While psychotherapy often focuses on addressing serious issues like anxiety, depression, and trauma, many therapists have discovered the value of incorporating humor into their practice. Using laughter and levity in appropriate ways can actually help clients make progress faster and feel better. Humor is an essential component of my practice. I use it to help my clients open up about issues, especially very sensitive ones, and show them the therapeutic process is not a scary or intimidating experience. Most therapists agree the right amount of humor at the right time can enhance the therapeutic process immensely.
Here are some ways humor benefits the therapeutic process:
It builds rapport and trust. Sharing a laugh with your therapist helps form an emotional connection early on. Clients feel more at ease opening up when they see the therapist has a lighter side.
It reduces anxiety and tension. Humor and laughter trigger the release of “feel-good” chemicals in the brain like endorphins and dopamine. This can relieve stress and ease anxious feelings that often arise in therapy sessions.
It provides perspective. Seeing the absurdity or irony in a situation through humor can help clients gain a new perspective on their problems. This shift in perspective often loosens the emotional grip pf painful thoughts and feelings.
It strengthens resilience. The ability to laugh at life’s difficulties is a sign of emotional strength and resilience. Therapists can help clients develop this coping skill through using humor together in sessions.
It signals progress. As clients make progress in therapy, they often become able to joke and find humor in things that previously upset them. This shows they are gaining some distance from their problems.
It strengthens the relationship. Sharing laughs together helps build trust, closeness, and a sense of fun between the therapist and client. This does not mean they are making light of their problems or not taking them seriously. It’s the exact opposite; it creates an alliance that is critical for making real progress.
As a therapist, I am often faced with questions from clients about what their “diagnosis is”. And when I ask them why they want to know it, or how will knowing it help them, they usually don’t know. Don’t get me wrong, I think it is very important to have a clear understanding of what is going on and be able to convey that to my clients. But what I often see/hear are people using their diagnosis as a shield, or as a label to identify who they are. If they are actively in treatment working through their issues to have a better quality of life, and want to advocate for others to have the same, I am all for it. If they are just throwing these labels around without any intent on getting help, then I believe that behavior has a negative impact on those who truly want help. Talking about mental health issues has become more mainstream; but with that openness comes more negative attention.
People sometimes exploit those with mental illness as a way to intimidate or demean them into submission. This behavior prevents people who need help from getting help, because they don’t want to be given the negative label of “mentally ill”. Stigmatization of mental illness has been around since the beginning of time. Even with all the progress that has been made, it still remains today. Unfortunately, the mentally ill aren’t the only group that gets marginalized and stigmatized.
The LGBTQ+ community, African-Americans, Latino-Americans, Asian-Americans, Jews, Muslims, Women, and Mexicans are some of the more frequently targeted groups. These groups have been targeted so much that the very category they are under becomes a “label” for those that hate. It gets weaponized by ignorant, bigoted people by what they say and what they do to these groups. I won’t provide a lot of examples because this is supposed to be a blog post not a manifesto!
But the real issues we should be focusing on is answering these questions: WHY? Why do you say or do harmful things to people in these groups? Why does it matter to you what they do or how they are? Why are you so threatened by someone who is different from you?…Yes you are…And why do you think you are better than them? What makes you so special?
I believe that everyone should be responsible for the way they think, feel, and act. I also believe that many of the people who are preoccupied with hate and bigoted way of thinking are the ones who aren’t taking responsibility for their own lives. There is undoubtedly an undiagnosed mental illness that lives inside most of them. In order to have such hate, and waste so much time expressing that hate, there has to be some serious self-loathing going on.
And I believe none of the aforementioned groups (“labels”) are the problem, HATE is the problem. People who carry this much hate around with them are unhappy people. They take out their life’s failures and frustrations on marginalized people. That’s low-hanging fruit, dude. They already have been subjected to that hate and bigotry. How about focusing on your own life, and putting that energy towards improving your quality of life; without negatively affecting others. This isn’t an inverse proportional arrangement. Better yet, try and get to know people that are different than you. You will find they are more like you than not. And heck, you may even like them. If nothing else, you will learn something.
If I have described you or your behavior then you are in the HATE category…and yes, I just labeled you.
I just saw JAWS in IMAX over the Labor Day weekend (twice in fact!) Jaws is a classic horror film, and the first summer blockbuster when it was released in 1975. It tells the story of a homicidal, Great White Shark, (a Carcharodon Carcharias) who terrorizes Amity Island. For the first half of the movie, the shark was not seen. If it wasn’t for the music we wouldn’t even know he was on the prowl. The town council was in denial about the danger of this man-eater, “it was a boating accident”, or “a swimmer who just got tired and drowned”. Chief Brody knew better, Hooper declared this was no boating accident, that it was, in fact, a shark, and it would continue to kill people unless the beaches were closed and they did something about this shark.
But Mayor Vaughn said, “Amity is a summer town and they need summer dollars”. To further deflect the situation, he implored Brody to go after the vandal who painted a shark fin on their advertisement billboard, THAT was the real problem. Brody told him leaving the beaches open was like ringing the dinner bell!
Well, they left the beaches open, putting people in danger, all so the town council could line their pockets, come off like heroes, and get reelected. The mayor manipulated a council member to go into the water with his family to further demonstrate his political agenda. He minimized the danger and gave misinformation on camera about some swimmers who were injured when in fact they were devoured by a shark. It wasn’t until the next shark attack when the mayor’s son was within striking distance of the shark that he relented and closed the beaches, and hired someone to kill the shark.
This is Mrs. Taft, she’s an “islander” from Amity Island. She wanted the beaches to stay open so she could get her tan. It didn’t matter that the little Kintner boy was eaten by the shark off a raft like sushi on rice. It didn’t matter that more people could die, as long as she could have what she wanted.
This level of self-centeredness didn’t just occur in a mid-’70s horror flick, it exists to this day in real life. Politicians like Mayor Vaughn are running rampant in this country. Most if not all politicians lie at some point; some are subtle about it, while others flaunt it like they are quoting from a Bible…oh wait, some claim they are doing that as well. They spread misinformation to gain attention and keep it on them, not for any altruistic purposes, but to stir up divisive rhetoric and promote hate. It doesn’t matter if they haven’t researched the facts, they are banking on their followers not researching it either. And they don’t!
