where are the black male therapists?

(readers, I'm sorry I have not posted recently.  5 month old Ryan is sleeping right now so we will see if I can finish a blog before he wakes).  

Question:  My boyfriend and I have been growing apart and when we examined why he told me he feels the race thing is overwhelming him.  I'm white and he is black and while we love each other and our kids get along great, he is tired of the people staring at us when we are in public and the constant reminders of subtle racism exhaust him.  He is willing to go into couples counseling with me to try to overcome this issue but we cannot seem to find a black male therapist.  We are willing to try with someone else if we have to but I know if he doesn't feel like the therapist can really understand where he is coming from it is not going to work.  Any ideas?  

Answer:  Finding a therapist your boyfriend feels comfortable with is absolutely crucial, and while it might take a great deal of effort to find that person do not stop searching until you do. 

The fact is there are thousands of therapists who are skilled in couples counseling and who are culturally competent enough to help bring you and your boyfriend some clarity about the future of your relationship.

Just because a therapist does not share the experience of the client does not mean they cannot help.  I regularly work with clients who have been sexually assaulted, grew up in a divorced house hold, immigrated from another country, or who have had a day with really bad menstrual cramps.  I have never had to deal with any of these problems in my own life, and yet I seem to be able to help.

That being said, I never try to force it.  If a female student comes into my office and states they would rather work with a female I refer them right away.  It doesn't hurt my feelings, I just want them to start off with someone who will make them feel comfortable.

The experience of being judged and discriminated against based on the color of your skin is destructive in a way that can scarcely be comprehended by those who have not experienced it.  In addition, the experience of an African American male in our society is very different than that of an African American woman, so I can see why he would feel that any one not in that group would have difficulty understanding his level of discomfort in the relationship.  Since the race issue is central to the presenting problem, if you do not find someone who your boyfriend feels really gets it, therapy will be a waste of time.

The field of therapy is dominated by white females.  In my grad school cohort of over 100 social workers I was one of two hetero-sexual white males.  There were several African American men in my program but none of them were going into clinical social work.  The few African American male therapists I have met in my career have been in very high demand, but they are out there.

I would suggest utilizing websites like helppro.com, and if you are in an area with some universities contacting some of the clinical faculty and asking them for referrals.  The longer a person has been in the profession the more likely it is that they will have a contact and any good therapist is happy to help you find a good fit even if it isn't going to help them profit in anyway.

Another place to look is the spiritual community.  Many churches offer some pastoral counseling and if there is a church in your community that you believe would be supportive of your relationship and they have African American male ministers you may inquire to see if they provide counseling.  The added bonus is churches will often provide counseling as a free service.  

Once you have gathered some recommendations of effective therapists see if your boyfriend can do a phone interview with them to find out if he feels like it will be a good fit.  After a couple phone calls he may discover that finding a person who has a sense of humor that matches his is more important than finding someone who matches his race and gender.

Can't keep up with college

(Forgive me loyal readers, I always intend to blog but my 3 month old leaves little time or energy for writing.  I promise I will try to be more consistent in the future.   Have a question?  Email me and I will answer.)


I just transferred into a new university and absolutely love it.  One problem though is I set some goals too high and it kills me a little bit when I can't reach them.  Before coming in I expected great grades, playing time in my sport, pledging a fraternity and a significant increase in my romantic life.  Since being here I've struggled with grades even though I study a lot, I had to fight hard to get a spot on the team, the pledge process is wearing me out, and haven't had much luck with the ladies.  Is there a strategy I can take to not set my standards so high so I don't build up the stress of not achieving what I can't do all the time?


The problem is not having high standards it is with viewing failure as a bad thing.  I was once asked the question "what would you do if you weren't afraid?"  What if you did not have to fear failing out of school, not getting PT on the team, not getting a position in the fraternity, getting rejected by women.  How much lighter would you feel if all of these things were still possible but if they happened they would not make you question yourself anymore?  

The goal for you is to begin to view failure as feedback.  For example when lifting weights we are often told to continue going until our muscles give out.  This tells us when we have reached our maximum.  In your case you are putting too much on your plate and setting unrealistic standards of achievement.  Then when your time gives out instead of using that information to lighten your load, you blame yourself.  Not fair, not smart.  

Accept that you are only a normal human with 24 hours in your day.  Try listing all the things you wish to do and then rank the items from most to least important.  Then you have to budget your time according to those priorities.  When you "fail" at a task ask yourself "how can I learn from this, how can I 'Fail Forward' and turn this experience into something I want to remember instead of something I feel ashamed of.  

With regard to your sport, instead of measuring your success by how much playing time you got or how well you played ask yourself how alive you felt every time you stepped on the field.  Did you allow yourself in each run that you got to be fully present and in the moment or did you think about trying to impress your coaches and teammates?  Define success as mindfulness, (being fully present in the moment) and you will play much better and enjoy the game more. 

