Author: thecopingblog

[NOTE: The descriptions that follow are for dysfunctional extremes. Most people would show milder patterns and cope moderately well.] Relationship issues? Maybe one of the following patterns is the problem. Are you a dysfunctional giver, someone who avoids new challenges and subjugates their wants and needs in relationships, leading to interpersonal conflict? Whether excessively dependent, enabling, passive or cooperative, dysfunctional givers are not really giving. They shrink from responsibilities and run from insecurities, fears, and identity development; they also often inappropriately blame the taker. It is easy to understand why takers are attracted givers. Why, however, would a giver be attracted to a taker? The fact is, dysfunctional givers have a variety of self-interest motives that are served when interacting with takers: Givers have powerful dependency needs because of basic insecurities and related fears, and takers serve these dependency needs; givers become accustomed to having family members sacrifice for them; givers believe their actions are a way to secure and strengthen their relationships; givers have weak self-identity because they have not developed autonomy, individuality, and independence, which allows them to avoid the pain of facing their shortcomings; givers can avoid true intimacy and vulnerability in relationships, factors that can cause stress and anxiety. Givers often play the childlike, helpless role, or act like they are the victim: “You want me to pick you up when it’s sleeting outside? I can’t drive in those conditions. You know how nervous I get if I have to drive in bad weather. Do you want me to get killed? Thanks for caring so much!”

Maybe you’re more of a dysfunctional taker, someone who displays a limited capacity to understand, empathize, and meet their partner’s reasonable wants and needs. This limitation leads them to excessive manipulation, control, neglect, and abuse of others. Essentially, takers consume as much as possible from others without regard for their welfare. They do not consistently reciprocate in relationships, and tend to make others victims of a double standard, treating them in ways they themselves would not tolerate. Takers are psychological vampires. They draw as much “blood” as they can from their partners, friends, or family members, and then they either ignore or toss them aside. Paradoxically, takers become very frustrated and outraged when others are not there to meet their wants and needs. 

Typical actions and emotions that takers show are: displacing aggression on others close to them; fear of being vulnerable and getting hurt; excessive need for control; enhancing personal self-esteem at the expense of others; avoidance of responsibilities; low frustration tolerance; extreme feelings of entitlement. Takers tend to come across to others as very secure and high in self-esteem. However, they are neither. Takers desperately need to be the “top dog,” and seek relationships that allow them to satisfy their deep insecurities.Takers tend to test others early in a relationship in order to discover what they may be able to get away with down the road. For example, to avoid paying for dinner or some other activity, they “forget” their credit card or claim they will not get paid until next week. They may arrive forty-five minutes late for a date without a plausible explanation, and try to excuse their behavior by commenting on some recent stress, problem, lack of sleep, or a similar excuse. These actions are a way of gauging how the other person will respond. A passive or deferential type of response gives a taker a sign that this is the type of person they are likely to be able to manipulate.

Both these patterns are childlike, which prevents both givers and takers from becoming mature, constructive partners. They lose out on a great deal of satisfaction in their marriages, parent-child relations, and friendships.

Throughout this blog, we emphasize psychological principles for coping with stress:

There are only two things you can directly control: yourthoughts and youractions.

You must accept and face your emotions for what they are— – a part of you.

Inappropriate actions, not your emotions, are your coping challenge.

Optimistic, realistic actions are more important than thinking positive thoughts.

Personal happiness emerges from satisfying actions.

Personal pity parties are avoidance actions that disrupt effective coping.

You have no right to have the corners of your world padded for you.

You are not here to live up to others’ expectations.

Your actions must be guided by a social conscience, values, and ethical standards.

Successful coping with stress involves four steps:

Acceptance: You must resist the temptation to engage in denial about situations that bring you uncomfortable emotions. You must accept reality and your emotional reactions to it.

Accountability: Sometimes your actions have a positiveeffect on others, sometimes a negative effect, and sometimes no effect. You are responsible for realistically determining the impact of your actions.

