Licensed Psychologist

Managing Traumatic Stress: Dealing with the Hurricanes from Afar

Originally published by the American Psychological Association Even if you were not directly affected by the hurricanes, you may be distressed from watching images of the destruction and worrying about people’s who lives have been turned upside down. This can be especially true if a relative or loved one was affected by the disaster. APA offers the following suggestions for managing your hurricane-related distress:
  • Take a news break. Watching  endless replays of footage from the disasters can make your stress even greater. Although  you'll want to keep informed - especially  if you have loved ones affected by the disasters  -  take a break from watching  the news.
  • Acknowledge your feelings. Some feelings when witnessing a disaster may be difficult for you to accept. You may feel relief that the disaster  did not touch you, or you may feel guilt that you were left untouched  when so many were affected. Both feelings are common.
  • Keep things in perspective.  While the disaster can feel overwhelming, it is important to appreciate those things that continue  to be positive and a source of well-being and strength.
  • Find a productive way to help if you can. Many organizations are set up to provide  financial or other aid to victims of natural disasters. Contributing enables you to participate in the recovery and engage proactively.
  • Control what you can. There are routines in your life that you can continue and sometimes you need to do those and take a break from even thinking about the disasters.

How Do I Know If I Need Therapy?

Originally Published by the American Psychological Association Most of us face struggles at some point in our lives. These struggles may include stress at work, difficulty with a romantic partner, or problems with a family member. Alternatively, struggles may include emotional symptoms such as depression or anxiety, behavioral problems such as having difficulty throwing useless items away or drinking alcohol too often, and cognitive symptoms such as repetitive upsetting thoughts or uncontrolled worry. Sometimes, life's struggles can be eased by taking better care of yourself and perhaps talking about the issues with a supportive friend or family member. But there may be times when these steps don't resolve the issue. When this happens, it makes sense to consider seeking the help of a qualified licensed psychologist. How do you know if therapy is needed? Two general guidelines can be helpful when considering whether you or someone you love could benefit from therapy. First, is the problem distressing? And second, is it interfering with some aspect of life? When thinking about distress, here are some issues to consider:
  • Do you or someone close to you spend some amount of time every week thinking about the problem?
  • Is the problem embarrassing, to the point that you want to hide from others?
  • Over the past few months, has the problem reduced your quality of life?
When thinking about interference, some other issues may deserve consideration:
  • Does the problem take up considerable time (e.g., more than an hour per day)?
  • Have you curtailed your work or educational ambitions because of the problem?
  • Are you re-arranging your lifestyle to accommodate the problem?
A ‘yes’ response to any of these questions suggests that you might wish to consider seeking professional help. Remember that sometimes a problem might be less upsetting to you than it is to the people around you. This does not automatically mean that you are in the know and your friends or family are over-reacting to you. Rather, this situation suggests that you may wish to think about why the people who care about you are upset. Clearly, the decision to enter into therapy is a very personal one. Numerous advances have been made in the treatment of psychological disorders in the past decade and many therapies have been shown scientifically to be helpful. As you think about whether therapy might be helpful to you, remember that many psychological problems have been shown to be treatable using short-term therapy approaches. Learning more about different approaches to therapy might also help you to discern if one of them sounds like a good fit with your personality and approach to life. Given the range of therapeutic options that are available, you don‘t need to continue to struggle with a problem that is upsetting and/or getting in the way of other parts of your life. Help is available.

The Walking Wounded

From the January 2013 Monitor on Psychology by Dr. Siri Carpenter:

Excerpt: "Tempted to read just one more email before you sleep?  Don't.  New research finds that not getting enough sleep - whether because of our insatiable desire for digital media or more traditional sleep disturbances - has far-reaching effects on physical and psychological health." Read the full article.

