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When Words Hurt

When we think of domestic  abuse, we often think of someone being physically beaten but verbal abuse happens just as often. Unlike physical abuse, the participants in the relationship may not realize they’re harming each other– they may even find some transgressions to be “normal”.   Emotional abuse can happen between parent and child, romantic partners, among relatives and between friends.

In my  therapy practice, I’ve worked with many people who are being emotionally and verbally abused.  Many don’t realize they’re being abused and are hesitant to call what they’re experiencing abuse.  However as we talk and process the behavior of the other person and how it makes them feel it’s as if a light bulb goes off and they realize that yes it’s abusive and no one should be  treated this way.

If your answer is yes to these questions, you are most likely in an abusive relationship.

Does anyone regularly ridicule, dismiss, disregard your opinions, thoughts and feelings?

Does anyone make fun of you or put you down in front of others?

Does someone treat you as if you’re inferior to them?

Does someone make you feel that they are always right?

Does someone call you names and label you?

Do they blame you for their problems or unhappiness?

If you ever feel that you’re being emotionally or verbally abused, seeing a therapist may be very helpful for you.  Therapy can help you to understand the impact of an emotionally abusive relationship.   It can also help you to learn healthier ways of relating to others and caring for your own needs.  Remember no one deserves to be abused.

 

When You Can’t Stop Eating

Often when people think of eating disorders, they picture a young woman counting calories, wasting away in the case of anorexia, or a young woman hunched over the toilet purging her meals in order to stay slim in the case of bulimia.  However, many people often overlook or are unaware of compulsive overeating or binge eating, which is also a very serious eating disorder. In fact according to the National Association of Anorexia Nervosa and Associated Disorders, almost 5 % of adults in the United States have some form of binge eating disorder. Similar to alcoholism and substance abuse, binge eating is considered an addiction and is listed in the DSM V.  I have personal experience with binge eating disorder.  I struggled with this for many years and found help   through groups and individual psychotherapy.  However as with all addictions, it’s something which needs to be continued to be worked on in order to remain in recovery. Many are surprised to learn that binge eating is an addiction. However  if you do some online research, you will see that food activates the same reward pathways that are activated when one uses cocaine, opiates, etc.

According to the DSM V,  binge eating disorder is characterized by frequent episodes of eating large amounts of food and/or feeling unable to stop eating. People who have binge eating disorder often feel embarrassed about overeating and want to stop, but are trapped in a vicious cycle of shame and compulsive eating. In order to recover, one must change the relationship they have with food, a process that can take some sessions with a mental health professional.  If you feel that your eating is out of control, it’s important to reach out for help.

Symptoms

Behavioral and emotional signs and symptoms of binge-eating disorder include the following:

  • Eating unusually large amounts of food in a specific amount of time, such as over a 2-hour period
  • Feeling that your eating behavior is out of control
  • Eating even when you’re full or not hungry
  • Eating rapidly during binge episodes
  • Eating until you’re uncomfortably full
  • Frequently eating alone or in secret and/or hiding your food
  • Feeling depressed, disgusted, ashamed, guilty or upset about your eating
  • Frequently dieting, possibly without weight loss

 

 Causes

According to the Mayo Clinic, there are correlations between binge eating and depression, anxiety, and PTSD. Having tried many diets or having grown up in a household that promoted binge-eating behaviors also contribute to the disorder.

Risk factors
According to The Alliance For Eating Disorders  there are several factors which will increase a person’s risk for developing binge eating disorder.  This list of factors is from their  website, allianceforeatingdisorders.com.

  • Family history.You’re much more likely to have an eating disorder if your parents or siblings have (or had) an eating disorder. –
  • Psychological issues.Most people who have binge-eating disorder feel negatively about themselves and devalue their skills and accomplishments, which often coincides with depression.  Triggers for binging often include stress, poor body self-image, food, and boredom.
  • Dieting.Many people with binge-eating disorder have a history of dieting — some have dieted to excess dating back to childhood. Dieting or restricting calories during the day may trigger an urge to binge eat, especially if you have low self-esteem and depression.  You may also be hungry from restricting all day.
  • Your age.Although people of any age can have binge-eating disorder, it usually develops  in adolescence or during the early 20’s

.If not treated, binge eating disorder can causes health consequences down the road such as diabetes, obesity and high cholesterol.  Talk to your primary care doctor or a mental health provider about your binge eating symptoms and feelings. If you’re nervous or reluctant to seek treatment, talk to someone you trust about what you’re going through. A friend, loved one or   teacher can help you take the first steps to successful treatment of binge-eating disorder.  Over eaters Anonymous is also a resource where people who also deal with binge eating come together to support each other in recovery.  Remember, you’re not alone and seeking help is the first step towards recovery.

 

How can I have fun without drugs and alcohol?

