Celebrate the Small Wins: A Therapist's Perspective

Celebrate the Small Wins: A Therapist's Perspective

A mental health therapist often sees individuals focused on major life changes, overarching recovery goals, or profound transformations sought in therapy. However, the small victories are important. These moments along the way can make all the difference in sustaining momentum and fostering a positive mindset.

Why are these small victories so important?

Celebrating even the smallest achievements has a profound impact on well-being from a psychological standpoint. It is about recognizing the effort, courage, and resilience to take even one step forward.

Here's a glimpse into the power of celebrating small wins:

Boosting Motivation & Reinforcing Positive Behaviors: The brain responds to rewards. Celebrating small accomplishments, such as successfully managing a panic attack or attending therapy sessions consistently, triggers the release of dopamine—that feel-good chemical that boosts mood and motivates the repetition of positive actions. This creates a positive feedback loop, fueling further progress.

Building Self-Esteem and Confidence: Acknowledging even minor advancements in therapy, like a breakthrough insight or improved coping skills, helps individuals build a more positive self-image and strengthens their belief in their ability to achieve larger goals.

Shifting Focus from Negativity: Therapy often involves confronting painful experiences. Celebrating successes, however small, helps balance this perspective and shifts the focus to what's going well, fostering a hopeful and positive outlook.

Making Progress Tangible: In recovery and therapy, progress can sometimes feel slow or invisible. Celebrating small victories, such as days of sobriety or successful self-care practices, makes progress tangible and provides a sense of accomplishment.

Fostering Mindfulness: Recognizing and celebrating small wins encourages mindfulness by promoting awareness of present accomplishments, rather than dwelling on past failures or future anxieties.

Strengthening Support Systems: Sharing successes with loved ones, friends, or support groups enhances social bonds, reduces feelings of isolation, and fosters a sense of community, all of which are crucial for maintaining motivation and promoting long-term recovery.

Building Resilience: Celebrating small victories strengthens the ability to handle setbacks. By focusing on accomplishments, individuals learn to see challenges as temporary hurdles rather than insurmountable obstacles.

How can you start celebrating your small wins?

Journaling: Keep a progress journal to track achievements, no matter how minor. Reflecting on what has been overcome can be incredibly validating.

Self-Care: Engage in activities that nourish the mind, body, and spirit. Treat yourself to something enjoyable to acknowledge hard work.

Sharing: Share successes with your support network. Their encouragement can amplify positive feelings.

Mindfulness: Take time to reflect on your journey and appreciate the progress you've made.

Create Rituals: Develop personal rituals to mark achievements, whether it's a special meal or a symbolic token.

Every step forward, no matter how small, is a testament to strength and deserves to be celebrated. Embrace the power of celebrating small wins, and you'll find yourself fueled with motivation, resilience, and a growing sense of self-worth as you continue on your journey.

Social Synergy

As humans, we are social beings. We want to belong to a group; connect with others. Let’s take a closer look at two constructs of being social; social connection and social support.

what’s the difference?

Social connection and social support play immensely significant roles in enhancing human well-being, leading to a more satisfying and joyful existence. Social connection entails the profound sense of belonging and integration within a community or network of people. It encompasses the establishment of meaningful bonds with friends, family, colleagues, or even casual acquaintances, fostering a deep-seated feeling of belonging and the sharing of life's valuable moments.

Conversely, social support manifests as the invaluable provision of both practical and emotional aid, offered and received, specifically during times of adversity. It encompasses the sure availability of essential resources, encompassing compassionate advice, empathy, and genuine assistance from those we hold dear.

The Synergy

The synergistic presence of social connection and social support serves as a paramount factor in nurturing our mental and emotional well-being. The recipient has the gift of an encompassing sense of acceptance, affection, and unwavering encouragement.

The crux is that we need them both in our lives. Relationships, close or peripheral, provide us the means to met our needs and contribute to the continuation of cultural and social constructs. Our need for support will wax and wane through life’s circumstances. We can give and receive support as needed.

It’s important to note that connection and support are given and received uniquely for each individual. The variety, frequency, duration, and intensity of this synergistic presence is as prolific as there are individuals. Discovering what you want or need from these roles takes time, exposure to the variety, and patience in understanding yourself. Likewise, what we can offer others, whether through connection or support, is also largely dependent upon our ability and interest to proffer the synergy to our circle.

Social synergy is about meeting our needs, whether they are innate needs for belonging and fellowship, or psychological and emotional bonding through shared experiences. In the end, it affords total wellness.

Be Well.

New year, new perspective

Here we are, 5 days into 2023…how’s it going? Did you set resolutions, goals, or intentions? Are you still going to the gym or are you craving cookies yet; they are hard to resist! If you are still working on finalizing your goals for 2023 (you’re not alone in that!) let me encourage you to incorporate the 4 pillars of wellness (physical health - sex + relationships - spirituality - career + education). Here are some prompts to consider.

Physical Health

• Improve flexibility.

• Get tested for food sensitivities that cause inflammation.

• Consider taking supplements to support physical and mental health (e.g. omega’s, magnesium, turmeric).

• Replace worn out fitness equipment (e.g. worn shoes, tired exercise bands, the rotting bike tires).

Sex + relationships

• Establish or deepen communication with partner(s) about what turns you on and off sexually.

• Review the values of you as individuals and as partners to see how the align.

• Experiment with some kink play (e.g. light bondage, toys, role playing).

• Create open and ongoing dialogue about non-sexual intimacy satisfaction in all your relationships.

• Restore, create, or amend boundaries.

Spirituality

• Build routines that feed your soul.

• Volunteer, meditate, pray, journal.

• Get outside. Move, get sunshine.

• Call elders that you respect and learn from them.

Career + Education

• Build intentionality in performance goals, whether they are measured by your employer or you.

• Read some books for pleasure.

• Learn a new skill or hobby, take a class at the local community college or education center. (Urban gardening anyone?).

• Reflect on your career goals from 5th grade and where you are now. How did you get there? What’s different? What lessons can you pass onto others?

Looking ahead

I’ve been known to use cars as analogies when working with clients. Here’s another one. When we keep looking to the past we are looking in the rearview mirror. It’s small, it can be deceiving, and offers a limited view of what’s now behind us. But when we look to the future, through the windshield, we have a greater view of what’s ahead. We can maneuver our way through roadblocks, avoid construction zones, and enjoy the scenery along the way.

