Torso and legs of teenager running along beach with dogWhy do people develop addictions and compulsions? In general, their psychological purpose is to push out of conscious awareness anything disturbing. The unconscious mind knows how deeply upsetting some body-mind memories might be, as they could trigger anger, panic, grief, guilt, anxiety, shame, depression, or feelings of worthlessness. Thus, it will do anything it can to distract from them.

That may mean engaging in unhelpful or even self-destructive behaviors. After all, addictions and extreme habits, which can form out of obsessive compulsions (OCD), can be very engaging to the body-mind. This deep engagement with something else, anything else, is a wonderful distraction from unpleasant emotions.

Add to your natural propensity for avoiding pain those media messages suggesting various forms of distraction—porn, alcohol, vaping, shopping, extreme sports, etc.—may enhance your life and make you happy, and you have a recipe for a society inundated with addictions and compulsions. (See Anne Wilson Schaef’s book When Society Becomes an Addict for a deeper explanation of this concept.)

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For all the talk of its potential pitfalls, obsessive and compulsive thinking has worked for humanity’s benefit for millennia. The person who unrelentingly rubbed two sticks together to create fire, Marie Curie in her lab, and Albert Einstein incessantly mulling over ideas are just some of the countless examples of people becoming consumed with something essential and meaningful.

With any form of compulsive or addictive behavior, the important question is: Is it interfering with any aspect of your life? If it is having a deleterious effect in any area, such as relationships, finances, work, or health, you might want to do something about it.

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Fortunately, there are many ways to shift away from unwanted habits. William Glasser, MD, a renowned psychiatrist, wrote a book in 1985 called Positive Addiction. He argued the natural unconscious tendency to avoid psychological pain can be rerouted into positive addictions. In other words, the brain’s proclivity for repetition can be used creatively and productively. Those obsessive, compulsive energies can be channeled into useful and enjoyable distractions such as learning a new language, spending more time with friends and family, reading, exercising, or hobbies.

So is the answer simply reorienting one’s compulsive energies into positive activities? Well, yes and no.

So is the answer simply reorienting one’s compulsive energies into positive activities? Well, yes and no. As a holistic psychotherapist who uses Internal Family Systems (IFS) as one of the arrows in my therapeutic quiver, I would certainly suggest some energy redirection. Ultimately, though, the task is working with the parts of you that valiantly protect your wounded inner child to enable you to unburden some of that pain, as well as coming to appreciate all your other parts (called “protectors” in IFS) that may snort cocaine, drink excessively, gamble, have an eating disorder, or engage in risky sexual behaviors. As counterintuitive as it may seem, all of these things—destructive as they may be—are trying to help you. They will do anything to protect you from being flooded with negative or scary feelings. Anything.

As someone who has been working with people with addictions for over 40 years, I appreciate the way IFS allows a person to gently, yet deeply, explore inner terrain while learning how to compassionately create a new way of relating to all of their parts. Through the IFS process, a person can come to recognize how hard their parts work to give them peace, even if those parts still think the person is a child or teenager. Talking with those parts, getting to know them and their motivations, and developing a new loving relationship with them can be incredibly healing.

Many people with addictions are in 12-step programs, which are wonderful for creating a community of people who share a desire to eclipse the past and evolve. IFS is compatible with those as well.

When you can meet your cravings for temporary oblivion with greater patience and understanding, you may begin to explore your true self. In IFS, that means allowing you to access your inner self-leadership with all its creativity, curiosity, connectedness, confidence, calmness, creativity, clarity, courage, and compassion.

References:

  1. Glasser, W. (1985). Positive Addiction. New York, NY: Harper Perennial.
  2. Schaef, A. W. (1988). When Society Becomes an Addict. New York, NY: HarperOne.

Shoulder and torso view of a person scratching their arm. The person is wearing a magenta top and has shoulder-length hair.Do you feel compelled to remove flakes of dead skin from your nose? Do you have a hard time keeping your hands off pimples and blackheads? What about those random bumps on your arm that arise unexpectedly? For people diagnosed with excoriation disorder, skin picking is a common response to these and other generally harmless skin irritants.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, excoriation—which falls under the umbrella of obsessive compulsion—is characterized by recurrent skin picking resulting in some sort of skin lesion; repeated attempts to stop the picking; potential impairment or distress over the picking; and an inability to attribute the skin picking to a medical condition, substance abuse, or another mental health diagnosis. Like hair pulling and nail biting, research suggests that excoriation may be a body-focused repetitive behavior (BFRB).

Most people who pick can typically find multiple sites on their body to pick, squeeze, or scratch. It is often a search-and-find mission using fingernails or some other designated instrument. The result of the picking can be inflamed, red, and sometimes bloody skin. When scabs develop, they may represent another reason to pick.

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People who pick their skin often are ashamed and feel the need to conceal excoriation through the use of makeup, extra clothing, or hats. The shame may add to the distress they feel regarding their appearance or their behavior toward their body. Often, there is an undercurrent of perfectionism with BFRBs, especially skin picking, and a deeply held belief that any imperfections must be eliminated.

Often, therapy will address underlying feelings and emotions that fuel the behavior, exploration of triggers that affect when and where the person picks, and soothing strategies to deescalate compulsive behaviors.

Would you be surprised to know that more than 75% of people diagnosed with excoriation are female? It is estimated that excoriation affects 1.4% of the general population, although many experts think the number may be higher. Most often, the condition begins at the onset of puberty and becomes chronic over time.

Skin picking may be triggered by tension, stress, or boredom and often has a compulsive element to it, meaning the person cannot stop themselves from picking and feels compelled to either relieve uncomfortable feelings or respond to minor skin irritations. Most often it occurs without full awareness of the behavior and when the person is alone. While reading, studying, on the phone, or watching television are all common scenarios for excoriation to occur. Many people spend up to one hour per day picking or resisting the urge to pick. Often, another person has noticed and mentioned the behavior.

