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Instruct: My issue isn't resisting angry urges; it's the anger itself. My rage is extreme and vastly disproportionate to the direct stressor. It causes violent thoughts, but I never act. I stay lucid enough to know the rage is violent, not me. I don't want to drown myself in anger and resentment. Output: Knowing how you feel and also being able to stabilize yourself to act upon the tremendous anger you feel, are fine qualities.Anger, whatever the magnitude, generally reflects emotional pain that has not yet been placed into words.Try thinking over your growing up years because maybe you will discover certain repeated dynamics which upset you and that no one helped you feel secure through such times.Also, if either of your parents drank too much and raged when they were drunk, you may be repeating their patterns of how to respond to situations.   Even without drinking, the response patterns of yelling and throwing things are frightening enough to leave a permanent memory.If this describes part of your childhood, then it is possible you are becoming angry because it was the only emotion that either of your parents was able to express.

Instruct: My son claims that hes been having extremely violent thoughts and dreams. Not violent like he's hurting someone, but violent thoughts like horrible things happening to his loved ones. He explained one of his dreams the other day and it was so violent it was sickening. It was far beyond anything in a horror movie, he says he can't help these thoughts they just pop up. Please help! Output: If your son is reporting "extremely violent thoughts and dreams" please have an psychological evaluation done by a psychiatrist now before it gets even worse for him to bare.  Don't take his reports lightly.  For him  to tell you, he knows that something is not right.  He is seeking and needing help.  Get it immediately.  Best to be safe than sorry.

Instruct: What should I do when we see each other? Output: I am so sorry that this happened.  Nobody deserves to be outed without their permission.  I would encourage you to get in touch with someone who is supportive and accepting and plan to touch base with them after you see your wife's sister.  You can also plan to take some time for self care after you see her.  For example, if you enjoy bike rides, plan on taking a bike ride afterward.  Plan to do something that feels nurturing and caring.  Best of luck!

Instruct: I feel like I hate myself physically and emotionally sometimes. How can I start accepting myself and be more confident? Output: The answer would require a more in-depth knowledge of you and your situation. A lot of times, these feelings are the result of the people in your life treating you a certain way. You internalize it and accept it as your reality. The first step is to evaluate the people close to you, especially your parents. Even if you are an adult, think back to your childhood. Children who grow up in an unstable home often grow up to be adults with insecurities and emotional problems. The obvious, such as being abused, can certainly lead to a person having little to no confidence and self esteem, but there are other situations that might surprise you to hear they can be damaging to a person.You may have never been physically or sexually abused, but what about emotionally? Were you yelled at, berated, put down? Were you told you'd never amount to anything? Were you compared to siblings and felt like you always fell short, couldn't live up to expectations? When you hear something over and over again, you start to believe it.Maybe you weren't yelled at. Maybe it was the opposite. Studies show that children who grow up with a parent who is depressed show signs of emotional neglect. A chronically depressed mother, for example, may have seemed cold, detached, emotionless. She may have been less likely to show interest in a child's life, not give praise for accomplishments or show support by going to ballgames or performances. If one of your family members were chronically ill while you were growing up, chances are, a lot of the attention went to them, which could have led to your needs not being met.Any of these situations could cause a person to grow up feeling unimportant, unheard, unloved, or like they don't matter.Maybe nothing I've described here fits your situation. If you can't pinpoint what has caused you to feel this way on your own, a counselor can help.I am not saying "blame it on your parents" or telling you there's nothing you can do to change it! Quite the opposite! Understanding WHY you feel that way is a first step towards making the changes needed to feel better. Cognitive behavior therapy focuses on cognition - figure out the WHY. Then behavior - the HOW. 

Instruct: I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why, I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it. How can I help myself to change my behavior? Output: The best way to handle anxiety of this level is with a combination of appropriate medication given to you by a medical doctor, and therapy to help you understand the thoughts, feelings, and behaviors that are causing the anxiety. This is not something that anyone should just “white knuckle” and try to get through on their own with no help. Cognitive Behavioral Therapy is a technique that has been proven helpful for depression and anxiety. This takes a therapist trained in CBT. You will learn to recognize when and why you perform the behavior of hitting your head, help you deal with the underlying cause of this, and replace the behavior with a more positive behavior. You'll learn coping skills.You mention having a rough childhood. Anyone who has experienced trauma like this, especially long-term ongoing trauma from abuse of any kind, definitely does not need "exposure therapy", which is what is recommended for phobias. You need a therapist trained specifically in trauma informed therapy.You are on the right path by recognizing there is an issue and what it is. Good luck with your healing journey!

Instruct: After I told them, they yelled at me. Output: There are a lot of ways one could go about handling this kind of conflict. It is hard to know which way might be advisable if we don't know quite why they would yell (or, why would they care who you choose to sleep and/or partner with to begin with?)However, it is of utmost important that you accept yourself as bisexual, and sometimes that is easier said than done. But, when you are able to get to that acceptance that you are not in the majority in society as far as sexual orientation goes, and all that comes with that, and perhaps other issues you might have with it, it will be significantly easier for you to tolerate your family's lack of acceptance, and perhaps chalk it up to a severe lack of open-mindedness.But because it is family, and we don't choose our families but are forced to deal with them for the most part for better or worse (admittedly I'm not the biggest fan of outright estrangement), processing the loss of "the family that I hoped I had" will also be important for you moving forward in your life. You likely will be able to realize you don't need them to accept your sexual orientation for you to live a healthy and happy life. Perhaps when they see that they can't change you, they will actually just learn to accept it.

Instruct: My husband cheated on me and it hurt me very bad. It was a time when my health was poor. I'm have a hard time moving on. Output: How has your husband acted since then? Was he regretful? How did you find out? Did he confess? These are all things that you want to consider. Betrayal is very hard to get over so if it's taking you awhile to get over, know that this is normal.Hopefully you're husband has been very regretful and upfront and honest with you since this happened. It may take awhile to reestablish your trust with him and he should understand this. It's also very important to discuss WHY he cheated. You want to make sure that the reasoning behind this was not something that could arise again in the future. And if it can, there needs to be an action plan in place (i.e. being honest with how he's feeling) so that you both get a chance to rectify the situation.If the cheating has happened more than once, you may want to reevaluate your reasoning for staying in the marriage. It would be obvious that he did not truly regret what he had done or else he wouldn't repeat the same mistake. However, if it was a single event and he has shown you and continuously shows you that he genuinely loves you and is sorry for his mistake, I would give it a try. People do make mistakes and sometimes it takes an event like this to realize what you have.Know that it takes time and that you have the right to feel what you feel. If the relationship was a good, healthy relationship, it is worth saving. Ease back into it and be upfront with your feelings. In return, your husband should be patient and understanding of this. Also, marriage counselors are often a good go-to as they have a great deal of experience working with marriages in similar situations. Best of luck to you!

Instruct: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. Output: I would suggest keeping a log of those days when you are having a hard time. Items to write would be what were you doing before you felt this way, did you eat and what, what time of day is it, how much sleep did you get that night, etc... This can help you identify any triggers. Further assessment can be made by a health care professional. It does sound like you are experiencing some symptoms of anxiety.

Instruct: My fiancé and I have been together for 3 years and our relationship has always been good. The only issue we had was that he felt like he wasn't getting enough sexual attention from me. I recently found out he cheated on me with another women. He says he wants his family back but I'm confused on what to do. Is it possible for us to get past the cheating, or should I just move on? Output: Finding out about an affair is quite an emotional experience. It's usually jarring. I encourage you to give yourself some compassion about emotions that you have.You asked whether it is possible to get past the cheating and the answer is that it can be. It depends on many factors.I would recommend that you see a therapist who specializes in working with couples. There are certain ways that both of you could learn more about yourselves and each other that may actually serve to make your relationship stronger. Sometimes there are motivations for having an affair that can be discussed in therapy in a way that you become more aware of what each other is experiencing and where you want to go from here. It could be that learning to communicate differently would be helpful.Regarding whether you should "just move on," I recommend talking about with a therapist as well. At the very least, you can discuss more about what you are thinking and feeling and what your choices are as far as where you want to go from here.

Instruct: I was raped by multiple men, and now I can't stand the sight of myself. I wear lingerie to get my self excited enough to have sex with my wife. Output: Hello Utah, thank you for writing with your question. Sexual assault or sexual abuse is a very traumatic event that affects victims in many ways. Your difficulty in feeling sexually engaged and your description of the shame and self-loathing you feel are normal responses to the rapes you experienced. A good therapist can help you to process your traumas and understand that you did nothing wrong to cause the rapes; the shame is not yours. It takes a very patient and loving partner, but you can make progress towards a healthier sexual relationship with your wife. These are issues that I cannot address more fully here other than to recommend that you seek the assistance of a qualified professional. 

Instruct: After 25 years, I fell in love for the first time. The person acted for a week and left me without even saying goodbye. My heart is burning, and I can't take this pain. Output: Hi, San Diego. I'm sad that this was your first experience (in 25 years) with feeling in love. You deserve better. My understanding of today's (western?) social cultural norms is that it is somehow acceptable to abruptly stop communicating with someone you've been seeing, without explanation. I don't get it. It's rude. You're better off without this person around. There are still people who operate with respect, but this person isn't one of them.If I'm reading this right, you knew this person for a week? In my humble opinion, much heartache and many poor relationships come from attaching too soon. It takes years to get to know someone deeply. I know it's hard to keep yourself from falling in love, but you owe it to your heart to take these things more slowly, because everyone puts their best self forward at the beginning and it takes time for that to relax and for you to see who they are when times are tougher and real stuff happens.If I was your therapist, I'd be curious about how this is the first time you've fallen in love? Or is it that you were in love 25 years ago?  Was your heart broken then, or did something encourage your heart to close? What has kept you from either meeting people or letting yourself fall in love until now? Is there a danger that you will decide love isn't worth the risk? This is a crucial time for you to potentially seek professional support from a therapist in order to understand yourself and not shut down, if that's what happened before. :)

Instruct: I have been feeling more and more down for over a month. I have started having trouble sleeping due to panic attacks, but they are almost never triggered by something that I know of. Output: It could be really helpful to see a counselor/therapist about your increasing depression/panic symptoms. Finding out the cause of depression/anxiety isn't always as straightforward as it seems, since both issues tend to become patterns we engage in rather than solely related to a specific trigger/reason. For example, if I am feeling down about a particular circumstance in my life, then I start seeing life through this lens of feeling down, and typically I'll start to see a lot more that I get down about, and it can really build very quickly on itself. Same with anxiety. Obviously, this is a very simplified example and it can be very difficult to see how the pattern is maintained, but that's where working with a counselor/therapist comes in. I would be curious about whether you can start to notice the initial sensations of panic, and if you can (through the panic attack) continue to maintain awareness of the actual physical sensations. Even better if you can talk yourself through the sensations you're feeling - such as saying to yourself "Okay, I'm breathing really rapidly, and my heart is racing, now my palms are sweaty and my chest is feeling really tight..." Reminding yourself that it's just your body's reaction to stress, and while it might be overreacting right now, you're okay and eventually it will go away. I highly recommend the SAM for Anxiety Management app for the anxiety piece, and I wouldn't be surprised if addressing the anxiety helped to address some of the depression too. 

Instruct: I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes. Output: Anxiety is simply your system communicating to you that you are in danger. The issue that I see in most of my clients is that they try to reason with this anxiety. You do not reason with sensory states in the body. If your system tells your in danger (your stomache feels like it is knots, your heart is beating out of your chest,) validate by just being present with it. Take your breath to it. Breath in and out of that space. Say ok, I am in danger. I always tell my clients, "a crying baby wants to be held, not told to shut up." Listen to your system, validate it like you do a child and see what happens.

