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I Don’t Feel Right

by mshagaga
written by mshagaga

I’ve always felt sort of off. I was diagnosed with ADHD when I was in kindergarten and was almost immediately medicated. Things were fine until 8th grade when a boy left me and I spiraled into depression and self harm. Then in freshman year a boyfriend sexually assaulted me by saying that if I loved him I would let him do things. That messed me up more. Now it’s senior year and I don’t want to get out of bed. I shut down at the slightest hint of hostility or annoyance that someone directs towards me. I have thought running through my head telling me that people don’t like me and that I am doing things wrong and am being judged for them. I am scared to say things for fear that people will be upset. I pick at my skin and hair until my face and/or cuticles bleed. I continuously feel bored and numb. I feel as though I can’t get excited or aroused by things anymore despite that never being an issue before. I feel like this feeling has been growing since I was 13 and now it’s finally peaking and I don’t know what it is or what to do and I feel as though I am losing my mind. I just want to know what is going on with me.

Thank you for reaching out. Based upon the symptoms you describe, it sounds as though you may be experiencing depression and anxiety. I recommend seeking a consultation with a licensed mental health professional and possibly the consultation of a psychiatrist for medication evaluation. It takes courage to seek help but there is a light at the end of the tunnel.

Best of luck to you!

– Dr. Mimi

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How to Find a Therapist

by hrcounts
written by hrcounts

I would like to be able to talk to someone but know the only way I’ll be able to talk about personal issues is to pay a therapist. The problem is that owning to a number of previous experiences, I can’t find one that seems to work for me. I have post traumatic stress disorder. I have been receiving an increasing number of death threats as the country becomes more polarized. My most recent death threat came just last month. In December I was held at gun point and in May of 2014 someone actually took a shot at me. Because of the nature of my work law enforcement cannot be involved as that is a violation of the offender’s privacy. Everything is reported through work, but I’m having trouble coping because most people in the area, including my family, thinks that shooting at Federal Employees makes for good sport. (These are people who deify Cliven Bundy and probably Ted Bundy.) I was seeing a professor through the University of Idaho, but stopped seeing him in private practice after he killed his girlfriend in 2011. He’s in prison now. In 2013 I was seeing a different therapist, but he told me that I was under satanic attack and the President Obama was brainwashing me. I stopped seeing him immediately because I was pretty sure he was crazier than I was. Most recently I was seeing a man from January to April who insisted that my life would be better if I converted to Christianity and started attending church. He wasn’t as crazy as the previous guy, but I do wish I could talk to a therapist who isn’t trying to change my religion (I’m not christian), sexuality (I don’t know if I’m hetero, homo, or bi and I don’t see how it’s relevant since I haven’t been on a date since 2006), career path (I work for the Federal Government), or relationship status (single and staying that way). What are some key questions to ask a person before starting therapy and ultimately wasting my time and money? Also, what kinds of answers do I need to be looking for from the therapist? (age 37, from the US)

Wow, you have had some incredible bad luck with therapists. I’m so sorry and hope that your next experience will be much more helpful. The best ways to find a therapist are to get a referral from someone you trust, such as a like-minded friend who has been to the person themselves, or to read up on the therapist before you ever make an appointment. Many therapists have personal websites these days or have profiles on public sites like Psych Central or Psychology Today. This way you can see what they are all about and narrow down the field of candidates.

The next step is to request a consultation, either by phone or in person, if available.  This gives you a chance to see if you think it will be a good match. I would recommend that you ask how much experience the person has treating PTSD, especially in relation to complications with government employers. For example, a therapist who has worked with police and fire or military clients might be well versed in the issues you face. Based on your past experience, I would also recommend that you specifically seek a therapist who does not describe themselves as a Christian counselor.

My last thought on the matter would be to speak to your human resource department regarding EAP services or to see if they have contracts with therapists to help employees such as yourself. This may be the easiest and most affordable way to get help. I hope that you stay safe and find a good match with a therapist soon.

All the best,

Dr. Holly Counts

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Nervous Jaw Clenching

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

In the past year I have begun clenching and popping my jaw and I just found out how noticeable it is to others. Apparently I also widen my eyes and jut out my jaw. My cousin showed me a picture she had taken and I am in the background obviously doing it. It has also caused me to have a deep wrinkle under my chin. I am mortified now about it, especially at work. I take 200 mg of Zoloft every morning as well as 15 mg of Adderall twice daily and a 1 mg Klonapin at night. I am under a psychiatrist’s care for depression, anxiety, PTSD and ADD and have been for 8 years. I have also been in an inpatient facility twice, most recently in 2011. I am isolating myself because I am embarrassed of what I’m doing with my jaw and eyes. After seeing the picture I know how strange I look. Thank you for any help you can give.

It may be important to receive a medical evaluation to rule out a physical cause. The jaw clenching is likely related to anxiety and stress but without further investigation, you cannot be certain. You may want to consult either your primary care physician or a dentist.

You’ve been taking medication for a variety of mental health problems for nearly a decade. The jaw clenching might be a sign that your anxiety is not well controlled and that your medication needs to be adjusted. Have you ever considered counseling in addition to the medication?

You have become self-conscious about the photo and have begun to isolate. You may not be making the jaw-clenching face as much as you think. It may have just been one bad picture. Keep in mind that most people are unhappy with their photos because they’re overly self-critical. This may be the case with you. Also, even when photographers work with professional models, most of the pictures are unusable. Photographers often have to take many pictures, perhaps hundreds of pictures, to get the right shot. They recognize that of the hundreds of photos snapped, only one or two may be good. You may be overly self-critical.

Comprehensive mental health treatment typically requires both medication and psychotherapy. Many people find that one without the other just isn’t enough. Counseling could help you to deal with the root cause of your psychological problems. Counseling may be what’s missing from your treatment. Please take care.

Dr. Kristina Randle

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Disorientation & Confusion

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

For background: I have been diagnosed with chronic severe treatment resistant Major Depressive Disorder, PTSD, PMDD, GAD, and mild agoraphobia. All those combined equals lots of sleep disturbance, including a lot of nightmares and frequent sleep paralysis.

I have tried way too many meds to count, but currently I’m on Effexor, Zoloft, Xanax PRN, Vistiril for sleep, birth control, and Prazosin as a PRN for sleep/nightmares.

