Lisa Find Love

One thing I shared with my wife Rachel about a year into our relationship was the time I suffered a nervous breakdown in graduate school. It would be an important moment in any relationship because I shared the time in my life when I was most vulnerable and at my weakest point. Did I technically suffer a nervous breakdown? I’m not sure, all I remember is the turning point came when I drove home late one night, collapsed on my kitchen floor and started crying uncontrollably. Up to that point, I had developed a quasi-schizophrenic outlook on life and could no longer bear the weight of the world-view I constructed. In psychological terms, my conscious self could no longer handle the subconscious content coming forth.

In some ways I blame the state of Texas. In other ways, I blame myself. I guess going from the state of Washington to graduate school in a college town north of Dallas was too much culture shock for me. It didn’t help I had social anxiety issues that surfaced during my early college years, later resulting in depression. By the time I got to Texas, I just wasn’t able to adapt to a new school, new friends, and a totally new Texas way of life.

During that time period in my life I remember keeping a journal. I remember writing about new meanings of different colors and numbers, or at least new ways I interpreted them. For example, I remember sometimes wearing red shirts to signify I was wounded or bleeding. I felt my soul was bleeding or perhaps that I was a wounded angel. I remember writing about how I felt like people were out to get me. Usually this feeling coincided for some reason with when I drove on the highway or drove late at night. I remember the strange feeling I got after attending a church for several months that myself and another trumpet player attended. Not long after sending a bizarre letter to the church saying I could no longer attend, the other trumpet player got cancer and ended up passing away within a year or so.

Other things that happened I don’t remember well because I think I burned the journal out of shame. It was a period in my life (I was 24 years old at the time) when my brain tried to find a shortcut or figure out how life worked. When it all became too much for me to handle, I stopped. I vowed to never go down that path again. I never told anybody my thoughts because I knew they sounded crazy. I was living an intense schizophrenic reality as a sort of life experiment, and that could only last so long.

One unfortunate side effect from that period and a feeling I have probably buried is the shame and guilt that went along with all of the “crazy” thoughts I had. Due to that guilt, I repressed or tried to forget much of that time period in my life. I have never had problems with mental illness or schizophrenia since that time despite bouts of depression, but I bet there are issues and feelings that are still affecting me today in ways that I’m not conscious of. In terms of the treatment I received while in graduate school, I just remember counseling and anti-depressant medication. I don’t even remember bringing up any of my thoughts to anyone else because I knew how crazy it would make me seem. There was also the shame.

Upon hearing my story about this turbulent time in my life, I recall Rachel being concerned that I could possibly have a similar response in the future to a new situation. I reassured her I was more mature and knew better than to put myself in that situation again. After all, I’d moved to Chicago and Spain — life situations that were all together more tenuous than moving to Texas, and I had no issues. 

It was nice that we could bond over our experiences with anti-depressants since Rachel had gone through similar problems with depression while in school. Rachel and I also initially bonded over my interest in dreams and famous Swiss psychologist Carl Jung. When we first started dating I was reading a lot of books about Jung, dreams, and his ideas of the subconscious. One of our first long conversations we had at a bar was a conversation about dreams and all the different meanings of symbols. It intrigued her and she was interested in figuring some things out about her own subconscious. 

In the beginning, I remember I could help her a little and talk about things she dreamed about. But over time, I stopped reading books about Jung and the subconscious. Life started demanding more from me and I didn’t have time. When Rachel kept asking me about her dreams and what things meant, it became harder to answer or give her insight. I wanted to be able to, but it was above my expertise.

After awhile, I gave her the books by Jungian scholar James Hall and had her read the passage that might relate to her dreams. After awhile, I got annoyed because I couldn’t answer her questions. After awhile, she stopped asking. She needed her own Jungian analyst, but I didn’t even have a degree in psychology — I was just an armchair psychologist. I wish I could have helped more. My wife suffered from an undiagnosed borderline personality disorder (BPD) and died from suicide after our fourth year of marriage. I now realize I fell into the trap of having a “savior complex” (also known as “rescue fantasy”), the very thing psychologists and therapists are told to watch out for when they are in training. I wanted to help her, but didn’t know the best way how. Some people are difficult to help, and people with BPD, dangerously so.  

During the beginning of our relationship, Rachel and I were at places in our life where we didn’t want to continue taking anti-depressants, nor did we feel like it was necessary. We each knew the effects of taking medication like that and understood we were each able to deal with life in a more mature, grounded way. Mental health at that time still had a stigma and neither of us wanted to be seen as “crazy”. The shame was with us both.

The reason why the mental health stigma overshadowed our lives was because I knew at least I was ashamed of it. I was ashamed my wife continued to have issues, ashamed that I couldn’t figure life out, ashamed things weren’t easier. As a result of the shame, I didn’t want to talk about it with anyone outside our marriage. I thought we were supposed to manage it by ourselves.

Granted, my wife got help when she started to have therapy sessions in 2014, not long after we got married. I was obviously fine with that and supported her decision since my belief is that everyone should have a therapist if they can afford it. We also went to marriage counseling prior to being married. 

However, in our entire relationship, the issues she had and conversely that we were having, were never something we talked about with family and friends. Like our previous issues in school, I thought mental health issues were something you endured and then got over — things you dealt with yourself and then moved on. Consequently, when all the warning signs were going off with Rachel during that summer with all the rain, I still thought we could manage it. We were again in marriage counseling and talking to a therapist that helped us with our communication problems. In addition, Rachel saw her own therapist. Rachel told me that both therapy sessions weren’t enough however. She also told me one time in a moment of weakness she might need to be hospitalized. I think the guilt and shame kept us from acting. Nobody wants to admit defeat, even when life has seemingly won and is kicking you while you’re down.

Part of the mental health stigma is also fear of the unknown. One keeps their distance from what is unpredictable or unsafe and mental illness can create a divide where people run away instead of confronting what is unknown. That’s another reason we didn’t seek immediate hospitalization. We were used to running away from the instability and chaos. 

The insidious way the stigma affected our relationship was that in our relationship cycle of fights I mentioned before, whenever Rachel acted out of anger and showed signs of BPD, I would later keep my distance. My natural inclination instead of showing her more love and affection was to show less. I needed time to recover and feel safe myself. From a book by an increasingly famous London psychologist named Dr. Julia Shaw entitled Evil: The Science Behind Humanity’s Dark Side, she recounts studies that prove people keep their distance, socially as well as physically, from people with mental illness. She states that as a result of this dismissiveness and because of how others treat them, mentally ill people suffer from increased anxiety, stress, and lower quality of life. Even though I never admitted it to myself, I think I subconsciously knew Rachel was mentally ill. In a way, her condition exploited my weakness for not confronting conflict. If we had greater knowledge about BPD and the effects of mental health and the mental health stigma, I know we would have known what to do that summer. We just didn’t.

Many people with clinical depression have tried an array of medication and still feel sick. Maybe they’ve tried different selective serotonin reuptake inhibitors (SSRIs) or selective norepinephrine reuptake inhibitors (SNRIs). Maybe they’ve taken these antidepressants along with an antipsychotic (a common strategy to boost effectiveness).

Either way, the lack of improvement can make individuals feel even more hopeless and fear the darkness will never lift.

If this sounds all-too familiar, you’re definitely not alone. In fact, up to 30 percent of people with depression don’t respond to the first few antidepressants they try.

Many individuals with treatment-resistant depression may benefit from a class of antidepressants that today is rarely offered to them: monoamine oxidase inhibitors or MAOIs.