Containment in Relationships

While the vicissitudes of ordinary discourse in relationships may be easy for many of us, this is by no means the case for everyone. What can we make of the times when words are not treated as simply the best tools we’ve come up with for communicating our private experiences to others, but instead serve as triggers in relationships- triggers that can lead one to feel quite threatened or to feel the need to marshal whatever defenses may be available in one’s arsenal? What can we do when seemingly ordinary attempts at communication lead to feelings of humiliation, woundedness, or unbidden vulnerability? Unfortunate circumstances such as a history of trauma in relationships, bullying, or chronic humiliation are only a few of the things that can lead a person to feel a sense of danger about making contact with another person’s point of view. Rather than experiencing another’s perspective as food for thought, an opportunity for meaningful reflection or increased intimacy, or helpful feedback about one’s interaction with the external world- those of us wounded by past traumas may at times experience others’ ideas as weapons of destruction that can lead to painful and concrete outcomes such as disruptions in the ability to think, the visceral experience of being slapped in the face, a rush of adrenaline or “out of control” emotion, or even physiological distress/illness. And since meaningful relationships typically require a level of communication that involves a regular open exchange between oneself and others, relationships can be a minefield for those who experience the other person’s mind as a potential source of danger and distress. This is, of course, not only difficult for the one who feels so raw to the other’s impact, but is also difficult for the partner or loved one in relationship with such a person. It is certainly not easy to speak freely of one’s impressions, needs, or observations- only to have this easy conversational flow be treated as an act of aggression or a threat. It is also not easy to be on the receiving end of defenses such as rage, counter-attack, or distance and withdrawal. And so, the fate of a conversation between two partners very much depends on each person’s ability (not just willingness!) to hear and take in the other’s communications without feeling unduly threatened, as well as each partner’s ability to accommodate to the other’s capacities (or lack of capacity) to do the same. One partner may need to learn how to tone down a sense of reactivity to the other’s communications; the other may need to figure out how to speak in a way that will expand his loved one’s tenuous ability to hear and to be aware. Whether it’s feedback about oneself that is felt to be painful; awareness of the other’s needs, separateness, or vulnerability; or even perhaps just the unknown of what we may come to feel, know, or remember when talking with another, finding ways to help the people we love most be able to stretch their capacities to listen and to know, is often a task left to the one who is perhaps a little less wounded- or vulnerable- in the moment. (And of course the one who finds himself positioned in the more vulnerable position can shift from one minute to the next!) So, how do we take some of the sting out of talking, thinking, and listening? One of my favorite techniques is the simple one of “asking permission”. By the simple act of asking another’s permission before we offer our thoughts, we avoid catching the person off-guard; we give the other a sense of healthy control; and we create a sense of receptivity which can open up space for our words can to enter willingly and gently, rather than by force. We can also communicate in ways that allow the other to “save face”, whether it’s during a shared parallel activity (like cooking together in the kitchen) or while sitting side by side (in the car, for example), easing the pressure often demanded by direct face to face communication. We might use metaphor, stories about our own selves, or open-ended comments that reduce the sense of threat that the other may experience from a more direct communication. Perhaps the best gift we can give another is to simply hold stuff inside ourselves until the other is truly ready for us to share it. Processing and containing our own thoughts, feelings, and perspective until the time seems right to “put it out there”, can give those we love the much needed space they may need in order to heal from past assaults and impingements to their own sense of self and integrity of being…allowing them slowly to trust that inviting in another may actually be a rewarding experience rather than a threatening one. Is this a gift you can give to those who need it most? Originally posted on Goldstein Therapy- Clifton, NJ

This May Be Comforting

If you wear a hijab, I'll sit with you on the train. If you're trans, I'll go to the bathroom with you. If you're a person of color, I'll stand with you if the cops stop you. If you're a person with disabilities, I'll hand you my megaphone. If you're an immigrant, I'll help you find resources. If you're a survivor, I'll believe you. If you're a refugee, I'll make sure you're welcome. If you're a veteran, I'll take up your fight. If you're a LGBTQ, I won't let anybody tell you you're broken. If you're a woman, I'll make sure you get home ok. If you're tired, me too. If you need a hug, I've got an infinite supply. If you need me, I'll be with you. All I ask is that you be with me, too.

