World of Psychology Dr. John Grohol's daily update on all things in psychology and mental health. Since 1999. 2017-01-20T21:30:51Z Suzanne Kane <![CDATA[4 Tips to Finding Inspiration]]> 2017-01-08T21:20:51Z 2017-01-20T21:30:51Z

“Become the sky. Take an axe to the prison wall. Escape.” – Rumi

Little child girl plays superhero. Child on the background of suIt’s safe to say that everyone can use a little inspiration now and then. Correction, make that everyone can use a little inspiration daily. To be inspired is such a positive emotional experience that it should be cherished, nurtured and remembered. But how do you find inspiration in the first place? Is there some specific process to tap into inspiration or is it a matter of chance?

There are many ways to look at how you find inspiration, but here are a few choices that may help.

  1. Learn to see the wonder in life — all aspects of life. 
    Undoubtedly there are many unknowns in your life. Everyone has a list of things they feel unsure of, don’t know about or feel little confidence in. It could be that they’ve never been reassured as a child or not sufficiently enough to gain self-confidence. Perhaps they were not given the freedom and encouraged to experiment, to try something new. That would tend to dampen enthusiasm and put a damper on any seeds of inspiration.

    One approach to changing this is to deliberately focus on what it is in life that is of wonder. Insert mindfulness into everything you do. In this way, you start to see things differently and tend to view life choices as more positive and possible.

  2. Develop a routine that allows for discovery
    Anytime you embark on a new adventure, you feel a sense of excitement, knowing that there are things you’re likely to learn, experiences to have and people to meet. By establishing and developing a daily routine that gives you time and space to discover new things you create a buffer zone that makes room for inspiration to grow and fill it.

    Of course, for this to happen, you also must allow yourself to be open to discovery. Get rid of the filter that prohibits exploration and silence the voice that tells you you’re wasting time. You’re not. Even if you are in the process of completing a task, giving yourself permission to discover means that inspiration can find its way into your consciousness, pointing out new avenues to pursue, different paths to take, something else to research and learn.

  3. Nurture pleasurable experiences.
    If something feels good and you feel pleasure doing it, as long as it doesn’t bring harm to others or yourself, go for it. Indulge in the experiences you find most comforting, exciting, consider fun, the ones you can’t wait to get involved in. This might be going for long walks in nature, working in the garden, crafting something, joining others in a hobby or recreational activity, searching for an answer to a problem or something else. What gets you so motivated that you lose track of time while you’re doing it is a good place to start. Welcome and nurture these pleasurable experiences. They will help your budding inspiration to flourish and grow.
  4. Do things differently and do different things.
    Maybe your life has become a daily grind. Nothing seems to excite you as you do the same things over and over. There’s a quick way out of this and it involves doing things differently. It also involves doing different things.

    Take a different way to work or school. Start at the middle instead of the end. If you’ve never planned before starting a project, map out the steps before you get involved in the actions necessary. Maybe you pride yourself on doing things solo. Switch it up and enlist the assistance of others, if nothing more than for moral support and encouragement.

Once you stop limiting yourself you’ll find that ideas begin flowing and solutions occur to you that you couldn’t imagine before. Without that blockage in your mind, inspiration naturally finds its way to the surface.

Kurt Smith, Psy.D., LMFT, LPCC, AFC <![CDATA[7 Red Flags to Watch Out for in a New Relationship]]> 2017-01-08T21:13:42Z 2017-01-20T16:45:10Z bigstock-123639038You’re dating someone new and everything seems to be going pretty well. That is until you see something a little off in their behavior. When you’re first getting to know someone, you don’t want to analyze and judge every single thing they do or way they act, but you also want to evaluate what kind of person they are and if they could be a good fit for you.

When we really like someone, we often want to overlook certain behaviors and chock it up to them having a bad day or our reading the situation wrong. But before you get too invested in someone, it’s important to know what their personality is really like. Here are seven red flags to watch out for in a new relationship.

1. Your friends don’t like him.

True friends have your best interest in mind. If they don’t like the new guy you’re dating, they probably see something in him that you don’t. Sometimes the excitement of a new relationship blinds us to someone’s true qualities. If you’re not getting a good report from your friends, try to take a step back and take a closer look at your beau to try to better see what they see.

2. She talks about herself a lot.

People who constantly talk about themselves are usually self-absorbed and a bit narcissistic. If she doesn’t ask you questions about your day, your family, etc., then she likely doesn’t truly care. Staying in a one-sided relationship with someone who is completely self-centered isn’t healthy and will ultimately leave you unfulfilled.

3. You find him checking out other women.

Your guy should be into you. If you find him scanning the restaurant or club, looking at other women, then he might be looking for his next fling. It’s disrespectful to check out other women, especially when he is on a date with you. If he respects you, he won’t be doing this or he’ll be willing to change.

4. She talks down to you or others.

No one wants to feel belittled or talked down to. If your new girl criticizes you, diminishes your feelings, or insults you in any way, then she isn’t a catch. The same thing goes with how she treats others. If she treats you like a god, but you see her discounting others, the time will likely come when she discounts you too.

5. Small things set him off.

Some men tend to have tempers when they become angry and this isn’t always a cause for concern. But if little things make him furious, or minor details cause him to erupt, then he could have anger issues. If little things make him mad, how will he react when larger problems come your way?

6. She is controlling.

Whether she tells you to stop hanging out with your guy friends or she always dictates when and where the dates will be, she has to have the final say in your life. Sometimes this can come out in small ways like her asking, “Oh, you’re wearing that?” Stay with this girl and she will eventually want to control every aspect of your life. It is probably wise to get far away from this one.

7. You’ve experienced any sort of violence.

If he has grabbed you forcefully even once, get out. Violent men are dangerous men and need professional help. A common mistake is to stay and tell yourself you will be the one to help him. Violence is never acceptable. Run the other way if he is acting aggressive toward you or anyone else.

New relationships should be pretty drama free for the most part. Early on, it’s all about the excitement of getting to know each other, first kisses, and having fun together. If you just started dating someone and are questioning their maturity, character, or sincerity, trust your gut, value yourself, and consider if the relationship is really worth continuing to invest in.

Brandi-Ann Uyemura, M.A. <![CDATA[Best of Our Blogs: January 20, 2017]]> 2017-01-19T21:56:34Z 2017-01-20T11:30:30Z I heard health coach and author Amy Kurtz say something that changed my worldview of healing and health. On Insights at the Edge, she said, “Healing is a journey, not a destination.” Although she was talking about chronic illness, I think anyone struggling with their health can appreciate […]]]>

I heard health coach and author Amy Kurtz say something that changed my worldview of healing and health. On Insights at the Edge, she said, “Healing is a journey, not a destination.” Although she was talking about chronic illness, I think anyone struggling with their health can appreciate that statement.

