Transport back with me, to Algebra class—seventh grade, eighth grade, or whenever that was for you. You’ve already learned how to solve more straightforward math equations—those with just subtraction or just division or just exponents. Now, you’re learning to solve more complex equations that include multiple of these.

Your algebra teacher shares with you something revelatory: Because these new, complicated equations have multiple types of math in them, you need something called an order of operations to work through them—a step-by-step approach to solving these multifaceted problems.

Enter PEMDAS. Aka, Please Excuse My Dear Aunt Sally. Aka, Parentheses, Exponents, Multiplication, Division, Addition, Subtraction.

It’s an acronym. It’s a mnemonic. It’s a guide. It’s a praxis. It’s basically everything you could ever want and need to solve life’s most challenging math problems. It reminds you to process problems one step at a time, and it gives you the step-by-step order to follow. It’s a religion.

Perhaps most excitingly, the underlying principle of PEMDAS extends far beyond algebra class, and indeed far beyond the field of math. (Thankfully, because I stopped understanding math when I got to geometry.)

This principle—that an order of operations can provide a helpful framework for solving complex problems—is one you can apply to yourself each day. Specifically, as you navigate the inevitable moments of feeling multiple negative emotions at once.

These moments are so deeply common. When you make a big mistake, you might feel distress, failure, and anxiety. When you’re underpaid at work, you might feel frustrated, inferior, and worried about paying the bills. When your romantic partner wrongs you, you might feel anger, sadness, and unsafe. When your child struggles in a way you can relate to, you might feel concerned about your kid, insecure about your parenting skills, and personally triggered.

These moments create unique challenges characterized by the broader sense of emotional overwhelm. All the emotions you’re feeling simultaneously—they can sort of glom together, into what seems like a big, heavy, amorphous emotional heap. You might think, “Where do I even start?”

In these moments, just as in algebra class, a clear order of operations can aid you. This emotional order of operations is a lot like PEMDAS, but also has a key difference.

Regarding how they’re alike: First, both require you to assess the problem you’re looking at, specifically by naming its components parts. For example, solving the math equation

X = (2+ 4) + 5² – 3 x 3 

requires you to first notice it includes Parentheses, an Exponent, Multiplication, Addition, and Subtraction. This step is as important to solving the math problem as it is to navigating complicated emotional moments. Simply put, labeling the multiple negative emotions you’re feeling in any moment sets you up to effectively and efficiently work through those emotions.

Another similarity between an order of operations for math and emotions, is that after you identify the key components of the current problem, it’s recommended to address each of those components singularly and in a stepwise fashion. In our equation

X = (2+ 4) + 5² – 3 x 3 

per PEMDAS, you’d first take care of what’s in the Parentheses: 2 + 4 = 6. You’d then address the Exponent: 5² = 25. Next, the Multiplication: 3 x 3 = 9. Finally, Addition and Subtraction, left to right: (6) + 25 – 9 = 22. Therefore, after taking things methodically and stepwise, you solve for X, as 22.

Same goes for those moments with multiple negative emotions: Address each component one at a time. Let’s use one of our earlier examples: When you make a big mistake, you might feel distress, failure, and anxiety.

After identifying these component emotional parts, attempt to process and respond to them one by one. I listed distress first because I recommend dealing with any general “distress” first. This is because experiencing general distress itself can be aversive and can compromise your ability to process other emotions. You may have heard of the related concept of distress intolerance, which is when we feel dysregulated simply because we’re distressed at all.

This makes sense; distress is distressing. But labeling general distress—and using a few microskills to reduce it—can help set you up to process other, more situation-specific emotions you’re feeling. Such distress tolerance microskills include breathing/relaxation exercises; visualizing something positive; splashing cold water on your face; grounding yourself in the present moment by connecting with your current sensory experiences; or repeating an empowering phrase to yourself, e.g., “You’ve got this.”

After you complete this important step in your emotional order of operations, move on to the next emotion—the one that feels most strong. I recommend this approach, because often if you can process a little or a lot of this strongest emotion, some of the other negative emotions you’re feeling may also dissipate.

Let’s say in our example, the remaining emotion you felt most strongly was failure. Using some microskills to address these failure feelings can go a long way. Such microskills include generating counterevidence to the feeling of failure—asking yourself, “When have I been successful, now or in the past?”; de-catastrophizing—reminding yourself that likely the worst outcome you’re imagining now will not manifest; and, self-compassion—generating compassionate contextual reasons for the mistake you made, “I was stressed, I did my best.”

Processing some general distress and failure hopefully would have you feeling better already. But, to the extent that you want, keep going in your emotional order of operations—aiming to process any remaining emotions one by one, until you feel better enough to move forward from whatever complex or challenging emotional experience you’re having.

For sure, each of your complex emotional experiences is unique—just like each algebra problem is. But, an order of operations will give you a broader, guiding framework to use across experiences.

Here’s where we get to that key difference between PEMDAS and our emotional order of operations: PEMDAS leads to you solve problems, whereas our new system leads you to process, but not necessarily “solve,” emotions.

