How Can I Better Manage Fear and Rejection or the Vulnerability in a Relationship?

Vulnerability is a powerful tool for interpersonal connection at the cost of being incredibly scary for most people. The fearfulness around being vulnerable is understandable. Sharing your intimate thoughts and feelings to others when there is no guarantee of a positive reaction is not an easy thing to do. 

Why is vulnerability so hard?

The nature of vulnerability, in that it requires you to share something you feel shame about, is that it will be difficult. You are intentionally putting yourself at the risk of being hurt to gain the opportunity to be understood and to connect more deeply with others. If what you are divulging is not hard or scary, it is not an act of true vulnerability. In fact, the dictionary definition of ‘vulnerable’ is “capable of being physically or emotionally wounded”. Despite the daunting nature of vulnerability, it is an integral part of forging deep personal relationships. It fosters mutual empathy, trust, and understanding, all of which are vital for building and maintaining healthy, long term relationships.

What does vulnerability have to do with rejection?

Vulnerability and rejection are inevitable parts of the human experience, so it is important to know how to manage the complicated feelings that can arise as a result of these experiences. Here are a few approaches you can try:

Remember that rejection does not define you as a person or affect your worth

Vulnerability researcher Brené Brown highlights the importance of self-worth in her TedTalk, saying “There was only one variable that separated the people who have a strong sense of… belonging and the people who really struggle for it… people who have a strong sense of… belonging believe they're worthy of love and belonging.” There is a study that demonstrates that people with higher self-esteem emotionally suffer less when confronted with rejection. Of course, believing you are worthy is much easier said than done. Psychotherapy, self-worth activity worksheets, and positive affirmations are some solid strategies for increasing your self-worth.

Focus on what you could gain, not what you could lose

While vulnerability and risking rejection are scary to practice, they can also lead to new opportunities and stronger relationships. When faced with an opportunity to be vulnerable, try to reframe your thinking from assuming the worst case scenario and instead turn your attention to what you might gain. As opposed to something like “what if I ask my friend out on a date and they don’t want to be my friend anymore?,” reframe this thought to something like “what if I ask my friend out on a date and they say yes and we start a wonderful romantic relationship?” Like anything, positive thinking takes practice and it will not be what your brain automatically jumps to the first time you try it, but after a while your thinking and perspective start to shift. 

Avoid making assumptions about other people’s motivations

Particularly when rejection is not accompanied by an explanation, it is easy to let your mind run wild with all the things you might have done wrong to “deserve” such a response. This is a valid reaction, but not a fruitful one. It’s not possible to guess what is going through someone else’s mind unless they explicitly explain it and even then, miscommunication is always a possibility. Assuming the worst, that the person hates you or that there is something wrong with you, will only fuel your anxiety around the situation. There is a study that shows that positive thinking increases resilience to daily stressors. This means that the more you work to shift your anxious thoughts to positive thoughts, the better you will be able to cope with the anxiety-provoking stressor. When those thoughts come up, acknowledge them and try to let them pass by or counter them by reminding yourself that their behavior has no bearing on your worth, regardless of their motivations.  

Keep picking yourself up and putting yourself out there

Perhaps the most difficult and most essential part of managing your fear of rejection is exposure to it. When you experience the pain of rejection, it is a natural instinct to want to put up emotional walls to avoid being hurt again. Unfortunately, this will have the undesirable side effect of preventing you from forging close relationships. You have to let yourself grieve and work through your feelings in order to move on. Being repeatedly exposed to an anxiety-provoking stimulus may be necessary in order to decrease anxiety. Crying, journaling, grounding yourself in nature, or doing whatever else feels cathartic for your negative emotions can help you process this experience and allow you to move forward. Perhaps with enough distance from the painful experience, you can even appreciate what it taught you and how it helped you grow. 

