Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky.  Is this normal? Should I still be feeling like this?

Response: Yes, feeling nervous for the first few or several sessions of therapy, is completely normal.Therapy is an unusual way to have a conversation with someone.   The person is an expert in recognizing and understanding dynamics of human interactions.   For some people the fear is that the therapist knows more about you than you do yourself.In general terms hopefully your therapist has worked with many other people who've faced problems similar to yours.In this sense the therapist has a general idea of the basic dynamics you most likely are handling.No therapist could possibly know your particular details and your particular areas of upset or in what ways you feel unsure of yourself.Once you start to trust both your own right to tell your particular story and start to also feel that your therapist is listening attentively and cares what you tell the person, your nervousness will start to disappear all on its own.Good luck in getting the most from your therapy sessions!


Context: My daughter is in later elementary school. She can't color in the lines. Her words jumble together when she writes unless there are big spaces or she skips lines.

Response: If your daughter is the same age as most of the other students in her class, and the other students easily complete the tasks you list here, then there is a problem in the performance of these tasks for your daughter.Without knowing more about the context of your daughter's life, for example, is she a new student to the school and class, are there major stressors in the home environment, does your daughter have friends, does your daughter have the same problems she has in school, when she is in other environments?Also, who is telling you she has these problems?  Are you the one who notices what you describe here or is your daughter or is her teacher telling you these facts?Depending on your answers to the questions, start to get clarity with the classroom teacher and the school guidance counselor as to the source of your daughter's problem.Good luck!


Context:
My fiancé and I come from a strong Christian background but both went off the "straight and narrow" once before. He is having a hard time accepting my past, especially  that I'm not a virgin. He has a hard time in general accepting himself and others.

His insecurities are hurting our relationship. How can I help him let go of my past and decide to live in the present?

Response: Your patience with his pace of accepting your past, is the factor most in your control in this situation.Everyone accepts a new understanding at their own particular rate.  Yours may be faster than his pace.Since it is possible he may accelerate his pace of accepting your past if he knows that this is a priority for you, tell him about your own discomfort .Even if knowing how you feel does not motivate him to a quicker pace of accepting your past, you will have the peace of mind to know you gave him all the information you possibly had to give.


Context:
I'm always listening to my husband, but it feels like he never listens to me.

How do I get my husband to listen to me instead of me listening to him all the time?

Response: Does your husband want to listen to you?Find this out by asking him the question!This way you know whether the goal you'd like to reach is even possible.Some partners prefer that one person is the rule maker or the only one who is entitled to talk about themselves.If your husband tells you he wants to listen to you, or even that he does listen to you, then you can explain in detail the way you define "listening", which may be very different than his definition.Basically, no one can directly change someone into being more openminded.What is possible is to tell him your wishes, your willingness to be patient while he develops the habit of listening to you and point out that a relationship is more fulfilling when both partners feel they are receiving from the other one.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky.  Is this normal? Should I still be feeling like this?

Response: Therapy does not work overnight, oftentimes it is a lifelong struggle, the therapists job is not to "cure" you or to remove something but rather to make you strong enough to live your life with your own peculiarities and struggles, remember we are human and constantly fallible. Another important thing to note is that although you go to therapy, that is just a room, most of the magic and work takes place in your real life outside of that room.


Context:
My fiancé and I come from a strong Christian background but both went off the "straight and narrow" once before. He is having a hard time accepting my past, especially  that I'm not a virgin. He has a hard time in general accepting himself and others.

His insecurities are hurting our relationship. How can I help him let go of my past and decide to live in the present?

Response:
This suffering and clinging to the past, especially a troubled past or a past that we dont like, may be  amplified due to the Christian framework that may be built into your life. I am not averse to religion, i just think that many times it puts unreasonable expectations on us and helps us to form a guilt complex or perhaps even insecurities, we are humans and humans make mistakes. you mention the straight and narrow, this is a notion that you must give up on and let go, humans can never travel the straight and narrow for their whole lives there are bounds to be mistakes, we are the most fallible species on the planet and please tell your fiance to have some mercy on himself, he is not perfect. Here is a story about clinging on to things you may find useful to mediate on:Once
there lived a village of creatures along the bottom of a great crystal
river. The current of the river swept silently over them all -- young and
old, rich and poor, good and evil -- the current going its own way, knowing
only its own crystal self.
Each creature in its own
manner clung tightly to the twigs and rocks of the river bottom, for clinging
was their way of life, and resisting the current was what each had learned
from birth.
But one creature said
at last, "I am tired of clinging. Though I cannot see it with my eyes,
I trust that the current knows where it is going. I shall let go, and let
it take me where it will. Clinging, I shall die of boredom."
The other creatures laughed
and said, "Fool! Let go, and that current you worship will throw you tumbled
and smashed against the rocks, and you will die quicker than boredom!"
But the one heeded them
not, and taking a breath did let go, and at once was tumbled and smashed
by the current across the rocks.
Yet in time, as the creature
refused to cling again, the current lifted him free from the bottom, and
he was bruised and hurt no more.
And the creatures downstream,
to whom he was a stranger, cried, "See a miracle! A creature like ourselves,
yet he flies! See the messiah, come to save us all!"
And the one carried in
the current said, "I am no more messiah than you. The river delights to
lift us free, if only we dare let go. Our true work is this voyage, this
adventure."
But they cried the more,
"Savior!" all the while clinging to the rocks, and when they looked again
he was gone, and they were left alone making legends of a savior.


Context:
I'm always listening to my husband, but it feels like he never listens to me.

How do I get my husband to listen to me instead of me listening to him all the time?

Response: It's hard when you feel as if you're the only one that's taking the time to listen to your spouse. But, I would look at this as an opportunity to see if you can become aware of what exactly is happening between you, when you try and talk with your husband. Sometimes, it can be in the way dialogue is approached. I would suggest paying attention to the way you begin dialogue with your husband. See if blame and criticism are present. When blame and criticism are included, bids for connection, can quickly go off track. This can sometimes start off with something like: "why don't you..." "you aren't..." "you don't..." Partners can quickly go into defensive mode if they feel they are being attacked and sometimes starting off like this can feel like an attack.  Also, become aware of the time of day or evening when you approach your husband. Sometimes, this can make a big difference for couples as far as when they can truly be present for one another.  If you find this pattern continues, you might consider seeking professional help through couples therapy. A trained couples therapist can help you both understand more about what's happening between you.


Context: I have been married for 11 years. Within the past 2 years we have drifted far apart. We coexist together but there is very little personal interest in each other. I often feel that my husband has "friends" at work that he is more emotional invested in than me. I feel very alone and just uncared for.  Is there anything I can do to feel reconnected?

Response: Feeling alone in your marriage is one of the most painful feelings. Wanting connection with your spouse yet feeling the all too familiar distance that's keeping you apart can be so hurtful. But, change is possible. You might be able to move closer toward each other on your own but since there has been two years of distance, I would suggest looking into couples therapy with a trained couples therapist. They are trained in helping couples begin to examine what's been happening that has caused a drift in your marriage. I'm also curious if there was a significant event that occurred around the time you started feeling distant. If there was something that occurred during this time that is hard for you both to talk about, couples therapy can help with this also. It can provide a safe and supportive space for you both.


Context: I'm obsessing about a terrible breakup. Everything is a constant reminder.  How do I move on?

Response: Dealing with a breakup is difficult. We have high hopes and then those hopes and dreams are dashed and we feel at a loss for how to deal with this sudden change in our lives. First, it is important to acknowledge that losing a relationship is a loss and we need to grieve that loss. If we don't allow ourselves time to process and move through the grieving process, we may remain stuck and it may make it hard to move on. So in some ways, you don't want to move on too soon by just trying to ignore your feelings. Instead, take good care of yourself, talk to friends and give your self time to heal. The second most important thing is to forgive yourself; this is also an important part of taking care of yourself. You might be blaming yourself and re-living moments when you wish you would have done things differently. By replaying those thoughts you remain stuck. When we begin to forgive ourselves, we truly begin to heal. Lastly, in my experience the people who have the most difficulty moving on have not really severed all ties with their ex. They are still following them on social media or even checking in with texts. This is probably the hardest part for some people, but to move forward there needs to be a clear boundary and a clear ending. If you have a clear ending, you can have a new beginning. I hope this helps. Take good care of yourself!


Context:
Every time I send a message to someone or a group message on Instagram, iMessage, or snapchat people will read my messages but then they won't answer me.

