Dr. Alyson Nerenberg Psychology Associates, PC

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Should I Stay or Should I Go?

Although our practice advocates for staying together and working through relationship struggles whenever possible, sometimes it is not in your best interest to stay. The questions below can help you determine what the best course of action may be for you. Unfortunately, there is no definitive formula for deciding if your relationship has enough positive attributes to warrant the difficult process of working on it. However, through the process of honestly answering the questions below you will likely gain some clarity. Feel free to go over your answers with your therapist, 12-step sponsor, or a close and supportive friend.

  1. Is there physical violence in your relationship? You should not stay in a physically abusive relationship. The psychotherapist Mira Kirshenbaum clarifies this issue, writing, “Abuse that happens more than once means you must leave the relationship. Otherwise, it will happen again and again and it will get worse, and your self-esteem will fall and your sense of being trapped will grow.” I believe that if there is even one episode of physical violence that causes the possibility of injury or death, there is nothing to discuss. You need to leave immediately for the sake of your physical safety. Kirshenbaum further expands on this topic by saying that the “only exception is when the abusive partner is currently, actively, and motivatedly participating in a program designed to treat abusive partners and stays in the program for at least a year,” and that while this is happening the abuse has stopped. Although domestic violence is beyond the scope of this book, it is worth saying that if physical violence occurs, there are resources, including women’s shelters and other spousal abuse resource centers, that can help you create a plan to leave your relationship quickly and safely.
  2. Were things ever really good in your relationship? This is an important question because it leads to other questions. Were you ever in love? Were you ever genuinely happy together? Kirshenbaum states it simply, “You can often fix what was broken, but you can rarely fix what never worked in the first place.” In other words, a relationship that was never very good is not likely to become good in the future. An analogy for this concept is buying a house. When you go to buy a house, even if the house looks messy and the wallpaper is ugly when you first see it, if it is solid and sturdy underneath all of the dirt and clutter you can clean it up and have a beautiful home. On the other hand, there are houses that may look great on the outside but there is structural damage on the inside due to a poorly laid foundation. They may have water damage or a major termite infestation. You do not want to invest in a home that is truly rotten in its foundation. If you can’t remember a single point in your relationship when you were truly happy together, then it does not have a good foundation and it may be time to leave.
  3.  Do you and your partner have a couple of pleasurable activities that you both enjoy? A relationship where the partners share at least a few common interests is often worth saving. Some examples include: having friends over for dinner, cuddling in bed, doing crossword puzzles together over a couple of cups of coffee, watching movies together, going to the dog park, playing racquetball, and cooking gourmet meals together. This does not mean that you and your partner have to share every interest, but you should have at least a few recreational pursuits that you enjoy doing together.
  4. Do you actually like each other? Step back from any temporary anger that is occurring in the moment and ask yourself if you truly like your partner and if you believe that your partner likes you. Do you enjoy spending time together, or do you dread that moment when your partner walks through the door? Although no couple likes each other every moment of every day, it is important that you are mostly comfortable and happy to be with your partner the same way that you genuinely enjoy being with a friend. Also, does your partner make you feel like you are liked and cared about?
  5. Do you trust each other? It is difficult to recover when you are in a relationship that has experienced a breach of trust. However, many relationships do survive even the pain and betrayal of infidelity. But it is almost impossible to recover if you believe that everything out of your partner’s mouth is a lie. When you are in a committed relationship, you often are in a position to trust the other person with your home, your finances, your kids, and your feelings. If you don’t believe that your partner is capable of honesty, it is time to reconsider your investment.
  6. Do you still want to be touched by your partner? What about sex? Is it still good together? It is important for couples to engage in physical touch, including kissing, hugging, holding hands, and rubbing each other’s shoulders. Sometimes in anger there is a mutual shut down of sexual behaviors. Wanting to touch and be touched by your partner is a sign that there is still a physical and emotional attraction. Desiring physical touch is an important indicator that there is still some chemistry there, and it is worth working to end the shutdown. Enjoying physical intimacy is important in finding your way back to each other.
  7. Do you share core values and beliefs? Although no two people have the same exact set of values and beliefs, there needs to be some common ground. It is important to share some of the same views regarding religion, politics, finances, and raising kids. Without those commonalities, you are coming from two different playing fields and you may have a difficult time compromising or understanding one another.
  8. Do you and your partner usually find a way to resolve differences? Conflicts will inevitably occur in your relationship as no two people see things in the exact same way. When this happens, are you able to work through the disagreements in a respectful manner or is one person silently seething with resentments? Does one member “hit below the belt,” saying incredibly cruel insults to the other? Are your arguments growth opportunities where each person learns about and develops empathy for the other one, or is there an invisible scoreboard?
  9. Do you both generally feel respected? If one member of the couple is constantly silencing the other one and not listening to his/her opinions, the other one will feel disrespected and may shut down and refrain from speaking. This can lead to distance or a power struggle. One member may want to “take charge” at all times and be dismissive or curt with the other. This is not helpful for the relationship. In a healthy relationship, each person should feel listened to and respected.
  10. Do you have kids? I am not implying that having kids together is the only reason to stay in a relationship, but it is a reason to think long and hard before leaving. After all, your decision to leave impacts not only you but your children. My friend, the esteemed therapist and author Robert Weiss, eloquently says, “Breaking up a family is a significantly more profound decision than splitting up a couple because the lives and futures of several people, some of whom may be too young to fend for themselves, are at stake.”
  11. Are you both fully invested in fighting to save your relationship? Are you both willing to do whatever it takes to save your relationship, including going to a good couples therapist, writing in a journal, or going to a couples workshop? It is difficult to resurrect your relationship if only one of you is invested in trying to save it.
  12. Have you cut and run before? Is it your pattern to disappear when a relationship becomes difficult? Is your perfectionism leading you to leave as soon as you face hurt and disappointment? It may be worth it to stick around and work on yourself before you flee for greener pastures.


