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Codependency is often referred to as “relationship addiction.” It’s an emotional and behavioral condition that interferes with an individual’s ability to develop a healthy, mutually satisfying relationship. It can be frustrating and destructive, but there are things that you can do to learn how to stop being codependent. To start, you should:

• Look for signs of a healthy relationship
• Maintain healthy boundaries
• Care for yourself
• Get help from a mental health professional

The term codependency was first used to describe the partner of someone with an addiction—whose unhealthy choices enable or encourage the addiction to continue. But over the years, it’s been expanded to include individuals who maintain one-sided, emotionally destructive, or abusive relationships, and those relationships don’t necessarily have to be romantic.

Signs of Codependency

Individuals who are codependent have good intentions. They want to care for a family member who is struggling. But their efforts become compulsive and unhealthy. Some signs of codependency include:

• A desire to “be needed.” Their attempts to rescue, save, and support their loved one allows the other individual to become even more dependent on them. The act of giving often gives a codependent individual a sense of satisfaction as long as they gain recognition.
• They might feel trapped and grow resentful. Their choices often backfire, and they may feel helpless yet unable to break away from the relationship or change their interactions.
• The relationship tends to deteriorate over time. It’s often riddled with anxiety, frustration, and pity, rather than love and comfort.

For some individuals, codependent relationships become commonplace. They seek out friendships or romantic relationships where they are encouraged to act like martyrs.

Consequently, they devote all their time to caring for others and completely lose sight of what’s important to them.

Examples of Codependency

Here are some examples of what a codependent relationship might look like:

In parent-child relationships it can involve:

• Doing everything for an adult child who should be independent
• Getting a sense of meaning or purpose from financially supporting an adult child
• Never allowing a child do to anything independently
• Dropping everything to care for a parent
• Neglecting other responsibilities and relationships to respond to parents’ demands
• Never talking about problems in family relationships or behaviors

In romantic relationships it can involve:

• Investing a lot of energy and time into caring for a partner with an alcohol or substance abuse problem
• Making excuses or covering for the other person’s bad behavior
• Neglecting self-care, work, or other relationships to care for your partner
• Enabling a partner’s destructive or unhealthy behavior
• Not allowing your partner to take responsibility for their own lives
• Not allowing your partner to maintain their independence

Why It Happens

Codependency occurs in dysfunctional families where members often experience anger, pain, fear, or shame that is denied or ignored. Underlying issues that contribute to the dysfunction may involve:

• Addiction to drugs, alcohol, work, food, sex, gambling, relationships
• Abuse (physical, emotional, or sexual)
• Chronic physical illness or mental illness

Problems within the family are never confronted. Codependent individuals don’t bring up the fact that issues exist. Family members repress their emotions and disregard their own needs in an effort to care for the individual who is struggling.

All of the attention and energy goes toward the individual who is abusive, ill, or addicted. The codependent individual usually sacrifices all of their own needs to care for the family member who is struggling. They usually experience social, emotional, and physical consequences as they disregard their own health, welfare, and safety.

Risk Factors and Characteristics

While anyone might find themselves in a codependent relationship, there are certain factors that increase the risk. Researchers have identified several factors that are often linked with codependency:

• Lack of trust in self or others
• Fear of being alone or abandoned
• A need to control other people
• Chronic anger
• Frequent lying
• Poor communication skills
• Trouble making decisions
• Problems with intimacy
• Difficulty establishing boundaries
• Trouble adjusting to change
• An extreme need for approval and recognition
• A tendency to become hurt when others don’t recognize their efforts
• An inclination to do more than their share all the time
• A tendency to confuse love and pity
• An exaggerated sense of responsibility for the actions of others

Individuals in the helping professions are also more likely to be in codependent relationships. It’s estimated that one-third of nurses have moderate to severe levels of codependency. Nurses need to be sensitive to the needs of others and often need to set aside their own feelings for the good of their patients. They may also find validation in their ability to care for others, and that need may spill over into their personal lives.

Identifying Codependent Relationships

While codependency isn’t something that shows up in a lab test or a brain scan, there are some questions that you can ask yourself to help spot codependent behavior.

• Do you feel compelled to help other people?
• Do you try to control events and how other people should behave?
• Are you afraid to let other people be who they are and allow events to happen naturally?
• Do you feel ashamed of who you are?
• Do you try to control events and people through helplessness, guilt, coercion, threats, advice-giving, manipulation, or domination?
• Do you have a hard time asking others for help?
• Do you feel compelled or forced to help people solve their problems (i.e., offering advice)?
• Do you often hide what you are really feeling?
• Do you avoid openly talking about problems?
• Do you push painful thoughts and feelings out of your awareness?
• Do you blame yourself and put yourself down?

If you answer yes to many of these questions, it may be a sign of codependent behavior patterns in your relationships. Identifying these patterns is an important step in learning how to stop being codependent.

