Relationship Issues Therapists in Arlington, VA

Photo of Kristin Heinz, MBA, MSW, LCSW, LICSW, Clinical Social Work/Therapist
Kristin Heinz
Clinical Social Work/Therapist, MBA, MSW, LCSW, LICSW
Verified Verified
4 Endorsed
Arlington, VA 22209
I am a Licensed Clinical Social Worker who works with adolescents, adults, and couples. My area of expertise is grief and bereavement work. Grief results from many different kinds of losses. Whether you are struggling with the death of loved one, the ending of a long-term relationship, the loss of a job, or even an identity crisis stemming from a major life change, such as marriage, birth of a child, retirement, or medical diagnosis, you may be experiencing a variety of emotions typical with grief. Working through these emotions is essential in order to heal.
I am a Licensed Clinical Social Worker who works with adolescents, adults, and couples. My area of expertise is grief and bereavement work. Grief results from many different kinds of losses. Whether you are struggling with the death of loved one, the ending of a long-term relationship, the loss of a job, or even an identity crisis stemming from a major life change, such as marriage, birth of a child, retirement, or medical diagnosis, you may be experiencing a variety of emotions typical with grief. Working through these emotions is essential in order to heal.
(571) 418-6933 View (571) 418-6933
Photo of Latoya Gassaway-White, LPC , Licensed Professional Counselor
Latoya Gassaway-White
Licensed Professional Counselor, LPC
Verified Verified
Arlington, VA 22206
I am Dr. Latoya Gassaway-White, and I have my LPC. I have been practicing CBT and solution-focused mostly, but I have experience with psychodynamic and family therapy approaches. I believe that clients dictate which type of therapy to approach and that it is best when a client leads the way. Together we create realistic and attainable goals, and then I help my clients tackle and achieve those goals. I work primarily with clients with anxiety, depression, and relationship difficulties.
I am Dr. Latoya Gassaway-White, and I have my LPC. I have been practicing CBT and solution-focused mostly, but I have experience with psychodynamic and family therapy approaches. I believe that clients dictate which type of therapy to approach and that it is best when a client leads the way. Together we create realistic and attainable goals, and then I help my clients tackle and achieve those goals. I work primarily with clients with anxiety, depression, and relationship difficulties.
(757) 290-1975 View (757) 290-1975
Photo of Summer Drum, MEd, MA, Pre-Licensed Professional
Summer Drum
Pre-Licensed Professional, MEd, MA
Verified Verified
Arlington, VA 22209
I work with clients across the lifespan experiencing a wide range of issues, including anxiety, depression, difficult life transitions, relationship problems, identity & sexuality issues, trauma, and shame.
Starting therapy can feel vulnerable, uncomfortable, and even scary. It may also feel exciting or give you a sense of relief. I want to assure you that no matter what it is you are feeling or experiencing, you aren't alone. This is your healing journey, and I am here to support you with care and compassion and without judgment.
I work with clients across the lifespan experiencing a wide range of issues, including anxiety, depression, difficult life transitions, relationship problems, identity & sexuality issues, trauma, and shame.
Starting therapy can feel vulnerable, uncomfortable, and even scary. It may also feel exciting or give you a sense of relief. I want to assure you that no matter what it is you are feeling or experiencing, you aren't alone. This is your healing journey, and I am here to support you with care and compassion and without judgment.
(301) 742-2282 View (301) 742-2282
Photo of Michael Joseph Brenneis, PhD, LPC, LMFT, Licensed Professional Counselor
Michael Joseph Brenneis
Licensed Professional Counselor, PhD, LPC, LMFT
Verified Verified
Arlington, VA 22204
I am an interactive therapist who uses the therapeutic relationship as the entry point for exploring the thoughts, feelings, and habits that have become difficult for the client. I believe that people are natural learners who have become who they are through what they have learned from experience, and that psychotherapy is a focused and intentional way of continuing to learn about life, self, and relationship in ways that help a person move toward more effective and satisfying ways of living. I am optimistic, as I believe that as long as we are talking there is always hope for improvement.
I am an interactive therapist who uses the therapeutic relationship as the entry point for exploring the thoughts, feelings, and habits that have become difficult for the client. I believe that people are natural learners who have become who they are through what they have learned from experience, and that psychotherapy is a focused and intentional way of continuing to learn about life, self, and relationship in ways that help a person move toward more effective and satisfying ways of living. I am optimistic, as I believe that as long as we are talking there is always hope for improvement.
