Hypochondriasis: When Worrying About Your Health Goes Too Far

“All the powers of imagination combine in hypochondria.” ~ Mason Cooley

If you were to google the symptoms from hunger pains and a low-grade fever, the internet might tell you you have appendicitis or another life-threatening illness. It is likely that you have had something similar happen–thinking a minor sickness is actually something far more concerning. While this may be laughable for many people, some individuals genuinely and subconsciously worry they have contracted (or may contract) a very serious illness from day-to-day life. This type of excessive worry is uncontrollable for some, and is a type of mental illness called hypochondriasis.

While hypochondriasis is the proper name for this illness, you have likely heard of it referred to as health anxiety, illness anxiety disorder, hypochondria, or that someone struggling with this mental illness is a “hypochondriac.” It is defined as the excessive worry of being or becoming seriously ill–even with the absence of worrisome physical symptoms. You may believe that normal body sensations or minor symptoms are signs of severe illness, even if or when a thorough medical exam does not reveal a serious medical condition.

This mental illness, like several others, is difficult in the fact that it is relentless–it never stops. No matter where you go, you worry about germs and contracting deadly sicknesses; it is as if the rest of your life is merely background music to the constant worrying that is hypochondriasis. This severe distress can majorly interrupt your life.

Symptoms of illness anxiety disorder involve preoccupation with the idea that you are seriously ill, based on normal body sensations (like the sounds of a hungry stomach) or minor signs (like a minor rash). Signs and symptoms may include:

  • Being preoccupied with having or getting a serious disease or health condition
  • Worrying that minor symptoms or body sensations are indicative of a serious illness
  • Being easily alarmed about your health status
  • Finding little or no reassurance from doctor visits or negative test results
  • Worrying about a specific medical condition because it runs in your family
  • Having so much distress about possible illnesses that it is hard for you to function
  • Repeatedly checking your body for signs of illness or disease
  • Frequently making medical appointments for reassurance (or even avoiding medical care for fear of being diagnosed with a serious illness)
  • Avoiding people, places or activities for fear of health risks
  • Constantly talking about your health and possible illnesses
  • Frequently searching the internet for causes of symptoms or possible illnesses

The causes for hypochondria are unclear, but there are three common hypothesis. First, you may have a difficult time accepting the uncertainty of an uncomfortable or unusual symptom in your body, which may lead you to search for evidence that would provide a more concrete answer–often resulting in an unnecessarily serious diagnosis. The second option is that you have had a parent or other family member excessively worry about their own or your health. The third possibility is that you have had a past experience with a serious illness that has created an overwhelming fear or paranoia surrounding unusual physical sensations.

The best prevention and treatments for hypochondria are simple. First, see your doctor for your routine check-ups to ensure optimal health. He/she can help reassure you that you are healthy, and this professional diagnosis may be useful to fall back on if you start worrying about your overall health. Second, if you have problems with anxiety, seek professional guidance from a mental health counselor as quickly as possible to help stop symptoms from worsening and impairing your quality of life. Third, learn to recognize when you are feeling stressed, how stress affects your body, and how to manage your stress (think meditation, exercise, a healthy diet, self-care, etc). And lastly, stick with your treatment plan to help prevent relapses or worsening of symptoms.

Just as you would go to a medical doctor with a broken limb or an unresolved alarming health concern, you should see a qualified, trained and experienced therapist to treat your mental needs. Hypochondria is a very real and debilitating mental illness. There is a way to work through your excessive worries and fears of sickness. I am here to help. Please contact me today with questions or to schedule a session.
Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Supporting A Loved One Through Alcohol Addiction

Each Al-Anon Family Group has but one purpose: to help families of alcoholics. We do this by practicing the Twelve Steps of AA ourselves, by encouraging and understanding our alcoholic relatives, and by welcoming and giving comfort to families of alcoholics.

It can be so difficult to know your place if you have a friend or family member struggling with an alcohol addiction. You may not know what to say or how to help; you may feel like their addiction is straining your relationship; you may resent their choices. While it is true that you cannot force a person to get help for alcoholism, there are various ways you can support them and encourage them to seek treatment.

You have likely heard of Alcoholics Anonymous (or AA). In April, I wrote a post that detailed the basics of Alcoholics Anonymous. I tried to cover everything from what it is, to how it started, its main tenets, if it works, and how it applies to those who do not believe in God. I detailed the strength that comes from utilizing this specialized support group of complete strangers who understand the path of the alcoholic’s addiction.  This is a program of recovery for specifically for alcoholics; Al-Anon, however, is different. It is a program of recovery for people who are affected by someone else’s drinking, whether that be a friend or family. It is one of many resources available to support those indirectly affected by alcoholism. This post is dedicated to how you can support a loved one through alcohol addiction.