How to Stop Being Codependent

Some individuals are able to overcome codependency on their own. Learning about what it means to be codependent and the harm it causes can be enough for some individuals to change their behavior. Some steps you can take to overcome codependence include:

• Look for signs of a healthy relationship. In order to break out of codependent patterns, you need to first understand what a healthy, loving relationship looks like. Signs of a healthy relationship include making time for each other, maintaining independence, being honest and open, showing affection, and having equality.
• Having healthy boundaries. People with good relationships are supportive of each other, but they also respect each other’s boundaries. A boundary is a limit that establishes what you are willing and unwilling to accept in a relationship. Spend some time thinking about what is acceptable to you. Work on listening to the other person, but don’t allow their problems to consume your life. Practice finding ways to decline requests that step over your boundaries. Set limits, then work on enforcing them.
• Take care of yourself. People who are in codependent relationships often have low self-esteem. In order to stop being codependent, you need to start by valuing yourself. Learn more about the things that make you happy and the kind of life that you want to live. Spend time doing the things that you love to do. Work on overcoming negative self-talk and replace self-defeating thoughts with more positive, realistic ones. Also be sure that you are taking care of your health by getting the food, rest, and self-care that you need for your emotional well-being.

Getting Help

Codependency often requires professional treatment, however. It can be treated with talk therapy. Research shows that several different types of therapy treatments can be effective in improving the quality of one’s life and learning how to stop being codependent.

Group Therapy

There are several different group interventions that may be effective for codependency. The group dynamic gives individuals an opportunity to form healthier relationships in an appropriate space. Group therapy often involves giving positive feedback and holding individuals accountable.

Group therapy methods may vary. Some involve cognitive behavioral therapy, where members learn specific skill-building strategies.

Other codependency groups follow the 12-step model. Similar to the way other 12-step groups are run, individuals learn about their relationship addiction. Goals may include increasing self-awareness, self-esteem, and the expression of feelings.

Family Therapy

Family therapy targets the dysfunctional family dynamics. Family members learn how to recognize their dysfunctional patterns so they can learn how to improve their relationships.

Improved communication is often a key goal of family therapy. Issues that have never before been discussed in the family may be raised in therapy. Sometimes, one individual creates a change (such as getting sober or encouraging someone to be more independent) and it can change the entire family dynamic.

Cognitive Therapy

Cognitive therapy can target the thoughts that contribute to unhealthy relationship patterns. For example, an individual who thinks, “I can’t stand being alone,” is likely to go to great lengths to maintain the relationship, even when it’s not healthy to do so. Therapy sessions might focus on learning how to tolerate uncomfortable emotions and changing irrational thoughts.

The goal is likely to create positive behavior changes and allow the other individual to accept more personal responsibility for their own actions.

Treatment may delve into a person’s childhood, since most codependent individuals are patterning their relationships after ones they grew up seeing. Therapy may assist someone in getting in touch with their emotions and helping them experience a wide range of feelings again.

Next Steps

If you suspect you are codependent in your relationship and you’re struggling to create positive change, seek professional help. You might start by talking to your doctor or you can reach out to a mental health professional directly about how to stop being codependent.

If you aren’t comfortable speaking to a therapist in person or you are hesitant to attend a group, consider online therapy. You can speak to a therapist from the privacy of your own home from one of your electronic devices via video, live chat, or messaging.

Hippopotomonstrosesquipedaliophobia is the fear of long words. The exact triggers are highly personalized; for example, some people fear long, multisyllabic words, and others, long, obscure words. Some even fear common words of moderate length.

Specific phobias like hippopotomonstrosesquipedaliophobia affect between 3% and 15% of the population. Their relative rarity, however, does not change how devastating they can be for those who have them.

Symptoms of Hippopotomonstrosesquipedaliophobia

Although some phobias lead to physical symptoms such as shaking, freezing in place, or sweating, symptoms of the fear of long words can be more subtle.

You might mentally lock up when confronted with particularly long words. Or, you might limit your speaking and writing, brushing off textbooks and scholarly works by saying “that author is too pretentious” or “I never did have a head for science.”

Children with hippopotomonstrosesquipedaliophobia might develop school-related phobias or lose interest in their academics. Other possible symptoms associated with a specific phobia such as the phobia of long words include:

• A feeling of imminent danger or a need to escape
• Heart palpitations, sweating, or trembling
• Shortness of breath or choking sensation
• Chest pain
• Abdominal discomfort or nausea
• Lightheadedness or dizziness
• A feeling of “going crazy”
• Tingling, chills, or a heat flush

Diagnosis of Hippopotomonstrosesquipedaliophobia

Hippopotomonstrosesquipedaliophobia is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), but a mental health professional might consider the criteria for a specific phobia when evaluating for a diagnosis of the fear of long words.

This criterion includes having a pronounced fear or anxiety around the phobia which, in this case, is long words. This fear or anxiety also:

• Often happens immediately upon encountering it
• Is out of proportion with how dangerous it actually is
• Causes the person to avoid it
• Lasts for six months or more

The fear of long words may be related to other fears of reading or writing. For example, bibliophobia (the fear of books) could be aggravated or caused by the fear of long words. Mythophobia (the fear of legends) also could be caused by the fear of lengthy, unfamiliar passages, particularly in older legends.

Another potentially related fear is metrophobia or the fear of poetry. By its nature, poetry often contains unfamiliar words and unusual phrasing that can strike fear in those predisposed to discomfort with long words.

Logophobia is the fear of words altogether. This might encompass only words with particular sounds, suffixes, prefixes, etc. or words at large.

