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Hello, friends! In this Q&A episode, I answer some great listener questions covering topics which include finding the right therapist, anxiety around family gatherings, and coping with grief. Also, find out what this episodes bonus Patreon question is!

I have listened to both of your books on Audible and have been listening to your podcasts for about 2 months now. Your books and podcasts have helped make it easier to process through my depression and anxiety. When I would reach out to read/listen to other resources, I would often get lost in the jargon and give up. Your resources have made it a lot easier to talk about/unpack my depression and anxiety.

I have been using online means of therapy (Better Help, Talkspace) for about 3 months now. While I have found this therapy, along with your resources, to be SUPER helpful, however I have started to realize that I struggle to open up to female therapists and that has led to me to plateau my progress.

On both platforms I’ve tried (Talkspace & Pride Counseling/Better Help) I have requested male therapists and both platforms have responded that they do not have any male therapists licensed in my state (Iowa).

Due to my work schedule and distance (I live in rural Iowa) I am unable to travel to a male therapist in person. I’m curious as to what my options are? I don’t want to give up therapy, having someone to talk to one-on-one has helped so much, but it cases me even more anxiety to continue with female therapists.

Thank you for the compliments on my work and I’m glad to hear that you have been able to find a way to get some help that works with your life. There are so many options out there these days and I’m proud that you’ve been able to use things like Better Help and my own online resources. That’s great.

In terms of having a gender preference for your therapist, I think that is totally valid. Many people have gender preferences, especially if the content they are talking about is related to their experience within their own gender. That’s just one of many different dimensions that you may care about. For instance, my wife really prefers to have a queer therapist to talk to. The fit between you and the therapist matters, as do your expectations for what you might get out of therapy. So I’m glad that you are recognizing where a limitation might be happening. You are not stuck – there is another option here.

Options with online therapy

Online therapy is basically built for people like you, that live in a rural area and have challenging schedules. First thing to note is that online therapy apps are not the only way to get online therapy. In fact, most research support exists for online therapy that is done with a private provider. I think I’ve talked about this topic a few times on the podcast and elsewhere, but it’s important to me so I’m going to cover it again. According to the way psychology licensure works, you can actually work with anyone licensed in your state. So if your local area doesn’t have the type of resources that you need, you could work with someone from a different area of your state and do it over the Internet. A great way to do this is by going on Psychology Today and using their tool. You can sort by male therapists that do online counseling. I picked a random city in Iowa and found a bunch of options.

There are pluses and minuses to doing it this way – one plus is that you can potentially use your insurance just like you were seeing them in person. A minus is that if you can’t use insurance it will cost whatever the therapist’s normal hourly rate is. Online therapy done privately is not cheaper usually then in-person therapy. The platform is also a little different, many private online therapists don’t do texting etc. Rather, it’s just normal sessions done remotely via video conferencing software.

So this would be my best option for you. Find an area of your state that you’d like to search in. Find a provider that does internet sessions. Contact them and let them know the situation. Chances are they’d be happy to work with you.

Don’t let this little hiccup stop you! You got this.

I’m dating a wonderful guy who has a very big family. He is very very close to them, and they’re all really nice. He’s been trying to get me to spend more time with him and his family, but despite the fact they’ve been nothing but good to me I find myself very panicky and nervous around them. I kept trying to understand why I feel this way and noticed that in the past whenever I would visit friends who live with their parents, as a child and as an adult, I would always feel very uncomfortable as well. I have a very bad relationship with my own family (divorce, verbal abuse, and bad family dynamics) and perhaps this is playing a role here. I feel really bad that I keep avoiding my boyfriend’s family events but just the thought of seeing them makes me extremely anxious. Any advice for what I could do?