With your fraternity stop focusing on getting a position and instead focus on creating memories.  Whether you stay in that fraternity for two more weeks or two more years the reason to join it is to enhance your college experience not to build your resume.  Every experience in pledge-ship both bad and good (and I had way more bad that good when I was a pledge) is hopefully going to be a memory that you will cherish.  

With class don't worry about your GPA, just try to get as mentally involved as you can in each class that you attend and in each project that you do.  Most of us spent college just jumping through hoops and trying to get grades and if any learning occurred it was a happy accident.  That attitude was a huge waste of my tuition money.  If you are fully present in class when you are in class whether you get a D or an A in the class it won't matter because you will have learned.  Your college GPA will not get you a good job your internships will and if you don't do any internships before you graduate you are really wasting your time.  

With regard to women, if your goal is just to hook up with as many girls as possible that is a great way to get a disease and a lot of regret.  If you want to meet the kind of girl that would be relationship material try becoming a curious conversationalist.  Strike up conversations with any person that seems interesting, regardless of whether or not you have any romantic interest in them.  When the people you are talking to realize that you have interest in them as a person and not just as a potential notch in your bed stand they will tend to have a more positive response and they may end up introducing you to your perfect match.  Or they may just be the other end of a single conversation you will never forget. 

Do you see the theme here?  You are putting so much pressure on yourself because you are surviving your life right now rather than living it.  I have a big sign in my office that says "BE HERE NOW"  to remind me to take a breath and savor the moments.  When we savor our life we may not have as much time for everything but we get far more out of each thing we do.   We stop seeing our activities in terms of success and failure and rather in terms of memories we wish to repeat and memories we wish to learn from.  No failure in that equation.  

gave ex full custody, am I a bad Mom?

(This blog has not been as frequent as it should be as I just had my first child a month ago and moved into a new home 3 weeks ago.  No more excuses, if you write me questions I will answer and post, your job is to follow.)

Question:  After four years of marriage my husband and I divorced and I granted him full custody of our son.  There were a number of issues in our marriage, one of them being I think my husband was using me so he could present a better candidate to adoption agencies.  My husband did all the work to set up the adoption and he is an extremely loving father.  It may sound terrible but while I do love my son I do not feel as connected to him as I think I would be if he was my biological child.  After the divorce I moved to a neighboring state and while I have visitation every other weekend it didn't make sense for me to fight my ex for custody.  I felt like I was doing what was best for my son and I felt no need to use him as leverage to punish my ex.  When I tell people my ex husband has custody that look at me as if I must be a terrible mother or a meth addict.  How do I get people, particularly my son as he gets older, to understand that it's because I love my son that I left him with his Father.  

Answer:  The only opinion that matters is that of your son.  Adopted children are particularly sensitive to feelings of abandonment, as long as you go out of your way to call and remain in his life even when you do not have visitation things there should be fine.  

In society at large there is a bias that children should be with their mothers no matter what.  I know many fathers who have stayed in a loveless marriage because they were petrified that they would lose contact with their children.  You are not being paranoid if you assume that people are pre-judging you when they hear you do not have custody of your child.  People are also pre-judging you when they find out you are divorced, if you have had a home foreclosed on, lost a job, are a white sox fan...

So when you go into a situation with a person who is new in your life and an awkward topic comes up how do you prove you are not a child abuser or meth addict?  Answer:  act like a normal person.

In previous posts of may have discussed the Tabloid Effect.  When we are in the supermarket we all notice the tabloids which claim outrageous, and sometimes true, things about celebrities.  If I see a headline that says, "Angelina Jolie Eats Babies!"  and I like Angelina Jolie I will think, "that's crazy talk".  If I hate Angelina Jolie I will think "I knew that bitch was eating babies."  and if I have never heard of Angelina Jolie I will think "Hmmm guess I wouldn't leave my kids at her house".

No matter what I thought when I read the headline if I were ever to meet Angelina Jolie I would weigh my experience with her much more heavily than any rumors that I had previously heard about.

If you believe that your son is better off with your ex-husband then he is, and you made the right decision.  Never let society scare you out of doing the right thing, especially for your child, just because it isn't the norm. People will pre-judge you when you do something that is not typical but if you have the power to move past that pre-judgement very quickly so do not let it slow you down from meeting people and letting them know your story.

As I said before the most important thing is that you tell your son over and over and over and over and over and over and over and over and over and over how much you love him and that you want to maintain a place in his life.  In so doing you can help him to realize that he is not destined to be abandoned and that even when people leave that doesn't mean relationships have to end.

Failed out, now what?!