The same perspective applies to our wellness. When we keep looking backwards we may miss what’s in front of us. I encourage you continue looking ahead as you embrace your total wellness in 2023!

Be Well.

Sarah B.

Using the nervous system to heal

Every one has the same basic outline of the autonomic nervous system (ANS), with sympathetic and parasympathetic, that helps us respond to danger or threats; unfortunately the ANS can be overstimulated from traumatic events or experiences, creating a lasting pattern of over responding to innocuous situations. Ever hear of the book The Body Keeps the Score by Bessel van der Kolk? (if you haven’t, i highly recommend reading it!) There are other researchers and books that have studied the impact of lived experiences on our ANS responses such as Stephen Porges with Polyvagal Theory, and Francine Shapiro with EMDR.

I’m not an expert in all those models, nor am I a neuroscientist. But I do know is this; without retraining our responses, we can stay in a state of over activation causing a hurtful impact to our mental, emotional, and physical wellness.

Basics of the ANS

THe ANS is divided into two sections; the sympathetic and parasympathetic. The sympathetic system controls our heart rate, breathing, muscle activation. This system is triggered when there is a imminent danger or stressful event. This is that fight or flight response. People often describe feeling their heart pounding, maybe get a little sweaty, their breathing becomes faster and more shallow. People may experience some fidgetiness or restlessness. All these is the body’s way of preparing for action to respond to the danger or stress.

The parasympathetic system is linked to a state or stillness, often referred to freeze or called rest and digest. If the sympathetic system is the upper torso (heart and lungs) then the parasympathetic system is the lower torso (diaphragm and digestion). People describe feelings of heaviness, low energy, stiffness or inability to move quickly. These two systems work hand in hand to help us respond to danger or stress.

Rewire your ANS

In order to find some relief from over activation of the ANS, one must become familiar with their unique cues and triggering factors. Working with a therapist, the individual will uncover some of the past and/or current experiences and triggering moments that elicit an ANS response that may be unnecessary or exaggerated. This exercise can take weeks to uncover and requires patience from the client and the therapist. There are many ways to go about uncovering these cues and triggers; traditional talk therapy, hypnosis, brain scans to name a few.

The goal is to find a way to rewire the brain and ANS to these moments, allowing the connection between the body and the mind to be reconfigured. Not quite rewriting the history, but rewiring or retraining the body to respond in a way that is more aligned with core experiences of safety and connectedness. Techniques such as polyvagal theory, EMDR, brain-spotting, are highly successful in providing client with new ways to respond to past experience and future life events.

Be Well.

Choosing a Therapist: Red + Green Flags

As a therapist it is easy for me to share with you how to select the right therapist for your needs. However, when i went through the process myself, i was able to experience the process from a client’s perspective. I firmly believe that every therapist needs their own therapist. Regardless of who you are, the supportive people in your life, it’s so rewarding to have a truly objective person in your corner. If you have a current therapist, are looking for one, or helping someone else with finding one, read on for some tips in choosing a therapist.

Just as you would watch for red flags and green flags in a relationship, friendship or business partner, you can look for signs in a therapist. The flags listed below may not apply to everyone, so take what you need.

Red Flags

1. Unreliable. A therapist that is unreliable can make it difficult for you to find appointments consistently. The unreliability may also lead to poor follow up of services.

2. Insincere or Judgmental. One of the reasons you want to see an objective person is to avoid judgments from others. Being able to freely voice what you are thinking and feeling is essential to building rapport and feelings of safety within the therapeutic process.

3. Talks about themselves too much. A therapist may occasionally share some minor details about their lives with you during a session. But the rule of thumb is that it mustn’t derail the focus from the client to the therapist. Too much self disclosure means that they are either shifting their relationship to you from professional to personal, or they have poor boundaries.

4. Other red flags include: makes you feel uncomfortable or unsafe; engages in unethical behaviors; shares information about other clients with you; overly focused on billing/financials; imposing their values onto you; telling you what to do (therapy is not advice giving). If any one of these red flags show up, and you feel safe and comfortable to do so, bring it up to the therapist. Ask to speak to their supervisor. File a complaint with their licensing board. Do not feel obligated to return to therapy if you feel unsafe working with them.

Green Flags

1. Attentive and Attuned. A therapist’s role is to pay attention and listen; a.k.a. be an active listener. Listening to the words, the tone, the timber, the body language, the emotion expressed. All these are ways that the therapist should be engaging with you. You should feel ‘heard’ and safe in the sessions. Sometimes though a therapist may be distracted; it happens because we are human too. If your therapist reflects on something incorrectly, speak up and correct it.

2. Have skills that meet your needs. There are three kinds of therapists. The kind that niche down into working with clients on a specific need (e.g., sex therapy), the kind that are generalists and work briefly with all need areas, and the kind that say they are experts in everything. A great therapist is the first two kinds. You don’t necessarily need a specialized therapist for your needs. But if they are accessible to you, you may want to check them out as an option. Steer clear of the “expert in all” kinds of therapist.

3. Use evidence based techniques. Every therapist has learned in school a variety of interventions and modalities to help their clients. Some common ones include CBT, EFT, EMDR, Solution focused. If this is your first foray into therapy, you may want to read up on the techniques and see which feels right for you; talk to friends about their experiences. If you are more experienced in therapy, using a keyword of what is effective for you, say CBT, can help when searching.

More Green Flags

Other green flags to look for include: they want therapy to end because you have worked through the initial concern, not because they want to keep their caseload flush; they work with you on goals because they want what’s best for you; they are a strong communicator; they educate themselves continuously; they earn your trust; and they challenge you- respectfully- so that you begin to see a change in yourself.

When looking for a therapist, personal preference is important. Know what you are looking for, do some research. The biggest practice in town may not be your best ally for your needs; small solo practices are very powerful. Always ask for a free consultation; this is your chance to interview the therapist and make sure you like them. Ask questions, be clear that their values or mission statement aligns with your goals and values. Take the time to find the right one at the start, and you’’ll find your best match.

Be Well.

3 Tips to Creating Behavioral Change

People enter therapy for a variety of reasons but at the core of it is that they want something to change. Change a response, change a behavior, change their goals, change their symptoms. Change is hard and change is not linear. Identifying the specific behavior, response, or emotional state that you want to change is only a part of the process. Once that’s identified, you must identify the new behavior, skills, or response that you wish to develop. This is called goal setting.