What if we were to view health not as some perfect, unattainable goal, but something that teaches us to be kinder, gentler and caring to ourselves?

Can we perceive our pain and struggle as insightful friends? Can we view it as messages highlighting areas of our lives that need exploration and tending?

It’s changed the way I view my own illness. Along with our posts this week on control, narcissism, stress and relationships let it bring hope to all who feel hopeless.

Paper Napkin Mental Health Challenge #2: Sphere of Control
(Stress Better) – Feel helpless and disempowered in your own life? Renee teaches us a simple way to take back control.

Spot a Narcissist by His Need to Put You (and Everyone) Down
(Knotted) – Not all narcissists are loud and obnoxious, but all will do this to you.

27 Signs of Superficial Relationships
(NLP Discoveries) – You’re a deep person trying to connect with other deeply felt people. But if your relationships look like this, you might want to keep searching.

I Think Mom Has a Mental Disorder
(Strength Over Adversity) – When we grow up hurt and abused as children, we look for answers as adults. Sarah’s spent her entire life wondering, “Why?” and after reconnecting with her mother, this is what she realized.

6 Tips to Manage Stress and Avoid Burnout at Work
(Working Well) – Feeling burnt out? Here are six strategies to help you find calm during stressful times.

Psych Central Staff http:// <![CDATA[The Danger of Lead Exposure to Prenatal Neurodevelopment]]> 2017-01-08T21:16:02Z 2017-01-19T21:30:21Z bipolar-pregnant-uk

During the prenatal period, the fetus begins to form one of the most complex structures in nature, the human brain. This process is called neural embryogenesis and it represents one of the most complicated processes in prenatal life. The process relies on the tight regulation of behavior of the cells that will make up the brain. Neuronal stem cells (NSC) play a key role in embryonic brain development.

NSCs need a special environment in order to be able to carry out their function in neural embryogenesis, the creation of new cells to populate the nervous system. However, in some cases, harmful environmental exposure can result in abnormal NSC behavior. Prenatal exposure to lead is one of these harmful influences that may overwhelm the NSCs’ mechanisms of coping with cellular damage. As a result, NSC-regulated processes in neural embryogenesis may become affected, often leading to neurodevelopmental disorders.

Upon fertilization, from a single cell, a mass of cells is formed and later this mass divides into several layers from which all structures of the human body originate. This is also the case for the central nervous system. It derives from one of the layers that forms the neural tube, the precursor to the brain, brainstem, and the spinal cord. Initially, the neural tube is rather small, but due to the creation of new cells from NSCs it gradually enlarges. Later, the cells in the neural tube get specialized to different functions by changing their cellular and biochemical characteristics. Evidently, if something goes wrong at any of these steps, developmental brain abnormalities may occur.

Lead has been a part of human civilization for a long period of time. However, only recently has the mechanisms by which lead causes negative health effects began to emerge. Lead is particularly harmful to NSCs, even when the exposure is minimal. Very minimal prenatal exposure to lead has been linked to lower IQ, aggressiveness, and other problems. Research studies have also shown that prenatal exposure to lead produces more harm than exposure during the postnatal period. These findings have been linked to the mechanisms behind cellular injury of NSCs by lead. The proposed mechanisms affect essential cellular functions that result in an increase in reactive oxygen species (ROS) and alterations in DNA methylation.

Reactive oxygen species are molecules that are naturally occurring as a result of cellular respiration. However, during pathologic conditions their levels can increase substantially. Chronic lead intoxication results in the increase of ROS through several mechanisms. Among them, there is a direct effect of lead ions on the proteins that regulate ROS levels. Additionally, lead can increase the level of ROS indirectly through interaction with aminolevulinic acid, a biochemical precursor for the components of hemoglobin. ROS can damage various structures in the cell and while doing this, create even more ROS. Additionally, ROS are involved in cellular death signalling and other cellular responses.

DNA methylation is one of the mechanisms regulating gene expression, and the regulation of gene expression is one of the bases of cellular differentiation. It has been shown that exposure to lead results in the alteration of DNA methylation, which in turn is associated with the inhibition of NSCs differentiation. Through mechanisms that are not yet known, lead causes changes in the methylation patterns close to genes strongly associated with neuronal differentiation.

Cells do not remain passive during these processes. Like other cells, NSCs have mechanism by which they counteract many of these harmful events. One the most recent investigation has studied the process involving the protein Nrf2.

Nrf2 has been directly linked to NSC’s protective mechanism against oxidative stress caused by exposure to lead. Nrf2 is associated with protein KEAP1 in the cytoplasm. When the levels of ROS increases, Nrf2 separates from the KEAP1, migrates to the nucleus and binds to specific DNA regions called antioxidant response elements (AREs). Upon Nrf2 binding, AREs activate expression of its target genes that code for diverse proteins responsible for cellular ROS detoxification.

Additionally, a new Nrf2 target, SPP1 protein, has been recently identified. SPP1 has particular significance in the lesion of NSC because it has been associated with neuroprotective properties through in vitro studies and through the association of mutations in its coding gene sequence with neurological diseases. These effects are the result of the signalling mechanism involving an anti-apoptotic and pro-proliferative process. The process results in compensatory responses to lead inhibition of NSCs proliferation. As a result, SPP1 has been proposed as a protective mediator of neurotoxicity in lead exposure.

Many diseases result from excessive cellular damage that cells are not able to adapt to. This is the case for NSCs where essential neurodevelopmental processes can be altered by lead toxicity. Although NSCs are equipped with protective mechanisms, they are often not powerful enough to counteract the harmful environmental influences. In such cases, the alterations of neural embryogenesis, proliferation, and differentiation take place. Specific changes leading to particular neurological manifestations still remain to be investigated in detail.

Our improved understanding of the harmful effect of lead on prenatal neurodevelopment calls for increased attention to avoid the exposure of future mothers to this toxic element. It is believed that millions of pregnant women around the world are regularly exposed to high concentrations of lead in food and drinking water. This often affects the health of the younger generation in many countries around the world.


