10 Worst Things to Say To Someone Struggling With A Mental Illness

Photo Credit: Jeshoots

Photo Credit: Jeshoots

Sadly, there are many families, friends, and even co-workers who are insensitive to someone else’s mental health challenges. It’s a sad reality but it exists more than you may think. As a therapist, my experience over the past 6-7yrs in the field of mental health has been that our society lacks knowledge and grace when it comes to the words they use to describe, relate to, or even attempt to comfort those struggling with a mental health challenge. Believe it or not, many people are lost for words when someone says “I am seeing and hearing things,” “I am feeling suicidal and don’t see the purpose in life,” or “I am feeling so anxious that I cannot sleep.” Compassion is the key to relating to those who are hurting. Unfortunately, some people cannot pretend to be compassionate if they are not truly caring for others. But some people simply need to learn how to communicate better.

What has been your experience with people who lack knowledge about mental illness? Do they say things that comfort you or do you find that they are insensitive?

Visit me on Linkedin! Lets have a conversation about this…    and check out the article on my sister-site through PsychCentral: blogs.psychcentral.com/caregivers

Triangulation: Why the term can be dangerous

three people photo

Photo Credit: francisco_osorio

Have you ever heard of the term “triangulate” or “triangulation?” It’s a term that refers to the act of confusing a situation in such a way that 3 or more people are fighting against each other. A classic example of this is when your son or daughter runs to dad to ask for something that the mother has already told the child she/he could not have. Another classic example of this is when a teacher tells a child why she/he is failing 7th grade and the child goes to dad (who has a very short fuse and can be verbally aggressive) and complains about the teacher and how unfair everything is. In both scenarios, the adults in the situation are likely to start fighting each other and forget about the true problem at hand.

Triangulation occurs in many areas of interpersonal communication. Some people engage in triangulation to control others or achieve a specific purpose (intentional triangulation), while others are very unaware of the fact that they are actually doing it. In other cases, it might appear as if the person is triangulating when in fact, they are simply trying to get someone else’s point of view about something or support. It is important to know when this is happening and when it is not. This is very difficult, even for therapists such as myself! But with experience and knowledge about the concept, you are more likely to spot when triangulation is occurring and how to stop it.

The dangerous use of the term triangulation

I’ve been in many situations where triangulation was occurring (intentionally and unintentionally) and I’ve also been in situations where it wasn’t happening at all but someone termed the interaction “triangulation.” In cases where someone uses the term “triangulation” to manipulate how others see your situation, you are likely to feel unheard, unloved, and misunderstood. I’m a firm believer that any psychological concept or term can be used against an innocent person. There are, and I’m sure you have met them, people who will use psychological concepts and intelligent lexicon to manipulate and cause others to view you as the “troublemaker.” An example of this is often noticed in divorce or custody situations where the burned spouse (“evil spouse” – we’ll use this term for purposes of this conversation) will do anything to make the other spouse (“good spouse”) look evil. This might entail using the children as pawns or speaking negative things about one spouse to the children when the other spouse is absent. When the “good spouse” finds out that they have been talked about negatively to the children, they run to someone else (an aunt, a grandmother, a friend,etc.) to talk to for support. The evil spouse then tell the children “your mother is trying to control us by trying to be the “good person.” Some people will actually use the term triangulate: “your mother is trying to triangulate me and my kids.”

I’ve seen situations where the term is used in workplaces against people who are trying to do the right thing. I’ve also seen the term used in mental health clinics to describe client’s with borderline personality disorder who tend to struggle with healthy relationships. It’s frightening to think that this term can be used against you. But this is why I bring this topic up. Being educated to this is the first step toward learning how to defend yourself.

To see how others describe triangulation, watch this brief interesting clip:

Inspiration Sunday

moving forwardDo you have ? Is it correct or skewed? I’ve learned that only the correct vision can take you where you want to be.

Whose with me??!!

Everyday is a new lesson for me. No matter how far I think I’ve come, how intelligent I have become, how socially engaged I am, and how motivated I feel at the time, I realize that only the correct vision can carry me to the next stage. My vision, personally, comes directly from the PowerSource (i.e. God). How do you get your vision? The challenge isn’t so much getting the correct perspective but keeping it. What a challenge indeed.


What Dr Martin Luther King Has Done For Mental Health

MLK MemorialAs you read the headline I’m sure you questioned what relevance Dr. Martin Luther King, Jr serves to the discussion of severe or untreated mental health. Rarely do we ever hear people emphasize the importance of following the example of Dr. King in our “fight” against society’s lack of knowledge about severe and untreated mental illness. But Dr. King embodied so many sophisticated qualities that add such a rich tapestry of cultural legacy and inheritance to my own life and society in general.

Continue Reading »

How Burn-Out Affects Mental Health Professionals

Andrew RichardsHave you ever heard of the terms “burnout,”  “compassion fatigue,” or “secondary traumatic stress?” If not, you’ll soon find out what these terms mean in this article. Each week we discuss issues specific to parents, families, caregivers, and individuals who are living with or helping someone with a mental health condition. But this week, we’ll talk a bit about the mental health professional and the challenges many helpers face. The challenges that mental health professionals face can ultimately affect the type of service you receive. This doesn’t mean that the professional is incapable of helping you, but it does mean that skill level can be affected. You should be aware of how compassion fatigue affects someone you are working closely with.  Continue Reading »

Psychosis: Symptoms, disorders, and ways to cope

We have been talking a lot about psychotic disorders, childhood onset-schizophrenia, delusions, and hallucinations,so lets discuss the differences between the psychotic disorders and ways to cope as a family member, parent, friend, companion, or caregiver to someone who is suffering.

Families, friends, and caregivers are often uninformed about the type of psychotic symptoms their loved one may be experiencing. For many therapists, including myself, observing and correctly identifying symptoms can be extremely complex and require months if not years of psychological evaluation. Before a correct diagnosis can be made, therapists must do a comprehensive assessment using informal tools (information from family, friends, and caretakers) and formal tools (tests, questionnaires, observations) to get clarity and direction. So it is no wonder families, friends, caregivers, and parents often struggle to understand some of the psychotic symptoms their loved one is experiencing.

Psychotic disorders include a profound disturbance in perception and thought. They can entail a host of symptoms. Here is a listing of psychotic disorders listed in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders:

  • Schizophrenia (hallucinations, delusions, flat affect, lack of motivation, social isolation)
  • Schizo-affective disorder (major depressive disorder and symptoms of schizophrenia)
  • Delusional disorder (non-bizarre delusions)
  • Brief psychotic disorder (delusions, hallucinations, incoherent speech): onset =less than 1month
  • Shared psychotic disorder (a delusion develops in an individual in a close relationship with another individual who has delusions). See my website, Anchored In Knowledge, for more information.
  • Substance-induced psychotic disorder (psychotic-like symptoms due to substance abuse)

For those living with an individual experiencing some of the above disorders and accompanying symptoms, life can be very disturbing and emotionally draining. What is even more draining is not having a complete understanding of what you are observing. As a result, you must educate yourself and others around you. It’s very important to know the difference between delusions and hallucinations:

  1. Delusions: A delusion has to do with our belief system. It is a belief strongly held to be true despite evidence that the belief is not true. It is a firmly held belief that cannot be undone by facts or reasoning. This is one of the reasons why a delusion is of a psychotic nature because no reason, no fact, no evidence can change it.Delusions come in many forms such as:
    • Persecutory: this includes an individual believing that everyone is out to get them, that they are being persecuted. The belief is so strong that the individual might begin to isolate or withdraw from others for fear of being persecuted.
    • Grandeur: These delusions often include thoughts of great importance such as feeling like God or feeling like a beautiful celebrity. Think of the movie Hush Hush Sweet Charlette. Actress Bette Davis, played the role of a caretaker of a family member who needed care. Throughout the movie, Charlette dressed, spoke, and behaved as if she was a beautiful star on stage. She was psychotic to say the least.
    • Jealousy: This type of jealousy is sometimes called morbid or pathological jealousy because it takes on a very psychotic and unnatural nature. It’s the kind of jealousy that occurs between two lovers. One person might begin to believe that their spouse is cheating on them or being unfaithful without any concrete proof or reason to worry. This person might contemplate murder just to end their feelings of jealousy. This is not love or obsession, it is a delusional belief that borders obsession.
    • Erotomania: this type of delusion is the strong belief that someone of a higher status (celebrity, television personality, supervisor, professor, famous researcher, etc) is in love with the person. This is not a fantasy or strong desire. It is an unshakable belief that the person has some sort of personal connection with the person and feels true feelings of love for them. Erotomania has led to incidents of stalking and even murder.
  2. Hallucinations: Has to do with our senses (hearing, seeing, feeling, smelling, tasting). Hallucinations include a profound disturbance in perception which can affect a person’s connection to reality and even behavior. Extreme aggression can result from an individual who is either frustrated by their hallucinations or cannot distinguish between reality and fiction. For example, command hallucinations, which includes a person hearing voices telling them to harm others, can greatly impact a person’s behavior and lead to aggression or even death. There are also a variety of hallucinations as well:
    • Visual: These type of hallucinations often entail seeing shadows, seeing silhouettes of people, seeing demons or other frightening images.
    • Auditory: Auditory hallucinations are the most common. When a patient or client comes into a psychiatric healthcare facility for evaluation, the most disturbing symptoms are often auditory hallucinations. These types of hallucinations may entail the person’s name being called, dogs barking, doors slamming, one or more talking voices, or even white noise.
    • Olfactory: Every human being has what is known as the Olfactory bulb, which is located in the fore-brain (the area of the brain behind the forehead) that entails our perception of odors and controls our sense of smell. In cases where psychotic disorders are present, olfactory hallucinations are typical such as smelling smoke or something burning. Some individuals claim they can randomly smell the scent of flowers or cologne.
    • Tactile: This type of hallucination has to deal with touch. It often entails feeling pressure on the skin or feeling things crawling on the body.
    • Gustatory: These hallucinations have to do with taste. Some individuals state that they can taste poison in their food.

