Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

4071This week is Mental Health Awareness Week which was established by the U.S. congress in 1990 to recognize the National Alliance of Mental Illness’ efforts to raise the awareness of mental illness. It just so happens that last week’s police chase and subsequent shooting and killing of Miriam Carey has brought mental illness and postpartum psychosis into the spotlight.

What Is Postpartum Psychosis?

Many people have heard of postpartum depression, but not many people have heard of it’s evil sister, postpartum psychosis. When I was in graduate school I was so fascinated by postpartum psychosis that I actually did a 20 page research paper on the phenomenon.

It isn’t uncommon for women, after giving birth to feel down, sad or even somewhat depressed. This is what is known as “baby blues” and approximately 70-80% of mothers feel this contradicting negative thoughts and sadness after experiencing the joy of giving birth.

Many women don’t talk about it because they feel guilty or “bad” because of these feelings, but it’s important that they talk about the way they feel so that the “baby blues” don’t progress into something deeper like postpartum depression.

Postpartum depression basically is a much more intense and prolonged feeling of negativity, depression and mood swings when compared to the “baby blues”.  This can last weeks, months or even longer.

Postpartum psychosis is the most severe and extreme form of postpartum depression and not only does it typically include the intense sadness, negativity and mood swings of postpartum depression, but it also includes the onset of psychotic symptoms after childbirth.

An example taken from a personal experience I had dealing with a client I diagnosed with postpartum psychosis is that she was extremely depressed at times and then highly erratic and impulsive other times. She was extremely irritable and was having hallucinations which included voices and delusions that her newborn was evil and needed to be killed.

Like a lot of women who deal with the “baby blues”, postpartum depression and postpartum psychosis, she tried to hide the way she was feeling and mask her psychotic symptoms until it got to the point that she was about to drown her child in the bathtub. It was then she went to her family for help and was taken to the psychiatric hospital.

This particular young lady ended up being okay after treatment which included therapy and a brief period of taking lithium. Her child was subsequently raised by the maternal grandparents although legally this young woman still has full custody and spends time with her daughter often.

Postpartum psychosis is extremely rare which is one reason it is not often talked about and another reason many people who suffer from it try to hide it because they are struggling to try to understand exactly what it is they are going through and may feel alone.

Symptoms

Symptoms of postpartum psychosis Include, but are not limited to:

  • euphoria
  • overactivity (hyper)
  • decreased sleep
  • talkative (loquaciousness/hyperverbal)
  • flight of ideas
  • disinhibition
  • irritability
  • violence
  • delusions
  • grandiose thinking or behavior
  • religiously preoccupied
  • delusions
  • hallucinations
  • depression
  • mood swings
  • mutism

Other Famous Examples of Postpartum Psychosis

Melanie Blocker-Stokes

melanie&sam
Melanie and her husband Sam.

Although postpartum psychosis is rare, some popular cases include Melanie Blocker-Stokes, a successful pharmaceutical sales manager happily married to a physician.

On June 11, 2001 she gave birth to a baby girl and soon developed severe depression, stopped eating and drinking and no longer could swallow just four weeks after giving birth.

She became paranoid and thought her neighbors closed their blinds because they thought she was a bad mother and although she was in and out of several hospitals, was on several medications and even received electroconvulsive therapy, she killed herself by jumping off of the roof top of a Chicago hotel. Her daughter was only 3 and a half months old.

Melanie always wanted to become a mother and it’s a tragedy that becoming a mother ultimately took her life. She had written in her journal before her death: “How can I explain to anybody how something has, literally, come inside my body…I’m no good to anyone. No good to myself.” 

She called some her friends and family and left what they now know were her final goodbyes and to her husband she left a note that simply read: “Sam, I adore you, Sommer and Andy, Mel.” Andy was her husband Sam’s son and her stepson and Sommer (Sommer Skyy) was her newborn child.

Her battle with postpartum psychosis helped congress pass the Melanie Blocker-Stokes Postpartum Depression Research and Care Act in 2010 aimed at increasing research, education and screening of postpartum depression and postpartum psychosis. Sadly not much has been done since it was passed, but this is the story that sparked me to write my research paper in graduate school and got me interested in postpartum psychosis.

Andrea Yates

Perhaps most famously there was Andrea Yates whose mental health seemed to deteriorate with each child she gave birth to. She had attempted suicide twice and was urged against not having any more children after being hospitalized in a psychiatric hospital after her fourth child. Never-the-least she gave birth to a fifth child and three months later she was hospitalized again twice and warned not to be left alone with her children.

However, one day she was left alone for only an hour and tragically drowned all five of her children. She’s currently committed to a high-security psychiatric hospital.

