Question: I stress over everything. If I don't have enough "quality time" with my boyfriend, I start to feel resentment towards him. He has three children, and they are great kids, but I find we don't have much time together. I break down easily and find myself depressed.

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


Question:
I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I'm not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and does not keep me up to date on everything that he does throughout the day, which he used to.
I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I Don't know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town?

Response: Relationships at any amount of distance can be so hard! It makes sense that you are encountering more anxiety than usual given that major change in your relationship. And you're right that being separated from our partners can heighten our insecurities and worries about not only our relationship security but about our partner's interest. Have you talked with your boyfriend about this struggle you're feeling? It can be hard to have this kind of conversation without triggering a sense of blame and subsequent defensiveness in our partners, but it really is possible. If you have any concerns about being able to do this, then a session or two with a local counselor or therapist might be really helpful - and it really can be just about finding the way to share what you're feeling.As far as coping with anxiety, there are a lot of options but I highly recommend an app called Self-Help for Anxiety Management. There's so much good information in this app to help you learn to pay attention to what kinds of thoughts are helpful or unhelpful, and there are also lots of activities for calming down and decreasing the intensity of that anxiety. The best part is, it's free!


Question: I have cheated on my husband of five years roughly ten times. I pretend we aren't married at my work. Recently, he has caught on, but I lie to cover it. He use to talk to girls online, but I have caught myself constantly having a affair.

Response: Clearly you seem interested in being other people, and you are also concerned about your husband being unfaithful online.  But it seems like there is something that keeps you with your husband.   And I have so many questions for you: What are you looking for outside of your marriage?  Are you willing to give that up if your husband is not able to provide it?  Do you want to stay together and make it work? Do you want to open the lines of communication with your husband, so you could analyze the situation together?I suggest attending couple's therapy or even couple's mediation to assess and discuss where you want to go whit your relationship.  It will also help to establish healthy lines of communication, where you could express the pros and cons of the relationship, analyze if you are willing to work to stay together, or have some closure and process a separation.


Question: I'm a man, and I'm soon to be married. I have been messing around with other men on the side. It started as a once in a while thing, but it's been happening a lot. I don't know what to do.

Response: Hello, and thank you for your question. When faced with these kinds of difficult challenges, I usually encourage people to look to their values for help in determining what their behavior should be. Indeed, it is usually when our behaviors conflict with our values that we don't feel very content with our lives. Perhaps you can take some time to think through a couple of these questions: What kind of person do I want to be deep in my heart? What kind of character do I want to have when in public and in my private world when nobody is watching? How would I want others to describe me? Let's say that you want others to see you as being authentic, and YOU also value authenticity as something you want to live by. You may feel like this value is currently at odds with the behaviors you are engaging in right now. That you are not being the person that you really are deep in your heart. This is not an unusual struggle when it comes to sexual behavior and sexual orientation. So please, try not to feel alone. We all know quite well how unacceptable it may be to be seen as gay, lesbian, bisexual, etc. And I am not just talking about being unaccepted by others, but a person may have a VERY hard time accepting themselves. Thinking about your values and living a life based on them can bring a lot of freedom, but I won't lie, it can also bring a lot of pain at the same time. For example, someone with the value of living authentically may decide they have to tell others who they are and what they stand for, even if that means people may disapprove. That may cause a lot of pain, but it may also come with a sense of freedom to live a life based on honesty and authenticity. It may be helpful to find a counselor who is trained in affirmative therapy, which is recommended for people who are navigating their sexual behaviors and figuring out what is right for them. I would also sit down and think through some of the questions above and consider what your values are... both as an individual and as someone's fiancee.Above all, I wish you well in this journey.


Question: I told her that if daddy dies, we will never see him again. She started crying because I wouldn't make her daddy die.

Response: Children often have a difficult time expressing emotions accurately. It is also very likely that your daughter does not understand  the permanence of death. Having said that, she is using some very specific ideas here and I would recommend contacting a local mental health professional with some experience working with children.I would also wonder where she is getting this idea. Sometimes children hear things on TV or from an adult and we are not even aware of how much they are remembering.It may be helpful to teach her things that she can do when she is angry, like say that she is mad because she cannot have the toy that she is asking for.I'm curious as to how long it is that she stays mad like this and whether she talks to her dad after she is no longer angry. Does she say the same sorts of things about you?It may also be helpful for you to work with a mental health professional (possibly the same one who is working with your daughter) so that you can have some support with this as well.


Question: I get very nervous and anxious/scared before sex.

Response: I first wonder what your anxiety or fear connects to. I don't know whether it is about sex itself or about ideas of worthiness or feeling desirable.There is also a difference between having self-doubt about the actual physicality of having sex (performance-related) or having doubts about whether you want to have sex with a particular person.Having sex can lead to feelings of great vulnerability. If your partner is someone you trust, consider discussing what it is that comes up for you around the issue of sex. This is the certain things that your partner would be willing to do that and the ease your discomfort, like staying with you for some time before and after sexual interactions.Another idea to consider is spending time with your partner and using nonsexual touch for each other (perhaps first you to him and then him to you) and communicating very clearly about what you like and do not like. Some people like to be spoken to during physical touch and other people do not. All of this can be part of your discussions. When you feel comfortable with that, you could move into sexual touch in this manner and actually look at what you do and do not like. You may also consider discussing things that are totally off-limits for you all the time and things for which you would like warning or awareness before they happen. There are really a number of different ways to work on becoming more comfortable if you trust your partner and if your concern is about sex itself.If this feels pretty structured, it is initially. Generally, the idea is to learn more about each other and yourselves and then the process becomes much more natural.If the concern relates more to self-esteem related sex, consider asking your partner to list several things that he or she likes about you. Even if you don't necessarily see yourself in the same light, consider that this is how your partner sees you, so these are some of the things that make you attractive to them (perhaps both in sexual ways and in a wider discussion of the relationship).If this is difficult for you to sort out on your own, consider seeing a therapist with experience working with couples or relationships.


Question: Both of my parents committed suicide together, and I was the one who found them. I suffer from overwhelming depression, which is having an extreme effect on me and my husband's sex lives. He does not understand at all and is always making me feel so uncomfortable about sex.

Response: Hello, and thank you for your question. First, I want to tell you how sorry I am for the experience you had with your parents. That is a grief and trauma that is certainly hard to imagine. Trauma and grief can affect us in many ways, and certainly deeply personal things like our sex lives. It may be difficult for others to make the connection, but it is there. So, for example, if stress and trauma make you feel like you are not interested in sex, a partner may take it as a personal rejection rather than response to stress, trauma or grief. If your husband will agree to it, couple's counseling may be your best bet. A counselor can help you with your communication and may be able to provide some education to your husband about trauma and how it can have an impact on intimacy. If he doesn't agree to go, it may be worth it to go on your own. You still have a lot you are dealing with yourself. And sometimes our personally therapy can influence others, so it may be a good idea. It is important to remember that even though you are married you have the right to make decisions about your body, and that includes when you want to have sex with it. I hope this is helpful, and some of my colleagues may have ideas, also. Be well.


Question: I have suffered many things at home and school. We never went to the doctor to diagnose depression or anything like that, but I always feel like a part of my heart is missing. I try to fill it in with objects or, in this case, a woman.

Response: There could be many reasons but often people feel validated when they are in a relationship, the need to be in a relationship can be related to a belief of unlovability which often stems from our childhood. The relationship sort of soothes this temporarily and the others interest or desire helps counteract the ingrained belief. There are many questions that may help understand why, how was your relationship with your mother (caregivers)?  How was your childhood etc.? Many people describe having a hole or void they try and fill with material things or people but it only is a temporary fix which usually drives the person to the next relationship, or object in hopes it will be fulfilling but it never is because fulfillment is work we need to do ourselves. This journey involves finding acceptance and love for ourselves. Once we have that we don't need to look elsewhere for fulfillment.