There is no one exact formula that will tell you how to support someone facing an addiction to alcohol. Every person is different and, therefore, each person’s recovery process will be unique. Some people may rely heavily on their support system and want to involve you in each step during treatment; others may be more reserved and may only come to you when they need a listening ear or want to talk. The best thing you can do for a loved one who is recovering is to motivate and support them every step of the way. Here are several specific ideas for how you can get involved and offer support:

  • Learn about his/her condition. Understanding that, over time, alcohol rewires a person’s brain and causes it to function differently, sheds light on why he/she cannot simply choose to stop drinking alcohol.
  • Know the warning signs. Some signs are recognizable while others are subtle. Several telltale signs of a potential drinking problem are irrational behavior, lack of interest in hobbies and ignoring responsibilities. (This step is particularly important for those who have not yet recognized the need for help to overcome an alcohol addiction.)
  • Offer to help research alcohol rehab programs and types of therapy. Deciding on where to go for treatment is one of the most important factors in a person’s recovery journey.
  • Attend support group meetings or counseling sessions with your loved one. This will give you insight to their journey as well as guide you in how to handle different situations. (AA meetings are generally open, which means you can attend with your loved one. These meetings offer a great deal of support and advice for living with someone who has a drinking problem.)
  • Attend Al-Anon meetings. Just as those facing alcohol addiction will attend AA meetings, you should attend Al-Anon meetings. Here you will find support as you meet others who also love someone with an alcohol addiction, and will be able to personally work through the 12 steps of Al-Anon. Visit this website to find a meeting near you.
  • Help with the post-rehab recovery plan. Be constant as your loved one navigates life as a recovering addict.
  • Be optimistic. Addiction recovery is a steady uphill battle that will come with victories and defeats. When setbacks come, try not to be critical and face the future with hope. When progress occurs, celebrate it and continue pushing forward.

Family and friends should understand that the recovery process can come with many ups and downs–for both parties. When things get difficult, remember that having a steady support system will make a profound difference for your loved one. Your support will surely influence whether or not he/she seeks help for their drinking problem, will buoy him/her through treatment, and will increase the likelihood that he/she will maintain sobriety after treatment. Your role is crucial!

More than 15 million people struggle with an alcohol use disorder in the United States, but less than eight percent of those receive treatment.  Alcoholics Anonymous is a free resource available to all that will offer tools to both the individual facing the addiction, as well as his/her loved ones. Alcoholism affects everyone, including family members and friends of the alcoholic. This can damage relationships and cause you to feel a wide range of emotions like disappointment, anger, doubt and denial. Although your primary goal is likely to get your loved one help, be sure to get the help you might also need. In many instances, speaking with a counselor is helpful and even necessary. If you feel you could use professional help, I invite you to contact me today or schedule a session. Whether you are the one facing the addiction, or the one offering support, I am here to help you every step of the way!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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#optoutside

“I believe that there is a subtle magnetism in Nature, which, if we unconsciously yield to it, will direct us aright.” ~ Walden by Henry David Thoreau

Summer is nigh upon us! Stores nationwide have their swimsuits and outdoor pools at the forefront of their aisles. Most places in the United States are warming up and there is a buzz in the air that comes from the excitement summer brings. I want to share some ideas to help you make the most of the great outdoors this summer!

But first, let’s go over the power of being outside. Not too long ago, I wrote a blog post called, “Outdoor Therapy: Nature’s Cure.” In it, I shared that studies are repeatedly showing that being outside has positive psychological and physiological benefits. Ecotherapy (also known as green therapy, nature therapy, and earth-centered therapy) is contact with nature and is a powerful new kind of therapy. This type of therapy with nature has been found to be just as effective against depression as traditional psychotherapy or medication! And the amazing thing about ecotherapy is that it is free. Not only that, but it is completely accessible to anyone at anytime!

I know what you are thinking. I have a job and/or kids and a life with so much to do that makes it impossible to be outside all the time! I hear you. I know that it is not easy to make time to do something elective. Regardless, we need to put down our paperwork, pause our housework, and turn off our computer and get outside. Yes, we have many obligations and responsibilities that demand our attention, and making time for self-care seems like one more thing to squeeze into our overbooked schedules (to learn more about self-care, read this post). I have personally found it therapeutic to walk a trail near my home multiple times a week. I am refreshed and rejuvenated when I get outside, breathe in the air, smell the fresh honeysuckle, observe the dogs and their owners, and feel my body moving (especially helpful since I spend the majority of my day sitting for hours at a time). I can assure you that you will be better off because of the time you spend outside!

The following 55 ideas will jumpstart your summer and up the time you spend outdoors (and none of them require a great amount of time nor a large amount of money):

