All Posts Tagged: south florida counseling

Darbi Miller, MS, LMFT – Consult The Expert On Increasing Relational Self-Awareness

For this month’s Consult The Expert interview, we spoke with Darbi Miller, MS, LMFT, one of the marriage and family therapists here at The Center For Treatment Of Mood And Anxiety Disorders. Although she likes working with all ages, she enjoys the dynamic surrounding family and relationships.

“One of my favorite things to work with is increasing clients’ relational self-awareness,” she said. “I also enjoy exploring peoples’ Families of Origin, which is connected to self-awareness from my perspective.” 

What Is Relational Self-Awareness?

I asked her to explain what she means by relational self-awareness. “Family of Origin and self-awareness are related,” she said. “In any experience with another person, relational self-awareness can look like asking ourselves, “What is mine? What is yours? What is ours?”

“We each have our own stories, beliefs, and experiences,” she continued. “Relational self-awareness looks at what each person brings to the table and how this affects the interaction between us. If we are self-aware, we have a compass for ourselves which translates into tolerance. We are able to share our personal values and beliefs and hear the other person’s.”

“If we are not self-aware, our interactions are based in fear. We begin looking for approval or we get defensive because we may feel we will “lose” in some way if we are vulnerable with the other person. When you have self-awareness, however, you can be vulnerable and can create more intimacy in all of your relationships.”

Ms. Miller cited a Harvard study that has followed individuals over an eighty-year period. It found that the quality of our relationships has more impact on our health than even our cholesterol levels. “It turns out that surrounding ourselves with positive, close relationships creates a better sense of community within ourselves, which in turn, has a better health impact,” she said.

We discussed how relational self-awareness can help with anxiety treatment. “With anxiety, behind that is usually fear on a basic level. Our thoughts are powerful. If you can get to the core and understand the fear (how can I feel more connection with myself?), connecting to your body and grounding yourself, allows this to be part of the healing process.”

How Does Family Of Origin Fit In?

Ms. Miller explained how Family of Origin fits into treatment of mood disorders. “We come from our own system that was learned in childhood. This is the Family of Origin,” she said. “This system has patterns, beliefs, and values that we can sometimes see, but sometimes aren’t aware of. We all have a family role – maybe we’re the funny one, the responsible one, or the nurturing one. This role can carry into our adult lives and play out between couples.”

“Sometimes people go into a relationship expecting it to heal their Family of Origin wounds. Although it can happen that a new relationship can be good and healing, if we enter it expecting our partner to instinctively know what we need to heal, that may not be the case and we’re disappointed,” she said. “If you are expecting your partner to heal you, where is this coming from? The answer leads back to relational self-awareness.”

How Do These Concepts Help With Therapy?

I asked how knowing what we bring with us from our Family of Origin can be used to improve our own mood disorders.

“Knowing what you have “inherited” and what you can change can be very empowering,” Ms. Miller said. “You don’t have to operate out of same system you inherited. You have control. The realization that you don’t have to follow the same patterns – and you get to decide – can help with anxiety and trauma.”

“I mainly use this work for people who feel stuck in their life, work, and relationships,” she explained. “During therapy, my approach is always to start at the top. We begin with something action-focused, like behavior organization, and getting back into routines that can have a positive effect on the person’s mood and decrease anxiety.”

“I also use cognitive behavioral therapy to challenge negative thoughts. Taken together, these give people some relief. But if they are still looking for more, this is when we explore other things like Family of Origin and relational self-awareness.”

“When we look into Family of Origin, we can choose to do the work for ourselves and also within the family roles, with siblings and parents. I typically go three levels up within the family to look at the generational dynamic,” she continued. “Doing this work can uncover patterns that influence a person’s mood, narratives, and the core beliefs that influence mood, which can be healing.”

“People want to explore these concepts, but in a safe space,” Ms. Miller said. “So, we balance a safe space with these tools, allowing them to go deeper to uncover the aspects that may be underlying their anxiety, depression, or trauma.”

Have Further Questions?

If you or someone you love have questions or would like further information about treatment for anxiety disorders, the mental health professionals at The Center for Treatment of Anxiety and Mood Disorders in Delray Beach, Florida, can help. For more information, contact us or call us today at 561-496-1094.