Vulnerability is undoubtedly challenging, as it requires us to expose our innermost selves without any guarantee of a positive outcome. This is especially true for those who have trauma or are neurodivergent, and it’s much easier said than done. Neurodivergent people are prone to challenges being vulnerable due to several factors including Rejection Sensitive Dysphoria, Trauma, and different communication styles than their neurotypical counterparts. However, it is through this very act of vulnerability that we open the doors to deep and meaningful connections with others. Even the challenge itself and the painful experience of being rejected is important for self-growth and building emotional resilience. If you are experiencing challenges with vulnerability or rejection, consider seeking out support from a mental health professional. By embracing vulnerability, we can foster empathy, trust, and understanding, which are essential elements for building and nurturing healthy, long-lasting relationships.           

Pelvic Congestion Syndrome: Causes, Symptoms, and Treatments

Chronic pelvic pain is a common occurrence among people assigned female at birth, affecting an estimated 15% of people of childbearing age in the United States. One of the causes of pelvic pain is pelvic congestion syndrome (PCS). PCS occurs when varicose veins develop around the ovaries. Varicose veins are twisted, enlarged veins that most often appear on the legs because standing and walking cause the blood to engorge the leg veins. Most of the time, varicose veins are completely benign and painless but when they appear on the ovaries, they can cause pain and discomfort. The exact cause is still unknown but pregnancy and estrogen can both play key roles in making the veins structurally unsound. Any type of chronic pain can be disruptive to your life so it is important to learn about the cause of your pain and what your treatment options are. This article will cover the symptoms of pelvic congestion syndrome, how it affects one’s sex life, and the treatment options that exist. 

What are the symptoms of pelvic congestion syndrome?

Dull and achy pelvic pain is the primary symptom of PCS, but it can manifest as a sharp pain as well. The pain can be exacerbated after standing or sitting for a long time, before and during menstruation or sexual activity. Additional symptoms include varicose veins in other places like the pelvis, buttocks, and vulva, an irritable bowel, stress incontinence, and pain with urination.   

How does pelvic congestion syndrome affect one’s sex life?

As mentioned above, pelvic congestion syndrome and the associated pain tends to be exacerbated by sexual intercourse. This not only poses physical obstacles to having sex, especially penetrative sex, but chronic pain can also cause a low libido. That does not mean that you can never achieve a fulfilling sex life though. In addition to the PCS treatment options below, there are ways to have great sex without penetration. You can engage in alternative forms of intimacy, like mutual masturbation, give and/or receive a sensual massage, or cuddle skin-to-skin. There are also ways to try to boost your libido, if you so desire. None of these options provide a permanent solution, but there are treatment options that can make it easier to live with PCS. 

   What are the treatment options for pelvic congestion syndrome?

Diagnosing pelvic congestion syndrome is not easy because the symptoms are easily conflated with other conditions and there is no test that will outright prove that PCS is the culprit. For this reason, doctors will typically run tests to rule out similar conditions, as well as use imaging like ultrasounds. Ultrasounds provide a view of the soft tissue; if more detailed imaging is required, a doctor may opt for an MRI or CT scan. The goal of diagnosis and treatment is to reduce or relieve pelvic pain, but there is unfortunately no known cure for PCS. The treatment you and your doctor pursue will depend on factors such as the severity of your symptoms and your medical history.

Treatment options for PCS may include: 

  • Gonadotropin hormone drugs. Gonadotropins are hormones that regulate ovarian function; they are essential for growth, development, and reproduction functions. These drugs can block ovarian function and therefore relieve some pain.  

  • Progestin hormone drugs. Similarly to gonadotropins, progestin drugs are hormonal drugs that serve to relieve pain by assisting the regulatory function of your reproductive system. 

  • Sclerotherapy or embolization. A sclerotherapy is a typical treatment option for any varicose veins, including pelvic veins, such as is the case for PCS. It involves a needle that injects a solution which causes the damaged vein to scar and eventually fade as blood is rerouted to healthier veins. A similar concept but different execution is gonadal vein embolization is a minimally invasive treatment that involves a small incision for a tube that is used to dispatch a sclerosant that blocks the vein, therefore guiding the blood to healthier vessels, similar to how sclerotherapy works. 

  • Oophorectomy or Hysterectomy (to remove your uterus and ovaries). An oophorectomy (removal of the ovaries) and hysterectomy (removal of the uterus) are reserved for the most severe cases of PCS after milder treatments have failed. However, these procedures have been shown to be a very effective treatment for PCS pain in treatment-resistant cases.