(Lately I post very irregularly so you are going to want to follow the blog, on this site or on face book so you make sure you don't miss a posting)

Question:  Freshman year did not go so hot and my college has stated I cannot return next year.  My parents and I agree that I should take a year off from school.  I want to take the rest of my life off and just go ski and coach, which are the only two things that really make me happy.  I live in the mid-west and the flatness and the weather here really depress me.  I just don't feel like school is for me, but I know it isn't practical to try to be a ski bum the rest of my life.  The very idea though of trying to return to a campus and study stuff I don't care about makes me feel overwhelmed and trapped.  I don't know where to go from here.  

Answer:  It sounds like you do know what you want, you are just asking for permission to do something you and your parents think is impractical.  Let me tell you what I think is impractical, spending four years and 160,000 on a business degree so you can pray to get a job that you don't really want and maybe save up enough money to go skiing 20 days a year (by the time you are 30).

When I was 22 a man asked me what I really wanted to do.  I told him I wanted to travel around and put on presentations about male socialization and violence.  He asked, "Why don't you?"  I thought no one would take me seriously.  I thought I needed a masters degree.  I still gave it a shot but I didn't go after it very hard because I didn't believe I was "qualified".

12 years later I have two masters degrees and the knowledge that no one is going to take me seriously because of those.  Now I do those presentations but I'm not as good at them as I would have been back then because I'm out of practice.

The best education in life IS LIFE.  If you have a dream job find someone who is actually doing it and offer to work for them for free for as many hours as you can possibly spare.  Someone is getting paid to do something that you would pay to do.  I talk to people and coach lacrosse for a living.  Both are things I would pay to do.  If you are passionate about what you do and there is a market for your service you can make a living.

The purpose of college is a sorting machine where the really rich and the really bright meet and partner up as friends, romantically, and for business.  You don't need college for that, you can skip that step and go meet the people who are already where you want to be and form relationships.  College is a great life experience but it is not essential unless you want to go into certain fields which require a special license or certification. 

Dan Miller, author of the book 48 days to the work you love hosts a free pod cast that you can download from itunes or from his website http://www.48days.net/ which gives people advice about how to pursue their dream using practical steps that you can show to your parents.  Use this year to meet people and soak up experience and you will find you get a lot more useful knowledge out of that than any college could have given you. 

When you are the one who has "failed out" it feels like you are all alone and everybody else has their stuff together.  Most of your peers are just going through the motions of going to college because that is what everyone expected.   Many of them will hit their identity crisis in 3 years as graduation looms and they still have no idea what they really want to do with their lives.

Your mission now is to fail forward.  This experience is an opportunity if you can learn from it and use that information to make a quality plan for your future.  When you are feeling overwhelmed take smaller bites and chew, we don't swallow life a year at a time we do it day by day. 

 

Can sex at 13 be consensual?

(I'm sorry I didn't have time to blog in May.  Keep the questions coming and I promise I will answer even if they don't make the blog).  

Question:  When I was 13 I had a crush on a 21 year old guy and he raped me.  Years later I ran into him and he said "You know you wanted it."  When I told my therapist about it she said, that even if I had wanted it (which I didn't) it still would have been rape.  It took me a long time, but I know that bastard raped me, but I don't know if I believe that a 13 year old can't have consensual sex. I think when I was 13 if I had been with a loving guy who had been patient and kind I could have had beautiful consensual sex, even if the guy had been older.  Is that possible? 

Answer:  No, it is not possible for a 13 year old to have consensual sex with anyone, even the nicest kindest person on the planet, even if he was 12, because consent implies having a real understanding about what you are agreeing to, and no 13 year old is mentally and emotionally prepared for sex, even if they have been having it for years. 

I want to be clear that I am not even talking about the legal issues.  Legally a 13 year old having sex is seven kinds of wrong, but I don't think most people make their sexual decisions about what the law says, I think/hope they decide based on a morality that is far stronger than law.

There have been millions of examples of 13 year olds having sex throughout history who did not feel violated and who have had no regret about the experience.  There have also been examples of 13 year olds fighting in wars and working in coal mines and successfully doing all kinds of things that they were really not ready for. 

If we asked 13 year olds if they wanted to and fight in Afghanistan and we made it seem as glamorous and adult as our media makes sex seem you wouldn't be able to sign them up fast enough.  I would have signed up at 13 and no matter how many gory war documentaries you made me watch I still would have wanted to go.  Does that mean I would have been able to consent?  No, because no matter how many hours I played Call of Duty, I still just don't get it. 

13 year old boys and girls will continue having sex, and in certain cultures it will be supported by adults.  In other countries and cultures this may not be considered illegal or immoral but it will never be the most healthy thing for that individual's development. 

In this country, however, no matter how much that boy or girl "wants it" and sometimes they really really do, we must do everything in our power to help them to wait.  Just as we would ask them to wait before driving, going to college, or fighting in a war.  Some of them could handle it and be fine, but when something goes wrong and we still have so much growing to do a trauma can stunt growth permanently. 