  1. Walk your dog (or get a dog!)
  2. Count your steps. Iphones, outdoor apps, fitbits, and so many other technological advancements make it incredibly easy to use an activity tracker.
  3. Listen or watch for birds
  4. Look for shooting stars
  5. Camping (or glamping if that is more your style!)
  6. Hike or run a local trail
  7. Chase waterfalls, soak in some hot springs, or visit a local swimming hole, river, or lake
  8. Go fishing
  9. Plant a garden
  10. Pick fresh flowers outside
  11. Pick up landscape photography
  12. Have a picnic
  13. Go tubing, kayaking, or rafting
  14. Visit local farmers’ market
  15. Fly a kite
  16. Set up a hammock and relax!
  17. Have a bonfire (don’t forget the s’mores!)
  18. Go geocaching or letterboxing
  19. Go hot air ballooning
  20. Walk instead of driving (when possible)
  21. Ride your bike
  22. Take up mountain biking
  23. Rent local scooters
  24. Visit a new park
  25. Go on a run
  26. Walk a mile
  27. Explore a new neighborhood or houses under construction
  28. Dance in the rain
  29. Follow a rainbow
  30. Swing on a swing
  31. Play on a playground
  32. Go swimming (and jump off the diving board)
  33. Go surfing
  34. Watch the sunrise or sunset
  35. Try bouldering or rock climbing
  36. Visit a National Park
  37. Take a walk at lunch
  38. Sit on a sandy beach
  39. Plant a tree
  40. Outdoor BBQ
  41. Summer chairlift ride (preferably during the full moon!)
  42. Stroll around the city
  43. Play catch, basketball, kickball, or any outdoor yard game
  44. Get lawn seats to a concert
  45. Stand on a summit
  46. Go boating or sailing
  47. Listen to the ocean
  48. Organize an outdoor scavenger hunt
  49. Color with sidewalk chalk
  50. Wash your own car
  51. Participate in a park clean-up
  52. Try outdoor yoga (for the sunrise!)
  53. Collect seashells or build a sand castle
  54. Sand volleyball
  55. Set up an outdoor movie with a projector + sheet

Which ones will you do first? Consider making a list of these ideas (plus any others you might have!) and crossing them off as you complete them. Put them on the calendar and make them happen! Allow yourself to enjoy the beautiful warm weather this summer.

If you find yourself feeling frustrated with life, discouraged, or lonely this summer, I encourage you to reach for your tennis shoes before medication. Enjoying a healthy dose of mother nature does incredible good for both your mind and body.  I offer walk and talk therapy for some of my clients; it is amazing what can be accomplished when I spend just 20 minutes outside walking with my clients at the beginning of a session! Please do not hesitate to contact me today to schedule your first personalized session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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Continuing the Conversation on Teen Suicide: How to Help

“Don’t you know things can change / Things’ll go your way / If you hold on for one more day / Can you hold on for one more day?” ~ ”Hold On” by Wilson Phillips

Our community has felt the rippling effects of tragic suicides over the last year. We continue to grieve the loss of students and loved ones we miss so dearly. We know our community is not the only one experiencing the difficult aftermath of suicide, so we want to raise our voice to raise awareness.

Over the last few months, I have written two posts on the subject of teen suicide. Because this is such an important topic, I decided to split up my posts to do each one justice. First, I gave a general overview of teen suicide. Then I discussed the warning signs. Finally, I want to offer my personal and professional advice about how you can help.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

As I said, I dedicated an entire post to the warning signs someone considering suicide will likely exhibit. Please refer to that for a greater understanding on that subject. The main indicators are suicidal talk, self-harm, hopelessness, and neglecting appearance/friends/important activities.

If you see any of these warning signs in a friend or family member, the first thing you could do is talk about it. While it may be uncomfortable to discuss suicidal thoughts and behaviors, it may end up curbing a suicide attempt and saving a life. It is worth it! Some ideas to start this conversation could be something like, “I have been feeling concerned about you lately,” or, “Recently, I have noticed some differences in you and wondered how you are doing.” Similarly, you could say, “I wanted to check in with you because you have not seemed yourself lately.” If the person admits to feeling suicidal, you can then ask things like, “When did you begin feeling like this?” or, “Did something happen to make you start feeling this way?” as well as, “How can I best support you right now?” and even, “Have you thought about getting help?” Finally, words of comfort might include, “You are not alone in this. I’m here for you.” Another powerful idea is, “I may not be able to understand exactly how you feel, but I care about you and want to help,” as well as, “When you want to give up, tell yourself you will hold off for just one more day, hour, minute—whatever you can manage.”

If someone confides in you that he/she is considering suicide, evaluate the seriousness of the situation. Those at the highest risk for committing suicide in the near future have a specific suicide plan, the means to carry out the plan, a time set for doing it, and an intention to do it. Here is a suggestion for how to assess someone’s risk to suicide:

Low: Some suicidal thoughts. No suicide plan. Says he or she won’t attempt suicide.

Moderate: Suicidal thoughts. Vague plan that isn’t very lethal. Says he or she won’t attempt suicide.

High: Suicidal thoughts. Specific plan that is highly lethal. Says he or she won’t attempt suicide.

Severe: Suicidal thoughts. Specific plan that is highly lethal. Says he or she will attempt suicide.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If it seems the person is in the low to moderate range, offer empathy and a listening ear. Let your loved one know that he or she is not alone and that you care. A teen’s school counselors, teachers, or administration are trained and equipped to help too! If you are afraid to talk to someone face to face, call or text a crisis line for advice and referrals. Where applicable, you can help your friend/family member locate a treatment facility or take them to doctor appointments. Overall, I highly recommend encouraging the person to see a certified mental health professional as soon as possible.