Causes of Hippopotomonstrosesquipedaliophobia

Anxiety disorders are thought to be caused, in part, by environmental factors such as experiencing a traumatic event. In terms of hippopotomonstrosesquipedaliophobia, a person may have experienced a traumatic event tied to a long word.

Research suggests that genetics may play a role as well. It’s not uncommon for patients with a phobic disorder to also have a family history of these types of conditions.

The DSM-5 adds that people with specific tempers, like behavioral inhibition, may be more at risk of developing a specific phobia. However, more research is needed to determine the risk factors for developing a phobia of a specific object, such as a long word.

Impact of Hippopotomonstrosesquipedaliophobia

Like all phobias, the fear of long words can have a very real impact on a person’s daily functioning and quality of life. A college professor who is constantly exposed to lengthy words might have serious difficulties at work, for instance.

In the classroom, a young person with a fear of long words may experience anxiety that potentially leads to the development of a social phobia or feelings of isolation and depression. As they head toward adulthood, they may even choose a career path that provides less exposure to lengthy words, cutting their list of opportunities short.

Treatment for Hippopotomonstrosesquipedaliophobia

If you are diagnosed with a phobia, there is treatment available to help manage your symptoms. Treating a specific phobia such as hippopotomonstrosesquipedaliophobia may involve medication, psychotherapy, or both.

Medication

The most commonly prescribed medication for anxiety disorders are antidepressants such as selective serotonin reuptake inhibitors (SSRIs). Benzodiazepines, such as Xanax (alprazolam), may be prescribed as well.

Psychotherapy

Cognitive behavioral therapy (CBT) and exposure therapy are two types of psychotherapy that may be used to help treat the fear of long words. CBT helps identify and change negative thought patterns while exposure therapy is a type of behavioral therapy that involves facing your fears.

Coping With Hippopotomonstrosesquipedaliophobia

If your phobia of long words is mild and doesn’t significantly impact your life, making a conscious effort to expand your vocabulary can help. Look for opportunities to learn new words through reading or everyday conversation.

Additionally, if you come across an unfamiliar word, look it up. Developing a level of familiarity with the word may help ease your symptoms of anxiety.

If your symptoms are more serious and impacting your daily life, professional assistance may be needed. A mental health professional can help you work through your fears and provide more coping strategies for managing your symptoms during the treatment process.

Have you ever wondered what separates good athletes from elite ones? Or have you ever wanted to improve your own athletic performance? Sure, physical fitness and skill are important, but what’s going on in your head often determines how well you perform. That’s where sports psychology comes in.

Sports psychology (also often referred to as sport psychology) focuses on the psychological variables that influence physical activity and performance. Things like anxiety, focus, motivation, visualization, stress, and resilience can all affect how well people do during exercise, physical activity, or athletic competition.

Who Is Sport Psychology For?

Sports psychology is for elite athletes, weekend warriors, and anyone who wants to move their body more effectively. The field is often associated with professionals who help Olympic and professional athletes win in highly competitive settings, but that’s not all they do.

The tactics they use to help elite performers excel can also be utilized in recreational settings to help people enjoy sports, handle anxiety, and build motivation. Techniques like progressive muscle relaxation, hypnosis, and CBT can improve relaxation and concentration.

Understanding Sports Psychology

Sports psychology studies how psychological factors influence sports, athletic performance, exercise, and physical activity. Sports psychologists investigate how participating in sports can improve health and well-being. They also help athletes utilize psychology to improve their athletic performance and mental wellness.

For example, sports psychologists worked with elite basketball pros like Michael Jordan, Shaquille O’Neal, and Kobe Bryant to help them perform better on the basketball court. By teaching them psychological techniques for “being in the flow” and getting in “the zone,” they were able to hone their focus and athletic resilience.

A sports psychologist doesn’t just work with elite and professional athletes either. This type of professional also helps non-athletes and everyday exercisers learn how to enjoy sports and stick to an exercise program.

History of Sports Psychology

Sports psychology is a relatively young discipline in psychology; the first research lab devoted to the topic opened in 1925. The first U.S. lab closed a short while later (in the early 1930s) and American research did not resume in this area until the late 1960s when there was a revival of interest.

In 1965, the International Society of Sport Psychology (ISSP) was established. By the 1970s, sports psychology had been introduced as a university course offered at educational institutions throughout North America.

By the 1980s, sports psychology became the subject of a more rigorous scientific focus. Researchers began to explore how psychology could be used to improve athletic performance. They also looked at how exercise could be utilized to improve mood and lower stress levels.

Different Types of Sports Psychologists

Just as there are different types of psychologists—such as clinical psychologists, developmental psychologists, and forensic psychologists—there are also different types of sports psychologists.

Educational Sports Psychologists

An educational sports psychologist uses psychological methods to help athletes improve sports performance. This includes teaching them how to use certain techniques such as imagery, goal setting, or self talk to perform better on the court or field.

Clinical Sports Psychologists

Clinical sports psychologists work with athletes who have mental health conditions such as depression or anxiety. This work involves using strategies from both sports psychology and psychotherapy.

Exercise Psychologists

An exercise psychologist works with non-athlete clients or everyday exercisers to help them learn how to make working out a habit. This work can include some of the same techniques used by other sports psychologists, such as goal setting, practicing mindfulness, and the use of motivational techniques.

