7 Ways to Help a Child Deal with Traumatic Stress

Life is stressful. That’s a fact. To grow and learn we must try new things. Struggling, prevailing, and tolerating failures along the way builds confidence and the deep feeling in a child that “I can do it.” But the positive aspects of struggle and stress are lost when the amount of stress becomes too great and/or sustained.

Persistent and long-lasting stress on the mind and body caused by overwhelming emotions leads to traumatic stress, a condition characterized by a nervous system in overdrive. The brain’s emotional centers lock into a state of DANGER and the body operates in fight, flight, and freeze modes.

Traumatic stress feels awful. The body tenses and succumbs to many other physiological changes leading to digestive problems and headaches, for example. Furthermore, children overwhelmed by emotions can’t engage positively in learning as curiosity in the outside world is a byproduct of a calm nervous system, not one that’s in a state of high alert.

Imagine for a moment what it feels like when you are terrified. Do you feel well? Do you feel like learning, engaging in life, socializing with others? No! When children and adults alike are terrified, we want to run away, hide, and find safety again as soon as possible so we feel better. When we are scared, we feel vulnerable and insecure. After a while, we feel hopeless, numb and even dead inside. Depression, chronic anxiety, substance abuse, isolation, and aggression, are all symptoms of traumatic stress.

So, what can be done to help a child experiencing traumatic stress? Help them to feel calmer. Here are 7 ways:

1. Be with them — connection is soothing.

John Bowlby, the father of Attachment Theory, taught us that children need to feel safe and secure to thrive. It may seem elementary, but the first aspect of creating safety for a child is being there so a connection can be established.

A child with traumatic stress is scared (even if they don’t appear so on the outside, like how a bully or aggressive child may present). Simply having someone in the room can be a comfort even when there is push-back from the child. Being alone heightens fear.

2. Be gentle so as not to inadvertently startle or jar a child.

A child suffering traumatic stress is fragile and prickly, a byproduct of a hyper-aroused nervous system. We live in a very left-brain dominant culture where we don’t talk nearly enough about emotional safety conveyed through right brain communications. Right-brained communications are the non-verbal cues we unconsciously pick up from one another. Right-brain communications include tone of voice, eye contact, and body language.

Adults should strive to speak in a gentle, calm voice with soft eyes and slow movements to avoid jarring or startling a child. Just think about how you like to be approached when you are upset.

3. Play fosters safe positive connection, and positive connection is calming.

Play feels good and healthy for all people no matter what age. According to Polyvagal theory, play stimulates the social engagement system of the vagus nerve, the body’s largest nerve, and therefore relaxes the nervous system.

Play helps a child feel better and calm down. But play involves so much more than a game. It involves connection, smiling, speaking with a cheery and playful tone of voice, and movement. All of those actions calm a child.

It may seem counter intuitive to initiate play with a child under stress, but if they are receptive, it gives the nervous system a chance to calm down. Even if for a little while, a moment of playfulness is good.

4. Help a child name their feelings.

Putting language on emotions helps calm down the nervous system. We can use stories, our own personal stories or ones we create, to help a child put language on their emotions. For example, a mother could share with her traumatized child, “When I was little, my mother went away for a long time. She was sick, so she had to go to where doctors could help her. Even though I understood why she went away, I was still so sad and scared. And, sometimes I even felt angry at her for not being there for me. All those feelings are so natural.”

There are many ways to help children put language on their feelings. You can show them drawings of little faces with many feelings and they can point to the ones they relate to. You can help a child name their feelings with games, drawings, and puppets.

5. Help a child express their feelings.

Emotions contain impulses that generate biological energy. This energy needs to be expressed so it doesn’t get pent-up inside. For example, if a child is in danger, their brain will trigger fear. Fear sends signals throughout the body, setting off impulses to run. But if a child is in a situation where they cannot run to safety, like being restrained by Mexican border patrolmen, all that energy gets trapped in the body and leads to symptoms of traumatic stress.

Helping a child express their emotions can be done in a variety of creative ways, such as the through art, play, stories, fantasy, puppets, or by helping the child verbally or physically express themselves. You should feel free to experiment and take your cues from the child for what works best. Cues to look for that indicate you are helping a child are expressions of relief, happiness, calm, and a desire to play and connect more. If an intervention is not helping, you’ll see a child’s face and body demonstrate more tension, sadness, anger, rigidity, and withdrawal.

6. When a child accepts it, give hugs and other physical affection.

Holding, rocking, stroking, hugging, and swaddling can help soothe a stressed nervous system. Again, take your cues from the child. If they don’t like something, don’t do it. You can tell by the way the child looks and reacts if they are responding positive or negatively. If they stiffen, it’s a protest. If they relax and soften, that’s a green light.

7. Reassure a child and help them make sense of what’s happening.

A little reassurance goes along way. Be explicit! Say things like, “You will be ok,” “This feeling is temporary,” “You are not alone,” “It’s not your fault,” and, “You don’t deserve this.”

Don’t lie to a child. Do look for truthful ways you can reassure them that they are safe now and will not be alone. Explain what has happened and what is currently happening. For example, in the case of parental separation, “Mommy and daddy are safe and soon you will see them again. Until then, we’ll be together every day and I’ll take care of you.” Reassuring a child that they didn’t do anything bad and that they matter helps because children internalize shame, a sense that they are bad or unworthy when they feel bad.

Humans are wired for connection and thrive in conditions of safety and security. When safety and security is compromised, we must do everything we can to restore a child’s sense of safety and security as fast as possible. There are many educational resources available to adults that teach how to minimize stress and foster recovery in children. The cost to our society is great when our children suffer.7 Ways to Help a Child Deal with Traumatic Stress

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What Self-Love Isn’t

Psychology Today

Four concepts that you’re confusing with self-love.

Posted Feb 05, 2019

Source: Leszek Glasner/Shutterstock

All too often we seek love from others, before looking within. However, many are beginning to turn that focus inward as they contemplate the meaning and purpose of self-love. Although not a new term, the concept of self-love has been gaining popularity in recent years. Many are beginning to recognize the relationship between self-love and mental wellness. Further, people are questioning the circumstances in which we may even need love from ourselves as much, and perhaps more, than we do from others. Oftentimes during this assessment self-love criticism arises. However, these appraisals are based on misunderstandings. To help clarify, let’s be clear on what self-love is not.


When a person has a sense of entitlement, they may believe they are unconditionally owed something regardless of efforts, merit, or context. This should not be confused with the idea of recognizing your worth. Depending on your perspective on humility and deservingness, you may find it difficult to assertyou are worthy of self-love. If this is the case, it may be helpful to consider basic human needs. One could argue that compassion, care, and acceptance are as fundamental as water, food, or shelter. Therefore, recognize that your worth and need for self-love overall is not that ridiculous to seek. Self-love isn’t about why you deserve a billion dollars, a fancy yacht, or a mansion. It isn’t an overtly ambitious jump. It isn’t elite or exclusive, but a core aspect of humanity.article continues after advertisement


Focusing on self-love is not the pathway to obsession. Although self-love is a reflective process in which one turns their energy inward, the benefits are not selfish. In actuality, in order to care for others effectively, one must first care for themselves. Prior to taking off on an airplane, the flight attendant assures flyers that in case of an emergency, regardless of who is nearby, it is critical to first put on your oxygen mask before helping others. We wouldn’t dare tell someone who abides by this regulation that they are truly selfish. Similarly, you can’t pour from an empty cup. Self-focus is not egocentric; ultimately, self-focus helps you and others.

In addition, whereas narcissism may be superficial and vain, self-love is quite the opposite. Self-love delves beyond the surface and isn’t all rainbows and unicorns along the way. Along with recognizing your worth, needs, and goals, self-love requires the courage to distinguish your weaknesses, challenges, and obstacles. Therefore, self-love necessitates humility, empathy, and concern for the self as well as for others.article continues after advertisement


A sin is an act that is not only inappropriate, but often violent. Self-love is just the opposite. Self-love isn’t meant to go against a principle or moral grounding; it is the enlightened journey to care for yourself in order to prompt a domino effect of care and compassion for those around you. Nevertheless, due to varying concepts of what self-love truly entails, from time to time individuals may view self-love as being against their values and beliefs. Just as everyone is unique, their interpretation of scripture may vary as well. If you are struggling with differentiating self-love from sin, it may be helpful for you to research and reflect on whether or not a conflict truly exists.

