Anxiety as a Healthy Response

Anxiety: it’s something everyone deals with at one point or another, whether we all admit it or not. It’s one of the main reasons people seek therapy, and often medication. But what if I told you that anxiety is a completely normal reaction?

Not only is anxiety normal, it’s necessary. Anxiety is our body’s “fight or flight” system kicking into gear. Most anxiety is rooted in fear- fear of the unknown, fear of failure, etc… Without anxiety, we wouldn’t recognize potentially dangerous people or situations. Anxiety can also be a motivator- say you’re anxious about your first day at a new job. That anxiety can help you be more determined to do well and pay attention to what you’re doing.

Obviously, not all anxiety is healthy. If it monopolizes your day because you can’t think about anything else, if you’re losing significant amounts of sleep, if it’s causing stomach or physical reactions, then it can definitely be a bad thing. Those are times when seeking help to control the anxiety, through therapy and sometimes medication, is absolutely warranted and can be quite helpful.

However, I often encounter clients who want help “getting rid” of their anxiety around situations and people that warrant an anxious response. You’re worried about running into an ex-partner at a particular party that you may both be at? That’s a normal response. You’re a bit hypervigilent when walking to your car after getting off of work because it’s dark and you’re in a bad neighborhood? You’re in a new relationship, and you’re unsure of the other person’s feelings and where they stand? All normal. It’s difficult for any therapist to help clients “get rid of” this type of anxiety, because the last thing we want to do is stop you from having a healthy response to what’s going on in your world.

So, how do you tell the difference between “normal” anxiety and anxiety that warrants more concern? If you have a therapist, talk to them about it. If not, then ask yourself these questions:

  1. Am I consistently losing sleep over this?
  2. Where do I feel the anxiety? (stomach, head, jaw, etc.)
  3. Is this interfering with my day-to-day life? (For example, is it affecting your relationship, work, social life?)
  4. If one of my friends told me they were having this problem, what would I say to them?

Losing sleep, physical pain and interference with your daily life are key indicators that there is something more serious. The last question is about determining whether or not this is something you can work through on your own or if you need to ask for help. Asking for help is never wrong and sometimes issues that wouldn’t normally get to us throw us off track because of other things going on in our lives. Regardless of what type of anxiety it is, talking to a therapist can help you work through underlying issues, as well as learn was to self-soothe and lessen anxiety overall.

Who Wears the Pants?

I’ve never really been a “traditional gender roles” person. My father raised my brother and I on his own from the time I was 13. I was taught from a very young age how to run a household, manage a budget and hold a job simultaneously. The 1950’s housewife persona has never appealed to me; I’ve always known that I’m a career woman and the person that I marry will have to accept that I’m never going to be a stay at home mom or actually learn how to iron.

In a society where gender roles are becoming more fluid, people are having to adjust what they may have previously known or believed. Particularly within the LGBTQ community- how can you have “traditional gender roles” when both members of the couple are the same gender? Which begs the question, in a same-sex couple… who wears the pants?

There’s a saying out there that in successful relationships, no one wears the pants. I disagree. As a couples therapist, I believe that in successful relationships, you share the pants. That is to say, there is a healthy balance of power and control; no one person has more than the other, decisions are made jointly and no one feels bombarded or railroaded. One person may make more money than the other, one person may be more of a stay at home parent, but in healthy relationships neither of those things are held over the other person’s head because each person is contributing in their own way. It is normal in any relationship for one person to be better with money and budgeting, or at household chores, or at getting the day to day things done around the house. If one person works more hours or works later, it makes sense that the other one makes dinner most nights or takes on a few extra things around the house. That balance is not difficult to achieve, but it does involve having discussions with your partner about what expectations there are  and what each person is comfortable taking on.

I personally think that same-sex couples have an advantage over heterosexual couples in this regard: they’re already familiar with defying some of the standard hetero-normative stereotypes. It can be difficult to achieve the balance I mentioned earlier in any relationship, but I believe that in same-sex relationships, that balance comes more naturally because there aren’t any expectations set in advance about who does what. As we get further and further away from what used to be “traditional gender roles,” we open ourselves and our families up to a new kind of tradition- one that includes teaching our children that there doesn’t have to be a division between male and female, that gender isn’t necessarily binary, and that they don’t have to exist within a box created by someone else. So share the pants. Talk about the balance in your relationship, look for ways to improve that balance and work every day to maintain it.

