Image by Ibai Acevedo / Stocksy

I’ve received the entire gamut of questions about why I was in an abusive relationship, even as a psychologist, from the curious to the compassionate to the sanctimonious. When I was younger, I’d give the excuse that I was practically a child, and I didn’t know better.

But the truth is, anyone at any age, at any level of professional success or education accomplishments, could find themselves there. From double board-certified physicians to CEOs to lawyers, people have found themselves trapped. And the shame is suffocating.

If you are someone mired in such a relationship, or you are struggling to understand what’s going on for someone you love, then I wrote this for you.

Note: This is written from the context of a heterosexual relationship, where the man is an abuser, and the woman is the victim, for the ease of word flow. Importantly, women can absolutely be abusers, men can absolutely be victims, and all sorts of relationships can run the risk of being toxic.

If you are in immediate danger, call 9-1-1. For anonymous and confidential help, you can call the National Domestic Violence Hotline (1-800-799-7233 or TTY 1-800-787-3224) and speak with a trained advocate for free as many times as you need. They’re available 24 hours a day, seven days a week. You can also speak to them through a live private chat on their website.

1. She’d tasted the good times and knew it wasn’t just a pipe dream.

The beginning of most toxic relationships plays out like this: He bombards her with so much affection and attention, it feels out-of-this-world. For anyone who’s been neglected or bullied, this can feel like you’ve finally met your soul mate. He may play up your similarities—or even create similarities—and tell you he’s never met someone as amazing as you before. Or he could tell her about how the whole world’s been horrible to him, and he’s so grateful he finally found her.

But what this love bombing is really designed to do is to prevent her from having the personal space and clarity of mind to reflect on what’s really going on. She gets swept away in this avalanche, and if she has a tendency to rescue or caretake someone, then all the more she may feel wedded to this relationship.

Of course, things eventually change. He does little things, and then bigger things, to erode her boundaries and lower her standards while making her feel bad. He may get moody—and flip among the roles of victim, savior, and persecutor, so she never knows which person she is dealing with, and she’s always walking on eggshells. He will even blame her, so she’s trained to always be on her best behavior. And because she’s tasted the magical fairy-tale beginning, she knows she wasn’t dreaming. Instead, she’s been told that it’s her fault that things have changed, so she will bend over backward and work hard to bring those good times back.

2. She got suckered back in.

It takes a woman an average of seven attempts to leave a domestic violence situation for good, during which she may be killed or in severe danger.

Why is she hoovered back so many times, you ask? It’s simple. The toxic person knows which buttons to push and when to play nice.

It could be a message like “I would like to meet you to apologize and/or thank you for all the good times,” where she feels that maybe she owes him that chance to be decent. Or it could be a birthday or holiday message, where he appeals to nostalgia and sentiment, from which he spins his web to seduce her back in. If only to punish her for having the audacity to leave, and to break her.

3. She mistook trauma bonding for destiny.

The thing about trauma is that your nervous system is blunted most of the time, and it only comes alive when you’re experiencing danger. What this means is your feelings of pleasure and pain get confused, and even though a part of you is horrified, the other part of you feels like a zombie come alive. If you’ve been abused before as a child or in previous relationships, then this becomes even more ingrained. The brain tends to unconsciously draw us back to similar situations to try to repair what went wrong in what’s known as “repetition compulsion.” Except that with toxic people, you can never repair it because they cannot and will not change.

Repeat this across multiple relationships, and you literally feel beaten down—as if this type of relationship is your destiny. And having such a belief coupled with such a nervous system makes you feel as if you have no other alternative.

4. She thought it was “just a domestic.”

If that’s what the police are saying, if that’s what everyone dismisses it as, then it’s hard for her not to doubt herself. After all, she’s already been trained to blame herself for everything she did and did not do.

And then I remember the words of Sir Patrick Stewart: “There’s no such thing as ”just a domestic.'” 

5. She didn’t want to abandon him.

Many toxic people compare themselves to abandoned animals, should they be left. They might even talk about how if they failed in their current relationship with you, that was evidence that they were just failures in life. Plenty of drama like that, cinematographically orchestrated within a context of them drinking their sorrows away, looking at you with puppy dog eyes.

