Dr. Rob Burkham

Wednesday, November 21, 2007
Thomas writes:
Dear Dr. Burkham, My question is in regards to how to go about couples thearapy when we have been together for a few years but not yet on the marriage level. Is there anything out there for this in regards to infedelity and fixing our issues as a couple as well as on an individual level when we both agree that counseling would be a good thing? What options can we opt for when its not marriage counseling but as a couple that wants to work things out for the best? I thank you greatly for any advice that you could supply me on this.

Dear Thomas:  Couples counseling can take place whether a couple is married or not.  There should be no barriers to you two getting help together to 'work things out for the best'. 

Dr. Rob Burkham

Tuesday, November 20, 2007
afraid to leave writes:
i have been seeing a thearpist for about a year - i have issues regarding self esteem, motivation, etc. and have been trying to work through residual pain and difficulties reulting from very physically and sexually abusive long term relatinoship in my past as well as my father's death at a young age (among other things). my therapist is very kind and compassionate and at times we have a very close connection. I havedifficulty leaving at hte end of sessions and reently have begun to get panicked and virtually breakdown - afraid to leave - i don't know what to do - i want to keep seeing her but it has become so painful to leave that i dont accomplish much - we have talked about it and tried various things but nothing seems to work. any thoughts at

Dear Afraid:  You are obviously up against some very powerful and important issues for you and you are doing well to talk to your therapist to design some strategies to help you end the session in a less anxious state.  It may be that if you have plans for what you will do right after the session to help calm yourself down, that would help.  In general, strengthening your ability to handle yourself and your emotions without the presence of your therapist, that would help alot.  Best of luck to you!

Dr. Rob Burkham

Monday, November 19, 2007
Robin writes:
Dear Dr. Burkham, Thank you so much for this wonderful site! I look forward to reading your book this holiday. My question is: where can a client find out more about basic ethics practices in therapy? And what is a therapist's responsibility when she hears that a colleague might be violating those practices? I have been seeing my therapist for over a year for depression. I was referred to her by a friend's therapist who works in the same practice (in fact, she established the practice). This friend has told me that her therapist has done various things that I believe might be serious ethics violations (the most extreme example is setting this client up with the therapist's own former boyfriend/current client). I know this is hear-say and shouldn't be my concern, but it impacts my sometimes shaky confidence in the therapeutic process. I trust my therapist, but would like to discuss it with her and be reassured she wouldn't condone this sort of behavior. That said, I'm also afraid to bring it up because I don't want to open a can of worms based on hear-say. If I brought this up, what's my therapist's responsibility as a licensed practitioner?

Dear Robin:  Thanks for the kind words!  The Ethical Principles of Psychologists is the code of conduct for psychologists and is available, I think, on the APA website.  Other therapy professions have similar codes of conduct.  I don't know if you have to research what those documents say--because you don't need to determine if your therapist's partner has committed an ethical violation.  I think it is enough if you voice your concern to your therapist and to your friend and let them figure out what to do.  In voicing your concern to your therapist, she will be in a difficult situation but it is her responsibility, not yours, to figure out what to do.  The way she responds to your concerns can increase your trust in your current therapist or undermine your trust.  I'd like to hear how this turns out.

Dr. Rob Burkham

Friday, November 16, 2007
Linda writes:
Hi Dr. B I wanted to find out how you feel about this. If someone starts off therapy feeling they are worthless and everyone is better than they are and always have felt that way. Then they are now becoming more self centered and put themself first for a change and what will make them happy is this okay and is it normal to behave like this?? Is it a good thing?? I am doing it but it still is hard to get use to it sometimes I feel guilty that I am trying to be happy and take care of myself. How long does it take afte you start feeling this way for it to be permanent?? Or what would be a good way to tell if I am going to stay like this?? I lost alot of weight a couple of years ago 50 pounds. But I went throught 10 years of yo-yo dieting and that was hard. I don't want this to be like a crash diet that is temporary. I would like permanent results so how can someone tell is time the only way to find out?? Anothe thing why do people relapse??? Say they are going to do somthing and they do it for a short period then go back to their old habits and whats a good way to to stop this ??? Or is this connected with our self esteem we want to be better so we do better and expect more from ourselves?? Sorry for the really confusing question.

Dear Linda:  Wow, you have hit on many very important issues in your 'confusing question'!  I've broken your concerns down into three questions, the first being 'why does recovering from feeling worthless feel self-centered'?  This is because you have been under-valuing yourself for years and the change feels like you are over-valuing yourself.  However, this is probably not accurate.  You are probably valuing yourself as much as you value others which is healthy!  But it feels self-centered!

Your second question has to do with why people relapse.  I have a whole section of my book and a diagram on page 98 to explain this.  Briefly, no matter how much a person's habitual way of thinking and behaving is a problem for them, they are still strongly attached to it and it is very hard to let go.  Like any bad habit, it doesn't go away without a struggle.  People change by a process of two steps forward and one step back.  They make positive changes, they then get challenged or feel uncomfortable, and then they take a step back.  They then feel frustrated with going back towards the old ways, and continue working to move forward.  Then the process repeats itself. 

Your third question is something like 'how long before people feel comfortable with their changes?'  This varies alot but it is often longer than people hoped!  Most therapy clients are surprised by how long the old ways hang around and how foreign the new ways feel.  It's a bit like learning a foreign language, after alot of effort and fits and starts, eventually you start to think in the new language--it becomes a 'natural' part of you. 

So, you've raised great questions and my answers are somewhat brief but The Therapy Triangle deals with these questions in more depth.  Good luck!

Dr. Rob Burkham

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