Thursday, February 12, 2015

Classic Defense Mechanisms:The Good and the Bad

Classic Defense Mechanisms: The Good and the Bad

And the signs of each of the four types.

Defense mechanisms keep us in check and balanced. But, as with most things in life, there are healthy defense mechanisms (which prevent us from acting out in negative ways) and unhealthy ones (which simply make things worse). DMs help us manage our unconscious and unacceptable thoughts and urges, curbing anxiety and the other negative feelings we’d experience if we were more aware of our upsetting thoughts.

Nonetheless, relying too heavily on unhealthy DMs impedes our ability to resolve psychic conflicts. It keeps us “stuck” in a negative cycle and prevents us from living happier and more authentic lives. Dr. George Valliant, a noted psychiatrist, grouped defense mechanisms into four categories, which I’ve broken down here.

Level I pathological defenses are most commonly seen in individuals struggling with psychotic illness. They may also be experienced in dreams and during childhood.

Conversion. When an interpersonal conflict is expressed physically. Think about being so angry that you lose your ability to speak.
Denial. Denial is a common reaction to any real-life crisis that’s too painful and/or threatening to process—like refusing to accept a terminal medical diagnosis or the death of a loved one.
Splitting. Often difficult to pin down, splitting occurs when we’re unable to integrate negative and positive impulses, feelings and/or behaviors. Thinking becomes back and white, and we define experiences, people and circumstances into either “all good” or “all bad.” Splitting hinders nuanced thinking, healthy relationships, and emotional control, making it difficult to tolerate ambivalence and uncertainty.
Projection. Managing extreme discomfort caused by a moral or psychological dilemma by  “throwing it” onto another individual or group.
Superiority complex. When an inflated sense of self obscures feelings of inferiority and poor self-esteem.
Inferiority complex. A rampant overachiever might be fueled by poor self-esteem, self-doubt and feelings of not living up to society’s standards. Those with an inferiority complex are forever out to prove themselves through their accomplishments.

Level II immature defenses are equally common in young children, adolescents and adults. When used in excess, they can interfere with our ability to properly assess reality, maintain and build relationships, and lead fulfilling lives.

Acting out. When unconscious wishes or desires are physically acted upon, rather than expressed.
Fantasy. Retreating into imaginary worlds and daydreams to avoid psychic conflicts.
Wishful thinking. Basing decisions and behaviors on what we’d like our reality to be, rather than going by hard evidence, rationality and reality.
Idealization. One of the most common defense mechanisms, idealization places another person in an overwhelmingly positive light. This creates conflicts in a relationship because it skews our sense of reality, thwarts understanding, and impedes the ability to truly know a person.
Passive aggression. This oft-used term denotes an indirect form of aggression toward others. Common examples include procrastination, sarcasm, hostile jokes, resentment.
Projection. When we foist our unwanted, unacknowledged, unacceptable thoughts onto another person.
Projective identification. Unconsciously acting out the thoughts, feelings or behaviors projected onto us by others.
Somatization. When psychic conflicts are manifested in physical symptoms like headaches, digestive illnesses and chronic pain.

Level III neurotic defenses are most common in adults. And while they may have short-term advantages, coping often suffers in the long term.

Displacement. Shifting unacceptable impulses to a more acceptable and/or less threatening target. Phobias are a prime example, as they involve displacement of anxiety.
Intellectualization. When we use abstract, theoretical or philosophical thinking as a way of controlling or warding off unacceptable impulses or feelings. Someone who recently witnessed a horrifying car accident, for example, might flatly recounting the facts without any hint of anxiety, fear or sorrow.
Rationalization. A form of intellectualization, in which we create reasonable explanations for our upsetting thoughts, emotions and behaviors.
Repression. This complex DM keeps threatening internal thoughts and impulses buried in the unconscious.
Undoing. When an unacceptable behavior, thought, impulse or emotion is countered with a more acceptable thought or behavior. A person may overeat one day, then feel compelled to eat very little the next. Most commonly associated with obsessional disorders.

