Category Archives: Sex and Relationships

Toxic Relationships: Recognizing Key Signs

Toxic Relationship

What is a toxic relationship?

A toxic relationship is any relationship we have with another person that makes us feel drained, anxious or less then. Instead of building us up and making us feel good about ourselves, these relationships break us down in subtle and not so subtle ways. We can have toxic relationships with just about anyone, from the receptionist at the dentist, to our boss or co-workers, to our parents and children, to our most intimate romantic partner. The more intimate the relationship, the harder it is to recognize that the relationship is toxic- and the harder and more painful it is to change it.

What are the signs of a toxic relationship?

1. How do you FEEL around the person?

-Do you get anxious thinking about your next interaction with them? (anticipatory anxiety)

-Do you have a physical reaction? (your stomach hurts, your head spins, you feel ungrounded or unsafe)

-Are you drained emotionally and physically after you leave the toxic person?

2. How do you ACT around the person?

-Are you making excuses for or needing to constantly defend yourself and your actions?

-Do you become a person who you are not normally either by becoming overly hostile or passive?

3. Do you need to RECOVER after you leave them?

-Are you so drained emotionally and physically that you need to go to bed, eat, drink or take drugs?

-Do you swear that you will never see or interact with them like that again?

-Do you scratch your head and wonder “What was that about?”

Why is it so hard to get out of toxic relationships?

-Because we get addicted. We think we need the approval, validation and love of a person who once gave it to us.

-We keep chasing the original high, hoping it will come back to us.

-We deny the truth of the situation, because it’s painful. Who wants to admit that they are addicted to a toxic relationship. There’s an incredible amount of shame associated with that.

What to do to get out?

-Be willing to admit there is an issue.

-Because our denial is so strong around toxic relationships we need to write our feelings down and create a record of them. Keep a journal of how you feel before, during and after your interactions with your trigger person.

-Find a trusted friend or professional with whom you can test your reality. The nature of toxic relationships is that they are crazy making. They make us doubt ourselves and our self worth.

-Set boundaries. Limit your time and exposure to certain people who trigger negative emotions in you.

-Believe in yourself and trust that the universe will provide a better more loving place for you.

 

 

 

 

 

The DSM-5: Update to Changes

The DSM-5 is the main tool clinicians- and insurance companies- use to code mental health conditions. It’s also a highly controversial scientific manual for in addition to codifying mental health issues, it often stigmatizes the people who are diagnosed.

On December 1, 2012, the American Psychiatric Association’s board of trustees approved the newest version. This was no simple task. It took 13 years to complete and involved the participation of 1,500 mental health experts.

The changes to the DSM-5 attempt to view mental health issues on a spectrum rather than in fixed boxes. The best example is the changes to the diagnosis of autistic disorders. Previously, autism was codified as stages of severity that began with Asperger’s. Under the DSM-5, these sharp distinctions are lost and in their place a single autism spectrum disorder has been established.

Other changes include additions and eliminations. New diagnosises include:

Hoarding

Bing Eating

Skin Picking

The DSM-5 did not include diagnosis codification for:

Children who experience difficulty after their parents divorce

Hypersexual behavior

While not a perfect manual, the DSM-5 is our profession’s best effort in diagnosing and treating the wide range of mental health disorders from which people suffer.

 

Divorce Step Family Style: Dr. Hokemeyer quoted in New York Times

In today’s Style section of the New York Times, Elissa Gootman penned a great article on how to negotiate relationships with step children in a divorce. I’m honored that she closed the article on a positive, up beat note that contained my discussion of how in the midst of the turmoil, make sure you are guided by love- Love of self and others! Here’s the section I’m referring to:

WHAT’S YOUR MOTIVE?

The decision to nurture former step-relationships can mean accepting certain awkward situations, like waiting in the same hospital as your former husband while your former stepdaughter-in-law gives birth to a baby who would have been your stepgrandchild.

When a client of Dr. Hokemeyer’s expressed a desire to be present at the hospital while the daughter of her longtime but now former husband gave birth, the therapist worked with her to answer what he considered the key question: what was her motive?

“When there’s a divorce, there’s a profound sense of loss, and people try to mitigate that loss by holding on to relationships that they would be better off letting go,” Dr. Hokemeyer said. “Make sure that you are acting out of genuine love and concern for the other person, and not out of anger and attempts to manipulate.” In the birth case, Dr. Hokemeyer and his client determined that her motives were pure. She genuinely cared for her ex-stepdaughter-in-law and wanted to preserve their relationship, which was meaningful and deep, though convoluted to describe

50 Shades of Grey: What Men Can Get From Reading It.

This posting by Dr. Paul Hokemeyer first appeared on the Dr. Oz website

By Paul Hokemeyer, PhD, JD
I just finished reading 50 Shades of Grey. For most of you, the book needs no introduction. It’s a hot and steamy novel that’s been a topic of conversation among women of all ages for some time now. Some of you, however, may be late to the game. If you fall into this second category, chances are you’re a woman who’s been in a coma or a man who thinks the book is “silly” and irrelevant to you.

For all the men who think 50 Shades is silly or irrelevant, I challenge your beliefs. There’s an enormous amount you can learn in its 514 pages about yourself as a sexual being and your role as a romantic partner to the woman in your life.

I also have to confess that in regard to the book, I was both late to the game and a skeptic. I’d heard about the book from nearly all of my female friends and was taken by their reaction. Without exception, the women found the book mesmerizing, wildly entertaining and incredibly erotic. What struck me most about this reaction was how it remained consistent among women of all ages, socio-economic classes and even sexual orientations. I overheard 20-year-old women giggling about it on the train, my lesbian colleague couldn’t put it down, and my 50-something-year-old Ivy League educated neighbor described it as “porn” that she found “absolutely delicious.” Finally, after one of my female friends insisted, “Paul you must read this book. It’s full of psychological stuff that you’ll find fascinating,” I decided to take the plunge and see what all the estrogen-fueled hype was about.

After devouring the book over a long weekend, I was pleased with the results of my “psychological study.” Through it, I gained great insight into what women want out of men and how we can be better lovers. For the sake of brevity, I’ve outlined what I learned in the bullet points below:
Women need to feel valued: Men often take their female partners for granted. This is especially true when the couple has been together for a while. Men need to stay attentive to the details of their partner’s lives and consciously value them as human beings.
It’s okay for men to be vulnerable and sensitive: Women love men for their strengths and for their vulnerabilities. By sharing their emotional vulnerabilities, men will strengthen their romantic relationships.
Sex is an important communication tool in a relationship: Sex is not a mechanical act. It’s a way partners communicate their desires for and respect of one another.
Sex is a whole lot more than penetration: Women want romance. Know that the journey is more important than the destination. Slow down and enjoy the scenery along the way.
Intimacy demands trust: At the heart of romantic relationships is an intimacy that is borne of trust. Women must be able to trust their men. This requires their men to be trustworthy.
While 50 Shades has a great sexual content, it also has great insight to enable men to be better partners, lovers and friends to their romantic partners. It’s a book that’s entertaining and enlightening, sexy and stimulating. Most importantly, it’s a book that need not be reserved for women only. Men can learn a great deal from it’s content. I certainly did.

Internet Addiction

Dr. Hokemeyer discusses the concept of an addictive personality in relation to internet addiction

A real high for some high-tech users [Reading Eagle, Pa.]

By Dan Kelly, Reading Eagle, Pa. McClatchy-Tribune Information Services

July 12–If you drink alcohol or take drugs, it stands to reason that they will have an impact on the balance of chemicals in your brain.

But can spending too much time on Facebook, Twitter and other social media cause a surge of compounds that act like drugs or alcohol and keep you coming back?

Experts say yes — emphatically.

“It’s funny you should mention that,” said George M. Vogel, executive director of the Berks County Council on Chemical Abuse. “The working title of our annual meeting in November is ‘Cybertechnology: Are we too connected?’ ”

Vogel said social media — like alcohol and chemicals — can become addictive because in the process of surfing the Web, our brains generate endorphins that produce a sense of pleasure. Like other highs, we crave that first Internet high and keep going back trying to duplicate that original experience. The result is that a person who once surfed the Web for a half-hour is spending 40 to 80 hours a week logged on.

In January 2011, a group of researchers at the University of Bergen in Norway developed a test they called the Bergen Facebook Addiction Scale.

The test confirmed that people were responding to Facebook in the same way drug addicts and alcoholics responded to their substance of choice.