There have been a multitude of studies on the success rates of those that set goals (look up the Harvard study on goals). Sometimes though, even having a goal isn’t enough to create the change you desire. One key factor that is essential to the process is motivation.

Motivating Change

Motivation is defined as the need or desire to achieve a goal. It has as many faces as there are goals and people. It is the internal process or condition that moves us towards something different. It may be a feeling or physical sensation that we wish to experience differently. The source of motivation is internal, not external. We may want to display the accomplishments of our motivation externally (e.g. looking great for our high school reunion) yet the internal processes that create that desire are based in receiving affirmations or praise from others.

Stages of Change

Back in 1983, researchers James Prochaska and Carlo DiClemente were studying participants in changing behavior, specifically smoking cessation. During this study they developed what are known today as the Stages of Change; a part of their Transtheoretical Model of Behavioral Change. Originally used to assist people create change from addictions, it has since been applied a plethora of behaviors. The stages follow the individual from the “I don’t have a problem” to the “I will skills to sustain my self improvement.” Check out this article for more detail.

1. Pre-Contemplation

2. Contemplation

3. Preparation

4. Action

5. Maintenance

Implementing Change

Once we can see change occurring within the therapeutic process, it’s rewarding! It’s like seeing that you can fit in that smaller dress size just in time for the high school reunion. The hardest part, though, is in consistently implementing the change. This is the process of creating new routines or habits, and developing new neural pathways. This is why I say change is not linear. We will have lapses or relapses. There will be setbacks. And you can restore your change behavior and move forward. Some tips to creating sustainable behavioral change.

1. Be clear on the internal motivation for creating change. When we try to fool ourselves into thinking that it’s something different, like trying to please someone else, we will not be as likely to maintain success.

2. Be consistent. Creating new behaviors, or change, requires time and effort. Once you have clarity on the internal motivation, you can find ways to remind yourself. Post notes on your mirror. Make a vision board. Set measured timelines to achieve mini goals. Practice daily.

3. Be compassionate. It’s nearly impossible to be 100% on point to your goal every single time. As we learn something new, we need to learn to fail as much as experience the success. It’s within the failures that we learn to adapt.

Change is hard and change isn’t linear. But change is possible.

Be Well.

Intimate Partner Betrayal

Betrayal is the violation of a presumptive contract, trust, or confidence. It is a conflict that can be experienced within any type of relationship; familial, romantic, friendship, and collegial. It can leave the individuals broken, angry, and searching for answers, much like in times of grief and loss. Betrayal is not solely sexual in nature either. It can take the form of financial, emotional, spiritual, or physical violations of trust. The type of relationship and trust that is betrayed doesn’t lessen its impact however. The most commonly discussed type of betrayal is that within an intimate relationship.

What is Intimate Partner Betrayal?

Intimate partner betrayal is when one partner uses deception, lies, and manipulation to violate the boundaries within the relationship. Just as there are multiple layers of contract or trust with an intimate partner, there are as many layers of betrayal. Intimate partner betrayal is not so much about the sexual act itself. Rather it’s about the moral infringement within the relationship. Values within an intimate partnership include trust, honesty, loyalty, sense of security, belonging, and love. When one of those is broken by one partner acting out sexually, it creates a chasm and requires care and attention. Betrayal trauma can be deep rooted for some partners especially if they have past traumatic experiences related to moral infringements.

Discovery

According to a small survey from 2021, 46% of people admit to infidelity (aka cheating), with kissing another person as the most frequent type of infidelity. This same survey also found that guilt was the most common reason for disclosure. But disclosure usually comes in what is called “trickle truths.” Little bits of truth of behavior in an attempt to either keep the behavior going, or to avoid the response and hurt the full truth will inflict on their partner. During this time, the partner has encountered suspicious behavior and deception. They have learned to doubt themselves and the truth about what they see. They can justify or normalize behaviors of the addict. Discovery day (“d-day”) is the day when the betrayed partner uncovers some, more, or all of the addicts behaviors. Discovery days look different for each relationship. Then the catalyst of crisis is uncovered.

At this time of crisis, the partner is in emotional turmoil. Intense information seeking occurs, confrontation, ultimatums and seeking help are usual responses. The addict however is offering “trickle truths” about their behaviors. Most fear that the full truth will hurt the partner more than maintaining the lies; others are afraid of the partners responses.

Recovery

Many of the signs and symptoms experienced by the betrayed partner meet much of the diagnostic criteria for PTSD. Intrusive or obsessive thinking, difficulty concentrating, blaming, loss of libido are all signs consistent with betrayal and post traumatic responses. Recovery and healing has three parts; treatment and recovery for the addict, healing and self discovery for the partner, and, if the partners want to remain together, joint therapy to begin to establish boundaries and rebuild trust within the relationship. Much like grieving, the recovery process from betrayal is not linear nor is it standardized in duration. It is a fluid process.

Recovery for the addict is about uncovering the addiction cycle and behaviors that contributed to their betrayal, and creating emotional restitution.

Recovery for the partner is about building empowerment, resourcing for self care, empathy and education.

Recovery is possible. Healing is possible. Restoration is possible. It all takes time, effort, commitment and trust. In the end, discovery day can turn into decision day about the future for each partner and the relationship as a whole.

Be Well.

Food Play in the Bedroom

Have you ever notices the many commonalities between sex and food. Both are nourishing. Both are sensual. Both offer variety. And don’t forget the words used to describe food and sex are often interchangeable!

The interplay of Food Play

This week over in social media (find it here) I’ve been talking about food and sex. Food and sex can be used for pleasure, nourishment, and experimentation. Food play, often refers to sitophilia, is a form of sexual fetishism in which participants are aroused by erotic situations involving food. The phrase can also refer to non-sexual play with food, such as food displays that are decorative or playful, and joy of preparing food. Then there’s the aphrodisiac side of food; foods that purport to increase sexual arousal or pleasure. And if we can believe that a food can increase sexual arousal, then we must also believe that food can decrease sexual arousal. For example, back in Ancient Rome, the Romans believed that lettuce immediately rendered men impotent.

Guidelines for Food Play

If want to incorporate food play into your sex life, here are some basic guidelines to keep it spicy and safe. 

Consent

Have consent from your partner before introducing food. Have the conversation far in advance, talking about the pros and cons of the idea. Ask about foods that are unsavory to your partner or that trigger allergies.

Containment

Keep food away from genitalia. The risk of infections, skin irritations or lost food is too great a risk. Plus there are plenty of food safe erogenous zones above the waist. Only exception would be plain ice.

