identity. They call these mothers “mothers without borders,” as they tend to lack the ability to establish healthy boundaries. [amazon_affiliate]

Enmeshed relationships can have profound effects on daughters as they journey into adulthood. As Forward and Glynn explain, a daughter may not know “where she stops and her mom begins.” This may lead to developmental setbacks in the attempts of daughters to become independent, develop a sense of identity, and express themselves individually.

Enmeshed relationships can have profound effects on daughters as they journey into adulthood. As Forward and Glynn explain, a daughter may not know “where she stops and her mom begins.” This may lead to developmental setbacks in the attempts of daughters to become independent, develop a sense of identity, and express themselves individually. A daughter may also feel uncomfortable and sometimes resentful of her mother’s over-involvement in her dating life, but because the intrusion is often packaged as motherly love, they may give in to the familiar pattern of behavior.

Mothers who have unfulfilled needs, lack a romantic partner, and/or are affected be low self-esteem may look outside themselves to fill what feels empty inside. They may, thus, be more susceptible to the creation of these entangled relationships, especially with regard to the development of a “surrogate girlfriend” role, as connecting with a daughter’s partner may serve as somewhat of a replacement for what they feel is missing or lost.

I encourage daughters and mothers to consider the following:

Daughters, you may form hundreds of friendships and share your stories and life events with countless people. However, you will only have one mother. Enjoy the closeness that comes with this bond and the many ways you can be a part of each other’s worlds. Recognize that a large step for your growth into adulthood is developing the ability to think and respond as an individual. Part of this is having experiences of your own, separate from your mother. You will know your mother-daughter relationship is healthy when you feel safe venturing away from the nest.

Mothers, when you honor and value your role as a mother and demonstrate responsibility, respect, and healthy boundaries, you send the message to your daughter that you are willing to do this tough job because she is worth it. As you model for her not only the role of a mother, but that of a responsible adult, you are at the same time fortifying her self-esteem—and your own.

Gordon and Shaffer interviewed a mother who described it best: “We share best-friend moments, but she is not my best friend, that would rob her of what we really cherish – which is that I am and remain her mother.”

References:

1. Forward, S., & Frazier, D. (2013). Mothers who can’t love: A healing guide for daughters. New York, NY: HarperCollins.
2. Gordon, L. P., & Shaffer, S. M. (2009). Too close for comfort: Questioning the intimacy of today’s new mother-daughter relationship. New York, NY: Berkley Books.
3. Lieberman, D. J., Ph.D. (2010). Setting boundaries with difficult people. Lakewood, NJ: Viter Press.
4. Williams, P. (2012, April 22). My mom is my BFF. New York. Retrieved from http://nymag.com/news/features/mother-daughter-best-friends-2012-4

Love is powerful. It can be reduced to chemical reactions in the brain or elevated to spiritual phenomenon. Love invites us to be brave and expose our deepest selves. Love can also feel like an unwelcome spotlight that reveals our dirtiest secrets.

We all have them—the parts of ourselves that are weak and afraid at best, disgusting and shameful at worst. We work hard to hide them away so no one ever sees them. We believe that these parts—and ultimately ourselves—don’t deserve compassion. Perhaps we don’t even feel worthy of love itself. What does that mean about our ability to be in a loving relationship with another person?

We often hear that you have to love yourself first to able to love or, worse, be loved. This is a toxic way to view yourself and only reinforces the very fears that keep you hidden in the first place. Your struggle to love yourself does not devalue the love you have to share, nor does it render you unlovable. Your ability to love yourself just changes the way you experience a loving relationship.

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What Does It Mean to Love Yourself?

Loving yourself refers to accepting all parts of yourself, even the ones that bring you discomfort. It means taking care of yourself when despair instructs you to isolate and withhold. It means learning to believe in two seemingly opposing truths at the same time: you are good enough as you are and you have room to grow. Loving yourself is not an unchanging state that you either exist in or don’t. You will have days when you will revel in the chance to be kind and gentle with yourself, and there will be days it will feel like swimming upstream.

When you look at love as something dynamic, as a behavior, as a conscious effort, it becomes more accessible. Loving yourself is not set in stone, but a choice over which you have control. You have the freedom to offer love to yourself and to open yourself up to a new experience of being in love. Here are five ways loving yourself makes your relationships stronger:

1. When you love yourself, you can share yourself with your partner without fear.

When you love yourself, you can recognize your imperfections and refrain from judging them. You know all humans are in a constant state of flux, and that these imperfections are opportunities to evolve. You have nothing to hide and can be honest with your partner about your flaws and how you attend to them. And since you no longer allow shame to cloud your self-image, you can acknowledge your strengths and talents—the very attributes your partner has appreciated all along.