Addictive personality traits

Another danger is that someone who has an addictive personality can become addicted to the Internet after kicking a drug or alcohol addiction.

Examples commonly used by researchers include a man who kicks an alcohol addiction, then becomes addicted to searching for sex partners on the Internet, or a woman who beats an addiction to painkillers, then develops an addiction to Internet shopping.

“When it comes to addiction I look for two things: tolerance and withdrawal,” said Dr. Paul Hokemeyer, an addiction specialist with Caron Treatment Centers, the addiction treatment facility near Wernersville.

When it comes to the Internet, the symptoms are the same as with drugs and alcohol.

“Tolerance is when a person needs more and more time,” Hokemeyer said. “They go from 15 minutes to five to eight hours a day.

“With withdrawal, all they feel is fear, dread and anxiety over not being connected.”

A person kicking one addiction doesn’t mean the loss of his or her addictive personality traits.

“Addiction is a lifelong process,” Hokemeyer said.

Hokemeyer said counselors are starting to see more and better studies and data linking the Internet and addiction.

“We’re beginning to see some trends,” he said.

Scientist now believe that, with the Internet, people are developing what is called a process addiction, rather than a substance addiction.

“They get addicted not to sex but the process of finding sex on the Internet, or the process of shopping,” Hokemeyer said.

Counselors are finding more cases involving patients who are becoming addicted to behaviors and not just substances, said Tom Adil, director of adolescent services at Reading Hospital.

Whether addicted to a substance or a process, the result is seldom good.

“It is like an adolescent cutting themselves,” Adil said.

In that process, the cutting produces pain. The pain causes the brain to release adrenaline, like the natural fight-or-flight response in humans. The adrenaline causes the body to produce endorphins that create a pleasurable sensation.

When someone can’t cope with a problem, a substance or a process becomes a method of taking the pain away.

“Like any addiction, negative types of coping run aground (because) of negative consequences,” Adil said.

Contact Dan Kelly: 610-371-5040 or dkelly@readingeagle.com.

___

(c)2012 the Reading Eagle (Reading, Pa.)

Visit the Reading Eagle (Reading, Pa.) at readingeagle.com

50 Shades of Grey

Is ‘Fifty Shades’ poorly written? Who really cares?

 ”I think that women are giving other women permission to read it and get in touch with their sexuality,” says Dr. Paul Hokemeyer, a marriage and family therapist who is a frequent guest on The Dr. Oz Show. “And there’s something very normalizing about that.”
 
By EMILY J. MINORPalm Beach Post Staff Writer

Updated: 5:49 p.m. Wednesday, May 30, 2012

Posted: 5:48 p.m. Wednesday, May 30, 2012

 

My favorite side effect from the Fifty Shades books is probably the little story singer John Mayer told on Late Night with Jimmy Fallon.

Whether it’s true or not, who knows? But Mayer says he took the first book, Fifty Shades of Grey, and actually sang a page to a woman, a possible bed partner, in an attempt to get her all ready for the sack.

Oh Anastasia. Your alabaster skin is so hot.

Who doesn’t love a little romance resulting from all this Fifty Shades madness?

Well, that and the fact that I now know what a spreader bar is, and it’s not something farmers use for fertilizing the fields.

The first time I heard about this phenom series, a trilogy – I hesitate to use the word “threesome” – was only about a month or so ago. I’m a late bloomer, a considerate understatement now that I am deep in the third book, Fifty Shades Freed, and starting to realizing what’s going on in American bedrooms.

And dining rooms. And automobiles. And boat houses.

And it’s not Saturday-night sex with a bottle of Astroglide.

There we were, my schoolteacher friend and me, barreling down Interstate 95 to attend a sporting event involving a bat, a ball, and beer, and she was screaming, and I mean screaming, as she weaved her car with the broken speedometer through fellow travelers, some of them probably Fifty Shades readers and therefore technically unfit for driving in that they were presumedly still a bit weak in the knees from Chapter 21 in the second book, Fifty Shades Darker.

OH MY GOD, she was bellowing. YOU HAVE TO READ THEM.

And I think teachers should be obeyed, much like Anastasia Steele obeys Christian Grey, unless she wants to be spanked.