In 2002, the director of the Stanford University Forgiveness Project, Dr. Fred Luskin described forgiveness as a feeling of peace that emerges as you take your hurt less personally and take responsibility for how you feel. Both Luskin and Dr. John Gottman, founder of the Gottman Institute, describe a distress-maintaining scenario called a grievance story. They explain that when we have trouble forgiving someone, it is because we put on a selective filter and select only those elements of the experience that support our own perception of events. This creates a sense of righteous indignation as we recall the most negative aspects of the person and his or her most hurtful actions. We then view the most virtuous and innocent aspects of ourselves, filtering out any personal shortcomings. Maintaining this mindset supports our own grievance stories, where we are victims and therefore allowed to harbor and nurture resentments. Luskin urges us to change our grievance story to a forgiveness story, where we become the hero instead of the victim.

Forgiveness does not change the past, but it does change the present. It does not take away your pain. It does, however, mean that even though you are wounded you are choosing to hurt and suffer less. Hurting is a normal part of life and is a reality when you are in a relationship with someone else. There is no relationship that is pain free.

More importantly, just because you chose to forgive someone does not mean that you are necessarily going to stay in the relationship. You have choices. You can forgive and rejoin the relationship or you can forgive and never speak to that person again. The act of forgiveness is for you and no one else.

Turn On the Beauty, Forgiveness, and Gratitude Channels

When we stay stuck in our grievance story, we spend all of our time focused on grudges, anger, and wounds. We lose sight of the good aspects of our lives. Luskin describes the act of picturing yourself changing the trauma channel on a television. I have used this analogy with many patients who are caught up in their grievance story. I ask them to picture their television sets and all of the many channels that are available to watch. Instead of staying on the trauma channel, I ask them to envision themselves switching to the beauty channel or the gratitude channel. If they turn on the beauty channel, they could embrace nature shows or appreciate incredible music. They could also notice the taste of a delicious meal, the sight of a field filled with wildflowers, or the tantalizing aromas around them.

I then ask my patients to picture themselves switching the station to the gratitude channel. I ask them to imagine themselves walking into a supermarket filled with an abundance of delicious food. I tell them to picture themselves saying thank you for having so many options available. Then I take it a step further by asking them to imagine themselves walking into a hospital or a nursing home and saying thank you for the fact that they are healthy when so many people are not.

After they have a moment to contemplate their good fortune, I ask them to remember any kind act done to them by their parents or other family members. Additionally, I ask them to give a silent prayer of thanks for small acts of kindness, such as when they walk into a store and a salesclerk offers help. I also speak of the value of mentally thanking each of the drivers who are following the rules of the road. There are so many little things that we take for granted when we are not watching the gratitude channel.

Lastly, I ask my patients to turn on the forgiveness channel. When you are looking at the world through the lens of forgiveness, you notice people who have forgiven others. I urge my clients to ask people they know who have forgiven others to tell them their stories. I also ask them to remember a time in the past when they themselves have forgiven others. I remind them that they can do this again. I suggest that they read books about people who have forgiven others and to search for forgiveness stories in their own families. I suggest that they practice forgiving even the smallest offenses that are done against them, whether it is a waitress who brought them the wrong order or an acquaintance who messed up the pronunciation of their name. The act of forgiveness is like exercising a muscle. It gets stronger with each bit of practice.


Navigating Life’s Wrong Turns

I am directionally challenged. In the past, I got overwhelmed by maps and needed to write out my directions in words, including as many landmarks as possible so it would make sense to me and I wouldn’t end up lost. From my perspective, one of the greatest inventions of all time is navigation systems for cars and phones. Instead of having to fumble with maps and directions from strangers, I can just follow my Waze app.

In therapy sessions, I often share with patients my belief that the navigation system I use in my car is a great analogy for life. I explain that there are times while driving, even with this wonderful navigation system, that I blow it. I miss the turn completely, or I turn left when the app says to turn right. What I love about the navigation system is that it does not judge me, it just tells me how to correct my course. The navigation system does not say to me, “You screwed up, you stupid idiot!” Instead, it says, “in a quarter mile turn right.” There is no cruelty, sarcasm, or judgment. It simply tells me to do the next right thing.

Twelve-step fellowships have been promoting this “do the next right thing” slogan for years, and it is one of the principles I try to follow as I live my life. Instead of beating myself up for making choices that were not exactly in line with my highest self, I just keep showing up and trying to do better. Whether I overreact as a parent or communicate too harshly to a friend, I concentrate on breathing, and on slowly letting go of the harsh voice in my head that is judging myself. I try to quiet that critical voice and focus on compassion and self-forgiveness. When that doesn’t work, I just try to do the next right thing.


Two Questions I Ask at the Beginning of a Couples Therapy Session

I often start a couple’s therapy session by asking, “What have you done to help your relationship this week?” This is a very powerful question because it changes the couple’s mindset. Instead of pathologizing the problems in their marriage, it turns the focus to what they have done well. It also sets up the image of them working as a team to help rescue their relationship.

After I ask this question, there is often a pause as each member of the couple reflects back upon their successes the previous week. They each have the opportunity to share a behavior that makes them feel proud. This experience also helps them reframe small gains as essential contributions to the health of a relationship.

