Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response:
Goodbyes can be hard.
Chances are most of the goodbyes you have experienced in your life have been
difficult. Saying goodbye to a therapist can be different. It can be an
opportunity to create a healthy ending in a positive relationship in your life.
If you work with a therapist who is skilled, then saying goodbye can be just as
transformative as the therapy itself. Ending therapy is also known
as termination. I know, termination does not have a great ring to it!
However, it is what it is. It is an ending of the relationship as it existed.
It is reality cold and stark. Of course, when I talk to clients I Don't use the
word termination, I usually say our goodbye.  Under what circumstances does therapy usually
end? Therapy should end when a client does not need further assistance, is not
receiving any benefit from therapy, or might be harmed by continuing to work
with a particular therapist.In the best case scenario
the decision to move on from therapy and say our goodbyes happens when both
the therapist and the client feel like the client is ready to move on and move
up!  Ending the therapeutic relationship
should actually be worked on from the very first session. What I mean by that
is, there should be an understanding that the work we do together will have an
ending and that is a good thing because it means the client has gained the
skills to continue working on themselves independently. So the first session I
have with clients usually outlines a plan where the end goal is discussed and
we both have an understanding of the skills the client wants to learn or what
they hope to achieve. Now sometimes there are
situations where the therapist ends the relationship and the client may take
that personally, it is hard when any relationship ends and it might bring up
feelings of sadness, and fear or abandonment. Any good therapist will end the
relationship based on what is right for the client. What are some situations
where a therapist might end the relationship?If the situation the client
is dealing with is out of the therapist's scope of practice, the therapist may
end the relationship and refer the client to someone else. This is in the
client's best interest. Another reason a therapist might end the relationship
is that the therapist is in a place in her life which prevents her from being
objective and helpful.  A therapist who
is going through a painful divorce may have difficulty working with a couple
that considering divorce. A good therapist may see that their judgement may be
clouded and want to refer the client to see someone else. This is good practice
and helps the client.If a client is actively
suicidal or actively using substances then the therapist may end the
relationship and refer out for a higher level of care. The client may need to
be hospitalized or may need an inpatient substance abuse treatment program.
Therapy may be terminated while they are being treated and may continue after
the intensive program is completed.
Ending therapy should be a
time for connection and bringing together accomplishments, or reviewing the
next important step the client needs to take. It should not be an experience of
abandonment. A skilled therapist will help a client gain a new perspective on
closure. For some clients, it may be the one time in their lives when they get
a clean ending in a healthy relationship and they get to feel a sense of
control on creating that ending. Good luck to you!


Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In the best case scenario, it's a mutual discussion and decision. If not,  I've had the discussion initiated both ways, by me, when I sense the client has gone has far as they want, by lack of interest in accepting or completing homework assignments, missing or cancelling appointments, usually at the last minute, lack of participation during sessions.  Client initiates by asking me pointed questions about why the need for homework assignments,, by forgetting their calendar, or their checkbook :) , by suggesting that we make appointments over longer intervals (once a week to once a month, for example).  I rarely have had to terminate a working relationship--that's why I don't charge for the first visit, so we know if we are a good fit before we start working together.  Then I periodically ask whether the client feels we are making progress, moving in the right direction, talking about the most relevant issues etc.


Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In my therapy practice the decision to end therapy is mutually made together with the patient.Otherwise, the person can end up with a sense of tremendous rejection and abandonment.The way you'll both know therapy is coming to a close is that the discussion will feel lighter and move easily.The person's mood will be better, they will smile more, sit in their seat in a more relaxed way, look more at ease, take better care of their appearance.One of the ways to end therapy is to gradually decrease the frequency of the sessions.Sometimes people who are in my practice start to come each three weeks, then monthly, then every three months.This gives a sense of security, friendliness, and casualness to the therapy, and de-medicalizes it as though the person was treated for a medical symptom and the symptom stops completely one day.Talk therapy is about life and life problems usually end gradually.I end my therapy in a way which mirrors the life process in which many interaction and situation problems show their effects gradually and show different effects over time.


Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!


Question: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: This is a question that is very specific to each person. There are definitely some variables, but I can give you some general ideas for when counseling might end:When a client has met all of their goals, at least to a degree when they feel that they no longer need to work on them with the assistance of a counselorSometimes a decision is made that a client is no longer benefiting from counseling at a certain timeSometimes clients have to remain in counseling in order to receive medication. This depends on agency policy, but sometimes it is a requirement. If the medication is necessary and cannot be prescribed by a primary care physician, frequency of sessions is usually decreased greatlyI'm not sure why you are asking this question, but it is also something that is often discussed at the beginning of treatment. Oftentimes "discharge goals" change as treatment progresses because more is known about clients, their goals, changes in their goals, and many other things. Changes are normal, but your counselor probably has discharge goals in mind, at least generally, from the beginning. I strongly encourage you to ask about it!


Question:
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back.
 I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do.

Response: I'm sorry to hear that this has happened. Counselors are legally and ethically required to make sure that they always put the wellbeing of their clients above their own interests. In addition, counselor ethical rules, and the laws in just about every state, make it illegal for counselors to take advantage of a client financially. A counselor borrowing money from a client (even if the counselor pays it back) would usually be considered to be taking advantage of the client.There are a few options you have at this point if you can't (or don't want) to continue to try to contact him directly. You can file a complaint with your states' regulatory board and let them know what has happened.  An investigator will then look into the situation for you.  Another option would be for you to find a different counsleor who can provide you with an independent and netural point of view to help you figure out how you want to handle this situation.


Question:
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back.
 I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do.

Response: Do you want this therapist to have your credit card information?If not, then cancel the credit cards that you believe may now be accessible to this therapist.Therapists are expected to keep very clear boundaries between the therapy work and not have other relationships, such as "friend" or "money lender" with someone who is their patient.Therapists are never "friends" with their patients.Letting you believe that you are the therapist's friend, is a violation of professional ethics and almost definitely, a violation of the Consumer Protection laws in your State.Start by dropping this person as your therapist.  He has broken too many ethical standards to be worthy of offering therapy.Think over if you'd like remaining friends with this person, whom you describe as lacking integrity and stealing from you.If you need help getting back money from him, then contact the police and talk to a detective about what has happened so far.  The detective will advise according to the laws in your community and State, whether to file a police report, and what steps are necessary to utilize the Court system to get back your funds.If you'd like doing future patients who may be treated to similar ways by this therapist, a favor, go online and file a complaint with the therapist's Licensing Board.Good luck!


Question:
My therapist is gay so there are no sexual issues here. However, my therapist for six years has made me believe that he cares about me and that we are friends. I have loaned money to him many times, and he always paid me back.
 I had a medical emergency last weekend and I was heavily medicated. I knew that this therapist came into my home and wrote down my credit card information so he could pay back what he owed me, but this therapist dropped me off and never came again. I don't know what to do.

Response: Therapists, regardless of the discipline (i.e. licensed professional counselor, social worker, psychologist) are expected to put the health and well-being of the client first. Each professional discipline does have a code of ethics as well as a licensing board in each state. In order to get licensed the therapist must agree to abide by the highest standards of conduct including state, local and federal regulations in addition to the code of conduct. You do have the option of reporting this person to the appropriate licencing board in your state. The other concern is if this person has unauthorized access to your credit card. If you did not give it to him or authorize use this becomes a legal matter that you can also report to the legal authorities in your city or town. Therapy and counseling are effective because professionals gain the trust of the client. Betrayal of that trust by crossing boundaries and developing a relationship outside the therapist/client relationship is hurtful. Please know that the vast majority of counselors are highly ethical individuals who put the welfare of the client first.


Question: I just wanted to get to know one so I can hear about their college experience and the courses they took. I also wanted to know if they enjoy their job and how long they were in school.

