Ask someone about what makes a relationship strong, and you'll get responses that include trust, honesty, communication or a mix of all three. Trust is a requirement for a healthy relationship. But what happens when that trust is broken? Here are some tips to consider to rebuild the trust in your relationship,

Acknowledge the process will be difficult. Rebuilding trust is a complex and difficult task. Accept that there will be progress and setbacks, it will be time-consuming, and that the relationship may not survive. 
 
Reflect on how trust was broken. In order to fix something, you have to know why and how it broke. Every relationship is different, but usually there are signs of trouble in the relationship. 

What was each person's role? It takes two to tango. It's important to be accountable for your behavior, however, it's equally important to understand how the distrusting behavior came about. I've written more about this process in a post about infidelity. 

Express your pain and uncertainty. People aren't computers. You can't just reboot and wipe out a virus from your system. Share your feelings with the person. Acknowledge that there is pain, confusion, anger, and sadness. You have to purge your emotional world. 

Let go. Letting go is not about forgiving the other person, it's about forgiving yourself and moving forward. In order to move forward in a relationship, you have to come to peace with the past. Letting go can be difficult but it doesn't have to hold you back from happiness. 

Mutual recommitment. Both people have to recommit to the relationship. If there has been infidelity, all communication has to be severed with the person, all communication. You can't recommit when your mind and emotions are somewhere else. 

Communicate. Start from the basics. Seek counseling. If trust was violated, it almost always means the communication was lacking or artificial. Learn how to communicate respectfully and effectively. 

Express what you need from one another. Part of the recommitment process is being clear and direct about not only what was lacking, but also what each person needs moving forward. 

Set goals together. A therapist may be helpful here to provide balance and a realistic expectation. Setting goals together provides two things: 1) both people are on the same page about the direction of the relationship, 2) it's a healthy exercise of communication and connection, which was probably lacking in the relationship. 

Check in regularly. Again, weekly therapy sessions can be helpful here. Or set aside time each week to check in and reflect on progress, difficulties, or changes in the trust rebuilding process. Weekly discussions also keep you invested and mindful of your relationship. Another thing that was lacking that lead to the trust fissure. 

Praise and show gratitude. Praise one another for effort and positive growth, even if it's minuscule. Just like letting go, the process of praising can be beneficial not only for the other person, but also for you. 


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Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

A family member was recently diagnosed with a mental illness. I want to help but I don't know what to do. What can I do for this person?

-- Anonymous August 2014

It's almost a certainty that every person will find themselves asking this question as approximately 1 in 4 people will experience a mental illness during their lifetime. For a comparison, do you know anyone that is left handed? Approximately 10% of the population is a lefty. So you're 2.5 times more likely to know someone with a mental illness than a lefty. 

Mental illness is a condition like no other. An individual's mental illness is unique. Universally effective interventions don't exist in the way that a medical doctor might treat a broken bone. Here are 10 tips for what to do if a family member has a mental illness:

Accept the Illness. Accept that the person has a mental illness. Understand that the symptoms you see are rooted in the mental illness, not the person. 

Educate yourself. What's the first thing someone does when they are diagnosed with a medical condition? Immediate Google search. Do the same with depression, anxiety, or the diagnosed condition. Research not only the health condition but also ways to intervene in positive and healthy ways. 

Attend health professional appointments with your family member. Ask questions at appointments about symptoms, warning signs, and coping strategies. 

Combine your Google education with your family experience. I tell patients and families that they are the expert on themselves and their family. With your newly found education from researching the illness, see how that education fits with your family. Not all individuals have the same family dynamic and symptom presentation.

Respect. Treat each member of the family with respect. A mental illness does not make anyone less valuable or worthy. Although this previous post is about addiction, many of the tips can be generally applied in how to communicate in a respectful and empathic way. 

Keep your family intact. Yes, a mental illness calls for an increase in attention, time, and energy for that individual, but don't lose focus on the other members of the family. Continue family activities to the extent that you can.

Be realistic. One of the first questions I hear is, "How long does this last and when is it cured?" There isn't an easy answer. Have a major goal in mind but break the big goal down into smaller goals. In developing these goals, include all appropriate members of the family, including the person with the mental illness. 

Stay connected. It's not uncommon for families to experience shame, confusion, and embarrassment. Part of your education is accepting that one person isn't to blame, and it's vital to stay connected to others. Continue relationships with friends and other families. Reach out to support groups through organizations like NAMI.

Be a clear and consistent presence. It can be difficult but be a consistent and healthy support for your family member. Find that healthy balance and stay away from contributing to unhealthy behavior. Sometimes your love can enable unhealthy behaviors and decisions. When you find that line, have a discussion with your family member about how you see your role in their life and the possible limitations of your role. 

Stay healthy. Make sure that you continue to make healthy decisions for yourself. Be aware that you aren't significantly sacrificing your mental health in trying to fix a loved one. You can only help when you are at your best, or at least in a mentally strong state. Whatever activities help you manage stress, continue them. 

I often recommend family members to participate in their own therapy as it can be incredibly stressful when dealing with another family member's mental illness.

Remain hopeful, realistic, but hopeful. Hope doesn't fix a mental illness, but it provides an atmosphere to remain motivated to overcome a mental illness. Hope doesn't have to be the notion that this mental illness will be gone by the end of the week, it can be that we are going to have a good day. 

As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support! 

I don't know how it happened. My child is obese and refuses to eat healthy foods, what do I do? 

--  Anonymous May 2014

Childhood obesity has now reach an epidemic level in the United States. Here are the latest statistics (CDC, 2012):

Childhood obesity has more than doubled in children and quadrupled in adolescents over the last 30 years.

Approximately 20% of children and adolescents are considered obese. 

70% of obese teens and kids had at least one risk factor for cardiovascular disease.

There are many more troubling statistics but you get the point. The weight of our children is possibly the biggest childhood issue that is known today. However, obesity isn't exclusive to childhood as over 1/3 of adults are obese and 2/3 are either obese or overweight. 

Simply stated, obesity is defined as having excess body fat based on the body mass index (BMI) scale. Like most health issues, experts point to a mixture of genetic, environmental, social, and personal factors. That's true to an extent, but you can certainly have a significant impact by the daily choices you make. 

What Can I Do?

Get to the root. Really ask yourself, "How did this happen?" Weight issues don't happen overnight. Be thoughtful and honest about what factors played a part in your child's weight gain. 

Also, consider there may be an underlying issue like depression or an overactive gland. Consulting with your primary care physician may be appropriate. 

Educate your child and you. Schedule an appointment with a nutritionist. Read about healthy eating. Talk to your child about the rewards of healthy eating and the risks of unhealthy eating. Is the overeating a way to cope?

Co-create. Especially for kids, it's helpful to have a schedule or plan on paper. Work together with your child on a plan and remain firm that there will be changes, maybe even drastic changes. 

Co-creating something with your child gives them the sense that they have control and a say in their life. It makes them feel important, because they are. 

Healthy choices. Yes the ultimate goal is to lose weight. The current goal is to make healthy choices. Many people use the weigh scale to measure progress. Start with healthier choices. 

Progress sometimes can be your child trying a carrot, or 
eating a healthy portion of their favorite snack instead of the entire box. Don't confuse progress with success. 

You have obviously tried to give your child healthy options. It might be worthwhile to think outside the box or try something different. Here is a previous post about picky eaters and some tips. 

Decrease unhealthy options. Give your child choices but decrease the availability of unhealthy foods. If you have to, keep unhealthy snacks out of the house. 

In my home, our steak knives are on the kitchen counter. When our children were old enough to reach them, we explained they were sharp and not toys as knives can really hurt. After about the 3rd lecture, we realized that the easiest thing to do would be to move them to an unreachable position. 

The same goes for food, if your child can't control their portion, then do it for them. Healthy boundaries aren't just for your relationships. 

Be active. No, you don't need a personal trainer. Go for a walk after dinner, make it a family outing. If they aren't the athletic type, find non-athletic but active activities. 

Drink water. I have emphasized drinking water in other posts. It is healthy and necessary to drink water. Water is an appetite suppressant and increases your metabolism. 

