7 Signs Complex Trauma Is Impairing Your Relationship


Have you had dysfunctional relationships? Complex trauma may be to blame.

Key points

  • Years after wounding events, someone with complex PTSD might have trouble finding and keeping loving and fulfilling romantic relationships.
  • Because complex trauma happens cumulatively over a long time, it’s sometimes hard to identify.
  • Happy, healthy relationships are possible even when one has complex PTSD, but not until the trauma is processed and healed.
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When a person is exposed to multiple traumatic events over a long period, they can develop complex post-traumatic stress disorder. Unlike typical PTSD, which can be triggered by a single traumatic event, such as a car crash or an assault, complex PTSD is the result of many traumatic events, often of an interpersonal nature, spread out over time but often occurring during childhood or adolescence. Witnessing the illness or death of a caregiver, abuse or neglect by caregivers, or frequent exposure to violent or chaotic situations can result in complex trauma. Years after these wounding events, someone with complex PTSD might have trouble finding and keeping loving and fulfilling romantic relationships and have no idea that complex trauma is the reason why.

Because the trauma happened cumulatively over a long time, it’s sometimes hard to identify that it is to blame for one’s unhappiness. If you have experienced a series of dysfunctional romantic relationships, often feel dissatisfied with your romantic partners but can’t pinpoint exactly why, or have frequent unsatisfying sex with many partners, complex trauma may be to blame.

Here are seven signs that complex trauma is the reason why your romantic relationships aren’t working out.

1. You are always worried that your partners are going to leave you.

Constantly feeling insecure in a relationship is common among people with complex PTSD. Multiple major upheavals in childhood or having caregivers who were sometimes very loving and attentive and sometimes unavailable or aloof can lead to an anxious attachment style in adulthood and trigger a constant fear that your partner will leave you.

2. You act “needy” or “clingy.”

If a partner has ever described you as “needy or “clingy,” you might have complex PTSD. Because you are afraid of being abandoned, you cling intensely to your partner, and this behavior can eventually drive your partner away, thus fulfilling your fear of being abandoned. This pattern can last for years until you recognize and process the trauma that lies behind your behavior.

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3. You are hypersensitive or hypervigilant.

If you feel hypervigilant to signs of trouble, or you are hypersensitive to slights even when you’re in a stable relationship with a loving partner, you might have complex PTSD. If you feel anxious or on edge most or all of the time when you’re in a relationship, and this pattern continues through multiple relationships, it might be time to seek treatment for complex trauma.

4. You never have long-term relationships.

If you like the idea of being in a long-term relationship, but you constantly find yourself ending relationships abruptly or are never with one person for very long, you may have an avoidant attachment style caused by complex PTSD. If you experienced childhood neglect or rejection by your caregivers, you might reject others to save yourself from being rejected. This “you can’t hurt me if I hurt you first” attitude is devastating to your chance at love.

5. You often feel agitated or antsy in a relationship.

If emotional intimacy makes you feel like you want to run for the hills, or if a long-term commitment feels like a threat to your sense of self, complex PTSD may be affecting your relationships. This behavior will keep you from ever getting close enough to a romantic partner to form the type of healthy bond that long-term love requires.

6. You have a hard time trusting romantic partners.

If you experienced abuse or neglect or lived in a chaotic environment as a child, you may have a hard time trusting your romantic partners. This is especially true if the caregiver you loved was also a source of the trauma you experienced. As an adult, you may crave closeness but then push it away when it appears. This is a sign of an anxious-avoidant attachment style caused by complex trauma.

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7. You often say yes to sex even when you don’t want it.

If you frequently find yourself agreeing to sex or initiating sex even when you don’t feel sexual desire, you may have complex PTSD. You might do this because you crave immediate feelings of closeness, or you find that sex dulls other negative emotions. Then, when the physical intimacy is achieved, you may abruptly pull away, potentially ending a romantic relationship before it’s had the chance to begin, and you move on to a new partner. This is a sign of an anxious-avoidant attachment style triggered by complex trauma.

The above are just some of the ways that complex trauma can impair your relationships. Happy, healthy relationships are possible even when you have complex PTSD, but not until you process it and heal. First, you must recognize that the troubles you are experiencing in your romantic life aren’t the fault of your partners or your current situation but due to events that occurred years or even decades earlier.

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Beyond Happiness: A Psychologically Rich Life Is a Good Life


What we get from psychological richness that happiness does not provide.

Do you think a good life is a happy life? A meaningful life? It can be. But there is another dimension of the good life that, until now, has been vastly underappreciated. In an important article just made available online at Psychological Review, “A psychologically rich life: Beyond happiness and meaning,” Shigehiro Oishi of the University of Virginia and Erin C. Westgate of the University of Florida show us that psychological richness is the kind of wealth that can contribute to a truly good life.

Oishi and Westgate define a psychologically rich life as “a life characterized by a variety of interesting and perspective-changing experiences.” They are not trying to tell us what should count as a good life. Instead, they are asking what kinds of ideal lives people imagine for themselves, and a psychologically rich life is one of the kinds of lives that people desire.

Happy lives, meaningful lives, and psychologically rich lives have some things in common; you don’t necessarily have to choose. But a psychologically rich life is distinct from those other two kinds of good lives.

What Are the Characteristics of a Psychologically Rich Life?

Three key characteristics of a psychologically rich life are variety, interestingness, and perspective-changing experiences. The “Psychologically Rich Life Questionnaire” taps those characteristics.

  • Variety: “My life has been full of unique, unusual experiences.”
  • Interest: “I have had a lot of interesting experiences.”
  • Perspective changes: “On my deathbed, I am likely to say ‘I have seen and learned a lot.’”

The characteristics of a happy life are very different, and include comfort, security, and joy. The characteristics of a meaningful life are different, too, and include significance and purpose.

Personality: What Kinds of People Lead Psychologically Rich Lives?

At least three personality characteristics typify people who lead psychologically rich lives:

  • They are curious.
  • They are open to experience (e.g., they have unconventional attitudes, artistic sensitivity, intellectual curiosity, flexibility, depth of feeling).
  • They experience emotions intensely, both positive and negative ones.

It is not enough just to experience intense emotions. You also need to think about those emotional experiences and try to make sense of them.

Personal growth, autonomy, self-acceptance, purpose in life, and positive relations are also associated with a psychologically rich life. The authors suggest that people leading psychologically rich lives do not just hang out with the same person or persons all the time or pursue one goal in just one domain of life.

People leading psychologically rich lives also tend to be more liberal. “Those leading happy and/or meaningful lives tend to prefer to maintain social order and the status quo,” Oishi and Westgate note, “whereas those leading psychologically rich lives seem to embrace social change.”

What Facilitates a Life of Psychological Richness?

Do you want to have a happy life? It will help if you have resources such as money, time, and relationships (in the broad sense of the term, not just romantic ones). Want a meaningful life? Having moral principles, relationships (in the broad sense), and consistency might help.

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If you want a psychologically rich life, it will help to have curiosity, time, energy, and spontaneity.

Certain kinds of life experiences are associated with a psychologically rich life. They include:

  • Spending a semester abroad, or just taking short trips in your everyday life
  • Challenging or dramatic life events

That last one is one of the more intriguing and unique experiences that can contribute to a psychologically rich life. People who have experienced catastrophes and tragedies might not say that their lives are happier as a result, but their lives probably would be psychologically richer. Divorce, for example, can be painful—but it can also change your perspective in a way that can be psychologically enriching.

What Do You Get Out of a Psychologically Rich Life?

People who lead happy lives get personal satisfaction. People who live meaningful lives get to contribute to society. People who live psychologically rich lives are rewarded with wisdom. For example:

  • They have a depth and breadth of knowledge.
  • They have complex reasoning styles.
  • They consider multiple causes for other people’s behavior.
  • They realize that what they know isn’t definitive and isn’t universal.

This wisdom, the authors believe, comes from the many different kinds of life experiences of people who lead psychologically rich lives, experiences that introduce them to different perspectives and show them life’s complexities.

In their day-to-day lives, people who lead psychologically rich lives engage in some novel activities, and not just routine ones. As students, they take more challenging courses and they care about actually learning things, and not just getting good grades.

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On their deathbed, the people who led happy lives might say, “I had fun!” People who led meaningful lives might say, “I made a difference!” People who led psychologically rich lives might instead say, “What a journey!”

Global Perspectives: The Good Life, in 9 Nations

Oishi and Westgate wanted to test their ideas in a variety of countries. They asked people in nine nations—India, Singapore, Angola, Japan, South Korea, Norway, Portugal, Germany, and the U.S.—to describe their ideal life. Then they asked them to rate that life on happiness, meaningfulness, and psychological richness (e.g., eventful, interesting). People in all nine nations typically rated their ideal lives as high on all three dimensions.

What if they had to choose just one? Happiness was the most popular choice in every country. Meaningfulness was next. Still, a nontrivial percentage of people in each nation, between 7 percent and 17 percent, said that they would choose a psychologically rich life, even at the expense of a happy life and a meaningful life.

Are Single People Especially Likely to Lead Psychologically Rich Lives?

The authors never compared people of different marital or relationship statuses in the studies they described. They did, however, mention this:

“According to Kierkegaard, a married person with a secure, well-respected job and children may have a happy and (in many respects) meaningful life, but not necessarily a life rich in diverse perspective-changing experiences. Although most people choose such a conventional, secure, and well-respected life, others… choose the esthetic wanderer’s life instead—unconventional, unstable, and uncompromising.”

Several of the characteristics and experiences of people who lead psychologically rich lives have also been linked to staying single or liking single life. For example:

  • Open-minded: In “The badass personalities of people who like being alone,” I reviewed multiple studies showing that people who like spending time alone, and people who are unafraid of being single, are more likely than others to be open-minded.
  • Personal growth: In a study of adults at midlife, more than 1,000 people who had always been single were compared to more than 3,000 people who had been continuously married. The people who stayed single, compared to those who stayed married, reported experiencing more personal growth. They were more likely to agree with statements such as: “For me, life has been a continuous process of learning, changing, and growth.”
  • Autonomy: In the same study, the people who had stayed single were more likely to agree with statements such as “I judge myself by what I think is important, not by the values of what others think is important.” In response to questions on the Single at Heart quiz, people who are single at heart are more likely to describe themselves as self-sufficient, as having personal mastery, and as wanting to make their own decisions about matters both small and large.
  • Adventurous: People who are single at heart may be especially likely to pursue their dreams. That could mean pursuing adventures or other intriguing opportunities, or choosing meaningful work over more lucrative work when they can’t have both, or being there for the people who mean the most to them.
  • They don’t put just one person at the center of their lives: By definition, people who are single at heart do not organize their lives around a romantic partner. They spend time with, and care about, the people they find valuable, without automatically prioritizing a romantic partner or a potential partner.

Can we conclude from the research that single people lead psychologically richer lives than people who are married? I don’t know about single people in general, but my own hypothesis is that people who choose to be single for positive reasons, such as the single at heart, would tend to experience more psychological richness in their lives.

The Biggest Mistake After a Relationship Breakup


Positive coping after a breakup requires consideration of the purpose of loss.

Key points

  • Starting a new serious relationship too soon after a long-term relationship ends can have many negative emotional consequences.
  • Starting a new relationship too soon indicates an attempt at avoidant coping, which is a dysfunctional strategy.
  • Reflecting on one’s part in co-creating a dysfunctional relationship and relearning how to live singly are key to effective healing from loss.

Because every relationship and every personality are different, there’s no ideal or correct way to manage a breakup. Breakups are inevitably painful and complex because they involve a loss and a host of complex and sometimes contradictory emotions. While there’s no psychologically healthy way to avoid negative feelings post-breakup, there are behaviors that can make the emotional experience even more difficult. Specifically, starting a new serious relationship too soon after a long-term relationship ends can have many negative emotional consequences.

Based on anecdotal data of having counseled individuals and couples for many years, in addition to receiving extensive clinical training and researching relationship dynamics for many years, individuals often move on too soon after a serious relationship ends. On a commonsense level, the motivation to replace a lost relationship with a new one is understandable. Losing a relationship is painful not only because of the associated symbolic and emotional losses but also because of the disruption and loss of so many shared behavioral routines.

Starting a new relationship too soon indicates which type of coping strategy?

The motivation to start a new relationship is often an attempt at emotional avoidance. Rather than confront uncomfortable feelings, an individual propels himself or herself into a relationship for a quick mood and ego boost. Avoidance as a strategy, however, is dysfunctional because it is impulsive, born out of childlike wishes and fantasies as opposed to the thought-through, long-term thinking and planning that should characterize adult decision-making.

What is the purpose of the time period after a breakup?

Having an action plan for coping makes relationship dissolution more manageable, and one’s action plan should include consideration of purpose. In particular, the time post-breakup has one primary purpose: to grieve the loss that occurred and to learn from it.

As a practicing psychologist, I’ve heard many individuals say they didn’t need much time to heal because the grieving process started long before the official end of their relationship. Put another way, they would say they already mourned the loss of the relationship while they were technically in it. That argument has some validity; it’s true that sadness and disappointment typically precede the formal end of a relationship for months or even years, and that the subtle awareness that the relationship is ending accumulates to the point of actual termination. Yet the argument doesn’t account for the need a person has to learn to be happy enough on one’s own – without needing or depending on another love interest to make them feel good and valued.

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Your responsibility in the relationship ending.

The most helpful practice anyone can engage in post-breakup is to reflect on what they did or did not do that contributed to the relationship disintegrating. This framework does not ask what you did that caused the end, but rather what you may have done to help co-create a dysfunctional relationship that ultimately ended.

Ask yourself the following question: “What did I do in the relationship that contributed to problems in the relationship?” Following that, ask yourself “What are three or four things I will do differently in my next relationship to be a better partner?”

If you’ve recently ended a relationship, you may tell yourself that you already know those answers after a month or two of being single. As a practicing psychologist, I can assure you that additional valuable realizations will come at six months, a year, or even further in the future. Those who experience a long-term relationship ending would serve themselves well to go through at least a couple different seasons in the calendar year as a single person before considering looking for a new romantic relationship.

How to practice positive self-talk.

Because positive self-talk (the running internal dialog we have with ourselves) is crucial to mental health, remember to show yourself compassion as you heal from a relationship loss. Take your negative feelings about the breakup and flip the script on them, using what clinicians call cognitive reframing. Tell yourself that the fact that you want a relationship – when you’re ready – shows that you still value emotional attachment and that you weren’t so destroyed by the previous relationship that you gave up on relationships altogether.

The positive point is that you have the capacity and desire for attachment; the change you must make is to be cautious and deliberate in the way you go about seeking that attachment. Taking time to reflect and live comfortably as a single person post-breakup is a far better strategy to find a meaningful connection than jumping into a new relationship quickly, magically thinking that the new one will be better than the last without having done the proper mental work.

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A strategy for seeking healthy companionship when you’re ready.

After many months have passed and one has relearned how to comfortable live singly, casual dating is a wise option for companionship rather than setting out on a course to find the next long-term partner.

With dating, two individuals get their needs met for socialization and playfulness, but they avoid the pressure of long-term emotional contracts. Communicate directly from the start, “I need to date slowly” or “I’m not ready to jump right into a serious relationship.” Limiting the frequency of seeing each other once per week or once every other week may also lead to more successful dating outcomes.

Too often, people see each other too soon and later feel overwhelmed or pressured by the intensity of the new relationship. If dating couples start slowly, two individuals bypass unnecessary pressure and fairy-tale expectations for a future relationship, and lay the foundation for a relationship that can be healthy and lasting.

