On my Ask the Marriage Therapist a Question post there were some who complained about their relationships with their therapists, and I was also asked some questions about how to choose a therapist. It has occurred to me that a post on how to choose a therapist would be helpful. Then I quickly realized that if I’m serious about going on a word-count diet and wish to repent of posting 2,000 word posts the way I did in 2010, I need to divide this topic into smaller parts and create a series rather than try to eat that roasted turkey in one meal. Here are some of my ideas about issues to think about when shopping for a therapist, starting with considerations regarding cost. I hope my readers will find this helpful. I’m starting with this topic of because I think cost is the number one or number two reasons why so many who need mental health services don’t seek out the help they need. I see four main options available to consumers:

Self-help

No, I don’t advise that you perform surgery on yourself in front of your bathroom mirror to fix a problematic heart valve, but sometimes we already have what it takes to take charge of our problems and bring peace and control to our lives without having to hire a professional therapist. Alcoholics Anonymous remains one of the best available options for alcohol addiction treatment, even though their groups are led by lay counselors and volunteers whose only formal education came from places like Hard Knocks Community College and Life’s Lessons University. There are countless support groups for all kinds of life problems, from “love addiction” to grief and everything in-between. And there are also many self-help books that people with relatively mild problems can find very helpful. When my wife and I lost a child (Grace was stillborn just 8 days before her due date), my wife got involved in an on-line community for parents of stillborn children that she found to be very helpful. However, for people with severe problems or those who are a danger to themselves or to others, self-help isn’t the way to go. I’ve had couples come to see me after spending lots of money on books that never really helped them improve their marriages. Self-help is good to try, but you need to know when it’s time to punt and get some professional help. Self-help is usually relatively quite inexpensive in comparison to other options.

Free or low-cost options

If you ask around you will discover treatment options in places such as Heartland Community Medical Clinic or at local universities that have student-staffed therapy centers that offer cheap or free counseling. Sometimes these low-cost providers are employing therapists-in-training who practice under the supervision of clinical supervisors. In other settings, the practitioner may be a pastoral counselor with training from a seminary or a certified life coach. Please understand that while many of those who provide pastoral counseling or coaching are very talented (there are some pastors that I would trust with a client more than I trust some licensed therapists), they are not licensed to diagnose and treat mental illness in Kansas. Before considering a low-cost option, you need to have an idea of the depth of your needs. If you have a severe condition (hearing voices, debilitating phobias, so depressed you can’t get out of bed, etc.), you need a licensed mental health professional, not a lay counselor, pastoral counselor or coach. Pastoral counselors or support groups sometime simply ask the “client” to consider making a contribution to the church or non-profit that supports them. Those “contributions” are likely tax-deductible. Life coaches can charge for services because what they do is considered “education” rather than “treatment”.

Insurance

“Well, Paul, if I have insurance coverage, then why would I consider any other option? This is the reason why people get insurance in the first place, right?” It may seem that simple: I have Blue Cross/Blue Shield and pay for it every month, so why would I not use it? Prepare yourself, reader, for this where Paul gets on his soap box and becomes [even more] preachier than usual… if "preachier" is even a word. As consumers, you need to be aware of the benefits and the consequences of using insurance when you see a mental health professional. All your medical records are considered private and confidential. Or, to be more specific, your records are kept under wraps on a “need to know, right to know” sort of basis, per HIPAA. So, when you use your insurance coverage to pay for services, the information given to your doctor (symptoms, diagnosis, etc.) are then accessed by the insurance company. They become a permanent part of your medical history and become included in a “clearing house” of medical records. Your medical records exist for the purpose of aiding healers in providing you with appropriate services, however, some of the entities accessing your medical records will use those records like a credit report; as a way to assess business risk. Your medical records are a permanent record of your treatment for physical and mental illnesses, and historical items on those records never age off or go away. Sometimes that information is considered derogatory by medical insurance companies, life insurance companies and even potential employers. A single notation indicating treatment for a mental condition can cost you insurance coverage or even a job opportunity. A former client of mine was denied insurance coverage because of his health records. His “sin”? A month after his son died in a motorcycle accident he sought out a counselor to help him cope with his grief. He went to a counselor two times over a matter that any one of us would consider “reasonable”, but got red-flagged over those two sessions and was denied a health insurance policy a few months later. Would you like a job with the Federal government, a job that is funded by Federal funds, or maybe a job with a government contractor? Depending on the circumstances, the Office of Personnel Management (OPM) will likely perform a very thorough check on you as part of your application process, one that will include your mental health history. I remember talking to an OPM agent about welder applying for a job at a shipyard who was denied a very lucrative position on a nuclear submarine project because of a failed background check. No, he wasn’t a criminal, a terrorist or a red commie, he was just a guy with a small “ding” on his record. There are countless ways that a mental health “ding” on your record can cost you many opportunities in life, and those records do not go away. It’s quite common for military officers to seek out privately practicing therapist who are “off post” to protect a much-needed security clearance.

Using insurance for marriage therapy? The vast majority of insurance companies will not pay for “relationship” therapy because a problematic marriage is not a mental disorder. So, if a therapist is charging an insurance company for marital therapy, chances are very good that the insurance company is being told by the therapist that one or both of the clients has a mental disorder. It’s an ethical and legal quagmire to “slap a diagnosis” on a client for the sake of obtaining compensation from an insurance company; but it’s a common practice and a potential “ding” on the couple’s mental health history. Are you okay with being labeled “mentally ill” for the sake of not paying out of pocket for marital therapy? Before you let a therapist bill your insurance company for marriage counseling, contact your insurance company and ask if they reimburse for “partner relational problems”.

That being said [Paul comes down off his soap box], a year of weekly sessions with a therapist can cost you thousands, so you make the call: Do I lose my money or do I risk my reputation? Unfortunately, you may have to choose between money and reputation in order to get the services you desire.

Out of pocket

Out of pocket payment is referred to as “private pay” and simply means that you pay for your services out of pocket at time of service. Some people will bite this bullet in an effort to avoid the “dings” I complained about above. But be warned: that doesn’t always work. I knew of a nurse who didn’t want anyone at work knowing about her issues, so she went to a therapist who practiced in another town and paid out of pocket. She then sought a prescription she needed from another out-of-town doctor and filled the prescription at a pharmacy in that town. But something happened in “the system” when the prescription was filled and the information about her mental health diagnosis and treatment still ended up on her permanent record. If your goal is to keep your personal business out of the hands of Big Brother, then you may be better served to find a therapist who only takes private payment. A therapist who isn’t on any insurance panels is completely unplugged from any and all of the various databases and systems. They are a dying breed, but some therapists still maintain their records entirely on legal pads that are locked in filing cabinets. If you are able to get the services you need from a private-pay therapist practicing nothing more than “talk therapy”, you’ll probably be successful in keeping your treatment history with them completely private. If you add the services of a doctor or a nurse practitioner to the treatment process, you decrease your opportunity for full privacy. Add a prescription at a national chain pharmacy, and your chances of maintaining your privacy are near zero. If you have a need for medications as part of your treatment protocol and you have access to insurance, you’re probably better off using your insurance and risking the potential consequences so you can get the treatment you need. If talk therapy alone meets your therapeutic needs and you have the ability to pay out of pocket, I encourage you to consider private pay as a payment option.

Next Week: Tips For Choosing a Therapist: The Various Domains of Mental Health

The headline on December 22nd was all-too-familiar in its wording: “Lawrence man sentenced to 49 years for raping girl”. The story tells us that it started when she was only 11 years old. As readers, we reacted to the offense. We were angered by the crime. We were sad for the victim. We were confused about why this happens. We were beside ourselves that these things happen to anyone, and even more upset that it happened to a child. Our angry, sad confusion spilled out onto the on-line message board. Some on the message board called for the death penalty, while others suggested solutions far more barbaric while still others expressed hope for the victim.

Then an anonymous user, “none2”, simply posted “I’ll never understand why a grownup wants to mess with a child”. Indeed… those of us who have never sinned in this way just don’t “get it”. Sex with a child makes as much sense to us as eating a meal of gravel or swimming in a sewer. How can anyone “like” kids in a sexual way?

We are baffled by these crimes because pedophilia is a condition ordinary people just don’t understand. Because most of us don’t understand what motivates a pedophile, the sexual perpetration of a child progresses with a degree of stealth. If only we could see the problem with greater clarity we might be able to do more to prevent sex crimes against children and keep it out of our homes, our churches and our communities. But even with a sex offender registry, ankle monitors and harsh prison sentences, we continue to have men (and the occasional woman) who pursue and sexually perpetrate children in our communities. We can’t control it. We can’t stop it. We can’t even predict it.

