Of course, feeling trapped is a state of mind. No one needs consent to leave a relationship. Millions of people remain in unhappy relationships that range from empty to abusive for many reasons; however, the feeling of suffocation or of having no choices stems from fear that’s often unconscious.

People give many explanations for staying in bad relationships, ranging from caring for young children to caring for a sick mate. One man was too afraid and guilt-ridden to leave his ill wife (11 years his senior). His ambivalence made him so distressed, he died before she did! Money binds couples, too, especially in a bad economy. Yet, more affluent couples may cling to a comfortable lifestyle, while their marriage dissolves into a business arrangement.

Homemakers fear being self-supporting or single moms, and breadwinners dread paying support and seeing their assets divided. Often spouses fear feeling shamed for leaving a “failed” marriage. Some even worry their spouse may harm him- or herself. Battered women may stay out of fear of retaliation. Most people tell themselves “The grass isn’t any greener,” believe they’re too old to find love again and imagine nightmarish online dating scenarios. Also, some cultures still stigmatize divorce.

Unconscious Fears

Despite the abundance of reasons, many of which are realistic, there are deeper, unconscious ones that keep people trapped – usually fears of separation and loneliness. In longer relationships, spouses often don’t develop individual activities or support networks. In the past, an extended family served that function.

Whereas women tend to have girlfriends in whom they confide and are usually closer with their parents, traditionally, men focus on work, but disregard their emotional needs and rely exclusively on their wife for support. Yet, both men and women often neglect developing individual interests. Some codependent women give up their friends, hobbies, and activities and adopt those of their male companions. The combined effect of this adds to fears of loneliness and isolation people envisage from being on their own.

For spouses married a number of years, their identity may be as a “husband” or “wife” – a “provider” or “homemaker.” The loneliness experienced upon divorce is tinged with feeling lost. It’s an identity crisis. This also may be significant for a noncustodial parent, for whom parenting is a major source of self-esteem.

Some people have never lived alone. They left home or their college roommate for a marriage or romantic partner. The relationship helped them leave home – physically. Yet, they’ve never completed the developmental milestone of “leaving home” psychologically, meaning becoming an autonomous adult. They are as tied to their mate as they once were to their parents.

Going through divorce or separation brings with it all of the unfinished work of becoming an independent “adult.” Fears about leaving their spouse and children may be reiterations of the fears and guilt that they would have had upon separating from their parents, which were avoided by quickly getting into a relationship or marriage.

Guilt about leaving a spouse may be due to the fact that their parents didn’t appropriately encourage emotional separation. Although the negative impact of divorce upon children is real, parents’ worries may also be projections of fears for themselves. This is compounded if they suffered from their parents’ divorce.

Lack of Autonomy

Autonomy implies being an emotionally secure, separate, and independent person. The lack of autonomy not only makes separation difficult, it naturally also makes people more dependent upon their partner. The consequence is that people feel trapped or “on the fence” and wracked with ambivalence. On one hand, they crave freedom and independence; on the other hand, they want the security of a relationship – even a bad one. Autonomy doesn’t mean you don’t need others. In fact, it allows you to experience healthy dependence on others without the fear of suffocation. Examples of psychological autonomy include:

1. You don’t feel lost and empty when you’re alone.
2. You don’t feel responsible for others’ feelings and actions.
3. You don’t take things personally.
4. You can make decisions on your own.
5. You have your own opinions and values and aren’t easily suggestible.
6. You can initiate and do things on your own.
7. You can say “no” and ask for space.
8. You have your own friends.

Often, it’s this lack of autonomy that makes people unhappy in relationships or unable to commit. Because they can’t leave, they fear getting close. They’re afraid of even more dependence – of losing themselves completely. They may people-please or sacrifice their needs, interests, and friends, and then build resentments toward their partner.

A Way Out of Your Unhappiness

The way out may not require leaving the relationship. Freedom is an inside job. Develop a support system and become more independent and assertive. Take responsibility for your happiness by developing your passions instead of focusing on the relationship. Find out more about becoming assertive in my e-book, How to Speak Your Mind — Become Assertive and Set Limits.

I’m just getting to know Michelle. She had her first baby 3 weeks ago and has been sad and irritable ever since. Her pediatrician was worried about her at the well-baby visit this week and sent her to me. She’d had a tough pregnancy (morning sickness that wouldn’t quit for what felt to her like forever), made tougher by the financial stress that came from her husband being out of work for several months. The doctor is worried that she and her baby aren’t getting off to a good start.

Sadly, moms like Michelle often feel alone and guilty. Not feeling what they think they are supposed to feel, they are embarrassed to admit to themselves and others that things aren’t going well. Just when they need help the most, many don’t reach out. Some start to resent their babies and begrudge them time and attention. They force themselves to do what needs to be done but don’t provide their newborns with the nurturing they need.

Still others give up on nursing, or holding their babies when bottle feeding, depriving themselves and their babies with the closeness that comes with the quiet feeding times. Propping a bottle is the best they can do. Overtired, irritable, and sinking into depression, life after birth isn’t at all what they expected.

As hormones shift and settle, it’s absolutely normal to feel what is commonly known as the baby blues in the weeks following birth. One of my clients described the first couple of weeks after her first child was born as PMS times ten. Others feel more emotionally fragile than usual and maybe a little weepy. Still others are surprised that they are on an emotional roller coaster, feeling great one minute and set off into tears by something that normally wouldn’t bother them the next. It’s all because the endorphins from delivery are leaving the new mother’s system and the body is resetting itself.

Different women react differently but normal baby blues are usually accompanied by moments of joy and wonder and happiness about the baby and motherhood. The emotions settle down after a couple of weeks and the routines and rhythms of new parenting get established.

But when those up and downs last more than a few weeks, and especially if they get worse, it may indicate that the new mom is developing postpartum depression (PPD). This happens to between 11 and 18 percent of new mothers, according to a 2010 survey by the Centers for Disease Control (CDC). Surprisingly, it can last anywhere from a couple of months to a couple of years.

Symptoms of Postpartum Depression

Postpartum depression looks like any major depression. Things that once gave the mother pleasure are no longer fun or interesting. She has trouble concentrating and making decisions. There are disturbances in sleep, appetite, and sexual interest. In some cases, there are thoughts of suicide. Many report feeling disconnected from their baby and some worry that they will hurt their baby. Feelings of hopelessness, helplessness and worthlessness immobilize them. Many feel guilty that they can’t love their child, which makes them feel even more inadequate.

In some cases, women develop psychotic delusions, thinking their baby is possessed or has special and frightening powers. Sadly, in some cases, the psychosis includes command hallucinations to kill the child.

Who Develops Postpartum Depression?

There are a number of issues that contribute to a woman’s risk of developing PPD:

• A prior diagnosis of major depression. Up to 30 percent of women who have had an episode of major depression also develop PPD.
• Having a relative who has ever had major depression or PDD seems to be a contributing factor.
• Lack of education about what to realistically expect of herself or the baby. Teen mothers who idealized what it would mean to have a baby to love with little appreciation for the work involved are especially vulnerable.
• Lack of an adequate support system. Unable to turn to someone for practical help or emotional support, a vulnerable new mom can become easily overwhelmed.
• A pregnancy or birth that had complications, especially if mother and baby had to be separated after the birth in order for one or the other to recover. This can get in the way of normal mother-child bonding.
• Being under unusual stress already. New mothers who are also dealing with financial stress, a shaky relationship with the baby’s dad, family problems, or isolation are more vulnerable.
• Multiple births. The demands of multiple babies are overwhelming even with substantial support.
• Having a miscarriage or stillbirth. The normal grieving of loss is made worse by the shifting hormones.

What to Do

In cases of the normal “baby blues,” often all a new mom needs is reassurance and some more practical help. Engaging the dad to be more helpful, joining a support group for new parents, or finding other sources of support so the mom can get some rest and develop more confidence in her mothering instincts and skills can put things back on track. As with any other stressful or demanding situation, new parenthood goes better when the parents are eating right, getting enough sleep, and getting some exercise. Friends and family can help by bringing some dinners, offering to take over with the baby for an hour or so so that the parents can get a nap, or by babysitting siblings to give the parents time to focus on the infant without feeling guilty or pulled in multiple directions.

Postpartum depression, however, is a serious condition that requires more than naps and caring attention. If the problem has persisted beyond a few weeks and has been unresponsive to support and help, the mother should first be evaluated for a medical condition. Sometimes a vitamin deficiency or another undiagnosed problem is a contributing factor.