Regardless of your faith or belief system, it may be worthwhile to consider the commonalities in various world religions. Oftentimes, the tasks encapsulated with being a moral person include benevolence, forgiveness, and personal growth, all of which align well with the practice of self-love. More specifically, the golden rule of treating others as you want to be treated is the essence of self-love. From this common adage, we often jump to the lesson to treat others kindly, but we should not forget the implication that it requires being kind to ourselves as well.article continues after advertisement

An excuse

Self-love is an active, engaged process that evokes a wealth of positive benefits. Nevertheless, the journey is not always an easy one. A critical component in self-love is recognizing your limits, needs, and worth, and asserting intrapersonal and interpersonal boundaries as needed to uphold them. While this all-encompassing process may include mental health days, massages, and indulging in your favorite home-cooked meal, it is not an exploitation of all things good. Ironically, perpetual pampering could actually be neglectful and, hence, distinct from self-love. The full process of self-love includes the good, the bad, and the ugly. Beyond the stereotypically positive perks, self-love also includes the decision to recognize your areas for growth, tailoring a potentially difficult yet necessary plan of attack, and bravely tackling it head on. To an outsider without context, self-love could appear as an excuse; however, it is critical that you not use self-love as your hall pass to escape responsibility, accountability, and difficult situations in general. In contrast, true self-love can be enacted by taking accountability and responsibility as you courageously embark on arduous paths.

Source: pexels

The process of self-love begins with the mere task of being able to appreciate you for you. It is crucial to be kind and considerate toward yourself; however, self-love is more than a sentiment. Beyond your ability to tend to yourself, you must remember that self-love is an intentional practice to learn and cultivate. Self-love provides you with the opportunity to see yourself completely, to recognize and value your strengths and weaknesses, triumphs and challenges. With an emphasis on the self, this journey is ultimately an independent one. Although it is helpful to unite with others who are on a similar path, at the end of the day, self-growth is predominantly dependent on personal effort. The process of loving oneself is a subjective experience. Just because a tip has worked for many does not mean it will work for all. Honor your individuality as you find your definition of self-love.

This is an excerpt from The Self-Love Workbook.Psychology Today


11 Questions to Ask Before Getting a Divorce

The New York Times · by Eric V Copage · May 18, 2017

Common sense suggests that asking the right questions before getting married can make for a better union, but rarely is the other side of the coin examined.

That could be because, by the time the prospect of divorce surfaces, spouses may already be in a stressful frame of mind, and in no mood for a game of 20 — or even 11 — questions.

That is a mistake, said Nancy Colier, a psychotherapist in Manhattan. Even if the ultimate decision is to dissolve the marriage, asking the right questions before contacting a lawyer or mediator, and perhaps with the assistance of a marriage counselor, may prove worthwhile.

The New York Times asked some people well versed in the challenges and difficulties of marriage and divorce to suggest questions that may make a split more amicable, or even save the union. Here are 11 of their ideas:

CreditJulia Rothman

1. Have you made clear your concerns about the relationship?

“You may think that you have communicated, but your partner may not have really heard,” said Sherry Amatenstein, a marriage therapist in Manhattan and Queens and the author of books on relationships.

“Research shows that people hear only between 30 to 35 percent of what is said to them,” she said, “because we’re so full of ‘I’m going to say this to them.’”

If, for example, you believe your spouse is not making you a priority and, say, fails to spend time with you, this behavior can’t be changed unless he or she is aware of your concerns.

“You want to be really clear that you’ve given it everything in terms of speaking truth to your partner,” Ms. Colier said. That could help in healing if the marriage dissolves, she said, because you’ll know that you have done everything possible to make the relationship work.

CreditJulia Rothman

2. Do you and your spouse have shared expectations about the roles you play in the relationship?

“Sometimes the problem may be as simple as not understanding how your partner expects you to behave,” said Hope Adair, who, along with her ex-husband, was featured in a 2014 Times column that explored marriages that have failed. “It’s like, ‘This is what husbands or wives do and you’re not doing that.’”

If, for instance, one person expects the other to take the lead in managing finances, and he or she would prefer not to, problems can result.

CreditJulia Rothman

3. If there is a way to save the marriage, what would it be?

The Rev. Kevin Wright, the minister of education at the Riverside Church in Manhattan, suggests this exercise: On one side of a sheet of paper or computer screen, make a list of what you think you need to do to save the marriage, and on the other side, what your spouse needs to do. And make sure your spouse does the same. It’s important that both of you perform this exercise. Otherwise, he said, “this question can very easily become a question all about what the other person needs to do.”

CreditJulia Rothman

4. Would you really be happier without your partner?

“You have to look fiercely and realistically at whether what you’re getting in the relationship is worth what you’re giving up,” Ms. Colier said. “Perhaps your spouse doesn’t interest you as a sexual partner as much as you would want, but maybe your spouse’s co-parenting skills, willingness to help with everyday chores or companionship can offset the negative and make the trade-off worth it.” Getting a clear idea of what is most important in your life can make the decision of whether to stay in the marriage less overwhelming.

CreditJulia Rothman

5. Do you still love him or her?

Even if the answer is yes, divorce may still be the right path. “There are a lot of reasons that people decide they can’t stay married, but our emotions aren’t wired on an on/off switch,” said Wendy Paris, a writer specializing in relationships. “Some of the anger we see in divorce comes from the fact that we do still feel love for this person, and can feel hurt, unloved in return, or unvalued.”

CreditJulia Rothman

6. What is your biggest fear in ending the relationship?

“For some people, it might be the fear of being single again — the fear of being alone for the rest of their life,” Ms. Colier said. “For others, it is the fear of losing a sense of physical intimacy.” An understanding of what those fears are may help in deciding whether divorce is the best way forward, she said.

CreditJulia Rothman

7. Are you letting the prospect of divorce ruin your self-image?

The realization that divorce may be near often makes people feel like failures, Ms. Paris said. Instead of dwelling on how you may have stumbled, look at the relationship’s end in “a more empowering way,” she suggested, concentrating on what you did right. For example, “I have given intimacy a real try,” or “I am trying different options to figure out what is the best for everybody.”

CreditJulia Rothman

8. How can a divorce be handled to minimize the harm on the children?

“If you’re really miserable together, getting divorced is the best thing to do,” Ms. Amatenstein said. “But you will always be parents together. You are still going to be in each other’s lives. You need to think about how you’re going to do this and refrain from using the kids as cannon fodder.”

CreditJulia Rothman

9. Are you prepared for the financial stresses divorce may bring?

“What I recommend to people is that they start thinking about the financial as early in the process as possible,” Ms. Colier said. “That means meeting, if you can, with a financial adviser, talking to lawyers and writing down what this is going to cost. There is so much that is going to change — and so much fear. It’s important to feel grounded with as many financial facts as possible. You’ll feel safer that way.”

CreditJulia Rothman

10. Am I ready to handle the day-to-day details of living that my spouse took care of?

“We prepare for most other major transitions, but divorce can seem to erupt like a volcano,” Ms. Paris said, “and our lack of preparation adds to the chaos.”

Understand that you may find yourself paying bills or figuring out taxes for the first time in years. If there are children, who will take the lead in keeping track of their activities calendar?

CreditJulia Rothman

11. How do I keep from making the same mistake the next time around?

Understand that the problem may be you, not the particular marriage. If you are bored in a relationship, you may find yourself bored in another one, too, said Erika Doukas, a clinical psychologist in private practice in Manhattan and Larchmont, N.Y. If you quarrel with your spouse over whose relatives to visit during the holidays, the same conflict may reappear in a subsequent marriage. Dr. Doukas said spouses who were able to realize that they contribute to marital problems could sometimes change course and possibly save a relationship or, failing that, make a future one more long lasting.


The therapy behind play therapy – Counseling Today

Ashley Wroton, a licensed professional counselor (LPC), says parents of her young clients have told her that pediatricians sometimes make comments suggesting that they try “real” therapy with their child rather than play therapy.

“Play therapy is real therapy,” says Wroton, a registered play therapist who works with clients ages 3-12 at a group outpatient practice in Hampton, Virginia. “Play is the medium through which the therapy occurs. … The play helps them open up to make better connections.”

The idea that play therapy isn’t a wholly serious or legitimate approach to therapy is a misconception with which play therapists often contend — including among other helping professionals, says Jeff Cochran, a professor of counselor education and head of the Department of Educational Psychology and Counseling at the University of Tennessee. Perhaps understandably, those not trained in the theory might be skeptical of the effectiveness of allowing a child to explore a room full of art supplies, stuffed animals and toys for the length of the therapy session. However, Cochran explains, under the watchful eyes of a play therapist, the toys are a medium through which the child communicates, learns, self-discovers, shares experiences and forms a trusting therapeutic relationship. The play, he asserts, serves simply as a bridge to therapy.