Delusions and hallucinations can be dangerous for the individual experiencing them and those around the individual. Hallucinations can cause people to act on their emotions. Delusions can turn into rooted beliefs that cause the individual to act. For example, a woman who writes letters to Alex Baldwin begins to believe he is sending her messages that he is in love with her,  may attempt to buy tickets to all of his shows and cyber stalk him. A strong delusion such as this can lead to emotional (and maybe even) financial distress.

Delusions and hallucinations are not easy to cope with. But here are a few things to try:

  1. Do not argue facts: I always encourage families to refrain from arguing with their loved one about their delusions or hallucinations. The key is to be mindful that the delusion or hallucination is very real to them. So if you go against the delusion or hallucination, you are “going against them.” Although not true, this is often the experience of people in these shoes.
  2. Understand their emotions: Hallucinations and delusions often have an emotional component of some sort. The woman attracted to and writing Alex Baldwin may feel “emotionally connected” to the point of behaving as if she “knows” him on a personal level. If you find there is a strong emotional connection with the delusion or hallucination, try to talk with your loved one and calmly discuss your concerns.
  3. Get inside their head: Individuals experiencing delusions or hallucinations may be difficult to talk to, especially if they do not believe they are impaired/ill. So wait until the individual brings up their experience and discuss it without judgment. Try not to ask questions that would make your loved one feel condemned or “crazy.” You want to try to understand, no matter how unstable their reasoning is, their thought processes. This is good “data” for if you ever have to discuss your case with a psychiatrist.

The most important thing to do in such cases is to be compassionate and understand that your loved one is going through something quite serious. Reaching out for help is important, but so too is showing love and understanding, even if the delusions or hallucinations are unrealistic.

I always enjoy hearing your thoughts, post below.

All the best

Editor’s note: This article was originally published on blogs.psychcentral.com/caregivers May 8, 2013 but has been updated to reflect comprehensiveness and accuracy.


Healthline. (2014). Psychosis. Retrieved November 23, 2014 from http://www.healthline.com/health/psychosis#Overview1.

Kiran, C., & Chaudhury, S. (2009). Understanding Delusions. Retrieved November 20, 2014, from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3016695/.

MedPlus. (2014). Hallucinations. Retrieved November 1. 2014, from http://www.nlm.nih.gov/medlineplus/ency/article/003258.htm.


Discussing the Controversy of Borderline Personality Disorder Traits in Adolescents


Risky Teenager Photo Credit: BinaSveda

Over the past two weeks I have enjoyed writing about and sharing with you the diagnostic issues and parental fears surrounding Borderline Personality Disorder (BPD) and the possibility of adolescents being diagnosed with the disorder. Last week we discussed treatment options for adolescents exhibiting borderline personality traits (a diagnostic term and label that many of you were unfamiliar with and challenged). The week before that we discussed adolescents who exhibit strong symptoms or traits of the disorder. This week we will be discussing some of the issues that were brought to my attention on Facebook,Twitter, and Pinterest regarding the term “Borderline Personality Traits.” I will also mention some of the recent research and theories surrounding adolescent BPD and “challenge” you to give me your best counter-argument. Lets give it a shot!

As discussed over the past two weeks, borderline personality disorder has previously been well known as an “adult only” disorder due to the riskiness of the person with severe symptoms, emotional turmoil, intense fear(s) of abandonment, self-injurious behaviors and suicidal ideations, and relational chaos that characterizes the disorder. However, recent researchers such as Dr. Blaise Aguirre, MD and previous researchers such as Psychiatrist James Masterson, MD were extremely interested in adolescents who tended to exhibit the symptoms of BPD and encouraged other mental health professionals to open their minds to a possible diagnosis in adolescence. Dr. Masterson met with multiple cases of teens who exhibited strong patterns of BPD (i.e., Chronic Self-injurious behavior such as cutting or burning, multiple psychiatric hospitalizations or placements, extreme need for affirmation, physical or verbal aggressiveness, poor thinking and cognitive processing, emotional instability or switchable moods, roller-coaster moods or behaviors that keep others confused, difficulty maintaining stable relationships, stormy relationships (fast attachments, strong desire for emotional connection), extreme reactions to minor events, risky behavior (substance abuse, sexual indiscretion, gambling, driving fast or risk taking), rage or excessive anger, sensitivity (easily offended), over-reactivity, etc.) and found no real logical reasoning from his colleagues for why they did not diagnose BPD other than the fact that:

“putting the diagnosis off until age 18 allowed for the hopeful resolution of this adolescent turmoil until the parents could be absolved of any guilt or diagnosis” (p. 27).

But Dr. Aguirre poses a great question:

“What do these young people look like the day before they turn 18 and the day before that?

What does the number 18 have to do with anything? What happens that makes this number magical for people who are fearful of the diagnosis being applied to a teenager younger than age 18? Dr. Aguirre states that he is very used to seeing teens as young as 13 exhibit borderline personality traits. From my experience as a therapist, I tend to see many youngsters ages 12-17 diagnosed with major depressive disorder (MDD), Anxiety disorder, NOS (none-otherwise specified), or even bipolar disorder or Mood Disorder NOS because many mental health professionals would rather diagnose a child incorrectly and treat the child incorrectly than to diagnose a long-lasting label such as BPD. But it is important that we consider the pros and cons of delaying this diagnosis for the simple fact of “sustaining hope.”

Research currently suggests that the earlier a diagnosis can be made, the better the outcome or prognosis. While there are high rates of co-morbidity or co-occurrence with BPD, meaning that other disorders are often diagnosed with BPD, early treatment can reduce the overall intensity of all present symptoms. For example, lets imagine that the mental health field has decided to start diagnosing teens with BPD. A teenager diagnosed with major depressive disorder and BPD can have a better prognosis if the BPD symptoms are properly treated because the depression could be strongly driven by the BPD symptoms. It would not make too much sense to treat the depression (which would be like trying to apply a tiny bandaid to a burn) if the BPD is what makes the depression worse. A youngster in this scenario would suffer for years with symptoms and struggle with correctly identifying why the depression will not subside. Many kids today go through this very scenario and spend thousands of dollars seeing specialists, receiving treatments, and purchasing medications that DO NOT work or provide only temporary relief. By the time a young person is 18-years-old, the diagnosis of BPD is finally given and the teen can begin to work on the emotional emptiness, confusion, and relational turmoil that dominated their adolescent years. But for many young adults who finally receive the diagnosis, there is a grieving process that might include denial or rejection of the diagnosis because the young adult has already received multiple treatments that did not work and might believe nothing will ever work. Many young adults lose hope after years of searching for the “correct diagnosis” during adolescence. If only the teen were diagnosed sooner with the disorder might they have received the treatment that would give the hope for their future.

Now… I would like to hear from you in response to some of the current theories of the BPD traits in adolescence. Below I will list a few theories, comments, or questions for you to think about, discuss, and share your concerns about.

