Treating issues for adolescents, adults and couples, such as:

Anger Management

I help clients develop strategies and techniques for managing intense anger or aggressive episodes. These techniques involve learning ways to “cool off” and validate underlying feelings so that they may be communicated more effectively. Generally speaking, difficulty with anger is typically the result of a person having difficulty regulating their emotions.

Individuals who have difficulty with emotional regulation report that they are constantly intruded upon by their feelings or find that they are unable to feel the normal range of human emotion. Their emotional reactions are highly reactive, and they experience emotional lability. They may become easily and quickly sad, angry or anxious and have difficulty coming back to a stable emotional baseline. The good news is they also have a greater ability to experience joy and happiness. People who struggle with emotional reactivity feel like they are walking around with no ‘emotional skin’ in other words they have no buffer to protect themselves from difficult emotional feelings. Because they are so emotionally vulnerable sometimes they go to extreme behaviors (i.e. suicidal behaviors, drug/alcohol use) to try to take care of themselves and to alert the environment to take better care of them. The emotional pain they experience causes them to turn to quick, short term, solutions to emotional lability as a way to cope.

Emotional Regulation is achieving a balanced emotional life where you are neither numbed out from your emotional experiences nor emotionally overwhelmed by them. Achieving emotional balance is done through both talk therapy as well as learning specific concrete strategies for managing your emotional experiences. Therapy helps individuals to feel more in control of their emotional reactions, so they can consider the longer terms goals, and become more effective in communicating their emotions to others.

Research shows that Dialectical Behavioral Therapy (DBT), a structured approach originally designed to treat Borderline Personality Disorder, is effective for emotional regulation. DBT gives individuals concrete techniques to help lessen the emotional intensity they feel and to develop better ways to communicate their feelings to others.

I have advanced training in Dialectical Behavioral Therapy (DBT).

Here is a recent blog I wrote on anger and intimate relationships:

Do You Connect With Anger?

Do you find yourself attacking your partner or friends and then later regretting it? When a partner or friend makes a demand of you or gives you negative feedback, do you use anger to get them to back down? Do you find it easier to communicate your true feelings and opinions when you are angry? Anger is an ‘easy’ emotion—felt so intensely that words and actions flow instantaneously and without conscious reflection.

Take the example of Melanie, who feels ashamed of herself as she, once again, frantically scrolls through her romantic partner’s emails, text messages and Facebook account while he showers. As she perceives suspicious material, a cryptic text here, a ‘like’ on another girl’s Facebook picture there, her thoughts travel in a million different directions. Imagining infidelity, distrust and picturing her partner engaging in various liaisons with his female friends, she panics. By the time he exits the shower, she is enraged. The accusing and questioning leaves her partner befuddled, to the point that he cannot think straight or even remember exactly who he communicated with that week or, let alone, why. Melanie encodes his deer-in-the-headlights expression as evidence of his guilt and disloyalty. Throwing one verbal attack after another at him, she eventually exhausts herself and the two go to sleep. The next morning Melanie recognizes she overreacted and makes amends, only to find herself repeating this same scenario in less than a week’s time. Each time her partner accepts her apologies, loving her in spite of herself, she feels more connected and secure in the relationship.

For some, communicating through anger is a dysfunctional way to be one’s true self and connect. When a person has difficulty with self-acceptance, they may dismiss and push aside their moment-to-moment negative emotions to avoid conflict and remain accepted by others. At some point, the dam breaks and an event that may warrant minor annoyance triggers rage. People who fall into this pattern feel a sense of relief in finally being able to express their true self. The only way they can experience love is when a partner or friend responds to their unpredictable anger with forgiveness and unconditional support.

However, anger’s authenticity is short lived. It is hard to be the close friend or long term partner of someone who chronically uses anger to connect. Ultimately, anger serves to distance and erode meaningful connection. And initial relief quickly turns to shame and guilt for having to express what may be genuine feelings in such a destructive way toward someone they cherish. In the long term, connecting through anger begets self-alienation.

If you fall into this pattern, work to notice your feelings in the moment. Instead of blowing off your opinions and negative emotions to ‘get along’ and be ‘friends with everyone,’ reflect on what you like or dislike about the events and people in your life. Do not wait until your emotions hit a boiling point; communicate your thoughts and feelings on an ongoing basis. With anger, notice when you feel frustrated or disappointed so that it does not build into rage. Reframe blame toward others by owning your feelings without shame, i.e. instead of “Who are you texting!?” try “I feel insecure.”