Instruct: I’m in a relationship with my child's father. I’m a really jealous person. We don’t go out or do anything with other people because of me. To keep our relationship going, I know I have to stop being jealous, but I can’t. How can I get over these issues? Output: It may be important to look at this as getting through something rather than "getting over it." If you're aware of the reasons why you are jealous, I don't know if they relate to this relationship or a previous one, but you could remind yourself of the differences if your feelings of jealousy relate to something from your past.Also, it may be beneficial to have a conversation with your child's father if you are both open to having a discussion about this in a way that you summarize what each other is saying so you are sure that you are understanding each other, at least to some degree.Also, consider what you may want from your child's father to assist you with this. You cannot make him do anything to support you with this, but you can certainly ask.What is something you could start or stop doing to move you toward your goal?

Instruct: My ex-boyfriend boyfriend and I lived together. He had a two year affair with a girl and had three pregnancies with her. One was an abortion, another was a miscarriage, and then she had the third baby. They are not together, but he continues to contact me and wants me back. He has nothing to offer me. Output: Hi Attica,This is a question I think a lot of people deal with...they feel confusion about why they can't forget about or get over (or stop connecting with) someone who they absolutely know isn't good for them. In your case, part of the problem is that he keeps trying to get back in touch with you. For some people, honestly, it's a game... to see how much power they have over you or it's their need to control you. If you don't want contact from this person, it's really important to give him clear messages about boundaries ("Don't contact me again"), and then ignore all of their communications. Any interactions or responses from you at all will feed their behaviour. Remind yourself why you don't want to be with them. I hear you doing that already when you say "he has nothing to offer me". That's great self-talk.But let's get back to the question of why we have a hard time letting go of people like this. Sometimes it's because we still hope they will change. Maybe we remember who they used to be or how they used to treat us, and we think it can go back to the way it felt in those "good old days". The problem there is that, over the first few years, as intimacy grows, people tend to show more of who they are, not less. So what they're eventually showing you is who they are and what they're capable of. People do change and grow, but it won't happen at your pace. Accept that person for who they are and stop expecting them to change. Another reason we can't let go is because we picture our ex with someone new in the future and we wonder if they will be a better person for the next partner in their life. This is a normal... but not a healthy... thought. It's as though we want them to stay, maybe apologize, and heal our hurts; maybe make up for past mistakes. You deserve that healing, you deserve better than you got, you deserve apologies, but to expect that from the person who hurt you and hasn't demonstrated that compassion as yet is probably foolhardy. It is my belief that underlying some of the above scenarios is the deep belief that we must somehow be responsible for the hurts our exes have caused. If you blame yourself in any way for someone's poor treatment of you, you will be dancing around trying to do things differently so that they can treat you better. It will be impossible to let go, because you blame yourself for their behaviours.Draw a line. Their behaviours are about them, not you, and the only solution is to challenge and reduce thoughts of them, and create physical and emotional distance. These things plus time will help the events of the past fade from importance.

Instruct: My wife and I have a great relationship except for our sex lives. We are pretty transparent and honest, and basically, she feels bad because she never wants to have sex. She doesn't have the desire. She's also never orgasmed. She feels like a terrible wife and fears I'll cheat on her. She doesn't know why. Last time we had sex, she cried and felt bad and didn't know why she cried. However, she also told me that the last time we had sex, she felt me in her, but it just felt "ehh" and wanted to stop. That makes me feel really awful. We rarely have foreplay. Everything I try tickles her, so she makes me stop. We are both frustrated but very much in love. She and I are in our early 20s. We’re married and we have a baby on the way. Output: I suggest seeking the support of an AASECT certified sex therapist to help work through much of the issues you address, you simply may need some really qualified support. Also, you might be interested in watching Esther Perel's ted talk on the secret to desire in a long term relationship, and/or you might want to sign up for my own 8-part-series on Reconnecting Parent Couples

Instruct: All my friends have either hooked up or had a girlfriend but me. I try to be happy for them, but I get really upset every time they hook up. Output: If you mean “hooked up” as having sex with no care for the person, and you’d like a girlfriend, then realize relationships require more complex alignment with a partner than being a sex buddy.Pay attention to all your feelings toward a girl so that you’ll approach someone who attracts you for reasons in addition to sexual allure.Also, the process of knowing someone takes much more time than only to sleep with someone.Have patience and kindness toward yourself while you get to know the qualities which attract you to a potential girlfriend.

Instruct: I am an international student, and it is my first semester in graduate school in the United States. I faced a cultural shock, and I was so depressed when I arrived here. My counselor in the university was my savior. He helped me a great deal. Now I am going back to my country for a vacation. I was thinking to get him something special with my country's name on it, and I remembered that he likes wine. My country is known for that. Is it appropriate to give him wine as a gift after Christmas? Output: I don't think it's appropriate to give your counselor a bottle of wine. Your counselor helped you and supported you, which is great, But a gift is inappropriate. I can understand that you want to show your gratitude. There are many other ways to do that. You could drop your counselor a note or card, thank him in person, or tell him how much he helped you. These small gestures can be very meaningful for both of you. 

Instruct: Does counseling really do anything that can help people? Output: Counseling allows us to have a sacred space, a space that is set apart from the outside world, it is a space of non-judgement and exploration. Being that the universe is not made for us and that the the world tends to be a fairly untamed place at times, this sacred space allows us to explore ourselves. It allows for greater reflection upon our attitudes, our behaviors and our feelings. Imagine if you will a small goldfish swimming around the usual fish tank, although I dont attest to know what a goldfish thinks, I would imagine he does not see the world outside of him, he only sees the small fishbowl, oblivious to the outside world, when one comes into the counseling room, one is trying to gain insight that was not previously there. Remember the observer affect, one cannot truly act objectively with the world, we are in a dynamic relationship with life, it reacts to us and we to it, the time in the counseling room allows us to gain an understanding that is beyond the normal limits, allowing us to see what was before hidden, often times in plain sight.

Instruct: How does a person start the counseling process? Output: Approaching a counselor can seem intimidating at first, but most mental health professionals want to help you feel safe and heard.  You can often find counselors using search engines like CounselChat or Psychology Today.  These websites allow you to get to know therapists before you take the next step.  These days, counselors have websites where you can learn even more.  These websites usually have clear instructions for contact.  Typically, you can reach out via phone or email to request a consultation.  During a consultation call, you can ask the therapist questions about their credentials and areas of expertise.  If you feel like you connect, you can schedule a first session where you will tell them more about yourself and why you are seeking therapy.  The thing to remember is that therapists want you to reach out to them, and they are happy to be approached for support.  Good luck!  

Instruct: I have a child with my baby mother. She works I take care of our young son. She says she is not cheating I have not found anything but she always putting me down, telling me to get out and telling me she doesn't love me, but then the next day after our fight she says she does. I'm having a hard time because before our child she said she was raped by a family member but she never went to the hospital or the cops. Now me and my family don't talk. She's always telling me I'm annoying and just belittles me. Nothing I do is right. She says I work you watch the baby. On her days off she never cooks or cleans. I have no friends or family and a couple months ago she was confiding to some guy, but says he's not any thing to her. What do I do? I don't want to leave. Output: It sounds like you are in a tough situation. You have to ask yourself why you don't want to leave her. Is it because of the child? Or is it because you want the relationship to work? You must consider that being in an abusive relationship is not healthy for you or your child. So if the abuse continues, it would be more beneficial for you and your child to move out.On the other hand, if you are just wanting the relationship to work out despite its current state, you need to evaluate whether the relationship is worth salvaging. It seems as though you are very unhappy and undervalued in this relationship. Although your question revealed just a short bit of information, I didn't read about any positives in the relationship. Sometimes it's extremely hard to leave a relationship even though you know that the relationship itself is harmful for you. However, with time and focus you can do it. Each day will get a little easier and you have to trust yourself that you are making the right situation for you and your child.However, if you really feel that you want to stay in the relationship, you have to be upfront with her. You need to tell her exactly how you feel and give her specific examples of how she is hurting you. This gives her a chance to render the situation. If after this there is no improvement, I suggest that you start reconsidering your decision to stay.I also think it would be valuable for you to start engaging in things outside of the home that make you happy. Are there any hobbies you enjoy? Are there any groups in the area that you can join such as playgroups that will allow you to engage with other parents? Start looking into these options and finding an avenue for you to do something for your own benefit.It is certainly not healthy for you to isolate yourself from friends and family. You need to have additional support networks besides the one with your girlfriend, especially since this has not been a healthy environment lately.Thank you for reaching out. I wish you the best of luck with your relationship.

Instruct: My boyfriend is always saying he's done with me and says he's leaving, but then at the end of the night, he's still here. He wakes up in the morning, acts like nothing happen, and repeats this every night. Output: Do the two of you ever talk over why he does this or your reaction to it?Are you asking your question because his behavior upsets you or only out of curiosity to understand him better?Basically, first know your own reason for your question.   Then go ahead and tell him if what he does bothers you.  In the best of cases, he doesn't realize how his actions affect you and he will change.

Instruct: I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I’m not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and doesn’t keep me up to date on everything that he does throughout the day, which he used to. I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I don’t know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town? Output: In a way, yes, you have separation anxiety. It's normal in a relationship for us to slow down a bit with the attachment behaviours that establish and deepen love and connection. So, just because your boyfriend isn't talking as much or keeping you up-to-date doesn't necessarily mean what you fear it means...that he's forgotten about you or loves you less. It could mean quite the opposite...that he's focused on being successful in his new job and impressing you. He may think he's loving you more, but you feel loved less. You have two jobs to do here. The first is to manage your anxiety by "talking back" to the thoughts it puts into your head. It sounds like "It's normal to be insecure, but I have tons of evidence that he loves me and that I mean the world to him..." Find that evidence that helps you refute what anxiety is trying to claim. The second part of your job is to let him know what you need. You need more affection and connection during this period when he's away (more texts, phone calls, information). It's okay to want that, and I am sure he will be relieved to know exactly what he can do to help you feel secure and calm when he's away. 

Instruct: My ex-boyfriend and I met over a year ago. We hit it off and fell in love pretty quick. However, he has trust issues and assumed I was cheating. When I found out I was pregnant, we had just broken up. Five months later, I lost the baby, and we did not speak for a few weeks. Now we are talking, and he says he loves me but is afraid I will hurt him "again." I just want to know where to go with this because I love him so much, and I want to get back to us being happy and a family. Output: Trust is essential in romantic relationships and it is common to have trust issues - because the stakes are so high. If both of you are committed and willing to be fully honest with each other, trust can be repaired and become stronger than ever. I would encourage you to seek out professional help as it easy to get derailed by fear when trying to work things out in the absence of trust. When fear takes over - we tend to become defensive and act in ways that makes it harder to trust one another. In addition to getting professional support I would encourage you to learn more about building trust in relationships and deepening connection through accessing various online resources on relationships.

Instruct: How does a counselor decide when to end counseling sessions or to terminate working with a client? Output: In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C

Instruct: I have manic depression and last summer was very very bad. I have recurring nightmares and I avoid anything that will give me a similar feeling as I did that summer. Output: A PTSD diagnosis requires an event which occurred at least 6 months prior to the symptoms.   Depression is a common symptom of PTSD, but depression can come from many other sources as well.  In the end, diagnoses are systems of behavioral labels.  If you believe that one label (PTSD) is worse than another (Depression), you are creating a false hierarchy.   Consider consulting a CBT therapist, such as the fine clinicians listed in AcademyofCT.org.  You may also want to look at my book, Living Yes, for many ideas about challenging your thinking and improving you mood. www.LivingYes.org. I hope you feel better soon.  ~Mark  (www.MarkMorrisLCSW.com and www.LivingYes.org)

Instruct: I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? Output: Yeah, you might :)At least, it certainly feels like that, I bet...Not to mention that most counselors out there might generally feel overwhelmed with a "case" with so many problems.  And, so, you will slog along week-to-week with gradual improvements occurring as she slowly does her best to chip away...The real issue is that these folks don't yet comprehend the integrative nature of each of these subjects and how generally simple it is to understand them, and then eradicate them.

