Building Your Love House: How To Focus On A Solid Foundation

So, indulge me in looking at the healthiness of a love relationship (or any relationship of significance for that matter) through the lens of the analogy of a house. A house has of course two main components: a frame and a foundation. The frame mainly encompasses what externally and internally looks and feels appealing about the house. So it’s obviously important to have the best and most enjoyable frame to that house you can have.

Yet there is another essential part of a house, which of course is the foundation. The part of the house that holds the frame up and keeps it in place, regardless of how the frame actually looks and feels.

Enough said; you know what a house is composed of!

Now I’ll use the word house as an analogy for a love relationship. Let me actually give a specific relationship example: my own current one. My girlfriend and I have been together for 2 1/2 years. At this point I can safely say to date it’s the healthiest relationship I’ve ever been in. I say this because our “house” has a great frame AND is built on an increasingly rock-solid foundation. Our frame is made up especially of: physical chemistry, lots of laughs, very good communication, constructively challenging each other, taking as-needed “time-outs”, and frequent displays of affection. A very appealing and enjoyable frame that we both feel blessed to have.

But it’s our house’s foundation that counts more. A foundation that has four hugely important pieces, all under the heading of mutual: mutual respect, trust, specialness, and comfort. Now, as very positive as that all sounds, you might wonder if say we argue at all? Yes we sure do sometimes. You might also wonder if there are times we may irritate each other or hurt each other‘s feelings (unintentionally)? Ring up another yes for sure. But fortunately, these kinds of challenges have to date created only very small, temporary cracks in our foundation.

The big four pieces of our foundation overall remain solidly in place. Which we are both totally committed to working on building and keeping in place—including going for some sessions of therapy or counseling if needed!
Moral of the story? Well, let’s call it like it is: a real house can have a beautiful frame to it. But if cracks develop in its foundation, much less the foundation crumbles, then no matter how beautiful the frame may be the house collapses anyway. Same exact thing really of course for a love relationship “house.”

So, if you are currently in a love relationship yourself, or are seeking one out and hope to find one soon, make sure you get as solid a foundation in place as the two of you can. The best of a true future together rides — or, should I say, stands on it.

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Care-Givers Versus Care-Takers

The other day, I was thinking about the distinction between being a care-giver vs. a care-taker. So I went to the “God of Google” for some non-cosmic insight on the matter. In several places that came up, the distinction made between the two essentially boiled down to this: care-GIVING involves giving in a deeply caring and personal way to a loved one, while care-TAKING refers more to a paid position, involving a person or situation as the object of the care-taking.

This distinction didn’t work very well for me I decided. So I went ahead and created a personally-preferred distinction. I’m sticking with care-giving as the personal giving of care to a loved one. But I’m switching care-TAKING to: the personal act of RECEIVING care from someone, be it a loved one, friend, or otherwise. I went with this distinction because I think it’s important to recognize that wonderfully care-giving people by nature can struggle with being on the receiving end—i.e., the taking in—of care-giving. Irrational guilt often is the underlying culprit here: essentially, feeling they don’t really deserve or have the right to receive care-giving—even when it’s clearly needed. So in enough instances, a care-giver by nature who at least temporarily needs care-giving given to them needs to be assured and reassured that it is perfectly ok to receive it, as it is a HUMAN NEED at times for everyone!

One more piece though. Care-givers do not always do a very good job of taking care of—or should I say giving care to—THEMSELVES. So to all you care-givers out there, I say: give yourself permission to receive care when you need it—but also make sure to take care of yourself too. After all, how can you really sustain being the best care-giver you expect yourself to be if you don’t balance it out at least some with taking or giving the best care you can to you?!

-Dr. Sid

On Anxiety Disorder

ANXIETY DISORDER: SUB-CATEGORIES

Many millions of people suffer from clinical anxiety. Sometimes the anxiety occurs in an extremely intense form–called a panic attack, and sometimes in an ongoing intermittent manner–called generalized anxiety. What these share in common is the personal and emotional distress they can cause you, in the short run and very possibly in the long run as well.

Suffering from either of these two types of anxiety disorder can make life less fun. You can end up worrying if not virtually obsessing about when your next episode may occur. This is especially true if during the time the anxiety hits you, it becomes much tougher to concentrate clearly, feel socially at ease, make good decisions, and generally feel free enough to laugh and enjoy yourself. Or to put this a bit differently, when you are in the throes of some significant if not overwhelming amount of anxiety, you can feel temporarily powerless at best, and outright paralyzed at worst!

