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After first meeting the client, what is the process that a counselor facilitates?

A good therapist will discuss what brought you to therapy in the first place and devise a therapy plan with you on some of the things that you may want to work on.  The plan is not set in stone as things may arise during your therapy sessions. You also agree on how often and when you would like to meet. 

How does a counselor decide when to end counseling sessions or to terminate working with a client?

In the best case scenario, it's a mutual discussion and decision. If not,  I've had the discussion initiated both ways, by me, when I sense the client has gone has far as they want, by lack of interest in accepting or completing homework assignments, missing or cancelling appointments, usually at the last minute, lack of participation during sessions.  Client initiates by asking me pointed questions about why the need for homework assignments,, by forgetting their calendar, or their checkbook :) , by suggesting that we make appointments over longer intervals (once a week to once a month, for example).  I rarely have had to terminate a working relationship--that's why I don't charge for the first visit, so we know if we are a good fit before we start working together.  Then I periodically ask whether the client feels we are making progress, moving in the right direction, talking about the most relevant issues etc.

Does counseling really do anything that can help people?

Experts have defined counseling as a healing relationship that helps patients by providing a space to vent, process and receive unconditional support.  Many of my clients have expressed that they are able to find their own answers during the session, because they have the right person listening to them.  Some thought they were safe sharing their concerns with friends or relatives who are good listeners, but later they felt ashamed or guilty about what they shared.  So why people should share private issues with a Counselor (a stranger)?  Confidentiality is the key word.  A good counseling relationship should provide a space where people are able to share their deepest thoughts and feelings, allowing themselves to be vulnerable and explore those emotions that are difficult to share without implications.  Beyond the ability to provide a safe place, counselors are trained to identify symptoms and behavioral patterns, and can provide insight on how develop coping mechanisms to improve their life.I am a License Professional Counselor working on a private practice in Puerto Rico: Latitude Counseling, and also I’m licensed in Texas, where I provide theletherapy services.  If you would like to learn more about the services available, you may call 787-466-5478 or visit www.latitudecounseling.com¿Cómo la consejería ayuda a las personas?¿Realmente la consejería hace algo para ayudar a otros?Expertos definen la consejería como una relación sanadora que ayuda a los pacientes proveyéndoles un espacio para ventilar, procesar y recibir apoyo incondicional.  Algunos de mis clientes han expresado que son capaces de encontrar las respuestas a sus problemas durante la sesión de consejería, porque tiene a la persona indicada escuchándolos.   Otros cuentan que se sentian seguros compartiendo sus preocupaciones con su familia o amigos, pero esas preocupaciones afectaron sus relaciones negativamente, o los dejaron con sentimientos de culpa. Así que, ¿Por qué deben las personas compartir asuntos privados con consejero, (un extraño)?  Confidencialidad es la clave.  Una buena relación de consejería debe proveer un espacio donde las personas puedan compartir sus más íntimos pensamientos y sentimientos, permitiéndoles ser vulnerables y explorar esas emociones que son difíciles de compartir sin consecuencias. Mas allá de proveer un espacio seguro, lo consejeros profesionales estamos entrenados para identificar síntomas, patrones de conducta, y proveer perspectiva en cómo desarrollar los mecanismos de defensa necesarios para mejorar la calidad de vida.Soy Consejera Profesional Licenciada en Puerto Rico, donde practico a través de Latitdue Counseling, también estoy licenciada en Texas, donde proveo servicios de teleterapia.  Para más información llame al 787-466-5478 o visite www.latitudecounseling.com

My ex-fiancé (whom I am still seeing) left me because of the pressure from all three of his teenage daughters. They wanted him to try to work it out with their mom (his ex-girlfriend of 20 years). He and I split three months ago, but I have been seeing him pretty regularly despite the fact that he is living back with his ex-girlfriend and kids. He is "co-existing" for the kids and fighting all the time with his ex-girlfriend. His daughters don’t want their dad with me because my two boys (grown adults and on their own now) had bad reputations and issues with drugs. His daughters say it is embarrassing for him to be with me. He and I had an absolutely amazing relationship and connect on so many levels. He is getting a lot of pressure from his family and his longtime friends to "do the right thing" and stay with his ex-girlfriend for the kids. He says he wants me to wait. We were going get married last year. He bought me a $1000 dress, we had invitations made, and everything set up, but then his girls told him they'd never speak to him again if he married me. He says he’s trying to mend his relationship with them.

Hello. It seems you are in a set of circumstances that are highly uncomfortable for you. Do you feel those circumstances are healthy? Do you find pleasure being in such a place of uncertainty? Why do you continue to be in this situation? Without meaning to appear that I might be lacking in compassion, you do have the option to leave the connection completely if the harm it is doing is more that the pleasure it brings you. Is there a benefit to being in this relationship? Do you consider this situation to be for your highest good? Is it healthy to be involved in something that is not likely healthy or perhaps could even be seen as dysfunctional? In truth, only you can decide the answers to these very important questions. I would encourage you to think of who benefits by being in this situation, and how you might be able to find happiness in other relationships that are healthier and more positive. In my clinical view based on what I read, this particular relationship does not carry the joy I am sure you want, nor the healthy interactions you would expect in a functional romantic engagement with another person.Beating yourself up about potentially wasting all this time waiting for the other person to come around will not serve a positive purpose. It likely will only lower your self-esteem. There is a time to wait to see how things develop, and a time to move on to other experiences. You are the one to make that choice, but I would encourage you to connect with your inner higher self, for the most clear answer. Chances are, you already know the answer, you just need to embrace it. Getting in touch with a counselor in your area can also help ferret out some of the deeper issues that you might not have felt comfortable expressing here.

I was raped a couple months ago, Since then, along with other unfortunately events that have occurred, I have been having trouble feeling emotions. It's almost as if I'm a sociopath lacking any feeling. What can I do to change this?

You are describing a very legitimate reaction to trauma.  Rape is an aweful experience and I am very sorry that happened to you.  When horrible things happen, people often react in a way that interferes with the ability to live a normal life and function the way they did in the past.  This is very common and the goal is to help you manage the stress caused by dealing with negative events and with help you can regain emotional well-being.  This is especially important if you have had more than one negative thing happen.  Oftentimes, the unconscious reaction is to become numb and avoid all feelings, especially if more than one negative event occurred.  A big part of what causes people trouble are feelings of guilt.  We often blame ourselves when bad things happen. It is actually difficult to comprehend the concept that we don't always have control of what happens in life.  In addition, when you mentioned feeling like a sociopath, it sounded like you feel like your reaction is wrong.  The first thing you can do is realize that your feelings and reactions are o.k., you aren't doing anything wrong, and nothing is wrong with you.  The next step is to start dealing with the impact of these traumatic experiences. Identifying your feelings, and knowing the thoughts and beliefs that are behind those emotions can help you regain your sense of happiness.  Research shows that understanding and expressing those thoughts and feelings can help.  If doesn't sound like you need to do anything to change yourself, but talking to a counselor can be helpful in managing your reaction to a incredibly traumatic experience.  I hope this helps you understand your feelings and can get to a place where you enjoy life.  

I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

That is a really tough situation that a lot of young people are experiencing right now. The first thing to under is that you can’t change who your parents are and cannot change their behavior. The thing to keep in mind is that you can control your responses and actions.  You may need to keep living at home with them for the next few months or years and the best way to do this is to have a plan. The second thing is to keep in mind that their controlling behavior is most likely not about based your behavior. Controlling parents are often driven by their concept of what will keep their children safe and happy. Unfortunately this is not always accurate but keep in mind it is not a personal attack.  There are ways you can deal with controlling parents – and most of them require creating a plan of action.Examples of action plans:Decide in advance how you’ll calmly and rationally respond to your parents when you feel they’re trying to control youArrange to phone a friend or trusted adult when you feel like you’re losing controlTalk in person to an adult you trust. There aren’t any quick tips on how to deal with parents who want to control you; you need to find strategies that are geared to your specific family situation. Get specific coping tips from books about family dynamics, such as:Toxic Parents: Overcoming Their Hurtful Legacy and Reclaiming Your Life by Susan ForwardCutting Loose: An Adult's Guide to Coming to Terms with Your Parents by Howard HalpernA counselor can be a good resource and provide support and guidance about issues addressing normal growth and development during periods of transition.

I'm planning to have baby, so I have to quit smoking - but it's hard. Sometimes it's not a physical need, it's mental. I cannot help myself from thinking about smoking. What can I do to get rid of this addiction?

Quitting smoking can be difficult. It's also true that there is part that is sometimes a physical need and a part that is often connected to emotions in some way. From the way that you wrote this, it sounds like you may have been able to stop smoking physically, but still have cravings.One thing you can do is talk with your primary care physician or OB/GYN about whether there is anything that you can take to help with the cravings. Sometimes that can very helpful.As far as the more emotional or mental piece, these things come to mind:Sometimes a crucial part is looking at the habit of smoking and seeing what else you can do to keep your mind and hands busy. There are sometimes toys, like those available at Office Playground, that may help to keep you physically occupied.There can also be changes or additions to your routine because I imagine that smoking took up a great deal of your time. Maybe when you have the temptation to get up and go to have a cigarette, you could have several other things that you can get up and do instead. The list is endless, but a few examples could be doing some physical exercise (with the permission of your doctor) just for a couple minutes because that could help with the craving as well, completing a puzzle, learning a new activity that requires using your hands (painting or knitting, perhaps).Another piece of quitting smoking is often linked to anxiety or other emotional changes, perhaps irritability. Depending on what it is that you may be feeling,  learning other strategies to use can be helpful as well.This can all be quite overwhelming and a very big life change. I would recommend that if things do not become easier for you, consider talking with a therapist. Then you could not only have some more strategies or ideas directly related to you, but you could have very direct support for what you are trying to do.I give you a lot of credit!

How does a counselor decide when to end counseling sessions or to terminate working with a client?

