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Q: I started out with anorexia but now am bulimic/anorexic and have been this way for about 3 yrs now.
I am on a binge/purge cycle and have purged everyday at least since November. One person knows about my ED and I am so scared to get help even though I know that I need it. I am fully aware of the dangers of bulimia. I am being treated for one of the symptoms of bulimia, which is passing out because of malnutrition. However, the doctors did not figure out that it is due to an ED. I’m 18 so I can get help without my family knowing which is a big deal for me because I can not let them know. They have a lot to deal with right now plus my mother does not really understand how to deal with things. Shes Bipolar and every once in a while has a Schizophrenic episode. I am scared of my father and stay away from him so I can’t tell him either, my whole family dynamic is screwy. However, I am considering getting help for my ED. What should I expect if I do decide to go to a therapist? What kind of questions will they ask me. Thanks for your help.
A: First of all, I’m so glad that you are considering eating disorder treatment because the fact that you are passing out means that you are not only suffering from psychological problems but that you are in physical danger too.
Please disclose your eating disorder to your physician so he or she can be a resource for you and can help you find a psychotherapist or eating disorder treatment center.
While every therapist is different, I can give you a general idea of what to expect on your initial evaluation session. The initial session is an assessment where you’ll sit down in the therapist’s office and talk about what brings you to therapy; you’ll get a feel for the therapist’s style. This session will include filling out some paperwork – a mental health and family relationship history, rating scales or a brief checklist to establish a baseline to track your progress, and a release of information so your therapist can communicate and coordinate care with your physician and request your medical records, if needed. After gathering this information, the therapist will give you a diagnosis and make treatment recommendations. The recommendations may include outpatient psychotherapy, intensive outpatient psychotherapy, or inpatient treatment.
As you seek a therapist, make sure you find one who specializes in treating eating disorders. A great resource to find a therapist is available PsychCentral.com’s Find Help link. Another excellent resource is EDReferral.com and they have several eating disorder therapists listed in your state. It can be helpful to meet with a few different therapists so you can find one you feel most comfortable talking with and you feel most confidence in. Just like any other relationship, you’ll click with some therapists over others. Consider your physical symptoms as warning signs telling you that you need to address this problem now. Please, don’t wait to get help.
I have been married for 15 years. I have grown very much but he has not. He will not deal with any issues between us. He is really immature. He never accepts responsibility for his part in any problem. (Everything is always my fault according to him.) We went to counseling two times but the same thing happened. He only argued with the counselor and she said she couldn’t talk to him.
I started my own business in 2004 so I could become financially independent so I could divorce my husband. I am still too poor to leave him, but my finances are getting a little better. I think in a year I will have money to leave. I am so antsy. I can hardly stand him. Everyday I say in my mind, “I hate him so much.” It is so difficult for me. Other people do not like him either. He is anti-social. We have no “couple” friends because no one likes him. I can hardly stand it anymore. I need to do something.
A: I’m so glad that you are reaching out for help and advice with your difficult marital situation. It sounds like you feel trapped and extremely resentful that your husband won’t own up to his contribution to your distressed marriage and continue seeing a counselor. Considering his defensiveness, I’m surprised that your husband actually attended two counseling sessions. On some level, that tells me that he does care about the relationship and about you.
I have several questions for you. Does your husband know how seriously you are considering divorce? Does he know exactly what you’re looking for from him in order for you to stay happily in your current marriage? Does he want to stay in the marriage?
If you haven’t told him how desperate you feel, it may be time to let him know. Tell him how lonely you are and how you long for a closer relationship with him, but that you are losing hope about this marriage unless you can find a way to feel closer to him. If he isn’t willing to go to marriage counseling again, ask him what he is willing to do. Is he willing to go to a marriage retreat? Attend a workshop? Will he read a book? I recommend that you both read the book Hold Me Tight: Seven Conversations For A Lifetime Of Love by Dr. Sue Johnson to understand the root of the disconnection that your marriage is stuck in. If he isn’t willing to do anything to improve the relationship, then it’s clear that you need to make a change and continue with your plan of becoming financially independent so you can move on.
Q: Hi! I had a pretty unstable childhood growing up and worked really hard to accept the life I had and move on as well as love the life I have now.