This isn’t totally surprising, because while math is quantitative, life is qualitative. This qualitative richness of life is what makes it so beautiful, but also sometimes so gut-wrenching. We can simultaneously be grateful for both systems like PEMDAS that solve problems, and for more emotion-based orders of operations that don’t solve problems, but help us live a more fulfilling life.

Thanks, algebra teacher. Thanks, Aunt Sally. And now, thanks, new emotional order of operations.

Steff Du Bois, PhD, (he/they) is a clinician in private practice, and associate professor of psychology at the Illinois Institute of Technology (IIT). They lead the Du Bois Health Psychology Laboratory, where they mentor psychology students and conduct health psychology research.

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When food helps you cope, you’re not only eating to satisfy physical hunger. You’re eating to numb emotional pain and calm the stress in your body. Intuitive eating is a non-diet approach to eating and living a healthy lifestyle—freeing you from the rigid constraints of diet culture. But when eating is the way you cope with the pain of childhood trauma, it can feel hard to stop emotionally eating and develop intuitive eating skills.

A foundational principle of intuitive eating is to notice when your body is hungry and when it feels full. Noticing your body’s inner signals and sensations is called interoceptive awareness. This awareness includes physiological sensations such as hunger and satiety, and also emotional sensations such as anxiety or fear. Attuned interoceptive awareness helps you honor your body’s needs to live an intuitive eating lifestyle.

Sounds like a positive and achievable goal, right? Yet, if you’re one of thousands of people with a history of early trauma and abuse and you struggle with emotional eating, you may have a harder time noticing what your body is communicating to you. This is not failure on your part. Intuitive eating may feel inaccessible because the physiological and emotional effects of trauma—unsettling sensations, underlying anxiety, uneasiness, and suppressed and repressed memories—stay stored in the body. These trauma-based emotions can block you from noticing your body’s hunger/fullness signs.

For example, you’ve probably noticed that physical hunger and emotional hunger sometimes feel intertwined. It’s hard to know if you’re hungry for food when emotional hunger and stress leave you craving for something—anything—to fill a deeper void or calm the anxiety in your body. Searching your refrigerator for an evening snack—right after eating dinner—may seem to satisfy your hunger. Or maybe it’s numbing the sadness triggered by another Saturday night alone.

Am I hungry? Or am I sad and lonely?

Sometimes it’s hard to tell the difference.

Early trauma and abuse, especially when chronic, causes nervous system dysregulation. The brain’s normal reaction to threats—the fight-flight-freeze response activated by the part of the brain called the amygdala—intensifies. This makes you hypersensitive to stress so that your body and emotions easily become dysregulated: You feel overwhelmed and experience unsettling sensations in your body. For example, your breathing quickens; you get a sinking feeling in your gut. You feel anxious and afraid, or shut down and go numb.

In this stressed state, you emotionally eat to ground yourself even when your body doesn’t need food. Learning how to calm your nervous system will help because a calm body helps you feel safe. When you and your body feel safe, you’re better able to identify the difference between physical hunger and emotional overwhelm. This body awareness helps you make mindful— rather than impulsive—self-care choices, and opens the space to discover ways to soothe yourself without using food.

Here are four simple and practical ways to develop a more connected relationship with your body and help move you on the path to becoming an intuitive eater.

1. Learn your body’s emotional cues.

Noticing your body’s hunger/fullness signs is a foundational intuitive eating skill. But these signs may be hard to notice when emotional hunger is misread as physical hunger. That’s why it’s important to learn how your body and nervous system communicate emotion to you.

Throughout the day, check in with your body. Use this simple five-point body-awareness scale to notice and gauge how calm or unsettled your body feels.

1 – I feel calm and peaceful.

2 – I feel at ease.

3 – I feel a little unsettled.

4 – I feel very unsettled.

5 – I feel overwhelmed.

What number represents how you and your body feel right now? If you’re at a three, four, or five on the scale, use the following breathing exercise.

2. Breathe to settle your body.

Box breathing, also known as four-step breathing, helps you activate your body’s natural relaxation response. This proven practice, with roots in Hindu pranayama breathing, helps calm your body and reduce stress. Here’s what you do:

1. Breathe in to the count of four.

2. Hold the breath for four counts.

3. Exhale for four counts.

4. Hold the breath for four counts.

5. Repeat the sequence three or four times.

(If four counts feels too long, use three.)

When you’re at a three or higher on the above body-awareness scale, use box breathing. This can help you feel calmer and reduces the likelihood that your body becomes highly dysregulated. As you feel calmer and safe in your body, you’re then less apt to impulsively use food to reduce the overwhelm.

Develop the daily habit of using box breathing to give yourself moments of peace and relaxation. The more you condition your body to feel relaxed, the easier it is to settle yourself when your body is dysregulated.

3. Take your body for a walk.

I’m not talking about walking for exercise, although that’s important. I want you to think of walking as a way to make friends with your body. Schedule quality time with it like you would make a date with a close friend.

Plan about ten, fifteen, or twenty minutes once a week and take your body for a walk. If walking is hard or you’re a person who uses a wheelchair, give your body light stretching or chair yoga movements. Whether walking or stretching, do this by yourself. This time is for you and your body, and not to be shared with a friend.