Peter J. Wagner, Hae-Ryung Park, Zhaoxi Wang, Rory Kirchner, Yongyue Wei, Li Su, Kirstie Stanfield, Tomas R. Guilarte, Robert O. Wright, David C. Christiani, and Quan Lu (2016) In Vitro Effects of Lead on Gene Expression in Neural Stem Cells and Associations between Upregulated Genes and Cognitive Scores in Children. Environ Health Perspect; DOI:10.1289/EHP265

Temple S. (2001) The development of neural stem cells. Nature 414(6859): 112-7. DOI: 10.1038/35102174

Senut MC, Sen A, Cingolani P, Shaik A, Land SJ, Ruden DM (2014) Lead exposure disrupts global DNA methylation in human embryonic stem cells and alters their neuronal differentiation. Toxicol Sci. 139(1): 142-61. DOI: 10.1093/toxsci/kfu028

Seiji Ishii and Kazue Hashimoto-Torii (2015) Impact of prenatal environmental stress on cortical development. Front. Cell. Neurosci. 9: 207. DOI: 10.3389/fncel.2015.00207

This guest article originally appeared on the award-winning health and science blog and brain-themed community, BrainBlogger: How Prenatal Lead Exposure Results in Neurodevelopmental Disorders.

Anjail Ameen-Rice, LCSW <![CDATA[How to Cope when You Have a Problem with Over Empathizing]]> 2017-01-08T21:20:40Z 2017-01-19T16:45:08Z bigstock-141782249Empathy is defined as the ability to understand and share the feelings of another. Nature allots all of us varying degrees of empathy. Those in the helping professions (psychologists, social workers, counselors, etc.) tend to have a higher level of empathy than those in other positions. To that effect, they often find themselves spending an above average amount of time thinking about other people’s issues. So much so that they feel guilty when they can’t come up with a resolution for that person’s problems.

While it’s great to be a supportive therapist, life coach, friend or family member, being consumed with another person’s issues can become exhausting and at a certain point the person may feel like it’s time to change this behavior.

Here are some helpful tips on how to change this behavior.

Before you begin listening to a person’s problem, set your mind to remember that you are meant to serve as supportive listener. By focusing on what the person is saying, rather than thinking about how you are going to fix or solve their problem, you are creating a boundary whereby once the conversation has ended you will not focus on how you are going to fix their problem.

Second, as you are listening to the person, empathize with them, but realize they are the one who has to get through the problem. Once the person is out of your presence they will be the one who will have to go through it alone, and you must remember to remain hopeful that things will work out well for them. Therefore, your responsibility is to try your best to give them the tools they need to make it through the issue successfully.

After the conversation ends, if you may find yourself burdened with curiosity, consider checking in with the person for an update. During that conversation, it’s best to continue the mindset that you’re only there to offer additional support to the person, but continue to remember that you are not going to take on their issue as if it’s your own.

Utilize faith

Many people identify as having some form of faith. Furthermore, people will make statements like “pray for me”, but forget that prayer is not just a statement, it requires an action. Offering a prayer for the person about their situation is an additional way of relieving yourself from the burden of feeling like their issue is solely your responsibility because you are passing it on to your higher power. Include a prayer for inner peace for yourself to your higher power is also very helpful.

Survey your feelings

If you have an obsessive personality then the root of the reason for your behavior may be an underlying anxiety disorder and you should consider getting yourself evaluated by a professional. Worrying about an issue is normal, however, worrying excessively about issues that are not in your control can be a strong indicator that you may have an anxiety disorder.

Get some rest

Finally get some rest and remind yourself the scenarios we create in our minds are usually worse than reality. 

Release negative feelings

After you have taken all of these step willfully release yourself from any residual feelings of guilt or grief. This is probably the most difficult thing to do, because you’ll find yourself questioning whether or not it’s “ok” to let your residual feelings go.

Ultimately, separating a person’s feelings from your own will allow you to feel less burdened and help you maintain your ability to be a good support system for others.


Gabe Howard <![CDATA[PODCAST: What’s the Difference Between Mental Health and Physical Health?]]> 2017-01-19T15:07:30Z 2017-01-19T11:30:52Z In this episode of the Psych Central Show, hosts Gabe and Vincent discuss the perception that mental health is fundamentally different from physical health. They discuss the lack of biochemical “markers” that can identify physical illnesses and whether we will ever have a simple lab test […]]]>

In this episode of the Psych Central Show, hosts Gabe and Vincent discuss the perception that mental health is fundamentally different from physical health. They discuss the lack of biochemical “markers” that can identify physical illnesses and whether we will ever have a simple lab test to diagnose depression, for example. They discuss how physical illness can affect mental health (and vice versa), and ultimately agree that the difference comes down to just one thing.

Listen as Our Hosts Discuss the Difference Between Mental Health and Physical Health

“Physical health can drive mental health; mental health can drive physical health; and they all live, of course, in one person.” ~ Gabe Howard



About The Psych Central Show Podcast

The Psych Central Show is our newest offering — an interesting, in-depth weekly podcast that looks into all things mental health and psychology. Hosted by Gabe Howard and featuring Vincent M. Wales.

The Psych Central Show Podcast iTunes
Google Play The Psych Central Show


Gabe Howard is a professional speaker, award-winning writer, and mental health advocate who lives with bipolar 1 and anxiety disorders. Diagnosed in 2003, he has made it his mission to put a human face on what it means to live with mental illness.

Gabe writes the Don’t Call Me Crazy Blog for as well as is an associate editor. He also writes and Video Blogs for Bipolar Magazine Online. He’s been a keynote speaker for NAMI (National Alliance on Mental Illness), MHA (Mental Health America), OSU (Ohio State University), along with many other venues. To work with Gabe please contact him via his website at or e-mail


vmw2010squareVincent M. Wales is the author of several award-winning speculative fiction novels and the creator of costumed hero Dynamistress. He lives with persistent depressive disorder and is a trained suicide prevention crisis counselor with additional counseling background. A Pennsylvania native, he obtained his BA in English writing from Penn State. While a resident of Utah, he founded the Freethought Society of Northern Utah. He now lives in Sacramento, California. Visit his websites at and



Previous Episodes can also be found at

Subscribe to The Psych Central Show on iTunes and Google Play.

Matthew Loeb <![CDATA[The Expectation Game]]> 2017-01-08T21:15:55Z 2017-01-18T21:30:29Z Love On Playing Cards“I can’t believe you are choosing that career path,” your domineering father screams.

“You are too nice; you need to be meaner,” your well-meaning uncle prods.

“You are too sensitive,” your mother admonishes.

Monday morning quarterback? What happens when Monday morning is every morning? As you sift through the compliments and criticism, your identity becomes more malleable than Trump’s health care policies.

And borrowing Trump’s parlance, that is a yuuuge problem. You define yourself — not your parents, not your siblings, not your boss. For some of us, this is easier said (or, in my case, written) than done.

Many of us carry childhood expectations like excess baggage. Now into my 30s, I still cringe at my father’s bullying tirades. His obsession: law school. Striding across to collect my law school diploma, my plastered smile belied my simmering resentment. I was more peevish than prideful.

As grey wisps dot my hair, I recognize his fallacy — and mine as well. An admitted people pleaser, I invited others’ feedback — often to my detriment. Craving approval, I unintentionally sidetracked — or delayed — my professional ambitions.