After listening to the couple share the positive behaviors that they have contributed, and providing supportive feedback and reassurance, I ask them my second question, “What have you done to hurt your relationship this week?” This question normalizes the fact that we all do things that harm our relationships. It implies that despite our best intentions, we all engage in behaviors that are not ideal.

For individuals who are coping with illusions of perfection, this question is freeing. It can be a springboard to address deeper patterns in their relationship, or it can simply provide an opportunity to examine a situation where they “blew it.”
As we look at what each partner did that did not go well, we are able to practice working through shameful feelings in order to help each person listen to one another. There is also an opportunity for accountability, apologizing, and forgiveness.

My hope in implementing these questions is that the couples I treat will begin to reframe their small positive interactions as successes, and will look at their struggles as not being the end of the world. My longer-term hope is that after several sessions in couples therapy, they will be able to check in with each other on a weekly basis and ask themselves these questions without a therapist present.


Family Hike #89

Dr. Alyson Nerenberg, Psy.D. discusses the importance of family time and the great outdoors, especially during the COVID-19 lockdown. My husband and I have always liked the outdoors.  We enjoy hiking and have even spent a week long summer vacation visiting Jackson Hole, Wyoming. Once or twice a year we actually manage to take the kids out with us hiking in our local National Park.  We take the dog, Rosie, with us too, and feel proud of ourselves that we “aired our family out,” by getting them away from their screens. However, in this time of Covid 19, we have taken hiking to a whole new level. Instead of participating in family hikes once or twice a year, we are now hiking two or three times a week.

Normally we are a very busy family.  My oldest daughter lives away at college and when we are lucky enough to have her grace us with her presence, she either wants to shop, sleep, study or make arrangements to see her friends. We are kind of a “pit stop” on the way to better plans. My younger daughter is equally busy. She is the queen of “hanging out” and at any moment has three or four friends lounged out across her bed passing around a bag of chips.  Getting her to join us on a hike usually takes quite a bit of creativity and persuasion. Our son is the youngest by many years so we still have a captive participant for our hikes; however, he has tennis, baseball and Sunday school making up his weekends. Additionally, he tells us that hiking is boring for him unless his sisters are dragged along for the experience. I’d like to blame our busy schedules on our kids’ schedules, but that is just not the case.  In a typical weekend my husband is scheduled for two tennis matches or practice sessions.  Add in my own weekly tennis clinic and spin class, and now that I think about it, it is a miracle that we even have a moment to speak to each other, let alone go for a weekend hike.

But now we are in a time of quarantine….All of our schedules are cleared.  My daughter left her sorority house and campus life behind.  My younger daughter’s busy senior year in high school came to a screeching halt. Even baseball season for our son was canceled in 2020. There are no tennis matches, or gyms to go to. I actually miss the parade of teenage girls who are always camped out at my kitchen table. Now I just stare at my four immediate family members and hear my hyperactive husband ask, “Who wants to go for a hike?” In a time when there are limited options we all pile in the family car and drive to our local hiking location, Valley Green. Although the kids may be grumbling, they agree to go.  Our dog, Rosie is the most willing participant.  Come to think of it, she has never gotten so much attention in her whole life!

Once we get out of the car, we can exhale. Our family is surrounded by beauty. Spring is beginning to blossom and the leaves are starting to appear on the trees.  Some branches are still bare, but the creek flows in such a soothing way. For a moment, I forget about the quarantine and all of the losses that we are experiencing. I forget about the fact that my mother’s childhood best friend died today. I let go of the worry about my patients that I am carrying like a deep dark cloud in my heart. Each of the traumas they suffered this week impacted my soul. I don’t think about my own daughter missing her senior class trip, prom and graduation. I release the sadness of seeing my older daughter’s wonderful college semester be interrupted. I let go of my worry about what next year will look like and whether either of my girls will be able to go away to college. I choose to not think about what the academic and social losses will mean to my young son. For just a moment my husband lets go of his uncertainty about the future of his business.

Instead I choose to watch my son run off and jump on the rocks next to the stream. His sister chases after him while my oldest walks Rosie.  I look up at the sky and feel the sun warming up the brisk cool day. Being out in nature reminds me that there are bigger things than the Cornona virus.  Bigger than news reports, and fear are spirituality and hope. When I am in nature with people I love, I can connect with something larger than myself. Instead of focusing on losses I choose to listen to the sound of the stream and I continue to exhale. I watch a blackbird fly overhead and remind myself that this is just one part of our story and that this period of time will pass.


Love in a Time of Corona Virus

My 30 year old patient just told me he recently asked a woman he met on Hinge “Would you rather go on a first date through: FaceTime, Zoom or scream at each other from 6 feet away in a park?” Being quarantined home alone in his apartment reminded him of his deep desire to develop a healthy relationship. For some people living alone, the loneliness they are experiencing helps them prioritize the importance of forging intimate relationships.

For other people who are already in intimate relationships and living together, it may feel like the ultimate stress test.  In fact, there has been research that looked at how people cope after tragic life events. In 2002 The Journal of Family Psychology produced a paper after Hurricane Hugo looking at how people in devastated counties of South Carolina coped after this tragedy. In this paper, the authors explained how attachment theorists would predict more marriages and births. Stress researchers on the other hand, predicted that marriages and births would decline and divorces would increase. What actually happened the year after Hurricane Hugo was that they both were right. There was an increase in marriages as well as births and there was also an increase in divorces. What this showed was that life-threatening events motivate people to take significant actions in their lives. What this could mean for us in the time of Covid-19 is that this is a crucial time for people to take stock of their lives and realize what is really important.