If the person is in the high to severe ranges, and a suicide attempt seems imminent, call a local crisis center, dial 911, or take the person to an emergency room immediately. Remove anything that could be potentially harmful, like guns, drugs, knives, and other lethal objects from the vicinity. Do not, under any circumstances, leave a suicidal person alone!

If you are the one experiencing suicidal thoughts or feelings, surround yourself with people you trust and get help. There are so many resources available today, including the National Suicide Prevention Hotline (24 hours a day at 1-800-273-8255) as well as counselors in the schools. They can be trusted to help you. Remember that suicide closely affects at least six people–often many more! Absolutely no one will be better off with you gone…quite the contrary, actually. You matter. You are worthy of love and life. Life is worth fighting for. Do not give up on yourself!

A suicidal person may not ask for help, but that does not mean help is not wanted. People who take their lives do not want to die—they simply want to escape the hurt. Suicide prevention starts with recognizing the warning signs and taking them seriously. If you think a friend or family member is considering suicide (or if you are considering taking your own life), be brave. Speak up. Get help. Talking openly about suicidal thoughts and feelings can save a life, including yours!

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Continuing the Conversation on Teen Suicide: Warning Signs

“There’s no need to go and blow the candle out / Because you’re not done. / You’re far too young / And the best is yet to come.” ~”Lullaby” by Nickelback

Suicide is devastating to family, friends, and a community. The loss from suicide leaves a gaping hole in families, neighborhoods, schools, and communities; each suicide intimately affects at least six other people. Parents, siblings, classmates, coaches, and neighbors may be left wondering if they could have done something to prevent that young person from turning to suicide. In this post I will go over the suicide warning signs someone who is contemplating suicide might exhibit. In a future post, I will discuss how to help this person, or get help if you are the one considering suicide.

The World Health Organization estimates that approximately 1 million people worldwide die each year from suicide. For those who are not in the grips of suicidal depression and despair, it may be difficult and even confusing to understand what would drive so many individuals to take their own lives. However, a suicidal person is in so much pain that he or she can see no other option. This is why knowing what to look for can prevent suicide and provide help and hope as an alternative.

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

WARNING SIGNS

There are many potential warning signs to suicide; the following are some of the most common red flags to look for:

  1. Self-harm or suicidal talk. Take any talk or mention of suicide very seriously. This is not just a warning sign, it is a cry for help!
  2. Talking or writing a lot about death or dying.
  3. Hopelessness. Though subtle, studies have found that hopelessness is a strong predictor of suicide. This hopelessness is often accompanied by “unbearable” feelings, a bleak future, and feeling like there nothing to look forward to.
  4. Loss of interest in day-to-day activities.
  5. Neglect of his/her appearance.
  6. Big changes in eating or sleeping habits.
  7. Withdrawing from friends and family. Increasing social isolation and the desire to be left alone.
  8. Dramatic mood swings or sudden personality changes, such as switching from outgoing to withdrawn or well-behaved to rebellious.
  9. Self-loathing and self-hatred. Feelings of worthlessness, guilt, shame, and self-hatred; feeling like a burden that no one would miss.
  10. Self-destructive behaviors. Increased alcohol or drug use, reckless driving, unsafe sex.
  11. Seeking out lethal means, such as weapons and drugs.
  12. Getting affairs in order. Making out a will, giving away prized possessions, making arrangements for family members.
  13. Saying goodbyes. This might include unusual or unexpected visits or calls to family and friends and saying goodbye to people as if they will not be seeing each other again.

These signals are even more dangerous if the person has a mood disorder such as depression or bipolar disorder, suffers from alcohol dependence, has previously attempted suicide, or has a family history of suicide. Take these red flags very seriously!

National Suicide Prevention Hotline (24 hours a day): 1-800-273-8255

If you see or experience any of these warning signs, do not dismiss them! I will write a detailed post on what to say and how to help in these situations next week. If you need immediate help, I suggest approaching a teacher or school counselor–they are trained to assist you and your classmates with this delicate yet urgent matter. Additionally, the National Suicide Prevention Hotline is available for calls and chats 24 hours a day (1-800-273-8255), and most communities have hotlines you can text for immediate anonymous help. In dire circumstances, call 911.

Knowing these warning signs could save a life. Pay attention to your peers. As always, please do not hesitate to contact me with questions. If you are battling thoughts and feelings of hopelessness and self-harm, please click here to schedule a session. My door is always open for you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Magic of Saying No

“Whenever you say yes to something, it means you’re saying no to something else.” ~Susan Biali

We all feel badly when we have to say no to something or someone.  It is so much easier to say yes when people need help–even if it comes at personal expense. Though selfless service is necessary and admirable at times, there are other times where it is more applaudable to say no. Saying yes to everything means you will be spread too thin and will not able to get things done well or at all; it is physically impossible to take on something new without slacking on something else!  This post will focus on the magic of saying no in hopes of giving you the courage to say so when appropriate.

(Disclaimer, I am not specifically referring to saying no in relationships regarding boundaries and physical intimacy–though that topic is incredibly important. I will write about this specific subject in the future. Instead, I am referring to saying no instead of yes when asked to take on additional responsibilities that you simply cannot accommodate.)