“MAOIs are the best antidepressants on the planet,” said Mark D. Rego, M.D., a psychiatrist with 23 years of experience, specializing in treatment-resistant individuals, and an assistant clinical professor of psychiatry at Yale University School of Medicine.

Dr. Rego has seen incredible changes in patients with severe depression who were struggling with profound anxiety, insomnia, and suicidal thoughts and taking strong doses of antipsychotic medication and SSRIs. After taking an MAOI, their symptoms “vanished.”

After her husband passed away, Sue Trupin fell into a deep depression that lasted 3 years. During this time, she tried over 10 different medications in different combinations. She was hospitalized twice. She received 12 sessions of electroconvulsive therapy. Finally, a new psychiatrist prescribed the MAOI tranylcypromine (Parnate).

As Trupin writes in her eloquent piece, “About 10 days later, sitting in my parked car, I heard on the radio the legendary jazz saxophonist Ben Webster. A shiver of pleasure invigorated me. Later in the day, I bought bags of fresh food at the market, smiled at a chubby baby, and became overwhelmed by the devotion of a friend. The lights were blinking brightly, and then miraculously they were staying on. I’ve been well now for four years, in my right mind because of an old, inexpensive, and uncommonly prescribed drug.”

Discovered in the late 1950s, MAOIs have a well-established history of efficacy, particularly in managing difficult-to-treat depression. *

So why aren’t MAOIs prescribed more often?

For starters, today’s psychiatrists may have less experience with this drug class, said Kristina Deligiannidis, M.D., an associate professor at The Feinstein Institutes for Medical Research at Northwell Health.

In his editorial, Much Ado About Nothing, Australian neuropharmacologist and MAOI expert Ken Gillman, M.D., cites research that’s found this to be true.

Gillman also notes that “the ability to properly manage MAOI treatment should be in the repertoire of all psychiatrists. It is regrettable that this is not the case.” In fact, Gillman is part of the “International MAOI Expert Group,” which includes clinicians, academics, and researchers.

In this statement, he and his colleagues note that the “group was formed in March 2018 to promote actions aimed at: improving education; stimulating research; increasing clinical usage; and assuring continued availability of MAOIs worldwide.”

While MAOIs aren’t the right choice for everyone, Dr. Deligiannidis noted that they “should be considered part of a comprehensive treatment plan” for individuals with treatment-resistant depression or atypical depression. She defined atypical depression as “mood reactivity, significant weight gain or increase in appetite, hypersomnia, leaden paralysis, and long-standing pattern of interpersonal rejection sensitivity.”

There are other reasons MAOI use has declined—reasons that have more to do with misunderstandings than actual facts. Below, you’ll find several common concerns followed by the reality.

Concern: Too Restrictive Diet

One of the biggest concerns with prescribing MAOIs is that patients won’t be able to adhere to the stringent diet that’s required. This means abstaining from foods that are high in the amino acid tyramine because of the danger of a hypertensive crisis (a severe spike in blood pressure that can lead to stroke).

However, today, this stringent diet isn’t actually all that stringent.

According to Rego, “You have to almost go out of your way to get a [hypertensive] reaction.” He gives patients taking MAOIs a simple list with foods that aren’t allowed and foods that are allowed in moderation.

Deligiannidis noted that in the past, some foods that were believed to have high tyramine levels contain little or no tyramine, including: raspberries, chocolate, avocadoes, bananas, and Chianti wine.

Plus, as Gillman notes in his editorial, because of recent changes in food production techniques, the once high concentrations of tyramine in foods such as aged cheeses, salami, and soy sauce have significantly diminished. In fact, today, many matured cheeses—once thought to be dangerous– have negligible concentrations of tyramine, he writes.

Concern: Serotonin Syndrome

Combining certain drugs with MAOIs can cause serotonin syndrome, also known as serotonin toxicity. Serotonin syndrome can range in severity and can be fatal. Some individuals have mild symptoms, such as increased blood pressure and heartbeat, dilated pupils, sweating, shivering, and twitching muscles. Others can additionally have hyperthermia, agitation, and frenetic speech. In severe cases, individuals have all of these symptoms, along with muscle rigidity, delirium, and rapid, dramatic swings in pulse rate and blood pressure.

According to Rego, taking the over-the-counter cough suppressant dextromethorphan, along with an MAOI, can cause serotonin syndrome. So can taking an SSRI or SNRI.

Fortunately, these drug interactions are “all easily avoidable,” Rego said. He noted that he’s less concerned about patients making a mistake, and more concerned about them going to the hospital where the staff is unaware that they’re taking an MAOI or doesn’t understand how MAOIs work.

To avoid this, he stresses the importance of wearing an alert bracelet or a pendant—just like you would if you had severe allergies or diabetes.

It’s common for individuals to be taking an SSRI or SNRI before trying an MAOI. To avoid serotonin syndrome, it’s important to have a “wash-out” period. This is when individuals need to wait weeks for their bodies to eliminate a drug before they can start the new one. Understandably, during this time, there’s a concern that depression symptoms will worsen.

Consequently, Rego prescribes medication to help bridge this gap. For example, if a patient is taking Zoloft, he might prescribe a benzodiazepine to manage anxiety, and lithium to manage mood during the 2-week waiting period. He also recommends patients alert their loved ones about the change and get extra support; make sure they’re getting enough sleep and rest; and keep stressors at bay.

Therapy also is a critical part of a comprehensive plan, and could help tremendously during this transition.

Available MAOIs

Rego noted that there are four licensed MAOIs in the U.S. Selegiline (Emsam) is an MAO-B inhibitor, which comes in a skin patch. The other three MAOIs are non-selective. “Marplan is almost never used [simply because] we’re not that familiar with it,” Rego said. “Nardil is commonly used, but it’s sedating and causes weight gain.”

Rego prefers Parnate and noted that it “should be everyone’s number one choice.” “It’s the easiest to take and doesn’t make you tired or gain weight.” The only significant side effect, he said, is that it’s stimulating. Which is why whenever he’s prescribing any antidepressants, Rego asks patients how well they can tolerate caffeine. If they mention adverse reactions (e.g., faster heartbeat, shortness of breath), Rego might prescribe a medication to control anxiety until the stimulating effects wear off.

MAOIs won’t work for everyone. For example, they’re typically contraindicated for people with severe personality disorders. That’s because, Rego said, these individuals tend to be impulsive, struggle with suicidal thoughts (and attempts), and engage in self-injurious behavior. Which means they can intentionally take a medication that interacts with their MAOI, he said.

However, for some individuals with severe depression, MAOIs can be transformative. As Rego said, “It is not an exaggeration to say, it can change a person’s life.” And that means physicians must become experts in prescribing MAOIs and offer them as a viable option when other antidepressants haven’t worked.

* For example, here’s a 2013 review on MAOIs; a 2017 review on tranylcypromine (Parnate); and an article on MDedge Psychiatry.

The sun is streaming through the curtains of a room that you have never seen before. You squint and rub your bloodshot eyes, as your hand reaches out to feel the prone body of the snoring person who a few hours earlier was a stranger. You notice your own naked body and wonder how the two of you spent the interceding time. You look at the floor next to the bed and see your clothes, strewn across the carpet, wine bottles and glasses, a few joints, and a line of cocaine on the dresser across the room.

