Category Archives: Anxiety Disorders

On Self-Hatred

In my forty years of work as a psychotherapist, I have come across countless people who are extremely unhappy with themselves. Their dissatisfaction varies, but the overall impact is that they feel depressed.

The late Theodore Isaac Rubin, MD, and Psychoanalyst, addressed this self-dissatisfaction in a book entitled Compassion and Self Hate. Dr. Rubin wrote the book “Lisa and David.” which became a Hollywood movie named David and Lisa. It is still a movie worth renting and viewing. 

Dr. Rubin borrows from a great psychoanalyst of the mid-twentieth century, Karen Horney. Horney asserts that we have three selves:

1. Actual Self: Who we are with our physical and emotional abilities and disabilities or limitations.

2. Real Self: Who we could be if we freed ourselves from our self-dislike and unrealistic fears.

3. Despised Self: Self Effacing and very neurotic.

4. Idealized Self: The illusion of glorious goals that are impossible to achieve but that we believe we should achieve.

Dr. Rubin reduces this formula to two selves, the Actual Self and the Real Self.

Actual Self: Who we are with all of our talents, limitations, and illnesses, both physical and psychological.

Real Self: The illusions we believe in about who we should be, being wealthy, powerful, lovable, and independent.

If we hold on to illusions about our Real Self is the extent to which we reject our Actual Self and feel self-hate.

For example: 

An individual may cherish the belief that they should be happy. After all, pursuing happiness is guaranteed in the U.S. Constitution. But what is happiness? As Dr. Rubin states, “For me, happiness is feeling good, nothing more… feeling fairly comfortable and relatively tension-free.” 

He then says that we can sustain happiness only for a limited time. Life is not perfect, and moods change. However, the illusion that one should be happy all the time creates self-hate. If someone clings to the illusion that they should be happy all the time, and they are not, they will condemn themselves for not achieving this goal. The problem is that the goal of feeling happy all the time is not achievable.

Perhaps people hold on to unrealistic beliefs about themselves, which explains the epidemic of addiction. Substances offer a temporary that causes a person to feel joyful and omnipotent. When the drug wears out and reality sets in, the self-hate reasserts itself.

To continue the analogy of the drug abuser, the sense of self-hate and wish for joy that propels the addiction also serves as a powerful source of self-punishment. Drug addiction carries with it lots of physical and emotional abuse.

Looking at the dynamic of self-hate in another way, Dr. Rubin talks about the illusions we have about money. There is a commonly held illusion that money can solve all problems. Many patients have told me they would feel free of their problems and suffering if they had enough money. However, real-life tells us a different story.

Lots of people love to play the lottery, hoping to become millionaires. We read about poor or working people winning the lottery and going home fabulously wealthy. Oh, how many of us wish for the same fate? You know the old saying, “Be careful of what you wish for.” It may come true.” The fact is that the lives of many people who won the lottery ended in tragedy. Some of them spent every dollar they won and became bankrupt. Others committed suicide, became addicted to drugs, or suffered an abysmal fate. Money did not solve their problems. Yet, we convince ourselves that it will solve our problems and beat ourselves for not earning or winning a fortune.

The same phenomenon occurs with marriages. Many people enter into marriage with illusionary expectations. These expectations often have perfect bliss, constant sexual fulfillment, and a regular flow of nurturing and love. However, actual life is not this way. Yes, marriage can bring lots of satisfaction, but it also brings many problems and difficulties. Married couples disagree and quarrel, deal with difficult children, and have work and family issues.

The more significant the gap between expectations and reality, the greater sense of disappointment, bitterness, and failure we will experience.

Dr. Rubin states that to be compassionate to others, we must learn to be compassionate to ourselves. The way to be self-compassionate is to learn to accept the Real Self with its limitations.

Accepting who we are instead of wishing for something or someone else is the road to compassion. It means ending self-hatred. Part of the way to end self-hatred is for a person to identify mistaken beliefs and make changes. 

Dogs and Health, a Winning Combination

We know that exercise is good for the heart. We know that having companionship is good for health. But did you know that owning a dog helps relieve stress and lower blood pressure and heart rate? 

