Recently, I had the opportunity to participate in the Overcoming Shame & Guilt Online Conference, hosted by Avaiya and Enlightenment Village. During the 7 day conference, doctors, psychotherapists, thought leaders, and others shared their opinions on navigating experiences of shame and guilt and talked about how these two differing-but-sometimes-related feelings can impact well-being, relationships, and the ability to achieve happiness.

I found it really interesting to contemplate the differences between shame and guilt and to hear various perspectives on how encountering each of these feelings impacts our lives. While there were some slightly differing views on whether there are any benefits to shame and guilt and whether you can ever completely get rid of them, the consensus seemed to be that these emotions can be quite destructive, yet also come with some benefits, especially in terms of guiding a person’s moral code and helping us grow.

Guilt vs. Shame

“Guilt says I did wrong. Shame says I am wrong.”

I see guilt as an emotion you experience when you feel bad about a specific thing or event—something you did or didn’t do. Shame, on the other hand, is an overarching feeling that you are inadequate or that you are somehow bad or wrong as a person on the whole. It’s always there, whether you do right or wrong. It’s about feeling fundamentally flawed or worthless as a person. Lisa Burgess summed it up nicely in her interview, saying, “Guilt says I did wrong. Shame says I am wrong.”

How Shame Can Impact Behavior and Mental Health

I do a lot of work in terms of helping individuals improve self-esteem and have seen how shame really plays a role in the lives of people who feel worthless or inadequate. Shame keeps people trapped, preventing them from being okay with who they are or believing they are good enough. Shame can wreak havoc on a person’s self-esteem and ability to navigate the world and relationships in a successful way.

It can be quite difficult to have healthy, authentic relationships when one or both parties experience a great deal of shame. People with shame tend to hide behind a facade, not wanting the world to know how badly they feel about themselves. Bullies, for example, are individuals who often put others down with the flawed belief that doing so will help them feel better, conquering their shame by putting it on someone else. Similarly, narcissism is a defense mechanism for hiding deep-seated feelings of shame and inadequacy. These ineffective, often subconscious attempts to prove the shame away don’t work. Rather, they create dysfunction and unhealthy patterns that only complicate the situation and interfere with one’s ability to have healthy, truly connected relationships.

How Are Shame and Guilt Connected?

People with shame tend to experience a lot of guilt, often stemming from a cycle of these dysfunctional patterns and a downward spiral of behaviors that ultimately make things feel worse. Guilt, on the other hand, is not always synonymous with shame. People with low levels of shame and a healthy level of self-esteem undoubtedly will experience situations and encounters that lead to feelings of guilt; however, they tend to navigate these experiences well and address guilt in effective ways that propel them forward rather than keeping them trapped in a place of self-hatred.

Guilt, when it’s rightfully experienced, can help guide a person’s morals and help people grow and learn from mistakes. For example, if you cheat on a test and feel guilty, you may learn that’s not a way you want to be and decide to make different choices in the future. If you say something to hurt someone’s feelings, you may go on to apologize, deepening the connection in the relationship. But when guilt is unwarranted, irrational, blown out of proportion, or coupled with feelings of shame, it can lead to feelings of more shame and may be an indication of mental health or identity issues that need to be addressed.

I specialize in working with new moms experiencing perinatal mood and anxiety disorders. This population represents one example of how excessive guilt can be a symptom of a larger issue rather than just a feeling that comes during isolated incidents and can be resolved through growth and understanding. Statistics show 1 in 5 to 7 new moms will experience a mental health issue such as depression, anxiety, obsessive-compulsive disorder (OCD), or posttraumatic stress (PTSD) during or following pregnancy, and excessive guilt can play a huge role in the struggles shared by this population.

In general, most moms face some layer of “mom guilt” at some point during parenting, but those struggling with untreated perinatal mood and anxiety issues tend to be ridden with overwhelming and irrational guilt—guilt regarding beliefs that they aren’t a good enough mom, that they are doing things wrong, that they are not effectively bonding with their new baby, or guilt because they may have obsessive or unsettling thoughts regarding their baby’s well-being. This type of unchecked, mounting guilt becomes unhealthy and needs to be acknowledged and treated.

Often, conquering shame and guilt involves learning to pay attention to your own internal dialogue and the potentially irrational beliefs and destructive messages that create feelings of inadequacy.

How Can We Overcome Guilt and Shame?

I do think it’s possible to overcome shame and guilt; however, it often takes some work and a willingness to seek help. In cases of perinatal mood and anxiety disorders, where guilt is a symptom of a larger issue, medication and/or therapy may be vital and can lead to relatively quick improvements that prevent a potential downward spiral into shame.

Tackling other instances of excessive guilt or destructive shame may take more time and involves exploration and processing of events that created the shame, but working to rid yourself of this crippling feeling is well worth the time and investment involved in therapy and self-discovery. Conquering shame requires an openness to becoming more self-aware and a willingness to make changes. The tools I teach in my building self-esteem workshops and in therapy with the individuals I see in my private practice help people focus inward and gain insight regarding where shame and guilt begin to develop.

Often, conquering shame and guilt involves learning to pay attention to your own internal dialogue and the potentially irrational beliefs and destructive messages that create feelings of inadequacy. People in general, and especially those who have a lot of shame, tend to have a negativity bias, especially when it comes to the thoughts they have about who they are and how they fit into the world. Negative and self-depreciating thoughts, whether conscious or subconscious, can breed feelings of shame.

When we begin to monitor our own thinking and make connections to the experiences or specific messages we hear, assume, or internalize throughout life, we can more clearly recognize where shame stems from, then can ultimately work to challenge, reframe, or shift these messages to allow for a future where we can move beyond shame.

Part of this process involves learning to accept ourselves as we are and recognizing that nobody is perfect. We are going to make mistakes, have flaws, have skeletons in our closets, and have encounters with others who treat us poorly. Despite any of these things, we all are worthy and capable of creating a better future.

The decision to let go of shame versus stay stuck in a place of shame is ultimately a choice. It’s not easy; it takes a lot of strength, courage, and determination to face the ugly shame monster, but doing so will grant us the opportunity to move forward with a happier and more fulfilling future as the veil of shame is lifted.

If you’re struggling with deep-seated guilt or shame, there is hope. Find a therapist in your area who can help you develop healthy thought processes to deal with shame.