Whether you have been asked to help watch a pet or child, pick something up, drop something off, or take on additional responsibilities at work, you have certainly been asked to help. Oftentimes it feels like yes is the only acceptable answer, even if it comes at great personal expense. Saying no means you could potentially hurt, anger or disappoint the person you are saying no to. You may fear appearing selfish, lazy, or uncaring. You want people to love (or at least like) you. So you inconvenience yourself and say yes.

However, saying no is actually a sign of strength because it shows that you know yourself and your limits. It allows you to give of yourself fully, within your limits, and not overextend or exhaust yourself. Having and maintaining personal boundaries can build important relationships by fostering honesty, openness and trust. (I am not suggesting you immediately decline an opportunity to help someone when asked. I believe in the power of service and have written several times about its power.) Saying yes when the answer should have been no only leads to frustration and resentment. Learning to say no can be a magical skill when used appropriately!

Now, let’s discuss the steps involved in the art of saying no:

Step one: Honor your time and priorities.

Time is an extremely precious commodity for everyone. There are only 24 hours in a day, so you must choose to spend your time wisely. Even if you do happen to have some extra time (which for most of us is rare), is this new commitment really the way you want or need to spend that time? Does it honor what is most important to you? Are your priorities in line? If you are asked to take on a new commitment that will cut into your valued family time, it may make saying no easier.

Step two: Take a moment + Raincheck

When someone asks for help, instead of giving an immediate (most likely affirmative) response on the spot, say that you need to check your calendar and will get back to him/her. If you end up needing to say no, maybe volunteer yourself to help in the future when you are more available. This can assure them that you are willing and want to help, but are unable to at the moment!

Step three: Do not apologize.

A common way to start out is “I’m sorry but …” as people think that it sounds more polite. While politeness is important, apologizing just makes it sound weaker. Your time is your time. How you choose to spend your time is your choice. You need to be firm, and unapologetic about safeguarding your precious, finite time!

Step four: SAY NO.

You may cringe at the very thought of saying the abrasive, n-o word to someone. That’s okay! There are many ways around this that will still get your point across. Let’s say your friend asks to borrow your car, and you are less than excited about the idea. Here are seven ways to assertively, yet diplomatically, decline:

I prefer to be the only one driving my car.“

I prefer not to lend out my car.”

It doesn’t work for me to lend out my car.”

It’s important to me that I keep my car for my own use.”

“Unfortunately, I’m not going to be able to lend you my car.”

I’m uncomfortable with letting others drive my car.“

I made a promise to myself that I’m not going to let other people drive my car.”  

Notice that all of these suggestions are “I” statements. This puts ownership on you and therefore makes it more difficult for the listener to dispute. If someone is persistent in wanting you to do what he or she wants, keep repeating “no” using any combination of the statements above. Hold your ground until the person realizes you mean what you say.

Remember, saying no does not mean you are an uncaring, selfish person. It simply means you know and honor your time, priorities, and limits. Saying no protects you, earns the respect of others, and frees you to spend your time doing what is most important to you. It is actually quite magical! Setting skillful boundaries is an act of self-compassion. It is liberating and it is your right.

Next time you are asked to help someone, consider your priorities and how you wish to honor your time, pause before answering, offer a raincheck, do not apologize if you are busy and cannot feasibly rearrange things, and if necessary, say no. Remember that there are only 24 hours in a day. In order to spend it wisely, sometimes it will be necessary to say no! As always, please feel free to contact me with questions, and click here if you would like to schedule a session.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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How Can I Help?: Supporting Those Facing Infertility

At a neighborhood function not too long ago, Rachael complimented Abigail on her cute children. Abigail quickly responded with, “It’s about time that you jump on the bandwagon and have some cute kids yourself!” What might have seemed like a harmless comment to Abigail cut Rachael right to the core. What Abigail did not know was that Rachael and her husband had been trying to get pregnant for years and were struggling with infertility.

It is estimated that 15 million Americans (one in six couples) have infertility issues. If it is not you going through it, it is your sibling, your friend, your coworker, or your neighbor.  Like many physical health conditions that have mental health implications, infertility often goes unnoticed by well-intentioned friends, family, and co-workers. If you are trusted to be let in on the tender topic of someone’s infertility, there are certain things you can do to help those struggling with this difficult trial.