Could it be that there is something they don't like about me? I don't understand why they won't answer my messages. How do I get people to respond to me?

Response: I understand the feeling of not being liked due to not having any responses on the sites you list.More than likely the non-response has less to do with liking you than w liking the way you write your messages.Have you tried asking a question in your posts?  This would be one way to invite people to answer your post.When you write,  imagine yourself as the reader of the post.If you think about the wording of a question which would motivate you to respond, then this formula will very likely be the same for many others who read your post.Good luck!


Context:
My dad doesn't like the fact that I'm a boy. He yells at me daily because of it and he tells me I'm extreme and over dramatic.

I get so depressed  because of my dad's yelling. He keeps asking me why I can't just be happy the way I am and yells at me on a daily basis. Is this considered emotional abuse?

Response: Maybe this is emotional abuse.It certainly is irritating and annoying to be yelled at for being yourself.Maybe at a time when he's not yelling you can bring up the topic of your own willingness, if this is true, to discuss questions he has about your gender.There's no guarantee he won't start yelling midway through a dialogue like this.  Only then you will be on firm ground to excuse yourself from the conversation since you already explained that you're willing to talk with him and not to be yelled at by him.


Context: I'm  very depressed. How do I find someone to talk to?

Response: Great that you realize talking with a professional counselor about how you feel, would be helpful!If you'd like a very fast response by phone, then google "depression hotline" for where you live.  And, if you have a specific topic which upsets you then google around with this topic to see if there are services specific to your interest.If you've got time to invest in looking for the best fit therapist for yourself, then google "therapy' or "therapist".There will be many, many names which come up.I know I sound like I work for google only it is the easiest way to find lots of information.I send you good luck!


Context: What makes a healthy marriage last?

Response: I appreciate your question.The answer of what makes a "good marriage" are as varied as there are marriages.Basically, similarity, like mindedness in beliefs and values, makes a good marriage. The best chance of getting along with someone on a longterm basis is when two people see life and the world in similar ways.Even though "opposites attract" this is a short lived dynamic which breaks apart when there aren't enough similarities in common between the partners.


Context: I'm having relationship problems and I want to fix them to make things right before I lose her. How can I learn how to listen and get myself together?

Response: I'm glad to read about your willingness to develop new ways to invest yourself with your partner.The easier way to fix a relationship is when both people are helped to recognize the ways the couple dynamic falls short of what each person would like.Couples therapy is exactly this.Still, relationships can change if one person changes since changing one part of a system will change the system itself.Besides starting to work with a therapist on what you can do differently, reflect within yourself on the situations when problems arise between the two of you.See if you can figure out what you wanted and what you partner wanted in that particular moment. Was one of you trying to help the other and the person felt insulted by the suggestion of needing help?This is only an example of how intentions are misread or not welcome by one partner from the other.Also keep in mind there is a limit to everyone's flexibility.Reflecting and self-awareness are the first step.The second step is to know when you've reached the end of possibilities to change yourself and not be accepted for who you are.This raises the question of whether the two of you are far apart in similarities in order to be happy together.Good luck in enjoying the changes you will try to make!


Context: My wife and I got separated because I asked about her contact with a male friend of hers. The next day, she kicked me out.  She let me move back two days later. Yesterday, she said she wanted a divorce then quickly changed her mind. I asked if the other guy was a factor, but she says it's not my business.

Response: When "threats" of leaving, such as what you described in your question ("kicking you out, wanting divorce") are continuous in your marriage, it can start to erode at the foundation of your relationship, impacting both partners. And, if you're concerned about the influence of another male in the relationship, and are unable to express your concerns or fears to your wife, it's extremely difficult to build a secure functioning relationship. From the information provided in your question, it seems as if there is some avoidance evident in your relationship. Avoidance of being able to express yourself and have honest communication about your relationship. If your wife is willing, I would recommend seeing a marriage counselor to help you both during this time. Or, for you to talk with an individual therapist, if marriage counseling isn't an option.


Context: I've only been married three months. Every week, we argue about something, and it seems to be getting worse.

Response: One key factor to consider is, are you able to repair after your arguments? It seems from your question that repair is lacking after any disagreement or argument. When couples are able to repair after an argument, they have an opportunity to learn more about each other's needs moving forward. I'm also curious if you're having the same type of arguments over and over? If you're stuck in a particular pattern, and can start recognizing what happens between you when this pattern happens, then you can start to name it. Once you name it, then you can take a break to cool off and come back to each after your nervous system has had a chance to calm down (about 30 minutes). The key here though is to make sure you have a plan in place - when things are good between you - an agreement between you that when you both start to get escalated, you'll name it or have an agreed upon code word to signal you don't want to continue this cycle, and then agree to cool off and come back together at a later time. That way, when this is enacted during an argument, nobody feels abandoned during the cool off time. Rather, both partners know they will return at a time when they can truly hear each other and hear their needs.


Context: My ex-wife married and used me to have a child. She now uses that child as a pawn. I know my child misses me, but I need to move on and not live in the past. How do I do this? Do I see my child as much as possible or very little? Is it more confusing for the child?

Response: I am really glad you reached out. When parents get divorced, they still need to figure out how to have relationship so that they can parent their child. We might divorce our partners, however, we don't divorce our children. If anything our children need to know that we are still a stable force in their lives. Unfortunately, in some relationships children get used as a bargaining piece and I am hearing that may be happening in your relationship. You can move on from the relationship with your ex while still maintaining a relationship with your child. It is possible and it takes both parents to agree to do the right thing by their child. It is important for your children to have some consistency in his or her time with you. For example, if you and your ex don't have a parenting schedule it is something that you want to create so that you can not only decide for you when you will see your child, but your child can know when you will be available just for her. This will lay the foundation for consistency and allow your child to have some security in troubled times.I would highly recommend you sit down with your ex and discuss how you can both be a positive source in your child's life. How you can both be there to help raise her. If this is not a conversation that you can have on your own you might seek out help from the court. There are parenting experts and mediators who might be able to assist you.Remember, in any discussion keep the focus on what is best for your child and you will be moving in the right direction.Best of luck to you!


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky.  Is this normal? Should I still be feeling like this?

Response: It takes a lot of courage to go to therapy.  I have gone myself as a Counselor and know what that feeling is like. This is normal but hopefully you have become more comfortable with your therapist. This might be something to bring up to your Therapist and openly discuss (scary to do but its ok) this may even relieve some of your anxiety.  If it continues, you may want to consider trying another therapist as this one may not be the best fit for you.


Context: I was raped a couple months ago, Since then, along with other unfortunately events that have occurred, I have been having trouble feeling emotions. It's almost as if I'm a sociopath lacking any feeling. What can I do to change this?

Response: First and foremost, be gentle and patient with yourself. It is normal to feel a range of emotions after a severe trauma including no emotions at all. Try not to push yourself to feel, just notice the lack of emotion you are experiencing right now. Maybe write about your emotions and the lack of them or talk about it with a safe person. Unfortunately recovering from trauma can take time and it's best done at your own pace. If you aren't feeling there may be a reason you aren't feeling. For severe trauma I always recommend working with a trained trauma professional who has the training to guide you on your path to healing fully.


Context:
I'm always listening to my husband, but it feels like he never listens to me.

How do I get my husband to listen to me instead of me listening to him all the time?

Response: Thanks for reaching out. This is a great question. Communication is definitely a 2-way street. One person cannot participate in a discussion. It takes a talker and a listener. Furthermore, communication will breakdown if each party is only focusing on his or her agenda and is not open to what the other person is saying.  since I can't ask you questions about what is going on, I am going to make a guess at one situation that comes up a lot when I work with couples. One person focuses more on solving the issue, than listening to their partner.  This can be frustrating for the partner who wants to just be "heard."I understand that you are working really hard to listen to him and he might not be putting as much effort into listening to you. That can be really frustrating and difficult and I want to acknowledge you for wanting to improve your relationship.One of the best strategies to gettting heard, is actually to BE A GOOD LISTENER to someone else. I know you are probably already a good listener and for you to work on listening skills may seem counterintuitive, right? You want to get heard and now you are the one doing the listening. But this can really create more effective communication if you invest time working on doing some active listening in your relationship because then you get to model those skills for your husband and allow him to see what it feels like to be listened to and then you can even teach him some of those skills. In other words, you practice specific techniques that you can use and then teach later on. Here are some skills for you to use consciously and then you can teach:Pay attention and use your body language to convey that you are in the conversation. No texting or distractions. Lean in. Focus.Listen for content and for emotion. Clarify what you don't understand. Try to understand the person's underlying emotions. Don't rush to judgement or to changing what is going on with the person. Sit in a place where you are really curious and want to understand what is going on. Encourage the other person to continue speaking, Nod and vocalize that you hear what they are saying.Ask questions to get to understand the other person's point of view.I believe when we can model these kinds of listening skills, and the other person feels heard, they will be more likely to listen to us. If you don't find that this doesn't spill over in that way, then have a discussion about what you are practicing and that you are learning these skills to be a better listener so you can understand him better. Then explain how it might be helpful if you both tried it. If there is push back from him, set up a trial period to just try the skill, perhaps for 2 weeks and see if it helps. If communication is really breaking down, then it might be time to work with a counselor who can help with these skills.Best of luck to you!


