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What is empathy, and how do I help my child manage it? KEY POINTS Children who are empaths often have big feelings that they don't know how to manage. Parents need to be alert for certain signs that their child is high in empathy and struggling with it. Parents can make life easier for their child by planning ahead a little and not overscheduling. I don’t know about you, but in my house, my children and I have big feelings. As an empath who has three empathic children, our interactions and emotional experiences are a bit more intense than most. Dr. Judy Orloff defines an empathic person as one who is deeply in tune with the feelings of others in their environment. She further describes an empath as an “emotional sponge who absorbs both the positivity and the stress of people and the world.” Empaths process the emotional tone and energy of those around them, whether they want to or not. This also means that the “energy battery” drains quickly, which can lead to overstimulation by one’s thoughts and environment. For example, a child or person who is at school or work may find that within an hour or a few hours, people’s voices and lights may feel like “too much.” For our children who are empathic, their nervous systems are also wired a bit differently. Jean Decet and Yoshiya Moriguchi found that the limbic system, the part of the brain responsible for processing emotion, has more complex neuronal connections in the brains of people who are highly empathic (BioPsychoSocial Medicine, 2007). Jen Granneman and Andre Solo stated that the empathic brain connects emotion with action. Thus, if another person is observed to be in distress, the empathic person will feel compelled to help rather than observing alone. According to “15 Signs You May Be An Empath”, the following is a list of traits that are associated with a child, teen, or young adult who is empathic: Becoming easily overwhelmed Having a strong intuition Finding comfort and peace in being outside or in nature Dislike of crowds Having a strong sense of caring for other Being a good problem solver Needing to rest after being around people Dislike of conflict Difficulty with fitting in Judy Orloff noted in her book, The Empath’s Survival Guide, that “empath children feel too much but don’t know how to manage the sensory overload. They see more, hear more, smell more, intuit more, and experience emotions more.” Parent Strategies for an empathic child As parents, what can we do to honor and help our empathic children to manage their abilities and their interactions with others and their environment? Give the Feeling a Name. One of the hardest things I’ve had to witness as a parent is when my child was dysregulated and overwhelmed but didn’t know why. A strategy that has been helpful for all three of my kids and for the many other children, teens, young adults, and adults with whom we work is giving the sensation or feeling a name. Name it. Call it anger. Call it overwhelm. Call it fatigue. Call it what it is. As parents and as educators, it’s important that we recognize the behavioral signs of a child who is overwhelmed, and rather than treating it as a “behavioral” response that requires a consequence or a behavior plan, ask the question and then give the space and validation for the child to feel what they feel until that feeling passes. If it won’t pass on its own and a sensory break is needed, provide it. Create a plan in advance and set aside space within the classroom or school building to sit in silence with the lights turned off, run around the gymnasium, or take a walk. An Occupational Therapist, private or within the school, can help with finding the appropriate strategies for different physiological sensations at different times of the day. The other thing to emphasize and help your child recognize is that feelings come in like big waves: They crash, and then they subside. That is, there is the build-up, the crash, and then the release and calm down. As a parent or professional, you will notice that the recovery time will decrease, and the child will be able to bounce back with greater ease. Again, I say child, but this applies to children, teens, young adults, and adults. A parent can do the same at home. When my now-14-year-old daughter was in elementary school, she was very overwhelmed by the end of the day. I created a tent for her with sensory calming activities inside, such as coloring, water beads, fidgets, a pillow, and a blanket. She sat in this space, which was created just for her, whenever she felt overwhelmed or whenever I saw that she was feeling overwhelmed. It helped a great deal. It made her more available after her body and mind had calmed, to process what she was feeling and to think of other strategies that could help before she got to this heightened place. Further, help your child to understand that sometimes they will feel other people’s energy and feelings and not know they are not their own. For example, your child can feel when another person is angry or can feel the tension between two people in a room. These feelings are absorbed into their body, and they may not know why they feel “off,” and they may not know how they got here. Ask your child the questions: “Is this your feeling or someone else’s?” “Were there people in the room with you who were feeling angry, sad, or mad with themselves or with another person?” “If it’s not yours, how can you let it go?” Avoid Overscheduling Your Child. Empathic children struggle to transition from one activity or event to the next. This doesn’t give them time to decompress and get ready for the next thing. My policy has been, and continues to be, one activity per child per season. If you have therapies scheduled as well, be mindful of not scheduling an appointment right after school or scheduling too many nights in a row. Avoid Rushing Your Child. If your children are anything like mine, they can not be rushed. With that said, have a schedule or calendar that your child maintains and that you can update each week with therapies, activities, birthday parties, and family events. This allows your child to anticipate and be aware of what’s coming up instead of “springing” it on them the day before or the day of. Our highly empathic children need time to wrap their minds around what’s happening next and go through their mental list of what they want to do before it’s time to go. Give notice of the time that you will need to leave your home and what time to start getting ready. Set alarms to guide the process so you’re not realizing the time, panicking and rushing to get out of the door. This will also create overwhelm and dysregulation for your child. Raising an empathic child requires a great deal of awareness and creating a strategy around helping your child to give a name to their experience and to recognize the ability that they have. Liz Nissim-Matheis, Ph.D. - website

Myth or mental health disorder? KEY POINTS "Sex addiction" is not a medical term. It's most often termed compulsive sexual behavior or hypersexuality. Sexual compulsivity is technically not an addiction, but it's an emerging psychiatric disorder. Sexual compulsivity is a trying condition, but with treatment and dedication to healing, can be overcome. Michael had an enviable career with a high-paying job, and he was happily married with children, not to mention he enjoyed a satisfying sex life with his attractive wife. However, this facade masked a double life, in which he surfed for hardcore pornography at every available opportunity and visited adult entertainment stores with arcades while he was also a paying member of multiple dating sites intended for hookups. Some mistake compulsive sexual behavior as "sex addiction." It's often mentioned in the media with glee, a sensational and salacious habit attributed to sports stars like Tiger Woods and Hollywood celebrities. While the term "sex addiction" is widely used in the media and popular culture, it isn't considered an actual addiction, disorder, or diagnosis. Sex addiction isn't a medical term. It's more of a media buzzword not included in the DSM-5. In psychology, it's most often termed compulsive sexual behavior, sexual compulsivity, or hypersexuality. Compulsive sexual behavior is technically not considered an addiction, although it's an emerging psychiatric disorder. Many people advocate for it to be considered as another form of unhealthy consumption, alongside addictions to alcohol, drugs, gaming, or gambling. The cravings for sexual activity are similar to cravings felt for alcohol or drugs by those with substance addictions. Sexual compulsivity can take many forms. It's not always about having indiscriminate and frequent sexual intercourse. It can also include a dependency on pornography or an obsession with, and an inability to control, various other sexual fantasies, urges, and