2. When you love yourself, you can trust your partner’s love for you.

When your partner tells you how kind, generous, and attractive you are, you can believe it. Self-doubt won’t prevent you from accepting your partner’s love. You will know that—while you’re not perfect—you have a lot to offer, and it is absolutely believable that someone would value you. You won’t have to be shocked that this person you hold in high esteem regards you as equally amazing. When you allow someone to love you, you reinforce that you are indeed lovable. Loving yourself becomes more than an option; it becomes your right.

3. When you love yourself, you can express your needs without guilt.

Recognizing your own value means recognizing that your needs are just as important as your partner’s. Rather than feeling like a burden or undeserving of attention, you will find the courage to ask for what feels good to you. The more you realize your own worth, the less you will accept others’ disrespect or lack of kindness. Loving yourself means setting healthy boundaries and requiring that others treat you in a way that makes you feel appreciated.

Without shame, doubt, and fear to blind you, you can work together to find a joint resolution that strengthens your commitment and deepens your bond to each other.

4. When you love yourself, you can fight fair.

That’s right. When you love yourself, you can have conflict in a relationship and it won’t feel like the end of the world. You won’t automatically take everything personally, which means less self-blame and anger. Rather than shaming yourself or lashing out at your partner, you’ll be able to take responsibility for your actions in a clear-headed and thoughtful manner. You’ll be able to express your concerns knowing you have the right to be happy and heard. You’ll encourage your partner to understand you, just as you will try to understand them. Without shame, doubt, and fear to blind you, you can work together to find a joint resolution that strengthens your commitment and deepens your bond to each other.

5. When you love yourself, you can be independent from your partner.

When you love yourself, you don’t have to feel insecure about your partner’s life outside of you. When your partner is away, you can still hold onto your own value. Your partner doesn’t exist for your validation and security; they are their own person. You can support the development of your partner’s personal story, and they can support yours. Your partner’s interests and friends won’t be threatening because you believe your partner has reason to come back to you. You recognize that your sphere of control extends only to your own behavior. You can allow for your partner to make their own choices, trusting they will remain mindful of the love you share. You may even find that when you and your partner explore life outside of each other, you reinvigorate the relationship. You get to be curious about each other’s separate experiences of the world and find new reasons to be excited about one another.

To practice loving yourself is to discover the kind of love you wish to receive. Explore what it means to love and to be loved. Understand your needs, your fears, and your strengths. Learn to develop the kind of relationship that suits you best. With a stronger sense of your value, you can offer yourself and your partner the open-hearted, limitless relationship you both deserve. No more hiding, no more shame. Just your authentic, imperfectly perfect self—to be seen, heard, and cherished, just like you’ve always wanted.

More than 50 million students are enrolled in public schools across the United States. Of those, one in five meet the criteria for a mental health condition. About 70-80% of these students won’t receive any kind of treatment or therapy. Because children and adolescents spend most of their time at school, teachers, administrators, school nurses, and other staff are often in a unique position to be the first to identify any problems or issues in a child’s life. Here are some ways for public schools to better address this rising mental health crisis.

Mental Health Screening in Public Schools

Most schools do not have any type of mental health screening in place for students. The National Association on Mental Illness supports mental health screenings for several reasons. Half or more of chronic mental health issues begin at or before age 14. Early identification and treatment can help prevent more serious problems down the road.

Just as screenings are done for a variety of physical health problems, mental health screenings in public schools could greatly benefit vulnerable students. Conducting mental health screenings in schools allows teachers to recognize the warning signs of various mental health issues, allowing for earlier identification and quicker connections to the treatment resources students might need.

The Role of Public School Nurses in Mental Health

While school nurses are usually the most likely to catch any mental health issues early on, many schools only have one on-staff nurse, and many of these nurses only work part-time. It is not uncommon for entire school districts to share one nurse, meaning that one nurse may see hundreds or even thousands of students (depending upon the size of the district). This makes it more unlikely that a school nurse would be able to spot symptoms of mental health issues, as the nurse may not be available or have enough time with each student to address their needs.