Mother's Day or Doomsday

Mother's Day. Images of mothers and happy children are everywhere. It seems that everyone is part of this joyous celebration. Everyone, that is, except the woman who has not been able to conceive. For her, Mother's Day is a nightmare, a painful reminder of her failure. She feels disappointed in herself, disillusioned that her body has betrayed her, and defective as a woman. Men have been socialized to think of parenthood as one possible ingredient in their traditional adult roles; girls are programmed to think of the achievement of motherhood as an absolute necessity to their identity as adult women. They perceive a threat to their ability to become mothers as a threat to their ability to be seen as legitimate adult females. No other activity can substitute for it. A woman without children often feels cheated, angry, depressed, jealous and anxious. She doesn't have what she's dreamed of all her life. Her body isn't cooperating with her desire to become a mother. She feels like a failure. She is jealous of people who have children, and guilty for feeling jealous. She is tired of all of the questions and advice from family, friends, and even strangers. She is frustrated that the medical tests and procedures have not worked. Each month she rides an emotional roller coaster first hopeful and then devastated. Caught up in the quest to have a child, women forget that they are anything other than childless. It is important for infertile women to reclaim their lives, regain control and once again feel joy and meaning in their lives. There are powerful psychological tools that women can use to help themselves. They can learn to change their negative thoughts. They can learn how to nourish themselves. They can improve communication with their spouses. These techniques have helped many women feel more optimistic, and less anxious and stressed. They feel better, their lives feel more meaningful, and sometimes, once they have have done these things, they may find themselves pregnant.

Infertility and the Mind-Body Connection

Couples in distress may disagree about sexual issues, romance, money, or infidelity. They criticize and blame each other, and often cannot let go of painful incidents or arguments from years past. They are quick to bring up grievances with their partner but are unable to listen and truly hear what their partner has to say. What is going on?

Drs. Sue Johnson, Harville Hendrix and Helen Hunt, believe that the root of the problem is that the partners do not have an adequate emotional connection. They state that the need for a safe emotional connection is basic to all relationships. When that connection is present, partners feel safe with each other, and can risk emotional vulnerability as they listen and speak to each other openly about their feelings and needs. When safe connections are lost, partners seek to protect themselves and avoid hurt. They may blame each other, or even get aggressive in an effort to get a response. Alternately, they may shut down and try not to care. If the reconnection does not occur, their struggle intensifies, continues, and becomes more painful.

Think about the messages that you have received from important people in your life about closeness and trust. What did your past relationships teach you? Did you see loved ones as reliable or untrustworthy? Was your voice heard and listen to, or were you told to be "seen and not heard?" Did you learn to distance yourself, or not need others because depending on others was dangerous? Were you taught that it is weak to need closeness, or support? What strategies did you use in past relationships when things went wrong? When you felt alone or disconnected in your present relationship did you become very emotional and demanding, or were you more likely to shut down? How well do these patterns work for you in your relationships?

Relationships are never easy but as you become aware of your dysfunctional behavior patterns, you have the power to change them. You can make your relationships more meaningful by learning a new way of relating to one another. As you develop healthy communication patterns you will be building trust and allowing rewarding emotional connections.

Hold Me Tight, Dr. Sue Johnson
Making Marriage Simple, Harville Hendrix, PhD and Helen Hunt, PhD

Choosing a Therapist: Psychiatrist or Psychologist

The term "psychologist" and "psychiatrist" are often used interchangeably to describe a person who conducts psychotherapy. In fact,these two professions are not interchangeable. There are significant differences between these professional roles. Examining the educational background required for each profession can be helpful in understanding their differences. Psychiatrists go to medical school like other physicians. After three or four years they receive their M.D. degree. They spend the next four years in a residency which generally includes inpatient and outpatient rotations in general medicine, family medicine, pediatrics, neurology, and psychiatry. This residency does not usually include specific training in psychology and psychotherapy. After they complete their residency and pass the state board exam, these physicians can obtain a license to practice. As physicians, they are able to prescribe medicine and admit patients to hospitals. Clinical Psychologists typically spend five to seven years receiving graduate training in psychology in order to obtain a doctoral degree, (most commonly a Ph.D. but may be a Psy.D. or an Ed.D.), in clinical or counseling psychology. Psychology is the study of people: how they think, act, react, and interact. All course work is related to understanding every aspect of human behavior and the thoughts, feelings, and motivation underlying this behavior. Two years of supervised clinical experience follow receipt of the doctorate degree when candidates are trained to diagnose, perform psychotherapy, and help people understand themselves and address their emotional issues. Following these two years of clinical experience, they may take the state licensing exam. Only after they have met the above requirements and passed the state licensing exam are they able to practice clinical psychology and call themselves a "psychologist." Some psychologists and psychiatrists go on to receive further specialized training after attaining their Ph.D. or M.D. Degrees. Advanced programs in child, adolescent, family, marriage and couples therapy, group psychotherapy, psychoanalytic psychotherapy, and behavioral and cognitive therapy may require at least one to three years of additional coursework and supervision. A clinician who has obtained one or more Certificates in advanced training programs is among the most highly trained mental health professionals. Psychotherapy is conducted with individuals, groups, couples, and families. Psychotherapists help people to overcome stress, emotional problems, relationship problems, and troublesome habits. Psychologists treat people by providing psychotherapy focused on helping people understand the root of their problems and what they can do to change destructive behaviors, grow emotionally, and enhance their lives. Most psychiatrists in private practice focus on symptom relief using medicine to correct chemical imbalances that affect their clients. Most psychologists do not prescribe medicine. However, some psychologists who have taken advanced training in psychopharmacology can prescribe medicine as a part of their psychotherapy treatment.

Mind Body Connection

Your emotional, social, and spiritual state has been proven to have a significant impact on your physical health. Stressful events like birth of a new baby, retirement or loss of a job, money problems, divorce, or the death of a loved one often seem linked with the occurrence of physical symptoms. We hear about people who have heart attacks soon after retirement or the development of serious illnesses following a major life change. Students cramming for final exams frequently get sick. Our immune system is weakened and we are more susceptible to illness during those times when we are feeling anxious or upset.

Research has demonstrated that the use of stress reducing techniques can lower blood pressure and stress hormone levels, relieve pain and improve immune functioning. Mind Body medicine has also improved clinical conditions such as HIV, cancer, insomnia, anxiety, depression and post traumatic stress disorder (PTSD). There is even preliminary evidence that muscles in the body can be toned and strengthened through mental exertion.

You can learn to use your thoughts to positively influence some of your body's physical responses, thus reducing your level of stress. Research has shown that when a person recalls or imagines a happy experience his body and mind tend to relax. On the other hand, when she recalls or imagines a frightening experience, her heart beats faster, her hands may become cold and clammy, and she may begin to sweat.

Below are some relaxation exercises that can help you use the power of your mind to reduce anxiety and promote an increased sense of well being. They do not take the place of needed medical treatment, but they do have powerful psychological benefits.

Relaxed Breathing

Sit or lie down in a comfortable place. Slowly take a deep breath through your nose, hold it, and then slowly, breathe out through your mouth. Focus on your breathing and breathe in a regular rhythm counting from one to five each time you inhale and exhale. Practice this relaxed breathing for 5 minutes two times a day or whenever you feel stressed.

Progressive Muscle Relaxation
 
  • Progressive muscle relaxation involves sequentially tensing and then relaxing specific muscle groups in the body, one at a time, and progressing throughout the entire body.

  • The key to this exercise is to tighten a specific muscle group for at least 5 seconds until you feel the tension, and then release the muscles for 10 seconds, noticing the difference in how the muscles feel before and after the exercise.

  • You can start by relaxing the muscles in your legs and feet, working up through each muscle group to your neck, shoulders, and scalp.


Mind Relaxation

Close your eyes. Breathe normally through your nose. As you exhale, say a word or phrase such as "calm" or "I feel peaceful." Continue for 10 minutes. If your mind wanders, remind yourself to think about your breathing and the word that you have chosen. Keep your breathing slow and steady.

* * *

There are many other tools that trained professionals utilize to help calm you and help you deal with pain and stress. Exercise, yoga, massage, meditation, and guided imagery can also be used to enhance the mind-body connection.
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