“We” cannot predict it, otherwise “we” would put an end to it; but there are others who might be able predict it. The men who commit these crimes, those who “like” children, they know that they have this problem. Before Raymond Stockton began to be physically inappropriate with an 11-year-old girl, he had fantasies about doing inappropriate things with children. They who are on the verge of becoming first-time perpetrators are the ones with the most power to prevent these sorts of crimes. A man with such urges cannot wait until he gives in to his urges for first time, and then try to turn back and live as if it never happened. Once he’s crossed that line he’s extremely likely to repeat (and to likely to increase) his offenses. Only those who are aware that they have a sexual attraction toward children – but who haven’t yet acted upon those fantasies – can prevent the victimization of a child.

We need to make it easier for men who are sexually attracted toward children to come out of their closet of pedophilic tendencies and seek help. In my professional practice I’ve worked with many men who have had sexual addictions and have come forward and sought help for their perfectly legal compulsive sexual behaviors, but they rarely seek help right away because of fear. They usually live in some denial about their problem for some time, often until they are caught by their wife or their employer. But even though I’ve treated many men who were already on the sex offender registry, I’ve never treated a man for pedophilia who first sat down and talked frankly with me about his problem before being found out (arrested). I’ve had men confess half-truths to me about sexual issues regarding minors, but never the whole truth about their on-going temptations; not until I read about their arrest in the paper or saw their faces on the nightly news. It is always after the fact, always after the crime, before they seek help and come 100% clean about their problem. This is what must change if our children are going to be safer from these crimes. The answer lies with the pedophiles.

It is fear that keeps pedophiles from seeking help before becoming actual perpetrators. If a man can be utterly petrified of others discovering his perfectly legal 10-hour-a-week straight sex, heterosexual pornography habit, imagine how difficult, how absolutely terrifying, it would be for a man to admit to another person that he desires to be sexual with children. It is the most taboo of all taboos. It is monstrous to consider; something un-confessable and highly illegal.

Another significant set of problems is that pedophiles lack self-awareness and they lack self-control. They are so ashamed of their urges that they live in denial of how serious the problem is. So they convince themselves that they can stop anytime they want to… but that right now, they just don’t want to. “Someday I’ll stop, but not today.” They think they can use children as eye candy without being completely overtaken by their desire to begin accessing child porn or overtaken by the urge to touch children inappropriately. They think they are “only window shopping” and that they can window shop without ever making a purchase; and that is what gets them in trouble. They don’t realize that their pedophilic fantasies are an inevitable path toward criminal activity. They don’t realize that the excitement that is building inside will someday demand an outlet. They delude themselves into believing that they have full mastery over their urges and refuse to admit that they are trying to hold back a Hoover Dam of temptation.

What to do? Here’s what I have to offer:

• If you are excited by children and in a way that you wouldn’t want others to know about, you are likely a pedophile. Even if you don’t have explicitly sexual thoughts about kids, you can still be a pedophile. A man who really likes to have children sit on his lap, or who really likes spending time appreciating the “form” of a child’s body is likely a pedophile. If this is you, then now is the time to break your denial.
• If the description above seems to apply to you, then you must tell someone. Right now. Not tomorrow. Right [expletive] now! Don’t take time to pray about it or think about it. Conviction not acted upon fades quickly, so tell someone. Who do you tell? That’s not an easy thing to decide. Consider starting with your family physician. They may not be qualified to treat you, but they are likely to have mental health resources they can refer you to. If you haven’t yet committed a crime and you are not an imminent threat to another person, then they are also bound by their code of professional ethics to maintain confidentiality (no one will know what you told your doctor, as long as you haven't committed a crime). A male therapist is another choice, and easier to get in to see on short notice (in this economy).
• Make treatment a priority in your life. Sit down and write out all the potential consequences of becoming a perpetrator of children: Consequences for the victims, consequences for yourself, consequences for your family, etc. What would the legal implications be? What would it be like to be a registered sex offender? Because of these fears you have learned to hide and deny your problem. The time to find the motivation to get better is NOW so you can maintain your freedom and protect your would-be victims. Instead of being afraid to admit your problem, be afraid to hide it.

If this is your problem then you need to experience the oxymoron of fear-fueled courage. Courageously pursue a healthier path for yourself while also maintaining a healthy fear of what may happen if you don’t.

(NOTICE: Paul Hahn is a therapist licensed with the State of Kansas and is therefore a mandated reporter by State law. If you send information or confessions to Mr. Hahn in the form of e-mails, phone calls, or message board posts about sex crimes against children, the disabled or the elderly, that information will be turned over to law enforcement officials.)

Frank Costanza: "Many Christmases ago, I went to buy a doll for my son. I reached for the last one they had, but so did another man. As I rained blows upon him, I realized there had to be another way."

Cosmo Kramer: "What happened to the doll?"

Frank Costanza: "It was destroyed. But out of that a new holiday was born: a Festivus for the rest of us!"

Kramer: "That must have been some kind of doll."

Frank Costanza: "She was."

“But out of that (a fist-fight with a man over a doll), a new holiday was born… FOR THE REST OF US!” That's both ridiculous and hilarious. Especially when Jerry Stiller and Michael Richards deliver the lines. And why not ordain a new Holiday Season tradition and add it alongside the mainstream traditions? What’s the diff?

From what I can gather from watching the now-classic Seinfeld episode and from Wikipedia, the tradition has three main practices that one must adhere to should you yearn to be numbered among the Festivus faithful:

1. The erection of an aluminum Festivus pole sometime after Thanksgiving, but no later than December 23rd. The pole would presumably be “displayed” in a prominent place in the living room, the rumpus room or on the front lawn. Why an aluminum pole? I don’t know why, but I theorize that since Festivus originated in the mid-sixties, it seems that the aluminum pole may have been a rebellion of sorts against buying an overpriced aluminum Christmas tree from a department store (I imagine Frank Costanza screeching “See? I made my OWN aluminum-holiday decoration, you bloodsuckers!”). Frank Costanza kept his Festivus pole in the crawl-space during the off-season, but I don’t think that’s a requirement.

2. The Festivus meal, together with the Airing of Grievances. The Airing of Grievances is exactly what it sounds like: family members expressing their gripes and getting stuff off their chests. Of course, the grievances would no doubt include complaints against family members, who would naturally be present for the… uh, “festivities”. And this would not just be acceptable, but preferable, so that the airing could be wholly honest; because die-hard practitioners of Festivus consider it a High and Holy Day. Side Note: Some have taken creative license with the Festivus meal tradition and have inserted a requirement that the meal be entirely kosher. This is not a traditional practice, and ironically, considered quite unorthodox.

3. After the meal, the first-born son or daughter must challenge the head-of-household to the Feats of Strength. The Feats of Strength requires the first-born to pin the head-of-household’s head to the floor in a wrestling match. Fueled by the vicious manner in which grievances were aired (and a belly full of ham) the offspring must defeat his elder “mano-a-mano” in order for the holiday to be complete. In fact, the holiday is not concluded until the head-of-household has been subdued in this fashion. Otherwise the Festivus pole remains in its place as a symbol of shame and failure; shame for the entire family to bear for as many days as the pole remains past December 23rd.

And with Festivus, no presents are exchanged. Fugetaboutit.

I’m glad that Festivus isn’t a “real” Christmas tradition, even though it seems that some prisoners have successfully sued for the freedom to “observe” Festivus in jail, as their religion of choice. (It seems to me that someone has say too much time on their hands!) If it were a “real” holiday, it would be a painfully honest experience. Purely and painfully real and honest. But in reality, how far away from reality is the fantastic holiday Festivus from our own holiday experiences with our families? Think about it: A meaningless decorative symbol, hurt feelings and fighting. Does any of this sound familiar? Is it any wonder that suicides peak around the holidays? Isn’t this what the Holiday Season has become for many Americans? As an addiction group leader, I warn the men in my group about the potential triggers they may encounter during the holidays. Because for many, the holidays hold little meaning, but provide great opportunity for old, unresolved family “junk” to get stirred up. For some, the holidays are expensive, stressful and painful… with little or no positives.