There’s a lot of high-brow grousing going on right now about the series – written by a British TV executive, first launched as Internet fan fiction – that is, fantasy chapters about existing books and existing characters – and then snatched up by Random House because of the following author E L James had established online. Apparently there is a widespread literary opinion that the books – a continuing story about a young woman, a recent college grad, who falls in love with an ultra-wealthy businessman who is “fifty shades” of messed up because of his crack-addicted birth mother – are poorly written.

But I hadn’t noticed.

Erotica has been around since the dawn of time. Have you watched HBO’s Game of Thrones? My mother used to keep a tame version stashed under her bed. Remember those old True Story magazines? But what’s so different about the Fifty Shades series, I think, is how everyone’s talking about it.

Indeed, Hokemeyer speaks the truth. We’re not hiding our copies in the T-shirt drawer or under the bed. Women are reading Fifty Shades books on airplanes and in waiting rooms and while standing in line at the grocery.

In just six weeks, the series sold 10 million copies – which begs the obvious question:

Just how horny are we?

“Here’s what I think,” says Dr. Maureen Whelihan, a West Palm Beach OB/GYN who is considered a leading national expert in sexual medicine.

“I think people, especially people in long-term relationships, they don’t believe they’re horny. They don’t believe they have the drive. So when they read these books, there’s that intense dopamine surge that gets women aroused and they get a little validation that they’re not broken.”

On these matters, I completely trust Whelihan, who through the years has collected women’s intimate sexual stories, everything from bedroom practices to libido levels, then teamed up with a writer to put the stories in a book.

Yes, this is a woman who knows her sex and I’m betting Maureen Whelihan was all hip about bondage, discipline, sadism, masochism back when I still thought BDSM was the airport code for Boulder, with an extra letter thrown in for good measure.

Like maybe a clue about my cute luggage, or something?

Sex and money are two funny things in our lives. They pretty much rule how we live, from happiness to contentment to physical fulfillment, yet we don’t talk about them much. Nowadays, though, we all seem to have gone a bit haywire. Well, I should speak only for myself – a grown woman who recently started yelling “Fifty Shades, baby,” after a few mojitos.

“I really just think these books are permission-giving for women to talk to their girlfriends and to talk to other people,” Whelihan says.

And her recommendation to all the John Mayers out there?

“Don’t send her to the girls’ book club,” Whelihan says. “Read her the book. Give her a glass of wine.

“I assure you there will be frequent breaks.”

And who doesn’t want that?

Marriage in Midlife

My Midlife Marriage

I’m getting married in less then a month. It’s the second marriage for both my fiancé and I. And it’s a very different experience from my first.

 

In contrast to my first marriage, my second is a lot more complicated – and a lot more meaningful. While my first was defined by the naïveté and lightness of youth, my second is defined by the heft of my midlife emotional and material accumulations.

 

This isn’t to say that my second marriage is inferior to my first. If that were the case, I wouldn’t do it. It’s just that it requires me to answer a more mature set of questions.

 

First of all, I had to get clear why I wanted to re-marry. My fiancé and I have successfully lived together for the last 10 years, so why would I want to change things? We don’t plan on having any more children and our families are definitely not pressuring us. So why go through all the fuss? Why deal with all the bother? Why risk the chance that by formalizing our relationship, we’ll destroy it?

 

My answers to these questions did not come quickly or easily. They were found in private thought, in loving conversations and angry debates with my fiancé, in frank conversations with friends, family members, ex-wives, and in tear-filled sessions with a gifted therapist.  In short, they came by having the courage to ask hard questions and being willing to live with the answers. And the answers I reached told me to dive deeper into my relationship and wade through the uncertainties and certainties of the second half of my life – not alone, but in a religious, personal and social commitment to another human being.

 

My answers also showed me that while my first marriage was defined by the expansiveness of life, my second marriage is bound by an awareness of its termination. When I first married in my 20s, death was a distant and abstract construct. Now in my 40s, I’ve experienced the fragility of life concretely.  In midlife, the vows I’ll take “until death do us part” resonate with a pitch that I wasn’t able to perceive fresh out of college.

 

While there is a great deal of joy in my midlife marriage, there’s also a fair amount of sorrow. The joy comes from my experience of loving and being loved, the acceptance and participation of our mature families, the ability to stand before God and the willingness to commit to my partner completely. The sorrow comes from knowing that just as things have beginnings, everything comes to an end, and the people who are with us today, may not be in the coming tomorrows.

