What’s the worst advice you ever got from a therapist?

Betsy Sansby
Betsy Sansby, Designer of IOS Communication App at Express Yourself Ecards

Shortly after my mom died, I saw a therapist who had been great to our family during the ordeal. Something had happened to my body. I wasn’t able to sleep, eat, or function. I was terrified. As it turned out, I was clinically depressed, and the symptoms were symptoms of anxious depressive illness.

The therapist I saw (and trusted) told me to drive out to a cornfield and scream. That was it. I was stunned. Not only was this terrible advice; it stopped me from looking for another therapist for several months.

The second “worst advice” incident came when I hired an old supervisor of mine who had been a fantastic mentor for me when I first got out of school. Instead of advising me to be gentle with myself, and assemble a team to help me get back on my feet, she decided to excavate my childhood so I could work through the traumatic incidents I had endured.

I saw this therapist twice each week for a couple of months, and instead of feeling better, I got sadder and sicker. One day I got up the courage to ask, “Do you really think that reliving every traumatic moment I can remember from childhood is what I need?”

Her answer was, “Yes. I absolutely do.” Wow.

When a person’s mental or physical state is fragile, it’s not appropriate to go deep diving into traumatic memories. What they need is to feel safe, to be ‘held with love’ (figuratively) for at least one precious hour each week.

I respectfully ended therapy with my old supervisor, telling her I was feeling worse after each session. I was barely able to function as it was. I didn’t need more things to feel wretched about. She accepted my decision, but did not apologize for misreading my fragile state, or for re-traumatizing me every week. My respect ended the day we parted ways.

You’ll know when you’re being given bad advice. It makes you feel small, less able, less strong, and pressured to be other than where you are in the present.

Good intentions are no excuse for bad advice.

Understanding the bewildering symptoms of a panic disorder

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Panic attacks can take many forms. They can be triggered by any number of things:

1 medication

2 nightmares

3 PTSD (a serious condition caused by physical and or psychological trauma)

4 phobias

5 depression

6 prolonged stress

7 illness

8 medical procedures

9 social anxiety

10 insomnia.

11 obsessive thinking. Example: “What if some terrible thing happens? Then what will I do?”) I call this involuntary self-torture Looping.

12 Nothing at all. (I know. Crazy. Sometimes the body gets panicked for no apparent reason).

And while panic attacks are generally harmless, the cascade of symptoms they set off in the body are enough to send a person to the ER.

A panic attack happens when parts of the brain (thalamus+cortex+amygdala) overreact to sensory input (loud noise, sketchy person, medical procedure, a horrific event), or mental stimuli (“What if?” “And then what?” “I’m losing it.”).

Basically, a panic attack happens when parts of the brain (thalamus+cortex+amygdala) overreact to sensory input (loud noise, sketchy person, medical procedure, seeing a horrific event), or mental stimuli (“What if?” “And then what?” “I’m losing it.”).

Regardless of whether you’re dealing with a top-down process * (thoughts triggering panic), or a bottom-up process* (sensory data triggering anxious thoughts triggering physical symptomes), the results are the same. The stress cycle kicks in, causing your mind to check its files for what could possible be causing such dreadful symptoms.

As your mind scrambles frantically to figure out what the hell is going on, the questions it asks you begin to spin out of control. Here are some of the usual suspects:

“What’s happening?”

“I think I’m having a heart attack!’

“I feel like jumping out of my skin!”

“Something must be terribly wrong for me to be feelings this bad.

“I must have stomach cancer.”

“Oh, no! What if I die and my kids have to get along without me?”

“I’m not psychotic, so why is my body going crazy?”

This is the Stress Cycle, our primitive, 100% natural, survival reactions kicking in when we perceive a threat to our mental or physical symptoms. Basically, it’s a runaway train fueled by adrenaline, and kept alive by anxious thought.

A panic attack is when the Stress Cycle keeps firing when there’s no relief. As Claire Weekes (Hope and Help for Your Nerves—the best book ever written on anxiety) says, “Anxiety is nothing more than oversensised nerves kept alive by bewilderment and fear.”


How do I end a toxic relationship with someone?

For most of us, ending a toxic relationship isn’t the real problem. It’s removing the guilt associated with it that is.

