Dear Stephen,

I don’t know if you see people for depression. Maybe you only work with couples. But I’ve been feeling down for a long time now, and I don’t really have a good reason. My life is okay. I have a job, and I’m in a good relationship, and I really don’t have a lot to worry about. I know I could lose some weight, but I’ve even gotten to a better place on that issue, even though my mother did her best to shame me into the cycle of dieting that so many of my friends have also been caught in. I just feel – blah. And it’s springtime, which is usually a decent time of year for me. A friend told me I should try an antidepressant. What do you think?

Mysteriously Sad

Dear Mysteriously,

I’m glad to hear that your life is going fairly well, even if your emotions aren’t a good match for your life circumstances. (And yes, I do work with individuals, and sometimes we work on depression. Other times, anxiety, or relationship concerns, or whatever else is bothering the person.)

I worked for several years in various behavioral-health organizations, and I still appreciate the wisdom about medication that I learned at Group Health, where I was a therapist from 2004-2007. At Group Health, clients are encouraged to talk to a counselor and see in that face-to-face meeting whether medication is a good option for them. Some people have a big problem with medications, and in those situations, it’s probably better not to go in that direction and stick with counseling alone. Other times, a person is open to trying a medication, and they start a small dose (for example, 10 mg of Prozac per day) and see how things go for a few weeks.

I haven’t met you, so it would be unethical for me to state unequivocally what you should do. But from what you’ve told me, you sound like someone who might want to explore this question with your physician, or with a counselor. I personally try not to be a hard-liner in either direction: for some people, medications are essential, and for others, medications are not appropriate. In most cases, meds are most effective when combined with counseling.

One final note: I wouldn’t want anyone to ‘medicate away’ their sad feelings if the feelings are related to something that’s weighing on your heart and begs to be dealt with. Your life is going well right now, but is it possible that you feel down because it could actually be going much better? Or is there a loss you suffered a while back that you’re only now beginning to wrestle with? I encourage you to seek a counselor who can help you sort some of these issues out, and then address your question about medications.

Take good care!

Stephen

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Dear Stephen,

I’ve been nosing around for a counselor recently and came across your blogs. I like what you’ve had to say and thought I’d give it a try: my girlfriend and I have been together about seven months and things are going well. We have, however, struggled to come out as a (lesbian) couple. She has been out for years. I am have only begun the “coming out process,” as she calls it. I’m terrified. I’m terrified of what my family and friends will think; that we will be harassed in public; that my work associates will not associate with me, etc. There are also people I love and respect deeply that I have not told yet. We live in a widely interconnected community and I’m afraid those people will hear through the grapevine and lose respect for me because I do not have the strength yet to tell them in person. Her openness and my fear has led to several conflicts: twice we have been invited to dinner at someone’s house as a couple, on multiple occasions she has introduced me as her girlfriend to complete strangers, brought her parents over to meet me, and now she wants me to spend a weekend at her parents’ home. All without my knowledge or permission. I want to be an active part of her life, but I feel uncomfortable in many of these situations. I have tried to pluck up my courage and be “loud and proud”, and she has tried to be understanding, but I just can’t do it. When these situations pop up, I get anxious and snap at her, or withdraw. This has become a bone of contention between us; I think she feels stifled by me, and I feel exposed by her. How do I navigate these situations while still being respectful of both our positions?

Sincerely,

Peeking out the closet door

Dear Peeking,

I think the best way to look at your dilemma is this: neither of you was put on earth to be the ideal partner for the other. So…either of you could decide (with good reason) that you’d rather be with someone else, someone who is a better fit. And…either of you could decide (with good reason) that you could grow and change in the direction of the other: she could appreciate your need for discretion and boundaries, and she could get in touch with the notion that people who are in a different place in the coming-out process deserve patience and support. This could be a way for her to become a more supportive, sensitive, and gracious person.

Or you could appreciate her courage, and see her “out and proud” approach to her sexual orientation as something worth emulating. This could be a way for you to become a more confident, daring, and forceful person. In both cases, the person who soaks up the life experience and wisdom of the other person will enjoy the learning and growth that results from such an effort.