One important developmental task for growing into adult maturity is to develop a sense of belonging. Children need to have a sense of who they are in the context of family history, culture and traditions. This identity is a big part of developing their individual sense of “self” that they’ll need if they are to become well-rounded adults. Well-formed holiday traditions can play a part in this important aspect of “becoming”. As a Christian, I can tell my daughter about how “Jesus is the reason for the season” and teach her to sing Silent Night and The First Noel as part of our family traditions; and for her those can become anchors for the development of her understanding of why we appreciate this special time of year and who we are as a family and a Christian community. Others may choose other beliefs or values to hang their holiday hat on, such as Kwanzaa or Hanukah.

One doesn’t have to be the follower of a religion to make something meaningful out of a holiday. In fact, most Christmas traditions (the date of December 25th, the decorating of a tree; yada, yada, yada…) originated from pagan or idolatrous practices that were hijacked by us Christians and adapted to help us celebrate the birth of the Christ. So this holiday season, I encourage you to reflect on whether your family has developed meaningful traditions that can be passed on to the next generation. What values or symbols of the season are important to you, and are you teaching those traditions to your children? For that matter, even if you are only a couple who don’t yet have children, what are the two of you doing to create meaning for when you become parents, or for when you invite friends into your homes for the holidays?

These are important questions for people living in these times, because George Costanza’s story of “raining blows” is only funny if you can forget that on Black Friday 2010 people got into fist-fights and got stabbed over “stuff” at Best Buy and Dillard’s. This, sadly, happened in the name of celebrating the “Christ-Mass”. Decide to make something meaningful out of your holidays, because otherwise it may just end up being Festivus: a meaningless decoration you store in the crawl-space, some ham and so much stress that you just can’t wait to go back to work on the 27th.

Merry Christ-Mass, readers.

My daughter: she is a disappointment. She can’t seem to get anything right. Until just a few weeks ago she needed help putting her shoes on her feet. She can now get them on her feet, but she still doesn’t know how to tie the laces. She doesn’t even try to do it herself. She’s illiterate, too. She thinks it’s a big deal that she knows the alphabet, but she still can only write maybe half of the alphabet by hand. And when she draws, she draws like she’s drunk. She scribbles something that looks like Quasimodo got hit by a truck and she says “It’s YOU daddy!” as if I’m supposed to be all happy that she thinks I look like that. Sometimes I lie to her and say stuff like “Thanks, Hon. That’s a great drawing you made of me. Oh, I’m holding it upside-down? Sorry, dear… yes, it looks even more like me when I hold it this way.” Geez… She hasn’t made much of her life: no money of her own, no driver’s license. She acts like independence is a bad thing; something for others, but not for her. She’s never had a job, never been on a date, hasn’t graduated from college. She’s never accomplished anything meaningful. She’s got to be learning disabled, or in that Forrest Gump range of borderline intelligence or something like that because I expected so much more from her than this. I had all these dreams of who she’d be… smart… accomplished… hard-working… but she’s none of those things. Heck, she doesn’t even know how to fry an egg.

But maybe she can’t fry an egg because she’s not allowed to play with fire. You see, she’s turning four next week.

I don’t really think this way about my three-year-old. My baby girl is doing just what her mother and I would want for her to be doing at this stage of her life. Preschool in the mornings, naps in the afternoons and picking up her toys before bedtime every night is pretty much a full day of work for her. She still puts her shoes on the wrong feet about half the time, and she has to wear a bib or she’ll have to change her outfit after every meal. Sometimes she gets pushed to the limits of her maturity and she’ll misbehave or break down in tears. Most of her conflicts require the intervention of someone older than she. She makes a lot of mistakes. Lots. If we didn’t watch her closely… who knows what kind of trouble she’d find herself in?

And… that’s what it’s like to be three years into “life”. The stuff you don’t know easily outweighs the stuff you do know. At three years of age, a person needs a lot of help from older people. At three years of age it’s important that the few things that go well are celebrated with exuberance because it has taken most of that little person’s life to learn to complete simple three-year-old tasks. I’m thrilled that my daughter can draw a circle and call it a picture of my face because just drawing a decent circle wasn’t something she could do six months ago, and at this time last year she was still working on learning her colors and shapes. She’s doing very well – if you keep in mind that she’s only three.

Why do we show so much grace to three-year-old children when they make a mess of things, but so little grace toward ourselves when we only live up to our expected level of maturity? Expecting me to act 46 when I am in fact at the age of 46 is reasonable. But what if I’m 46, and my wife is 28 (What? It could happen!), but our marriage is only seven months old? What would you expect from my marriage at the age of seven months old? Perfection? If it’s OK to poop in one’s diapers several times a day when a baby is seven-months-old, then why do we so often sound the alarm when the marital equivalent of “poopy-diapers” happens to a seven-month-old marriage? Marriage, like life, is a developmental experience. We understand and accept that the maturation of an individual takes place slowly and in stages, so why don’t we accept the same for our relationships? If a person believes in the Biblical concept that in marriage the “two become one flesh” (Gen. 2:24), then marriage creates a new “life” that didn’t exist prior to the marriage. I like to say that a “Me” and a “Me” create a “We” when two people get married. And the honeymooning “we” is but an infant. It doesn’t have any history. It has no competencies. It must grow and learn and develop smarts and strengths from nothing. The “we” will poop its diapers. As it learns to walk and to do things, it will totter and stagger along. It will be anything but graceful. It will fall and skin its knees, and will cry when it’s hurting. It’s vulnerable, so you’ll want to pay close attention if it gets sick. Don’t expect much out of it for… well, a while. It will have be an awkward tweener before becoming graceful homecoming royalty. It has to grow up before it can live up to its potential.

Is your two-year old “we” “throwing tantrums”? Don’t ignore the problems, and don’t seek someone to punish over the problems; but rather, learn to discover the unique needs of your “we” so you can address what’s not going well. Don’t expect a new union to look like the marriage of grandparents. Those well-developed unions have been through much more than your little “we” and have learned to handle adversity. In fact, the problems of marriage are the very experiences required of anyone who would want a “good” marriage. As Dr. David Schnarch put it: “No one is ready for marriage. Marriage makes you ready for marriage.”

I’m not upset that my three-year-old daughter can’t tie her shoes or that she’s afraid of the dark. She’s exactly who she needs to be at this point in her life, and because her father and mother are not going to give up on her – but rather, are committed to helping her through whatever may come – I’m sure that she’ll learn what she needs to learn, and then some. Someday her parents will marvel at the woman she will have become.

We just need to believe in the process of growing up, and that is true for marriages just as it is for little girls. Don’t let the growing pains intimidate or discourage you, for those difficulties are often just a necessary piece of the process of maturing your “we”. Talk to your “we” and ask it what it needs, and be willing to sacrificially give your “we” the love and nurturing that it needs to grow.

We are a little more than a month away from the annual mass exercise in dishonesty we’ve come to call our New Year’s Resolutions (NYR). Normally decent people will, without even cracking a smile, brazenly lie before God and man by “committing” to their 2011 NYR. They will claim a renewed commitment to losing weight, reading more non-fiction, fewer one-night stands, driving the speed limit, finishing doctoral dissertation(s), saving more money, curing ugliness, etc. Daily regimens will be established no later than January 4th. The same regimens will then cease to be so legalistically daily (“I don’t have to jog if it’s dark outside, do I?”; “Weekends don’t count…”) within one week. By February, only the Independent Baptists will be holding each other accountable to their resolutions. By May, 1% or fewer of us have maintained our “I swear to GOD, I’m going to DO this!” commitments; and the 1% who have kept their commitments are actually just suffering from a compulsion disorder and are no longer in control of themselves (“Am I over-doing it if I clean the toilet five times after every use?”). As a culture, we will conspire to lie to each other and silently agree to collectively fail… and we’ll do it again in 2012 as sure as the Russians can see Sarah Palin from their backyards.

I’m no one to throw stones, because I can’t even remember any of my NYRs from the past decade. But, my excuse is that I’m terribly lacking in discipline, and never really put much effort into my resolution to “become more disciplined” back in… whatever year that was. Regardless, I think I may be able to help other sufferers of the affliction even though it appears the physician cannot heal himself. If you are the type who would take marriage advice from Larry King or who believes that “the card that pays you back” will make you rich if you’ll just use it more often, then keep reading…

How do you go about picking your resolutions? This is where many of us fail: We don’t attack a true target of opportunity. We resolve to stop doing certain things (or to start doing certain things) that we think we are supposed to care about, but in reality, we don’t place much value on them. A person thinks that others think they should stop reading Penthouse Forum and start reading The Message, so that becomes their next NYR. I think others think I’m too fat, so I’ll lose weight. My dad says I’ve never done anything meaningful with my life, so I’ll finally finish my master’s thesis and prove him wrong. I’ll resolve to do [fill in the blank] because [all the wrong reasons] and quickly lose my motivation to change because my heart was never really into the resolution to begin with.