  • Question: Why does diagnosing an 18 year old with BPD seem better to you than diagnosing a younger adolescent? What is it about this particular age that makes a BPD diagnosis more “fair?”
  • Discussion: As a therapist who works with many adolescents struggling with relational chaos, emotional emptiness, suicidal attempts, self-injurious behaviors, and confusion, I see so many teens who could benefit from receiving the diagnosis of BPD early in their treatment. It feels almost unethical to treat a child for something you clearly know isn’t the true diagnosis just because society is more comfortable with waiting for the BPD diagnosis until age 18. For many psychiatrists across the nation, “borderline personality traits” is a label that is often applied to the diagnostic profile of the teen so that the diagnosis might be considered in the future. This, however, still does not prevent the “stigma” many are afraid of because the label is still listed on the diagnostic profile as “traits of borderline personality disorder.” So from my view, it seems that the teen is already labeled. Having “traits” of BPD doesn’t always mean the teen has the disorder, but it does suggest that there is a strong possibility. For those of you who are unfamiliar with the term “traits of borderline personality disorder,” psychiatrists and many mental health hospitals are beginning to use this label to alert other professionals to the possibility of a teen having this disorder.

What are your thoughts regarding this label? Have you seen this label or heard of it yet? Do you believe it promotes stigma or promotes early treatment?

  • Comment: It is very important that we consider that early treatment is the most important reason for a teen being diagnosed with BPD early. It is not so much about stigma as it is about early treatment. You must keep in mind that the teen is more likely to be “stigmatized” (in school, in the home, and in the community) if symptoms become so profound, due to lack of treatment, that normal functioning is unlikely.

As always, feel free to share your thoughts. Lets keep learning together!


Aguirre, B. (2012). Borderline Personality Disorder. Psychiatric Times. Retrieved October 2, 2014, from http://www.psychiatrictimes.com/articles/borderline-personality-disorder-adolescents.

Aguirre, B. (2014). Borderline personality disorder in adolescents: what to do when your teen has BPD. Beverly, MA: Fair Winds Press. 


Can Teens Be Diagnosed With Borderline Personality Disorder?


Photo credit: Martin Walls

Are you the parent, grandparent, or family member of a teen or pre-teen who exhibits an inability to control their impulses, emotional reactions, behaviors, aggression, suicidal thoughts, self-injurious behaviors, and anger? Is the behavior so extreme that you are afraid to discuss minor issues for fear of upsetting this teen or becoming the focal point of their angry outbursts? If so, perhaps you are dealing with a teen who is beginning to exhibit borderline personality traits.

Believe it or not, relationships in which there is an individual who tends to change like a chameleon and another individual who is fearful to live with this chameleon is more prevalent than you think.  In fact, research suggests that about 1.6% of individuals experience borderline personality disorder and are often misdiagnosed as having bipolar disorder, oppositional defiant disorder (ODD), or even conduct disorder. Other youngsters are simply undiagnosed.

A large percentage of individuals with the disorder remain confused as to why they cannot experience their emotions in ways that do not lead to suicidal thinking, suicide attempts, self-injurious behaviors such as cutting, and that results in chronic relational tension. Most adolescents are often confused by their intense emotional rages because they are often told by the adults in their lives that their emotions are typical because they are growing, developing new hormones, and going through multiple social, emotional, physiological, and sometimes even environmental and familial changes. All of these things can often lead to intense emotional reactions to minor situations in the teens life. But it is often when the emotional intensity lasts for long durations of time, interferes with daily functioning, and creates irrationality and overreactions that it is time to pursue mental health treatment. 

Personality disorders have been characterized by mental health professionals as coming in clusters such as cluster A (paranoid, odd, and eccentric thinking and behavior), B (emotionally unstable, erratic, dramatic, unpredictable behaviors and thinking), and C (distrustful, fearful, and anxious behaviors and thinking). These clusters help professionals identify certain personality characteristics of individuals who might be exhibiting traits of a particular personality disorder. Looking at these clusters at face value, it is easy to identify some of your own behaviors and patterns of thinking. But what distinguishes someone with personality disorder traits is the intensity and duration of the symptoms.

Borderline personality disorder (BPD) is often observed among certain populations and in certain settings than in others. For example, BPD is often observed in females more than males and about 20% of clients who enter inpatient treatment exhibit signs of BPD while 11% exhibit symptoms in outpatient settings.  Because BPD is often not diagnosed before the age of 18 (often due to the stigma attached to the diagnosis), it is unlikely that an adolescent would be diagnosed with the disorder. However, a doctor might diagnose a teen with what is known as borderline personality traits. This allows a client the possibility of receiving the right treatment as she or he develops and also alerts the next mental health professional to these characteristics that might interfere with the correct treatment of other symptoms such as depression or anxiety. Some research suggests that adolescents can be correctly and reliably diagnosed with the disorder, while other studies suggest teens cannot due to the fact that teens are in a constant state of change. As a result, doctors often stick to adding “borderline personality traits” to a youngsters diagnostic profile.  Traits often include the following symptoms:

  1. Chronic Self-injurious behavior such as cutting or burning
  2. Multiple psychiatric hospitalizations or placements
  3. extreme need for affirmation
  4. suicidal ideation (thoughts)
  5. physical or verbal aggressiveness
  6. poor thinking and cognitive processing
  7. emotional instability
  8. switchable moods
  9. roller-coaster moods or behaviors that keep others confused
  10. difficulty maintaining stable relationships (stormy relationships, fast attachments, strong desire for emotional connection)
  11. extreme reactions to minor events (positive or negative)
  12. risky behavior (substance abuse, sexual indiscretion, gambling, driving fast or risk taking)
  13. rage or excessive anger
  14. sensitivity (easily offended)
  15. over-reactivity
  16. lability (emotions such as crying, anger, or both that might appear impressionistic or attention seeking)
  17. recklessness (over-spending, loaning too much money to someone, sneaking out of the house, chronic partying)
  18. difficulty with rejection (feeling suicidal or cutting at the close of a relationships – short or long term)
  19. skewed perceptions (a teen might feel that “everyone hates me”)
  20. poor sense of self (lack of identity)
  21. paranoia (believing someone is following or stalking them or talking about them)
  22. trouble regulating emotions (appearing to lack control and needing someone to help them calm down)
  23. irrationality (unable to be reasonable or logical)

There are various treatment options available for adolescents who are suffering from the above symptoms and exhibiting possible signs of a borderline personality disorder diagnosis. It is important that parents and families consider both inpatient and outpatient options for an adolescent who is at risk for completing a suicide, engaging in extremely risky behaviors, and falling prey to substance abuse.

As always, feel free to share your experiences and questions. Next week we will discuss inpatient and outpatient treatment options for teens exhibiting traits of borderline personality disorder.

I wish you well


Aguirre, B. (2012). Borderline Personality Disorder. Psychiatric Times. Retrieved October 2, 2014, from http://www.psychiatrictimes.com/articles/borderline-personality-disorder-adolescents.

Mayo Clinic. (2014). Personality Disorders. Diseases and Conditions. Retrieved October 4, 2014, from http://www.mayoclinic.org/diseases-conditions/personality-disorders/basics/symptoms/con-20030111.

National Institute of Mental Health. (2013). Borderline Personality Disorder. Retrieved September 1, 2013 from, http://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml.

Effective problem-solving in a crisis


Photo Credit: BartekAmbrozik

Crisis. What comes to mind when you hear this term? Do you think of natural disasters such as hurricanes, national health concerns like the Ebola virus, personal struggles such as a divorce or failed relationship, or perhaps something less dramatic but still emotionally draining such as failed expectations or loss of a good job. Whatever the stressor (a situation that outweighs your ability to cope with it), a crisis can be any of the above situations and be long-term or short-term.  Continue Reading »

When your child is 302’d: What Should You Know?


Click here for photo credit

Involuntary commitment. What comes to mind when you hear this word? Chaos and confusion? Fear and pandemonium? Loss and grief? For many parents, having to commit your child to a hospital against their will is something that doesn’t fit into the schema of adults. The thought, the action is unfathomable. How could a child, someone who is barely familiar with the operations of life, be so out of control that a hospital would have to be contacted for help? The experience is heart wrenching for many loving and caring families. Continue Reading »

Eating Disorders: When Eating Becomes A Prison


Photo credit: SlawekLukjanow

Do you know someone with an eating disorder? Do you know what it is? Trying to support a loved one or friend who sticks her finger down her throat to purge the food she just ate, strips you of your ability to reason and make sense out of life. Observing a loved one or friend refusing food out of a strong fear of gaining weight to the point of starvation, changes everything you thought you ever knew. For a therapist who works with eating disorders (or any mental health problem for that matter), the situation can bring you to a point of desperate seeking for understanding. Continue Reading »

Parenting: It’s quite complicated!


