Popular Psychology

Why Do Some People Find It Hard To Receive Gifts?

by Torey C. Richards, LMHC16 Comments on Why Do Some People Find It Hard To Receive Gifts?

istock_000011997208xsmallThe other day at work I decided to do a random act of kindness by buying one of my employees lunch. This is not unusual for me as I will often buy my employees things like coffee or sandwhiches, but what was unusual was her reaction.

While most of my employees will offer to pay, when I tell them, “no, I got it”, they generally just accept whatever it is I am offering them. However, this particular employee immediately fell into what I would almost call a panic. She insisted that I take her money, even when I refused. Her face turned red, her eyes got watery and she begged me to take her money.

My response to her was simple. I told her that we all do nice things for other people and sometimes it’s okay to allow other people to do nice things for us.

As soon as I said that, I realized that I too often have trouble accepting gifts and acts of kindness from other people. I am a giver by nature. I think I inherited that from my mother and sisters. I love to give and the joy that comes with giving, yet it is very awkward and sometimes difficult for me to allow others to gift me in the same way I love to gift other people.

I remember when I was in graduate school I paid for a lady who was standing in line behind me without her knowing it. We didn’t know each other, and by the time she realized I had paid for her lunch I was already headed towards the door. She turned around and said “thank you” and paused for awhile as if she assumed I wanted something from her (i.e., her name, her number, conversation, etc.) but I didn’t. I simply  smiled and walked out of the door.

However, some people, like the employee I mentioned above, would have had a very hard time accepting that random act of kindness.

With the holiday season right around the corner, this is a great time to explore why is it that some people find it hard to accept gifts.

Not Wanting The Attention

Some people feel awkward about the attention that comes along with receiving a gift. Often they feel like the spotlight is on them, even if no one else is around and may be embarrassed. I think in the case I mentioned above, this was largely a factor. I offered to pay for her meal in front of several other people, all of who I had paid for their meals before so they didn’t see a big deal about it, but to the other person, she may have felt like she was put in the spotlight and didn’t want to be.

I think what goes along with this is, some people are used to everything having a catch to it and believe that people don’t do random acts of kindness without wanting something in return. Perhaps she thought by accepting my gift I would either ask for a favor or she would feel as if she owed me one, which defeats the whole purpose of a random act of kindness.

Not Feeling Like They Are Deserving of The Gift

Some people have self-esteem issues or aren’t used to people doing anything nice for them so they will reject any gift. They may feel like they haven’t done anything to deserve the gift, even if the person giving the gift feels otherwise. The more expensive or thoughtful the gift is, the more likely it is that someone will think that they aren’t worth it. They will feel uncomfortable and even overwhelmed.

Conditioning

Some people have been conditioned to feel a certain way about receiving gifts. For example, someone who grew up with their family giving them everything they could and were made to feel guilty about excepting things from other people, may grow into adults who find it hard to accept gifts. Women in particular who are raised to give and take care of other people, but not themelves, may find it hard to allow other people to do nice things for them.

Allowing Yourself To Receive Gifts

People who give gifts generally do so because the act of giving makes them happy. They put forth a lot of effort and enjoy the whole process of choosing (or making) a gift and giving it to you. You didn’t ask them to do this, but it is their way of showing kindess, appreciation and/or love and all you have to do is allow yourself to be part of the process by enjoying receiving the gift. It’s a beautiful process and you can do the same if you choose, or simply be thankful that someone thought enough about you to give you a gift, whatever it is.

When people have a hard time receiving gifts, they often also have a hard time allowing other people to nurture them, be there for them or even love them. You can practice receiving physical gifts by starting to allow yourself to be nurtured. Allow people to listen to you when you need to talk, to hold you when you need to be held, to support you when you need support. Allow people to encourage you when you need encouragement and to be there for you emotionally when you need that too.

Many people who have trouble receiving gifts have either focused too much on other people or have shut off the parts of themselves that need nurturing by telling themelves they don’t need it. Identifying what your needs are and how you would like others to support and care for you in ways that feel good, will open us up to being able to receive not only physical gifts, but gifts that go far beyond physical. It will allow us to not only nuture other people, but to allow ourselves to be nutured when needed.