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Anxiety

Anxiety can take on a variety of different forms depending on the individual. Oftentimes people who come into therapy for anxiety because they experience excessive anxiety and worry (apprehensive expectation) over a number of events in their life (work, children, relationships, finances, activities) and the source of the worry can change from day-to-day. People experiencing this kind of anxiety feel they cannot control or lessen the worry and that they are intruded upon by it on an hourly/daily basis.  As a result they have difficulty concentrating or being present. At times they feel they can’t think straight or as if their mind is ‘going blank.’  This kind of persistent worry wears a person down so that they may become more irritable, fatigued, or have difficulty sleeping.

Anxiety includes a strong sense of

  • Feeling tense,
  • Dread,
  • Agitation,
  • Feeling “keyed up”, and/or
  • Having repetitive worried thoughts about the past, present and future.

Individuals with anxiety have difficulty enjoying their experiences because they are consumed by worry and apprehension over future or past happenings.
Episodes of intense fear are called panic attacks and can often result from a chronic overload of anxiety. Panic attacks are terrifying for the individual and involve a series of physiological symptoms, including rapid heart beat, sweating, increased pulse, as well as thoughts of dying or of not being safe in one’s surroundings.

Therapy can help you both manage and resolve issues that may be causing anxiety.


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Attentional Difficulties

Some clients report difficulty with their attention span and trouble concentrating. I help these individuals develop strategies (sometimes with the addition of medication as prescribed by a psychiatrist) to increase executive functioning, planning and follow through skills. Not all people with attention issues meet the full diagnostic criteria for Attention Deficit Disorder, at times attentional issues are the result of other issues such as life stress, depression and/or anxiety.  Together we can determine if you meet the criteria for ADD or if you have general ‘attention issues.’

Individuals with Attention Deficit Disorder often describe symptoms such as the following (From the DSMIV):

(1) inattention: six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities

often has difficulty sustaining attention in tasks or play activities

often does not seem to listen when spoken to directly

often does not follow through on instructions and fails to finish school work, chores, or duties in the workplace (not due to

oppositional behavior or failure to understand instructions)

often has difficulty organizing tasks and activities

often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)

often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)

is often easily distracted by extraneous stimuli

is often forgetful in daily activities

OR

(2) hyperactivity-impulsivity: six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:

Hyperactivity

often fidgets with hands or feet or squirms in seat

often leaves seat in classroom or in other situations in which remaining seated is expected

often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings of restlessness)

often has difficulty playing or engaging in leisure activities quietly

is often “on the go” or often acts as if “driven by a motor”

often talks excessively

Impulsivity

often blurts out answers before questions have been completed

often has difficulty awaiting turn

often interrupts or intrudes on others (e.g., butts into conversations or games)

Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.

Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).

There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.

The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Dissociative Disorders, or a Personality Disorder).


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Cutting

Cutting is a self-harm behavior where a person feels some sense of emotional relief from cutting oneself with a knife or a blade. Cutting, like other self-harm behaviors, is often used to relieve such emotions as emptiness, loneliness, sadness and anger. Many individuals who cut report a momentary feeling of relief followed by shame and negative feelings about the self. Cutting is a behavior often associated with Borderline Personality Disorder.

Self-harm—also known as self-injury or self-aggression, is typically performed to regulate one’s emotional world, to blunt an overwhelming emotional reaction, or to literally “feel something,” so as to not be numbed out from one’s emotions. This behavior is seen in both men and women, though women are more likely to cut than men.

There are a host of other types of self-harm behaviors that individuals may use compulsively in order to regulate their emotional experiences, including:

  • alcohol,
  • drugs,
  • gambling,
  • head banging,
  • impulsive spending,
  • pornography addiction,
  • sex, and
  • suicidal gestures

Like cutting, these behaviors also tend to be used as ways to help a person to feel better emotionally, although in the long term they often leave the person feeling worse and more depleted.

Dialectical Behavioral Therapy (DBT) can be highly successful in reducing self-harm behaviors. In this therapeutic approach, concrete strategies are given to reduce self-injury behaviors, and to develop alternative ways for managing negative emotions.