According to the American Association of Pediatrics, schools function as the mental health system for approximately 80% of students. For this reason, school nurses play a critical role in identifying problems so they can be treated as soon as possible. Unfortunately, school nurses typically receive little to no training in mental health.

While nurses aren’t expected to be psychologists or therapists, they should be aware of emotional, physical, and behavioral warning signs for common mental health problems. Awareness and recognition of problems as soon as they arise could prevent a suicide.

Integrated Mental Health Strategy in Public Schools

Researchers suggest the best way to help students with mental health issues may be to have teachers, counselors, administrators, and school nurses work together to spot and handle mental health issues. Saddling this responsibility on one teacher or administrator is not likely to be effective because they typically do not have the necessary training or time. On average, school counselors see around 500 students. School nurses may see even more students, especially if they are the only nurse for an entire district. Teachers also see a significant amount of students, ranging from 20-30 in elementary schools to hundreds of students in middle schools and high schools where students change classes and teachers throughout the day.

[fat_widget_left]Integrating mental health care and strategies in public schools can help all staff who encounter students. They will likely be better able to recognize mental health problems and provide early intervention as well as prevention for many issues, including thoughts of suicide, drug and alcohol use, and relationship abuse. To recognize these potential problems, some degree of training in mental health will likely be necessary.

Some signs that a student may be experiencing a mental health condition include:

• Sudden changes in a student’s mood or behavior
• Frequent mood swings
• Behavioral problems such as aggression, temper tantrums, or lashing out in school
• Poor academic performance
• Poor hygiene
• Frequent absences
• No longer participating in extracurricular activities
• Isolation from peers
• Difficulty paying attention in class
• Excessive worrying or anxiety
• Hyperactivity
• Difficulty relating to others
• Somatic complaints (stomachaches, headaches) with no clear physiological cause

Providing Mental Health Services in Public Schools

According to the 2016 Children’s Mental Health Report, young people with access to mental health treatment and services in school are 10 times more likely to seek help for mental health and substance abuse concerns than those who do not have such programs available. Many schools are choosing to address the rising mental health crisis in the public-school system by hiring a professional psychotherapist, counselor, or psychologist on staff. Other schools have therapists come in from community mental health centers to see students who are struggling with mental health issues beyond the guidance counselor’s scope of expertise.

Congresswoman Grace Napolitano is currently working on implementing the Mental Health in Schools Act, which would provide $200 million in funding through competitive grants of $1 million each to 200 public schools across the country. This funding would help them provide on-site licensed mental health professionals in public schools. Napolitano has been executing these programs since 2001 in 14 public schools in her congressional district. This approach has proven successful and will be expanded nationwide through the funding provided by the Substance Abuse and Mental Health Services Administration.

References:

1. Anderson, M. & Cardoza, K. (2016, September 7). A silent epidemic: Our public schools are struggling to handle millions of students with mental health problems. Retrieved from http://apps.npr.org/mental-health/
2. Association for Children’s Mental Health. (n.d.). Problems at school. Retrieved from http://www.acmh-mi.org/get-help/navigating/problems-at-school/
3. Cardoza, K. (2016, September 3). School nurses can be mental health ‘detectives’ but they need help. Retrieved from http://www.npr.org/sections/ed/2016/09/03/478835294/school-nurses-can-be-mental-health-detectives-but-they-need-help
4. Child Mind Institute. (2016). 2016 children’s mental health report. Retrieved from http://childmind.org/report/2016-childrens-mental-health-report/
5. Facts on the Mental Health in Schools Act. (n.d.). Retrieved from http://napolitano.house.gov/resources/additional-resources/mental-health-schools-act/facts-mental-health-schools-act
6. Firth, S. (2015, February 20). Hospitals see alarming increase in suicidal children. Retrieved from http://www.medpagetoday.com/pediatrics/preventivecare/50117
7. National Alliance on Mental Illness. (n.d.). Mental health screening. Retrieved from http://www.nami.org/Learn-More/Public-Policy/Mental-Health-Screening
8. Shefall, A., Asti, L., et al. (2016, September). Suicide in elementary school-aged children and elderly adolescents. doi:10.1542/peds.2016-0436

A common theme in my office lately has been difficulty with assertiveness. Whether it’s breaking off a relationship that’s no longer working, asking for a well-deserved raise, requesting an extension on a project, or setting healthy boundaries with others, many of the people I work with struggle with voicing their needs and advocating for their best interests.