Walking dates are a good way to get acquainted with your body and develop interoceptive awareness. Since walking can calm your nervous system, it can feel easier to focus on your body while moving. As you walk, notice what’s happening in your body. For example, notice the rhythm of your breathing. Is it rapid and shallow or even and deep? Notice your emotional state. Does your body feel agitated and tense, or peaceful and calm? Draw your attention to your arms and legs. Do they feel sluggish and heavy, or sturdy and strong? Notice, as best you can, how hungry, full, or satisfied you feel.

Use this time to also offer appreciation to your body. For example, you can say:

“Thank you, eyes, for allowing me to see these trees.”

“Thank you, lungs, for allowing me to breathe.”

“Thank you, body, for all you do for me.”

As you walk, stay tuned in to your body as best you can while gifting it messages of appreciation. Your intention is to spend quality, focused time with your body—with no judgment or expectation—to convey that you’re making it a priority, listening to its messages, and want to be its friend.

4. Talk to your body with respect.

Your body has a consciousness of its own, and you regularly communicate with it with your thoughts and words. When you tell your body that you “hate” it or call it “ugly,” your body’s health and energy level weaken. Imagine talking to a friend that way. Your relationship would suffer, right? And so does the relationship with your body.

Think of your body as your BFF or a young child entrusted to your care. It needs you to speak to it with love and kindness. I know that’s sometimes hard to do, especially when you’re struggling with body shame and self-loathing. That’s okay. You’re human and doing the best you can. When you’re upset with your body and speak to it harshly, please don’t judge yourself. Simply apologize and say to your body, “I’m sorry for speaking to you that way.” Then let your body know that you will do your best to nourish it with loving words.

Begin right now and say to your body, “I promise to feed you kind words and thoughts.”

Practice Makes Progress

These four simple practices convey love and respect to your body. You’re communicating that you want to know what it needs and are willing to give it your time and thoughtful attention. As you connect with your body in these ways, interoceptive awareness expands and, over time, this awareness helps you move toward a freedom-filled lifestyle of intuitive eating and mindful self-care.

Diane Petrella, MSW, is a clinical social worker and holistic psychotherapist specializing in childhood trauma and emotional eating. She has a private psychotherapy practice in Providence, RI. You can find out more about Diane at www.dianepetrella.com.

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You’ve decided to attend couples counseling, but where should you start and how do you get the most out of it? If you’ve never been to couples counseling before, you may feel intimidated by the process.

Start by finding the right fit. It is well known that the best possibility for success lies in the fit between you and your therapist. My suggestion is to screen therapists initially by asking what kind of training they have in couples’ theory—it’s okay if you don’t understand their answer; they should just have an answer. I also like to know what percentage of their caseload is couples, and it’s good to aim for a therapist who has at least 50 percent couples in their practice. Conducting couples therapy is a completely different skill than individual therapy, so you want someone who has some experience in this area. Even then, you’ll have to gauge how you feel when sitting with the therapist. Are you comfortable? Do you feel like they hear and respect both of you?

Know your goals going in. You can’t hit a target you’re not aiming at, so if you want to make progress, it’s good to clarify what exactly you are trying to accomplish with the work. If you have a hard time doing this, ask the therapist directly to help you come up with achievable goals. Often, two partners have different expectations and wishes concerning the outcome. It’s helpful to be on the same page and to try to develop a road map of how to get to the destination.

Do the work. Even the best couples therapist in the world can’t help you if you are only working on your relationship one hour a week. Outside of the therapy room, you’ll need to be putting into practice everything you are learning, and intentionally trying to change patterns.

Expect discomfort. If you’ve been in individual therapy, you know that it feels great to have an advocate, someone who is 100 percent on your side with unconditional regard. Couples counseling is an entirely different experience. Hopefully your therapist will be very balanced in challenging each of you on your contribution to the problem, but you will be challenged. If you are going to change an unhelpful dynamic, you will need to see your part in the problem, and be willing to hear suggestions about how you can do things differently. Expect to leave the office at times feeling discouraged and even hopeless. This is part of the process and entirely normal.

Collaborate with the therapist. Your therapist is the expert on healthy relationships, but you are the expert on you. Not every intervention or direction the therapist might take will work for you. We, as therapists, really love when you let us know that something we’re doing isn’t working for you. In this way, we can customize the treatment specifically to you and your situation. You are the consumer, and need to speak up to make sure that the services you are receiving are working for you. Therapists are not always right; we make mistakes. We are happy to have your feedback and collaboration so that we can adjust the course as we go.

Don’t be afraid to switch therapists. We all have a different style, and our greatest wish is that you are set up with a therapist who fits you. So, if after collaborating with your current therapist, you still feel like the therapy isn’t working for you, a switch may be in order. Start by talking to your therapist! I know it seems counterintuitive, but if you tell your therapist specifically what isn’t working for you, they may be able to suggest another therapist whose style fits what you are looking for. For example, some therapists are warm and nondirective; other therapists are very active and challenging. Some therapists stick to practical nuts-and-bolts aspects of your relationship; some therapists delve deep into the emotional realm. It’s quite an investment in time and money to do this work, so don’t be afraid to advocate for yourself if you think a different style would serve you better.