The good news is that choosing not being around toxic people can be life changing. Suddenly, you’re free! You can breathe again. What a relief it is to not be dreading the next phone call, visit, invitation, conversation, or uncomfortable gathering.

No matter who you are, you have a right to live without fear of: disappointing, irritating, or being judged, criticized, dismissed, or taken advantage of. You are not a bad person for wanting this. Who doesn’t?

The hardest part of this process is dealing with the fallout from family, friends, or coworkers. Everyone will have an opinion, and some will tell you you’re making a bad decicision. And maybe you are.

But the thing to remember is that it’s your “bad decision,” not theirs. Only you know what being around that person feels like to you.

Your life may change for the better without this person in it, but your choice may not feel better to other people. This is especially true if the person you’re trying to get rid of is a relative who is still close with other members of your family.

So you’ll have more decisions to make. But go easy on yourself. You don’t need to make a scene or proclamation. And you don’t have to decide everything at once. Take whatever step you’re ready to take, and congratulate yourself for making progress. Freedom isn’t a light switch. It’s a lifelong process.

Why you’re always mistreated and disrespected.


Review of Express Yourself ECards App


Review of Express Yourself Ecards at GreatApps.com

Tired of being misunderstood? Wish you knew what to say and how to say it better? Express Yourself E-Cards help you clarify your thoughts and feelings, and nd the perfect words to communicate them more effectively.

App Review on Great Apps.com

The Express Yourself Ecard app is a deceptively simple, powerful communication tool. The ten ecards in the app help you express yourself in ten common situations where most of us mere mortals struggle to gure out what we’re feeling and how to say it.

Unlike generic greeting cards, the ecards you create with this app are specific, personal, and deep. No two ecards you send will ever be the same.

After you’ve chosen the ecard that fits your situation, you’re guided through a series of fill-in-the-blanks and checklists. At this stage you’re likely to experience an “Aha!” moment or two, as you recognize your true feelings for the first time. It can feel a little like therapy, which makes sense because the app was created by a marriage and family therapist.

Once you’ve finished completing an ecard, the app magically creates a letter that makes you sound better than you ever thought you could. If you want to tweak it further, the app allows you to edit it or save it as a draft to work on later. You can even add a photo if you want. And the user-interface is simple and clear, right up through the moment you hit “Send.”

You’re likely to experience an “Aha!” moment or two, as you recognize your true feelings for the first time.

Even a good communicator can benefit from using The Express Yourself Ecard app to talk about difficult subjects. For example, if you want to tell someone they’ve hurt your feelings, using the app’s “Ouch” card will decrease the likelihood they’ll get defensive and increase the likelihood you’ll get heard. Sending the app’s “Sorry” card will make any apology much more complete and effective. The “Can I Be Honest?” card will make it possible for you to tell the truth when you’re frightened about how it will be received. And although it may be easy to say a simple “I love you,” the app’s “I’m Loving You” card will help you say it in a more meaningful and memorable way.

Each of the ten ecards in the app has the potential to increase your self-understanding at the same time as it increases the chance you’ll be understood by the important people in your life. So if you’re looking for an easy way to say something hard, give the Express Yourself Ecard app a try.

Each of the 10 ECards consists of a sequence of fill-in-the-blank questions and checklists. This combination allows you to create a unique and personal Ecard that maximizes your chances of being understood.

But there’s more. Completing the checklists takes you on a journey of self-discovery. That means that even if you never send an ECard, you’ll bene t from the process.

Although many of the choices you’re given on the checklists won’t apply to your situation, some of them will. And those will cause an unmistakable shift in your body that says: “Yes! That’s it!” That’s the feeling we get each time we find words or phrases that match our experience.

Here are the 10 cards:

  1. Ouch!
  1. Sorry.
  1. Thanks.
  1. Can I be honest?
  1. Talk to me!
  1. Please listen!
  1. I have a request.
  1. I’m loving you.
  1. Can you help?
  1. Want me to appreciate you more?
  1. . Here’s how they work.


  1. Pick whichever card fits the situation.
  1. Fill in the blanks and choose from the checklists on the card.
  1. Preview the card and edit it as much or as little as you wish.
  1. Add an optional photo.
  1. Hit Send.


  1. You receive an email with a private link to view your card.
  1. You feel a lot better.

What makes Express Yourself ECards special?

• They’re not generic. Every card you send will be unique.

• They go deep.

• They are fully editable. You can add, delete, or change anything before sending.

• They increase self-awareness and self-confidence.

• They increase emotional uency.

• They make it easy to talk about difficult topics.

Who can benefit from using them?

  • Couples and anyone in a relationship.
  • Parents and kids.
  • Engineers and computer nerds.
  • Speech therapists and occupational therapists.
  • Psychotherapists, school counselors, and teachers.

Will the app work for someone on the autism spectrum?

Although it wasn’t designed specifically for this purpose, the Express Yourself ECards app has proven to be an amazing communication tool for high-functioning adolescents and adults on the autism spectrum. For those who have trouble reading or writing, checklists can be read aloud and completed by a parent, teacher, or friend.

About Betsy Sansby, MS, LMFT, creator of Express Yourself E-Cards

Betsy is a marriage and family therapist with over 30 years experience teaching couples and families how to communicate better. The app worked so well with her clients, she decided to make it available to everyone.

203-612-5222 (tel) • Email: Info@GreatApps.com

GreatApps.com is a media company that focuses on app marketing and consumer use of apps.

Meditation makes my anxiety worse

Does meditation only make your anxiety worse?

For clients with anxiety or in the midst of a depressive episode, there is no “bloom of the present moment,” a phrase coined by Jon Kabat Zinn, who developed the 8-week program called Mindfulness-Based Stress Reduction Program. There is only relentless spinning, merciless dread, or feeling like you want to rip your skin off.

If sitting meditation only makes you want to jump out of your skin, you’re better off starting with another practice that reduces anxiety, but doesn’t require isolation or complete stillness. I suggest developing a daily practice of some kind of moving meditation: yoga, tai chi, Qi gong, or even chanting. The idea for someone with anxiety is to get a break, to feel a sense of grace, flow, ease inside. All of the practices I just mentioned will help.

Don’t give up. Even the worst anxiety won’t kill you. There is one book I recommend to anyone suffering from depression or anxiety, “Hope and Help for Your Nerves,” by the late Dr. Claire Weeks. It has been a lifesaver for thousands and thousands of people. The link above will send you to Discover Books, which sells it for a lot less money than Amazon.

Deciphering a Dying Man’s Wishes

So sorry your boyfriend is dying and that you’re having to struggle with this issue at such a vulnerable time for both of you.

I think it’s important to know why your boyfriend is asking you to leave. It could mean any number of things, and it would be good to know what his reasons are before you decide a course of action.

For example:

  • It could be that seeing you suffer is too painful for him. If that’s the case, your presence may be adding to his own suffering, since he can’t relieve you of it. He might be able to spend time with you if your were sharing your grief and pain elsewhere—like with a friend or counselor. That way, when you were with your boyfriend, he might experience you as a support, instead of an amplifier of his own suffering.
  • It could be that he feels embarrassed having you see him in a weakened state. if he is getting weaker or losing the full functioning of all his faculties. It’s hard to see yourself being whittle away by disease or pain, much less having someone you love witness this diminishment.
  • It could be that he feels guilty for leaving you, so he’s concerned about you ‘wasting your time’ on him when you could be looking for someone who isn’t dying.
  • It could be that the way you’re trying to support him isn’t the way he wants to feel supported. I think it’s worth asking him if there is some way you could be with him that would actually be a comfort. You can assume he’s going through his own internal ‘night of the soul,’ so without asking, it’s impossible to know what’s behind his request, and if anything you could offer might be helpful.
  • It could be that he has other reasons for wanting you to leave. And he may not be able to articulate or be unwilling to talk about them.

Whatever his reasons, it sounds like you could used some grief counseling to prepare yourself for the inevitable, and to work though whatever issues are coming up for you through all this. Remember that you both matter. You both have needs right now that you may not be able to satisfy.

I recommend that you get more information from your boyfriend so you are clear why he’s insisting you move on right now, instead of letting you be with him through all this. In the event that he won’t or can’t explain, I would honor his wishes.

Dying is taking away your boyfriend’s liberty, his freedom, his vitality, his future, his choices, his sense of control. By honoring his wishes you are showing him you respect his right to choose how, and in whose presence he spends his final months, weeks, days, and moments.

