Tag Archives: anxiety

Finding Your Marital North Star

premarital counseling charleston scOften times when I work with premarital couples I ask them what characteristics they would like to see in their marriage. I encourage these couples to take time to think about what is important to them in a relationship, write it down and look back on in frequently.  I then talked to couples about using this list as their North Star that will guide their behavior in their marriage.


During the good times we don’t need this list as a guide. We can easily see the good in our partner and are open and loving. But when things become difficult we quickly lose sight of what is important to us and we get pulled off course.


In difficult times many people will begin to use their partner’s behavior as a guide for their own behavior (i.e. you hurt me so I will hurt you back, you are disrespectful to me so I will be disrespectful back, you withhold from me so I will withhold from you). One can see how this would become a vicious cycle for disaster.


We get pulled away from what we really want in our relationship if we base our behavior on someone else’s behavior.  This is because behavior is not a constant in any relationship. Additionally, our perception of behavior is not constant so all it would take is our perception being off for us to be pulled off course.



I was having brunch with an unmarried pregnant friend recently. During the course of brunch she was telling me that she was in a difficult position about what last name to give her baby who was soon to be born. She was no longer with the baby’s father in the romantic sense and she was not happy with all of his life choices.


On the one hand she was not particularly attached to her last name and she did not feel compelled to give the baby her name for any personal reason.  But, on the other hand she was not sure if she wanted to give her baby the father’s last name because she felt as if she was rewarding him with that honor.


We talked about it a little and I asked her if she wanted a friend answer or a therapist answer. She said she would like to hear both. As her friend I told her, “F- him” we laughed and than I told her about what I talked about above.


I asked her to think about what kind of relationship she would ideally like to have. What characteristics would it have? I encouraged her to use these as a guide during these difficult times so she did not get pulled away from what she really wanted in her relationship.


There is one mistake that people commonly make with this exercise. They make their list and then expect their partner to do it. Or, they give these things only if they feel their partner is doing the same thing.


What ever you want in your relationship give it to your partner, but give it freely with no expectation of getting it back or needing it back. When we need to get the behavior back in order to give it we fall into the trap of using our partner’s behavior as our guide. This will lead us off course.



There is one phrase that helps me when making difficult decisions in my life and I use this as my guide in all my relationships, whether personal or professional. My go-to phrase that helps me is “Is it loving?”


This phrase helps me when I get off course and even though I am not behaviorally perfect and forget this phrase, it is always there to help when I am ready and open to accept its strength and wisdom.


The phrase, “Is it loving?” does not mean I become a doormat in every situation. It might be more loving to leave a situation then it would be to stay. If I am married to someone who hits me and my children the most loving thing might be to leave. This person hitting me cannot see that there is a better way to live. As long as I stay I may be holding them back from seeing another way to manage their anger.


It might be more loving to stop giving financial support to my child so they can learn how strong they really are. It might be more loving to let my child struggle with the consequences of poor decisions. Being expelled from school and grounded for drinking at school helps the child learn appropriate behavior. It may also keep them from progressing their behavior of drinking that later develops into driving under the influence and killing someone else.



“Is it loving” can also be applied to the thoughts I think about other people. Thinking unloving thoughts about any one has a direct effect on me. I don’t like the way I feel when I think of someone else being the “bad guy”. When we can see the innocence in another it has a different effect. When I can see the person as doing the best they can in that circumstance the emotional pressure is released.



Examples of Characteristics People Report Using as Their North Star in Their Marriage:



  • Respect
  • Listen to understand not to dispute
  • Kindness
  • Forgiveness
  • Understanding
  • Not nitpicking faults
  • Open to suggestions
  • Giving partner space to be exactly the way they are
  • Taking responsibility for behavior
  • Willing to admit when they make a mistake

Working On Internal Peace to Experience External Peace.

AYP1224744In this entry I will not be telling anything you don’t already know.  Think of this entry not as something novel but as a reminder of the obviousness that is all around us. We can witness evidence of the following commentary in our every experience.


It is your direct experience that you must listen to, not the writing. Wait for the message to ring true for you. If it does not resonate with you, move away without judging the encounter.



I do not respond to anything directly, but rather to my interpretation of the event. Many people tend to understand this statement on a general surface level but where most stop is the application of it.  We tend to forget the meaning of this statement when we encounter something that triggers an emotional charge for us. When we are experiencing the event, it appears that what is causing us trouble is outside of us.  In truth, it is our own filter that effects how we see something.


