We like to think we are good listeners, but I’m smart enough to know that even I miss things. Being a good listener is more than just allowing the other person to speak and you being nearby. You have to take in what the person is saying and sometimes go deeper. You may have to read between the lines, ask questions, and offer support. You may even have to bite your tongue, resist giving suggestions, and just truly listen, reflect what you are hearing, and ask the person if you understand the situation correctly.

Sometimes, you may be confused as to why the other person is sharing with you. Does he or she want you to just be there and listen? Does he or she want your opinion and help in problem-solving his or her struggle? I can tell you that a lot of us guys are great at coming up with ideas for you, so if this is what you are looking for, you may be in for a treat. But what if you need to just vent? It’s OK to get yourself out of an uncomfortable situation (say, a disagreement at work or with a neighbor), know that is not the time or place to sound off, and find a friend or significant other to bend an ear a bit and blow off some steam.

If you are not looking for advice in those moments, it may be important to share this upfront. “Hey! Can I vent with you a little bit?” you might say. “I had a frustrating day at work. I’m not looking for advice right now, but I could really use your support.” This is a perfect start to the conversation. If I am in a position to just listen, I can best support this person without having to come up with a game plan. If I am confused, I can ask questions and even share how I might feel in that situation: “Wow! That sounds frustrating. I can imagine that was not a comfortable moment.” Not that there is a specific way to respond in every situation, but since I care about the other person, the sharer will know of my concern in being there.

The idea of being mindful can be challenging, though. Buddha noted mindfulness as a key to enlightenment. But it takes practice. When I am present for the sharer, I am not thinking about what I am going to do later in the day or about the meal from earlier. I am in that moment with the person, paying attention to what he or she is experiencing, both in actual words and emotion. Unfortunately, I fear our everyday lives are over-full of activities and stressors, both good and bad. We are constantly being bombarded by stimuli—conversations around us, work expectations, family members’ activities, places to go, people to see, television, radio, game systems, a trillion new phone apps, etc.—all competing for our attention. This makes it too easy to drift in and out of conversations with all the ideas in our minds.

We need to resist the urge to drift away from the person or situation at hand, especially if we want to have meaningful relationships in which we feel supported by others and they feel supported by us. If you find it difficult to remain focused, do some reflection on all that is going on in your life and evaluate if there is too much. If so, perhaps you can cut back on some of those things. Even a few reductions may help you both relax more and find it easier to focus on the moment. Furthermore, tools such as meditation and other relaxation techniques can allow you to give your mind a rest for a bit as well as help you better manage stressful times that can command your attention.

Art therapy is a specialized area of mental health that uses art materials and the creative process to explore emotions, reduce anxiety, increase self-esteem, and resolve other psychological conflicts. The American Art Therapy Association states that art therapy can be an effective mental health treatment for individuals who have experienced depression, trauma, medical illness, and social difficulties. Making art in therapy can be a way to achieve personal insight as well as healing.

There’s more to art therapy than simply “drawing your feelings.” Art therapists are trained to lead people through the creative process in a therapeutic way. Just as your doctor may prescribe a medication or behavioral change to aid your physical healing, your art therapist offers art-based therapy interventions that are tailored to your needs. As with every aspect of therapy, the choice to engage with specific types of materials will ultimately be up to you.

“Art washes from the soul the dust of everyday life.” —Pablo Picasso

In this article, we’ll take a look at some of the top questions people have about art therapy.

Q: Do I need art training or experience to participate in art therapy?

A: No art experience is necessary for you. Your art therapist is highly trained in visual art as well as psychology, and he or she will guide you in the process of creating art using specific types of materials. All you need is a willingness to experiment and explore.

Q: What kind of training should my art therapist have?

A: Art therapy is a profession that requires at least a master’s degree in a program with specific art therapy components.[fat_widget_right]While expressive arts therapists are trained in art therapy, there is also the designation of art therapist whereby the therapist studies only art therapy. There are also associations that offer certification as a supplement to your education, rather than a degree. Many art therapists have an art therapy credential called an ATR that indicates they are registered with the national art therapy credentials board.

Q: What kind of art will I make in art therapy?

A: It depends on your interests as well as the therapeutic benefits of certain types of art for your situation. Art therapy can include a wide range of art materials and processes. Your sessions could potentially include activities such as working with clay, painting, making a mask, creating a visual journal, and assembling a collage. Most often, the focus will be on the process rather than creating a finished art product.

Q: Do I get to keep the artwork that I make in art therapy? Will the art therapist show it to anyone else?

A: Your artwork is your creation and always belongs to you. Some people choose to keep the finished artwork, while others may decide to leave it in the care of the art therapist. Your art therapist will not show your artwork to anyone without your permission. The code of ethics followed by art therapists specifies that an art therapist must safeguard a client’s art creations the same way he/she would protect any other privileged information.

Q: Why are some art materials more appropriate for my situation than others? What does it mean to have an art therapist prescribe an art process for me?