Goodbyes can be hard. Chances are most of the goodbyes you have experienced in your life have been difficult. Saying goodbye to a therapist can be different. It can be an opportunity to create a healthy ending in a positive relationship in your life. If you work with a therapist who is skilled, then saying goodbye can be just as transformative as the therapy itself. Ending therapy is also known as “termination.” I know, “termination” doesn’t have a great ring to it! However, it is what it is. It is an ending of the relationship as it existed. It is reality cold and stark. Of course, when I talk to clients I don’t use the word “termination,” I usually say “our goodbye.”  Under what circumstances does therapy usually end? Therapy should end when a client does not need further assistance, is not receiving any benefit from therapy, or might be harmed by continuing to work with a particular therapist.In the best case scenario the decision to move on from therapy and “say our goodbyes” happens when both the therapist and the client feel like the client is ready to move on and move up!  Ending the therapeutic relationship should actually be worked on from the very first session. What I mean by that is, there should be an understanding that the work we do together will have an ending and that is a good thing because it means the client has gained the skills to continue working on themselves independently. So the first session I have with clients usually outlines a plan where the end goal is discussed and we both have an understanding of the skills the client wants to learn or what they hope to achieve. Now sometimes there are situations where the therapist ends the relationship and the client may take that personally, it is hard when any relationship ends and it might bring up feelings of sadness, and fear or abandonment. Any good therapist will end the relationship based on what is right for the client. What are some situations where a therapist might end the relationship?If the situation the client is dealing with is out of the therapist's scope of practice, the therapist may end the relationship and refer the client to someone else. This is in the client’s best interest. Another reason a therapist might end the relationship is that the therapist is in a place in her life which prevents her from being objective and helpful.  A therapist who is going through a painful divorce may have difficulty working with a couple that considering divorce. A good therapist may see that their judgement may be clouded and want to refer the client to see someone else. This is good practice and helps the client.If a client is actively suicidal or actively using substances then the therapist may end the relationship and refer out for a higher level of care. The client may need to be hospitalized or may need an inpatient substance abuse treatment program. Therapy may be terminated while they are being treated and may continue after the intensive program is completed.  Ending therapy should be a time for connection and bringing together accomplishments, or reviewing the next important step the client needs to take. It should not be an experience of abandonment. A skilled therapist will help a client gain a new perspective on closure. For some clients, it may be the one time in their lives when they get a clean ending in a healthy relationship and they get to feel a sense of control on creating that ending. Good luck to you!

I'm planning to have baby, so I have to quit smoking - but it's hard. Sometimes it's not a physical need, it's mental. I cannot help myself from thinking about smoking. What can I do to get rid of this addiction?

It is very good news that you realize the risks of smoking cigarettes while pregnant and are willing to stop.Thinking about smoking is a typical and frequent reaction to being without the substance.Be creative with what you know about yourself to distract you when this psychological urge comes up.  My suggestions are to imagine smoking if you find this would relieve the sense of wanting to smoke.Or, do the opposite and remind yourself of all the good reasons to not smoke.Also, since you're planning pregnancy then ask your partner for ideas on how to make the psychological feeling to want to smoke, feel less intense.Another suggestion is that your partner is your texting buddy to stop smoking.   With AA groups, a sponsor is always available for the alcoholic who feels distress about the urge to drink.   Having a trusted and caring person to tell about your problem helps in many situations.  Maybe it will help you to stop smoking.Good luck!

I'm a teenager and I've been sneaking out of my house at night for a year now. I've been caught several times. I want to stop doing this but I don't know where to start. How do I stop?

Where do you go and what is your reason to go wherever this is?Try to understand these reasons because the answers may give you good guidance as to other ways to get what   it is your trying to reach by sneaking from your home at night.If for example, you're sneaking out because your parents are arguing and you feel hurt by this and want to escape hearing their arguments, then you can come up with other ways to hear less of their arguments.If you sneak out bc your parents restrict your friends or time to socialize with your friends, and your friends are doing legal and safe behaviors, then maybe you could do some socializing online w them.Also, I wonder the reason why either of your parents isn't aware that you leave the house.  Do you feel your parent would offer and would you ask your parent to give their suggestions so you feel more motivated to stay home?

I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it. What is wrong with me, and how can I stop having these thoughts?

Those  critical thoughts most likely came into your mind as the way you understood what one of your parents or some other adult who was very meaningful to you, at a very young age.When we are too young to distinguish whether what a grown person tells us, feels accurate, we absorb their opinions as our own.Your question shows you've reached the point of emotional maturity to know that your opinion about yourself is not the same as what is inside your emotional brain and stored there since you were too young to know that someone else's opinions are not necessarily your opinions.Nothing is wrong with you, everything is right with you to wonder how to more firmly establish your own point of view.Start the habit to revise any viewpoints about yourself which don't feel true.Then replace these thoughts with better ones which you decide on your own.After a while of doing this you'll either automatically think the more positive thoughts about yourself or at least be in the habit to know that negative viewpoints about you are not necessarily true.

How does a counselor decide when to end counseling sessions or to terminate working with a client?

Counseling ends when the client has received the maximum benefit from the therapist. Even if the therapist believes the client is not making progress, the client may feel they are improving and receiving a benefit. And the therapist may see a benefit and the client does not. It is best to have ongoing dialogue with the client to determine when termination is appropriate.

How does a counselor decide when to end counseling sessions or to terminate working with a client?

There are several reasons for a counselor to decide to end counseling.  A major reason to end counseling is if the counselor feels that he or she does not have the skills or experience to work with the client.  This may happen during the intake process or after working with the client for some time.  If the clinician feels that the client is not benefitting from the therapy, it is ethical to suggest that the client terminate the therapy.  The process of termination must not injure the client and, if necessary, the clinician may need to refer the client to other treatment modalities.  Another reason to terminate working with a client is if the client needs a higher level of care.  If the client has a crisis or is at risk of hurting himself or someone else, he or she may need a higher level of care.  In this circumstance, the clinician may need to involve outside services such as a crisis unit.  A third reason to terminate with a client is if the clinician feels that he or she cannot remain professional with the client relationship.  For example, if the issues that the client is working on bring up something significant for the clinician and the clinician feels that he is unable to separate that from the professional relationship.  In this instance, the clinician should refer the client to another therapist.  Finally, if the client has reached her goals for therapy and no longer needs treatment, the clinician and client should terminate treatment.

What are some difficulties that a counselor can encounter when dealing with a client?

Each counselor will have their own list of "difficulties" in doing therapy work with a client.  Even if clinically trained similarly, since counselors are human then their response to your question will reflect their unique differences as humans.On my list is when the emotional pain I feel for someone describing some type of injustice or unfair treatment by another, feels very deep.Sometimes I feel like avoiding the pain I feel by asking questions which will steer the conversation away from the painful areas the client talks about.What in fact is necessary to clear out their pain, is to step further into so as to realize their emotional pain isn't greater than who they are.

Does counseling really do anything that can help people?

Yes, counseling can help people.How this happens is bc the counselor can guide the person or couple into deeper areas of their thoughts and emotions than the person or partners would typically avoid or not even realize they are avoiding.Also, a counseling session offers emotional safety because the therapist will intervene with thoughtful questions if someone's strong emotions overwhelm them.This is different than in everyday circumstances.  When someone feels overwhelmed by their own or someone else's feelings, there is no one who asks reflective questions.Last, people get better in therapy because often therapy is the first time the person has a chance to trust someone with their confidential information and know this information will always be protected.

I'm planning to have baby, so I have to quit smoking - but it's hard. Sometimes it's not a physical need, it's mental. I cannot help myself from thinking about smoking. What can I do to get rid of this addiction?

Hopefully you feel you have the time to follow this procedure.1. For a week - log when you smoke - time, place and activity2. Plan on cutting back 10% for a week.Cut out the easiest times.3.Next change the times and and activities for 3 days - consider water or candy or gum if it is very tough. 4. Cut another 10% each week until you are done. 

How does a counselor decide when to end counseling sessions or to terminate working with a client?

I will work with clients and continually review progress with them and determine if counseling is helping.  If a client appears to have less to talk about in sessions, appears more stable for a period of time and has reached therapeutic goals I will talk about termination.  Some clients however I may continue with on a monthly or bi monthly process to allow for check-ins to see how they are doing and if they need more help at that time.

I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

Hello. It sounds like you and your parents are not balanced in your communication and awareness of expectations. Your growth is not only reflected in your ability to understand and apply new knowledge and skills, it is also reflective of your parents acceptance of your understanding and application. Have you tried talking with your parents to let them know your concerns?This talking is best when face to face and during non active conflict ( can't begin stating rules during an argument, etc). Sometimes it is even helpful to write down ways you feel you can be supported by them and supportive to them. Maybe share this list or reflective piece with them to review, or use when communicating the expectations. Unfortunately, until there are clear expectations stated and expressed, the scale will be uneven and frustrations will increase. Dr. T

After first meeting the client, what is the process that a counselor facilitates?

After meeting a client, many Counselors will ask you lots of questions in order to complete a thorough assessment of what you came to counseling for. This assessment is required by most insurances and allows the Counselor to give a diagnosis, which is also required by most insurances in order for them to pay the Counselor. If you are paying out of pocket, this diagnosis is not really required for payment, but many Counselors will still perform a comprehensive assessment because we really want to know what the issues are that brought you to us. The better we understand what it is that bothers you, what you would like to get out of the counseling, and all the various things that tend to affect people such as family upbringing and medical issues, the easier it is for us to help you reach those goals. How the counseling actually plays out from there depends a lot on the theory that the Counselor uses to direct their approach to counseling, and that information is too much for this little post.

I start counseling/therapy in a few days (I'm freaking out) but my main fear is that I'll cry and embarrass myself, is it something to worry about?

Many people cry during their therapy sessions. Actually most people cry in their therapist's office. I tell my clients that it's safe to cry in my office and crying isn't a sign of weakness. It's a normal human response to pain. People actually do more harm to themselves by trying not to cry than by crying. Crying is very cleansing and an important part of the healing process for many people.

How does a counselor decide when to end counseling sessions or to terminate working with a client?

In general, I usually let the client decide when this should occur, sometimes with some clients it will be a joint agreement, but even in that case it should weigh mostly on what the client feels. In short, therapy ends when you feel your done.C

I've been bullied for years and the teachers have done nothing about it. I haven't been diagnosed with depression, but i have been extremely sad for years. How can I deal with being bullied at school when the teachers won't help?

To be bullied is very painful.I'm glad you know the bullies are doing the wrong thing and whatever they are telling you is pure meanness.Depending on how independent you feel, why not tell either your classroom teacher or schedule an appointment with the vice principal?Bullying other students is taken very seriously in some states and schools are expected to address the bullying until the victimized student feels safe.If you hesitate to do this on your own, then would you ask either of your parents or even a friend of yours who is also in the school, to report the problem?In case you are afraid the bullies will retaliate for reporting them, then tell this to whatever school authority you decide to ask for help.You're entitled to be protected by your school.

I need help knowing how to deal with stress. What can I do?

Something different works for each of us.There are the outward answers of self-pampering and making your home and work environment as pleasant as possible.A deeper level way to decrease stress is through exercise or alternative practices like yoga or tai chi.If the stress is more deeply rooted than temporarily feeling irritated for a few days, then give yourself some time to reflect and clarify what the meaning of the stress is to you.Self-understanding and appreciating your efforts to know yourself may decrease stress because you'll be more focused and attentive to who you are.  This will influence you overall to make good decisions for yourself and these will naturally be ones which decrease stress as much as possible.

I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why, I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it. How can I help myself to change my behavior?