What I will do now is expand upon the two categories presented above, and then add two more: phobias and post-traumatic-stress induced.

PANIC ATTACKS

For any of you who suffer from–or in the past suffered from–panic attacks, you know how terribly upsetting it is to be in its clutches. Your heart pounds, your hands sweat, your stomach churns, your breathing gets shallow, and you can feel frozen to the spot. As for your mind: it in all likelihood will go heavily into obsessing that you are having a heart attack, or going crazy, or both. If you are lucky–relatively speaking–the attack will subside quickly. But if you are not so lucky, it can last for minutes, if not many minutes. Which can actually feel like it’s hours more than minutes!

GENERALIZED ANXIETY DISORDER

Diagnostically speaking, generalized anxiety disorder is the clinical condition in which you can best be described colloquially as a “real worrier.” Often enough feeling jittery and nervous, you may nonetheless be able to overall go about your life in a reasonably well-functioning manner. But you still can expect to experience some very anxiety-filled moments on a good day, and many of those moments on a bad day, when all you can think about is any person or situation that has you worried and filled with anxiety.

PHOBIAS

As you may know, a phobia is an anxiety condition in which your often intense anxiety is connected to a specific object or situation. Examples of phobias you may be personally familiar with or have heard about include public speaking, small spaces, flying, snakes or spiders, needle injections, large dogs, or heights. The key piece about phobias is that the anxiety they trigger can be as intense as in a panic attack. Yet the trigger for these attacks may not be as clear as in the case of a phobia, and therefore cannot be outright avoided as is the case with phobic objects or situations.

POST-TRAUMATIC STRESS (PTS) INDUCED

In distinguishing PTS-induced intense anxiety from phobias and panic attacks, the resulting anxiety in the former case reflects the fact that sufferer has already experienced a major life trauma. Examples of these include being in war, or being the victim of any of the following: a natural disaster, a violent crime, an animal bite, a car or plane crash, or a significant medical mistake. In the case of phobias in contrast, the sufferer typically develops strong anxiety in ANTICIPATION of having a distressing experience in the presence of the phobic object, but in most instances without actually HAVING HAD that experience. In the case of panic attacks, these typically do not involve a previous major life trauma–although paradoxically it can sure feel like having one of these attacks is a trauma itself!

TREATMENT OPTIONS: SELF-HELP AND PROFESSIONAL

Managing or controlling any of these categories of anxiety disorders can be–as you may well know–a whole lot easier said than done. I therefore recommend you pursue both self-help tools as well as professional interventions in your efforts to tackle your particular type of anxiety problem. On the self-help front, you should consider, e.g., mindful meditation of some type, physical exercise, reassuring self-talk, diversionary/distracting activity, and prayer. On the professional intervention front, you can pursue counseling or psychotherapy, and possibly medication.

One last point. Many years ago, I published an article in a national magazine, entitled “Anxiety Attacks Can Be Guilt Attacks.” Especially if your anxiety problem is mainly of the generalized/worrying type, and whether it’s obvious to you or not, you can figure at least part of your problem is significant unresolved GUILT. So I highly recommend you face that likelihood, and get that guilt resolved to the best of your ability as part of your anxiety-reduction plan.

On Grief and Loss

GRIEF AND LOSS

What do all of the following share in common: 1) the death of a loved; 2) a relationship breakup; 3) a job layoff or termination; 4) a home being destroyed by fire or tornado; and 5) significant physical limitations resulting from a serious illness or injury?  Maybe it’s obvious, but they all involve a major personal loss, any one of which can be psychologically and emotionally painful.  The loss does not have to be a total one to be difficult to cope with.  What matters most is when the loss, whatever it may be, leaves you often feeling a mix of very sad and anxious, total loss or not.  The sadness connects with grief; the anxiety connects with fear of loss of security and/or self-confidence.

Elizabeth Kubler-Ross, in her 1969 book “On Death and Dying,” postulated 5 stages of grief connected specifically to the coping with the loss of a loved one via death.  Kubler-Ross named these stages denial, anger, bargaining, depression, and acceptance.  However, in my over 30 years as a practicing psychologist, it has been my professional experience that in enough instances, the grieving process is not as etched in stone regarding these stages as Kubler-Ross postulated.  In addition, so-called stages of grieving can occur every bit as much with the other four types of significant losses spelled out above as with the death of a loved one.