When someone more than two years older than a teen wants to connect intimately with them they are betraying signs that something is emotionally malformed within them.  Healthy adults are repelled by the idea of sex with someone who is not fully formed.  Unfortunately many younger teens, especially girls, find these emotionally stunted predators attractive because they feel like they have something in common with them.  They do, both people are not fully formed, but the teen still has a chance to grow, and the predator, is unlikely to ever grow into a healthy person. 

What if my boyfriend is addicted to porn?

(this blog would like to be followed, when you click to follow the blog smiles and an angel gets its wings.  If you have a question e-mail and I will answer)

Question:  My boyfriend and I have been together for two years and lately it seems I am always the one who has to initiate sex or any kind cuddling or intimacy.  He is not the type to cheat, but over the years we have had several arguments about porn and although he swore he would stop using it, when I checked the Internet search history it was obvious he had been using it A LOT.   My friends tell me that most guys check out porn, but I feel like a 24 year old guy should still have enough energy left for his girlfriend.  To be honest I hate that he uses it at all, I feel like I should be enough for him, then when we are together and he doesn't stay "excited" I feel like a failure.  What am I supposed to do?  I've already asked him to stop using porn and he lied to me.  I love him but I feel like I'm in a fight I can't win.  Should I insist he go into counseling or I break up with him?  Help!

Answer:  I'm not sure if he is an addict but your boyfriend certainly has a porn problem.  A person has a problem with any issue (drinking, drugs, gambling, self injury, sex) when they persist in a behavior even after it has caused problems in their life functioning and/or relationships.  

Whether or not he is addicted getting rid of the porn is not going to fix your relationship because the real problem is communication, and until that is fixed neither of you are getting your sexual or intimacy needs met. 

I'm guessing that your boyfriend discovered porn long before the two of you met and it filled niche for him in his life.  It was a readily available, low cost/consequence way to find sexual release.  When you guys began to connect the excitement of the relationship was probably enough to gratify him, or maybe he continued using porn in conjunction with your relationship.  Regardless, most people in a new relationship are hesitant to share their sexual fantasies for fear of being rejected.  

Somewhere along the way you discovered his use of porn and you broadcast a message loud and clear that you were not okay with it.  An unintended consequence of this was that you probably caused him to feel shame and this led him to close off communication about his sexual needs and desires.   

Now the question becomes how can your boyfriend win?  If he has a desire for something outside the pattern of love making that you have developed he cannot express it without risking rejection.  If he seeks out porn for release he is lying to you and betraying you.  As the relationship continues the increased pressure he feels sounds like it is leading to some erectile dysfunction and the shame spiral just gets worse. 

As an added complication, some men who are porn/masturbation addicted can have a very hard time ejaculating without the familiar pressure that only they know how to provide. As much as vagina/mouth/anus of a partner might be infinitely more desirable to them in concept in real life the body may only respond to what it has grown accustomed to. 

The fix for this is simple.  Get curious.  You need to approach your boyfriend and in an open and non-judgemental way and explore with him what he was getting from the porn.  As long as it does not involve something illegal or immoral perhaps there is a way you can share some of his turn ons and stop having to view porn as a competitor.  Your boyfriend will probably be suspicious that this is some kind of trap and will be hesitant to share so it is likely you will have to provide him with some of your hidden desires first until he can really trust that it is okay to share.

Although most porn is sexist, misogynistic, insipid and of low quality, you might be able to find some movies that are not pornographic but still provide enough sexual tension to excite both of you.

One way to help take away the pressure on sex is to set a goal up front of making love without penetration.  There are a million ways to get each other off and if the activity involves sharing and connection then that is what making love is really all about.  People have sex with each other every day without any connection being shared, and that kind of mutual masturbation using each other's bodies is not likely to bring contentment back to your relationship. 

If after you try these things you feel that your boyfriend's use of porn is still a competitor and something that is getting in the way of the two of you feeling connection and intimacy, then don't give him an ultimatum, talk to him about it.  If he is willing to seek help support that, if he isn't it may be time for you to move on, but do not attempt to force him into anything as he has already shown that would just lead to lying and more mistrust. 

Ultimately your intimacy will be only as good as your communication.  Until you can establish that either of you can ask for anything (doesn't mean you will get it) without being judged there will be a barrier between you.  Seek to break down that barrier to communication and you may find that a lot of pleasant nights lay ahead. 

people treat me like I'm a joke

(sorry it's been awhile, but if you write a question I will post a response, eventually... please sign up to follow on this site or on facebook) 

Question: lately I feel like everybody takes me as a joke and never seriously.  My friends constantly make fun of me to the point where I don't wanna talk to them. If I ask my parents for help they either say suck it up or tell me something no where near relevant to what I need help with. If I ask anybody at my college to hang out they look at me like a weirdo even though we get along perfectly fine in class. I try to help other people out as much as I can to gain respect but I feel whatever pops out of my mouth nobody will listen, take seriously or just laugh at including teachers. It comes to the point where I hate people and don't feel like going out much. How can I get people to take me seriously?

Answer:  People will take you seriously in direct proportion to your own confidence.  When you feel a lack of confidence it is common to have that dream where you are in a fight with someone and you land punches but your hands are as light as feathers and they do nothing.  It sounds like that is how you are feeling right now.

It sounds like you are suffering from anhedonia, a common symptom of depression where you cease to enjoy things that you once really enjoyed.  Based on the amount of stress you seem to be suffering from it would not be surprising if you were feeling some clinical depression and you may benefit from medication and most certainly from more counseling.  I would encourage you to make an appointment with a psychiatrist to get evaluated for medication and try to find a therapist you can relate to. 

Your situation is disturbingly common right now.  I was just talking with a friend this morning about how we feel for people your age, job prospects stink and the existential angst that people tend to feel in their early 20's and mid 40's is falling on the back drop of a world which does not seem to be offering a lot of hope right now.  It will get better, but right now you need some support. 

You have to remind yourself that you do have something to offer.  I'm not into aura's and crystals and a lot of new age healing, but I do feel like people can sense confidence and desperation in others.  When someone is sneezing and coughing all over themselves we move away from them because we have a natural instinct to avoid illness.  When people are emotionally unhealthy and are feeling crappy others tend to avoid them as well so right when you need connection most it is the hardest to find and hold on to. 

You have to start doing something that fills you up and makes you feel good about you.  I would suggest volunteer work with disabled kids.  No one can leave doing that without feeling great about their lives and the parents and kids really appreciate the time you put in.

If you ask a person in your class if they want to help volunteer at an event like this they just think you are altruistic and nice and even if they don't want to attend they don't think you are a creeper.  You will meet people at these events and this may lead to other social outlets.

I would also try to get a job at a restaurant, even busing tables at a tgi fridays, is a good place to meet other young people.  You work with them on Friday and Saturday nights and so even if you don't go out after you feel like you did something and there are a lot of people in their early to late 20's who work in restaurants.  You just need to be careful to avoid the drug scene in a lot of restaurants. 

The other thing is you have to develop a plan for your future that you really like.  This is often the hardest thing to do when you are feeling down.  It doesn't matter so much what the career is but imagine all the other parts of your life. Do you want to live in the city or the suburbs?  In Chicago or in the mountains?  Everytime you meet an adult imagine yourself trying on their life and steal pieces of each life that you like until you have a vision of what you want for your future from the kind of marriage and dog you will own, to the way you will organize your garage.

The first step to achieving success is defining it in concrete terms that you can work toward.  It is always up to you to change your vision of success if you want to but having a destination in mind helps keep you motivated when life around you sucks.

What does it mean to be a man? A message to my family.

There is no question for this one, just me on my soap box. 

I am part of a coalition called Up 2 Us that strives to get men more involved in standing up against domestic violence and sexual assault.  Our mission is to get men to see these not as women's problems but as human problems that impact all of us. 

http://www.facebook.com/group.php?gid=204132927681&ref=ts

http://www.zcenter.org/uptous.htm

We give presentations where we try to accomplish 3 things.  1.) get people to question what they have learned about what it means to be a man and create a new definition for themselves that they really believe in.  2.) become an ally to those who step outside the box of typical man hood by refusing to participate in mocking them and by openly supporting them.  3.) interrupt violence be it physical or verbal (jokes, comments, harassment) when ever it is safe to do so.  

Because of my involvement with Up 2 Us I have been asked to participate in a documentary intended for students about to start college.  I thought I would point out to my audience that most guys would be willing to fight a room full of rapists if they were told one of those guys might hurt a woman they loved.  If however, those same guys were to asked to have a conversation with 10 of their male friends and relatives about rape and about manhood, none of them would do it. 

Sounds crazy.  One should be so much easier than the other.  Why is it so hard for us to talk to the men in our lives when we know that the only real way to protect the women we love is to make a change in the men who surround them.  The sad fact is most rapes are not committed by strangers.  Men we like, our buddies, can assault someone and claim they didn't know any better, they were drunk, or some other lame excuse.  

But before I could get too frustrated with any one else I asked, "why haven't I done it."  I have two nephews in college and three that will be there soon.  Johnny, Joey, Brendan, Kevin, Brian this post is for you.  I want to talk to you about what it means to be a man, and what it doesn't mean. 

Being a man, being a Maigler, is about hard work, taking care of your responsibilities, being dependable, and putting the needs of others ahead of yourself.   If you can do those things you are a man in my eyes and I'm proud to have you share my name.