I see gifts and benefits to both choices: it’s great (even exhilarating) to be “out and proud,” and it’s also great (and wise) to be discreet and quiet about one’s own life. And in your particular case, I don’t doubt that your instinct for self-preservation serves you well: it’s likely that you’re right about the harsh reactions you might suffer from certain people in your life if they learn that you are a lesbian. At some point, it would be great if they came around, but for now, who am I to say that you’re wrong to be cautious? But I’ll also say this: think about the possibility that your friend (or girlfriend, or partner, or spouse, or just friend? who knows for sure just yet?!) has some wisdom to offer you. She’s more pushy than you are, and perhaps less considerate, less sensitive. But she could be in your life right now to teach you that you’re ready to take the next step in your own development as a sexual being…or simply as a human being.

Take some time to reflect on this, and take good care—

Stephen

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Dear Stephen,

I just found out that my boyfriend has been cheating on me, even though we’ve had what I thought was a non-open (that means closed!) relationship. I’m pretty upset about it…just the fact that he stepped out once was hard to hear, and then I found out that he’s also very into porn, and has been with lots of different guys over the course of our relationship. I don’t know if we’re going to make it, but I’m also really concerned about him and wonder if he needs an intervention or something. Is he a sex addict?

–Concerned and Upset

Dear Concerned,

I can’t tell you what’s going on with your boyfriend himself, since I haven’t met him, much less assessed what’s going on with him, but I can tell you my thoughts on sex addiction. First, you should know that the jury is still out on the question of whether “sex addiction” is a useful and ethical way to describe a person’s sexual problem. You are likely to find therapists and other medical professionals in your community who use the disease model of addiction to describe a person’s out-of-control sexual behaviors and habits, but you’ll also find therapists like me who won’t go that far. (For what it’s worth, the primary diagnostic manual in the field of psychiatry, psychology, and psychotherapy–the DSM–is not considering “sex addiction” as an additional disorder in its next edition. There is simply not enough consensus about this in the field to warrant its inclusion in the official listing of ‘disorders.’)

There are problems with using a disease/addiction model when talking about a person’s sexuality. Unlike external substances like alcohol and drugs, sex is something that is fully integrated into our physical being. It’s a fundamental dimension of human sensation, human relationships, and human experience. It’s how we propogate the species, and it’s simply a major part of a natural human life on earth. If your boyfriend were thinking about joining a celibate religious order, he might want to discern with his superiors whether he truly wants to live a life in which his sexual behavior is highly constrained. But–and I think it’s safe to guess that he’s not interested in that!–outside of a context like that, his use of the addiction model to change his sexual behavior will have its limits. Unlike an alcoholic, your boyfriend would be striving for a sex life in which sex happens–perhaps on a daily basis–but happens in a context that is, in his own opinion, life-giving and healthy.

Having said that, the addiction model offers wisdom up to a point … wisdom that a person who believes s/he has sexual-behavior problems might like to know. For example, it might be helpful for that person to identify triggers of problematic behavior, or social contexts where it’s more likely to happen; and it may be a good idea to identify friends or companions who can help that person make healthier choices. These are tactics that lots of addicts use to maintain sobriety. But one doesn’t have to say, “I am a sexual addict,” to build a new sex life that is more in keeping with what they want.

You may have noticed that I’ve shifted the focus off your boyfriend and onto a general, non-specific person. That’s because, as interesting as your question is, I’m guessing it’s not the best question for you to ask right now. Your boyfriend is behaving in ways that upset you. Your boyfriend has done things that have harmed you emotionally. And–this is important!–your boyfriend has potentially put you at physical risk if the two of you have had sex while he was having sex with other people. Are you sure that both of you have been tested for sexually-transmitted infections? These questions are more worthy of your attention right now than your boyfriend’s need for a sexual treatment plan.

Take good care of yourself, ask your own questions first, and I think that whatever your boyfriend chooses to do, you’ll be in a better position.

–Stephen

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Sometimes, when my own little advice column isn’t busy, I check out “Prudie” on slate.com. Here’s her latest post. I particularly liked how she responded to the reader who got into hot water with his wife and her sister. It’s a great example of dual relationships, triangles, and the general mess of trouble we all get into from time to time. I particularly like how Prudie handled the idea of spouses sharing confidences. There are times when it is—ahem—ABSOLUTELY WRONG to share certain things with your spouse (for example, someone else’s deeply private information that’s been entrusted to you for professional reasons, which is to say, the content of my daily work life!), but in family situations like the one described, Prudie’s right: the sister was being unreasonable and not respecting the jam she was putting her brother-in-law and sister into. (Oh, and Prudie’s right to agree with the reader that he behaved idiotically too!) It’s worth a read.

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Dear Stephen,

Okay, so I confess, I Googled you. I was looking for a therapist and I liked your site, so I looked for other evidence of you on the Internet. Much to my surprise, I saw you on a blog for a church in Seattle. Are you a Christian counselor? I don’t mean any disrespect, but I am not interested in that.

–Looking for a Secular Perspective

Dear Secular,

I’m glad you asked! I’ve been wondering when someone would do a Google search on me and ask me this. I’m happy to tell you that no, I am not a Christian counselor. I am trained as a “systems” therapist (also known as a couple and family therapist), and though the university that trained me is affiliated with the Lutheran church, the therapy graduate program was fully and thoroughly non-sectarian. I have not been trained as a chaplain, spiritual director, or any other kind of religious counselor.

Having said all that, I do have a personal spiritual practice, and a religious orientation. Since it’s pretty much out in the open anyway, I think it’s time to say on my own website that I am an active Episcopalian at a progressive, affirming church in Seattle. We don’t do a political litmus test, but our church attracts fairly liberal—and highly open-minded—people. If you want to learn more, click here.

I’ve been fairly “closeted”—I suppose that’s the right word—about all this because the majority of my clients do not identify with any religious organization, and some have been harmed by churches who rejected them for being gay (or for other reasons). I never—ever!—take our therapy in a religious direction, with only one exception: if the client is asking her own religious or spiritual questions and wants to talk about them with me, I can help her wrestle with those questions using her own religious background as a starting point, and often enough I’ll know a fair amount about that background, at least in a general sense. (If she says, “I was raised Catholic,” I’ll have a very educated guess about what she means.) But even then, my training, and my temperament as a therapist, prevent me from falling into the role of a religious counselor. It is important that I do the work for which I was licensed.

I also keep the wisdom of my own tradition in mind. One Episcopal priest I know and respect said to me, “The church can be a great place to hide from God.” I think he meant that religious people can do all kinds of irreligious things—awful things!—or shrink from a truly ethical life, and rationalize it by going to church every week. And a Catholic priest I know and respect said to me, “If the Holy Spirit is only present inside the church, then we are all in very big trouble.” I think he meant that not only does the institutional church have plenty of problems, including the fact that it simply doesn’t work for the majority of human beings on this planet, but there is far too much beauty and creativity and wisdom beyond the church walls for anyone to fantasize that the church can somehow contain the Source of All Being that, in churches, goes by the name of God. I say all this because these are reasons why it’s quite easy for me to walk away from church language, church politics, and even church worldviews when I step into my counseling office.

So if you’re interested in receiving non-religious counseling, you really can get it from someone who has his own religious community. Just let me know!

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Dear Stephen,

I stumbled upon your website while searching the internet for advice and found your replies to others’ questions very interesting and helpful. I have been in a relationship with my girlfriend for about a year. She’s been dealing with a death in the family recently, and I have tried to be supportive, wanting to have a relationship and get to know this woman while respecting the ups and downs of her family situation. I know the past few months have been a blur for her and she feels emotionally scattered. When I had a birthday recently, she gave me a sweet card and apologized for not getting me anything because she couldn’t think or plan anything during this tough time for her family. So I planned my own day and had a lovely time. Then, a few weeks later she told me she was looking for something for me for my birthday. This weekend we celebrated our anniversary and she drove us to a friend’s house and we had a lovely time. I planned meals and food for us because she felt she couldn’t plan anything yet since she was still coping with family problems. But then, during the weekend, we missed a mutual friend’s birthday and my partner wanted to make it up to her by planning a fancy birthday dinner with lots of courses. I started feeling angry and annoyed and jealous (and even more petty) that my partner wanted to do something special for a friend without having planned something special for us. Yes, for our anniversary she did drive us to a friend’s house, but I felt that I planned the whole thing and have been planning things for her for months. And the first time she is capable of planning something, I feel hurt because it’s not for me. Am I being crazy or selfish? Really petty? I’m trying to be understanding of my partner’s grief, but I am struggling to communicate (and to weigh) my own needs in the relationship. I would appreciate any advice.