Family & Coming Out

I grew up in a family where we believed in the idea of unconditional love. We all messed up on occasion, but at the end of the day, family is family and we were there for each other no matter what. I had instilled in me a “no strings attached” approach to family- when your family needs something, or when there is something that you can do for them to make their lives easier, you do it- no questions asked, no strings attached. Money doesn’t matter, time doesn’t matter, even political differences and differences of opinion don’t matter, because that’s what family means.

When I hear about LGBTQ people being afraid to come out to their families, it really bothers me. “Family” and “fear” don’t go together in my book. Family should be a safe place, not one that invokes fear or makes you feel like you should have to hide anything. Of course I know that isn’t the case in many families. The thought that I could lose my family because of some aspect of me as a person that they don’t approve of would definitely make me second guess whether it was something they really needed to know about.

I’m an academic, so of course I have to ask why this is. If you love someone, why does their sexuality or their gender matter? In what way does it change who they are as a person? I’ve never heard a reasonable answer to these questions because there isn’t one. Sexuality and gender do not define a person; they are aspects of a person. They don’t make a person who they are; their personality, morals, values, beliefs, etc. do that. None of that changes when a person comes out.

I would never advise a client to come out in a situation where they don’t feel safe. I would; however, advise all families to consider the following: according to GLSEN, 30% of suicides each year are LGBTQ individuals, and greater than 50% of transgender youth attempt suicide. Much of this is due to fear of not being accepted by family, friends and peers. According to PFLAG, LGBTQ youth who experience family rejection during adolescence are three times more likely to use illegal drugs. I have counseled many LGBTQ teens and young adults, and I can honestly tell you that the ones who have supportive families are much happier and well-adjusted than those who face discrimination and judgment within their own household and family.

It comes down to this: what kind of family do you want? Adjusting to the news that someone you love identifies as LGBTQ can be difficult, but there are many ways to help that do not involve rejection, discrimination or judgment. Ask them what they need. Seek therapy as a family to figure out how to be the kind of parent or family member that they need, and how to find acceptance. Rejection is a choice, and so is acceptance.- Choose the latter for them and for you.

I am the Eternal Learner

Most people spend a majority of their lives before the age of 20 in school. We start around five years oldand continue till age 18. Some of us go to college, which is another 4 years, and some go further and complete graduate school. I’m one of those- I was in school from the time I was five years old until I was 26, with nothing more than a few months in between. I was used to working 30 hours a week, interning 25 hours a week, and taking roughly 3-9 hours of classes a week. After completing my graduate degree, there was a major adjustment period. I had a job that I worked 40 hours a week… and that was it. I had been in school for over 21 years, and suddenly there were no tests to study for, no papers to write and no projects to complete. What was I going to do with all that free time?

I became bored pretty quickly. I’m a person who NEEDS to be busy. I like down time, but I can only enjoy it if I feel like I’ve earned it. Granted, 21 years of school and work probably earned me that down time, but I felt incomplete. I’ve always been an avid reader, so I spent a lot of time reading. I enjoy reading the most when I feel like I’m learning something, which is a theme throughout my life. Nothing is interesting or stimulating to me unless I’m learning something new. Many of the jobs I’ve had I’ve left not because I had to, but because there wasn’t much else to learn and it became monotonous.

Because of this, I’ve deemed myself an “eternal learner,” which makes counseling the perfect career for me. I really do learn something new with every client; every client teaches me something. Counseling is a constantly evolving field, because psychology is still a fairly young science. There is so much that is yet undiscovered, and being part of that discovery is a huge motivator for me.

I believe that learning is what makes life worth living, which is why as a therapist, I not only counsel my clients but educate them as much as possible. I believe that in order to overcome something, you have to understand it and how it uniquely affects you. If counseling is to be truly beneficial, whatever you learn you should be able to apply to other situations that come up later on. People will always need therapists, but the goal of therapy isn’t to make you dependent upon us, it is to teach you the tools you need in order to be able to handle similar problems and situations in the future on your own. So I get the best of both worlds- I get to teach and learn all at the same time.

Appreciation in Relationships

One of the reoccurring themes I see in couples counseling is appreciation, or the lack thereof. Particularly with couples that have been together for a long time, appreciation can fall to the wayside when they start to take things for granted. This could be something as small as minor household chores. If your partner has always done the dishes, you may not think to thank them or acknowledge how much you appreciate it. What if they just stopped one day? The dishes would pile up, the kitchen would be a mess, it may attract bugs or pests, etc. Often, we don’t realize how important something little like that is until it doesn’t get done. When I ask couples to start acknowledging the little things their partner does around the house, they often think that it is a ridiculous suggestion. Why should they thank their partner for something that they should be doing anyway? That attitude signals a problem to me: the little things your partner does are just as important as the bigger things. Those little things help your household and relationship run more smoothly. Why wouldn’t you thank them for their contributions to that, just as they should be thanking you for yours?

