“Do you go to the gym because you hate your body? Or do you go to the gym because you love your body?” Lisa, a registered dietitian and the founder of The Well Necessities, recently asked this question; I was intrigued. On the surface, as long as I am going to the gym, who cares why I go to the gym. But, emotionally and psychologically the answer to this question changes my experience and my relationship with fitness and healthy living. I can head to the gym with excitement, passion, and joy, or feel like I am being pushed or dragged toward the gym door.

This question applies to many areas of our life, particularly in romantic relationships. We need to ask ourselves; why do we do what we do? Is it to avoid a consequence? Or are we driven by self-love?  

We spend much of our life making decisions based on avoiding consequences. Can you stop and ask yourself “Why do I (fill in the blank)?”
 
Do you buy flowers because you love your wife/husband and the two of you as a couple?
Do you buy flowers because you know she/he will be upset?
 
Are you going to therapy to heal from your sexual transgressions because your relationship is important to you?
Are you going to therapy to heal from a sexual transgression because you can’t stand the guilt you’re living with?
 
Are you spending time with your kids because you cherish them?
Are you spending time with your kids because you do not want to be a bad father/mother?
 
The behavioral outcomes (i.e. you bought flowers) are the same, yet the emotional experience is vastly different. If we make decisions and do things because we are avoiding consequences, we never truly connect to the emotional benefits of our actions. Making a choice out of willingness - rather than avoidance - allows us to be immersed in the experience. Most importantly, the choice will feel natural and effortless. 

Sexuality and gender are complex and complicated. For those who hate ambiguity, this might not be the greatest era. 

According to researcher Sandra Bem, gender is on a spectrum. Meaning, we can have both masculine and feminine traits. But, because we like to think in boxes, we are not comfortable with spectrums and we insist that people check the box. We are forced to pick a camp, thereby, limiting our emotional and behavioral openness.

Martin Bergmann in his book “Anatomy of Loving” explains that is hard to know true gender identity because society influences us. Gender stereotypes are enforced before we are even born. Some might argue that gender expectations are not particularly problematic; “why does it matter if we expect boys to be lawyers and girls to be nurses?” Besides for limiting our intellectual opportunities, the main issue with gender stereotypes are the repercussions. Men and women experience immense shame when they do not live up to their gender expectations.

Sigmund Freud believed that we are born bisexual and we suppress our attraction to the same-sex. Therefore, he wrote that we all have the potential to be gay.  Sexuality is fluid but we have been socialized to be heterosexual. This is not to say that all of us are attracted to the same-sex and we are denying it. Merely, some of us have emotional and sexual openness to both genders.

What about fantasies? Is this an indication that I am gay? No! Our sexual fantasies have specific psychological benefits (a longer conversation for a different time), in short; men experience gay fantasies as a relief. They feel that gay fantasies are less performance based and a test of their manhood. Yet, on the other hand, some men experience immense shame about their fantasies and see it as a threat to their masculinity. Similarly, women have gay fantasies or watch lesbian porn as well, and in the same way that men find these fantasies freeing, so do women. 
​
Perhaps bisexuality does not apply to you, but love sure does apply to you. When we fall in love with the opposite gender we are falling in love with gendered parts of ourselves that we rejected. From early on, we received explicit and implicit messages about what’s acceptable and lovable in a boy or a girl. We learned to shut down and cut off those parts (behaviors) that did not fit our gender. When we fall in love we feel whole again, because we have found the person who has the missing pieces.

​You promised your lover to be there in sickness and health. But, did you promise that you will always know what is on his or her mind? Where did this myth of “if you love me, you would know” come from? How has it happened that we began to equate “knowing everything about you” with love?

To feel loved, we need to feel known. But to be known, we need to talk, we need to show up, and we need to communicate. I don’t know where we went so wrong that we decided that “true lovers” could skip the step of communication. And to be known means that my partner can read my mind and understand my subtle hints. Again and again, I hear the phrase, “if you loved me, you would know what I need” or “If you loved me, you would know why I am upset.”