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Depression

Depression is an emotional issue where a person feels down in mood for two or more weeks. Down mood includes:

  • feelings of worthlessness,
  • guilt,
  • irritability,
  • tearfulness,
  • lack of interest, and
  • lack of pleasure from usually enjoyable activities.

Depression often involves repetitive negative thoughts about the self and may also include the loss of or increase in appetite as well as either excessive sleep or difficulty falling and staying asleep.

Therapy can help you both manage and resolve issues that may be causing depression or Dysthymia. Below are some symptoms of both depression and dysthymia.

DSM-IV Depression Criteria:

Depressed mood and/or loss of interest or pleasure in life activities for at least 2 weeks and at least five of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning almost every day

1. Depressed mood most of the day.

2. Diminished interest or pleasure in all or most activities.

3. Significant unintentional weight loss or gain.

4. Insomnia or sleeping too much.

5. Agitation or psychomotor retardation noticed by others.

6. Fatigue or loss of energy.

7. Feelings of worthlessness or excessive guilt.

8. Diminished ability to think or concentrate, or indecisiveness.

9. Recurrent thoughts of death.

DSM-IV Dysthymia Criteria:

Depressed mood most of the day for more days than not, for at least 2 years, and the presence of two or more of the following symptoms that cause clinically significant impairment in social, work, or other important areas of functioning:

1. Poor appetite or overeating.

2. Insomnia or sleeping too much.

3. Low energy or fatigue.

4. Low self-esteem.

5. Poor concentration or difficulty making decisions.

6. Feelings of hopelessness


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Dialectical Behavioral Therapy (DBT)

Dialectical Behavioral Therapy (DBT) is a therapeutic approach developed by Marsha Linehan. DBT blends behavioral problem solving with acceptance-based strategies, and an emphasis on dialectical processes. DBT was originally developed for acutely suicidal individuals over 20 years ago. An increasing number of studies now demonstrate that DBT is a promising intervention for a variety of issues including: binge eating disorder, bipolar disorder, emotional instability, families dealing with children with emotional instability, families of suicidal individuals, victims of domestic abuse and depression.

DBT helps individuals cope with:

  • impulsive behavior
  • Cutting behavior
  • feelings of emptiness
  • fear of being alone/abandonment
  • anger outbursts
  • suicidal behavior
  • self-harm behavior
  • intense emotional instability
  • emotional communication
  • knowing what you feel when you feel it
  • relationship difficulties (maintaining healthy relationships/ending destructive ones)

This highly structured approach gives clients concrete skills around mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. It involves a considerable amount of both validation as well as active problem solving. DBT not only helps with reducing symptoms but in addition, research shows that those in DBT develop significantly greater self-affirmation, self-love, self-protection, as well as less self-attack, during the course of treatment and maintained these gains at 1 year follow up. DBT is a well-researched, highly effective approach for treating both emotional dysregulation and also Borderline Personality Disorder.

DSM IV Diagnostic Criteria for Borderline Personality Disorder (At least 5 of the following):

1.A pattern of intense and unstable interpersonal relationships.

2.Frantic efforts to avoid real or imagined abandonment.

3.Identity disturbance or problems with sense of self.

4.Impulsivity that is potentially self-damaging.

5.Recurrent suicidal or parasuicidal behavior.

6.Affective instability.

7.Chronic feelings of emptiness.

8.Inappropriate intense or uncontrollable anger.

9.Transient stress-related paranoid ideation or severe dissociative symptoms.

 


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Emotional Regulation

Individuals who have difficulty with emotional regulation report that they are constantly intruded upon by their feelings or find that they are unable to feel the normal range of human emotion. Their emotional reactions are highly reactive, and they experience emotional lability. They may become easily and quickly sad, angry or anxious and have difficulty coming back to a stable emotional baseline. The good news is they also have a greater ability to experience joy and happiness. People who struggle with emotional reactivity feel like they are walking around with no ‘emotional skin’ in other words they have no buffer to protect themselves from difficult emotional feelings. Because they are so emotionally vulnerable sometimes they go to extreme behaviors (i.e. suicidal behaviors, drug/alcohol use) to try to take care of themselves and to alert the environment to take better care of them. The emotional pain they experience causes them to turn to quick, short term, solutions to emotional lability as a way to cope.

