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Am I Too Dependent on My Boyfriend?

by Dr. Marie Hartwell-Walker June 1st, 2024
written by Dr. Marie Hartwell-Walker

From a teen in Morocco:  I really love my boyfriend but I think there’s something wrong with me. I don’t have friends I trust no one except my boyfriend, we’ve been together for 2 years now almost three and I love him a lot. We spent the whole previous year together in the same house and all, but he had to go abroad to study.

I don’t think that I’m coping with this very well, it has been 2 months since he left and I think I’m going crazy. I constantly need him to text me and to call me at least once in a day every day. But stuff are very complicated now since our schedules don’t match. So we barely talk during the day and he calls me at around 3 or 4 am. I always cry when I don’t have his attention or when he forgets to call me or doesn’t text back in time. I get mad and start shaking while crying.

I think I’m hurting our relationship but it’s really hard and I need help to calm down and get my stuff together. I don’t want to lose him.

Thank you for writing. I know this is painful, but I do believe that the current situation may be a good thing for you. You are learning that you are in fact much too dependent. The kind of dependency you describe will doom your relationship. It is good to identify the problem now and to take steps to become the mature and independent person you can be.

A healthy relationship is one in which each person is a whole, mature, confident person, with or without the relationship. Interdependence is very different and much healthier than dependence. In an interdependent relationship, the two people are a team. Each brings strengths to the relationship. Each person can turn to the other for intimacy and support. But they each feel competent and competent without the other. They each have a circle of friends they enjoy. Each feels supported in being all they can be.

What you are describing is dependency. Often in such relationships, one person is the needy one; the other is the rescuer. Neither role is ultimately satisfying or healthy. You don’t feel complete without your partner constantly validating and supporting you. Without daily (hourly?) reassurance that he loves  you and is there for you, you fear that you have nothing. You are entirely too needy. If he needs you to be needy to feel man enough, he is contributing to the problem. This relationship can’t last unless you get yourself together and you both recalibrate how you behave with each other.

On your side: I strongly urge you to make an appointment with a counselor. A counselor will help you discover the roots of your fears and will then support you in managing your anxiety and becoming a full, growing, mature young woman. You deserve that. You will flourish best if you are in a relationship that supports it.

Your boyfriend seems to be struggling to change your relationship. If he is a chronic rescuer, he would also benefit from some counseling to help him establish another way to love.

Your relationship has a much better chance of lasting if you each take the steps you need to take to become more able to love in a healthy way.

I wish you well,

Dr. Marie

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Not Sure What’s Wrong

by Kristina Randle, Ph.D., LCSW May 27th, 2024
written by Kristina Randle, Ph.D., LCSW

I’m 18 years old and there are some weird things that have been going on since i was little. and are beginning to get worse. here are some sitchuations that has happend. I’ve never asked anyone or had them checked out.

As a kid growing up i had a great home, i did not speak to anyone til 4th grade, as i progressed i wanted to be the center of attention, but when that happend i almost wanted to cry because it was too much.

I have a great fear of people talking about me, looking at me, making fun of me, an public speaking. I can socialize and have a good conversation. but in a group of people i almost shut down and get nervous and studder a lot. i can easliy break down and cry trying to give a speech in class. i’ve gotten called retarded, dumb, stupid.. the works, there’s a long list of things i have been called. always made fun of.

I love being alone. I am perfectly content with out anyone by myside. including family, and friends…

my mind is constantly racing, and thinking. I’m always messing with something or stressed or worried or bored or something. i switch the mood all the time. my thought process is like scrambled eggs..i always forget everything.

one particular problem has occured forever and for example. my room is messy. just like any other teenager’s room, however when my parents come up to “help clean” they start touching things and moving things. it makes me wanna scream and i ball my eyes out because they are touching everything.this has happend since i was at least 8.

panic attacks and anxiety attacks along with asthma are very common with me when i get stressed. i always feel like everyone is attacking me personally. i need help, i need to know whats going on..

I cannot determine your diagnosis with certainty based on a short letter but some of your symptoms are consistent with schizotypal personality disorder. These specific symptoms include:

  • consistent, long-term and excessive social anxiety
  • preference to be alone
  • difficulty with social interaction
  • lack of close friends
  • suspiciousness and paranoia

To gain the most accurate diagnosis, you should make an appointment with a mental health professional for a psychiatric evaluation. A psychiatric evaluation generally involves a one to two hour meeting with a mental health professional who gathers detailed information about your current symptoms, your historical symptoms, your family life, how you relate to others, your education and career history, your family involvement, and your developmental and medical history. On some occasions, evaluators will suggest blood work or X-rays to rule out any underlying medical conditions.

Counseling could also benefit you. It is important to recognize that for you therapy may be challenging, due to your social anxiety, but it should not stop you from beginning. Based on your letter, it seems as though this is a long-standing issue that has significantly impacted the quality of your life. Though therapy might be difficult, it is certainly worth the effort. It can help you deal with your intense anxiety. Therapy can also teach you the necessary coping skills to deal with everyday life problems.

Medication might also be helpful. Antidepressant medication and anti-anxiety medication may bring you significant relief.

You can look for psychotherapist by clicking on the “find help” tab at the top of this page. You may also want to consult your doctor regarding this matter. He or she may have a referral they can offer for a psychotherapist or may know of a clinic where you can get a thorough and complete psychiatric evaluation. I hope that this answer helps to point you in the right direction. I wish you the best of luck. Please take care.

Dr. Kristina Randle

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I Don’t Have the Number of Friends I’d Like

by Dr. Marie Hartwell-Walker May 26th, 2024
written by Dr. Marie Hartwell-Walker

From Australia: For a long time I’ve found it difficult to make friends despite trying really hard (joining many things where I have ongoing contact with the same people, local things, initiating further contact etc). Work is a difficult option given commuting distance and hierarchies I’m at the bottom of.

I’ve undergone extensive therapy to find out why and do something about it but therapists haven’t been able to find a reason, I do not have a personality disorder or mental health condition not even social anxiety. I score average in personality tests. My only issue is that I come across as “quiet” as I’m softly spoken but have been advised there’s no way I can make my voice louder without straining it. Some do have an issue that I don’t have an attendant partner and don’t have children.

I’ve kept my spirits up by using CBT eg remind self we all go through this, just have to keep trying and it will happen. And I’ve kept trying by joining new things to the point that people now comment on I do a lot.

I do have a few friends which I’m happy about. But it’s always good to keep meeting new people and making new friends as people do move on. I dread ever having to move from my current area (expensive) given it would take years to build friendships in a new area.
It’s so discouraging seeing others including those with similar personality types and even those who can be quite nasty easily making friends whilst I put in so much time and effort.

It seems to be a sign of the times where more and more are finding this whilst others have no time to admit new people into their lives.
It seems I need to come to some type of acceptance about my situation and somehow need to manage with less people in my life even though I’m social. I’m happy to continue with ongoing activities but want to manage the disappointment of friendships not developing from these. How do I go about this as I do not want to undergo any more therapy for a problem I don’t have or doesn’t appear fixable.

I think you are correct. Your problem isn’t that you don’t have enough friends. The problem may be that you have set a standard for “enough” that isn’t realistic. You say you have a few friends. You say that you keep meeting people and that you are involved in many activities. That suggests to me that you in fact know a lot of people who know who you are but you don’t think you have enough close friends in your inner circle.

We live in a time when people have hundreds of “friends” on social media and where stories in movies and TV shows seem to indicate that life should be populated by many, many people being involved in our lives. It may be some comfort to you to know that research doesn’t support it.

You are in your 50s. Most people your age have 3 – 5 really good friends in addition to a few extended family members who are important in their lives. Think of types of relationships as being like an archery target. The middle bullseye is you. The next circle is that 3 – 5 good friends and family. The next circle out is for acquaintances and work people — people you see regularly who know you a bit but they aren’t people you would confide in. Beyond that is a circle of people you recognize from your community or church, etc., but don’t relate to other than a smile of recognition or a wave. The next circle is populated by strangers.

