Saturday, September 24, 2011

15 Natural Ways Treat Depression.

While therapy and medication are key in controlling depression, there’s also a lot you can do on your own to fight back. Making changes to your own behavior -- your physical activity, diet, and lifestyle -- can be effective natural depression treatments.

“Lifestyle changes are a very important part of treatment,” says Ian A. Cook, MD, director of the Depression Research Program at the University of California Los Angeles.

On their own, Cook says, natural depression treatments can beat back milder forms of disease. For more severe depression, they can complement other approaches. When medication and therapy aren’t enough, treating depression naturally through lifestyle can help push people toward full recovery.

“Fighting depression is a war that’s waged day to day, not just over weeks and months while you wait for other treatments to take effect,” says Dean F. MacKinnon, MD, associate professor of psychiatry at the Johns Hopkins Hospital in Baltimore.

So as bleak as things might seem, there are things that you can do, right now, that will help you feel better. Here’s what you need to know about natural depression treatments.

Get in a Routine to Treat Depression Naturally

If you’re depressed, or have been depressed, you need a routine. Depression can strip away the structure from your life, letting one day bleed into the next. That absence of order can also make your depression worse.

“It’s extremely stressful to wake up in the morning and have no idea what you’re going to do with the day,” says MacKinnon.

Cook agrees. “Having a routine gives you a sense of control over the day,” says Cook. “We know that helps, and we know that not having a sense of control makes people feel worse.”

What should you build into your schedule to help fight depression naturally?

1. Exercise. Study after study has found that physical activity can boost mood, says Cook. How much? You don’t need to run marathons to get a benefit. “It seems like half an hour several times a week may be enough,” Cook says. “More than that may not have a further effect on mood. There seems to be a plateau.”
The type of exercise you use as a natural depression treatment doesn’t seem to matter. “Your cardiologist might want you getting a lot of aerobic exercise for your heart,” says MacKinnon. “But for your mental health, just getting out and walking can be enough.”

2. Diet. There is no depression diet, but there are great benefits to healthy eating. “I don’t think there’s any particular dietary regimen you need to follow,” says MacKinnon. “A basic healthy eating plan should do.”
Nutrition is an important element in your effort to help treat your depression, MacKinnon says. “Healing from depression is a physiological process, just like healing from a physical injury,” he tells WebMD. He says that without good nutrition, medications for depression can’t work as effectively.
There are some other things to keep in mind. Ask your doctor if your medication might cause weight gain. If so, you may want to take special care with your diet. If your depression is associated with an eating disorder -- like anorexia or binge eating -- you need to be working with an expert.

3. Sleep. While sleep problems are a symptom of depression, they can also make it worse. Some people with depression sleep excessively. Many more depressed people suffer from insomnia. Either way, you need to do something.
Lying in bed and willing yourself to sleep won’t work. But one natural depression treatment is to make your life more conducive to getting a good sleep. Go to bed and get up at the same time every day. Try not to nap. Take all the distractions out of your bedroom -- no computer and no TV.

4. Goals. To help yourself during treatment for depression, it’s important to meet goals that you set for yourself. The trick here is to come up with realistic goals -- ones that you can really accomplish in a day. Drafting a 20-page to do list is not going to help. If you’re having trouble setting goals, Cook recommends working with a therapist, family member, or friend. Someone who can help you prioritize what’s most important and break larger tasks into smaller, more manageable ones.

5. Responsibilities. When you’re depressed, a natural inclination is to pull back -- to give up all your responsibilities at home and at work. It’s a feeling you should fight against. Staying active and having daily responsibilities can work as a natural depression treatment. They help ground you and give you a sense of accomplishment.
Obviously, don’t push yourself too far. If you’re not ready to go back to work or school, that’s fine. Think about part-time. If that seems like too much, consider a little volunteer work.
“If you’re volunteering to help clean up a playground, you’re still doing something,” says MacKinnon. “You’re getting out of the house, and at the end of the day you know that you accomplished something.”

6. Relaxation. Don’t assume that fun or relaxing things will happen naturally. The only way to make them happen is to plan them.

Cognitive Ways to Cope With Depression Naturally

In your fight against depression, a lot of the work is mental -- changing how you think.