The inability to speak up and ask for want we want often stems from a variety of subconscious fears and/or irrational belief systems. We may be afraid of making others mad or hurt, reluctant to put anyone else out, or terrified of appearing demanding or unreasonable. We tend to hold onto irrational belief systems that tell us we are responsible for the feelings of others. Thus, we avoid making requests that may create any form of discomfort or tension. Sometimes we hold deep-seated attitudes that the needs and wants of others are more important than our own. We ultimately wind up shutting down and remaining silent—in other words, being passive or non-assertive.

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The problem with an inability to be assertive is that it often goes hand-in-hand with low self-esteem. When we are unable to be assertive, we may set into motion a vicious cycle where feelings of unworthiness are reinforced, leaving us even less empowered to stand up and take proper care of our needs. When we are unable to be assertive, we send ourselves a subtle yet powerful message that we are not good or worthy enough. It’s a form of self-belittling that becomes a destructive habit over time. The portrayal of weakness, indecisiveness, or inhibition is also conveyed to others, leaving us more vulnerable to being depreciated or taken advantage of.

As we remain silent in various situations, we may also begin harboring feelings of frustration and anger, leading to a buildup of resentment that results in assertiveness being all the more difficult. Many people find themselves initially unable to speak up, but ultimately reaching a boiling point, after which they cross the line and wind up engaging in aggressive communication or behavior.

When we are able to speak up for ourselves, we set a tone of equality, honesty, and mutual respect. Acting assertively allows us to establish healthy boundaries with others and to improve our chances of fulfilling our needs and meeting our goals.

I tend to view assertiveness on a continuum, with healthy assertion being the middle ground and goal, and non-assertion and aggression being the two opposite-end extremes. Assertiveness training is an important part of the work I do in helping individuals to build self-esteem. One of the most useful and encouraging things to know is that assertiveness is a skill that can be learned, practiced, and improved upon. It is not necessarily an inherent personality trait. Rather, it takes a concentrated effort to develop it.

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In Your Perfect Right: Assertiveness and Equality in Your Life and Relationships (9th edition), Robert Alberti and Michael Emmons define assertive communication as “direct, firm, positive—and when necessary persistent—action intended to promote equality in person-to-person relationships.” They say “assertiveness enables us to act in our own best interests to stand up for ourselves without undue anxiety, to exercise personal rights without denying the rights of others, and to express our feelings honestly and comfortably.”

When we are able to speak up for ourselves, we set a tone of equality, honesty, and mutual respect. Acting assertively allows us to establish healthy boundaries with others and to improve our chances of fulfilling our needs and meeting our goals.

Most importantly, assertiveness helps us to build and maintain healthy self-esteem.

There are always going to be situations where certain assertive messages do not result in the end goal being achieved. You may not get the promotion, extension, appreciation, or respect you are asking for. There will always be challenging, difficult, or abusive people who refuse to embrace your assertiveness or fail to match your level of healthy communication. Don’t be discouraged. The fact you tried to advocate for your desires and needs sends a powerful message that you value and respect yourself enough to speak up.

Remember it does take effort and it may involve some work to challenge the irrational beliefs that stand in your way. But with practice and determination, you can become more assertive, build self-esteem, and experience a more rewarding quality of life.

Reference:

Alberti, R. & Emmons, M. (2008). Your perfect right: Assertiveness and equality in your life and relationships (9^th ed.). Atascadero, CA: Impact Publishers.

Do you ever wonder how happily married couples stay that way? As it turns out, happy couples are pretty much like every other couple. They have heated arguments. They have work stresses. They struggle to raise their kids. Difficult family situations pop up, and often partners don’t see eye to eye. So what sets happily married couples apart? What keeps them relatively happy and satisfied?

One important distinction that sets happily married couples apart from unhappily married couples is a greater capacity for emotional intelligence (EQ) in their relationship. What exactly is emotional intelligence, you ask? It can be defined as being skilled in awareness of your emotions, understanding your emotions and managing your emotions in a wise and empathetic way. Emotions are a powerful force that sets the tone for a marriage, good or bad.

Happy couples apply their emotional intelligence in their daily interactions with each other. They discuss issues in a courteous way. They listen. Their positive interactions outweigh their negative interactions. They tend to express admiration, understanding, and respect for each other.

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There is a feeling that your partner is in your corner, has your back, and will support you no matter what. These characteristics create a positive emotional climate leading to feelings of closeness, intimacy, and greater overall satisfaction and happiness.

