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Ask Julie: My Therapist Looks Like A Skeleton

Q: I don’t know what to do. I have been seeing my therapist for 3 years. I suffer with body image issues and distorted eating. My therapist has always been thin/healthy. Sometimes her weight drops and I am very sensitive to it. We have talked about it before and I am very open with it if I feel triggered by her. I saw her today and she looks like an eating disordered patient. She said she is aware of it and working on it. She said she has medical issues that make her body do things if she’s not careful and stress plays a part. I believe she is OK and she will work at getting back up to a healthy weight, but its really hard for me to make sense of. Why can she look like that but I have to work to keep myself healthy? Why are such high expectations put on me that she doesn’t live up to? She is my biggest role model, and all I can think of at this moment is starving myself until I look like her. She is happy, successful, smart, has a family and is pretty. She said, “I hope you’re not jealous of this (her body)” and she said that she wished she was in a different place. I just can’t get the picture of her out of my mind. Oh and she’s been getting sick a lot recently. It scares me. I want her to be healthy. She’s MY motivation to be healthy. But when she’s not…my motivation goes away and I want to restrict. How do I make sense of this?

A: Wow. What a tough situation! I want to validate your confusion about how to make sense of your therapist’s weight loss. It sounds like you’ve handled this things well so far by being open with your concern for her health, and talking about how her weight loss is impacting your recovery process. It’s scary when someone close to you is obviously ill and I’m glad that you are asking for help to deal with your concerns.

I can hear that on one level you trust that your therapist is addressing the problem, and on another level you’re angry about the double standard — she can be at a seemingly unhealthy weight and you’re expected to be at a healthy weight. While it is normal to be concerned about your therapist, I think there may be more for you to learn about yourself and your relationship patterns.

Your comment that you can’t get the picture of her out of your mind may be a sign that you’re too focused on her. I’m curious, have you had other close relationships where you’ve focused on their problems or issues in a way that negatively impacted you? Core relationship patterns and emotional wounds often replay themselves in clients’ feelings and thoughts about their therapist. You may want to explore these patterns with your therapist.

Just like children who idealize their parents eventually come to realize that their parents aren’t perfect, it sounds like you are experiencing a similar realization with your therapist. Instead of seeing her as the epitome of health, her drastic weight loss has knocked her off of the pedestal of perfection in your eyes.  There may be some grieving that goes along with acknowledging that your role model isn’t everything you hoped she’d be.

It’s time for you to work toward developing an internal source of motivation for health and recovery instead of relying solely on your therapist for your motivation. Ultimately, who you are and who you want to become are defined and chosen by you, not by any external source. You are stronger than you think you are.

Keep the dialogue with your therapist focused on you and trust that she’s aware and taking care of her own struggles. If after a few months she’s not improving and you are still frequently triggered by her appearance, it may be time to talk to your therapist about transferring to another therapist.

Thanks for writing in and I wish you well in your continued recovery.

Take good care of yourself!

Julie Hanks, LCSW

Ask Julie: I’m Caring for Mentally Ill Adult Brother

Q: If something was to happen to me my brother would not be able to survive.  I need help. My mother adopted my brother at 13 whom is 21 now.  He had been foster care since he was 2 years old.  They labeled him as mentally ill.  We would hit is head on the wall, get upset and not talk for hours, and walk with his head shaking and hand dangling.  He was in LD classes in school and had visited 33 different schools in his lifetime.  Growing up he moved to main stream classes and currently he is in his 3rd year in college but just started taking regular classes.  My mother passed away in 2007 and it was left to my dad to raise him.  My dad tried to get him help and was told that he could take care of himself.  My dad could not handle it any longer so I took him in.  It took him 7 times to pass his test to get his license.  He does maintain a dish washing job.  The best I can discribe him is he can do things but needs to be reminded and has no sense of reasoning.  Only follows directions but will follow them exactly.  Just yesterday he didn’t understand that if he couldn’t make it to work that he had to let them know.  He thought he could just go in the next day and tell them.  I have remind him to clean his room, and he isn’t apart of the household.  He just stays in his room all the time.  I have realized he needs someone for a lifetime and I can’t provide it.  I am a single mother of three girls and need help.  He needs help with his finances.  I didn’t realize that til he was 500 dollars in the hole and wasn’t paying any bills.  I just don’t know where to start to get him the help that he needs.  Please help.