Hello. I have to wonder from a behavioral perspective if what you are doing is useful for you. In other words, does it serve a purpose in some way when you find yourself doing it. Yes, this could well be an expression of anxiety, or maybe some type of coping skill you have developed over the years to deal with stressful situations. Yet it sounds like you have developed a sort of knee-jerk behavioral conditioning that causes you to do this behavior during specific (or perhaps even non-specific) circumstances. Do you think it is a self-soothing behavior? Do you feel good after you have done it? The behavior itself is likely causing some form of slow physical damage, so I would recommend you have yourself checked by a doctor, to rule out any injury. If none exists, this obviously doesn't excuse the behavior, it just says that for the moment luck is on your side.When we do any behavior of any kind, it is good to ask if what we are doing has merit or value. Is the behavior helping us to solve our problem, or is it merely creating yet another problem by doing the behavior in the first place. In the same way that a person might drink excessively because they are stressed and need to cope with some unresolved issue, when they are done drinking the original problem will still likely be there, but now they are intoxicated. No closer to solving the issue. When we deal with things like anxiety or depression, we need to do things that work on dealing with the symptoms, but also get to the root issue that created those feelings and find effective solutions. So the things we do to cope with life events need to not be ones that cause us harm, but rather support us as we move forward and work to deal with what life throws at us.Sometimes seeking support from a friend or a counselor is a good idea. Being given the opportunity to express your feelings about what is going on around you and getting feedback and insight from others is much more effective than actions of self-harm, wouldn't you agree? So I would encourage you to find a counselor or a trusted friend who can help you find positive behaviors you can take to deal with your feelings, as you also work to find the answers to the day to day issues of living a life filled with promise and opportunity.Reach out if you need help...there will likely be a hand there waiting for you.

Every winter I find myself getting sad because of the weather. How can I fight this?

One theory is that instead of "fighting" your feelings, accept your sad feelings and work with them.   Feeling sad may open many doors to reflect and make peace with the source of your sadness.Also, I believe fighting against the natural cycle of rest and hibernation may not even be possible to succeed.   Winter for most creatures is a time of withdrawal and slowdown.  Our bodies and moods are part of nature as well.  Fighting what is part of nature seems like a tiring fight which the person will lose.Last point, there are the winter holidays to break up the dark and cold of winter.   Maybe you can invent some of your own winter celebrations so you'll have a few gatherings to look forward to hosting.

I've never been able to talk with my parents. My parents are in their sixties while I am a teenager. I love both of them but not their personalities. I feel that they do not take me seriously whenever I talk about a serious event in my life. If my dad doesn’t believe me, then my mom goes along with my dad and acts like she doesn’t believe me either. I’m a pansexual, but I can’t trust my own parents. I've fought depression and won; however, stress and anxiety are killing me. I feel that my friends don't listen to me. I know they have their own problems, which I do my best to help with. But they don't always try to help me with mine, when I really need them. I feel as if my childhood has been taken from me. I feel as if I have no one whom I can trust.

Life sounds extremely frustrating for you right now.As long as you've reached your conclusion that your parents do not take you seriously when you would like to speak with them on a serious topic, and that you feel unable to trust either of them, then work with your own information.Many people don't know how to listen and aren't trustworthy.  As painful and aggravating as having parents who fit this description, you're better off to honor what you realize than to continue fighting what is not in your hands to change.Since you write about having a similar problem with friends, then maybe this comes about because you pick friends who are similarly unsatisfying to be with as are your parents.The first step out of this dilemma would be to accept how crummy you feel about the way your parents are toward you.If you're able to live with the sadness and resentment of having parents who don't want to know how to understand you, then you'll start to develop a new and more satisfying definition of what you expect from the behaviors of your friends.Trust yourself that what you feel and see is accurate, then it becomes easier to trust and welcome new people who are formatted differently than either your parents or your friends who sound very similar to your parents' ways.

My brother has been diagnosed with paranoid schizophrenia and has not been taking his medication. He's been using methamphetamine and alcohol and was found sleeping naked in my step mom driveway in 12 degree weather. I was adopted in by his dad (who just passed) and his mother will not Get involved because she's afraid of financial responsibility. Do I have the rights to be able to sign my brother into mentalhealth facility?

The answer depends on what State you live.Since the description you write here is that your brother may be a serious risk to himself and others, it is worth contacting a mental health hotline or one of your local area hospitals and talk to a social worker or other professional level person in their psychiatry department.  Ask the same question you posted here.   Your question is a good one and merits serious follow through.

I feel like I am internally screaming all the time. Externally, I am calm, but I have this intense, unidentifiable emotion constantly. I don't feel sad. I don't cry a lot. I feel rather emotionally distant other than the internal screaming. It kind of feels like I'm a caged animal.

It sounds like you are trying to find a label to help you to understand why you are feeling the way you are feeling.  Sometimes there are no labels for how we feel.  Sometimes there is no name for the emotions that we are experiencing. Regardless, you do not have to continue to feel this way, no matter what you call it.  If you are seeking to experience an internal calmness such as your external calmness, you may want to try some mindfulness practices or meditation.  However, being able to get at the root cause of what you are feeling may be what you need to help you release this feeling for the long term.  I recommend seeking support for this to allow this internal screaming to get some air and begin to breathe. 

How does a person start the counseling process?

The first thing to do is to reflect on what you want to seek counseling. Search online and then set up a phone consultation. A person can find out a lot about a counselor and the services that they offer over the phone. After a consultation then set up an intake questions. The overall goal is to make sure that you are comfortable with the counselor and the services they can offer.

I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it. What is wrong with me, and how can I stop having these thoughts?

First off, there is nothing wrong with you.  In fact, having random thoughts we feel we cannot control is actually quite common and normal.  Sometimes our thoughts think they are protecting us (if we think we aren't worth anything, it won't hurt when we get rejected) but they are actually doing quite the opposite.  They are keeping us "stuck" and creating a self-prophization.  (If I think I am not worth anything, I don't have to try, and I will keep proving to myself that I am not worth anything).  There are many techniques to work through and start to change our negative self-talk.  There are actually many self-help workbooks that can help with this as well.  A technique I like to use is meditation or mindfulness.  This can teach us to accept our thoughts (not fight them) and then learn to let them go.  Release the power they have on us.  If we can learn to release these and not ruminate on them, this will give us the space to allow more positive and supportive thoughts to come in.  Mantras can help with this as well (I AM worth a lot, I AM important, I have value).  Saying these to yourself everyday over and over (even if at first you don't believe) can retrain our brains to believe it (and allow us to believe it).  I have even wrote positive mantras to myself in my bathroom mirror so I am forced to look at these throughout the day.Please remember to not be hard on yourself as you begin to attempt to change the automatic thought patterns.  It took a while for you to get where you are and it will take a while for this change to kick in and feel normal.  So allow the process to happen slowly and allow yourself to accept you as the amazing and brave person you are.  

I'm a female in my mid 20s. Lately I tend to over drink and I've become a very angry drunk. In the past, I have even cheated on my boyfriend while I was under the influence of alcohol. But now, even if I don't do anything wrong and don't embarrass myself, I still feel really guilty after a night of drinking. I don't understand why I'm feeling this way. Does this mean I have a problem?

Speaking with a licensed therapist will help you figure out if indeed you have a problem or not.  I would say the first question you should ask yourself is why you are drinking? The second would be why you feel the need to drink in excess? It may be due to a life event or the crowd you are running with.  Either way a therapist will be able to help you through this as you already made the first step in admitting you are having a difficult time. 

My boyfriend is in recovery from drug addiction. We recently got into a fight and he has become very distant. I don't know what to do to fix the relationship.

I would first suggest you sitting down with him and voicing your concerns about how distant he has been, or more importantly you have felt that he is.  This will give clarification to the situation as we need to remember that everyone's perception can be different. Remember that relationships take work and take communication.

How does a person start the counseling process?

I think it is important that you are able to convey what you are looking for in a therapist even if that changes over time.  You need to look at it like you are interviewing the counselor and that they will be able to provide you with the therapy you need.  To many times we do not know and it ends up not being a good fit and then people are left with a bad experience and do not want to re-engage.  Remembering you are basically hiring someone to help you so I would treat it as such. Do some research and be clear as to why you are coming to therapy and ask questions as how they will be able to help you. 

My brother has been a heroin addict for years, and he’s now in his mid-30s. He has taken from me my mom and my grandparents. He's sick in the head. Now he moved his girlfriend into the house because they both manipulated us. Today, my mom and my brother went toe-to-toe over his girlfriend not helping around the house and always being high. I ended up hitting my brother for getting so close to my mom's face. I feel terrible, but he's always picking his girlfriend over us. Mind you, he tells other girls that he hates his girlfriend, he's single, and she's only living here because he feels bad. We tried kicking them out and everything, but nothing is working. They do nothing to try and help.

I think the best thing for you is to speak with someone on how you can best cope with the situation.  It can be challenging living in a household with someone who is currently addicted.  It is also important that you realize that you can only work on yourself.  Other individuals need to take the same accountability.  Enabling often happens in households with addiction. It can be a challenging environment to live in.  

I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

Unfortunately I think most of us have heard this, so you are not alone.  If you are still under her roof she has leverage as to what her expectations are while you are living there.  I would consider therapy for the both of you to see if there could be a middle ground that could be agreed upon.  Often times a 3rd party can help with conflict.  If there is no resolution then I would look to get creative in finding a place of your own. 

I have three children: a biological daughter, a stepdaughter, and a stepson. I found out my stepdaughter overdosed today. My daughter blames me. I told her to stay out of it. I'm scared of all three kids now. They all blame me for their choices they made. All three have drug addictions. I had a stroke in 2013 so I need to depend on people from now on.

Blaming others is one of our greatest coping mechanisms.  It is not just for addiction, and often we blame the ones closest to us.  You can not stop them from blaming you, you can stop yourself for taking on the burden.  We are all in charge of the choices we make.  No one makes us do something other than our self.  We choose how we internalize and react to situations.  I would find a good therapist who understands family dynamics and addiction to help you cope with your current environment and help you move forward.  

She's my stepmom. I'm pretty sure she's illegally buying the drugs and hiding them from my dad.

I would suggest having a conversation with your dad and then having a conversation as a family with your stepmom.  Usually there are other signs of use that can often be missed.  Be aware of behavior changes and mood swings.  Be supportive and ready to listen often times individuals suffering from addiction will deny use until they are ready for help. 

I recently lost a friend to suicide. I'm smoking marijuana and drinking more to cope with it. How can I handle this better?

First I am so sorry for your loss.  Most people go through the grieving process.  I would get a better understanding of what that process is.  Everyone has their own way of handling loss.  You are taking the first step in realizing that you are having a difficult time coping with it.  I would reach out to a therapist that has experience treatment patients with loss. I would also recognize that drinking and smoking are both substances that will not make depression or depressive thoughts any better.  