(703) 957-7419 View (703) 957-7419
Photo of Lauren Levine, PsyD, Psychologist
Lauren Levine
Psychologist, PsyD
Verified Verified
2 Endorsed
Arlington, VA 22201
For many of us, it can seem easier to support others, yet we struggle with taking care of ourselves. We often know how to be a good friend to a loved one, while falling short on being our own friend. Therapy is a great step in practicing self-awareness and self-care. It also is a way to learn skills that can help you achieve your goals. Using Cognitive-Behavioral Therapy (CBT) and other evidenced-based interventions, I work with clients to relieve suffering and achieve better quality of life. I specialize in working with depression, anxiety, OCD, adjustment difficulties, and relationship concerns.
For many of us, it can seem easier to support others, yet we struggle with taking care of ourselves. We often know how to be a good friend to a loved one, while falling short on being our own friend. Therapy is a great step in practicing self-awareness and self-care. It also is a way to learn skills that can help you achieve your goals. Using Cognitive-Behavioral Therapy (CBT) and other evidenced-based interventions, I work with clients to relieve suffering and achieve better quality of life. I specialize in working with depression, anxiety, OCD, adjustment difficulties, and relationship concerns.
(571) 281-7994 View (571) 281-7994
Photo of Heather D Sheets - Dr. Heather Sheets, PLLC, PsyD , Psychologist
Dr. Heather Sheets, PLLC
Psychologist, PsyD
Verified Verified
1 Endorsed
Arlington, VA 22207
Using motivational interviewing, narrative therapy, and cognitive-behavioral techniques to identify the relationship between your thoughts, feelings, and the choices that follow, I will work with you to embrace your true self and create a life that is authentic and emotionally fulfilling.
There are certain transition points in life: moments when you identify a shift in your inner dialogue, or you recognize a need for lasting change, or you decide it’s time to choose which of your life experiences should be footnotes and which should be part of your greater narrative. I believe these are moments of opportunity—and together, we can use the discomfort caused by life changes, relationship issues, depression, anxiety, or other stressors to navigate the next portion of your life journey in a brave, healthy direction. I look forward to learning more about you and your goals for change.
Using motivational interviewing, narrative therapy, and cognitive-behavioral techniques to identify the relationship between your thoughts, feelings, and the choices that follow, I will work with you to embrace your true self and create a life that is authentic and emotionally fulfilling.
There are certain transition points in life: moments when you identify a shift in your inner dialogue, or you recognize a need for lasting change, or you decide it’s time to choose which of your life experiences should be footnotes and which should be part of your greater narrative. I believe these are moments of opportunity—and together, we can use the discomfort caused by life changes, relationship issues, depression, anxiety, or other stressors to navigate the next portion of your life journey in a brave, healthy direction. I look forward to learning more about you and your goals for change.
(571) 290-2825 View (571) 290-2825
Photo of Meredith L McEver, LCSW, Clinical Social Work/Therapist
Meredith L McEver
Clinical Social Work/Therapist, LCSW
Verified Verified
Arlington, VA 22204  (Online Only)
Most adults come to me seeking help for anxiety, depression, relationship issues, or stress.
I use exploration of thoughts & feelings, mindfulness, meditation, and creativity to help you feel greater peace, be more aware of the present moment, pay less attention to unhelpful thoughts and live your life more fully. I believe that noticing what's "right" about you and paying attention to your inner wisdom greatly enhance the process of change and I focus on these areas in our time together. Everyone experiences difficulties at times and therapy can be an effective first step in finding freedom from suffering. I strive to create a safe and supportive environment and help you develop a nonjudgemental attitude toward yourself.
Most adults come to me seeking help for anxiety, depression, relationship issues, or stress.
I use exploration of thoughts & feelings, mindfulness, meditation, and creativity to help you feel greater peace, be more aware of the present moment, pay less attention to unhelpful thoughts and live your life more fully. I believe that noticing what's "right" about you and paying attention to your inner wisdom greatly enhance the process of change and I focus on these areas in our time together. Everyone experiences difficulties at times and therapy can be an effective first step in finding freedom from suffering. I strive to create a safe and supportive environment and help you develop a nonjudgemental attitude toward yourself.