A: Thanks for writing in for help. I want to commend your for taking in your brother. That is very courageous. It sounds extremely difficult to see no end in sight, and to know how vulnerable he would be in the world without someone to guide and support him. I believe that there are two things that need to happen at this point: 1) access additional support for your brother and 2) find  help and relief for you so you don’t completely burn out.

Does your brother have an official diagnosis? If not, I recommend that you take your brother in for psychological testing and evaluation. Depending on his diagnosis, he may be eligible for additional resources and care through your state, and may qualify for disability benefits. Please consider contacting NAMI (National Alliance for Mental Illness) in North Carolina and inquire about advocacy and support services in your area, and contact your community social services agency here. Your brother may be eligible for some type of supervised housing situation, occupational therapy for life management skills, and other services. Putting some long-term help in place for your brother will hopefully alleviate some of your current burden and decrease your concerns about him if something should happen to you.

In the short run let’s get you some additional help. Can your father take shifts caring for your brother to give you a break on a regular basis? Are there any adult day care services in your area where you could know he was safe? There are resources available. Please reach out for support for both of you.

Take good care of you and yours!

Julie Hanks, LCSW

Ask Julie: Anger Issues Due To Childhood Abuse

Q: I have acknowledged the fact that I have an anger problem, but I have not been able to find a way to deal with it. When I get angry I scream, curse, and get verbally abusive with the person that I am angry with. I have broken objects by throwing them across the room or by simply breaking them myself. I have injured myself by punching and kicking walls and random objects. Whenever I try to control my anger I feel light-headed, weak and shaky. After my anger passes I feel frustrated because I couldn’t control myself and break down in tears.

I have seen a therapist before for my anger issues and it only helped me for a couple of days before I was my old self again. While in therapy the therapist handed me a paper with a list of questions, one of the questions being; “have you ever been sexually abused?” I answered no, even though I experienced sexual abuse as a child. When I was 7 I started being abused by a close family mem

ber, it lasted until I turned 11 1/2 years old (when I started puberty.) I have never told anybody about it because I feel embarrassed and ashamed of the fact that the abuse lasted for so long. I know that the abuse was not my fault but I find myself constantly blaming myself for it because I never told anyone about it. I’m now 21 years old and I am afraid that I will hurt someone due to my anger. The relationships that I have been in before have not lasted long due to my anger and I’m tired of not being in control of my emotions.

I am seeking advice for what I should do to try and resolve my problem. I know that by talking about my abuse with someone I might be able to let the emotions that I have locked inside out, but I know that I will never be able to talk to someone about it due to the embarrassment that I feel. So I’m kind of at an edge here. Any type of advice would be helpful and greatly appreciated. Thank you for your time.

Click the arrow below to listen to the therapist’s response…

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To find a therapist who can help resolve your abuse issues click Find Help.  Please visit www.malesurvivor.org for more resources to heal from male childhood sexual abuse.

Take good care of yourself!

Julie Hanks, LCSW

*This is my first Ask the Therapist AUDIO response. What do you think? Like it, hate it? Let me know your thoughts.

3 Surprising Things About Mental Health: Sharecare.com Interview

In December, Sharecare Now named me the #1 online depression influencer of the past year! Crazy, huh? I love how the internet makes the world feel smaller because it allows us to talk to people all over the planet!

Since December, I’ve been in touch with the great folks at Sharecare who are passionate about connecting people with accurate health information online. A few weeks ago I chatted with the delightful Anne Kerueger, the Editorial Director at Sharecare.com about my life experience, how I became a therapist in the mental health field, what I wish clients understood, and why I’m thrilled when high-profile stars talk about their mental illness.

Read 3 Things A Therapist Wants You To Know

Oh, and feel free to comment on the article too.

 

What A Great Way To Start 2012!

On Dec. 31, 2011, a day I was really struggling emotionally (yes, therapists struggle, too), I received a message on Facebook. This thoughtful expression of gratitude lifted my heavy heart and reassured me that my efforts are in some small way making a difference for good in the world. That’s all I can hope for. Welcome 2012.

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“Dear Julie,  I can’t end this year without sharing my story and thanking you for the role that you played in it. As a child I survived horrible traumas that I suppressed until adulthood. The beginning of this year I knew that I needed help and prayed for guidance on how to get the help that I needed. You have always been one of my favorite LDS artists and in May you posted a song on your Facebook page. I can’t remember who sang it or the name of the song, but it mentioned that sometimes crying can be so healing. That night for the first time since the trauma, I allowed myself to cry and mourn what had happened to me. It felt so healing. It gave me the courage to seek help from Wasatch Family Therapy and I began therapy with Melanie Davis. She is exactly what I needed and is amazing. I am so excited to say that I am doing so well right now and I feel like I have my life back. I can’t even begin to thank you for the difference you have made in my life. I am a survivor and know that I can accomplish anything. I hope that you have a wonderful 2012…I know that I will.”