My friend is abusing her prescription medicine. Even though she told me she didn't have any more pills, I found she has prescriptions for anxiety medications.

Your friend needs to admit they have a problem.  If not no matter how many pills you take they will find a way to get more.  It is also a federal offense to take someone else's medication so if you did take it she could have you arrested.  In other instances it can be more dangerous to take medication away than slowly tapering off of them.  Like anything we put into our system our tolerance builds up and can effect us in different ways.  I would listen to her and discuss why she feels that she needs to be on the medications rather than playing bad cop in this situation.  Encourage her to get help and let her know you re there for her. 

My boyfriend and I recently broke up. One week, we were fine, and the next, he told me he needed space. He completely deleted me out of his life. He does have an opiate addiction. He claimed he was sober, but since we've split, I've heard many lies from him. Could he be using again, and does this addiction affect the mind?

Studies have proven that addiction affects the brain, there are many coping skills that addicts use to enable their addiction as well.  I would recommend that you speak with someone abut your relationship and your concerns.  Not only so you can have more clarity in the situation but we often tend to gravitate around or toward the same types of individuals.  Being more aware of your relationship will help you in the future when re-engaging in personal relationships. 

I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends. I spent the weekend with him and it upset my boyfriend. Was i wrong?

The most important thing to ask yourself here is, "how did this action affect my relationship, and is it worth the consequences?" Regardless of your intentions in this action, your boyfriend is uncomfortable with this type of behavior. From here, we can objectively decide if spending time with your previous partner (because that is likely what your boyfriend sees them as) is worth harming the relationship you currently have. It is very rare that a person would be comfortable with their partner spending more than a very little amount of time with their exes. Many times, it just gives the wrong impressions. It is very possible that your partner may believe that since you spend so much time with them, that they are still a contender for the most intimate relationship you have to offer, and truth be told, they kind of are. The best intimate relationships, are friendships first and foremost. It is also a good thing to consider what you are getting out of the relationship with your ex that you are not getting out of the relationship with your current boyfriend. If you go to this person for emotional support before your boyfriend, then it is very likely you're involved in some "emotional infidelity". When we turn to others instead of our partner, it is as if we "ran into another person's arms" instead of theirs. No matter who you are, that hurts. 

I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed?

Although some people managing depression feel sad or "down",  it is a possible to have depression without an obvious sad mood.  Many people indicate that they feel numb or flat.  People managing depression often have low motivation. They may stay in bed for long periods of time and only get up for absolutely necessary activities.  People with depression may also feel inappropriate guilt or shame.   If you have been experiencing the symptoms you described for more than two weeks, I recommend that you see a counselor to get a more in-depth evaluation.   The symptoms you are experiencing are typical of depression, and with a bit of support, you could regain energy and improved self-esteem.  The stigma surrounding mental health can make a diagnosis or a label of depression seem scary.  The important thing to remember is that mental health disorders are as important as and as treatable physical health disorders.    Hang in there.  Healing is possible! 

How does a person start the counseling process?

Approaching a counselor can seem intimidating at first, but most mental health professionals want to help you feel safe and heard.  You can often find counselors using search engines like CounselChat or Psychology Today.  These websites allow you to get to know therapists before you take the next step.  These days, counselors have websites where you can learn even more.  These websites usually have clear instructions for contact.  Typically, you can reach out via phone or email to request a consultation.  During a consultation call, you can ask the therapist questions about their credentials and areas of expertise.  If you feel like you connect, you can schedule a first session where you will tell them more about yourself and why you are seeking therapy.  The thing to remember is that therapists want you to reach out to them, and they are happy to be approached for support.  Good luck!  

I just took a job that requires me to travel far away from home. My family and I really need this job. People keep telling me I have "anxiety" and I'm terrified of having an anxiety attack on the road. This is all new to me. What can I do?

First of all, congratulations on your new role! Transitions can be challenging, and it sounds like you are experiencing a lot of change.  This would be difficult for many people, and it seems that you have an added layer of challenge.  I recommend visiting a therapist to determine the root cause of your anxiety and working to unravel those causes piece by piece. I know seeing a therapist can be challenging when traveling, and online counseling could be a good solution. In the meantime, here are a few of my favorite anxiety stopping strategies.  1. Grounding Exercises: When you feel your anxiety increasing, take a deep breath and begin things in your room (or where ever you are) that have things in common. For example, name all of the blue things that you can see.  You can also do non-visual grounding exercises like naming all of the hte sports teams you can think of or all of the state capitals.  This will get your mind off of your anxiety and connect you to space.  2. The pretzel: This is a seated pose that will stop any anxiety attack in its tracks.  Start in a seated position and cross your dominate leg over your nondominant leg. Then, stretch your arms out in front of you with the back of your hands facing one another.  Cross your arms in front of each other so that your palms are touching.  Flip your arms into your body.  You will end with your elbows by your side and your hands crossed under your chin.  Close your eyes and take long breaths in through your nose and out through your mouth.  This calming pose will help you get through even the toughest of panic episodes. 3. Bilateral stimulation and visualization: Start in a seated position with your hands placed on your knees. Tap each knee in an alternating pattern. Close your eyes and begin visualizing a peaceful setting. The combination of bilateral stimulation and visualization will help calm your body and mind.  I could go on and on, but these techniques should get you started.  These techniques should help you manage anxiety in a pinch.  Best of luck! 

I just wanted to get to know one so I can hear about their college experience and the courses they took. I also wanted to know if they enjoy their job and how long they were in school.

Mental Health is an exciting and rewarding field.  I hear you saying that you want to be a psychologist, and that is one path to working in mental health.  You could study psychology, social work or counseling to become a practicing therapist. I am a Licensed Professional Counselor Associate and a Licensed Clinical Addiction Specialist.  I currently provide assessments and supervise several counselors in a large clinic in Asheville.  I also have a private practice online. I studied Sociology and Interpersonal Communication as an undergraduate, and then I received a counseling masters degree.   My master's degree was comprised of several supervised practice courses and theory courses.    I really enjoyed my education, and I find my career equally rewarding and enjoyable. If you are considering working in the field, I recommend emailing several counselors, social workers, and psychologists in your area and setting up an informational interview.  Not everyone you contact will be willing to give you their time, but many may.   This will help you determine which path to therapy may be right for you.  Licensing restrictions and abilities vary state to state and a local practitioner may be able to provide you with a specific list of challenges/triumphs about their particular license and education.    Psychologists are usually PhD level practitioners and require more education to begin.  LCSWs , LPCs and LMFTS can practice with a master's degree.  Best of luck! This is an exciting time.  

How do I make myself happy without the people who made me happy? Now that they’re gone, I feel sad. It’s been two months now but I seem to be unable to stay okay and independent.

Hello. So, someone made you happy but is no longer around? I am sure that feels devastating. As a counselor I usually have to ponder this kind of thought because it lends itself to suggesting that happiness comes from the external, rather than the internal side of a person's life. Happiness is formed within ourselves. All the external trappings of happiness are usually quite fleeting, and temporary. Even relationships fo not last forever. If we get to a place where we are reliant and dependent on those around us to create happiness in our lives, then we lose the opportunities for us to do it ourselves. We are entirely capable of finding ways to be happy. Sometimes this entails working out issues that are holding us back from reaching a place of peace, or resolution to a specific problem.What I would offer to you, is to find ways in which you can develop happiness for yourself. What do you like about your life as it is right now? What can you do to create change in your life to increase your happiness? These kinds of questions can be valuable to you as you seek out ways to make happiness an internal rather than an external event. Mourning the loss of a social connection (in whatever way that occurred), is part of the grieving process, but it is not permanent. It is a path to healing and moving forward. From this, you can seek out new sources of happiness. I encourage you to remember that happiness is independent of the external experience you have in the world. Happiness is an expression of the internal feelings, so that will be the source or the font of positive emotion from which you really draw. If you are lacking in happiness, then it becomes important to examine why that is, and what you can do about it to promote self-care. Seeking out a professional counselor can also be a good option as you move through the grief/loss process and examine the reasons happiness is not in greater supply.I wish you happiness for every day of your life.Best wishes.

What am I doing wrong? My wife and I are fighting all the time. What can I do? We don't agree on anything and she usually jumps to conclusions, which are usually wrong on how I feel. She is very family-oriented while all of my family left me on my butt, abused, ignored and messed up with me mentally. I'm not a family-oriented person. I only have two people in my life - my best friend and my wife. My mother forced my father out of my life so I do not know who he really is. We've gotten in contact but he just makes comments on how much I look like her when in fact I look more like him. This makes me mad because I don't want to look like my mother. I hate her. All that she did was bring me down and make me homeless, which she was successful at. I need guidance in my life. I don't want to lose my wife but we need to have a space because we usually hit each other and it's not healthy. I'm dying to make our relationship healthy. I've never wanted anything more than this. Please help me. I need your advice.

Hello. It sounds to me like you are carrying an enormous amount of emotional weight, and maybe even an equally enormous amount of guilt and feelings of failure about your marriage. I cannot imagine how challenging this is for you right now. Marriages take lots of work, and often the only examples we tend to have are of those we saw when we were young - good, bad, or indifferent. There are no easy answers to your questions, and I won't presume that my response to you will be the linch-pin that heals all your pain. But I can maybe give some thoughts and reflections. First and foremost, cut yourself some slack. No one is perfect. We fail more often than we succeed, but in the end we learn, and that learning helps us grow. Yes, you're right, the abusive aspects of your marriage are not good, and need to stop. You probably are doing more harm than good in that regard, and this will quickly destroy anything you have in your marriage that is even remotely in your favor. Seeing a therapist for yourself, and then seeing a therapist as a couple is a good approach. You have issues that you need to resolve, that, while they impact your marriage because they are part of the history of your life, they are separate from your marriage in many respects.Joining a marriage support group can also be helpful. You can find these through local counseling resources. Sometimes your local crisis numbers can provide services in your area that can be helpful. If you belong to a religious or spiritual community, then you might see if there is any type of counseling offered for free or at a reduced rate. Sometimes pastoral support is focused on the spiritual side of any issues addressed, so if you feel this is important it might be a viable option for you.Lastly, parents are imperfect. Yep...its true. They had no more of a guaranteed parenting success manual than you do at having chances for a perfect marriage. We limp along and do our best. Having said that, we can still take the best from our past and apply to our future, no matter how small or insignificant it might be for us. The bad stuff serves as lessons of what to avoid, and we are each responsible and accountable for our actions in this life. Both with ourselves, and toward other people. So this becomes a guiding principle in our actions. It may be that you discover that the marriage you are in is not a good fit.  I am sure that remains to be seen, but either way you both must be involved in saving it. If only one of you cares, then 100% of the energy to salvage the marriage rests on the shoulders of one person. That's not fair. So be sure you have a clear understanding from your wife about what she wants, and work to create an amicable solution. All of this said, seek out supportive friends, and actively work to do your part to make the changes you want to see in your life. One way or the other, you will benefit from it.Be well.

