Tuesday, December 25, 2007

Merry Christmas!

Merry Christmas, everyon! I hope everyone has a blessed Holiday season!

Sunday, December 23, 2007

Verbal Abuse - Denial

According to Patricia Evans, denial is another form of verbal abuse. Denial occurs when the abuser outright denies the partner's reality and experiences.

Some examples of statements that deny a partner's experience and/or reality are:
"We never had that conversation."
"That never happened."
"I never said that."
"You're making all of that up."

Although the abuser knows these things have occurred, he or she tells his or her partner they did not in order to make him or her doubt one's experiences and reality.

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Thursday, December 20, 2007

Verbal Abuse - Countering

Countering is a form of verbal abuse in which an abuser tries to dominate or control his or her partner and/or his or her partner’s reality, experiences, and/or feelings, according to Patricia Evans.

Evans remarks in her book The Verbally Abusive Relationship that when an abuser constantly counters his or her partner, the partner cannot truly know what the abuser thinks or feels.

Countering is a tactic in which an abuser will tell his or her partner that he or she is wrong – that one’s reality, feelings, perceptions, and thoughts – are wrong.

Here are some examples of countering.

Example 1:

Partner: I think the acting in that movie was done really well.

Abuser: How can you say that? The acting was horrible!

Example 2:

Abuser: That doctor didn’t know what he was talking about. I wonder if he even went to medical school.

Partner: You didn’t think he knew what he was talking about? I actually thought he seemed very intelligent about his subject matter.

Abuser: You’re wrong.

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Monday, December 3, 2007

Friday, September 7, 2007

Increase suicide rates

This new report from the Center for Disease Control and Prevention (CDC) really reiterates the importance of recognizing signs of suicide and the efforts mental health professionals, teachers, parents, and clergy should be making in suicide prevention.

You can view the report here.

Additionally, you can learn to identify the warning signs of suicide here.

Thursday, July 26, 2007

Erasing memories

Scientists Find Drug to Banish Bad Memories

This is very interesting. I wonder in what cases it would actually be better to forget that something happened? Aren't we, as humans, supposed to remember things, even bad ones, so that we can learn from them?

Monday, July 16, 2007

Verbal Abuse Disguised as Jokes

Trigger warning: This post contains details of verbal abusive situations.

Verbal abuse is often disguised by jokes by the perpetrator. These "jokes" are cutting, getting to the partner's core. They often demean the partner's femininity or abilities.

Some examples are:
~Boy, are you easily entertained.
~What else can you expect from a woman?
~You couldn't find your head if it weren't attached.

When/if you tell your partner that you do not think his "jokes" are funny, he may snap at you or tell you that you are too sensitive or that you cannot take a joke.

Do not think there is anything wrong with your sense of humor. These "jokes" are not funny, they are abusive.

Tuesday, July 10, 2007

Verbal Abuse - Undermining

Trigger warning: This post contains details of the things verbal abusers may say and do. This post may trigger memories of verbal abuse.

Underming is a tactic verbal abusers utilize to dampen his partner's enthusiasm, happiness, or excitement.

Undermining includes anything a partner uses to dampen your excitement. Some examples might include the following phrases:
-Who cares?
-That's stupid.
-Nobody asked you.
-Who asked for your opinion?
-Who are you trying to impress?
-What makes you think you're so smart?
-You'll never make it.
-It's over your head.

In her book, The Verbally Abusive Relationship, Patricia Evans even describes a situation in which every time one woman sat down to study, her partner took on a very concerned look and asked if she was OK. Over time, the woman became very anxious about studying, something she had originally been very enthusiastic about.

When you are constantly undermined, the verbal abuser tears at your self-esteem by making you feel as if your opinions, thoughts, and feelings don't matter.

Friday, July 6, 2007

Verbal Abuse: Withholding

Trigger warning: This entry contains detailed description of verbally abusive behavior.



Verbal abuse, unlike physical abuse, can be overt or covert. It isn't always obvious to the victim/survivor or her loved ones that she is being abused.



14 categories constitute verbal abuse, one of which is withholding.



Withholding occurs when one partner withholds affection, information, thoughts, and feelings from his partner. When one person in a relationship withholds, intimacy cannot be created. Survivors of verbal abuse who have experienced withholding say they do not know what they did "wrong" to be ignored.



Some examples of withholding might include:

-a partner withholding affection from you until you do what he wants you to do.

-refusing to give you information about where he is going, when he is coming back, about financial resources, and other forms of information.

-withholding material resources - in marriage, especially, withholding a promised food budget, bill payments, etc.

-refusing to answer questions, make eye contact, etc.

-withholding affection and comfort when you need it.

-ignoring you.

Over time, withholding damages self-esteem. The mistake many survivors of verbal abuse make, including myself, is that they try to "fix" the problem. They desperately try to figure out how to make the abuser happy so that he will quit withholding.



The truth is, there is absolutely nothing you can do to please your abuser to get him to quit withholding from you. Withholding, like all other abusive behaviors is about power and control.

Introduction to Verbal Abuse

First, on an administrative note: I've had to take a long hiatus from posting to this blog due to personal circumstances. However, I now find it appropriate and necessary to post here once again.

Patricia Evans was one of the first authors to explore verbal abuse in her book, The Verbally Abusive Relationship. Over the course of the next 2-3 weeks, I will be taking an in depth look at verbal abuse, the things verbal abusers say and do, how to respond to it, and how to escape it.

Please be advised that many of these entries contain detailed descriptions of abusive behavior. For your own safety, if you find verbal abuse too triggering, please refrain from reading this material.

Saturday, March 31, 2007

Families and Friends: Self-Harm

Your best friend calls you up crying hysterically. You try to ask her what's wrong, but she gets flustered and ends up telling you she has to go. The next day she confides in you that she cut herself again last night. You feel so helpless! You wish you could do something to help her. The good news is, you CAN do something to help.

Here are some things you can do to help your self-harming loved one:

1. Offer a chance for him or her to talk - Some self-harmers are trying to communicate through cutting, burning, hair pulling, and so forth. Given a chance to talk, some self-harmers will be more than happy to talk. Others may not know how to express how they feel. Still others may be reluctant to talk about what's going on. No matter what the case, be patient and don't push. Simply let him or her know that you are there to listen if he or she wants to talk about anything with you.

2. Nurture and care for them no matter whether your loved one has recently self-harmed or not. Some self-harmers feel that they can only get your attention when they hurt themselves. It's important to nurture your loved one regularly. Here are some ideas of caring things to do:
-Send your loved one a paper or e-card.
-Bring her a flower.
-Set some time each week where you and your loved one do something fun together.
-Take her to lunch or a movie.
-Hug her (if she likes hugs).

3. Offer distractions. Sometimes self-harmers merely need a distraction from their feelings for a while. Offer to go to a movie or dinner with your loved one. If you can offer her to spend the night at your house or offer to come stay at her house for the night.

4. Set some boundaries. Tell your loved one that you can talk up until 10PM at night, but if you don't want her to call at 3AM, let her know that. You might also tell her that you care about her, but you don't want her to hurt herself while she is actually talking to you because it hurts you to see her do this.

5. Be available. You can't be helpful if you're not available to your loved one.

6. Be patient. Sometimes families and friends of self-harmers expect them to stop self-harming right away. This may not, and in fact, often does not, happen. Stopping self-harming behavior can take months or years. It requires consistent support from loved ones and professional help for a self-harmer to break this unhealthy coping mechanism.

7. Get support for yourself. If you need to, talk with a therapist about your own feelings regarding someone who self-harms. Sometimes it is important to get help for yourself when you are supporting a loved one.

8. Educate yourself. The more you understand about self-harming behavior, its causes, and other related mental illnesses, the better off you'll be. This is one of the best sites I've ever found on self-harm.

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Friday, March 23, 2007

When People Say, "Enough"

This topic will probably cause some controversy, but I'm taking the plunge!

Tonight on 20/20 the show aired a segment on a restaurant owner who said "enough" with children who misbehave. 20/20 apparently hired two children actors to misbehave in the restaurant in order to see what other customers', waitresses' and waiters', and the restaurant owner would react.

Several customers were very irritated with the children. A few of them even asked the "parents" if they could better control them because they were in a public place. Several other customers also complained to the manager and waiters and waitresses.

The owner of the restaurant decided to let the "family" finish their meal, but asked them to never return to her restaurant. She proceeded to post a sign on the restaurant door saying that misbehaved children will not be tolerated in her place of business.

I have often thought about when it is appropriate to step in and ask parents to keep a better eye on their children. Sometimes it really irritates and saddens me that some parents don't seem to care about how their children behave. Nor do they seem to care about how their children's behavior affects other people.

Of course, the restaurant owner received a lot of criticism about the sign she posted on her door.

What do you think? Was this restaurant owner responding to out of control children appropriately?

Feel free to discuss in the comments section!

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Sunday, March 18, 2007

Important Sexual Assault Legislation Meeting in Minnesota

I realize this is tomorrow (Monday) morning and I am sorry for the short notice. I just found out about this tonight myself. I hope a lot of people can go and testify to the importance of this legislation at the meeting.

From the Sexual Assault Prevention Network:
Hello:

I just wanted you to be aware of a hearing that was scheduled late Friday regarding legislation to clarify Minnesota's statute of limitations for victims of childhood sexual abuse and provide funding the department of Public Safety, in coordination with the National Child Protection Training Center for work on mandatory reporting.

THIS IS CRITICAL LEGISLATION to empower victims of childhood sexual abuse with rights under civil law to HOLD THEIR ABUSERS ACCOUNTABLE.

**** The hearing is in Room 10 of the State Office Building, tomorrow morning, at 8:30 AM in the Public Safety Finance Committee chaired by Rep. Michael Paymar, one of our strong supporters.

**** This has all come about rapidly so my apologies for the short notice. However, the opponents have wasted no time in coming up with a line-up of witnesses AGAINST our bill:

The following witnesses would like to tesity regarding HF2134 Grace Schwab, Minnesota School Boards Association Valarie Dosland, Minnesota Childcare Association Father Kevin McDonough, Archdiocese of Minneapolis and St. Paul Reverend Karen Bockelman, Northeastern Minnesota Synod -- ELCA Dan Connolly -- Faegre & Benson Phyllis Willerscheidt

IF THERE IS ANY WAY YOU CAN BE THERE ON SHORT NOTICE TO WITNESS THE HEARING AND PROVIDE SUPPORT FOR VICTIMS, WE'D GREATLY APPRECIATE IT!

Saturday, March 17, 2007

Why Do They Self-Harm?

One of the things I've discovered throughout my psychology and social work education and training is that people do things for reasons. These reasons may not always be clear to observers, however. And like any other coping mechanism, people self-harm for various reasons.

These are some of the reasons self-harmers commonly give for their self-inflicted violence:

-To numb feelings or to escape depression, dissociation, or emptiness.
-On the contrary, some self-harmers self-injure to escape numbness; they want to feel something.
--To prevent suicide (please see my post below for more information).
-To escape tension or overwhelming feelings.
-To communicate their emotional pain.
-As a way of continuing abusive patterns (many self-harmers have experienced abuse).
-To validate emotional pain.
-To gain control over something, their bodies.
-To punish oneself for being "bad".
-To cope with feelings of anger, alienation, depersonalization, depression, or disassociation.
-To get grounded or to escape a flashback.

Self-harmers have found that hurting themselves is a way in which they can cope with their feelings that seem to painful to just sit with. While the behavior may successfully prevent suicide, once the self-harmer is "hooked" on it, it is very difficult to stop. Learning new, healthier coping mechanisms is hard work and takes a lot of time and practice. For this reason it may take self-harmers months or years to completely stop self-harming.

Sunday, March 11, 2007

Self-Harm and Suicide

Most people think self-harm is an indication that someone is trying to kill oneself. I have known several colleagues who have even thought this about their mental health clients. However, contrary to the belief, self-harm is not a suicide attempt, nor is it necessarily an indication that someone wants to kill himself or herself.

Self-harmers often have to use this unhealthy coping mechanism to SURVIVE their circumstances. Self-harmers often come from abusive, neglectful, or otherwise traumatic backgrounds.

It is vital that you talk with a self-harmer about their intentions when they self-harm before assuming that they want to kill themselves.

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Tuesday, March 6, 2007

Who Self-Injures?

The typical self-injurer is female and is in her mid-twenties to her early thirties. Self-injurers typically begin hurting themselves in adolescence, but some individuals begin harming themselves before or after this period in their lives as well. Self-harmers are generally intelligent, middle to upper-middle class, well-educated, and has suffered from sexual and/or physical abuse. Many self-harmers also have at least one alcoholic parent.

Certain personality characteristics are also typical of self-harmers such as an inability to accept rejection, tend not to plan for the future, tend to hate and invalidate themselves, tend to have poor emotional regulation, are usually angry at themselves, may be suicidal or self-destructive, suffer from depression and anxiety, do not feel as if they have much control, and tend to be avoidant. These individuals also tend to lack healthy coping skills.

Self-injurers may engage in other unhealthy coping mechanisms such as eating disordered behavior, substance abuse, reckless driving, unnecessary risk taking, and/or shoplifting.

Monday, February 26, 2007

Self-injury

March 1st is National Self-Injury Awareness Day. Please wear a red and black ribbon in support of the day.

This month I will be posting some information about self-injury.

I'll start today with a definition.
Self-harm is any action ones takes with the intent of hurting oneself and leaves marks lasting for more than one hour.

Some types of self-injury include cutting, burning, hitting oneself, interfering with the healing of wounds, bruising oneself, skin picking, hair pulling, and scab picking.

Thursday, February 22, 2007

Eating Disorders: Coping with Social Situations

Individuals with eating disorders often have a difficult time coping with social situations where food is involved, such as the holidays, parties, or other social events.

I have written an e-book entitled Eating Disorders: Coping With the Holidays and Other Social Situations. I used my personal and professional experience and knowledge to create this informative booklet for other women who have difficulty coping in these situations.

The book is $1.95. It's succinct, but packed with useful information.

Click the link above or on the sidebar to order.

Happy Reading!

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Tuesday, February 20, 2007

Eating Disorder Not Otherwise Specified IS Real

Eating Disorder Not Otherwise Specified (ED NOS) is as real as Anorexia Nervosa or Bulimia Nervosa.

ED NOS is diagnosed when an individual does not quite meet the criteria for Anorexia or Bulimia Nervosa, yet has disordered eating behavior. For instance, ED NOS might be diagnosed if a teen girl is significantly underweight, but has not stopped having menstruation. Or a young woman might be diagnosed with ED NOS if she has been engaging in binge-eating and purging behaviors for more than three months, but she only does it on average once a week.

Individuals who compulsively overeat are also diagnosed with ED NOS.

Despite the lack of attention the media and even many mental health professionals give individuals with ED NOS, it is a real issue. It's likely that more individuals suffer from ED NOS than from Anorexia Nervosa and/or Bulimia Nervosa.

What lies at the core of disordered eating is often similar whether the individual starves herself, binge-eats and purges, or overeats.

In the end it doesn't really matter WHAT diagnosis the individual with disordered eating has. It matters more that the individual needs help and that she is hurting.

If you know someone with ED NOS, please take their issues and concerns as seriously as you would with an individual that has Anorexia or Bulimia Nervosa.

Friday, February 16, 2007

Books

If you have a loved one who suffers from an eating disorder, you may not understand his or her mindset.

There are some really good fiction books written about eating disorders that can help a loved one of a family member or friend better understand the condition.

Some of the good fiction books I've read about eating disorders include:

The Best Little Girl in the World by Steven Levenkron

Diary of an Anorecix Girl by Morgan Menzie

Stick Figure by Lori Gottieb

The Monster Within: Facing an Eating Disorder by Cynthia Rowland McClure

Tuesday, February 13, 2007

What is Bulimia

Bulimia Nervosa affects about 1-3% of American women and .01-.03% of American men according to the American Psychiatric Association (2000).

The symptoms of Bulimia Nervosa according to the American Psychiatric Association are:
1. Recurrent episodes of binge eating. Binge eating is classified by eating a significantly larger amount of food within any 2-hour time frame than most people would eat in similar circumstances and time period. Binge eating is also classified as a sense of loss of control, feeling that one cannot stop eating, or that one does not have control over what or how much he or she eats.

2. Inappropriate compensatory behaviors in order to avoid gaining weight such as taking diuretics, fasting, excessively exercising, purposeful vomiting, or laxative abuse.

3. Binge eating and inappropriate compensatory behaviors (purging) occur together, on average at least two times a week for three months or longer.

4. Weight and shape significantly affect one's evaluation of himself or herself.

Purging type: During the current episode of Bulimia Nervosa, the compensatory behaviors include the misuse of laxatives, enemas, or purposeful vomiting.

Nonpurging type: During the current episode of Bulimia Nervosa, inappropriate compensatory behaviors include excessive exercise and/or fasting and the person does not regularly engage in the misuse of laxatives, diuretics, enemas, or self-induced vomiting.


Case example: Lauren is a 20-year old college sophomore. She has good grades, has lots of friends, and is outgoing. She gets together with her friends on Friday night to enjoy a movie. They often have pizza, ice cream, and other snacks when they watch the movie and afterwards when they catch up on that week's happenings.

What her friends don't know is that Lauren binges and makes herself vomit every night before she goes to bed. She does this after most of her dorm mates have gone to sleep so that no one will catch her vomiting in the bathroom.

Lauren's family have started to notice how awful her tooth look and the multiple scratches on her knuckles. When confronted about this, she just tells them that she knows she should take better care of her teeth. She makes up excuses for the scratches on her hands.


Lauren is suffering from Bulimia Nervosa and without medical and psychological help, the consequences of her mental condition could be fatal.

Wednesday, February 7, 2007

Eating Disorder Awareness

February is Eating Disorder Awareness month.

I will continue to discuss eating disorders this month.

Here are some other resources where you can find information, support, and other resources:

National Eating Disorder Association - you can find out more information about National Eating Disorder Awareness Week here.

Association of Anorexia Nervosa and Associated Disorders

Something Fishy Website

Anorexia Nervosa and Related Disorders Inc

Pale Reflections

The Alliance for Eating Disorder Awareness

I hope these resources are helpful.

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Tuesday, February 6, 2007

Eating disorders as coping mechanisms

Eating disorders are coping mechanisms.

When one focuses on food, weight, and his or her body image, he or she is avoiding the emotions that underlie the disorder.

A girl's parents get a divorce and she uses self-starvation to deal with her feelings of guilt, hurt, and sadness.

A boy is bullied at school and he uses binge eating in order to stuff his feelings of inadequacy, rejection, and shame.

Oftentimes, individuals who suffer from eating disorders aren't even aware of why they are using them as coping mechanisms. The goal of therapy is to uncover the underlying issues, to raise self-esteem, and to learn how to cope with feelings healthily.

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Sunday, February 4, 2007

Living with Anorexia Nervosa

Reading the diagnostic criteria for Anorexia Nervosa from the Diagnostic and Statistical Manual of Mental Disorders is vastly different than hearing the stories of individuals who have suffered with the condition. In this post, I want to offer some insight into what it is like to live with Anorexia Nervosa.

I initially began starving myself at the age of 13 or 14 as a way to lose some weight, to look as thin as my friends looked. I wanted people to compliment my looks like they did with my friends.

Because I attended a residential school for most of my high school career, starving myself was easy. All I had to do was lie to my mother about what I had eaten that day. No one could force me to eat away from home.

When I transferred schools in the middle of my junior year, I was already obsessed with the amount of food I was eating. It became harder to hide my starving behaviors, though, so I gained a little weight during that time.

However, when I moved to college, I began starving myself with a new vigor I never knew I had. I was determined to be thin, beautiful, and perfect. During my college years I lost a significant amount of weight.

It was during this time, too, that I began to have insight into why I was so intent on starving myself. I learned that I used restricting behaviors to cope with feelings I couldn’t handle, especially “negative feelings”.

I began to explore my restricting behaviors in therapy and I learned that being with my family was especially triggering for my eating disorder. When I went home I felt as if I had no control over what happened to me, and I used restricting behavior in order to give myself control over something – my body and weight.

I hated my body so much. No matter how thin I got, it was never thin enough. I thought thoughts like, “I am so fat!” even when I was extremely underweight, “I am eating too much” when I was only consuming a mere 500 calories or less a day, and “I’m still not good enough”.

As I entered into my Master’s program, I continue to starve myself, at least for the first year of my program. When my boyfriend, Dave, moved in during my second year in the program, however, things changed. I actively sought more intensive therapy for my eating disorder and Dave and I worked on getting my weight to a healthy level.

Since then, I have spent a year in recovery from Anorexia Nervosa. I still have plenty of days where I feel I am too fat, not good enough, or as if I am eating too much. But now I know that when these thoughts occur, I need to pay attention to what is going on inside of me. I need to examine my feelings and I need to examine why I feel as if I have no control over my life.

Recovery is possible for you or a loved one who has Anorexia Nervosa. Recovery is a hard and trying journey, one that you or your loved one will be on for many years. But once you’ve achieved a level of recovery, you’ll never want to go back into your eating disorder.

Eating disorders don’t have to control you; you can beat it with professional help, time, and a strong support system.

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Tuesday, January 30, 2007

Anorexia

Eating disorders are serious issues in American society. One of the 3 eating disorders, Anorexia Nervosa affects approximately 0.5% of American women and 0.05% of American men, according to the American Psychological Association (2000). Not only do individuals with Anorexia Nervosa suffer physically, they also suffer mentally as well.

What is Anorexia Nervosa exactly?

The Diagnostic and Statistical Manual of Mental Disorders defines Anorexia Nervosa with these specific criteria:

1. Refusal to maintain a minimal body weight (less than 85% of weight expected for age and height).

2. An intense fear of becoming fat or gaining weight.

3. Denial of unhealthily low weight, basing one's self-evaluation on his/her weight, or a disturbance in the way in which one experiences his/her body shape or weight.

4. Amenorrhea, the absence of menstrual cycles for at least three consecutive months (in postmenarchael women) or the presence of menstruation only when on hormones such as estrogen.

Anorexia Nervosa has two subtypes:

Restricting type - during the current episode of Anorexia the individual has not engaged in any binge-esting or purging behaviors. Binge-eating is classified as consuming significantly more calories in one sitting than what is considered "typical" for that culture. Purging behaviors could include the misuse of laxatives, diuretics, or self-induced vomiting.

Binge-eating/purging type - During the current episode of Anorexia the individual has engaged in binge-eating and/or purging on a regular basis.

Example:
Nancy is a college freshman this year. She has difficult adapting to change and misses her friends and family very much. Nancy became concerned about her weight when her roommate said she could stand to lose a few pounds at the gym with her. It has been six months since Nancy's roommate expressed this judgement, but Nancy continues to worry about her weight. Nancy keeps a chart of the food and calories she consumes, eats very little, and exercises multiple hours a day. Yet she manages to keep good grades.

Friends and family have expressed concern for Nancy, telling her she has gotten too thin and that she needs to eat more. Nancy, however, sees herself as extremely fat and feels she needs to lose more weight.

At her last doctor's visit, Nancy admistted that she has not had her menstrual cycle for four months now, but refuses to go into treatment for her eating disorder, insisting that she doesn't have a problem.


Anorexia Nervosa is a serious condition, and those who suffer from it often face serious medical complications and sometimes even death as a resulf of the lack of nutrients being put into the body and dangerously low body weight.

This post is the first of a series of posts on eating disorders. Later this week, I will discuss how to recognize Anorexia Nervosa in family and friends, how to help those who suffer with the condition, and the medical consequences that result from Anorexia.

Tuesday, January 23, 2007

Building trust

I've been talking about trust lately. Last time, I discussed how I believe one can determine whether he/she is able to place increasing amounts of trust in a potential friend. In this post, I'll share my opinions and insights into how one can build trust with another individual.

Relationships are built on trust, so it is important for us, as individuals, to learn how to build trust with other people.

Honesty is the first element in trust I think about when I hear the word "trust". In order for someone to trust you, you have to be honest with that person. And you have to be honest consistently. It's usually easy to be honest about some things while it's difficult to be honest about others. For instance, your new friend asks you if you like the outfit she's wearing. If you love it, you can easily say something like "I love that outfit on you! It really brings out your eyes". However, if you hate the outfit on your new friend, it might be hard to tell her this because you don't want to hurt her feelings.

It is always best to be honest about your feelings, thoughts, and opinions with other people. This doesn't mean that you should be overly critical of others, demean their thoughts, or invalidate their feelings. You can be honest and tactful. In the example above you could say something like "To be honest, I don't think that outfit suits you. The color doesn't bring out your assets the way I've seen colors do for you".

Another aspect of building trust in relationships is consistency. Call every time you need to cancel or reschedule your plans with a friend. Make being late and/or cancelations infrequent. Don't make your friend guess as to how you will react to similar situations. Along with consistency comes consciensiouness, which should be extended to everyone in your life.

You also need to keep the lines of communication open. Openly share and discuss your feelings, thoughts, opinions, and experiences with one another.

Consistency, honesty, and open communication will allow you and the new person in your life to build a solid relationship on trust.

Sunday, January 21, 2007

Trust in friendships

As I discussed in my last post, trust is an essential and difficult aspect of relationships. Trust can be especially difficult for individuals who have been through abuse or trauma.

I know this because I grew up in an abusive household. It wasn't until I went to college that I began to learn the importance of trust in relationships. Whether you are trying to develop a friendship or romantic relationship with another person, trust is the basis on which a relationship is built.

So, how do you know when or even if you can trust a potential friend or partner?

Through my experiences, relationships, and my own therapeutic work, I have learned a great deal about trust in friendships.

First, it is important to realize that trust is built over time. Trust shouldn't be given all at once. Oftentimes survivors of abuse or trauma may let down their guard too easily, allowing others to cross their boundaries too early in a developing friendship.

Don't disclose all of your personal information, background, and/or secrets at once. In fact, you may want to start with "small talk". When first meeting someone, get to know them by asking them what I call surface questions. Examples of these might include:
What is your favorite...?
Where are you from?
What are you studying / what do you do in your current job?
Do you have any siblings?

And so forth. Getting to know someone gradually will allow you to develop a greater sense of trust over time.

Do things you both enjoy. Spending time together will allow you to develop a solid friendship. When you spend time with one another, you also have the opportunity to learn more about each other. When you see a movie, for instance, the movie may inspire you to talk about mutual interests or to bring up things you have not discussed before such as your opinions, thoughts, feelings, or experiences.

Consistency is another factor in trust in my opinion. If your potential friend agrees to meet you at Starbucks at 10AM and she runs into traffic, causing her to arrive late, does she call to let you know she'll be late? Does she offer an apology or explanation for her lateness?

Likewise, does your potential friend call to cancel ahead of time if she can't make your meeting? Are her actions consistent with her words? If she tells you she really wants to get to know you, but then doesn't call, e-mail, or make plans with you for the next three months, her words and actions are not consistent with one another.

There are times when we are ALL late, unable to cancel ahead of time, break someone's confidence accidentally, or neglect to keep good contact with our friends. However if these things are happening consistently, the person in question may or may not be trustworthy.

I believe trust is earned, built over time. If you have concerns about potential friends, talk to the people you trust (long-time friends, counselors, a pastor, etc) to get their take on the situation. Then, you may want to consider talking with your potential friend about your concerns regarding him or her.

The most important thing to remember is to take relationships slowly; don't let new or potential friends cross all your boundaries initially and listen to your instincts!

Tuesday, January 16, 2007

Trust

Trust is one of those abstract concepts everyone seems to hold a different opinion about. It appears to be hard to define in any definite terms. But I'd like to share the insights I've gained about trust through my work as a student social worker.

In my first internship in my master's program in social work, I worked in a safe house and transitional housing unit. Not only had many of these women been abused by their former partners, but they had also been abused by family members and friends, people they thought they could trust.

And yet, here I was asking them to trust me, a total stranger. While I have suffered my own significant traumas, I couldn't ethically blurt this out to all the women in the safe house. While the statement might have shown them that I could relate to them, the statement might also make them warier of trusting me. They might feel as if I were too fragile to help them or that they needed to listen to me rather than my doing my job as their counselor.

Thus, I had to figure out different ways of earning their trust, and I did. I built rapport with the mothers and their children by spending a lot of time with them, eating dinner with them, attending their group sessions with them, talking about how their day was, and about their children. I also got to know each child by spending time with them - playing and talking with them, and just allowing them to be the carefree children they deserved to be.

It took two or three months before one mom, which the staff had a particularly hard time connecting with, began to trust me. We took things in baby steps. I got to know her - her likes and dislikes, what she did during the day, her ambitions, and so forth. Eventually, I let her know that if she ever needed to talk that I was available to help her. Opening the therapeutic door for her was an enormous step, one she wasn't ready to take before my internship ended. However, being able to really connect with this woman showed her that there are people out here to support her. I really think the trust she and I built together was monumental considering all that she had been through, and I was truly amazed at how much she accomplished in the short time we had spent together.

So, what is trust exactly? As I said earlier, trust is really difficult to define, but here is what I believe trust is. Trust is being able to count on someone, to know that you can confide in someone and that that someone won't defy your confidence. Trust is being able to share your innermost throughts, feelings, dreams, and ambitions with someone and that same someone should be able to share theirs with you. When you trust someone, you know that person will not judge you based merely on situational circumstances, but rather, they will look past situations and behaviors to seeing your core being.

I believe trust has to built over a period of time. If you have never been through significant trauma, trust might come more easily to you whereas those who have been abused or traumatized might need to take more time to get to know someone before they begin to place any trust in that person.

I believe trust is earned. And when it is broken, you have to re-earn the trust you lost.

If you're having trouble trusting or struggling with the fact that a friend or family member doesn't trust you, tune in later this week to learn how you can cope with these issues.

Monday, January 15, 2007

Recovery

If you're recovering from any type of addictive behavior, whether it be an eating disorder, self-injury, alcoholism, drug abuse, or smoking, you know how hard it can be to get through even one day without using your coping mechanism. Some days you just feel there is no hope. You don't think you'll ever recover.

Sometimes we just need a little reminder that recovery is possible. Inspirational stories are a great way to remind ourselves of the possibility of recovery. This is a very inspirational story about a young man who suffered from alcoholism and recovered. He's currently five years sober! Go ahead and read for yourself - I think you'll find his experience truly inspiring.

Friday, January 12, 2007

Self-harm

Self-harm has been getting increased attention by the media over the past decade. I wanted to share my experiences as a self-harmer with others in order to help dispel the myths surrounding self-harm. I hope my personal essay sheds light on this topic. If you are a self-harmer, know you are not alone. Family and friends of individuals who hurt themselves may want to read the facts versus myths article I have written on the subject.

Wednesday, January 10, 2007

Coping with trauma anniversaries

As a trauma survivor I know how difficult trauma anniversaries can be. Other people may tell you to “get over it” or just not think about the trauma around the anniversary time, but we, as trauma survivors, know it’s not always that simple. Thus, I have created a list of suggestions that may help you care for yourself during a trauma anniversary as well as the time surrounding it.

Treat yourself to something you love: It is important during tough times that you remind yourself that you deserve good things and that you did not deserve the abuse, rape, or violence you experienced or witnessed. Sometimes it is hard to know what to do for yourself because when you are in this state of mind you feel as if you don’t deserve good things or to treat yourself well. So, here are some suggestions that may help you think of your own!
- Take a hot bath or shower.
- Put on your favorite scented lotion.
- Enjoy something you love to eat or drink. For instance, indulge in a Starbucks coffee, ice cream, chocolate, fruit, yogurt, or whatever you love.
- Wear comfortable clothes.
- Take a walk, run, bike ride, or whatever you enjoy doing.
- Cuddle with your cat or dog.
- Talk with a trusted friend.
- Plan dinner, shopping, a workout, or other activity with someone you enjoy spending time with.

Grounding techniques: Learning grounding techniques will help you if you are experience flashbacks or panic attacks. These techniques focus on the present, so they will bring you back to the present instead of the past.
- Clap your hands together or stomp your feet on the floor.
- Tell yourself you are safe and in the present.
- Touch the things around you and name them aloud or to yourself.
- Name the noises you hear around you or focus on any conversations taking place near you.

Make a safety plan: A safety plan will allow you to stay safe during an anniversary. You might want to notify trusted people of your trauma anniversary and request their support. It is perfectly okay to ask for the support you need. Think about what is helpful for you and tell trusted people so that they can better support you. You might ask trusted people to talk with you, go out to dinner, shop with you, watch a good movie with you, or just be available to listen to you.

If you have a tendency to self-injure, make a list of individuals, hotlines, and hospitals you can call in times of emergencies. Reaching out to someone, whether it is a friend, pastor or priest, family member, counselor, or a trauma related hotline is a healthy way to cope with your feelings.

Remind yourself that it will pass: It is hard to cope with feelings of helplessness, hopelessness, depression, fear, and anger. It’s also difficult to cope with symptoms you may experience from Post-Traumatic Stress Disorder such as nightmares, easily startled, flashbacks, and triggers of the trauma. However, reminding yourself that the feelings and symptoms will pass may help ease the anxiety you feel about them.

Set aside time to relax each day: Setting aside time to relax may ease your symptoms and anxiety. What do you enjoy doing that eases your mind? Here are some suggestions to help you get started.
- Read.
- Write in a journal or a letter to a friend.
- Listen to your favorite music.
- Talk with a friend or other loved one.
- Spend time with your cat or dog.

Pray or meditate: Finally, engaging in prayer or meditation may help you through an anniversary time. If you are religious, pray to your Higher Power for the strength and courage you need to get through this difficult time. Read the Bible to find peace and comfort. Go to church for support from the church community.

If you meditate, make sure you set aside some time everyday to do so. I hear meditation is relaxing to the body, mind, and spirit.

Getting through trauma anniversaries is difficult, but you don’t have to do it alone. The suggestions provided here will help you take care of yourself while struggling through the feelings and symptoms associated with traumatic memories anniversaries often bring to the surface.

Friday, January 5, 2007

How can I help?

Post-Traumatic Stress Disorder is not only hard for the trauma survivor, but oftentimes, for families and friends of the trauma survivor as well.

Here are some things you can do to support a trauma survivor suffering from Post-Traumatic Stress Disorder:

1. Educate yourself: Educating yourself about Post-Traumatic Stress Disorder, its symptoms, causes, and treatments will go a long way in helping you support a trauma survivor. The more you understand about the condition, they better able you are to be supportive of your loved one.

2. Encourage the trauma survivor to seek help: As I mentioned in the post below, there are no "magic pills" to cure PTSD. The only way a trauma survivor can move forward in healing from a traumatic event is by exploring it in detail in counseling. Understandbly, your loved one will be afraid to go through this process. Reliving a traumatic event is not only tough, igoing through the process can bring up feelings of fear, anger, depression, helplessness, and hopelessness.

3. Show active support: If the trauma survivor decides to enter therapy, support him or her. It might be helpful to think of things you can do to support the individual. For instance, you can offer to sit in the waiting room while the individual is in therapy or to be available for support after the appointment. Alternatively, offer to spend quality time with the trauma survivor so that he or she knows he/she is cared about. Letting the trauma survivor know that you are available to listen is also a good idea.

4. Don't push: While it is a good idea to encourage the trauma survivor to seek professional help, it is not a good idea to try to force him/her to do so. Likewise, offer your ear to the trauma survivor, but don't try to coerce or force the individual to talk about the trauma if he/she doesn't want to.

5. Get help yourself: If you are having a hard time handling the trauma or the feelings surrounding it, you should seek therapy, regardless of whether or not the traumatized individual is.

6. Grounding: Individuals with PTSD often experience flashbacks, where one feels like he/she is going through the trauma all over again. It is important that you know some grounding techniques that you can teach the trauma survivor, if he or she is open to learning them. Here are some grounding techniques one can use in the midst of a flashback or panic attack:
-Stamp your feet on the floor
-Clap your hands
-Touch the things around you and name them out loud or look at the things around you and name them out loud
-Pet a pet
-Talk to a trusted person

All of these techniques help focus the mind on the here and now, rather than on the past.

Tuesday, January 2, 2007

Mental Illness Profile

Post-Traumatic Stress Disorder

The criteria for Post-Traumatic Stress Disorder (PTSD) are as follows according to the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders IV-TR:

A. The individual was exposed to a traumatic event where both the following were present:
-The individual experienced or witnessed, or was confronted with an event/s that involved actual or threatened death, serious injury, or threat to the physical integrity of the individual or another person.
-The individual's response included intense fear, horror, or helplessness.

B. The traumatic event is persistently reexperienced as evidenced in one or more of the following:
-Nightmares
-Psychological distress when presented with internal or external cues that remind the individual about an aspect of the trauma
-Feeling as if one is reliving the traumatic event through hallucinations, illusions, and/or dissociative flashbacks
-Intense and disturbing recollections of the event such as perceptions, thoughts, and/or images

C. Persistently avoiding of stimuli that remind the individual of the trauma or numbing of general responsiveness, that was not present before the traumatic event as exhibited by three or more of the following:
-The individual makes efforts to avoid feelings, thoughts, and/or conversations associated with the traumatic event.
-the individual possesses an inability to recall certain important aspects of the traumatic event.
the individual avoids activities, places, or other people that remind him or her of the traumatic event
-diminished interest or participation in significant activities
-the individual has a feeling of a foreshortened future.
exhibits a restricted range of affect
the individual feels estranged or detached from others.

D. Exhibits increased arousal by two or more of the following:
-Sleeping difficulties
-Exagerated startle response
-Hypervigilence
-Outbursts of anger or irritability
-Concentration difficulties

Symptoms in categories C and D last for more than one month.


What does all of this mean?

Let me give you an example of what a person with post-traumatic stress disorder may look like.

C was raped by an acquaintance three months ago. Ever since, she has not been sleeping well. She cannot seem to get to sleep at night; however, when she does sleep, she has awful nightmares of the rape. She also experiences flashbacks where she feels as if the rape is happening all over again. These are especially triggered by certain things that remind her of the trauma. For instance, a vanilla candle was burning in the living room when she was raped, it was dark in the room, and the phone kept ringing. Thus, when she hears a phone ring, she will immediately go into a dissociative flashback, where she feels the rape happening all over again. Because C was raped in her living room, she tries to avoid spending as much time in there as she can. She also threw the vanilla candle away, but told her mother the glass container had shattered on the floor while she was dusting the coffee table. C has not told her parents what happened that night and while she tries to pretend that nothing is wrong, her parents have noticed changes in their daughter's personality. C was a relatively calm teenager before the trauma. She made straight A's in school. However, since the rape, she has been irritable and has become angry at her parents, seemingly yelling at them for no reason at all. Her grades have also dropped because C has experienced an inability in concentrating on her schoolwork.
C has also become very jumpy. She looks over her shoulder a lot and starts at every little noise. When she hears a car backfire or any other loud noise, she goes into a panic attack.


C's case shows us what one individual with PTSD might experience on a daily basis. However, individuals with PTSD rarely, if ever, experience the same symptoms in the same ways.

While there is currently no medication to treat PTSD in its entirety, anti-anxiety medications such as Xanax, Ativan, or Buspar might help take the edge off the symptoms. The only "cure" for PTSD is for the individual to work through the trauma in therapy.

Tomorrow, I'll discuss how loved ones might help a family member or friend with PTSD.