“When you’re depressed, you become trained to see the world and yourself in a negative way,” says MacKinnon. These patterns of thought can have a lasting impact. They can linger on months or years after you’ve resolved the biological cause of the depression, MacKinnon says.

Automatic negative thoughts are particular sources of trouble. These thoughts occur spontaneously when you encounter a situation and affect how you feel. They can link to one another in a chain, dragging you downward.

An example: Your boss asks you to rewrite the opening of a proposal you worked on. Rather than just doing it, you dwell on it. In your mind, this incident becomes symptomatic of deeper problems. You’re incompetent. You’re going to be fired. You’ll be penniless. You’ll lose your house. Your family will hate you. You’re a complete screw-up. You don’t deserve to live. In seconds, your good mood disappears and you’re plunged into misery.

How can you battle automatic negative thinking?

7. Reflect. At first, it’s very hard to catch yourself engaging in automatic thinking, says Cook. By definition, you’re not completely aware that it’s happening. Instead, Cook says it’s often easier to look back on a bad day and figure out what happened in hindsight. How did you get from feeling pretty good in the morning to feeling horrible by noon? What events -- and what thoughts -- led you to such a depressive state of mind?
By reconstructing what happened, you learn how your mind works and what automatic thinking you’re prone to. Then you can do something about it. “In time, you get a lot better at recognizing automatic thoughts in the moment,” says Cook, “so you can stop them before they get out of control.”

8. Take a break. When you find yourself engaging in automatic thinking, clear your head. Cook recommends breathing exercises or simply getting up and walking around. “Taking a break from whatever you’re doing physically can create a break in the mental process,” he tells WebMD.

9. Use logic. The next time some problem is making you feel terrible about yourself, try to use logic as a natural depression treatment. Depression can make you think bad things about yourself that are grotesquely exaggerated. “Try to impose some reason,” says Cook. “Inject some reality.” Is it really true that no one likes you? Is there real evidence for that? Sure, you might feel like the most stupid and hateful person on the planet, but really, what are the odds?

Other Natural Depression Treatments

In addition to getting in a routine and making cognitive changes, there are other natural depression treatments you should consider. Here’s a rundown.

10. Reach out to friends and family. To get through a depression, you need the support of trusted family and friends. Talking about what you’re going through can be a good natural depression treatment. Try to develop a network of supports. That way, you’re not putting too much pressure on a single person.
A friend shouldn’t only be a shoulder to cry on. Sometimes, you might want to set aside your feelings for a few hours. “Taking a break from thinking about your depression can be helpful,” says Cook. “You can just try to enjoy being with that other person.”
MacKinnon agrees. “If you were recovering from pneumonia, you wouldn’t feel obligated to regale everyone with details about what you were coughing up,” says MacKinnon. “It’s OK not to talk to everybody about what you’ve been through with your depression.”

11. Get support. In addition to relying on your friends and family, joining a support group can also be a good natural depression treatment. There, you’ll meet people who really understand what you’ve been through – perhaps in a way that your family and friends can’t.

12. Check with your doctor before using supplements. While lots of supplements have been promoted as depression cures, the research has been mixed. Always check with your doctor before starting any supplement, especially if you’re already on other medications.

13. Watch out for substance abuse. Lots of people deal with depression by relying on alcohol and other substances. Don’t. After a few hours, these substances only leave you feeling worse. If you think you have a substance abuse problem, don’t wait until your depression is resolved to deal with it. Get help now.

14. Do something new. When you’re depressed, you’re in a rut. A typical day might be spent cycling between the bed, the television, and the computer. Cook recommends that people push themselves to do something different and new as a natural depression treatment. Go to a museum. Pick up a used book and read it on a park bench. Volunteer at a soup kitchen. Take a language class.

15. Don’t ignore serious signs of depression. While using natural depression treatments on your own can help a lot, they have limits. “People are amazingly resourceful when it comes to helping themselves,” says Cook. “But when they become so depressed that they can no longer function, or they’re feeling like the world would be better without them, they need to get professional help.”

Don’t Forget: Make Time for Things You Enjoy

Experts agree: If you’re depressed, you have to make time for things you enjoy. You have to relax. You have to do things that are fun.

This may be advice you’ve heard before. And there’s a problem with this natural depression treatment. When you’re depressed, or recovering from depression, having fun can seem impossible. Things that used to be fun don’t feel fun anymore. So why bother?

It’s a common problem, experts say. “One of the insidious aspects of depression is that it trains you to become hopeless about finding anything in life pleasurable,” says MacKinnon.

But this is just another unhealthy thought pattern that depression instills in us. The key is to unlearn it. While we assume that having fun is supposed to be effortless, it isn’t. You’ve gotten out of practice.

So as perverse as it might sound, you may have to work at having fun. Schedule things you used to enjoy. Even if it feels like a chore, keep going out with friends. Keep going to the movies and keep playing tennis.

“Sometimes, you really have to take a leap of faith and force yourself to do these things,” says MacKinnon. The act of doing them is itself a form of rehab, he says. You’re retraining yourself. In time, fun things really will feel fun again.

Thursday, September 22, 2011

Are you lonely?

Loneliness is defined as a lack of desired social connection and social support. It is often associated with feelings of isolation, worthlessness, and sadness. Loneliness is not necessarily the state of being alone. One can be utterly lonely in a room full of people who don’t seem to notice, in a college dorm with no special friend, in a marriage with no understanding. Loneliness is not the peaceful solitude we cherish. It is the pain of being without meaningful connection, a feeling of emptiness that entraps us in fears, longing and negative perceptions about ourselves and others.

Loneliness is widely prevalent. In a survey of eighteen countries, the United States was in the top quarter of countries in terms of average levels of loneliness.

Loneliness is a dangerous place both physically and psychologically. Research finds that loneliness is associated with alterations in the functioning of the cardiovascular, endocrineand immune systems. It is implicated as a risk factor in high blood pressure, diminished cognitive abilities, progression of Alzheimer’s disease and sleep difficulties. Psychologically, loneliness has been associated with depression, stress, hostility, lack of confidence and unhappiness.

A new study offers important findings about the connection between loneliness and depression.

While there is often overlap and confusion between depressed and lonely feelings, the researchers demonstrate that loneliness and depression are conceptually and operationally different phenomena.

Loneliness, as measured in the study by the UCLA Loneliness Scale -Revised (a 20 item questionnaire) is reflected in questions as “How often do you feel unhappy doing so any things alone? How often do you feel shut out and excluded by others?
Depression, as measured in this study by CES-D (a 20 item questionnaire) is reflected in questions as “I felt that I could not shake the blues even with help from my family or friends.” “I had crying spells.”
Studying 229 middle age adults, researchers VanderWeele, Hawkley, Thisted & Cacioppo tested the adults for loneliness and depression each year for five years. They found that loneliness persisted across the years and had a major effect on increasing depression symptoms.

The researchers report that by using a marginal structural model analysis that separates out factors and can study loneliness and depression over a number of years, prior loneliness (two years) proves to be a more significant predictor of later depression than self-esteem or even prior depression.

Of crucial importance is the additional finding that if you intervene to reduce loneliness, you can significantly reduce depression symptoms. In fact, the quicker the intervention to reduce loneliness, the better the reduction of depression. Intervention to reduce loneliness 2 years prior to assessment of depression had a greater impact on reducing depression than one year.

Strategies for Reducing Loneliness

As we recognize the suffering from depression in those we love or in ourselves, it is worth considering the impact of loneliness on depression and the proven value of taking steps to intervene.

State of Mind

“The Mind can make a heaven out of Hell or a Hell out of Heaven” (John Milton)

A central component to loneliness is perception of self and others. Feeling alone and without the social connections desired, one can begin to see everything “through a glass darkly.” The world feels rejecting and everyone else seems connected. Loneliness is self-perpetuating as it becomes more and more difficult to believe that anyone cares or that a call or email could make a difference.