The most miserable people I’ve ever met were people who weren’t living according to their values. People who didn’t believe the Bible to be God’s Word, but who were still trying to conform to its authority in order to look good & right in the eyes of others: miserable. People who did believe the Bible to be God’s Word but who weren’t living according to its guidance: miserable. People who have hopes that they are unable to pursue because of oppression or suppression: miserable. People who want to scream, but who have no voice: miserable. People who just want to live their own life, but cannot live according to who they really are because they have relinquished to much control to others: so very miserable.

Before you pick a NYR for 2011, I encourage you to identify a dearly-held value that you are not presently living out in your life. What’s important to you, but “small” in your life? Where in your life are you not living according to what matters to most to you? Consider the following exercise as a way to identify areas of your life that “need attention” and may be good candidates for next year’s NYR. To do this exercise correctly, read each step only after having completed the step before it. You’ll probably ruin the exercise if you look ahead, so read each step only after completing the step before it. You’ll need a Big Chief tablet (a Son of Big Chief tablet will do in a pinch) and a #2.48 pencil. OK… BEGIN!:

Step One: List of What’s Important

Get a sheet of paper and make a list of the things you value the most in life. What are your greatest priorities in life? You need to list a minimum of 10 values/priorities. Some suggestions to consider: Money, Children, Career, God, Volunteering at …, Becoming a better …, Health, Education, Political Activism, Water Skiing, etc. The longer your list, the better. Don’t read any further until you’ve completed this step.

Step Two: Reduce your List

Take your list of 10+ priorities and reduce it to the five most important. Take your time. Do it right. Cross off everything other than the top five. Don’t read any further until you’ve completed this step.

Step Three: Order your List

Take your list of five priorities, values, etc. and put them in order of importance. Take your time. Do it right. Don’t read any further until you’ve completed this step.

Step Four: Make a List of What/Who You’ve Been Devoted To

What do you actually spend your time and money on? It’s a hard thing to consider because we may not like the truth, but doing this part right is critical. Be truthful about where your time and money are spent. Write it down. If you are in the habit of lying to yourself, then this part may be hard. Take your time and demand honesty from yourself about how you’ve been living: what takes the bulk of your time and your money. It may help if you look at your bank statements and your schedule on your Blackberry. Yes, for the most part, it’s nearly impossible for “work” to be anything lower than #3 for those of us who haven’t produced winning lottery numbers or haven’t married “up” in a big way. The question to ask is: How much of “work” is strictly limited to subsistence and how much is about the things we get from work beyond our need to simply survive? If your household has more cars than drivers, and more bedrooms than sleepers, then you are working for much more than “survival”. Be honest about how much time you spend with your hobbies on the weekend compared to the time you spend, say, with your children. A “Jesus is LORD!” bumper sticker says a lot, but only giving 45 minutes a week and .5% of your income to your “Lord” says much more. Be honest about your children getting more of your time than your spouse, or vice-versa. Be truthful about how much goes into your IRA , your car payment or your child’s 529 plan. This isn’t a witch hunt or an evaluation of your morals. Rather, it’s simply an honest evaluation of what you’re “putting yourself into”. Make your list at least 10 items long. Don’t read any further until you’ve completed this step.

Step Five: Reduce Your List, Again.

Take your list of 10+ things you spend your time and money on and reduce it to five things. Don’t read any further until you’ve completed this step.

Step Six: Order Your List, Again.

Take your list of five places you spend your time and money and put them in order. List them according to which one takes the most, etc. Don’t read any further until you’ve completed this step.

Step Seven: Compare the List from Step Three to the List from Step Six

This is where you determine what you need to consider “resolving” in your life. If your list of priorities and values from step three doesn’t match your list of what takes your time and money on step six, then you are not living according to your values. This is a good place to discover what’s amiss in your life. Showing devotion to things that don’t really matter to you or neglecting the things in life that matter to you can rob you of your happiness. When we ask “What do I wish to change in my life?” we first need to understand what matters the most in life, and whether or not the things that matter the most are getting our best efforts, or merely getting our leftovers.

Jesus said “Where your riches are, there your heart will be also.” Yet it seems that many of us keep putting our “riches” in places that don’t speak to the desires of our hearts. Eventually, we completely lose touch with the things we once held dear. Such is the path to chronic unhappiness.

I hope this process of discovery blesses at least some of you in the New Year. While I’m at it, let me be the first to wish you all a Happy New Year.

This post is a follow-up to last week’s Relationship(s) Matter(s) post: Ask the Marriage Therapist a Question.

Before I answer any questions, I want to make some things clear:

1. This is not marriage therapy. Do not attempt to make direct application of these responses to any real-life situations. My responses are generalizations based on a very limited amount of information.
2. If there is abuse or violence in your home, contact the police, Social and Rehabilitative Services (SRS) or some other appropriate resource or shelter for help with accommodations. Do not attempt to “fix” an abusive or violent spouse without seeking professional, qualified help.

This question came from Mrs. Ruby Slippers:

"Following the birth of our baby my husband said my weight was making him look at other women. Considering I had just given birth, shouldn't he take responsibility for his wandering eyes instead of pushing it off on me? I am doing my part by working out and eating right to lose the weight and I think he should be patient and be attracted to me since I ruined my body to give him a child."

I’m sorry to hear that he finds it so easy to say such hurtful things to you. There are two problems here that need to be addressed. First, your husband needs to learn to take responsibility for his own actions. If you presented yourself to him with the face of Grace Kelly and the body of Pamela Anderson he would still be looking at other women. Bearded Gnome put it well when he posted “your weight wasn't making him look at other women. something in him was making him look at other women.” A “man” takes responsibility for his own actions and for his own mistakes. Your husband is relationally immature and lacks self-control. If he’s a Christian, he needs to pursue an understanding of how he can better apply Ephesians 5:25 to his marriage: “Husbands, love your wives, as Christ loved the church and gave himself up for her…” (ESV, emphasis added). Your husband’s words do not reflect love, and he needs to fix that. And, he needs to quit looking at porn, which I’m sure he is doing. Big time.

Secondly, you also have a problem to look at. Your response to his inappropriate comment was “I am doing my part by working out and eating right to lose the weight and I think he should be patient…”. When did “working out” and losing weight become necessary for receiving love? Where did you get the idea that you need to work on meeting a set of external physical standards in order for him to be attracted to you? I’ve gained 70 pounds since I got married and my wife, well… let’s just say that she no longer fits in her wedding dress. I would like to address my weight gain for several reasons, but at no point has my wife said “I can’t be intimate with you until you lose some of that lard from your behind.” Your husband communicated that EXTERNAL BEAUTY = LOVABILITY, but you didn’t rip him a new one? Somewhere along the line, you bought into the idea that you need to earn his love and acceptance by never gaining weight, never going grey and always keeping up with the airbrushed “beauty” of Ms. October. If you want others to love and accept you for who you are, start by being the first one to say “I will love Mrs. Slippers for who she is, large butt and all, regardless of how others judge her love-ability!” Your chubbiness is your glory, a symbol of your motherhood. It’s entirely your choice to keep your chubbiness or to lose it, but don’t be shamed into slimming down when the real solution to the problem is for your husband to grow up.

It seems that you both have shame and self-loathing issues that need to be addressed. He’s seeking validation through another person’s external beauty, and you don’t have the self-esteem to realize that you deserve love just for being who you are. It seems to me that there is a lack of healthy self-love in your lives.

From Ms. Magoo:

"How do you go about finding a good marriage counselor? My husband and I are on our third one, but each one we found to be extremely bothersome. The first told us she is currently battleing an eating disorder, the second never said a word (literally, during each session, just let us talk and then ooh time's up!), and now we're on #3. Is there a science to this? A helpful website or good recommendations?"

