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<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have anxieties about everyday stressors, i.e. finances, work, relationships, kids, and maintaining a household. }} [/INST] Something to remember about anxiety is that it's a useful and necessary response to stressors, and we all have a level of anxiety that falls somewhere on the spectrum from very slight to very overwhelming. Anxiety is our brain's way of prompting us to deal with the stress in our lives by getting us geared up for action. Some helpful ways of managing anxiety are actually very simple. The first I'd recommend is a calm breathing technique - breathe in for 4-5 seconds, and then out for 7-8 seconds. Try to repeat this for 3-5 minutes. Another suggestion is to pay closer attention in the moments you feel the physical symptoms of anxiety and see if you can describe - without judging - the sensations to yourself. Try to be very specific, such as "my palms are feeling very sweaty, and I can feel the slight tightness and fluttering in my belly of the butterflies." Then try to sit with these sensations without deciding if they are good or bad - just experiencing them as intentionally as possible.  Combining the calm breathing with this technique can also be very helpful. If you feel that these techniques don't help and your anxiety about everyday stressors are inhibiting you from being able to engage in life the way you want to, then I'd highly recommend going for an assessment or even just consultation with a professional. This professional can help you determine if therapy/counseling would be helpful for you to develop additional skills for managing those interfering anxiety symptoms. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have anxieties about everyday stressors, i.e. finances, work, relationships, kids, and maintaining a household. }} [/INST] Since it is clear that people react differently to the same stressors, we know that the stressors are not causing the anxiety, our thoughts about the stressors are. Often, cognitive distortions are the problem. Some common cognitive distortions include catastrophizing (predicting the worst), future telling, black and white thinking (if it's not perfect, it's terrible), mind-reading (I just know he is angry at me) and can't-standitis (I can't stand this situation). There are more, but the list is long, and if some of these are resonating with you, I would advise looking up CBT (cognitive behavioral therapy) tips, worksheets, booklets etc. on line, or contact a local CBT therapist. Another helpful piece of info on anxiety, is that it is prone to something called "symptom stress" - being anxious about anxiety. If we could hear this symptom stress it might sound like, "Oh no I'm getting nervous about this, I'm getting uptight, I look nervous, what if I have a panic attack!" followed by  more cognitive distortions such as "I can't stand being anxious!" and "this is horrible!" The antidote to this is acceptance.  Kind of like not stopping the waves but learning to surf instead (Jon Kabat-Zinn). If you happen to feel anxious, say to yourself - this is just a reaction I'm having that is unpleasant, but not horrible. I can tolerate and survive some anxiety, I can breathe deeply, and I'll be OK because panic attacks never killed anyone. I can stand this and it is temporary. You get the idea.We can increase our awareness of anxiety-provoking self-talk, and counteract it with calming and reassuring self-talk. We have the ability to think about our thinking, decide which thoughts are healthy and which are unhealthy, and choose which to focus on. We brainwash ourselves with our thinking, and according to self-perception theory, " we learn what we believe when we hear ourselves speak," so we may as well be a calming, reassuring presence in our own minds. :) </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] First step is to remove the label of your behavior as a syndrome and instead understand the reasons for it."Imposter syndrome" sounds like a name someone made up to write a book and have lots of people buy it bc it gives the feeling they know themselves by calling themselves this name.Instead, consider your own unique qualities including your fears of being recognized as adding value to people's lives.If you were told growing up that you're worthless, or if your chosen career goes against family advice and expectations, or if you simply are a shy person, then these would be the starting points to understand your reluctance to believe in yourself.The more you understand yourself and trust the truths you find as to who you are, the less you will feel fraudulent.Good luck in your career work! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] It would be very helpful to identify with you eventual pattern where the imposter syndrome is more or less present. Are there specific situations where you've noticed the feelings of "I'm going to be found out as a fraud" becoming more strong? It seems that shaking this feeling is very important to you. In my opinion, before shaking that feeling, we need to get closer to it and understand its roots. If you would like to get closer to the feeling, you might consider asking yourself questions such: "What is the trigger for this feeling? How does it feel in the body? What is the thought process I engage with after noticing this feeling? All the best. Rossana Mag. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Hello. First, I am so sorry you are experiencing these feelings. They can be intense, I will do my best to offer some suggestions or thoughts that I hope will be helpful to you. There could be a number of things occurring. Therapy is a delicate, private decision and I would first like to commend you for the fact that you are not giving up, that you are working to figure this out, and make this work, it sounds like you are engaged and motivated to receive support from a professional, your continued  dedication and motivation will take you far. I would first start by asking if you have discussed this with your therapist, if you feel comfortable enough telling your therapist what is going on, maybe inform the therapist that  that you feel nervous and shaky. I am a firm believer in open communication between the client and therapist as this builds a healthy therapeutic relationship that yields positive outcomes, if this can be obtained and well received. This is YOUR time for healing and therapy should be a safe, supportive environment to not only process but to seek support and guidance from a professional who can help you move past the barriers. If you feel you are comfortable and able to speak to your therapist, that would be my first suggestion, is to tell he or she how you are feeling. If they know then they can help determine the potential cause and allow you to process and move forward. If this is left un resolved it will be hard for you to move forward. If you are not comfortable discussing this with your therapist, this may be something to take into consideration and worthy of thinking about: why you are not comfortable speaking to the therapist. I understand this is difficult. If I may offer one more suggestion, breathing exercises are very beneficial. Remind yourself what you are working to achieve, close your eyes in a safe moment and breathe in and out slowly, in slowly through your nose and out through your mouth with pursed lips. Breathe in for approximately 5-10 seconds, then let it out slowly. Be sure and do this when you are in private, and feel safe environment. When you begin, I suggest putting your hand on your stomach, over your belly button to feel yourself actually taking in those deep breaths. I know it may sound kind of silly but they really work and are incredibly helpful. We often forget to breathe, especially when we  are feeling anxious. You are supported here and try taking yourself through the above thought process and breathing and practice the breathing several times a day. I hope this shaky and uneasy feeling eases. Wishing you the very best!Laura Cassity, LMSW, LMAC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] If you have only been to a couple of sessions, it makes sense that you might still feel apprehensive at first. Therapy is hard work! You may be talking about some things that you never talked to anyone about before. Opening up to stranger can be scary. After you feel comfortable with your counselor, and trust has built up and you feel understood in session, you should feel more relaxed. I would encourage you to talk to your counselor about feeling a little shaky. Sharing what the process is like for you is important in your work. If you still feel unsure about sharing after several sessions, it is important to take a look at that and try to understand where that may be coming from. For example, are you and the therapist not a good fit? But, again if you are just starting out in working together, feeling a little bit nervous makes perfect sense, and I encourage you to give it a bit more time and to talk to your therapist about how you are feeling. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Hi there, Thank you for your question. It's absolutely ok to feel nervous going to therapy. I have experienced anxiety going to see my own therapist. There can be a few reasons why you might feel this way. First, it is always unnerving to see a person who is a stranger and to share intimate things with that stranger. You mentioned it has only been a couple of sessions. Your anxiety might subside as you continue to see your therapist and grow more comfortable with him/her. Another reason why you might feel particularly nervous is perhaps you are not comfortable sharing things. As children, we might have bad experiences opening up to others. Someone might bully or ridicule us, and that experience can stay with us for a long time, making it extra scary to share our intimate feelings and thoughts with others. If this the case, as you continue with your sessions and have positive interactions with your therapists, this anxiety will subside with time and you will re-learn that it is safe to share. And the last thought why you might feel the shakes is perhaps you know that you need to talk about some past experiences or memories that are uncomfortable and difficult. Regardless of the reason, it might help you to bring up your nervousness in your session and share how you feel with your therapist. Having an open dialogue about your anxiety with your therapist can help you resolve some of that anxiety and built greater trust with your therapist. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Thank you for your question. It's completely normal and natural to feel nervous before a therapy session. Many people report having felt this way. I can't say enough regarding the amount of courage it takes to reach out and attend a therapy session. For many people, it can take weeks, months, or even years of contemplating whether to see a therapist or not before actually contacting one and attending the first session. It takes courage to want to work through any struggles you may be having or personal growth you aspire toward. In your question, you mentioned that you've "gone several times and are still feeling nervous and shaky." If you feel comfortable with your therapist and it's a good fit for you, I would suggest talking about this with your therapist. You don't have to struggle each time you have your appointment. Together, you and your therapist can work toward helping you have a different experience. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Sure, why not!It's nerve-wracking to go to a man or woman you've never met before and who is a total stranger, that you are paying to take an interest in your life.  You're likely feeling an internal truth about the sessions, the man or woman with you, and the man or woman sitting across from you.  I'd listen to those feelings.Wouldn't it not be best to go to those around you that do provide comfort and aid, first?  Wouldn't it be better to attend to those of faith around you who have love to offer, first?  Wouldn't it be better to go to your family and loved ones, first? :)Might try that; see if your nervousness evaporates... </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] It depends on your definition of "normal"!:) I would say that the average client I see feels some level of nervous energy when they come into their sessions, and especially at the beginning. I think that with clients who I work with that have difficult times in relationships, maybe being able to trust people is tougher for them given their life experiences, the expectation would be that they have a harder time moving through those nerves and feeling more at peace in sessions.In my opinion, a competent therapist could help you explore where these nerves are actually coming from (talking about yourself, relating to another, something else?) I encourage all of my clients to bring up whatever emotions are coming up for them in the moment, as it's helpful to the client to recognize the "present moment" emotion and then being able to process, learn from, and move through to a more peaceful place, if that is what is being sought. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Therapy can feel very weird to begin with - think about it, how often do we go and tell a relative stranger our deepest, darkest thoughts in the rest of our life? So I think its reasonable to expect a certain level of nerves as you get used to your therapist and to the whole process of talking about yourself and vulnerable topics. That said, its definitely worth bringing to the attention of your therapist (if you haven't already) to see if there is anything that they can do, or that the two of you can explore together, that might make the process feel less intimidating to you. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Yes, feeling nervous for the first few or several sessions of therapy, is completely normal.Therapy is an unusual way to have a conversation with someone.   The person is an expert in recognizing and understanding dynamics of human interactions.   For some people the fear is that the therapist knows more about you than you do yourself.In general terms hopefully your therapist has worked with many other people who've faced problems similar to yours.In this sense the therapist has a general idea of the basic dynamics you most likely are handling.No therapist could possibly know your particular details and your particular areas of upset or in what ways you feel unsure of yourself.Once you start to trust both your own right to tell your particular story and start to also feel that your therapist is listening attentively and cares what you tell the person, your nervousness will start to disappear all on its own.Good luck in getting the most from your therapy sessions! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Well, it's generally okay to feel anxious or nervous about going into therapy, particularly in the beginning because the process of being open about what you are going through, much less to someone who you don't know well, can be anxiety-producing. It's also common to feel anxious when you are discussing something that is important, difficult to discuss, or you are making changes that are very difficult for you.The most important thing I can tell you, though, is to discuss with your therapist this idea that you feel nervous and shaky. Some anxiety can actually help to motivate or lead you toward change. There are also level of anxiety that can be counterproductive, so it's a good thing to discuss. Personally, I can tell you that I would want my clients to tell me about anxiety they feel 100% of the time. That opens the dialog to discuss whether it is the level of anxiety that they want to sit with and learn about in discovering more about themselves and their experiences and/or whether they would like to do something to lessen the feeling of anxiety.Thanks for writing here. If it caused anxiety for you to do so, I hope that feeling is diminishing for you, at least related to writing here. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] of  I would love to know a little bit more about what's going on in your life but I will attempt an answer.Yes, you could still be shaky and nervous going to therapy. This therapy thing your doing is sometimes scary. First, because your opening up things that you might have never wanted to. Second, your still building a relationship with this therapist person. You may never get over that. The therapist really can't be your "friend". They are there to push the buttons that you might not want pushed and help you heal.  That in itself is scary and can make you anxious. Third, you really never know where this therapy thing will go. Yes, there are goals. But sometimes side roads need to be taken and sometimes that is scary.Know this you are in the right place. You are taking steps to change. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Hello there.  You ask about being nervous and shaky walking in to your therapy session and want to know if its normal? ...  I realize there a few ways to look at this.  I presume you weren't anticipating feeling this way; and probably hoped to feel the opposite..  Well, my initial response is yes, sure, it can be within reason to feel this way.  Have you been in therapy before? Is this somewhat new? That could be part of the reason. But either way; new or not, I think when are entering into a meeting that holds potential evaluation of deep things about you and your heart and soul, it can cause anyone to tremble. The soul can be anticipating some things could be shaken up here, and it can feel scary to look at these things and then change.  Looking deep at our life can feel daunting and scary; so your response just might be regards to potential growth trying to happen.   OR, is there something about the therapist you don't feel confident about?  This too might be in play as a reason for your feelings...  Maybe you lack confidence in that therapist ?  Have you let your therapist know how you feel?  That would be good to explore...I would like to encourage you to look at these ideas.  Hope it helps.   Let me knowKindly,keithkeithcounseling.com </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] "Normal" can be an insidious word to use because it can undermine your sense of worth.  It implies there's one particular way you should be behaving and can leave you feeling crappy and "abnormal" if you're not behaving according to that prescribed standard.  Instead, what I'd recommend is to pay attention to your emotional experiences when you're attending therapy.  Explore your feelings and thoughts without judgement and try to reflect and understand what's going on that's causing you anxiety.  Once you figure out the underlying meaning of the anxiety, you can figure out a way to handle it and action steps to take to diminish it. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Everyone has different experiences going to therapy. Being nervous can be a typical emotion one might feel. Emotions are our body's way of telling us important information about ourselves. I would suggest talking openly in your sessions about this. That way you can process your thoughts and feelings with the guidance of your counselor. There are probably underlining emotions (fears or insecurities) that are being stirred up during your therapy sessions. Your counselor might suggest individual counseling depending on what you learn about your anxiety. In individual therapy you would have time to deal with your own stressors. As you address your issues, then you will have tools and skills that will be useful in addressing the couple relationship. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] I would be more concerned with how is this being addressed in therapy. Therapy can be a rewarding process, however often times we do not pay much attention to the messages being sent to our bodies. I believe in somatic therapy which deals with our mind & body connection. I would think it may not be a question of normal or abnormal however if it is impacting you then you must pay attention to that. It would be helpful to explore the feelings you're having  with your therapist. It may be something that needs addressing to help alleviate those feelings or have a better understanding of why they are showing up when it is time for therapy. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past. Currently I'm going through anxiety and my thearapist is not available. How do I handle this? }} [/INST] Sounds like a lot is going on right now at such a young age. I'd start with discussing with mom your concerns and ideal situation. I'm unsure what prevents you from staying there, but whoever you are staying with, it should be brought to their attention. In regards to your anxiety attacks, deep breathing is always a benefits. I have a link you can use to help to do this online if you are interested. In addition, finding ways you usually cope with anxiety and what's worked before can help and if it isn't, exploring new way to calm you down can be beneficial. This is something you can speak with your therapist about going forward when they are available.In regards to feeling suicidal: I would call suicide prevention hotline (You can google them) if you truly feel the ideation is getting worse. They are professional agents who can speak with you about your ideation and help you through the process. Hope this helps. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past. Currently I'm going through anxiety and my thearapist is not available. How do I handle this? }} [/INST] OK first things first. We have to think of your safety and take care of those thoughts of hurting yourself.Yes, this is a major problem for you and can cause anxiety and depression. You have the right to be sick and tired. Kids often are pawns in this marital problems that their parents have. I'm sorry that this is happening to you.I am not sure of your rights in the state you live in but as far as I know you as a 17 year old you have the right to stay where you want. So your'e going through an anxiety episode and your therapist is not available.  If I'm the therapist we would have already set up a plan so that if you are in this situation you would know what to do. In the worst case scenario you would be able to contact me.But I would have given you several exercises to help reduce your anxiety.Staying with your mom should be your choice. I know you probably don't want to hurt anyone's feelings but there are ways to ease the tension. Maybe with your permission and their agreement, we all could meet together for a session or two to ease your tensions and get over and through this hassle. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm 17 and I'm sick and tired of going back and forth. I'd like to stay at my mother's house. This problem has really affected me. I've had anxiety attacks and suicidal thoughts and self-harm in the past. Currently I'm going through anxiety and my thearapist is not available. How do I handle this? }} [/INST] I am so sorry to hear you are going through this. Divorce can be so disruptive in a child's life.I'd really need a lot more information about your situation before I'd feel comfortable offering any advice or suggestions. There are so many variables, and not knowing the whole story, any advice could possibly make your situation worse.I do see some positives, though. One, you say you have a therapist. That's great! I hope you're able to talk to them about this soon. Still, they can't give you legal advice, and a lot of this situation may be dictated by the law. What your therapist can help with, though, is dealing with whatever situation you have to follow by law. If you can't change the situation, you at least need to learn how to cope with it better. Two, you're 17. When you're 18, you're legally an adult and will not be bound by any custody rules or visitation plans in place. Honestly, teenagers usually have a lot of say with the courts in custody arrangements. Since you didn't specify more on the situation, I have no idea what your specific situation is. Were your parents ever married? Are they separated or divorced? Was there ever a court hearing for custody? Not all couples have an official court order arrangement. All families are different, too. Was there abuse between your parents? Towards you by one of them? Does either of them have addiction issues, major health or mental health issues, or anything like that? You mentioned that you want to live with your mom, but didn't say why. Are you afraid to tell your dad you want to stay with your mom? Is mom the lenient and fun parent while dad is the more strict one, or is there something else going on? This isn't a decision that should be placed entirely on you, and it also isn't a decision that anyone else needs to make on your behalf without your input. But advice on what to do needs to come from the people who know more about your situation so they can help recommend the best thing for you. Whatever you do, hang in there! 18 will be here before you know it. Focus on that. Freedom. College. Plan for your future that YOU control, and focus on making it the best it can be. Do not let the anxiety and depression cloud your thoughts and make you do something irreversible. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ When I'm around people, I sometimes think someone has made a comment to me or asked me to do something. I will be focusing on something else and then randomly think I hear something about me. I never know if it was actually said. }} [/INST] It sounds like you are having difficulty knowing if people are saying things to you, or if you only thought someone was talking to you, and this is anxiety producing. It's understandable that it could be confusing and/or a bit scary to be unsure if people are speaking to you or not. It's hard to say exactly what is going on from just this description, but if you can work with a competent therapist, you may be able to get more insight into what is happening, get clarity about your social interactions, and develop some ways to deal with the anxiety. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I’m not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and doesn’t keep me up to date on everything that he does throughout the day, which he used to. I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I don’t know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town? }} [/INST] Relationships at any amount of distance can be so hard! It makes sense that you are encountering more anxiety than usual given that major change in your relationship. And you're right that being separated from our partners can heighten our insecurities and worries about not only our relationship security but about our partner's interest. Have you talked with your boyfriend about this struggle you're feeling? It can be hard to have this kind of conversation without triggering a sense of blame and subsequent defensiveness in our partners, but it really is possible. If you have any concerns about being able to do this, then a session or two with a local counselor or therapist might be really helpful - and it really can be just about finding the way to share what you're feeling.As far as coping with anxiety, there are a lot of options but I highly recommend an app called Self-Help for Anxiety Management. There's so much good information in this app to help you learn to pay attention to what kinds of thoughts are helpful or unhelpful, and there are also lots of activities for calming down and decreasing the intensity of that anxiety. The best part is, it's free! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I’m not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and doesn’t keep me up to date on everything that he does throughout the day, which he used to. I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I don’t know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town? }} [/INST] In a way, yes, you have separation anxiety. It's normal in a relationship for us to slow down a bit with the attachment behaviours that establish and deepen love and connection. So, just because your boyfriend isn't talking as much or keeping you up-to-date doesn't necessarily mean what you fear it means...that he's forgotten about you or loves you less. It could mean quite the opposite...that he's focused on being successful in his new job and impressing you. He may think he's loving you more, but you feel loved less. You have two jobs to do here. The first is to manage your anxiety by "talking back" to the thoughts it puts into your head. It sounds like "It's normal to be insecure, but I have tons of evidence that he loves me and that I mean the world to him..." Find that evidence that helps you refute what anxiety is trying to claim. The second part of your job is to let him know what you need. You need more affection and connection during this period when he's away (more texts, phone calls, information). It's okay to want that, and I am sure he will be relieved to know exactly what he can do to help you feel secure and calm when he's away. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been with my boyfriend for more than a year. He recently got a new job and travels a lot. I’m not used to him being gone all the time. I feel as though he has forgotten about me because he does not talk with me as much and doesn’t keep me up to date on everything that he does throughout the day, which he used to. I feel lost, sad and unwanted. This is really a tough new challenge. I just want to break up with him, but I love him so much. I don’t know why he is acting this way lately. I believe I have separation anxiety. Is there anything that I can do to help me cope with this while he is out of town? }} [/INST] Consider talking with your boyfriend about times that you may be able to talk together while he is away. This way, you have an idea when you'll be able to contact him. Does he recognize the feelings that you have while he is away? How do you feel when you are together with him and he is home?I'm also curious as to how the level of your anxiety (on a scale of 1 to 10, perhaps) changes during the parts of his trips. Maybe there are certain parts that are more or less related to anxiety for you. Perhaps you have less anxiety while working or involved in a specific activity, for example, spending time with friends.When you are both in the same area (when your boyfriend is not traveling), do you do some things independently with friends? Do you know what leads to your anxiety when he is away? I don't know whether it is a general feeling of wanting him to come back or anxiety that something specific will happen to you or him.Do you ever recall feeling this way in your past? If so, what was happening then?What do you have that makes you feel very safe and comfortable?Consider working with a mental health professional in the area. Perhaps it would be helpful for the two of you to meet with a therapist who specializes in couples to see what kind of relationship you want to have and what you can each do to contribute to that relationship. There could be things that you could both start or stop doing to help your relationship move in the direction where you would like it to go. As an example, perhaps you would like a text before your boyfriend goes to bed, no matter what time zone or time of day it is. Perhaps he would prefer a good morning text or call/voicemail from you. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I panicked over a minor parking lot mistake. It was totally my fault, but due to another insurance issue, I left a note with an illegible phone number. Guilty over this, I got an envelope containing several hundred dollars. Unfortunately, by the time I returned, the other driver had seen my ersatz note and drove away. Since I cannot make this up to that individual, how do I atone for my cowardly act? I have been trying to do random acts of kindness in hopes that karma will somehow even out. }} [/INST] Thanks for sharing as it shows your humanity and that you have a sensitive conscience. In your example here I'd encourage you to always think, "safety first"; and never offer a stranger at the accident scene "...several hundred dollars". Why? Because it could go badly against you (i.e. extortion, robbed, or would this be considered a bribe).   To the point, I'm reminded of Steps Eight and Nine in many 12-step programs regarding making amends. In your specific example since the injured unidentified party departed, and by your own admission you've been doing random acts of kindness, it seems to me you've acted in reasonable good faith fashion to make amends. Well done.   I'm not a karma expert but as a therapist I would invite you to explore the deeper story behind your use of the words "cowardly", "guilty", and what it does for you to engage in "random acts of kindness". What a fascinating journey this could be for you. Best wishes. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Anxiety can cause such a feeling of discomfort in our bodies that it can seem unbearable. The concern that I can hear in what you have written is that the thought of having some anxiety has now left you uncomfortable with any anxiety at all - and that can become a problem, indeed. As opposed to thinking about your anxiety as something much bigger than you, it could be helpful to start breaking it down. What are the things specifically that cause you anxiety about this new job? Is it being away from your family? If so, why? Once you start breaking down what causes you to feel anxiety into smaller "mouthfuls", then we are far better able to understand what has led to discomfort and start to problem solve the issue. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] It is ok to have anxiety.   Please don't be anxious about being anxious.If you feel anxiety coming over you, then pull off the road to a safe place.   Concentrate on centering yourself and to breath slowly.   Take some sips of water.  Sit still.     The anxiety should pass in about twenty minutes.If it does not pass, then continue calming yourself until you feel safe enough to drive to your hotel.     You can always explain to your supervisor that you were taking care of a medical problem, because anxiety is a medical problem. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Anxiety often occurs when big or unexpected changes come to our lives, like having new jobs, relocating, or assuming new roles. Notice if your anxiety feels like excitement, concerns, or fear.It seems like you are excited about your new job, but worried because OTHERS are telling you that you have anxiety.   Let's notice how other‘s input is affecting your thoughts and maybe causing more anxiety that you may really have.   If you are indeed experiencing anxiety, that does not mean that you will have panic attacks.   But if you are experiencing panic attacks, or suffer them at some point, you could learn how to reduce them either with therapy or medication.You can learn how to process it depending what triggers it and channel it, in a useful way.  For example, you could plan a schedule around your new job and be meticulous about it because you are worried about how your new job may affect your routine, or, you could feel overwhelmed with your schedule, focus on the feeling, but not do anything about it.  Notice the difference?  The key is in recognizing if you are anxious about something that you can change or have control over it, and take action if you do, and recognizing when you cannot control things and be OK with not being in control.I teach clients how to use meditation and cognitive reframing techniques to help calm anxiety symptoms.  If you are interested in engaging in counseling or teletherapy you may contact me at 787-466-5478.I wish you success on your new journey!Estoy preocupada por mi nuevo trabajoLa gente me dice que tengo ansiedad y estoy aterrorizada de tener un ataque de pánico en la carretera.  Esto es nuevo par a mí. ¿Que puedo hacer?La ansiedad ocurre comúnmente cuando llegan cambios grandes o inesperados en nuestras vidas, como tener un nuevo empleo, mudarse o asumir nuevos roles.Al parecer estás emocionada por tu nuevo trabajo, pero preocupada por que OTROS te dicen que tienes ansiedad.  Notemos como la opinión de otros esta influenciando tus pensamientos y tal vez te puede estar causando más ansiedad de lo que realmente tienes.  Si realmente estas pasando por un periodo de ansiedad, no es necesario que vayas a experimentar ataques de pánico.  Pero si ya los haz experimentado puedes utilizar terapia o medicamentos para controlarlos.Nota si tu ansiedad se siente emocionante, preocupada o temerosa.  Puedes aprender a procesar estos sentimientos dependiendo que pensamiento los causen y canalizar la ansiedad de manera productiva.  Por ejemplo: te puedes enfocar en organizar una agenda porque te preocupa como tu nuevo empleo afectara tu rutina diaria.  O te puedes sentir agobio respecto a cómo tu trabajo afecta tu rutina, y no hace nada más que preocuparte constantemente.  ¿Notas la diferencia?  La clave está en saber cuándo te preocupas  por algo que puedes cambiar, y tomar acción; vs. cuando te preocupas  por algo que no puedes cambiar y aceptar que no lo puedes cambiar.Le enseño a mis pacientes a  usar técnicas de meditación y re enfoque cognitivo para manejar síntomas de ansiedad  y desorden de pánico.  Si te interesa una cita de consejería o tele-terapia me puedes contactar al 787-466-5478. ¡Mucho éxito en tu nueva jornada! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] There are lots of things you can do, but first: Congratulations on your new job!  Commuting long distances can be stressful, but there are some things you can do.First, make sure that your seating arrangement in your car is comfortable. If you are driving long distances on a regular basis, you want to make sure that your body is in a comfortable position. Second, select some music or podcasts that work for you, rather than against you. Soothing music is good, as well as inspirational podcasts. Alternatively, listening to books can be a great way to spend the time, improve your mood, and find inspiration. Third, make sure that you have plenty of time for your commute. If the drive normally takes you 30 minutes, plan on 45 (or if it's 45 minutes, plan on an hour). This way you won't be rushed, can take your time, can focus on your driving, and if traffic is a bit backed up, you've got plenty of time to reach your destination.Finally, if you do find yourself being anxious in a way that impedes your driving, pull over to the side of the road, take some deep breaths, and sit with your feelings. Take a deep drink of water. Consider jotting your feelings down in a journal. If its safe, get out of the car and walk around a bit, stretching you muscles and breathing in the air.But most of all, be kind to yourself. I wish you much success in your new job. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm a teenager, and while I’ve never been to any kind of therapist, I noticed I experience several anxiety symptoms. I frequently find myself not going out and following my parent around the house. I can't go into stores (grocery stores specifically) on my own, and when I do, I have to be on the phone with my dad the whole time. I also forget things a lot. }} [/INST] With the way you described your anxiety, it sounds like you have different types of anxiety. I'm not sure whether you have anxiety of public places, large crowds, being alone  (sometimes called separation anxiety), or some combination thereof.One thing that would be helpful would be to track your anxiety and see how anxious you are (on a scale of 1 to 10) in different situations. Also, if you know what leads up to your anxiety, it would be good to know this as well so you can look for patterns.As for forgetting things, you could be anxious because you are forgetting things or you could be forgetting things because you are anxious. When you are having anxiety, certain parts of your brain are overactive because you are in a kind of protective mode. It's also possible that forgetting things and anxiety are not related.Something else to try would be to notice where you feel your anxiety in your body and put your hand there is a way of giving yourself comfort.Another thing about anxiety is that having anxiety can lead to more worry about having more anxiety. One thing that helps for some people is to go to the regular primary care doctor to make sure that there are no physical problems (just for the regular physical) so they know that there are no physical problems and that the anxiety will lessen in a few minutes.Also, if you are able to notice your feet on the floor or your hips in the chair, this is helping you to be mindful of your body and connecting you to your surroundings. During this in combination with naming your emotions can be soothing as well. For example, in the grocery store, if you are feeling anxious, you could say to yourself "I'm anxious right now and I'm okay" while gently shifting your weight from one foot to the other. No one around you would notice what you were doing and the motion may be soothing to you.Anxiety can have a lot of different causes and things that trigger it. If it is difficult for you to work it out on your own (which is very common), consider talking with a local therapist so you can have more specific ideas.Also consider making a list of people who you trust and what it is about them that makes you feel comfortable. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am a really shy person. I'm currently in a graduate program which requires lots of presentations, but they always make me feel stressed out and less confident. How can I get more confident? }} [/INST] Wow, congratulations on being in a masters program. You are in a unique place. So few have reached that level. You should give yourself a pat on the back.Confidence is not something that comes naturally. But can and does come with practice.Having gone through two masters programs I can sympathize with your your dilemma. So how is the stress affecting you?Is it serious enough to stop you from presenting or is it just "butterflies"?There are many ways of dealing with the anxiety and stress. Much depends on how serious the stress is.So here are a few ideas:1. Practice in front of a mirror.Sounds strange but the practice helps.2. Ask some friends to listen to your presentations. Not so much for their input as to just get used to presenting.3. Focus on the material you are presenting. The subject matter is what you want to get across. Step away from your nerves and get into the facts you want to present. Let the material you present be the focus. 4. Remember everyone else is just as nervous as you. Share your fears with some of your classmates and gain support from them. Focus on a friendly face during the presentation. Be a support to them in return.5. "Fake it, till you make it". Yes it sounds blunt. But sometimes that's what it takes. Even if you feel like it, you won't die.So much more can be discussed with a competent counselor. Take the time to let a professional help you work through this.Again you have come a long way to be in a graduate program. Congratulations you have done great work so far. It's just one step at a time, take the steps. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am a really shy person. I'm currently in a graduate program which requires lots of presentations, but they always make me feel stressed out and less confident. How can I get more confident? }} [/INST] A good way to start is the language or "self talk" that is happening inside your mind.  Looking at your question, when it is said that the presentations "make me feel stress" you are giving the responsibility of the stress to the presentations and taking that away from your self.  The presentations cannot give or take away your stress, that's something only you can do and you can do it!   What language can you change in your self talk?  For example, are you saying "I can't speak in front of an audience! I'll fail?"  That sounds a lot different than "I studied my butt off and if I practice speaking out loud, I can ace this presentation!"  Although this is a short answer, I do believe that counseling will help you overcome these stressful feelings and bring out your inner confidence. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am a really shy person. I'm currently in a graduate program which requires lots of presentations, but they always make me feel stressed out and less confident. How can I get more confident? }} [/INST] Have you tried rehearsing to yourself or a trusted friend what you will present to the class?   The more confident you feel in a safe space, the more chance there will be of making the same presentation to a larger group.Giving presentations is not necessarily a difficulty with communication.   It has more to do with performance than expressing yourself clearly.Practice, practice, and practice, until you see yourself improve in how you present.Also, keep in mind that whatever anxiety you may feel about making a mistake, the audience is almost alway much more forgiving than the person who feels anxious.Anxiety heightens fear, so whatever concerns you have, check if they are growing from anxiety instead of a realistic assessment of your abilities or audience receptivity.Good luck! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] People do cry in therapy sometimes, but it's not at all necessary to cry in order for most kinds of therapy to be helpful. When you start counseling you don't yet know your counselor very well, so it's normal to keep your feelings in check until you feel comfortable and a bit more relaxed with your counselor and with the situation. Sometimes, though, there are emotions that have been waiting and waiting to finally find someone who will listen with a kind ear. If you feel safe right away in the situation with your counselor, you might just cry in spite of your fears about it. Your therapist is used to people expressing how they feel and will keep strict confidentiality, so even though it's embarrassing, finally experiencing someone truly listening with empathy and kindness may just be worth it. It's okay too to let your counselor know right at the beginning that you're kind of freaked out about getting too emotional in front of another person. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Crying is a natural process when you talk about upsetting things especially in therapy when you are opening up and being so vulnerable. I suggest that you consider how you would feel/respond to someone that was confiding to you and they began to cry. If you felt concerned, supportive and empathetic then you know exactly how us therapists feel when our clients are emotional in sessions. I suggest that you think of times where you have cried and how you felt at that time in public and what would have helped to make you feel less uncomfortable during your tears. I think of crying like any other natural reaction of our body such as sneezing, laughing, coughing. You can't help but do those things and most people won't really judge negatively if you do it in public. Similarly, crying is our body's reaction when we are emotional whether it is tears of joy, from a hilarious joke or from being upset. If you are very uncomfortable about crying but willing to start therapy perhaps you can ask the therapist if you can turn your chair around if you begin crying. This way you are not facing them and can self soothe without worrying about how you physically look at that time.I wish you luck and you should be proud of yourself for starting therapy and I wish you a wonderful journey on this important path that you are embarking on. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Yes, if crying is how you are expressing an emotion, then not only would it be normal, but hopefully encouraged, because it's an important part of therapy to have a safe space to express your emotions. We might encourage you to put words to the tears as well, to help you expand on your experience and begin to make more sense of it.As a therapist, our job is help you open up and feel comfortable enough doing so. I sincerely hope no therapist would ever shame you for whatever experience you are having in the room. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Hi there !  As someone who has practiced as a clinical psychologist for 25 years , I would say that crying is NOTHING TO WORRY ABOUT AT ALL ! Almost every single person I have worked with has cried at one point or another.  Starting therapy takes a lot of courage; when you work with a therapist ,once you feel safe ,  you talk about a lot of very private and potentially emotional things that you may have never discussed with anyone before.  I have seen  people cry with sadness , cry with relief at releasing painful things they have held onto for a long time, cry because they feel so relieved that they finally feel heard.   I myself have sometimes cried with clients because some things they talk about are so profoundly moving.   I can assure you that most , if not all , therapists expect clients to cry  and there is nothing to be embarrassed about.   Crying can be very cathartic and can allow us to release a lot of painful feelings we have been stuffing down.   Crying is  often a sign that you are really working things through and getting in touch with feelings that you need to get in touch with in order to heal .So , to summarize , don't worry at all about crying! It will probably feel uncomfortable  at first , but I promise you , you will not be judged for crying in therapy.   And it will be less embarrassing once it happens a time or two and you are assured that your therapist will be there for you and won't judge you !Good luck !! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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 </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Please feel free to cry during therapy if you suddenly feel painful emotions arising when you describe some of your unsatisfying and unfulfilling relationships and situations.Crying when realizing the emotional hurt and unfairness between you and someone, clears you for new ways of handling interactions.As a therapist, I always have a box of tissues on the table next to the couch where people who utilize my therapy, sit.I hope you will soon discover that once your tears unlock your awareness of harmful relationships in your life, you will quickly see the freedom to establish new and happier patterns of relating.Have a good therapy! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Please do not worry about crying. People cry, laugh, rage, rant, and talk during counseling sessions. Part of the therapy process is to look at your feelings, and to feel what you are actually feeling (instead of what you think you should feel). So if you need to cry, that's ok. If you feel embarrassed because you cried, or if you feel anxious that you might cry, well those feelings are ok as well. Your counselor can help you manage your feelings so that you can attain your goals, and your counseling session is the perfect place for that. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I feel too scared to meet people I don't know - even relatives. I don't ever raise my hand or talk in school. I feel like no one understands. How can I handle this? }} [/INST] Congratulations on your courage to ask this question!This shows you are willing to engage with other people, just not in all situations, especially the in person ones.Start by "meeting" yourself.Reflect as thoroughly as possible as to what you imagine will be the outcome of meeting others or of speaking up during a class.Some people are afraid of being criticized or judged by other people, or do this to themselves inwardly.  If you are judging or criticizing yourself to be less worthy of having opinions or views or of being who you are, than others, then the thought of actually placing yourself in this situation, would feel intolerable.One way to move out from this position of feeling less than others, is to recognize that these feelings are inside of you.Then it is possible to know at least on an intellectual level that it is not true that any one person is superior to another.All the people whom you are afraid to meet, also have their own insecurities.We are all equal in worth and in having blindspots about ourselves.Also, it is possible that you are naturally shy and may be expecting more from yourself than is reasonable, in terms of a standard about meeting others.You may have a few fears of being judged unfairly, you may also simply not enjoy being around people very much.Be aware to not push yourself beyond your natural limits.  Overcoming fears of being judged is different than forcing yourself to do what is against your basic nature. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've known him for about six years. We've dated off and on. I hadn't seen him in close to three years but recently started seeing him again. I really want this to last this time. I stayed the night. Do I text, call, or make contact first, the same day of the morning I left his house? }} [/INST] I don't see why you can't call, text, or make contact first. It would be up to him to reply when he can and wants to, but I don't know why you couldn't initiate contact.One thing to consider as you get to know each other better is having conversations about conversations. For example, you could say "I'd like to call or text you more often, but I'm concerned about _____ (listing what you are most worried about)." Then he can discuss his reaction and you can have a dialogue about it. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Probably a good portion of living like a recluse was necessary so you had time to rest and recuperate from so much major adjustment in your life.Have you told some of the people in your life about the many changes you've been through?   It is possible people sense something different about you and aren't sure whether to ask or not ask questions.Also, understand what type of qualities you'd like to offer and receive in a friendship.   Given that raising a kid who has autism takes a lot of energy and time, the way you socialize will change.Start with one person whom you're pretty sure would welcome you and whom you would gain by bringing them into your life.As a result of how this interaction goes, how you decide to spend your time together, what you'll discuss, you will know more about yourself and what you require to feel good around other people.Then, you can consider if you're ready to add others into your world. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] It is possible that you could have or be developing an anxiety disorder. There isn't really enough information provided here to suggest a particular disorder, but it might be worth meeting with a counselor or therapist to do a formal assessment. Some of the questions they might ask could be what other kinds of physical symptoms you experience, how frequently these physical symptoms happen, what's going on for you when they tend to happen, and how frequently/intensely you find yourself worrying in general. Anxiety itself is a really natural thing - it's just when it starts interfering with your ability to "do life" the way you want that we start to consider potential disorders. It might be that for the most part, the anxiety you feel is normal and you simply have some triggers that intensify it more than usual. Working on your own or with the support of a counselor/therapist to both address those triggers at the root and also to develop ways of managing the actual anxiety symptoms. This two-fold approach can be really helpful for not letting anxiety keep you from engaging in life the way you'd like. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] These types of symptoms can be very disruptive to life!  Anxiety often presents in two key ways:  1) physical symptoms such as: racing heart rate, sweaty palms, dry mouth, shaking or trembling or nausea - often these physical sypmtoms are categorized as a Panic Attack.  2) mentally anxiety presents itself as worry.  Worry that spirals out of control, worry that dirsupts your life and concentration.  Worry that keeps from being present in your life.  Anxiety when it begins to spiral out of control either with disruptive mental or physical symptoms, needs to be addressed formally.  I urge you to see a counselor and/or a psychiatrist soon to begin to address these issues.  Good Luck, Sitka Stueve, LSCSW </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] Feelings of anxiety can be scary and sometimes we're not aware of the triggers that lead up to moments of anxiety, i. e., heart racing, sweaty palms, sweating, shortness of breath. It's important to realize that in moments of anxiety our body & mind are experiencing a reaction from our primal or reptilian brain that is signaling the flight or fight response within us, which kicks the hypothalamus into action flooding our body with chemicals, like adrenaline or cortisol.  So, one way to work with anxiety is to find out what the triggers are that lead to anxiety, such as fear, stress. negative thought patterns, not enough food or sleep. Keeping a daily journal can help you track the patterns and triggers and once you identify the triggers you can ameliorate them by learning new skills & techniques and by reducing stress and getting enough sleep. One quick way to reduce anxiety is by taking deeper breathes, sometimes this is called belly breathing. When you breath in make sure your belly rises and expands and as you breath out the belly deflates. Many of us do shallow breathing up in our chest which does not allow for a full breath, and getting a full breath is so important as a tool to help relax us in times of stress & anxiety . </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] Yes, it seems like you may have a type of anxiety: but considering that it is intermittent, it may be a good idea to talk to a therapist and explore what triggers the anxiety.  Different types of anxiety are caused by different scenarios, memories, or stressors.   Once you identify what triggers the anxiety, you may be able to identify the coping mechanism that will help you handle your symptoms.¿Tengo algún tipo de ansiedad?A veces estoy bien, puedo salir a reunirme con personas, pero otros días, mi corazón se acelera y las palabras no salen de mi boca.   Siempre pensé que era normal y que solo estaba nervioso, pero el otro día, me tomo casi 30 minutos encontrar el valor para salir del carro y entrar a Target.Si parece que tienes un tipo de ansiedad, y considerando que es intermitente, puede ser útil hablar con un consejero para explorar su causa.   Hay diferentes tupos de ansiedad que son causados por diferentes estímulos, memorias y escenarios. Ya que logres identificar que causa tu ansiedad, entonces podrás aprender mecanismos de defensa que te ayuden a controlar la ansiedad. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] Your, sitting in your car for 30 minutes, story sounds so sad and frustrating.Yes, you're describing classic symptoms of anxiety.Anxiety itself is the indirect result of repeatedly being in positions of feeling helpless or frightened.Are you able to recall from your growing up years of feeling insecure?You may not have felt loved and nurtured as much as you needed.Some people develop anxiety from missing enough love.  They feel lacking in ability to take care of themselves, similar to the lack of being sufficiently taken care of when younger.Try understanding if you felt neglected emotionally.If "yes", then start the slow process of emotionally rewarding and acknowledging yourself.Progress will be slow.Eventually you'll stabilize the way you feel toward yourself.This will gradually result in decreased anxiety. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Sometimes, I'm fine and can go out or meet people, but other days, my heart races and words physically cannot come out of my mouth. I've always thought it was normal and I was just nervous, but the other day, it took me almost 30 minutes of sitting in my car to find the courage to enter Target by myself. }} [/INST] First, be aware that each end every one of us has anxiety at some point. That certainly seems to fit what you're describing here, but that doesn't mean you have an anxiety disorder, necessarily. That's where there is a difference. Anyone who has a hard time with public speaking or feels uncomfortable in large crowds, for example, is experiencing anxiety.It sounds like it would be helpful to look at the differences between the days when you are more comfortable on the days that you are not. If you notice your anxiety is keeping you from doing things that you need or want to do, it may be helpful to talk with and mental health professional.I wonder also whether your appetite and sleeping patterns are the same or similar to how they were before you experienced this anxiety, when your anxiety started, and whether you feel more comfortable when someone you trust is there with you.If you have an idea of times or situations in which you feel anxious, consider carrying a small smooth rock or another object that makes you feel calm and centered. Perhaps you can keep it in your pocket and remember specific comfortable times while you have it in your hand. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ A lot of times, I avoid situations where I am to meet new people because I have a fear of embarrassing myself. I often avoid large groups of people, like parties, because I think they all constantly judge me. }} [/INST] Hello, and thank you for your question. First, I want you to know that you are certainly not alone on this issue. Everyone, at some point in time, has a fear of public embarrassment. But for many people, this fear can become so awful that it begins to have a real negative impact on their quality of life.  They will try to avoid any situation that they even THINK will cause them embarrassment or anxiety. Escaping a possible embarrassing moment by avoiding or isolating may cause some relief at first, but then many times the avoidance will eventually lead to loneliness, isolation, and even despair. By avoiding, we can also miss out on things that make us feel alive and bring enjoyment. There are many self-help books that offer advice on this issue. You can do an internet search, and I recommend reading the reviews of the book. That is  great way to find out if others have found the book helpful. Another option is to seek a counselor to help you with this fear. I would recommend a counselor who specializes in helping people who have anxiety or social anxiety. Acceptance and Commitment Therapy is  a good choice for helping with anxiety, but there are many others. The truth is that anxiety and fear of embarrassing ourselves is not something that any of us will ever "get over", but we can learn to respond to those feelings differently. A colleague may offer some other advice, as well.. Be wellRobin Landwehr, DBH, LPC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have severe anxiety and have tried everything. Everything makes it worst.The only thing that helps is my emotional support animal. }} [/INST] Sorry to read of your suffering.Is it actually permitted that people are able to take support animals to school?I see your point of the animal helping you.  I just also see the point that some people have allergies to animal hair or dander, or may feel distracted by an animal in the classroom.You may end up feeling worse, if when you bring your support animal to school, that it disturbs people or interferes with the routines of the class.For your anxiety, I suggest some loving kindness toward yourself.  Be patient with yourself and that you have anxiety.  If you're able to accept that some situations create great discomfort for you, maybe you'll tolerate these difficult situation.Embrace your anxiety as part of you, basically, rather than trying to banish it, which because it actually is part of you, is impossible to achieve.In a way, I'm suggesting you become your own "support animal".  Love yourself, be kind to yourself, and see if you feel a little less stressed in school. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I don't understand why this is happening. Why do I feel this way? }} [/INST] The first step to answer your question is to reflect on what is going on in your life overall.  If you're in the midst of severe stress, whether within your relationship or effort to establish a relationship, upheaval in family dynamics, some type of significant loss like a job or someone with whom you feel closely attached, then you may simply be creating the solitude which is necessary to better understand and absorb the meaning of these changes.I assume you mean you are by yourself when you are indoors.What you write sounds like you're not happy with this recent urge rather than that you and someone or others are having great and fun times together.One way to encourage yourself to go back outdoors is to connect w a friend or search for an interest within you to develop.This way with either of these, you'd feel a little bit of motivation to join and get more involved with either of these. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am a peaceful person, but I often find myself having thoughts about killing people. Eventhough I like the thoughts at the time, they make me cry. Why do I feel like this? }} [/INST] Hello, and thank you for your question. Clearly this is something that has you very concerned. Sometimes thoughts are just thoughts, and they are pretty harmless. Many people have thoughts of killing someone, but they would never actually do it. They really don't even want to do it, they are just having a thought. Other times, thoughts are a sign of something more serious, and we should receive help when they start to worry us. I would recommend meeting with a counselor to discuss these thoughts. It is usually a safe environment where you can get advice with little judgement. Now, If you begin to start thinking about killing someone specific and making a plan to do it in reality- you should call for help immediately. By help, I mean 9-11, or a family member or friend. You would want to get help before doing something to harm yourself and others. Again, none of this is to judge, but rather to encourage you to get the help you're seeking. Either way, when we become concerned about some aspect of our behavior, seeking counseling is usually a good choice. Be well, Robin J. Landwehr, DBH, LPCC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I shake and have panic attacks. }} [/INST] One of the first things I would suggest is to see if you can keep track of what is leading you to feel anxious. If you shake all the time, consider talking with your primary care physician. Sometimes that can be a hormonal imbalance or another chemical imbalance (such as thyroid).One of the most difficult things about anxiety is that having anxiety (particularly panic attacks) can lead to anxiety about having more panic attacks. Also remember that panic attacks are typically part of your brain's protective response to what it considers to be some sort of threat. You may have heard of the fight or flight response. When you have an anxiety attack, your body is preparing you to react to something that isn't actually a threat, so it's almost as if you're fight or flight response is overactive. Here is an image that may be helpful: http://psychology.tools/fight-or-flight-response.htmlThere are many different things you can do. You can practice breathing, mindfulness, meditation, or yoga techniques. If you decide to try some breathing techniques, try breathing in for a count of five, holding for a count of five, breathing out for a count of five, and repeating five times.Also remember that it is easier to learn these techniques when you're not having a panic attack. At that point, it can be really difficult to use methods to not panic. Also remember that panic attacks typically last 5 to 10 minutes. Using techniques to slow your breathing or become focused on the room around you is probably most helpful when you first start to feel anxious.Here are some other techniques that may help to decrease anxiety: http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/As you figure out what is leading up to your anxiety, also consider asking yourself what is making that certain issue a big concern for you. Another important question could be when you have felt that way before. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Fears are not that difficult to deal with, first you need to train yourself to relax using some relaxation strategy, once you are able to employ that in your daily life, you then need to start facing your fear, for instance I'll use an example of a man who has a fear of driving over a bridge. We would build a hierarchy of fears, that is a list of fears ranging from least to most, for example the man may want to start by looking at a picture of a bridge while employing his relation technique, then he may want to see a real bridge from a distance while employing that same relaxation technique, then moving closer to the bridge, then maybe standing on a bridge, all the while moving closer to his fear while relaxing, until you come to most fearful proposition which is crossing that bridge, or you can also engage in flooding which is for example, if you were scared of an elevator, go into an elevator until you are not panicking anymore, in the movie Batman Begins, Bruce Wayne who has a great fear of bats, goes into this cave and allows himself to be surrounded by bats until he is no longer fearful of them. Secondly, look at your fears, do they even need to be worked on, some fears are healthy, for example if i was a therapist in New York City and someone came to me and said "I'm scared of snakes", I would probably say that is OK because there are very little snakes left in ManhattanHope that helps C </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Fear is a part of life. In fact, our five main emotions are joy, fear, sadness, shame, and anger. We tend to spend a lot of time and energy running away from or trying to get rid of most of those emotions and the more we do that, the more we set ourselves up for failure and disappointment. As a result of viewing our human emotions as "bad" or "wrong," we often get caught up in a trap of thinking we have to overcome them or get rid of them before we can do what matters to us. In reality, you can do what is important to you while having your fears! My question for you is, what would you do if this fear was completely gone? What behaviors would you have if you were the ideal you? What skills, knowledge, or personal qualities would you develop? What kind of relationships would you have?I imagine your fear has kept you from achieving those goals because your mind tells you you can't do it until the fear is gone. I challenge you to do the following exercise:What is a goal you would like to achieve? Example: I would like to change careersWhat actions are necessary to complete this goal? Example: see a career counselor to determine my ideal career, go back to school/get a certification, network with others in my desired industryWhat thoughts, feelings, or urges might get in my way? Example: thoughts of "What if I fail? I'm not smart enough. I can't do it. I'm too busy to put energy into this." Feelings of fear, shame, excitement. Urges to distract myself through drinking or watch tv instead of taking action.It would be helpful to remind myself that: example: It is natural to have these thoughts, feelings, and urges but I can take action anyway. I deserve to have a fulfilling life.The smallest and easiest step I can take now: example: research career counselors in my area and write down their phone numbersThe time, day and date that I will take that first step, is: example: Tonight at 7pm At least think through these answers but it is most beneficial to write them down. I hope this helps! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] This answer could be very different depending on the fear, the degree of it, and what it connects to.I wonder the following:On a scale of 1 to 10, how upset, anxious, or scared to you get when you think about overcoming this? If it's more than a 5/10, I would definitely recommend talking with a therapist in your area.A lot of fears that we have come from something that at one time was self-protective and important. Do you know where your fear started? If you think it is still protecting you or helping you in some way, talk with someone (like a therapist) about it.If it is something that you know is irrational (for example, fear of being hurt by static cling from winter clothing), is there some part of that that you are not afraid of?I really encourage you to consider whether your fear has a lot of emotions connected to it or if it ties from something in your past that was very emotional for you at the time. If it does, consider working with a therapist to establish emotional safety before taking away the fear or anxiety that may actually be helpful to you.Also, the fact that you notice that you are afraid of something and you don't want to be afraid of it anymore is a big step in the forward direction. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Biologically, fear is designed to protect us from harm. Fear is not always a bad thing, and in fact can be quite healthy and appropriate depending on the situation. A phobia, however, is different. You used the term "fear" rather than "phobia". A phobia is an irrational fear - meaning it is not rational for you to fear that thing. If your situation is a phobia, exposure therapy can help. This consists of gradually exposing yourself a little at a time to the thing you are afraid of. Some people with phobias find that the irrational fear interferes with their life and they do need to overcome it. Someone who is afraid to drive over bridges may go to great lengths to avoid routes that have bridges. People who are afraid of elevators may always use the stairs instead, which may not always be feasible. If overcoming a phobia will improve the quality of your life, then by all means, seek professional help to overcome it.Everyone has fears, or things that make them nervous. Public speaking, asking a person out, fear of failure. Examine what your fear is and try to determine the reason for the fear. When you can get to the root cause of the fear, you can deal with that issue. A lot of times, it is a self-esteem issue. You may be able to peel back the layers of the fear and find out what's causing it and deal with the real issue. Some fears are caused by trauma. Someone with PTSD is going to have an exaggerated fear response and will find themselves being kicked into "fight or flight" mode over things that someone without the trauma experience wouldn't notice or react to. In cases like this, exposure therapy would be the wrong approach and could actually make things worse. If there is a possibility that a past trauma is the cause of your fear, I strongly urge you to seek a therapist - not just any therapist, but one who is trained to work with trauma and abuse victims. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] Hello, and thank you for your question. Overcoming fears is something that everyone struggles with at one time or another. Sometimes we come across something that scares us, we push through it and suddenly we aren't afraid anymore. But sometimes it can seem like our fears just take over and we cannot overcome them. There are some options:1. You can go to a counselor and receive some type of treatment. What kind of treatment would depend on the type of fears you are experiencing. For example, if you have a general phobia about something, they may use various techniques to help you manage it.  2. There are different websites and even some self-help books that you can use to try to overcome your fears. When it comes to overcoming certain fears or phobias, exposure therapy well-studied and proven to work. A therapist would help you with this, but some websites give instructions for how to do it yourself. I am not sure how well it works when you try it by yourself, but here is a link to a website that does offer some tools. http://psychology.tools/anxiety.htmlSome colleagues may offer you some other types of advice. Be well.Robin J. Landwehr, DBH, LPCC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] First, let me express my support and compassion for what you're going through. Hearing voices can be incredibly difficult and can feel like you can't get a moment's peace, even in the privacy of your own mind. And not everyone will necessarily understand what you're dealing with, so I imagine you may also be feeling isolated or somehow different. Atta girl/boy on reaching out for help! Many people find benefit to taking medications, such as risperdal, seroquel, and so on. These should be prescribed by a nurse practitioner or psychiatrist -- I do not recommend a primary care doctor venture into this area, as a general rule. Discuss the options thoroughly and insist on a good rapport with your prescriber, if you decide to go this route. Some people are having results with a talk-therapist to develop coping strategies. There is a new and somewhat less conventional approach to challenging voices with a professional to assist you, rather than to suppress the voices, which medication will do. There is peer-run organization and a general approach that attempts to live with voices in a different way.  You can read about it in Living With Voices by Marius Romme. I have heard interviews but have not read the book(s) and can't speak to its efficacy. No matter what steps you decide to try, managing your stress, sleep, exercise, healthy food is essential -- in other words, just the daily care and feeding of yourself should be included in all of your efforts and bears surprising benefits to your brain and emotional health. Best wishes to you,Karen Keys, LMHC, CASAC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] This isn't something you can do on your own. If you haven't already, you need to see a medical doctor ASAP to rule out medical causes for this. Many diseases, illnesses, and conditions can cause hallucinations. In the elderly, sometimes it's something as simple as a urinary tract infection. Some medicines may have that side effect as well.However, you say you've been hearing them since you were little. I have no idea how old you are now, but something that has been going on for many years does lead me to think it could be a type of schizophrenia. A psychiatrist could diagnose that after taking a complete look at your history, medical history, etc. There are medications that they can put you on that will help. One thing that I find encouraging is that you recognize you're hearing voices. This means you are not so far into a delusion as to believe it is real. A lot of people that hear or see things that aren't there are not able to have the awareness that these things are not real. They fully believe what they're hearing/seeing. It's completely real to them. Because you have the awareness that you do, I feel this is a very good sign that with treatment you can live a normal life (assuming you are not already receiving treatment for it. If you are and are still hearing the voices, please know that medications often need to be changed and adjusted, and the voices may never completely go away but medicines certainly help dull them a lot. Always talk to your doctor when it seems your symptoms are getting worse so that they can make the necessary medication adjustments for you).If at any time the voices are telling you to do something, please go to an ER as this is an emergency. Sometimes people hear voices telling them to harm themselves, harm someone else, or do other things that are against the law. Do not try to deal with something like that on your own. There are people who can help. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] 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. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ 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? }} [/INST] The best way to handle anxiety of this level is with a combination of appropriate medication given to you by a medical doctor, and therapy to help you understand the thoughts, feelings, and behaviors that are causing the anxiety. This is not something that anyone should just “white knuckle” and try to get through on their own with no help. Cognitive Behavioral Therapy is a technique that has been proven helpful for depression and anxiety. This takes a therapist trained in CBT. You will learn to recognize when and why you perform the behavior of hitting your head, help you deal with the underlying cause of this, and replace the behavior with a more positive behavior. You'll learn coping skills.You mention having a rough childhood. Anyone who has experienced trauma like this, especially long-term ongoing trauma from abuse of any kind, definitely does not need "exposure therapy", which is what is recommended for phobias. You need a therapist trained specifically in trauma informed therapy.You are on the right path by recognizing there is an issue and what it is. Good luck with your healing journey! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have several issues that I need to work through. However, I am afraid of and do not trust therapists after a horrible experience. I'm dealing with grief and guilt over losing my sons due to drug use. I have a very complicated traumatic relationship issue that is causing me severe anxiety and fear. }} [/INST] I am sorry that you had this experience. Therapy should be a healthy positive experience off g growth. You have the right to look for certain high qualities in a therapist and finding the right one. Each therapist is bound by a code of ethics and clients should have high expectations. You are trusting them to guide, support and help you achieve the absolute best outcome and success. You should never be or feel judged, and you should feel comfortable and feel as though your therapy process is moving along with YOUR GOALS IN MIND. Speaking as a therapist, I encourage my clients to always let me know how they feel, even if they disagree with me, they also have the right to inform me if something I'm doing simply is not working for them, communication is critical in maintaining a healthy therapeutic alliance/ therapeutic relationship. I'm able to offer ways of thinking and strategies to my clients they may not have thought of. Its important to listen to my clients. It's also critical for clients to feel they can share in a environment that feels safe, non judgmental and confidential.Remember, you are the driver in your healing process, you should be the one in control because you know what your life struggles are. Speaking as a therapist, I'm here to guide my clients toward achieving their goals, encouraging and empowering my clients in what is meaningful to them to achieve. You should feel comfortable speaking your thoughts, my advice would look one who open hearing toy feel, even it's regarding them a therapist. That they are open to feedback.With all of that being said, it will take time to trust again but remember, ask questions and communicate with the next therapist  share  your experience and how it made you feel and that trust and being spoken  in a respectful , non judgemental and non condnscending way is critical for you. Be honest clearly state your expectations from start.  I offer free 50 minute first sessions for clients. The reason. I do this is because I feel that clients deserve opportunity observe the environment, ask me questions and have the opportunity to determine their level of comfort and decide if it's a good fit. Other therapists sometimes offer the similar, try finding one willing to offer a  consultation as that could give you the opportunity to feel things out and set forth expectations.The article below is an excellent article about what to look for in a therapist. It is worth your time reading because you are WORTH FINDING THE BEST HELP AVAILABLE! This article was written based on both evidence from research and clinical experience. I would strongly encourage anyone searching for help to read this and even use it as your guide. I hope this was helpful.https://www.psychologytoday.com/blog/insight-therapy/201603/10-ways-spot-good-therapistLaura Cassity, LMSW, LMAC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Why am I so afraid of it? I don't understand. }} [/INST] Your fear is somewhat reasonable.  No one wants to be raped and I imagine everyone is afraid of what being raped would feel like.Do you mean that this fear is on your mind more often than you would like?If this is the case, then try understanding the reason behind your fear.Is it because you personally know or know of someone who was raped?  One general direction of what would help is to regain confidence in your decisions of keeping yourself safe.  The more you trust yourself to avoid social situations with lots of drinking, isolated physical surroundings, and being in isolated locations with someone with whom you're not very familiar, probably your fear will decrease.The other general direction to understand is if in your family history, people have been violated severely, either emotionally, mentally, or physically.In families in which people have suffered severe violations of themselves, often the emotional patterning of expecting to be hurt by others, plants itself very deeply and transmits to the younger generation.Its possible then, that you are suffering from fears established in other family members who have not yet been able to fully understand and accept their own suffering.The good news is that individual therapy, with a credentialed and licensed therapist, is ideal for a safe place to open and clear this type of emotional burden. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ Why am I so afraid of it? I don't understand. }} [/INST] Why are you afraid of rape? Because it is a problem in the United States! The National Sexual Violence Resource Center reports that one in five women (0r 20%) will be raped (http://www.nsvrc.org/sites/default/files/publications_nsvrc_factsheet_media-packet_statistics-about-sexual-violence_0.pdf) and that 80% of women know their assailant. Given these statistics, it is perfectly logical to be afraid. However, there are things you can do to reduce the risk of rape, such as being aware of your surroundings, and limiting the use of drugs or alcohol.The Enhanced Access, Knowledge, Act program for college-aged women has been shown to reduce the risk of rape by more than 50%. (http://www.blueprintsprograms.com/factsheet/eaaa-enhanced-assess-acknowledge-act-sexual-assault-resistance-education) You may want to see if a program like this is available in your area. Another great app for when you need to walk somewhere alone, is the Companion App (http://www.companionapp.io). Friends or family can track your progress from one point to another via the GPS in your phone.In addition, talking with a counselor about your fears would also be a good idea. Sometimes fears are rational and reasonable. Sometimes they are over-reactions and unreasonable. When then are over-reactions and unreasonable, they can have a negative impact on your life. In this case, a counselor could help you understand why your fears are unreasonable, and how you can stop them from negatively impacting your life. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have attention-deficit/hyperactivity disorder, posttraumatic stress disorder, anxiety, anger, and memory problems. I can't work. I have no income. I'm on medicine, but I feel worthless. I want to be normal. }} [/INST] I am so sorry to hear that you are struggling.  It sounds like you've had a traumatic experience that has impacted your life in many ways.  Without knowing much about your history, I wonder if the trauma you suffered has lead to the anxiety, anger, and memory problems you are dealing with, in addition to PTSD.  I would encourage you to look for a trauma therapist who offers a sliding scale or pro bono services.  There may also be community mental health services in your area that offer free therapy if you are eligible for grant. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I never feel like myself. I can’t even think straight anymore. I start stuttering and I can’t remember anything. I always get nervous and usually talk myself down but recently end up fighting with, what feels like, someone else. I don’t know why I feel this way, but I hate it. }} [/INST] Hello,I am wondering if you might be experiencing some form of dissociation.  People who dissociate might feel like the world around them is unreal and unfamiliar, or that they are not really in their bodies and that they are observing themselves from outside of their bodies.  Dissociation can also mean that there are parts of you that have "split off" and sometimes parts are can feel like they are at odds with each other or are locked in conflict.  Sometimes dissociation happens after someone experiences a trauma.  Therapy can help you to understand what is going on and help you to integrate your experiences and ultimately heal.I am a therapist in Houston who specializes in dissociation.  On my website I have information specific to dissociation that might be helpful to you. Sarah </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I had to put a restraining order against my ex-fiancé. He was served last night. He was mentally and verbally abusive towards me. I thought it was my nerves, but every time I stand up, I get sick. If I sit and rock, I'm fine. }} [/INST] Hello, and thank you for your question. You may be right, your physical symptoms of getting sick to your stomach may very well be your nerves or anxiety. That is totally normal and understandable given your circumstances. Another thing that is not unusual is that you feel better when you sit and rock. That is actually a fairly common way that many people comfort themselves in times of high stress. If you are concerned that there is an actual physical illness causing these symptoms, you may want to visit your primary care provider. They may tell you that they don't see anything physically wrong with you, and at that point you may want to visit a counselor about the symptoms and your relationship experience. A visit with a counselor may be a good idea either way. I work as a counselor in primary care, and I promise you that many people have very real physical symptoms when they have gone through abuse. Unexplainable stomach and headaches are very common. Sometimes, with counseling, those physical symptoms actually stop. Be well, and I hope you feel better soon.Robin J. Landwehr, DBH, LPCC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better. }} [/INST] I don't know how old you are, but in Pennsylvania, if you are over 14, you can have therapy without your parents' consent. If you are young enough to use their insurance, that could be complicated, but depending on the state, there may be ways to work around that as well. If transportation is a problem, call a local mental health agency and see if they can connect you with assistance.In the meantime, try searching for a phone helpline in the county where you live. They may be able to help you figure out where you can get help.Another idea is that if you are in school, your guidance counselor may be able to provide links to where you can go for help. He or she may also be able to give you more specific ideas to help with your panic attacks.I know you said your mom refuses to offer help, which included seeing a doctor, but I wonder if she trusts the doctors that is your primary care physician (also called a family doctor) who you see when you have a minor medical ailment that may need medication. That doctor may be able to help you as well.Some of the information here may be helpful to you because it explains some of what anxiety is and there are some quizzes there that may give you information to discuss with a doctor or therapist when you get connected with one. http://www.webmd.com/anxiety-panic/guide/mental-health-anxiety-disorders This may give you other information to speak with your mom about. Remember that I'm not asking you to actually diagnose yourself with one of these things, but just offering some basic information that may help you be able to talk about what is going on.If you are having a panic attack or having a moment of anxiety, try focusing on different things in the room around you. It may help to shift your focus briefly outside of what you are feeling and that may lessen the feeling a bit. Also remember that sometimes anxiety leads to more anxiety about having a panic attack in the future. Remember that they usually and after a few minutes.It would also be helpful for you to keep track of what leads up to your anxiety.Best wishes to you and keep trying until you get connected to someone. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I've been dealing with this for years. My mom thinks I'm overly emotional and refuses to offer any help, like therapy or seeing a doctor. She's seen me when I'm having a panic attack and just said I was faking for attention or that I'm a hypochondriac. I just want to get better. }} [/INST] How old are you?Are you old enough in your State to have therapy without your mother's consent?Your mom's attitude toward you may be one significant reason on why you feels so much tension in the first place.Don't let her opinions and beliefs get in the way of what you know about yourself.Are you in school and does that school have a guidance counselor?Would you talk with that person about your difficult getting your mom to retain helping services for you?Keep looking for local resources which will support you either directly or indirectly by advocating for your right to receive mental health care. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else. }} [/INST] Do you think you're abusing xanax?It is a highly addictive drug so maybe one reason you feel compelled to take more is bc you already are addicted.Drugs don't do anything helpful in solving life's problems.   Once the effect wears off, the stressful situation is once again waiting for you to address it.Think over your reason for not directly asking your psychologist about upping your dose.Also, do you ever talk about your life problems with this psychologist or only your need for drugs?    The more gradual path to a better life is to not need drugs in the first place. This consists of your willingness to face the matters that are creating such terrible feelings inside you. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else. }} [/INST] In general, Xanax is very short-acting. You mentioned that you are afraid that your medical provider will take you off of the Xanax and put you on something else. If the Xanax is not working well for you, I wonder if something else may work better. What is your reasoning there? Also, sometimes there are medications that you can take in addition to Xanax.In addition to talking with your medical provider about changing the medication, try to track your levels of anxiety on a scale of 1 to 10 throughout the day so you can get a pattern of what is happening. Also consider writing down what is happening before you have anxiety attacks. This may help your medical provider know what medication may be helpful to you or what changes could be made.As far as how to discuss this with your medical provider, I would suggest mentioning the symptom changes you are having (anxiety attacks that are not helped with 0.5mg of Xanax) and ask what they would suggest that might help. If your medical provider suggests taking you off of the Xanax, I would recommend talking about the reasons why you would prefer to stay on the Xanax and what your concerns are about coming off of it. You could also ask whether anything could be combined with Xanax.There are also many other anxiety medications. I have seen lots of people that take more than one medication to lessen anxiety that they are having.I would also consider talking with a therapist (unless the person who is prescribing a medication is also doing therapy with you). Getting more information about your anxiety and how it is affecting you may be greatly helpful to you. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I’ve been on 0.5 mg of Xanax twice a day for the past month. It hasn't been helping me at all, but when I take 1 mg during a big anxiety attack, it calms me down. I was wondering how I can ask my psychologist to up the dose to 1 mg twice a day without her thinking I'm abusing them. I just have very big anxiety attacks. Should I stay on the 0.5mg and deal with the attacks or should I ask to up the dose? I'm afraid she will take me off them and put me on something else. }} [/INST] Hello, and thank you for your question. While counselors work closely with medical providers, and sometimes have discussions about medications with people, we rarely make recommendations about how much or what type of medication a person should be taking. This is because prescribing and advising on medication is out of our scope of practice. The only exception would be if a counselor is also a physician, nurse practitioner, physician's assistant, etc. Having said that, I certainly understand that anxiety is a real serious problem that many folks struggle with. If you are currently not in therapy to help you with these panic attacks, you should consider it. Medications can be helpful for anxiety, and medications like Xanax may help for immediate relief, but they do nothing to deal with the root of anxiety and may not help with anxiety long-term. Therapists who have experience in exposure therapies would be good people to start with. Exposure therapy has good outcomes for people with anxiety disorders and panic attacks. If you are interested in speaking with your provider about the Xanax, I think explaining it the way you did on here is just fine. The provider will then decide if they feel comfortable increasing your medication. Please remember that medical providers are not trying to give people a hard time. Medications like Xanax really are highly addictive. The more you take, the more you may feel you need. The more often you may feel you need to use it. Depending on the frequency and amount of use, some people suffer serious withdrawal symptoms when they do not take the medication. It is a good idea to talk to medical provider about all of those things so that you can partner on right course of action to manage this anxiety. I certainly hope that you get some relief.... I know anxiety is awful.Robin J. Landwehr, DBH, LPC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am so terrified of having sex anymore because I have been told over and over that sex is dangerous even though me and my partner used both forms of protection. My partner is not happy about this and simply wants more sex, and honestly, I want to give that to her. }} [/INST] I am wondering who is telling you that sex is dangerous.  Is this medical advice, or is this someone’s opinion trying to scare you from having sex?  And if so, how old are you? Is it ok to have sex, do you want to have sex?  It sounds like you want to make your partner happy, and that you are taking care of protecting yourself and your partner, but maybe you are forgetting to consider what do you really want.  Having sexual relations is a very personal decision; you and your partner have to consent.  It is also important to talk about the possible consequences and being responsible for them as well.  But sex should be something that you enjoy, not that you should be fearful of.  A therapist can help you to process those negative thoughts and feelings that may impair you from enjoying your sexual life. ¿Cómo puedo superar mi miedo de un embarazo no deseado y poder tener sexo otra vez?Estoy aterrorizado de tener sexo porque me han dicho una y otra vez que el sexo es peligroso, inclusive cuando yo y mi pareja usamos dos métodos de protección.  Mi pareja no está contenta y simplemente quiere más sexo, y honestamente, yo quiero darle lo que ella quiere.Me pregunto quién te está diciendo que el sexo es peligroso.  ¿Esto es aviso medico, o es alguien intentando asustarte para que no tengas relaciones?  ¿Y si es así, que edad tienes?  ¿Es apropiado que tengas sexo a tu edad?  ¿Quieres tener sexo? Me parece que estas enfocado en hacer feliz a tu pareja, y te estás protegiendo y protegiéndola, pero tal vez están olvidando analizar que tu quieres realmente.  Recuerda que tener una relación sexual es una decisión personal, en la que tú y tu pareja deben de estar de acuerdo.   También es importante hablar de las posibles consecuencias de tener relaciones, como un embarazo, y discutir sus opciones e intenciones, si eso ocurriera.  Ya que han tenido comunicación al respecto, el sexo debe ser algo que disfruten,  no que temen.  Un terapista te puede ayudar a procesar esos pensamientos negativos y los sentimientos que te pudieran impedir disfrutar de tu vida sexual. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I was in a car accident and totaled my car. I gave up my job of nine years to pursue school full-time to better myself. I failed a class, and my boyfriend that I live with thinks I’m stupid and wants to break up with me. I have nowhere to go, and I feel like I’m losing everything. }} [/INST] When we feel overwhelmed by life situations, it is important to understand where the feeling is coming from.  Once we understand the source, it is important to normalize the situations that got us there and find balance in our lives.First, car accidents are common, and since they are accidents they are not a reflection of us.   When we have an accident we feel anxious, worried, and may have some trauma after the accidents.  If you have been experiencing anxiety since the car accident, talk to your doctor or therapist about it.  Second, a lot of people fail classes, tasks, deadlines, etc. but they don’t give up on their goal.  We have to remember that failing is part of the learning process, and having the courage to try again is what gives us determination and character.  Remind yourself what motivated you to leave your job, and the courage and determination that took to do so, then channel that energy back into school.  Third, when we have problems in our relationships, is helpful to look for ways to improve communication, discuss our concerns and how we want to resolve them, but it may be that the relationship needs to end if there isn’t enough interest in one of the parts or if there’s verbal or emotional abuse.  Consider talking to your boyfriend and set some boundaries regarding appropriate communication.At all times:  focus on being kind to yourself and improving your self-esteem: increase self-care activities, do more things that you enjoy, meditate in what gives you peace and make an effort to have more of that in your life.   At the end, you are the one in control of your life, and you determine who you become.¿Qué puedo hacer cuando siento que mi vida está fuera de control?Estuve en un accidente de auto, y fue pérdida total.  Deje mi trabajo de 9 años para completar un grado a tiempo completo.  Falle una clase, y mi novio piensa que soy estúpida, el quiere dejarme.  No tengo a donde ir y siento que lo estoy perdiendo todo.Cuando nos sentimos agobiados es importante reconocer donde estamos parados y entender de donde vienen esas emociones.  Ya que entendemos la fuente de agobio, es importante normalizar las situaciones que lo causaron, y volver a encontrar el balance en nuestra vida.Primero, los accidentes de auto son comunes, y por ser accidentes no son un reflejo de nosotros o nuestras destrezas.  Cuando experimentamos accidentes no s sentimos ansiosos, preocupados, y puede que experimentemos algún trauma.  Si sientes ansiedad, extrema preocupación habla con tu doctor o terapista al respecto.  Segundo, muchas personas fallan clases, tareas, fechas de entrega, pero no se rinden.  Tenemos que recordar que fallar es parte del proceso de aprendizaje, y tener el valor de intentarlo de nuevo, es lo que nos da determinación y carácter.   Recuerda que te impulsó a dejar tu trabajo y canaliza esa energía en la escuela.  Tercero,  cuando tenemos problemas en las relaciones, es importante comunicar nuestras preocupaciones y diferencias, pero puede ser que la relación termine si no hay interés mutuo o si hay algún tipo de abuso.   Considera hablar con tu novio y establecer límites respecto a la comunicación apropiada.En todo momento: enfócate en cuidarte a ti misma y mejorar tu autoestima, aumenta las actividades que te ayudan a sentirte bien, medita sobre lo que te paz y pasa más tiempo practicando esas actividades. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ It's especially bad at night time. I am scared of sleeping alone. }} [/INST] Being able to know you feel anxiety and write about it, is the first step to addressing and handling it!Generally, anxiety is deep fear of not being able to handle what comes up in life.  Somehow the person was insufficiently nurtured and so felt  insecure when very young.Usually the person had to fend on at least a psychological and emotional level for themselves before reaching an age when doing so would have been reasonable.Their inner feeling of overwhelmed from when very young, hasn't faced the reality that the grown person is now capable, even if this takes some practice. Try asking yourself what you are afraid of and theorize how you would handle these situations as a grown person.Also, sometimes anxiety comes from feeling lonely.  This loneliness is reminiscent of the loneliness that the grown person now, felt when being left to take care of situations as a child which were too difficult and complex for any child to address. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I am on the track and softball team. My school is small, so I play all four sports it offers. I feel obligated to do track because I'm not a horrible runner, and my dad wants me to. The catch is is that the days before a track meet and the morning of, I get sick and cry. }} [/INST] Does anyone notice that you get sick and cry on track meet days?Have you told anyone?From what you write, as much as you would like to please your school and dad, something within you doesn't quite want to fully follow through.Step one in life always is to know what you want and what your limits are.   