 

 

Popular Psychology, The Perplexed Minds of Teenagers

How Your Teen Gets In Their Own Way And How To Help Them Stop Sabatoging Themselves

by Torey C. Richards, LMHC5 Comments on How Your Teen Gets In Their Own Way And How To Help Them Stop Sabatoging Themselves

istock_stockphoto4u-1-teen-girl-hugging-knees-looking-sad-cWorking with teenagers for as long as I have, I realize that many of them come with various challenges, from emotional and educational challenges to family issues that seem to drag them down. However, in a majority of the cases I’ve worked with, the teens themselves are usually the ones who are getting in their own way of success and happiness.

They often don’t see it that way and will blame their family, their friends, their environment, any and everything, but themselves and it will take many sessions before I am able to help them realize that they themselves are indeed the cause of their problems through self-destructive and self-defeating behaviors and thus are also the answer to their problems.

Most people who have been around adolescence know that many times they get in their own way and do things that are self-defeating or self-destructive. Self-defeating behaviors are behaviors that get in the way of constructive action while self-destructive behavior generally causes some type of harm to the person.

In early adolescence for example, teens often start focusing more on friends, fighting with their parents and other adults as they try to discover their own identity and may end up struggling in school in response to paying more attention to friends than to their grades.

During this time of conflict, (ages 9-13), it is common for certain self-injurious behaviors to start occurring, such as cutting as a way to deal with much of the psychological conflict and pain, especially with teenager girls while teenage boys may do things such as punching walls, getting into fights or destroying property even if it’s their own.

During mid adolescence, ages 13-15, friends are generally ultra important and so is being accepted by your peers. This is the age that teens are going to high school for the first time and can be overwhelmed by the pressure to fit in.

When a teenagers faces feelings of inadequacy about their self-image they may shy away from their peers and develop anxiety issues and/or depression or even self-destructive behaviors such as eating disorders and suicidal thoughts.

During late adolescence, ages 15-18, teenagers may engage in self-defeating behaviors that include more risk taking such as drugs, alcohol, and sex simply for the excitement of it and not considering the dangers that can happen.

This is the age that I worked with the most to either help them stop drinking or using drugs, or to help them with issues surrounding sex including pregnancies, sexually transmitted diseases and even rape.

As someone who has worked with teens for a long time, it can be very frustrating to see a young lady with endless potential, waste it because she wants to be liked by her friends or a boy or she doesn’t like herself. The same rings true for many of the young men I worked with who were more concerned about having a  “tough guy” image, than actually doing something positive with their lives.

Parents indeed find this self-defeating and self-destructive behavior frustrating, but what can they do? Often times teenagers are too defensive to actually take and listen to advice from their parents so parents often would bring their children to me and then wonder what it was about me, or what did I say that got through to their teenager that they couldn’t and I would always tell them that they had to practice objective parenting.

They had to work on not telling their teenager what to do and think or what not to do or think, to not judge, but instead simply draw conclusion between their choices and the consequences of their choices in an empathetic and objective way, and then let their teen decide to either continue the behavior or to try something different.

This is often hard for parents to do because they would like to control their teenagers choices, but they can’t. They have to allow their teenager to make their own choices, however, parents can continuously attempt to put healthier and more constructive choices in front of their teenager for them to accept or not to accept.

The more healthy options you place in front of a teen, the more likely they are to accept at least some of them. As a therapist that is what I did. I would know that I wanted a teen to stop doing a particular self-destructive or self-defeating behavior, I would share my observations about what they are doing and what they are getting (or not getting) from their actions and then attempt to continuously give them multiple alternatives in hopes that they would try at least one.

For example, one teenage girl was obsessed with trying to get pregnant simply because she wanted a baby. I tried to help her see how having a baby would hinder many of her plans and goals for the future, but she didn’t really see that. I then gave her many other things she could be doing instead of trying to get pregnant and she finally decided to try one which is playing softball. She tried out for the team, made the team and two years later graduated from high school with a scholarship to play softball and never got pregnant.