It is also true that when we reach adulthood, it is harder to make friends than it is for young people. Adults often already have enough friends and family members to keep track of. Friendships take time to develop and maintain. Often people’s lives are so packed with work, family obligations and personal stresses that there simply isn’t time to take in a new friend, even if they would very much like to.

I think you should focus on maintaining the friends you have and getting other social needs met by continuing to engage in activities and work that you enjoy. Perhaps some of those relationships will evolve naturally. But I do want you to know that having a few good, good friends puts you well within what is normal.

I wish you well.
Dr. Marie

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Maladaptive Daydreaming? Maybe Some Dissociative Issue?

by Kristina Randle, Ph.D., LCSW May 25th, 2024
written by Kristina Randle, Ph.D., LCSW

When I was young, around 6th grade, I started listening to music while laying down for hours at a time. I would just daydream, the topic was very…dark. I was the star of the day dream and my character was kidnapped and put into human trafficking. She would constantly be raped, tortured, humiliated, and dehumanized and this went on for years. Any moment I could I would slip into this world and the character suffered more and more abuse. It seeped into my dreams and scared me. I did not like this place, but couldn’t stop. Eventually the character was no longer me, my name and face stopped being used. But for all intent and purposes it kinda was still me.

Characters from tv shows and books were in here, typically they’d fall into danger and my character would have to suffer in some way to protect them. While I don’t have the time to simply lay around all day anymore, I still visit this place, although not quite intentionally? This is the only world I’ve imagined, although it does have different time lines I guess.

This started as a way to get away from my life. My family was dysfunctional, neglectful, emotionally abusive, and I was under constant stress. I was a parentfied child to my twin sister and mother. So maybe this is some dissociative issue? Idk what it is but it still bothers me and I can’t talk to anyone about it. I have no idea how to bring it up to a therapist, or what kind of therapist to see for it. While my life’s gotten better I still daydream, and it gets in the way of my school work sometimes. I’ll drift into this world if I’m feeling depressed and don’t want to deal with my emotions.

Basically I need help finding help, what kind of therapist should I see for this? How do I even begin to tell them about it? And is there any clue as to what this could even be? Am I crazy?

You began daydreaming to escape your chaotic life. You utilized the term maladaptive daydreaming and while it is not an officially recognized diagnostic label, there are empirical studies that describe it as a observable phenomenon. Maladaptive daydreaming is distressful often because it produces negative emotions which can hinder social, occupational and academic performance. Daydreaming is a normal mental activity that is virtually universal. Maladaptive daydreaming, however, is less common and often indicative of psychological distress. In some studies, individuals who engaged in maladaptive daydreaming had higher rates of obsessive-compulsive symptoms and dissociation when compared to control subjects.

It’s possible that your maladaptive daydreaming is a form of dissociation or derealization. In that case, it would be important to learn grounding techniques to decrease these experiences and psychological strategies for dealing with reality. These can be learned in counseling.

Therapists will not think that you are “crazy.” They don’t think that way about their clients. Most therapists will know how to help you but it might be advantageous to choose one who specializes in dissociative disorders. The literature suggests that individuals with maladaptive daydreaming may benefit from cognitive behavioral therapies, exposure and response prevention therapies, mindfulness training, and perhaps hypnosis.

Generally speaking, the best way to find a therapist is to contact four or five and describe your symptoms and ask how they would help. Choose the therapist who is the most knowledgeable and with whom you feel the most comfortable. They will likely be your best choice. I hope this answer assists you in knowing how to proceed. Good luck and please take care.

Dr. Kristina Randle

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Stuck in the past

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 22nd, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I am feeling extremely distressed. I saw a therapist for 3 months in US and now I’ve moved to a country where I can’t really afford a therapist and at the same time, I don’t trust the mental health system here. This is what I was diagnosed with in US:

1. ADHD

2. Depression

Here is what I’m having issues with:

1. Stuck in the past, I also get stuck in my emotions when someone is rude to me.
2. I was sexually molested for 5 years by my brother in law who also manipulated me and at the same time got my sisters (I have 2) against me in order to isolate me. I told my mom this a month ago now that I’m almost 27 and her response was more of shock + “why didn’t you tell me this before? ” and now when I tell her how hurt I am at her response. She says ” well, if you would have told me this earlier I could have done something. What do you want me to do now?”

This really makes me angry. Makes me feel like I don’t have anyone to support me. I also told my dad, who emotionally abused me at the same time I was being sexually abused. Its really hard opening up to my family, no one wants to discuss anything, its usually criticism or covering up emotions/situations for them.

My mom also said that no one would believe me, only my parents would, which I believe is true.

3. My dad is extremely sick. He is almost bedridden after a few strokes and that disturbs me. He was also very emotionally abusive and controlling while I was growing up. As a child, he was my favorite and he always supported and protected me, but the moment I became a teenager, he started emotionally abusing me, which really confused me and I ended up isolating myself because I was in a dysfunctional family where at the same time I was being sexually molested, had really mean sisters, had my parents always criticizing me and telling me how I really need to change because my behavior is bad (but it was because my sisters were always mean and they’d always go make a huge deal out of everything I did to my parents.. such as, if I didn’t want to share my cd with them, I was really bad and I didn’t have a heart- etc..) and I was also not allowed to have any friends at all. I was so depressed while growing up.

3. Now that I’m older, I can’t get away from the past. For years I carried the guilt and secrecy of the sexual molestation because I kept thinking I was stupid and it was my fault that this happened and now I feel angry that I got manipulated and I’m angry at my past, I’m also angry at the fact that I can’t build close relationships anymore, I’m too scared to.

4. I also just exited a relationship where my ex was emotionally abusive and with him, I started feeling like I was losing myself. I am a very logical person and whenever I found out things he was doing wrong he turned it around on me saying “think about it. Your logic is so flawed. What’s wrong with you?” He did this on many occasions and always had to make all decisions. He betrayed me and turned it around on me claiming me to be crazy. I actually did start feeling crazy, I started losing myself, and I didn’t know who I was anymore with him. I’m still getting over that relationship.

I also have anxiety issues, although they have gone down a bit after discussing with the therapist who told me I didn’t consider my feelings because I was taught to take care of others feelings.

Now I have moved in with my parents for a little bit and everything just comes all back in my head. I just can’t escape the past. IT’S KILLING ME, mentally, physically, and emotionally.

I am so angry at the following:

1. Why was I emotionally and sexually abused as an adolescent, it’s not fair!
2. Now I have problems with trust and intimacy, all because this man sexually abused me.
3. I can’t build relationships or close friendships because I was never taught to, in fact I wasn’t even allowed to during my teen years, I felt so isolated. I’ve lived in so much isolation it’s started to kill me inside now and I just don’t know how to change that. I don’t feel comfortable when someone genuinely likes me (as a friend), it feels very odd.
4. I was able to have sex before, but now I don’t think I like being touched. I’ve been avoiding it for a while… Actually, I’ve lost interest in bf/gf relationships but I’m not promiscuous either…
5. I feel like I have PSTD because I’m having lots of flashbacks from the sexual and emotional abuse but that also makes me angrier, why should I have all these problems because one psycho couldn’t control his behavior?!

PLEASE HELP!

I’m so angry at the past and at the effect it has had on me now that I’ve grown up. I feel so alone and isolated. I don’t feel like I can open up to anyone. My parents are extremely critical, they criticize everything in me, first I used to be super thin and I needed to eat, now that I have grown up and I weigh 150 for a 5’8, I need to lose weight– its like there’s always something I need to fix about myself. I’m too emotional, I’m too this and that.. everything is just wrong with me all the time. That’s how they make me feel. What also makes me angry is that they instill a lot of fear in me. Every time I try to do something they have fear about, where they’re concerned about me, they put it in me saying “DONT DO XYZ or THIS WILL HAPPEN. IT can happen, what will you do then”. UGH! I just wished I had some support! I feel terrible!

What a difficult set of circumstances and experiences you have to cope with. These are weighty matters and I will do my best to sort it through.

You are in India, and say that you do not trust the mental health system there. But there may be an even more important resource there for you to engage with. I would seek out a meditation teacher as a base for you being able to soothe yourself. A good teacher will be able to help you hold the uncomfortable feelings and allow your mind to settle. The studies on the value and importance of meditation are numerous. You are in a country revered for its meditative practices. If the psychotherapy is not okay for you, meditation with a good teacher will be helpful.