Ask Betsy: How do we ever get over the loss of someone we care about

I’m not sure we ever get over the loss of someone who was special to us. We just stumble forward as best we can, hoping that the pain of their memory and loss of our time with them will soften over time. What has surprised me most about the losses in my life is that the loss of my black lab 25 years ago is the loss I feel most often. Alice was playful, happy, not-too-bright, but always loving, even when I left her home alone for long periods of time, or was too busy to play with her. 

I think in the end, time is the best healer. Time, and also finding a place in your heart to hold your fond memories of those you’ve lost. When I accidentally broke the hydraulic mechanism on one of my brother’s kitchen stools, he said “You HAD do do it! You coudn’t leave well enough alone, could you?” 

We both cracked up. I knew he didn’t care about the chair. He was making a joke out of it by channeling our deadmother’s voice. He did a flawless impression of her kind of response to an accident or dumb mistake. In that moment, I loved my brother and we both remembered our dead mother for the crazy shit she used to say to us. 

The picture above is me with my dad, his beloved Mini, and wife, Marcia. I miss the crazy shit he used to do, too!

Ask Betsy: How do I keep my depression from recurring

The greatest fear for most people who have suffered through and survived a long depressive illness is that it will recur.

And recurrences are common, especially if you have had 3 or more episodes.The reason is simple. Depressive symptoms are never completely forgotten. And because depression tends to last for weeks, months, or years, the symptoms of the illness become deeply-grooved and easily triggered ways of being.

Think about anything you do over and over. The more you repeat anything, the better you get at doing it. And whatever we get good at becomes easier to do the next time. And in the case of depression, once your brain has “practiced” being depressed for long enough, it takes less and less to trigger another depressive episode.

For example, my first episode of depression began with a series of migraines that made it impossible for me to sleep, feel emotionally-fragile and exhausted, and caused a dark mood that worsened as evening approached in anticipation of yet another sleepless night. The longer these symptoms lasted—which began in the winter, and during perimenopause (a hormonally-difficult time for many women)—the worse I felt. Within weeks, I was sure i had at least a brain tumor, and might also be suffering from some extreme gastrointestinal condition.

As far as I knew at the time, I wasn’t depressed. I was physically ill. I felt—and still feel when I get a rash of migraines—like I had a full-body flu. But after getting checked up one side and down the other, I got a diagnosis of clinical depression, which turned out to be exactly what was causing my symptoms. My first episode was brought on by a perfect storm: perimenopause (with its attendant hormonal instability), migraines (with all of its dirty rotten symptoms), and an exhausting period of care taking for a dying grandmother (which took a terrible toll on me emotionally and physically).

I eventually dug my way out of this episode, but it took two years of medication trials, steadfast support from friends and family, and a lot of physical and mental health therapy. Because I wasn’t just depressed, but had almost crippling anxiety, I was exhausted, but also wired. This meant that I was compelled to keep moving, to do everything I could to get better. I did yoga and tai chi. I walked twice a day. I forced myself to drink protein shakes so I wouldn’t lose more and more weight (which happened anyway), and I worked with my medical team to find a medication regimen I could tolerate.

My advice to you now—while you’re well—is to develop a plan to increase your mental and physical resilience, and weaken the neurological bonds that have been created to make depression easier to fall into. There are two programs designed to help you do this. One is called MBCT, which stands for Mindfulness-based Cognitive Therapy, which is an 8-week program that consists of 8, 2 hr. classes in yoga, meditation, and cognitive therapy designed to prevent depression relapse. The other is almost the same. It’s called MBSR—which stands for Mindfulness-based Stress Reduction—and it is virtually identical to the MBCT program, only without the cognitive therapy aspect. The link to this second program (actually created by Jon Kabat-Zinn as the first program like this) offers you a chance to take MBSR for free.

As one therapist who was diagnosed with a brain tumor once wrote: “Do it now! You don’t learn to meditate after you’re diagnosed with a brain turmor.”

The MBCT program has been scientifically-proven to reduce depression relapse by 50% in people who have suffered 3 or more episodes of clinical depression. No other treatment I know of (and I’m a highly-motivated therapist and fellow sufferer) gets the kind of results this program gets. It doesn’t require that you stop taking your meds—which I do NOT recommend you do either—but it does require daily practices that strengthen your mind and body’s abilities to maintain stability under fire. This means that even though your body will remember traumatic events, people, situations, seasons that have triggered dark episodes, you will be in a stronger place mentally and physically to challenge and replace depressive habits of thinking and reacting so that slight triggers do not cause you to slide back into the dark rabbit hole of depression.