Response: It's a great idea for you to reach out to find a psychologist to talk to if this is a field you might be interested in pursuing. Regarding the length of schooling, it generally takes 4 years of college and an additional 4 to 7 years of graduate school to earn a doctorate degree to become a psychologist. There are also other similar professions, including counseling that don't require a doctorate degree. Licensed counselors generally completed 4 years of college and an additional 2 years of graduate school. If you are thinking about a career in psychology, the local APA chapter would be a good place to start to find a local psychologist to talk to. Here's a link to the NJ APA chapter:https://www.psychologynj.org/


Question: I just wanted to get to know one so I can hear about their college experience and the courses they took. I also wanted to know if they enjoy their job and how long they were in school.

Response: Mental Health is an exciting and rewarding field.  I hear you saying that you want to be a psychologist, and that is one path to working in mental health.  You could study psychology, social work or counseling to become a practicing therapist. I am a Licensed Professional Counselor Associate and a Licensed Clinical Addiction Specialist.  I currently provide assessments and supervise several counselors in a large clinic in Asheville.  I also have a private practice online. I studied Sociology and Interpersonal Communication as an undergraduate, and then I received a counseling masters degree.   My master's degree was comprised of several supervised practice courses and theory courses.    I really enjoyed my education, and I find my career equally rewarding and enjoyable. If you are considering working in the field, I recommend emailing several counselors, social workers, and psychologists in your area and setting up an informational interview.  Not everyone you contact will be willing to give you their time, but many may.   This will help you determine which path to therapy may be right for you.  Licensing restrictions and abilities vary state to state and a local practitioner may be able to provide you with a specific list of challenges/triumphs about their particular license and education.    Psychologists are usually PhD level practitioners and require more education to begin.  LCSWs , LPCs and LMFTS can practice with a master's degree.  Best of luck! This is an exciting time.


Question: 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?

Response: This is a great question. In general it is not appropriate for counselors to accept gifts from their clients. There are some exceptions to this general rule - including a recognition that there may be a valid cultural aspect to this type of gift giving.It might be best to simply offer your counselor a holiday card as an expression of your feelings. You could also talk to your counselor about the gift and ask if him it if would be appropriate.In the end, I know he would most appreciate just knowing how much the counseling meant to you.


Question: 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?

Response: 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.


Question: 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?

Response: Hi, Different therapists are guided by the ethical guidelines of their own associations or colleges when it comes to receiving gifts, so this may differ a bit from therapist to therapist. It's important to me that I be sensitive to cultural norms, and to my client's needs. In Canada, and the US, it is customary for people to sometimes express gratitude with a small gift, and I have from time to time received small tokens of appreciation because I believe it would be rude to refuse this. It is never necessary to give a therapist a gift, but if you wish to express your gratitude in this way, I don't think it's inappropriate.


Question: I have an eating disorder of binging. I've had gastric sleeve surgery. I need help with issues of abuse as a child, addiction, and abusive men. I have been in therapy for five months and get no feedback from my therapist.

Response: It can be really frustrating to feel like your counselor is not providing you with the help you need.My recommendation in a situation like this would be to let your counselor know how you feel. Specifically tell Your counselor that you don't seem to be getting the amount of feedback you would like.If this doesn't help, then you might want to look for another counselor who will be a better fit for you.


Question: I have an eating disorder of binging. I've had gastric sleeve surgery. I need help with issues of abuse as a child, addiction, and abusive men. I have been in therapy for five months and get no feedback from my therapist.

Response: Hi Anaheim,Relationships with therapists have some things in common with other relationships; they work best if there is dialogue about what your hopes, thoughts, emotions and needs are. Are you letting your therapist know what your goals are? It's okay to say "I'd really like us to focus on this piece", or "I'm looking for specific direction about how to manage this part". Your therapist is wise if they ask questions that determine what your needs are, but they can't read your mind. Not every therapist will be a good fit for you. I know I'm not a good fit for everyone I meet. We have different styles; some are more  passive and focus on listening. This might be the type of therapist you have. For some people this is what they want, but maybe it's not for you. Maybe you want someone who digs at you more, asks more questions, gives you strategies, lets you know what they think... someone more active. If this is the case, it doesn't mean s/he's a bad therapist...it's just not what you're looking for. Sometimes people think they can't end sessions with their therapist; they might be worried about hurt feelings. But, in the end, you don't owe your therapist anything if you feel it's not working or it's not a good match. Just move on and try someone new. Maybe ask them questions first about their style, even. Best of luck!


Question: I'm worried I should see a therapist due to past events and current mental status. I'm just so unsure of how to ask my doctor about seeing someone.

Response: Having this kind of conversation with a doctor can feel difficult. But remember, you are the expert on you. Any good medical professional will recognize that.You are absolutely right to think about the importance of being your own health care advocate. Generally, the best approach is simply to be honest. Let your doctor know what you are concerned about and tell your doctor what you think might help. If there is a specific issue that youd like to address in counseling, let you doctor know about it. And Don't hesitate to directly ask for a referral.I know this may all feel a little overwhelming. It might help to bring a family member or significant-other with you to provide support when you talk to your doctor. it's great that You've already taken this first step to reach out. you're on the right track.


Question: I'm worried I should see a therapist due to past events and current mental status. I'm just so unsure of how to ask my doctor about seeing someone.

Response: Thanks for your question. I'm glad you realize that you need extra support and are being proactive. Simply explain to your doctor the feelings you have been experiencing and how you feel that speaking with a mental health therapist would be beneficial. However, keep in mind that you do not have to go into detail about your personal feelings. You can simply state that you are feeling down, overwhelmed, stressed, or whatever it may be. I'm sure your doctor will be glad to direct you from there. Best of luck you you! I hope that you will be feeling better soon!


Question: I need help dealing with stress. How can I handle it all and feel less stressed out?

Response: In case you feel some relief to know you're feeling the tone of our times.We live with crumbling of our values which then gives rise to insecurity everywhere.  If someone doesn't know what their values are then its difficult to do anything, and right now everyday we hear uncertainty in what used to be our basic assumptions.You're more normal for noticing and feeling stressed than if you imagine life felt fine the way it is!One road to take is to accept that there are no clear roads forward.  This means to change long term goals into shorter ones.Also, in general the more focused you can be as to your particular wishes, motivations, interests, and people about whom you care, the greater will be your sense of confidence that your personal world is as secure as it can be for right now.And, it helps too to know that nothing lasts forever, eventually all of what is up in the air will start to land in a much more clear way.


Question: I need help dealing with stress. How can I handle it all and feel less stressed out?

Response: Part of handling stress is making sure that your perception of the stress is accurate. Sometimes stress can seem more than it really is. One thing that I encourage my clients to do is to ask themselves, "What is this stressor really about?" Simplifying stress is a key to minimizing stress and leads to feeling less stressed out.


Question: I need help dealing with stress. How can I handle it all and feel less stressed out?

Response: There are many causes for feeling stressed out. Between a demanding job, family responsibilities, and everything else that can come up, stress becomes more and more part of our everyday life. One of the best ways to combat the toxic effects of stress on our bodies, social lives, and overall well being is to engage in self-care. But not the self-care that most people think of like vacations or massages. The best self-care is the kind that helps you live the life that you already have rather than escape it. You see, the reason why vacations and massages don't work long term in reducing stress is that they allow you to escape from what is causing the stress without truly fixing it so you just return to what already stressed you out. So, instead you need to find ways to help live with the stressors that you already have. They can be things like creating a more manageable schedule, introducing healthy eating or exercising, financial planning, and even learning a few simple relaxation skills. The key to combatting stress is to make small but consistent changes to your life so that it becomes more manageable and more enjoyable.


Question: I need help knowing how to deal with stress. What can I do?