While her mother thought I had worked some type of miracle (she was sure her daughter wouldn’t finish high school without getting pregnant) all I did was give her an opportunity to try something new and that ended up being self-affirming and she basically did the rest.

As a therapist, it is easy for me to be non-judgmental, to allow teenagers to continue making mistakes and learning from them while still giving them healthy alternatives until they finally realize that what they are doing isn’t working and are ready to try something different.

For parents, it’s hard for them to have that same amount of patience because the attachment they have with their teen makes it much more painful for them to witness their teenager continuously sabotage themselves by making poor choices. It’s very difficult for them to be as objective as I try to be.

Because this is very difficult for most parents to do, seeking help from a therapist is often the best solution, especially if the behavior is self-destructive such as cutting, suicidal thoughts, eating disorders, etc.

A book I recommend for teenagers who are constantly self-sabotaging themselves is How to Get Out of Your Own Way by Tyrese Gibson.

Popular Psychology

Donald Glover’s Dark Instagram Musings: Celebrity Meldown Or A Cry For Help?

by Torey C. Richards, LMHC1 Comment on Donald Glover’s Dark Instagram Musings: Celebrity Meldown Or A Cry For Help?

1089859-chidlishgambino-617-409I know Donald Glover more for his music. He’s a rapper and goes by the name Childish Gambino, but he’s not just any rapper. In my opinion he is a lyrical genius and generally writes lyrics that are controversial and thought-provoking at the same time. His music, for the most part has a sense of depth to it which separates real artists from those who think they are real artists.

Most people however know Donald Glover from his work as a writer on the NBC hit 30 Rock as well as his character Troy on the NBC show Community which he recently left, some say to pursue his rap career. He’s also a talented comedian and only 30 years old.

Recently, Glover set the social world ablaze when he went diary like on his Instagram account on October 14th, revealing some intimate and honest feelings about his inner most fears which include fears over disappointing his fans, his career and his love life.

On a piece of hotel stationery he wrote:

  • “I feel like I’m letting everyone down,”
  • “I’m afraid people hate who I really am.”Donald-Glover-467-1
  • “I’m afraid I hate who I really am.”
  • “I’m afraid this is all an accident.”
  • “I’m scared I won’t know anything ever again.”
  • “I’m scared I never knew anything.”
  • “I’m afraid I’ll regret this.”
  • “I’m afraid this doesn’t matter at all.”
  • “I don’t wanna rap,” he wrote. “I wanted to be on my own.” (clarifying that he didn’t leave Community to pursue his rap career)
  • “I’m afraid of the future,”
  • “I’m afraid my parents won’t live long enough to see my kids”
  • “I’m afraid people think I hate my race.”
  • “I’m afraid people think I hate women.”

On one hand, this freeing of emotions, this type of introspection is heroic.

Celebrities, especially Donald Glover, often times come off as shallow, narcissistic, and ego-maniacs. It’s refreshing to hear a celebrity express his fears. It humanizes them and reminds us that we have much more in common with each other than we may realize.

This sort of expression is good for the person too, it’s a catharsis and can help us not only think about what we are doing and where we are going, but also helps us bring balance back into our lives. The release of emotion is generally the mind and body trying to get back to a sense of balance when we feel out of balance.

However, there are times when this type of expression, especially when made as public as Donald Glover’s was, is a cry for help. A sign that someone is dealing with more mental angst, anxiety and/or depression than they may believe they can handle so they are putting it all out there in hopes that if the action alone doesn’t bring about a sense of relief, then hopefully it will gain the attention of people willing to help them get back into a state of balance and peace. Donald-Glover-467-2

Some of his fans even feared that this could be a type of suicide note for now or in the future, and while I don’t believe it is, I can see where they could get that from. We’ve lost enough young celebrities this year to know that many have no overt signs of suicidal tendencies and the ones they did have were often overlooked or ignored. I would hate for this to be another one.

If I were someone close to Donald Glover, his friend, his family, even his business partner, I would definitely use this as an opportunity to reach out to him to make sure that he is okay. Chances are he is fine. Artist, depression and anxiety often go hand in hand. There’s been many studies and books written on manic depression and creativity and how depression, anxiety and even mania can spark creativity and yet sabotage the artist by overwhelming them.