Improving your relationship is a brave undertaking, and takes some work. You’ll be learning new skills, new ways of interacting and deepening your connection. Try to look at it as an adventure and mastery of new skills. Great relationships usually don’t happen by accident, so you are joining those committed to creating healthy and loving relationships.

Lisa Gray, LMFT, is a licensed mental health professional with a private practice in the San Francisco Bay Area, where she specializes in high-conflict couples and chronic illness/pain. After working as an air traffic controller for ten years, and serving as a peer debriefing counselor for fellow controllers, Lisa decided to go back to school to study counseling. She graduated from John F. Kennedy University in 2004 with a master’s degree in clinical counseling, and has been working in the field ever since. Lisa is passionate about teaching couples to practice healthy conflict, so that their relationships can thrive and grow. Lisa reviews self-help books on her Instagram, Therapy Book Nook. She lives in the Bay Area with her family and three large dogs.

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Emotional immaturity encompasses a wide range of personality styles. People can be very different yet still show the traits of emotional immaturity. This syndrome is not a type of mental illness, and ordinary, “normal” people may show its signs. People with psychiatric diagnoses often have underlying immaturity, but not all EIPs qualify for a psychiatric diagnosis. A person’s EI traits become especially noticeable when stress increases or relationships become more intimate.

Emotional immaturity is easier to recognize if you focus on the basics. Although emotional immaturity exists on a continuum of severity, the following five characteristics are foundational in all EIPs, independent of their personality type or level of functioning:

Egocentrism is the basis of the EIP’s orientation toward life. Like young children, they primarily view the world through their own self-preoccupations and swiftly entangle you in their expectations.

With such a self-centered approach, EIPs have limited empathy for others. They don’t put themselves in other people’s shoes nor imagine their inner experience. While they may be intelligent and socially skilled, they don’t feel for other people so much as sense advantage and opposition. This is why an EIP can be an admired or powerful figure in society, yet still have trouble relating to other people in an adequately mature way.

Although EIPs may be plenty smart, they avoid self-reflection. Self-justifying and often self-righteous, they rarely question themselves. They focus on their immediate emotions and desires, seemingly oblivious to how they’re impacting others or even their own future. Instead of reflecting on their behavior, they get defensive and double down on their own position if someone gets upset with them.

When it comes to getting close to other people, EIPs pull back from emotional intimacy. They have a hard time accepting heartfelt emotion from others and certainly have trouble giving it. They may seem highly emotional when they blow up or lose emotional control, but that’s not the same as emotional intimacy. Emotional intimacy occurs between two people who share and process emotional information with each other, getting to know one another at a deep level. This process need not even be in words; it can be the sense one feels that the other person “gets” you and can connect with you in a deeply authentic way. In contrast, EIPs are more likely to become defensive, evasive, or belligerent when others (including their children) try to relate to them with emotional openness and honesty. (You can imagine the negative effect this kind of response has on a young child seeking connection.)

In their approach to the world, EIPs use affective realism, defining reality as what they feel it to be (Barrett and Bar 2009). Their psychological coping mechanisms are immature (G. Vaillant 2000) and simplistic, especially as they deny, dismiss, or distort any reality they don’t like. Their lack of rational objectivity means that it’s nearly impossible to reason with them once their emotions take hold.

Now let’s look at some additional characteristics. Some EIPs are extroverted and dominant, while others are more introverted, passive, and dependent. But whatever their style, EIPs tend to be rigid, superficial, rather shallow personalities. They often express themselves in platitudes or clichéd sound bites that are lacking in real thought. They are not well integrated psychologically, meaning that conflicting aspects of their personality coexist with no awareness of contradiction. They can say one thing and do another with no embarrassment because they don’t notice the mismatch. They focus on the immediate “part” of a situation, not its whole meaning.

Emotionally, they live in the present moment, blurting the first thing that comes to mind and reacting with no regard for the long-term effects of their impulsivity. Their high reactivity also means they are easily overwhelmed, making any problem feel like an emergency to them.

EIPs think in simplistic, literal, black-and-white terms. Logic tends to be used mostly as an opportunistic weapon, not as an essential determinant of their thinking. They typically oversimplify complex topics in ways that make it hard to reason with them.

Actively dominant EIPs overrun other people’s ideas and boundaries. Many are very status and role conscious, expecting others to keep to their assigned roles. Even a more passive and acquiescent EIP won’t show much empathy or interest in your life. Your subjective experience just doesn’t register with them. They expect you to mirror their moods: if they’re happy or upset, you should be too.

EIPs jump to conclusions and easily take offense, making it extremely hard—if not impossible—to talk out problems and disagreements. In conversation, they don’t listen well because, like children, they are always vying for center stage. When communicating, they are set on “broadcast” rather than “receive.” They have little curiosity for your viewpoint and feel affronted and unloved if you don’t do what they want.

