One of the most difficult parts of raising a child with autism is the fear of losing them. For my son, the combination of intelligence, impulsivity, and an inability to comprehend danger results in my family living in a constant state of hypervigilance and fear. When we go out, there is always the possibility he will try to run away. When we’re home, there is the fear that he will get out of the house. Our family has addressed this issue with an ability to think “outside the box” and one step ahead of our 14-year-old son, Ben.

1. Under lock and key
The most obvious way to keep a child safe at home are locked doors. We learned the hard way that deadbolt locks with a switch that can be turned by hand was only effective until he was 6 years old. One day he unlocked it and wandered out of the house while I was only one room away. Luckily, I caught him in time before he was halfway down the street. We switched to locks with keys and installed them on every door leading to the outside, my laundry room, my daughter’s bedroom, and our master bedroom. They are all master keyed so that our house key opens them all. In addition, we don’t keep our keys hanging next to the door. It’s inconvenient, but that’s the point.

2. Keeping watch: tag, you’re it
Another safety trick we use at home is something I learned from a life guard. While attending a beach outing for kids with special needs, they handed out lanyards with laminated cards that said “I’m Watching” on one side and had emergency first aid information on the other. This was to ensure that when there is a group of adults hanging out watching their kids play in the water, the parent wearing the lanyard is responsible for watching the child. This made me think about our own situation at home, where too often, my husband thought I was watching Ben while I assumed he was. This situation leads not only to missing kids but also to marital strife. So, we put the keys to the house on a lanyard, and the designated Ben-watcher wears it at all times. This way, when one of us needs to use the bathroom, we literally hand off the lanyard to the other person.

3. Tracking devices, helicopters and bloodhounds, oh my!
One of the most frustrating things about staying one step ahead is that we often don’t think about something until it presents itself as an obvious problem. Even after we changed the locks and donned our key lanyard, Ben’s safety was still not guaranteed. Last year, our greatest fear became a reality when Ben climbed our 6-foot privacy fence with the speed and dexterity of a tomcat. The person watching him was only a few yards away and watched him do it but could not reach him fast enough. He disappeared into the woods for 3 hours and was found with the aid of search helicopters and bloodhounds just before the sun set; he was cold, wet, and shivering.
After that incident, we obtained a tracking bracelet from our local county sheriff’s department that Ben wears on his ankle at all times. In the event that he ever goes missing, we can contact the police, who will find him using the radio signal from the device, rather than alerting the local news and calling the search cavalry. And from what they tell me, as long as the device is checked regularly and in working order, it doesn’t take 3 hours to find someone with this device.

4. Out and about
Parents of children with autism spectrum disorder know how difficult it can often be to take our children out into the world. A simple trip to the grocery store can become disastrous in no time flat. When our kids get overstimulated or can’t communicate, tantrums ensue and we often have to make a quick exit, while not making eye contact with fellow shoppers and store employees. Ben’s Houdini-like skills have also extended outside the home; school, stores, and Grandma’s house have all been settings for a “Ben Escape.” One thing we do now when going out is use a wheelchair with a seatbelt. Because of Ben’s sensory issues and difficulty transitioning, the wheelchair provides a secure, safe place for him to sit as well as the emotional stability of his seat remaining the same while his environment changes. Portable door alarms have been helpful on the rare occasion that we stay at a hotel. We’ve even been known to stack some of the hotel furniture in front of the door, from floor to ceiling, providing a barricade that would make a lot of noise if he tried to get past it. We’ve done the math, and we’re statistically more likely to lose our son than to have to evacuate in a hotel fire.

5. Vaseline
Yes, you read that right; Vaseline. Good old petroleum jelly became my best friend after Ben’s 3-hour tour of the woods. I needed a way to keep fence-hopping to a minimum, and apparently barbed wire is frowned upon by our home owners association. So, several jars and a very icky fence top later, the problem was solved. If having an autistic child in the drug-store line doesn’t solicit enough curious glances from fellow shoppers, nine extra-large jars of Vaseline is sure to.

For more information about wandering and a free box of safety materials, contact the National Autism Association at http://nationalautismassociation.org/big-red-safety-box/

Related articles:
The Difference 1 Makes: Reflections on the CDC Autism Rates
Autism on the Rise: Are We Prepared?

Irritable bowel syndrome (IBS) is a relatively common condition that results in abdominal discomfort, bloating, diarrhea, and constipation. According to the Mayo Clinic, IBS develops more often in women than in men and is also more likely to develop before the age of 35. Unlike other diseases that affect the intestines, IBS causes no permanent damage and does not appear to increase the risk of colon cancer. Mild and moderate cases of the condition can often be managed with lifestyle changes rather than medication. In more severe cases of IBS, certain prescription medications have been shown to reduce symptoms and improve quality of life.