Being a man has nothing to do with sex, or fighting, or how much food you can eat or booze you can drink. Being a man is not about proving anything to anyone but yourself.  You do not need to control a woman, you do not need to always be right, you can let yourself be disrespected and not fight that guy if he isn't worth your time (and none of them are). 

I love you boys and I want to protect you from the mistakes that I have made.  I never want any woman to regret that she met you.  I know that feeling and what I've done to earn it, and if I can spare you from it I want to.  I want you to realize that sex without intimacy is nothing more than mutual masturbation and you are better off without it. 

As I look above at my definition of a man I realize that any woman I admire could live those words too.  I think maybe we should worry less about earning the title of manhood and worry more about becoming a responsible adult and a decent human being and the rest will take care of itself.

I hope to talk to you boys more about these things in person.  I will ask everyone sees this blog to do the same.  Ask yourself what kind of men you want the boys in your life to grow up to be, what kind of men you want the girls in your life to be surrounded by.  Then have a conversation with those boys and girls about it so maybe, just maybe, you can save them from the pain of regret that life has taught us all so bitterly. 

More violence is done out of ignorance than malice.  We can chase that ignorance from this earth if we acknowledge that it is Up 2 Us. 

Eating Disorders program for my son?

(if you read this blog and have a thought post a comment, if you like it post a nice comment or even sign up to follow it on this site or on facebook.  If you have a question e-mail me and I will answer)

Question:  Last week my son informed his therapist that he has an eating disorder and he thinks he needs to go into a treatment program.  My husband and I were shocked, my son is thin but he is a runner and he looks normal compared to most of the boys.  We want to get our son the best care possible but we have had difficulty even getting calls back from some of the local eating disorders programs, and they all seem to be geared for girls.  Should we be looking for a specialized program for boys and men?  Is this the kind of thing where he is going to need to leave school for a month or can he be treated a couple times a week with a therapist?  We just don't know where to start.   

Answer:  The ideal treatment program does not exist.  It does not matter what issue you are dealing with, from eating disorders to anxiety to addiction, since every person has such individual circumstances, strengths, and symptoms there will never be a perfect fit.  I would love to tell you about a great program for boys and men with eating issues, and there are probably a couple but if they are out of state or a zillion dollars you may be better off focusing on factors other than gender in finding the right fit for your son.  

So start by doing your homework on the web and try to find someone in the field to talk to who does not have a financial interest in which program you pick.  National Eating Disorders is a non-profit that can provide resources (http://www.nationaleatingdisorders.org/).  Another track is to call an nationally renown program like McCallum Place in Missouri (http://www.mccallumplace.com/) and ask them if they have any recommendations for your area.

After you have a rank list of the local programs contact your insurance company and see what they cover.  While it might sound cold to pick a treatment option based on what insurance will pay for, eating disorders, like any addiction, often take more than one stint in treatment to crack.  If you go bankrupt, which can honestly happen, you won't be able to provide your son with any treatment and his condition may worsen if he feels like he is causing a great deal of financial stress to the family.  Often insurance companies want to make sure you have tried some less intensive interventions first, like out patient therapy with an eating disorders specialist, before they are willing to pop for a 30-60 day stay in a treatment facility.

To be frank insurance companies HATE eating disorders because they represent a huge financial drain which can last for decades.  This has led them to create barriers to paying for treatment which have led to the closure of a number of programs and reduction in staff at others.  You may not be getting a phone call or an e-mail back right away for some of these reasons but if you don't get a good feeling when you actually do talk to someone try to go on to the next program.  Families really need to partner with treatment providers to make sure that any gains can be sustained when a person leaves treatment. 

Some factors that impact the severity and course of treatment for an eating disorder are the amount of time the person has had the eating disorder, how much of the persons time and thought is devoted to food and eating, how much shame and guilt is associated with food.

There is a difference between an eating disorder and disordered eating.  Disordered eating are the behaviors that a person with an eating disorder might display (restricting, binging, purging, hyper exercise after eating...) without the emotional obsession with food.  A person with an eating disorder may still obsess about everything they put in their mouth even during periods where they have no disordered eating behaviors.

A large percentage of people with eating disorders may also have another issue that needs treatment and may shift between negative coping skills to deal with uncomfortable emotions.  We often see a triangle with Eating disorders at one point, self injury at another, and risk taking behaviors (ex.) drugs and alcohol, unprotected sex, shoplifting, unsafe driving...) at the third.  People may shift from one point to another as they try to convince themselves that they don't have a problem.

The key to treatment for eating disorders is to find another way to get the emotional relief that the disordered eating behaviors have provided in the past.  Eating disorders are the hardest addiction to successfully treat because the abstinence model is impossible.  You can stop drinking, gambling, self injuring, etc... but you cannot stop eating and not eating. 

Treatment programs will first work to develop healthier coping skills to deal with uncomfortable emotions and then go back and find out how the eating developed so if there is an old trauma that needs healing it can be dealt with instead of just covered over by new and better coping skills.