We then use our interpretation of the event to justify our response to the event. When one truly understands that they do not respond to anything directly but to their interpretation of it, they will understand that what is causing them trouble is not outside of them.  This can be liberating for many people because at this point they stop trying to control other people to find peace.



The interpretation of an event is always coming from me, therefore the grievance I perceive is coming from me.


The next step involves looking at where I am hoping to influence change. Most of us get caught up in the old pattern of trying to change another’s behavior so that you feel better.


Listen to me more so I feel different.

Desire me so I feel different.

Stand up for me more so I feel different.

Start helping with the housework more so I feel different.

Dress sexier so I feel different.

Don’t yell at me so I feel different.


There is a pattern here. The only reason we ever want people to be different is so that we feel different. There is a problem in this thinking. 1) I have no control over another person. 2) Refer back to the statement “I do not respond to anything directly but to my interpretation of it”. The problem is not in the other person it is in your perception of that other person.


For some this way of thinking is very frustrating. “Are you telling me that my partner does not have to listen to me or show me respect?!?!?”,  is a comment some will retaliate with. When I hear this retort I know that they have not yet comprehended what I am attempting to communicate.


We often will not interpret a situation correctly because we are looking through an old filter. Instead of seeing what is in front of us we look for evidence that supports a belief we already have.


If I have a belief that I am unlovable I will be seeing the world through this filter and look for evidence to support this belief. A lot of time we will be completely unaware of our internal beliefs. If someone were to say to you, “You have the belief that you are unlovable”, you’d might say, “You’re nuts”.


We have a difficult time seeing what beliefs are influencing us because they are so engrained. It’s like noticing the air, or a fish noticing water.


We see our unconscious belief by the way we interpret our external world. You can always tell how a person feels about themselves by how they talk/feel about others. 


We color our world by our internal beliefs. Everything in this world that happens is a fact, it does turn good, bad, happy, sad until it goes through my own filter of interpretation. Here is an example of what I mean:


Fact: You tell your husband about an event that is important to you. Your husband does not look up from his newspaper or respond to what you just said.


Event seen through one filter: He never listens. He is rude for not listening to something that is important to me.  I don’t understand why I bother to share important things with him.


Same event seen through a different filter:  He does not appear to be listening to me.  He might need this time to decompress. Him not listening to me is not a personal attack.


The way we interpret an event has everything to do with what is going on in our internal world. I am not saying that it isn’t great to have a partner who listens, is supportive, and helps. What I am saying is that we often will base our emotional stability on something that we have no control over, another’s behavior. Additionally, what I am saying is that your happiness is not dependent on the other person being different.



Cleaning off our emotional filters is key. We begin to do this when we begin to see what is happening and how we are pulling into our old belief system time and time again.


You can begin to clean out old emotional baggage when you start to see that you are not responding to the event, but your interpretation of the event. Then, when you forgive the person for what they are not actually doing. What I mean by this is, what is causing you difficulty is not their behavior but your own filter.


They might tell you they just cheated on you with your best friend, but even in this situation what is giving you trouble is your interpretation of the event. This does not necessarily mean that you stay in any situation. What it does mean is that your emotional wellbeing can stay intact regardless of what appears to be going on outside of you.



When you see the innocence in another you are reminded of your own innocence.  When you are reminded of your own innocence you will remind yourself of your true nature, which is whole, complete and infinitely lovable. When you remember your true nature you will not fear what you perceive going on outside of you.


Can Someone Really Make You Feel Bad?: How responsible are you for your own feelings?

“No one can make you feel inferior without your consent.” -Eleanor Roosevelt


The above quote is one I refer to often when working with people. The problem is never coming from the other person, but we continuously give away our power by putting the responsibility on someone else.


It is difficult to believe that the pain we can feel when interacting with another person is actually coming from us, but it is. It doesn’t matter what the action, if you feel an emotional reaction to it, know that it comes from you.  Let’s do a short exercise just for the sake of clearing up this point.


For a minute, imagine the last person you became upset with. Got them in your head? Now, imagine that you are in an altercation with this person and they call you a “purple unicorn”.


They keep calling you a “purple unicorn” over and over again. Would it upset you being called a “purple unicorn”? My guess would be no. I have yet to run into a person who says being called a ‘purple unicorn’ feels damaging in some way.


Most people admit they would think that the other person was crazy because they know they are not a purple unicorn. I imagine you would say something close to that.  In this example of another person calling you a “purple unicorn” you can see that the behavior is clearly about them.