Uses for Sports Psychology

Contemporary sports psychology is a diverse field and there are a number of different topics that are of special interest to sports psychologists. Here are a few areas of sports psychology and how they are utilized.

Attentional Focus

Attentional focus involves the ability to tune out distractions (such as a crowd of screaming fans) and focus on the task at hand. This allows athletes to manage their mental focus, even in the face of other things that are vying for their attention.

Common strategies that might be used for this purpose include deep breathing, paying attention to bodily signals and sensations, and mindfulness. All of these can help athletes stay focused on the present moment.

Mental Toughness

Mental toughness has become an area of increasing interest in sports psychology. The term refers to the psychological characteristics that are important for an athlete to reach optimal performance.

Among these characteristics are having an unshakeable belief in one’s self, the ability to bounce back from setbacks, and an insatiable desire to succeed. Reacting to situations positively, remaining calm under pressure, and retaining control are a few others that contribute to mental toughness.

Visualization and Goal-Setting

Setting a goal, then visualizing each step needed to reach that goal can help mentally prepare the athlete for training or competition. Visualization involves creating a mental image of what you “intend” to happen. Athletes can use this skill to envision the outcome they are pursuing. They might visualize themselves winning an event, for instance, or going through the steps needed to complete a difficult movement.

Motivation and Team-Building

Some sports psychologists work with professional athletes and coaches to improve performance by increasing motivation. A major subject in sports psychology, the study of motivation looks at both extrinsic and intrinsic motivators.

Team building is also an important topic in this field. Sports psychologists might work with coaches and athletes to help develop a sense of comradery and assist them in working together efficiently and effectively.

Anxiety

Professional sports psychologists help athletes cope with the intense pressure that comes from competition. This often involves finding ways to reduce performance anxiety and combat burnout.

It is common for athletes to get nervous before a game, performance, or competition. But these nerves can have a negative impact on performance. So, learning tactics to stay calm is important for helping athletes perform their best.

Burnout can also happen to athletes who frequently experience pressure, anxiety, and intense practice schedules. Helping athletes restore their sense of balance, learn to relax, and keep up their motivation can help when they are starting to become burnt out.

Rehabilitation

Another important focus of sports psychology is on helping athletes recover and return to their sport after an injury. A sports injury can lead to emotional reactions in addition to physical injury, which can include feelings of anger, frustration, hopelessness, and fear.

How Effective Is Sports Psychology?

Research indicates that using various sports psychology techniques can help improve the performance of all types of athletes, from very young gymnasts (aged 8 to 13) to some of the top Olympians.

For example, one study noted that doctors commonly have negative reactions when treating acutely unwell patients. Yet, when doctors used the same psychological routines as athletes, they were able to better control these reactions. It also improved their patient care.

Others suggest that sports psychologists can play an important role in reducing obesity, particularly in children. By helping kids increase their physical activity and their enjoyment of the activity, a sports psychologist can help kids achieve and maintain a healthy weight.

Sports Psychology Techniques That Improve Performance

So, what psychological techniques do sports psychologists use to improve performance and motivation? Some professionals use one specific technique when helping their clients, while others use a wide range of sports psychology techniques.

Progressive Relaxation

Relaxation techniques offer athletes many benefits. Among them are an increase in self-confidence, better concentration, and lower levels of anxiety and stress—all of which work together to improve performance.

One of the relaxation strategies sports psychologists use with their clients is progressive muscle relaxation. This technique involves having them tense a group of muscles, hold them tense for a few seconds, then allow them to relax.

Hypnosis

Some health professionals use hypnosis to help their patients quit smoking. A sports psychologist might use this same technique to help their clients perform better in their sport of choice.

Research indicates that hypnosis (which involves putting someone in a state of focused attention with increased suggestibility) can be used to improve performance for athletes participating in a variety of sports, from basketball to golf to soccer.

Biofeedback

Biofeedback involves using feedback provided by the body to notice how it feels physiologically in times of stress (elevated heart rate, tense muscles, etc.). This information can then be used to help control these effects, providing a more positive biological response.

Cognitive Behavioral Therapy

Cognitive behavioral therapy (CBT) is used to help all kinds of people identify and change destructive thoughts and behaviors. Therefore, it would only stand to reason that athletes would also benefit from its effects.

One case study involving a 17-year-old female cross-country skier noted that CBT helped reduce performance anxiety while improving sport-specific behaviors. Another piece of research involved 16 NCAA Division I athletes with severe injuries and found that CBT enhanced their emotional well-being during recovery.

Becoming a Sports Psychologist

Becoming a sports psychologist could be exciting for many psychology students, and it may be a good career choice for those with a strong interest in sports and physical activity.

According to the American Psychological Association, most sports psychologists have a master’s or doctorate degree in clinical, counseling, or sports psychology. In addition to these requirements, they generally need additional coursework in subjects such as kinesiology, sports medicine, physiology, marketing, and business.

Some professionals also choose to specialize in:

• Applied sports psychology: This involves directly teaching people skills to improve their performance
• Academic sports psychology: This involves conducting research on sports psychology and teaching university courses
• Clinical sports psychology: This combines sports psychology with psychotherapy to help people who are dealing with mental health problems

If you are interested in this career, start by learning more about the educational requirements, job duties, salaries, and other considerations about careers in sports psychology.