Emotional Regulation is achieving a balanced emotional life where you are neither numbed out from your emotional experiences nor emotionally overwhelmed by them. Achieving emotional balance is done through both talk therapy as well as learning specific concrete strategies for managing your emotional experiences.  Therapy helps individuals to feel more in control of their emotional reactions, so they can consider the longer terms goals, and become more effective in communicating their emotions to others.

Research shows that Dialectical Behavioral Therapy (DBT), a structured approach originally designed to treat Borderline Personality Disorder, is effective for emotional regulation. DBT gives individuals concrete techniques to help lessen the emotional intensity they feel and to develop better ways to communicate their feelings to others.

I have advanced training in Dialectical Behavioral Therapy (DBT).


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General Medical Conditions

Individuals who manage serious medical diagnoses (including diabetes, multiple sclerosis, cancer, hyper/hypo thryroidism, alopecia, scoliosis, and a host of others) often report mood changes and changes in their sense of self, resulting from the diagnosis. So often people tend to blame themselves, feel badly or experience shame for conditions that they are powerless to control. Psychotherapy helps by putting this fact into perspective so that people do not have the added burden of a negative, internal dialogue, on top of a serious medical issue. People discover power and control in managing simply the illness but not also feeling the burden of low self-esteem, depression or self-criticism.

In addition, some individuals find it relieving to talk about all of their feelings with someone who is not in their family or immediate social network so that they can better process where they are with the condition and not have to concern themselves with how they are impacting those they are close to.

People who are grappling with medical issues also have to navigate the, sometimes, stressful world of healthcare and become their own best advocate in what can feel like a very confusing and contradictory sphere. I help clients to process this extremely important part of living with a serious medical issue and provide strategies for being your own best advocate.

Serious medical issues can drastically impact a person’s life and functioning. I help these individuals to process their diagnoses and to go on to have fulfilling lives while managing possible medical limitations.


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Issues

Feeling tense, a sense of dread, agitated, keyed up, and/or having repetitive worried thoughts about the past, present and future. Individuals with anxiety have difficulty enjoying their experiences because they are consumed by worry and apprehension over future or past happenings.

Feeling down in mood for 2 or more weeks. Down mood includes feelings of worthlessness, guilt, irritability, tearfulness, lack of interest and lack of pleasure from usually enjoyable activities. Depression often involves repetitive negative thoughts about the self. Depression may also include the loss of or increase in appetite as well as interrupted sleeping cycles (either excessive sleep or difficulty falling and staying asleep).

Dr. Weber sees individuals who struggle with their sense of self. Clients often report long-term feelings of inadequacy, on-going self-criticism, and not feeling ‘good enough.’

Dr. Weber has advanced training in Dialectical Behavioral Therapy (DBT), which is a structured approach originally designed for the treatment of Borderline Personality. In addition, research has shown this treatment to also be effective for individuals struggling with controlling the intensity of their emotional reactions. This approach gives individuals concrete techniques to help lessen the emotional intensity they feel and to develop better ways to communicate their feelings to others.

This is a behavior often associated with Borderline Personality. Although a harmful and maladaptive behavior, the individual involved feels some sense of emotional relief from the act of cutting. Dialectical Behavioral Therapy (DBT) has been shown to be highly successful in reducing cutting behaviors. Concrete strategies are given to reduce cutting behaviors, and to develop alternative ways for managing negative emotions.

A therapeutic approach developed by Marsha Linehan to help individuals cope with impulsive behavior, self-harm behavior, and intense emotional instability. This is a highly structured approach that gives clients concrete skills around mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. It involves a considerable amount of both validation as well as active problem solving. DBT is a well-researched approach that is highly effective in treating both emotional dysregulation and also Borderline Personality.

Panic attacks are episodes of intense fear and can often result from a chronic overload of anxiety. Panic attacks are terrifying for the individual and involve a series of physiological symptoms (including rapid heart beat, sweating, chest pain, shaking, shortness of breath, nausea, feeling dizzy, increased pulse), as well as thoughts of dying or of not being safe in one’s surroundings. Panic is often associated with an overwhelming urge to flee a situation. Dr. Weber helps individuals to understand the underlying beliefs involved in the panic and to develop alternate ways to cope and manage panic symptoms.