Check it out

Use foods that invite all the senses. This isn’t just about taste. Use foods that have variety of texture, temperature, and taste. Alternate between sweet and spicy, and warm and spicy.

Contact

Use your mouth. Oral sex isn’t just about mouth to genital contact. Be creative with your mouth as you use food in the safe zones. Lick, suck, nibble. And be sure your mouth is empty of food before moving to the genitalia too.

Create a Plan

Be prepared. Have the food items nearby. Use bedsheets or towels that you don’t mind getting dirty. Have clean up supplies available if necessary. Ideally clean up is part of play (see number 4) but if you need a bit more clean up before moving on, have rags, wipes or the like nearby. And don’t forget the usual preparations of lube and condoms, or toys.

Celebrate

Have fun. Sex is about the pleasure, the experience, the fun. Food play doesn’t have to be intimidating. Start small and as the experience draws you in, expand the foods and play that you welcome into the bed.

Bon Appetit and Be Well! 

What I learned AS a sex therapist

I haven’t always been a traditional therapist.

My early career was spent working with the justice involved population. From roles of monitoring and supervising, to assessment and treatment. Years later I became your typical therapist; sitting in a comfy chair empathetically listening to clients. My role as a sex therapist ranges from topics regarding sex play, building desire, and healthy self pleasure, to compulsive sexual behaviors and sexual offending treatment. In my over 20 years I have discovered a lot about people, and a lot about me. Here are some discoveries i’ve uncovered while working as a sex therapist.

Leave you at the door

When entering the field of counseling and therapy, just as in any field, you need to be sure this is what you want. Admittedly there are a variety of potential career paths to take as a therapist, so the options exist if you need a change. As a grad student a few of the tenants of therapy is to be nonjudgmental, nonmaleficence (do no harm) and create beneficence (do good). I like to think of this as leaving ‘me’ outside so that I can create space for the client. The less I bring me in, the more I am able to listen openly and with genuineness. As a sex therapist, i am to listen.

Expect the unexpected

I recall people being surprised that I would be working with the justice involved population, let alone people convicted of a sexual offense. Maybe it’s because i was so young? Whatever the reason, guess I just didn’t match their expectations. The point is that the same idea applies to my clients. I can’t have a preconceived idea of who they are or what they represent. Whether they are involved in the legal system or want hotter sex with their partner. I don’t know their story. I don’t know their needs and goals for therapy. As a sex therapist, I am to be a compassionate ally.

Learn to laugh

Yes, really. Therapy isn’t always serious. Laughter sometimes is the best medicine and it can be very therapeutic when talking about sex. Clients bring in their embarrassing stories, learn a new term or slang, share a meme. As a sex therapist, i am to balance levity with lightheartedness.

Choose knowledge

I am a firm believer that therapy is a place of education just as much as a place for healing. So let’s talk about sex, baby. Let’s talk about anatomy and desire. Let’s talk about fantasies and sex toys. Let’s talk about learning to create plans that prevent future victims. As a sex therapist, I am to educate.

I’ll admit that when i graduated I didn’t envision myself being a sex therapist; I have no regrets!

Top 5 Boundaries for Your Total Wellness

Boundaries— a common topic within therapy sessions, conversations, blog posts and social media. Let’s just start with a working definition of boundaries though. According to the dictionary, boundaries are lines that mark the limits to an area; a limit to a subject of sphere. A psychological definition is similar but it is applied personally. They are limits set on how we respond, act, engage with other people, and how they respond, act and engage with us. Boundaries typically originate from our experiences and observations, both past and present. We can look at boundary setting in two ways; as fences and gates.

Fences + Gates

Have you ever had an unproductive conversation with a coworker? You may have to set a new boundary to have conversations in person rather than email.

Ever leave a family gathering feeling emotional drained? You may have to create a boundary that you’re unwilling to be the listening ear for others while sacrificing your fun.

Ever feel like you’re lost your connection to friends? Maybe the boundary is to open your calendar to say ‘yes’ more.

Boundaries can be like fences, limiting others’ access to us and our energy. Or they can be like gates, where we allow a controlled amount of access to ourselves and our energy. Boundaries can be set in any relationship—intimate partners, friends, family, professional—and are malleable. We can establish or reestablish them based on our current life experiences and observations.

Top 5 boundaries for your total wellness

Here are the top 5 categories of boundaries commonly discussed in therapy:

1. Relationships. Labeling or defining the relationship, sexuality and intimacy.

2. Time. Saying yes when you mean no. Being expected to participate or help despite not being consulted on your availability.

3. Being the fixer/savior. If you are always being asked to problem solve for others, you may be their savior. jack of all trades types that everyone relies on.

4. Your body. What you wear, how you look, comment from others, etc

5. Family. Presence and participation in family activities, traditions and values that no longer align with yours.

Any ring a bell for you? Setting boundaries in these areas can be hard if we’ve not felt the need or even opened our mind to the benefits they bring. To get started, evaluate recent situations where you felt uneasy or unsatisfied. What contributed to that feeling? Look back to text messages, social media posts, or even screen shots, and memes you sent around that same time. These can be hints to what we were feeling/thinking during that situation.

As Brene Brown states, “Daring to set boundaries is about loving ourselves even when we risk disappointing others.” The more clarity and certainty you have about your boundaries, the more consistent you will be enforcing your them with others.

Be Well!

Self Love: and what can get in the way

There are two initial responses when people hear the term self love.  Either you’re in the “love thyself and self improvement” camp, or you’re in the “pleasure thyself and sex positive” camp. The truth is, you can pitch your tent in both camps because they are connected.

 Attachment and the ANS

From an infancy we are developing our connection with ourselves and others. Through the works of John Bowlby and Mary Ainsworth we’ve learned about attachment theory. That the security and safety we felt as children contribute to the way in which we interact with the world around as adults. As children when we received comfort from a caregiver we felt secure and loved. When that comfort was absent or given inconsistently we tend to feel insecure in interpersonal connections and have greater difficulty in achieving feelings of safety. This fosters self reliance and dependence on self soothing behaviors, often in maladaptive or hurtful ways.