You slide out of bed, gather your belongings, hightail it to the bathroom and quickly get yourself street ready. Wondering how you will explain your lateness for work this time, you swear you will never allow this to happen again. That resolve lasts until the next weekend, where you are once again at the familiar bar where you and your friends hang out. You insist that they keep you from leaving with someone other than one of them and they promise, but once you are a few drinks deep, your resolve goes out the window and you find yourself on the arm of a person with whom you have been flirting and dancing, your inhibitions washed away on the wave of alcohol that is now coursing through you.

Alcohol is the most frequently used mood-altering and mind-numbing substance in the United States. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that over half of all American adults were current drinkers of alcohol at the time of their 2015 national survey. When enjoyed in moderation, it can be a social lubricant, a shared activity, a way of celebrating life events. When indulged in excess, used habitually, or abused, it can establish and continue a pattern of behavior that can cause serious damage and wreak havoc on your life.

It is also the most oft imbibed date rape drug, according to various police reports and experts who specialize in sexual assault cases. It far surpasses Rohypnol, (a.k.a. ‘roofies’) that is sometimes used to spike an unguarded drink.

The downside of sexual activity when impaired

• Risky sexual behavior
• Increased risk of STDs
• Increased chance of pregnancy
• Lack of ability to consent to sexual activity
• Greater likelihood of physical or sexual assault
• Use of additional substances beyond what was ingested at the onset
• Being abandoned in an unfamiliar place
• Getting robbed
• Loss of memory of what occurred/blackouts
• Death

Traumatic Experiences

According to a woman I spoke to who was willing to she here experience here, sex while impaired in committed relationships was “missing something. The only time I could feel comfortable in my own skin was after a few drinks. That meant, I couldn’t even get in bed with my husband unless I had a few… and then a few turned into a few too many.”

When she considered where that pattern began, she remembered her first traumatic sexual encounter in her teens when in the basement of a boy’s home, they were mixing drinks and she passed out and the next thing she knew, her pants were around her ankles and he was nowhere in sight. Over the years, she repressed the memory and it came to her awareness in a couple’s counseling session they had to repair the rift that was caused by her drinking.

When she made a courageous decision to get into recovery, she had to face the frightening prospect of being with her husband without a substance between them. Awkward initially, she admitted that she felt like she was a teenager again and in many ways, a virgin, since she had not known what it was like to be fully present in any sexual encounter.

Shame

A gay man I spoke to had limited experience with sober sex, since his relationships with men were fueled by substances and the way he met these companions was in bars. On the rare occasions those encounters occurred, he felt a sense of shame arise since his family and church told him his inclination, attractions and actions were sinful. He too entered treatment and began to face the reality of who he was and how he chose to share loving interactions with partners. To date, he remains sober and is in a committed relationship leading toward marriage.

Codependence

A couple who have been in a long-term relationship both have substance abuse problems. When they met, they were both drinking heavily, and much of their social life consisted of meeting up at their favorite bar after work, having several drinks and then heading home to bed. Morning-after hangovers greeted them along with the chirping of birds.

In therapy, they admitted that they had never felt intimate with each other and that sex was something they did because it was expected, and not because they truly enjoyed it. Their therapist reminded them that their commitment to monogamy was not genuine, since the substances were like two additional partners in their relationship. They were allowing their addictions to share their bed and it simply wasn’t big enough to accommodate all four of them. In subsequent sessions, they — with a sense of embarrassment — admitted that they were having a better time under the covers than they had under the influence.

True Intimacy

A young man in an Intensive Outpatient (IOP) where he had gone following inpatient rehab, expressed fear of sober sex, since he had rarely experienced it. He presented as calm and confident and by most standards, except his own, he was attractive and well-spoken.

He shared with the group (and gave the therapist permission to share his story so it could be a cautionary tale to others) that in the depths of his addiction, he had gone on a spree, drank, snorted cocaine and downed a handful of pills. He denied that it was a suicide attempt but rather a common occurrence. His body rebelled, he vomited the pills and then with dramatic pause, while he was telling the group what happened next, they groaned because they knew what was coming. Yes, he tossed them back into his mouth. He was alone at the time, but said that there were nearly as many dramatic experiences when he was with women who witnessed and in some cases shared intoxication with him. He kept the group informed about his forays into dating, mating and relating with sober women and let them know that sober sex was far more rewarding than what he had previously experienced.

In 12-step programs, the recommendation is that a person in recovery wait a year before engaging in a new relationship or sexual interaction with that person. Even if someone’s decision making power isn’t compromised by a substance, it may still be by the psychological impediments of the addiction. Call it the “addicted to love syndrome” that recovery pioneer John Bradshaw wrote about in his book called Post-Romantic Stress Disorder: What to Do When the Honeymoon Is Over. The same pleasure-inducing feelings that come along with substances are also contained within the hormones dopamine and norepinephrine that join the party when sexual interaction occurs.

Feedback from those who have experienced sober sex:

• Get to know what kind of touch you like and what kind of touch you don’t like.
• Communicate that with any partner with whom you share intimacy.
• Take it slowly, knowing that there is no rush.
• Set boundaries that feel safe for you as you remind yourself that not only does no mean no, but only a fully expressed yes means yes.
• Have a safer sex conversation with potential partners, and keep your agreements about what that means.
• Take time to get to know your partner (again, if you are in a long-term relationship) as a unique individual.
• Engage in romantic activities.
• Be fully present with your partner.
• Write enticing notes to each other.
• Express physical affection that need not lead to sex.
• Be brave.
• Have fun.

My sister, Amber, died by suicide on New Year’s Eve 2013. I’d last seen her just a few days prior at Christmas. She seemed “off” — depressed and over-apologetic — but certainly no one expected that she was suicidal. 

She’d been struggling with depression and substance use, but had also gotten help and was working to get her life back together. In fact, she’d been a patient in my facility just six months prior. As a counselor and as her brother, I had so many questions. How could I have missed the signs? Did I fail her? Did I let her down? In the immediate aftermath, I felt anguish, hurt, anger and a sense of guilt, all at the same time.

According to the CDC, suicide is the 10th leading cause of death in the US for all ages, and the second leading cause of death among individuals between the ages of 10 and 34. Anyone who’s lost someone they love knows that dealing with grief is extremely difficult. But for survivors of suicide, that grief is compounded by the stigma and shame that often accompanies these tragic situations. 

As a result, our emotional expression gets thwarted — we’re unsure how or when we can express our feelings. If you say, “I lost my mom to cancer,” everyone understands and empathizes with that grief. But, “I lost my sister to suicide,” could evoke an entirely different reaction, and even just saying that out loud can feel almost like an admission of guilt. Many survivors feel partly responsible when a loved one commits suicide, just as I did. How did we not know? How did we not see the signs? You certainly wouldn’t feel that way about a loved one who died from cancer.

Because of these feelings of guilt and responsibility, many of us fear we won’t receive the same empathy for our grief if we speak about it openly. That means many of us never fully give ourselves an opportunity to heal. Since we struggle with how to talk about or honor the memory of our loved ones, we keep those feelings bottled up, sending us down our own dark path of depression and despair. 

Remembering our loved ones lost to suicide is critically important in the healing process. It’s important to know that you deserve to heal, to feel grief and communicate the sense of loss that comes with the passing of anyone you love, no matter what the circumstances.

In honor of International Survivors of Suicide Loss Day, here are some healthy strategies you can use to begin or continue your journey to healing. 