(571) 470-5613 View (571) 470-5613
Photo of Alexis Buckheit, MSEd, LPC, LCPC, Licensed Professional Counselor
Alexis Buckheit
Licensed Professional Counselor, MSEd, LPC, LCPC
Verified Verified
5 Endorsed
Arlington, VA 22209
I enjoy working with clients who suffer from eating disorders, trauma,anxiety, depression, self-esteem issues, relationship issues, and managing life's transitions.
It's such a big step to reach out for help and so important to find a therapist that feels like the right fit. I am passionate about working together with clients during challenging times in their lives and believe in healing for all. I see the therapeutic relationship as the most important factor in supporting clients to explore and understand themselves and move towards self-discovery, self-acceptance, and healing. I am a warm, empathetic person and strive to provide a safe and supportive space to foster a productive therapeutic relationship, allowing individuals to create enduring and lasting change within their lives.
I enjoy working with clients who suffer from eating disorders, trauma,anxiety, depression, self-esteem issues, relationship issues, and managing life's transitions.
It's such a big step to reach out for help and so important to find a therapist that feels like the right fit. I am passionate about working together with clients during challenging times in their lives and believe in healing for all. I see the therapeutic relationship as the most important factor in supporting clients to explore and understand themselves and move towards self-discovery, self-acceptance, and healing. I am a warm, empathetic person and strive to provide a safe and supportive space to foster a productive therapeutic relationship, allowing individuals to create enduring and lasting change within their lives.
(703) 420-3055 View (703) 420-3055
Photo of Courtney Freiman, PsyD, Psychologist
Courtney Freiman
Psychologist, PsyD
Verified Verified
5 Endorsed
Arlington, VA 22201  (Online Only)
In addition, I work with couples enduring marital/ relationship difficulties.
Change, no matter how necessary it may be, is never easy. I create an open and supportive environment which allows individuals to feel comfortable in sharing their personal stories. I help empower individuals to set healthy goals and gain personal insight. I offer patience, support and constructive feedback to help individuals become more aware of their needs and to teach people the skills needed to make positive and adaptive choices. I utilize an eclectic approach to therapy which allows me to tailor treatment to a person's needs in order to assess difficulties, set realistic goals, and to evaluate progress.
In addition, I work with couples enduring marital/ relationship difficulties.
Change, no matter how necessary it may be, is never easy. I create an open and supportive environment which allows individuals to feel comfortable in sharing their personal stories. I help empower individuals to set healthy goals and gain personal insight. I offer patience, support and constructive feedback to help individuals become more aware of their needs and to teach people the skills needed to make positive and adaptive choices. I utilize an eclectic approach to therapy which allows me to tailor treatment to a person's needs in order to assess difficulties, set realistic goals, and to evaluate progress.
(203) 819-7782 View (203) 819-7782
Photo of Anthony LoPresti, MS, PsyD, Psychologist
Anthony LoPresti
Psychologist, MS, PsyD
Verified Verified
1 Endorsed
Arlington, VA 22209
I value a compassionate, warm, genuine therapeutic relationship that can help you come to know your problems and identify actionable solutions.
It can be difficult to find the "right" therapist. Many clients are nervous about what therapy entails and wonder if counseling will really help them. Although this is completely normal, it shouldn't get in the way of finding the support you deserve. I have found success helping clients navigate relational and professional difficulties. Sometimes these problems come from an identifiable stressor (such as trauma), and other times are more nebulous. I am committed to helping you better understand yourself and create long-lasting change.
I value a compassionate, warm, genuine therapeutic relationship that can help you come to know your problems and identify actionable solutions.
It can be difficult to find the "right" therapist. Many clients are nervous about what therapy entails and wonder if counseling will really help them. Although this is completely normal, it shouldn't get in the way of finding the support you deserve. I have found success helping clients navigate relational and professional difficulties. Sometimes these problems come from an identifiable stressor (such as trauma), and other times are more nebulous. I am committed to helping you better understand yourself and create long-lasting change.