Tricyclic antidepressants, the so-called first generation of antidepressant medications, have for years been prescribed to people with serious cases of IBS. There are several competing theories as to why these medications work so well for this condition. On the one hand, tricyclics have pain-relieving properties as one of their secondary effects. Less pain may lead a patient to report symptomatic improvement, particularly if pain was his or her dominant complaint. Another theory maintains that IBS is somehow linked with depression, and a reduction in the symptoms of depression may simultaneously reduce symptoms of IBS. The connection between mental state and IBS is not well understood and demands further research. Yet a third theory maintains that tricyclics alter the way the brain processes nerve signals from the intestines. This may lead to a more relaxed colon or less urgent or painful feelings when having a bowel movement.

Clinical researchers in Belgium surmised that newer antidepressant medications might be just as effective against IBS as the older tricyclics, with potentially fewer adverse effects. They conducted a trial with Celexa (citalopram) to determine its usefulness in managing IBS symptoms. Celexa belongs to the class of antidepressants known as selective serotonin reuptake inhibitors. What little research has been done on these medications and IBS has been promising. An earlier study showed that Celexa works to relax the colon shortly after food consumption, a possibly therapeutic action for anyone with IBS. The most recent study involved a crossover design with a placebo-controlled group. After an initial treatment period, the groups switched places for a second treatment period. Participants kept daily journals of their symptoms, and examinations during the trial provided empirical data. The results were significant but not as informative as the team had hoped. Celexa did lead to improvement of many symptoms but not bowel regularity. Interestingly, most participants reported a much improved sense of well-being that did not always match their objective symptom improvement. This suggests that Celexa’s psychotropic properties may have as much to do with its effectiveness on IBS patients as anything else.

Other studies with a similar approach have produced mixed results. The lesson here, according to the researchers, is that the emotional health and well-being of IBS patients cannot be neglected. A pharmaceutical solution is often sought when lifestyle changes and talk therapy might be more beneficial without the risk of side effects.

References

1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Citalopram.  Retrieved March 10, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001041/
2. MayoClinic.com. (n.d.). Irritable bowel syndrome. Retrieved March 13, 2012, from http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106
3. Tack, J., Broekart, D., Fischler, B., Van Oudenhove, L., Gevers, A.M., Janssens, J. (2006). A controlled crossover stud of the selective serotonin reuptake inhibitor citalopram in irritable bowel syndrome. Neurogastroenterology, 55, 1095-1103.

Probation officers assume a large level of responsibility for the offenders in their care and the community at large. They are responsible for monitoring criminal offenders and assessing what level of risk they pose to the general public. When offenders commit an infraction, such as a technical violation of not meeting the conditions of their probation, it is up to the probation officer to manage that infraction and ultimately decide the consequence. Individuals who struggle with mental health issues such as depression, schizophrenia, and bipolar account for a large percentage of offenders. Unlike offenders with substance abuse problems, the main cause of reincarceration for mentally ill offenders is a technical violation, not a new criminal offense. Research has shown that in fact, mentally ill offenders are just as unlikely to commit a new offense as are offenders with no history of mental illness or drug abuse. But unfortunately, mentally ill offenders are monitored more closely and assessed more harshly than substance abusing offenders.

Jennifer Eno Louden of the Department of Psychology at the University of Texas recently conducted a study to better evaluate the conditions by which probation officers assess and manage mentally ill offenders. Her goal was to determine whether these offenders were being unfairly assessed, resulting in increased rates of reincarceration. Louden enlisted 234 probation officers and presented them with probation violation scenarios committed by a mentally ill offender, an offender with substance use issues, an offender with both problems, and an offender with neither. She evaluated their risk assessments and management recommendations and found that even though statistics show substance users as more likely to engage in violent acts, the officers rated the mentally ill offenders as being 13% more likely to commit acts of violence.

The primary risk management strategy recommended by the officers was forced psychological treatment, usually in the form of medication. Although mental health treatment is not a negative recommendation, forcing the treatment is seen as a cause for concern. For these individuals, many of whom have schizophrenia, the negative side effects of medication can cause more harm than good. The goal of treatment was not helping the offenders address their mental health problems but rather managing their behavior; however, it did not help them decrease their chance of reoffending. Louden believes this study demonstrates the need for further training and education for probation officers who work with mentally ill offenders. She said, “By targeting interventions away from a sole focus on mental disorder toward robust predictors of recidivism, real improvements can be made in the criminal justice outcomes for offenders with mental disorders.”