1. Find a safe space to communicate your feelings. In order to accept it and process the grief, you must be able to communicate your feelings with others who understand what you’re going through. It can be tough to do this with family members who may also be feeling the same sense of guilt or responsibility, but that makes it even more important for you all to acknowledge that feeling. Simply talking about how you feel in a safe environment can help put you on the road to healing.
2. Know that there’s no formula for grieving. When dealing with any loss, certainly there are feelings many of us all have in common, and even in the case of suicide, we may experience similar emotions. But how and when we experience them is entirely individual. There is no workflow, no timeline, no prescribed method or formula. It’s important to give yourself permission to feel how you feel in the moment. There is no “right way” to grieve a suicide.
3. Find a community of suicide loss survivors. When you’re ready, seek out a therapist, a survivor’s group or some other organization that can help you to navigate the grief process. I attended an Out of the Darkness community walk after my sister died, and I clearly remember someone on stage saying, “it’s not your fault.” Those four little words hit me like a sword! I’d been feeling and thinking that to myself, but no one had ever said it to me out loud. I finally heard the message, and it became a pivotal point in my healing and in my journey to helping other survivors — if I hadn’t heard it, maybe they hadn’t either. I’ve since made it a point to say those exact words to any survivors I meet.
4. Celebrate milestone days. Again, because of the shame and stigma associated with suicide, many of us are afraid to celebrate the life of a loved one openly. But keeping their memory alive — especially of how they were in happier times — is so important for healing. For me, the holiday season is particularly tough because of the timing of my sister’s death, but I’ve learned to instead focus on the good stories, to talk about good times and remember her as the fun, loving sister, mother and friend that she was. Look at old photos, play your loved one’s favorite songs, or do something they loved to do. We always joked that my sister was a terrible dancer, but she loved to dance. So, on her birthday, my niece and I play Amber’s favorite songs and we dance, act silly and laugh at how she used to be such a terrible dancer. I also sometimes turn to social media to post a tribute, photo or funny story on Instagram, Facebook or Twitter in remembrance of Amber on special days. If you know someone who’s a suicide loss survivor, I encourage you to ask them about their loved one. Many of us think asking them to share memories will dredge up grief, but in reality, it brings the one you’ve lost back to life in your memories even for just a moment.
5. Educate yourself on depression, mental health and addiction. If you don’t suffer with these issues, it’s hard to understand how these diseases can force someone’s mind to think that they’re hopeless or a burden and that suicide is the answer. It’s natural to feel anger toward the person you’ve lost — “how could you leave us like this?” — but it’s better to direct that anger where it should be aimed: at the disease that drove them to that end, or at the failure of our healthcare system or interventions to provide the help they needed. Understanding the disease can not only help you grieve, but also help to chisel away at the stigma associated with it.

If you know someone who’s struggling with depression or suicidal thoughts, or perhaps you are yourself, please know that you are not alone. There are people who care and resources that can help. 

Start by calling the 1-800-273-TALK crisis hotline or texting TALK to 741741. Both provide free, private and confidential support for anyone who calls or texts 24/7.

Organizations like Out of the Darkness, the American Association for Suicide Prevention and the American Association of Suicidology all provide resources for prevention and those who are in crisis, as well as survivors groups and events for those who have lost loved ones and need help to heal. 

No one should have to suffer in silence. Reaching out for help is the first, and most important step.

In my last post, I described clinical studies upending the myth that nice men are at a disadvantage when dating. Research finds that women value kindness in men even more than good looks—though they do appreciate a handsome face.

Do men share these values when seeking female partners? Research indicates that they do—though not quite as much.

An article in Evolutionary Biology called “Selflessness is Sexy” describes research finding that both men and women seeking long-term relationships were more attracted to people whose interests were altruistic rather than neutral.

In the study, researchers asked heterosexual individuals to rate the attractiveness of members of the opposite sex. Participants viewed pictures of individuals alongside lists of their interests. For example, some women would see a picture of a man named Daniel that noted that one of his interests was being an unpaid mentor for disruptive children. Other women saw a card that was identical except for one detail—instead of saying Daniel helped kids it said he really likes the science-fiction show Torchwood.

When asked to consider these individuals as long-term partners, both men and women found the individuals who engaged in altruistic endeavors as significantly more attractive. However, the halo effect didn’t work when the participants were asked to consider short-term relationships. Engaging in altruistic behavior only boosted men’s desirability slightly, and it didn’t help women at all.

An article in the British Journal of Psychology describes research examining the impact of another pro-social behavior on attractiveness: trustworthiness.

In the study, heterosexual university students were asked to rate the desirability of opposite-sex individuals for either short or long-term relationships. They viewed video clips of the individuals and learned how they behaved in an economic game designed to measure trustworthiness.

Obviously attractiveness (as measured by a prior survey) and trustworthiness both boosted an individual’s desirability, especially in the context of long-term relationships. What intrigued researchers was the size of the attractiveness boost that individuals got when they were trustworthy—and vice versa. Both were greater than the sum of their parts. To the researchers, this news was mixed:  “Ironically, according to folk wisdom, possessing a good character may compensate for a lack of physical attractiveness. Unfortunately however, while our results show that pro-sociality can indeed increase individuals’ desirability as a romantic partner, they also suggest that this is especially true for those who are already physically attractive in the first place,” they write.

Life is not completely fair, but you knew that already. Still, the research is clear that if you’re looking for a long-term relationship, it pays to be a good egg.

Sara Eckel is the author of It’s Not You: 27 (Wrong) Reasons You’re Single. You can get a free bonus chapter of her book at saraeckel.com. You can also find her on Twitter and Facebook. Ask her questions here.

The post Are You Trustworthy and Kind? That’s Hot appeared first on eharmony Advice.

Several years ago I spoke with a woman who had recently moved to a new town and had joined a fitness group in the community. The woman was single but everyone else in the group was married. Shortly after she introduced herself she mentioned that she had just ended a relationship.

In truth though, she hadn’t had a romantic partner for seven years. The woman said she didn’t like being dishonest, but at the same time the fib served the purpose she intended: She didn’t have to explain herself. “I didn’t want to have to deal with their questions or concerned looks if I told them it had been seven years. Saying I had just gotten out of something meant that we could move on,” she explained.

I understand the impulse. As I say in my book, It’s Not You, I had been unattached for eight years before my husband and I met, and when I would share this information sometimes people would give me a puzzled look. I got the sense that they wanted me to present an explanation for this—to say that I wasn’t interested in finding a partner or that I was too busy with my career.

But these things weren’t true.  I wanted to be in a romantic relationship, and I put a lot of effort into finding a partner. It just … wasn’t happening.

I felt really embarrassed about this, and deeply uncomfortable whenever anyone asked how long it had been since my last relationship. I bought into the idea that there had to be some reason­, some fatal flaw that kept me from finding a partner. After all, eight years of failing at something is a long time.

I’ve now been married to my husband Mark for nine years, and I see it differently. A completely arbitrary set of circumstances led to our meeting each other. There was nothing I could have done to make it happen; it just did. During the many years prior to meeting him, I wasn’t failing to meet the right person. I was just exercising the good judgment to not get involved with the wrong ones.

I’m sure I made plenty of mistakes along the way. I probably overlooked some terrific men because I wasn’t ready or just oblivious. The odds are also fairly high that I did dumb or inconsiderate things that put off other great guys. I’m sure I could have done better.  But whatever mistakes I made weren’t fatal—they were just human.

If you’ve been searching for a partner for a long time, it’s natural to feel frustrated. It’s natural to want to examine yourself and your behavior and ask what you’re doing wrong. That can be useful—for example, if you find that your social circle has remained unchanged since college, it’s probably a good idea to shake things up.

