What to Expect During a Session with Elizabeth Mahaney, LMHC, MFT, NCC, DCC, Ph.D


Step 1 (To Do): Attune to Awarenesses

Awarenesses may start with researched assessments based on thousands of couples that will recognize cycles of conflict so issues can be stopped and transformed into moments for intimacy and connection. Receive a detailed analysis on your relationship style so you can turn your insecurity into opportunities for a deeper romantic bond. Miscommunication and disconnect happens when the lack of self-awareness could be part of the problem and partners don’t understand each other. My first task is to get you on the same page with yourself and loved ones. Let’s create a game plan and brainstorm agreements about how to start the process. This step can feel overwhelming but my goal is to help you focus and narrow down specific goals. We will approach the problems collaboratively with questions like: “How can life feel better?”, “How can each of you start positive changes intrinsically?”, “You are a subjective human and you can only feel and control you”. Therefore, all change happens intrinsically.

Step 2 (Doing): Attach to Agreements

Learn how to intentionally ask for what you feel and need in a way that gives your partner a way to express love. Create a culture of love and respect that builds trust and sexual passion. We will deal with perpetual problems, heal old wounds, and rekindle the spark of companionship together. Playfully explore ways to create a sexually fulling and passionate relationship. Let’s create more intimacy that brought you together in the first place, create new agreements that make life more enjoyable, and meet each other’s needs. I’ll offer you specific techniques, resources, interventions, tools, or activities that may work for you by brainstorming, collaborating, and developing the treatment plan together. I will also explain how to connect through communication by making specific actionable, immediately do-able, positive requests. Learn how to love your partner without losing yourself.

Step 3 (Done): Accountability for Lasting Change

I give you all the tools you need to understand what changes need to be made, avoid relapse and continue to build a meaningful relationship that gets better with time. I’ll also help hold you accountable for creating, trouble shooting, and maintaining sustainable intentional responses to “This Thing Called Life” and… changes along the way.


Moving Through & Beyond Grief and Loss

In my work as a mental health professional, I have seen many clients dealing with losses of all kinds-loss of loved ones through death and divorce, for instance. These experiences are difficult for everyone.

Personally, the month of May feels like an emotional rollercoaster saturated with sadness from the loss of my nephew and a longtime childhood BFF. Both of them born in May and left us in this same month way too early… My body remembers so much joy celebrating birthdays and also the trauma associated with their deaths. My daughter was also born in the midst of all the chaos that May has to offer which serves as a reminder that amongst the deep sadness, there is so much love and joy to be shared. Although, tears seem to hit me at times during the month, I like to focus on celebrating all of our May babies in any way that seems fit!

Stages of Recovery from Loss
There are some predictable stages that most people pass through after losing something or someone important. In her work on death and dying, Elisabeth Kubler-Ross outlined five stages of grieving.

Shock and Denial: The first reaction to loss is often the inability to feel anything. This may include feeling numb, weak, overwhelmed, anxious, not yourself, or withdrawn.

Anger: Blaming yourself or others for the loss.

Bargaining: "If you'll just let him live, I'll promise to go to church every Sunday for the rest of my life."

Depression: Feeling deep sadness, disturbed sleep and eating patterns, thoughts of suicide, excessive crying.

Acceptance: Beginning to look for the lessons of the experience.

Kubler-Ross said that the grieving process involves experiencing all five stages, although not always in this order. She also said that people often cycle back and forth through a number of the stages before coming to the stage of acceptance.

Kinds of Losses
Some examples of significant losses are:
*    Loss of a person through death
*   Divorce
*    Job loss
*    Loss of your good health when you are diagnosed with a disease
*    Loss of a body part through accident or surgery
*    Loss of an ability, such as blindness
*    Loss of a friend who has moved
*    Loss of everything familiar when you move away

Each kind of loss affects each person in a different way, but the recovery process usually follows Kubler-Ross's five stages.

Recovering from Loss: Some Key Points
    1.    You are responsible for your own grief process. No one can tell you how to grieve, and no one will do your grieving for you. It is hard work and you must manage the process by yourself.
    2.    The grief process has a purpose. It is to help you learn to accept the reality of the loss and to learn from the experience.
    3.    Remind yourself that your grief will soften and may or may not end. Grief will change. You will not feel like this forever. You will keep healing. You may have good days and sad days…
    4.    Take care of your health. Grief is extremely stressful, and it requires energy to manage the stress.
    5.    Be careful with food and drink. While it may be tempting to numb the pain with food and drink, this can lead to the additional problems of alcohol dependence and weight gain. Also, numbing the pain means you are prolonging denial. This will make your grieving process longer.
    6.    Talk about the person who is no longer in your life. People sometimes avoid talking about the loss as a denial mechanism. However, this prolongs denial and the grieving process.
    7.    Take time to be alone. In the days and weeks following the loss of a loved one, there is often a flurry of activity with many visitors and phone calls. Added to the stress of your loss, this can be completely exhausting. People will understand if you don't answer the phone for an afternoon or go to your room and close the door for a while.
Don't make any important decisions until your life feels more balanced. It can be tempting to make some important changes right after a major loss as an effort to feel 
more in control.
    8.    Maintain a normal routine if you can. You have enough changes in your life right now. Try to get up in the morning, go to bed at night, and eat your meals at the same times you usually do.
    9.    Ask for help. You will need it. If you don't want to be alone, or if you want someone to take you somewhere, it is okay to ask. People don't expect you to be self-sufficient right now.
    10.    Let people help you. People want to help because it gives them a way to express their feelings. Staying connected with people is especially important now, and accepting help is a way of staying connected. As time passes, it is important to be assertive to ask yourself or others to meet your needs. No one is a mind reader. Be clear and specific to ask for what you would like to see happen in a positive way. This way, you will more likely get your need met. Often times, people focus on what is not working, what doesn’t feel good, and what they don’t like. This negative way of thinking and judging almost always guarantees miscommunication. Instead, create what you would like to see happen by asking for what you need.
    11.    Keep a journal of your feelings and experiences during the grieving process. Writing about your feelings helps you express them, rather than keeping them inside. It also gives you something to remember and review in the future, which you will appreciate.
    12.    Avoid making extreme life changes after a major loss. Don't make any important decisions until your life feels more balanced. It can be tempting to make some important changes right after a major loss as an effort to feel more in control. If you can, put off such changes and decisions until later.
    13.    Don't hurry your grief process. People sometimes want to put their feelings and memories behind them because they are painful. But grieving takes time, and there are no shortcuts.
    14.    Remind yourself that although grief hurts, it will not harm you. Grief is painful, but you will survive and even grow from the experience.
    15.    Expect to regress in your recovery process from time to time. This is normal. It may happen unexpectedly, but it probably won't last long.
    16.    Acknowledge the anniversary of your loss by taking the day off or doing something special. Have supportive people ready to be with you. It could be a difficult day and it's better not to be alone.

17. Not everyone in your immediate and extended family will grieve the same way. Compassion and empathy can help you support others while self-empathy and self-compassion will help facilitate your self-care. Try to remember that your whole family and friends are also grieving.

How to Help Someone Who Is Grieving
1.    Don't try to get them to feel or be anything but what they are. Simply hold space for anything that comes up…
2.    Don't reward them for acting cheerful or "like your old self." This teaches them to suppress their feelings around you.
3.    Don't avoid them. They need your support.
4.    Let them tell about the loss again and again, if they need to.
5.    Recognize that unexpected, perhaps inappropriate behavior is part of the grieving process. It means the bereaved person is moving forward.

Judgement, blame, shame, guilt and anger do not help anyone who is suffering. Instead, thoughtfulness, compassionate communication, and meeting your loved one where he or she is, without trying to change her feelings, can be super supportive. Empathy, holding space for one another, and reminiscing can facilitate connection and family cohesion. Try to remain non-judgmental and connected through difficult emotional times. Openness to meeting yourself and other’s where they are without judging the process can help meet everyone’s needs!