The Bottom Line

Pelvic congestion syndrome is a taxing condition that has the potential to significantly impact your quality of life, particularly your sex life. However, with a proper diagnosis and treatment plan, you can find relief. If you suspect you have PCS, you should consult with a healthcare professional to explore your options. Additionally, if you need extra support for your mental health and/or your libido and sex life due to the chronic pain, consider reaching out to a therapist.   

I Think I Have ADHD, Now What?

If you suspect that you may have Attention-Deficit/Hyperactivity Disorder (ADHD), you may feel overwhelmed and uncertain about what to do next. ADHD is a neurodevelopmental disorder that affects children and adults, and it can significantly impact various aspects of life, including work, school, relationships, and daily functioning. If you suspect you have ADHD, take proactive steps to seek assessment, diagnosis, and appropriate interventions. This blog post will provide a comprehensive guide to help you navigate next steps and offer resources for those who experience ADHD symptoms.

Education and Self Assessment

The first step is to educate yourself about ADHD and assess your symptoms. You can start by taking a reputable self-assessment tool, such as the Adult ADHD Self-Report Scale (ASRS), to understand your symptoms and their severity. Remember that self-assessment tools are not diagnostic but they may provide valuable information to be further discussed with a qualified healthcare professional.

Seek Professional Evaluation

If you suspect you have ADHD, it's crucial to seek a professional evaluation from a psychiatrist, psychologist, or neurologist who is experienced and qualified in diagnosing ADHD. A comprehensive evaluation typically includes a thorough clinical interview, a medical and psychiatric history review, and an assessment of ADHD symptoms. It may also entail other evaluations, such as cognitive testing or rating scales.

Educate Yourself about Treatment Options

ADHD is a treatable condition, and various evidence-based treatment options are available, including medication, therapy, and behavioral interventions. Educating yourself about these options is essential, and working with your healthcare professional to develop a treatment plan tailored to your needs and preferences. It's also important to understand the potential benefits, risks, and side effects of ADHD medications and to carefully follow the prescribed treatment plan.

Locate an ADHD Specialist

If you receive a diagnosis of ADHD, it may be important to you to work with qualified healthcare professionals who specialize in ADHD to develop and execute a treatment plan. ADHD specialists may include psychiatrists, psychologists, therapists, or other mental health professionals with expertise in ADHD treatment. They can provide tailored interventions, such as medication management, therapy, or behavioral strategies to address your unique needs and challenges associated with ADHD. Sometimes, you may find professionals that provide both diagnostic and treatment services.

Develop Coping Strategies and Lifestyle Modifications

Developing coping strategies and lifestyle modifications can help manage ADHD symptoms. Coping strategies may include time management techniques, organization skills, creating a structured routine, setting realistic goals, and managing stress. Adopting a healthy lifestyle, including regular exercise, a healthy diet, and adequate sleep can also support overall well-being and help manage ADHD symptoms.

Seek Support and Connect with Others

ADHD can be challenging to manage on your own, and seeking support from others is important. This may include talking to trusted friends or family members, joining support groups or online communities for individuals with ADHD, or working with a therapist to address the social-emotional and psychological challenges associated with ADHD. Connecting with others who share similar experiences can provide validation, understanding, and valuable tips for managing ADHD symptoms.

Learn to Advocate for Yourself

Advocacy and self-empowerment are paramount to effectively managing ADHD. Educate yourself about your rights, accommodations, and available educational, work, or community resources. Develop self-advocacy skills to communicate your needs effectively and assertively, and seek resources and support services to help you navigate challenges and access appropriate accommodations or services. It's important to be proactive in advocating for yourself and seeking the support you need to thrive with ADHD.

Takeaways

If you suspect that you have ADHD, it's essential to take proactive steps to seek evaluation, diagnosis, and appropriate interventions. Educating yourself and developing a way to manage your ADHD in a way that resonates with you can bring lasting impacts on you and your interpersonal relationships. Remember, you are not alone; resources and support are available to help you with ADHD.