Just don’t play the blame or shame game. Instead, take credit for what you’ve done right. If you haven’t been in a relationship in a long time, then that means that you haven’t been in a bad relationship for a long time. Not everyone can say that.

We all have flaws and limitations. But we also have strengths. When I was single I had an unfortunate tendency to focus on the former but I think we would all—no matter what our relationship status—do well to focus on the latter. When you find the right person they will see your limitations, but they will be far more interested in your strengths—your compassion, your terrific sense of humor. They will focus on those qualities, and you should too.

Sara Eckel is the author of It’s Not You: 27 (Wrong) Reasons You’re Single. You can get a free bonus chapter of her book at saraeckel.com. You can also find her on Twitter and Facebook. Ask her questions here.

The post Why the “How Long Has It Been?” Question is Irrelevant appeared first on eharmony Advice.

You can be anything you want to be, we’ll love you no matter what, my parents used to say. But what if I got bad grades and was mean to my sister? What if I was lazy and shallow? What if I sold drugs or killed a person, I thought, at 10 years old. Oh, the dishonesty. From a kid’s eyes, from my eyes, expressions of unconditional positive regard are hard to trust. How could they be anything but empty platitudes, concealing a less palatable set of rigid expectations?

The past several nights, I’ve sat, infant son in arms, gently rocking in a dimly lit nursery. My left elbow propping up his wobbly head, my right arm holding a book, The Pout-Pout Fish. 

In this New York Times bestseller, of which I have been gifted three copies, we’re introduced to depression. There are three things to know about the pout-pout fish: he’s unhappy, he’s killing the mood, and there’s nothing that can be done about it, according to the pout-pout fish.

A series of aquatic antagonists pass through, chastising the pout-pout fish for his behavior and propagating mental health stigma that’s always been so prevalent in these sorts of communities. Alas, the pout-pout fish remains resolute; his grumpy demeanor is his destiny. 

That is, until the kiss-kiss fish comes along. 

With nothing to say, no lectures on morality, no self-help cliche’s, no assertive you need to change, she offers a kiss. A simple gesture of affection, an overture of acceptance, and the pout-pout fish was transformed — now manically spreading love and affection throughout his community of judgmental and insensitive sea-creatures acquaintances. 

It hits me hard, expressing a profound truth about how to pull people out of depression, so I think, as my son focuses in on the book, pulling it out of my hands, and quickly thrusting the corner into his eyeball.

Carl Rogers and Unconditional Positive Regard

In the 1950s, the psychologist Carl Rogers popularized the concept of unconditional positive regard in academic and psychological circles. Fred Rogers, aka Mr. Rogers, who you could be forgiven for confusing with Carl Rogers, embodied this attitude in his heart-melting quote “you don’t need to do anything sensational for people to love you.”

The concept is simple, regard people positively, and don’t make your best regards conditional on anything. It’s about accepting people despite their faults and loving people no matter who they’ve become. 

Unconditional Positive Regard is an attitude. It can be applied in a range of settings and relationships. Parents to children, teachers towards students, scientists towards a research subject that is tripping on mushrooms, and from Carl Roger’s perspective, a therapist towards their clients. By 2010, the mental health benefits of incorporating unconditional positive regard into therapy had become clear.

But there seems to be an uncomfortable contradiction at the heart of practicing unconditional positive regard as a therapy. How can you think exclusively good things about a person when your goal is to change them? How could there not be a clear acknowledgment of another person’s shortcomings? 

According to Rogers, there’s a simple answer: separate the person from the behavior. People can suck, but something more fundamental within them is still loved. The goal is to remember that a singular manifestation of ourselves does not define us in our entirety. To be clear, the goal is not to think that our kids or co-workers or clients are perfect, just that they are people, and that beneath the surface of misbehavior lies a human who is desperately grasping for the same things anyone is.

The other challenge with positive regard is bringing it into our personal lives. How can we transcend the emotional traps of sibling rivalries, parental neglect, and disobedient children? When our fates are so thoroughly entwined with the behaviors of another person, how can we genuinely have empathy when they do us wrong? 

One of the difficult truths I’ve had to accept about mental illness in my own life is that people who are suffering are often hard to be around. At the heart of mental-health stigma is a devastating reality: depression and anxiety are often paired with hostility or the withholding of a broiling resentment. Often the times that people need help the most are the same times when people are the least approachable. How can we maintain a positive attitude towards our friends and family when met with such vitriol?

The answer, in my view, has to involve humility. Before we can empathize with the suffering of someone we love, we need to know what it’s like to suffer ourselves. More simply, we need to recognize that we all suffer. To regard others with unconditional positivity, we need to recognize that when it comes to important things, most people have no clue what they’re doing, rather, that we have very little clue what we’re doing.

But feeling it is one thing, and expressing it is another. Without the courage to be vulnerable, all that humility isn’t worth anything. Somehow, we need to try and transcend our social-media-mandate to share only our accomplishments, only our sparks of genius and beauty (says the person sharing a piece of writing he spent hours on). Only if we’re willing to be vulnerable, to expose our insecurities to the people whose affection we most desperately want, can be taken seriously when we express unconditional positivity.

I frequently receive emails from men repeating a familiar complaint. Why do women always fall for jerks? Why do they always overlook nice guys, like me?

“Nice guys finish last” is a saying so deeply embedded in our culture that many of us accept it without question. But when it comes to dating at least, research shows it isn’t true. Studies of heterosexual women’s dating preferences show that kindness is an asset, not a liability.

In a fascinating study published in the journal Sex Roles, researchers had women play a dating game where they could chose between two men, “Todd” and “Michael.” The women saw the men’s pictures and read the answers that both men gave to various questions. Then they selected which one they preferred.

When conducting their evaluations, every woman in the study saw the same picture and answers depicting Michael, who was presented as a fairly plain man who gave inoffensive middle-of-the-road answers to the questions. But there six different versions of Todd. For half the women, Todd’s picture was very handsome; for the other half his looks were on a par with Michael’s. (Studies like these use surveys to find a rough consensus on which pictures people find attractive.) There were also three different Todd personalities revealed by the answers to the questions—“nice Todd,” “neutral Todd,” and “jerk Todd.”

By examining which versions of Todd the women preferred to Michael, they were able to answer the age-old dating question: what matters more, looks or personality?

Not surprisingly, handsome and nice Todd was the clear winner. All other things being equal, the study revealed that being good-looking provides a distinct advantage when dating. I know—shocker.

But being good-looking was not as important as being nice. When Todd had a nice or neutral personality, women preferred handsome Todd over Michael. When handsome Todd had a jerky personality women were not swayed by good looks; they opted for plain-looking Michael instead. “Being attractive made Todd a more desirable partner when he was nice or neutral, but it was still a huge disadvantage when he was a jerk,” the researchers wrote.

The study revealed some other interesting things about how women perceive niceness. The women also rated “nice Todd” as being more intelligent and more easygoing than Michael. Nice Todd was seen as just as exciting and funny as jerk Todd (though less than neutral Todd). “Generally, the nicer Todd was portrayed, the more desirable he was perceived,” the researchers wrote.