Suicide: Warning Signs and Treatment

It is reported that suicide, the act of deliberately ending one's own life, is a cause of death for about 30,000 people (including 5,000 between the ages of 15 to 24 years old) each year in the United States. Since many suicides are not reported as such, the actual number is most likely much higher. Suicide goes unreported because of its stigma or because family members find it too painful to confront the truth.
The rate of suicide in this country is about 12 per 100,000 people, making it the ninth leading cause of death in the United States during the years from 1993 to 1995. According to the American Association of Suicidology (which studies suicide and its prevention), there are between eight and 20 attempts at suicide for each death from suicide. This means that there are anywhere from 240,000 to 600,000 suicide attempts each year. This rate jumps to 200 attempts for every completed suicide when young people (ages 15 to 24) are involved.
Other Facts about Suicide
    In the U.S., Nevada has the highest rate of suicide.
    More suicides happen in the spring than at other times of the year.
    The most lethal days of the week are Monday and Friday.
    Rich people and poor people alike kill themselves. Suicide is an equal-opportunity killer, and is chosen by people from every group imaginable. The most common victims are white males aged 65 and older.
    More men than women kill themselves, but women are more likely to attempt suicide.
    60% of people who commit suicide do so with guns.
Why People Commit Suicide
There are many reasons why people kill themselves, and we seldom know why certain individuals choose this route. The following factors seem to play a role in many suicides, but none of them guarantees that a person will end his or her life. Often it is a combination of factors that seem to interact with a person's circumstances; the factors are unique for each person. Some of these factors include:
Clinical depression. This type of depression is much more than just a simple case of the blues; it is severe and debilitating. It may surprise you to know that people who suffer from depression are at the greatest risk for suicide after they have begun treatment and are beginning to feel better. The reason for this is that when a person is severely depressed, they may lack the energy to carry out suicide. When they begin to recover and feel better, their energy begins to return and they may carry it out then.
Alcoholism and drug abuse are associated with a higher suicide rate because these substances impair judgment. Over half of all adolescent suicides and suicide attempts are associated with alcohol. When a person is under the influence of alcohol, he or she has fewer inhibitions and may also think and act in ways that would never happen when sober. Alcoholism and drug abuse also create additional stresses in the lives of users and may result in depression and a tendency toward desperate behavior.
Mental illness. People who have certain disorders, such as schizophrenia, have a higher risk of suicide.
Physical illness, including terminal illness and the illnesses common as people age, is often a factor that contributes to people taking their own lives.
Feeling hopeless is very common among people who commit suicide. Hopelessness may be part of clinical depression, or it may be the result of an illness or other dire circumstance. When a person feels hopeless, he or she feels trapped, and suicide may seem like the only way out.
Anger motivates some people to commit suicide. After a long, unhappy relationship and years of building anger, these people see their suicide as a dramatic way to send a message of retribution.
A sudden loss may precipitate suicide in some people. The shock and grief of an enormous loss-of a person or a job-may drive a person to such an extreme.
Experiencing a scandal or extreme embarrassment leads some people to feel so trapped in their situation that they can think of no other way out.
Suicide Warning Signs
One expert says that eight out of 10 people who kill themselves have given clear warnings that they were considering suicide. While these warning signs can be evident for almost anyone at some point in their life, it is important to be aware of them and take them seriously when you see them.
    Making a threat of suicide, e.g., "I wish I were dead," "I'm going to end it."
    Expressing hopelessness
    Expressing helplessness
    Expressing worthlessness
    Talking about death
    Having previous suicide attempts
    Seeming depressed, moody, or angry
    Having trouble at school or at work
    Abusing alcohol or drugs
    Taking risks
    Withdrawing from other people
    Behaving differently or oddly
    Sleep difficulties
    Loss of appetite
    Giving away prized possessions.
    Suddenly seeming happy after exhibiting several of the behaviors listed above.
The treatment for a suicidal person varies, depending on severity and the underlying cause. Treatment can range from immediate hospitalization to weekly psychotherapy with a licensed mental health professional. It may also include antidepressant medication or treatment for drug or alcohol addiction.
What to Do if Someone Is Suicidal
Take action immediately. Depending on the urgency of the situation, call your doctor, hospital, mental health center, suicide hotline, or police emergency number (911).

Out-of-Network Insurance Claims Reimbursed with Ease Using BETTER


At South Tampa Therapy & Mediation, we know that dealing with payments and insurance can put a damper on the great work you accomplish during a session. That’s why we’ve partnered with Better, a company that makes it easy for out-of-network clients to get reimbursed.

Better accepts superbills directly from South Tampa Therapy, simplifying the process for both us and our clients. Once clients sign up, they take a photo of their superbill and email it to claims@getbetter.co 

Attachment and Differentiation in Relationships: An Interview with Ellyn Bader, Ph.D.

The idealized relationship where partners are fused at the hip is not a healthy relationship, as it doesn’t allow for the unique differences of each partner. Bader highlights this fusion as a conflict avoidant stance that happens when one partner feels anxious or uncomfortable and attempts to merge with their spouse.

One way of doing this is becoming more like your partner in hopes of being loved. There’s a deep fear that says, “If I express my needs and have different needs than my partner, I’m going to be abandoned.”

The other conflict avoidant stance is loving your partner at arm’s length. The fear in this stance says, “If I become more open and vulnerable, I’m going to get swallowed up and lose my sense of self.”

As Dr. David Schnarch states in his book entitled Passionate Marriage, “Giving up your individuality to be together is as defeating in the long run as giving up your relationship to maintain your individuality. Either way, you end up being less of a person with less of a relationship.”

Fusion happens when a person is fearful of encountering differences. These can be minor differences including how one spends their time or their hobbies, or major differences such as conflict style and desire for togetherness. The opposite of fusion is differentiation.

The Risk of Growth

Bader describes differentiation as an active process “in which partners define themselves to each other.” Differentiation requires the risk of being open to growth and being honest not only with your partner, but also with yourself.

  • If you’re anxious, it could mean realizing that you lean on partner so much that if they become unstable, you both fall down. Your demands on your partner and the way you discuss conflict may be pushing your partner away, which is the very thing you fear.

  • If you’re avoidant, it could mean noticing that you neglect your partner’s needs and prioritize yourself over your relationship. As a result, you perpetuate the loneliness you feel.

To grow in your relationship requires a willingness to stand on what Bader calls your “developmental edge” and differentiate yourself as an individual.

What Differentiation Looks Like

In conflict, a differentiated lover can give space to their partner who is emotionally overwhelmed while also remaining close enough to be caring and supportive, but not so close that they lose themselves emotionally. Instead of reacting with overwhelming emotion, a differentiated partner, according to Bader, expresses curiosity about their partner’s emotional state:

“Can you tell me more about what’s going on?”
“Can you tell me about these feelings?”

The more differentiated you are, the less likely you are to take things as personally. As a result, you can soothe yourself or reach out to be soothed by your partner in a helpful way. Instead of saying, “You’re such a jerk. You never care for me,” a differentiated partner would say, “I’m feeling really overwhelmed and lonely. Could you give me a hug?”

To differentiate is to develop a secure way of relating to your partner. This earned security, as highlighted by Bader, is created both internally and developed within the context of a relationship. This requires being authentic with your feelings and needs.

You can cultivate a secure and functioning relationship by recognizing and taking responsibility for your part in creating unhealthy dynamics in your relationship. When you do this, you can then express your needs, desires, and wishes in a way that allows you and your partner to work together to meet each other’s needs.

When both partners are whole, not only is there more flexibility in the marriage, but there is also more intimacy.

If you’d like to learn more about Ellyn Bader and her Developmental Model of Couples Therapy, you can visit her website here.

Rejection Sensitive Dysphoria

Rejection Sensitive Dysphoria

Do you have ADHD? Have you heard about rejection-sensitive dysphoria? Characterized by a strong emotional response and a fear of certain situations, rejection sensitive dysphoria is a form and symptom of mental illness that is strongly associated with attention deficit hypersensitivity disorder.