I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing. What can I do to manage my stress?

It sounds like you are experiencing burnout and have very little, if no job satisfaction.  There are some aspects of this that are in your control and others that are not.  What type of work do you typically enjoy?  Do you enjoy high stress work? What keeps you in this job? Is there a reason you have stayed?  Is your boss reasonable to have a conversation with?  I recommend a few things.  For one, you may want to have a discussion with your boss about your job duties and see if there is a way to either eliminate some responsibilities or get higher pay.  Another option, if you are unable to have an open conversation, you can start to look at an ideal work situation, what would you like/ be OK with/ absolutely hate about a job. Then possibly try to look for a new job that fits these qualifications. If you are unable to leave your job, you may want to attempt to balance your work life with more activities that create joy outside of work.  Sometimes that balance can help you tolerate work more.  I recommend that you find a supportive person to talk with and process these frustrations as burnout can lead us to do things we may regret.  

How does a person start the counseling process?

The easiest way to start the counseling process is to do a little research online. A quick search for the type of counseling you are looking for can be helpful. There are lots of Counselors out there to choose from, so many times you will have to take it a few steps further than that. Check out their website, social media, and any reviews (but remember, people are not always very nice). If you plan on using insurance to pay for at least part of the services, look for one that is in your network. You can find out if someone is in your network by looking for providers on your insurance's website. If your coverage isn't that great and you know you're going to be paying for it all anyway (because you're an all-star and verified your coverage already with the insurance company), then you can really pick any Counselor you want, but working with one that is at least out of network will give you the benefit of having it applied to your deductible. If you have any questions about that process or just want some help in getting your benefits from the insurance company once you've started counseling, Better is a good option. Once you've found a Counselor you think is a good fit for you, normally the best step to take here is to call and schedule your very first appointment. With many Counselors you can now send an email, but a phone call can normally tell you quite a bit about someone and their clinic. Once you're all scheduled, they will either get you to do some paperwork before you come in, or many times they just let you fill it out once you get there. From there, all you have to do is show up!

I've gone to a couple therapy sessions so far and still everytime I walk in I get nervous and shaky. Is this normal? Should I still be feeling like this?

It can be uncomfortable talking to someone about your life in the great detail that is normally necessary for counseling to be beneficial. Since you're already going to counseling, congratulations on taking that big, first, stress-inducing step. Hopefully by now you are starting to feel a little more comfortable with your therapist. It can be helpful to address this big "elephant in the room" and talk to your therapist about this. I do my best to help people feel comfortable when they come to counseling, but regardless of how hard we try, sometimes it is just a little hard to get accustomed to. The good news is, the more you keep at it, the more "normal" it will become. 

I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed?

I would not focus on what other people say. Do you feel what you have described impacts your day to day functioning? Try to evaluate how is your self esteem, motivation and self confidence. How about negative thoughts or hopelessness? Any concerns about your grades sliding down? If you answered yes to any questions, may be its time to see a counsellor.

I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it. What is wrong with me, and how can I stop having these thoughts?

Life is beautiful without unwanted thoughts and stress. With proper strategies and tools it is possible to regain control over your thoughts. I guess you are just having "thoughts" and not actually "hearing voices"? My suggestion is to see a therapist and go from there.

I don't remember when the voices in my head started, but I remember Hearing them when I was little. I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

You are right. It is not normal to hear voices that aren't your own but the fact is some people do. In my experience, medication seem to help. It is also important to understand when you hear voices the most - meaning it is important to understand what the triggers are. It is also important to understand when the voices are the least - meaning what helps you deal with the voices better. My clients have reported that their triggers are being in social gathering or around strangers or for some even the TV. Trying to identify your triggers is helpful for some people. Clients have also reported that listening to music, watching TV, being with friend or family helps them deal with their voices. Every individual is different and you need to figure out what works for you and what triggers your voices. My suggestion is to see a therapist / health care provider and then go from there.I hope this helps.  

I've hit my head on walls and floors ever since I was young. I sometimes still do it but I don't exactly know why, I have anxiety and I had a rough childhood but now I'll start to hit my head and sometimes not realize it but I don't know how to stop or even why I'm doing it. How can I help myself to change my behavior?

Give yourself a lot of empathy and care for having had a rough childhood and realizing that life can be better than how you were treated when growing up.Be patient with yourself too bc lasting change takes time. Alternatives to hitting your head require constant gentle reminders to do these new behaviors, or if you've discovered a satisfying alternative in one moment, time is required for you to repeat this alternative until it feels natural.Anxiety usually means someone did not feel well understood growing up and was rushed to comply with the wishes of others who were a regular part of their lives.Anxiety lessens as the person starts to know and accept their wishes and needs as valid.  Allow yourself to learn who you truly are in the spirit of accepting whatever you discover about yourself.The behaviors will naturally change with your new understanding and self acceptance.Good luck and enjoy this self discovery project!

I know that I need to get past my feelings for this person I fell in love with, but t's so difficult to move on because he showed me feelings I've never felt before. I feel like I don't want to be without my genuine love for him, but logically, I know I need to be without him. I can't discuss this with anybody in my life because the conditions surrounding our love are considered "wrong" by a lot of people. How can I get myself to just move on?

Love is a deep and nuanced feeling so start to accept that a simple cutting of emotional connection isn't possible.Honor the love you felt for this person.  Acknowledgement of your love feelings will most likely help you find a dignified way to accept them while at the same time slowly developing new ways to live your life in a way which does not include the actual person.Your feelings will always belong to you.  The newly discovered sense of how love feels will be with you and positively influence all your relationships.  There is a benefit to feeling loved even if it is not forever in this lifetime.Also, your partner opened your feelings, the feelings which showed in fact already were within you.  He opened the door and this door belongs to you.I hope you will find ways to appreciate having been loved and to be open that your feelings of being loved are a positive influence in all your relationships.

How does a counselor decide when to end counseling sessions or to terminate working with a client?

For a therapist, deciding to end counseling sessions or terminate working with a client is a thoughtful and intentional decision. One that is not entered into lightly. While there are many considerations counselors take into account, to help answer this question, I'll offer an example of two areas that counselor's take into consideration when ending counseling sessions:Does the client need different or more specialized care than the current counselor can provide? This requires the counselor to determine whether referring the client to another therapist or health care provider is needed.And, has the therapeutic relationship reached treatment goal(s)? While this question is specific to the counselor, I'd like to also add that a client, at any time, can end counseling.

How does a person start the counseling process?

Starting the counseling process can be daunting but here are some ways that hopefully help make the process a little less overwhelming. First,I'd start with finding a therapist through a therapist directory and searching for a therapist specifically in your area and with the expertise you're looking for. There are many reputable therapist directories online that offer specific information and links to therapist websites to learn more about how they can help.Next, I'd pick two or three of interest to contact directly. Have a list of questions that are important to you that you can ask to determine whether a particular therapist is a good fit. Many therapists offer a free phone consultation to allow you both to determine whether it is a good fit.Then, after you schedule, the next step is to see what it's like being in session to determine if the fit is still a match. 

My son was diagnosed with autism a few years ago and I stopped working so that I could take care of him. I also was dealing with an abusive relationship (mentally, physically, and emotionally). Now I live like a recluse and I always feel nervous around people. How can I feel more comfortable around other people?

It sounds like you have taken on a caretaker role for a while as well as experienced some pretty severe interpersonal trauma.  It makes sense that you would feel nervous around people.  Working through the trauma of an abusive relationship in itself can be a difficult process.  And then to add on the caretaker part can make things even more difficult.  First off, you may want to seek support to work through what you have experienced.  Many cities offer support with survivors of domestic violence and there is a hotline to help with this 888-724-7240 as well as online resources.  Processing the isolation of this relationship as well as working with your son can help to overcome the anxiety related to others.  Accessing autism support networks may be of support as well.  Other parents that will understand your experiences are a good and tend to be safer place to start in attempting to connect to others.Very importantly, go slow and be kind to yourself as you begin to adapt to a new life of allowing others to care for you as you so clearly have for others.

I don't remember when the voices in my head started, but I remember Hearing them when I was little. I know it's not normal to hear voices that aren't your own. I fight the voices and I want them to stop. They've been here so long and I want them gone. How can I make the voices stop?

How is your life going overall?Since you hear voices since you were young I wonder whether you mean the thoughts each of us has about what to do, our opinions, including self-criticism and praise.I try to understand how severe a problem these voices are if you've managed to get to a point in life of awareness about the voices.Usually when mental health people hear about voices the immediate thought is you need drugs bc you are psychotic.Since this is going on for a number of years, I wonder if the problem is something different.

I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends. I spent the weekend with him and it upset my boyfriend. Was i wrong?

Hello. There are a number of factors playing into this situation. A former romantic partner coming back onto the scene during a current relationship; you spending alone time (and spending the night) with that former partner; and the uneasy feelings experienced by your current partner (boyfriend). Now those are the ones you have openly expressed. There are very likely other issues that prompted this behavior on your part. You ask if you were wrong. It is not a question I will be able to answer, because it is not one I am meant to answer. It is up to you to find that truth. Now, if you are feeling guilty, was it because of some sexual engagement occurred when you spent the night? If so, you might want to look at why that happened. Do you feel secure in your current relationship? Is this the relationship you want, or do you want to be with the former boyfriend?Important questions, but ones you need to ask and answer. Odds are, there is something that triggered this event to occur and it becomes a focal point in discovering any unexplored discomfort or other issues with your current boyfriend. Seeking relationship counseling can be effective in sorting this out, so be open to that possibility to help you clarify your thoughts and feelings.Best of luck to you.

There is just no communication at all between us. She sleeps constantly all day (not at night). She acts angry and unfocused and stays in her very messy room all the time. The only time she comes out is to eat. She has aches and fatigue, weight gain, hair loss and skin problems. She does not look after her health. I don't know how to communicate with her. She is not open to any suggestions. How do I get through to her?

I'm sorry for what sounds like a frustrating situation.For how long has your daughter lived the way you describe and did it start all of a sudden or more gradually come on?What you write sounds like a major depressive disorder and this can start for a variety of reasons and improve in just as many different ways.Start with how you are feeling about the situation.  Ask yourself for how long you will be able to tolerate the way your daughter lives and if you feel any satisfaction in your mother daughter relationship.If she is of legal age, and you don't want her to live with you,  you've tried convincing her to get medical care for its own sake and to more clearly see her emotional and psychological health, and she is unwilling to take care of herself, you can discuss your options with the adult protective services agency in your state.The first step is to know what exactly is her problem so you can decide if its own you are willing to take care of or not.