Psychology Today Magazine published an article in its April 2006 edition about a research project completed at the State University of New York at Buffalo. In this study, 480 people experienced various stress-inducing tasks. Sometimes, the subject could have their dog present during the task, and in other cases, the dog could not be with its owner. The same was true of the subject’s spouse. Sometimes, the spouse could participate, and the spouse was absent in others. Before, during, and after the experiment, blood pressure and heart rate were carefully monitored and documented. The results of the study were fascinating:

Results:

The tasks required of the subjects were successful in sending heart rates and blood pressure soaring.

When a participant’s spouse was present, blood pressure and heart rate were the highest of all participants, even though the spouse could provide any social support they thought necessary.

Stress response was lowest among those allowed to have their dogs present during and after the task.

It is not surprising that the researchers speculated that those with their dogs present had a better outcome because dogs are comforting and non-critical.

This study coincides with another recent research project, which showed that loneliness and the lack of social support in an individual’s life lead to high blood pressure. A pet, particularly a dog, goes a long way toward providing owners with a sense of responsibility, comfort, and companionship that has real health benefits. 

The mere process of walking a dog leads to the opportunity to speak with people and interact. Children, other adult dog owners, and interested neighbors stop interacting with those walking their dogs. In addition, dogs are always welcoming when their owner returns home from having been elsewhere. This welcome feels very good and reassuring for those who live by themselves and may feel socially isolated.

Financial Problems Impact Mental Health

Not since the great depression have so many people collectively been dealing with financial hardship. The Covid pandemic locked down nations and caused people to lose their livelihoods. It is not surprising that we also see increases in the rates of depression.

Other studies have also linked depression and anxiety with financial burdens. This study suggests that individuals with depression and anxiety are three times more likely to be in debt.

It’s a Vicious Cycle

Solving any problem requires clear thinking and an ability to take action. When financial burdens cause a person to become anxious and depressed, they live in an emotional state that makes it almost impossible to solve their financial problems.

For instance, when people feel depressed, it is common for them to feel overwhelmed and out of control. They want to avoid problems because they can’t bear the weight of it all. 

Depression and anxiety can also make it hard for people to get proper sleep. The lack of sleep creates a mental fog, making it incredibly hard to figure out a solution to any problem.

Talking to Someone Can Help

No, I’m not talking about a financial planner. I’m talking about speaking with a therapist. A licensed therapist can help you find some calm in the storm. Working with a therapist often brings clarity that can help you heal from depression and anxiety and get your financial life back in order.

There is no reason to be ashamed. At one point, most of us have experienced trouble with our finances and felt depressed and anxious. It is a standard part of living in these modern times when the economy seems to go against us.

If you or a loved one have been having a hard time financially and feeling stressed and overwhelmed, please contact me. I would be happy to help you deal with your current situation.

On Lauging and Laughter

We are living in difficult times. There is the war in Ukraine, two years of coronavirus, domestic political turmoil, rising crime, and changes in the economy. Challenging times like these create a lot of anxiety, worry, and stress. However, as individuals, there is little we can do to solve these problems. One psychologically beneficial coping mechanism is to laugh. Laughter reduces a lot of stress and worry.

When I was a college student many years ago, I wrote a term paper about the Pygmies of the Congo in Africa. While researching the paper, I came across one observation of their way of life that caused me to laugh. The anthropologist who wrote his observations while living with these people was that when something struck them as funny, they would begin laughing until the laughter became so side-splitting that they rolled on the ground. At the same time, tears came rolling down their faces.

When I was a child, I remember that I loved to see Jerry Lewis movies. I would laugh so hard and loud that my laughter spread through the isles of the theater until everyone was laughing at me laughing.

I remember a psychology class I took in college where the professor used a lot of humor in his lectures. One day, he said something that made all of us laugh. I don’t know if it was his joke, something about my mood that morning, or the atmosphere in the classroom, but I couldn’t stop laughing even after the others had. That caused the other students to resume laughing after they had stopped. For fear of being reprimanded, I looked up and was relieved to see the professor laughing along with all the rest of us. Our laughter was purely spontaneous and left me warm feelings about the class and professor that I still remember after these decades.