Reference:

Gunyon-Meyer, B., Cole, J., Tremayne, L, & Standeven, L. (2018). Perinatal mood disorders: Components of care [Training manual]. Retrieved from Postpartum Support International 2-Day Perinatal Mood and Anxiety Disorders Training.

A cup of herbal tea next to some candles and lavender flowersIt’s that time of year when the kids have gone back to school and we are approaching daylights savings. I know in my family, it’s been an adjustment to get everyone on a better sleep schedule after the late nights of summer fun.

Simultaneously, I’ve noticed in my practice that several of the people I work with have mentioned difficulties getting to bed at decent times, struggles maintaining an ideal sleep schedule, and a lack of feeling rested upon awakening in the mornings. Given this common trend around issues related to sleep, I thought before we head into the dark nights of winter, now would be a good time for us all to think about our own sleep hygiene.

What Is Sleep Hygiene?

I find the phrase “sleep hygiene” a little odd. For me, it conjures up images of bubble baths, toothpaste, and soap in the bedroom. While brushing your teeth before bed is a good habit and one that may help signal an end to your day, sleep hygiene isn’t just about cleanliness. Rather, it’s about all of the habits and agendas you maintain around your bedtime routine and night of sleep.

The definition of hygiene according to Dictionary.com is “conditions or practices conducive to maintaining health and preventing disease, especially through cleanliness.” As cleanliness is only one aspect, it makes sense to think about all of the other conditions and practices surrounding sleep. Sleep may seem like a trivial thing. We all do it; it’s a natural process that should be easy. But easy isn’t always the case.

The Challenge of Maintaining Good Sleep Hygiene

Getting good sleep can be a challenge for many, yet sleep is truly a vital component to life. It’s fairly common knowledge that research confirms getting enough restful sleep is an important part of staying healthy and operating at your best. Unfortunately, some adults find it difficult to sleep well, and many have fallen into patterns that are counterproductive to obtaining the best rest possible. If this rings true for you, stop to think about your own bedtime routine and the conditions you maintain for sleep.

Many parents of young kids are familiar with the importance of a bedtime routine—they’ve likely established one to help their babies and toddlers learn to easily go to bed each night. Whether it’s bath, story, milk, and a song, or some other type of tuck-in ritual, we know that a good routine helps kids get to bed, and we know how important it is for them to sleep. Sleep helps children to grow, develop, function well, be attentive in school, and avoid crankiness.

While adults may not need as many hours of sleep as kids, rest is still important. Yet as we get older, have more free will, and are inundated with modern technologies and daily stressors, we often neglect good sleep habits and can consequently wind up facing things like chronic insomnia, poor health, irritability, lack of concentration, and even impaired judgment from neglecting to give our bodies the sleep they require.

Tips for Better Sleep Hygiene

Below is a list of some of the most common recommendations involved in developing and maintaining good sleep hygiene:

Routine things like locking up the house, drinking a cup of tea, putting on pajamas, washing your face, and brushing your teeth can become rituals when performed regularly and consistently before bed.

How to Wind Down Before Bed

Remember that it’s hard to benefit from these tools unless you practice and become familiar with them during times when you are not already feeling stressed, overly anxious, or experiencing insomnia. Try them often and as you become more comfortable with various techniques, they can be tools to help you get to sleep faster.

If you struggle with sleeping well or maintaining a healthy sleep schedule, consider implementing these tips to see what might help. Be patient with yourself. It may take time to break bad habits and establish healthier ones, but with time and persistence, you can discover better sleep hygiene and ultimately train your body to get better rest.

Working with a therapist may help you find sleep strategies that work for you if you have a difficult time maintaining good sleep hygiene.

Reference:

Hygiene. (2018.) Retrieved from https://www.dictionary.com/browse/hygiene?s=t

Woman takes a moment to enjoy her coffee and the sunlight on her face.Earlier this week I participated for the first time in a “ladies’ night out” tennis round robin event in my community. Throughout the evening, I found myself noticing how many exclamations of “sorry” I kept hearing across all the courts.

From my work in leading self-esteem workshops, I know many women tend to personalize mistakes and over-apologize for even the smallest of errors. Thus, I found it amusing to witness firsthand how many apologies were being thrown around during what was ultimately a laid-back, fun event.

I began to wonder: Do men say “sorry” this much when they are playing sports? Do they apologize for every missed shot or fumble? While I don’t know for sure, I assume that overall, women probably do this more often. This is not meant to stereotype, but the fact is, in general, women seem to struggle with the tendency to over-apologize. And it likely relates to self-esteem.

While looking at research for my recently released book The Self-Esteem Workbook for Women: 5 Steps to Gaining Confidence and Inner Strength, I came across the results of an interesting study that found women do have lower levels of self-esteem than men and this discrepancy is observed worldwide (Bleidorn, 2016).

In recent years, we are learning more and more about the brain and figuring out how neurological factors play a role in various conditions. Historically, few studies have looked at the neurological basis of self-esteem; however, a 2014 Dartmouth College study showed that levels of self-esteem are related to how different regions of the brain connect: People with strong white matter connections from the medial prefrontal cortex, the area dealing with self-knowledge, to the ventral striatum, the area dealing with reward systems, demonstrated high levels of self-esteem over the long-term. A well-functioning connection with high levels of activity between these two areas correlated with high self-esteem in the moment. These results suggest that feelings of self-worth may stem from neurological connections integrating information about the self with positive affect and reward.

This description may sound complicated and highly technical, but the important point behind this research is that connections and integrations in the brain play a role in self-esteem. And these connections may work differently for men and women.

It’s interesting to consider how biology contributes to the self-esteem differences we witness between genders, but what does this mean for women? Because women appear to be predisposed to lower levels of self-esteem, it’s all the more important for women to actively take steps to build self-esteem. How do we do this?

Unfortunately, the tools necessary to help build self-esteem aren’t taught in childhood or in most school systems; often, they are things individuals learn only when they wind up struggling with mood or relationship problems that cause them to seek help. But I believe everyone, especially women, deserves self-confidence and can benefit from developing an awareness of what it takes to find inner strength. Because self-esteem impacts every area of life—career, relationships, parenting, emotional health, and overall well-being—it’s vital to gain a better understanding of how you can actively build and maintain a healthy sense of self-worth.

Because women appear to be predisposed to lower levels of self-esteem, it’s all the more important for women to actively take steps to build self-esteem.

In The Self-Esteem Workbook for Women, I provide five steps with exercises and case studies to guide women in improving their self-esteem. Outlined below is an overview. For a deeper look into the five steps, I encourage you to check out the workbook, where you can move though each step on a personal level and at your own pace.

1. Know Yourself

Building self-esteem first involves knowing who you are: identifying what you like, knowing what you want out of life, and developing an awareness of how your past experiences have shaped the person you are today. It requires paying attention to how you treat yourself and developing an awareness of the internal messages you grapple with.

2. Care for Yourself

Developing healthy self-esteem also encompasses recognizing how powerful your internal voice is and learning to rewire your brain by developing more effective thinking patterns. It involves acting as your own cheerleader and being mindful that things such as diet, exercise, sleep, and setting realistic expectations all play a role in how you feel about yourself. Beyond the basics, caring for yourself means ensuring you take time out to nurture your spirit by doing things you enjoy.

3. Respect Yourself

Respecting yourself is vital to maintaining healthy self-esteem. It involves assessing and upholding your values without sacrificing your well-being to please others. It’s about developing trust in yourself and learning skills to become more assertive.

4. Accept Yourself

Fostering healthy self-esteem involves acknowledging your limits and imperfections, accepting mistakes, and learning to more effectively deal with criticisms. It necessitates knowing your threshold for stress, developing self-compassion, and forgiving yourself for faults or missteps.

5. Love Yourself

To truly demonstrate self-esteem, you must believe in your worth and care about your future. Loving yourself means treating yourself as well as you treat friends and loved ones. Doing this involves creating better boundaries in relationships. It also entails celebrating your strengths and learning to accept compliments.

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These steps may sound overly simplistic; conversely, they may sound overwhelming. But building healthy self-esteem is possible. It does require you to actively turn inward and develop a greater sense of self-awareness. With dedicated effort, focused attention, and a willingness to put new tools into practice, you can build self-esteem and experience a greater level of confidence. Doing so will help you to ultimately achieve a more rewarding life.

If you struggle with self-esteem, contact a licensed therapist in your area.

References:

  1. Bleidorn, W., Denissen, J.A., Gebauer, J. E., Arslan, R.C., Rentfrow, P.J., Potter, J., & Gosling, S.D. (2016, September 1). Age and Gender Differences in Self-Esteem—A Cross-Cultural Window. Journal of Personality and Social Psychology, 111(3): 396-410.
  2. Dartmouth researchers discover a source of self-esteem in the brain. (2014, June 16). Retrieved from https://www.dartmouth.edu/press-releases/brainselfesteem061614.html
  3. MacCutcheon, M. (2018). The self-esteem workbook for women: 5 steps to gaining confidence and inner strength. Emeryville, CA: Althea Press.

Side view of older adult relaxing with feet up, looking out large windowIn my work with people who are facing things like stress, anxiety, or trauma, I often talk about the importance of making time for relaxation and self-care. Relaxation techniques, mindfulness, and meditation are some of the buzzwords that encompass practices that involve slowing down the mind and body.

These practices can be extremely effective. They not only provide a sense of calm, they can also create positive effects on the nervous system. They may even lead to noted physiological improvements, such as slowed breathing and decreased heart rate and blood pressure. These techniques are some of the best ways to improve physical and mental health. Even better? They typically have no negative side effects.

I teach various forms of relaxation multiple times a week, to many of the people I work with in my office. I recently became aware of how I had personally strayed from practicing what I preached. When I was pregnant with my first child, I made a conscious effort to embrace meditation. I was fully aware that the fetus experiences everything the mom feels. I also believed that a calm mom created a healthy, calm baby. But several years (and two more babies) later, I’m finding I rarely make time to utilize the tools I so often teach to others.

The Challenges of Relaxation

While I do use various relaxation techniques at night if I’m having a hard time falling asleep or when I’m aware I feel excessively stressed, I’ve gotten away from using meditation as a regular practice. I fully admit it’s often difficult to find the time.  [fat_widget_right]

Our society and age of technology can make this even more challenging. I realized this last week as I was sitting in a doctor’s office, waiting to be called back for my appointment. I passed time aimlessly looking things up on my iPhone. I checked my text messages, then my emails. Checked my Instagram feed, then my Facebook feed. Went back to check my emails again. There was nothing new, so I checked my text messages again. I checked my Google analytics app just for the heck of it. Then I checked my email again. “Oh! Somebody on SoundCloud liked the guided meditation I uploaded.”

This made me pause. I had recorded a guided meditation for the people I worked with to use at home. I urged each of them to make mindfulness a part of their routine. “Find a few moments every day to pause and slow down your mind and body,” I had suggested. But here I was, during the one moment in my day that involved simply sitting in silence. What was I doing? Frantically going back and forth between apps in order to kill time.

I stopped and checked in with myself, mentally asking how I felt in that moment. I realized I was anxious. Not about the appointment, but anxious and annoyed that things weren’t moving fast enough. I wanted to get the appointment done and get on with my day. I wanted to tackle some of the things on my ever-growing to-do list. I couldn’t do that while waiting, but by staring at my phone I was wasting a valuable opportunity to pause and allow myself a “reset.”

I know that pausing and slowing down can help create a sense of calm. I also know that from a place of calm, I’m always better and more effective at managing stress and upcoming tasks. But I often get so swept up in the busyness of life that I forget to stop and smell the roses, so to speak.

When we don’t make a point to slow things down and make time for stillness and relaxation, the less effective we become at managing the stressors in our lives.

I wondered why it was so hard for me to just sit in silence for a few moments. Balancing family and work schedules leaves little time for sitting quietly. So why was I not embracing this rare opportunity to enjoy a period of time where I had nothing to do besides sit and wait? Why did I feel the need to keep checking my email and going back and forth between apps? I wasn’t expecting anything important. I had just gotten caught up in the fast pace of life and the pressure to constantly juggle everything on my plate. In doing so, I neglected the chance to just be still.

When our lives become so busy and chaotic, we often forget to slow down. Some people have a difficult time being alone with themselves. Either their thoughts are filled with negative, anxious, or self-deprecating self-talk they would rather avoid, or they have become so disconnected from their sense of identity that they aren’t sure how to handle idle time alone.

Neither of these are true for me. In fact, I relish time alone. Nonetheless, the more chaotic, busy, and full my life becomes, the more difficult remembering to slow down seems to be.

Making Time to Slow Down

When we don’t make a point to slow things down and make time for stillness and relaxation, the less effective we become at managing the stressors in our lives. This can sometimes pose problems. An important point I teach about relaxation techniques is how vital it is to practice these tools on a regular, ongoing basis. It’s important to make them a part of your daily routine and use them often instead of just calling on them during moments of chaos.

This is especially true when you are first learning to embrace mindfulness and meditation and incorporate them into your life. Relying on relaxation tools only during moments of stress may help you to better cope in the moment. But utilizing them on a regular basis will help you operate from a place that is more grounded and stable. This can allow you to mitigate some of the stress that might otherwise become overwhelming.

Try this simple exercise:

Get into a comfortable position and try to relax. Release as much tension from your body as possible. Take a few deep breaths in … and out. Imagine your body is like a big, stable, old oak tree. Imagine yourself being strong and steady, even amid strong winds and stormy weather. Close your eyes and visualize this as you continue to breathe in and out deeply.

Imagine roots at the base of your spine, traveling down through anything below you and deep into the earth. Visualize these roots planted firmly into the ground. Imagine that any negative emotions or stressors can travel out of you, through these roots, and back into the earth where they can be released and recycled.

After you’ve finished embracing this visualization, check in with yourself to see how you are feeling. Notice if you experience any shifts in your emotions or changes in sensations in your body. Hopefully this exercise helps you to establish a better sense of calm. If so, congratulate yourself for successfully using a mindfulness tool. Know you can use this simple meditation anywhere, at any time, in order to feel more stable and secure.

If you found the visualization difficult, keep practicing. There are books, CDs, websites, YouTube videos, and more out there to help you embrace the practice of meditation. If you find the idea of meditating uncomfortable, that’s okay. My original thoughts on meditation years ago were a bit cynical. I believed it sounded hokey, crazy, or foreign. I imagined elderly monks in faraway places sitting perfectly still, eyes closed, for hours on end, depriving themselves of the ability to scratch an itch, not even allowing themselves to eat. I thought meditation meant blanking out your brain and not allowing a single thought to pass though your mind. This, I found impossible.

I’ve since discovered meditation really just means slowing down, developing more awareness, and taking time to be more mindful and present. There are many different techniques and ways to do this. One book I like is Learn to Meditate: A Practical Guide to Self-Discovery and Fulfillment, which offers many techniques for practicing mindfulness. Find what works for you. [amazon_affiliate]

It doesn’t take hours, and it doesn’t need to be difficult. You just need to find a few short moments to regularly and consciously slow down, become more self-aware, and allow your mind to take a break from everything you are juggling. If you aren’t sure how to begin, I encourage you to reach out for help. A compassionate therapist or counselor can offer guidance and support as you explore meditation and mindfulness practices.

Reference:

Fontana, D. (1999). Learn to meditate: A practical guide to self-discovery and fulfillment. San Francisco, CA: Chronicle Books.

Father and child wash vegetables at sink in small, bright kitchenA few months ago, I identified and acknowledged one of my biggest stressors in raising young children: mealtime. The constant battles during meals, nagging the kids to stay at the table, concerns about whether they are getting enough nutrition, inability to eat in peace amid the many requests, and frustration regarding all the food and spilled drinks on the floor are painful enough.

Worse is managing these things while fielding the judgmental voice of my mom, in person or in my head, critiquing my parenting decisions and expressing disdain over the audacity I would “let the kids go to bed hungry.”

I know I have good instincts when it comes to raising kids. And my training in child development lends itself to having knowledge and tools that prove useful. Yet I found myself second-guessing my decisions and feeling stressed about feeding my children. I began to realize I was allowing unsolicited advice, critical comments, and a stream of perceived judgment to get under my skin and negatively impact my mood.

My mom and her mom—both wonderful mothers and grandmothers—come from a line of women who believe in spoon-feeding and stuffing babies until they are fatter than Thanksgiving turkeys. They’ve spent hours on end tricking toddlers into taking yet another bite. Although my kids were growing normally and were above average in the height and weight percentiles, I found myself falling victim to the suggestion that, somehow, I was not feeding them properly or enough.

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I began to realize how much I dreaded meals, especially dinner, not only because of the tedious routine involved in preparing meals and getting kids to eat them, but also because of the way I wound up feeling like a failure because of my kids’ (ages 4, 2, and 6 months) inability to sit politely at the table while graciously gobbling up every bite. Sick of feeling defeated every evening, I signed up for a lecture on mealtimes with toddlers that was being offered through our preschool.

I listened with relief (and a slight sense of smugness) as the presenter confirmed that much of the advice recommended by the American Academy of Pediatrics was consistent with my line of thinking when it comes to feeding kids. She confirmed it is normal for children to have day-to-day and meal-to-meal appetite changes. Not only do their appetites vary in terms of how much they eat, their interest in certain foods can flip-flop at the drop of a hat. It’s not worth getting frustrated or arguing with your child over the fact he loved black beans last night yet refuses to touch them today. And if your kid eats 10 chicken nuggets for lunch today but nothing all day tomorrow, that’s okay. Experts recommend we look at children’s nutrition over the course of a full month rather than at every meal, daily, or even from week to week.

It was useful for me to be reminded that kids’ stomachs are quite small and don’t need as much food as we may think. Contrary to my well-intended mother’s conviction, a child will not die from skipping a meal; in fact, it’s normal for a child to sometimes be disinterested in food all day. She will eventually make up for it with a huge appetite another time. As long as children eat well at some meals, it’s okay if they barely touch their food during others. Keeping this in mind allows me to let go of much of the frustration that was ruining my meals.

More important than ensuring children eat every bite is avoiding power struggles related to food. When we force children to eat when they are not hungry or interested, or when we insist, “You must be hungry, you need to eat,” we inadvertently set them up to ignore their own body signals. Children need to learn to recognize, trust, and listen to their hunger cues—to eat when they are hungry and stop when they are full. When we force kids to eat, bribe them, or create the expectation they must finish everything on their plates for us to feel proud of them, we set them up for struggles later in life. Eating disorders, overeating, and using food as a coping mechanism may develop as ways to self-soothe and cope with stress.

Rather than nag children about eating, we need to teach them lessons about nutrition and food and then allow them to make choices. This sometimes means learning the consequences of poor decisions. For example, you might explain, “I’m worried that if you don’t eat your dinner, you may be hungry later,” allow them to decide whether they eat, and let them experience the consequence of feeling hungry later if they refuse dinner. This helps them to learn.