Pair this attachment style with our ANS (autonomic nervous system) functioning and we can find ourselves with relationship struggles, self doubt, or even a vacancy of love for self. The ANS is the part of our nervous system that helps us distinguish between safety and danger. According to the Polyvagal Theory (by Stephen Porges and Deb Dana) we can find ourselves in three stages of activation: ventral vagal (safety and connection with others), sympathetic state (flight or fight), and dorsal vagal (parasympathetic state or freeze). When we are more frequently in the sympathetic and parasympathetic (dorsal vagal) states, we are more concerned about self protection than about self love. Although maybe protecting oneself is a sign of love? 

Overthinking it a little? 

In her book, Self Compassion: The Proven Power of Being Kind to Yourself, Kristin Neff, PhD. describes the tendency to find fault, guilt or flaws in who we are (shame) and in our behaviors (guilt). This tendency is the antithesis of compassion and prevents us from finding forgiveness and the ability to love ourselves more generously and compassionately. In today’s society we are bombarded with the best versions of people; through social media, movies and magazines, and even when chatting within our friend groups. This breeds comparisons and, as the saying goes, can steal our joy. That is, if you believe there is joy to be had in the first place. Too often our inner self doubt and harsh self judgments show up in how we present to others. For example, making a disparaging statement about our performance in the work presentation because it’s better for us to dis ourselves first than to experience to sting of criticisms from others. 

These constant negative thoughts, doubts, judgments, comparisons and critiques can keep us in our heads and not in our body. Even when we are feeling sexy or attractive or sensual, our negative self talk can ruin the mood. Getting out of our head and into our body can be extremely helpful. Practicing yoga, mindfulness, progressive muscle relaxation, or meditation are all techniques that move our awareness from our mind and into our present body. 

Get your sexy back

So here we are, in that other camp of self pleasure and sex positivity. You can skip this section if it’s not your flavor; I won’t even know. Self stimulation is one of many ways you can pleasure yourself (i.e. masturbation). But since I’m a sexologist, sex talk is what I’m good at. First, not every one masturbates. But according to this 2019 study, a whopping 84% do masturbate and do it to satisfy sexual urges, experience pleasure or to relax. It’s important to note here that reaching orgasm is not the goal; it happens - about 59% for men and 42% for women all the time – but is often not the goal. Second, more often for women than men, the pleasure needs to start before the sex. Meaning, when you can set the scene – sounds, scents, lights, texture – that put you in the mood you’re increasing the likelihood of feeling good and creates more pleasurable self love experiences. 

Lastly, here is where the rubber meets the road (pun intended!). If we have difficulty connecting because of an insecure or anxious attachment style, because we have trauma related to sexual experiences, or ruminate in self doubt even in the most sensual environments, we are going to struggle with finding self-pleasuring love satisfying.

How to love thyself

 I can’t give you step-by-step instructions on how to love yourself; only you can do that. I can however encourage you to experiment. Read some books. Talk to a therapist. Find healing in your 4 pillars of wellness. Practice mindfulness. Touch yourself in a nonsexual way. Practice giving yourself nurturing touches, such as hugging yourself, or gently caressing your cheek when agitated. Practice positive self talk and self compassion.

Here’s to finding a new love; yourself. 

Be Well.  

A Few of My Favorite Things

How many of you are now humming that song from the Sound of Music? I may have done that intentionally because it is one of my favorite movies this time of year (White Christmas starring Bing Crosby is the other). Read through to the end to learn why the song and movie is associated with Christmas. I know that you are so eager to learn about some of my favorite things, so here goes.

Therapy

Okay okay, i’m not biased on this I promise! Participating in therapy is a great tool for so many to find healing, solutions, restore confidence and learn new skills. According to a NAMI report 21% of U.S. adults experienced mental illness in 2020; that’s 52.9 million people, or 1 in 5 adults. Of those adults 46% received treatment. We can undoubtedly guess that during the global pandemic of 2020 these numbers in mental health and therapy needs increased from 2019. What was once very taboo has become a bit more normalized. Thanks in part to the Gen Z-ers who are very vocal about participating in therapy, to the influx of social media posts by lay persons and professionals related to therapeutic benefits. Here’s a tidbit that you may not know; even therapists have therapist. It’s our role to leave our worries outside the therapy room door so that we can be fully present for you. But that means we need someone to helps us process it all too.

Supplements

Let me be very clear before I start talking about this. I am not a licensed medical practitioner, but I am a certified health coach, so always consult your medical practitioner before starting a new supplement. If you want more information about the health coaching I offer, check out the page on my website. Based upon my own experiences using supplements paired with my training as a health coach, there are a few supplements that have proven to be valuable in improving moods, maintaining a healthy brain, and healthy lifestyle.

First up is omega fats. I am not a fish eater; in fact my motto as a child was ‘nothing from the sea.’ This has since changed and I now love mollusks and shellfish. However shellfish does not offer me the healthy omega 3 fats that come from cold water fish (e.g., salmon). Other healthy fats in the omega 6 + 9 variety are more prevalent in my daily diet. So I supplement with omega 3-6-9 pills. This article provides more details on the differences, sources and importance of taking omega fats in supplement form. Other supplements I highly recommend is magnesium and turmeric. Turmeric has many health benefits, the most notable is that it’s a natural anti-inflammatory and antioxidant. Additional benefits include improvements in brain health related to depression and prevention of Alzheimers (source). Lastly is magnesium, essential for brain and body health. It’s the most abundant mineral found in the body yet you’re likely not getting enough through your diet. Check out Dr. James DiNicolantonio’s videos on magnesium here and here.

Pets

If you’ve sat in my office or been in my virtual office, you’ve likely seen my cat. As ornery as she is, my cat is a calming force when I come home. She loves snuggles, has anxious attachment tendencies (is that possible in animals?!) and is a big talker, as are most Siamese cats. Owning a pet certainly comes with disadvantages (financial cost or clean up), yet more and more people own pets. Over half (57%) of the population owns at least one pet (source) which tells us there’s got to be something good for us about owning a pet. One study in particular looked at the wellbeing of owners, conducting 3 separate studies to find their conclusions. Improvements were more significant than originally proposed proving that owning a pet increases the social support aspect of the owner. Consider how many people you have become close with at the dog park because the dogs are playing together! Other benefits more commonly discussed from pet ownership include, reduction in depressive and anxious symptoms, improved self esteem, and increased physical activity. Considering getting a pet? Be sure to do your research on all the expectations and responsibilities of pet ownership. Plus there are opportunities for interactions with pets without the ownership responsibilities through volunteering at a shelter, working with therapy animal trainers, etc.