Look at how many artists, musicians, and actors have killed themselves either purposely or through drugs and alcohol.

While I definitely think it’s freeing and refreshing to see an artist be so open about their fears, I think it’s also a warning sign for those closest to him to make sure that he stays balanced and doesn’t go too far unto the side of negativity and ends up ruining his life or doing something that is irreversible.

I am all about creative expression and introspection, but I also know that celebrities most often do not ask for help directly, usually do to their pride and status, yet they are just like the rest of us when it comes to dealing with our intrapsychic suffering.

Popular Psychology

Mental Health Awareness Week: Borderline Personality Disorder

by Torey C. Richards, LMHC1 Comment on Mental Health Awareness Week: Borderline Personality Disorder

istock_000008463493xsmall-243x300Perhaps out of all of the different types of personality disorders, borderline personality disorder is the most studied and most known as it seems like more and more people today are being diagnosed with borderline personality disorder (BPD) and it was definitely one of the most common personality disorders I run into when working with teenage girls.

People with borderline personality disorder are said to stand on the threshold between neurosis and psychosis. They are characterized by their incredibly unstable affect, behavior, mood, self-image and object relations (how they relate to others).

Borderline personality disorder is thought to represent about 1 to 2 percent of the population and is twice as common in women compared to men.

People who have borderline personality disorder seem to be in a constant state of crisis. They experience almost every emotion to the extreme and typically have mood swings. They can go from being very angry and confrontational one moment, to crying the next moment to feeling nothing at all the very next. They may even have very brief periods of psychosis known as micropsychotic episodes that are generally not as bizarre as those who have full-blown psychotic breaks and may even go largely unnoticed or written off as “strange”.

The behavior of people with BPD is highly unpredictable and they generally do not achieve everything they can to their full potential. Their lives are usually marred by repetitive, self-destructive actions.

These individuals are very often associated with cutting and other self-injurious behaviors as they may harm themselves as a way of crying out for help, to express anger or to feel pain or numb themselves from intense and overwhelming emotions and affect. As a matter of fact, most of the young women I ended up counseling who had BPD were referred to me for their self-injurious behaviors and/or their intense mood swings.

They may feel both dependent and hostile which creates an environment for stormy interpersonal relationships. They can be dependent on the people they are closest to, yet lash out with intense anger at the smallest perceived slight or frustration. They basically pull and push people away all the time, yet they can not tolerate being alone and will prefer chasing and trying to have relationships with people who are not good for them, even if they themselves are not satisfied in the relationship. They tend to prefer that roller coaster over their own company.

They will complain about being treated like crap in their relationships, discuss leaving their partner, yet if their partner doesn’t respond to their text or phone call they will panic and do whatever it takes to track them down.

When they are forced to be alone, even briefly, they will take a stranger as a friend or become promiscuous to fill the loneliness they feel. They are often trying to fill the void of chronic feelings of emptiness, boredom and lack of a sense of identity. They may even complain about how depressed they feel despite all the other emotions that they usually display.

People with borderline personality disorder tend to distort their relationships by characterizing people to be all good or all bad. They will see people as either nurturing or as evil, hateful figures that threaten their security needs and are always threatening to abandon them whenever they feel dependent. The good person, even if they really are not a good person, then gets idealized while the bad person, even if they really are good, gets devalued. More often than not, the same person can be seen as good one moment and bad the next, meaning that a woman can see her husband as perfect and caring today and tomorrow he is the most evil man in the world and she hates his guts, even if nothing really changed between them over the last twenty-four hours.

This aspect of BPD I found extremely frustrating at times because one moment a client would see me as the only person in the world who could understand and help her and the next session she would treat me like she hated me and like I hadn’t ever helped her. One client in particular for instance was chatting with me like I was her best friend one week, the next week when I was redirecting a negative statement she made about herself she said “F*ck you” out of the blue and walked out of the room, only to come back the next week and apologize, but this cycle repeated itself over and  over again. It wasn’t uncommon for her to tell me in one session that she “couldn’t stand me” and the next session tell me that I was the only one who understood her.