 Why is “dropping a hint” is problematic? Not everyone understands hints. We are not all great mind-readers. In fact, studies show that we over estimate our skills of mind-reading but, we are terrible at mind-reading (Ames & Kammrath, 2004).
 
Here is how a hint dropping situation ends:
You tell your partner “I’ll be home late tonight” (You are thinking that if you tell them you will be late they will get the hint that you are still upset about how they yelled at you last night).

Your partner hears, “He/she will be home late tonight” and they go about making plans for the evening.

You get upset and you start making interpretations such as, “he/she is so self-centered. He/she does not even realize that I am upset.”

As you are stewing in your office and staying out late, your partner is pouring him or herself some red wine and enjoying their favorite Netflix show.

As promised, you come home late, only to find your partner on the couch smiling peacefully at the TV screen. You get even angrier. You make more interpretations, confirming your earlier hypothesis; He/she is self-absorbed, stupid, unaware, selfish, doesn’t care about you… You storm off to bed.

Sounds familiar?

By dropping a hint and failing to communicate directly, you exacerbated a situation that could have been tamed by merely sharing your feelings. Sharing your feelings will get you closer to having your needs met. Most importantly, authentic communication is a direct pathway toward intimacy and marital satisfaction. 

Expecting your partner to mind-read and sending hints only digs you deeper into your cocoon of misery. It does not benefit your relationship. Period. Hints just intensify your anger at your partner because you are enraged by how oblivious he or she is. You get angrier, and your partner gets more confused.  Avoiding direct communication causes you both to be uneasy and feel insecure. It is never clear if someone is upset and both of you end up in a lonely corner where you are constantly wondering if someone is upset because someone failed to “get the hint”.

In summary, if you find yourself dropping hints, take the hint and recognize that you and your partner are not comfortable with communication. In order to avoid the dropping-hints-trap, state your needs clearly and specifically. Remember that your partner does not live inside your brain.

I recently read the book by Emily Nagoski “Come as you are” and the overall voice of her book is her intense desire to announce to the world “you need to know this!” I caught that fever when I read the chapter on sexual non-concordance. Here I am carrying the inspiration forward and shouting (in my head) you need to know this!

What is sexual non-concordance?
Sexual concordance is when the genital response and the subjective sexual response; “I am interested in sexy time” are in alignment. Meaning, that there are evident physiological responses; a man has an erection and a woman has vaginal swelling and lubrication, plus the person reports feeling aroused. Sexual non-concordance is when we consciously do not report sexual arousal, but physiologically, our body is responding. Visa versa, we can subjectively report interest in sexual activity but physiologically the genitals are not aroused (Nagoski, 2015). For example, a woman might feel aroused and excited to have sex with her partner, but when she attempts to have sex she experiences vaginal dryness. Similarly, a man might be excited and emotionally aroused but then unable to attain an erection.

How does this sexual non-concordance happen?
There are two ways that we process information; bottom up processing and top down processing. Bottom up processing is referring to our bodies response to outside stimuli that is not in our conscious control. Top down processing is referring to our cognitive appraisal, cognitive control, and attention toward stimuli presented to us. Top down processing is dependent on personal goals, biases, perception, appraisal, and what we believe is appropriate. Top down is an active process and a conscious response to information. As for bottom up, it is an automatic response without our conscious control.
Bottom up sexual arousal is the physiological response to sexually explicit stimuli (something you find sexy), such that there is genital arousal, however, this does not mean that you will be interested in sexy time. Even more, you might not even be conscious of your arousal. Researchers showed a variety of porn scenes to men and women and asked them to rate the porn based on how aroused they felt. The participants reported feeling aroused for only one type of porn but when they measured their physiological sexual arousal (heart rate, vaginal blood flow) they were equally aroused for all the porn scenes. Top down sexual arousal, is the conscious awareness AND interest in sexual arousal. Such that, the person will report the sexual arousal and possibly pursue sexual activity. For example, being touched gently by your partner while you are rushing and trying to leave the house might feel irritating. If you are being touched gently by your partner while relaxing in bed, you will experience the touch as sexually arousing. This means that being aware of sexual information or receiving sexual stimulation is not enough. The top down processing is responsible for the motivation and interest in sexual activity.
​
Because two systems are at play when sexual arousal and sexual interest occur, there is a potential for miscommunications between the systems. Not only is there miscommunication between systems, sometimes, the top down process suppress and stops the bottom up processing. Once the person is sexually stimulated, he or she must make the conscious decision to enjoy the sexual arousal in pursuit of sexual activity. However, since top down processing is subject to biases, attitudes, and social rules, it can easily interfere with genital arousal and stop sexual arousal despite the desire to be sexually active. As mentioned before, top down processing is our cognitive control over presented information. Even if there is a biological genital response to sexually explicit information, the possibility of sexual arousal is dependent on the mood and the environment. We cognitively need to evaluate the sexual stimulus and the environment as arousing. Hence, there might be blood flow to the genitals and vaginal lubrication (bottom up), but if the conscious mind (top down) is not “in the mood”, or in the right emotional state, sexual activity will not happen.
 