“Because we refer to it as play, [people assume] it’s supposed to be all light and easy for the child. But, no, it’s work,” says Cochran, a member of the American Counseling Association.

Defining play therapy

The fourth edition of The Counseling Dictionary, published by ACA, defines play therapy as the “use of play as a means of establishing rapport, uncovering what is troubling a person (often achild), and bringing about a resolution.”

Under the broad umbrella of play therapy are a number of focused methods and approaches, ranging from child-centered, filial and dyadic to animal-assisted play therapy. Although most often associated with children, play therapy can also be used in varying forms with teenagers and adults, as well as with children and their parents or their caretakers together. It can also be used in conjunction with more traditional therapy methods such as cognitive behavioral, Adlerian, Gestalt and narrative therapies.

However, simply having some toys in a therapy office or encouraging clients to draw or play with blocks as they talk with a counselor is not play therapy, stresses Dee Ray, an LPC and director of the Center for Play Therapy at the University of North Texas. The 2014 ACA Code of Ethics emphasizes that practitioners should undergo “appropriate education, training and supervised experience” to become fully competent in a specialty area such as play therapy before using it in practice. Practitioners can also obtain special play therapy credentials (such as the registered play therapist credential) through training, supervision and other requirements. These credentials provide practitioners additional credibility and may be preferred by certain employers or clients, Ray explains.

The process

Play therapy generally begins with a period of observation and assessment by the counselor, followed by work to process and focus on challenges the practitioner has identified based on cues the client exhibits during play.

Wroton starts therapy by talking with her child client’s parents or caregivers to hear what they believe the presenting issue is. After first watching the child play on his or her own, Wroton conducts a session in which the child and adult caregivers (or other family members living in the home with the child) play together so she can observe how they interact. Afterward, she talks with the parents or caregivers about what she noticed.

Play therapists learn much through observation, including how the child handles separation from the caregiver when the child is brought into the therapy room, Wroton says. Some children are clingy or start crying when the parent leaves, whereas others don’t seem to mind at all. This provides play therapists cues about the child’s level of attachment.

Other cues can be found in how clients play with objects in the playroom. For example, clients with anxiety, obsessive-compulsive behaviors or control issues are often very structured in their play, Wroton says. They might engage in organizing behaviors rather than playful play. She remembers one young boy who gravitated toward arranging the stuffed animals by category: jungle animals, farm animals, aquatic animals and so on.

At the same time, Wroton says, practitioners need to watch from session to session to see if clients’ play behaviors change at all. At first, organizing behaviors might be a way for clients to soothe themselves or to create order because they’re nervous. But if those same behaviors continue across sessions, they could be an indication of anxiety, autism, past trauma or other issues.

Most important, each client in play therapy will need a tailored approach and a different degree of involvement from the counselor, Wroton says. She notes that some of her clients are very independent while playing, hardly making eye contact with her as she makes observations and asks questions, whereas others invite her to play with them.

Play can run the gamut from imaginative to soothing or sensory, such as child clients painting or placing their hands in water or sand elements. As clients explore and play, Wroton narrates with questions such as “I wonder why this toy is doing that?” or “I notice that you don’t invite me to play. Do you invite other friends to play?”

In imaginative and role-play scenarios, Wroton might ask her child clients, “What could have gone differently?” or “What do you wish had gone differently?” Their answers, along with the scene they have acted out previously, can provide clues about the issues troubling these children. For example, repeatedly arranging toy figures with a “bad guy” in the scene might indicate that a child is struggling with trauma or violence from his or her past.

Wroton says she determines the course of sessions “once I learn how they [the children] do the work and how engaged they are. … I use the dynamic I see in session with them. I use my narration to challenge their thought process, make observations and ask questions. [I] guide and tease at those threads I see coming out.”

The power of play

A quote from play therapy researcher and author Garry Landreth is often used to explain the method’s effectiveness: “In the play therapy experience, toys are like the child’s words, and play is the child’s language.”

In addition to speaking a child’s language, play therapy provides a supportive, therapeutic environment and, therefore, an incubator for learning and healing, Cochran says. “When a therapist is reaching out to the child in kindness, [the child] will gradually open up. It makes all the rest of the pieces work from that therapeutic relationship core,” he says. “They cherish the undivided attention that for some adults might be too intense.”

Cochran and his wife, Nancy, both specialize in child-centered play therapy and together present trainings and workshops on the topic. They co-led an education session titled “Growing play therapy up for older children, adolescents and adults” at the ACA 2018 Conference & Expo in Atlanta this past spring.

“Once the child knows that the therapy hour is a place where they are safe, a spark is lit,” says Nancy, an ACA member and a trainer and consultant in child-centered play therapy with the National Institute for Relationship Enhancement. “With children, that’s the purity of it. The child has the ability to … take the lead and work through to mastery.”

In fact, the crux of what makes play therapy so effective — and different from most other counseling methods — is that it is directed by the client, the Cochrans assert. Play therapists don’t suggest that clients play with a certain toy or work on a presenting problem. Instead, play therapists offer warmth, empathy and a gentle structure for clients to make their own meaning through the exploration and play they chose to engage in.

In play therapy, Jeff explains, the counselor sets up the process that leads to self-discovery on the part of the client. “You let the process teach them,” he says.

“It’s really the child that directs,” Nancy says. “They’ve got a unique voice in here [the play therapy room] which doesn’t always include words. When children are given the chance to go on a journey of self-discovery, they come in and they find a unique voice within that room. Once they find their individual voice, they become more accepting of self. Not only that, but they embrace self.”

Play therapy gives clients a safe space to explore what it feels like to be in control, she adds, with learning opportunities presenting themselves at every turn. As young clients try out the various toys in the playroom, they are learning what they do and don’t like, explains Nancy, an adjunct assistant professor in the Department of Educational Psychology and Counseling at the University of Tennessee. They can also push against preconceived ideas — whether of their own making or instilled in them by others — of what they are and aren’t good at.

In the process, Jeff adds, these clients are learning not only that they can play the xylophone, for example, but that they can take on a challenge and master it.

“They can try and fail and put themselves at risk in sessions [in ways] that they wouldn’t otherwise,” Nancy says. “The process and the therapist’s unconditional positive regard allow the child to make choices and be their own guide. They can be surprised by what is discovered.”

Giving clients control

One of the Cochrans’ graduate students worked with a child referred to play therapy because he was exhibiting obstinate behavior at preschool and not connecting with classmates. The 4-year-old had experienced abuse in his past, and his fear of taking risks discouraged him from trying new things or learning at school. Nancy says that the boy was nonverbal until the 10th session of play therapy.

In his first appointment, the boy was withdrawn and anxious, alternately slouching against the wall, crawling underneath a rug and hiding behind a shelf of toy bins for much of the session. Throughout the session, the Cochrans’ graduate counseling student offered gentle narration, such as “You’re not too sure about this” and “This is difficult for you.” She stayed with him, talking him through the process, which showed that she was committed to allowing him to choose how to proceed in his playtime, Nancy says.

Afterward, the graduate student confided to Nancy that she thought she had failed and had just made the young boy miserable. When they went back and watched video footage of the session together, however, Nancy pointed out something that the counseling student had missed. The boy had repeatedly tossed toys out from behind the shelf where he was hiding, but in the very last minute of the session, he found a pair of toy binoculars and had looked through them directly at the counseling student.

“It showed that he was curious, reaching out and was open to an eventual relationship,” Nancy says. “[I told the student], ‘Think of all the things he expressed and you helped him express. It was so beautiful that you stayed warmly right there with him.’”

Over the course of therapy, the young client opened up more and more. At the second and following sessions, he went behind the shelf and dumped toys out, both to explore and to see how the student counselor would react. He later gravitated to self-expressive work in a sand tray and used the counselor as an ally as he fought with a punching bag and engaged in imaginative role-play and rescue schemes. Eventually, the boy and the counselor played together, with the boy proudly setting up challenges and showing off his skills tossing balls into a toy bin.

The client was in foster care, and over the course of therapy, his play evolved from symbolic to direct expression as he drew pictures of what he wanted his family to look like, Nancy adds.