Many individuals report difficulty managing interpersonal distress. Sometimes a mental health diagnosis can make managing relationships more difficult. In addition, some clients present with difficultly expressing their feelings or managing conflicts in relationships. Others report difficulty keeping or finding the types of relationships that they want.

Parents and teenagers must navigate a difficult process as the teenager begins to separate from the parents and form his/her separate identity. Dr. Weber works with both parents and teenagers to help in this process in terms of developing strategies for communication, conflict resolution, and ways to begin connecting more effectively. Dr. Weber helps the teenager and the parent to finds ways to better understand and to develop greater tolerance for one another.

Some clients present to treatment with Dr. Weber in order to process a past or present trauma. Trauma is exposure to a stressor that involves actual or perceived threat, danger, serious injury, or emotional injury to the self or another person. The response to the event may involve fear, helplessness, and can manifest in persistent avoidance of triggers associated with the trauma, and/or hyper vigilance to events surrounding the trauma. Some traumatic experiences can lead to Posttraumatic Stress Disorder where the event is relived in various ways and causes intense emotional distress and arousal. Clients who have trauma in their backgrounds often have both trouble relaxing as well as trouble connecting to their immediate ‘here and now’ experience.

Some individuals enter psychotherapy without serious mental health symptoms but are managing a difficult life transition, i.e. divorce, family changes, death/dying issues, moving, job changes, medical issues. These folks are often looking for a place to process this transition and to gain support for the life change.

Individuals who manage serious medical diagnoses (including diabetes, multiple sclerosis, cancer, hyper/hypo thryroidism, alopecia, scoliosis, and a host of others) often report mood changes and changes in their sense of self, resulting from the diagnosis. Serious medical issues can drastically impact a person’s life and functioning. Dr. Weber helps these individuals to process their diagnoses and to go on to have fulfilling lives while managing possible medical limitations.

Some clients report that, although they want to have relationships and connections with others, they are bombarded by chronic and acute anxiety when faced with new social situations or people. Dr. Weber works with social anxiety by helping individuals to understand their underlying beliefs and fears about these situations, and to develop increased confidence in social situations.

Dr. Weber helps clients to develop strategies and techniques for managing feeling chronically overloaded by work and personal stress. These techniques include talk therapy, mindfulness, and limit setting.

Dr. Weber helps clients to develop strategies and techniques for managing intense anger or aggressive explosiveness. These techniques involve learning ways to cool off and validate underlying feelings so that they may be communicated more effectively.

Some clients report difficulty with their attention span and trouble concentrating. Dr. Weber helps these individuals to develop strategies and techniques (often with the addition of medication as prescribed by a psychiatrist) to help with executive functioning, planning, and accomplishing goals.


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Managing Difficult Life Transitions

Some individuals enter psychotherapy without serious mental health symptoms but are managing a difficult life transition like a divorce, family changes, death/bereavement, moving, processing identity changes, adoption, job changes and medical issues. These individuals are often looking for a place to process this transition and to gain support for the life change.

Psychotherapy is not only for a psychiatric diagnosis, like depression or anxiety, some enter therapy to process transitions so that they may better manage their life and achieve their goals. Some people dread the life transition they are facing or fear change; therapy helps these people to feel enriched by the life event and/or develop an enhanced sense of meaning or purpose as a result. Therapy can help with transitions so they become opportunities for growth and greater actualization/awareness of a person’s goals.


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Panic

Panic attacks are episodes of intense fear and can often result from a chronic overload of anxiety. Panic attacks are terrifying for the individual and involve a series of physiological symptoms (including rapid heart beat, sweating, chest pain, shaking, shortness of breath, nausea, feeling dizzy, increased pulse), as well as thoughts of dying or of not being safe in one’s surroundings. Panic is often associated with an overwhelming urge to flee a situation. I help individuals to understand the underlying beliefs involved in the panic and to develop alternate ways to cope and manage panic symptoms.

Panic Disorder (Without Agoraphobia) from DSMIV.