Antidepressants can be an effective treatment for depression, but they can also have side effects. People who use medications like antidepressants may potentially become constipated. This side effect can be uncomfortable, but there are strategies you can try to find relief.

Learn more about why this side effect happens, what to watch for, and what you can do to relieve this side effect.

Why Antidepressants Can Cause Constipation

Constipation is a common side effect of tricyclic antidepressants such as Elavil (amitriptyline) and Norpramin (desipramine). In addition to treating depression, tricyclic antidepressants may also be prescribed to treat anxiety or insomnia.  

Tricyclic antidepressants block the action of the neurotransmitter acetylcholine. When this neurotransmitter is blocked, the muscular contractions which propel waste matter through the digestive tract are slowed, and the intestinal secretions which lubricate the passage of feces are drier, causing constipation. 

Because of their gastrointestinal effects, tricyclic antidepressants are sometimes prescribed to help slow activity in the digestive tract. For example, they might be prescribed to help treat conditions such as diarrhea and irritable bowel syndrome (IBS).

Other Possible Causes of Constipation

Many different factors can contribute to constipation. It can be a side effect of medications such as antidepressants, but it can also be caused by pregnancy, lifestyle choices, and certain medical conditions. Some causes that might lead to constipation include:

Lifestyle Factors

• Low fiber diet
• Dehydration
• Lack of exercise
• Changes in daily routine
• Consuming certain foods such as cheese or milk
• Stress

Medical Conditions

• Diabetes
• Diverticular disease
• Hypothyroidism
• Intestinal obstruction
• Irritable bowel syndrome
• Pregnancy

Medications

• Allergy medications
• Antacids
• Blood pressure medications
• Ibruprofen
• Iron supplements
• Pain medications

Constipation Symptoms

When a person has constipation, this means that their bowel movements have become more difficult and/or less frequent than what is normal. This can then lead to unpleasant symptoms such as:

• Dry, hard stools
• Feeling bloated
• Feeling like they didn’t completely empty their bowel
• Less frequent bowel movements
• Nausea
• Small or hard stools
• Straining during bowel movements
• Stomach ache and cramps
• Swollen or painful abdomen
• Vomiting

Although what is considered normal varies, most people will have a bowel movement between three times a day to once or twice a week. If the time between bowel movements begins to stretch longer, however, then it can become very uncomfortable when they finally do occur.

Relieving Constipation 

If you are experiencing symptoms of constipation caused by an antidepressant, some self-care strategies can help you find relief:

• Consume prunes or bran cereal
• Drink plenty of water and avoid alcohol and caffeinated beverages, which can contribute to dehydration
• Eat high-fiber foods, such as fruits, vegetables, and whole grains
• Get regular exercise
• Limit your daily intake of fatty foods, including cheese, eggs, and meat
• Take fiber supplements
• Use stool softeners or laxatives if other steps to relieve constipation have failed

When to Talk to Your Doctor

If you are experiencing symptoms of constipation and self-care has not provided sufficient relief, talk to your doctor about what you are experiencing. They can assess your condition and help recommend treatments and remedies that can help.

• While your symptoms may have begun after you started an antidepressant, your doctor may still want to rule out other possible causes. They will ask questions about your symptoms, take a medical history, and discuss your lifestyle habits, including information about diet and exercise.
• They may also order lab tests, imaging tests, or a colonoscopy to help rule out medical conditions contributing to your constipation symptoms. 
• Your doctor might recommend specific lifestyle changes such as consuming more dietary fiber and drinking more water.
• They may also suggest over-the-counter remedies that can provide relief. If your constipation is severe or if other methods have not worked, they might opt to prescribe a medication to treat constipation.

If side effects are disruptive or distressing, your doctor may also consider changing the dosage of your medication or switching to a different type of antidepressant.

Potential Complications

Constipation can cause other problems, including:

• Hemorrhoids: Swollen, inflamed veins
• Anal fissures: Tears in the lining of the anus
• Diverticulitis: Infection in the colon wall
• Incontinence: Inability to control bladder muscles due to damage to the pelvic floor muscles

Signs of Fecal Impaction

Fecal impaction can occur with long-term constipation and can potentially have some very serious complications, including tearing of the rectum or colon. If a person is experiencing fecal impaction after having long-term constipation, they may begin to have the following additional symptoms:

• Bladder pressure or loss of bladder control
• Fast heartbeat or dizziness when straining to pass stool
• Leakage of liquid stools or sudden watery diarrhea
• Lower back pain
• Rectal bleeding
• Significant cramping or bloating

If you have already become impacted, your doctor will take steps to remove the impacted stool. This may be done by using warm mineral oil enemas to soften and lubricate the stool, manually removing the impaction, or using laxatives. Very rarely, surgery may necessary to remove an impaction.

Mindfulness-based cognitive therapy (MBCT) is a type of psychotherapy that involves a combination of cognitive behavioral therapy (CBT), meditation, and the cultivation of a present-oriented, non-judgmental attitude called “mindfulness.”​

MBCT was developed by therapists Zindel Segal, Mark Williams, and John Teasdale, who sought to build upon cognitive therapy. They felt that by integrating cognitive therapy with a program developed in 1979 by Jon Kabat-Zinn called mindfulness-based stress reduction (MBSR), therapy could be more effective.