​You scanned the headings of this blog post and  I am sure you are surprised. Relationships as a habit, being independent, endless harmony, and knowing everything about your partner: These are generally qualities that are deemed positive for a relationship or a long lasting love life. However, as we classically know “too much of a good thing is not always a good thing.”

Making your relationship into a habit
The killer: The beginning of relationships are exciting and invigorating. However, there is one nagging thought “will this last?” While the relationship continues to develop and we realize that we really like this person and we really like who we are while we are with him or her, we begin to desire more. Naturally, we want the relationship to continue, maybe hoping it will last a lifetime. Hence, we begin to make efforts toward chasing away the nagging thought of “will this last?” We desire this person so much, that we want to chase away the unpredictability of the relationship. To manage our anxiety, we move toward securing the relationship (and that means something different for every person) by creating routines and predictability. While security, predictability, and routine, is always positive progress for a relationship, there is an inherent risk in making your relationship predictable and almost monotonous. Your relationship becomes a habit, and no one feels sexy when they are someone’s habit. Habits are not particularly invigorating or exciting, habits are just there. You practiced long enough and now it is a part of your life, you do not need to think about it.  Secure relationships would definitely be on the list of good habits. Conversely, constant seeking of excitement and “non-habit” relationships are what fuel sexual affairs. So now, all this seems too confusing. Hence, we need to find that magic spot between stability and keeping a relationship passionate.

The remedy: Trying to do something different is always good for a relationship. Instead of trying to find something new to do, kick it up a notch and try to stop doing what you always do and see what happens. Let the moment take you. For example, you always kiss your partner good night, it is ingrained in your routine and you are not even aware that you are doing it. What happens if one night you don’t kiss her? How does she react? What happens between the two of you? Do you do something else? How do you feel? How does she feel? No matter how this ends, you will learn something new about your relationship and your partner. Be aware: It is risky! But perhaps your relationship has been yearning for some risk.

Being Independent
The killer: “Independence is a problem? Didn’t you write an article on the importance of independence?” Yes! and I also wrote an article on dependency leading to satisfaction and commitment. But, complete independence and eliminating dependency in a relationship is the recipe for the death of love. Being dependent on someone makes the relationship “high-stakes”. The more we desire, the more we fear the loss. When we have a high-stakes risk, we invest in it. It is the high-stakes in relationships that fuels romantic passion. Desiring our partners love, is a declaration of dependency. You cannot have desire without dependence. You are dependent on your partner’s reaction and your partner’s response toward you; “will he/she love you or not?”. Hence, dependency makes us feel vulnerable and many of us are entrenched in trying to escape vulnerability. In fact, one of the character traits of narcissistic personality disorder is the inability to be dependent on a romantic partner. Narcissists are unable to admit that they need their lover in their life. For narcissistic men and women, dependency is too threatening and they are likely to escape the relationship (physically or emotionally) the moment they feel a sense of dependency.

The remedy: Be dependent. Ok, not completely dependent. You need to strike the balance between being independent but not fearing to admit some dependency on your lover. If the word “need” is too much for you, then go with the word “desire”, then take the plunge to express to your partner that you desire his or her love, comfort, recognition, respect… If there is something that your partner does best, let them know. For example, your partner makes a wicked coffee, thank him and let him know that his barista skills beat yours.