Humility: Self-preoccupation is a barrier to effective coping. You are not the primary ingredient in the recipe.

Empathy: You must listen to and learn from others. You can resolve conflicts better, and feel more independent and empowered, when you act with the needs of others in mind.

Acceptance and Accountability provide you with a solid coping base, and allow you to enter the Humility Circle. Imagine five actions placed around a circle. At the top, the first position, “Humility,” encourages you to admit that you are not the primary ingredient in your life recipe. Moving around the circle, the second position is “Freedom.” Humility releases you from self-preoccupation and gives you a sense of freedom—an optimistic spirit—that is uplifting. Continuing around the circle, the third position is “Sharing.” Strengthened with your new-found positivity, you can now share yourself with others who are also fighting stress in their lives. You move to the fourth position, “Communication.” Sharing your struggles with others not only requires you to talk to them, but also to listen to and learn from them. That brings you to the fifth and final position, “Empathy.” The circle is now complete. You begin with reducing a focus on yourself as the center of it all, and end with an empathetic understanding of others who are wrestling with life challenges just as you are. Released from the prison of self-absorbed ego, you are able reach out to help others because you understand their plight. Purged of considering yourself special and deserving of pity, you cope with your stressors by helping others with their difficulties. Empathy is the gold standard of coping. There is no more effective therapy than empathetic service to others. The absence of empathy is denial; its presence generates acceptance of what is going on, accountability of what you can do about it, and humility in the presence of others’ suffering.

Zach’s father abandoned the family when Zach was just a child, and he grew up with an alcoholic mother who had a gambling problem. These experiences planted the seeds of insecurity and abandonment anxiety in Zach’s mind, but throughout childhood and into his teen years and young adulthood, Zach compensated by being outgoing and socially active. In college he developed a close friendship with a classmate, Kyle, and was pretty much “adopted” by Kyle’s family. He spent a lot of time with them and Kyle’s dad became a surrogate dad to Zach.

            After graduating from college, Zach and Kyle worked at Kyle’s family business. Zach married and they began a family. Zach, however, was chronically plagued by unresolved issues from his childhood and adolescence; he fought fears of being abandoned and alone, clearly the result of his father leaving, and the lack of warmth and nurturance from his mother. Zach spent most of his adulthood avoiding facing these issues and the insecurities they caused him. He neither appreciated nor understood how powerful and stressful these conflicts were; nor was he able to face the reality that they prevented him from ever truly trusting and sharing himself fully with anyone. Psychologically, he was chronically adrift and lonely. 

            Zach’s denial and avoidance of facing his core conflicts became manifest in fanciful “get rich quick schemes,” and he developed a serious gambling problem. He confided to Kyle, “No amount of money will ever be enough for me.” His risky schemes and gambling worsened, and he had to borrow large sums of money, most of which he never paid back. Problems and pressures grew. On more than one occasion Zach quit his job, only to return days later asking to be reinstated. The time came, however, when Kyle’s father said, “No.” Soon, Zach faced bankruptcy, loss of his home, public shame, and embarrassment. During this time, he consulted a priest and psychologist, but he never fully revealed to either the real nature of his psychological problems. He was never sufficiently motivated to confront his fears. Feeling alone and unwanted, he was hell bent on self-destruction, a perfect example of how unchecked self-sabotage actions lead to inescapable blind alleys.

            One day Zach’s wife came home and found him dead by his own hand. There was no note; there were no good-byes. From Zach’s perspective, there was no more pain for him. He no longer needed to avoid unpleasant thoughts and feelings. Memories of his father’s abandonment, and painful comparisons of his life versus Kyle’s did not have to be endured any longer. Zach quit on his wife and kids the way his dad quit on him. Ultimately, he became caught in a vicious cycle of self-destruction that led to his death. He was filled with too much anxiety, depression, guilt, anger, shame, low self-esteem, hopelessness, narcissism, and self-defeating actions to overcome the conflicts and fears that had begun decades earlier.