More dominant EIPs have low stress tolerance, tend to be impatient, and pressure others to give them what they want. They expect their relationships to revolve around their reactive emotions, and they relate primarily through pronouncements, controls, and demands. Impatience plus egocentrism means that they take things personally and blame everything on other people. EIPs also can be irrationally stubborn, with hair-trigger defensiveness toward anything that threatens their beliefs or self-esteem. They are prone to meltdowns, making people around them feel rushed, criticized, and fearful of upsetting them further. The more passive EIPs may not be as flamboyant emotionally, but underneath their relatively calm demeanor lurks an implacable egocentrism concerning their agendas and motivations.

In close relationships, EIPs expect others to stabilize them emotionally and prop up their self-esteem. The burden of maintaining peace in the relationship usually falls to the other person because EIPs don’t do the emotional work (Fraad 2008) necessary to keep relationships on an even keel. Insensitive to others’ feelings, they think that love means giving blanket approval and letting them do whatever they want. Like a young child, an EIP gains power by distressing others until they capitulate. After funneling your attention into an EIP, you’ll probably come away feeling depleted and drained of energy.

Even the quieter EIPs are instinctively emotionally coercive, controlling you with guilt, fear, shame, or self-doubt. Unless you give in, they will peg you as bad or untrustworthy, and if you do something they don’t like, they will confide in other people against you rather than dealing with you directly.

Whether EIPs demand your attention and self-sacrifice or quietly expect you to prop them up, they have a hard time accepting love. When you act lovingly toward them, they act as if they can’t stand to let it in. With such poor receptive capacity (L. M. Vaillant 1997), they are like a distressed child who won’t let their parent soothe them. The closer you try to get to them, the more they pull back. This is because emotional intimacy threatens to overwhelm and disorganize them. Their fear of emotional intimacy often comes out in irritability, provocations, or conflicts that forestall closeness or vulnerability.

Because EIPs project blame onto other people, you might unwittingly accept their confusing distortions and take responsibility for things that weren’t your fault. Therefore, it is critically important to maintain healthy detachment and think objectively about their behavior.

Lindsay C. Gibson, PsyD, is a clinical psychologist in private practice who specializes in individual psychotherapy and coaching with adult children of emotionally immature parents. She is author of Adult Children of Emotionally Immature Parents, Recovering from Emotionally Immature Parents, and Self-Care for Adult Children of Immature Parents.

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As a therapist, TikTok has been on my mind a lot lately. It seems that on a weekly basis, at least one client will start a sentence with, “I saw this thing on TikTok…” and they’ll go on to describe a short clip that sounds very validating in one way or another. It’ll often be a collection of symptoms that are succinctly explained and packaged into a diagnosis, or a video related to attachment theory that (again, succinctly) explains a behavior pattern or why something might be a trigger. These sorts of videos can feel like a lightbulb going off. What was once confusing and frustrating is now made clear, and answers are provided. 

Many of us have, very understandably, found a lot of comfort in TikToks, reels, videos, and Instagram posts that help us make sense of mental health struggles that are often painful, complex, or misunderstood. I want people to feel less alone in their struggles. I want clients to feel validated, and I want mental health struggles to be normalized and better understood. I also see some downsides to people using social media as their main source of mental health information.  

Both Instagram and TikTok only offer small bits of information that are, of course, not personalized. It’s impossible to take something that was written to appeal to as many people as possible and make it apply to a personal situation that is inevitably nuanced and complicated. Thankfully, therapists on social media are generally pretty good about giving this caveat. While Instagram has been around for quite a few years now, mental health pages have soared in popularity in recent years, and the issue of depersonalized snippets of information is even more prevalent on TikTok, the platform du jour. This is where I see the most information about various mental health diagnoses, such as “5 Unexpected ADHD Symptoms.” This can lead to new insights about one’s experiences, as well as a lot of self-diagnosing.  

There’s no getting around the fact that diagnosing requires meeting one-on-one with a licensed professional. I hope that people can perhaps use mental health posts and TikToks to seek care if they read about symptoms or experiences that resonate and are concerning, but as tempting as it might be, someone cannot draw conclusions about their mental health from these posts alone. If people feel that they can self-diagnosis via TikTok, I worry that they may also believe they can self-treat via TikTok, too.  

This is problematic without even considering the concern that the information may not be accurate. Social media platforms are not designed exclusively for licensed mental health professionals, so there is often concern about the quality of information that people get. When necessary, I’ll correct any misinformation that I hear clients relay, but otherwise, I try to stick with what is meaningful to the client. What about the video resonated with them, and why? What does that tell me about what’s important to them right now or what’s impacting their life most? If I keep my focus on these questions, I’m less likely to get distracted by issues around the quality of their information sources. The same goes for self-diagnosing. Rather than getting wrapped up in frustration with the client’s self-diagnosis, I try to focus on: Why is this important to them? What are they experiencing that’s painful or affecting their life? And maybe it leads to a diagnosis that ends up being immensely helpful for the client.  

The group practice where I work has a successful Instagram and TikTok that I’m certainly grateful for. People tell us on a regular basis that something we posted was meaningful or comforting to them, and clients have found our practice via social media. I also hope that both givers and receivers of widely distributed mental health information can interact with this content more mindfully, with consumers taking everything with a grain of salt and using posts as cues to get curious and investigate further, rather than taking them as fact. 

Emma Lauer, LCSW, is a therapist specializing in the treatment of eating disorders, self-harming behaviors, and trauma. Emma is an eye movement desensitization and reprocessing (EMDR)-certified therapist, and has taught at Arizona State University. She currently practices therapy and oversees interns and other staff therapists as clinical supervisor at Find Your Shine Therapy, a group private practice in Tempe, AZ

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To compare ourselves to others is human.  

But it can also harm our social and emotional well-being. With the ubiquity of image-conscious social media, it’s easier than ever to be pulled down into a “who’s-better-than-me” haze of self-doubt. 

When we get into the habit of measuring our success against others’ perceived achievements, we can come to rely on those benchmarks to determine how we should feel about ourselves. Unfortunately, others often paint a rosy picture of their lives, leading us to be unfairly critical of ourselves. 

Social media platforms like Instagram fuel comparisons that can easily increase negative mood and anxiety levels, especially when individuals are looking at fitness, model, and beauty blogging accounts.   

There are two types of social comparison to be on the lookout for.  

Downward comparisons involve identifying those we feel we have accomplished more than, or who we think we stand in better relative position to. These comparisons can elevate our self-esteem and spark a sense of pride, although those good feelings may not last long. In contrast, upward comparisons are more likely to generate feelings of shame or inadequacy since we are judging that person as better off than we are in some way. 

Upward comparison could also be seen as a type of “threat assessment,” a check to see if others are outpacing us in the areas of life we value most. If so, we may begin to work harder to reduce that gap and preserve a positive sense of self.  

The degree of similarity we perceive between ourselves and our “comparison points” can influence these effects. Upward comparison, for example, may not weigh as heavily on our self-esteem when we’re comparing ourselves to a celebrity versus a coworker who recently received a promotion. 

There are five ways you can reduce your tendency to engage in upward and downward social comparison: 

1. Try temporal social comparison instead. Researchers have found that when you compare your present self favorably to your past self, you’re likely to feel encouraged and more motivated to continue on a path of self-improvement. Here’s one question you can ask yourself to bring the comparison point inward: In what ways have I made progress over the past year? 

2. Find strengths and values you have in common with others. While upward and downward comparisons can breed competition, identifying strengths and values that you share with others can foster a greater sense of connection and parallelism. It is easier to admire someone who is successful without envy or negative self-esteem consequences if you also focus on similar qualities that have made you successful. 

3. Identify the core belief driving the comparison. Negative core beliefs about ourselves can propel us into the comparison lane. Two culprits are unlovability and worthlessness. If you can discover the situations that activate those beliefs—like a rejection—you can challenge their negative meanings. In doing so, you’ll be less likely to seek out downward comparison support for self-esteem.  

4. Challenge perfectionism. A driving force behind social comparison is a self-imposed need to be perfect. Perfectionism makes us hypervigilant to any signs that we are falling short of our unrealistic standards. If you can accept yourself as an imperfect person doing the best you can under the circumstances, then you are much less likely to feel less than when looking at someone else’s accomplishments. You also may be less likely to criticize others for their shortcomings. 

5. Limit social media use.  Taking a break from Instagram, TikTok, Facebook, LinkedIn, and other social media can lower the likelihood that you will gravitate toward unrealistic representations of success, status, and progress. In this way, you are removing the tempting sources of comparison.  

Give yourself grace when battling your social comparison itch. We all slip into these upward and downward modes. The more you practice stepping back from pole-position living, the more easily you’ll be able to step into a state of unpressured self-acceptance. And I think you’ll find it an even more rewarding place to be. 

Scott Glassman, PsyD, is a licensed psychologist, and director of the Master of Applied Positive Psychology Program at the Philadelphia College of Osteopathic Medicine. He is founder of the popular wellness program, A Happier You. 

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Many first-time clients come to therapy seeking “quick fixes,” and expect the therapist to do the work and “solve” the problem. These clients will specifically ask us “what to say” or “what to do,” seeing the therapist as an all-knowing advisor, rather than a support or resource. As clinicians, we are aware that this approach to therapy isn’t appropriate or helpful because it doesn’t result in lasting changes in the client or promote true growth and healing. This approach also undermines the client’s self-determination and potential.

Here is how to address this insistent client with finesse:

• Clarify the therapist’s role: Clarify your role as the “therapist” and the type of support and feedback you are able to give to the client. You can also clarify your limitations and be clear about the things you are not able to do or feedback you are unable to give. Reiterate that your job is to empower the client to make their own choices and decisions that reflect their personal values and goals.

• Clarify the client’s role: Clarify the client’s role as an active participant in therapy. Explain that as an active participant, they are encouraged to self-reflect and, through therapy, learn and develop new skills and approaches they can apply on their own between sessions to improve their mental health and meet their personal goals. Make it clear that the client is their own change agent and has the ability and capacity to make decisions that are best for them. Emphasize that they are the expert of their own life and internal processes.