Level IV mature defenses are the healthiest DMs, simply because they don’t lead to harmful outcomes—nor do they prevent us from developing relationships and being intimate with others. They enhance our sense of fulfillment, pleasure and self-control by allowing us to effectively integrate conflicting emotions, thoughts and behaviors in a positive way. There are many mature defenses, but here are the most relevant:

Patience. Being patient reduces acting-out behavior and avoidance.
Identification. Crucial to any personality, identification is an unconscious modeling of one’s self based on another—usually someone we admire. It also helps us understand and empathize with others. (Note: Identification is only as good as the person with whom you’re identifying, so choose wisely.)
Sublimation. Those who can readily sublimate have no trouble funneling negative impulses, emotions or wishes into positive, socially acceptable behaviors—like when a child confines his aggression to the sports field.
Altruism. Deriving personal joy and gratification from meeting the needs and wishes of others.
Thought suppression/distraction. This hinges on the ability to compartmentalize, pushing unwanted thoughts into the pre-conscious (versus the inaccessible unconscious). This allows us to effectively cope with our current reality by being mindful and emotionally present.

So, how do we know which defense mechanisms are helpful and which ones aren’t? And is avoiding anxiety and other negative feelings really good for us? Doing so can deny us the opportunity to dig deeper in an effort to identify and confront the underlying causes. After all, it’s impossible to fix what we don’t know is broken in the first place.

A big step in the right direction is having the capacity to tolerate unpleasant emotions. Being able to “sit with” frustration, fear, sadness, anxiety and rejection creates the emotional and cognitive space necessary to find effective solutions to our problems. So honing in on the DMs we use to ward off anxiety and other difficult feelings is a valuable tool in our quest to weed out what we’re really struggling with. And it gives us the power to make things better.

In my next blog, I’ll offer tips for recognizing counterproductive defense mechanisms, along with some strategies to help you deal more effectively with negative emotions.

Sunday, November 30, 2014

The Perils of Black-and-White Thinking

The Perils of Black-and-White Thinking

Dr. Paula Durlofsky gives four ways to combat all-or-nothing thinking.

Black and White
Black-and-white thinking—also known as polarized or all-or-nothing thinking—occurs when we process people and circumstances as either "all good " or "all bad.” In such a mindset, tasks must be done in a certain way and lead to a specific outcome. When those lofty expectations aren't met, black-and-white thinkers often see themselves as failures and are unable to put any sort of positive spin on their efforts. Disappointed by their own behavior or that of others, they quickly become upset.
Black-and-white thinkers often misunderstand others, and it’s not uncommon for them to struggle in relationships. They might say things like,  "I'm a failure,” "He's perfect at everything he does, unlike me,” and "I'm unlucky all the time.” It’s an oversimplified version of life. And the more polarized our thinking, the more vulnerable we are to depression, mood swings and anxiety. Some studies even suggest that black-and-white thinking is a remnant of our instinctual "fight or flight" reflex. After all, there really is no room for uncertainty when faced with a life-threatening situation. Such physical and emotional arousal leaves us feeling emotionally wound-up, inhibiting the ability to think and act rationally.
In truth, most events aren’t completely horrible or completely wonderful. They fall somewhere in the middle—in life's gray zone. Slowing down to think and feel in the gray zone can be immensely helpful in countering distress and intense emotional stimulation. Black-and-white thinking puts pressure on us to make snap decisions. But when we allow ourselves to sit back and process things in a "maybe this”/"maybe that” fashion, the pressure is lifted. Clearer thinking is the result, helping us devise more constructive real-life options for solving life's many challenges.

Four strategies for changing black and-white thinking: 
  1. Be conscious of the words you use to describe or express your feelings. “Always," “impossible," “ruined,” “never," “perfect," “terrible” and “disastrous" are absolutes and not at all helpful in understanding relationships or situations that are dynamic , complex and grounded in reality. 
  2. Work on becoming less rigid in your thinking. Challenge your thoughts. Ask yourself,  "Is it possible to be a generally intelligent person but not proficient in everything?” or, "Can what I’m facing be difficult now but get better in time?" 
  3. Accept the fact that no one is perfect. We’re all human; we all make mistakes. Try to see the value in learning from those mistakes.
  4. Learn to physically relax and cognitively slow down. Black-and-white thinking spikes when emotions are high. Relaxation techniques like slow breathing help to curb emotional arousal, allowing our more rational selves to take over. 
About This Blog

Dr. Paula Durlofsky is a psychologist in private practice in Bryn Mawr, whose practice focuses on psychological issues affecting individuals, couples, and families.
Dr. Durlofsky treats a wide variety of disorders and has a special interest in issues affecting women. She is affiliated with Bryn Mawr Hospital, Lankenau Hospital, the Women's Resource Center in Wayne, and the Psychoanalytic Center of Philadelphia. In addition to her practice, Dr. Durlofsky is a workshop facilitator and blogger.
If you have questions or feedback for Dr. Durlofsky, please don't hesitate to reach out to her via email at