A later study published in Evolutionary Psychology reveals similar findings. In that study, researchers found that women considering men for long-term relationships valued altruism more than physical attractiveness. Women looked at pictures of men with varying degrees of attractiveness alongside scenarios that showed the men behaving altruistically or not. When given the choice between a less attractive man who was altruistic or a more attractive man who wasn’t altruistic, more women chose the nicer, less hot guy. “This suggests that if a man possesses only one of these traits, it is altruism that is more valuable, particularly for LT relationships,” say the authors, who note that the altruism effect didn’t work when women considered short-term relationships.

The upshot: If you’re a man seeking a long-term relationship with a woman, being conventionally good-looking always helps. However, it is less important than being kind. And the great news is, being nice doesn’t require winning any kind of genetic lottery. Kindness is a choice you can always make, a quality you can continue to cultivate and grow.

Sara Eckel is the author of It’s Not You: 27 (Wrong) Reasons You’re Single. You can get a free bonus chapter of her book at saraeckel.com. You can also find her on Twitter and Facebook. Ask her questions here.

The post Looks Matter to Women, But Kindness Matters More appeared first on eharmony Advice.

There is a book I love by Lauren Winner. It’s called Still: Notes on a Mid-Faith Crisis, and is about the ways she drifted from faith and found it again, slowly and differently, in the year after her mother died and her married ended. When I think about being single at Thanksgiving, I think about one small essay from this book. She is celebrating Thanksgiving with her family just a couple of weeks after she has moved out of the house she and her almost ex husband shared. There have been deaths and illnesses and some hard things in the family, besides her own hard time. She brings a poem to read. It is this one, by W. S. Merwin:

Thanks

Listen
with the night falling we are saying thank you
we are stopping on the bridges to bow from the railings
we are running out of the glass rooms
with our mouths full of food to look at the sky
and say thank you
we are standing by the water thanking it
standing by the windows looking out
in our directions

back from a series of hospitals back from a mugging
after funerals we are saying thank you
after the news of the dead
whether or not we knew them we are saying thank you

over telephones we are saying thank you
in doorways and in the backs of cars and in elevators
remembering wars and the police at the door
and the beatings on stairs we are saying thank you
in the banks we are saying thank you
in the faces of the officials and the rich
and of all who will never change
we go on saying thank you thank you

with the animals dying around us
taking our feelings we are saying thank you
with the forests falling faster than the minutes
of our lives we are saying thank you
with the words going out like cells of a brain
with the cities growing over us
we are saying thank you faster and faster
with nobody listening we are saying thank you
thank you we are saying and waving
dark though it is

She loves this poem, loves the idea that humans continue to say thank you even when everything is hard and going wrong and things are actually very tragic. She hopes that her family will think these things, too, in fact, she is waiting for them to applaud her choice, but then her aunt says: “Well, that was bleak” and everyone goes back to eating their pie.

I think what I love the most about this short essay is simply this: it’s a lovely idea to talk about being thankful in all things, in the face of muggings and hospitals and seemingly endless evenings alone when you would rather not be. But sometimes it just sucks, and those times often correspond to the holidays when it seems like everyone has someone except you. Sometimes, we don’t have to pull out our gratitude journals and wrack our brains for what we’re thankful for. Sometimes, it’s just bleak.

You have other things in your life, of course, and I’m guessing you’re even thankful for them most of the time. But this year, I’m giving you a pass. This year you don’t have to be performative about how okay you are. This year, it’s okay if you don’t feel like being thankful for another year in which you don’t have to fight anyone for leftovers. Sometimes singleness is just bleak. Sometimes it isn’t beautiful and redemptive. Sometimes it’s just hard.

The other thing I love about that essay is that sometimes you really are in that space where you can see the beauty in the hard things. This poem serves as a wonderful reminder that the human spirit is indomitable. One person’s bleak can be another person’s place of wonder. It all depends on the timing. It all depends on where you are in the process. This year, just be where you are. Sometimes that is enough to be thankful for.

About the author: Cara Strickland writes about food and drink, mental health, faith and being single from her home in the Pacific Northwest. She enjoys hot tea, good wine, and deep conversations. She will always want to play with your dog. Connect with her on Twitter @anxiouscook.

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Consent is now a word trending on social media and for good reason. The #metoo movement looms large as people are speaking out about sometimes decades old boundary violations that may have been mildly intrusive on one end of the spectrum, such as an unwanted platonic hug, to sexual in nature. Regardless of the language you speak, the four words used in the title of this article are essential to learn in order to safely navigate the relationship waters.

Dictionary.com defines consent in this manner:

as a verb (used without object) – “to permit, approve, or agree; comply or yield”

as a noun – “permission, approval, or agreement; compliance; acquiescence” or as “agreement in sentiment, opinion, a course of action.”

And it defines boundaries as “something that indicates bounds or limits; a limiting or bounding line.”

Consent is a broader topic that extends beyond touch. It relates to any aspect of human interaction. If someone asks you if they may borrow your car, you have three choices. You can say yes, you can say no, or you can ask for time to consider your options. The response you offer may be a direct correlation to what you were taught about your freedom to make your own call on anything asked of you. You are also at liberty to change your mind about any decision you make. One key is to re-negotiate your agreement, rather than impulsively pulling the rug out from under the person. Trust and consistency are also components of healthy relationships.

In my work as a therapist, I have sat with many who were not permitted to speak their truth. Saying no often felt dangerous, either physically or emotionally, so they learned to nod, smile and say yes when everything within them was screaming, “no!” It takes courage to stretch beyond those established comfort zones.

Other reasons people say yes is fear of hurting the feelings of others or rejection if they don’t “go along to get along.”

One of my activities is offering platonic touch by consent via the FREE HUGS movement. It was created in 2004 by someone with the pseudonym Juan Mann and since then it has become a world-wide phenom. 

On Valentine’s Day weekend 2014, I took a group of friends to 30th Street Station in Philadelphia for a Free Hugs Flash Mob. In about an hour, I estimate that we hugged a few hundred people. We had our signs and open arms and inquired if people wanted a hug. If they said yes, we shared a moment in time with each other. If they declined, we thanked them and moved on.

One person who approached us was an Iraq war vet who told us that he was the sole survivor of his platoon and that, as a result of survivor’s guilt, he had contemplated ending his life, “Until I met you people. Can I join you?” Of course, through tears, we gave him a sign and he was off to the races. My thought was, “Hugs save lives.”

I was to discover a few months later, how prescient that revelation was. On the way home from the gym on June 12, 2014, I had a heart attack. As part of my cardiac rehab, I walked around Doylestown, PA. What occurred to me was that I could add hugging to the mix since hugs are emotionally heart friendly as well as physically heart healthy. Friends had begun to refer to us as Hugmobsters and I added the tagline Armed with Love, since the word ‘mob’ has negative connotations. One artist friend designed the logo which is a heart with arms and hands. Since then, this mission to help people meet the need for connection across all self-created chasms and divides has taken me to several states (NJ, PA, DE, NY, MD, DC, VA, OR) and two countries (Ireland and Canada).

The ways in which it (no pun intended) touches on the topic of boundaries and consent is that if someone declines a hug, there are other options such as handshakes, high fives, fist bumps or virtual hugs. Some people, for their own reasons are simply not at ease with touch from a stranger. I have many affectionate friends and family members who would not take it to the streets as I do. Since its inception, Hugmobsters has received wonderful media coverage (print, radio and television).

Touch by consent is an important topic to broach at home. In an article entitled, “We Can Teach Kids Consent Without Bringing Sex Into The Conversation,” by Martha Kempner, she focuses on the importance of parents helping their children set body boundaries. Tickling is a good place to start. She describes that amid laughing when her father was doing so, her 4-year-old daughter called out for him to stop. Her words were saying one thing, while her reaction was communicating something else. He responds to her words and immediately ceases. Later in the article, Kempner explains to her older daughter that consent is permission, offered willingly.