Their actions are coming from them and it has no effect on you because you know you are not a “purple unicorn”.


But let’s change things around a bit. Let us change the name “purple unicorn” to something else. What if we changed it to “jerk”, “bitch”, “incompetent”, “selfish”, or any other name that gives us a little sting? Now we might be looking at a different story. We all have names we react to, but have you ever thought about why you react to them?


We react to “negative” things people say or do because it triggers a belief we already have about ourselves. “P.U. ” doesn’t affect you because you know you are not one, but other names do affect you because it is an idea we secretly harbor about ourselves.  People can only supply a stimulus; how we react to this stimulus reflects a lot about our belief system. 


Many people will respond by saying, “Well my partner doesn’t call me names. I am angry because he doesn’t do ______________(fill in the blank with what upsets you).


Some say they are upset because of the cheating, or lack of sex, or lack of attention.  One often times looks at their partner and quickly evaluates them on how well they are doing as a partner by whether or not they give that person want they think they want.  Very rarely does an individual take a second look and ask the important questions. Questions like: “Why do I believe I need my husband to listen to me (tell me I’m beautiful, tell me what a good job I’m doing, etc)?”, “Do I really need him to talk to me?”, “What would my day be like if I didn’t have the expectation that he should talk to me?”, Would I be happier without this thought?”.



When we refuse to take a deeper look we are left powerless and unhappy. We are letting our happiness ride on a factor we have no control over, someone else’s behavior.


If we begin to question, really question, why we think we need that other’s attention we can return to our only place of power- ourselves. Why do I need my partner to give me attention? If we truly look at this and want a real answer, we will get it.


Often times we don’t want a real answer. Often times we just want to be right. Many people answer angrily and says something like “because she’s my wife and she should be having sex with me 3 times a week”, or “I’m not crazy for wanting my husband to show me love” or fill in your choice answer that makes you look right.  Ask yourself, “Would I rather be right or would I rather be happy?”


When we truly want an answer to questions like “Why do I really need my partner’s attention?” we’ll start to get answers like: “Because I believe if someone doesn’t recognize my worth it’s not there”, or “I don’t feel lovable if someone does not show me attention”, or “I am putting my own desire for something over my partner’s desire to not do something. I am acting out of fear of not having enough and not from a place of love”.


It can seem impossible at times when we are hurt to start asking these questions with the hopes to get real answers. It is tempting to make ourselves “right”. When we are upset we feel like this is our only option if we want to heal. But being “right” rarely helps anyone. After the short-lived high wears off we are usually left with an uneasy feeling of isolation.


Natural Way of Treating Anxiety with Nutrition: Pyroluria- medical condition that shows up as anxiety

As some of you already know, I am continuously looking for various ways of treating issues that present themselves in therapy. I like to have various option to for clients and educate them so that they can make the decisions for themselves.

There are many different view point when it comes to health-care and it’s no surprise that clients have various desires on how they would like to address their concerns. Some desire the assistance of a medication and for that I refer them to a number of well qualified psychiatrists in the Charleston area. Some people want to use medication as a last resort and for those individuals I will sometime suggest seeing a Naturopathic Physicians. 

Sherri Jacobs is Naturopathic Physicians in the Charleston area that I have recently been in contact with. Besides being very personable, I appreciate her beliefs when it comes to treating people. She reports that her philosophy is to find a balance between modern medicine and treating the body naturally.

She disclosed that a number of ailments can become elevated if the body is given what it needs nutritionally and taken care of with an adequate balance of rest and movement.  She does, however, believe modern medicine plays an important role and that for some ailments it may be necessary.

While talking with Sherri she began to discuss how a number of individuals will experience symptoms of anxiety and depression that are actually due to an imbalance in the body- either getting to much of one thing or not enough of another. She disclose that she had written an article on how  pyroluria could look like anxiety in a number of individuals and often times went untreated.

I asked Sherri if she would send me the article so I could post it on the website. Within minutes the article was in my email in box for me to read over and post.

Below is the article she sent to me that you are free to read it you so choose. I found it very informative and easy to understand. I do have a few disclaimers.

Warning: Do not discontinue any medications without consulting your health-care provider first. If you are not happy with your current health-care provider seek a second opinion from a qualified provider. 

This article is not intended to be used as a treatment regiment. This article is for educational purposes only.  If you are interested in a natural form of treatment please consult a license provider in your area.