–Trying to Be Supportive

Dear Trying,

If your partner is dealing with a death in the family, then you’re right to give her some latitude. A friend of mine has a good rule of thumb: depending on how significant the death is, the grieving person can reasonably expect to be out of sorts for up to a year. Though I am not Jewish, I appreciate the Jewish wisdom of a one-year grieving process (discussed here). We’re too quick in our culture to paper over our feelings and move forward, as if bereavement can really be wrapped up in a matter of days or weeks.

Having said that, your partner does not get a free pass out of behaving ethically in her relationships, and you do not need to suspend your own thoughts and feelings for a year. You get to feel resentful. I say this first of all because if you do feel resentful, there’s not much you can do about that. Feelings are like the weather: they come over you. You can control how you handle your feelings, but the feelings themselves just happen. It sounds like you feel resentful because your partner took a pass on your birthday (for the most part) and then decided to order up a full birthday special for your friend. This is not something you need to swallow.

You might want to have a sit-down with your partner. Tell her, first of all, that you understand that the grieving process is a serious thing, and that her grief honors the family member who died. Tell her you want to be supportive, and you understand that she’s been unable to do the usual “relationshippy” things, like planning a special birthday experience for you. You could even ask her if there’s anything further you could do (or not do) to help her during this time. And then tell her that for the sake of your relationship, you need to let her know that you were taken aback when she said she wanted to plan an event for your friend. Tell her you really struggled with this because you don’t want to sound petty, but you couldn’t help feeling stung by it.

It’s normal for couples to avoid these kinds of conversations. You don’t want to sound petty, or you don’t want to overburden the relationship with discussions about your expectations. But if you’re approaching your partner from a mature, sensitive, yet self-confident stance, she’ll most likely notice that. If you really don’t think you’re being petty, then you will effectively communicate to her that you love her, support her, and also expect your propers as her partner.

Someone I know said it this way to her partner: “If I’m your partner, then when the plane is going down, it’s my hand you’re holding.” It sounds like you want this kind of relationship—a relationship where each of you is #1 in the eyes of the other. Even if your partner is grieving, it’s not petty or crazy or selfish to ask for this.

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Dear Stephen,

I am having a difficulty with my partner; it appears to be a very minor and silly complaint on the surface but I think it has a lot more meaning for us. The basic issue is that my partner travels a lot and has a thing about taking cabs. Not really a phobia, more of a discomfort about hygiene and the potential for offensive or uncomfortable conversation (which really does seem to happen quite often). His company pays for the service but he would prefer me to take him. I do not like driving him to the airport. It is just not pleasant. He asks me, “What is the big deal?” I find this difficult to answer; but I guess the big deal is that I just don’t want to and that I do not care enough about his discomfort with cabs to overcome that. In the past I have taken him out of guilt because I feel like it should not be an issue for me. But now I am trying to be honest with myself and him so as to avoid being upset and causing fights. Sometimes I will take him to the airport and be really rude and unpleasant. At other times I have taken him out of sincerity and it has been pleasant for both of us, but this is quite rare. I am confused as to whether I need to overcome my distaste for driving him to the airport or if I need to not care about his dislike for taking cabs. If you have any suggestions as to how to deal with this I would greatly appreciate it!

Taxi Dog

Dear Taxi,

So the thing is, I don’t like cheese.

(Bear with me. This really is about you!)

But as I said, I don’t like cheese. Or at least I don’t like it in most of its forms, particularly when you can see the rot–sorry, the “flavorful color” such as you’d find in blue cheese. But my partner is a marvelous cook, and my partner loves cheese, and is often puzzled (and sometimes frustrated) when I express my distaste for curdled milk nast–sorry, cheese. It’s a similar situation to yours, which is why I bring it up. Be assured: this is happening to you not because you’re petty, but because in any relationship–all relationships–it is inevitable that the couple will bump into each other like this.