• Set and reinforce boundaries: After clarifying the role of both client and therapist, actively set and reinforce boundaries throughout treatment. Gently remind the client of your respective roles and responsibilities, and reiterate what type of support you can and cannot offer.

Leah Aguirre, LCSW, is a licensed clinical social worker practicing in San Diego, CA. She works primarily with teens and adults who have experienced complex trauma, including childhood abuse, domestic violence, and dating violence, and provides trauma-based treatment including eye movement desensitization and reprocessing (EMDR). Aguirre writes a blog on Psychology Today, and has been featured in Bumble, GQ, The San Diego Union-Tribune, and in the Reframe and DiveThru apps.

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If you’re struggling with intrusive disturbing images coming into your head, either from a phobia, or anxiety, or post-traumatic stress disorder (PTSD), or nightmares, it’s urgent you get relief fast. Images are intense: they grab all of your attention, they are powerful, and they can be disturbing and stay with you in unsettling ways. But how do you stop that image if it’s just popping into your head unexpectedly? It turns out the trick is not to try and prevent intrusive thoughts or images, but to change them. The skill you can use to make this change is called imagery rescripting, or ImRs. As the technique has become more popular, it’s showing more potential to help treat a broad set of problems, including anxiety, obsessive-compulsive disorder (OCD), social phobia, health anxiety, childhood abuse and trauma, grief, and even more intense conditions such as personality disorders. In fact, some studies show that ImRs achieves clinical goals faster than traditional cognitive behavioral therapy (CBT) methods in these areas.  

So, how does it work? 

ImRs as a skill is pretty simple: in the therapy setting, the therapist guides the client to pull up a particular image into their mind’s eye (usually with closed eyes, but not necessarily). The next step is to change the image. If the image is simple, such as a particular image from a traumatic car accident, this means an image depicting a different outcome, such as an airbag deploying safely. The therapist and client may practice drawing this image in mind together over a few sessions, with the client practicing regularly on their own and sharing regular feedback. The idea is that you select the most disturbing recurring image, and, using ImRs, morph that image into something different—and by practicing, you alter the image the next time it pops into your head. You have cleared neural pathways to make that image different. Sounds deceptively simple, right? That’s the thing: it’s simple and it works.  

A more complex version works with images that tell a story. Kind of like moving from working with a still image to a scene from a movie. Very often, the scene derives from a memory. This approach can work with an obsessive worry (the scene of a bad thing happening), or a stressful social interaction, a memory that fuels depression, or a traumatic childhood memory. The ImRs skill to address a scene is to change the ending of the story. For example, a client brings a traumatic childhood memory to session, a scene of the child version of the client being yelled at by a demeaning father. Client and therapist, each with eyes closed, can go into the image together and change the ending by having the adult version of the client confront the father, or simply remove the child from the scene to protect him and offer care and encouragement. This altered ending—however fantastic and not really part of history—still becomes part of the brain’s record of the time, including the change in self-esteem related to the rescripting. 

Using Magic and the Full Creative Freedom of the Imagination 

The fun part of ImRs is that you get to use your imagination. In fact, imagination is an important tool for success, no matter how fantastic, as long as it works. I call this the “Jedi” or “Willy Wonka” or “Harry Potter” part of ImRs. If you are rescripting an intimidating person in your image, you can turn them into a character from “The Office,” or Elmer Fudd. If you are revisiting a childhood memory with an abusive adult, you can turn the child into a confident giant who can speak his mind to the adult. If a more low-key tone is appropriate, you can just imagine a bubble of safety around the child. You don’t need to obey the laws of physics in order for the magic to work.  

Neurological Changes

Over the last thirty years, neuropsychologists using functional magnetic resonance imaging (fMRI) have studied the effects of trauma on the brain, as well as the changes that happen with different therapeutic interventions, including repeating the traumatic story, writing a narrative, and using ImRs. Results have been exciting, and indicate that neural pathways related to the source of fear and stress response from a traumatic memory are actually altered with rescripting. In this sense, you actually can change the past. You may not be changing the actual historical events, but you can change the meaning of the event, so that it is less traumatic.  

Promising Applications of Imagery Rescripting

By combining ImRs with other methods, such as gestalt and chairwork, self-talk, expressive writing therapy, and mindfulness meditation, it’s possible to bring the power of ImRs into the self-help world—as I do in my book Your Coping Skills Aren’t Working. Here’s an example I use from my book: suppose you finish a stressful meeting with your boss, and are feeling let down, hopeless, and ashamed, even though the meeting wasn’t as bad as it feels. You might take yourself for a mindful walk, focus on that inner child who is feeling demeaned just as she was as a child at home, and remind her that you are an adult now and can take good care of her. This way, you are able to gain some distance from the intensity of the feeling, place it in history, and practice self-soothing. This will also help you be less triggered and more in control when you need it.  

Keep in Mind

If you would like to do ImRs with a therapist, make sure they have training and supervision in the method, such as a certified schema therapist.  

Richard Brouillette, LCSW, is a certified schema therapist who works with entrepreneurs, creatives, and activists seeking to overcome anxiety, find fulfillment, and improve their relationships. He has written for The New York Times, and is an expert opinion blogger for Psychology Today. 