I think this is a great question and situation where you can definitely make a difference. First question I’d be curious about is whether this is a situation where it’s solely his family that has this effect on your or if it’s generally any group get together circumstance? Either way, I think that your insight about your family’s own patterns is very wise. There are a number of reasons that it could relate to what you’re feeling now. It could simply be a matter of association. You associate the presence of family situations with the negative feelings and experiences that you’ve had. There can also be a bit of an effect where the positive family associations that you see within your partner’s family highlight negative feelings that you have toward your own family. Maybe a close cousin to the feeling of jealousy. Kind of like how seeing happy people can make you feel more bad about yourself when you are depressed. Either way, I think it’s totally understandable that you have had a hard time, which has led to some avoidance of family events.

Communication and gradual exposure are key

Sounds like you’re trying your best, but you have been surprised by how difficult this has been. One thing you may consider to ease the situation and avoid any misunderstanding is to talk with your partner and possibly even his family about it. To let them know that it’s nothing personal, but you are realizing that being around a connected, happy, family is causing you anxiety that has been hard to deal with. When we don’t communicate, the situation is left up to interpretation. I’m not sure if this situation has caused any sort of turmoil or hurt feelings, but I can definitely see a situation where someone like his mother feels like it’s something that she did to offend you, which is obviously not the case. So getting that baseline communication taken care of can help with these sorts of misinterpretations and can also make them more helpful as you approach the situation.

I think a big part of this is going to be taking it one step at a time and exposing yourself gradually to these situations that make you anxious. I won’t dive into exposure concepts completely here since I just covered it in detail on episode 195, but you could certainly work out a little hierarchy for yourself where you start with maybe very small group interactions with family members until you feel comfortable before stepping it up to bigger groups, and finally, larger get-togethers

One way to conceptualize this whole situation is an opportunity to have a corrective emotional experience. As I said before, you have legitimate reasons to be hesitant and your current anxiety makes a degree of sense. But you also have a unique opportunity to work through the issue with a family that appears to be supportive. I call this a corrective emotional experience because it allows you to recognize that there is a different way of being part of a family without the same pain and abuse that you have experienced before. It doesn’t mean that his family is perfect – nobody is. But you get to practice a different way of interacting with family as a means to undo some of that problematic learning from your past.

So give it some time. Try your best to communicate what is going on so that there are no unnecessary hard feelings. Ease into exposing yourself to those situations and allow the comfort to build over time. You don’t have to get it all right at once, but like I said this is a good opportunity.

Last thing I’ll say is that you might consider the context of the time spent with them. Maybe doing things outside of the house vs inside of the house could make a difference. Or having an activity to focus on like going bowling or watching a movie. Whatever the activity, it might help to provide a good focal point and a distraction to prevent you from simply dwelling on the anxiety that you have at every moment.

Hi Duff, I recently lost my mother (58) due to a combination of liver disease and severe pneumonia. She was a longtime drinker and lived life on her own terms, raising myself and my 2 siblings on her own. The past 5 years we were all made aware of her end stage liver disease and she quit drinking immediately. She was taking care of herself, working on getting a transplant, and was the most caring and loving person. I was with her in the hospital the last 3 weeks of her life and was right by her side when she passed. She was my best friend. I am having such a hard time living my life without her comfort. Even through her struggles with alcohol, we were so close. I’m the youngest daughter (31) and the least complicated of my siblings. I feel like I’ve dedicated my life to making her proud and now that she’s no longer here, I feel an overwhelming sense of loneliness. I am married and my husband tries to listen but he himself struggles with chronic pain so I feel like I am burdening him with my troubles. Are there any books or resources you know of that will help me better handle this situation? I’ve spoken with people who have lost a parent before and hearing “it never gets better” or “it gets worse with time” chills me to my core. I’d like to help myself feel better. It’s what my mom would want.

Hi, friend. I’m so sorry to hear this.

One of the things that I want to first highlight about your whole question is that you said you “recently” lost your mother. You also said that she was your best friend. You aren’t supposed to feel good yet. You’re mourning. It feels like absolute shit to lose someone that you love and you are going to have to have some grace with yourself in feeling whatever it is that you feel. It’s normal to be in denial or forget that she’s gone at times. It’s normal to be pissed at the unfair world for taking someone so important to you. It’s normal to feel lost, confused, hazy, and disoriented. It’s normal to feel hopeless and to have a hard time picturing what life could look like without her. You are human and these are all things that you might feel because this person made you and meant the world to you. I want you to feel better than you do now too, but you don’t have to get down on yourself for feeling this way. It’s almost a testament to how much she meant to you. I’m sure you’re not expecting other family members to feel better already, right? I’m sure your mother wouldn’t want you to be so hard on yourself.