Borderline Personality Disorder (BPD)


If you have BPD, everything feels unstable: your relationships, moods, thinking, behavior—even your identity. But there is hope and this guide to symptoms, treatment, and recovery can help.

Illustration, bold colors, overlapping faces in profile

What is borderline personality disorder (BPD)?

If you have borderline personality disorder (BPD), you probably feel like you’re on a rollercoaster—and not just because of your unstable emotions or relationships, but also the wavering sense of who you are. Your self-image, goals, and even your likes and dislikes may change frequently in ways that feel confusing and unclear.

People with BPD tend to be extremely sensitive. Some describe it as like having an exposed nerve ending. Small things can trigger intense reactions. And once upset, you have trouble calming down. It’s easy to understand how this emotional volatility and inability to self-soothe leads to relationship turmoil and impulsive—even reckless—behavior.

When you’re in the throes of overwhelming emotions, you’re unable to think straight or stay grounded. You may say hurtful things or act out in dangerous or inappropriate ways that make you feel guilty or ashamed afterwards. It’s a painful cycle that can feel impossible to escape. But it’s not. There are effective BPD treatments and coping skills that can help you feel better and back in control of your thoughts, feelings, and actions.

BPD is treatable

In the past, many mental health professionals found it difficult to treat borderline personality disorder (BPD), so they came to the conclusion that there was little to be done. But we now know that BPD is treatable. In fact, the long-term prognosis for BPD is better than those for depression and bipolar disorder. However, it requires a specialized approach. The bottom line is that most people with BPD can and do get better—and they do so fairly rapidly with the right treatments and support.

[Read: Helping Someone with Borderline Personality Disorder]

Healing is a matter of breaking the dysfunctional patterns of thinking, feeling, and behaving that are causing you distress. It’s not easy to change lifelong habits. Choosing to pause, reflect, and then act in new ways will feel unnatural and uncomfortable at first. But with time you’ll form new habits that help you maintain your emotional balance and stay in control.

Recognizing borderline personality disorder

Do you identify with the following statements?

  • I often feel “empty.”
  • My emotions shift very quickly, and I often experience extreme sadness, anger, and anxiety.
  • I’m constantly afraid that the people I care about will abandon me or leave me.
  • I would describe most of my romantic relationships as intense, but unstable.
  • The way I feel about the people in my life can dramatically change from one moment to the next—and I don’t always understand why.
  • I often do things that I know are dangerous or unhealthy, such as driving recklessly, having unsafe sex, binge drinking, using drugs, or going on spending sprees.
  • I’ve attempted to hurt myself, engaged in self-harm behaviors such as cutting, or threatened suicide.
  • When I’m feeling insecure in a relationship, I tend to lash out or make impulsive gestures to keep the other person close.

If you identify with several of the statements, you may suffer from borderline personality disorder. Of course, you need a mental health professional to make an official diagnosis, as BPD can be easily confused with other issues. But even without a diagnosis, you may find the self-help tips in this article helpful for calming your inner emotional storm and learning to control self-damaging impulses.

Signs and symptoms

Borderline personality disorder (BPD) manifests in many different ways, but for the purposes of diagnosis, mental health professionals group the symptoms into nine major categories. In order to be diagnosed with BPD, you must show signs of at least five of these symptoms. Furthermore, the symptoms must be long-standing (usually beginning in adolescence) and impact many areas of your life.

The 9 symptoms of BPD

  1. Fear of abandonment. People with BPD are often terrified of being abandoned or left alone. Even something as innocuous as a loved one arriving home late from work or going away for the weekend may trigger intense fear. This can prompt frantic efforts to keep the other person close. You may beg, cling, start fights, track your loved one’s movements, or even physically block the person from leaving. Unfortunately, this behavior tends to have the opposite effect—driving others away.
  2. Unstable relationships. People with BPD tend to have relationships that are intense and short-lived. You may fall in love quickly, believing that each new person is the one who will make you feel whole, only to be quickly disappointed. Your relationships either seem perfect or horrible, without any middle ground. Your lovers, friends, or family members may feel like they have emotional whiplash as a result of your rapid swings from idealization to devaluation, anger, and hate.
  3. Unclear or shifting self-image. When you have BPD, your sense of self is typically unstable. Sometimes you may feel good about yourself, but other times you hate yourself, or even view yourself as evil. You probably don’t have a clear idea of who you are or what you want in life. As a result, you may frequently change jobs, friends, lovers, religion, values, goals, or even sexual identity.
  4. Impulsive, self-destructive behaviors. If you have BPD, you may engage in harmful, sensation-seeking behaviors, especially when you’re upset. You may impulsively spend money you can’t afford, binge eat, drive recklessly, shoplift, engage in risky sex, or overdo it with drugs or alcohol. These risky behaviors may help you feel better in the moment, but they hurt you and those around you over the long-term.
  5. Self-harm. Suicidal behavior and deliberate self-harm is common in people with BPD. Suicidal behavior includes thinking about suicide, making suicidal gestures or threats, or actually carrying out a suicide attempt. Self-harm encompasses all other attempts to hurt yourself without suicidal intent. Common forms of self-harm include cutting and burning.
  6. Extreme emotional swings. Unstable emotions and moods are common with BPD. One moment, you may feel happy, and the next, despondent. Little things that other people brush off can send you into an emotional tailspin. These mood swings are intense, but they tend to pass fairly quickly (unlike the emotional swings of depression or bipolar disorder), usually lasting just a few minutes or hours.
  7. Chronic feelings of emptiness. People with BPD often talk about feeling empty, as if there’s a hole or a void inside them. At the extreme, you may feel as if you’re “nothing” or “nobody.” This feeling is uncomfortable, so you may try to fill the void with things like drugs, food, or sex. But nothing feels truly satisfying.
  8. Explosive anger. If you have BPD, you may struggle with intense anger and a short temper. You may also have trouble controlling yourself once the fuse is lit—yelling, throwing things, or becoming completely consumed by rage. It’s important to note that this anger isn’t always directed outwards. You may spend a lot of time feeling angry at yourself.
  9. Feeling suspicious or out of touch with reality. People with BPD often struggle with paranoia or suspicious thoughts about others’ motives. When under stress, you may even lose touch with reality—an experience known as dissociation. You may feel foggy, spaced out, or as if you’re outside your own body.

Common co-occurring disorders

Borderline personality disorder is rarely diagnosed on its own. Common co-occurring disorders include:

When BPD is successfully treated, the other disorders often get improve, too. But the reverse isn’t always true. For example, you may successfully treat symptoms of depression and still struggle with BPD.


Most mental health professionals believe that borderline personality disorder (BPD) is caused by a combination of inherited or internal biological factors and external environmental factors, such as traumatic experiences in childhood.

Brain differences

There are many complex things happening in the BPD brain, and researchers are still untangling what it all means. But in essence, if you have BPD, your brain is on high alert. Things feel more scary and stressful to you than they do to other people. Your fight-or-flight switch is easily tripped, and once it’s on, it hijacks your rational brain, triggering primitive survival instincts that aren’t always appropriate to the situation at hand.

This may make it sound as if there’s nothing you can do. After all, what can you do if your brain is different? But the truth is that you can change your brain. Every time you practice a new coping response or self-soothing technique you are creating new neural pathways. Some treatments, such as mindfulness meditation, can even grow your brain matter. And the more you practice, the stronger and more automatic these pathways will become. So don’t give up! With time and dedication, you can change the way you think, feel, and act.

Personality disorders and stigma

When psychologists talk about “personality,” they’re referring to the patterns of thinking, feeling, and behaving that make each of us unique. No one acts exactly the same all the time, but we do tend to interact and engage with the world in fairly consistent ways. This is why people are often described as “shy,” “outgoing,” “meticulous,” “fun-loving,” and so on. These are elements of personality.

Because personality is so intrinsically connected to identity, the term “personality disorder” might leave you feeling like there’s something fundamentally wrong with who you are. But a personality disorder is not a character judgment. In clinical terms, “personality disorder” means that your pattern of relating to the world is significantly different from the norm. (In other words, you don’t act in ways that most people expect). This causes consistent problems for you in many areas of your life, such as your relationships, career, and your feelings about yourself and others. But most importantly, these patterns can be changed!

Self-help tips: 3 keys to coping with BPD

  1. Calm the emotional storm
  2. Learn to control impulsivity and tolerate distress
  3. Improve your interpersonal skills

Self-help tip 1: Calm the emotional storm

As someone with BPD, you’ve probably spent a lot of time fighting your impulses and emotions, so acceptance can be a tough thing to wrap your mind around. But accepting your emotions doesn’t mean approving of them or resigning yourself to suffering. All it means is that you stop trying to fight, avoid, suppress, or deny what you’re feeling. Giving yourself permission to have these feelings can take away a lot of their power.

Try to simply experience your feelings without judgment or criticism. Let go of the past and the future and focus exclusively on the present moment. Mindfulness techniques can be very effective in this regard.

  • Start by observing your emotions, as if from the outside.
  • Watch as they come and go (it may help to think of them as waves).
  • Focus on the physical sensations that accompany your emotions.
  • Tell yourself that you accept what you’re feeling right now.
  • Remind yourself that just because you’re feeling something doesn’t mean it’s reality.

[Listen: Eye of the Storm Meditation]

Do something that stimulates one or more of your senses

Engaging your sense is one of the quickest and easiest ways to quickly self-soothe. You will need to experiment to find out which sensory-based stimulation works best for you. You’ll also need different strategies for different moods. What may help when you’re angry or agitated is very different from what may help when you’re numb or depressed. Here are some ideas to get started:

Touch. If you’re not feeling enough, try running cold or hot (but not scalding hot) water over your hands; hold a piece of ice; or grip an object or the edge of a piece of furniture as tightly as you can. If you’re feeling too much, and need to calm down, try taking a hot bath or shower; snuggling under the bed covers, or cuddling with a pet.

Taste. If you’re feeling empty and numb, try sucking on strong-flavored mints or candies, or slowly eat something with an intense flavor, such as salt-and-vinegar chips. If you want to calm down, try something soothing such as hot tea or soup.

Smell. Light a candle, smell the flowers, try aromatherapy, spritz your favorite perfume, or whip up something in the kitchen that smells good. You may find that you respond best to strong smells, such as citrus, spices, and incense.

Sight. Focus on an image that captures your attention. This can be something in your immediate environment (a great view, a beautiful flower arrangement, a favorite painting or photo) or something in your imagination that you visualize.

Sound. Try listening to loud music, ringing a buzzer, or blowing a whistle when you need a jolt. To calm down, turn on soothing music or listen to the soothing sounds of nature, such as wind, birds, or the ocean. A sound machine works well if you can’t hear the real thing.

Reduce your emotional vulnerability

You’re more likely to experience negative emotions when you’re run down and under stress. That’s why it’s very important to take care of your physical and mental well-being.

Take care of yourself by:

  • Avoid mood-altering drugs
  • Eating a balanced, nutritious diet
  • Getting plenty of quality sleep
  • Exercising regularly
  • Minimizing stress
  • Practicing relaxation techniques

Tip 2: Learn to control impulsivity and tolerate distress

The calming techniques discussed above can help you relax when you’re starting to become derailed by stress. But what do you do when you’re feeling overwhelmed by difficult feelings? This is where the impulsivity of borderline personality disorder (BPD) comes in. In the heat of the moment, you’re so desperate for relief that you’ll do anything, including things you know you shouldn’t—such as cutting, reckless sex, dangerous driving, and binge drinking. It may even feel like you don’t have a choice.

Moving from being out of control of your behavior to being in control

It’s important to recognize that these impulsive behaviors serve a purpose. They’re coping mechanisms for dealing with distress. They make you feel better, even if just for a brief moment. But the long-term costs are extremely high.

Regaining control of your behavior starts with learning to tolerate distress. It’s the key to changing the destructive patterns of BPD. The ability to tolerate distress will help you press pause when you have the urge to act out. Instead of reacting to difficult emotions with self-destructive behaviors, you will learn to ride them out while remaining in control of the experience.

For a step-by-step, self-guided program that will teach you how to ride the “wild horse” of overwhelming feelings, check out our free Emotional Intelligence Toolkit. The toolkit teaches you how to:

  • get in touch with your emotions
  • live with emotional intensity
  • manage unpleasant or threatening feelings
  • stay calm and focused even in upsetting situations

The toolkit will teach you how to tolerate distress, but it doesn’t stop there. It will also teach you how to move from being emotionally shut down to experiencing your emotions fully. This allows you to experience the full range of positive emotions such as joy, peace, and fulfillment that are also cut off when you attempt to avoid negative feelings.

A grounding exercise to help you pause and regain control

Once the fight-or-flight response is triggered, there is no way to “think yourself” calm. Instead of focusing on your thoughts, focus on what you’re feeling in your body. The following grounding exercise is a simple, quick way to put the brakes on impulsivity, calm down, and regain control. It can make a big difference in just a few short minutes.

Find a quiet spot and sit in a comfortable position.

Focus on what you’re experiencing in your body. Feel the surface you’re sitting on. Feel your feet on the floor. Feel your hands in your lap.

Concentrate on your breathing, taking slow, deep breaths. Breathe in slowly. Pause for a count of three. Then slowly breathe out, once more pausing for a count of three. Continue to do this for several minutes.

In case of emergency, distract yourself

If your attempts to calm down aren’t working and you’re starting to feel overwhelmed by destructive urges, distracting yourself may help. All you need is something to capture your focus long enough for the negative impulse to go away. Anything that draws your attention can work, but distraction is most effective when the activity is also soothing. In addition to the sensory-based strategies mentioned previously, here are some things you might try:

Watch TV. Choose something that’s the opposite of what you’re feeling: a comedy, if you’re feeling sad, or something relaxing if you’re angry or agitated.

Do something you enjoy that keeps you busy. This could be anything: gardening, painting, playing an instrument, knitting, reading a book, playing a computer game, or doing a Sudoku or word puzzle.

Throw yourself into work. You can also distract yourself with chores and errands: cleaning your house, doing yard work, going grocery shopping, grooming your pet, or doing the laundry.

Get active. Vigorous exercise is a healthy way to get your adrenaline pumping and let off steam. If you’re feeling stressed, you may want to try more relaxing activities such as yoga or a walk around your neighborhood.

Call a friend. Talking to someone you trust can be a quick and highly effective way to distract yourself, feel better, and gain some perspective.

Tip 3: Improve your interpersonal skills

If you have borderline personality disorder, you’ve probably struggled with maintaining stable, satisfying relationships with lovers, co-workers, and friends. This is because you have trouble stepping back and seeing things from other people’s perspective. You tend to misread the thoughts and feelings of others, misunderstand how others see you, and overlook how they’re affected by your behavior. It’s not that you don’t care, but when it comes to other people, you have a big blind spot. Recognizing your interpersonal blind spot is the first step. When you stop blaming others, you can start taking steps to improve your relationships and your social skills.

Check your assumptions

When you’re derailed by stress and negativity, as people with BPD often are, it’s easy to misread the intentions of others. If you’re aware of this tendency, check your assumptions. Remember, you’re not a mind reader! Instead of jumping to (usually negative) conclusions, consider alternative motivations. As an example, let’s say that your partner was abrupt with you on the phone and now you’re feeling insecure and afraid they’ve lost interest in you. Before you act on those feelings:

Stop to consider the different possibilities. Maybe your partner is under pressure at work. Maybe he’s having a stressful day. Maybe he hasn’t had his coffee yet. There are many alternative explanations for his behavior.