I then asked her to tell us more about their relationship with therapist #3…

We've been for about 3 months, weekly sessions. On one hand, I do like her. She comes up with a lot of good questions and things to think about and gives us homework each week. And I do feel like I can talk freely and openly around her. However, sometimes I get a judgemental vibe from her. She is divorced and has several children with her first husband, and when we talk about the "D" word or other issues that might be "sensitive," she hasn't been hesitant to call names or tell us how she really feels :) This has been a little too abrasive for me a few times, where I feel put-down after the session. These things have only occurred twice now, and very recently, so I'm now questioning sticking with the this one too! So for now, I'm still trying to figure out if we'll ever find someone we really like, how to find that person, or if I'm just being too particular

I’m more than happy to address the first question and I’d also like to comment on the Magoo family’s experiences with their various therapists as well.

You find a good marriage therapist by asking people you trust. Your family doctor is a good person to ask. If you know anyone who has been to a therapist, ask them if they’d recommend that person in the future. If you are part of an organized religion, your minister/priest/rabbi most likely knows someone that they trust. Apart from that, you can use the web to do some research, but every clinician’s website is basically touting that person’s view of themselves. I consider it a red flag when a clinician claims to be proficient in 20 different areas of mental health. Counseling psychology is a lot like the medical field. You go to your general practitioner for flu symptoms, “it hurts when I smile”, and mysterious rashes, but you see a specialist for issues that are clearly unique and require expertise. I’m more trusting of a clinician who lists a handful of competencies than I am of someone who thinks they’re good at everything. Also, when you are searching on the web, certifications and credentials should mean something to you. Some of those certifications can be difficult to obtain and they can tell you a lot about the clinician’s orientation and skill-set.

Some thoughts about your various relationships with your three therapists:

1. Some would consider her disclosure to you unprofessional and inappropriate, but I will not immediately judge her for what she said. I self-disclose to my clients when I deem it appropriate. Was she turning the attention away from you when she told you about her disorder, or was the statement related to your treatment? It’s been said that every therapist has their own therapist. (I’m an exception, but mostly because I cannot afford one!) She has a problem that she’s working on, so don’t discount her for being human. I would say that her eating disorder was not, by itself, a reason to fire her. Her mental health issues are really only a problem if she was impaired by the eating disorder, impaired in a way that would affect her therapeutic skills.

2. Every therapist has a different style. Some are very vocal and directive and they fill the therapy room with their personality and ideas. These are the ones that come out and tell you what you need to know with a tone of authority. Dr. Phil would fit that mold [eyes rolling…]. Others are minimalists who say very little and give direction in slight nudges, ultimately letting you find your own path to healing. Some of the very best therapists take this kind of stance, and have a nice way of letting their clients discover their own answers. Their words are few, which makes each statement they make that much more meaningful. But, I think a good therapist needs to communicate their style to their clients, especially if they are literally saying nothing at all during their sessions. My guess is that #2 was either a brilliant genius, or way in over his head (and terrified) with all the messy feelings you two brought into your sessions.

3. She is “sensitive” around divorce and some other issues, and she often leaves you feeling “put down”. Number Three is ashamed of her failures in life and she projects that onto you (and onto others, such as her children, I’m sure). She’s an example of what Jesus meant when he said “Out of the overflow of the heart the mouth speaks”: She has wounds that need to be addressed so that she doesn’t spew forward from her wounded place. That’s not a good “join” to have with a client. In fact, the issue of chronic shame can be linked to a number of mental disorders. Shame can really hurt. Going to a therapist who makes you feel small and ashamed is like going under the knife with a surgeon who’s running a fever and sneezes a lot, but won’t wear a mask. Shame is not a path to healing. You need to be supported, not berated. I hope #3 can afford a therapist of her own.

From Mrs. WhatsGoingOn:

"OK, so...addiction to TV/Video games/computer. Currently, my SO does not have a "career" (he has an almost-fulltime job, not great). Everytime I come home, he's on his video game, and he plays until at least 1 or 2 in the morning (last night, it was 4am). I have to beg him most of the time to look for jobs. He's had problems finding one lately (no shocker), and he's really discouraged, so he uses that excuse to not look at any others. I pay almost all of the bills too, and he is really stingy about any money that he gives me. He has thousands in the bank, but it's for a "new car" (which he does need, but it's a very unpractical sports car unsuitable for Kansas weather). Anyhow, he also keep me up at night when I hear him playing his game outside the door...last night I got about 3 hours of sleep because of the noise. If he didn't have to get up for work, he would sleep until at least 12pm every day. It has taken a toll on our relationship obviously, as I'm a very productive person, and I won't relax until I feel like I've gotten things done...where he is the exact opposite. I try to be okay with it, but our intimacy suffers, and we fight about it a lot. Am I being unreasonable to think that this behavior is NOT okay for someone in their mid-20's, who doesn't have a full time job? He just tries to make me feel bad by saying I'm just trying to sabatoge it because I "hate the game." It's true...I find yelling at people halfway across the country and acting like a high school bully moron is pretty immature, but while I want him to have his fun, I want to feel like I'm actually with him, and not his babysitter. I love him, and we have a great time when he's NOT playing his game and actually spending time together, but he can't get away from it long enough to do that most of the time."

I can personally relate to parts of your story. I know what it’s like to stay up late playing games or looking at porn. I remember some of the reasons why I did that, and I hear similar themes in what you’ve described to us.

You used the word “immature” to describe his behaviors on-line. Mr. WGO has hit the limits of his maturity, and that’s why he invests his time and energies the way he is right now. You can tell what means a lot to a person by looking at their checkbook register and by looking at their weekly schedule. Your husband gets more satisfaction out of saving for a sports car than he does by contributing to the family budget. In terms of money, his values are: toys mean more than fiscal fairness & integrity. Your husband also spends more time in a fantasy gaming world than he does in any other “real” experiences. He drags his butt all day at work because he values his accomplishments in the war against alien-zombie-Nazis than he values his career. From what you say, it’s getting to the point where even you matter less than the gaming. In terms of time and energy, his values are: escapism is preferable to real life.

Why would he want to live like this? My guess is that he really doesn’t want to live like this, but because he doesn’t have the maturity to cope with how hard life is for him as a married twenty-something trying to get ahead in a difficult economy, he must turn to an escape. He hates his job, but more importantly, I think he hates himself because of his lack of accomplishments. He kills evil enemies for hours every night in a virtual world to help himself feel like he’s done something meaningful in life; something he doesn’t get from his mundane job and the rest of his real life. He’s probably fighting off depression, and I wouldn’t be surprised if he’s had suicidal thoughts.

You are in a tough spot, because on one hand, 1) you must stop enabling him (and you are enabling him); but on the other hand, 2) he really needs your moral support. About the enabling: demand change and demand equity. If you spend 80% of your paycheck on the bills, then he needs to give the same proportion of his check. Tell him that he’s not buying himself a car, but that he’s buying the family a car, and that you expect him to make an auto purchase that’s appropriate for the family. You aren’t his girlfriend or his roommate, you are his wife, and his use of family resources (what he calls “his” money) should match the needs of the family. Sports cars are for single people and for families that already have the grocery-getter paid off. That doesn’t immediately make sense to him because the dream of the sports car is key to him feeling good about himself; so he’ll throw a major tantrum if you try to kill his Corvette dream. At the same time, because his ability to cope with his unhappiness is being taxed, he needs a lot of emotional and spiritual support. It’s not a crime to be immature (we were all that way at one time). You helping him grow through this problem would be like him helping you limp around if you had a broken foot. He needs your love and understanding, and he needs you to set limits and to articulate expectations as his wife. If he’ll talk to you about how he feels, give him a chance to spill it all out. Let him see you as more than a complainer. Let him experience you as his biggest fan and supporter, and a wife who expects him to fully show up for “life”.

BTW: He’s likely addicted to that game. The answer to that problem is to quit cold-turkey. Get ready for another manipulative tantrum when you bring that up. Good luck.

Monkey “C” asked:

“How can a wife help to make a wonderful stay-at-home father not feel immasculated due to his lack of financial income?”

Why should any stay-at-home-parent feel that, regardless of gender? That struggle is not limited to men. I have a good friend in Johnson County whose husband makes plenty of money (cha-ching!!), so she stays home and home-schools their kids. What she’s doing has immense value to their family, yet she still expresses that she sometimes doubts the importance of her contributions. We like it when we can measure our accomplishments (like, by the size of a paycheck), but the most important things we’ll do in life usually defy being measured in any way.

The structure of your question makes me wonder where these feelings of emasculation are coming from. I’ll share two ideas with you. First of all, you have to take responsibility for feeling like a man 24/7/365. Your wife cannot do that for you. You have to remind yourself that you are living according to your values; that you are being an involved dad because you know it will be an immeasurable blessing to your children that they had a parent at home with them full-time. Secondly, does the bread winner have more power in your home? In many traditionally-structured American families, the dad was the one who earned the money and he controlled all major decisions about how that money was spent. Are you now living a reversed version of that with your wife in the 21st century? Alm77 even gave this telling reply to your question: “She needs to let him continue to make important decisions.” Does one of you “let” the other make important decisions because they bring in the bread!? Even the wording of that seemingly equalitarian response reveals our tendency to grant greater power to the person who makes the most money. “Let”? If you feel like you are in a one-down position with her because of her financial contributions, I think you need to have a talk about power and equity in the home. The “rules” you apply to yourselves today will be honored by your children in their homes later in life, so demonstrate equalitarian values to your children if you want them to value fairness when they are married. There need not be a subordinate position for the one who stays home, not unless you’ve both agreed that is how you want to live. Some families choose for one to be in the leadership role because of tradition or religion, and because that structure reflects their (his and hers) values, it usually works out well for them. If you’ve become secondary in the power structure, and without any agreement or discussion about becoming the Mini-Me to her Dr. Evil, then you need to have a talk with the wifey about power and money.

Lady J asked a question that’ll resonate with more than a few of the wives out there (and, maybe a husband or two):

Here's one that has been discussed in our "hen" group. If a husband and wife go to sleep and then hubby wakes up and can't go back to sleep, should the wife be expect to wake up at 1 a.m. (and lose sleep) and "help" him get back to sleep? Now here's the tricky part. When the wife goes to sleep all was fine but evidently said or did something when he tried to wake her up, that she has no recollection of, that made him mad and he is mad the rest of the day. Should the wife be held accountable for something she said or did in her sleep? Should she be expected to wake up several nights a week?

For those who are wondering how she “helps” get him back to sleep: she gives him sex and that helps him relax and get to sleep.

I also have a hard time getting back to sleep when I wake up. I also need help sleeping at night and even have a diagnosed sleeping disorder. The answer is: a sleeping pill. Are you a sleeping pill? Tell him to take responsibility for his own sleep and to go see his doctor. And, if he’s mad all day over something you mumbled in your sleep: again, he needs to be more responsible for his moods.

This may seem unrelated, but does he show signs of ADHD, have anxiety issues or issues with premature ejaculation? “What in the WORLD do those things have to do with my husband not sleeping?” you ask? His sleep problem is alleviated by sexual release, which suggests to me that he may have trouble self-soothing and calming himself. Also, ADHD symptoms and premature ejaculation are sometimes correlated with anxiety. His sleep problem may be an anxiety problem. Also, if he looks at porn, his anxiety, self-soothing and premature ejaculation problems are at risk for worsening (those are potential side-effects of chronic porn use).

InaTux asked a really great question…

I've heard (maybe this is true, maybe not, hence why I'm asking) that marriage counseling can make matters worse for a couple. Have you had any experience with that happening? I suppose what I'm asking is, is counseling for couples a good idea if they're at the breaking point, or is it one of those things where it'll get worse before it gets better?

Before I come out an answer the question, I’ll ask a related question: What is the ultimate goal of marriage/couples counseling? Some therapists advocate for the idea of the “good enough marriage” and consider any marriage that doesn’t end in divorce to be a success story (assuming there isn’t abuse, violence, coercion, etc. taking place in the family). Other therapists consider it their calling to strive for something beyond the mere preservation of the union, but rather endeavor to enrich relationships and build intimacy in marriages. They want their clients to do more than just survive, they want them to thrive. So anytime we are asking questions about success or failure, we have to ask ourselves what we wanted or expected from the process when we went to a therapist in the first place.

OK, I’ll answer your question with an analogy. Marriage therapy is a lot like 1950s dentistry: Most people only go after they are in so much pain they cannot take it any longer, the treatment often hurts more than the sickness, things are really bad early in treatment (which may require some extractions), things may never again seem completely “right” again (even if the treatment goes well), and it usually involves the dentist saying something like “You should have come to see me before it got this bad”. And, as Vertigo indicated, it is common, or even expected, for things to get worse on the path to things getting better. The reason why couples fight, avoid each other and say hurtful things is because of painful junk in their lives that they aren’t addressing. Addressing that “junk” is sometimes difficult, and sometimes the end result is that the marriage (or the engagement, or the courtship) ends as a result of what is revealed in therapy. Sometimes, the ending of the relationship is a “good” outcome of therapy because it is what’s best for the situation.

Now Bacon had a long question about his wife’s behavior that I won’t paste because of how long it is… but I’ll recount the highlights: She is out all night, many nights a week. She has lame excuses, if any excuse at all, for why she’s out late. She neglects her role in the family as wife and mother over whatever it is she’s doing all night long. She’s constantly texting and taking phone calls and having to talk in some other room, and feels like her privacy is being invaded if he asks questions about it. She also accuses him of cheating on her any time he gets an unexpected call or text message.

Well, three things need to be acknowledged or at least considered:

First of all, she has “abandoned” Bacon and the Bacon Bits. She’s no longer present as a fully functional member of the marriage or the family. It’s only partial abandonment, but abandonment is happening.

Secondly, as sure as water is wet, she’s having an affair. I’m sorry to be so blunt, but her behavior is classic for adultery.

Thirdly, you need to also consider that she may be an addict. Addiction and adultery share many of the same signs, and her behavior could be explained by the presence of an addiction. But, even if that is part of her problem, she’s probably also having an affair alongside the addiction

Give her an ultimatum: She works to restore fidelity, or she leaves. You and your kids deserve better treatment. I kinda hope you made all that stuff up, because otherwise your life is only going to get even more “interesting” in the near future.

J.C. Stepmom 28 asked:

So what does one do when various methods of therapy are attended (family, couple, single) and fatherchuck is attentive during the session but any homework or aftercare is avoided at all costs.

At this point there needs to be some work done around motivation. We have a saying in the therapy biz: “Believe Behavior”. Meaning, that a person who claims to be full of motivation but who doesn’t actually follow through isn’t actually motivated at all. There may be some reasons for the lack of motivation, and those reasons need to be addressed. My guess is (and this is just a guess) that Mr. Stepmom has a long history of getting by with lip service, so he’s been conditioned and trained to just tell people what they want to hear as a way to reduce the volume of complaints. But, of course (as I’m sure you are discovering) there is a consequence for this form of procrastination: eventually a breaking point is reached and lip service is no longer enough. You and your therapist will have to work on changing the patterns of interaction between you so that he can discover that lip service isn’t enough.

Amesn gave us some family history about her father having a “midlife crisis” and skipping out on his first wife for a newer model down in S. America. She’s surprised that her father’s fling has turned into a full-fledged commitment to wife number 2 and she asks:

“what suggestions do you have for men and women alike who begin to see signs of their spouse grasping desperately to hold onto their youth so that it doesn't end as badly as my parent's marriage did?”

Is the “midlife crisis” an attempt to “hold onto… youth”? I don’t think that the classic “midlife crisis” divorce (wait for children to leave home, then pursue adulterous liaisons with women half his age, then leave first wife for newer, sportier “trophy wife”) is an attempt to hold onto youth. I think there are some common themes to the “midlife crisis” divorce scenario:

1. A lack of intimate connection in marriage #1. People who have profoundly close connection to each other rarely stray into adultery. Intimacy has been called an inoculation against infidelity. When people stay together for 20+ years and then suddenly divorce, it’s usually because they spent the best years of their marriage working on raising kids in lieu of working on raising their marriage. When the last of the kids leave the nest, it’s like a fuse is lit on the marriage and if someone doesn’t address the lack of connection between them, then one of the two will sometimes leave.
2. Immaturity. Do you know why “normal” adults don’t pursue romantic relationships with teenagers? This is because we are rarely attracted to people who are at a different level of maturity than ourselves. When I was 15, I thought 15 year-old girls were awesome. At 46, I can appreciate the beauty of a person of any age, but would never expect my heart to go pitter-patter over someone who’s at a different stage of maturity than I am. When a man who is a grandfather (the “elder” stage of life) is deeply attracted to a woman who hasn’t even completed the task of raising her own children (early in the “parent” stage of life), then it speaks to the actual maturity level of the older person who wishes to share his life with someone so young. Amesn’s dad may be a captain of industry, may hold advanced degrees and may be a grandfather, yet he can still be immature for his age (or, for his apparent level of maturity). Aged wine is better than new wine, and in the same way, immature people don’t have the maturity to satisfy the relational needs of the mature. If Amesn’s dad has found his “soul mate” in the much-younger woman, it’s because he’s “behind the rest of the class” and needed to go back and repeat a grade (in a manner of speaking).
3. Arrogance. Some people simply think they are entitled to whatever they want without any concern for others. Anecdotally, it seems to me that many of these left-the-first-wife-for-a-skinnier/bustier/younger-trophy-wife stories involve men who think a lot of themselves. They are narcissistic and behave as if they should have whatever they want because they are special, in their own eyes. It seems that some on the most outrageous stories of infidelity involve doctors and politicians. Often these are people who, at least in their own minds, see themselves as being above the rules. They cheat, and when they are caught, they respond as if they are justified. That’s just me sharing an observation.