            [NOTE: We learned the details of Zach’s life from his wife, who came to counseling to deal with his suicide.]

Justin is a first-year college student finding himself confronted with information—mostly out of class—that contradicts some of the “facts” he was raised to accept: Black people are intellectually inferior to Whites, lazy, and lacking in ambition; gays are indecent degenerates, morally corrupt sinners who seek to undermine America’s virtue; women are a threat to men in the workplace, and need to be kept out of positions of authority. As the semester progressed, Justin’s social circle expanded, and he was stressed to discover that many of his beliefs just did not stand up to the reality of his experiences. At first, he discounted his college experiences as exceptions to the real world; his thinking involved denial, selective perception, and distorting the reality around him. But slowly, he began to consider another alternative: “Maybe my beliefs about these groups are wrong.”

It’s interesting to note that when confronted with troublesome contradictions like Justin experienced, the last thing most people do to resolve their mental anguish is to change their beliefs. When you think about it, that makes some sense. When coping requires you to change your beliefs, the first step in the process is looking squarely at those beliefs and asking yourself, “Do I have poor judgment? Am I avoiding something? Am I afraid of something that makes me hold onto these beliefs?” Tackling such questions can be tough.

Rodney was an 18-year-old who believed that all Mormon men had multiple wives, only one of whom they made public. The rest were hidden away. Rodney’s father taught him this “fact,” and Rodney’s self-esteem was based on praise and acceptance from his father. He had a mostly unconscious fear of offending his father and suffering rejection, which would plunge him into anxiety about being abandoned. Psychologically, therefore, he could not reject his father’s beliefs and, to our knowledge, he never did. Allegiance to his father kept him in psychological balance. When anyone challenged Rodney’s belief about Mormons—even a practicing member of the Mormon church—he told them they were wrong. He was not interested in rejecting his father’s beliefs.

Sometimes, however, people do change their beliefs. Rachel, a 35-year-old single woman, avoided romantic commitment. At a deep mental level, Rachel feared she would be sexually promiscuous like her mother, who was a prostitute throughout Rachel’s childhood. Rachel believed and feared that romantic involvement would lead her to promiscuity, and expose to herself and others that she had no moral values. Only complete avoidance of emotional commitment could keep her fears hidden. Rachel required long-term professional counseling to be able to accept the reality of her core fears. Over time she was able to consider alternative beliefs and actions that enabled her to cope with her anxiety in more realistic fashion.

Carol, a 19-year-old college student suffered intense test anxiety. Rather than face this truth realistically, she was able to convince her school’s Learning Skills Center that she needed special arrangements in her courses for taking tests. She was a solid B student, but she was tormented with the belief that she was a “dumb, incompetent, loser” who couldn’t face a challenge without special help. Carol was aware of her core fear, and she was able to work with a college counselor for alternative ways—notably better study practices—to confront the anxiety.

When it comes to dealing with stress, no matter what beliefs we’re talking about, when they are unrealistic, illogical, inconsistent, and contradictory—and your actions perpetuate those beliefs—you should attack those beliefs critically and work at discarding them in favor of alternatives. Discuss your choices with a trusted friend, advisor, or professional counselor. Finally, when you choose new actions consistent with more realistic beliefs, make sure you have a reliable social support network. Coping with stress by changing your beliefs is seldom accomplished alone.

Are you regularly self-critical, always casting yourself as the enemy? It’s tough to cope effectively if you are your own enemy. Sure, you have negative thoughts and feelings, but it helps to remember that they are a natural part of life, and having them does not make you weird or abnormal. If someone criticizes you, well, that’s their problem, not yours; you’re not here to live up to others’ expectations. You must also remember your values. Do you give in to self-destructive behavior—drug/alcohol abuse, social withdrawal, gambling, eating disorders, jeopardizing your family’s welfare—at the expense of your values? If you value your roles as parent, spouse, employee, or friend, but, at the same time, let yourself become less effective in these roles, how can you expect to feel good about yourself?  If you value work, family, and friends, you must act accordingly, and with a sincere commitment and dedication. Coordinate your actions with your values.