Ask the person to clarify their intentions. One of the simplest ways to check your assumptions is to ask the other person what they’re thinking or feeling. Double check what they meant by their words or actions. Instead of asking in an accusatory manner, try a softer approach: “I could be wrong, but it feels like…” or “Maybe I’m being overly sensitive, but I get the sense that…

Put a stop to projection

Do you have a tendency to take your negative feelings and project them on to other people? Do you lash out at others when you’re feeling bad about yourself? Does feedback or constructive criticism feel like a personal attack? If so, you may have a problem with projection.

To fight projection, you’ll need to learn to apply the brakes—just like you did to curb your impulsive behaviors. Tune in to your emotions and the physical sensations in your body. Take note of signs of stress, such as rapid heart rate, muscle tension, sweating, nausea, or light-headedness. When you’re feeling this way, you’re likely to go on the attack and say something you’ll regret later. Pause and take a few slow deep breaths. Then ask yourself the following three questions:

  1. Am I upset with myself?
  2. Am I feeling ashamed or afraid?
  3. Am I worried about being abandoned?

If the answer is yes, take a conversation break. Tell the other person that you’re feeling emotional and would like some time to think before discussing things further.

Take responsibility for your role

Finally, it’s important to take responsibility for the role you play in your relationships. Ask yourself how your actions might contribute to problems. How do your words and behaviors make your loved ones feel? Are you falling into the trap of seeing the other person as either all good or all bad? As you make an effort to put yourself in other people’s shoes, give them the benefit of the doubt, and reduce your defensiveness, you’ll start to notice a difference in the quality of your relationships.

Diagnosis and treatment

It’s important to remember that you can’t diagnose borderline personality disorder on your own. So if you think that you or a loved one may be suffering from BPD, it’s best to seek professional help. BPD is often confused or overlaps with other conditions, so you need a mental health professional to evaluate you and make an accurate diagnosis. Try to find someone with experience diagnosing and treating BPD.

The importance of finding the right therapist

The support and guidance of a qualified therapist can make a huge difference in BPD treatment and recovery. Therapy may serve as a safe space where you can start working through your relationship and trust issues and “try on” new coping techniques.

An experienced professional will be familiar with BPD therapies such as dialectical behavior therapy (DBT) and schema-focused therapy. But while these therapies have proven to be helpful, it’s not always necessary to follow a specific treatment approach. Many experts believe that weekly therapy involving education about the disorder, family support, and social and emotional skills training can treat most BPD cases.

It’s important to take the time to find a therapist you feel safe with—someone who seems to get you and makes you feel accepted and understood. Take your time finding the right person. But once you do, make a commitment to therapy. You may start out thinking that your therapist is going to be your savior, only to become disillusioned and feel like they have nothing to offer. Remember that these swings from idealization to demonization are a symptom of BPD. Try to stick it out with your therapist and allow the relationship to grow. And keep in mind that change, by its very nature, is uncomfortable. If you don’t ever feel uncomfortable in therapy, you’re probably not progressing.

Don’t count on a medication cure

Although many people with BPD take medication, the fact is that there is very little research showing that it is helpful. What’s more, in the U.S., the Food and Drug Administration (FDA) has not approved any medications for the treatment of BPD. This doesn’t mean that medication is never helpful—especially if you suffer from co-occurring problems such as depression or anxiety—but it is not a cure for BPD itself.

When it comes to BPD, therapy is much more effective. You just have to give it time. However, your doctor may consider medication if:

  • You have been diagnosed with both BPD and depression or bipolar disorder.
  • You suffer from panic attacks or severe anxiety.
  • You begin hallucinating or having bizarre, paranoid thoughts.
  • You are feeling suicidal or at risk of hurting yourself or others.

6 Steps To Setting Healthy Boundaries With Parents (And What That Looks Like)

Alyssa "Lia" Mancao, LCSW

Growing up, it’s expected for our parents to set rules around curfew, cleanliness, household chores, how to treat others, and establish routines. Parents also set boundaries with their kids in hopes to help them become independent. But things start to get complicated when children grow up into adults, yet the parent struggles with the balance between being a parent and letting their adult child have their own life. If this is an area of tension in your family, here’s what you need to know about setting healthy boundaries with parents.

Why setting boundaries with parents is so important.

Setting boundaries with your parents is important for various reasons: It prevents you from building resentment toward them and promotes healthy, enjoyable interactions, while also helping you further establish individuation—that is, having an identity outside of your relationship with your parents. Without proper boundaries, parents may believe and feel that it is OK for them to be imposing their beliefs and ways of living onto their adult children.

While these conversations can be difficult to have, they are necessary in developing a healthy relationship with them and with yourself. The end result of setting healthy boundaries with your parents can lead to a decrease in anxiety, resentment, improved ability to manage conflict, and healthy self-esteem.

What healthy boundaries with parents look like.

Healthy boundaries with parents involve mutual acknowledgment that you are an adult with your own thoughts, opinions, beliefs, experiences, and needs. It means owning your needs and being able to say no when you want to say no and yes when you want to say yes.

Examples of poor boundaries from a parent might look like:

  • Having unexpected and frequent visits from them
  • Unsolicited input about your partner
  • Unsolicited advice about how you’re raising your children
  • Having them buy things for your home without asking you
  • Frequent comments about your diet or body
  • Interfering in your personal life

Setting boundaries with parents look like:

  • Identifying what your own unique values are, some of which may be different from theirs
  • Being able to act in a way that is consistent with your values and beliefs
  • Being clear on what you need
  • Establishing rules on how you would like to be treated.

How to set boundaries with parents.

1. Be clear and concise.

Before coming to your parents with what you would like for them to adjust, first ask yourself what is bothering you and explore why. Conceptualize the issue. Identifying how their specific behavior makes you feel will help you feel more confident and secure in asking for what you want.

Being clear and concise means being straightforward and stating exactly what it is you need from them without apologizing. Make sure that your request is concrete, coherent, and measurable.

For example, this comment might not go over well: “Please stop dropping by unexpectedly all of the time, because it’s getting really annoying.”

Try this instead: “It is difficult for me when you drop by unexpectedly. Moving forward, can you call first? And remember I can only spend time with you on the weekends.”

The more you practice being concise, the easier it gets.

2. Be assertive and compassionate.

Being assertive involves stating how you feel and what you need without trying to hurt the other person. This includes maintaining eye contact, maintaining a sense of calm, being open to having a conversation, actively listening to the other person, monitoring your tone, having a straight posture, and being direct.

At the same time, being compassionate is also important. This means understanding where your parents may be coming from and understanding the difficulties they may be experiencing in letting go of the role they once had in your life, while also simultaneously honoring your needs. Practicing compassion helps us stay grounded and come from a place of love versus defensiveness.

3. Demonstrate appreciation.

When setting a boundary with your parent, it may help to show appreciation toward what you are grateful for in the relationship, and perhaps the intent behind their behaviors. For example, if you have a parent that ongoingly interferes in your relationship, you can state that you appreciate their concern for you or appreciate that they want what’s best for you, but you also would like for them to stop trying to get involved in your romances because you are capable of making your own decisions. Showing your parents appreciation tells them that you still value them showing up in your life. You just would like how they show up to look differently.

4. Practice the “broken record” technique.

If your parents combat your requests for healthier boundaries, try the “broken record” technique. This is a practice in assertive communication where you do not engage in tangents, arguments, or circular conversation. Rather, you continue to repeat your needs clearly and concisely over and over. This demonstrates that you are sticking to your boundaries and are not interested in engaging in an argument or negotiation about your boundaries.

An example of the broken record technique might look like saying “I am not engaging any further; stop making comments about how I am raising my children” and saying this as many times as you feel comfortable. This technique conveys and reinforces your message without getting into trying to justify why you want certain boundaries in place.

5. Know your limits.

Take the time to be clear about what you are willing to tolerate and not tolerate from them. Where will you draw the line? For example, can you only manage talking on the phone with your parents once a month? Every day? There is nothing wrong with you for wanting to set limits with your parents. This is a healthy part of individuation.

Additionally, if the conversation isn’t going in a direction that is helpful or productive, know when it is time for you to end the conversation. Pay attention to how you are feeling and how much discomfort is healthy for you to tolerate. If you feel like you need a break or walk away from the conversation, it’s important to do so to prevent yourself from getting angry and escalating the conversation.

6. Release any guilt about having boundaries.

Setting boundaries with parents can stir up feelings of doubt, fear, and guilt. In order for us to be able to practice assertive communication and compassion toward ourselves, we have to practice recognizing feelings of guilt around setting boundaries. Guilt can be an indicator that we feel like we are doing something wrong, and it’s important to fully know that setting boundaries with your parents is not wrong. It is just is. Boundaries are an important part in preserving the relationship and building your sense of self.

A practice in releasing guilt can be reciting affirmations like “I deserve to express myself” and “I am allowed to have my needs met.”

At the end of the day, you get to decide your boundaries and your terms. Remind yourself of why you are setting your boundaries, and practice self-validation and self-compassion before, during, and after the conversation with your parents.

Couples and Attachment Differences

https://www.psychologytoday.com/us/blog/living-finesse/202108/couples-and-attachment-differencesTeyhou Smyth Ph.D., LMFT


What do you know about attachment styles in an intimate relationship?

Key points

  • Couples don’t need identical attachment styles to function successfully in a relationship, but knowing how it impacts the relationship can help.
  • Even with two securely attached people, the need for communication and problem-solving is crucial for a healthy relationship.
  • Differing attachment styles may require extra intention and effort to work through problem areas.

When we enter an intimate relationship, whether we have a complementary attachment style to our love interest is not on the radar in the least, but ultimately it is the factor that influences relationships the most.

Couples do not need to have an identical attachment style to function successfully in a relationship but having an awareness of the ways one’s style can impact the relationship increases the odds of satisfaction and longevity.

Attachment develops as a result of nature and nurture. It begins in utero and is influenced by maternal experiences and genetics. It is then impacted during early childhood in the ways caregivers respond to our cries in infancy, how our needs are met, and the way we are treated.

Throughout our lives, relationships with family, friends, and others play into our attachment style, reinforcing or correcting our innate understanding of how other humans respond to us.

Through this collection of experiences and genetic wiring, our attachment style is borne. Attachment styles are classified as secure, avoidant, anxious, or disorganized.

How Couples’ Attachment Styles Impact the Relationship

Two people with secure attachment are likely to have a greater sense of stability in their relationship. Not to say that the relationship will be perfect or without strife, but the baseline ability to trust the process of human relationships is a good indicator for success.

Even with two securely attached people, the need for communication and problem-solving is crucial for a healthy relationship. For couples in which one (or both) people have anxious, avoidant, or disorganized attachment, communication can be difficult.

Communication Issues

Attachment style can impact the way couples communicate, and often it is as much about what is unspoken as what is said aloud. People who struggle with anxious or avoidant attachment styles may read too much into non-verbal communication or make assumptions about their partner’s intent or feelings based on underlying beliefs about themselves.

Someone who has an avoidant attachment style may struggle with confrontation and this can result in resentments and perpetuated miscommunication between couples.

Problems With Trust

Trust is a primary challenge for people with insecure attachment styles. It may not even be obvious that the underlying issue is trust-related, but it manifests in murky ways like not fully investing in a relationship or keeping emotional distance for self-protection.

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More obvious ways trust is affected are through jealousy, insecurity about a partner’s dedication, and feeling preoccupied by self-doubt. Insecure attachment can even contribute to infidelity, as there can be a sense of relationship futility, boredom, and challenges with getting one’s needs met.

Positive Outcomes for Differing Attachment Styles in Relationships

Differing attachment styles in a relationship does not mean imminent doom, it just requires extra intention and effort to work through the problem areas.

Sometimes couples who have attachment differences can experience personal growth because of their work in a relationship, and this can mean greater couple satisfaction and a healthier sense of self-worth.

While no one should enter a relationship with the expectation of healing personal pain, (a setup for failure), sometimes it can become a joint effort and a happy side effect if two people are committed to mutual growth.

Healing Old Wounds

Couples who begin to explore the way their attachment styles affect their relationship may find that it helps reframe a lot of past life events, including prior relationships and lessons learned in childhood.

When individuals are doing their own attachment work within a safe, loving relationship it can offer a lot of healing. The work is two parts; one’s own journey toward exploring self-worth and having a safe place to practice healthy attachment behaviors within a committed relationship.

Learning to Trust

One of the most beautiful aspects of couples growing together and doing attachment work is the mutual trust that can be built.

Learning how to communicate and get one’s needs met effectively, gaining a greater understanding of how attachment directs relationship behaviors, and finding workarounds can disrupt insecure attachment and offer new, healthier experiences.

Even though our innate attachment style is hard-wired, we can make informed decisions about thoughts, feelings, and behaviors that can shape the quality of our relationships with ourselves and others.

Couples who have differing attachment styles may find that the best is yet to come when they are open to exploring attachment togethe

If you’re depressed or anxious, you’re not weak and you’re not crazy — you’re a human being with unmet needs,”


Staying Visible When Your Team Is in the Office…But You’re WFH


July 30, 2021
In an all-remote work environment, everyone’s in the same situation, so it’s a level playing field when it comes to managing your personal brand. But as we shift into a hybrid phase of work, in which many employees are headed back to the office, a new question emerges: if you plan to work remotely full-time or most of the time, how can you stay visible when your in-office colleagues are likely to have far more exposure to the boss, as well as access to casually transmitted information that could prove useful to their careers and promotional opportunities?

For nearly a decade, I’ve researched personal branding at work, and I’ve discovered four key strategies that can help remote workers maintain their visibility and their strong reputation, even when measured against coworkers who are putting in more face time at the office.

Overdeliver to combat the negative assumptions that can come with remote work.

It’s true that the previous stigma against WFH has decreased markedly during the pandemic, as many knowledge workers had the opportunity to try it for themselves. But it’s also probable that leaders may revert to their past frame of reference once they’re back in the office — namely, that employees they can’t directly monitor may well be goofing off. That’s why it’s essential for remote workers to overindex on creating perceptions of rock solid reliability.

This may include reinforcing that you’re meeting or exceeding deadlines. For instance, if your manager has asked you to write a time-sensitive report, you could just send it to them with a simple email — or you could make your contribution more noticeable by writing something like this: “Julie, as promised, I’m attaching the ABC report here. I know the official deadline is Thursday but I wanted to send it over to you early so that we have more time to make revisions if necessary.” This verbiage stops being effective if you use it too often (you don’t want to come across as a brown-noser). But used sparingly, it can draw attention to your ability to deliver in clutch situations. And the short phrase “as promised” is almost always effective in reinforcing that you live up to your commitments.

Fight against the pull toward transactional relationships. 

Colleagues working together in an office have plenty of organic opportunities, from elevator rides to breakroom encounters, to develop a low-key, ambient awareness of each other’s lives (everything from where they last vacationed to what their favorite sports teams are). That information isn’t essential to performing your job, of course, so it’s easy to overlook its importance. But it provides a form of “social glue” that enables you to connect with colleagues beyond the purely transactional format of Zoom calls discussing a particular project or account.

Research has shown that online negotiations are far more likely to be resolved successfully when participants share personal information with one another and thereby create a bond, rather than sticking to “just the facts” of the deal. Similarly, a colleague who feels a personal connection to you is almost certainly more likely to advocate for you when you’re not in the room, or volunteer to help you even when it’s not convenient, as compared to someone with whom you have a more distant relationship.