So, in this blog post, we’ll cover all you need to know about rejection sensitivity, and how it may affect your day-to-day life!

What is RSD or Rejection Sensitive Dysphoria

If you’ve been diagnosed with attention-deficit hyperactivity disorder ADHD, then you’ve probably experienced episodes of rejection sensitive dysphoria. Well, rejection-sensitive dysphoria is a form of suffering, where a person may experience severe emotional sensitivity and emotional pain.

Generally, this means that people with ADHD will perceive a situation negatively, when in reality the situation may not aim to cause them emotional pain. Let’s look at an example; if a person with rejection-sensitive dysphoria was to receive a delayed “text message response” from a person they are fond of, then that person with RSD may experience symptoms such as anxiety and low-self esteem.

Rejection Definition

By definition, rejection denotes to the action where a person’s ideas, concepts, behavior, etc may be refused or dismissed for a given reason. Generally, rejection can come in the form of social rejection or emotional rejection. This may result in a person developing severe anxiety in a specific situation, loss of self-esteem, and a feeling of hopelessness.

Dysphoria Definition

In general, the term dysphoria comes from the Greek word, dysphoros, which translates to hard to bear. Therefore, dysphoria simply can be defined as a feeling or state of mind that’s hard to bear, or uneasy.

Often people may associate gender dysphoria with rejection-sensitive dysphoria. However, it is important to note that gender dysphoria refers to the idea where a person may be dissatisfied or displeased with the gender they were born with. This was commonly referred to as gender identity disorder and has sparked much debate in the LGBTQ community.

Rejection Sensitivity and Relationships

In 1996, a study discovered that rejection sensitivity can play a major role when it comes to peoples intimate relationship. The study discovered that people with rejection sensitivity experience:

  • insecurity in their intimate relationships

  • satisfaction problems

For example, do you know a person who may be quite emotionally dependent on their partner? Or a person who fears that their partner may leave them? These are all examples of a rejection sensitive person as they have a fear of their partner leaving them.

Now, do you know of a person who seems unhappy in their relationship? Perhaps it’s not their partner’s fault, but rather how the rejection sensitive individual perceives their relationship to be. This example demonstrates that rejection sensitive individuals may experience general dissatisfaction and unhappiness in their intimate relationships.


Rejection Sensitivity and Relationships—It Affects Men and Women Differently!

Men with rejection sensitivity generally tend to be very controlling of their intimate relationships. Men with rejection sensitivity may get more or easily jealous of situations that may compromise their relationship with their partner. It’s been suggested that mean who demonstrate reactive, controlling, and jealous behaviors are at risk of potentially emotionally abusing their partners.

In contrast, women with rejection sensitivity may behave quite differently from men, when in an intimate relationship. In general, women tend to remain a lot more hostile and negative when in a relationship. For example, a woman who feels as though she is not receiving sufficient attention may tend to verbally abuse her partner, or deny them sexual satisfaction.


Attention Deficit Hyperactivity Disorder aka ADHD is defined as the mental and brain disorder that affects a persons brain activity. ADHD is most commonly associated with:

  • Inattention

  • Hyperactivity

  • Impulsivity

Generally, adult ADHD may present itself a lot differently, than a child with ADHD. For example, children with ADHD may experience increased hyperactivity and an inability to focus. Whereas, an adult may experience more rejection sensitivity and hyperactivity-impulsivity.

ADHD is a form of brain development disorder. This is because people with ADHD generally tend to have a less developed caudate nucleus, putamen, nucleus accumbens, pallidum, thalamus, amygdala, and the hippocampus.  Now if we look at each of these parts of the brain, we would be able to see, how they contribute to our emotions, thoughts, and day-to-day lives.

For example, the amygdala is the part of the brain that is responsible for functions such as memory, emotions, and decision making. An adult with ADHD would then have a much smaller amygdala, thus resulting in their inability to focus, and their rejection sensitivity.

Is Rejection Sensitive Dysphoria the Same As Social Phobia?

Social Phobia is also more commonly known as social anxiety disorder. Social Phobia refers to the idea that people may have a fear of either being placed in a social situation or a fear of being the center of attention.

This form of mental illness generally denotes to the idea that a person may experience overwhelming feelings, anxiety, increased heart rate, and muscle tension as a result of being placed in a social situation. As such, a person with social anxiety disorder may develop symptoms similar to rejection sensitivity. This includes depressive thoughts, low self-esteem, and sensitivity to criticism.

When we look at rejection sensitive people, then there’s no doubt that both mental illnesses look the same! However, the causes of social phobia are generally associated with genetics, past social and cultural experiences. Similarly, the causes of ADHD are often associated with underdevelopment of the brain. Rejection sensitivity is similar in the sense that it becomes one of the underlying symptoms of both social phobia and ADHD

Is Hysteroid Dysphoria a Type of Rejection Sensitivity?

According to the American Journal of Psychiatry, hysteroid dysphoria is a form of chronic mental illness that causes a person to experience episodes of depression as a result of a specific type of stress. As opposed to it being a specific type of rejection sensitivity, hysteroid dysphoria is a subtype of atypical depression that includes rejection sensitivity as a symptom.

RSD Symptoms

Understanding the symptoms of rejection-sensitive dysphoria can be quite complex. This is because RSD is actually a type of symptom for patients with ADHD. However, in general, a person with ADHD and rejection sensitivity may experience the following symptoms:

  • setting high standards for oneself

  • strong emotional reaction

  • Shyness

  • depression or depression thoughts

  • fear of failure

  • rage towards the situation or person that causes them discomfort

  • loss of self-esteem

  • seeking for self-approval from family, friends, and/or partners

  • A feeling of hopelessness

  • The person may criticize themselves a lot

How To Treat RSD or Rejection Sensitive Dysphoria

Because rejection-sensitive dysphoria is associated with ADHD, your mental health professional may consider treating the ADHD first. Originally, the conventional method of treatment for rejection sensitivity was psychotherapy. Over time this treatment has shown some efficacy.  Today, however, your mental health professional may also recommend medications such as a combination of alpha agonists guanfacine and clonidine—or, monoamine oxidase inhibitors (MAOIs).

 4 Facts About Rejection Sensitive Dysphoria

  1. Rejection sensitivity is a difficult concept to understand. Some forms of rejection sensitivity suggest that people may feel their emotions (depression, fear, etc) prior to the stressful situation occurring. As a result, they may find or perceive the situation in a negative manner.

  2. ADHD is often misdiagnosed as either bipolar disorder or Asperger’s syndrome.

  3. Over the last few years, there’s been a lot of debate suggesting that people with ADHD are more at risk of developing mental illnesses such as Alzheimer’s disease. However, this is still a topic that’s currently being studied.

  4. Cognitive-behavioral therapy has become one of the common treatment for people suffering from ADHD. Cognitive-behavioral therapy is a type of therapy that focuses on thoughts, behaviors, and emotions.

Rejection Sensitive Dysphoria and You

Rejection sensitive dysphoria is a symptom that is most commonly associated with ADHD in adults and children. This form of mental illness often presents as intensive emotional feelings, fears, and outbursts of depression as a result of potential underdevelopment. While there is no cure, rejection sensitivity and ADHD can be controlled through treatment with medication.




How ADHD Ignites Rejection Sensitive Dysphoria


https://www.sciencedaily.com/releases/2017/02/170216105919.htm https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2771869/

7 Daily Rituals Intentional Couples Use to Cultivate Lasting Love

Due to the daily pressures, distractions, and dynamics of modern life, a romantic couple doesn’t have to be dysfunctional to grow distant over time. Long working hours and the demands of raising children can push date night, sex, and romantic vacations to last place on the priority list.

Researchers at UCLA observed 30 dual-career couples with young children to understand the daily challenges for finding opportunities to build strong relationships and families. They discovered that these couples: 

  1. Spend less than 10% of their time at home with each other and without their children around

  2. Are career-focused with long working hours (partner one) and a have a double burden of work and childcare (partner two)

  3. Prioritize children and household needs over the needs of their spouse or self

  4. Become more like roommates, drifting apart emotionally and physically

  5. Miss important opportunities to connect emotionally on a daily basis

With high expectations in our careers and relationships, yet little guidance on how to make love last, we are clearly struggling.