When you devote your life to pleasing others, you sacrifice a part of you. For what? A hollow compliment? You — and I — are better than that.

Let others’ expectations fade into the background. You are your own person–and you dictate your happiness. Try this column. Plotting my next career move, I started submitting articles for Psych Central. Questioning my abilities, my apprehension nearly derailed me. “Who will read these articles? Is divulging my own story self-serving? What will people think of me?” I grimaced.

But in a moment of clarity, I shrugged off the shrieking doubts. I do enjoy writing and, ultimately, this is more about satisfying myself than others. And, yes, it has been empowering to share my successes, doubts, and (I hope) the occasional insight — not to mention writing is more affordable than weekly therapy. Through this unexpected detour into the world of writing, I have also discovered my professional interests: mental interest and leadership. Stepping off the well-worn, “expected” path has been more rewarding than, well, filing that all-consuming brief.

As the calendar year flips, your happiness is dependent on one person: you. Yes, family and friends are important; we need a support system for those hair-splitting days. But, ask yourself, whether you are staying true to yourself: your interests, your passions, and your happiness. Because in your people-pleasin’ quest, you may be discounting the most important person: you.

Jason Drwal, Ph.D. <![CDATA[5 Essential Steps to Rebound from Rejection]]> 2017-01-08T20:46:13Z 2017-01-18T16:45:25Z 3d number five 5 symbol with rustic gold metal

This is Part Three in a series on Overcoming Rejection. Click here for Part One and Part Two.

You were turned down for a date; your boss shot down your proposal; you were never invited back for a second interview; or maybe you were dealt another rejection. What do you do now, especially if rejection stings you more than most people? Follow these five steps to bounce back from rejection.

  1. Take time to heal.
    Rejection stings, even for the strongest of us. We want to either erase it from our memory or analyze it to death. As I mentioned in a post about
    The Number One Mistake in Dealing with Rejection, analyzing your feelings is good but not when you’re an emotional wreck. Research has found that being good at delaying gratification can help people who are sensitive to rejection. One way to delay gratification is to take time away from a hurtful situation, at least until your head clears. This could be a few minutes but more likely a few hours or days. Once you’re feeling calmer, come back and start to figure out what went wrong.
  2. Acknowledge your emotion.
    Amy Morin, author of
    13 Things Mentally Strong People Don’t Do, points out that people who are mentally tough acknowledge their emotions. If you’re sensitive to rejection, you also need to acknowledge your feelings, whether you’re angry, upset, or depressed. That is different than just stewing in hurt and making blanket negative statements, like “Everyone hates me!” or “I’m so stupid!” Understanding your emotions can allow you to start to deal with them more effectively. Look beyond over-generalized negative self-talk and understand how you feel.
  3. Remember no one can reject you without your consent.
    As I discussed in my post on
    Overcoming Rejection: 5 Inspiring Lessons from Famous Women, the most damming effects of rejection come from rejecting ourselves. You have the power to change that and to decide whether you internalize negative feedback and criticism. Rejection doesn’t have to mean we are fatally flawed.
  4. Put away the crystal ball.
    Many studies of rejection sensitive people find that they anticipate rejection and act in ways that make them feel rejected. For example,
    one study found that people sensitive to rejection tended to break up with their partners after conflict, while those low in rejection sensitivity tended to stay together. How ironic that when we feel most vulnerable, we tend to reject others preemptively. This doesn’t mean we’re bad people for being sensitive but be aware of whether you are seeing rejection as inevitable. Try to become more aware of this tendency and recognize that your fears are going to anticipate the worst. If possible, try to think of other alternatives to a situation — not just the bad ones.
  5. Practice self-compassion.
    Loving kindness, also called Metta, is a way to practice self-compassion. Self-compassion is hard for people who are sensitive to rejection but it is a much-needed medicine. Why do we fear rejection? Because we feel vulnerable and flawed. If we learn to love ourselves and have compassion for others, we can heal those pains. The best part is that you don’t have to wait for rejection to develop self-compassion. You can practice
    the loving kindness meditation a few minutes every day and start building more self-acceptance.

These five steps aren’t a cure for the pain of rejection but they will strengthen your ability to rebound from it and to see it in a different light. As you practice them, you’ll find that you have more control over how you feel and eventually learn to let go of rejection.


Ayduk, O., Mendoza-Denton, R., Mischel, W., Downey, G., Peake, P. K., & Rodriguez, M. (2000). Regulating the interpersonal self: strategic self-regulation for coping with rejection sensitivity. Journal of personality and social psychology79(5), 776.

Downey, G., Freitas, A. L., Michaelis, B., & Khouri, H. (1998). The self-fulfilling prophecy in close relationships: rejection sensitivity and rejection by romantic partners. Journal of personality and social psychology75(2), 545.

Therese J. Borchard <![CDATA[How to Handle a Depression Relapse]]> 2017-01-02T21:48:50Z 2017-01-18T11:30:17Z bigstock-136011137For anyone who has ever been debilitated by severe depression, there is nothing more frightening than the feeling that you’re relapsing into another episode. We chalk up the first few days of angst to a bad stretch and hope it gets better from there. But by the time we’ve hit six weeks of crying spells and the kind of anxiety that steals our appetite, there’s usually some panic that we are headed into the Black Hole of Depression yet again.

All of us want so badly to be cured and to find the magical remedy that will make depression and anxiety disappear forever, whether that be a medication combination or a mix of natural therapies. When we find that what we’re doing isn’t enough to keep us immune to the setbacks that often happen with chronic depression, it can be so incredibly frustrating, discouraging, and maddening.

It’s especially scary when the tools that once worked for us during past depressive episodes are no longer effective or cause other problems, and we’re forced to figure this thing out all over again, feeling around in the darkness for sources of light and hope — not knowing if what we hold in our hands is a flashlight or a mouse trap.

Relapsed? You’re Not Alone

In this blog, I try to include all kinds of tips and suggestions for living with depression and anxiety that I’ve gleaned from research or from my own experience. I want to be a source of encouragement for you and to inspire creative ways of tackling an illness. But I realize what helps the reader most is to know that he or she is not alone. When I hear from you, your messages most often say thank you for being real, for admitting that I don’t have sanity figured out, and that I’m merely a companion on the road with you, trying to do my best to reach a point where I’m doing more living and less coping.

In the spirit of that honesty, let me say that I’ve been really struggling for the last few weeks, and it’s made me feel more in touch with the exasperating efforts of so many of you to stay sane. Sometimes the act of getting up in the morning (if you can sleep, that is) and putting on your shoes, trying to tackle another day when you feel so defeated, and so completely dead to the world, is the most beautiful act of courage there is. Sometimes the agreement to hang around for another day on this earth despite the raw pain inside is a warrior’s act of bravery and integrity.