Both (1) and (2):

(1) recurrent unexpected Panic Attacks
(2) at least one of the attacks has been followed by 1 month (or more) of one (or more) of the following:

(a) persistent concern about having additional attacks
(b) worry about the implications of the attack or its consequences (e.g., losing control, having a heart attack, “going crazy”)
(c) a significant change in behavior related to the attacks

B. Absence of Agoraphobia–fear of leaving.

C. The Panic Attacks are not due to the direct physiological effects of asubstance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., hyperthyroidism).

D. The Panic Attacks are not better accounted for by another mental disorder, such as Social Phobia (e.g., occurring on exposure to feared social situations),Specific Phobia (e.g., on exposure to a specific phobic situation), Obsessive-Compulsive Disorder (e.g., on exposure to dirt in someone with an obsession about contamination), Posttraumatic Stress Disorder (e.g., in response to stimuli associated with a severe stressor), or Separation Anxiety Disorder(e.g., in response to being away from home or close relatives).


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Parent/Adolescent Communication

Parents and teenagers must navigate a difficult process as the teenager begins to separate from the parents and form his or her separate identity. I work with both parents and teenagers to help in this process in terms of developing strategies for communication, conflict resolution and ways to begin connecting more effectively. I help both the teenager and the parent find ways to better understand and to develop greater tolerance for one another.

More than any other developmental stage, the teenage years necessitate that parents alter their typical ways of parenting, become more flexible, more patient, more emotionally attentive. We sometimes think that only young children need this kind of nurturing but this is not the case. The major shift, however, is that old rules often need to be altered to accommodate the teenager’s burgeoning sense of independence. She has to feel more in control over her choices so that she can become her own person. Of course, all of this needs to be done with appropriate (not rigid) limit setting so that she can try out independence in a safe and boundaried manner. Psychotherapy can help with this process.

At times parents and teenagers feel roadblocked–they can’t seem to form or achieve mutually agreed upon goals, set limits that both agree to, or find ways to empathize and validate one another. When parents and teenagers enter therapy they often find that talking with a third party helps them to better understand the others’ perspective. This understanding and compassion for each others way of seeing things often sets the stage for moving forward and not being stuck in rigid ways of managing one anthers behavior.

 


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Relationship Concerns

Many individuals report difficulty managing interpersonal distress. Sometimes a mental health diagnosis can make managing relationships more difficult. In addition, some clients present with difficultly expressing their feelings or managing conflicts in relationships. Others report difficulty keeping or finding the types of relationships that they want.

One of my specialties is helping people to work through their negative romantic relationship dynamics. Here is an excerpt from a recent blog that summarizes some of the issues people talk to me about:

Are you continually disappointed in your relationships? Are you in the middle of a breakup, or considering divorce? Have you never had a romantic relationship that deeply fulfilled you?

It may be time for a relationship audit.

We tend to repeat the mistakes of our past relationships until we can actually identify the issues we’re repeating. Only by knowing your history can you develop the awareness necessary to change dysfunctional dynamics at the moments they occur. Without this awareness, too many of us are essentially looking for love aimlessly, with no compass or means to get grounded in a healthy way.

What is a relationship audit?

Patterns in love tend to repeat. Until you are fully aware of what you are repeating, you will never have control over who you let into your intimate world.

Conducting a relationship audit means identifying these patterns—beginning with the first relationships you had with your caregivers in childhood. Reflecting upon your past and current relationships—romantic, friendship and familial—and writing down patterns you notice will help you to build awareness for the self-defeating tendencies you reenact when it comes to love. If you work at it, you will notice similar personality traits in your friends/ romantic partners, some may be healthy traits others may not.

How to Do a Relationship Audit

Take an inventory of your relationship history and identify the ways you may cast romantic partners in certain roles based on how you were treated by caregivers, siblings, or friends while growing up Reflect on the ways in which your needs were attended, or went unattended, in childhood—and consider how you may have picked partners who treated you similarly.

Then ask yourself if your parents or caregivers exhibit traits that are similar to those that attract you to your partners. Are you playing a role with partners similar to the one you played as a child with your parents? Or, alternatively, have you adopted the role of one of your parents in relationships, or even that of a previous partner?

The most important goal of a relationship audit is to identify patterns in terms of what you are drawn to in your romantic relationships and friendships; acknowledge what is healthy and what is unhealthy; and see if there is a link to how your caregivers treated you as a child.

