A recent global study found that people with OCD show normal delay discounting. • People with OCD compulsively perform rituals for immediate relief, despite negative long-term consequences. • The research on whether people with OCD have an impairment in delaying gratification has been inconclusive. • A recent global study found that people with OCD do not differ from healthy people in their delay discounting. • Depression and anxiety symptoms were associated with higher delay discounting within the OCD group. People with obsessive-compulsive disorder (OCD) suffer from intrusive, obsessive thoughts. To ease their distress, they often feel compelled to engage in repetitive behaviors, or rituals, in response to these thoughts. For people diagnosed with OCD, performing these elaborate rituals gets in the way of daily functioning. The rituals provide relief in the short term, but they lead to negative consequences in the long term (e.g., lost productivity). Thus, people with OCD are often characterized as being impulsive or lacking in self-control. But how do they perform in a typical impulsivity task? One hallmark measure of impulsivity is delay discounting—the extent to which people prefer smaller, sooner rewards over larger, later rewards. Delay discounting is measured by having people make a series of choices between smaller amounts of money they could receive today (e.g., $10 now) and larger amounts they could receive after a delay (e.g., $20 in seven days). Delay discounting is elevated in people with conditions like substance use disorder and borderline personality disorder, where impulsivity is a key symptom. But most prior research on delay discounting in OCD has been inconclusive, with some studies finding that people with OCD have normal delay discounting and others showing that they have higher-than-average delay discounting. These previous studies had small sample sizes and often recruited people with OCD who were being treated with medication (e.g., selective serotonin reuptake inhibitors), thus making it hard to know whether there is truly no effect of OCD on discounting or if the effect is just small and possibly being masked by medication effects. To address these limitations, I recently collaborated with a global team of OCD researchers from sites in Brazil, India, the Netherlands, South Africa, and the United States to examine whether people with OCD differ from healthy participants in their delay discounting. About 50 people with (unmedicated) OCD and about 50 healthy participants without OCD were recruited from each site, yielding a total sample size of 268 people with OCD and 256 healthy control participants. Great care was taken to harmonize the discounting task across sites. The results were definitive: People with OCD did not differ from healthy participants in their delay discounting. How do we reconcile this null finding with the reality that people with OCD are unable to resist the urge for immediate relief that their rituals provide them? Well, despite how findings from this task have often been interpreted, the delay discounting task might not actually be measuring the ability to resist immediate gratification. Instead, it might be measuring negative expectations about the future. Indeed, within the OCD group in our study, delay discounting was not associated with either impulsive (e.g., drug use) or compulsive (e.g., hand-washing) behaviors. Instead, it was the people with OCD who were more depressed and anxious who were less willing to wait for delayed rewards. People who are depressed and anxious tend to prefer immediate rewards over delayed ones, probably because they have a pessimistic view of future outcomes. Taken together, this recent study has two major implications. First, the tendency to prioritize immediate rewards can be more readily attributed to a negative view of the future than an inability to resist temptation. Second, people with OCD can be compulsive without necessarily being impulsive. They may have difficulty resisting the urge to perform rituals, but that doesn’t mean that they cannot find value in pursuing long-term rewards and planning for the future. (In fact, one study in people with obsessive-compulsive personality disorder found that they were more future-oriented than healthy participants.) The conclusions of this study are strengthened not just by the large, diverse sample, but also by the fact that we controlled for other factors that might influence delay discounting, like age, gender, education, socioeconomic status, and general intelligence. Large-scale collaborative studies like the Global OCD study are speeding up our ability to gain psychological insights, which will help us to better understand decision-making processes and develop more effective treatments for disorders like OCD. Karolina Lempert, Ph.D., - Blog -

Emotional strength is an essential component of our mental well-being. It helps us navigate life’s challenges, adapt to change, and recover from setbacks. While many of us possess some level of resilience, there are ways to enhance it through guided support. This blog post will explore resilience therapy, what it entails, and how it can empower you to build emotional strength. Understanding Resilience Therapy Resilience therapy focuses on enhancing a person's ability to recover from adversity. It offers individuals tools to manage stress, face life's difficulties, and ultimately bounce back stronger. By developing emotional strength, individuals can better cope with challenges and improve their overall mental health. Research shows that resilience is not merely a trait one possesses; it can be cultivated. According to a study published by the American Psychological Association, individuals who engage in therapeutic practices can significantly improve their resilience. For example, therapy sessions often include strategies such as cognitive-behavioral techniques, mindfulness practices, and developing a positive mindset. A serene space designed for personal reflection and therapy. The Role of Guided Support in Building Resilience Guided support is an integral aspect of resilience therapy. This support can come in various forms, including therapy sessions, group support meetings, and coaching. Professional therapists or counselors provide a safe space where individuals can discuss their feelings and experiences. This openness fosters personal growth and development. Consider the case of John, a 35-year-old who faced significant life changes. After losing his job during an economic downturn, he felt lost and overwhelmed. By engaging with a therapist, John started to explore his emotions and thoughts, learning effective coping strategies. With guided support, he gained insights into his situation, which helped him navigate his job search with renewed confidence. Statistically, a survey by the National Institute of Mental Health found that individuals who sought support from professionals showed a 60% improvement in their coping skills after six months of therapy. A welcoming environment conducive to group discussion and support. What is the Resilience Focused Approach? The resilience-focused approach is grounded in the belief that everyone has the capability to overcome difficulties and adapt positively to stress. This methodology emphasizes the strengths individuals possess rather than focusing solely on their problems. In practice, this approach encourages clients to identify personal strengths, set realistic goals, and engage in problem-solving strategies. For instance, during sessions, therapists often guide clients to reflect on past challenges they've overcome. This promotes a greater understanding of their capabilities and enhances their confidence in future hardships. One example of this approach in action is when a person may face a significant life challenge, like a divorce. A therapist might guide them to focus on resilience-building exercises, such as creating a support network, finding new hobbies, and practicing self-care. The outcome is a stronger emotional foundation during an unsettling time. A thoughtful setting for personal reflection and journaling. Practical Steps to Build Emotional Strength Building emotional strength does not happen overnight; it requires intentional effort and practice. Here are some practical steps to consider: 1. Establish a Routine: Consistent routines provide structure, which can be comforting during turbulent times. Incorporate activities that encourage mental well-being, whether it’s exercise, meditation, or journaling. 2. Seek Support: Don’t hesitate to seek professional help. Engaging with therapy or counseling can provide you with the tools needed to build resilience. Therapists can introduce you to methods like resilience focused therapy which provides tailored guidance. 3. Develop Mindfulness: Practicing mindfulness helps you stay grounded in the present. Techniques such as deep breathing, meditation, and yoga can help reduce stress and increase emotional awareness. 4. Set Achievable Goals: Break down larger challenges into smaller, manageable goals. Celebrate your successes, no matter how small, to build confidence. 5. Reflect and Learn: Take time to reflect on past experiences. What have you learned from overcoming challenges? This reflection helps reinforce your ability to handle future difficulties. 6. Engage in Healthy Activities: Activities like physical exercise, connecting with nature, or pursuing a hobby can enhance mood and build emotional strength. By incorporating these steps into your daily life, you can start to foster greater emotional resilience. Fostering Community Connection Another crucial element in building emotional strength is community. Surrounding yourself with a supportive network can significantly impact your resilience. Here are some ways to build a stronger connection with your community: • Participate in Group Therapy: Group settings offer a sense of belonging and shared experiences. Engaging with others who face similar challenges can help reduce feelings of isolation. • Volunteer or Help Others: Helping others can boost your emotional well-being. Volunteering allows you to connect and contribute positively, which can empower you. • Join Local Clubs or Activities: Engaging in community activities or clubs fosters connections and can promote a sense of purpose. Whether it’s a book club or a sports team, working towards common goals with others can enhance emotional health. By fostering these connections, you create a support system that reinforces your emotional strength. Moving Forward with Emotional Strength Building emotional strength through guided support is a powerful journey. Remember, it is okay to ask for help along the way. Engaging in resilience therapy can provide you with the tools and insights necessary to face life's challenges head-on. As you navigate through life, practice self-compassion. Emotional resilience is a process, and it takes time to develop. With the right support and a commitment to growth, you can cultivate the emotional strength needed to thrive, whatever challenges come your way. Understanding that resilience can be actively developed and strengthened is essential. Whether it’s through guided support or community engagement, taking these steps can lead to profound personal growth. Embrace the journey and take charge of your emotional well-being today.