(571) 200-5286 View (571) 200-5286
Photo of Anne N Kamau, LPC, NCC, MA, Licensed Professional Counselor
Anne N Kamau
Licensed Professional Counselor, LPC, NCC, MA
Verified Verified
3 Endorsed
Arlington, VA 22204
Do you long for relief from anxiety and depression? Is low self-esteem holding you back? Do you feel stuck in a toxic relationship that stresses and drains you? Oftentimes we feel like it’s impossible to beat these patterns, to feel truly confident, to break free. And it impacts our daily lives in more ways than we know. These problems can make you hide, minimize, and suppress yourself. They can make you live below your full potential.
Do you long for relief from anxiety and depression? Is low self-esteem holding you back? Do you feel stuck in a toxic relationship that stresses and drains you? Oftentimes we feel like it’s impossible to beat these patterns, to feel truly confident, to break free. And it impacts our daily lives in more ways than we know. These problems can make you hide, minimize, and suppress yourself. They can make you live below your full potential.
(571) 341-7249 View (571) 341-7249
Photo of Elizabeth (Puma) Cornick, LCSW, Clinical Social Work/Therapist
Elizabeth (Puma) Cornick
Clinical Social Work/Therapist, LCSW
Verified Verified
Arlington, VA 22209
I provide treatment for a variety of issues: anxiety, depression, relationship problems, parenting, infertility, among others.
I have been a practicing psychotherapist in the metropolitan area for the past 25 years. I received my B.A. from the University of Virginia and MSW from Catholic University. Emotional distress, as uncomfortable as it is, represents not only an opportunity to heal, but a chance to grow. It can be a chance to discover how to be effective at reaching one's objectives and achieving fulfillment, whether it be emotional, relational, or professional. My aim is to assist in this process.
I provide treatment for a variety of issues: anxiety, depression, relationship problems, parenting, infertility, among others.
I have been a practicing psychotherapist in the metropolitan area for the past 25 years. I received my B.A. from the University of Virginia and MSW from Catholic University. Emotional distress, as uncomfortable as it is, represents not only an opportunity to heal, but a chance to grow. It can be a chance to discover how to be effective at reaching one's objectives and achieving fulfillment, whether it be emotional, relational, or professional. My aim is to assist in this process.
(703) 662-1961 View (703) 662-1961
Photo of Caley Gelsomino, LCSW, Clinical Social Work/Therapist
Caley Gelsomino
Clinical Social Work/Therapist, LCSW
Verified Verified
Arlington, VA 22201  (Online Only)
Whether you are seeking support for anxiety, trauma or relationship issues, i'm here to guide you towards emotional well-being and personal growth.
Hi, im Caley a Licensed Clinical Social Worker (LCSW) at CBG Counseling a practice of millennial therapists with a modern approach too therapy. I know first hand how important it is to trust and be able to relate to your therapist which is why i show up as my authentic self in sessions. At CBG Counseling we specialize in helping millennial women process trauma and overcome feelings of anxiety. We offer virtual counseling services tailored to your individual needs. Embrace the convenience and privacy of online sessions from the comfort of your own space.
Whether you are seeking support for anxiety, trauma or relationship issues, i'm here to guide you towards emotional well-being and personal growth.
Hi, im Caley a Licensed Clinical Social Worker (LCSW) at CBG Counseling a practice of millennial therapists with a modern approach too therapy. I know first hand how important it is to trust and be able to relate to your therapist which is why i show up as my authentic self in sessions. At CBG Counseling we specialize in helping millennial women process trauma and overcome feelings of anxiety. We offer virtual counseling services tailored to your individual needs. Embrace the convenience and privacy of online sessions from the comfort of your own space.
(571) 495-3367 View (571) 495-3367
Photo of Dr. Angela Cano Sampson, PhD,  , LPC, NCC, CSC, Licensed Professional Counselor
Dr. Angela Cano Sampson
Licensed Professional Counselor, PhD, , LPC, NCC, CSC
Verified Verified
Arlington, VA 22209  (Online Only)
Divorced and now Happily Married, I understand the challenges involved with building a strong, team-like, marital relationship and letting go of the OLD to embrace the NEW.
At Evolución, we believe that our journeys in life can leave us all feeling challenged and alone and from time to time it can feel unmanageable. Our hopes at Evolución are to provide support and encouragement for individuals, couples, and families along the path. Our goal at Evolución is your space to discover and EVOLVE without judgment. It is your space in this world to be inspired, supported, and motivated to help you heal, restore and recharge in whatever way you desire. I work with clients as they work their way through social, emotional, identity, and relationship issues that they are faced with in their life journey.