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: It's completely understandable that you would have male friends and that you would want to spend time with them.  When you cross over from friends to a relationship, it does change things.  Some people are very easy going and wouldn't feel threatened by what you did  Others would be upset.  If your boyfriend is upset by you spending time with this male friend, then you need to talk about it.  Each of you needs to express your feelings about the situation and listen to the other with patience and respect.  Then you can make a decision on what is best for you and your relationship.  Maybe he wouldn't be upset if you saw this friend while you were with your boyfriend.  Or maybe your boyfriend would feel better if he got to know this person better and could trust him.  Most likely you can come up with a situation that will make both of you comfortable going forward.  You didn't do anything "wrong" because it doesn't sound like you intended to hurt your boyfriend.  But if you really care about your boyfriend, then you probably care about making him upset.  Instead of looking at this issue as a problem, try to look at it as an opportunity to connect.  If you can both listen to each other and understand each other, your relationship can become even closer.


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: Thank you for submitting this question. I think this type of situation can be common for many couples struggling with how to keep friendships with past relationships while being in a new relationship. For me, more information is needed here...but given the information provided, the way I interpret the question is...I'm assuming your boyfriend didn't know you were going to spend the weekend with your good friend?  Working off of this assumption, I would suggest beginning an open and honest dialogue with your boyfriend about what specifically upset him? And to talk about your point of view regarding spending the weekend with him. I would also suggest talking about how you both envision your relationship when it comes to spending time with others. If you feel like you can't have this conversation without it going off track, please consider seeing a couples therapist. They can help you begin these important conversations that can help shape and develop the relationship you and your boyfriend long for.


Context:
I crossdress and like to be feminine but I am attracted to women, but yet that seems to bother girls I date or ask out.

How can I approach them about it? should I hold back and keep it a secret, or should I just be up-front about it.  I wonder if i should stop or if I should continue to do it since it makes me happy.  What should I do?

Response: Keep doing the crossdressing since you like it.Your problem sounds more a matter of timing and reason to tell the girl about it.Not keeping a secret is a good attitude regarding meaningful parts of your life.  Usually our relationship partner is someone whom we trust as a safe person to know all about us.Once you feel at ease with your potential partner then bring up your crossdressing.  Based on their handling of this intimate part of your life, you will know more as to whether or not you feel more or less drawn to them.Secrets held within a relationship usually get worse with time.   The person who feels unsafe in truly being and stating themselves eventually will end up feeling ashamed of parts of them which prior to the relationship, felt good or at least not worrisome.


Context: I don't know how else to explain it. All I can say is that I feel empty, I feel nothing.  How do I stop feeling this way?

Response: Your question is very broad because feeling empty can develop for many different reasons.You're certainly not alone in feeling this way!Try to follow the logic of your feelings by asking yourself questions about the empty feeling.   Doing this may open up a discovery about the reason for the emptiness feeling.When do you feel empty, are there certain situations it happens more often than another, what helps the feeling go away, what or who is helpful in relieving the empty feeling.Sometimes people need a little help to get started in understanding how to recognize their feelings.Consider a therapist, any disciplined practice which encourages self-knowledge, such as some yoga practices, and a creative discipline like photography or music. As long as you concentrate on increasing your self-understanding, eventually you'll find the answer to your question!


Context: People who are parental figures in my life have, in the past, hurt me, and some continue to do so. It makes me feel like I'm not good enough for my husband or the life he provides me. I have had jobs, but I am going through a lot of my past garbage and trying to figure out when it all went wrong. Any time I bring these things up, I am expected to be over the issue. These are people that you can't just cut out, but I have never received apologies for so much of my pain. I don't know what to do any more. I don't know who I am anymore.

Response: Hello. Adults who come from abusive home histories (physical, emotional, or even psychological), may take a long time to heal from that abuse. We carry our past with us everywhere we go, and it is up to us to find resolutions to past hurts. This is often easier said than done, but it is possible. From the perspective of those with whom you have shared your concerns, it might be assumed that based on where you are in life and who you are now, that you have already worked through any issues from your younger years. Some of our deepest scars in life are indeed invisible and suppressed. We have to get to the place where we can take care of the inner child that is still hurting, by recognizing that those who hurt us - however they did, might have had their own challenges which prevented them from functioning and behaving in ways we might have deeply needed. Those who have directly hurt you, may not be capable of acknowledging and understanding how you were affected by their actions - even in the worst of cases. They themselves may be doing what they can, either out of shame or heartbreak for their own actions, to work on forgetting how they behaved toward you all those years before. How are they behaving toward you now? Can you find it in your heart to forgive those who have hurt you? Forgiveness is the gift we give ourselves, and isn't dependent on an apology from an offender. By forgiving (even in the absence of any apology), we are releasing the weight of the burden we are carrying that reflects the offense we feel was committed against us. Sometimes therapy can be helpful in this process. Talking with someone who can be non-judgmental and reflects an empathetic position toward you might be what you need right now. Seeking out a therapist to help you work through these negatives feelings and thoughts is much easier, than trying to go it alone. I would encourage you to reach out and find someone who resonates with you on that journey, so that you can begin a path toward healing.Warm regards,Shawn Berthel, M.S., LMHC


Context: I've been going through a rough time lately. I been into nothing but women. I’ve never thought about men until a week ago. I’m very upset and depressed about this. It's not normal to me. I looked at gay porn more than once to prove that I’m not gay. I get the same results each time, and I feel disgust. This is tough on me. I'm scared that I looked too many times. I keep thinking about it and shake all the time.

Response: Hello. Coming to terms with the idea that you might be of a sexuality other than the one in which you were socially raised to be, can be emotionally disturbing, and quite unsettling. It creates anxiety, maybe even panic, and leaves us feeling confused and uncertain about our own sense of identity. It becomes important to first ask yourself how you feel when you are thinking of being intimate with guys, or if you desire them to be intimate with you. It is important to know what impact this has on you, because it can determine your level of follow through and desire in pursuing sexual activity with someone of the same sex. I am not going to pass judgment on you either way - even for having the thoughts. I have worked with the lesbian, gay, bisexual, transgender, queer (LGBTQ) community in various ways over the years. Many I speak to, say they had to struggle to come to terms with this awareness about how they see themselves sexually. Maybe you are bisexual, and don't have an exclusive attraction to the same sex. You might consider doing some searches online for community support groups in your area, to explore the feelings and issues around this topic. Talking to someone who you trust can be helpful too. Running from your feelings is not a good idea, and others in a support group for sexuality issues, might be able to relate to you and what you're going through right now. This will offer you perspective, as you think on how this plays out in your life.Counselors are typically well trained to provide clinical services to clients who are experiencing feelings and thoughts much like the ones you are having now. I encourage you to consider reaching out for help. You are not crazy or insane for thinking of working with a counselor, nor of having feelings of same sex attraction. If you decide you are indeed gay, then know that you are not alone and never will be alone in that feeling. There is a huge community of support for you. Additionally, we all need help sometimes dealing with all sort of issues. A counselor can work more in depth with you to examine the motivations behind the feelings, and help you come to terms with them more directly. I hope that you come to a place where you feel less alone and more secure with yourself as you examine this area of your life. No matter what, do not fear being yourself. Again...you are not alone, I promise.Warm regards,Shawn Berthel, M.S., LMHC


Context: Every winter I find myself getting sad because of the weather.  How can I fight this?