behaviors. It's an out-of-control feeling of never being satisfied or a constant battle to control behavior that's on autopilot. People with sexual compulsivity return to their behaviors, time and time again, despite the negative consequences. There are many signs that someone you love may have a sexual compulsion. The individual engages in phone sex, cybersex, use of sex workers, pornography, or exhibitionism. The person might have multiple sex partners or cheat on their partners. They may habitually masturbate. On the other hand, they may develop a tolerance to pornography, meaning they will require more extreme and explicit imagery to become sexually aroused. Sexual compulsivity is more common in men than women. In some cases, men may develop porn-induced erectile dysfunction (PIED), impotence caused by excessive porn consumption. The person usually has trouble making and keeping healthy and stable relationships. They may also show a downward work performance and career loss from an inability to focus on work or watching pornography at work. Sometimes the person doesn't even recognize these signs as they disassociate themselves from their behaviors or rationalize them. Hiding, lying, and gaslighting are also characteristics of this compulsion as a result of the shame, guilt, and fear associated with the behaviors. When caught, the person may even be defensive of their actions, arguing that indulging in pornography, even to an excessive degree, is "just what men do" and that "boys will be boys." Others feel remorse and regret for their behaviors but also a deep sense of hopelessness and powerlessness. Their temporary pleasure and unhealthy relationships precede forming healthy, intimate relationships. Sexual compulsivity has an enormous negative impact on those coping with it and those around them. It can cause great damage to relationships and result in the neglect and abuse of a spouse or partner, children, and other family members. It can cause negative consequences for a person's job, career, and finances. It can lead to substance abuse or jail time for sexual offenses. It affects a person's emotional and physical health, possibly leading to STIs. There is growing evidence that compulsive sexual behavior, over time, might cause changes in the brain's pathways, especially in areas related to reinforcement, creating new nerve pathways of addictive behavior. Over time, more intense sexual content and stimulation are needed for satisfaction or relief. There are many potential causes of compulsive sexual behavior. It may be based on childhood trauma, like molestation or rape, and may have a genetic component. Sexual compulsivity is often underpinned by depression, anxiety, and other mental issues, such as personality disorders or obsessive-compulsive disorder. Despite the denialism surrounding the condition, there are several treatments to help people recover from their addiction and abuse, including therapy, medications, and techniques like meditation and mindfulness. As always, having a healthy diet and daily exercise play a significant role in recovery. Some have success with support groups and 12-step programs, like Sex Addicts Anonymous or Sexaholics Anonymous. Most people will require a combination of these modalities to manage their behavior and ultimately regain control over their lives. Sexual compulsivity is an extremely trying mental health condition, but it can be overcome with appropriate treatment and dedication to healing. Karen Stollznow, Ph.D. - website - books

Understanding what enables happiness allows you to take the steps to reach it. Happiness is a highly sought-after, yet elusive, quality. Our culture sends unhealthy messages about happiness. A large body of research has identified the most common sources of happiness. There are other, less researched, though still impactful factors that can lead to happiness. Happiness is, for many in our culture, the Holy Grail of life. At the same time, is there a personal quality that we pursue with such vigor and commit so much time, energy, and money to with so little success? One reason why so many people are unable to find that mindset and feeling that we all seek is that they don’t truly understand what happiness really is and how to experience it. There is no doubt that the journey of the experience of happiness isn’t easy, but it is reachable if you can clearly see what that ethereal goal is. Where many people err in their striving for inner peace is how they try to get it. Our culture sends messages to us that happiness involves focusing on ourselves, maximizing pleasure, and minimizing anything that causes discomfort. For example, advertising campaigns equate consumption with happiness (e.g., Coca-Cola: Open Happiness). However, research suggests that this hedonistic approach actually creates unstable, fluctuating, and transitory states of happiness. In fact, happiness doesn’t equate at all with pleasure. It is also not unequivocally related to major positive or negative life events. Happiness is also not experienced as an emotional states often described as euphoria or elation. What the Research Says About Happiness If you have ever read about the research on happiness, you’ll have learned two things. First, over the last several decades, a large body of research has identified the key contributors to happiness. Second, that research has consistently shown that there are certain factors that most impact happiness (and they aren’t what many people think): Genetics Healthy relationships Meaningful goals Satisfying work Physical health Financial stability Though there is not a robust body of research that supports my additional contributors to happiness, both my professional and personal experience have demonstrated these to also impact happiness. Letting Go of Emotional Baggage I would suggest that no matter how many of the evidence-based influences on happiness you have, you will not be truly happy if you are burdened by emotional baggage that might include low self-esteem, insecurity, perfectionism, fear of failure, anxiety (non-clinical), expectations, need to please, and need to control, to name a few. Emotional baggage weighs you down psychologically (e.g., negativity), emotionally (e.g., sadness, anger, frustration), and behaviorally (e.g., self-sabotage), thus making any level of consistent happiness a near impossibility. To fully experience happiness, you need to let go of your emotional baggage, though admittedly, it is easier said than done. Emotional baggage is mostly unconscious and, even if you are aware of your baggage, that mindfulness isn’t always enough to gain control of it. There are many ways to attempt to let go of emotional baggage, including reading, seminars, and group support. At the same time, the best outcomes will likely come from addressing your emotional baggage with a trained mental-health professional. Reducing Life Stress Life stress, in the form of family conflict, work or school difficulties, financial instability, unexpected events, and health problems, just to name a few, is another aspect of our lives that can prevent you from being happy. Our primitive neurological and psychological reactions to stress, including activation of the sympathetic nervous system and hypervigilance, respectively, create body and mind states that also make happiness very difficult to experience. Life stress can be handled proactively and reactively. The ideal scenario involves taking steps to prevent stress from becoming debilitating. For example, you might end an unhappy marriage (though admittedly that can cause another, entirely different, set of stressors), leave a stressful job, maintain your physical health with a healthful lifestyle (e.g., healthy eating and exercise), or build a positive social support system. Unfortunately, some level of stress is an unavoidable aspect of modern life, so not all stress can be avoided. As such, when stress arises, it’s important to have the tools to manage and mitigate it; for example, exercise, meditation, sleep, mental imagery, massage, mindfulness, humor, and support from others. Controlling Your Life Being out of control is one thing that we humans do not like. This aversion arose due to evolution because, during primitive times, if our ancestors were out of control, death was likely to follow. Yet, there are many aspects of our lives with which we can’t be in total control, whether our physical or mental health, work, finances, or relationships. Ultimately, the only thing you can control is yourself, namely, the way you think, the emotions you experience, and how you act on and react to your world. At the heart of gaining and regaining control of your life is a simple distinction: do you react as a victim (i.e., “I’m helpless to change my life,”) or a master (i.e., “I’m going to take control of what I can in my life”)? This shift requires that