People take these politicians and talking-heads at their word because they strike a nerve, an internal fuse if you will; they provide an outlet for people’s fear and anger within themselves that they have limited coping skills to address on their own. It is easier to blame others for their insecurities and misfortunes instead of taking responsibility for themselves.
Politicians and talking-heads prey on these people not to help them but to exploit them; while lining their pockets, gaining followers, and getting elected. Once they get what they want, they don’t all of sudden become compassionate and give back, no, they double down because they have to maintain this persona. Some don’t even believe what they are saying but they know it gets results, and that is all that matters. As long as they are able to get what they want, their selfish behavior will continue. Now, there are some “less intelligent” politicians and talking-heads, who believe they can say or do whatever with impunity; whether it is spreading misinformation, inciting anger/violence, or threatening people.
In order for the greater society to feel secure and hopeful for the future, there needs to be checks and balances for those who challenge the rule of law and thumb their noses at democracy. Talking heads who report information with skewed viewpoints or misinformation should be labeled “entertainment”, not news. Politicians should be held responsible for their actions and should have term limits.
People need to feel like they are being treated fairly, and not marginalized because of their socioeconomic status, the color of their skin, sex, or sexual orientation. When these factors are exploited, it does nothing but suppress, oppress, and regress society. This leads to all sorts of mental health and addiction issues, as well as violent and other acting-out behaviors. This in turn makes our job as mental health professionals more complicated than it already is.
Our job as therapists is to assist our clients toward self-improvement and a better quality of life. Often times their outlook is negative or bleak. It is extremely important for us to show them a path that is positive and hopeful. While it is often emphasized there are factors outside of their control they need to let go of; it is sometimes a daunting task. Those outside factors can carry a lot of weight, making it difficult for people with mental health issues to come out from under them. They need those public representatives to provide the information they need to make the best-informed decisions for their lives. That is what they are there for! (Otherwise, they are entertainers and should be labeled as such)
We will continue to be there for our clients, educating them about their mental health issues, and empowering them to manage their outside world. All we ask is that everyone else does their part to be informed, be kind to their neighbor no matter who they are or what they look like, and reject hate and negativity.
The term “friend” has come up many times in my practice and in my personal life as well. I hear it all the time, “my friend ” this and “my friend” that. I may ask how long they have known that person, or how well they know that person (or vice versa) So then I ask (myself), is there a statute of limitations on being someone’s friend when the friendship is not in use? Does it need to be renewed every few years, or does it expire? Is that a lifetime title you are giving that person? What do they need to do in order to maintain that title? Do they need to make a phone call every few years to keep it active? Will a text message saying “Hey” do?
I don’t know why I find this fascinating but I do. This is just my opinion…and maybe I’m doing a little ranting (so if you have anything you want to contribute please feel free to comment!). I think sometimes we hold on to that “friendship” from our past for nostalgic reasons. Or is it just more difficult to let that relationship go?
But what is aFRIEND anyway? I believe Cookie Monster may have said it best, “Sometimes me think, What is friend? Then me say, Friend is someone to share last cookie with”.
Friend: definition from dictionary.com:
1) a person attached to another by feelings of affection or personal regard,
2) a person who gives assistance, a supporter,
3) a person who is on good terms with another; a person who is not hostile,
4) a person associated with another as a contact on a social media site.
The Oxford Dictionary defines a friend as: A person with whom one has a bond of mutual affection, typically one exclusive of sexual or family relations.
Here is the Urban dictionary definition of friend: A friend is someone you love and who loves you, someone you respect and who respects you, someone whom you trust and who trusts you. A friend is honest and makes you want to be honest, too. A friend is loyal.
I believe a friendship is both conditional and unconditional. It is conditional on there being a mutual benefit for both parties to be in the friendship and stay in the friendship; it cannot be beneficial to one party and not the other and be deemed a friendship. It is unconditional in one’s love and respect for the other person.
It is unconditional when one can step out of their own shoes and into their friend’s shoes without any preconceived quid pro quo (such as “I’ll do this for you if you do this for me”, or “I did that for you now you owe me”)…just being there for that person because they are in need at the moment, and awareness it will be reciprocated if needed. It is unconditional when you look forward to seeing that person and they look forward to seeing you; knowing that each other’s time is valuable and worth giving that time to that person. It is unconditional when you can go a long time without seeing or talking to each other, and when you are together it’s as if you were never apart. There is an immediate affection and appreciation for that person.
“Friends show their love in times of trouble, not in happiness” -Euripedes
When push comes to shove, in times of need, who are you going to reach out to? Your family? Your co-workers? Your neighbors? Someone, you only see at your kid’s baseball games? Or someone who understands you, has always been there, and would drop everything to be there. Can you identify who those people are? Is it one person? Maybe you don’t have that person. You’re not alone if you don’t.
Acquaintance
What is an acquaintance? By comparison, an acquaintanceis defined as: a person known to one, but not a close friend (dictionary.com) The Cambridge Dictionary defines an acquaintance as: a person whom you know but do not know well and who is therefore not exactly a friend.
The Urban dictionary defines acquaintance as: someone you know but not close to, a friend you don’t see that often or don’t feel close to, someone you don’t see outside school or work.
I believe an acquaintance is someone you know; it doesn’t matter how much you know about that person but you know them. It is somebody you can be friendly with, someone you share a mutual interest with. The difference lies in the nature of the relationship. This is not someone you would normally spend time with (outside of that mutual interest that brought you together). This is NOT an unconditional relationship; meaning sharing love and respect for each other, wanting to spend your free time with that person. An acquaintance could be a quid pro quo type relationship, like an exchange of services that benefits both parties. This could also be someone you were once friends with but the nature of the relationship has changed, such as a high school friend that you haven’t had contact with since the last reunion. You might label them “old friends” or “childhood friends” but they are really acquaintances now.