The way you feel about your feelings known as meta-emotions affects the way you interact with your partner. If you were taught as a child that negative feelings are bad and you were discouraged from expressing them, you may find yourself minimizing or avoiding conflict as much as possible or you may find yourself denying your feelings and working hard to please others. Uncomfortable negative feelings such as anger, fear, or hurt are useful signals letting you know something is wrong and needs to be attended to. Avoiding these powerful feelings only strengthens their negative impact on you and your relationship, thus making it more difficult to cope when they resurface over and over again.

Make a commitment to acknowledge, understand, and express your emotions without using criticism, blame, or judgment.

Here are a few ways you can raise your emotional intelligence in your relationship:

1. Make friends with your feelings. Identify what you are feeling and what triggered this feeling. Take some time, away from your partner if necessary, to understand what is causing you to feel this way. Is there a history to this feeling? Give yourself permission to feel angry, hurt, or afraid. Your feelings do not define who you are as a person.
2. Calm down. Negative feelings have a way of overwhelming us and clouding our judgment. When flooded with a negative perspective, it is difficult to be objective and look at things in a balanced way. You may find yourself being more critical or defensive than usual. Decrease your tension by taking a break from the problem. Relax your mind and body with activities you enjoy, such as listening to music, reading, walking, or meditating.
3. Turn toward your partner. After you have identified your feelings and returned to a calmer state, you are ready to begin a more productive conversation. Express your needs in an assertive but non-aggressive way. Try to listen to your partner without interrupting. Acknowledge and validate your partner’s feelings. If negative feelings flare up again, take another break from the issue. Do not start a discussion again for anywhere from 20 minutes to 24 hours.

Make a commitment to acknowledge, understand, and express your emotions without using criticism, blame, or judgment. Negative emotions are not the enemy; it’s how they are expressed that can be problematic. When negative emotions come up, take a break, calm down, and then try turning again toward your partner to discuss. Doing so will most likely lead to greater connection and understanding between you, increasing your level of satisfaction and happiness in your relationship.

Reference:

Gottman, J. M., & Silver, N. (2000). The Seven Principles for Making Marriage Work: A Practical Guide from the Country’s Foremost Relationship Expert. New York, NY: Harmony.

Often in my practice, I hear people in conflict about wanting to tell someone something that is true for them, but worrying about hurting the other person’s feelings. This arises regarding needs in romantic relationships, differing opinions with coworkers, and obligation-inducing invitations from acquaintances—from the most intimate to the most impersonal interactions.

We withhold relevant truths about ourselves and our preferences from people we are in relationship with for a litany of reasons: to shield them from pain, to avoid disappointing, to prevent angry reactions and conflict, out of fear of being vulnerable, or out of concern for other potential consequences. There are an infinite number of rationales as to why it may not be easy or enjoyable to speak your truth.

Considering the feelings and well-being of others is crucial. It is the foundation of a democratic, civil, and just society. However, humans can become overly concerned with the feelings of those around them to the detriment of their own welfare and experience. It is possible to be too considerate, too nice.

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There is a difference between sincerely and mindfully attending to the experience of others and your impact on them, and over-functioning in a relationship by trying to remove the unavoidable pain that is part of life for all of us, pain we are all built for.

A psychologically balanced person is someone whose thoughts, feelings, and behaviors are aligned and mirror one another. In order to stay connected to your experience and act upon it, you must at times relay parts of who you are or what you want that may be painful for others to hear and digest. This may be difficult, but the alternative keeps you sheltered in a life that does not truly fit.

While being “nice” and “going along to get along” may keep your life stable and seemingly safe, you may also be imprisoning yourself and those around you. Anytime you block what you know to be true from expressing itself, you shut off key avenues to joy, authenticity, and freedom. This avoidance of the truth can have consequences in the form of addiction, hostility, decreased empathy, chronic stress, loneliness, and apathy, to name a few.

When you withhold important truths, you bar yourself from showing up authentically, from really being known. You prevent what needs to happen next in your life from coming to fruition. A significant byproduct of this is you also hinder others’ access to important information about themselves. When fear or resistance to saying something undesirable wins, you may protect people in the short term, but in the long run you keep them in the dark about things they would be better off knowing. This is because your truth directly impacts what is true for someone in relationship with you.

