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Q1: 08.39. How would you help a patient who struggles with communicating, as in limited vocabulary, using the wrong words, struggling to get through sentences and overall struggling to communicate.Strange question but as a therapist, how much would you have to see or understand before you decided that this needs to be dealt with in some kind of structural way, in order for the therapy to work. Would you just wait and see for a year or two if it goes away? Or would you find some way to deal with it right away. Q2: 15.16. How can I deal with the urge to draw away from people and commitments and being afraid of commitment and intimacy because I'm too scared of hurting anyone or negatively affecting anyone's life? I don't think that it's my self-esteem that is my issue. It's more that I always expect others to have a low esteem of me. Like, e.g. I do think that I have good qualities, but I think that others want other good qualities than the ones I have and have high standards for qualities where I'm not doing so well. Q3: 23.59. I remember you saying in the AKA videos that if our coping skills don't suffice or if we find that we need so much self-care we don't manage our daily responsibilities we need more help. Now my problem is: 'Help' seems to really wipe me out. I get socially exhausted from it. In the end rather than it helping it seems to deplete my energy, which is a bit of a problem because having low energy is one of my main issues in the first place.I don't really know how to manage that. So I wonder: How do I manage that? How do I go about that 'needing more help' when 'getting help' makes me feel so bad? Q4: 27.55. I’ve heard you mention the phrase “your world gets smaller and smaller” -or something along those lines- and it has stuck with me. I have actually felt that way - that my world is shrinking. I blame it on Covid but am wondering if I will go back to normal when the pandemic becomes controlled (or mostly controlled). I used to be a pretty adventurous person but feel like that is no longer who I am. Am I just living in a smaller world in order to be a good human and follow the advice of the experts? Or is it just because my anxiety is taking over? Do you think I’ll be able to regain that old part of me that I miss? Q5: 32.50. My question is I’m due to have my baby in 5 weeks and I’m going to be having her in a hospital. With my first daughter it was very different and a big secret due to abuse etc. I’ve been terrified of people touching me all my life but I know it’s going to happen. I tried to bring it up with my midwife but she said ‘you’ll have to get over it, everyone does.’ I explained my trauma history to her but she wasn’t very understanding. How do I just get over it and just deal with what’s going to happen? Q6: 39.14. My therapist doesn't bring up my eating often, so I don't bring it up either. I alays feel so awkward about it and don't know what to say. How should I bring it up? Do I even need to? She's aware of it and we've talked about it before. There's a huge part of me that questions if I don't even have an ED and I made it up and that's what I want to talk about. Talking about it just makes me so uncomfortable and I don't know how to bring it up. Q7: 43.44. On Tuesday 2nd, I learnt that one of my friends had taken her own life. In the days afterwards, I replayed every memory that I had of her. I struggled to remember any time when she did not seem happy and content. She had got married a year and a half previously, and only recently bought a new house. She always seemed to have a huge number of friends. I saw no warning signs. Here's the question: if someone like this can end their own life, how can I look for any warning signs in any of my friends or family? How do I know if anyone at all that I know or love might be at risk of suicide any time now? Q8: 49.00. I am going into treatment next week for 3 weeks and I am so scared and so nervous. Do you have any ideas of what i can expect? What will the days look like and what do they work on in there? From what I know I will not be able to have access to the dietitian even though I have an ED because my BMI isn’t low enough. They told me that they aren’t going to tell me to stop what I’m doing because I’m still in a safe zone. So I won't be on an ED Ward from what I know which is fine but it just makes me feel like no one is taking it seriously and then one day I might not be in a safe zone and it’s too late. Q9: 54.00. I heard you talk about hypersexuality recently and I have become very curious about this. I experienced a sexual abuse at 13 right before I started high school. For a few years up until I was around 19 I would go to parties and often end up sleeping with someone. I would also text boys all through the day at school and meet up with them afterwards. I’m now 26 & not like this at all now that I’ve done some hefty work on the abuse in therapy, so I know it’s not who I am or what I like normally. I have learned in therapy a few reasons this could be but never really received a clear answer other than “it’s a coping mechanism”. I was wondering if there is a possibility this could have been hypersexuality? How is it defined? Q10: 1.00.33. Hi, I have self harmed on and off for years. This past week I accidently cut deeper than usual and nicked an artery. Had to call a friend to take me into ED. They stitched it and let me go home without seeing the psych team as they were busy. But since then the hospital outpatients team keep calling me and the gp got sent a letter and is calling me. Like im in no worse place than I was a few weeks ago so why are they all freaking out now?? There was no trigger, nothing happened. I am not in crisis. I am always anxious. Its just there in the background all the time. When the distractions stop it gets louder. A month or so ago I stopped my valdoxan and quetiapine because they weren't really helping anyways and are expensive... if I go to the dr she will just get grumpy I stopped and put me back on?? Q11: 1.05.37. I have been either blessed or cursed with a very powerful intuition for other people's feelings. I can often read their emotions before they feel them themselves. This intuition served me very well as a child. Neither my mother nor father were exactly stable, and being able to predict how they feel saved me from their anger while my sister endured a great deal of torment from them. This hasn't served me so well as an adult. I became somewhat of a slave to this intuition. Often I have done what others wanted, rather than what I wanted, because I was afraid of the displeasure that I sensed in them. I am working on overcoming that. What really troubles me, though, is that this intuition is often incorrect. When I was younger, especially while I still drank alcohol, this intuition transformed itself into paranoia. I believed that people hated me, I felt it. At its worst, I even had hallucinations. I could not tell what the voices were saying, but I was certain that they were ridiculing me. At these times, my intuition tormented me. Of course, I can take medicine. I'm currently on lamotrigine. Medicine has never been a guarantee of stability for me. Abstaining from alcohol and making sure I always get enough