I think we may know many people, but we are really friends with a smaller percentage of them. It is even a smaller number when we consider who we label “close friends” or “best friends”. So why do we call these acquaintances in our lives friends? For one, simply, it’s probably just easier. Another possibility, unfortunately, is YOU believe they are your friend but they really aren’t. You are always there for THEM but they aren’t really there for you. When you talk to them on the phone (or text) they are the ones who dominate the conversation, or somehow turn what you are talking about into something about them. This is a lop-sided friendship.
This illustration below (waitbutwhy.com) gives you an idea of what I am talking about. The majority of people on our mountain are acquaintances (gathered there at the bottom), and as you go up the mountain (closer to you sitting on the top), the number of people are fewer and fewer. So we don’t have a lot of friends, we have a lot of acquaintances. Those with a mountain that is top heavy with people they consider friends probably are trying to be all things to all people, and should a take little time to focus on themselves (see blog post, “I-I Me-Me Mine: The Case for Being Selfish).
“He who hath many friends hath none”-Aristotle
“Friendship with oneself is all important, because without it one cannot be friends with anyone else in the world”-Eleanor Roosevelt
When I am working with clients who are struggling to cope with issues like anxiety (including social phobia), depression, relationship issues, family issues, addiction, etc, I strongly encourage them to reach out to their support network. They need to have the social support to help them get through these issues…they cannot do it alone. When my clients have a good support system, even if it is 1 or 2 good friends, their ability to recover or improve their self-esteem and well-being increases dramatically. It is just as significant negatively when the support network is not there. I will ask my clients about their friends, and who they feel close to, and get a sense of how successful they will be at meeting their goals. That doesn’t mean if they don’t have friends they won’t meet their goals, it’s just going to be a little more challenging.
What about all those acquaintances???
Sometimes we have acquaintances that we just didn’t do enough (or anything) to cultivate into a friendship. Sometimes we are too loyal to our current friend group that we don’t want to offend them by exploring other relationships. Sometimes we make negative assumptions about those acquaintances, when in fact they have friendship potential. But because of those assumptions, we hesitated exploring a possible friendship.
When you have a limited social support network it’s difficult to seek new people to be friends with. As we get older and have more responsibilities, we have less time to develop new relationships. Maybe we don’t need to acquire new people to develop friendships, but instead invest the time to boost up those “Tier 3, not really friends” category.
Having people in your life you like to spend time with can really boost your self-esteem. You don’t always need a close or best friend around to lean on, sometimes you just want to share a laugh with people you can relate to, with no strings attached…but they aren’t necessarily your friends! 😉
“I have learned that to be with those I like is enough”-Walt Whitman
May is National Mental Health Awareness Month. Beginning in 1949, Mental Health Awareness Month has put a spotlight on the importance of mental health and wellness. There is such a stigma attached to mental illness or mental health in general, that over 70 years of advocacy and education have yet to overcome.
While 1 in 5 people will experience mental illness at some point in their lifetimes, everyone has faced or will face struggles and challenges that affect their mental health. You don’t have to be diagnosed by a doctor or therapist to know if you’re mental health is compromised.
Anxiety: Intense, excessive, and persistent worry and fear about everyday situations. Some symptoms include: Fast heart rate, rapid breathing, sweating, and feeling tired.
Stress: Any type of change that causes physical, emotional, or psychological strain. Stress is your body’s response to anything that requires attention or action.
Depressive symptoms: Hopeless outlook, loss of interest or pleasure, fatigue, sleep issues, irritability, changes in appetite and weight, uncontrollable emotions, thinking about death.
Alcohol abuse: Use of alcoholic beverages to excess, either on individual occasions (binge drinking) or as a regular practice.
Cannabis Abuse: when a person cannot stop using marijuana (dependence) and/or exhibits withdrawal symptoms when not using (ie. irritability, mood and sleep issues, decreased appetite, cravings, restlessness.
I mention these mental health issues because they are the most common issues people are in counseling to address. Everyone has experienced at least one of these at some point in their lifetimes. It may not be the presenting issue they initially come into counseling for. Oftentimes, people come in to address relationship, work-related, anger management, school, or behavioral problems. It is through the counseling process that the above-mentioned mental health issues surface. Mental health issues are often the root cause of the conflict they are experiencing.
So if these are issues that all of us have or will go through in our lives, then why is there a stigma? The viewpoint of mental illness is people afflicted with one are seen as a “weakness”, laziness, “soft”, or a “snowflake”. This level of ignorance is astounding and dangerous. The lack of understanding, awareness, and compassion is the reason so many people struggle through life untreated. Why is someone with a mental health issue looked down upon, or seen as different than anyone else? People are embarrassed and hesitant to seek counseling because of the negative connotations mental health brings. Their reluctance to seek out treatment has led to worsening symptoms, self-medication through alcohol and drugs, and suicide. If the past few years have taught us anything, the loudest voices are often the most misinformed yet influential people out there. They express their ignorant views about mental health, ostracizing those who desperately need assistance and pushing them into the shadows. Then we hear all of the “thoughts and prayers” when something tragic happens.
The past couple of years have seen unprecedented levels of anxiety, depression, alcohol, and substance abuse issues due to all things Covid-19. The pandemic took a tremendous toll on everybody in every way imaginable. It is still wreaking havoc on people today and will be felt for years to come.
I am passionate about helping people with their mental health. I welcome discussing it with those who are, shall we say, less informed. It takes tremendous courage and strength to accept that one needs help with their mental health. When someone comes to me for counseling, I want them to know they made the right decision and that help is on the way.
If you are experiencing any of the above issues, please do not hesitate to contact a therapist. You will be thankful you did! We don’t bite! We are people just like you! We are here to assist you so you can have a better quality of life and be the best YOU that you can be!
Artist – Josh Groban | Lyrics – Richard Marx and Linda Thompson
Fly me up to where you are
Beyond the distant star
I wish upon tonight
To see you smile
If only for awhile to know you’re there
A breath away’s not far
To where you are
It has been over 7 years since my father passed away and it feels like it was yesterday…but also a lifetime ago at the same time. I have said that I live in an alternate universe since he’s been gone; nothing is the same, and nothing will ever be the same. I think about him from time to time, there are reminders of him everywhere. He left his imprint on this world, not just in the hearts and minds of myself, my sister, and our families, but in the many many people he helped over the years (he was a therapist too), and those he worked with. He entrusted in all of us, the promise that we would move on, better our lives, and try, as he did, to leave this world better than it was.
It has been a tall order, I’m not going to lie…Although I understand the responsibilities of being an adult, sometimes I don’t wanna be an adult! I want to complain to my dad!!
It isn’t like I need a lot of “adulty” advice but he was always the one who had the answers; right, wrong, or otherwise, he had the answer. Now I have to be the one with all the answers and I am finding that I don’t have them all. It seems like a waste, all that information he had is gone forever. I try to think of how he would’ve handled certain situations or how he solved that dilemma. Sometimes it works sometimes it doesn’t, but I try and learn from it.
~Food for Thought~
“Psychologists have clinically observed that overly prolonged grief in the bereaved usually signifies a poor relationship with the one who died.”
How is one supposed to move on after losing someone? That’s the $20,000 question, isn’t it? The first answer simply is “You just have to” You needto continue living your life and making it the best it can be; knowing that life is fleeting…you need to pass on what you have learned to the next generation (whether or not you have children). “You need to enjoy each day as if it was your last”, you’ve heard that one before I’m sure. Well, you know what? Sometimes that is just impossible to execute, sometimes I just want to do nothing and let the minutes and hours tick away. I mean, what is the point of all this anyway? They’ll find their way, they’ll move on just like I had to, right? Maybe, but why leave them so much uncertainty when their lives are just starting out?
What if I was able to provide some guidance or direction that I wasn’t given by my father. Maybe I DO know the answer, maybe I just need to keep working on myself, improving my quality of life, and passing on whatever I know while I can for as long as I can. There has to be some meaning to life and the only way to find it is to move on and move forward.
~Food for Thought~
“The reality is that you will grieve forever. You will not ‘get over’ the loss of a loved one; you will learn to live with it. You will heal and you will rebuild yourself around the loss you have suffered. You will be whole again but you will never be the same. Nor should you be the same nor would you want to.”
Today I reflect on my loss as I mourn the loss of a very close friend of my father’s. This man not only shared the same passions as my father and myself but also had a zest for life in general. He was very active right up until he was hit with a stroke. It came out of nowhere and stopped short any and all plans for the future…just like that. He left a tremendous legacy behind in all that he has touched but also left a void that can never be replaced. How does one prepare for this? Can you really prepare for this? Whether you are the one who has died or the one who is left behind, there really is no way to properly prepare for this inevitability. That is why it is so important to make the living days count, no matter how big or small. Live each day to make it better than yesterday. And although this day gives me pause, I know tomorrow I will pick up where I left off and live life the best way I can.
I know I am dating myself here with a Neil Sedaka song, but I thought it was fitting for this topic. You don’t need to go download the song on iTunes or Spotify, unless you really want to. But be warned, next thing you know you’ll be listening to all of his tunes, singing them in the car, or while you’re working out in the gym!!
I have worked with many clients with various relationship issues but none has been more difficult than addressing the aftermath of a break-up. Regardless of which side of the break-up you are on, coping with it can be extremely difficult, if not traumatic. While the relationship is over, some may experience grief-like symptoms as a result. Typically I hear people having appetite issues (not eating or overeating), having trouble sleeping, feeling nauseous, and having no desire or motivation to do anything. They’re also angry, sad, lonely, and feeling rejected and lost about their future.
“When you break up, your whole identity is shattered. It’s like death.”
-Dennis Quaid
Dennis Quaid was right, it really can feel like a death. In some way it is a death, the end of the relationship, it isn’t coming back. The symptoms described above, while illustrating what may happen at the end of a relationship, are the same symptoms described for someone experiencing grief from death.
It’s Over?!?!
So how do I get over it you ask!? Great question! Sometimes it is as simple as giving it time; “Time heals all wounds”. This basically means with the passage of time (and distance from that relationship), things will get better and you will be able to move on with your life. If that doesn’t work for you, the following are some other ways to cope with the break-up:
Write or talk about it: Sometimes writing in a journal or diary helps get the intrusive thoughts and feelings out of your head. Also, it can serve as a reminder of where you were throughout the different stages of grief about the relationship. Talking to trusted confidants, friends, or a therapist is also helpful not only for getting the thoughts and feelings out, but for receiving feedback, guidance, and support through the recovery process.
Self-care: You need to take care of your basic needs. Eating right, getting a good night’s sleep, and exercising are key components of self-care. But you also need to just make sure you’re doing all the basics (i.e. bathing, brushing teeth, etc). It is so important to try and resume your normal activities. One thing self-care certainly does not include is any self-DESTRUCTIVE behaviors. We’re talking about pretty much all the addictive behaviors here: alcohol, drugs, overeating, gambling, shopping, casual sex, etc.
Exercise: Specifically cardiovascular exercise. This type of exercise gets the heart rate going in a healthier way, releasing endorphins that make you feel better. It can also help “clear your head” by providing a healthy distraction. Go for a run or a brisk walk or bike ride at least 3x/week for 30-60 minutes.
Practice gratitude: Remind yourself of all the things you appreciate in your life instead of focusing so much on the negative. Make a list of the things you are thankful for, even if you have to force yourself to find something positive. In time this process will get easier as well.
Laughter:Laughter is the best medicine as they say. Do something that will “lighten the mood”, whether watching a comedy TV show or movie or sharing a light moment with a friend. Laughter has been known to boost mood, improve overall health, and speed up the healing process. Not everything in life has to be so serious, even a breakup.
Give back:It’s not all about you! Believe it or not, other people have it worse than you do, yeah it’s probably hard to see that when you are deep in the grief process of the breakup, but it’s true. Performing acts of kindness have been shown to alleviate stress and depression, as well as improve one’s overall health.
“Pain is certain, suffering is optional.”
—Buddha
Believe it or not, you can die from a broken heart. The condition is called Takotsubo cardiomyopathy, or stress cardiomyopathy.
According to the Mayo Clinic,Broken Heart Syndromeis a temporary heart condition that’s often brought on by stressful situations, such as the death of a loved one. The condition can also be triggered by a serious physical illness or surgery. People with broken heart syndrome may have sudden chest pain or think they’re having a heart attack. Broken heart syndrome may be caused by the heart’s reaction to a sudden surge of stress hormones.
Obviously, if you are experiencing symptoms that mimic a heart attack like shortness of breath and chest tightness for any extended period of time you should seek medical assistance. Of course, this may most likely be anxiety-related symptoms you are experiencing, so practicing relaxation techniques like breathing exercises, yoga, meditation, etc can help alleviate the anxiety-related symptoms associated with the break-up.
MOVE ON!?!?
So how do I move on once I have accepted the relationship is over? Another great question! Well, some might say it is easier said than done. Doing the techniques and skills I’ve identified here are very important for the recovery process. But that may not be enough. So here are some other things to consider:
Recognize he/she might have not been the right one for you. Sometimes we are more attached to the IDEA and FEELING of the relationship, but not necessarily with this person. But since you were just in a relationship with this person, you still perceive he/she is THE person for you. Sometimes when you feel this way you tend to bargain and compromise your principles to convince this person to take you back (or convince yourself this person is still the right person for you). This is delusional thinking and can lead to more self-destructive if not humiliating behavior.
Eliminate (or significantly reduce) your contact with this person: Unless you have something or someone you have to continue to be associated with (children, businesses, etc), I strongly recommend detaching from this person entirely. That means all forms of social media, phone numbers, emails, etc. What about mutual friends? That may be more difficult and should be taken up individually. They may not want to get in the middle of your situation and opt to remove themselves from both of you. Again, this should be addressed on a case-by-case basis.
Closure: Sometimes it is necessary to get closure from the other person. “Why did you break up with me?” “Did you ever really love me?” There are usually unanswered questions after a break-up and ideally getting those questions answered can aid in the recovery. But don’t be surprised if the other person doesn’t want to talk with you about it or answer those questions. I’m not saying that is right or wrong, but that is their choice and you will have to ultimately accept whatever it is they decide to do with that.
Forgiveness: When the time is right in your mind and your heart, forgiving the other person can really set you free. But first, you MUST forgive yourself. You need to forgive yourself for holding on to the baggage that may have prevented you from living the life you wanted to live. You need to forgive yourself for the emotional turmoil you put yourself through; just forgive yourself for everything that has happened. When you do that, it will be easier to forgive the other person, hence setting yourself free.
There is hope for those going through a painful break-up. With time and healing, break-up sufferers can move on to have happy, fulfilling lives. If you are struggling with a break-up or contemplating breaking up a relationship, seek professional assistance for guidance through the process.
I thought this would be a good time to talk about some issues and problems that I know have affected each and every one of us at one time or another. I am willing to bet that 95% of you have had at least one of these four bad boys, Anxiety, Depression, Insomnia, and/or Pain. The other 5% of you are either in denial or self-medicating with enough alcohol or drugs to notice!
In my practice, I see people who have at LEAST one of these issues if not all of them, and it isn’t uncommon. Often times it is the combination of these issues that results in overwhelming dysfunction in people’s lives. These four issues feed off each other to create a swirling vortex of negativity, sending the afflicted person to a dark place…and often times taking other people (especially significant others) with them. This may lead to self-medication which could lead to addiction, which could lead to total self-destruction. Ladies and Gentlemen, I give you what I call the FOUR HORSEMEN OF THE APOCALYPSE OF MENTAL HEALTH!
PAIN:Pain comes from the Latin word “poena” meaning a fine or penalty. The medical definition of pain is an unpleasant sensation that can range from mild localized discomfort to agony. Pain has both physical and emotional components. The physical pain comes from nerve stimulation. These nerve fibers carry the information to the brain which in turn sends a signal back to the affected area in the form of a physical sensation. The emotional components of pain vary depending on the degree of pain but can include increased anxiety, helplessness, aversion, anger, despair, sleeplessness, and hopelessness. Does any of those sound like the other three horsemen?
Treatment for pain varies by the degree and duration of the pain. Acute pain issues like a cut or a headache can be addressed through readily available means like a band-aid or Tylenol. But chronic pain issues whether mild or severe, are the ones that take a toll on the afflicted person, wearing them down over time, and sometimes running out of treatment options to alleviate the pain. There are various medications you can take for pain, from acetaminophen (Tylenol) to NSAIDs (ibuprofen, naproxen, aspirin, etc) to antidepressants to anti-seizure medications to steroids to opioids. There are non-medication treatment options like physical therapy, psychotherapy, TENS (transcutaneous electrical nerve stimulation) therapy, meditation, relaxation techniques, visual imagery, biofeedback, hypnosis, hot and cold therapy, massage, acupuncture…to name just a few 😟😧😨😩😬. Have you had any of these treatments to alleviate your pain? Have any of you tried ALL of them? I have…
INSOMNIA: Insomnia comes from the Latin term “insomnis” meaning sleepless. The medical definition of insomnia is difficulty falling asleep or staying asleep, even when the person has a chance to do so. People with insomnia usually experience any of the following symptoms: fatigue, low energy, difficulty concentrating, mood disturbances, and decreased concentration at work or at school. A study done in 2011 showed that insomnia costs the U.S. workforce $63.2 billion a year in lost productivity. Some of the contributing factors included increased mistakes or accidents, frequent sick leave time, chronic absenteeism, substance abuse, and workplace violence.
The “self-medicating addictive crowd” factor in here: drinking alcohol and taking drugs to de-stress at night results in disrupted and restless sleep (or none at all), then excessive caffeine intake during the day to stay awake…then rinse and repeat day after day. If you are not self-medicating at night then you are up all night perseverating about various issues you are anxious or worried about, whether from that day or in anticipation of the next day’s stress. Either way, when you start your day you are compromised due to the lack of sleep, and vulnerable to some of the symptoms I listed above. I emphasize to my clients that sleep is priority #1; if you are not getting enough sleep you are not functioning at 100% “battery life”. If you are not functioning at 100%, you are at risk of the other 3 horsemen running you over! Never mind the fact that if you are sleep-deprived you probably look like a zombie in the apocalypse!!
I won’t get into the nitty-gritty about anxiety and depression here but I will enlighten you with some interesting facts and statistics about these very common mental health issues:
Anxiety disorders are the most common mental illness in the U.S. affecting over 40 million people over the age of 18, roughly 18% of the population.
Anxiety disorders are highly treatable yet only about 37% of the sufferers receive treatment.
People with anxiety disorders are 3-5x more likely to visit the doctor and six times more likely to be hospitalized for psychiatric disorders.
Anxiety disorders develop from a complex set of risk factors, including genetics, brain chemistry, personality, and life events.
11% of adolescents will have depression by age 18.
30% of college students reported feeling depressed which disrupted their ability to function in school.
$80 billion annual cost to the workforce from lost productivity and healthcare due to depression.
There is a difference between “everyday anxiety” and Anxiety Disorders. For example, worrying about paying bills, getting a job, a romantic breakup, or other important events are examples of everyday anxiety. Constant and unsubstantiated worry that causes significant distress and interferes with daily life is an example of an anxiety disorder.
The same can be said about “feeling blue” vs. Depression. Feeling down or “blue” is very common in today’s society. People are experiencing more stress than before, working longer hours, making less money, etc. So it is relatively normal if someone isn’t feeling 100% on a given day. What separates that from clinical depression is the severity of the symptoms and the duration of those symptoms. Typically you need to have these symptoms for a least 2 weeks, and the severity of the symptoms causes significant distress and disruption in the person’s life.
Here are some questions to ask yourself, and if you answer ‘YES’ to any of them you may want to consider talking with a therapist or doctor:
Is your mood interfering with your personal relationships or your job performance?
Have these feelings lasted for longer than two weeks?
Is your stress from a single, identifiable stressor (example: serious illness of a child) that does not have a clear end in sight?
Are you beginning to feel worthless or guilty about the situation?
Is the stress not allowing you to find happiness in other parts of your life?
(PsychCentral, “Depression vs. The Blues by Ben Martin, PsyD.)
Treatment for the Four Horsemen I specifically chose to discuss these four issues in this post not only because of their interrelatedness in human functioning but also for a treatment modality that specifically addresses them.
Cranial Electrotherapy Stimulation (CES): CES is a form of neurostimulation that delivers a small, pulsed alternating current via electrodes on the head (or earlobes). It is cleared by the U.S. FDA as a prescriptive non-invasive electromedical treatment that has been shown to decrease anxiety, depression, and insomnia symptoms significantly.
ALPHA-STIM
Alpha-Stim (AID) & (M): Alpha-Stim has taken CES, which had been developed in the 1970s, and used its waveform technology to produce a treatment modality that can treat anxiety, depression, and insomnia. The ‘M’ model combines this waveform technology with microcurrent electrotherapy to provide a non-invasive treatment for pain.
Shown above are the two treatment modalities that Alpha-Stim provides. The first one you see the electrodes attached to the man’s earlobes to treat the symptoms of anxiety, depression, and/or insomnia. The second picture shows a man using the ‘M’ model’s electrodes to treat the localized pain.
Alpha-Stim technology is safe, with no serious adverse events reported in 30 years of clinical use. It can be used as a stand-alone treatment, or as an adjunct to medication and counseling. In my practice, I use the Alpha-Stim with many of my clients, as an adjunct treatment modality during their counseling sessions. Some of them are concurrently on psychotropic medication which, according to studies, shows an increase in effectiveness (of the medication) with Alpha-Stim.
It is a 20-minute treatment, with the electrodes clipped to the person’s earlobes. The treatments are cumulative, so the more you use it the more effective the results. At the same time though, I have had a number of my clients report a decrease in symptoms after the first treatment. It may last for a couple of days, but still, it was quite noticeable to them.
For the treatment of Insomnia, using Alpha-Stim can increase your sleep time, reduce sleep disturbances, and improve overall sleep quality. Some of their research showed military service members with Insomnia showed an average increase of 43 minutes of sleep after just 5 treatments. In one study the subjects who rated their quality of sleep as poor dropped from 60% to 5% from the beginning of the study.
For the treatment of pain, Alpha-Stim’s research has shown a 71% decrease in severe pain after only 5 treatments. Chronic pain sufferers reported significantly improved functionality with Alpha-Stim treatments. This is most definitely an option to consider if you are experiencing pain issues, instead of taking the opioid pain medications that have become an epidemic in this country. I have used the pain treatment modality from this unit and did notice results; (I just didn’t keep up with it to see how I would fare with long term usage. Hey, I never said I was a good patient!! So, do as I say not as I do!! Don’t you hate that line?!?!).
Either way, if you have the opportunity…and the financial where with all (it costs ~$800.00 for the AID-which treats anxiety, insomnia, and depression, and ~$1200.00 for the M model which includes the pain management component), give it a try. Alpha-Stim is not covered by most insurances, but it should.
(Note: I am not a paid spokesperson for this product, I just really believe in the technology and have seen significant results with many of my clients. Go to http://www.alpha-stim.com to read all the information about this product and show it to your doctor or therapist to see if they would be willing to write you a prescription for it. You need to have a medical or behavioral health professional make the formal request for this treatment modality. I agree with this policy because I firmly believe this works best in conjunction with counseling, medication, or both.)
There are many ways to address and conquer the Four Horsemen, do not despair and do not give up. I just illustrated one of them. Cognitive behavioral therapy (CBT) and medication management are more conventional methods of treatment for these conditions. But new treatments are being developed all the time. Keep digging, don’t give up, and don’t give in; a better quality of life is out there for you too.
“Oh the nerves, the nerves; the mysteries of this machine called man! Oh the little that unhinges it, poor creatures that we are!” ~Charles Dickens
Heart palpitations, sweaty palms, dry mouth, flushed face, nausea, and dizziness…must be your first date or a job interview, or maybe a big test…NOPE! You’re at a PARTY!!! HUH?? How can that be? Those are symptoms of anxiety or someone having a panic attack…but at a PARTY?? WHAT GIVES?!?!? Social Anxiety…
SOCIAL ANXIETY- (social phobia) “is the fear of social situations that involve interaction with other people. You could say social anxiety is the fear and anxiety of being negatively judged and evaluated by other people. It is a pervasive disorder and causes anxiety and fear in almost all areas of a person’s life”. (Social Anxiety Association)
This happens to be one of the largest mental health problems in the world today. Obviously, this doesn’t just affect people at parties; this affects them anywhere they are in the presence of others where they perceive they will be judged negatively. It can be quite debilitating, disrupting major aspects of their lives.
Aloof, cold, unfriendly, unapproachable, a “bitch”, stuck-up, angry, weird... these are some of the unflattering terms sometimes used to describe people with social anxiety. In reality, people with social anxiety are petrified, paralyzed by fear, and unable to relax and blend in.
People with social anxiety will appear withdrawn, shy, quiet, and even disinterested. They also may self-medicate with drugs or alcohol to lower that anxiety that may be holding them back in social settings.
(There are many problems with this, one of which is when that person doesn’t know when to stop drinking. Without alcohol they could be reserved or shy; with alcohol they could be loud, boisterous, and obnoxious. This not only doesn’t solve the social anxiety issue, it also creates the very perception they were trying to avoid).
There are many triggers that cause significant distress for them; but ask yourself if you have experienced anxiety from any of these, because you may have social anxiety as well!
Being introduced to other people: How’s your handshake, is it firm or a dead fish when you meet people? Can you remember their name? Are you making eye contact?
Being teased or criticized: Friends like to “bust chops” with each other but for some, it is extremely embarrassing and/or anxiety-provoking. Victims of bullying experience significant anxiety in social settings, whether they are in the presence of the bully or not; they believe the people around them will start teasing them and embarrassing them…it’s very traumatic. At your job, maybe your work is being critiqued and you start thinking, “I must be really incompetent”, or “she must really not like me”.
Being the center of attention: While there are certainly some who love being the center of attention, people with social anxiety dread it, and they can be extremely embarrassed being the focal point in a social setting.
Many people do not like being the center of attention, it’s like the spotlight is on you, and you need to perform, while everyone else is watching and judging you. NO PRESSURE! It’s like walking into a room with a bunch of people in it and all of a sudden they are all looking at YOUUUUU…”OOOOOH, look who just walked in! Look at how he stands with those two legs of his, who does he think he is anyway??” The reality is, THEY DON’T CARE!!! You got their attention for exactly 1.5 seconds and then they went back to what they were doing. You THINK they are devoting more time to you, studying you, analyzing you, smelling you, but they aren’t. (Well, maybe not smelling you…)
What I have learned over the years, (and a little bit from watching the movie High Anxiety Mel Brooks classic, highly recommend!), is sometimes if you want to go unnoticed you need to do something that is noticeable. If you feel like people are judging you for basically walking into a room and breathing why not give them something (intentionally) to focus on? One way to do this is doing something self-deprecating…that’s right, make fun of yourself!Poking fun at yourself, or even saying something about your social anxiety can actually diffuse the otherwise uncomfortable environment you are in. Then, like I said, they will resume what they were doing before, and you are in! I believe laughter is the “Great Diffuser”, it breaks the ice, eases tension, and makes those around you less anxious (including yourself)…but it needs to come from you. When you make fun of yourself or the situation, you know what you will find?? Other people there feel the same way or have been in the same situation.
Of course, it makes things a lot easier when you enter and see someone you know; make a point of going up to that person and greeting them. Don’t wait for them to come to you.]
Being watched or observed while doing something:“I always feel like, someone is watching me-eee”, sorry Maxwell reference there (Who knew who Maxwell was…where are my 80’s people?!). This is the ultimate in being judged; performing a task, or performing in general while people are watching you. “What are they thinking?” “Do they like what I’m doing?” “What if I mess up? They’re going to laugh at me” “They must think I’m incompetent”
Talking in a formal, public situation: Public speaking #1 fear (see the previous point) Another thing I have learned over the years from speaking in public is having tunnel vision. Actually, it is something I developed back in high school when I was a pitcher for the school baseball team. I was able to tune out the stimuli around me and only focus on what was in front of me. When I let distractions get in my head, my performance suffered. In public speaking situations, I would zone in on one or two friendly faces. When I did this I was able to tune out the rest of the stimulation around me and deliver my speech or whatever I was talking about. The longer I was up there the more at ease I was.
Meeting people in authority: Meeting important people or those who have influence can be quite intimidating. You are trying to put your best foot forward and make a good impression. What if you felt so anxious you avoided meeting them at all? What would the ramifications be? Missed opportunities, failed promotions, negative/false perceptions, loss of friends and significant others, etc.
Feeling insecure and out of place in social situations: How about sitting with a group of people and there is a conversation going on and you have absolutely nothing to contribute. And then the death knell strikes…someone turns to you and says...how come you’re not talking??? 😨
Other triggers for social anxiety:Making phone calls, ordering at a restaurant, returning something to a store, or raising your hand in class.
Conversations
Some clients I have worked with report having a difficult time starting (or continuing) a conversation. And if they don’t have ready conversation topics to discuss, they try and avoid being in that situation in the first place. Here are some ideas to consider:
Ask questions: Show genuine interest in the person you are with. Make sure they are not closed-ended questions, meaning questions that lead to “yes or no” answers or one-word answers. If you are listening to their answers you should be able to ask a follow-up question or two.
Avoid the one-upmanship response: This isn’t a competition, responding with something that appears to outshine their response is a turn-off and a certain conversation killer. If they ask you a similar question you answer honestly, but you are avoiding being dismissive of their responses.
Maximize similarities and redirect differences. There are more things that bind us than divide us. Emphasizing the differences can lead to unnecessary arguments or confrontations…certain conversation killers, AND a possible setback in progress working through social anxiety.
Remember, social anxiety is extremely common, more people have it than you think. Talking to a therapist about it can really help unburden you of this weight you are carrying. Sometimes knowing someone else struggling with social anxiety can help; support groups are a great way to see that you are not alone and to explore different ways to overcome your anxiety.
“It’s sad actually because my anxiety keeps me from enjoying things as much as I should at this age” -Amanda Seyfried
“Comedy is probably a way to deal with anxiety. Sometimes it’s a way of dealing with pain” -Hugh Grant
“It’s official: The biggest back-to-school bullies are anxiety, worry, and fear”-Chuck Norris
If you have any questions and/or comments please feel free to submit them here. I hope this was helpful and entertaining!
While men and women both experience depression, their symptoms may seem different. Men may display more anger or aggressive behavior, expressing their depression outward. Family, friends, and even medical professionals may not see these symptoms as depressive symptoms; and let’s be honest, even if they did and told the man so, most likely he would deny it and not seek treatment for it. Men may attribute it to some external factor like problems at work or financial stress, therefore they won’t readily accept they need to talk with someone about depression.
What is depression?
Depression is a common but serious mood disorder that affects the ability to feel, think, and handle daily activities. Clinical or Major Depressive Disorder must have symptoms present for 2 weeks to confirm the diagnosis.
(Click the link below for more information about depression)
As I mentioned earlier, men experience depression differently than women. The following are some examples of signs or symptoms for men to consider:
Escapist behavior, such as spending a lot of time at work or on sports
Irritability or inappropriate anger
Controlling or violent or abusive behavior
Risky or reckless behavior like excessive speeding or disobeying traffic laws, road rage, etc.
Alcohol and/or drug abuse
Common depressive symptoms: feeling sad, hopeless, empty, feeling extremely tired, difficulty sleeping, little to no pleasure in activities
Focusing on more physiological symptoms like headaches, digestive problems, tiredness, long-term pain issues, etc.
Downplaying these signs and symptoms, making some other excuses as reasons for the way they feel, externalizing emotional pain
Reluctance to discussing depressive symptoms (difficulty trusting to open up)
Resistance to mental health treatment (stigma-men don’t ask for help)
Whether you seek treatment or not, men should be honest with themselves about how they are feeling or what they are thinking. Sometimes it is difficult to accept that you are not feeling as well as you would like, and may even be embarrassed to say something to someone. The following are some coping skills to consider while you are sorting out these thoughts and feelings:
Set realistic goals and prioritize. Know your limits and do not go past them. When you are feeling overwhelmed, usually it is because you have taken on more than you can handle. It’s not macho to pile everything on and take care of things yourself–it’s foolish! Identify the top 3 things that need to be addressed and ONLY focus on those three things. Once you have a better handle on them, you can address other issues on your list.
Seek out emotional support. You would be surprised who your support network is; all you have to do is ask. Reach out to someone you trust and mention to them that you are having a difficult time, and ask if they would mind if you vented to them. Who knows, it may really help, and next time you will be the one they come to!! More people relate to what you are going through then not, so reach out to someone.
Learn ways to alleviate stress. This is extremely important, often times the depressive symptoms you are experiencing are the result of significant unaddressed stress. Massage, meditation, yoga, physical activity like sports or weight lifting, progressive relaxation exercises, etc. are some stress relieving activities to consider.
Live healthy lifestyle. This encompasses many different areas like proper diet and nutrition, regular exercise, adequate sleep, socialization with people who are positive influences (and not those who are steeped in negativity), etc.
Men have been sex-role-stereotyped to be the “strong silent type”: don’t express feelings, tough it out, be self-confident and aggressive, “fix things”, physically imposing, sexually experienced, driven. These societal and cultural norms create rigid beliefs about masculinity that are misguided and maladaptive to modern-day living. This creates undue pressure not only for the men but for the women who have to deal with them!! If more men would be honest and open about their feelings (and be willing to address them), there would be significantly less conflict and significantly more understanding.
I have worked with a number of men in my practice, as well as known some personally, who have (or should have been) diagnosed with depression. I too have experienced depression and probably have been Dysthymic for years.
Dysthymia: a mild but long-term form of depression. I describe it, non-clinically, as chronic “low-grade dumpiness”. I told you it wasn’t clinical! It’s not Eeyore from Winnie the Pooh level, but it could go there. What is most noticeable is irritability, low frustration tolerance, and physical tension from the shoulders to the head.
I notice the more irritable (or depressed) men are the more judgemental they are, and the more absolute their thinking is (black or white, right or wrong). “Only the Sith deal in absolutes”…sorry Star Wars reference there. But this absolute thinking could lead someone down a dark path, maybe not Darth Vader territory. There is an increased level of inflexibility, and/or an inability to consider alternate viewpoints and ideas. It is difficult for people to communicate with them because they do not want to be vulnerable, or exposed as “less than a man”. They may appear unreasonable, but in reality they are trying to keep the attention away from what is really going on…their depression.
Men will focus more on external issues that may not actually affect them personally or express negative thoughts that serve no other purpose but to accentuate the irritability (or depression) they are feeling. Sometimes it may come off as humor or sarcasm, but there is truth and anger mixed in. How can you tell if it is just joking behavior versus passive-aggressive sarcastic behavior? You can tell by who or what the humor is directed at. When it is directed at a “them”, to me it is an attempt to joke at someone or something else’s expense. I don’t find that funny, I see that as someone’s way of “lightly” expressing their dissatisfaction or displeasure with that person or thing. (Now, I am not referring to stand-up comedians or satire, although they could take things too far as well)
When I see people using self-deprecating humor, laughing at themselves, or including themselves in the joke, I find that to be more relatable humor. (Now of course, when I see people constantly putting themselves down “humorously”, that to me is not funny either). I believe we have to use humor to get through the rigors of our lives, it is essential, but how one uses it is significant. People who use humor or sarcasm to express themselves, especially about other people, are very likely masking some internal struggle they have not or are not willing to address.
When men understand what is going on with themselves internally, they feel the weight of the world being lifted, they feel more understood, and are less likely to be irritable and angry…and less depressed. It is not a sign of weakness for men to talk with someone about their mental health. In fact, it is the complete opposite; it is a sign of internal strength to admit one cannot manage the stressors of their world by themselves. About 2/3 of my clientele are male, and almost every one of them had a different view of therapy leaving than they did when they first came in (mostly positive!).
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