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Category Archives: Mental Health
“A patient arrived in the office for his psychotherapy appointment. He was visibly agitated, and when I asked him what happened, he reported the following incident: He was driving out of his development. To arrive at my office, it required that he make a left turn onto a highway, not an easy task. He has to cross the south lanes to turn left onto the northern lanes in the office’s direction. Turning left means turning onto the left northern lane and crossing into the right lane. The driver must look carefully that no cars are coming in either direction. My patient, noticing a car coming in the left northerly lane but judging that it was distant enough for him to turn, safely executed the turn and shifted right. Once in the right lane, the other car driver starts loudly honking at him. Unnerved by the blaring sound of the horn, turned his head to see what was happening. He noticed that the car driver was angry and repeatedly gestured at him. “It looked as though he was a raving, spitting, and cursing lunatic,” in his words. Feeling both provoked and angry, he felt tempted to pull over and have a confrontation to “teach that guy a lesson.” Thinking better of it, he allowed the whole incident to pass, except he could not shake his angry feelings or revenge fantasies. He reported he felt rattled, incensed, nervous, and wanted to fight and even pull a gun on that guy. Fortunately, he has no gun and doesn’t know how to use one.
It’s a familiar scene. A person starts the day with a fight with your wife, or your boss gives you a warning, or on the way to work or back home, there is a traffic jam that tries your patience. Under these and similar types of circumstances, you feel frustrated and angry. You could quickly explode if just one more thing happens. Then, one more thing happens when another car weaves in and out of lanes, and you get even angrier.
For too many people, all this pent-up emotion expresses when driving. There is a name for it, Road Rage. It is one of the leading causes of traffic accidents and violent confrontations between angry drivers. Of course, for some people, this has less to do with circumstances and more to do with the fact that they are angry people, always seething and always ready to explode. Whatever may be the factors that enrage one driver, the outward expression of this rage sometimes provokes the ire of another driver who feels he must protect his male ego from humiliation. Of course, drivers tend to blame the other drivers for anything that happens but never themselves.
Road rage can have dire consequences. If there are family and friends in the car, an angry confrontation can be highly embarrassing. Among these are sometimes deadly traffic accidents and fights with others who may even pull a gun and receive a citation from the police. In many states, three or more citations can lead to suspension of the driver’s license and spending an afternoon in jail. In other cases, all of this drama can cause a lawsuit with significant financial damages awarded to the other drivers.
How can these scenarios be prevented? One strategy for those with anger problems is to interrupt their thoughts and ask themselves two things: first, everyone must concentrate on their driving and not the other person. In addition, everyone needs to remind themselves that whatever happens on the road is not personal.
1) Is it worth it to get out of the car or take some other dangerous action and
2) What are the consequences of taking action?
If you lose control of yourself in these incidents, it’s essential to seek professional help. Learning to control one’s behavior is essential to a functioning civilization. People should not and must not give in to their impulses.
Help is available. Contact Dr. Schwartz at. firstname.lastname@example.org
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.
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:
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 Feeling Lonely and Isolated
Loneliness, A Health Hazard
“Its deeply seated in me
The birds are chirping
I can hear the voices
My kids are chatting around
But I feel lonely,
I am a lonely person…… “
Poem by Asma Khan
What is loneliness? How is it defined?
The word lonely, is used here, has nothing to do with being alone. As the poem above states, it’s possible to be surrounded by people, even loved ones, and yet feel lonely.
In reality, loneliness is a state of mind. In that state of mind, people feel empty, alone, and unwanted. Lonely people want human contact. Yet, their state of mind makes it more difficult to form connections with other people. Loneliness is a damaging state of mind. It damages one’s mental and physical health.
For twenty years, John Cacioppo, Ph.D. and clinical psychologist, has studied loneliness. He is the co-author of a recent book, “Loneliness: Human Nature and the Need for Social Connection.” The book’s central theme is that loneliness causes many physical illnesses. For example, studies show that social isolation and loneliness increase the flow of stress hormones. Stress hormones are those that make us alert when danger is present. When someone is lonely, they produce stress hormones with no real threat. As a result, the immune system is damaged, causing a vulnerability to viral diseases. The cardiovascular system rises, leading to stroke and heart attack because blood pressure increases, sleep is disturbed, and the aging process increases. The chronic stress caused by loneliness can even hasten the onset of Alzheimer’s disease.
According to Dr. Cacioppo, some of the adverse effects of loneliness are:
* Depression and suicide
* Cardiovascular disease and stroke
* Increased stress levels
* Decreased memory and learning
* Antisocial behavior
* Poor decision-making
* Alcoholism and drug abuse
* The progression of Alzheimer’s disease
* Altered brain function.”
James J. Lynch, Ph.D., published a brilliant book a few years ago called “A Cry Unheard.” What is significant about the message Dr. Lynch conveys is that loneliness is a failure to communicate, engage in discourse, and be committed to each other and the community. In addition, he clarifies it is not merely talking that makes up communication, but the type of talk that is vitally important to human health. He coins the phrase “toxic talk” to describe a speech that destroys the other person’s self-esteem and well-being. The destruction of that self-esteem leads to loneliness, early heart disease, and death. Criticism, negativity, lack of praise, lack of warm feeling, rejection, and other factors that increase alienation and distance between people characterize toxic talk. According to Dr. Lynch, unwholesome talk increases social isolation and leads to early death.
Listed are a few suggestions that Dr. Cacioppo provides on how to overcome loneliness:
1. Recognize that loneliness is a sign that something needs to change.
2. Understand the effects of loneliness on your physical and mental life.
3. Consider doing community service or another activity that you enjoy. These situations present tremendous opportunities to meet people and cultivate new friendships and social interactions.
4. Focus on developing quality relationships with people who share similar attitudes, interests, and values with you.
5. Expect the best. Lonely people often expect rejection, so instead, focus on positive thoughts and attitudes in your social relationships.
It is important to remember that loneliness is a state of mind linked to wanting human contact but feeling alone. People can be alone and not feel lonely, or they can have contact with people and still experience feelings of isolation.
Dr. Schwartz is available for consultation or psychotherapy at Email email@example.com
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
Grief vs. Depression
Losing a loved one is a jarring and tragic experience. It brings on a period of grief and mourning filled with feelings of sadness, anxiety, guilt, and reliving of the past shared with the deceased going back years. People amid the mourning process have described such feelings as loss of appetite, nausea, tearfulness, restless sleep, guilt about not being able to prevent the death from having occurred, and deep feelings of sadness. Many have described the feelings of grief sweeping over them and then subsiding until the process starts again.
Reliving and talking about the person who has died can come with laughter, as those grieving remember funny and warm times. However, there is now a controversy over whether grief differs from grieving?
Ultimately, the psychiatrist must use their judgment on whether the patient is grieving or having a major depressive episode. The American Psychiatric Association’s Diagnostic and Statistical Manual shows differences between grief and major depression. Let’s look at the differences and similarities in symptoms of grieving after a loss instead of Major-Depression.
Symptoms of Grief:
1. Sadness, despair, mourning
2. Fatigue or low energy
4. Loss of appetite
5. Poor sleep
6. Poor concentration
7. Happy and sad memories
8. Mild feelings of guilt
Gradually and after an undetermined time, these feelings remain as the individual regains equilibrium as they return to everyday life.
Many of these symptoms are similar to the feeling of people with Major-Depression. Still, significantly different symptoms are part of the profile.
2. Exaggerated guilt
3. Suicidal thoughts
4. Low self-esteem
8. Loss of interest in pleasurable activities
9. Exaggerated fatigue
In major depression, these feelings are ongoing and carry the real danger of suicide. Daily functioning at work and home is impaired, and the individual feels as if they will never climb out of these feelings.
An essential difference between grief and Major-Depression is that, in major depression, the feelings of loss of the loved one are compensated for by warm memories. One friend recently told me that his beloved childhood people are alive in him as beautiful memories.
The death of a loved one often results in feelings of emptiness. But, for those who suffer from depression, nothing, not even warm memories, compensates for the loss. Freud referred to this in his classic book, “Mourning and Melancholia,” in which he pointed out that the one who is depressed turns their energy into attacking the self rather than integrating loved ones who are now gone.
Some people hold onto the mistaken belief that mourning last for two weeks. However, who is to say that it takes only two weeks to grieve? The time spent mourning a loved one varies according to each individual. The danger of a mistaken diagnosis is that a physician might prescribe antidepressant medication when none is needed. But, that is where the experience and expertise of the MD are essential. Ultimately, mourning runs its course and resolves itself.
Of course, where someone has Majord-Depression and is also grieving, the grief process may be complicated by the fact of depression. It is also possible that, for some people, the death of a loved one can turn into a depression.
Diagnosing people with any mental illness is complicated and dangerous if the diagnosis is incorrect.
The reader needs to understand that psychotherapy is always available to help those individuals who are in pain. Help is available.
Contact Dr. Schwartz at firstname.lastname@example.org.
Please visit his website at http://www.allanschwartztherapy.net.
Journaling and Mental Health
“You have been through a difficult and traumatizing divorce. When all was over, you felt a sense of relief besides exhaustion and some depression. Several months have passed and you continue to feel the lingering effects of having been through something very stressful. A friend of yours suggests you write about the experience of the divorce as a way of feeling better and putting the episode behind you. You do some investigating and discover that there is solid evidence to support friends’ suggestions.”
Were you among the many young people who kept a diary when you grew up? It’s probably something that more females did as compared to males. Research shows it’s something all of us can benefit from in our adulthood. Rather than a diary, it’s called a journal. Writing a journal can have therapeutic benefits and, perhaps, be a way to change one’s life story or narrative. Clinical Psychologist James Pennebaker, University of Texas, is the leading researcher using physical and mental health journaling. He has completed many controlled research studies documenting the benefits of writing daily. Many other researchers, such as Joshua Smith, Ph.D., and Lauren Smith, Ph.D., have further documented the benefits of writing.
Pam Trachta, owner of Through a Different Lens, a consulting business, reports that “When I journal, or when I teach others to, I strive not to be intellectual and logical and articulate, but to feel the wave, the energy behind an event and to summon images of what that wave feels like, acts like, what it’s saying to me and what I would say to it.” Do not worry about grammar, spelling, or sounding literate. Just write.
According to Pennebaker, developing a deeper understanding of an event and the emotions it generates helps the brain digest the information. Pennebaker thinks that your brain turns it into a more easily stored story when you analyze a traumatic event. “Storytelling simplifies a complex experience,” he says. Turning the memory into a story can be painful at first. It can take weeks or months to notice an improvement. Smyth and Pennebaker report that patients often feel worse when they journal.
Here are some suggestions for how to journal:
1. Write for yourself
2. Write about all the emotions associated with the event.
3. Set aside 30 minutes at a regular time for three or four days in a row when you won’t be disturbed.
4. Explore how the topic relates to other aspects of your life, such as your childhood and relationships.
5. Write continuously and don’t think about spelling or grammar.
Journal writing about traumatic events can be difficult, time-consuming, and careful. Writing about the worst events of your life can dredge up solid emotions, and healing doesn’t follow. For example, journaling therapy doesn’t seem to work by itself with people who are severely depressed or who have post-traumatic stress disorder. Smyth suggests notifying either your health care professional or someone close to you before attempting this exercise. Let them judge if it’s helping or hurting you.
Also, keep your healing journal private. It’s okay to tear up the pages or burn them once you’ve written about the event. Showing them to anyone who isn’t a therapist or healthcare professional could make matters worse–it could be hazardous for a battered woman to show the pages to her spouse.
Some therapists integrate journaling into their therapeutic practice. Journaling is something you can look for in a therapist if interested. You can certainly do something while in therapy to discuss with your therapist if you are experiencing difficult emotions. Remember, one does not have to be in therapy to write a journal.
Psychotherapy help is available. Email Dr. Schwartz at email@example.com
Teenagers, Depression and Suicide
Teenagers and Depression and Suicide
Most of us remember our teenage years as being very difficult. I have heard many adults, friends, family members, clients, and others unequivocally state that they would never want to revisit those days. Among the many problems adolescents face are feeling accepted by peers, believing that they are attractive, getting along with parents and siblings. Then there is also coping with school and adjusting to the rapid physical changes brought on by hormones, rapid growth in height, powerful sexual urges, and dealing with the pressure to use drugs and alcohol. It is not surprising that many of these teenagers feel anxiety and depression.
Adolescence is when young people join social groups of males and females. There are parties and the first experience of dating and sexual play. The Covid pandemic has brought these experiences to a halt. Many schools are closed, and most people wear masks to prevent the spread of the virus. These factors are not conducive to socialization. Perhaps, with the pandemic declining, everyone will resume their everyday lives.
Today, adolescents have the added pressure of social media. At least some teens are the targets of these insults and rumors who experience terrible feelings of despair. Sadly, it is easy for bullies of either gender to beat up each other by posting horrible things about youngsters they dislike. The result is shocking reports of suicides committed by these unfortunate youngsters.
During the past two years, teens have struggled with the Covid pandemic. Isolated at home and enduring internet learning, more young people, commit suicide. The quote is from the Baylor College of Medicine:
“During the COVID pandemic, I, along with most pediatricians, have seen an exponential rise in teenagers admitted to the hospital with suicidal thoughts and attempts. Some had been lonely and contemplating suicide for a while. Some made rash decisions and cried of regret when recounting their actions.”
“When a child tries to commit suicide by firearm, they are likely to succeed.”
“The pandemic uniquely affected adolescents. Social isolation, constant uncertainty, stress, and fear have plagued their lives. According to the CDC, teenage emergency room visits for suicide attempts increased significantly during the pandemic, with a 50% rise in cases in females and an almost 4% increase in males. Suicidality among teens in Texas was on the rise before the pandemic. However, most suicidal attempts are not fatal except for guns.”
“In Texas, guns are the second leading cause of death among children and adolescents. Suicide is also the second leading cause of death among American youth.”
Teenagers depend upon parental cooperation for psychotherapy. For example, they need to be driven to appointments and be provided with money to pay for sessions. Because of their age, parental involvement is essential for the therapeutic process to succeed. Parental involvement means that there will be joint sessions with the therapist and separate meetings with parents. Many parents are reluctant to get involved because they fear blaming their child’s problems.
Experience with teenagers shows that parental attitude and cooperation make a big difference in whether the treatment is successful.
There are several ways parents can sabotage psychotherapy:
1. Failure to make the car available to the teen or drive them to the appointment.
2. Failure to pay for sessions.
3. Refusal to attend family sessions.
4. Defensiveness for fear of being blamed.
5. hostility blaming the teenager for everything.
6. Rejecting depression as a real medical problem and blaming the teenager.
7. Attempting to hide a history of child abuse.
All parents must know the importance of teenage depression and the need for psychotherapy. Multiple factors can cause our teens to become depressed, and many of them have nothing to do with the family. Today, children are growing up in a complex, dangerous, and uncertain world. In addition, they’re learning to cope with the opposite sex can become complicated. Breaking up with a boy or girlfriend can cause grief and depression. It is a mistake not to take this seriously.
Dr. Schwartz is available for consultation. He is available at firstname.lastname@example.org