Friday, November 7, 2014

Demystifying Narcissistic Personality Disorder


     Most are familiar with the story of narcissus, the Greek myth about a man who falls hopelessly in love with his own reflection seen in a pond where he stops to get a drink of water after a day spent walking through the woods. The myth has a variety of endings. One popular ending describes narcissus dying from starvation and thirst because he can not tear himself away from his own reflection. I find this particular ending to be most helpful for describing narcissistic personality disorder ( NPD) since at the core this disorder is an inability for one to receive or give love; in essence individuals with NPD are starving themselves of affection.

  The term narcissist or referring to one as having NPD is commonly said today. And narcissism may truly be on the rise as a result of our culture's obsession with social media, youth and physical appearance.

To be diagnosed with NPD a person must meet five or move of the following symptoms:

-has a grandiose sense of self importance. Exaggerates achievements and talents and expects to be recognized as superior without commensurate achievements.

- is preoccupied with fantasies of unlimited omnipotence, success, intelligence, beauty and ideal love.

- believes that he or she is special or unique and can only be understood by or should only associate with other special or high status people or institutions.

-requires excessive admiration

- has a strong sense of entitlement. Have unreasonable expectations of receiving favorable treatment or automatic compliance with his or her own expectations.

- is exploitative of others by taking advantage of others to achieve his or her own goals.

- lack empathy. Is unable and unwilling to recognize or identify the emotional needs and feelings if others.

- is often envious of others and or believes that others are envious of him or her.

- regularly behaves in arrogant and hairy ways.

NPD affects more men than women, is seen in approximately 7% of the general population and can range from mild to severe. It is thought that both biological and psychological factors contribute to the disorder. In regards to biological factors, studies suggest that individuals with NPD are more emotionally sensitive in temperament. Studies investigating psychological factors contributing to NPD indicate several psychosocial factors. The main ones being abuse or neglect in childhood, excessive praise for good behaviors and excessive criticism for bad behaviors in childhood, overindulgence and over evaluation by parents and or peers, unpredictable and unreliable caregiving and learning manipulative behaviors from parents and caregivers.

It is important to recognize that individuals with NPD struggle with profound feelings of shame, fear of rejection and feel emotionally threatened when criticized. Individuals with NPD often react with intense rage, hostility and aggression to any criticism, real or imagined. This type of reaction causes others to retreat or distance themselves from them, all of which inhibits people with NPD from having genuine and meaningful relationships.

Although NPD is a treatable disorder, most people with NPD do not voluntarily seek treatment because they are unable to acknowledge their self-destructive behaviors and thoughts. Psychoanalytic-Psychodynamic therapy, cognitive and behavioral therapy and group therapy have all been shown to be effective treatment approaches for treating NPD. As with all therapy, building a strong and positive therapeutic relationship is key for successful treatment. When an individual with NPD develops a therapeutic relationship that is secure and safe he or she can work through his or her profound feelings of shame and rejection without feeling emotionally threatened. One important therapeutic goal is to help the person with NPD develop the ability for self-compassion, compassion for others, and empathy; all necessary skills for developing meaningful relationships and for having the ability to give and receive love.

If you or a loved is struggling with NPD consider an evaluation with a mental professional. There is hope and help out there for you.

Tuesday, October 14, 2014

Do You Text and Tell? Flirty behavior through technology can lead to deception, secrets and betrayal.

     Emotional affairs often start out as innocent friendships. Email, texting, instant messaging, and social media sites are never "closed for business" so communicating with others is a 24 hour /7day a week opportunity. This makes it easy for innocent friendships to heat-up fast. Once casual communications turn into flirty texting banter, obsessions develop around the next communication with this person, feelings of marital dissatisfaction are discussed, and these communications are kept secret from your partner, the line between innocent friendship and emotional affair has been crossed.
An emotional affair is an "affair of the heart" and is predicated upon the attachment two individuals create outside their marriage or relationship. A deep attachment develops by sharing intimate thoughts, feelings, and vulnerabilities and by relying on one another for emotional support and companionship. Many people convince themselves that because sex is not involved, they are not having an affair. But they are. Affairs, whether emotional or sexual, involve secrecy, deception and betrayal. The more emotional energy put into the other person the less there is for your partner and your relationship. Often the most devastating aspect of an emotional affair is the deep attachment that develops with this other person. This attachment is tough competition for your marriage or relationship.