NON-DEATH VARIATIONS ON THE TYPES AND STAGES OF GRIEVING

Take 58 year old David.  David was recently was laid off from his job of 27 years.  For several months, David and several of his co-workers had seen the writing on the wall of an impending “unavoidable” layoff.  So there was no room for denial here, nor for bargaining, over this job loss.  In addition, the layoff did not outright depress David, nor could he accept it.  But one thing the layoff sure did make him feel was: angry!  Anger centering mainly on the fact that David had been a loyal, hard-working, productive company employee for more than 2-plus decades.  As a result, no matter how much he knew the company was justifying the layoffs as “unavoidable,” David felt convinced in his heart that he in no way DESERVED to be laid off.  So anger reigned supreme for David as a result of this loss; as did anxiety I might add, given the likely challenge now facing him of finding another job at his age.

Now take Jennifer.  Married for 7 years, she was by nature a trusting soul, and very much in love with her husband Ira.  Yet in the past year, Jennifer had been dealing with certain behaviors on Ira’s part that were increasingly causing her more and more angst.  These especially involved Ira claiming he was now required to work late a couple of nights a week (something he had never done before), and excessive unexplained phone texting.  Jennifer was upset by these behaviors yes, but she refused to believe what her mother and best friend were telling her: that they suspected Ira was having an affair.  Alas, one night Jennifer decided uncharacteristically to “snoop” into Ira’s computer.  And there in the trash she found an ongoing exchange of deleted emails between Ira and another woman, lurid and loving in detailed nature.

No longer able to remain in denial of the obvious truth, Jennifer did not go into anger mode, as her sadness simply overwhelmed her.  When she finally confronted Ira, he not only acknowledged the truth of his affair, but even more devastatingly to Jennifer, he informed her of his intent to divorce her.  Begging (bargaining) for even some marital counseling got her nowhere.  And then for many years after the actual divorce, Jennifer remained so sad and anxious at the core that acceptance of her marital loss remained extremely difficult for her to do.

The moral of the story regarding these two significant personal, non-death losses is that they are examples of how Kubler-Ross’ five postulated stages of grief by no means universally occur, nor do they necessarily occur in the chronological order she elucidated.  What does consistently occur though in the case of significant personal loss is any of a range of painful emotions, some of which go beyond those presented by Kubler-Ross.  These can include for example guilt, jealousy, abandonment, embarrassment, and as noted above anxiety/fear.  Keep in mind too that any of these emotions can realistically and humanly have no “statute of limitations” regarding the duration of their intensity and presence, consciously or subconsciously.

CLINICAL SYMPTOMS OF GRIEF AND LOSS

Moving to the clinical aspect of grief and loss, there are a variety of possible psychological problems that intense grief can trigger, in the short run and possibly in the long run.  These include depression, anxiety, post-traumatic stress, addiction, and eating disorders.  As with the  loss-triggered emotions listed above, there is no statue of limitations on the potential duration or intensity of any of these symptoms.

HEALING FROM GRIEF AND LOSS

Safe to say we all grew up hearing the expression “time heals all wounds.”  Well, now that most of us are grown up, I will at least speak for myself when I say I have learned that the idea that time heals all wounds–especially grief/loss wounds–is far from guaranteed.  Some important losses can leave us with long-lasting if not permanent feelings of any one or more of the powerful emotions listed above, from sadness, to guilt, to loneliness, to anger, to fear.  So to help yourself heal from these emotional wounds of grief and loss, you will need to DO some things over time to increase your healing potential.  Options here especially include becoming involved in a grief/loss support group, disregarding anyone who tells you to “move on!” or “get over it already!”, staying as busy and distracted as possible, tapping into religious or personally spiritual pursuit, or–if the clinical symptom piece does not subside–seeking professional counseling and/or psychiatric medication.

In closing, I encourage you to keep in mind that any significant loss–again, be it the death of a loved one, a relationship breakup, a change or loss of a job/school/residence, or suffering a physically debilitating injury or illness–can trigger a range of painful emotions, which can vary per person in intensity, duration, and chronological order.  Therefore, let me underscore, any of these emotions is called HUMAN, and not what too many people judge them as being: “weak!”