About Darbi Miller, MS, LMFT

Darbi Miller is a Licensed registered Marriage and Family Therapist. She has extensive training in Integrative Systemic Therapy however, does not believe one model fits all. Her approach is strength-based, collaborative, holistic, and geared to meet her client’s specific needs and goals. She works to truly understand each client and the systems that surround them. She believes therapy is a courageous step and feels privileged to bear witness to their journey. Through her authenticity, empathy, and compassion, she provides a safe space for exploration. Darbi works to integrate her knowledge into meaningful and collaborative sessions with individuals, couples, and families. Her areas of interest include walk/talk therapy, the mind/body connection, increasing relational self-awareness, high-conflict couples, and full family work. 

She holds a Bachelor of Arts in Psychology from Michigan State University and a Master of Science in Marriage and Family Therapy from Northwestern University, where she received academic distinction. She is also certified as an Eating Psychology Coach and a Prepare/Enrich Facilitator. Darbi has worked in a variety of settings including schools, hospitals, university clinics, and in-home. She also published an article in the Encyclopedia of Couple and Family Therapy on conjoint sex therapy.

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Nonie L. Craige, LCSW – Consult The Expert On Communication And Relationships

In our second Consult The Expert interview for March, we spoke with Nonie L. Craige, LCSW, a psychotherapist at the Center for Treatment of Anxiety and Mood Disorders.

Our conversation touched on elements of communication, including emotional blackmail, narcissistic abuse, and how to respond to them. We also explored different temperament traits and how parents can learn to adapt to their children’s innate natures to create a healthier parent/child relationship.

“These are my passion areas,” Ms. Craige said, “because they help build self-esteem. Self-esteem is at the foundation of everything!”

Relationship Issues And Communication

The first area we discussed was emotional blackmail. “Back in the ‘90s, Dr. Susan Forward wrote a book called, “Emotional Blackmail: When the People in Your Life Use Fear, Obligation, and Guilt to Manipulate You,”” Ms. Craige said. “This book examined a very common, hurtful problem that affects our daily living and how we communicate.

Most of us are unknowingly being emotionally blackmailed at one time or another by someone we know and depend on. It could be our spouse, our child, our boss, or our friend. Sometimes, we can be the blackmailer, as well.”

I asked Ms. Craige for an example of emotional blackmail. “Let’s say your mother surprises you with a special dinner – on a night you have other plans,” she responded. “Mom calls you up, very excited to share this delicious meal with you.

You say, “Mom, I can’t come over tonight. I have tickets for a show.” Instead of her saying, “Oh I didn’t know. I should have asked you first,” your mom makes you feel uncomfortable. She says, “But, I made this meal just for you. I cooked your favorites! I thought we were close. I thought you wanted to spend time with me.” This is emotional blackmail, because she is pushing you to change your plans to satisfy hers.”

Ms. Craige says that emotional blackmail is not a matter of miscommunication or different communication styles. “It is about the imbalance of power and control. There are different ways to manipulate, but basically Dr. Forward’s book says that the tools of emotional blackmail are fear, obligation, and guilt (FOG). No relationship or communication should ever include FOG. It is unacceptable.”

Although emotional blackmail implies planning and being devious, Ms. Craige says it really is an impulsive act that’s done because of feeling insecure. “People say things to make you feel uncomfortable and use manipulation if they feel rejected, because it gives them power. When we do this within the dynamics of a couples or parental relationship, we change from a loving spouse or parent to a manipulator in order to feel safe and secure for the moment. We ignore why the person can’t do something and focus on why they should do it for us.”

Emotional blackmail is ultimately a form of emotional abuse, however, and can cause damage to the person who is being victimized.

Narcissistic Abuse In Relationships

How does emotional abuse correspond to narcissism? “The new buzzword right now is “narcissistic abuse,” Ms. Craige said. “Emotional abuse can look like narcissism, but it isn’t a true personality disorder.”

She notes that only about five percent of the population may be diagnosed with Narcissistic Personality Disorder (NPD). The disorder includes such traits as requiring excessive admiration, lacking empathy, and having no interest in how others feel or what they need.

“The mother who makes you dinner and then says something to make you feel guilty about not coming to eat with her isn’t being narcissistic,” Ms. Craige said. “If she’s usually a warm, loving mom who is giving and caring, then she’s not a narcissist. She’s manipulating you about this particular dinner because she’s feeling rejected.”