As an educator who offers classes that highlight consensual touch, I share, “When children are taught that their bodies are their own and have the right to say yes or no to touch, they experience as a sense of personal strength that they might not otherwise. We teach children about ‘good touch vs. bad touch,’ but the truth is even what we might label ‘good’ may be unwanted. What the child learns is that touch is not offered or expected freely, but rather, coercively. How does that translate into assault? When a child is not empowered to say no to seemingly benevolent touch, how can he or she ward off malevolent contact?

Some adults find it difficult to say no as well and require encouragement. One simple way to explain the concept of consent comes from a video that equates it with tea.

Betty Martin, “a Chiropractor, a Body Electric School trained Sacred Intimate, Certified Sexological Bodyworker, Foundations of Facilitation trainer, and a self-propelled erotic adventurer and intimacy coach,” created a tool called The Wheel of Consent by which people can have a greater understanding of the essential nature of human interaction. She breaks them down into four quadrants: Give, Take, Allow and Receive. Each one brings with it, an opportunity to set boundaries and be fully expressed with regards to the rights and responsibilities of relating.

• What are your current values, beliefs and practices around consent and boundaries?  
• What were you taught about your body and your sovereignty over it, deciding who touches you and how they touch you?
• Who were your role models for respecting healthy boundaries?
• Who modeled unhealthy boundaries?
• Have you chosen which to follow?
• What do you say yes to and what do you say no to in your life?
• Do you ask for your needs to be met, with the growing ability to hear either answer?
• Let’s explore in what ways these have served you and in what ways they have held you back from fully honoring your deepest needs and desires.   
• What would it be like to have healthy and strong interactions with the people in your life in which you could easily say YES to what you want and NO to what you don’t want and realize you have the right to both?

We can all relate to feeling put upon and irritated by some people, but powerless to stop accommodating them. Though we take issue with their behavior, needs, or implicit demands, it’s not so easy to set limits. We may be uncomfortable with conflict and not want anyone to be mad or disappointed. We may feel bad and genuinely want to help, or want to be liked and seen as a good person and team player.  

Using wishful thinking and taking the path of least resistance, we get pulled into repetitive patterns where we feel controlled, build up resentment, and want to escape or act out. People tend to deny or overestimate what they can actually tolerate or do — failing to have realistic expectations of themselves or others — even when it’s predictable how scenarios will play out. Rather than face what’s true and accommodate that reality, we act based on what we think we and others should be able to do — or hope the problem will disappear. 

Further, when we do try to set limits with certain people we still can’t get them to respect what we tell them. Popular misconceptions and even subtle strategic errors can make setting limits a losing battle. The good news is that you can easily become successful – using a method that sidesteps struggle, and puts you in control.

Popular mistakes that cause boundary setting to fail:

1. Telling people what they should do — or not do (and why they’re wrong).

This creates resistance and struggle. Trying to change or manage the other person is not likely to be well-received — or successful, especially when unsolicited and there’s a pattern of problematic behavior. Most people don’t like to be told what to do and why they’re wrong. Or they may not be able to stop.

2. Poor timing/wrong intent: reacting from anger/frustration in the heat of the moment when you’re at your wit’s end.

This “approach” triggers a reaction in kind, escalates and prolongs the situation. It is a desperate attempt to try to force the other person to do something. Turning up the volume sends executive functions offline — further limiting a person’s ability to control themselves or process information.

Limits are different than punishment and are not motivated by, or delivered in, anger. The feelings/motivation behind what we do affects the message received, and determines its impact. 

3. Trying to get people to admit/own up to something or recognize that the limits are for their own good.

This approach creates a control struggle around autonomy inviting argument, debate and resistance/counter force. It is experienced as emotional force: trying to control how the other person thinks or feels — and can also be humiliating. 

4. Saying too much, justifying, over-explaining and being invested in convincing the other person that what you’re saying is reasonable or right.

This approach seems insecure, relinquishes power, diminishes credibility. Allows an opening for opposition or argument. It is associated with needing validation, fear of the other person getting mad, or the misconception that logic works when emotions are at play. Setting limits effectively requires coming from a position of strength (different from dominance/force) — being grounded and emotionally separate from the other person. 

5. Being unprepared — including not factoring in what you already know about how things will realistically play out.

This sets up preventable failure. Or having a plan but not consistently doing what you say you’ll do. Sabotages credibility. Also, intermittent reinforcement increases problematic behavior.

Essential ingredients of effective boundary setting:

1. Tell the other person what you are going to do, not what they should do. You’re only in control of what you do, but what you do can limit the other person. Think ahead, troubleshooting in advance to anticipate predictable resistance/reactions — incorporating this information into your plan.
2. Be firm but dispassionate, clear and concise both when boundaries are established and when enforcing. Introduce limits at neutral times and then calmly, without fanfare, in the relevant moment. No tone, no struggle, no explaining. Minimal effort. Effective consequences stand on their own.
3. Make it about you and your limits — NOT about them or what’s best for them. Stay in your own lane. This works because it’s argument-proof and can’t be refuted.
4. Offer up that you could be wrong. Being “objectively” correct isn’t related to success here. Making it about your opinion or simply what you’re comfortable with or not puts you in charge without imposing anything. Allowing the other person to hold onto their viewpoint prevents a control struggle and is respectful. Easy.

Examples of effective and ineffective limit setting:

1. Your teen wants to go to an unsupervised party.

Mistake scenario:

Teen: (mad) “It’s ridiculous — I’m 16, why do you have to know who I’m with always? I’m not doing anything wrong. You obviously don’t trust me.”

Mom: “I do trust you. But I don’t know what your friends are up to.” (Engaging and trying to convince.)

Teen: “Oh so you don’t trust my friends either.” (eye roll).

An extended debate ensues.

Effective scenario:

Mom: “As a parent I have to respect what I’m comfortable with, right or wrong, I’m just not comfortable with you going to an unsupervised party.”

Teen: “Why do you have to be so paranoid?”

Mom: “Maybe I do worry too much/am old fashioned but, as a parent, I have to do what I think is right in good conscience/can live with.”

2. You spouse, teen, or anyone sounds irritated upon contact:

Mistake:

Parent or spouse approaches Cody…

Cody: “WHAAAAAT…” (irritated, annoyed)

Parent or spouse: ”Why are you always so disrespectful/in a bad mood?  I’m pretty nice to you. You don’t hear me answering like that.” Argument ensues. (Guilt trip, provocative)

or

“Forget it, I’m not going to tell you.” Cold shoulder. (Passive-aggressive, creates ongoing tension, negative vibe continues longer.)

Effective: 

(Neutral tone) “Oh sounds like you’re in a bad mood/having a bad day. Text me later when you’re around and it’s a better time.” Walk out/hang up. 

3. Finding yourself pulled into a deteriorating conversation with your partner:

Mistake: 

“Why are you always yelling?”

“Stop talking, I can’t take it.”

“Why are you denying being mad?”

Walks out  — without saying anything. (Provocative, passive-aggressive)

Effective: 

“I’m taking a break from this conversation. We can continue later.” Calmly walk out. (Trusts instincts and avoids engaging but provides reassurance that you’re not bailing or abandoning.)

“I’m not comfortable talking now. I’ll come back/Let me know later when you want to connect.”