Only the intentional couple has a chance to deepen their emotional connection in order to bond over the years of their relationship.

Learning to Stand in Love

When we are falling in love we are often more intentional than married couples might be about going on dates, having intimate conversations to learn about each other, and making time for shared adventures.

It’s easy to fall in love, but much harder to stand in love, which requires intentionally creating moments of connection and intimacy.

Perhaps a look at another realm of life can reveal an analogous secret to making this all work…

Successful business owners often share that their energy and time is far more important than money. It turns out that it’s how they choose to spend their time and energy that determines how much money they make.

The same is undoubtedly true for a person’s love life. It’s easy to let cell phones, TV, and other electronic devices drain our time and energy while we are home. Social media and TV shows are designed to entertain us by strategically offering the most captivating and shocking stories and memes. Mark Manson argues that “Smartphones Are The New Cigarettes.”

Just recently I was on my phone while my partner was talking about something important. I was skimming all the videos, articles, and quotes on my Facebook feed on how to be a better lover.

It wasn’t until my partner said, “You’re not listening to me!” that I realized I was mindlessly sucked into my phone and half-heartedly listening to one of the most important people in my life.

See the irony?

Couples must stand against the urge to take the easy route of just passively letting things happen in our relationships. The sad truth of love is that if we do nothing to actively improve our romantic relationships, even without doing anything that is actively destructive, the relationships will get worse over time. Relationships require active work and maintenance. After all, even when a couple is first dating, things don’t just happen. The active efforts of the couple make them happen.

According to the author of The Intentional Family, we need to focus on two connection killers to make our relationships better: how we spend our time and how we use technology.

  1. Many couples are time-poor. Driving kids to soccer practice after a full day of work, only to come home and cook or do the laundry, leaves very little time for oneself and one’s significant other. A busy couple can first focus on improving the quality of their interactions by truly focusing on each other and the relationship during the time that is available.

  2. Couples fail to intentionally disconnect with the outside world, missing the opportunity to truly connect with each other’s inner worlds. Our electronic devices are always sending us notifications that can interrupt and distract us from enjoying relationship time. The good news is that just making some minor changes in how devices are used can significantly improve the quality of a couple’s time together.

Ritualizing Daily Interactions

One of the best ways to intentionally improve a relationship is to add meaning to the daily habits we already practice, as well as to cultivate new rituals that make the moments we have together, even when we are crazy busy, more meaningful and connecting.

A romantic ritual is an event that is repeated, planned, and, most importantly, designed to be meaningful to both partners.

Intentional Rituals You Can Start Today

In Wired for Dating, Stan Tatkin, PsyD. states that “you can and should be your partner’s best antidepressant and anti-anxiety agent.” The following rituals not only create opportunities for connection but also reduce the stress burdens many of us carry today.

Sit down with your lover and select two rituals below that you’d like to try out in your relationship. Before implementing them, talk together about why these rituals will be meaningful to both of you. If there are prior experiences that come to mind during this discussion, such as childhood memories, take the time to share those in depth. Finally, hash out the when, who, and what of how the ritual will occur to ensure that it is feasible to add the ritual to your lives. Try it for a trial period and then check back in with each other to assess how it went.

Eating Together

At mealtime without kids, you may find yourself plopped down on the couch watching the latest Netflix series, or browsing social media while sitting at the dining table.

With kids, conflicting work, school, and extracurricular activity schedules make it tough to find the time to connect with your lover at mealtime, or to have the energy to cook healthy food.

When meals are eaten together in a space that facilitates conversation, couples often feel more connected and as a result, tend to have fewer petty fights.

Here are 4 tips for enhancing your mealtime:

  1. Discuss who does what; such as who buys the food, who cooks the food, and who sets the table. One couple I worked with has one partner cook while the other partner sets the table before the kids join. Another couple takes turns cooking their favorite dishes.

  2. Think about how you connect. During the cooking process, a few couples would play some light music, pour a glass of wine, and talk to each other before the kids joined for the meal. It’s helpful to consider the environment of where the couple or family eats as well. Does it have a TV playing? Are cell phones allowed? Intentionally think about potential distractions and interruptions and decide in advance which ones both partners are okay with.

  3. Consider what the family as a whole might talk about at mealtime to further strengthen the bond. A billionaire’s father used to ask, “What have you failed at this week?” Other families discuss what they appreciate, or something they have accomplished. It’s also helpful to have clear rules around what shouldn’t be discussed, such as marital conflicts.

  4. Is the start and end clear? What signals the start of the meal? Is it a specific start time or someone telling the family it’s time for dinner? When does the ritual end? Is this when everyone has finished eating? Does everyone help out with the dishes?

If you struggle to find time for a romantic or family dinner each night, think of opportunities during morning and weekend meals, such as a regular Sunday brunch. Maybe on certain nights you can go out to eat, creating a ritual such as Taco Tuesdays.

Waking and Sleeping Together

Couples with mismatched sleeping styles, as in the case of an early bird paired with a night owl, can experience instability in the relationship. This can lead to more conflict, less time for shared activities, less sex, and less connecting conversation. 

Tatkin believes that it’s healthy for partners, even those with different sleep styles, to discover ways to begin and end their days together with rituals. Here are some ways to stay in sync:

The Morning:

  • Get up early and share coffee, or go back to bed after a 15-minute conversation

  • Cuddle for a few minutes before starting the day

  • Tell each other one thing you appreciate about each other

  • Cook breakfast together

The Evening:

  • Pillow Gazing: Look into each other’s eyes and focus on softening the gaze for a few minutes before falling asleep

  • Have some calming tea and talk while in bed

  • Read to each other

  • Express gratitude for your partner

Leaving for the Day and Reuniting at Night:

Home is wherever the relationship is, and how couples part and reunite influences their energy, self-esteem, and emotional connection.

When you or your partner leave for the day, do you embrace each other? Do you kiss? When you reunite, do you hug and tell your partner you missed them?

This study of 30 couples found that the men who returned home later in the day received no acknowledgment from their distracted family members. Being greeted in a loving way is a fantastic start to an evening at home. Here are some ideas:


  • A six-second kiss. Dr. Gottman who has observed thousands of couples for 40 years calls this kiss a “kiss with potential.”

  • A nice full hug that embraces both partners (not a one-arm type hug)

  • Asking your partner what are they most excited about today? Or what are they worried about today? Dr. Gottman calls this building a map of your partner’s daily life.


  • Tatkin suggests a “Welcome Home routine.” Greet your partner and give them a long hug and kiss.

  • Hugging to relax: Dr. Schnarch, a renowned Couples Therapist, encourages partners to hold each other until they relax. This physical connection can help reduce stress and reconnect the couple. My partner and I often embrace for at least 30 seconds when the last partner gets home.

Talking Daily

When a relationship is new, falling in love requires lots of one-on-one talking about the good and stressful parts of the couple’s day and what is meaningful to each of them.

According to Dr. Doughty, the author of The Intentional Family, “Few dating couples would get married if they had as little focused conversation as most married couples do.”

Dr. Gottman’s research highlights that after couple’s therapy, the couples who have a daily stress-reducing conversation are less likely to relapse than couples who don’t talk daily.

Intentionally talking with each other one-on-one, even for just 15 minutes, can be good enough for busy couples. Focus on discussing how your daily events made you feel, rather than just talking about the facts of the events that occurred.

One of the best ways to do this is to tie the talking ritual to enjoying a beverage together. Dr. Doughty has coffee with his wife every night after dinner at the dining table. My partner and I have apple cider vinegar and talk while we sit up in bed.

Having a daily conversation deepens tenderness towards each partner, creates a better emotional and sexual connection, and prevents fights over little things that often arise when a couple lacks meaningful connection on a daily basis.