Another reason people with BPD are trying even for therapists is that they are very good at subconsciously projecting a role unto someone and getting that person to unconsciously play that role. It can be very draining and even scary trying to deal with someone who has BPD as their impulsiveness and instability as well as their dependency needs can make them overwhelming for many people.

For the most part, this particular client and all other clients I’ve dealt with who had BPD were overall pleasant people with great personalities whenever they were in a good mood and I generally enjoyed our sessions, but there were times when they made therapy so difficult that although I enjoyed working with them, I was relieved when I was able to discharge them, not that I was happy to get rid of them so to say, but it was draining and by then I felt like I had given them everything they could have learned from me and now needed to practice the skills they built up with others.

 DSM-IV-TR Diagnostic Criteria for Borderline Personality Disorder

The Diagnostic and Statistical Manual of Mental Disorders (DSM) is what we use in the mental health field to diagnose mental disorders and personality disorders and it list the criteria for BPD as:

A pervasive pattern of instability of interpersonal relationships, self-image and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1)   Frantic efforts to avoid real or imagined abandonment.

Note:  Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2)   A pattern of unstable and intense interpersonal relationships characterized by alternating between  extremes of idealization and devaluation.

3)  Identity disturbance:  markedly and persistently unstable self-image or sense of self.

4)   Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).

Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5)   Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

6)   Affective [mood] instability.

7)   Chronic feelings of emptiness.

8)   Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9)   Transient, stress-related paranoid ideation or severe dissociative symptoms.

 Treatment

Psychotherapy has had the best results for treating individuals with borderline personality disorder, especially when combined with pharmacotherapy. Reality-oriented and social skills training are ideal in order to help people with BPD see how their actions affect others. Intense psychotherapy on an individual and group level is often recommended to help clients work on their interpersonal skills and to deal with their self-destructive and self-injurious behaviors.

Dialectical behavior therapy (DBT) is a specific type of psychotherapy that works great with people who have borderline personality disorder, especially those who do self-harm behaviors like cutting. It has perhaps gotten the best recognition for being high effective with people who have BPD.

I mostly used psychotherapy in the form of cognitive behavioral therapy, but later started utilizing much of DBT and it proved to work faster if not better than traditional cognitive behavioral therapy.

More Information

There are some great books on borderline personality disorder, but I recommend the classic, I Hate You- Don’t Leave Me: Understanding Borderline Personality Disorder by Kreisman MD, Jerold J. and Hal Straus as a great place to start.

www.borderlinepersonalitydisorder.com  is another great resource and they even have a list of movies with characters who have BPD and they include:

Fatal Attraction (1987)

In “Fatal Attraction,” the infamous femme fatale character played by Glenn Close displays the emotional instability and fear of abandonment that are symptomatic of someone with Borderline Personality Disorder. Her character also exhibits the BPD symptoms of self-harm, intense anger, and manipulation as she stalks her former lover and his family.

Single White Female (1992)

Jennifer Jason Leigh’s character in “Single White Female” exhibits the Borderline Personality Disorder symptoms of fear of abandonment, impulsivity, and mirroring as she attempts to take over the persona and life of her roommate (Bridget Fonda).

Girl, Interrupted (1999)

“Girl, Interrupted” is based on the memoir of Susanna Kaysen, who struggled with mental illness and Borderline Personality Disorder as a teenager and young adult. The film, which stars Winona Ryder and Angelina Jolie, centers around Kaysen’s 18-month stay at a mental hospital.

Hours (2002)

The three main characters in “The Hours,” which include author Virginia Woolf, all struggle with Borderline Personality Disorder, depression, and suicide. The movie, which links women from different generations to Woolf’s book “Mrs. Dalloway,” stars Nicole Kidman, Meryl Streep, and Julianne Moore.

Monster (2003)

Charlize Theron transformed into the role of female serial killer Aileen Wuornos in “Monster.” Wuornos was diagnosed with Borderline Personality Disorder, which may have contributed to the unstable and angry behaviors that led to her killing at least six men.