Endless Harmony
The Killer: I know I am pushing it now. But, endless harmony is the killer. The essence of relationships, as cliché as this sounds, are “its ups and downs.” Relationships will always have disagreements. If you are waiting for the day when you and your partner will never, ever fight again, you might want to reevaluate. If couples are in a relationship, past their honeymoon phase, and never fight or disagree, then their relationship is dead. Endless harmony means that one of you are not being honest. Partners will often avoid telling one another what they think or feel in order to avoid a fight. They create a façade of harmony when internally they are sitting on a lifetime of emotions they have never disclosed. Or, one partner is completely checked out of the relationship. He or she could not careless about their partner or their relationship.  

The remedy: Check in with one another. If expressing yourself in the moment is not your style or sometimes you don’t even know what you are feeling till after the fact, create a time of the day or week that is dedicated to sharing with your partner. For example, your partner mumbles under her breath that this is the third time this week she’s cleaned up after you and you are such a slob. You go about your day but find yourself irritable and yelling at your kids. You insightfully recognize that you were quiet hurt by your partner’s comment but you are unsure how to bring it up to her since the incident has passed. If you have a set time of day where you check in, you would be able to express your hurt feelings to your partner without trying to find the “right moment.”
 
“I know everything about you”
The Killer: Knowing everything there is to know about our partner makes us feel secure. We want to know what our partner is up to and we want to believe that our partner does not have hidden parts to him or self. However, there is a risk in believing that we know everything about him or her. The declaration of “I know everything there is to know about you” undermines and undervalues the complexity of the human psyche. We will never know each other completely -- that is what makes human relationships interesting, and yes, sometimes quite difficult. We are always changing, new environments stimulate different responses and triggering events evoke parts of our personality we might not have known about. When you stop being curious and discovering new aspects of your partner, your relationship stops growing.

The remedy: Be curious. Remain open and curious to learn about your partner. Ask you partner questions with curiosity and leave judgment outside the room. Asking questions with curiosity gives the other person the opportunity to respond honestly rather than defensively. Curious questions cultivate respect in a relationship allowing space for individualism and honoring differences. By remaining curious, you are guaranteed to learn something new about your partner.

​With the summer months approaching and social events taking place, many will struggle with social anxiety to some degree. Social anxiety may present itself on a spectrum. There are various marks, depending on the individual. In general, social anxiety refers to as one’s experience of anxiety in social situations. To a certain degree, anxiety serves us well. One example of this is when we are make big decisions or are in important situations. In those cases, anxiety helps alert our mind to the risks, which consequently brings us to think more thoroughly through our choices and/or behaviors. But for those who struggle with some form of social anxiety, every day events such as starting a conversation or attending an event can be very stressful. There are helpful techniques one can practice and incorporate when starting and continuing a successful, pleasant conversation with another individual.
 
Pointers for starting a conversation

• When starting a conversation, you want to be aware of making eye contact and speaking loud enough for others to hear you.

 

• When starting a conversation, start by speaking about something general, and not too personal, such as the weather. Another conversation starter is giving someone a compliment, or simply introducing yourself by saying “we haven’t met, I’m…”

 
Pointers for continuing a conversation:

• Carrying conversation takes more than one-person participation; therefore, it’s best to keep a balance between contributing to the conversation and listening. Try not to speak too much.

 

• Another point to be aware of is maintaining a genuine sense of self, and to some degree a certain sense of vulnerability. People appreciate vulnerability (though not too much since it can put people off when they don’t know you well enough). Others may relate to what you are saying or presenting, and this gives them a chance to normalize that feeling for themselves.

 

• When you are first getting to know someone, you want to show some curiosity about who they are, while being careful not to get too personal (as it can put people off since you just met). Try to keep your questions open ended since such questions require more than a yes or no answer. Examples of open-ended questions would be questions that begin with what, why or where. Some topics to bring up that are not too personal would be their hobbies or their line of work.