But I haven’t really answered Amesn’s question very directly. The truth is, I believe in the idea that intimacy is your best weapon against infidelity. Profoundly-joined people just don’t want to leave. They are less tempted. A person that is part of a well-joined and mature union doesn’t see their aging partner as broken down, but as well broken in. If Amesn wants to avoid following her father’s path, she is best served by pursuing deeper connection with her spouse than he did. Being wrapped up in the same stuff (money, kids, church, etc.) doesn’t mean that two people are creating a profoundly rich bond with each other.

OK, it’ll be a while before I do another one of these “Ask the Marriage Therapist a Question” posts because this was more work than I bargained for. But I appreciate the energy with which so many people participated in the discussion.

OH! I almost forgot to address any of the zombie questions! I’ll end with this:

If your spouse has turned into a zombie, you should immediately divorce them. One reason is obvious: there is no hope for reconciliation if they insist on eating your brains. Where’s the give-and-take in that? Also, you vowed to remain married “Till death do you part”, and if he/she is a zombie… they are dead, and technically, the “fault” is on them for becoming undead in the first place. So you should get to keep the car and the house… as well as the ammunition and freeze-dried foods.

Peace.

I'm a little intimidated by the idea of soliciting questions from the general public, but I'm willing to give it a try.

So this is how it'll go:

1. You ask a question that you'd like a Marriage & Family Therapist to answer. Please state your question carefully so as to minimize the risk of a misunderstanding.

2. I'll consider answering every question, but I reserve the right to pick and choose which ones to answer and which ones to ignore. If I think someone is asking a question just to pick a fight or "stump the therapist", I'll be sure to ignore it. Also, some questions may not be appropriate to answer in a forum such as this, and other questions may be outside of the limits of my experience, education or qualifications, so I won't answer those either. There are lots of reasons I may not answer a particular question, so if I don't respond to your question, please don't feel slighted.

3. I'll answer a select number of questions next week in my post entitled The Marriage Therapist Answers Questions (#1). Some of my answers will be really great and, just... brilliant. Others won't be so good.

So, post your questions below. If you are not an anonymous user on the LJW forums, then please feel free to ask personal questions with "I have a 'friend' who...". I will politely answer with "Your 'friend' needs to consider..." as if I have no idea who you are talking about.

Get it? Alright, then. Post yer questions.

Men “always” seem to want or expect more sex from their partners than they get. And, women also sometimes complain that they are not getting their fair share of action in the bedroom. I was once told by an old man that if you put a penny in a jar every time you have sex during your first year of marriage, and then you took a penny out of the same jar every time you had sex after the first year of your marriage, that your jar would still have pennies in it when you died. [sigh] Is it any wonder that so many young people are hesitant to get married?

Last year a German company began to seek FDA approval for the drug flibanserin as a treatment for a condition the diagnostic manual (the DSM IV-TR) calls hypoactive sexual desire disorder (HSDD). The targeted application: to treat women who have decreased desire for sex. Some were excited and began to tout it as the long-awaited bookend to Viagra; a “female” Viagra. Others, such as the group Our Bodies Ourselves, were less excited about the drug and the diagnosis of HSDD, and issued this statement:

“The diagnosis of HSDD unnecessarily medicalizes women's sexual lives. Attempting to treat low libido with a pill ignores the fact that many women's level of desire is deeply affected by everyday life stress and interpersonal relationships.”

I agree with that. And in 2010 the FDA declined to approve the drug in an almost unanimous vote, citing problems of efficacy and that the “dizziness and fatigue” experienced by 15% of test subjects outweighed the slight benefits of the drug. Good riddance, and please don’t come back, if you ask me.

It is my experience that the majority of sexual problems between partners are about relationship dynamics and/or unresolved wounds. They aren’t about being bored or about a decreased lack of interest in sex. It’s also not about getting older and losing one’s libido with age. It’s not about needing sex toys, lube or about a need to “experiment”. In my experience, nearly all adults are quite ready and able to have satisfying sex with a committed partner, but many of us who are married are having very little sex, or we find satisfying sex elusive.

Frankly, if you are in a sexless marriage you need to quit rationalizing and making excuses for the situation. It goes against our design to be sexless, especially when we have access to an appropriate sex partner. At the risk of over-generalizing, let me simply state that if you are in a sexless marriage, you probably have a relationship problem. (Or, it could be that you have a two month old baby; a very legitimate reason for not having much sex.) The general rule of thumb is that if you have sex no more than ten times a year, you are in a sexless marriage. And you can’t count the sex that happened because someone was drunk or the trying-to-have-a-baby-sex that reduces you to being little more than a stud horse. We’re talking about two people making love, and whether or not it’s happening with satisfying regularity in your bedroom.

Let’s look at some legitimate explanations for why you couples may no longer be having sex.

Physiological Problems

There are many physical problems that can make sex problematic or impossible. Some of those problems involve the presence of pain during sex: female sexual arousal disorder (a lack of natural lubrication), dyspareunia (pain in the genitals during sex; in either gender) or vaginismus (when her vagina uncontrollably tightens around his penis really hard). These conditions can make sex impossible due to the level of discomfort experienced during sex. And, if you have a television, you probably know more than you want to know about erectile dysfunction (ED) and the number of companies who want to sell us a pill to treat it. ED is a condition where a man is not physiologically able to get (or maintain) an adequate erection, usually due to blood flow problems to the penis. There are also issues related to our orgasmic functioning, such as premature ejaculation on one end of the spectrum, and orgasmic disorders related to the inability to orgasm at all on the other end of the spectrum. There are lots of ways to not enjoy sex that at least seem to be completely physiological in nature.

Most of these problems can be due to physical injury, infection or can be in part due to age. However… we are sometimes too quick to assume that these are problems requiring medical treatment, because all the symptoms related to the conditions I just listed can also have their root in emotional difficulties or relationship problems. If you are experiencing any of these problems during sex, I advise you to have a doctor assess you for any medical conditions that may be the cause of your distress. If a medical examination doesn’t produce any red flags, then it would behoove you to consider looking more closely at matters of emotion or intimacy, or to consider relationship issues that may cause your body to say “No” to sex. These problems (assuming the absence of any physiological issues) are your body speaking for your soul and informing you that you are not ready for intimacy at this time in your life, or with the particular person you are with. If you once had a satisfying sex life with your current partner but your physical experiences of sex have since changed (and not because of a medical condition), you’ll want to consider that relationship issues may be at the root of the problem.

Sexual or Emotional Trauma in the Past

It can be hard to predict how a victim of sexual trauma will respond to the trauma. Some “act out” by becoming hyper-sexual. I know a woman who was raped in her early teens. Her response to the rape was to spend most of the rest of her teen years in a dating (sexual) relationship with her rapist. Now, as an adult, she has cheated on her husband several times. What she’s doing is “acting out” of her trauma; she hasn’t healed or recovered from the sexual trauma of her past. Her trauma is begging for attention by throwing temper tantrums in the form of sexual “acting out”, but she’s not addressing the issues that her trauma is asking her to address. Sadly, she’s at risk of more “acting out” behaviors until she finally starts looking at the pain she’s been avoiding.

In other cases, there is an “acting in”, or an aversion to sex and intimacy as a result of past trauma. These people have experienced some sort of perpetration in their past and now are fearful of anything sexual. They may also have shame issues around their sexuality as a result of their sexual trauma.