sleep have been much more effective than drugs. But since my intuition has betrayed me on numerous occasions I can never trust it. What should one do when they have a natural mechanism for reading people, but this mechanism is broken? Should I try to ignore my intuition entirely off of logic alone? Q12: 1.13.56. It's been a hard time recently. I have a tricky "relationship" with my Mum and Sister.. both are judgemental, undermining, controlling that ranges from annoying to Toxic. Even when good things are happening in my Life and I'm beginning to Trust in Myself to have a good life, I get negative judgemental comments. Trying to communicate my boundaries is met with Immature responses or more toxic responses. I ended up blocking my mum and my sister to keep a boundary for my own Space and needs to focus on my new job and health..The problem is my nieces lose connection to me as their Aunty (which my sister has been tolerating communication for the girls ( 6.5yrs and 4yrs ) benefit but this comes at a price to my self-worth. I am always the one who compromises my needs, wants and doesn't share my feelings or emotions with family..Is it okay to go no contact for a longer period even if there are younger family members connected and would be impacted indirectly or directly. Q13: 1.18.00. The other day, I saw a bad wreck. I didn't know the person personally, but I knew who it was because of the logos all over her car. I saw the initial hit and her car do flips, but left as I saw emergency vehicles that happened to be passing go over. She and her dogs ended up not surviving. Ever since I've been more on edge wondering if I could have done something to help out and maybe it would've been enough to save them. How do you get past the guilt and nervousness when you can accept there probably wasn't anything you could've done and it wasn't anyone with a personal connection to you? Q14: 1.21.18. In my sessions lately, we've been talking about my attachment towards my therapist. Most of the time I just shut down and I rely on her a lot which I'm trying to work on. She's expressed to me how the attachment is good and is actually a positive thing but still won't reassure me that she'll always be there for me because therapists can close their practice, get into accidents, etc. Whenever she says these things, it really hurts. I feel like the only way I'll feel safe is if she does promise she'll always be there but I know that's not realistic. Q15: 1.28.45. I finished my final exams and officially graduated vocational school last week. I was expecting with all the stress and anxiety gone after finishing, that my mental health would get better. Instead I feel like it's the exact opposite: All the things I planned to do in my free time seem boring and unexciting now, I can't motivate myself to do anything, time is super slow and I struggle to cover my basic needs. Is it weird that I wish for the stress to come back? I decided to start a new round of vocational school which won't begin until September. I'm kinda looking forward to that but the time until then just seems so unbearable long. Could you please share some tips and advice? Q16: 1.32.44. I feel like so many of the people who are important to me are struggling right now. I really want to support them all as much as I can and I think I'm doing an ok job most of the time although I also feel guilty because I always feel like I should be doing more. I've also been having a bit of a rough time with my mental health generally and I have to end therapy in a few sessions for insurance reasons. I feel like I don't really have anyone to turn to because the people I would normally talk to need my support more than I need theirs right now. I was just wondering if you can give me any advice on how to feel less alone and take care of myself so I can support the people I love? Q17: 1.36.24. I have been fantasizing a lot about self-harm and have come close a few times. What stops me?? Well, I live with my mom and I don't want to let her down and hurt her again. I used to be a self-harmer, I am so scared that if I started again I don't know if I could stop. it's getting harder and harder to stop myself. I feel like I act like everything is ok but in reality, I am a duck all calm on the top but under the water, my feet are going like mad. Q18: 1.39.28. How do you deal with someone else's mental health when you are barely handling your own. My mom told me tonight that she has been having panic attacks at night without telling me and is feeling depressed. How do you deal with someone else when you are barely holding on yourself? Q19: 1.44.29. I have been taking horseback riding lessons at this barn for the last six years. During that time there have been many frustrations with lessons being cancelled and stuff like that, but I have always stayed because I love the horses. Last week the instructor emailed out a new policy stating that she is allowed to give "virtual lessons" instead of our regular riding lessons in the case of bad weather (which is frequent this time of year in Michigan) or Covid. Basically, we still pay full tuition and watch a video of her discussing a riding topic instead of actually riding. I finally stood up for myself. I told her I felt it was wrong for her to take tuition and give a video instead of a lesson. I said that I value the barn time and that is why I take lessons in the first place, so taking virtual lessons is not something I want to do. I asked several times to be allowed to schedule a make-up lesson at a later time, instead of attending the virtual lesson. She responded that it was “offensive". I have two questions about this. First- is it okay to offend people? Because I kind of feel bad that she was offended. Second, I’m actually kind of proud of myself for speaking up about this. I wanted to discuss this with my therapist today but I felt like if she knew I was able to stand up for myself, she would think I’m making up all my social anxiety symptoms, because someone with social anxiety wouldn’t be able to do that. And the irony is I know that thought is due to anxiety but I still couldn’t tell her. Is it common to want to hide good things from your therapist? How do I deal with that? Q20: 1.50.56. About a month ago I started on an antidepressant for depression and it’s started to feel like I’m not drowning in the symptoms anymore. Every therapy session since starting feels less of working on things and more of just checking in and talking about what all happened since the last session. Is this normal while monitoring to see if the medication is helping? When do you know when it’s time to start working on things again? Q21: 1.53.54. Is it necessary to be fully open in therapy or can you keep some stuff to yourself during the first year and still progress. I have some stuff that I'm not ready to admit out loud to myself yet and am not too sure whether my therapist knows - I have a feeling she does as she usually catches things quite quickly. Is it ok to keep some things to myself and speak about them when I am ready in therapy even if it takes ages and how will I know I'm ready? Where is the line to what I can keep to myself - how do I know what I'm dealing with is too much for me to be dealing with in my mind alone?

Katie K