Anyways, the past week or so I have noticed myself having momentary disorientation, like one morning listening to the radio they were talking about the president, and I honestly thought they meant Barack Obama. And not like I was confused, I literally thought it was 2012. I’ve been having other moments like that where I’m confused as to what day of the week it is, like I have to ask someone, and it’s not just like when you casually ask “what day is it?” because you’re tired. I LITERALLY do NOT know what day it is or think it’s a different day of the week. Same thing with what year it is, what house I live in – like I wake up and don’t know where I am because I remember living in a different apartment or house from a previous time in my life.

I will also admit that I have had a very calm feeling of suicidal ideation lately, contemplating what it would be like to take a few too many pills and just drift off (but it’s just ideation, I would never harm myself like that).

My psychiatrist believes I may have obsessive compulsive disorder, primarily because of excoriation – skin picking, not sure if that’s important.

Could this confusion and disorientation be attributed to my depression or PTSD? Of course I have flashbacks, but that feels more like, I feel like the situation I’m in is being transformed into a prior terrifying situation. These moments of disorientation are not like that, I mean, sometimes there is fear, but when I have a flashback, I still know where I am, I just feel my mind playing a trick on me.

Do you think this is a normal symptom of depression or PTSD or one of my other diagnoses?

Thank you!

It’s possible that your disorientation and confusion are caused by a number of factors including your mental health symptoms, medications, and sleep disturbances. Each one of these individually could be causing the problem or it may be a combination of all them.

You are in treatment with a psychiatrist, but what about a therapist? Most psychiatrists don’t provide talk therapy. You mentioned being “treatment-resistant” and I am taking that to mean that you’ve been to counseling before. If so, try again. Some people prefer a medication-only approach to treatment, but I think that would be too limiting for you. Counseling is an effective treatment for all of the symptoms you have described.

Report these problems to your psychiatrist and ask about adjusting your medications. Also, consider counseling. Even if you’ve tried it and didn’t find it useful, try it again. Therapists vary in their abilities.

Overcoming mental health problems is often a function of finding the right help. I recommend that you contact at least five therapists and interview them over the phone. Choose the one with whom you feel the strongest connection and then meet with them in person. The right treatment could make all the difference. Please take care.

Dr. Kristina Randle

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I Can’t Tell that I’m Dreaming

by hrcounts
written by hrcounts

Lately, I’ve been having a very difficult time trying to fall asleep. I’ve tried different over the counter sleep aides that don’t help me at all. I’ve also tried drinking alcohol to the point of becoming “tipsy” to try to fall asleep. Nothing really helps. And when I manage to finally fall asleep, I have these dreams that make me feel like I’m not asleep. Like I’ve entered another realm of reality. I have a difficult time waking up. And when I do, I’m so confused because I believe I was elsewhere. These dreams affect my emotions throughout the day. I’m not sure if this is a product of the aftermath of being sexually assaulted almost 2 years ago or not. But I can’t stand living this way. What is going on? (age 22, from US)

A: Sleep issues can be caused by so many things that it can sometimes be difficult to understand what the real culprit is and how to address it. Sleep is vital to healthy functioning but can be affected by our physical state, emotional state, environmental influences and so on.

Dreams are a complex phenomenon as well, and can also be affected by many factors such as stress, food, alcohol, and medication. Sometimes the content of dreams is made up of images and information that we have seen or heard recently and they may not even make much sense. However, other times our dreams are a window into our unconscious mind and may be related to our life experiences or current stressors.

I can’t be certain that your sleep difficulties are related to your traumatic experience, but there is a high likelihood that they are. One of the symptoms of post-traumatic stress disorder (PTSD) is hypervigalence or heightened awareness. This can happen in the sleep state as well, in that there is a part of you that is always “on guard.”

I hope that you have spoken with a therapist about your sexual assault and if you haven’t, I encourage you to do so. You may also considering making an appointment with a sleep specialist. I’m including a link to the National Sleep Foundation for more general information. I wish you sweet dreams.

All the best,

Dr. Holly Counts

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How Do I Cope?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From a teen in Indonesia: I am a 19 y.o. female who experiences abuse since childhood (verbally and physically) from my caregiver and was diagnosed with chronic depression. However, I feel like my symptomps are more compatible with C-PTSD. Another disturbing feeling I experienced but not listed in the C-PTSD symptomps is a sense of sadness and loss of momentary joy when I part with my friends. I also feel like though I have friends that (supposedly) dear me, I also feel like I’m alone and can’t depend/open up to them because I feel like I’m being bothersome. I feel like I have no one I could really rely on and it could be frustratingly lonely sometimes. I have a difficult time putting my feelings to words and I feel like nobody can really understand.
My question is: are those normal feelings someone with C-PTSD experiences or is there something else going on with me?

I live in a small city in South Asia and the psychiatrists I saw are not familiar with C-PTSD. Please kindly help answer my worries. Thank you.

I’m very glad you wrote. The International Classification of Diseases (ICD) identifies complex PTSD as a separate condition, though the DSM-5 currently does not. Although you believe that your doctors are unfamiliar with the disorder, I suspect they are. If not, they can learn about it on the internet just as you did.

I don’t know enough about you to answer whether it is an appropriate diagnosis for you.  What matters to me is not the label but your level of distress and your level of functioning.

Some of what you describe is common for someone your age. The teen years are a time when people figure out who they are and who they feel most comfortable with socially. It is not unusual to go through periods of doubt about friends, feelings of being misunderstood, and worries about how to express one’s own feelings. Because it is usual doesn’t make it any less painful. But it’s important to sort out what is mental illness and what is developmental. Your provider can help you with this.

I hope you are able to see a therapist regularly to learn ways to cope with depression. You might also find it supportive to join one of the forums here at LifeHelper.

Just a friendly reminder: Get enough sleep. Eat well. Get outside for some exercise each day. I know. I know. This may not sound like psychological advice. But, trust me. Taking care of the body is an important part of taking care of our mental health. If you wait until you “feel like” doing these things, they aren’t likely to happen. It’s important to do the best you can to do them every day whether you “feel like it” or not. Doing them will make you feel at least somewhat better.

I wish you well.
Dr. Marie

 

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How to Help Boyfriend Who Just Told Me He Was Molested Several Times As A Child

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

My boyfriend just told me that he was abused as a child by several different people. One of the predators was a family friend, one was a classmate, and one was a family member. He told me his parents were angry with him for not speaking up sooner and basically blamed him.

He is a very sweet man and extremely overprotective of his little brother because one of his molesters threatened to do the same to his brother if he told anyone. He has really bad anxiety now, works to the point of fatigue, and has chronic body pain as a result. He also told me he has hated himself his whole life. He didn’t want to tell me about his abuse because he thought I would think less of him. He finally opened up because he was feeling extremely anxious after an argument with his brother.