This article discusses the techniques, uses, and benefits of mindfulness-based cognitive therapy. It also covers the efficacy of this approach and other things to consider before you try a CBT mindfulness approach.

Techniques in Mindfulness-Based Cognitive Therapy

Mindfulness-based cognitive therapy builds upon the principles of cognitive therapy by using techniques such as mindfulness meditation to teach people to consciously pay attention to their thoughts and feelings without placing any judgments upon them.

There are a number of mindfulness techniques and exercises that are utilized as a part of MBCT. Some of these include:

• Meditation: People may practice guided or self-directed meditation that helps them gain a greater awareness of their body, thoughts, and breathing. 
• Body scan exercise: This involves lying down and bringing awareness and attention to different areas of the body. People usually begin at their toes and move up through the body until they reach the top of the head. 
• Mindfulness practices: Mindfulness involves becoming more aware of the present moment. It’s something that can be practiced during meditation, but people can also incorporate these activities into the things they do every day.
• Mindfulness stretching: This activity involves stretching mindfully to help bring awareness to both the body and mind. 
• Yoga: MBCT may also encourage people to practice different yoga poses that can help facilitate mindful stretching of the body.

People might be taught what’s known as the “three-minute breathing space technique,” which focuses on three steps, each one minute in duration:

1. Observing your experience (How are you doing right now?)
2. Focusing on your breath
3. Attending to your body and physical sensations

What CBT Mindfulness Can Help With

Research suggests that mindfulness-based cognitive therapy can be effective in helping individuals who have experienced multiple episodes of depression. While it was originally developed to treat depression, it has also been shown to be effective for other uses including:

Benefits of Mindfulness-Based Cognitive Therapy

A primary assumption of cognitive therapy is that thoughts precede moods and that false self-beliefs lead to negative emotions such as depression. MBCT utilizes elements of cognitive therapy to help you recognize and reassess your patterns of negative thoughts and replace them with positive thoughts that more closely reflect reality.

This approach helps people review their thoughts without getting caught up in what could have been or might occur in the future. MBCT encourages clarity of thought and provides you with the tools needed to more easily let go of negative thoughts instead of letting them feed your depression.

Much like cognitive therapy, mindfulness-based cognitive therapy operates on the theory that if you have a history of depression and become distressed, you are likely to return to those automatic cognitive processes that triggered a depressive episode in the past.

The combination of mindfulness and cognitive therapy is what makes MBCT so effective. Mindfulness helps you observe and identify your feelings while cognitive therapy teaches you to interrupt automatic thought processes and work through feelings in a healthy way.

Effectiveness of CBT Mindfulness

The primary goal of MBCT is to help patients with chronic depression learn how to avoid relapses by not engaging in those automatic thought patterns that perpetuate and worsen depression. A study published in The Lancet found that mindfulness-based cognitive therapy helped prevent depression recurrence as effectively as maintenance antidepressant medication did.

Research also has shown that mindfulness-based cognitive therapy can reduce the severity of depressive symptoms as well as help reduce cravings for addictive substances. Research also suggests that MBCT can be safe and effective for treating people who are currently experiencing active depression.

Things to Consider

Research on the efficacy of mindfulness-based cognitive therapy for active or severe depression is still ongoing. It’s important to talk to your doctor about your symptoms to determine if this approach is right for you. 

It is important to note that while the class or group aspect of MBCT is important, much of the work is done outside of class. Participants are asked to do homework, which includes listening to recorded guided meditations and trying to cultivate mindfulness in their daily lives.

This may mean bringing mindfulness to day-to-day activities, like brushing your teeth, showering, washing the dishes, exercising, or making your bed, by applying CBT mindfulness skills such as:

• Doing what works rather than second-guessing yourself
• Focusing on the moment without distraction from other ideas or events
• Participating without being self-conscious
• Paying close attention to what is going on around you
• Taking a non-judgmental stance

How to Get Started

The mindfulness-based cognitive therapy program is a group intervention that lasts eight weeks. During those eight weeks, there is a weekly course, which lasts two hours, and one day-long class after the fifth week.

There is not necessarily an established network of teachers around the globe or a single directory in which you can find a program close to home. Talk to your doctor or consider searching an online therapist directory if you are interested in finding an MBCT therapist in your area.

Mindfulness has become increasingly popular for its ability to promote mental health, so even mental health professionals who are not specifically trained in MBCT may incorporate some aspects of CBT and mindfulness practices in their therapy sessions.

Solution-focused brief therapy (SFBT) is a strength-based approach to psychotherapy that focuses on solution-building rather than problem-solving. Unlike other forms of psychotherapy that analyze present problems and past causes, SFBT concentrates on current circumstances and future hopes.

Spouses Steve de Shazer and Insoo Kim Berg developed SFBT in the 1970s and 1980s at the Brief Family Therapy Center in Milwaukee.

Techniques

SFBT is an approach that falls under the umbrella of constructive therapies. Constructivism posits that people are meaning makers and are ultimately the creators of their own realities. The SFBT therapist believes that change in life is inevitable. Because someone creates their own reality, they may as well change for the better.