The problem I struggle with is habits from my parents that I have adopted myself. I struggle with a temper problem when I feel things are getting out of control and it is becoming a huge problem for me. I want to not get so upset over little things and have prayed really hard for help. I know that my parents acted that way but I want to be different. So I guess my question is how can I overcome the way I was taught to act and be the person I know I can be? Any help would be greatly appreciated!
A: How wonderful that you recognize the need to better manage your temper and move beyond the negative patterns you absorbed from your parents.
I’ve worked with many clients who’ve had similar struggles and a strong desire to act in a more patient and kind way than their parents. Have you considered doing some counseling to work through some of the emotional pain, abandonment, and loss of your early experiences? If not, I’d like to suggest that you consider it. LDSCounselors.net is a great resource to find an LDS counselor in your area.
In my clinical experience, temper problems and other troubling behaviors usually stem from a “younger” part of your self, a part that holds unresolved pain, and can be seen as a signal that there is some earlier emotion or experience that needs attention. Here an example to illustrate this process. Say you have a sick child who is whining and needing extra attention for several days in a row. If, in your own childhood, you had to deal with your own pain, emotional or physical, alone or without adequate comfort from parents, feelings of resentment may arise in response to your child’s needs. It may feel unjust that he has someone to take care of him and you didn’t. That resentment may manifest itself as an angry outburst that seems to come out of nowhere.
In addition to counseling, start noticing the smaller physical cues that you’re starting to feel overwhelmed and that things “are getting out of control”. These cues may be tense shoulders, racing heart, confusion, feeling like you need to escape, to name a few. My guess is that you are still in the process of learning to recognize and attend to subtle emotional cues so the small signals build up until you have an outburst that requires your attention.
My boyfriend and I dated for four months. After we first broke up, we started talking again. We talked for three months. Then I found out that the reason why he broke up with me was because he liked my sister.
I was really hurt, but I still talked to him because I really, really cared about him. I could forgive him even if he liked my sister.
Another month passes by and we are still talking to each other. Then one night, I confront him about him liking my sister. He said that he used to get a feeling when he was around my sister, but he doesn’t get it anymore. He told me that he really cared about me now. I forgave him.
After another month, we went for a second shot at our relationship. We lasted for another 3 months. He broke up with me on a text.
After my relationship with him, I’ve become a really jealous person of my sister. I don’t like to have the same guy friends as her. I don’t like her talking to my guy friends. I don’t like her hanging out with me. I like to keep my life separate for hers now. I need to get over my jealousy issue with my sister.
Please help me.
A: Your jealousy toward your sister is certainly understandable given your ex-boyfriend’s attraction to her, but your intense jealousy is misplaced.
Your ex is the one who hurt you, not your sister. I think you’re pushing your sister away to avoid getting hurt again, but it’s not going to work. Some guys will like you and others will like your sister. As long as you’re focused on keeping your sister away from all of your male friends you’ll stay stuck in the jealousy instead of learning how to move on in a healthy way after a relationship breakup.
Feeling hurt and betrayed after a breakup is normal, and the fact that your boyfriend broke up with you via text doesn’t say much about his character. When you feel the jealousy toward your sister coming up, identify it for what it is — hurt and fear. I think that the real question is why would you choose to get back together with a guy who told you he had feelings your sister? I recommend that you focus less on your sister and more on building your own feelings of self-worth so you can feel deserving of a relationship with someone who wants to be with you.
Q: I am “in love†with a celebrity male, 29 years older than me.
Since I was ten, before I knew his name, I was sexually obsessed with him. That obsession later turned into this “relationship†I made up. I have lost myself, believing that we have many things in common, and that he really loves me even though we never meet. I feel like I will never get over this. I am in a happy relationship now, for over a year, but these sexually desires for this celebrity keep coming back. I come up with these fantasies that his children will love me, his friends want us to be together. I have had a fantasy that he has been looking for me his whole life. I can’t stop.
A: It’s wonderful that you’re wanting to get to the bottom of your obsession by reaching out for help.
In order to figure out why this fantasy relationship has such a hold on you, I urge you to dig deeper and discover what this celebrity represents to you, emotionally and relationally. It sounds like in this fantasy love relationship you feel desired, special, treasured, accepted, and embraced by someone special — the very things that we all long for and look for in our love relationships. The problem isn’t in wanting those things, but in holding on to a fantasy that will never really satisfy your needs instead of finding ways to get your emotional needs met in real-life relationships. The intensity of your fantasy and the large age difference between you and and this celebrity makes me suspect that you have a “hole in your soul†regarding an important male relationship in your early life that needs some attention and healing.
Here are a few questions to help you start looking deeper and start to discover what this fantasy is really about and why it is so intense and long-lasting.
Did you feel loved and accepted by your father?
Did you have any losses, neglect or abuse involving males in your life?
When you are thinking about having this celebrities love what emotions, in addition to sexual attraction, come up inside you?
As you sort through your emotions your fantasies will still continue to surface. When they do I recommend framing them in a non-judgmental way that includes identifying what the desires are really about. For example, you might say to yourself, “Hello celebrity obsession. Thanks for letting me know that I still have some emotional healing to do when it comes to my male relationships. I’m working on that. Goodbye†After acknowledging the fantasy, don’t focus on it, but turn to your current relationship for connection and comfort.
If I had more information about your relationship history I could help you make more sense of your obsession. Since I don’t, please consider seeking a counselor to help you get to the emotional root of your obsession and begin to heal your unmet needs. Click on the Psych Central Find Help link to find a psychotherapist in your area to help you move on from this celebrity obsession and find more satisfaction and fulfillment in reality.
Q: I’m a student receiving my Master’s degree. Within the past two years I’ve felt my body and mind change significantly in many ways.
I feel extremely anxious when doing tasks (even small ones like packing/unpacking a suitcase). This is the same with grocery shopping or attempting my homework. I then push everything aside and get nothing done. My habits of cleanliness such as my apartment have declined because I refuse to motivate myself to clean. I’ll find myself in the kitchen then in the bedroom for some reason the randomly in the bathroom, ultimately accomplishing nothing. I get distracted by TV a lot and it impedes my homework. I also feel pressured on what to do when I finish my masters and feel like I’m too lackadaisical to even search for jobs. My relationship with my boyfriend is also affected by this in that I’ll freak out on him, refuse sex, and find him at the mercy of which high or low I’ll be on. I’ll also find myself drinking and smoking cigarettes more often to avoid doing work or tasks. I feel like I have adult ADD due to these symptoms and have spoken with my mother, who revealed she believes she has it as well but was never properly diagnosed. I would like to know what to do and what would happen if I see a psychiatrist.
A: Next time you talk with your mom ask her if she recalls you having similar attention problems in elementary school.
While your symptoms do sound a lot like adult ADD, it’s important to determine whether you experienced these symptoms during childhood or whether they are new. If all of your symptoms are recent, it’s very unlikely that you have ADD. If they’ve been going on for years, it’s more likely that you have have ADD.
There are other possible explanations for your recent changes in your behavior and emotions. Depression or anxiety disorders often emerge in young adulthood and symptoms are similar to what you’re describing – difficulty concentrating, irritability, lack of motivation. ADD is often associated with other mental health conditions as well, so there may be a combination of issues that you’re struggling with.
Your idea about getting an evaluation by a psychiatrist is right on target! An evaluation will provide a clear diagnosis and suggest course of treatment to help you manage your symptoms. Your doctor will likely recommend medication or psychotherapy, or a combination of both.
If you’ve never had a psychiatric or mental health evaluation, it’s natural to be a little nervous because you have no idea what to expect. When you set up an appointment with a psychiatrist, he or she might give you some questionnaires to fill out before the appointment. During your appointment he or she will perform an in-depth interview with you. Medical or psychological testing may also be recommended. In addition to your evaluation and psychotherapy, you and your boyfriend may want to consider couples counseling to help repair any damage to your relationship.
You are in a stressful time of life full of transitions and important decisions – graduate school, serious relationships, career choices. These can be exciting and incredibly stressful. Make sure you’re taking care of your basic needs by getting adequate sleep, eating well, and engaging in regular recreation and exercise. No matter what your diagnosis, all of these lifestyle choices will help you manage your symptoms and will contribute to your overall health and happiness.