At one point early on in therapy, the counselor moved in to sit next to the client as he was working at the sand tray. He responded during the next session by putting objects in all the chairs to let her know that he wasn’t quite ready for that, Nancy recalls with a chuckle. “He was in control to let her in, little by little. But from the start, he wanted to know her and wanted her to know him. That connection was made from the very first session by giving him control of when and how — even though that first session wasn’t very playful.”

Watching video footage of the difference between when the client first came to play therapy and later sessions is remarkable, according to Nancy. “When you look across the sessions we did with him, his whole physical presence in the room changes, from looking downcast, to playing, laughing and making eye contact.”

In play therapy, clients learn to shed the defensive behaviors they have established to hide a vulnerable core, Nancy says. “They grow up — or down — to the age they’re supposed to be. You can have a child in play therapy who is 7 years going on 40, or 7 years going on 2. They develop the skills [in play therapy] to be a good, solid 7 years old,” she says. “They try on roles, explore what it feels like to be in control, integrate what is useful and let go of what they don’t need.”

Jeff acknowledges that play therapy’s power of self-discovery “sounds deceptively simple. … It’s hard to believe it can be so impactful.” However, through play, clients are able to examine themselves and push limits to discover patterns of repeated mistakes and blind spots.

For example, a play therapist might see young clients use a doll to act out, fluctuating between caring and nurturing behaviors and hurtful behaviors. Jeff says the counselor can narrate with empathy, accepting all play behaviors and attending to the child’s process as the child makes choices of how she or he wants to be in life.

“Being with a child while she tries on hurtful ways of being can be like allowing a child to have all chocolate for lunch to find out that it’s not actually good,” Jeff says. “They’re playing out what they’re thinking about: ‘How does it feel? What does it mean to me?’ They can fluctuate between what they’ve seen in their life versus what they want.”

Testing limits and making connections

Ray, an ACA fellow and a professor in the counseling program at the University of North Texas, is a registered play therapist and a certified supervisor in both child-centered play therapy and child-parent relationship therapy. She estimates that roughly 70 percent of a play therapist’s work is nonverbal and 30 percent is verbal. When play therapy practitioners do speak, it is typically to offer reflection and encouragement on the play they are observing or to offer guidance such as setting limits, she says.

“If [the child client] is depending on an adult to make decisions, I would respond, ‘In here, it’s up to you.’ If they’re asking, ‘How do I spell this?’ or ‘How do I draw this?’ the answer would be, ‘In here, you can draw or spell it any way you want to,’” Ray says.

When a young client becomes angry or tests limits, the counselor can recognize how the client is feeling and redirect the behavior. For example, when the child gets agitated, the play therapist can suggest that rather than drawing on the wall, they draw together on paper, rip the paper or punch a punching bag, Ray says.

“The child learns that every decision they make has consequences,” she says. “Acknowledge that they do have that feeling, and the feeling is OK. But never say, ‘You can’t.’ Say, ‘This [behavior] is not for doing.’”

This type of limit setting emphasizes that the child’s feelings are valid, Ray explains. It also sends the message that the child’s behavior — not the child himself or herself — is the problem and that there are always other ways of expressing strong feelings through an acceptable behavior. If a counselor presents the limit as “You can’t,” it implies that something about the child is not OK, Ray says. This type of response also might engage the child in a power struggle with the counselor by personalizing the expression of the feeling, she explains.

Children will naturally bump up against limits as a form of exploration, so play therapists will often see young clients who want to climb on things, break toys or exhibit other destructive behaviors, Jeff Cochran says. As with so many aspects of play therapy, the manner in which the counselor diffuses these urges can be an opportunity for self-discovery.

“We start with a simple opening message: ‘In this room, you can say anything you want and do almost anything you want, and if there’s something that’s not OK to do, I will tell you,’” Cochran says.

When the child does bump into a limit, the play therapist responds with empathy to the child’s experience in that moment and limits as little of the child’s behavior as possible — just enough to keep the child and therapist safe and the therapy room functional. “That in itself becomes therapeutic,” Cochran says. “They learn that there are ways to express themselves other than pushing boundaries. The therapist doesn’t have to make that happen; it’s a naturally occurring thing. They learn themselves who they are and what they want. Is what you are doing going to get you what you want?”

The growth and learning that begin in play therapy naturally carry over and are applied elsewhere in clients’ lives, Wroton says. In other words, the “work” of play therapy continues, even if the play therapist doesn’t observe a direct cause and effect in sessions, she says.

Wroton remembers one client, a 9-year-old boy, who had been adopted after going through the foster care system. Before being removed from his birth home, he had been exposed to graphic sexual content, anger, violence and alcohol abuse. In play therapy, he responded well and gravitated to making scenes in a sand tray.

Wroton told the boy, “I want to know what it’s like to be in your world.” Repeatedly, he would respond to this prompt by creating a scene that involved a king figure and several blue Smurfs. He would bury and uncover the Smurfs, and then rebury them. When he was finally finished making his scene, the Smurfs would always remain buried beneath the sand. They weren’t uncovered until it was time to clean up, Wroton says. The boy didn’t identify who or what these figures might represent, simply referring to them as “Smurfs,” she adds.

Then, one day, something changed for the client: He buried and reburied the Smurfs like usual, but he also buried the king and left him beneath the sand. Afterward, Wroton received a call from the client’s adoptive mother. Her son, who previously had never talked much about his past, was suddenly opening up and connecting more with her.

Wroton thinks the Smurfs and king figure in the boy’s sand tray scenes represented experiences and feelings that the young client had tucked away — including family members who were abusive yet for whom he also held some positive memories. Through the sand tray, he was processing these feelings and coming to terms with what the memories meant to him.

“Typically, a change in play means a change in processing,” Wroton says. “What motivated him that day, I’m not sure. For a month and a half, he had played out that scene over and over with the same characters. We might do the work here, but the application of it, and the completion of the work, is done [outside of session]. And that’s the end goal.”

What lies beneath

Ray thinks there is no better method than play therapy for reaching children who have behavioral or mental health challenges. “So many of our interventions are about telling, doing and suggesting. But in play therapy, we trust the client to know where they need to go,” says Ray, a past president of the Association for Child and Adolescent Counseling, a division of ACA. “It’s an intervention that trusts the child — they know where to go to solve their own problems and move toward self-enhancing solutions. If you offer a relationship that facilitates growth, the child is able to make the change through the developmentally appropriate language of play.”

“It’s something that is very, very different than most mental health interventions,” Ray continues. “It’s not acting upon the child; it’s acting with the child.”

The self-directive aspect of play therapy reached one of Ray’s clients in ways that other more direct methods might have failed to do. The 8-year-old girl was referred to Ray by her school because of aggressive behavior, which included being suspended after trying to hit her teacher. However, in play therapy, the girl never mentioned any anger regarding school, her teacher or her classmates. Instead, she played out scenes from her family and home life, where, it turns out, she was being abused.

In play therapy sessions with Ray, the client gravitated toward drawing her family and setting up scenes with figures in a dollhouse. As the characters in the dollhouse would interact, the girl would exhibit what Ray calls a “play disruption.” In the middle of a dollhouse scene, the girl would become more active and move through the room, often throwing or trying to break things. After directing her energy and aggression in this way, she was able to finish her scene in the dollhouse.

The girl wasn’t willing to talk with anyone about her family issues at school. The style of her play in play therapy, however, was an outlet for her to communicate and process what was happening. The young client talked about specific abuses that were happening at home during the family scenes she played out in therapy, Ray says.

Once the root of the child’s struggles became clear, Ray took the necessary steps to report the suspected abuse, documenting what the client had verbalized in session. Through play, the client formed a therapeutic bond with Ray and was able to work through what was troubling her. As a result, the child’s aggressive behavior at school dissipated.

“If I had brought the child in and said, ‘Let’s talk about how you’re aggressive at school,’ she would have shut down and not talked,” Ray says. “Having a counselor who trusts a child is so different than what many children experience [from adults]. That message of, ‘I’m going to accept you no matter what and trust that you know where you need to go,’ that, to me, is the healing factor of play therapy. It’s predicated on this amazing factor that if you put a child in an environment where they have control, they will move toward change.”

Not just for kids

Missy Galica, an ACA member and LPC intern in Lubbock, Texas, uses sand tray therapy in her work with adult clients, including college students from Texas Tech University. The medium can be particularly helpful for clients of any age who are struggling to find the words to articulate how they are feeling, she says.