you make a deliberate decision to take control of your life. Purpose Beyond Yourself Sadly, we live in a culture that venerates selfishness. We’re constantly bombarded by messages about putting our own needs first. Narcissism has become a cultural toxin. Yet, paradoxically, I have found that focusing on myself makes me less happy. To the contrary, when I focus on others, in terms of love, support, and their needs, I’m actually happier. That’s why it’s important to have a purpose in your life that is beyond your own selfish needs and wants. Your purpose outside of yourself could be a career path (e.g., working for a nonprofit) or an avocation (e.g., volunteering). In either case, that purpose offers you many benefits that can encourage happiness. First, you aren’t constantly dwelling on your own unhappiness or deficits in your life. Rather, you are focusing on helping others. Second, when you help others, you are connecting with and building positive relationships with them which, as I mentioned above, is the number-one contributor to happiness. Third, it is immensely gratifying and nurturing to see you are helping others find happiness. Finally, when you have a purpose beyond yourself, you experience changes in your brain including to endorphins, dopamine, and serotonin. Find Daily Joy Happiness is a psychological, emotional, and physiological state that can be nourished in your everyday life. Small experiences of joy (e.g., at work, with family, in avocations), feeling and conveying positive emotions (e.g., love, inspiration, excitement), simple acts of giving to others (e.g., helping family or friends), expressing gratitude to those who help you (e.g., thanking a waiter or cashier), and appreciating your good fortune (e.g., being healthy, having strong relationships) can all feed your happiness and make it more resilient when difficult times arise. The opportunity to appreciate and smile at the simple pleasures in life and, even better, to laugh also produce psychological, emotional, and physiological benefits that bolster happiness. As someone very wise once said, happiness isn’t a destination, it’s a journey. By understanding and being mindful of what enables happiness to emerge, you can take active steps to build and maintain your happiness through the vicissitudes of life. Jim Taylor, PhD - Website - Book

Our study reveals the challenges of moral consistency in infidelity. Many people have affairs even though they love their partners. Infidelity can act as a stressor, with negative, neutral, or even positive outcomes. We can cultivate a spirit of healthy curiosity towards relationship ethics. My colleagues and I recently published a study on romantic infidelity. We recruited a sample of individuals (mostly middle-aged, married heterosexual men) through Ashley Madison, a dating app for married people who are looking to cheat. The company's tagline is: “Life is short. Have an affair.” Just under 2,000 people participated in our study. They told us about their relationships with their spouses, their motivations, and how they felt about their affairs. Past studies in this area found that when people had worse marriages (i.e., they indicated low relationship satisfaction or high conflict), they were more likely to have affairs compared to those whose relationships were better. But we did not find evidence for that in our samples. Overall, our participants rated their relationship quality as decent (not extremely high, obviously, but not very low either). In particular, our participants noted how much they felt love for their partners, and about a quarter of them said they did couples counseling to improve their relationships. The one thing that seemed to be lacking was sex. Half of our participants said they weren’t sexually active at all with their partners, and sexual dissatisfaction was a major motivation for our participants to seek affairs. But among those who had affairs, their relationships did not get worse over time, nor did their psychological well-being. This is yet another result from previous studies that we could not find in ours. The participants who had affairs said they enjoyed them very much and felt little regret. This pattern was surprising in itself, considering that most people say that infidelity is morally wrong and a sign of a bad marriage. How can this be? And more generally, how can infidelity be so common if most people agree that it’s unethical? I’ll give you a handful of uneasy thoughts to chew on, which may help explain this paradox. People are complicated. Monogamy is arduous. Moral consistency may not truly exist in an objective sense. People’s behavior often stems from underlying goals and motivations. We have goals for social connection, intimacy, and sex, along with goals for virtuousness, productivity, freedom, variety, and a lot more. But we can’t have everything we want in life, so difficult tradeoffs often result. The various goals we have may come into conflict with each other. People want to stay devoted to their spouses, who sometimes may be disinterested in sex (or disinterested in their partner’s body). Some may rather have an affair than dissolve a sexless or unexciting marriage, perhaps because they value the other aspects of their marriage with a lifelong partner. Sometimes spouses end up becoming closer friends over time, even as passion fades. In this sense, people may be making a moral tradeoff. Even as the average person disapproves of cheating, they may do so if they believe it’s the lesser of two evils. As I wrote in a recent chapter for a psychology encyclopedia, some evolutionary theorists suggest that humans, like most animals, are not predisposed toward enthusiastically maintaining lifelong sexual exclusivity with one partner. In other words, monogamy can work for many people, but that doesn’t mean it’s enjoyable. It’s normal for people to desire others (romantically and/or sexually) throughout their lives. The challenge for us is how to contend with those feelings, and social norms often dictate how we do this. Some people attempt to repress those desires and internalize shame. Some engage with pornography. Some have open relationships. Some people cheat. Depending on social and environmental conditions throughout the world, most societies fall somewhere in the middle of a “monogamy spectrum.” In many societies, some type of open relationship is not only normal, but actively encouraged. Knowing how common that is, it’s a bit peculiar that people anywhere would show such extreme distress toward an instance of infidelity. Not only do people strongly disapprove of their partners cheating on them, they also express moral condemnation toward others’ infidelities. People seem really bothered when other people are unfaithful to their spouses. Fellow PT contributor Justin Lehmiller and I also noted in a separate book chapter that people often treat infidelity in absolutist terms—an ethical failure to be avoided at all costs. Scientists may have adopted this moralistic view as well. But we suggest more nuance. Infidelity can act as a stressor, which could result in negative, neutral, or even positive outcomes, depending on other variables, including personality traits, community norms, and other relationship factors. Both exclusive and open relationships have strong ethical boundaries. Sometimes those boundaries are bent, and sometimes they are broken. But people often don’t stop to consider why those boundaries are set in the first place, what purpose they serve, and whether they actually strengthen or weaken relationships. Many people believe that having an agreement to be sexually exclusive with a partner will protect them from betrayal, but this is unwise considering how commonly infidelity happens, even in relationships that are happy and satisfying. I suggest we have a healthy spirit of curiosity when thinking about relationship ethics. Instead of being reactive to the idea of others’ affairs, we should be genuinely inquisitive and responsive. We should try to understand why people behave the way they do, instead of just writing it off as sinful. People are more complicated (and more interesting) than merely “good” or “bad,” and there’s a lot more we have yet to learn about this fraught area of human experience. Dylan Selterman, PhD - Website References: Selterman, D., Joel, S., & Dale, V. (2023). No Remorse: Sexual Infidelity Is Not Clearly Linked with Relationship Satisfaction or Well-Being in Ashley Madison Users. Archives of Sexual Behavior, 1-13; Selterman, D. (2022). Monogamy and Relationship Ethics. Routledge Encyclopedia of Psychology in the Real World. https://doi.org/10.4324/9780367198459-REPRW58-1; Lehmiller, J., & Selterman, D. (2022). The Nature of Infidelity in Nonheterosexual Relationships. In T. Delecce & T. K. Shackelford (Eds.) The Oxford Handbook of Infidelity. New York, NY: Oxford University Press.