For people who are consumed with work, being home full-time gives them the opportunity to focus on their relationships with family. Although there is a great deal of good in this, it can also be very stressful. Add in the additional stress of financial uncertainty, fear about getting sick and losing the ones we love, as well as the fact that there is no end in sight to this.  We are all experiencing grief as we cope with the various losses in our lives.

As a clinical psychologist who usually spends my days counseling individuals and couples face to face in my office, I have had to change my practice. I now conduct all of my therapy sessions through FaceTime, phone calls or zoom sessions. As people get more and more anxious, I find myself working harder and longer hours.  I am more tired and depleted as a result.  Upon reflection, I have learned a lot of useful information through this time and would like to share what I have learned with you so that your relationships do not suffer through this time of Covid-19.

What I Have Learned Counseling Couples During Covid-19 Through Face-Time and Phone Sessions

  1. Tone of voice is everything. How something is said, not just what is said matters. During my phone sessions, I am much more focused on the way information is stated.  Without the distraction of looking at someone, I am able to really notice the pauses between words and how forceful one person can be in her communication style.  I can literally feel the other person distancing himself when the communication style is harsh. This reminds me of the significance of modulating my own voice when speaking to my family members. Letting go of the intenseness of our communication may allow us to be heard in a more gentle yet meaningful way.
  2. Changing Your Praise to Criticism Ratio- According to Dr. John Gottman’s research for a relationship to stay together there needs to be five positives to each negative remark. While you are home spending more time with your partner, it is easy to focus on what is bothering you. Make a conscious effort to instead point out what you appreciate. “Thank you for taking our children for a walk so I could get some work done. I am glad that you are so connected with nature and able to teach our children to value it, too.” “I am so fortunate that you are a great cook.”
  3. Gratitude is Essential- In a time of loss it is so important to focus on what we still have. Before each of my Facetime or phone sessions I spend a moment thinking about each person I am going to meet.  I focus on something I am grateful for because of our relationship. I reflect on the woman who had the strength to leave her abusive relationship before the time of quarantine. I am so grateful she is safe now.  She taught me to not waver on your own convictions and the value of being brave. I am, also, grateful for the man who got into recovery one month before the quarantine and is now using online 12 step meetings.  He has taught me the value of persistence. Along with being grateful for each of the wonderful people I am able to counsel, I am also grateful for the little things like having a good cup of my favorite hazelnut coffee and having a bright and beautiful office to sit in while I do my counseling. I am also extremely grateful for my white fluffy dog, Rosie who is always up for a walk. If expressing gratitude does not come easily to you, begin with a gratitude journal or a moment of meditation where you just focus on the awareness of what you are grateful for.
  4. The Value of Touch- The corona virus time of social distancing has decreased our ability to take and give touch, handshakes and hugs. It is so important to affirm the people you are living with by touching them, holding hands and snuggling up. We are all scared in this uncertain time and touch is an important way to help soothe yourself and others.
  5. Eye Contact Matters- It is important “to be present” while you are in the same house. When you are living in close quarters with someone and not emotionally connected, you may feel lonelier than if you were alone.
  6. Boundaries are Crucial- When you are spending almost all of your time in the same house or apartment, it is very important to try and respect each other’s space. If you are quarantined with young children, it is essential that you put them to bed early enough to have some “adult time.” Even if you are just going on a walk together, “couple time” is important.
  7. Don’t be “The Bickersons.”- This is the time to let go of resentments and pettiness. Limiting the toxic energy of fighting is important for your physical as well as your emotional health.
  8. Keep Your Sense of Humor- While our family was playing Monoply, it struck my 20 year old daughter as ridiculous how hard I was trying to make a deal with our 9 year old who stuck to his guns and refused. She laughed so hard that no sound came out and her eyes teared.  I have carried that image with me for days.  In a time when our future feels bleak, and there is a sense of heaviness and fear around us, I am glad to have a moment of lightness and joy. Although it is easy to get caught up in the news and the dire situation we are all existing in, moments of levity and laughter are necessary to feed our souls.
  9. Respect Each Other’s Differences- Each person approaches moments of crisis in different ways. For example, one person may binge-watch news programs and read all he can about Covid19, while the other person may want less information. My husband believes in reading everything he can about the crisis. I get overwhelmed by too much information.  When we were in bed he was reading aloud about how Covid19 was impacting NYC and I had to set a boundary.  I told him that I would prefer to read my novel, and did not want to hear more about the crisis before falling asleep so I would not have bad dreams or sleep fitfully. Another difference that couples may experience in a crisis is that one person may be preoccupied with fears of taking risks while the other person wants to maintain a more normal life. Lastly, after a disaster, one person in a couple may be more optimistic, proactive and hopeful while the other is more passive, fatalistic and pessimistic. It is not that one person is right and the other is wrong, it is simply that each person has a different style of coping with trauma.
  1. Kind gestures go a long way. My husband included a pack of Twizzlers when he came back from the grocery store after buying the essentials that we need. We have been watching a lot of movies at home recently and he knows what my favorite movie theater snack is. Whether it is unloading the dish washer or massaging your partners feet caring gestures allow each person to feel valued. These are tough times and little acts of kindness can seem like luxuries that help us get through it.