Question: I've been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response: Hello, and thank you for your question. While counselors work closely with medical providers, and sometimes have discussions about medications with people, we rarely make recommendations about how much or what type of medication a person should be taking. This is because prescribing and advising on medication is out of our scope of practice. The only exception would be if a counselor is also a physician, nurse practitioner, physician's assistant, etc. Having said that, I certainly understand that anxiety is a real serious problem that many folks struggle with. If you are currently not in therapy to help you with these panic attacks, you should consider it. Medications can be helpful for anxiety, and medications like Xanax may help for immediate relief, but they do nothing to deal with the root of anxiety and may not help with anxiety long-term. Therapists who have experience in exposure therapies would be good people to start with. Exposure therapy has good outcomes for people with anxiety disorders and panic attacks. If you are interested in speaking with your provider about the Xanax, I think explaining it the way you did on here is just fine. The provider will then decide if they feel comfortable increasing your medication. Please remember that medical providers are not trying to give people a hard time. Medications like Xanax really are highly addictive. The more you take, the more you may feel you need. The more often you may feel you need to use it. Depending on the frequency and amount of use, some people suffer serious withdrawal symptoms when they do not take the medication. It is a good idea to talk to medical provider about all of those things so that you can partner on right course of action to manage this anxiety. I certainly hope that you get some relief.... I know anxiety is awful.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: It is possible that you could have or be developing an anxiety disorder. There isn't really enough information provided here to suggest a particular disorder, but it might be worth meeting with a counselor or therapist to do a formal assessment. Some of the questions they might ask could be what other kinds of physical symptoms you experience, how frequently these physical symptoms happen, what's going on for you when they tend to happen, and how frequently/intensely you find yourself worrying in general. Anxiety itself is a really natural thing - it's just when it starts interfering with your ability to "do life" the way you want that we start to consider potential disorders. It might be that for the most part, the anxiety you feel is normal and you simply have some triggers that intensify it more than usual. Working on your own or with the support of a counselor/therapist to both address those triggers at the root and also to develop ways of managing the actual anxiety symptoms. This two-fold approach can be really helpful for not letting anxiety keep you from engaging in life the way you'd like.


Question: I have been feeling more and more down for over a month. I have started having trouble sleeping due to panic attacks, but they are almost never triggered by something that I know of.

Response: It could be really helpful to see a counselor/therapist about your increasing depression/panic symptoms. Finding out the cause of depression/anxiety isn't always as straightforward as it seems, since both issues tend to become patterns we engage in rather than solely related to a specific trigger/reason. For example, if I am feeling down about a particular circumstance in my life, then I start seeing life through this lens of feeling down, and typically I'll start to see a lot more that I get down about, and it can really build very quickly on itself. Same with anxiety. Obviously, this is a very simplified example and it can be very difficult to see how the pattern is maintained, but that's where working with a counselor/therapist comes in. I would be curious about whether you can start to notice the initial sensations of panic, and if you can (through the panic attack) continue to maintain awareness of the actual physical sensations. Even better if you can talk yourself through the sensations you're feeling - such as saying to yourself "Okay, I'm breathing really rapidly, and my heart is racing, now my palms are sweaty and my chest is feeling really tight..." Reminding yourself that it's just your body's reaction to stress, and while it might be overreacting right now, you're okay and eventually it will go away. I highly recommend the SAM for Anxiety Management app for the anxiety piece, and I wouldn't be surprised if addressing the anxiety helped to address some of the depression too.


Question: Her father and I have been dealing with this problem for quite some time now. She is an adolescent, and the problem is mostly food. She is now overweight, and we just don't know what to do anymore. She can be disrespectful and doesn't listen to or respect what we say.

Response: I would be curious about there potentially being some emotional or physical trauma in your daughter's history that she is struggling with. Physical trauma is usually easier to identify, but emotional trauma can be feeling a lack of emotional connection in her important relationships, having experienced bullying, or some other emotional injury. The fact that there are some defiance symptoms going on suggests that she might be in need of a safe place to process what she's going through, and the potential issue with control or meeting emotional needs with food is also concerning. I would recommend looking for a therapist/counselor who works with children/adolescents in the area of addressing trauma for an assessment. They may be able to ask the right questions to see whether trauma is truly the issue.


Question: I'm in my late 50s. I never loved or have been loved. I need deeper help than is offered in my small town, but I cannot leave this town because of agoraphobia. I find myself losing hope more and more. My brain barely works anymore, and my memory so small, I forget in a moment. I serve no purpose. I'm incapable of work or anything of value, and I never have been. I'm a complete waste of time and resources, and yet I keep trying. Why? Why does God insist that I continue to exist? I'm not suicidal, just tired.

Response: The fact that you're reaching out says that there is something in you that wants this to be different, and that drive might be something worth tapping into. "Why do I keep trying?" is a question that might give you some insight into what it is in you that keeps you going. A lot of therapists/counselors are now offering video therapy. As long as you're in the same state as a therapist offering this service, you could connect with someone helpful from the comfort of your home, even being in your small town. I'd recommend looking into this option, because you're asking a lot of really deep questions and might benefit from having those conversations with someone who can help you find your own answers.


Question:
I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I'm not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and does not keep me up to date on everything that he does throughout the day, which he used to.
I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I Don't know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town?

Response: Consider talking with your boyfriend about times that you may be able to talk together while he is away. This way, you have an idea when you'll be able to contact him. Does he recognize the feelings that you have while he is away? How do you feel when you are together with him and he is home?I'm also curious as to how the level of your anxiety (on a scale of 1 to 10, perhaps) changes during the parts of his trips. Maybe there are certain parts that are more or less related to anxiety for you. Perhaps you have less anxiety while working or involved in a specific activity, for example, spending time with friends.When you are both in the same area (when your boyfriend is not traveling), do you do some things independently with friends? Do you know what leads to your anxiety when he is away? I don't know whether it is a general feeling of wanting him to come back or anxiety that something specific will happen to you or him.Do you ever recall feeling this way in your past? If so, what was happening then?What do you have that makes you feel very safe and comfortable?Consider working with a mental health professional in the area. Perhaps it would be helpful for the two of you to meet with a therapist who specializes in couples to see what kind of relationship you want to have and what you can each do to contribute to that relationship. There could be things that you could both start or stop doing to help your relationship move in the direction where you would like it to go. As an example, perhaps you would like a text before your boyfriend goes to bed, no matter what time zone or time of day it is. Perhaps he would prefer a good morning text or call/voicemail from you.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: First, be aware that each end every one of us has anxiety at some point. That certainly seems to fit what you're describing here, but that doesn't mean you have an anxiety disorder, necessarily. That's where there is a difference. Anyone who has a hard time with public speaking or feels uncomfortable in large crowds, for example, is experiencing anxiety.It sounds like it would be helpful to look at the differences between the days when you are more comfortable on the days that you are not. If you notice your anxiety is keeping you from doing things that you need or want to do, it may be helpful to talk with and mental health professional.I wonder also whether your appetite and sleeping patterns are the same or similar to how they were before you experienced this anxiety, when your anxiety started, and whether you feel more comfortable when someone you trust is there with you.If you have an idea of times or situations in which you feel anxious, consider carrying a small smooth rock or another object that makes you feel calm and centered. Perhaps you can keep it in your pocket and remember specific comfortable times while you have it in your hand.


Question: I've been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response: In general, Xanax is very short-acting. You mentioned that you are afraid that your medical provider will take you off of the Xanax and put you on something else. If the Xanax is not working well for you, I wonder if something else may work better. What is your reasoning there? Also, sometimes there are medications that you can take in addition to Xanax.In addition to talking with your medical provider about changing the medication, try to track your levels of anxiety on a scale of 1 to 10 throughout the day so you can get a pattern of what is happening. Also consider writing down what is happening before you have anxiety attacks. This may help your medical provider know what medication may be helpful to you or what changes could be made.As far as how to discuss this with your medical provider, I would suggest mentioning the symptom changes you are having (anxiety attacks that are not helped with 0.5mg of Xanax) and ask what they would suggest that might help. If your medical provider suggests taking you off of the Xanax, I would recommend talking about the reasons why you would prefer to stay on the Xanax and what your concerns are about coming off of it. You could also ask whether anything could be combined with Xanax.There are also many other anxiety medications. I have seen lots of people that take more than one medication to lessen anxiety that they are having.I would also consider talking with a therapist (unless the person who is prescribing a medication is also doing therapy with you). Getting more information about your anxiety and how it is affecting you may be greatly helpful to you.


