Marriage Counsellor and Psychologist Shivani Misri Sadhoo

When you have been cheated on by your partner, you surely feel broken, lost and so many other emotions including humiliation. Cheating also transforms us as a person and it generally, is a permanent change. Have you been cheated on? Read this to confirm if these changes were experienced by you too as shared by Delhi’s leading marriage counselor Shivani Misri Sadhoo.

Relationship expert Shivani Sadhoo says getting cheated in a relationship could have a profound impact on a person’s emotional, psychological, and behavioral well-being. Here are certain common ways that being cheated on can change a person:

Loss of Trust:

Infidelity shatters the base of trust in a relationship. It can make a person skeptical and suspicious, not just in future relationships but also in their overall interactions with people. They may find it difficult to trust others, including close friends and family members.

Emotional Distress:

Discovering that your spouse has cheated on you can cause intense emotional pain, leading to feelings of betrayal, anger, sadness, and humiliation. This emotional distress may persist for a long time, even after the relationship has ended. It can also trigger anxiety and depression, impacting a person’s mental health.

Self-Esteem and Self-Worth:

Being cheated on can profoundly hit an individual’s self-esteem and self-worth. They may question their attractiveness, worthiness, and their ability to maintain a healthy relationship. This can lead to feelings of inadequacy and self-doubt, which may affect their future relationships and overall self-confidence.

Relationship Problems:

People who have been cheated on mostly find it challenging to form new romantic relationships. They may struggle with intimacy and fear being hurt again. It can be challenging to fully open up and trust a new partner, leading to difficulties in building a deep emotional connection.

Insecurity and Jealousy:

The experience of being cheated on could make a person overly vigilant and possessive in future relationships. They may become excessively jealous, constantly seeking reassurance and validation from their partner. This insecurity can strain relationships and create a cycle of suspicion and doubt.

Fear of Abandonment:

Infidelity may instill a fear of being abandoned in a person. They might worry that they are not enough for their partner, leading to clingy behavior or a constant need for reassurance. This fear can hinder the development of a healthy and balanced relationship.

Problems in Forgiving:

Healing from infidelity mostly involves forgiveness, but it could be a challenging and lengthy process. Some persons might find it difficult to forgive their partner or even themselves. Lingering resentment and bitterness can hinder personal growth and prevent the person from moving forward.

Alterations in Behavior:

Being cheated on can lead to changes in behavior and coping mechanisms. Some individuals may become more guarded, emotionally distant, or reluctant to commit to future relationships. On the other hand, some may become overly vigilant, snooping through their partner’s belongings or invading their privacy due to a fear of being deceived again.

It is essential to note that while being cheated might have significant impacts, not everyone will experience these changes in the same manner. Each person’s response to infidelity is unique, and healing and recovery processes differ from person to person. Seeking support from friends, family, or professional counselors can be beneficial in navigating the aftermath of infidelity and redeveloping trust.

Personal boundaries are the “limits” that a person needs in his/her life and relationship, to dictate to other people how they should treat and behave with them and what they can expect from them. Unfortunately, a lot of people set poor personal boundaries and suffer, day and night in their friendship, professions, and relationships.

The problem lies in the fact that as toddlers and children, society teaches us to say “Yes” to elders, be it in school or at home. Society at large appreciates obedience and does not encourage kids and teenagers to ask questions, which in fact is the foundation of a free mind, self-belief, and bravery.

The problem starts when this obedient child, grows-ups and enters the throat-cutting competitive world, find himself/herself in a group of peers, or finds a partner with poor morals and weak self-belief, and fails to say “NO” against emotional, psychological, and materialistic worldly exploitations.

In today’s blog, India’s eminent psychologist and couples therapist Shivani Sadhoo signs that can help you identify if you are suffering in your life due to poor personal boundaries.

1. You completely hate it when you let others down

It means that you mostly go along with the other person’s plans and say yes to all the things you wouldn’t normally choose to do, and possibly do not want to do. Joining added committees, agreeing to visit restaurants where you know you will not be able to avail anything for your kid’s health restrictions on the menu, opting to go along with a messy schedule at work in an attempt to accommodate your boss’ new whim.

2. You are continuously tired and don’t even know the reason

And every mother said, “Yes” Though it is completely different from “mom-tired,” it is incredibly common. It occurs as you are giving all your energy away by continuously tending to everyone else’s wishes and needs and putting your own interest on the shelf.

3. You feel like how other person feels is solely up to you

You always worry whether they are having a good time and feeling good. You go beyond your limits to make certain this is the case. It means you feel guilty and anxious quite regularly. You seldom feel settled because there is always going to be an individual who is upset or a blame to put out. And you ought to be the one to do it.

4. It’s simple for others to take advantage of you

It’s simply for others to take advantage of you. You are pretty certain that is not what you agreed to, but you would rather not say anything. And they also, know you won’t either. You might even wonder if you are being manipulated by those who are actually closest to you.

5. Deep within you think no one respects you

This is perhaps because you have been pushed over far too many times, so they never think they need to.

6. It is too difficult for you to take and make decisions on the basis of your own needs

You are not able to take any stand for yourself because you feel what others want or will feel.  Eventually, when you truly decide for yourself, you find it overwhelming or exhausting.

7. You are not certain who you are or what you like

Perhaps you may feel like having an identity crisis. You do not know what you prefer or love. How it feels to make a decision on your own interests. Rather you are preoccupied with what others want you to do.

Stay tuned to Saarthi’s blog because we will be posting soon the article by Shivani Misri Sadhoo on ways one can set their personal boundaries correctly.

BPD or borderline personality disorder is relatively common. Actually, it is estimated that one in 100 people live with this condition. Or, to put it in a different way, 1.4%of the adult population has been diagnosed with BPD — the majority of them women.  And yet, in spite of its prevalence, this illness remains quite stigmatized. Most individuals do not know what borderline personality disorder is. Their only information of the condition comes from the media, and from shows and cinemas such as Fatal Attraction or Tamasha But the actual condition differs quite a bit from the movie portrayals. There are still several misconceptions about BPD.

Shivani Sadhoo says borderline personality disorder (BPD) is a mental illness that is usually misunderstood by the general population and even certain healthcare professionals. It is also a disorder that has the ability to negatively affect the lives of others. Because of the two issues, there are several misconceptions about BPD. But if you or someone you know has BPD, it is important to understand the facts about the illness in order to start recovery. There is both help and hope.

So this article, by Psychologist Shivani Misri Sadhoo talks about what is a borderline personality disorder? The signs and symptoms, and how it is treated? Here is everything one needs to know about borderline personality disorder.

What is BPD?

A borderline personality disorder is a personality disorder or illness marked by an ongoing pattern of differing moods, self-image, and behaviour.

People having BPD might experience mood swings and/or perceive things in extremes, i.e. everything is excellent or worst. Life is black or white. People having borderline personality disorder struggle with their sense of self-worth. Their self-image is usually distorted and/or unstable, as are their relationships. They might swing from being extremely close to the friends and loved ones in their life to being completely angry and/or distant.

The Signs and Symptoms

While everyone will experience BPD in different ways, but those who live with borderline personality disorder seem to have difficulties with:

•        Impulsivity
•        Feeling bad about themselves
•        Controlling their emotions
•        Self-harm
•        Suicidal thoughts
•        Dissociation
•        Feeling ’empty’ or numb
•        Identity confusion
•        Depression
•        Paranoia
•        Maintaining stable relationships

The Causes

The actual reason for borderline personality disorder is not known; however, some research suggests that genetics, environmental, cultural, and social factors might play a role. There is no sole reason why certain people develop a borderline personality disorder. Also, professionals cannot use things such as blood tests or brain scans to help diagnose who are suffering.

That said, you might be more vulnerable to BPD if a close family member, such as a parent or sibling also has BPD.  Experiencing long-term distress in your childhood may also increase your chances of being diagnosed with BPD, as can your brain’s development.

Studies indicate that people having borderline personality disorder might have structural and functional changes in the brain specifically, in the areas that control impulses and emotional regulation. However, is it not certain whether these changes are risk factors for the disorder, or done by the disorder.

Ways it is Diagnosed

There are no medical tests that can confirm or deny the presence of BPD. In fact, BPD is diagnosed based on a sequence of assessments, including a medical examination, a psychological evaluation, and a discussion of your signs and symptoms.

A qualified and professional mental health professional like a psychiatrist, psychologist, experienced in diagnosing and treating mental disorders is able to diagnose borderline personality disorder by completing a thorough screening, interview, including a discussion related symptoms; performing a careful and complete medical bases evaluation, which will help rule out other possible causes of symptoms and by asking about family medical histories, including any history of mental illness.

The manner it is Treated

BPD is historically quite hard to treat, but saying that there is assistance and hope for those having this condition.

Beware Laziness May Lead to Depression Warns Counselor Shivani Misri Sadhoo

Let’s assume you have always been a disciplined person. You were an academic achiever from the early stages of your school days.

However, there are specific areas in your life in which you admit that you are “lazy.” You believe you do not flourish when it comes to doing household chores. So, you hire someone to help in those areas.

Sometimes, though, it still bothers you to think that there is “laziness” in you. In several cultures, “lazy” is a very negative term.

Why is laziness such a frowned-upon trait? Is it even a trait, or is it the symptom of something else, such as anxiety, depression, or mental illness?

In this blog, India’s Top Psychologist Shivani Misri Sadhoo, will help you to examine the myth of laziness and why you need to ask—am I depressed or lazy?

The Key Difference Among Depression and Laziness

Depression and laziness have many things in common, which is why several people are misbranded as lazy.

The reason the word “lazy” mostly goes with depression is that it is a common symptom of depression and mental illness.

Depression and laziness both impact concentration, motivation, energy levels, and the quality of work produced.

The difference is this depression impacts one’s mental health and mood, while lazy people are simply unmotivated by things beyond their control because they lack self-awareness or deep insight into what motivates them.

How Would You Know if you are Depressed or Lazy?

How would you know if you are lazy? Depression feels quite dark, you will notice that it is hard to get out of bed in the morning. Not because you are so relaxed and enjoying your cozy time, but because you are sad, dejected, and feeling lackluster and hopeless.

Laziness is more of a circumstantial experience. Some days you might feel lazy because you are tired from a hectic week. On the other hand, depression can last for several weeks or months irrespective of how much rest you get.

Actual Laziness Could be a Myth

Some people may argue that actual laziness is a moral failure, else a temperament is a myth.

Certainly, everyone has days where he/she is voluntarily and blissfully lazy. When you take a day off, for instance. Being lazy is a way of self-care. The space to watch TV, order your favorite food, and enjoy some moments to breathe without the hectic pace of life as a corporate professional is absolutely necessary.

Reasons Why One Might Struggle with Laziness

From the perspective of a counselor, laziness is actually the reflection that suggests an individual’s mental health and overall wellness needs some sort of examination.

One Perhaps Has Issues Pertaining to Value Linking

Value linking refers to whether one feels that an assignment aligns with your own values.

At work, you are often assigned tasks that appear mindless or useless. If you get tripped up by value linking, you might probably have a difficult time completing an important assignment for your boss—even if it is a top priority and due next hour or day—if you think the task has no value.

Most people have the capability to suspend their thoughts around value linking just to work on projects assigned to them by their superiors. However, some people find it almost impossible to do work that has little or no perceived value.

If you are a value-linking individual, it is important to speak to your boss regarding this. Make certain you ask about why a project or assignment is so important.

Dig in deep until you can truly align to the overarching value of work so you can finally get it done. Otherwise, you will reject getting started and continue to procrastinate, and earn the word “lazy.”

One is Lazy, as They Have Too Much to Do

When one works remotely, one is inundated with work from every aspect. His computer, phone. Notifications reminding when your on-line meeting is starting. It is way too much.

It has been seen many people respond to this experience of overwhelm with what seems like laziness. They hide. They drag the covers over their head and use their avoidance and unresponsiveness as a manner of saying, he/she is overwhelmed.

How to Encourage Individuals with Depression and Mental Health Issues

One of the finest methods to totally deflate and degrade someone having depression is to call them lazy. Language has enough power. When you notice someone being lazy at work, pause and consider how to motivate them.

Consider swapping out the word “lazy” from your dictionary completely. As mentioned above, laziness has quite a negative connotation and can bring up damaging feelings.

Encourage your employees, family members, colleagues to schedule routine into their calendars. Sometimes it is called “thinking time” or moments of space.

It may seem like laziness, but it is actually the most replenishing time one can put on their agenda.

Simply Lazy or Depressed – Both are Absolutely Fine

Laziness and depression are both parts of human life. Neither is good or bad.

Let us everyone work to relieve yourselves and each other of the intense judgment of the two human experiences.

When we are in a relationship with a person, we have an additional bond with that person with all humanity. Imagine the bond to be a very strong silver code that ties, two people together. Because we are “suckers for punishment”. It literally sucks us back to the person until we either realize that we no longer need them and move on.

Psychologist Shivani Misri Sadhoo says to identify a relationship predator partner else it becomes way too late. A relationship predator is insidious and slowly consumes away your confidence and self-esteem. Where the impacts are for the long term may be lifelong and might take even longer to recover. One should never willingly enter into a damaging relationship, even when someone close to you warns, you what they can see but you cannot.

This blog by India’s leading marriage counselor Shivani Misri Sadhoo discusses Relationship-Predator and why some people still love a person who has victimized them.

Relationship-Predators are Common

More than 3 Million incidents of partner violence are reported each year, including both a man and a woman. 1/3^rd of women and 1/4^th of men have experienced some sort of interpersonal violence and for one-fourth of women and one-seventh of men, it’s severe.

A woman gets physically beaten or assaulted every 9 seconds.

20 persons are victims by their intimate partner each minute, adding about 10 million every year.

Some Facts About Relationship-Predators

Both men and women can be victims. If someone you love says they’ve been the victim of domestic or emotional violence, you should believe and support them, since no gender is safe and no amount of physical strength or emotional fortitude protects against relationship predators.

·         Usually, relationship crimes take place behind closed doors.

·         Predators blame the victim.

·         Predator deny their actions.

·         The predators desire to be correct and in control.

·         The predators are possessive and could try to isolate their partner from friends or family.

·         The predators are hypersensitive and could react with rage.

You may not realize that predators feel powerless. They never act insecure to hide the truth. One common thing is that their motive is to have power over their victim. To them, communication is a win-lose game.

Reasons Why One Still Loves a relationship-predators

There are some reasons why one still loves a relationship predator. One of the points one raises is that falling in love is natural. So, if somehow things go awful. It does not mean that they should leave the person. Thoughts like forgiveness and kindness rule the course. Let us take some of the reasons why one still loves the person.

Being Refused to Survive

If one is not treated with respect in his/her family and has low self-esteem, he/she will tend to deny the crime. Often thoughts cross probably I deserve the same. And blaming oneself is often easy stating probably it’s your own fault. And the life without that person has no meaning.

Projection, Glorification and Recurrence of Compulsion

Sometimes thoughts of unpleasant childhood run amok. Maybe if the predator reminds you of one of your parents. Then thinking liking probably now you can mend the things keep on running in your mind. You end up believing that this could be the time to redeem your overall past and secure a future.

The Cycle

Just like a fact that a honeymoon cannot go on forever. Similarly, you get yourself in a trap believing the one or two incidents of being a victim will not be repeated. This gives you the belief that you can stay together.

Empathy

Many people feel that having empathy with a person will help things to go better. However, in doing so one often ignores empathy for himself/herself. As a result, you start to deny the fact that you are living with pain.

These are often some of the reasons that force one to stay with a predator. Even if there is a repeated offence.

What to Do

If one is being mentally and emotionally predator, believe your gut instincts. Know that it is not correct and you do not need to live this way. Otherwise, your options come down to the specifics of your circumstances.

·         Accept that the relationship cime isn’t your responsibility.

·         Disengage and set personal boundaries.

·         Exit the relationship or circumstances.

·         Give yourself time to heal.

·         If you feel you are in a violent, controlling, co-dependent or bad relationship or want to get recovery from such a relationship contact.

Your Counselor Is Now Just Skype/Video Call Away

During the current challenging time, it’s common to experience anxiety, depression, sleeplessness, and relationship challenges at home. While you are under lockdown and maintaining social distancing norms to help the country to control COVID-19 spread, your very own counsellor Shivani is now just a call and Skype video call away from you.

However, in this age of coronavirus, we hope to offer our therapeutic help. Change is difficult for all of us and changing the way you meet with your therapist is no exception.  But try it before you disregard this option.  This is a challenging moment in time, and fears and anxieties are running high. 

You may find, telepsychology isn’t a second-rate option. Instead, it’s an effective and efficient upgrade to a valuable service! 

Feel free to call Counselor Shivani Misri Sadhoo at +91-8860875040 for telephonic or video support and to book an online counselling session to address any relationship issues, or emotional and psychological challenges.

Most amongst you know the obvious factors such as infidelity, lack of trust that can damage a relationship. Besides those, there are several reasons which can destroy a happy relationship but these hardly ever catch your attention until it is too late.

Counselor Shivani says perhaps it would not be incorrect to call these as silent killers because those are too subtle to get noticed. But you can certainly save yourself and your partner from falling prey to these relationship killers if you are a bit careful. So, look out for those signs to protect your bond with your partner from hitting the rock bottom.

This blog, by top Marriage Counselor and Relationship Expert, Shivani Misri Sadhoo discusses the biggest silent killers of a relationship and how to address them. Here they are.

Harboring Bitterness

When couples are in a long-term relationship or have been married for some time, they face this issue of harboring hidden bitterness. Suppressed or unaddressed resentments can create irreversible damage to a relationship. It is quite important to express anger or frustration because suppressed bitterness will come firing out in the future and can erode a relationship.

Assumptions

When couples brag that they are so compatible that they can even complete each other’s sentences, it could be both good as well as a bad sign. What they really need to ask is, can two individuals be so close that they know everything regarding each other to such a point that they can read minds? Or is it simply an assumption? Sometimes, just assuming about your partner’s likes and dislikes and doing things accordingly can do more damage to a relationship than good. Rather than assuming, it is always better if the partners let each other express their views and desires.

Taken for Granted

This is one of the unacknowledged factors that often leads to cracks in the most stable relationships. It is a common human behavior to take a person for granted when you are with him/her for a long time. So, how do you stop it? One of the methods to hold yourself back from being taken for granted is just by breaking the routine.

Not Talking about Intimacy

There are individuals who shy away from discussing their physical needs with a partner. Feeling sexually unsatisfied in a relationship is very common but a lot of couples never address this issue because of insecurity and fear. But unfulfilled desires may lead to low-self-esteem, infidelity, and resentment. The best solution to this problem is to talk about your desires and let your partner know what you need and what are your needs in terms of physical intimacy.

It is Mostly I than We

Selfishness is another unaddressed issue that has the capability to ruin even the strongest of the relationships. The only manner to get over this habit of thinking merely about your interest is by prioritizing what is best for the relationship with your partner.

While being afraid of the dark might be a part of normal development in some young children, this is not the case for older children and adults. Nyctophobia is basically an age-inappropriate fear of darkness that can force someone to limit their activities, avoid specific circumstances, and experience anxiety in the anticipation of there being lying something dangerous and no light.

Psychologist Shivani says it is when the concern crosses over from being an inborn protective technic to being a clinical issue that it is designated as a phobia.

This blog specifically revolves around Nyctophobia, and India’s top Psychologist and Counselor Shivani Misri Sadhoo talks about the causes and treatment for the same.

Causes

Nyctophobia, also known as scotophobia, lygophobia, and achluophobia. This may be evolutionary in nature as several predators hunt at night. The fear might not be linked to darkness itself but unknown dangers are hidden in the darkness (this is why horror and suspense movies generally use darkness as a way to scare audiences). A general lack of security and confidence also plays into this as well, particularly if you tend to be afraid of the dark mostly while alone.

Psychoanalytic believes that fear of the dark could be related to the separation anxiety from a primary attachment figure, a phenomenon that has been detailed further.

Symptoms and Diagnosis

Symptoms of nyctophobia differs from individual to individual and according to the severity of a specific case. In general, symptoms of nyctophobia includes:

·         Getting nervous in any darkened surroundings.

·         Being reluctant to go out at night.

·         Experiencing physiological symptoms like increased heart rate, sweating, visible shaking, and also feeling ill (nausea, headaches, and diarrhea) when forced to spend some time in the dark.

·         Need to put on the light at night while sleeping.

Symptoms of during more severe cases of nyctophobia include:

·         Trying to run away from dark areas or rooms.

·         Getting angry or defensive if anyone tries to force or tease you to spend time in the dark.

·         Compulsively staying back indoors at night.

Nyctophobia has certain diagnostic criteria that are common to every phobia, which separates them from simple fears.

Treatment

The aim of therapy is to challenge the fearful beliefs about the dark by replacing the negative self-talk with more positive ones. The rate of successful treatment for certain phobias such as nyctophobia is approximately 90% and mostly accomplished with the help of techniques drawn from the cognitive-behavioral school therapy.

The treatment plan your therapist would recommend for you or your child could include:

·         Exposure to the dark in bits, incremental, non-threatening doses in a method called desensitization.

·         1-on-1 talk therapy, family therapy, or even group therapy.

·         Learning relaxation techniques, like deep breathing, meditation, or yoga.

·         Medications such as anti-anxiety and antidepressant.

If you are struggling due to any sort of phobia or other psychological issues. Do not hide them. Rather, you do not need to panic, you should seek some help from a qualified psychologist.

Your Counselor Is Now Just Skype/Video Call Away

During the current challenging time, it’s common to experience anxiety, depression, sleeplessness, and relationship challenges at home. While you are under lockdown and maintaining social distancing norms to help the country to control COVID-10 spread, your very own counsellor Shivani is now just a call and Skype video call away from you.

However, in this age of coronavirus, we hope to offer our therapeutic help. Change is difficult for all of us and changing the way you meet with your therapist is no exception.  But try it before you disregard this option.  This is a challenging moment in time, and fears and anxieties are running high. 

You may find, telepsychology isn’t a second-rate option. Instead, it’s an effective and efficient upgrade to a valuable service! 

Feel free to call Counselor Shivani Misri Sadhoo at +91-8860875040 for telephonic or video support and to book an online counselling session to address any relationship issues, emotional and psychological challenges.

Gaslighting is a way in which an individual or entity, in order to gain more power, makes a victim question their reality. It works way better than you might think. Any individual is prone to gaslighting, and it is a common tactic of dictators, narcissists, and cult leaders. It is done steadily, so the victim never realizes how heavily they have been brainwashed.

Psychologist Shivani Misri Sadhoo tells about the warning signs of gaslighting.

They Tell Outright Lies

You know this is a blatant lie. Yet they are telling you the lie with a straight face. Why are they so blatant? Because they are setting up a precedent. Once they tell you a big lie, you are unsure if anything they say is real. Keeping you unsteady and off-kilter is the goal.

They Instantly Deny They Ever Said Anything

You know he said he would do something you know he told it. But they downright deny it. It makes you doubt questioning your reality, maybe they never said that thing. And the more they do it, the more you question yourself and start accepting theirs.

They Wear You Over a Period of Time

This is one of the subtle things about gaslighting, it is done steadily, over time. A lie here and there a snide comment quite often and then it begins ramping up. Even the smartest, most self-aware person can be sucked into gaslighting it is that powerful. It is the frog in the frying pan analogy. The heat is turned up gradually, so the frog never fails to realize what is happening to it.

Whatever is Near or Dear to You, They Use it as a Tool

They know-how important your kids or friends are to you, and they know how dearer your identity is to you. So those may be one of the initial things they attack. If you have kids, they will tell you that you should not have had those kids. They will tell you will be a worthy person if only you did not have a long list of negative qualities. They attack the base of your being.

Their Words and Actions Differ

When one is dealing with an individual or entity that gaslights, look for what they are doing irrespective of what they are saying. What they are saying means nothing it is plain talk. What they are doing is a concern.

They Tell You, Everyone, You Know is a Liar

By constantly telling you that everyone you know is a liar, it again makes you doubt your reality. You have never known someone with the ability to do this, so they must be telling the truth, correct? No. It is a manipulation tactic. It makes people turn to the gaslighter for the “right” information, which is not the right information at all.

Your Counselor Is Now Just Skype/Video Call Away

During the current challenging time, it’s common to experience anxiety, depression, sleeplessness, and relationship challenges at home. While you are under lockdown and maintaining social distancing norms to help the country to control COVID-10 spread, your very own counsellor Shivani is now just a call and Skype video call away from you.

However, in this age of coronavirus, we hope to offer our therapeutic help.  Change is difficult for all of us and changing the way you meet with your therapist is no exception.  But try it before you disregard this option.  This is a challenging moment in time, and fears and anxieties are running high.

 
You may find, telepsychology isn’t a second-rate option.  Instead, it’s an effective and efficient upgrade to a valuable service! 

Feel free to call Counselor Shivani Misri Sadhoo at +91-8860875040 for telephonic or video support and to book an online counselling session to address any relationship issues, emotional and psychological challenges.