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The song she’s referring to is “Blessings” by Laura Story -  a song I wish I’d written.

Ask Julie: Will My Therapist Have To Tell My Parents When I Cut Myself?

I am 14 and recently my parents have discovered I struggle with self-injury. After discovering this, they are going to send me to see a therapist to help with the issue. They, of course, know I struggle with self-injury, but I would prefer if they did not hear about it if I tell the therapist when I self-injure. Is this possible, or is it required that they inform my parents when I cut? As a minor, do I have any confidentiality from my parents?

A: First of all, I’m glad that your parents are going to take you to a therapist to address your cutting. Your cutting is a warning sign that something in your emotional life needs to be addressed. While there is confidentiality between client and therapist, there are limits to that confidentiality.  Therapists are required ethically and by law to intervene when a client is threatening serious harm to self.  Since cutting can  range from minor surface scratches to life threatening wounds, and I don’t know how serious your self-injurious behavior is, I am not able to fully answer your question. Your question can be best answered by your specific therapist when you meet with him or her. At your first session, I suggest that you ask your therapist how he or she will handle your disclosure of self-injury.  Because you are a minor, it is likely that your parents will be involved in some way in your treatment. Many therapists will require family therapy  when working with minors because family dynamics often play a part in a child’s distress, and because parents play an important role in the healing process.

My biggest concern regarding your question isn’t whether or not your therapist will tell your parents, but why you don’t want your parents to know the full extent of your self-injury. Is it because you are embarrassed of what they will think? Is it because you don’t want to upset them? Is it because they will be angry with you? Is it because they will overreact? I hope you will address this important question with your therapist.

The fact that your parents are taking you to therapy to get help tells me that they are concerned about you, that they care about you, and that they acknowledge that you are in pain and need professional help. Consider that they may be able to help and support you through this difficult time as you sort through your emotions and resolve the pain underlying your self-harming behavior. You are 14 and it’s their job to make sure you are safe.

Take good care of yourself, and let your parents take good care of you, too.

Julie Hanks, LCSW

“Ask The Therapist” Live Facebook Event Dec. 21

The holiday season can bring out the best…and the worst in all of us, and in family relationships. Here’s your chance to get FREE advice to help you during the holidays and those cold winter months.

I’m excited to be participating in PsychCentral.com’s Ask the Therapist Live Facebook Q & A event with Dr. Marie Hartwell-Walker. We will both be available to answer YOUR mental health and relationship questions on Wed. Dec. 21st at 5:30-6:30PM MST in real-time in our Ask The Therapist Facebook Group.

Click here for details

Send you question to PsychCentral’s Ask The Therapist column anytime here

8 Surefire Ways To Emotionally Mess Up Your Kid

Do you worry about your child’s emotional health? Worry no longer.

Here are eight suggestions that will nearly guarantee your child will suffer from poor mental health, strained family relationships, poor peer relationships, low self-esteem and chronic emotional problems throughout his or her life.

1) Shut down all emotional expression

If your child expresses anger, sadness, fear be sure to make fun of them, tell them not to feel, and dismiss their emotions. Withhold love whenever they express emotion, especially vulnerable feelings. Another tactic is to express more intense emotions than they are showing so they’ll stop feeling and focus on comforting you.

2) Set inconsistent rules

Never talk openly about your expectations for your child’s behavior. Make your child guess what the ground rules are and change them constantly. Be sporadic and unpredictable in giving consequences and punishment.

3) Ask your child to solve your problems

Share all of your worries, concerns, and relationship problems and ask them to solve it for you. Always present yourself as incapable of taking care of yourself and your child.

Read more

Ask Julie: Why Am I Afraid To Grow Up?

Q: I’m a 25 year old male. I’ll just start off by saying that opening sentences take me sometimes hours to write (this one took ten minutes).  The same goes for my life – I just can’t seem to get anything started:  Job applications, writing routines, relationships with the opposite sex, you name it.

The only thing is, I usually succeed once I get started.  So, I’m trying to figure out why I can’t get things moving.  I graduated college almost a year ago and have only applied to about 5 different districts (I’m a state-certified English teacher) out of the hundreds in my state.