Instruct: I found out my boyfriend takes anti-depression medicine. Lately he's been saying he has a lot on his mind, and he needs time to think about us. We've only been dating 3 weeks but I like him a lot. Output: Give him the time and space he needs.  Obviously something is going on with him that he needs time to process, think about, and work through.  Respect that most men are not talkers but more thinkers.  If and when he is ready to talk, he will.  When and if he does talk, be a comforting listener and put yourself in his shoes the best you can to be the support he needs.  Don't take it personal because you just been dating 3 weeks and his depression maybe something that been going on for a while.  If you do like him...showing him by being patient and supportive at this time.

Instruct: Often times I find myself thinking scary thoughts and sometimes I even scare myself into thinking that something bad is going to happen to me. Once it starts, the thought continues going through my head and I can't get it out. How can I stop these thoughts? Output: Hi there,I first want to let you know that having these thoughts is completely normal. Studies have been done that show that 80% of human thoughts are "negative" so you are not alone. I like to think of thoughts as a tornado... if you are in a tornado, you are completely consumed by it and it is nearly impossible to do anything beneficial. However, when you are, let's say, a mile away from a tornado, it is still scary but you have the option to do something that is important to you such as get shelter or make sure your family and friends are safe. When unhelpful or scary thoughts arise, we tend to start a "war" with them, which is the equivalent of jumping into the tornado. This makes the thoughts and emotions bigger and intensifies the feelings that go with them. So the question I imagine you have is "how do I get out of the tornado?" There are 3 steps to doing this:Get distance from your thoughts by adding "I am noticing I'm having the thought that...." to the front of them. For example, "I am noticing I am having the thought that something bad is going to happen to me."   The purpose of this is not to decrease your fear or get rid of the thought. These thoughts might always be there and that is okay because that is how the mind naturally works so struggling with that is a waste of time and energy. The purpose is to gain some distance from the thoughts so you don't get swept away by them. You can imagine them floating along like leaves in a stream or clouds in the sky (and often the same thought will come back again and again but that's okay... just continue to notice it with curiosity). I imagine the thoughts get in your way of doing what really matters to you so if you can get a little bit of distance, you can do things that are fulfilling and meaningful to you. Tune into your body and notice what sensations come up and where you feel them most intensely. Then breathe into them and make room for them. Our 5 main emotions are: joy, sadness, fear/anxiety, shame, and anger. ALL of these emotions are part of being human and there is no escaping them. So again, struggling with them ends up intensifying them. Instead, let them be and make a little bit of room for them. Often a side effect of this is the intensity will decrease but it might not. The purpose is to keep them from becoming more intense. Contact the present moment. Notice what is happening here and now. One way of doing this is tuning into the five senses. What are some things you hear, see, taste, smell, and feel? Another way is to notice what is happening in your body (without trying to change it). How deep are your breaths, what is happening with your heart rate, are you cold/warm, etc?Implementing these three steps can help you to refrain from getting caught up in your unhelpful thoughts. Unfortunately there is no way to get rid of thoughts or feelings completely. So the only option that works in the long run is to accept them while continuing to do what matters to you and what is fulfilling to you.I hope this helps!

Instruct: I found out my boyfriend takes anti-depression medicine. Lately he's been saying he has a lot on his mind, and he needs time to think about us. We've only been dating 3 weeks but I like him a lot. Output: Give him the time and space he needs.  Obviously something is going on with him that he needs time to process, think about, and work through.  Respect that most men are not talkers but more thinkers.  If and when he is ready to talk, he will.  When and if he does talk, be a comforting listener and put yourself in his shoes the best you can to be the support he needs.  Don't take it personal because you just been dating 3 weeks and his depression maybe something that been going on for a while.  If you do like him...showing him by being patient and supportive at this time.

Instruct: How do therapists classify the type of personality their clients have? What characteristics do they look at to decide what type of personality the client has? I've read about this online, but I'd like to understand this from a therapist's point of view. Output: This is a great question, and I am happy to have the opportunity to explain my approach. When I am determining what type of personality a client has, I take my time and really absorb their lens/ point of view to themselves and others. Determining a personality type takes some time getting to know the person, and building rapport. After taking time to get to know them, and learning about their view they have of themselves and others, it is important to pick-up on more specific personality traits, which comprehensively contribute to a personality type. Clinicians, including myself, often witness certain traits that are enduring and consistent, which indicate a type of personality. For example, if a therapist is noticing that a client is exhibiting traits of organization, needing to be on time, planning, and perfectionism, these traits contribute to the "type A personality". In addition to utilizing clinical judgment, clinicians often use personality assessments and follow the guidelines of the DSM-5/ ICD-10. 

Instruct: I am married, but I had sex with my friend. I feel guilty, but I feel not guilty too. Do I need to feel guilty? It's my body, and I have full rights to do what I like. Output: Yes, of course, it's your body and you can do what you feel like doing.Do you feel a commitment to your partner?Your guilt probably is pointing out the feeling of having done with your body what your spirit tells you is a violation of the commitment you feel toward your partner.The good news is that this is a moment for you to examine how strong your commitment is to your partner.Find balance between satisfying your freedom to do as you please, with your sense of being a partner, which means prioritizing the partner once in a while.

Instruct: Every winter I find myself getting sad because of the weather. How can I fight this? Output: There can be lots of different factors contributing to this. Here are some possible tips:Consider if you know anything about what specifically is making you feel sad? If you're looking for activities because you cannot participate in what you like to do in the warmer months, consider finding some indoor winter activitiesConnect with others. One idea is to join a group (such as a book club) that meets regularly. This could give you something to look forward to regardless of the colder weather.Enjoy the sunshine from indoors. You may notice that sometimes looks are deceiving women is bright and sunny outside, but is also quite cold when you open the door. If you are staying inside for the day, consider allowing yourself to enjoy the sunlight without specifically considering that it is also cold.Consider using a light box. Certain types of light boxes are designed to help with the "winter blues." You can find more information here: http://www.mayoclinic.org/tests-procedures/light-therapy/home/ovc-20197416Recently, one of the nurse practitioners that I work with has been checking a lot of vitamin D and vitamin B12 levels and she says the lower levels of these vitamins can contribute to feelings of less motivation or energy than is desired.Each of us has days when we are not thrilled about the weather and may be feeling sort of "bummed" or "down." If you find yourself having these days frequently or for several consecutive days in the above strategies are not helping, consider talking with a therapist about more specific strategies that may be of help to you. Also, because  if everything you would see is likely to live in your area, they would be familiar with the weather patterns where you are and may have some tips that they use for themselves or With other clients.

Instruct: I've only been married three months. Every week, we argue about something, and it seems to be getting worse. Output: At the begin g of marriages, we expect to be living on an eternal honeymoon, but the reality can be different.  This is a process of adaptation, even if you had known your better half for a long time, during the first months and years of marriage you go through a process of settling in your new roles and confront new challenges together that as you resolve become new rules and agreements.Yes, you can work this issues by practicing assertive communication, being clear with each other about what is the problem, how you feel about it and how would you like to resolve it.  Learn to close arguments with resolutions, and reminding that you care about each other, that’s why you choose to be together.  Discuss your roles and expectations, this is normally done over a marriage preparation class, is never too late to sit down a talk about what you want and look for in a husband/wife and clarify your roles and rules. Find couples therapist who mediates communication and helps both of to you learn assertive communication skills and conflict resolution. ¿Cómo puedo arreglar mi matrimonio?He estado casado por tan solo tres meses.  Cada semana discutimos sobre algo y parece ponerse cada vez peor.Al inicio del matrimonio, esperamos vivir una eterna luna de miel, pero la realidad es diferente.  Es un proceso de adaptación, sin importar por cuánto tiempo hayas conocido a tu pareja.   Durante estos primeros meses se definen los roles en el matrimonio, también enfrentan nuevos retos juntos que según resuelven se convierten en reglas y acuerdos.Sí, puedes resolver estos problemas practicando comunicación asertiva. Deben aclarar sobre cuál es el problema, como se sienten al respecto y como lo quieren resolver.  Aprendan a resolver las discusiones con decisiones claras y recordando que si les importan uno al otro, y por eso decidieron estar juntos en primer lugar.  Discutan sus roles y expectativas, regularmente esto se hace durante clases de preparación matrimonial, pero nunca es tarde para hablar sobre lo que les gustaría que fuera su matrimonio y lo que esperan de su pareja, así clarifican los roles y reglas que aplicaran a su unión.Encuentren un consejero matrimonial que les ayude a mediar los problemas de comunicación y les ayude a aprender destrezas de comunicación asertiva y resolución de conflictos.

Instruct: I was born a girl, but I want to be a boy. Because of my religion I can't tell my family. I know they won't accept me. What do I do? Output: It is really important for you to be comfortable with your identity. With that said, it is also so important for you to be safe. It may be helpful for you to find supports (in your life, community, or online) that you can talk about how you feel and potentially gain supportive persons if your family does not accept you. It will be really important to connect with others and even a counselor to help you.

Instruct: My husband and I have been married for seven years, and in that time, we have only had sex four or five times. Others have told me that most men would have left me by now. Honestly, I think I have a low sex drive or neither one of us actually knows what we are doing. I want to be better connected with my husband. Output: There are many different ways that can be approached in your situation.1. I would recommend a complete medical examination including blood test. i would want to know if there are any medical issues in your low sex drive.2. Where is your husband in this situation? Is he resentful, accepting, demanding or neutral?3. What is your past sexual history? has this had an affect on your current issue?4.Has there been problems in your past with abuse of any kind?5. Understand that intimacy is more than sex. What other ways can you be close to your spouse?6. It sounds like there is some confusion about sexual intimacy from both of you.Couples counseling would be a great place to start. All of these areas need to be explored before any treatment goals can be established.You need to talk with a professional counselor to explore how to better connect with your spouse.

Instruct: I have no real friends. I have a girlfriend who irritates me but loves me to death. I push her away and pushes me away. We’re going through a breakup, and I have nobody. Output: Having time all to yourself may be necessary so you have time to reflect on your own identity and values, become more clear on what matters most to you, and with this increased self-understanding, be able to attract people who will feel like satisfying friends.Having a relationship with someone whom you push away and are pushed away, with someone who is irritating, seems to have limited benefit for each of you.Maybe you are together from fear of being alone, and being alone is exactly what you may now need in your life in order to draw more favorable people to you.

Instruct: I'm in college currently, so I am not a direct victim anymore. My father is very abusive with his words and actions, and my siblings are getting treated horribly. Output: Yes you can help!  Emotional and verbal abuse can cause a negative impact in your family.  It is important that you encourage your siblings to seek assistance with a therapist, and maybe help them find one, they should have school counselors available and if not our college counselor may help you to get referrals.  It’s also a good idea to talk to your mom about the issue and ask her if she would like help as well.  If you are concerned about your siblings' safety, contact Family Protective Services in your state, they will investigate and refer your father to classes or therapy as needed. It takes courage to do the right thing, you can do this!¿Hay algo que pueda hacer para ayudar a mis hermanos a escapar de nuestro emocionalmente abusivo padre?Actualmente estoy en la universidad, así que no soy victima directamente.  Mi padre es muy abusivo con sus palabras y acciones, y trata a mis hermanos horriblemente.¡Tu si puedes ayudar!  El abuso emocional y verbal puede causar daños graves en la familia.  Es importante que motives a tus hermanos a visitar e incluso encontrar a un terapista, la escuela debe tener uno disponible, y también puedes pedirle referidos a tu Consejero universitario.  También es buena idea que hables con tu mama al respecto y le preguntes si a ella le gustaría buscar ayuda.  Si te preocupa la seguridad de tus hermanos, contacta a el Departamento de Protección a la Familia en tu estado para reportar el abuso.  Ellos investigaran y determinaran si el hogar es un ambiente seguro par tus hermanos y recomendaran terapia o clases para tu papa.  Hay que ser valiente para hacer lo correcto, ¡tú puedes hacerlo!

Instruct: What makes a healthy marriage last? Output: I appreciate your question.The answer of what makes a "good marriage" are as varied as there are marriages.Basically, similarity, like mindedness in beliefs and values, makes a good marriage. The best chance of getting along with someone on a longterm basis is when two people see life and the world in similar ways.Even though "opposites attract" this is a short lived dynamic which breaks apart when there aren't enough similarities in common between the partners.