A: Art materials have inherent healing qualities, but some are more appropriate for certain types of situations. For example, there is a therapeutic difference between using colored pencils, which are very dry and controlled, as opposed to watercolor paint, which is extremely wet and difficult to control. Your art therapist has specialized training in assessing which materials to suggest based on the issues you are facing, your frame of mind during the session, and other factors. Art therapists also have an extensive personal background in studio art, making them personally familiar with the use of specific types of art materials so that they can guide you through any difficulties that may arise in the creative process.

Q: Will the art therapist “interpret” my artwork?

A: Art therapists can use a variety of approaches, just as counselors or psychotherapists may utilize different approaches. It is not customary for a therapist to interpret your art. In a humanistic or transpersonal approach to art therapy, the focus will be on the personal meaning that you find within your own creative work, rather than an arbitrary meaning imposed by the therapist. You are the expert on your own artwork and creative process, and the art therapist’s role is to facilitate explorations of your work rather than to analyze or interpret it.

Reference:

Pablo Picasso Quotes—Art as Therapy. (2010, October 10). Retrieved May 6, 2013, from quotes: http://www.arttherapyblog.com/c/art-quotes/#ixzz2SYtZgGua

One of the first signs of schizophrenia is a psychotic episode. Symptoms of psychosis can appear weeks, months, or even years before a psychotic episode requiring medical attention. Because psychotic symptoms can appear suddenly or more subtly, the duration of untreated psychosis (DUP) varies from individual to individual. Likewise, the acute onset or subtle onset of symptoms can also impact whether symptoms become severe (SC) or persist as less severe (NonSC). Schizophrenia can be difficult to treat, but many people who receive care for symptoms are able to achieve remission within the first few months. However, relapse is not uncommon and estimates point to a nearly 75% relapse rate within the first five years of treatment.

Nobuhiso Kanahara of the Department of Psychiatry at the Graduate School of Medicine at Chiba University in Japan wanted to explore how symptom severity, DUP, and mode of onset (MoO) of symptoms, either subtle or acute, affect long-term illness prognosis. To do this, Kanahara conducted a 10-year study involving several hundred participants treated for psychosis at a psychiatric hospital. The participants were assessed at initial intake for symptom severity, MoO and DUP. These factors were evaluated and measured against treatment outcomes and future diagnoses of schizophrenia.

The results revealed that although the DUP did not differ significantly between participants with SC and NonSC participants, those with acute onset had much shorter DUPs than those with more subtle MoOs. Further, those with subtle MoO, although they did not have more severe symptoms than acute MoO participants, did have poorer overall global functioning in the long-term. In other words, the subtle MoO participants had both longer DUPs and poorer illness prognoses than those with acute MoO.

Kanahara believes that acute and sudden psychosis can lead to more prompt medical attention and therefore, better treatment outcome. Individuals with more insidious MoO, on the other hand, may have symptoms that go unnoticed for a long period of time. In fact, in this study, the DUP for MoO was over three years at its longest, suggesting a chronic psychotic state than can lead to poorer overall outcomes.

Kanahara said, “Taken together, these results indicate that the initial positive symptoms do not act definitively as a prognosis predictor.” However, DUP and MoO appear to be strong indicators of overall illness outcome and therefore, should be examined more closely in clinical assessments and trials.

Reference:
Kanahara, N., Yoshida, T., Oda, Y., Yamanaka, H., Moriyama, T., et al. (2013). Onset pattern and long-term prognosis in schizophrenia: 10-year longitudinal follow-up study. PLoS ONE 8(6): e67273. doi:10.1371/journal.pone.0067273

With gay rights making big advances, more gay couples are coming forth to dismantle the stereotype that their relationships are superficial and brief. The truth is they can be just as committed and loving as heterosexual ones. They can also have the same types of conflict: family, finances, household chores, parenting, and so on. Any two people trying to live together are going to run into disagreements. There are a few things, however, that are unique to same-sex couples.

One of the most difficult aspects for same-sex couples can be keeping a boundary between lovers and friends. In a heterosexual relationship, the boundaries are clearly marked by sex: A man may spend a “night out with the boys” without engendering feelings of insecurity in his partner. Likewise, a woman could go to a bridal shower with no concerns on the part of her husband. Should he want to have dinner with an ex-girlfriend, however, or if her workout trainer is a man, there may be some tension.

In gay relationships, there is no such division—most friends and exes are of the same sex as the couple. They also tend to share the same friendship circle. It would be weird, therefore, if one half of the couple socialized with their friends while the other stayed home. In fact, exes are often part of the friendship circle, making it even more awkward.

There is no one way to handle this situation, but as it is healthy for every couple to spend some time apart, it would be wise to agree to some rules at the beginning of the relationship. For example, if one partner was friends with “Kelly” long before the couple got together, it might be agreed that occasional get-togethers with just the two of them would be OK. Or maybe the rule is no attending parties alone if an ex is going to be there. Better still, discuss underlying fears and where they are coming from long before the situation arises. Remember, though, that it is not useful to get angry or make light of your partner’s fears. Defensiveness tends to exacerbate the fear. Make sure they feel heard, and that you respect what they are saying before you start reassuring. It goes without saying—but I’m going to say it anyway—you shouldn’t add fuel to the fire by staying out until early morning or talking with your friend several times a day.