My Super Ex-Girlfriend (2006)

One of the few comedy movies that features a character with Borderline Personality Disorder is “My Super Ex-Girlfriend.” In this movie, Uma Thurman portrays a woman with superpowers and a secret identity who also displays the BPD symptoms of impulsivity, unstable interpersonal relationships, and poor self-image.

Popular Psychology

Mental Health Awareness Week: Miriam Carey And Postpartum Psychosis

by Torey C. Richards, LMHC3 Comments on 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.

Abnormal Psychology, Popular Psychology

Blinded By Beauty: Ignorance Towards The Mentally Ill

by Torey C. Richards, LMHC1 Comment on 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.

Taking Control of Your LIfe

10 Mindfulness Techniques You Can Start Using Today

by Torey C. Richards, LMHCLeave a Comment on 10 Mindfulness Techniques You Can Start Using Today

IMG_148084419922650Most of us spend a lot of time feeling pain, guilt or regret about our past and anxiety about our future. We can get so wrapped up in this past and future thinking that we don’t even enjoy the present moment we are living in.

Mindfulness is a form of self-awareness that helps brings us back to the present moment. It is taken from mindfulness meditation which is based on Buddhist meditation principles. It the past decade or so it has become very popular, especially as part of dialectical behavior training which has been successful in treating borderline personality disorders.

The basics of mindfulness helps us to pay attention to the present moment and disengage from the mental clutter and chatter that is almost always filling our minds.

How many times have you found yourself at a party, in a meeting, on a date even playing with your kids and yet while you are physically there, mentally you are somewhere else. You are in your head, dwelling on your past, thinking about the future and not living in that very moment. We have so much going on in our lives today that it’s hard to live in the present.

We are with our spouses, but thinking about everything we have to do at work tomorrow so we aren’t really hearing what they are saying or we are doing a task we do regularly, but are just going through the motions and not really paying attention to what we are doing (which is one reason accidents happen).

I have to admit that there have been many times when listening to a client that my mind will wonder. I’ll start thinking about my past, I’ll start thinking about what I have to do later that day and before I realize it, I’ve missed a good portion of what that client was talking about (it’s bad I know, but it happens… therapist are human too). I have to fight with myself sometimes to stay in the present, to not allow the clutter and chatter in my brain to take me anywhere else, but to remain in the here and now which takes practice.

As a matter of fact, during group therapy, being in the present and being mindful are two of my 10 rules. Often times when one group member is talking, some of the others will drift off to their own issues, their own regrets over the past and anxieties about the future to the point that they can’t offer support and encouragement to the group member who was speaking because mentally they weren’t there.

Here I’ve listed 10 ways to help you start being more mindful and to start living in and enjoying the present moment today.

  1. One Minute exercise: sit in front of a clock or look at your watch for exactly one minute and focus all of your attention only on your breathing and nothing else. Sounds simple, but your mind will tend to rebel and try to fill itself with all kinds of past and future thoughts. Resist it, focus simply on your breathing for one minute. Once you have this down pat you can start extending it by another minute up to five minutes or even longer!

  2. Take a shower. Showers can be relaxing and can be a mini vacation away from everything and everyone else. Feel free to use your imagination and picture yourself standing under a tropical waterfall.
  3. Speaking of water, sticking your hand in some warm water and concentrating on the sensation on your skin is not only a great way to bring you back to the present, but it is also helpful for de-stressing because it brings your brain a sense of comfort. If you aren’t near any warm water try rubbing your hands together to get a similar affect.
  4. Listen to music, calming music preferably and music you’re not familiar with is best, but really listen to it, not just the words, but the sounds of the instruments and the rhythm of the beat. Even familiar music can sound new again when you truly are present with it.

  5. Mindful Eating: Most of the time when we eat, we aren’t really paying attention to what we are doing. We are distracted by our mind, the television or anything else. In mindful eating, you sit down with no distractions, paying full attention to every bite you select and put into your mouth being aware of its color, how it smells, how it taste, the different textures, how it feels in your mouth. You may be surprised at how your food actually tastes different once you slow down and focus on it and possibly, how little of it you actually need to fill full. If trying this for an entire meal is too hard, try doing it for the first two bites of each meal.

  6. Mindful Walking: This is similar to mindful eating accept you take a walk and allow yourself to only focus on what is happening right now. How the ground feels beneath your feet, how the wind and/or sun feels on your skin, on how the leaves look and sound on the trees, even observing other people. It’s also good to pay attention to your breathing as you walk to help keep you present and centered.
  7. The acronym R.A.I.N. is used to describe a more advanced technique for when you are feeling unpleasant emotions where “R” stands for recognizing when a strong emotions is present, “A” is to acknowledge the emotion (instead of denying or running from it), “I” is to investigate where the feeling is coming from by checking in with your mind, body and feelings, and “N” is to non-identify with what’s there, meaning to not allow the emotion to define you or control you, but to understand that it is just another passing emotion that doesn’t have to control you. RAIN is about staying with your emotions and then letting them go, not dwelling on them or doing things to try to escape them, but acknowledging them and then allowing them to leave. It can be challenging to stay with your emotions and still let them go which is why this and the next technique are both considered advanced, but once you practice and can use them effectively, they can be life changing.
  8. Most of the time before we know it, our minds are racing, we are thinking about the past, the future, anxious, and just going through the motions of our daily routine. This is when we need to find time to S.T.O.P. which means to Stop what you are doing, if only for a minute, Take a breath and pay attention to your breathing, allowing it to flow in through your nose deeply and out through your mouth fully. You can try imagining breathing in a cloud through your nose and blowing it back out through your mouth. Observe your thoughts, feelings and emotions. Know that you can observe them, but they are just thoughts, feelings and emotions, that doesn’t make them facts they are not permanent. Often times recognizing, observing and letting thoughts, feelings and emotions go will work much faster than any psychotropic medication can in alleviating anxiety and depression. Lasting proceed with something supportive and positive such as talking with a friend or exercising.
  9. Un-tunnel your vision. A lot of times when we are stressed it’s because we are focusing on a single point that eliminates or obscures all other options. Try extending your arms all the way out until you form a “T” and then wiggle your fingers. Slowly bring your arms back in until your fingers are insight and then extend them again. Repeat this. Playing with your peripheral vision can help your brain to remember to expand and to remember that their are other options and possibilities other than that single point it’s currently focusing on that’s causing you stress.
  10. Come up with your own ways to be mindful and in the here and now! There are so many different ways we can practice being in the moment and there is no better way than finding something that works best for you.

A lot of our discomfort comes from worrying about the future and beating ourselves up about the past, but the past is gone and the future has not happened yet. Living happens in the moment we are in right now so taking some time to remember that and appreciate the present will definitely make our entire life experience richer.

Abnormal Psychology, Taking Control of Your LIfe, Therapist are Humans Too

Sensitive People: Absorbing Other People Emotions

by Torey C. Richards, LMHCLeave a Comment on Sensitive People: Absorbing Other People Emotions

Teenage girl looking thoughtful about troublesI’m highly sensitive to other people emotions and energy. I have been for probably all of my life, but it is something I have just become aware of in the past few years. I can be having a good day, feeling happy and all it can take is an interaction without someone close to me, to bring me down.

When I discovered this sensitivity, it was quite alarming. It seemed like my mood and even the way I felt about myself were dependent on how the people around me were feeling and even how they felt towards me at that moment. You can imagine the amount of stress, anxiety and uncertainty it would cause me and often times I didn’t understand why. Looking back I think I thought that they’re mood and feelings had something to do with me. It took a lot of introspection before I realized a few things:

  1. Rarely if ever did the other persons mood, feelings or behavior have absolutely anything to do with me and,
  2. I can not control other people’s feelings.

A large part of it boiled down to control. I wanted everyone around me to be happy, to like me, to treat me the way I would treat them, and when they didn’t, I automatically assumed it was my fault and whatever joy or happiness I had would go away and turn into either self-blame, dysthymia or anger, especially when the people were close to me such as a girlfriend or close friend.