I hate relapse. There is nothing more unsettling to my core than the first few weeks that I can’t restrain my crying — especially in public places — and when simple decisions that I have to make in a grocery store between two types of brands of yogurt can render me disabled. I detest the painful ruminations that play over and over again in my brain, even as I try like hell to practice mindfulness techniques and stay in the moment. I abhor lying awake at night, knowing that my sleeplessness will cause more tears the next day. And I loathe that feeling of being trapped in this world — with no exit ramp available — which stalks me throughout the day and night.

But resisting and running from the relapse only makes things worse. I’m learning with each depression setback that I must lean into it — that I can spare myself some of the suffering attached to it if I simply let it be. It’s important to identify any triggers that may have caused it, to make amendments wherever possible, and to get the necessary blood work done or to check in with a physician about certain biochemical changes in your body that may be causing it. In my case, there were lots of those. But I keep on learning the same difficult message in the midst of relapse: that by wanting things to be different, I add to my pain. Conversely, when I can let go of that person I wish I were, the functioning body I so desperately want, and the reality that I want to be mine, when I can accept the very painful moment or hour or day for what it is, I can experience a bit of calm within the anguish.

Painful Lessons I’ve Learned from Depression Relapses

What has consoled me when I begin to panic and let fear drive my emotions is to remember that setbacks are not permanent conditions. Relapses don’t last into infinity. The perspective I have in the midst of my intense struggle insists that I will feel this way forever. But my track record for getting better is 100 percent. So is yours. Even within the worst hours of my relapses are found moments where the pain is less intense, and where I can catch my breath and get ready for the next round of contractions. If I analyze the discomfort, I will find that it isn’t solid, and that there are holes of stillness I can look forward to — that I can attach myself to like buoys in the waves of distress.

Relapse teaches me over and over again that life isn’t linear and often can’t fit into a neat outline. As hard as we try to control all the aspects of our mental health, those of us who’ve suffered the beast of depression in a chronic way will most likely run into relapse more than once in our lives. These setbacks, as painful as they are, teach us invaluable lessons like how to accept messiness, frustration, and ambiguity with grace.

They teach us, like Gilda Radner once wrote, that “some poems don’t rhyme, and some stories don’t have a clear beginning, middle, and end” … that “life is about not knowing, having to change, taking the moment and making the best of it, without knowing what’s going to happen next.”

Join Project Beyond Blue, the new depression community.

Originally posted on Sanity Break at Everyday Health.

Jennifer Artesani, M.Ed., LMHC <![CDATA[Backhanded Compliments: Identify, Recognize, & Resolve]]> 2017-01-08T20:56:47Z 2017-01-17T21:30:59Z Caucasian businesswoman giving a bribe. Uncorrupted businesswomaEver give a compliment to someone and they seemed upset with you? Maybe they did not show the gratitude you thought they would or gave you a funny look after. This could be the result of accidentally giving a backhanded compliment.

A backhanded compliment is a compliment that actually has an insult in it as well. WHAT?! I know, seems to not make much sense right? How could complimenting someone be loaded with an insult? Especially when we had no intentions of insulting the person. Unfortunately, it happens.

The purpose of this article is to help us recognize what areas of a compliment could be perceived as an insult to help us better avoid accidental backhanded compliments. We will also discuss how to recognize if you may have just given one and how to resolve the situation.


Let’s start with an example so we can make better sense of this. Your friend comes up to you and excitedly informs you that they just got into the local college. You’re happy for them and want to give them a compliment. You might say “Congrats! That’s a great school for a state school.” OOPS! We may have just insulted them.

Let’s break it down. It is a compliment to say “congrats” and it’s a compliment to call it a “great school.” In our mind we also may feel that pointing out the fact that it’s a great school for a state school is a compliment. However, it may not be perceived that way. What they might hear is “That’s a great school… but only for a state school and not when being compared with other schools.”

I know this may be frustrating because it’s not what you meant. Try to ask yourself if the compliment you are giving can be perceived in any other way. You could either shorten your compliment and say “Congrats! That’s a great school!” because it’s not necessary that they know the facts of it being a great state school. You can also rephrase it if you really wanted them to know that it’s one of the top state schools. This may look like this “Congrats! That’s a great school! It’s one of the top rated schools of the state.”


Now we want to prepare for when we do give a backhanded compliment (because we all accidentally do at some point). Notice if after you give a compliment if the person tightens up their face or body posture or if their expression falls more flat. You can also notice if they gasp or move their face back (such as being taken aback). These may be signs they felt your compliment had an insult in it.

Let’s try an example. You notice your friend cut their hair and you like it. You might say “I like your hair like that, it’s so much better this way!” OOPS again! They stopped smiling and their jaw drops and eyebrows raise up. This is also a sign they are upset, confused, or surprised. Can you think of what part they might have taken as an insult? It’s the part where you unintentionally insulted their previous hair style. By saying “it’s so much better this way” you are also saying “that last way was not as good” or “I did not like that other hair cut.”

So let’s try this again. “I like your hair like that” is a way to simplify it without taking the chance of adding an insult accidentally. You can also try, “I like your hair, it looked great before but I’m really liking this new look too!”


The purpose of the previous paragraph was to be aware of signs the other person may give us that we have given them a backhanded compliment. Once we’ve identified the person is upset we can try and resolve it. We can do this even when we are not sure if they are upset or what we said that was taken as an insult.

A good rule of thumb if you think someone is upset but are not sure is to simply ask (much better then assuming). Simply say something like “you look upset, did I say something to upset you?” Hopefully they will be honest and tell you the truth so you can work on resolving the issue.

If they say that they are upset keep it simple again. Rather than explaining yourself and what you said you can simply let them know you are sorry and that it was not your intention to upset them. A lot of times we think we need to explain ourselves or defend our statement when really we just need to apologize and accept it offended them in order to move on.

Let’s recap. A backhanded compliment is usually a well-intentioned compliment that unintentionally had an insult buried in it. We can identify if we have given one to someone by their response. If we do feel their response indicates we have insulted them we can directly ask them and then simply apologize that it was not our intent.

So don’t be afraid to give compliments. If you’re ever not sure just keep it simple! 

Knowing we sometimes give backhanded compliments on accident it’s good for us to realize that if we ever receive one that it may also be an accident. Remember, don’t assume it was meant to insult you. If you’re really upset just let them know what exactly hurt your feelings. 