Question: I'm a man, and I'm soon to be married. I have been messing around with other men on the side. It started as a once in a while thing, but it's been happening a lot. I don't know what to do.

Response: If you are happy with the person that you are about to be married to and are also enjoying time with other men, it could be possible that you are attracted to people of more than one gender.Having said that, some people have feelings toward people of more than one gender that are not really related to romance or attraction, but any number of other feelings, such as trust and communication. I don't know whether your use of the phrase "messing around" was related specifically to being romantically or sexually involved with the people who you are or referring to or if you are saying that you are enjoying spending time with them. These terms have different definitions for almost everyone.I would definitely recommend speaking with a local mental health practitioner in your area, not because there is anything wrong about the way you are feeling, but because there are a lot of different parts of what is happening in your life right now and it may be helpful to talk about the feelings and thoughts with someone who can help you to learn more about yourself and the people are most important in your life (yourself included).I also suggest looking at a few things that you love and appreciate about yourself.


Question: He wants to wear makeup and heels. He even tucks his penis away to resemble a vagina. He wants me to wear a strap on and have anal sex with him. I have tried this for him, but I Don't like it and have told him so. He keeps making comments about it and says he can't live without it.

Response: It sounds like you may be asking two different questions.With regard to what you said about your husband dressing as a female in your bedroom, I wonder if you would consider asking him more about this. If you choose to do that, I would suggest that you ask him whether a certain time is a good time to have a conversation and asking questions for five minutes or more that are related to you learning more about his experience. This can be difficult to do at times, particularly when you may want to offer your own opinions or become very anxious or of type. Consider thinking of a phrase that may help you to stay calm during the discussion. It may be helpful to think of yourself as asking questions as if you were an investigative reporter and using questions that start with words like "what, how, who, where, when." Questions that start with "why," can be very difficult to answer for some people and can be overwhelming because it often links to answers involving emotions that may or may not be understood. Also try restating what your husband is saying to make sure that you are understanding correctly. If what he is telling you is different than what you have heard or thought of for many years, it may be challenging to follow his meaning initially. Remember that listening to your husband does not imply agreement with what he is saying, just that you are following and looking to understand what he is experiencing. I also recommend sticking to one topic for the conversation, but this could be done with many different topics over time.You could also see if he would be willing to have a discussion where he listens like an investigative reporter to learn more about the experience that you are having.As far as what you mentioned about the sexual experience, maybe if you can discuss what it is that you don't like and/or understand what it is that he does like, you could see if there is some middle ground here. It depends on what you both prefer.These types of conversations can be difficult to have for some couples, at least initially. Having structured conversations, such as the ones I've described briefly above, can feel awkward initially, but the reason it can be helpful is because it can lead to further understanding in a way that decreases the chances of having an argument.Also consider seeing a therapist in your area who specializes in couples to discuss some of these ideas.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: Your, sitting in your car for 30 minutes, story sounds so sad and frustrating.Yes, you're describing classic symptoms of anxiety.Anxiety itself is the indirect result of repeatedly being in positions of feeling helpless or frightened.Are you able to recall from your growing up years of feeling insecure?You may not have felt loved and nurtured as much as you needed.Some people develop anxiety from missing enough love.  They feel lacking in ability to take care of themselves, similar to the lack of being sufficiently taken care of when younger.Try understanding if you felt neglected emotionally.If "yes", then start the slow process of emotionally rewarding and acknowledging yourself.Progress will be slow.Eventually you'll stabilize the way you feel toward yourself.This will gradually result in decreased anxiety.


Question: I have known I was always different. This year, in December, I found out that I never felt female. I did research and have identified myself as male but don't know how to tell my dad.

Response: I admire your courage.If you are concerned about telling your dad regarding your gender identity, I would suggest a couple of things. There are a lot of groups or other supports for people who are working through some of the same changes that you may be going through now. I don't mean to convey that everyone thinks, feels, or acts the same by any means, but rather that it may be helpful to talk to others who have had some similar experiences.I was trying to include some links for you, but that particular button isn't functioning window. If you search for "transgender support" on Google, you'll find GLAAD and PFLAG, both of which are national organizations. This does not mean that you have to identify as "transgender," but researching that term may help you to find both national and local resources.As far as telling your dad, if that is particularly concerning for you, I suggest either talking through the details with a local therapist or considering if you have a trusted friend or family member (one who will respect your privacy with regard to who you would like to know about what you are experiencing at this time) so that you can talk with some people to have support. This may help with two things: allowing you to find some support for yourself as you work through the changes that you are going through now and also possibly talking with someone who knows your dad and may be able to talk with you regarding how or when to tell him.One thing that I tell anyone who wants to discuss something that is very important to them is to ask the person they want to talk to whether this is a good time for an important conversation. That way, you have greater chances of having the person's attention and/or not needing to end the conversation quickly. Also, please remember that you know yourself best, as each of us does.


Question: I'm a girl, and I can't tell whether I'm bisexual or gay. I like girls a little more than boys, but I don't really know.

Response: Sexual orientation is not always something that is clearly definable. Some people look at it on a continuum where being attracted to only boys is at one end, only girls is at the other, and bisexual is in the middle. Anywhere in between those points can be any amount of attraction to boys or girls.If you don't know whether you are gay or bisexual, that is okay. A lot of people don't know for quite some time. In addition to that, after people do know who they are attracted to, a lot of times they do not use the terms "gay" or "bisexual" for quite a while.It's okay not to know.Think about what sorts of expectations you have for your ideal relationship. Some examples may include trust, respect, availability for conversation or connection, etc. Whatever it is that you find important in a relationship is likely what matters most.If you are struggling with learning what it is that you would like in a relationship or any other feelings connected with what you are thinking and feeling, I would suggest connecting with a local therapist so you have a place to talk about what you are experiencing.


Question: I went to my ex-boyfriend to reach out to one of his high school friends who's attempted to commit suicide. When I went to him to reach out to his high school friend, he told me that I put him in a terrible position and put an enormous load on his shoulders. He was very angry that I went to him to do that. Am I in the wrong for going to him to reach out? He helped me so much with my depression and bad habits, so that's why I thought of him to reach out. He made me feel awful for thinking highly of him to help. Why did he react this way towards me? I think he's being selfish.

Response: I'm glad you think so highly of your boyfriend and his ability to be there when you would like to talk about things that are important to you.I see why you would want them to reach out. I also wonder about how close he was with his friend and what he thought you meant when you asked him to reach out. It sounds as if he is thinking that doing so would mean that he is responsible for his friend's well-being, although I can't say that for certain.Would you be willing to have a discussion with your boyfriend where for a few minutes (five minutes or so), you ask him about what made him react that way? During this time, try to listen and ask questions is if you are an investigative reporter and are trying to learn more about his experience. You can also summarize what you are hearing to make sure that you understand it as he does. This does not mean that you have to agree with what you say, but just that you follow. I hear you saying that you think he's being selfish. I'm suggesting that just during this conversation, you ask questions to focus on what he is thinking and feeling. In one sentence, the goal would be to learn more about his experience.I would not be at all surprised if he is scared.Are you aware of what kind of support he wants through this time?


Question: I've been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response: Staying on the lower dose may give you more room to learn strategies for coping with your anxiety.  Medications are so helpful, and needed at times, but it's also important to have a variety of tools you use to manage your responses to stress.  If you are not already seeing a therapist, consider finding one who can help you learn some effective strategies, like replacing self-defeating thoughts with ones that work better for you, or mindfulness, relaxation, or other tools to keep your anxiety in the manageable range!


Question: He is always telling me our fights are only and all my fault, he bashes me to our young child, and he is addicted to a few substances.

Response: The behaviors you describe are boundary violations.  You can not change your spouse, but you can respond to his behaviors in ways that protect your boundaries and ensure your safety.  This is very hard to do without support.  Finding a therapist who understands the dynamics of abusive relationships may be helpful.  If you are not ready to do this, I recommend the book "Boundaries" by Dr. Henry Cloud and Dr. John Townsend.  It's a great resource for helping one recognize boundary violations and learning how to respond to them in ways that are constructive!


