What to Expect at Your First Therapy Session

1. You're never sure what kind of mood your parents will be in before you walk in the living room or kitchen.

Let's put this on record: parenting is tough — especially on top of trying to maintain a work-life balance. But, this doesn't mean you're meant to be unsure of what to expect every time you come around your parents. If you have to "'read the room'" a lot "before speaking," Slavens indicates this is one of the more subtle signs of dysfunction.

This is where you may have learned how to become passive-aggressive if that's something you struggle with. The reason for this is because "clear and direct communication is avoided and/or seen as bad or aggressive," according to Dr. Miller.

2. You tend to feel like you're constantly compared to and in competition with your siblings.

My heart truly wants to believe this isn't intentional behavior from parents, but I can't say I haven't heard people talk about feeling like they'd never measure up to the 'golden child' of their family. You may have felt insecure about your grades, the college you chose to go to, your career goals, or even your physical appearance. Slavens says this "struggle with self-worth or second-guessing yourself constantly" is yet another sign that your family's dynamic wasn't the healthiest.

Also, Dr. Miller says this could've caused you to learn to "shrink yourself in the presence of loved ones." Even worse, you may "feel the need to hide pieces of yourself in order to be loved and accepted."

3. There was constant yelling and screaming during arguments, making you fearful of disagreements or hardships.

If you grew up in a home where arguments always led to screaming and yelling, chances are you're not a fan of loud voices or hard moments. Honestly, Slavens says it's not hard to believe that "conflict make you anxious, even when it’s minor." Unsurprisingly, you may have become a referee during these arguments and currently find yourself being a mediator in your platonic or romantic relationships. Why?

Dr. Miller says, "You constantly feel the need to manage everyone else’s emotions often at the cost of your own needs and wellbeing." You know, to keep the peace.

Here are some more obvious signs you grew up in a dysfunctional family

4. You had to take on a parental role when one of your parents decided to stop being an adult.

I imagine that having an emotionally immature parent is one of the most aggravating and stressful things to deal with. Not only that, but you may have had to help keep the household afloat. You may have had to get a job or two to help pay bills, listening to an adult conversation as your mom or dad laid their problems at your young feet, and more!

If you "family roles were flipped" and you "maybe had to parent your own parents," Slavens says this is a form of emotional dysfunction.

5. You weren't allowed to go anywhere with your friends because your parents wanted to keep an eye on you at all times.

Slavens says boundaries that "didn't exist" or "were rigid and controlling" is a sign your home was a little...interesting. Being concerned about your whereabouts is one thing, but it's another when you're unable to do anything without your parents' eagle-eyes on you. Something as simple as going to the mall with your friends may have become a lecture about the dangers of shoplifting or car wrecks. Again, these are valid concerns but they shouldn't be treated like the verbal form of doom scrolling.

6. You consistently witnessed one of your parents abuse alcohol or drugs at home.

This is a tough because substance abuse is so prevalent in varies socioeconomic statuses and communities. From the functioning alcoholic to the one who becomes belligerent after they've had too much to drink, it always affects those around them. Slavens says if "there was ongoing neglect, substance abuse, or verbal/physical aggression," your home probably didn't safe.

I recognize some of these signs of a dysfunctional family. But that doesn't mean they're affecting my current relationships, right?

I hate to break it to you, but it's possible your childhood wounds have shown up before. "Dysfunctional dynamics don’t stay in childhood — they tend to creep into how you connect with others," says Slavens. Similarly, Dr. Miller agrees that "we typically repeat what we learned at home with our families in our other relationships." How?

"This includes the beliefs and rules we follow, often completely subconsciously, about what can and can’t talk about and why, as well as what emotions are allowed to be expressed, who can express them and how, and how we should or must respond to those people and their emotions," explains Dr. Miller.

Another way to look at this is how Slavens has outlined it:

In Platonic Relationships:

1. Overextending yourself to please others, even at your own expense
2. Feeling like you have to "earn your friends' affections.
3. Avoiding vulnerability because it feels unsafe.

In Romantic Relationships:

1. Struggling to trust your partner or feeling overly suspicious
2. Repeating patterns like dating people who are emotionally unavailable or controlling.
3. Feeling overly responsible for your partner's happiness — or relying on them for yours.

OMG! How do I unlearn habits from my dysfunctional family?

Honestly, everyone has a few bad habits they've carried from their childhood to adulthood. You're not an outlier because some things weren't 100% normal so I don't want you to feel like you're a failure for not having having it all together. "Dysfunction doesn’t have to define your future relationships," Slavens assures. Dr. Miller says you can start to unlearn things "that aren't working for you anymore" by "gathering your family's larger context to gain insight into how and why, for them, the behaviors make sense."

By taking a look at your family's "history and larger social and political contexts" gives you a chance to "see them as whole people with full lives," she says. Once you do that, she believes "you can examine what pieces make sense for you to keep and what parts you'd like to learn to do differently." Her other suggestion? Don't forget you're ability to utilize a "therapist who works systemically, like an LMFT" who "can be a huge support in this process."

Slavens' tips include the following:

1. Practice self-awareness: Notice when a response feels automatic — like people-pleasing or shutting down during conflict — and ask yourself, Is this helping me, or is this a leftover habit from the past?
2. Set boundaries: If your childhood lacked healthy boundaries, learning to say “no” without guilt is a game-changer. Boundaries protect your energy and teach others how to treat you.
3. Learn healthy conflict skills: If conflict made you feel unsafe growing up, it’s natural to avoid it. But healthy conflict is necessary in relationships. Practice expressing your needs calmly and directly.
4. Therapy, therapy, therapy: A good therapist can help untangle the messy, “weird” things that got normalized and give you tools to rebuild healthier ways of relating to yourself and others.
5. Surround yourself with healthier models: Whether it’s friends, mentors, or books/podcasts, seek examples of functional relationships and start observing what feels different.

While you're busy unlearning things, Dr. Miller also wants you to remember something. "Recognize that how your family does something is simply that; how your particular family system figured out and were taught to navigate the world. It isn’t inherently right because you’ve normalized it nor is the way another person or family does it inherently wrong," she says.

Are there really assigned roles in friend groups or am I just imagining things?

Like I said before, it can seem like you and your friends unintentionally gravitate toward certain 'roles.' It's not like anyone woke up one day and decided, "I'm going to be the 'mother hen' of the group," but it tends to happen. Why?

Paruolo says, "In my clinical work, I've consistently observed that our friendship roles often mirror our early family dynamics. These patterns show up naturally — think about who in your friend group gets the first crisis call, who plans all the gatherings, or who everyone turns to for emotional support." I'm willing to bet you thought of a name for each scenario — including yours — because I know I did!

"Like in families, we each fall into specific roles that feel familiar to us," Paruolo further explains.

What actually makes someone an empathetic person?

There's so many definitions for empathy, but I thought it would be wise to ask a licensed professional for her opinion on the matter. "Empathy means to feel what others are feeling. You do not have to have a personal direct experience with something to feel empathy for another person," shares Paruolo.

For example, your friend could call to tell you she has to have fibroid removal surgery and is feeling scared. You may have never had surgery, but you could find yourself feeling the need to comfort her in spite of this. Paruolo says, "The cool thing about our brains is that we have mirror neurons, which means part of our brain is set up to feel what others feel. The ability to attune to others' emotional states comes naturally to some people, while others may need to develop this capacity more consciously."

To break it down even further, here's signs that Paruolo says point to your empathetic nature.

Physical Signs:

• Getting physically exhausted after being in crowds
• Feeling drained after social interactions, even enjoyable ones (OMG I feel so seen!)
• Needing extra time alone to recharge

Emotional Signs:

• Absorbing other people's emotions like a sponge
• Feeling anxious or overwhelmed in emotionally charged environments
• Finding it hard to watch violence or cruelty in movies/TV

Social Signs:

• Feeling responsible for others' happiness
• Having trouble saying "no" to people who need help

Mental Signs:

• Picking up on subtle changes in others' moods
• Being highly attuned to body language and tone
• Finding it hard to distinguish your feelings from others' feelings

It sounds like I'm the empathetic friend, but are there any downsides to this?

I've been an empath for as long as I can remember and I've found that I have to 'recharge' my social batteries at times. I thought it was because I was trying to be superwoman by fixing others' problems, but it turns out theres more to it than that. Paruolo says, "Empathetic friends and people have an uncanny ability to sense others' emotional states even when unspoken, and frequently need recovery time after intense social interactions. They tend to be deeply affected by others' experiences and naturally consider situations from multiple perspectives."

In the long run, she says it can be "distressing" for some people to always feel the feelings of others. Over time, she says, "it can cause you to shut down and retract." This can look like not being as quick to respond to the funny memes your friends send you or not even answering their phone calls right away.

But, this doesn't mean you're the only person who tends to go through this. "Many empaths struggle with maintaining boundaries due to their deep emotional attunement," she says. Color me guilty because this sounds so much like me. It got so bad at one point that my sister nicknamed me 'Captain Save-A-Lot,' which is actually the clean version of what she truly meant. Still, empathy fatigue is no laughing matter nor does it mean you're defected. You just have the natural ability to show people their feelings are important to you.

How can I protect my peace as the empathetic friend?

You know you need to set boundaries, but what does that mean? Paruolo says, "The key is understanding that empathy needs to be balanced with compassion - it's not just about feeling others' emotions but also knowing how to help without depleting yourself."

One of the things she loves to do is "encourage empaths to set clear boundaries around their emotional availability and make time for regular grounding exercises." As with gratitude journaling, try to focus on an activity that calls for you to be present. Focus on what you can hear, see, touch, taste, and smell.

"Self-care isn't just a luxury; it's essential maintenance for empaths. This might mean scheduling alone time, finding a supportive therapist, or joining communities where you can process your experiences," Paruolo implores.

I know how to be there for others, but how do I ask for emotional support when I need it?

You may feel like it's impossible to ask others for help since your shoulders are the ones people cry on, but you're only doing yourself a disservice by not speaking up. No one's super resilient or able to handle all of their distressing feelings alone. We're not meant to.

It's the reason Paruolo wants you to speak up about what you need. "The most effective approach I've seen is being direct about your needs rather than hoping others will figure them out," she says. I made this mistake during postpartum and found myself expecting my family & friends to know exactly how I felt, but they're not mind readers. The more I verbally asked for help with little or big tasks, the more my mental and emotional load lightened.

Paruolo wants you to look at "asking for support as strengthening your friendships through trust and vulnerability, instead of waiting until you're overwhelmed." By the time you reach that point, you'll be ready to enter rage or full-blown shut down mode and they're not fun.

Avoid unlocking their proverbial doors by scheduling "regular check-ins with trusted friends," suggests Paruolo. "This creates a sustainable support system and helps prevent emotional crisis points.

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