     Emotional affairs generally happen when something is lacking in our relationship or within ourselves. In regards to relationships, not feeling important, desired or understood is often a trigger. Being able to connect with another person who seem to fill these voids feels good, and it's these good feelings that keep the emotional affair going. On an individual level, the emotional affair may be warding off feelings of low self-esteem and inadequacy. It's important to note that most affairs, sexual or emotional, do not end well. And when given the chance to be legitimate, often do not survive.

Below are 4 tips for healing from an emotional affair

1. Take responsibility for the emotional affair by being honest with yourself and your partner. We all make mistakes and do things we may regret. Once we no longer deny we are engaging in behaviors that are hurtful and damaging to us, genuine change, healing and understanding can take place.
2. Terminate the relationship. This will be difficult because an attachment has been made. Emotions and thoughts associated with mourning and loss should be expected. And as with any significant loss, will take time to heal from.
3. Be open to marital therapy. Marital therapy can help identify what is missing in your present relationship and the steps you can take as a couple to make your relationship better. Marital therapy can also help with exploring whether to continue or terminate your relationship.
4. Consider individual therapy. Underlying and unresolved issues surrounding intimacy can contribute to one's vulnerability to becoming involved in an emotional affair. Whether repairing your present relationship or considering a new relationship; exploring and understanding the underlying factors associated with the emotional affair will help with achieving genuinely satisfying and fulfilling future relationships and maybe even affair proof ones too.

Monday, September 1, 2014

Speed Bump Ahead! Tips for Making A Smooth Transition To Hectic Fall Days

     Transitioning to the hectic schedule of fall from the lazy, hazy days of summer can be just as stressful for parents as it is for kids. It is not uncommon for people and families to experience a growing sense of anxiety over getting back into the busy school and work routine.  Change of any kind can create anxiety so it is not unexpected that huge changes in our schedule would make us feel anxious too.

     Transitions are hard; they represent the reality that our lives and circumstances are continually changing, evolving and transforming. And when there is change there is also loss, the loss of what it is we are leaving behind.  Children get older and so do we. Many families for the first time this fall will experience a child going off to kindergarten, high school, college, and some will be first time empty nesters. When we process loss we gain the ability to fully embrace life’s inevitable changes and processing loss prevents us from feeling “stuck” or “stalled” in our lives as well.

     Many people and families experience loss at the start of a new year related to spending less time together, having less personal freedom and having a less flexible schedule. Becoming aware of situations and events that are likely to increase your and your families stress levels will help to actively manage anticipated anxiety and promote healthy coping behaviors. Learning to plan ahead and being able to discuss your emotions about change and loss with loved ones is important since chronic stress and depression negatively impacts our emotional health and contributes to depression, substance abuse, and even physical illness.  

Below are tips for making your transition to fall smoother:

1.      Get a full night’s sleep. A minimum of 7-8 hours of sleep per night helps to regulate mood, decrease anxiety and depression, and improves concentration.

2.      Set realistic goals for you and your family. Avoid over scheduling your family and you. Ease into active days by slowly adding activities for both your child and you as the year progresses.

3.      As a family sit down and openly discuss concerns about the up-coming year. This may include sorting out conflicts with schedules, carpools, and mealtimes.

4.      Make sure to schedule consistent “family time” during the busy week. Maintaining a deep sense of connection with those we love combats stress, depression and anxiety. And it’s a great way to add love and laughter to your new year.

5.      Give yourself a break too! Set aside time for relaxing and decompressing from the busy, hectic days of fall.

Saturday, August 9, 2014

Marital and Relationship Happiness--Keys To Success



     Let's be honest, relationships are hard work. They demand a lot from us and the quality of our relationships greatly predicts our degree of happiness in life. So working on cultivating and sustaining healthy relationships is VERY important for us to do. However, the majority of relationships do not last. Current divorce statistics report 45-50% of marriages end in divorce with second and third marriages having even higher divorce rates.

     Nourishing a relationship requires us to be thoughtful, caring, compassionate, loving and also mindful of how our behaviors and expressions impact the other person.  Conflicts are bound to happen at some point during any relationship; there will be tough times when one or both individuals feel hurt, frustrated, angry, or let down by the other. Social scientists have found that how couples navigate the tough times and just as importantly the good times is a major predictor of relationship success. Kindness was found to be the biggest factor associated with fulfilling relationships. Not only is kindness important in the couple's day to day interactions but also when couples argue. Kindness during periods of conflict is determined by the couples ability to express their anger, upset and frustration without personal attacks. Kindness not only improves the quality of our relationships it also improves our own emotional well being. When we feel better about ourselves our relationships reap the benefits. And an environment of kindness naturally fosters feelings of emotional security and safety; essential ingredients for a successful relationship.

     Not surprisingly, personal criticism of each other was most associated with unhappy relationships.  Personal attacks can have lasting and devastating consequences on a relationship and it leads to feelings of contempt and resentment. Learning to be kind to each other and being mindful of our partner's feelings is the foundation needed for building strong, healthy relationships.

 Below are tips for cultivating kindness in your relationship:

1. Compliment your partner.

On a daily basis tell your partner something you liked that he or she did either that day or did recently. Research shows that when couples regularly express their gratitude to each other they remind themselves of their partner's good qualities and what attracted them to each other in the first place. Complimenting your partner on a daily basis provides a healthy dose of sparkle and helps keep a couple together over the long haul.

2. Learn to compromise.

Couples that are able to compromise have a better of chance of staying together and be happier in their relationships. Just to be clear, there is a big difference between compromise and sacrifice; which means means giving up something completely for the sake of your partner. Sacrificing creates contention and resentment. Compromise, on the other hand, requires an understanding of your partner's ideas, opinions, and knowing what is important to him or her and why. This information is helpful for negotiating compromises with our partner. It prevents us from feeling "pushed" or "controlled", the type of feelings that often inhibit productive compromises and lead to power struggles instead.

3. Remember no one is perfect.

No one is perfect or good at everything they do. We all make mistakes and bound to hurt and/or disappoint our partner at one time or another. Accepting this reality helps us to have the capacity to forgive and to resolve conflicts when they arise rather then harbor contempt and resentment, only to be brought up at a later time.

4. Communicate, communicate, communicate.

 Although the idea of our partner being someone who "fully gets us" sounds ideal, no one can actually read our minds. Learning to communicate by actively listening to your partner and using "I" statements, especially when discussing emotional topics, feelings and expectations, fosters an environment of mutual understanding and respect. When we feel understood by our partner, even when they disagree with us, genuine feelings of connection and caring are felt. All of which decreases the chances for couples to have emotionally damaging arguments.

Wednesday, July 23, 2014

Ask Dr. Durlofsky: What's In The Mailbag

Hi Dr. Durlofsky,
I came across your article on Guilt this evening and it really had me thinking how do I control this "Guilt" feeling. 

Tonight I was suppose to attend a work buddy/acquaintance's film project. Like I said.. acquaintance. He is someone I see often at work but we have never met up outside of work. He is in the process of creating footage for his independent film.

On a side note: The past two week I have been looking for a new roommate. My current roommate who is truly good friend of mine, made a big decision to move in with her boyfriend. To get the ball rolling I've been conducting multiple interviews for the past two weeks to find a similar replacement. This has no been an easy process. On Thursday I met with someone who appeared to be ideal! She had everything I was looking for in a roommate, respectful, clean, hard worker, eco friendly, athletic, active, healthy, easy going, and a home body. I got the news last night that she found a different apartment closer to her work. I was hoping to share a living space with her, it turns out it wasn't meant to be. This event in itself has been stressful and now I feel like I'm back to square one. Although I have other potential roommates in line this feeling knocked me down today. 

I made a commitment to show up at my work friend's event but I ended up letting him know I had to cancel. Due to the stressful roommate situation I felt like I wouldn't be much fun if I ended up going to this all- nighter event. 

My friend's response to my having to cancel plans made me feel like a horrible person. He texted me, 'Ugh..really? well, ok." An hour later he texted "Good luck with your living situation stuff." It made me feel like I am letting him down. I can't help but feel guilty when I decline someone. I know I am a great friend to those around me and typically I do try to attend the events I am invited to. I am such a giving person and usually I am right there when someone asks me to do something for them. I take it personal when someone responds back to me in a negative way because I would always try to understand where the other person is coming from. I constantly feel like I need to validate my reasons or come up with a better excuse. I don't though and try to keep it short, sweet and honest- but it doesn't always seem like that works out for me.  Do you have any idea how I can get around this feeling and stop getting caught up in a guilt trip?