I always push away good women and have trouble letting go of the women who hurt me. I feel the need to seek approval and love from women who don’t return the love.
A: What a painful dynamic to be dealing with.
I’m guessing that you might even feel like you’ll never have your love and safety needs met in relationships. While I don’t know your history, I can guess that this pattern likely has roots in an important early relationship in which your needs for safety, love, and nurturing were not met, or where you were physically or emotionally abandoned, abused or neglected. I have seen this pattern in my clinical practice over and over again, so I want to reassure you that you are not alone in feeling stuck in a pattern of seeking unhealthy relationships.
Our earliest attachments to our parents or guardians provides a template for our future relationships, especially when it comes to our sexual relationships. It is likely that your current pattern with lovers is an extension of an earlier pattern where you experienced yourself as undeserving of love and nurturing and you internalized feelings of shame (“I’m badâ€). Please seek psychotherapy to help you identify and resolve this painful pattern and discover how lovable you really are. Through psychotherapy you can work to resolve any childhood wounds or unhealthy patterns that are getting in the way of you giving and receiving love. To find a therapist in your area who can help you please click on the Find Help link at the top of the page and look for some one with experience in trauma and family of origin issues. I have seen many clients heal from this destructive relationship patterns and go on to have fulfilling relationships, so I have hope that you can too.
Q: About a year ago I went to my doctor and told her how I was feeling, she told me I had
symptoms of BPD and to maybe see a therapist.
I never ended up going but I did look it up and a lot/almost all of it related to me. I never thought much of it because I just thought I was a normal teenage girl who liked to party a little too much, didn’t really know who I was, and was sad & insecure sometimes.
I recently got into a relationship, about 4 months ago, I’ve never been in one before. I don’t even know how to act in a relationship because I usually push the other person away in fear that once they get to know me they’ll leave me, so I leave first. He’s the first guy I’ve ever had any sort of real connection with but we fight a lot. For the most part we usually fight because of me, I get these feelings and emotions that come out of no where and I freak out about. For some reason they made me look up borderline personality disorder and I relate more then ever. I don’t know if it’s all coming out because I just have no idea how to function in a relationship or because something really is wrong. I just don’t think it’s that hard to learn how to be in a relationship and I don’t think most people go through this. I constantly need reassurance that he likes, that he thinks I’m pretty, that he likes my body, that I’m important to him. When he’s not around, all I can think is that I could be single, that it would be better that way. When he’s with me all I can think is that I never want to be alone again. Every little detail I found myself getting upset over, I start fights over stupid things. I also find myself thinking; If he’s not with me and he’s not texting me I think he’s cheating because why would someone like him want anything to do with someone like me? But then sometimes I think I could get a way better looking guy then him, that I’m too good for him.
I’m sure I could go on but this is the gist of whats going on. Everything just seems so black and white. Either I think things are perfect or everything has going to shit. Is something wrong with me, I keep wondering? Maybe I’m too insecure or jealous or something. I don’t know whats going on, I don’t know why I can’t let things just be. I just wanted some advice on this, thanks in advance.
A: What an insightful young woman you are. I’m glad that you are reaching out for help with your confusing and painful emotions and trying to figure out what to do to feel better.
I agree with you and with your doctor. What you are describing does sounds like characteristics of Borderline Personality Disorder. The fact that you are in your first relationship, and with someone you have a connection to is likely heightening your fears and insecurities, but is probably not causing them.
Please reach out to a psychotherapist in your area who specializes in working with BPD to get an official diagnosis, and to get help to understand and manage your intense emotions, change what you believe about yourself, and to learn more effective ways of relating to others. The good news is that treatment is available and can be very effective, but it will take a long-term commitment to healing on your part. Dialectical Behavior Therapy is among the most effective treatments for BPD. I urge you to contact your doctor to get a referral to a therapist or to click the Find Help on Psych Central’s website and find a therapist who specializes in personality disorders and begin your journey of healing.
Take good care of yourself!
Send me your relationship and mental health questions here!