He considers himself weak and sometimes gets physically violent towards other aggressive men. He has never laid a hand on me and I don’t think he ever would lay a hand on a woman. I feel like he likes getting into fights with other men because it proves his masculinity. He’s been extremely anxious since admitting everything to me and I’m not sure how to help. I already told him I love him and want to help him get through this. I told him he is not to blame in this situation at all and that he is a survivor. I’m not sure what else I should/can do. Please help!

You should encourage him to seek counseling and support him, if he’s willing to go for help. That’s the best you can do in this situation. You are not his therapist and cannot do any more than offer your love and support. His problems can be effectively treated by a mental health professional in counseling.

Apparently he views masculinity in terms of aggressiveness and dominance. Angry men who feel weak and who feel that they have something to prove, can sometimes be violent. These men also tend to be jealous and controlling in relationships. These characteristics might not describe your boyfriend, but his aggressiveness towards men and his need to prove his masculinity could translate into aggressiveness towards you.

It’s a mistake to think that his violent tendencies towards men are an isolated issue. Your stating that he has not harmed a woman and you do not think that he would means to me that the issue has at least crossed your mind. His anger and need to prove his masculinity, could be problematic for your relationship and could lead to you being harmed.

If he’s unwilling to seek help despite these issues, then you have to decide if you want to stay in a relationship with someone who knowingly has problems but refuses to treat them. Remember that the purpose of dating is to find the best match and that most of the people you date will not be a match. I would advise against choosing a mate with evident psychological problems who is unwilling to deal with them. They make for disastrous life partners. Please take care.

Dr. Kristina Randle

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Communicating with Someone Who Has Shut Down Through PTSD

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hello, I am trying to find the things I should do and the things I shouldn’t do when approaching my husband. He has just been diagnosed with PTSD after years of alcohol and drug abuse. He is a VERY loving man who will suddenly change and push me and his loved ones away. Over the years I have dealt with it by moving completely out of the picture due to the accompanying abuse and thinking it was just an alcohol problem. After his last episode, which left him nearly dead, we have talked in depth and he talked me through the episodes where he just disappears. We made a pact for me to ignor his rejections and just keep ‘kissing him’. When he started sliding this time I managed to get him to a doctor and he was diagnosed with PTSD. But now I’ve lost him again. It is like a Jeckyl and Hyde situation as he cannot remember when he was in the ‘zone’. He only remembers the repercussions. Before, when he used to hit me he would experience huge guilt, recently he has been loosing total trust in me because of the way I have reacted. He has found an ‘enabler’ at the moment who pays for everything and doesn’t trigger his trauma so he is in no danger other than massive increased alcohol consumption and codependency. However last week he was experiencing psychosis and foned me in a frantic state asking for help whilst shouting at me. I seem to be making matters increasingly worse by contacting him. This isnt just a lovers tiff, it is a life threatening situation and I have no support and no indication of what I should do and, more importantly, what I should not do.

These are the facts as I understand them: your husband has been diagnosed with PTSD due to his use of alcohol and drug abuse; his alcohol use is not under control; when intoxicated he can become violent and psychotic; you have been advised to keep “kissing him” while he is intoxicated and to ignore his “rejections.”

You also wrote that he has an enabler and that he is “in no danger other than massive increased alcohol consumption and codependency…[and] it is a life-threatening situation.”

It’s unclear who is the enabler. Are you referring to yourself or someone else?

It’s difficult for me to give you specific advice because I would need more information. If I had the opportunity to ask follow-up questions, I would have many.

Your husband’s life may be in danger because of his drinking, but I believe that your life might be in greater danger. He is actively, drinking despite being aware of the fact that he can become violent and psychotic while intoxicated. He is dangerous, and he doesn’t seem to care about how his behavior affects others. He continues to drink despite it significantly damaging his life and the lives of those around him.

You asked what you should and should not do in this situation. You should not be accepting of your husband’s behavior. You should keep your distance from him until his drinking is under control. You should not “kiss him” until he no longer rejects you — I take that to mean that you should physically kiss him until he stops pushing you away. Such a circumstance puts you in danger of being physically harmed.

I do not understand why he was given a diagnosis of PTSD. Given the information you have provided, it would seem not to be indicated, however there may be much more information available to the diagnostician, which would make the diagnosis appropriate.

You should ask your husband to seek help. If he’s unwilling, then you should keep your distance. You should seek professional help to assist you in learning how to interact with your husband and how to navigate this dangerous situation. Counseling could help you with this very difficult set of circumstances. I hope I’ve helped. Please take care.

Dr. Kristina Randle

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Why Do I Have Attachment Problems?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I’ve been having some issues with getting attached to people for quite some time now. I’m not sure what it is about the person but when I meet someone who fills the role of a caregiver I become completely attached almost right away. They usually are professional relationships with teachers, profs., and even therapists and it becomes very difficult for me to detach myself from them even though I would very much like to. I end up coming to the conclusion that I wish I’d never met them and I usually feel guilty about it, I feel like there is something wrong with me because it’s been happening since I was a young child. Back then it was easier for me to become close with someone and for the relationship to still be healthy, I also found it easier to detach myself from them. As I got older however it shifted and I didn’t feel it was okay anymore to become close with a teacher even if I wanted to. Now I feel like it’s not really within my control and even though I know that the relationship must remain as a professional one I still have problems adjusting to their inevitable departure from my life.

I actually was reading about borderline personality disorder and I matched some of the symptoms dead on. Sometimes I think it might have to deal with the relationship I have with my mother. As a child I always used to fantasize about being from a different family and the people that I would get attached to sometimes I would see as being my mother. She wasn’t at all affectionate with me and today I have issues with expressing myself emotionally and asking for help. My father was in and out of my life until I was 11 when he split for good. Even when he was in my life he had issues with loving me, my mother told me on many occasions that he would often be quite cold to me and only really pay attention to my brother which whom he still is in contact with today. My brother sometimes pities me because my dad seemed to love him and not me.

Growing up was quite hectic, my family all have substance abuse issues and I was taken away when I was four to live with foster parents after my parents left me in the middle of the night. In fact none of my family really ever shows much affection towards one another and have major communication problems. They tend to hold things in then let it all out when they’re drinking. As a child they never turned on me but now that I’m older my odds of them attacking me are just as high as any other family member. I’ve been having problems adjusting to that but hopefully I can develop a thicker coat of skin to handle it.