Learning more about our values will help us proactively prevent bullying. In 1999, nearly 51 percent of LGB teens reported being depressed. The figure has not changed. One of the most significant ways we can prevent bullying is to help youth connect to their values. Children need to understand that their identity should not be a cause for bullying. Once, while teaching a social-emotional learning (SEL) class, one of the youths I worked with told me how badly he was bullied during high school. I was shocked because he was such an outgoing and gregarious young man. When I expressed my disbelief, he said, “Why is that so surprising? I’m a little gay boy.” Even though he was 22 and came from a completely different generation from me, it was still the rule, not an exception: LGBTQ+ youth get bullied. Also, his language and referring to himself as “a little gay boy” was almost as if he subconsciously blamed the reason for getting bullied on himself. As parents and caregivers, we must continue to reinforce at home that, no matter what, a child is never the cause of getting bullied. Nothing about an individual needs to change in order to prevent bullying. That’s like saying a person who dresses a certain way is responsible for being harassed. The bully and the reasons they choose to bully are what needs to change. Creating a new narrative and shifting the focus will prevent shame from continuing to be the subconscious self-talk of bullied youth. Each of us is familiar with bullying. We’ve either been bullied ourselves, or it has indirectly touched our lives. For LGBTQ+ youth, the numbers are consistently higher. Institutional, cultural, familial, and interpersonal discriminatory beliefs are the root causes of violence toward LGBTQ+ individuals. There are many intersectionalities related to these types of discrimination, but the key factors related to LGBTQ+ bullying are sexism, racism, classism, misogyny, toxic masculinity, queerphobia, heteronormativity, and shame. What LGBTQ+ bullying boils down to is fear. And fear can manifest itself in many ways. What drives bullying is usually related, but not limited to lack, unhappiness, insecurity, disempowerment, no feeling of purpose, hurt, anger, blame, peer pressure, group dynamics, rite of passage, need to fit in, and power dynamics. Ultimately, LGBTQ+ bullying looks like fear + misguided beliefs = LGBTQ+ bullying. One of the principles of non-violent communication is that we always operate from our values. At any given moment, our actions reflect our values. One of the most significant ways we can prevent bullying is to help youth consciously connect to their values. Only when we know our values can we know when we aren’t connected to them. Proactive Prevention A few years ago, I remember talking to my six-year-old niece. She told me how two of her friends had come by earlier in the day. I said, “Oh, how fun. Did they come over to play?” She replied, “No, they came over to say sorry for pulling my hair.” Surprised, I asked my niece, “What did you say after they apologized?” She immediately said, “I accept your apology!” I had to laugh at how cute she was. Then I asked where she learned such a mature response. She told me it was something they learned at school, so I asked her to give me an example of how it’s taught. She said, “Well if one student is mean to another student, our teacher will bring us together and ask them to apologize. The apology isn’t complete until the other person says, ‘I accept your apology.’” Then, in the most matter-of-fact way and in her cute six-year-old voice, she said, “I don’t know why we don’t do that at home. Home is just the same as school, so I don’t understand why it’s not something we do at home.” I had to pause with what she said because it was true. What I learned teaching social-emotional learning for six years is how important it is for parents to reinforce at-home concepts our students learned in class. Most children of marginalized groups, including LGBTQ+ youth, have received some form of shameful message about their identity. Especially if their identity isn’t spoken about or affirmed by an adult when they are young. The more we engage in open and honest conversations with children at home, the more we can proactively prevent bullying and shame–including some of their most harmful effects, like addiction, suicide, and depression. The Centers for Disease Control and Prevention (CDC) published a study in The Journal of the American Medical Association (JAMA) in 2019 that shows the suicide rate in the United States among 15-24-year-olds has increased to its highest point since 2000, with a recent increase, especially in males 15-19 years old. Not long after, US News and World Report released a study published in JAMA Pediatrics showing while depression rates for heterosexual teens have dropped since 1999, the rate for LGB teens hasn’t dropped. Depression rates for LGB teens have remained the same (the study didn’t include results from transgender youth). According to the study, each year between 1999 and 2017, roughly 33,500 teens were surveyed on their struggles with sustained bouts of depressed moods, such as sadness and hopelessness. Among the teens who identified as straight, about 3 in 10 reported being depressed for two weeks in a row or more in 1999. By 2017, the number dropped five percentage points. For sexual-minority teens, the numbers were much worse. In 1999, approximately 51 percent of LGB teens reported being depressed. And nearly 20 years later, the figure hasn’t changed. Caitlin Ryan, director of the Family Acceptance Project at San Francisco State University, says that while images of LGB people have become more positive over the past 20 years, “there is an enormous gap between need and reality when it comes to social services for LGBT youth.” Caitlin talks about the importance of getting families and more social services involved to support youth. She says, "Kids are coming out earlier, and parents are much more aware of sexual orientation and gender identification than ever. That’s great. But that means we now have to step up and fill a huge and continuously growing need for more and more child development and family support to help these kids." Ultimately, having systems in place at home, in schools, and on playgrounds will help us empower youth and prevent LGBTQ+ bullying. “The answer to the bullying problem,” says Brené Brown, “starts with this question: Do we have the courage to be the adults that our children need us to be?” If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. Chris Tompkins, AMFT - Website - Book References: “National Survey on LGBTQ Youth Mental Health,” The Trevor Project, 2019, https://www.thetrevorproject.org/wp-content/uploads/2019/06/The-Trevor-….; Oren Miron, MA et al., “Suicide Rates Among Adolescents and Young Adults in the United States, 2000-2017,” JAMA, June 18, 2019, DOI: https://doi.org/10.1001/jama.2019.5054; Alan Mozes, “Depression Rates Not Budging for Lesbian and Gay Teens,” US News & World Report, October 22, 2019, https://www.usnews.com/news/health-news/articles/2019-10-22/depression-….

Carefully consider what you say and how you say it. Parents naturally want to give their children advice about handling future situations or past actions. Parents should consider whether their advice fits their children’s personality. Short-term imperfection is to be expected when cultivating the longer term goals of autonomy and competency. As parents, you will advise your children throughout their lives, and you will likely feel that certain advice is especially critical for your children to hear. But how can you ensure that your child will listen to your messages? What follows is context for understanding some of the factors that can affect your children's receptivity to guidance, as well as some suggestions about ways you can communicate to promote their listening. One quality that constitutes good counsel is presenting your children with possible actions they might implement that fit their character or personality. Most of us have had the opportunity to witness peers or colleagues handle situations in ways we admire but that feel foreign to us. When you present solutions to your children, consider the temperamental or maturational differences between you and them that might make your suggestions difficult to enact. While you want to stretch your children's capacity to try different problem-solving solutions, it’s important that the solutions you offer aren’t ones they will be unlikely to use. You may also think there is one optimal way your children should respond in a given situation, especially if you believe that their responding any differently would encourage someone to mistreat them. Although you may be right, remember that you are in this for the long haul. You are not just trying to give the best advice in the moment, but cultivating in your children the necessary skills to make good decisions down the road when you might not be around to influence their actions. To encourage reasonable and healthy risk-taking, it is important to communicate that their minor missteps are not tragedies. Help them know that your goal for them is autonomous, thoughtful problem-solving that they reflect upon and revise accordingly. How advice is delivered often determines the likelihood that it will be used. Because most of us don't want to hear what we're doing wrong, the manner in which our flaws are pointed out to us is critical. For many, hearing implications that there was no possibility of a positive outcome due to their actions leaves them feeling ashamed or put down. Even great advice will likely be ignored if it is delivered with overtones of shaming, contempt, or derision. Some people are more sensitive than others to feedback when the delivery is perceived to be harsh. Think whether, in offering your children advice, you are intimating something fixed about their character that will shift their focus from the