As a remote worker, you’ll have to think harder about how to engineer these connections; you can’t rely on bumping into someone who invites you to lunch. You’ll likely have to be the initiator, whether you decide to invite colleagues for one-on-one video chats or host a virtual networking event. But the effort is worth it, given the powerful impact of social connections on both your reputation at work and your ability to do your job successfully.

Make yourself physically visible.

Where geographically feasible, try to come into the office occasionally to meet with colleagues and ensure, particularly with new hires with whom you don’t have a previous history, that they can “put a face to the name.”

Similarly, even if your office culture permits online meetings with the video camera turned off, make a point of keeping yours on and ensuring your face is well-lit, with a professional backdrop. This may seem like a minor aesthetic point, and overkill if other colleagues are keeping their cameras off. But if those colleagues are putting in more face time at the office, the people around them have far more data to use (in the form of interpersonal interactions) in forming judgments about them. If you’re working from home full-time, on the other hand, this is the only way you’re connecting with colleagues, so you need to be hypervigilant about how you’re presenting yourself.

Ensure you’re easy to work with.

For obvious reasons, overextended managers appreciate employees who are willing to adjust to their schedules and work around their preferences. As a remote worker, you’re never going to be as accessible as someone sitting 10 feet away whom they can grab when a question arises or a new idea pops into their head — so you’ll need to make yourself easy to work with in other ways.

For instance, it’s valuable to have an explicit conversation about your manager’s communication preferences. Do they find phone calls to be the most efficient way to connect? Or are they an adherent of email, or Slack, or text messages? Make sure you understand how — and when — they expect to be able to reach you, how they’d prefer that you contact them, and their assumptions around response time, including during nights and weekends.

You’ll be far more successful if you understand, and honor, their desired communication style, even if it’s not your natural preference. Your goal is to minimize friction in their ability to connect with you when needed. Similarly, even if your boss hasn’t requested it, it’s useful for you to suggest a regular (perhaps weekly) one-on-one check-in meeting, ideally on video. That ensures you’ll have at least a small amount of direct contact every week, including an opportunity to ask questions, clarify expectations, and keep your boss updated on your progress.

The risk when working from home is that your contributions fade into the background until the point when your boss and colleagues feel that you’re no longer essential to the enterprise. By following these four strategies, you can stay visible and ensure that you’re viewed as a valued contributor who makes a significant impact on your team’s success.

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Emotional Flashbacks: What They Feel Like, And How To Cope With Them


If you’ve ever had a flashback, you’ll know how disorientating and terrifying it can be. Flashbacks are known to be a symptom of post-traumatic stress disorder (PTSD) where the person can literally see and hear the traumatic event as if it were happening again right now. Yet there is also a kind of flashback that may not include visual or auditory aspects, and instead is more of a feeling – as though thrown back into the threatening circumstances from childhood.

Emotional flashbacks are often associated with a diagnosis of complex trauma, or c-ptsd. Complex trauma can occur from ongoing adverse childhood conditions, including abuse, neglect or abandonment – especially if the perpetrator was close to the child (such as a parent or other relative). Complex trauma symptoms can also develop if the child’s parents were busy or emotionally unavailable. It can feel traumatic for children not to receive regular, consistent, unconditional love when they want and need it – and this can create attachment issues that play out in adulthood.

If a child is being abused, neglected or ignored, he or she doesn’t have many options: he or she is too tiny to fight back or tell the perpetrator to stop, so often the response is to freeze, submit or dissociate as a way of coping with something intolerable. Fast forward to adulthood and people with c-ptsd may find themselves triggered and catapulted back to those feelings of being trapped, scared, with no options for escape. That re-experiencing in the here-and-now of those original feelings is an emotional flashback.

What do emotional flashbacks feel like?

An emotional flashback can be triggered by a situation, a circumstance or an event that reminds you exactly what happened to you in childhood. You can feel transported back to those feelings of helplessness and despair, with no safe parental figure around to make it all better.

Psychotherapist Pete Walker, who has written extensively on emotional flashbacks and complex trauma, says: “Emotional flashbacks are sudden and often prolonged regressions (‘amygdala hijackings’) to the frightening circumstances of childhood. They are typically experienced as intense and confusing episodes of fear and/or despair – or as sorrowful and/or enraged reactions to this fear and despair.”

On top of that, people experiencing an emotional flashback can feel lonely and ashamed and humiliated for having those feelings – reinforcing an innate sense that there is fundamentally something wrong with them.

You can feel as powerless and distressed when the original events happened. For example, a woman with c-ptsd or insecure attachment could be waiting to hear from a relatively new partner about a next date, but the text or phone call doesn’t come. The woman may then feel triggered and descend into extreme feelings of abandonment and rejection which may tap into original feelings she had when a parent was meant to pick her up and forgot about her. The woman in the here and now experiences those same childhood feelings – which may be out of proportion to the situation in hand. The woman may act out on these feelings – for example, by making multiple calls to the new partner until they pick up, or by texting the new partner and ending the relationship. She may be taking control, but she may still be re-enacting the original wound. She then feels bad about herself, and this reinforces her belief that she is unlovable.

How to cope with emotional flashbacks

Identify your triggers

Once you begin to recognise the things that trigger you (people, situations, relationship dynamics etc) you can take steps to reassure yourself when you start to become triggered. Awareness is everything.

Talk yourself down

Pete Walker recommends saying to yourself: “I’m just having a flashback. There is no danger here. I am safe.” Act like the wise, protecting parent you may not have had to reassure your scared inner child that you’re OK.

Take deep breaths

Breathing deeply from below the naval into your abdomen over a couple of minutes will bring you back into your body and back into the here and now. Make the out-breath a beat longer than the in-breath for maximum effect.

Soothe your senses

Sensory information around you (from your sight, sound, taste, touch or smell) may be triggering the scared part of your brain and the flashback response. Soothe your senses with something reassuring to look at, music that relaxes you, a scent that transports you to a safe place, or an object you can touch to ground and centre you.

Don’t beat yourself up

You’re not a bad person for having an emotional flashback, or an exaggerated response to a current stressor or trigger. You simply had a moment that took you back to the past. That doesn’t make you a faulty individual.

Think about therapy

Working on an open-ended basis with an experienced therapist will enable you to identify coping strategies for your day-to-day challenges, as well as working with the wounded inner child and helping it to process what happened way back when.

If you’ve been experiencing emotional flashbacks, or other post-traumatic symptoms, you may want to reach out to a therapist for support. At The Awareness Centre we have a team of counsellors, psychotherapists and psychologists offering sessions seven days a week from our centres in Clapham and Tooting. Email us on [email protected] or call 020 8673 4545 for an initial discussion and to book your first appointment.

Karen Dempsey

With a 20-year career in print and online publishing and an MA in creative writing, Karen Dempsey has worked as a journalist, editor and copywriter and has managed large editorial teams. She is a qualified, accredited and practising psychotherapist with an MA/diploma in transpersonal integrative counselling & psychotherapy.
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8 Comments. Leave new

  • Thanks heaps . I think the line between emotional only and what happens when child gets older ie flash back with physical recall will be blurred. Maybe care givers/parents can inflict trama by response to aberant activity between children. What you say to them for such behavior will be taken quite literally. in emotion age recall stage. They probably have issues relating to knowledge beyond years. Such as all the phycological stuff to come from gaining such exparances.


    • Thanks for your comments. We’re pleased to hear our blog post resonated with you. Children can take parents’ comments literally, and what they take on board can hang around and reappear as flashbacks when they’re older. If you’re experiencing them yourself, and they’re becoming an issue for you, then do reach out for professional support.


  • I’ve recently been DX with C-PTSD from long term domestic violence. How do emotional flashbacks take place for this vs the C-PTSD emotional flashbacks for childhood trauma. The latter seems to be the norm that is mostly discussed therefore must be more common for C-PTSD. Do you have an article addressing this side of C-PTSD and emotional flashbacks? Thanks.


    • Hello. Thanks for taking time to read our blog and post your comments. Flashbacks can be incredibly intense and distressing, making you feel you’re right back at the original horrifying event. We’re sorry to hear you’ve been through long-term domestic violence. We haven’t yet created an article that looks at flashbacks and domestic violence, but we will do so in response to your request.


  • Hi it only happens now and then so 3yrs ago my son slammed his bedroom door shut and took my daughters finger off it was horrible but every now and then I see it all again happening it comes back a lot when I see the fire fighters frist responder drive past me or if its parked I see it all and then just cry, how can I stop it and it probley sounds silly.


    • Hi Michelle. This does not sound silly at all. Flashbacks can happen when we haven’t processed an emotional experience that was overwhelming at the time. You may want to reach out for support with a therapist who works with flashbacks and traumatic experiences. Your GP may be a good place to start. Wishing you all the best.


  • I found myself nodding yes a lot while reading this article. I am now dealing with the memories of my childhood popping up here and there. Strange that I didn’t realize it before. Thank you


    • Hello Brian. We’re pleased to hear that our blog post has been useful for you. Being able to identify when you’re having an emotional flashback can give you more time and choice as to how to deal with it. Wishing you well.


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Resentment: The silent relationship killer

“Do you think your wife would ever leave you?” It was a jarring question, one that shook up routine coaching session. “Absolutely,” I said without any hesitation. I surprised myself with my answer’s assertiveness. It was a bit like jumping off a cliff at an amusement park. You trick your legs into jumping, a split second before your brain processes the “Holy sh*t” moment. But my wife (Lisa) and I both knew that there was resentment in our relationship. And understood its potential to wreck havoc.

The marriage overconfidence trap

Lisa and I often discuss the grim prognostications for marriage in the US, headlined by the 50% divorce rate. One out of every two marriages will end in divorce.

Yup – and we’re also better than average at relationships

But it was the directness of my coach’s question shook me out of my overconfidence. 93% of drivers believe they’re better than average drivers – a statistical impossibility. The intellectual part of my brain clearly understood the statistics, yet my emotional brain said “Sure, but not us.”

So what’s the issue?

After all, on the surface we seem to have all of the preconditions for a thriving marriage. We’re financially secure. I’m not beholden to the 9-to-5, don’t have a boss, and complete professional autonomy. Heck, we’re even done saving for college. But during that split second, was my body telling me something that my brain wouldn’t acknowledge?

Kids, man. Kids

John Gottman is a psychology professor who studies marriage stability and divorce prediction from his famous “love lab.” In his book The Seven Principles for Making Marriage Work, he confirmed what many new parents have experienced firsthand: marital satisfaction plummets after the birth of a first child.

67% of couples report a decline in marital satisfaction after the first child is born
New baby, who dis? Satisfaction plummets, resentment spikes

Why do 67% of couples “become very unhappy” during the first three years of their child’s life? Gottman’s research identifies a few reasons:

  • The frequency and intensity of relationship conflicts increases significantly
  • The fatigue makes it impossible to have an emotional connection
  • A baby does not emotionally “retreat” from an unhappy parent (and mom, in particular)
  • Though both parents work much harder after the birth of their child, they both feel unappreciated

Resentment: The inverse of appreciation

Appreciation is defined as the “recognition and enjoyment of the good qualities of someone.” Simple, right? Not so fast. Appreciation – or should I say, the lack thereof – is the seedling of relationship resentment. Resentment acts as a relationship tax, forcefully injecting itself into every dimension of our marriage: money, in-laws, chores, vacations, and parenting philosophies. And left unchecked, it has some gnarly copounding effects.

This is just so damn hard

What’s more difficult, being the primary breadwinner or caretaker? The appreciation/resentment paradox is our post-industrial version of “To be, or not to be.” (Here, it’s important for me to disclaim that I can only speak about our own situation where we’ve consciously separated the breadwinner and caretaker roles.)

The fight for appreciation can look like a boxer's stare down.
You’ll appreciate me, by the time this is over

As the primary breadwinner, I think I have it harder. When I was part of the corporate grind, I’d point to the non-stop email and conference calls, navigation of internal politics and banality of corporate bureaucracy. Today, as a solopreneur, I’d add to the list cash flow volatility, untested business models, and watching your savings go down for nearly three years.

But being a primary caretaker is also damn hard. There’s the straight up physical (pregnancy, labor, soreness), emotional (post-partum, the “WTF is going on”), societal (the elusive hunt for the pre-baby bod, mom shaming), fatigue (breast-feeding, all-nighters, sleep training) and loss of freedom (naps, seriously, naps). And let’s not forget the emotional labor.

What's harder: Caretaker or caregiver? This is where the resentment begins

The kicker: identity

But on the caregiver side there’s the big kahuna: the loss of identity. With the snap of a finger, Lisa went from professionally-trained fine artist… to a Mother. Here’s how the (aptly named) Scary Mommy blog describes this shift:

I’m talking about the fact that in one quick instant, you go from being woman, girlfriend, wife, professional, artist, lover, free-thinking-doing-being-person to MOTHER. Just like that. And mother, at least at first, is bigger than all those other things, whether you want it to be or not.

During some of our trying moments, Lisa would lament how once paternity leave ended “You get to go back to being Khe from RadReads.”

Culture portrays women as mothers and wives and men as heroes
A true hero’s journey

Caregiver versus breadwinner: what’s harder?

This is the part where the Bros on the Internet like to hit back. A sampling of their arguments:


  • Have you ever been reamed out by your boss?
  • Do you know how much it sucks to fly cross-country for one meeting?
  • Have you ever had to update a PowerPoint at midnight on Friday?!?!


(Yes to all of the above, btw) And in the quiet corners of the Thursday Happy Hour you’ll start to hear the paternal grumblings: “What can possibly be so hard about napping all day, going out on mom dates (they drink, don’t they?) and playing peek-a-boo with a cute baby?” I know, because these thoughts have all crossed my mind.

The final verdict?

Guess what: Being a caregiver and breadwinner are both hard
Spoiler alert: Both of you deserve to be appreciated.

I hate to break it to you, but they’re both hard. In different ways. At different times. With different combos of physical and emotional. So let’s move on. But one thing is for damn sure: Everyone loses by dwelling on the unanswerable question of “Who has it harder?”

Resentment in action

Let’s leave the abstract and identify two specific examples where a droplet of resentment can quietly start sucking all of the air (and joy) out of a relationship: Economy Plus and Date Night.

Economy Plus

The decision to buy the extra legroom has always been a divisive issue within the RadReads community. It’s the classic paradox of delayed gratification – do you optimize for the journey or the destination?

But for us, the blow-out fights over $59 upgrades can be reduced to the resentment-driven question of “who has it harder?”

As the primary breadwinner, this frivolous purchase triggers hyper-vigilance against lifestyle creep, angst about our income uncertainty and fear of going broke. (All harbingers of the pernicious scarcity mindset.) And having gone from a really high income to a virtually non-existent one, makes me really insecure. So during that fight, deep inside there’s a scared little boy (I’m not being dramatic) pleading “Do you know how hard it is to make money on this path?”

The primary caretaker has their own gripes about the non-upgrade. The kid(s) will probably be more on her lap – she’s the gatekeeper of all the snacks, an on-premise supply of milk, and possesses the uncanny superpower to get them to nap in 17 inch seat. Come on, splurge on the $59 bucks for crissake.

Here’s the thing: this had nothing to do with Economy Plus and everything to do with years of built up resentment.

Date night

The next example is date night, long heralded as the savior to any marriage. Yet how does this act of relaxation turn into a source of resentment? Once again, the caregiver-breadwinner conflict rears its ugly head (courtesy of emotional labor). Let’s examine what happens from each perspective:

The Breadwinner (i.e. me) waltzes home, proud to have made the reservation on OpenTable and counting down the minutes until that first cocktail. After all, there was a big board meeting that week, so this is the night to blow some steam with your boo.