I will warn you, though, the tools you learn in the 8-week course require daily practice, and that practice needs to continue between episodes, otherwise, you won’t be able to call on them when you need them. What you’re trying to do is weaken your tendency to slide into despair with the least provocation/memory of a depressive episode, and strengthen your ability to quickly catch a slip before it gathers steam and turns into a slide.

I also strongly recommend; that you NOT play games with medications that are working. I have on countless occasions decided that I no longer need the medications I’ve been on. This is especially true when I’ve been depression-free for years. And each time I have done this, I have eventually crashed. Don’t do it. The medications that work for you are helping. In fact, both cardiologists and neuroscientists will tell you that the worse thing for the heart and brain is untreated depression. There is evidence that the SSRIs (the most commonly-prescribed antidepressants) have been found to promote the growth of new neurons in the brain (neurogenesis), which is a great thing, especially since untreated depression can cause neurons in the brain to die, causing a shrinking of structures in the brain that regulate emotions and deal with stress.

I have just created a Facebook page called @counselorsgetit. It’s about supporting other therapists and professionals to remove the stigma surrounding mental illness by sharing out own experiences with it. This blog is my attempt to be a part of the solution. If you need help, ask for it. If you’ve made it through another nasty episode, now is the time to develop these skills.

Tricky Tuesday: How to communicate with someone who refuses to talk to you 

Today’s Tricky Tuesday is about breaking through the silence when someone you care about is unwilling or unable to talk to you.

First off, you must understand the distinction between those two states–Unwilling or unable. While the two may exist at the same time, they don’t necessarily.

You must understand the distinction between these two states—unwilling or unable. While the two may exist at the same time, they don’t necessarily.

Unwilling can mean many things:

  • I’m hiding something.
  • I’m afraid of your reaction.
  • I’m ashamed of something I did.
  • I’m stalling for time to come up with an alibi or excuse.
  • I’m showing you how it feels to be shut out.
  • I’m trying to guilt you into doing something you forgot to do, or don’t want to do.
  • I want you to suffer.
  • I’m trying to make you think I know more than I do about something you did (so you’ll confess).
  • I’m actually protecting you by not saying what I’d like to say right now.
  • I need to focus on another task or issue that can’t wait.
  • I refuse to talk about this with others present.
  • I don’t feel safe or equipped to talk about this topic, except in therapy.

Unable can mean something very different:

  • I’m over-stimulated right now and my brain isn’t working well enough to talk.
  • I’m not sure what I’m feeling because my body is flooded with multiple feelings at once.
  • I can’t find the right words.
  • I need more time to process what I’m feeling.
  • I can’t be pressured into talking.
  • I’m too tired.
  • I need to better-rested before we have this conversation.
  • You always interrupt me or tell me what I should be thinking or doing, so I can’t get my thoughts out.

The situation

Ben and Joel have adopted a child. Initially, they were thrilled, but for the past few days, something hasn’t felt right.  Ben came home from work Friday, agitated. He barely acknowledged Joel or the baby the entire weekend.

Before the baby came, the couple had agreed: Ben would keep working as a teacher, and Joel would take unpaid leave from work to stay home with their new baby. Then, once school was out, Ben would take over for the summer and Joel would go back to work.


The silence was deafening.  Joel knew something was wrong, but Ben refused to talk and insisted everything was fine. The truth was, Ben had lost his temper with a student who made an offensive joke about gays.  Witnesses saw Ben chase the boy down the hall and shove him against a locker.  Ben was fired.

There is nothing unusual about this kind of problem. When shame takes over, it becomes painful–if not impossible—to speak about it.

The Talk to Me, Already!  card was designed to give the person who’s feeling shut out a way to connect with the person unwilling or unable to speak. It allows the Sender to express their hurt, anger, suspicions, or fears from a distance when the person in the room is unreceptive. Below is an example of screenshots I took an Express Yourself ECard Joel might have written to Ben. The remaining checklists (not visible on the first screenshot) give Joel a chance to express both his hurt and his love for Ben, as well as his desire to know the truth so he can be part of whatever solutionthey need to come up with as a couple.