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Body & Soul
How Can You Tell if it’s Time to See a Therapist?
Renee Garfinkel • September 22, 2010
-Life is messy and often confusing. Sometimes you’re up, and then you’re down. You have a plan, and life throws you a curve. Life can feel like it’s just too much, and it can make you question, “Is this all there is?” No one is happy all the time. No one’s life is perfect.
So how can you decide that your particular situation is one that might be helped by psychotherapy?
You might be lucky enough to have a close friend or family member who has had a positive experience with therapy and is comfortable enough with it – and with you – to make the suggestion. Other people can often see your distress more clearly than you can yourself, so consider their recommendation seriously.
But even if no one has said anything to you here are some signs that it’s time to see a therapist:
• When the same kinds of problems recur in your life. You may have conflicts at work or repeated “misunderstandings” with your friends. You may have disappointing romantic relationships or frequently feel that you don’t fit in. Or you might notice that people become annoyed with you, and you don’t really understand why. The key here is that when a problematic situation becomes familiar and you recognize that you’ve been in the same spot before, that’s when it’s time to see a therapist.
• You’re having trouble sleeping.
• You notice a change in your usual sleeping, eating or drinking habits.
• You’re having trouble concentrating or motivating
yourself to do things.
• You’re irritable or anxious and searching for something to blame it on.
• You feel physically unwell, but your doctor says you’re okay.
• The things you used to enjoy are not much fun anymore, and nothing else positive has taken their place.
• You’re trying to figure something out or to move forward with a work or family issue, and you’re stuck.
The list is by no means exhaustive; rather, it is meant to be suggestive. Besides paying attention
to the way you are feeling and thinking, it is important to recognize that certain life situations,
while normal and even desirable, can be so stressful that they put you at risk.
It’s easy to understand that a death in the family or the breakup of a relationship makes you emotionally vulnerable, but it is also the case that life transitions, such as leaving school and starting work or moving to a new city, are challenges that shake up your life and make new demands at the same time as they remove you from your old friends and other supports. These transitions can often be navigated more smoothly with the help of a therapist.
Georgetowner • June 2, 2010
I am a successful, attractive D.C. woman about to turn 38 and will be celebrating with (drumroll, please) YET ANOTHER BREAKUP! This time I really thought the relationship was a go, but he turned out to be exactly like every other guy I’ve dated over the years, and I’m finally noticing the pattern. Things always start off well — the connection is strong, the sex is fantastic, we make big plans for the future. Then, after four months, six months, or a year, things change and he just isn’t there for me anymore. He starts “forgetting” plans we’ve made, not including me in activities, changing the rules. I’m not good at confrontation, so I seem to just let the distance grow while frantically trying to bring us back closer together. Eventually, he just ends it with the “It’s not you, it’s me” spiel. What can I do moving forward besides giving up entirely?
— Done With Men on Dumbarton
Dear Done With Men:
Wisdom comes with age, and it sounds like congratulations are in order for identifying a pattern in your past relationships! That’s really the first step in making a change: figuring out what we’ve done before that just isn’t working.
You have described the classic relationship trajectory. We all start off in the romantic stage, with its popping hormones, long-term fantasizing and believing we’ve found a kindred spirit who knows us inside out without even having to finish a sentence. That’s nature’s trick for getting us into a relationship. Soon, however, our brain chemistry changes, and we enter the power struggle phase. It sounds like this is the part that trips you up, and you’re not alone. You say you don’t like confrontation, so you allow the walls between you and your would-be soulmate to build thicker and thicker. You may be using unconscious tools to try to drag him back into deep connection — tools like passive aggression, controlling behavior, pouting, etc. Meanwhile, he also may be using his own tools to maintain his safe distance: isolating himself, forgetting your plans together, acting like it’s not his problem. The result is the classic push-and-pull scenario, until the loving bonds break under the stress. The power struggle is survived only through awareness and communication. When you both understand what you need to feel safe in relationship, then you both are able to start giving back to it.