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Safety behaviors are behaviors people engage in to prevent or minimize either something bad happening or to manage their own distress. They tend to contribute to the maintenance of anxiety-related issues. What makes a “safety behavior” a safety behavior is that these behaviors are likely to have minimal impact on a feared outcome. Obsessive-compulsive disorder (OCD) is a classic example: someone with OCD may engage in rituals to ward of catastrophic things from happening even though these actions are unlikely to have much effect, and, if anything, tend to cause more anxiety. Having to have your phone on you whenever you leave the house in case something bad happens is an example of a common safety behavior.  

Safety behaviors can be very powerful. One client I worked with felt the need to carry an inhaler on his person whenever he went jogging because he feared having an asthma attack—even though his doctor had assured him he was not asthmatic. I suggested he try running without it. At the next session, the client observed that during the first few days of running without his inhaler, he felt extremely anxious. However, he quickly got used to it, and within a week, no longer thought about it.  

Because reliance on safety behaviors can maintain anxiety, it’s long been assumed that safety behaviors must be eliminated in the treatment of anxiety disorders through exposure therapy, where people learn to systematically confront their anxiety and do things they have been avoiding. 

But are safety behaviors always a problem? Blakey and Abramowitz (2016) ask this question in a literature of research on safety behaviors.  

Research to date has been mixed on this question, as some studies have found safety behaviors interfere with exposure therapy, and some have found they don’t. Additionally, thoughtful use of safety behaviors may help people engage in exposure they would not be willing to do otherwise.  

From their review, the researchers concluded that, while safety behaviors aren’t “unconditionally deleterious,” they tend to get in the way of exposure therapy more often than not. The authors recommend that once identified, therapists should work with anxiety clients to eliminate their reliance on safety behaviors as soon as clients are willing. “Willing” is a key word here, as clients may be reluctant to give them up. 

For example, some people with fears around driving are more comfortable if they have a passenger who can take over if the driver becomes overwhelmed with panic. Therefore, they may be more comfortable driving new routes with a trusted passenger than alone. Some clients may even initially refuse to drive new routes without a loved one accompanying them. However, this safety behavior can get in the way of making progress if the client cannot drive any new route by themselves. In these ways, the same safety behaviors that may help facilitate client progress in exposure can become a barrier to completing treatment if the client isn’t willing to eventually give up certain avoidance behaviors. 

In my recent book on acceptance and commitment therapy (ACT)-informed exposure, I wrote:  

A metaphor one of us uses with clients is rivulets feeding an anxiety river. The more rivulets that feed the anxiety river, the stronger it flows. Although we may not be able to block every single rivulet, we want to disrupt as many as we can to weaken the flow of the river as much as possible. Every avoidance behavior is a potential rivulet. Even if some appear small and inconsequential, they nonetheless reinforce anxiety and psychological inflexibility, and they should be disrupted as much as possible.  

In working with people on anxiety, we want to eventually wean people off reliance on safety behaviors, so that they’re able to engage their lives with greater freedom and flexibility. 

Brian L. Thompson, PhD, is a licensed psychologist; and director of the anxiety clinic at the Portland Psychotherapy in Portland, OR. He specializes in working with anxiety and obsessive-compulsive and related disorders, and has published research in these areas.

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When a client experiences uncertainty, doubt, confusion, or anxiety, they may engage in a repetitive behavior commonly referred to as reassurance-seeking. This is a common compulsion for people with obsessive-compulsive disorder (OCD), health anxiety, and several other anxiety disorders. Reassurance-seeking often involves asking the same (or similar) questions over and over in an attempt to reduce or remove uncertainty.

While it may feel helpful to reassure or soothe their fears at that moment, it is important to know that providing too much reassurance can worsen our client’s anxiety.

What to do when a client consistently asks for reassurance:

1. Educate them on the cycle for reassurance.

Educate your client on the long-term impact of providing reassurance. While it may make them feel better in the short term, it will only keep them stuck in a loop in the long term.

2. Ask them what they would have to tolerate if they didn’t ask for reassurance.

It can be very beneficial for our clients to understand and recognize the emotion behind their compulsive behavior. Common emotions that lead to reassurance-seeking are uncertainty, anxiety, fear, doubt, and shame.

3. Teach them mindfulness and self-compassion tools to help them tolerate the discomfort they experience instead of seeking reassurance.

Mindfulness can be a powerful tool when practicing tolerating discomfort. During the session, you can experiment with these questions: Can you observe your thoughts at that moment? Can you allow the discomfort nonjudgmentally? How can you be kind and nurturing while you allow this discomfort?

4. Celebrate their wins!

Never forget to celebrate a client’s attempt to make small, effective behavioral changes in their lives. In my practice, we celebrate even 1 percent changes, as they lead to big changes.

Kimberley Quinlan, LMFT, is a psychotherapist in private practice specializing in the treatment of obsessive-compulsive disorder (OCD) and related disorders. She is host of the Your Anxiety Toolkit podcast, and founder of www.cbtschool.com—an online psychoeducation platform for OCD, anxiety disorders, and body-focused repetitive behaviors (BFRBs).

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