There are several other reasons that appreciation is so important in relationships. One of them is because it increases your positive interactions. According to John Gottman, renowned couples researcher and therapist, couples need a positive to negative interaction ratio of 5:1, meaning for every one negative interaction or thought you have regarding your partner, you need 5 positive ones to make up for it. Thanking your partner for the little but important things they do is an easy way to increase that number. Gottman also discusses what he calls “building a culture of appreciation, fondness, and admiration” within your relationship. Many people struggle with what is called “hyper-vigilence for negativity.” This is when you search your environment and your situations for the bad things instead of the good. If you’re looking for bad, you’ll find it. The same applies if you’re looking for good… so why wouldn’t you choose to look for the good instead? The happiest couples are the ones who look for opportunities to recognize their partners for the good things they do.

Another way to show appreciation is to compliment your partner. Reminding them of the things you love about them, particularly when they’re having a bad day or are feeling down, is an excellent way to show them appreciation, fondness and admiration. It’s very important to remind your partner that you support them, you’re proud of them, you’re attracted to them, and all of the things you admire about them. Give affection and compliments as often as possible. Remind yourself and your partner of what made you fall in love in the first place, and do that as frequently as you can. Making appreciation a priority in your relationship is a surefire way to keep the spark alive, and to increase both partners’ happiness and satisfaction.

Mental Health Awareness

Because I work in the field of Mental Health, I’m constantly surrounded by people who are seeking help. Unfortunately, there are still millions of people who need help, but don’t ask for it. According to the National Alliance on Mental Illness, one in five adults have a mental illness, but only 60% of those people seek help. Why?

As far as we’ve come as a society, we still attach a stigma not only to mental illness, but therapy in general. I can’t tell you how many times I’ve heard people say things like, “Therapy is only for people who are crazy,” or “I would never talk to a complete stranger about my problems.” We have no problem gossiping about other people’s issues and condemning them for their problems, yet we judge others for seeking help with those same things. In order to stop this from happening, we have to dispel the stigma surrounding mental health and therapy, and see it for what it really is.

So how do we change the way people see mental health? I believe it starts with changing the conversations we have about mental health. When we see a friend who eats healthy or goes to the gym regularly, we don’t judge them and say horrible things about them; we admire them for taking care of their body and often wish we had the willpower and the time to do the same. The same rule should apply for people who go to therapy- it’s like going to the gym for your brain. Physical health and mental health go hand in hand, and should be looked at the same way. When you have a cold or the flu, you see a doctor. When you are experiencing depression or anxiety, you see a therapist. Both provide you with the tools you need and the path to healing to help make the problem better. The added bonus with therapy is that those tools are reusable and often applicable across various situations.

Seeking counseling does not mean you’re “crazy.” It means you’re human, and more importantly, that you place importance on taking care of your mental health. Some people are equipped with the tools they need to be able to handle things on their own most of the time, but a lot of people need help learning and employing those tools. There is no shame in that. Not everyone was born into a family where effective problem solving and coping skills were modeled for them and not everyone has the perfect balance of chemicals in their brain that work to keep them from experiencing unhealthy levels of stress, anxiety and depression. For the millions of people who need help, and especially for those afraid to ask for it, support, awareness, and empathy are absolutely crucial. Remember, physical health and mental health are equally important: change starts with those of us willing to stand up and advocate for it.


Eat Right: Vegan for a Week

A lot of people have expressed to me an interest in going vegan. People are under the impression that it’s really hard to do and very expensive. It’s actually neither if you just plan ahead, have some staple ingredients, and prepare things in advance.

Eating a more whole foods, plant based diet can help you lose weight, feel better, and live a healthier life. I try to think of things I’m ADDING to my diet (vegetables, fruit, nuts, beans, and seeds), rather than what I’m LOSING. Many of the meat substitutes (with some brands being better than others, but you must try to get your favorite) taste like the real deal and when you compare the calories, sodium, and fat, you would be amazed at the difference.