By finding and expressing what is genuine for you, you clear a path for someone to come closer to their truth. They have the opportunity to see you more fully, know where they stand, and decide how they want to live based on what is accurate and real. You offer them the gift of more information about their own lives. What they do with that information is up to them. Your work is yours; theirs is theirs.

Placing truth at a premium requires holding your own pain without medicating it, denying it, or projecting it onto someone else. You may find experiencing difficult feelings such as sadness, anger, and disappointment actually feels better than trying to fend off these feelings, which can lead to suffering.

To be clear, this is not permission to be mean. This is not a go-ahead to bully, to say nasty things, or to act upon an intention to be hurtful or cruel. This is taking a deep breath and conveying what is honest and accurate for you in a way that respects the experience of the other. It is permission to set yourself free and give others the key to their own freedom—the right to know what is happening in the other half of the relationship.

None of this is a walk in the park. This practice requires the ability to tolerate another’s pain without moving to fix it, own it, or run away from it. It also means dealing with possibly not being liked or not being seen as “good.” It requires having your own voice and self-love be enough. It means acknowledging that two conflicting truths can coexist, and honoring what is yours while respecting another’s.

Placing truth at a premium requires holding your own pain without medicating it, denying it, or projecting it onto someone else. You may find experiencing difficult feelings such as sadness, anger, and disappointment actually feels better than trying to fend off these feelings, which can lead to suffering. When emotions are accepted and felt for what they are, there may be a “clean” factor to the experience. It may be raw, intense, and painful, but afterward it can feel renewing and relieving. Tucking in your feelings and denying “what is” is a conduit to anxiety, shame, and guilt.

Is telling the truth scary as hell? Yes. Does it sometimes put important things in your life at risk? Definitely. Can the truth change everything? Bet on it.

Are there other options for operating in life? Absolutely. However, if you want to live an authentic life and have meaningful relationships, psychological health, and spiritual freedom, organize your life around what is true. With a little tact, telling the truth does not have to amount to being mean or bad; it is simply conveying what is and using your reality as your north star. The more your motives and actions parallel your authenticity, the more you are empowered to create the life you want. You must face pain or disappointment, allow truth to be the ground beneath your feet, and move forward not based upon what you should do, but what you want and need.

Dialectical behavior therapy (DBT) is an evidence-based therapeutic model originally developed by Dr. Marsha Linehan. She found that traditional cognitive behavioral therapies did not always help people who experienced chronic suicidal ideation or symptoms of borderline personality. Since then, DBT has been found to be effective with several other groups of people, including teenagers.

One component of DBT involves group skills training in addition to weekly individual counseling. In the group setting, people can learn and practice skills in a helpful and supportive environment, with active peer feedback. (Individual counseling can then focus on how a person is applying the skills to their own life, as well as process any concerns or issues that pop up over the course of the week.)

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Positive Assumptions for Teens in DBT Group Skills Training

Many people know the playful phrase, “When you assume, you make an ass out of you and me.” Why is this? Because assumptions are unproven beliefs. If you assume wrongly, without taking the time to gather or confirm your assumptions with credible sources, it can hurt relationships. However, assumptions can benefit the therapeutic process when everyone agrees on the same positive assumptions.

The following are DBT’s Treatment Assumptions for Teens in a Skills Training Group. Agreeing to these assumptions is believed to be helpful for teens, their caregivers, and the skills trainers. The idea is to become more accepting, less judgmental, and to think and act more dialectically (one of the core concepts of DBT).