 
These are all good tools and techniques to use when one struggles with social anxiety. However, it’s important to keep in mind that during such times one may need further assistance to accomplish or overcome this struggle. Therapeutic interventions have been proven to assist individuals with social anxiety. In a therapeutic relationship, a therapist and client can work together to role-play and overcome fears that may come up for them. 

Every time I suggest to a client the idea of scheduling sex, without fail I get the same reaction. Either turning up their nose or a flat out no accompanied by “that so unromantic” or “it kills the vibe, if I need to schedule sex I would rather not do it.”  
​
Since you refuse to schedule sex, this is what it looks like: You want to flirt but you withhold because you're afraid that it will lead to sex and you just do not have time. Days go by as you and your partner make halfhearted attempts at initiating sex but you are both so distracted that nothing ever happens. You are tempted to sext your partner but abstain because you know you’ll both be drained at the end of the day, so why bother ignite the passion. You neglect to do anything to spark sexual tension because you've completely forgotten that sex is even a thing.
​
Imagine this, you know that your sex-date is scheduled for Monday or Wednesday or whatever your favorite day of the week is. You allow yourself to flirt, because you know there is no way sex is happening. So flirt all you want because you are going right back to that task that is waiting for you. You sext or send naughty messages as your sex-date draws closer. You allow sexual tension to build up because you know you are going down (or up) with a bang. All the passion that you invest has a goal and when on your sex-date you are present, no distractions. You are excited to remain intimately engaged because you most definitely remember that sex is a still a thing.
​
And if you break the schedule... have sex outside the allowed day… oh well, I doubt you'll complain.
​

​I used to wonder what makes one individual more resilient than another when faced with a painful situation or struggle. Linehan M. speaks on the concept of radical acceptance and its usefulness in painful situations. When one is faced with a painful or challenging situation, there are several ways in which he or she can perform: they can solve the problem, change how they feel about it, accept it, or stay miserable. However, Linehan talks about total and complete acceptance – radical acceptance – as a way to manage life’s challenges. When one accepts his or her situation, it doesn’t necessarily mean the person is glad about it. In actuality, radical acceptance may bring about sadness; but this is accompanied by an added feeling of centeredness. On the other hand, when we don’t radically accept our situation, the sadness may not be present. Instead, a deep sense of unbearable pain may take its place. 

There are times when reality is painful and, as a result, we try to push away the associated emotions and or fight against it through unhealthy coping mechanisms. Although this form of coping tends to bring about a temporary relief, in the long run, it intensifies the unwanted feelings. This happens when we bury the underlining emotions or situations and instead resort to obtaining temporary relief through unhealthy coping mechanisms. When one incorporates radical acceptance into their daily life, they are committing to accepting their reality as it is, and understanding what they can and cannot control. Furthermore, part of radical acceptance is being nonjudgmental and looking at just the facts of the situation, in addition to letting go and not fighting against the reality of the situation. While Many of us find it difficult to be present when dealing with uncomfortable and painful moments or emotions, that is all part of radical acceptance through which we can achieve a meaningful life.

​Taking a step towards self-betterment, and achieving a sense of centeredness happens when one completely and totally accept their reality, even if they think the reality is unbearable. Through psychotherapy, therapists and clients work together to bring about a radical acceptance of the past and present, in order to accomplish a more centered sense of self in any given situation.




Reference
Linehan, M. Cognitive-Behavioral Therapy of Borderline Personality Disorder. New York: The Guilford Press, 1993. ​

The definition of self-esteem is one’s evaluation of their own self-worth. The ultimate question being, “Am I worthy?” Our culture has hijacked worthiness into being something that society decides upon. It is no longer, “I am worthy just because”, but it is “I am worthy because I earn money, I am a mother, I have a career, I own a car… “ Hence, if worthiness has been hijacked, so has self-esteem. Self-esteem has become the pursuit of all the things society decided are worthy actions, behaviors, milestones, and items. Pursuing self-worth became an outcomes based task, if you can prove it, if you succeeded at it, then you are worthy, otherwise, you are not worthy and your self-esteem plummets. Society defines worthiness and we have all bought into it. Your measuring stick of self-esteem is yours and societies idea and definition of who is worthy, what makes one worthy, and what we should consider valuable. With this understanding of self-esteem, we become hyper focused with only one area of improvement. We invest all our self-worth in specific domains such as being a good mother, being financially stable, or having the job of our dreams.