            Do you regularly ask yourself, “How am I doing?” or, “Am I happy enough?” If you overdo this self-focus you can lose your ability to feel satisfied in the present. For example, chronically depressed and anxious people are likely to focus on whether they are feeling better. They search for answers in social situations to see how they are doing: “Does Joe see I’m here?” “Do I look foolish to Sally?” They also monitor their own actions: “Is my heart racing?” “Am I sweating?” “Am I just pretending?” “How well am I relating?” They try to feel “right,” which makes it impossible to be themselves and have a good time. Coping well with stress does not mean you should constantly check on your actions and worry about what others are thinking. It’s the same with trying to maintain complete control over what’s going on around you. Such efforts are not coping solutions, but only present you with coping problems. In the final analysis, actions based on fear and anxiety are the basis for the issues most people face; fear and anxiety are the motivators for the conflicts that produce most psychological problems and encourage inappropriate actions. Can you see that your emotions are not the problem, but inappropriate actions servicing the emotions are?

            Stop treating your emotions as if they are alien invaders. They are you! We all have them and they are a natural part of living. You are not weird. Accept your emotions but do not be governed or dominated by them. Acceptance of their presence and focusing on your behavior are the keys to effective coping.

Biological Evolution. Darwin says organisms evolve through natural selection, which occurs because those individuals with a wider variety of traits are more likely to survive and produce more offspring. In other words, diversity of traits is essential for survival.

Psychological Evolution. In 1974, psychologist Sandra Bem published the Bem Sex-Role Inventory. The test measured where one’s sex-role traits fall on a scale ranging from “Traditional Male” to “Traditional Female,” with “Psychological Androgyny” falling in the middle of the scale. Traditional Male sex-roles are characteristics like competitiveness, aggressiveness, assertiveness, and domineering. Traditional Female sex-roles include traits like sensitivity, emotional, caring, and passive. The post-WWII childrearing culture of the US identified good parenting as teaching boys traditional male sex-roles (“You need to be tough, kid!), and teaching girls traditional female sex-roles (“Remember, honey, you must always nurture your children and support your husband, and make sure your household is well-run.”)

            Bem’s message was that forcing children into rigid sex-roles limited their diversity and their ability to cope well with everyday life. For instance, what if a situation requires caring, sympathy, and displays of emotion? Well, the traditional male is lost; he doesn’t know how to behave without sacrificing his masculinity-dependent self-esteem. Similarly, what if a situation requires assertiveness and an aggressively competitive spirit? In this case, the traditional female is lost because to act in those ways would be a threat to her femininity. Thus, Bem says, teaching children to display traditional sex-roles severely limits their ability to adapt and cope—evolve—with a variety of situations. This dilemma is where psychological androgyny comes in. The androgynous woman is caring and sensitive, but if the situation demands it, she can also be aggressive and competitive. By the same token, the androgynous man is dominant, powerful, and tough, but if the situation demands it, he can also be emotional, sympathetic, and soft. Parents should, therefore, encourage androgyny—diversity of traits—in their children in order to foster psychological evolution, and help them be more effective at coping with stress.

            Social Evolution. Evolution is based on the principle of diversity of traits, which increases the odds of survival. We believe this principle applies not only to biological development of a species, but also to the psychological of individuals within a species. How about social structures that individuals form? Does the principle of diversity also apply to those groupings? Could one argue, for instance, that a human society that accepts a wide range of interests, abilities, needs, and backgrounds—compared to a society that encourages homogeneity among its members—is stronger and healthier, and more likely to adapt and successfully meet challenges? Is diversity among members of a society necessary for survival of that society?

Fernandez and Dries note in Best Practices in Supporting Grieving Students, “Many times people think those who experienced a loss have grieved ‘long enough’ (according to their own arbitrary expectations) and therefore should simply move on. As with other mental health conditions, this simply is not true; grief is a process of healing that must run its course. Mourning is the process that transforms acute grief into something manageable. It is the utilization of coping strategies, while remembering the loved person, that can lead the bereaved to healing.”

Grief is one of those emotions that holds the temptation of avoidance and denial in front of us. People often say, “I wish I could avoid the grief I’m feeling. This loss has just been devastating to me and I am having such a hard time keeping the grief from getting to me.” As we often see in these blog posts, avoidance is a major obstacle to coping with life’s challenges. Grief is no different, and when we are confronted with it, we must expend a lot of emotional effort to work through it and not work around it. Fernandez and Dries point out that grief is also often complicated by denial, depression, and guilt: The grief-stricken may not accept the loss as real (e.g., denial); they may be so consumed by their grief that they lose themselves (e.g., depression); they may feel guilty that they caused the loss (e.g., magical thinking); and, they may feel they are disrespecting the other party if they re-engage. Such reactions can exacerbate grief. People generally do not realize that grief from loss is often a sign of the strengths your lost loved one has given you. Thus, grief must not be dreaded, denied, covered up, or avoided; to do so would dishonor the memory of the one now gone. Instead of avoidance, you can direct your grief into the coping skills taught to you by your lost loved one; in this way you deal with your grief by using the strengths the person gave you, and by doing so you honor the person.

How can you best grieve over the loss of a loved one? Accept that grief is a sign of the immense strengths the one you have lost has given you. Your grief means that you have loved. Work through your grief by cherishing the love you experienced with the one you have lost. Grief must not be denied, or avoided; to do so would dishonor the memory of the one now gone. Use mourning to embrace your grief as a tribute to the loved one. Channel your grief into the coping skills taught to you, and thus re-define the grief into effective coping behavior. You will always miss your loved one; but you will also treasure the memories of this person who so effectively taught you to meet the challenges now facing you. Remember that the deeper your grief, the stronger your love for the lost one, and the better you are able to cope. Move forward positively, and work through your grief, not around it by denial or avoidance. Complete the tasks and challenges that face you to honor your lost one.

One of the important components of being able to cope well with stress is empathy, the ability to understand how another person is feeling. The upside of empathy is that it fosters helping others, and that helping often leads to putting your own issues in perspective, and getting a better understand of those issues.

Recently I was talking with an acquaintance who is a strong anti-vaccine guy. Let’s note that one’s position on the value of vaccinations is usually based on doctrines from any of several streams of thought, such as political science, religion, history, and medical ethics, just to name a few. It is also safe to say that most anti-vaxers are comfortable with their opinion and not psychologically troubled, even though their opinion may make them sound like they are not concerned with the welfare of others and have no empathy them. In other words, empathy is not required for one to be psychologically healthy. What we are saying is that if you are troubled and having difficulties coping with the stresses in your life, finding empathy for others at that point can help you.

Let’s consider the case of Franklin Delano Roosevelt (FDR), 32^nd US President. After beginning what looked to be a great political career, FDR was stricken with polio at the age of 39, and was never again able to walk without leg braces and assistance. Just standing, much less taking steps, was an immense undertaking involving considerable pain and effort, and he spent most of his days in a wheelchair. In her book, Leadership in Turbulent Times, historian Doris Kearns Goodwin describes how FDR—long before becoming president—underwent a kind of psychological rebirth at a health spa in Warm Springs, Georgia. He found his way there after hearing reports that the waters of the spa had positive effects on paralyzed victims like himself.