corrective action you want them to take and make them focus instead on what a disappointment they think they are to you. You don't want your child's attention divided between taking and implementing your present advice and defending their past actions. Are you a parent who communicates your judgment of others openly? If so, your children will quickly learn the criteria for your praise and criticism. They will also grow to know what you think about their actions. It will not matter if you openly express your opinions or not. This is called vicarious learning, and parents frequently teach in this way, though often unknowingly. For example, if your children watch you dismiss or think little of people you believe are lazy, they will know, when you casually suggest that they don’t seem very goal-directed or as interested in doing well, that your words are code for “lazy” and that laziness disgusts you. How best, then, to present your feedback? For starters, try to avoid words like “always” or “never” —they are extreme and absolute, and there are usually exceptions that make such statements untrue. As I have recommended in earlier posts, it’s helpful to begin with a soft start-up that does not place blame. Start with expressions like “You may not have realized it,” “I wonder if,” and “Do you think things would have turned out differently if…?” Also, if you know reasons that would make your child less likely to take your advice, it’s a good idea to address those reasons from the outset. For example, if they fear you are undercutting their autonomy, then be clear that that is not your intention. This helps dispel any misperceptions about why you are offering your guidance. If you would like your children to consider other options than the ones they seem inclined to pursue, consider gentle reflecting questions like these: “What's your goal?” “What are you hoping will happen?” “Is there something that you're hoping for in the other person’s response?” “Do you think they will be receptive?” “Have you thought of how you will feel if they're not receptive?” “Will it bother you?” As your child gets older, you can be more explicit with them about your intentions and ask them directly about the best ways for you to offer advice. For example, “You know that my wish as a parent is to help you navigate tricky situations with more ease and success than I did. But I also realize that I may not always offer advice in ways you like. Can you give me an idea of what approach works best for you?” Any of these scripts are drafts that you can change to sound truer to your own voice. And just as I am suggesting that your children may not come up with the perfect solution for any given situation, you may not either in terms of how you offer them advice. And remember to check in with your children later to see how things worked out. Besides asking them whether their strategy was successful, you can also ask if there is something more you could have done or said to be supportive. You, too, will get better at this with time. Pamela Brown, PhD, Website

Research is increasingly teaching us how to match treatments to the individual. With so many options, it can be hard for providers and patients to know which treatment to start with. Personalized medicine can be applied in behavioral health disorders such as depression. However, experts are still debating the effectiveness of some tools, and there is still much to be learned. If there’s one consistent truth in behavioral health treatment, it’s that one size does not fit all. Cookie-cutter treatment often doesn't work, even if an accurate diagnosis has been made and standard-of-care interventions are applied. In the case of major depressive disorder, for example, numerous options are available. In terms of pharmacotherapy, there are many medication treatments all with different mechanisms of action. Drug classes include selective serotonin reuptake inhibitors, norepinephrine-dopamine reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, tricyclic antidepressants, and more. But not all patients with a diagnosis of depression will respond to all of these treatment options. The truth is we are all different. Heterogeneity within a diagnostic group is the rule, not the exception. And, as a field, we are still in the early stages of trying to figure out what treatment is best for the patient. In the real world, prescribers, like psychiatrists, often have to try several medicines, before finding the best one for a particular patient. Sometimes it takes weeks or months before we get an answer to the question of which medication is best for that individual. It’s an often-frustrating process of trial and error. Therapists also struggle with a similar situation. Often trained in several modalities, we will often pick and choose from our various skill sets, trialing one kind of intervention, and then another, until finding the one that fits the person's needs in front of us. Meanwhile, the patient’s life continues to unravel. Wouldn’t we all be better off if we better knew how to match treatments to a patient’s individual needs off the bat? How Things Work Today: Where Your Behavioral Health Provider Is Coming From When mental health practitioners first evaluate patients in their offices, we may spend the first session, or several, to identify any underlying diagnoses, based on the diagnostic bible, otherwise known as the Diagnostic and Statistical Manual. One of the primary reasons we do this is to inform our recommendations and treatment plan. A diagnosis gives us a treatment direction. Once we know the diagnosis, we have an idea about the next steps; our training has taught us about the standard of care, and we already know the first-line treatments. If we don't know, we can go to the literature to identify the treatments that are most likely to work best for this diagnosis. Results from clinical trials, especially large, double-blind, randomized controlled trials, are the foundations of a psychiatrist’s decision-making about treatment. A typical study of this type takes a large group of people with a single diagnosis—say, major depressive disorder—and randomizes them to active treatment or placebo. The patients are followed over time. Measurements of the patient’s clinical status, after weeks of treatment, are compiled and analyzed to answer the following question: Does the active treatment get people better faster than the placebo, and if so is it a statistically significant difference? If so, then several more studies, in different populations, need to be done. If several studies show the medication to be effective, the field adopts that medicine or psychotherapy as a recommended standard of care intervention. But, unfortunately, not all treatments work for all people. There is significant variability within each diagnosis, based on metabolism, brain chemistry and function, genetics, comorbidity, and any number of other factors. The fact is that individual patients respond differently than the populations in the drug studies do. Many medicines have been studied and found, on the whole, to be effective within the categories of addictions, anxiety disorders, major depressive disorder, bipolar disorder, and psychotic disorders, to name just a few. Numerous psychotherapies, also growing in number, are also evidence-based within each diagnostic category. So, in the face of numerous treatment options to choose from, providers don’t have much information on which one might be best for the patient. Sometimes they’ll go with experience, familiarity, and intuition. Occasionally, there is guidance from the literature about how to match treatment to the individual. But often times it’s just a guessing game. To avoid the time-consuming and in some cases life-threatening trial and error process, where we pick treatments based on intuition and personal experience, we need better ways to know ahead of time what the individual in front of us needs most. The Importance of Defining Subtypes to Inform Treatment “Precision medicine” and “personalized medicine” have been high-priority research agendas for over a decade. These terms refer to medical care designed to optimize efficiency or therapeutic benefit for particular groups of patients and involve using genetic or other biomarker information to make treatment decisions. This is especially important as more and more treatment options are coming out. Research to define subgroups within diagnostic categories, with the end goal to increase the efficiency and effectiveness of treatment, is a major focus of behavioral health research. Genetics, radiologic imaging measures, demographic information, blood tests (such as hormone levels), cognitive function, and behavioral traits are examples of markers that can be utilized to define these subgroups. Examples of disorders being studied using these methods include post-traumatic stress disorder, mood disorder, psychotic disorders (like schizophrenia), substance use disorders, and other addictions. The more researchers explore the validity of subgroups, the closer we will come to being able to identify which medication is best for the individual patient in front of us—treatment matching—thereby improving the outcomes of patients and the efficacy of existing treatments, potentially saving lives. The Future Research in this area of behavioral health and addictions is still in its early phases. For major depressive disorder, there are some early signs of useable tools. Some facilities and providers are, for example, encouraging patients to do genetic testing to identify the medications to avoid, and the ones that are most likely to work with minimal side effects. Some experts express concerns that these expensive tests are not yet ready for prime-time, because it is still not established whether they actually improve patient outcomes—i.e. that testing helps patients get better any faster. Yet other studies (many, it must be said, funded by the companies that produce