Response: Something different works for each of us.There are the outward answers of self-pampering and making your home and work environment as pleasant as possible.A deeper level way to decrease stress is through exercise or alternative practices like yoga or tai chi.If the stress is more deeply rooted than temporarily feeling irritated for a few days, then give yourself some time to reflect and clarify what the meaning of the stress is to you.Self-understanding and appreciating your efforts to know yourself may decrease stress because you'll be more focused and attentive to who you are.  This will influence you overall to make good decisions for yourself and these will naturally be ones which decrease stress as much as possible.


Question: I need help knowing how to deal with stress. What can I do?

Response: Our body reacts to stress typically by breathing more shallowly, increasing our heart rate and tensing our muscles - so one thing that I find really effective is to try to do the opposite of that, which sends the signal to our mind that we are relaxed. So that means, taking slower, fuller breaths and trying to relax any areas where we might be gripping our muscles. Check out meditation apps such as 'Breathe', which can talk you through a relaxing breath exercise. I recommend using the app daily, whether you feel stressed or not, and then also using it when you re feeling particular moments of stress - that way you are practicing the skill when you feel calm(wish) and it'll be ready and able to help you when stress hits hard.


Question: I need help knowing how to deal with stress. What can I do?

Response: Learn how to meditate. I recommend a Mindful Based Stress Reduction MBSR program.


Question: I'm in my late 20s. I have two jobs right now, I'm in school, and I feel like I just have a lot under my belt right now. I get stressed out really easily. I tend to worry and over-think. I'm just worried about money and everything.

Response: A good start is to pay attention to some basic issues: sleep, nutrition, exercise and socially supportive relationships. A great car on an empty tank will not get you very far.


Question: Is it a type of fetish, or is it normal?

Response: Maybe it is a way to secretly satisfy your own wish to be or to live life gay.


Question: I am a young adult, and I was sexually assaulted by an older man when I was a teenager (which has really intensified the guilt/shame). However, I've been attracted to much older men since I was even younger than that.

Response: Sometimes the reason for being attracted to older men is because of growing up with a father who was distant.If you grew up having enough interaction with your dad to know you'd have liked more and didn't receive this, then maybe your longings of childhood are still active within you.It is ok to like older men.Just be sure you're not idealizing them, or anyone else.Because regardless of age, a relationship is based on who the two people really are, not how we'd like imagining them.


Question: I have been experiencing a lot of sexual tension with a lot of the guys that I talk to nowadays. I keep imagining having sex with them. I have never had sex before, nor have I had a boyfriend. I feel lonely and empty. I feel like my body is not okay, and I am missing something. I talk to so many boys in school, and I always fantasize about half of them. I want this feeling to stop because it is interfering with my time to study since most of the time, I am busy thinking about sex.

Response: Hi Montreal, I'm glad you wrote. What you're experiencing is normal. We're sexual beings. We have a built-in desire to connect sexually with others, because it feels good, to keep procreation going, and mostly to "connect" with other people, because connecting with others makes us feel fulfilled and valuable. Sexual desire is a healthy part of you. Maybe your body is telling you it wants to dive into that water and taste it instead of just staring at it? It sounds like you're beginning to explore yourself sexually, and that's okay.At your young age, you also have another innate burning desire, and that is to know yourself. I see both of these desires burning and competing in you. It's a bit of a crazy time...you want to connect with others but you're not sure who you are or what you want from them. You want to know yourself but you can't learn about yourself in a vacuum. It's okay to trust your instincts. It's okay to connect sexually with others, as long as you're preventing disease and pregnancy and you know how to protect your boundaries. But even as I write this, I think maybe I'm being controlling and overprotective of you; it's your body and you're in charge of what happens to it! (But I do want you to be safe...whatever that means to you). Maybe talk to someone you trust. With each encounter you have with other people (sexual or not), you will learn more about yourself and what you want, both sexually and just in relationship or friendship. You will develop a sense of who you are.Have you tried to get to know yourself sexually? This is a super place to start, and knowing how your own body works can give you confidence when you eventually connect with others. When you explore your own body, what feels good? What brings you to orgasm? I wish you well as you explore both who you are and how it feels to connect with others safely. :)


Question: Back in high school, my friend and I used to masturbate around each other. I hate even talking about it now because it's so weird. We didn't even realize how messed up it was at the time. One time, it escalated and we ended up doing it for each other. It wasn't supposed to be a gay thing, but it sure sounds like it now that I talk about it. I pushed this away until it recently came up in my head again. I'm having a lot of trouble.

Response: Writing about your high school masturbation times with your friend, is itself a form of acknowledging the full picture of who you are.   You are doing well to reflect on your actions in the truthful way you are doing.Also positive is that you have perspective, that at your age and social maturity, you were innocently doing something that in adult terms, would be considered in a negative way.Maybe through your more mature mind's eye of today, you can feel some compassion and understanding for your high school self.  This way your sense of self-judgment may start to dissolve a little bit more.


Question: These "jokes" are made about everything. They seem to have the need to say something "funny" about everything. It's not funny, just awkward.

Response: I agree, it is awkward when people make jokes about subjects which may not be funny at all.  And, if a person only jokes, then after laughing and realizing the person has nothing of themselves to offer, this can also be quite tedious.Realize that you are more aware of human interaction having many levels of expression.  You could start avoiding people who irritate you by the way they behave.


Question: My best friend and I were pranking her friend, and I told her to tell him that she likes him. She said no, but I forced her. After she told him, he told her that he likes her too. Their friendship is ruined because of me. She won't forgive me, and I feel really guilty. I feel like crying.

Response: In order for your friend to forgive you she'd need to trust you understand the damage you introduced into her relationship with her friend.Its possible if you offer your friend expressions of your empathy toward her  over an extended time, possibly she'll forgive you.You're certainly learning relationship lessons on how to treat people and the effect of betraying another person, which will last forever.Maybe this was meant to be the outcome.


Question: My best friend and I were pranking her friend, and I told her to tell him that she likes him. She said no, but I forced her. After she told him, he told her that he likes her too. Their friendship is ruined because of me. She won't forgive me, and I feel really guilty. I feel like crying.

Response: This takes time. I don't know how long it has been, but perhaps if your friend is willing to discuss other things with you for a little while, you could discuss this at some point in the future.Hopefully the true intentions will become apparent (in the idea that it was a prank).Also, I encourage you to look at how this is affecting you and how you feel about yourself as well. If it was meant to be a joke and it did not work, that is not entirely your fault.I wonder how you could forgive yourself for what happened?Are you able to seek what you meant to do compared to what actually happened?Do you notice that not everything that has happened here is in your control?Do you recognize that even though you would like things to be better, if your friend is not ready or willing, you are trying to do your part to make it right?Maybe everyone who is/was involved in this can talk together all at the same time to set straight what is truth and what was misunderstood.I wonder if you can think of your own positive attributes (for example: honesty, compassion, trustworthiness, friendship, good listener, caring) and look at what truly exists within you rather than just one your friend is able to see right now.This can be really difficult for multiple reasons, not the least of which is that it involves more than just you, so it's important to focus on the idea that you can ask these other people who were involved to discuss it, but that is ultimately up to them.Best wishes for looking at the positive parts of yourself and your friendships.


Question: I was mentored by this guy for a few years spiritually. It was okay at times, but other times, it was just weird. I try not to think about it too much, but a lot of manipulation and lying happened, yet no one else really believed me when I told them. It's like he's two different people, and no one else really sees that side of him. I was blamed for a lot of our troubles, and now we don't really talk much. I'm worried because he's in a trusted position of leadership and no one suspects anything. They just think I'm attacking his character. How do I know for sure?