Laughter

You’ve heard the saying, laughter is the best medicine? And I’m guessing that you’ve even experienced the perks of laughter after a game night with friends. But just how good for you is it to laugh? The idea that laughter as medicine became a subject of interest in 1979 when Norman Cousins spoke about it’s analgesic effects on his own illness is his book An Anatomy of an Illness. Since then multiple studies have shown the psychological benefits of laughter; improving affect, reduction of depression and anxiety symptoms to name a few. In more recent years however there is growing evidence that laughter even has physiological benefits. This article outlines more of the details of the studies conducted. Suffice it to say that you could prescribe laughter for yourself and reap the psychological and physiological benefits. Creating a new weekly habit for 30-minutes belly laughing, a great way to share!

Looking ahead

Now that you’ve had a peak into a few of my favorite things, let’s return to the history of the song. Various stories suggest that the fame of the song, A Few of My Favorite Things, is because of Julie Andrews singing the song on The Garry Moore holiday special back in 1961 before the movie came out in 1964. Another story is that the song was created and performed to be a Billboard hit in preparation for the release of the Sound of Music movie in 1964. Still another story is that the tv stations wanted family friendly movies aired during the holidays when families were most often coming together, and Sound of Music was an easy choice. So as this year draws to a close in the coming weeks, I hope that you will embrace a few of your favorite things and share with others. May your smile be bright, your holidays be peaceful and your hearts be overflowing. Be Well!

Separated by our shared experiences

Blog by Kim Melendy

The 4th Wave of COVID: A Mental Health Crisis

Over the last two years, the pandemic has not only been an ongoing epidemiological crisis, but also a psychological crisis that will linger long after we return to a new normal.  A transformative shift in our collective conscious fueled by collective trauma and ambiguous loss has occurred around the world resulting in what is being called the 4th wave of COVID, a crisis of mental health.   During the height of the pandemic and continuing over the past year, our entire country has experienced what can only be described as a collective trauma.  We were coping together, but separately, throughout the quarantine and lockdowns.    Isolated together and yearning for connections that we took for granted in the past, we gained a newfound respect for all the connections that before COVID wouldn’t get a second thought. Then we felt a profound sense of loss as those connections faded and some even completely disappeared. However, we didn’t just lose the people; we lost the places too.  Those safe places, the places that gave our life structure and meaning.  As we return to normalcy, we are afraid to trust again - are those people, events, and places we once knew still safe?  We ask ourselves is my memory accurate, does reality match my inner perspective of what I lost?  Can what we lost be recaptured, relearning how to live, to reconnect with our friends, with family, and with the places we lost?  

Uniqueness amongst similarity

As we collectively begin to cope with the new normal of post pandemic life, another different wave is now upon us.  Prior to the pandemic, the rates of mental illness rose steadily in the US year over year, but now post-pandemic, the rates have exploded across all population groups.  Not only are we experiencing this explosion due to the costs incurred to our mental health during the pandemic, but also the mounting shift in mental health awareness in the last few years has been accelerated by the pandemic.  For many, the collective trauma of the pandemic sent us flocking to our social media where we found solace in the connections and in supporting each other through the difficult times.  We feel more secure than ever to talk about our struggles with mental health and to offer support to those we know are experiencing mental health issues.   We have experienced a unique group experience; we were experiencing the same isolation, fear, and uncertainty together.  Some of us coped by openly sharing deeply emotional and painful thoughts that in the past would have been brushed off. But now people are more supportive due to this collectively traumatic and slow-moving event.  The views on mental health and mental health treatment are changing dramatically and quickly due to this shift in mental health awareness.  Discussing mental health is now a new conversation that we can all engage in together.

Looming concerns

The emerging transformative discussions around mental health post-COVID can be seen as positive progress for us as a society.  However, this new wave of mental health demand has become a massive strain on an already weakened mental health system in the US.  Per a survey conducted by the APA in October 2021, waitlists are longer than ever and demand is outpacing availability for over 72% of their respondents.  Prospective clients are reaching out for help in navigating their struggles in this post-pandemic new normal yet the overload to both public agency and private practice clinicians in our mental health system force them to be turned away.  The ever present and growing demand for mental health services is not going away, and the implications of not addressing it could be detrimental for many people in our country and around the world.  Mental health struggles and the consequences affect not only us the individual, but also our family, community and institutions that surround us.  We cannot as a country allow our people to become hopeless in the face of this adversity.  We cannot hope to fully heal and recover from the pandemic while only addressing the medical need.  It is imperative that we tackle mental health simultaneously and with an equal amount of fervency and resources.  

My POV

As a graduate counseling student and current private practice intern, the prospect of entering a profession that is evolving and growing so quickly is exciting and at the same time extremely daunting.  The majority of my first client contacts have included a conversation regarding counselor availability, and the prospective clients’ experiences and past inability to find someone, anyone, with openings.  The relief I hear in their voices when I explain that I’m an intern and can offer open availability, brings me a sense of happiness for them that they found me; and in the same moment I am disheartened knowing there are so many others in my community who will be forced to continue searching.  Coming out of the last two years with my own experiences, it’s my goal as a counselor to use my practice to assist my clients with emerging from these difficult times with a new sense of awareness of themselves and of each other.  I’ll be encouraging my clients to seek positive influences in their lives as we return to our new normal and to extend that positivity into the community, in hopes that they will be healing themselves and their community along the way. 

Helpful Tips

If you, or someone you know, are struggling through this transition back to normal and have been unsuccessful in finding a counselor or services.  There are resources in the community and online that you can connect with to help with coping and bringing positive viewpoints into your life.  You can also share with others in your network who could also be struggling.

• Perform an audit of who and what organizations you follow on social media.  Are these connections adding to your life or is the content causing unneeded stress?  

• Seek out individuals and organizations that are producing social media content and providing support that you need at this moment.  This not only will improve your social media experience but also increase the reach of content providers making a difference in your community when you like and/or share posts.

• Reach out to your network for recommendations for digital support groups, this could be on Facebook, Discord or other social media platforms.

• Use these connections to network and be the first to know when a contact is offering counseling openings, forming new support groups, and/or other mental health resources you can take advantage of in the community.

• In the New Year, Total Wellness 365 will be resuming the support group called Women’s Wellness Circles.  This is an opportunity to build connections with other women that have been through similar experiences the last couple of years.  

Getting the ball rolling on building those connections and networks is the first step to healing and for our community to heal together.