I also still live at home with my parents, and although they have threatened to kick me out, I usually find temporary work just in time to save myself.  Although I used to get 95% of my college schoolwork done here, I can’t seem to get focused when it comes to applying for jobs or keeping in touch with love interests or former colleagues.

Home-wise, there’s no major problems.  I’m comfortable here, and I don’t have to pay rent.  I don’t always have the sense of independence I want, but I’ve learned how to deal with it, just like I have learned how to deal with sadness, anger, guilt, and anxiety.  I focus on something else.  But I feel like it’s starting to get trapped inside, to a point where I will never be able to express myself.  I feel like this will cause me to regret everything later in life.

The main thing is that I know exactly what I have to do in life to move forward, but I just can’t seem to do it.  I don’t even have a logical explanation why – I just don’t.  Same goes for relationships. I was talking to a female friend who I have liked for over a year, and we mentioned our feelings for each other because we’re currently seeing other people (so it was means for conversation).  She asked if I had liked her, and I said yes.  When she asked “Why didn’t you tell me?” My honest answer had to be “I’m at a point in life where I’m just not acting on anything.” Tension followed, and I felt a little regretful afterward, but then I told myself not to dwell on it.  So, I don’t.  I’m not really feeling anything about it right now – that has all passed.

Do you think that my outlook on life (not to dwell on my past) is affecting my future?  I feel like the more I say the past doesn’t matter, the more I’ll act exactly like I have been, and I’ll only end up stuck.  I want to be 100% independent, not because of man pride or anything, but because I’m ready to live my own life.  How do I start?

A: Yes, I do think that your pattern of not examining the past IS affecting your future, but the real question is what are you most afraid of finding if you do look back and if you do feel?  Are you afraid of failure? What is your biggest fear if you did openly express yourself to your parents?  If you don’t have healthy ways to process emotions that come up in life they will likely build up over time and manifest in self-destructive ways. My guess is that this pattern is a large part of why you are feeling so paralyzed in your life.

Look for healthier ways to deal with your emotions. Consider journaling your feelings, joining a men’s therapy group, or talk with an individual therapist to help you get to the emotional root of why you’re feeling reluctant to start your adult life. Cultivate encouraging and supportive male friendships. Exercise to relieve stress, improve mood, and feel a sense of accomplishment and power. You mentioned that you don’t have the sense of independence that you want but you’ve “learned to deal with it.” Your sense of independence is paramount at this stage of life so I encourage you to foster that desire, not to relinquish it. It is important to take action, even if it’s clumsy and things don’t turn out perfectly. Ask out the woman that you’re interested in, send out 5 job applications every day, speak openly with your parents about your feelings, start paying them rent or pay them by contributing to the care of the home and yard. If usually feels better to act, even when you don’t feel like it, than to feel powerless in your own life.

I have a few questions about your parents. Why are your parents letting a capable 25-year-old adult son with a college education live in their home rent-free? Is it possible that they are enabling you to stay “stuck” at home because they are afraid of you leaving? Are you a buffer or a distraction that keeps them from dealing with marital problems? There may be some family issues contributing to your current dynamic.  Again, consider seeking help from a therapist to help you understand and resolve your internal struggle and understand any family dynamics that may be adding to your difficulty “growing up.”

Take good care of yourself!

Julie Hanks, LCSW

Originally appeared in my PsychCentral.com column

Ask Julie: Confused Future Psychologist

What should I focus more on in my 10 year journey to get my doctors in psych?

A: First of all, how great that you know which direction you’d like to study in graduate school while you’re still an undergraduate student. Here are a few bits of advice that may help you on your educational journey.

Volunteer or work in the field. Volunteer or get a job in the social service field to learn more about what areas of psychology you most enjoy.  Experience will also be a great addition to your graduate school applications.

Keep a high GPA.  A high GPA will help you will help you to have more options when applying to graduate schools.

Take a variety of courses. As an undergraduate student, take a variety of psychology and social science courses to give you a broad overview of the field.

Work as a research assistant. Getting firsthand exposure to the research projects will help you understand and get comfortable with the research aspect of your doctoral studies.

Get into therapy. If you haven’t already done so, experiencing being on the patient/client end of the therapeutic relationship is the best training you’ll have. It will better prepare you for the emotions that will inevitably come as part of working in the mental health field.

Good luck in your studies!

Julie Hanks, LCSW