Response: You may intuitively be sensing what many professionals in the social sciences and psychology have already understood.Just Google "psychopaths and leadership" and many articles come up about boardroom politics and that psychopaths are very successful in these roles.Theoretically, is it terrible that corporate leadership qualities match those of psychopaths?  Well, yes.  And, I consider your question as a mark of your sensitive awareness toward other people.  Being able to recognize social dynamics, is a strength that you have.Psychopaths know how to be charming and to twist words so that others believe that their own interest is the same as the psychopath's.I agree with you about not being able to change people's minds who are attached to this person's interactions.The only way you can introduce a change in the relationship system of a psychopath is that if you are aware of illegal or law breaking activity, and you have evidence of this, that you contact relevant authorities.No one is allowed to break laws, including psychopaths.


Question: I was mentored by this guy for a few years spiritually. It was okay at times, but other times, it was just weird. I try not to think about it too much, but a lot of manipulation and lying happened, yet no one else really believed me when I told them. It's like he's two different people, and no one else really sees that side of him. I was blamed for a lot of our troubles, and now we don't really talk much. I'm worried because he's in a trusted position of leadership and no one suspects anything. They just think I'm attacking his character. How do I know for sure?

Response: It doesn't really matter what the actual diagnosis is, and whether or not he is an actual psychopath, he has manipulated and lied to you, and that is enough reason for you to stay far away from him. Men (and women) with these characteristics can become violent. They can also make your life difficult by creating financial or legal trouble for you. Again, forget about him, and contact the police if you think he is in a position to harm others.


Question: 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?

Response: 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!


Question: 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?

Response: Sorry to hear your friends aren't responding to you. If these friends are in-person as well as online, perhaps going to them in person and asking talking to them about your concern. Perhaps it's the way you send messages or the way they are receiving them. if they say no, then a simple request to respond to your messages. Measure the result and notice if there are even small differences. Also understand, why this is so important to you. Ask yourself, why it's so important for you to receive these messages from friends. What does it mean when they don't respond.


Question: 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?

Response: I'm sorry that you are having a difficult time.I wonder about how your friendships are in person. If you get along well with people and have effective conversations with them face-to-face, there could be some kind of technology-related problem.Have you tried gently talking to people about how you send a message and they didn't answer? If you can phrase it in such a way that they recognize that you are asking for information and not blaming them for not answering you, that could be effective.I'd also encourage you to consider how much this is bothering you. If it is causing a significant amount of anxiety (say, more than 5/10 if 10 is really anxious), I would suggest talking with a local therapist.In the meantime, consider talking about this with someone you trust to whom you can get more details to get a more specific answer.


Question: She mostly targets me on social media. The bullying used to be much worse, but it is still going on. The comments are so vague, but I know that they are meant for me. Even when I confront her, she messages me short phrases to try to get in my head. If I try to fight back, she will ruin me.

Response: Sorry to hear of your problem situation.  Feeling intimidated by another person is very unsettling.Stop having contact with the person.Bullies only interact with others either by intimidating someone or by themselves feeling intimidated by someone.Bullies do not have the same dynamics as everyone else.No one can convince or persuade or talk a bully out of their behavior.The best protection for yourself, assuming you are not being physically threatened by the person, is to close contact with them.This does not take away any of the disappointment or sadness of wishing for a better relationship with the person.Until the bully wants to interact differently with others, only harm can result from contact with them.Step one is to stop the bleeding, then to assess and learn to live with not having the person in your life.


Question: It's really hard to not have negative feelings about friends who don't put any effort into nourishing our relationship.

Response: One thing I would ask is "why are you still hanging with those {friends}?" A relationship needs to be nurtured by both parties, it is a dynamic fluctuation between two people. I would ask you to question why you continue to remain together as friends, I always believed that a relationship should emit positivity towards all parties involved, if your in a relationship that is one-sided, it is inevitable that it will start to de-compensate. Never travel with the circus, never travel with fools, everything in life should have some positive payout, will things at times be negative, of course they will, but in order to keep something or someone in your life there should be more positivity than negativity.Hope this helps, C


Question: It's really hard to not have negative feelings about friends who don't put any effort into nourishing our relationship.

Response: Interpersonal relationship (either positive or negatives) need to or more persons who give and receive: attention, dedication, time and communication. But what makes friendships special is that they last trough time, at least with those who we call our true friends, those who know us well and whom we have a special connection and those from whom we disconnect at times, without fear of losing them.Consider what is that you are going trough yourself and with your relationship, talk to your friend about your concern; let him (her) know that you would like to spend more time together.  Plan an activity that you both enjoy or try to discover a new hobby. If your friend is not enthusiastic or engaged, give him (her) some time and focus your energy spending time with other friends or enjoying activities in solitude. After a waiting period, call again to let your friend know how you are and that you are still a friend.   If you continue feeling rejected, analyze why you value this relationship so much and consider if it's worth to maintain it.


Question: I'm having problems shutting them out and putting up walls.

Response: It sounds like you would like to let other people get close to you and at the same time you are finding yourself compelled to keep people at a distance. Often times, when we have difficulty trusting others, it is because we have specific fears about what would happen if we get close or let our guard down. Such fears may be rooted in past experiences in relationships in which we were hurt and or disappointed. In working with a therapist, you can gain insight into what is underneath your compulsion to put walls around yourself and develop ways to form authentic, lasting, satisfying relationships with others.


Question: I'm having a quinceaÃ±era, and the girls don't like their dresses. They never told me, and now it's a week away. I don't know what to do.

Response: How did you find out that the girls aren't happy with their dresses?Did you hear this directly from one of them or is this third hand information that someone else told you about one of the girls in your party?The answer matters because gossiping instead of directly telling you about a problem, is a problem in itself.I suggest a conversation with the entire group of girls in which you tell them how you actually are feeling about their opinions about the dresses.One topic you may consider bringing up is what everyone expects to get out of the party.  Are they coming because they like one another and wearing a dress in which the girl is happy, is only one way of having fun together?You may learn a great deal as to the difference in values about a quinceaÃ±a among you and your friends.I hope you'll have a fun party!


Question: I would like to be able to have more positive relationships in the present.

Response:
Staying present is an attitude most of us aspire
to, and most of us have to work at it'scertainly at first. I'm here to tell you
that living in the now or being mindful is a skill anyone can learn. Unfortunately,
the only way to do it is to do it. What a paradox! But there are plenty of
other skills that we are not born with: walking on stilts, riding a bike,
swimming, and driving a car are good examples. You can't learn them by reading about
them.Having said that, I can recommend two books on
the subject: Eckhart Tolle's The Power of
Now and David Richo's When the Past
is Present. Richo asks that we Don't beat ourselves up about dwelling on
past events. This is nature's way of reminding us that we have unfinished
business. But while we are attended to the wounds and confusion that litter our earlier lives, we can prepare to inhabit the expanded present that awaits us.He offers three helpful steps to making any important life
change:Step One: Hold in awareness the behavior,
belief, attitude, or characteristic you want to change in yourself and how you
want to be different. Awareness is the opposite of distraction and stuffing.Step Two: Live as if you have
already made the change. (This is hard and takes courage, but you can do it.
Ride that bike even if for a foot or two.)Step Three: Be persistent.
(Practice, practice, practice.)Just as two-year-olds are able to walk
confidently after hundreds of hours of practice, you'll be able to stay in the
here and now as long as you want after trying and failing many, many times.


Question: I would like to be able to have more positive relationships in the present.

Response: Would you describe yourself as sensitive to your surroundings and emotions?If yes, this may explain why letting go of past problems, is itself a problem.The dynamic of living one day at a time and letting go of past problems, is more imaginary and wishful than real.It is a popular notion of TV, FB, and media.Doing the letting go, has nothing to do with what is actually possible to do.Problems are not "let go", they are resolved somehow.Living one day at a time isn't possible for anyone who has consciousness.  No one can really disconnect from reality every day on which they wake up.Instead of trying to do the impossible which is promoted online and in media, allow yourself time to recognize what went into creating a problem in your life, in the first place.  Understanding problems leads to peacefulness and resolution.  Then you will have more freedom to make new relationships.Also, be patient with this process and yourself.If you have deep attachment to painful situations in your life, then possibly now is your time for understanding what went wrong.This is a process which cannot be rushed if it is to be done well.If it is done thoroughly, then you very naturally will bring new relationships into your life.And life will no longer feel so painful that you can only manage "one day at a time" without hurting.  You won't need to forget what happened yesterday.


Question: I would like to be able to have more positive relationships in the present.

Response: Hi Chapel Hill, I like your goal; research is telling us more and more that one of the most important keys to happiness is having healthy relationships. If we feel successful in that area, it can give us the confidence and hope to tackle anything life throws at us.There are personal barriers we all have to having healthy relationships; it's our "stuff", our "baggage" (not a steam trunk, right...you have a cute little Gucci bag!). You hint that people may have hurt you in the past. Maybe fear says "stay away...hold onto resentment or you will be hurt again!". Resentment, or simply focusing on the past is certainly a barrier to improving any relationship. Learning to forgive ourselves and others is so important. And remember...forgiveness isn't about saying something was okay; it only means "It happened, I can't change that, and I don't want to carry it (anger, hurt, resentment) around anymore, so I let it go." Or...sometimes fear tells us that people won't accept us; this keeps us isolated for sure! But really, all fear wants is power over us. Fear is a trickster! It tells us that if we let go of the past, we will be rejected or hurt. It says "I'm trying to protect you!", but what it REALLY wants is to paralyze and isolate us all so it can feel powerful. Once you pull the sheeps clothing off of fear, you can see that it doesn't help you at all!Once you see where your personal barriers are, and you start to refute those thoughts in your mind, you can begin to build new ideas about yourself and other people that are based on compassion instead of fear... Everyone deserves forgiveness and compassion.No one deserves to be judged by their worst moments.If I look in the rearview mirror, I can't move forward.We are all beautifully imperfect.I can't change the past, but I have the power to make the future good.I wish you the best on your journey!


Question: I would like to be able to have more positive relationships in the present.

Response: Take one day at a time!!!  Each day do things that make you happy, moves to a positive place, focusing on the future, give you a sense of fulfillment and accomplishment.  Journal at the end of the day of how well you did that day in focusing on these things.  Each day should be a step better than the previous day.  You will have days that you didn't do as well....that is human and OK.  Just get back on track the next day....At the end of the week, review how well you did and give your self a grade.  If did well, you deserve ice cream, etc.  If not so good, OK....tell yourself next week "got to focus one day at a time".  You can do it....it takes practice but will get better each day,  I wish you happy days and happy future...


Question: I would like to be able to have more positive relationships in the present.

Response: Remember, the past no longer exists and the future is just an illusion as we don't know what will happen tomorrow, so take the present as your guide. That is all we can do, so keep saying this to yourself and try to help someone each day.  The happiness is helping others to feel a bit better.


Question: In this argument my friends are all against me so I'm wondering if I'm exaggerating my feelings. I feel like I'm being attacked and that is making me blow things out of proportion and taking the role of the victim, when in reality I'm the one being unreasonable and I am simply annoying my reasonable friends. Or are they really being insensitive and not respecting me in our friendship?

Response: Conflict is a tricky beast and shows up in every one of our relationships. What I'm reading is that you find yourself in a loop of  seeking validation of your thoughts and feelings from your friends rather than validating yourself. Am I right? If you aren't validating yourself, no one else will be able to either.  Try finding a small nugget of truth in the feedback your friends give you, this will help to lower your defenses and help your friends hear what you are really sharing.  And then if you are still feeling vulnerable, share that too...


Question: They're calling me names like hypocrite and a baby even when they act in the same manner as I do. I'm tired of being called names. What should I do?

Response: It sounds like your confused as to why your friends would be calling you a hypocrite when they act in the same manner, correct? Communication is key to any relationship. I would recommend speaking with your friends face-to-face to address why they feel your behavior is concerning. In-person contact is the best method of sorting out differences considering texts, emails or any written response can be misconstrued. Be upfront with them and let them know that being accused of hypocrisy is hurtful and you feel it is unfounded. If after speaking with them you feel that they have valid reasons for the way they are feeling, maybe you can consider modifying your behavior accordingly. Especially if this friendship is valuable to you. However, make sure they are aware that there is a respectful way to address these issues and name calling is not one of them. On the other hand, if you feel that their reasons are indeed unfounded, it may be best to distance yourself from the relationship. Not all friendships are healthy ones. And it is important that you surround yourself with people who are an asset to your self esteem as opposed to those that hinder it.I hope you are able to get this matter sorted. Best of luck!


Question:
I've been bullied for years and the teachers have done nothing about it. I haven't been diagnosed with depression, but i have been extremely sad for years.
 How can I deal with being bullied at school when the teachers won't help?

Response: That's a very difficult situation that you are in. But you are not alone. I have several school-aged clients who find little to no assistance from their teachers at their schools regarding bullying.There are a few options that are available to you to help deal with being bullied at school. One option that I would suggest is for you to talk to your support network. Friends and family can sometimes be good sources of support. Another option would be to speak with us about your counselor, if you have one. And third, there are some excellent online sources of support regarding the bullying at school (www.stopbullying.org).


Question:
I've been bullied for years and the teachers have done nothing about it. I haven't been diagnosed with depression, but i have been extremely sad for years.
 How can I deal with being bullied at school when the teachers won't help?

Response: Teachers don't do anything about it due to liability of the school (school and faculty would get sued and have claims made against them); wouldn't expect much out of them;Couple things:1) Realize that bullies accuse others of the very crimes they are doing themselves;2) Bullies aren't actually all that weak as others have said, but do not stand up against constant pressure of truth-telling;3) Research yourself, or pay someone, to locate the bully's mother and father, and let them know what you have experienced (by way of text, phone, letter, etc.);4) Access your own mother and father and tell them what you have experienced, and see if they will help;Long term, society must return to a more masculine way of being such that these sorts of troubles are dealt with at the home :)Learn to be man/woman, and watch the magic happen.


Question:
I've been bullied for years and the teachers have done nothing about it. I haven't been diagnosed with depression, but i have been extremely sad for years.
 How can I deal with being bullied at school when the teachers won't help?

Response: To be bullied is very painful.I'm glad you know the bullies are doing the wrong thing and whatever they are telling you is pure meanness.Depending on how independent you feel, why not tell either your classroom teacher or schedule an appointment with the vice principal?Bullying other students is taken very seriously in some states and schools are expected to address the bullying until the victimized student feels safe.If you hesitate to do this on your own, then would you ask either of your parents or even a friend of yours who is also in the school, to report the problem?In case you are afraid the bullies will retaliate for reporting them, then tell this to whatever school authority you decide to ask for help.You're entitled to be protected by your school.


Question:
I nanny a three year old. When he wakes up in the morning he calls out for someone to come get him. If I am the one to go get him out of bed he gets really upset and refuses to let me near him. He screams that he wants his mom or dad (they work from home). The rest of the day he loves me. But not in the mornings.
 What can I do?

Response: It doesn't sound like he hates you, just misses mom and dad in the mornings. You could validate his feelings by saying something like "I know you want to see mom and dad right now, but they are working" and then give him a couple options of things that may take his mind off of it. This could be choosing what he has for breakfast or playing a game of his choice. If possible, it may also be helpful if you could create a routine in which he stops by mom and dad to say good morning. If this is routine, he will come to understand that he will be able to see mom and dad for a minute and not become anxious about seeing them.


Question:
I nanny a three year old. When he wakes up in the morning he calls out for someone to come get him. If I am the one to go get him out of bed he gets really upset and refuses to let me near him. He screams that he wants his mom or dad (they work from home). The rest of the day he loves me. But not in the mornings.
 What can I do?

Response: Be lighthearted, this toddler may not be a morning person! He is most likely wanting to connect with either parent when he arises in the morning. It could be helpful to talk with his parents and establish a routine that he would be comfortable with.


Question:
I nanny a three year old. When he wakes up in the morning he calls out for someone to come get him. If I am the one to go get him out of bed he gets really upset and refuses to let me near him. He screams that he wants his mom or dad (they work from home). The rest of the day he loves me. But not in the mornings.
 What can I do?

Response: It is very likely the child is upset by the fact that the parents have left, more than that he hates you in particular.The fact that by afternoon he is happy with you shows more likelihood that he reacts to the parents departure more than who you are.


Question: I need to get on base to see my doctor. My ID card was in my wallet which was stolen. I'm unable to reach my husband at this time. He is only one who can take me on base in order to get a new ID so I can continue to see doctor. Is there anything I can do?

Response: You should be able to get a replacement ID card either from the Personnel Office on your local base (the actual name of this office will vary depending on which branch of the military it is). You may also be required to go to the Military Police or Security office on base to report the loss of your old ID card.


Question: I need to get on base to see my doctor. My ID card was in my wallet which was stolen. I'm unable to reach my husband at this time. He is only one who can take me on base in order to get a new ID so I can continue to see doctor. Is there anything I can do?

Response: Do you have any other form of identification? The first place to stop would be the Visitor's Center or whichever department issues passes. They are located outside of the gate so you do not need a military ID to enter. If you have another form of identification it's possible that they can give you a pass in order to go and obtain a new military ID. If you do not, you could always ask someone else to sponsor you on (a friend, coworker, etc.) that have military access. Depending on the threat level, they may not need your ID as long as you are with someone that has access. Keep in mind that currently (6/11/15) all military bases are on Bravo which unfortunately means you will need your own ID.Finally, if all else fails, call your doctor and explain your situation. I'm sure they would be more than willing to discuss your options.Also, it's important to make sure that you report your wallet being stolen if you haven't already. Security Forces on base can help you with this and to ensure your ID does not get into the wrong hands. Good luck!


Question: I need to get on base to see my doctor. My ID card was in my wallet which was stolen. I'm unable to reach my husband at this time. He is only one who can take me on base in order to get a new ID so I can continue to see doctor. Is there anything I can do?

Response: As a prior military spouse myself I can happily report that you have several options in this case. First, you can go to the visitors center and let them know what has happened to get a temporary pass for a new id. Also, you can call the squadron commander or other official from your husband's unit to get them to tell you how to proceed. You can also contact the military personnel flight for more information The best thing is to get a new id as soon as you can. There should be no problems because it was stolen and yu might need to report it to the military police or security forces on base.


Question: I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm.

Response: In a way, self-harm can present somewhat like an addiction.  According to new research within the field of neuroscience there is a valid explanation for this.  When a person cuts or uses other forms of self harm, the body produces endorphins to help make a person feel better.  If a person was dealing with depression or high anxiety, that might be misinterpreted by the brain as a way to help oneself feel better and a new neural network or map might form (addiction) that would utilize this new behavior.  Another way to look at it would be thru a behavioral lens, a positive reward for a behavior, even though the behavior has other long term negative consequences.  Consider working with someone who can both have you work on and address those items that trigger your behavior and the root causes, in this case sadness or depression, and second find someone who can help give you alternatives that take into account the neurological requirement by replacing the behavior with another behavior (such as snapping a rubber band on the wrist) and working to extinguish the unwanted behavior.   Someone who is trained in Dialectic Behavior Therapy and/or Interpersonal Neurobiology would most likely have the skills and means available to address this with you.


Question: I self-harm, and I stop for awhile. Then when I see something sad or depressing, I automatically want to self-harm.

Response: Self-harm has a way of becoming a go-to method of coping. When we get stuck using self-harm as a way to deal and manage emotions, when something serious happens it totally makes sense that that will be one the first things to go through the mind. It is its own kind of addiction. There is a therapy, DBT or, Dialectical Behavior Therapy, which focusing on giving you new tools to get through hard times, understand and manage your emotions, to stay present and to deal with relationships. This one of the most effective interventions there is for self-harm. If you are interested in DBT, reach a local therapist in your area and ask if they do DBT or can recommend you to a DBT program. This can help immensely. Self-harm recovery is totally possible, but it is definitely hard work!


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: Hello, and thank you for your question. This is a very serious time. I don't mean to frighten you, but you are right to be concerned. The time right after people leave the hospital after receiving psychiatric services is a time of high risk for suicide. It is very important, after hospitalization, to get follow-up care with a professional as soon as possible. If your husband has an established therapist, this is the time to call. It is also a good time to alert your support system of friends, family, clergy or others to let them know he is still struggling. This is good support for him AND you.It is important to think about means and opportunity to make another attempt. Means really do matter.  So, if you have a firearm in the home, it is really important to remove it. You can't remove all things that a person may hurt themselves with, but some things are more lethal than others. Firearms are very lethal. I am not sure what means he used last time, but try to reduce the opportunity for him to access it again. This is where your support system can help out. People can take turns hanging out with him until you are sure the crisis is over.If you believe that an attempt is going to occur, talk to your husband about going back to the hospital. If he refuses, you will want to find out what your options are to have him go even if he doesn't want to. I know the thought of that really hurts, but it can save his life. Calling 9-1-1 is always a good option if you are not sure. Usually a suicide crisis, meaning they want to harm themselves right now, lasts a few minutes, hours or days. Sometimes when you get them through the crisis stage, they no longer want to commit suicide. But, as you are indicating, that feeling of wanting to commit suicide can come back again. So, it is always good to have a plan. If you want more information, call the National Suicide Prevention Lifeline. They will always answer: 1-800-273-8255. They can help you create a specific safety plan. I do hope things work out alright. Be well.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: This is actually more common then we often realize, and actually understandable, as he has gone through a trauma, an unresolved existential crisis.  He was taken care of by others and now is again left alone with his own internal, and rather horrific inner struggle.In my work with CCT, or Contextual Conceptual Therapy, (see www.suicidetherapy.com) I have learned how trapped suicidal people are in their own isolation, also called a "mysterious isolation," a form of self protection which cuts the off from their Self, or spirit.  And unless they address this message from their soul, accompany a guide on a journey to discover their own missing information, that is to recognize how their own uncomforted emotional pain has resulted in a coping stategy which has effectively cut themselves off from their own beauty, their Self, and their ability to receive love from themselves and others. Their attempt to kill themselves is a cry from their soul or spirit that they cannot live the life they are living any longer.  They take this literally and try to end their life, when in fact what their soul or spirit is saying is they need to begin to live the life they came here to live.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: I'm thankful to read your husband found care and that his suicide attempt wasn't successful.   While he was hospitalized, and prior to his release, your husband would've been provided in writing a self-care action plan. This typically includes things like committing to a contract 'not to harm' and what to do if he felt overwhelmed by his anger, depression, and hopelessness (e.g. call 911, call therapist, go to nearest hospital emergency department). Additionally, his protocol would've provided instructions for his taking medication(s) as directed, having a follow-up appointment(s) with his psychiatrist/psychologist/clinical social worker, and participating in some form of small group support.  If your husband's struggling as you describe, and you are feeling overwhelmed or frightened for his (your) safety, I'd encourage you to seek immediate assistance.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: This must be so difficult for both of you.  Watching someone you love suffer so profoundly can bring up lots of difficult feelings.  Without knowing what you are already doing, I have a few thoughts to share with you. First and foremost, know that you cannot fix this for him, and get support for yourself.As much as you are able, make space in your relationship for him to talk about what he is experiencing.  He might not want to talk, and that is ok.If he wants to talk, try to listen without judgement and without trying to talk him out of his feelings.  Focus on validating his feelings and just sitting with him in his pain.Let him know how you feel...that you love him, that you care, that you are concerned, that this is scary for you too, that you are here.I hope that this is helpful.  On my website (www.sarahmcintyrelpc.com), I've written a series of blog posts about coping with distress.  The techniques I've written about there may be supportive for you and your husband.  Sending warm wishes your way.  -Sarah


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: I appreciate that you are concerned about your husband's emotions and want to support him as best you can right now. I imagine that you must be going through your own difficult time too. You've had a complicated shock and trauma in your life and in your marriage; it's normal for both of your emotions to move from hope to despair to fear, anger, gratitude... there is no wrong way to feel and there is no particular pattern your emotions or his will follow. Try not to assume what he is feeling but ask him instead. "How are you doing today?" is something that can be asked over and over again and your love and compassion for him will come through. If he has a hard time talking, you can share your observations. "I notice you're more withdrawn. This worries me." Certainly it will help you if you know what he's thinking and feeling because he hid his intentions to hurt himself. It's normal that you want to know. If there is depression and hopelessness, this likely was part of what led to his initial despair. There is help out there. Depression is treatable, and seeking that treatment is important right now at this vulnerable time. This is the kind of complex situation that can be assisted by a therapist who is qualified to help you both understand and manage your emotions. Whether your husband seeks help or not, I hope that you do.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: A failed suicide attempt is commonly thought of as a cry for help, however it can also be a serious attempt to find a permanent solution to depression, hopelessness or other feelings a person feels are unbearable. it's wonderful that you want to support your husband, but If your husband is feeling depressed and hopeless, you can best help him by getting him to a mental health professional. Feelings of hopelessness and depression, and previous attempts at suicide are all risk factors for future suicide attempts. With a mental health professional, or in the emergency room of a hospital, your husband should be evaluated for suicidal thoughts, intent and plan, and if he is a danger to himself he should probably be hospitalized again until he is stable. Without knowing the particulars, your husband may suffer from Major Depressive Disorder or some other illness on the depressive spectrum. In that case medication could help him immensely, at which point you can offer your support and encouragement him to practice gentle self-care. And do not forget to practice it for yourself.  Remember: a suicide attempt not only affects the person, but it is an immense stressor for his or her loved ones as well. As they say, put your oxygen mask on first. Then you will be better able to provide your husband with calm and loving care and attention.Kayla Schwartz, LMSW[email protected]


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: The fact that you're reaching out for help here is really helpful.The first thing I would suggest is that you consider seeing a local mental health professional yourself to be able to talk about the details, how this is affecting you, and how you can hold onto you are while also being supportive to you husband.From the way that you describe this, I wonder what has changed since coming home from the hospital. Perhaps you can have a conversation with your husband this and mention that you are asking him questions to learn more about his experience and you can discuss how you notice that things were going much better when he came home from the hospital, and now things are not as good. Perhaps he can tell you about what is different so that you may know him would be most helpful to him.I also hope that you husband is still continuing with his own treatment.There may also be a local peer support telephone number for the county that you live in that they be able to help you determine whether your husband needs more immediate treatment if he is feeling hopeless again. There are national crisis telephone numbers listed below as well.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: Since as husband and wife your lives are closely joined, how your husband feels greatly influences the way you feel.Give yourself some time to concentrate on how you've been affected by your husband's suicide attempt.   Even if you decide against immediately telling him how you're feeling, knowing this about yourself will guide how and the topics you bring up with him.Is your husband talking easily with you?Do you have some ideas as to what is creating his feeling of hopelessness?The ideal approach would be if the two of you are able to discuss what bothers him and what bothers you.Depending on how far away you each are from such a position, you may benefit from speaking with a licensed professional therapist who can guide you and or you and your husband on opening up for discussion what feels stressful enough to merit taking one's own life.


Question: After he got home from the hospital he was angry, then for a time wonderful. Now he is depressed and hopeless again.

Response: 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.


Question: 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.

Response: 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.


Question: 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.

Response: That's a great question. There is such a wide range of ways to define "personality" that it is difficult to identify specific characteristics that are used to identify personality types.That being said, some clinicians will use standardized tests (or assessments) to assess a client's type of personality. While these tests can't tell us everything about a person, they can help us understand where we are within larger groups of different personality styles.Some counselors will also use a diagnostic tool (like the DSM or ICD) to help a client understand a diagnosis that is related to a personality disorder.


Question: 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.

Response: Not very well :)So, you got the Jungians, and you got the Big Fiver's, and you got every manner of Ivory-Tower Orc in between, loosening the chains on their drooling, snarling Pet Theories...The real truth is, does it matter?  If it does, what does it matter?If it's still of keen interest to you, I would presume that God designed most of his creatures with a "simpler set" of personality blueprints; not a complex set as theorized by man;Also realize that this level of reality is dualistic in nature; that means there is two of everything;So, imagine that whatever personalities you observe, and whatever words come to mind, also think of the opposite word, and you'll have a good sense of what actual personalities look like :)Then, share your findings; it'll be pretty neat to see what you come up with.


Question: 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.

Response: In my therapy practice I avoid characterizing people except for whether or not they are self-harming or a risk to harm other people.As long as someone is sincerely trying to know more about themselves my work is help the person clarify who they really are and how their true self may be quite different than the life the person created for themselves, based on satisfying other people's standards.In broad terms, personality disorders have stock characteristics which change very minimally over time instead of  uniqueness  which constantly flows and changes with circumstances over time.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: I think we all go through a period of time where we think we aren't worth anything. Sometimes these feelings are a result of low self esteem or because of shame. The most important part of dealing with this thought is to separate feelings from reality. "I don't feel worth anything, but I know what I do is important, I know who I am matters to others. I know I am loved and cared about."When you find yourself having these thoughts, stop, take a few deep breaths and try to reframe what you're thinking.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: There is nothing wrong with you! Sometimes we get intrusive thoughts that can be worrisome. One things that can be helpful is to identify if there is a trigger to these thoughts - something in your life that makes these thoughts more common (an experience, a person, a place, a situation, etc.). It will also be helpful to try and challenge this type of thinking by focusing on ways in which you are worthwhile as a person and have worth in your life. CBT (Cognitive Behavioral Therapy) may be particularly helpful with this, also. If you are open to seeing a therapist, find one that does CBT. You can also find resources on CBT online. It focuses on stopping and challenging unhelpful and harmful thinking patterns and replacing it with more helpful and healthy thinking patterns.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: We all suffer from random thoughts from time to time. Being able to manage your thoughts and choose what to think about yourself is something you would learn in  counseling. An effective treatment modality for this situation is cognitive behavioral therapy.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: A lot of times the thoughts we have about ourselves are messages we have received from other people and later internalized them. So in that sense, these thoughts are yours and belong to you, but you have received these messages from somebody else. Even though we all receive messages like this at times, it pays to be careful not to ignore other messages we are receiving, such as a loved one appreciating your help or attention, a friend responding to encouragement, or a colleague showing interest in you. I hope this helps.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: Those kinds of thoughts can be quite difficult to handle, but if they are your own thoughts (and not voices you are hearing, which can be very different), they likely are not new to you. From what I've learned from clients I work with, often these thoughts have been quite useful for them over the course of their lives, that through criticizing oneself, it is a way of motivating oneself. However, in your case and in most of those clients, it has caught up to them and it's almost like they no longer need the motivation (that they can do just fine motivating themselves by themselves!)I think it's important to see these thoughts as the voice of the "inner critic." That inner critic was there for a long time, again, because "it" (I like to identify it as a thing inside of you) thought that you needed motivation in the form of criticism to stay on task with your life. But now that that kind of sentiment is no longer needed by you, it might be time to have a different kind of relationship with it. But it wants to be heard. It doesn't want to silenced (Or "stopped" in your words.) So instead of trying to ignore it, perhaps we can see all the ways you are worth something and internalize (take in, let those ways resonate with you, sit with them, think about them) so that the inner critic can see that it isn't quite correct in what it is saying. In essence, you are instead sitting with the thoughts or worthiness instead of worthlessness.If that is challenging, sometimes seeing someone who is objective, such as a therapist, can be helpful. They can help you see the ways in which you are strong, have resilience, as well as any positive attributes that might be hard to see in the face of this loud inner critic. And, above all, if you feel like this doesn't resonate for you, and that the voices might actually be voices, an evaluation should be sought to further tease out what sorts of symptoms you are experiencing.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: We have thousands of thoughts a day. Some thoughts we choose to think, and some thoughts are random as you describe. We can't control the first random thought but as soon as we become aware of it we can make a conscious choice to change the thought. Positive affirmations are messages we intentionally read to or tell ourselves to help us counteract negative thoughts. If you find yourself under stress on some days more than others you may notice an increase of these negative thoughts about yourself.  To help you neutralize your negative thoughts and make it more natural to randomly think positive thoughts about yourself you might find it helpful to work with a therapist who specializes in cognitive behavioral therapy. This professional can help you build insight into your errors in thinking, help you develop a stress management plan, and provide you with additional tools to boost your self-esteem.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: Many people have thoughts like those you describe, and often it feels like someone else is saying it because they are things that may have been said to you when you were very young.  When young children hear negative things about themselves they tend to internalize these negative ideas and to form negative core beliefs.  The good news is we can learn to stop these thoughts and to replace them with healthier thoughts.  The first step is to catch yourself when you are thinking these thoughts, and to stay "stop!"; then replace it with another thought.  So for instance, maybe you fail a test or get rejected by a romantic interest.  You catch yourself saying "you aren't worth anything". Stop this thought, and replace it with "You didn't do as well on that test as you would have liked.  Let's figure out how you can do better next time."  Or "she may not want to go out with you, but someone else will". So the idea is to develop a voice of a "friend", who can tell you the kind of things you would say to your own best friend.  You might also pick up the book, Feeling Good, by David Burns. He gives many tips for how to change Negative Self Talk.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: Talking to a licensed profession who can discuss this in greater depth can be best. As a general information, in short, I can say that our thoughts are greatly influenced by our early life experiences. Our thoughts are processed through schemes, these are mental images or templates by which we make meaning of the world around us.  While our upbringing has a great influence on the way we see and interact with the world around us as adults, However, we are not condemned to abide by them for life, in psychotherapy, you learn to change negative schemas with positive ones. Yeah, if you had less than optimal childhood you would have some sort of negative schemas that unconsciously lead to self-sabotage your efforts for success and happiness. The research in the field of interpersonal neurobiology suggests that without conscious awareness and reflective practices we tend to interact with the world by repeating old habits of mind. On the other hand, in psychotherapy you can learn helpful strategies to increase your conscious abilities to stay in control of your mind in the present moment and reduce intrusions of negative mind habits. Yoga, meditation, and tai chi are also found to increase self-awareness and lessen the intrusions of negative self-judgment on one's psyche.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: Life is beautiful without unwanted thoughts and stress. With proper strategies and tools it is possible to regain control over your thoughts. I guess you are just having "thoughts" and not actually "hearing voices"? My suggestion is to see a therapist and go from there.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: First off, there is nothing wrong with you.  In fact, having random thoughts we feel we cannot control is actually quite common and normal.  Sometimes our thoughts think they are protecting us (if we think we aren't worth anything, it won't hurt when we get rejected) but they are actually doing quite the opposite.  They are keeping us "stuck" and creating a self-prophization.  (If I think I am not worth anything, I don't have to try, and I will keep proving to myself that I am not worth anything).  There are many techniques to work through and start to change our negative self-talk.  There are actually many self-help workbooks that can help with this as well.  A technique I like to use is meditation or mindfulness.  This can teach us to accept our thoughts (not fight them) and then learn to let them go.  Release the power they have on us.  If we can learn to release these and not ruminate on them, this will give us the space to allow more positive and supportive thoughts to come in.  Mantras can help with this as well (I AM worth a lot, I AM important, I have value).  Saying these to yourself everyday over and over (even if at first you don't believe) can retrain our brains to believe it (and allow us to believe it).  I have even wrote positive mantras to myself in my bathroom mirror so I am forced to look at these throughout the day.Please remember to not be hard on yourself as you begin to attempt to change the automatic thought patterns.  It took a while for you to get where you are and it will take a while for this change to kick in and feel normal.  So allow the process to happen slowly and allow yourself to accept you as the amazing and brave person you are.


Question:
I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it.
 What is wrong with me, and how can I stop having these thoughts?

Response: Those  critical thoughts most likely came into your mind as the way you understood what one of your parents or some other adult who was very meaningful to you, at a very young age.When we are too young to distinguish whether what a grown person tells us, feels accurate, we absorb their opinions as our own.Your question shows you've reached the point of emotional maturity to know that your opinion about yourself is not the same as what is inside your emotional brain and stored there since you were too young to know that someone else's opinions are not necessarily your opinions.Nothing is wrong with you, everything is right with you to wonder how to more firmly establish your own point of view.Start the habit to revise any viewpoints about yourself which don't feel true.Then replace these thoughts with better ones which you decide on your own.After a while of doing this you'll either automatically think the more positive thoughts about yourself or at least be in the habit to know that negative viewpoints about you are not necessarily true.


Question: I'm currently struggling with diagnosed depression, anxiety, and Misophonia. Also, I am 99% sure I have Borderline Personality Disorder and Avoidant Personality Disorder. I read the DSM-IV, taken college psychology, etc. I know it in my heart I have them. Is self-diagnosing okay with the right research?

Response: Any diagnosis is limited in its usefulness.Knowing the name of some typical ways you may feel, think and behave, doesn't help you or anyone to understand why the person is the way they are and how to change any of these characteristics.Both self-diagnosing and being diagnosed are equally unhelpful to know why you are the way you are and what to do about it.Consider yourself a person who wants to find a better way to be who you are, and this will get you further with better results than to read a list of descriptions which all are very indicting and negative sounding.


Question: I'm currently struggling with diagnosed depression, anxiety, and Misophonia. Also, I am 99% sure I have Borderline Personality Disorder and Avoidant Personality Disorder. I read the DSM-IV, taken college psychology, etc. I know it in my heart I have them. Is self-diagnosing okay with the right research?

Response: Hello, and thank you for your question. Self-diagnosing is something that we all do about one health issue or another. Taking a guess about what may or may not be happening to us is completely normal, however the actual clinical diagnoses of a mental health disorder requires a licensed mental health professional. Here are a few reasons for this: 1. Making a clinical diagnosis often requires other things besides matching up the symptoms of a disorder. To come to a diagnoses for any of the things you mentioned, a counselor would consult the DSM, but they may also use some type of screening tool, assessment or scale. Many disorders have similarities and it requires someone with training to tease out the differences in the symptoms. 2. Our judgement is sometimes off when it comes to assessing ourselves. We really can't be objective. Something as serious as determining a diagnosis really needs to be done by someone who has that objectivity. In addition, once you know your diagnosis, treating it usually requires help from a professional. 3. Sometimes the symptoms of a mental health disorder makes self-diagnoses impossible, in and of itself. For example, someone could be having hallucinations or delusions and not realize it. That would clearly make it impossible for them to diagnose themselves. There a many examples where something like this could happen with different mental health disorders. There are other reasons, but these are three important ones. Now, does this mean that you are wrong about your diagnosis? Maybe not. You may be correct. But, it is important to get this confirmed by a professional mental health clinician. If a disorder is then found, you can begin to talk about treatment. Hope this was helpful. Be well.