It took a long time for me to start working on not allowing other people emotions to affect mine, and honestly it is something I still struggle with on nearly a daily basis. Some days are better than others and when I do find myself losing my inner peace to someone else’s energy, I get discouraged because I know it’s not about me and that I can’t control their emotions nor should I allow them to have power over mine.

I learned however that if I beat myself up too bad for allowing someone to move me from my inner peace, I end up doing more emotional harm than good because I become negative towards myself for being “weak” or even “stupid” (negative self-talk never helps and is almost always a recipe for increased anxiety and depression).

I’m starting to realize that one way to stop giving so much power to other people over my emotions is by not expecting things from them that they can not give me, such as unconditional love, unconditional positive regard or fulfilling any of my various needs that can only be filled by me and God. By not expecting those needs to be met by others I have taken back much of my power, but still at times, it’s a struggle just like when trying to undo any bad habit physically or mentally.

Some Negatives to Being Hypersensitive

As I stated above, being hypersensitive to other people emotions makes it very easy to be affected by others emotions, usually not for the better. This can be very draining and overwhelming and can easily lead to anxiety and depression. This can cause us to withdraw so that we can process and deal with our emotions, which other people may not understand and take it negatively that we need time and space alone, especially since we live in a culture that devalues sensitivity. Lastly, hypersensitive people may have unrealistic expectations of perfectionism towards themselves (i.e., everyone is supposed to like me).

Some Positives About Being Hypersensitive

Just like most things that are negative, there are of course positive things about being hypersensitive emotionally. I think evolutionarily it helps us to pick up slight shifts in someones temperament or even the energy around us. I’ve been in rooms where everyone around me was talking, yet no one noticed the sudden shift in tension, or how someone else became emotional, angry or nervous during a certain topic. I would sometimes leave those situations knowing more about a person I didn’t even talk to just by watching the subtle changes in their expressions.

I think being hypersensitive to other people emotions help me to be more in touch with my own emotions. I’m always amazed at how many people aren’t in touch with their emotions and as a counselor, often it’s my job to help them to get in touch with their true emotions so that they can start living a real, authentic life. We hide from our emotions, mask our emotions (even from ourselves) and often don’t know why we feel or act in certain ways because we are not used to being in touch with that part of us. Hypersensitive people are almost always, sometimes neurotically checking in with their thoughts and emotions.

I think being hypersensitive also leads to being more creative, to being able to express ones emotions more through music, art, dance, poetry and writing for example. It also makes us more empathetic to others which in the field of mental health is a must.

Some Tips for Hypersensitive People

  1. You have to recognize and acknowledge that you are absorbing other people emotions. I’ve been doing it for years and until I actually realized it, I wasn’t doing anything different to try to stop it.
  2. When you start feeling a certain way after an encounter with someone, ask yourself if what you are feeling is really your emotion or theirs. You’ll be surprised to find out that most of the time it’s not yours and if it’s theirs then immediately release it. This alone will make you feel better most of the time.
  3. Remember that you are not responsible for nor can you control other people emotions so don’t worry over it because in doing so, you’ll just be absorbing it into your own emotional state.
  4. Identify what/who is making you feel a certain way and try to distance yourself if you can. If you can’t, go back through steps 1 to 3. Sometimes it’s a particular friend or group of coworkers that are the main source. Putting some distance between you and them can help alleviate the problem.
  5. When you start to feel overwhelmed by other people emotions, even if you can’t get away, try mindfulness or deep breathing techniques to help bring you back to your own inner peace.
  6. Speaking of inner peace, always try to work on building up your own inner peace by being good to yourself, exercising, eating right, maintaining good emotional, physical and mental health and surrounding yourself with people who bring you good and positive energy. BE GOOD TO  YOURSELF!

Being hypersensitive to other people emotions is both a gift and a curse, but look at it like a power that you have to master so that you are in control of your emotions and able to use all of the positive qualities that come along with being sensitive to other people emotions.

 

Abnormal Psychology, Popular Psychology

The Face of Mental Illness

by Torey C. Richards, LMHC3 Comments on 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.

 

Popular Psychology

Treatment Of The Mentally Ill In A War Torn Country

by Torey C. Richards, LMHC3 Comments on 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.