Another issue unique to same-sex couples is that each partner may be at a different level of comfort with being “out.” One partner may be comfortable with holding hands or kissing in public. The other may not be there yet, or may have more fears about negative repercussions. In this scenario, it is good to remember that each person is entitled to develop in his/her own way. Pushing your partner to be at your level is unfair and insensitive. If it is a major area of conflict, it might be helpful to see a therapist to gain understanding of each other’s viewpoints and find a place of compromise.

The above issue can be particularly tough when it comes to family. Many stories have been written about in-law troubles, but in same-sex couples there is an additional layer of conflict. It may be that one partner is not yet out to his or her parents, which puts the other in an awkward position. Or perhaps they are out, but the parents are not accepting. Again, very uncomfortable. Does she go to dinner there alone? Does he refuse to see his family if they don’t accept his partner? Because each person, couple, and situation is unique, the answers have to be worked out by each individual couple. However, there are better ways to address this than to make your partner choose between his/her parents and you.

While it is hard not to feel hurt when your partner seems to be taking his or her parents’ side, try to remember that your boyfriend or girlfriend probably has imperfect parents just like everyone else and that there are issues leftover from childhood. Also, everyone feels the family bond (or lack thereof) differently. I would say that attitude is a big factor here: Is your partner willing to admit that there may need to be some changes made, or does he or she refuse to even discuss the matter? Does he or she acknowledge your feelings, or does he or she get defensive? Does he or she rationalize and say, “We only have to see them twice a year”? If you really feel you are being left out in the cold, there may be more going wrong in the relationship than just in-laws and you might have to take a closer look at the whole picture.

When it comes to relationships, a certain amount of conflict is normal. How you handle it, however, is what makes the difference between a healthy, lasting relationship and one that ends bitterly. Being aware of potential issues, and talking them over before they get too heated, is one way to keep trouble to a minimum.

Last weekend I went to see the musical Wicked and found myself thinking about perception and self-acceptance. The show, based on a book of the same title, is the story of The Wizard of Oz as told from the perspective of Elphaba, the wicked witch of the west. From the beginning, the reimagining of this story questions the power of how we see things, and what happens when that perception is shifted. Our heroine is now the vilified underdog who was born with green skin instead of the sweet, young girl from Kansas.

In the play, the wizard himself speaks at great length about the power of perception. He acknowledges that the only power he really has is that other people believe he is powerful. His entire identity relies on the power of perception. The film version of the wizard is exposed by Toto to be just a man behind a curtain. Fallible and even a little bit tacky, his identity is based not on an internal sense of who he is, but on how others see him. When we actually meet the great and powerful Oz, he feels inauthentic.

We all have inside of us a “person behind the curtain.” For some, it’s an internal voice that doles out judgments aimed at others or internally at ourselves. From behind the curtain, we watch to see how people see us and if it matches the version of ourselves we want to put out into the world. Our internal wizard feeds on fear and anxiety. What will people think? How do I compare to others? It can be exhausting, working so hard to not feel rejection or judgment. In all of the hustle and bustle, it’s easy to lose track of our authentic selves.

The practice of radical self-acceptance provides an alternative perspective from which to view ourselves. It’s a way to interrupt the voice of self-judgment that comes from the “person behind the curtain.” Clinical psychologist Tara Brach writes that “wanting and fearing are natural energies. … But when they become the core of our identity, we lose sight of the fullness of our being.” (2003, p. 20) Brach points out that having feelings or fear, anxiety, jealousy, and envy is natural; it’s part of being human. Experiencing these feelings is not something that we need to be ashamed of. In fact, when we judge them and try to push them away, we can become stuck in a cycle of self-judgment. From a perspective of radical acceptance, internalizing these feelings into our identity can inhibit our ability to fully be ourselves, our ability to be authentic.

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In the story of Wicked, Elphaba spends her life as an outcast because of her green skin. This experience of suffering impacts her view of the world and who she grows up to be. Because of her differences, Elphaba cannot live behind a curtain as easily as the wizard. By accepting herself and the things that have happened to her, she is an example of the practice of radical acceptance. Elphaba never tries to be perfect or to be someone who everyone likes; instead, she tries to be her whole self.

Accepting our whole selves is not a cop-out to justify not making changes in our lives. Carl Rogers points out, “The curious paradox is that when I accept myself just as I am, then I can change.” (p. 38) The act of acceptance is a powerful one, and a difficult one. The practice of radical self-acceptance acknowledges and holds lovingly our whole selves. This includes the parts of us that we don’t like, the parts that we’re ashamed of, and the parts that we don’t want to share with others. What if it were OK that we’re not perfect? What if we strove instead to be whole?

How a story is told changes the meaning of what we hear. In Wicked, we’re asked to see things from a different perspective, and we learn things about the villain in the story that change everything. Suddenly, good and bad are harder to determine. Real life is like that, too; it can be messy, murky, and beautiful all at the same time. In our own lives, we are the authors of the story. We get to decide how we want to see ourselves. Challenging our self-judgments and accepting all parts of ourselves can help us stay connected to our own authenticity.

Reference:

Brach, T. (2003). Radical acceptance: Embracing your life with the heart of a buddha. New York: Bantam Bell.