On the other hand, the Caregiver (Lisa) needs help getting the babysitter situated. The kids are hysterical because they’re not feeling the new sitter. Dinner needs to be prepped. Are the PJs out? Is the Apple TV set up? Oh and did you get the cash, like I asked? (Crap!) Next thing you know, we’re 45 minutes into dinner staring down at our plates in silence.

This dynamic – and how it builds up resentment – is perfectly encapsulated in Emma’s viral comic You Should Have Asked.

Date night doesn’t just involve opening the OpenTable and Uber apps.

Let’s examine the tape (and again, I can only speak to our marriage). On date night, I feel that I deserve a relaxing night out. And because I made the economics of the night possible, all I need to do is open the Uber app.

On the other hand, Lisa feels that date night starts with the coordination of the kids and sitter, long before we even step foot in the restaurant. And if all that coordination falls on her, the date’s no longer a date. We might as well save ourselves the drama and stay home.

Who is right? Who is more deserving of a break at this juncture?

Date Night: Who deserves a break?

This is the part of the post where the Bros reappear – calling me whipped or denuded of my God-given masculinity. It turns out that letting go of your ego is a much easier route than digging your heels and trying to win the battle of who’s got it harder. And even if you do “win,” (whatever that means) you’ve paid a hefty price: emotional detachment.

Resentment compounds (just like interest payments)

It’s hard to pinpoint when the seeds of resentment were planted. Having kids is an obvious marker, but I truly think it started long before we met. Why? For each partner, it’s a manifestation of their own insecurities. For me, the scarcity mindset turns so much of life into an ongoing struggle. And if everything is a struggle, goddammit – I want to feel appreciated!

The author Malachy McCourt wrote: “Resentment is like taking poison and waiting for the other person to die.” That’s bit dramatic, but left unchecked resentment can become a self-fulfilling prophecy. Twitter friend Visakan Veerasami succintly describes how relationships need a “waste elimination system” and how “hitting snooze” on difficult conversations can have some serious ramifications.

1. Hit snooze on difficult conversations2. Backlog from 1 overwhelms3. Start spacing out in each other's presence4. The spark is gone.5. Fights become trivial6. Cycle worsens
The resentment “death spiral”

How to deal with resentment

With time, resentment in a relationship acts accumulates and hardens like wet leather. But our minds and hearts are more malleable than we think. Curiosity, empathy, and trust can quickly rightsize a relationship that feels like two ships sailing in the night.

1. Name it, to tame it

The philosopher Carl Jung wrote: “Until you make the unconscious conscious, it will direct your life and you will call it fate.” It’s much easier to see recurring behaviors if you can identify them with a name.

Understanding that the date night fight is really about appreciation can help you cut through the noise and get straight the heart of the issue. And you can get there with some simple questions:


  • What are you feeling right now?
  • Where is this coming from? (Note: not in a passive-aggressive tone)
  • How can I best support you right now?


2. Share your own introspection

One of the hallmarks of difficult conversations is that they tend to be conversations about identity. Being a good partner bears striking similarities to being a good boss. So we can draw lessons from the management classic Difficult Conversations, as Doug Stone, Bruce Patton and Sheila Heen devote entire chapters to the link between difficult conversations and our sense of self. The Harvard professors describe how looking inward gives us significant leverage in managing our anxiety during these tense situations:

To become more familiar with your [particular sensitivities], observe whether there are patterns to what tends to knock you off balance during difficult conversations, and then ask yourself why. What about your identity feels at risk? What does this mean to you? How would it feel if what you fear were true? It may take some digging. 

3. Turn towards, instead of away

In Gottman’s Seven Principles for Making Marriage Work he introduces the concept of bids. Bids are “any attempt from one partner to another for attention, affirmation, affection, or any other positive connection” and can show up “in simple ways, a smile or wink, and more complex ways, like a request for advice or help.”

In my experience, bids can be reflective “Look at that moon,” subtle (grabbing your hand during a walk), or explicit (“I’m really struggling with my mom right now.”) How the bid “receiver” reacts is critical as they might:

[su_list icon=”icon: bolt” icon_color=”#2a2a2a”]

  • Be distracted (i.e. Thinking about work) and just ignore it
  • Be stressed and therefore dismissive (or even worst, condescending)
  • Or feel outright resentful, twisting the logic in a manipulative way to clap back (“My mom doesn’t stress me out that way.”)

Bids are “little moments” that slowly build up mutual trust, funding what Gottman calls an “emotional bank account” that one can draw on later when things get tense. His research shows that 86% of couples that “turned into their bids” stayed married and found that “arguments between couples were not about specific topics like money or sex, but instead failed bids for connection.

Yet to their subtle nature, bids can be easy to miss – especially once resentment has hardened a relationship. And Gottman details the serious repercussions to missing a bid:

To “miss” a bid is to “turn away.” Turning away can be devastating. It’s even more devastating than “turning against” or rejecting the bid. Rejecting a bid at least provides the opportunity for continued engagement and repair. Missing the bid results in diminished bids, or worse, making bids for attention, enjoyment, and affection somewhere else.

As a simple first step, Gottman suggests openly taking inventory of your bids with your partner with the following questions:


  • Could or should I get better at making bids? How?
  • What keeps me from making bids?
  • What is my impulse for turning?
  • Do I turn away or against more often than I turn towards?


4. Don’t go to sleep mad

So we’ve established that resentment compounds and accumulates. Yet after a fight it’s actually possible to abate the ensuing death spiral – it just requires setting aside your ego.

The biggest realization that we’ve had is that in the heat of the moment, you don’t have to resolve the particulars of a conflict. And if you’ve read this far, you know that these are complex issues without black-or-white solutions. Apologies quell resentment’s powerful momentum.

It helps to make the apology specific. “I apologize for raising my voice. I apologize for saying this mean thing.” The specificity of the apology honors the fact that a broad solution isn’t possible whilst passions are flaring. And with any accelerating conflict – a brief pause (combined with a night of sleep) – can defuse any tense situation.

5. Go heavy on the attaboys and attagirls

Three words. (And nope, not the L-Word.) You can never say them enough. “I appreciate you.”

I appreciate you. I love you.

Say it as often as possible. Just make sure you mean it. Just make sure you feel it.

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EMDR in a Nutshell: Healing from Trauma


What Is EMDR?

Eye Movement Desensitization and Reprocessing (EMDR) is a guided process that supports trauma work by using “bilateral stimulation” (BLS), or stimulating each hemisphere of the brain alternately via the senses. EMDR also involves talking, deep breathing, and other ways of grounding the nervous system. (“To ground” the nervous system means to bring its level of activation back or closer to the “ground” or baseline level.)

There are many kinds of BLS that can work well, although eye movements have been shown to be the most effective. In my practice, I use a combination of eye movements (watching a light or my finger moving back and forth), as well as sounds alternating in each ear through headphones—whichever the client prefers.

When we first meet, I work together with my client to figure out what combination of sounds and colors feels best. (A person’s own report is the best indicator for what kind of stimulation works best for them.)

Rather than medicalizing distress, EMDR provides a way of healing from trauma. EMDR isn’t about trying to treat the symptoms of an illness. It’s about healing from the root cause.

What Can EMDR Treat, and What Is It Not Helpful for?

EMDR can be very useful for trauma, specific anxieties and phobias, and many forms of impact left behind by difficult experiences or relational patterns. EMDR can be effective for Complex Post Traumatic Stress Disorder (C-PTSD) and developmental traumas.

Another form of EMDR called Eye Movement Desensitization (EMD) can be helpful to reduce distress due to overwhelming or complex traumas and triggers, which can be used in place of or in preparation for additional reprocessing.

EMDR can be used to prepare for specific future actions (public speaking being one common example).

It is even possible to use EMDR for memories that may be vague, pre-verbal, or otherwise not fully available to consciousness. This is accomplished by processing the physical responses and triggers we have in the present.

EMDR is less directly useful for depression, grief, the impact of neglect, and other experiences we might characterize with the word “lack.” Many or most forms of difficult human experience involve both fear and loss, and working on the somatic or body-based reactivity to trauma with EMDR can allow grief work to become tolerable. In other words, EMDR can open the way for other therapies (such as psychodynamic, existential, and other “talk” therapies) to be more effective.

What Is the Difference Between a Traumatic Memory and Other Memories?

Each memory we have is stored in a “neural tree,” which (in theory) is a structure of cells that we could pick up and look at. Our non-traumatic or ordinary memories have many “branches” into the frontal cortex of the brain, which allows us to describe the memory with language, and into the hippocampus, which allows us to put the experience into the context of time (i.e. we know it happened in the past and therefore that it is now over).

Conversely, the neural trees of traumatic memories have fewer of these branches, and they also have a greater number of “roots” that anchor them to the amygdala, which is the fight/flight/freeze center of the brain. (“Freezing”, or dissociation, can be thought of as a protective numbing response to the “fight or flight” responses of anger, anxiety and fear. “Drifty,” “numb,” and “confused” are some words clients who experience dissociation have used to describe how it feels to them.)

This makes it much easier for a traumatic memory to activate the adrenal glands, and thereby the threat response system throughout the whole body. This is what we mean when we colloquially use the word “trigger”: the body has been activated for survival in response to a present stimulus that is meaningfully reminiscent of the past.

What Is Trauma Work?

“Trauma work,” “trauma processing,” or just “processing” are all shorthand ways we refer to helping neural trees grow more branches and untwine their roots! EMDR can make this process much easier and faster, though the process itself is ancient. We say that the brain “knows” how to heal itself, much like how the skin “knows” how to heal a cut. EMDR gives the brain support—much like how antiseptics and bandages can support healing wounds of the skin.

As we said above, unprocessed traumatic memories are less connected to the frontal cortex. This means we have less ability to use language to “look at” the memory, instead of “be in it,” and it’s much harder for our systems to believe that the memory is in the past and that the threat is over—it can feel like it’s happening all over again. “Naming it to tame it,” or putting experience into words (which, in EMDR, happens between doses or “sets” of BLS), helps grow more connections to the frontal cortex.

Another reason doing trauma work is one of the greatest challenges we face is because the brain and body don’t have a system that tells us we are in “mild distress.” We can only adjust between “life and death (fight, flight or freeze)” and “calm (rest and digest).” Recalling traumatic memories, alternating with taking breaks, helps the “roots” into the amygdala unwind and the survival system to quiet.

So even contemplating trauma work can feel like life and death! It’s important to be aware that there’s a reason for this intensity, and that after successful processing, it will fade. Working on trauma is not likely to be comfortable, but if it is not tolerable for my client, we stop (using a stop signal we agree on before we begin). If that happens, we focus on support and using grounding skills until their nervous system is closer to baseline. Trauma work is not as hard as trauma!

How Does EMDR Work?

EMDR allows us to process trauma by activating traumatic memories at the same time as it gives the nervous system cues for safety. This creates an “in and out” rhythm, which helps the brain get back in sync, and supports your brain in building connections to the neurons that store these memories.

We have data that clearly show that EMDR gets good results. Science is still exploring the reasons why EMDR works, but here are some of the most popular current theories, one or all of which could be true:

  1. The back-and-forth visual motion communicates to the amygdala that your body is in motion, which tells the brain that it is safe, active, and not trapped.
  2. The ocular nerve or other sense organs are stimulated, the activity of which facilitates rewriting (basically, it gets the area “warmed up” and ready for change).
  3. Stimulation of the sense organs takes up some of the brain’s bandwidth and resources (such as oxygen and glucose), which means less is available to fuel panic responses.
  4. The eye moments mimic what happens in REM sleep, another time when the brain is processing and storing memories. (This process is not fully understood, but it’s theorized to be similar to how EMDR and BLS work.)
  5. Trauma disrupts the natural rhythm of brainwaves, and EMDR provides a “corrective” rhythm to resonate with the brain as it processes disruptive memories.
  6. Predictable structure while talking about trauma is distracting and calming.

Any form of verbalizing trauma while in the regulating presence of a trusted other will have beneficial effects, for at least two reasons. First, “If you can name it, you can tame it”: Language activates the frontal cortex, which helps to build neural bridges, as well as causing a release of endorphins and other soothing neurotransmitters.

Second, our nervous systems are built from birth to monitor the internal state of others (including breath and pulse rates), and to resonate with them—so sharing a story with someone who is calm can help us calm ourselves while we tell it.

What Happens During an EMDR Session?

EMDR has a few different phases. In the first phase, I lay the groundwork with my client, including practicing grounding skills, setting up a stop signal, getting more familiar with BLS, and making sure they have a crisis plan and other supports in place in case they need help between sessions.

Next, we work together to come up with some “headlines” of memories to target, and explore the client’s feelings and beliefs about these memories. This doesn’t mean it’s not ok if we discover more along the way, but it can help us find some good places to start. In fact, we might say that it’s more likely than not that other memories will come up. That’s neither good nor bad, it’s just the brain going through the networks of association it has.

If relevant, we may also set goals at this point for a future action the person is working towards.

Most often, BLS is not used until session two (although this does not mean that processing cannot begin in your brain before that!). At that point, I work with the person to bring up the memory we agreed to use as a starting point, paying attention to the sense information, body feelings, and emotions that go with the memory.

Then, we do about 20 to 30 seconds of BLS. During that time, I ask my clients to “just notice,” “go with,” or “follow” what they’re noticing inside themselves. At the end of every “set,” I ask them to take a deep breath, tell me a sentence or two about what they’re noticing, and then we repeat.

It’s kind of like you’re on a train ride, and I’m on the phone with you, asking you what you see out the window.

Sometimes, what a person feels and notices from set to set will change, and sometimes it won’t. It’s even perfectly normal to have periods of feeling nothing at all. This is often the brain’s way of resting, assessing safety and connection, or otherwise taking care of you, and sometimes the best thing to do is just notice that feeling for a few minutes.

Although I keep a close eye on how my client is feeling as we go, I trust their own report most of all—as a person is their own best guide to how they’re doing. Some experiences are not always visible from the outside, such as “red lining” (panic, fury, etc.) or “blue lining” (dissociating).

I always tell my clients that if they think they’re feeling too much or too little, or are otherwise outside of their “zone of tolerance,” it’s important for the healing of their nervous system that they let me know. That way, we can take a break and use grounding skills before we continue.

Most sessions are spent doing sets for about 20 to 40 minutes. At the end of every session, we wrap up by using grounding skills to return the person’s nervous system to a tolerable state. I also ask if there’s anything they want to “leave in the container of therapy” (which doesn’t mean it won’t come to mind between sessions, but rather that they will set the intention not to continue to focus on it). Then we check in for a minute or two so we can both share thoughts and observations about the session.

Reprocessing can take several sessions. On average, it ranges from 3 to 12 weeks, though it can be significantly shorter or longer. Sometimes a person may feel different by the end of a session, and sometimes they may not.

What Do I Do Between Sessions?

In between sessions, clients may continue to process memories, meaning they may still be remembering, feeling, or even dreaming things. If that happens, their job is to notice it as much or as little as they’d like to, and then use a grounding skill. (“They don’t work if you don’t use them!”)

The client’s most important job, and their only “homework,” is to keep their nervous system and emotions within tolerable limits as much as they can. (It’s ok if they can’t do this perfectly, but it’s important to set it as a goal to strive towards.)