Whether laughter is medicine is unclear. Studies show that laughter is the best medicine for stress, worry, and many other problems. Psychologist Robert Provine, Ph.D., is the foremost expert on laughter. He states that:

“Laughing more could make you healthier, but we don’t know,” he says. “I certainly wouldn’t want people to laugh more just to avoid dying — because eventually, they’ll be disappointed.”

Of course, that is a joke. Most laughter is not a result of a joke but is a laughable part of being with people. Research on relationships is measurable by the amount of laughter. Problems and conflicts cause people to divorce or end relationships. Yet, one of the most apparent ingredients of any happy relationship is laughter. Laughter may be a symptom of how well a couple is doing. Laughter binds people together. During the beginning stage of a romance, people frequently laugh. It is a time of fun, warmth, joyfulness, and spontaneity. Couples need to laugh a lot more.

Laughing is also very social. It brings people together. It brings people together because it’s contagious. When you hear someone laugh, you also start to laugh. Do you remember how you also yawn when you see someone yawn?

How might a couple reintroduce laughter into their relationship? According to Provine, the most primitive form of stimulating laughter is tickling. Not only does tickling cause laughter, but it also causes the person getting tickled to turn around and start tickling. In addition to couples engaging in tickling and laughing, we love to tickle babies and children because it’s fun to see and hear them laugh and giggle.

It’s always fun to get together with people who also spontaneously laugh. Once the laughter begins, everything that happens is funny.

Do you allow laughter into your life? Just remember, we don’t laugh to solve problems. We don’t laugh to improve our health. We laugh because we do, and it feels great. So, let’s all get together and laugh.

Contact Dr. Schwartz for a consulation and/or psychotherapy

Pandemic, The Economy, War and Life and Death

Along with American citizens and people worldwide, I am extremely upset about the Pandemic, Ukraine, Russia, and the economy. 

 Many friends, family, and clients say that they believed the Pandemic was over. However, Russia invaded Ukraine, and anxiety rose once anxiety and worry rose again. If these events aren’t bad enough, we have been plagued by rising prices for everything from gasoline, building materials, and food, among many other essential items.

I was born in 1942, in the middle of WW 11. My grandfather’s youngest brother, Uncle Sam, served in and earned the Purple Heart in the first World War. My three uncles served in World War 2. Then, there was the war to establish the State of Israel. Next was the invasion of Israel, the Korean War, Vietnam, invasion of Iraq, Gulf War, and Afghanistan, and more minor wars were between these. And, evermore, nations are gaining nuclear weapons and missiles. In these wars, including the current war in Ukraine, all of us witness acts of destruction. The destruction includes human lives, cities, buildings, and all the things people take for granted in their daily lives.

The great psychoanalyst, Sigmund Freud, wrote about the issues surrounding war, life, and death after World War 1. 

Freud’s Theories of Life and Death Instincts

Sigmund Freud’s theory of drives developed throughout his life and work. He initially described a class of drives known as life instincts. He believed these drives handled much of our behavior.

Eventually, he believed that life instincts alone could not explain all human behavior. With his book Beyond the Pleasure Principle in 1920, Freud concluded all instincts fall into two major classes: life drives or death drives.

The Life Drive (Eros)

Sometimes referred to as sexual instincts, the life drives deal with basic survival, pleasure, and reproduction. These instincts or drives are essential for sustaining the individual’s life and the continuation of the species.

While we think of life instincts regarding sexual procreation, these drives include thirst, hunger, and pain avoidance. The energy created by the life instincts is known as libido.

Freud proposed Eros was opposed by ego forces (the organized, realistic part of a person’s psyche that mediates between desires). In this latter view, he maintained that life instincts were opposed by the self-destructive death instincts, known as Thanatos.

Behaviors commonly associated with life instincts include love, cooperation, and other social actions. The life drives focus on preserving life, both the individual and the species. This drive compels people to engage in actions that sustain their own lives, such as looking after their health and safety. It also exerts itself through sexual drives, motivating people to create and nurture new life. 