When you eliminate ultimatums, micromanaging, pressure, and control issues over food, you can relinquish some of the frustration that comes with parenting a toddler. You can also instill in your children healthier messaging around eating.

Being consistent with meals and snacks helps children to know what to expect and learn to regulate their appetite. Experts recommend that adults eat with children as often as possible and that everyone eat the same meal. No short-order cooking or making separate meals for kids. Caregivers should control the specifics of meals—the what, when, and where regarding food being served—but children should be allowed to control what they eat off their plates and how much. That’s right—children can refuse to eat specific foods and decline taking even one bite. Parents should choose healthy foods and ensure that at least one item per meal is something the child likes.

In our house, I recommend everyone try at least one bite of each food, even if they think they don’t or won’t like it. We talk about how taste buds change, and I allow the kids to spit the bite into a napkin if they don’t like it. Hard as it may be, I also try to remember that it’s normal for them to not sit still, to play with food, and to make a mess. Depending on age, it’s all part of learning about their world, developing hand-eye coordination, testing limits, and becoming independent.

When you eliminate ultimatums, micromanaging, pressure, and control issues over food, you can relinquish some of the frustration that comes with parenting a toddler. You can also instill in your children healthier messaging around eating.

To recap and give some additional advice I found helpful:

It was validating to step outside of the chaos of my kitchen and hear that my “laid-back” way of handling mealtimes was, in fact, in line with recommendations by the “experts.” Following the presentation I attended, my husband and I sat down with our kids and explained we were going to make some family rules around mealtime. Together, we created a list of rules to make meals more enjoyable for us all. In hopes it inspires your own transformation out of chaos into “hectic but good family fun,” I share with you my family’s list of mealtime rules:

Raising toddlers can be a wonderful, though trying, experience. Don’t let mealtimes drag you down. By avoiding tension and frustration related to eating, you can make meals a more pleasant and valuable experience for everyone.

If you’re struggling as a parent, don’t hesitate to contact a licensed counselor who has experience with child and adolescent issues.

Reference:

Toddler – Food and feeding. (n.d.). Retrieved from https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/HALF-Implementation-Guide/Age-Specific-Content/Pages/Toddler-Food-and-Feeding.aspx

Adult with natural hair speaks with emotion present on face in therapy room to counselor who is seen from rear onlyI was recently talking to a colleague about the topic of therapist self-disclosure and when it’s appropriate to reveal versus withhold certain details regarding personal information. My colleague referenced the term “broaching,” saying, “There is a difference between self-disclosure and broaching.” This piqued my curiosity, as I was unfamiliar with the term.

She explained how broaching is a vital and culturally competent tool and went on to give the following examples: Telling a person in therapy I am from the East Coast and not the South, thus there may be references to Southern culture I am not familiar with; pointing out I was born in the United States, therefore conveying I may not have a full understanding of the experience of someone who immigrated from China; or asking a black individual what it is like to work with me, a white therapist.

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As she listed these examples, I was happy to realize this was a concept I was actually very familiar with and trained in. Despite not previously being aware there was a term for it, broaching is something I’ve found to be incredibly important in my work.

Broaching, as defined by Day-Vines (2007), “is more than consideration or acknowledgement of racial and cultural factors; it refers to the counselor’s explicit efforts to both initiate and respond to the sociocultural and sociopolitical concerns during treatment.”

Broaching involves the therapist mentioning their awareness of race, ethnicity, culture, and other obvious differences as a way to build rapport, invite open communication about diversity, and let people in therapy know that nothing is off the table. By broaching otherwise overlooked or unmentioned subjects, therapists demonstrate there is value in talking about all perspectives and aspects of various experiences and issues.

While I had excellent training in multiculturalism during my graduate program, I didn’t fully appreciate the importance and positive impact of broaching until I utilized the technique with someone during my internship. While working with a young African woman, I listened as she expressed frustration with an experience in trying to buy a car. She described how she felt taken advantage of by the salesman due to being young and female.

If you are a therapist who finds it difficult to use broaching or one who lacks strong training in multicultural issues, consider getting training in this area. If you are an individual in therapy and have found yourself holding back about important aspects of your life due to fear your therapist will be offended or unable to understand, take a chance and go there.

At one point in the conversation, I nodded in agreement and said, “And there may have been some racism going on, too!” Her eyes lit up and she exclaimed, “Thank you for saying that! Yes! I didn’t want to mention that because I was afraid of offending you or that you wouldn’t understand.”

This led to an important conversation about how I may be able to relate to some aspects of her experiences, but I could never truly understand it fully, especially in regard to what it is like to be an immigrant or a woman of color in our society. I invited her to always feel comfortable bringing up issues of race and our differences, and I acknowledged the reality that things like racism and prejudice are a huge part of her existence and worth talking about. It was incredibly powerful and eye-opening to see how broaching strengthened our relationship and allowed this individual to permit herself to go deeper in her work by sharing every aspect of her various experiences.

Mentioning differences and pointing out the “elephant in the room” makes uncomfortable, awkward, or taboo topics less of an issue, barrier, or obstacle in treatment. It is vital that therapists consider how cultural factors play a role in the experiences of people seeking help. While it can feel awkward to do so, it is the job of therapists to open the door for the people we work with to feel safe and comfortable enough to talk about the important aspects of their world. When done in a genuine, appropriate, and respectful way, initiating these conversations can help individuals to feel more comfortable and can lead to some rewarding interactions that further the treatment.

Broaching has the power to help individuals to feel safer, more respected, better understood, and more empowered. People tend to feel more comfortable with people similar to them, believing they will be better able to relate and understand; however, more important than sharing the same traits is the therapist’s attitude toward recognizing and acknowledging similarities and differences in things like age, generation, race, ethnicity, culture, gender, sexual orientation, disabilities, and socioeconomic status.

If you are a therapist who finds it difficult to use broaching or one who lacks strong training in multicultural issues, consider getting training in this area. If you are an individual in therapy and have found yourself holding back about important aspects of your life due to fear your therapist will be offended or unable to understand, take a chance and go there. You deserve a space where you can be authentic and 100% transparent about your experiences. If your therapist does not demonstrate an ability to handle broaching, it may be worth finding a provider who is a better fit.