FDR came from the “upper crust” of the American socioeconomic ladder, the elite of society. At Warm Springs, however, he interacted with—and became friends with—people he came to call his “fellow polios.” They were not the elite of society, but victims like him. He discovered that his association with them energized his spirits, and taught him the importance of teamwork, friendship, and a sensitivity to how others felt. He learned how to communicate—both listening and speaking—with his fellows as equals, without elitism, condescension, or superiority. In short, FDR discovered humility and empathy, two qualities we often discuss in this blog as essential to learning how to cope with psychological adversity and become more mentally healthy. If you are troubled and having difficulties coping with the stresses in your life, finding personal humility and empathy for others, and serving them, can help in the recovery journey.

In the immediate aftermath of tragedies like school shootings, we often hear officials say something like, “Classes will resume after a time of remembrance. Counselors will be available for anyone feeling the need for help.” Counselors will be available—and fast (this is called Immediate Crisis Debriefing). After all, psychologists know that letting stress from a traumatic event fester can lead to severe emotional problems down the road. So, we need to nip things in the bud right away. That sounds good, but there is research showing that immediate crisis debriefing can be ineffective and in some cases even makes things worse for victims. How can this be? How can talking with a counselor about your trauma not help you? Let’s consider two possibilities.

            First of all, maybe the debriefing took place too soon. Whenever a traumatic event strikes us, our brain needs time to process the event. Sometimes for days we can be in somewhat of a fog over what happened. At a conscious level we seem to be denying the event when we say, “I don’t want to talk about it.” At a sub-conscious level, however, once the emotional reactions begin to subside, our brain is processing and sorting and attempting to make sense of it all. Talking about it during that period may be ineffective because the cathartic restructuring is premature. The brain is not ready to process the healing.

            A second potential problem with immediate debriefing is that it may give the victim a false sense of security. Thus, several weeks after the event you may say to a friend, “You know, you still seem a little out of sorts about it. Maybe you should see a counselor.” The victim responds, “No problem, I already talked to a counselor. Everything’s cool.” But everything is not cool if the counseling took place before the victim was cognitively prepared to profit from it. In a sense, the counseling never took place. Unfortunately, the victim, feeling reassured from talking with a counselor, has trouble recognizing the coping problem.       

            Given these potential problems, when is the right time to encourage a victim of a traumatic event to receive counseling? One week later? Six weeks? Several months? Unfortunately, there is no absolute answer that would be appropriate in every case. That reality can make it difficult for a friend or relative to know when to reach out to a victim. If the victim is a relative or a close friend, the odds are you will be able to sense that he or she is not progressing well following the event. Just remember, for a few days following the trauma that is to be expected. Once several weeks have gone by, however, and you still sense poor coping, it is probably best to get more forceful in getting the victim out of the denial and avoidance pattern that is still present. Unfortunately, there is no hard and fast rule to follow here.

One of my students told me a story that shows how easy it is to think you have “put a trauma to rest” in your mind. About four weeks after 9/11, this student went home for Fall break. She lived in New Jersey and the World Trade Center had always been plainly visible from her bedroom. That night she crawled into bed and reflexively turned toward her window to say goodnight to the twin towers, her “guardian angels” since she was a child. “My God!” she said to herself, “they’re gone!” She was surprised at how startled she was because she knew they were destroyed in the attack four weeks earlier. “In a sense,” she told me, “I guess I had not really processed the reality directly, and at some level in my mind there was denial that the event occurred. It’s fascinating because I had talked about the event several times with my parents on the phone and I had obviously seen news clips on TV. But there had been no direct contact until that night in my bedroom. In that sense, I had not really directly experienced the reality of the event.”