Cognitive Re-framing

A Meta-Analysis of Interventions to Reduce Loneliness found that the most effective interventions for reducing loneliness are those that involve changing our negative news of self and others. An example of this is cognitive re-framing. This psychological technique involves re-assessing a situation with a new meaning and as such, altering our perspective, our feelings and eventually our behavior. Even a small step of reconsidering can matter. For example,

You consider going down to the faculty lunch room rather than staying in your classroom and assuming everyone else has received an invitation – More likely everyone is barely getting through the morning and won’t know where you are or why you choose to stay away- if you don’t show up.
You go to the book club you registered for even though you were too anxious to go to the first meeting. You consider that they probably didn’t become life-long friends in one week.
On a Friday night, you consider that EVERYONE is calling someone to find out what is going on. NO ONE gets calls without making calls.
A Different Way of Being with Self

From Pain to Passion -Another antidote to the emptiness and longing of loneliness is to step out of pain into your own passion. Pursuing what you love is a win-win. When you are doing what you love be it hiking, fishing, reading or golf (yes you can join a three-some), you are back in control of fueling yourself physically and emotionally. In most cases, your mood, manner, smile and posture change. Sometimes the added bonus is that you come across someone who also likes fishing.

Traveling with a Goal- A newly divorced and lonely young woman once told me that she could never travel again. She disliked “groups” and “Who ever goes to Paris alone?” We worked on the idea that if you are on a mission, if you have a goal, then it changes your feeling about being alone. You are far less worried about who is next to you – and far more determined to see what is in front of you.

She set off for Paris with the goal of taking photos of balconies with flowering pots. She came home with photos and the stories of the paths and people she found along the way.

The Power of Pets

Pets are awonderful antidote to loneliness. It is hard to wonder “Who would want to be with me?” when a big or little creature is waiting at the window eager to see you and ready to go almost anywhere with you. The fact the pets are a magnet for people is a bonus to the feelings of connection and value one gives and gets from pets.
An interesting study of nursing home residents found that the residents were less lonely after spending time alone with a dog then they were when they visited with a dog and other people. Whereas the original hypothesis was that the dog would increase interaction among the residents and reduce loneliness, it became clear that the special one on one feeling with the dogs did much more.
Altruism-Looking Beyond Self

The effort to help another or to give to others has been found to reduce feelings of loneliness. In one sense it disrupts the self-perpetuating negative focus on self because it involves focus on another. It reduces the hesitancy of stepping forward to risk connection and the fear of rejection because the goal is giving – not getting. The privilege to help is a gift in that it increases our sense of worth and provides meaning for being.

Spirituality-The Impact of Belief

There is evidence that spirituality reduces loneliness. In one research study that matched groups of healthy and ill adults, the findings revealed that in both groups the higher the Religious Well Being Scores and the Spiritual Well Being Scores the lower the loneliness scores.

It may well be that a belief system affords a person a sense of not being alone, of having a Higher Being to turn to, or perhaps a reframing of being alone as an opportunity to meditate, pray, appreciate nature – make room for God.
Spirituality may also reduce loneliness because whether as a mental image or actually in a church, temple or mosque full of people, there is acceptance and connection in a community of believers.
You can step away from loneliness in many ways – it is a step worth taking.

Monday, September 19, 2011

Is “Sexting” Cheating You Out of Real Intimacy?

There is a good, sound argument for how technology can bring two people together. Countless couples have now met, married, forged unions, and had children as a result of a dating website, a Facebook chat, or a bold text message. Technology has provided a new platform for millions of people to take that first step in a relationship. This has been especially helpful to people who are shy, overworked, or just too exhausted to make a consistent effort to get out and meet someone.

Between smart phones and the Internet, the possibilities for flirtation are now endless. This can be healthy when it comes to keeping the spark alive between a couple, particularly one enduring forced separations. It can also be beneficial to two people first getting to know each other; it’s much easier to ask for a date by text than face-to-face. The so-called “sexting” that takes place between two people getting together can be positive when the flirtation turns into action, i.e. when the text messaged invitation becomes the actual first date. The trouble arises when devices become a substitute for real relating. When it comes to love in the time of technology, there are four elements (what I call the four D’s) that we all should be wary of: Distraction, Disconnection, Desensitization, and Dishonesty.

Distraction
Relationships are hard work. The baggage each person carries with them weighs heavily on the way a couple relates to each other. Caring for someone deeply can trigger old feelings, memories, and fears. The closer things get, the more obstacles we should expect to encounter. Devices are a major distraction from the real challenges that arise in a relationship. Passing time on our Blackberry helps us avoid major issues or problems that are lying right next to us in bed. When the going gets tough, the tough start texting.

This problem is one that has been explored by Dr. Pat Love, the acclaimed author of “The Truth About Love” and “Hot Monogamy,” and it’s one I discussed with her recently when we were recording our upcoming webinar, “Love in the Time of Twitter.” We wanted to explore how interpersonal relationships have been impacted by new media and explore how love can be preserved in the face of such colossal distraction. As Love recently wrote, “Other than breathing we spend more time streaming technology than any other activity … This constant state of stimulation leaves little room for contemplation, mindfulness, and deep intimacy, which are all necessary for maintaining relationships.”

A damaged connection can lead us to start looking for excitement or romance in other places, like Twitter, Facebook, or exes whose numbers are conveniently programmed into our cell phones. This communication doesn’t always lead to deception or infidelity, but the distraction alone inhibits us from repairing the connection we have with our partners. It limits our ability to attune to our partners and be sensitive to their needs and aware of what lights them up. Time spent with devices can keep us from taking the time to talk through problems, resolve arguments, or simply spend time enjoying each other — actions that would rekindle the spark we initially felt in our relationships.

Disconnection
The trouble with much of the flirting we do via email, text, or live chat is that it can be highly impersonal. Many of the examples we’ve seen of “sexting,” from everyone from close friends to high-profile politicians, seem to cross the line from real relating to total fantasy. The trouble is that people often prefer the intoxicating illusion of connection and sense of possibility to the everyday acts of romance that are available to them. As I said before, relationships bring real challenges that we can easily avoid in a cyber world. The deeper we travel into fantasy, the further we drift from what is really important to us, who we really are, and what we really want. We replace a deep and meaningful connection with surface pleasures that fail to fulfill us in the long run.

Desensitization
Technology has the wonderfully destructive ability to tune us out. The outlets for instant gratification have invaded our homes in the form of apps, online shops, games, videos, social media, and more. We rarely have to face our fears on Facebook or feel our anger over a game of Angry Birds. Technology can numb us from pain, but it also numbs us from passion. Any activity we use to cut off negative emotions has the unfortunate effect of diminishing positive emotions as well. This can be particularly taxing on our intimate relationships. If we use the little energy we have left at the end of a day to return emails or surf the Web, think about what we are sacrificing in the way of attunement, affection, passion, and personal exchange.

Dishonesty
One of the most glaring downsides of new media is that, in many relationships, it has bred an environment of deception and distrust. We now not only live in a world where many people think it okay to search through their partner’s cell phone, but a world in which these same people often find something that confirms their suspicions. From flirty texts to secret lives, people have used technology not just to escape but to deceive.

This deception can take place when we withhold information from our partner that we fear will make him or her jealous. It can take place when we substitute the excitement of a secret flirtation for the passion we once felt in our relationship. It can even occur when we deceive ourselves that the relationships we forge and people we meet online are perfect or superior to our imperfect, real-life unions. In this sense, we can use varying degrees of “sexting” as a build-up of ourselves or a way to feel dirty or bad about ourselves. In either case, we are avoiding the truth, preferring an illusion of what could be over what we really have.

The solution to the problem of technology invading our relationships is far from hopeless. In each individual case, one must examine how he or she uses technology and whether or not that use is distancing him or her from a loved one. If it is being used as a distraction, what are we avoiding? If it is being used as a desensitizer, what pain are we not facing? The sentiment may be easier said than done, but it holds true that it is always better to do the hard part, challenge ourselves to get close, and fight to have a satisfying relationship. In this journey, we can use technology to get closer as opposed to moving further away from each other. We can use it to ask sensitive questions about each other’s day, to plan an exciting night together, or to keep connected in a world where one million distractions are always readily available, if not in the ceaseless streaming of gadgets but the never-ending output of our own minds.