John M. Grohol, Psy.D. <![CDATA[Trying to Lose Weight? Maybe You Should Ditch That New Wearable]]> 2017-01-20T02:03:14Z 2017-01-17T16:45:43Z Wearable technology — those gadgets people wear around their wrist to track their heart rate or number of steps walked or run — is all the rage. This sort of personal data tracking is especially popular among younger people and those who exercise regularly. Whether it’s […]]]>

Wearable technology — those gadgets people wear around their wrist to track their heart rate or number of steps walked or run — is all the rage. This sort of personal data tracking is especially popular among younger people and those who exercise regularly. Whether it’s a Fitbit, Nike+ Fuelband, a Garmin Vivofit, or some other fitness tracker, people love the ability to easily track their progress over time.

But if you’re wearing one of these devices while trying to lose weight, you may find it surprising that wearable technology likely won’t help you — and could even hurt (a little) in your weight-loss journey.

Can Fitbit & Other Wearables Help You Lose Weight?

Science, of course, can help us answer this question. The latest study to shed light on this area was published in the journal JAMA in September 2016, by Jakicic et al., and followed 470 younger adults (ages 18 to 35) over the course of two years. In this randomized clinical trial, researchers placed 233 subjects in the standard intervention group and 237 people in the enhanced intervention group (whose members eventually wore a wearable technology device to help track their progress). Just over 74 percent of people completed the study.

All participants in the study were placed on a low-calorie diet, prescribed a certain amount of physical activity per week, and had group counseling sessions. At the six-month mark, both groups added telephone counseling sessions, text message prompts, and access to study materials on a website.

At the same six-month mark, participants who were in the standard intervention group started self-monitoring of diet and physical activity using a website. Those randomly assigned to the enhanced intervention group were provided with a wearable device and accompanying web interface to monitor diet and physical activity.

At the end of two years, both groups had significant improvements in their physical fitness, activity, and diet, as well as their physical composition.

The surprising finding was that for members of the group who wore a wearable such as a Fitbit, they lost a little less than half the weight of the standard intervention group. The standard group lost an average of 13 lbs. compared to the wearable group’s of just over 7 lbs. That’s a significant 41 percent difference.

To be clear, this study found that if you sport a wearable such as a Fitbit in your efforts to lose weight, you will actually lose significantly less weight than if you didn’t wear the fitness tracker. You will still lose weight — assuming you stick to the exercise, diet, and other things the study provided participants, such as group counseling. You’ll just lose less weight than if you hadn’t bothered with the Fitbit in the first place.

Why would technology work against the user in this way?

It could be discouraging for some people to see their objective fitness numbers on days they don’t exercise as much as they normally do. The numbers could also encourage individuals to eat a little bit more than they normally would, since they can review their efforts in real-time — something not typically possible without a fitness tracker. “Hey, I did an extra 10 percent in my workout today! I deserve a special treat!” the thinking might go.

The Dangers of Technology Before Research

This study points out a significant problem facing our culture today. Technology moves much faster than the research that’s needed in order to prove whether the technology’s benefits are real or not. Not only is this true in the case of wearables, but virtually every health app available for download today lacks research support for its intended use. There are virtually no long-term studies on the impact of this kind of technology — the JAMA study being one of the very few available today.

Lacking the necessary research foundation, these technology tools encourage consumers to spend hundreds of millions of dollars annually on things that may provide little actual benefit. You could look at it much like those brain-training programs that were all the rage a few years ago — programs that had very little actual research backing the specific tools for their marketed benefits. Worse yet, a study published earlier in 2016 (Murakami et al., 2016) found that some fitness trackers may wildly misstate calorie counts.

Technology is sadly all-too-often taking the role of the new snake oil, marketed not by sideshow hucksters, but by multinational technology companies who see a large sales opportunity with little risk. Nobody seems to care that not only do many of these apps and technologies not work quite in the way they are marketed, but they may actually cause you trouble in your efforts to improve or change a part of your life.

Our recommendation? Feel free to use fitness trackers, but don’t obsess over the numbers they provide, or believe they’re giving you any kind of permission to indulge on a day the numbers say you’ve expended more calories. Take their numbers with a grain of salt. Focus on eating a healthy diet, cut down on snacks and sweets, and exercise regularly — with or without a fitness tracker.



John M. Jakicic, Kelliann K. Davis, Renee J. Rogers, et al. (2016). Effect of Wearable Technology Combined With a Lifestyle Intervention on Long-term Weight Loss The IDEA Randomized Clinical Trial. JAMA, 316, 1161-1171. doi:10.1001/jama.2016.12858

Murakami H, Kawakami R, Nakae S, Nakata Y, Ishikawa-Takata K, Tanaka S, Miyachi M. Accuracy of Wearable Devices for Estimating Total Energy Expenditure Comparison With Metabolic Chamber and Doubly Labeled Water Method. JAMA Intern Med. 2016;176(5):702-703. doi:10.1001/jamainternmed.2016.0152

Brandi-Ann Uyemura, M.A. <![CDATA[Best of Our Blogs: January 17, 2017]]> 2017-01-16T23:07:12Z 2017-01-17T11:30:43Z As I write this, it is Martin Luther King, Jr. Day. With the state of the world today, let’s all take time to exercise and practice the promising dreams of a hopeful and powerful leader. On The King Center website, his wife Coretta Scott King shares […]]]>

As I write this, it is Martin Luther King, Jr. Day. With the state of the world today, let’s all take time to exercise and practice the promising dreams of a hopeful and powerful leader. On The King Center website, his wife Coretta Scott King shares the best ways we can do that.

“The Martin Luther King, Jr. Holiday celebrates the life and legacy of a man who brought hope and healing to America. We commemorate as well the timeless values he taught us through his example — the values of courage, truth, justice, compassion, dignity, humility and service that so radiantly defined Dr. King’s character and empowered his leadership. On this holiday, we commemorate the universal, unconditional love, forgiveness and nonviolence that empowered his revolutionary spirit.”

Continue to celebrate with our posts this week which will enrich your relationships and change the way you think about church, compliments and codependency.

An Obstacle to The 5 Stages of Grief: Emotional Neglect From Childhood
(Childhood Emotional Neglect) – It’s a test on how you live your life that you wouldn’t expect. Here’s how your childhood prevents you from healthy grieving and what you can do about it.

Narcissism in the Church
(Narcissism Meets Normalcy) – Church should be a place of peace, love and community. But here Lenora shares why it’s so triggering and toxic for those who grew up in a narcissistic family.

Are You in a Codependent Relationship?
(Happily Imperfect) – It’s the reason why you feel resentful and drained in your relationship. Here are the signs of codependency and how to change it.

IQ May Matter in Bipolar Disorder
(Bipolar Laid Bare) – New research unveils a relationship between IQ and bipolar disorder. Find out how intelligence could potentially protect individuals from some of the effects of bipolar.

How Flattery Can Be Abusive
(The Exhausted Woman) – When is a compliment not a compliment? When its intention is to manipulate, control or abuse another person.

ML Walker <![CDATA[One Year Later. Mom’s Still Dead.]]> 2017-01-04T22:50:45Z 2017-01-16T21:30:44Z Grief. It’s a funny thing. I don’t understand it and I don’t want to, I just wish it would go away. One year and a half later and I still find myself crying mid-day because I can’t call my Mom to remind me that everything […]]]>

Grief. It’s a funny thing. I don’t understand it and I don’t want to, I just wish it would go away. One year and a half later and I still find myself crying mid-day because I can’t call my Mom to remind me that everything is going to be okay. Sure, the impact of losing her has changed — the first year I spent many nights dreaming about her, re-living the events leading up to her death, and wishing that I would awaken and somehow she would be there, here, with me. I cried and prayed that I would awaken and find out that this was all unreal, that she somehow miraculously came back to life! That she is still here, still alive, and still with me. Day after day, I waited, hoped, listened, for her return. Wishful thinking…and emotional exhaustion is all that I have been left with.

Distracting myself has also taken its course. At first, I found comfort going through all of her things, unearthing stuff from the house I grew up in, looking at old pictures and reminiscing on memories. All of these activities somehow made me think that she was still alive, still vibrant, still with me. When those feelings rendered themselves useless, I found myself absorbing my life in work, in love, in alcohol — in anything to stop me from feeling, really feeling, and embracing the reality that she is gone.

One foot wants to live in denial because denial means that my life is still the same and I still have her to fall back on and to make things better. One foot wants to move on, to see a life full and complete without a mother to depend on, to see that I am going to be okay. Welcome to Purgatory. 

The triggers are random and come at me with an unfaltering, intangible, unforgivable force. It’s as simple as a friend complaining about her overbearing mother who won’t stop calling, seeing a bald woman who is obviously going through chemo, hearing a song on the radio, a stupid holiday weekend, not knowing how to clean a wood floor that I would have asked her advice on, a voice in my head that sounds like her. These small, simple things send me into a loop of despair and tears.

There is no way to see it coming, to prepare, to know. It just hits me like a bolt of energy, energy so encompassing I have to stop whatever it was I was doing. It’s unnerving, inevitable, and on some level comforting, for in that moment, I am reminded of what I have lost, and I know that her memory will always live in me. She is never really gone; I am never really without her. Years may go by, feelings may fade, but her memory lives on. Her legacy lives on in us.

As I’m still, STILL! working through the grief of losing her, I am no longer seething with anger at the doctors or the unfairness of the situation, and in its place, I just feel sad. Lost. Scared.

As every sun sets, as every new wrinkle sets in, as every moment of self-pity renders itself useless, as every action or mannerism I find myself displaying that she used to do. For every one of these moments, I am reminded of my Mother. These small occurrences make me crave her, my beautiful Mother, even more. I find some days are really really hard to be without my Mom, others remind me that I was lucky to have her as long as I did, that others are far worse off than I am, than I was. I suppose it may always be this way.

Abe Kass, M.A. R.S.W., R.M.F.T. <![CDATA[Candid Conversation Is a Necessary Step for Surviving Infidelity]]> 2017-01-04T21:20:36Z 2017-01-16T16:45:03Z Businesswoman and business man having a very serious conversatioAs painful as infidelity is — often deeply wounding both partners — it is not a topic that can be avoided.

Couples that stand a realistic chance to repair their relationship in the aftermath of infidelity must set aside time alone to discuss what happen and share their feelings.

Doing so is the fifth of seven steps that I’ve identified, which if carefully followed by both partners, provide the best chance of avoiding dissolution of the relationship. In fact, these 7 Survival Steps offer a path to move forward together as a caring, dedicated, and respectful couple.

[You can view all of my prior Psych Central articles on infidelity and other topics here:]

Step #5, which I discuss in this article, is: Make Time to Discuss the Affair and Your Feelings. For most couples, a limited period each day works best — so that neither partner gets overwhelmed.

A vital part of recovering from infidelity comes when the partner who was betrayed — eventually, can offer forgiveness to the partner who strayed. For that to happen, and for forgiveness to be genuine, the partner who was betrayed must know enough about the affair so that her (or his) forgiveness actually means something.

For the sake of illustration, in this article I will refer to the partner was betrayed as “Sue” and the partner who strayed as “John.” I will name John’s sexual partner, “Violet.” The model would be no different if the gender roles were reversed and it was John who was betrayed and Sue who strayed. John and Sue are a fictional couple but represent a composite of many men and women who I’ve helped over the years.

Sue will have questions about John’s affair with Violet. Sue has a right, and a need to ask — although it’s important that the questions aren’t simply anger expressing itself in disguise.

The intent of the questions must be to obtain necessary information, not extract revenge, or to uncover unnecessary details that can only create more pain and haunting images.

These are some examples of questions that are generally appropriate for the partner who was betrayed to ask of the partner who strayed:

  • When did the affair start?
  • Where did you meet?
  • How often did you meet?
  • How much did you tell him/her about us?
  • Did you discuss our sexual life with him/her?
  • Who else knows about the affair?
  • Are there any photos or videos of the two of you?
  • If yes, are any of them of a sexual nature?
  • How have you left it with your sexual partner?
  • Did you take precautions against sexually transmitted diseases?
  • If yes, be specific.
  • Did you give (him/her) any gifts?
  • Did he/she give you any gifts?

These are some examples of questions that are generally best to avoid:

  • What attracted you to him/her?
  • Do you love him/her?
  • Do you still love me?
  • Is she/he more physically attractive to you than I am?
  • Describe specific sexual acts you engaged in? (Did you do intimate things with him/her that we don’t do?)
  • Did you have pet names for each other?

Sue doesn’t need to know every detail. And needless to say, John must answer Sue’s questions fully and truthfully. Lying was integral to John’s affair, and has no place in the recovery.

The healing process in the aftermath of infidelity is emotionally difficult. It may take Sue and John many weeks, even months to complete.

Sue and John, like all couples rebounding from infidelity, should take it slowly. Pushing too hard and going too fast might lead to fighting and actually further damage their already fragile relationship. (It is often advisable for couples recovering from infidelity to seek the assistance and support of a relationship therapist.)

If Sue needs time to rage and vent, that’s understandable. She should be cautious, however, recognizing that words once spoken, can never be unspoken.

So even in anger, if Sue hopes to preserve her marriage to John, she must always be respectful and mindful of her words.

