Could Schema Therapy Help Treat Narcissistic Personality?

This is an interesting article I found on: www.goodtherapy.org

See credits below.


Narcissistic personality disorder (NPD), or narcissism, as it’s often called, is one of the cluster B personality disorders, or emotional/impulsive personality disorders.

Narcissism is one of the least studied personality disorders. Different subtypes of narcissism present with varying features, making diagnosis challenging. People with narcissism may also see no need for counseling and consider it pointless or beneath them. If they do begin therapy, they may react angrily when faced with challenges, try to manipulate their therapist, or find it hard to consider things from other perspectives. They often leave therapy early, especially if they don’t see any benefit in it.

Recent research aims to identify new therapy approaches that can help people living with personality disorders achieve lasting change. Schema therapy, one such treatment, is considered helpful for people who don’t respond well to other types of therapy. It’s proven effective in treating borderline personality, another condition long considered difficult to treat.

Research looking at schema therapy for narcissism is still in the early stages, but existing clinical data suggests it has promise.

People living with narcissism have a deep need for admiration and recognition and draw self-esteem from the praise and positive regard of others.

The Roots of Narcissism

Personality disorders are characterized by rigid, long-lasting patterns of behavior that affect life and relationships, causing distress and making it difficult to function. People living with personality disorders may not always recognize that some of their behaviors cause problems or affect others negatively.

Like other personality disorders, narcissism is a serious mental health issue. Many consider it more serious and harmful than most other personality disorders, since people with narcissism generally lack empathy and may not care about the effects of their actions.

The causes of narcissism aren’t fully understood. Some potential factors in development may include:

  • Having a parent who is extremely adoring or overly critical, or a parent who switches between these modes
  • Having a parent with narcissism
  • Inheriting certain traits that increase risk for personality disorders
  • Experiencing trauma, abuse, neglect, or indifferent parenting

People living with narcissism have a deep need for admiration and recognition and draw self-esteem from the praise and positive regard of others. Since connecting with people on an intimate level requires a level of vulnerability, people with narcissism may avoid meaningful relationships in order to protect their illusion of grandiosity and keep an unstable self-identity from being revealed.

Researchers have identified four main subtypes of NPD. It’s possible to have features of multiple subtypes or shift between subtypes at different points in life.

  • Overt narcissism most often involves entitled, attention-seeking behavior. A primary feature is an exaggerated sense of self-importance. People with this subtype tend to be charming and arrogant and often exploit others. They may do fairly well in the workplace but struggle to get along with others or do tasks they consider demeaning or otherwise beneath them.
  • Covert narcissism may include anxiety, significant emotional distress, and extreme sensitivity to criticism or perceived insults. This subtype is often characterized by shyness, even social isolation. People with covert narcissism tend to have an internal sense of superiority and fantasize about their talents being recognized while speaking modestly about themselves, even putting themselves down.
  • High-functioning narcissism involves similar traits to overt narcissism, but people with this subtype can generally function well in society and may not appear to have a personality disorder. They are often able to adapt narcissistic traits such as charm and competitiveness in order to achieve success and may have relationships that are shallow but lasting. Criticism, perceived failure, or age-related challenges such as poor health or perceived loss of attractiveness may cause distress or crisis.
  • Malignant narcissism, considered the most severe subtype, involves overt narcissism traits along with traits of antisocial personality and paranoia. People with this subtype may lie and manipulate others easily, behave in aggressive ways, enjoy intimidating others, and avoid any work or task unless it benefits them in some way. They often have no desire to change, so treatment may be very difficult.

Narcissism often involves symptoms that are less known than grandiosity and lack of empathy, including:

Most people with narcissism struggle to maintain employment and personal relationships, changing partners readily when they don’t receive the admiration they need. It’s also common for people to fantasize about being recognized for their superiority and humiliating people who have “wronged” them.

When therapy can help address these concerns, particularly vulnerability and self-esteem, narcissistic behaviors may improve.

Schema Therapy: An Effective Treatment for Narcissistic Personality?

Even when people with narcissism do seek therapy, whether for distress related to narcissism or other mental health symptoms, treatment can be complicated. Believing a therapist has insulted them, failed to recognize their specialness, or isn’t skilled or reputable enough to treat them leads many people with narcissism to quit therapy early in treatment. Research suggests therapy progresses more slowly for people with narcissism, leading to slower improvement of symptoms.

Schema therapy, however, may have increased potential to treat NPD. Schema therapists offer support and validation while helping people work to understand and address the emotional mindsets causing problems in their life. For narcissism, this is often the persistent, private sense of inferiority and fear of failure.

Schema therapy combines elements of cognitive behavioral therapy, emotion-focused therapy, Gestalt therapy, and psychodynamic therapy, among others. The idea behind this approach is that schemas, or patterns of thought and behavior, develop as a result of unmet emotional needs and other early childhood experiences. These schemas are reinforced throughout life by challenges, abuse, trauma, and other negative or harmful experiences. Unless they’re addressed in positive ways, they contribute to the development of harmful or unhealthy methods of coping. These coping styles can affect behavior throughout life, often in ways that cause distress.

Schema therapists offer support and validation while helping people work to understand and address the emotional mindsets causing problems in their life.

The goal of the approach is to help people identify needs that weren’t met in childhood and learn how to get them met in healthy ways that don’t cause harm, either to themselves or to others. To help clients achieve this goal, schema therapists group schemas and coping responses into modes and use a range of strategies to address them, including roleplay, interpersonal techniques, and cognitive behavioral approaches. Therapists may set limits, as a parent would, within the bounds of the therapeutic relationship to help clients confront schemas.

The schema modes commonly associated with narcissism are:

  • Detached Protector/Self-Soother: This avoidant mode involves behaviors that are soothing, stimulating, or distracting—anything that helps turn off emotions. These behaviors might include substance abuse, risky sex, gambling, fantasizing, or overwork. It’s also common to shut out or reject people as well as emotions. Typical function isn’t always affected, but it may seem almost mechanical and lack any personal investment.
  • Self-Aggrandizer: A mode in the overcompensation category, this involves many behaviors typically associated with narcissism—superiority, entitlement, and manipulative tactics. People in this mode tend to show little interest in anyone but themselves, boast of real or inflated achievements, and openly seek admiration to avoid revealing hidden vulnerabilities and insecurities.

By confronting these modes and working through them with the help of the schema therapist, people in therapy can begin to access the Healthy Adult mode, which helps heal the vulnerabilities of early childhood and fosters healthier modes of coping. After reaching this mode, people may be able to begin functioning at a more typical level and be more able to take responsibility for their actions and see how they affect others.

Schema therapy has been successful in the treatment of other personality disorders, including borderline personality. Clinical trials on its use with narcissism are still forthcoming, but research and clinical observations suggest schema therapy could help people with narcissism have more success in treatment.

Why Do Narcissists Seek Therapy?

People living with NPD often believe themselves superior and struggle to consider the feelings and needs of others. This can make their actions particularly hurtful. Narcissism also often involves intentional manipulation or emotional abuse—behaviors that cause significant pain to partners of people with narcissism. In fact, many therapists specialize in helping the partners of people with narcissism heal.

The typical traits linked to narcissism, along with the tendency of many with NPD to see nothing wrong with their behavior, have contributed to the belief that therapy can’t treat narcissism. But therapy can help people with narcissism improve—if they want to change.

Andrea Schneider, LCSW, a therapist in San Dimas, California, explains what might prompt a person with NPD to seek counseling. “Typically,” she says, “Someone … with narcissistic personality may have some flexibility with some behavioral change when they are confronted with significant stressors (like a relationship ending or other crisis).”

People with NPD may not ever seek therapy for symptoms associated with narcissism. Instead, they might decide to get help for other symptoms or issues. These could be co-occurring conditions or long-term mental health effects associated with narcissism. In many cases, it’s these challenges that contribute to the desire for change.

People with narcissism may seek help for:

Narcissistic personality and associated conditions can significantly impact quality of life and emotional well-being. Addiction and stress can cause health concerns, for example, while the inability to sustain a relationship could lead to complete isolation.

To date, few studies have looked at treatment for narcissism because people with NPD don’t seek therapy often. If they do, they may only do so because someone else has urged them into it. Therapy can still have benefit, but the person with narcissism must recognize the problems with their behavior and make efforts toward change.

Finding a Schema Therapist

People who don’t see a need to address their behavior are unlikely to be able to make lasting change. But research on schema therapy suggests the approach could benefit people living with narcissism when other types of therapy don’t help. Experts do agree that narcissism often poses treatment challenges for therapists and can make progress in therapy difficult.

Schema therapy involves validation and empathy for a person’s difficulties and distress. When people with narcissism approach therapy with a willingness to change, or at least to make an effort to address harmful behaviors, the mode work involved in schema therapy may help them learn to confront the vulnerabilities they fear in a healthier way.

It can be difficult to find a schema therapist, especially if you live in a smaller city. But many therapists may be trained to incorporate elements of schema therapy into treatment. If you or a loved one has symptoms of narcissistic personality disorder, consider reaching out to a therapist who offers schema therapy or practices mode work. Don’t be discouraged by the myths about narcissism—change is possible for anyone. Begin your search for a trained, compassionate counselor today.

Author’s Note: If you’re involved in a relationship where there is intimate partner abuse of any kind—physical, emotional, or sexual—relationship therapy is usually not recommended. We encourage you to review our crisis page and reach out for support.

References:

  1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition. Arlington, VA: American Psychiatric Association.
  2. Behary, W. T., & Dieckmann, E. (2011, July 20). Schema therapy for narcissism: The art of empathic confrontation, limit-setting, and leverage. In W. K. Campbell and J. D. Miller (Eds.), The handbook of narcissism and narcissistic personality disorder: Theoretical approaches, empirical findings, and treatments. Hoboken, NJ: John Wiley & Sons.
  3. Behary, W. T., & Dieckmann, E. (2013). Schema therapy for pathological narcissism: The art of adaptive reparenting. In J. S. Ogrodniczuk (Ed.), Understanding and treating pathological narcissism (pp. 285-300). Washington, DC, US: American Psychological Association.
  4. Caligor, E., Levy, K. N., & Yeomans, F. E. (2015, April 30). Narcissistic personality disorder: Diagnostic and clinical challenges. American Journal of Psychiatry, 172(5). Retrieved from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.2014.14060723?url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org&rfr_dat=cr_pub%3Dpubmed&
  5. Dieckmann, E., & Behary, W. (2015). Schema therapy: An approach for treating narcissistic personality disorder. Fortschritte der Neurologie-Psychiatrie, 83(8), 463-477. doi: 10.1055/s-0035-1553484
  6. Ekselius, L. (2018). Personality disorder: A disease in disguise. Upsala Journal of Medical Sciences, 123(4), 194-204. doi: 10.1080/03009734.2018.1526235
  7. Mayo Clinic Staff. (2017, November 18). Narcissistic personality disorder. Retrieved from https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662
  8. Ritzl, A., Csukly, G., Balázs, K., & Égerházi, A. (2018, September 13). Facial emotion recognition deficits and alexithymia in borderline, narcissistic, and histrionic personality disorders. Psychiatry Research, 270, 154-159. doi: 10.1016/j.psychres.2018.09.017
  9. Young, J., & First, M. (2003). Schema mode listing. Retrieved from http://www.schematherapy.com/id72.htm
  10. Young, J., Klosko, J. S., & Weishaar, M. E. (2003). Schema therapy: A practitioner’s guide. New York City, NY: Guildford Press. Retrieved from https://www.guilford.com/excerpts/young.pdf?t

© Copyright 2019 GoodTherapy.org. All rights reserved.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

Podcast: There’s More to Trauma than PTSD

This is an interesting article I found on: www.psychcentral.com

See credits below.




Most of us are familiar with post-traumatic stress disorder. PTSD (deservedly) gets a lot of attention, largely focused on soldiers returning from service. But trauma comes in many forms, and most people have experienced it in one form or another. In this episode, learn about the differences between PTSD and other forms of trauma, how to identify it, and what can be done about it.

Subscribe to Our Show!
The Psych Central Show Podcast iTunes The Psych Central Show Podast on Spotify Google Play The Psych Central Show
And Remember to Review Us!

About Our Guest

Robert T. Muller, Ph.D., is the author of the psychotherapy book, “Trauma & the Struggle to Open Up: From Avoidance to Recovery & Growth,” which focuses on healing from trauma.

Dr. Muller trained at Harvard, was on faculty at the University of Massachusetts, and is currently at York University in Toronto. He has over 25 years in the field.

Books by Robert T. Muller

Videos by Robert T. Muller

Contact Information

TRAUMA SHOW TRANSCRIPT

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Narrator 1: Welcome to the Psych Central show, where each episode presents an in-depth look at issues from the field of psychology and mental health – with host Gabe Howard and co-host Vincent M. Wales.

Gabe Howard: Hello, everyone, and welcome to this week’s episode of the Psych Central Show Podcast. My name is Gabe Howard and I’m here with my fellow host Vincent M. Wales and our guest today is Dr. Robert T. Muller and he is the author of the psychotherapy book Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth, which focuses on healing from trauma. Robert welcome to the show.

Dr. Robert T. Muller: Very, very glad to be here.

Vincent M. Wales: We are glad to have you. So the word trauma is thrown around a lot these days. What do we really mean by that?

Dr. Robert T. Muller: Well, so there are different kinds of traumatic experiences but they all are based in the fact that something clear has happened to the person in the external world. Something that overwhelms their normal coping abilities and this can be a natural disaster, of course, but it can also be an event that occurs in the home. It could be something like physical or sexual abuse from a caregiver or various kinds of assault. And these are experiences that are overwhelming and most people who go through these overwhelming experiences don’t end up with post-traumatic stress disorder or various kinds of consequences. But a number of them do. and when they do and they’re left with these feelings of great distress and that’s what we refer to as trauma. The feelings that are left in the person that affect them, that affect their choices, that affect their relationships, that affect the way they engage in friendships following an overwhelming experience. And it’s hard, it’s very, very tough for people to deal with.

Gabe Howard: You know, outside of people who work in this field, the only really thing that they understand about trauma is post-traumatic stress disorder. That’s like the closest that the general public gets when you’re talking about trauma. Where does PTSD fit in? Can you kind of help people understand that?

Dr. Robert T. Muller: So the term PTSD we see in the psychiatric literature, and by PTSD we mean that the person has a disorder after a traumatic event post-traumatic stress disorder. So that means that they are continuing to suffer and by disorder we mean that their mental health is suffering and that they’re experiencing symptoms of re-experiencing the event, flashbacks. They may remember and have memory intrusions, memories of the event. And that’s very severe. They also have startle responses where they’re stressed very, very easily and by stress that can be very overwhelming stress. They also have problems with mood because they often feel depressed because of these traumatic experiences. And then finally they try to stay away from the things that remind them about whatever happened. So we see post-traumatic stress disorder in Vietnam vets, Gulf Wars vets, vets who’ve come back from Afghanistan, for sure. So we can also see these symptoms in victims of domestic violence and people who have been to experiences even who haven’t gone to war. So PTSD refers to the psychiatric language that’s used to describe the symptoms that many people have after a traumatic event. So that’s what it’s really meant by PTSD.

Gabe Howard: Thank you so much for that. And just to clarify, you can be traumatized and not develop PTSD. Is that correct?

Well you can be. Yeah. So here we get into a little bit of different words can sometimes mean similar things but when we talk about someone who is traumatized, they have all kinds of symptoms. They may not have exactly that cluster of things that I mentioned that we call PTSD but they’re going to have very similar experiences. There’s something called Complex PTSD and that’s a little bit different. Complex PTSD refers to people very often who have had traumatic events happen in childhood and in relationships. They feel betrayed by people who have who they thought were going to care for them the most. And when people have complex PTSD, very often what they have are huge problems in relationships. So, they’ve been hurt by somebody, they may feel tremendously abandoned by someone who they trusted. And then in life and in relationships, they now struggle to trust and they often really question other people. They question whether they can really trust them and they have a hard time with developing relationships because they feel scared. There are many feelings of fear that come over them. Shame, feelings of shame are common in complex PTSD. So, complex PTSD can take longer to heal than PTSD. If treatment for PTSD tends to be something more like six months to a year, treatment of complex PTSD can be two, three years, maybe even four years something like that. Pretty common. So those are some distinctions.

Vincent M. Wales: Thank you. Gabe and I are both very familiar with abandonment disorder and that sort of thing, attachment disorders. And there seems to be a very clear relation there with complex PTSD?

Dr. Robert T. Muller: For sure there is. There often is that for sure. There are feelings of abandonment very often and people with complex PTSD, and there are attachment problems. So, by attachment, that means that in times of distress they have difficulty turning to others who if you had a secure, what’s called a secure attachment, you might have an easier time turning to the people who feel, you know, should care about you. You know you might do that more easily; you might turn to them and ask for help and feel comfortable with that. But when people have what’s called an insecure attachment, and this is very common in complex PTSD, they have a great deal of difficulty turning to those people, who really you would think that they could turn to, their husbands, wives, their friends. They have a hard time turning to them because they feel very very frightened very often that people are going to just going to let them down. It’s a very very challenging disorder to treat. But it’s important for a therapist who works with people like this be what’s called trauma informed. Where they know about the effects of trauma so they can help people like this manage and find their way through their trauma.

Gabe Howard: Trauma informed care is something again, coming up more and more in mental health circles. Can you explain what trauma informed care means?

Dr. Robert T. Muller: So, there are many conditions that are related to trauma. It’s not just trauma therapists who come across people who have trauma histories. Family doctors very often will come across people who come in complaining of migraines, fibromyalgia, chronic fatigue, irritable bowel syndrome, immune system kind of disorders, stress related disorders. All of those are greatly exacerbated in people who have trauma histories. So it’s very important for family doctors. It’s very important for teachers, actually, to be trauma informed because you may see a kid in your class who appears like they have ADHD. They can’t sit still, they’re irritable, and that may also be a reaction to trauma. And I’m not saying that every person with all these disorders has a trauma history. I’m not saying that. Most of time people have migraines not because of trauma. But, if you do have a trauma history, all of those conditions can be greatly exacerbated. And so it’s very important for professionals who work interpersonally with people, family doctors, chiropractors, dentists, temporomandibular joint dysfunctions can be a symptom of trauma. Teachers, nurses, it’s very important for them to be trauma informed. For them to understand about the different manifestations of trauma. And there are many very often the immune system because of the stress of trauma the immune system has been affected. And that makes you more susceptible to a variety of different disorders. That’s why you need to be trauma informed.

Vincent M. Wales: Now for someone who has a pre-existing mental illness, whether it’s bipolar, or depression, or what have you, how are they affected by trauma? Is it any differently than someone without those issues?

Dr. Robert T. Muller: Yeah. Yeah. So trauma exacerbates other kinds of conditions. People have, let’s say, a family history of depression or family history of bipolar illness and then very traumatic thing happens to them. That can exacerbate other problems that they have. So it’s very difficult to disentangle this symptom is caused by this and this is a symptom caused by that. It’s impossible really to disentangle what’s caused by what. But what you do want to do is you want to work with people if you’re doing therapy with an individual who’s been through this. You want to work with them in a way where if somebody has bipolar illness where you get them seeing a good psychiatrist who can prescribe the right medication. But then if they have a trauma history that doesn’t mean that that’s it. That medication is all of the treatment. No. Somebody has a trauma history, they’ve got to find a way to talk about what’s happened to them. And that’s very difficult when you’ve been through trauma. It’s hard to talk about. And so good trauma informed therapies will work with a person in a measured, paced way to help them slowly feel comfortable. We’re starting to talk about what happened. And that can be very, very challenging.

Gabe Howard: It’s interesting. As someone who lives with bipolar disorder, I know the importance of being able to tell my medical team, whether it’s a psychiatrist, or a social worker, or a psychologist, you know, what’s going on inside my head, what my challenges are, what I need help with. It sounds like you’re saying somebody who just has a trauma background really needs to respond the same way. They have to be able to explain that to their medical team in order to get the right care.

Dr. Robert T. Muller: Well the thing with trauma is that people, a lot of professionals are not trauma informed. And so what ends up happening is that you get people going in for symptoms. So somebody with a trauma history, a typical kind of presentation. I’ll just give a name, Susan. Susan was raped let’s say in university. She experiences all kinds of difficulty in classes. She then goes and sees her doctor, gets put on an antidepressant. Is O K for a year or two on this antidepressant. And then, she starts to date again and then whoa. All these symptoms start to come back. She starts to experience confusion. She experiences other symptoms like headaches. She goes back and gets sent to a specialist. Then she says she has difficulty with her eating. Then the question of what? Does she have an eating disorder? And so what you end up with is this smorgasbord of different professionals. You know, this person specializes in depression, that person specializes in eating disorders, this sort of person specializes in migraines and whatever, trying to treat this person. And you don’t have a coherent treatment plan. And it’s because none of these professionals actually sat down and said, “Tell me a little bit about what happened in your life for the last five years. Walk me through it. What’s happened? Anything important? Tell me about it.” And if you do that with people, you can look for this. Sort of sitting down where you can say OK. Yes. Look at this. This person’s had these depression symptoms and this eating disorder seem to have really gotten a lot worse when dot dot dot. And then you could start to put the pieces of the puzzle together. And so you’re not just treating for this disorder or that disorder or the other disorder, but you develop a coherent plan to help the person find a way to start to deal with the underlying trauma that led to a variety of different responses. So that’s where it’s really important to be trauma informed.

Gabe Howard: We’ll be right back after these words from our sponsor.

Narrator 2: This episode is sponsored by BetterHelp.com, secure, convenient and affordable online counselling. All counselors are licensed, accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions, plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face-to-face session. Go to BetterHelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. BetterHelp.com/PsychCentral.

Vincent M. Wales: Welcome back. We’re here with Dr. Robert T. Muller discussing trauma. There’s a therapy relationship. What’s so important about that?

Dr. Robert T. Muller: Well it’s really, really important, the therapy relationship. And in trauma work, that’s absolutely true. It’s even true in other kinds of psychiatric or psychological problems. Research on outcomes of mental health problems and treatment strategies, what we find is, that regardless of the school of thought that the clinician uses, let’s say people go to see a cognitive behavioral therapist, or the person goes to see a psychoanalyst, or the person goes to see a Gestalt therapist, you name it. Regardless of the school of thought, the one thing that seems to run throughout therapy is the benefits of having a good, strong psychotherapy relationship. And so this means that if you’re a cognitive behavioral therapist, it might be that the person got better in part because you help them look at their underlying thoughts and how their thoughts affect their feelings and how to help them change their behaviors and they’ll improve their feelings. Maybe. Maybe that’s a piece of it. But it also is the case for research what we know is that if you do that in the context where the two of you are really working together and feel like you’re on the same page then therapy will be much more effective. So this is true for all schools of thought of therapy and psychoanalysis and everything else. And so this therapy relationship research shows is really important. So what does that mean? That therapist and client are working together, on the same page working toward similar goals. The same goals really. You have to have similarity of thought around the goals and there’s a sense of warmth. There’s a sense that the client feels that their therapist gives a darn. That they really do actually care. And that the therapist gets it. That the client has to feel that the therapist gets it and is listening and paying attention. These are really important skills. And you know, Carl Rogers in the 1950s really honed in on this. And since then we’ve come up with all kinds of therapies. And I’m not saying these other therapies are not helpful. I’m just saying that going back to basics is really important. That the skills that Rogers taught around empathy turned out to be, in fact research shows, they’re very important. This is really the case with trauma therapy. When you’ve been traumatized and you’ve been traumatized most often when people feel in relationships that they’ve been hurt, then they might work with a therapist and think my therapist doesn’t like me, or my therapist is going to abandon me. My therapist is judging me. And it’s understandable that you’d feel this way as a client. If you’ve been hurt, when your trust has been violated, you’re going to be very cautious for good reason in relationships, and you’re even going to be cautious around your relationship with your therapist. You don’t know whether your therapist is just trying to manipulate you. In all fairness, you don’t know. And so it’s very important for the therapist to be attentive to these kinds of relational issues and trauma. Are my client and I are on the same page? And that sort of thing.

Gabe Howard: Who should go to trauma therapy? I mean who is, I know that the answer might be anybody who is traumatized, but you know more specifically, like who is trauma therapy for exactly?

Dr. Robert T. Muller: So very often if you’re holding something that feels like it’s a huge burden that’s something to notice. So pay attention. Pay attention to this question. Ask yourself, am I carrying around a deep burden from years ago? Am I holding on to a secret? A secret that if other people knew, I would feel judged? I would feel that they would hate me? I would feel ashamed of those sorts of things? Am I being loyal to people who harm me? Those are all questions that you can ask yourself. I talk a little bit about this in Trauma and the Struggle to Open Up, the idea of how people, how many trauma symptoms develop, and these themes are really, really big. The themes of secrecy, feelings of betrayal, themes of loyalty to those who maybe you shouldn’t necessarily be so loyal to. But those are the kinds of questions to ask yourself. That is does the thought or some memory about something, does it make you feel sick? Does it make you feel like this feeling of I’m a bad person? You know, when I think about x y z that happened to me, I feel terrible guilt. How could I? How could I have done that? If you’re asking some questions like why me? Or if you’re asking questions of yourself like why not me? Why did X Y Z happen to my brother and not me? Those sorts of questions are very important questions that can be addressed in trauma therapy. And very often people have those questions in association with symptoms. When you know when you think about x y z that I just mentioned, maybe you feel depressed? Or maybe you feel self-loathing or disappointed in yourself? Why did I do that? Why didn’t I help my sister when such and such? When dad was, I don’t know, especially when Dad was drinking the way he was or mom was? Why didn’t I? So if you ask yourself those kinds of questions and you’re pained by it, that might be a sign that getting help, that talking to a therapist around your history is important. Because you’ve been trying to deal with this on your own for so long, and that can feel very lonely, it can feel very burdensome. And you don’t have to be alone in dealing with these things. That’s where I would think of therapy.

Vincent M. Wales: Right. We also have what we call post-traumatic growth. Is that just a fancy word for recovery or?

Dr. Robert T. Muller: Well no. No, it’s related to recovery. I mean people you hope that through trauma therapy people will get back to the way they were before you know they started really deteriorating. But it doesn’t exactly work that way. Recovery is a bit unpredictable. And what happens is as people start to talk about their problems, and start to talk about their history, they start to deal with things in a way that they never dealt with before. And so they start asking themselves questions like I mentioned. Why me? Why not me? Maybe those kinds of questions. Like what’s my place in the world after what happened to me? I thought my identity would be such and such but now I just don’t know. So when you start addressing questions like that, those kinds of questions lead to a re-evaluation of yourself. And so along with recovery, along with feeling better, along with removing, or removing and recovering from these psychiatric symptoms, that you really want to recover from, along with that comes a new understanding as you start to delve into issues from the past. And so that’s where there’s an opportunity for what’s called post-traumatic growth. That through the process of talking about and questioning and dealing with, there’s a reckoning. And that reckoning can help you grow in ways you may not have imagined. You may realize things about yourself that you hadn’t really thought of before. You know, like you may realize things like previously when I thought about such and such, I just felt guilt about what I did. But now, as I think about it now, actually, I was pretty strong the way I stood up to so and the way I did such and such. And I feel, I actually feel proud of myself for that. That may not sound like a big deal, but it can really feel like a big deal if you’ve felt ashamed of yourself for so long.

Gabe Howard: Do you do you think there’s a lot of people who are suffering from trauma who just don’t realize it? And how do we reach those people? Because you can’t exactly go ask for help if you don’t know that you are in need of help, right?

Dr. Robert T. Muller: Well this is why trauma education is so important. There’s getting to be more and more education about this. I have an online therapy and mental health magazine called The Trauma & Mental Health Report where you know my students and I, we publish articles and they’re very, very straightforward articles written for general consumption. They’re not academic heavy kinds of articles. And we’re trying to teach people about what happens in trauma. We have a lot of stories. You know for example, one of my favorite stories is A Corporal Speaks: 10 Questions for a Soldier Who Served in Afghanistan. And he tells his story. This corporal who came back and happened to be a Canadian, and who served alongside Americans. And many of the stories relate actually to the American soldiers who he served with. And it’s just a really interesting story. And these stories and so we’re trying to teach about how people struggle with these things in a way that the general public can start to learn. Not just people in mental health or whatever academics who know about this stuff, but that people in the general population can start to learn about this. And I think there’s greater interest. There’s more interest lately I’ve noticed in the topic of disassociation, people who have been through trauma, many of them dissociate. So they check out. They sort of go absent at times, you know. Why do they do this? Because sometimes. emotional trauma can be so overwhelming that they lose focus and lose attention to that and start thinking about some totally different things. And that allows them to feel okay. But you know that can be very very challenging when you dissociate a lot in your everyday life. So there’s a little bit more knowledge about that in the general public. I mean I’m noticing increasingly. So I think it’s, I think it’s really about education. And I think what you guys are doing here with this podcast and other people, other mental health podcasts, are becoming much more commonplace and people are asking these questions. There’s more stuff out there. I think that I think is the way to get people to learn about this stuff.

Gabe Howard: We agree with everything you just said except other mental health podcasts. We’re completely unaware of any other podcast other than this one. Don’t search for them. No, just kidding. I just have a couple of more questions because we’re about out of time. But one is please talk about your book for a moment and where folks can find it. I’m assuming you’re going to say Amazon. And what got you interested in researching and writing about trauma in the first place? I imagine they go kind of hand-in-hand.

Dr. Robert T. Muller: Yeah, that’s for sure. So I’ll do the thing about the book. It’s called Trauma and the Struggle to Open Up: From Avoidance to Recovery and Growth. It is available on Amazon and mental health bookstores as well. So there’s a hardcopy and a Kindle as well. So. what got me interested in trauma is not a short answer, but also what originally got me interested is a little bit different than when I realized, you know years later when I worked in the field for a long time. Originally, I just thought it was you know an interesting research topic and my supervisor was interested in it in graduate school. But what I realized in my 40s, was that there was a much deeper unconscious reason, I think, that I really got drawn into it. And I also realized that much more so as I did my own psychotherapy. And that is that my parents were children during the Holocaust. And both of them actually were separated from their families, and I believe to some extent traumatized by the Holocaust to some extent. I would say that their childhoods were shaped in ways that you can never imagine. My father’s father was actually killed. My mother’s parents were not killed they were okay, but they were there. My mom was separated from them. She was only 6 years old. She was separated from her parents for months. And so it was terrifying for a 6-year-old. She had no idea where her parents were and they left her in the care of a non-Jewish woman. Again, this saved my mom’s life, but this was a terrifying experience for her. And so I grew up with stories about the Holocaust and with stories about what it was like to be a child during the Holocaust. What it means to lose your innocence as a child. What it means to lose your childhood as a child. And so those kinds of experiences I think to a very large extent shaped me. I believe that’s ultimately why I went into this. Why I went into this field and why I can connect with trauma survivors I think it’s that experience. That’s a fair answer.

Gabe Howard: Yes. Thank you so much.

Vincent M. Wales: Wow. Well thank you for sharing that story with us.

Dr. Robert T. Muller: No problem.

Vincent M. Wales: That’s really heavy. And thank you so much for being here and for informing us on trauma so that we can recognize it and deal with it when we have it.

Dr. Robert T. Muller: OK. Ok. My pleasure.

Vincent M. Wales: And remember, you can get one week of free, convenient, affordable, private online counseling anytime anywhere by visiting BetterHelp.com/PsychCentral. Thanks. We’ll see you next week.

Narrator 1: Thank you for listening to the Psych Central Show. Please rate, review, and subscribe on iTunes or wherever you found this podcast. We encourage you to share our show on social media and with friends and family. Previous episodes can be found at PsychCentral.com/show. PsychCentral.com is the internet’s oldest and largest independent mental health website. Psych Central is overseen by Dr. John Grohol, a mental health expert and one of the pioneering leaders in online mental health. Our host, Gabe Howard, is an award-winning writer and speaker who travels nationally. You can find more information on Gabe at GabeHoward.com. Our co-host, Vincent M. Wales, is a trained suicide prevention crisis counselor and author of several award-winning speculative fiction novels. You can learn more about Vincent at VincentMWales.com. If you have feedback about the show, please email [email protected].

About The Psych Central Show Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. He is also one of the co-hosts of the popular show, A Bipolar, a Schizophrenic, and a Podcast. As a speaker, he travels nationally and is available to make your event stand out. To work with Gabe, please visit his website, gabehoward.com.

Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. He is also the author of several award-winning novels and creator of the costumed hero, Dynamistress. Visit his websites at www.vincentmwales.com and www.dynamistress.com.

Podcast: There’s More to Trauma than PTSD

Related Articles

View Original Article

Hope you enjoyed reading this article.
Please feel free to share!

5 Myths and Facts About Drug Rehab

This is an interesting article I found on: www.goodtherapy.org

See credits below.


Drug abuse is a serious health concern. Overdose-related deaths in the United States have reached epidemic level. In fact, the Centers for Disease Control and Prevention (CDC) estimate an average of 130 people die from opioid overdose each day. This number doesn’t take into account deaths related to other drugs, which may increase this number.

Any drug use can become dangerous. Marijuana, now legal for medicinal and recreational use in many states, may help relieve pain, chemotherapy side effects, and symptoms of mental health concerns such as anxiety and posttraumatic stress. Research has also suggested marijuana may help treat addiction in some people. But despite these potential benefits, it can become addictive and could have health effects such as short-term memory impairment, impaired brain function, and respiratory health issues, among others.

Recreational use of illegal substances, even short-term use, can have serious health effects, including anxiety, paranoia, depression, suicidal thoughts, hallucinations, nausea, increased heart rate and blood pressure, and more. There’s also a risk of death due to overdose or complications. Long-term use of certain drugs could increase risk of violent behavior and may lead to legal trouble. Abusing drugs can also lead to drug dependency, or addiction.

Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives.

If you’re experiencing addiction, you’re not alone. According to statistics from the Substance Abuse and Mental Health Services Administration, more than 20 million Americans experienced a substance abuse disorder in 2014. Addiction can be difficult to overcome, no matter how hard a person tries. Professional support, in the form of inpatient or outpatient drug rehab, can benefit many people living with drug addiction.

Myths about drug rehab are plentiful. If you’re considering rehab for yourself or a loved one, making sure you have all the facts will help you make a more informed decision. Here, we present five common myths about drug rehab and the facts to counter them.

Drug Rehab Myths and Facts

Myth: Only wealthy people go to rehab.
Fact: Anyone can go to rehab.

It’s true that drug rehab can become expensive. Some people may not even consider inpatient rehab an option, believing it to be out of their budget. But the cost of drug rehab can depend on a number of factors, and there are rehab options for a range of budgets. See our article here for a more detailed explanation of rehab costs.

Some drug rehab centers offer low-cost or sliding-scale fees, based on your income. According to the 2012 National Survey of Substance Abuse, 62% of rehab facilities charge based on a sliding scale. Facilities may also offer payment programs or other types of financial assistance to people in need. Many drug rehab centers accept insurance, though not all insurance providers cover rehab.

When considering rehab, talk to your insurance provider and the rehab facility you’re interested in to get a better idea of the cost involved. Some centers may be able to work with you or refer you to another quality center that is more affordable. If the cost of inpatient rehab is a barrier, you might also consider outpatient drug rehab programs.

Myth: Rehab is for when you hit “rock bottom.”
Fact: You can begin recovering from addiction at any time.

Many people go to rehab when no other treatment option has worked. Often, they’ve lived with addiction for many years. Rehab can help people who’ve reached their absolute low work to overcome addiction, but it can also help people begin to break free of addiction before it significantly impacts their lives. Research suggests early intervention helps improve treatment outcomes.

Addiction not only contributes to emotional and physical health concerns, it can also lead to homelessness, unemployment, debt, and breakup or divorce. Choosing to enter rehab when you first find yourself becoming dependent on substances can help you begin the recovery process before addiction can have more of an effect on your life.

Myth: Rehab is only for people who can’t quit on their own.
Fact: Anyone experiencing addiction can get help in rehab.

The idea that addiction only happens to weak or flawed people is widespread. It might seem logical: Many people experiment with drugs, but not everyone becomes addicted. But drug abuse alters brain chemistry and affects cognitive function, leading to cravings for the substance and eventually addiction. Certain factors, including genetics, can increase a person’s risk for addiction.

Although a person might choose to try drugs, they don’t choose to become addicted. Once addicted, many people can’t stop using drugs without professional help. Needing rehab isn’t a sign of weakness. Changes in the brain resulting from addiction can make it extremely challenging, if not impossible, to stop using drugs without the support of health care providers trained in addiction support.

Whether you’ve tried to stop using drugs and relapsed or are just beginning to realize you may have a problem with substance abuse, rehab can help you begin recovery.

Myth: Rehab will prevent a person from relapsing.
Fact: Relapse is common, but treatment can help reduce its impact.

Between 40 and 60% of people dealing with addiction will relapse, according to the National Institute on Drug Abuse. While rehab may help reduce your risk of relapse, completing a drug rehab program doesn’t guarantee you’ll never relapse.

But rehab still has benefit. Research shows rehab can help by helping you develop skills to resist cravings, making relapse less likely. If you do relapse, the length of the relapse may be shorter. People who participate in treatment programs such as rehab also tend to relapse fewer times than people who don’t. Rehab can also lead to improvements in your relationships with friends, family, and loved ones. Developing stronger bonds with people you care for can also decrease the likelihood of relapse.

Myth: Rehab doesn’t work if you force someone to go.
Fact: Rehab can work even if you don’t want treatment.

Some people choose to enter rehab on their own, but some people experiencing addiction may not see its effects on their life, or they may not believe they have a problem with substance abuse. They may only decide to enter rehab grudgingly, after a court order or intervention from loved ones.

Being issued an ultimatum or feeling otherwise “forced” into rehab could make some people resistant to treatment, at first. According to the National Institute on Drug Abuse, however, people who feel pressured to overcome addiction in order to maintain an important relationship or avoid criminal charges, for example, often do better in treatment, even though they didn’t choose to enter rehab on their own.

Substance abuse and addiction can have serious, lifelong consequences. But there is help. Drug rehab may seem like an extreme measure, but this is partially due to the many myths surrounding rehab treatment.

Numerous studies support the benefits of rehab for addiction recovery. Inpatient centers provide a safe place to begin the detox and recovery process at any stage of addiction. Some facilities are expensive, but it’s possible to find affordable centers that will work with you to find a treatment program that’s right for your needs and your budget.

Don’t let myths about drug rehab keep you from getting addiction recovery support. Compassionate care is available! Begin your search today at GoodTherapy. Recovery may be a lifelong journey, but you are not alone.

References:

  1. American Addiction Centers. (2019, February 14). How much does rehab cost? Retrieved from https://americanaddictioncenters.org/alcohol-rehab/cost
  2. American Addiction Centers. (2018, October 15). Rehab success rates and statistics. Retrieved from https://americanaddictioncenters.org/rehab-guide/success-rates-and-statistics
  3. Blending perspectives and building common ground. Myths and facts about addiction treatment. (1999, April 1). U.S. Department of Health and Human Services. Retrieved from https://aspe.hhs.gov/report/blending-perspectives-and-building-common-ground/myths-and-facts-about-addiction-and-treatment
  4. Centers for Disease Control and Prevention. (2018, December 19). Understanding the epidemic. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
  5. Leshner, A. I. (n.d.). Exploring myths about drug abuse. National Institute on Drug Abuse. Retrieved from https://archives.drugabuse.gov/exploring-myths-about-drug-abuse
  6. Mayo Clinic. (2017, July 20). Intervention: Help a loved one overcome addiction. Retrieved from https://www.mayoclinic.org/diseases-conditions/mental-illness/in-depth/intervention/art-20047451
  7. Mayo Clinic. (2017, October 26). Drug addiction (substance use disorder). Retrieved from https://www.mayoclinic.org/diseases-conditions/drug-addiction/symptoms-causes/syc-20365112
  8. National Academies of Science, Engineering, and Medicine. (2017). The health effects of cannabis and cannabinoids: The current state of evidence and recommendations for research. Retrieved from http://nationalacademies.org/hmd/reports/2017/health-effects-of-cannabis-and-cannabinoids.aspx
  9. National Institute on Drug Abuse. (2018). Drugs, brains, and behavior: The science of addiction. Retrieved from https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery
  10. National Institute on Drug Abuse. (2018). Is marijuana addictive? Retrieved from https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-addictive
  11. Substance Abuse and Mental Health Services Administration. (2015). Behavioral health trends in the United States: Results from the 2014 national survey on drug use and health. Retrieved from https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf
  12. Substance Abuse and Mental Health Services Administration. (2016). Early intervention, treatment, and management of substance use disorders. In Facing addiction in America: The surgeon general’s report on alcohol, drugs, and health [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK424859
  13. Substance Abuse and Mental Health Services Administration. (2019, January 30). Mental health and substance use disorders. Retrieved from https://www.samhsa.gov/find-help/disorders
  14. Walsh, Z., Gonzalez, R., Crosby, K., Thiessena, M. S., Carrolla, C., & Bonn-Miller, M. O. (2017). Medical cannabis and mental health: A guided systematic review. Clinical Psychology Review, 51, 15-29. Retrieved from https://www.sciencedirect.com/science/article/pii/S0272735816300939?via%3Dihub
  15. Weber, L. (2015, July 11). How much does inpatient rehab cost? Retrieved from https://addictionblog.org/rehab/inpatient-rehab/how-much-does-inpatient-rehab-cost

© Copyright 2019 GoodTherapy.org. All rights reserved.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

How to Own Your Power: Using Influence Consciously

This is an interesting article I found on: www.goodtherapy.org

See credits below.


I want to say a sentence, a prompt, to you. It will be a positive sentence. Your task is just to notice and reflect on what your internal response is.

“It’s okay to own your power.”

There are a variety of ways that people can react to this idea, but they tend to follow a few trends. Were your thoughts similar to any of these?

  • “At first the idea seemed fine, but then, on deeper reflection, I noticed that I don’t like owning my power, so I sometimes avoid it.”
  • “It doesn’t feel okay because I’m afraid I will use it to cause harm.”
  • “I became aware that I don’t think I have power at all.”
  • “I notice I’m afraid of being held accountable for everything I do or say.”
  • “I think, in alarm, about the sentence ‘power corrupts.’”

It is entirely natural to feel wary of power. The news every day gives us a dose of information about misuses and abuses of power, and we all have our own experiences of power being misused towards us. Not often do we hear stories of uses of power that support well-being and promote the good of all.

Power has become such a loaded term that you may be surprised to hear a definition of power that does not idolize or vilify it: Power is the ability to have an effect or to have influence. Power is a neutral concept. We all need power to take action, to bring forth our dreams, and to influence others. People are often looking to us to step into our power in healthy ways.

From the Right Use of Power point of view, there are four kinds of power to understand, own, and pay attention to.

  1. The first and most basic is personal power, which everyone has. It is your ability to influence your own life and to decide how to be with others.
  2. The next is role power. This is the extra layer of power and responsibility that is added on to personal power whenever you are in a position of authority, such as teacher, therapist, lawyer, employer, elected official, etc.
  3. The next is status power, which is mostly unearned and culturally conferred. It involves traits such as race, sex, religion, heritage, able bodied-ness, age, etc. (You might also call this privilege).
  4. And the fourth kind is collective power—the additional power that groups of people have when they are acting together.

Using our power wisely and well requires us, rather than avoiding or disowning, to OWN all of these kinds of power. Understanding the impacts and relational dynamics that accompany each type of power is the key to their beneficial use. There may be ways that you already use and interact with these types of power, but how conscious are you in how you do so and the impact it has?

In this article, we are focusing on PERSONAL POWER. Personal power is your birthright. We all have power. Even babies can choose to roll a ball or impact others’ behavior when they cry or smile. One of the tasks of a lifetime is to develop skillful use of your personal power so that you have the impact on others that you want to have. This self-awareness can be used to guide you to progressively healthier relationships.

There are many ways we use our personal power to influence our personal relationships. These uses of power can be seen as variables, where opposing qualities can be put on a continuum. A good way to explore the range of your own qualities is to write or print the continuums below, then put a mark on the spot on each continuum where you tend to land. Of course, in healthy relationships, there is room for a range of responses based on circumstances, but most of us have natural tendencies.

As you do this activity, please note that all of these qualities on all of the continuums are positive. One is not better than another. It is not intrinsically better to be directive or responsive, and having a healthy range of responses to different situations is a good thing.

However, misuses and abuses of power tend to happen more at the extremes of each continuum. For example, someone who is at the extreme of the strength side of the continuum may be experienced as forceful, inflexible, or mean. Meanwhile, someone at the extreme end of the heart side of the continuum may be experienced as a pushover, conflict-avoidant, or unable to give direct instructions. At both extremes, people become disconnected and relationships become painful, confusing, and difficult.

Directive ————————————————————————–Responsive

Firmly boundaried ———————————————————–Flexibly boundaried

Task-focused ——————————————————————— Relationship-focused

Persistent ————————————————————————–Letting go

Truth-focused ———————————————————————-Harmony-focused

Strength-centered —————————————————————-Heart-centered

Extroverted ————————————————————————-Introverted

Now you have a picture of your personal power profile. How do you feel about your profile? Are there any tendencies that you would like to shift in one direction or the other to have more of the influence you want to have? Are there any tendencies that feel particularly ‘stuck’ in one place? What is it like to OWN your power so that you can have conscious choice in how you use it for good?

If you want to explore this further and initiate an interesting conversation, try comparing your profile with people you are closely related to. You will be increasingly able to have the kind of relationships you want and are capable of as you grow to understand and own your power.

If you would like help addressing power-related issues in your life, you can find a therapist here.

© Copyright 2019 GoodTherapy.org. All rights reserved.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

Drug Addiction Among Senior Citizens: A Growing Crisis

This is an interesting article I found on: www.goodtherapy.org

See credits below.


Drug addiction and abuse among seniors has risen steadily over the last decade. This is partially because Baby Boomers have always had comparatively high rates of substance use and abuse. As they age, prescription drug use also becomes more prevalent among this group, increasing the risk of addiction. For example, a person who initially takes a prescription painkiller to deal with the pain of arthritis can quickly become addicted.

A 2015 AARP Public Policy Institute analysis found 1.2% of seniors admit to abusing prescription painkillers. The actual prevalence rate of abuse may be even higher. As with most age groups, however, the leading source of addiction among seniors remains alcohol.

Facts About Substance Abuse in Older Adults

According to the United States Census Bureau, there were 43.1 million seniors over the age of 65 in the U.S. in 2012. According to 2007-2014 National Survey on Drug Use and Health data:

  • An estimated 5.7 million seniors will have a substance addiction by 2020.
  • In an average day, 6 million seniors use alcohol, while 132,000 use marijuana and 4,300 use cocaine.
  • On an average day in 2011, 2,056 seniors visited the emergency room for drug-related reasons. Prescription and nonprescription pain relievers were the leading cause of these visits.

The U.S. has seen a surge in opioid use and abuse over the past two decades. Opioid overdoses now kill more people than breast cancer. Seniors are not the age group most likely to abuse opioids, though they may be more vulnerable to opioid-related health issues than other groups. Seniors with health issues may be less physically resilient, increasing their risk of opioid overdose. When opioids interact with other drugs, the results can be lethal.

Recognizing Addiction in Elders

A number of risk factors increase a senior’s likelihood of abusing and becoming addicted to drugs and alcohol. Those include:

  • Use of prescription painkillers. Addiction is especially likely if the senior uses multiple painkillers over a long period of time.
  • A prior history of drug or alcohol abuse. Baby Boomers have higher rates of substance use than most generations that came before them. As they age, their substance abuse is predicted to escalate.
  • Social isolation. For some seniors, drugs and alcohol are a way to escape feelings of isolation and boredom. Isolation also allows an addiction to fester and go unnoticed.
  • Mental health issues. There is a significant correlation between mental health diagnoses and substance abuse, particularly in people who have not sought mental health treatment. Some seniors use addictive substances to self-medicate. For example, an elder might use amphetamines to fight the low energy and motivation that accompany depression.
  • Access to potentially addictive drugs. Seniors who receive many prescriptions may save the leftover drugs. Those drugs can become a tempting alternative to boredom and other unpleasant emotions, increasing the risk of addiction.

The symptoms of addiction in elders may resemble dementia. Loved ones who do not know the senior is abusing drugs may even dismiss addiction symptoms as signs of normal aging. Moreover, addiction can be a factor in some forms of dementia. For example, Korsakoff syndrome is a dementia that is usually prompted by alcoholism.

Loved ones should not dismiss personality or mood changes in seniors, since these are not part of normal aging. Other warning signs of addiction include:

  • Confusion, forgetfulness, and poor decision-making.
  • Seeming drunk, high, or out of it.
  • Using many prescription pills.
  • Taking prescription drugs without a prescription.
  • Loss of interest in previously enjoyed activities.
  • Mood swings.

If you know a senior with these symptoms, urge your loved one to see their doctor.

Nursing Homes and Stigma

Addiction is a medical condition, not a personal or moral failing. In some cases, an addiction is the inevitable result of being prescribed too many addictive drugs for too long. Despite this, many senior care communities, including some nursing homes, refuse to admit seniors receiving addiction treatment.

Addiction is a medical condition, not a personal or moral failing.In Ohio, a trade group that represents more than 900 skilled care facilities released a statement saying that none of its members admit seniors with addictions. Some legal experts say this is a violation of the Americans with Disabilities Act (ADA). The ADA is a federal law that prohibits discrimination on the basis of disability, including mental health disabilities such as addiction.

For seniors who need acute or long-term nursing care, this presents a conundrum: either conceal the addiction, thereby avoiding addiction treatment to get necessary nursing care, or pursue addiction treatment and miss out on nursing services. These options can leave caregivers trying to fill care gaps that skilled nursing facilities typically fill.

Even when nursing homes do accept seniors, stigma can color the treatment they offer. Staff may harbor negative views about people with addictions or treat addiction medications such as methadone as an unnecessary luxury.

How to Find the Best Senior Rehab Center For Your Needs

Not all elders necessarily need senior-specific addiction treatment. For most seniors, the cycle of addiction is identical to that of younger groups. However, some seniors may need help with medication management or with finding alternatives for managing chronic pain. Seniors (or their caregivers) can partner with their doctor to find a rehab facility or outpatient treatment provider that can address the senior’s medical needs.

If you are a caregiver looking for treatment on behalf of a senior, here are some questions to ask before agreeing to any specific treatment:

  • What treatment methods do you use, and what is the evidence supporting them?
  • Can you help manage other conditions, and if not, will you partner with the senior’s doctor to manage these conditions?
  • Can you provide a safe environment for vulnerable seniors, such as those with osteoporosis or dementia?
  • How long does treatment typically last, and what is your success rate?
  • What do you do if there is a medical emergency?
  • Do you offer therapy, group counseling, family support, or other services to ensure seniors get comprehensive help?
  • What is the specific cost of the program, and are there additional costs for additional services?

Which Addiction Treatments Do Medicare Cover?

Federal law mandates mental health and substance abuse parity. This means Medicare and other insurance programs must offer similar coverage for mental health conditions as they do for physical health conditions.

Medicare covers outpatient, inpatient, and partial hospitalization programs when it deems these treatments “reasonable and necessary.” A senior may first have to be diagnosed with an addictive disorder before Medicare will cover treatment. In most cases, a senior must pursue outpatient treatment before Medicare will approve coverage for inpatient treatment.

Additionally, Medicare does not pay for bundled inpatient addiction treatment services. It instead approves services on an individual and case-by-case basis. So some treatments, such as therapy and withdrawal medication, may be covered, while other treatments—especially experimental and alternative treatments—may not be covered. Medicare will not pay for training or educational services unless they directly contribute to treatment (as opposed to recreation or diversion).

A compassionate counselor can help seniors manage their addiction. When addiction has impacted family members, family therapy can help loved ones sort through their options. There is no shame in seeking help.

References:

  1. Benson, W. F., & Alrich, N. (2017). Rural older adults hit hard by opioid epidemic. Aging Today. Retrieved from https://www.asaging.org/blog/rural-older-adults-hit-hard-opioid-epidemic
  2. Bond, A. (2018, April 17). Nursing homes routinely refuse people on addiction treatment—Which some experts say is illegal. STAT News. Retrieved from https://www.statnews.com/2018/04/17/nursing-homes-addiction-treatment
  3. Dean, O. (2017). Prescription drug abuse among older adults [PDF]. AARP Public Policy Institute. Retrieved from https://www.aarp.org/content/dam/aarp/ppi/2017/07/prescription-drug-abuse-among-older-adults.pdf
  4. Fueled by aging Baby Boomers, nation’s older population to nearly double in the next 20 years, Census Bureau reports. (2014, May 06). United States Census Bureau. Retrieved from https://www.census.gov/newsroom/press-releases/2014/cb14-84.html
  5. Korsakoff syndrome. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/what-is-dementia/types-of-dementia/korsakoff-syndrome
  6. Kuerbis, A., Sacco, P., Blazer, D. G., & Moore, A. A. (2014). Substance abuse among older adults. Clinics in Geriatric Medicine, 30(3), 629-654. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4146436
  7. Mattson, M., Lipari, R. N., Hays, C., & Van Horn, S. L. (n.d.). A day in the life of older adults: Substance use facts. Retrieved from https://www.samhsa.gov/data/sites/default/files/report_2792/ShortReport-2792.html
  8. Medicare coverage of substance abuse services [PDF]. (2016, April 28). Department of Health and Human Services Centers for Medicare and Medicaid Services. Retrieved from https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnmattersarticles/downloads/se1604.pdf

© Copyright 2019 GoodTherapy.org. All rights reserved.

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

How Trauma and Dissociation Disrupt Your Ability to Form Memories

This is an interesting article I found on: www.goodtherapy.org

See credits below.


“Memories warm you up from the inside. But they also tear you apart.” Haruki Murakami

We all know from popular drama (TV shows, movies, etc.) that traumatic events are often forgotten by the sufferer. People who experience a devastating event such as a car accident, natural disaster, or terror attack often cannot remember the incident. It’s also common not to remember what took place right before or right after the incident. In a similar way, many adults who suffered child abuse have difficulty recalling large chunks of time from childhood. In these cases, problems with memory can continue into adulthood as well, particularly when faced with emotional distress.

Our brain and nervous system have evolved to do spectacular things: we can read, write, make music, and contemplate the meaning of life. But the brain’s first and foremost duty is to keep us alive. When it comes to traumatic events, the part of our brain that protects our physical and emotional well-being takes control. In this process, the parts of the brain that are responsible for higher thought processes, such as forming and retrieving memories, are suppressed.

How the Brain Forms Memories

On a regular stress-free day, memories for facts are made and stored in three steps: acquisition, consolidation, and retrieval.

  • Acquisition occurs through the combination of sensory experience and emotion. The amygdala processes and interprets the experience so it can become a memory.
  • The hippocampus consolidates the experience and sends the information off to the appropriate place for storage (memories are stored all over the brain).
  • It is thought that retrieval of factual memories occurs as a function of the prefrontal cortex. When we want to think of a fact, such as the definition of a word, the prefrontal cortex retrieves it and we remember.

When we are confronted with life-threatening danger, the brain behaves differently. The amygdala sends an emergency signal to the hypothalamus, which in turn activates the fight or flight response. Corticosteroids are then released into the bloodstream in order to prepare the body for action. Blood pressure, heart rate, and respiratory function all increase to provide the body and brain with extra energy and oxygen. Our alertness increases, and our body is ready to move.

When this is happening, the amygdala inhibits the activity of the prefrontal cortex. When faced with danger, this is useful, as the prefrontal cortex operates substantially slower. While it is trying to work out what is happening, our body may be harmed. The quicker, action-oriented part of the brain enables us to respond rapidly and try to avoid danger. We act fast. Later, once we are safe, we have time to think. In respect to memory, the parts of the brain involved in memory formation are shut down when faced with a traumatic experience.

The activation of the fight or flight response prevents the parts of the brain responsible for creating and retrieving memory from functioning effectively. This is why we can forget what occurred around a traumatic event. In the case of ongoing trauma, such as with childhood abuse, ongoing problems with memory and the related process can occur, leading to what is understood as dissociation.

Dissociation and Memories

At the heart of dissociation is memory disruption.At the heart of dissociation is memory disruption. During dissociation, the normally integrated functions of perception, experience, identity, and consciousness are disrupted and do not thread together to form a cohesive sense of self. People with dissociation often experience a sense that things are not real; they can feel disconnected from themselves and the world around them. Their sense of identity can shift, their memories can turn off, and the connection between past and present events can be disrupted.

In understanding the human response to trauma, it is understood that dissociation is a central defense mechanism because it provides a kind of mental escape when physical escape is not possible. This type of defense is often the only kind available for children living in abusive situations. Posttraumatic stress (PTSD) and complex posttraumatic stress (C-PTSD) often go hand in hand with dissociation. In studies investigating the impact of PTSD and memory, researchers have found that people with dissociative symptoms have a greater impairment with both working memory and long-term memory.

Long-Term Impact of Memory Impairment

To understand the long-term impact of memory impairment due to dissociation, we need to look at the context from which it arises. Dissociation occurs as a result of ongoing trauma which is associated with chronic stress. A chronically stressed brain and nervous system have difficulty learning. The hippocampus, critical for memory formation and consolidation, can become damaged from ongoing exposure to stress hormones. Researchers have found that the hippocampus actually shrinks in people who suffer from major depression. In addition to the emotional impact of chronic stress and abuse, difficulties with learning and memory can occur as well.

Implications range from difficulties with academics to reduced on-the-job learning and performance. In terms of survival, the implications are serious, as we all need the ability to prepare for, find, and keep employment. Unfortunately, once a person frees him or herself from an abusive childhood, the effects can follow into adulthood in unexpected ways. A damaged hippocampus and overactive nervous system can make life more difficult than it has to be. Over time, self-esteem and confidence can be negatively impacted as well.

Fortunately, the prognosis of dissociation can be optimistic. Researchers have found treatment with antidepressants can increase hippocampal volume. Talk therapy and other therapeutic approaches that are designed to reduce stress and increase emotional resilience may also help.

If you are experiencing trauma or dissociation, you can find a mental health professional here.

References

  1. Bedard-Gilligan, M., & Zoellner, L. A. (2012). Dissociation and memory fragmentation in post-traumatic stress disorder: An evaluation of the dissociative encoding hypothesis. Memory, 20(3), 277-299. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22348400
  2. Lanius, R. A. (2015). Trauma-related dissociation and altered states of consciousness: A call for clinical, treatment, and neuroscience research. European Journal of Psychotraumatology, 6(1), 27905. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439425
  3. Nuwer, R. (2013, August 1) Why can’t accident victims remember what happened to them? Smithsonian. Retrieved from https://www.smithsonianmag.com/smart-news/why-cant-accident-victims-remember-what-happened-to-them-21942918
  4. Özdemir, O., Özdemir, P. G., Boysan, M., & Yilmaz, E. (2015). The relationships between dissociation, attention, and memory dysfunction. Nöro Psikiyatri Arşivi, 52(1), 36-41. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5352997
  5. Phelps, E. A. (2004). Human emotion and memory: Interactions of the amygdala and hippocampal complex. Current Opinion in Neurobiology, 14(2), 198-202. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/15082325
  6. Rosack, J. (2003, September 5) Antidepressants may prevent hippocampus from shrinking. Psychiatric News. Retrieved from https://psychnews.psychiatryonline.org/doi/full/10.1176/pn.38.17.0024
  7. Sapolsky, R. M. (2001). Depression, antidepressants, and the shrinking hippocampus. Proceedings of the National Academy of Sciences, 98(22), 12320-12322. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC60045

© Copyright 2019 GoodTherapy.org. All rights reserved. Permission to publish granted by Fabiana Franco, PhD, therapist in New York City, New York

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

Podcast: Dwelling on the Past Mistakes Caused by Mental Illness

This is an interesting article I found on: www.psychcentral.com

See credits below.




Once we reach recovery from mental illness, we tend to dwell on the mistakes of our past. Thoughts of failures and people we’ve hurt ruminate inside our head and make it difficult to move forward.

Why do we think about these things? Does it protect us, make us feel better, or is it way to keep us from moving forward? In this episode, our hosts discuss their past failures in the hopes it allows our listeners to realize living in the past only really accomplishes one thing . . .

SUBSCRIBE & REVIEW

Google PlaySpotify

“It just creeps into the deep dark depths of my head and it just goes around, and around, and around.”
– Michelle Hammer

Highlights From ‘Ruminations’’ Episode

[2:00] We are talking about ruminations today

[4:30] Ruminations feed delusions

[6:00] Gabe dwells on his past wives

[8:20] Michelle ruminates about how her brother treated her in the past

[11:00] Gabe tried to set up his brother to get in trouble

[13:00] We want Michelle to make amends with her brother

[18:00] Why ruminating is detrimental to your health.

[19:30] Gabe dwells about his biological father

[21:00] Why can’t we just get over things and move on?

Computer Generated Transcript for ‘Dwelling on the Past Mistakes Caused by Mental Illness’ Show

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: [00:00:07] For reasons that utterly escape everyone involved, you’re listening to A Bipolar, A Schizophrenic, and A Podcast. Here are your hosts, Gabe Howard and Michelle Hammer.

Gabe: [00:00:19] You’re listening to a person living with bipolar, a person living with schizophrenia, and a digital portable media file. My name is Gabe Howard and I’m a person living with bipolar disorder.

Michelle: [00:00:28] Hi, I’m Michelle Hammer and I’m a person living with schizophrenia. Are you guys happy now?

Gabe: [00:00:33] Yeah. See we changed it for everybody.

Michelle: [00:00:36] My god, don’t write any more letters. Please stay off our social media. Person first language, okay?

Gabe: [00:00:43] I think we did it. I think, you know, by doing it this way, though we have now wiped out discrimination. We’ve wiped out stigma. There’s enough beds for everybody. Homelessness due to mental illness is gone. There’s nobody incarcerated in prisons. By using person first language we have solved all of those other problems, right?

Michelle: [00:01:04] We must of. That’s why person’s first language is always number one comment we get. Absolutely.

Gabe: [00:01:09] Hang on. I’m getting a weird text message.

Michelle: [00:01:11] Oh. Oh no, what happened?

Gabe: [00:01:13] Yeah. It turns out we didn’t do anything. We didn’t do anything. Like a person first language. It didn’t. It didn’t solve any problems. No. Now people are mad at us for mocking them.

Michelle: [00:01:22] Oh, no! We mocked people? We never make fun of anything on this show.

Gabe: [00:01:27] We were always so polite and professional and educational. We never say fuck.

Michelle: [00:01:32] We never say fuck, or suck my dick, or your –

Gabe: [00:01:37] [Laughter]

Michelle: [00:01:37] God, Gabe, what are you laughing at? I’m being really serious right now. I’m a person living with schizophrenia. I am a person living with my past.

Gabe: [00:01:45] You’re a person living with your past?

Michelle: [00:01:46] My past that I dwell on with my ruminations. Now I’m going to ruminate about this situation: that I couldn’t make the world better. I need to make the world better. Gabe, I need to make the world better.

Gabe: [00:01:58] This is the worst segue in the history of our show. And that, that’s saying something. Because we’ve had some mighty awful segues.

Michelle: [00:02:08] What are we doing?

Gabe: [00:02:11] In case you haven’t figured it out, ladies and gentlemen, we are talking about things that we have ruminated on both before we were diagnosed, during like the recovery period where we’re trying to get better, and things that still kind of haunt us today and we are going to desperately eke 20 minutes out of this.

Michelle: [00:02:26] Desperately.

Gabe: [00:02:28] So Michelle what are some ruminations that like today think the last six months as longtime listener of this show know we’re in recovery. You are doing quite well despite the fact that you’re a schizophrenic. I am doing quite well despite the fact that I’m living with bipolar disorder we’ve gotten over mania depression psychosis and everything in between. But we still ruminate on things because one everybody does. We should probably start there. Do you think that ruminating about things is the domain of only people with mental illness or do you think that everybody ruminates?

Michelle: [00:02:59] I think everybody ruminates to a certain extent. It’s fine ruminating, you just can’t stop it is when it really gets out of control.

Gabe: [00:03:07] I like that we’ve challenged ourselves to put the word “ruminating” in this show as many times as possible.

Michelle: [00:03:13] How do you spell this word?

Gabe: [00:03:15] I have no idea. I have no idea that that’s really a problem for the show

Michelle: [00:03:19] Should we define ruminating for people?

Gabe: [00:03:20] Do it.

Michelle: [00:03:21] Ruminating is when you can think of the same thing over and over and over again you just cannot get it out of your head. It just goes around and around and around. Usually it drives you nuts.

Gabe: [00:03:33] So, for example, Michelle’s mother, who has absolutely no mental illness to speak of, ruminates about why Michelle is a failure.

Michelle: [00:03:42] Hey.

Gabe: [00:03:42] It just she can’t get it out of her head.

Michelle: [00:03:44] I’m not a failure.

Gabe: [00:03:45] I didn’t say that you were. I said that your mother ruminates about it.

Michelle: [00:03:47] She does not.

Gabe: [00:03:48] I mean maybe a little bit?

Michelle: [00:03:49] She doesn’t.

Gabe: [00:03:50] Okay well my mother despite having no mental illness whatsoever ruminates on whether or not I’m going to throw her under the bus on a podcast.

Michelle: [00:03:58] Does she?

Gabe: [00:03:58] I mean, probably.

Michelle: [00:03:59] I don’t know.

Gabe: [00:04:01] Yeah, I don’t think she gives a shit.

Michelle: [00:04:02] I often ruminate why I was fired from any previous job.

Gabe: [00:04:05] Do you ruminate about being fired from the job as a symptom of schizophrenia? Or is it just something that you wish you could go back in time and figure out?

Michelle: [00:04:14] Well it’s more like different situations that happened and how I wish I could have handled them differently.

Gabe: [00:04:19] But doesn’t everybody do that? Like do you ever do this? And be honest, I mean sincerely be honest. Remember we value honesty. Do you ever get in a fight with your girlfriend, and like you’re fighting, you’re yelling, you’re screaming, and then you retreat to separate corners. All is quiet. It’s over, you’ve made up and you think, “God, I wish I would have said that?” Or like you run through it in your mind?

Michelle: [00:04:40] But that’s different than ruminating.

Gabe: [00:04:42] Well, how is it?

Michelle: [00:04:43] Different for me? Because ruminating just doesn’t stop it. I’ll go around and around and around and even when I’m walking through the street walking through anything I almost will turn delusional and think I’m with those other people having that conversation start getting angry just start making the whole situation 8 million times worse than it was because I keep thinking about it over and over and over and over and over and over again. It won’t go away and if they hate it so much.

Gabe: [00:05:08] In your mind ruminating and delusions they feed each other?

Michelle: [00:05:13] Yes absolutely.

Gabe: [00:05:14] First you’re thinking about the thing. I got fired. They fired me. H.R. called walk me down with the seventh time I got. By the time you’re done you’re back in that time and place. You’re feeling it again and it’s like it’s happening right now. Even though it was three years ago.

Michelle: [00:05:26] Yes.

Gabe: [00:05:27] Wow. Does that still happen to you like in 2019? Does this still happen to Michelle Hammer?

Michelle: [00:05:32] Yes.

Gabe: [00:05:33] What’s the coping skill to get around it? Because you’re right. You’re a well accomplished person. Why do we care?

Michelle: [00:05:38] Honestly, talking about the ruminating thoughts. Because when you talk about the ruminating thoughts usually the person you’re talking to is going, “Why do you care so much about this?” You maybe talk it out a little bit, and then you’re like, “Wow. You’re right. Who cares about this dumb stupid person or this story or anything about the situation. It’s so useless why am I thinking about it so much and you can’t change the past anyway. You’re right. I talked it out. Now I feel better.

Gabe: [00:06:03] But can’t you kinda change the past? Can’t you remember it differently? You can’t you edit it in your mind, can’t you fix the things that have gone wrong previously in the future just like with different people?

Michelle: [00:06:16] You mean like learning from your past?

Gabe: [00:06:17] No. Learning sounds mature and we don’t really like that here.

Michelle: [00:06:21] OK. So then I don’t know what you’re talking about.

Gabe: [00:06:23] Here’s a good example. I’m on my third marriage. My wife is wonderful and I love her and this marriage has stood many many years. And I have no complaints. I want to say that right now. But I’ve been divorced twice. Not nasty divorces, but, you know, things that didn’t feel good. And I’ve been through breakups etc.. So every now and again my wife will do something and it will remind me of something that my ex-wife did and I’ll think. “Wait a minute. You know I let that go when wife number two did it. So I have to fix it with wife number three.” Even though they’re a completely different person. It’s a completely different time and nothing is the same except for maybe like one little thing. Don’t you ever do that? Like don’t you ever try to set a boundary with your current friend that you didn’t set with your last friend that is now you’re like mortal enemy?

Michelle: [00:07:10] No.

Gabe: [00:07:11] No?

Michelle: [00:07:11] No. Something that I do I know I do with my anxiety but I put on other people, is that I’ll start asking them a million questions about things. And then they’re like, “Why are you asking me a million questions?” And I’m like, “Oh, it’s my anxiety. I just wondered at the time? I just wondered if you know the place? I just wanted to know what you’re going to do after? What you are going to do before? I’m like, I’m just anxious. I’m sorry. I wanted to know.” If that makes any sense.

Gabe: [00:07:33] I certainly do that, too. You know like that constant time checking thing? That you don’t wanna be late?

Michelle: [00:07:37] Yes.

Gabe: [00:07:38] So what time is it? It’s four o’clock. OK. We have to be there at four thirty. What time is it? It’s four or one. OK. We have to be there at four thirty. What time is it? Dude ,it’s still four or one. But you know some of the things that are trapped in my head that I just can’t get out are just what a bad friend I was, or what a awful son I was, or what a terrible family member I was.

Michelle: [00:07:58] Yeah, yeah.

Gabe: [00:07:58] And sometimes I get mad at the people around me because I assume that they’re still mad at me because I’m still mad at me. Does stuff like that ever happen to you?

Michelle: [00:08:09] I mean, I still hold a lot of vendettas against my brother, which I owe to him. Right? Everyone says that I just dwell on the past. Even he says that I just, like, stay on the past. About when we’re very young. Me and my brother, and how mean he was to me and everything. We would see each other in the hallway of high school, and he wouldn’t even say hello to me. Yet, when he went off to college, and we were still using AIM, and he would instant message me, I would not reply. So he wouldn’t speak to me when he saw me in high school in the hallway, yet I stopped replying to him when he went off to college. And that was not OK. Which makes no sense to me. Yet, now we haven’t seen each other in a long time because he lives in another country. And when he comes back, I now have to be nice to him. Because I guess he’s a different person now? Yet, I never got any kind of apologies or anything like that, but I’m supposed to see that he’s a different person now. I don’t know why. And we’re supposed to be good friends now or something like that. I guess, just out of curiosity, why? I’m just wondering.

Gabe: [00:09:12] Is your brother a different person now?

Michelle: [00:09:14] Apparently, he’s a different person now. I don’t know. But-.

Gabe: [00:09:18] He had to leave the country to really get away with you.

Michelle: [00:09:20] I don’t know where it changed, but I’m supposed to treat him differently now. I’m supposed to forget everything from the past, all of the abuse from the past, and I’m supposed to like him now. I don’t know why.

Gabe: [00:09:31] I haven’t heard described any abuse. What you described is a couple of adult siblings that do not talk to each other.

Michelle: [00:09:36] No. Well okay.

Gabe: [00:09:37] What’s he mean to you? Did he call you names? Wait, did he pull your pigtails?

Michelle: [00:09:39] Well, he went to karate, and he would practice all of his karate moves on me. Constant wrestling, slamming my head into the ground until my nose bleeds. Calling me Michael instead of Michelle. Calling me a boy. That kind of went with Michael. Slamming the door in my face. Not letting me play with him. Like when we’re very little. Try to use his toys, not allowed to use his toys. Actually, when my mom and dad came home with me from the hospital when I was born, and they said, “Oh, Seth, here’s your sister.” He threw a stuffed animal at me. Yeah. I don’t know why they told me that story.

Gabe: [00:10:11] So he’s your older brother?

Michelle: [00:10:12] Yes.

Gabe: [00:10:12] Because you said that he threw a stuffed animal at you when you came home from the hospital and they told you that story and you’re putting this together with all of the other issues that you had with your brother growing up when you were kids?

Michelle: [00:10:27] Yeah and my like broke my necklace too, and then blamed me for it because that I was being annoying. So he had to push me and my necklace got in the way and it broke.

Gabe: [00:10:36] This is fabulous that you bring this up and here’s why. Because in my brother and sister’s world, I’m your older brother. I was the oldest. I was incredibly jealous of my brother. One time to get him in trouble when we were kids, I took syrup out of the pantry and I dumped it on the floor so that I could frame him for doing it. Knowing that he’d get in trouble. My mother just happened to be moving faster than normal that morning and watched me do it. And even though she saw me do it, I still tried to blame him for it. Absolutely, unequivocally, just hated having him as a brother. I was a top dog. I was the oldest. I used to live with Grandma. Then my mother remarried and nine months later I got this bastard in my house and I treated him like absolute garbage. Absolute garbage.

Michelle: [00:11:22] My favorite was when he would say, “You’re stupid.” And I would say, “No, you are stupid.” And then he would say, “Well, I’m smarter than you. So if I’m stupid, how dumb are you?

Gabe: [00:11:30] You know you’re an adult now, right?

Michelle: [00:11:31] I know. But obviously I can not get over this because I don’t understand why I’m supposed to like him now when I never received any kind of apology.

Gabe: [00:11:38] What kind of apology do you want when you were growing up?

Michelle: [00:11:41] Maybe just, “I’m sorry I was a horrible asshole to you, and ignored you for years and everything like that.”

Gabe: [00:11:47] Listen I never ever ever told my brother and sister, “I’m sorry. I was a horrible asshole to you.” Ever.

Michelle: [00:11:55] So that I don’t understand, why do I have to accept him back in my life?

Gabe: [00:11:59] I mean you don’t. But do you feel good right now?

Michelle: [00:12:01] I’m being told by everybody in my family that I need to accept him back in my life.

Gabe: [00:12:06] Okay. Well fuck them. Don’t. Just sit around and think about how pissed off and angry 8, 12, and 15 year old Michelle was.

Michelle: [00:12:13] Hang on one second, we’ve got to hear from our sponsor.

Announcer: [00:12:16] This episode is sponsored by betterhelp.com secure convenient and affordable online counselling. All counselors are licensed accredited professionals. Anything you share is confidential. Schedule secure video or phone sessions plus chat and text with your therapist whenever you feel it’s needed. A month of online therapy often costs less than a single traditional face to face session. Go to betterhelp.com/PsychCentral and experience seven days of free therapy to see if online counselling is right for you. Betterhelp.com/PsychCentral.

Michelle: [00:12:44] Want us to answer your questions on the show? Head over to PsychCentral.com/BSPquestions and fill out the form.

Gabe: [00:12:54] We’re back, still trying to say the word rumination as many times as humanly possible. You’re 30 years old, you’ve moved on with your life. But you’re still thinking about shit that happened to you when you were literally eight years old.

Michelle: [00:13:06] Ok, I see where you’re going with this.

Gabe: [00:13:08] How is that working out for you?

Michelle: [00:13:08] I don’t know. I don’t see him. I don’t have to speak to him. And then my mom says, “Have you spoken to your brother? Have you texted him? Have you spoken to him?” Yeah. “I don’t like that you guys don’t have a relationship. Why do my children hate each other?”

Gabe: [00:13:23] Well, I mean you articulated why y’all hate each.

Michelle: [00:13:25] I know, I’m just saying, that’s what she says.

Gabe: [00:13:27] I mean, has he done anything to you as an adult? Let let’s establish that like right out. In the time that you both became adult grown people, has he? Or has he been fine?

Michelle: [00:13:36] Well, when I graduated college he was working at kind of in the design agency kind of area. His boss, the creative director, he wanted to give me some advice. So he brought me in and he looks at my portfolio and his boss said to me, “I like your stuff. I want to give you some help. I wanted to offer you like a part time internship here, but your brother said no”.

Gabe: [00:13:54] Well but you don’t know that’s true.

Michelle: [00:13:57] His boss said it to me.

Gabe: [00:13:58] Yeah, but so what? People lie all the time.

Michelle: [00:14:00] No that’s 100 percent something my brother would do. Why would he lie and say I would offer you an internship here, but your brother said no? Because why would he invite me to come there and look at my portfolio and see all of my work and give me advice? Why would he offer to do that?

Gabe: [00:14:16] If he was gonna tell you no, why did he do it at all?

Michelle: [00:14:17] He was just giving me advice. And he just said that he wanted to offer me an internship, and that he would totally do that for me, but my brother said no.

Gabe: [00:14:25] So your brother was the boss of his boss?

Michelle: [00:14:27] My brother said do not hire her as an intern.

Gabe: [00:14:31] Then why did he talk to you at all?

Michelle: [00:14:32] Because he wanted to give me advice.

Gabe: [00:14:34] Did you ask your brother about this?

Michelle: [00:14:36] No I wouldn’t want to start a fight.

Gabe: [00:14:39] But, I kinda smell a rat here.

Michelle: [00:14:41] No I don’t smell a rat here. Obviously, Gabe, you don’t know my brother if you don’t believe this story.

Gabe: [00:14:46] It just doesn’t have the ring of truth.

Michelle: [00:14:47] Actually, it does very much ring true.

Gabe: [00:14:50] Okay. Let’s say that that is completely true. It’s 100 percent.

Michelle: [00:14:52] Okay.

Gabe: [00:14:52] Let’s say it rings true?

Michelle: [00:14:54] Say it rings true? It’s 100 true.

Gabe: [00:14:55] Right, it’s 100 percent true. I agree. How long ago was that? How many years?

Michelle: [00:15:00] I believe I was 22. Okay so it was eight years ago.

Gabe: [00:15:04] Eight years? Everybody, Michelle Hammer is 30 years old.

Michelle: [00:15:04] You said adult life, Gabe. I was bringing up something in my adult life that’s it. So you know, it’s just so you know, you said something in my adult life.

Gabe: [00:15:14] I don’t know. I do not. You’re very upset about this.

Michelle: [00:15:17] He didn’t want me to work in the same place that he was working. You said adult life there you go or not.

Gabe: [00:15:25] But you keep repeating that.

Michelle: [00:15:26] Also, my brother lives in Colombia. Colombia the country, not the college. People have gotten that very mixed up before.

Gabe: [00:15:31] Did you throw your brother out of the country?

Michelle: [00:15:35] I’m glad he left.

Gabe: [00:15:35] Okay.

Michelle: [00:15:38] Meanwhile, you know who’s never been invited to Colombia to come see him?

Gabe: [00:15:40] I’m gonna go with you.

Michelle: [00:15:41] Yeah.

Gabe: [00:15:42] Do you think the reason you’ve never been invited is because you hate him?

Michelle: [00:15:48] He’s never invited me.

Gabe: [00:15:48] Because you hate him.

Michelle: [00:15:50] Well, he’s never invited me.

Gabe: [00:15:51] Because you hate him.

Michelle: [00:15:52] He’s never invited me.

Gabe: [00:15:53] Have you invited him to your house?

Michelle: [00:15:55] He’s been to my apartment. He’s been there.

Gabe: [00:15:58] You’re upset about this aren’t you?

Michelle: [00:15:58] Well, we’re dwelling on the past, Gabe.

Gabe: [00:16:00] You want to have a relationship with your brother, don’t you?

Michelle: [00:16:03] We do not get along.

Gabe: [00:16:05] I didn’t say do you get along. I said do you want to get along?

Michelle: [00:16:08] I want him to acknowledge what he’s done.

Gabe: [00:16:13] But why do you want him to acknowledge what he’s done?

Michelle: [00:16:16] Because he acts so innocent.

Gabe: [00:16:17] I’m being really serious.

Michelle: [00:16:19] Like look, he acts like he did nothing wrong. And then the past is of the past and I should ignore it.

Gabe: [00:16:24] Listen here’s what I’m saying, you think about the things that happened as a kid and as a young adult. A lot. And it brings it up. You are clearly unhappy about this and other members of your family know that you’re unhappy about this and try to fix it. Albeit apparently poorly. And I completely agree that all of these things are true. The question that I have for you this is the only question that I want you to answer. Do you want him to apologize because you want an apology? Or do you want him to apologize because you miss your brother and you want to mend the relationship?

Michelle: [00:16:56] Yes, I would like to mend the relationship.

Gabe: [00:16:58] Ok, well then say that. Say that the reason that you think about this so much is because you’re sad that you’re fighting with your brother.

Michelle: [00:17:05] And I’ve had friends who’ve met my brother on multiple occasions and have told me your brother’s a dick.

Gabe: [00:17:11] Yeah, he sounds like a real dick. Listen –

Michelle: [00:17:13] I’m just saying. I’m just saying.

Gabe: [00:17:14] I am not saying that he is not. Your brother’s a dick. I’m saying that you need to understand your own motivation because until you do I don’t think you’re gonna get over it. And I think a lot of our listeners have somebody in their life that they feel this way about. Whether it’s a friend, a family member, in some cases it’s like a parent or a guardian. It’s somebody who helped raised them or an authority figure and they’re all ruminating on this day in and day out. And if they don’t fix the relationship or get over the relationship it either a handcuffs them in the present like it’s handcuffed to you because you’re thinking about this right now and it is occupying way too much of your space for some dude who doesn’t even live in the country. And two, you just need to let it go and decide hey look this relationship isn’t for me and stop thinking about it. Frankly I don’t think any of this has anything to do with schizophrenia. I don’t think it does. It has everything to do with the fact that familiar relationships our family our friends, that’s the kind of stuff that fucks you up.

Michelle: [00:18:10] I think what it has to do with schizophrenia is the fact that I’ll think about it and I’ll just scrape into my head and it creeps in the deep dark depths of my head and I’ll just go around and around and around and around.

Gabe: [00:18:22] You want to know who my big brother is? You want to know who does that for me? You want to know who creeps into my head and just turns around and around and won’t let go ever? My biological father. The dude is dead. He is dead and I think about him the exact same way you think about your brother.

Michelle: [00:18:41] Really?

Gabe: [00:18:41] Yeah he’s dead. He can’t apologize. He can’t make up for it. It’s over. I won because I didn’t die of alcoholism.

Michelle: [00:18:49] I can get why.

Gabe: [00:18:50] Why did you hate me? That’s all I can think about, why did he hate me? And now you’re gonna do the exact same thing that I just did for you. You’re gonna be like, “Dude, he didn’t hate you he was a dick. He was an alcoholic. He abandoned his kid.” This is the level that we torture ourselves.

Michelle: [00:19:02] I get that though. When a parent chooses alcohol over a kid. I can understand why the kid feels very upset.

Gabe: [00:19:10] Oh, look I don’t think he chose alcohol over me. I think he chose literally anything. I think he would have chosen like a blowing leaf over me.

Michelle: [00:19:18] Sometimes, a father is just a sperm.

Gabe: [00:19:20] Yeah. You know I call on my sperm donor.

Michelle: [00:19:22] Yeah. That’s sometimes just what a father is.

Gabe: [00:19:25] But this is the biggest rumination that I have because I wonder how did he know? On the day that I was born, that I was broken and worthless? How come he knew what nobody else can figure out?

Michelle: [00:19:37] He didn’t know that.

Gabe: [00:19:37] But, I mean –

Michelle: [00:19:38] He knew he was broken.

Gabe: [00:19:41] He didn’t know that. He had a good life. He was happy. He died fine.

Michelle: [00:19:44] No, he wasn’t happy, he was an alcoholic.

Gabe: [00:19:46] Yeah, a happy one.

Michelle: [00:19:47] No, there’s no happy alcoholics.

Gabe: [00:19:50] You know that whole self medicating thing it doesn’t play sometimes. I don’t think he was self medicating at all. I think he was just a guy that did whatever he wanted and said whatever he wanted and behaved however. He was just immature.

Michelle: [00:20:00] Then he wasn’t ready to be a dad.

Gabe: [00:20:03] I mean he was very young. My mother got pregnant in high school and he was also in high school.

Michelle: [00:20:07] So ok, that makes a little bit better.

Gabe: [00:20:08] But he never made up for it. I saw him on his deathbed. He was in hospice. He had jaundice, his eyes were yellow. They told me had less than two weeks to live. And I’m like, “Do you have anything to say to me?” And he was like, “It’s your mom’s fault.”

Michelle: [00:20:23] That’s what he said?

Gabe: [00:20:23] That’s pretty much what he said.

Michelle: [00:20:25] He’s a dick.

Gabe: [00:20:26] Oh, yeah.

Michelle: [00:20:26] Like he’s a dick. Your biological dad, he’s a dick.

Gabe: [00:20:29] But why can’t I get over it?

Michelle: [00:20:31] Because he’s your dad.

Gabe: [00:20:33] Yeah I got a dad. He’s alive. He lives in Tennessee. He’s cool.

Michelle: [00:20:35] Because he’s a part of you.

Gabe: [00:20:37] And I’m not trying to be crass here, but he’s just a guy who had sex with my mom. I appreciate the DNA and all

Michelle: [00:20:45] But if you can say that, then why can’t you get over it?

Gabe: [00:20:48] Exactly. And that’s why it ruminates because the intellectual part of Gabe Howard thinks –

Michelle: [00:20:54] So are you mad at your mom for boning this dude?

Gabe: [00:20:57] No. Well, I mean, I’m mad at my mom for giving me life but that’s like a whole ‘nother episode. I don’t understand why I got to be born and why I have to be born broken and why I’m here.

Michelle: [00:21:08] There’s a reason why you’re here and there’s a purpose here and it’s.

Gabe: [00:21:12] I don’t I don’t believe that.

Michelle: [00:21:13] Purpose. I believe that there’s always a reason why you’re here.

Gabe: [00:21:17] You believe in vape pens.

Michelle: [00:21:20] You believe in Diet Coke. Maybe there’s a universe of no diet coke.

Gabe: [00:21:23] That’s mean.

Michelle: [00:21:24] You’re not there. That’s near here.

Gabe: [00:21:27] That’s mean.

Michelle: [00:21:28] You’re here to drink Diet Coke.

Gabe: [00:21:30] Michelle, seriously. Seriously, none of this is serving either one of us so why do we do it?

Michelle: [00:21:36] Because it doesn’t go away.

Gabe: [00:21:39] And why doesn’t it go away?

Michelle: [00:21:40] I don’t know why it doesn’t go away.

Gabe: [00:21:42] Exactly. Judging by our emails a lot of our listeners have this problem where they just have this thing that they just can’t get over. And if they have learned nothing by listening to this show it’s that they’re not alone. A lot of people have these things that they just can’t get over and I think that anybody listening to me and you for the last 20 minutes would think wow these two need to get over that because it’s not serving them in any way.

Michelle: [00:22:05] Just a little bit. Don’t you think?

Gabe: [00:22:06] But we’re not letting it go. I hope that maybe they listen to us and they realize how unhelpful this is to just not get over and they think wow I don’t want to be like them and they let go of their anger and the things that they’re just ruminating on and can’t get over. But I suspect that a lot of people are gonna hang on to that rumination and I hope that they find some way to minimize it because at the end of the day Michelle we have minimized it. It is not impacting us the same way at our current age. That it probably did 10 years ago. Do you think you think about this less now than you did five years ago?

Michelle: [00:22:44] Oh definitely much less.

Gabe: [00:22:45] So there really is some wisdom in time heals all wounds.

Michelle: [00:22:49] And you know living in another country.

Gabe: [00:22:52] So I had to kill my biological father. You had to send your brother to another country and now suddenly we’re getting better. That’s fantastic. That is definitely actionable advice. Everybody is excited that they listen to this episode of a bipolar schizophrenic podcast because now they can beat their own ruminations with death and deportation.

Michelle: [00:23:15] Yes.

Gabe: [00:23:16] Not every episode can be a winner ladies and gentlemen but we hope you got something out of it. Thank you for tuning into this episode of A Bipolar, a Schizophrenic, and a Podcast. Don’t forget to hop over to store.PsychCentra.com, there is a few shirts left. This is the last time. Literally the last time we will ever pitch the “Define Normal” shirts on this show. So if you have been hanging on wanting to buy one, now is the time. Thank you everybody. Please like us everywhere and we will see you next time.

Michelle: [00:23:45] He’s a dick!

Announcer: [00:23:50]You’ve been listening to a bipolar a schizophrenic kind of podcast. If you love this episode don’t keep it to yourself head over to iTunes or your preferred podcast app to subscribe rate and review to work with Gabe go to GabeHoward.com. To work with Michelle go to Schizophrenic.NYC. For free mental health resources and online support groups. Head over to PsychCentral.com Show’s official Web site PsychCentral.com/bsp you can e-mail us at [email protected]. Thank you for listening and share widely.

Meet Your Bipolar and Schizophrenic Hosts

GABE HOWARD was formally diagnosed with bipolar and anxiety disorders after being committed to a psychiatric hospital in 2003. Now in recovery, Gabe is a prominent mental health activist and host of the award-winning Psych Central Show podcast. He is also an award-winning writer and speaker, traveling nationally to share the humorous, yet educational, story of his bipolar life. To work with Gabe, visit gabehoward.com.MICHELLE HAMMER was officially diagnosed with schizophrenia at age 22, but incorrectly diagnosed with bipolar disorder at 18. Michelle is an award-winning mental health advocate who has been featured in press all over the world. In May 2015, Michelle founded the company Schizophrenic.NYC, a mental health clothing line, with the mission of reducing stigma by starting conversations about mental health. She is a firm believer that confidence can get you anywhere. To work with Michelle, visit Schizophrenic.NYC.Podcast: Dwelling on the Past Mistakes Caused by Mental Illness

Related Articles

View Original Article

Hope you enjoyed reading this article.
Please feel free to share!

a-new-chapter-of-my-life-begins

Psychology Around the Net: March 30, 2019

This is an interesting article I found on: www.psychcentral.com

See credits below.


Do you struggle breaking the ice during social or networking situations? Are you interested in spring cleaning your energy this weekend? Have you had some negative mental health experiences with fitness apps?

We’ve got the latest on each of these and more in this week’s Psychology Around the Net!

Psychologists Agree: ‘Tell Me About Yourself’ Is the Only Icebreaker You’ll Ever Need: Talking to new people at a social function or networking event can be tough, especially for people with social anxiety. How do you get their attention? How do you start talking to them? How do you break the ice? Psychologists say the best way to do all that is with four simple words: tell me about yourself. Personally, I kind of freeze up and experience more anxiety when people ask me to tell them about myself (OMG what do I say?!), but here are six tips to help us all navigate the “tell me about yourself” process from start to finish.

Air Pollution Tied to Mental Health Issues in Teenagers: A recent study involving more than 2,000 British teenagers whose health researchers followed from birth until they turned 18 years old has associated urban air pollution with an increased risk for psychotic experiences. According to the study, almost a third of the participants reported they had experienced at least one psychotic experience, ranging from mild paranoia to a more severe psychotic symptom, since the age of 12.

9 Ways to ‘Spring Clean’ Your Energy: Entertaining “blah” thoughts, cluttered and dusty personal space, losing motivation to keep up healthy routines — you have to admit, these and others are ways your energy can get junked up during the dark winter months. Now that spring is here, let’s look at some of the ways you can clean that energy up.

These ‘Wear Your Meds’ Buttons Tackle the Stigma of Taking Mental Illness Drugs: Have y’all heard of the #WearYourMeds movement started by Lauren Weiss? Essentially, you wear a button (or buttons, depending) that depicts the mental health medication you take (alternatively, you can purchase a button that reads “Wear Your Meds”) as a way to, ideally, act as a conversation starter to promote mental health awareness. Although it’s not affiliated with the National Alliance on Mental Illness (NAMI), all proceeds do go to NAMI. Thoughts?

Sports Psychologists Say Running Apps May Be Damaging Your Health: My knee-jerk reaction to this title was, “What?! I love my C25K app!” After reading the article, I realized the professionals make some good points. Sports psychologists Dr. Andrew Wood and Dr. Martin Turner believe fitness apps (and running apps in particular), which generally are designed to help us meet certain fitness or training goals, could do us more harm than good by contributing to an unhealthy relationship with exercise (and our need for social media validation).

Pope Francis Wants Psychological Testing to Prevent Problem Priests. But Can It Really Do That? ICYMI: The Catholic Church is dealing with one sexual abuse scandal after another lately. Now, Pope Francis has announced a policy he wants to implement worldwide — one that would, ideally, prevent any man from becoming a priest if he can’t pass a psychological evaluation proving he’s suited to a life of chastity. However, scholars, researchers, and even others in the Church are questioning whether or not this is actually possible.

Psychology Around the Net: March 30, 2019

Related Articles

View Original Article

Hope you enjoyed reading this article.
Please feel free to share!

A Parent’s Guide to Marijuana Wax and Its Impact on Youth

This is an interesting article I found on: www.goodtherapy.org

See credits below.


Now that marijuana use is becoming legalized all across the country, America’s teenagers are reaping the consequences. True, there is nothing new under the sun with teenagers using drugs, particularly marijuana, but the situation is different than how it was back in the 60s and 70s. Now, marijuana is no longer a “gateway” drug; rather, it is the “end” choice.

What Is Marijuana Wax?

Marijuana wax is a concentrated form of marijuana (cannabis) that resembles ear wax. It contains 90% THC (tetrahydrocannabinol, the active ingredient in cannabis). One small “hit” of wax causes the same euphoric effect as that created by smoking 1-2 marijuana cigarettes (joints).

Teenagers typically use wax via a vape pen. This tool extracts the THC rather than burning it, so the drug is basically odorless and smokeless. Teenagers can use wax with a vape pen without any obvious detection, and the tool can be easily concealed. This is very alarming because teenagers can use wax basically under the noses of their authority figures.

Many teenagers have discovered that using wax brings many “benefits”:

  • Allows self-medication for anxiety and depression
  • Is easy to use without detection
  • Helps teenagers forget about their problems
  • Eliminates boredom

The unfortunate result is that as many teenagers are developing independence and learning how to navigate life, the marijuana user is learning to cope with their problems by avoidance or “numbing out”. This creates a lack of creativity and motivation. These youth are not experiencing the exuberance of life, but are developing an “I don’t care” attitude. This is alarming at best; mainly it is devastating.

The Effects of Wax and Other Forms of Marijuana

The short-term effects of using wax include attention and memory problems, distorted perception, poor judgment, and poor coordination.

Along with the short-term issues, there are also long-term psychological and health concerns involved with the use of wax. Regular use of marijuana can cause:

  • An onset or worsening of mental health issues. These might include psychosis, depression, anxiety, anger control problems, mood disorders, sleep disturbance, or even suicidal ideation.
  • Addiction. Withdrawal symptoms include nausea, cold sweats, lack of appetite, sleeplessness, and irritability.
  • Chronic lung problems, including bronchitis and lingering cough.
  • A permanent decrease in IQ.
  • Lower quality of life overall, including lower income level, academic issues, and poorer performance in work.

Barriers to Treatment for Marijuana Abuse

Speaking as a substance abuse counselor who works with teenagers who use cannabis, treatment is often challenging. Usually when teenagers seek counseling for their substance use, it is because some adult authority figure or institution has demanded it. Court- or school-mandated substance use treatment brings an additional set of problems.

Addressing the underlying “want” is the best approach to treatment. It is also the most difficult. Ask yourself, why does my teenager not want to feel? Why do they not care about themself? What is the underlying motivation of this youth?For one thing, effective counseling requires the “counselee” to be motivated to change. People coerced into treatment are not internally motivated. External motivation often causes people to resist. This is even more likely for rebellious teenagers, determined to set their own terms and define their own choices. One of the jobs of the counselor is to figure out how to overcome this dynamic, “win” the youth over, and help break through the teen’s resistance.

Another problem faced by concerned adults is the social acceptability of marijuana. Since so many adults are using the drug themselves, to the point that many states have made it a legal substance, there is a trickle-down effect on the youth in our society. Oftentimes I hear teens say things like, “It helps me with my anxiety. It’s only an herb; a natural plant created by God that helps me feel good.” These are the same arguments adults use.

In addition to this, I have made the observation that marijuana no longer seems to be a gateway drug as it was in the past. Rather, it is the drug of choice for the majority of drug-using teenagers, far surpassing even the use of cigarettes. Alarmingly, about half of all teenagers, particularly in states which have legalized marijuana, have tried the substance some time during their high school years.

What Can Parents Do About Teen Marijuana Use?

One thing parents can do is to know the signs that their teen is using marijuana. These signs include the following:

  • Having bloodshot eyes
  • Being overly tired and lethargic
  • Giggling for no apparent reason
  • Eating a lot (having the “munchies”)
  • Letting grades slip
  • Showing excessive moodiness
  • Wearing clothing or decorating their belongings with pro-drug messages
  • Having excess money or lack of money
  • Being unkempt or having poor hygiene
  • Associating with drug-using peers
  • Having drug paraphernalia such as vape pens, pipes, cigarette paper, small glass containers, etc.

If you do suspect your teen is using marijuana, it is important that you don’t ignore the clues. Address the issue straight on. Talk in no uncertain terms, directly. Have a “zero tolerance” attitude about drug use.

In addition, here are some other suggestions for how to address a teenager who is using marijuana in any form, including wax:

  1. Be a good role model.
  2. Develop a healthy relationship with your teenager.
  3. Set boundaries.
  4. Be aware of what your teen is doing with their time.
  5. Educate your child about the effects of marijuana use.
  6. Be involved in your teenager’s life.
  7. Don’t allow your teen to use drugs in your home or go to social activities which allow the use of drugs or alcohol.
  8. Do not use drugs yourself.

The best way to deal with any type of drug use is to raise kids in such a way that they won’t want to use in the first place. A harder task, still, is getting the teenager to stop wanting to use it once they’ve started. Addressing the underlying “want” is the best approach to treatment. It is also the most difficult. Ask yourself, why does my teenager not want to feel? Why do they not care about themself? What is the underlying motivation of this youth?

From my experience, when questioning teens who use wax, I hear the following responses:

“Life is boring. Wax makes it fun.”

“I just want to chill.”

“I like how it makes me feel.”

“It helps me not care about anything.”

If these statements depict why your teen is using wax, then try to solve the underlying problems. Eliminate boredom. Teach your teenager how to find joy in life. Give them a purpose. Teach your teen that they matter and that taking care of oneself is important.

If you need help getting your teen to stop using marijuana, you can find an addiction counselor here.

References:

  1. Marijuana and teens. (2018). American Academy of Child and Adolescent Psychiatry. Retrieved from: https://www.aacap.org/aacap/families_and_youth/facts_for_families/fff-guide/Marijuana-and-Teens-106.aspx
  2. Palacios, K. (n.sd.) The dangers of smoking marijuana wax [PDF]. Retrieved from https://www.ihs.gov/california/tasks/sites/default/assets/File/BP2014-3_MarijuanaWax_Palacios.pdf
  3. Volkow, N.D. (2018.) Marijuana: Facts parents need to know. Retrieved from: https://www.drugabuse.gov/publications/marijuana-facts-parents-need-to-know/letter-to-parents

© Copyright 2019 GoodTherapy.org. All rights reserved. Permission to publish granted by Sharie Stines, PsyD, therapist in La Mirada, California

The preceding article was solely written by the author named above. Any views and opinions expressed are not necessarily shared by GoodTherapy.org. Questions or concerns about the preceding article can be directed to the author or posted as a comment below.

Original Article

Hope you enjoyed reading this article.
Please feel free to share!

a-new-chapter-of-my-life-begins

Should Mental Health Determine Pain Treatment Options?

This is an interesting article I found on: www.psychcentral.com

See credits below.


Patients with a mental health condition might have a hard time accessing opioids for pain relief, while patients with unexplained pain are often referred to psychiatric care, which does little to alleviate their symptoms. Finding treatment can be frustrating and humiliating.

Four years ago, Dez Nelson’s pain management clinic demanded that she complete a visit with a psychologist. Nelson was surprised, since she had no history of mental illness, but she didn’t feel that she could push back on the request.

“Of course I said okay — I didn’t want to lose my treatment,” Nelson told The Fix. “I was not happy about it, but I did it.”

Nelson, 38, went to the appointment and had a mixed experience with the psychologist. She hasn’t been back since and the pain clinic hasn’t asked her to visit a psychologist again. Still, Nelson said that the experience highlighted — yet again — the discrimination pain patients face.

“It was a condition of my continued care,” she said. “It seemed like they’re bringing it up in a beneficial light, as part of a multi-pronged approach to pain care. But I don’t think [mental health treatment] should be forced on a patient who doesn’t think they need it.”

Chronic pain and mental illness are among the most stigmatized conditions in modern medicine. The conditions frequently intersect and change the way that patients are cared for and treated. Patients who have a mental illness might have a hard time accessing opioids for pain relief, while patients with unexplained pain are often referred to psychiatric care, which does little to alleviate their physical symptoms. At the same time, research suggests there is a strong connection between mental health and pain: depression can cause painful physical symptoms, while living with chronic pain can cause people to become depressed.

All of this makes treating chronic pain and mental illness complex and frustrating for doctors and patients alike.

A Mental Health Diagnosis Affects the Way Your Doctor Treats You

Elizabeth* is a professor in her mid-thirties who had undiagnosed Lyme disease for eight years. Her Lyme contributed to the development of an autoimmune disease that has led to widespread inflammatory and nerve pain throughout her body. Elizabeth also has bipolar disorder. Despite the fact that she has been stable on medication for a decade, her mental health diagnosis complicates her pain treatment.

“Doctors’ demeanor changes when I tell them my medications. When I say I have bipolar disorder, it’s a whole different ballpark. To them that’s clearly a risk factor and red flag for drug abuse,” Elizabeth said.

Opioids are one of the few treatments Elizabeth has found that works to alleviate her pain. But she also takes benzodiazepines on an as-needed basis to control her anxiety (usually once a week). Even though Elizabeth is well aware of the risk of combining the two medications and knows better than to take the two pills together, doctors refuse to prescribe both. They don’t seem to trust her not to abuse them.

“I could tell them that I wouldn’t take them together. But that’s not a valid choice,” Elizabeth said.

While doctors were extremely cautious about this drug interaction, they didn’t focus on another drug-related risk: medications that are used to treat nerve pain can cause adverse reactions in patients with bipolar disorder. No one warned Elizabeth of this danger, and she ended up being hospitalized for psychosis after a long stretch of stability.

“The doctors didn’t talk about it because it’s just a side effect, not a liability concern,” she said.

On the flip-side, Elizabeth has experienced psychiatric providers who were skeptical of her pain diagnosis.

“They wrote in my chart that I had a delusion that I had Lyme disease,” she said…

Find out more about the complications of treating pain in patients with mental illness, the dangers of confusing one’s body with one’s psyche, and the “time bomb” of untreated pain in the original article Should Your Mental Health Determine How Your Pain Is Treated? at The Fix.

Should Mental Health Determine Pain Treatment Options?

Related Articles

View Original Article

Hope you enjoyed reading this article.
Please feel free to share!