There are a number of questions we check in about as we prepare to engage in EMDR:

  • How will you know if you’re outside of your tolerable zone?
  • What grounding skills will you use?
  • What friends and family can you connect with, whether to ask for help using grounding skills, talk about what you’re feeling, or just to share space?
  • If you are unable to ground yourself on your own or with the assistance of loved ones,   what hotlines and/or mental health professionals will you call and how?
What Might Be Different After EMDR Is Complete?

The good and bad news is that EMDR does not make you forget what has happened. After processing, accessing memories of a traumatizing event will feel much like accessing any other memory. The most noticeable difference will likely be that the memory no longer creates an overwhelming body response.

After EMDR, it’s common for a phase of grief work to begin. This can involve feeling sadness and anger, as well as (in some cases) shifts in sense of identity or what is important to us. Sometimes we need support to explore questions like “Who am I without this fear?” or “Is it ok to get better?” Continuing in talk therapy after EMDR is over may help people continue to integrate their experiences and to heal.

To anyone contemplating EMDR, I wish you good healing, and congratulations to anyone who is willing to take the risks to talk about the hard stuff. I believe the greatest gift we can give to ourselves and to others is to make room for our feelings.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.

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When Therapy Is Going Nowhere

Escaping the “Groundhog Day” Cycle

By William Doherty

May/June 2013

Although you can’t tell it from the cases that appear in publications and training videos, psychotherapy mostly involves talking to clients who like working with us, but find it hard to change. Eventually, rather than helping these clients navigate dramatic whitewater rapids, our main challenge becomes steering the clinical relationship out of the swamps and marshes where it can get stuck, sometimes for years.

Our long-term clients might have us banging our heads against the wall at times, screaming, “I can’t believe you’re making that self-destructive choice again! After all this time, haven’t you heard a word I’ve said?” But mostly, they elicit far less dramatic reactions. They’re cooperative, agreeable, and attached to us as therapists. They’re open to our insights and suggestions, fill a regular time slot in our schedule, and pay their bills. So what’s the problem? Nothing—except that not much goes on in sessions: no implosions or explosions, no breakthroughs or backslides, no itching to finish therapy and get on with life. It starts to feel like “till death (or retirement) us do part.”

Often when we begin with these clients, our early work generates some movement and change, but then a kind of stagnation sets in. This is the case with my couple who’s fully engaged in therapy sessions but “too busy” to try anything different at home, and the woman who uses sessions to recap the ins and outs of her week but never addresses any serious issues. Without much happening—with no real intensity or vitality—ease eventually turns to boredom, at least for the therapist. After months or years circling the same issues, we end up with what I call “Groundhog Day therapy,” named after the early 1990s film in which a burned-out TV weatherman played by Bill Murray is doomed to live through the same day, with the same events, over and over again.

So why do therapists tend to get stuck in clinical relationships where we spend session after session spinning our wheels? One reason is that these sessions ensure a predictable, paying slot in our schedule. Another reason, however, is that we usually don’t tell anyone about these cases. We reserve supervision or consultation for more compelling crises or direct conflicts in the clinical relationship. Groundhog Day cases, where no one is threatening divorce or suicide, lack the drama of standard consultation cases. We might worry that even our consultation groups will get bored of hearing about the same client who isn’t particularly miserable, but isn’t leading the life he or she wants, either.

Another reason we remain stuck with clients going nowhere in therapy is that most of us keep “progress notes” instead of tracking outcomes. I confess to this habit, especially when it came to a couple I’d been seeing for several years. When I looked through a year’s worth of their session notes, more than half of them recorded some improvement from session to session. But when I stepped back and asked the couple to evaluate the progress of their overall relationship, they concurred with me that nothing much had shifted. In fact, a mentor once told me that two-thirds of the records he reviewed for mental health hospitals reported progress, even for patients who never got better overall. As therapists, we like to think we’re making headway, and our clients want therapy to be worthwhile, but treatment sometimes shifts without our noticing it from change-oriented work that has an ending to long-term, maintenance-oriented work that doesn’t have an end point.

So what do you do when you find yourself with a Groundhog Day case? The commonest mistake—one I’ve committed myself—is what I call “lurching,” or making a sudden, unannounced shift in how you’re approaching the client. One form of lurching is shifting abruptly from a therapeutic posture of empathic support to one of hard-nosed challenge. I’ve seen frustrated therapists who’d been oozing nurturance for months suddenly blurt out, “You have a choice: you can stay miserable, or you can get a divorce.” These moves might temporarily shake the client up and reinvigorate the therapy relationship, but they usually end badly. Either the client forgives the unexpected rudeness and therapeutic homeostasis is restored, or the therapeutic relationship spirals downhill until the client fires us.

Another form of lurching is trying out a different, more dramatic type of therapy without preparing the client. It’s like when a physician moves from prescribing a simple acid reflux medication to scheduling major esophageal surgery without first stopping to reevaluate the diagnosis or overall treatment plan with the patient. For example, in one couples therapy case I consulted on, the husband wasn’t getting over his wife’s affair. The therapist, familiar with the current trendiness of traumatology in the field and having just taken an introductory course in Eye Movement Desensitization and Reprocessing therapy, jumped to initiate two trauma treatment sessions with the husband. Both of these sessions failed, and the therapist gave up on the couple.

In pulling a new technique out of her hat, this therapist failed to ask herself something basic: how could she uncover what might be causing the husband to cling to his grief and anger? She’d regarded the husband’s reaction as a symptom to be expunged, rather than part of a larger narrative. In a sense, she skirted the very heart of talk therapy. But she’s not the only one. These days, many of us are overly focused on the flashy public-workshop intervention in which the proponent of some new attachment-based, body-oriented, Buddhist-inspired, or neurophysiological-leaning approach enthralls us with a new method. When we throw all our energy into the latest fads in the field, we stop working at the essence of what we do: the routine conversational practices of psychotherapy—the skills that keep therapy moving from minute to minute and session to session.

The key to dealing constructively with stuck cases is to treat the clinical relationship pattern first, and only then to consider alternative treatment strategies. The following three steps detail a process I’ve developed, including the words I tend to use, for gently dislodging stuck clinical relationships, without lurching.

Set time to evaluate progress together. After asking the client for his or her priorities for a particular session, I say something like, “I’d also like to spend some time in this session looking at where you are currently in terms of the problems you came to therapy with, how far you feel you’ve come, and where our work is now.” We decide together whether to start with the client’s priorities for the session or with mine. I do this in a matter-of-fact way, not assuming a challenging mode, but letting the client know this will be an important conversation.

Assess where you are in the course of therapy. After listening to the client’s sense of progress and affirming whatever I can agree with, I ask follow-up questions that direct attention to the work we’re doing together. An example might be something like this: “Where do you think we are in terms of our work in therapy? Are we in the winding-down phase, the middle phase, past the middle phase?” This question implies that we aren’t going to be doing this work forever—that there’s a beginning, middle, and end, and that the client has a big say in determining the timing of our work. Generally, I accept whatever the client offers as an appraisal of our current stage of work.

Share your perspective on the “plateau.” In the third phase, I share my perspective on the plateau I see in our work. I’ll say something like, “As I’ve been thinking about our work, it seems to me that significant changes were coming in the earlier phases, which is common, and that we reached a plateau a while back. I don’t know if you see it that way.” Plateau is a more positive description than saying therapy is “stalled” or “unmoving,” and invites the client to join me in evaluating the recent results of therapy. I focus on “we” and “our work,” not just on the client’s individual movement. In this way, I acknowledge that I’m part of this system and have a role in everything that goes on; I share space on the plateau. With this framework set up, most clients agree that we’ve been circling around issues without much forward progress. I sometimes even say that I prefer to work intensively with people and take breaks from therapy, rather than stay on plateaus for too long.

For one couple I worked with, the pressure of coping with their son’s problems had brought them into couples therapy at the recommendation of an adolescent psychiatrist who was alarmed about how divided they were in dealing with their son. Of course, they had marital issues as well, including difficulty with emotional intimacy, which they were trying to tackle. But that phase of the therapy was slow going. They seemed to use the sessions well, but admitted to inertia at home, where they rarely followed through on what they’d learned in our sessions. Despite my best efforts to have them reflect on what might be blocking the energy for intimacy, therapy was bogging down.

Rather than escalate my efforts to break through with this couple, I did my “let’s evaluate our work” protocol, which led to a consensus about how therapy had progressed. We agreed that they’d learned to work as a parental team, with their son functioning better for it, and our sessions had given them insight into their marital issues, but without much change on that front occurring at home. I said that a plateau in therapy after good initial work is common, and that it gives us a chance to decide what to do next, including ending our work for now. They seemed relieved that I didn’t expect them to manufacture energy for changing their marriage. Earlier in my career, I might have increased my efforts to avoid failure and, as a result, bestowed a sense of failure on them. Instead, after one more session, we finished up with our heads held high.

These “Where are we now?” conversations don’t always mean an end to treatment. Sometimes they lead to reinvigorated therapy, as was the case with a woman who’d come to see me in crisis after a divorce. In the beginning of our work, she’d learned how to cope with her ex-husband and kids and to avoid some of the land mines in the divorce process. Gradually, however, I began to get the sense that I was serving more as a trusted confidant than a therapist. She mostly wanted to talk about the ups and downs of her week, along with routine complaints about her ex-husband. After we reflected on her progress and the plateau in our work together, she said she had more issues to focus on and wanted to continue our therapy to work on them. I then asked her the questions I put to all clients who say they want to continue: “What are your priorities for the next phase of our work? What do you feel a sense of urgency about?”

With these questions, I signal that I want a new contract if I’m going to sign on for another phase of therapy. In this case, since she’d reentered the dating world, the new contract was to work on finding a way for her to have both connections and boundaries in close relationships, and I was able to help her avoid her tendency to overinvest and then cut and run.

Of course, these conversations don’t always go this smoothly. Sometimes clients’ fears of abandonment and worries about making it on their own will surface. Fortunately, the emergence of these emotions can allow real therapy work to begin again, providing a new focus on issues of loss and autonomy.

Other times when trying to move from a plateau, it takes a while for the conversation to play out and a conclusion to be reached. In the case of a multiyear therapeutic relationship, for example, I may introduce the conversation, but suggest that we reflect on it over time by saying, “I’m not looking for any quick conclusion on this, but it’s good for us to keep track of where you are with what you came here to work on, and where we seem to be going now.” The idea here is to broach the subject while signaling that there’ll be no lurches or quick unilateral decisions. If the conversation is moving in the direction of ending therapy, I always indicate that we’re deciding on “stopping for now,” explaining that the door is open if clients want to come back for more work in the future.

My attitude is like that of a music instructor whose client has learned the basic scales and a few songs and is satisfied with that progress for the time being. I celebrate the gains and fully accept the client’s decision to put his or her energies elsewhere. We both know that there’s room for improvement, perhaps the potential to master Rachmaninoff, but that now isn’t the time. There’s no harm, no foul in taking a time out, even a permanent one.

This approach relates to Andy Christensen’s Integrated Acceptance model of couples therapy, which includes two phases: one geared toward helping couples change, and one geared toward helping couples accept what’s not likely to change. As psychiatrist David Burns points out in his recent Networker webcast “Motivating the Anxious Client” and his other work on motivation, when a therapist and client agree that not much is changing in therapy and the therapist accepts this reality and the reasons for it without trying to “sell” more change, the client is often paradoxically remotivated to change.

Common Mistakes with Therapeutic Plateaus

Another form of stuck clinical relationships involves the client who keeps making self-destructive choices, ones the therapist is on record as having repeatedly warned against. One therapist in a workshop I led talked about her long-term therapy with a woman who kept bringing new men home from AA groups, living with them for a time, and then feeling used and abandoned when they didn’t need her any longer. I don’t know how many sessions the client spent talking about this pattern and agreeing about how harmful this behavior was for her. She’d always conclude that she wasn’t going to do it anymore, and then, bingo, a few weeks later, there’d be a new sad sack living at her house. Another classic scenario is the woman who continually returns to an abusive husband or boyfriend in the hope that, this time, his apology indicates real change, or the married man who’s had a series of affairs and resists talking to his wife about his unhappiness in the marriage because he doesn’t want to deal with the fallout of those conversations.

The big challenge for these clinical relationships isn’t that the client is behaving in a self-defeating way—it’s the client’s life, after all—but that these individuals cling to therapy, desperately asking for help but declining to take the responsibility to extricate themselves from toxic situations.

In my own clinical experience, Cindy stands out. She enjoyed therapy and had inherited enough money to work or not as she pleased. She’d made strides in her single parenting—the kids were now raised—but continued to allow herself to be used by one man after another. Each time, she worked in therapy to extricate herself from the relationship, but whenever a new questionable character came along, she was impervious to my fervent attempts to get her to pay attention to the multiple red flags whipping in the wind. I’m not talking about subtle signals here: one man asked her for a good-sized loan after three dates, another offered to pay her younger daughter’s college tuition (never having met the girl) and then asked for a “bridge loan,” and yet another flirted openly with Cindy’s adult daughter. When I’d ask if she saw a familiar pattern, she’d reply, “Well, I have a different sense this time. I’m stronger, and this man is really not like the others.”

These are our Dr. Phil cases, when we want to ask, perhaps with a snarky, self-satisfied smirk, “So how’s that working out for you?” Except we’re not on TV. We’re caught up in an ongoing clinical relationship, and it’s important that we not make the following common mistakes:

Acting as if the client’s decisions reflect our competence. This is the central mistake behind most lapses in the therapist’s craft when working with challenging clients. The truth, of course, is that we’re responsible only for how we conduct ourselves in the therapy room, not for how our clients behave in their own lives. But it’s hard to hold on to our boundaries when we see clients drive their cars over cliff after cliff while begging us for driving tips.

Acting like disapproving parents. Schooled in avoiding direct advice, most therapists ask screwdriver-like questions such as, “What was going on in your mind when you invited another man to move in with you after meeting him just twice?” The client gets the underlying drift: The therapist thinks I’m an idiot.

Assigning pejorative clinical interpretations. When therapists lose their boundaries, feel overresponsible, and don’t really know what to do, they often default to poking at the function of the symptom with questions like “Why do you think you need men to treat you so badly?” When the client denies needing to be abused, the therapist doubles down: “If you don’t like it, then why do you think you keep putting yourself in this situation?” The client then translates this statement as You’re even more messed up than either us thought before.

Threatening to end therapy. Usually we fire the client in indirect ways like “I don’t see how this therapy is really helping you.” I know of one frustrated therapist, however, who said outright that she couldn’t work with a client as long as the client chose to stay in an abusive marriage. In another case, the frustrated therapist waited until a husband, following another marital argument in the session, blurted out, “We’re not getting anywhere in this therapy.” The therapist saw an opening and said, “If you don’t think the therapy is helping, then maybe we shouldn’t keep meeting. Why don’t you think about whether you want to continue and call me back if you want to schedule an appointment?”

Coming on too strong. In a number of my couples cases, one spouse’s individual therapist seemed to have taken such a hard position in favor of divorce that the client was too ashamed to continue therapy and attempt to reconcile the marriage. In reality, it’s unlikely that the individual therapist likes to promote divorce. Instead, I imagine that the therapist was sick of seeing no movement, but lacked a more skillful way of dealing with the impasse.

Listening too closely to the negativity of our consultation group. It often happens that a consultation group feels it’s listened too long to your stories about an impossible client and wants to put both you and the client out of misery. I remember a case consultation when a colleague leaned in toward me, lowered her voice, and said, “Maybe you should ask your client what she gets out of being so unhappy? What’s in it for her?” The problem here wasn’t her advice; it was the negative energy behind it that I inadvertently absorbed. Having consulted yet again on this particular client’s case, I probably should have carried a big sign with me when I walked into our next therapy session—Warning: Lurch Risk Ahead.

