RSS Feed

Category Archives: Guest Bloggers

Tell Me Again What You Think of Me: Depression and Reassurance-Seeking in Couples

Man comforting his sad mourning friendApproximately 18.1 million Americans adults suffer from depression each year.[1] They experience symptoms such as irritability, fatigue, persistent feelings of sadness, disinterest in once-pleasurable activities, difficulty concentrating, sleep disturbances, and even thoughts of death.  In addition to these symptoms, depression also negatively affects communication in close interpersonal relationships, such as with friends, partners, and family members.

For example, depressed individuals are more likely to engage in reassurance-seeking behavior: asking for affirmation that he or she is lovable, worthy, and valued.[2]  Although most people ask for reassurance occasionally, individuals with depression tend to seek reassurance persistently and repeatedly, even after their partners have already offered it.[3] Some experts even suggest that excessive requests for interpersonal approval may be both a cause and a consequence of depression,[4] due in part to depressed individuals’ tendency to doubt or dismiss positive feedback from others.

A group of researchers at The Family Institute at Northwestern University, led by Dr. Lynne Knobloch-Fedders, studied the links between reassuring-seeking behavior and depression among couples.  In collaboration with colleagues at the University of Illinois and Michigan State University, the researchers investigated the communication behavior of 69 couples seeking treatment for relationship problems and depression.  Results of the study, which was funded by the Randy Gerson Memorial Research Award from the American Psychological Foundation, indicated that depressive symptoms were a primary predictor of reassurance-seeking behavior in couples.[5]  The researchers’ next step is to begin testing interventions designed to help reduce excessive reassurance-seeking, and increase positive communication and validation, among couples seeking treatment for depression.

Lynne Knobloch-Fedders, PhD,  is a licensed clinical psychologist at The Family Institute at Northwestern University, with expertise in couples therapy, premarital counseling, depression and anxiety disorders, infertility and adoption. Additionally, she maintains a clinical research program, with a primary focus on the associations between couples’ interpersonal behavior, relationship distress, and individual psychopathology. 

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester.  The Institute also conducts research which is incorporated into both our Clinical Service and Education Programs. Learn more about our Depression Treatment Program. Visit our website to learn more about our services.


[1] Kessler, R. C., Chiu, W. T., Demler, O., Merikangas, K. R., & Walters E. E. (2005). Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617-627.

[2] Joiner, T. E., Jr., Metalsky, G. I., Katz, J., & Beach, S. R. H. (1999). Depression and excessive reassurance-seeking. Psychological Inquiry, 10, 269-278.

[3] Pettit, J. W., & Joiner, T. E., Jr. (2006). Chronic depression. Washington, D.C.: American Psychological Association.

[4] Haeffel, G. J., Voelz, Z. R., & Joiner, T. E., Jr. (2007). Vulnerability to depressive symptoms: Clarifying the role of excessive reassurance seeking and perceived social support in an interpersonal model of depression. Cognition and Emotion, 21, 681-688.

[5] Knobloch, L.K., Knobloch-Fedders, L.M., & Durbin, C.E. (2011).  Depressive symptoms and relational uncertainty as predictors of reassurance-seeking and negative feedback-seeking in conversation.  Communication Monographs, 78, 437-462.

Thankfully Mindful

thanksgiving blog photo 1.jpg

Today’s blog comes from Ellen Bee, MA, LPC, to remind us how to be mindful during Thanksgiving.

You look different, have you gained weight? Did you brother’s friend ever throw that birthday party for his cat? What are your views on foreign policy? These are the kinds of questions I hear around the Thanksgiving table. Normal, right? To be fair, I look forward to a day that is reserved for gluttony, gratitude, family and friends. Yet I cannot help but also feel a sense of overwhelming anxiety in having to answer said queries that sometimes border interrogation. Is it possible to navigate these two conflicting feelings of excitement and worry?

Practicing mindfulness can help to alleviate some stressors associated with Thanksgiving, whether you are fielding Aunt Kathy’s questions or simply choosing between dessert options. Acknowledge your feelings and take notice of what is happening around you. What do you see? Can you smell the turkey baking in the oven? Is there music playing ever so softly in the background? Focus on the present and try to work towards accepting those feelings.

It is easy to lose sight of yourself in all of the chaos of not only Thanksgiving, but everyday life. What are you grateful for today? For me, I am thankful for the sense of belonging and for the supportive community that surrounds me. Too easily I forget to check in with myself. Take some time to reflect and listen to your body and mind this holiday season.

Take a deep breath in. Loosen a belt notch. Breathe out.

