Menopause Awareness Month: Let’s Start Something

Something as natural as menopause can feel pretty darn disabling. But where the real disability comes into play is what this event in a woman’s life impacts — not just her or the man she’s in a committed relationship with, but their relationship, their families, friends, and workmates. Looked at that way, there’s not one justifiable reason for ignorance. about menopause.

MiddlesexMD Blog

My car’s license plate reads “HOTFLAS.” I take it for granted, until someone rolls down his window to talk to me at a stop sign.

“Hey, I like your license plate,” he says. “You must be about 50. Wow, my wife is going through that. It’s really tough. It’s been a real challenge.”

Only a few days later, I was meeting with a colleague from a nonprofit for whom I volunteer. “Remind me what you do,” he said. It took about half a sentence from me (“I’m a doctor specializing in menopause care…”) to strike a nerve with him. “It’s like a stranger is living in my house,” he said, of his wife’s journey through menopause.

It’s Menopause Awareness Month. These men—among so many others who regularly cross my path—are aware of menopause. Now. I think it’s safe to say that the experience has taken them—and their wives—somewhat by…

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This Teen Knows When Apology Is Not Enough

You can make your relationship better! The writer of this post is 18 years old and already gets it. But does The Boyfriend?

This is what I find doing therapy with couples — neither gets what the other is saying. The misunderstanding, frustration, and hurt are one of the reasons arguments — fights — happen.

As always, start becoming aware of what’s going through your head.  Lots of us fight about everything else but what’s really got us hurt/angry/acting out.

Next step is to do something with your awareness.  In this case you can start making apology stick by choosing how best to apologize.

Uh, uh, not what floats your boat, but what floats your partner’s.  Find help discovering what that is by reading Gary Chapman’s The 5 Love Languages.  It will help a lot.

Find Kathe Skinner in Colorado Springs where she specializes working with the many parts of couples.  With husband David, Kathe also teaches a Secular Couple Communication Workshop.  Find out more! 

Long Distance Love Life Of A Teen

I wrote a post yesterday about the frustration when my boyfriend does not apologise, and how it makes me feel, and despite believing I’d never get an apology…I got one before the end of the day.

However, it didn’t solve anything for me.  Feelings of hurt didn’t magically disappear, nor did the frustration.  Yet, if I say ‘your apology means nothing’, he may be put off from apologising (if needed) again, so where does that leave me?

With the conclusion that he has to make it up to me.

I’m not an expensive girl, and I’m easily made happy by the simplest of things. Give me your hoodie that has your scent all over it?  I’m beaming from ear to ear.  Buy me a KFC, or a doughnut?  Let me kiss the daylights out of you.  I’m very, easily, satisfied like that.

But what do I want?  I’m not materialistic…

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hefner and twinsFantasy’s a powerful thing.  It fuels the head trip of desire and compels the illusion of feeling good, even when there are no hands on.   Multi-billion dollar industries – from publishing to prostitution to porn – start here first.   

But how does the brain distinguish between what’s real and what’s imagined?   Scientists’ hypotheses point to the involvement of different areas of the brain and the multi-directional processing among them.  

Sexual fantasies are a solo adventure usually leading to release through orgasm.  For some the mind’s eye is enough to induce a significant physical event like orgasm.  Actual visual stimulation is so powerful that doctors’ offices getting sperm samples provide men with sexually explicit magazines as a way for patients to get it up and over with.   Humans are not alone:  Species that are down the evolutionary ladder from us also purposely seek out ways to feel good “down there”.  Elephants rub, monkeys twiddle away the hours masturbating, and male dogs lust after people’s legs.

Sometimes fantasy goes wild and boundaries are blurred, creating a new “reality”.  One example is the substitution of social bonds created by in-person interaction with texting, sexting, and hook-up sites.  We’ve always looked for love in the wrong places but it’s easier now; you don’t have to take a shower to “chat”.  Carried to extreme, fantasy never becomes reality:  the lure of being anyone you choose, often without consequence, is a strong inducement to stay impersonal.

It’s long been known that our brains are hardwired for pleasure, with specific neural pathways acting as highways.  As with anything pleasurable, the possibility of overindulgence, abuse, is possible.  While most brains have stopping, or surfeit, mechanisms, other brains are glitched to go wild.  Especially worrisome is the effect on young brains of unrelenting and ever-more-present societal messages about sex.  Young brains are not yet equipped with that Jiminy-Cricket-battle between the super-ego and the id; with this age group (and for some adults), the id wins almost every time.  Understandably there is concern for young people among parents, educators, and the mental health community.

The mental health and medical communities are concerned about the rise within the broader population of sexually identified mental health diagnoses as well as the rise in sexually transmitted disease.  It’s no longer unusual to know someone with herpes; it’s even been authoritatively predicted that in ten years over half of women and 40% of men will have contracted genital herpes.

Fantasy enables our addiction to the belief that if we can imagine it, we can make it real.  It sounds snappy when Sony says it, but those are dangerous words.  Not only because that’s not always true, but because it shouldn’t always be true..  Powerful as it is, sexual fantasy is just that.  Many of us are still hanging with Freud rather than updating our belief that it’s abnormal not to fantasize when bringing about orgasm. 

In praise of sexual fantasy: 

  • Leads to sexual activity, conjoint or solo, and that’s a good thing;

  • By inducing orgasm the body rids itself of stale sperm, an evolutionary advantage;

  • Orgasm reduces blood pressure, aids sleep, counts as exercise, lowers heart attack risk, lessens pain;

  • Can infuse a dulled relationship with newness;

  • Takes us on a journey we probably otherwise wouldn’t be capable of;

  • Stimulates creative thinking;

  • Enables us to practice social skills;

  • Offers an escape from criticism that may induce self-consciousness or an inability to function sexually;

  • Makes us feel good about ourselves, powerful, potent, and desirable;

  • Enhances relationship;

  • Mostly, sexual fantasy Is fun.

Sex is the adult version of play and fantasy is our way of looking forward to playing.  As thinking beings we need fantasy, daydreaming, and imagination as a pathway to our best self.  Fantasy is a pleasure in itself. 

Kathe Skinner is a Marriage & Family Therapist whose private practice focuses on couples, especially those whose relationship is impacted by visible or invisible disability or illness for whom sexuality is often a significant issue.  It’s probable that childhood exposure to an overly enthusiastic dog is the reason she’s a cat person.  Then again, sometimes a cigar is just a cigar.  With their two hooligan cats, Petey and Lucy, she and her husband David live in Colorado Springs where she maintains a private practice and where she and David co-instruct Couple Communication Workshops.  

Copyright 2015, Being Heard, LLC

Defining “normal”

Thanks to Cassandra for being insightful as well as a good writer. I know the rest of us with invisible illnesses share her perspectives! Find her at

Indisposed and Undiagnosed

I have recently come across many posts where sufferers write about how they long to be “normal”. In a few of my posts, and most recently, I too speak of that longing for a norm.
I guess what I truly long for is familiarity, because when I fell ill I also felt like I lost a huge chunk of myself to the illness.
You may feel like you are not a whole person anymore. You might be embarrassed or ashamed that you have an illness. It happened to me, as I’m sure it has happened to you. It isn’t your fault – it’s inevitable.
It leaves you wishing to be normal, but when you think about it, what really is “normal”?

Google defines normal as, ”conforming to a standard; usual, typical, or expected”.

Is there only one standard that Google, and society, is referring to?
What do YOU…

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robot“I can’t work with someone who’s broken,” he said calmly.

The young man had just read my Disclosure, a description of rights that, as a Marriage & Family Therapist, I’m legally required to give all clients.  Although it isn’t necessary, my Disclosure also relates that I have multiple sclerosis; I don’t want clients to wonder whether my stumbling is about a liquid lunch.

Broken, he said.  BrokenI never imagine anyone thinking of me as “damaged” – hell, even in my most self-pitying moments I don’t think of myself in that way. 

I was temporarily speechless; did he really say that? 

“Tell you what,” I said when I was sure my response wouldn’t betray my hurt, “think about it until next time.”  Then I went home and cried.

At our final session he admitted what had evidently been in his mind for the three months we worked together.  He was glad he’d given me a chance.  “I found out I was broken, too,” he told me.

That young man understood that no one is perfect, not even therapists.  That healers can be in need of healing, too.  By making it “normal” to have flaws —  even serious or disabling ones (his anxiety and my m.s.) — the young man was able to let go of the stigma of emotional distress, the impossibility of being perfect, that was behind his anxiety in the first place.

I still disclose my disability to clients although the passage of twelve years has made symptoms apparent that were once easy to hide.  I fundamentally believe that clients who come to therapy often do so because they feel alone with how they feel; as Roy Orbison sang, the feeling is that we’re the “only one” who experiences the depth of pain we do.  How secretly pleasing to know that the someone who slips-up, isn’t always self-assured, or doesn’t always behave the way the experts’ books say is your own therapist!