Instruct: They don't go away, and I feel like I'm going crazy. Does that ever stop? Can it be a symptom of medication? Output: This can certainly be a side effect of some medications. If the voices are so powerful that you can not sleep or they are constantly present, you shouldn't wait any time, but go and see your doctor straight away.

Instruct: I have a problem with binge eating, especially during times of stress. I binge eat and feel so overwhelmed with shame and disappointment that I end up going to the gym and trying to exercise the calories off. I am in my late 20s, and I have been dealing with this since I was a teenager. Are there any coping mechanisms I can use to break this cycle? Output: Hello,This question describes a very typical setup of what is called the  Binge, Repent, Repeat cycle. This means that typically after you binge, you experience emotions as you described "shame and disappointment" and then because of these emotions you "repent" (i.e. vow to never binge again, promise to "do better," go to the gym, etc.) and then ultimately end up bingeing again. There are many coping mechanisms for binge eating and one of the best is actually attempting to NORMALIZE eating. Meaning you need to attempt to eat normally, eating appropriately portioned meals 3 times a day, with snacks in between. IF you binge, then it may be helpful to remind yourself that when you attempt to compensate for your bingeing behaviors, and you end up feeling restricted from over exercising or undereating, then this actually leads to a binge again. Thus, reverting you back to the cycle. If you binge, it will be helpful to try and get back on a normal schedule of eating instead of trying to compensate for the binge. Although it may feel counterproductive, getting back on a normal eating schedule will prevent you from entering into the restrictive cycle. It can also be helpful to remind yourself that the binge has already occurred, it is in the past and the goal is to move forward without focusing on the past. Focus on what you can do differently next time. What emotions or situations led up to the binge? What can you to do prevent or change the circumstances that led to the binge, or the way that you handled the situation? Lastly, if you're struggling with "normalizing" eating, it can be helpful to work with a professional that can provide counseling and coaching to help you learn how to eating normally, mindfully and without feeling the guilt and other harmful emotions sometimes associated with disordered eating. I would be more than happy to assist you if you ever have any questions or want to reach out to somebody. You can contact me via my website: http://www.maddenwellnessky.com/ 

Instruct: My mother takes care of niece whom my sister abandoned. She calls me every day complaining, but I don't want to hear it anymore. Output: These are common challenges that involve setting healthy boundaries with family, as well as friends and co-workers.  Therapy can help you to define, establish and enforce boundaries between self and others by being assertive.  This involves determining what things make you uncomfortable and how to communicate that with assertive, not passive, not aggressive, actions and language.

Instruct: I've always thought that there wasn't much good out there for me. Now that things are actually going well, it kind of scares me. I spent most of my life feeling unwanted and figured I would be alone. I recently met a great woman who seems to really like me, and I don't know how to process this. It's bothering both of us. Output: Congrats on having a happiness problem.Go slowly and tell your partner how you feel as you discover how being loved feels.On a deep level you’re releasing yourself from interaction patterns which treated you poorly and unkindly.Time is needed of repeated occurrences of this newfound loving behavior toward you.Gradually you will trust more and more that your new living relationship life is your reality.

Instruct: I’m facing severe depression and anxiety and I just feel like I’m going through a lot. This really distracts me and I cant get my mind off the things that are bothering me. How do I overcome this anxierty and depression? Output: Depression and anxiety can be disconcerting and disruptive to our lives in many ways. I am sorry that you are suffering so much. Depression and anxiety can arise due to experiences, genetics or a combination of both. I like for my clients look at their issues as whole persons so I would also recommend these tips:Physical: regular exercise, healthy balanced diet, rest and sleepMental: how we think is how we feel. How are you interpreting the events that are happening to you? Try to interpret them in a less negative way. Unfortunately we cannot stop our thoughts as our brain is always working. If you can't see your issues in a different way then stop struggling and allow and accept whatever the unhelpful thoughts are. Choose to take actions based on your values and what will give you a fulfilling life no matter what your thoughts are. Remember, your thoughts have no power unless you act upon them. Emotional: do not let feelings dictate your actions, even if something feels anxious take action again based on your values and how you want to live.   Social: connect with healthy friends and family that will be a positive support. Take up some hobbies and recreation activities as well. If things do not improve I would encourage you to make an appointment with a talk therapist and discuss these issues. I would encourage you to also be open to consider an evaluation for anti-depressants with these issues as well. If you ever feel like you might hurt yourself please call 911 or go to your nearest ER.

Instruct: Does counseling really do anything that can help people? Output: Hi there! Thank you for your question. It's a great question and one that many people want to know the answer to. The short answer is, YES! Counseling can be very helpful to people struggling with many different things. There has been a lot of research conducted to prove that counseling is an effective way to help people with mental health concerns, life stressors, and many other issues. In addition, there are many people who would tell you that counseling made a positive, profound impact on their lives. Indeed, some would tell you that counseling saved their lives. Now, not everyone would tell you that counseling helped. But when you think about it, there are many medical treatments for a variety of healthcare issues that also do not help everyone. So, is counseling guaranteed? No. But, it is something that is worth trying if someone is suffering or is just wanting some perspective or support. Also, there is many different types of counseling. Different counselors have different styles and have different training for various issues. This means that you are likely to find someone who has a good style and expertise in an area that you want to work on. If you don't know where to go, I suggest contacting your state's counseling association. They can help. I think the real question that most people have is, how? How does it help? That question is a bit more complicated, because there are many different models of counseling/therapy that work in different ways. What I can tell you is that, regardless of the model of counseling, the relationship between counselor and client is the most important factor. I don't mean that the relationship has to be ooowy goowy... but it does have to be one where there is trust and openness. A counselor will spend time to make sure that you are working together as a team toward a common goal. If you go to counseling and you don't feel this is the case, tell your counselor. An ethical counselor will welcome your feedback. I hope this is helpful, please ask more questions! I hope some colleagues add some other thoughts, too. Be well,Robin J. Landwehr, DBH, LPCC, NCC

Instruct: I never get infections or scars or anything, and it doesn't bother me if it gets filled up with blood or something, but I'm concerned. Output: Hi Houston, The fact that you're concerned says a lot. If I was your therapist I'd ask you questions about your worries and how this is causing a problem in your life. You're causing perhaps permanent changes (damage?) to your body, and it's likely you're trying to express something...pain maybe? A therapist can help you to explore what's going on for you and how to get your needs for self-expression met in a more healthy way. Good luck!

Instruct: I avoid talking to him because he always makes me more upset. I can't be honest with him about anything because he is always rude to me. Output: Hi Troy, I totally get this. It's a dilemma; you want your dad to know how he's hurting you but you don't feel safe enough to say anything to him. Your reaction is understandable; it's his responsibility as a parent to work harder than you to create that safe place for you to be open. But that's not who your dad is. Your dad is your dad, and waiting for him to change won't really help. Nothing you do can change your dad, but...there are things you can do for yourself and your relationship with him. While your response of avoiding him is understandable, I wonder what effect it has on your dad. It's possible that he's feeling frustrated, rejected and punished by your withdrawal. You may think he knows that you're feeling hurt, but he probably doesn't. So this is the squirrel chasing its tail: your dad is rude, so your habit is to be silent, then he maybe feels abandoned and frustrated. His frustration comes out as more rudeness, which makes you want to withdraw more, and the cycle starts all over again. You can't change his part of the cycle but you can change yours.Are you willing to take a risk? Can you be honest about how you're feeling? What's the worst thing that could happen if you said to your dad "You know why I avoid you? I stay silent because when I talk to you say rude things. So if you want me to talk, I need to know you can listen." I imagine it would come out differently because you're a few generations younger than me, but put that into your own words.I don't know the level of your dad's 'rudeness'. If he is abusive, then a better plan is to see a therapist alone or talk to someone about this. I don't want to put you at any risk. But if you don't worry your dad will hurt you, maybe give honesty a try.My point is that, as rude as your dad may be, checking out of a relationship by being silent is also rude. It's powerful...your silence. Your dad can't read your mind, and if you want things to be better you will need to get in that ring with him.And, if you're both open to it, seeing a therapist together can be really helpful. :)

Instruct: I'm 15 and my girlfriend is 14. Am I a pedophile because I'm attracted to her and she's under 18? Output: No. You are not a pedophile. You are both under the appropriate age where it would be seen so. Your both only a year a part so this shouldn't a worry to you. Like Frank said below, Pedophelia is a problem that won't apply to this situation.

Instruct: I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes. Output: The are two ways that such anxiety can be dealt with. One is an attempt to replace maladaptive thinking by examining the distorted thinking and resetting the fight-or-flight response with more reasonable, accurate ones. As an example "I'm scared of spiders." But if you change the thinking from being scared to "I'm bigger than the spider," it allows the mind to reach a calmer state of mind. Mindfulness-based therapy can also help  focus on the bodily sensations that arise when you feel anxious. Instead of avoiding or withdrawing from these feelings, remain present and fully experience the symptoms of anxiety. Instead of avoiding distressing thoughts, open up to them in an effort to realize and acknowledge that they are not literally true.Although it may seem counter-intuitive, fully realizing the experience of anxiety enables the release of over identification with negative thoughts. You can practice responding to disruptive thoughts, and letting these thoughts go.By remaining present in the body, you'll learn that the anxiety being experienced is merely a reaction to perceived threats. By positively responding to threatening events instead of being reactive you can overcome an erroneous fight-or-flight response.

Instruct: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments. Output: It sounds as if you would benefit from talking with a local mental health professionals so you can discuss some details.Having said that, I wonder if you could consider how you would define yourself to someone who doesn't know you. For example, honest, adaptable, fun-loving, dependable, compassionate, open-minded, dedicated, etc. If you're looking for a list of adjectives, try these: https://www.englishclub.com/vocabulary/adjectives-personality-positive.htm . There is a list of negative ones here too. If you're going to use those, try to use three positive ones for each of the negative ones. You could also try asking yourself what you love about yourself and/or what others love about you. Sometimes it's easier to consider what others see as our positive points and if this is difficult for you, try asking someone who you trust to help you with the list.The idea here is to look at your relationship with yourself. I don't mean this in a way that you would be talking to yourself and receiving answers, but rather looking at yourself in a way that you deserve the same kind of loving and compassion that you give to others or want others to have.I'm also curious as to whether you are eating and sleeping okay, as these things can really affect your focus and many other changes, such as differences in your emotions. Also, you saying that you are struggling to put things into perspective leads me to believe that you are going through some things right now that are not typical for you, if so, consider from whom you have support and the ability to talk about what you are going through.Consider Metta meditation here to help give yourself loving kindness: http://www.mettainstitute.org/mettameditation.html

Instruct: I stress over everything. If I don't have enough "quality time" with my boyfriend, I start to feel resentment towards him. He has three children, and they are great kids, but I find we don't have much time together. I break down easily and find myself depressed. Output: Everyone has some level of anxiety - it's what helps us respond to stressors in our lives and clues us into the fact that we need to respond to something going on. However, if you're feeling overwhelmed by racing thoughts, feeling like you spend a lot of energy worrying about something specific or even pretty much anything at all, and you're starting to find that it's getting in your way when it comes to living your life the way you want, then I'd suggest seeing a counselor or therapist for an assessment for anxiety. Your other concerns, though, seem pretty "normal" for someone who is in a relationship with a partner who has children. As a married stepmother, I've been there, and as a therapist, I can tell you that the boundaries and communication skills you have in your relationships need to be healthy for you to feel healthy. Finding some support from a group of others whose partners have children might be really helpful - being able to hear from others that you aren't alone in feeling like this can really lighten the load, and they might have some good ideas for handling certain situations. Another option is to find a counselor or therapist who has experience working with step/blended family dynamics - because even if you're not officially married, those dynamics come into play whenever there are kids from another relationship involved. You may even consider couples counseling so that both of you can learn to talk about your relationship needs and concerns in a way that will encourage connection and strengthen your sense of partnership.