these testing kits) have reported that they do have clinical benefits and cause overall cost savings. However, more research needs to be done to find affordable, accessible, and accurate ways for behavioral health providers to individualize treatment with medications. In addictions—which will be the focus of my next four articles—there are some signs of affordable, accessible markers that can be deployed now. Although the work is preliminary, these potentially useful markers are not costly, and if clinicians are to have this information in mind when making decisions, it is unlikely to cause harm. Conclusion In this age of a ballooning number of treatment options, researchers have been working hard to identify the best ways to subtype people within a diagnostic category in order to pick the best medication. A textbook, or several, could be written about sub-typing in behavioral health disorders to guide pharmaco- and psycho-therapeutic treatment for mental health and addictive disorders. I don’t have the space to cover it all. Therefore, in the next group of articles, I’ll limit my review of the literature to three groups of clinical diagnoses: alcohol use disorders, other substance use disorders, and the debated topic of food addiction. I’ll also do an additional article on the promise of sub-tying using an addictions neuroscience framework. I’ll primarily be focusing on sub-typing to guide medication treatment rather than choosing between psychotherapeutic modalities. That said, there is a growing (exciting) literature focused on treatment matching in psychotherapy, too, and in a few places (like in the article about the neuroscience-based sub-typing paradigm, and in the article about alcohol use disorders), I’ll occasionally reference treatment-matching in psychotherapy too. June 14, 2023 - Claire Wilcox, MD - Website - Books by Author: Food Addiction, Obesity, and Disorders of Overeating: An Evidence-Based Assessment and Clinical Guide

Practical ways to relieve the pressure How to Avoid Parental Burnout With kids home for the summer, it may feel reminiscent of life during Covid-19. Trying to keep children occupied while continuing to work and take care of home and family responsibilities can stretch any parent’s mental, physical, and emotional resources. And not just during summer, or a pandemic. The regular day-to-day of kids picking at their dinner, battling bedtime, having homework meltdowns, squabbling with siblings and struggling with friendships can all add up, causing some parents to reach the point of burnout. But it doesn’t have to get to this point. Finding practical ways to relieve the pressure and preserve your energy can help reduce your burnout risk. What is parental burnout? According to the American Psychological Association, “burnout” is defined as physical, emotional, or mental exhaustion accompanied by: · decreased motivation · lowered performance · negative attitudes toward oneself and others It’s caused by a high degree of stress and tension, especially from extreme and prolonged physical or mental exertion, or an overburdening workload. If you can relate, you’re not alone. Most parents have experienced some level of exhaustion at some point, or many points, along the parenting journey. The type of exhaustion you experience may vary, depending on the age of your kid(s). Physical exhaustion is common during the younger years, while mental and emotional exhaustion are more likely during the ups and downs of parenting a tween or teen. But parental burnout goes beyond feeling worn out at the end of a rough day. The excessive or prolonged exhaustion takes its toll, especially when you have a lack of resources to deal with it. What are the symptoms of parental burnout? While burnout affects everyone differently, there are some common signs to look out for: · fatigue · physical or emotional exhaustion · irritability · emotional distancing from your child · lack of motivation · feeling alone · isolation or detachment from others · feeling helpless or hopeless · self-doubt · physical symptoms, such as headaches or muscle aches Unlike other jobs, the role of parent is one you can’t quit, which can leave some parents feeling trapped. As a result, they may resort to things like yelling, avoidance, neglect, or violence, even if they’ve never engaged in these types of behaviors before. This can lead to feelings of shame or guilt, which may result in unhealthy coping patterns, such as overeating or drinking. It becomes a vicious cycle of negative behaviors leading to negative feelings leading to more negative behaviors. Tips to prevent parental burnout While you can’t escape exhaustion altogether, there are some things you can do to avoid reaching the point of burnout. Let the little things go. It’s natural to want to be the best parent you can be. But when perfection is the goal, it’s easy to get stuck in a sea of “shoulds.” Research suggests parents who are perfectionists or put pressure on themselves experience higher rates of burnout. Try to remember there’s no such thing as “the perfect parent.” See how it feels to let go of some of the smaller things. Maybe the pile of laundry in the corner can wait another day, or you end up giving in to “just one more hour” of screen time. Sometimes a good day is good enough for today. And that’s ok. Take a parental “time-out.” It’s hard to meet your child’s social/emotional needs when you’re feeling wiped out yourself. If you can, step away for a brief period, especially when stress and emotions are high. Getting out of the house, or just in a closet for a few deep breaths, can help you return to the situation with calm and focus. Prioritize self-care. While it might seem like adding one more thing to your “to-do” list, self-care can soothe your nerves and recharge your battery, so you actually have more to give as a parent. Adequate sleep may seem elusive at times, but it can make a huge difference, along with getting regular exercise and prioritizing healthy foods. Fun is self-care, too, so do whatever speaks to your soul, whether it’s soaking in a warm tub, reading a novel, or spending a night out with your partner or friends. Ask for help. Of course, finding time for yourself is not so simple. When? How? Consider leaning on family and friends, or perhaps trusted members of your religious community. You may be surprised how willing they are to babysit or pitch in where needed, especially if they’re familiar with the demands of parenting. This also extends to your children. Enlist their help with chores to take some of the household duties off your shoulders. Finally, if you find it difficult to manage stress on your own, reaching out to a therapist can help you work through difficult thoughts and emotions, as well as find other ways to get the support and relief you need. Susan Fishman, NCC, CRC, Website Sources: https://www.apa.org/monitor/2021/10/cover-parental-burnout; https://dictionary.apa.org/burnout; https://www.psychologytoday.com/us/blog/the-ocd-monster/202105/7-tips-prevent-parental-burnout; https://link.springer.com/article/10.1007/s10826-019-01607-1

Swipe left or swipe right? Swipe left or Swipe Right? Millions of people make this decision on hundreds of different online dating sites every day. At the present time, there are over 8000 dating sites across the globe. Thirty percent of U.S. adults have used or are using an online dating site during their lifetime. (Pew Research Center, 2020) Why are these sites so popular? For one thing, they are convenient. Prior to the advent of online dating, people generally met potential dating partners through mutual acquaintances, at a local bar, a party or other event. These were face-to-face encounters, there were no “profiles,” and there were no screens or smart phones available to remotely find a soulmate. With online dating, the task of finding someone is much easier. For the equivalent cost of one or two nights out with friends, you can purchase a monthly subscription to a dating site that will do the work for you, so to speak. It will help you find “matches” without having to go through the hassle and effort that was once required AND from your own home or wherever you choose to log in. But how successful are these dating sites in finding you an effective match? In the United States, thirty-nine percent of users of these sites say they have found a significant-other that resulted in a committed relationship or marriage. (Pew Research Center, 2020) This is a substantial number of people! There is no doubt that for many, these sites pay off in terms of helping people find the results they are looking for. But does this success rate mean that using these sites is necessarily good for everyone’s mental health? The answer may surprise you: For one, many users of online dating sites spend excessive amounts of time simply looking at the sites. The act of scrolling and tapping that is often required is a core behavioral pattern that is often connected to smartphone addiction. The sites are designed so that we spend more time on them, engaging in behavior that is more likely to lead to addiction. (G. Bonilla-Zorita, 2020) Research shows that spending more time on the sites may also lead to higher rates of anxiety and depression. Those with social anxiety are more prone to developing these symptoms. For many people, online dating is not really about dating but about self-validation. Many people connect with others on these sites, not to date but for validation of their own self-worth. If someone’s self-esteem is hooked up with how others respond to them online, they may become dependent on a dating site to bring them the life satisfaction that they cannot find elsewhere. This may lead to depression as a person with this type of dependency is substituting online dating for finding healthier forms of happiness in their everyday lives. (G. Bonilla-Zorita, 2020). In addition, those who peruse these sites often develop what is known as lower conscientiousness. This trait leads to higher sensation-seeking and sexual permissiveness; patterns that are often self-sabotaging and can become dangerous, increasing the chance of physical and/or sexual abuse. (G. Bonilla-Zorita, 2020). Finally, there are pitfalls to online dating that are endemic to all social media connections: deceit and financial exploitation. Many online dates “complain” that the profile they are viewing is inaccurate and portrays information that is false in a variety of different ways that may lead to serious consequences. Is online dating worth it? The answer is yes, however, it is advisable to be aware of the pitfalls; extended use may cause serious mental health issues, including the possibility of smartphone addiction and may lead to a greater chance of risky behavior and deceit. It is very important to evaluate (with the help of a professional if necessary) what your motives are in pursuing online dating. Are you looking to meet someone significant or are you looking for self-validation and to improve your self-esteem? Are you using online dating sites to avoid other important areas of your life and more healthy development? If your real motivation is not actually to date but for other unhealthy reasons, you will be spending your money on something that probably won’t lead to finding a healthy relationship and it may ultimately bring you more unhappiness and general frustration towards meeting other people. David Steingart, LCSW