According to a new study led by Panayotes Demakakos of the Department of Epidemiology and Public Health at University College London, older people with depression walk slower than their peers who do not have depression. Gait speed, or the speed that a person walks, is influenced by a host of factors, including physical ability, range of motion, musculoskeletal health, and mental health. Although there has been some evidence that psychological conditions can affect gait by way of diminished physical health, there is little research focused on examining a direct link between gait speed and psychological health, and in particular, depression.

Demakakos wanted to explore how depression and gait speed were related and also to evaluate whether their influence was bidirectional. In particular, Demakakos wanted to find out if older individuals with depression had slower gait speeds than those without, and if slow gait speeds predicted depression in older individuals.

Using a sample of 4,581 individuals over age 60, Demakakos measured depressive symptoms and gait speed across a six-year period. The results revealed that people with slow gait speeds had a higher risk of developing depression in the two years following assessment than those with average gait speeds. Further, Demakakos also discovered that depressive symptoms were directly linked to slow gait speeds.

The results can be interpreted in many ways. First, as people age, they experience declines in physical health and mobility. These factors can decrease gait speed and by limiting physical ability, can eventually erode mental well-being and put people at risk for depression. Second, as depressive symptoms increase, physical mobility can become impaired, pain can increase and fatigue can set in, all of which combine to decrease walking speed.

The results presented here were consistent even after demographic factors such as marital status, socioeconomic status, and gender were taken into consideration. In sum, this study shows that gait speed could act as an early indicator for depression. Demakakos added, “These findings point to depression as a modifiable risk that needs to be targeted by disability prevention programs at older ages.”

Reference:
Demakakos, P., Cooper, R., Hamer, M., de Oliveira, C., Hardy, R., et al. (2013). The bidirectional association between depressive symptoms and gait speed: Evidence from the English Longitudinal Study of Ageing (ELSA). PLoS ONE 8(7): e68632. doi:10.1371/journal.pone.0068632

“Paradoxically, the ability to be alone is the condition for the ability to love.” – Eric Fromm, The Art of Loving

Self-Nurture through Self-Mirroring

Finding a way to emotionally take care of ourselves when we are alone is an individual process of self-discovery. One way to truthfully see ourselves is through collage therapy. Collage therapy is a simple form of art therapy that does not require drawing or painting. It can help you see your inner life in a fresh way. We all project personal meaning onto everything we see. If we are having trouble verbalizing what we are feeling, we can mirror our emotions through spontaneous collage.

Choosing imagery spontaneously, and then seeing what feelings and ideas arise, can incite new understanding about what you unconsciously believe about yourself and how you feel about your life. Whenever you feel strong feelings that you do not fully understand, take a few moments to spontaneously choose some imagery from an old magazine. Cut out and glue your pictures down without much thought. Then take a few minutes to contemplate what you have chosen.

The Loneliness of Individuation

As we learn to express ourselves more authentically, our particularity asserts itself into our life, and we may begin to feel misunderstood by those around us. Many years ago, I put together a spontaneous collage about loneliness when I was discovering my true life path. At the time, I was discovering new strengths and gifts inside of myself and I excitedly tried to share my newly discovered authenticity with the people in my life. But few at the time seemed to understand what I was going through. I was mistakenly looking outside of myself to be mirrored for my inner truths.

I was not yet devoted to mirroring myself to myself. I was still looking for validation from the outside. I was still looking for other people to help me feel good about myself. Sitting alone with ourselves is not always easy. Difficult emotions that we do not want to feel tend to come into our awareness when we are quiet and alone. We can mistake these uncomfortable feelings as loneliness instead of seeing the emotional awareness that is trying to rise. It is during such times of emotional discomfort that is becomes easy to fall into unhealthy distractions. Thinking we are lonely, we may want to spend time with people in ways that are not healthy or meaningful to divert our attention away from what feels emotionally uncomfortable inside.

Instead of spending time in ways that are merely distracting us from what we feel, we could turn towards our inner strength and creativity during our alone time instead. Being alone is a fruitful time to tend to our emotions in order to understand how we feel on a more truthful level. When we start to see our deeper thoughts and feelings more carefully—in the outer projection of our collage—we realize that we have a distinctiveness that wants to reveal itself. We consider that we may never be able to rely on other people to know the total depths of who we are, but we can choose to know ourselves profoundly. When we realize that we need to do our own inner work, without insisting on validation from others, we may begin to feel lonely.

Strength in Loneliness

As we become more authentically expressive and self-examining of all our feelings, we might find that some of the relationships we have been hiding in no longer support our fullest self-expression. Some people do not leave unhealthy relationships because they fear loneliness more that they fear abuse. If we have felt abandoned, shunned, or ignored for expressing our true feelings as children, the loneliness of true self-expression can be a primal place of fear. The genuine loneliness of authenticity can feel piercing to the core when we have received little validation for how we felt in the past.

Our authentic self-expression can feel like it is the exact place where we have not been loved in the past, yet it is this very place where we need to learn how to love ourselves. As we progressively delve into our uniqueness, however, we grow to understand that we can find self-love and emotional strength in the aloneness of our unique personhood. As we become more honest about expressing the truth of our feelings, the fear of not being loved and accepted can intensify at first. But it is in our most alone places, when we are willing to stay in supportive witness to our arising truths, that we can find the love we crave.