Instruct: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this? Output: Well, it's generally okay to feel anxious or nervous about going into therapy, particularly in the beginning because the process of being open about what you are going through, much less to someone who you don't know well, can be anxiety-producing. It's also common to feel anxious when you are discussing something that is important, difficult to discuss, or you are making changes that are very difficult for you.The most important thing I can tell you, though, is to discuss with your therapist this idea that you feel nervous and shaky. Some anxiety can actually help to motivate or lead you toward change. There are also level of anxiety that can be counterproductive, so it's a good thing to discuss. Personally, I can tell you that I would want my clients to tell me about anxiety they feel 100% of the time. That opens the dialog to discuss whether it is the level of anxiety that they want to sit with and learn about in discovering more about themselves and their experiences and/or whether they would like to do something to lessen the feeling of anxiety.Thanks for writing here. If it caused anxiety for you to do so, I hope that feeling is diminishing for you, at least related to writing here.

Instruct: I don’t love my sister. I would never wish her harm, but if I could, I would wish for us not to be related. Is this cruel? Why must blood mean we have to be friends? Am I being unreasonable and is there a way to fix this? I do care about her, like I do every human being, but I’d rather be with my friends than be with her at all. It’s not just a "teenager phase." I still love my mom and dad, and I’m very close to them. However, it’s my sister I don’t love or have ever really liked at all. Output: Hi. My guess is there's a lot of deep history here that I don't know about. Have you felt hurt by your sister in the past, or are you just 'different people'? It's a common feeling people have about siblings; that they're very different and they wouldn't choose them as friends, but most people stay connected to family unless there's a good reason not to. We don't choose our family, do we? Your feelings are normal and they don't make you cruel. If you were mean to her, that might be a different thing. It might be considered cruel to cut her out of your life for no reason, but choosing to not hang out with her a lot isn't cruel, in my mind. Perhaps you at least owe your sister kindness and respect (if she respects you), but not necessarily friendship. How you respond here is up to you; there are no rules. You get to decide how much 'family' means to you and how much time you spend with friends or family. This may shift at different times in your life though. Cutting all ties with a sister now (you haven't said you want that though) might mean she won't want to be there for you in the future when you need her. Also, how you treat your sister affects your other family members as well. There are many things to consider here, but the bottom line is that you get to surround yourself with the people you want in your life.

Instruct: When I'm in large crowds I get angry and I just can't deal with people. I don't really like other people (I prefer animals) they make me nervous and scared. I lay awake at night thinking and having conversations in my head and i almost always end up making myself feel terrible and crying, I have more conversions in my head than I do with actual people. I don't know what's wrong with me and why I feel this way. What should I do? Output: You are a unique individual exhibiting some of the traits of a specific type of temperament. Through temperament counseling you can come to know, accept, and manage your God-given temperament to become all that God intended. There is nothing wrong with you -- God loves you as you are and wants to help you balance your temperament needs.

Instruct: I'm going through some things with my feelings and myself. I barely sleep and I do nothing but think about how I'm worthless and how I shouldn't be here. I've never tried or contemplated suicide. I've always wanted to fix my issues, but I never get around to it. How can I change my feeling of being worthless to everyone? Output: It sounds like you may be putting yourself last. You wrote that you want to fix your issues but never get around to it. I wonder how you are spending your mental and physical energy. Are you spending time taking care of and doing for others? I also wonder where the thoughts and feelings of being worthless are coming from - are you around people who treat you poorly or are hurtful? Or do you feel it is more of a worry you have but aren't really sure how others feel? It may be helpful to talk to someone about your feelings - a counselor perhaps - to clarify your feelings and move forward from se that are hurting you.

Instruct: My husband and I have been married for seven years, and in that time, we have only had sex four or five times. Others have told me that most men would have left me by now. Honestly, I think I have a low sex drive or neither one of us actually knows what we are doing. I want to be better connected with my husband. Output: I work with many couples that experience a wide range of sexual and relationship challenges. The one aspect I tell many folks that I work with, is this: Every person and relationship is different. There really isn't a "normal" amount of sex a person should have or want to have. If having sex 4 to 5 times in the course of your relationship is satisfying to you and your husband, there is nothing wrong with it. If you or your husband would like to have sex more often, I suggest talking with a counselor about this to find ways to engage in a sexual life in which you are both satisfied. The aspect of connectedness is an important one. While sex can be very connecting for many couples, it isn't the only way to connect. I find that communication about the matter of frequency of sex, checking in to see how you and your husband feel, as well as communicant about your needs for connection are an important start to fulfilling this need.

Instruct: In middle school and high school, my friends and family thought I was gay. I tried telling them, but they wouldn’t believe me. It almost feels like they wanted me to be. Now I’m actually starting to believe them. I know I wasn’t back then, and now I’m not sure anymore. Output: I agree with Amy. We get a lot of pressure from others and even ourselves to define who we are and what we want at a pretty early age. The truth is, our sexuality can change and grow in directions we never imagined. I may be wrong, but I am getting the impression that you may not want to be gay. That this is something you didn't like others suggesting and now you are uncomfortable with the idea that it may be true. This would certainly be understandable. Your sexuality is YOURS and yours alone. It can be quite frustrating and hurful when others try to define who you are. And it can be equally frustrating when you are trying to figure it out for yourself. The truth is that there are many different possibilities when it comes to sexual orientation. It may help to think about what qualities you find attractive. What kind of person can you see yourself being attracted to? Someone smart? Funny? Loves dogs? If you look for these qualities in a person they may lead you to being attracted to someone of the same sex, but maybe not. At least you would be choosing someone based on values and qualities that you love and admire. Another idea is to chat with a counselor, if you are interested. Preferrably one who has done some training in affirmative therapy. Be well and be you..Robin  J. Landwehr, DBH, LPC, NCC

Instruct: I know I'm ruining my life with a lot of the decisions I make. I consistently tell myself I need to make some serious changes in my life, but I just can't seem to even though I really want to. Why can't I force myself to change? Output: In general the reason people aren't able to change is because the person feels a sense of fear to change.What the roots are of this fear are usually easiest to identify by talking with someone whom you trust and feel safe to talk about your inner thoughts and emotions.If you haven't got someone like this in your life, which is common, then shop around for a therapist because a therapist is someone who is professionally trained to listen in a way which helps someone know more about who they are.Be patient with yourself too.  Change sometimes feels much scarier and is more complex than simple compared with whatever you would like to change.

Instruct: I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust. Output: First, thank you for sharing such deep personal information. It can be difficult to share such intimate information. To begin, it sounds likes your primary concern your desire to speak to someone who takes your mental health seriously. You've tried talking to your parents and your friends and neither have made that connection in the area you need. I'm sorry to hear that. it's unfortunate. However, I think a couple things can be done to try to address this. If you want support1) Parents- Sit down with one of them and tell them with all seriousness that you need to talk about something that is affecting you deeply. Perhaps speaking to both can be too much for one room. If you try to speak to mom or dad by themselves, it may create that intimate atmosphere needed to understand where you are coming from. 2) Friends: Like parents it can be difficult to speak to your friends about challenges with your mental health. When you're feeling down and anxious, friends can be great help or not their at all. With friends, it may be one of those things where you also need to create an intimate environment with one friend to speak to about your sadness and anxiety. If anything, speak to the fact you're hurt and help them understand that if they can't understand the depressionIf you don't want support Coping Strategies: Identify coping skills and strategy that help you when you're feeling down. Ideas:A.) JournalingB) PaintingC) ExerciseD) MusicE) Reading AffirmationF) Listening To Motivation Videos

Instruct: I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends. I spent the weekend with him and it upset my boyfriend. Was i wrong? Output: That is a difficult situation and there is no right or wrong. You both need to discuss it and come up with a solution that works for the both of you. You want to spend time with your friend but your boyfriend  may feel betrayed by you spending quality time with another man you have been intimate with. There may be a way for you both to get your needs met. Maybe you only spend short periods of time with your friend, not a whole weekend. Or you check in with your boyfriend  periodically when you see your friend. It really depends on the two of you. If it becomes too difficult, you may need a neutral party to help you establish appropriate boundaries around this issue. Good luck!

Instruct: I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? Output: Absolutely not!  In fact, most people have many issues,  A lot lot of the issues you are describing commonly go hand in hand ( in "therapy speak" we call it co-morbid conditions)I would venture that most of the feelings you are struggling with stem from your early trauma.  You would benifit tremendously from counseling!  A good therapist will develope a treatment plan that addresses all of your needs. With help you could definitely live a happy life without all of your anxiety and depression getting in the way!

Instruct: When I got home, my boyfriend and I got into an argument. He got upset and he started hitting his face. That is the first time he has ever done that, but I would be lying if I said that didn't scare me. I locked myself in the room. Output: Sounds scary to watch.  I agree with you!Maybe he felt so overwhelmed by anger, hurt and frustration that he went back to an old behavior from his past in which someone hit him for having strong emotions.Now that the incident is past, bring up the topic to him so the two of you can discuss it.Just the fact of you having empathy and caring what he was feeling at the time, may be restorative to him.At the very least, you may find out exactly what the answer is to your question as to why he did this in the first place!

Instruct: I'm a female in my mid 20s. Lately I tend to over drink and I've become a very angry drunk. In the past, I have even cheated on my boyfriend while I was under the influence of alcohol. But now, even if I don't do anything wrong and don't embarrass myself, I still feel really guilty after a night of drinking. I don't understand why I'm feeling this way. Does this mean I have a problem? Output: I offer that getting a professional assessment is in order to look at your relationship with alcohol.

Instruct: How do you know you have the right therapist for you? How would I know how to "train" my therapist to be able to give me what I need from treatment? Output: What an important question! I think one of the first things to assess is this: Do you feel comfortable with your therapist? Do you feel like you can talk openly about what's going on in your life without feeling judged? Do you experience your therapy as a safe space to process your thoughts and feelings? Feeling comfortable with your therapist is a crucial factor. Once you feel comfortable with your therapist, you can have a conversation about what works for you in therapy. Tell your therapist what is helpful, and what you don't find helpful. A skilled therapist can shift his or her style and techniques to meet your individual needs, and this may be an ongoing conversation that the two of you have during therapy. Oftentimes, there is just an X factor between client and therapist that either makes the relationship work or can make it feel like something is missing. This is no one's fault, it's just that not every therapist will be a perfect match for every client. If you feel uncomfortable with your therapist or feel like that x factor is missing, it is a good idea to keep searching for therapist who is right for you.

Instruct: My boyfriend lost his dad to suicide. He says that because his dad died, so did his heart. He says that he can't be there for me or love me anymore and wants nothing to do with me ever again. Why is he doing this when we were very happy together? He says that I have done nothing wrong but he just can't be with me. Output: I am sorry to learn of this.  You must be extremely frustrated and heartbroken.  To begin, he is correct.  You have done nothing wrong.  This is entirely a coping mechanism in overdrive.  It is fear.  It is anger.  It is extreme sadness.  It is feelings of abandonment.  It is intense emotional pain.  It is his way of protecting himself from potential unexpected additional loss.I am not familiar with how old this post is, but often, it will require time and understanding.  If he speaks with you, encourage him to get grief counseling.  Do not encourage it for your relationship, encourage it for his betterment coping with losing his dad.  Start there.  Good Luck.

Instruct: My husband and I are separated and he doesn't even want to talk to me. He says he doesn't love me anymore, but I would do anything to get him back. Is there any hope? Output: Most important is to take care of your feelings regarding that he has left you.From your description  there doesn't seem to be much hope your husband would like to keep the marriage going.Has a long time passed since the two of you separated?   Sometimes, and really this is very rare, people decide to return to their marriage.If he impulsively decided to leave and now is a short while since he did this, then there is some hope he will decide to stay together.If he's been out of the house for a while and tells you what you wrote, then there is greater chance he's had time to think through to split and will follow through.As painful as it is to hear that someone with whom you'd like to be, doesn't want to be with you, accepting your hurt feelings will eventually let you come to peace with your feelings.To keep hoping against the facts of what he's said to you, only makes your own pain intensify.

