Category Archives: mental health

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When Bad Things Happen

Our response to negative events can make all the difference.

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Certain realities in life can only be seen through eyes cleansed by tears.

                                                                         Pope Francis

 difficult times in life

Why do bad things happen? A national survey asked people what they would ask God, if they could ask him only one question. The number one question posed was, “Why is there suffering in the world?”

The only accurate answer to that question is, “I don’t know.” We may speculate. We may have our theories, but there will always be events in this life that are beyond comprehension.

For what it’s worth, I’ll briefly share my personal thoughts on the question, noting that others have voiced similar opinions. First, I don’t believe that God causes bad events. I believe God suffers along with us when we suffer, because He loves us. I also believe that God can, and does, use bad events for good. I believe we experience pain and suffering in this life, because we live in a sinful and broken world. Much suffering is directly caused by sinful behavior, our own or someone else’s. Other times, bad things happen where no sin was involved, such as physical illness or natural disasters. In these cases, it makes sense to me that such events occur simply because we live in a broken world.

So, we’re left with the reality that bad things do happen. Since we can’t change this reality, we need to look at how we can best respond to it. There are several truths that can help us with our response.

  1. Bad things happen to everyone. We are not alone or unique in our suffering. We may perceive that life is easy for some, but we would be wrong. Others may hide their dark days or seem to handle them well, but they still occur. Understanding that life is difficult for everyone helps us accept our difficulties with more grace.
  2. We don’t have to feel alone. When bad things happen, we need to lean on others. We need other’s support. If you are a believer, you know that you need to lean on God during these times. I know that my spiritual growth accelerates during my difficult times. During such times, I am reminded that I need to depend on something greater than myself.
  3. Others don’t have to feel alone. We naturally reach out during the bad times. We want to help, to support, and to encourage. We are blessed when we reach out to bless others. Bad times spur us to do this.
  4. We see life more clearly. Bad events help us see what is really important. Issues that once seemed so important, fade into the background. Our bad times work like a miner’s sifting pan, allowing the unimportant and trivial to fall back into the river, while highlighting the true gold in life.
  5. We reorganize our priorities. I have worked with many people who have altered their life’s direction following a negative life event. Some have come to a place of gratitude for the bad event, as a needed turning point.

So, we are left with the reality that bad things happen to everyone. We can’t avoid them. We may not be able to understand them. But, we can work on how we respond to them, and that can make all the difference.

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I’ve Never Told Anyone This, But ….

It's comforting to know that your secret feelings are shared by many others.

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Over 36 years of practicing psychology, I have heard this phrase quite a lot. Sometimes during shared feelingsthe first session, and sometimes after several sessions, the client will pause for a moment, then begin with that phrase. They will go on to share something they have never shared with another human being. Sometimes their voice will crack, or their face will reveal their discomfort.

 

I feel the importance of those moments. I realize that my reaction to this information can have a significant impact. I know that my reaction can determine whether they feel acceptance or shame. I also know that my response can affect the future or our counseling relationship.

 

I consider it an honor that they have decided they trust me enough to share this thing they have never before shared before. Of course, I know that my role as a psychologist and the confidentiality of the therapy setting play a part, but I still think it says something about their perceptions of me as a human being.

 

The information may be an event that happened during childhood. It may be some characteristic or trait. It could be an opinion or pattern of thinking they have kept hidden. Regardless of the content, they have felt afraid or ashamed to tell it to any other human being.

 

I think about how hard it must have been to have carried this secret. I imagine the burden they have felt through the years. I consider the situations where they had to choose their words carefully to protect the information.

 

The person has kept this information a secret for a reason. In most cases, he has imagined that others would be judgmental or disapproving. He anticipates being ostracized, rejected or at least treated differently.

 

Whether or not we have a particular secret, we all wonder at times if other people think the way we do. Are we similar to others or are we different? Do others share similar feelings, reactions or insecurities? Are we normal or abnormal?

 

One of the nice parts of my job is helping the person, who has always thought she was abnormal, realize that she’s not. It’s very comforting to know that your feelings are shared by many others. It’s a relief when you can understand that you are simply being human, imperfect just like everyone else.