Ellen Bee, MA, LPC, is a Staff Therapist at The Family Institute at Northwestern University in Child, Adolescent & Family Services. She specializes in the treatment of mood disorders, trauma, anxiety, depression, behavioral issues, and school refusal.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Learn more about our services.

Putting Gratitude into Practice

gratitude blog post 11.22.16.jpgThanksgiving – whatever its historic origin, the last Thursday in November has evolved to be a time of year where people pause and ask themselves what they are grateful for. It is a time where gratitude is felt and expressed. In honor of this day of giving and receiving thanks, Amy Drucker, LMFT, highlights the importance and benefits of the practice of gratitude – today and every day of the year.

Research over the last decade has shown the positive psychological, social and physical benefits of practicing gratitude. One such notable study, conducted by Robert Emmons at UC Davis, highlights that grateful people have a higher sense of self-worth, are more resilient, are more able to be present in their lives, and are able to actually minimize toxic and negative emotions by more deeply defining the neural pathways of positive thought.

So the question is: how does one practice gratitude?

Some simple, helpful suggestions are to do one or both of the following:

  • Create a daily gratitude list in a journal or notebook. When waking in the morning or before retiring at night, write down in list form what you are grateful for. It is encouraged that one be specific in this endeavor. Instead of “I am grateful for sunsets,” maybe consider “I am grateful for the way the sky turns pastel and the clouds seem to glow when then sun is setting.” Instead of “I am grateful for my dog,” consider “I am grateful that I have a furry companion that I can come home to and who always greets me with a wagging tail.” Write as many or a few as you like, but if you are on a roll, keep writing!
  • During or in the wake of a challenging day, play The Gratitude Game. Say you missed your train by 10 seconds; your lunch order was wrong; and you got locked out of your apartment. The aim of the game is to find the silver lining. For every “complaint,” find the inverse. The Gratitude Game, using the above example might go like this: I live in a city where public transportation exists and I am able to save money by taking it. I have the ability to pay for meals and nourish myself with food. I live in an apartment building and have a roof over my head every night. Even if you have only one frustrating event take place in your day, The Gratitude Game can still be played!

Both of the above may feel goofy or contrived, even entirely pointless at first, but give yourself a chance to reap the benefits of sowing gratitude in your life.

It goes without saying that things can certainly be challenging at holiday time, too. Holidays have a way of being an organic, annual mile marker that can create a constellation of less pleasant emotions. People may feel sadness, nostalgia or isolation during the holiday season; thus, the benefits of practicing gratitude could be exceptionally helpful in insulating against some of these more painful emotions that spike during this time of year.

The goal of practicing gratitude is not to facilitate Pollyannaism, nor is it to negate the spectrum of emotions that human beings experience on a given day, or at a given time of year. The goal of practicing gratitude might instead be thought of as a way to create (and add to) a constantly simmering stew of appreciation for one’s life and how one views that life — when times are tough, one can siphon from that bubbling stew and find strength and hope; when times are good, one can share that hearty stew and help nourish those around them.

Happy Thanksgiving! Cheers to a grateful Holiday Season and year!

Amy Drucker, LMFT, is a clinical staff therapist at The Family Institute. Her approach is solution-focused, strength-based, mindful, and collaborative. She sees clients predominantly out of The Family Institute’s downtown location and enjoys working with individuals and couples seeking support around communication, raising self-awareness, addiction and recovery, and life transitions.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Learn more about our services

Lending Support to the Caregiver

caregiver blog photo.jpgChronic health conditions affect Americans in virtually all facets of society, causing many to experience physical or mental difficulties, and sometimes both. People with such difficulties often require a caregiver to assist with their daily functioning. These caregivers, often family members to the patient, take on not only their own responsibilities, but those of the lives of another, making way for a unique set of challenges for them to adapt to. With these excess stressors, peer support and understanding is paramount to the well-being of the caregiver.

This month we commemorate National Caregiver Month in recognition and support of all those who dedicate their time to ensure the well-being of another.

When an individual takes on the role of a caregiver, they often experience significant life changes – some leave their jobs, relinquish a personal hobby, or have less time to socially engage with others.   Life shifts such as these lead many caregivers to feel isolated or withdrawn, with some studies reporting that up to 50% of caregivers meet criteria for clinical depression (Medrano, 2015).  However, the role of a caregiver can be one of great personal fulfillment and importance, and while the majority of their time may be spent helping another, it is essential they take the time to tend to their own health and well-being.

If you are a caregiver for another, here are some tips to keep in mind to stay on top of your own personal needs:

  • Maintain a healthy diet and exercise regularly. Be sure to make time for your individual health needs and address them.
  • Ensure you have social support. Having close friends and family to share one’s concerns is crucial to maintaining a positive mentality.
  • Don’t be afraid to seek help. A variety of programs and interventions exist specifically geared toward caregivers and their needs.

Gustavo Medrano, PhD, is a licensed clinical psychologist at The Family Institute. He specializes in working with individuals with depression/mood disorders, stress management and chronic illness and disabilities.

If you or someone you know is a caregiver in need of professional mental health support, or for additional information, please call The Family Institute at 847-733-4300.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Visit our website to learn more about our services. 

Calming the Storm

anxiety 2.jpgWe all need to place an importance on our own well-being and mental health. As we mentioned in our previous blog, Keep Anxiety at Bay, everyone experiences anxiety, which is completely normal. It is how we react to that anxiety that matters.

Today, Velizar Nikiforov, MA, LPC, suggests five additional ways to keep anxiety in check.

1. Breathe
As anxiety mounts, our central nervous system places the body on high alert, ready to escape or defend against whatever might be threatening us. The breath quickens and our muscles tense, and these physical changes make our brain more likely to focus on potential dangers. As a result, our anxiety accelerates. You can begin reversing this spiral by taking a few minutes to slow your breath and calm the body. A good set of exercises is described here:

2. Track your thoughts
When caught up in a cycle of worry, it is easy to forget that we’re frequently frightened not by what is happening right in front of us, but rather by ominous thoughts about terrible events either now or in the future. Using mindfulness exercises can give us a chance to step back and connect with the present moment. A short guided meditation exercise can create the space to observe our thoughts from what they are instead of being swept away by them. Several guided meditations are available here:

3. Check your thinking
The anxious mind is focused on protecting us from threats, so when we worry, threats are all we see. Whatever we’re thinking about, our anxious mind is likely to latch onto the worst possible outcome. We then usually accept our mind’s fortune-telling unquestioningly. Instead, take a few minutes to examine your thoughts. Ask some questions about what you’re worried about: what is the worst case scenario you’re worried about? Step back and consider: what’s the best case? What is most likely to happen, given your experience and knowledge? Worry thoughts are stubborn, so you may need to write down the answers to these questions and take a few minutes to really think through them. A tool to help with this exercise is the “What if…” form:

4. Stop feeding the anxiety
When we get caught in a whirl of worry, we begin grasping for safety. This may take the form of repeatedly looking for reassuring information—refreshing and reloading Twitter, checking the weather, staying glued to the news, asking questions of loved ones. This can provide a spell of relief, but this is fleeting. Soon we’re back for another fix of reassurance, continuing the cycle of anxiety. To break the cycle, use one of the skills above and pause long enough to notice that anxiety eventually dissipates on its own.

5. Break away
Sometimes it’s best to simply step away from anxiety. Tune in to your values and do something that nourishes them. Exercise, connect with loved ones, engage in a pleasurable activity, volunteer: all of these allow you to get back in touch with your direct experience and set aside dark ruminations.

 Velizar Nikiforov, MA, LPC, is a Staff Therapist on the Cognitive Behavioral Therapy Team at The Family Institute. He specializes in working with individuals with depression, obsessive-compulsive disorder and anxiety.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Learn more about our Anxiety and Panic Treatment Program. Visit our website to learn more about our services. 

How is Parenting Adopted Children Unique?

Adoption blog photo 1.jpgToday’s blog comes from Allen Sabey, PhD, LMFT, in recognition of National Adoption Awareness Month.

Parenting adopted children can be uniquely challenging. One such challenge that adopted children often face is forming a secure attachment with their new parent(s). Basically, a secure attachment is a reliable emotional bond or trusting relationship between a child and a parent. For example, securely attached children feel more comfortable going to parents to receive comfort when distressed. As a result of inconsistent caregivers in the past, adopted children may struggle to trust a new parent and turn to them for comfort. Fortunately, adoptive parents can take proven steps to ensure their adopted child will form this important secure attachment relationship with them.

First, adopted children may need extra portions of love and understanding. Parents should frequently show and express their love to their adopted child in ways that are meaningful to their child. For example, parents should regularly play with their younger children. In addition, some adopted children struggle with feeling unwanted or confused about their potentially new culture. It is helpful when parents simply express understanding and acceptance of these feelings.

Second, adoptive parents need to maintain firm expectations for their adopted children. Perhaps because of the prior difficulties faced by the child, parents may feel the need to overcompensate and not enact the same structure and discipline as with other children. However, all children, no matter their backgrounds, need a strong sense of structure and firm expectations to thrive.

Lastly, adoptive parents may need to have an extra measure of patience as their adopted child slowly learns that they can trust them. Adopted children are sometimes more resistant to affection or reluctant to open up to their new parents at first and so time is a necessary ingredient.