Wednesday, September 7, 2011

Healthy Boundaries

Boundaries are essential to healthy relationships and, really, a healthy life. Setting and sustaining boundaries is a skill. Unfortunately, it’s a skill that many of us don’t learn, according to psychologist and coach Dana Gionta, Ph.D. We might pick up pointers here and there from experience or through watching others. But for many of us, boundary-building is a relatively new concept and a challenging one.

Having healthy boundaries means “knowing and understanding what your limits are,” Dr. Gionta said.

Below, she offers insight into building better boundaries and maintaining them.

1. Name your limits.

You can’t set good boundaries if you’re unsure of where you stand. So identify your physical, emotional, mental and spiritual limits, Gionta said. Consider what you can tolerate and accept and what makes you feel uncomfortable or stressed. “Those feelings help us identify what our limits are.”

2. Tune into your feelings.

Gionta has observed two key feelings in others that are red flags or cues that we’re letting go of our boundaries: discomfort and resentment. She suggested thinking of these feelings on a continuum from one to 10. Six to 10 is in the higher zone, she said.

If you’re at the higher end of this continuum, during an interaction or in a situation, Gionta suggested asking yourself, what is causing that? What is it about this interaction, or the person’s expectation that is bothering me?

Resentment usually “comes from being taken advantage of or not appreciated.” It’s often a sign that we’re pushing ourselves either beyond our own limits because we feel guilty (and want to be a good daughter or wife, for instance), or someone else is imposing their expectations, views or values on us, she said.

“When someone acts in a way that makes you feel uncomfortable, that’s a cue to us they may be violating or crossing a boundary,” Gionta said.

3. Be direct.

With some people, maintaining healthy boundaries doesn’t require a direct and clear-cut dialogue. Usually, this is the case if people are similar in their communication styles, views, personalities and general approach to life, Gionta said. They’ll “approach each other similarly.”

With others, such as those who have a different personality or cultural background, you’ll need to be more direct about your boundaries. Consider the following example: “one person feels [that] challenging someone’s opinions is a healthy way of communicating,” but to another person this feels disrespectful and tense.

There are other times you might need to be direct. For instance, in a romantic relationship, time can become a boundary issue, Gionta said. Partners might need to talk about how much time they need to maintain their sense of self and how much time to spend together.

4. Give yourself permission.

Fear, guilt and self-doubt are big potential pitfalls, Gionta said. We might fear the other person’s response if we set and enforce our boundaries. We might feel guilty by speaking up or saying no to a family member. Many believe that they should be able to cope with a situation or say yes because they’re a good daughter or son, even though they “feel drained or taken advantage of.” We might wonder if we even deserve to have boundaries in the first place.

Boundaries aren’t just a sign of a healthy relationship; they’re a sign of self-respect. So give yourself the permission to set boundaries and work to preserve them.

5. Practice self-awareness.

Again, boundaries are all about honing in on your feelings and honoring them. If you notice yourself slipping and not sustaining your boundaries, Gionta suggested asking yourself: What’s changed? Consider “What I am doing or [what is] the other person doing?” or “What is the situation eliciting that’s making me resentful or stressed?” Then, mull over your options: “What am I going to do about the situation? What do I have control over?”

6. Consider your past and present.

How you were raised along with your role in your family can become additional obstacles in setting and preserving boundaries. If you held the role of caretaker, you learned to focus on others, letting yourself be drained emotionally or physically, Gionta said. Ignoring your own needs might have become the norm for you.

Also, think about the people you surround yourself with, she said. “Are the relationships reciprocal?” Is there a healthy give and take?

Beyond relationships, your environment might be unhealthy, too. For instance, if your workday is eight hours a day, but your co-workers stay at least 10 to 11, “there’s an implicit expectation to go above and beyond” at work, Gionta said. It can be challenging being the only one or one of a few trying to maintain healthy boundaries, she said. Again, this is where tuning into your feelings and needs and honoring them becomes critical.

7. Make self-care a priority.

Gionta helps her clients make self-care a priority, which also involves giving yourself permission to put yourself first. When we do this, “our need and motivation to set boundaries become stronger,” she said. Self-care also means recognizing the importance of your feelings and honoring them. These feelings serve as “important cues about our wellbeing and about what makes us happy and unhappy.”

Putting yourself first also gives you the “energy, peace of mind and positive outlook to be more present with others and be there” for them.” And “When we’re in a better place, we can be a better wife, mother, husband, co-worker or friend.”

8. Seek support.

If you’re having a hard time with boundaries, “seek some support, whether [that’s a] support group, church, counseling, coaching or good friends.” With friends or family, you can even make “it a priority with each other to practice setting boundaries together [and] hold each other accountable.”

Consider seeking support through resources, too. Gionta likes the following books: The Art of Extreme Self-Care: Transform Your Life One Month at a Time and Boundaries in Marriage (along with several books on boundaries by the same authors).

9. Be assertive.

Of course, we know that it’s not enough to create boundaries; we actually have to follow through. Even though we know intellectually that people aren’t mind readers, we still expect others to know what hurts us, Gionta said. Since they don’t, it’s important to assertively communicate with the other person when they’ve crossed a boundary.

In a respectful way, let the other person know what in particular is bothersome to you and that you can work together to address it, Gionta said.

10. Start small.

Like any new skill, assertively communicating your boundaries takes practice. Gionta suggested starting with a small boundary that isn’t threatening to you, and then incrementally increasing to more challenging boundaries. “Build upon your success, and [at first] try not to take on something that feels overwhelming.”

“Setting boundaries takes courage, practice and support,” Gionta said. And remember that it’s a skill you can master.

A Rebuilding of Healing.

“For many people, an affair is deeply traumatizing [and] some marriages can’t recover from it,” said Jason Seidel, PsyD, founder and director of The Colorado Center for Clinical Excellence in Denver. But if you decide to work on your relationship post-affair, you must accept a hard truth: Another affair can happen. This is the paradox of healing, Seidel said.

Often, partners who’ve been cheated on will demand full access to their spouse’s email, cell phone records, Facebook and other accounts (or they’ll sneak around to get the access), he said. They see this as legitimate and essential to helping reestablish trust in the relationship. A common belief is “How could I ever trust you again unless you give me full access?”

While this thinking is understandable, it simply doesn’t work.


The real issue, at the core, is self-protection. Partners cling to the idea that if they have all the information and control enough of their partner’s life, they’ll somehow be spared another betrayal, Seidel said. (Some partners also will take this distrust into new relationships, where they automatically doubt the person and almost prepare themselves for infidelity, he said.)

But the reality is that “no amount of access satisfies the need,” and it’s a “false sense of security.” While it might seem contradictory, to fully heal and rebuild your relationship, partners need to relinquish control of their spouse’s behavior.

Clutching to controlling ways only distances you more from your partner and stalls progress. It “undermines your partner’s willingness to own up to their behavior” or feel remorseful or accountable. It creates a counterattack that disrupts healing, Seidel said.

Of course, other work is required, too. “Affairs don’t happen in relationships that are strong to begin with,” Seidel said, who works with couples on a number of issues that plague the relationship. This “may take a tremendous amount of effort.”

One of the key elements of recovering and healing from an affair is to “drop into your grief and grieve the relationship you thought you had.” It also involves “grieving the loss of your naïveté.” The other partner must honor this grieving process and not rush it, he said.

In time, the “wounded partner” also needs to look inward and decide whether they’re able to open their heart to their partner again — and whether they’ll be OK if another betrayal occurs. But this doesn’t mean closing your eyes if you sense your partner is being dishonest or “not working on making amends or really understanding what happened,” he said.

Seidel’s other advice to betrayed partners is to accept that your powers are limited, get clear on your own boundaries and build up resources like social support.

The partners who cheated also have a difficult time post-affair. Unless the affair is done in “a callous and cavalier way,” they often struggle with a “sense of devastation, deep shame and fear.” They lose their sense of self, in part because they didn’t believe that they were the type to commit adultery. The best way to heal and “process these particular emotions may be in individual therapy where the unfaithful partner can sort through them with less defensiveness,” Seidel said.

Again, healing after an affair and rebuilding the relationship requires the effort of both partners, along with the difficult acceptance that ultimately another betrayal could happen, “and if so, where will you be in terms of your resources and your sense of strength to move on?”