I'm 15 and my girlfriend is 14. Am I a pedophile because I'm attracted to her and she's under 18?

You wrote that each of you is under the age of 18.   A 15 year old cannot be a pedophile because you're not an adult.Also, if you mean "girlfriend" in a romantic way then this makes sense bc romantic relationships include physical attraction to the other person.

How does a person start the counseling process?

I always suggest that you find the right fit. You have every right to interview the therapist and ask as many questions as you need. It is our job as a therapist to explain our approach and philosophy. This gives you a good overview of the therapist. Just call and say that you would like to talk to the therapist. Say your interested in the services but unclear about how the process works. From there a seasoned therapist should be proficient in helping to guide you through the process with ease and comfort. www.lifecounselingorlando.com

I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

Unfortunately you seem to have yourself in a double bind. By living with your mom she is not going to stop her attempts at what you perceive as "controlling". There is no use in trying to debate or get her to "see your point". As long as your there and you personalize her attempts at control, then you will find yourself frustrated and resentful. Try to find an extra job or a roommate so that you can do the natural process of moving on out.www.lifecounselingorlando.com

I feel so alone. I have so many people around me, but it seems as they just listen and dont understand. They say it will all be okay, or they don't listen to me st all. Everyone says they are here for me but it doesn't feel like they are. Why do I feel so alone?

We feel alone because we are not comfortable with being our self. When you find that nobody is around do you feel alone? Your never alone. Once you take the journey to really understand who you are and unconditionally loving all that is you, there will never be an alone moment. We seek outside of self to fill inside. This is the big lie of the planet. All you need and have ever needed you supply yourself. www.lifecounselingorlando.com

My boyfriend and I have been dating for almost 2 years. I've been really sad lately and for the past few months I've realized I'm just way too dependent on him. It makes me really upset to be so dependent on someone else, but I can't help it. I don't even know who I am without him. How can I be less dependent on my him?

From what you write you've got good motivation to change and awareness as to what you'd like to change. These are very good predictors that you'll be successful in what you'd like to change.Try, the next time you realize you're depending on your bf instead of friends, yourself, to interrupt whatever typical action you'd take.Do something different instead!If when you'd like advice and usually ask your bf, ask a different trusted someone.Or, when you feel lonely, contact a friend or introspect on your own if usually you'd contact your bf.Also, being dependent on a bf is part of a trusting intimate relationship.   Dependency in the sense that you each are reliably available to each other, is a good quality.Only if it seems excessive, such as you're isolating yourself from other close friendships, is dependency on a partner, a problem.

My fiancé and I have been together for 3 years and our relationship has always been good. The only issue we had was that he felt like he wasn't getting enough sexual attention from me. I recently found out he cheated on me with another women. He says he wants his family back but I'm confused on what to do. Is it possible for us to get past the cheating, or should I just move on?

Definitely yes, it is possible for a couple to trust each other again and become close with each other.Since your trust was broken, your fiancé would need to earn back your belief that he is faithful to you.Do you feel he empathizes with how you felt to find out about his cheating?Before you have this question answered, based on what you write there is a sense of your own doubt as to whether you are with the right partner.Before you and he address regaining your trust, first decide if you'd like to work on this.Ask yourself if the sexual attention he felt he wasn't getting from you was bc you're not as interested in him as you imagine or once felt in the past.If each of you sincerely wants to be together, it is possible to talk about your respective needs and help the other person feel safe again with the other.

I'm dealing with an illness that will never go away and I feel like my life will never change for the better. I feel alone and that i have no one. How can I overcome this pain and learn to be happy alone?

Is it possible that even though your illness is chronic, that it goes through phases in which you are more comfortable and that it requires less focus from you than at other times?I think the idea of having a lifelong illness is frustrating and can be depressing to think about.  Thoughts are not necessarily the truth of what will actually happen though.Illness makes negative situations look worse so be sure you are concentrating on specific areas of your life and not just assuming they will work out badly because you are ill.One way to be happy alone is to love and appreciate, nurture and be kind to yourself.This frame of mind may generate new answers to find ways of being among other people too.

After first meeting the client, what is the process that a counselor facilitates?

Each counselor may have a different process, so I'm not the end all authority here.  For myself, I review policies and confidentiality concerns with people first and answer any questions they have. Then I'll let them know I'll be writing a lot in this session and I have an assessment form that I like to get completed, but I want to have a conversation and I'll ask questions as we go.  My first question is usually, "How do you feel I can best help you today?"  Some people are very at ease and tell me many details.  Others are a bit more reserved and I have to demonstrate more curiosity.  Even people who have been very apprehensive are usually feeling very relaxed by the time the session is over.  Usually, when we get close to end of session time, I'll summarize what I think are the biggest concerns from what I've heard and confirm whether or not the person wants to work on those things.  I also try to give an exercise targetting my biggest concern for them to work on in between sessions.  For instance, a relaxation method if they are very anxious.  Counselors are just humans as well, so it does take a bit of time to really get to know another person.  I always tell people that are apprehensive to give the counselor 3 or 4 sessions to determine if they really connect with them.  I hope that helps, Allison 

I have a fear of something and I want to face that fear to overcome it, but I don't know how. What can I do?

Your fear may have deeper roots within your sense of who you are, than you realize.   Fears are sometimes irrational so that logic doesn't get rid of them.Think about whether you felt secure and confident as a child.  Also, did any major bad events happen to you with other people or situations when you were growing up?Often these overwhelming situations of childhood stay with us as fears of situations in our adult lives.  If the root of the problem w the fear is from long ago, then probably a therapist who can ask you questions which help you remember upsetting childhood circumstances, may help you to dissolve the current fear.Another possibility is CBT, cognitive behavior therapy which teaches people short term mantras to do something which is safe, say being a passenger in a commercial airplane, which feels frightening to a person.CBT is short term and results are limited to specific fears.  It is a much quicker approach than self-understanding.

I have a friend that who I used to be in a relationship with. It was brief and turned into us being just good friends. I spent the weekend with him and it upset my boyfriend. Was i wrong?

While you can't be responsible for your boyfriend's feelings, relationships do come with expectations.  Both people in a relationship bring their own expectations into it.  These expectations are usually unspoken, but result in conflict as you are experiencing here!  Your boyfriend expects you not to spend the weekend with this guy.  He may expect you not to spend the weekend with any guy at all.  He may expect you to spend every single weekend with him!  You'll have to decide if his expectations are ones you can live with.  Relationships do require some compromise out of concern for our partner, but you get to choose how much you compromise. We get upset about things that make us feel insecure.  You spending the weekend with an ex makes your boyfriend feel insecure.  That doesn't mean you did anything wrong.  It just means that you have to decide if it's more important for you to maintain your freedom to spend weekends with whomever you wish, or to help your boyfriend feel secure in your relationship. Good luck!  Hope that helps,Allison 

I start counseling/therapy in a few days (I'm freaking out) but my main fear is that I'll cry and embarrass myself, is it something to worry about?

Lots of people do cry in session, but your therapist won't be uneasy with this.  Crying is a natural response and it also releases toxins, so some might say it's necessary!  Remember that you can be in charge of what you talk about in your session and if there's something that feels too uncomfortable, just say, "I'm not ready to talk about that."  Your counselor wants  you to feel at ease and will probably not push you right away to a very uncomfortable place.  As you get to know your therapist, you will feel more relaxed and even not worry so much about how you appear to them.  It's normal to be anxious going into a new situation especially when you might not feel in control of uncomfortable emotions.  Don't give up, go and put your best effort in! Hope that helps, Allison 

I crossdress and like to be feminine but I am attracted to women, but yet that seems to bother girls I date or ask out. How can I approach them about it? should I hold back and keep it a secret, or should I just be up-front about it. I wonder if i should stop or if I should continue to do it since it makes me happy. What should I do?

While this might not be the first thing you want to discuss when you meet someone, it is important for you to be yourself.  It's better to weed out 10 people who can't accept you to find that one who can.  

My fiancé and I come from a strong Christian background but both went off the "straight and narrow" once before. He is having a hard time accepting my past, especially that I'm not a virgin. He has a hard time in general accepting himself and others. His insecurities are hurting our relationship. How can I help him let go of my past and decide to live in the present?

You are right that his insecurities are at the root of the issue.  You cannot change that for him.  He will have to do the work to handle those emotions on his own.  What you can do is reassure him in whatever ways possible, but always recognizing that you can't "fix" this for him.  When I work with people who struggle with their partner's past experiences, I always frame it like this:  Everything that you've experienced has resulted in you being the person you are today.  The person they claim to love.  If you had not gone through some of those experiences, you would not be in the position you're in now, ready to commit to him and know that you're satisfied with that.  Just as when bad things happen to us, we have to find a way to appreciate the lessons learned your fiance has to accept that you're the person you are today because of what you have gone through.  Celebrate that you have moved through that and have landed in this perfect position with him!Hope that helps, Allison 

I'm obsessing about a terrible breakup. Everything is a constant reminder. How do I move on?

Initially, everything is a reminder because there is a trace of that other person present in everything in your life. When we lose someone, we're saying goodbye to what we thought our future was going to be.  Accepting that's changed and allowing ourselves to envision a new future is necessary to "move on". Start learning something new or try a new activity that you've always wanted to do.  Find whatever is "good" about being out of the relationship and focus on those things.  This can be an exciting time of transformation for you.   As time goes by, you'll add new things in your life that aren't entwined with this relationship and those things will begin to crowd out those things associated with the relationship.  Give yourself a little empathy, no one goes through a breakup without being sad.  It's ok to be sad.  It's even ok to feel devastated.  Loss of a relationship touches a primal need we have to belong.  It makes us feel insecure, unanchored.  In truth, we are ok, safe even.  This experience will open different perspectives for you.  There are lessons you'll take from it that will add another facet to you as a person.  Maybe in time, you'll even appreciate this experience.  I'm sorry you're hurting right now.  Best wishes to you, Allison 

I have PTSD. The side effects are really bad and have impacts on sex, anger and my relationships. I even lost my job month ago. How can I get my life back?

It is brave of you to speak out, PTSD is not a joke and it can quickly take a toll on all aspect of life. Please, know that you are not alone and with the right help you can overcome these challenges. Living with PTSD can be very emotionally exhausting, but you can learn ways to cope with its challenges and find fulfillment in your life again. This means being proactively involved with the process, learning about the problem and positive ways to manage it can be a good start. This can also mean seeking professional help. It is important to address the problem both at the physiological and psychological level, this can mean using medication that is prescribed by a MD to reduce the intensity symptoms and also working with an experienced licensed professional. Having healthy life habits such as good sleep hygiene, healthy diet, staying away from self-medicating with drugs and alcohol, and exercising can help reduce the intensity of the symptoms as well. Please, consult with a licensed professional close to you to get more information on resources you can possibly find helpful to you. 