Still others are like a former client of mine who was “all of the above”. She was gang raped in her teens and she blamed herself for it (she became “shame-bonded” to sex). She then spent most of her adult life in hypersexual, abusive relationships. She ended one of her marriages on a Monday because she had been in a three day sexual binge with a man she met at a church conference on the Friday before, and she wanted to continue the relationship with the man. Her husband wouldn’t agree to share her with her new boyfriend, and the new guy eventually became her next husband. She later became aware that she was an emotionally and sexually unhealthy person, and she began to seek ways to heal from the wounds of her past. It was at that time that she began to put up sexual boundaries for the first time in her life. She requested that she and her husband have a period of abstinence from sex so they could build healthier patterns in their marriage (and healthier behaviors in the bedroom), and so that she could take some time to heal. He was fine with her wanting to heal, but the abstinence thing was… not easy for him to adapt to at first. I ran into them a while ago and they seemed to be doing well.

Present-Day Wounds

Here’s an explanation of possibly why you are in a sexless marriage that many don’t want to accept: You are in a sexless marriage because that’s what you have earned. Sex is about intimacy. It’s about vulnerability. It’s about having joyful connections with each other. It’s about mutual respect, appreciation and love. But a pattern of insincerity, betrayal, abuse, inconsideration or emotional neglect will foster hurt, anger, anxiety, shame, mistrust, distance and loneliness. I’ve seen it go both ways: Men who rage against their wives also somehow become confused when their wives don’t want to get naked with them; and women who don’t want to share their hearts with their husbands will still expect their husbands to share physically intimate moments with them. I remember one session where the frustrated wife complained “Why can’t we just have sex? Why do I have to deal with all his feelings?”

A Lack of Connection

Similarly, if you want to have wonderfully messy sex with your partner, then be willing to “earn” those moments by participating in some messy emotional encounters beforehand. Our sex lives tend to be a powerful metaphor for the emotional and relational truths of our marriages. Some of us become emotionally detached during sex, while others might make a lot of eye contact, talk and laugh during sex. A client of mine recently told me of a particularly empty sexual experience he had. He paid for a lap dance at a strip club. The girl was appropriately flirtatious and seductive right up to the point when she did the actual “dance”. At that moment, she seemed to completely unplug herself from what they were doing. Her face became emotionless; she seemed to just “check out”. And why wouldn’t she? She wasn’t the least bit invested in him. It was a business transaction, with as much commitment as the Redbox machine will show my wife tonight when she pays her $1 for a one-day rental of Robin Hood. When it’s Redbox machine or a stripper, we understand it being very “mechanical”. But if we see sex as an opportunity to make love, we desire a connection with our partner. Some of us are OK with sex being little more than an act of mutual masturbation involving our and our partner’s genitals, but if we prefer to make love rather than to just copulate with each other, we’ll grow tired of disconnected sex. We may even become… sad about having meaningless sex. Sad because of the emotional connection that is missing from sex, and as a result, sex may no longer be just “disconnected”, but it may become emotionally painful. So we may just avoid sex altogether rather than be reminded of how much we’d prefer love making over an impersonal mechanical act.

In a recent blog installment I made mention of how the Biblical word for sex is the same as the verb “to know” in the ancient Hebrew. When Adam “knew” Eve in Genesis 1, we are reading the Hebrew word yada, which is “to know” or “to make self known”, but when Lot’s daughters “lay with” their father (they thought he was literally the last man on Earth so they got him drunk and used him for his sperm), it was the word shakab, simply meaning “to lie down”. Do you wish to experience sex like it was when the fearless and naked Adam and Even pioneered sex, fresh and bold, or do you simply want to get horizontal and ejaculate with your partner? In the spiritual sense, we need the “nakedness” of Adam and Eve if we wish to have intimate love making. And if you aren’t promoting “nakedness” with a partner who desires (or, who requires) intimacy, you might find yourself in a sexless union.

You may want to ask “Why was it OK to have sex earlier in our relationship when we didn’t have “naked intimacy”, but now, all of the sudden, it’s a requirement to have sex?” A: Because you aren’t kids anymore, that’s why. Relationships are like children. They start out small and unsophisticated, but we eventually anticipate that they will grow up and mature. Some of us yearn for our marriages to grow beyond the groping newness of our honeymoons into something… more. You may be one of those people who now wants your union to be mature and grown up, or you may have married someone who desires to experience that with their partner. In either case, you’ll need to invest in the maturation of your marriage if you want to return to satisfying sex. If you make those investments into the maturation of your marriage, your sex life can potentially become… more than your fantasies have dreamed it could be.

The Sexual Anorexic

Groucho Marx once said “I would never be the member of a club who would have me as a member.” That is a wonderful way to explain the identity of the sexual anorexic: They loathe themselves, and think that everyone else should loathe them as well. It can be hard for sexual anorexics to see themselves truthfully just as it is hard for those with anorexia nervosa to see their protruding bones in the mirror. I’m somewhat well-acquainted with this because (prepare yourself for some major TMI…) I was sexually anorexic. I was a raging porn addict for much of my adult life. I entered into recovery and began to gain some control over my “solo sex” behaviors with porn, but I was still being sexless in my marriage. It took me some time to realize that if I was really becoming sexually healthy, I would be actually having sex in my marriage. My porn use was my “acting out”, while withholding sex from my wife was a form of “acting in”. I thought that I wasn’t having sex because I had gained control over my sexually compulsive behaviors, but if I was “in control” of my behaviors, I would have been doing the natural thing: having sex with my wife, and with regularity. When I began to address my sexually anorexic behaviors, it became more clear that I didn’t want to be sexual within a relational context because I didn’t see myself as someone that someone should want to have sex with. I “wasn’t someone to be with”, in my own eyes. I had a hard time accepting that a woman might find me acceptable; acceptable to the point of sharing intimate moments with. I needed to deal with some shame issues in order for me to work through the problem.

The difficulty in addressing sexual anorexia is the same as the difficulty of confronting anorexia nervosa in that perception is an issue. “How could a porn addict be afraid of sex?” is the question that puzzled me. There are lots of rationalizations and explanations for why we aren’t having sex that are easier to swallow than “you don’t think people should like you.” But if you are in a marriage where your partner has a desire for sex and none of the other explanations listed above have revealed an explanation why you aren’t having sex, then I encourage you to look deep inside and consider whether or not you might be sexually anorexic.

They Want Sex with an Adult

Yes, I know, you are an adult. Do you behave like one? People who beg for sex are not “sexy”. People who complain about sex are not “sexy”. People who use guilt, shame and other forms of manipulation are not sexually attractive. If you are throwing tantrums about matters of sex, you are not presenting yourself to your partner as one who appears to be “mature and ready for sex”. If your partner is giving you sex because you are whining about it, they may eventually burn out and just decide to quit being co-dependent with you around your demands for unearned, false intimacy. When I was 16 I used a fake I.D. to get into disco in Wichita called Pogo’s. I pretty much just stood around watching others enjoy themselves for most of the night until I began to realize that my adventure into a real 1970’s disco would end without me even dancing with someone. So, I saw two college-aged women sitting at a table and I approached with the super-irresistible line “I’ve been here all night and haven’t danced with anyone, will you dance with me?” With a minimum of eye-contact she said “No”. Why would she dance with me? I appealed to her sense of pity. I suppose that sex-because-I-pity-you is better than none at all, but you can’t expect to do that week after week for the life of your marriage before someone decides that they miss having sex with an equal, with someone who acts like they are actually bringing something good to the relationship. Whiny, desperate pleas for sex send the message that you are still growing up into an adult. Adults don’t beg for intimacy, they partner with another and then they both build it.

Eventually a girl I kinda knew took pity on me and we danced to Le Freak faded into Another One Bites The Dust. I was a charity case, and I knew it; but I was 16, not 30 years old, and I wasn't married to her. If someone has sex with you because you are a charity case, don’t expect it more than once, even if you are married to them.

So what are good “first steps” for you and your sexless partner? Start with some frank, daring talk about how/why the sex stopped happening. Keep in mind that lots of fat, ugly and old people are having plenty of good sex, so don’t be afraid to say “We can still be awesome lovers, stretch-marks and all.” Avoid blaming each other for the lack of sex, even if you have legitimate complaints and wounds to resolve. Regardless of why you aren’t having sex, the “sexlessness” you’ve both created is having a negative impact on both of you, so commit to working on the problem together. Don’t fall into the trap of believing that only one of you is/has the problem. These problems are likely about relationship dynamics, with means it takes two to tango, especially if it’s a really bad tango.