Although there is no way to “divorce proof” your marriage in a time of the Corona Virus, being aware of the differences that you have, and working hard to care for each other in this stressful time should help you move through this crisis with your relationships intact and potentially stronger. If you are not in a relationship, use this time to be kind to yourself, as well as focus on the positive qualities that you have to offer. At the end of the day Covid19 may take away a lot of things from us, but it does not take away our ability to be loving to ourselves and others.


8 Tips to Safeguard Your Mental Health in the Midst of the COVID-19 Pandemic by Katie Dixon

In the wake of the coronavirus pandemic, fear and worry abound. We are confronted with preoccupations about our physical health and safety, financial security, and the uncertainty of the timeline projected for the current quarantine. Additionally, we have been required to make drastic changes to our daily routines, seemingly overnight. Keeping up with news and social media updates can further exacerbate our already precarious state as each piece of new information seems to be more dismal than the last. Fortunately, we are now well-equipped with some practical information about protecting our physical health. My hope is that this post will provide practical information to safeguard your mental health during these uncertain times.

  1. Stay informed and follow recommendations

It is important to stay informed about changes being made to the current protocol to minimize the impact of the coronavirus. While much remains undetermined, you have control over your response to every situation with which you are faced. There is real power in that. By adhering to the recommended protocol, you are doing your part for your family, for your community, and for yourself. If you are willing and able to find other ways to serve members of your local community, to make donations, or anything else that supports those on the front lines of this issue, that is a most admirable thing to do. However, sometimes the most courageous thing we can do is simply what we have been asked to do. The guidelines you are being asked to follow may be different based on your line of work, your age, whether or not you or someone in your household is experiencing symptoms, etc. By keeping up with any new recommendations for your specific circumstances, take comfort in knowing that you are caring for yourself and those around you to the very best of your ability. When your mind begins racing and asking “what if?” questions, remind yourself that you are acting responsibly by doing what is recommended.

  1. Know yourself and have compassion

Each of us has a different response to stress. Get in touch with the thoughts and behaviors that exacerbate your stress unnecessarily and those that help to alleviate it. All stress is not bad. In fact, a certain level of stress can keep us alert and motivated to take necessary precautions. That being said, an adaptive stress response has the potential to quickly spiral into unchecked anxiety. The results can impact our sense of ourselves in the world, our relationships, and our ability to function in meeting the demands of our daily lives.

If you know that watching the latest news updates or reading articles from various sources will help you to feel empowered under these circumstances, then that is what makes sense for you. I would still encourage limits with the amount of information you take in. It is important to make time for other things to maintain some normalcy and balance in your life.

Perhaps you are someone who is overwhelmed by the constant stream of information. That is okay, too. You may need to unplug in order to assuage your worries and that is what works for you. Know yourself and be patient with yourself. We do not all need to be on high alert at every moment of every day in confronting this situation. In fact, having a bunch of people who are riddled with worry is not much help to anyone. If you live with other people who are responding to this situation differently than you are, try to be patient with them also. Everyone is responding in the best way they know how.

  1. Connect and disconnect

It is important to stay connected to what is happening in some way. For those who become easily saturated by media and social media, you may opt for one source for information that you check once a day or every other day for important updates. You may instead choose to have a quick conversation with a loved one who can synthesize updates in a way that feels less overwhelming. This is still staying informed.

For those who feel that knowledge is power, there is often a sense of security that comes with having an intellectual approach towards a problem. If this strategy is helpful for you, then watch and read what you can. I still recommend putting parameters around this, however, as anxiety can quickly feed into an obsessive need to gather information. You do not need to get the latest news update at 2:00 am, for example. It would be better to get some rest and learn any new updates the next day. It is important to make room for aspects of your life other than gathering every piece of information you can. It is okay, and even necessary to your mental health, for you to disconnect from time to time and direct your attention to other areas of your life.

  1. Have a plan of action

When anxious feelings rise to the surface it may be helpful to ask yourself, “Is there something I can do in this moment to mitigate my worry?” If there is something practical you can do, in most cases, I would recommend that you go ahead and do it. When we boil anxiety down, what we are really dealing with is fear. It is fear of uncertainty, of the unknown, and of that which we can not control. Sometimes creating plans around the things we do have control over provides an outlet for some of our worries. Having a plan and executing it, creates a sense of purpose and allows us to control that which is within our control when so much remains uncertain.

An example of this might be checking in with your grandmother regularly.  If you know that calling your grandmother would make you feel less worried, then by all means, make that call. If you know your children will be home from school all day and you want them to get outdoors for a bit, you can plan for that. Having a plan and a routine is an excellent way to manage anxiety. Sometimes our plans won’t go as we expected or an unforeseen circumstance will thwart our carefully laid out agenda. Practicing being flexible also prevents us from creating further stress during an already stressful time.

  1. Stick to your routine as much as possible

Sticking to your routine may be tricky considering that your usual daily schedule has likely been completely upended. You can still commit to making the time to eat regular meals, to stay on a consistent sleep schedule, to maintain good personal hygiene, and to keep up with the things you enjoy. Of course, a few adjustments will be necessary. Remember, flexibility is key.

If you enjoy going to the gym everyday, you might find some great workouts online that can be done without the need for equipment. If you typically enjoy a favorite meal from a restaurant during the week, you might learn how to make that favorite meal at home. The novelty of this experience may mean that some of you are embracing the opportunity to wear your pajamas all day. Why not? Go for it! However, if you have been in those same pj’s all week, it might be time to consider reestablishing some structure in your day. You can still get up and get dressed. You can plan which things you can still do with very little adjustment at home and those that will require some creativity. There is no right or wrong approach to this, but those who struggle with anxiety or depression usually benefit from adhering to an established routine.