“Keep in mind that you are allowed to feel very strongly about something and express those feelings without it involving emotional blackmail,” she says. “If there is no pressure or threat to make the other person feel bad, it is not emotional blackmail. If, in this case, your mother had said she was disappointed that you weren’t coming to eat with her, she would be voicing her feelings. It became emotional blackmail when she made you feel guilty and uncomfortable for not giving up your own plans.”

An emotional blackmailer wants to win at all costs. “If the person who wants something won’t give up, it is abuse. This abuse doesn’t have to come from a person with NPD.”

How To Remedy Emotional Blackmail: Being Assertive

“Assertiveness skills tie into standing up for yourself, but not being angry,” according to Ms. Craige. “Let’s be crystal clear – assertiveness is not being nasty, angry, sarcastic, belittling or nagging. There is no attitude involved in being assertive.”

“Instead,” she continued, “being assertive is sharing how you feel right now. If you are yelling at someone, you are being loud, not assertive. Being assertive is finding the right balance between expressing how we feel, with tact and not being aggressive. It is developing and acknowledging yourself, honing your communication skills and confidence about your message, along with control of your delivery and getting your message across. Don’t distort your message with angry emotions.”

We all have responsibilities we have to take care of. “Many women want to say no when someone asks for help, but they say yes, despite their responsibilities. Once you say yes, you take away your downtime and add stress to your life.”

I asked Ms. Craige how someone can assertively say no in such a situation. “If it fits your schedule, it is okay to help out, but if you can’t do it, then offer to help another time,” she answered.

“If you aren’t comfortable saying no, then don’t say it. Instead, you can offer to help at a later, more convenient time. Say something like, I do want to help, but today won’t work. How about Tuesday instead? You don’t have to give a hard no, but notice that this response is not angry: it gives you a way to say that you want to help without being pushed. And, it conveys that you have other things on your plate, but are willing to help – on your schedule.”

Whether it is your friend, spouse or your boss, when you are asked to do something you feel uncomfortable with, “You can simply say, “I feel uncomfortable about doing that. Can I get back to you?” Ms. Craige replied.

Parent/Child Communication Challenges

Ms. Craige also talked about communication between parents and kids. “The way we interpret and interact with the world around us is called our temperament, she said. “We are all born with different temperaments. Knowing the differences between them is very important for raising children and having a less stressful home life.”

“There are nine main temperament traits,” according to Ms. Craige. “Learning about them will help you understand how you, your spouse, and your children interact and will make life easier.  A child’s temperament is not a matter of right or wrong or a result of bad parenting skills. Each of us responds to the world in our own unique way.”

“For example,” she continued, “a parent might be a laid-back type who enjoys relaxing when they have down time, but their child might have an active temperament and enjoy being busy all the time. This can result in irritation for both. An important part of parenting is to reduce friction and frustration by adjusting to the child’s unique needs. A “goodness of fit” must be developed between the parent and child.”

What Is Goodness Of Fit?

Goodness of fit “influences the parent/child relationship and should be monitored and adjusted to by the adult’s behavior, not the child’s,” Ms. Craige said. “This is the bedrock for all areas of development. The parent/child relationship that is influenced by a poor fit between parent and child can disrupt the flow of the household, create unnecessary stress, and places the child at risk for developing other issues.”

Although there are nine temperament traits, we discussed what she considers to be the five most important ones:

  • Activity – is the child in constant motion or calm and relaxed? An active child bounces, jumps, runs, and is always moving even when sleeping, eating, bathing, etc. A less active child will enjoy sitting and playing quietly with dolls or reading books or drawing for hours. Be sure to give an active child more time to get ready, get dressed, to finish homework, and so forth, because they will resist being rushed.
  • Regularity – some children are predictable: they want to eat, sleep, and use the bathroom at roughly the same time each day. They seem to have their own internal schedule. Children who are not predictable may not want to eat at a scheduled time or may go to sleep early one day and want to stay up on another.
  • Approach – some children accept every stranger with enthusiasm and are eager to try new things. Children who are more cautious will hold back and may fuss when asked to do something new, start a new school, and so on. Don’t criticize a cautious child, instead be encouraging and give them time to observe, think about, and adapt to new people or situations.
  • Adaptability – some kids take new situations and people in stride. Others have a harder time. For the child who struggles with being adaptable, set routines, avoid unexpected changes, and give them extra time when switching modes. 
  • Intensity – How does your child react to different situations? Some react strongly and cry or yell when frustrated. Others work through them calmly and with a smile. Try not to overreact to the intensity of a strong reactor. You are not doing anything wrong, this child’s temperament is simply intense.