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A Time of New Beginnings

We often look to a new year as a time for positive change.

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As we celebrate the new year, we often think of new year’s resolutions. I don’t hear people talkNew Year about them as often as I used to, but the topic still comes up. I think most of us consider resolutions a waste of time, as they’re usually forgotten by February.

But still, a new year can be thought of as a new beginning or a new start. We hope that this year will be better than the last, that we will finally make that positive change, or at least have better luck. We look toward the future.

While New Year’s resolutions often fail, there is a benefit to setting goals. Research shows that most top athletes and business people set goals. They often attribute their success to proper goal setting. Their goals help them focus their efforts and increase their motivation.

So, how do we set goals that actually make a difference? Here are some guidelines to consider.

  1. Make your goals measurable. A goal should be specific so it is easy to determine whether it was or was not met. Saying you want to be a better person is nice, but your success will depend on the day of the week and who you ask. Saying that you will show some act of kindness every day is a little more manageable. Saying you will be healthier is too vague. Saying you will love twenty pounds is measurable.
  2. Give yourself a timeframe. Set a specific time where you will check your success or failure. Saying, “I will lose twenty pounds by March first” will increase your motivation and focus.
  3. Don’t set too many goals. We can become overwhelmed by too many goals. Keep the number at three or less at first. If you succeed at those, you can add more.
  4. Visualize your success. There is tremendous power in visualization. Picture the time when the goal is a reality. Imagine yourself twenty pounds lighter. Picture the project as already completed. Be as detailed in your visualization as possible. Notice what you see, feel and hear in that moment. Notice the look on your face. Notice how good you feel with your success.
  5. Avoid self-criticism if you fail at a goal. You will not succeed at every goal you set. When you do fail, just start over. Try to identify why you failed and make corrections. Learn from your mistakes, but don’t beat yourself up with them. Self-abuse never helps. It just crushes your motivation and morale.

 

As this new year rings in, consider how you want your life to look. Self-growth is a good thing. You often can improve your circumstances. For years I have said, “I want to live my life deliberately.” Be intentional. Set a goal or two this new year, and see what happens.

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I’ll Be Home For Christmas

Enjoy your holidays, but be realistic about your expectations.

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One of my favorite Christmas cards was given to me by a client. On the front of the card, there is a photo of a beautiful snow-covered farm scene. The farm house is beautifully decorated for Christmas GatheringsChristmas. The caption at the top says, “I’ll be home for Christmas.” When you open the card, the words read, “And in therapy for the next year.”

 

The card is funny but expresses an unfortunate truth. I talk to so many people who grew up in dysfunctional families. They recall a parent’s substance abuse, an abandoning or critical parent, or constant drama and infighting through childhood. Like all children, they carried this overriding hope that the parents would change, and they would at last feel the love they had longed for. Like all children, those family experiences created self-esteem wounds, where they believed that they were at fault. They mistakenly believed that they were defective, unlovable or inadequate.

 

Many of those children carry this hope of family change into adulthood. As adults, they still long for that negative, critical parent to finally be proud of them. They hope to see expressions of love, or attention from that distant or abandoning parent. Their hope is fueled by the mistaken belief that their worth is measured by the parent’s behaviors toward them. They believe that loving or accepting behaviors from the parent will mean that the defective child has finally grown into a competent and lovable adult.

 

Now, here’s where the Christmas card comes in. These people carry the hope that this time or this visit, things will be different. They hope that this Christmas, they will see the change. They may not be conscious of this hope. They may consciously realize that the negative parent won’t change until they decide to change. But, subconsciously they carry hope.

 

The person who returns home for a visit, carrying this unrealistic hope, is primed for disappointment. When the family member once again behaves critically, is rejecting, or gets drunk, that hope is shattered. The result can be anger, depression, or a deepening of an old self-esteem wound.

 

Of course, the truth is that the parent’s critical or rejecting behaviors reflect a problem with the parent, not an inadequacy in the child. And, the parent won’t change until he or she realizes the problem and has a desire to change.