 

This focus on the end is the most distinguishing feature of my midlife marriage. It puts into sharp relief the preciousness of life and the value of being able to share that preciousness with another person. I’m incredibly grateful for the chance to love and commit again to another person and for the awareness that comes from my midlife experiences. This time when I walk down the aisle, I’ll do so with a greater respect for the swift rush of life and gratitude for my ability to savor its bitter sweetness.

Relationship Agreements

By 
NYTimesFashion on Twitter

As news spread of the recent wedding of Mark Zuckerberg, the Facebook billionaire, and Priscilla Chan, the recently graduated medical student, one aspect of their courtship has drawn scrutiny from the chatterati. Years earlier, before Ms. Chan moved to Palo Alto, Calif., to be near Mr. Zuckerberg, the couple forged a relationship agreement in which she insisted on at least one date night and 100 minutes together a week, not in his apartment or at the Facebook office.

(The agreement was reported by Sarah Lacy in her 2008 book “Once You’re Lucky, Twice You’re Good.” Facebook had no comment.)

Such agreements are hardly common. But many couples do make contracts, written or oral, delineating the idiosyncratic needs of their relationship: how much time they need to spend together and apart; who cooks and who cleans; who feeds the fish. Some turn to couples’ counselors, some hammer out such agreements themselves (as did Ms. Chan and Mr. Zuckerberg, apparently), and others even resort to lawyers. Such discussions expose a couple’s vulnerabilities, and make clear how each partner wants to be heard and understood.

“Each party has a chance to draw a line in the sand or negotiate,” said Kelly M. Roberts, a marriage and family therapist in Oklahoma City. “It’s not based on economic earnings but on relationship capital.”

These are different from prenuptial agreements, which are used to protect marital assets in case of death or divorce. By contrast, relationship agreements can read like wish lists: a business plan for a successful romance. And unlike prenups, which have been challenged in court, most lawyers think that such agreements generally are legally unenforceable.

“It’s more about acknowledging the seriousness of the discussion,” said Cheryl Lynn Hepfer, a matrimonial lawyer in Bethesda, Md. “People’s memories fail. So they say, ‘Remember when this was so important to us that we signed, with witnesses?’ ”

Lawyers say these contracts are a stripped-down version of cohabitation agreements, which gay men and lesbians in particular began writing years ago when states prohibitedsame-sex marriage. Those agreements, which protected finances, often enumerated relational requirements.

Ken Altshuler, a lawyer from Portland, Me., who is president of the American Academy of Matrimonial Lawyers, said that in one cohabitation agreement he drafted, a partner prone to seasickness allowed his partner to take one cruise-ship vacation a year, alone.

In return, the seasick-prone partner could not “berate or complain” about cruises, including such digs as blasting the theme from “The Love Boat.”

Cohabitation agreements are now also used by heterosexual couples who may not envision marriage. An agreement might stipulate, for example, that if one partner sets aside graduate studies to work to support the other while finishing up school, then eventually they must reverse roles.

“The issues haven’t changed, but how we’re framing them has,” said Paul Hokemeyer, a Manhattan therapist. “Women are saying: ‘I have a place in the world. I won’t just wait around and expect you to be kind and generous. Let’s nail this down.’ ”

Even just documenting the emotional quid pro quos of a relationship has value, couples’ therapists said. The process forces people to confront issues that might otherwise fester.

Relationship agreements also have contemporary currency because they can be used to “dtr,” texting shorthand for “define the relationship.” And once a couple has worked out their latest terms to “dtr,” they can post a status update on Facebook.

Left for a Younger Woman?

Left for a Younger Woman? 5 Steps to Thrive

One of the most devastating things that can happen to a woman is to be cheated on or left for a younger woman. It’s insulting, it’s humiliating, and it’s infuriating. In my clinical and personal experience, the women who’ve faced this situation feel they’ll never get over their pain – but they do. And if they consciously process their betrayal, they come through it stronger, more confident and happier women.

 

If this happens to you, know you will get through it, too. You’ll feel like you can’t, but you can. Acknowledge it won’t be an easy process. It will require you to recognize painful truths about the men you love and trusted, to manage the shame and judgment you feel from others and to pull yourself from the gutter where you feel you’ve been dumped.