Other questions to consider in your audit:

What is my “type”? Who I am attracted to? On first blush, you may think all of your partners or friends are very different from one another, but typically there are personality traits that overlap and to which we are drawn.
Does any of your childhood history get reenacted in your romantic or friendship relationships? Did you feel you could rely on your caretakers for most of what you needed, or just some? Were you overly gratified or emotionally neglected?
Are the romantic partners you choose similar to your mother or your father in healthy ways or unhealthy ways?
Are your relationships overly dependent, in which you need your partner people to be around all of the time? Or do you tend to be in relationships without closeness or intimate communication?
Do you get so absorbed by your partners’ needs that there is no “you” separate from them?
Why Is an Audit Important?

So-called “mirror” neurons in the brain teach us how to love and cause us to imitate how we saw love between our family members and how we received love. In most cases, this is not bad. There is usually good love mixed in with the problematic parts. What is important is to notice what might be self-defeating and work to change it in your adult life.

Love patterns repeat—and this repetition is almost always driven by a hope to gain mastery over a dysfunctional dynamic. Unfortunately, it rarely works out this way—many who continually pick the same partners begin to feel hopeless about finding true love. People continue to suffer with poor relationships until they become fully aware of how they replay a self-defeating script in their adult lives.

Self-awareness is the key to unlocking the pattern and building a new, more fulfilling relationship dynamic. In my book Having Sex, Wanting Intimacy—Why Women Settle for One-Sided Relationships (link is external), I describe people I’ve worked with who have become aware of how they do not let men know their real selves—and how this contributes to having low emotional intimacy with their partners. They say, “He doesn’t really care about me” but they do not work to let him in and be known. Once they become aware of this, they realize the power they have in setting the relationship in the right direction—or, if the partner cannot rise to the challenge, recognizes she has to let him go.

Ask yourself the hard questions. Be honest about your role in past relationships, and how you may unintentionally bring your own unaddressed issues into them. With a therapist or on your own, work through these issues so that you no longer allow them to taint the water of every new relationship.

There is research to suggest that people are drawn to mates who have similar maturity levels, abilities to communicate, and capacity for emotional intimacy. Until you do the work to improve these domains for yourself, you are likely going to land in relationships with people who are similarly deficient. As you improve your communication and emotional intimacy skills, you will become more attractive to healthier and wiser partners.


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Self-Esteem

Most people face some sort of struggle with their self-esteem at some point in their life. These struggles are a natural part of the human experience. Long-term feelings of inadequacy, ongoing self-criticism, and constant feelings of “not good enough” can be helped by therapy. Chronic self-esteem issues can effect every aspect of a person’s life, including friendships, romantic connections, professional goals and overall contentment. People who struggle with low self-esteem often have an ongoing, negative, internal dialogue that they are powerless to shut down. They tell me they wish they could ‘stop thinking’ and have difficulty being alone simply because they do not want to experience the negative thoughts that come along with this. Although they may be very successful in many areas of their life, people with chronic low self-worth still struggle with feeling ‘good enough’ or feel they don’t deserve what they have.

Therapy can help you learn ways to manage the issues that may be affecting your self-esteem. Therapy can help a person with low self-esteem by:

Becoming more aware of the negative, critical, thinking spiral that many with low self-esteem struggle with.

Learning to turn down the volume on your internal critic.

More fully accept yourself, as you are.

Developing ways to see yourself in a more (realistic) positive light.

Developing ways to be less hard on yourself and more tolerant.

Finding peace with your perceived flaws.

When people become at peace within themselves they no longer engage in repetitive self-criticism and find they have more room to be present in their pursuits and relationships. Most importantly, they tend to enjoy life more.


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Social Anxiety and Shyness

Some clients report that, although they want to have relationships and connections with others, they are bombarded by chronic and acute anxiety when faced with new social situations or people. I work with social anxiety by helping individuals to understand their underlying beliefs and fears about these situations, and to develop increased confidence in social situations.


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Stress Management

I help clients to develop strategies and techniques for managing feeling chronically overloaded by work and personal stress. These techniques include talk therapy, mindfulness, and limit setting. Stress is a result of feeling like you capacity is far smaller than what life is throwing at you and feeling that you cannot possibly work on growing your capacity because life keeps throwing more and more turmoil your way.