What brings many of Galica’s college-age clients to counseling are academic struggles. By creating scenes in a sand tray, the students are often able to work through nonacademic issues that are troubling them and spilling over into their behavior and schoolwork.

Sand tray work “is good for those who just aren’t good at [verbal] communication or for those whose brains work faster than their mouths,” Galica says. “The sand tray makes them slow down. You really have to think about what you’re doing. You have to think about the representation and object placement. It’s also good for those who get nervous or people who just don’t like getting grilled with questions [from a counselor.] It gives them time to explore what they want to say, and they don’t have to have answers right away.”

As is the case with child-centered play therapy, sand tray work is nondirective. The client chooses what gets made in the sand tray and the meaning attached to it. Counselors should be careful to prompt clients to describe and talk about the scenes they have made in the sand tray without interjecting their own observations, Galica emphasizes.

“If you don’t ‘get it’ at first, if you don’t see a meaning, it’s OK. It’s the client’s space to do what they need to do,” she says. “Anything you can think of that happens in life can be represented in a sand tray, [but] don’t make any assumptions. Ask the client what things represent. You may see something and assume, ‘Oh, this is XYZ,’ but it may be the opposite.”

As part of the meaning-making process, Galica takes photos of each scene after clients finish their sand trays. Later, they look at the photos together, talk about the progress the client has made and discuss how the person’s sand tray scenes have evolved. This is also a good way to track and prompt discussions of representations that come up repeatedly with clients, Galica says.

Clients often have to take some time to think it through before they can explain the scenes they have created in their sand trays. Many times, Galica says, issues and challenges that have been troubling clients don’t become clear to them until they see the issues played out in a sand tray. For example, a client who is feeling overwhelmed with school or home life might put figures all in a jumble on top of one another. Or a client may use one object to represent themselves and place another object or objects at a distance or facing away from them. In this case, the client may be struggling with loss, attachment issues or fear of letting loved ones down. Ultimately, however, it is up to the client — not the counselor — to discover and talk through the issue that has taken shape in the sand tray. At the same time, the counselor provides the prompting and support to help and encourage the client, Galica says.

“It can be tempting to ask, ‘What are you doing?’ or ‘What does that mean?’ But don’t stop them. Let it play out. Wait to the end and then say, ‘Talk to me about this. Describe it for me,’” Galica suggests. “Often, it will be something you [the counselor] never would have thought of. I learn something new every day.”

Galica recalls a particular client whose parents wanted him to become an engineer and were paying his way through college. He hated his engineering courses, however, and harbored a desire to become a jazz musician. This had manifested into academic and other struggles while he was away from home. When the client made sand tray scenes, he often placed a female figure at a distance from the figure he used to represent himself. After multiple sand trays and discussions, it became clear that the client was terrified to tell his mother he didn’t want to be an engineer.

Galica began to focus on that fear with the client, asking him to express his feelings in a draft letter to his parents. She also had him speak to an empty chair as if his mother were there, which is a technique often used in Gestalt therapy. It took the student the entire semester before he felt prepared to tell his parents about his own dreams for his future.

As clients play out situations in sand trays, Galica asks them to show her what they would want life to look like if they had a magic wand to fix everything they were struggling with. What would a resolution look like? What would it look like in five, 10 or 20 years? From there, Galica and her clients talk through the issues and consider options for arriving at realistic resolutions.

Galica says sand trays can easily be used in conjunction with any modality to which a counselor is loyal. She regularly uses them along with cognitive behavior therapy for her college-age clients. Another benefit, she notes, is that the materials are readily available and easily transportable. Practitioners can pick up a plastic tray, sand and small figurines at any big box or craft supply store.

Sand tray work is a method that many counselors might not consider for adult clients “because we’re culturally conditioned [to think] that we don’t play after a certain age,” Galica says. However, sand tray work is very accessible (for both counselor and client), creative and versatile, she asserts.

“Broadly, it’s a way for clients to communicate without having to use words, because they may not have the words,” Galica says. For the client, it means, “I don’t have to stare you in the eyes and tell you all my secrets; the sand tray will tell you. … The beautiful thing about this is that as a counselor, there is no [need to assign] meaning. The only meaning comes from the client.”


To contact the counselors interviewed for this article, email:


Additional resources

Books published by ACA (Available at counseling.org/publications/bookstore)

From Counseling Today (ct.counseling.org)

ACA divisions

  • The Association for Child and Adolescent Counseling: acachild.org

Search for podcasts, online courses and other ACA resources at aca.digitellinc.com/aca/


Bethany Bray is a staff writer and social media coordinator for Counseling Today. Contact her
at bbray@counseling.org.

Letters to the editorct@counseling.org


Opinions expressed and statements made in articles appearing on CT Online should not be assumed to represent the opinions of the editors or policies of the American Counseling Association.

How Narcissists Conduct Psychological Warfare

Narcissists often lack a conscience, so climbing in the ring with one is like bringing a knife to a gun fight. Wielding cruelty and abuse like it’s their right, the narcissist easily wounds a person with a conscience who often feels guilty for firing back. The guilt perpetuates feelings of responsibility and self-doubt, frequently causing the person with a conscience to surrender. So how does a person create a fair fight? The most effective way is to fully understand the narcissist’s most lethal weapon, projective identification, and to disarm in article continues after advertisement

It’s truly amazing how unfair, underhanded and malicious a narcissist can be, but rarely do they feel true remorse for their deeds. Readily deflecting, distorting, and projecting, they alter their perception of reality, freeing themselves from accountability while simultaneously projecting blame onto another. Their line of unconscious defense mechanisms operates like a force field around their ego, excusing them from deep and sincere feelings of remorse, insight, introspection, and accountability. Thus, they feel like they are never wrong.

Occasionally, when their back is against the wall, the narcissist may act as though they feel sincere remorse. However, this may be a trick to regain the trust of the person whom they are manipulating. Also, operating from a victim stance assists him or her in controlling others through guilt.

Projective identification is the most powerful psychological mechanism in a narcissist’s arsenal. It is what creates the toxic chemistry that psychologically chains an empath to a narcissist. Projection, which is the first component of projective identification, is a psychoanalytic term used to describe the unconscious process of expelling one’s own intolerable qualities and attributing them to someone else. For example, an individual who routinely acts rude may call someone else rude. This person does not see the quality in himself or herself but perceives it in others. Narcissists utilize this defense mechanism routinely. In couples counseling, for example, I often hear the narcissist in the relationship “diagnose” their partner as the narcissist. article continues after advertisement

Identification is the second component and is the empath’s role. An empath’s access to deeper emotions such as insight, introspection, deep remorse, accountability, and empathy, automatically qualifies them as less rigidly defended. Most of the deeper capabilities cause the ego to experience a tinge of pain, so a person who has access to the deeper emotions has a stronger ego. It requires fewer defensive structures to be activated. As a result of this “open heart,” the empath unknowingly absorbs the projections from the narcissist and unconsciously identifies them as their own. As the narcissist projects his or her shameful qualities onto the empath, the empath instantly feels shame, insignificance,and incompetence.

These feelings cause a tremendous amount of self-doubt in the empath. Suddenly, he or she is vulnerable to believing the distortions communicated by the narcissist. Eventually, they are convinced they are the root of the problems in the relationship, so they begin to cater and appease, giving the narcissist control. The narcissist takes advantage of their power and intensifies their tactics to isolate and cause conflict with the empath’s friends, family, and work relationships. The empath’s sense of self slowly erodes, and their support system wanes, so they begin to feel dependent on the narcissist, ensnared in the lethal cycle of projective identification.

Breaking the chain of projective identification requires the empath to become consciously aware of this unconscious dynamic. Once the insidious psychological mechanism is illuminated, the empath’s knowledge protects them from believing the narcissist’s distortions about who they are. After recovering elements of their sense-of-self that were lost, an empath regains the strength to strive for space and independence from the narcissist. Once the empath has succeeded in creating distance in the relationship, he or she is safe from the narcissist’s projections.

Feeling Stuck or Anxious? Change Your Story to Move Forward

Whether we are thinking about events that happened in the past, are happening now, or will happen in the future, the stories we tell ourselves and the ways in which we think about negative events in our lives can influence our emotional reactions. Over-focusing on the negative emotional content of events or replaying them over and over in your mind can actually make you ruminate more and feel worse over time. Think about your last breakup or your last interaction with a mean person! It’s easy to just relive the feelings over and over again, feeling worse and creating more negative meanings with each new round. But there is a silver lining! Recently, researchers at the University of Michigan and the University of California, Berkeley have found that certain ways of thinking about events can actually be helpful and lead to new perspectives or diminished distress and anxiety.article continues after advertisement

In this article, you will read about three such perspective-taking tools and the research that supports them.