It is hard to say what your son will need without more information but I can tell you that his prognosis is excellent just because he has stated he is willing to get help. 

Your son is likely to get well no matter which treatment program he goes to if he really wants to move on.  All the programs work if the clients work with the program.  Be prepared that he may have issues with food for the rest of his life but he is fully capable of moving on to a life that is so full of good things that eating issues seem like a thing of the distant past.

Can I be gay for just one person?

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Question:  About 18 months ago my friend and I hooked up when we were drunk.  I have always been straight and while I might have kissed another girl at a party to raise an eyebrow and I've always been huge into cuddling with female friends when watching movies or hanging out, there was never anything sexual about it, at least for me.  For the next year my friend and I would hook up on and off, but it was like I had this wall in my mind that this wasn't me, and it was just a game for both of us while we waited to find Mr. Right.  I know it doesn't sound like it from this question but I am a deeply religious person and my church believes homosexuality is a choice and a sin, so I've felt a lot of guilt about the whole thing.  Over the last couple months something has really changed for me.  I'm still attracted to guys and I've never been sexually attracted to another girl, but now I don't want anyone else... God I'm having a hard time even writing this but I think I'm in love with her.  Does this mean I've been lying to myself my whole life?  All those times when I was in high school cuddling with a friend was that really early signs of me being gay, or something?  I've never really believed in bi-sexuality I always just thought those were broken people just looking for anyone to screw or to get attention and now that this is happening to me I feel like my world is upside down.  Can a person be gay for just one person?  I don't know what to do my family and her family would never accept us and I would lose all the people I love from my church.  What if I tell her how I feel and she doesn't feel the same way back?  Help!

Answer:  Feelings are not rational do not try to make them behave that way.  You love this girl so yes, you can be gay for just one person.  It sounds like if you had not been indoctrinated and taught that certain things were wrong and sinful you would have no question in your mind that this is true.  It also sounds like you are looking for someone to tell you that this is impossible so you won't have to risk being rejected, which is a fear greater than losing your church and your identity. 

Alfred Kinsey helped the modern world open the door to the notion that it is normal for human sexuality to go way beyond a man and a woman.  In the ancient world this was so widely accepted that even Emperors would openly take lovers of the same sex.

Our obsession with putting labels on things in an attempt to classify and understand generally works for about 90% of any category but there are always exceptions.  Mammals don't lay eggs except for the platypus.  There are 300 million people in America so even if only 1% were something other than fully hetero-sexual (and the number is probably closer to 15%) that would be 3 million people.  That's a lot of exceptions, don't be shocked if you are one of them.     

The bible generally makes the argument that any sex that is not between two married people trying to create a child is wrong.  Accordingly, if you think you are going to hell for having sex with a girl but having sex with a guy outside of marriage is okay then you weren't listening to your church to begin with.

A great recipe for driving yourself crazy is deciding how the world should be and trying to conform your life and your feelings to fit that.  Not gonna work.  If you want to make it through life without having a breakdown try listening to your feelings instead of trying to control them.  If you love this girl go after her, if she doesn't love you back or if she breaks your heart join the rest of us who have taken our shot at greatness and fallen short.

Just because you fell in love with one woman it does not make you bi-sexual.  You may love just this one girl and love nothing but men for the rest of your life because that is all you are drawn to.  You may fall in love with nothing but women for the rest of your life but still choose to take a male lover and a husband because that is how you want to live.  Whatever you do is fine if you are living your life honestly with yourself and your partners and you stop trying to bend the facts to fit the philosophy.  Good luck and go get her.   

Is my friend addicted to her medication?

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Question:  For years a friend of mine had anxiety issues.  It gradually got worse and worse to the point where she had a hard time driving (ex. she couldn't make left turns and would start to freak out if she had to go to a stop light).  Recently she started taking anti-anxiety medication and she is doing great, better than she's been in years, but is she stuck taking them forever?  Will she ever be able to be independent of the medication or is she now addicted to it?  

Answer:  There is a difference between reliance and addiction.  My wife relies heavily on her glasses, without them she could not see well enough to drive or distinguish faces across a room.  My wife is not addicted to her glasses.  

Many people who are reliant on any external source of aide or support can become psychologically dependent on it.  They may feel that without Mom to pack their lunch for them, or the walker they use to get to the car, they will simply not be able to function.  In some cases this is detrimental to a person's development and independence, we often speak of learned helplessness when a person simply gives up without the external support they are used to.  In most cases, however, as long as a person remembers that even without support they can function, it might be really uncomfortable or inconvenient but they will get by, then it is not a problem.

Something becomes an addiction when the relationship with a substance, behavior, person, becomes a priority out of balance with all other priorities.  If a friend would risk your relationship by lying to you to protect their relationship with drugs, gambling, sex, etc.. then they may have an addiction or a Dependence Problem.