Treatment for skin picking is often found in cognitive behavioral therapy, dialectical behavior therapy, rational emotive behavioral therapy, or acceptance and commitment therapy facilitated by a licensed mental health provider. Often, therapy will address underlying feelings and emotions that fuel the behavior, exploration of triggers that affect when and where the person picks, and soothing strategies to deescalate compulsive behaviors.

Those with BFRBs may also find relief with tactile and meditative strategies. Tactile replacements may be helpful in providing substitute relief and can include bubble-wrap popping, fidget toys, cooking, working with clay, painting, or even using a piece of ribbon as a soothing instrument to wrap, rip, and stroke. Meditative behaviors such as yoga, cleaning, walking, or listening to music can also be effective in soothing the urge to pick.

Although excoriation is a complicated and often distressing behavior, it is manageable with professional treatment and replacement behaviors.

References:

  1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author.
  2. OCD & Related Disorders Program. (n.d.). Excoriation. Retrieved from https://mghocd.org/clinical-services/excoriation/

A book lies open on a table. shining lights come out of the pagesThere are different kinds of lies: pathological lies, lies so you won’t get caught, lies of convenience, lies for self-protection, and social lies. They all have something in common: if someone is focused on telling you only what you want to hear, or only what they want you to hear, you’re not hearing what you might want or even need to know. You might fall for their stories, if they’re convincing enough. People who lie pathologically tend to tell VERY good stories. I’m going to tell you about one such person in particular.

Anita (not her real name) told the most wonderful and romantic stories about her life. I felt so good listening to her. Anita was a talented storyteller, and I am a sucker for stories.

When we first met, she was all smiles and seemed easy to get along with. I liked her right away. “My life would be perfect,” she told me, “if only I had a boyfriend.” She began telling me about a man who worked in her office. He had beautiful, big brown eyes and strong arms. When she looked over at him, he was almost always looking at her. It was clear they were attracted to each other. He asked her out for lunch. He asked her out to the movies. He brought her flowers and little cute presents. She made him brownies and brought them to the office.

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“Do you think he likes me?” she asked.

“I sure do!” I said.

After a few months, they started to get serious. Their romance was touching. He was older, but he was considerate and helpful. He enjoyed her youthful enthusiasm, and she enjoyed the many ways he showed he cared for her. He was courtly and charming. She felt safe with him.

Their relationship seemed fine at first, but then another woman wanted to enter the picture.

“What will I do?” Anita asked me. “What if he likes her more than he likes me? And who does she think she is, anyway?”

Anita quickly vanquished her rival, and she and her boyfriend were soon planning on moving in together. I wondered to myself if they would get married, maybe have kids. I was so happy for her. They were even starting to talk about buying a house.

Listening to Anita was like reading a really good book, one I couldn’t put down, or watching a movie I knew I would have to see again. Her story was about every dream come true. All things were possible. Life was always only good. Life was a fairy tale.

At first, I thought: Well, it’s young love. Eventually life will get back to normal. I even worried: Would Anita be able to take it if they actually had a disagreement, much less an argument? Everything can’t be perfect ALL of the time! Usually there is a little trouble in paradise—after a while, anyway. But Anita and her boyfriend never disagreed. They always wanted to do the same things at the same time.

Gradually, I began to believe her story felt too good to be true. Then I realized that, in fact, it wasn’t true at all. I had, in fact, been listening to a fairy tale. It felt like a switch in my brain clicked on when I realized Anita had the hallmarks of a person who pathologically lies. She made the whole thing up!

Gradually, I began to believe her story felt too good to be true. Then I realized that, in fact, it wasn’t true at all. I had, in fact, been listening to a fairy tale. It felt like a switch in my brain clicked on when I realized Anita had the hallmarks of a person who pathologically lies. She made the whole thing up! Anita needed to keep me fascinated; she had a real desire to control and manipulate how I thought about her.

I was shocked. My thoughts must have shown on my face. Once I figured out she was lying, she didn’t want to talk to me anymore. The thing is, I liked Anita, but she couldn’t believe that anyone could like her if they knew her as she really was. Her lies, I believe, stemmed from serious dissatisfaction with herself, a need to be loved, and a need to mess around with other people’s minds. She always had to be the best, the winner, HUGE!

I felt pretty stupid.

Even though I had been bamboozled, I still wanted to be friends with Anita. I suppose many people would have simply dropped her, but not me. We continued to meet for a time, and Anita tried out different story lines with interesting beginnings, but I wasn’t buying. I wanted to have a real conversation, but it wasn’t happening. Anita felt her real life was boring, and she was ashamed of herself. She thought she was too ordinary. She couldn’t see the beauty of the everyday. I think, at some moments, she believed her own lies. She was inventing her life as she thought it should be, and it had to be exceptional.

Storytellers need listeners, and I’m a good one—but eventually even I can identify a lie when I hear one.

I’ll bet you can, too.

Two people and a small dog sit under a tree with bright pink blossomsProductive and meaningful time management is a highly prized skill, but failing to make space in your day for unscheduled time may have a direct and negative effect on your sense of well-being. While many people seek therapy to master situation-specific goals, an overwhelming percentage struggle to let themselves relax and exist without actually doing anything. Without a basic ability to be comfortable being yourself, attaining states of further contentment and well-being through psychotherapy can be much more difficult. As the saying asks us to consider, is our inherent purpose to exist as human beings or human doings?

Our educational and work systems reward deadline-driven industriousness, and our society values people who work hard, meet goals, and build impressive résumés. With the invention of smartphones, digital calendars, GPS maps, and other technological tools, we have become increasingly able to accomplish more things faster than would have been imaginable a few decades ago. The lines between work and personal time blur more than ever as our attention to work email may extend throughout our waking hours and our families and friends distract our work or study periods with text or social media communication. And to what end? Societally, we seem conditioned to believe our worth is tied to using our time “wisely.” However we may define that, we seem to have lost our ability to value our space, solitude, and downtime. Ultimately, this is leading to individual and collective loss of the experience of feeling both content and human.