Are you or a family member struggling to cope with the aftermath of infidelity? I offer other helpful articles at

Lynn Margolies, PhD <![CDATA[Stressed Out Teens & Empathic Parents: What to Do When It’s Contagious?]]> 2017-01-04T21:20:52Z 2017-01-16T11:30:31Z Teenage Girl In Trouble With ParentsThough we hear a lot about the effect of parents on children’s development, parenting, like other close relationships, is a reciprocal interaction — not a one-way street. Children with difficult challenges, such as executive function deficits, can tax any parent’s equilibrium. Parents of teens with such issues are often overwhelmed and under increased stress.

Repeated experiences of frustration and defeat in the context of a mounting problem can lead any parent to feel rejected, helpless and increasingly anxious. When, on top of this, there is a particularly strong empathic emotional connection or identification with the child, parents are at risk for falling into a common counterproductive parenting pattern fueled by excessive empathy, worry and guilt.

James, 16, was a good kid — well-liked by peers, teachers and other adults. He struggled at school and with homework due to intermingling executive function deficits, anxiety, and depression. Anxiety made it harder for him to think and focus, while the impact of feeling incompetent again and again generated more anxiety, dread, and depression.

James pretended he had everything under control but secretly felt stupid and ashamed. He desperately tried to escape blowing his cover using avoidance, procrastination, and cover up. At times, when agitation and panic spilled out, everyone’s instinct was to rescue him, for example, by letting him leave school to go home.

The course of this cycle of escape and inevitable crash was painfully obvious to his mom, Abby — who lived with an insidious feeling of anxiety and dread on her son’s behalf, that was uncannily similar to his own feelings.  James was attached to his mom but acted irritable and rejecting when she asked him anything about his homework, yelling at her to leave him alone and accusing her of not trusting him. Though Abby was a good mom — smart, informed, and intuitive — she became increasingly cautious and tentative to avoided upsetting James — knowing how demoralized he could become.

What went wrong here?

Intuitive parents like Abby with a sensitive emotional connection to their teen can experience a vicarious visceral awareness of teens’ distress. Tuning in to teens is essential in order for parents to sense what teens are going through and for teens to feel seen. But, as in this example, empathy can go awry, functioning as a contagion effect in which parents “catch” teens’  pain and hone in on it. When this happens, parents in effect become a mirror of teens’ disabling feelings, and temporarily lose access to their own executive functions — leaving no one with sufficient distance, flexibility, perspective, or equanimity to help.

Abby was sensitively linked to James’ anxiety and dread of failure, to the point of experiencing these feelings on her own and his behalf, leading to colluding in anxious avoidance. This dynamic developed into an unhelpful pattern of cautious, overprotective parenting — a common problem afflicting parents who bear excessive anxiety and fear on their teens’ behalf, and/or their own.

The problem with over cautious, overprotective parenting:

Fearful of triggering James into feeling deflated, upset, or mad — Abby learned to tiptoe around him. Paradoxically, using kid gloves had the opposite effect — unconsciously communicating a lack of faith and validating his view of himself as weak, defective, and bad. This approach also left James’ emotions in charge and, not only gave him power he couldn’t manage, but fueled a cycle of irritability, guilt, and shame.

James mom did not speak about the truth they both knew — in an effort to protect him from feeling exposed and despondent. However, doing so perpetuated the ever-increasing burden of lies and isolation he had to bear. Further, from a skill building point of view, rescuing James by avoiding hard topics and letting him leave school when panicky, for example, rewarded avoidance by giving him instant relief. Alternatively, when escape isn’t available, it creates the space and incentive for teens to learn new strategies — if given the opportunity — breaking the cycle of avoidance.   

Positive example of talking to teens about difficult things:

Abby sought help for James and parenting guidance for herself. Learning how to access a more composed frame of mind, Abby gained the ability to handle James differently and was able to rebound from times when she couldn’t .

James lied again about having handed in his research paper and other homework and his mom was on to him, as always.

Phase 1: Making a request, planning

This time, instead of asking him and pretending she believed him, she approached him and said, “James, I need 10 minutes to talk. (Time limited, manageable, neutral enough. Note that she isn’t telling him what he needs.) When can we do this?” (Respectful, considers his terms and timing.)


“Hey, I have an idea?” (If done in a positive tone authentically, this often works — encouraging curiosity. Wait to hear what he says.)  

Phase 2: Setting the stage

“I want to tell you something as your mom — it’s not anything bad.” (alleviates fear).

“Can you agree to stay calm and not react…just listen and consider what I’m saying?” (Sets a manageable expectation; allows him to activate his executive functions and prepare rather than be taken by surprise and react instinctively, implies a positive  expectation that he’s capable of this.)

“Afterwards, if you want to dismiss it that’s fine.” (Allows him autonomy and control, makes it more manageable.)

“Can you agree to do this? Or in some cases, use the challenge of “Do you think you can do that?”  but only you think this won’t be perceived as blaming or condescending   (gets his consent, making it more likely  he’ll comply)

Phase 3: Delivering the message

“I’m not sure but I think (being tentative allows him to avoid a control struggle because you’re not telling him who he is) that when you feel things are too much — your natural reaction is to block them out and not think about things to get space and some peace (makes it sound understandable that he does this)

“I have the feeling that you may be in over your head right now and maybe haven’t handed stuff in (alleviates stress because the secret is out, without exposing him)  

“I may be wrong (reinforces his autonomy, gives him freedom to consider it since you’re not forcing your belief on him)”

“But I’m just asking you to consider this — I don’t need you to give me an answer or anything. “

“If it were true (help him save face) I think there might be options we can think about together if you wanted to (offering to problem solve implies there are options even he doesn’t take you up on it then).

Approaching — rather than avoiding — problems using a confident, matter-of-fact, respectful demeanor and time-limited, planned approach can desensitize teens to their fear of anxiety (the cause of panic). The accumulated experience of doing this expands teens’ capacity to tolerate feelings rather than have meltdowns.

A calm and balanced emotional climate provides the backdrop teens need to stretch themselves without becoming flooded or avoidant — challenging teens within the limits of their capacity (not too little and not too much). When Abby was able to be forthright, courageous and calm while facing difficulties with James, she appealed to his higher level of functioning. Interestingly, when she did this he often succeeded in living up to these expectations.

Through their interactions Abby gave James the chance to experience himself as more capable and cooperative, as well as relieve the burden created by having to hide and cover up. Vicarious transmission of feelings in closely linked parents and teens can be a risk factor for unhealthy contagion, but can also give parents an edge in impacting teens positively when parents are able to “hold their own.”

Through staying grounded and steady, Abby was able to create a better, healthier relationship with her son — which is parents’ most important tool and teens’ most protective resource.  In addition, through their connection, James’ mom also transmitted to him the tune of a more regulated state of mind.

Disclaimer: The characters from these vignettes are fictitious. They were derived from a composite of people and events for the purpose of representing real-life situations and psychological dilemmas that occur in families.