Those who may have been struggling with depression prior to the onset of the coronavirus pandemic may have already been finding it difficult to complete daily tasks. Now is not the time to give in to your feelings of not wanting to do anything. For these individuals, I recommend setting at least one goal each day and accomplishing it, no matter how small. Weeks of doing nothing or not knowing what to do will inevitably take a toll on your mental health. Of course, you can take a break from the demands of daily life more easily now, if that is what you need. Nonetheless, getting into some kind of routine will be a friend to you while sheltering in place.

  1. Try something new

Now that most of us have more free time at our disposal, this is the perfect opportunity to explore some new hobbies. This might be a chance to do some home projects, to watch a movie you have been wanting to see, to learn a new language, to read that book you have been wanting to read or write that book you have been wanting to write! I am not suggesting that you pretend like the world is not in the midst of a crisis because it is and we all are. Some of us will be affected more profoundly than others. I am guessing you give a lot of thought to that on any given day and that you have been doing so for the past couple of weeks. It is okay to give your mind a break from it all. If you are practicing social distancing to the best of your ability, you are doing your part.

It is okay to relax, to learn, and even to experience joy in the midst of adverse circumstances. This problem will continue to exist whether or not you take a break from being inundated with new information about it. Having the opportunity to recharge is healthy for you and everyone around you. Taking a break from the demands of daily life is a healthy practice in the best or worst of times. Do something nice for yourself, something that you have been putting off doing because you haven’t been able to find the time. This is your chance!

  1. Challenge feelings of guilt

Unwarranted feelings of guilt may be a byproduct of this whole situation for those who are generally faring well. It is okay that your situation is not completely dire. It is not your fault that other people are experiencing tragedy and loss. Of course, we must be compassionate, but you will not prevent others from suffering by suffering yourself. Be grateful for the things in your life that remain consistent and stable. You are doing your part to protect others by following the recommended protocol. Find peace in that. You do not have anything to feel guilty about.

  1. Talk to someone

Talking to someone is undoubtedly the best thing you can do for yourself during this time. If you are overwhelmed by your feelings and unsure of what to do next, please seek the support of a mental health professional. There are people who are trained to work with you in understanding and managing what you are experiencing right now. Due to the current social distancing guidelines, many therapists are offering teletherapy to clients. It is easier than ever to connect with someone who is ready to listen through a video-conferencing platform or by phone. If you are someone who has been personally affected by the coronavirus, there are resources available to you whether your situation involves loss of a loved one, worry over a loved one’s health or loss of income. Please reach out for support. It is readily accessible to you.

From a more personal perspective, it may be useful to have a list of a few people in your life who you can reach out to when you are feeling overwhelmed. Sometimes just being able to express how you are feeling lessens the intensity of it. Many of your family members, friends, colleagues and neighbors will likely be able to relate to what you are feeling right now.

  1. Avoid complete isolation

Social distancing is a term we are now all too familiar with, but it does not mean complete isolation. There may be introverts who are welcoming the opportunity to spend quiet time alone. For those who thrive on social connection, social distancing may lead to symptoms of depression. Please be mindful of this and to find ways to connect even when you are not able to be with others physically. I would encourage you to connect with someone at least once a day, especially if you live alone. You can do this through FaceTime and any other number of messaging tools such as Zoom, Google Hangouts, WhatsApp and House Party, just to name a few. For connecting with family and friends who may be less tech-savvy, you can always opt for an old-fashioned phone call. It is vital that we make connections with others, when possible, as we are inherently social creatures. This truth is consistent even for introverts.

Additionally, if you know someone who is living alone or is under particularly stringent recommendations due to living in a retirement community or being symptomatic, please reach out to them from time to time. Those who were already feeling isolated are prone to feeling more isolated, alone, and even abandoned. If you are the person who is experiencing such feelings, being the first person to reach out to someone else is an essential first step to interrupting these emotions and preventing the onset of depressive symptoms. If you don’t have anyone you feel you can reach out to, this would be an opportune time to take advantage of the many professional resources available to you and seek the support of a mental health clinician.

  1. Harness the power of positive thinking

Much of my work with clients involves incorporating positive thinking into their daily lives. There are times in life when thinking positively can seem nearly impossible. For many of us, this may feel like one of those times. I am not suggesting that we should avoid looking at our current situation realistically. In fact, I am a huge proponent of acceptance of the situation exactly as it is. You might say to yourself, “This is terrible.” In this case, you would be absolutely right!  Coming to terms with our current reality is a critical exercise. It is even more imperative to recognize that things are constantly changing and the situation as it is right now, will also change. This is where you can learn to harness the power of positive thinking.

It is okay to be scared, angry, restless, and frustrated. This situation may call for any of those feelings at any given moment. The best thing you can do is acknowledge you are feeling that way, and give yourself permission to feel it fully, no matter how uncomfortable it may be. The next step after feeling the emotion fully is absolutely crucial. Commit to yourself that you will not stay there with that negative emotion. Tell yourself that you will not remain in that place of fear, anger, restlessness or frustration. In your mind, you may list all the reasons that justify that the situation is absolutely awful. When you find yourself doing that,  counter those thoughts with the things you still have to be grateful for even in trying times. For every negative feeling or thought, counter it with something positive. This will keep you from falling into a pattern of negative-thinking which can lead to more persistent issues relating to anxiety and depression. There is always something for which we can be grateful even when it seems like a complete stretch. Reach for that thing and hold it. Let it be your shield from the things that are not always going your way.

A practical way to jump start positive thinking is to keep a gratitude journal. You can take a few moments each day to write down three things you are grateful for. There is added benefit to doing this in the morning in order to begin the day from a place of positivity. You can re-read those three things again before bed to help offset any negative feelings that may have come up throughout the day.

A final note

We will always be faced with problems in our lives. Usually, these problems affect us individually at varying times, but our experiences are universal. Right now we are facing a big problem together. Your worry at this time is shared by many. Your hope is shared by many also. My hope is that you may find comfort in that. Someone in the world is feeling exactly what you are feeling right now, no matter what that feeling may be. Please remember that whatever you feel at this moment is absolutely okay. If the tips provided in this post do not help to alleviate some of the stress around the present circumstance, please reach out for support. There is so much available. We will all get through this, together.


When Your Life Has More Drama Than a Reality TV Show: Time to Unpack the Karpman Triangle

As a psychologist specializing in healing from addictions and relationship counseling, I am frequently confronted with difficult situations in relationships. The pain involved in an unhealthy relationship is enormous yet people stay stuck in their discomfort for many years. Why? When confronted with this overwhelmingly difficult question, I like to explain it in more simple terms. Recently, I have been utilizing Stephen Karpman’s Drama Triangle (1968) to explain dysfunctional relationships and why people stay in them.

Although Karpman described this triangle over fifty years ago, it can still apply to our relationships today. He explained it as a social model of human interaction where there is a map of destructive interactions that can occur between people in conflict. I have adapted this model by putting my own modern spin on it to help my patients understand why they are feeling dissatisfied in their relationships. For simplicity, I have described each of the roles with masculine pronouns, however each of the categories could be taken on by individuals of any gender.

At the bottom of the triangle is the victim role.  This is the person in a relationship who feels oppressed, helpless, hopeless, powerless, ashamed and unable to function effectively. He is the person who says ”Poor me”.  He struggles with solving problems or finding any pleasure in life. This is a person who lacks any accountability and subsequently does not gain insight into his situation. He often feels depressed or anxious along with a great deal of shame.  This position is so painful that after a while it may become intolerable. This role could be the woman whose husband is an addict, or the man who was fired from his job.  It could be the spouse whose partner had an affair.  It is a person who feels like he has no power in the present situation. Because this position in the triangle is so painful, the victim may quickly move to one of the other roles.

For example, the victim may take on the rescuer role where he says “Let me help you.” This is the role of being an enabler. The benefit of this role is that when someone focuses all of his energy on someone else, it enables him to ignore his own anxiety and issues. The negative effects of this role is that it can keep the victim dependent and give the victim permission to fail.  Additionally, when a person feels like he does not have any worth, he will keep trying to prove his value by “doing more and more.” Examples of this are: compulsive caretaking including doing all of the housework, taking care of all of the child care responsibilities, along with working full time and then feeling like a martyr. Once the rescuer feels  resentful, like a martyr it is easy to switch roles again and enter the persecutor role.

The persecutor role is the victimizer.  He is the villain or the offender and acts out his rage. He may say “It is all your fault.” He can be controlling, blaming, critical, oppressive, rigid and superior.  The persecutor acts entitled and shows his anger through his bad behavior.  He can scream in rage and be physically, emotionally or sexually abusive.  The victimizing may be overt such as being physically abusive, or it can be covert such as having an affair. The persecutor’s behavior is a way of indulging in entitlement or displaying rage. It could involve compulsive shopping, gambling or drinking until oblivion. After acting out in that way, the persecutor feels terrible about himself and often can not tolerate this role anymore, so he switches to being a victim again, or tries to make up for his wrong actions by compulsively caretaking in the rescuer role.

This is called a triangle of dysfunction.  There is very little health on this triangle and partners often stay stuck in their pathology. In fact, I have often seen individuals lose years of their lives to this “dance” remaining a victim, perpetrator or rescuer.  The only way out of this triangle is through vulnerability. It takes a person willing to risk looking at his own part and behaviors through accountability, honesty and acknowledgement. Therapy is a process that can help individuals look at the part they play on this triangle and share their feelings of pain and fear that are occurring beneath the surface. Through honest sharing of emotions, couples find their way to more straightforward ways of relating to one another and finally step off of the drama triangle.


Does Your Face Light Up?

One of the most important life lessons I have learned occurred while I was watching an old interview with Toni Morrison. Morrison described how when a child enters the room and looks to see her parents, what she is searching for is to see if their faces are lighting up. Are their eyes sparkling?  Do the grown-ups in the room care if she is there?

So often parents are preoccupied on their cell phones and spend too much time checking their texts and emails, worrying about the next event they have to attend, or their next deadline.  If they do notice their child, it is usually to focus on her imperfections. The parents may fix their daughter’s hair or tuck in her shirt.  They may believe that this is caring for their child by trying to fix her and make sure she looks “presentable.” However, the message the child receives is that she “is not good enough” the way she is.

This concept gave me an “Ah-ha moment.” I heard it when my children were babies and have always tried my best to allow my eyes to sparkle whenever they walked into a room.  Sometimes I still try to consciously stop myself from “fixing them” and just allow my face to light up as I take in their incredible presences.  I have also expanded this concept to apply to not just what children crave but what everybody craves. Whether it is the cashier at the grocery store, our colleagues at work or our partner greeting us at the end of a long day, we all long to know that we are seen, appreciated and that we matter.

Maya Angelou expanded upon this topic by describing that there are four questions that we are unconsciously asking each other all of the time. The four questions are:

  1. Do you see me?
  2. Do you care that I am here?
  3. Am I enough for you, or do you need me to be better in some way?
  4. Can I tell that I am special to you by the way that you look at me?

Although these questions are rarely vocalized out loud, and are often unconscious, when the silent answer is YES, people feel appreciated and loved. Whether it is your children, your colleagues, your partner or anyone in your community who truly feels valued by you, it is because you have answered these four questions in an affirmative way.

One of the reasons that dogs are so universally loved is because they answer these four questions consistently with a Big YES! Dogs are creatures that frequently live in the present moment. Humans sometimes fail in this arena. What that looks like is often disconnection. In my practice I hear people expressing dissatisfaction and feeling isolated.

They often say:  “He didn’t even look up from his computer when I walked into the room.”

“She’s looking at me but it’s like she’s looking past me”

“I know he loves me but he’s just so checked out. Sometimes I want to shake him.”

How do we change this phenomenon?

We take an extra second to actually look at the other person. We allow our eyes to sparkle as we smile. We truly connect.  Connection is not based on the amount of time we spend with someone but instead, it is the quality of our presence. Being present does not require meditation, deep breaths or any mantra. It is simply a decision “Ok, I am going to be present now.” ”In this second I will smile with my eyes and truly listen to what the other person is saying. I will do my best to communicate that I am happy that the other person is here .” This does not need to be communicated in words but instead can be shown nonverbally on your face, in your touch, with your eyes and with the quality of your presence.


Finding Your Zen–For Meditation Flunkees

Dr. Alyson Nerenberg, Psy.D., CSAT-S can help you find your way to live in the moment and meditate.In 2020 there seems to be an unwritten rule that all holistic therapists are supposed to recommend  that their patients meditate. This recommendation has become so popular that it feels “on trend” like eating kale or suggesting yoga.  The goals of meditation are varied, but generally the purpose is to encourage our patients to “be in the present,” unplug and focus inward. Many therapists suggest meditation apps as well as going to private meditation classes. While that is a great aspirational goal for many people, it does not work for everyone.

Several years ago, I googled “surrounding meditation classes” and did not find many that were close to where I lived and had times that were convenient for a working mother. However, I did find one class that I could attend, but found it difficult to incorporate it into my schedule on top of my regular cardio workouts and other life commitments.  Subsequently, that meditation studio moved out of my area.  After that unsuccessful endeavor, I downloaded a couple of meditation apps on my phone and began the process of “disconnecting.” I went into my bedroom, surrounded myself with a bunch of pillows, closed the door and began my meditation practice. Unfortunately, my family members all found me. The first offender was my teenage daughter who had an urgent question for me one minute into my practice.  After “shooing” her out of the room, I got into my comfortable position again, and my young son came looking for me.  After explaining to him that “Mommy is busy right now,” I once again tried to engage in the practice of meditation.  Two minutes later my husband found me and wanted to talk. Before you judge me for having no boundaries, I want you to appreciate the fact that I live with several family members who have ADD. The moment that I am preoccupied, I suddenly become the most fascinating person in the house. After patiently explaining to my husband that this was “my time,” I locked the door.  Unfortunately, my dog suddenly experienced separation anxiety and started barking outside of my bedroom.  At this point, I gave up and decided that meditation might not be the relaxation of choice for me.

About ten years ago, I rediscovered my love of tennis.  Tennis was a sport that I began playing in high school, but gave up after graduation. As my daughters grew up they began taking lessons and got on their school tennis teams. After many years of being a tennis mom/spectator I decided that I wanted to play again too. Reconnecting with this sport has been very therapeutic for me.  As an adult, I initially started by joining a tennis clinic where I made some new “tennis friends.” After a few years of practicing, I took a risk and joined a team where I played doubles. Now, I do not want to misrepresent myself as an amazing player but through practice I have become above average.  More importantly, I found an outlet for my competitive energy as well as a place where I could get exercise and have fun.

Recently, I became aware of some of the psychological benefits of playing tennis.  I realized that while I am playing a match I actually use many of the techniques I recommend to my patients. For example, I use positive self-talk while playing.  I may speak to myself in a kind voice and say things like “You’ve got this.” or “You can do it.” On a side note, my partner tells me that she appreciates when I say those positive statements aloud to encourage her. When I feel myself getting anxious before returning a serve, I remind myself to breathe. Just the act of exhaling a deep breath makes me feel calmer. Additionally, playing in a match helps me stay in the present moment. For example, if there is ever a dispute between players about whether a ball was in or out, or if I made a bad serve, I have learned to “let it go.” Instead of beating myself up about if my opponent is judging me about whether my call was correct or not or if my serve was “good enough,” I have learned to move on and just focus on the next ball that is hit to me.  My mantra while I am playing is simply the words “be present” and I repeat this to myself many times during a match. Additionally, while I am playing, I do not think about my family members, patients or any worries. I just focus on “the next ball in front of me.”

So, I have a choice: I can beat myself up for being a “meditation flunkee,” or celebrate my resiliency in finding a sport that I actually enjoy, that gives me the benefit of  ”living in the moment.” Those of you who know me are aware that I choose the later option, embracing my spirit and ability to persevere in finding an activity that provides me a pleasurable way to focus my attention. What I would like to leave you with dear blog readers, is if meditation does not suit you, find a sport or activity that helps you relax and focus on the present moment.  Whether it is playing basketball, running marathons,  taking pottery classes or performing in a play,  take a risk and find your zen.  There is not one correct way to “do life.” Explore what works for you and stick with it!