Reference:

Day-Vines, N.L., et al. (2007). Broaching the subjects of race, ethnicity, and culture during the counseling process. Journal of Counseling & Development, 85, 401-409.

Two people sit at table in cafe, one upset, the other offering comfort and supportMany of us are aware of the importance of validating other people’s feelings. We know recognizing and acknowledging feelings helps others to feel understood, valued, cared about, and important. We can easily recognize how abusive, mean-spirited, or hostile interactions involve a failure to validate feelings and, sometimes, purposeful attempts to be hurtful.

But well-intended exchanges among well-meaning people can also miss the mark on validating feelings and can cause people to feel a lack of support. Even during conversations where we feel tremendous compassion and want to help, it can be all too easy to unknowingly or unintentionally minimize and invalidate what the other person is trying to convey, ultimately creating more conflict or strong feelings of frustration, hurt, anger, and rejection.

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In theory, acknowledging feelings is easy. Validating feelings doesn’t mean you accept or agree with the other person’s position; it simply means you acknowledge what they are saying. Yet, effectively acknowledging the emotions and experiences of others can at times be a challenge.

Let’s take the following simple example and explore seven ways failure to validate can occur. Imagine you didn’t get enough sleep last night and you feel utterly exhausted today. You complain to someone—your partner, parent, friend, or coworker—by saying, “I am so tired!” Consider how you might feel if any of the following reactions occurred:

1. Minimizing or Denying

“The day will be over soon enough!”

Many people are uncomfortable with feelings, especially negative ones. They don’t want to accept them, give them any power, or allow them to exist. People sometimes incorrectly believe that ignoring feelings will help them to diminish and ultimately disappear. However, this is rarely the case. Ignoring, minimizing, or denying feelings either causes them to amplify or results in other negative feelings, namely those of being hurt, isolated, or rejected.

2. Blaming or Scolding

“You shouldn’t have stayed up so late watching that movie!”

Sometimes people look for the reason behind negative feelings or difficult experiences. They assume pointing out the cause or giving a rationale may lessen the negative situation or, perhaps, prevent it from reoccurring. Attempting to teach a lesson has its place, but doing so without acknowledging present feelings typically closes off the person to hearing the message.

3. Lecturing

“You really need to get more sleep. Not getting enough sleep is bad for your immune system!”

Sometimes we unintentionally state our concern for others in a way that feels more like a lecture. Without first validating feelings or offering empathy, our message comes across as preachy and judgmental rather than well-intended, helpful, and supportive.

4. Unsolicited Advice

“You should start going to bed earlier. Try a relaxing bubble bath and stop looking at your iPad that late in the evening.”

People often want to be helpful, thus they jump to providing suggestions and advice. However useful the guidance may be, providing it too soon, prior to acknowledging feelings, can wind up feeling judgmental. It makes the messenger appear superior and can feel like there is an underlying implication of ignorance and incompetence.

5. Questioning

“Why were you up so late last night?”

While asking questions can be helpful to get more information about the situation, asking them without first acknowledging feelings can come across as critical, uncaring, and dismissive. Intentionally or otherwise, questions can imply blame, which may ultimately make the person feel resentful, misunderstood, and more inclined to shut down.

6. Shifting Focus

“I was up so late last night because …”

We often connect with others over shared experiences and we tell our own stories as a way to relate to one another. However, shifting the focus to your own experience before first validating the experience of the other person can make you seem self-absorbed and can create distance.

7. Comparing

“Oh, my gosh, I’m SO exhausted.”

When people want to be helpful, they are compelled to look for the solution, fix a problem, or remove any discomfort. But, delivered in the absence of validation, these approaches often backfire.

Similar to shifting the focus, we sometimes respond to somebody’s experience or emotions by sharing our own feelings. While the intent may be to connect over a common occurrence, such sharing can feel like a comparison that ultimately minimizes the person’s feelings and makes them feel ignored rather than understood.

I’m not saying any of these things are bad in and of themselves. They are all perfectly fine and useful approaches when delivered with appropriate timing and in appropriate circumstances. The problem lies in jumping to these things too soon without first acknowledging the feelings or empathizing with the situation. All of the above responses would likely be better received if they were prefaced by something to the effect of, “Being tired in the middle of the day is the worst!” Or, “I’m sorry you are so tired!” Offering validation prior to advice, motivation, wisdom, or sharing helps the subsequent message to come across as caring rather than dismissive.

When people want to be helpful, they are compelled to look for the solution, fix a problem, or remove any discomfort. But, delivered in the absence of validation, these approaches often backfire. It can be incredibly frustrating and unhelpful to feel talked at versus understood in the heat of the moment or when talking about personal emotions. Sharing feelings opens people up to being vulnerable. And when we feel vulnerable, we need validation, empathy, and understanding rather than tidbits of advice or storytelling.

Validating involves ensuring your first response is one of acknowledgment and empathy. Hearing “That really sucks!” or “That sounds so stressful!” is often more helpful than any of the lectures, questioning, or unsolicited advice that may follow. It may sound silly or like unnecessary fluff, but we are hardwired to need connection, and only in feeling heard do we truly feel connected, supported, and understood.

Thoughtful professional wearing sweater with short hair sits in comfortable office looking out windowOne challenge that can arise for therapists is the decision whether to disclose personal tidbits of information as they become potentially relevant during treatment with the people we help. I recently provided consult to a colleague who brought this dilemma to light and gave me the opportunity to contemplate all of the aspects involved in deciding whether to share information in our work.

In this particular scenario, my colleague was conflicted about whether to disclose to a woman she was working with that they shared the same medical practice. Normally, this piece of information might be an insignificant coincidence; however, this specific case was more complicated. A large focus of what the woman was discussing in the session involved decisions she was making regarding one of the doctors in the practice as it related to the future of her health care. My colleague, her therapist, had strong opinions about this particular doctor due to a very negative personal experience she had. As she listened to the woman explain her situation, she felt conflicted over whether to speak up about the fact she knew this doctor or stay quiet and focus solely on the woman’s experience.

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Both felt like no-win options. On the one hand, it felt awkward to take the focus off the woman’s experience by mentioning her own knowledge of the practice. On the other, she felt that simply listening and nodding without mentioning her familiarity with the doctor was like withholding a secret or being dishonest. And that felt like a threat to her credibility and to the therapeutic relationship.

As we contemplated her options, we discussed various questions, including: What if the two women ran into each other in the doctor’s office waiting room? What if the woman mentioned her therapist by name to the doctor and he revealed he knows her? If the woman somehow found out her therapist knew of this doctor all along with no mention, would she feel betrayed? Would it be a threat to their working effectively together?

I had a similar experience in the past in terms of feeling uncomfortable holding a “secret” from two people I was working with. I had a long-standing relationship with each individual. Well into my work with both, it became apparent the two had met and become friends. As the two talked about their budding relationship in their individual therapy sessions, I sat with the discomfort of being unable, due to confidentiality, to blurt out, “I know this person!”

Sometimes, obvious conflicts are apparent up front and we have the opportunity to inform an individual that, due to a conflict of interest, we are going to need to refer them to a colleague. But when coincidences and complications arise well into the course of treatment or are not obvious conflicts, our options and decisions as therapists become more complicated. We are often faced with navigating how to balance being transparent, open, and honest while adhering to boundaries, ethics, and legal codes.

When ethical or legal boundaries do not prohibit therapists from sharing information, appropriate self-disclosure can be incredibly useful in therapy. For one, sharing common experiences can strengthen the therapeutic relationship. Additionally, revealing limited personal information or mentioning mutual experiences can help make the therapist seem more “human” or “real,” which can increase the comfort level of the person seeking help.

When a therapist decides to disclose certain information, it’s important to keep in mind that the reason for doing so is to help support the person in therapy and advance the treatment. The therapist must ensure the disclosure is in the best interests of and for the benefit of the person they are helping and be careful not to turn the focus on the therapist.

A strong therapeutic alliance is one of the biggest factors in whether therapy is helpful, and some level of disclosure can help in developing this necessary rapport. Additionally, when therapists share that they personally relate to pain, struggle, or challenge, they can instill hope and help to reduce feelings of isolation or helplessness.

The key to disclosing lies in determining when it is appropriate. In line with most health care provider codes of ethics, the first obligation is to do no harm, so it’s paramount to think about the welfare of the individual in treatment and to contemplate all the ways they may be impacted by the decision to share or not share. In more complicated situations, it is important to seek outside consultation with other professionals or colleagues to ensure the therapist is looking at the situation from every angle and that personal needs, emotions, and biases are not clouding their judgment.

When a therapist decides to disclose certain information, it’s important to keep in mind that the reason for doing so is to help support the person in therapy and advance the treatment. The therapist must ensure the disclosure is in the best interests of and for the benefit of the person they are helping and be careful not to turn the focus on the therapist. The therapist should not disclose anything that may require the person they are helping to then be in a position of caring for the therapist. For example, it would not be appropriate to bring up unresolved grief or any other issues the therapist is wrestling with.

Disclosure is effective only when the person in therapy feels supported, understood, and validated, so care should be taken in the timing and delivery of the information. It is not helpful if the person feels the therapist is wasting valuable time with their own interjections or anecdotes, so therapists should consider whether disclosure can be summed up in a simple sentence or whether it would require a more in-depth explanation that takes up time and turns the focus away from the person’s experience.

Questions for Therapists to Consider Regarding Disclosure

Some questions therapists must ask themselves when deciding whether to share certain information include:

Apart from issues that involve clear legal or ethical guidelines, there is often no right or wrong answer as to whether disclosing certain information is appropriate or warranted. By considering the above questions, therapists may be better able to make decisions that are well thought out and upholding of their duty to act in the best interests of the people they help.

Shiba Inu with eye half closed lying on pillow in living room relaxingI recently experienced an increase in my anxiety related to the flood of emotions I have been navigating in dealing with my aging, ailing dog. Only half-jokingly, I told my colleague, “I need to find my own therapist who specializes in ‘pet owner anxiety.’ ”

I’ve seen countless articles and research studies supporting the theory animals can help improve anxiety, stress, and depression, and I’ve heard of more and more people registering their pets as emotional support animals. However, it occurred to me that I’d never really come across information regarding the anxiety that can come with owning a pet, though it’s likely something many pet owners and animal lovers experience at some point.

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Owning a pet can be wonderful. Pets provide great companionship and, for many people, animals are loyal, loving members of the family. But loving a “fur baby” comes with its hardships, too. There is the potential for stress with things like adjusting to owning a new pet, training a pet, acquainting new pets and existing pets, introducing pets and children, and finding solutions to various responsibilities in terms of help with pet sitting, dog walking, etc. But for me, the greatest anxiety has come with navigating the options, recommendations, and uncertainty after finding out my dog’s health is failing.

One of the most devastating parts of pet ownership is coming to terms with the fact we will likely have to say goodbye to our beloved companions whose lifespans just don’t equal ours. While many pets seem forever young, they do age, their health eventually declines, and we are faced with even more responsibilities as we take care of the additional duties and demands that come with caring for an elderly or sick animal.

About a year and a half ago, my dog was diagnosed with congestive heart failure. Ever since, I’ve grappled with topics related to the uncertainty of death, the anticipation of grief, and the difficulty in having to make confusing and difficult decisions regarding his care.

Death and loss are never easy topics, but I find them to be particularly complicated with pets. For one, they cannot tell you how they feel or voice an opinion in their care the way many aging or ill humans can. Additionally, the knowledge pets are animals as opposed to humans can bring about confusion regarding what that means in terms of our devotion to giving them the best possible care while doing what is in everyone’s best interests.

There are differing opinions when it comes to the value we place on our animal friends. For some people, pets are “just animals.” The emotional attachment some have with their pets may not be understood or validated by those who don’t share the same love of dogs, cats, iguanas, or whatever your beloved pet may be. For others, pets are truly members of the family and losing a pet can be incredibly challenging and affecting.

While I share the sentiment that my dog is a beloved part of my family, I’ve found it overwhelming and difficult to navigate his diagnosis as I balance the discrepancy between doing everything we can versus doing what is realistic. Lately, I’ve wished I had a best friend who is a vet—someone who could give me an honest, unbiased opinion not from a business or professional perspective, but from a place of truly compassionate and candid advising to ease the helplessness and confusion I’ve faced.

I share this in hopes other pet owners who relate can recognize that the strong emotions they feel regarding their pet’s care, health, and life are valid. Pet ownership, rewarding as it can be, can be a source of great stress and anxiety and is a valid reason to seek support when needed.