On Anger Management

Almost everyone has heard the term anger management. Some of you may have even seen the comical version of the term anger management, i.e., the movie by that name, starring Jack Nicholson and Adam Sandler. For the very most part though, need I say there isn’t much room in real life for thinking about it in humorous terms.

In addressing the subject of anger management, let me first focus on the word anger, or a little more specifically, “angry.” The key here is that for many people, hearing someone sound and look angry implies that that person is being judged as being out of control (i.e., “flying off the handle” or “flipping out”). Yet for other people, the word angry may NOT imply being out of control. Instead, it may imply being frustrated or irritated–feelings which even if strong are usually perceived as the person still being in control of themselves. There also are many instances in which a person is perceived by others as being out of control–i.e., angry–yet NOT out of control in the eyes of the “angry” person himself/herself. And when this becomes a pattern of behavior, others may perceive that person as having an “anger management” problem, but the person himself/herself may not.

One postscript here. I think it’s safe to say that when it comes to someone having a pattern of launching into full-blown RAGE episodes, even that person will have to acknowledge that that clearly reflects a major problem they have controlling their anger!

Psychological Factors Surrounding An Anger Management Problem

People with an anger management problem are likely to have that problem for a variety of possible psychological reasons. Let me break these reasons down into 4 main categories: 1) feelings of betrayal, injustice, and entitlement; 2) parental role-modeling; 3) “masking” of vulnerability; and 4) feeling empowered.

1) Feelings of betrayal, injustice, and entitlement–The definition of betrayal that I use in my work (as well as in my personal life) is: any significant feeling of letdown, by someone important to you, based on what you believed you had the right to believe they would never do to you. Connecting this to problems with getting a handle on anger, it’s safe to say that the more someone feels either one huge betrayal or a series of betrayals that add up to a huge one, the more that person is likely to develop a storehouse of anger. This especially applies, I will add, to the feeling of betrayal being triggered by severe abuse, severe neglect, or outright abandonment. The sense of injustice that typically accompanies deep feelings of betrayal, combined with a strong sense of entitlement that the injustice be undone or eliminated only adds to the size–not to mention persistence – of that storehouse.

2) Parental role-modeling–Simply stated, a person is much more to develop an anger management problem if they had at least one parent who presented with this problem themselves.

3) “Masking” of vulnerability–While I see this issue as generally applying to men more than women, there certainly are exceptions on both sides of the gender coin. The basic point here is: suppose someone is having difficulty dealing with strong vulnerable feelings like, e.g., fear or anxiety, guilt, hurt, or sadness. The more that person judges themselves as “weak” for having much less showing these feelings, the more automatically if not reflexively he/she may display strong anger. This display of anger then “masks” those weak–i.e, vulnerable–feelings.

4) Feeling empowered–Many people who have an anger management problem, whether they acknowledge it or not, experience a surge of feeling powerful when they are angry. This surge can behaviorally manifest in what could be seen or felt stereotypically as “macho” behavior or “attack mode.” In contrast, and going back to the “masking” concept, when someone is feeling any of the vulnerable feelings listed above to a strong if not overwhelming degree, accompanying that negative self-judgment of “weakness” can be the opposite of feeling powerful, i.e., feeling powerLESS (consciously or subconsciously).

Brain Physiology And The “Highjacking” Phenomenon

To help you gain a further understanding of why impaired anger management is such a complicated syndrome, we must also look inside the brain. To keep this as understandable as possible, there are two main structures in the brain that have a great deal of bearing on anger management. The first structure is called the AMYGDALA (a-mig-duh-luh). This is the part of our brain that is centrally involved in the universal “fight/flight” response, where “flight” refers to fear or anxiety and “fight” refers to anger and aggression. In brief, when someone is stressed and resultingly develops a good deal of agitation inside, the amygdala actively fires away. If the intensity of the agitation quickly becomes intense, the amygdala can quickly become not just reactive but, more problematically, HYPERreactive. If the stressor triggering hyperactivity in the amygdala is fear-related, the person will likely develop a very high level of fear or anxiety. If on the other hand the trigger is anger-related, then the person is likely to become intensely angry.