1. The “Fly on the Wall” Perspective

When you picture a negative event in your mind, you may imagine the event as if it is happening to you right now, with you at the center of things. However, it is also possible to picture the event from an “observer” perspective as if you were a fly on the wall, watching the event happening to a distant self. It turns out that adopting the “fly on the wall” approach can actually create psychological distance, which gives you a bit of space from being caught up in your negative thoughts and feelings about the event. In a series of studies, researchers compared the effects of reflecting on past emotional events (e.g., events that made them feel sad, anxious, or angry) from a self-immersed versus self-distanced perspective. The results showed that the self-distanced group were less likely to re-experience the negative emotions associated with the event, were more likely to report thoughts about the event that reflected new insights and a changed perspective (e.g., new understandings of why you or others behaved as they did, more closure), and were less likely to ruminate about the event in the upcoming week.

Similar results were found when the participants focused on an anxiety-provoking future event. Those in the self-distanced group were more likely to think about the event as a challenge versus a threat, and they showed less physiological signs of anxiety (e.g., elevated heart rate or blood pressure) when thinking about the event. Statistical analyses showed that these effects may have been due to the self-distanced group picturing the upcoming event with less vivid imagery. Vivid imagery is known to create more intense negative emotions. Therefore, picturing an event with less vivid imagery should make it seem less threatening.article continues after advertisement

2. The “Not Me” Perspective

For most of us, it is easier to stay objective and give wiser advice when we are considering a friend’s problem rather than our own troubles. One reason for this may be that focusing on negative qualities of the self can create intense negative feelings. Thinking about ourselves as cowardly or unlovable or incompetent, for example, can create negative emotionality that interferes with problem-solving. Finding distance from the self may help us stay more objective and rational. Another way to find distance from the self, aside from imagery, is to talk about ourselves in the third person, either using our name or the pronouns “he” or “she” or “you,” rather than “I” or “me.”

The researchers tested this out by asking participants to “prepare themselves psychologically” for meeting a new person. One group was told to think about the upcoming interaction using “I” or “me” terms, and the other group was told to use their own names or non-first-person pronouns (e.g., “Melanie will tell jokes to make the other person comfortable” versus “I will tell jokes”). Both groups then met with a confederate of the opposite sex, and their interactions were rated by judges who did not know which condition the participants were in. As predicted, the judges rated the “Not Me” group as performing better overall than the “Me” group. The “Not Me” group also reported feeling less anxious during the interaction compared to the “Me” group.article continues after advertisement

3. The “Time Travel” Perspective

A third way to create some space from your immediate feelings about a situation is to picture how you might feel about this same situation in the future. Generally, most people believe that the future will be better than the past, and that time heals negative feelings. We also believe that we will likely get wiser and more objective with age. Thinking of a future self is another way of creating psychological distance from difficult feelings. In a series of studies, the researchers compared the effects of thinking about their stressors from a “near-future” perspective (one week from now) versus a “far-future” perspective (10 years from now). Using stressors ranging from work deadlines to the death of a spouse, participants who were instructed to adopt a “far-future” perspective reported less distress about the event they were thinking of. This result held both for completed events and those that were still ongoing. In another study, the researchers looked at various possible explanations for this effect and found that the key ingredient in reducing distress was “impermanence focus,” or telling yourself that your current feelings are temporary and will pass or diminish over time.

Take-Home Message

This exciting new line of research provides growing evidence that creating psychological distance from negative memories or threatening future events can help you regulate negative emotions or find less threatening, more objective ways to view the events. These techniques seem to help lessen the intensity of negative emotions so they don’t perpetuate future rumination or anxious anticipation. It’s all in the stories we tell ourselves!


Kross, E., & Ayduk, O. Self-Distancing: Theory, Research and Current Directions. Advances in Experimental Social Psychology 55, 81–136 (2017).

White, R. E., Kuehn, M. M., Duckworth, A. L., Kross, E., & Ayduk, Ö. (2018, September 17). Focusing on the Future From Afar: Self-Distancing From Future Stressors Facilitates Adaptive Coping. Emotion. Advance online publication. http://dx.doi.org/10.1037/emo0000491

Psychology Today

4 Ways Porn Warps the Male Brain

“I love looking at porn. Besides, it doesn’t hurt anything. It’s only fantasy. What’s the problem?”

Now, you may not have a moral problem with porn, but many are starting to have a medical problem with it. The more we study the impact of porn on the male brain, the more men are starting to think twice about porn being a harmless pastime.

1. Porn gives men a new standard of beauty.

In 2002, the Journal of Sex and Marital Therapy, published research showing that when men are shown pictures of centerfold models from Playboy and Penthouse, this significantly lowered their judgements about the attractiveness of “average” people.

In our hyper-sexualized media culture, is this something that really needs to be reinforced? Should we train our brains to rate women by the size, shape, and harmony of their body parts? Do we want our standard of beauty to be shaped by a fictional standard or by the woman we are actually in love with?

2. Male brains don’t just view porn. They enter into it.

The journal NeuroImage published a study in 2008 demonstrating that as men are sexually aroused by porn films, something called “mirror neurons” in the brain also fire.

What is a mirror neuron? Have you ever seen someone get hit in the face with a ball or some other blunt object, and then your own body recoils? This is because of mirror neurons: you instantly react as if you were the one hit.

When it comes to porn, the brain naturally imagines the viewer in the pornographic scene. When a man is turned on by porn his body is not merely responding to the naked woman. His brain is picturing himself as the main character, heightening the arousal. You see, porn isn’t merely arousing to men because the women in it are attractive, but because it makes the man feel sexy.

This trains men not to get their sense of personal validation from real life relationships but from pixels on a screen.

3. The more porn men watch, the more their brains look like an addict’s brain.

In 2014 scientists at Cambridge discovered that the brains of habitual porn users show great similarity to the brains of alcoholics. When a self-confessed porn addict is hooked up to an MRI machine and then is shown a pornographic image, a brain structure called the ventral striatum “lights up” in the same way it lights up for an alcoholic who sees a picture of an drink.

You might be thinking, “So what?” Well, researchers speculate that continued use of porn over time, especially starting at younger ages, makes it such that we actually lose willpower. The more we watch porn, the more difficult it is for men to say to no to watching porn because of the strong craving they feel.

This is not the kind of men most men want to be. We want to enjoy our passions, not be enslaved to them.

4. Porn makes violence sexy.

According to research by Dr. Dolf Zillmann and Dr. Jennings Bryant, the more porn one is exposed to, the more likely one is willing to trivialize rape. In their experiments, after watching just five hours of pornographic films stretched over a six-week period, subjects were willing to cut the sentencing of an accused rapist nearly in half, compared to those who had not watched pornography at all.

Those who watched more porn were also likely to believe that practices like sadomasochism were two to three times more common in general society than those who had not seen porn. Of course porn doesn’t make most consumers into sexually violent people, it does train men to embrace a culture of objectification, reinforcing a belief that women exist to give sexual pleasure to men. Again, is this the kind of men we want to become?

Let me make an appeal to men:

  • if your goal is to become a man whose standard of beauty is shaped by the one you love…
  • if your goal is to feel a personal sense of worth and validation based on your most valuable relationships…
  • if your goal is to be a man of self-mastery, not enslaved to your passions…
  • and if your goal is to treat women as people to be served and loved, not see them as objects for your pleasure…

…then consuming porn will take you in the opposite direction.



Her Cheating Heart: Understanding Why She Cheated on You

Source: Sementsova Lesia/Shutterstock

First things first: If you’re female and reading this wondering why I’m only writing about women who cheat, know that a post I published a few months ago — “13 Reasons Why Men Cheat” — has become one of my most widely read, with over 1 million views.

But now it’s time to look at female infidelity.

There is a common misperception that it’s only men who step out on their partners, and that women are always faithful. To that, I say: Who are all these men cheating with exactly? Do heterosexual men only cheat with single women and each other?

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The simple truth is that approximately as many married, heterosexual women cheat as married, heterosexual men. Research suggests that 10 to 20 percent of men and women in marriages or other committed (monogamous) relationships will actively engage in sexual activity outside of their primary relationship. And these numbers are likely under-reported, possibly by a wide margin, thanks to denial and confusion about what constitutes infidelity in the digital era. For example: Are you cheating if you look at porn? If you flirt on social media? If you have a profile on Ashley Madison that you check regularly, even though you never hook up in person?