If she is medically okay, those who care about her and her baby need to encourage her to get some counseling, both for the emotional support counseling offers and for some practical advice. Cognitive-behavioral treatment seems to be especially helpful. Since women who have experienced postpartum depression are vulnerable to having another episode of depression in their lives, it is wise to establish a relationship with a mental health counselor to make it easier to seek help if it is needed in the future. If the mom has had thoughts of suicide or infanticide, the therapist can help the family learn how to protect them both. If the birthing center or hospital offers a PPD support group, the new mom and dad should be encouraged to try it. Finally, sometimes psychotropic medications are indicated to alleviate the depression.

The baby blues are uncomfortable. Postpartum depression is serious. In either case, a new mom deserves to get practical help from family and friends. When that alone doesn’t help a new mom adjust, it’s time to seek out professional help as well.

Neurobiology of Breaking Habits

Self-destructive behavior patterns, such as addictions, are hard to break because they provide immediate relief. But their aftermath makes people defeated and ashamed, requiring more relief, and the cycle continues. These habitual, compulsive behavior patterns limit new learning and connections in the brain by obstructing opportunities to experience the positive rewards from sustainable, effective coping strategies.

Kaitlyn, 17, was bright, vibrant and charismatic. She was adopted at birth (and knew this all along), then struggled from early childhood with both epilepsy and an unbearable sense of psychological pain and inner isolation she could not articulate.

Kaitlyn’s shame and sense of herself as unlovable had its origins in feeling unwanted and abandoned. She was naturally outspoken, gregarious and likable, but developed an early pattern of self-consciousness and inhibition with peers, driven by fear of rejection. She learned to act according to what she thought friends and boys wanted – anxious to be liked and secure her relationships.

Shame, Rage and Self-Harm

Kaitlyn had a history of self-harm, typically provoked by real or imagined rejection. She harbored a secret fantasy of being hurt and then rescued, and impulses to make her pain visible and have it validated by others. This dynamic was an unconscious attempt to manage overpowering feelings. It brought others close enough so she wasn’t alone, while reassuring her she was still loved.

Shame is a terrible feeling of badness associated with wanting to hide one’s head and disappear. Kaitlyn’s feeling of shame and badness was fueled by episodes of rage at home, confirming her fear that she was a “monster” who drove people away and didn’t deserve love and happiness. Rage can be a defense against intolerable shame, when shame turns into blame and is projected onto others. In this way, the bad feeling is passed on like a hot potato, providing temporary respite from feeing terrible, but propelling the cycle of shame and self-destructive behavior.

Self-Fulfilling Prophecy and Self-Sabotage

Shame-based self-perceptions that are acted out through self-destructive fantasies and behavior create a self-fulfilling prophecy, providing rigged evidence of badness. Feelings such as worthlessness, badness, and inferiority have various origins in early experience when we are developing a sense of self. These feelings may later be experienced as factual — as if they represent the truth about who we are. When such compartmentalized experiences of oneself remain secret and unarticulated they can lead to unconscious pressure to make this inner “truth” a reality, leading to self-sabotage.

Dysfunctional behavior patterns are habits with psychological, often unconscious, motives. Breaking them requires insight into what function they serve and the discipline to stop them. It also requires courage and initiative to try out new behaviors and allow a different chain of events to occur. On a neurobehavioral level, new behaviors that generate positive feedback create new pathways in the brain, allowing momentum for psychological growth and change.

Kaitlyn had been caught in waves of powerful feelings and a difficult cycle of self-defeating patterns. But she wanted more than anything to be strong, self-respecting and independent and began to use her determination to work toward these positive goals, instead of hurting herself.

Kaitlyn’s first step was talking in family therapy about being secretly drawn to videos about suicide and self-harm on YouTube, especially when feeling sad or alone. She initially feared being judged and was scared that access to the videos would be taken away. However, as she trusted that it was safe to talk about these secrets without being judged and could make her own decision, Kaitlyn was able to evaluate what she wanted to do.

When taking a neutral step back to assess her thoughts and feelings, Kaitlyn recognized that exposing her mind to this content fed her fantasies, pulling her deeper into darkness, and created a cycle of regression which impeded independence and forward motion. Just as she could choose what food to put into her body based on its effect, she could decide whether she wanted to expose her mind to stories and images that made it harder to resist being self-destructive.

Trying Out New Behaviors

With encouragement, Kaitlyn became motivated to try out new ways to comfort herself. Learning better ways to regulate and take charge of her feelings gave Kaitlyn a jumpstart to taking healthy risks in the world.

Kaitlyn enrolled in a Saturday class in public speaking at a local college to develop her confidence. Having had a seizure at home after the first class, she missed the following class. She felt alienated and experienced a familiar sense of herself as defective, followed by the temptation to hide. In therapy she talked about the isolation and sadness she felt.

A week later, right after the next class, Kaitlyn burst with glee into the family therapy session, followed by her mom and dad. Grabbing the feelings list, she began the meeting as always — naming the feelings that fit her state at the moment: “Alive, amazed, confident, exuberant, happy, hopeful, proud,” she said. The excitement was contagious, but we glanced at each other curiously, waiting to find out what changed.

Kaitlyn went on to describe the class. The teacher asked for improvisational introductions by each student. Inspired by another student who made himself vulnerable, Kaitlyn bravely went up in front of the class and spontaneously spoke to her experience with epilepsy, telling her story in public for the first time. Looking around the classroom as she spoke authentically, Kaitlyn noticed people listening and completely engaged. Invigorated, she was fully present and one with herself. Everything felt natural. The class was mesmerized, responding with tears and applause.

Pride – the Antidote to Shame

Kaitlyn could barely contain the exhilaration brought on by this new feeling of pride (the antidote to shame) which emerged from a new experience of herself in relation to others. She took action that transformed her loneliness and alienation into a feeling of mastery and power. But the feeling of pride came not only from challenging herself with something meaningful to her and succeeding, but from something deeper.

Healthy Risk-Taking and Changing Behavior Patterns

Kaitlyn resisted the impulse to hide or pretend that typically escalated her feeling of being alone and ignited a self-destructive cycle. Instead, she took a healthy risk to let herself be seen, acting confidently from a position of strength and self-respect rather than a wish to be rescued.

Kaitlyn’s behavior created an opportunity for interpersonal feedback that challenged her sense of herself as defective and the belief that she could feel connected and affirmed only through pain. The key element here was that this challenge occurred experientially, not intellectually.

Healthy behaviors that foster connection and affirmation from a position of self-acceptance and self-respect offer the possibility of sustainable attachments. Here, Kaitlyn broke the cycle of feeling connected and affirmed only through darkness, potentially releasing herself from a treadmill of pain.

Choosing Happiness over Suffering: the Results

As she basked in the fact that people seemed to not only like her, but respect her and admire her courage, I said, “You see — you don’t have to hurt yourself to get people to see and care about you.” “ I like being happy!” Kaitlyn exclaimed, with a sense of wonder alongside awareness of the irony of this statement. She glance at her dad and they both smiled knowingly, “Who knew?!” her dad piped up in his good-humored way.

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.

• You’re alone. I can recall Valentine’s Days I wished I were in love with someone who loved me. Worse were Valentine’s Days when I missed an ex or spent time thinking about someone who wasn’t in love with me. Looking back, what was sad was that I made myself unhappy and ruined one, if not more, days thinking “if only.”
• You’re in a new relationship.Another Valentine’s trap happens when you’re newly in love. It may be the first Valentine’s Day of your relationship, and you wonder whether your partner will surprise you with something special. Will he or she ignore the day or hopefully say the unmentionable, four-letter L-word?You’re stressed about whether your card should be funny or mushy. Fear of humiliation and abandonment restrain you from being vulnerable. You don’t want your feelings rejected or to scare off your partner. Guys, you could be afraid of hurting your girl’s feelings by not doing or saying enough. Or you could be afraid to do or say too much, which might be misinterpreted as a commitment for which you’re unprepared.
• You’re in a fight.One of the worst feelings on Valentine’s Day is to be fighting with your partner. Any other day wouldn’t be as painful. On Valentine’s Day, though, your worst fears and disappointments about your partner and the relationship are highlighted. In addition to being hurt or angry about the argument, you compare how you feel to how you imagine the day should be and how you want to feel.You don’t have to be fighting to be on eggshells all day and disappointed because your partner is an addict, ignoring you, or is looking for a fight to avoid admitting he didn’t plan anything or doesn’t want to go out. You can easily spend the entire day looking and waiting for cues, wondering whether you will spend the evening together. It’s hard to generate loving feelings seeing your wife neglecting the children or drunk all day.
• You’re in a dull or dead relationship.Many couples in long relationships have lost the spark of love. Valentine’s Day may be a cruel reminder or an opportunity to rekindle it. When romance fades, it can be replaced with love based on deep caring and shared life experience. You might decide not to do anything special. Yet you can still acknowledge your love for each other – even if it’s not romantic love, it’s deep and abiding.Some relationships have died. Intimacy’s gone, but the couple can’t let go, whether due to age, children, health, or finances. Usually, despite those reasons, there’s a deep attachment. Often one person imagines he or she is staying for the other and is in denial of his or her own attachment needs and fears about leaving.
• You’re in a loving relationship.You’re among the fortunate few if you’re in a long, loving relationship. Valentine’s Day may still present problems, especially for husbands who don’t want to disappoint their wives. You can get caught in the dilemma of not being able to decide whether to surprise your wife or ask her what she’d like. It’s okay to ask. Some people would rather know, but beware of a common trap: When your significant other replies, “it doesn’t really matter, I’m just happy with all you do. Don’t get me anything.” In this case, you should get him or her something special. Failure to act can be dangerous.Wives, too, can get caught up in waiting and wondering, and not wanting to upset plans their husbands may have made.

Six Tips

1. Stay in the present reality. Take the label off, and just enjoy the day. Don’t look up an ex or waste time fantasizing about someone with whom you’re not involved. Don’t think about your relationship’s future or troubles or replay past disappointing holidays.
2. Take responsibility for your feelings. If you’re experiencing painful emotions, honor them – for a half-hour. Then plan a great day. Remember it takes two to have an argument. Take responsibility for your contribution and your feelings. Own them, apologize if necessary, and make a fresh start with your partner. You’re the one who suffers if you don’t. Waiting for an apology feeds your resentment.
3. Let go of expectations. They plant the seeds of disappointment and resentment. Instead, be open to what your partner and the universe have in store for you.
4. Focus on giving love. Remember the love you feel is the love you give. Even if you’re in a relationship, write yourself a love letter about your wonderful traits and acts of courage. Tell yourself you love you. Read it aloud in the mirror. This may sound foolish, but it works and boosts your self-esteem! You can also focus on the positive traits of your partner. Imagine opening your heart and sending him or her love. If that’s difficult, recall a time when you shared love, and then bring that memory fully into the present.
5. Be creative. It shows an investment of time, love, and thought when you create something special. You can create a treasure hunt for your partner to find a gift or card. Instead of roses, sprinkle the bed with flower petals. Give a sensuous candlelit foot rub, massage, or body wash. Write your favorite, shared memories with colored pens. Make a collage of your dream home, family, or past or future adventures together designed with leaves, dried flowers, photographs, or magazine clippings.
6. Whatever you do, be real. Authenticity is romantic. Your true feelings are apparent anyway, and hiding them creates more problems. That doesn’t mean you have to spill your guts, but in a dicey situation, choose words that are true for you.

During midlife typically we are burdened by taking care of children and parents. We are faced with loss — loss of youth, previous roles and opportunities. Midlife transition often is associated with a shift in our sense of time, leading us to reflect on our lives so far, decisions we’ve made, and the future. Midlife transition does not have to involve calamity, but for some people it turns into a crisis.

Midlife crises can occur in both men and women, but take a particular form in men facing identity crises, often spilling into family life. Men in midlife crises feel hopelessly trapped in an identity or lifestyle they experience as constraining, fueled by an acute awareness of time passing. Finding themselves in a life that feels empty and inauthentic, they feel pressure to break out, and may desperately grasp at a chance for vitality and pleasure.

David, 47, a family man and do-gooder, felt lonely and trapped in his marriage. He always followed the “right” path, accommodated others, and made life decisions based on his sense of what was expected. David had a strong sense of loyalty and responsibility, and seemed an unlikely candidate for an affair. When a female colleague at work befriended him, David felt flattered. In his unhappiness, he fantasized and was drawn to her, but never considered cheating. But while away on business, David indulged temptation. Acting on his impulses, he unwittingly became swept into a full-blown affair.

David had unconsciously followed a prefabricated, externally driven trajectory formed by others’ expectations – part of what set him up for rebellion and crisis at midlife. Men with similar profiles make automatic life decisions, without inner reflection or a “felt” sense. They swallow parental or societal values whole, without question, later feeling oppressed, deprived, and resentful. These and other risk factors – including limited self-awareness, difficulty talking openly, and feeling unloved or unsupported in their marriages – create breeding grounds for crises driven by the need to escape.

An essential developmental issue for men in midlife is sorting out who they are separate from societal and family expectations. This task also is common to adolescence (Levinson, D., 1978). In adolescence, modulated risk-taking and contained rebellion against parents’ values can facilitate healthy differentiation and development of an autonomous sense of self. When parents set protective limits on opportunities for dangerous behavior, while allowing teens their voice and room to make their own choices (for example: clothing, hobbies), teens are helped to discover and “own” what’s right for them.

With men at midlife, a similar balance between restraint/limits and exploration is needed as issues of freedom, autonomy, and self-definition from adolescence are reworked. Mastery and opportunity come from self-exploration, not outward rebellion. The key is recognizing that the protest is an internal conflict over constraints and self-perceptions internalized in the past, creating an internal divide.

Natural midlife development in men naturally elicits awareness of previously unexpressed needs and parts of the self (Levinson, D., 1978) which may be felt as an ambiguous sense of something wrong or missing. In men whose histories may not have supported the development of their identity, such internal cues may be misinterpreted as a sign of a fatal flaw in their lives, leading to the impulse to flee.

But signals from within of something unrequited can provide positive impetus for self-examination and psychological and interpersonal growth. Healthy resolution occurs when self-examination leads to an achievable vision of change anchored to the context of our lives. Gary, a man struggling with midlife issues, worked to understand the emptiness he felt. Ultimately, he transformed loss into fulfillment by embracing the role of mentoring others, coming into his own, rather than giving in to longings for youth and the wish to go back.

Midlife crises can lead to growth or destruction. When it seems there’s no way out, creating a crisis, an unconscious process forces change. Experiencing the reality that we can lose our spouse is a powerful antidote to complacency. This jolt can trump fear of conflict and change, mobilizing couples to face destructive patterns and rebuild stronger relationships.

But prevention is better. Couples can work together using protective guidelines to contain midlife challenges and crises.

Tips for Men

• Mourn losses, but limit time spent in fantasy, regret and longing for what cannot be recaptured.
• Examine past decisions without judgment to understand what factors in you, possibly still at play, drove those decisions.
• Brainstorm about what you want now in your marriage, work, leisure.
• Realistically assess what’s possible now and what opportunities are gone.
• Imagine how it would feel day-to-day if you lost your wife and family.
• Realistically assess your need for security vs. excitement.
• Identify and write down things in your life for which you’re grateful.
• Include your wife and others in conversations about this.

Tips for Spouse

• Recognize biases in how you view your husband and ways these perceptions might constrain him.
• Be open to seeing him differently – as his friends or others do – and letting him change.
• Notice him – what makes him happy and unhappy?
• Share excitement over his successes.
• Show interest in what he likes.
• Find out how he’s feeling in the marriage, whether he’s lonely.
• Be open to change.

References

Levinson, Daniel J. (1978). Seasons of a Man’s Life. New York: Random House, Inc.

The Joy of Growing Old. (December, 2010). Retrieved January 22, 2013 from www.theeconomist.com

The Introvert’s Way by Psych Central’s own Sophia Dembling continues this trend.  Unlike Quiet, it not only provides scientific and cultural background but also practical tips and a thorough-note of complete understanding of the introvert’s nature.  An introvert myself, I have never read a book that I have so truly felt myself in.  This is a tribute to Ms. Dembling’s writing as well as to relief that introversion is slowly becoming recognized as something other than a personality flaw.

The Introvert’s Way begins with a summary of our current state—America is a “nation of extroverts (p. 2).”  The volume is turned up, everything is public, and we are told that the more outgoing and social you are, the better.  Open cubicles are the most popular work environment, and kids who like to read alone concern their teachers.  Ms. Dembling examines how these views came to be through a review of scientific literature and theories of introversion.  Sigmund Freud considered it pathological (something to do with sexual repression, of course), and Carl Jung posited that it was negative psychic energy flow.

Recent theories have been more positive: the Big Five theory of personalities places introversion on a continuum that also includes agreeableness, conscientiousness, etc., and research into sensory processing has provided some support for physical and/or genetic underpinnings.  The exception to this trend is that introversion was almost added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) in 2010 as a diagnostic factor in Schizotypal Personality Disorder until an outcry removed it prior to publication.

Trying to define introversion is difficult.  It is not the same as being shy, misanthropic, or narcissistic.  The default, then, is to define it as the absence of extroverted behavior, although as Ms. Dembling explains, even if “…it is not yet fully defined [...], it is becoming increasingly clear that introversion is more than just the absence of extroversion (p.7).”  Research is ongoing, and one recent development is that brain scanning has found proof that “Highly Sensitive Persons” process information more deeply and sensitively than others.

Ms. Dembling notes that because of this ambiguity, it is extremely important to combat the misunderstandings surrounding introversion.  Firstly, “we don’t watch because we long to join the fun.  We watch because that is the fun (p.36).”  Secondly, there is a difference between loneliness, being alone, and solitude.  Scientific measures of loneliness have nothing to do with the number of friends you have or the amount of time you spend alone.  If you do not long to be with other people when you are by yourself, you are merely alone, not lonely.  And if you find this state tranquil, restful, and inviting, you have solitude (p. 58).  Finally, people think that introverts are always shy and avoid social situations, but there is a difference between the state of extroversion and the trait of extroversion (p.61).  An introvert can choose to exhibit many extroverted qualities and vice versa.

With this background fully established, The Introvert’s Way goes on to directly address the challenges that introverts face and includes advice and techniques for coping with them.  There is even an entire chapter on the common mistakes introverts make and how to avoid them.  General suggestions include watching body language to ensure you don’t exude a negative aura and managing your energy.  After accepting that you are an introvert and that it’s ok, you need to figure out how much energy you are able to give and the best ways to allot it.

Ms. Dembling also emphasizes the need for introverts to recognize the importance of small talk as well as socialization in general:

“…[small talk] isn’t supposed to be fascinating.  It’s just supposed to be a friendly connection.”

“Sometimes[…] I approach socializing like I do broccoli.  It’s good for me even when I’m not one hundred percent enthusiastic about it.” p. 77, 82

To that effect, she details techniques to use when dealing with challenging situations such as conferences, on the job, or trying to make friends.

After the advice come some cautions: Ms. Dembling admits that introverts can be self-righteous and judgmental, although to some extent this is the natural reaction to being constantly judged by others.  It is important to remember, though, that, “A blanket dismissal of extroverts is bigoted and, well, shallow (p. 138).”  She notes too that relying on alcohol to become extroverted is not a good plan, and that being internally focused and constantly thinking interferes with mindfulness, which is positively correlated with happiness.  Introverts need to learn to relax their brains and just be in the moment to avoid becoming too wrapped up in the world inside.

The Introvert’s Way continues by detailing the challenges and opportunities present with introverted children and in romantic relationships between differing personality types, stressing the importance of understanding, communication, and clear parameters from both parties.  A series of affirmations are suggested for introverts to use to remind themselves that just because your needs are different doesn’t make them bad.  The book ends with a final emphasis on finding middle ground and all personality types getting along: even though introverts may feel resentful about being dismissed in our current culture, “We reject the myth that extroversion is better than introversion, and so we must also reject any idea that introversion is better than extroversion (p. 145).”

With its combination of great writing and meaty content, The Introvert’s Way is the best psychology book I’ve read in quite a while (that I’m its target audience I’m sure helps, but even allowing for that).  Ms. Dembling’s short sentences are chock full of facts, and the fantastic chapter titles are icing on an already-entertaining cake (see “We Didn’t Know You Were an Introvert, We Thought You Were Just a Bitch” or “Hell is a Cocktail Party”).

Using humor to deflect what can be hurtful is welcome: “…introverts are not anti-people…I don’t eat tuna salad every day, but that doesn’t mean I’m anti-tuna salad (p. 49).” 

Overall, the information is wonderful (and needed) for introverts who have been told their entire lives that something is wrong with them.  It’s just great to know that we’re not alone and not weird (at least not for this reason alone!).  The chapter on the main insults introverts receive and defenses against them (“I F#&$Iing Hate It When They Say That”) is an especially good combination of practical advice on how to calmly explain and deflect inaccurate characterizations, and a rallying cry that introverts will no longer accept dismissal or disdain.

To her credit, Ms. Dembling doesn’t hide fact that while there are a lot of theories explaining introversion/extroversion, there aren’t a lot of actual research findings.  She also repeatedly emphasizes that one personality type is not better than the other; rather, that each should be equally understood and accepted.  There is a good balance of specific personal anecdotes and generalizations, and when making sweeping generalizations, Ms. Dembling notes that this is the case.

The Introvert’s Way is an important addition to the new body of personality type literature that has been growing over the past couple of years.  In addition to being a pleasure to read, it is a ‘must-read’ for anyone who is an introvert or is close to one, whether in family, a friendship, or a relationship.  The bridge between the introverts and extroverts is being built, and Ms. Dembling has contributed a keystone.

The Introvert’s Way: Living a Quiet Life in a Noisy World
By: Sophia Dembling
New York: Penguin Group (Perigee imprint), 2012

Our Inner Dialogue Affects Our Thoughts and Feelings

How we manage our thoughts when they come into our mind (our “inner dialogue”) directly affects how we feel and what we do. If we use this to our advantage, we can have a potent tool to manage our state of mind and have more control over ourselves. Alternatively, we can give in to “natural” instincts and thought patterns and see what happens when they take over.

Jeremy, 42, was bright and outgoing — though as a boy he was shy, insecure and lonely. In high school he was convinced that any girl he liked would be out of his league and would not like him. He coped with these painful feelings by using his imagination, comforting himself with sexual scenarios in which any girl he liked would fall in love with him. Jeremy was never inappropriate with anyone and kept these fantasies a secret.

As an adult, Jeremy was active socially and happily married with a satisfying sex life. Still, he continued in the vivid fantasy life he had as a boy, habitually imagining scenarios about various women who crossed his path,Though Jeremy’s self-image seemed positive, unconsciously he carried with him the deeply ingrained, buried sense of himself as rejected and unlovable, and continued to use the power he found in his mind to abolish this perception of himself. Jeremy never sought help for this issue, since he believed that fantasizing was harmless, and that he was no different than other men.

Jeremy frequently fantasized about Zooey, a single co-worker at the same firm. He had made a commitment to himself never to let on t her about these fantasies, knowing that doing so could put him at greater risk for acting on them. Jeremy described his relationship with Zooey as neutral. There had never been any flirtation between them and Jeremy never felt any special connection with her other than a private attraction.

Eventually, Zooey decided to leave the firm for another job. As the two of them were saying goodbye, Zooey suddenly confessed to Jeremy that she had been fantasizing about him over the last several years. To his surprise, Jeremy found himself excitedly blurting out that he had actually been fantasizing about her too. At that juncture Zooey reached out to him to say goodbye, kissing him on the lips. Despite having breached his own boundaries, Jeremy rationalized to himself that he was still safe, since he had informed Zooey that he was happily married.

Previously, Jeremy’s fantasies had seemed safely compartmentalized. However, Zooey’s unexpected confession instantly dissolved the fragile line separating fantasy and reality, making Jeremy’s fantasy suddenly come true. In this confusing zone where the two worlds blend, acting in ways previously contained to the fantasy world can feel instinctive. After all, one has already “been there” in one’s mind.

Jeremy found himself drawn into in an excited, infatuated state that felt irresistible. Following the farewell incident, he and Zooey exchanged various texts and phone calls, a new occurrence. Jeremy said that he didn’t want to have an affair, and had no intention of doing so. Nevertheless, he was reluctant to follow his therapist’s recommendation to cut off contact entirely and make the ending of his relationship with Zooey final.

We can all think of instances where friends, colleagues, family members, and other individuals we come into contact with have been forced to manage the ending of a romantic relationship. Many of us have experienced this firsthand as well. For many, the ending of a romantic relationship can be viewed as a true test of resilience.

How our Thinking can Influence Recovery

I have helped several of my clients through rocky areas in their relationships. Breakups, however, typically are the most difficult relationship issues. Many of my clients say: “What am I supposed to do now? I need this person in my life. I can’t live without them!” Statements such as these paint a picture of exactly how powerful romantic connections can be, as well as how dependent we can become on them. This dependence can cause a loss of personal identity in one or both of the members of the couple and cause post-breakup life to feel foreign. Such statements also can lead to people becoming depressed.

Our thoughts cause our feelings and behaviors. Thinking precedes everything we do and feel. Consider a terrorist act: When a nation is subjected to a terror group’s attacks, common reactions include fear, disgust, anger, and confusion. However, the attackers might react with feelings of pride, happiness, and celebration due to viewing their mission as accomplished. This shows how many ways there are to think, and ultimately feel, about a given situation.

When people hold irrational beliefs about a breakup, those irrational thoughts can cause depression.

Irrational Beliefs about Breakups and Rational Replacement Thoughts to Practice

We can develop the skills that help us to feel the way we want to feel about any situation (Pucci, 2010). Our thinking will dictate how we feel about, and ultimately cope with, a breakup, as well as any other occurrences in our lives. Irrational thoughts and beliefs that cause us to feel hopeless or depressed about our breakup can be replaced with more rational ones. This will make the ending of a relationship feel much more bearable.

Irrational Thought: “I can’t live without this person. I need them in my life!”

Rational Replacement Thought: “I can live without this person. There are definitely things I need in order to live, like air, food, and water. I do not need this person to stay alive. Sure, I miss them, but my life will not end if they are not in it, and I do not need them.”

Irrational Thought: “My life has no meaning without my partner.”

Rational Replacement Thought: “My relationship was merely one meaningful aspect of my life. There are many ways for my life to have meaning, and my relationship is not the only way to achieve that meaning. My work, my family, my friends, and ___________ all bring meaning to my life.”

Irrational Thought: “I am no longer me without my partner.”

Rational Replacement Thought: “I have always been myself. Nothing can change that I am me, just like I cannot change who others are. It is possible that I may have simply lost sight of some of my interests outside of my relationship, but these can be regained.”

Irrational Thought: “I can’t weather the ending of my relationship. I would rather die. There is nothing to live for anymore.”

Rational Replacement Thought: “It isn’t a matter of wanting to die. It is a matter of wanting my partner back. I can and will survive this. There are plenty of things to live for. For example, I have my friends, my family, my pet, my meaningful job, etc. I have merely experienced a sudden life change, and I have all of these other things to live for. I refuse to let one negative life experience cancel out all of the other good that I have in my life.”

Irrational Thought: “There must be something wrong with me if my partner left me.”

Rational Replacement Thought: “There is nothing wrong with me. My partner and I ending our relationship is not a reflection of my character or overall worth. This situation simply means that might not have seen eye-to-eye on things. There is someone else out there who I will be compatible with.”

Irrational Thought: “I will walk the Earth alone for the rest of my life and I will never meet anyone else.”

Rational Replacement Thought: “There is no evidence to say that I will never find another partner. One failed relationship does not foreshadow future failed relationships. The only thing my ended relationship means is that we were not as compatible as we thought. There are plenty of other people out there who things might work out with. It is just a matter of finding them.”

Irrational Thought: “I hate couples now and I resent their happiness.”

Rational Replacement Thought: “It is irrational to hate other people because my relationship didn’t work out. They had no part in what happened and are simply living their lives. Their relationship has no connection to me, and they are certainly not in a relationship to spite me or rub it in my face.”

Irrational Thought: “I can’t be alone.”

Rational Replacement Thought: “I can manage being alone, although it might be uncomfortable. The fact that I am single at this very moment indicates that I can be alone. I am doing it and nothing bad has happened, aside from being uncomfortable. Sure, I’d certainly like to not be alone right now, but I will live. After all, this is only temporary.”

It’s not Wrong because it Feels Wrong

The ending of a relationship is an enormous life change. It will take time, patience, and practice in order for successful adjustment to take place. We often experience the belief that, if something feels foreign or wrong, then it must, in fact, be wrong. Due to the emotional involvement that characterizes romantic relationships, there will undoubtedly be times when life without this person feels wrong or “funny,” but this does not mean that it truly is, or that you are doing something wrong.

Feelings such as these do not indicate that you cannot manage the separation. What they do mean, however, is that you are adjusting. Imagine swinging a baseball bat or golf club in the hand that is not your dominant one (the one you have been using your whole life). It would take practice to become used to this process but, in time, you would grow to be more skillful at it. With practice, you will better able to adjust to life after your breakup.

References

Pucci, A.R. (2010). Feel the way you want to feel…no matter what! Use rational self-counseling to overcome life’s most difficult problems. Bloomington, IN: iUniverse.

The basis of Red Flags is that some people—more than we typically assume—are sociopaths, and if we are not careful to educate ourselves about their potential dangers, we are all capable of being victims of, as Andersen calls it, love fraud.

Andersen is quick to caution that the word “sociopath” is not meant in a formal sense, as a medical professional might use it. It is instead used “as a generic description for a social predator, someone who lives his or her life by exploiting others.” Although Andersen does provide a solid amount of psychological background on sociopaths, the fact that she uses the word in a way in which it is not supposed to be used is rather curious. By painting overly broad strokes, Andersen runs the risk of oversimplifying and writing in absolute terms when doing so is inappropriate.

As Andersen writes: “Sociopaths are male, female, old, young, well-groomed, disheveled. They come in all shapes and sizes.” In this way, it is frustrating that Andersen chose to cast the term that is the basis of her thesis as something of a catchall.

This is not to devalue the merits of Andersen’s book. While her subject is not widely known, it is indeed interesting and worthy of analysis. That said, when dealing with a subject that is so psychologically complex, it is counterintuitive to make the foundation so simplistic.

There are a lot of good things in Red Flags. Often, though, general themes and ideas are restated in different ways, and the same advice and wisdom is recycled. Again, what is said is certainly interesting and noteworthy, but the constant restating diminishes the impact of the ideas and negates some of their legitimacy. It’s not so much what is said that falters, but how it is said.

Along these lines, another criticism of Red Flags is its implicitly anti-male tone. Admittedly, Andersen does cite a statistic that men are three times more likely to be sociopaths than are women, and, as evidenced by the quotation above, she does concede that women, too, can be sociopaths. But of the numerous examples Andersen includes throughout the book, only a handful portrays a woman as the sociopath instead of a man.

Moreover, of the almost 250 pages, Andersen spends only two discussing female sociopaths. Despite the fact that men are statistically more likely to be sociopaths than are women, it would have been prudent to dedicate more text and examples to women being the predator. To not do so comes off as a something of a covert attack on men.

Despite these criticisms, it must be noted that Red Flags does provide some useful information. Through her website, Andersen has heard from and communicated with thousands of people who were, like she, victims of love fraud. And in the modern age in which we live, many of these relationships were started through online dating websites. Andersen writes:

Because of its global outreach and anonymity, the Internet is custom-tailored for social predators. It offers an endless supply of potential victims, so the hunt is simply a numbers game. Sociopaths register on multiple dating sites simultaneously. They randomly friend people on Facebook. They just keep baiting their hooks until someone bites.

Anonymity is a core characteristic of the Internet. When communicating via the web, you never really know with whom you are talking, and sociopaths use this to their advantage, pretending to be anybody they want.

Approximately one in five relationships is started through online dating. With the medium continuously gaining popularity and appeal, Andersen is right to caution against blind faith in it. While online dating is without question a useful—and for some, necessary—tool, it should be approached with a certain level of caution, especially when someone whom one is talking to fits Andersen’s bill of a sociopath.

Although Red Flags of Love Fraud is perhaps not as academic as it should be, it is nonetheless informative. It is certainly flawed, but it is also prescient: Considering how many people are victims of love fraud, not nearly enough are aware of its realities. Andersen’s book is a good first step.

Red Flags of Love Fraud — 10 Signs You’re Dating a Sociopath
By Donna Andersen
Anderly: June 11, 2012
Paperback, 246 pages
$19.95

However, emotional abandonment has nothing to do with proximity. It can happen when the other person is lying right beside you — when you can’t connect and your emotional needs aren’t being met in the relationship.

Emotional Needs

Often people aren’t aware of their emotional needs and just feel that something’s missing. But people have many emotional needs in intimate relationships. They include the following needs:

• To be listened to and understood
• To be nurtured
• To be appreciated
• To be valued
• To be accepted
• For affection
• For love
• For companionship

Consequently, if there is high conflict, abuse, or infidelity, these emotional needs go unmet. Sometimes, infidelity is a symptom of emotional abandonment in the relationship by one or both partners. Additionally, if one partner is addicted, the other may feel neglected, because the addiction comes first and consumes the addict’s attention, preventing him or her from being present.

Causes of Emotional Abandonment

Yet even in a healthy relationship, there are periods, days, and even moments of emotional abandonment that may be intentional or unconscious. They can be caused by:

• Intentionally withholding communication or affection
• External stressors, including the demands of parenting
• Illness
• Conflicting work schedules
• Lack of mutual interests and time spent together
• Preoccupation and self-centeredness
• Lack of healthy communication
• Unresolved resentment
• Fear of intimacy

When couples don’t share common interests or work and sleep schedules, one or both may feel abandoned. You have to make an extra effort to spend time talking about your experiences and intimate feelings with each other to keep the relationship fresh and alive.

More harmful are unhealthy communication patterns that may have developed, where one or both partners doesn’t share openly, listen with respect, and respond with interest to the other. If you feel ignored or that your partner doesn’t understand or care about what you’re communicating, then there’s a chance that eventually you may stop talking to him or her. Walls begin to build and you find yourself living separate lives emotionally. One sign may be that you talk more to your friends than to your partner or are disinterested in sex or spending time together.

Resentments easily develop in relationships when your feelings, especially hurt or anger, aren’t expressed. When they go underground, you may either pull away emotionally or push your partner away with criticism or undermining comments. If you have expectations that you don’t communicate, but instead believe your partner should be able to guess or intuit them, you’re setting yourself up for disappointment and resentment.

When you or your partner fears intimacy, you may pull away, put up walls, or push one another away. Usually, this fear isn’t conscious. In counseling, couples are able to talk about their ambivalence, which allows them to get closer. Often abandoning behavior occurs after a period of closeness or sex. One person may physically withdraw or create distance by not talking or even by talking too much. Either way, it may leave the other person feeling alone and abandoned. Fears of intimacy usually stem from emotional abandonment in childhood.

In Childhood

Emotional abandonment in childhood can happen if the primary caretaker, usually the mother, is unable to be present emotionally for her baby. It’s often because she’s replicating her childhood experience, but it may also be due to stress. It’s important for a baby’s emotional development that the mother attune to her child’s feelings and needs and reflect them back. She may be preoccupied, cold, or unable to empathize with her child’s success or upsetting emotions. He or she then ends up feeling alone, rejected, or deflated. The reverse is also true – where a parent gives a child a lot of attention, but isn’t attuned to what the child actually needs. The child’s needs hence go unmet, which is a form of abandonment.

Abandonment happens later, too, when children are criticized, controlled, unfairly treated, or otherwise given a message that they or their experience is unimportant or wrong. Children are vulnerable, and it doesn’t take much for a child to feel hurt and “abandoned.” Abandonment can occur when a parent confides in his or her child or expects a child to take on age-inappropriate responsibilities. At those times, the child must suppress his or her feelings and needs in order to meet the needs of the adult.

A few incidents of emotional abandonment don’t harm a child’s healthy development, but when they’re common occurrences, they reflect deficits in the parent, which affect the child’s sense of self and security that often lead to intimacy issues and codependency in adult relationships. Couples counseling can bring couples together to enjoy more closeness, heal from abandonment, and change their behavior.

Usually women complain about emotionally unavailable men. Yet many women aren’t aware they’re emotionally unavailable, too. When you get hooked on someone else who is (think Carrie Bradshaw and Mr. Big), your problem is disguised as his. This keeps you in denial of your own unavailability.

There are several types of unavailability, both temporary and chronic. Some people have always been unavailable due to mental illness or a troubled childhood. Others temporarily make something a higher priority than a relationship, such as a family obligation, education, project, or a health concern. People recently divorced or widowed may temporarily not be ready to get involved with someone new. In the middle are those who are too afraid to risk falling in love because they’ve been hurt by one or more relationships, which may include being hurt by a parent when they were a child. Often these different reasons for unavailability overlap, and it’s difficult to ascertain whether the problem is chronic or will pass.

If you’re looking for a close, committed relationship, a person living in another state, or who is married or still in love with someone else is not going to be there for you. Similarly, addicts, including workaholics, are unavailable because their addiction is the priority and it controls them. Still, some people give the appearance of availability and speak openly about their feelings and their past. You don’t realize until you’re already in a relationship that they’re unable to really connect emotionally or make a commitment.

10 Signs of Someone Unavailable Emotionally

Here’s a list of more subtle red flags that may signal unavailability, especially when several add up. They apply to both genders. Following them are questions to ask yourself to find out whether you’re ready for a committed relationship.

1. Flirting with flattery. Men who are too flattering may also be adept listeners and communicators, like snake charmers. Often good at short-term intimacy, some lure with self-disclosure and vulnerability, but they prefer the chase to the catch.

2. Control. Someone who won’t be inconvenienced to modify his or her routine. Typically, commitment phobics are inflexible and loathe compromises. Relationships revolve around them.

3. Listen. Your date may hint or even admit that he or she isn’t good at relationships or doesn’t believe in or isn’t ready for marriage. Listen to these negative facts and believe them. Ignore vulnerability, bragging, and compliments.

4. The past. Find out if the person has had a long-term relationship and why it ended. You may learn that prior relationships ended at the stage when intimacy normally develops.

5. Perfection seekers. These people look for and find a fatal flaw in the opposite sex and then move on. The problem is that they’re scared of intimacy. When they can’t find imperfection, their anxiety rises. Given time, they will find an excuse to end the relationship. Don’t be tempted to believe you’re better than their past partners.

6. Anger. Notice rudeness to waiters and others, revealing pent-up rage. This type of person is demanding and probably emotionally abusive.

7. Arrogance. Avoid someone who brags and acts cocky, signaling low self-esteem. It takes confidence to be intimate and committed.

8. Lateness. Chronic lateness is inconsiderate, and can also indicate the person is avoiding a relationship, but don’t assume that punctuality means he or she’s a catch.

9. Invasiveness or evasiveness. Secrecy, evasiveness, or inappropriate questions too soon about money or sex, for example, indicate a hidden agenda and unwillingness to allow a relationship to unfold. Conversely, someone may conceal his or her past due to shame, which may create an obstacle to getting close.

10. Seduction. Beware of sexual cues given too early. Seducers avoid authenticity because they don’t believe they’re enough to keep a partner. Once the relationship gets real, they’ll sabotage it. Seduction is a power play and about conquest.

Most people reveal their emotional availability early on. Pay attention to the facts, especially if there’s mutual attraction. Even if the person seems to be Mr. or Mrs. Right, yet is emotionally unavailable, you’re left with nothing but pain. If you overlook, deny, or rationalize to avoid short-term disappointment, you run the risk of enduring long-term misery.

10 Questions to Ask Yourself

Be honest with yourself about your own availability.

• Are you angry at the opposite sex? Do you like jokes at their expense? If so, you may need to heal from past wounds before you’re comfortable getting close to someone.
• Do you make excuses to avoid getting together?
• Do you think you’re so independent you don’t need anyone?
• Do you fear falling in love because you may get hurt?
• Are you always waiting for the other shoe to drop? Although people complain about their problems, many have even more difficulty accepting the good.
• Are you distrustful? Maybe you’ve been betrayed or lied to in the past and now look for it in everyone.
• Do you avoid intimacy by filling quiet times with distractions?
• Are you uncomfortable talking about yourself and your feelings? Do you have secrets you’re ashamed of that make you feel undesirable or unlovable?
• Do you usually like to keep your options open in case someone better comes along?
• Do you fear a relationship may place too many expectations on you, that you’d give up your independence or lose your autonomy?

If you answered yes to some of these questions, counseling can help you heal in order to risk getting close. If you’re involved with someone emotionally unavailable, pressuring him or her to be more intimate is counterproductive. However, marriage or couples counseling can change the relationship dynamics and help you to have a more fulfilling intimate relationship.

We all develop rhythms of closeness, levels of intimacy, and some sense of who does what in our relationships. When those rhythms and expectations get disrupted, the commitment to the friendship gets challenged in a big way.

Here’s a not-uncommon scenario:

Two moms have been friends forever. The husbands like each other well enough that their friendship has also been growing. The families watch each others’ kids, carpool, and get together pretty regularly for barbecues, pizza nights, or just to hang out at the local swimming hole or at the mall. The moms turn to each other for support and help when a kid gets the flu or the car breaks down. The dads man the grill at the kids’ Little League games. The two families have an easygoing and important connection.

Then one of the kids is diagnosed with a serious illness or gets into serious trouble. During the first few months, their friends usually pick up the slack. But when the problem becomes chronic, the parents of the kid in distress are too preoccupied with their child to be available for fun, for long talks, or to take a turn with the carpool. Suddenly the terms of the friendship have to change.

Often friends start to drift away. They don’t mean to contribute to the stress. They’re not bad people. It’s just that life was already full. They don’t know how to fold care and support for another family into their routines. Fearing they will do or say the wrong thing, they pull back. Nothing in their experience tells them how to be helpful. They don’t know how to grieve the loss of the kind of friendship they had and yet create another, perhaps equally rewarding, one.

5 Tips for Helping a Friend in Need

There really are things friends can do when a friend is in chronic need. The rhythm of the relationship does need to change but the relationship itself doesn’t need to get lost.

Here are some guidelines to help you be the friend you’d like to be if a friend gets caught up in a long-term crisis:

1. Remember that people need to tell their stories.

One way that people metabolize grief is by talking about it. Listen with compassion and without judgment. Don’t offer advice unless asked. Don’t offer “pep talks.” Acknowledging their reality communicates respect for what they are going through. Do be clear about how often and when you can manage time to talk. People don’t want to feel like they are burdening their friends or imposing too much, so it helps to have some parameters. If you’re too busy when called, say so. But call back. Parents need to know there are at least a few people they can call when they are feeling overwhelmed or distressed as well as when there is good news.

2. Provide practical help.

Families who have children with chronic problems need practical help that doesn’t fade after the initial diagnosis. Most are grateful for some respite. Consider offering to take on a chore like doing the laundry or mowing the lawn. Offer to babysit the sick or disabled child for a few hours so the parents can have a date night. Take on a bigger share of the carpool or take their turn for other expected activities, such as bringing cookies to playgroup or doing the team fundraiser. Encourage them to join a support group with other parents with similar challenges and provide the babysitting so they can go.

3. Keep the focus on the child, not the problem.

Remember that your friends have a child with a disability, an illness or a problem. These kids are more than disabled or sick or problem children. Find things to talk about that recognize the child’s growth, personality, and interests.

4. Remember that there is no “normal” timeline for chronic issues.

Don’t expect your friends to get “back to normal.” As one parent put it to me, “A piece of my heart called my child is out in the world and injured. That’s not going to change.” Just as the family has to accept a permanent change in its plans, you have to accept permanent changes in your friend and your friend’s availability.

5. Change the rules of friendship.

For many friends, there’s an unspoken rule about reciprocity. “I invite you to dinner this month. You invite me next month. I call you. You call me.” When a family is challenged, that concept of fairness no longer applies. Embrace the idea that what goes around comes around. This friendship may always be off-balance in terms of who does more, calls more, or is more thoughtful. But someday you or someone you love may well be on the receiving end. That’s what being in the village of humanity is all about.

There are great gifts that can come from succeeding at realigning the relationship. The family that is dealing with chronic crisis is shored up by the nurturance and support of the people who know them best. Their friends can develop the personal depth that comes from bearing witness and making a meaningful contribution to others. Both families benefit from the intimacy that comes from getting through a difficult time together.

Acts of violence have always been a part of human nature and will continue unless we become some sci-fi world with better living through chemistry and genetic manipulation. Sure, there are general reasons the experts will point to, such as alienation; access to guns; too much exposure to violence; a society whose leaders lack values; and families who are disconnected from community.

But the reality is that the great majority of teenagers are growing up in this environment and not killing anyone. That doesn’t mean we should ignore steps to reduce the negative influences on their lives and ours. It does mean that no matter what we do, there will always be tragedies. We simply do not have that much control over another person’s life. That is a frightening reality for most parents to accept.

But this doesn’t mean that parents shouldn’t be doing things that make it more likely that their children would turn out okay. Inside each home there are parents asking if their son or daughter could be in trouble and the parents might not know it. Or, even scarier, there are parents who see their children struggling and feel powerless to help. What do we know that will help?

Well, the research points to the same issue nearly every time: children who have stronger relationships with their parents are less likely to end up in serious trouble. My emphasis on “serious” is because too often parents are upset about issues that are not life-threatening or life-determining. Clean rooms, grades and homework, being disorganized, being impulsive and screwing up, foul language, a few extra holes in an ear, some grungy friends, some broken curfews, or the protective or manipulative “lies” that children use to try to get away with things – all normal adolescent behaviors that do not alone signify a child “going down the tubes.”

Adolescence is a time for many teens to experience disconnection and disorientation, to become confused and uncertain about their values or about their capacity for success. It is a time to be scared about changing bodies and changing friends and experiencing failures when success may have usually come easily. It is a time to defy and distrust authority. It is a time, especially in with the phenomenon of the Internet, when teens’ worlds expand exponentially and it is quite a challenge for them to digest and manage all to which they are exposed.

Parents often respond to this by waging battles for control. While it is essential to have some unequivocal rules that involve health and safety and to seek help from others if there are signs of more serious trouble (e.g., depression, explosive outbursts, eating disorders, substance abuse, marked change in personality), it is particularly important to focus less on content and more on process.

What does this mean? Simply, that nothing is a substitute for maintaining the connection between you and your teenager. Time must be found for one-to-one interactions. Parents must be ready to give their attention when a teenager is suddenly ready to talk. Parents need to spend some time inside the world of their teenager and try to do so without being too judgmental. Do errands and chores together. Find an activity that can be shared. Take a teenage child out to dinner occasionally. A parent whose work involves travel can bring along a teenage child and turn it into a significantly valuable time together. Know each other!

Remember that you most likely did some things wrong along the way. It can be helpful to share that. Why should your child be open with you if there is not some reciprocity? That includes sharing some of your current anxieties or mistakes. We all mess up. We all have our vulnerabilities. We all seek safety and security. In that way, you and your teen have much in common. The key difference is that a teen’s life has few real choices and does not have a valued place in our society. We ask them to be responsible but there is little immediate reinforcement for that except to keep the adults from being angry and disappointed with them. Believe in your child, even when he or she is struggling, or simply not meeting your expectations.

For some parents, there is the harsh reality that, despite doing a good job, their child is having significant problems, and the parents are being shut out while nothing seems to be helping. This is definitely painful and scary. Even with professional help and support from school staff, some child will fall into a “black hole,” influenced by biology, peers, and social forces. This underscores another reality about the tragedies that have been taking place: All the perpetrators have been male.

Our society gives out powerful messages that are absorbed by our children. What girls hear and respond to leads them to turn against themselves, especially in the form of eating disorders (and a skyrocketing rate of smoking). What boys hear and respond to leads them to turn against others, in acts of verbal and physical abuse. In the face of all this, parents are worried, possibly more than ever, about the health and success of their children.

But I must return to my primary message of urging parents to have a more optimistic outlook and to not let their anxiety sabotage what is most important, the relationship each parent has with each child. A friend and colleague, Bob Brooks, often speaks about the resiliency of children and what contributes to it. The research clearly indicates that the presence of a “charismatic adult” is one of the primary predictors of turning out okay.

So often I read the stories of successful adults who grew up under terrible circumstances and there is always reference to a parent, relative, teacher, or coach who believed in them and provided guidance and an available ear when needed. Dr. Brooks often ends his presentations by challenging parents to be that charismatic adult in the lives of their children. It is no guarantee that everything will turn out all right. Nothing can do that. But it does make it much more likely that you will end up with an adult child who is not only doing well but is also your friend.

So what is it? My definition is someone who has lost the connection to his or her core self, so that his or her thinking and behavior revolves around someone or something external, including a person, a substance, or an activity, such as sex or gambling.

It’s as if codependents are turned inside out. Instead of self-esteem, they have other esteem, based upon what others think and feel. Instead of meeting their own needs, they meet the needs of others, and instead of responding to their own thoughts and feelings, they react to those of others. It’s a haywire system, because they have to control others to feel okay, but that just makes matters worse and leads to conflict and pain. It also makes emotional intimacy difficult.

Some people criticize the codependency movement and say that it’s created more loneliness. They argue that relationships are nurturing and that we’re naturally meant to be dependent. I couldn’t agree more. The point is that codependent relationships are not only painful, but can be unsupportive and destructive. Codependents have problems receiving the good stuff that relationships can potentially offer.

Codependency for Dummies goes into great detail about the difference between codependent and healthy, interdependent relationships, between healthy caregiving and codependent care-taking, and understanding the boundaries between responsibility for yourself and responsibility to others, something that eludes codependents.

Not all codependents are caretakers, but if you are one, you have a hard time listening to other people’s problems without trying to help. Sometimes you even feel responsible and guilty for their feelings. This creates high reactivity for couples who constantly are blaming each other for their own feelings and defending themselves when their partner shares his or her feelings.

What’s missing is a sense of separateness between them known as emotional boundaries. Boundaries simply mean that your thoughts and feelings belong to you. I’m not responsible for them; I didn’t make you feel them. For real intimacy to happen, you need to have a sense of separate identity and feel safe enough to express your feelings without being afraid of criticism or rejection.

This is where the codependent core issue of low self-esteem comes in. With a fragile self, codependents are afraid of rejection and abandonment, but on the flip side, they fear losing themselves when they get attached in a relationship. They tend to give up their needs to accommodate their partner, sometimes letting go of outside friends and activities they used to enjoy, and even when the relationship isn’t working, they are stuck like glue. So many codependents aren’t even in relationships, contrary to common belief, because they’re afraid of losing their independence, which you don’t really lose in a healthy interdependent relationship.

Many codependents have to dance a tightrope of pursuing partners, but never really catching them, or distancing themselves, but never really leaving. It’s a two-step that’s even done in marriages, but creates constant pain in the relationship. Fleeting moments of closeness are just enough to keep the dance going, unless the partners give up on intimacy entirely.

Communication is another area where dependents have a dilemma. They can’t say “No” without feeling guilty, and are resentful when they say “Yes” to things they would rather not do. This is because they avoid taking positions at all costs, due to their fear of rejection. Like clever politicians, they don’t want to say anything that might upset someone else.

The book goes into detail about how to improve your communication. You’ll learn how to be assertive, how to set boundaries, and how to handle verbal abuse. You can practice saying no on your own. Codependents are always explaining and justifying themselves. Remember, “No” is a complete sentence.

Codependents spend far too much of their precious lives worrying about things and people over which they have no control. Healing from codependency starts with getting to know yourself better, honoring yourself, and expressing yourself. Start doing things that make you happy, rather than deferring to others or waiting for someone else to make you happy. Building a relationship with yourself leaves you no time to worry about someone over whom you have no control, anyway. You might think this is selfish, but when you love yourself, you radiate love that’s healing to be around. It overflows onto everyone you interact with.

Don’t feel bad if that includes you. Most American families are dysfunctional. You’re in the majority!

Researchers also found that codependent symptoms got worse if left untreated. The good news is that they’re reversible.

Following is a list of symptoms of codependents. You needn’t have them all to qualify as codependent.

• Low self-esteem.Feeling that you’re not good enough or comparing yourself to others are signs of low self-esteem. The tricky thing about self-esteem is that some people think highly of themselves, but it’s only a disguise — they actually feel unlovable or inadequate. Underneath, usually hidden from consciousness, are feelings of shame.Guilt and perfectionism often go along with low self-esteem. If everything is perfect, you don’t feel bad about yourself.
• People-pleasing. It’s fine to want to please someone you care about, but codependents usually don’t think they have a choice. Saying “No” causes them anxiety. Some codependents have a hard time saying “No” to anyone. They go out of their way and sacrifice their own needs to accommodate other people.
• Poor boundaries.Boundaries are sort of an imaginary line between you and others. It divides up what’s yours and somebody else’s, and that applies not only to your body, money, and belongings, but also to your feelings, thoughts and needs. That’s especially where codependents get into trouble. They have blurry or weak boundaries. They feel responsible for other people’s feelings and problems or blame their own on someone else.Some codependents have rigid boundaries. They are closed off and withdrawn, making it hard for other people to get close to them. Sometimes, people flip back and forth between having weak boundaries and having rigid ones.
• Reactivity. A consequence of poor boundaries is that you react to everyone’s thoughts and feelings. If someone says something you disagree with, you either believe it or become defensive. You absorb their words, because there’s no boundary. With a boundary, you’d realize it was just their opinion and not a reflection of you and not feel threatened by disagreements.
• Caretaking. Another effect of poor boundaries is that if someone else has a problem, you want to help them to the point that you give up yourself. It’s natural to feel empathy and sympathy for someone, but codependents start putting other people ahead of themselves. In fact, they need to help and might feel rejected if another person doesn’t want help. Moreover, they keep trying to help and fix the other person, even when that person clearly isn’t taking their advice.
• Control.Control helps codependents feel safe and secure. Everyone needs some control over events in their life. You wouldn’t want to live in constant uncertainty and chaos, but for codependents, control limits their ability to take risks and share their feelings. Sometimes they have an addiction that either helps them loosen up, like alcoholism, or helps them hold their feelings down, like workaholism, so that they don’t feel out of control.Codependents also need to control those close to them, because they need other people to behave in a certain way to feel okay. In fact, people-pleasing and care-taking can be used to control and manipulate people. Alternatively, codependents are bossy and tell you what you should or shouldn’t do. This is a violation of someone else’s boundary.
• Dysfunctional communication. Codependents have trouble when it comes to communicating their thoughts, feelings and needs. Of course, if you don’t know what you think, feel or need, this becomes a problem. Other times, you know, but you won’t own up to your truth. You’re afraid to be truthful, because you don’t want to upset someone else. Instead of saying, “I don’t like that,” you might pretend that it’s okay or tell someone what to do. Communication becomes dishonest and confusing when you try to manipulate the other person out of fear.
• Obsessions.Codependents have a tendency to spend their time thinking about other people or relationships. This is caused by their dependency and anxieties and fears. They can also become obsessed when they think they’ve made or might make a “mistake.”Sometimes you can lapse into fantasy about how you’d like things to be or about someone you love as a way to avoid the pain of the present. This is one way to stay in denial, discussed below, but it keeps you from living your life.
• Dependency. Codependents need other people to like them to feel okay about themselves. They’re afraid of being rejected or abandoned, even if they can function on their own. Others need always to be in a relationship, because they feel depressed or lonely when they’re by themselves for too long. This trait makes it hard for them to end a relationship, even when the relationship is painful or abusive. They end up feeling trapped.
• Denial. One of the problems people face in getting help for codependency is that they’re in denial about it, meaning that they don’t face their problem. Usually they think the problem is someone else or the situation. They either keep complaining or trying to fix the other person, or go from one relationship or job to another and never own up the fact that they have a problem.Codependents also deny their feelings and needs. Often, they don’t know what they’re feeling and are instead focused on what others are feeling. The same thing goes for their needs. They pay attention to other people’s needs and not their own. They might be in denial of their need for space and autonomy. Although some codependents seem needy, others act like they’re self-sufficient when it comes to needing help. They won’t reach out and have trouble receiving. They are in denial of their vulnerability and need for love and intimacy.
• Problems with intimacy. By this I’m not referring to sex, although sexual dysfunction often is a reflection of an intimacy problem. I’m talking about being open and close with someone in an intimate relationship. Because of the shame and weak boundaries, you might fear that you’ll be judged, rejected, or left. On the other hand, you may fear being smothered in a relationship and losing your autonomy. You might deny your need for closeness and feel that your partner wants too much of your time; your partner complains that you’re unavailable, but he or she is denying his or her need for separateness.
• Painful emotions. Codependency creates stress and leads to painful emotions. Shame and low self-esteem create anxiety and fear about being judged, rejected or abandoned; making mistakes; being a failure; feeling trapped by being close or being alone. The other symptoms lead to feelings of anger and resentment, depression, hopelessness, and despair. When the feelings are too much, you can feel numb.

There is help for recovery and change. The first step is getting guidance and support. These symptoms are deeply ingrained habits and difficult to identify and change on your own. Join a 12-Step program, such as Codependents Anonymous or seek counseling. Work on becoming more assertive and building your self-esteem.