Question: I've been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else.

Response: Do you think you're abusing xanax?It is a highly addictive drug so maybe one reason you feel compelled to take more is bc you already are addicted.Drugs don't do anything helpful in solving life's problems.   Once the effect wears off, the stressful situation is once again waiting for you to address it.Think over your reason for not directly asking your psychologist about upping your dose.Also, do you ever talk about your life problems with this psychologist or only your need for drugs?    The more gradual path to a better life is to not need drugs in the first place. This consists of your willingness to face the matters that are creating such terrible feelings inside you.


Question: I have terrible anxiety and depression. I've tried various therapists and pills, but nothing's helped.

Response: Is it possible you simply didn't mix well with the particular therapists with whom you've worked?   If this is possible, interview a therapist before  starting therapy.   Then you will be choosing a therapist who feels compatible with your way of seeing yourself and your life.Also, therapy isn't for everyone.Read about the different healing modalities and see if one of these speaks to your interest in feeling better.What matters most is finding among all the legitimate healing methods, what you believe will be effective.


Question: I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better.

Response: How old are you?Are you old enough in your State to have therapy without your mother's consent?Your mom's attitude toward you may be one significant reason on why you feels so much tension in the first place.Don't let her opinions and beliefs get in the way of what you know about yourself.Are you in school and does that school have a guidance counselor?Would you talk with that person about your difficult getting your mom to retain helping services for you?Keep looking for local resources which will support you either directly or indirectly by advocating for your right to receive mental health care.


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: I'm in my early 20s. I've worked since two months after I turned 18. I have plans. I could become an electrician, or I could operate heavy machinery. I have goals, but I do nothing to try to meet them because I don't feel I can. I just want a better life for my fianceee and the kids than I did.

Response: For starters, commend yourself for being committed to working. You have no idea what is going to happen in the next second, so focusing on thinking you will never have a good career or amount to anything financially is creating a fictitious story.  Remind yourself of that every time the thought pops up.  The false belief that nothing good will happen is sucking out energy you can use on pursuing your career dreams. Next, do you know what you need to do to become an electrician or heavy machinery operator? If not, find out. Then, set up a realistic schedule for yourself to accomplish the steps. As you accomplish each step, see your progress.  Notice that you are moving closer to your goal.  Every day remind yourself why you are pursuing this career.  In fact, write it down and tape it on your bathroom mirror.  When you start to feel discouraged, remember your goal and remind yourself that you have no idea if you'll make it or not but you are going to give it everything you have to find out. Anything worth pursuing is going to take a lot of persistence and hard work. Stay with it! You and your family are worth it!


Question: My husband had an emotional affair with his ex-wife in November. She invited him to dinner, alone, with their daughter. I wasnt aware of this until after 11pm when I asked where he was. He had been drinking, and I told him not to come home that night. The next morning, we talked about going to counseling. He went out that night with friends and said his ex-wife wasn't going. I found out in April that she did go. I gave him the chance to get everything out in the open. I found out that he stayed that second night with her. I asked if they slept in the same bed, and he said yes, both nights. His daughter wasn't there the second night. He claims they didn't have sex, but what else should I think?

Response: My answer is going to be super simplistic but I believe this may be what you need. Ask your husband if he wants to stay married to you.  If he says yes, then it would be helpful to go to a marriage counselor and work this out with a professional.  If he says no, then you can file for divorce.


Question: I believe it is wrong for men to look at inappropriate content. The father of my child has agreed to respect my beliefs. His co-worker sent him an inappropriate video. He got mad because he does not think he should tell his friend to not send him things like that.

Response: In my book, this is a boundary issue. Although you do not like inappropriate content, it is not up to you what your child's father looks at or what his friend sends him.  It is really hard not to monitor other people's lives, but in the end, your rights begin and end with you.


Question: I'm a man, and I'm soon to be married. I have been messing around with other men on the side. It started as a once in a while thing, but it's been happening a lot. I don't know what to do.

Response: Divorce is expensive emotionally and financially. If your fiance is not ok with an open marriage, it would be a good idea to seek the help of a counselor before you get married.


Question: I told her that if daddy dies, we will never see him again. She started crying because I wouldn't make her daddy die.

Response: It's normal for a child to be so angry she wanted someone to die, but this seems to be heading into a dangerous realm. I think it would be wise to have her seen by a child psychologist just to rule out anything more serious.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: Though I don't know for sure, it sounds like anxiety to me. I think it would be helpful if you work with a therapist who specializes in anxiety disorders.


Question: I have terrible anxiety and depression. I've tried various therapists and pills, but nothing's helped.

Response: I'm sorry that you have tried several different things and not had much relief.I will say that there are several different types of medications that may help and each therapist is different, so it is quite possible that a different combination of things you've already tried may be helpful.I would encourage you to continue trying different therapists. I would say to give each one at least six sessions before you decide that the approach that they are using is not working for you. Also, most places have a certain sort of structured initial session that must be done, but after that, the decisions are largely up to what you and the clinician feel is helping. If something is or is not working, communicate this with your therapist. This is a big deal. Most therapists I know actually welcome this feedback.There is a fair amount of research into the idea that the therapeutic alliance (the relationship that you have in the context of working through the reasons that brought you into therapy) is very important. Also, sometimes anxiety and depression can make it difficult to go to therapy on a regular basis. If that is something with which you are struggling, I would encourage you to talk about that as well.In addition to a solid relationship with a therapist who you connect with, you may consider trying something like yoga or meditation. Mindfulness is sometimes helpful as well.Here's a link to questions for finding suitable therapists: http://www.pharmatherapist.com/12-tips-for-finding-a-suitable-therapist


Question: I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better.

Response: I don't know how old you are, but in Pennsylvania, if you are over 14, you can have therapy without your parents' consent. If you are young enough to use their insurance, that could be complicated, but depending on the state, there may be ways to work around that as well. If transportation is a problem, call a local mental health agency and see if they can connect you with assistance.In the meantime, try searching for a phone helpline in the county where you live. They may be able to help you figure out where you can get help.Another idea is that if you are in school, your guidance counselor may be able to provide links to where you can go for help. He or she may also be able to give you more specific ideas to help with your panic attacks.I know you said your mom refuses to offer help, which included seeing a doctor, but I wonder if she trusts the doctors that is your primary care physician (also called a family doctor) who you see when you have a minor medical ailment that may need medication. That doctor may be able to help you as well.Some of the information here may be helpful to you because it explains some of what anxiety is and there are some quizzes there that may give you information to discuss with a doctor or therapist when you get connected with one. http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders This may give you other information to speak with your mom about. Remember that I'm not asking you to actually diagnose yourself with one of these things, but just offering some basic information that may help you be able to talk about what is going on.If you are having a panic attack or having a moment of anxiety, try focusing on different things in the room around you. It may help to shift your focus briefly outside of what you are feeling and that may lessen the feeling a bit. Also remember that sometimes anxiety leads to more anxiety about having a panic attack in the future. Remember that they usually and after a few minutes.It would also be helpful for you to keep track of what leads up to your anxiety.Best wishes to you and keep trying until you get connected to someone.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: These types of symptoms can be very disruptive to life!  Anxiety often presents in two key ways:  1) physical symptoms such as: racing heart rate, sweaty palms, dry mouth, shaking or trembling or nausea - often these physical sypmtoms are categorized as a Panic Attack.  2) mentally anxiety presents itself as worry.  Worry that spirals out of control, worry that dirsupts your life and concentration.  Worry that keeps from being present in your life.  Anxiety when it begins to spiral out of control either with disruptive mental or physical symptoms, needs to be addressed formally.  I urge you to see a counselor and/or a psychiatrist soon to begin to address these issues.  Good Luck,


Question: I've been with a man for four years. For the last year, he has said he is done, but he still talks, texts, visits, and has not moved on with anyone else. His words do not match his actions. I love this man, but it's hurting so much.