Instruct: I'm a teenage gay girl, and I'm in love with a girl a few years older than me. She loves me too, but we're not physically together at the moment. I've been thinking about being transgender soon too, but my family doesn't accept me, so I honestly don't know what to do about that because I feel like I have to constantly hide the real me. It hurts so much to hide the real me. What can I do? Output: They would probably be helpful to speak with a local mental health professional about this, not because there's anything wrong with the real you, but because having these conversations can be difficult and you may choose to talk about your real self in different ways with different people.Maybe you could talk about your concerns with your significant other and discuss different ways you may be able to discuss your relationship that fit with how each of you defines your love for one another.Because you are saying openly that you are gay, and it sounds like you already identify yourself as gay, as compared to considering being transgender "soon," it may be worth considering disclosing the fact that you are gay now and disclosing the idea that you are transgender after you have worked through that yourself. I would like for you to be able to be true to yourself and show the real you. It could also be that you already know that you are transgender, but with the way that you  phrased it here, I'm not certain.Here is a link to a hotline that you may want to consider using. The Trevor Project is about helping teenagers who identify as LGBTQ: http://www.thetrevorproject.org/Here is another national site where you may be able to find a local chapter: https://www.pflag.org/I don't know what you mean when you said that your family will not accept you, but since you are concerned about your family's reaction, I would suggest that it may be helpful to have a therapist or some other support in place before telling your family. The decision of whether or not to wait longer to tell them is ultimately yours, but I wonder if you have a likelihood of explaining what you are experiencing in a way that would be truer to you and also perhaps easier for your family to follow if you had time to process it with supportive people first.Please remember that you are not alone in this. There are people in the world who can and will accept you for who you are.

Instruct: Then turn right back around and say he loves me and needs me. This rollercoaster is crazy. Output: Yes, I agree with your view about the "rollercoaster" sounding "crazy"!Concentrate on knowing what your reasons are for staying with this guy, given the broad facts that you state.What are you gaining from being together and are these gains outweighing how you feel when your companion says the opposite of what he just told you?Also, examine yourself for any fears of being alone.Very often, people stay in detrimental relationships because of a fear that being alone will feel worse.It may, initially feel this way after a breakup.This is from change itself.Eventually, stability and peace of mind return, and being alone with oneself is preferred to being taken on an emotional rollercoaster by a partner.

Instruct: Maybe this is a stupid question, but I sometimes don't know what's real or not. If feel at times like everyone's lying. How do I know if God is one of those lies? Output: The way that I see it is that Humans have always been afraid of life and death, historically we have always tried to understand life, we try to organize it, categorize it, explore it, and we've built up this system, our system and societies system around us to help us define what life and (death) is, this system or way is not real but only a perception of our own value judgements, it is, no matter how you try to argue it, a false system of conditioning, humans have a finite mind and a finite mind cannot ever hope to understand an infinite mind of which a god would be. God has been developed over time as a security blanket for our child-like selves, the world is a beautifully brutal place and what is more reassuring than a master that will take care of us and show us the way. On Earth alone there are thousands of gods and even many more systems of thought, economics, societal structures and so on, it is almost as though it were a supermarket with so many choices, we have more choices in gods than we do flavors of ice cream at Baskin-Robbins, so then I ask you, "which one is real?, and "what is real?"

Instruct: I'm a male in my 20s. My girlfriend is in her late 30s. She's great. She's funny and smart, she has a big heart, and we have an excellent sex life. She recently moved in with me partially because she wanted to and partially because she had no place to go. We fight a lot. It’s mostly my fault, I must admit. She doesn't like my insecurity and lack of trust I have for her. I have trust issues. Also, I can't fathom why a woman like her is with me, so I'm always dreading when a better dude will come along. I don't think she's happy. She's very submissive and she loves me very much, but also the fact that she has nowhere to go must be influencing her decision to stay. I love her so much, but my jealousy is not likely to diminish. I never believed in the whole "If you love them, let them go," but I do now. I really want her to be happy. Should I end it with her? She has no place to go so I feel like I can’t break up with her. I’m literally trapped. Output: It sounds like there are assumptions being made regarding how she feels about you and why she is with you. I would not suggest breaking up with her without first attempting to resolve your own issues. You may not only regret your decision, but might find that the exact same problem arises in future relationships. I would recommend seeing a therapist who can help you figure out what is at the root of all of this. By learning about your own insecurities and where they come from, you can expect to discover new ways of responding and relating to others, which will likely impact your relationship in a positive manner.

Instruct: What should I do when we see each other? Output: Echoing others here, I'm sorry, she shouldn't have. Hopefully, you will have a conversation (or, in reality, several conversations) about relationship expectations of privacy~ Are there things your wife would prefer you not share with her family? Without exploring what is or isn't okay through healthy dialog, it's entirely possible she felt her sister was 'in the circle' of people she could share this with. All that said, though ... now that you've been outed, you have an opportunity to be more authentically you: what will you do with it?

Instruct: My mother has Alzheimer's and she has become so nasty and mean to everyone and she always asks for unrealistic, silly or meaningless items. I get so frustrated and angry, but then I feel guilty because I know it probably isn’t her fault. How can I cope with feeling like this? Output: It is very difficult to move from being the child to be the care giver as in your situation. Your mother's behavior as you describe it is a part of this disease. As the disease progresses and she is less aware of the present including her surroundings and who she is speaking to. Your response of anger and frustration are understandable. It is also a part of the grief process as you see you mother slipping away mentally. In the moment that you feel the anger step away, take some deep breathes and give yourself time to calm down. Then return to whatever you were doing with her. Caregivers of Alzheimer's patients need a lot of support themselves. There are support groups  as well as respite services available in many areas that will help you understand the process that each of you is going through. You can get more information about Alzheimer's disease and local resources by going to www.alz.org

Instruct: This is my recovery, and I don't feel that it is okay for them to ask this. They told me it is policy due to the fact that I may run into a peer there. I am a peer counselor in the small community that I grew up in. I am in recovery myself. I was asked to come work for this organization after I was two years sober (I was in treatment in this organization). I work with mental health peers and run life skill groups. I don't work with substance peers. Output: Hello, and thank you for your question. I know that workplaces have some latitude when it comes to requiring certain behaviors from their employees. For example, they may require you to tell them if you get into some kind of legal trouble. But this situation seems completely different. For one thing, 12 step meetings are supposed to be anonymous. I am not sure how they would know that you attended unless you or someone else told them. I agree that it seems like to cross a line. Usually each state has an office that manages complaints related to employment, such as the Department of Labor or EEOC. You may want to see which entity is in your state and contact them. It would be worth asking them to see if this is a legal practice. If it is but you still want/need to stay at this job, then you may want to look for alternate sources of support for your sobriety. There are active online support groups that would allow you to do things from the privacy of your home. SMART Recovery http://www.smartrecovery.org/ is a website that many people like. There are also online groups that specifically discuss the 12 steps. No matter what, I give you a lot of credit for doing your best to keep your sobriety and continuing to see the value in having support. Robin J. Landwehr, DBH, LPCC, NCC

Instruct: Does counseling really do anything that can help people? Output: Yes, counseling can help people.How this happens is bc the counselor can guide the person or couple into deeper areas of their thoughts and emotions than the person or partners would typically avoid or not even realize they are avoiding.Also, a counseling session offers emotional safety because the therapist will intervene with thoughtful questions if someone's strong emotions overwhelm them.This is different than in everyday circumstances.  When someone feels overwhelmed by their own or someone else's feelings, there is no one who asks reflective questions.Last, people get better in therapy because often therapy is the first time the person has a chance to trust someone with their confidential information and know this information will always be protected.

Instruct: I've been like this ever since I was in school; back then I transferred to another school. Now I'm thinking about changing my job. Output: Many times when things become difficult to manage, is because we are getting out of our comfort zone, so we seek growth and change.  Coping with the difficulties does make you more resilient and helps you to build the confidence you need to solve problems in the future. Now I wonder:  are things getting tough in a way that you are not able to resolve them?  Do you need to move or change to save yourself or prevent any harm? If so, it is OK to know when to remove ourselves form situations that harm us more than helping us.   On the other hand, are the things getting tough because you need to learn a new skill?  If so, how can you learn them and is there someone who can help you overcome this challenge?  I help my clients to identify their strengths and areas where they can achieve growth, things like polishing up your resume and evaluate new job opportunities could help you discover a new you.If you would like to engage in counseling, I am licensed in Texas and Puerto Rico, you can contact me at 787-466-5478. Cada vez que las cosas se ponen difíciles, hago cambios en mi vida.He sido así desde que estaba en la escuela; antes me transfería de escuela.  Ahora pienso cambiar de trabajo.Muchas veces cuando las situaciones se tornan en difíciles de manejar, es porque nos sacan de nuestra zona de comodidad, con el propósito de buscar el cambio y el crecimiento.  Manejar las dificultades si te vuelve más resistente, y desarrolla tu autoestima para que puedas resolver problemas en el futuro.    Ahora, te pregunto: ¿se están poniendo las cosas difíciles al punto que no puedes manejarlas?  ¿Necesitas removerte de la situación para evitar que te hagan daño? Si es así, entonces está bien reconocer cuando nos debemos remover de una situación dañina que nos daña más de lo que nos permite crecer. O por el otro lado, ¿Se están poniendo las cosas difíciles porque necesitas a prender una nueva destreza?   Si es así, ¿cómo puedes aprender esa destreza y quien te puede ayudar?Ayudo a mis clientes a identificar sus fortalezas y áreas de crecimiento, el actualizar y pulir tu resume junto con explorar opciones de empleo, te puede llevar a descubrir nuevos talentos en ti.Si te gustaría hacer una cita, soy Consejera Profesional Licenciada en Texas y en Puerto Rico, llama al 787-466-5478.

Instruct: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments. Output: Give yourself credit for what you already know.For instance, you do know that you're unsure about your life direction. Take off any pressure on yourself to decide an answer in a certain amount of time.  Inner reflection work takes time and has its own course.   Trust that answers will show once you've done the work to understand yourself and circumstance, and the relationships in your life.From what you describe, your interest is in a broad scope life change. One direction is to start with only one specific part of your life you would like to change.  By examining one area in detail you will gain self-trust and confidence in handling your life.   And, you will have clarity as to which area to change first.

Instruct: She was raised by her abusive father and his wife. 30 years ago I shot and killed my rapist and was convicted in Louisiana. I lost custody of my daughter and served 5 years. When I was released, she was 5 and didn't remember me. Many many sad memories came from my having to leave her visit after visit, having to leave her in Texas to travel back to Louisiana. She doesn't remember that. I do. Over the years, I thought we had developed a close mother daughter relationship. She gave me good reason to doubt that on several occasions but especially last year. I have been cruel to her verbally and to my son who I met years after giving him up for adoption. Last night, I was angry at the world and afraid of God. I drank and cussed out a maintenance worker for not doing his job 4 months running. Now I'm not only feeling guilty for that but afraid of being evicted now. Help. Output: Was either parent abusive or violent toward you?You sound to have suffered emotionally in your relationships since early in life.One point to consider is to strive for moderation in what you offer in relationships.A lot of what you've lived through is extreme, either as victim or perpetrator.If you imagine that apologizing to the custodian for the way spoke to him, would calm him down, do so.At the very least, you'll be actively resolving your guilt over cussing at him, and fear of his retaliation.

Instruct: Two years ago, I was separated from the military into my contract for medical issues. It has emotionally destroyed me. I now basically hate myself. It's embarrassing to be separated from the one place who takes anyone. My family has been in the armed forces, and it has always been my dream. I can't do this alone anymore, and now my family is even worried. Output: It sounds like being separated from the armed forces is a major loss for you. It takes some time to work through the emotions related to this and it often takes longer if you are trying to work through it without a lot of support.Is there a task that you were doing during your military service that can in some way transfer into civilian life? I don't know what else your life involves, whether you have close friends or a romantic partner, a career, activities that you like to do, and many other things. You may be able to use some of the things that you still have today as a way to start moving forward in a different direction.Your military service will always be a part of you. Thank you for your service.