            My student was not suffering from PTSD, but her story illustrates the dynamics of recovery from trauma. At some level, and at some point in time, the victim must “establish contact” with the reality of the event. How this is done varies from person to person. For some, mentally reliving or rehearsing an event and talking about it is sufficient. Others, however, may require something more tangible. Many Vietnam veterans find remarkably positive effects from visiting “The Wall” in Washington, just as survivors of the Orlando Pulse Club mass shooting find solace when standing next to the Club. WWII veterans have had similar cathartic experiences visiting Pearl Harbor or the beaches of Normandy. The grief-stricken can often cope with a traumatic loss better by visiting the grave of the lost one

            The important point here, however, is that “making contact,” whether mentally or physically present, is most likely to be beneficial when there is a time gap between the event and the safe contact. Time must be allowed for the mind to process the event. This processing delay may look like Denial to an outside observer, but it is helpful before the mind can begin the healing process. If crisis debriefing takes place too soon, that healing might be obstructed.

            So, when you see a friend troubled by an upsetting event (and that can include a romantic breakup), and they don’t want to talk about it right away, give them a break. Grant them some “denial breathing room” for a period of time. That period will probably be longer for serious trauma, such as a rape or near-death experience, compared to milder events, such as a romantic partner announcing, “I hope we can still be friends.” In either case, however, allowing a victim some time to process the event will make your helping actions more effective.

Meredith’s case illustrates how childhood experiences can form the core of psychological dysfunctions and persist well into adulthood—specifically how early chronic avoidance of psychological conflicts can lead to later self-destructive actions. When these actions occur over long periods of time, replacing them with more productive behaviors is extremely difficult for both therapist and client.

Meredith grew up in a secluded, economically- and socially-depressed small town. She was the oldest of five siblings and it was her job to help take care of them because mom worked and dad was chronically ill. Her parents were very domineering, and throughout her teen years they reminded Meredith again and again that she was not living up to their expectations; her early years brought her nothing but constant criticism from her parents. Their frequent scolding and emotional abuse stifled her development of a healthy identity, self-esteem, and self-confidence; she grew into adulthood believing she was incompetent, unworthy, and unable to meet others’ standards.

Meredith graduated from high school and over the next ten years had two failed marriages, both to alcoholics. Predictably, she married men who treated her poorly. Because of her childhood, she expected poor treatment from men and, ironically, this was the type of treatment that made her comfortable. It seems paradoxical—although a dynamic that psychologists see often—that people who have psychologically painful experiences in childhood frequently find themselves as adults attracted to partners who re-create that childhood distress. Why? The conflict and distress are what they are used to dealing with, and that familiarity provides them with a sense of predictability.

In her 30s Meredith found her way into counseling, and began to show some insight into her problems. “Everywhere I go I see couples. It seems that there is no one made for me.” She adds, “Being alone makes me wonder if I think right. Sometimes I pray to die. Since high school the world isn’t what I thought it would be. I’m tired. I’ve worked all of my life and have nothing to show for it.” Her counselor says, “Meredith doesn’t want to kill herself because she believes she will go to hell as a sinner. But, she says there’s no joy in her life, only fear. She admits that people are her downfall.” She doesn’t speak with others unless they speak to her first, and at lunchtime she eats in her car to avoid being around co-workers. These actions keep her feeling lonely and alienated. Her counselor says, “Meredith has no confidence when it comes to interacting with others. The strong negative influence of her troublesome childhood years is very apparent. It’s tough to break down.”

Meredith basically spends her days re-creating her childhood. She believes she can never live up to others’ expectations, and she has put herself between a rock and a hard place. Her withdrawal from life creates a self-fulfilling prophesy because she does not allow herself to have productive social experiences that can re-program her brain. She feels socially inept, and is so afraid of being around others that she is unwilling to learn how to interact with others and just be herself. In typical subtle-suicide, self-sabotaging fashion, she says, “I don’t care if I live or die.” Meredith’s case illustrates several rules of effective coping: First, she allows herself to be dominated by a concern for what others may think of her, something over which she has no control; second, she is unwilling to develop actions in her present that will help her stop living the pity parade of her past; third, she keeps herself as the center of her life; finally, she has not given herself permission to experience life and empathize with others. Although she continues in counseling, her counselor notes, “Her prognosis is not good.”