How healing to know you’re really not the only one.

Kathe Skinner is a Marriage & Family Therapist specializing in couples work, especially with those whose relationships are impacted by invisible disability or chronic illness.  She’s been diagnosed with multiple sclerosis for over 35 years.  At home in Colorado with David, her husband, and their two hooligan cats, Petey and Lucy, no one in their household believes in Kathe’s perfection.  Find information about the Skinners’ upcoming Couples Communication Workshop at www.beingheardnow.comand Kathe’s other dynamic practice and programs at

Image Courtesy of supakitmod at

© 2015, Being Heard, LLC


guilhermina guide 3

Super-star athletes are polishing their personas with the advent of the Summer Olympics to be held in Rio de Janeiro in 2016.  One of them, Jamaican mega-medal winner Usain Bolt, has the gracefulness of a natural athlete. With his perpetual smile and generally good nature, Bolt is no pushover.

One doesn’t get the impression that Usain Bolt would promote something disagreeable.

Despite his gifts, or maybe because of them, Bolt also demonstrates a remarkably generous spirit, e.g., his 2012 embrace of double-amputee Oscar Pistorius, who competed against Bolt.

At a recent promo event, Bolt paired with Brazilian Paralympic multi-medalist Terezinha Guilhermina as her guide runner. Vision-impaired para-athletes compete under strict guidelines that may include use of sighted guide runners. Guilhermina trains and competes with guide Guilherme Soares de Santana; tethered at the wrist, she runs blindfolded as they match each other in speed and timing.

This high-speed dance is like a successful relationship: Trust is essential.  Good communication is quick but subtle, successful only with lots of practice.  Even when a compatible partner is found — no easy task in itself — the tasks are twice as difficult, twice as demanding.

If you’ve ever run a playground race with one leg joined to another person’s you begin to understand how tough it is to run as one.

Even so, Bolt expressed concern that Guilhermina would fall over or be unable to run fast enough. Both fears were unfounded.

Like running in synch, when an able-bodied athlete joins with a para-athlete, one shadows the other. Both understand the effort, sacrifice, and ability that has brought them to the medal podium.  As in a good marriage, there is mutual admiration and respect; knowledge that the differences are not diminishments.

Now for the preachy part:  There are two separate and unequal worlds when it comes to sport.  Usain Bolt, personable as he is, sells because of his able-bodied ability, not his smile.  Paralympic athletes sell to the larger audience only when paired with Olympic athletes; it doesn’t matter that their talent, drive, focus, and commitment to excellence are the same.

“Blade runner” Arthur Pistorius got more ink because of his fall from grace than from his rise to it.

Societal disequity is an old story and not just one about disability. Overcoming innate human suspicion and dislike of what is different requires conscious and concerted effort.  The nudge may come from decades’ worth of disabled vets with their can-do mentality, greater numbers, and the societal bequeathing of a high moral ground.

Personally, I’ll take it any way I can get it:  If the result to being paired with an able-bodied celebrity is lasting inclusion and a broader definition of human value, then drop the red flag and let the sports begin.

Kathe Skinner is a Marriage & Family Therapist whose private practice focuses on couples, especially those whose relationship is complicated by invisible or visible disability.  Diagnosed with multiple sclerosis for nearly 40 years and understands that athletes go beyond themselves to compete.  With two world-class cat nappers, Petey and Lucy, Kathe and husband David live in Colorado where she doesn’t ski.

Read more about their Couples Communication Workshops at  While you’re at it, check out our newest site,

Sex and Alzheimer’s: A Tangled Web

This is a hugely important topic and worth the read, especially as us boomers age in place…

MiddlesexMD Blog

No conversation about dementia is easy, especially when it regards someone you love. Talking about sex is no piece of cake, either. But any conversation about Alzheimer’s or dementia ought to include sex.

Because sex will very likely be an issue that caregivers have to deal with at some point. A recent patient told me that sex remains a very special connection with her husband, who is in the early stages of Alzheimer’s; she looks to preserve that connection as long as possible.

We are sexual creatures all our lives. Alzheimer’s doesn’t change that fact, although it will alter the experience and expression of sex in a relationship—both for the person with dementia and for the partner. It’s better to be emotionally prepared and to have your resources in place than to be taken by surprise by loss or uncharacteristic or embarrassing behavior.

So, let’s talk.

A diagnosis of Alzheimer’s disease is…

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How To Balance A Family, Your Job, And Your Stresses

How To Overcome Your Persistent Fears And Anxieties In Your Life!!

By: Stan Popovich

It can be difficult for adults to have to take care of their families and manage their careers. This can cause a lot of stress and anxiety. As a result, here are a few steps in how to do take care of your family and your career without getting stressed.

Try to set goals for yourself when you manage your family or career. When you go to work each day, try to set some goals for you to accomplish. For instance, let’s say your goal for today is to finish the report that your boss wants. At the end of the day, you will feel better about yourself knowing that you were able to finish that report. When you accomplish these smaller goals, you will feel happier, more confident, and less stressed.

Delegate part of your responsibilities. When taking care of the family, get your spouse to…

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day of dead 

Every zombie has a family.  And on the first and second days of November that zombie’s family, and thousands of others throughout Mexico, is honored in a celebration with 3,000 year old roots – Dia de los Muertos.

Like an Irish wake or an African-American jazz funeral, Day of the Dead is a combination mourning and celebration held to honor those who have died.  Entire cemeteries are cheery with flowers, lit by bonfires and candles that brighten feasts of the dead’s favorite foods.  Tequila flows freely and stories are told that relive families’ histories.

Dia de los Muertos remembers and honors the players in a family’s past, keeping history alive from generation to generation.

Proliferating like Mexican restaurants, Dia de los Muertos has taken hold throughout the non-Latino world.  What may account for its popularity is how colorfully and cheerfully death and rebirth are celebrated – music, traditional food and drink, and art highlight what is, in many places, a community-wide event.

Lacking Mexicans’ cultural traditions, though, many people north of the border live in an existential funk, lacking a sense of who they are or what they want.  Feeling directionless, without a sense of family or personal continuity, makes knowing where you fit in the Grand Scheme of Things impossible.   Both you and your family, even an entire culture, can disappear when there’s collective amnesia about the past.

In my psychotherapy practice I talk with people who’ve been amalgamated into a fractured mainstream, one whose one size doesn’t fit everyone, inevitably too broad for too many to wrap their arms around.   “Where have I been and where am I going?” are unanswerable when we appear out of nothing; phantoms are figments that have no future and no past.  They just “are”, with no “was” and no “will be”.  That’s how lots of us feel.

It’s surprising that many of my clients have no knowledge of their roots.  How each of us came to be who we are is multi-layered and multi-populated, providing the best answer to the question we asked from the time we could talk — why? 

That everyone in a Mexican community is celebrating the same thing further cements inclusion, a sense of belonging; it’s what many of us missed in our own families of origin.  In community there’s support as we mourn the many losses in our lives — family, friends, pets, our very ways of being in the world.  There is mutual support in sickness and in health, in sorrow and joy. These are the two sides to the existential coin.

Zombies, acquainted as they are with the dead, are the only ones who can help resurrect families’ missing histories.  Knowing that Grandfather was a mean drunk whose third wife was passive helps us understand reasons for our own passivity, alcoholic behavior, failures at marriage.

There’s a Mexican saying, Hay más tiempo que vida — There is more time than life.   Maximizing time on this side of the doorway is helped by knowing how we came to be who we are.   These are the ongoing tasks of our lives:  To get unstuck from feeling alone by getting acquainted with the generations inside us.  To utilize that acquaintance to fill in the outline of the lonely singular “me” with the fleshed out, colorized pictures of “us”.  To provide reassurance in our times of trouble that they, too, had troubles.

Here’s what zombies can teach us about family history:  the more information gained, the more stories listened to, the more secrets unknotted, the greater the perspective we have.

With information and perspective comes the sight we need to make choices on our own behalf.

The better we know and understand our predecessors’ successes and mistakes, the freer we become to design and live our own present and future.  And, as every wise zombie knows, sometimes a bit of mourning has to happen before the party can begin.

Kathe Skinner is a psychotherapist in private practice who specializes working with couples and the individuals who make them up.  Using in- and out of-session exercises, she helps individuals identify what they bring forward from their own families of origin so that they can identify and break free of negative patterns in their marriages.  She and husband, David, and twin kitties, Petey and Lucy, live in the land of Pikes Peak.  Find out more about Kathe at
Copyrighted by Mexican artist John Huerta, who uses the style of Day of the Dead to illustrate the women in his life who’ve died. 
© Being Heard, LLC, 2014

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WordPress Tags: zombie, zombies, family history, Mexico, Day of the Dead, Dia de los Muertos, dead, generation, generations, family, family of origin,