In SFBT, the therapist is a skilled conversation facilitator. They do not present themselves as an expert but instead comes from a “not-knowing” point of view. 

Drawing upon the client’s expertise in themselves, the therapist uses a variety of techniques and questions to demonstrate their strengths, resources, and desires. With the focus shifted to what is already working in a client’s life, and how things will look when they are better, more room opens up for the solutions to arrive.

Miracle Questions

The miracle question is a technique that therapists use to assist clients to think “outside the square.” It asks the client to consider life without the problem by setting up a scene where a miracle happens and the problem is gone. The exact language may vary, but the basic wording is this:

“Suppose that while you are sleeping tonight and the entire house is quiet, a miracle happens. The miracle is that the problem which brought you here is solved. But because you are sleeping, you don’t know that the miracle has happened. So, when you wake up tomorrow morning, what might be the small change that will make you say to yourself, ‘Wow, something must have happened—the problem is gone!'”

Asked this way, miracle questions help clients open up to future possibilities.

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Exception Questions

Exception questions allow clients to identify times when things have been different for them. Finding times when the problem wasn’t so much of a problem.

Examples of exception questions include:

• “Tell me about times when you felt happiest.”
• “What was it about that day that made it a better day?”
• “Can you think of a time when the problem was not present in your life?”

By exploring how these exceptions happened, a therapist can empower clients to find a solution. 

Scaling Questions

Scaling questions invite clients to perceive their problems on a continuum. They’re also a helpful way to track progress toward goals and monitor change. 

Generally, scales are from 1 to 10. When working with a client who is dealing with anxiety, for example, a therapist might say:

“If 10 is the most anxious and 1 is the most relaxed, what number would you put yourself on right now?”

Questions like these are usually followed with questions related to scaling, such as asking the client to explain why they chose the number they did and why their number is not one lower. They’ll likely also ask the client how they will know they are moving up the scale.

What SFBT Can Help With?

SFBT is best when a client is trying to reach a goal or overcome a particular problem. It can stand alone as a therapeutic intervention, or it can be used along with other therapy styles. It’s used to treat people of all ages and a wide range of issues including addiction, child behavioral problems, and relationship problems.

This form of therapy is typically not used to treat major psychiatric conditions such as psychosis and schizophrenia.

Benefits of SFBT

The major advantage of SFBT is its brevity. SFBT is a form of “brief therapy,” typically lasting between 5–8 sessions. Because of this, it is often less costly than other forms of therapy.

Instead of digging into old wounds, more time is spent focusing on resolutions, which makes SFBT great for people who have a specific goal in mind and just need a little help reaching it.

Effectiveness

Research shows that SFBT can effectively:

• Decrease addiction severity and trauma symptoms
• Decrease marital issues and marital burnout in women
• Improve classroom behavioral problems in children with special education needs
• Reduce externalizing behavioral problems, including conduct disorder, and conflict management
• Reduce internalizing behavioral problems, such as depression, anxiety, and self-esteem

SFBT can be just as effective (sometimes even more so) than other evidence-based practices, such as cognitive behavioral therapy (CBT) and interpersonal psychotherapy.

Things to Consider

If you are looking to dissect your childhood or come upon a great deal of insight about your life’s trajectory, SFBT may not be the kind of therapy you are looking for. If, however, you want laser-focused help to move into a new area of your life without getting lost in the details, SFBT may be a good fit for you.

How to Get Started

If you have an issue you can’t seem to solve and think you might benefit from SFBT, you can start by asking your physician for a recommendation. If you’re seeing a mental health practitioner for other reasons, they may be able to provide a recommendation as well. Local and state mental health agencies also often have resources you can turn to.

Once you have found a qualified professional, make an appointment and ensure they accept your insurance. Your first appointment will probably involve filling out the necessary paperwork, which can include details regarding your symptoms, medical history, and insurance plan.

We all have that one person in our lives who pushes all our buttons. You know the one—they’re an expert at guilt trips, and instead of supporting our choices, they make us feel bad for putting our own needs first.

It could be a parent, partner, friend, or colleague—anyone who uses our emotions against us to get us to do what they want, even if it’s not the best thing for us.

This type of behavior is known as emotional blackmail. A form of emotional abuse, emotional blackmail is a manipulation technique people use to assert power and control in relationships, says Ashley Peña, LCSW, Executive Director at Mission Connection.

Whether it’s a controlling parent, a demanding boss, a manipulative partner, or a difficult friend, dealing with emotional blackmail can be nerve-wracking. Someone who is emotionally blackmailing you may try to stonewall, manipulate, guilt, shame, or threaten you into doing what they want you to do.

However, it’s important to recognize this toxic behavior and take steps to address it. Setting healthy boundaries and sticking to them is key to protecting yourself and maintaining health relationships.

Recognizing Emotional Blackmail

Emotional blackmail can take many forms. Here are some of the different emotional blackmail tactics to watch out for.

Silent Treatment

The person might stonewall you and give you the silent treatment when you don’t do what they want. This is a passive-aggressive communication tactic that people use to gain the upper-hand.

For example, the person may stop talking to you or responding to your calls and texts. Although it doesn’t sound like such a big deal, it can be incredibly frustrating when it’s someone important to you.

Guilt Trips

The person may lay on a big, fat guilt trip, making you feel bad about prioritizing your own wants or needs above theirs. They may make you feel indebted to them, like you owe them something, even if that’s not necessarily the case.

For example, a parent or family member who doesn’t approve of your life choices may say something along the lines of: “After everything we’ve done for you, this is how you repay us?”

This tactic plays on our desire to please others. Those of us who are empaths may be particularly susceptible to guilt trips.

Manipulation

Emotional blackmail can be pretty toxic, especially when it enters the realm of manipulation. The person may, for example, play the victim card in a given situation, making it seem like they’re suffering because of something you did, even when that is clearly not the case.

For example, a co-worker might say, “I can’t believe you won’t cover my shift. Now I’ll have to work late, and it’s all your fault.”

Exaggeration

The person might magnify their problems and try to make you feel responsible for their troubles, in order to get you to do what they want.

For example, Peña explains that a parent might say something like: “If you do that again, you’re going to be the reason why I lose my job and then we will have nothing.”

Shaming

The person might call you out about something in front of others to pressure you into doing what they want.

For example, if you made a small mistake in a memo, a colleague might make a big deal about it in a team meeting and use it to discredit your ideas.

Threat and Ultimatums

The person may threaten you or issue ultimatums if you don’t do what they want. You might feel like you have no choice but to do as they ask.

According to Peña, these are some threatening behaviors to watch out for:

• Threatening punishment in effort to control you
• Threatening to hurt themselves or claiming they will be unable to function without you
• Threatening to make you face the consequences of their misfortunes

For instance, if you want to leave your marriage, your spouse may emotionally blackmail you into staying by saying: “If you leave me, I’ll make sure I get the kids, then you’ll be all alone.” Or, they might even say something like “You can’t leave me, I won’t survive a day without you.”

Effective emotional blackmail often plays on some of our biggest fears—the blackmailer often knows where we are most vulnerable.

The Impact of Emotional Blackmail

Research shows us that emotional blackmail can be just as harmful as physical abuse because it can be mentally and emotionally scarring.

In relationships, emotional blackmail is a form of abuse that can cause us to live in a constant state of guilt and fear, leading to depression, anxiety, low self-esteem, lack of identity and integrity, and difficulty connecting with other people, Peña explains.

In the workplace, emotional blackmail can cause us to give in to unreasonable demands and severely compromise our mental and physical well-being.

Emotionally blackmailing children can affect the development of their core beliefs in a way that negatively impacts their relationships and careers in adulthood, Peña adds.

Addressing Emotional Blackmail

These are some strategies that can help you address emotional blackmail:

• Spot the red flags: The first step is to recognize problematic behavior and red flags. If it doesn’t seem like something is in your best interests, it probably isn’t.
• Stay cool: Although it can be difficult when you’re facing down an emotional blackmailer, keeping your cool can help you stay in control of the situation. Reacting emotionally just gives them what they want.
• Remember that you’re in control of your choices: Remind yourself that you’re not responsible for someone else’s problems. You have the right to make the choices that are best for you, without feeling guilty about it. Don’t let guilt or fear drive your decisions.
• Share your perspective neutrally: Use “I feel” statements to share your feelings and needs without pointing fingers. For example, instead of saying “You’re making me feel guilty,” try “I feel uncomfortable when you use guilt to get your way.”
• Know when to walk away: Ask yourself whether the relationship is healthy. If it’s taking a toll on your mental and emotional well-being, it may not be. It’s important to recognize when it’s time to walk away from a toxic relationship.
• Limit your exposure to the person: Sometimes, creating physical or emotional distance is the best way to protect yourself. You can also block them on social media, if they’re using digital platforms to manipulate you.
• Find a shoulder to lean on: Talk to a trusted friend or family member about what’s going on. They can provide advice and emotional support, which can be incredibly helpful when you’re dealing with emotional manipulation.
• Seek support: Navigating emotional abuse can be extremely challenging, so it can be helpful to seek the support of a mental healthcare professional, says Peña.
• Prioritize self-care: Self-care is key. Whether it’s hitting the gym, taking some downtime, spending time with the fam, or cooking your favorite meal, do what you need to do to take care of yourself.

Establishing Boundaries

These are some tips that can help you set boundaries to protect yourself against someone who uses emotional blackmail:

• Identify your boundaries: First things first, you need to know what your boundaries are. Take some time to reflect on what you’re comfortable with and what crosses the line for you.
• Assert yourself: Use clear, concise, and assertive language to express your limits. For example, you can say, “I don’t appreciate when you guilt-trip me and I won’t give in to it.”
• Lay out the consequences: Let the person know the consequences of crossing your boundaries. For instance, you could say “If you continue to try to manipulate me, I will walk away from this conversation.”
• Stick to your guns: Once you’ve set your boundaries, it’s important to show the person you mean business by sticking to them. Don’t waver or compromise when they test you.

We know that emotional blackmail can be stressful and overwhelming. However, it’s important to stand up for yourself and set boundaries so that the person can’t manipulate you anymore. 

Remember that you’re in charge of your life and your decisions, and no one can scare you or guilt you into doing something you don’t want to do. Although it can be difficult to walk away from a toxic situation, loved ones and mental health professionals can be a source of support and strength to rely on during this process.