Secondly, since you also have a computer you can be Skype enabled. (For those unfamiliar Skype is a software application for computers that allows Internet-based free voice calls, instant messaging, and video calls to others on the platform. It also allows extremely low-cost calls from a debit account to landline phones. This is a particularly good service for long-distance international calls.)

This would allow you to call out to online therapists for a very nominal fee for the purpose of sorting through some of the issues you made mention of. See the banner at the top of the page. We also have an international referral base and there may be someone in your country you can ask for more direct guidance. Use the find help tab above.

This service can also help you stay connected with your social network you may have here. It will also help you as you connect to the online community. Please check our home page for a listing of our free support groups. We have over 160 and some are directly tailored to abuse and PTSD.

As with most things we have to use many tools to gain some peace. Here I am recommending you use tools at the opposite end of the spectrum. Go inside yourself to find the comfort and peace that is there waiting to be discovered and nurtured, and reach out with the vast resources of technology to the greater world outside.

Wishing you patience and peace,
Dr. Dan

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Early Menopause?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 20th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

After about six months of going to doctors and more doctors to try to find an explanation for some strange physical symptoms I have been having, I was recently told that I am very likely to go through menopause in the next two years or so. As a 26 year-old who recently finished a master’s degree and just finished my first year in a job that I love, this news was not only surprising, but also devastating. I’m single, have always been healthy, and haven’t really given much thought to having children yet. Now I’m faced with decisions that I feel completely unprepared to make. I have talked with my doctors who have suggested that I look into freezing my eggs (sooner rather than later), fertility clinics who have overwhelmed me with information about the process of retrieving, storing, and freezing my eggs as well as IVF, and friends and family members who all have opinions of their own.

I have spent these past few days reflecting, weighing my options, praying, crying, trying to listen to myself, and trying to make some sort of decision about whether or not to go through the extremely expensive process of saving my eggs, knowing that the success rates are low. I do not know whether I want to have children. I know I’m not ready to have them now as I am starting a career and figuring out who I am, but what if I want them in five or ten years? I know adoption would be a possibility–and I know that I could love an adopted child as if they were my own biological child.

I went from living my life in the present a few weeks ago to being rushed into the future. I suddenly have doctors asking me how I would feel about having a child in the next year or so (which I’m not ready to do) or how I would feel about freezing my eggs (or fertilizing them and freezing the embryos) or how I would feel about never having my own biological children. I’m overwhelmed with such big questions, and I feel completely unprepared to make these decisions.

I see a therapist regularly, and she and I have begun to talk through my options and all of the pros and cons. It feels like there is no “right” or even “good” choice. The more information I gather, the more complicated and confusing everything seems. I am leaning toward letting my body do what it is going to do naturally and to later adopt children if I choose to do so, but I’m afraid to commit to that decision, because I know it comes with deep grief, sadness, and potentially irreversible consequences. No matter how much I obsess about this or learn more about the process, I don’t come up with a decision I feel good about. How am I supposed to go about making such a decision?

Your situation moved me deeply because your thoughtful nature and awareness are so keenly attuned to the dynamics of your situation. I hope I can offer a perspective that can be helpful.

Dan Gilbert is a Harvard psychologist who studies how we think about the future and try to predict what will make us happy when we get there. I am reducing his immense body of work to a few sentences which could not possibly do it justice, but in essence he explains that we don’t do a very good job of predicting what will make us happy –that we are more or less over-influenced by the present moment and that causes us to make systematic errors in what we think will make us happy down the road.

What tends to be true is that our happiness and what brings us a sense of contentment comes from having the courage to face our life circumstances directly. When we can accept our challenges and joys that are hidden in our life circumstance with an open attitude then we take our life and turn it into a work of art.

Stay with yourself. Stay present with your mind and your body. You already have a trusted therapist and a team of doctors. It seems to me the work is to stay present with yourself and don’t lose these moments of your life to indeterminate futures. What I am encouraging you to do is cultivate a mindfulness meditation practice. Notice where your mind takes you. Here is more information about mindfulness.

The shift is toward self-acceptance and believing that you will be okay with yourself regardless of what you decide.

Wishing you patience and peace,
Dr. Dan

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How to Deal with an Over-Jealous Sister?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 13th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I’ve been upset these days: I have a little sister who is several years younger than me. We grew up together and had a fine relationship back then. Up until I turned into a teenager in high school, her attitude started to change. I realized she started to bad-mouth people that she didn’t get along with so I keep a distance with her. Things get worse due to forceful interference from family members. Until later and even now, whenever I try to get over the barrier and mend our relationship a bit by looking to her fine points and praise her, she became so conceited. It gets to the point that she’d bad-mouth me or even her brother (also younger than me) to make herself look good in front of parents and others.

It seems like she always try to prove herself to be the best, the smartest while while she’s not really. She got envious and show that directly whenever I got recognition for my education/schooling, my job or anything little thing that I do. I think she’s just so ridiculous, just never grow up. It comes to the point where she did cruel things to my pets that I love just to draw attention or as a way to deal with her own negative feelings, I don’t really know. just what’s the problem with her? She wanted to go for an art school, but it turned out she didn’t have enough passion and patience for that. She quit and claimed to go for the medical school, it’s way too difficult for her and she quit again. No one including me said anything about that as long as she tries to accept herself and focus on current tasks. Then she got out of school, applied for a job and quit sometime later. Her over-conceited attitude caused her trouble at workplace again.

And now, she’s direct her insecurities at me who got higher than her whenever possible. I really hate that kind of fraud. What should I do? (From the USA)

  I don’t think this is yours to fix. You stated your age in the profile as 29 — and at this stage in life your emphasis needs to be on your growth and development rather than trying to heal your sister.

There is wisdom from Al-anon, the 12-step program for family and friends of people who struggle with alcohol. They suggest to “detach with love” as a way of coping. I’ve written about this here, and think you might find some useful thoughts about your relationship with your sister. The key is to realize this is your sister’s issue and not letting it become yours is key. Less contact, less sharing of the particulars of your life, and more emphasis on developing those relationships where you are prized and appreciated and you can support others is the way to go.

Wishing you patience and peace,
Dr. Dan

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Impostor Syndrome

by Kristina Randle, Ph.D., LCSW May 11th, 2024
written by Kristina Randle, Ph.D., LCSW

I’ve realized one of my biggest issues is a feeling of inadequacy, of being an imposter. From an outsider’s view, I’m the picture of success: I went to a top 3 Ivy league college, am currently a medical student at one of the best medical schools in the US, I have extremely kind and good-hearted friends, and I’ve been blessed with a passion and talent for music. However, I feel like any second now someone will “find me out,” and everyone will realize I am a fraud. In some sense I have always felt this way about myself: I was top of my class in high school, but all throughout felt entirely insecure in my intelligence and chalked it up solely to hard, sometimes obsessive, work ethic. I feel like ALL my successes have been due to an inordinate amount of work, not actual skill. I see others around me, especially now, who work hard, but don’t have to work nearly as hard as I do to achieve better successes. It’s frustrating because I feel like such an idiot compared to my peers. I am such a SLOW learner. It takes me a ridiculous number of repetitions to get something. My obsessiveness about learning things well has gotten me far, I guess. But, I’m realizing more and more that society, the “real world,” and especially a job as demanding as medicine, require an ability to learn quickly, and they praise a high level of common sense. I’m screwed! I truly lack both of these things. I have always been book smart, but lots of basic concepts just don’t click. I truly am an idiot.

Med school has been tough because I have to spend much more time studying than most. And I’m doing fantastic, probably top 25% of my class so far. It’s just, still, I feel stupid. I don’t understand politics, economics, things that “adults” just kind of seem to develop an understanding of at some point. Same with basic history. Totally a blur to me. I feel childish because I can never contribute to intellectual “adult” conversations about these meaningful topics. I’m not well-read- I’ve somehow just mastered the art of getting amazing grades and acing tests in school. I feel like I kind of put all my cookies in one jar, and now I’m not well-rounded.