Information presented in below article does not necessarily represent the options and practice of Good Loving.  ______________________________________________________________________________________________________

Pyroluria: A Cause for Anxiety

A notable patient comes through the door that has been anxious most of their lives or suffered frequently from episodes of nervous exhaustion. Her anxiety has become all consuming since a major life transition. Anti-depressants and anti- anxiety medications have not offered lasting relief. She describes herself as artistic, perfectionist and creative, but suffers from significant inner tension and fear. Since anxiety has become a common condition in our modern world, most clinicians find it a rarity when someone does not check the stress/anxiety box on their intake questionnaire; it is pervasive. As Naturopathic Physicians, we offer anxiety sufferers a chance at lasting relief by seeking and uncovering the underlying biochemical causes of the distress.

One biochemical cause of anxiety is a controversial and understudied condition which has significant implications in the treatment of anxiety; pyroluria. First discovered in the 1950’s by Dr. Abram Hoffer, pyroluria is a genetic condition of altered hemoglobin breakdown, resulting in a depletion of vitamin B6. Without adequate B6, the body is not able to convert tryptophan to serotonin. In the absence of adequate serotonin levels, many different psychiatric disorders, like anxiety and depression can develop.

A normal by-product from the breakdown of hemoglobin, kryptopyrroles are found in elevated amounts in individuals with this genetic abnormality. As the pyrroles are being excreted from the body, they bind two important nutrients; Vitamin B6 and Zinc. The elevated levels of kryptopyrroles create a higher demand for B6 and Zinc and subsequently may cause a relative deficiency. This relative deficiency results in a myriad of different symptoms that wax and wane over the years depending on someone’s level of stress. Decompensated pyroluria is marked by symptoms of inner tension, nervous exhaustion and fearfulness.

The cumulative effects B6 and Zinc deficiencies have cascading yet ill-defined systemic effects. Vitamin B6 is necessary for the conversion of tryptophan to the neurotransmitter serotonin, and plays important roles in proper protein and carbohydrate metabolism and a healthy immune system. Zinc regulates insulin

activity, acts as a powerful antioxidant, plays a central role in immune function and regulates gene expression.

The combination of depleted B6 and zinc status is a disaster for mental health. Both nutrients are essential for healthy brain function. Dr. Joan Larson, PhD., founder of Health Recovery Center in Minneapolis and author of Depression Free Naturally explains the role of B6 and Zinc in the following way. “B6 is the co- enzyme (meaning it is absolutely essential) in over FIFTY enzymatic brain reactions where amino groups are transformed or transferred. B6 has an important role in your nervous system’s balance. It is required to utilize protein for energy. Brain depletion of dopamine and serotonin occur without B6, creating ongoing anxiety and depression. Zinc deficiency also results in multiple disorders. The brain uses at least sixty zinc enzymes so zinc deficiency has a marked effect on mood states. Anxiety and depression have been observed in patients who develop zinc deficiency from intravenous feedings. These patients experienced prompt relief from their acquired depression after zinc was supplied”1


Dr. Larson recommends the use of Bio-Center Lab as the only reliable lab for testing. The test is inexpensive and can be ordered directly by the patient. The lab will assess the level of pyrroles found in the urine. Results from 10-20mcg/dl of pyrroles are considered borderline. Above 20mcg/dl is considered positive for pyroluria.

Because of the low-cost and ease of the test, I frequently recommend it after simple prescreening when I am working with a patient who complains of anxiety. A positive test insures compliance with the protocol.

Most pyrolurics have gone undiagnosed for many years. Due to the constant anxiety creating surges of cortisol and adrenaline, it is imperative for the clinician to also treat the adrenal glands. An adrenal stress index is warranted for a complete evaluation of a pyroluric patient.


Pyroluria Screening Questionnaire:
1. Do you tend to skip breakfast or have morning nausea?
2. Do you tend to be anxious?
3. Do you have other members in your immediate or extended family with schizophrenia?
4. Are there members of your immediate or extended family who have committed suicide?
5. Do you have white spots on your nails?
6. Did you get a “stitch” in your side when you ran as a child?
7. Did you have moderate to severe acne as a teenager?
8. Do you have pain or creaking in your knees?
9. Do you have cold hands and feet?
10. Do you have stretch marks as an adolescent or adult even without a large weight gain or loss?
11. Are your teeth or were your teeth before orthodontic treatment crowded with teeth growing over teeth? 12. Did puberty start a little later for you than others?
13. Are you easily tired?
14. Do you tend toward apathy?
15. Do you have a tendency toward iron-deficiency anemia or test borderline?
16. Do you have eczema or psoriasis?
17. Do you have tingling sensations or even tremors in your arms or legs?
18. Do you tend to have paler skin than other family members?
19. Do you tend to get overwhelmed in stressful situations?
20. Do you have trouble remembering your dreams?
21. Are you now or have you been a vegetarian?
22. Are you now or have you before been an alcoholic?
23. Do you find yourself socially withdrawn and dependent fairly strongly on one person?

24. Poor short term memory?
25. Poor ability to cope with stress?
26. Mood swings or temper outbursts?
27. Much higher capability and alertness in the evening compared to mornings? 28. Sensitive to bright light?

Pyroluria Support Protocol:

page4image3536 page4image3960









1 cap at breakfast 1 cap at lunch


Zinc Picolinate+



2 caps at breakfast 1 cap at lunch





1 cap at breakfast 1 cap at lunch (=500mg B6)


Manganese Aspartate/ Citrate+


2 caps at dinner


Chelated Magnesium


1 cap at breakfast 1 cap at dinner





1 cap at breakfast 1 cap at lunch


Pantothenic Acid



1 cap at breakfast 1 cap at lunch

page4image48712 page4image49304

Vitamin C Natural




1 cap at breakfast 1 cap at lunch

*Do not exceed 2,00mg of B6/P5P combination
*Adjust B6 dosage until you recall your last dream before waking +Zinc and Manganese compete for absorption. Do not take together

Protocol adapted from Depression Free Naturally by Joan Larson, PhD.


Individuals with pyroluria, loosely called pyrolurics, will notice marked benefit with the protocol in about 6 weeks. Although, most people, especially with long- standing anxiety, will require 6 months of treatment, my pyroluric patients’ have been able to discontinue their protocol after 3-4 months and then use the supplements on an “as needed” basis. Since pyroluria is a genetic condition, supplementation will be required for a lifetime; however, most patients are able to take supplement breaks. The pyroluric patient will notice the familiar inner tension as a sign to return to the protocol.


As a clinician who specializes in the nutritional management of stress, pyroluria is NOT the most common nutritional cause of anxiety. It is a cause that is worthy of attention. Admittedly, there is a dearth of adequate research and scientific articles on the topic. However, my clinical experience has proven it worth consideration. The level of anxiety and inner tension experienced by a pyroluric is considerable. The life changing benefits of diagnosing and treating pyroluria are life changing. I encourage everyone to add it to their differential diagnosis when assessing a patient with a history of anxiety.

Case Study
27 year old female
No significant past medical history Chief complaint: Anxiety

Claire was fair-skinned, freckled and thin. She described herself as always uptight, perfectionist, unable to relax, mild insomnia, easily startled, worrier. She remembers being this way most of her life, although her anxiety seems to be getting worse over the past few years. She describes her mother as highly anxious and over protective, although her mother has denied any anxiety issues. Her twin sister has similar issues with anxiety.

Patient was seeing a counselor and had tried numerous anti-depressant and anti- anxiety medications without lasting relief.

PE: numerous white spots on nails, cold extremities, otherwise unremarkable

Labs: Mild anemia (borderline low Hgb and Hct, decreased MCV , elevated RDW, ferritin at 11ng/ml, otherwise unremarkable)

Recommendations: While waiting for the results of her pyroluria test, I placed her on a diet focused on stabilizing blood sugar levels. I gave her specific recommendations for decreasing stress (regular exercise, breathing techniques).

Pyroluria test:

Positive at 25mcg/dl

Patient started the complete pyroluria protocol. At her 2 week follow-up, she noticed mild improvement in sleep. I did not hear from the patient again for 5 months. After 5 months she sent me an email update. She was feeling so much better after 3 months on the protocol that she decided to make a change. She moved across the country and started a new job. Her stress levels were manageable and she felt stronger than she could remember. She was also training for a marathon. Her focus was now on convincing her sister to take a pyroluria test.

1. Larson,Joan.DepressionFreeNaturally.NewYork:RandomHouse Publishing Group, 1999.


2. Kaslow,Jeremy.“Pyroluria.” <http://www.drkaslow.com/html/pyroluria.html>.

Bio: Sherri Jacobs, ND, CNS graduated from Bastyr University in 2005. Her practice is centered around nutrition therapy for women’s health, weight loss and stress management. She is co-creator of the 360 Weight Loss Plan. You can find more information about Dr. Jacobs and her practice at www.HealthECoaching.com