How to Get Therapy Moving Again

So how do we effectively shift gears with stuck clients who repeatedly make unfortunate choices? Here are some approaches I’ve learned from respected colleagues and developed to use in my own clinical work.

Return regularly to the client’s need to stay on course and honor the client’s stance. Virginia Satir used to talk about the two universal drives operating simultaneously in people in distress: the desire for growth, which means change, and the desire for stability. As therapists, we have to address both drives. For my client Cindy, choosing yet another inappropriate boyfriend gave her more pain, but reassured her in a way: even at age 50, I can attract guys, and I’m never without one.

In the case of a woman who can’t stop bringing home new men from AA meetings despite a series of disastrous relationships, I’d prepare myself to see something positive and honorable or wise and smart in her choices. For example, I might say, “You’re somebody who doesn’t want to give up on men, even though you’ve had bad experiences in the past. An important value for you is to bring yourself fresh to each new relationship and not assume this guy must be a jerk because some other guys have been jerks.” If she seemed to feel understood by this reflection, I might add, “And you believe deeply in AA and its philosophy, so AA meetings seem like a good place to find a man who’s making a fresh start in his life.” (I should note that actually believing what you say is critical to pulling this off.) As psychiatrist David Burns’s work with therapeutic motivation and resistance-to-change has shown, this exchange would almost certainly lead her to express the other side of her ambivalence: the dashed hopes, the feeling of being used, the sense of futility in making the same poor choice over and over.

When a woman continues to stay with an abusive partner, therapists often make the mistake of focusing solely on her vulnerability or her “codependency.” A better approach is to start by honoring her commitment to keeping her family together: “Lynne, I see you as someone who cares deeply about keeping your commitments to your marriage and your family. You know your kids love their dad, and you want to keep your family together if it’s possible. You’re not someone who cuts and runs when times get tough in a relationship.” Notice that there’s no but at the end of this statement. It’s important to let her take it in and talk with her about that side of her experience for a while without pouncing on the risk or pathology associated with it. If you can honor her commitment in this way, you’re telling her that you see her as a strong person who cares about those around her—and not as a helpless victim. If you work this side of the coin in a heartfelt way, she’s likely to be open to exploring the other side, which involves her feelings of not deserving to be treated better or her worries that keeping the family together may actually be harming the children.

Bookend major challenges with autonomy-granting comments. When challenging a client, it’s critical not to come across as a parent. If I feel I must confront clients about choices they’re making, I usually begin with words that acknowledge their autonomy. To a married man having a career- and marriage-threatening affair with a drug-using coworker, I said, “Doug, I’m going to say something challenging here. I’m going to offer it with an understanding that this is your life and that I don’t get a vote in your decisions. Here’s what I’m concerned about. . . .” Another way to set up these challenges is to start with something like, “I’m sure you’ve thought about what I am going to say.” The idea is to signal respect before getting pushy. After the challenge comes another autonomy statement such as “That’s just how it looks from where I’m sitting. You’re the one who gets to decide.” This bookend approach to challenges makes it less likely that the client will have a you’re-not-the-boss-of-me response.

When challenging stuck clients, use subjective, personal, and “ordinary” language. Saying things like “I see you enacting the same self-destructive pattern you learned in your family of origin” is therapy-speak and won’t resonate with the client. It’s better to use subjective phrases like “I’m worried for you” and “This is what I’m concerned about.” In an impasse, I say things like “I’m worried for you right now. I’m worried that a very positive part of you—your openness to each person who comes into your life—is getting you into one bad relationship after another. Each time this happens, you seem to go deeper into a pit of despair. That’s what I’m worried about for you.” This comes across as a personal, caring challenge delivered in human terms. It’s not a clinical insight subject to agreement or disagreement, and most clients can take it in. This kind of challenge is also not parental if it’s sandwiched between autonomy-granting statements. Step 1: I respect you as an adult. Step 2: I care about you and am worried for you. Step 3: It’s your choice, and I don’t get a vote.

Learn how to recover when you’ve come on too strong. Cindy, the woman who’d been with a series of mooching men, had started seeing yet another new guy who talked money early on. She knew well my concerns about her pattern and shared them. After a particularly challenging session in which my conversational craft had slipped into badgering, I knew I needed to do repair work.

So I began the next session by saying, “You know, I came on pretty strong last time with my concerns about this new relationship. How are you feeling now about the stance I took in our last session?” She acknowledged that my concern made her feel cared for, but she worried that she was disappointing me. We then processed the clear reality that I was skeptical about a choice she was making and talked about how we could live with that tension and still do good work together. In fact, she thought I was probably right, but then revealed for the first time that she saw herself as a “betting woman,” who was OK with long shots when it came to relationships. She thought she’d decline to lend money to this current guy, but would keep open the possibility that this could be a good relationship. This exchange helped repair a frayed clinical relationship, in which I’d almost become overresponsible and not therapeutic.

Stop pushing for change, and wait for another opening when life teaches lessons. Cindy and I moved on to work on ways she could keep as healthy an emotional balance as possible in a relationship I thought was basically unhealthy. At some point, one of us would be proven right by the outcome of the episode. The result was that most of my frustration melted away because I didn’t define my goal as getting her out of this relationship. Rather, I tried to help her learn what she could from the situation she’d chosen to be in.

Not having to defend her decision allowed Cindy to appraise the relationship realistically as it developed. She eventually came to focus on the fact that the man wouldn’t let her see his apartment. With my support, she dug in her heels on this one. I coached her on how to talk with her boyfriend about her feelings and how not to back down when he claimed his place was so shoddy that he didn’t want to disrespect her by taking her there. Finally, she decided to tell him that she wanted her loan repaid and that she wasn’t going to give him any more money, whereupon he disappeared from her life.

When we processed all of this, she saw clearly how she’d blinded herself to red flags that had come up in the relationship. Recently, about 15 years after we’d finished therapy, I got an email from her saying that her life was good, that she’d had better relationships with men in recent years, and that none of them had borrowed money from her.

Becoming a Therapeutic Craftsperson

If the risk for new therapists is falling on their faces because they’re still learning their craft, the risk for experienced therapists is being captured by our competence. We become habituated to the role of “pretty good therapist,” and we stop getting better. The research behind this idea is sobering: clinical outcomes aren’t related to the therapist’s experience level. Overall, experienced therapists have no better success than newbies. However, unless we can compare our work with fellow therapists on similar cases and find that others have succeeded where we’ve failed, we’re tempted to assume that when therapy falls short, the fault is with the clients. We might tell ourselves that they just aren’t motivated, that they have an Axis-II diagnosis, or that their marriage was doomed anyway. Often our colleagues help foster our inflated sense of capacity, rushing to reassure us that our clinical failures are either not failures or not our fault, because we’re competent therapists.

How do we avoid being captured by our competence? I’ve learned that the key is never to stop being a student. It’s hard to habituate while being a graduate student because there’s always something new coming at you; there’s always someone who knows more than you and is paid to teach it to you. The challenge after leaving school is to learn how to keep learning. Anthropologist and cyberneticist Gregory Bateson’s research showed that dolphins figured out how to create novel jumps and flips when they realized they’d only be rewarded for originality, not for doing their old tricks. Bateson called this “second-order learning”—learning how to learn. Therapists, too, need to bring this type of learning into practice.

The therapists I’ve admired most in my career have been those who continually change and develop while holding onto the core of who they are as therapists. They’re interested in new models and new evidence, but not in serially reinventing themselves with each new fad. What I’ve come to see recently is that learning new models counts for little if therapists don’t continually improve their basic craft, the day-to-day skills of their work. Not focusing on the basic craft is like being a surgeon who learns advanced techniques without being good at making incisions and preventing infections.

Another strategy for avoiding decades on a clinical plateau is to be a perfectionist without being immersed in self-criticism. I always question whether I could have done better with a difficult case, but I rarely beat myself up over it. I experiment with the small details of therapy (like how to frame key questions) and with the structure and flow of therapy (like how to open sessions and to blend individual and couples conversations). I’m a sponge for nuance and details when I see master therapists share their work. However, I pay more attention to what they do—their craft—than to how they theorize it.

I get a rush when I pick up a gem from a colleague who has a skilled turn of phrase or way of structuring an intervention. For example, a colleague recently recounted a small intervention he’d made with a stuck case: he’d invited the client to begin sitting in a chair different from the one she’d used for years in the therapy room. The client’s energy in the session shifted noticeably, and my colleague capitalized on the new energy to move the work forward again. Talk about breaking the power of habituation!

These days, I’m having the most fun of my career trying to hone my craft in “discernment counseling,” a specialized way to work with mixed-agenda couples in which one partner is leaning out of the relationship and the other one wants to save it. What I enjoy the most is making adjustments in the protocol because a new wrinkle has shown itself.

Discernment counseling opens with a two-hour session that starts with the couple, then goes to each individual separately, and ends with each spouse sharing with the other the takeaways from their individual sessions. I’d always started out the individual spouse conversations by talking to the leaning-out spouse, assuming that this person is ambivalent both about the marriage and the counseling. I’d strive to build a connection and learn more about what’s driving this person out of the marriage, so that I could fold that into the individual conversation with the leaning-in partner, who presumably is already on board to work on the relationship. Sounds sensible, right?

Well, I began to notice cases in which the leaning-out spouses were quite clear about what it would take to fix the marriage and their role in the problems, while the leaning-in spouses were pretty clueless about the problems and not sure what working on the marriage would even entail. One leaning-in but clueless husband, for instance, didn’t realize that his temper and outbursts were a serious problem for his wife. In this case, I adjusted my thinking and met with him first to get a clear picture of what he understood, so I’d know how to proceed with his leaning-out wife. While I was talking with him alone, he had a revelation that led me to make another shift in my thinking: Why wait until the end of the session to ask him to summarize for his wife what he’d realized with me? Why not have him share the new realization with his wife right away? That way, I could fold her response into my individual time with her.

Rather than offering a commentary on my experience with discernment counseling, my point in relaying this story is to give an example of how I continue to hone my craft as a therapist. In this case, I saw where my approach was breaking down and experimented with a more successful alternative.

I find this kind of self-correction great fun, and I revel in sharing my experiences with colleagues so they can experiment with the change in protocol if it makes sense to them. Experienced therapists have had enough training to avoid serious undertows or completely capsizing the therapeutic conversation, but the more we strive to learn how other therapists practice the nuances of their craft, the more skillful we ourselves will be at navigating out of the bogs and marshes where our clinical relationships get stuck.


William Doherty, Ph.D., is a professor of family social science and the director of the Minnesota Couples on the Brink Project at the University of Minnesota.

Photo © Morgan David De Lossy / Corbis

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Monday, December 21, 2020 11:35:29 AM | posted by Andre
Not much love in the comments so far, so I would like to add some. This article was very helpful and timely for me, helping me see my recent over-responsibility and tendency to lurch. It nicely makes clear my counter-transference about the progress of therapy, without developing my resistance. ;^) And searching my Evernotes, I see that I already studied this article two years ago. It proves the point that sometimes, like our clients, we are only ready to take in a certain amount at a time. Thanks Psychotherapy Networker, and Bill, for providing this lesson again. PS: You spoke of learning small tidbits from others. One tiny idea I will share, that came to me only with this reading, is perhaps using a scaling question (1-10) for the phase of the therapy, rather than speculations of “Are we in the winding-down phase, the middle phase, past the middle phase?” Those could inadvertently set up expectations or demand characteristics. What do you think?

Friday, February 28, 2020 6:24:32 PM | posted by Gottfried Brieger
I find it disappointing that the article does not address a key question in the client-therapist relationship. While medical patients are entitled to diagnoses and treatments as needed, the psychological patient apparently is not entitled to a diagnosis but will most likely be enlisted in a trial-and-error set of psychoactive pharmaceuticals. Never mind that many of these have serious side effects. Never mind that studies on the prolonged use of these drugs is rarely undertaken. Probably the most devastating practice is the ” professional secrecy” which shields the therapist from accountability. I have never seen a court case involving incompetence of a therapist. The patient does not live in isolation. His/her family and friends ned to know what is going on with the patient and what they can do to ameliorate the symptoms that the patient exhibits. When will we see accountability in this fraught (but well-compensated) field?

Tuesday, November 12, 2019 10:44:50 AM | posted by margaret
Heartbreaking that in this entire article not once is the elephant in the room mentioned: these couple therapists are not utilizing a theoretical model for working with couples that works. Emotionally Focused Therapy (EFT), pioneered by researcher Sue Johnson PhD has a 75-80% success rate with couples! Having a blueprint that works, having the stages of EFT to work with, having the EFT tango to guide me step by step, staying out of content, enjoying ongoing supervision and peer support for working with EFT and leaning in to process WORKS! If you are going to write as an expert on couples, please do your homework by going to www.iceeft.com to learn how EFT is dedicated to ongoing discovery and research, how it offers passionate teaching of the model, is constantly seeking ways for further advance effective psychotherapy with couples, and provides collaborative consultation to couple therapists in 45 countries and growing around the world. In summary, EFT gives us a theory, research findings, and a direction for successful outcomes. The research and results truly are remarkable. – Margaret Petersen MFT

Tuesday, August 6, 2019 12:02:19 AM | posted by Colonel Buck
Several years ago someone wrote in to Ann Landers inquiring about the chances of finding a competent therapist. She answered that it was about the same as finding a competent plumber, about 50/50. Incompetent therapists need to be hounded from the profession. Please report your experience on yelp dot com, and don’t be afraid to name names.

Friday, March 1, 2019 7:08:14 AM | posted by Anonymous
I have had my therapist of 3+ years recently try out a ‘lurching’ approach with me, and I have to say it has dramatically affected our therapeutic bond is a very negative way. I no longer trust him or feel comfortable sharing anything with him. Although we have discussed his error at length, and he has apologized, I cannot seem to move past this. After a lot of trying to figure out why, I am realizing that it is because that one action/comment on his part invalidated the 3 years of support and empathy he had shown. I guess it makes me doubt his sincerity or authenticity all along. I have decided to terminate therapy because I now see it is a completely fake process.

Thursday, October 11, 2018 9:57:48 PM | posted by Jose M Veiras
I don’t understand why they call it “Therapy” when is just a conversation without a plan. I get irritated when at the beginning of the conversation the therapist ask me How do you feel today? Or what’s in your mind today? I don’t want to feel better about my issues, I want to improve them.