My daughter seemed to be developing at a normal rate until about the age of 10. She then started to act younger than she is. Now she only wants to play with younger kids and she doesn't act her age. I don't know why this is happening. Is this normal?

This is certainly an important issue to look into, It is always helpful to speak with the child's pediatrician since they are most familiar with the child's developmental history. Also, children tend to regress behaviorally when facing events and interactions they feel to have no control over, this can be as simple as a loss of a pet, a recent move, death in the family,  and/or as serious as sexual abuse, and other things. If you have not spoken to the school that can be a good starting point. 

I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it. What is wrong with me, and how can I stop having these thoughts?

Talking to a licensed profession who can discuss this in greater depth can be best. As a general information, in short, I can say that our thoughts are greatly influenced by our early life experiences. Our thoughts are processed through schemes, these are mental images or templates by which we make meaning of the world around us.  While our upbringing has a great influence on the way we see and interact with the world around us as adults, However, we are not condemned to abide by them for life, in psychotherapy, you learn to change negative schemas with positive ones. Yeah, if you had less than optimal childhood you would have some sort of negative schemas that unconsciously lead to self-sabotage your efforts for success and happiness. The research in the field of interpersonal neurobiology suggests that without conscious awareness and reflective practices we tend to interact with the world by repeating old habits of mind. On the other hand, in psychotherapy you can learn helpful strategies to increase your conscious abilities to stay in control of your mind in the present moment and reduce intrusions of negative mind habits. Yoga, meditation, and tai chi are also found to increase self-awareness and lessen the intrusions of negative self-judgment on one's psyche. 

I just took a job that requires me to travel far away from home. My family and I really need this job. People keep telling me I have "anxiety" and I'm terrified of having an anxiety attack on the road. This is all new to me. What can I do?

Bravo, on your success in securing a job and also for being proactive with your need. Starting a new job can be scary and having to travel away from your home and family can make it even more anxiety provoking. Do allow yourself to be anxious about this new journey, we can be hard on ourselves, think if it was a friend that was turning to you for help, what solutions would you have offered them, but also continue to seek to secure right support as well. Talking to your physician is always a good place to start; your physician can tell you if there are organic influences causing your anxiety that may be out of your control. Additionally, talking to close or compassionate family and friends is always good. It is important that you turn to supportive people at the time of emotional need, talking about our challenges can help break the cycle of anxiety at least momentarily. Remember, to further your success, it requires a healthy self, if you have supportive relationships relying on and turning to people who can be there without judgment is great. Healthy lifestyle like eating right, sleeping enough, and regular exercise also never fails to help improve overall emotional health. Additional self-care measures such as repeated relaxation practices can help you become more familiar with your nervous systems reactivity and you can implement strategies to ease anxiety in various situations as it demands. The more resources the better you will be equipped to manage challenges and concerns at the time notice.  You can find a lot from the internet too, use your best judgment as what may not be appropriate for you there are some wonderful apps on most smartphones that can help you learn and practice grounding strategies to ease anxiety. If you have access to a therapy you find more specific strategies that would best fit your needs. Good luck, wish you a happy journey and much success.

How does a person start the counseling process?

First, identify the areas that you need help with. What are the issues that are most troubling you? Are these situations creating an impact on your daily routine?Second, do some research as to the type of counselling service you are looking and that would best suit your needs. Are you looking for individual sesssions, couples/family sessions, etc. And research potential therapists in your area that focus their counselling approach on your therapeutic needs. Third, contact the therapist (most don't answer the phones, so leave a message or send an email). Don't be affraid to ask questions. You want to make sure that this professional is a good "match" for you and will work with you at working toward your therapeutic goals (the things you want to address/work on during the sessions).Fourth, have the expectation that, depending on the issues, you will need multiple sessions/appointments with the therapist to really address the issues and work toward your therapeutic goals.It takes strength and courage to reach out for help, but I know you can reach your goals. It takes time, patience, and practice do really address your needs. Good luck!

I love my girlfriend so much. I get an erection even just thinking about her or seeing her. But the two times we tried to have sex I couldn't get an erection. We've only had sex once and it was a long time ago. Why this is happening and what can I do about it?

I'm sorry to hear of your problem.First step as always when a possible medical explanation exists, go for a urology check up to either your internist or a urologist.Once you know there is no medical reason which would prevent an erection, then we can consider the psychological and emotion based factors.Maybe you're nervous about your sexual performance or that your gf may be disappointed in your performance.Men often mistake their own fears of performance failure with the assumption that their partner thinks about sex as a performance.Talk with your gf about whatever is on your mind which may inhibit you from enjoying sex.The reasons are endless.What matters is to have a heartfelt dialogue with each other.The emotional support which comes through such an intimate conversation may very well be the catalyst for a more relaxed and satisfying approach to sex w your gf.

I know I need to deal with my depression. But I don't know how and I don't want to tell anyone. How can I deal with depression without telling anyone?

Love yourself more and treat yourself kindly, with empathy and compassion.Usually when people feel depressed they also feel lonely and isolated.  Since at this time you wouldn't want to tell anyone about the way you feel, which includes the possibility that a few of the ones whom you tell would offer you emotional support, give this to yourself.Also consider to make a goal of eventually telling someone whom you are reasonably sure would understand and empathize, about your depression.This will help alleviate the sense of shame, unworthiness and pervasive guilt which often comes along with depression.Sending you good luck!

My girlfriend just quit drinking and she became really depressed. She told me that she wants to move. What can I do to help her? I want her to stay.

People often have very different values and opinions when they are drinking excessively and when they stop drinking so much.Did the two of you share drinking as an activity?  If yes, then did you stop drinking too?Often when partners meet each other as drinking buddies when one gets sober, the relationship ends.  Once the terms of any relationship changes, one possibility is that it dissolves.The best way to go is to start the conversation of what you genuinely want.  This is the only way she'll really know your thoughts.Ask her to give serious consideration and discussion over at least a few weeks or months, to moving away from you.  This is a fair request since you are in a relationship.If she's changed so much by giving up drinking, which is possible, that she no longer wants to be in relationship to you, then you are better off being without a drinking gf, even if the truth she delivers is a hurtful one.

I am in my early 20s and I still live with my parents because I can't afford to live alone. My mother says that if I live under her roof I have to follow her rules. She is trying to control my life. What should I do?

Hello. Even though legally you are an adult, it is a matter of courtesy to respect the homes of your parents. As long as you live there, you should be considerate of their needs. At the same time, there should be conversation about what each of you considers appropriate as it pertains to communication between a parent and an adult (even though you are still her offspring). This will require openness, honesty, and a willingness to give from both sides in a respectful way. Healthy boundaries can be established and honored when each is willing to do their part in this new relationship. Your mother knows you are an adult, but has not had as many years of treating you like one. So mentally and emotionally this will take some time for her to adapt. Share your concerns with her, and see if you can come up with a set of rules that you both can honor. It will be a great stepping stone for both of you as you move into this new chapter together as you begin relating a little differently.Reach out for help to a counselor if needed. You don't have to sort this out on your own. And lastly, take good care of yourself in the process. You are moving through some exciting times in your life. The more you can have support as you explore new events, the better you might feel less stressed.Warm regards.

Our relationship ended about 7 years ago, but don't know how to let go. How can I get over that person and move on?

What you're most likely trying to get over is to be attracted to the qualities which you felt attracted to in the person.The problem isn't releasing yourself from the person, per se.   Letting go of a person means separating yourself from the qualities in a partner which you value.Two possibilities exist.Either you continue to feel strongly that the qualities in the past relationship are still meaningful and you'd like to base your next relationship on these qualities.Or, the person had qualities which are no longer relevant or necessary in your life and this is the reason the relationship ended.It is possible that even if you had an adequate exposure to certain qualities in someone that you simply miss the companionship of a relationship.See if you can figure out whether you need the qualities this person gave you or whether you simply like being part of a couple.If you like the particular qualities of your previous parter and these are still relevant to your life, you'll attract a partner who has similar qualities.Basically people attract what they need.The more open you are to attracting what you need in a partner, the more likely your next partner will have these qualities.In this way, you'll get over the particular person and still have the satisfaction to be in a relationship. 

My husband and I had our first threesome recently. Everyone was drinking and he was on her more then me. He and I talked about it afterwards and it made me feel better, and now I'm craving more of it. But before it gets close to happening I get this empty feeling. Why am I feeling this way?

Because the acrobatics and excitement of sex has nothing to do with the meaning of deeper emotional attachment to another person with whom we are in a relationship.Try to distinguish between your feelings of excitement from the novel sexual arrangement and what you feel is necessary in order to feel emotionally close and attached to your husband.

I have PTSD. The side effects are really bad and have impacts on sex, anger and my relationships. I even lost my job month ago. How can I get my life back?

Slowly is the rate at which you'll get back your life.Being traumatized means not feeling safe in almost all areas of life.Be patient with yourself as you try to regain trust that people will not harm you and will be sources of satisfaction in your life.It is possible that the trauma in your life requires such great attention on your part to your own inner emotional safety that you are better off with a less intensive job than the one you recently lost.Try to prioritize restoring your emotional and psychological health.  With this as the top area of your attention then you may have an easier time to accept a lesser degree of involvement in your work and relationships.When you feel angry, try to examine if underlying the anger are feelings of stress, fear, insecurity regarding your position in relationship to the person toward whom you feel angry.   Anger is often the surface reaction to more destabilizing emotions like fear and insecurity.Gradually by nurturing and comforting yourself, living at a pace which is uniquely comfortable to what and how much you can handle, you'll regain your trust in both yourself and relating to others.

After first meeting the client, what is the process that a counselor facilitates?

There are probably no two therapists alike because first and foremost we are human beings!And...our personalities may somewhat guide how we go about getting to know you, identifying what you would like to be different in your life and developing a plan to get where you would like to be. The very most important thing that will determine a successful outcome is the healthy therapeutic relationship between you and your therapist.  If you don't feel safe, comfortable and ready to work together, then it is likely not a good fit. And that's OK...speak up and the therapist should assist you in finding someone you can readily work with.

I'm in my late teens and live with my dad. The only time I go out is for my college classes. Sometimes when I see my friends I want to talk with them, but sometimes I won't want to talk to them for days or even weeks. Sometimes I feel i'm not worth knowing or i'm never going to do anything right. Are they right, am I depressed?