  1. Learn more about infertility. Understand the causes, the language, the options, the process. This will not only help you understand the infertility journey, but it will mean so much to the people struggling that you took the time to understand their situation.
  2. Take comfort in knowing that it is not necessary for you to give advice. In fact, it is not your place to give advice. It is unlikely that you will suggest a route that has not already been thought of and some options might not be realistic, as you may not be aware of your friend’s personal, medical, or financial situation or history, nor their personal beliefs or values. Though it is natural to want to jump in and help problem-solve, infertility is an extremely personal issue; the decisions that need to be made and obstacles that need to be managed are deeply personal.
  3. Avoid trigger phrases. Though you mean well, there are certain responses that are rarely comforting and tend to minimize the very real fears and challenges your loved one is trying to share with you. A few of these include: “Where there’s a will there’s a way”; “Don’t worry; your time will come”; “It will happen when the timing is right”; “Just relax, it’ll happen when you’re less stressed”; “What’s meant to be will be”; “At least you can get pregnant.”
  4. LISTEN. While you may want to offer solutions or words of comfort, oftentimes, the best thing that those struggling with infertility need is a listening ear. They need someone to talk to and someone to be there for them. Instead of chiming in with possible solutions to their dilemma, let them guide the conversation and then be supportive of their plans, whatever they may be. Just listening will mean so much to the person trusting you with this deeply personal issue!
  5. Help where you can. Instead of working overtime to “fix” situations that are beyond anyone’s control, focus on making smaller decisions and stressors more manageable. Attend appointments. Watch kids (if there are older children involved). Be an exercise buddy (sometimes, those undergoing treatment need to lose weight in order for treatment to be more effective). Help around the house. Supply meals. Pick up groceries. Suggest a fun activity, like a comedic movie or a paint class or a number of other non-baby related things. These daily hassles tend to feel even bigger in the face of major life challenges like infertility.

Lastly, my advice would be to recognize and validate the uniqueness of their situation. Although many face infertility, no two struggles are alike. What one person finds most difficult can be very different from another’s perspective. For some, it may be the physical discomfort that comes from medications, daily injections, or invasive ultrasounds and procedures. For others, the financial commitment can generate significant stress and even become a barrier to treatment. Many mourn the loss of a “natural” conception. This is why one of the most helpful approaches is to remain open to a loved one’s experience. Sit with them in the lows, celebrate the highs, and just be present when things feel stagnant. Hear them out. Hear their story. Be there for them…whatever that might look like!

You may feel completely overwhelmed and unsure what to do or how to help. You may worry about saying the wrong thing or not saying enough. That is okay. Your loved one trusts you enough to confide in you and surely does not expect you to know exactly what to say or do. Remember that imperfect support is always better than nothing at all. Learn about infertility, avoid trigger phrases, listen, and help where you can. As you do these things, you will be able to support your loved one through the colossal trial that is infertility, and can bring a sense of peace, hope, and happiness back into their lives. If you are struggling with infertility, and believe the support of a therapist would be helpfuI, contact me. Let me be here for you!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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When Your Consent is Taken Away

“Our lives begin to end the day we become silent about things that matter.” ~Martin Luther King Jr.

Almost a year and a half ago, Alyssa Milano posted on Twitter: “If you’ve been sexually harassed or assaulted write ‘me too’ as a reply to this tweet.” 24 hours later, there were more than 500,000 responses. 12 months later, the hashtag was estimated to have been tweeted over 18 million times. The #MeToo movement has caught people’s attention worldwide, yet sexual assault continues to be a difficult topic. Although uncomfortable to discuss, it is prevalent and life-altering, and worthy of our attention and dialogue. I write this post in line with April’s Sexual Assault Awareness Month campaign to raise public awareness about sexual violence and to educate communities on how to prevent it.

In my initial research for this blog post, I found some staggering statistics I would like to include:

  • Approximately eight out of 10 sexual assaults are committed by someone known to the victim
  • More than half of female victims of rape reported being raped by an intimate partner and 40.8% by an acquaintance.
  • A forcible rape occurs every 6.2 minutes within the United States.
  • Nearly 1 in 5 women (18.3%) and 1 in 71 men (1.4%) have been raped at some time in their lives
  • Most female victims of completed rape (79.6%) experienced their first rape before the age of 25, and 42.2% before the age of 18.
  • More than 1 in 4 male victims of completed rape (27.8%) experienced their first rape when they were 10 years of age or younger.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

Let’s discuss the basics of sexual assault. The term “sexual assault” refers to sexual contact or behavior that occurs without explicit consent of the victim. Some examples of sexual assault include attempted rape; fondling or unwanted sexual touching; forcing a victim to perform sexual acts; penetration of the victim’s body; sexual intercourse against a person’s will; forcible sodomy (anal or oral sex against a person’s will); forcible object penetration; marital rape; sexual contact with minors, whether consensual or not; incest; or any unwanted or coerced sexual contact.

Sexual assault can happen to anyone of any age, gender, race, and socioeconomic background. It can happen at any time or place. Assailants may be strangers, acquaintances, friends, or family members, and they may use violence, threats, coercion, manipulation, or other forms of pressure or deception to commit sexual assault.

Not all sexual assault is rape, but rape is one of the more well-known forms of sexual assault,. For its Uniform Crime Reports, the FBI defines rape as “penetration, no matter how slight, of the vagina or anus with any body part or object, or oral penetration by a sex organ of another person, without the consent of the victim.” This can be done in one of three ways; the first is called a “blitz” sexual assault, which is when a perpetrator quickly and brutally assaults the victim with no prior contact, often at night in public.  The second is called “contact sexual assault”, and is when a perpetrator tries to gain their victim’s trust by flirting, luring the victim to their car, or otherwise trying to coerce the victim into a situation where the sexual assault will occur. The third type of rape is a home invasion sexual assault–when a stranger breaks into the victim’s home to commit the assault.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

The distinguishing line between sexual assault and consensual sexual activity is just that: CONSENT. Consent is a voluntary, sober, enthusiastic, informed, mutual, honest and verbal agreement. It is an active agreement that cannot be coerced. Consent is a process which must be asked for every step of the way. Consent is never implied and cannot be assumed, even in a relationship; simply dating a person does not give the right to sexual interactions. Legally, an intoxicated person cannot give consent!

