Welcome to my blog! Here you’ll find my latest blogs as well as videos!
You can find books and articles I’ve published or been quoted in at:
www.patricktullytherapy.com/publications
Have an idea? Please let me know at: patrick@patricktullytherapy.com
We’re born with the ability to respond quickly to danger. It is an ability known as the fight or flight system, where – in the face of danger – neurochemicals send signals throughout your body to help you fight or flee:
Without this system, it would be difficult for us to react quickly and powerfully enough to protect ourselves if we were placed in harm’s way.
But there is a problem.
It may be a dangerous time for many of us, but most of us are not face to face with tigers anymore. Our fight or flight system is activated by things that are not necessarily dangerous, or where the system itself (rapid heartbeat, racing thoughts, etc.) hurts our ability to perform. For example, the right or flight system may make it possible for us to protect our children from a predator, but it gets in the way at a morning meeting. It may help us react quickly to a potential car accident, but it makes taking a plane a lot more challenging.
Anxiety is what happens when we’re experiencing the symptoms of the fight or flight system, but in situations where it hurts our quality of life, rather than saves it.
Have you ever told someone you had anxiety and they responded with “don’t worry?”
We know that’s easier said than done. Once you have anxiety, it becomes difficult to address on your own. That is why people see therapists.
Anxiety happens internally. Most people recognize that their anxiety has an irrational component, but experiences anxiety anyway because – even if they cognitively know they should not feel anxious, they still feel anxious emotionally.
“You don’t heal anxiety by convincing yourself nothing bad will happen; that’s not true and your nervous system knows it.” Says Chantal Vice, a therapist on Long Island and owner of Heart in Mind Psychotherapy.” You heal by learning that you can survive uncertainty, that your worth is not on trial, and that discomfort is not the same thing as danger.”
Panic disorder – a type of anxiety disorder – is often fueled by a desire to stop and rationalize yourself out of it. During panic attacks, people may try to tell themselves not to panic, only to get more anxious, experience more anxiety, and have a worse panic attack as a result. Over time, they may even stop going outside, worried about getting additional attacks.
One of the ways we treat panic attacks is helping people get through them and move on. Rather than try to stop the attack, we give them permission to have the attack and then move on more quickly, so that they feel like the attack doesn’t have the same life impact. Over time, they start fearing the attacks less, which in turn decreases both their frequency and severity.
Anxiety is not stopped through logic alone. What we have to do, together, is teach you how to accept your anxiety and stop allowing it to control your life. Over time, as we teach you to fear anxiety less, you’ll find that anxiety has less and less power and, ultimately, severity.
If you’re struggling with anxiety, please reach out to me today.
We talk about relationships as though they are a single entity – a single thing that needs to be worked on. But relationships are made up of two unique people, and sometimes, the best way to have successful relationships (whether you’re currently with someone or single) is to work on yourself.
Couples counseling can be useful for a couple that is going through life challenges. Yet it’s individual psychotherapy that likely has the best benefits for someone that wants to experience more fulfilling, more meaningful, healthier relationships. That is because a great relationship starts from within – it starts by addressing yourself and your needs, so that you’re not allowing those issues to affect your ability to be with a partner.
One of my good friends, Esther Oh, is a therapist in San Francisco, and one of her services is dating coaching – something uniquely useful for people that that are looking to enhance their relationships. According to Esther: “Many people do not realize how much their mental health is affecting their relationships. From the way they react to conflict to the joy they get from love to the confidence they exude to others, our mental health affects almost every part of meeting partners, dating, and marriage.”
It can be easy for us to envision why severe mental health challenges can affect dating and relationships. If a person has severe social anxiety, for example, they are likely going to have trouble meeting someone. This is something that clearly should be addressed in therapy.
But what about anxiety that is less severe? What about mental health issues that are more manageable?
Even here, we can see the ways that something like mild anxiety can affect our ability to find, maintain, and grow healthy relationships:
“There is even evidence that stress can affect your pheromones and how you smell to other people. People that can sense your stress are going to have trouble connecting with you” says Esther. “In that sense, therapy may even make you more attractive!”
Jon Abelack, a therapist in New Canaan, addresses this in his own blog post, “How Manageable Anxiety Becomes a Life Altering Problem.” He writes “Those with anxiety tend to have issues in their relationships. They may feel nervous when a partner or someone they’re dating does not respond fast enough. They may have intimacy issues, worried about getting hurt or about disappointing their partner. They may be distracted, unable to fully commit to the relationship because their anxiety/stress is dominating their minds.”
I see the same thing in my work. I see clients that are struggling in their relationships and struggling with their mental health, and while they contact me to ask if I provide couples counseling, we often find that individual therapy is the secret to addressing their mental health needs.
So yes, if a relationship is really struggling and you want to help it, maybe you need a couples counselor. But if you’re looking to have better relationships – either with your current partner or a new one – what you may want is individual therapy. Contact me today to get started.
The moment someone feels that their relationship is stuck, or they are struggling to overcome challenges that are holding back their marriage from being something more, one of the first thoughts that many couples have is “we should look into couples counseling.”
Couples counseling is a highly effective, extensively researched way for couples to learn to communicate, work through their problems, and grow. But what we as therapists often find is that the problem isn’t always the couple as a unit. Rather, it can often be individual struggles that a person is dealing with that stand in the way of both partners’ happiness.
Some people have a fear of commitment. Others have trauma from their past. Others need to learn how to accept love from someone. Some people need help examining their beliefs about relationships in order to address them effectively. Others are just meeting people in ways that aren’t conducive to long term commitment.
Yet for some people, the issue isn’t necessarily about the relationship at all. An example of this is anxiety. Anxiety is an overwhelming mental health condition. A person struggles with restlessness, rapid thoughts, stomach issues, sweating, nervousness, and general unease. If the person has a condition like panic disorder, then they are also frequently experiencing bouts of severe anxiety that leave them drained, empty, and inside their own mind.
“Lots of times when we see a patient that is struggling with intimacy issues, arousal, or isn’t able to focus on their partner’s needs, we also find that they struggle with anxiety” says Dr. Marc Shulman, a psychologist on Long Island that provides couples counseling and anxiety therapy. “We can support them through their relationship, but we still need to address the anxiety individually so that they can give and receive love better with their partner.”
While we often talk about the symptoms of anxiety and how they affect the individual, anxiety can also affect a person in a way that alters the relationship as well. Anxiety causes:
Anxiety can make it easy to get overwhelmed, it can make it harder to communicate, and it can make it harder to feel happy.
“Anxiety is a constant distraction,” says Dr. Sadi Fox. a psychologist and couples counselor with Flourish Psychology in Brooklyn. “If someone is frequently distracted by and affected by their anxiety, it’s easy to understand why their relationship – especially the parts that require positive feelings, like intimacy, become more difficult for a person to manage.”
Dr. Sehdev, a psychiatrist in Dallas that specializes in anxiety, sexual dysfunction, and TMS therapy, notes that intimacy, specifically, is often affected by anxiety. “One of the medications that we might prescribe for some types of sexual dysfunction are the same medications used to treat anxiety and depression, such as SSRIs.” If the person’s relationship is being affected by intimacy, anxiety is often one of the first places we look.
I specialize in individual relationship counseling. This type of therapy involves working with someone as an individual, with the idea and goal of helping the person with their own individual needs so that they can really give themselves to relationships better.
While there is a space for couples to work together, it’s important to remember that relationships are made up of two individuals, each with their own needs. There are many situations in which it is best to work with both partners together, but there are also many situations where the best approach is to address each couple individually, because each one needs a space they can share, grow, and address their own issues.
Anxiety may only be one of these many issues, but it does serve as an example of how relationships are complex, and how often growing as a couple means also addressing specific challenges that you face as individuals. If you’d like to learn more about individual relationship therapy, please contact me today.
First and foremost: Happy New Year! I hope you had a wonderful time with your family and friends over the holiday season. Every year has its challenges, but the hope is that we can look back on the past year and still be able to remember some joys and progress that we made on ourselves over the last 12 months.
Still, it is a new year once again, which means it’s time to think about the future. Many of us have long given up on the idea of resolutions, but it is still not uncommon to think about what’s in front of you and create goals or have hopes for ourselves that we want to reach.
Whether you call these “new year’s resolutions” or not, we’re all familiar with the idea that many new years resolutions “fail.” As Flourish Psychology writes, in the form of a Seinfeld joke: “Making resolutions is very easy. It’s keeping the resolutions that is the problem. Anyone can make a resolution. But keeping the resolution is the most important part of the resolution.”
There are many reasons that these resolutions, goals, and desires for ourselves fail, but most of the time, the issue is because they are all related to our mental health. It’s very difficult to care for your body when you do not care for your mind. It is nearly impossible to achieve a goal when you’re sad, down, anxious, or otherwise stressed.
Indeed, our mental health doesn’t just prevent our resolutions. Many times, without us realizing it, they *are* our resolutions. When we set a goal to do something like “learn a new language,” we are not only doing that to expand our abilities. We are also doing it because we believe it will make our lives happier and more fulfilling. The goals we undertake are, often, designed to improve our mental health.
That’s why, this year, maybe the resolution you should have is the one that will help you achieve all your goals and provide benefits that last a lifetime. This year, you should resolve to address your mental health.
The primary benefit of addressing mental health as a resolution is that your mental health plays a role in all other components of your life, including any other goals that you may want to take on and the benefits of achieving those goals. For example, if you resolve to travel more, and you do, but you struggle with depression, that travel is not going to bring you the fulfillment you hope for. It’s also going to make it harder to get yourself to travel.
But there are other benefits as well. Mental health care is:
Better mental health is a resolution that you can keep every year, and it will always provide you with other dividends, such as improved ability to reach other goals and more energy to stay focused on the tasks at hand.
Mental healthcare is a smart goal for 2024 and beyond. But there are a few barriers. I’m licensed in California, Texas, and Florida, and there are issues that can affect people that may stand in the way of addressing their mental health. In Texas, the issue is a dramatic shortage in providers. Paul Burke, a California insurance agent and owner of Burke Insurance Services, writes “therapists are often covered by private insurance, but the issue is a lack of providers. California has been slow to remove (and in some cases have actively created) barriers that can make it harder for patients to find therapists in the state able to treat them.”
California is doing better on the health insurance and mental health legislation front. According to Mary of LyteSpeed Learning, an online insurance course provider for the state, the CA legislature has passed several bills such as Senate Bill 326 and Assembly Bill 531, all of which expand access and pour resources into the state’s mental healthcare programs.” Jeff Adler of LTCR Pacific, a long term care insurance provider, agrees, stating that California’s health insurance programs have helped open the door for better mental health related care.
The issue in California, however, is time and cost. Cost of living here is high, making it a bit more difficult to pay out of pocket (despite the benefits), and many of us now work remotely, which can make it difficult to stay with the same therapist as you move around the state.
Despite these barriers, the value of addressing mental health cannot be understated. While many other resolutions and goals are admirable, there is little denying that mental health plays a role in all of your goals, and many people push off receiving therapy and other mental health services for far too long. If you’re ready to go into 2024 caring about your mental health, please contact me today.
Tinder – Swipe Life (Archived Article from Former Editorial Website)
I was quoted in this article by Suzannah Weiss.
Being Friends with Your Ex
by Suzannah Weiss
Published: Wednesday, May 06, 2020
I never understood the phrase “falling out of love.” In fact, when I first heard it, I found it deeply disturbing. I’d learned about love as something that lasts forever, something strong enough to outlast any breakup.
The first time I fell in love, I honored this belief. My partner and I told each other early on that we’d love each other forever, no matter where our relationship went. The deep caring I had for him did not disappear after he broke up with me, and we remained friends for years before drifting apart. Even now, I still have love for him, though I have no romantic or sexual attraction to him at all.
Two years later, when I broke up with my second boyfriend, I told him, “Relationships don’t end — they just shift.” We’d talked about the soul-level connection we had and our shared past lives, so the idea of being completely out of each other’s lives was not conceivable to either of us. We shared the belief that love is unconditional, which means it’s not conditional upon being in a relationship. Once you love someone, you always will.
He and I still talk every once in a while about what’s going on in our lives or the world. We’ve occasionally even said “I love you” with the understanding it’s meant platonically. I’m in another relationship, which I talk openly with him about, and he’s been in other relationships at various points. As with my first ex, the sexual and romantic attraction faded, but the love did not.
Then there are the flings that never made it far before landing in the “friend zone,” as it’s called, as if friendship were a consolation. There’s the guy I dated for a month in college, stopped speaking to for a year, then begun inviting to my dorm for drinks and friendly banter. And there are several people from dating apps I took on one or two dates, decided it wasn’t a match, then became good friends with.
Most of us learn as kids that the proper trajectory for a relationship is to date, become serious, and then get married and stay together as life partners. But why is this considered a more desirable path than, say, dating, becoming close friends, then being in each other’s wedding parties? When we get too attached to one particular outcome, we miss out on the potential that each unique relationship holds.
“Being friends with an ex can have many advantages because this is a person who likely knows you on a deeper level than other people. This allows you to have someone you can confide in, aside from any partner, and who can support you,” says marriage and family therapist Patrick Tully. “It can be quite healing, actually, to remain friends with an ex.”
Still, friendships with exes can be tricky territory, and befriending an ex you still have feelings for sets you up for disappointment. “You should be certain that both of you are completely over your relationship and neither one of you wants to get back together,” says marriage and family therapist Amy McManus. “It’s extremely hard to be friends if this is not the case.” This may take a while, and that’s OK. “It can take time to process a breakup, whether or not you initiated the breakup,” says Tully.
That’s why I’ve typically waited a few months or even years to befriend exes. I once tried befriending an ex right after we broke up, but I ended up crushed that we were only friends and jealous when he mentioned love interests. So, I now wait until I’m over a person, which often means waiting until I’m dating someone else.
McManus advises against even being friends with or following exes on social media until you’re over them. “If you are not in another relationship and you see them with another person on social media, it can be depressing, and it can easily suck you into obsessing and stalking,” she says.
It’s easiest to be friends with an ex if you broke up a while ago, are both seeing other people, and have limited circumstances under which you see each other, like when you’re visiting their city, says McManus. However, if either of you is seeing someone else, this can also add another layer of complication. “If a person still cares for their ex, it can be problematic in a current relationship,” says Tully.
If your partner feels uncomfortable about your friendship with your ex, you should ask yourself whether they have a reason to be. Even if you’re no longer romantically involved with your ex, certain behaviors like flirting or bad-mouthing your significant other may border on emotional cheating.
Perhaps you can find a compromise that helps your partner feel comfortable, like only hanging out with your ex in a group. However, if you feel your partner’s request that you avoid your ex is unreasonable, you don’t have to honor it, says Tully. The important thing is to make sure you’re not sacrificing your time with your partner to spend time with your ex, but that’s true for all your friends.
As for me, my current partner doesn’t think anything of my friendships with exes. I don’t hide them from him because I have nothing to hide, and he recognizes that. He also knows it means that even if things don’t last between us, he’ll remain in my heart as well.
Society pressures us to put relationships into boxes with labels, like “ex” or “partner” or “friend.” But the truth is, people’s roles in our lives are always shifting, and embracing these shifts is the only way to appreciate every relationship for what it is. That way, the end of a relationship doesn’t seem so devastating — because it’s really the beginning of a new one.
Tinder used to have an online lifestyle magazine called Swipe Life. I was able to salvage the above article with the help of the WayBack Machine at Archive.org