Miriam Carey

Miriam Carey was a 34 year old mother of a one year old little girl. She was a dental hygienist with plans on going to dental school. Last week she made the decision to drive from her home in Conneticut to Washington, D.C. Some reports say that she was mad with President Obama for listening to her phone conversations.

Miriam Carey
Miriam Carey

In any case, with her young daughter in tow, she drove to Capitol Hill, crashing into barricades around the White House, police cars and speeding recklessly down Pennsylvania Avenue before she was shot and killed by law enforcement after attempting to use her car as a weapon.

It’s unfortunate that Miriam Carey was shot and killed, especially with her one year old daughter in the car. After listening to her family talk on CNN last week talk about her struggles with postpartum psychosis and a family history of mental illness including schizophrenia, I wish something could have been done sooner although she was apparently taking medication for an unknown mental illness.

It’s possible that although her family knew she was having some mental problems, they didn’t know how severe they were or even what they were because she was most likely keeping them in the dark and the Health Insurance Portability and Accountability Act (HIPPA) keeps doctors and mental health professionals from being able to discuss a persons medical and mental issues with family members which helps explain why her family members and friends where all shocked that she was behaving so erratically and reckless especially with her daughter in the car. They were all shocked to learn that she had even driving to Washington, D.C. out of the blue.

They may have known she had issues, but never suspected that they were as severe as they turned out to be.

According to everything I have read as reported by her family members and her boyfriend, her main symptoms were paranoia and delusions. It’s a good chance that her mental health problems existed before she was pregnant and that her pregnancy exacerbated the condition and developed into postpartum psychosis.

For example, she could have been suffering from bipolar disorder or a mood disorder previously and possibly stopped taking her medication to prevent them from having side effects on the baby and then everything just snow balled out of control with the natural hormonal and mood changes that occur with pregnancy.

Many women who develop postpartum psychosis already have other underlying mental health issues

Her death however is not in vain as it helps bring attention to postpartum complications like “baby blues”, postpartum depression and postpartum psychosis so that maybe more women who are suffering silently will speak out and reach out for help.

If you or someone you know is suffering from postpartum depression of any kind, have them speak with their doctor. For more information visit http://www.postpartum.net/ or call 1-800-944-4PDD.

Blinded By Beauty: Ignorance Towards The Mentally Ill

Alexander_AyannaYesterday while watching the local news, I saw a story about an officer who was called to an apartment complex after residents called bout a naked woman outside of her apartment.

Upon arriving, officer Ryan McIntosh found 20-year-old Ayanna Alexander outside of her apartment, but she had put on clothing by then.

Ayanna, who is an exotic dancer, told the officer that she was upset because she didn’t have a ride to work at Rachels, a local strip club.

The officer didn’t think Ayanna was impaired or had any other medical conditions, so he called his supervisor and got permission to drive Ayanna to work. He dropped her off and left, only to be called back shortly afterwards to a nearby restaurant after receiving a call about a naked woman thrashing the restaurant and disturbing patrons.

The officers arrived at the restaurant to find Ayanns with no pants or underwear on and during questioning by the police, she removed her shirt and bra and said she wanted to go to jail.

Ayanna was charged with disturbing the peace, indecent exposure and trespassing.

The problem I have with this is, not many people in their right minds, especially an “attractive” 20-year-old woman would just strip naked and cause havoc. To me, this just screams mental illness from the start, rather it is bipolar disorder or something else, but from the start of this story i felt like this woman should have been taken to the hospital for a mental evaluation, not taken to work and just dropped off.

Even after the second incident, instead of taking her to jail, I still feel like she should have been taken for a mental evaluation. Something clearly isn’t right. Maybe it is drugs, who knows? The officer said she didn’t seem impaired, but her behavior was abnormal and he didn’t do a urinary drug screen to rule out she was on anything.

Also, he was obviously not a Crisis Intervention Team officer or had much training, experience or exposure to mental illnesses or he would have recognized that this woman was in need of help, not a ride to her place of employment.

I’m not necessarily blaming the officer for not being trained properly, but I am blaming him for being ignorant and perhaps even blinded by an attractive female and wanting to do the “nice” thing by giving her a ride to work instead of truly investigating the incident.

At the hospital I work at it’s not uncommon for officers to bring us young, attractive, 20 something year old women they find naked running or walking through the streets or just sitting in the middle of the road. Nine times out of ten these women are not under the influence of any drugs or alcohol, but are suffering some type of mental break.

Often times it’s their first psychotic episode and they go on to be diagnosed and treated for bipolar disorder (most commonly), and other times they are people with long histories of mental illness.

The late teens and early twenties are the prime ages for the development of bipolar disorder and it’s not uncommon for people to present with symptoms of erratic, impulsive and irrational behavior for the first time around 20.

If this woman is simply arrested, charged and then released, she will get no help and eventually spiral out of control again, but maybe next time she won’t run into a naive officer who is trying to be nice, but maybe a predator or someone else who instead of helping this lady may victimize her or she may do something much more reckless and dangerous than taking off her clothing and throwing food in a restaurant.

Sometimes it’s hard to recognize and start treating the first symptoms of a mental illness, but to me it’s common sense that if you come across a naked, exotic dancer who gets paid to take her clothes off, doing it for free outside in the daytime, something isn’t right and the two most likely culprits are drugs and mental illness.

If the officer quickly decided she wasn’t impaired or had a medical conditions, why didn’t he take her to rule out a mental health condition other than ignorance? This is a problem on many occasions, but especially when you consider that the jails and prisons in our country today house many more mentally ill people than all of the mental hospitals, clinics and institutions combined.

Untrained officers come in contact with mentally ill people on nearly a daily basis and often times the result is tragic (numerous officer related shootings involving mentally ill people is what sparked crisis intervention team training for law enforcement officers), or they are arrested or simply ignored.

In this case, two out of three happened. Her mental condition was ignored and then she was arrested.

The Face of Mental Illness

girl-in-shadows-istockI love working in a psychiatric hospital because it’s rarely boring. The type of people who come through the door are everyday people, no different from you or me, it’s just that what they are dealing with at the time is more than they or most likely any of us can handle.

I remember when I first started working here, a senior co-worker said that the only thing separating us from the patients is that we have the keys that let us in and out.

That’s one reason customer service, even in a mental hospital is so important. We strive on treating everyone, no matter what their circumstances or mental state, fairly and therapeutically because you never know when we or one of our family members or friends will end up in a place like this and it’s fairly easy.

Say the “magic words” to the right person and you may find yourself involuntarily hospitalized. Have an over exaggerated emotional or behavioral reaction and you may end up placed in a mental hospital to help you calm down.

Since I’ve been here I’ve seen correction officers, police officers, teachers, college students, professional athletes, lawyers, daughters of politicians, doctors, nurses and business owners come through our doors under involuntary hospitalization statuses.

People are placed here everyday who feel like they shouldn’t be and some may very well not be, but the majority at least need a cool down period.

For example, last week a college student got into a fight with his girlfriend and someone reported he threatened to kill himself. He denied does accusations, but he was emotionally upset enough that law enforcement thought it was best that he was brought here for his safety and the safety of those around him.

Now that he was here he didn’t want to be here and wanted to leave. He kept trying to convince me and everyone that he didn’t need to be here, but in doing so, he was getting more and more upset and therefore appearing more and more like he needed to be here for his safety and those around him.

I kept trying to talk to him and tell him that if he truly didn’t think he should be hospitalized then he needed to be calm and relaxed, otherwise he was risking looking like every other patient in the hospital who truly needed to be there.

However, he was so agitated and insistent on leaving that we had to place him on an elopement risk which lessened the chance of him being released sooner than he would have been otherwise.

When people think of the patients in a mental hospital, they almost automatically get an image in their head as if mental illness has a face. Those of us who work in the field or know someone or are ourselves suffering from a mental illness know that this couldn’t be further from the truth.

This morning I spoke with the mother of one of our patients who just graduated with an advanced degree and has an extremely high IQ, but has a long history of bipolar disorder and hasn’t been on her medication in over a year.

This is a beautiful young lady who was found sitting outside naked, stating that her old self had died and given birth to her new self with a new name she was calling herself by and a new age. She also believed she had God like powers.

Here at the hospital, for the most part, this young lady was selectively mute and at times appeared catatonic. We even had to carry and pose her limp body at one point when we had to transport her to another part of our facility.

She was definitely in need of some medication to help her start getting back to her “normal” self.

I was really hoping to speak with her, I throughly enjoy talking to people who both have a long history of mental illness and the ability and awareness to really talk about it and analyze their experiences, but she wasn’t speaking to anyone, so I spoke with her mother for a while about her history of treatment and tried to help calm her mother’s fears about her daughter’s recent deterioration.

This young lady reminds me that mental illness is all around us and it’s nothing to be ashamed of or to run from. Sometimes it’s in your face like the guy talking to himself while begging for change or it’s wrapped in the package of a pretty grad school graduate who on most days could hold the most intellectual conversations, but today she’s just staring into out of space unresponsive to the world around her.

 

Treatment Of The Mentally Ill In A War Torn Country

706x410q70simon-somalia-subbedMThe other day I was reading a very interesting article about how mentally ill people are treated in Somalia where they have one of the highest numbers of mentally ill people in the world.

Somalia is a country that’s been plagued by war, famine and disease for decades. As a result, at least 1 out of 3 of their 10 million citizens are affected with a mental illness, including many former soldiers, some who joined various armies and fractions at as early as 7 years old and are suffering from post traumatic stress disorder (PTSD).

On top of all this, a very large number of the population uses a drug called Khat, which is a plant that you can chew and it causes psychedelic effects. It’s legal and addicting although it can cause both health and mental damage.

Things are further complicated for the mentally ill in Somalia because of the lack of qualified mental health professionals. Many of the mental health workers in Somalia have only received 3 months of training through the World Health Organization (WHO), which is advocating for the humane and proper treatment of the mentally ill in Somalia and worldwide.

WHO officials have rescued mentally ill people from some very poor conditions. Families who have mentally ill family members in Somalia often don’t know what to do or where to turn for help so they chain them to beds in the house or to trees in the yard, including one lady who was chained by her husband to a tree for eight years and gave birth to three children.

Faith and folklore also play a role in treating the mentally ill in Somalia, with individuals sometimes being flogged to get rid of the “evil spirits”, locked in a room with a hyena for three day stretches in hopes that the hyena would eat away the “evil spirits”, or simply just beaten to death by villagers.

The streets of Mogadishu, Somalia’s capital, are littered with the mentally ill sleeping under bridges or wandering around aimlessly chewing on Khat. Most of these individuals are suffering from some sort of mental trauma and are receiving no help.

Something that makes this story even sadder is that Somalia’s only trained psychiatrist died last year in a car crash. It’s one thing to have one psychiatrist in a country of 10 million people, but when that person dies and there is no one else to take their place, the fate of the mentally ill seems that much dimmer.

A lot of money is going into rebuilding Somalia and helping with diseases like HIV, TB and diarrhea, but not enough funding is going into helping the mentally ill.

I can only imagine that it will be nearly impossible to build a stronger country, economically, educationally and health wise, if such a large portion of the population is suffering from mental trauma.

Where will these workers come from? How can they function if they are suffering from a mental illness without being treated? How will the children who are suffering learn and grow up to be productive citizens?

This is only a snap shot about mental illness in a third world, war torn country and similar terrible conditions are played out everyday around the world.

Hearing about these deplorable conditions initially made me wish I could go to Somalia to help out, but I realized that it also makes me want to advocate even stronger for the rights and proper treatment of the mentally ill here in the United States and across the world through education, information and community service.

Defeat Unpleasant Thoughts By Ignoring Them

iStock_000009024892XSmall-300x240I recently read an article on psychologytoday.com entitled Why Our Thoughts Are Not Real. This wasn’t the first time I had read an article that talked about the fallaciousness of our thoughts and how we often misinterpret the information our thoughts give us.

Everyday we are filled with thousands of thoughts, most of them aren’t even real, but we assume and act on them as if they are real and that is what causes us to have many of the feelings and behaviors we have that cause us so much strife.

Our thoughts on their own are just thoughts, they don’t exist in reality, you can’t touch them and they really aren’t anything at all until we make them real by engaging in, dwelling on and trying to do something about them.

I try to explain this a lot when I work with clients dealing with anxiety. They will have a thought pop into their head, such as “I don’t think my shirt matches my pants today and everyone is going to notice and I am going to be walking around looking like a fool and people will be laughing behind my back.”

Consciously the client didn’t chose to have this thought, it just popped into her head and if she ignores it for a while, it will likely fade away and she will forget she even had that thought, but what most people do, especially people with anxiety, we try to do something to get rid of the thought which causes us to pay more attention to the thought which causes the thought to become more real and anxiety provoking.

The person in this case is then more likely to continue wondering if she looks stupid, may go look in the mirror and start scrutinizing her attire even more and may go to a coworker asking “do I look stupid in this” and may feel relieved when the co-worker says “No, you look fine” or may create even more anxiety by saying that her coworker is just too nice to hurt her feelings.

Whatever the case, the point is that because she is thinking about the thought, that isn’t even real, she is making it more and more real and creating more and more anxiety, when if she would have just let the thought enter her brain, allow herself to not do anything about it, including thinking about it, the thought most likely would have left her awareness and she would have went on with her day without being overly conscious about her attire.

When we start given our thoughts attention, that’s when they start to feel real and start to have some control over us because we typically want to do something about it. People with anxiety generally create more anxiety because they attend too much to their anxious thoughts and generally try to get rid of it, by doing something which causes even more anxiety, similar to someone with obsessive compulsive disorder. The same goes for people suffering from depression. They may have the unreal thought “no body likes me” and so they withdraw from people and when they find themselves alone use that as further proof that “no body likes me”.

When it comes to anxiety, I had a client who suffered with anxiety and her boyfriend would break up with her almost every week. When he would break up with her she would have the thought, “If he leaves me I will be alone and miserable for the rest of my life”, that thought would cause her to panic and she would call and text him repeatedly. He wouldn’t respond which would amplify that thought and her anxiety so she would jump in her car and drive fast and recklessly to his house where she would pound on the door and cry until he opened it and they reconciled.

Later she would always be depressed by the frantic and pathetic way she responded, yet the next week she would do it all over again.

I had to help her learn to just sit with her thoughts and feelings and do nothing about them, even though she felt like she needed to. It was hard for her not to call, text and drive to go see him the first few times we worked on this, her anxiety was through the roof,  but when she finally allowed herself to sit with the anxiety, to try to not think about it, she was surprised that after about 20 minutes, the anxiety went from a level 10 to about a 2. It would come back when she thought about it and we had to work on letting it go again, and once again her anxiety would go back down without her doing absolutely anything except not giving it life by attending to it and trying to do something about it.

After a few sessions she was able to sit with her anxiety and not have it cause her whole world to stop or spin out of control and with that, her self-confidence increased and she was able to handle her situations a lot better, without panic, but with a clear level head.

I think this is something we can all practice. Remember that our thoughts are not real until we breathe life until them, and especially when it comes to an uncomfortable thought, sometimes doing nothing about it, including not thinking about it, will allow it to leave our consciousness and fade into nothingness instead of causing us to feel and do erratic and irrational things.

Distraction is a good tool to use when it comes to this. Instead of thinking about the thought, do something to distract yourself. I do it all the time and with practice it becomes really simple. Usually in about five minutes whatever the thought was causing the anxiety, sadness, or whatever, will fade from my consciousness and not have crippled my day or caused me a great deal of distress. This is a simple solution that can help us all live happier, more fulfilled lives.

Young Stars Bright Futures Cut Short By Suicide

GTY_lee_thompson_young_dm_130819_16x9_992
Lee Thompson

I have been a fan of Lee Thompson since my college days when I would find myself watching The Famous Jett Jackson on the Disney channel despite it being meant for teens between the ages of 12 and 16.  After all, here was an African-American movie star/spy who lived with his father and grandmother and got into various adventurous with his friends, how could I not find that interesting?

Lee also starred in the movie Friday Night Lights and was in Akeelah and The Bee .

Tragically however, Lee, who was currently starring in TNTs police drama Rizzoli & Isles, committed suicide on August 19th. He was just 29 years old.

I personally was shocked by the news of his death because he was a fairly low key actor. I never heard about him getting into trouble with the law, abusing drugs or alcohol or even much about him having any mental or emotional instability. I always assumed he was just doing fine and that is the danger when it comes to suicide.

As I have stated before, I have done a lot of crisis counseling in the aftermath of people who have committed suicide and often the words I hear from family members and friends is that they thought the person was doing just fine and their suicide came as a huge shock.

And this is where some of the stigma that surrounds mental illness comes into play. According to sources, Lee may have been battling depression quietly for a long time. Some are saying that he really changed once he started practicing an African religion called Yoruba, but it’s very likely that in an attempt to ease his depression, he sought refuge in religion and when that failed to lighten his depression, he unfortunately thought his only alternative was death.

Sources say that his mom was worried about him because many of his friends that lived in Los Angeles with him had moved and that he was surrounded mostly by “industry types” and not real friends. If this is true, definitely having a lack of a support system/network increases the chances of someone with suicidal thoughts to actually act on them.

Apparently Lee was close to his mother and sister, but probably out of pride and/or shame (stigma even), never told them about his depression or at least about how bad it really was. Many times men feel weak for feeling depressed and will hold it in and take their lives without anyone knowing how long they had been suffering.

His coworkers on the set of the show Rizzoli & Isles got suspicious when he didn’t show up for work and sent an officer to his house to check on him and that is where he was found dead. Jackson didn’t leave behind a suicide note, but sources say that he took his life with a gun.

This comes right after reality television star Gia Allemand (who was also 29) of Bachelor and Maxim modeling fame committed suicide by hanging herself with a vacuum cleaner cord two hours after her NBA boyfriend Ryan Anderson told her that he didn’t love her any more on August 12th.

102538232
Gia

According to Gia’s father, she had a long history struggling with dealing with rejection when it came to friends and boyfriends.

Honestly I didn’t know much about Gia until this happened. I remember getting ready for work when it came on the morning news show and I paused to listen to the story. It’s troubling to me when anyone who commits suicide, but it’s especially painful when people who are in the spot light commit suicide because that often sends a message to their fans and others that it’s okay to end your life if you think there is no other solution.

There are ALWAYS other solutions.

Unfortunately when you are in the middle of a deep depression or a mental/emotional/psychological break down, it’s easy to imagine that life will never get better, that it will never be as you want it to be and that death is an easy escape.

Suicide is a permanent decision to a temporary problem is a popular saying, but unfortunately suicidal people ususally believe that their problem is indeed permanent even when it’s not.

**If you or someone you know needs help, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255)**

Your Plans For Your Life May Upset Those Who Are Supposed To Support You

Ronda Rousey - Press ConferenceThis morning I read about Ronda Rousey, someone many of you probably have never heard of, but she is one of, if not the most famous woman in mixed martial arts and is the current female bantam weight champion.

Last week Thursday she hinted in a MMA article that she may retire early and possibly have a baby. A simple consideration for a young lady in her twenties, but many of her “fans” didn’t take it that way.

Many of her “fans” were irate and took to Twitter angry that she could even be thinking about retiring early, when she is still in the prime of her fighting career, and even more so, to retire and have a baby as if even thinking about a life outside of fighting was a sin.

She fought back on Twitter with her own angry comments and disappointment that even her talking about, thinking about retiring had her receiving backlash. She went on to say basically that she isn’t going to continue doing something if she feels like she’s accomplished what she set out to accomplish and/or doesn’t enjoy doing it any more.

That got me to thinking about a lot of things, including how we are affected by other peoples expectations for us and plans for us. You see, many of her so-called “fans” had put Ronda into a box and couldn’t even imagine her stepping outside of that box until they were ready for her to do so.

People will always have expectations and plans for us and a lot of times those expectations and plans will go against our very own expectations and plans. As long as we are living up to other people expectations and plans for us and our lives (living within their box) then things are very copacetic, but once we go outside of those boundaries, then things can get complicated and even heated.

We know this from being children, especially teenagers and young adults.

Maybe your parents expected you to go to college to be a doctor, but you decided to follow your dreams of being a fashion designer. How did that work out? Did your parents still support you or did they show their disapproval the way Ronda’s “fans” have at her decision to not fight until she is physically beat to a pulp with no life outside of fighting?

The same thing comes with friends and relationships. Maybe your husband expects you to stay at home with the kids, but that’s not what you want for your life? Is he going to support you in your decision or is he going to make you feel bad for even considering working outside of the home?

Most of us are influenced to some extent by other people’s expectations and plans for us and often times we don’t even know it. When we make plans for our own lives that go against what other people already had planned for us, it can send across waves of anxiety, even amongst those who are supposed to have our best interest at heart.

Take for example if you and all of your friends are stuck in a dead end job, but you decide to go back to school, switch jobs or are given a promotion. These same friends may resist that change, try to prevent you from making it or have animosity towards you for doing it.

Why?

One reason is that when we do something for ourselves that goes against other people’s plans and expectations for us, it causes them to reflect on how that change will effect them and forces them to think about themselves, their lives and about what they are and are not doing.

That’s why you can’t always expect your friends and family to encourage or celebrate your changes and accomplishment because your new direction may cause them anxiety which usually causes people (instead of focusing with in) to lash out either by not supporting your decision, plotting against it or having bitterness towards you for something as simple as buying a new car or getting a new hair-do.

When you do something that is different, they have to ask themselves, “now what for me?” and/or “What does this say about me?” Does your new car make them wonder what are they doing wrong so that they can’t afford a new car? Does your new hairstyle make them wonder why they can’t be as courageous as you are (instead of looking inward and recognizing that unconscious thought, they are likely to “dislike” your new hairstyle and try to make you dislike it too).

So, when making plans for your life, I think it is good and healthy to expect some resistance from those who are supposed to care about you the most. Hopefully all you will get is support, but don’t be surprised if you meet resistance or what some people call “hate”. Don’t get frustrated by it or allow it to distract you. All it is is a mirror being reflected back on them that makes them have to question their life and that is a good thing when they use it for motivation instead of “hater-ation”.

Attachments: How Our Very Earliest Relationships Impact Our Current Relationships

20130805_194648
Photo Courtesy of Sylvia Olson

Recently a friend of mine and I had an intellectual and introspective conversation about the way we act when it comes to relationships. We discussed the ways we react to love, to break ups, to trust issues and to abandonment.

It was during this conversation that I started trying to identify our attachment styles because it was clear to me that ours were different, yet neither one of us had what I felt was a healthy attachment style.

As a clinician, I’ve always been aware of attachment styles, especially when it came to attachment disorders  like reactive attachment disorder (RAD), but I never really gave them much thought when it came to my own life until I was having this conversation with someone who seemed so opposite, yet familiar.

What Exactly Are Attachment Styles?

Attachment styles are patterns of relating to others that develop early in childhood and they consciously and/or unconsciously continue to play a role in our relationships throughout life. We base much of our attachment style on the very early relationships we had with our parents (especially our mothers) or guardians.

The attachment style we operate from influences how we go about getting our needs met and how we meet or don’t meet the needs of others.

When we have a healthy attachment style we are confident, secure and easily interact with other people in a balanced relationship.

When we have an unhealthy attachment style we tend to be insecure, anxious, and/or detached and tend to find other people who fit into our unhealthy attachment style which generally means making bad choices in relationships because the people we choose tend to lack the capability to be good partners for us in the relationship.

We typically tend to project our sense of how we think relationships are, through our attachment style.

For instance, someone who has an insecure attachment style will likely seek out other relationships that confirm to them that they should be insecure. They will unconsciously seek out people who are unfaithful and friends who aren’t trustworthy, even when those relationships are clearly hurtful and destructive.

It’s helpful to understand what your attachment style is so that you can be aware of some of the unconscious factors that may be playing major roles in your adult relationships.

There are four basic patterns of attachment  and we’ll discuss each one briefly in efforts to help you identify which style mostly resembles the way you relate to others, especially in your love life.

Secure Attachment

Lucky, the majority of of us have what is called secure attachment, which means that we grew up seeing our parents or caregiver as a safe and secure place, which allowed us to go out and explore our world as an individual.

People with secure attachment tend to have better relationships compared to the other attachment styles. They tend to find romantic partners who also have secure attachment. They feel connected, secure and do not try to control their partners or cut off their partners independency.

As adults they are supportive and aren’t afraid to ask for support when they feel they need it. Their relationships are generally more open, honest and fair because while they like feeling independent, they also like being connected with those in their life without hampering their independence.

The way they relate and love other people is usually more genuine and they act out of places of love, rather than fear or anger more often than those who have other attachment styles.

Anxious Preoccupied Attachment

People who have this type of attachment are often “starving” for love or attention. They tend to cling to people even when there is no real love and trust isn’t present. These people are usually looking for someone who “completes” them because they don’t feel complete by themselves and feel safer when they are in some sort of relationship. At the same time as they are clinging to others, they tend to do things that push them away.

Because these individuals are afraid of abandonment, they come off as anxious, insecure and desperate and do things to confirm their believe that they should feel this way such as becoming possessive, super clingy, demanding of time and attention and trying to control their partners independence. As a matter of fact, they may see their partners independence as rejection and confirming that they should be feeling anxious and insecure.

They may for instance see their best friends interest in other people as signs that they don’t want to be friends any more and will hurt them or if they’re in a relationship, they may see their partners interest in a “boys night out” as a sign that he doesn’t love her and wants to be with other women, therefor confirming their believes that they should be insecure and anxious.

Dismissive Avoidant Attachment

People who have this type of attachment seem to be emotionally detached, especially when it comes to people they are supposed to love and care about. They tend to isolate themselves and create a false sense of independence, often times isolating themselves from family and friends. These are the people that may seem totally wrapped up in themselves and their own well-being.

However, their false sense of independency is just that, it’s not real and they crave real relationships with others just like all humans do. We are social creature by nature. People with dismissive avoidant attachments will deny the importance of real relationships with family, friends and other loved ones and will detach easily from the people in their lives often for little to no reason at all.

This is a psychological defense that they use to shut off their emotions, usually to prevent from getting hurt, feeling rejected or having to be vulnerable in anyway. For example, even when they are really angry or sad, they may look unfazed. They have an uncanny ability to not react and just shut off all emotions.

They may repeatedly chose relationships with unhealthy people so that they will be forced to detach and affirm that they need to be detached and distant because they will only get hurt if they allow themselves to be vulnerable. Even if they are in a good relationship, they are likely to run or cut off all communication at the slightest hint that they are allowing themselves to be exposed.

Fearful Avoidant Attachment

People who have fearful avoidant attachment are always at a point where they are trying not to be too close to other people and at the same time, they don’t want to be too distant from them either. They try to maintain this balance by hiding their fear,  but it’s nearly impossible to do for very long.

These people sometimes come off as unpredictable or even “bipolar” as they try to maintain that balance and often react in overly emotional ways. They usually believe that you have to go towards other people if you want to get your needs met (love, attention, security, etc.), but also believe that if you get too close you will get burned.

The very people they want to run to and turn to for love and support end up being the same people they are extremely afraid of being too close to. You can imagine how this type of attachment would play out in familial and romantic relationships and the turmoil it could cause. Because of this, they usually aren’t very successful at truly getting their needs met by others.

For instance, a wife with this type of attachment may feel like she needs her husband to be more attentive to her, but is too afraid to admit it and therefore never tells him and is bitter when he continues to be inattentive.

In the worse situations, these people tend to be more likely than the other attachment styles to end up in abusive relationships. They tend to like the dramatic type of relationships that are like emotional roller coasters as they fear being abandoned by their partner, but at the same time have difficulty being emotionally available and intimate.

Knowing your attachment style, even understanding some of the dynamics that helped develop it, can help you learn to change the way you relate to others so that you can have more genuine, fulfilling and valuable relationships with others.

I believe my attachment style most closely resembles anxious preoccupied attachment. Now that I know that I can not only analyze my past relationships, but change my future ones for the better.

By recognizing the defenses that we use to avoid being emotionally connected with other people and challenging ourselves to enter into friendships and relationships with people who have secure attachment styles, we can work on our issues in those relationships.

If you want more information, there are plenty of good books on attachment, but I personally recommend Attachments: Why You Love, Feel, and Act the Way You Do by Dr. Tim Clinton and Dr. Gary Sibcy.

 

Allow Yourself To Have Fun

istock_000015814289xsmallThe other day I found myself feeling a lot of anxiety. It was even manifesting itself in the form of physical symptoms like a slight headache and uneasy stomach. It took sitting with myself in introspection to realize that part of the anxiety I was feeling came from me taking things too seriously and not allowing myself to relax and have fun.

These things included situations in both my personal and professional lives. I wanted everything to be so perfect, afraid of making any mistakes, that I wasn’t truly enjoying what should be great and nurturing experiences.

I had become rigid and so critical of myself that I was feeling trapped and suffocated in the same way I have seen many people who are so afraid of making a mistake, looking like a fool, taking a chance or letting people see them vulnerable that they walk around stoic and detached or anxious and miserable. I was afraid to turn left or right, to get out of my lane, so I just kept moving forward even when I didn’t like or care for the direction I was headed.

I’ve never been the adventurous type, I’ve  always been afraid of taking risks, big or small. I always felt like I had to do the right thing, even if that right thing meant living a boring, safe, unfulfilled life.  I’ve never been spontaneous and have always admired people who are.

I’ve always been afraid of what other people may think or say if I did something unexpected or that put me first.

In many ways those other-imposed and self-imposed rigid boundaries were preventing me from living my best life, a full life, something I am always advocating for in the people I work with.

Last night I was watching the final episodes of season two of In Treatment, a show about a therapist and his clients that used to come on HBO. In one of the episodes, one of the therapist’s clients, Walter, a 68 year old man who had spent his whole life caring for and worrying about everyone else while maintaining rigid parameters while putting himself last, discovered that despite everything he had done his whole life, he had never truly lived or been happy. It was a depressing discovery and he felt like he was too old to start living, but his therapist, Paul, assured him that it was never too old to start focusing on himself and living a full live, but it had to start now.

I don’t want to be that way. I don’t want to discover one day at the age of 48, 58 or 68 that I have never truly lived because I have been so busy worrying about other people, what they think about me and not living the life I was meant to live, never truly being happy.

So many of us are living, but aren’t truly living. We aren’t fully participating in life. We are too afraid of making a mistake. We have to allow ourselves to be spontaneous, take risk and to not always worry about being appropriate or what other people may say or think.

We were not meant to be this rigid, this repressed and afraid of living the life we have been given. We have to find away to relax, enjoy life and have fun, to stop taking ourselves and everything so seriously so that we can see the true beauty of life. Many of us live with guilt and shame that has been placed on us by others or ourselves that keep us from moving forward and enjoying life. We have to let that go. We have to get out and enjoy life, experience life so that we can live a full life in touch with our whole self.

Sure there will be mistakes we make, lessons learned, but those will only serve to help us discover our boundaries and learn discipline, but for us to discover those parts of ourselves we have to loosen up, stop punishing ourselves and allowing others to punish us.

Life is meant to be lived, to be fully experienced, not to be so inhibited and rigid that we are just going through the day to day motions until the day we die.

Today, do something different, step out side of your comfort zone, of the boundaries that have been set for you by yourself and others. Live life and trust yourself that you won’t fall off the deep in, but will discover what life was meant to be. Start today and hopefully you and I both will continue to make really enjoying life and having fun with less inhabitions and fear, an essential part of our existence.