Here’s the breakdown: 1) partner A has a preference; 2) that preference bumps up against partner B’s preferences and/or lifestyle; 3) partner B isn’t sure how seriously to take partner A’s preference, or how seriously to take his own way of doing things. What’s partner B to do? I think there are at least two healthy options:

First, think about healthy pushback. Specifically, you could communicate to your partner that while you understand his dilemma, you are not willing to do this particular relationship behavior (picking him up at the airport). If you take this tack, you’ll notice immediately a lot of cultural pressure–most of it inside yourself–that says, “You’re being petty. Come on! It’s just picking him up at the airport. Everybody does it! Don’t be selfish!” But it can be a healthy choice to resist that pressure. It can actually be a gift to your partner, because you are making your choice–a choice that does not relieve him of his problem, and flies in the face of conventional wisdom about relationships–under the assumption that he’s a big kid who can solve his problems in other ways, and you’re both big kids who can enjoy intimacy, trust, and happiness together without slavishly adhering to cultural expectations. Basically, if you’re doing healthy pushback, you’re deciding that you will not pick him up at the airport unless you want to give the favor to him freely as a gift. You are resisting the dull pressure of duty and guilt, and you are expecting that both you and your partner can adjust to this unconventional but self-assured behavior.

Second, you could go in the other direction completely–but in a healthy way. You could notice your resistance, and creatively choose to disregard it, telling yourself that you want to open up to your partner and accommodate him more than you want to stand your ground on this issue. You could make meaning of your resistance as just that–resistance–and say to yourself, “I am choosing purposely to disregard my impulse to push back. I am opening myself up to my partner, as a gift to him but also to myself.” The gift to him is fairly obvious: he gets a ride home, and he gets the even more valuable gift of a partner who is creatively (not anxiously or guiltily) saying Yes to his vision for the relationship–or at least his vision for airport transportation. But the gift to yourself is also significant: you are opening yourself up to the reality and worldview of another person, in this small way (but most of the specific things we do to change and grow in relationships are fairly small). Opening up like this is–like healthy pushback–an opportunity for growth.

Either way, try to look at it–and carry it out–as a positive, intentional decision on your part, not a decision born of guilt, fear, or resentment.

Meanwhile, I’ll think about opening up to eating more cheese!

–Stephen

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Dear Stephen,

You’ll probably think I’m the shallowest person ever to ask you for advice, but I can’t stand it anymore. I’ve been with my partner for four years now, which I think is a long time. I’m happy with him, and he’s happy with me (or so he tells me), and he’s a really great guy. He’s sexy too. We have a great life together. But… he has this little mannerism. He closes his eyes a lot when he’s talking, which I know is just something he does for no real reason, but it’s hard not to think that he’s being haughty when he does it. I feel dumb writing this out. I should be grateful to have such a great person in my life, right? But lately I’ve been focusing on it more. It’s starting to really eat at me. Since it’s been a few years, we’ve been talking about taking the next step, which for us can’t be marriage but domestic partnership (thanks for nothing, state of Washington). How can I get past this pet peeve?

–Shamefully Shallow

Dear Shamefully,

I’m glad you screwed up the courage to ask me about this, even though at first glance it does seem like one of those Seinfeld kinds of problems. Take it easy on yourself: this kind of thing is normal in even the healthiest relationships. I’d say you have a couple of options. First, depending on the level of comfort and everyday honesty in your relationship, you could actually bring it up to him, and in a way that is relaxed and self-deprecating. Something like, “Honey, you know I love you more than my luggage, but what *is* it with you closing your eyes when you talk?” He may not even know he does it. If you bring it up to him, what’s the worst that can happen? He might blush, or be irritated with you, or take offense. He might get self-conscious about it. It could even lead to a disagreement, or a fight. But it could also be an opportunity for your relationship to go to the next level. It’s one of those smaller, everyday risks that can improve your intimacy and openness together. And the upside is that he could find it amusing, understand your little concern, and be a big boy about it.

Another option: do nothing, and when he closes his eyes, take it as an opportunity to focus on something else, or listen more carefully to what he’s saying. Breathe deeply, take a long drink of water, and try to direct your attention to other things. Tell yourself that it’s not a big deal, and that it’s distracting you from the heart and soul of your relationship.

Either way, it’s better to do something like these options rather than struggling with it under the assumption that you’re being shallow. And either way, you’ll probably grow and change as you wrestle with this small but significant concern in your relationship.

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Dear Stephen,

I know, I know, this is a cliche, but my husband forgot our anniversary and I’m pissed. The thing is, I’m not 100% sure he forgot, but on the day of the anniversary he showed up after work, went into his home office, and came out with a card. He’s got tons of stuff in the office, and I wouldn’t put it past him to have a stash of cards for those “Oh crap I forgot” moments he likes to have. Sorry if I sound crabby, but it’s really upsetting to me when he forgets. It means he doesn’t love me, and doesn’t care about us. But I feel like I can’t nag him about it because that’s all it will sound like–nagging. Plus, this all happened like three months ago, so it feels like I’d be petty if I brought it up now. What should I do?

Ignored in Illinois

Dear Ignored,

I like the alliteration in your advice-column name, but I suggest “Pissed in Peoria.” I’m not joking around–seriously, I think you’re mad, and I certainly understand why. But I encourage you to stay with that rather than focusing on the conclusions you’re jumping to (such as the belief that your husband is ignoring you, doesn’t love you, doesn’t care about you). You’re mad because of these conclusions and beliefs, so at some point you’ll need to address them, but it helps to stay with yourself first, and focus on what you yourself can do about the problem.

Here’s what I would do: I would sit down with him and tell him what I really want to happen on anniversaries. I know it doesn’t sound romantic, and you’re probably right that he might feel defensive–and might even think you’re a nag! But you’re not. You just know what you want, and you’re getting that across to him. And be really detailed about it. Instead of saying, “I want you to be caring and respectful of me, and remember our anniversary,” say, “I want our anniversary to be really special, and for me that means dinner out, gifts, and time together, just the two of us.” You could then let him know that when this hasn’t happened in the past, you’ve felt angry and hurt. You know that those are your feelings, and that they’re based on the conclusions and beliefs you created in response to his behavior, but you understand that they are not facts.

If he gets defensive, hang in there. Your job is not to try and convict him in a kangaroo court where you’re the judge and he’s the hapless defendant. Even if he feels that way, it doesn’t have to be what’s really happening. Your job is simply to connect with your husband about your desires, and for that, you need to take your own desires seriously, own them, and extravert them to him. It may not sound romantic, and it may not sound fair. But all it really is is you taking the lead, from a mature stance, so that the anniversaries to come are joyous celebrations of your life together.

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Dear Stephen,

My partner recently asked me to move in with her. We’ve been dating for a couple of years now, so we get lots of jokes from our friends because we aren’t the stereotypical “U-Haul on the second date” lesbian couple. I think one of the reasons we’ve waited so long is that my partner has a cat and knows I’m highly allergic to cats. (And she simply adores her cat.) I’ve spent some time in her apartment and had allergic reactions, though they haven’t been really bad, probably because I don’t usually spend very much time there and she’s willing to stay over at my place most of the time. I really want to move in with her, but my allergy is a serious problem. My partner is trying to be cool about it, but I can see it annoys her that I’m letting my allergy stand in the way of our next step as a couple. I don’t want to ask her to get rid of the cat, but I’m really feeling that if the cat doesn’t go, I can’t move in. Help!

–Allergy Girl

Dear Allergy Girl,

It sounds like the two of you just need to have a good talk, and also do some research about the problem. First, the talk: tell your girlfriend that you’re worried that she is frustrated with you about this problem, and that if she is, you understand her frustration. Tell her you’re willing to work with her on the situation, but you also need her to meet you halfway. I found a book that addresses the issue in a balanced way (see the link below). In her book “The Natural Cat,” author Anitra Frazier discusses natural methods that truly help reduce allergic reactions. She encourages cat owners to feed their cats well and brush them often. I think it also helps to vacuum or sweep regularly, keep the air moving in the apartment, and generally be sensitive to the presence of the cat’s fur in the living space. In Frazier’s experience, healthy, well-brushed cats are far less allergenic. In addition, she encourages the person with the allergy to consider a shot or other treatments to minimize their symptoms. (This could be a true sign of love on your part!) If your reactions so far haven’t been severe, that might mean that your partner is already raising a healthy and happy cat, and that all she needs to do is increase the brushing. Cats (and dogs) also benefit from Omega-3 fish-oil supplements that improve the health of their skin and coat. Bottom line: if you’re both willing to make some changes and understand the concerns of the other, you should be okay. Again, see below for the link to a good book.

–Stephen

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