How do I stop feeling like this all the time?

Imposter syndrome was first identified in the 1970s. It is generally thought to be a collection of feelings of inadequacy about one’s competence that persist despite high achievements. It is common for some high achievers to fear that they are going to be “found out” as frauds and who feel as though they are not deserving of their success.

At its core, imposter syndrome is not believing the truth about one’s own abilities. It involves a discrepancy between the truth about your accomplishments and how you feel about your accomplishments. Your feelings should be in line with the truth.

Objectively, by all measures, you are a success. When you truly understand the truth, your feelings of inadequacy, your imposter syndrome, should dissipate.

Another illogical line of thinking is that you have to try harder than other people to be successful. Just because you perceive it that way doesn’t make it accurate. The only way to accurately compare yourself to your medical school peers, would be survey them about the number of hours they study and what kind of grades they receive. Without that objective information, you are guessing. And as with any survey, we have to understand that many people lie on surveys to make themselves look better, even though the survey may be anonymous.

The objective information that you do have would suggest that your study habits are superior to your peers. They study less than you and don’t do as well as you. Your efforts seemed to have paid off, resulting in your being in the top 25% of your class.

If you worked extra hard, compared to your peers, and wound up in the bottom 25% of your class, that would suggest something was wrong. But that’s not the case. You did extra work and it paid off.

Being in the top 25% of your class, excelling in school, and so forth, all require hard work. The more time you put into achieving your goals, the better you will do. That is as true for you as it is for anyone else. If you spent less time studying, then you would not do as well.

At the core of your thinking is the idea that you are not as intelligent as other people because you don’t seem to have some innate ability that you perceive other people as having. The skills learned in medical school are not innate. Everyone who wants to be a doctor has to go to medical school.

There is a myth that individuals who are good at something are born with certain talents but closer inspection shows that preparation and practice have much more to do with one’s success than an innate talent. Malcolm Gladwell wrote about this very topic in his book, Outliers: The Story of Success. He found that how hard one works is often the determining factor between who makes it and who doesn’t. “Working really hard is what successful people do.”

It’s important to assess ourselves and our abilities as accurately as possible. That’s what psychologically healthy people do. You must commit yourself to believing in the truth as it is, not how you desire or fear it to be. It would be the best way to eliminate the discrepancy between your success and how you feel about your success.

If this continues to be a problem, consider cognitive behavioral therapy (CBT). CBT is especially effective at targeting and correcting illogical self-perceptions. You might also try reading about imposter syndrome, particularly among medical school students. It seems to be that because medical school is highly competitive, anxiety about one’s abilities is common.

I would also like to add that you mention your musical talent. I would suggest that you become familiar with right brain dominance. Do your friends who are so politically oriented have the same ease of familiarity with the arts? Are they as creative, as sensitive as you?

Please take care.

Dr. Kristina Randle

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I Don’t Want to Feel So Helpless Any More

by Dr. Marie Hartwell-Walker May 8th, 2024
written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: Hello, I’m a freshman in college struggling with bouts of depression as well as some intense social anxiety. I’;m typically a pretty happy person and I’ve never gone to a specialist mostly because the thought of it makes my skin crawl just thinking about it as does doing a lot of things that involves meeting or speaking to people I don’t know to the point where sometimes I want to cry. Somedays are good and I can communicate with people without a problem but when it’s bad I can barely make eye contact with the people who are talking to me and I’ll fall back into nervous ticks like picking at my nails, rock, and or shaking my foot.

I just feel so uncomfortable and I don’t  know what to do. I’ve always had trouble talking to people even when I was a little kid and for the most part I’ve kept to myself my only consistent outlet being softball which I’ve played since I was 6. For a while now I’ve written off my feelings as a part of puberty and something that I’ll grow out of but it only seems to be getting worse. I’m not sure what it is but I’ve always felt like I’m a little off. In high school I never went out and partied with people and I’ve always thought it was dumb to do so. I haven’t done so much as to hold a guy’s hand let alone kiss one. I feel like socially I’m so far behind other people my age. I isolate myself from people when relationships get too intense and I avoid any type of attention positive or negative. I have a very active imagination and I often find myself getting lost in it ignoring the world around me going into autopilot while I’m doing things which helps me cope when I get in uncomfortable situations.

My parents are very supportive and my father has been pushing me to reach out to someone for a long time now. I just don’t want to feel so hopeless anymore. I want to understand what’s going on with me and why I get these feelings.

Thank you for reading this more than likely jumbled mess.

Thank you for writing. Your letter is not a “jumbled mess”. It is an articulate statement of very difficult feelings. Please listen to your dad. I know you know he’s right. You do need to reach out to someone. I also know how difficult that can be. The paradox of mental distress is that just when a person feels so stuck, the way out is to take the first step. In your case, it means making an appointment with a licensed mental health counselor who can help you determine what is wrong and make recommendations about how to become more comfortable in the social world.

Your letter is so well done, it can be a big help. Bring it to the first appointment or ask if you can mail it to the counselor ahead of time. Then you won’t have to explain what’s so painful to you on the first meeting with a stranger and the counselor will know where to start.

My guess is that things have gotten worse since you graduated from high school because the familiar faces and familiar routines helped you feel comfortable. Now that you are in college, you’ve had to start over. Please don’t scold yourself for feeling so distressed. Many people go through some version of the same thing when they have to deal with a new social environment. A positive side to this is that the change highlights the issues enough that someone like yourself faces it and gets the help they need.

I wish you well.

Dr. Marie

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I’m Not Sure if I Am a Psychopath or Sociopath

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 6th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I Do Realize That I Have A Few Psychopathic Traits, However, I’m Not Sure If I Am A Psychopath Or Sociopath.
Recently I’ve started to question and compare my actions and thoughts to others. I’ve started to be more aware of myself. I first noticed that whenever I would be angry at someone in close with ( a partner, parent or best friend)my usual feelings that I experience for them disappear completely and it’s as if they’ve changed from the people I care about to the people that I hate the most. So I did research starting from there. I’ve then realized that I lack empathy, guilt, remorse, compassion, you name it. However, I feel empathy for animals, not for humans. This is what’s making me confused. Once I’ve hurt someone, mostly emotionally, I wouldn’t feel guilty, even after my feelings for them have returned (after calming down). I’ve also realized that I’m very manipulative and dominant, I hate it whenever I feel like I’m not in control. I become more aggressive. And once something doesn’t go my way, I play as the victim or I try to make the person feel guilty or pity me so that they can give in. I don’t lie often, mostly because I don’t feel the need to since I don’t do bad things, I don’t mind following the rules as I think that they’re fair and don’t interfere with my life. I do lie sometimes, whenever I need to, I always get away with it. I also have superficial charm, it’s much easier to do online, I’ve noticed that people would fall for me in a matter of days to even a few hours. I don’t think that I am very narcissistic because I do have insecurities but sometimes I would feel like I am better than others, but that kind of feeling disappears quickly. I’ve been told that I can be cruel at times, I do admit that I am, especially towards people I dislike. I also feel satisfaction in seeing them hurt. I have a partner and I do get tremendously jealous, to the point that it’s emotionally violent for my partner. I would like to add that I also get bored very easily. (From Canada)

Thanks for sending in your concerns. Maybe the best place to start is with an adequate definition of the terms you’ve used: psychopath and sociopath. Perhaps understanding more about each of these will be helpful.

First is to understand that psychopath and sociopath are pop psychology terms that are manifestations of an antisocial personality disorder, which means that they share the common traits of disregarding others rights and safety while being deceptive and manipulative. In spite of how these personalities are portrayed in Hollywood, neither is necessarily violent.

The main instrument for diagnosing people with antisocial personality disorder comes from The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), which defines antisocial personality as an individual with 3 or more of the following traits:

  1. Regularly breaks or flouts the law
  2. Constantly lies and deceives others
  3. Is impulsive and doesn’t plan ahead
  4. Can be prone to fighting and aggressiveness
  5. Has little regard for the safety of others
  6. Irresponsible, can’t meet financial obligations
  7. Doesn’t feel remorse or guilt

To determine if your behaviors match this criteria here is a brief quiz that is not meant to diagnose but help you understand more about these concerns.