If your child doesn't like water, then compromise by adding some fruit or flavor the water. It's healthier than drinking soda or fruit juices. 

Slow down. When your child is eating, slow them down. The faster your child eats, the more they will eat before they realize they are full. 

Slow your child's eating by cutting their food into smaller bites, encouraging water between bites, and giving them parts of their portion every few minutes instead of all of it at once. Make a game of eating and see who can chew one bite the most. 

Have conversations that your kids enjoy. Kids are more likely to eat more slowly if they are talking about Spiderman or Frozen than homework.  

Be realistic. Set real goals for your child and yourself. Almost everyone thinks in the terms of losing X weight in Y days. A realistic goal for the first week or month may actually be to keep the weight steady. A goal for the day may be to try one new food or to wait 15 minutes when hungry instead of eating right away. 

Be your child's cheerleader. Praise your child for even the smallest success. One of the toughest challenges to losing weight is feeling hopeless and not seeing progress. Praising your child instills hope and helps your child realize that progress is happening, even if a goal hasn't been met. 


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It's a topic that many don't want to talk about but it's a problem here and across the globe. I keep not wanting to write about this, but time and time again I am reminded that it is needed. About 10% of children are sexually abused (National Center for Victims of Crime). That number breaks down to approximately 20% of girls and 5% of boys. Approximately 60% of victims are abused by someone in their social circle.

What Do I Do? 

Remain calm. Yes, it is easier said than done, but it's very important to try to remain calm because it helps your child remain calm.

Find a safe place to talk. Children are usually confused, scared, and anxious. Provide a comfortable environment. 

Listen to your child. Your child may have difficulty putting their experience into words. That's okay, just listen.

Seek medical attention. Seek medical attention if appropriate. Sometimes there can be internal injuries that aren't visible. Ask if their body hurts and where. 

Stay connected. Your child needs you the day they talk and the days and weeks following. Observe your child and look for signs that they are having difficulty coping. Children who have been abused often isolate themselves, are vigilant, use inappropriate sexual language, are easily upset, and can experience separation anxiety. 

Praise your child. Praise them for their bravery to speak up. Praise them for their honesty. 

Seek outside support. If you feel it is necessary, seek outside support to help your child cope. 

What Not To Do

Do not confront the alleged perpetrator with the victim. Almost everyone experiences the thought of confronting the perpetrator. Do not do that with the victim. 

Do not ignore what happened. Don't sweep it under the rug. Don't "protect the family" or the "reputation" of the alleged perpetrator. 

When you ignore what happened (even if you have doubts), then you are condoning the actions of the perpetrator and disbelieving the victim. I've had many people share that they feel this way, and that can cause irreparable psychological damage.

Do not blame your child, directly or indirectly. Many kids feel like they made a mistake, or did something bad. Make sure your child knows that they aren't to blame and that the other person needs help. 

Child abuse (any type) is a challenging and heartbreaking situation. However, research shows the most important thing you can do for a child is provide a loving and supportive environment. If your child knows you are on their side and you believe and love them, that can be all the child needs to recover and even thrive. 


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Parents have described this scenario as their "worst nightmare." They aren't specifically referring to their child's mental illness. They are speaking to the helplessness they feel, to take their child's pain away. 

In my 10 years of working with families, parents are getting better. They are acknowledging their child's mental health issue and actively taking steps to meet the challenge head on. Before we get to the suggestions, let's review a few signs of childhood mental illness.

Warning Signs of Childhood Mental Illness

Mood change. A shift in your child's mood that has lasted more than a few weeks and causes problems in relationships at home and school. 

Behavior shift. Sudden changes in behavior, including dangerous and aggressive behavior, that causes problems in relationships at school or home. 

Academic problems. Your child's academic performance has dropped sharply in the last year or even months.

Sleep. Your child sleeps significantly more or less than usual or has difficulty falling asleep. 

Isolation. You don't hear about friends anymore. Your child spends most of the day in the bedroom and is no longer interested in hobbies or activities. 

Substance abuse. Yes, drug and alcohol use is far too common. No, that doesn't make it okay or healthy. You may think it's just "teens being teens" but it might be more than that. 

Tips To Consider If You Suspect Your Child May Have A Mental Illness

Consult your pediatrician. Not all pediatricians are well-versed in mental health issues but they can rule out medical issues. Sometimes a medical condition can present or lead to mental health issues. 

Seek out professional psychological help. Usually your pediatrician can help with a referral. Google is also your friend. Search your local area for child psychologists and other mental health professionals. 

Be patient. It's hard seeing your child struggle, and not having the answers. With that said, be patient. Find the right professional(s) for your child and your family. 

Stay engaged. Sometimes it's easier to distance yourself from the issue. Stay committed and active. Participate in appointments and discussions. You know your child better than any doctor. I always encourage parents to share their thoughts and questions. It's invaluable.

Don't blame your child. Maybe this should be the first tip, because it's probably the most important. Be supportive. Your child is already feeling a number of emotions, no need to add guilt and shame. 

Keep the communication lines open. Make sure your child knows they can talk about their feelings. Sometimes kids can feel ashamed and confused. It's important to try to keep communicating, even if only to listen. 

It's a process. Mental health is messy. There isn't a clear cut cure for anxiety or depression. Each person is different and with that comes a unique treatment plan. Recognize that treatment is a process. 

Find support for you. It's stressful and scary. It's also common to feel isolated and alone. Lean on family, clergy, friends, and even other families who are going through the same experience. You might be surprised (pleasantly in an odd way) by the support groups and helpful programs that are located close to you.


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As a child psychologist, I have worked closely with not only families, but also the schools. With these professional experiences (paired with my personal experiences), it has become abundantly clear that the best schools have the most active, engaged parents. 

I'm not suggesting that teachers, school staff, and other support staff are unimportant. They obviously are and will always be important. I'm suggesting that the best schools have parents helping in diverse and meaningful ways. There seems to be an underlying belief that the parental role is limited to making sure your child is punctual, homework is complete, and permissions slips are signed. Parents can and should do so much more. 

Yes, there are the basics: PTA meetings, parent-teacher conferences, and open houses. The basics, as in each parent should already be attending these events. Participation in these activities doesn't constitute getting "involved". Complaining without constructive suggestions and personal investment isn't getting involved. So if you have a problem and have no intention of removing your child from the school, bring a solution with your issue. 

How To Get More Involved

I know, every parent is busy. Everyone is busy to an extent. I'm not suggesting to volunteer 4 hours a week, or even 4 hours a month. Even 1 hour per month can make an impact.

Contact the school with your idea(s). Start with contacting the school with your ideas and how you can help. Again, if you have ideas, suggestions, or criticisms, be sure to include how you can be a part of the solution. In my experience, schools are always open to parents' suggestions. The deflating part is when the conversation begins and ends with the idea. 

Inquire on what the school needs. New computers, improved security, keeping the school grounds clean. Sometimes it's just being available during recess. Usually a school has a "wish-list". Ask about their aspirations and determine if you can help.

Be realistic. You don't have to develop a new academic standard or spend all week volunteering. Determine how much time you can give and plan accordingly. You'd be amazed by how many kids value even a 5-minute interaction, even if it's a chat about the weather. 

Be consistent. This is true in life, but certainly true if you are working with kids. There is always excitement at the beginning of a project, and sometimes frustration builds when you hit a road block. Stay consistent. If you say you're coming the first Monday of the month from 9:30-10:00am to help with snack time, then do it.

Put away your pride. If you are an artist and can help with the art program, then awesome. If you are a professional and the school needs someone to manage snack time, then do it. There is no shame in helping a school improve, regardless of the task. Sometimes you have to sacrifice your personal aspirations for the good of the school.

You Are Helping Your Kid, Even If They Don't See You

We depend on schools to foster academic achievement in our kids. Sometimes we mistakenly ask them to take the lead to foster emotional and social development as well. That's not their job, it's the parents job to lay the emotional and social foundation of our kids. The school provides emotional and social opportunities. 

By being more active in their school, you are teaching your kids to be engaged in the community, the spirit of volunteering, and that you are invested in their school experience. Your school involvement can boost your child's self-esteem, self-confidence, and the parent-child relationship. 

So do you want your child to attend a great school? It starts with you. 


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I want to expand on "The Biggest Complaint From Kids About Their Parents Is..." post from a couple weeks ago by briefly describing 10 ways to make sure that your kid will hate you. The title is partially in jest but the reasoning behind this post is serious. When kids express to me anger about their parents, it's common for them to talk about some or all of the items below:

Dismiss their feelings. The rationale here is covered by the "The Biggest Complaint From Kids..." post linked above. 

Correct their feelings. It's one thing for a parent to ignore and brush off a kid's feelings, it's an entirely different to tell them what they are feeling is wrong. A feeling may be misdirected, based on inaccurate information, or expressed in an unhealthy manner, but it's not wrong. It's a feeling.

Hypocrisy. Kids, especially teenagers, have a sharp radar for hypocrisy. Be fair and straightforward. Whatever you do, limit statements like, "Do as I say, not as I do." You can sometimes pull that type of cliche on younger kids, teens will eat you up alive. 

Always playing the parent card. Key word here is "always". Sometimes it is completely appropriate and healthy to play the parent card. Do it too much, and a couple of things happen: 1) kids lose respect for you because your decisions are based on what other parents do and 2) kids won't talk to you about serious things because they feel the parent card will be used at any time.  
Choose their hobbies and activities for them. Yes, sports may have taught you about life. That doesn't mean it will do the same for your child. Let them discover what they are passionate about. You can introduce them to things you liked, but recognize the difference in your aspirations and theirs. 

Inconsistent parenting. I repeat this tip again and again because of its importance. Different parenting styles aren't complementary, they are confusing and annoying. The analogy I use for adults is imagine having two bosses where one says you have to be in the office on Fridays and the other says work from home on Fridays. That feeling you feel right now is how kids feel when they get different messages from parents. 
 
Talking in front of your kids like they are invisible. Nothing is more belittling than someone talking about you to others in your presence. Nothing is more irritating than someone talk about you to others in your presence. No different for kids. 

Focusing on the negative. It's important to help kids understand where they made a mistake and reflect on how to do something differently next time. However, no one wants to be around someone who is always focusing on the negative. If you are focusing on the negative, don't be surprised when your kids head straight to their bedroom once they enter the house. Don't be surprised when they focus on the negative, too. 

Judging their friends. As kids get older, their peer group becomes a bigger part of their identity and self-esteem. Criticizing your kid's friends is like criticizing your child. This doesn't mean their friends are off-limits, just be careful in how you present your feedback. 

Stop caring (and loving). At first I was surprised when I heard kids complain about their parents letting them do whatever they want. However, what they said next was always the same. Kids felt that when parents stopped caring, they stopped loving. Even for kids who fight with their parents constantly, the loss of feeling loved can have devastating consequences. 

I wrote this post for parents but I hope everyone reading can see how these items can lead to problems in any type of relationship, not just the parent-child relationship. At least as an adult you usually have the option of ending the relationship or at least limiting time spent with that person. 


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If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. You can also follow me on twitter here. Thanks for your support!

In working with families, a big part of the therapy process is helping each family member find their voice in a healthy and productive manner. In finding your voice, I am referring to the ability to express your thoughts and opinions in a way that is heard and respected.

Unfortunately in many instances, family conflict revolves around finding your voice, or lack thereof. The biggest complaint from kids about parents is they aren't allowed to express themselves, they are either dismissed or ignored. When this issue is brought to the attention of parents, the parent(s) usually has a logical and reasonable explanation. For example, a kid suggests pizza every night for dinner and the parent responds with a “no” without discussion. Many will read this and think what's the problem. The answer is it depends.

If you have a kid that feels heard and validated, then this conversation isn't a problem. If you have a kid that feels ignored or unheard regularly, then this is another example of being dismissed. I'm not suggesting to have pizza night nightly or even every week; the issue here is allowing your kid to speak their mind, to have a say. In this situation, I would suggest for the parents to listen to why it makes sense to have pizza every night, empathize with your kid's excitement at the idea of having pizza nightly, and ultimately explain why this proposal is unrealistic.

Again, many may be thinking why even go through these steps for such a silly proposal. It's less about the proposal and more about having a real, fair conversation with your kid. The more a parent listens to a kid's thoughts and feelings, the more likely the kid is to respect and accept a parent's decision.

I thought it would be helpful to share a few statements that I hear on a regular basis from kids about their parents:

Parents are always right, they are never wrong. This is a big one. What's the point of expressing your feelings to someone who isn't open to another perspective? In these situations, kids distance themselves, the relationship weakens, and kids go elsewhere for care and support.

When it's clear that they are wrong, they never say they are sorry. Apologize when appropriate. I say this all the time to parents and anyone in a mentor role. An apology expresses that you care about the other person and it's perfectly normal to be imperfect.

They don't follow the rules that they make us follow. If your kid makes this type of observation, take a moment and reflect on if they have an accurate impression of what just happened. Even if they don't, ask them why the feel the way that they feel. If they are right, then admit it.

Obviously not all kids feel express these type of parental issues, not even some of the time. However, these are great examples of how kids can feel helpless and unheard. Help your kid find their voice in discussions, it will help with their self-esteem, confidence, and future relationships.


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If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. You can also follow me on twitter here. Thanks for your support! 

There is an underlying belief that the legalization of marijuana is harmful because marijuana is a gateway drug. I always ask law enforcement about marijuana being a gateway drug and the answer is almost always a unanimous yes.

However, research tells a different story. I'm not about to argue for the legalization of marijuana, that isn't the message I'm attempting to convey. Rather, I'd like to illustrate how alcohol is actually the gateway drug, and how we as a society seem to be okay with alcohol's harmful and often deadly consequences.

A recent study found that teens who abused alcohol are twice as likely to abuse prescription opiate drugs than those who only used marijuana. This is an important statistic because prescription drug abuse and overdoses are skyrocketing across the country. Opiate drug overdoses kill more Americans yearly than cocaine and heroin overdoses combined.

Alcohol research tends to focus on underage/teen use. In a recent survey by the Centers for Disease Control (CDC), 25% of 8th graders, 40% of 10th graders, and 53% of 12th graders reported drinking alcohol in the last month. If this isn't alarming enough, the study dug deeper and found that 79% of teens drank because it felt good, 67% to forget their problems, and 66% because of peer pressure. For me, these responses allude to underlying mental health concerns like poor self-esteem, deficits in coping skills, depression, anxiety, and loneliness.

Makes sense, right? Adolescence is tough for teens and parents. Teens are dealing with social and academic pressures, identity issues, and navigating the world of independence. So what's the excuse for adults? Over 35,000 adults die each year from dependent and non-dependent use of alcohol (CDC). When including unintentional deaths, homicides, and other indirectly related deaths, the 35,000 number more than doubles. According to the National Council on Alcohol and Drug Dependence (NCADD), alcohol plays a role in approximately 40% of all violent crimes in a given year. That equates to almost 4,000 violent crimes per day.

Most feedback from adults for reasons to drink ironically sound very similar to teen responses: for fun, to relax and forget about problems/stress, and because of social expectations. The problem here is the more you drink, the worse you think. Over time, social drinking can evolve into an addiction and into your preferred coping mechanism for stress or any issue.

So what is really being said when a teen is told that they can't drink until the arbitrary age of 21? You aren't old enough to handle the responsibility of drinking at this time, wait a few years. The problem is that millions of adults show time and again that they can't handle the responsibility either. Research repeatedly shows that most people use alcohol as a coping mechanism, as a way to avoid real life issues.

At a societal level, it seems there is a hint of “oh, he's been drinking, that explains it,” to justify behavior. It is almost as if alcohol is being blamed, taking away the responsibility from the individual.

There needs to be a shift in the alcohol dialogue. There needs to be more honesty and courage. Alcohol needs to be talked about for what it is, an unhealthy coping mechanism for many that kills tens of thousands every year. The statistics don't lie. Maybe “happy hour” should be renamed “ignore your problems hour".


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