Exercising Together

Actively maintaining health together is a great way to stay connected.

  • Start or end the day with a walk around the neighborhood

  • Go to a gym class together

  • Head to and leave the gym together

  • Play on a sports team together

Remember, if couples do nothing to actively improve their relationship, even without doing anything that is destructive, the relationship will get worse over time. That’s why it is vital to intentionally cultivate daily rituals that help partners reconnect.

Relationships thrive when couples realize that the seemingly insignificant moments, such as a loving hug and kiss when one partner comes home, are often the most significant of all. By being intentional, couples can transform dull, mindless routines into a source of connection and fun.

Source: Reposted from www.KyleBenson.net

  1. Campos, B., Graesch, A. P., Repetti, R., Bradbury, T., & Ochs, E. (2009). Opportunity for interaction? A naturalistic observation study of dual-earner families after work and school. Journal of Family Psychology, 23(6), 798-807. https://doi.org/10.1037/a0015824 

  2. Larson, J.H., Crane, D. R., & Smith, C. W. (1991) Morning and night couples: The effect of wake and sleep patterns on marital adjustment. Journal of Marital and Family Therapy, 17(1), 53-65. https://doi.org/10.1111/j.1752-0606.1991.tb00864.x 

What is NVC Compassionate Communication? How can it help me?

KeyFactsAbout NonviolentCommunication(NVC)

ProducedbyPuddleDancerPressandtheCenterforNonviolentCommunication Updated


1 Why do people find value in learning NVC?..............................................................

2 The Life-Changing Benefits of NVC ............................................................................

3 What makes NVC unique? ..........................................................................................

4 Transforming conflict with NVC..................................................................................

5 Improving relationships with NVC..............................................................................

6 Social change with NVC ..............................................................................................

7 The role of the Center for Nonviolent Communication............................................

8 About Marshall Rosenberg ........................................................................................

9 AboutPuddleDancerPress..........................................................................................


Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org


Most of us are hungry for skills that can improve the quality of our relationships, to deepen our sense of personal empowerment or simply help us communicate more effectively. Unfortunately, most of us have been educated from birth to compete, judge, demand and diagnose; to think and communicate in terms of what is “right“ and “wrong“ with people. At best, the habitual ways we think and speak hinder communication and create misunderstanding and frustration. And still worse, they can cause anger and pain, and may lead to violence. Without wanting to, even people with the best of intentions generate needless conflict.

NVC helps us reach beneath the surface and discover what is alive and vital within us, and how all of our actions are based on human needs that we are seeking to meet. We learn to develop a vocabulary of feelings and needs that helps us more clearly express what is going on in us, and understand what is going on it others, at any given moment. When we understand and acknowledge our needs, we develop a shared foundation for much more satisfying relationships. Join the thousands of people worldwide who have improved their relationships and their lives with this simple yet revolutionary process.

Marshall Rosenberg provides us with the most effective tools to foster health and relationships. Nonviolent Communication connects soul to soul . . . It is the missing element in what we do.”
- Deepak Chopra, author,

How to Know God and Ageless Body, Timeless Mind

The Life-Changing Benefits of NVC

Conflict Resolution

  • Resolve conflicts peacefully—personal or public, domestic or international

  • Get to the heart of conflict and disputes quickly

  • Improve cooperation––listen so others are really heard

  • Transform criticism and blame into compassionate connection

• Prevent future pain and misunderstanding

Personal Relationships

  • Deepen your emotional connections

  • Transform judgment and criticism into understanding and connection

  • Listen so others are really heard

  • Get what you want more often without using demands, guilt or shame

  • Hear the needs behind whatever anyone does or says

    Parenting and Families

  • Reduce family conflicts and sibling rivalry

  • Move beyond power struggles to cooperation and trust

  • Create a quality of connection that embodies unconditional love

  • Protect and nurture the autonomy of children

  • Motivate using “power-with” rather than “power-over” strategies

    Education and Schools

  • Maximize the individual potential of all students

  • Strengthen students’ interest, retention and connection to their work

  • Improve safety, trust and connection in your classroom

  • Improve classroom teamwork, efficiency and cooperation

  • Strengthen classroom and teacher-parent relationships


“Schools in which parents and teachers relate as partners — where Nonviolent Communication is part of every interaction — are communities of learning, rather than top-down, impersonal factories.”

- Riane Eisler, author, The Chalice and the Blade, Tomorrow’s Children and The Power of Partnership

Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

The Life-Changing Benefits of NVC, continued

Personal Growth and Healing

  • Transform shame and depression into personal empowerment

  • Heal old pain

  • Transform unhealthy habits

  • Stay connected to your own needs and preferences

  • Eat by choice, not by habit

    Organizational Effectiveness

  • Improve teamwork, efficiency and morale

  • Increase meeting productivity

  • Maximize the quality of your services or products

  • Maximize your organization’s benefit to the community

    Anger Management

  • Transform anger before it leads to behavior you’ll regret

  • Discover the needs behind your anger

  • Learn to appreciate what triggers you and others

  • Identify solutions that are satisfying to everyone

  • Express anger in ways that connect us to others

    Business Relationships

  • Strengthen employee morale and loyalty

  • Resolve workplace conflicts quickly and effectively

  • Reduce office stress and absenteeism

  • Maximize the potential of all employees

  • Hear and address customer needs more effectively

  • Offer employee evaluations that promote personal growth

  • Improve the effectiveness of job and college interviews

    Conflict Resolution

“Nonviolent Communication is one of the most useful processes you’ll ever learn.”

- William Ury, author, Getting to Yes

  • Transformcriticismandblameintocompassionateconnection

  • Preventfuturepainandmisunderstanding


  • Connect your actions to your spiritual values

  • Transform enemy images and moralistic judgments

  • Connect to our common humanity

  • Overcome cultural conditioning that promotes violence

  • Care for your own needs first to fuel compassion for others

    What Makes NVC Unique?

    How is NVC different from other self-help, communication or conflict resolution tools?

  • Unique Assumptions—NVC begins by assuming that we are all compassionate by nature and that violent strate-

    gies—whether verbal or physical—are learned behaviors taught and supported by the prevailing culture. It also as- sumes that we all share the same, basic human needs, and that all actions are a strategy to meet one or more of these needs.

  • It’s Simple—NVC offers an effective four-step communication process that’s easy to grasp.

  • More Than a Communication Model—NVC goes beyond communication techniques by showing us how to stay con- nected to the life energy in ourselves and others. It also helps us to be conscious about the impact of how we think

    and how we use language in everyday conversation.


• Resolveconflictspeacefully—personalorpublic,domesticor international

  • Gettotheheartofconflictanddisputesquickly

  • Improvecooperation––listensoothersarereallyheard

Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

What Makes NVC Unique, continued

  • Broad Application—NVC is a powerful tool with a variety of applications, from interpersonal relationships to international negotiation; personal healing to conflict resolution; social change to drug/alcohol treatment; trauma recovery to prison inmate rehabilitation.

  • Results Are Substantial—NVC helps transform anger, destructive attitudes and habitual behaviors into more peaceful, life-serving actions. Around the globe, NVC has contributed to a significant reduction in violence in some of the most war-torn regions. NVC helps individuals, families and organizations reduce conflict, foster trust, deepen emotional connections, heal pain and strengthen personal empowerment.

    Transforming Conflict with NVC

How can NVC help me reduce conflict in my life?

  • Develop Your Emotional Vocabulary—Improve your ability

    to clearly express your feelings and needs. Your expanded emotional vocabulary will help you avoid making moralistic judgments, blaming others for your feelings, and using other strategies that often contribute to conflicts. Teach your children these skills to empower them to resolve their conflicts peacefully.

  • Stay Connected to Your Feelings and Needs—Prevent and reduce conflicts by learning to stay connected to your feelings and needs through self-empathy. Increase satisfying
    outcomes from emotionally charged situations by entering them from a place of calm and compassion, rather than defensiveness or anger.