Response: Sometimes its quite literally the lack of sunshine that can affect our mood - in these cases it can be worth experimenting with a sun lamp, to boost your dose of vitamin D, when the sun isn't naturally out. Also consider, what is it that the change in weather, changes in your life? If for example, when its sunny you are an outdoorsy, active person and when the weather changes, you're whole activity level changes along with it, you could explore how to get some of that activity replicated indoors in the winter months.


Context: I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky.  Is this normal? Should I still be feeling like this?

Response: Therapy can feel very weird to begin with - think about it, how often do we go and tell a relative stranger our deepest, darkest thoughts in the rest of our life? So I think its reasonable to expect a certain level of nerves as you get used to your therapist and to the whole process of talking about yourself and vulnerable topics. That said, its definitely worth bringing to the attention of your therapist (if you haven't already) to see if there is anything that they can do, or that the two of you can explore together, that might make the process feel less intimidating to you.


Context: I need help knowing how to deal with stress. What can I do?

Response: Learn how to meditate. I recommend a Mindful Based Stress Reduction MBSR program.


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: That is a difficult situation and there is no right or wrong. You both need to discuss it and come up with a solution that works for the both of you. You want to spend time with your friend but your boyfriend  may feel betrayed by you spending quality time with another man you have been intimate with. There may be a way for you both to get your needs met. Maybe you only spend short periods of time with your friend, not a whole weekend. Or you check in with your boyfriend  periodically when you see your friend. It really depends on the two of you. If it becomes too difficult, you may need a neutral party to help you establish appropriate boundaries around this issue. Good luck!


Context: I'm  very depressed. How do I find someone to talk to?

Response: Hang in there! Feeling depressed sucks but talking with someone can really help - so its awesome that you're already trying to figure out how to find that person. Tons of good suggestions already but to add my two cents - you can find therapists in your area and read a little bit about them to find someone you like the sound of via this website, and also via www.psychologytoday.com; if you have health insurance your insurer might be able to make recommendations as to therapists covered by your plan, or if you happen to be in school, the school itself should be able to connect you with either their own counselor or a center that they recommend nearby. Finding someone can take a few calls or a bit of research so if you need some immediate support, or find yourself having thoughts of hurting yourself, you can also call the great folks who run the Suicide crisis line https://suicidepreventionlifeline.org - they are great in moments of crisis.


Context:
I'm dealing with an illness that will never go away and I feel like my life will never change for the better. I feel alone and that i have no one.

How can I overcome this pain and learn to be happy alone?

Response: I'm so sorry you're feeling like things will never get better. Try to remember that whatever illness you are dealing with, you are not the only person to have dealt with it and you are not alone! Out there, just waiting for you, is a group of people that will totally understand what you're going through and will be able to share how they coped. Try searching for a support group for your illness - google and www.psychologytoday.com are both good places to start for those groups.


Context: I need help knowing how to deal with stress. What can I do?

Response: Our body reacts to stress typically by breathing more shallowly, increasing our heart rate and tensing our muscles - so one thing that I find really effective is to try to do the opposite of that, which sends the signal to our mind that we are relaxed. So that means, taking slower, fuller breaths and trying to relax any areas where we might be gripping our muscles. Check out meditation apps such as 'Breathe', which can talk you through a relaxing breath exercise. I recommend using the app daily, whether you feel stressed or not, and then also using it when you re feeling particular moments of stress - that way you are practicing the skill when you feel calm(wish) and it'll be ready and able to help you when stress hits hard.


Context:
I am in my early 20s and I still live with my parents because I can't afford to live alone.

My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

Response: You're among many millennials who live with their parents due to financial reasons.Does your mother mean rules pertaining to the way your family household organizes its daily or does she mean something else?Every household needs rules as responsibilities to keep the house clean, who does the grocery shopping, the way costs are distributed for this and all the other carrying charges  and tasks of maintaining the house in decent order, as well as respecting the privacy and noise level requests of others who live in the home.This set of responsibilities applies whenever more than one person lives with another person.Have you tried simply telling your mom that you're willing to be a responsible household member and that you prefer to keep the details of the way you live the rest of your life, to yourself?This would show respect to your mom and start the discussion as to the areas of your life you feel deserve privacy and how you would like to handle when your right to run your own life overlaps with any household duties.


Context: My ex-wife married and used me to have a child. She now uses that child as a pawn. I know my child misses me, but I need to move on and not live in the past. How do I do this? Do I see my child as much as possible or very little? Is it more confusing for the child?

Response: What are the ways your ex-wife uses your child as a pawn?This answer determines the best ways to handle particular situations.Basically, distinguish that your father relationship to your child lasts has great meaning for your child and as the adult, the responsibility for managing this relationship falls on you.Your relationship to your ex wife took place between two adults and therefore you are only responsible for your own actions to repair the damage done to you.From what you write, you already have a plan in progress to do this by separating yourself as much as possible from contact with the ex.In a way the challenge of keeping active as a parent while also distancing and clearing your emotions of the hurt and betrayal done to you, will establish both a solid relationship with your child and grow more acceptance and self-forgiveness of having been taken advantage of and tricked.


Context:
I'm concerned about My 12 year old daughter.

About a month or two ago she started walking on her toes, as well as coloring and writing very messy. This all happened very suddenly. She has never walked on her tiptoes and has always colored and written very neatly.

Is this something I should be concerned abou? Any advice will help.

Response: Have you asked your daughter why she's doing the behaviors you describe?Often the best way to find out why someone does something is to simply ask them their reason.Her answer will give you some guidance as to next possible steps.If she's pretending to be a fantasy figure or trying to find out how being taller feels, or walking on high heels or some other image then knowing this rules out that she has some unbearable pain in her arch which may require more practical answers such as new shoes or even indicate a medical problem.Ask if she's noticed any change in the way she walks.   Maybe she doesn't know she's doing this and maybe she feels embarrassed to tell you she's doing something a bit odd.Since usually 12 year olds don't color, is it new that she started coloring?Maybe given the fact of messy handwriting, she's in a phase of pretending or reflecting on good times as a young child.Then this becomes the topic of examination.Does she feel insecure about being on the cusp of adolescence?Some of these questions can be asked directly and some are for you to first decide based on what you know of your daughter, which questions and what direction to take in understanding your daughter's motivation.


Context:
A few years ago I was making love to my wife when for no known reason I lost my erection,

Now I'm In my early 30s and my problem has become more and more frequent.  This is causing major problems for my ego and it's diminishing my self esteem. This has resulted in ongoing depression and tearing apart my marriage.

I am devastated and cannot find a cause for these issues. I am very attracted to my wife and want to express it in the bedroom like I used to.

What could be causing this, and what can I do about it?

Response: First step always is to do a medical rule out so that you're sure the problem is psychological and emotion based, not a medical condition which requires care and attention.If you are medically clear in the reasons for losing your erection, then reflect on what may be creating a loss in confidence in either who you are and what you're doing with your life, or whether your wife has these sort of problems within herself.Often a problem transfers ownership of who shows it.If you are a sensitive person its possible your erection problem reflects your wife's insecurities and self-doubt.  If she is someone who is reluctant to talk about feeling unsure then in a certain way by you showing a problem, she can avoid looking at herself.There may not be a direct cause such as usually exists in a medical problem.Medicine looks for symptoms to treat.Our emotional lives are much more indirect.If you feel stress at work or are unhappy in the place you live, for example, then your frustration may show up in your sex life.Basically, do a broad inward search of your life and what it holds and maybe ask your wife to do the same.You may clear the air within yourselves and between each other so the problem goes away.


Context: I need help dealing with stress. How can I handle it all and feel less stressed out?

Response: In case you feel some relief to know you're feeling the tone of our times.We live with crumbling of our values which then gives rise to insecurity everywhere.  If someone doesn't know what their values are then its difficult to do anything, and right now everyday we hear uncertainty in what used to be our basic assumptions.You're more normal for noticing and feeling stressed than if you imagine life felt fine the way it is!One road to take is to accept that there are no clear roads forward.  This means to change long term goals into shorter ones.Also, in general the more focused you can be as to your particular wishes, motivations, interests, and people about whom you care, the greater will be your sense of confidence that your personal world is as secure as it can be for right now.And, it helps too to know that nothing lasts forever, eventually all of what is up in the air will start to land in a much more clear way.


Context:
I know I need to deal with my depression. But I don't know how and I don't want to tell anyone.

How can I deal with depression without telling anyone?