The other key structure in the brain involved in anger management is known as the PREFRONTAL CORTEX (PFC). This is the crucial structure in the brain that is the seat of rational and logical thinking, including good decision-making, concentration and attention, and impulse control. Connecting this to anger (as well as fear too), the brain-based physiological general rule of thumb here is: the more the person’s PFC is functioning at a normal–i.e., non-stressed/agitated–level, the more controlled and better managed will that person’s anger be in general.

Now let’s tie these two structures of the brain together as it relates to anger management problems. In a nutshell, when some stressful/agitating situation triggers significant hyperactivity in the amygdala, the process known as “high-jacking” occurs. Specifically, the amygdala essentially overtakes–i.e., high-jacks–the PFC, resulting in significant impairment in the person’s ability to think clearly, concentrate adequately, and control their self-defeating impulses. In anger management terms, this means that when the amygdala is triggered to become very hyperactive, and the PFC’s functioning is therefore limited, anger takes control of the person. Which in the extreme–such as in a state of pure rage–creates the proverbial “zero to 60” effect. The overall moral of the story here being: this high-jacking process in the brain does not excuse a person with an anger management problem, but it most certainly helps EXPLAIN the problem.

Strategies For Anger Management

Given all that’s spelled out above on the psychology and brain-based physiology of anger management, I hope you are clear–maybe clearer than you’ve ever been–just how much easier said than done it is to achieve. And yet: whether you’ve ever really looked at it this way or not, in the end there are two extremely important reasons to work on anger management. The first reason is an individual one: self-respect. Simply stated–and feelings of empowerment and masked vulnerability notwithstanding– if you let intense anger take control of you, you cannot possibly respect yourself for your pattern of “flipping out” and “flying off the handle.” But just like with addiction, and to put it bluntly, who the heck ever thinks about self-respect when you’re in the middle of being very angry or indulging in an addictive substance! Yet the psychological fact of life is: a pattern of a significant loss of self-control guarantees an accompanying loss of self-respect. And that’s, let me reiterate, whether you ever consciously think about that or not.

The second reason to work on anger management has to do with being challenged or confronted by significant others about their feeling that your problem controlling anger is in there eyes sabotaging your relationship with them. If that is their experience and perception, and your relationship with them truly matters to you, then I’d say it’s advisable you get to work on your problem for this reason too!

On that note, presented below is a “menu” of strategies I recommend for working on anger management. Like a real menu, you can choose the same item each time, or change around if you feel trying a different item would be better for you. Let me preface this menu though by saying that no matter which items on the menu you choose to try to help yourself manage your anger better, it is absolutely essential that you practice them as often as possible. Otherwise, you must face the music as they say: if you don’t practice them, there is virtually no chance that you will make any progress on this troubling–and trouble-MAKING–front.

The menu I recommend for anger management includes the following:

–mindful meditation (especially focusing on breathing, tension in the body, and visual imagery; more spiritual pursuit of some type can also be a meditative option )

–“get physical” (e.g., walking or more strenuous exercise, gardening, or something cathartic like pillow-pounding)

–“get vocal” (e.g., call a friend, or: go in the car, don’t drive anywhere, and yell your heart out)

–“get your journal” (emotional venting in written form)

–“get musical” (listen to whatever type of music you believe can help you reduce your agitation)

–“get perspective” (basically, force yourself to remember that you are allowing your anger to control you in a way that can be sabotaging to your self-respect and also potentially to the relationship with someone important to you; that perspective can leave you still feeling angry yes, but able to express it in a more reasonable and controlled manner)

–“get de-stressed” (do the best you can to cut down on the overall stress in your life)

Last but not least, given the complexity of the problem of agitation management and the big challenge it therefore presents, I highly encourage you to give yourself a big pat on the back each and every time you do something to keep your anger to a manageable and controlled level!

On Psychology & Spirituality

Personal Definition of Spirituality

The practice of some form of spirituality is for many people an important part of their daily lives. Yet the term “spirituality” itself can mean different things to different people. As you may recognize, for some people, spiritual practice automatically connotes having a theistic set of beliefs, in which the central focus surrounds a belief in God. Yet under the heading of the term theistic spiritual practice can be two sub-categories: a belief in God through involvement in a chosen religion vs. on one’s own, without any religious involvement.