• Everyone in the group is doing the best they can. People are behaving, thinking, and emoting the best way they are capable at this time. It is hoped that, with time and practice, their “best” will improve.
• Everyone in the group wants to improve. People don’t want to stay feeling, behaving, or thinking the way they currently are. As humans, we are always striving to grow and develop in meaningful ways.
• Everyone needs to do better, and be more motivated to change. This assumption goes hand-in-hand with the first two assumptions. While people are doing the best they can and want to improve, they need to do (or behave) better and increase their motivation in order to make these changes.
• People may not have caused all of their problems, but they have to solve them anyway. The phrase “the best-laid plans oft go awry” applies here. If someone rear-ends your car, you may not have caused the accident or be considered “at fault,” but you still need to figure out how you are going to fix your car. The same concept applies to group members’ experiences. Note: For adolescents, given that they are underage, they may need to reach out to supportive adults to help solve problems that are beyond their control or ability to solve on their own.
• The lives of group members are painful as they are currently being lived. The average person experiences many challenges. However, if you consider the experiences that contributed to a group member being recommended and accepted to a DBT skills training group, it would be ridiculous not to consider that life may be extra hard and painful right now.
• Group members must learn and practice new behaviors in all important situations in their lives. It’s always awesome when a group member can master a skill in the therapy or group room. However, if you aren’t taking and using the skills all the other hours of the week you spend outside of these rooms, you aren’t getting the most bang for your buck. This means practicing and discussing your experience using these skills in daily life experiences.
• There is no absolute truth. This is a difficult concept to grasp and live. By valuing the validity of two viewpoints, even when they seem like polar opposites, people can learn to value and respect each other. This is a concept that is often further discussed and practiced when members learn more about how to think and act more dialectically.
• Teens and their family members cannot fail in DBT. This is a radical concept for some people. Often, people in therapy and their families are blamed for not being motivated enough, working hard enough, or trying hard enough. In DBT, blame is not effective (plus, you would never tell someone suffering from a broken bone that isn’t healing properly that they aren’t working hard enough to heal themselves). It may simply be time to consider a different course of treatment if things are not improving, just as an orthopedist may discuss a different treatment if a broken bone is not healing as expected.

If these assumptions make sense to you, and you are interested in enrolling yourself or your teen in DBT skills group therapy, I urge you to talk with your therapist or contact one about options in your community.

Reference:

Rathus, J. H., & Miller, A. L. (2015). DBT Skills Manual for Adolescents. New York, NY: Guilford Press.

One of the most common types of questions I get as a therapist pertains to people wanting to know if they are “normal” in some way. Here’s an exchange I had with a person in therapy recently:

Person: “Well, you’re the expert, so please tell me. I think it’s normal that I’m angry at my husband for cheating. Am I right?”

Me: “Yes, in a sense it is normal that you are angry at him. But we’ve been working through this for many months, and it seems the intensity of your anger has not decreased and you are not just angry at him, but you seem angry about a lot of things in general in your life. I’ve noticed that you get angry often.”

I think people tend to ask if their emotions are “normal” when they suspect that the intensity of their reactions or the frequency of their negative feelings are problematic. I’m not a fan of the word “normal” because, to me, it is a statistical term. It also seems to imply that a large majority of people experience the same thing, and because of this, it must be “healthy.” It is entirely possible many people experience intense emotions on a frequent basis, but that does not mean this is healthy.

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One benchmark of emotional and psychological health is the ability to regulate affect. In other words, if your emotions frequently impact you, or if you find it difficult to let go of negative emotions; reduce the intensity of your emotions; or shift from a negative emotional state (anger, anxiety, etc.) into a positive state (calm, joy, optimism, etc.), then your emotional regulation may not be entirely healthy.

What Causes Emotional Dysregulation?

There are many reasons a person’s emotions may not be well regulated. These can include growing up in a home where the adults did not have good emotion regulation skills, growing up in a family where there was substance abuse, not being taught emotion regulation skills as a child, being raised by parents who were afraid to hold appropriate boundaries, and experiencing trauma.

Research (Thompson & Calkins, 1996; Thompson, Flood, & Lundquist, 1995) shows that children raised in emotionally difficult environments have more difficulties with how they feel later in life. Trauma in either childhood or adulthood can lead to a dysregulation of affect (Seligowski, A. V. et al., 2015). Psychology researcher Allan Shore writes, “A large number of studies now demonstrate that alterations of brain development are associated with less than optimal early maternal care, especially with severe ‘relational trauma’ such as abuse and neglect” (Shore, A., 2011). (Author’s note: Although Shore uses the term “maternal,” it is generally accepted that this is taken to mean the child’s primary caretaker[s], male or female.)

What Does ‘Healthy’ Emotional Regulation Look Like?

Here are examples of emotional reactions I would consider within the range of “healthy”:

• You are frustrated by your toddler who is constantly pouring liquids in various places. You take a deep breath and let the realization set in that he is learning containment and volume. You lovingly direct him to a pouring station you set up on your patio.
• You feel angry, hurt, and betrayed that your husband cheated. After your initial anger subsides a bit, you begin to think about the situation more clearly and realize he has been expressing loneliness in the marriage and you have ignored that. In time, you are able to acknowledge your role in the marital dynamic and feel some empathy for the emptiness that led your husband to seek comfort elsewhere. You know people sometimes make errors in judgment, and you forgive him and work toward rebuilding your relationship. (Or you decide you prefer to part ways, but move past your anger and rebuild your life.)
• You are frustrated by both the person in front of you in the grocery store checkout line who has 50 coupons and the cashier who is much too slow. But you realize not everyone has the same abilities or the same life challenges, and you wait patiently.
• You are anxious about a family member being several hours late to an event, but you assume that more than likely everything is fine and they will call you as soon as they can.
• You are annoyed that your contractor didn’t return your call quickly, but you understand that sometimes people are busy and get overwhelmed. You give him a reasonable amount of time and follow up cordially.
• Your boyfriend breaks up with you. You are hurt and disappointed, but you practice good self-care and remind yourself that you will get over the pain and find a relationship partner who is a better match for you.

What Does ‘Unhealthy’ Emotion Regulation Look Like?

The reactions below indicate you may have trouble regulating your emotions:

• When your toddler pours liquids in various places, you yell at him, tell him he is being a “bad boy,” and punish him somehow.
• When your husband strays, you hold onto your anger for months or even years, unable to forgive. Many things trigger your anger: It comes back in full force when you hear of someone cheating on their spouse, when you see infidelity in a movie, or when your husband does something inconsiderate.
• Irritated, you tell the person in front of you in the checkout line that they are being inconsiderate and holding everyone else up. You tell the cashier to speed things up, too.
• When your family member is several hours late to an event, you call and text the person multiple times. When you do not hear from them, you begin to worry that something horrible has happened, or you become angry at them for being rude.
• When your contractor doesn’t return your call quickly, you leave a message telling him he’s unprofessional and the way he is treating you is unacceptable.
• You are devastated when your boyfriend breaks up with you. You call him several times and angrily insist he meet with you to talk things over. You ask for explanations and beg him to try again. When he refuses, your rage intensifies and you act out.

3 Ways to Improve Your Emotional Health

1. Find the right therapist. If you relate to any of the “unhealthy” reactions above, you may benefit from working with a therapist. In particular, a therapist trained in dialectical behavior therapy (DBT) and psychodynamic therapy would likely be able to help you reduce the intensity of your emotions and improve your emotion regulation skills.

2. Get a DBT workbook. Dialectical behavior therapy has an excellent track record for helping improve emotion regulation skills. Make a commitment to spending 30 minutes a week reading and doing exercises in the workbook for as long as it takes to feel your emotions have moved into the “healthy” range.

3. Practice good self-care. Self-care is immensely important to maintaining emotional wellness. Self-care includes:

• Positive self-talk. Practice self-compassion by talking to yourself in a supportive way—the way you would speak to a good friend experiencing the same issue.
• Getting the sleep you need. For most adults, this ranges between seven and nine hours of uninterrupted sleep each night. If you have difficulty sleeping, read some articles on good sleep habits, and make them part of your evening routine.
• Connecting with others. Good self-care includes spending time with supportive friends.
• Nutrition and exercise. Giving your body the nutrients and energy it needs will help the areas of your brain responsible for emotion regulation to function better.
• Leisure and recreation. Regularly spending time doing activities you find fun can help keep strong emotions at bay.

It’s perfectly normal to feel a range of emotions, and individuals vary in how strong or frequent their emotions are. But when negative feelings are too intense or linger too long, it may affect your health and relationships. By learning emotion regulation skills and practicing good self-care, you may begin to feel more joy and inner peace, and less anxiety, stress, sadness, and anger.

References:

1. Schore, A. N. (2011). Bowlby’s “Environment of evolutionary adaptedness”: Recent studies on the interpersonal neurobiology of attachment and emotional development. Human nature, early experience and the environment of evolutionary adaptedness, ed. D. Narvaez, J. Panksepp, A. Schore, and T. Gleason. New York: Oxford University Press.
2. Seligowski, A. V., Lee, D. J., Bardeen, J. R., & Orcutt, H. K. (2015). Emotion regulation and posttraumatic stress symptoms: A meta-analysis. Cognitive behaviour therapy, 44(2), 87-102.
3. Thompson, R. A., & Calkins, S. D. (1996). The double-edged sword: Emotional regulation for children at risk. Development and Psychopathology, 8(01), 163. doi:10.1017/s0954579400007021
4. Thompson, R. A., Flood, M. F., & Lundquist, L. (1995). Emotional regulation: Its relations to attachment and developmental psychopathology. In Rochester symposium on developmental psychopathology: Emotion, cognition, and representation (Vol. 6, pp. 261-299).