Positive emotions such as love, affection, and social cooperation are also associated with life drives. These behaviors support both individual well-being and the harmonious existence of a cooperative and healthy society.

The Death Drive (Thanatos)

Freud first introduced the concept of the death drive in his essay Beyond the Pleasure Principle. He theorized that the death drive is the drive toward death and destruction, famously declaring that “the aim of all life is death.”

Freud believed that people typically channel their death drive outwards and manifest as aggression toward others. However, this drive can also be directed inwards, which can cause self-harm or suicide.

Freud based this theory on various clinical observations. For instance, Freud noted that people who experience a traumatic event would often reenact that experience. While studying soldiers returning from World War I, Freud observed they had a tendency to repeat the traumatic experiences that took them back to the combat scene.

He noted similar behavior in his 18-month-old grandson, Ernst, who played a game called Fort/Da whenever his mother was away. To deal with his anxiety, his grandson would repeatedly toss away and retrieve a wooden reel with a piece of string tied around it. Freud wondered how “repetition of this distressing experience as a game fit in with the pleasure principle?”

Freud concluded people hold an unconscious desire to die, but life instincts largely temper this wish.

According to Freud, the death drive stands in stark contrast to the drive to survive, procreate, and satisfy desires. In Freud’s view, all living organisms have an instinct” toward death.” in Freud’s view. The compulsion to repeat was “something that would seem more primitive, more elementary, more instinctual than the pleasure principle it overrides.” He further proposed that the death drive extended that compulsion.

As yet another war presents the danger of spreading into a wider conflict. Could Ukraine become the starting point of a third world war? I could not help but ask myself if Freud was correct. Does humanity have a drive towards self-destruction and extinction? What do you believe? I am available for exchanging ideas at

dransphd@aol.com

Trauma and Gaslighting

Gaslighting Quotes That Capture This Emotional Manipulation

  1. “Gaslighting is mind control to make victims doubt their reality.” — Tracy Malone.
  2. “Gaslighting is a subtle form of emotional manipulation that often results in the recipient doubting their own perception of reality and their sanity. In addition, gaslighting is a method of manipulation by toxic people to gain power over you. The worst part about gaslighting is that it undermines your self-worth to the point where you’re second-guessing everything.” — Dana Arcuri.
  3. “It frightens me because I feel vulnerable to attacks, an easy target for gaslighting. Phrases like ‘No, I didn’t say that!’, ‘You don’t remember,’ and ‘You must have forgotten,’ start rattling my brain and making me jittery.” — Ankita Sahani

There are many times of childhood trauma, where family members state it happened a long time ago, and it’s time to get over it. The same people who say that engage in gaslighting the survivor of childhood trauma.

What is meant by gaslighting?

Gaslighting refers to the act of undermining another person’s reality by denying facts, the surrounding environment, or their feelings and memories. Ultimately, the target of gaslighting may doubt their sanity.

The trauma of childhood abuse can have long-lasting repercussions that affect your understanding of yourself and the world around you. For many, the effects of abuse show up in dysfunctional interpersonal relationships resulting from attachment disruptions at pivotal points of childhood development. By examining the impact of childhood abuse on interpersonal relationships and the role of therapy in healing, people can better understand their experiences and the possibilities for recovery.

One result of childhood trauma can be dissociative disorders:

Dissociative disorders involve the inability to distinguish between thoughts, memories, surroundings, actions, and identity. People with dissociative disorders escape reality in involuntary and unhealthy ways and cause problems with functioning in everyday life. In one case, a patient dissociated when she had to move from her apartment after many years. Any stress can set off this disorder. 