The place to look for understanding the origin of an antisocial personality disorder is in childhood. The pattern of behavior often begins with four different categories classified as conduct disorders and include: People with these symptoms are at greater risk for antisocial personality disorder.

  • Aggression to people and animals
  • Destruction of property
  • Deceitfulness or theft
  • Serious violations of rules or laws

The best way to find out more is to talk to a professional. A clinical psychologist can conduct a series of tests along with an interview to help determine what your symptoms mean. Since you list your age as 16 I’d recommend asking your parents to help set up a meeting.

Finally, your email and asking these questions is an important element, perhaps, the most important, in understanding your true character. Your desire to learn more about yourself and understand who you are is the hallmark of someone who wants to grow. Of all the things you’ve mentioned this is the strongest, and the most important for you to capitalize on going forward.

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Am I Abusive?

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP May 4th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I think I’m becoming an abusive person. In recent years I’ve started to care less and less about friends and family, the only reason I made friends this year was to use them as stepping ladders to benefit my ego and social image. I know I’m very manipulative over my family, and I know it’s bad. I just don’t feel guilty, or maybe I choose to ignore it when I hurt them. I truly resent being around them, as unappreciative as that is. I constantly try to control them or make them miserable illogically and impulsively. I threaten my father with physical harm or accuse him of having no emotions, and blame my mother for being manipulative and vain. Both of them were verbally/psychologically abusive towards me in my childhood. They despise each other and I have no love for my father. The only reason is to assure myself I have full control over them. I know one day I’ll push it too far but that doesn’t concern me in the slightest. Contrary, driving someone to insanity or death makes me feel safe, self-assured, and accomplished. Affection is unbearably threatening. They don’t fight back because they’re scared I’ll try to kill myself again. I know I don’t deserve any tolerance or kindness due to my behavior but I’m numb to shame.

What actually makes me worried is my future work/personal relationships. I’m terrible with receiving and giving affection, to the point where it noticeably damages the mental health of those around me. I subconsciously know that people (might) have relatively good intentions but I always push them away with harsh words, intolerance or criticism. I feel like if I don’t, they’ll ruin my efforts and take advantage of me. The thought of anyone having control over me is vile and infuriating. I want at least one healthy relationship but whenever the opportunities arise I become possessive and emotionally manipulative, then cut them off entirely. I’ve been in denial about this but it’s pretty clear that I’m the shitty person that’s to blame. I guess these little things don’t really matter on a large scale but I worry. Is this going to go away with time? If not, how do I fix myself? (From the USA)

I deeply appreciate your email and the courage it takes to ask this question. The part of you that wrote this email and requesting help is the part of you that needs to continue to step forward. It is the part of your awareness that is most in touch with your ability to change. Without it there is not a likelihood that you will see these issues go away in time. In fact, it tends to be that conditions worsen without a deliberate approach to improvement.

While I cannot diagnose, I would recommend you learn more about something known as an antisocial personality disorder. If you read the material we have here at Psych Central by Dr. Donald Black, MD, you’ll see what this particular condition looks like. I think you will see it identifies and discusses the symptoms and treatment. Here are a few indicators from this article that echo the things you’ve discussed.

  • Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
  • Impulsivity or failure to plan ahead
  • Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  • Reckless disregard for the safety of self or others
  • Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
  • Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

You need not have all of these to be identified — and of course, I can be wrong about this, but I would highly recommend you begin individual psychotherapy and then group psychotherapy with someone with experience in treating this condition. The find help tab at the top of the page will help you find someone in this area.

Take your initiative to write us here and put it to good use by following up with therapy. Your desire to change is the most important feature in changing who you are.

Wishing you patience and peace,
Dr. Dan

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My Partner Is Unable to Verbalize in Emotionally Charged Conversation, Despite Desperately Wanting To

by Kristina Randle, Ph.D., LCSW April 29th, 2024
written by Kristina Randle, Ph.D., LCSW

Even in the absence of conflict, my partner is unable to engage in deep conversation or to express his thoughts and feelings verbally. This has caused multiple relationships to fail in his life and he desperately wishes that kind of communication was available to him. He is an amazing listener, very open-hearted and present, but cannot engage in two-sided conversation unless it’s small talk. He doesn’t understand why this is the case and has experienced this since childhood. When he is asked for verbal feedback, he experiences obvious physiological symptoms of stress (sweating, elevated heart rate, possibly tearfulness as his non-communication is a trigger for having experienced a lot of pain from loss of relationships for this reason). He has said that he experiences his feelings more in terms of colors and shapes than in describable words, which obviously contributes to a communication issue that is certain to end our relationship too if left as is. He is interested in trying to understand what’s happening for him and becoming communicative, but has never had a practice of self-reflection or access of counseling or therapy. I love him and feel invested in giving him room to figure this out. My communication skills are highly developed and this is a significant stress on our relationship as I am accustomed to being able to process and engage verbally in a deep way with those close to me. I am making an effort to find less verbal ways we can also connect so that I am also participating in his realm, but when it comes to the nuts and bolts of our relationship we need to be able to have two-way conversation, and I need to be able to get feedback and validation when I open myself up and discuss something with my partner. Do you have any suggestions for a good starting point for him as he begins the journey of trying to unravel this? Whether or not our relationship can be saved, I want to support his desire to make this change for his own life and ability to connect with people. Thank you so much.

It sounds as though he might be experiencing anxiety and/or panic attacks. Anxiety and panic are highly treatable. I suggest that he begin counseling. You and he might also be good candidates for couples counseling. As long as he is willing to participate in treatment and sticks with it, for however long it is necessary, expect a positive outcome.

The fact that you’re asking for help on his behalf is a bit concerning because it would suggest that you might be trying to “fix” him. You can’t do the work for him. Your support is undoubtedly essential in assisting him through the process of change but he has to want to change and agree to participate in treatment. As long as he is willing and able to participate in treatment, there is hope for change.

Another suggestion you can make is his reading self-help books about communication skills, relationships and anxiety disorders. Books are a good resource for education but therapy is the most efficient way to correct these issues. Continue to be supportive, suggest counseling and hope that he is willing to participate in treatment. I wish you both the best of luck. Please take care.

Dr. Kristina Randle

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Depressed, Suicidal & No One to Talk to

by Kristina Randle, Ph.D., LCSW April 25th, 2024
written by Kristina Randle, Ph.D., LCSW

hi. im 14. and to be honest, im really depressed. im suicidal almost every night, and sometimes in the daytime. im really mature for my age. i self harm a lot. i suffered for 2 years, stopped, then picked it up again. i have severe depression, bpd, and anxiety. i think im bipolar and ive talked to my mom about it but she doesnt believe me. my parents are extremely harsh on me and i feel i have no reason to live. i just wish somebody out there would listen to me and take me seriously. i think i have some anger issues too, and ive punched walls and taken out my anger on people and my pet cat, which i feel guilty about immediatly afterwards. i dont abuse my friends or pet but i yell and say mean things. i just hate myself and im too scared and depressed and too much of a failure to complete life. i have a therapist but shes stupid and doesnt even listen to me. whatever. i guess this is goodbye to the world sine i want to commit suicide within the next 3 mmonths. i have many plans, i just need some anthehistamines to make sure i dont puke up the pills if i choose that way. i hope someone here listens and doesnt take me for granted and think im kidding. i mean it.

I am sorry for what you’re experiencing. It is difficult to feel that you have no options and no one to talk to but realize that suicide is never the answer. It is always the wrong choice. The problems you are facing can be resolved. Your life can get better. It has for many people and it can for you too.

People may contemplate suicide for many reasons but fundamentally it’s due to the pain that they feel and because they have not yet developed the appropriate coping skills. There are many good ways to deal with the issues that are causing you distress.

You have a therapist but you don’t feel that she’s helpful. Have you told her about your suicidal feelings? If not, you should do so immediately. It is possible that she isn’t helping because you are concealing important personal information from her. It is also possible that she’s providing ineffective therapy. Without more details about your situation, I can’t say with certainty what the problems are.