“Remember that what can seem like a negative temperament trait in childhood can be a positive one in adulthood,” she noted. “You might be annoyed to have to adjust the time for your son who is very methodical and slow when getting ready to go somewhere, but you’ll definitely appreciate his caution when it comes time for him to start driving!”

She said it is important to understand that temperament allows the parent to not take their child’s behavior personally. “What can seem like them intentionally pushing your buttons is often just the child’s traits driving their behavior. It’s not a personal affront.”

Never pit one child against the other, either. “Creating the idea that one child’s response is wrong and their sibling’s is right can create some very disturbing outcomes,” Ms. Craige said. “When it comes to temperament, telling a child to be more like his brother or sister is out of place. The other kid may be doing something more the way you, yourself, would do it, so you feel comfortable with how they are doing it. But this child likely isn’t doing it better than the other child, it’s just that you are more comfortable with their behavior.”

She finished by saying that a child should not be criticized for how they respond. “It is not an issue of being good or bad,” she said. “Remember that the individual response is not inherently wrong, it is most often simply a matter of innate temperament.”

We Are Here For You

If you find yourself in a situation where someone is using emotional blackmail to control your behavior, you can learn to counter their manipulation very calmly and put an end to this unhealthy pattern of communication. Remember that you have a right to set boundaries and, by offering options to help, will eliminate the dreaded word “no” that you don’t want to say. Likewise, parents who may be challenged by their child’s behavior may need some extra support.

Our caring professionals are available to help you on your journey to a healthier, happier life. Contact us for more information or call us today at (561) 496-1094.

About Nonie L. Craige, LCSW – Licensed Clinical Social Work Therapist

Nonie L. Craige, LCSW is a licensed Clinical Social Work Therapist who uses a collaborative interactional approach to create a safe supportive environment during a time of expressed concern and stress. Using several different approaches including Cognitive Behavioral and Dialectic Behavior Therapy, Ms. Craige focuses on enhancing self-esteem and core issues of anxiety and conflicts. Therapy includes enhancing assertiveness and healthy communication skills. Ms. Craige promotes this life changing journey with each patient as she helps you gain new insights and learn new tools with which to reduce or eliminate unhealthy anxiety.

Ms. Craige works successfully with adults who have experienced various forms of childhood and adult abuse. Whether it is emotional, physical, neglect or sexual abuse, patients will gain better awareness and control as well as freedom from self-defeating thoughts.

Ms. Craige received her degree from Adelphi University in New York. She also obtained training at the William Alanson White Institute of Psychiatry and Psychology and conducted training workshops at FORDHAM University.

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Jerome Siegmeister, MD, MaED – Consult The Expert On How Virtual Schooling Is Affecting Children

The Center’s newest clinician, Dr. Jerome Siegmeister, MD, MaED, is an expert on the psychiatric concerns of children and adolescents. A former high school teacher, he has a unique perspective on how children learn and the societal skills they can only develop through social interaction with peers. Since the pandemic, what he has seen has left him genuinely concerned.

During these last two years, parents and kids have had to adapt to shut downs and periods of online learning. While some students do just fine with virtual classes, many more are struggling – not just with learning through an online format, but with the loss of the in-person connection with classmates. “Covid has really devastated these kids,” he says. “Though some children can do well in this environment, virtual learning causes an issue for most.”

“The virtual learning modality is basically a lecture modality,” he continues – and therein lies part of the problem. “What do you and I do when listening to a lecture? If we are honest, most of us listen to it in the background while doing other things, so we miss a lot of the information.”

“Children are no different,” he says. “From a developmental standpoint, it is clearly better for kids to attend in-person schooling, but the unfortunate reality is that we need to be worried about public health, as well. In many cases, virtual learning is all we have right now, but this isn’t workable for many kids.”

Loss of knowledge isn’t the only side effect the pandemic has had on the nation’s children. “Virtual classes have their place because kids need to be learning, one way or another, but it comes at a price,” he explains. “It is very obvious that our children’s socialization has been affected and will be for a long time to come.”

“At this point, we have lost at least eighteen months of socialization,” he says. “Society pushes the idea that we need others to validate us, so kids rely on social acceptance for much of their self-worth. Covid took away much of that.”