And somewhere along the lines with his sob stories, persecutory accusations, and while also claiming to be wiser than her, she became his caretaker. She became afraid of provoking him, watching her behavior just in case it would trigger him. And she also learned that if she called him out for his bad behavior, or simply needed time off to recalibrate after an abusive episode, those very acts would trigger worse behaviors because she made him feel bad.

Everything she did was potentially hurting him. And if she walked away, she’d be really letting him down.

She didn’t see that, in what she was doing, she had abandoned herself.

6. She blamed herself.

That self-critical voice in her head, whether it was about the relationship or anything else, grew louder and louder. But really, it was his voice masquerading as hers, akin to that line in The Phantom of the Opera that goes “I am the mask you wear, it’s me they hear.”

He recites a litany of her misdeeds and terrible traits, from her instability to how difficult she is. Except it’s projection, where he tars her with that very brush that’s really his.

Even if she realized he was toxic, the blame game was way too strong by then.

She’d blame herself for not seeing that in the first place. For being abused. For not pushing back enough. For being with him. For not being able to love it away. For always triggering it. For staying. For going back. For being with him.


7. He became more sophisticated at his craft with time, and she got more beaten down. 

The more information you tell a toxic type with regards to their behavior, the more they learn to tick the boxes of “correct behavior” and even appear to have empathy. And as she got more and more exhausted, often, anything goes.

And what does one do when they reach this point? You feel like a gambler, desperate at the table. All logic and knowledge about odds hurl out of the window. You tell yourself, “One more, one more and it will all turn around,” while you reference platitudes from the fairy tales you grew up with. Love wins it all, eternal salvation after a life of martyrdom, and they lived happily ever after.

8. She was isolated and alone.

The deal with gaslighting isn’t just about someone lying to you. Really, it is someone consistently screwing with your sense of reality, such that black becomes white, and white becomes pink—if they say so. You become disconnected from your own gut, moral compass, and values. Part of this is orchestrated systematically to beat you down; another part is also an autopilot mechanism in which you survive because questioning too much can drive you mad.

And not only are you isolated from yourself; you are also isolated from the people you love.

He may not have told her overtly, “I don’t like your friends and family; don’t hang out with them,” and he could even say out loud “I really like them,” entertaining them like the biggest charmer in the world. But when asleep, he could whisper in her ears about them, denigrate them, anything to subliminally influence her. Or he could indirectly “train” her to avoid them, for instance by having a paranoid fit every time she sees them, so she implicitly learns to associate “going out with others” with “dangerous for my relationship.”

And the longer she is disconnected from her loved ones, the harder it feels to reach out again. How does she even find the words to explain her absence, without sounding stupid? Or how does she delicately dance around the fact that he has been displaying some disturbing behaviors, even if “he doesn’t mean it, he’s had a traumatic past, I’m the one triggering it”? 

Some toxic types even play that “us against the world” card, planting these seeds, especially during that dizzying whirlwind of the love-bombing phase. Because you both are twin-flame soul mates in a mad world, you’re the only person who truly gets him, so why not run away to some alternative lifestyle or new place where you can start a whole new life together? 

And at the heart of it all, it all feels romantic, doesn’t it?

9. She had no resources.

A common modus operandi is to live together quickly, and then she gets pregnant, following which he tells her to quit her job. She becomes totally dependent on him; she may have even signed her bank account over to him jointly, and he might have wiped it clean due to some addiction he claims he cannot help. And as time passes, she doesn’t quite know how to reenter the commercial world.

More disturbing, however, is the phenomenon where women are held beholden to the abuser because they are immigrants whose visa has been sponsored. A Cambridge study found that the threat of deportation—coupled with being alone in a new country, sometimes without the familiarity of speaking the official language—is another factor used to keep her silent.

And if her abuser is a charming, giving person within the community, then nobody would believe her. He may even orchestrate situations where he pushes her buttons in public, then makes her look unstable so people eventually think she’s the crazy one.

The scene has been set. She has zero social capital and much less financial capital.

10. She’s been told it’s too late.

Maybe she’s a shadow of her old self. Her youth is gone, and her body is no longer as lithe as when they first met because who has the head space to really take care of themselves in a relationship like this? 