The fact that you have a therapist shows that your parents understand that you need help. It shows that they care. I would encourage you to tell your parents about your ineffective therapy sessions and your suicidal thoughts. They may be able to assist you in receiving more effective treatment.

You are clearly suffering and you need to make that known to those around you. It also important to realize that at this point in time you are not thinking clearly. The proof is demonstrated by your belief that your situation cannot improve. It can and it has for millions of people before you.

I don’t underestimate your pain. It can feel overwhelming but the truth is, it just feels that way. In reality it is not overwhelming. It hurts but that pain will end and much more quickly with the help of a good therapist. Do not mistakenly believe that the only way to help yourself is to end your life. There are good ways to deal with life problems and those skills can be learned. Please get help now.

If you feel that you cannot protect yourself, go to the hospital or call 911. Please take care.

Dr. Kristina Randle

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I Don’t Know if I’m Being Abused

by Dr. Marie Hartwell-Walker April 24th, 2024
written by Dr. Marie Hartwell-Walker

From a teen in the U.S.: For half of my life i’ve been living with my mother and my stepfather in one state until we moved down to another recently.

When my mom was with my biological dad, they fought pretty often but I thought nothing of it. My mom and stepdad have the same problem but as I am older i’m beginning to recognize problems in their relationship. Not only that but there are common arguments that happen over and over again, which makes it hard to approach them.

My main problem is that I feel this could be a cause to some emotional distress i’m having. I feel I cannot talk to friends about this because i’ll burden them with my problems. I’ve been trying to do research on it but I can’t validate what i’m feeling.

To describe it, I have common problems of invalidation when doing house tasks and getting put down when i’m not doing my homework which I think some action is reasonable up to a point. But because of that i’m afraid of doing something wrong and have anxiety over tasks i’m assigned to do around the house. I live in an 8 person house so keeping up with the mess is hard to do.

Apart from that, I used to be very afraid or having anxiety of going out with friends mainly because my parents needed me so much at home to babysit and do chores that I felt like I couldn’t go out. This happened also during extra-curricular activities like Theater (staying out till 10 pm for show week) or clubs.

I feel like I can’t approach anyone in my family or friends to help me validate my feelings at all. After moving a few months back, i’ve noticed that I stay inside more than I should and kinda beat myself up over things that I probably shouldn’t be like doing a simple task wrong. This kind of makes me afraid to get a job.

Is there anything I can do or use to help me validate myself with these feelings? My situation feels like it could be way worse considering that I know many situations of others that are worse than mine.

I don’t have enough information to know if you are being “abused”. It does seem that your life is very complicated. You are a responsible and intelligent young man. A household of 8? I gather that there are other kids in the family, which already makes life complicated. And your mom and stepdad aren’t getting along. And you also recently moved. All this adds up to a high score on the stress-o-meter. It makes sense to me that you are feeling less than wonderful.

I suggest you do the best you can to minimize how much you need other people in the family to validate you. It sounds like they themselves are equally stressed. Instead, do what you think is right and best. Then focus on making new friends and connections in your new town. A part time job is one of the best ways to do that. Do the job well and you will also get some of that validation you are looking for. Your involvement with theatre is also a resource for both friendships and validation.

What will not help is staying home and in your room. Isolating may help you avoid some kinds of stress but it creates even more.

If you have difficulty getting motivated to do the things that will help you help yourself, I suggest you talk with the school counselor or find a therapist to provide you with some needed support. If you can’t do that due to cost or privacy issues, consider calling the Boys Town Hotline. Counselors are available 24/7 to talk to teen like you. It is free and confidential. Here’s the website: http://www.boystown.org You can call, chat online or write.

I wish you well.
Dr. Marie

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Panic When I Must Make a Decision

by Holly Counts, Psy.D. April 22nd, 2024
written by Holly Counts, Psy.D.

Since my late 20’s, every significant personal decision I have had to make has turned my life upside down.  Curiously, during my career I was able to make many business decisions without difficulty. This problem seems to be a combination of phobia and ocd. Even when I make a decision whether by impulse, through extensive research. or by following advice of others, I absolutely panic when trying to carry through with it and if I do stay with it, I am often physically sick about it for days.  I have been to many psychiatrists and therapists, many of whom could not seem to understand that this is more than just indecisiveness. I have taken nearly every tranquilizer and antidepressant on the market.  Do you know of any therapist or psychiatrists that has successfully treated this particular phobia?  If not, what type of therapy should I seek?

 

A:  Thanks for writing in with your question. I do not know any specific therapists or psychiatrists in your area to recommend for your particular issue, but have you tried working with a provider who does specialize in the issues you mention, OCD and phobias? You can look up therapists and their specialty on LifeHelper, Psychology Today or by contacting your state’s licensing boards (counseling, psychology, etc). 

You say your problem goes beyond indecisiveness, and I agree, especially considering the length and severity of the problem. However, have you tried to educate yourself on the underlying issue? I did a quick search and found a few self-help books that might interest you. http://boomersandbooks.wordpress.com/2011/07/27/the-art-of-indecision/

Finally, if you are not getting the results you need through traditional psychotherapy, I would suggest that you broaden your scope. For example, have you examined your problem from a spiritual perspective, from a philosophical perspective, etc.? Ask yourself what is at the root of your fear and face it directly. It reminds me of a quote I heard once, “There are no mistakes, only feedback.” In other words, every choice and decision we make is an opportunity to learn more about ourselves and the world around us. Take the pressure off yourself and just live your life. You’ve been suffering long enough.

All the best,

Dr. Holly Counts

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Anxiety in Social Situations

by Holly Counts, Psy.D. April 19th, 2024
written by Holly Counts, Psy.D.

Hi please help me. I don’t know what to do anymore. I think I already have a severe anxiety. It started when I was 10 (I’m 16 now) and my family had to move to a province because my father got a promotion in his work. I was even excited back then to meet new people and live in a different place but then when I got there my whole life changed. I had a hard time adjusting and making new friends, mainly because of the language or dialect. In my first weeks there, I was actually sort of popular because I’m from some other part of our country and I speak differently. I thought that was good but then it became a problem. Some didn’t want to talk to me because they were having a hard time understanding me that I started not to talk. I was afraid for others to know that I don’t speak their language. So that’s what I did in my four year stay there. I don’t interact. I always kept my mouth shut. I just made one friend and she’s the most hated person in school so I was also bullied. So that was also one of the reasons why no one wanted to be with me. But in truth, I only became friends with that person because no one wanted to be friends with me. In 9th grade, we moved back to where I originally came from. I was so glad to be back in my own city and speak my language without fear so I thought it was all over. But then in my new school, I was very sad to realize that I was still not the old me. I was rejected by my peers again but harsher this time that I often didn’t want to go to school. I really don’t know what to do anymore. It’s getting worse now. I’ve lost my ability to interact with people now because of so many years of isolation and rejection that I have experienced. People think I’m rude because I don’t talk. But I really want to interact with them and make lots of friends.  I just have an extreme shyness and I always feel like I’m lesser than someone.  People always ask me why I’m so quiet and I always want to shout at them that I’m not it’s just there’s something controlling me that doesn’t want me to speak. My mind is actually bursting with words I just can’t get them out because I’m afraid of being judged. Now I always avoid social situations because I always fail in it and I’m always having attacks like stuttering and fast beating of the heart. I also have low self esteem because of the way I look and perceived by others and because I can’t seem to achieve anything in school anymore. I’m also sort of depressed because of loneliness and unhappiness brought by the anxiety. I look confident and happy on the outside but I am painfully dying on the inside. I’m only pretending I’m happy and that nothing is wrong with me. I want to be checked but they might say it’s only a phase in my age but they’re wrong. This is different. I just want this anxiety to be removed from me forever and be a normal kid again, like teens my age who have lots of friends, adored and accepted. Just like I used to be. This is really interfering with my life especially on how I relate and interact with people right now. I’m afraid that when i grow up, I will have a hard time getting a job and be unsuccessful in life. Please tell me what should I do? 

A:  I’m sorry that you are going through all this and know that it must be hard. You are at an age that your friends can feel like the most important thing in life. It sounds like the last few years have been very difficult with the move and loss of friends. I agree that your anxiety could get worse if you don’t get it turned around soon. I also believe that if someone feels like they should get some professional help; it’s probably a great idea. 

