 Thanks to Jonathan Hoxmark on Unsplash for this beauty! Perfectionism and OCD
What is perfectionism? Oxford dictionary defines it as “refusal to accept any standard short of perfection.”[1] That’s automatically problematic.[2] Perfectionism leads to a circumscribed focus, stress, and suffering for not only individuals, but for loved ones nearby who feel the weight of being perfect. Is this the same as OCD? Nope. OCD and perfectionism often get confused. They both can affect and drive distress in one another, but they are separate. OCD involves unwanted (intrusive) thoughts, urges, and impulses that cause distress; furthermore, compulsions are repetitive behaviors or thoughts that attempt to reduce distress or prevent something bad from happening. Perfectionistic manifestations of OCD, often referred to as “just right / not just right” fit this categorization. Separately, in Perfectionism, someone pursues “perfect” thought, behavior, or action initially out of interest or enjoyment (rather than to suppress an intrusive thought/urge/impulse, like in OCD).[3] There are typically problems that go with this, however. So a difference between the two is that OCD is ego-dystonic and Perfectionism is typically ego-syntonic (you can check out my video here explaining the difference). Examples of perfectionistic thoughts and behaviors[4,5]:
My Perfectionism I am a "recovering" perfectionist. And it’s a problem when I’m not, well, “recovering” from it. One of the mechanisms that keeps perfectionism going is the belief that it is helpful (this is a “Positive Belief” about perfectionism, and it is a cognitive distortion). When I succeed at a task- and especially if I get a lot of praise, it is a natural reinforcer that I must be doing well. However, if I spent 8 hours researching, writing, and proofing this blog today, that is problematic for me at this point in life (and I easily can spend that much time). What is a problem or not sometimes depends on the person and their situation- maybe a journalist would spend that much time or even more, but I am a full-time clinician with a family, church, volunteer involvements, and hobbies. If I make this post “perfect,” in my perfectionism, I will seriously miss out on other things. This pursuit of perfection doesn't stop with one blog post. It will always generalize if allowed. So if I let it, the pressure of perfection will continue (and does, at times) to move on to other things like caring for my home, caring for people in my life, my relationship with others, my diet, exercise, my spiritual walk, my car, money, and so on. And being honest with you, these things are tied up in anxiety and simultaneously selfishness- attempting to control these things rather than to engage with them/others in a meaningful way by learning to lean into the fear and live based on what is valuable. Parenting is probably the single biggest event that pressed me with the realization I need really challenge my perfectionism. There are two stark realities to me in life: I can either do my work/relationships/home life/etc. “perfectly” and end up in an ever narrowing scope of anxious overwhelm trying to keep all the balls in the air, OR learn to tolerate the distress that comes doing things "not just right" and focus on the big picture, growing towards what I love and value. And the reality usually is that in time, this fear habituates when not engaging in avoidance, rituals, or control strategies. Making Change Whether in therapy or personal life, to change how I behave and think and respond in life, I need to be aware/monitor what it is that needs to change (good therapy, support, and resources such as on my website can help). Even if I know what needs to be done, if I can’t effectively observe and catch it when it occurs, I will not be able to change it. Next, I will need tools and strategies to effectively grow and mature. In therapy, some of these are Exposure Therapy, Cognitive Restructuring, and more. In essence, at the point of the problem I must be able to insert the solution- and consistently. Lastly, I want to continue to monitor and gain feedback to incorporate learning and solidify growth. I don’t want to oversimplify this- if you are having a problem with any of the areas I have discussed, please reach out to a competent trusted person and/or therapist. Today I gave myself the time limit of 3 hours- start to finish- to research, write, upload and post. And it’s simultaneously stressful and joyous at the same time. I’m going to do a behavioral experiment and keep doing it- “testing” whether or not my choice(s) in leaning into my fear of failure a) doesn’t end up as bad as it feels like it will, and/or b) I was able to handle or face it anyway. We’ll have to see- I'm leaning in!!! Openly, Justin K. Hughes References: [1] https://www.lexico.com/en/definition/perfectionism [2] First of all, it’s a whole mess to even get into a truly perfect standard- if I make and continue to make mistakes, I am not perfect. I cannot even begin to conceive what perfect is, then, since I would make a mistake in defining “perfect.” [3] The Diagnosis of Obsessive Compulsive Personality Disorder (OCPD) may apply when a person pursues perfectionistic behavior to pathologically disordered levels. [4] Grayson, J. (2014). Freedom from obsessive-compulsive disorder: a personalized recovery program for living with uncertainty. New York: Berkley Books. [5] Minirth, F. B., & Meier, P. D. (2015). Happiness is a choice: enhance joy and meaning in your life. Grand Rapids, MI: Spire.