Divorced and now Happily Married, I understand the challenges involved with building a strong, team-like, marital relationship and letting go of the OLD to embrace the NEW.
At Evolución, we believe that our journeys in life can leave us all feeling challenged and alone and from time to time it can feel unmanageable. Our hopes at Evolución are to provide support and encouragement for individuals, couples, and families along the path. Our goal at Evolución is your space to discover and EVOLVE without judgment. It is your space in this world to be inspired, supported, and motivated to help you heal, restore and recharge in whatever way you desire. I work with clients as they work their way through social, emotional, identity, and relationship issues that they are faced with in their life journey.
(571) 520-7511 View (571) 520-7511
Photo of Jelena Kecmanovic - Dr K., PhD, Psychologist
Jelena Kecmanovic - Dr K.
Psychologist, PhD
Verified Verified
Arlington, VA 22201
If you are looking for a seasoned, astute, and evidence-based psychologist who can help with anxiety, worry, stress management for high achievers, interpersonal problems, and existential concerns, we might be a good fit. I have over 30 years of psychotherapy, teaching, writing, and presenting experience and am an adjunct professor at Georgetown University. I am also a frequent contributor to the Washington Post. Committed to using the most effective treatments available, I integrate Cognitive-Behavioral Therapy (CBT) with existential approaches, all while building a strong, supportive, and collaborative therapeutic relationship.
If you are looking for a seasoned, astute, and evidence-based psychologist who can help with anxiety, worry, stress management for high achievers, interpersonal problems, and existential concerns, we might be a good fit. I have over 30 years of psychotherapy, teaching, writing, and presenting experience and am an adjunct professor at Georgetown University. I am also a frequent contributor to the Washington Post. Committed to using the most effective treatments available, I integrate Cognitive-Behavioral Therapy (CBT) with existential approaches, all while building a strong, supportive, and collaborative therapeutic relationship.
(202) 800-2046 View (202) 800-2046
Photo of Lakeisha Grayer - Modern Mind Therapy + Life Coaching, LPC, Licensed Professional Counselor
Modern Mind Therapy + Life Coaching
Licensed Professional Counselor, LPC
Verified Verified
Arlington, VA 22203
Everyone decides to seek counseling for many reasons; some need to respond to unexpected changes in their lives, while others seek self-exploration and growth within themselves or a relationship.
Modern Mind is a new approach to mental wellness focused on updating your mental consciousness in a way that frees you from negative thought patterns. By using an integrative approach that treats you as a whole person, not a diagnosis. The goal is to empower you by helping you to develop problem-solving and enhanced coping skills that create long-lasting, growth-oriented solutions tailored to your unique needs.
Everyone decides to seek counseling for many reasons; some need to respond to unexpected changes in their lives, while others seek self-exploration and growth within themselves or a relationship.
Modern Mind is a new approach to mental wellness focused on updating your mental consciousness in a way that frees you from negative thought patterns. By using an integrative approach that treats you as a whole person, not a diagnosis. The goal is to empower you by helping you to develop problem-solving and enhanced coping skills that create long-lasting, growth-oriented solutions tailored to your unique needs.
(571) 200-3932 View (571) 200-3932
Photo of Meredith Luttrell, LPC, LCPC, Licensed Professional Counselor
Meredith Luttrell
Licensed Professional Counselor, LPC, LCPC
Verified Verified
5 Endorsed
Arlington, VA 22209
I particularly enjoy working with clients hoping to change unhealthy relationship patterns, and manage the effects of trauma, depression, anxiety.
I view therapy as a collaborative process where the client is the expert on themselves, and the therapeutic relationship is the most important factor in creating change. It is important to have a safe, empowering, and supportive environment in order to examine hurtful relationship patterns and emotional difficulties, and in turn change negative self-evaluations to better respond to life's challenges. I am genuinely interested in and committed to helping my clients gain insight and express their needs in order to engage in more healthy relationships and live the life they want.
I particularly enjoy working with clients hoping to change unhealthy relationship patterns, and manage the effects of trauma, depression, anxiety.
I view therapy as a collaborative process where the client is the expert on themselves, and the therapeutic relationship is the most important factor in creating change. It is important to have a safe, empowering, and supportive environment in order to examine hurtful relationship patterns and emotional difficulties, and in turn change negative self-evaluations to better respond to life's challenges. I am genuinely interested in and committed to helping my clients gain insight and express their needs in order to engage in more healthy relationships and live the life they want.
(757) 793-2859 View (757) 793-2859
Photo of Lyzaida I. Rivera-Bauer, PhD, Psychologist
Lyzaida I. Rivera-Bauer
Psychologist, PhD
Verified Verified
3 Endorsed
Arlington, VA 22209
Do you feel tense, anxious, on edge? Do you worry about work, relationships, family- seemingly everything? Are you kept awake at night by racing thoughts, rehashing things you said yesterday, reviewing tomorrow's to-do list? I can help! I have experience working with a range of issues, and specialize in treating anxiety, OCD, and relationship difficulties. I work collaboratively to identify problematic patterns of thoughts, feelings, and behaviors, and guide you in learning and implementing strategies to change these cycles. We can explore why these issues developed, to help you better understand yourself and live a more fulfilling life.
Do you feel tense, anxious, on edge? Do you worry about work, relationships, family- seemingly everything? Are you kept awake at night by racing thoughts, rehashing things you said yesterday, reviewing tomorrow's to-do list? I can help! I have experience working with a range of issues, and specialize in treating anxiety, OCD, and relationship difficulties. I work collaboratively to identify problematic patterns of thoughts, feelings, and behaviors, and guide you in learning and implementing strategies to change these cycles. We can explore why these issues developed, to help you better understand yourself and live a more fulfilling life.
(571) 202-7125 View (571) 202-7125
Photo of Laila Salem Farmand, PsyD, Psychologist
Laila Salem Farmand
Psychologist, PsyD
Verified Verified
2 Endorsed
Arlington, VA 22203
Dr. Farmand is a licensed clinical psychologist specializing in the following areas: Infertility concerns, postpartum depression and anxiety, adjustments to becoming a new mother, ADHD, relationship concerns/couples counseling, workplace stress, depression, anxiety, insomnia, adjustment issues, emotion regulation concerns, stress management, family of origin problems, and college or graduate student concerns. Dr. Farmand also works with parents around managing childhood impulse control and behavioral problems.
Dr. Farmand is a licensed clinical psychologist specializing in the following areas: Infertility concerns, postpartum depression and anxiety, adjustments to becoming a new mother, ADHD, relationship concerns/couples counseling, workplace stress, depression, anxiety, insomnia, adjustment issues, emotion regulation concerns, stress management, family of origin problems, and college or graduate student concerns. Dr. Farmand also works with parents around managing childhood impulse control and behavioral problems.
(703) 936-2891 View (703) 936-2891
Photo of Shelley Fontanella, MA, LPC, Licensed Professional Counselor
Shelley Fontanella
Licensed Professional Counselor, MA, LPC
Verified Verified
Arlington, VA 22204
I have experience working with depression, anxiety, relationship issues, body image issues, grief, and more.
Life can be difficult and at times leave wounds, but with some work we can be restored. I am an interactive therapist who feels privileged to walk alongside of my clients through various life situations. I see counseling as a relationship where you set aside time to evaluate where you are in life and where you want to be. As the counselor, I see my job as helping you to problem solve difficult areas of your life and facilitate self investigation into your past and current behaviors and thoughts with the end goal of bringing you greater fulfillment.
I have experience working with depression, anxiety, relationship issues, body image issues, grief, and more.
Life can be difficult and at times leave wounds, but with some work we can be restored. I am an interactive therapist who feels privileged to walk alongside of my clients through various life situations. I see counseling as a relationship where you set aside time to evaluate where you are in life and where you want to be. As the counselor, I see my job as helping you to problem solve difficult areas of your life and facilitate self investigation into your past and current behaviors and thoughts with the end goal of bringing you greater fulfillment.
(703) 468-8168 View (703) 468-8168
1
...
Relationship Issues Therapists
While need for human connection appears to be innate, the ability to form healthy, loving relationships is learned. Some evidence suggests that the ability to form a stable relationship starts to form in infancy, in a child's earliest experiences with a caregiver who reliably meets the infant's needs for food, care, warmth, protection, stimulation, and social contact. Such relationships are not destiny, but they are theorized to establish deeply ingrained patterns of relating to others. The end of a relationship, however, is often a source of great psychological anguish.