I think a good therapist could not only help you with your shyness and social skills, but also help you work through the trauma of feeling bullied and isolated.  Sometimes therapy groups (or support groups) are also a wonderful addition to individual counseling because it’s a safe environment to practice interaction with others. I suggest that you speak to your parents soon about your desire to seek help. You can also talk to the school nurse or counselor to get some recommendations. 

In the meantime, it might help to try to make some friends outside of your everyday environment so that you won’t feel so judged. For example, join a club or group that is not affiliated with your school, get a part-time job, join a church group or volunteer for an organization in your community. It might also help to practice speaking to strangers, just to get your confidence built back up. Make a point of speaking to people while riding a bus or waiting in line at a store, etc. 

I am confident that if you get some help, and continue to work on the issue yourself, you will make friends and begin to feel comfortable speaking with others again.   

All the best,

Dr. Holly Counts

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Is My Girlfriend Insecure or Am I Wrong?

by Dr. Marie Hartwell-Walker April 18th, 2024
written by Dr. Marie Hartwell-Walker

From the U.S.: My girlfriend gets really really upset when I don’t share every detail of my life with her exactly when it is happening. I have been seeing my girlfriend for about 2 years now. She lives in Chicago and I live in the central part of Illinois. Its about a 3 hour drive. Our relationship revolves around communicating through our phones and sometimes we skype when we find time in our busy busy lives. I am back in school trying to finish up my degree, and it takes up a huge part of my time. Between studying and class and homework, I am usually bogged down with that on top of my obligations to life and her.

There was an instance last night, I told her during the day I was going to be busy after work because I had to get ready to come up to the city for a wedding, shop, do laundry, pack and also my lab group was talking about getting together to study for an upcoming test. I told her all these things and we didn’t talk much but I did text her when I got a moment. I got a text about 8 pm from one of the group members ( who happens to be a girl ) that she wanted to meet up and study. I told her I was grabbing my book and heading out because I didn’t want to get home super late because I still had things I had to do.

The study session was very beneficial but I forgot to text my girlfriend and let her know I was doing it. I told her after the fact I was sorry I didn’t text her because I ended up meeting up with a group mate from class to study for the test tomorrow. She didn’t answer.

I woke up the next morning to a massive text from her bashing me, cursing me, saying she was hurt, pointing fingers at me how she does things for me and I do this to her, how I don’t communicate things to her, how my life is always secret. I told her that I actually had told her about me having to meet with a study group for a test, but she said it was unacceptable because I didn’t text her RIGHT THEN and tell her what I was doing.

I don’t understand why I get this treatment. I am a pretty laid back guy and generally don’t start conflict in the relationship, a long distance one is hard enough. I have had some issues with her thinking I am going to leave her for other girls in the past, but she was the one that wanted me to get back into school so I can finish and truly start a career, not just a dead end job. I told her two semesters ago I was going to have to interact with women in study groups, not that I can help it because group work is required in most classes.

She graduated with a bachelors degree so out of all people I assumed she would understand what it takes to get through college. I just don’t know what to do here and I can’t come to a conclusion. I love my girlfriend for a lot of things, but these few details that aren’t so lovable are what I am having an issue about. I know that people aren’t perfect but this has been ongoing for almost the whole relationship. Hopefully you have some insight to make me feel better about the situation. Thank you.

From your description, I’d say that your girlfriend is terribly insecure. It’s unreasonable to expect you to maintain a running commentary on your every move. You are working hard and juggling a great deal. If she loves you and trusts you, she should be more supportive and understanding. She certainly shouldn’t be bashing you and cursing you. And you shouldn’t be putting up with that kind of behavior.

Did something happen to your girlfriend in the past that makes her so distrustful? Perhaps that’s the conversation you should be having with her. If so, her behavior is more understandable but that doesn’t make it acceptable. If she tries to protect herself by controlling you, she is going to create the very thing she fears. For your own peace of mind, you will have to leave her despite all her good qualities.

Try having a direct conversation with her. Make it clear that you will not accept the terms that she is setting for your relationship. Reassure her of your love. Remind her that you have done nothing to deserve distrust. And make it clear that you will not stay in a relationship where you are distrusted and verbally abused. Then see where it goes. If she can’t let up on micromanaging your life, please think hard about whether this is the relationship for you.

I wish you well.
Dr. Marie

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I’m Not Sure I Can Recover & I Don’t Know What to Do

by Kristina Randle, Ph.D., LCSW April 17th, 2024
written by Kristina Randle, Ph.D., LCSW

Hi, I’m 26 years old and have struggled with depression and anorexia since I was 13. In the past 3 years, my anorexia has got particularly bad (before, I managed to maintain a BMI of 15) after an eating disorder (ED) admission which triggered some very distressing memories and I was consequently diagnosed with PTSD.

My anorexia has become a coping mechanism and every time I’ve got to safer weight, my depression/ PTSD gets worse, particularly when trying to address them in therapy. I do want to be well but I’m caught in a cycle and have no idea how to get out of it. I was sectioned in 2018 for a year after my BMI dropped to 11/12 and then got transferred to a residential house for people with severe and enduring EDs. I’ve got to a BMI of 15 but I’m already slipping backwards and am unable to work on my PTSD due to the COVID-19 situation and my therapist thinks I won’t cope mentally due to being trapped in a house with 4 other patients plus up to 3 staff (I’m very hypervigilant). I’m so tired of it all and just want to feel better/ happier and not have to feel so on edge and not have nightmares constantly.

I’m feeling pretty hopeless and don’t know how to keep going. Any suggestions? Can I ever get out of this situation?

I understand that this is very difficult situation made even more challenging with the pandemic. Much like yourself, people are feeling more stressed than usual. People are frightened of becoming sick, losing their jobs, and not being able to leave their homes. A Newsweek article recently reported a 34% increase in the number of anxiety medications and other mental health medications being prescribed. People are clearly struggling.

Insomnia and nightmares are also problems for many people. One Harvard University professor collected approximately 6,000 dream samples from over 2,400 people. She was able to collect such a large sample of dreams because of the increased number of people discussing their pandemic dreams. Many of them are dreaming about being sick with the virus, being in crowded public places without a mask or inappropriate levels of social distancing. Others dream of losing control, and some are simply nightmares. That suggests that people are struggling, missing out on the things they are used to, and reacting to the stress of this unprecedented time in our lives.

In some respects, much of what you’re experiencing is consistent with what many others are experiencing. Unfortunately, you’re experiencing it on top of the other issues you mentioned including anorexia, depression and PTSD. Understandably, it can feel overwhelming but there is hope for you. All of the disorders you have are treatable. It may take some time, and it may take you finding the right therapist or type of therapy but it is worth trying. There is hope for people who have these disorders.

You have a therapist now and is important to evaluate whether or not she is the right therapist for you. In addition, it’s important to evaluate your current type of therapy. Are you in the therapy you need to be in? Are you feeling at least slightly better after each session? Are you working with a therapist who has successfully treated other people with similar problems?

As you may already know, anorexia is a complex disorder. It is thought that environmental and psychological factors influence the expression of genetic risk that leads to the eating pathology. The most current research would suggest that anorexia is a brain-based disorder that overlaps neurobiologically with anxiety disorders and addictions. Studies have indicated, regarding treatment, that eating disorder-focused therapy is superior to individual therapy among adolescents. It is less clear what treatment modality works best with adults. One novel treatment that is showing promise is cognitive remediation therapy (CRT). This particular therapy aims to improve cognitive flexibility and holistic information processing. Another potential promising therapy is exposure therapy for anorexia. Exposure therapy involves fear conditioning, by systematically and slowly exposing one to one’s fears in order to overcome them. Other approaches involve medications such as olanzapine which can increase one’s appetite.

The most important thing for you at this time is not giving up and realizing that there is hope for you. It might be helpful to read the stories of individuals who have overcome anorexia, to learn more about what they did, and their mindsets. It may also be helpful to work with your therapist to adjust your medication during the pandemic as well as developing better coping skills. The more coping skills you have, and the more flexible you are in your thinking, the easier it will be to endure this difficult time.