Try these five essential coping skills to navigate your chronic illness and thrive. Living with a chronic medical condition is a circumstance that is very close to my own heart. I have lived with a chronic illness my entire adult life, and I'm not alone. According to the Centers for Disease Control, 129 million Americans currently live with some type of chronic condition, whether it's a physical or mental health condition. That's nearly half the current population of the United States. Therefore, many of us struggle regularly to manage a condition that cannot be cured. For this article, I will focus on chronic physical conditions and how to cope with them while doing your best to sustain your overall health and well-being. One of the most important things to remember when a chronic illness takes up residence in your body is that you are not imagining an illness. Whether you are diagnosed with a condition that medical doctors are confident they know how to manage, or one that seems to elude medical science in terms of our understanding of its nature and course, it is real. The fact that physicians and scientists have yet to fully understand its origin, symptoms, or impact on your life does not mean that you are exaggerating its impact on your everyday functioning. It is also important to remember that people who do not live with a chronic physical condition will not fully understand what has happened to you and what will continue to be your battle. They may mean well and sympathize with your pain to an extent. Some of them will give you a lot of advice, like “just reduce your stress” or “get more rest.” But they won't truly grasp how a chronic condition reshapes your life, impacts your decisions, and affects your relationships. Remember that you don't have to buy into what others tell you about your chronic physical illness. For example, proper diet and exercise won't be the cure for your condition, and just believing that you can isn’t enough to overcome the illness. It is true, however, that you don't have to be defined by your chronic condition. In most cases, you do not have to completely surrender to its consequences. You can still enjoy life. There are many ways to manage the symptoms and setbacks without missing out on your activities and interests. Of course, there are always exceptions, and some people are severely limited in their functioning as the illness progresses. But there are many ways to adapt to life with a chronic illness, and that's the focus of this post. Here are some things to consider as you navigate life with a chronic physical health condition that will help you maintain your mental health and overall well-being. 1. Practice self-compassion. Most of us feel bad about ourselves when our chronic illness delays or changes our plans. We think that if we are just stronger and more resilient, we should be able to push through. However, often the best way to take care of ourselves is not to push ourselves too hard. We can still do many things, but maybe not at the same pace as others or even at the same pace that we used to. The end goal is longevity, but if we push ourselves hard, we end up feeling sicker. Remind yourself that you are still strong even on days that you feel weaker. 2. Determine your daily activities according to your level of pain and symptoms. This may sound basic, but you'd be surprised how many people I talk to who try to do the same activities, regardless of their level of pain. When you wake up in the morning, rate your pain on a scale from one to five. A pain level of two means you may be able to go on about your daily plans. A pain level of four or five means you adjust your activities. For example, if you planned to go for a walk and you woke up feeling tired, achy, or nauseous, you can decide to go for a shorter walk instead, or perhaps skip the walk until later in the day if you feel better. When you live with an illness, you must acknowledge that sometimes plans change, and activities may need to be rescheduled or adjusted. 3. Leave the house prepared. You may wake up feeling pretty good and go on about your day. But later you start feeling exhausted or having other symptoms and you don’t have medicine, water, or a snack. Think about how you may feel at the end of your day before it begins so that you're prepared to have what you need to take care of yourself and give yourself permission to come home early. Be prepared if you have a long day ahead of you to rearrange plans if necessary. Try to resist being set in your mind that the day has to go a certain way. 4. Gather your best social support. The support system that we acquire over time is not always prepared to handle our circumstances. We make friends in high school or college who may continue to be our friends, but they might not be the best person to call if we are having a bad health day. Make sure you have friends in your circle who understand your health condition or at least make an effort to do so. While they may not be able to put themselves in your shoes, they should be able to provide compassion and give you a pass if you have to change plans. 5. Assemble a medical team that understands you. Similar to your friend group, you want to surround yourself with healthcare providers who do not dismiss or minimize your health condition. Not all trained professionals are as adept at treating chronic conditions. Sometimes, even if they are trained, they don't have enough empathy to adequately support you. For example, you want a doctor who listens to your symptoms without interrupting and considers your unique experience, rather than one who dismisses the reality of your condition and gives you generic advice. We don't always get to choose our healthcare providers, but if you do have a say in the matter, select those who will walk beside you on your journey with chronic illness. The chronic illness that you live with is your reality. Don’t let other people minimize that. Be true to what you feel and listen to your own body. Get the resources that you need rather than doing what other people think you need to do. By listening to your own instincts, you’ll be able to better manage life with a chronic illness. Carla Shuman, Ph.D., - Website - Blog -

While you’re figuring out your new life with divorce, your child is adjusting, too. Children may blame themselves for the breakup. It's important to let them know they were not responsible. Don't try to "one-up" your ex. Your child doesn't need lavish gifts to know they're loved. Creating similar rules for each of your households helps develop a consistent environment for your child. When marriages end, it can create a lot of stress for everyone involved. There are often disagreements, resentments, and plenty of hurt feelings to go around. This can be especially difficult for children. When parents get divorced, children have their entire world turned around. All of a sudden, they have to deal with things that before the divorce seemed unthinkable. Children believe their parents are solid and unchangeable. Even when things are not great at home, it still seems like their parents will work it out. After all, their parents had been together for as long as they can remember. When they split, a child’s world is completely thrown into disarray. During this time of heightened tensions and often explosive emotional reactions, it’s important to take a look at what’s best for the child in helping them adjust to their new reality. Your child is not at fault . It’s important that children understand their parents’ divorce is not their fault. This may seem self-evident since they weren’t the ones initiating the problems. Children may be internalizing their hurt about the situation and start to blame themselves. Even though it may be illogical from an adult’s perspective, children often turn their fear and upset inward and start thinking of all the things they did that may have upset their parents. This in turn can cause them to believe they were the reason their parents are ending their marriage. That’s why it’s important for children to understand that the divorce was not about anything they did wrong. Occasionally, parents may lash out and blame the child because of their upset. This is something that never