Often I deal with parents who are afraid to allow their children to use medication for ADHD, Depression, Anxiety, etc... They worry that the child will use this as a crutch and will not push themselves through tough times instead relying on the medication.  The fear is legitimate if the medication is presented as an answer instead of as part of a process of healing and coping.  

When a person has anxiety their brain has stopped perceiving the world as it actually is and chemical signals are being sent around the brain telling it that there is grave danger when really there is little or none.  The brain can be re-calibrated without medication using a number of different therapies, from relaxation techniques to exposure therapy which helps to react appropriately to stimuli.  This can be a long and really uncomfortable process particularly without medication.

There are two ways medications are used to treat anxiety.  The more healthy way is using medications like SSRI's which build up slowly in the system and help the brain to see the world as it is.  The more immediate way is to use medications when an anxiety or panic attack flares up.   These PRN (as needed) medications hold a high risk of addiction and doctor's like to avoid them if possible because they reinforce a negative notion that when I have a problem I pop a pill and I feel better.  These are medications that tend to get abused and are very dangerous when combined with alcohol or other drugs.

If your friend is working with a doctor and a therapist there is a very good chance she will be able to go off the medication some day.  If she is not doing any therapy she may always be dependent on medication but again that will not be an addiction unless she begins to put her reliance on the medication ahead of other things.  For example if she risks driving under the influence because she cannot bare the idea of driving without a prn anxiety medication even though she has been drinking.

Ultimately medications are a tool to help us live as if we did not have the impairment which triggered their use.   So long as the medication is being used as prescribed by a doctor and is leading to more healthy and typical functioning than life without it then support your friend and worry instead about whose turn it is to drive.

My friend is a horrible, awful, wonderful LIAR, I think.

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Question: My friend is really smart and funny and I love hanging out with her but lately I don't feel like I can trust her.  She always has these really dramatic things happening to her that she won't allow us to talk to anyone about to verify, like she said she has cancer but we are not allowed to mention it around her parents.  Things have gotten worse in this area since we started high school and me and most of our friends went to public school and she went to a small private school in our community.  I think she tells lies so that we will stay with her and keep caring about her, but I don't like being manipulated.  On the other hand I think what if she is telling the truth and I am just the worlds worst friend for questioning her when she really needs my understanding.  How do I confront her without offending her?  

Answer: Liars lie because they do not have the confidence that if they tell the truth they will not be rejected.  You need to confront your friend with all the good things you think about her, how much she matters to you and why.  Then you can express your confusion about how all the bad things keep happening to one person and why it stretches your belief. 

Imagine she is telling the truth and you don't confront her.  Eventually you will grow more and more distant from her as your discomfort with her incredible life situation and the way she tries to compartmentalize it.  Regardless something needs to change or else this you will lose this friendship.  

So often people try to avoid conflict to save a friendship, most often we see this when romantic feelings are held by one member of a friendship and they do not express them to avoid conflict and tension.  Well guess what?  A real friendship can survive some tension, and if it can't then how strong can it really be?  

In my experience every time I have avoided conflict in a relationship that relationship has withered on the vine and other relationships began to demand more of my time and attention.  In cases where I avoided expressing romantic feelings for a female friend eventually one of us started dating somebody else and the friendship was difficult to make time for.  What really got saved? 

So write your friend a note or speak to her one on one in a venue where she will not be embarrassed.  Start by bringing up an image of a time you felt really close to her so that you both have a good vibe going into a more difficult concept.  Tell her this is how you want to feel again but right now you don't.

Then you use the Ask Maigler patented 4 point method for discussing difficult subjects.  1.) How I'm feeling 2.) What I think the problem is 3.)  What I'm afraid of (both by bringing this issue up and if I didn't bring this issue up) 4.) What I hope will happen next.

There is a 99% chance your friend has been lying and this is one of the most difficult habits to change.  So part 4 is the most crucial.  DO NOT ask your friend to confess she is a liar.  Instead tell her that when she tells some of these stories that stretch credulity you have a hard time relating to her.  Ask her permission for you to say that when you are feeling uncomfortable. 

When she tells a lie what is she really asking for?  She really wants to know that she is cared for.  Well ask her to simply cut to the chase and rather than telling you the details express that you just want to know how she is feeling and what she needs from you.  By doing this you are less likely to get caught up in the BS and you will give her what she really needs.  If this is successful in time she will be able to break her habit of lying because she will realize she doesn't need it anymore, at least not with you.

Be aware however, for this to work, if she does call you and tells you she is sad and she doesn't know why, you cannot just blow her off and tell her that you really have to study right now.  If you do she will be reinforced in her belief that she needs to create a fantastic circumstance to get anyone to listen to her.

Good luck, it sounds like this friend has some really good qualities, hopefully her bad habit doesn't end up driving all her friends away.