Archive | Mental Helath RSS feed for this section

Is Everyone An Addict?

14 Oct

 

With the term “addiction” being used so loosely these days, it seems we all could fit into at least one category of addiction.  There’s sex addiction, love addiction, chocolate addiction, carb addiction, gaming addiction, shopping addiction, Facebook addiction, the list goes on…  So are these “real” addictions or just a reflection of our tendency to think the worst of ourselves and others?  The answer to this lies in how you define the term addiction.

There is no formal diagnosis of addiction in the DSM-IV (the so-called bible for psychological diagnoses).  So the definition of addiction is left up to one’s personal opinion.  I use the term addiction under certain circumstances.  If person continues to engage in a behavior despite it causing significant negative consequences in their life, then it might be an addition.  But it’s also more than that.  I consider a person to have an addiction if they feel compelled to act in a way that is detrimental to them in the long run.  By compelled, I mean that they feel out of control and have difficulty limiting or adjusting the behavior (i.e., a person tries to stop or limit their use of a substance, but just can’t seem to do it).

I also believe that a person can be addicted to activities, not just substances.  Research has shown that similar parts of the brain are stimulated in various types of addictive behaviors.  So whether it’s chocolate, cocaine or sex the same part of the brain is activated when a person is addicted.  But I also think that the term addiction is often used improperly.  Some people use the term addiction and compulsion interchangeably.  But there is a difference between these two.

A compulsion, as in Obsessive Compulsive Disorder, is when an individual engages in a specific behavior in an attempt to mitigate their feelings of anxiety.  A compulsion is a ritual that a person performs that is repetitive and excessive.  It can be an action or a mental activity that the person feels driven to perform.  In order to be a true compulsion as part of OCD, it must take up more than an hour per day and interfere with the person’s ability to function effectively in social, work or other personal activities.  These compulsions can also be detrimental to the person in the long run, similar to an addiction, but in a different way.  For example, an individual’s compulsion to wash their hands repeatedly due to fears of contamination and germs may create problems in the long run when their behavior causes them distress and interferes with their relationships.  They may spend so much time engaging in the behavior that it interferes with them getting other things done at work or home.

So even though both types of behaviors may seem out of control and have negative consequences, they are different.  They are also different in terms of brain activity.   The addictive behaviors stimulate the pleasure centers of the brain and OCD behaviors trigger deeper parts of the brain (the basal ganglia and thalamus, in particular).  In addition, a compulsion differs from an addiction because the individual with an addiction is responding to a craving, whereas a person with a compulsion is responding to obsessive worry.

Being more precise about the terms we use helps to ensure we get the right treatment.  With greater precision we are also casting a smaller net in deciding what behavior is problematic.  To call a tendency to spend a lot of time of Facebook an addiction may minimize the severity and seriousness associated with a true addiction.  Like most things, both compulsions and addictions occur along a continuum.  Some addictive behavior is normal.  And some compulsive behavior is normal.  To determine the severity of an addiction or compulsion often requires looking at the consequences on one’s overall quality of life.

So what do you think?  Does this mean everyone is an addict?  Are you convinced that food addiction, for example, is real?  Post your comments  below.

Tags: , , , , ,

A Real Housewives Tragedy: The Suicide of Russell Armstrong

21 Aug

With the media attention given to Russell Armstrong’s recent tragic suicide, I figured there may be an opportunity for the public to understand suicide a little bit better.  Russell, the husband of Real Housewives of Beverly Hills, Taylor Armtrong, was reportedly suffering from major financial strain and he and his wife were in the process of divorce.  Instead of speculate as to why he did what he did, I intend to help readers understand suicide from a psychologist who has often worked intimately with it (me).

For many of us, we are mystified by such a horrific act and may struggle to comprehend how someone could make a decision to end their life- especially when there are children involved.  I have seen firsthand the devastating consequences suicide can have on the surviving family members, friends and loved ones.  I hope by debunking some common myths about suicide I can give readers an opportunity to understand suicide better and hopefully taken action if to prevent it, if needed.

Myth 1:  Everyone who commits suicide suffers from clinical depression.

Although depression is one of the most common reasons a person may have thoughts of suicide, not everyone who suicides has clinical depression.  People with Bipolar illness and Schizophrenia are at a particularly high risk of suicide.  Individuals with a substance abuse issues or addiction are also at an increased risk.  We also know that recent losses- such as a major financial loss or the death of a loved one or divorce can trigger thoughts of suicide even when the person does not meet criteria for Major Depression.

One thought pattern that is common among people who suicide is a sense of hopelessness.  The recent financial crisis in theU.S.affects people on a macro and micro level.  We may feel hopeless about the economy in general and if one has serious financial stress on top of that, they may feel even more hopeless and fearful.  The relationship between financial crisis is not just an American phenomenon.  Research found inEuropethat the number of suicides in European countries increased during their recent financial crisis.

Myth 2:  More women commit suicide than men.

In theUnited Statesresearch has found that actually more men than women commit suicide.  However, almost twice as many women attempt suicide than men.  It is believed that the reason for this is that men tend to use more lethal means.

Myth 3:  It is a bad idea to ask someone if they feel suicidal, because it might give them ideas, or somehow encourage them to do it.

Clinicians know that this is not true because it is our duty to make sure we ask if people feel suicidal and assess for risk when we see clients in therapy.  However, many people may hold onto the unfounded belief that asking someone if they are feeling suicidal may somehow push them over the edge to do it.  Due to this unfounded fear loved ones may avoid talking about suicide with the person they are worried about.  It is often difficult for individuals contemplating suicide to talk about it with others, asking them directly about it may open the door for them to share.  It is very important to realize that just asking someone if they are thinking of suicide will not make them do it.  Think of it this way- if you yourself are not feeling suicidal and someone asked you about it- would you suddenly think to yourself “Hmmmm…. That sounds like a good idea.”  Suicidal thoughts and actions are a very personal choice.  If you are concerned about someone, the best thing you can do is ask them in a very matter-of-fact and non-accusatory way.  Try to be gentle and straightforward.  They may be relieved someone has asked and may want help but not be sure how to ask for it.

Myth 4:  We can always see if coming.  Who is going to suicide and when is predictable.

Even clinicians who are trained to assess a risk of suicide in others may not know who and when someone will suicide.  Many people who do suicide don’t seek psychological help beforehand.  If someone suffers from depression, they may actually seem better in the days and weeks leading up to their suicide.  This is thought to be because they feel relief in having come to the decision to end their life and escape their emotional pain.  Also, when someone is starting to come out of a depression but is still feeling sad they may still have the depressed mood, but they may have the energy to carry out their plans.  It is important to know the warning signs of suicide and take them seriously!  But we must also acknowledge that we can not predict human behavior with 100% accuracy.  This is very important for the loved ones of suicide victims to understand since there is often strong feelings of guilt among the loved ones who are left behind.  (See below for some common warning signs of suicide).

The Serious Consequences of Suicide

Suicide is a selfish act.  It has a tremendous effect on those left behind- often creating scars that will last a lifetime.  When I have clients who are having thoughts of suicide I often remind them very bluntly about the impact that decision could have on their loved ones and children.  Sometimes people get so locked into their own pain, they find it hard to look outside themselves, and they may have a distorted view that somehow ending their life will be better for others.  This distorted view must be challenged and any mention of suicide or indication of suicide be taken very seriously.  If you are a survivor of suicide (meaning someone you loved has committed suicide), there are resources available to help you.  Check out the American Foundation for Suicide Prevention at http://www.afsp.org/index.cfm?fuseaction=home.viewPage&page_id=1

Warning Signs:

–          person starts talking about death or suicide

–          the person begins to give away their belongings

–          the person is suffering from serious depression

–          the person has access to firearms or other lethal means

–          there has experienced a recent personal loss- or serious financial loss

–          the person is intoxicated or abusing substances

If you have more questions or would like assistance for yourself or someone you know, more information is available at http://www.suicidepreventionlifeline.org/

Tags: , , , , , , ,

Do Bootcamps for Teens Really Work? Check out this article from wetpaint.com

15 Jul

With Emily (Shay Mitchell)’s ex-flame Maya (Bianca Lawson) coming home from boot camp on an upcoming episode of Pretty Little Liars, can we expect her to give up her experimentation with sex and drugs? According to Dr. Alisa Robinson, PhD., of askdoctoralisa.com, if Maya’s parents are expecting the pseudo-military treatment to reform their lost little girl, they’ll be sadly mistaken.

 

Read the rest of the article at http://www.wetpaint.com/pretty-little-liars/articles/exclusive-will-maya-return-to-rosewood-a-changed-woman

Tags: , , , , , ,

The Complexity of Mother-Daughter Relationships and The Real Housewives of New York

8 Jul

The relationships between mothers and daughters are often complex.  The most recent episode of Real Housewives of New York illustrated this.  I’m sure many women can relate to LuAnn’s attempts at finding the right balance between being a friend and being a mother.  Ramona’s daughter, Avery, expressed frustration with her mom for not being home enough, but also demonstrated respect and admiration for her mother in a very touching way.  This type of mixed feelings is very common in parental relationships.  There is no such thing as a perfect parent, but an emphasis on what is wrong or missing in a parent is often most salient during the teen and young adult years.

 

It is clear that there is much love between Ramona and her daughter Avery, and it’s is very possible that Avery is what we called “parentified.”  To be parentified means that the family dynamics influence a child to take on an adult role before they are actually an adult.  This can happen when one or more parent has a substance abuse problem. The child ends up being the responsible one, and may take over some patent-like responsibilities, or may act or think like a “little adult.”  Becoming parentified can also occur when a child has many siblings and out of necessity must help to raise the younger children in the household, hence spending more time parenting than being a kid.  Avery demonstrates wisdom beyond her years.  She is reasonable in the advice she gives to her mom and Sonja as they shop for Burlesque clothing.  Yet, she also tells her mom that she doesn’t like being home alone at 9:30 at night when her mom and dad are out.  Although one could be quick to judge these mother daughter relationships, the one common theme is the presence of love.

 

Perhaps the take away message from watching the complex and interesting dynamics between the mothers and daughters of The Real Housewives of New York is that mothers are human, too.  They can make mistakes and still be good mothers.  They can disappoint us, anger us, or even betray us, but it doesn’t mean we stop loving them.  Mother and daughter relationships are complex and varied.  Although it’s possible that some mother daughter relationships are too damaging and may never be repaired, many women may find peace in accepting their mother for who she is.

 

Getting to a place of acceptance of your mother for who she is may not make for good television ratings, but it will allow you to have a more enjoyable and peaceful relationship with the person who will forever be your mother.

Tags: , , , , , , ,

Sex Addiction: Is It Real?

19 Apr

 

The issue of infidelity and sexual addiction has been a hot topic in the media recently. Just because a person has been unfaithful to a spouse or partner does not mean they necessarily have an addiction. With that being said, sexual addiction does exist, and for many people this addiction can ruin their careers, relationships and lives.

Like most human behaviors, sexual problems fall along a continuum. The question often boils down to how much the person’s behavior is interfering with their ability to function normally or how much stress the behaviors create in their lives. Does their sexual behavior interfere with having normal healthy relationships? Does it interfere with their job? Does it put them at risk with the law? Someone with a sex addiction is compelled to act on their sexual urges. Their sexual compulsions begin to dominate their life. Just as with other addictions, the individual eventually begins to sacrifice what is most important to them in order to continue to engage in their sexually destructive behaviors. Some behaviors common to sex addicts are: compulsive masturbation, multiple affairs, prostitution, exhibitionism, excessive use of pornography, multiple anonymous partners, cybersex, voyeurism, and molestation/rape. A person does not have to engage in all of these acts to be a sex addict. Some sex addicts only engage in one of these types of sexual behaviors, others engage in many or all of them.

Many people often wonder why someone would cheat on a partner that seems to be such a good catch (Haley Berry, Sandra Bullock, etc.) But when someone has a sexual addiction it is not about their partner, or lack of a “good” partner. Although problems in one’s marriage or relationship can fuel a desire to stray, when someone has a true sexual addiction, their compulsion to act on their sexual urges and fantasies can over-ride even very healthy, stable and happy relationships.

Blaming infidelity on sexual addiction may be a ploy for some, but it may be a very real problem for others. It’s important to recognize sexual addiction as a serious problem. Educating yourself about the signs and symptoms of sexual addiction may help you to identify problem behaviors in yourself or others. Sexual addiction can be treated. Many people have been able to create healthier, happier lives once they treat their sex addiction.

Tags: , , ,

Celebrity Narcissism

18 Mar

Narcissism is nothing new. However, the increase in narcissism among celebrities appears to be on the rise. Dr. Drew Pinsky, a medical doctor and addiction medicine specialist who works with and treats celebrities and their addictions, has written a book about the prevalence of narcissism in media and the impact that may have on those who look up to these people. 

Narcissism is a personality characteristic and is also an official personality disorder according to the DSM-IV (the so-called bible for psychological diagnoses). Individuals with Narcissistic Personality Disorder tend to present themselves with a grandiose sense of importance. They often believe they are superior to others and may only want to associate with other people that they believe are at their level. These individuals often lack remorse for others, and their feelings of empathy may be shallow. There are varying degrees of narcissism, from what is called “healthy narcissism” to extreme versions of Narcissistic Personality Disorder.

Healthy narcissism refers to a high level of self-esteem and sense of self-worth. It refers to the ability to put yourself first sometimes. But it does not mean that you have a lack of regard for the feelings and needs of others. Extreme narcissism, on the other hand, refers to individuals who exhibit many of the characteristics of Narcissistic Personality Disorder.  Individuals with Narcissistic Personality Disorder demonstrate elitism. The person feels privileged and important above others (even if they do not have commensurate achievements).  They often present with what is called “histrionic” features. They may be sexually seductive, enticing, glib and clever, and can be pathological liars.

Individuals with Narcissistic Personality Disorder seem to have high levels of self-esteem but their view of themself as grandiose and important is actually serving to counteract deep feelings of inferiority. It is as if they are over-compensating by creating illusions of being superior, exceptional, and admirable. Some individuals with Narcissistic Personality Disorder will also demonstrate deficits in their conscience. They may be unscrupulous, deceptive, and amoral. Criminals with psychopathic traits frequently have extreme levels of narcissism. It is also often seen among celebrities and those in the entertainment business. These people may have no problem in stepping on others to get ahead. They may use relationships with others to advance their own careers and may switch from one partner to the next based on who has the highest status (or who raises their status by association).

What Dr. Drew and other researchers have found is that narcissism is very common among celebrities, especially reality stars. It seems that individuals with high levels of narcissism tend to be drawn to the spotlight. They are also often quite charming and likeable to others. However, this tendency for others to be drawn to them only lasts so long, as they tend to not make good mates. Being in a relationship with someone who has Narcissistic Personality Disorder can be very painful. Imagine being in a relationship with someone who is only concerned with self-interest, who is unwilling to admit wrongs, and who is increasingly likely to cheat.

Research has found that narcissistic traits are highly correlated to an individual’s likelihood of cheating (Buss & Shackelford, 1997). Although narcissists may not openly scheme to exploit and take advantage of others, they often end up treating those they are in relationships with badly. People who are in relationships with them often feel depressed, demeaned and frustrated. For many people who are in a relationship with a narcissist an important step is to understand this personality style and then use the information to help you decide how much of a relationship you truly want to have with that person, to learn how to set limits with them and take care of their own needs. I have worked with people who have had parents with Narcissistic Personality Disorder and this often leads to low self-esteem in adulthood. A narcissistic parent can be very damaging. A good resource for those wanting to understand narcissism better is the book “Why Is It All About You? The Seven Deadly Sins of Narcissism” by Sandy Hotchkiss, LCSW.

Once you begin to understand narcissism and how it manifests, you will become much more able to spot it in individuals in your life.  You will also likely begin to recognize it in popular culture and media. You may begin to understand celebrity behavior and antics better. Hopefully, by seeing celebrity narcissism for what it is, we can begin to de-glamorize celebrity bad behavior and see it for what it really is.

Tags: , , , , , ,

The Remorse of a Reptile: Making Sense of the Alleged Murder of Chelsea King

7 Mar

 

The recent case of Chelsea King, a 17 year old girl who went missing while jogging on a trail in the San Diego area, has garnered much media attention.  Now that John Albert Gardner III has been charged with the rape and murder of Chelsea King many are left questioning how someone could commit such a horrific crime against another human being. John Gardner has a history of sexually violent acts against minors, and previous court documents reportedly describe him as “callous and vicious.” This extreme callousness and lack of remorse for others has actually been linked to a deficit in the brain of people like him. In some ways, these individual’s brains are more like that of a reptile than a human.

Individuals with a serious lack of remorse and who prey on other human beings are often referred to as psychopaths. This term is often used interchangeably with the term sociopath.  Essentially, what these terms refer to is a specific personality structure in which in an individual lacks remorse for their actions, demonstrates extreme narcissism and has a predatory nature towards other human beings. They have no sense of empathy and are almost completely motivated by self-interest. Although many psychopaths are criminals- not all are. It has been suggested that they tend to be overrepresented in politics, top ranks of corporations, law enforcement agencies, law, and in the media.

Robert Hare, Ph.D. is a specialist in the area of psychopathy.  He defines some of the key characteristics of psychopathy as:

  • Aggressive narcissism
  • Glibness or superficial charm
  • Grandiose sense of self-worth
  • Pathological lying
  • Cunning / manipulative
  • Lack of remorse or guilt
  • Shallow
  • Callous / lack of empathy
  • Tendency to engage in a socially deviant lifestyle
  • Need for stimulation
  • Parasitic lifestyle (living off of others, taking advantage of other peoples’ kindness)
  • Poor behavioral control
  • Lack of realistic, long-term goals
  • Impulsivity
  • Irresponsibility
  • A history of juvenile delinquency

 

So how are the brains of psychopaths different from other humans?  Research has found that they vary in several ways.  One is the difference in how their limbic system operates. The limbic system is a part of the brain that is essentially right in the middle of your brain.  It is responsible for regulating emotions, some aspects of behavior, long-term memory, and other functions.  What researchers have found is that the limbic system in people considered to be psychopaths processes information differently. Brain scans have shown that there is little to no activity in the part of the limbic system that produces a sense of empathy. The part of the limbic system that modulates affect and emotions and the parental response to offspring that is present in mammals, is essentially non-active in the brains of psychopaths. It is as if this part of their brain is functioning similar to how a reptile’s would. In a sense they really are “cold-blooded.”

Tags: , , , , , , ,

The Worry Bug

24 Jan

[picapp align=”none” wrap=”false” link=”term=bug&iid=202597″ src=”0199/e753ee0f-5dd4-46e8-a868-268113ba3381.jpg?adImageId=10094167&imageId=202597″ width=”380″ height=”323″ /]

We all worry.  That is a natural part of life.  It is essential for us as humans to have the capacity to worry or experience anxiety.  It is part of what keeps us safe.  However, some people are plagued by worry so much that they end up suffering major consequences.  Some of the consequences of chronic worrying are:

  • Difficulty making decisions/indecisiveness
  • fatigue
  • physical pains- including headaches and muscle pain
  • increased propensity for getting sick
  • depression
  • increased tendency to procrastinate
  • irritability
  • poor sleep
  • difficulty concentrating or focusing

These are just a few of the most common consequences of worrying too much.  When individuals chronically worry- or have the “worry bug” they decrease their immune response.  Their body is in a hypervigillant state, and stress hormones are released into the body.  These stress hormones can help your body prepare for a flight-or-fight response.  But research is finding that when they are released for long periods of time (such as when a person is a chronic worrier) it can have a major impact on the human body and lead to a myriad of physical problems and ailments.

So what can you do if you’ve got the worry bug?  There are many different things you can do to start living your life differently and stop worrying so much.  However, keep in mind, that most of the techniques for ridding yourself of the worry bug takes time and practice.  One of the essential components to effectively ridding yourself of chronic worry is a shift in your focus from a future- oriented perspective to a present-moment perspective.  Worry is almost always future- oriented.  It often starts with the words “What if…”

“What if I don’t get the promotion?”

“What if he thinks badly of me?”

“What if I something bad happens to my son when he’s out with his friends?”

“What if I get hurt while driving my car?”

The list goes on and on….  What may start with a simple “What if” question then begins to transform into a complex web of “what if’s,” as one what if leads to another to another and another.  Along with this line of thinking also comes visual imagery of the imagined event.  Usually this imagined, feared event frightens us or upsets us in some way.  And what do you think happens when you begin to imagine some terrifying event take place in the future?  Your body tenses up, and it begins to act AS IF the event is really happening.  But this is the catch- IT HASN’T HAPPENED YET!  Now we have a physiological response (remember: release of stress hormones in the body) to an IMAGINED event, not a real one.  Our body becomes affected by this worrying, we start to feel fearful of this imagined outcome and we try to do whatever we think we can to avoid this terrible outcome from happening.  As a result we often end up feeling stuck.

The important piece of this equation is that all of this mental energy is spent attempting to predict or anticipate a FUTURE outcome.  By beginning to focus on the here-and-now we spend less time engaging in thoughts about the future and more time living our lives in the present moment.  One way to begin to live your life more in the present moment is through a mindfulness practice.  (More about Mindfulness will be discussed in this website).  Mindfulness is not the only avenue to ridding one’s self of the worry bug, but it is one that has been proven to work.

There are many techniques that have been proven  to help manage worry, such as:  worry time, the stop technique, and other cognitive-behavioral strategies.  These techniques can be helpful in learning to worry less.  Some of the core features of learning to worry less are:

  • Increase the amount of time you spend in the present moment.  This can be done by engaging in a mindfulness practice.  You can make this shift by increasing your awareness of the time you spend thinking about the future and remembering to bring yourself back to the present moment.  So next time you find yourself consumed by the worry bug, regain your focus on what is actually happening in the moment.  Take a breath, look around, and re-engage in what is going on right in front of you.

 

  • Recognize what you can and cannot control.  The serenity prayer that is used as part of the 12-step recovery process works for a reason.  Once you can begin to quickly recognize the things in your life that you can and cannot control you can begin to live much more peacefully.  Are you worrying about something you can’t control?  Are you trying to control or predict the future?  Are you trying to control another person’s  behavior?  Remember the things that you can control are actually quite few.  (As an exercise see if you can list right now the things you can and can’t control and notice what you come up with).

 

  • Slow down- The worry bug often gets you revved up.  Your mind is moving fast, and your body may be moving fast, too.  When you are anxious, stressed and worried it is difficult to create a shift in your thinking.  Sometimes the key to turning off the worry bug is to SLOW DOWN.  Sometimes you may need to slow your body first.  Stop what you are doing and stop multi-tasking.  Do something relaxing, if possible, or even just sit quietly for a moment.    The worry bug does not like quiet. 

Remember- I am not suggesting that you do not think about the future, or ever ponder about potential scenarios in the future.  The goal is to strike a balance between the time you spend thinking about the future or past and the time you spend living in the present moment.  Many people live a great deal of their lives constantly two steps ahead of themselves.  When you do this, you are prone to living a life filled with worry, uncertainty, stress and agitation. 

So now that you have read this information, sit where you are for just a few moments in silence and let the information soak in.  Perhaps you might set and intention for yourself for how you would like to practice living your life differently from this moment forward.

And after you give yourself a few moments of silence.  Then open your eyes and move on to the next moments of your day…

Tags: , , , , , , ,