Monday, August 27, 2018 2:25:26 PM | posted by Gayle
I really appreciate your posting here, as I am both a survivor (veteran MST and childhood trauma) and a former student of psychology (also one who worked in a clinical psychology lab as an RA who studied childhood trauma among foster kids). As adult survivors, we didn’t get the chance at treatment or even validation for the childhood or adulthood victimizations that have happened to us; no justice, lack of treatment close to the time of the trauma, etc. Maladaptive coping skills and maladaptive cognition tied to those maladaptive behaviors set in over long periods of time. Changing a survivor’s lifestyle is easier said than done for even the most seasoned therapists. As a survivor, I really appreciate those who can deal with or prevent their own secondary traumas from occurring when hearing survivors’ stories over and over again. I know I couldn’t do that, but I can do research, which empowers me. Much research on the subject of trauma has shown that externalizing behavioral problems, adjustment problems, and psychosocial problems are all related to post-traumatic stress (whether or not the survivor meets the diagnostic criteria of PTSD). The longer the time span between the traumatic event (most often, complex traumatic events and polyvictimizations across the lifespan by the time a client finds the courage to enter therapy as an adult), the harder it is for both the therapist and the client to find common ground in life-long and lasting life changes that will benefit the client. Most survivors are afraid of letting go of their maladaptive coping skills – but why? It’s the etiology of not only the trauma that keeps a person stuck, but also the etiology of why clients are afraid and/or unwilling to change their lifestyle in a more healthy, positive way. If the etiology of trauma is early childhood abuse, preverbal childhood body memories, emotional abuse, emotional neglect* (distinguished here from other forms of neglect), and separation trauma, and the etiology as well as history of maladaptive coping skills followed as a means to survive in an unsafe world that may re-harm them (which often gets reinforced by adulthood re-victimizations, the news, neighborhood violence, continued stigma on mental illness, and factors outside individual responsibility), efforts to suggest healthier ways of living might be visited by thoughts (cognition) such as, “I am a target unless I do these things to protect me or appear less of a target,” or “I will get hurt again, but I will do whatever I can to mask the pain if and when it happens,” or “I am afraid that if I do healthier things, I will feel anxiety, fear, and sadness more because it hurts to realize and grieve over all the losses in my life, and healthier coping skills reminds me of how hard my life is and how great it could have been had the trauma never occurred.” For me, these are issues that I was never able to address in treatment until recently. Sometimes getting at the etiologies of the reasons why clients are reluctant to change might unravel post-traumatic truths about their life, their self-worth, their losses, and their continued and ongoing traumas that persist in their lives (e.g., research has shown that neighborhood violence and poverty are not only connected with each other, but they are also forms of traumas that are often experienced by survivors of childhood trauma who wind up in poor neighborhoods with lack of resources to better qualities of life; they believe that this is as good as it is going to get, and that being healthy among some of the unhealthy persons who live in crime-infested neighborhoods could make them an easier target to be re-victimized, which victimology studies have also revealed to be statistically significant amongst the polyvictimized). Thus, not all of the thoughts of trauma survivors are irrational, and so treatment should include ways of understanding CULTURAL DIFFERENCES and SUBCULTURAL DIFFERENCES related to SES, race/ethnicity, regional cultural practices (e.g., crime-infested neighborhoods or neighborhoods with high levels of sexual predators). Understanding that the world is not always fair or just (i.e., the antithesis “just world” fallacy that most would like to blame the victim or individuals as primarily responsible for ongoing re-victimization or even treatment resistance), and understanding that there is some rational belief systems that are embedded within maladaptive coping, might help stir things along in treatment. To acknowledge this and then say that despite such rational reasons to remain in unhealthy situations or doing unhealthy things means that the client is not seeing his or her own self-worth, his or her own potential for self-actualization, etc. The remembering and mourning and grieving may have already passed, but depression is likely to ensue unless more humanistic and existential efforts are also addressed. If a person feels as though he or she is too old now to start a new and healthy life, or if healthier relationships are not possible with such a “damaged person” (e.g., negative self-talk), then, in conjunction with CBT or other coping skills, it is always good to mix in a bit of positive psychology, narrative therapy, sense-of-coherence, self-esteem building (not just assertiveness training, but also re-defining purpose and self-actualization). I understand that some therapists believe that positive psychology and self-esteem building might lead to increased narcissism, but this is not always the case. There is healthy narcissism and unhealthy narcissism that rarely gets addressed in clinical settings, and healthy narcissism goes a long way to building a person’s confidence, self-esteem, self-efficacy, and mastery. Understanding how to meet a person where they are at in the stuck phase of treatment is important because post-traumatic sequelae is also traumatic. The trauma symptoms continue when trauma in other forms of non-victimization prevail; to the survivor, it feels like the same threat, and their self-worth and identity depreciate. For those who have a hard time with attachments (e.g., they appear forever attached to the therapist and cannot let go), they might feel the need to act out or so just to maintain the relationship; in such cases, they are afraid of healthier lifestyle changes because they are afraid of experiencing a “traumatic loss,” even though it would not be traumatic should they learn how to become independent and securely attached. I’ve known some survivors in groups admit this to us non-professionals, but they would never dare tell their therapist. That’s also what keeps some stuck. Other things that concern those who are more avoidant and less “needy,” are those who quit therapy prematurely or who don’t believe that life gets any better for themselves; they may fear getting close to “healthier” persons, or they may have healthy people in their lives and healthy attachments, but they make poor choices because they are afraid somehow that they’d be more of a target when healthier. There’s many different ways that survivors think in terms of lifestyle changes, and some of the post-trauma traumas might need to be addressed, also. It’s never a simple onion; there are layers within layers that must be remembered, mourned/grieved, processed, coped with, re-framed, and accepted before one can move on toward a healthier life. Hope this helps – from one trauma survivor and a former student of psychology (I admit I don’t know much, but I have the life experience of over 40 years to know what I’ve heard and seen among the survivor population). Kudos to you for posting this information and struggle!

Saturday, September 30, 2017 8:57:11 PM | posted by
I have been in an out of therapy for many years. I have been with my current therapist for five of those years. I see exactly where you are coming from and often have to ask myself these questions not the other way around. I have explained myself at least 3 times with her on these issues. She says I Don’t know? I have told her 2x now it is time for me to discontinue therapy Because I am doing better and can do Ok without her and we are only chit chatting now. It’s time to STOP therapy! Thank you for all your help. You have done well. Now I must fire you. Amen!

Thursday, September 21, 2017 11:01:59 AM | posted by Sally
From a patient’s point of view: Do therapists actually feel a sense of responsibility for directing their “non-suicidal/non-divorce” patients toward an end goal? Patients are paying you for a service. Period. You are either competent to provide that service or not. If a patient is able to be vulnerable and open with you – it’s your JOB to direct that toward a productive end goal and not just take their money and give nothing in return. The truth is – most therapists are just good/decent listeners that provide an outside perspective and follow up with some cliche but true run of the mill advice somebody can get from a self-help book. I think you have an obligation to let those patients know that they don’t need therapy and should spend more time with trusted friends.

Wednesday, September 6, 2017 12:57:00 PM | posted by
Great article…it has helped a lot to understand the problems I face as a therapist

Balancing Values: How Attitudes about Money Affect Relationships

Young couple doing financial planning

Love may bring two people together, but sometimes money is what drives them apart. Matters of finance can strain relationships in many ways, such as when spouses keep secret debts from their partners or, as a recent study showed, when wives make more than their husbands.

One source of conflict is how differently people are raised to think about saving, spending, and investing. Yiting Li, a PhD student in family social science at the University of Minnesota’s College of Education and Human Development, is studying how the financial values parents instill in their children can clash with the financial habits of their romantic partners as they grow older and enter into long-term relationships.

“When you are young, you observe your parents as financial role models and learn things from them that you internalize as part of your own identity,” Li said. “This is why money is sometimes really hard to talk about—because there’s no right or wrong answer. It’s about personal values.”

Up until the time children leave for college or otherwise move out of the house, they pick up cues from how their parents talk about money and budgeting, a process called financial socialization. Part of this process happens intentionally, when parents make a point of teaching their children, for example, to leave expensive products on the shelf or stick to a shopping list at the grocery store, guiding their children away from impulsive spending.

But parents’ habits can unintentionally influence their children, too. If they feel uncomfortable talking about their salary or debt, for example, children may be left to infer what they can from what they observe. Cultural norms can factor in, too: in Li’s previous research, she found Asian American parents don’t often talk about finances with their children, while parents of international students going to the US from Asia tend to instruct them about how to spend and invest their money.

Regardless of how it happens, children internalize many of their parents’ attitudes and behaviors, meaning two children from different families can have vastly different perspectives on finances. Li wanted to explore the question that has received little research attention in the past: what happens when they grow up and enter a long-term relationship?

“I might spend a thousand dollars on whatever I want because I can afford it,” she said. “But some people think, ‘If I have a thousand dollars, I need to pay my loans, pay my mortgage, and then move to the things that I want.’ There’s no right or wrong answer; it’s just different.”

A Matter of Values

In studying how family financial socialization goes on to affect romantic relationships, Li focused on couples who were married or otherwise living together. While people may see hints of their partner’s financial attitudes during the earlier stages of dating, they still handle most spending and budgeting individually. Once they start living together, though, it’s no longer possible to keep financial habits separate from the relationship. Couples will discover whether they agree or disagree, and in some cases may find it hard to resolve their differences and continue the relationship.

“This is a turning point for the young couples,” Li said. “If you’re cohabitating, you have to think about what kind of financial life you will have—who pays the rent, who pays the bills. Probably, you won’t continue the relationship if you disagree too much.”

In her research, Li used data from Arizona Pathways to Life Success for University Students (APLUS), a survey lead by the U’s Joyce Serido, PhD, associate professor of family social science, which studies the factors influencing young adults’ pathways to stability and happiness. The survey has been running since 2008, tracking the roles that healthy relationships, responsible financial decisions, and personally meaningful work play as young adults move further into adulthood.

The survey questions explored to what extent couples believed their partner was spending within their budget, tracking their monthly expenses, paying down credit card balances, and saving money for the future. They also evaluated how they think their partner sees their habits, and to what extent they might agree or disagree with these habits. Li said many couples may accurately perceive one another’s financial values, but still disagree with the practices themselves.

Through her research, Li helped to fill a gap in the field by showing that that parents are not the only ones financially socializing young adults—romantic partners also become an important influence, and the dissonance between the two can cause conflicts in the relationship.

Now, as she moves on to her dissertation, Li aims to conduct additional research to expand her work. Ultimately, her hope is that the research will shed light on how finance-related conflicts surface in relationships and how they can best be addressed.

“Let’s open up the conversation and share our thoughts,” Li said. “Maybe we can agree to disagree, or maybe we can compromise somewhere in between and have a plan for the future. It’s not a romantic subject, but we have to start somewhere.”

Kevin Coss

Kevin Coss

Kevin is a writer with the Office of the Vice President for Research.

[email protected]

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Skip to Content Go to the U of M home page One Stop MyU Office of the Vice President for Research Inquiry Blog Header Subscribe About Us Back to Inquiry Home Balancing Values: How Attitudes about Money Affect Relationships May 30, 2019 by Kevin Coss Young couple doing financial planning Love may bring two people together, but sometimes money is what drives them apart. Matters of finance can strain relationships in many ways, such as when spouses keep secret debts from their partners or, as a recent study showed, when wives make more than their husbands. One source of conflict is how differently people are raised to think about saving, spending, and investing. Yiting Li, a PhD student in family social science at the University of Minnesota’s College of Education and Human Development, is studying how the financial values parents instill in their children can clash with the financial habits of their romantic partners as they grow older and enter into long-term relationships. “When you are young, you observe your parents as financial role models and learn things from them that you internalize as part of your own identity,” Li said. “This is why money is sometimes really hard to talk about—because there’s no right or wrong answer. It’s about personal values.” Up until the time children leave for college or otherwise move out of the house, they pick up cues from how their parents talk about money and budgeting, a process called financial socialization. Part of this process happens intentionally, when parents make a point of teaching their children, for example, to leave expensive products on the shelf or stick to a shopping list at the grocery store, guiding their children away from impulsive spending. But parents’ habits can unintentionally influence their children, too. If they feel uncomfortable talking about their salary or debt, for example, children may be left to infer what they can from what they observe. Cultural norms can factor in, too: in Li’s previous research, she found Asian American parents don’t often talk about finances with their children, while parents of international students going to the US from Asia tend to instruct them about how to spend and invest their money. Regardless of how it happens, children internalize many of their parents’ attitudes and behaviors, meaning two children from different families can have vastly different perspectives on finances. Li wanted to explore the question that has received little research attention in the past: what happens when they grow up and enter a long-term relationship? “I might spend a thousand dollars on whatever I want because I can afford it,” she said. “But some people think, ‘If I have a thousand dollars, I need to pay my loans, pay my mortgage, and then move to the things that I want.’ There’s no right or wrong answer; it’s just different.” A Matter of Values In studying how family financial socialization goes on to affect romantic relationships, Li focused on couples who were married or otherwise living together. While people may see hints of their partner’s financial attitudes during the earlier stages of dating, they still handle most spending and budgeting individually. Once they start living together, though, it’s no longer possible to keep financial habits separate from the relationship. Couples will discover whether they agree or disagree, and in some cases may find it hard to resolve their differences and continue the relationship. “This is a turning point for the young couples,” Li said. “If you’re cohabitating, you have to think about what kind of financial life you will have—who pays the rent, who pays the bills. Probably, you won’t continue the relationship if you disagree too much.” In her research, Li used data from Arizona Pathways to Life Success for University Students (APLUS), a survey lead by the U’s Joyce Serido, PhD, associate professor of family social science, which studies the factors influencing young adults’ pathways to stability and happiness. The survey has been running since 2008, tracking the roles that healthy relationships, responsible financial decisions, and personally meaningful work play as young adults move further into adulthood. The survey questions explored to what extent couples believed their partner was spending within their budget, tracking their monthly expenses, paying down credit card balances, and saving money for the future. They also evaluated how they think their partner sees their habits, and to what extent they might agree or disagree with these habits. Li said many couples may accurately perceive one another’s financial values, but still disagree with the practices themselves. Through her research, Li helped to fill a gap in the field by showing that that parents are not the only ones financially socializing young adults—romantic partners also become an important influence, and the dissonance between the two can cause conflicts in the relationship. Now, as she moves on to her dissertation, Li aims to conduct additional research to expand her work. Ultimately, her hope is that the research will shed light on how finance-related conflicts surface in relationships and how they can best be addressed. “Let’s open up the conversation and share our thoughts,” Li said. “Maybe we can agree to disagree, or maybe we can compromise somewhere in between and have a plan for the future. It’s not a romantic subject, but we have to start somewhere.” Categories: Research & Discovery Kevin Coss Kevin Coss Kevin is a writer with the Office of the Vice President for Research. [email protected] Latest Blog Posts Close-up of Lake Superior agate Revealing the Invisible: New Supercomputer Equipped to Find Meaning in Data July 29, 2021 by Kevin Coss Agate, named after Minnesota’s state gemstone, will supercharge research by offering roughly seven times the computing power of the existing Mesabi system. 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Read More Categories: Research & Discovery Close-up of a hand using a pipette to drop liquid into a well plate Research Tools: Distributing Resources to Spur Scientific Progress July 28, 2021 by Kevin Coss A Technology Commercialization program helps researchers share tools developed in the course of their work with others in academic and industry settings. Read More Categories: Business & Technology Categories Infrastructure & Capabilities Research & Discovery Vision & Impact Business & Technology Contributors Kevin Coss Erin Dennis Deane Morrison Gold block M Vaughn Schmid portrait Dan Gilchrist Meher Khan Kirsten Gray button-webpage-vholly.png Subscribe to get Inquiry in your inbox Subscribe to OVPR’s Inquiry Newsletter Email Address * Office of the Vice President for Research 420 Johnston Hall 101 Pleasant St. SE Minneapolis, MN 55455 Email: [email protected] Phone: (612) 625-3394 OVPR Home Website Feedback/Questions Maps & Directions Parking & Transportation Last Modified: May 30, 2019 – 10:34am. Back to Top © 2018 Regents of the University of Minnesota. All rights reserved. The University of Minnesota is an equal opportunity educator and employer. Privacy Statement Report Accessibility Concerns Skip to Content Go to the U of M home page One Stop MyU