But now let’s look at people who identify themselves as atheists, who of course disavow a belief in God or a God-like figure. “If you so choose, please feel free to replace the word God with words you may prefer, like Higher Power or Spirit. Just for consistency, I will stick with using God.” From the standpoint of a theistic bent regarding spiritual practice, it can almost be concluded that atheists do not do any type of spiritual practice. In order to dismiss this conclusion entirely, one can choose to define one form of spiritual practice in “earthly”–i.e., non-theistic–terms. Allow to me propose a definition of spiritual practice that cuts across theistic and atheistic belief systems. At risk of sounding glib or oversimplifying the matter, that definition is: anything you do that LIFTS YOUR SPIRITS. With the understanding that there is a range of how much lifting of your spirits a particular spiritual practice can provide you. So therefore, one type of spiritual practice you do may lift your spirits a small amount, another one a bigger amount, and a third one a very significant amount.

Taking this notion one more step, you can end up with two categories fitting this definition of spiritual practice. The two categories can be called theistic practice vs. in this case “personal/situational” practice. If you are a theist, your spirits can soar to varying degrees through some type of connecting to God, be it in a house of worship, or for that matter anywhere else you feel that connection to God, as for example looking out at the ocean, or walking in the woods. Yet truth be told there are non-theistic ways to make your spirits soar too– sometimes every bit as much as involving a theistic spiritual practice. Take the same two situational examples I just listed: staring out at the ocean and walking in the woods. Simply stated, many people can experience an uplifting in their spirits by doing either of these two things, without feeling any connection whatsoever to God. Spiritual uplifting can also occur from doing anything like, e.g., listening to or playing your favorite music, doing yoga, eating a wonderful meal, attending an event you find highly entertaining, reading an absorbing book, doing rewarding volunteer work, attending an inspiring class or workshop, watching a child play and laugh, or making love. And certainly these examples do not exhaust the the list of what any of us can find to be a spiritual practice to lift up our spirits–none of which requiring any belief in or feeling any connection to God!

Spiritual Practice Applied to Psychological Distress

People who seek professional help for psychological problems such as anxiety and depression may or may not view spiritual practices as a beneficial tool in their efforts to manage these conditions. In my experience, most psychotherapy techniques are not primarily spiritually-oriented. Instead, they are geared mainly towards efforts to, e.g., create more positive cognitions, manage stress and fear better, build up self-worth, and improve the quality of relationships. Mainly through talking things out with the therapist and then doing occasional “homeworks” to apply what is discussed in session is how these techniques are seen as hopefully helping people reduce their clinical symptoms.

I would like to propose here that there is room to bring spirituality into psychotherapeutic treatment. In this context of spirituality though, I am going to focus mainly on theistic spiritual practices. My main point is to very much encourage anyone who has a strong religious or personal belief in God to utilize this belief in a manner that maximizes its potential therapeutic benefit. More specifically, let’s suppose you are mired in the throes of episodes of depression or anxiety. As an alternative to attempting only to e.g., utilize more positive cognitions, practice specific symptom-management techniques, or do non-theistic mindfulness meditating–as many therapy approaches are geared towards–you might start utilizing some type of THEISTIC spiritual practice to better manage and control your clinical symptoms. Thus for example, when you are conscious of feeling overtaken by a bout of depression or episode of anxiety, as a spiritual practice try in your own way turning right to GOD, such as through some type of preferred prayer, or simply talking to God in a manner that makes you feel like you are turning to Him for, e.g., comfort, courage, inner emotional strength, and determination. All of which can, if your faith in God is solid, provide you with at minimum needed situational relief from your clinical symptoms, and at maximum more confidence that you can control these symptoms from taking control of you.

Yes, you can also psychologically benefit from non-theistic spiritual practices (or for that matter, prescribed medication for more intense symptoms). But if you can embrace theistic spiritual practice–without the necessity to have to practice it through involvement in organized religion–then my own personal/theistic belief is that God is always there inside you, anytime and anyplace you need to turn to Him. So you can if you choose turn to Him especially for help in dealing with your depression or anxiety–or for that matter any other stressful psychological challenges you are faced with. I therefore encourage you to give yourself the option of a spiritual practice involving going right to God as quickly and regularly as you can. By doing so, hopefully you can come to feel you have a strong and trusted ally inside you, to help you cope with your psychologically challenging problems.