A big thank you to our Counselor intern Kimberly Melendy for writing this information blog on how the mental health crisis is impacting our communities and her unique perspective. She can be reached by contacting the office.

How the season changes our moods

Common SADness

It's common for people to experience days when they feel not like themselves, down or a little blue but they can return to feeling energetic and like themselves again rather quickly. Sometimes those sad days start during the winter months and end when the days get longer. When these mood changes have a longer and more significant impact a person's thoughts, feelings and daily life, they may be experiencing what is called SAD or Seasonal Affective Disorder. SAD is not as uncommon as you’d think. It is experienced by millions of people, many of whom may not even realize it.

Here are some factors common in those with SAD: people who live in colder climates (northern states and countries), people who already have a mental illness diagnosis or family history of mental illness, occurs in more women than men, people living in parts of the country with fewer hours of daylight during winter (like New England). Here in Cincinnati it’s now getting dark around the end of the work day. Although that makes it hard to resist going straight to bed when I get home, it also feels unusual to being going out and being social or active after work when my internal clock is telling me it’s midnight!

SAD signs + symptoms

Since SAD is a specific type of depression many of the symptoms will sound much like those of major depression disorder. Now is the time to add my disclaimer for those that don’t read to the end of the blog (you know who you are). Having these symptoms does not equal a diagnosis of seasonal affective disorder; if you have many of these symptoms and you want support please talk to a licensed mental health professional. Now, back to it. Let’s look at the core symptoms of SAD:

• Feeling depressed most of the day, nearly every day

• Losing interest in activities you once enjoyed

• Having low energy

• Having problems with sleeping

• Experiencing changes in your appetite or weight

• Feeling sluggish or agitated

• Having difficulty concentrating

• Feeling hopeless, worthless or guilty

• Having frequent thoughts of death or suicide

Did you know there are two types of SAD, summer-pattern and winter-pattern depression. Of the symptoms that differentiate these, most notable is appetite and sleep changes. Diagnosis requires taking a full history of symptoms during past seasons and ruling out other mental health disorders (again, by a qualified mental health professional).

Why do people develop SAD?

Although there is no definitive scientific explanation for why people develop SAD of SAD-like symptoms, the experiences are still valid. Here is what scientists and clinicians have posited

• Your biological clock or circadian rhythm. Shorter hours of daylight and colder temperatures almost seems to push us to stay inside or under the covers. Fewer hours of daylight may confuse our internal clock of our usual wake/sleep cycle.

• Drop in serotonin levels. Serotonin, A neurotransmitter, is the primary mood stabilizer. Often considered the happy chemical, it is constructed by vitamin D (the ‘sunshine drug’). So less daylight = less vitamin D = less serotonin.

• Intrusive thoughts/feelings. Ruminating on negative thoughts and feelings associated with colder and shorter days such as the limitations of socializing, access or mobility. Additionally, associated memories or events can trigger negative thoughts and feelings and may contribute to associated behaviors of SAD such as isolating, increased sleeping, ruminating.

What can I do?

As I indicated at the start of the blog many people experience these symptoms and may not have realized that they could have SAD. Or they have some of the symptoms but not enough for a diagnosis. Bottom line is if you are experiences mood changes related to the season change, you can make changes to help you feel better. And if you have been successfully managing your SAD-like symptoms thus far, hooray! You can still take a look at the list below and consider making adjustments or additions to having a brighter fall and winter!

1. Stick to your routine. Although it’s harder now, sticking to your routine will help stave off the disruption to your circadian rhythm. Wake up and go to sleep at the same time as you do in summer months.

2. Make plans. Having something or someone to look forward to increases your chances of acting on it. So make those plans in the evening; go to happy hour, walk around downtown with hot cocoa, schedule to snuggle on the couch and watch a movie.

3. Use light therapy. Ever popular and available for quick delivery are light therapy lamps. Its popularity started in the late 1980’s and has been a bright light in effectively treating SAD ever since.

4. Psychotherapy. Yes, I mention it because I’m a therapist but more importantly I mention it because it works! Talking to a therapist about your thoughts and feelings can lighten the load you carry during the season.

5. Supplements. Increase your intake of omega fatty acids and vitamin D and helps improve your moods. Since many of the neurotransmitters associated with our moods are fat soluble, having healthy fats in our body is super important. Supplements are the most common way to absorb more of these nutrients but the best way is through whole food nutrition. Always talk to your doctor first.

Try some of these strategies, share some of your own, talk to your friends, make plans and Be Well!

4 themes in treating porn addiction

Exactly what is involved in treating my porn addiction?

You think you have a porn addiction, or someone you love has told you that you need to get treatment for your porn use. If you are questioning what a porn addiction is or how to determine if you have one, take a look at this previous blog. Or consider this very brief description: If you find that you have a loss of control, tried and failed to stop, lose track of time when engaging in porn use, and continue use despite consequences, you may be have compulsory or addictive porn use.

Yep, that fits

If those factors mentioned above sound familiar then the next step is to decide if you want to stop. Very few people can say they have been successful at stopping a behavior when forced to do so. Even in the most strict environments people still must choose to change. Change takes courage, resources, knowledge and support.

Once you decide to reach out for help there are some components that are essential in effective porn addiction treatment. Let’s take a look.

4 Main Components

technology

Most porn use is accessed through the internet. In fact according to recent statistics, every second:

• 28,258 users are watching pornography on the internet.

• $3,075.64 is being spent on pornography on the internet.

Since pornography is so accessible online, whether at home or work, keeping your internet browsing secure is one way to limit the access to factors that can trigger you. There are multiple apps or programs available to install on your computer/devices that help block, interrupt or report your access and time on pornography sites. Enlisting the help of a loved one is another way to help you.

support

Whether your support system comes from a family member, friend or community they are each an integral piece of building and sustaining recovery. However what some don’t consider is inviting someone into your support system needs to know all those nitty-gritty details of your behavior. Disclosure to a support person is different from disclosure to an intimate partner (something for another blog).

Support persons are ideal when they have characteristics that demand accountability and honesty from the addict. When considering whom could be a support person, consider these factors:

• Accessibility: are they available to you when you need them?

• Accountability: will they hold you responsible for your behaviors or let some slide?

• Openness: will they be honest with you about their own experience and/or limitations when supporting you? Will they be aware of their own opinions and help you develop healthy strategies for you?

• Commitment: will they be there for the whole journey?