Response: It can be really tough to tell someone - anyone - that you're feeling depressed. But finding that supportive person that you can share with is a big part of the battle with depression. Depression thrives on being secret, it seems to grow the more we isolate ourselves and hide it away so I'm with Laura Cassidy, when she suggests finding that professional support person so you can start fighting back against your depression. If that feels like too big a step right now, maybe check out a book or two... I'm a big fan of a book called 'Feeling Good' by Dr. David Burns if you want some practical thoughts on tackling depression and on 'Radical Acceptance' by Tara Brach if you prefer something a little more spiritual.


Context:
I've been bullied for years and the teachers have done nothing about it. I haven't been diagnosed with depression, but i have been extremely sad for years.

How can I deal with being bullied at school when the teachers won't help?

Response: That's a very difficult situation that you are in. But you are not alone. I have several school-aged clients who find little to no assistance from their teachers at their schools regarding bullying.There are a few options that are available to you to help deal with being bullied at school. One option that I would suggest is for you to talk to your support network. Friends and family can sometimes be good sources of support. Another option would be to speak with us about your counselor, if you have one. And third, there are some excellent online sources of support regarding the bullying at school (www.stopbullying.org).


Context:
A few years ago I was making love to my wife when for no known reason I lost my erection,

Now I'm In my early 30s and my problem has become more and more frequent.  This is causing major problems for my ego and it's diminishing my self esteem. This has resulted in ongoing depression and tearing apart my marriage.

I am devastated and cannot find a cause for these issues. I am very attracted to my wife and want to express it in the bedroom like I used to.

What could be causing this, and what can I do about it?

Response: When I'm working with men with this type of situation, I always suggest a medical examination to rule out any type of organic reason for a difficulty in maintaining interaction. In cases where there is no medical reason for the loss of erection, I find that many men have a similar situation in experiencing negative intrusive thinking during lovemaking. My counseling approach for this situation is to incorporate the use of mindful sex.


Context: I need help dealing with stress. How can I handle it all and feel less stressed out?

Response: Part of handling stress is making sure that your perception of the stress is accurate. Sometimes stress can seem more than it really is. One thing that I encourage my clients to do is to ask themselves, "What is this stressor really about?" Simplifying stress is a key to minimizing stress and leads to feeling less stressed out.


Context: I don't know how else to explain it. All I can say is that I feel empty, I feel nothing.  How do I stop feeling this way?

Response: A feeling of emptiness can be from a lack of awareness and acknowledgment for the things, the people, the places that you have in your life. The use of affirmation and gratitudes helps to remind ourselves of all of the aspects of our lives.


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: This can be a very complicated situation. The boundaries of relationship include the rules to follow in the relationship. It is important to follow the rules of your relationship  in regards to each person being able to spend time with exes. If you and your boyfriend agree upon a rule about spending time with exes, then there should be no problem.


Context:
A few years ago I was making love to my wife when for no known reason I lost my erection,

Now I'm In my early 30s and my problem has become more and more frequent.  This is causing major problems for my ego and it's diminishing my self esteem. This has resulted in ongoing depression and tearing apart my marriage.

I am devastated and cannot find a cause for these issues. I am very attracted to my wife and want to express it in the bedroom like I used to.

What could be causing this, and what can I do about it?

Response: For starters, know that this is a normal experience for many men at some point in their lives. While this can certainly cause some embarrassment, a diminished sexual esteem or relationship problems, it is important to know you are not alone. I am going to move forward assuming that you have already checked with a medical professional to rule out any medical problems that may be related to this. Assuming that is the case, for most this happens for two primary reasons. It is either a short term biological shortage of blood flow to the penis. This can be caused my diet, lack of exercise, even stress. Another primary reason for loss of erections are anxiety. Have their been recent relationship issues? Are you feeling as though you aren't satisfied in the bedroom? These are just a few aspects that can cause subconscious anxiety and loss of erection. My suggestion to you would be to seek out a counselor that specializes in sexuality that can assist you in moving forward with this.  Best of Luck!


Context:
My fiancé and I have been together for 3 years and our relationship has always been good. The only issue we had was that he felt like he wasn't getting enough sexual attention from me.

I recently found out he cheated on me with another women.  He says he wants his family back but I'm confused on what to do.  Is it possible for us to get past the cheating, or should I just move on?

Response: As a relationship therapist I work with couples all the time that are in the repair phase of their relationship after infidelity. The short answer to this, is not only is it possible to have a satisfying and fullfilling relationship after infidelity, it happens more often that we may know. The current rate of infidelity is high, while it's not important to go into many reasons, it mau be important to know you aren't alone in this! My biggest suggestion for you would be to seek out a professional counselor that specializes in working with couples healing from infidelity. Best of luck!


Context: Does counseling really do anything that can help people?

Response: Hello. Yes, counseling can be beneficial to many people. One of the effective components to effective therapy, is when the client becomes willing to participate in the counseling. I don't mean just show up and listen to the counselor for 45-50 minutes, but also that the client themselves opens up and shares with the counselor the issues that brought them to counseling in the first place. This requires you to be vulnerable, capable of moving past your protective measures of showing the best of yourself, and allowing the counselor to see the sides of you that likely are not as favorable. Therapy works when you and the counselor engage openly, honestly, and with mutual trust that both of you will work for common goals - your improvement of self. It does take time, and there are no quick fixes (usually), so be prepared to invest in yourself and explore the dark places. You'll thank yourself later, knowing that you are more connected to yourself and might even feel more whole after the process. Be well.


Context: Does counseling really do anything that can help people?

Response: I love this question! Some people shy away from counseling because they think since they already talk about how they feel to their relatives or friends they shouldn't need a counselor. However, if you are having a difficult time, counseling can be beneficial in helping you move forward and get your life back on track. Counseling is not like the kind of talking we do to people we know. For one, your counselor does not have a history with you and has no expectations of how you will act and what you will do. In that way, counselors come to a session without judgement and expectation. This gives you the platform to truly explore your thoughts and feelings. A counselor can also help you understand your motivation and help you integrate your past experiences and recommend coping skills that can help you if you are feeling overwhelmed by your emotions. Over time, as you work with a counselor you will get feedback and also be able to share new insights. The work you do is based on you and where you are at. Oftentimes, when we talk to friends they bring their own agenda to a conversation, and while they mean well they may offer solutions that work for them and not you. A counselor will help you uncover the solutions that work best for you and help you find the motivation to follow through with your plan.Best of luck to you!


Context:
I'm dealing with imposter syndrome in graduate school.  I know that by all accounts I am a phenomenal graduate student, and that I am well-published.  I am well liked by students and faculty alike.  And yet I cannot shake the feeling that I'm going to be found out as a fraud.

How can I get over this feeling?

Response: It would be very helpful to identify with you eventual pattern where the imposter syndrome is more or less present. Are there specific situations where you've noticed the feelings of "I'm going to be found out as a fraud" becoming more strong? It seems that shaking this feeling is very important to you. In my opinion, before shaking that feeling, we need to get closer to it and understand its roots. If you would like to get closer to the feeling, you might consider asking yourself questions such: "What is the trigger for this feeling? How does it feel in the body? What is the thought process I engage with after noticing this feeling? All the best. Rossana Mag.


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: It is not the case of being right or wrong, in my view. If you are asking, I believe you truly care for your boyfriend. It seems like he is having difficulties in establishing trust in this relationship. The ideal would be to come closer to his upsetness and to show him that you are there for him. I hope all goes well. Rossana Mag.


Context:
I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends.

I spent the weekend with him and  it upset my boyfriend. Was i wrong?

Response: Ideally you and your boyfriend will reach a balance point where you and your boyfriend are each happy with the level of involvement you have with your former boyfriend.Start w a discussion with your current boyfriend as to what specifically he doesn't like about your friendship with your former boyfriend.It is possible that you can answer his concerns as well he can find out from you more as to what the friendship is all about.As a therapist, I've never seen a former romantic relationship become only a friendship.   As sincere as you may be in your intention to only keep the friendship with the former relationship partner, if  your former boyfriend secretly has romantic feelings for you, then at best, you've got an unclear friendship with this person.The obvious possibility is to socialize together with your current boyfriend and your former one. If neither guy would go for this, then this would show there is an undercurrent of competition for your romantic attention.Basically make your romantic partner's feelings and your own, the major considerations and discuss from this perspective.