I don’t really have healthy ways of coping with things. My main tool is self harm which tends to help though it’s now become more of an addiction than a release. I suffer from major depressive disorder, PTSD and an array of anxiety disorders which I was recently hospitalized for a few months ago after I overdosed on painkillers. I tend to hold things in and that’s kinda what I’ve been working on in therapy. I guess I’m wondering why I’m like that and what can I do about it so that it doesn’t cause me so much distress anymore?

It does not seem that you had a healthy attachment with your mother or father. Healthy, stable relationships were never modeled for you. Neither parent was emotionally available to you. Your father was not in your life long enough to really get to know him and when you and he did interact, he essentially ignored you. It’s human nature to want safe and stable relationships with others. Ideally these relationships are supposed to occur with your parents. When an individual lacks these stable and important relationships with their parents they often spend their adult lives attempting to secure these attachments with others. Because you never had a true bond with your parents you’re searching for healthy attachments with others whom you’ve deemed as safe (teachers, therapists, etc). It makes sense that you would have a difficult time with attachment given your history. The above explanation might help explain “why” you have trouble with attachment.

Individuals with borderline personality disorder have problems developing healthy relationships. Attachment is usually a problem for them. They also fear abandonment. Again, it makes sense for individuals with borderline personality disorder to have difficulty in relationships because many have had interrupted or troubled attachments with their primary caretakers.

It is possible that you have borderline personality disorder but if you do please know that it is a treatable disorder. If you are currently in treatment you should ask your therapist about whether you have the disorder. If you do your therapist might alter your current treatment regimen.

You asked what you could do to stop the distressing attachment problems you experience. Since you’re currently in therapy it would be helpful if you focused on this issue. Does your therapist know this is an issue for you? I hope so.

You can learn a new way of interacting with people. A good therapist can teach you how to behave in relationships. He or she can model “healthy behavior” for you. He or she can also analyze your relationships with others and point out what areas need to be adapted or improved. The goal for therapy should be to teach or model for you what a healthy relationship is like. Dialectical behavior therapy is a biopsychosocial mode of treatment that has been proved to work well with individuals with borderline personality disorder. It may be helpful for you. Take care.

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My Boyfriend with Bipolar Broke Up with Me During His Episode

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP
written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

My boyfriend of one year, who I have been looking at apartments with, broke up with me out of the blue. He has been feeling suicidal, which he dropped on me as we were walking into my parents house. I was completely caught off guard and said this was a selfish (cringe) time to disclose this information since we are always together. I apologized right after we had dealt with my family and tried to talk but he didn’t want to. He said everything was fine. I offered we go home and he said he wanted to stay. We went out on a boat trip with my family the next day. My boyfriend got really drunk and got into a fight with me because he wanted me to drive him to his friends (we were in the middle of the ocean). I tried hugging him to show I loved him and it was okay and to calm down but that just made it worse. He said I tried to smother him, broke up with me in front of my family, and forced my family to take him to a private beach where he waited for someone to pick him up. Once we both got back home a few days later we tried to talk but he told me that I never supported his mental health. I had no idea he felt this way, that episodes like this were so intense. He told me he had bipolar but he never talked about it. I was really involved in finding him a therapist and I was always there but he would tell me he just “needed to be quiet” and he was “okay.” I’m not sure what to do. He won’t talk to me anymore and has wiped me from his life. This is the total opposite of the person who asked my grandfather (one month ago) for permission to marry me. I’m extremely lost. I have PTSD and so all of this is extremely triggering for me. I’ve been completely open with my mental health and the boundaries I need. I don’t know if I should keep checking on him or leave him alone. I left him alone because he said he wanted space when this first happened but then he threw in my face that i wasn’t there for him when we did talk.

Leave him alone for right now. Regardless of what the diagnosis is for your boyfriend, the timing is too important to ignore. Whether we blame this on his illness, insecurity, nerves, lack of self-confidence, or simply inappropriate behavior your boyfriend sabotaged the relationship as it was on the brink of blossoming. As I see it your boyfriend didn’t break up with you during his episode as much as his episode came during the greatest intimacy of your relationship. He asks permission to marry you, then announces he is feeling suicidal when walking into your parent’s home. You seeing this as selfish is an honest reaction, but it isn’t so much selfish as it is interesting timing, which I think is what you are reacting to.

Based on the timing alone I’d say he was having great difficulty in tolerating good things happening in his life with you. This would explain why he moved toward greater intimacy and once it became imminent he found a way to bail. Also, he didn’t take you up on the offer to go home because (my guess) he was determined (at least unconsciously) to sabotage it. Hence the drinking episode and impossible demand for you to follow through on.

This isn’t something you can fix or couple therapy can help. Your ex-boyfriend has some major issues in his life that need to be dealt with personally and professionally. They aren’t going to improve with your love and support if they can’t be taken in. As much as these things are necessary for all types of recovery a person must be able to receive them. If he is hell-bent on sabotaging your best efforts at supporting him and greater intimacy—you’ll want to give him a great deal of space—and work on nurturing yourself for now.

The find help tab at the top of the page can help you find a therapist in your area.

Wishing you patience and peace,
Dr. Dan

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Do You Have to Believe in a Technique for It to Work?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From the U.S.: My PTSD has been difficult to treat and I have often wondered if it is a matter of “belief”;. I understand that trust may be an issue there, but I do trust my therapist and very much respect him, I just think EMDR is bullshit. We’ve tried it 7 times now and I’ve read several books/articles and it just strikes me as Confession for secular people, complete with ritual and sanctification. (I’m sorry, I’m a scientist, if it works by simulating REM, then why don’t we just compare fMRI scans of EMDR and REM? You could even scan the same client!) I want it to work, I’ve tried coaching myself to let it happen, let the process do its thing but it just hasn’t been the “miracle” you read about for me, which is crushing.

We are now trying IFS, which I actually do buy into, but I sensed some doubt from my therapist when I suggested it. So I keep telling myself that it doesn’t matter what he believes, as long as he can facilitate the process effectively, I’m doing the work and I believe it. He is trained and follows the “script”, but every-time we go there, I literally freeze up and glare at him (While inside my head “you don’t believe this, you’re just playing the game, it’s just more bullshit” etc.) We’ve talked about how my inner critic/skeptic has been interfering with pretty much everything, but I still have this feeling that “belief”; may play into it.