A support person may even be someone from the local sex addicts anonymous (SAA) or sex and love addicts anonymous (SLAA) groups.

Abstinence

One of the core guidelines when participating in recovery from porn addiction is abstinence. Abstinence is about purposefully and deliberately choosing not to engage in an action or practice that is wanted or desired. A secondary behavior that coincides with porn addiction is masturbation. Therefore abstinence is creating a ‘clean slate’ behaviorally that includes active steps to cease porn use and masturbation. Many addicts fear that this is a lifetime requirement for sustainable recovery but the bottom line is that a recovery success plan is created in collaboration with your therapist that is uniquely healthy for you.

As hard as it may be to accept or practice, abstinence from the behavior is the most direct route to beginning recovery. A part of recovery is to uncover how your behavior was initially triggered and became the addiction that it is today. Creating emergency plans or behavioral intercessions when those urges arise, is a key conversation with your therapist (and or support person) when starting recovery.

Environmental Cues

Managing your environment and triggers is part of recovery, part of your success. When addiction has its grip on you, it’s hard to be fully aware of the triggers or environmental cues that are increasing your urge to use the porn. Uncovering those environmental cues is essential in creating a safe space for you.

What are environmental cues? These are the sights, sounds, smells and sensations that are present when we engage in a certain behavior. For example, each evening after work you routinely sit in your comfy chair at home, pull a fuzzy blanket over you, grab the remote and sip some wine. Each time you do, these actions are intricately linked in your brain. But then you decide that you want to cut back on your alcohol consumption. The next time you sit in that chair, pull up the fuzzy blanket and grab the remote, you’ll be reaching for that glass of wine that isn’t there. The same idea applies to porn addition. You have created a connection that when you see, smell, hear and feel something, your brain inevitably tells you to start looking at porn.

Working with a therapist, you can dissect the linked behaviors, or rituals, that coincide with your porn use. Then begin to remove and replace those behaviors with something more aligned with your treatment goals.

Now what?

The first step towards recovery is to admit that you are not in control of your porn use; instead, it controls you. Working towards recovery is a marathon, not a race. Reread the sections above and see what changes you can make in your life now. Even one change will make a difference. And that one change can foster hope for more changes to be made. Finally, remember you are not alone in this journey. Finding support through local recovery groups and a therapist specializing in porn, sex and love addiction is essential for your sustained sexual wellness. Be Well.

How to be an expert at identifying your feelings

Emotions vs. feelings

Wait! There’s a difference?! 

In fact there is. 

Emotions are the biochemical reactions (e.g. neurotransmitters) to an external stimulus. The amygdala is primarily responsible for this emotional arousal. The amygdala is at the center of our brain and also where the flight-fight-freeze-fawn responses originate. Like when the hair goes up on our necks, or our stomach drops? That’s emotions; the generalized physical sensation experienced. 

Feelings on the other hand are the conscious experience of the emotion stimulus. The feelings, or labels, we apply are actually our personal interpretation of the emotional response. The interpretation comes from our lived experiences, beliefs, memories, thoughts and awareness of the situation or trigger. 

To get an accurate understanding we must collect information from both our emotions and our feelings. By creating this awareness within ourselves we can then more fully appreciate the experience and more healthfully respond to the trigger. 

Each human experience triggers an emotional response, which in turn triggers our feelings, and responses. So let’s ask a few simple questions to get a better grasp of things. 

Tell me, oh great amygdala, what am I feeling? 

 In my years as a therapist helping others navigate their emotions and feelings, I’ve learned that many are unfamiliar with their own body’s physical response to feelings. So I talk to them about building awareness of their physical sensations in everyday situations. 

What are physical sensations? Those are the biological events occurring in our body, again triggered by our amygdala. Some examples include sweating, hot red cheeks, tingling on our hands, rapid heart rate, or shallow fast breathing. Think back to a time earlier today when there was an increase in tension or excitement. What was happening in your body? I tell my clients to do a mental body scan—head to toe—to see what’s different in that moment. 

Once there is a new awareness of the emotions, or physical sensations, experienced, I then help my clients create an understanding of the feelings associated with it. Here is where we get to label things. 

[pulls out her label maker…]

Did you know that there are approximately 3000 words used to describe feelings in the English language! That’s a lot of labels! How did we get so many? Read on to find out. 

One of the most prominent theories of the 20th century is Robert Plutchik's wheel of emotions. Since we now know that once we label the emotion, it is called a feeling, we will now refer to them as feelings on the Plutchik wheel. Plutchik proposed eight basic feelings—joy, sadness, trust, disgust, fear, anger, surprise, and anticipation. Using colors to represent each basic feeling, the wheel showed that these overlapped and bled into the next like hue on a color wheel. With those 8 basic categories to start, that leads to over 34,000 combinations of feelings! 



Too many choices! I need an easy answer!

Like the Pixar movie, Inside Out, sometimes it’s easiest to identify a fewer number of options. In the movie there are five major categories of feelings portrayed—anger, sadness, joy, fear, and disgust. The key is to collect all the data points possible to identify the final answer. So how do you determine what you’re experiencing? Here are some simple steps to Identifying your Feelings applied to a simple example. 

Picture it. You are at work and the boss stops by your workspace saying, “Come find me later, we need to talk.”

(Gulp. Anyone else having an immediate reaction to this? No? Just me. Okay.)

1. Pay attention to what’s happening in your body. This means creating that awareness of body language and physical sensations. 

   “I immediately notice that my heart rate has increased and I’m starting to sweat. My shoulders have climbed up into my ears (tensing) and I have an awkward smile and am nodding foolishly.”

2. Decide what happened to make you feel this way. This can be the full situation or a portion of the situation. Don’t negate the automatic negative thoughts (ANTs) that come into play. 

   “My boss just unexpectedly came to my work space and asked to see me. I don’t know the reason and it’s an unusual way for her to ask me.”

3. Decide what to call the feeling. Here we get to put all the data points (see step 1) together and out a label on what’s happening. What label do we place on what we are experiencing? 

   “I’m feeling anxious and concerned about my performance on the job.”

 (Note that all the steps of the skill, Identifying your Feelings, are done mentally; not aloud).

Now that you have some clearer steps on how to more accurately and consistently identify our feelings, I hope that you find it useful while navigating everyday situations. If you are experiencing more intense feelings or find it difficult to find a helpful and healthy response to those feelings, I encourage you to find a  therapist who may be able to help.