Some of the greatest anxiety I’ve encountered has come from juggling the grief that comes with knowing my dog is reaching his life expectancy and dealing with an irreversible and fatal disease, all the while managing the guilt I experience when questioning whether it’s worth it to shell out $600-plus every six months, per the vet’s recommendation, for echocardiograms that will monitor the progression but not actually stop it. Being a first-time dog owner, I’ve struggled with nagging questions about whether I should be doing more; confusion as to whether various vets are giving me the best advice; guilt over my hesitancy at emptying my bank account for tests that won’t change the inevitable; and dread over what those final days will be like.

With our dying human relatives, we have no choice but to accept not knowing what the future holds as we await their final breath. With our pets, we’re faced with the potential we may have to make decisions and take it upon ourselves to assist in ending their lives. While it is said euthanizing a pet is one of the most loving and humane decisions you can make, it’s one that is never easy and it inevitably brings about an array of challenging emotions.

So as I struggle with the uncertainty of how things will progress, questions about what my next steps should be, and anguish over what’s to come, I find myself feeling a dreadful combination of anxiety, guilt, and helplessness. Thoughts of, “I’m never owning another pet again” creep in and I question whether the anxiety of anticipatory grief or actual grief is worse.

Rationally, I know it’s better to have loved and lost and that time will ease the pain. And I recognize the greatest factor in my anxiety is in anticipating my dog’s impending passing and knowing there is no course of action that will eliminate facing this hurdle. Yet I’m still struck by how stressed, lost, and guilty I’ve felt regarding truly knowing what steps to take between now and then—and how this dilemma, or any type of stress related to pet ownership, is something I’ve rarely heard others voice.

I share this in hopes other pet owners who relate can recognize that the strong emotions they feel regarding their pet’s care, health, and life are valid. Pet ownership, rewarding as it can be, can be a source of great stress and anxiety and is a valid reason to seek support when needed. While I haven’t come across resources specifically related to “pet owner anxiety,” I am happy to share that there are therapists out there who specialize in pet loss and there are resources and support groups around the country that focus on pet bereavement.

Cheerful but busy mother works on laptop while taking care of two childrenIt has been said motherhood is a thankless job, and this often feels true. There are a lot of things moms do to keep their families running, and many of these tasks seem to go unnoticed, which can contribute to moms experiencing overwhelm and burnout.

A few weeks ago, I found myself incredibly irritated after a tiff I had with my husband. It was during a morning when I was feeling particularly tired, run down, under the weather, and stressed about the many things I needed to get done. As I rushed to get out the door and drop the kids off at school, I snapped at him about something. He, in turn, got annoyed. It turned into a heated argument where he pointed out everything he was doing to help pick up the slack while I was exhausted and not feeling well during my third pregnancy. This threw me over the edge. How dare he point out the fact he washed some dishes and gave the kids a bath! Did he want me to break away from the 8,000 things I had to get done to present him with a medal?

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While I so appreciate the help, it felt like only a small dent in the laundry list of things I had on my plate that week. As I drove off, I fumed. And then I came to realize the hundreds of things I had to get done weren’t even on his radar.

This happened to be around the same time I was internally beating myself up for not meeting my own expectations for the kind of mom I wanted to be. I was juggling work, parenting, and being the chair for a large fundraiser about to take place, and I’d had to tell my daughter multiple times that week I was too busy to play with her. And just the day before, I’d found myself blowing up and yelling at my kids because my patience had reached a threshold. I felt terrible about it.

Feeling like I was on a tightrope without a net, I tried to cut myself some slack. I sat down and began listing all the things I do as a mom with young children. There is the obvious—feeding the kids, driving them to and from activities, breaking up sibling fights, doing laundry, washing dishes, planning meals, grocery shopping, cooking, and cleaning. But what I realized as I started to think about the little burdens on my mental to-do list is there are so many other little tasks cluttering my mind. In and of themselves, they may seem like minor things. But when you add them all up, these often-unrecognized tasks create a hefty workload for moms who are basically the equivalent to unpaid, overworked project managers. Sometimes it just feels like there aren’t enough hours in the day to get it all done.

Seeing these tasks laid out in a bullet-point list helped me to take a step back and recognize that, even on the days I feel like a crappy mom for sticking my kids in front of the TV, I am still doing a lot to be a caring and responsible parent.

Below, I present my ever-growing list in hopes it helps other moms realize, “Wow, yes! I do a lot!” (It should be noted I recognize dads also do a lot and that they may, in fact, cover many of the things on my list—as well as tasks that don’t appear here—in their own households.)

The Invisible Laundry List

Oh, and grow and birth humans, which, given the exhaustion and nausea pregnancy entails, is no small feat while keeping up with everything listed above if you have other children.

Moms do and manage a lot! And we do so while trying to make time to play with each child and remain calm and positive when disciplining. At times, it can be overwhelming or downright impossible.

Moms do and manage a lot! And we do so while trying to make time to play with each child and remain calm and positive when disciplining. At times, it can be overwhelming or downright impossible.

When I was younger, I was in the photography club at school and found myself irritated when rolls of film would pile up and my mom could never find the time to drop them off to be developed. How hard could it be? Just drop the film off and pick it up next week, I thought. I hate to admit it, but I now understand why she never did remember to bring that film to the store.

Recently, I found myself with a few hours of unexpected alone time when my morning plans got canceled at the last minute. I dropped my daughter off at school and walked back to my car, trying to decide what I was going to do with this gift of free time. I ended up sitting idly in the parking lot for a good 15 minutes at a complete loss for what to do next. Sure, there were about 800 errands I needed to do and would love to do while kid-free. But, ironically, I couldn’t think of a single thing in that moment.

I realized my brain is typically so cluttered with the long list of things that need to be done that in an instance of quiet and unstructured time, it went blank. I finally took a few deep breaths and thought about how my advice to others would be to embrace the silence and seize the opportunity to do something self-care related.

When we have so many responsibilities, it can be hard to stop and take time out to escape from the pandemonium of things weighing on our minds. But sometimes, pausing to give ourselves a chance to rest and relax is exactly what we need. By remembering to take time out, find balance, and sometimes put our own needs for sanity first, we give ourselves a reset that allows us to have a renewed outlook. We ultimately become better equipped to face the tasks, challenges, and stressors life presents.

If you, too, are a busy, overwhelmed mom, take just 10 minutes now to find some quiet, to sit down and relax. Make your own list of all you do. Writing it out is not only cathartic, but it can give you the opportunity to stop and give yourself the praise you so deserve.

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.