Reference:
Eno Louden, J., Skeem, J. L. (2012). How do probation officers assess and manage recidivism and violence risk for probationers with mental disorder? An experimental investigation. Law and Human Behavior. Advance online publication. doi: 10.1037/h0093991

Whether or not we believe we should talk about sex with our therapist in treatment may have something to do with what we believe therapy is for or what the expected outcome is.

Are you going to therapy for a relationship issue? For a mental disorder such as depression or anxiety? To overcome trauma? Or because you are having a difficult time adjusting to a new situation? Therapy is useful for a multitude of issues, and no, sex may not be the most significant thing affected by a particular issue, but it definitely doesn’t hurt for the therapist to ask about it, to allow for the conversation to include some open, honest discussion not just about sex but also about sexuality, to at least let the client know it is okay to bring up the topic of sex in the therapist’s office.

Pervasive in our society is the inability to talk about sex, awkwardness, and embarrassment, which in turn leave us often bereft of the coping skills required to handle sexual issues in our relationship as they come up. When we avoid talking about sex with our partners, it can lead us down the path of avoiding talking about lots of other things as well. We all know that open, honest communication is key in successful relationships, so the absence of conversation and inability to talk about sex with our partners can be like a ripple effect in the breakdown of communication in a relationship.  And when we go to therapy and our therapist also doesn’t feel comfortable talking about sex, the therapist in turn perpetuates what society has taught us—that sex is too taboo to talk about. This may be okay for some, but not for all. Some people want a more comprehensive experience.  Some people want more than just a quick fix for their problems. Some people want to address the problems at their root. Some people want real change and real growth.

In treating relationships, sex must be addressed. Sex is not always everything, but in relationships it is definitely something. Most therapists treat some aspect of relationships. Even when an individual comes in for treatment for depression, anxiety, trauma, a new life situation, etc., if the person in therapy is involved in a relationship, or is dating, or even if they are single and celibate, a few questions encouraging open, honest communication about any concerns he/she has about sex can make all the difference in the world. Therapy should be a nonjudgmental safe haven where an individual can work stuff out, ask questions, and find answers. An avoidant therapist who is uncomfortable talking about sex sends a subtle message that can perpetuate feelings of shame, guilt, or embarrassment about sex, which in the end thwarts growth. Therapy should promote growth, not thwart it.  In couples therapy, it is absolutely pertinent to ask about sex.

Feelings about our sexuality and our bodies are core in our lives. Many people walk around feeling bad about their desires or fantasies. Shame and guilt about sex are extremely common, and people have very little awareness of this. If a self-loathing, self-hating, guilt-ridden client comes to therapy, is it not best to address where the feelings come from? A client may not be that aware of the root of the problems. It is important for the therapist to open the door for exploration and discussion.

Therapists do not even have to be especially knowledgeable about sex. In fact, therapists rarely know anything about what the client has experienced, in terms of sex or any other aspects of the person’s life. Therapists are trained to ask questions in order to understand the client’s experience. The client is the expert on his or her experience. A therapist’s job is to ask questions and provide a nonjudgmental environment to foster the client’s growth.  In looking at it from this model, therapists do not need to be well-versed in something to be open about it.

Therapy is a holistic health treatment that is helpful in guiding people to lead happier, healthier, genuine, and more honest lives all the way around. In therapy we attempt to break down the road blocks that prevent us from moving forward on our life journey, whether it be in our relationships at work or with our friends, family, or partner. Many psychological issues have a physical manifestation. It is important to remember that a sexual issue may be a representation of something bigger, stemming from depression, anxiety, or a relationship problem. We cannot treat problems in a vacuum. Mind and body are connected. When you leave sex out of treatment, the client’s journey remains incomplete.

Related articles:
Sex Talk
The Importance of Addressing Sexual Issues in General Therapy
The Elephant in the Room: Why We Need Full Disclosure in Sex Therapy

Love and compassion are necessities, not luxuries. Without them humanity cannot survive. -Dalai Lama

In life we encounter many different experiences. Some are joyful and uplifting, and others are painful and challenging. When we encounter joy, there is a yearning to have it last forever, but when there’s pain our first reaction is to avoid, ignore, or push it away. When we react to joy or pain with any form of resistance—clinging to joy, pushing away or ignoring pain—we suffer. What helps us walk through our suffering and the suffering of others is to become aware of when we are reacting to pain and learn to transform this reaction into a compassionate, caring response.

Cultivating a Compassionate Response

My first encounter in learning to confront suffering with compassion was many years ago, when I held a position as an intern at a center for survivors of domestic violence. In this environment, I learned a great deal about extreme suffering, as the women I encountered lived in a hostile, aggressive, and sometimes dangerous environment. In the beginning I felt overwhelmed just trying to learn how to help people deal with life-threatening, painful situations while remaining objective. Working in this setting was stressful, and I recall leaving the center in tears as I watched clients return to hostile and oftentimes dangerous situations. It brought up deep feelings of helplessness, frustration, and judgment.