Emotional Self-Connection Heals Loneliness

It is our own emotional self-connection that heals loneliness. We can be surrounded by people, but if we are not authentically expressing who we are, we will feel lonely. When we feel authentically connected to ourselves, we feel connected with others. When we begin to know who we truly are, we can reach out for help in ways that are healing instead of hindering to our emotional growth. We can start to build a support system that can help us further develop into our unique strengths in the world.

We can extend ourselves in healthy ways towards genuine friendships with people on similar life paths. When we are in touch with our deeper truths we will start to gravitate towards people who nurture their own unique personhood and who respect our individuality. As we come to know how to soothe our painful feelings without demanding that other people do it for us, we deepen into a self-nurturance that is kind and mature. We can choose to become deeply present to our emotional life. As we tend to our own emotional needs, we discover the warmth and abiding friendship of the true self.

People often tell me that they have problems maintaining calm and respectful communication with their partner even though they intended to. They start out fine, but can’t follow through when their partner responds in disrespectful or angry ways. Some of these couples need the presence of an experienced couples therapist to be able to maintain calm and repair disruptions.

This article offers a communication model that outlines how to practice maintaining communication regarding how you feel in an honest and open way while keeping your calm. This is not about feeling good or even comfortable. This is about practicing staying calm even though you feel hurt and angry.

The rationale for this is having a fuller understanding of each other’s perspectives. Feeling angry doesn’t necessarily mean that you are bound to break up. It means that there is something you need to take care of.

If you manage to find solutions together, you will feel closer, safer, and understood on a deeper level. Imagine explaining to your partner that you are hurt and angry in a calm way. Also, imagine that your partner is able to hear you and respond in a loving way.

Because it is easier to express positive feelings and talk about what’s right in your relationship, I will recommend that you start with five positive statements about yourself, your partner, and your relationship. Build from the following, if you like:

1. What do you love about your partner?
2. What do you love about the relationship?
3. What is most important to you?
4. Give a concrete example of what makes you feel loved.
5. Give a concrete example of what you look forward to.

Expressing your love, appreciation, and willingness to stay connected and find solutions together is essential for your partner’s willingness to hear you out and consider your requests and proposed solutions to problems you are having.

[fat_widget_left]Expressing feelings of frustration, anger, fear, and sadness is a lot harder and takes some consideration. If you are able to stay calm and collected while you talk about your feelings, your chances of staying on track are higher. If you avoid blaming your partner and instead talk about what you feel, think, and what is important to you and why, it is more likely that your partner will respond positively.

Try to make it easier for your partner to listen to you and refrain from interrupting you and subsequently defending herself/himself. Try to make your statements more about yourself than about your partner. This is probably one of the hardest things to do. Self-expression is about defining yourself and what is most important to you, which is not easy when you are feeling upset and hurt.

It is natural in a relationship to feel at times that the other person is to blame. However, if you consider the matter, you will become aware that you have a responsibility for your own responses and reactions, and how you function as a partner has an influence on the relationship. Your feelings are your own, and to blame others for them is not conductive for your individual or relationship growth.

Before you start expressing feelings of anger and hurt, I recommend that you think about what you are going to say and how you are going to say it. Consider the following:

1. What are your feelings? Do you feel angry, hurt, sad, scared, lonely, jealous, guilty, etc.?
2. Give concrete examples such as, “I feel scared when you don’t call.”
3. Focus more on what you feel, think, and want, not on your partner’s shortcomings. “I feel lonely and I miss what we used to do together.”
4. Tell your partner why it is important to you that you honestly and openly express your feelings. Make sure you explain that self-expression goes both ways, and that it takes courage to talk about feeling vulnerable. Showing vulnerabilities is a sign of strength, and talking openly and honestly about how you feel is not a weakness.
5. Be mindful of how you express yourself. Tone of voice, facial expressions, body language, and eye contact are more important than most people think. Most of what you actually communicate to your partner has to do with how you communicate.
6. Be open and explicit about your intentions for having the conversation.
7. Make sure you are not having this conversation to get back at your partner. If you are very angry, you might feel vengeful. If that is the case, calm yourself and consider what is most important to you and what kind of partner you would like to be.

Don’t expect immediate success. Self-expression is a skill which takes practice to master. Ask for professional help if you need to.

An old high school classmate posed the question on his Facebook feed a few days ago: “Should we friend our exes on Facebook or is it equivalent to cheating?” Since couples therapy is my specialty, I was itching to think more about the question and posted a reply to his feed. The responses from others ran the gamut from “You should never friend a former lover!” to “Why not if your current relationship is a trusting one?” A couple of people openly confided in my high school buddy’s feed that Facebook aided infidelity and led to the demise of their marriage. One was the cheater, the other the “cheatee.” I was quite impressed with their candor and gut-wrenching vulnerability—both of them.

What are my thoughts on the question to friend or not to friend? In general, I am not black and white about espousing “rules to live by,” so know that first about my personality as a therapist. But I do think there are some things we can think about together in this article and you can think about with your partner later. Use this article as a conversation starter if you need help.