Proving that we are worthy comes with a high price. Since worthiness is prescribed by the culture you live in, you are always dependent on others to notice and validate that you are doing well. Relying on others for validation and recognition creates a cycle of fear and anxiety. You become anxious about the other person’s opinion and you become fearful that they will reject you. Rejection means, you are not worthy! And your self-esteem is crushed.

There are three things in life that satisfy us; competency, relatedness, and autonomy or what Freud said the ability to work, love, and play. Competency is our ability to work toward and master a task; relatedness is our ability to love and maintain relationships; autonomy is our ability to play and take risks. The pursuit of self-esteem interferes with these three life satisfying goals.

Competency is our ability not only to learn a new task, but to learn from our past experiences. Self-esteem steals this opportunity from you because you are focused on the end goal and not on the process. Learning from your process allows you to recognize specific failures so that you can recreate your journey by implementing changes to improve the process. Competency is not only about completing the task, it is about mastering the task in the most efficient, productive, and satisfying way.

Self-esteem interferes with our autonomy. Since self-esteem is contingent on societies rules and what society says is acceptable, you are stuck between embracing what you desire or satisfying others so that you can say you are worthy, by their standards (do you get this nonsense?). Essentially, self-esteem is confining and rigid, stifling your ability to play and take risks. For example, failure by society standards is terrible, only unworthy people fail. Therefore, you never try something new because you are afraid you will fail, if you fail then you are unworthy, and once again your self-esteem is hit. The cycle continues, you avoid risks because you do not want to ruffle the feathers of your delicate self-esteem.
 
Finally, self-esteem hinders our capacity to love and experience relationships. We get lost in the goal of being in a committed relationship (society says: “you should have a boyfriend, you should have tons of friends.”) that we lose sight of living in the moment, allowing the ups-and-downs of relationships impact us. We become so preoccupied with our self that we completely overlook the experiences of other people in our life. When people challenge us in relationships we fail to appraise ourselves accurately because we are too busy protecting our self-esteem. We jump for a quick fix instead of introspecting and reflecting.

Self-esteem cannot be the ultimate goal. Self-esteem will happen as a result of pursuing competency, relatedness, and autonomy. Use your internal voice to validate and motivate yourself. Let’s do away with self-esteem and focus on life-satisfaction, because you do not need to prove to yourself that you are worthy, “you are worthy just because.”

​Anxiety may cause many physical complications and jeopardize one’s physical health, even though the origin is due to a mental component. It’s interesting that a mental thing can cause a physical effect. Lets take for example the fight-or-flight response; your system creates the stress chemicals (adrenaline, norepinephrine, and cortisol) causing your heart to race and blood pressure to increase. This response is there to save us from danger, however in many cases when faced with mildly stressful situations we tend to interpret as threatening and instead of it helping us, it causes our brains to overreact to various situations as threatening. However, this continuous exaggerated brain activity can cause abrasions and deterioration to the heart, muscles and brain. There are some individuals that don’t necessarily internalize the daily anxiety and stresses. What makes one individual more prone to struggle with anxiety as apposed to another? Nature and nurture both play an important roll. On the one hand, learning how to react to stress may be a learned behavior, which was modeled by parents and or caregivers. On the other hand, a genetic predisposition to be reactive or calm is another side of the coin.

​Various activities to help reduce anxiety

1. Exercise – exercise has proven to reduce the impact of stress on the body
2. Balanced diet and a good nights sleep are both important in helping to reduce anxiety
3. Mindfulness – techniques combining the mind and body has been proven to assist in managing stress. Particularly, the practice of Tai chi has been brought to the attention of mental health therapists due to its ability to lower stress. Mindfulness helps calm our anxiety through deep breathing and improving flexibility.

 
Using all or some of the strategies mentioned above may help reduce stress and bring about an overall well-being, both mentally and physically.