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In order to understand the remedy for this modern-day issue, it is important to first understand the cause of our discontent. I believe an unfortunate confluence of cultural beliefs and technological advances have come together to rob us of our ability to be present and in tune with ourselves, necessary components to feeling “okay.”

Our society tells us that we must be occupied to avoid “wasting time” such that people begin to believe their self-worth and goodness are tied to their productivity. Much to my surprise, I frequently hear people seeking therapy say they are unable to take time to be present with themselves, as there are “more important” uses of their time. Perhaps our societal belief that “time is money” has been taken far beyond its original meaning, making people captive to their activity. What’s more, as these habits of busyness and speediness take hold, people may become less able to stand being unoccupied and thus seek out momentary entertainment as a means of “killing time.” When was the last time you waited in a long line and didn’t consider reaching for your phone?

If we fill every moment with activity and distraction, we are missing some of the greatest gifts contained within time itself. In order to feel better about ourselves, we must be willing to just “be” rather than “do.”

Layered atop the societal value placed on productivity, pervasive technology and social media have made instantaneous and perpetual distraction easily available. The level of instant gratification that arises out of the momentary amusement has made these devices ever-present in waiting rooms, at dinner tables, and in bed. Every moment of life is filled, and there is no space to simply feel or “be.” In fact, our tolerance and willingness to feel alone, bored, or unproductive, even for short periods of time, is diminishing. This is particularly true for younger people who have never known a world without ubiquitous connectivity, and for whom connection to self and other often comes through screens rather than a felt sense of self experienced through being present in the physical world. Learning to be present with yourself may ultimately enhance genuine real-world connection with others that is mistakenly being sought through screen-based interaction.

The problem with these societal beliefs and our reliance on digital entertainment is that creativity is born out of boredom. Our sense of aliveness comes from being present with the life we live. If we fill every moment with activity and distraction, we are missing some of the greatest gifts contained within time itself. In order to feel better about ourselves, we must be willing to just “be” rather than “do.”

The antidote to busyness and speediness is to spend unscheduled time experiencing being yourself. You may pause and try being yourself while you are in nature, between tasks, or upon waking. I find that doing this exercise in the presence of trees or plants can be helpful, as they provide an excellent example of living entities that are doing nothing more than being fully what they are. If you are unable to easily access flora, any space in which you feel comfortable and able to relax and “be” will work.

In order to “be,” allow yourself to explore what it means to be present with yourself and your surroundings. Notice the thoughts that arise, including any cravings relating to wanting to do something. Allow yourself to be curious about feelings, including those of boredom and loneliness. What sensations do you notice? None of these thoughts, feelings, or sensations is a problem. None is right or wrong. They simply provide information about your state of being at that moment, and this knowledge informs your endeavor to fully be yourself.

Finally, see if it’s possible to be yourself without needing to do or be anything else—just exist as who and what you naturally are. While these directions may seem simple, they contain the essence of what it means to be alive, the cure to our modern state of existence, and ultimately the foundation for building a state of contentment.

A scared child has fallen asleep under a bed with a teddy bearSome people live their lives in extreme fear, approaching life with a constant sense of terror. The simplest activities of living can become fraught with dangerous possibilities. Feelings of risk and leaving safe spaces can require a person to make a careful assessment of the world before venturing out. People I’ve worked in therapy with who have this terrorized way of relating to their environment often come into treatment expressing misery and self-hate. They blame themselves for their unhappy lives and have little understanding of how they came to feel terrified all the time. They desperately want more freedom in their lives, and just as desperately, they’re afraid to be free.

The first time Joe came to into my office he looked uneasy as he sat down and stared at me vacantly. “What brings you here?” I asked.

Joe mumbled as he bent his head to the floor, “I hate my life, I hate myself. I have no life. I’m afraid of everything. If I’m alone, I can’t travel, drive, or even leave my neighborhood without fearing that something terrible will happen and no one will be there to help me.”

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This was my introduction to 47-year-old Joe, whose story helped me understand what it means to be terrorized from early childhood experiences. I wanted to help Joe understand his terror so he could relinquish his guilt and self-hate and begin to move toward more freedom in his life.

Joe, an only child, grew up in a household with an absent father who was a workaholic and a controlling mother who was depressed and also likely experienced bipolar. His father died of a heart attack on the job when Joe was 16; his mother died by suicide from drowning herself in the bathtub when Joe was 23.

Joe described his childhood: “Before I started school, I have memories of my mother singing and dancing with me and telling funny stories. Growing up, my father was always working, so Mom would sometimes take me to the yard and play catch or goof around. As early as I remember, she would get very depressed. She’d take to bed and be irritable and mean to me. I had to be very quiet and not disturb her or she would scream that I was killing her. I would sometimes hide in the closet with a book or toy, and I wouldn’t make a sound. I was very scared and I knew if I bothered her she would come at me in a rage and threaten to kill herself. I never knew which mother would be around at any time. I could leave my happy mom and go to school and come home and find her slumped on the kitchen table crying that I didn’t love her, or my father was mean, or why didn’t I stay home from school because I knew she needed me. It was so confusing and scary. By junior high, she usually had things she wanted me to do, like cook or help her with chores. She insisted I come straight home from school. She didn’t like me to bring friends home or go to a friend’s house or even participate in activities after school. It felt like she was totally in charge of me. I knew if I pushed back she would get weepy and angry and tell me she was going to kill herself and what a terrible son I was. I felt as if I’d destroy her if I wasn’t careful. But I loved her and we were close. “

When Joe’s mother died by suicide, he was living on his own just a few streets from his mother’s house. He had been trying to reach her by phone. After several hours of not answering, he told me, “I just knew she had done it. I called a neighbor and asked her to meet me at the house. We found her in the bathtub. It’s been a lifelong struggle not to blame myself for her suicide. Rationally, I know it’s not my fault, but maybe I could have done something to prevent it.”

Joe and I spent many months working on his feelings of responsibility for his mother’s death. We considered that restricting his life and his freedom could be a way to punish himself. While this guilt likely contributes to Joe’s paralysis in engaging the world, more recently our work has focused on the ways in which growing up impacted Joe’s development into a terrified person.

Becoming Terrified in Early Childhood

As Joe became more able to talk about his experience of being terrified as a child and young adult, it became clear to both of us what a visceral experience it was. We understood that Joe wasn’t an ordinary scared child experiencing fear. Rather, that child with his toy in the closet was scared to death; he was terrified. His mother terrorized him. The danger he feared of making a sound while his mother was in her bed felt life threatening. Joe did his best to fend off her rages, attacks, and shaming behavior.

He recalled, “She’d get so cold and absent, or shout ‘You’re killing me,’ or ‘You want me dead, you’re stupid, you’re weak.’ She criticized everything.”

The threat of death was very real in Joe’s house. He explained, “She would tell me, ‘You’re going to find me dead one of these days if you can’t help keep this house clean,’ or, ‘If you don’t get home from school on time,’ or, later when I was in college, ‘If you don’t call me every day.’ ”

Joe’s father played no role in mitigating his mother’s destructive behavior. Joe coped alone with the possibility of his mother’s death. Her destructive communication and unpredictable emotional presence left him feeling unsafe, unprotected, and fearful for his own survival. If Joe didn’t consciously feel that his life was threatened, unconsciously he was terrified of his own annihilation.

In treatment, Joe began to develop a more compassionate attitude toward himself as he learned to appreciate how, as a terrorized child, it was necessary to find ways to protect himself and survive the threat of losing both his mother and himself. He simply could not allow himself to visualize engaging in any activity on his own. His was a dangerous world where no one could save him in an emergency. He hadn’t been able to keep his mother safe, and now surely he was not safe.

As we explored Joe’s terror of venturing into the external world, it became clear that he hadn’t developed the ability to enter his internal world. He wasn’t free to play with ideas about his life or to wonder about new and exciting possibilities. He had to be prepared to respond to his mother’s demands. Unconsciously, he had to dissociate his own needs and desires. Clearly, he had not been able to separate and individuate from his mother.

Developing Freedom to Individuate

Joe had learned to rely on his mother to define his identity and for his positive feelings. She needed him to be dependent and used the threat of her death or his annihilation to keep him controlled and connected. He had internalized his mother’s voice, which, in his adult years, continued to govern him. Even when a parent is deceased, terror can live on in their child’s psyche. Could Joe lessen the influence of this voice that kept him in a constant state of vigilance?

I believed Joe needed to emotionally recognize that he had kept himself imprisoned in the service of keeping his essential self alive in protective custody. If he could allow himself to enter his internal world, he would be able to discover his own wishes, desires, and needs and develop an identity separate from how his mother defined him. We had to consider his unconscious resistances to growing his self and leaving his mother’s voice behind. We explored the downside of “leaving” his mother. Joe realized that he still wanted to protect his memory of her.

“She was so fragile and depressed. I still can’t hurt her or blame her. It wasn’t her fault; she did the best she could, given the deficits of her life,” Joe said.

“I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”Joe has struggled to overcome his resistance to separating from his mother. He is more able to acknowledge her destructive behavior and experience some anger and disappointment. This could empower him, make him less terrified, and help resolve his conflict so he could choose his self-growth rather than continue to protect his mother.

“It’s hard. I spent my life protecting my mother and myself from death. I’m still protecting my image of her as a good mother who will take care of me. Maybe I believe that if I have my mother with me—even my dead mother—it will protect both of us. I know it’s time to stop protecting her. Even though I don’t believe it’s safe yet, I tell myself the risk is not so great—the pleasures and satisfactions in the world are worth the try. I’ve got to try.”

One doesn’t have to have a parent experiencing suicidal ideation to feel terror about their own survival (consciously or unconsciously). Parents terrify their children in many ways. For example, children can feel terror about their parent’s ability to survive and keep their child alive. Terror can also occur when a child is physically or emotionally abused or result behavior that is shaming, controlling, and/or emotionally withdrawn. Anxious or unpredictable attachment can leave a child in a terrified state.

Joe has a come a long way in working on his terror and his ability to feel safer in the world. I tell his story with the hope that others who have lived their lives in terror as the result of their early family experiences don’t have to be doomed to self-blame, hopelessness, and forever be imprisoned and terrorized. When those who work on themselves in therapy understand how they became terrorized people and emotionally comprehend the visceral feelings of terror that have been endured since early childhood, they can be helped to give up the need to protect significant others who terrorized them. Often, this is the start of a transition from self-blame to freedom of self-development.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

An empty, unmade bed with a plaid blanket in the middle of a roomBed bugs.

The mere mention of these critters sends shivers down my spine and can bring immediate itchiness to anyone aware of these pests and their elusive nature. Bed bugs are small, parasitic insects that tend to take up habitation in—you guessed it—the beds of us poor, unsuspecting humans, then feed on our blood when we sleep. They are in the news frequently and may have even sprung up in your area. Perhaps you have encountered bed bugs in your home or in your travels. This has been an epidemic for several years, but when a person is struggling with an infestation it is rarely talked about.

Unfortunately, bed bugs carry with them a certain stigma. There is a misguided perception they exist only in homes or dwellings that are not clean. Also, people may be “bugged out” when they find out someone has a bed bug issue. Perhaps they have read how easily they are transmitted from one person or place to another and want as much distance between them and the other person/place as possible.

At least that’s what many people with bed bugs fear—and what can keep them from turning to others for emotional support.

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On top of the sense of isolation people may experience because of bed bugs, they must contend with the simple knowledge that in their own sanctuary, the place they call home, they have been invaded by a near-invisible parasite that feeds on you in your most vulnerable state. Argh! If your skin is crawling just reading this, welcome to the experience of a person living with bed bugs.

Bed bugs may have invaded your space, but they do not need to take up all the space in your head!

Not only is treating a bed bug infestation costly both socially and financially, it can take a serious toll on mental health. I have worked with countless individuals dealing with these pests. I have also had my own bed bug scares, nearly sending me off the deep end. What I learned from others’ experiences and my own is that these bugs don’t simply impact our physical environment; perhaps worse, they invade our minds and can lead to an experience of extreme stress and isolation.

Perusing the internet on the topic of bed bugs could bring any person to a panic, whether they are struggling with the issue or not. My goal with this article is to provide anyone dealing with an infestation with some tips and tools to help them calm down and emotionally cope with their unexpected visitors. Bed bugs may have invaded your space, but they do not need to take up all the space in your head!

How to emotionally cope with bed bugs in eight steps:

  1. First, know you are not alone. A simple walk around my neighborhood in Philadelphia showcases countless mattresses thrown outside in what may mark a first panicked attempt at getting rid of bed bugs. A simple internet search on bed bugs yields thousands of results, indicating this problem is being experienced by way more people than just you. You may feel like a social pariah when dealing with bed bugs, but the truth is, due to the stigma and secrecy associated with bed bugs, you never know who else is dealing with them. Take refuge in the simple knowledge you are not the only one suffering the insufferable.
  2. Use some positive self-talk. Say to yourself, “I am a separate person from this problem. This is simply just a problem I am coping with, and it is not my entire life, nor does it represent who I am.” Think about all your positive roles and qualities. Parent, teacher, kind person, clean person—whatever makes up who you are, remind yourself of these things and that you are not just a person who has bed bugs. Each time the thoughts creep back in regarding the bugs, actively change your thoughts. It is not worth it to obsess about them; all you can do is proactively try to take care of the problem, and otherwise try to give your mind a break.
  3. Get outside. If the weather permits, do yourself a huge emotional favor and go for a walk. Sit under a tree. Bring a book. Nature has the power to heal us and bring us back to our sanity. In this case, it also gets you out of your hellhole of a home! Remember, you do not deserve the stress of these bugs. You deserve a break from the environment they have invaded, as well as a mental and emotional break.
  4. Remember that bed bugs are not really any different than other types of bugs. Think of them as less dangerous mosquitoes. Unlike mosquitoes, beg bugs are not known to be vectors of disease. Yes, they are gross. No, they can’t kill you.
  5. Use deep breathing. Breathe in, breathe out … slowly. Count your breaths as you focus on the sensation of breathing in and out. What does it feel like as the breath enters your nose, travels down to your lungs, and then begins to release? See, you already forgot about the bugs. Deep breathing is a form of meditation that helps us focus on the experience of the body rather than the constant thoughts roaming around our heads. Give yourself a moment to stop thinking about the bugs and to relax your nervous system.
  6. Get some exercise. Exercise has the power to not only increase your endorphins (feel-good chemicals in the brain), but it can get your mind off the problem. Exercise IN your home. Take back YOUR territory while pumping iron and gaining a sense of power and control. If you can’t stomach the thought of spending another moment near the source of the infestation, go to the gym or exercise outside. Special note: Yoga is wonderful for stress and can help you be kind to yourself during this terrible time.
  7. Tell someone! Don’t keep this to yourself. Yes, it can feel intimidating telling someone about an issue you might feel embarrassed about, but the relief of bringing someone into the experience of this issue can be a huge help and can take away the sense of isolation often incurred when someone has bed bugs. Tell a few people if you can, and make sure they know you don’t want this information passed around. Ask for a hug, if you feel so inclined; physical touch can be comforting.
  8. Lastly, do everything in your power to get rid of the bugs. Call an exterminator and follow all advice they give. The bugs CAN be beat and you WILL conquer them. Don’t allow the bugs to make you feel incapable and powerless—you are not.

In the end, you will get rid of the bugs. For now, the true goal is maintaining sanity and not allowing the bugs to wreak havoc on both your emotional and physical health. As with many other challenges we face, the worry is the worst part.

Rear view of mother and daughter hold hands at sunsetWired for connection, baby daughter looks into her mother’s eyes needing to see delight reflected back to her. What if, instead, baby’s gaze is met with emotional emptiness? Lights out. Nobody home.

And what if this blank stare isn’t the manifestation of a temporary hormonal condition but instead indicative of something more troublesome? What if mom’s emotional tank is perpetually low and she has little or nothing to give her daughter?

If mom didn’t get the love and affirmation she needed when she was young, then her daughter, in the role of the “good daughter,” learns quickly that mom’s needs—and not her own—are at the center of the relationship.

The emptiness mom feels inside can threaten to swallow both mother and daughter. There simply aren’t enough good feelings to go around. And like a bucket with a slow leak, the narcissistically defended mother’s good feelings about herself are in constant need of a refill. In response, the daughter learns to put her own needs on the back burner as she works to fill mom up.

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Many a “good daughter” learns making mom happy is necessary for their own emotional survival. To this end, the “good daughter” manages to subvert/suppress/deny her own needs to take care of mom.

The “good daughter” learns to:

  1. Look good for mom: The “good daughter’s” demeanor, appearance, and accomplishments must reflect well on mom.
  2. Act happy for mom: The “good daughter” acts cheerful, enthusiastic, and puts on a positive face so as not to overwhelm mom. Bad moods, setbacks, and struggles must be short-circuited, if not hidden.

The Cost of Being the ‘Good Daughter’

In the normal course of development, the “good daughter,” attuned to her mother’s needs, may bury her own needs for the mother’s sake. Understandably, these needs and feelings do not disappear. When these repressed needs surface, the “good daughter” may feel like a fake.

Sadly, when the “good daughter” of the narcissistically defended mother needs support from mom regarding loss, disappointment, or struggle, she may find that mom has little to give.

Mom isn’t evil, although her actions are frequently destructive. Simply put, a mother who is narcissistically injured is consumed with preserving and replenishing her impoverished sense of self. Her emotional tank is empty. The narcissistic defense means mom is forever in a relentless pursuit of the emotional supplies she did not get during pivotal times in her own development. Additionally, mom may feel the need to disguise her neediness, which may result in denial, defensiveness, and manipulation of her daughter.

When mom experiences deep insecurities, her parenting may be slightly or profoundly impaired.

Healthy functioning is restored when both mother and daughter are free to be themselves and no one needs to “be good” for anyone else.

Because the daughter has subverted her own needs, she runs the danger of becoming disassociated from those needs. She becomes “good” at the expense of being real. This can result in the “good daughter” feeling like an impostor, a fake, just waiting to be found out.

Because she is disconnected from her authentic self, the “good daughter” worries underneath it all that she isn’t good enough.

Since her sense of self is rooted in making another person happy, she is at risk for codependency in her relationships. And because she is used to making another person’s happiness the basis for her feelings of self-worth, she may base her sense of self-worth on her own daughter’s successes.

This is how being “good” for mom isn’t necessarily good for daughter. Or daughter’s daughter, for that matter.

Healing is possible, however. The “good daughter” must get in touch with her authentic self and start to mend the places within that she has long denied. In doing so, she enables herself to parent from a place of wholeness and confidence, and to empathize and accept both her own needs and her daughter’s. By becoming aware of and reclaiming forgotten parts of herself, the daughter of a mother with narcissism can end the cycle of maternal narcissism.

Healthy functioning is restored when both mother and daughter are free to be themselves and no one needs to “be good” for anyone else.

Note: The generalizations above may not apply to all dynamics in a family affected by parental narcissism. Also, although this article refers specifically to a mother and daughter for the purpose of narrative cohesion, any gender combination of parent and child can be similarly touched by narcissism.

A young professional hides face in hands while leaning against a fenceShame has a bad reputation. Let’s face it: it doesn’t feel good. I mean, who really wants to feel shame? It’s uncomfortable, even downright painful at times.

Here is something to consider, though: shame (closely related to guilt and regret) is an essential part of our survival and functioning and, in fact, is a gift from Mother Nature.

Let’s back up here a bit and first talk about the functions of emotions generally. Emotions are hardwired into our brains and help to warn us, facilitate connections to other people, and work through challenges. “Positive” emotions such as joy, pride, and love tend to feel good, while “negative” emotions such as anger, shame, and sadness tend to cause discomfort. It is easy to want to push away and avoid the “negative” emotions, but it is important to note that both types of emotions are necessary in order to function in the healthiest way possible.

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Now let’s get back to our friend, shame. Shame’s function is pretty important. Basically, it helps to keep us in check. Shame is a signal that there has been some sort of action that could harm others or ourselves. This could be an action that hurts a relationship with a loved one, something that could get us in trouble somehow, or a behavior that would be dangerous or harmful to us.

When we utilize shame appropriately and feel the right amount all the way through, it can be corrective and preventative in that it helps us to not make the same mistakes again. Having shame also helps us to repair when an action has caused harm to relationships. It helps us to identify and take accountability for our actions, and when others see we are experiencing some degree of shame, defenses usually go down and healing conversations can take place. When we feel shame about something self-inflicted (drinking, drugs, putting ourselves in dangerous positions, etc.), we can assess the steps we need to take in order to prevent doing future harm to ourselves.

We all do things that warrant feelings of shame, guilt, and remorse. It is part of the human experience. Making mistakes is an important part of learning, and shame is an excellent teacher.

As great as shame can be, sometimes we can have too little or too much. In doses that are too small, we do not get the full opportunity to learn from the experience. Our system is not able to fully register that we have engaged in a behavior that warrants some degree of remorse. As a result, we may be more likely to engage in the damaging behavior again, possibly with negative life consequences.

Too much shame can overwhelm us and distort the experience. We may blame ourselves for things we should not take accountability for (like someone else’s actions) and end up in an impossible position where we are trying to learn someone else’s lesson. The system becomes confused when shame is distorted because we are not able to control or prevent future actions of others.

Finding the right dose of shame is key. When assessing whether you have too much or too little shame, ask yourself: Did I engage in a behavior (or behaviors) that caused harm? If the answer is no, it is important to assign correct responsibility and to check in with yourself to make sure you are not taking on another person’s lesson. If the answer is yes, ask yourself: How much harm was caused by the behavior and would it be harmful if repeated? It is often helpful to use objective others as sounding boards when assessing your level of shame so you can learn from the situation and move forward.

We all do things that warrant feelings of shame, guilt, and remorse. It is part of the human experience. Making mistakes is an important part of learning, and shame is an excellent teacher.

Two people sit on a fence overlooking a field. One person has an arm around the other person. Being close to someone who is suffering because of trauma can be a difficult, bewildering experience. Trauma symptoms may appear suddenly, sometimes surfacing many years after a traumatic event. Or symptoms may creep up gradually. You might notice your loved one seems “off”—not like their usual self. Or their emotions can flare up suddenly and intensely for little apparent reason, even to the person. Some trauma survivors seem unusually flat or numb. They may become needy or clingy. Or they may withdraw, refusing help entirely.

Although symptoms may differ, responses to trauma have a similar underlying cause: a nervous system stuck in threat. Understanding what happens inside a person experiencing posttraumatic stress (commonly referred to as PTSD) provides a pathway to compassion, clarity, and possible solutions. This article is not therapeutic advice, and the advice of a qualified psychotherapist should always be sought. Think of this article as a general guide for families who suspect that a loved one has been impacted by trauma.

Trauma and stress are not the same thing. Stress refers to the body’s response to threat—a physiological and biochemical cascade of bodily changes designed to ensure survival. Informally, “stress” can also refer to subjective experiences: how it feels to be experiencing the challenge in the environment and in the body’s responses.

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The difference between stress and trauma is one of degree. Not all stress is bad; we need some challenges to stimulate us and encourage our growth. Trauma (or traumatic stress), on the other hand, refers to an internal state of overwhelm. This is an important point, and it explains why something that is “no big deal” for one person can be extremely traumatizing for another.

Trauma comes from overwhelm—when environmental circumstances are perceived as bigger than the individual’s capacity to handle them. When overwhelm happens, the body automatically mobilizes a survival response to deal with the threat, just as it does during stress. However, when the threat is too big or lasts too long and there is no effective response, it becomes trauma. For example, a person being cruelly taunted may not fight back because if they do, they may get into legal trouble and make the threat even worse. Not fighting back may be the smart thing to do, but the overall result is the body’s automatic survival response is ineffective against the threat.

When there is no way to fight back or run away, instead of deactivating, the mobilized survival response becomes “stuck” in the “on” position. It wants to complete and turn off, as it would if there had been a successful resolution of the threat, but it can’t. As a result, some bodily functions are stuck on “on.” For example, there may be lasting changes in blood pressure, heart rate, digestion, muscle tension, hormonal levels, and emotional reactivity.

Both stress and trauma involve the activation of the body’s threat response cycle. This survival response is hardwired into all vertebrate animals. Under threat, the unconscious brain and the body attempt to:

When stress happens, deactivation is possible. Traumatic overwhelm makes deactivation nearly impossible.

Threat responses are unconscious, hardwired, and involuntary. People cannot control these responses. When trauma has occurred, the person’s nervous system may still be involuntarily responding to prior circumstances more than to what’s actually happening.

Most importantly, threat responses are unconscious, hardwired, and involuntary. People cannot control these responses. When trauma has occurred, the person’s nervous system may still be involuntarily responding to prior circumstances more than to what’s actually happening. (This is what causes flashbacks or other re-experiencing of traumatic circumstances.) Posttraumatic stress responses are essentially the body’s survival alarms going off at the wrong time, because they have never been able to completely turn off.

Posttraumatic survival responses also occur much more quickly than conscious thought. In fact, intense activation of the threat response cycle shuts down the cortex, the area of the brain responsible for rational thought and verbal communication. This is why logical arguments don’t work when a person is in a posttraumatic stress response. They may be, literally, “too angry for words.” This also means that, for the most part, people with posttraumatic stress don’t intend to respond inappropriately to things going on in the environment around them and may feel very badly after the event is over, but at the moment, their automatic survival wiring is running the show.

Even when acute trauma triggers are not causing posttraumatic survival responses, a person whose nervous system is stuck in some phase of the threat response cycle is likely suffering. Eventually, they may start to numb out (dissociate) to protect against the ongoing awful feelings. Others become caught in cycles of addictive behaviors in order to try to manage the distress.

When a Loved One Is Experiencing Posttraumatic Stress

Loved ones who understand this can respond with compassion; however, this does not mean putting up with hurtful or dangerous behaviors. Some trauma survivors might even seem okay on the surface, but underneath, managing the unresolved trauma is using up some of their strength and energy. Unresolved trauma also tends to build up inside, making the person more emotionally and physically brittle over time. Eventually, symptoms may appear after a relatively mild stressor, such as a small fender bender.

The ultimate goal of treatment for posttraumatic stress is to foster deactivation of the nervous system and restoration of resilience (flexibility and the ability to “bounce back”). With this comes the ability to be fully present—instead of being partly stuck in the past—and to respond appropriately in the current moment. The neurological term for this resilience/responsiveness is self-regulation.

Here are several suggestions to keep in mind while supporting a loved one impacted by trauma:

To sum up, it can be incredibly distressing to be living in a nervous system that feels disobedient and unpredictable. However, as Dr. Peter Levine has said, humans were designed to withstand incredibly difficult conditions. With the help of a good practitioner, trauma survivors can access their underlying restorative ability of mind, body, and spirit, and continue on with their lives.

Note: I would like to acknowledge Phyllis Stein, PhD, SEP, for her editing contributions to this article.

References:

  1. Butler, E.A., & Randall, A.K. (2012). Emotional Coregulation in Close Relationships. Retrieved from http://emr.sagepub.com/content/5/2/202
  2. Center for Substance Abuse Treatment (U.S.). (2014). Treatment Improvement Protocol (TIP) Series, No. 57. Ch. 3. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK207191/
  3. Levine, P. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness. Berkeley, CA: North Atlantic Books.

Person stands against row of old windowsWhere do you feel safe? For me, it is not in my husband’s arms, it is in his heart. It is in a deep knowing that he will hold me there and that he feels me there even when I am not immediately in his presence. That with him I can take deep breaths and breathe in the love and affection he provides. The safety. What must it be like to have never had this feeling?

I didn’t have this feeling consistently before him. I trusted me, and I took care of me because that is what I learned to do as a child. Children who don’t feel “seen” by their parents often have an emptiness that grows with them as they move into adulthood.

What if you have carried this feeling with you for years, and now here you are, sitting in a therapist’s office, trying to “open up” and share your trauma history and heal from past abuse? How do you learn to trust the person who is supposed to be helping you, the one who is sitting across from you saying they will be with you in your journey, who holds you gently in their heart, looks at you with knowing eyes, and talks to you about your worth? The one who says they won’t judge you even before you share your most painful secrets?

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As a therapist, when I sit with someone who has never felt seen, I ask myself, “Why do I know you? Why can I feel you? What is it about your pain that is also mine?”

We all have parts of ourselves we wish we didn’t know, parts we say to ourselves, “That’s not me” or, “Who is that person?” We reject these needy, angry, or acting-out parts of ourselves in the same way they were rejected by the very people who were supposed to hold us fiercely in their hearts and minds: our parents.

We tell ourselves, “If they couldn’t love me, those people who bore me in their bodies, how could anyone else?”

And then we give up trying to explain these ugly secrets to ourselves, to others. We hide them, lock them away in the attics of our minds, put them in files, into containers, send them away. When an experience is too much for the minds of children to bear, this can happen in a fraction of a second.

And then we give up trying to explain these ugly secrets to ourselves, to others. We hide them, lock them away in the attics of our minds, put them in files, into containers, send them away. When an experience is too much for the minds of children to bear, this can happen in a fraction of a second.

Later, as adults, we may berate ourselves for this. But children cannot handle the types of trauma or even harsh words from a loved one the way most adults can. They crack more easily.

Other times, forgetting doesn’t come so easily or quickly. We have to focus our attention on trying to forget. Eventually, the more parts of ourselves that are hidden, the more we reject and disavow ourselves of them, the larger and more intense they grow. Sometimes they develop a life of their own.

When parts of the self develop their own life, memories, experience, belief systems, and values, when they have their own sets of thoughts and feelings about experiences, they are so separate we call them “alters” or “self states”—parts, in other words. These parts are out of our awareness or just on the other side of it. Dissociation should be thought of not as mental illness but rather mental injury, born out of the anguishing kind of pain that comes from feeling empty or from being filled with rage, feeling unloved, unwanted, used. You feel unrelatable and unknown, even to yourself. Getting to know these discarded parts of the self can be scary.

I know you likely will not trust me, that you may not be able to bear looking into my eyes. That it will become more painful as you get to know me and start to expect me to be there. That just when you think you are starting to feel hope, you will become the most terrified you have ever been. Because you will have finally been seen. And while you have waited your whole life for this, it may very well be more petrifying than you imagined.

That is why I will forever be in debt to you, the person in therapy—for allowing me to see into your eyes, your past, your most feared parts of the self. I will wonder to myself why and how I know you, why you are in my life, and how it is I can “feel” your presence. I will remain separate from you and yet walk beside you for a time. I will try to be a vessel worthy of your sorrow.

Two hands hold tea on wooden table. Tea has thyme leaves and lemon slices in itHave you ever felt like your emotions are so overwhelming they will never stabilize? Maybe you have an intense urge to return to unhealthy or risky behaviors to make yourself feel better. Dialectical behavior therapy (DBT) has a whole module that focuses on crisis survival skills. These are skills that help you hang in there, or cope, when emotions are overwhelming. It doesn’t make the feeling go away, but these skills can help you get through the intensity of these emotions.

Here is a brief overview of DBT’s crisis survival skills.

Distraction

These strategies are used to distract yourself from distressing thoughts, feelings, or situations that feel overwhelming. The acronym “ACCEPTS” can help with recall in the moment.

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Self-Soothe with Six Senses

These strategies can help you feel better and in control by using your five senses (and a sixth: movement) to ground you to this person, place, time, and situation.

IMPROVE the Moment

You can’t necessarily change the fact something is happening, but you can change the way you feel, think, or react using these skills.

Pros and Cons

Considering the short- and long-term pros and cons to a decision can be helpful in deciding how to react to a situation or feeling.

TIPP the Scale

This is a newer skill set introduced in the latest update to the DBT Skills Manual for Adolescents. These skills are used when managing extreme emotions or urges. Using these strategies may help adjust your body chemistry.

It is important to note that one skill might not be enough depending on how intense your emotion or urge is. You might need to try a few to find what works best for you. As with anything, it’s also possible that something might work in one moment and not in another. Have a willing attitude as you give these skills a try, and partner with a therapist trained in DBT if you want support.

Reference:

Rathus, J. H., & Miller, A. L. (2015). DBT skills manual for adolescents. New York: The Guilford Press.

Woman about to kick soccer ball into netFemale soccer players exposed to stereotypes about their playing ability experienced significant reductions in their dribbling speed, according to a study published in the journal Psychology of Sport and Exercise.

The study is just one amid an increasingly large volume of studies on stereotype threat. Stereotype threat is the tendency of marginalized groups, such as women and people of color, to underperform when they are made consciously aware of stereotypes about their group. For example, a persistent stereotype suggests women are innately less adept at math than men. According to several studies, when women are told scientific research shows gender differences between men and women in math, they often perform worse on math tests.

Stereotype Threat Reduces Female Soccer Players’ Skill

Although women’s sports continue to increase in popularity, stereotypes suggest women are inferior athletes. To test how this affects female performance, scientists from Germany recruited 36 competitive female soccer players from three different Frankfurt soccer clubs. Each participant was timed in a dribbling exercise at the beginning of the experiment.

Each participant read a fake article about soccer. One article discussed the increasing worldwide popularity of soccer, while the other argued that women are inferior soccer players. Next, researchers asked them to indicate, using a 7-point scale, how strongly they believed the statement “I think boys and girls play soccer equally well.”

[fat_widget_right]Researchers again timed players’ dribbling speed to assess the effects of the stereotype exposure. Women who had read the negative article about women’s athletic ability dribbled more slowly than they did before reading the article.

Stereotypes and Inequality Persist in Women’s Athletics

Female athletes are often exposed to stereotypes and discrimination, even within their own athletic leagues. Earlier this year, five members of the United States women’s soccer team filed a lawsuit alleging gender-based wage discrimination. The suit alleges that, although the team brought in $20 million more in revenue in 2015 than the men’s team, female players are paid about 25% of what male players earn.

References:

  1. Gorlick, A. (2009, February 24). Stereotype threat harms female, minority performance. Retrieved from http://news.stanford.edu/news/2009/february25/stereotype-threat-harms-latent-ability-022509.html
  2. Negative stereotypes affect female soccer performance. (2016, July 14). Retrieved from http://www.eurekalert.org/pub_releases/2016-07/e-nsa071416.php
  3. Quinn, D. M. (2003, January). Women, math, and stereotype threat. Retrieved from http://www.aas.org/cswa/status/2003/JANUARY2003/WomenMathStereotype.html
  4. U.S. women’s team files wage-discrimination action vs. U.S. Soccer. (2016, April 1). Retrieved from http://espn.go.com/espnw/sports/article/15102506/women-national-team-files-wage-discrimination-action-vs-us-soccer-federation
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