David Lechnyr, LCSW

Therapists have long known that when we have grown up in unstable, disruptive, and dysfunctional families end up having similar characteristics. As a result, they end up having traits that can directly affect their potential for having full and enjoyable lives. Originally, the research was focused on alcohol as the only dysfunction in the family (thus, Adult Children of Alcoholics, or ACOA). In recent years, the understanding of dysfunction in the family has extended beyond alcohol to the point that the new trend is to refer to those that grew up in such circumstances as Adult Children. It doesn't matter if the dysfunction in the family...

When we become discouraged, feel lost, are confused, and feel overwhelmed, it is easy to feel like we want all the pain and sadness to stop.  We want to run, to feel no more, and to have our upset, anger, and sadness removed quickly.  Understanding a few issues might be of help at these difficult times. Discouragement of Depression When we experience depressive feelings, it is easy to feel discouraged and to feel hopeless. Depression is many times anger turned inside because of things that has happened to us in life. At other times, depression is the result of a chemical imbalance. No matter...

At some point, you may find yourself in need of a good psychiatrist. There are three critical rules in doing this. Understanding the terminology in distinguishing between a psychiatrist, psychologist, and psychiatric mental nurse practitioner is the most important step. Setting your expectations appropriately and not sabotaging your approach is second. Third is the rule of not forgetting your ultimate goal. Rule 1: Know the Terminology If you are in need of general mental health medications, approaching your primary care physician (PCP) is a good first step. These tend to be general practitioners or family practice doctors. The advantage is one of accessibility; chances are,...

No one WANTS to swim with sharks. However, difficult people are, by their very nature, sharks: Aggressive, territorial, and tribal. When we unexpectedly find ourselves dealing with a difficult person, we assume that they will "play fair". In our desire to "get along with others", we often make the situation worse. In reality, we have no choice but to learn how to identify and respond assertively without being "eaten alive". Swimming with sharks is like any other skill: It cannot be learned from books alone; the novice must practice in order to develop the skills. The RULES, if followed, will...

People who suffer depression and anxiety frequently spend much of their time feeling shame about the past or worrying about the future. It comes as no surprise that this is a more common problem that we face every day than we'd like to admit to ourselves. How we understand feelings of guilt and shame helps us to focus and deal with these immobilizing emotions. Guilt and Shame From the Past Often, we have a feeling that we might have done some unforgivable thing in the past and deserve to be punished. Guilt is the punishment that makes us feel that we...

I have been frequently asked about what it takes to become a psychologist, psychiatrist, therapist or a clinical social worker. Many people are interested in becoming a therapist, or mental health professional. Ironically, there are not many places to find the answers. My goal is to shed some light on this and answer some of your questions. In general, you must go to four years of college to get a B.A. or B.S. (Bachelor's) degree. This is the general preparation for entry into professional graduate education which starts AFTER you have completed college. Many students will major in psychology or...

The Freedom of Choice is the most valued factor in our lives. Human beings will do most anything to insure that they can have choice in all of their decisions. Much of what counselors, therapists and psychologists hear in therapy is related to a sense that the individual does not have a sense of choice in their lives.  When we feel an obligation to do something, being forced to do what others want, we resist. This is made worse when there is a sense of betrayal in the relationship in some manner. This causes a worry about trust and how...

Relationships go through many stages, ups and downs, good times and bad. Most of the time we get through these difficult periods. At times, our intuition tells us that the relationship is in the midst of a crisis. Affairs can threaten your trust in the relationship. Understanding the critical clues to an affair can help keep things calm in difficult times. Clues to Unfaithfulness There is a sudden, and new, interest in one's physical appearance. New friends and acquaintances are developed outside of the marital relationship that become a focus on energy, focus and involvement. There are concerns about aging, time left, and a rush...

Starting up a private practice can be overwhelming, intimidating, and often a huge financial risk. Taking steps to mitigate the dangers involved demands approaching things from a business perspective; the dilemma is that this is the anthesis of what we consider a genuine therapist should be. Finding a way to blend the two – business skills with the therapist mindset and ethics – is the key. One of the services I offer is being a business mentor for mental health therapists (psychologists, social workers, licensed professional counselors, nurse practitioners, etc.) who are interested in starting, or refining, an independent private...

One of the most difficult issues in dealing with depression is the issue of medications and potential side effects.  Antidepressants can have different effects on sleep, changes in weight, sexual functioning, and in how they impact you when you stop taking them. Some prescriptions are more expensive than others, which can mean a higher insurance copay.  Some have fancy names with commercials that suggest they can cure you without any fuss.  Add to this the myriad of different choices, different mechanisms of action (SSRI, SNRI, Tricyclic, and so on) and multiple (brand vs. generic) names, and it's enough to tear...