If we were in my office together, I would offer that most likely you are feeling somewhat depressed. It's most important for me to impress that you "don't have to live like this..."  Other helpful information: Have you experienced similar symptoms before?  Anyone in  your family been depressed before?  Based on other physiological signs, like quality of sleep, appetite, energy/motivation, I would present you with some treatment options, one of which would be to consult with a medication management provider to assess your symptoms and provide additional information for you to consider.

I know that I need to get past my feelings for this person I fell in love with, but t's so difficult to move on because he showed me feelings I've never felt before. I feel like I don't want to be without my genuine love for him, but logically, I know I need to be without him. I can't discuss this with anybody in my life because the conditions surrounding our love are considered "wrong" by a lot of people. How can I get myself to just move on?

There is no wrong or right way to define a relationship. I believe each relationship we are in is an opportunity to expand and to know self on a deeper level. We are conditioned to believe that we are not valued, or worth much without the confirmation of others and the world around us. Give yourself time and try to not go to those who are toxic and enjoy the drama of others lives as s way to avoid looking at themselves. 

I want to live with my mom. My dad gets angry and makes me feel like everything is my fault. I still talk to my mom although My dad tells me that I'm no allowed to. I'm scared I will make the wrong decision and that my dad will hate me. How do I tell him that I want to live with my mom?

Yes, from what you wrote, your dad doesn't accept responsibility for the way he feels and blames you for his feelings.I'm glad you recognize he's handling himself less as a grown person and more like a young child.I also understand your hurt and frustration that your father handles himself in a way which shows for now that he is unwilling to respect your wishes.Your decision is not surprising since most people wouldn't want to live with a parent who shows little interest to respect their kids' decisions.In terms of how to tell him your choice, do this in simple and most basic information terms.   "I've decided for now to live w mom".I suggest to not offer reasons to him bc he doesn't seem interested in hearing them.   Giving him reasons would likely trigger him to rebut them.If he asks questions, answer them as simply as possible.If and when you feel he is more willing to understand and know you, then you'd feel more free to have genuine dialogue with him.Right now he doesn't seem very ready to handle this.

We rent from from my boyfriend's parents. His father drops by unannounced and stays for long periods of time. He lets himself into our home when we aren't there on a daily basis and takes our dogs to his house. He picks up our mail. He has NO boundaries. He's an opinionated, rude pushy person. He expects to spend every weekend around us, gives unsolicited advice on child rearing and does not respect our privacy at all. He barges in with no warning. He has a key and lets himself into our house without asking permission. I need help. How do I address this?

You're expecting reasonable behaviors from your boyfriend's father.Since the father is his, your boyfriend is the person in position to speak directly with his dad about the expectations you and he have of the father.If your boyfriend has a good relationship w his dad, which is not what this sounds like, then great!If your boyfriend has a stressed and tense relationship w his dad, then somehow he needs to develop or be coached and encouraged by the people in his life who truly care about and know him, a way to state the very reasonable standards you describe here.If all else fails, then a new living space is always another possibility! 

My dad makes me feel like shit and like I'm worthless. He calls me names and makes me feel depressed. I want to move out because I swear if I stay here, I'm going to lose it. What can I do?

If you're actually able to afford to move out and support your own life, then this is a reasonable choice.If you're not in such a position and must continue for a while to live w your dad, then emotionally protect yourself from him.Doing so is much more difficult than maybe it sounds.Do you have privacy in your house and can you spend more time in a self-created safe space than around your dad?Also, limit the amount of dialogue you have with him so you don't offer him a chance to feel invited to criticize you.Are there other people who live in the household w you and dad?If yes, then are they similarly called names or are you singled out by him? What do the other family members do when they hear your dad calling you names?Is it possible the other family members don't realize how hurt and upset you are by your dad's behavior?If yes, then make a project for yourself to tell the other family members that you suffer from your dad's name calling.It is possible the other family members will step in and tell your dad to stop.Not necessarily that he will stop.  Knowing the others support you emotionally and find you credible is helpful on its own.

I just took a job that requires me to travel far away from home. My family and I really need this job. People keep telling me I have "anxiety" and I'm terrified of having an anxiety attack on the road. This is all new to me. What can I do?

Anxiety or panic attacks can be very frightening.  Here are a few "tools" you can use that will help in the short term:  Keeping your mind occupied by listening to books on tape may help;  Counting backwards from 100 in 7's; Naming cities that begin with each letter of the alphabet; Keeping some ice or an ice pack in a cooler beside you, which you may take out and hold in your hand or to your face; Soothing self-talk such as "This is uncomfortable, but I can handle it" or "I've been through this before and can make it through again".  I recommend that you seek out a Therapist to help you with some long-term solutions to the anxiety.  Additionally, learning to breathe into the abdomen and practicing this daily is another long-term solution.  Yoga and meditation would be great!

How does a person start the counseling process?

Most counselors are very approachable and many offer a 15 minute chat by phone to allow you to talk about your issue, and to get a feel for the counselor.  If you like what you hear by phone, the next step is to set up a face-to-face meeting. Studies show that the most important element in effective therapy is that you feel a connection with your counselor.  Trust your instincts and if you don't feel comfortable, let him or her know that you don't think it's a good fit.  Many counselors list on websites like Psychology Today and Good Therapy.  Visit these websites to learn more about therapists in your area.

I keep having these random thoughts that I don't want. Things like "you aren't worth anything." I know they're my own thoughts but it feels like someone else is saying it. What is wrong with me, and how can I stop having these thoughts?

Many people have thoughts like those you describe, and often it feels like someone else is saying it because they are things that may have been said to you when you were very young.  When young children hear negative things about themselves they tend to internalize these negative ideas and to form negative core beliefs.  The good news is we can learn to stop these thoughts and to replace them with healthier thoughts.  The first step is to catch yourself when you are thinking these thoughts, and to stay "stop!"; then replace it with another thought.  So for instance, maybe you fail a test or get rejected by a romantic interest.  You catch yourself saying "you aren't worth anything". Stop this thought, and replace it with "You didn't do as well on that test as you would have liked.  Let's figure out how you can do better next time."  Or "she may not want to go out with you, but someone else will". So the idea is to develop a voice of a "friend", who can tell you the kind of things you would say to your own best friend.  You might also pick up the book, Feeling Good, by David Burns. He gives many tips for how to change Negative Self Talk.

I'm planning to have baby, so I have to quit smoking - but it's hard. Sometimes it's not a physical need, it's mental. I cannot help myself from thinking about smoking. What can I do to get rid of this addiction?

Breaking any habit is no easy feat.   Cutting down or cutting out cigarettes is very challenging, and there aren't any one size fits all solutions.  Fortunately, there are a lot of tricks and tools that you can use to stop smoking.  1. Many habits that we have are paired habits. If we do one thing, then we will do the other thing.  Think about the activities that you do when smoking and try to pair those activities with another activity other than smoking.  For instance, many people smoke while they drive.  Consider planning another activity to do while driving. (It might not be driving for you, but you get the idea! :)).  It might be taking a walk instead of smoking on your break at work.  2.  Create distance between you and the habit you are trying to break.  This approach could be used in a variety of different ways.  If you smoke first thing in the morning, consider leaving your cigarettes in a different room in your home.  Walking the extra couple of feet could help you decide not to smoke.   Leave your credit or debit cards at home and carry less emergency cash than a pack of cigarettes.  With this strategy, you are trying to create some distance between you the cigarettes so that you have to jump through extra hoops to get them.  3.  Consider cutting back before cutting out.  If you are smoking 10 cigarettes a day, try smoking 9. Then cut back to 8 and so on.  Having a plan to reduce harm may be more sustainable than cutting things out altogether. 4.  You could also talk to your doctor about the safety of nicotine patches. If you aren't already pregnant, this could be a great resource to help boost your success.  5. Focus on what you are gaining instead of what you are loosing. You may be losing cigarettes, but you are gaining money, health, taste buds, an increased sense of smell, lung capacity, a healthy baby etc.  You could plan small rewards/ treats with the money you save from decreasing cigarette purchases.  I recommend making these purchases small and frequent to keep up the momentum rather than waiting for a big payout a couple of months down the road.  Good luck! Cutting out cigarettes will be good for you and your baby.  

I am in a high stress position for a tech company. I am being overworked and underpaid for my contributions and it is not only giving me anxiety, but also demoralizing. What can I do to manage my stress?

Being in this position is tough. If seeking another career opportunity isn't viable, there are a couple of things you can do to manage stress on the job.  1. Have a ritual to begin the day:  Consider setting a one sentence intention and plan tasks for the day2. Take the breaks you are offered. I know it can be difficult to step away from your desk to eat lunch or take 10-minute breaks during the day, but prioritize this if you can. Sometimes 30 minutes of downtime and fresh air can help you feel better. 3.  Have a ritual to end the day:  If you commute by car consider an end of the day playlist.  Take a walk. Light a candle.  Clear your desk and write tasks for the next day. Whatever it is, send a signal to your brain that it is time to end the day.4. If you do work from home or are expected to be available after hours, set boundaries where you can.  Set a timer for answering emails and stick to that.  Have phone free meals.    Try to engage in activities that are rejuvenating like spending time the friends and family.  5. Try to limit alcohol/ drugs.  Move as much as you can.  Get outside in natural sunlight.  These are just ideas/ suggestions.  Even doing one of these things could be a step in the right direction.  Best of luck! 

I'm dealing with imposter syndrome in graduate school. I know that by all accounts I am a phenomenal graduate student, and that I am well-published. I am well liked by students and faculty alike. And yet I cannot shake the feeling that I'm going to be found out as a fraud. How can I get over this feeling?

It sounds like you are on the right track. Recognizing these nagging thoughts of self- doubt as "imposter syndrome" is a huge step in the right direction.  From what you have written here, it appears that you are able to challenge your own thoughts and provide yourself with evidence that counteracts the imposter syndrome.   Continuing to remind yourself of what you have accomplished and looking at the facts at hand can help diminish doubt.  Remember, many successful people battled imposter syndrome on the way to the top (and still manage it).  It might be helpful to read some of their stories so that you don't feel alone.  "The Cut" has a great article on "25 Famous Women on Imposter-Syndrome and Self-Doubt".   Business Insider has a great article about men and the imposter syndrome too.  Remember, if you jumped through all of the hoops to get into school and get published-- you belong. 

I just feel sad all the time and I don't like anyone in my family. I feel like they're trying to control me and won't let me grow.

Understandably the idea of someone who tries to control you, is good reason to feel sad.Your feelings sound like they are very strong and meaningful in your life.Keep in mind that your feelings about others has more to do with one's own self-view than with what the other person is actually doing.Unless the people in your family are actually interrupting and impeding your life in practical ways or by intimidation or other verbal ways to inhibit you, then there is a great chance your feelings of being controlled by other family members has more to do with your fears to be who you are than with any family members' actions.