Survivors of sexual assault often blame themselves for somehow behaving in a way that encouraged the perpetrator. When your consent is forcefully taken away, it is not your fault. I cannot possibly stress this enough: The victim is never to blame for the actions of the perpetrator! In my experience as a clinician, guilt is a feeling that each victim experiences during his/her healing process. Because of this, it is essential that victims get the appropriate and necessary treatment from a licensed, experienced therapist. I have treated numerous clients who have experienced sexual assault, and am equipped to help you or your loved one along this difficult yet beautiful path to healing. It is possible, and I am here for you. Please contact me today or click here to schedule a session.

Call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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The Direct Path to Happy Relationships

“Be direct. Be clear. Don’t worry about being correct. Worry about being real.” ~Jill Telford

Who can relate to the episode of That 70’s Show when Jackie is trying to get Kelso to do something, so she goes radio silent and expects him to figure it out? Of course he has no idea what she wants, and he actually goes the other direction–instead of getting closer to her to see what is wrong, he backs off, thinking things between them are great! She is left feeling frustrated because he did not magically figure out what she wanted, and this little tiff requires words in order to be sorted out.

In seeing this acted out, it is obvious that Jackie’s methods are comical and ineffective at best. However, it is not uncommon for this type of behavior to be employed in relationships outside of the 1970s. When you want or need something from your partner, what do you do? Do you sulk, whine, or pull back from the relationship as your way of indicating you need to be heard? Or do you speak up and directly voice your needs? Jackie’s type-of-response is referred to as “indirect support seeking” behavior and has a strong correlation to low self esteem. Ironically, such behavior elicits rejection–the exact thing Jackie’s type is trying to avoid! If this is something you do in your relationships, I imagine you are wondering…is there a better way to get what I need?

The answer is yes!

What I am about to say might sound too simple to be possible, but there is a way, and that way is by simply being direct. By saying what you need or think.

I have a close friend who I never have to worry if she is mad or if I offended her because she will tell me. She has taken the lead with being authentic, and has shown me how advantageous it is to have real, honest relationships. She says what she feels, thinks, and needs. It has created an incredible level of trust and openness in our relationship. Being direct removes so much anxiety and promotes closeness and trust. This can be done in any type of relationship!

Being direct and assertive involves being honest and genuine while remaining appropriate, diplomatic and respectful of yourself and others. It is not passive (being a doormat or a wimp), passive-aggressive (indirect communication, like not returning calls or emails hoping somebody gets the hint), or aggressive (being hostile and rude.) Being direct requires courage–the courage to be vulnerable and real.  It might be difficult to be direct when you tell someone you love them (or do not love them), when you need to confront someone about a problem, when you need to give difficult feedback, fire someone, say “no” to anything at all, or a host of other scenarios. In short, it is safe to say that you are likely to come under fire of potentially uncomfortable situations each day. Will you respond directly?

The following are suggestions for being more direct in your important relationships:

  • Consider the feelings you are holding inside and make your words match those feelings.
  • Before speaking, take Shirdi Sai Baba’s advice and ask yourself first, “Is it kind? Is it necessary? Is it true?” This will help you keep your ego in check and stop you from saying destructive things out of anger.
  • Keep it simple. Concise, clear, and brief is always better.
  • Speak in terms of “I” rather than “you” (“I need more physical affection” rather than, “You don’t show me enough affection”).
  • Focus on the behavior, rather than the person (“I need you to let me know when you are running late” rather than, “You are inconsiderate for making we wait”).
  • Avoid “always” and “never.” These superlatives are often unfair and untrue.
  • Avoid triangulation by speaking directly to the source.
  • Choose to love yourself by saying, “no” as needed. Know your limits!
  • Say it face to face. Do not express important sentiments or needs over text or email. Phone is okay, but in person is best. This will help prevent miscommunications.

Being direct is a skill that needs to be practiced and developed, but it can be done! Once understood, it will improve all of your important relationships. Indirect support seeking behaviors will nearly always leave you feeling rejected, alone, and misunderstood. Avoid this altogether by learning to say what you mean and meaning what you say. Be direct! I can speak from personal experience and say that communicating directly is liberating. It is the best way to get what you want or need out of all of your relationships. Communication is key in relationship satisfaction; if you need help communicating to the important people in your life, please do not hesitate to schedule a session. My door is always open!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

Personality and Social Psychology Bulletin: “Low Self-Esteem Predicts Indirect Support Seeking and Its Relationship Consequences in Intimate Relationships”

Alcohol Anonymous: Strength in Numbers

Alcoholics Anonymous

“When I stopped living in the problem and began living in the answer, the problem went away.”