All the best,

Dear Ellen,

For most people it is hard to say, "No" to other people's requests of them. So, you are not alone in this struggle. You wrote in your email that one reason why it is hard for you to say "no" is because you fear disappointing others and feel guilty when you do actually say, 'no". The truth is that when we neglect our own needs at the expense of others we end up disappointing ourselves most of all.
Learning how to nurture and attend to our emotional needs is crucial to our sense of well-being and good mental health. One step in achieving this is for us to believe our needs are reasonable and that WE are "ENTITLED" to the needs we have--whatever they may be (e.g. finding a roommate, wanting to rest rather then go out and the right to change our mind) and as long as our needs are not intentionally harming another. Once we feel entitled to care for ourselves in positive and helpful ways, feelings of irrational guilt should diminish. 

Good luck,
Dr. Paula Durlofsky

Hi, Doctor,
I've always had high-power jobs. Most people regard me as fearless but, in fact, I've always been anxious to a point of terror. I have absolutely nothing to worry about: sound physical health, as much money as I'll ever need, a 55-year marriage, two wonderful and successful children and three cherished grandchildren. My get-up-and-go has gone, I can't get absorbed in anything and even the daily routine of getting-up and getting started is daunting.
Rationally, I know there's nothing to worry about but worry I do. I'm often called upon to help others and always rise to the challenge. I just can't help myself. WHY? and what on earth can I do?  MAYDAY!

Dear W.S.,
It's confusing and frustrating when we can't put a finger on what is causing us to feel badly. However, from what you described in your email, it sounds like you may be struggling with depression. It is not uncommon to feel anxious and have difficulty concentrating when we are depressed. Another common symptom of depression is morning depression, clinically called diurnal mood variation (DV). Morning depression is one of the core features found in major depressive disorder (MDD). People with DV experience a worsening of depressive symptoms in the morning as opposed to in the afternoon and/or evening.
I recommend you see a mental health professional to be assessed for depression. Depression is treatable with psychotherapy, medications or a combination of both. 
Good luck!
Dr. Paula Durlofsky

Dear Dr Durlofsky
I have just come across your article called “Dealing with Uncertainty: How to Cope with Ambivalence and Decision-Making”.
I found it extremely interesting because I believe that it applies to me. I find it very difficult to make decisions and tend to just get swept along with other people’s lives and decisions and a lot of the time become unhappy. I have been in 2 long term relationships that I was unhappy in because I didn’t make the decision to leave. They both became mentally abusive and I am now 33, getting divorced and still worrying over a decision about whether or not I should keep the marital home my husband and I shared. My constant worrying about which path to take affects every aspect of my life including my new relationship. The same patterns seem to repeat themselves over and over again as well.
Is there any advice you can offer me around how I can overcome / solve this?
Kind regards

Dear Emma,

     It's good news to hear that you are aware of your ambivalent feelings being a pattern in many areas of your life. Self-awareness is a major step toward making real life changes. 

     Although a certain amount of ambivalence is perfectly normal, when we are consumed with ambivalent feelings we are often left feeling "stuck" and unable to move forward with our lives. Often times, we feel ambivalent because we are afraid that we will make the wrong decision, believe there is only ONE right answer, have unrealistic expectations surrounding our decision, and afraid our decisions will be irreversible. All of which is not a reality but can make us feel very anxious.  Therefore, anxiety is commonly associated with ambivalence. Our anxiety prevents us from understanding and asking ourselves important questions surrounding our decisions such as, "what do I wish to achieve with this decision and why?" Fully understanding our needs and "wishes" helps us to make better decisions and consequently to live more satisfying lives. 

     One significant way to decrease crippling ambivalence is to learn how to tolerant our anxiety. This is no easy task, but can be achieved with therapy. Once we are able to "sit with" our anxiety we gain the opportunity to understand the root of it, and we are in a much better place for making healthy and satisfying life-decisions! 

     Talking to a professional can also help you to better understand the ambivalence you have about leaving unhealthy relationships and maybe even with intimate relationships in general. Once you understand the root causes of your ambivalence you will, no doubt, be more confident in your ability to make the right decision for you.

Good luck!
Dr. Paula Durlofsky  

If you have a question you would like to ask, please email me at