Click here for photo credit

Being the parent of a child has to be one of the most difficult jobs in the world. The only thing lacking from a parent child relationship is payroll. A child has so many needs, desires, and milestones to achieve in life. It’s the parent who bears the burden until the child becomes mature enough to seek out their own wishes in this life. But despite the challenges that come with parenting, it is also perhaps one of the most rewarding (most of the time) jobs in the world.  Continue Reading »

6 Subtle characteristics of the pathological liar


Brian Lary

Have you ever communicated with a person who seemed to live in a fantasy world where everything said “felt” false? What about having an experience with a person who always seems mysterious and nothing they say ever comes to fusion? Well…if so, you might have been dealing with a sociopath or even a pathological liar. Continue Reading »

Characteristics of the stalker: Know what to look for

stalkerWhen you think of the word stalker what comes to mind? Do you think violence and vengefulness? Do you think fear on the part of the stalker? Do you think about the stalker’s lack of communication skills or even mental health problem(s)? Many people would agree that the first thing that comes to mind when they hear the word stalker is violence and vengefulness. Only a rare number of people would consider a stalker fearful and lacking in social skills. But many “sweet boys next door” can become a stalker for many reasons. Two reasons include mental health problems and lack of social skills.

One of the things we rarely discuss on this site are the characteristics of a stalker. But it’s important to understand that they too struggle with mental health or personality disorders that motivates this problematic behavior. Believe it or not, many stalkers, due to mental health or personality disorders, are impaired and lack the ability to reason and engage appropriately with others. For the most part, individuals who would be labeled a stalker often suffer from a lack of social skills and finds communicating with others challenging. For the most part, men are the stalkers, but women can also become stalkers as well. About 80% of women are victims of stalkers.

According to Marshall University’s Women Center, characteristics of the stalker can fall into 5 categories:

  1. Relationship: These stalkers tend to stalk previous partners and desire a relationship with the person. In some cases, the stalker in this category may desire a relationship with an acquaintance. Individuals who fit the stalker description and has had negative relationships in the past, often meet criteria for a personality disorder such as narcissistic personality disorder, antisocial personality disorder or sociopathy (i.e., a sociopath), or dependent personality disorder.


  1. Obsessed: This type of individual constantly thinks about the person they idolize. They might create a “mental life” involving the person and have a hard time imagining life without the person. You may have heard of the term erotomania which describes a delusion in which the person believes that someone, usually of a higher social status (celebrity, powerful person, etc.) is in love with him or her. It is likely that someone suffering from schizophrenia may fall prey to the erotomanic delusion.


  1. Rejected: Many stalkers have a history of challenging relationships and difficulty communicating with others. Some stalkers, especially if female, may meet criteria for borderline personality disorder in which rejection is often very difficult to cope with. This does not, however, describe all individuals with borderline personality disorder. However, it is likely that some individuals with this diagnosis could become a stalker due to a history of stormy relationships, roller coaster emotions, and unstable love affairs.


  1. Intelligent: Marshall University claims that stalkers are intelligent and carefully plan their stalking behavior. Someone who falls into this category could meet criteria for sociopathy. Sociopaths are adept at planning their “attack” and controlling others with charm or glib.


  1. Motivated: Most stalkers believe that their object of desire is the only person they could ever love and tend to be motivated to pursue based on this type of thinking.


There are also common personality characteristics of the stalker that are important to understand. These include:

  1. Narcissistic behaviors
  2. Selfishness
  3. History of domestic violence
  4. Inability to cope with rejection
  5. Obsessive, controlling, and compulsive
  6. Impulsivity
  7. Suffering from delusions or a severe mental illness that interferes with perception of reality
  8. Jealousy
  9. Manipulative behaviors
  10. Sexually maladaptive behaviors
  11. Deceptiveness
  12. Socially awkward, uncomfortable, or isolated
  13. Has a history of falling in love instantly
  14. Depends on others for a sense of self-worth
  15. Low self-esteem
  16. Tempermentalness


Can you think of any characteristics that might fit a stalker?

It is important to keep in mind that stalkers are not always individuals who are suffering from mental health or personality disorders, but that the possibility is very high. Most stalkers fit the criteria of sociopaths and narcissists. They are charmers, they have a way with words (although their words are often shallow and insincere), and they sometimes have a sex appeal or attractiveness that blinds victims to their true intent. The difficulty lies in trying to determine if someone is a stalker and if so, what type of stalker they are.

As always, stay informed!



Marshall University. (2014). Stalking. Women’s Center. Retrieved August 31, 2014, from http://www.marshall.edu/wcenter/stalking/.

Photo credit: sean carpenter


Avoiding an emotional hangover: What to do when you’re fed up


Emotion (Photo credit: rexquisite)

Have you ever noticed your emotions the day after a very stressful day running errands, meeting people, supporting family or friends, working, and meeting deadlines? Have you awakened wondering if you could have done something better the day before? Perhaps you could have spoken more friendly to someone or have greater patience with someone.

Continue Reading »


Speaking out about mental health changes lives

heartA few months ago I discussed making Personal Stories Week a yearly endeavor with a former colleague and one thing she said stood out to me: “people enjoy hearing and sharing good stories.” While I didn’t agree with her nonchalant stance on true stories of struggle with mental illness, she is right. Stories have a way of not only changing our perspective about events in life, but also inspiring, developing, and even changing our behavior.  In most cases, these “good” stories come through social media such as Twitter, Facebook, Instagram, MySpace, and other channels. We have become such a social-media driven society that most people don’t share their deepest hurts in person anymore. Most people turn to social media to inspire or educate others. 

We turned – Kathy Brandt, Dr. Russ Morfitt, Melanie Jimenez, and Sharon Page – to social media. It was a great experience and I hope the families and I can bring you more insightful stories.

To revisit many of the beautiful stories from the past week, click on the links below:

Learning from personal experience

A mother faces her son’s bipolar diagnosis

A mother and her son’s struggle with schizophrenia

Protecting yourself from unethical mental health settings

Personal stories week: A journey after suicide 

Personal Stories Week: Dr. Russell Morfitt discusses online counseling for anxiety

Accepting schizoaffective disorder: A mother’s most difficult challenge

The End and Thank You


Personal Stories Week – August 18-24

son and mother

It’s that time of year again when I collaborate with a group of readers, writers, parents, twitter followers, friends, and colleagues to discuss, during 1 entire week on blogs.psychcentral.com/caregivers (PsychCentral), their experiences with mental illness or other mental health challenges. Their experiences could be personal or professional and focus on challenges, miracles, systemic difficulties, financial strain, failures of the system, and many more issues that parents, families, friends, caregivers, and professionals have experienced. Come join us.

Continue Reading »

Change Is The Hardest Thing Ever

moving forwardChange. It’s a simple word but it can mean so many things to the person experiencing the change. I’ve had many changes in my personal life, changes that were both good and bad. Some change is on time and other changes come at the wrong time. Still, other changes are the result of your desire to change something, while other changes are not.  Continue Reading »

Fear, Uncertainty, and Discouragement: A condition of human existence

Belovodchenko AntonHow many of you rely on your faith for strength and courage as a caregiver, as an individual living in this stressful world, or as someone suffering from a mental health condition? For many people, their faith is the only thing they have to hold onto.

Continue Reading »

National Minority Mental Health Awareness Month

national minority mental health awareness month
Did you know that July is National Minority Mental Health Awareness Month? If not, you’re not alone. Sadly this month is often overlooked by the majority of Americans. It is a time when summer has bloomed, fireworks have entered the scene, and multiple summer parties and cook-outs are in full swing. It comes at a time of the year when so many people are outdoors, enjoying the summer time weather and penetrating sun. This lack of awareness, however, not only affects minorities struggling with mental health problems, but our society at large.


There are multiple things we need to do to bring greater awareness to minority mental health:

  1. Build awareness
  2. Remember services are difficult to locate
  3. Remind clinicians and mental health professionals to be culturally competent
  4. Understand that:
    • Many cultures lack knowledge about mental illness or see it as taboo
    • Lack support from their own culture to seek services
    • Do not trust opposite cultures helping them
    • Struggle with gender bias

Read more here or check into this great research article published on the topic.


Photo credit

Can you spot a pathological liar?

Think back to an age at which you told the most lies or “fibs?” Were you 4, 5, 8, or 10? Why did you tell the lie? Were you trying to get something in return, manipulate a situation in your favor, or avoid hurting someone’s feelings? If so, you are like the majority of us who curtail the truth in order to make things less stressful or negative for us. Curtailing the truth happens a lot, even in the lives of adults. Continue Reading »


Alex Hribal: A puzzle for professionals everywhere

Alex HribalDo you remember my article published on Alex Hribal, a 16-year old who stabbed 20 high school students and an adult in the Franklin Regional High School of a quiet suburb in Pennsylvania? The article was titled: Parental Responsibility in Tragedy through my sister-site Psychcentral/caregivers. The article focused on a very controversial topic which involves parents being held liable for the dangerous, violent, and careless behaviors of their children or a child whom they know struggles with behavioral or mental health challenges. Parents are held liable for cases such as Alex Hribal’s in many states. The difficulty is in proving negligence and arriving at a settlement for the “damages,” and in many case, lives lost.  Continue Reading »

The Overworked Mental Health Professional

Andrew RichardsEach week I see myself mentally, physically, and emotionally deteriorating (in inches) every time I encounter a new client, a new situation, a new challenge, a new mystery. It’s part for the course as a helping professional. No one will escape the fatigue. The field of psychiatry and the profession of mental health is both an emotionally and mentally stressful job. It only works best when the people involved have been “called” to do such a work. It is only then that the job will get done correctly, promptly, and with care. It is when the field incorporates people who either have lost motivation to care or simply don’t care, that the profession deteriorates more and more.  Continue Reading »

A long string of violent acts – A cry for help or criminal behavior?

What do you think of this paragraph?

She had reason to worry. When her son showed up at her Queens home in May 2009, he beat her, striking her in her face multiple times, and then wrapped an electrical cord around her neck. “Mom, I am going to kill you,” he said, according to court records.

When she passed out, he stole her 2002 Toyota Corolla and fled.

Read more about this tragic situation involving mental illness and criminal behavior, a dilemma many of us (mental health professionals) have trouble connecting and understanding.

Photo credit: Victor J. Blue for The New York Times


Mental Health In A Failed American System

Available April 22Base-book cover 2 -altered!

Is the mental health system making you feel all alone, lost, confused, and angry? If so, you are not alone. A therapist shares her experiences and insights about the system with multiple stories and resources for parents, families, and caregivers. She also offers a bonus chapter on bullying prevention and resources parents, families, and caregivers can pursue to protect their child with special needs.

Barnes & Noble





10 Cognitive Distortions That Keep Us Bound

OLYMPUS DIGITAL CAMERAToday I spoke with a good friend from graduate school about recent changes in her life. No matter how positive some parts of the change was, she found some way to think of the negative. We began to review what we had learned in school about “cognitive distortions.” We found that the both of us engage in some of these depending on the situation. Are you guilty too?

There are multiple types of cognitive distortions, but the 10 most common include:

  1. All or nothing/ black or white thinking: This type of thinking is “my way or the highway.”
  2. Should statements: “I should always be first,” “I should never take 2wks vacation.”
  3. Magnification/minimization: You exaggerate certain events or the negative and minimize (the “I don’t care” attitude) a situation.
  4. Over-generalization: You view a single situation (positive or negative) as never-ending, something that could happen again.
  5. Mental Filtering: You dwell on a single negative occurrence and focus in on it like a target. You can’t get your mind on other things. “Did you see how she looked at me!!!!”
  6. Labeling or mis-labeling: Instead of describing the situation for what it is (e.g., you filed your taxes too late), you begin to see yourself as the problem (“I’m so stupid, why can’t I ever do this earlier”).
  7. Emotional reasoning: You feel that your negative emotions reflect the truth, not error.
  8. Jumping to conclusions: You immediately believe the worst without first considering all the facts of the situation.
    • Mind reading: “I know she thinks I’m crazy because of how I look today.” Have you ever said this? Mind reading occurs when you think you know what someone is thinking about you without you checking the facts
    • Fortune Teller: You feel that something negative will happen without considering that perhaps something positive may happen.
  9. Personalization: You see yourself as being the reason for negative events.
  10. Disqualifying the positive: You point out all the negative facts without looking at the positive. You miss your beautiful daughter in her wedding gown because you just can’t get over her new mother-in-law.

As always, I wish you the best

Photo credit

Shopping Around in the Mental Health System

Svilen MilevWhen I go grocery shopping, I rarely stop at one store to buy all of my items. I often “cherry pick” by getting all meat from one store, my fresh produce at another, and then my dry goods at another. By the end of the week, I’ve been to about 3 stores total. Can you relate? Sadly, many families within the mental health system must act in the exact same way. 

The mental health system seems to be one of the most complex systems in the world. There is always something getting in the way of proper treatment such as policies, state laws, high turnover which leads to reduced number of staff, high costs, little to no insurance coverage, etc. Families today are up against the biggest beast in our modern day society. Despite high numbers of severe mental health need (7.7 million suffer adults and 20% of children and teens suffer from severe mental illness), we have multiple problems within our system that often include incompetent or uncaring workers who waste the time of families in need. As a therapist, I see these things almost daily.

There are 7 types of workers, I have encountered, that all individuals should look out for:

1. The lazy worker: This type of mental health professional refuses to go far and beyond their duties at work. If it is after hours, they will not help you. If helping you means contacting outside agencies, researching a problem, or discussing something with you, this person will avoid it at all costs. They might even shift the responsibility to the client or family of the client. You may not feel helped or cared for by this person. They are incompetent, disinterested in truly helping, and may only be in the profession for recognition, personal identity, pay, or prestige. Some people thrive off of having a hand in telling others what to do or having some effect on their lives. Those who enjoy making a difference are different because they are truly interested in helping. But the “lazy worker” will do nothing, but want to be recognized.

2. The “for show” worker: This person is like the lazy worker, but might do more work for the purpose of being recognized. This person is constantly in competition with co-workers and will often appear genuinely interested during the initial phase of treatment. This person is selfish and hopes to find an identity by working in the field.

3. The “professional” worker: This person is so very professional and loves to dress the part, act the part, sound the part, and fantasize by getting overly involved in the lives of others. This person is so consumed with themselves that no one can crack the phony fasade. This person is basically a narcissist.

4. The “let me check” worker: This person is like the lazy worker, but constantly has to double check facts (even basic facts) because they are rarely tuned in to their job. This person knows very little and seems to lack a breadth of knowledge necessary for the duties of the job. Therapists like this are constantly unsure about their position or how to help. They need others to guide them before they can guide others. There is very little to no creativity with this person. A person like this might also lack life experience. Beginning therapists usually fit this profile.

5. The “actor” worker: This person is very much like the “professional” worker but seems to recite what others have said or done. This person is an imitator and lacks originality. Dressing, speech, behavior, activities, suggestions, or advice might be echoed from someone this person idealizes such as a boss, senior worker, or historic figure. Tone of voice, attitude, or dressing might change to reflect the characteristics of the idealized person. I would go so far as to suggest a sociopathic personality.

6. The “ingenuine” worker: This person is very ingenuine and doesn’t really care about the emotional needs of the client seeking help or the client’s family. This person is highly engulfed in his/her own life, but believes their personal experience will make them a good therapist. This person usually lacks true compassion, but is the first to believe that they have skill (because of personal experience) to help others.

7. The “social justice” worker: This particular person is very conscious of social justice issues and seeks any opportunity to bring up the topic of sexism, racism, ageism, etc. to explain away personal difficulties or challenges the client may face. For example, a woman may say that she feels undermined by other females at work. The “social justice” worker may view this as an attack due to age, gender, or race. Of course, this is something that happens all the time, but we cannot explain away ALL situations using this perspective.

Believe it or not, the field entails many of these individuals including a host of other personalities. It is important to keep in mind that not all mental health professionals or therapists exhibit these traits in negative ways, but many do. The thing to watch out for is how rigid the person is and whether or not they truly care for you or your loved one. “Shopping around” in the mental health system is important because every therapist is different, every therapist is trained differently, and every therapist has experienced life differently. No one is the same. “shopping around” allows you to find a therapist who truly has you or your loved one’s best interest at heart, truly wants to fight for the rights of her/his clients, and demonstrates a consistent character over time. If you recognize an inconsistent personality that seems overbearing and unauthentic, run!

I wish you the best

Photo credit: Svilen Milev

The history of medicine – have we progressed?

Chris HolderWilliam Halsted and Sigmund Freud were two “scientists” who went down trying to crack the mystery of substance abuse use (Freud) and searching for the strongest numbing agent for surgical procedures (Halsted). Their nightmare was characterized by strong addictions, medical complications, and extreme health problems. Even more, their substance abuse addiction not only revealed their deep emotional and psychological needs, but the potential vulnerabilities of scientists in the world and the problems often associated with doctors who have access to prescription drugs. Watch the video to find out more and visit: http://halstedthedocumentary.org/.

Self-medication: Why doctors use prescription drugs

Doctors with substance abuse issues


Photo credit: Chris Holder

9 Troubling revisions of the DSM

Raphael Pinto9 Troublingrevisions of the DSM




Photo credit: Raphael Pinto

Would you know what to expect in a mental health evaluation?

Would you know what to expect in a mental health evaluation?

Hidden (300x200)A mental health assessment is often the very first step toward seeking mental health services. For youngsters, mental health assessments are more involved because parents, schools, and other people of importance are often included such as other doctors, speech therapists, etc. For adults, the process may be a bit less detailed and shorter in time. Find out what else happens in a mental health assessment by clicking above.


Photo credit

Understanding Psychological Abuse

David Garzon

Few studies focus on psychological abuse as much as they do emotional, physical, and sexual abuse. But by no means does this mean that psychological abuse is less detrimental.

Understanding psychological abuse


Photo credit: David Garzon

Youths in crisis: what are we doing wrong? (Video)

Gabriella Fabbri 2This is something I deal with daily in my work with youngsters. Many days it feels like we’re all doing everything wrong. Other days, are quite different. But where are we going to intervene and how? This is something we rarely discuss for fear of backlash from anti-stigma players, parents, families, and others too afraid to grapple with reality.

What are your thoughts about this continual and possibly worsening condition? It’s about time we find out.

Photo credit: Gabriella Fabbri

Without him who would we be? Celebrate his legacy today!


A gift from God, a hope for the future, direction for our souls, and peace for our hearts. He embodied it all.

Do you know Phineas Gage?

brainDo you know Phineas Gage?

Phineas Gage suffered a terrible tragedy that led neuroscientists to research the effects of trauma on the brain, emotions, and behavior. Find out what happened to Mr. Gage. You can read the article and watch the video:

Photo credit: Hidden

5 Benefits of Group Therapy

Joined Hands5 Benefits of Group Therapy

Group therapy is often disapproved of and shunned as a nuisance. But I believe, although I am not a big fan of it, that group therapy has 5 important benefits for both teens and adults. Find out what those benefits are.

Photo credit: Julia Freeman-Woolpert

5 Reasons why Behavior Therapy is a Good Choice for Teens

5 Reasons why Behavior Therapy is a Good Choice for Teens

Behavior therapy is a good choice for kids/teens with behavior problems. Find out why I say so.

Need help getting psychologically prepared for the New Year?

Radoslava TodorovaNeed help getting psychologically prepared for the New Year?

The New Year is always met with resistance because it means change. Some change is good, some is bad. For many of us, we will enter the new year with debt, new worries, insurance woes, reduced benefits, and some of the same challenges faced in 2013. Anxiety, depression, substance abuse, and suicidal thoughts are common. Find out what I believe can help you or someone you know cope better.

Photo credit: Radoslava Todorova

Failing to Bring Awareness to Mental Health in the Workplace

WorkplaceThis presentation was presented at the Pittsburgh Carnegie Library, Business and Technology Series event December 19. This presentation discusses the problems associated with corporations, organizations, and other businesses in failing to bring awareness to the existence of mental health. This presentation also touches upon the inability of employees to seek mental health care without fearing loss of employment, loss of confidentiality, or stigma.
Most employees have legal or federal rights to protect their mental health information from employers, but there are exceptions to this rule. HIPAA (Health Insurance Portability and Accountability Act of 1996), which supposedly protects all mental and medical health information from being exposed, is briefly discussed.

Welcome To Anchored-In-Knowledge!

144x200I’m so glad you have decided to visit this site!

Anchored-In-Knowledge was designed specifically for parents, families, and caregivers of individuals with mental health conditions. To find out how to navigate through this site, click here for my “Getting started” page.

This site is “family-friendly” for individuals seeking easily accessible and practical information. For daily updates, follow me on Twitter! For various topics relating to mental health, try my site at Mentalhealth.answers.com.

I hope you will find this site a resource

A Reminder: True Meaning During Christmas Time


Hello there!
I wanted to personally send my best wishes for a wonderful holiday season. This time of year is a wonderful time because it allows us to think over the accomplishments of the year, remember people we love, give gifts from the heart, and move forward into the new year. I love Christmas. It is not only a time for family, gifts, and love, but reflecting on our purpose, our divine purpose.
What has your journey been and what will it be? I find myself asking this question a lot, but more during this time of the year. What accomplishments (that are not materialistic) do I want to make in the coming year? These questions are introspective and very significant. Meaning emanates from these questions and has a way of forming new meaning for the coming year.

For some people, like my mother, thinking that far ahead is difficult. You’ll figure it out when you get there! I get you, that’s all well and good. :)

But then, there are those who are suffering during this time with missing a loved one, missing someone deceased, or wishing they had the romance and love that Christmas commercialism demonstrates through commercials and music. Sadly, Christmas time isn’t always a joyous time for everyone. If you are someone or know someone who has lost a loved one, know that you are not alone. I lost my dearest cousin 5 days before Christmas in a very tragic way last year. It is something I push to the back of my mind in order to cope. As a family, we will never forget it. So I flood myself with the beauty of the season and I try to remain as realistic as possible. Getting swept up in commercialism, only makes matters worse.

I just spoke with a Twitter follower via email who lost his son during this time to suicide. His son took his life 3 days before Christmas. Instead of wrapping gifts, spending quality time with family, and enjoying the festivities, he was contemplating ending it all. The way this man and his family copes is by staying very close, engaging in family time, and remembering their son. Sometimes attempting to push reality away only makes it worse.

Other people are saddened by the fact that they do not have a child to wrap gifts for, a husband to wake up to, or a family to visit on Christmas Day. Just know that we are all struggling with something around this time and that sometimes the best way to cope with sorrow is by reaching out to others. Having a sense of gratitude also helps.

Remember the homeless, remember those struggling with depression or other mental health conditions, and remember those who may need your smile and love today.

All the best to you in the new year!
Merry Christmas




A Balanced View: Having a baby with severe mental illness

Acelya AksunkurAn article was published a few weeks ago and circulated by http://www.rethinkmentalillness.org. The question that was posed was “am I crazy for wanting a baby with schizophrenia?” Many responded with both positive and negative replies, but many were imbalanced. Imbalanced information in the field of mental health is not a shocker. Imbalanced information circulates throughout the system all of the time. This is not new news. But I’d like to offer a balanced perspective to this story.

Firstly, having children is a very complicated matter and many things can go wrong with health. Although I am not a mother (yet!), working with children of all ages (5-22) has afforded me an inside look at the multiple challenges involved in child-rearing. Infants can be complicated little creatures, although so very cute! They can develop health and mental health problems, developmental challenges, or have very touch temperaments. Some kids are overly hyperactive, don’t catch on in school fast enough for teachers or parents, struggle with adjustment issues, suffer from separation anxiety, struggle with parental problems such as divorces or unstable relationships, and other kids just struggle with peer pressure, following authority, or getting good grades. Most kids are sweet, loving, beautiful little people. I love them! But there is a reality that we all fail to look at. We fail to look at the fact that these cute little people will one day grow up!

What are the down sides?

When kids grow up, we see they are susceptible to a host of issues that adults are and some kids end up growing up with substance abuse problems, severe depression, having suicidal thoughts, and other issues. The question for any parent should always be “are you ready to deal with whatever might result in this child’s life?” The next question for all parents should be “are you emotionally ready for their challenges?” Not all kids have challenges but for those that do, strong parents are needed.

On the flip side of this, children are often highly affected by the emotional stability or instability of their parents. If a parent is not stable enough to raise a child, that child can grow to have many emotional and psychological needs. Some kids go straight into substance abuse, while other kids end up delinquent. This, of course, is not the fate of ALL kids, but this reality does exist in many areas.

What are the positives?

Some parents have children and everything turns out okay. The fact that one has a severe mental health condition does not automatically dis-qualify them from having children. But there are things to consider before taking that leap. I have worked with children who are being raised by parents who suffer from depression, have felt suicidal in their past, or experience anxiety at intense levels. Some parents even struggle with mild cases of autism, mental retardation (or intellectual disabilities), and other conditions. Having loving, strong, dedicated, and supportive parents  has a way of trumping anything that could negatively affect a child in most cases. But there are a small number of cases that barely survive the emotional and psychological “trauma” of a parent. As a result, there are a few questions all parents struggling with mental health conditions should ask themselves.

The most important questions to ask a parent struggling with severe mental illness are:

  • “Are you stabilized enough to have a child?”
  • “How long will that stability last and what is the history of stabilization?”
  • “Will medications taken affect the developing baby?”
  • “Can you cope with the possibility of postpartum depression?”
  • “Do you know or understand the genetic heritability of the disease?”
  • “Are you prepared for dealing with the possibility of your child inheriting the disease?”
  • “Do you have a support system?”

Take away

We have to be careful not to pre-prejudge a mother suffering from a severe mental health condition. But it is important to consider the pros and cons and evaluate whether having a child is in the best interest of the unborn child.

To read the article about this dilemma, visit Mail Online.

Photo credit: Acelya Aksunkur

Book: Mental Health In A Failed American System

Base-book cover 2 -altered Get the e-Nook book on Barnesandnoble.com now! Looking for the paperback version? Released April 22, 2014!

Book Description

Families of an individual with a mental health diagnosis or special need are often the most frustrated and powerless among us. These individuals experience a host of fears and have concerns regarding diagnoses, what to expect, and how to secure financial support to cover costs. Mental Health In A Failed American System is a step-by-step personal guide that will offer the type of “companionship” parents, families, and caregivers need to develop knowledge about the mental health system. This brief guide highlights problems such as politics, universal lack of knowledge, and fear of stigma that contribute to poor policies, systemic barriers, and lack of resources. Millions of families identify with feeling alone, uninformed, and confused about the future.
Hill cautions all families to dedicate themselves to developing independence and empowerment through self-knowledge. She explains that self-knowledge is not simple rote memorization, but the objective investigation and comparing of information. She guides families to multiple resources and encourages in-depth evaluation of the field itself. Hill discusses the challenges inherent in the mental health system such as political control, ineffective science, and inadequate treatment protocols, state laws, and diagnostic measures. Carefully charting the continuing problems of mental health including the Diagnostic and Statistical Manual of Mental Disorders, she evaluates widespread problems that are becoming burdens to society.

Bonus chapter: Legally protecting children with special needs from bullying

©All rights reserved

Is this what we are coming to? Murder as a remedy to mental illness?

Korry B“Is this what we are coming to?”

I found myself asking this question after reading an article about a man in Fairview Oregon who was talking to himself in an apartment. When police arrived it was horrible, police fired several shots into the Fairview apartment after the man’s friend called 911. The man was taken to the hospital where he is in serious condition. “Is this what we are coming to?” After reading this story I found myself wondering if this is the type of society we are going to continue to foster as a result of a lack of knowledge regarding mental health issues. Continue Reading »

Spotting ethical violations in therapy

ID-10076027When a therapist communicates his most intimate thoughts, feelings, beliefs, or behaviors to a client in a therapy session or therapy relationship, the therapist has crossed a professional boundary. However, it is important for all clients to carefully consider the situation because some therapists share details about themselves to develop rapport. Such an incident is known as self-disclosure. Some self-disclosure is good for building a long-lasting relationship with commonalities. But there are those therapist-client relationships that cross the line and end up making the client the therapist and the therapist the client.

Some individuals believe that transference (when the client begins viewing the therapist outside of his or her professional role) and counter-transference (when a therapist reciprocates feelings of the client) can occur in which a therapist has crossed boundaries, making it difficult for a client to benefit from the transference because the therapist simply enjoys the confusion. Freudians or psychoanalysts believe that transference can be a useful tool for helping both therapist and client evaluate feelings, thoughts, and past relationships. If this is not done properly, the client can be manipulated or violated.

There are a lot of signs of a bad therapist, but ethical violations can be very difficult to spot. So I recommend clients look for:

  1. Violation of Confidentiality: Confidentiality is your legal and moral right to protection of your conversations in therapy, your files, your phone calls, your emails, and other types of information shared about your personal life. There are instances in which therapists may have to discuss your case with:
    • interns (students studying for their professional agree),
    • supervisors (people with more experience in the field),
    • lawyers (if a legal case is pending), police (if they request a warrant to search records), or
    • teachers (if a child or adolescent is in the process of getting an IEP or Individualized Education Plan)
  2. Violation of HIPAA: HIPAA is the Health Insurance Portability and Accountability Act of 1996. This law was passed to protect all medical and mental health information from “outsiders.” But some people claim the ACT has not stopped their employers, lawyers, etc. from requesting information on a psychiatric file. An ethical therapist will make sure that he or she protects the clinical records of clients. Therapists who do not make their policies clear on how they work with HIPAA regulated files, be sure to ask in advance.
  3. Socializing with clients: It is a common rule that therapists think hard and long about socializing with their clients. Some therapists accept invitations to graduations, weddings, or even funerals. It is up to that therapist whether he or she will accept invitations. However, if a therapist chooses to attend, such events should be once in a lifetime and not frequent occurrences. Socializing with a client can reduce relational respect and professional boundaries.
  4. Text or email: Some therapists allow clients to text or email them, while others text and email their clients. This can become a really big violation because clients may interfere with the personal lives of therapists or therapists may interfere with the lives of their clients. Either way, for me, email is for office hours only and for certain things. Texting is out of the question! But different therapists do different things. Frequent texting or emailing should be a red flag.
  5. Sexual misconduct: Believe it or not, some therapists end up abusing their power by taking advantage of clients. Some clients flirt with their therapists and therapists reciprocate. Some therapists come on to their clients. Either way, this is a great ethical and legal violation  that can lead to total career loss and thousands of dollars in legal fees.

You want to keep an eye out for therapists who walk over their clients, either blatantly or subliminally, especially if you are a parent, family member, or caretaker of a youngster in therapy. Young children and teens have a tough time evaluating what is good and what is bad for them. Adults are needed to do these things. With the permission of the child or teen and therapist, you may be able to sit in on a few sessions to get a feel of the therapist and his or her techniques and way of communicating.

As always, feel free to post your experiences. Let’s discuss and learn!

All the best


Williams, M.H. (1997). Boundary violations: Do some contended standards of care fail to encompass commonplace procedures of humanistic, behavioral, and eclectic psychotherapies? Psychotherapy: Theory, Research, Practice, Training, 34(3), 238-249. doi: 10.1037/h0087717



How to spot a bad therapist: 5 major signs you need to move on

SONY DSCAre you looking for a therapist? Do you currently have one? Do you know someone who is looking for a therapist or thinking of changing therapists? If so, this article is for you. Looking for or being comfortable with a therapist takes time. A therapist-client relationship takes time to develop, but if your therapist isn’t a good one, the relationship will never develop! Continue Reading »

Delusions Vs. Hallucinations: Differences and How To Cope

Billy AlexanderDelusions and hallucinations can be dangerous for the individual experiencing them and those around the individual. Hallucinations can cause people to act on their emotions. For example, an auditory hallucination is often in the form of voices telling an individual to do something dangerous such as harm themselves or others.

Delusions can turn into rooted beliefs that cause the individual to act on their belief. For example, a woman who writes letters to Alex Baldwin begins to believe he is sending her messages that he is in love with her,  may attempt to buy tickets to all of his shows and cyber stalk him. A strong delusion such as this can lead to emotional (and maybe even) financial distress.

Delusions and hallucinations are not easy to cope with. But here are a few things to try:

  1. Do not argue facts: I always encourage families to re-frame from arguing with their loved one about their delusions or hallucinations. The key is to be mindful that the delusion or hallucination is very real to them. So if you go against the delusion or hallucination, you are “going against them.” Although not true, this is often the experience of people in these shoes.
  2. Understand their emotions: Hallucinations and delusions often have an emotional component of some sort. The woman attracted to and writing Alex Baldwin may feel “emotionally connected” to the point of behaving as if she “knows” him on a personal level. If you find there is a strong emotional connection with the delusion or hallucination, try to talk with your loved one and calmly discuss your concerns.
  3. Get inside their head: Individuals experiencing delusions or hallucinations may be difficult to talk to, especially if they do not believe they are impaired/ill. So wait until the individual brings up their experience and discuss it without judgment. Try not to ask questions that would make your loved one feel condemned or “crazy.” You want to try to understand, no matter how unstable their reasoning is, their thought processes. This is good “data” for if you ever have to discuss your case with a psychiatrist.

The most important thing to do in such cases is to be compassionate and understand that your loved one is going through something quite serious. Reaching out for help is important, but so too is showing love and understanding, even if the delusions or hallucinations are unrealistic.

I’d love to hear your thoughts, post below.

All the best


©Photo Credit: Billy Alexander

5 Myths Parents Believe About Youngsters & Mental Health

Hidden-2A very sad reality is that innocent and sweet children suffer from severe and often untreated mental illnesses. Attention-Deficit Hyperactivity Disorder (ADHD), depression, bipolar disorder, anxiety disorders, obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), and a host of other mental health concerns have evaded the lives of many children and adolescents today. According to WebMD, about 20% of children experience a mental health problem, while about 5 million children and adolescents suffer from a severe mental illness.  

We must not forget about our substance related problems. Adolescents and even young children are beginning to abuse substances (street drugs, prescriptions, OTC meds, and house-hold products). According to the National Institute on Drug Abuse (2013), about 6.5% of 12th graders reported using marijuana daily.

Despite these facts, a variety of myths still invade our society and has a rather strong effect on whether a parent, family member, or caretaker will consider seeking mental health treatment for their young loved one.

Having spoken to multiple families, parents, and caregivers, I have come to the conclusion that 5 myths prevent appropriate and timely mental health treatment:

  1. Children don’t have stress: Unfortunately, a lot of adults believe that ALL children have wonderful lives filled with Disney characters, fantasies, and no worries. This is sadly far from the truth for some youngsters. We must keep in mind that some kids experience many of the same issues that stress adults such as:
    • Watching mom/dad struggle to pay bills
    • living in less than ideal living conditions
    • homelessness
    • hunger or malnutrition
    • poverty
    • discrimination and segregation
    • bullying or harassment
    • self-esteem issues
    • physiological symptoms that interfere with daily life
    • medical conditions such as diabetes
  2. Kids will outgrow their problems: The reality is that many kids will not outgrow their mental or behavioral health problems  although some kids are able to manage their symptoms better as they age. If you see troubling signs, I encourage you to seek help. Kids never outgrow serious problems.Hidden 3
  3. No therapist can help me!: The idea that ALL mental health professionals are bad is incorrect and biased. There are quite a few good therapists and mental health professionals, but you must search for the best fit. While there are good therapists, there are also incompetent therapists as well. Search wisely.
  4. Every child has a problem: While most people have quirks and habits that may be bothersome, ALL children do not have mental health or behavioral problems. We don’t want to “normalize” a problem that can grow and progress into negative ways. If you see symptoms or signs that concern you, reach out.
  5. My child is too smart for mental illness: A lot of people believe that if you are intelligent, you are not mentally ill. This is one of the biggest mistakes and myths there is. Intelligence has zero connection to mental health. An individual could have severe bipolar disorder or schizophrenia, yet hold a PhD or run a company of over 600 people. We should not continue to be blinded by this myth. A child who is getting A’s in class, could also be suffering from hallucinations, depression, or attention problems.

It is important that we search for balanced, correct information. Mental health is becoming a very serous public health concern and we cannot continue to ignore it.

All the best


WebMD. (2013). Mental illness in children. Anxiety & Panic Disorders Health Center. Retrieved May 22, 2013, from http://www.webmd.com/anxiety-panic/mental-health-illness-in-children.

National Institute on Drug Abuse. (2013). NIDA For Teens: Marijuana. Retrieved May 22, 2013, from http://teens.drugabuse.gov/drug-facts/marijuana.

Photo Credit: Hidden (Doriana S.)

Photo Credit: Hidden (Kinsey)


Understanding How Hallucinations Affect Your Loved One

Brain scanning technology is quickly approachi...

Brain scanning technology is quickly approaching levels of detail that will have serious implications (Photo credit: Wikipedia)

Any type of psychotic disorder can be extremely disturbing for families, caregivers, and even friends. The individual suffering from psychosis can seem very far away and out of touch with reality. It can be difficult to relate to this individual or even comfort them. Keep in mind that while you may be experiencing stress, distress, and fear in regards to these hallucinations, the person suffering is probably even more afraid.

In moments where your loved one is experiencing a psychotic disorder, it is important that you monitor them (ensuring that they are not a danger to themselves or others) and reach out for support. If you have questions or concerns about this topic, feel free to send me an email or post below.

There are various types of hallucinations that families, caregivers, and friends should be aware of:

  1. Visual: These type of hallucinations often entail seeing shadows, seeing silhouettes of people, seeing demons or other frightening images.
  2. Auditory: Auditory hallucinations are the most common. When a patient or client comes into a psychiatric healthcare facility for evaluation, the most disturbing symptoms are often auditory hallucinations. These types of hallucinations are often the person’s name being called, dogs barking, doors slamming, one or more talking voices, or even sometimes white noise.
  3. Olfactory: Every human being has what is known as the Olfactory bulb, which is located in the forebrain (the area of the brain behind the forehead) that entails our perception of odors and controls our sense of smell. In cases where psychotic disorders are present, olfactory hallucinations are typical such as smelling smoke or something burning. Some individuals clam they can randomly smell the scent of flowers or cologne.
  4.  Tactile: This type of hallucination has to deal with touch. It often entails feeling pressure on the skin or feeling things crawling on the body.
  5. Gustatory: These hallucinations have to do with taste. Some individuals state that they can taste poison in their food.

Most of the above hallucinations can also occur in individuals experiencing withdrawal from alcohol and other serious drugs such as methamphetamines known as DT’s (Delirium Tremens). Symptoms of DT’s can be extremely bothersome and frightening for individuals observing the withdrawal symptoms. Symptoms may include:

  • extreme perceptual disturbance such as seeing rats of mice,
  • shakes,
  • agitation or autonomic hyperactivity,
  • hypertension, fever,
  • disorientation, confusion,
  • nightmares, and feelings of imminent death

Keep in mind that although rare, children also experience these symptoms in cases involving psychosis or schizophrenia.

If you are dealing with any of these symptoms or have a loved one experiencing them, I encourage you to reach out to a local mental health professional. If you have questions, post them below.

I wish you well


Understanding your loved one: Coping with delusions

An example of walking in sandals.

An example of walking in sandals. (Photo credit: Wikipedia)

Maintaining a relationship with a loved one who may be experiencing delusions is like walking on shaky ground. Every step you take could land you in an argument or adversarial position. Whether you intend to argue your points or attempt to bring reality to the attention of your loved one, you will always be on the opposing side. Delusions are strong beliefs held to be true despite evidence to the contrary.


Here is a listing of types of delusions to be watchful of:

  1. Grandiose type: Delusions involve inflated worth, power, knowledge, or identity. This is not the same as narcissistic thinking. Grandiose delusions might sound like this: “I am usually more intelligent than most, so I must rid the world of people not as smart as me.”
  2. Erotomanic type: Strong belief that another person of higher status (celebrity, congressman, etc.) is in love with them. This can occur even when there has been no relational ties with the person.
  3. Jealous type: Strong belief that an intimate partner is being unfaithful, despite evidence to the contrary.
  4. Persecutory type: Delusions or strong beliefs that the person is being persecuted or malevolently treated.
  5. Somatic type: Delusion that the person has a physical defect or medical condition. This is different from hypochondria.
  6. Mixed type: Delusions that may entail all of the above.


There are a few things you can do to cope with this behavior:

  1. Don’t argue: It is going to be very difficult to unravel the entanglement of delusions that your loved one is entertaining. Keep in mind that they truly believe what they believe and they have a “deficit” in deciphering truth from fiction. This person needs a certain level of compassion.
  2. Don’t directly reject the delusion: I’ve learned from experience that delusions are strongly connected to emotions, so it will be difficult to reject that person’s belief without becoming confrontational. You want to take a neutral stance. You can do something simple such as getting off the topic or redirecting the conversation in a subtle manner.
  3. Don’t jump to pathologize: Don’t label your loved one’s delusion(s) as psychiatric just yet. There are cases in which delusions are part of medical or neurological conditions and also what I call “conditions of human nature.


This is a very difficult situation to live with. It is difficult to view reality from your loved one’s perspective when you know their perspective is skewed. It may be helpful for families and caregivers to discuss this situation with a therapist and ask for a consultation. In any event, make sure to take care of yourself and remember: do not argue with them. You won’t win.


I wish you all the best


For information on how to distinguish what type of delusions your loved one may be experiencing, visit my “sister site” at Caregivers, Family, and Friends.

2014 in review for New Years!

The WordPress.com stats helper monkeys prepared a 2014 annual report for this blog. It is wonderful to see just how much support Anchored-In-Knowledge received from all of you in 2014. I just want to Thank You for your continued support, comments, insights, and great blogs/websites. You help spread the message of mental illness, challenges patents, families, and caregivers experience.

My team and I are considering hosting an entire month of guest posts about mental health. I did it with blogs.psychcentral.com/caregivers so stay tuned for this news for early 2015!

Have a wonderful and meaningful New Year!


Here’s an excerpt:

A New York City subway train holds 1,200 people. This blog was viewed about 7,400 times in 2014. If it were a NYC subway train, it would take about 6 trips to carry that many people.

Click here to see the complete report.

what a shrink thinks

a psychotherapist's journal


The Quantified Child

Gary Direnfeld, MSW, RSW

Can you relate...

Disrupted Physician

Irrational Authority, Physician Health, and the 21st Century Medical Witchprickers

Clinical Psychology and People

Clinical Psychology and Well-Being: Approaches, Applications and Issues. (as experienced by Dr Gordon J Milson and guests)

SACPROS - Leading Mental Health Resource Directory for the Greater Sacramento Region

sacpros.org is devoted to breaking down the barriers which prevent access to mental health services by providing easy access to available services in the community


Counselling, Problem Gambling & Gaming, Cyberculture and Online Therapy & Support

The Persistent Platypus

Life's journey may not always be easy, but being true to your unique self and finding laughter in the small things makes the adventure unforgettable!


Get every new post delivered to your Inbox.

Join 158 other followers