1. Is Facebook replacing any kind of hole inside of you? You may be longing for some attention, longing to feel like you matter, and it may be outside of your awareness. Or you may know you want something but won’t ask for it from your partner. It is good to know fully that, “Yes, I want more attention,” so that you aren’t easily seduced into mistaking the attention of a former lover on Facebook as the remedy to a more common longing we human animals all feel from time to time—loneliness. The antidote is to talk it over with your partner. “I miss you.” “I want more attention.”
2. Are you able to be honest in your relationship? A colleague of mine, Julia Flood, wrote a great piece on what she calls “liars” and “lie invitees.” Couples unwittingly set the stage for cheating when they block truth telling. Sweeping things under the carpet/conflict avoidance, exploding in response to truth, and suffocating our partner are all deterrents to telling hard truths, such as “I feel mad and hurt when I am the only one managing our budget,” or, “Your drinking worries me,” or, “We aren’t having sex and I want to talk about how to reignite passion.” Being in a relationship is hard, and telling the truth makes you vulnerable, but not telling the truth can create the perfect agar for Facebook’s “ex accessibility factor” luring one into a potential danger zone. Both partners are involved in creating a ripe atmosphere for honesty.
3. Do you lead a purpose-driven life? In the early stages of love, we are intoxicated by love hormones of dopamine and norepinephrine … and then they wear off and are replaced by the cozy oxytocin hormones, and somewhere around two years we can get bored. Believing our relationship has lost its staying power, we might seek comfort by seeking out a “new” other to get that high back. All couples eventually reach a natural developmental phase of comfort, but the shift in romantic excitement does not spell impending doom. Unfortunately, romantic love has become so idealized in our culture that people get religious about pursuing it, says Robert Johnson in his book, WE. We may get addicted to this dopamine high or have misinformation about the natural rhythm of long-term relationships and start trolling Facebook to get our “fix” and find ourselves flirting with an ex. Esther Perel, in her book Mating in Captivity, encourages individuals to lead a life of personal fulfillment and purpose and have enough space between you and your partner that you can see your partner set ablaze by his or her life. Watching our partners in the act of doing something they are taking personal fulfillment in is the ultimate aphrodisiac.
4. What did you learn about love and sexual desire growing up? Stella Resnick does a nice job of laying out how and why we often don’t lust after those we love and often can’t love those we lust after in her book, The Heart of Desire. She says, “In my view, the love-lust dilemma is not an inherent aspect of human sexuality but rather an artifact of a society that unwittingly primes us from childhood through adulthood to separate love from sexual desire” (Resnik, 9). If that is the case, then Facebook becomes an easy way to find someone to be “in lust” with and avoid repairing that societal wounding we might carry about love and sex.
5. Is it OK for you and your partner to be different? The Couples Institute in Menlo Park, California, and many couples-therapist masters, such as David Schnarch, Esther Perel, and Terry Real, are proponents of not replacing the two individuals in relationship with a “big ball of we.” If we can freely express and listen to our differences and appreciate what makes us and our partners tick, with curiosity and a little humor there is a chance for both closeness and individuality—and that sustains interest in each other over the long haul. Our partner isn’t meant to be “everything” to us. It would be nice if our partners read our mind or could always clean the bathroom sink the way we do. It harkens back to our early childhood when our parents tended to every need without us having to ask. That brain circuitry from childhood gets lit up in romantic love, and we pull for our partner to be “the perfect parent” to us. Parentifying our partner usually happens unconsciously, and then we get enraged when they aren’t perfect at the gig or don’t want to play. It is hard to rewire that circuitry and to look and see that standing in front of us is just another human who is different than us whom we have chosen to be in relationship with over the long haul as an adult, not a child. Facebook is such an attractive way to not have to complete this necessary development of individuating from our partner. Couples therapy helps us embrace our partner’s humanity and our own in this “differentiated” way so we can continue our journey as a couple without the Facebook bait.

Long-term romantic relationships make demands on us as human animals to grow and complete some developmental stalemates from our younger life. We never had to grow past these when marriage was about duty. This new era of coupling for love necessitates learning some relating skills often picked up from a good couples therapist. With a solid relationship foundation, Facebook flirting stands a distant second place to the vitality of an honest relationship.

References:

1. Flood, Julia (2013). The Truth About Lies. [ONLINE] Available at: http://www.psychedinsanfrancisco.blogspot.com/2013/01/the-truth-about-lies.html. Last accessed 8 July 2013.
2. Johnson, Robert A., (2009). WE: Understanding the Psychology of Romantic Love. 2nd ed. USA: HarperOne.
3. Perel, Esther, (2007). Mating in Captivity. 1st ed. USA: Harper Perennial.
4. Resnick, Stella, (2012). The Heart of Desire Keys to the Pleasures of Love. 1st ed. New Jersey: John Wiley & Sons, Inc.

If you walked in on your partner masturbating, what do you think you would feel? Most people don’t ask themselves this question until it happens. They may assume that their partner has no need to masturbate because they believe they have a “healthy” sex life, while others avoid the thought of their partner masturbating because it may lead to other questions: Who is the person thinking about? What is he or she looking at?