0 Comments
"Ah sugar, ah honey honey. You are my candy girl, and you've got me wanting you." The Archies may have been describing a relationship with their lyrics, but that’s been me with my relationship to actual sugar. I love added sugar.[1] 5 years ago, I easily would:
 I didn’t think much about it. Once I began to shift from a trim guy in my young 20’s to borderline overweight/obese by my late 20’s, I was introduced to research on the deleterious effects of consuming so much added sugar in my diet. But I also gained maybe the most crucial part of any health advice: the support to live it out.
The most significant early clinical and research voice for me was Dr. Mark Hyman, Director, Center for Functional Medicine at the Cleveland Clinic. I was watching a documentary on Netflix in 2015[2] that featured him significantly. It added to my already growing knowledge and personal experience, which especially helped me a) stop compartmentalizing nutrition (150 calories from Coke ≠ 150 calories from vegetables) and b) look more closely at what I put in my body. Bolstered by personal recovery in multiple areas of my life, and leaning on my wife who was super supportive of me, these convergences facilitated what I hadn’t been able to do prior:
One of my discoveries is that existing advice often conflicts, and (as with all things) can be driven by profit, greed, and ambition. Instead of getting embroiled in all these details, I began to think critically for myself and make a plan with support. Here’s the simplest advice that’s now supported relatively across the board: Recommendations for Added Sugar: CDC (U.S.)
Part of a healthy body, mind, and spirit involves an honest look at what we put in our bodies. Nutrition is, of course, one of the most important realities of daily life. Much success and suffering comes from our consumption and discipline around food- and in that regard, it’s not much different from other areas of life such as our thoughts and beliefs, exercise, generosity, and work and rest. I’m nowhere near an expert in the food realm, and this post is more personal in nature. I hesitated writing it for a while so as not to make another one of those ‘Look at me now!’ posts. The last thing I want is for anyone reading this to feel shamed by a braggadocious post on self-improvement. I personally didn’t have a bunch of shame about my weight prior, nor would that have helped. I want to thank my sister-in-law, Camille, for encouraging me that people might benefit from my personal story. I hope it helps. As a therapist, I walk with people every day through CBT and counseling to take action. Traditional medicine, articles, and diets all serve their purpose. My job is to help people make change, personalized to them, in the context of reality- that we must all live in, or not- only to our detriment. If you take nothing else away from this, here are the keys I want to share:
Sincerely, Justin [1] Added sugar is different than sugar as it naturally occurs, like in fruits and vegetables. See Harvard Health's post here. [2] “Fed Up”- not that I endorse everything in it, but there were a couple key lessons that I have incorporated from this documentary. [3] This whole resource is quite fabulous with lots of good research and narrative. I nerded out with it! This post is intended for Christians looking to deepen their faith and mental health.  The Bible has a lot to say about fear and anxiety. In fact, some variation of “do not be afraid” is the most common directive in Scripture, occurring in some fashion more than ‘do not steal,’ ‘do not kill,’ and even ‘love your neighbor.’ How do anxiety and fear work? When we study these constructs in research, we are understanding mechanisms through which the body/brain is informed to face a threat or danger. We can argue these responses are inherently good, with their purpose being survival, protection, and preparedness. Its activation results in the sympathetic nervous system being primed: adrenalin and noradrenalin are produced, cortisol increases, heart rate increases, blood flow moves to muscles and away from extremities, speed and depth of breathing increases, and many other physiological changes occur.[1] I’m grateful to have these responses- when they are in context. Out of context, they suck, to put it bluntly. Problems like panic attacks, worry, phobias, obsessiveness, skin/hair picking/pulling, preoccupation, social fears, avoidance, and more can be quite terrible. One of the things I love most in my walk with Christ is context. Direction. “The Lord is at hand; do not be anxious about anything, but in everything by prayer and supplication with thanksgiving let your requests be made known to God” (Philippians 4:5b-6, ESV). What is being said here? Partly, “Do not be anxious about anything.” Since anxiety is a feeling of imminent threat- or in other words, it’s at hand- it’s very interesting that immediately before this phrase in Scripture we have another observation revealing a different type of imminence: “The Lord is at hand.” In the context of the Lord being near we are told, “Do not be anxious.” This Greek word for ‘be anxious,’ μεριμνᾶτε (transliterated as “merimnate”), means to be divided and distracted, fearful, and caring for things that are out of context.[2] Sounds a lot like anxiety disorders, right? Yep. Or even just day to day worry/anxiety? Yep. When a person feels anxiety and fear and misinterprets this as significant, a person’s entire life and values can shift to focus on whatever is the subject of their fear, whether classified medically as a disorder or not. This can lead to a preoccupation with avoiding something or someone (spiders, relationships, sex, social situations) to obsessively checking to make sure everything is okay (car, stove, locks, bodily sensations, health, perfectionistic behavior), or pursuing something (money, security, approval of others)- and MUCH more.[3] To help work through these things and avoid pathological responses, I believe we need supports like therapy, help from friends, breathing techniques, mindfulness, exposure techniques, etc. This only underscores our complexity (we are “fearfully and wonderfully made”[4] yet simultaneously all messed up[5]) and highlights what we are told in Scripture about our limits.[6] We can rightly use these tools to help us, just as we do nutrition, medicine, community, and so forth. But there is one thing these tools can’t do on their own: attach us to the very God of the universe and give us a lasting hope and focus- with meaning and purpose at the highest level. So God gives us a jewel of a passage in Philippians 4 where we are kindly reminded what our attention is to be on (context), and a little bit of how we can live it out (practice).[7] It is well known within the anxiety treatment world that even the most effective therapies (here’s looking at you, classic CBT, which I love and specialize in) often need supports to connect to larger beliefs, values, and commitments (ACT, DBT, and MI are some of the most common modalities). If we don’t connect a person to larger motivations and goals than “I just want to feel better,” it is often near impossible for a person to grow with sustainable change for the long term because they don’t have a sufficient reason and value to keep them invested. God gives us this.
Want more? Well, there’s two tips in the next two verses, Philippians 4:8-9
“Anxious for nothing” will take a lifetime to put into practice. I’m grateful to have the opportunity. ~Justin [1] Continued misinterpretation and repetitive experience of these symptoms worsens disorder, like in Panic Disorder, GAD, Phobias, OCD, PTSD, and more.
[2] Bible Hub. (n.d.). 3309. merimnaó. Retrieved July 13, 2019, from https://biblehub.com/greek/3309.htm [3] I think it’s very important to note that we have to be very careful with saying anxiety/fear is sin- and what we mean by this. A lot of Christians get tripped up on this, and many, ironically, become more anxious. The extent of this point would likely require an entire book, so I will not take the space here to elaborate. [4] Psalm 139:14; Genesis 1:26-27 [5] Jeremiah 17:9; Romans 3:23 [6] Psalm 73:26; 2 Corinthians 12:9-10 [7] Oh yes, there’s a whole lot more in Scripture on this topic. Let's not reduce a couple sentences into a "how-to-manual." The Myth of Disappearing Distress. If I do the right things, I won't have to face suffering, right?
It's easy for me as a therapist to exhort my clients to stay focused on the prize DESPITE the distress they feel. How easy it is to get off track! And while it's also easy for me to tell someone else this, it can be very cumbersome to do in practice. I, too, struggle to keep focused when challenges hit. But I'm always best prepared when I lean on my team: #support #faith #accountability #truth. Music: Remember Musician: @iksonofficial In Vivo Exposure
Directly facing feared objects or situations, examples include: Getting on a flight, touching a doorknob that feels “contaminated,” not going back to check a lock, or going to a social gathering. Good exposure attempts to match the content and detail of a person's fear as close as possible. So, for example, if a person fears “going crazy” in a social setting, the best exercise will be working up to facing that, not just exposing to the thought or word. On the other hand, if the fear is that a person will have inappropriate impulses (to harm, sexually, etc.), sitting with the intrusive thought and being present will serve best. Imaginal Exposure Imaginal exposure involves accessing the content of fears and anxieties through cognitive means. For example, a fear that someone will fail, make the wrong decision, harm someone, die, or choose the wrong relationship are not accessed by activating these life occurrences. They are addressed imaginally. There are many ways to practice Exposure imaginally, but the most common are writing scripts, stories, listening to recordings, watching videos, or using visualization. To be clear, Imaginal exposure often is the most confusing and hardest to grasp of exposure practices, as it seems to be creating negative thoughts or “bringing” unrealistic and negative thoughts on- the seeming antithesis of most of psychology and cognitive therapy. But what is really done here is only facing what a person is already experiencing, thinking and feeling. Interoceptive Exposure Intentionally bringing up physical sensations that are feared, such as: Heart racing, shortness of breath, sweaty palms. Ways to do this when a person's health allows are breathing through a cocktail straw, breathing rapidly, or sitting up quickly. Virtual Reality (VR) Exposure With the advent of new technology, we have a recently emerging type of exposure. Some may class Virtual Reality into imaginal exposure, but it can be seen as a cross between in vivo (situational) and imaginal. This is especially helpful with treating disorders such as Flying Phobia, where the access to an actual plane and flight to practice can be cost-prohibitive and difficult. What is Exposure Therapy?
Exposure therapy is a psychological treatment that is practiced in Behavioral and Cognitive Behavioral Therapy (CBT). It is indicated as a first line treatment for a number of disorders such as
Exposure therapy helps clients to systematically confront fearful stimuli along with changing fearful responses. This relearning increases confidence and decreases disruption in life. Over time, discomfort and fear typically decreases through active engagement rather than avoidance, suppression, neutralization, or ritualization. The evidence base is very strong for its use and effectiveness, though it is currently only applied a minority of the time in clinical settings. How Do You Do Exposure Therapy? The principles of exposure may be simple, but the specifics- personalized to any one individual- involve many working parts. Assessment
Do I want this, or do I not? Is this my actual desire, or what I don't want? Does this thought or desire define me? What if it's terrible or horrible? Sometimes the things I think about are because I value them or desire them. Sometimes the things I think about are because I don't value them or desire them. What the heck? Egosyntonic and Egodystonic are two psychological terms to describe phenomena of thoughts/urges that are synonymous and antonymous to what a person desires or wants. Sometimes our thoughts reflect very much what we desire or want, but around 90% of people endorse having "intrusive thoughts," or unwanted thoughts. It is crucial to do a good functional analysis on a thought/behavior to determine whether someone is doing something in order to pursue- or to avoid- the very same thing.  Photo by Joel Fulgencio on Unsplash  Photo by Leio McLaren on Unsplash “Security is mostly a superstition. It does not exist in nature, nor do the children of men as a whole experience it. Avoiding danger is no safer in the long run than outright exposure. Life is either a daring adventure, or nothing.” – Helen Keller
I don’t want to live my life being overly cautious, but rather appropriately cautious. We are discovering in the research of anxiety disorders, OCD, and now depressive disorders, that possessing an Intolerance of Uncertainty (IU) is a common construct linked with higher anxiety and life disruption. What is IU? My favorite definition: “Belief that uncertainty, newness, and change are intolerable because they are potentially dangerous” (Steketee et. al 2005, p. 125). IU links threat with uncertainty. But is uncertainty a threat? Take a moment and ponder one of your favorite memories. What did it involve? Was there any risk? Any vulnerability? Any chance of failure? Most of the best life stories I hear are of those that involve, well, all of these things. A person who cannot tolerate not knowing actually misses out. How? Isn’t knowledge power? What happens is this: the more control a person must have, the less control a person has. The more certainty that is sought, the more narrowly circumscribed life becomes. Quick examples:
Want to know how you handle uncertainty? Take the free IUS-12 assessment here. [Go to "Read More" below to find out how to score the assessment.] Let’s be clear: everyone is uncomfortable with some uncertainty. And reasonable protection from risks is part of being wise- which can also be subjective. But the more you necessitate that certainty must exist, the following is more likely to happen:
In the research on IU, there are also two subset strategies identified: Prospective anxiety (desire for predictability) and Inhibitory anxiety (uncertainty paralysis) (Fourtounas et. al 2016).
If you struggle with any of these, the next questions is this: How do I live with uncertainty and anxiety, while also taking suitable precautions? The solution is fairly straightforward, but not easy. Once a problem area has been identified (along with what is reasonable, normative, or within your values), gradually and consistently gain ground by pressing into your fear without using a false reassurance strategy that reinforces the false threat of uncertainty. In therapy, one of the most powerful tools that exists to deal with uncertainty is what we call Exposure and Response Prevention (ERP). This is the single most effective tool in treating OCD, and it is very valuable in other disorders. The reasons it usually has to be done in therapy are several:
I personally love Exposure because it helps me face life with a “bring-it-on” attitude rather than a “stumble-through-best-I-can.” ERP in therapy is very specific, very structured, and very powerful. However, even the person who is not in therapy can benefit from its principles:
“Some men storm imaginary Alps all their lives, and die in the foothills cursing difficulties which do not exist.” ~Edgar Watson Howe So what uncertainty are you not letting yourself live with? When is ‘not knowing’ unacceptable to you? Uncertainty is not the problem. It is unrealistic to be 100% certain about most everything in life. Life has few certificates of guarantee, and those are only as good as what is backing them. Ready to face your uncertainty? ~Justin  In this season of rush....I hate to admit it. Mom and Dad, please don't laugh too hard when I say....this.... I sometimes miss being told what to do. There. I said it.
I remember the drill of childhood. "When did you last eat? Here, have some food." "Looks like you could use a hug." "You're getting cranky; it's time for a nap." In my super-mature “I'm-smarter-than-a-child” mentality, I miss some of the plainest truths in life. One of these is the importance of rest. It’s the weekend before Christmas, and all through my house are temptations to “achieve” and find my worth in what I do and the approval of others. I’m trying to step back and rest. And I often will remind myself, “I’m more efficient when I rest.” What’s funny about that statement is that I still am finding an excuse for resting. What would it be like if I stop running the show for a moment? Slowing down the crazy pace of life is not only a discipline, it is an act of faith- one that acknowledges that I don’t control all and know all. And I don’t have to carry the universe on my shoulders. That’s freeing. I hope you “achieve” some great rest during this time of the year. Merry Christmas and Happy Holidays!! Yours truly, Justin  Thomas Plets on Pexels This post was originally published on 05/26/2016 on my wordpress and is newly updated. You’re surrounded by setpoints every day. They literally keep you alive. One of them is your set body temperature. If your body drops or rises a mere 15% beyond your core temperature, death occurs. Think of a setpoint like a reference point, a sort of boundary. Medically, it’s called homeostasis. The body regulates internal functioning (temperature, blood flow, oxygen) despite external circumstances. The body is always seeking homeostasis. So is the brain. And you can intentionally take charge for your mental, emotional, and relational health. Examples In our bodies, we break out in a fever when something is wrong- which is one way the body makes conditions unfavorable to viruses and bacteria- because they are temperature sensitive. In addicts, their brains have faced an onslaught of dopamine rushes- and the brain counters it by producing less dopamine to balance out- even sometimes ELIMINATING dopamine receptors. This is the brain naturally seeking to turn down a party that’s gotten too loud. The system Balanced functioning (homeostasis), whether biological, technological, or psychological, will involve three interdependent elements that help reach homeostasis- all centered on a setpoint:
Get negative In order to bring a system back to normal, negative feedback is used to regulate it. So when I say, “get negative,” or course I’m not telling you to have a negative outlook on life. What I AM saying is that a system that is out of control will only be put back in control/order by it being regulated by setpoints, carried out by either an internal or external force- and this is negative feedback. Okay, have I been sufficiently nerdy? Let’s get practical!! Sample exercises Check out how William uses all three processes of homeostasis as a married entrepreneur with children, who is also dealing with some alcohol abuse (#2 in each is the setpoint). Entrepreneur- 1) Financial accounts are reconciled daily by William (outside help oversees them weekly). 2) The business plan was developed with a setpoint of no greater than $100,000 debt. Crossing $50,000 debt signals a problem and requires meeting with the board. 3) If the setpoints are not honored, the board has full power and autonomy to enact established strategies. Temperature- 1) William’s two year old, Thomas, is running a fever- revealed by his behavior, and then it was gauged with a thermometer. 2) If 24 hours pass with a fever over 100 F- or at any point it goes beyond 103 F- the setpoint has been crossed. 3) Visit the doctor immediately. Remodeling- 1) Extra money was left over- discovered in the budget by William’s wife, Katie. 2) They determine no more than $10,000 will be spent on a kitchen remodel. The goal is $8,500; beyond the goal is a warning flag. 3) At the $8,500 mark, a conversation will be held with the contractor to hold to the budget. Alcohol Use- 1) After running into various troubles with alcohol, William considered his personal/family values and health recommendations. 2) A setpoint was made: only 2 drinks or less daily. 3) If this line is crossed, the commitment is to have an entire month sober. If this cannot be done, it is agreed on with his support team to increase treatment (e.g., go to a group, go to counseling). Got the hang of it? These steps can be applied to about anything, though I mostly use the Setpoints Exercise (click on the link below to access!) to help increase ownership and boundaries with addictions. It’s a straightforward way to get honest with anything you are facing, the amount of help you need, and what supports can get you there. This concept has helped assist many of my clients to face problems squarely, and in turn, to be more successful and realistic in addressing life challenges. Give it a try!  Will Malott on Unsplash  Vera Arsic on Pexels This post was originally published on 04/19/2015 on my wordpress and is newly updated. In Latin, Quid Pro Quo means, “something for something.” You scratch my back; I scratch yours. Tit for tat. It’s how the world runs. Or is it? In the business world, this often works. Social psychology calls it “reciprocity.” In relationships, well, this is where it gets fuzzy. Relationships require sacrifice regularly; they require that you stick around, presuming it’s reasonable to do so. In business, if someone doesn’t offer you a good deal, you can move on. If you keep doing this with relationships, you will bankrupt your heart and anyone close to you quicker than ever thought possible. Relationships involve the molding and holding of hearts. Business involves the flow of money. I want to call to the table that many principles that work for business DON’T in relationships, which is partly why someone can be extraordinarily successful in the business world but trade in relationships as often as changing underwear. The concept of reciprocity is fascinating, and I regularly utilize it in respectful ways when I consider how to engage in business, such as when I “add value” to interactions with businessmen and women by offering helpful counseling materials. This, in turn, increases my odds of getting a favorable response. Nothing wrong with it. I attempt to not do it ONLY for this reason. However, when I expect a certain response- demand it, even- I am not respecting a person’s freedom, uniqueness, or spontaneity. And this is precisely the problem when quid pro quo is present as a foundation in relationships. Everyone from Hendrix to Gottman to Eggerichs (see references below) point out the necessity of proactive initiative in love- an active, intentional doing what’s best for another, choosing love over “balancing the budget.” In fact, the eminent researcher Dr. John Gottman states the myth of quid pro quo in The Seven Principles for Making Marriage Work (2002): “But it’s really the unhappy marriage where this quid pro quo operates, where each feels the need to keep a running tally of who has done what for whom” (p. 15). Isn’t this the definition of selfishness? And it tears relationships apart. I don’t know of anyone who says, “Yes, being completely selfish is good; I want to live by the principles of selfishness and teach my kids to do the same.” No one really debates this. How quickly it takes over, though! My role as counselor isn’t to point a finger; it’s to help uncover what’s holding people back. Consider how you might be “losing while winning,” holding grudges, keeping a record of wrongs. These things are the opposite of contentment- and love. "Love keeps no record of wrongs," (1 Corinthians 13:5d) as is often quoted at weddings. Don’t wait for a person to do good to you. That’s the whole importance of the Golden Rule and the Greatest Commandment. If you wait around for the other person to “play by the rules” in loving you, prepare to be unsatisfied. There will come a time (in EVERY relationship) when loving another becomes hard: when the "high" of newness wears off, when the attractiveness of another becomes the norm, when that little quirk that you thought was wonderful turns out to annoy the heck out of you. If it’s left up to reciprocity, we’re screwed. In friendships, romantic relationships- ANY relationship. If a relationship fundamentally relies on quid pro quo, it will prove an unhappy ending. Find out how to love others despite what they bring to the table, and reap the overflowing results. If one person brings a feast to the table, just because the other doesn't bring one won't mean you can’t enjoy yours- and just maybe win them over in love. Sincerely yours, Justin For more information: Business Networking That Works...It's Called Quid Pro Quo (Forbes) Getting the Love You Want (Drs. Harville Hendrix and Helen LaKelly Hunt) Influence and Persuasion (Robert Cialdini) Love and Respect (Dr. Emerson Eggerichs) The Seven Principles for Making Marriage Work (Psych Central summary)  Photo by Everton Vila on Unsplash |
Justin K. Hughes, MA, LPC
Owner, Dallas Counseling, PLLC
justin@dallascounseling.com
P: 469-490-2002
17330 Preston Road, Suite 102D
Dallas, TX 75252
Owner, Dallas Counseling, PLLC
justin@dallascounseling.com
P: 469-490-2002
17330 Preston Road, Suite 102D
Dallas, TX 75252
©2019 Dallas Counseling, PLLC
View our Privacy Policy here.
View our Privacy Policy here.