I’ve had many clients say to me , “It’s impossible for me to have fun without being high or drunk or being sober is so boring.”   At first yes it probably is boring to do things without being high, I mean if being high didn’t make you feel good, people wouldn’t do it.   There is  good news there are a number of strategies and resources at your disposal that can help you limit your substance use and get involved in substance-free activities where you can have a good time.   You don’t have to set out on this challenge alone– it’s okay to reach out to a supportive friend, relative, or a professional, who can help you stay on course.

As you begin to reduce your substance use, take some time to reflect on what makes you feel happy and fulfilled. Sharpening your awareness of your social, professional, and spiritual interests can go a long way towards finding activities that excite you and people who share your interests outside of substance use. Consider these suggestions to get you started: organizations that work toward a cause in which you strongly believe, athletic groups, political campaigns, reading circles, writing and theatrical clubs When you find what you’re into, you might also invite your current group of friends to join you in some fun without substances. Getting involved in these types of activities may also pave the way to new friendships that don’t revolve around on using substances. Here are more ideas you can enjoy  by yourself or with others.

  •  Work out at the gym, try a new group exercise class, or plan to go running or walking outside.
  •  Visit museums or take a trip to a zoo or aquarium (any of which may offer discounted admission for students or on certain days).
  •  Try being a tourist in your own city and find the hidden treasures  by exploring new neighborhoods.
  •  Try perusing websites like meetup.com to find other people in your area that share your interests. If you don’t find a group that you’re into, you can have like-minded individuals seeking you out by creating a special-interest group of your own.

It’s also understandable that you may want to still see your friends who still use.  If they were even your friends in the first place. Most of the time, you are useless to your addict friends if you quit..  It is possible to avoid the temptations of  alcohol or other substances.. By engaging in some pre-planning before a night out, you can think ahead about how much you want to consume (if at all) and how to politely decline offers of alcohol or anything else  that might come your way. Start by thinking about how you’d ideally like to handle a situation when someone offers or encourages you to have a drink or take a hit. Some responses could include: “Thanks, but I’m cutting back for a while,” or “No, I have a drug test tomorrow.” It may also help to let others know that you’ve set a personal limit for the night or have stopped using if you find that helps you stick to your plan.  There are also activities you can do that may help you check in with your internal state and strengthen your resolve to limit your substance use. Learning yoga, meditation, mindfulness, and other relaxation techniques have helped many on the same road to coping  with stress resulting from this change in lifestyle, as well as provide motivation for improving mind-body health.

Remember, reducing any degree of psychological or physical dependence on substances takes time, and can be achieved through measured reductions in use.   In addition to filling your time with other activities and interests, it’s a good idea to  consider speaking with a counselor or therapist.  A therapist or counselor can help you define specific goals regarding your use, including how much you’d like to cut back and at what pace, which may make for a transition.

Best of luck on the road to personal change!

Why People Choose Online Therapy

When I think about why clients choose online therapy, the first answer that comes to my mind is about convenience: the comfort of being in your own office or home, no travel necessary, the time saved, and the time of sessions is usually more flexible.  I admit I was skeptical about doing online therapy but when I decided to begin my practice and I read about it, I realized that it is something I wanted to do in addition to seeing clients in a traditional office setting.  I have been providing online video therapy for awhile now and I do enjoy doing it and actually prefer it to working in a traditional office setting.

When I’ve asked clients how they feel about seeing me via video rather than in an office, they’ve stated that they feel comfortable working this way and it’s more convenient for them since they do not have to go to an office.  During a recent snow storm I was able to see 7 clients online, I would not have been able to do this in an office because it would have been very difficult for me or my clients to get to the office.

Another reason some people chose online therapy is that it gives an added layer of confidentiality.  With online therapy, no one else has to know that you’re going to therapy unless you chose to tell them.  I don’t feel as comfortable doing telephone therapy as I prefer to see my clients when we’re speaking however telephone counseling is also an option.

Some clients would not benefit from online therapy and do need to be seen in an office.  Clients who are schizophrenic and actively psychotic would not be good candidates for online therapy.  Also clients who have recent suicidal attempts would benefit from  in office therapy until they are more stable.

I have found the outcomes for my clients to be just as good whether I see them online or in my office and I’m so glad I made the leap and offer online therapy.

What is a Trigger?

Recently  we are often hearing about trigger warnings and on social media, many people will post a  warning before posting something which may be disturbing to others.  Triggers are not something new however until recently many people didn’t think about how something could trigger someone else.  If someone gets triggered, it often takes sometime to get out of the the moment and not think about the memory that was triggered by what they saw, heard or smelled.   Unfortunately it’s impossible to know what will trigger each person and some triggers are unavoidable.  It’s important to know if something will trigger you and to try to avoid any triggering situations.   Triggers are activated through one or more of the five senses: sight, sound, touch, smell and taste.  Sight and sound tend to be the most triggering for people.

 .

Sight

  • Often someone who resembles the abuser or who has similar traits or objects of the abuser will be triggering and bring back vivid memories of the abuse.
  • Witnessing someone else being abused.
  • The object that was used to abuse
  • Seeing a place or situation which reminds you of the abuse.