I should probably mention that I come from a strict Christian background and am an Evolutionary Biologist, so belief is something I struggle with in general. The nature of my trauma also involves a lot of betrayal and not being believed when I sought help. (I also dismissed Narrative therapy because I didn’t see how just making up a new story changed anything; how does denying reality make one healthy?) I tried appealing to my reason and look for the evidence base and the neuroscience, but human studies are fraught with bias and small sample sizes (the critic even gets in the way science!). How do I get over “belief” and allow it to happen?

What a good question! You are correct, of course. If you go into every session skeptical about whether it will work, you are focusing on your skepticism, not on the work. That can certainly get in the way of any treatment. It may be that it is your way to avoid dealing with painful material. That kind of avoidance is totally understandable, but it isn’t helping you heal.

On the other hand, just because you are critical doesn’t necessarily mean that you are avoiding. Your skepticism in therapy may only reflect your general approach to life as a scientist.

Fortunately, there are many, many ways to do therapeutic work. So there are at least 2 ways to deal with this impasse:

  1. Ask yourself what would happen if you were to make a leap of faith, suspend disbelief and jump into a particular approach entirely. Think about your answer as honestly as you can. You may discover what you’ve been avoiding. That would be the next topic of conversation with your therapist. Or…
  2. If your answer to that question is simply that it just isn’t working for you, you could explore more evidence-based techniques and find a therapist who is certified in such a technique. Cognitive-behavior therapy, for example, may be a better “fit” for the scientist in you. Find a trained therapist so you won’t be distracted by questions about his or her qualifications.

I applaud your effort to find an approach that works for you. I’m glad you aren’t going through the motions of therapy, but instead want to find a method that is truly compatible with your needs.

I wish you well.
Dr. Marie

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Burn Victim and Not Happy with My Life

by hrcounts
written by hrcounts

I’m 15 years old. When I was 13 I was in a bad accident where 30% of my body was burned with 3rd degree burns. Every since that day, I have thought about the accident. My mother is in debt because of me and my mistake. My mother would cry everyday while I’m the hospital and I would listen, feeling terrible. Once I got out of the hospital, I would cry myself to sleep and I had nightmares. I went to school and got ridiculed. I was the kid who “set himself on fire” or “crispy legs.” Let it be known I didn’t set myself on fire, it was an accident. Everyone mocked me and made fun of me. I was stared at and laughed at. Now I feel alone. I haven’t talked to anyone about this and all the feelings and depression I’ve built up over the years. Everyday, all throughout the day I think about my accident. It haunts me and I hate myself for getting burned and hurting my mother financially and emotionally. Recently my girlfriend broke up with me after I told her all of my thoughts and feelings. I would have killed myself if my mom didn’t tell me she was pregnant with my little brother, he seems to be the only reason I’m alive today. Now I just don’t see what the point of living is to be honest. Everyone is so hateful and no one cares about me. I don’t even care what happens to me. Words can’t describe how much I hate myself and how I’d give anything to take back what happened to me. I just don’t see what the point of living is anymore if it’s just gonna be filled with hate and stress. Death just seems so peaceful. I just want someone to care. No one understands what happened to me and the damage its done to me.

A: I’m so sorry that you have gone through such a difficult time, both physically and emotionally, but please don’t give up! I promise you that it will get better. You were at a difficult age when this happened and kids can be horribly mean and unsupportive of their peers. It may be difficult to believe now, but the older you get, the less this will matter. It sounds like this has been hard on both you and your mother, but like you said, it was an accident so please stop blaming yourself. I’m sure your mother is grateful everyday that you are still alive, and I hope that one day soon you will be too.

What you went through was traumatic and has affected your life greatly. That is why I think you should seek therapy to help you deal with it all. Talking to a professional who has training and experience in helping people through difficult life events will speed up your healing process and help you see hope in your future. Please talk to your mom soon (or your doctor or school counselor) about finding a therapist. You might benefit from a specific technique called EMDR and I’ve included the link so that you can find a trained therapist in your area. You’ve been through the worst of it already. Hang in there to see how wonderful life can be again.

All the best,

Dr. Holly Counts

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I Lost My Virginity to My Step-Brother, Was It abuse?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From the U.S.: Around age 7 my father began a serious relationship with my now step-mother. I also began to become sexually curious at this time. My step siblings and I would play some inappropriate games, such as spin the bottle, while exploring this curiosity. For my youngest step brother and I, this progressed over the years into a sexual attraction. By the time I was 13 we began to have oral sex and by age 16 we had intercourse.

Eventually, we developed our own sexual relationship with other people. There were times that he could come into the bathroom while I was showering, shut the lights off, get in with me and use the gap in my thighs to pleasure himself and then just leave… or ask me to give him oral sex until I got too exhausted to keep telling him no and caved. Anytime I brought friends over, he would try to seduce them and then beg me to come into his room later that same night.

One Christmas Eve when I was 16 he gave me a hicky the size of a silver dollar. Christmas morning when everyone asked me what was on my neck, I told them that HE DID IT to me. My step brother denied it and my family never talked about it again. However, dad and step-mom did move my room upstairs next to theirs instead of in the basement by him.

I felt, at the time, that I was in love with him and prayed over and over again that somehow we could be together. After every encounter I had with him I felt used and worthless; but I still wanted to do whatever it took to get him to love me. I just wanted my step-family to love me.

I carry those feelings with me to this day and I find it very hard to be sexually active without self medicating with alcohol first. I no longer have any relationship with that side of my family and, at 30, I’m still carrying this burden alone. I can not afford to seek professional help at the moment, but I am interested in writing a letter to my dad. I think that, that would be a great first step in healing. But, how do you even start a letter like that? Was it even abuse? Why didn’t they do anything to stop us?

There isn’t a simple answer to any of this, but I will share a few thoughts. It looks to me that what maybe started out as kid curiosity developed into an abusive relationship as the years went on. Lots of kids experiment with their sexuality with siblings or friends when they are young. Exploration of each other is not abuse; it’s innocent curiosity. But by the age of 7, most kids have been taught about physical boundaries and know that they are being “naughty” if they engage in more experimentation. It quite naturally stops.

You didn’t say if there is an age difference between you and the steps. If they were the same age, we could see the initial incidents as experimentation among innocent peers. But if they were older and getting you to play spin the bottle, they knew better and were using you.

As for the step brother who continued the behavior despite your efforts to stop it: That is abuse! There was nothing loving about it. He was using you for his own pleasure. The fact that he also made sexual overtures to your friends suggests that he had (and maybe still has) serious mental health issues.

Please don’t beat yourself up about what happened. Your responses at the time are not unusual or abnormal. Your participation does not mean that you are at fault.

You were desperate for the love of your family. It’s not unusual at all for a child to be confused about the difference between real love and sexual manipulation. Kids who need love will often comply with sexual demands — and may be led to believe that having sex means they are loved. Bodies often respond even when the mind doesn’t want to, which can be terribly confusing. Kids who don’t feel safe enough to tell adults (or who are convinced the adults won’t help anyway) feel helpless and often don’t tell.

As for your parents: They managed their fears about what might be going by moving you to a room next door. They may have thought or hoped that would stop whatever was happening. From their point of view, they were protecting both of you. It wasn’t enough, but it was an effort.

It makes absolute sense to me that you are having difficulty with sex and sexuality so many years later. As you have found, self-medicating with alcohol may make the act of sex possible but it does nothing to deepen love.

You do need treatment in order to reclaim your sexual self. You do need treatment if you are to trust another person enough to enjoy true love and intimacy. Fortunately, there are alternatives to paid therapy. Here is an article from our archives that might be helpful. I also suggest that you join one of the forums here at LifeHelper.

I caution you about writing a letter to your father without the support of a knowledgeable therapist or counselor. It’s important to have clear goals and to be prepared for whatever reaction such a letter might cause. It’s possible he will respond with loving kindness and an apology. It’s also possible he will deny what happened or blame you or not respond at all. Any such negative response might be re-traumatizing.

Until you have more support, it might be more helpful for you to write the letter but not send it. Sometimes putting things down on paper helps people get something off their chest. It sometimes also helps the writer organize their thoughts and perhaps come to some new understandings.

This is a painful past. I doesn’t need to result in a painful future. With good support from a therapist, you can get through this and have the life and love you deserve.

I wish you well.
Dr. Marie

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I Am Humiliated by Myself and Everything I Do, All the Time

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I hate every word I say, every thought I have, what I look like, what my name is, how I eat, how I sleep, how I breathe, how I smoke cigarettes, the way I interact with people, everything. I am embarrassed by every single thing I do, I am so weird. I’ve been told by a lot of people that I have strange mannerisms and weird ways of saying things, I know it isn’t just me who sees how embarrassing I am. I am alone right now and I am still embarrassed, so I know it isn’t solely another-people problem. I just can’t, literally can’t socialize or get a job or move ahead in my life or even make one single friend because I am the most embarrassing thing on Earth. I’m diagnosed with PTSD and Major Depression and Depersonalization/Derealization disorder, but this feeling is worse than all of it because it follows me around EVERYWHERE, no matter how hard I try I fail miserably at everything. I don’t know what’s wrong with me.

Depression is likely a major contributor to how you feel. The two other disorders you mentioned are likely contributing as well. There’s no indication in your letter that you are in treatment or have ever been. Lack of treatment could be the problem.

You wrote that other people think negatively of you. That may not be true. You might be misinterpreting their feedback.

Also consider that your negative self-opinion likely influences how you interact with people. You might inadvertently be training them to treat you a certain way. For instance, if you make self-deprecating comments, in their presence, they might simply be agreeing with you and not really believe what they are saying. If you said good things about yourself, they might also agree just to be socially agreeable.

The solution to this problem is counseling and possibly medication. Once your symptoms have improved, your negative self-beliefs will be replaced with more reasonable and realistic views of yourself and the world. Change your thinking and you can change your life. I hope you will give counseling a try. Please take care.

Dr. Kristina Randle

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Can Someone Have Schizophrenia and Borderline Personality Disorder?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I have a client that I am trying to help get in touch with mental health services. He has previously been diagnosed with schizophrenia, PTSD, and borderline personality disorder. I was recently told that it isn’t possible to have both schizophrenia and borderline personality disorder. Is this true, and if so what is the reasoning?

I am not aware of any “rule” that says that individuals diagnosed with schizophrenia cannot be diagnosed with borderline personality disorder.

Psycom’s website states, “Schizophrenia and borderline personality disorder (BPD) can share symptoms. One study found that both patients with schizophrenia and patients with BPD experience hearing voices. The difference between the two being that paranoid delusions occurred in less than one-third of patients with BPD, compared with two-thirds in schizophrenia. The study also found that auditory hallucinations are common in both populations. According to the results of this study, schizophrenia and BPD frequently co-exist. Accurate diagnosis of either or both conditions plays an important role in establishing an effective treatment plan.

As stated on Psycom’s website, “The term “borderline schizophrenia” does not refer to an established diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. It is sometimes used, however, to refer to an individual who meets some, but not all, of the criterion for schizophrenia or to refer to parallel symptoms of borderline personality disorder and schizophrenia. As noted previously, schizophrenia and borderline personality disorder (BPD) can share symptoms: one study found that both patients with schizophrenia and patients with BPD experience hearing voices. The difference between the two being that paranoid delusions occurred in less than one-third of patients with BPD, compared with two-thirds in schizophrenia. The study also found that auditory hallucinations are common in both populations. According to the results of this study, schizophrenia and BPD frequently co-exist, however, accurate diagnosis of either or both conditions plays an important role in establishing an effective treatment plan. While BPD is characterized by a pattern of instability in interpersonal relationships; schizophrenia is characterized by a range of cognitive, behavioral, and emotional dysfunctions.”

Perhaps the person you learned this information from incorrectly believes that borderline personality disorder means that the individual is “bordering” between neurosis and psychosis. Under this theory, a person could not be schizophrenic because they have not crossed the psychosis threshold (i.e. their bordering between neurosis and psychosis), a required feature of a schizophrenia diagnosis. “Borderline” does not mean that an individual is teetering between neurosis and psychosis, although some believe this. People with borderline personality disorder display certain symptoms such as mood and self-image instability, difficulty engaging in relationships, anger and depression, “all or nothing thinking”, and so forth. A person with schizophrenia can display these aforementioned symptoms, in addition to psychosis, as well as some of the other symptoms of schizophrenia. The two disorders are not mutually exclusive meaning that if a person has schizophrenia, then he or she cannot be diagnosed with borderline personality disorder. From my understanding, it is possible for an individual to have both disorders simultaneously. It may not be common, per se, but it’s still possible.

Lastly, to further illustrate BPD and schizophrenia similarities and differences, study.com summarizes, “People with any personality disorder (such as BPD) tend to lose the normal flexibility of personality. They are relatively coherent, and can think for themselves. Their thoughts make sense, more or less, and they can interact at some level of normalcy. Their problem is that their minds are stuck in a sort of psychological rut. In the case of the BPD sufferers, that rut is right on the edge of complete instability. Their relationships tend to be intense and difficult, because their thoughts and emotional reactions make intimacy difficult, yet they cling desperately to the people who are willing to spend time with them. Schizophrenia is not a personality disorder, in the way we described BPD. People who suffer from its various forms are losing touch with reality, altogether. Instead of having personalities that cause difficulty by becoming rigid and inflexible, the schizophrenic personality begins to dissolve. The BPD individual may walk a strange ‘road’ of inconsistencies in his life, but the schizophrenic may walk no ‘road’ at all. His day is often spent in constant distractions, confusions, distortions, and contortions caused by the fragmented activities happening in the various areas of the brain.”

I hope this information helps. Thank you for writing.

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Fear of Former Colleagues

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I recently attended a conference and ran into a former colleague who was very cruel to me. I was a victim of mobbing at a previous job. I am petrified that this woman talked to my current colleague and she has sabotaged my job. I get extremely anxious every time I must attend workshops or conferences for this reason. My former boss was a big gossiper and has essentially ruined my reputation in my field. Even if I don’t run into former colleagues I am petrified that someone will recognize me or my name and ask me where I used to work. It has been so crippling. Now I am suffering PTSD and am very anxious and having a hard time sleeping due to running into this former colleague. What can I do to get rid of the anxiety? How can I lose the fear? What should I attempt to believe in order to feel more confident?

You should consider seeking psychological treatment for your PTSD and anxiety. These symptoms seem to be significantly impairing your life. A mental health professional could teach you how to eliminate your anxiety and fears and become more confident. You might also benefit from medication, which could also significantly decrease your anxiety and stress levels.

Generally speaking, forcing yourself to believe in the reality of a situation could assist you in eliminating your anxiety. For instance, you seem to have a great deal of anxiety but is this anxiety warranted? You’re concerned that your current job will be compromised by former colleagues but how likely is it that this will occur? Perhaps your anxiety stems from the aftermath of what happened in your previous job but in reality, there may not be any real threat to your current job. In that instance, a therapist would attempt to determine the legitimacy of your anxiety and if it is excessive or unnecessary, assist you in alleviating it.

You may want to read the work of Dr. Janice Harper. She has been studying the concept of mobbing in the workplace and has written a book on the subject. She explains how the process of mobbing is essentially bullying. Others have written about the subject as well.

It may take some time to fully overcome the trauma you sustained. Thankfully you were able to remove yourself from that situation but you seem to be struggling. Counseling could greatly expedite the process of healing and overcoming your fears. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Why Do I Feel so Incomplete?

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

From the U.S. I guess I’ll start with the fact that I’m an Iraq war veteran. I don’t think that has anything to do with my issues but I’m not a doctor. For a few years I would on occasion feel like I didn’t belong anywhere, I cannot really describe the feeling, but I didn’t feel depressed. Those moments would only last a few days, maybe a week. Now I’m stuck, I feel like a part of me is gone and I don’t belong anywhere,I feel like I want to go somewhere but don’t know where.

My wife has noticed that I’m not “there”; that I’m somewhere, and I know this is upsetting her but we can’t figure it out. I have a good paying job, not a very satisfying one, I have a lovely home and beautiful wife. I have everything, on paper that is. But I don’t feel complete, it doesn’t make sense, people have far worse problems. All of this “nothing” that I am has made me sad, confused, and angry.

When I drink a little too much I become angry, everything bothers me. This is new, I’m not always like that. I get confused and frustrated all the time, and it’s over nothing of importance. I’m slowly losing my mind and unraveling faster and faster each day. One of the worst things find a therapist, I don’t know who’s in network or where to even go. Everything has this complicated system that blocks people instead of helping them. So I guess I just feel like I’m not here completely, I cannot keep focus for to long, but when I do and something interrupts it i get very irritated for no “real” reason, it’s unnecessary to act that way. Whats my deal?

Thank you for writing. And thank you for your service. Please do not minimize the effects of combat. You have done extremely well since discharge but you may still be having a reaction to your time in Iraq.

One of the ways that some people cope with challenging or traumatic situations is to emotionally distance themselves to some extent from what is happening. It’s a normal protective mechanism that helps people make it through. But sometimes it’s difficult to turn it off once out of the situation that made it necessary.

Drinking certainly won’t do it. Will power alone won’t do it. Even the support of a loving partner, family and friends often won’t do it. You need the guidance and support of a counselor who has experience with helping vets.

The place for you to start is with your local VA. Most have counselors available for veterans like yourself. If they don’t have counselors on staff, they may be able to direct your to local counselors who have experience with vets.

You didn’t mention what arm of the service you were in. Every branch has support services: Every program serves both those who were physically wounded and those who are experiencing mental health issues.

Army: Wounded Soldier
Navy: Safe Harbor
Marine Corps: Wounded Warrior
Air Force: Wounded Warrior

Please follow through and contact the appropriate program. You deserve the support. Some sessions with a counselor will help you enjoy the life you and your wife are building.

I wish you well.
Dr. Marie

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I’m Just a Pawn in Their Game…

by Dr. Marie Hartwell-Walker
written by Dr. Marie Hartwell-Walker

Hello. I’m a teenage girl living in Cali, USA. Ever since I remember, I’ve been struggling with mental illness. And it is very tiring to tell myself all these years that it will get better when it never has. I even see a therapist, but we’ve tried a lot of things and nothings worked even though I want it to work so badly.

It is probably because, no matter what, I can’t get away from my family until I’m an adult. Then I’m moving out of here. You see, I do like some members of our families, heck we even created some kind of support group for ourselves, but there’s others that are very toxic and I’m forced to hang out with since they live under the same roof. Heck, I even tried getting social services and a restraining order, but nothing has worked! But, I am one determined person and that’s the only thing keeping me sane.

When I was ten, some things happened (long story, can’t tell it in less than 400 words right now), that ended up as a scandal in my family. And what better to do with a scandal that left me with several PTSD than to use it to support your point? Want somebody to pay something? Bring up the scandal. And I can always hear them. Then, to make it worse, they then comment on me, saying that I’m a useless whore. Yeah, it was sexual assault, and I can’t do anything about it because “lack of evidence”…I even tried to get the police to intervene, but they did nothing as well!

And now it is almost Thanksgiving, and that’s by far my least favorite time of the year. Great, they’re just gonna argue again and bring up my story again and I’ll just gotta sit there and act pretty again.

So, I’ve a plan. Don’t know if it’ll work or not, since, well, there’s no telling if it’ll be successful. But I’m planning to write a book about my rather horrible childhood and publishing it somewhere. Even if one person believes the truth, then maybe I can finally find peace in myself.

As long as you are identified as being the only one with a problem, family members don’t need to face their own responsibility for whatever happened, and it’s unlikely things will change. However, since some family members are supportive, a toehold already exists for making change. From my point of view, then, this is a family therapy case, not a situation that will be improved with individual treatment.

If you haven’t already, please talk to your therapist about expanding your treatment to include the whole family. If the whole group won’t come, start with the people who are allies. If your therapist doesn’t feel qualified to change the mode of therapy, ask for a referral to someone who has experience and expertise in working with the whole family in the room.

Meanwhile, writing is an excellent way to manage your own feelings. I hope you are sharing your writings with your therapist. You will also feel more empowered if you are doing everything you can to get ready to live on your own. That means doing well in school so you have a chance at scholarships to college and/or developing some job skills so you can leave home and support yourself

I wish you well.
Dr. Marie

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Out of Control. Am I Self-Sabotaging?

by hrcounts
written by hrcounts

I am dating a guy that I really care about, he is generally really good to me and helps me better my life in terms of school and work. The idea of him talking to other girls bothers me, a lot. I’ve behaved very “crazy” like with him. I feel impulsive, out of control. I imagine all of these threats, and even if they are real, my behavior is out of control. I’m not asking this question so I could make my relationship better, I am asking because I am really concerned, and my behavior is affecting those around me. But I am not usually like this, I have not been like this with other guys. I am generally calm, I generally don’t experience anxiety mentally. I dislike emotional people, but now I am being extremely emotional and irrational.

Quick background: Severe physical, and emotional abuse as a child (burning, etc), into teenage years. Parents told me I wasn’t wanted repeatedly as a child. No sexual abuse by parents. Raped by ex-boyfriend, years later 1 abortion after being intimate for the first time with a guy while we were dating for over a year, abortion occurred while fully awake (no medication or sedative) and I watched them do it. Generally described as intelligent, however I do not manage my time right. I often cut myself short, I seem to be sabotaging myself (the proof is in my life). Extremely “rational” most of the time. (age 26, from US)

Thanks for writing in and I’m sorry that you were abused as a child and then experienced other traumas as a young adult. I suspect that it is all catching up to you now that you are in a stable, supportive relationship. I’ve seen it happen before — life finally seems to be good and then the past comes creeping in. Symptoms can come out of nowhere it seems.

If you want to save this relationship (and yourself) it is time to consider therapy. Even if you have gone before and thought that you had worked through your traumas, it is worth going again. The impulsivity, insecurity and new uncontrolled behavior are good signs that you are being triggered. The old saying is true that “in order to love someone else, you must first love yourself,” and I would add that in order to trust someone else, you must trust yourself. So be “rational” and go get some help.

All the best,

Dr. Holly Counts

 

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Ex vs. Kids — Who to Believe?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I sent in a question about this issue a little over a year ago and have received a useful response that I thought was workable. However, the situation is still not resolved. I’ve been divorced from my ex over five years. He has two domestic violence felonies and has been incarcerated for domestic violence (against me). Since his release from jail more than five years ago, he has sought community based mental health counseling. He’s been diagnosed with bi-polar disorder, PTSD, and OCD. He’s on social security disability. I still love him. But there are a number of issues: 1) He claims he’s no longer mentally ill and only takes his psychotropic drugs shortly before he’s scheduled for his monthly appointment with his psychiatrist. The rest of the time he doesn’t take his meds. 2) He’s isolating himself in a very messy apartment, has grandiose ideas about rewriting the Bible, believes in all kinds of conspiracy theories, and engages in magical thinking; for example: he’s more enlightened than other humans because of his spirituality. 3) He is pushing me to let him come back to me again despite my three grown son’s objections. My youngest son (now 28) is in counseling also for PTSD because when he was a child (from the age of 10) he has witnessed his stepfather’s (my ex-husband) abuse toward me. My ex tells me if I really loved him I wouldn’t leave him, that in the eyes of God we will never be divorced, and if I did decide to move on without him I would betray him like everybody else in life. When I tell him about my sons’ objections he says they should get over it, and that I shouldn’t allow them to control my life. 4) I have forgiven my ex, but feel he might be playing on my emotions. I’m afraid if I allowed him to live with me again he might become abusive again. 5) Most importantly, I’m torn between loyalty to my sons and loyalty to my ex. I have a good and loving relationship with my grown sons. I feel my relationship with them will suffer if I go back to my ex who is diagnosed with mental illness but is noncompliant in taking his meds regularly because he feels he’s no longer sick. My sons want my ex out of their lives and out of my life. I feel torn between my family and my ex.

I would concur with your sons who contend that reconnecting with your ex is a bad idea. To paraphrase Maya Angelou: “people always show you early on who they are and if you don’t hear it, it is because you are just not listening.”

Your ex has a history of abuse. History of violence is the most reliable predictor of future violence. No one can predict for certain if he will abuse you again but the fact that he is noncompliant with his medications and is currently experiencing symptoms of psychosis significantly increases the likelihood of violence.

It is often difficult for an individual to control their behavior while they are actively psychotic. By definition psychosis is a break with reality. In other words, individuals who are psychotic have difficulty distinguishing what is real and what is not real. Their judgment is significantly impaired. His misinterpretation of reality could result in violence.

If you choose to reconnect with your ex, then you should do so slowly and with strict boundaries placed upon the relationship. For instance, don’t allow him to return to your home until he has at least at least six months of proven medication compliance and there is clear evidence that his symptoms are under control. He’d have to prove to you that he is taking his medication on a consistent and daily basis, not just in the period before his psychiatry appointment.

Given the information provided, I would not advise you to continue your relationship with your ex. He is not mentally stable, he is noncompliant with his much-needed psychiatric medication, he has a history of violence towards you, and you already suspect that he may be manipulating your emotions. However, I understand that my knowledge of your situation is limited. There are likely many more details about the relationship that were not included in your letter. It would be advantageous to meet with a therapist to discuss your situation in further detail. A therapist could gather the necessary information to objectively evaluate your situation, and assist you in making the best possible decision about how to proceed.

Please take care. I wish you the best of luck.

Dr. Kristina Randle

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