  • Break Negative, Habitual Patterns—Overcome habitual patterns that often lead to conflict. Transform thinking patterns like moralistic judgments, blame, criticism, shoulds and “have-tos” that can lead to anger, depression, guilt or shame.

  • Hear the Needs Behind All Behavior—NVC teaches us that all behavior—even behavior we dislike—is a strategy to meet one of the many needs we all have in common. Diminish anger, violence and conflict by connecting to the needs behind whatever anyone does or says.

  • Get to the Heart of Conflict Quickly—Defuse heated situa- tions before they lead to behavior you’ll regret. Use empathy to let others know they are really heard—which is often all that is needed to transform conflict into powerful connection.

    Improving Relationships with NVC

    How can NVC improve the quality of my personal and professional relationships?

“Nonviolent Communication is instrumental in creating an extraordinary quality of life. This compassionate and inspiring message cuts right to the heart of successful communication.”

- Anthony Robbins, author, Awaken the Giant Within and Unlimited Power

Personal and Family Relationships

  • Make Clear, “Doable” Requests—Get what you want more often by learning how to make requests that are

    actually “doable”, easy to understand and can be done willingly.
    Learn alternatives to coercive behaviors like demands, threats of punishment or promises of reward that often motivate people to fulfill our requests from a sense of fear, guilt or shame.

  • Find Greater Intimacy—Strengthen your connection to your partner, siblings, family and friends by more clearly understanding their values, hopes and needs.


Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

Improving Relationships with NVC, continued

  • Listen More Effectively—Learn how to listen so your part- ner, colleague or family member is confident he/she has been heard. Learn how to translate another’s negative language into feelings and needs in order to transform emotionally charged situations into powerful connections.

  • Stay Connected to Your Values—Deepen your personal connections by entering all interactions from a place of compassion.

    Professional and Business Relationships

  • Lead More Effectively—NVC helps leaders let go of

    “power-over” leadership styles, such as the coercive use of threats of punishment or promises of reward, which can lead to resistance and often stifle individual creativity and potential. Leaders learn a “power-with” approach that re- spects and values everyone’s needs. The NVC approach to leadership enhances personal power, strengthens teamwork and maximizes individual potential.

  • Provide More Meaningful Employee Evaluations
    Provide staff with more empowering, meaningful evaluations
    that move beyond moralistic judgments of good/bad or
    right/wrong. Instead, identify specific behaviors that are or are not meeting needs, that present clear requests and create specific agreements for future actions.

  • Get to the Heart of Workplace Conflict Quickly—Mediate conflict more quickly by
    ensuring each person or party is really heard. Facilitate the communication of specific observations, the expression of feelings and the unmet needs that have triggered the conflict. Then create specific remedies that satisfy everyone’s needs, without compromise.

  • Improve Employee Morale—Improve employee morale by learning how to effectively acknowledge and value the needs of the entire workforce. Help ensure staff or colleagues are heard––often for the first time.

    Social Change with NVC

    What positive cultural shifts is NVC creating in the world?

  • An Internal Culture of Peace—Peace in the world begins with creating an internal culture of peace. NVC helps us

    live peacefully in deed and word by entering any interaction from a compassionate consciousness. It also provides

    us effective tools to heal pain, find mutually satisfying resolution to conflict and to get our needs met peacefully.

  • A New Generation of Corporate and Community Leaders—NVC is creating a new generation of leaders

    who know how to empower individuals, groups and communities without using coercion, fear of punishment or demands. Employers and communities are already witnessing substantial benefits in the effectiveness of their workforce and the rate at which we progress professionally and technologically.

  • A New Generation of Communicators—NVC is helping establish a new generation who have better skills to express their feelings and needs, to act from a place of compassion and to establish emotional connections that put meeting needs first.

  • Schools That Support Students’ Emotional Safety—NVC is helping create a new movement in education rooted in the importance of teaching emotional intelligence and establishing emotional safety in the classroom. Schools and classrooms that integrate NVC are already noticing improvements in test scores, a reduction in conflicts and violence, improved workforce preparedness and an increase in civic engagement.

  • An Empowered Peace Activism—Marshall Rosenberg’s message helps us work for social transformation from a place of understanding and compassion, rather than a place of fear, anger or moralistic judgment. We learn to hear the needs behind all behaviors, to ground our responses in compassion and act from a desire to meet our commo needs.

  • A Reduction in Violence by Addressing its Cause: Unmet Needs—NVC helps us move beyond the symptoms of violence to address its root cause—unmet needs. From substance abuse to domestic violence; from emotional abuse to anger management programs; and from social work to international peacekeeping efforts—NVC gives us the tools for more powerful, effective and substantive change.


“Marshall Rosenberg’s dynamic communication techniques transform potential conflicts into peaceful dialogues. You’ll learn simple tools to defuse arguments and create compassionate connections with your family, friends and others.”

- John Gray, Ph.D., author, Men Are From Mars, Women Are From Venus

Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

The Role of the Center for Nonviolent Communication

What role does the Center for Nonviolent Communication (CNVC) play in spreading
peace on our planet?
The Center for Nonviolent Communication (CNVC) is an international nonprofit peacemaking organization devoted to supporting the spread of Nonviolent Communication around the world. Find local, national and international training opportunities, trainer certification info, and a variety of other NVC educational materials at www.cnvc.org

Resources the Center provides:

  • CoordinationofMarshallRosenberg’sglobaltrainingactivities

  • Developmentofregionalandtheme-basedNVCprojects

  • NVC-relatedresearchinitiatives

  • NVCtrainercertificationprocesscomparabletoanindependentstudymaster’sdegreeprogram

  • Morethancertifiedtrainerswhoprovideworkshopsandseminarsincountrieson


  • Enewsletter,website,andtopic-basedemaillistservsthatconnectthemovement,celebrateprogressandcontinue


    What major steps is CNVC taking to decrease violence worldwide?

  • Training—MarshallRosenbergteachthroughouttheyear,withfocuson10nine-dayInternationalIntensive Trainings(IITs).TherigorousNVCcertificationprocesshelpsprotecttheintegrityofNVCteaching.Morethan CNVCcertifiedtrainersandhundredsmoreteachNVCincountriestopeopleeachyear.

  • EducationalMaterials—TheonlineNVCbookstoreatwww.nonviolentcommunication.comandCNVCbookstoreat www.cnvc.orgsellbooks,videos,audiotapesandotherlearningmaterials.

  • NVCProjects—Sevenregionalandtheme-basedprojectshavebeendevelopedtoprovidefocusandleadershipfor teachingNVCinaparticularapplication(suchassocialchangeandparenting)andinhigh-needgeographicloca tions.

  • ResearchInitiatives—CNVChasdevelopedanNVCresearchcommitteetodevelopscientificallybased,peer-reviewed researchstudiestoidentifythemeasurableimpactofNVCtraining.


“Changing the way the world works sounds daunting, but Nonviolent Communication helps liberate us from ancient patterns of violence.”

- Francis Lefkowitz, Body and Soul

Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

About Marshall Rosenberg


Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

PuddleDancerPress(PDP)isthepremierpublisherofNonviolentCommunication–relatedworks.Itsmissionistoprovide high-qualitymaterialsthathelppeoplecreateaworldinwhichallneedsaremetcompassionately.PDPistheunofficial marketingarmoftheinternationalCenterforNonviolentCommunication.Publishingrevenuesareusedtodevelop andimplementNVCpromotion,educationalmaterials,andmediacampaigns.ByworkinginpartnershipwithCNVC andNVCtrainers,teams,andlocalsupporters,PDPhascreatedacomprehensive,cost-effectivepromotioneffortthat hashelpedbringNVCtothousandsmorepeopleeachyear.


  • Shop NVC—Continue your learning. Purchase our NVC titles online safely and conveniently. Find multiple-copy and package discounts, learn more about our authors, and read dozens of book endorsements from renowned leaders, educators, relationship experts, and more.