Sometimes life is simply stressful and that is a normal part of the human experience. In other instances however, a person comes to feel that her entire life is always one big stress ball. In these cases people benefit from psychotherapy to help them to break down hard to manage issues or life events into smaller, more tolerable, goals and chunks of information. In addition, it helps to find other ways to cope with stress than either over doing or total avoidance. When people feel chronically stressed it can be tempting to either constantly be working to do things to stop the stress (compulsive work hours, constant business) or to avoid the stress entirely through procrastination or denial. Therapy can help a person to solve problems in living through behavioral strategies and reinforcement strategies to change your fears about what you are avoiding or fears about letting go of some of your burdens.

Life transitions including divorce, new babies, family changes, loss, work changes, marriage, break ups, can all be stressful for most, but having someone to work through these issues with can help.


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Trauma

Trauma is exposure to a stressor that involves actual or perceived threat, danger, serious injury, or emotional injury to the self or another person.

The response to the event may involve fear, helplessness, and can manifest in persistent avoidance of triggers associated with the trauma, and/or hyper-vigilance to events surrounding the trauma.

Some traumatic experiences can lead to Post-Traumatic Stress Disorder where the event is relived in various ways and causes intense emotional distress and physiological arousal. Clients who have trauma in their backgrounds often have both trouble relaxing as well as trouble connecting to their immediate ‘here and now’ experience. People who enter therapy for trauma do not always meet the diagnosis for P.T.S.D. but they typically relate to some of the following symptoms:

Post Traumatic Stress Disorder (DSM-IV Criteria)

The person experiences a traumatic event in which both of the following were present:
1. The person experienced or witnessed or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others
2. The person’s response involved intense fear, helplessness, or horror
B. The traumatic event is persistently re-experienced in any of the following ways:
1. Recurrent and intrusive distressing recollections of the event, including images, thoughts or perceptions
2. Recurrent distressing dreams of the event
3. Acting or feeling as if the traumatic event were recurring (eg reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those on wakening or when intoxicated)
4. Intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event
5. Physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma) as indicated by at least three of:
1. Efforts to avoid thoughts, feelings or conversations associated with the trauma
2. Efforts to avoid activities, places or people that arouse recollections of this trauma
3. Inability to recall an important aspect of the trauma
4. Markedly diminished interest or participation in significant activities
5. Feeling of detachment or estrangement from others
6. Restricted range of affect (eg unable to have loving feelings)
7. Sense of a foreshortened future (eg does not expect to have a career, marriage, children or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma) as indicated by at least two of the following:
1. Difficulty falling or staying asleep
2. Irritability or outbursts of anger
3. Difficulty concentrating
4. Hyper-vigilance
5. Exaggerated startle response


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I am a licensed clinical Washington DC psychologist and licensed Virginia psychologist practicing in Tysons Corner, VA and the Friendship Heights area of Northwest Washington, DC. I offer expertise in psychotherapy for adults, teenagers and couples. I tailor treatment to individual history and problem areas. Treatment occurs in a safe, supportive and healing environment.

Having Sex, Wanting Intimacy

'Having Sex, Wanting Intimacy'

My book, Having Sex, Wanting Intimacy—Why Women Settle for One-Sided Relationships, is for all women who wish to better understand the delicate constellation of factors that produce emotional intimacy with a romantic partner and for those who struggle with relationships, the hook-up culture or promiscuity. It is also for parents/educators who want to help girls with cultural messages that encourage being pleasing at the expense of developing a solid self-identity. Available in paperback in August 2014.

Media, Consulting and Public Speaking

I have a long-term interest in the impact of gender and culture on identity, self-esteem and relationship development. I am available for media inquiries, consulting and public speaking on how culture affects female identity, empowering girls for reciprocal relationships, developing healthy self-esteem, and how adult women can develop emotionally intimate, romantic, relationships. I also speak to groups of parents, educators, teens and singles who want to learn more about developing an ‘emotional toolkit’ that fosters the strengths necessary for building mutually, healthy friendship and romantic partnership.

Why Are Emotionally Unavailable Men So Damn Desirable?

Dr. Weber's blog entries originally appeared on Psychology Today.

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The allure of emotionally unavailable men is undeniable to many. Women caught up in their charms often spend inordinate time, energy, and internal resources working to get their special attention. Here are 5 reasons why unavailable men carry such value.

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