The Impact of Childhood Abuse on Interpersonal Relationships

In the absence of secure attachments, survivors of childhood abuse often develop dysfunctional attachment styles that disrupt your ability to interact with others in healthy ways. Emotional abuse, neglect, and sexual abuse are more strongly associated with interpersonal distress in adulthood than physical abuse. However, it is essential to remember that any abuse survivor can experience profound interpersonal difficulties, including:

  • An inability to trust: The ability to trust others is a critical part of forming and maintaining healthy relationships. However, when someone has experienced childhood abuse, that ability is often diminished or even removed altogether. As a result, you may be reluctant to engage in honest and open relationships for fear that you will be betrayed or harmed. Staying closed off, guarded, or hypervigilant can make it difficult for others to feel close to you, and you deny yourself the opportunity to form healthy and meaningful bonds. The lack of trust also affects all insecure attachment styles.
  • Avoidant attachment: Some people who do not experience the benefit of secure attachment in childhood must avoid attachment to others altogether. Avoidant people are unable to trust others. It also arises due to extreme self-reliance. Many abuse survivors learned that they could not rely on others to meet their attachment needs early. Those with an avoidant attachment may decide to ignore those needs or attempt to meet them yourself. In adulthood, this typically translates to social avoidance or the formation of emotionally distant relationships in which you remain unresponsive to the needs of others.
  • Ambivalent attachment: Survivors of childhood abuse develop a weak attachment style. People with an ambivalent attachment style desire intimacy. However, they are ever watchful of change in the relationship, sometimes to the point of paranoia, “frustrated and resentful, particularly if you feel misunderstood or vulnerable.
  • Disorganized attachment: People who experience this style are deeply fearful of relationships. However, they crave emotional closeness. You are at once afraid of intimacy and of being alone. As a result, you may lash out if you feel ignored or unloved while being reluctant to show affection for others. These patterns create significant barriers to forming and maintaining healthy relationships. 

People who experience childhood abuse are vulnerable to developing mental health disorders that compromise emotional and behavioral stability, including depression, anxiety, PTSD, and borderline personality disorder. These illnesses present additional challenges to engaging in healthy interpersonal relationships, leading to re-traumatization that creates further emotional damage.

Contact Dr. Schwartz at

dransphd@aol.com

It’s Enough to Make You Pull Your Hair Out

Do you remember a time when you were reading or studying for a school exam or writing a term paper and were quite unconsciously twirling, twisting, and pulling your hair until the strands fell out?

I have worked with people with Trichotillomania. They are also known as “trichsters,” but nothing is humorous about this disorder. It is a disorder also known as hair-pulling. “Trichotillomania is repetitive twisting and twirling of the hair. The hair loss is usually in a well-defined area with shortened, broken-off hairs and early regrowth of hair. The scalp is the most commonly involved site, but eyelashes and eyebrows may also be involved. The hair loss can also be patchy and poorly defined.”*

Some 2.5 million Americans experience this disorder. Hair pulling often begins during childhood or adolescence. For example, studies show that boys who pull out their hair start around the age of 8, while girls begin around twelve years of age or with the onset of puberty. By far, the highest percentages of people with this disorder are women, and they are 4 times more likely than males to engage in hair-pulling.

The ancient origins of the word, Trichotillomania come from Greek root terms meaning “hair,” “pulling,” and “mania,” or madness. Actually, there is nothing mad or crazy about this little-understood disorder. Today, psychiatry and medicine define it as an impulse control disorder. The implications are that it is medical in nature and specifically neurological in origin.

*Symptoms:

  • Constant tugging, pulling, or twisting of hair
  • An increasing sense of tension is present before the hair pulling
  • Sense of relief, pleasure, or gratification is reported after the hair pulling
  • Hair pulling leads to an uneven appearance
  • Bare patches or diffuse (all across) loss of hair
  • Hair regrowth in the bare spots feels like stubble
  • Some individuals may develop a bowel obstruction if they eat the hair they pull out
  • Other self-injury behaviors may be present
  • People suffering from this disorder often deny pulling out their hair

*(Information is from U.S. National Library of Medicine)

Many mental health specialists define this disorder as impulse control because those with this disorder cannot resist the urge to pull their hair. The impulse to tear one’s hair is so overpowering that it cannot be controlled. Once the habit has reached those dimensions, there is no way to resist the urge. The result is that bald spots emerge on the scalp. 

The presence of these bald spots becomes a source of great distress, particularly for teenage girls when they are at the height of concern about their appearance. In fact, the impact on one’s appearance and its social consequences have the most significant impact on the social and emotional adjustment of people with this disorder.

One of the most essential facts for sufferers and their loved ones to know about this behavioral disorder is that it is not a bad habit. People can learn to control or alter patterns with little difficulty. The overwhelming urge to pull hair places it outside of the category of a learned and bad habit.

It is said that there are two types of Trichotillomania: one in which the individual is aware that they want to pull their hair and another: in which the person is so involved and absorbed in an activity that they are unaware of what they are doing.

Among those who know they want to pull their hair, there is a feeling of extreme distress, depression, and anxiety, leading them to pull their hair out. The result is a feeling of relief or an end to the emotional numbness experienced by these individuals. However, there is no awareness that they have started to pull their hair for other people. Among the second group, the process of hair-pulling seems to be much less open to attention much of the time, until sometime after it has started. In all cases, once the person attempts to stop the behavior, the worse it becomes.

Reports about the prognosis of this disorder are that most children will outgrow it within a year. However, if this does not happen, it can and does last into adulthood.

There is no one accepted and proven treatment for this disorder. The commonly tried treatments are medication for depression, psychodynamic psychotherapy, cognitive-behavioral therapy, and behavior modification. One form of behavior modification is referred to as reverse habit conditioning. The patient is made aware of the behavior and when it will happen and then explores alternative coping mechanisms to the hair-pulling.

The Story of An Emotional Support Dog Team

Juli and Lily:The Story of an Emotional Support Dog Team By: Allan N. Schwartz, LCSW, Ph.D. and Juli: 

One year ago, a desperate, young twenty-two-year-old woman was brought to my office by her grandmother. She was tearful and depressed but her major complaint had to do with acute anxiety. Her grandmother was present because Juli was at the point where she was fearful of leaving the house unless accompanied by another person. In fact, her grandmother drove her to the appointment because Juli was now fearful of driving.  Although she never experienced an auto accident, never had a traumatic experience outside of her home, and had no logical reason to feel so extremely fearful, Juli was paralyzed with fears and phobias about the outside world. In Juli’s own words, “I was suffering from severe agoraphobia and social anxiety. At the same time, I experienced severe depression.” In sum, her life was at a standstill.

 

Anxiety disorders are like infectious diseases. If left untreated, they spread like germs, causing an ever increasing amount of sickness and disability. Juli had tried therapy before but without success. Now, she could no longer sit in a restaurant and enjoy a meal with family or friends. She couldn’t attend basketball games, go to the gym to workout, go to work, make purchases at the grocery store, or take a stroll down the block. Because she could not work, Juli lost the ability to support her self and was too paralyzed with fear to go to the welfare office or to social security to apply for financial benefits. Without the active financial support of her family, Juli would have been in even more dire circumstances.

Whenever Juli tried to summon up her courage and do the normal things that others take for granted, this is what she experienced: “I became overwhelmed with nausea, dizziness, and panic. I had numbness and a tingling sensation in my hands and feet and my vision became blurred. I even felt like would pass out and that was terrifying. I was especially afraid I would faint while driving or walking in the street.  I would have the petrifying thought that I would lose control and die.”

The fact that she could no longer earn her own living filled Juli with guilt because she was relying on her family for financial support. Juli’s father, a warm and loving man, paid all of her bills since she stopped working. However, this was a drain on his finances as he needed to apportion money for her younger sister and brother who were of college age. Besides all of this, the inability to earn a living added to Juli’s fears about her ability to function as a normal and independent woman in the future. In short, her anxiety disorder caused her pride and dignity to take a severe beating. As she describes it, “It was a viscous cycle. I panicked about not being able to work and I couldn’t work because I panicked.”

Psychotherapy: 

Two major approaches were taken to help Juli recover from her debilitating anxiety and panic disorder. First, she was referred for psychiatric evaluation and medication treatment. The psychiatrist to whom she was referred prescribed a combination of anti anxiety and anti depressant medications to help alleviate her major symptoms.

Second, Juli and I began a course of Cognitive-Behavioral Therapy (CBT). In this treatment, Juli kept a record of her thoughts prior to, during, and after her panic and anxiety attacks. She was then taught to examine the extent to which these thoughts were unfounded and helped to cause her bouts of anxiety and panic. She learned to replace her fearful and unrealistic thinking with assessments based in reality and fact. In addition to this, Juli and I practiced deep breathing and muscle relaxation in the office in order that she could learn how to reduce the damaging effects of fear and anxiety on her body. She practiced at home and elsewhere, particularly if she felt her anxiety increasing. Lastly, Juli and I practiced meditation, which she learned to use on a daily basis so that she could develop a calm and relaxed mindset.

Gradually, Juli made minor improvements and she could do more things with her life. She began attending therapy sessions on her own without her grandmother. She was able to drive herself to the sessions and gained a hard earned sense of improved self esteem.

However, the work was painfully slow and fraught with setbacks and relapses. When Juli was too fearful, she was unable to drive to the sessions. “There were times I would call Dr. Schwartz from my cell phone frenzied, pulled over on the freeway and he would have to talk me down just to get me back home safely.” Her social life remained limited because she could not go to restaurants and concerts with her friends. She was afraid of crowds at concerts and sports events, and avoided restaurants because her anxiety led to the nausea that robbed her of her appetite. Finally, the mere thought of work led to spasms of fear and the wish to avoid.

Impasse: 

Juli was becoming increasingly desperate. Her parents were complaining that she was not improving. Juli was living and had been working in Colorado, while her family with the exception of her maternal grandmother, lived in California. Each parent was pressuring Juli to return to
California. Juli was resistant to this idea. It was important to her to assert her independence and to prove that she could care for herself. Yet, her financial situation was reaching crisis proportions and the family was complaining about the cost of maintaining her in
Colorado while she could not work. Juli’s father was becoming increasingly frantic about finances and was pressuring his daughter to either return to California or get a job. He was losing patience. It seemed as though her therapy and progress were at an impasse and might end in failure.

Mingo, the Co-Therapist: 

For several years now my wife has been involved in training service dogs. This was of particular interest to me because I had read about the value of using dogs and other pets as co-therapists in the consulting room. Clearly seeing how distressed Juli was from the moment she entered my office, I asked her if she would like to have one of my wife’s service dogs present during the session. I explained that she could hold and pet the dog, which might help her to feel calmer. An animal lover, who once had a dog that her mother gave away, Juli, was excited by the idea of a dog being in the office. I excused myself and invited the most special dog I have ever met, Mingo, into the room.

Mingo is a Golden Retriever and a fully trained and certified emotional support service dog. She is warm and loving and has an instinct about when people are in need. From the moment I brought Mingo into the office to meet Juli, a tight bond was formed between the two of them. Mingo went right up to Juli, put her snout into Juli’s stomach and pressed as tight as she could. Juli wrapped her arms around the dog and another important step was taken toward Juli’s recovery. Every session thereafter, Mingo was present and available to Juli, who derived great pleasure and relief from her stress by stroking the dog’s thick, soft fur. As Juli describes it, “There is something so reassuring about having a dog in your lap when you panic. It’s like all your anxiety melts right off and onto them.” There was no question in my mind that Mingo was my co-therapist during these sessions.

But, how could this help Juli in the outside world? When she left the office to go home her fears returned. She did all of her therapeutic homework, including cognitive work, deep breathing, meditation, and muscle relaxation exercises. She was fully compliant with her medications, which had been modified by her psychiatrist in the hope that the right combination of medicines would resolve her symptoms. While there was slight improvement, it was not enough to improve the quality of her life. Something more had to be done to break the deadlock and help Juli get on with her life.

Enter Lily: 

I began to entertain the idea of Juli purchasing an emotional support dog of her own that could accompany her and be a comfort when she needed to leave the house for any reason. However, to my dismay, I soon discovered that purchasing a trained emotional support service dog is prohibitively expensive. I was beginning to feel as desperate as Juli and her family.

Then an idea occurred to me that just might be able to work in Juli’s favor. What if Juli adopted a puppy from the humane society that could be trained to be an emotional support dog?  When I proposed this idea to Juli she became very excited.

As Juli expressed it:

“The idea of having a dog appealed to me because of my experience with Mingo and because I thought I might feel safer, like someone would be able to look out for me all the time. Maybe this potential dog could alert someone if I did run into trouble and that thought seemed to put my mind at ease.”

 Juli always missed the dog her mother gave away, loved dogs in general, and welcomed the idea. I suggested that she give careful thought to this idea since caring for a dog is a major responsibility and expense and she might not have the necessary inner and outer resources to adopt and raise a puppy at this time. However, there was no restraining Juli. She was so excited about the idea that she recruited a friend to go with her to pet stores and the humane society.

I began receiving excited phone calls from this young woman on the weekends when she would be out with her friend looking at puppies. Juli would ask me about one type of breed or another and its suitability for her purposes. Usually, her choices were of very cute puppies that were destined to grow up and become large and ferocious canines that would be difficult to train. Besides that issue, there was the simple fact that pure bred dogs were extremely expensive.

One fine and quiet Sunday afternoon while I was out shopping at the mall, my cell phone rang. I answered the call to the irate voice of Juli’s father who wanted to know if I was aware that his daughter had just adopted a puppy from the pound. He was convinced that his daughter had completely lost her mind and should be sent home immediately. I assured him that, while I could not discuss his daughter with him due to issues of confidentiality, I was certain that she was not crazy and that I would look into the situation. He was skeptical but somewhat re-assured that I was willing to check it out.  That phone call left me feeling very much like I had made a serious blunder in suggesting what now seemed like a hair-brained idea. Ten minutes after this conversation the phone rang again. This time it was Juli who reported to me, with great excitement, that she had just adopted a puppy from the humane society. She also complained about her father, whom she had told so he could send her some extra money to adopt the dog. I then understood why her father was outraged. He feared the puppy would be an additional drain on his fragile budget.

Juli and I met Monday morning as we were scheduled to do. Accompanying her was the cutest puppy I could ever imagine. Juli named her Lily and often referred to her as “Miss” Lily. Lily was brown with big floppy ears and very large paws. Clearly a mix between a Labrador retriever and some other large breed, Lily was going to be a big dog. More than anything, Miss Lily was as friendly and cuddly as could be desired. She seemed to have the perfect temperament to be an emotional support dog.

Needing to solve the next problem of how to get Miss Lily and Juli trained, I gingerly approached my wife, the executive director and founder of Golden Kimba Service Dogs. Why did I approach my wife gingerly? Well, I knew that Juli could not pay for training sessions and that there was no way anyone could approach her father about adding more financial aid. Like the trooper she is, my wife took Juli and Miss Lily on for free and began training both of them.

Major Changes: 

Although the going was not easy, adopting, training, and being with Lily utterly changed Juli, her life and her ability to cope. As her constant friend and ally, Juli felt reassured with Lily’s presence. She began leaving her apartment to go on walks with Lily. On the streets or in the park, Juli met many people who came up to her wanting to pet the cute little puppy. Juli began taking training lessons with my wife. Eventually, Lily earned herself an official service dog in-training vest and Juli, an official I.D., which allowed them to enter stores and restaurants without being hassled by management wanting them to leave.

As Juli grew in confidence, she started to work, socialize, and feel terrific about herself.

Juli and Lily are now a spokesperson team for the use of emotional support dogs for people who are disabled by emotions they cannot seem to control. Even that is a major break through for Juli who, previously was so fearful she never would have spoken to strangers.

Lily is still in training and she and Juli and Lily continue to learn a lot about how to work together in public. But the main idea is that Juli is able to live her life again with the help of her friend and companion, Lily. As Juli sums it up:

“Lily is my best friend. I feel safe with her. She has been a  blessing in my life. Having a service dog is crucial for someone with my kind of illness. I have to take her on walks, I have to go to the store to buy her food, and it forces me to get out. It’s a win-win relationship. I do for her and she does for me, without even knowing it. My life would never have been the same without her.”

The story of Lily and Juli continues, but now there is hope.