Context:
I'm dealing with imposter syndrome in graduate school.  I know that by all accounts I am a phenomenal graduate student, and that I am well-published.  I am well liked by students and faculty alike.  And yet I cannot shake the feeling that I'm going to be found out as a fraud.

How can I get over this feeling?

Response: First step is to remove the label of your behavior as a syndrome and instead understand the reasons for it."Imposter syndrome" sounds like a name someone made up to write a book and have lots of people buy it bc it gives the feeling they know themselves by calling themselves this name.Instead, consider your own unique qualities including your fears of being recognized as adding value to people's lives.If you were told growing up that you're worthless, or if your chosen career goes against family advice and expectations, or if you simply are a shy person, then these would be the starting points to understand your reluctance to believe in yourself.The more you understand yourself and trust the truths you find as to who you are, the less you will feel fraudulent.Good luck in your career work!


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: From the very beginning of counseling sessions I emphasize that the work will and must end at some point.In counseling there is an arc to the process. A beginning, middle and end. I am always digging, searching and exploring. There comes a point where things come to there natural ending.I always leave an opening for continuing counseling in the future. At least as a check in.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: There are different reasons why a counselor may seek to terminate with a client and these will each have different processes by which the counselor will come to that decision. Here are a few examples. The counselor may determine that the client's needs are outside what the counselor is competent to be able to work with. A person may have come to the counselor talking about a particular issue but either when they first met or as counseling progressed, it may become clear that the issue is in fact something different or that there is an additional related issue. If that issue is outside the competence of the counselor, the counselor should look for alternatives, the most common of which would be to terminate and refer. Beyond clinical issues, this could also come up around particular other related facts, such as the culture of the client or linguistic issues. This could also be the choice of the counselor if they know someone that they feel would be a better match for the client's issues. Another reason for discharge (and possible referral) would be if the relationship does not seem to be a good fit. No counselor is the right person to work with everyone. If the right level of connection is not happening, the counselor will often look first at what they are doing, might talk about it with the client and ultimately will admit that things don't seem to be working to allow the desired therapeutic process to work. A similar process would be followed if the counselor determined that the client might not yet be ready for counseling as evidenced by lack of engagement such as frequent cancellations, not doing any agreed on work between sessions, showing up late or being really guarded in session. The easiest situation to decide on is when a person has met their counseling goals and have nothing new that they are working on. While this is the easiest one to determine, it is also probably the hardest one for the counselor as they may be like the client in not wanting the relationship to come to an end. However, counselors know that this is part of the process. They will also determine this by regularly reviewing the treatment plan or by sending in the sessions that the work has come to an end. This type of termination maybe final or may be with the intent that the client will return later to address other things that have been identified but for which they are not ready to move into. All of these (and other) situations involves the counselor being open to the relationship ending, to monitoring how things are going, then engaging in self reflection, possibly talking with the client and then coming to a conclusion on which the counselor  follows through.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: This is a question that is very specific to each person. There are definitely some variables, but I can give you some general ideas for when counseling might end:When a client has met all of their goals, at least to a degree when they feel that they no longer need to work on them with the assistance of a counselorSometimes a decision is made that a client is no longer benefiting from counseling at a certain timeSometimes clients have to remain in counseling in order to receive medication. This depends on agency policy, but sometimes it is a requirement. If the medication is necessary and cannot be prescribed by a primary care physician, frequency of sessions is usually decreased greatlyI'm not sure why you are asking this question, but it is also something that is often discussed at the beginning of treatment. Oftentimes "discharge goals" change as treatment progresses because more is known about clients, their goals, changes in their goals, and many other things. Changes are normal, but your counselor probably has discharge goals in mind, at least generally, from the beginning. I strongly encourage you to ask about it!


Context: How does a person start the counseling process?

Response: Usually people call me by phone, they introduce themselves, we chat for a bit, then we schedule a time for their appointment


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hi there, There are a number of reasons why a therapeutic relationship might end including, but not limited to the client reaching their goals, the client reaching a place of acceptance where they wish to remain or even a breach within the relationship.  The last aspect should likely be taken to supervision in order to be fully processed.  All of these things could happen, and usually happen organically (again, except for the last example). Your question, however, was about the counselor ending treatment. This is a bit more difficult and can be very nerve-wracking.  It may be beneficial to take this with you to supervision, as well.  It's important to understand why you feel the need to end or terminate with the client, as well. Do you feel that they would be better suited for another therapist, have they achieved their goals or is it something else?In regular, open-ended sessions, I try to make a point of checking in with the clients fairly frequently. In these check-ins, I use the time to ask the client how they feel about the sessions and if there is anything they wish to focus on more astutely.  I also ask if they have any immediate goals that they would like to prioritize.  In goal-oriented sessions, I check in more frequently to ensure that both the client and I remain focused and, should they wish to shift their focus, that they recognize it is part of my responsibilities to make sure we move back to the desired goal. Often, especially in longer term therapeutic relationships, we as clinicians can see that the client has reached their goal, however they are apprehensive about ending therapy.  This is actually a great place to go with them; why would they feel unable to handle issues in their external or internal environment without you? Often, having this open discussion can increase empowerment and mastery. That said, it could also highlight other issues which the client may have been apprehensive about going into within therapy and now, as the relationship seems to be ending, feels more confident in bringing these up. In the case where the relationship is a toxic one, terminating with a client may be the best option for both of you. It's a difficult conversation, but recall that part of the role of the therapist is to model that these discomforts can be managed. I hope that this brief response can assist you going forward!


Context: How does a person start the counseling process?

Response: Hello, There are many ways to approach a counselor and starting the process, however they all start with picking up the phone.  It's most definitely an uncomfortable feeling, but once that first step is taken it is often met with a wave of relief. My recommendation is always to call and speak with a therapist over the phone before scheduling an appointment. Listening to how they converse, use their tone and inflection, may give you a brief insight to how they will respond to you and increase your comfort right away. You may also discover, rather quickly, that this therapist is not the right match for you.Regardless of how you go about it, I like to remind all people who call, email, text or walk-in, therapists are a bit like pizzas - if you don't like the toppings, send it back! There are hundreds of therapists offering all kinds of styles of therapy - take the time to pick one that suits you.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: There are typically three reasons why therapy is terminated:1) Client has met therapy goals2) Client is not progressing 3) Therapist is not a good fit for clientIn order to properly assess whether therapy is helping and what progress is being made, the therapist needs to have ways of consistently checking in with clients sessions-by-session to determine what is helping, what isn't, and where the client is at in relation to their original therapy goals. When a client has met their goals, that is a good time to end counselling sessions unless the client has new goals or simply wants to check-in periodically to make sure that they are still on track (sometimes referred to as relapse prevention). When a client is not progressing, and feedback has been taken and attempts have been made to make the therapy more helpful for the client but to no avail, than it is considered unethical to continue to work with the client. In these circumstances, referring out to another therapist who may be a better fit is a good idea.


Context:
I'm in my late teens and live with my dad.  The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks.

Sometimes I feel i'm not worth knowing or i'm never going to do anything right.

Are they right, am I depressed?