Getting clear about your own expectations can really help you move toward a more conscious dating experience. What are your top 10 wants in a boyfriend? Do your past relationships reflect those desires? If they don’t, maybe your unconscious self is searching out a different kind of person. Taking the time to figure out what that part of you is looking for and why may result in a better match next time.
My wife and I have been happily married for 10 years. We had our second baby two months ago, and now my wife doesn’t seem interested in me anymore. She makes it very difficult for us to be physical — bringing our infant into the bedroom, always telling me how tired she is, breaking down and crying whenever I try to talk with her about our sex life. She used to be a runner and returned to her exercise routine immediately after our first son was born, but this time she has no motivation. She has stopped taking care of her appearance: she has gained weight, rarely wears makeup, still dresses in her maternity clothes, zones out in front of the TV. I’ve tried talking with her about it, but it usually ends in a fight after which she retreats from me and our kids, putting even more of the household burdens on me. I’m wondering if having kids was a huge mistake and if this means my marriage is permanently damaged.
— In Reserve on Reservoir
I can hear the earnestness in your words and can imagine you are anxious for a solution. But I also hear something else in your letter that may not be so obvious to someone sitting right inside your relationship — it sounds as if your wife may be severely depressed.
If every mom who wasn’t interested in sex so soon after giving birth was diagnosed with depression, antidepressants would be included in every box of diapers. In other words, a lagging sexual drive at eight weeks post-pregnancy is not unusual. But your wife’s disinterest compounds some of the other symptoms you named. Postpartum depression (PPD) afflicts approximately 10 percent of new mothers — that means it’s likely at least one mom in your playgroup suffers from it, or will during their childbearing years. The marked contrast between your wife’s first and second pregnancies sounds like a red flag — as is the lack of interest in her appearance, tendency to break down when confronted and gaping at the television.
The good news is that PPD is highly treatable with therapy and medication. Helping your wife find support, while letting her know you will be patient as she heals, is the very best option. At the same time, supporting someone dealing with depression can be difficult. Finding your own resources — confiding in a friend, counseling, or hiring a babysitter so you can have some time off — is also a valuable gift to you both.
My mother-in-law has always been overbearing and too into my business. She asks blunt questions at inappropriate times (e.g. She inquired, “How exactly are you going to lose weight before the wedding?” AT OUR ENGAGEMENT PARTY!). We have had some good times over the years, and I hoped we had grown closer now that we’ve given her her first grandchild. But my son is three and going through normal developmental steps, she continues to question my judgment about parenting, particularly asking blunt questions about whether he might have autism (he is not autistic in any way) or if he’s inherited my family’s “bigger boned” genes. I want to tell her off, but I know that wouldn’t be productive in the long run. Still, I think my frustration with her is obvious to everyone, including my son, and I don’t want him to develop animosity toward her either.
— Put-out on P Street
The irritating mother-in-law may be a tired cliché, but it’s a cliché for a reason — it comes up a lot!
Your frustration sounds entirely legitimate, and recognizing that your simmering bitterness might rub off on Junior shows even more self-awareness on your part. So let’s channel that effort into realizing that the fantasy that having a baby might magically change the person she is was just that, a fantasy, and she’s not doing anything new or different from the way she’s acted all the years you’ve known her son. That said, it is your job to protect your family from negative influences.
You haven’t mentioned your dear husband’s opinion on all of this, which suggests one of two things. Either he has no opinion because you haven’t shared your frustration with him, or he has chosen to ignore you both on this topic. Feeling like we aren’t alone in our struggles can be a major part of rising above insecurity. If you take the time to calmly, safely, carefully talk with him about your concerns, I imagine he might have some helpful advice for moving forward — whether that means enduring her negativity together, making a family decision to avoid her entirely, or sharing tips for how to get her to hear your side.
Stacy Notaras Murphy is a licensed professional counselor and certified Imago relationship therapist practicing at the Imago Center of DC in Georgetown. This column should not be considered a substitute for professional counseling. Please send your relationship questions to email@example.com.