Q: I have a 6 1/2 year old daughter. My husband was married and divorced before and has 2 children. We
haven’t told her any lies about anything but we haven’t told her the “whole” story about everything.
I didn’t really think she was old enough to need to know or understand. I also want to preserve her innocence as well as foundation about her parent’s marriage. She is getting older now though, and obviously seeing more; her brothers are rarely with us so she knows they have another mom and things like that. I don’t know what or how to tell her; I am just terrified that it will shatter her reality of what her life is and should be to know her Dad was married to someone else before. I know she doesn’t need any details, but she will be asking more questions, and I really don’t know what to say. I know this was a very long question but any help or advice you could give me would be so appreciated. I wish I could come see you for counseling but I do not have the means to do that. Thank you for your emails and advice that you give out to me and others who are in the same situation.
A:Â She may not be as traumatized as you think by knowing that her dad was married before, as long as you and your husband have made peace with his past.
Was there some kind of behavior on her dad’s part that led to the divorce like a affair or addiction or abuse in her dad’s past that you’re trying to shield her from? More important than saying the right things to your daughter is to examine your own feelings about the situation. I wonder if you’re projecting your own fears or insecurities about your husband’s previous marriage and children with another woman onto your daughter. Your daughter will take the emotional cues from you on how to think and feel about this situation. The more you can accept your husband’s past, the better your daughter will be able to accept it and integrate it into her life story in a healthy way.
My advice is for you and your husband to talk to your daughter about his past marriage in an honest, straightforward, and simple way. It might sound something like this, “Dad and I love each other very much and we love you. Before we got married, your Dad was married to ____ and they had your brothers. Their marriage ended. Dad and I found each other and fell in love and had you – one of the best decisions I’ve ever made. It might be kind of hard to understand this grown up stuff but if you have any questions about it, you can always come to me and Dad.”
Thanks for your email and feel free to drop me a note and let me know how the conversations go! Take good care of you and yours.
Have a question for me? Send me your family relationship and emotional health questions here!
Ask Julie: How do I get hubby to turn off his cell phone?
Q: “My big question is how do you tell your spouse to turn off his cell phone?
I am a stay-at-home mom so as soon as hubby gets home from work, my mouth keeps going
about my day, then the cell phone rings, but he has to take the call
because that is our income. So what do you do? He has to take the call
no matter what time of day because it could mean more money for us,
but wow, I want him to listen to me. What do I do?”
A: The goal is really less about getting him to turn off his phone, but more about helping him to hear your longing to be closer to him.
The good news is that you’re still trying to figure out how to get your husband’s full attention and to let him know how much you’ve missed him during the day. My guess is that you’re husband has no idea how much you need him, how much you miss him, and how you look forward to reconnecting with him when he arrives home. The goal is really less about getting him to turn off his phone, but more about understanding your heart and your longing to be closer to him.
As you approach this touchy subject with your husband make sure that your goal is not to control his behavior but to deepen your understanding of one another. Complaining and criticizing rarely get you what you want and often backfire by creating more disconnection. Ask yourself how you’re doing in really getting his heart about the burden and responsibility he feels in providing for your family in an uncertain economy. What is it like for him to feel so much pressure to be immediately available to his clients, employees, or whatever the case may be even when he’s not at work.
Here’s a great formula for expressing yourself in a kind, clear, and direct way.
I feel _____________________ (your emotion)
when you __________________(his specific behavior)
because I think ______________ (your thought).
It would mean a lot to me if _____________________ (your requested behavior change).
Try something like “I feel sad and scared when you take phone calls while I’m talking to you because I think that I’m not important to you. It would mean a lot to me if you would turn off the phone for 20 mins. right when you get home so I can touch base with you and have your full attention. When you’re gone at work I really miss you. I appreciate how hard you work to provide for our family.”
Julie de Azevedo Hanks, LCSW is a licensed therapist, self & relationship expert, media contributor, and director of Wasatch Family Therapy.  Visit www.wasatchfamilytherapy.com for individual, couple, family, & group counseling services designed to strengthen you and your family. Listen to Julie’s podcast You and Yours on the Women’s Information Network (The Win), and hear Julie every Monday morning at 7AM on B98.7!