helps the situation and can have lasting consequences on the child’s emotional development. If you notice your child withdrawing or struggling with what is happening within the family, it’s important that this issue is addressed and the child knows they will still be loved and cared for and that they have done nothing wrong. Don’t overburden your child. Divorce is a tough time for all involved. Your 5-year-old, 10-year-old, or 16-year-old doesn’t need to hear all about your hurt, regret, feelings of betrayal, etc. This is between you and your ex. Your child is not your therapist or your best friend. Your child is still going to love their other parent, even if you do not. Many parents are so distraught over their impending divorce that they confide inappropriate details and other adult issues to their child. Your child is likely to not understand the issues involved, and the last thing they need is to be put in the middle of your marriage issues. Also, don’t introduce your child to every new person you date. This can be confusing, and if they develop a bond with the person too soon and your relationship doesn’t last, it can create additional feelings of loss. Remember you both love your child . If possible, having events together can show family unity even after a divorce. Whether it’s joint birthday parties, holidays, etc., these things can show your child that even though you are living separately, there is still a connection between the parents. This is important so the child doesn’t feel he is betraying one of you by staying close to the other. Include the child in decisions whenever possible. Getting divorced is a decision between adults. Your child didn’t get a say and may have been blindsided by this new reality. As you and your ex set up schedules for custody of your child, ask them their preference as well. Don’t try to make them feel guilty if they want to spend time with the other parent. Having a say in their schedule can help a child feel that not everything is beyond their control. Don’t overcompensate for the divorce. While your marriage ended, you still need to be responsible parents. It’s important not to let your guilt or your desire to one-up the other parent guide your decisions. Your child doesn’t need to have lavish gifts given to them or get away with things you know are not in their best interest because you feel badly about how the divorce has affected them. To best care for them, continue being the steady, caring parent you’ve always been. Have similar rules at each home. One of the most difficult things to do is to coordinate a consistent set of household rules with your ex. Even if you and your ex are not getting along, it’s still important that you have similar rules in each household. Having that consistency can help your child feel safer and more secure in each of your homes. Support your ex-spouse when disputes happen. While you and your ex may have significant differences, those differences are not with your child. As much as possible, try to be supportive of each other in your child’s eyes. When the child is angry at your ex-partner, as difficult as it may be, hold the line and support your ex. It’s important the child doesn’t align with either parent against the other. Siding with your child against your ex when difficulties arise can create a triangulation where the child feels they can get what they want by turning one parent against the other. At the same time, if you feel your ex is in the wrong, hopefully the two of you can talk it out. This type of parenting conference is healthy and helps the child know that both you and your ex are on the same page regarding your parenting. While divorce is unfortunate and can be extremely painful for all involved, making sure family boundaries are upheld can be a huge help. It’s important that children can adjust to their new life with parents who live separately. The faster that parents can establish new routines and understandings, the faster all involved can start to heal from the divorce and move forward with the least amount of emotional upheaval possible. David Schwartz, LMFT, - Website - Blog -

How to heal emotionally after a devastating natural disaster. Acknowledge and validate your survivor's guilt; it’s a natural response to devastating events. Taking action by volunteering, donating, or supporting other channels guilt into positive help. Prioritize self-care, practice self-compassion, and reconnect with daily routines for emotional healing. Seek professional help if survivor's guilt becomes overwhelming or affects your daily life and well-being. In the aftermath of a devastating hurricane like Helene or Milton, the wreckage is not only physical—there's emotional damage, too. If you've survived while others around you have lost their homes, their livelihoods, or even their lives, you might experience a wave of conflicting emotions. I did. I survived Helene, grateful a large tree pummeled our garage instead of our bedroom. One of the most powerful and insidious emotions is survivor's guilt. It's a feeling that says, why them and not me? It’s as if, in surviving, you've inherited a burden—a deep, painful responsibility to those who didn’t make it. Survivor’s guilt isn’t unusual, but it is deeply personal and often misunderstood. Even if you haven't been directly hurt, witnessing others’ suffering can bring the complex mix of emotions to the surface. And if you’re reading this, you might be grappling with that very guilt, wondering how to manage it. Here are four ways to begin coping with survivor's guilt after a hurricane or other natural disaster: Acknowledge and Validate Your Feelings One of the first steps in addressing survivor’s guilt is acknowledging it. Your feelings are valid. You may experience emotions ranging from helplessness and sadness to shame and anger , and it's important to give yourself permission to feel them. Often, we suppress our emotions to get through the immediate crisis. Once the storm passes, we might feel as though we’re expected to just move on. However, your emotional response is just as real as any physical injury or loss. Survivor’s guilt thrives in silence. Speaking up—whether to a therapist, loved one, or even in a journal—can help diffuse the intensity of your feelings. You don’t need to keep it all inside. The guilt has its source in empathy. You care about others, and feeling guilty is part of human compassion. Recognize that your survival is not something to be ashamed of. One helpful exercise is to label the emotions as they come. The act of naming the feelings out loud or writing them down can reduce their overwhelming weight. Take Action to Help Others One of the most powerful antidotes to guilt is action. While you can't change the fact that you survived, you can contribute to the healing process of others. Helping your community in the aftermath of a hurricane can provide a sense of purpose, which can begin to ease survivor’s guilt. Personally, I immediately got into action volunteering to raise money for a group of artists who lost their studios, their art supplies, and their livelihoods for the foreseeable future. There are many ways to get involved, from volunteering with local organizations to donating supplies. Sometimes, just being there for others—whether family , friends, or even strangers—can make an enormous impact. Listening and validating the emotions of those who suffered major losses can be just as valuable as any material support. Focus on Healing Yourself, Too Survivor's guilt can lead to neglecting your own needs because you feel others are more deserving of help. But your pain, even if less visible, still matters. Healing yourself isn’t selfish—it’s essential. You can give back to others only when you’ve taken steps to care for yourself. Practice self-compassion and reconnect with small routines. Seek professional support if your guilt becomes overwhelming or affects your daily life. Therapy can offer tools for processing your emotions and finding ways to cope effectively. Reconnect with Routine After a disaster, your normal life is often upended. One way to regain your footing is by reestablishing small routines—whether it’s going for a morning walk, making a cup of tea, or spending quiet time meditating. Routines help ground you and remind you that life, while changed, continues. A Final Thought: Your Survival Is Not a Burden Survivor’s guilt can make it hard to see your survival as a gift, but by helping others and caring for yourself, you can begin to shift from guilt to gratitude. You don’t have to cope alone. Healing is a community effort, and, together, we can weather any storm. Michelle Tennant Nicholson, M.A., - Website - Blog -