  • NVC Quick Connect e-Newsletter—Sign up today to receive our monthly e-Newsletter, filled with expert articles, resources, related news, and exclusive specials on NVC learning materials. Archived e-Newsletters are also available.

  • Help Share NVC—Access hundreds of valuable tools, resources, and adaptable documents to help you share NVC, form a local NVC community, coordinate NVC workshops and trainings, and promote the life-enriching benefits of NVC training to organizations and communities in your area. Visit www.helpsharenvc.com

  • Pressroom—Journalists and producers can access author bios and photos, press kits, and other valuable information.

  • About NVC—Learn more about these life-changing communication skills including an overview of the four-part process, Key Facts about NVC, and access to NVC articles.


Find press kits, purchase NVC books/booklets, register for our e-newsletter, and more at: www.NonviolentCommunication.com Find trainer certification information, training, conferences, register for our newsletter and more at: www.CNVC.org

What Is a MTHFR Mutation?

What Is MTHFR?

MTHFR is an enzyme that adds a methyl group to folic acid to make it usable by the body. The MTHFR gene produces this enzyme that is necessary for properly using vitamin B9. This enzyme is also important for converting homocysteine into methionine, which the body needs for proper metabolism and muscle growth and which is needed for glutathione creation . The process of methylation also involves the enzyme from the MTHFR gene, so those with a mutation may have trouble effectively eliminating toxins from the body.

The genetics home reference offers more detail: The MTHFR gene provides instructions for making an enzyme called methylenetetrahydrofolate reductase. This enzyme plays a role in processing amino acids, the building blocks of proteins. Methylenetetrahydrofolate reductase is important for a chemical reaction involving forms of the vitamin folate (also called vitamin B9). Specifically, this enzyme converts a molecule called 5,10-methylenetetrahydrofolate to a molecule called 5-methyltetrahydrofolate. This reaction is required for the multistep process that converts the amino acid homocysteine to another amino acid, methionine. The body uses methionine to make proteins and other important compounds.

Contrary to how it looks, “MTHFR” is not an abbreviation for a curse word, but a shortened form of methylenetetrahydrofolate reductase… Aren’t you glad it is abbreviated?

I touched on the importance of the MTHFR enzyme briefly in my post about folic acid vs. folate and why I am careful to avoid synthetic folic acid in supplements and foods.

Those of us with a MTHFR gene mutation have a highly reduced ability to convert folic acid or even folate into a usable form. Research estimates that as much as half of the population may have an MTHFR gene mutation, though there are many variations of the mutation, depending on how the gene was passed down from the parents. More on that below.

Problems From an MTHFR Gene Mutation

Dr. Izabella Wentz explains how the MTHFR mutation can affect those who have it: Individuals with low activity of the MTHFR enzyme may present with elevated homocysteine levels, which have been associated with inflammation and heart disease, birth defects, difficult pregnancies, and potentially an impaired ability to detoxify.

Nutrient deficiencies in Folate, B6 and B12 have been associated with elevated homocysteine.

Individuals with the MTHFR gene actually have a difficult time processing folic acid that is present in most cheap supplements and added to processed foods. Some professionals claim that this type of folic acid may even cause a build-up in the body leading to toxicity. Studies have been done that showed folic acid supplements increased cancer risk… one more reason to ditch processed foods and your multivitamin!

Some naturopathic doctors like Dr. Doni Wilson suspect that lingering fatigue, fogginess, anxiety, sleep issues and inability to deal with alcohol and other toxins effectively can be a result of an underlying gene mutation like the MTHFR mutation. She explains how this affects many aspects of health and how stress is a compounding factor: Activated folate (named 5MTHF) goes on to give its methyl group to other nutrients and substances – a process called “methylation.” It is required for the creation of every cell in your body, so if it is not activated properly, you can imagine what a significant issue it would be. 5MTHF, along with several other nutrients, is also used to create and process neurotransmitters (messengers in the nervous system like serotonin, epinephrine, norepinephrine, and dopamine); create immune cells and process hormones (such as estrogen); as well as to produce energy and detoxify chemicals.

Stress, in all its forms, inhibits this “methylation” – the transfer of methyl from 5MTHF to other substances. So when you are under stress, it is especially important to provide the nutrients necessary for these processes.

To clarify in more detail, the liver is a major processing system, involving countless enzyme pathways, including methylation, which turn one nutrient into another and toxins into non-toxins, preparing them all to be used and/or expelled by the body. When you drink alcohol, it is your livers job to process it using methylation, but if your nutrients are depleted or you are stressed, your liver will not be able to complete the process effectively, leading to symptoms associated with a hangover.

Identifying a potential MTHFR defect is especially important for women of childbearing age, as this defect can increase the risk of many problems in an unborn child, including folate related disorders like Spina Bifida.

Types of MTHFR Mutation

There are many different possibilities when it comes to MTHFR gene mutations and science is still working to understand them all. I’ve included links to more in-depth resources below, but there are several common mutations that can occur.

The reason for all the types of mutations is variations in the specific genes passed on from each parent. In other words, if both parents pass on a healthy gene, a person won’t have a mutation at all. If one parent passes on a healthy gene but the other passes on a mutated gene, several variations can occur. If both parents pass on a mutated form, there are many more scenarios that can occur.

The two most problematic mutations that can occur are  C677T and A1298C, which denote the placement of the mutation on the gene. The most common forms of MTHFR mutation involve various combinations of these genes being passed on from each parent:

  • Homozygous: the same gene passed on from both parents-  can occur if both pass on the 677 mutation, or the 1298 mutation.

  • Heterozygous: one parent passed on the 677 mutation or the 1298 mutation but the other parent passed on a normal gene.

  • Compound Heterozygous: one parent passed on the 677 mutation and the other passed on the 1298 mutation.

  • Other more advanced and rare mutations.

What Happens When the MTHFR Gene Is Defective?

Those with a defective MTHFR gene have an impaired ability to produce the MTHFR enzyme (estimates range from 20%-70% or more). This can make it more difficult to break down and eliminate not only synthetic folic acid but other substances like heavy metals.

Since folic acid can’t be converted into the usable form, it can build up in the body, which can raise levels of homocysteine. High homocysteine levels are associated with a higher risk in cardiovascular disease. This also affects the conversion to glutathione, which the body needs to remove waste and which is a potent antioxidant.

In short, we are just learning the extent to which this can affect health, but there is strong evidence that because of the affect on methylation, it can increase cancer risk, cardiovascular disease risk, risk of fetal development problems and more. It can also possibly contribute to or exacerbate other problems like autoimmune disease, mental issues and more.

Dr. Ben Lynch of MTHFR.net has a comprehensive list of conditions he has been able to link to a MTHFR gene defect.

How to Get Tested for MTHFR Gene Defects

Though there are many symptoms that can be associated with an MTHFR defect, the symptoms can vary widely from person to person and only a test (blood or saliva) can verify a gene defect and the type.

Janie at Stop the Thyroid Madness compiled a great list of ways to get tested. Local doctors are able to run these tests as well, but not all doctors are well-versed in handing MTHFR issues…

Dr. Amy Yasko will test about 30 methylation SNP’s (single nucleotide polymorphisms)here. You may need a doctor’s prescription. It is considered to be a highly accurate test.

A similar one you can do on your own with saliva…and is highly recommended and popular…is from 23andme. It is stated to miss 5 SNP’s that Yasko’s will not miss, but is cheaper and still an excellent test. NOTE: 23andme states the following:

23andmeprovides ancestry-related genetic reports and uninterpreted raw genetic data. We no longer offer our health-related genetic reports. That does NOT mean you won’t get what you need. After the 23andme results come back, you’ll get “raw data”. You will upload that data to any of the following, which in turn will give you what you need:

  • Genetic Genie, which will look at your methylation genetics just by reading your 23andMe raw data.

  • Live Wello, which gives a great deal of information to you based on 23and me, plus links to learn more about each gene’s potential problem.

  • Nutrahacker will tell you what supplements you need to take, and which ones plus more you need to avoid, due to your mutations. It’s very interesting!