To help couples answer these questions, I offer you my fully functional, digital-era definition of what it means to cheat:

Infidelity (cheating) is the breaking of trust that occurs when you keep profound, meaningful secrets from a committed primary partner.

I like this definition for four primary reasons:

1. The definition speaks to the most basic element of what happens when we cheat on our partners. We betray their trust. In such cases, even more than our sextracurricular activity, it is the lying and the secrecy of betrayal that wounds a beloved and unknowing partner (male or female).

2. The definition encompasses both online and real-world sexual activity, as well as sexual and romantic activities that stop short of intercourse: everything from looking at porn to kissing another man/woman to something as simple as flirting (now commonly referred to as micro-cheating).

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3. The definition is flexible depending on the couple. It lets couples define their own version of sexual fidelity based on honest discussions and mutual decision-making. This means that it might be just fine to look at porn or to engage in some other form of extramarital sexual activity, as long as your mate knows about this behavior and is okay with it.

4. The definition helps the cheater understand that the problem he or she created occurred the moment he or she started lying to accommodate or cover up his or her infidelity. The harm is not a spouse finding out the bad news — the harm is that it was covered up.

None of that, of course, explains why women cheat. Nor does it address the fact that women and men often cheat for very different reasons.

So Why Do Women Cheat?

Typically, females step out on a committed partner for one or more of the following reasons:

  • They feel underappreciated, neglected, or ignored. They feel more like a housekeeper, nanny, or financial provider than a wife or girlfriend. So they seek an external situation that validates them for who they are, rather than the services they perform.
  • They crave intimacyWomen tend to feel valued and connected to a significant other more through non-sexual, emotional interplay (talking, having fun together, being thoughtful, building a home and social lifetogether, etc.) than sexual activity. When they’re not feeling that type of connection from their primary partner, they may seek it elsewhere.
  • They are overwhelmed by the needs of others. Recent research about women who cheat indicates that many women, despite stating that they deeply love their spouse, their home, their work, and their lives, cheat anyway. These women often describe feeling so under-supported and overwhelmed by having to be all things to all people at all times that they seek extramarital sex as a form of life-fulfillment.
  • They are lonely. Women can experience loneliness in a relationship for any number of reasons. Maybe their spouse works long hours or travels for business on a regular basis, or maybe their spouse is emotionally unavailable. Whatever the cause, they feel lonely, and they seek connection through infidelity to fill the void.
  • They expect too much from a primary relationship. Some women have unreasonable expectations about what their primary partner and relationship should provide. They expect their significant other to meet their every need 24/7, 365 days a year, and when that doesn’t happen, they seek attention elsewhere.
  • They are responding to or re-enacting early-life trauma and abuse.Sometimes women who experienced profound early-life (or adult) trauma, especially sexual trauma, will re-enact that trauma as a way of trying to master or control it.
  • They’re not having enough satisfying sex at home. There is a societal misconception that only men enjoy sex. But plenty of women also enjoy sex, and if they’re not getting it at home, or it’s not enjoyable to them, for whatever reason, they may well seek it elsewhere.

As with male cheaters, women who cheat typically do not realize (in the moment) how profoundly infidelity affects their partner and their relationship. Cheating hurts betrayed men just as much as it hurts betrayed women. The keeping of secrets, especially sexual and romantic secrets, damages relationship trust and is incredibly painful regardless of gender.

If a couple chooses to address the situation together, couple’s counseling can turn a relationship crisis into a growth opportunity. Unfortunately, even when experienced therapists are extensively involved with people committed to healing, some couples are unable to ever regain the necessary sense of trust and emotional safety required to make it together. For these couples, solid, neutral relationship therapy can help the people involved to process a long overdue goodbye. But cheating doesn’t have to be seen as the end of a relationship; instead, it can be viewed as a test of its maturity and ability to weather the storm.

4 Tips to Practice Mindfulness Based on New Research

Source: DepositPhotos/VIA Institute

“I forgot.”

“I’m too sleepy.”

“My mind is wandering.”

“I don’t have time.”

These are the thoughts and beliefs that stand between you and a mindfulness routine that can change your life. These are the most common obstacles that people report in mindfulness programs. They are all real and very normal…and also entirely surmountable. An important part of one program, Mindfulness-Based Strengths Practice (MBSP), involves the direct use of character strengths to overcome any obstacle you are facing.

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In addition, new research by Kelly Birtwell and colleagues in England, finds there are four main supports to help you with your mindfulness practice. You’ll be keeping up with your practice in no time.

1. Practical Resources

What are the concrete tools or resources that will help you with your practice? Perhaps you need an app or MP3 audios to get you started? Maybe you want to read a newsletter or blog post about what others are doing with their mindfulness practice? Perhaps you want to dig deep with a meditation book or a review of why mindfulness is beneficial?

Those who are interested and committed to mindfulness but who struggle with the discipline of the practice, or who forget to practice, might turn to the resource of cues. Cues are visuals, sounds, or tactile elements in your environment that remind you to be mindful. The sound of a bell, the tactile feel of a bracelet on your wrist that says “just be,” or the visual of your meditation chair, can all bring you back to the present moment. Turn to your love of learning strength to decide what you need to learn most and what will help you get there.

2. Time/Routine

How will you make time during your day to practice? Research has found that what’s more important in the practice of mindfulness is having a steady practice (high frequency) rather than long periods of practice (duration).

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Many people find it useful to link mindfulness with their daily activities. One example is to practice mindful breathing for 3 minutes before breakfast and dinner each day; another example is to start your day with 5 minutes of walking meditation after you get out of bed each morning. Discover what works best for you.

The key idea here is to create a routine that you will remember and keep up with. To create a good habit with mindfulness, be sure to think about how your highest strengths of character can help you. If you’re high in gratitude, embed a gratitudepractice into your routine. If you’re high in curiosity, be sure to involve time during your meditation for open and exploratory questions about your present-moment experience.

3. Support from Others

A central path for sustaining mindfulness practice is to be part of a community that practices. This can be in-person as a group, in-person online, or it can be a group that comes together to discuss their practice (and everyone practices on their own). The key idea here is that you feel supported in your practice.

Here’s how David described his experience in an online meditation group:

“When we come together as a group I get this sense that we’re all in this together. All of us are trying to improve ourselves with mindfulness. We all have challenges with the practice, from time to time. But there’s no judgment or feeling that one person is better than someone else. We all have our issues and are trying to move forward, together.”

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Other examples of support include having contact with a mindfulness teacher, having a “mindfulness buddy,” or participating in social media outlets on the topic. These connections do not have to be daily or weekly, they could be monthly connections. Examples of supportive communities can also be found in workplaces and schools where students or employees look forward to a weekly practice group or just a place to talk about the practice with one co-worker or a student group.

4. Attitudes and Beliefs

How you think about mindfulness, how you feel about it, and the character strengths you put forth in regard to mindfulness will go a long way in determining your degree of success at keeping up with mindfulness.

If you avoid the hundreds of scientific articles pointing out the benefits of mindfulness and you focus solely on one negative blogpost about how one person doesn’t like it, you will probably have a negative attitude. But if you keep a curious and open attitude, one marked by self-kindness when you forget to practice and self-forgiveness when you struggle, then you’ll probably be cultivating a healthy set of beliefs about the practice.

A couple of concluding reminders about healthy beliefs you can cultivate in regard to your mindfulness practice:

  • You have the resources (i.e., character strengths) to mindfully approach stress and problems.
  • Pursue your mindfulness practice imperfectly.

Other mindfulness articles you might find interesting:


Birtwell, K., Williams, K., van Marwijk, H., Armitage, C. J., & Sheffield, D. (2019). An exploration of formal and informal mindfulness practice and associations with wellbeing. Mindfulness, 10, 89-99. https://doi.org/10.1007/s12671-018-0951-y

When I’m With You: Addressing Youth Suicide | Psychology Today

Source: Alexander Raths/Shutterstock

The current hit song “I Like Me Better” by Lauv highlights the powerful nature of connection with others. Perhaps it’s those relationships that hold the key to addressing the epidemic that is youth suicide.

The Jason Foundation, a youth suicide prevention organization, has established a “Triangle of Prevention,” by providing students, parents and teachers the tools and resources necessary to try to identify and help at-risk youth.article continues after advertisement

Those they say are most at risk include the following.