I’m not a fan of eating big meals so I mostly “graze” throughout the day. The following is an example of 2 weeks in which I buy certain items from the grocery store and use them up throughout the course of the week, along with a list of those items:

Grocery Store:
Multi-grain sandwich rounds
Portabello mushrooms
Eggless egg noodles (or whole wheat fettucini)
Frozen spinach
Chickenless chicken
Tofurkey Turkey Deli Slices
Beefless Beef Tips

*Everything that’s in bold represents staples that I keep around at the house and office.

Breakfast: ½ a sandwich round folded over with peanut butter; ½ a banana (Freeze the other half)
Snack: Cantaloupe
Lunch: Sandwich (sandwich rounds, your choice of condiments, Tofurkey deli slices, tomato, lettuce, onion); Dill Pickle; Black Bean Soup
Snack: Wasabi peas
Dinner: Portabello Mushroom Stroganoff

Breakfast: Oatmeal with raisins, the other half of the banana from yesterday (frozen)
Snack: Watermelon
Lunch: Salad with your choice of dressing (tomatoes, onions, peppers, green olives, banana peppers); ½ a baked potato with vegan butter and sour cream
Snack: Pretzels with peanut butter
Dinner: “Chicken” Fajitas with peppers and onions (Add rice and black beans if you want, or have refried beans as a side)

Breakfast: ½ a sandwich round peanut butter sandwich, ½ a banana
Snack: Canteloupe
Lunch: Sandwich (hummus, Tofurkey, lettuce, tomato, onion, pickles, and salad dressing); lentil soup
Snack: Wasabi peas
Dinner: “Chicken” Salad; ½ a sandwich round, toasted with vegan butter and garlic powder; canteloupe

Breakfast: Oatmeal with raisins; ½ a banana
Snack: Watermelon
Lunch: Salad and ½ baked potato
Snack: Cashews
Dinner: Beefless beef tips with peppers, onion, rice, and Amino Acids

Breakfast: ½ a sandwich round with peanut butter and ½ a banana
Snack: Pretzels
Lunch: Leftover “chicken” salad sandwich; Dill Pickle
Snack: Watermelon
Dinner: Portabello Mushroom Burger with peppers and onions

Try this for a couple of weeks and see if you feel any better. Going vegan helped me to feel a lot better, mentally and physically. I lost 20 pounds within the first month and have kept it off for over 2 years. In 2 months I’ll be 40 years old and I’m at the same weight I was my senior year in high school. I’ve been told that my skin looks better. I also feel like I have more energy. When I used to eat lunch, I’d feel very sleepy afterwards, but not when I’m eating vegan and smaller meals throughout the day.

Add exercise to this lifestyle to ultimately boost your energy levels. Some yoga or pilates, walking or swimming, would be a great way to stay fit and feel more energetic. A 30 minute walk a day would do wonders, especially if you’re walking somewhere scenic like downtown. You can go on Youtube and find 30 minute yoga or pilates workouts.

Hope this helps!

Gay Marriage: Now What?

Six months ago, when gay marriage was finally legalized in Florida, I co-taught the workshop that couples have to take if they want to be married within 3 days of getting their marriage license. A few weeks ago, I had the honor of marrying two men who have been together for more than 28 years. With the great things that are happening in our country for equality right now, I started thinking… what really changes for couples when they legalize their union?

Marriage, as an institution, has been around longer than recorded history. In fact, it wasn’t even recognized as a religious sacrament until 1184. Even after that, churches stayed out of marriage for the most part until the 16th century, because marriage was considered a contract between two families. It seems like lately, though, parts of society are intent on defining marriage as something that is ordained by God and reserved for those who fit into the “traditional” view of marriage that much of society holds. Luckily for those of us who don’t subscribe to that view, our laws are changing to reflect a more inclusive definition for marriage.

As a marriage and family therapist, I work with both straight and gay couples, and the problems that occur within marriages are fairly similar across the board. Couples don’t come to me when they’re at their best; they come when they have run out of options and want to make a change. Those changes range from improving communication to learning healthier conflict styles to what to do when there has been infidelity. When I look at couples who come in for counseling who are married versus ones that aren’t, the biggest difference I see is the level of commitment. Marriage is a huge commitment: it is the legalization of the desire to be with the other person for the rest of their lives. In my experience, no one goes into marriage thinking, “If it doesn’t work out, there’s always divorce.” Additionally, there is a legally binding contract that influences the outcome of any separation, particularly if there is a prenuptial agreement or if the couple resides in a state where “what’s yours is mine, and what’s mine is yours.”

For many gay couples, this is a fairly new concept, at least from a legal perspective. I asked several couples, many who have been together for 20+ years why they would want to legalize their union with marriage. I heard that they wanted to because they want the same rights as everyone else, they had always wanted a traditional wedding, they wanted to do it for their families, but also to pave the way for future generations.

