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

Of Music and Life

“Music should strike fire from the heart of man, and bring tears from the eyes of woman.” Ludwig van Beethoven

“Without music, life would be a mistake. Friedrich Nietzsche.”

“When I hear music, I fear no danger. I am invulnerable. I see no foe. I am related to the earliest of times, and to the latest.” Henry David Thoreau.

“Music Hath Charms to Soothe the Savage Breast.”

This famous quotation from William Congreve (1670-1629) evidently has a lot more truth to it than he ever realized four hundred years ago.

To complete the quote: 

“Music hath charms to soothe the savage breast. To soften rocks or bend the knotted oak.”

According to Dr. Michael Miller, Director of the Center for Preventive Cardiology at the University of Maryland Medical Center, music can make you feel good. Therefore, possibly and possibly prevent a heart attack.

According to Dr. Miller, earlier studies showed that music affects heart rate and blood pressure. In addition, he states that laughter and prayer improve cardiac performance.

Dr. Miller’s research group selected a group of healthy participants to study the effects of music on the cardiovascular system. Subjects chose a joyful type of music that made them feel good and the second type of music that made them feel anxious. Using a blood pressure cuff, the researchers discovered that the people who listened to joyful music increased blood flow of the brachial artery, a very healthy response. However, the artery flow decreased when the subjects listened to anxiety-producing music.

What is very significant is that the increased artery flow was equal to what people experience after aerobic exercise.

So, what this means is that for you to remain heart healthy, it is essential to do such things as 

a) be careful about what you eat, 

b) maintain a healthy weight, 

c) exercise regularly 

d) provide yourself with the opportunities to laugh as much as possible, and, finally 

e) listen to music that you find joyful and is not anxiety-producing. 

Regularly performing these activities might allow you to prevent a future heart attack or stroke. At least, that is what the findings seem to suggest.

How it works:

Stress is a killer. Stress pumps lots of adrenaline into our system, resulting in the release of much bad stuff that clogs our arteries. However, the activities discussed above reduce and even reverse the impact of stress. Music, laughter, exercise, and others help release endorphins that create a wonderful, relaxed, and euphoric feeling. That is just the opposite of what work and other problems do to us. So, keeping your heart and mind healthy is very much a “laughing matter.”

Let yourself laugh and listen to happy music. “Soothe that savage breast” and live longer and more joyful.

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.

Nail Biting

An old friend from our college days would sit in the school library doing homework or studying while biting down on his nails. This was accompanied by his digging into the edges of the nails with his other hand in an attempt to pull off the loosened cuticles. If anyone reminded him that he was chewing his nails, he would pause for a while and then, entirely without intention, resume the process. 

The whole drama was remarkable because I had no such wish or impulse to do the same.

Did you ever bite your nails? If the answer is yes, you are not alone. Studies show that 60% of children and 45% of teens bite their nails. After age 18, the percentages of people who bite their nails dwindle. However, there are some cases of this continuing during adulthood. So, why does nail biting occur at all?

Nail-biting is part of what is referred to as pathological grooming. This is a group of behaviors that include hair pulling, trichotillomania, and skin picking, known as dermatillomania. These behaviors may be triggered by situations that provoke stress and anxiety. As with my old friend, homework and studying are undoubtedly stressful for most. Exams, term papers, and quizzes generate lots of worry and anxiety. Nail-biting becomes a way to relieve stress. Soon, it turns into a habit. Contrary to what some believe, it is not a habit that disturbs the nail-biter. Quite to the contrary, it feels good, which is part of the reason why it’s hard to stop.

Some mental health professionals have suggested that nail-biting may be a symptom of Obsessive-Compulsive Disorder (OCD) because they are aware of what they are doing but cannot stop. However, though aware of the problem, many nail biters have no wish to stop.

While stress may be one reason people bite, there is no solid research into this behavior and no identified reasons why it happens. In addition, there is no clear evidence that nail-biting is harmful either mentally or physically. Nevertheless, there are good reasons to stop. For example, fingers and hands can look unattractive due to broken fingernails that look shredded and torn. Also, putting hands to the mouth is unsanitary and increases the risk of introducing viruses into the system. That is one-way germs, such as the flu, are spread from one person to another.

There are a variety of strategies that people can use to stop this habit. One is to wear a bracelet that jingles. Jingling helps the individual realize they are biting and, therefore, stop. In addition, meditation, yoga, and other deep relaxation techniques relieve stress and tension to reduce the need to chew. 

Another technique is to keep the hands busy by holding a pen, knitting, or any other behavior that competes with nail-biting. In other words, it’s impossible to bite if the hands are doing other things. Some people have suggested keeping nails short and getting a manicure as a way of preventing one from putting a hand to mouth. Being aware of good hygiene to avoid colds and flu might also help. Finally, using post-its helps remind one to not bite.

Suppose this becomes a problem that interferes with social and functioning at work. In that case, it could be a symptom of a deeper problem that calls for psychotherapy. While nail-biting is considered harmless for most people, there are cases where this is not true. If you are uncertain about your nail-biting behavior, a consultation with a mental health practitioner is a good idea.