Sound

  • Anything that sounds like anger , pain or fear can be triggering.
  • Anything that resembles sounds that the abuser made for example . whistling,  or tone of voice
  • Words the abuser used.

Smell

  • Anything that resembles the smell of the abuser
  • Any smells that resemble the place or situation where the abuse occurred (ie. food cooking ,wood, odors, alcohol).

Touch

  • Anything that resembles the abuse or things that occurred prior to or after the abuse for example certain physical touch, someone standing too close or the way someone approaches you.

Taste

  • Anything that is related to the abuse, prior to the abuse or after the abuse for example. certain foods, alcohol, tobacco.

If you feel triggered  by something there are ways to help you to feel better.  Grounding exercises and deep breathing are usually helpful.  A good grounding exercise is to acknowledge that you’re being triggered, remind yourself that you’ll be ok and that you’re safe and not in the situation.  Think of some positive affirmations to repeat to yourself and most importantly be kind and compassionate to yourself and remind yourself that whatever happened was not your fault.

African American Women and Mental Health

There’s often a fear of putting our business in the street . . . of somehow revealing too much. Black women often perceive going to a therapist as something we don’t do.

African American women have the highest mortality rate for heart disease and stroke and the highest prevalence of high blood pressure and obesity. Recent research indicates that mental health plays a role in these health disparities. While many black women know and discuss the threats to their physical health, when it comes to mental health, there’s often silence and inaction.
Many black women are struggling with mental health issues but are not seeking professional help. Improving black women’s access to mental health treatment as a crucial element to addressing the serious, but often manageable, illnesses plaguing their physical health.

Women Who Need Care Go Without
Despite the emotional and physical consequences of mental-health problems, black women are less likely to seek treatment. The percentage of African Americans overall who receive needed mental-health care is only half that of whites, according to a Surgeon General report on mental health. By some estimates, only 7 percent of black women suffering from depression receive any treatment, compared with 20 percent of the general population.
The California Black Women’s Health Project, released the results of a study of more than 1,300 African American women across the state. The subjects in the study revealed that they tended to repress feelings, let frustration build and release tension through tears or conflict. The findings of the study, which included a series of focus group discussions across the state, led to a launch of a mental health initiative to improve African American women’s acceptance of and access to mental health treatment.

It’s important for African American women to realize that self care is not selfish and you must take care of you so you can take care of others. It is also important to recognize something is wrong and you deserve to feel well.

Many Black women have a distrust and place a stigma that black women on mental-health treatment, in part from their difficulty in finding a therapist to whom they can readily relate. African Americans comprise less than 6 percent of mental-health care providers nationally. Overcoming this shortage may be crucial to improving treatment outcomes for African American women. In my work in the mental health field, I have found from interviews with clients that mental-health practitioners “don’t get it when they are working with people who don’t look like them.”

African American women also struggle against the stigma associated with mental-health treatment.
One study found that the proportion of African Americans who feared mental-health treatment was more than twice that of whites, according to the surgeon general’s report. Part of the fear stems from wariness of the medical establishment that arises from past abuses, such as the Tuskegee experiment. (In 1932, the federal government sponsored a study to examine the impact of untreated syphilis involving black men. The experiment went on until 1972 without the test subjects’ knowledge and most of the subjects died without receiving treatment.) As a result of the distrust engendered by the now-infamous experiment and the stigma associated with seeking help, many black women rely on spiritual leaders and community members to handle personal problems. There’s also an added pressure from the ethic of the strong black woman, a cultural value that promotes toughness and self-sacrifice. They often think ‘My mother suffered. My grandmother suffered. It’s just the lot of black women in America. It doesn’t have to be that way.
There’s a deep-seated feeling that going to seek professional help is a sign of weakness. These ideas and feelings must change in order for all women to function at their best ability.

Online Therapy

Online counseling  also known as  e-therapy – is when a professional counselor or psychotherapist talks with you over the Internet, to give you emotional support, mental health advice or some other professional service.

Online therapy is an  alternative source of help when traditional psychotherapy is not accessible. Its effective. Its private. Its conducted by skilled, qualified, ethical professionals.  It works as well as face to face therapy with most clients.

Online therapy is usually offered either by private practitioners who will meet with you in a secure site which is HIPPA  compliant or there are online therapy clinics where you chose the therapist whom you would like to work with from a list of mental health practitioners.

Some websites such as Talkspace offer email and text based counseling.  This type of counseling is not the same as psychotherapy because you do not see the person and it’s difficult to gauge how well the person is doing via text and also you may not be able to have a continuous conversation with the person.

 

Online therapy works well if you have a very busy schedule, you live somewhere without many therapists, you have young children at home or it’s difficult for you to get to an office.  Online therapy is not suitable for people suffering from severe mental illness such as schizophrenia or schizoaffective disorder.  It is very helpful for people with anxiety or depression.  While online therapy is not for everyone it is a viable alternative to face to face psychotherapy.