Response: I'm alway wary of assigning a term to a feeling, as often that term becomes more important than the feeling itself. From the very little that you have written, it is clear that you are going through something that has made you extremely low, affected your self-esteem and motivation, limits your enjoyment of formerly pleasurable activities and affects your feelings of self-worth. All of these are aspects of being depressed, though you can be depressed and still not have "depression". Counseling is definitely a place where you can go and sort out why you have had such a sudden a drastic change to your mood. Sometimes our mood can be effected by changes in our routine, losses or significant disappointments. Talking with someone will not only help you to better understand why you are feeling this way, but they will also help you to ground yourself and learn strategies and tools to help you to manage your mood and strategize for the future. I do hope that you will reach out. Feeling alone can be harmful over long periods of time, as it can stop us from seeking out the support we need.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hello. The end of the counselor/client relationship is one of mutual respect and engagement. Counseling sessions can end for any number of reasons. Among them are the client's inability to make forward progress in therapy; the clinician's inability to help the client (for a variety of reasons); a mutually agreed upon time frame for a number of sessions to be provided; or the financial challenges of the client who decides that they need to put their resources elsewhere. In this last case, a counselor should never cancel sessions with a client simply on the basis of the client's inability to pay. That is traditionally seen as an unethical practice. Other arrangements can be made to provide care to the client, which in itself should be paramount.When the client and therapist decide that services are done, it is best if there is at least one or two more sessions to allow a case file review to occur, and to bring an appropriate psychological sense of closure to the client (and vicariously to the clinician as well, those this is perhaps not as important). This transition gives both a sense of having reached the end of a journey...rather than some abrupt departure from it. (An abrupt ending in therapy can have a varying level of impact both emotionally and psychologically on the client and therapist). Sometimes the closure of therapy is the result of a program of therapy being formally completed, in which there is a mutually known (albeit perhaps approximate) date of when that program will be finished. In this case, the client is likely feeling that impending closure and has time to prepare mentally and emotionally from a place of being the client in therapy, to a place of healing, growth and situational resolution.I have always worked in therapy with the following slogan (if you will), that I learned years ago during graduate school: "Not every therapist is good for every client, and not every client is good for every therapist." It is perhaps one of the most important guiding views I hold in working with clients. The therapeutic relationship is driven by mutuality - the desire of the client to get better at living life, and the therapist's desire to truly see the client heal and grow. When there is a block in this process from either side that prevents that synergy from occurring, the relationship that should be established may not be able to form. Or, if already formed, may at some point be unable to move forward. In these instances, referring the client to another type of service or clinician is appropriate. Usually, this can be seen pretty quickly by either party, though sometimes it is not always clear.Ultimately, the client and counselor need to work together to discover if the needs of the client (which is paramount) are being met in the therapeutic engagement with their current counselor, or if other arrangements need to be made to go elsewhere. If both are observant in this process, they can work together to maintain that sacred space and continue to reach the goals that have been set. Eventually, therapy will end, but hopefully based on the client's successful journey to the place where they wanted to go, and thus opening the next chapters of their life to a space that is more whole and brighter.


Context: How does a person start the counseling process?

Response: Hello. Counseling often begins way before the client ever actually calls the local therapist. There is often a tipping point in the internal struggle that the client experiences, where they can no longer deal with the issues on their own and thus giving the motivation to seek external help. That said, clients usually go seeking therapists based on what their insurance will cover, or what is likely to be more and more the case in the near future...what they are able to pay for out of pocket. That first phone call to a prospective counselor can often feel like torture, but it doesn't have to stay that way. Counselors are well trained to acknowledge the inherent goodness of all clients, and should be able to see and hear the sense of fear in the client of being judged or put down in some way. The counselor you select should be compassionate, caring, able to join with you on your journey to resolving your issues or concerns, and to do so without negative judgment of you as a person of worth.Once you have found a counselor you want to work with, you would then schedule an appointment to meet. That first session is often very low key. There might be some forms for you to complete, which will help the counselor address your concerns and learn a bit more about you. The counselor will typically provide you with what we generally call in the profession a professional disclosure or practice statement. This document (which may be several pages long) usually outlines the counselor's credentials; practice rules; forms of payment; office hours; emergency contact details; and confidentiality guidelines under state and federal law, among other details. All of this benefits you as the client, so that you are well informed and can focus your attention on why you are meeting with the counselor.In the first session, it is absolutely okay to be nervous. Here's a really big secret (which is important to keep in mind as counseling begins): Counselors are often as nervous (if not more) to meet a new client, as the client is to meet their new counselor. It's true. We as professionals are trying to put our best foot forward to impress you with our awesome counseling skills. While simultaneously hiding all the troubling unwanted issues that we ourselves have in our life too, and being worried that we might not know if we can help the client sitting in front of us. What makes it even more challenging, is that counselors are often put on a giant pedestal of perfection by clients (all while we as counselors tend to look at it like we're standing on a three legged stool). This is normal for us when seen from the eyes of the client. Counselors and clients are both human, and we both make mistakes. Coming from that place of understanding, might bring a sense of ease to both the client and the therapist as they seek to work together. Part of this perception of perfection held by clients toward counselors, is that the skills of the counselor might look like they have all the answers. We honestly do not, plain and simple. Counselors come from life experiences (where they might be farther down on life's road than you); they hold completion of various forms of training; and have advanced education. Yet we are in the end, imperfect beings struggling to help imperfect people. This makes it easier to be compassionate to new clients walking through our door with the hope that we will receive that same compassion in return. Very often, we can find ourselves reflected in our clients' lives with their struggles and can become more effective at helping if we have resolved similar issues in our own life. So as you begin to seek out a therapist, try looking for one who is aware of their own life issues and is actively working on them too. Someone who can meet you where you are at emotionally and can understand your sense of your struggle that you are facing at the present moment. That counselor may be a good example for you as you enter into therapy and build your own strength, and thus begin dealing with the issues more effectively you bring up in therapy.


Context: I'm dating this guy, Peter. My friend Jennifer used to date him a while ago, and she's fine with us dating. My ex-boyfriend, Paul, broke up with Jennifer, and she's devastated about it. Peter and I are going through a rough patch in our relationship. All of a sudden, Paul is in "love" with me, and he wants me back. I don't know what to do because I can't hurt my friend or my boyfriend, but I think I might Paul again.

Response: Hello. The dynamics of having a romantic relationship with someone is not always clear. Sometimes we jump from one relationship to another without giving ourselves a chance to adjust and grieve for the one we had to leave behind. When you find yourself in a situation where a previous partner is coming back into your life and desires to be with you again, it is important to ask yourself what the motivations are prompting that return. Is the person afraid of being alone? Are they jealous of your current relationship? Do you feel the same way about this returning relationship as you did before it was ended? How long and/or how committed is the current relationship you are in now with your current partner? Does your former partner not like being "dumped" and maybe they just want to get back together with you so that they can "dump" you instead? Some of these questions you may not be able to answer, and some of them might require your own internal reflection.You likely want to make a good decision, and you also might want to consider who it will impact, and how that will happen. Other friends might be upset at this sudden change, and it could create a strain on your friendship. You will want to carefully consider the value of that friendship before you take any actions that could damage it. Also perhaps think about what led you to end the relationship with your previous partner in the first place. Has there been a change in events or behavior that would cause you to think of a valid reason to give that person a second chance? How it will it impact your current relationship?Going into relationships should be done with reflection, patience, and full awareness. Ultimately you choose who is in your life, so you want to make those choices based on appropriate decision making, and with the ability to protect yourself from harm. No one else can make this choice for you. However, gaining the insight of friends or family can be helpful, as can seeking out the counsel of a therapist. In your heart, you will likely find the right answer. Learn to trust that more, as that is where the core of emotion tends to be when you need it. Use your mind to analyze things, but allow yourself to also feel your way through the situation too. The answer will arrive if you let it.


Context:
I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing.

What can I do to manage my stress?

Response: Hello. Workplace stress is one of those areas of living that troubles many people who need an income to survive. The interactions between you and coworkers is a mixed bag, and sorting that out can be difficult. Also, if you are feeling under appreciated and not well paid, this can add bitterness to your lot of emotions. A few questions can be kept in mind as you work through your situation. Do you have the option of talking to your employer about your experiences and feelings with regard to your current work? Do you have local resources that you can use to find different jobs in your field? Do you have connections with employment counselors or agencies that can support you with strategies in dealing with workplace stress? These questions might cause others to bubble up, and could begin a new journey into a new field.While still at your job, what can you do to take care of yourself? Are you taking breaks? Do you eat lunch at the office, or do you go somewhere away from the office to eat? What do you do when you have a few moments to breathe? Understanding that you can indeed find even the smallest strategies useful for self-care, can help bolster your energy and give you some support as you move through the day. Seeking the support of family and friends can be helpful as well. Knowing your personal limits and when to pull back and take a break will give you a chance to recharge your mental and physical energy, thus helping you face the demands of your job.


Context: How does a person start the counseling process?

Response: Hi! Great question! My suggestion would be to google therapists in your area.  One great website is called Psychology Today, which is a National site.  You can search for therapists in your zip code and search more specifically for the issue you are seeking support about.  It's a great way to find out if they therapist has a speciality, accepts insurance and whether they offer a free phone consultation. I would then make a list of the ones that may be a good fit and then give them a call!  :)  Hope this helps. Remember you get to ask anything you need to, to determine if someone is a good fit.  Don't be afraid to ask anything!  :)  Best of luck!


Context:
I crossdress and like to be feminine but I am attracted to women, but yet that seems to bother girls I date or ask out.

How can I approach them about it? should I hold back and keep it a secret, or should I just be up-front about it.  I wonder if i should stop or if I should continue to do it since it makes me happy.  What should I do?