 

In addition, don’t think your transformation from devastation to resolve will happen overnight. It often takes years and will track the five stages people go through when processing the death of a loved one. These stages include anger, denial, bargaining, depression, and acceptance. Unfortunately, you can’t go from anger to acceptance overnight. There’s a lot of ground you’ll need to cover in between. Give yourself the time and space to trudge it.

 

And while you’re trudging your road to a higher destiny, use the following five steps to enhance your journey. In them, you can stay on a healing path instead of falling into an emotional trap of self-pity and self-destruction.

 

1. Your anger is justified: Embrace it! In our society and culture, girls and women are taught that anger is “bad”. Nonsense! Feel your anger and express it in a safe and contained space. Don’t think you can banish anger from your life. It’s real and it’s yours. Get in touch with it and use it constructively. Exercise daily, scream into a pillow or blanket, buy a plastic bat and beat the heck out of an armchair. Discharge your anger OUT, don’t hold it in – or it will consume you.

 

2. Resist the urge to retaliate. This, of course, will take great resolve and the help of an army of friends and professionals. Your goal is not to “get even” with the cheating spouse.  It’s to take charge of your life, reclaim your dignity, and move forward into new love, joy and adventure.

 

3. Be of service to other women. Yes, I know, this is another one that goes against your impulses. You’ll want to hide out from the world and lick your wounds (or plan your revenge), but these self-focused responses are self-destructive. Instead, focus on how you can be of service to other women who are in pain. Volunteer at a domestic violence center or work with other recovering women. By getting out of your own head, you’ll reclaim your dignity and a place of value in the world.

 

4. Don’t look to be saved. This is your chance to prove you’re a person of worth and dignity. You have everything you need to heal and grow from this betrayal. Instead of looking for others (and in particular other men) to save you, look for people who can help you hold your pain and devastation. In this regard, the word “hold” means they will be there for you with understanding, compassion and non-judgment. Typically, this is a good psychotherapist, but it may also be a good friend, clergy member or a support group.

 

5. Track your progress daily. Your healing process will occur in tiny steps, not gigantic leaps. Be mindful of this and ask yourself each and every day if you are working toward the solution or stuck in the problem. When you find yourself stuck in the problem (and you will get stuck there), lovingly pull yourself back to the solution like you’re training a puppy. By focusing on the solution, you’ll ensure the success of your future. Keep a daily journal or write a blog. Years later, when you’ve reclaimed love and lust in your life, you’ll value what you’ve written.

 

Above all else, never forget you have what it takes to succeed. In my practice, I’ve seen the most seemingly fragile women learn to thrive from the most horrific betrayals. Women are the smartest, most intuitive, loving and insightful people I know and work with. Know that these women are YOU and consciously love yourself through this difficult process.

 

The Beauty of a Middle Aged Woman

The Beauty of a Middle Aged Woman

Last night the most beautiful woman sat next to me at my weekly meditation meeting. Usually, these situations don’t rattle me, but this particular woman captivated me in her splendor.

 

Barefoot, grey hair pulled back into a ponytail, face fresh and seasoned by time, she didn’t hide behind makeup or contort her features with surgical procedures. She owned the room not by screaming, “Look at me!” but by gently whispering, “I’m comfortable in my skin and in the world around me.”

 

In contrast to the collagen-lipped, eyelash-heavy women who refuse to mature with grace, this woman exuded a natural beauty. She didn’t strive to conform herself to someone else’s feminine ideal nor was she trapped in a time that didn’t suit her. At well over 50, she knew who she was and radiated a loving confidence to those of us around her.

 

Too often, women run from who they are destined to become because of a fear of becoming irrelevant or invisible. In this fearful state, they paint, inject and cover up the authentic parts of themselves that make them authentically beautiful. It’s a trap that’s easy to fall into and one that consists of unrealistic and unhealthy ideals of feminine beauty.

 

Middle age is not about being invisible and obsolete. It’s about editing out the distractions that prevent women from being who they’ve worked hard to become. A beautiful middle-aged woman doesn’t need Angelina’s lips, Kim’s eyelashes or Paris’ waistline to define her. Her beauty is not painted on. It radiates from within.

 

Women are extraordinary beautiful at each and every age of their existence. Their looks do not fade. They evolve into a deeper expression of the love in their hearts and the richness in their souls.

Added to Women’s HealthWellnessBeauty on Tue 02/28/2012