It already is difficult to avoid listening to your body.Try understanding what is difficult in telling your father that you'd like doing as he wishes, only are not able to do so because you are emotionally and physically distraught on the days you have track.After finishing the season for this year with your school's track team, then expect to concentrate on taking care of your own need to not do track.Hopefully your father will understand and care about your problem.   If he does not and track is more important than your well being, then you have a different problem entirely. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm socially awkward. I've always want to be popular. I've had the opportunity to be popular, but every time I get i,t I'm too scared. All I have to do is talk the popular people. They're really nice to me, but I'm too scared of change. I really want to work up the courage to lose my fear. }} [/INST] Change can be uncomfortable, but sometimes those uncomfortable moments are the opportunity for us to be the person we feel we really are.  It sounds like you like to spend the time in your head anticipating the worst, why not be in the present and encourage yourself that you can talk to people and it will be okay.  By telling yourself it will not be okay, or that it will go wrong you are hurting your confidence to do what you want.  Give yourself some credit for being awesome and tell yourself you can build new friendships...it may be the motivation you need to move past this fear. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I often get the feeling that I'm being watched, like video cameras are hidden wherever I am, even at home. I feel like people can see all that I do and are reading my thoughts. Things I read or hear on the radio seem to be about (or meant for) me, and people are talking about me when they whisper. }} [/INST] It sounds like you are feeling pretty overwhelmed with worry about being continuously monitored, with no privacy even in your own mind, and as if people are constantly saying things about you in whispers on in the media. It's hard to say from a post online what is at the root of this experience, but you may be able to get insight into that, as well as develop ways of coping with the distress of feeling this way, with the help of a good therapist. There is no pill or technique that can guarantee that this experience will go away, though it might, however, there are things that you can do so that you can understand it better and so that it does not have such an impact on your ability to lead a satisfy life. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have a bad habit of thinking and worrying about what others may think of me. I really want to stop it and enjoy things. }} [/INST] Thinking about what others think of us is a natural tendency. Human beings are social creatures and rely on feedback from the outside world of people, places, and things to let us know more about ourselves. We also have an inner voice, dialogue, conscience, etc. that helps us to determine the path for us. Often, when someone is worried about the external feedback, and focuses on this as the sole source of information, it can create a dependency that can become problematic. Balance is key to so many things in life. Your own voice is powerful and has strength to provide you the enjoyment you seek. Don't discount it and rely only on the voices of others. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I feel really uncomfortable when I have people's attention. It makes me not want to talk in public or answer questions in class. Can I get over this social anxiety? }} [/INST] you can learn lots of skills/techniques to feel more confident in what you need to do that will decrease your anxious response for sure! :) And  you can also learn how to work with your personality that may not like the attention. You may find that "talking" to others through the internet is more comfortable and you are great at it, or that you love one on one talking but aren't really made for group talking. There is a place in this world for you either way! Public speaking skills can be practiced in speech class, or toastmaster group, they will give you practice in a safe environment where the cool kids or cutest boy aren't ready to laugh at you.  What topics are you interested in and what groups can you do a little speaking up? Maybe in your small group at church try and raise you hand to share your opinion, or maybe your Girl Scout troop? Look around for a peer and one adult who you like to hear speak out, ask them to share with you 2 things that help them feel comfortable speaking in public. Check out some Ted Talks and see how they share in groups. Social anxiety is a difficult concern and picking apart what is your awesome personality and what needs skill building and mindfulness/anxiety  help are important steps. Good luck! </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I feel really uncomfortable when I have people's attention. It makes me not want to talk in public or answer questions in class. Can I get over this social anxiety? }} [/INST] Since anxiety usually about anticipating a bad result, or fear of being judged negatively, as though having failed some sort of test, consider what would give you the feeling of anticipating a good result from talking to an audience?Maybe, for example, if you prepared and rehearsed your talk more than what you typically would, you'd feel more secure in speaking  in front of an audience.Once you sort through your particular reason as to the source of your discomfort, it may feel more manageable.Yes, social anxiety can change.  You may naturally prefer smaller groups than an audience.And, it is possible to decrease anxiety in what may always be somewhat uncomfortable for you. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I have been having a lot of nightmares where I am being killed in different ways. I either wake up in a panic or just crying and sweating. It has made me terrified of falling asleep and is now affecting my daily life too. Can I make the nightmares stop? }} [/INST] Hello, and thank you for your question. Sleep problems, including insomnia and even the nightmares that you are writing about, are really common for people and so many people suffer from them. Here are a few things to consider or to try: 1. Have you changed or started taking any new medication lately? Medications can certainly affect your sleep and some can even cause vivid or frightening dreams. If you are taking a new medication, talk to your provider about the nightmares, this may be the cause. 2. Stress can certainly increase our difficulty with sleep and can also begin to affect our dream states. The dreams may not make much sense, but then again even good dreams don't always make much sense. Ask yourself, do I have any new or renewed stressors in my life? Work, school, relationships, health.... all of these areas and many more are places where stress can hide out. If this is the case, talk with your provider or consider seeing a counselor who may be able to help. 3. Something to consider is that once we start to have anxiety or stress about something, we can begin to obsess about it. My guess is that going to bed for sleep is no longer a pleasant thing for you. Your stress and fear of what may happen when you sleep could start way before you actually go to bed. This could increase your chances of having another bad dream. Try relaxation techniques before going to bed. If you have YouTube, you can pull up "Guided Meditation for Sleep" exercises to help you relax. There are many different ones to choose from. You may also want to try deep breathing.4. There are self-help ideas for managing bad nightmares. If you Google search "Nightmare Rescripting" or "Nightmare Exposure" you may find some ideas and instructions on how to manage dreams. I hope these ideas help. Be well... Robin J. Landwehr, DBH, LPC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I'm concerned about my boyfriend. I suffer from anxiety, but I always have this feeling he wants to hurt me because he told me he was interested in BDSM intercourse. We haven't tried it, but I've had this feeling he always wants to. }} [/INST] Hello! Thank you for your question. There are few things that people find more personal than their sexual relationships. When we feel connected to our partner, sex can be best thing since sliced bread. However, if we feel disconnected in some way, sex can feel degrading and even painful. I don’t know the specifics about your relationship or how comfortable you are in talking to your boyfriend, but this is one of those situations where communicating your fears is a good idea. The only exception to that would be if you believe he is actually a threat to you in some way. If you believe that, then you should do whatever you think is safe. It sounds like there is a part of you that is already afraid of him, and if that is the case then remaining safe is your top priority. Assuming you are able to share with him your feelings, telling him what you are and are not interested in sexually is very appropriate and sexually healthy. Sex is something that is supposed to be enjoyable for all parties. All parties should feel respected and able to say “no” to absolutely anything they are not comfortable with. I call the respectful agreement between sexual partners, “sex trust.” Sex Trust means your partner respects your boundaries. It means they won’t degrade you sexually with hurtful words, forced sex, or forcing or coercing sex in ways someone is not interested in having.  Your personal safety and mental well-being is what is most important. Now, if there is a part of you that is curious about BDSM and may be interested in participating in it, there are many websites that you can explore to learn information. I will warn you, some websites and articles are better or worse than others, but you may at least feel more informed. Many people engage in BDSM and have happy relationships, but again, it completely depends on what each person in the relationship wants. It is also important to know that BDSM is not just one thing and people practice it differently based on comfort. If it is something you are uncomfortable with, then you shouldn’t feel obligated to do it.   I hope this was helpful. Be well.   Robin J. Landwehr, DBH, LPC, NCC </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes. }} [/INST] This is a very common question in my practice. Panic attacks typically emerge from an underlying issue (ex. Depression, low self-esteem, fears). To decrease your anxiety symptoms it’s recommended to seek treatment with a therapist who specializes in working with anxiety disorders and most importantly one with whom you feel comfortable with.In my practice I educate clients about their anxiety and discuss building a framework with helpful tools for decreasing anxiety:1. Starting a daily mindfulness practice. For example: listening to guided meditation; engaging in deep breathing exercises; yoga practice; or other positive calming activities.2. Understand your negative and positive thoughts. Many times we tend to focus on the potential for bad things to happen. Increase positive self-talk when feeling down or when anxious. For example: "I don't need to worry, I am calm and relaxed". 3. Exposure to fearful or anxious situations. This can be accomplished under the care of a mental health professional. Many times we shy away from things that make us feel uncomfortable or insecure. This may led to an increase in isolating behaviors resulting in difficulty in performing things we were once able to do. For example: leaving the house; presenting in front of others; going to social events; and having conversations with people. However, the more we expose ourselves and practice the use of our positive coping skills (ex. deep breathing) the chances of anxiety will decrease. I hope this was helpful. Keep in mind, a therapist can help with guiding you through self relaxation and improvement. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes. }} [/INST] Anxiety is simply your system communicating to you that you are in danger. The issue that I see in most of my clients is that they try to reason with this anxiety. You do not reason with sensory states in the body. If your system tells your in danger (your stomache feels like it is knots, your heart is beating out of your chest,) validate by just being present with it. Take your breath to it. Breath in and out of that space. Say ok, I am in danger. I always tell my clients, "a crying baby wants to be held, not told to shut up." Listen to your system, validate it like you do a child and see what happens. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I get so much anxiety, and I don’t know why. I feel like I can’t do anything by myself because I’m scared of the outcomes. }} [/INST] The are two ways that such anxiety can be dealt with. One is an attempt to replace maladaptive thinking by examining the distorted thinking and resetting the fight-or-flight response with more reasonable, accurate ones. As an example "I'm scared of spiders." But if you change the thinking from being scared to "I'm bigger than the spider," it allows the mind to reach a calmer state of mind. Mindfulness-based therapy can also help  focus on the bodily sensations that arise when you feel anxious. Instead of avoiding or withdrawing from these feelings, remain present and fully experience the symptoms of anxiety. Instead of avoiding distressing thoughts, open up to them in an effort to realize and acknowledge that they are not literally true.Although it may seem counter-intuitive, fully realizing the experience of anxiety enables the release of over identification with negative thoughts. You can practice responding to disruptive thoughts, and letting these thoughts go.By remaining present in the body, you'll learn that the anxiety being experienced is merely a reaction to perceived threats. By positively responding to threatening events instead of being reactive you can overcome an erroneous fight-or-flight response. </s>

<s>[INST] <<SYS>> {{ give the helpful answer what user asked}} <</SYS>> {{ I started dating my fiancé two years ago. My first cousin is married to my fiancé’s sister. There has always been a communication issue between my uncle and aunt and my cousin and his wife. My uncle goes to my mom instead of talking to my cousin, and it upsets my mom. }} [/INST] Based on the information provided, this is an issue with boundaries.   Sounds like your uncle goes to your mom and possibly your mother takes the issues to you.  I do not like to assume so I will direct you to information regarding families dealing with enmeshment and triangulation.  Enmeshment is the concept of diffused boundaries in families and other personal relationships.  Triangulation is two individuals relaying information to a third party what cannot be said directly to each other.  From someone who has dealt with both these issues on a personal level, being informed about family dynamics is beneficial and can help you develop healthy boundaries for yourself within your family structure.  You may need assistance with developing healthy boundaries.  Although it is possible, it is not easy to change the way you have been operating for any extended amount of time.  Hope this help! </s>