I mentioned flexible thinking and coping mechanisms because I think they’re vitally important in overcoming anorexia. The fact that anorexia has become your coping mechanism suggests that a modification is desperately needed. The most concerning aspect of anorexia is the physical toll it takes on one’s body. It has the highest mortality rate of all psychiatric illnesses. Thus, it’s important to develop alternative strategies for dealing with stress, and there are many of them. You have to be willing to use them which means being willing to tolerate the discomfort that comes from not giving in to your more habitual coping mechanisms (i.e. anorexia).

Finally, you might find it useful to watch the show Obsessed. It used to be on the A&E Network but most of the episodes can now be found on YouTube. Obsessed focuses on individuals with obsessive-compulsive disorder. You don’t have obsessive-compulsive disorder however, I think there are many similarities between OCD and anorexia, specifically the inability to be cognitively flexible and the unwillingness to tolerate uncomfortable feelings. Part of what makes the show potentially helpful is that they demonstrate how exposure therapy can work quite effectively for individuals with OCD. It might help you to see what it’s like for people to tolerate uncomfortable feelings. An important element of exposure therapy is that even when someone feels uncomfortable and excessively anxious, those feelings eventually diminish and subside. It’s helpful to see firsthand that even when feeling overly anxious, eventually those feelings will subside.

To answer question directly, yes you can overcome this situation. Please don’t give up and keep trying, until you find something that works for you. You might also try treatments that are focused more on depression and/or PTSD. Perhaps, if those issues are dealt with, you might have an easier time overcoming the anorexia. Good luck and please take care.

Dr. Kristina Randle

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Boyfriend’s Parents and Their Cultural Disapproval

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP April 16th, 2024
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

My boyfriend immigrated here when he was 5. His family is very involved in their native culture/church and he is not. Due to them previously needing financial help and therefore him being in debt, he is unable to move out for another 1-2 years. They strongly prefer he be with someone from their culture and would constantly pressure him about it. Throughout our relationship they would tell him he should leave and try to set him up with other people (sometimes while I was standing there in their native language).

The way that his family interacts is that they’ll pick at him, yell and not let him get away or go into a different room until they have said what they wanted. He has a hole in his wall from them slamming it and they talk to him in an extremely degrading way when he disagrees with them. Considering he is usually gone from 6am-10/11pm this makes his home life extremely stressful because he can’t relax.

We have broken up twice because of this. After the first time we dated secretly for about a month and then told his family again. Throughout this we have been talking about a future. About 2 months ago he had a promise ring picked out and was talking about engagement. Then about a month ago he called off the relationship again due to family pressures. Presently we are back to being together without telling them. Is this the best course of action? I worry that if we tell them again, the exact same thing will happen in another couple of months. We’re currently working on how to handle stress but that just adds so much to his life.

Just looking at him and I our relationship is good. We are supportive, push each other to be better, and communicate well. We also legitimately get along and although we disagree sometimes we don’t really fight or resort to harsh words or raised voices. Based off conversations with him the family disapproval is his only concern with the relationship but it’s a major one.

Also, I’m 22 and he’s 23, we have been together for about a year. Even now he talks about wanting to move in together as soon as he is able to move out. I just don’t know what the best way to stay together and ideally eventually gain their acceptance would be.

I admire your persistence and grit for each other in this relationship. But not much will move you forward as a couple until he moves out. At your ages it is time to carve out the kind of life you are looking to live independent of his family. They sound abusive, demeaning, and unsupportive. The question for you is whether or not this relationship works for you. If you move in together it is likely they family will not accept you as you move forward.

The work for your boyfriend is to make the break independently from his relationship to you. He would need to leave because of issues with the family — not only because he loves you. This is difficult but likely to be a needed step. If he leaves only for you they will blame the relationship (and you). If he leaves because they are not honoring him it will be understood differently. It is an act of independence rather than because of his feelings for you.

I highly recommend you find counseling through your university for yourself as you work things through with him. If it is possible for the two of you to see a counselor together this will be important. It will help clarify what needs to be done as a couple, and what needs to be done independently.

Wishing you patience and peace,
Dr. Dan

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I Just Can’t Seem to Be Helped

by Kristina Randle, Ph.D., LCSW April 15th, 2024
written by Kristina Randle, Ph.D., LCSW

I have never been diagnosed with anything, but I’ve been dealing with a lot of things recently, and it impacted my everyday life greatly. People started noticing and they tried to help. My friends tried to do as much as they could but, us all being high school students and them having their own life to live they eventually stopped talking about it. I live alone with my mother and we have a very bad relationship so I didn’t really turn toward her for help. In the end it was just my partner that stayed by my side and did everything he could to make my life a bit easier.

One of the big problems is that I have a tendency not to feel things when I’m upset, and it can last for months or even years at a time, so when I’m in a bad place and he tries to help, and he goes out of his way to ease my burden even if it’s just a little, and I know that my non-reaction to all of his sacrifices is hurting him. He feels worthless because no matter how hard he tries I just don’t seem to be able to accept his help.

I know that I’m hurting him by just doing nothing and being empty but I just can’t snap out of it. No matter what he says to cheer me up, or when he tells me that I’m beautiful and that I’m the best things to ever happen to him, I just listen and think “Yeah, we both know that’s not true”.

I feel like I just can’t be helped, like it’s just plain impossible. I know exactly what’s wrong and I don’t do anything about it to the point of hurting the one person that I love. I keep destroying myself and I can’t seem to care, even if I know that I should care and that I should get professional help.

I feel like an empty shell, even typing this I don’t know if it’s sincere of if it’s just me pretending to care. I really don’t know what to do and it doesn’t bother me at all, I don’t even know what I’m expecting of this. I won’t say “help me” because really I feel nothing, but I don’t want my partner to suffer because of me. What can I do about that?

The symptoms you have described may be consistent with depression. People with depression often use similar words and phrases to describe their experiences. They feel numb. Their friends and family try to help, without much success. They can’t get out of bed. Every day seems worse than the day before. They feel like a burden to people, and so on. Depression can feel like a never-ending cycle of sadness and hopelessness.

Depression most assuredly feels bad but it is treatable. In fact, it may be one of the most treatable mental health conditions in the world. It’s only untreatable when people fail to seek help. Great treatments are available for depression and virtually all mental health conditions. Many people simply don’t seek help for it and suffer needlessly. Don’t make that mistake.

It’s also important to note that I’m not diagnosing you with depression or any other condition. Diagnosis over the Internet is impossible. Thus, it’s important for you to consult, in-person, a professional who can assess your symptoms and determine what may be wrong. They would be in the best position to help you.

Let’s further examine the idea that you cannot be helped. You’ve never consulted a professional, yet you have concluded that you cannot be helped. Logically, that’s a very inconsistent and irrational position.

Imagine, for a moment, that you had broken your leg. In this scenario, you never go to a doctor. You simply lugged around your broken leg and tolerated the immense pain. That’s essentially what you’re doing by not having sought treatment for the symptoms you have described. You are simply living with your emotional pain, never having sought professional help and subsequently concluding that you are a hopeless case. Nothing could be further from the truth.

When you recognize that something is wrong, and you’re not feeling good, you should always consult a professional. There’s nothing to be ashamed of. We all struggle from time to time and need the assistance of experts. Mental health treatment is available if you ask for it.

Regarding your partner, neither of you should have the expectation that he could cure these problems. As a layperson, he does not have expertise to effectively treat your symptoms. You would not have expected him to fix a broken leg because everyone knows only a trained physician, with expertise in orthopedics, could do that. Apply that same logic to mental health problems. Friends and family can offer you support but they cannot treat mental health problems. They are simply not trained to do so. Mental health professionals have the right expertise to help you.

I would highly recommend that you consult a mental health professional. If you don’t feel comfortable asking your mother, then perhaps another relative could assist you. Another option is to ask your family doctor or the school guidance counselor for their assistance.

Your symptoms are highly treatable if you are open and willing to seek help. I hope that my letter has convinced you to seek treatment. Please take care.

Dr. Kristina Randle

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