In sum, as adoptive parents consistently and frequently show love, express understanding, and firmly provide structure, a secure bond will form over time and their adopted children will come to trust them and feel emotionally safe.

Allen Sabey, PhD, LMFT, is the John J. B. Morgan Postdoctoral Clinical Research Fellow at The Family Institute. Some of his specialties include adoption, child behavioral problems, couple conflict and communication, and divorce/marital separation. He also maintains an active program of research that is aimed at understanding how and why family members provide care and support for one another, especially in times of distress.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Learn more about our Adoptive Families Program. Visit our website to learn more about our services. 


Cyberbullying — Distress beyond the playground

Cyberbullying.As children and teens increase their technology and social media use, they become more susceptible to being targets of a relatively new form of bullying — cyberbullying. We are past the days of negative interactions that both start and end on the playground; our children continue to be victimized by their peers outside of school as well.

In observation of National Bullying Prevention Month, today’s blog comes from Adam Margol, PsyD, a staff therapist at The Family Institute.

Estimates suggest that over 90% of adolescents are online, and those adolescents are spending close to a third of their waking hours using electronic devices (Lenhart et al., 2010 and Gerson & Rappaport, 2011). Due to adolescent’s constant access to electronic devices (including popular social networking sites like Facebook, Instagram and Snapchat), the opportunities for peer interactions to continue beyond the school day are extended, oftentimes lending themselves to cyberbullying.

Cyberbullying, or cybervictimization, is associated with negative outcomes such as low self-esteem, symptoms of anxiety and depression, and suicidal ideation (Landoll et al., 2015). In the Youth Internet Safety Survey, 93% of cyberbullied youth reported that the bullying made them feel sad or afraid to go to school (Raskauskas & Stoltz, 2007). The impact of negative peer interactions online is profound, which opens essential dialogue between children, parents, and their schools to help support our kids and to help them feel safe.

The question is — can it be prevented? The likelihood of adolescents refraining from ALL social media use is unrealistic. What can parents do to protect their children from cyberbullies?

  • Start the conversation with your kids about cyberbullying. Suggestions for starting the dialogue include asking:
    • What social media platforms do you use? How do you decide what to post or who to follow? Does anyone else know your password?
    • Have you ever gotten into a fight with someone online? Have you ever said anything to anyone online that you wish you could take back? Has anyone ever said anything to you online that made you upset or hurt your feelings?
    • Have you ever heard of cyberbullying? What does bullying include for you? Do you know anyone that has ever been bullied online? What happened in that situation and what was the outcome? Are you or any of your friends afraid to attend school or are uncomfortable at school because of what has happened online outside of school?
    • Has anyone teased, attacked, or spread rumors about you online? Has anyone ever asked you to send pictures of yourself to them? Has anyone asked you to send naked pictures of yourself? How did you respond or how would you respond if that were to happen?
  • Ensure that your children can identify supports to utilize if they do experience cyberbullying (e.g. parents, teachers, school counselors, therapists, etc.).
  • Let your children know that they can come to you for support if they were to ever experience any form of cyberbullying.

For more information about cyberbullying, visit:

Adam Margol, PsyD
, is a Staff Therapist at The Family Institute. He has experience working with children, adolescents and young adults with emotion regulation issues, social skills deficits, school issues, behavioral issues, learning disabilities/challenges, executive functioning deficits, ADHD, depression, anxiety, aggression, and developmental disabilities.

The Family Institute offers affordable, effective mental health counseling for families, couples and individuals in Evanston, Chicago, Northbrook and Westchester. Learn more about our services on our website.


Finkelhor, D., Mitchell, K. J., & Wolak, J. (2000). Online victimization: a report on the nation’s youth. Alexandria, VA: National Center for Missing and Exploited Children.

Gerson, R., & Rappaport, N. (2011). Cyber cruelty: understanding and preventing the new bullying. Adolescent Psychiatry, 1, 67-71.

Landoll, R. R., La Greca, A. M., Lai, B. S., Chan, S. F., & Herge, W. M. (2015). Cyber victimization by peers: Prospective associations with adolescent social anxiety and depressive symptoms. Journal of Adolescence, 42, 77–86.

Lenhart, A., Purcell, K., Smith, A., Zickuhr, K. (2010). Social media and young adults: Social media and mobile internet use among teens and young adults. Pew Internet and American Life Project, February 2010. Retrieved from

Raskauskas, J., & Stoltz, A. D. (2007). Involvement in traditional and electronic bullying among adolescents. Developmental Psychology, 43, 564-575.


%d bloggers like this: