Podcast: There’s More to Trauma than PTSD

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

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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.

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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

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Four Steps to Manage Obsessive-Compulsive Disorder

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

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When I was a young girl, I struggled with obsessive-compulsive disorder. I believed that if I landed on a crack in the sidewalk, something terrible would happen to me, so I did my best to skip over them. I feared that if I had bad thoughts of any kind, I would go to hell.

To purify myself, I would go to confession and Mass over and over again, and spend hours praying the rosary. I felt if I didn’t compliment someone, like the waitress where we were eating dinner, I would bring on the end of the world.

What Is OCD?

The National Institute of Mental Health defines OCD as a “common, chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that he or she feels the urge to repeat over and over.” OCD involves a painful, vicious cycle whereby you are tormented by thoughts and urges to do things, and yet when you do the very things that are supposed to bring you relief, you feel even worse and enslaved to your disorder.

The results of one study indicated that more than one quarter of the adults interviewed experienced obsession or compulsions at some point in their lives — that’s over 60 million people — even though only 2.3 percent of people met the criteria for a diagnosis of OCD at some point in their lives. The World Health Organization has ranked OCD as one of the top 20 causes of illness-related disability worldwide for individuals between 15 and 44 years of age.

Whenever I am under considerable stress, or when I hit a depressive episode, my obsessive-compulsive behavior returns. This is very common. OCD breeds on stress and depression. A resource that has been helpful to me is the book Brain Lock by Jeffrey M. Schwartz, M.D. He offers a four-step self-treatment for OCD that can free you from painful symptoms and even change your brain chemistry.

Distinguishing Form from Content of OCD

Before I go over the four steps, I wanted to go over two concepts he explains in the book that I found very helpful to understanding obsessive-compulsive behavior. The first is knowing the difference between the form of obsessive-compulsive disorder and its content.

The form consists of the thoughts and urges not making sense but constantly intruding into a person’s mind — the thought that won’t go away because the brain is not working properly. This is the nature of the beast. The content is the subject matter or genre of the thought. It’s why one person feels something is dirty, while another can’t stop worrying about the door being locked.

The OCD Brain

The second concept that is fascinating and beneficial to a person in the throes of OCD’s torture is to see a picture of the OCD brain. In order to help patients understand that OCD is, in fact, a medical condition resulting from a brain malfunction, Schwartz and his colleagues at UCLA used PET scanning to take pictures of brains besieged by obsessions and compulsive urges. The scans showed that in people with OCD, there was increased energy in the orbital cortex, the underside of the front of the brain. This part of the brain is working overtime.

According to Schwartz, by mastering the Four Steps of cognitive-biobehavioral self-treatment, it is possible to change the OCD brain chemistry so that the brain abnormalities no longer cause the intrusive thoughts and urges.

Step One: Relabel

Step one involves calling the intrusive thought or urge exactly what it is: an obsessive thought or a compulsive urge. In this step, you learn how to identify what’s OCD and what’s reality. You might repeat to yourself over and over again, “It’s not me — it’s OCD,” working constantly to separate the deceptive voice of OCD from your true voice. You constantly inform yourself that your brain is sending false messages that can’t be trusted.

Mindfulness can help here. By becoming an observer of our thoughts, rather than the author of them, we can take a step back in loving awareness and simply say, “Here comes an obsession. It’s okay … It will pass,” instead of getting wrapped up in it and investing our emotions into the content. We can ride the intensity much like a wave in the ocean, knowing that the discomfort won’t last if we can stick in there and not act on the urge.

Step Two: Reattribute

After you finish the first step, you might be left asking, “Why don’t these bothersome thoughts and urges go away?” The second step helps answer that question. Schwartz writes:

The answer is that they persist because they are symptoms of obsessive-compulsive disorder (OCD), a condition that has been scientifically demonstrated to be related to a biochemical imbalance in the brain that causes your brain to misfire. There is now strong scientific evidence that in OCD a part of your brain that works much like a gearshift in a car is not working properly. Therefore, your brain gets stuck in gear. As a result, it’s hard for you to shift behaviors. Your goal in the Reattribute step is to realize that the sticky thoughts and urges are due to your balky brain.

In the second step, we blame the brain, or in 12-step language, admit we are powerless and that our brain is sending false messages. We must repeat, “It’s not me — it’s just my brain.” Schwartz compares OCD to Parkinson’s disease — both interestingly are caused by disturbances in a brain structure called the striatum — in that it doesn’t help to lambast ourselves for our tremors (in Parkinson’s) or upsetting thoughts and urges (in OCD). By reattributing the pain to the medical condition, to the faulty brain wiring, we empower ourselves to respond with self-compassion.

Step Three: Refocus

In step three, we shift into action, our saving grace. “The key to the Refocus step is to do another behavior,” explains Schwartz. “When you do, you are repairing the broken gearshift in your brain.” The more we “work around” the nagging thoughts by refocusing our attention on some useful, constructive, enjoyable activity, the more our brain starts shifting to other behaviors and away from the obsessions and compulsions.

Step three requires a lot of practice, but the more we do it, the easier it becomes. Says Schwartz: “A key principle in self-directed cognitive behavioral therapy for OCD is this: It’s not how you feel, it’s what you do that counts.”

The secret of this step, and the hard part, is going on to another behavior even though the OCD thought or feeling is still there. At first, it’s extremely wearisome because you are expending a significant amount of energy processing the obsession or compulsion while trying to concentrate on something else. However, I completely agree with Schwartz when he says, “When you do the right things, feelings tend to improve as a matter of course. But spend too much time being overly concerned about uncomfortable feelings, and you may never get around to doing what it takes to improve.”

This step is really at the core of self-directed cognitive behavioral therapy because, according to Schwartz, we are fixing the broken filtering system in the brain and getting the automatic transmission in the caudate nucleus to start working again.

Step Four: Revalue

The fourth step can be understood as an accentuation of the first two steps, Relabeling and Reattributing. You are just doing them with more insight and wisdom now. With consistent practice of the first three steps, you can better acknowledge that the obsessions and urges are distractions to be ignored. “With this insight, you will be able to Revalue and devalue the pathological urges and fend them off until they begin to fade,” writes Schwartz.

Two ways of “actively revaluing,” he mentions are anticipating and accepting. It’s helpful to anticipate that obsessive thoughts will occur hundreds of times a day and not to be surprised by them. By anticipating them, we recognize them more quickly and can Relabel and Reattribute when they arise. Accepting that OCD is a treatable medical condition — a chronic one that makes surprise visits — allows us to respond with self-compassion when we are hit with upsetting thoughts and urges.

Four Steps to Manage Obsessive-Compulsive Disorder

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Why It’s Okay to Cry in Public

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

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I waited three months after I was discharged from the hospital for suicidal depression to make contact with the professional world again. I wanted to be sure I didn’t “crack,” like I had done in a group therapy session. A publishing conference seemed like an ideal, safe place to meet. A crowded room of book editors would certainly prevent any emotional outbursts on my part. So I reached out to colleague who had been feeding me assignments pre-nervous breakdown and invited her for a cup of coffee.

“How are you?” she asked me.

I stood there frozen, trying my best to mimic the natural smile I had practiced in front of the bathroom mirror that would accompany the words, “Fine! Thank you. How are you?”

Instead I burst into tears. Not a cute little whimper. A loud and ugly bawling — pig snorts included — the kind of sobbing widows do behind closed doors when the funeral is done.

“There’s the beginning and the end,” I thought. “Time to pay the parking bill.”

But something peculiar happened in that excruciating exchange: we bonded.

Embarrassment Leads to Trust

Researchers at the University of California, Berkley conducted five studies that confirmed this very phenomena: embarrassment — and public crying certainly qualifies as such — has a positive role in the bonding of friends, colleagues, and mates. The findings, published in the Journal of Personality and Social Psychology, suggest that people who embarrass easily are more altruistic, prosocial, selfless, and cooperative. In their gestures of embarrassment, they earn greater trust because others classify the transparency of expression (buried head, blushing, crying) as trustworthiness.

Robb Willer, Ph.D., an author of the study, writes, “Embarrassment is one emotional signature of a person to whom you can entrust valuable resources. It’s part of the social glue that fosters trust and cooperation in everyday life.”

Now public crying is even better than splitting your swimsuit in half during swim practice or asking a woman when her baby is due only to learn it was born four months ago (also guilty). Tears serve many uses. According to Dr. William Frey II, a biochemist and Director of the Alzheimer’s Research Center at Regions Hospital in St. Paul, Minnesota, emotional tears (as opposed to tears of irritability) remove toxins as well as chemicals like the endorphin leucine-enkaphalin and prolactin that have built up in the body from stress. Crying also lowers a person’s manganese level, a mineral that affects mood.

In a New York Times article, science writer Jane Brody quotes Dr. Frey:

Crying is an exocrine process, that is, a process in which a substance comes out of the body. Other exocrine processes, like exhaling, urinating, defecating and sweating, release toxic substances from the body. There’s every reason to think crying does the same, releasing chemicals that the body produces in response to stress.

Crying Builds a Community

Anthropologist Ashley Montagu once said in a Science Digest article that crying builds a community. Having done my share of public crying this last year, I think he is right.

If you spot a person crying in the back of the room at, say, a school fundraiser, your basic instinct (if you are a nice person) is to go comfort that person. Yeah, there’s the voice that says she’s pathetic for displaying public emotions, much like the couple fighting in the hallway; however, you want the crying to end because on some level it makes you uncomfortable — you want everyone to be happy, like the mom who pops a pacifier or a stick of butter into her 6-year-old’s mouth to shut him up.

The high sensitive types begin to swarm around this woman, as she divulges her life story. Voila! You find yourself with a group of new best friends in an Oprah moment, each person offering intimate details about herself. A women’s retreat has started, and there is no need for a lake house.

In a 2009 study published in Evolutionary Psychology, participants responded to images of faces with tears and faces with tears digitally removed, as well as tear-free control images. It was determined that tears signaled sadness and resolved ambiguity. According to Robert R. Provine, Ph.D., the study’s lead author and professor of psychology and neuroscience at the University of Maryland, Baltimore County, tears are a kind of social lubricant, helping people communicate. Says the abstract: “The evolution and development of emotional tearing in humans provide a novel, potent and neglected channel of affective communication.”

In a February 2016 study published in the journal Motivation and Emotion, researchers replicated and extended previous work by showing that tearful crying facilitates helping behavior and identified why people are more willing to help criers. First, the display of tears increases perceived helplessness of a person, which leads to a higher willingness to help that person. Second, crying individuals are typically perceived to be more agreeable and less aggressive and elicit more sympathy and compassion.

The third reason I find most interesting: seeing tears makes us feel more closely connected to the crying individual. According to the study, “This increase in felt connectedness with a crying individual could also promote prosocial behavior. In other words, the closer we feel to another individual, the most altruistically we behave towards that person.” The authors refer to ritual weeping, say, after adversity and disasters or when preparing for war. Those common tears build bonds between people.

I don’t LIKE crying. And certainly not in front of people. It feels humiliating, like I’m not in control of my emotions. However, I no longer practice smiling in front of the mirror or the sentiments that are packaged with the grin. I have learned to embrace my PDT — public display of tears — and be my transparent self, even if the result is more pig snorts.

Why It’s Okay to Cry in Public

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Surviving a Relationship Injury: Forgive But Don’t Forget

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

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In attachment-based counseling, we talk a lot about relationship and attachment injuries. Those of us who practice emotionally-focused therapies have our own lingo that the layperson may not clearly understand. For us, it’s second nature to discuss attachment issues, trauma, interactions, and perceptions, but what does that mean in terms of a client and their partner? How can the couple sitting in my office in tears relate that to how they’re feeling in the midst of their crisis?

It has occurred to me that I could perhaps help my clients understand and identify with these terms if I explain what a relationship injury is. I want to help couples understand what is behind the relationship injury and how to forgive each other (and themselves). This knowledge can help couples move forward in a stronger relationship.

What Is a Relationship Injury?

When we’re in a romantic relationship, we make a lot of assumptions about the person we’re with. We set out to prove these assumptions every day. You want to see your partner as someone kind, who has your best interest at heart: someone who will protect you, listen to you, be there for you in your time of need. Someone who thinks you are the most important person in their world, who loves you more than anyone. In return, you try to do all the same things for them. You see each other through the lens of love, friendship, and positivity.

When you commit to be in a relationship with your partner, you are completely invested in believing this narrative. When they fall short, the shock can feel overwhelming. The bottom drops out of all your shiny, happy perceptions, and it changes everything about the way you view your partner.

There is an entire spectrum of relationship injuries, and there’s no telling what the amount of pain caused will be. If you’re in a relationship with someone who is seen as dependable and upright, then you catch them in a lie, you can be left feeling like you don’t even know your own partner. That you’ve been living a lie.

When a partner betrays your trust at a time of great need, it can be devastating. The relationship injury could occur during a medical trauma, a death in the family, or any instance where the partner is needed for support and is not there for you. For example, a spouse may fail to arrive at your parent’s funeral when you are counting on them to be there.

When a partner lets you down so dramatically, it’s a violation of the attachment. It can be a game changer.

The Lasting Effects of a Relationship Injury

As completely invested in each other as you are, the devastation of a relationship injury can leave the injured partner feeling completely betrayed and alone. Everything gets looked at through the lens of that emotional pain. All of those positive feelings of security, of importance, of attractiveness, of well-being—they are gone in that moment.

In order for us to be happy, well-balanced individuals, we need to feel loved and important. Your partner is the person who helps you to feel that way. When all of that is suddenly taken away due to a relationship injury, it can bring up old injuries from our past, our family of origin, or prior relationships. The triggers for these injuries will further reinforce the downward spiral of emotions around feeling unimportant or unloved.

You may want to forgive your partner, but it’s not so easy to forget. Forgetting can feel like we are putting ourselves at risk; we want to avoid repeating the behavior that brought us to the crisis in the first place.

Rebuilding Connection After a Relationship Injury

How do you cope when you feel you cannot even count on the person who claims to love you the most? When you feel alone and are missing your best friend and partner? The work that has to be done requires several steps. The time frame will be different for each couple. Both have to commit to doing this work and to building up a stronger bond than the one that was broken through the relationship injury.

First, your partner needs to make a sincere apology. They have to own what happened, understand how deeply you are hurting, and come to a realization that their actions are responsible for this hurt. There’s really no making up for it. Your partner has to let you know that they truly regret the pain they caused, they will change their behavior going forward, and that they themselves are hurting simply knowing that they caused you to feel this anguish. Only then can a couple move forward with a new perspective.

The injured partner has to be able to see the sincerity in the apology with emotional presence. You need to believe your partner is committed to moving forward with a new and better relationship.

It can get tricky at this point. How do you forgive when it feels like you’ll never stop hurting? When you feel like the person that you counted on has let you down completely and you can’t see anything but the negatives in everything they say or do?

First, your partner needs to make a sincere apology. They have to own what happened, understand how deeply you are hurting, and come to a realization that their actions are responsible for this hurt.In order to truly forgive, the injured partner has to see enough positive interactions, enough good behavior to tip the scales in a positive direction. Not just lip service, but real proof over time that your partner sees you as important and is putting the relationship as a first priority. Forgiveness can happen with reservations, but there is often a trial period of “show me” that has to happen. It’s difficult not to be cynical or suspicious after feeling so hurt and betrayed.

Should you and your partner forget the relationship injury? I say no. I don’t mean that you should hold a grudge, keep score, or constantly bring up the past to your partner. What I mean is that your partner needs to keep the crisis in mind when they’re making decisions going forward. If they truly regret causing you pain, they are never going to want to do it again. Meanwhile, you need to keep the injury in mind so that you are always communicating, clarifying what may be misconstrued, and doing away with negative assumptions.

It is easy for couples to fall back into old negative patterns, especially if that has been your go-to for a long time. The work, the tough stuff, is to move forward: forgiving but not forgetting how painful it was to be estranged from each other. A couple needs to work daily to keep each other close and interact in loving ways. These habits will reinforce your positive perceptions of one another so you can build a lasting relationship.

If you need help working with your partner to rebuild trust, you can find a couples counselor here.

© Copyright 2019 GoodTherapy.org. All rights reserved. Permission to publish granted by Stuart Fensterheim, LCSW, therapist in Scottsdale, Arizona

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.

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Should Mental Health Determine Pain Treatment Options?

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

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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?

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Podcast: Support Groups for Mental Illness – What are They?

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Most people understand how doctors and therapists work, but many people can’t quite wrap their minds around support groups – especially peer-led ones. In this episode, our hosts dissect different types of support groups to make them better understood and more accessible. Listen Now!

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“[Mental Illness] Support groups are like a buffet — take what you want and leave the rest.”
– Gabe Howard

Highlights From ‘Mental Illness Support Groups’ Episode

[1:00] Lets talk about support groups.

[3:00] Fountain House in NYC is awesome!

[6:00] Why it’s great to be around like-minded people.

[8:00] Support groups in hospitals.

[12:00] Peer-run support groups, hints and tips.

[18:00] Gabe became a support group facilitator — what does that mean?

[25:00] Sometimes people come to support groups just to listen.

[26:00] Gabe and Michelle recommend support groups to listen and share.

[28:00] Don’t like your support group? You can find another!

Computer Generated Transcript for ‘Support Groups for Mental Illness – What are They?’ Show

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

Narrator: [00:00:09] For reasons that utterly escapes Everyone involved. You’re listening to A Bipolar, A Schizophrenic and A Podcast. Here are your hosts, Gabe Howard and Michelle Hammer. Thank you for tuning into A Bipolar, A Schizophrenic and A Podcast.

Gabe: [00:00:22] I’m Gabe, I have bipolar.

Michelle: [00:00:24] Hi I’m Michelle I’m schizophrenic.

Gabe: [00:00:26] And today we’re going to try to give some helpful information and maybe demystify things like support groups peer support groups support groups read by medical staff like social workers or doctors kind of talk about our experiences we’ve heard from others and just try to tie it up at a nice little bow. For those of you who are sitting there thinking Should I go to a group support group and what’s it going to be like and huh.

Michelle: [00:00:57] You’ve been to a a lot of support groups right Gabe?

Gabe: [00:00:59] I personally love support groups. I’ve been to all forms I’ve been to the ones led by a psychologist. I’ve been to ones led by social workers. I’ve been to ones led by peer supporters. Yeah, I am a I’m a big big believer and I go to a drop-in center which is run by people with mental illness and addiction for people with mental illness and addiction to drop in. So, it’s not exactly a support group but it’s still a group setting for people with mental illness and or addiction to kind of chill.

Michelle: [00:01:34] Yeah I do that too when I go to Fountain House in New York City. It’s kind of just like a clubhouse for people with mental illness and it’s not necessarily group therapy but you’re around like-minded people and you can have really good conversations and there’s really just no judgment there.

Michelle: [00:01:49] And it’s a really nice place to be around.

Gabe: [00:01:53] You sort of feel comfortable there because it’s set up for people like you and me.

Michelle: [00:01:59] It’s more like you’re not being judged. You feel no judgment in a support group. Everybody’s likeminded. Nobody’s thinking bad things about anything you say. You just have just a normal conversation and maybe you think somebody said something weird but then you’re like you know what I’m at this support group to what may maybe something I say somebody else thinks is weird but it’s okay cause we’re all talking to each other openly.

Gabe: [00:02:25] Let’s take this in sections so the section number one we’re going to talk about consumer operated services or peer run organizations drop in centers clubhouses like Fountain House where you go in New York City the Peer Center where I go in Columbus, Ohio and there’s there’s hundreds and hundreds of these models across the United States.

Gabe: [00:02:43] So let’s do that first. You go to probably one of the most famous drop in centers in the country. You’re really super lucky to live in New York City because fountain House has all kinds of services don’t you like a rooftop garden.

Michelle: [00:03:01] There might be a rooftop garden I don’t know if I’d been there but I am in the horticulture unit where they do all the planting and all that kind of stuff and sometimes I do help with the planting but a lot of times I just go there with my computer and I do my work there because I like to be surrounded by people that I can talk to as I’m doing my work. It’s just friendly. It’s nice it’s calming. I mean I could go to a Starbucks but that’s boring. Why not go to Fountain House chit chat with a bunch of fun people while I do my work.

Gabe: [00:03:32] You know the Peer Center where I go doesn’t have a garden. I mean we don’t we don’t have a garden and to call it a horticultural unit. That that that seriously really bad ass. But let’s talk about that for a moment because you know some people hearing this, they’re like wait a minute what does a garden have to do with mental health. And I’ll tell you this is probably my favorite thing to explain to people because at the Peer Center people come in and like oh you have mental illness and you have addiction issues and you’re playing cards. How does playing cards help? How does gardening help?

Gabe: [00:04:09] And here’s what I say. Are you ready for this?

Michelle: [00:04:11] I’m ready.

Gabe: [00:04:12] When you sit down with a group of likeminded people to play cards you talk and this whole game of spades or Uno or whatever game you choose to play that’s just kind of the distraction. Well you’re actually doing is talking about the things that are bothering you just like everybody else who plays cards you talk about your week. You talk about your grandkids you talk about your grandparents if you’re young you just you’re playing cards against humanity you feel bad. But in the best of ways. But these are very social activities. So, while you’re doing these social things you’re talking about the things that are that are eating you inside or you’re bragging about the things that you’re proud of to other likeminded people. Now nobody leaves a Fountain House or the Peer Center or any drop-in center and says Hey I said that I was 35 days sober and I was really proud of myself and everybody said they were proud of me too. No, they say I played cards but we know that you can play cards anywhere you went for that reassurance from. From people who are like you and understand. And that’s really the magic of these places.

Michelle: [00:05:18] It is the magic of these places. People find it interesting that I have friends that are so much older than me. I go to Fountain House. One of my best friends there she’s 56. Like people your friends a 56-year-old woman. No, she’s a really awesome person. She has great things to say. I love speaking to her. Why is it judgment. Is it stigma that she’s 56? What’s the big deal that she’s 56? We have likeminded mental capacity with mental illness and we just talk about regular things. Age doesn’t even make a difference there.

Gabe: [00:05:52] It is hard to find people. Probably because of the stigma that understand what we’re going through. You know I live with bipolar disorder and as you know people with bipolar disorder except for like my people we aren’t wearing shirts that say bipolar so people with schizophrenia people with depression we tend not to advertise it. So, it’s really easy to feel alone. But when you go to a drop-in center you go to a place like this you can sit around other people who also admit to living with mental illness and you can have real conversations about it. Listen Michelle and I we didn’t meet in a drop-in center but we could have you and I could have met in a drop-in center.

Michelle: [00:06:28] Oh definitely.

Gabe: [00:06:29] Yeah. We could’ve just been sitting there like Hey I take meds and it causes sexual side effects and my mouth is dry and you would’ve been like Oh my God.

Gabe: [00:06:36] Me too. And we could have just had this great conversation about how sometimes our medication pisses us off and when we left, we would’ve felt better because I would’ve been like oh my god I thought I was the only one. And you would have been like wow at least I’m not pitiful like that guy.

Gabe: [00:06:50] And the whole thing just drives forward that’s the magic of having a place where we belong and everybody has this. You want to play basketball you go to a gym. If you’re fat you join a gym.

Michelle: [00:07:03] Or you eat a bunch of Oreos.

Gabe: [00:07:05] I love Oreos.

Gabe: [00:07:07] All I’m saying is.

Michelle: [00:07:08] It’s a place of acceptance.

Gabe: [00:07:10] It is a place of acceptance and everybody has this in society. Everybody has this. There are all kinds of clubs and social events. There’s a whole website called meetup.

Gabe: [00:07:21] We’re likeminded people can.

Michelle: [00:07:22] Meetup. That’s how I found Mike post collegiate lacrosse team was meetup.com.

Gabe: [00:07:27] There you go. So, we like to be around people who understand us. We like to feel understood and that that’s not a mental illness thing. That’s not an addiction thing. That’s a human thing. And that’s why drop in centers consumer operated services peer run organizations the clubhouse model. That’s why all of these things are fantastic. But that sort of leads us into support groups because support groups are, they’re not the clubhouse model because you know clubhouse drop in centers et cetera.

Gabe: [00:07:54] They’re open like for periods of time you know they’re open for like you know morning to night etc. whereas a support group especially a Community Support Group is usually like an hour to an hour and a half maybe once or twice a week. So very different vibe.

Michelle: [00:08:10] I would agree with that. Yes.

Gabe: [00:08:12] And there’s two types of those groups. Well there’s probably more than two types but two types that we’re going to talk about here. There’s pure run support group which means a person with mental illness running a support group for other people with mental illness or in the case of like Alcoholics Anonymous recovered alcoholics running a support group for people who are trying to recover or in recovery from alcoholism. So that’s the peer run model.

Gabe: [00:08:35] And then there’s the more you know medical model it’s run by a social worker or psychologist or you know somebody with some sort of training and they both have their pluses and minuses. One is not better than the other. They both have their pluses minuses now Michelle you went to more than a few if I’m not mistaken.

Michelle: [00:08:53] A support group?

Gabe: [00:08:54] Yes support group that was led by a doctor or a social worker.

Michelle: [00:08:59] Well the first kind of support group I’ve really went to was when I was in a psych ward and it was just kind of run by a nurse and we would just go around talking and something that I got out of it that I didn’t even really follow was. Do you journal you should keep a journal and measure your mood in that way? And I was like Oh OK. Sure. The most reason why I even went to those little support groups that were having in the psych ward was because I was so bored. I just wanted to talk to people. But that actually was really helpful and it was nice talking to people. And of course, that wasn’t my last time in the psych ward because the next one I went to we didn’t do any of that. And I realized this is the worst hospital ever, because that other hospital was so much more helpful because they had a support group for us to all talk but this other hospital didn’t do anything for us. So, I realized that a support group in a hospital is actually very beneficial. It made me feel better. We were talking to everybody else that was in in the psych ward then and they were talking about things that got them there and things in the past learning about them. And it was very interesting to get everyone’s story.

Michelle: [00:10:13] And then when I was in the other hospital nobody really shared stories. And there was no support group. Everyone was just kind of talking to each other a little bit but nothing was really organized and it made me feel lonelier because I didn’t know why anyone else was in there.

Gabe: [00:10:33] I think it’s interesting that you were in this other hospital and you were like Oh my God I’m so bored I’m gonna go to this thing and please correct me if I’m wrong but you thought you’re gonna hate it. You thought it was stupid and dumb and you didn’t want to go. You were just so bored you were like oh I’m going to do this even this crap.

Michelle: [00:10:47] Yeah.

Gabe: [00:10:48] And then you missed it like you got so much out of it you wanted to do it again.

Michelle: [00:10:53] Yes.

Gabe: [00:10:54] I can see why you believed this.

Gabe: [00:10:56] I don’t I don’t judge you at all when somebody said hey I want you to sit in a room full of strangers and talk about your eating disorder or your bipolar disorder or your depression or suicidality I was like No. Why. Why do I want to know? No this is dumb. This is stupid. I felt the exact same way I got so much out of it. I first started like you with the you know the more I don’t wanna say traditional but the kind of everybody thinks about with the nurse or the doctor or the social worker sitting up front and the fun is organized in a specific way medically. You know they ask questions everybody shares that kind of thing. But then as that evolved it when I got back out in the community you know those were expensive and I didn’t have a lot of money. But what was free or very low costs like you know throw a couple dollars in a hat kind of thing we’re peer run support groups. And that was the same kind of idea.

Michelle: [00:11:50] Yeah.

Gabe: [00:11:50] People sharing stories etc. except the facilitator or moderator is another person living with mental illness. Again, the most famous peer run support group of all time is Alcoholics Anonymous. It’s exactly like that except for mental illness or depression or bipolar or you know just depending on how it’s structured. I loved these groups the one that I joined very first. Are you ready?

Michelle: [00:12:11] Yes.

Gabe: [00:12:12] Bipolar bears.

Michelle: [00:12:13] Bipolar bears. That sounds good because you are as big as a bear.

Gabe: [00:12:17] Oh man that’s so mean.

Michelle: [00:12:19] I want to see a fight between you and a bear and see who wins.

Gabe: [00:12:22] The bipolar bear.

Gabe: [00:12:24] I picked the support group though because I was scared and the name was so adorable.

Gabe: [00:12:30] No that’s kind of a messed up thing to say but I just I thought How can I be scared go into a group of bi polar bears. honestly that that’s just what I thought. Like how can I be scared?

Michelle: [00:12:41] Was there a stuffed animal bear that you had a hold every time you were speaking?

Gabe: [00:12:45] No but that would be a really good idea. I was very nervous to go and here some hints and tips for some people who are nervous to go. Go with a friend. Even if that friend doesn’t go into the room with you even if the friend has drops you off and waits in the hall. 1 – That’s a really good friend and 2 – you know sometimes that’s all it takes. You know somebody to like pick you up go to dinner first then go. I had somebody help me go to the group because I was scared she didn’t go in with me but she dropped me off and waited and I thought that was really super cool of her because I was scared to go but then you know I got to know people I made friends with the moderator facilitator you know just I became more comfortable just as we’re all you know as humans do.

Gabe: [00:13:30] And then I just became a person who went to this support group for a long time and then after a while I felt that I wasn’t getting anything out of it anymore like I had shared all of my stories I had heard a lot of stories and there’s a lot of power in that too. There’s a lot of power in hearing other people’s stories.

Michelle: [00:13:47] There really is there really is because you might think that you’ve done horrible things in your life and then you hear somebody else and you’re like oh we’re equal or you might hear somebody else Oh that’s way worse than what I did.

Gabe: [00:13:58] And it’s not about judgment. It’s about sort of sharing the burden.

Michelle: [00:14:02] It’s about understanding what your illness is and what could happen what could not happen and what you’ve done in your life and how you can accept it. Really.

Gabe: [00:14:13] Yeah. And when somebody tells you something that they did when they unload on you know they just. I didn’t mow the lawn and I was supposed to mow the lawn. And then you say to them you’re like look I didn’t mow the lawn either. There’s that connection. There’s that understanding. And that person feels better. And then you’re like Wait. Now I feel better because I helped you. And there’s just there’s a lot of power in that more so than people think and listen. Replace lawn with anything you want. Obviously when I walked into these groups for the first time, I thought I was the only person that never mowed the lawn. And then I learned that it was just so common. And then after I was there for a while new people walked in and they thought they were the only people that never mow the lawn. And I got to tell them that I mow the lawn. And I’m also thinking wow of all the analogies and examples to use. Why did I pick lawn mowing?

Michelle: [00:15:01] I don’t really know because I haven’t ever mowed on either.

Gabe: [00:15:05] Oh it’s OK though.

Gabe: [00:15:06] Neither have I.

Michelle: [00:15:07] The only as a peer support group if I ever went to. I went with my bipolar friend who took me to the bipolar support group at Columbia University where it’s just donation to get in.

Gabe: [00:15:17] Yeah.

Michelle: [00:15:18] And so I went there and I was talking I couldn’t relate fully to what everybody was saying but it was very interesting because this one guy was saying that his hyper sexuality was so big and he’s gay and he had you know unprotected sex and he got HIV.

Michelle: [00:15:36] So you know I’m schizophrenic and a bipolar group and people are talking about you know hyper sexuality and look what happened to this guy I’m a schizophrenic I go through all these troubles I do all these things but wow look what can happen. You know you would learn people’s stories and you know you kind of just understand that things could be so much worse even though you don’t think that your life is amazing.

Gabe: [00:16:02] We should probably touch for a moment because I don’t want people to get the idea that it’s like the suffering Olympics which we’ve talked about on this show before in a matter of somebody’s story being you know better worse. But at the same time, it is. I know exactly what you’re saying because sometimes I think Oh man, I thought that I hit rock bottom but I could have gone further and then other people they hear my story and they’re like oh wow this guy is way worse than me. It’s not about the judgment. It’s about the understanding the gravity of the situation and the breadth of the situation and just how just how bad it can get.

Michelle: [00:16:39] Yeah.

Gabe: [00:16:40] And then it’s also about finding those people and lifting them up and carrying them up and helping them and making it so that they’re rock bottom is way far below them because my rock bottom was way down there today. But you know when I sort of go into these support groups I was standing on rock bottom.

Michelle: [00:17:00] Hold up. We support from our sponsors. We’ll be right back.

Narrator: [00:17:04] 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.

Gabe: [00:17:35] We’re back talking about different types of support groups.

Michelle: [00:17:37] The support groups that you and you were so helpful for you that you became a facilitator. What was that like for you?

Gabe: [00:17:44] So one day I realized that I wasn’t getting anything out of the support groups anymore so I stopped going and that’s a great decision to make. Some people believe that you have to go to support groups for the rest of your life or you’re turning your back on people. That’s not true. You just keep going until you no longer get use out of it and then you step aside and let the next people sort of rise into their places. But I missed it and an organization that I was volunteering for put out a call for peer support facilitators for these groups you had to go through training.

Gabe: [00:18:15] I had to go through a three day training eight hours a day for three days. I had to learn a whole bunch of stuff I had to pass a test I had they had to make sure that I was good at it I guess. We learned things about like hot potatoes like what to do if somebody mess in certain words how to get people help how to have a resources how to structure the group how to you know the rules of engagement as it were how to de-escalate and on and on and on.

Gabe: [00:18:36] And I got through that. And then here here’s me and another person we get our own support group. Yeah. Like Gabe and Jane we’ll call her Jane because I want to protect her or her anonymity. Gabe and Jane now have the support group and people started coming and it’s different when you’re the facilitator. The biggest thing that you have to remember when you’re the facilitator is it’s not about you. It’s not about me at all. Like there’s no part of it that it’s about me. The only thing that I’m there to do is make sure that people are obeying the rules and keeping people safe and making sure that people have the resources that they need. That’s it. You know in a perfect world I wouldn’t speak at all.

Michelle: [00:19:22] Really?

Gabe: [00:19:23] Yeah I would come in. I would start the meeting. I would have everybody read the principles of support I would have everybody read the group guidelines. I would ask everybody by show of hands if they understood. I would ask who would like to go first. And then if everybody takes their turn one at a time and nobody gets upset or triggered and everybody shares information and has a nice reasonable conversation the next thing that I would need to say is all right well we have about five minutes left so we want to go ahead and wind down or they’re there anything that I can answer because we always like to end on time is very important we don’t want groups to go on and on and on and on and on. That would be perfect and you know believe it or not it worked that way a lot. Usually the most I had to do it would say something like. All right who wants to go next or. Hang on hang on hang on Jim. Michelle has been waiting to talk Michelle. You know stuff like that just like little things.

Michelle: [00:20:13] That’s funny because it has such an opposite experience that I had in the in that group that I went to maybe because I’m in New York City and people just can’t stop talking all the time. But it was just one after and another after another after another. A lot of people were talking about you know burning bridges self-sabotage all kinds of things like that with their partners that are cheating on their partners all the time is the hyper sexuality. Things like that. And at one point I had mentioned something about me being in the group but I’m schizophrenic and a girl goes, “Oh you don’t even know what people say to me. They said they say oh thank god you’re bipolar and not schizophrenic” and I’m like yeah I’m feeling this stigma in this group.

Gabe: [00:20:56] Well but wait though you even in your own description though you said that everybody talked one at a time.

Michelle: [00:21:02] Yeah but he was just flowing flowing flowing. It was never who wants to talk next everybody was chatting. Everybody just went on and on and on.

Gabe: [00:21:11] But it sounds like you had a really good facilitator because nobody talked over each other.

Gabe: [00:21:18] There were no side conversations and if there were did the facilitator shut it down.

Michelle: [00:21:22] It wasn’t the facilitator at the end was like this really went very well I also didn’t really have to moderate. You guys talk really great then.

Gabe: [00:21:34] And that’s what I mean by. If you if you do a good job, you’re just kind of like the cop sitting on the side of the road. You don’t have to do anything. People see you and they slow down if you’re a good facilitator you just kind of establish the rules and you enforce them. But you know you don’t have to enforce them unless people are breaking them. And for the most part groups went fine they went fine people learn from each other they share it. People talked and you know support groups are like a buffet take what you want and leave the rest just because something is put out there in a support group doesn’t mean that you have to take it accept it or agree with it. You are more than welcome to leave it right there. And I would encourage people to do this week after week after week and it went fine.

Michelle: [00:22:18] Were there ever any problems?

Gabe: [00:22:20] From time to time there would be a problem. I really want to stress that 90 percent of the time it was fantastic nothing more than you know just reminding people not to cross talk you know cause sometimes there’d be like a little cross talking where somebody is having a private conversation I remind them that you know they need to leave the room if they want to do that that kind of thing or you know I would notice that maybe a shyer person just wasn’t getting wasn’t jumping in.

Gabe: [00:22:43] So I’d quiet everybody down so that you know Michelle would have a chance to talk as she was maybe being a little shy.

Gabe: [00:22:49] You know stuff like that but. But every now and again of a fight would break out and be like No no. And that’s really poor wording on a podcast an argument a disagreement. Tensions would rise people would ramp up backs would be raised and I had de-escalation techniques that I use. I’d say all right stop everybody calms down please let’s all take a deep breath. Michelle, I understand that you’re upset that somebody said that lacrosse isn’t a real sport OK and Gabe. I understand that you think that lacrosse is not a real sport but that is that is not kind you. You should really apologize to Michelle for saying that and then the person usually apologizes and I would say and Michelle when somebody says something you disagree with yelling at them is not the best way.

Gabe: [00:23:42] So would you mind apologizing for yelling and then you would say I’m sorry I yelled at you and I say OK now let’s talk about what we were talking about before and I’d remember like what started the fight and get us back on that and almost I would say all but I honestly I think this worked 100 percent of the time I just really don’t like to say 100 percent of the time the two people they got in the argument would become like BFF’s. They almost always would because they would talk it out you know I would say look I didn’t mean it wasn’t a real sport I was just nervous and I don’t understand lacrosse and you would you would say Yeah look I you know I didn’t invent lacrosse. I don’t know why I got so mad and I’d be like but you’re a sports fan and you’d be like Yeah, I really like hockey. I like hockey and then the next thing you know we’re having a podcast.

Michelle: [00:24:25] How many people are you’re in these groups of you?

Gabe: [00:24:28] Anywhere from the smallest groups I ever had were probably six or seven the largest groups that I ever had were 15 to 16.

Michelle: [00:24:35] That’s huge.

Gabe: [00:24:36] Yeah. We weren’t allowed to have more than 15 people. Yeah, every now and again we would let the 16th person sneak in before we started turning people away but at 15 what was our maximum limit which is why I’m saying 15 or 16 because we really weren’t supposed to go over 15 because you’re right. That’s a huge group. And there were two of us. There were two facilitators and we would sit in a circle and we’d sit on either one and we’d make little notes at each other and we’d look at each other and we would just keep people on the right path.

Michelle: [00:25:04] I knew one person in the group that I went to. She was just there to listen. She just wanted to sit there and listen to people. She didn’t want to participate. Her method was just listening and I know that it was interesting there was a guy next to me. He said he was actually a preacher and he doesn’t really like to talk that much he likes to listen. But he was saying he’s a preacher and nobody that he works with knows that he’s bipolar because he’s a preacher and he asked to keep that that kind of like you know that he has strong you know successful man and he can’t tell anyone. You know in the church that he has bipolar because that would make him look bad. But he comes to these meetings and he listens. He doesn’t speak that much but it just helps him by being there.

Gabe: [00:25:50] By in the room. By being in the presence of other people. That’s enough for some people not me I’m a talker.

Michelle: [00:25:57] Yeah yeah.

Gabe: [00:25:58] I like to do a lot of talking a lot of sharing. I like to offer support but I also needed to remember when to listen and when to shut up and sometimes when I was a group member the facilitators would have to put their hand up and remind me to stop talking.

Gabe: [00:26:13] And that’s a good the thing for a facilitator to do.

Gabe: [00:26:17] And if the facilitator doesn’t write you’re not embarrassed you’re not a shame you’re understanding that they’re making space for everybody. I really like support groups and I encourage people to go to them if they are available in your community. Please go. Oftentimes they’re free. Maybe you got to throw a couple bucks in a hat. But even if you just sit there and listen you’ll learn so much and you’ll be in the presence of other people that have similar experiences.

Michelle: [00:26:43] It’s very it’s very helpful to note that you’re not alone.

Gabe: [00:26:47] Exactly. And some of those people listen. Some of those people will annoy you. There’s personality types that you will not get along.

Michelle: [00:26:54] Oh trust me yes.

Gabe: [00:26:55] And that’s okay too because it shows you that even people who are annoying have mental illness. That’s okay.

Gabe: [00:27:05] My mother annoys me. I still love her. Your mother annoys you Michelle.

Michelle: [00:27:11] Just the little.

Gabe: [00:27:12] Just a little.

Gabe: [00:27:14] And.

Michelle: [00:27:15] I still love her.

Gabe: [00:27:16] Yes.

Gabe: [00:27:17] So the people in a support group you will find that common ground and you don’t have to be best friends. In fact, I discourage going to a support group to make friends should go to a support group to get support. It doesn’t mean that a friendship won’t come out of it but that should not be your goal your goal should be to attentively listen. And your goal should be to truthfully share and if you do that, I think that you’ll get a lot out of it. So, if you are afraid to go find a buddy and go even if the body just sits outside or just go on your own. Talk to the facilitator let him know you’re scared show up early so that you’re there before the big group gets there and tell the facilitator that you’re nervous.

Michelle: [00:27:51] You can always change your name too.

Gabe: [00:27:53] There is most all the groups that I did. Everybody went by their first name and you’re right. We didn’t I didn’t I didn’t card anybody. So maybe everybody’s name was wrong.

Gabe: [00:28:02] I don’t know.

Michelle: [00:28:03] I mean you can change your name you cannot say what your job is.

Gabe: [00:28:07] Yes.

Michelle: [00:28:08] Just share only what you want to share. There’s one issue you want to talk about. You can only talk if you would make us only talk about that issue. That’s what you want to speak about you’re forced to say anything you don’t want to say.

Gabe: [00:28:19] Exactly. You can share as much as you want or as little as you want. All that’s required is honesty. It’s not full disclosure. And I think that people miss that sometimes they think that it’s some sort of an interrogation. It’s not. It’s participation at your speed at your rate. And if the support group isn’t working out for you don’t go back. There’s nothing wrong with that. If I am very lucky as are you Michelle because we live in big cities there’s dozens of support groups. So when I didn’t like one I just joined another one. If that’s the case for you know support group shop. If you only have the one you might have to work a little harder to make it work. But I really encourage support groups and finally the last thing that we want to say is PsychCentral.com has a ton on of online support groups. I like the in person one’s certainly better. The advantage of the online ones is they’re open 24 hours a day. They’re available when you need them. It’s kind of like a drop in center for online. So visit sites PsychCentral.com. Join the support groups and just have a blast. Those groups are really awesome and they don’t pelt you with advertising or ask you for a bunch of stuff either. So we really love Psych Central here at A Bipolar, A Schizophrenic And A Podcast.

Gabe: [00:29:31] Michelle Are we out?

Michelle: [00:29:33] I think we’re out.

Gabe: [00:29:34] Thank you everybody for tuning in. Remember you can head over to store.PsychCentral.com and pick up a Define Normal shirt when they’re gone their gone unless of course we order more or you can run over to PsychCentral.com. Join a support group read great articles everything over there is free and they are a very generous supporter.

Gabe: [00:29:51] Of this podcast. We’ll see everybody next week.

Narrator: [00:29:56] 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 PsychCentrald.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: Support Groups for Mental Illness – What are They?

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Is It Still Gaslighting If My Partner Has Asperger’s?

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

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Author’s note: It is always a challenge to choose genders when writing about neurodiverse couples. Here I use the example of an autistic man and a neurotypical woman. I don’t mean to imply there are no cases in which this is reversed. It’s just that at this time, men are diagnosed at a 4:1 ratio to women, and in my practice, it is the majority of men who are the autistic partners. This could reflect the higher frequency of autism among men, or it could mean more couples like this present for counseling than couples in which the autistic partner is female. It is also important to note that individuals on the spectrum can be susceptible to gaslighting from others, and I will address this in a separate article.

In my work with neurodiverse couples in which one partner is autistic, one of the words I hear most often is “gaslighting.” Here’s an example:

“It would be one thing if we just fought like other couples who eventually make up. But that’s not how it is with us. Instead, we argue about something, and he tells me I’m being irrational. Or childish. Or critical. Then he shuts down. Often, he storms out of the room. If I try to bring it up later, he tells me I’m imagining things, that he didn’t say that, or if he did say it, he didn’t mean it the way I took it. He says I’m being too sensitive. And he shuts down again. I’m left feeling as if I’ll explode with frustration. I’m furious. And I have nowhere to go with it. I start to wonder if he’s right about me. I don’t know what to believe anymore. Is this gaslighting?”

Gaslighting Defined

In brief, gaslighting is a term that derives from the 1944 movie called Gaslight in which a husband successfully manipulates his wife into doubting her own reality. The husband in the story has a dark secret which is at the root of everything he says and does to his wife. To him, she is not a person with her own interior life. She is a pawn in his selfish game, which until the end he plays shrewdly enough to cause her to doubt her own version of reality.

“Instead, we argue about something, and he tells me I’m being irrational. Or childish. Or critical. Then he shuts down. Often, he storms out of the room. If I try to bring it up later, he tells me I’m imagining things, that he didn’t say that, or if he did say it, he didn’t mean it the way I took it.”

In reference to the flickering gaslights in the story, this effect has become known as gaslighting: intentionally treating a person in such a way as to cause confusion and cognitive dissonance, which eventually lead to collapse into self-doubt.

Of note is that at the heart of the husband’s motivation is a desire for riches, symbolized by jewels. This part of the story is often overlooked, but it is worth consideration when we are talking about autistic behavior.

Questioning Reality in Neurodiverse Relationships

First, let’s return to the comments of the neurotypical partner I quoted above. One way to view her statement is in terms of gaslighting, just as it is laid out in the movie.

In this model, time after time, incident after incident, she is cajoled into questioning what her own eyes, ears, and heart are telling her. Finally, she gives up. She begins to believe the mirror her partner holds up to her reflects an accurate representation of who she is. In order to believe that, she has been forced to discount any impulse of her own that contradicts such an image. She collapses into self-doubt. His manipulation has succeeded. Does this make him right? His smugness suggests that he believes so. He feels clever. He has won.

What would motivate someone to treat another person this way? Such manipulation may be observable in certain personality disorders, such as narcissistic personality disorder (NPD), antisocial personality disorder, and borderline personality disorder (BPD). In short, it is not healthy to intentionally set out to dominate someone else by negating that person’s reality. Such individuals leave a trail of emotional wreckage in the lives of others. Shelves full of books and countless hours of therapy are devoted to helping those victimized by such manipulators.

Looking Beyond the Behavior: Self-Protection

Behind the behavior of the personality disordered, there is an unconscious drive to protect that which feels threatened, which is usually the person’s self-worth. In twisted logic, anything that might compromise such fragile emotional integrity must be extinguished at all costs before it can extinguish the very life of the manipulator. This may be felt as desperation.

As a result, manipulation can be rationalized. It may not be viewed as a choice but rather as a necessity for survival. Incidentally, there is no respect for someone who can be manipulated, which makes further mistreatment easier and may even be viewed as what the person deserves.

But this is not the motivation of someone with autism.

The Tragic Dance of the Neurodiverse Couple

The jewels an autistic person guards could best be described as personal integration and a sense of security in who he is. Threats may come from feeling overwhelmed emotionally in the face of what seems like unmanageable ambiguity and uncertainty, which often lead to untenably high anxiety. Reducing that anxiety, consciously or not, is the most likely driver for behavior that appears to be gaslighting in someone with Asperger’s.

Reducing that anxiety, consciously or not, is the most likely driver for behavior that appears to be gaslighting in someone with Asperger’s.

Often, this person is oblivious to the harmful effects of his behavior and doubts the validity of someone’s observation that it might be gaslighting. The fact is that I have never met an autistic person whose conscious intent is to manipulate his partner.

But the key phrase is “conscious intent.” Because even though a person with Asperger’s may not mean to manipulate (gaslight) his partner, her actual experience is the same as it would be if intent were there.

In short, we have a couple in which one partner feels as if he is fighting for survival and another partner who feels as if she is fighting for survival, and in a two-way charge, one person’s means of doing so obliterates the reality of the other. It is what I call the tragic dance of the neurodiverse couple.

Addressing the Tragic Dance in Couples Counseling

The autistic person can learn in counseling that his behavior has the effect of invalidating his partner’s emotional life. He can come to understand that even though he does not intend to inflict such pain, the effect is real. Her dismayed and perhaps argumentative behavior is how a neurotypical person might justifiably respond to what feels like manipulative behavior from someone else. She is not trying to criticize him. She is trying to express her pain.

More often than not, this realization is met with deep remorse and often guilt. In time, he can learn to understand his own way of being in the world without judging himself harshly as being wrong or defective, because that is not the correct metric. Emotional support for him is key to his growth in this area.

The neurotypical partner can learn, first and foremost, that her response to feeling manipulated is normal. Her pain and confusion are normal. They are valid. She must be allowed to acknowledge and heal her wounds, because it doesn’t matter whether she was stabbed intentionally or inadvertently: she is still bleeding.

The second step, though, is to begin to understand that her autistic partner is not trying to hurt her; instead, what she experiences as manipulation is his way of trying to reduce omnipresent anxiety, which usually derives from a lifelong experience of not quite getting things right when it comes to understanding someone else’s emotions. She needs emotional support in order to move forward. At the same time, she also has to come to terms with the fact that her partner’s way of offering this support may not align with her idea of what that support must look like.

The way to view communication in a neurodiverse couple, or any couple, is in terms of its effectiveness. This is the only metric that matters. It’s not a matter of who is right or who is wrong. The goal of communication is mutual understanding. In order to improve communication skills and strategies, recognizing differences with an effort to respect them without judgment becomes the foundation for growth in the relationship.

When I work with couples, we concentrate on slowing down conversational speed, considering linguistics and the formal logic of argument, and identifying the emotional subtext and context inherent in communication. It takes time. It takes practice. It is not always successful. When it is, it can be described as a process of two steps forward and one step back as two parallel lives learn to build bridges between two lines that will never completely merge.

Learning to trust deeply after years of being hurt, having the faith that being vulnerable one more time might be worth the risk, accepting that one’s interpretation of another’s behavior may not be the same as that person’s intent: these are the challenges.

It can’t be gaslighting without the intent to manipulate. Regardless, it can feel like gaslighting. Education about neurodiversity, skilled counseling, and communication in renewed mutual respect create the tools for interrupting this revolving door.

References:

  1. Gaslight (1944). (n.d.). Retrieved from https://www.imdb.com/title/tt0036855

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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.

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Podcast: Talking Suicide with a Bipolar and a Schizophrenic

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

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Suicide is something that most people think they understand, but there are many misconceptions about it. We say it’s a serious problem, yet will mention it casually and insensitively in certain settings. In this episode, our hosts openly discuss suicide and their personal stories with trying to end their own lives.

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“I thought about suicide every day for as far back as I can remember.”
– Gabe Howard

Highlights From ‘Suicide’ Episode

[1:00] Frankly discussing suicide.

[3:00] Don’t belittle a person’s suicide attempt.

[7:00] Why did Michelle try to end her life?

[10:00] Discussing families and suicide.

[12:00] Why did Gabe try to end his life?

[16:30] Michelle shares her suicide story.

[23:00] Michelle can’t understand how her mom did not know she had a mental illness.

[27:00] Gabe and Michelle agree that things get better.

Computer Generated Transcript for ‘Talking Suicide with a Bipolar and a Schizophrenic’ Show

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

Narrator: [00:00:05] For reasons that utterly escapes 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] Welcome to a bipolar a schizophrenic and a podcast. My name is Gabe Howard and I am bipolar.

Michelle: [00:00:24] Hi I’m Michelle and I am schizophrenic.

Gabe: [00:00:27] And today we are going to talk about suicide specifically. How are we still alive after having been suicidal for so long. And this is kind of a tricky one for us to cover because Michelle and I you know we kind of like to be bombastic. We kind of like to be funny. We kind of like to be out there and well we like to yell at each other. And suicide is a much it’s a scary topic. It’s something that sort of lends itself not to humor but to I don’t know it’s scary.

Michelle: [00:01:00] It is a scary topic. It’s something that doesn’t really get spoken about. It’s kind of something that like is very hush hush. And if you’ve ever really attempted suicide you don’t talk about it because then people just really judge you very harshly and they would say why would you do that. Don’t you care about people around you? How is that going to affect people around you what you did was something selfish.

Gabe: [00:01:23] There’s 80 billion reasons that this show should avoid suicide. Given how we talk about living with mental illness our mental illness and mental illness advocacy. But there’s one very big reason that we should cover it and that’s that we’re not afraid and we talk about everything The Good the Bad and The Ugly. But it’s gonna be a challenge for us. The first thing that we want to say immediately right out of the gate is Trigger Warning suicide. We are going to be talking about suicide and I’m not going to tell you that an inappropriate joke may or may not come up because hey we’re Gabe and Michelle.

Michelle: [00:02:02] That’s right.

Gabe: [00:02:03] This is what we do. If you are in danger right now if you are feeling suicidal please ask for help.

Gabe: [00:02:12] Call 911 if you’re in America call the suicide hotline tell a trusted friend go to the emergency room. Most importantly Michelle and I are still alive because we got help because we talked about it openly.

Michelle: [00:02:25] And I’m really bad at suicide.

Gabe: [00:02:28] Oh and the first inappropriate joke is right out of the gate okay Michelle. We sort of we did some research we made a list of topics and stuff that we want to discuss. And the first question that I get asked a lot is it if you were suicidal why didn’t you just do it. So you must not have been suicidal because you didn’t die. So you’re a liar I have a million things I want to say to that. One of them is Fuck you. That’s not how mental illness works.

Michelle: [00:02:57] Yeah. Yeah that’s a big fuck you like don’t belittle somebody whose suicide attempt because if they want to do it again . . . If you belittle somebody suicide attempt they’re going to think oh I didn’t really try to kill myself. So maybe next time I’ll try even harder and succeed.

Gabe: [00:03:15] Well I love this whole idea of this. This if you try suicide or if you say you’re suicidal it’s just a dramatic cry for help.

Gabe: [00:03:24] You want to hear some other dramatic cries for help I’m drowning. Help. My house is on fire. How I’m falling out of a helicopter. But the difference is when people yell those things people come to help. People come to help them.

Michelle: [00:03:41] But when someone says they’re suicidal. Oh, you’re just being dramatic. What’s wrong. Did you have a bad conversation today? You’re not really suicidal. You know it’s just you’re so it’s really just stop being dramatic. You don’t actually feel that way like you don’t know what’s going on in my head. You don’t know my thoughts. You don’t know what I’m dealing with. Don’t tell me it’s all in my head. That’s not no.

Gabe: [00:04:07] It this is really little thing that we have where society acknowledges that it’s a cry for help but then also says that the best thing to do is not help. I just I cannot stress enough that if somebody says that they are suicidal. If somebody says that they want to die. That is not drama. It is not. It’s none of those things. That person needs help and you’re saying well what if the person is lying and faking then that person is a jackass.

Michelle: [00:04:37] Yeah.

Gabe: [00:04:37] But to literally ignore every single person that asks for help because they’re fighting with their own brain because they’re mentally ill because they’re having suicidal thoughts because they’re so depressed they can’t take it anymore because some dickhead out there is being dramatic. That’s literally nonsense.

Michelle: [00:04:57] Yeah after one suicide attempt my friend told me you weren’t really trying to kill yourself that time. You know what happened a month or two later. I then tried to kill myself again. Did that time count?

Gabe: [00:05:11] Michelle How many times did you attempt suicide.

Michelle: [00:05:14] Well I mean attempt. I mean like did I attempt but I attempted about attempted really it wrong. I didn’t know what I was doing but I would say maybe 7 times.

Gabe: [00:05:24] That’s a lot and you’re very lucky that you’re still alive. I do appreciate your joke. You must be really bad at suicide. I for one am glad this this statistically holds up for whatever reason women do tend to suck at suicide. There’s a lot of research into this one of these is the methods we’re not going to give methods because that just well we’re trying to be mature.

Michelle: [00:05:47] Something I did learn about women differently in women and men is that women like to be found looking like themselves.

Gabe: [00:05:54] Yeah men don’t care.

Michelle: [00:05:55] Yeah men are like you know find me find me all disgusting. I don’t care.

Gabe: [00:06:00] Aren’t you glad that vanity saved your life.

Michelle: [00:06:03] Yeah I guess so. I guess they saved my life.

Gabe: [00:06:05] Yeah the our society really messes with us but when you’re feeling suicidal at all this is an example of your brain not working properly. We as humans are our bodies our minds are. Our consciousness is set up to defend ourselves. If you walk up to a stranger and you throw a tennis ball at their face and they see it they’ll duck. They don’t have to think about it. They don’t have to consider it. They don’t have to wonder what all they know is that an object is coming at them and they immediately take evasive action. It’s biological. It’s built into our brains. And yet when we’re feeling suicidal or when we try suicide it’s we’re overriding that. And that’s the illness process. Our bodies have decided to steer into danger rather than away from it. And that’s an unnatural state of being. So that this the first way that you know that something is wrong.

Gabe: [00:07:01] Our bodies want to protect themselves. We just do.

Michelle: [00:07:05] Every time I tried to kill myself I thought I had to kill myself. I thought it was something that was better for the future. I thought everyone would be better without me and everyone would be happier if I was gone. I would be less of a burden on everybody’s life. But thinking back now that I can really do retrospective kind of thoughts it would have ruined people’s lives.

Gabe: [00:07:32] Oh yeah.

Michelle: [00:07:33] It would have really ruined people’s lives. So, the thoughts I have of oh I’m a burden. You know I should be gone.

Michelle: [00:07:39] I would have put horrible burdens on all of my friends and my family and they might still be thinking about me every day about what I did and how maybe they could have helped me and they couldn’t. And they might not be okay now because of what I did.

Gabe: [00:07:57] There’s a quote out there and I really like it and I don’t know who to credit it to it is not ours but it says that suicide does not end the pain, it just transfers it to somebody else. And I believe that that is so true.

Michelle: [00:08:09] Yes.

Gabe: [00:08:10] When I was suicidal I convinced myself that my granny didn’t love me. And as everybody knows I am granny’s favorite.

Michelle: [00:08:16] Yes.

Gabe: [00:08:16] I convinced myself that my friends my family just even strangers would be happy if I were dead. And this is nonsense because it looks like strangers don’t give a shit if I’m alive or dead. So, to have convinced myself that strangers would be happy that I was dead. It literally they don’t care. That’s why they’re strangers. I’m not. I’m not saying this to be mean to strangers I’m just they wouldn’t be happy or sad they’d be indifferent. That’s just how life works. We’re not emotionally invested with every single person that we’d see you live in New York City. If you were emotionally invested in every single person that you laid eyes on you won’t have time to podcast.

Michelle: [00:08:55] I wouldn’t I wouldn’t. I’m just kind of bringing at one thing this is about my mother that she is she of course she’s not going to like that I’m saying this but what I was in college you know her my grandparents were alive and my mom would call me and she would say “you know Michelle my mother’s sick my father’s crazy, can you just be OK, So I don’t have to worry about you.” What does that make me feel like? A huge burden.

Gabe: [00:09:21] Yeah it does. And let’s take this from your mother’s perspective because you know we want to be fair our parents. Mine too. I don’t know how my mom and dad and grandma and grandpa and brother and sister and friends and family escape my anger these days because they did all of those things too. They said that I was being dramatic. They didn’t get me the help that I needed as long-term listeners of the show know a complete stranger took me to the hospital my friends and family were not absent. My parents are good parents but they didn’t know they didn’t do anything. Your mother was just like hey get a grip and don’t cause me problems because I have other things to worry about. If your mom would have understood that you were sick, she never would have told you hey don’t be sick from cancer. she never would have told you. Like if you’ve gotten like a traumatic accident and you were like you know like learning to walk again, she never would have said hey can you just like walk today so this doesn’t cause a problem. Your mom’s not an idiot. She was just ignorant about what was going on and that’s an extra burden to people like us because now their ignorance becomes our problem and we’re already sick.

Michelle: [00:10:29] Yeah. How was I supposed to feel in that situation?

Gabe: [00:10:32] You were supposed to feel shitty.

Michelle: [00:10:34] What was her logic there like of her telling me. Can you just be better so I don’t have to worry about you?

Gabe: [00:10:41] Her logic is that you had control because she hadn’t yet understood that you didn’t have control as so many people. I did the same thing as your mother to myself. I thought that I was just an asshole and I can’t say it any other way. My parents would sit me down and say you can’t behave this way you can’t skip school you can’t stay up all night you can’t talk to people like that you can’t behave this way. And then when I became an adult and started well, we all know what I did as an adult. These were not the values that my parents taught me. I thought that I had control. I didn’t realize I was sick. I thought that I was just making really shitty decisions and I kept doing it over and over and over again.

Michelle: [00:11:22] Let’s pause and hear from our sponsor.

Narrator: [00:11:24] 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.

Gabe: [00:11:55] And we’re back.

Michelle: [00:11:56] Do you think that the world would have just been better off if you weren’t gone?

Gabe: [00:12:01] No. No. I thought it at the time I really did think it at the time. I thought that everybody would be relieved. I thought that they would be like oh we don’t have to worry about Gabe anymore. We don’t have to be concerned that Gabe is going to get fired or cause a problem or divorce his wife for cheat on his wife or yell at his wife or yell at us or we’ve all heard.

Michelle: [00:12:20] The wrath of Gabe.

Gabe: [00:12:22] Yeah. These things didn’t come out of nowhere. I kind of wish that I could escape that label because the wrath of Gabe hasn’t existed since you know treatment but I was a person with untreated bipolar disorder and you know bipolar rage is a thing as much as I hate the reminder that I used to be so out of control that I would just start screaming at people uncontrollably and non-stop like I was some sort of like Supreme Court justice candidate just bothers me.

Michelle: [00:12:50] Did you always believe that you were in there right when you were screaming?

Gabe: [00:12:55] Yeah.

Gabe: [00:12:56] Who starts screaming because they think they’re wrong. I had no ability to consider another point of view. None whatsoever. And the more they wanted me to consider their point of view the angrier I became and the angrier I became the more I would yell and the more that I would I just sort of built on itself so you can see where when you’ve got that kind of emotion just railing at somebody they’re going to look at you like you’re just insane they’re going to look at you like you’re an asshole and those would be the faces that I would think about when I would be contemplating whether or not I want to live or die.

Michelle: [00:13:33] So you 100% are glad you’re alive right now?

Gabe: [00:13:37] Unequipped I have achieved it more than I ever thought possible. I don’t know I mean for like a dude with bipolar disorder I mean like just for a dude.

Gabe: [00:13:48] I never thought I could get here. I had so many problems so many and I still have a lot of problems.

Michelle: [00:13:56] I have a question.

Michelle: [00:13:57] So how old were you when you first thought of suicide attempts and tried to almost make a suicide attempt.

Gabe: [00:14:07] Zero. I was 0 years old. I thought about suicide every single day as far back as I can remember. 4 years old 5 years old 6 years. I thought that everybody was thinking about suicide. I really did and nobody ever knew. Nobody dissuaded me of this.

Michelle: [00:14:26] Did you tell people?

Gabe: [00:14:28] No. Why would I. I thought it was normal. I did. And listen you know I have never seen my mother go to the bathroom.

Gabe: [00:14:37] I just I want to put that right out there for the general public. I have never seen my mother go to the bathroom but I do assume that she does.

Michelle: [00:14:45] Yeah.

Gabe: [00:14:45] It’s just an assumption. So, if my mother is the one person on the planet that never has to use the restroom she should tell me because there’s no way that I would know this. I thought about suicide every day but nobody walked up to me and said hey thinking about suicide is abnormal and I didn’t tell them because I thought they were all thinking about it too. This is just how it was. I just assumed that they were thinking about it and they just assumed that I wasn’t.

Michelle: [00:15:11] Was anyone berating me with insults?

Gabe: [00:15:14] I mean I wouldn’t say berating me with insults because that sounds like they were calling me like jerk face but there was a lot of negativity in my life that people didn’t realize was negative. Kind of like the example that you used of your mother like where she said look, I’ve just got way too much going on I need you to be okay because she’s going through the illness of her of her parents which is a real big deal to her.

Michelle: [00:15:36] It is.

Gabe: [00:15:37] But that put a lot of burden on you.

Gabe: [00:15:40] So nobody was berating me with insults but my family was not understanding of what I was going through and I really thought that I was an asshole. I thought I was a bad kid.

Gabe: [00:15:50] I thought that they didn’t love me and I carried this very day because I I cannot stress this enough. Michelle, my parents are good parents. They’re good parents.

Gabe: [00:16:03] They’re fantastic parents. I don’t have a story about how my parents were awful or beat me or called me names or treated me like shit.

Gabe: [00:16:12] They were good parents and they made all kinds of mistakes like tons of mistakes like every mistake they made just compounded and made my life even worse and worse and worse. But this isn’t because they were malicious or bad it’s because they were human and nobody taught them about mental illness either.

Michelle: [00:16:29] Well I have a story in 11th grade, I walked out of my physics class.

Gabe: [00:16:36] Your 11th grade was much different from my 11th grade.

Michelle: [00:16:39] Yeah I walked in our home. I took the keys to the car when I had a permit and I drove to a drugstore. I found some like you know it was sleeping pills but obviously they were not like prescriptions sleeping pills. Went home took all the pills went to bed didn’t die but my eyes were all dilated. Couldn’t read a book. I was sitting next to my mom. And the day just went on. I tried to kill myself that day. It didn’t work. And the day we just went on like a regular day.

Gabe: [00:17:16] And nobody noticed.

Michelle: [00:17:18] Well I got in trouble because I was the teacher said that I just walked out of my physics class. But that was it.

Gabe: [00:17:25] Yeah.

Michelle: [00:17:25] Nothing nobody said. What did you do. Did you do anything after. Nobody questioned anything after. Nobody said why did you walk out of your physics class? Where did you go? What did you do?

Michelle: [00:17:37] I remember I was home. My mom goes “Why are you home right now?”

Michelle: [00:17:41] Because she came home from work and I go “Oh I wasn’t feeling good so I came home,” but really maybe I should have been honest and what I did.

Gabe: [00:17:49] Right.

Michelle: [00:17:50] But I didn’t.

Michelle: [00:17:52] And there’s like so many things I would have wished I would have said to my younger self that like this. This is not the answer because just because you think you’re stupid and this physics class is so hard and you hate your life already this is not a reason to kill yourself.

Gabe: [00:18:09] You know it’s an interesting thing that you brought up there like what would you tell your younger self.

Gabe: [00:18:13] Like if today’s Michelle could call 20 year ago you know.

Michelle: [00:18:17] Like physics was like not a reason, but I mean things I would have told to my younger self was, why would killing yourself now, what would that do for anyone?

Michelle: [00:18:31] You’re in high school. Everyone’s going to like Oh that that’s the girl that killed herself. I don’t think anyone would have been like “Oh I’m so devastated.” I honestly didn’t wouldn’t even think that anyone would have even cared at that point in my life. I didn’t think anyone really liked me at that point in my life and I was definitely having schizophrenia symptoms. I remember sitting in the back of that physics class having a delusion cracking up laughing at nothing and a girl two seats ahead turns around and goes. “Are you okay.” And I’m like “Oh what.”

Michelle: [00:19:04] She goes “You’re laughing it’s something.” I go “oh sorry” I didn’t even know. So, I was having schizophrenia hallucinations delusions in that class and had no idea I was schizophrenic but I obviously was.

Gabe: [00:19:19] And nobody noticed.

Michelle: [00:19:19] And that girl who sees ahead notice something was wrong. But I didn’t know what it was.

Gabe: [00:19:27] It’s interesting to consider like what our families would have felt or what they would have done or how they would have reacted had we been successful at ending our lives. And as our listeners know we work as a speakers and writers and in addition to podcasting and we go to a lot of mental health conferences and I hear people’s stories all the time.

Gabe: [00:19:53] I interview people about their stories and I mean no disrespect when I say this but when you hear a story from a thousand different people you sort of build up a thick skin to it and they don’t really affect me like they did in the beginning and this is good. This is this is I’m not saying this in any bad way I love hearing stories and I want people to tell their stories and I’m glad that we play a role in getting stories out to the greater public. But myself you know I tend to remain kind of emotionless by them one time I got hired to give a speech and the keynote speaker was a gentleman running for judge. He was going to be a judge. So, I went on before him because he was the keynote. So, I was like I was like the opening act. And I just had low 15-minute thing and I came up and I gave my speech it’s you know it’s condensed and beautiful and I talked about it.

Michelle: [00:20:48] And I’m sure it was the greatest speech. The greatest speech Gabe Howard gives the greatest speeches.

Gabe: [00:20:55] Yes I did get a standing ovation while you’re mocking me.

Michelle: [00:20:58] Oh wow.

Gabe: [00:21:01] Yeah yeah.

Gabe: [00:21:02] I’ve only gotten 4 in my life but that’s not the point of the story. The point of the story is after I was done, I sat down.

Gabe: [00:21:09] I plopped my ass and my seat and the next person got introduced. This was this gentleman running for judge he was about my parent’s age and he was very very dapper African-American gentleman. He was wearing a suit and his wife. You know same age and beautiful and when they called him up, he walked up with his wife and you know I don’t really think anything of this like I said I’m kind of bored like I have to say the next hour you know whatever. It’s not even my town.

Gabe: [00:21:33] Like I can’t even vote for him for Judge if I wanted to. But he said we’re changing things up a little bit. And my wife wants to talk for a moment about why we’re mental health advocates and she talked for just like 5 minutes.

Gabe: [00:21:48] And she told the story of their perfect beautiful son who died by suicide in his first or second year of college.

Gabe: [00:22:00] And she said, “We did everything right. We lived in the best neighborhoods we sentence in the most expensive private school we could find. You know he went to Europe. He. He got into the finest college. We were so proud. You know my husband’s a judge were upper middle class. We both hold advanced degrees. We gave everything to our children.”

Michelle: [00:22:22] That means nothing.

Gabe: [00:22:23] Yeah. And that’s what she said. Except we did not understand mental illness. We did not understand that he was struggling we did not make a way for him to ask for help. He could not get out of whatever it was that made him do this. And now for the rest of our lives we don’t have a son. And I started to cry because as I was looking at them all I could think of as if I was successful would be my parents. These two, they did not set out to be mental health advocates. They didn’t want to be at a mental health conference. They didn’t know this guy was a lawyer that became a judge. I mean just they became mental health advocates because they missed it and because they were too late and because they don’t want this to happen to other people it could be my parents I’d be gone and my parents would just be standing there saying we don’t know what happened and we don’t want it to happen to other people. And that’s why we need to talk about this more. That’s why we need more mental health education.

Gabe: [00:23:24] That’s why we need to understand suicidality and mental illness because me and you Michelle we’re lucky it’s not our parents.

Michelle: [00:23:33] Yeah I believe in high school. My mom. Well when I was not doing my homework in high school it was more because I believed I would never graduate. I mean I believed I was going to die. But my thought. My mom. She believed it was a learning disability.

Gabe: [00:23:49] Sure.

Michelle: [00:23:49] Because she was really unaware of what mental mental health and mental illness was. So when she found out years later when I was in college that it was a mental illness.

Michelle: [00:23:59] She was like “Oh I never even thought of that.”

Michelle: [00:24:04] How could you not think of that?

Gabe: [00:24:05] Because we didn’t think about it either Michelle.

Michelle: [00:24:09] It’s just education and it’s just different because I think generations ago they didn’t do that. And even considering my mom never thought about mental illness when my mother’s grandmother lived in a psychiatric center from the moment my grandmother was born until she died and my mom has memories of going to visit her in the center where she spoke like a baby and was just just for lack of a better word she was looney tunes so to have that in our family and to not see anything like that in me.

Michelle: [00:24:50] How could it have been such a shock if it runs in our family?

Gabe: [00:24:54] Because nobody everybody thought that it was a one off that it was a one in a million that it was never going to happen. And just it’s like getting struck by lightning. You do. I have a family member that was struck by lightning. You know I don’t look up at the sky and try to avoid it right. I still go out in the rain. I just think here is a one in a million thing.

Michelle: [00:25:11] There’s my dad’s first cousin Lori. She’s schizophrenic as well.

Gabe: [00:25:15] Well there you go.

Michelle: [00:25:16] My mom’s sister takes anti-depressants. Was it denial?

Gabe: [00:25:22] Yeah probably. It was denial it was lack of understanding and it was ignorance and it was the ostrich.

Michelle: [00:25:28] I mean I don’t know I don’t hold it against her. I don’t hold it against her. That she didn’t see it.

Michelle: [00:25:35] I think maybe it was a denial thing. She didn’t look into it. She really thought it was a learning disability because she always said that I don’t read and if you don’t read, you’re not smart. Well I read some books but what was hard for me about reading is that I was so busy in my head all the time. It’s hard to read a book when your mind’s racing back and forth.

Gabe: [00:25:56] It’s all over the place.

Gabe: [00:25:57] Michelle what do we want to leave our listeners with. I mean because we’ve covered a lot. I mean this is this is you know this is not our normal. I hate Michelle, Michelle hates Gabe and then we start screaming at each other show and that’s for the best. But really is for the best.

Michelle: [00:26:11] I mean just to leave listeners with…suicide is not an answer. And like I said I tried that 7 times and I failed 7 times. It’s not even an easy thing to do. And most likely you’ll end up in a psych ward where that’s not fun to be in. So really weigh your options and then just don’t do it.

Michelle: [00:26:37] It’s not a good idea. You’re going to hurt more than just yourself. You’re going to hurt the people around you instead of the people that love you. And if you keep on going with your life things do get better. My life has just gone leaps and bounds better than I ever thought would ever happen in my life. I never thought I’d be recording a podcast with Mr. Gabe Howard and talking about mental health like I do now. I thought I’d be pathetic my entire life. I couldn’t I would never will.

Gabe: [00:27:10] Oh well the two are not mutually exclusive.

Gabe: [00:27:12] That’s going to be recording a podcast with me and still be pathetic.

Michelle: [00:27:17] I guess but I never really envisioned a future because I never thought I would get there. I mean at that point I’m still it’s still hard for me to envision a future but that’s almost my own insecurity thinking nothing will ever really work out.

Gabe: [00:27:29] Of course of course Michelle there’s. I want to leave our listeners with just a couple of quick things one.

Gabe: [00:27:36] As we said before suicide it doesn’t end the pain. It just transfers it to somebody else. There’s another quote that I really like that is suicide is a permanent solution to a temporary problem.

Michelle: [00:27:48] Yes.

Gabe: [00:27:48] But the thing that I keep in my head probably fourth most of all after where I can find Diet Coke at 2:00 a.m. is at looking back now I realize that I didn’t want to die.

Gabe: [00:28:03] I never wanted to die. I wanted the pain to stop and I didn’t know how to make the pain stop. I just didn’t. And the only thing that my battered bewildered disease the brain could come up with was suicide. That is not a good option and it’s far from the only option. And once I got treatment, I found all of these better ways to make the pain stop. And that’s all I ever wanted. I never wanted to die. I just didn’t want to suffer anymore. And I would say to anybody who’s thinking about contemplating it has in the past or maybe in the future you don’t want to die. You want the pain to stop. There are much better ways to make the pain stop. Please invest in yourself and look into them. Ask everybody that you know for help. Go to the emergency room call the suicide hotline. Talk to your general practitioner.

Gabe: [00:28:58] Go to the local urgent care. I hear that you can go to the drugstore and Wal-Mart and see a doctor now do whatever it takes.

Michelle: [00:29:07] Your life is valuable and we want you in the world.

Gabe: [00:29:12] Completely agree. Thank you everybody for listening to this week’s episode of a bipolar, a schizophrenic and a podcast. Please review rank. Share us everywhere Facebook algorithm has gone I don’t know schizophrenic. Can we say that?

Michelle: [00:29:26] Sure.

Gabe: [00:29:26] Because it just it just pushes everything down. So at this point I think you’re gonna have to like share our Website via a smoke signal maybe like tattoo it on your arm and show people. I don’t know but whatever you do it for Michelle and I to maintain our high luxury standard of living. We’re just we’re gonna need you to be there.

Gabe: [00:29:47] We’ll see everybody next week.

Michelle: [00:29:49] We love you!

Narrator: [00:29:51] You’ve been listening to a bipolar a schizophrenic and a 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 PsychCentrald.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: Talking Suicide with a Bipolar and a Schizophrenic

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Psychology Around the Net: March 9, 2019

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

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Happy Saturday (or whatever day you’re reading this) sweet readers!

This week’s Psychology Around the Net covers a personal account of how running helped one author’s anxiety and fear, how green spaces work to boost your well-being and social connections, why “hip” office settings aren’t benefiting employees the way employers would like them to, and more.

Enjoy!

Moving the Body, Boosting the Mind: Running Your Way to Better Mental Health: Bella Mackie, author of Jog On: How Running Saved My Life, weighs in on how physical activity (specifically, running) helped release her from a life of anxiety, fear, and intrusive thoughts.

Hyperhidrosis Associated with Higher Anxiety, Depression, ADD: New research shows patients who have primary hyperhidrosis — “a rare disorder characterized by excessive sweating on the palms of the hands, the soles of the feet, in the armpits (axillary), in the groin area, and/or under the breasts” — are significantly more likely to develop mental health conditions such as attention deficit disorder (ADD), anxiety, and depression.

Green Spaces Can Help You Trust Strangers: Last week I directed you to research about how growing up in an area lacking in green spaces can contribute to depression in adult years; now, we learn from a new case study about how green spaces and other colorful urban design elements can increase the well-being and social connections among the city’s residents.

Physician Mental Health: The Role of Self-Compassion and Detachment: Finding the professional balance between showing compassion to and engaging emotionally with their patients can leave medical providers suppressing their feelings, doing a disservice to their own mental health and well-being. Enter REVAMP.

Hip Offices Are Part of Our Mental Health Crisis. Here’s Why: Taking the occasional mental health day has become the corporate cure-all for employees experiencing burnout, but now offices are trying to create “hip,” “cool” workplace environments in an attempt to prevent burnout and even help employee mental health. According to one entrepreneur, these aren’t effective methods.

Motivation Through Appreciation: The Science Behind a Happy Workplace: On that note, here’s a look at how something as seemingly simple as employee appreciation can boost happiness and motivation. So, what are some super basic yet super effective ways employers can show appreciation to their employees?

Psychology Around the Net: March 9, 2019

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Finding Healing and Connection in the Therapeutic Relationship

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

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In the following article, names and personal identifiers have been changed to protect confidentiality.

“When I hear babies crying, I have a strong urge to kill them,” Mina said, her eyes downcast. I watched her sitting across from me, body slumped, a young woman tall and lanky, arms covered with intricate tattoos, refusing to make any eye contact at all. It was the beginning of a new year and her first session in therapy. I felt panic arise as I wondered if she was experiencing psychosis and needing more intense care than I could provide in my private practice. Thoughts about liability and safety were also at the forefront of my mind.

Mina displayed what I can only describe as an unusually high level of self-loathing, unable to take in any of my positive comments. She was also very fearful of me, or rather, fearful of how I would respond to her, and fearful of what she imagined as her negative and destructive effects on me. Having diagnosed herself with posttraumatic stress disorder (PTSD) with high levels of dissociation and existential anxiety, Mina talked about how she felt alienated from the image she saw in her mirror and often used “we” to refer to herself.

She was plagued with body image issues as well and had some confusion about her gender identity and sexual orientation. Having just quit her job, unable to deal with its stresses, she was spending most of the day at home, either lying in bed or in front of the television, severely depressed.

As sessions progressed, we processed together Mina’s feelings of aloneness, of having felt different and “weird” as a child of immigrants growing up in a predominantly white neighborhood, her experiences of racism, and her internalization of the criticisms and blame heaped on her by her parents: a narcissistic father, prone to rages, and a mother who emotionally abused her, for example, by refusing to speak to her for months when Mina was a teenager as punishment for some perceived slight. These experiences had instilled in Mina a deep fear of making mistakes and a fear of others’ reactions, anticipating anger and hostility. Mina was frozen in terror.

Mina’s inner world fascinates me. As I attune to her, I enter another dimension. I am now with another client, Dorothy, who has suffered unspeakable abuse and torture.

Dorothy must muster all her strength to escape the clutches of her abuser and save the life of her baby, Toto. I am willing to do anything for her. But what is my role? And what lessons have I yet to learn? How do I heal (her and/or me)? I am filled with a sense of urgency, for time is running out for Dorothy and Toto…

For someone who presented with such severe presenting symptoms, Mina’s progress in therapy was remarkably swift. I began to look forward to her sessions, waiting to learn from her what she had learned about herself. Mina was practicing being mindful (and so diligently!), honing her self-observing skills, often surprising me with her startlingly sharp insights about the source of her debilitating fears and negative self-beliefs, rooted in childhood experiences.

When Mina began to date, we processed her fears of intimacy and her wanting to end the relationship preemptively to avoid anticipated rejection and abandonment. Mina had begun to trust me at last, taking in my feedback of my experiences of her, and beginning to consider the possibility that she could indeed be interesting and likeable to others.

Mina began to develop increased self-confidence, self-trust, and self-love, using me as a mirror for her experiences of herself and the outer world. Yet through all this work together, she still refused to make any eye contact at all, having never looked at me directly.

Will I be able to save Dorothy and her baby in time? I face my doubts and fears and I tell myself “I am enough.” I search through my arsenal of superpowers, finding courage, intellect, and empathy. I begin to feel invincible. I walk alongside Dorothy, who is snuggling her baby, keeping her warm and safe. We are ready to overcome any challenge that comes our way. Suddenly, we are sucked into a vortex of magical currents–homeward bound…

It was session thirty-nine, about 8 months into therapy. Mina ventured to take a risk: to make eye contact at last. She expressed amazement and joy at finally being able to gaze directly at me, feeling the authentic and genuine unconditional regard I had always held for her. This session was a marker for the positive spiral of growth and spiritual awakening that ensued in both of us.

The universe was in sync.

Back to Mina’s initial statementabout her urge to kill crying babiesI did inquire more about it in the initial sessions. As we explored and dug deeper together, we came to the understanding that the sound of babies crying triggered memories of her own pain and suffering as a child. The urge to kill was really her intense need and desire to end others’ suffering.

As she began to connect with and understand her own deep caring and compassion for others, it became a pivotal step in helping to shift her deep-seated self-hatred into self-compassion. It is the development and nurturance of this self-compassion that paved the way for Mina’s true healing and the acceptance of her past and present, propelling her transformative and spiritual growth.

Another new year was on the horizon, and we agreed to terminate sessions after almost exactly a year in therapy. We processed her experiences in her journey of self-discovery, and mine as her witness, and the growth and positive transformation in both of us. For her healing had been a true gift, healing and transforming me as well.

In the end, transformative work at its basics is often simply the Self re-finding itself. We are all interconnected–there is no “other.”

Healing can be hard work, but a compassionate therapist can make starting the process easier. Find a therapist in your area here.

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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.

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