There's evidence that bio-genetics play a significant role in suicidal activity. Heredity, environmental factors, and epigenetics contribute to suicide risk. There is a 2.1 to 2.7-fold increase of suicide risk in relatives of suicide victims. Family suicide history should be considered a strong risk factor and heavily inform one's overall level of risk and safety planning. A family history of suicide is correlated with a 2.1 to 2.75-fold risk increase in relatives (e.g., Qin, 2003; Jang et al., 2002). When presented with this information, students and concerned parents have asked me, “Is suicide something genetic?” My answer is, “It depends.” As noted by Hoehne et al. (2015), “The heritability of suicide is well-established.” If, however, by “genetic,” one means the inheritance of a specific, self-destructive gene that pointedly leads to suicide, then no, that’s not been discovered. If someone means suicide is influenced by genetics, that’s a different story. A multifactorial blueprint To start, one might figure that such genetic influence is rooted in, say, depression, a disorder known for genetic factors that are highly correlated with suicidal activity. For example, Zai et al. (2012) wrote, “In a study of suicide records dating from 1880 to 1980 in an Amish community, Egeland and Sussex (1985) found 26 reported suicides that aggregated within four families who also had a high incidence of mood disorders….” They continued, however, “The authors also found other families that were affected by multiple mood disorders but had no history of suicidal behavior.” Next, add to this the statement from Diblasi et al. (2021), “Broadly, molecular studies suggest a complexity of suicide etiology that cannot simply be accounted for by depression.” Based on the above two researchers’ statements, it’s clear that genetics influence depression, and while some depressed people become suicidal, it’s more complicated than the influence of any inherited mood alone. The “ingredients” are perhaps best encapsulated by Kouter et al. (2019), who wrote, “[Suicide] is a result of the interplay between hereditary and environmental factors, tied together by epigenetics.” A survey of biogenetic factors In more recent years, increasingly-sophisticated medical technology has allowed researchers to examine specific aspects of brain anatomy and genes that contribute to suicidal activity. For example, Cha et al. (2017), citing Gosnell et al. (2016), provided: “The hippocampus, which is connected with the body’s stress response system and important in mood regulation and memory, has been found to be structurally abnormal in suicide attempters. The [dorsolateral prefrontal cortex] is involved in goal-directed behavior, decision-making, and emotion regulation and is also found to be structurally abnormal in suicide attempters.” Further, there is the ventral prefrontal cortex (VPC), which is important in “binding together the large-scale networks that subserve emotional processing, decision-making...” (Gage & Baars, 2018). The VPC seems influenced by molecular-level complications, illustrating the role of biological or genetic intricacies underlying some people’s suicidal activity. To expand, Leonard (2005), for example, noted postmortem studies of depressed people found that the VPC showed serotonin deficits. Serotonin is believed to be essential in controlling aggressive or impulsive behaviors (e.g., Popova, 2008). Leonard surmised this implies a dysfunction in the serotonergic system, for which “there is increasing evidence of a genetic basis.” This said, biological contributions quickly become more complicated, going from gray matter to microbiology. Readers interested in an in-depth review of molecular contributions may be interested in reading Turecki’s 2014 paper, The Molecular Bases of the Suicidal Brain. In brief, the author explained how early-life adverse environmental factors (epigenetics) can alter gene expression, which influences stress response associated with a lifetime susceptibility to suicidal behavior. As for the suicide-stress response link, O’Connor (2020) pointed out that hypothalamic-pituitary-adrenal (HPA) axis dysregulation is a particular culprit, which, as noted by Berardelli et al. (2020), disrupts healthy neurotransmission. To add to this more specifically, Oquendo et al. (2014) observed that an altered stress response seems responsible for downstream effects in the form of the aforementioned serotonin system abnormalities. If this seems overwhelming, bear in mind that it is only a glimpse of the research on the bio-genetic factors of suicide. In addition, is it chicken or egg? Do people with the above complications have more proneness to being depressed, a state of being that then interacts with those factors for a dangerous cocktail? Or does being depressed initiate some of the bio-genetic abnormalities that are correlated with suicide attempts? Clinical implications Outside of psychiatrists prescribing antidepressants, clinicians likely aren’t able to change someone’s bio-genetics. Further, antidepressants alone likely cannot alter such a complicated equation to eradicate bio-genetic risk factors entirely. There may also be cultural factors related to the family for clinicians to consider. For instance, Jang et al. (2022) discovered that South Korean survivors of suicide victims were three times more likely to die by suicide. Interestingly, this was especially true for wives whose husbands died by suicide. The best that clinicians can do is: 1) Always ask about a family history of suicide, and 2) if present, weigh it as a significant factor when deciding someone’s level of risk or the observation or safety planning required. If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. Disclaimer: The material provided in this post is for informational purposes only and is not intended to diagnose, treat, or prevent any illness or suicide in readers or people they know. The information should not replace personalized care or intervention from an individual’s provider or formal supervision if you’re a practitioner or student. Anthony D. Smith, LMHC - Blog

When all the focus is on one person’s needs. Healthy relationships involve equality and mutual respect. When one partner has disproportionate power, their goals and desires may be prioritized over their partner's. Being in a powerless role can lead to self-silencing, over-apology, objectification, and negative emotions. A romantic relationship shouldn’t be a power struggle. While it may not be realistic to feel perfectly equal all the time, people in healthy relationships at least strive for this goal. Rather than trying to maximize their own power at their partner’s expense, they want one another to feel empowered to make decisions. Not all relationships follow this pattern, though. Sometimes the balance of power is heavily lopsided, with one person’s needs and goals taking priority. The powerful partner may benefit from this dynamic, but the powerless partner is more likely to suffer. Research has identified a range of negative experiences associated with being in a lower-power role, five of which are described here. If you relate to these, it could be a sign that there is an imbalance in your relationship worth examining. 1. You don’t feel like you can be yourself with your partner Powerful people may feel more free to express themselves, whereas those who lack power may feel pressure to tailor their behavior to the needs of others. One study found that romantic partners with less power (agreeing with statements like, “Even if I voice them, my views have little sway”) were more likely to hide negative thoughts and feelings during daily interactions with their partners, whereas their partners were unlikely to feel this constraint. Another study found that even just thinking about a time when someone else had control or influence over them made people feel that it was harder to be themselves and share their true feelings. 2. You’re always the one apologizing Power may reduce people’s motivation to apologize for their transgressions. In a series of studies, higher-power people were more likely to make “non-apologies,” for example downplaying the offense, making excuses, and blaming the other person. Those in low-power positions were more likely to make genuine apologies involving taking responsibility, expressing remorse, and making amends—perhaps even when they were not the ones at fault. Consistent with this pattern, research suggests that power may in some cases make people less likely to feel compassion for others’ suffering. 3. They can tease you, but you can’t tease them A third red flag is asymmetrical teasing. Teasing can be playful and harmless, but it can also be used to humiliate or belittle. Studies have found that people with higher power tend to tease others more frequently and in more direct and hostile ways. Those with lower power, by contrast, are less likely to tease in the first place, and when they do, it’s more likely to be delivered in a kind and polite way, presumably because they fear a negative reaction from the higher power person. 4. They treat you like an object Research suggests that powerful people are more likely to objectify others, evaluating them in terms of their usefulness (that is, how they serve the powerful person’s interests), and giving less consideration to the other person’s humanity. One set of experiments found that this objectification can be literal: when heterosexual participants were in positions of power, they were more likely to perceive images of opposite-sex people using cognitive processes similar to those used when perceiving physical objects, as if they were viewing a collection of parts rather than a person. Other research has found that the dehumanizing effect of associating people with objects can increase the risk of sexual exploitation. 5. You don’t feel good when you’re around them Power creates what researchers have called a reward-rich environment, one where people feel free to pursue their goals and feel confident that good things will come to them. Low power can instead create a threat-rich environment, where people have to stay vigilant to avoid negative outcomes or punishment and feel limited in what they can comfortably do or say. Put simply, having power tends to feel good while lacking power does not. In one study, when dating couples discussed topics related to their relationship, partners with less power felt more negative emotions, including shame, embarrassment, and discomfort, whereas their higher power partners had more positive emotions, such as pride, happiness, and amusement. Is There a Way Out? Power imbalances can create a vicious cycle where the negative consequences of the imbalance only serve to reinforce it: the more self-conscious and inhibited the lower power person feels, the harder it may be to stand up for themselves, and the more easily the powerful person is able to get their way in the future. Sometimes an imbalance can be rectified, especially if your partner is open to working on it, but other times ending the relationship may be the best course of action. This is especially true if there are signs of abuse. Research has found that a power imbalance is a risk factor for the development of intimate partner violence, making it important to identify and address this dynamic early on. Even if a power-imbalanced relationship does not involve abuse, it may still cause harm. Getting support from loved ones and mental health professionals can be helpful for regaining a sense of power and re-evaluating the relationship. For example, if your focus has been on what your partner wants and whether you’re doing a good enough job giving it to them, try turning the tables, and ask yourself what you want in a partner and a relationship. Does your partner have qualities that you value? Do you feel happy and fulfilled spending time with them? These may seem like obvious questions, but when all your energy is going towards trying to please another person, you may forget to ask them. While it’s laudable to value your partner’s happiness, you deserve someone who will do the same for you. Juliana Breines, PhD - Blog

Make it a focal point of your life. It's easy to forget the importance of our emotional health when we're caught up in the daily grind. But neglecting our emotional well-being comes at a significant cost, affecting our relationships, work performance, and overall quality of life. That's why it's critical to prioritize our emotional health and make it a focal point of our lives. This blog is resource to help you cultivate your emotional well-being and lead a happier, more fulfilling life. So, let's take care of ourselves - nothing is more important than staying emotionally healthy! Understanding Emotional Health Taking care of our emotional health means understanding and acknowledging our positive and negative emotions. It means effectively managing stress and anxiety and nurturing healthy relationships with us and others. Emotional health also involves coping with life's challenges and setbacks, such as loss or failure. Research shows that poor emotional health can lead to physical problems, such as lowered immunity, increased risk of heart disease, and other chronic illnesses. Therefore, it is vital to prioritize emotional self-care in our daily lives. The following sections will explore practical ways to manage our emotional health, from mindfulness practices to seeking professional help. We can live a happier, more fulfilling life by cultivating emotional health. Seeking Professional Support Despite our best efforts to prioritize self-care and manage our emotional health, there may be times when we need professional support. Seeking help from a therapist or counselor can be a proactive step toward improving emotional well-being. It is essential to recognize that seeking professional support is a sign of strength, not weakness. Just as we would seek medical attention for physical health concerns, it is equally important to seek professional support for emotional health concerns. A therapist can provide a safe and confidential space to explore and process emotions, develop coping skills and strategies, and better understand oneself. Understandably, seeking professional help can be intimidating or stigmatized in certain cultures. However, it is essential to recognize that therapy is not only for those with severe mental health concerns. Therapy can benefit anyone, regardless of their emotional state. Taking the step to seek professional help can be challenging, but it is crucial to taking care of our emotional health. Doing so gives us the tools and support needed to navigate our emotions and live a more fulfilling life. Building a Support System Maintaining our emotional well-being is a complex and ongoing process. While practicing self-care and seeking professional help is crucial, having a support system can also make an immense difference. A support system may include family members, friends, colleagues, or virtual communities offering a listening ear, encouragement, and an overall sense of belongingness. These individuals can be precious during times of emotional distress or hardship. They can provide motivation when we feel demotivated and comfort when we feel vulnerable. It's essential to acknowledge that seeking help from others is not a sign of weakness but rather a courageous act of strength. A robust support system can aid us in maintaining good emotional health and providing comfort during challenging times. Here are some steps to building a support system for emotional health: Identify supportive and trustworthy individuals: Consider individuals in your life who consistently exhibit kindness, empathy, and understanding. These can be people you are close to, such as family and friends, or colleagues and acquaintances with whom you have a positive relationship. Communicate your needs: Communicating your needs with your support system can be helpful. Let them know what emotional support you need, whether a listening ear, advice, or someone to spend time with. Be selective in who you confide in. While it is essential to have a support system, it is equally important to be selective in who you confide. Choose individuals who have earned your trust and positively impact your emotional well-being. Prioritize reciprocal relationships: Building a support system does not mean relying solely on others to provide emotional support. It is essential to prioritize reciprocal relationships in which you also support others in your life. Consider joining a support group: Support groups can be a helpful resource for individuals facing similar challenges or experiences. They provide a sense of community and can provide invaluable support and perspective. Building a support system can take time and effort, but the benefits for emotional health can be substantial. With the correct individuals and resources, navigating emotional challenges can become more manageable and fulfilling. Warning signs to look out for Here are some common warning signs that your emotional health is at risk: Persistent feelings of sadness, anxiety, or emptiness Loss of interest in activities that once brought joy or pleasure Feeling isolated or disconnected from others Changes in appetite or sleeping habits Chronic fatigue, lethargy, or lack of focus Inability to manage stress or cope with daily challenges Increase in substance use or other self-destructive behaviors If you have experienced any of these warning signs, it is essential to seek professional support and build a robust support system around you. Taking care of your emotional health is a continuous process, and it's essential to be proactive in identifying potential risks and taking steps to maintain and improve your emotional well-being. Remember, self-care is not selfish, and prioritizing your emotional health benefits you and those around you. Final Thoughts To summarize, prioritizing our emotional health is crucial to leading a happy and satisfied life. It's essential to recognize any warning signs indicating risk and take immediate steps to address them. Building a solid support system and seeking professional help is essential to maintaining emotional well-being. One must understand that emotional health cannot be ignored or overlooked. By placing importance on our emotional health, we can lead fulfilling lives and positively impact those around us. Matt Guttman, LCSW - Website