4. Co-worker who asks for help a lot or engages you in unwanted conversation:

Mistake:

Co-worker: “Hey — I got this email …”

Linda: (Engaging but being unfriendly, not saying much.) “Hmmm…” (Too indirect, still depleting, doesn’t solve the problem.) 

Linda: “I’m on deadline right now.” or “I don’t feel well today.” 

Co-worker: “Oh that’s ok, can you help me afterwards tomorrow?”

Effective:

“I’m at my capacity limit and need to focus my time/energy on my own work.”

“I can’t really concentrate in these conversations because I’m distracted by having to do my work.”

“I’m not going to respond anymore because I have to concentrate on my work.”

“Sorry — can’t help. I need to focus on/spend all my time on my own work from now on.”

5. Intrusive or needy family member/relative/friend who thinks you’re on call.

Calling or texting repeatedly, the intrusive person asks, “Why aren’t you answering my texts/calls???” 

Mistake:

Sam: “I’m busy.”

Intrusive person: “Where were you before?”

Sam: “At the gym.”

Intrusive person: “Oh so I guess you have time to exercise then.”

Sam: “Well I need to be healthy…”

Intrusive person: “Well so do I but….”

Effective: 

“When I don’t answer just know it means I’ll get back to you when I can.”

“I’m limiting screen time, text, email, phone so it may take a while for me to get back.”

“I’m actually off my phone at work now so I won’t be responding then.”

Boundary setting is challenging. Most people have difficulty and, without a  strategy, resort to repeating the same tactic when unsuccessful, trying harder, or giving in. Another common obstacle is  feeling it’s mean or selfish to set limits, but it’s actually hurtful not to. Boundaries protect relationships — allowing us to put our own oxygen mask on first, rather than be disingenuous, set ourselves up to become resentful, and then want to escape. With the tools to be successful, you can now take charge.

As a therapist, I am a keen observer of human behavior and interactions. I have long been fascinated by what makes people tick. Sometimes I am in awe of the altruism and generosity I witness and sometimes shake my head in disappointment, when those who have the capacity to help don’t always. Then again, I freely admit my biases and judgements, so if this resonates with you, it is not meant to shame, but rather to call on a common humanity.

A few years ago, my friend Ondreah and I were on our way to an event at one of our favorite retreat centers called Mt. Eden, as I steered my Jeep into a gas station once we crossed the bridge that brought us from Pennsylvania to New Jersey. Anyone who lives in the Keystone State knows that the Garden State boasts gas prices that can be as much as 20 cents a gallon cheaper. As the attendant was pumping the gas (there are no self-serve gas stations there, hence the bumper sticker that reads “Jersey girls don’t pump their own gas.”), I noticed a bare-chested man wearing shorts, stumbling in the street and then collapsing. It was a scorchingly hot summer day, so his plight felt more immediate. I dialed 911 and described the scenario. I was transferred to a local dispatcher and once again described what I was witnessing playing out before my eyes.

By this point, the man had rounded the corner facing the bridge and literally stepped in front of a car that was stopped and draped himself across the hood and then slid back down to the street. Carrying the phone, I walked toward him and at the request of the police officer, I handed my phone to the bridge guard and I leaned down to speak with the man who identified himself and declared that he was drunk. I could hear a siren in the distance, heralding the arrival of help. Then, I walked back to the car and we were on our way.

A short while after we arrived at the gathering, I ran into someone I knew, and I described what had transpired. His response surprised me. He replied that it would have been ok either way — whether or not I chose to help. I was incredulous. I was taught by my parents that if someone was in need and you could help, it was your role to do so.

I remember many years ago, again at a gas station (I see a pattern developing here) in a rather dangerous neighborhood in Philadelphia, I witnessed someone being robbed. Back then, there weren’t cell phones, so I found a pay phone and called the police from there.

I believe that we are not responsible FOR each other, but rather, TO each other. We live on this island Earth together. How is it possible for someone to walk away if they are able to lend a hand? If I couldn’t intervene directly, I would always seek someone who could.

Remember Kitty Genovese? The following excerpt is from an article in the New York Times written by Martin Gansberg on March 27, 1964:

For more than half an hour 38 respectable, law-abiding citizens in Queens watched a killer stalk and stab a woman in three separate attacks in Kew Gardens.

Twice their chatter and the sudden glow of their bedroom lights interrupted him and frightened him off. Each time he returned, sought her out, and stabbed her again. Not one person telephoned the police during the assault; one witness called after the woman was dead.

The above reported events are true and took place on March 14, 1964.

The brutal murder of Kitty Genovese and the disturbing lack of action by her neighbors became emblematic in what many perceived as an evolving culture of violence and apathy in the United States. In fact, social scientists still debate the causes of what is now known as “the Genovese Syndrome.”

When witnesses were questioned about why they didn’t call the police, the answers ranged from thinking it was a lovers’ quarrel, to fear for their own safety, to simply not wanting to get involved.

Since then, it has come to light that the number was exaggerated. My take is that whether it was 38 or 8, it is our social responsibility to help if we can.

The truth is, I’m no hero and there were other people who eventually gathered around the man on the bridge and picked him up and got him to safety on the grass while awaiting the ambulance. I was glad to see that as well. We are all in this together and my choice will always be to exercise my social responsibility.

An experience that hits closer to home unfolded over the past few weeks. A college friend with whom I had shared an apartment in my 20s reached out to me. She found herself in dire straits and knowing that I have what I call my ‘social worker’s rolodex brain’ of resources, she contacted me as we brainstormed ways of helping her through it. I had many suggestions that one by one, she checked off as having already done them, and, sadly, she discovered that she fell through the cracks of the system. The next step was to set up a GoFundMe page to ask for financial assistance. We spent time crafting what I thought was a clear and powerful message:

As a professional woman in the health care field, I spent much of my life taking care of others. Now I find myself in the distressing position of needing help. 

It was a cascade of events that led me to my current situation. I am homeless and unemployed. I am using a walker to get around since being in a few accidents and the cumulative effect of lifting patients. I have attempted to utilize the social service system in Florida, to no avail. I am not eligible for them. I am also medically compromised and in pain.

I have been in touch with an organization that may be able to help me with permanent housing.

What I am asking for is some financial assistance to get me over the hump of living in my vehicle, until I can get something more stable.

I am grateful for whatever you can offer.

She requested what was not a huge amount of money and, with the number of people we both know, we imagined that the response would be filled easily and quickly. Not so. Three out of thousands of people donated to the campaign. I had sent money prior to creating the page. I consider what many frivolously spend money on without thinking twice. For the price of a cup of coffee and donut, if each person who saw it made a donation, she would be well taken care of. Although I can only be responsible to my own choices and can’t legislate anyone else’s conscience, I feel disappointed.

I asked her if she had contacted friends directly and she told me, “I spoke with a couple of people this week and the mirror effect may be happening here, it’s scary for people to acknowledge that someone on their tribe/circle is actually experiencing this.”

Call it the ‘mirror effect,’ or ‘bystander syndrome,’ by which people think the other person will help, my question is how to help people get past this and not use it as a reason to allow for suffering and struggling when the means to help are at our disposal.

When contemplating that query, I consider this song “What Must Be Done” by Brother Sun:

I learned as a child there are two ways to see,
the world as it is and the way it should be.
Some people say that’s just not my problem,
some people do what must be done.
They see the hole in the fabric that must be sewn.
They see the way blockaded and they roll back the stone.
They see the day beyond the horizon
and they do what must be done.