  • Sterling Hill’s app mthfrsupport.com/sterlings-app or you can contact her and pay for a call to help with interpretation of your genetics.

A VAST amount of genetic information can be obtained from Promethease.com

Here’s a good string about testing methyl pathways vs genome testing.


Though it isn’t possible to change a gene, there are things that can be done to minimize the potential for problems or to help avoid problems in children (before and during the mother’s pregnancy). As I said, the research is still developing on this, but some things that I find personally helpful are:

  • Focusing on gut health: Especially when the body has impaired ability to use certain nutrients, it is important to focus on gut health so that the body can absorb the nutrients from food as effectively as possible. I personally avoid antibacterial soapsvegetable oilsprocessed grains and refined sugars and support my gut with fermented foods and homemade broth. This also helps avoid candida, which can make MTHFR related problems worse.

  • Avoiding environmental toxins as much as possible: Those with an MTHFR gene defect have an impaired ability to eliminate toxins. I avoid plastics, chemicals in beauty supplies and cleaning products, and scented candles, which can all release harmful chemicals. We use houseplants and other methods of cleaning our indoor air, and filter our drinking and shower water.

  • Not taking anything with Folic Acid: As I explained in this post, folic acid is the synthetic form of folate that cannot be used by those with a MTHFR defect and which can be very toxic. I avoid any supplements with folic acid and only take L-MTHF forms, which are the methylated forms that my body can use. I also take a methyl-B12 which is supposed to help the body use L-MTHF.

  • Lots of Leafy Greens: According to Dr. Ben Lynch, dark leafy greens contain the methylated forms of folate that those with a gene defect need. As if we needed more reasons that it is important to consume green veggies… I try to work in green veggies at every meal.

  • Avoid Processed Foods: Again, as if anyone needed another reason to avoid processed foods… Many processed foods have synthetic folic acid added.

  • Avoiding things that can block or deplete folate levels: Certain medications, including hormonal contraceptives can interfere with folate levels, and medicines like antacids can interfere with B-12 absorption.

  • Avoiding Heavy Metals: Heavy metals in diet or environment are harder to remove from the body for those with a gene defect, so I’m careful to avoid these.

  • Help a Body Out: Since those with a MTHFR defect have an impaired ability to eliminate toxins, I do things to help support my body in this process, such as: detox bathssauna usedrinking enough waterdry brushing my skin and exercise (sweating). I also do strange things like using detox mud shampoodetoxing my pits, and foot soaks.


This video with Dr. Alan Christianson and Dr. Ben Lynch provides lot of detail about MTHFR and how it affects health. https://youtu.be/NulhJMN4wks

Additional Reading

If you are new to MTHFR and feel overwhelmed like I did, here are some great resources for more reading:

DECIDING Instead of SLIDING…Handling Major Relationship Transitions

Deciding Instead of Sliding…Handling Major Relationship Transitions

Handling Relationship Transitions

How good are the two of you at handling relationship transitions?  Are you deciding or sliding into essential relationship decisions?

Sooner or later, there comes a time in every intimate relationship when you both face the task of making a significant decision together.

These could be decisions about the degree of relationship commitment, or perhaps a decision together which requires a substantial financial, lifestyle, or emotional investment.

The degree of skill you have in handling major relationship transitions will not only impact the outcome of those decisions, but it will also either enhance or degrade your capacity for a deep and lasting intimate connection.

Here are a few examples of the kinds of decisions where deciding is better than sliding:

  • Choosing to live together

  • Deciding to commit to each other exclusively

  • Deciding to support your partner as they finish a higher degree, or make a career change

  • Deciding to marry

  • Choosing to have children

  • Deciding to make a significant financial investment, such as a business, home, or investment property.

  • Deciding to pick up and move somewhere new

  • Deciding to allow someone to live with you, such as an aging parent

  • Deciding to adopt, or become foster parents

  • Deciding on making a will, or other important legal decisions

The Downside of Sliding

There are several reasons why spouses might individually slide instead of collaboratively decide into relationship transitions.

Some sliding spouses are conflict-avoidant. They just want their partners to be happy.

They will “go along to get along.” Sometimes, passive-aggressive tendencies result in a spouse seeming to comply, but then bitterly complaining after the fact. “You always get what you want anyway…what good would it do for me to resist you? I never have any say in this marriage!

The problem in sliding is that you are not fully showing up.

The Upside of Deciding

Most relationship transitions which impact a committed couple require both of you to express your feelings, discuss your values, and share your concerns and aspirations. This is intimacy 101.

Conflict is baked in the cake. You are two distinct individuals with your own thoughts and feelings. For a relationship transition to be successful, mutual respect, safety, and collaboration are required.

If your relationship is new, decision-making is the process by which emotional muscle is built.

Don’t collapse into compliance if it doesn’t feel right for you.

Your gut feelings are a valuable sign that a deeper, more generative conversation may be needed so that both of your complex, perhaps contradictory feelings, can be safely explored.

Don’t push your agenda, force an agreement, or dismiss any of your partner’s ideas out of hand either.

Deciding instead of sliding on essential relationship transitions is the bedrock of relational health.

Relationships are easy when you readily agree. It’s at times when you both want different things that your intimate bond is stress-tested, and intimacy will deepen.

Sliding or Deciding…Common Obstacles to Intimacy

Here are some indications that your relationship transition decision-making skills may need an upgrade:

  • You feel that your partner is pressuring you to go along with them before you feel comfortable

  • your partner is dismissing your concerns or is attacking you for “dragging your feet.”

  • you and your partner are in emotional gridlock over the decision, continually arguing or bickering about the decision. You’re getting nowhere fast.

  • You’ve slid. You’ve given your reluctant consent. But you’re feeling worried, stressed, highly anxious about the consequences of your compliance.

  • You’re not feeling heard. Your partner is not interested in exploring any ideas which contradict their point of view. They refuse to let you respectfully raise concerns.

If any of these issues describe how you slide or decide, your decision-making skills as a couple may require an upgrade.

Tips for Deciding Instead of Sliding into Major Relationship Decisions

1. Have a Generative Conversation and Take Notes

Generative Conversations are a powerful tool to help you both build intimacy and collaborate successfully on significant relationship transitions. One of you is the speaker, and the other asks good questions, listens, takes notes, and summarizes to the satisfaction of the speaking partner.

Once the speaker feels understood you reverse roles. Allow each other to explore the decision safely. Don’t interrupt or editorialize. Listen for understanding. You might learn something powerful and meaningful.

2. Explore All Options…Then Reflect…and Explore Some More

While it’s obvious that you bost must evaluate all the pros and cons of any significant relationship decision, it’s also helpful to reflect on what you’ve learned and plan follow-up conversations. In other words, don’t rush this process.

Take time to have an honest discussion about all the possible complications and implications of this relationship transition. Respect your partner’s anxiety and concerns. Let them play the “Devil’s Advocate.” Discussing potential difficulties is not necessarily the ‘doom and gloom’ stance of a naysayer.

It might be wise to curb your enthusiasm and acknowledge that problems and issues may arise with this relationship transition. When you both anticipate possible problems in advance, you’re more likely to be able to deal with them if they come up effectively.

3. Be Patient… Take Time to Listen and Reflect

Sometimes the best thing to do is nothing. Keep workshopping the decision in follow up conversations. Be respectful and courteous to one another. Some couples have fun reversing their stances, arguing for or against the decision from their partner’s point of view.

If doubts persist, take time to sit with the decision and continue to explore and discuss the critical issues surrounding the potential relationship transition with your partner.

It’s hard to do this in our instant gratification culture, but a lot of good things can come by being patient and biding your time. Situations can change, new ideas might emerge, and sometimes, through the process of having a series of generative conversations, your thoughts feelings may shift over time.

Ultimately, as a committed couple, when it comes to making major relationship transitions, you both have to feel that the decision is in your mutual best interest.

If you’re always the one who makes unilateral decisions in your relationship, you may ultimately lose in the end.