~ Alcoholics Anonymous

According to the 2015 National Survey on Drug Use and Health, 86.4 percent of people ages 18 or older reported that they drank alcohol at some point in their lifetime. While it may not lead to an addiction for some, it does for others. Alcohol has touched all of our lives in one way or another, whether it is personally or through someone we care about. Because April is Alcohol Awareness month, I want to dedicate a post to one of the most helpful, renowned support groups for those working to overcome an addiction to alcohol: Alcoholics Anonymous.

WHAT IS ALCOHOLICS ANONYMOUS (AA)?

Alcoholics Anonymous is an international group of men and women who have had or are working to conquer a drinking problem. AA is open to all races, politically neutral, self-supporting, and is available almost everywhere. There are no age or education requirements, and membership is open to anyone who wants to do something about his or her drinking problem.

HOW DID AA START?

Alcoholics Anonymous was founded by Bill Wilson and Dr. Bob Smith, who were both recovering alcoholics. In 1935, Alcoholics Anonymous began as a community-based fellowship which encouraged sobriety for other recovering alcoholics. These two men developed the 12 steps to aid their attendees, and later introduced the 12 traditions to help further define the group’s purpose and achieve continuity for AA groups across the country (and later around the globe). AA paved the way for other support groups; today Narcotics Anonymous, Gamblers Anonymous, and Overeaters Anonymous are just three of the many groups that have modeled themselves after the AA meeting concept.

WHAT ARE THE MAIN TENETS OF AA?

The original steps are still intact and many former addicts credit the group with helping them through recovery. The 12 steps that govern all AA group meetings are presented in linear fashion, but participants see them as an ongoing circle. The following steps may be revisited until the recovering addict is comfortable in that stage of their recovery process:

  1. Admit powerless over alcohol
  2. Accept that a higher power, in whatever form, will restore your sanity
  3. Make a decision to turn your will and life over to a higher power
  4. Take a moral inventory of yourself
  5. Admit to a higher power, another human, and yourself the nature of your wrongdoings
  6. Accept that a higher power will remove your character defects
  7. Humbly request the higher power remove your shortcomings
  8. List people you hurt during your addiction and be willing to make amends
  9. Make amends to those people unless it would harm them
  10. Continue to take a personal inventory, and when you’re wrong, admit it
  11. Use prayer and meditation to connect with the higher power
  12. Carry the message of AA to other alcoholics and continue to practice the principles of the 12 steps in your daily life

DOES AA WORK?

Because AA is anonymous, some members of the group do not participate in studies since it could breach anonymity. Many want their participation in AA to remain unidentified, in line with the group’s original intention. Additionally, participants might not want to admit to relapse. A New York Times article stated that AA claims that up to 75% of its members stay abstinent.  Alcoholics Anonymous’ Big Book touts about a 50% success rate, stating that another 25% remain sober after some relapses. Though it is difficult to know just how effective it is, it is safe to say that many people have been helped by regularly attending AA. Just how effective depends on the participant.

CAN AA WORK FOR THOSE WHO DON’T BELIEVE IN GOD?

The first time I read through the twelve steps, I was surprised how often God was referred to. While the faith-based program of AA may be effective for some, it does not work for everyone — particularly those who do not subscribe to God as a higher power.  Might I offer a solution: AA founder, Bill Wilson, encountered the term “higher power” in the book, Varieties of Religious Experience, by William James. In this book, James offers many examples from Christian traditions, as well as non-Christian examples. One of the best examples of “higher and friendly power” is borrowed from Henry David Thoreau walking in the midst at Walden Pond feeling a sense of connection to pine needles. He cited other examples of a “higher power” to potentially include moral principles, patriotism, civic engagement, and even a higher or better self. Therefore, the term “higher power” does not have to be a faith-based term and thus varies from participant to participant.

You could go to an AA meeting in Los Angeles, London or Lima and each one would be carried out in a similar fashion. This is because the steps and traditions of Alcoholics Anonymous are the foundation for every meeting. In each meeting, members will get to know one another, discuss progress and relapses, and support each other through sponsor programs. Although it can be difficult going to an AA meeting with complete strangers and admitting to such a personal issue, it is the only place where every participant knows exactly how you feel. They have been where you are and can support you in your journey. That is powerful. To quote AA literature: “The feeling of having shared in a common peril is one element in the powerful cement which binds us.”  This instantaneous bond cultivates a unique feeling of community and understanding that is incredibly helpful to those recovering from alcohol addiction.

The only real way to find out if Alcoholics Anonymous can help you is to give it a try. See for yourself if you think the help and support from others struggling with the same problem can help you stay sober. As Alcoholics Anonymous has no dues or fees, you have nothing to lose in choosing to visit a few meetings. I strongly encourage it. Call now at 877-600-9205 or go online and use a meeting finder to find a meeting in your area. Click here if you are local to the Dallas/Ft. Worth area and could benefit from community resources. In like manner, if you feel you could use professional help, I invite you to contact me today or schedule a session to begin your journey toward recovery. I am here to help you along the uphill road of addiction recovery!

Melissa Cluff is a licensed marriage and family therapist based in Lewisville, Texas, personally seeing clients in the North Dallas area.

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