 

The holidays can be a very special time of year. Enjoy the good parts. Establish your own traditions but remember that people basically act like themselves. Try to be realistic about your expectations when you make that Christmas visit. It might save you some of the cost of therapy.

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The Medicine of Laughter

A good laugh can do much to improve our mental and physical health.

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We all laugh. In fact, laughter is universal. Regardless of culture or native language, all humanslaughter laugh. It is a hardwired response, involving the brain centers of emotion and memory; the amygdala and the hippocampus. It activates the pleasure systems of the brain.

A baby’s first laugh will delight her parents at about 14 to 18 weeks of age. At about eight months of age, infants begin doing things to make others laugh. Without words, they begin clowning to make others laugh. They may try to put their toes into their caregiver’s mouth or expose their naked tummy, while shaking back and forth. At this early age, they seem to understand humor.

Comedians make us laugh by exploiting our expectations. They set us up, then surprise us with the punch line. We laugh at the unexpected or the absurd.

So, why do we laugh? Other than the fact that it feels good, are there benefits to a good belly laugh. Research indicates that laughter serves us well. Here are a few ways that laughter is good medicine.

  1. Laughter is good for your heart. It gives us a good cardiovascular workout, much like going for a walk. A good laugh will strengthen your heart muscle.

 

  1. It is a natural pain killer. Laughter makes us produce endorphins, which increase comfort, decrease pain, and just make us feel good.

 

  1. It protects us from disease. Studies show that people who laugh regularly have lower incidence of chronic diseases, such as diabetes or hypertension. Laughter also boosts our immune system, helping us ward off infections.

 

  1. Laughter decreases our blood pressure. People who laugh frequently tend to have lower blood pressure, which decreases the risk of heart attack or stroke.

 

  1. It decreases stress and anxiety. We increase our relaxation response when we laugh. Our stress hormones go down, and we become less anxious. Genuine laughter calms an anxious mind.

 

  1. Laughter helps depression. Studies have shown that watching funny television shows or movies improves one’s outlook on life. While it may be more difficult to laugh when depressed, the research suggests that watching comedy significantly decreases the emotional pain of the disease.

 

  1. It strengthens relationship bonds. Laughing with others increases our feelings of connection. Sharing a funny moment makes us feel closer to each other. A non-threatening humorous comment can often ease a tense discussion.

 

  1. It can shift our perspective. When dealing with a problem, a little laughter can help us distance ourselves from the seriousness of the difficulty, helping us feel less overwhelmed.

 

These are just a few of the benefits of laughter. So, let yourself laugh a little. Look for things that make you laugh. The best laughter is when you spontaneously laugh with a friend or loved one. But, you can also find humor on the internet. Just google “clean comedy” or “clean jokes.” Don’t take yourself too seriously. You’ll feel better for it.

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But, It’s Not Fair!

We tend to have the mistaken belief that life should be fair.

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It seems to begin early in childhood. Every parent has heard the complaint, “But, that’s not Life is Unfairfair.” We seem to have this instinctual expectation that the world should be fair, and that expectation often continues into adulthood.

 

When we perceive that we have not been treated fairly, we complain. To ourselves, or to anyone who will listen, we complain about our unfair treatment. Our protests reflect our inner expectation that life should be fair. Even though we intellectually know better, our complaints also indicate that we assume life has been fair to everyone else.

 

So, what do we mean by fairness? Arthur Dobrin, DSW, teacher of applied ethics at Hofstra University, points out that there are three different perceptions of fairness. These are as follows:

 

  1. Sameness: This is the expectation that everyone will be treated equally. Everyone pays the same thing, and everyone gets the same thing. Regardless of need and circumstances, everything is equal. Everyone eats, or no one does. Senior citizens pay the same as younger adults and children. No one gets more than another. Dr. Dobrin calls this perception of fairness, equality of outcome.

 

  1. Deservedness: This is the expectation that you get what you deserve. If you work hard, you get everything you earn, and you keep it. You get only what you earn, and you get nothing if you don’t earn it. Those who are smarter, more talented and harder working will have more, and the inept, unmotivated or less diligent will have less. Dobrin says this is fairness as individual freedom.

 

  1. Need: This is the perception that those who have more should give more to help those who are unable to contribute as much. This is based on the belief that we all have obligations to one another, and that we should show compassion to those who have less. Here we see fairness linked with responsibility. Dr. Dobrin notes that this is fairness as social justice.

 

As you read through these, I suspect you agreed with some elements of all three. Most of us adhere to each perception, depending on the circumstances. We may also apply one concept to the world, and a different one to ourselves.

 

However, the truth is that life is not fair. A tornado will rip through a neighborhood, completely destroying one house, while not touching the one next door. One person gets cancer, while another remains healthy. It’s hard to understand. It’s not fair.

 

I certainly don’t pretend to understand why things happen the way they do. I do know, however, that obsessing or moaning about the unfairness of life accomplishes nothing. It just intensifies our pain. Once we accept that life isn’t fair, once we accept that life is difficult, we can begin to move on and live again. It may be hard, but it’s the reality of this life.

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Making Yourself Happy

There are steps we can take to make ourselves happier.

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Most people are as happy as they make up their minds to be.making yourself happy

                                                                       Abraham Lincoln

 

How happy are you today? How happy are you most days? Do you tend to go through your days with a sense of well-being or joy, or do you tend to move from one problem to another in your mind?

 

Research, and common sense, suggest that we have more influence over our happiness than we think. We can increase our feelings of happiness if we are deliberate about it. Most of the time, we can improve our mood if we make the effort.

 

Now, I want to be clear that I’m not referring to clinical depression here. The disease of depression is a physical and mental disorder, which requires treatment. You can’t just snap out of depression. Even in depression, however, you can sometimes improve your mood with effort. You can’t just decide to make it go away.

 

I’m referring to our day-to-day moods when depression is not a factor. In these situations, we can shift our mood if we try.  We don’t have perfect control over our mood, but we do have more control than we think.

 

Have you ever noticed that your mood one day might be pretty positive, and another day be down and out. Did you notice that your life situation might have been exactly the same on both days? It wasn’t your circumstances that determined your mood, it was your thinking, your perspective or your outlook. One day you thought negatively about yourself or your life, and the other day your thoughts were more positive.

 

So let’s imagine that you listened to the quote from Abraham Lincoln above, and made up your mind to be happy today. You determined this morning to make it a good day. How would you do it? What thoughts would you generate? What thoughts would you avoid? What would you want to notice or focus on?

 

Most likely, you already know the answers to these questions. You would want to deliberately notice or focus on the positive aspects of your life. You would try to avoid obsessing about your problems. You would remind yourself of the things you have to be thankful for. You would make efforts to cheer others up, or make them feel better. You would look for humor. You would get engaged in life activities. You would take the time to notice the beauty of nature. You would remind yourself of the positive traits of those around you, rather than their deficits. You would take the time to do something nice for yourself, or give yourself a little treat, without guilt. You would try to smile more.

 

The problem is not that we don’t know what to do. We just forget to do it. We focus our attention on the negative circumstances in our lives and believe strongly that we can’t feel better as long as those circumstances exist. We believe that we have no choice. We exclaim, “How could I possibly be happier in this situation?”

 

You may be right. Some circumstances are so negative that they do dictate your mood but most are not.  Everyone has negative and positive circumstances in their lives. If you’re waiting for all your negative circumstances to disappear before you can experience happiness, you will be waiting a long time.

 

What would it take for you to improve your happiness level just one or two notches? Why not give it a try. Be deliberate today about improving your mood. Make up your mind to feel better today. See if Lincoln was on to something.

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Mental Health Services in Schools

Mental health programs offered in schools could offer much needed help for our children.

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One in five children has a diagnosable mental health problem, but nearly two-thirds get little or no help. An estimated 13% of children and adolescents worldwide have significant mentalmental health programs in schools health problems, such as anxiety or depression. Over 15% of high school students have seriously considered attempting suicide. These statistics, plus the many school shootings make it clear that our children and adolescents have mental health needs. Since most children spend much of their time at school, it offers an excellent opportunity to reach many of them with mental health education, prevention and treatment.

 

There have been attempts to provide mental health services in the schools. For many years, schools have had school counselors on-site. Unfortunately, they have often been given administrative duties that limited their time to do actual counseling. At times, schools have contracted with clinical mental health professionals so that students with identified diagnoses could be seen on the school campus during the school day. This service does increase the availability of treatment, but many students can slip through the cracks, and insurance or Medicaid has to be billed for the treatment.

 

There have been several examples of more comprehensive school-based mental health programs. A recent review in the Harvard Review of Psychiatry evaluated the effectiveness of eight such programs. The research linked those programs to benefits such as reducing anxiety, improving reading scores, reducing bullying in school, and lowering rates of substance abuse in young adults. Altogether, the programs reached over 27 million students over the last ten years.

 

These comprehensive programs provide a combination of mental health education, social skills building, small-group activities and when needed, individual therapy. The education components are sometimes taught by specially trained teachers, and sometimes by mental health professionals. Services are made available to all students, regardless of insurance coverage.

 

The Harvard Review authors concluded that school-based programs continue to be one of the most promising types of preventive mental health interventions for children. Of course, such programs will cost money, but considering the prevalence of mental health programs in our children and adolescents, and the recent incidents of school violence, we may not have a choice.

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The Dangers of Social Media (Part 4)

It's easier to be cruel when you're hiding behind a computer screen.

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This is the fourth and final article on the potential negative effects of social media. In this series, we have discussed cyberbullyinghow too much dependence on social media can impair a child’s ability to read face-to-face social cues, how electronic communication can lead to hurtful miscommunication, and how we can be impacted by the Facebook delusion. Today, we will explore social media bullying.

Cyberbullying occurs when someone uses social media in an aggressive, demeaning or harassing manner. The bullying can include critical comments, spreading rumors or threatening statements. Like other forms of bullying, it can create depression, anxiety, lowered self-esteem, social isolation and even suicide. Cyberbullying Hotline reports that 42% of teenagers with social media access report experiencing cyberbullying over the past year. They reported that 20% of cyberbullied kids have considered suicide because of the bullying, and 1 in 10 attempted it.

Unfortunately, bullying has always been a common experience of childhood and adolescence. The negative impact of bullying has always been tremendous. Social media, however, has added another element to the problem.

The fact that social media communication occurs without face-to-face contact makes bullying easier. The Cyberbullying Hotline survey indicated that 81% of teenagers say that bullying online is easier to get away with. Kids and adults will often say things online that they would never say face-to-face.

Throughout history, aggressors have dehumanized their victims, ignoring their individualization or common humanity. They conditioned themselves, or were taught, to perceive their enemy as less than human, making it easier to take away their basic human rights, including life itself. One example of this was the dehumanization of the Jews by the Nazis.

Social media accomplishes the same thing by eliminating face-to-face contact. You don’t have to look at the face of your victim when you bully them. You don’t have to see the hurt in their eyes. It’s a little like putting a hood on your victim before you execute them. You feel less restraint, guilt or remorse.

Cyberbullying can be quite vicious and devastating to its victims. There are sites where a teenager can upload her photo for feedback. The comments are more often critical and cruel than complementary or supportive. There are also many examples of teenagers actually urging another teen to commit suicide, saying the world would be better off without them. Unfortunately, they sometimes listen to the advice.

Of all the dangers of social media, cyberbullying is the worst. Parents need to monitor social media use of their children and adolescents, as best they can. Don’t be afraid to ask your child if they have been bullied online, and how it impacted them. Try to establish an open line of communication, where they will be more likely to talk to you about abuse. Don’t underestimate the dangers of social media.

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Are You Really Experiencing Your Life?

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We live most of our lives mindlessly. We may be doing one thing, but our minds tend to be on other things. We live in the present moment, but our minds are on the past or the future.

I first learned about the technique of “mindfulness” on a PBS television program, called “Healing and the Mind.” The host was the excellent reporter, Bill Moyers, and each episode featured a clinic, somewhere in the world, that specialized in mind/body medicine.

On this particular episode, he featured a clinic at Massachusetts Medical Center, a major teaching hospital where many Harvard medical students do their rotations and internships. People come there from all over the world for assessment and treatment of serious medical disorders.

In that hospital, is a clinic that was originally called “The Center for Catastrophic Illness,” and was founded by a psychologist, named Jon Kabit-Zinn. Patients are referred to this clinic who have any illness that has proven to be a catastrophe in their lives. The clinic has been enormously effective in helping these patients deal with their various illnesses.

The clinic teaches the technique of mindfulness. The technique has been practiced in Asia for about four thousand years, but has only been applied to healthcare in the US for about twenty years. While mindfulness practice cannot directly cure many physical illnesses, it can help patients deal with their difficulties with much less distress and discomfort. It has even been shown to cure some stress-related illnesses.

The technique involves three components, (a) noticing, (b) without judging, (c) in the present moment. To notice means to truly experience, to really be in the moment. Focus your attention on that event. Experience it with your five senses. If you are somewhere, really be there. Focus your mind on what you are doing, rather than something in the past or the future.

For example, if you are driving, notice the experience of driving. What do you see? What do you feel? Notice the unconscious movement of your hand on the steering wheel. Notice the subtle rumble of the road noise. Do the same with any experience. If you are interacting with a loved one, really focus your attention on that person and the interaction. If you are washing dishes, notice the various aspects of the experience, the feel of the water, the feel of the soap or the movements of your hands.

Now, try to recall some of the favorite moments of your life. I would bet that you experienced each of these favorite moments mindfully. You were focused on what you were doing at the time. If you experienced the moment mindlessly, you wouldn’t recall it as a favorite moment. I wonder how many other moments could have been favorites, if we had experienced them mindfully rather than mindlessly.

The second part of mindfulness is to notice “without judging.” This means to not analyze our experience in our minds, but to just experience it. We don’t focus on whether the experience is good or bad. It just is. For example, patients are actually taught to be mindful of their pain. This may seem strange, but we find that, when patients notice pain, without thinking of it as good or bad, the pain lessons, or at least becomes less distressful. We usually try to escape from our pain, and in doing so, make ourselves more tense. This tension actually worsens the discomfort.

The last part of mindfulness is “in the present moment.” This means to focus your attention on the present moment, rather than experiencing the present moment with your mind thinking about something in the past or something in the future.

Let’s think about time for a moment. All time can be divided into three parts; the past, the future, and the present. Everything prior to this moment in time is the past. Nothing in the past actually exists, except in our memories. Everything after this moment is the future, and nothing in the future actually exists except in our imaginations. The only thing that actually exists at any moment is that thin slice of time we call the present.

Yet, we live most of our present moments thinking about something in the past or something in the future. We don’t really experience the present moment, because we are analyzing, reminiscing or regretting past events or anticipating, dreading or worrying about future events. We thus miss the experience of the present moment.

Take a moment now to be mindful of the present moment. Notice what your five senses are experiencing. Notice your breathing. The act of noticing the breath can always bring you back to the present moment. Your breath is always with you. Let yourself simply be in the present moment now and experiencing this moment fully. If your mind wanders to the past or the future, it’s okay. Just gently bring your attention back to your breath and the present moment.

Practice this for a few moments at a time. If you can stay in the present moment for a few seconds, that’s good enough at first. After being mindful of the present moment experience for a little while, notice what you feel. Most people report that they feel a sense of calm or peace.

Practice mindfulness several times per day. You don’t have to take time out of your day at first. Just be mindful of whatever you’re doing. Then, if you like, take a few moments out of your day to get in a more extended time of present moment awareness. Give it a try!

Question: If you have tried present-moment mindfulness, what did you experience? Also, report any difficulties you experienced in trying the technique.