Response: This can be difficult and confusing.If you think your boyfriend would be open to having a discussion, try asking him for a time when he is willing to have an important discussion. When that time matches with a time that is good for you, try discussing the type of relationship that you each want to have and what you can start and stop doing to get there. He may want to be really good friends. He may also be trying to figure out what he is feeling. If you end up talking over one another, try letting one person be the one who is talking about their feelings for about five minutes and during that time, try having the other person asked questions to gain more understanding of their experience. Then you can switch. Also consider asking questions that cannot be answered with yes or no, but lead to more explanations.Questions that start with the words how, what, when, who are usually better than questions starting with "why" because they can be emotional triggers for some people.If this is difficult to do between the two of you, consider seeing a therapist who specializes in couples.


Question: My doctor seems to think I am in danger of having one. I neglected to ask how this was different than an episode. I have been formally diagnosed with bipolar type 1.

Response: I will admit that I'm not specifically familiar with this from my own experience.My best educated guess is that you could have a seizure during which you have some sort of symptoms similar to a hallucination (which is one of the psychotic symptoms) when you hear or see things that aren't really there.In looking briefly online, I was able to find some information here: http://www.epilepsy.com/information/professionals/about-epilepsy-seizures/psychiatric-and-behavioral-aspects/psychiatric-2It sounds like this would be a symptom in addition to an already existing seizure disorder, not a seizure disorder in addition to a mental health problem. If it is the other way around, I'm not sure how that would work. It is common with some types of seizures to have an altered state of reality during or shortly after the seizure, so that could also be related.I would suggest you talk to your physician about this directly so that if they are worried about this, you can learn more about what is making them concerned about it and what, if anything, you could do to lessen the likelihood of it or how to handle it if it does happen.


Question: I've been with a man for four years. For the last year, he has said he is done, but he still talks, texts, visits, and has not moved on with anyone else. His words do not match his actions. I love this man, but it's hurting so much.

Response: Have you brought up the topic as to the way you're feeling?The best way for someone to understand us or to understand someone, is to directly talk about  the specific problem.To start the discussion w your partner, understand your own reasons for continuing the relationship.Given his stated disinterest in the relationship, your mood is probably affected by this.Once you are clear on how the range of your feelings, especially any fears on being alone, suggesting you may be staying w this guy simply to avoid such fears, then you'll be ready w your self-knowledge, to start a conversation w your partner about your relationship.


Question: We had great chemistry, but then he became distant. I had the feeling that I can't be without him. As soon as I felt the difference, I was scared to lose him. I started freaking out if he did not answer, thinking that something bad happened.

Response: The simplest answer is that love feels good, obsessions don't.Love deepens a sense of peacefulness and security.Obsessions give anxiety and worry of feeling abandoned.One suggestion is to study more about yourself and why you'd feel so ill at ease when you aren't w this person.


Question: We had great chemistry, but then he became distant. I had the feeling that I can't be without him. As soon as I felt the difference, I was scared to lose him. I started freaking out if he did not answer, thinking that something bad happened.

Response: People often care deeply for those whom they love. I don't know how long you have been together. It is also common to want to be very closely connected to people who are important to you.It may be helpful to have a conversation about talking more or talking about how you feel when he is not there and how he feels about answering you right away. It may be helpful for both of you to listen to each other and what you are feeling and experiencing so that you can look at what may work for both of you. For example, maybe you could remind yourself that he will answer you when he is not busy or as soon as he can.Sometimes just talking about these feelings can be helpful so that you can both have open discussions about whether the amount or type of communication is too much or in a style that is not working for both of you. You could also consider leaving text messages or something that does not require an immediate response so that when he is busy, you have the ability to write a message, and he has the ability to answer when he can.I also wonder where you are getting the idea that something bad happened. I don't know whether something happen with this person in the past or perhaps at another time in your life.Some people benefit from ideas such as not going to bed angry, but this is difficult for others.I would suggest considering what makes each of you feel loved, valued, appreciated, or special.Also think about what styles of communication you both like and what is and is not okay in the context of an argument.It may be difficult to talk about what has related to him being distant and it may be helpful to talk about ways to communicate about this first (such as taking a 10 minute timeout if it becomes overwhelming).Perhaps talking with a therapist who specializes in couples would be helpful if talking about this between you is confusing or if you do not both feel heard by the other person. Remember that feeling heard does not mean that you have to agree with one another.


Question: I shake and have panic attacks.

Response: One of the first things I would suggest is to see if you can keep track of what is leading you to feel anxious. If you shake all the time, consider talking with your primary care physician. Sometimes that can be a hormonal imbalance or another chemical imbalance (such as thyroid).One of the most difficult things about anxiety is that having anxiety (particularly panic attacks) can lead to anxiety about having more panic attacks. Also remember that panic attacks are typically part of your brain's protective response to what it considers to be some sort of threat. You may have heard of the fight or flight response. When you have an anxiety attack, your body is preparing you to react to something that isn't actually a threat, so it's almost as if you're fight or flight response is overactive. Here is an image that may be helpful: http://psychology.tools/fight-or-flight-response.htmlThere are many different things you can do. You can practice breathing, mindfulness, meditation, or yoga techniques. If you decide to try some breathing techniques, try breathing in for a count of five, holding for a count of five, breathing out for a count of five, and repeating five times.Also remember that it is easier to learn these techniques when you're not having a panic attack. At that point, it can be really difficult to use methods to not panic. Also remember that panic attacks typically last 5 to 10 minutes. Using techniques to slow your breathing or become focused on the room around you is probably most helpful when you first start to feel anxious.Here are some other techniques that may help to decrease anxiety: http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/As you figure out what is leading up to your anxiety, also consider asking yourself what is making that certain issue a big concern for you. Another important question could be when you have felt that way before.


Question: I just don't know what I want in life anymore. I'm can't figure out what it is that is keeping me distracted and unfocused. I can't put things into perspective at all. I'm just stuck, and I'm disappointed with my lack of accomplishments.

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


Question: There are many people willing to lovingly provide me with a home. I have food, clothes, and a university education, but I never feel like I belong. Even when I have a good time with people who are supposed to be close, I feel like I'm just out with friends and I never go home.

Response: For some people, having a sense of belonging takes some time.You mentioned that you have an education and some basic daily needs. I wonder if you may be able to look at your relationship with yourself and what makes you feel happy, safe, and having a sense of accomplishment. If you have those feelings, I wonder how you define trust and who you trust.You say you have a good time with people who are "supposed to be close," so I wonder what keeps them from feeling close. I have also wondering if you have been emotionally hurt in the past, and if so, you may have some protective defenses that you use (maybe on purpose, maybe not) to protect yourself from being hurt again. Remember that this idea comes in degrees where you can be more perfect in certain situations and a little less in others. Being emotionally protected is on a spectrum or continuum, where you can make an infinite amount of adjustments or changes with different people and situations.I also wonder what it is that you want in your "home," and how you define it. Consider giving yourself permission to think about how you would define your perfect home in a world where there were no realistic restrictions (such as money or location). After you have that, consider what parts of that you can have. Perhaps there is a small part that you could make a reality within a week or so.Thank you for reaching out. If this continues to be difficult for you, consider seeing a local mental health professional so you can discuss some more specific details.


Question: I'm in my mid 20s with a husband and children. I love my family, but I feel like I've lost my identity, and I don't know who I am other than a mom and wife. At times, all I can think is what I gave up and how I feel unhappy and trapped, but I know I'd feel like worse without them. I loathe myself at times. I have an amazing life, so why can't I just enjoy it?

Response: It sound like there are some parts of your life that you really enjoy it and also some things that you wish were different.You say you feel like nothing more than a wife and mom, so I wonder if you could make a list of what else you are (friend, daughter, etc.). I also wonder if you could list your positive attributes or skills.I don't know what you gave up, but I wonder if there is some way that you could spend an hour or so a week working on things that you like and/or spending some time with what you did before you had children. For example, if you're missing a certain part of your career, maybe you could work with your husband to come up with a plan where you could do whenever that is for one day a week. There are often a lot of small changes that can lead you in that direction.Of course, that is assuming that you want to continue being involved with what you were doing before.  If not, what else do you want to do? What is it that makes you feel happy? What do you look forward to? Remember that looking forward to having an hour or two where you can do something for yourself does not mean that you are not a good mother or wife. These ideas can coexist.Can you talk with your husband about how you are feeling? Do you have trust for one another with feelings such as these?


Question: I'm a teenager. My dad has been jail for the last five years. It's tough, but my mom really tries to give a normal life to my two sisters, my brother, and I. I feel like I took upon a parent role when I'm the second youngest, and I'm not stable. My mother and sisters say I'm overdramatic. I'm just so hurt, and I keep breaking down.

Response: It sounds like you have a lot of weight on your shoulders.I'm not sure what you mean when you say you're not stable and you are breaking down. If you are crying because you're sad, that is okay. If you are crying a lot or having trouble eating or sleeping, that's different than just crying sometimes because you are sad. It may be helpful to talk with a local mental health professional in your area. They can help you to figure out what you could do differently to have the role in your family that you would like while also supporting yourself and what you want.


Question: My boyfriend has this close female friend. It always bothered me because of how close they are, so I decided to meet her. That made the situation worse because they were even closer than what I thought. They acted like a couple rather than friends with each other. There was no physical interaction, but he talks to this girl a lot. What can I do? Leaving him isn't an option.

Response: I wonder if you could have a conversation with your boyfriend about how you are feeling. A few things may help with that:Try having the conversation you are both able to have a conversation about something that is important (for example, not during a commercial for a TV show)Maybe your boyfriend will be willing to listen to you for about five minutes asking questions to learn more about your experience, kind of like an investigative reporter wouldSee if your boyfriend is able to capture the essence of what you're saying by summarizing it for youRemember that hearing you and following what you're saying does not mean that he agreesAlso consider if there are events in your past that are affecting the way you are looking at this relationship between your boyfriend and this other girl (we all bring our own histories into relationships and we unconsciously expect that what has worked in other relationships will work in current ones)Then you can switch so that you can hear more about what he is experiencing (for example, what it is that he likes about her)Also consider having a discussion that if one of you becomes very emotional and needs a break from the discussion, discuss having a timeout that will last for a certain time frame (usually between 15 minutes and one hour) and then come back to continue the discussionRemember that the goal here is just to learn more about what each of you is going through, not to find a solution right awayThis can be difficult. Consider working with a couples therapist to discuss it together.


Question: She constantly tells me what I am doing wrong. For once, I want her to be proud of me. it's like no matter what I do, she does not have one nice word to say to me. She is always hateful towards me and always has been.

Response: I imagine this is very difficult and confusing for you.It sounds like there are things for which you are proud of yourself, which is really good. I hope there are also other people in your life that are currently able to recognize the good things that you're doing.If you think your mom would be willing to go to see a local mental health professional with you, that may be a good place to have some discussions about the relationship that the two of you have. The reason I'm suggesting that it may be easier to have the conversations there is because sometimes the mental health professional can point out parts of conflict that are not easy for the people who are involved to actually see by themselves.If you want to try to talk with you mom to see how she is feeling, maybe she would be willing to discuss it with you. If you're going to have a conversation like that, I would suggest you try these things:Ask her if this would be a good time to have an important conversation. If she says no, consider asking her when would be a better time.Try to have the conversation with the goal of taking about five minutes to learn more about where she is coming from on this. If you can ask questions to learn more about that, you may be able to know more about what she is thinking and feeling.This doesn't mean that you have to agree with her, but just that you are able to hear where she is coming from.Try to ask questions that start with the words who, what, how, where, when. Questions that start with the word "why" can be difficult to answer and can lead to a lot of extra emotion.Try to summarize what she is saying to see if you have it right.If you want your mom to know how you feel, after you can listen to what she is saying and see if she is willing to listen to what you would like to say.If you're going to tell your mom about how you feel, consider having some points written down ahead of time so you can explain yourself the way that you want to.It will probably be really hard to listen to her without being defensive right away. I know I would be wanting to jump right into the conversation. Remember that jumping in right away will probably make it more difficult to learn where your mom is coming from.Also, if she says she doesn't want to have a conversation, remember that she has that choice.If your mom does not want to go to see a counselor with you, remember that you could go on your own. Depending on your state and exactly how old you are, you may need your parent's permission to be in treatment, but not always. If you need help to figure that out, try contacting a couple of local mental health agencies to see if they can help you figure out what to do if you want to talk to someone.


Question: He was in love with someone years ago, and he still thinks about her time to time. He said, and I quote, "That relationship is definitely over. I love you, but that girl will always be in my mind." It just didn't feel like he appreciated all the things I've done to make him happy.

Response: It sounds like you were in a tough spot here.I'm not able to tell you whether or not you made a mistake because the decision is yours. I am wondering what led you to ask whether you made a mistake and whether you wish you were still in the relationship with this guy. If so, is it an option to talk about this with him?If you decide to get back together, consider having some conversations about what your concerns are and taking about five minutes or so to listen to this guy's thoughts, feelings, etc. Then see if you can repeat the essence of what he said to make sure you have it right. Then maybe you can ask some questions that you have and see if he is willing to listen. When each of you is in the role of asking questions, try to ask them as if you are an investigative reporter trying to learn more about each other's experience.If you are looking for information on coping with breaking up and you don't want to get back together or that's not an option, consider looking at how you define yourself and what is most important to you at this moment. I hear you saying you've done a lot of things to make him happy. I'm wondering what is making you happy. Hopefully you have friends or family that you can trust and talk to. Even if you don't talk about your relationship with all of them, I hope you have some people around whom you can be emotionally safe and comfortable.


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: Yes, it seems like you may have a type of anxiety: but considering that it is intermittent, it may be a good idea to talk to a therapist and explore what triggers the anxiety.  Different types of anxiety are caused by different scenarios, memories, or stressors.   Once you identify what triggers the anxiety, you may be able to identify the coping mechanism that will help you handle your symptoms.


Question: I'm feeling rejected and frustrated. This is not new. The first month we were together, sex was about every day. Then it slowed down to once a month right away. I love my husband, but I am struggling with this.

Response: Feeling rejected and frustrated is a reasonable reaction to your experience with your husband. I want to encourage you that his actions may have little to do with you, and regardless of outcomes, I hope you find the help you need to process through your pain and still have hope for your marriage.   If your husband was to work with me I'd explore with him his understanding of, and experience with, intimacy in relationship with others. Furthermore, like other male clients of mine, I'd challenge your husband to secure an updated full medical exam from his PCP (primary care physician) and/or urologist in order to identify or rule out any organic issues which may be causing his apparent lack of desire for sexual intimacy. If there are no physical issues, per se, I would encourage your husband to process further his family of origin story-line regarding rules, roles, sex, and sexuality along with working through his sexual and trauma histories.


Question: I believe my partner has a masturbation and porn problem. He masturbates daily, even when I am lying in bed sleeping beside him. We have sex once a week. He is rough and worries about his needs. He never touches me, and treats me like a porn star, wanting to finish on my face or chest.

Response: The comments here from the other therapists are "spot on". As a Certified Sex Addiction Therapist-Candidate I'm convinced your partner's acting out creates trauma for you. Your partner's addiction is NOT your fault and his recovery IS his responsibility. What's paramount is for you to get immediate help from an experienced therapist who understands trauma as result of the partner's/spouse's problematic sexual behaviors. Your needs, safety, and the establishment of reasonable boundaries is vital to your well-being. I wish you the very best.Resources for Your Consideration: 1) https://www.iitap.com/, 2) https://www.sanon.org/, 3) http://www.cosa-recovery.org/


Question: I'm a man, and I'm soon to be married. I have been messing around with other men on the side. It started as a once in a while thing, but it's been happening a lot. I don't know what to do.

Response: It took a lot of courage to share what must be so shameful to you and to ask for help. Regardless of your sexual attraction/orientation, I'd encourage you to get honest with yourself and your partner/fiancee and put a temporary hold on your wedding plans -- getting married will NOT resolve your acting out. It seems to me you need more space, time to sort through with an experienced therapist more of your sex/sexuality story-line and apparent anxiety surrounding the upcoming nuptials. In the immediate I encourage you to also take the initiative to have yourself tested for STDs, etc. and if you've been sexually intimate with your partner/fiancee s/he needs to be similarly tested. Best wishes.Resources for Your Consideration: 1) The book "Not Gay: Sex between Straight White Men" by Jane Ward, 2) http://www.sca-recovery.org/, 3) https://slaafws.org/


Question: My husband's ex-wife married a man who was charged with seven felony counts of pandering involving a minor. He, by his own admission, is addicted to child pornography. My step-daughters are now all teenagers. They do not know. My husband's ex-wife has kept this information from my step-daughters. The step-father has had issues regarding his pornography addiction recently. The ex-wife minimizes it by saying that he has "repented." It is a constant strain on my husband, knowing that his girls are living with a man who is addicted to child pornography. My own therapist believes the girls should be told. The ex-wife says her therapist says the opposite.

Response: The information from the other therapists here is sound and prudent. There are what sounds to be real legal (is this man a RSO [registered sex offender]; is he prohibited from being in proximity to minors? use/possession of child porn violates any # of state and federal statues...) and safety issues at play here. Your husband's daughters have an immediate "need to know" and this can be done developmentally-contextual, factually and in a non-shaming fashion. I would further counsel that you and your husband (his daughters welfare is at stake) seek immediate legal counsel. The ex-wife here seems to be between a "rock and a hard place" of her own creation -- she desperately needs care, treatment for herself. Resources for Your Consideration: 1) http://www.missingkids.com/home; 2) https://www.justice.gov/criminal-ceos/citizens-guide-us-federal-law-child-pornography


Question: I have been diagnosed with general anxiety and depression by my family doctor. They wrote a prescription for me to have an emotional support dog, I have the paper work, and I gave it to my apartment manager. They said I can't keep the ESD because I'm not disabled. What do you suggest I do?

Response: This can be a difficult situation.  Typically, only animals that are specifically trains to accomplish a specific task are legally protected as Service Animsls. Even though that can be very helpful, emotional support animals are not generally protected in the same way.You might not be able to make your landlord accommodate you. If possible, you may want to consider a different apparent that is more animal friendly.


Question: I've been with a man for four years. For the last year, he has said he is done, but he still talks, texts, visits, and has not moved on with anyone else. His words do not match his actions. I love this man, but it's hurting so much.

Response: That does sound very confusing...and hurtful.  You do not have to tolerate someone treating you in a way that hurts you.  It may be helpful to decide where the boundaries are for you and to stay true to them in your interactions with him.  You teach other people how they are allowed to treat you.


Question: I'm a man, and I'm soon to be married. I have been messing around with other men on the side. It started as a once in a while thing, but it's been happening a lot. I don't know what to do.

Response: I would start by examining the reasons for seeking out other relationships. Are you getting something from the other men that you do not currently receive from your current partner? Such as, is it more exciting with others and that excitement is lacking in your current relationship?


Question: Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself.

Response: I would suggest keeping a log of those days when you are having a hard time. Items to write would be what were you doing before you felt this way, did you eat and what, what time of day is it, how much sleep did you get that night, etc... This can help you identify any triggers. Further assessment can be made by a health care professional. It does sound like you are experiencing some symptoms of anxiety.


Question: When my son was a teenager, we sent him to live with his dad because of the constant disrespectful attitude. A week after he graduated, his dad made him leave because of the same issues. All four parents tried to talk to him, and he just refuses help all around. He is now living with his grandparents. He had a job, and took steps to get his license and an insured vehicle. I thought he was heading down the right road, and then he tells me he quit his job because he didn't like it. I just Don't know what to do.

Response: I admire your efforts. You can continue to offer assistance for your son, but it is ultimately up to him to decide what to do with the information or ideas that you are giving to him.One thing you might try is to ask questions in a way that enables you to learn more about what he is experiencing. For example, if he is willing to talk to you about what he does on a daily basis and/or what he would like to be doing, you may be able to get a sense of what he finds difficult and find some resources to help.I might ask things like this (just as examples):Can we talk for a few minutes about some things that I would like to learn more about?I'm just looking to learn more about what has been happening for you recently and I'm not trying to make you do anything.I know you said you quit your job because you didn't like it. Could you tell me more about what you liked and what you didn't like?Do you see yourself doing the same kind of job in the future?What is it that makes you happy or what is it that you look forward to doing?Can you think of anything that I can do to be of support to you?If he is interested, you may be able to connect him with an area community college to learn more about possible job opportunities.With the way that I wrote the questions above, it probably sounds like it's relatively easy. In reality, it may not be an easy conversation and your son may choose not to discuss it with you. If that's the case, I'd remind yourself that you are trying to do everything you can.


Question: In middle school and high school, my friends and family thought I was gay. I tried telling them, but they wouldnt believe me. It almost feels like they wanted me to be. Now I'm actually starting to believe them. I know I wasnt back then, and now I'm not sure anymore.

Response: I agree with Amy. We get a lot of pressure from others and even ourselves to define who we are and what we want at a pretty early age. The truth is, our sexuality can change and grow in directions we never imagined. I may be wrong, but I am getting the impression that you may not want to be gay. That this is something you didn't like others suggesting and now you are uncomfortable with the idea that it may be true. This would certainly be understandable. Your sexuality is YOURS and yours alone. It can be quite frustrating and hurful when others try to define who you are. And it can be equally frustrating when you are trying to figure it out for yourself. The truth is that there are many different possibilities when it comes to sexual orientation. It may help to think about what qualities you find attractive. What kind of person can you see yourself being attracted to? Someone smart? Funny? Loves dogs? If you look for these qualities in a person they may lead you to being attracted to someone of the same sex, but maybe not. At least you would be choosing someone based on values and qualities that you love and admire. Another idea is to chat with a counselor, if you are interested. Preferrably one who has done some training in affirmative therapy. Be well and be you..


Question: I was the one who ended it, and I'm so glad I did. It was the best decision I made in my life. But how do I stop the nightmares and flashbacks? It is creating a wall in my current relationship.

Response: One thing you could try to do on your own is to focus on the partner who is in front of you now. If you are able to connect with them via touch or focusing on their tone of voice, that may help to center you. Tried to stay grounded and/or mindful. That is being aware of your position in the room, your feet on the floor, your hands in your lap, or your hips in the chair. Being mindful of the environment you are currently (for example, noticing what is around you) may be helpful. Try to use all your senses. For example, you could focus on hearing your husband's voice, feeling his hand in yours, being wrapped in your favorite blanket, seeing a comforting photo, using a comforting sense or candle, or tasting an apple that reminds you of times when you have enjoyed yourself in the kitchen.It also sounds like you are having a very specific reaction that could very well be related to trauma. I would recommend that you talk with a local mental health professional.Remember, just because it was the best decision of your life, that doesn't mean that what happened to you or in your presence automatically leaves you when you leave the relationship. Our brain is actually hardwired to remember things that have caused us pain or great emotional distress as a way of protecting us from them happening again. This is a very natural response and the reactions you have as far as nightmares and flashbacks are the past coming forward and your brain trying to make sense of it all.


Question: I panicked over a minor parking lot mistake. It was totally my fault, but due to another insurance issue, I left a note with an illegible phone number. Guilty over this, I got an envelope containing several hundred dollars. Unfortunately, by the time I returned, the other driver had seen my ersatz note and drove away. Since I cannot make this up to that individual, how do I atone for my cowardly act? I have been trying to do random acts of kindness in hopes that karma will somehow even out.

Response: Thanks for sharing as it shows your humanity and that you have a sensitive conscience. In your example here I'd encourage you to always think, "safety first"; and never offer a stranger at the accident scene "...several hundred dollars". Why? Because it could go badly against you (i.e. extortion, robbed, or would this be considered a bribe).   To the point, I'm reminded of Steps Eight and Nine in many 12-step programs regarding making amends. In your specific example since the injured unidentified party departed, and by your own admission you've been doing random acts of kindness, it seems to me you've acted in reasonable good faith fashion to make amends. Well done.   I'm not a karma expert but as a therapist I would invite you to explore the deeper story behind your use of the words "cowardly", "guilty", and what it does for you to engage in "random acts of kindness". What a fascinating journey this could be for you. Best wishes.


Question: I don't know what to say. I have never really known who I am.

Response: This is perhaps the deepest question that one can ask of themselves and the answer is as elusive as the deepest enigma. We are fluid beings, we are never the same from day to day, we learn or unlearn, we evolve or some of us even devolve, we are in a state of constant flux, changing and adapting, like a cloud in the sky that has its shape changed by the wind, life whittles us away and carves us constantly, trying to understand this question is like trying to bite your own teeth, however we can have a sense of what we would call our core and to understand the core, we need to live and to experience, but also to think deeply, analytically, and critically, by engaging with life we get a sense that we are like the Earth itself, inside of us there is a core, just as there is inside our planet but our continents shift and change over time, like those continents so does our own nature shift throughout our lives.


Question: I've become so jaded that I can't control my thoughts. I cannot focus on anything and been having anxiety attacks.

Response: I imagine that it's pretty disconcerting to feel as though you lost yourself.When you said that you are jaded, I'm not sure whether you mean that you are jaded toward someone, something, life in general, or some combination thereof.One of the difficult things about anxiety is that anxiety can lead to more anxiety because of being concerned about having another panic attack. Consider remembering that panic attacks usually only last a few minutes and the reason they don't go away right away is because of the way your brain releases chemicals because some part of your brain is reacting as if you are in danger in some way.As far as finding yourself, you may consider looking at what parts of each day you can control as a way to stay centered. You could also focus on something that makes you feel happy and/or comfortable.You may also consider the list of values here to give yourself an idea of what is most important to you, what it is that you are living by now, and what values you would prefer to live by. http://www.therapistaid.com/therapy-worksheet/values-clarificationIf this proves to be difficult, consider seeing a local therapist.


Question: My husband and I have been married for seven years, and in that time, we have only had sex four or five times. Others have told me that most men would have left me by now. Honestly, I think I have a low sex drive or neither one of us actually knows what we are doing. I want to be better connected with my husband.

Response: There are a lot of different things that could be playing a role here.First, different people have unique levels of sex drive, and sometimes there is a hormonal imbalance.Because you say both that there is a possibility that neither one of you "actually knows what you're doing," and you want to be better connected with your husband, consider having some time where you sit together and touch each other in nonsexual ways and communicate about what you like and don't like. One person would be doing the touching and the other would be communicating. Then the rules would switch. After you both become comfortable with that, you could try the same thing with touching that is sexual in nature.Dr. Tammy Nelson is a therapist who specializes in relationships and sexual issues and she has several books and lots of other resources on her website: https://www.drtammynelson.com/There are actually therapists who specialize in sex therapy and if you are interested in that, you would want a therapist who is a CSAT (certified sex addiction therapist). This does not mean that they only specialize in sexual addiction, but they do have special training in discussing sexual elements of relationships and their training is quite extensive.In addition to connecting sexually, you may consider discussing with your husband whether each of you are aware of things that make you feel valued, special, loved, and appreciated. It may be that making positive changes related to your sex life would also improve your relationship, and vice versa.


Question: I have been diagnosed with general anxiety and depression by my family doctor. They wrote a prescription for me to have an emotional support dog, I have the paper work, and I gave it to my apartment manager. They said I can't keep the ESD because I'm not disabled. What do you suggest I do?

Response: This is tricky because there are different types of emotional support dogs. The ones that are officially trained actually go through months of training and then are paired with someone for whom they perform specific tasks.You may benefit from looking at the blog written by Valerie Parrott, who has an emotional support dog due to severe anxiety and panic. I will warn you that her blog is very blunt, but she is honest and she has gone through this process: https://thedogintheroom.wordpress.com/2016/06/20/what-makes-a-service-dog/#more-508


Question: I don't know what to say. I have never really known who I am.

Response: Because you put this under the category of spirituality, I'm not sure whether you are asking how you find yourself as far as religious or spiritual beliefs or overall.If you are talking about learning more about religious or spirituality, consider either going to or speaking with someone who is involved with a nondenominational church service (the Salvation Army usually has something) so you can discuss questions or ideas that you may have.As far as finding yourself in general, I suggest considering what makes you happy and/or comfortable. I also wonder if looking at the list of values here may be helpful to you: http://www.therapistaid.com/therapy-worksheet/values-clarification


Question: My mother takes care of niece whom my sister abandoned. She calls me every day complaining, but I don't want to hear it anymore.

Response: This sounds stressful.You mentioned that you want to learn how to avoid them. I'm not sure whether you want to avoid them overall or if you would like to ask your mom to maybe only talk to you about it for a few minutes about your niece in each conversation that you have.Maybe you can connect your mom with some support. It sounds as if she has lost part of herself and/or is very stressed out and in talking with you about it because she trusts you enough for you to be someone she can speak openly, you are becoming stressed because of things that you cannot directly change. This is the presumptive based on the amount of information that you posted, but it sounds like there is a bit of a circle of stress here.I also wonder who you could talk with when you are stressed.It may be helpful to see a local mental health professional to help redefine some boundaries so you can have the type of relationship with your mother that you want without necessarily feeling stressed out by it every day.


Question: My fiancee and I recently had an argument over finances. He gives me the money each month to pay his automobile insurance. He no longer has one of the vehicles on the policy. He realized he was still paying for the coverage and asked why I was allowing him to continue to do that since I was physically paying it for him. My response was that he was giving me the money, and I just made the payment. I didn't think of the coverages. He was angry about it. I still can't figure out that anger.

Response: A few things come to mind. I wonder if your fiancee is still angry about it or if he was angry in that moment and has now worked through it.It sounds like there was also a difference in expectations here. You were just  paying the bill with the money he was giving to you and he may have assumed you were reading it. You thought that you were following his directions. It could be that you could have a discussion about it, but that depends on how much of a hot button issue it still is for either of you.If you're going to talk about it, I might suggest asking whether this would be a good time to have a discussion about what happened with the automobile insurance so that you can both use the opportunity to learn more about yourselves and each other around this particular issue.


Question: She said she needed space after three days of dating, and she got a boyfriend a week later. I still really miss her, and she told me she still likes me.

Response: It sounds as if your ex-girlfriend is trying to figure out what type of relationship she is looking to have with you. There are lots of levels of relationships, from a basic acquaintance, to a more friendly acquaintance, to a friend, close friend, best friend, early romantic partner, committed romantic partner, and many more.If she is willing to have a conversation with you about her feelings, it may be helpful to have her explain her feelings to you while listening as an investigative reporter and asking questions that cannot be answered with yes or no, but are what are called open-ended questions, which ask her to provide more information. During this process, it would be helpful for you to try to think of it as not being personal, but just listening and trying to understand the experience from her perspective. After you have done this for five minutes (it's a rough estimate, but basically until you can restate what she is saying and she says you have it right), you can switch so she is asking you questions about how you are feeling. The goal is not necessarily to change the outcome, but to learn more about yourselves and each other.Then you may have an idea of where you stand in each other's eyes.


Question: I recently went through a divorce. My ex-husband called my sister saying bad things about me. My sister never defended me. Now that I showed the truth, she's shutting me up and saying she doesn't care about the fight. Why didn't she convey that to him from the beginning?

Response: Unfortunately, I can't tell you what your sister was feeling or why she reacted that way.I can say that divorces can be difficult or confusing for everyone involved. While the divorce is most impactful for the couple going through it, the divorce itself also changes extended family dynamics. Also, a lot of people don't act the same way around extended family (or other people) as they do at home behind closed doors, so there are times when divorce is a real shock to everyone who was not directly involved in it.I wonder if you are at a place where you can shift your focus into looking at your relationship with your sister, how she is treating you, how you feel around her now, etc. I do not know how close you were before all of this and how close you feel now, but perhaps if you can assess your overall relationship, you could find a time when you could ask about this (why she didn't convey that to him from the beginning) in a way that is calm, not defensive, and is honestly looking for an answer from your sister, not looking to defend yourself at that moment. If that conversation can happen, it may be quite a difficult one, so it may be good to have something to think of to remind yourself that you are trying to gather information from her and him that conversation, it's not about you, but is about where she was coming from. After you think you understand that (I'm saying that you understand where she's coming from, not that you agree with what she's saying), you could see if she's willing to listen to how you feel about it.