Marriage isn’t about a church, a dress or a party. It is about two people having the right to formally express their love and devotion to one another in a way that binds them emotionally and legally. You don’t have to get married to love someone and be with them for the rest of your lives- but having the option is something we all deserve, and now have.

Psychological Survival

When I was in grad school, a professor started a semester with 2 questions: Would you ever have owned a slave? Would you have ever considered being a Nazi?

Of course everyone answered “no”.

Weeks later he stormed into the classroom and was clearly pissed off. He stated that someone in the class had complained that he didn’t give enough tests, so he was administering one today. Two people spoke up to tell him that was unfair and he yelled at them and sent them out of the room. He left the class after passing out the test and I started to hear giggles. I turned over the test and it said: “Behavior modification works.” On the next page, “I can make you do almost anything I want.” And on the last page, “I just proved it to you.”

When asked why we didn’t challenge him, we explained it was because we pay a lot of money for school and want to make good grades. His point was that, if we wouldn’t speak up because of money and grades, what made us think we would have stood up to slavery or the Nazis? Speaking up could have you killed, or your family.

It was a powerful message that I never forgot. It made me think of the show “Walking Dead” and the book “Lord of the Flies”. Both stories are about survival in which common everyday people become the monsters they started out fearing.

Of course, it’s hard to imagine being in situations such as that in our time. A zombie apocalypse isn’t realistic and it’s not every day we get stranded on a desert island. However, there are extremely stressful situations such as combat and natural disasters. Under extreme duress it’s easy to fall into an “anything goes” situation.

How does one maintain psychological survival in those instances? You have to direct your fears, manage your emotions, and keep your ego in check. You have to first decide TO survive. Where there’s a will, there’s a way. If you’re in the mindset that you can do it, then you will. Don’t ever accept the “fact” that it’s a useless, helpless situation.

You also have to value teamwork and accept that there might be others who are better at certain things than you. Make sure to delegate responsibilities and focus on each individual’s strengths rather than weaknesses. It’s important for us all to be aware of our core values and not to panic in stressful situations. When you are feeling overwhelmed, that’s an indication that you need to step back from the situation, assess what’s going on, remember your core values, and act accordingly.

Hope that helps!

90-Day Self Love Challenge Part 3 of 4– Managing the Ego

I’m a regular guest on The Lillian McDermott Radio Show which airs every 2nd and 4th Tuesday, 9am EDT at  During last September’s show, we were discussing depression and anxiety and I mentioned quite often, the root cause of depression and anxiety is a lack of selflove.  Lillian was very interested in how we can work to love ourselves more fully. Together we embarked on developing the 90-Day Self Love Challenge.  This blog covers the 61-75 days of that challenge.

“I am my own worst enemy.”  Are you at all surprised by how profoundly true that statement is?  Author Eckhardt Tolle wrote in The Power of Now all problems exist in the mind.  It makes sense if you think that if its true happiness comes from “out there,” then it must be true all problems come from “out there” as well.

When we live our lives believing our happiness and sorrows exist outside of ourselves, beyond our control, it leaves us in the unfortunate position of feeling victimized, without power and control.  Being put in such a very scary position leaves us no other alternative than to defend ourselves from the inevitable and constant attacks from the world.  This is where the ego comes in.

The ego is a construct of our personality designed to protect us from the hostile world we live in.  The ego needs to defend, appear strong and in control to others, and most importantly, be right; because if you can’t be right in this world, then what have you got?

The ego is not a bad thing, really.  It just does what it does.  Some would say the tiger is evil for killing the beautiful gazelle.  Others say the tiger is good for it plays an important role in the circle of life.  But the tiger is neither good nor evil.  It just is.  So it is also true for the ego.

We can’t be ego free.  We have to accept we will always yearn with the desire to be right, appear strong and in control to others, and feel a need to defend ourselves from what we tend to expect is a hostile world.  We can learn how to manage our ego.  I remember clearly my prior addiction to being right. There was a time in my life I would die on any principle if I convinced everyone else I was right.  What a waste of time!  Rather than make me appear weak and out of control, giving up my need to be right actually helped me become a stronger person.

We did a lot of work in this area on the radio show. We did 15 days of exercises to help you recognize and manage negative ego responses. I will address days 75-90 in upcoming posts.  In the meantime, I invite you to work on this 90-Day selflove challenge.  Go to to learn more.