Response: Thanks for asking this question. I think the most important part of what you mentioned was that you do it because it makes you happy. For that reason, I would encourage you to keep doing what makes you happy.As far as telling girls or keeping it a secret, I don't really think that it's necessarily one or the other, at least not the first time that you meet. In other words, one part of your decision-making could be whether it is something that you always want to address in the first date, or perhaps something that you address after you've known each other for a couple of meetings. The answer to that question may also change depending on who you are dating. I would imagine that each person that you are with mainly due to a different decision this was when to disclose this. It sounds like this is an important part of you, so I would think that if you were going to date someone long-term, you would want them to know about the most important parts of you, including that.I also encourage you to remember that if you meet someone who is not comfortable with this, that does not mean that there is anything wrong with what you are doing, but rather something that the other person is in some way deciding not to continue learning about or choosing to have someone they are dating like to cross-dress.I'd also ask you to consider this: Are the people who you say this to expecting it? My guess is that the answer is probably not. Along with that, Are they going to have questions? I would imagine so.Are you comfortable answering questions?I wonder if you could figure out yourself or with friends (or perhaps even with a therapist) how you would answer these sorts of questions:What exactly is cross-dressing?Does that change the gender that you're attracted to?What does it mean to you?Why is it important to you?And what you want your listening person to know about you related to cross-dressing.There could even be ways that you can start the conversation by asking them to be open to listen to you and ask questions about what they are thinking before they make any quick decisions about you or the relationship.I certainly hope that you find the right person for you. I imagine that having this conversation could be stressful, especially considering the idea that you have had some negative reactions in the past. Remember that talking this through with a therapist could be very helpful.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: Hopefully both the client and counselor would together decide when to terminate counseling sessions. It's really helpful for the client to leave counseling with a solid sense of what he or she has accomplished in counseling, so it can be a good idea to spend some time acknowledging that in the last session or sessions. Sometimes, however, a client has needs beyond the scope of the counselor's expertise. That's a good time for a conversation about those needs and ideas of  how best to meet them, whether by adding in care with an additional mental health professional or transferring care entirely to a new mental health provider.


Context:
My daughter seemed to be developing at a normal rate until about the age of 10. She then started to act younger than she is.

Now she only wants to play with younger kids and she doesn't act her age. I don't know why this is happening. Is this normal?

Response: Good for you to know your daughter's friendship circles and to notice when these have changed.While friendships are key relationships, they are not the only indicator of someone not developing normally.Is your observation and opinion that your daughter isn't normal based on other factors or just this one?If this is the only factor then start with reflecting on what circumstances may be influencing your daughter to socialize with younger kids.Has she ben ostracized or bullied by her peers and may be retreating to avoid further emotional hurt?Is she keeping up with her school work?Sometimes kids who feel overwhelmed by schoolwork will regress into conditions in which they feel more success and control.Are there family circumstances such as the death of someone with whom your daughter felt close?  Or, is there a new younger sibling in the family or a younger sibling who due to their own circumstance receives more attention than your daughter may wish for herself.Once you've reflected on which areas may be affecting your daughter, gently ask her some questions about her comfort with what you theorize may be the source of the problem.Its also possible that offering her your extra time and interest may increase her sense of self so that she feels secure enough to increase her social time with her age group.


Context: After first meeting the client, what is the process that a counselor facilitates?

Response: Great question which I imagine many other people have as well.The therapist will want to know your main source of life discomfort.  In what areas are the problem interactions which you hope will disappear?The therapist is trained to listen for your emotions to your story.  And to open these up to you in a kind and safe way so that you'll start to see your circumstance in a new light in which you feel more of your own authority to handle the troubling conditions.The therapist and you will refine your thinking and theories.   The therapist will ask questions to help you prepare for any stumbling blocks along your way of creating your own new answers to the problem you brought to counseling.I hope you'll enjoy learning and creating new thinking and interacting patterns!


Context:
I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing.

What can I do to manage my stress?

Response: Recognize your reason for continuing to work for this place.Sometimes "overworked and underpaid" is tolerable bc of the valuable learning which the person will take with them when they've decided the time has come for these lessons to end.Or, are you in this place bc it is an easy commute to your home or fits well with other parts of your life such as education or some health related program?As long as you have a good reason to be there, you will feel there is good purpose.If there is no good purpose and every day you wake up to work for a place you can't stand, then its time to look for a new position.


Context:
My son was diagnosed with autism a few years ago and I stopped working so that I could take care of him.  I also was dealing with an abusive relationship (mentally, physically, and emotionally). Now I live like a recluse and I always feel nervous around people.

How can I feel more comfortable around other people?

Response: Probably a good portion of living like a recluse was necessary so you had time to rest and recuperate from so much major adjustment in your life.Have you told some of the people in your life about the many changes you've been through?   It is possible people sense something different about you and aren't sure whether to ask or not ask questions.Also, understand what type of qualities you'd like to offer and receive in a friendship.   Given that raising a kid who has autism takes a lot of energy and time, the way you socialize will change.Start with one person whom you're pretty sure would welcome you and whom you would gain by bringing them into your life.As a result of how this interaction goes, how you decide to spend your time together, what you'll discuss, you will know more about yourself and what you require to feel good around other people.Then, you can consider if you're ready to add others into your world.


Context: What are the basic skills a good counselor needs to have?

Response: To be non-judgemental, know who they themselves are, be able to step forward and ask questions with ease and grace into painful emotional areas.Also to respect human difference in accomplishing basic life tasks and everyday living.


Context: How does a counselor decide when to end counseling sessions or to terminate working with a client?

Response: In my therapy practice the decision to end therapy is mutually made together with the patient.Otherwise, the person can end up with a sense of tremendous rejection and abandonment.The way you'll both know therapy is coming to a close is that the discussion will feel lighter and move easily.The person's mood will be better, they will smile more, sit in their seat in a more relaxed way, look more at ease, take better care of their appearance.One of the ways to end therapy is to gradually decrease the frequency of the sessions.Sometimes people who are in my practice start to come each three weeks, then monthly, then every three months.This gives a sense of security, friendliness, and casualness to the therapy, and de-medicalizes it as though the person was treated for a medical symptom and the symptom stops completely one day.Talk therapy is about life and life problems usually end gradually.I end my therapy in a way which mirrors the life process in which many interaction and situation problems show their effects gradually and show different effects over time.


Context: How does a person start the counseling process?

Response: Phone or email a counselor whose profile you've read and which feels right for you.Ask to get a feel as to the way the person would handle your problem and work with you.In my practice I offer a phone consult which generally continues for twenty minutes.I feel it is only fair that a prospective patient has a feel for the service they are about to purchase before they can be expected to pay money for a service which may not be to their liking at all.


Context: I don't understand why this is happening. Why do I feel this way?

Response: The first step to answer your question is to reflect on what is going on in your life overall.  If you're in the midst of severe stress, whether within your relationship or effort to establish a relationship, upheaval in family dynamics, some type of significant loss like a job or someone with whom you feel closely attached, then you may simply be creating the solitude which is necessary to better understand and absorb the meaning of these changes.I assume you mean you are by yourself when you are indoors.What you write sounds like you're not happy with this recent urge rather than that you and someone or others are having great and fun times together.One way to encourage yourself to go back outdoors is to connect w a friend or search for an interest within you to develop.This way with either of these, you'd feel a little bit of motivation to join and get more involved with either of these.


Context:
I'm in my late teens and live with my dad.  The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks.

Sometimes I feel i'm not worth knowing or i'm never going to do anything right.

Are they right, am I depressed?

Response: The answer to the question of whether or not you're depressed, is less meaningful than what you are doing to feel strong and secure in your life.Otherwise, people shortcut themselves to go deeper in understanding who they are and what they'd like to do with their lives, and accept "depression" as though it is their new name.What you write sounds like classic depression.What to do about this feeling is to get closer to yourself in an accepting way.  Assume that what you do in daily living is somehow necessary.  Unless you are doing immoral or illegal actions to other people, to accept your own wishes as truth will open you to appreciate why you do what you do.Make believe you're interesting and find out more about who you are, if you have trouble to start with thinking of yourself as worth understanding.The more you appreciate who you are and your unique strengths, vulnerabilities and fears, the more these will dissolve by what seems on their own.In fact they will disappear bc you are believing in yourself and your ways.Good luck!