Have you asked yourself what is healthy and unhealthy regarding masturbation in your relationship? Do you and your partner even discuss masturbation? Some couples wonder whether masturbation can hurt their relationship. Other couples don’t even discuss the topic.

Here are five ways masturbation could, in fact, hurt your relationship:

1. You are looking forward to masturbating more than being with your partner.

Your partner could feel neglected or not desired if you prefer to masturbate rather than sexually connect with him or her.

2. You masturbate to the point of self-injury.

If you are at the point of self-injury, you may be experiencing compulsive masturbation, which can lead to other challenges in your relationship.

3. You feel shame regarding your masturbation.

Shame can present itself because of religious/spiritual beliefs, media messages, or family views. It can lead to secrecy or even maintaining a double life of sorts around your sexual behavior.

4. It interferes with work.

People who use masturbation as a coping mechanism for stress may masturbate privately at work. Aside from possible ramifications professionally, this can lead to other possible unhealthy stress-management behaviors. If you are turning to non-relational relief as a form of dealing with stress versus relational relief, you may be inclined to hold in difficult feelings and not share them with the people who care about you most.

5. You tried unsuccessfully to decrease or stop masturbating.

One of the criteria for addictive behaviors is an unsuccessful attempt to stop the behavior. Masturbation may increase in frequency, and you may feel helpless to stop. You may want to consult a professional if you relate with this.

These points are not about whether masturbation itself is healthy or unhealthy, but rather when it could potentially damage the relationship. Either together or with the help of a therapist, couples should discuss their views on masturbation in their relationship and come to an agreement that both parties feel comfortable with.

If you think you are engaging in addictive behaviors, consult a trained professional who has experience working with sexually compulsive behaviors.

When parental involvement is limited, children typically receive scant mirroring or encouragement. They have no one reflecting back to them that they are worthwhile, admirable, or interesting. When parents are over-involved, their excessive control over how their children define themselves in the world provides few opportunities for the child to self-reflect and have his or her own positive thoughts and feelings. In both cases, the development of self-confidence and self-esteem are compromised.

At the age of 25, “Carol” came to therapy feeling depressed and anxious. She had little sense of what she wanted for herself in life and no belief that if she knew what she wanted, she had what it took to get it. She had been a sociology major in college and was now working as a salesperson in a women’s clothing boutique; she had a few girlfriends and dated very occasionally. Tearfully, Carol told me, “I am so unhappy. I look around and see other people my age having fun, loving their jobs, feeling good about themselves. I feel like such a nothing. I don’t have a clue about what I want to be when I grow up. I’m scared to death when I go on a date that the guy will find me stupid and boring. I feel so awkward and uncomfortable around people.”

I asked Carol about her family. “My parents were divorced when I was 8,” she said. “My father remarried a year later, and I lived with my mother. I saw my father and his wife every other weekend at first and then less and less. My mother never remarried, but she was married to her job. I didn’t see her much since she always seemed to be working. I had a lot of babysitters when I was young. I had no siblings and was by myself a lot. Maybe from middle school on, I didn’t have many friends, so I would just go home by myself and watch TV. I was an average student, but really, I guess I was apathetic. Sometimes I think I’m smart; I don’t know. I didn’t care much about anything.”

Sounding sad and angry, Carol continued: “As long as I went to school and got Bs and Cs, my mother didn’t say much. She never helped me with my homework. She never asked me about my life. She was cheery and not mean, but not very involved. My father became mostly a phone call. He paid for my college but was totally uninvolved. I talked to the guidance counselor and chose a bunch of colleges to apply to, but really, I didn’t care much. I was kind of scared to go away on my own, but I never told anyone. I got through college OK, but it wasn’t any different than life before. I had a couple of friends, but I didn’t get involved much. I don’t know what else to tell you. There really isn’t much of interest about me or my life.”

“Sally” was also an only child who, unlike Carol, had parents who doted on her. She was a high achiever in school, which earned her substantial praise and admiration from her parents. When Sally came to therapy at age 23, she, too, was depressed and anxious. When I asked Sally to describe her family, she told me, “I have a very close relationship with my parents. I love them so much and rely on them for everything. They are always there with their ideas and opinions and suggestions. It’s very confusing to me that I feel so miserable so much of the time. My parents are such cheerleaders for me; I don’t know why I don’t feel better about myself.”

Over the many months that Sally and I explored her negative feelings about herself and her lack of self-confidence, a pattern of relationship between Sally and her parents began to emerge. It was quite clear that Sally’s parents were very engaged with her life and always had been. Sally related, “When I was in elementary school, my parents would simply beam when I told them my grades or the compliments I got from teachers. They were very hands-on. When I wanted to take music lessons, my mother, a musician herself, discouraged me, saying that it wasn’t something I really excelled at, so why bother—it would only make me feel second rate. They had definite ideas about what I should do and guided me about everything. When I wanted to join the swim team, my father convinced me it wasn’t a good idea because I wasn’t a top-notch swimmer. I remember feeling a little badly, but I figured he knew best.”

Sounding proud of her parents’ involvement, Carol told me, “Both my parents helped me plan my college education. They chose the college, and we all agreed that I would go on to law school after graduation. Somewhere in college, I started to get depressed and I couldn’t think about law school. I would tell them I was feeling down, and they would say how that didn’t make sense, that I had so much going for me. I know they wanted what’s best for me. I really didn’t want to go to law school when I graduated, but they told me it was foolish, I would make a great lawyer. I didn’t think so, but it’s so confusing because I’m clueless about what I do want to do. I have no real idea of who I am. I am my parents’ daughter, but I guess I don’t feel like my own person.”

Both Carol and Sally experienced severe low self-esteem and lack of self-confidence. For Carol, the emotional absence of her parents from her life, and the minimal appreciation and recognition they offered, contributed significantly to her inability to develop a separate self with feelings of value and confidence. Without the experience of parents responding to a child’s spirit and achievements (whether taking first steps, laughing at their jokes, making a diorama, or going on a first date), children are deprived of the building blocks for self-confidence and self-esteem. To feel “I can do it,” or even more important, “You are proud, pleased, and delighted with me,” is a crucial experience that Carol never had.

A parent’s pleasure at a child’s achievements and with the person becomes a platform from which a child ventures out into the world with the knowledge that he or she will be OK. Sally’s parents seemed to convey a total belief in her ability to be successful in the world. Or did they? Sally’s experiences and choices in the world were overseen by her parents, who communicated they always knew what was right for her. Feeling protective, they tried to eliminate anything that might cause Sally frustration or feelings of being less than excellent. However, they never gave her the emotional space to make her own choices, to make mistakes, and to learn that she was resilient. The only way she knew how to assess and think about who she was and how she was doing in the world required reliance on her parents’ view of her. As Sally and I talked, it was clear that she couldn’t rely on herself or her peers in decision making, or even to feel good about herself. It was not surprising that Sally hadn’t developed the ability to think about herself as an individual separate from her parents or to know what she wanted to do with her life.

For both Carol and Sally, talking in therapy opened up new possibilities for thinking about self. Carol became aware of her anger toward her parents and realized that blaming them was keeping her from taking charge of herself in the world. After expressing much resentment and sadness about the experiences she missed out on since childhood, Carol started to push herself and risked trying new things. Even though it made her anxious, she went online and began dating. She decided to try and reconnect with people who were “almost” friends in college. She started to talk to me about taking some courses to explore some possible career paths. It was scary, and each step caused great anxiety. But each success added to her feelings of self-worth and self-confidence.

Sally started to recognize that she had been idealizing her parents and is slowly becoming more comfortable with seeing them as humans with frailties. This allows her to accept her own lack of perfection and tolerate the frustration of trying new things and not easily succeeding at them. She has been calling her parents less frequently and risking making decisions on her own. She has also been sharing more with friends, something she didn’t do in the past. She is clear she doesn’t want to go to law school and has been considering going back to school to become a teacher.

The self-esteem and self-confidence of both women were affected by the over- and under-involvement of their parents. While it helps that children know their parents are there to support them practically and emotionally, parents also need to be comfortable stepping back to allow their children to make decisions, struggle, fail, and succeed. This balance between providing support and giving children the freedom to discover their own individual desires, strengths, and weaknesses is the basis of how children develop self-confidence and self-esteem.

Research has shown that people with attention deficit hyperactivity (ADHD) have cognitive and functioning deficits. They often have high levels of impulsivity and low levels of task attention. These deficits can result in social, personal, and academic difficulties. In the study of ADHD, numerous strategies have been tested to improve attention and decrease impulsivity. Among them are behavioral and cognitive approaches, some of which have been shown to be successful.

But an existing theory at the core of ADHD research is that of reward motivation, which suggests that people with ADHD respond better and demonstrate less impulsivity and more attention when rewarded compared to when there is no reward for a task. To test this theory further, Ivo Marx of the Department of Psychiatry and Psychotherapy at the University of Rostock in Germany recently recruited 38 adults with ADHD and 40 without ADHD for a controlled experiment. In the experiment, the participants underwent a battery of cognitive tests with and without rewards. The response times, false positives, impulsivity rates, and overall performances were measured and compared.

Marx found that the individuals with ADHD exhibited higher levels of impulsivity and lower levels of attention when there was no reward present. However, when a reward was offered, they were less impulsive and their outcomes had fewer false positives. In other words, their performance was better and far improved in the presence of a reward. In fact, the participants with ADHD performed similarly to those without ADHD when they were motivated by a reward.

Marx believes that these findings, which are in line with existing research, underscore the importance of reward motivation for people who tend to be impulsive. The results suggest that perhaps being motivated by a reward encourages individuals with ADHD to slow down their reaction times and engage a “stop-and-think” strategy. Additionally, these results show the importance of such a strategy for improving outcomes for cognitive tasks. This could be extremely useful at helping ADHD individuals improve their cognitive outcomes in various settings, including personal, academic and professional arenas. Marx added, “Taken together, our results support the existence of both cognitive and motivational mechanisms for the disorder, which is in line with current models of ADHD.”

Reference:
Marx, I., Höpcke, C., Berger, C., Wandschneider, R., Herpertz, S.C. (2013). The impact of financial reward contingencies on cognitive function profiles in adult ADHD. PLoS ONE 8(6): e67002. doi:10.1371/journal.pone.0067002