Even older teens are being challenged by this new world. “The pandemic has been very hard for kids who are transitioning to college,” he notes. “Life is drastically different for them, especially if they are having to do their first year of college virtually. They are missing out on the social aspects that help them adjust to college life.”

He is optimistic, though. For most kids who are struggling, “it isn’t too hard to stabilize them and they can do really well,” he says. “Counseling and working one on one with kids will make things better in the majority of cases.”

When working with children, Dr. Siegmeister believes in treating the whole person. Depending on the child’s individual needs, this may mean combining two or more treatment methods, such as using cognitive behavior therapy along with medical treatments if there is an underlying psychiatric concern. He also likes to take a team approach to treatment and frequently involves parents, teachers, or college faculty, so the child can achieve the quickest resolution of their symptoms.

As unlikely as it may sound, Dr. Siegmester says there is actually a silver lining to the pandemic. “Mental health is often swept under the rug,” he says, “but depression is now pretty pervasive in both children and adults and people recognize this. In fact, many so called “sick days” happen because the person is depressed and really needs to take a mental health day. The positive outcome from covid is that people are now much more aware of anxiety and depression because they’ve experienced it themselves. This means it has become much more acceptable to seek help.”

About Jerome Siegmesiter, MD, MaED. (Child And Adolescent Psychiatry / General Psychiatry)

Jerome Siegmeister, MD, MaED, is a South Florida Native. He has worked with clients of all ages, and believes that the whole person needs to be treated. Consequently, he evaluates all aspects of the situation, from medical to situational, to determine the best initial course. He has a background in both individual and group therapies, employing supportive, behavioral, and insight oriented approaches, as appropriate to best fit his client’s needs, as well as comfort with medical treatment of any underlying conditions that might manifest psychiatrically. He has significant experience in all forms of psychiatric issues, including mood symptoms, thought disorders, anxiety, phobias, attention deficits, behavioral issues, insomnia, compulsive disorders, emotional lability, substance abuse, and trauma.

Dr. Siegmeister graduated with his Bachelor’s from Florida International University, after which he spent a number of years teaching, and obtained a Masters from the University of South Florida in Career and Technical Education/Adult Education. Upon deciding to pursue medicine, he initially completed a Post Baccalaureate Pre-Medical Certificate program at the University of Miami, and then obtained his MD from the University of Miami Miller School of Medicine, staying there afterwards for his specialty training in Psychiatry, followed by a fellowship in Child and Adolescent Psychiatry, where he served as Chief Fellow, and was awarded with a Research Distinction. After training, he has worked providing Emergency care, with additional work in inpatient settings, both in mental health and as a consultant to medical units at multiple hospitals. He is currently Board Certified by the American Board of Psychiatry and Neurology in both general Psychiatry, and Child and Adolescent Psychiatry, and by the National Board of Physicians and Surgeons in Psychiatry.

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Marsha Glines, PHD

Marsha Glines, Ph.D – Consult The Expert On Overcoming Learning Challenges

Marsha Glines, Ph.D is the only person on the Center for Treatment of Anxiety and Mood Disorder’s team who is not a therapist or behaviorist – she is an educator who brings a diagnostic standpoint to the Center. Her role is best defined as that of an academic coach. “I believe very strongly that learning should be empowering and meaningful,” she says. “Everyone learns differently and not everyone can learn through traditional classroom methods.”

The frontal lobe of our brain synthesizes and organizes information. “We have more than 100,000 neurons in our brains, so we each receive information differently than anyone else,” Dr. Glines says. “This means we also process the information we receive differently from each other.”

These information reception and processing systems are called metacognitive skills. Figuring out someone’s metacognitive skills tells how the person thinks, which then can help determine their learning strengths.

When an individual has challenges with learning through traditional classroom methods, “My role is how to find the appropriate path to learning for this person. Part of that is really getting to understand the student. This involves analyzing how they look at a problem and adjusting my strategies to help them learn and understand.”

To better recognize how each client learns, she begins by observing the individual and asking questions to help figure out their learning process. In addition, Dr. Glines takes an informal “inventory” of the skills and methods the person has successfully used in the past. Putting this information together gives her a good indication of where the student is in terms of learning.

The process then turns to modifying and experimenting with this information to see what works for the student. “If they are struggling in algebra, for example, we need to figure out how to change up the way they study algebra to make it useful for everyday skills.”

“The goal of my work is to find meaningfulness and purposefulness in how we learn. I help individuals find what their strongest cognitive pathways to their brain are, how to understand these pathways, and how to learn with them,” she explains. Does the client do better by hearing a lecture? Are they a visual learner? Do symbols or colors combine with what they are hearing to help them learn? Uncovering these unique methods makes a huge difference in the person’s understanding and retention of information.

Once Dr. Glines knows these strengths, she creates personalized education plans for what would be helpful for this person’s learning method. To do this, she uses repetition, challenge, novelty, and movement. “Our brains are wired to respond to new things, so changing up our learning method helps us learn and retain information,” she says. “I might teach them how to use symbols to remember something. Tools like mind maps and graphic organizers work well for a visual learner, for example.”

Similar to mnemonics, using tools, such as color coding the papers that students take notes on, can help with processing and retention.

At one point, Dr. Glines worked with students in a Psychology class to help them remember the differences between the pioneers in the mental health field. “These historical figures can all blur together,” she says, “so we discussed what color they thought of when they learned about Freud. Let’s say it was red. They assigned the color red to everything about Freud, even down to taking lecture notes on red paper.”

“Maybe Jung was the color brown”, she continues. “So his information was keyed to everything brown. At test time, when they saw a question about Freud, they recalled that he was red, not brown.” This allowed the students to “see” their lecture notes section in their notebook, which jogged their memory and often allowed them to correctly come up with the answer to the test questions.

Along the same lines, spatial models, symbols, and even acting out the information can function like a mnemonic. “Instead of just thinking in language and words, this is a different way of processing information and memory. It taps into different pathways of the brain’s retrieval system.”

Dr. Glines might also incorporate technology into the student’s learning process. “There are devices like smart pens that can record a lecture as the student takes notes, then lets the student replay that lecture,” she says.

This can be especially helpful for individuals who have learning disabilities. The person may not be able to visualize a spoken word in a text form, for example, which makes taking notes extremely challenging.  A smart pen can record oral notes, however. Later, the student can replay the lecture and even transform it from oral form to written text with the touch of a button. “A student can even tap a word in those notes, which then comes up to show them the meaning of words they find challenging,” she says.

Before any of these non-traditional learning plans can help an individual, though, they need to take ownership of what they value and what is important to them.

“What have you achieved and what do you hope to achieve? These are things you value and every decision we make is based on what we value,” she says. “These answers are empowering. Many people don’t take their school knowledge and think of how to apply it in real life, yet this is what gives ownership to the information we learn. If you can give the topic or subject meaning, you can learn and recall it much better.”

About Marsha Glines, Ph.D. (Academic Coach / Learning Specialist)

Dr. Marsha Glines has a national reputation in teaching and learning theory, special education, non-traditional program design and higher education curriculum development. Prior to joining the Lynn University community in 1991, Dr. Glines was the founding president of Beacon College and in October 2021 she was awarded an Honorary Degree Of Humane Letters from Beacon. While at Lynn University, Dr. Glines created and provided oversight of many academic alternative, innovative programs including: an undergraduate human service degree, the Advancement Program, the Lynn Educational Alternative Program and the “nationally recognized” Institute for Achievement and Learning.

Among her many achievements, Dr. Glines has published several pieces on post-secondary learning opportunities for students with learning disabilities and her work has been discussed in several books. In addition, she has conducted numerous training workshops both nationally and internationally and is a frequent presenter at various conferences on learning and higher education. She continues to teach remotely in Regis College’s undergrad and graduate education departments.

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Getting to Know Anxiety Book Cover

Getting to Know Anxiety

Without a doubt, today’s world is stressful. The end result is that anxiety and mood concerns are now common worldwide and the numbers are skyrocketing.

Written by two mental health experts with nearly eight decades of patient treatment between them, Getting to Know Anxiety describes the basics of anxiety and anxiety disorders in down-to-earth language. In it, Drs. Rosen and Gross offer readers an overview of today’s challenging mental health issues and the most current treatment methods available, as well as practical strategies for mental and emotional self-care.

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woman grocery shopping while wearing a mask

Coronavirus Anxiety In The New Normal

Life during the pandemic is slowly returning to a “new normal.” Here in Florida, we’ve reopened just about everything as long as certain rules are followed and masks and social distancing is used.

While many welcome these new freedoms, some people are either wary of going out or are finding their coronavirus anxiety levels are still too high to consider it. Although the prospect of reopening is both welcomed and scary, there are ways to help reduce your anxiety.

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What is resilience? Resilience is something we all want, few of us practice and most of us have little idea as to what it is. We go through our lives in lock-step dealing with life’s numerous pitfalls and challenges without an understanding of the impact that stress has on our bodies and psyche. Resilience represents an individual’s ability to effectively tolerate life’s stressors, to more effectively “go with the flow” so to speak. To be resilient means that even though we cannot avoid stress we have the capability of actively managing it.

So it becomes quite clear that there is value in better understanding this concept. More importantly, we need to develop the capacity of resilience. For some, resilience may be an inborn trait. These individuals are lucky enough to be born with nervous systems that automatically foster resilience while others may be born with nervous systems that overreact to stress. The pathological worrier when faced with a life challenge may intensify the stress reaction by catastrophic thinking that leads to unhealthy emotional and physiologic reactivity. Those of us with resilience traits should learn how to enhance them while those with limited stress-control capabilities need to find ways to develop such traits.

Simply speaking, resilience is multifaceted. It requires first that we make ourselves aware of how we journey through life. When we are stuck in traffic and find ourselves being late for a meeting or activity, how do we react to this potential stress. We have a choice of fretting over it to the point that our heart rate goes up, stomach acid gets released in larger quantities and our brain fires off alarm reactions. This type of stress further releases unhealthy bodily chemicals like free radicals, brain chemicals that signal danger. It is not uncommon for this to result in back and head musculature contraction leading to tension headaches and backaches. But we also have the choice of placing this stress in a more appropriate perspective by consciously acknowledging that we truly may have no control over the traffic situation, did not cause it and certainly have no way of clearing a path through bumper to bumper vehicles. This does not mean that we shouldn’t feel badly about being late for our appointment and apologize when we get to our destination, but at the same time we don’t need to get ourselves into a tizzy over this. We can further trouble shoot and adjust our departure time if this route is known for traffic jams. Just discuss highway travel strategy with anyone residing in the Los Angeles area!

Resilience is about reasserting locus of control in situations that appear to be beyond our control. A psychological term, locus of control refers to establishing a mindset of control despite the nature of the challenge facing us. This requires being cognizant of how we are dealing with the issue in front of us no matter how vexing it may be. It sounds so simple yet this concept is mastered by few of us. We tend to be engaged in a mindless dance through life without attending to the need to be “present”, to attend to how we are reacting to each step of our travels. The task at hand is to regain the locus of control, to get back into the captain’s seat of life and actively do the best we can under the circumstances.

In reality, resilience is multi-faceted. It is about balance and the conscious decision to attend to the myriad aspects of our daily life journey. There are some simple aspects to this balance. Attending to nutrition, adequate sleep, exercise, establishing a daily routine and maintaining social interactions comprise a core set of basics. Self awareness is an essential component of this balance. However, as indicated earlier in this discussion, self-awareness escapes many of us. For example, how many of us are aware of our breathing? How shallow or deep, rapid or slow? Do we breathe in or breath out through our nose or our mouth? Does it make a difference? Do we inhale by natural downward excursion of our abdominal diaphragm or through the expansion of our ribcage? Research decades ago revealed that diaphragmatic breathing is healthier because it allows for a more robust intake of air than that of ribcage breathing. In fact, a researcher identified what is called the Q reflex or Quieting reflex in response to diaphragmatic breathing. It is no accident that the ancients emphasized the importance of breath work and diaphragmatic respiration as the core of meditation that is today a critical component of Yoga meditation.

Healthy self-talk is another major aspect of resilience development. We all engage is self-talk. Unfortunately, much self-talk is negative and self critical. Becoming aware of this tendency is absolutely essential. It is one thing if the negativity is well earned. We should certainly own up to our mistakes and failures. However, it is more common for self critical thinking to not be based on the facts but emanate from a life of low self regard and confidence, much of it based on unhelpful childhood conditioning.

This brings us to the importance of pursuing mindfulness in our quest to develop resilience. Mindfulness requires attention to our present situation, not just a cursory approach but a comprehensive assessment of the here-and-now. It is much more than our motorist we previously discussed stuck in traffic reacting to being late by getting upset and wallowing in this negative state. It requires an active participation in the event, acknowledging the problem, recognizing the absence of realistic control over the traffic jam, the need to call ahead and alert our destination of the unfortunate circumstance while appropriately apologizing for this situation. Mindfulness also involves taking active responsibility for our self-talk and learning how to develop more effective filters for the negativity that invades much of our personal internal banter. This ability can be learned and must be practiced regularly to become more of an automatic process. The ability to clear one’s mind of negativity becomes one of the finest gifts that we can provide for ourselves. Successful meditators will tell you about the bliss they encounter when they are able to empty their minds of non-essential thoughts.

Finally, we cannot have a discussion about resiliency without understanding the concept of emotional dysregulation. It turns out that the human psyche is composed of two operating systems. We are all aware of the two popular computer operating systems, one that runs Apple software and the other Microsoft software. The human operating system that we are most aware of is composed of words that result in language based communication. This particular system is based on logic. It is what this article utilizes as you read it. However, parallel to this operating system is one that is based on emotions. Emotions are not easily defined using words or language. Emotional expression is by its nature illogical. It is most important to understand that the operating system that governs emotions is extremely powerful and often gains control over our logical language-based operating system. Abusive relationships, addictive behaviors, impulsive and rash life decisions are examples of the dominance of emotions over logic.

Our challenge becomes one of regaining control over our emotional being. The first step in this process is to becoming mindful of our emotional production and not allowing emotions to run amok without conscious awareness. Once we can recognize problematic emotions we have the ability to modify and channel them in a more helpful manner. One can actually learn the skillsets necessary to control the emotional operating system and with practice incorporate them into our daily existence. Dialectical behavior therapy (DBT) a component of cognitive behavior therapy (CBT) has been a major advance in addressing the painful human toll of emotional dysregulation.

The twenty-first century has its own unique challenges and stressors to say the least. World events, internet connectedness, social media pressures and information explosiveness make our reality more complex than ever before. Fear not, for even though one may not be born with innate resilience it is possible to nurture this capability. However, this is not a passive process. It requires hard work and introspection often involving the assistance of a trained mental health professional. The benefits of resilience are immeasurable and certainly worthy of our efforts and hard work. Good luck!

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Facts About Obsessive Intrusive Catastrophic Thoughts

Facts About Obsessive Intrusive Catastrophic Thoughts – South Florida Mental Health Counseling

Anxiety is a normal part of life. We all feel it at some point when we have a major test, interview, meeting, or some other important occasion approaching. For people who suffer from an anxiety disorder, however, this develops into an excessive, irrational dread of everyday situations to the point that it cripples the person’s lifestyle.

At the heart of most anxiety disorders are obsessive intrusive catastrophic thoughts. These are scary, intrusive thoughts and/or images that occur over and over. The more the person tries to stop them, the more they persist. Like anxiety, the average person experiences these types of thoughts at one point or another. However, for those with anxiety disorders such as obsessive compulsive disorder or depression, these thoughts become paralyzing, panic-provoking, and unrelenting.

Dr. Andrew Rosen, a South Florida mental health professional notes that there are three categories of obsessive thinking and intrusive thoughts:

  • Inappropriate aggressive thoughts or violent obsessions about harming others or oneself. Like many other intrusive thoughts, this is a part of being human, but for many they can become severe or distressing to the point that a person may be afraid to perform their typical daily functions.
  • Inappropriate sexual thoughts or images regarding intimate actions with strangers, acquaintances, family, friends, religious figures, or any number of other people. These thoughts often lead to confusion, guilt, shame, or self-loathing.
  • Irreverent religious thoughts that compel a person either toward acts they consider sinful or toward obsessive religious actions. A person crippled by these thoughts might feel a disturbing fear of reciting prayers incorrectly, or be tortured by the urge to perform blasphemous acts during religious rituals.

If you or someone you know is dealing with obsessive intrusive catastrophic thoughts that have begun to obstruct their normal way of life, it’s important to seek help. Counseling for obsessive thoughts can include exposure therapy or cognitive behavioral therapy. Your South Florida mental health professional may also suggest combining therapy with medication depending on your individual situation. Without treatment, a person with this level of intrusive thoughts can eventually find themselves cut-off from their friends and family. But seeking treatment can help initiate a return to normal life.

For more information about mental health therapy in South Florida or for help in dealing with obsessive intrusive catastrophic thoughts, call Dr. Andrew Rosen and The Center for Treatment of Anxiety Disorders in Delray Beach, Florida. They can be reached by calling 561-496-1094 or by emailing Dr. Rosen and The Center today.


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