Coping with grief

Let’s talk about the support aspect. I am sure that your family including your husband does not feel burdened by your pain and the support you need, but it is true that you may not want to rely on them for all of it, especially if they have their own stuff going on. How about some professional help? Two options that could really help would be individual therapy for you and grief support groups. On the individual therapy side, it would probably just be nice to have someone to unload some of your feelings onto that knows the right way to make you feel heard and supported and that you don’t have to worry about burdening, since it’s literally their job. It also might be a great place to have a sounding board to work out some things that you are still trying to wrap your mind around.

Groups can often be found through local healthcare organizations or by simply google searching grief support groups and your city. When I did this for my city, the top result was a “motherless daughter’s” group. While I understand the fear of people saying that it gets worse over time, etc. That’s not going to be the character of every group, especially if they have a skilled facilitator who can help the group remain focused and productive. It can be so powerful to see the range of reactions and heal together with others who know what you’re going through.

There are a gazillion books on grief as well as other resources such as videos, podcasts, and blog posts. I don’t have a specific recommendation for you, but I think it would be a potentially great idea for you to start taking in some content related to what you’re going through. Sometimes all it takes is hearing something said in the right way that resonates with you to make something click in your mind. There isn’t something that is going to make it not hurt or make you get “over it” – but you can still live a good life in the context of this loss and the harsh sting of the pain won’t be so immediate in every moment. You not only lost your mother, but the life you thought you’d be able to have with her moving forward. You can still create a great life, but it will be different than that mental picture you had. Over time, the voice of hers that echos in your head will become more internalized and you will be able to know that you are making her proud even though she is not with you anymore.

I love loveee your podcast, you’re doing great things! So I’m a 22 year old female, I’m a nurse myself and am currently almost a year out of school working as a practicing nurse! Fun stuff :). However, nursing school was very tough for me, and having had anxiety my whole life, nursing school just ramped it up to new levels. I was always on the go. I was also learning about some pretty scary illnesses and have thought I’ve had so many different diseases which I’ve seen multiple doctors for. Finally overcoming the physical health scares I’ve had, I find that I have a lot of residual cognitive complaints now. I’ve had anxiety my whole life and I’ve never experienced what I do now. I feel like I am constantly in a fog, a general feeling of unsettled, sad, crying randomly sometimes, trouble finding words in a sentence at times, like in a funk, and horrible memory. I am currently on Effexor 37.5mg which was a about a recent switch of like 6 months from Prozac which I was originally on for years. I look at my cognitive symptoms online and see stuff about dementia. I have no familial history of dementia but I am afraid I’m getting it and it’s sucking the joy out of my life. I’m trying to exercise, do self help books, pray, and all that fun stuff. I also recently decided to make an appointment with a psychiatrist so they can evaluate me further. But I can’t help but feel like something is wrong. Knowing how well you know psychology, have you ever heard of anything like this? It’s getting to the point that while I’m working as a nurse I’m making silly mistakes and I’ve been extra cautious lately pre-emptively because I feel so foggy. Is this anything you’ve ever heard of? Even if you don’t answer this on your podcast, I’d love to hear back from you. I know it’s hard to tell over text about everything, this is just a small snippit but I just wanted your thoughts. Thank you for your time!

If you would like to hear my advice on this week’s bonus question, check out my Patreon!

Sponsor:

This episode of Hardcore Self Help is sponsored by Lionrock Recovery.

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Visit lionrockrecovery.com/duff for more information and a free and totally confidential consultation. For The Hardcore Self Help Podcast listeners who enroll in Lionrock’s IOP program, simply mention coupon code “DUFF” and they’ll send you a free Amazon Fire pre-loaded with everything you need to log in and get started. Terms and conditions apply.

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