Instruct: I have been dealing with depression and anxiety for a number of years. I have been on medication, but lately my depression has felt worse. Can counseling help? Output: Certainly counselling can help. however, there is a caveat, namely, you will need the right counsellor with the right approach. This leads to two questions: 1) What are the identifiers for the right counsellor, and 2) What is the right approach?1) What are the identifiers for the right counsellor? The right counsellor will almost certainly have a lot of experience. He or she will have done a lot personal work and have an ongoing practice of inner work both on their own and with the support of an experienced therapist. This person will be viewing you as a human being with challenges, not as a diagnostic category. He or she will be willing to work with you over an extended period of time and have experience doing such work. Further they will be well versed in approaches that are responsive to you in the moment and overall. The in-depth work will be collaborativel designed in an ongoing way that is responsive to you, the moment, your overall life experience, and their in-the-moment experience. It goes without saying that you will subjectively evaluate the felt sense of connection with this person and the feeling that they are invested in their work with you, value you as a human being, and value the connection. As well, it is crucial that you feel this connection and that your therapist 'gets you.' 2) What is the right approach?  As Carl Jung stated, "When the doctor sits down with the patient he (or she) must drop all theories and learn the theory of this person." The approach must include a bond between you and your therapist that is in a continuous process of development, attention to pre-verbal imprinting, development of awareness ability, ongoing development of the ability to attend to and stay with inner experience, development of a process orientation, attention to egoic structures that were seeded from the earliest days in the service of perceptions of threats to needs being met, identification of current egoic states and work with these inner selves and their relationship with each other to facilitate movement from developmental points of arrest, increased ability to access and contain non-ordinary states of consciousness, attending to what is, and working with this in the service of moving towards optimal human development.depression is generally experienced as the system shutting down. anxiety is a signal that something is wrong. anxiety is not the problem. it is a sign that there is a problem. the core of these issues is a lack of inner security that is the outcome of insufficient bonding. the work of psychotherapy is to establish an environment and relationship that will facilitate work with the bonding ruptures and re-initiation of the developmental process that stopped at an early stage.

Instruct: Ive been in an on an off relationship with a this man for almost 3 years. Even though I care about him, he continues to hurt me. He and his wife were separated when we met. Now he's going through a really difficult divorce from her and is taking it really hard. I want to end this relationship, but I don't feel like I can. How can I let go? Output: First decide what you truly would like in the current relationship. Understand your reasons for staying in the relationship.Three years is a substantial amount of time to be involved with someone.   Whatever attachment you feel toward this man is deep and complex.Instead of deciding to leave or not leave, change your question to figuring out your satisfactions and dissatisfaction with the man. Also important is to tell the man your feelings.Whatever problem you are feeling may become clarified by discussing what bothers you.At the very least, you will give the guy a chance to show how interested he actually is in the tension you currently feel and have felt for a while.

Instruct: In middle school and high school, my friends and family thought I was gay. I tried telling them, but they wouldn’t believe me. It almost feels like they wanted me to be. Now I’m actually starting to believe them. I know I wasn’t back then, and now I’m not sure anymore. Output: I agree with Amy. We get a lot of pressure from others and even ourselves to define who we are and what we want at a pretty early age. The truth is, our sexuality can change and grow in directions we never imagined. I may be wrong, but I am getting the impression that you may not want to be gay. That this is something you didn't like others suggesting and now you are uncomfortable with the idea that it may be true. This would certainly be understandable. Your sexuality is YOURS and yours alone. It can be quite frustrating and hurful when others try to define who you are. And it can be equally frustrating when you are trying to figure it out for yourself. The truth is that there are many different possibilities when it comes to sexual orientation. It may help to think about what qualities you find attractive. What kind of person can you see yourself being attracted to? Someone smart? Funny? Loves dogs? If you look for these qualities in a person they may lead you to being attracted to someone of the same sex, but maybe not. At least you would be choosing someone based on values and qualities that you love and admire. Another idea is to chat with a counselor, if you are interested. Preferrably one who has done some training in affirmative therapy. Be well and be you..Robin  J. Landwehr, DBH, LPC, NCC

Instruct: I feel too scared to meet people I don't know - even relatives. I don't ever raise my hand or talk in school. I feel like no one understands. How can I handle this? Output: Congratulations on your courage to ask this question!This shows you are willing to engage with other people, just not in all situations, especially the in person ones.Start by "meeting" yourself.Reflect as thoroughly as possible as to what you imagine will be the outcome of meeting others or of speaking up during a class.Some people are afraid of being criticized or judged by other people, or do this to themselves inwardly.  If you are judging or criticizing yourself to be less worthy of having opinions or views or of being who you are, than others, then the thought of actually placing yourself in this situation, would feel intolerable.One way to move out from this position of feeling less than others, is to recognize that these feelings are inside of you.Then it is possible to know at least on an intellectual level that it is not true that any one person is superior to another.All the people whom you are afraid to meet, also have their own insecurities.We are all equal in worth and in having blindspots about ourselves.Also, it is possible that you are naturally shy and may be expecting more from yourself than is reasonable, in terms of a standard about meeting others.You may have a few fears of being judged unfairly, you may also simply not enjoy being around people very much.Be aware to not push yourself beyond your natural limits.  Overcoming fears of being judged is different than forcing yourself to do what is against your basic nature.

Instruct: I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do? Output: Unfortunately I think most of us have heard this, so you are not alone.  If you are still under her roof she has leverage as to what her expectations are while you are living there.  I would consider therapy for the both of you to see if there could be a middle ground that could be agreed upon.  Often times a 3rd party can help with conflict.  If there is no resolution then I would look to get creative in finding a place of your own.

Instruct: I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed? Output: I would not focus on what other people say. Do you feel what you have described impacts your day to day functioning? Try to evaluate how is your self esteem, motivation and self confidence. How about negative thoughts or hopelessness? Any concerns about your grades sliding down? If you answered yes to any questions, may be its time to see a counsellor.

Instruct: Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me. Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me? Output: I understand the feeling of not being liked due to not having any responses on the sites you list.More than likely the non-response has less to do with liking you than w liking the way you write your messages.Have you tried asking a question in your posts?  This would be one way to invite people to answer your post.When you write,  imagine yourself as the reader of the post.If you think about the wording of a question which would motivate you to respond, then this formula will very likely be the same for many others who read your post.Good luck!

Instruct: I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? Output: This is a great question! I personally don't believe that any client could ever have too many issues for counseling. In fact, that type of thinking may be stopping you from seeking counseling, so it may be hindering you from getting the help you need. In fact, all of what you described points to the importance of you seeking help in order to cope with the many challenges in your life. If you seek counseling, it will be important for you to understand that you may need to remain in counseling for a sustained period of time in order to work through each of these issues. All of these issues won't be able to be solved right away or in a brief period of time. Counseling will take commitment and hard work, but it is possible for you to recover and heal from all of the issues you described.Many clients come into counseling with numerous issues rather than just one particular thing. Most of the time, the issues relate to and exacerbate each other. We call these "comorbid" conditions, which means that two or more mental health problems exist at one time. A lot of the times, when you start to work on one issue, the other issues get better as a result.I encourage you to find a professional therapist that can help you learn how to cope with all of the mental health difficulties that you described. You deserve the help just as much as anyone else.

Instruct: I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing. What can I do to manage my stress? Output: It sounds like you are experiencing burnout and have very little, if no job satisfaction.  There are some aspects of this that are in your control and others that are not.  What type of work do you typically enjoy?  Do you enjoy high stress work? What keeps you in this job? Is there a reason you have stayed?  Is your boss reasonable to have a conversation with?  I recommend a few things.  For one, you may want to have a discussion with your boss about your job duties and see if there is a way to either eliminate some responsibilities or get higher pay.  Another option, if you are unable to have an open conversation, you can start to look at an ideal work situation, what would you like/ be OK with/ absolutely hate about a job. Then possibly try to look for a new job that fits these qualifications. If you are unable to leave your job, you may want to attempt to balance your work life with more activities that create joy outside of work.  Sometimes that balance can help you tolerate work more.  I recommend that you find a supportive person to talk with and process these frustrations as burnout can lead us to do things we may regret.  

Instruct: I'm going through some things with my feelings and myself. I barely sleep and I do nothing but think about how I'm worthless and how I shouldn't be here. I've never tried or contemplated suicide. I've always wanted to fix my issues, but I never get around to it. How can I change my feeling of being worthless to everyone? Output: You can, for sure... and the first step is to believe you are worthy TO YOURSELF. Recognizing you are in a quest is already a big first step. Taking the time to start figuring out who you are is definitely the next... do so with SELF COMPASSION and kindness. Know this is a process and just look forward for what you might find.  I do recommend you find someone to talk to (there are many options out there that can fit the situation you are in), and I also recommend you start by giving yourself the importance to invest some time and effort in this quest. YOU DESERVE IT. There are some excellent TED Talks you can google, great books you can read, or even joining a yoga practice, team or some kind of hobby may help. Anything that shows yourself you are worthy of this effort. Have patience and start!!!! the answer is out there waiting for you. Asking these questions already set you on the right path.

Instruct: I have three children. The oldest is nine and not my biological child. The middle child is three and the youngest is one. I have a great relationship with the oldest two children but I haven't developed the same level of attatchment to the youngest child. I rarely want her around and look forward to her nap times. Is this normal? Output: This is your experience, your feeling and you are wondering if it is normal, which means is this common or the rule. This question about how you feel about your third child leads me to believe you are dis- turbed [etymology: agitated or stirred up].  Feelings are messages from our soul or spirit that something is not right.  So, though  it might be normal [common, the rule]  to look forward to a one year olds nap time when you have a three year old a nine year old, the dis- turbance or stirring up in you, is important and requires your attention, your listening, if you will to your higher self.

Instruct: I feel like I would be more comfortable as a girl even though I still like girls. I think I'm like a girl stuck in a guy body. I imagine myself as a girl too. I think this more because my friends say that if I was a girl I would be a hot looking one. And I don't care about having boobs or anything. I just feel like the way that I do act will make more sense if I was a girl. Output: I understand that gender and/or sexual identity crises can be very difficult to navigate, although in today’s time I think we have made a lot of progress and it is becoming easier for individuals to find themselves and also find acceptance from society.I am unsure how old you are. If you are a child or teenager, this is a normal time to have identity questions and to be in a phase where you are trying to figure out who you are and what you want out of life. I hope that you have understanding and supportive friends and family that you can talk to and who will support you in how you feel and what you may decide to do. A lot of people, unfortunately, do not, and if this is the case then it makes it harder for you. Because then you may not feel safe exploring these feelings and decisions.I urge you not to try to make any permanent changes for quite some time. By this I mean a sex change. Anything permanent like surgery or hormone replacement to change your actual gender is something that does not need to be done lightly. Please find a therapist that can help you explore your feelings and your identity crisis. Of course there are things that you can do that are not permanent changes. Many people decide to dress like their gender of choice. Maybe experimenting in this way is something that you could do.See if you have a local chapter of PFLAG in your area. PFLAG stands for Parents, Families and Friends of Lesbians and Gays. They are able to help not only with those who identify as lesbian or gay, but also transgendered and asexual. I wish you all the best in your identity crisis. It would be very easy for you to sink into depression if you do not have good support and understanding from those around you during this time. Find a professional that can help, especially if you experience depression or any thoughts of harming yourself.

Instruct: My husband and I have been married for seven years, and in that time, we have only had sex four or five times. Others have told me that most men would have left me by now. Honestly, I think I have a low sex drive or neither one of us actually knows what we are doing. I want to be better connected with my husband. Output: It's encouraging that you say you want "to be better connected with [your] husband," and since he hasn't left you, he must care about you and the relationship more than he does about just having sex. You don't say whether he complains or not, but even if he doesn't it seems there's a sense of something important missing for both of you.Most likely to connect better with him physically you'll need to become better connected with yourself and your body. Men often feel fulfilled by sex simply because it happened - the woman they want received them, allowed them to make love with her. For women that can sometimes be more complicated. A woman who loves sex most likely also loves her body, knows what pleasures her, and feels confident asking for what she wants. Self-pleasuring can be a way for you to discover more about your sexuality, and a classic resource is Betty Dodson's book Sex for One: The Joy of Selfloving. A good counselor or sex therapist can be very helpful with your whole relationship as well as the sexual part of it, but not all counselors are comfortable working with sexual issues. Shop around and be sure you find someone who can help you and your husband get better connected on all levels.

Instruct: Why am I so afraid of it? I don't understand. Output: Your fear is somewhat reasonable.  No one wants to be raped and I imagine everyone is afraid of what being raped would feel like.Do you mean that this fear is on your mind more often than you would like?If this is the case, then try understanding the reason behind your fear.Is it because you personally know or know of someone who was raped?  One general direction of what would help is to regain confidence in your decisions of keeping yourself safe.  The more you trust yourself to avoid social situations with lots of drinking, isolated physical surroundings, and being in isolated locations with someone with whom you're not very familiar, probably your fear will decrease.The other general direction to understand is if in your family history, people have been violated severely, either emotionally, mentally, or physically.In families in which people have suffered severe violations of themselves, often the emotional patterning of expecting to be hurt by others, plants itself very deeply and transmits to the younger generation.Its possible then, that you are suffering from fears established in other family members who have not yet been able to fully understand and accept their own suffering.The good news is that individual therapy, with a credentialed and licensed therapist, is ideal for a safe place to open and clear this type of emotional burden.

Instruct: I'm a male in my 20s. My girlfriend is in her late 30s. She's great. She's funny and smart, she has a big heart, and we have an excellent sex life. She recently moved in with me partially because she wanted to and partially because she had no place to go. We fight a lot. It’s mostly my fault, I must admit. She doesn't like my insecurity and lack of trust I have for her. I have trust issues. Also, I can't fathom why a woman like her is with me, so I'm always dreading when a better dude will come along. I don't think she's happy. She's very submissive and she loves me very much, but also the fact that she has nowhere to go must be influencing her decision to stay. I love her so much, but my jealousy is not likely to diminish. I never believed in the whole "If you love them, let them go," but I do now. I really want her to be happy. Should I end it with her? She has no place to go so I feel like I can’t break up with her. I’m literally trapped. Output: It sounds like there are assumptions being made regarding how she feels about you and why she is with you. I would not suggest breaking up with her without first attempting to resolve your own issues. You may not only regret your decision, but might find that the exact same problem arises in future relationships. I would recommend seeing a therapist who can help you figure out what is at the root of all of this. By learning about your own insecurities and where they come from, you can expect to discover new ways of responding and relating to others, which will likely impact your relationship in a positive manner.

Instruct: I have so many issues to address. I have a history of sexual abuse, I’m a breast cancer survivor and I am a lifetime insomniac. I have a long history of depression and I’m beginning to have anxiety. I have low self esteem but I’ve been happily married for almost 35 years. I’ve never had counseling about any of this. Do I have too many issues to address in counseling? Output: Not at all my dear. Human beings are complex creatures, and in my opinion, our issues interconnect in a very nuanced web between our levels of being (for example, mind, body, and spirit). Everything you bring up affects all three. The truly beautiful thing about the human body is that when you begin to work on one, the others improve as well!I would encourage you to seek out a counselor who's style and approach speaks to you and start with whichever issue feels most pressing to you. A skilled therapist will flow with you at your own pace and make recommendations to other professionals (e.g., physicians, holistic practitioners, EMDR specialists for trauma etc) as needed to complement the psychotherapy work you're doing with him or her to help you find the total healing you seek. I wish you well on your journey!

Instruct: How do I make myself happy without the people who made me happy? Now that they’re gone, I feel sad. It’s been two months now but I seem to be unable to stay okay and independent. Output: It sounds like you have been feeling pretty down, since the loss of a relationship, and you're wondering how to be happy by yourself. Intimacy is a very natural human desire and at the same time learning to enjoy ourselves, even when we are alone, can strengthen our ability to lead a satisfying life in and out of relationship. Working with a therapist, you may be able to gain insight into how you show up in your relationships with yourself and others and discover more fulfilling ways to do so.

Instruct: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again. Output: It seems like you are very receptive of your husband’s emotions and want to support him trough this time.  But it is also important of being aware of your emotions.  How are you feeling after the suicide attempt?  It is common to experience negative feelings while you try to make sense of the incident.  Feelings like anger, shame, guilt and fear are frequent; while, wanting to avoid, minimize and become distant from the person are parts of the defense mechanism to attempt a quick resolution.  Once you understand and overcome those feelings you may be in a better position to help your husband; who may be experiencing some negative feelings as well.First, it is important to have a safety plan in place, which includes removing harming objects from the home, knowing who to call if there’s a new attempt (either 9-1-1, or nearby treatment center), have a professional expert who monitors you and your husband’s progress, either a Counselor or mental health provider could help you manage negative feelings and identify ways to handle triggering situations.Once the safety plan is in place,  make him feel supported and not judged, saying open ended statements, like: “I am glad that you are here, please let me know what I can do to help you through this process”.  Making small changes toward a healthier living may help as well.  Exercising, eating healthier and practicing new leisure activities may be good ways to start.  Also, explore your spirituality and your husbands, looking for ways to encourage each other by joining a support group or finding people who share your spiritual beliefs.If you have more questions or concerns I offer teletherapy in the State of Texas, and traditional Counseling in Puerto Rico, call 787-466-5478. ¿Cómo puedo ayudar a mi esposo después de un intento de suicidio?Después de que el llego a casa del hospital estaba enojado, luego por un tiempo maravilloso.  Ahora está deprimido y sin ánimos.Parece que estas muy atenta a los sentimientos de tu esposo, y que lo deseas ayudar durante este momento de su vida.  Pero también es importante estar consciente de tus propias emociones.  ¿Cómo te has sentido luego de este intento de suicidio?   Es común que experimentes emociones negativas mientras los recientes sucesos hacen sentido.   Sentimientos como coraje, vergüenza, culpa y miedo son comunes, y el querer evitar, minimizar o distanciarte son mecanismos de defensa igualmente comunes.  Ya que comprendas y superes estos sentimientos,  estarás en una mejor posición para ofrecerle ayuda, recuerda que tu esposo también debe de estar experimentando sentimientos negativos. Es muy importante tener un plan de seguridad, esto incluye remover todos los objetos que pueden ser dañinos o facilitar un futuro atentado, saber a quién llamar en caso de una emergencia (9-1-1 o una clínica de emergencias cercana),  tener un experto que monitoree tu progreso y el de tu esposo, puede ser un Consejero u otro experto de salud mental que te ayude a manejar los sentimientos negativos y situaciones retantes.Ya que el plan de seguridad sea activado, crea un ambiente donde tu esposo se sienta apoyado y no juzgado.  Utiliza frases abiertas para comunicarte, dile que estas feliz de que este contigo, y quieres saber cómo puedes ayudarlo durante esta etapa.   También haz cambios pequeños para mejorar su calidad de vida como pareja.  Hacer ejercicios, comer más saludable y compartir actividades puede ser un buen comienzo. Explorar tu espiritualidad y la de tu esposo también puede ser de ayuda, y encontrar personas o grupos que compartan esos mismos intereses puede ser una manera de mantenerse motivados.Si tienes más preguntas o preocupaciones sobre el tema, ofrezco teleterapia en Texas y Consejería Tradicional en Puerto Rico, llama al 787-466-5478 para más información.

Instruct: I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing. What can I do to manage my stress? Output: I think it's important to tease more of this situation out to figure out what is at the root of the stress. It is emotionally dangerous to be at a job for a lengthy duration in which you feel overworked and underpaid. You will not perform well as you mention, and thus your self-esteem will continually take a hit without really any effort. So, I don't know that simply coping with your stress would be advisable as a first step.You don't speak about a lot of what the office dynamics are like, which can be a big indicator for me of what can be done to help you feel better (because we exist as a part of a relationship with everything, including people at our job.) I would encourage you to speak up about your contributions to your boss. Often, "overworked and underpaid" also includes the "my boss never notices me," and that can demoralizing. If we feel appreciated, that can go a long way. I've found that it is quite common for bosses to require some instruction for how to show each of their employees "appreciation" (and it goes deeper than "thank you" or taking you out to lunch - it's almost something felt as opposed to made explicit.)But sometimes appreciation isn't going to do the trick either. Because that overworked and underpaid actually has led you to feel "burnout." You have zero interest in doing the job in the way it is designed, so some real changes need to be implemented. The bottom line? Try not to just "suck it up" and do all of the "self care" work on your own. If your company isn't helping you to take care of yourself (I'm talking to you, boss that handles employee pay and/or work conditions!) then you also have to question if this is a company worth working for. While I don't know exactly what you do, it sounds like you have confidence in your contributions! So take that confidence to a tech company that will support you (and there are tech companies out there!)

Instruct: I'm concerned about My 12 year old daughter. About a month or two ago she started walking on her toes, as well as coloring and writing very messy. This all happened very suddenly. She has never walked on her tiptoes and has always colored and written very neatly. Is this something I should be concerned abou? Any advice will help. Output: Have you asked your daughter why she's doing the behaviors you describe?Often the best way to find out why someone does something is to simply ask them their reason.Her answer will give you some guidance as to next possible steps.If she's pretending to be a fantasy figure or trying to find out how being taller feels, or walking on high heels or some other image then knowing this rules out that she has some unbearable pain in her arch which may require more practical answers such as new shoes or even indicate a medical problem.Ask if she's noticed any change in the way she walks.   Maybe she doesn't know she's doing this and maybe she feels embarrassed to tell you she's doing something a bit odd.Since usually 12 year olds don't color, is it new that she started coloring?Maybe given the fact of messy handwriting, she's in a phase of pretending or reflecting on good times as a young child.Then this becomes the topic of examination.Does she feel insecure about being on the cusp of adolescence?Some of these questions can be asked directly and some are for you to first decide based on what you know of your daughter, which questions and what direction to take in understanding your daughter's motivation.   

Instruct: I was the one who ended it, and I'm so glad I did. It was the best decision I made in my life. But how do I stop the nightmares and flashbacks? It is creating a wall in my current relationship. Output:   Thanks for sharing and asking for help.  You mention that you're the one who ended the relationship in the past, yet are haunted by nightmares and flashbacks. Your comments here lead me to wonder that you may have experienced some form of trauma in this past relationship; and, if so, I would encourage you to additionally consider the whole of your story-line as it relates to trauma. Doing so will serve you well for your own peace-of-mind especially so in your current relationship.  The best way to do all of this in a supportive fashion is to work with an experienced therapist who specializes in trauma-focused care. The therapist may, if indicated, wish to to incorporate EMDR (Eye Movement Desensitization and Reprocessing) which "...is a psychotherapy that enables people to heal from the symptoms and emotional distress that are the result of disturbing life experiences.  Best wishes.Resource for Your Consideration: http://www.emdr.com/

Instruct: I met a guy a while ago, and I can't stop thinking about him. I feel like I love him, but I don't think I know him. What if he is not who I think he is? I cry sometimes thinking someone is going to be with him or that he has a girlfriend. I don't know, am I too obsessive? Every time we talk though, it's like magic. He makes me feel amazing, but what if I'm mistaken? Output: Keller, it sounds like you're living this relationship in your mind, instead of in the real world. You can get answers to your questions by talking to him...getting to know him will answer all the curiosities you have. You're asking the questions in your head instead of being in the friendship. So what is it that gets in the way of actually asking the questions and getting to know him? Fear of rejection? Fear of something else? If you have fear that keeps you from having fulfilling friendships, I recommend a therapist to help you work through that. I wish you well. :)