Tag Archives: anxiety

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. 

Journaling and Mental Health

For example:

“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 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 Eyes Are The Windows To The Soul

There are many metaphors about eyes. For example, we see “eye to eye” about an issue. In other words, are we in agreement? There is the biblical principle about “an eye for an eye.” According to Dictionary.com, the focus of justice requires punishment equal in kind to the offense, not more significant than the offense, as was frequently given in ancient times. Thus, if someone puts out another’s eye, one of the offender’s eyes should be put out. The principle is stated in the Book of Exodus as “Thou shalt give life for life, eye for an eye, tooth for tooth, hand for hand, foot for foot.”

It is not known who wrote the words, “The eyes are the windows to the soul.” It may have been written by an Arab of ancient times or from the Old Testament version of the bible. But no one really knows.

Of course, the meaning of the words is that one can see their hidden emotions, attitudes, and thoughts by looking into a person’s eyes.

Studies in psychology show that the human infant responds directly to parental eye contact. In fact, even the youngest infants prefer staring at any shapes that resemble the human face. More than that, they like adult faces that stare directly at them rather than with eyes averted. Anyone who has bottle-fed or nursed an infant cannot help but notice how the baby’s eyes stare directly into their own. The infant learns a lot about human communication and interaction through eye contact. Because much of human interaction is nonverbal, eye contact effectively communicates our needs and wants.

Having grown up in New York City and frequently traveled the subway system, I soon learned the importance of avoiding eye contact with other passengers, along with millions of other New Yorkers. The reason was simple: Direct eye contact can easily be misperceived by a stranger as a challenge to fight. In addition, many paranoid patients report that being stared at feels like an aggressive attack. In fact, some paranoid patients have been known to make drawings of the human head and figure with huge eyes. The grossly distorted pictures often represent looking out suspiciously into what is perceived as a dangerous and aggressive world.

In fact, it is often said that, much like in the animal world, when two males who are strangers stare at each other, they are sending the challenging and dangerous message about being willing to fight. This is sometimes verbally expressed as “get out of my face, man!!” Another verbal challenge to the stare is, “What are you staring at, man???” This is said in a loud and aggressive way. People even speak of power struggles with another by “staring them down.” On the other hand, when a man and woman stare at one another, they communicate sexual interest. The eyes can be used in coy, seductive, and inviting sexual attraction between man and woman.

Early in my mental health internship in a psychiatric hospital, a young adolescent closed her eyes upon seeing me. This psychotic patient thought I would not see her by not looking at me.

Children love to play staring games with each other. The idea of the game is to see who can stare the longest without laughing or blinking. The ” loser ” is the child who laughs, blinks, or averts the eyes first is the “loser.” In this way, children engage in a kind of “arm wrestling contest.” The winner is the “strongest.”

It is commonly known that a child could have severe developmental disabilities, such as autism if they constantly avoid eye contact. And this is a good indicator of a child who has problems with social interaction.

Those who are shy may have difficulty with eye contact out of a sense of embarrassment. This is why blushing can be so very painful for those who tend to easily blush when speaking to people. Their discomfort is about the notion that the blush will reveal their shyness. My strategy for people who have struggled with this is to embrace their shyness and openly and proudly admit it.

The eyes are fraught with all types of symbolic meanings for human beings.

A Serious Sexual Problem for Couples: The Problem of Premature Ejaculation

There is a lot for doctors to learn about what causes premature ejaculation. However, many theories range from psychological to biological. For example, some suspect that PE may have something to do with serotonin in the brain. Serotonin is a neurotransmitter or a brain chemical that has a lot to do with feelings of pleasure. Therefore, if there is an over or undersupply of serotonin, it could be a causal factor in PE.

On the other hand, it’s thought that, for some men, premature ejaculation may have been somehow learned or conditioned into becoming a problem. For example, the theory goes that if a boy was masturbating and was doing it very fast so as not to get caught, his quickness might have caused PE. However, there is no evidence to support that theory or that it is a learned behavior. 

Another possibility is that depression or anxiety may be a causal factor, but little evidence supports that theory.

Whatever the causes, at least one out of five men experience this sexual dysfunction. It can happen to anyone at any age in life. But, contrary to popular belief, older men can experience this problem as much as younger men.

In terms of treatment, there are several approaches. Because there is the possibility that the brain’s neurotransmitters may cause PE, medications such as SSRIs can be helpful. These are among the class of drugs used to treat depression. However, one of the side effects of the SSRIs is that it is more difficult for the patient to orgasm. This negative side effect may help those with PE by delaying ejaculation.

It’s also important to know that medication treatment is helpful with behavioral therapy, commonly known as sex therapy. There are licensed sex therapists who provide this type of therapy. This therapy teaches several techniques that help the couple delay the male’s ejaculation. Therefore, sex therapy includes couples rather than men alone. For example, lovers learn one method for the female to squeeze the penis when her partner is about to ejaculate, forcing a delay of the orgasm thereby, repeated several times until penile sensitivity lessens, giving the male greater control to delay the process.

There are also self-help techniques that a couple can use. For example, the male can masturbate two to three hours before having sex, reducing penile sensitivity and, therefore, delayed ejaculation during intercourse.

In coping with this problem, couples must have patience with one another. Most certainly, PE arouses much anxiety and tension for couples struggling with this problem. 

Coping Strategies for Anxiety and Stress During the Coronavirus Pandemic

Are you feeling irritable and short-tempered and getting into arguments at home? So many people are experiencing nervousness and restlessness? So many are finding it difficult to fall asleep and stay asleep? You are not alone.

There are many things about which people are feeling stressed, anxious, and worried. For example, Coronavirus and social unrest are causing worry and fear. Also, many have lost jobs and their salaries. One of the most challenging things that many must deal with is that it isolates them at home—having to be indoors, whether alone or even with family, is extremely difficult. I’m hearing from many people who feel irritable, angry, sensitive, anxious, and depressed. What can people do to help themselves deal better with these problems?

Here or some suggestions for coping during this difficult time:

  • While wearing masks, go out for walks, whether alone, with family, or with friends. In doing so, it is essential to remember to maintain Social distancing.
  • Avoiding alcohol is extremely important. The reports are that many people are drinking as a way of self-medicating their problems. Rather than working as self-medication, drinking worsens the problems. It creates irritability and the tendency to get into arguments at home.
  • Social interaction is essential. The frustration is that the Coronavirus makes it difficult to socialize. While wearing masks and maintaining social distance, it is not only possible to mix but necessary. In my psychotherapy practice, I encourage people to chat as much as possible while maintaining safety.
  • Exercise is important. I know of one person who reported that they walk around their house as much as possible, including going upstairs and downstairs.
  • Owning a dog can help. People who own dogs understand they must be what walked. Two crucial goals or achieved for those who have the dog. One important goal is getting out of the house and walking, allowing for some exercise. Besides, I always remind my clients that it’s impossible to be isolated when you own a dog. Neighbors, children, and anyone will greet and pet the dog. That is often the beginning of a friendly chat.
  • One of the best medicines in the world, for most situations, is his humor. That is why I recommend watching funny television programs. These movies are comic and email humorous cartoons to family and friends. There is nothing like making jokes, laughing, smiling, having a sense of humor, or being suitable for the body and good for the soul.
  • Listening to music is one of the most soothing it will axing things a person can do.
  • I strongly recommend meditation. There is a beautiful app named CALM. Download this app to your cell phone. By either sitting or lying down and listening to some meditations is hugely relieving. The reflections are guided or purely musical and, depending on your choice, can last from 5 to 30 minutes.
  • Under stress, many people breathe in a more shallow way without realizing it’s happening. Instead, it’s essential to take a full breath, count to five, let it out, and repeat two or three times. You can feel the body relax.
  • Additional strategies include avoiding watching the news.
  • Stretch to relax muscle tension—deep muscle relaxation techniques.
  • Nature helps a great deal, such as walking in the local park.
  • Avoid turning to alcohol to self-medicate. That only worsens all the symptoms mentioned, including domestic violence and child abuse.

People are experiencing feeling shut into their homes as frustrating. There is evidence that this has resulted in increased alcohol consumptions, domestic violence, and child abuse. It is essential to turn to psychotherapy for this and all the other reasons mentioned if the different strategies do not work.

It may seem silly, but it’s also important to smile. What is an old song, “smile and the entire world smiles with you.” It is accurate, and evidence points to the fact that smiling helps us feel better.