[fat_widget_right]

In helping these survivors, my initial reaction was to try and fix, change, or in some way rescue them. This was a reactive response as I was trying to get the pain (theirs and mine) to subside, and guess what? It didn’t work! It only increased my own feelings of helplessness and didn’t create the supportive, compassionate environment that promotes healing and empowerment. Luckily, I had a compassionate, patient, and wonderful supervisor who taught me that providing a nonjudgmental presence, connecting with an open heart, and having compassion towards the person, and myself, as I listened to their stories was what healed. This meant I had to let go of trying to control the outcome and allow myself to be present with their pain and my own. It was a growth experience that continues to help me in my professional and personal life.

Opening Heart and Mind Helps Connect and Heal

Running groups for survivors of domestic violence, I hear stories about physical, emotional, and verbal abuse. These stories are traumatic and heart-breaking. They all share a common theme of fear, loss of identity, and confusion. The shared experience of having to set aside their needs in an attempt to meet the needs of a controlling partner, whose wants and expectations are insatiable and unrealistic, left them with a sense of low self-worth, shame, and suffering. What helps them heal and become empowered is their ability to let go of judgment, share their stories in a supportive environment, and learn to develop a practice of self-care and compassion.

What Gets in the Way of Compassion

As we travel through life we will encounter pain. It might be through the loss of a loved one, the end of a relationship, or recovery from a severe illness. Or perhaps it’s the small stuff that brings up feelings of shame, inadequacy, or worthlessness. When this happens, the tendency is to get lost in judgment; we beat ourselves or others up in an attempt to stop the pain. This only intensifies our suffering. Caught in this reactive response we forget that there’s a real need to treat ourselves with kindness, love, and compassion. When we turn towards suffering with compassion it helps us heal and reconnect with life.

The Practice of Compassion

In helping people learn the skill of transforming reactivity into a compassionate and caring response, I use the example of a hurt child or a pet. I ask them how they would help a child who is sad or a pet that is hurt. What would that response look like? They usually state they’d give the child or pet a hug and comfort them with kind words or a gentle touch. Our deepest need, when we are in pain, is compassion; this is what helps us heal. It is not a luxury, it’s a necessity! This turning towards pain, with an open heart and the intention to heal, is what helps us to live life fully.

Developing Self-Compassion

Becoming aware of when we are reacting or in any way judging ourselves is the first step. The second step is to become present with how our bodies, minds, and hearts are responding to the experience of pain. Setting an intention to be kind towards ourselves and let go of reacting is what helps us to connect with compassion.

The following are some steps you can take towards developing a caring and compassionate practice:

1. Awareness is the first step! Notice when you are reactive or triggered. Your body sends signals when reactivity happens. You might feel blood rushing to your face or a tensing up of the hands or body. Your breathing may be shallow and your thoughts may be filled with judgment.
2. Connect with the present moment by letting go of thoughts and focusing on the sensation of the breath as it comes in and out of your body, or focus on feeling the ground beneath your feet. This helps to slow down reactivity and calm the mind.
3. Place your hand on your heart in acknowledgment of the difficulty you are facing in this moment. Imagine the placing of the hand on the heart as symbolic of opening the heart to compassion or sending healing to the hurt place inside.
4. Visualize yourself held or embraced by a spiritual figure or someone who loves you.
5. Allow yourself to take in the healing sensation of compassion until you feel calmer and more connected to the present moment.

When we allow ourselves to care for ourselves and others, it is a profound act of kindness that refills the heart, energizes the body, and nourishes the soul. In that moment of opening our hearts to self and others, we recognize the immense healing power of compassion and reconnect with life and love.

May you be free from suffering.

May your heart be filled with compassion.

Healthy conflict resolution is essential to maintaining positive and constructive adult relationships. Individuals usually learn how to handle conflict in childhood. Children watch the way adults work through disagreements and model those patterns of behavior as they develop into adults and begin to form relationships with others. The bonds that children have with their caregivers also influence the way in which they address conflicts. People who have secure attachments with their parents and caregivers are often able to work through challenges with other people in respectful, affectionate, and loving ways. They are capable of recognizing when they need to ask for forgiveness and are willing to compromise to achieve a resolution that is mutually satisfying to all involved. Individuals who have insecure attachments, however, are often unable to handle situations as amicably. Insecure attachment can be expressed through avoidant or anxious behaviors. People who are avoidant in nature tend to withdraw and shut down when faced with conflict. Anxious individuals may demand attention, even negative attention, and use aggressive and hostile tactics to engage someone in a conflict dispute.

For children who have grown up witnessing dysfunctional conflict resolution strategies, having a secure attachment with others could help them avoid making the same mistakes of their parents. Rather than continuing the negative behaviors they have seen displayed by their own parents, these secure, self-reliant, and confident people may choose to use healthier mechanisms to maintain harmony in their adult relationships. Joyce A. Baptist of the School of Family Studies and Human Services at Kansas State University wanted to better understand how attachment style affected emotional processing learned in families of origin. She enlisted 203 young adults who had been raised in families with various emotional functioning styles for a study that evaluated how the adult children managed conflict.

Baptist found that the participants who had witnessed extreme disengagement in childhood were more likely to use aggressive and antagonistic disagreement strategies in adulthood. The most anxiously attached individuals in this group were the most apt to engage in hostile behaviors as their anxiety escalated. Those with minimally avoidant styles worked through disagreements in a more civil way. Baptist believes these results suggest that secure attachments can help protect individuals from dysfunctional and destructive conflict resolution patterns. These findings could impact how professionals assist people who have communication and compromise problems in their adult relationships. She added, “Considering the interrelations between emotional processing in families of origin and insecurities in attachment will allow therapists to better identify and treat the root of the destructive conflict behavior.”

Reference:
Baptist, J. A., Thompson, D. E., Norton, A. M., Hardy, N. R., Link, C. D. (2012). The effects of the intergenerational transmission of family emotional processes on conflict styles: The moderating role of attachment. American Journal of Family Therapy 40.1, 56-73.

Despite decades of research and several new classes of antidepressant medications, successful treatment of depression is still an elusive goal. In particular, people with major depressive disorder (MDD) often fail to respond to the first line of treatment or relapse after a short period of recovery. The search for new therapies and combinations of therapies is ongoing. Recently, the antipsychotic medication Abilify (aripiprazole) has been prescribed as a secondary treatment for MDD patients, often with positive outcomes.

Originally designed as a treatment for symptoms of schizophrenia and other psychotic disorders, Abilify’s usage has expanded widely in just a few years. Now, doctors are prescribing this medication for conditions ranging from bipolar disorder to certain forms of autism. Like all psychotropic medications, Abilify works by altering the balance of chemicals in the brain called neurotransmitters. Several of these neurotransmitters, including serotonin and dopamine, are largely responsible for a person’s emotional state. Abilify has demonstrated great potential to stabilize emotional states for a wide variety of patients. This includes the capacity to reduce anger and aggressive outbursts, which is why its original usage was for psychotic patients.

In 2007, the Food and Drug Administration approved Abilify as a supplementary treatment option for patients with MDD who were already following a course of traditional antidepressants. Several clinical trials and controlled experiments have demonstrated that Abilify may offer a “boost” to the mood stabilizing attributes of antidepressants. At the same time, Abilify may work to offset some of the more unpleasant side effects of these drugs, such as sexual dysfunction.

In addition to its effectiveness as a supplementary therapy, clinical trials and tests indicated that Abilify is a relatively safe and well-tolerated medication in depressed patients. The most commonly reported side effect associated with the medication was restlessness. Rarely was this side effect bothersome enough to cause the patient to discontinue taking Abilify.

Millions of people experience the debilitating symptoms of depression every day. Nevertheless, a reliable cure or even a more effective treatment for depression is likely still many years away. Because the brain is the body’s most sophisticated organ, understanding how best to restore the proper neurochemical balance is difficult. Discovering the most successful early treatment options is therefore important in reducing relapse and improving long-term outcomes.

References

1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Major depression. Retrieved February 20, 2012. Available from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001941/
2. Pae, C., Forbes, A., & Patkar, A. A. (2011). Aripiprazole as adjunctive therapy for patients with major depressive disorder. CNS Drugs, 25(2), 109-127.

Racism and prejudice are issues that are at the forefront of social concern today. Ethnic differences are causing riots, uprisings, and loss of life in nations throughout the world, including our own. Classic conditioning is a theory that suggests that individuals learn racism and prejudice through exposure to events by either experiencing them personally or observing them. Once a perspective is formed, it can be reinforced through continual verbal, visual, or actual cues. For instance, a person who has a fearful encounter with someone from another race may later see others exhibit fear, thus reinforcing their opinion and prejudice of that race. Likewise, this effect can be reversed if this same person goes on to experience positive situations with people of the other race. Either way, discrimination and prejudice are learned at a very young age and unless it is reversed, can lead to significant stress and anxiety. People who are discriminated against based on their religion, race, or sexual preference often face obstacles in many areas of their lives. Finding a career, a job, or school can be a challenging experience for people who are faced with prejudice and discrimination.

To identify how different ethnic groups learn racism and how it is perceived across different races, David Rollock, Associate Professor of the Department of Psychological Sciences at Purdue University, recently conducted a study involving participants who were African American, White, Asian, and Hispanic. The 282 participants ranged in age from 17 to 61 years old and responded to a questionnaire that asked them about their experiences with prejudice. They were instructed to report their emotional responses to various interracial encounters, positive and negative.

Rollock discovered that the White participants had the strongest negative emotions as a result of bad interracial experiences, while other races experienced lower levels of negativity. The findings also showed that Whites reported fear as the most common response to negative interracial experiences, regardless of whether they were verbal, observed, or physically experienced. Whites and African Americans had similar levels of anxiety, but these levels were much lower than levels found in the Asian and Hispanic participants.

Although all the participants exhibited anger as a result of interracial experiences, it was minimal. Rollock also found that some of the participants had positive interracial experiences that decreased their prejudice, but the effect was minimal. Rollock added, “Interestingly, people from different ethnic and sex groups did not appear to ‘learn’ their adverse race-elicited emotions in different ways, suggesting that strategies that build or reduce adverse race-elicited emotion for members of one group should be similarly effective with other groups.” This finding could help clinicians who are dealing with victims and perpetrators of racial intolerance. By understanding that the mechanism that leads to prejudice and racism is similar across all races, mental health professionals should be able to help most people overcome these obstacles, regardless of their ethnicity.

Reference:
Conger, A. J., Dygdon, J. A., Rollock, D. (2012). Conditioned emotional responses in racial prejudice. Ethnic & Racial Studies 35.2, 298-319.

If you want to make God laugh, tell him your plans.
-Woody Allen

No matter who you are, things will happen that throw you off-kilter. Life intrudes on inner peace with an uncanny regularity. It may be your boss, spouse or partner, children, house, parents, finances, health, or even a freaky weather event, but life has its own trajectory, and no one can know what new challenge awaits.

Luckily, there are many ways to regain equilibrium. Trial and error, plumbing your depths to see what really works for you, and discerning the differences between various situations that trigger your sympathetic nervous system—your fight or flight reaction—are all very helpful in developing an emotional first aid kit.

When you find you have strayed from your center, allow the imbalance. Just notice what is going on emotionally, physically, and mentally. What are you telling yourself about this experience? Are you ready to regroup, or do you need a bit more time to explore what is happening? Sometimes, the hardest thing is allowing yourself to totter emotionally, to grieve or feel angry, overwhelmed, or exhausted. Whatever is happening, it won’t last.

Ten Tips For Emergency Emotional First Aid

Since it is easy to get thrown off-kilter when you are shocked or surprised by unwelcome news, you may want to try these techniques as first responses:

1. Take slow, deep breaths, and allow a little extra time to exhale.
2. Remind yourself that this, too, shall pass.
3. Allow space for all of your feelings.
4. Have faith in yourself. The truth is that you can handle more than you might believe at this particular moment. You can use prayer or meditation for added support and to access your belief in a greater power.
5. Don’t take anything personally.
6. Try to stick with your routine, even if you are feeling dazed or numb. Having a routine will anchor you.
7. Eat, sleep, and get some fresh air.
8. Picture your 6-year-old self, and lovingly embrace that child. Gently reassure the frightened little being inside.
9. Connect with someone, such as a friend or family member, a therapist or neighbor, even a stranger on a local hot line.
10. Understand that you are here for everything, good and bad. Visualize yourself as a river of experiences, and let life flow without judgment.

Reading this list takes only a few minutes, but actually working through each item builds resiliency and will help you keep going, one second at a time. Sometimes, just existing during a traumatic experience is the best you can do and remembering that as time passes, your perspective will change. For now, it is best to accept the present, do what you can, and choose to believe everything is happening for your highest good.

If or when you are ready to re-center, reach out to a trusted friend, relative, clergy person, or therapist. Speak honestly and openly. Being heard and understood is one of the most bonding, loving, and freeing experiences you can have, but you have to ask for help. If this has been hard for you in the past, break out of your old rut of being super-independent and pick up the phone. Find a therapist in my area.

If company doesn’t fit the bill, try some solitude. Silence can be soothing and afford you the opportunity to integrate what you have experienced. If that feels overwhelming, try a guided meditation. There are numerous free podcasts on iTunes, like Meditation Oasis, A Quiet Mind, or The Meditation Podcast. If you have the time, try a soothing Yoga Nidra practice—this is a guided practice of yogic sleep, where you are in the liminal space between waking and sleeping, and involves no knowledge of yoga postures. (My favorite is available free from iTunes through Elsie’s Yoga Podcast, episode #62.)

Take a bath with Epsom salts and lavender oil. The magnesium sulfate in the salts will quiet any muscle tension, and the essential oil—about six to eight drops—will calm your mind and act as a pain reliever.

Read something inspirational. Try some poetry, or escape with a novel. Reading is both relaxing and engaging. If audio books work better for you, check some out from the library and download them to your iTunes so you’ll have a ready supply.

Music really can soothe the savage breast, as the playwright William Congreve suggested in the late 17th century. Find something that works for you: it may be hard rock, or hemi-synch. Sanskrit chants can be remarkably helpful, as they bathe you in mantras designed to calm your nervous system. Chanting them yourself will bring even greater benefits, as making the sounds activates different parts of the mouth that correspond to different areas in your brain. The simplest one is om, a sound that is said to embody all sounds.

Moving your body takes the kinks out emotionally, too. Even if the last thing you feel like doing is dancing, yoga, or taking a walk, just do something for five minutes as an experiment. If you feel better, do another five minutes.

Allow nature to work its magic. Dr. Samuel Hahnemann, the father of homeopathic medicine, wrote that eating well, sleeping enough, and getting fresh air are essential to good health, mentally and physically. Don’t underestimate their value.

Rebalance with a favorite ritual, like making yourself a cup of tea and sipping it slowly.

Psychotherapists and clients who are working with issues of dissociation talk about being grounded a lot. What we usually mean by grounded is the experience of feeling present and aware in our bodies and being able to interact with the world around us with a clarity of our senses. There are even formulas that seem to have developed for how to be present—“feel your feet on the floor, your butt in your chair, and breathe.” Sometimes this is enough, but often it’s not.

Moving your body is a much faster and more reliable method for becoming grounded. Although movement in general is often helpful for restoring awareness to the body and breaking free of dissociation, centered and well-organized movement is even more useful.

Try the following experiments to see if you can notice the benefits of grounding movement:

1.  Jump up and down and side to side while waving your arms wildly. What was that like for you? What did you notice physically and emotionally, both during and after the exercise? How satisfying was that?
2. Now try standing with your feet shoulder width apart and begin rotating in your hip joints. Twist side to side, letting your arms follow the movement of your torso. (Some people find it helpful to imagine that they are a washing machine). What was this like? What were your physical and emotional sensations? Did you find this movement satisfying?

People typically report that the second exercise helps them bring their surroundings into focus and reduces anxiety and fearfulness. They feel more grounded and less dissociated.

This works because it offers an organized and nonthreatening way to quite literally expand the body and bodily awareness.

Dissociation is a flight response to a perceived threat. Checking out, via either partial or total amnesia, or switching into another part of the self, makes awareness of the threat disappear. This is a very handy skill for small children who are not able to adequately protect themselves. This is less useful for adults who have developed habits of dissociating—whether the threat is present in the moment or remembered.

The problem with dissociation is that adults, who are capable of protecting themselves, lose access to that protective ability when they split. As a colleague of mine likes to say, if there’s a tiger in the room and you pretend it’s not there, that doesn’t actually make the tiger disappear. Dissociation doesn’t make you more safe, and it actually makes you less safe.

But, clients often tell me, if I don’t dissociate and I choose instead to be present, then I’ll be stuck in my fears—how does being petrified make me any safer? Good point, I reply. They’re right, after all. Being frozen with fear is not any more effective than dissociating is for dealing with that oncoming tiger. What is effective for safety is being present and grounded.

Here’s another experiment you can try which demonstrates this point:

1.  Imagine that you’re afraid. It might help to recall a time when something scared you—perhaps a loud noise, a spider, or something else that frightened you a little bit. Notice what happens in your body (pay attention to your breathing, posture, and points of tension).
2. Now imagine that you’re safe and satisfied. Pull up a memory of an experience of being warm and secure and loved. What’s going on in your body this time?

In general, people report that when they’re afraid, their bodies constrict and collapse, their stomachs tighten, breathing becomes shallow, jaws clench, and they notice tension in their arms, chest, legs, and/or back. When doing the second exercise, they typically feel their bodies open up and relax.

The feeling of safety is a lot like the feeling created by the washing machine exercise at the beginning of this article. This suggests that being present in our bodies is the path to safety. Instead of having to only choose between dissociation and petrifaction, people working with dissociation can make use of movement to come into a state of groundedness and safety.

Childhood emotional maltreatment (CEM) can have lingering effects. Adults who suffered mistreatment as children often struggle emotionally and socially throughout their lives as a result of being neglected or emotionally abused. Although there is an abundance of literature and research that focuses on the negative impact of childhood maltreatment (CM) in general, there is little available clinical evidence documenting the devastating effects of CEM. It has been well established that CM, including sexual and physical abuse, can increase the risk for depression, anxiety, substance misuse, and a host of other emotional problems. However, for adults who experienced CEM, one of the most difficult challenges they face is cultivating a healthy romantic relationship.

CEM can significantly deteriorate one’s self-esteem and erode an individual’s ability to trust another person. Beliefs about one’s value and worth and a bond of trust are the foundation of a healthy intimate relationship. This foundation can be further compromised when CEM survivors exhibit body-image dissatisfaction, which is often manifested through disordered eating behaviors. To provide more detailed evidence of the long-term consequences of CEM on relationships, Dana Lassri of the Stress & Risk and Resilience Research Lab at the Department of Psychology at Ben-Gurion University in Israel examined the stability and satisfaction of intimate relationships in a sample of college students with a history of CEM in two separate studies. Lassri found that CEM directly impacted relationship fulfillment in the participants by way of self-criticism. Specifically, Lassri discovered that the participants with CEM had extremely low levels of self-value, exhibited difficulty coping with stress, and held negative attitudes about life events.

[fat_widget_right]

The results also revealed that the individuals who had posttraumatic stress due to the CEM were less able to realize their self-worth and had significant problems maintaining relationship satisfaction.  This could be caused by internalizing behaviors due to the abuse or by a child’s inability to properly comprehend their circumstances. Either way, Lassri believes that even though these findings were gathered from college-age individuals, the behaviors could potentially worsen throughout adulthood. Lassri added, “Over time, this tendency might be consolidated, becoming a defining part of a person’s personality; and ultimately derailing relationships in general and romantic relationships in particular.”

Reference:
Lassri, D., Shahar, G. (2012). Self-criticism mediates the link between childhood emotional maltreatment and young adults’ romantic relationships.” Journal of Social and Clinical Psychology 31.3, 289-311.

A dear friend was telling me the other day about a bumper sticker that had symbols of some of the world’s religions and writing that said “coexist.” What a shame that as we approach the start of the Easter/Passover season, in which many of the world’s believers participate, people are far from accepting the right of others to worship as they see fit without judgment or condemnation. Why is it that many people feel that their religion is the one true way to believe in and connect to God?

I can only speculate from my perspective as psychotherapist and Yoruba/Lucumi priest. Here are some random guesses.

• This attitude is a hedge against feeling inferior or less than. If someone follows the “superior” faith, then that means that they are superior and everyone else is beneath them.
• It is a means of wielding control or having power over others. In other words, only the truly enlightened are capable of ruling, decision-making, or governing. This entitles them to natural resources, land, livestock, workers and so on.
• It satisfies a sense of entitlement—to more wealth, power, prestige, position, material things, and opportunity. In reality, a sense of entitlement is just a defense against feeling shame, unworthiness, and powerlessness.
• It is a way of fighting fear—of annihilation, conquest, enslavement.
• It represents an urgent demand for respect and reverence. However, in reality, one cannot demand respect; it must be earned. And reverence should be reserved for the divine.
• It justifies conquest and oppression of others—nations, individuals, a particular gender (in most cases, women).
• It serves as a substitute for good parenting and can be used to threaten children with punishment on a divine level if they don’t behave.
• It is a statement that people feel threatened by anyone who is different than themselves. Perhaps that goes back to instinct—the hardwired flight or fight response.

So what can we as individuals do to combat this worldwide pathologic response of religious fundamentalists who are ironically supposed to have a love of God and God’s children?

• For one, we can be aware of our own biases and judgments. This can be a challenge, especially in extremist situations, such as in some parts of the world where women are treated so badly. We can try to all be New Yorkers as described on a New York City subway poster: NYC: where we accept your personal beliefs; where we are judgmental about your shoes. (That’s a joke.)
• We can challenge others who claim religious moral superiority when we are in their company, pointing out the weaknesses of their positions (of course, only if it is safe to do so).
• We can support individuals, groups, and others who promote tolerance and acceptance of religious differences (and other differences).
• By the same token, we can boycott, whenever possible, those who/that promote intolerance. This statement is ironic in view of a recent news item I heard about the Christian right wanting people to boycott Starbucks, which was supporting acceptance of choice in relationships. (Asking New Yorkers to boycott Starbucks is totally unrealistic, I might add.) Probably goes for other parts of the country as well.

I’m sure my readers will have something to say about what I have written in this article. Please feel free to offer your own list of examples of reasons why it is so hard for many to coexist and what solutions are possible.

And if you’re a practitioner, have a joyful Easter-Passover holiday.