Building and maintaining strong relationships is a fundamental aspect of human life. Whether with family, friends, or romantic partners, robust connections can lead to greater happiness and fulfillment. In the pursuit of deeper understanding and connection, many people turn to relationship therapy as a valuable resource. In this post, we will explore effective tools for strengthening relationships and delve into specific relationship therapy techniques that can help you foster a closer bond with your loved ones. Importance of Relationship Therapy Understanding what drives relationships and what makes them thrive is crucial for anyone seeking to improve their connections. Relationship therapy provides a safe space for individuals and couples to discuss their feelings and thoughts openly. Trained therapists can guide conversations, helping partners express themselves in ways that promote understanding and empathy. Statistics show that approximately 70% of couples who undergo therapy report feeling more satisfied in their relationships afterward. This is a testament to the effectiveness of professional guidance in addressing conflicts and miscommunications. Beyond just resolving issues, relationship therapy encourages healthier patterns of communication and interaction. Key Tools in Relationship Therapy There are several tools used in relationship therapy to help couples navigate their challenges. These tools are designed to bring about deeper connections and help partners understand each other better. Below are some essential tools that you may find helpful: 1. Communication Exercises Clear communication is the cornerstone of any healthy relationship. Relationship therapy emphasizes techniques that foster open dialogue. For instance, "I" statements encourage expressing feelings without assigning blame. Instead of saying, "You never listen to me," partners learn to say, "I feel unheard when we don't talk." This shift helps to reduce defensiveness and encourages openness. A setup that encourages open dialogue in therapy sessions. 2. Active Listening Techniques Active listening is about fully concentrating, understanding, responding, and remembering what the other person says. Therapists often guide couples through exercises that enhance their listening skills. One method is summarizing what the other person has said to ensure clarity. This practice confirms that both partners are on the same page and values each other's perspectives. 3. Emotional Check-Ins Relationship therapy encourages regular emotional check-ins, where partners ask each other how they feel weekly or bi-weekly. This practice can prevent feelings of neglect from building up and fosters a culture of understanding and care. Healthy check-in questions include: What made you feel loved this week? Was there a moment when you felt disconnected? 4. Conflict Resolution Strategies Every relationship will encounter disagreements. Relationship therapy helps couples develop strategies for resolving conflicts without causing harm to each other. One effective approach is creating a "time-out" plan during heated discussions, which allows both partners to cool down before addressing the issue at hand. This prevents hurtful words or actions that may escalate conflicts. 5. Shared Activities and Rituals Creating shared experiences strengthens bonds. Therapists often recommend couples engage in activities they both enjoy, whether it's cooking, hiking, or attending a class together. Establishing rituals, such as weekly date nights, can enhance connection and ensure time is dedicated solely to nurturing the relationship. What are the 9 steps of emotionally focused couples therapy? Emotionally Focused Couples Therapy (EFT) is a structured approach for helping couples understand and improve their emotional responses. It consists of nine distinct steps that guide partners through emotional exploration and relationship enhancement. They include: Assessment of Attachment : Understanding how individuals perceive their relationship. Understanding Negative Cycles : Identifying patterns that lead to conflict. Restructuring Interactions : Encouraging new, supportive interactions. Fostering Emotional Engagement : Promoting vulnerability by expressing fears and needs. Creating Shared Meaning : Helping partners create a shared vision for the future. Addressing Identified Issues : Tactfully addressing specific problems. Consolidating Gains : Reinforcing positive changes made during therapy. Planning for the Future : Outlining ways to continue nurturing the relationship. Closure : Ending therapy with the tools to maintain improvements. By following these steps during therapy, couples can break free from negative patterns and find new, positive ways to connect. Couples engaging in an activity to strengthen their bond. Building Emotional Resilience Another vital aspect of successful relationships is emotional resilience. Resilience helps individuals cope with stress and recover from adversity, influencing how partners react in challenging situations. Relationship therapy techniques often focus on developing resilience through practices such as mindfulness and self-compassion. By fostering these qualities, partners can create a foundation of support for one another. When one partner feels overwhelmed, the other can provide the necessary emotional backing, which fortifies the relationship. The Role of Professional Guidance Sometimes, it can be challenging to navigate issues alone. Seeking professional help can provide clarity and strategies that may not be apparent. Therapists can offer personalized techniques based on the couple's unique dynamic. Moreover, many people find that just having an impartial party can significantly alter the tone of discussions. For couples struggling to communicate or resolve conflicts, exploring relationship therapy techniques can introduce helpful frameworks. These techniques enable partners to work towards mutual understanding and healing. The Power of Gratitude and Appreciation Cultivating a culture of gratitude in relationships can significantly enhance emotional well-being. Partners should take time to regularly express appreciation for each other. Simple gestures like verbal affirmations, heartfelt notes, or small surprises can uplift a relationship's emotional climate. Research shows that expressing gratitude can increase satisfaction and connection in relationships. By regularly acknowledging each other's contributions, partners can create a stable environment that fosters love and kinship. Small acts lead to lasting impacts, and gratitude is a straightforward tool for creating positivity. Keeping the Connection Alive Maintaining a strong bond requires ongoing effort and creativity. Partners should take initiative to explore new experiences and grow together. Participating in workshops, traveling, or even trying new hobbies can fortify relationships and keep the excitement alive. The willingness to evolve together can strengthen the foundation of any relationship. Approach every opportunity to explore and share with a sense of curiosity, and it will foster growth and closeness. Final Thoughts In summary, effective tools for strengthening relationships are numerous and varied. Relationship therapy provides a guided approach for couples who wish to deepen their connection. From communication exercises to emotional check-ins, each tool serves its unique purpose in building healthier, more satisfying bonds. Whether you're facing challenges in your relationship or simply want to enrich your connection, remember that growth takes time and effort. Be open, seek help when necessary, and continue to nurture your relationship. With the right tools and techniques at your disposal, you can create lasting love and understanding in your connections.

A new novel explores a sibling's lifelong struggles with a mentally ill sister. When a sibling suffers with mental illness, family members may feel anxious, overwhelmed, and resentful. Some brothers and sisters stay in an unhealthy job or relationship out of loyalty to a mentally ill sibling. Through transference, old childhood feelings toward a sibling often resurface in adult relationships. “No one will love you more or hurt you more than a sister.” These words appear on the opening page of Betsy Lerner’s first novel, and it’s certainly the case in Shred Sisters . The veteran literary agent and editor’s novel tells the gripping story of a family struggling to live with the mental illness of one of two daughters. The book spotlights how mental illness can ruin a sibling relationship , destroy a family , and lead to periods of estrangement. Amy, who narrates the story in a vulnerable, intimate voice, has had to endure her sister Ollie’s erratic conduct since they were children. Each family member denies or enables Ollie’s volatile and unpredictable behavior, which exacts a great toll on Amy as well as her parents’ marriage. Lerner vividly portrays how supporting someone with a mental health condition can lead to feelings of frustration, exhaustion, and guilt. How mental illness can stress the family As the book illustrates, when one sibling suffers with mental illness, family relationships can shatter for the following reasons: Emotional strain: Siblings of a mentally ill brother or sister frequently feel overwhelmed, anxious , and resentful, as the responsibility for managing the situation can be emotionally draining. Lack of understanding: A mentally ill person’s behaviors can be hard to understand. Tension and distance may damage the relationship when a brother or sister misinterprets or feels unable to relate to a sibling's experiences. Unrealistic expectations: It’s difficult to know just how well a sibling can function, especially when capabilities fluctuate. The resulting uncertainty can lead to unrealistic expectations, frustrations, and disappointments. Communication difficulties: Because mental illness can affect communication skills, siblings may find it challenging to have open, honest conversations. The limitations of these sibling conversations may lead to misunderstandings and conflict. Stigma: Some family members, perceiving a stigma, feel embarrassed and uncomfortable discussing their issues. This happens throughout the family system, to both the healthy and the mentally ill family members, and it can create or increase isolation. Feelings of helplessness: Some siblings feel powerless to help a brother or sister suffering with mental illness. This can compound feelings of guilt and frustration. The Sibling Ghosts of Childhood Shred Sisters also accurately depicts what marriage and family therapist Karen Gail Lewis calls the ghosts that are at play in sibling relationships. In her book Sibling Therapy , Lewis outlines four underrecognized ways in which memories and feelings haunt brothers and sisters throughout their lives. Frozen images: The childhood perception or characterization of a sibling can become “frozen” and sustained for years, no matter how much individuals have changed. These frozen images can be applied to adults who re-enact childhood behaviors through sibling transference (see below). Lewis offers the example of a brother who taunted a sister when they were little. These taunts can become internalized; long after the scars dim, the memories and emotions remain, she writes. Crystallized roles: Parents sometimes “label” their children, assigning roles that shape their behavior: the clown, the smart one, the troublemaker, etc. Once assigned a role, children tend to fulfill it. A crystallized role shapes identity, and—unless an individual becomes aware of the role and decides how to alter behavior—it can define adult life. Unhealthy loyalty: This is a subtle behavior pattern in which a sibling holds back out of worried loyalty to a brother or sister. A sibling may feel disloyal if, for example, he or she moves on in life while their sibling remains stuck in an unsatisfying job, challenging circumstances, or an unhappy emotional state. In this situation, some siblings feel as if they are abandoning a brother or sister. Sibling transference: Transference describes the phenomenon in which an individual redirects emotions, often unconsciously, from one person to another. Old childhood feelings toward a sibling often resurface in adulthood, in both personal and work relationships. The person may respond to people in their present-day life as they did to siblings when they were children. The transference may be positive or negative; either way, it works against clarity in relationships with friends, lovers, and colleagues. In Shred Sisters , Amy is especially driven by these "ghosts" that Lewis has identified. The sisters are stuck in frozen images and crystallized roles. Amy early on describes herself as small, skinny, and clumsy, while “good things come in tall, willowy packages like Ollie’s.” Amy is convinced that Ollie always gets special treatment; snooping in files, she discovers that their parents, who have high expectations of her, let Ollie get away with abysmal grades. Amy’s unhealthy loyalty to her sister may help explain why she forfeits a thriving career in science. After finishing her undergraduate degree in three years, she dedicates herself to studying and caring for lab animals. Having distinguished herself by logging more hours in the lab than other researchers and receiving recognition on several research papers published in scientific journals, Amy suddenly and surprisingly quits when some of her grant proposals are rejected. The book explores the idea of sibling transference in terms of Amy’s choice of men. When Amy gets involved with a man who is just as erratic as her sister, her therapist suggests that “what happened with Josh had to do with Ollie.” Lerner writes from Amy’s perspective: “I refused to believe that she [Ollie] permeated all my relationships. …” Lewis would argue that, yes, Ollie has permeated all of Amy's relationships, as siblings are our "first marriage” partners. “Siblings provide the first experiences of living intimately with peers, people of the same hierarchical level and the same generation,” Lewis explains. People are often surprised to recognize that how they feel in their marriage, friendships, or even in a relationship with a coworker bears a resemblance to “how they felt in some problematic situations with siblings in their ‘first marriage.’” For those who would like to learn more, Shred Sisters thoroughly explores in a dramatic, most engaging way the impact and long reach of Amy’s “first marriage” to a mentally ill sister. Fern Schumer Chapman - Website - Blog - References Lews, Dr. Karen Gail (2023) Sibling Therapy, The Ghosts from Childhood that Haunt Your Clients' Love and Work, Oxford University Press, New York, NY Lerner, Betsy (2024) Shred Sisters, Grove Press, New York, NY

Teaching teens to recognize toxic traits and build safe relationships. For safety in relationships, we can teach teens to recognize red flags and trust their gut. It's important to understand traits of ASPD and NPD to help spot unhealthy behaviors early in relationships. How individuals name and present themselves, and how they treat others, reveals character and values. In light of the recent assault and abuse allegations against rap mogul Sean Combs, we have an opportunity to reflect and teach our teens valuable lessons about trust, safety, and relationships. This troubling situation highlights crucial issues, especially for young people navigating the complexities of dating and meeting new people online or in person. It’s essential for parents to start conversations early about recognizing red flags and building healthy connections. Trust the Gut Trust is foundational in any relationship, starting from the very first swipe on a dating app or a chance meeting at school or a party. Without knowing someone well, we make judgments about whether they are trustworthy based on appearance and gestures. It’s important to teach our teens that trust is not only a feeling but something that should be earned over time. Often, feelings of mistrust are felt in the gut before the mind catches up. These instinctive perceptions help us stay safe and grounded. Teens need to learn to listen to that inner voice, even when it is clouded by attention, praise, interest, or gifts. Many people now say that something felt off about Diddy well before these allegations surfaced, illustrating how gut feelings can serve as early warnings. Two Dangerous Personality Disorders to Watch For Before forming friendships or dating someone, teens can learn to recognize unhealthy traits that may indicate serious mental health issues. Personality disorders are characterized by long-standing patterns of thinking, feeling, and behaving that often emerge in late adolescence or early adulthood. These patterns are rigid, making it difficult for the person to adapt to different situations or maintain healthy relationships. Understanding these traits can help teens make safer decisions. If someone shows multiple warning signs, it's crucial to say "no" to any invites, offers, or attention bids. Teaching teens to recognize these red flags and practice firm boundaries can protect them from future harm. 1. Antisocial Personality Disorder (ASPD) Often called "sociopathy," ASPD is defined by a pervasive pattern of disregard for others' rights, along with deceitfulness, impulsivity , aggression, irresponsibility, and a lack of remorse. People with ASPD are often manipulative or exploitative or violate the rights of others without feeling guilt or empathy. 2. Narcissistic Personality Disorder (NPD) NPD is characterized by a lack of empathy and a need for admiration. Some key traits include: Grandiosity: Believing oneself to be superior or special. Need for Admiration: Craving constant praise and validation. Lack of Empathy: Having little regard for others’ feelings or needs. Sense of Entitlement: Expecting special treatment or privileges. Arrogance: Displaying boastful or condescending attitudes. Exploitative Behavior: Using others for personal gain without concern for their well-being. Preoccupation With Success or Power: Obsessing over fantasies of wealth, power, and beauty. Envy: Feeling jealous of others or believing others are envious of them. Superficial Charm: Being charismatic or charming but only to manipulate others. While only trained professionals can diagnose these personality disorders, understanding these traits can empower teens to protect themselves from unhealthy relationships. Five Red Flags to Watch For Recognizing warning signs early on can help teens avoid unhealthy or potentially dangerous relationships. Here are five clues to consider before trusting anyone who wants to get close. 1. Eyes If someone frequently wears sunglasses indoors or in their profile pictures, take caution. Unless there's a medical reason, concealing the eyes may indicate they don't want you to see their true intentions. Trust is built on open connection, and avoiding eye contact can signal secrecy or dishonesty. 2. Name and Self-Perception Pay attention to how someone refers to themselves. Do they use grandiose nicknames or talk about themselves in the third person? Titles that emphasize importance or power can indicate an inflated ego. Personalized apparel, tattoos, or online personas like gaming and social media usernames reveal a lot about values and character (e.g., names like "Bad Boy" suggest certain self-perceptions). 3. Gait and Presence Notice how they move in social situations. Do they walk ahead of everyone, expecting attention, and treating others as an entourage? A domineering presence often signifies a need for control and a lack of respect for others' space and time. For example, if a boyfriend walks impatiently ahead of his partner, it can indicate a lack of empathy or regard for her and others. 4. Coping Skills How does this person handle stress? Coping mechanisms reveal emotional maturity. Drinking heavily, using drugs, engaging in pornography, or endlessly scrolling through social media are warning signs. Actions often speak louder than words—if someone claims to value family but mainly posts about material possessions or partying, take note. Asking potential dates about their views on counseling, self-improvement, and mindfulness practices is a great way to gauge their self-awareness. If they are unwilling to seek therapy, show vulnerability, or accept support, it can indicate poor emotional regulation. 5. Treatment of Others Observe how they treat those who aren’t in their immediate circle—such as waitstaff, store clerks, or parking attendants. Do they show kindness, respect, and patience? Or do they act entitled, condescending, or dismissive? Someone who mistreats or ridicules strangers often reveals a lack of empathy and respect, behaviors that can quickly extend to those closer to them. Simple acts like holding doors, smiling genuinely, and waiting their turn show humility and respect. Trust Is Earned Over Time Trust should be seen as something that grows over time rather than something given freely at the start of a relationship. By understanding these red flags and teaching teens to recognize early signs of unhealthy behavior, we can empower them to build relationships that are safe, supportive, and based on mutual respect. By fostering open discussions about trust, respect, and emotional safety, we prepare our teens to navigate the world of dating and relationships with confidence and care. Cheralyn Leeby, Ph.D., LMFT, - Website - Blog -

... and how everybody suffers as a result. Some families find themselves forced to orient their home-life around one person's anger issues. Everybody in these families will develop coping mechanisms, but the source of the pain may never get addressed. Growing up in a home with an angry parent can create long-term issues including conflict aversion, an inability to process emotions, and stress. Dad has a temper. Everybody in the family knows that to keep a calm house; nobody can upset Dad. Mom frequently reminds the kids not to upset their father and hides potential sources of stress from him like a bad report card, a car dent, or a financial setback. The kids know how to read his moods from little details—like the pitch of his voice or how loudly the front door closes. When they sense their father’s stress increasing, the kids walk on eggshells, taking up as little space as possible. And when Dad inevitably explodes, the kids all quickly turn to their coping mechanisms. One child shuts down, becoming totally silent. Another slips out of the room and hides in their bedroom to read a book until things blow over. The third makes jokes to try to diffuse the tension. Mom, too, uses her coping mechanisms: placating, begging, smoothing things over, and when that does not work, escalating. After the explosion, Dad leaves to spend time alone, and Mom checks on the kids. She explains to them that Dad is going through a hard time at work and not to be too hard on him. The kids tell her it’s OK and they understand. Later, when his mood has shifted, Dad re-emerges as his happy self, and the whole house sighs in relief. But it always happens again. This is the profile of a family that orbits around the dad’s anger (to be clear, this scenario can happen with mothers too). And to them, it feels normal. What's Happening Here In this family , Dad’s anger rules the home. It is unpredictable, scary, and ever-present. To cope, the whole family strives to create a peaceful environment to limit the likelihood and ferocity of the next outburst. Notice that in this family, everybody is held responsible for Dad’s emotions and actions—except Dad. Children are expected to keep themselves in check while Dad gets as angry as he wants. Mom simultaneously tries to protect her children from his mood s by teaching them ways to avoid angering him, all the while reinforcing the idea that his anger is their responsibility. Everybody in the family has developed coping skills. They shut down, stay small, or act out to try to manage the situation. And so the big picture never gets addressed. None of this is easy. In some families, the most volatile family member is also the primary breadwinner, leaving the rest of the family beholden to their moods as part of the deal for financial security. And the family may fear for their physical safety if that anger continues to escalate. As a result, nobody ever asks: Why is Dad allowed to continue acting like this? What would accountability look like here? Why isn’t Dad tasked with learning to find healthy coping mechanisms? What would it be like if Dad learned to channel his anger into other healthier outlets? What would it look like if the parents made a point of telling their children that they are not responsible for an adult’s feelings? What if Mom started setting boundaries with Dad (assuming she felt safe)? The family can work harder and harder to control their own parts of the puzzle at great personal and collective cost. But only with Dad’s changed behavior and accountability will anything shift in the bigger picture. What is the Long-Term Impact of Growing Up Like This? I’ve heard versions of this household described dozens of times in my therapy sessions with now-adult children. What happens to adults who grew up in a house ruled by one person’s unchecked anger? Some of my clients describe how they never learned to show their unhappiness because crying or overwhelm upset their volatile parent. They certainly never learned what healthy anger looks like or how to manage it. To them, anger itself is the enemy. This can lead to extreme conflict aversion, which impacts their ability to have healthy adult relationships that invariably include some conflict. These clients describe becoming hyper-attuned to others’ emotions while learning to ignore their own experiences, creating a world in which they bend over backward to meet other people’s needs while treating their basic needs are “too much.” They struggle to set boundaries because they learned young that it was their job to accommodate others without ever taking themselves into account. And some enter platonic and romantic relationships in which they feel similarly shut down or abused, because those traits, displayed through anger, do not register as red flags. In fact, they feel a little like home. And many of these adult children will downplay the impact. "It wasn't that bad," they explain. "My dad never hit me. He just got really upset." But as we see, a home like this can leave lasting scars. In the short term, the home becomes a place of chronic stress. In the long term, the anger’s implications echo down the generations, creating lasting issues for all those who endured it. Sarah Epstein, LMFT, - Website - Blog -

Choosing the right therapist can be a pivotal step in your journey toward emotional wellness and personal growth. With so many options available, it can feel overwhelming to know where to start. In this article, we’ll discuss how to find a therapist who meets your specific needs, what qualifications to look for, and various approaches to therapy. A warm and inviting therapy room designed for comfort. Understanding Your Therapy Needs Before you even begin your search, reflect on what you want to achieve by entering therapy. Are you dealing with anxiety, depression, relationship issues, or a major life transition? Understanding your needs will help you find a therapist who specializes in that area. Different therapists focus on different aspects of mental health. Some may specialize in children and adolescents, while others focus on couples or individuals dealing with trauma. Knowing your area of need can significantly narrow down your options. Types of Therapy Approaches Therapists use various methods to help their clients. Here are a few common approaches: Cognitive Behavioral Therapy (CBT) : This method focuses on changing negative thought patterns and behaviors. It’s effective for conditions like anxiety and depression. Dialectical Behavior Therapy (DBT) : This approach combines cognitive-behavioral techniques with mindfulness. It’s often recommended for individuals struggling with emotional dysregulation and self-harm. Humanistic Therapy : This type emphasizes personal growth and self-actualization. Therapists work with clients to help them understand their emotions and experiences. Psychoanalytic Therapy : Grounded in the theories of Freud, this approach delves into the unconscious mind and past experiences to understand current issues. Play Therapy : This type of therapy focuses on immersion in fully functional play rooms to help younger patients utilize play as a medium to express their thoughts, feelings, and experiences. Trained therapists guide the patient through play activities in a confidential, safe environment . Understanding these approaches can help you determine which one resonates with you. A collection of therapy and psychology books for reference. What is a Licenced Therapist? Therapists must have a minimum number of clinical hours of post-graduate education and supervised experience before they are able to apply for a un-restricted state license and practice independently. This rule helps ensure that therapists have adequate training and experience to provide effective help. However, not every therapist will adhere strictly to this rule. It's important to consider individual qualifications. Look for credentials like licensure (LCSW, LPC, LMFT, etc.) and ask about their professional training and experience in your area of concern. How to Evaluate Credentials When searching for a therapist, evaluate their credentials. Here are the primary credentials to consider: License : Ensure the therapist is licensed to practice in your state. Licenses vary by state, so make sure to verify appropriately. Education : Look for therapists who hold advanced degrees in family therapy, psychology, counseling, or a related field. Specializations : Some therapists undergo extra training and certification in specific areas (e.g., trauma, childhood issues, substance abuse, EMDR, etc.). You can often find this information on the therapist’s website or public profiles. Consider Practical Factors Selecting a therapist also hinges on practical considerations. Keep the following in mind: Location : Decide if you want to see someone in-person or if online therapy will work better for you. Searching for therapy near me may yield local options that can meet your needs. Insurance : Check if your insurance covers therapy. Many insurance companies cover mental health. But not many providers are in-network. At The Resilience Center, we take over +35 insurance companies and are in-network. We believe in providing high-quality, exceptional therapy by partnering with your insurance company to make sure you have access to affordable care. Availability : Different therapists have different schedules. Ensure your therapist's availability aligns with your own. Talk with one of our specialists to find the best time that fits your schedule. The Importance of the Initial Consultation Before committing to a therapist, consider scheduling an initial consultation. This session allows both you and the therapist to determine if you are a good fit. Here are some questions to ask: What is your therapeutic approach? What experience do you have with my specific issues? How do you track progress in therapy? Feel comfortable discussing your concerns and what you're hoping to achieve. A good therapist will understand and help navigate these initial questions. Trust Your Instincts After the initial consultation, trust your instincts about whether you feel comfortable and connected to the therapist. A strong therapeutic alliance is critical for successful outcomes in therapy. If you don't feel that initial connection or if something feels off, it's okay to seek someone else. Recognizing Red Flags While searching for a therapist, be aware of potential red flags: Lack of Professionalism : This includes being consistently late, not having clear boundaries, or not being prepared for your sessions. Pushing Personal Beliefs : A therapist should support you without imposing personal opinions or beliefs onto you. Avoiding Your Concerns : If your therapist doesn't address your concerns or seems uninterested, it may be time to consider a change. Making the Decision to Start Therapy Once you've narrowed down your options and chosen a therapist, it’s time to take that brave step of starting therapy. Remember, therapy is a process that may require time and patience. Results may not be immediate, but commitment to the process often yields significant rewards. A serene and calming outdoor space designed for contemplation. What to Expect in Your Early Sessions In your initial sessions, you may discuss your concerns, history, and goals. The therapist may also explain their approach, how sessions will be structured, and what to expect moving forward. Being open and honest during these sessions can help you gain the most out of your therapy. The Role of Feedback in Therapy As the therapeutic process unfolds, don't hesitate to provide feedback. Therapists value input regarding what is working for you and what isn't. Open communication helps in adjusting the therapeutic approach, making it more effective for your unique situation. Embracing the Therapeutic Journey Entering therapy is an act of courage and self-care. Finding the right therapist can pave the way for meaningful change in your life. From understanding your needs to recognizing red flags and giving feedback, you have the power to shape your own therapeutic journey. With the right support, you can navigate life's challenges and foster personal growth. By taking the time to find a suitable therapist and being committed to the process, you are taking a significant step toward a healthier and happier you.

Understanding and navigating various levels of care. The process of finding the right mental health treatment can be overwhelming. There are several common mental health levels of care that are recognized by insurances. Self-help groups offer free support that can be easy to access virtually and in person. There is an endless and overwhelming amount of information on the internet about mental health treatment options. Many people have no idea where to begin or what type of care they or their loved ones may need. There is common terminology important for those seeking treatment and their loved ones to understand when reaching out for help. In order to figure out what type of care may be the best fit, it is helpful to obtain a mental health or a biopsychosocial assessment by a therapist. However, if an individual is having immediate safety issues, from suicidality, homochirality, or self-injury, they receive immediate attention by calling 911, 211, or going to a local emergency room. The following levels of care are listed in order of the lowest to the highest: Outpatient Services This is the lowest level of care and often the most desirable for those who want to seek out discreet support. Outpatient care may involve receiving treatment from a therapist, psychiatrist, psychiatric nurse practitioner, or others who may be part of a clinic. They may or may not be in-network with insurance providers. Some outpatient clinics may also provide weekly group therapy, which can lead to a comprehensive treatment plan. Ideally, an outpatient provider is able to conduct a LOCUS mental health level of care determination and biopsychosocial assessment to determine the best treatment plan for a client. Contacting your health insurance company for a list of mental health providers can be an option. Additionally, Psychology Today has a comprehensive outpatient therapist directory. Mental Health Self-Help Groups These groups are free and open to the public. Most offer virtual options and can provide a social support community for individuals and even family members with mental health conditions. Anxiety and Depression Association of America (ADAA) Depression and Bipolar Support Alliance (DBSA) NAMI Groups International Obsessive-Compulsive Disorder Foundation Post-Partum Support International Schizophrenia & Psychosis Action Alliance SHE RECOVERS (all recovery, trained facilitators) Intensive Outpatient Program (IOP) IOPs are usually held three hours per day, three days per week. Some IOP programs are in the evening, allowing for those being treated to maintain part-time or full-time work. These programs typically involve group therapy , along with individual therapy , case management, and medication management. These programs can last for various lengths of time (most often, about six to eight weeks), as individuals are able to engage in work, volunteering, or academics simultaneously. They are both insurance-based and private-pay. Partial Hospitalization Program (Day Treatment) These programs are often based in clinics or hospitals and allow an individual to attend treatment throughout the day while living at home. Clients generally need to take time off from work or are not currently working in order to attend, as they run five hours per day, five days a week. These programs involve group therapy, along with individual therapy, case management, and medication management (if needed). Individuals attend partial programs for generally about six to eight weeks, depending on the program, their insurance, and their ability to self-pay. The intention is to then step individuals down to an outpatient treatment plan upon discharge from the program. If an individual is continuing to struggle with mental health stability and acute safety issues in a partial program, then this may indicate that they need a higher level of care, such as residential or inpatient treatment. Residential Treatment All residential treatment programs require that clients live at the program during treatment, but it is not a locked facility. There are many types of programs and locations to choose from in terms of this type of care. These programs include group therapy much of the day, individual therapy sessions, and medication management (if needed). Some programs offer alternative forms of treatment, such as equine therapy, wilderness excursions, acupuncture, yoga, expressive therapy, and many others. Some programs do take insurance, but some are private. The length of stay for clients is typically 30 days minimum, and it is crucial that comprehensive aftercare planning is established for support in acclimating back to the patient's home environment. Inpatient Treatment This is the highest level of care. Individuals are placed in a locked unit, usually in a hospital setting. This is a temporary stabilization program that is intended to support a client in acute medication and treatment interventions and then refer them to appropriate lower levels of care. Clients are held in these types of programs until they are physically and psychologically stabilized. The length of stay is based on the medical necessity and insurance coverage. The most important step is to reach out for help from mental health or medical professionals in order to receive support in navigating this process. Sarah Allen Benton, M.S., LMHC., LPC, - Website - Blog - References Level of Care Utilization System (LOCUS), DC Department of Mental Health

Changing "dispositional" to "situational" explanations speeds your recovery. Dispositional explanations attribute depression to internal traits, situational ones to external events. Believing depression is inherent hinders recovery; situational focus helps you find solutions. Recognizing situational triggers allows you to change your mood and emotional responses. To shift explanations: notice mood drops, stop dispositional thoughts, recall triggering events. A "dispositional explanation" attributes your depressed moods and maladaptive behaviors to internal factors, like personality traits or personal characteristics. A "situational explanation" attributes those dark moods and dysfunctional behaviors to external factors, like the environment, social context, or specific circumstances surrounding the situation. A dispositional explanation for depressive feelings focuses on "who someone is" while a situational explanation focuses on "what the situation is." Learning to switch from dispositional to situational explanations for negative feelings makes it easier to change and is a useful tool in regulating your emotions . Everyone experiences ups and downs — days they feel competent and contented with moments of happiness, and days they’re down or even depressed. How you explain your moods can make a big difference in how easy it is to recover from those times your heart drops and darkness settles over you. Furthermore, while — as a child — you may have learned how to explain your feelings from your mother and how she explained her darker moods, you can change those habitual explanations for feelings of depression by learning a new skill. Learning to walk back in time, until you identify the moment your “heart sank,” is the door to relief from a depressed mood. Every week at least one client shows up looking more miserable than usual. I usually ask: “What happened?” Last week, a 46-year-old woman, a team leader at a small tech company who is often excited about her team’s latest project, appeared sleep-deprived, red-eyed, and darkly depressed. “What happened?” I ask. “Nothing happened; I just got depressed again.” I ask again: “Come on, when did your mood drop?” Her response: “You know, I’m usually depressed, so what’s new.” She’s making a “dispositional explanation” for her mood. That means she believes she gets depressed because of her personality, her “disposition,” or how she’s wired. I challenge her explanation. “That’s not always how you are. Last week you were feeling proud of the work you and your team are doing, and things were going well at home. You seemed even cheerful.” She’d heard me challenge this kind of explanation for her moods before. Sighing, she said quietly: “I know what you’re thinking; don’t get impatient with me.” I understand. It takes time to change your habitual way of explaining things that happen to you, especially those things with depression-tinged feelings attached. This client is not always depressed. Her mood drops when a higher-level manager complains to her: “Your team seems to be moving too slowly.” Or when someone she admires suggests she made a stupid mistake by interviewing and hiring a new team assistant who turned out to be chronically sloppy. Or when her 17-year-old son decided to have a “deep talk” with her; he’d decided to tell her “in all honestly” about all the mistakes he thought she’d made as a mother —going back to middle school. In other words, she gets depressed when something upsetting happens, especially when she feels put down. Her drop in mood is “situational” —it’s her response to a specific situation. There’s nothing mysterious about it. While there’s almost always a situational explanation for her darker moods, she forgets that when she feels down. She’s not always depressed. She’s not even prone to depression. But when a situation really bothers or humiliates her, she forgets she felt quite contented the day or the week before. She forgets her mood dropped when something specific happened. The reason these matters If you find yourself down and you believe it’s just how you’re wired, you also tend to believe it’s permanent. Therefore, you’re unlikely to search for a solution. You may think there’s no hope of changing and you’ll always feel the same dismal feelings. But when you learn to look for the situational explanations for your drop in mood, you’ll start figuring out how to change the situation. You don’t have to sit around depressed for long; once you locate the moment your heart sank, you’ve found the explanation. Finding situational explanations for your feelings opens you up to the idea of change. Moving from dispositional to situational explanations It's not so hard to learn how to change your thinking about the way you feel. Step One: Learn to identify a drop in your mood quickly. When you find yourself depressed or moody, notice it. Become aware of it. Quickly. Identify it when you’re thinking: “That’s the way I am.” or “I have a depressive personality.” Step Two: As soon as you realize your mood dropped and you’ve begun that habitual explanation for feelings of depression — “This is just the way I am; I’ll always be on the edge of depression” — stop yourself. The way to do this is with a mini-meditation. As soon as you feel your heart drop, pay attention and, for a moment, stop what you’re doing. Start paying attention to your breathing. Notice your breath going in and out. Begin to count (to yourself) each breath as you exhale. Do this very briefly — like for two or three minutes. Step Three: Then recollect the details of when your mood dropped. At first, you might return to insisting this is just how you are. But try again. Seriously, when did you get so down? Go an hour at a time, a day at a time, and soon you’ll remember. Perhaps you ran into an old friend yesterday, and you felt a moment of joy when you saw her. And then you saw her face, and realized that she didn’t seem so happy to see you. That was the moment. You walked away, embarrassment and disappointment rushing over you. Perhaps you wondered, “Did I do something to her, something I can’t remember?” Ready to blame yourself, after walking away your emotions dysregulated. The scene was humiliating. It may seem easier to forget it than to dwell on the miserable memory. So as it slips away from your memory, you’re left with a terrible mood and the thought “this is how I am, I’m a depressive, I always end up this way.” But then you remember: “Think about your explanation.” You didn’t feel bad the day before. Remember the situation. It’s better to remember a humiliating situation than to turn the explanation inward and attribute your depressed mood to your personality, your disposition. Step Four: You can learn to stop yourself when you’re whispering those dispositional explanations. Challenge your habitual explanations and ask yourself: “When did my mood change?” It doesn’t take that long to learn to stop, quiet your jumbled thoughts with a mini-meditation, and ask yourself about the situation. Learning to identify the situational explanation for those times you find yourself depressed changes how you respond to those darker moods. Instead of crawling away, adding insult to injury, you’ll be able to learn to protect yourself from the impact of painful or humiliating situations. You’ll be open to taking actions to counter your mood and create a new situation. Lynn E. O’Connor, Ph.D., - Website - Blog -