  • Gay and lesbian youth
  • Learning disabled youth
  • Loners
  • Youth with low self-esteem
  • Depressed youth
  • Students in serious trouble
  • Abused, molested, or neglected youth
  • Youth with a genetic predisposition

Citing data collected by the Search Institute, CNN reported this month that “nearly 14 percent” of the 120,617 youth surveyed (ranging in age from 11-19) reported trying to kill themselves. Transgender teens reported the highest rates of suicide attempts (Scutti, 2018).

The Jed Foundation also notes that suicide is the second-leading cause of death for teenagers and young adults and offers the following “warning signs” that someone may be thinking of dying by suicide.

  • Talking about or making plans for suicide
  • Displaying hopelessness about the future
  • Expressing marked emotional pain or distress
  • Showing changes in behavior, such as:
    • Withdrawal from friends and family
    • Changes in sleep (increased or decreased)
    • Anger or hostility that seems out of character or out of context
    • Recent increased agitation
  • Withdrawal from friends and family
  • Changes in sleep (increased or decreased)
  • Anger or hostility that seems out of character or out of context
  • Recent increased agitation

The National Alliance on Mental Illness (NAMI), sponsor of the CureStigma campaign, says, “Each year, more than 41,000 individuals die by suicide, leaving behind their friends and family members to navigate the tragedy of loss … Too often the feelings of shame and stigma prevent them from talking openly” (NAMI, 2018).article continues after advertisement

“Postvention” recommendations for survivors were addressed in a February 2017 Psychology Today article, “Falling to Pieces,” following the suicide death of a Connecticut prep school senior. In it were common questions that were asked after a suicide and answered by Scott Poland, Ed.D., a CARE advisory board member and professor at Nova Southeastern University.

Why did he die by suicide? We are never going to know the answer to that question as the answer has died with him. The focus needs to be on helping students with their thoughts and feelings and everyone in the school community working together to prevent future suicides.

Didn’t he make a poor choice and is it OK to be angry with him? He did make a very poor choice, and research has found that many young people who survived a suicide attempt are very glad to be alive and never attempted suicide again. You have permission for any and all of your feelings in the aftermath of suicide, and it is OK to be angry with him. The suicide of a young person has been compared to throwing a rock into a pond with ripple effects in the school, church, and community at large, and there is often a search for a simple explanation. These ripple effects have never been greater than at the present, with the existence of social networks (e.g., Facebook) … Many individuals who died by suicide had untreated mental illnesses, and it is important that everyone is aware of resources that are available in the school and community so that needed treatment can be obtained.article continues after advertisement

Isn’t someone or something to blame for this suicide? The suicide victim made this decision and there is no one to blame. The decision to die by suicide involved every interaction and experience throughout the young person’s entire life up until the moment he died, and yet it did not have to happen. It is the fault of no one.

How can I cope with this suicide? It is important to remember what or who has helped you cope when you have had to deal with sad things in your life before. Please turn to the important adults in your life for help and share your feelings with them. It is important to maintain normal routines and proper sleeping and eating habits, and to engage in regular exercise. Please avoid drugs and alcohol. Resiliency, which is the ability to bounce back from adversity, is a learned behavior. Everyone does best when surrounded by friends and family who care and by viewing the future in a positive manner.

Important considerations, one and all.

Even so, perhaps our best efforts can be expended on preventing suicides in the first place. JFI states that four out of five teens who attempt suicide give “clear warning signs.” Because peers may be the first to become aware of a plan for suicide, TeensHealth provides some tips on how they might respond, with two of the most important ones being to ask and listen. “If you have a friend who is talking about suicide or showing other warning signs, don’t wait to see if he or she starts to feel better. Talk about it. Most of the time, people who are considering suicide are willing to discuss it if someone asks them out of concern and care … Listen to your friend without judging and offer reassurance that you’re there and you care. If you think your friend is in immediate danger, stay close—make sure he or she isn’t left alone” (TeensHealth, 2018).

Others analyzing recent research, including The Social Good founder Curtis Hougland, see trends leading away from telltale signs. He told me, “The data is showing that suicide is less related to mental health disorders. It is often a cultural contagion, and timing is everything.”

Also in play is the precipitous rise in the use of smartphones by young people. In her November 2017 article “With Teen Mental Health Deteriorating Over Five Years, There’s a Likely Culprit,” Jean Twenge, a professor of psychology at San Diego State University, points to evidence of a link between the proliferation of smartphones and increasing rates of mental health issues among young people. She says, “Around 2012, something started going wrong in the lives of teens. In just the five years between 2010 and 2015, the number of U.S. teens who felt useless and joyless—classic symptoms of depression—surged 33 percent in large national surveys. Teen suicide attempts increased 23 percent. Even more troubling, the number of 13- to 18-year-olds who committed suicide jumped 31 percent” (Twenge, 2017).

More recently, in her New York Times op-ed “Taking Away the Phones Won’t Solve Our Teenagers’ Problems,” Tracy A. Dennis-Tiwary, a psychology professor at Hunter College and the Graduate Center of the City University of New York, pushes back on the notion that “excessive and compulsive” smartphone use causes mental health problems. She says, “In other words, there simply does not yet exist a prospective longitudinal study showing that, all things being equal, teenagers who use smartphones more often or in certain ways are more likely than their fellows to subsequently develop mental illness.”

Dennis-Tiwary advocates for large studies following people over time to reveal correlation and concludes, “Yes, we should devote resources to making smartphones less addictive, but we should devote even more resources to addressing the public health crisis of anxiety that is causing teenagers so much suffering and driving them to seek relief in the ultimate escape machines” (Dennis-Tiwary, 2018).

In the meantime, we can all give the gift of being with the young people we know.

For immediate help, 24/7: National Suicide Prevention Lifeline, 1-800-273-TALK, or Crisis Text Line by texting TALK to 741741.

To find therapists near you, see the Psychology Today Therapy Directory.


Dennis-Tiwary, T. (2018). Taking away the phones won’t solve our teenagers’ problems. The New York Times. July 14, 2018. https://www.nytimes.com/2018/07/14/opinion/sunday/smartphone-addiction-teenagers-stress.html (17 Sept. 2018).

JED. (2018). Youth suicide. The Jed Foundation. https://www.jedfoundation.org/youth-suicide/ (17 Sept. 2018).

JFI. (2018a). Resources. Jason Foundation, Inc. http://jasonfoundation.com/youth-suicide/resources/ (17 Sept. 2018).

JFI. (2018b). Warning signs. Jason Foundation Inc. http://jasonfoundation.com/youth-suicide/warning-signs/ (17 Sept. 2018).

Lauv. (2017). I like me better. WaveMusic. May 21, 2017. https://www.youtube.com/watch?v=cQhV-PfMoh4 (17 Sept. 2018).

Miller, C. (2018). Does social media cause depression? How heavy Instagram and Facebook use may be affecting kids negatively. Child Mind Institute. https://childmind.org/article/is-social-media-use-causing-depression/ (17 Sept. 2018).

NAMI. (2018a). Suicide Prevention Awareness Month. National Alliance on Mental Illness. https://www.nami.org/suicideawarenessmonth (17 Sept. 2018).

NAMI. (2018b). Cure Stigma. National Alliance on Mental Illness. https://www.curestigma.org/ (17 Sept. 2018).

Poland, S. (2016). After a suicide: answering student questions and providing support. Nova Southeastern University. http://www.nova.edu/suicideprevention/forms/after-a-suicide-answering-questions-from-students.pdf (17 Sept. 2018).

Scutti, S. (2018). Among teens, transgender males are most likely to attempt suicide, study says. CNN. September 11, 2018. https://www.cnn.com/2018/09/11/health/transgender-teen-attempted-suicide-study/index.html (17 Sept. 2018).

TeensHealth. (2018). Warning signs of suicide. TeensHealth. The Nemours Foundation. https://kidshealth.org/en/teens/talking-about-suicide.html (17 Sept. 2018).

Twenge, J. (2017). With teen mental health deteriorating over five years, there’s a likely culprit. The Conversation. November 14, 2017. https://theconversation.com/with-teen-mental-health-deteriorating-over-five-years-theres-a-likely-culprit-86996 (17 Sept. 2018).

Wallace, S. (2017). Falling to pieces: putting youth back together again. Psychology Today. February 7, 2017. https://www.psychologytoday.com/us/blog/decisions-teens-make/201702/falling-pieces?#_=_ (17 Sept. 2018).