He might even tell her all too often about how she should be grateful he’s still with her. No one would ever want to be with her again. People would laugh at her if she tried to look for a relationship again; after all, she’s the unstable one, she’s damaged goods. She’s nothing without him, she has nothing without him.

He is her only option.

11. She doesn’t know how to deal with the danger.

If you live on tenterhooks everyday, you are exhausted. Physically, emotionally, spiritually, cognitively, everything. You have no capacity to deal with more. It’s easier to knuckle under.

She knows—from the indirect and direct threats he’s made—she is in danger. The dog might die. The kids might be taken away. He’ll fight her to the last cent and discredit her. He might have strangled her, slapped her, or kicked her on multiple occasions, and she knows that’s just a taste of what will happen if she even dares to leave.

Because a person in an abusive relationship is in the most danger as they’re preparing to leave.

12. She wanted to (help) keep him accountable.

Dark personality types are the acme of those who promise to change. The sophisticated ones even tell you that they know all about their toxic behavior while situating it in an old pattern like a difficult childhood, exes hurting them, or their battles with substances. They may even ask you to hold them accountable.

And what does she do if she’s the kind of person who always works harder to be a better version of herself? She automatically assumes that everyone else is capable of growth and willing to grow.

Mistakenly attributing such a mindset and determination to the toxic person is what keeps her hooked. Even if he may sometimes laugh it off and pretend he never said that, or say he can’t promise he will be successful in changing.

13. She suffered from positivity bias. 

The human brain is wired to remember losses and negative memories because that keeps us from repeating the same mistakes so we stay alive. In the case of toxic relationships, I have observed a curious case of the exact opposite, which I call positivity bias.

She will remember the piecemeal times that he’s changed, even lauding his efforts. And she will dismiss the times he regressed even more than his changes, explaining it away with any excuse possible. She will also selectively remember and replay the good times, over the bad times. And more importantly, she will say, he’s not 100% bad. Or he doesn’t tick all the boxes for being a “full-blown” psychopath, narcissist, or sociopath.

Part of this is because of what we call confirmation bias—we discard evidence that contradicts what we (want to) believe, and strongly replay those times that align with our perspectives. In neuroscience terms, keep rehearsing that memory and going over it, and that becomes stronger and stronger.

And what’s worse is, she could even have false memories because he gaslit her over and over again.

The takeaway.

So many years later, I no longer fall back on the excuse of “I was young then, in a foreign land.”

It can happen to anyone.

The dynamics of such a relationship are set up to get people hoodwinked and trapped. Add that to personal vulnerabilities that make us attracted, desperate to please, or feel responsible for their bad behavior, as well as the sophisticated machinations of dark personality types who’ve spent their entire life perfecting their craft, and it is a Molotov cocktail of danger.

As a society that’s learning to embrace the gravity of mental health, perhaps we should evolve the question “Why did you stay?” to “Why do they abuse?



For migraine sufferers, vacation headaches are all too common—here’s what might be at play.

For most people, browsing through vacation photos is a fun trip down memory lane, remembering all of the cool places you’ve visited. For some, it might feel more like recalling the times an incredibly inconvenient, massive headache surfaced with neck pain, dizziness, and sound sensitivity.

Headaches can, unfortunately, happen at any time, and getting a migraine while on your paid time off isn’t as uncommon as you might think. So, what’s the deal with head pain that hits just when you’re hoping to relax? Here are some of the precipitating factors for vacation headaches, according to experts—and what you can do to keep them from ruining your time off.

What Is a Vacation Headache?

We vacation to manage some of the outcomes of job stress with health and well-being activities. However, one outcome of stress, and an unpleasant disruption to our well-being, are headaches. Vacation headaches, or headaches that occur while on vacation can result because you are finally relaxing and taking it easy with less stress, in a perceived less stressful environment. Health spoke with experts to understand six reasons why vacationing can literally cause a headache for some people.

You Have a Let-down Headache

Picture this: You’ve just settled into a beach chair in the midst of a tranquil scene when you feel a migraine coming on. Or you’re finally able to take that walk, or hike, following your final exams for the semester, when your head starts to hurt. Or you’re finally able to meet up for brunch with friends after what feels like weeks of emergency room visits with your sick child when you feel the onset of another headache. These headaches phenomenon is what is known as a “let-down headache.”

“A let-down headache is a headache which occurs when there has been a drop in stress levels,” Deena Kuruvilla, MD, neurologist, headache specialist, and director of the Westport Headache Institute, told Health. “Many patients with chronic or episodic migraine tell me that their headache frequency [was] really well controlled on preventive migraine treatments, but then boom, they go on vacation and experience an attack!”

A study published in Neurology indicated that for some people headaches don’t get triggered from stress, but when stress is released. However, it’s not exactly clear why. “While we do not know the exact cause of let-down migraine, one possibility that has been proposed is a fluctuation in our stress hormone levels,” stated Dr. Kuruvilla. “These stress hormones increase during times of stress and then decline when we are relaxed.”1

Fortunately, to keep your relaxation from backfiring into a headache, you do have options. To stabilize stress levels, especially prior to leaving for vacation, try,2

  1. Getting more sleep.
  2. Making lists to help prioritize what’s important.
  3. Managing time commitments.
  4. Clearly communicating your needs and feelings.
  5. Spending quality time with a partner or friend.

These and other stress management activities can help avoid the spike-and-drop pattern that might trigger a migraine.

Lots of Smaller Stressors Added Up

The truth is, not every aspect of vacation is stress-free bliss. From last-minute packing woes to the difficult in-laws, you may be visiting, there is a number of reasons why you might need a vacation from your vacation. All of these can add up to stress headaches—literally and figuratively.

Remaining or becoming calm is easier said than done when you are stressed. However, self-care strategies for de-stressing are your best bet for preventing the onset of a headache. Try these suggestions to help guide you to a calmer place of well-being,

  • Download a guided meditation to listen to in the car.
  • Practice deep breathing exercises in the airport terminal.
  • Give yourself quiet, unscheduled breaks throughout your trip.

You’re off Your Typical Sleep Schedule

When you’re away from your own bed, sleep doesn’t always come easily. “Migraine and sleep run hand in hand,” stated Dr. Kuruvilla, “[especially when] traveling across time zones [which] can throw off a person’s circadian rhythm, [and] contribute to sleep disruption and migraine attacks.”

For better shuteye on vacation, practice healthy sleep hygiene by,

  • Discontinuing the use of devices before heading to bed.
  • Keeping a cool, dark bedroom.
  • Sticking to your usual bedtime routine as much as possible.

While you’re at it, tuck some melatonin in along with your toiletries. “Melatonin is a hormone that helps regulate the circadian rhythm. Research studies have shown it can be helpful for the prevention of migraine,” stated Dr. Kuruvilla.34

You’re Dehydrated

It’s hard to overstate the importance of staying hydrated to prevent head pain. “Even 1-2% of body water loss can increase your chances of developing headaches,” dietitian Maryann Walsh, MFN, RD, CDE, told Health. “So, it’s critical to get adequate water.”

But while air travel alone can be dehydrating, the low humidity in a plane cabin isn’t the only factor that can lead to vacation dehydration. Simply switching environments can bump us out of our usual healthy habits. “Being out of your normal routine can lead to not hydrating as you normally would, especially if you are on a road trip or flight and you’d rather not have to stop or get up to use the restroom every hour,” stated Walsh.

Then there’s that ubiquitous vacation frenemy: alcohol. “Because alcohol acts as a diuretic, it can further cause us to be dehydrated,” indicated Walsh. “If we aren’t drinking enough water before, in between, and after a day or night of cocktails, this can lead not only to a dreaded hangover, but also headaches.”5

Want to get ahead of head pain from dehydration? Always keep a bottle of H2O in your travel bag, as well as keep the water flowing alongside any alcoholic drinks you consume.

Your Diet Changed Up

Could that dinner you enjoyed at a five-star restaurant send you loading up on Ibuprofen the next day? It’s possible. For some people, foods high in substances like tyramine, nitrates, sulfites, and artificial ingredients can be a trigger for head pain. Common culprits include aged cheeses, cured and processed meats, pickled foods, and alcohol—all of which you’ll frequently encounter in restaurant dining.67

Meanwhile, travel can disrupt other individual diet choices you might normally make to live pain-free. “Some of us may have dietary headache triggers that we usually avoid in our daily lives but may not be able to avoid if there are sneaky ingredients we are consuming out at restaurants,” stated Walsh.

And don’t forget the impact of caffeine. Fluctuations in caffeine intake are known for tripping the headache wire. If vacation mode has you chilling out sans coffee—when you’d normally drink several cups a day—a headache can result. Rather than drastically deviate from your norm, try keeping your caffeine intake consistent.

You’re at a Higher Altitude

As you make your way up winding roads for a mountain getaway, you’re likely looking forward to fresh air and cooler temps, but altitude change can be a hidden cause of headaches. Hypoxia

Altitude-related headaches occur most often over 8,500 feet. However, you don’t have to be scaling Everest for altitude to mess with your head; even smaller elevation changes may lead to discomfort—your brain tissues may not get enough oxygen the higher you go. “Studies have confirmed that all migraine-associated symptoms, headache frequency, and headache severity tend to worsen with increasing altitude,” stated Dr. Kuruvilla. The higher you go the more likely you are to experience hypoxia which, “[o]ne of the proposed mechanisms is a loss of oxygenation to the brain as a result of being at an increased altitude.”8

If altitude-related headaches put a damper on your mountain retreats, do your best to stay hydrated and take frequent breaks as you travel upward. Or ask your doctor if a prescription medication could be right for you. And, if all else fails, consider swapping the cabin in the Rockies for a trip to the beach.


Image by Mariela Naplatanova / Stocksy

As anyone who has ever eaten an entire ice cream tub in one sitting, it’s very easy to overdo it on the sweet stuff. Sugar is incredibly addicting, and there are certain hormonal, emotional, and physiological reasons we may crave it so much. Here’s a look at some of the factors that cause you to crave sugar and what to do to stop them.

The reasons your body craves sugar.

The average American adult consumes 17 teaspoons of added sugars a day according to the USDA Agricultural Research Service. However, the recommended amount per the Dietary Guidelines for Americans is less than 10% of your overall diet, equivalent to about 12 teaspoons a day. Here are some reasons you might be feeling the need to reach for something sweet:

1. You’re exhausted.

“During times of fatigue or exhaustion, the first thing we crave is sugar,” says Maya Feller, R.D., a Brooklyn-based registered dietitian nutritionist and author of the upcoming book, Eating From Our Roots. “That’s because sugar is rapidly metabolized and is the body’s preferred source of energy.”

Research shows1 that eating sugar is a physiologically adaptive behavior that provides the energy needed to stay awake. The problem with this? Sugar’s initial energy boost is short-lived, making you seek out more. These well-balanced meals and snacks are much better for sustained energy.


When you’re tired, sugar provides an energy boost because it’s metabolized fast. Eating foods high in omega-3, B vitamins, selenium, CoQ10, and vitamin E can nix cravings.

2. You’re stressed.

“Past research has found that when primates were under stress, they sought out carbohydrates2—primarily in the form of fruit,” says Steven Gundry, M.D., a cardiothoracic surgeon and author of Unlocking the Keto Code. “We think it’s because these compounds produce the feel-good hormone serotonin.”

Humans under stress react the same way—by reaching for something sweet to feel relief (albeit short). The problem with this is that eating sugar too frequently can create a habit, which stress then ingrains as a behavior.

Carbs come in many forms, and if you’re feeling stressed, the best way to balance yourself out may be by consuming complex carbs. That’s because they take longer to digest and will keep blood sugar levels stable. If you’ve got to have something sweet, stick to dark chocolate with 70% to 85% cocoa to prevent a blood sugar spike.


We’re wired to crave carbohydrates when under stress, and sugar is a soluble carb. Showing yourself some compassion may help you make better choices—opt for whole grains, apples, berries, or oranges to get a carb fix that won’t send your blood sugar soaring.

3. Your gut isn’t getting what it needs.

Gundry says one of the theories around what makes humans hungry is the Gut Flora-Centric Theory of Hunger. “This is a theory that says our hunger is controlled by how much our gut bacteria is being fed the foods they need,” he says.

“If gut bacteria are getting the right kind of fuel, it sends messages to the brain that it’s happy3, and we don’t have to go looking for additional food.” When gut bacteria aren’t getting the right nutrition, however, the brain sends out an SOS signal, saying it needs energy fast. The quick fix is often sugar.

But one thing that’s much better for your gut health, Gundry says, is prebiotic fiber—a nondigestible fiber that nourishes beneficial gut bacteria, halting cravings.

Prebiotic-rich foods include nuts, bananas, oats, and apples. “MCT oil also feeds gut bacteria,” Gundry adds. “It’s a fat that’s absorbed directly from the gut into the blood and liver. From there it’s converted into ketones that provide fuel for the brain.”


Your gut is a driver of the foods you crave. Eat foods that promote a healthy gut like nuts, bananas, oats, apples, and other prebiotic fibers and you’ll crave less sugar.

4. You’re consuming too many artificial sweeteners.

“Artificial sweeteners have messed with our system when it comes to detecting sugar,” says Gundry. “That’s because we don’t have sugar receptors in our tongue; we have sweet receptors. Before, sweet receptors tasted something sweet, which was sugar, and alerted the brain and pancreas that sugar was on the way. The pancreas would then produce insulin in preparation.” 

Artificial sweeteners do not follow the same natural process. First, insulin must pull sugar out of the bloodstream, which can increase the risk of hypoglycemia. “The brain never gets its sugar, and it tells the body to go out and get some more for it,” says Gundry. “This can cause someone to eat or drink more artificial sweeteners, creating a craving and habit4, such as becoming addicted to Diet Coke.”


Artificial sweeteners make your brain crave more sugar, feeding a never-ending cycle. Avoid them when you can.

The healthiest foods to satisfy sugar cravings.

The next time you’re craving sugar, reach for these foods that deliver the complex carbs, prebiotics, etc., your body actually needs:

  • Fruit
  • Nuts
  • Whole grains
  • Healthy fats like a half an avocado
  • Purple potatoes
  • Dark chocolate
  • Amaranth
  • Chia seeds (try making chia pudding)
  • Dark leafy greens like kale and spinach
  • Fatty fish like salmon

When to see a doctor.

“Sugar cravings are for the most part harmless and a natural occurrence,” says Feller. “However, when sugar cravings are combined with dizziness, weakness, or fatigue, it may be a sign of a more serious blood sugar imbalance that needs to be addressed with your physician.”

If you’re experiencing blurred vision, an increased need to urinate (especially at night), fatigue, and increased thirst with sugar cravings, these could be early warning signs of high blood sugar, and if left untreated could lead to diabetes.


Frequently Asked Questions

How do I stop sugar cravings?

Spoiler alert: Your body needs sugar! You just want to make sure you’re getting the right kind of sugar. Eat nutrient-dense, whole foods, along with prebiotics to fuel your gut and retrain your brain on what kind of sugar it’s looking for. 

Do you crave sugar when your iron is low?

Potentially. Feller says when we restrict our diet or have a nutrient imbalance, sugar cravings can be a sign of that internal struggle. Plus, low iron levels make you feel less energized, which in turn can make you crave sugar for some extra pep.

Why do I crave sweets as I get older?

“It’s not so much age, it’s more that the older a person gets the more sedentary they may be,” says Gundry. “This makes them become metabolically inflexible, increasing blood sugar levels, glucose, and resistance to insulin.” All of this confuses and depletes the brain, which can result in sugar cravings.

Does hypoglycemia make you crave sugar?

“Hypoglycemia literally means ‘low blood sugar,’ and it may cause an increased desire for sugar,” says Feller. “The brain and body prefer to use glucose (sugar) as their main energy source, so when these energy sources are depleted, the brain sends a signal to eat something that will raise blood sugar levels.” That signal can result in craving sugar, yet sugar levels can be restored with one of the healthier options listed above.

The takeaway.

Craving sugar is what your body was designed to do. Many of the nutrient-dense foods we should be eating daily have naturally occurring sugars already in them. If you consistently eat these foods, regulate stress, and practice good sleep hygiene, your cravings should subside and you’ll be sneaking into the cookie jar much less often.


%d bloggers like this: