Social Distancing and Mental Health

Social Distancing and Mental Health

Everyday it seems like more and more measures are being put in place to keep people physically apart in an effort to combat the Coronavirus (COVID-19). While this is necessary to keep us healthy and to stop the spread of the virus, social distancing overtime can have a negative psychological effect on many people.

Yesterday, the governor of the state I live in (Florida), issued a stay-at-home order which bans all non-essential activities and asked people to stay home as much as possible. Schools are closed. Bars are closed. Hair Salons are closed. Most restaurants are closed except for take out. It is a necessary measure and one that most other states have also put into place.

However, the loss of social connection for some people cave have a devastating impact. 

Research on people who have been quarantined (an extreme form of social distancing) during events such as Ebola, SARS and the H1N1 flu show that many experienced short and long term mental health problems.  Many reported increased substance abuse, stress, anxiety, depression and insomnia even three years after the quarantine ended. 

While most of us are not under a quarantine, they are other byproducts of social distancing that can effect our mental state including the negative effect on the economy.

A record number of people have lost their jobs and have filed for unemployment. Many are struggling to pay their rent and other bill. They are facing uncertain and unpredictable futures. This can cause a number of mental health challenges for anyone, but especially for those already struggling with mental health issues. 

This doesn’t even take into account that many kids are also home which can cause added stress to parents. Think about a couple who is already struggling to get along and add the stress of kids being home, financial instability and everyone being forced to be around each other more than they usually would and you could have the recipe for a disaster.

The elderly are particularly at risks for not only the Coronavirus, but for mental health problems due to increased social isolation.

A lot of elderly people already feel isolated and have few or shrinking support systems. Many already felt lonely before the increased social distancing started. Now having visitors is discouraged and seeing loved ones face to face may be impossible.

A study done In 2015 by Holt-Lunstad and her colleagues suggest that loneliness and isolation can increase the risk of someone dying earlier than if they were not lonely. That’s a sad thing to think about when we are forced to social isolate to protect each other, especially the elderly.  

The majority of people will be perfectly fine during this pandemic. Some people naturally social isolate as is and their lives have minimally if at all been affected.

Others will get closer to their families and connect over social media, telephone, Face-time, etc.  However, nothing can substitute for face to face human interactions such as hugging and holding hands which can positively affect someone’s health both mentally and physically.

Imagine being sick in the hospital and not being allowed any visitors due to the virus. It’s  for your safety and the safety of your loved ones, yet you are being deprived of the connection and human touch you may need at the worst time. 

Fortunately, we due live in a time of incredible methods of communication and  there are a lot of telehealth and telepsych options for people who may need additional support to get them through this period. 

We have to practice social distancing to get through this and we have to obey the stay-at-home and other orders given by our authorities to keep our communities safe, but let’s not forget about those who may need a little extra attention during this time so that they don’t feel forgotten and they don’t fall into a mental health crisis without their support system there to help. 

We can stay home and yet still find ways to stay connected with each other.

Why I Train Brazilian Jiu Jitsu and I Think You Should Too

Why I Train Brazilian Jiu Jitsu and I Think  You Should Too

Nearly exactly a year ago today I started taking Brazilian Jiu Jitsu (BJJ). It was something I had been wanting to do, but had put off for almost ten years. I kept coming up with a excuses, but mostly, I was afraid. The longer I put it off, the more excuses I came up with. In those nearly ten years I went from having no children, to having two children. From having a relatively easy job to a very taxing one. I brought a new car and then another new car. The excuses from time to finances became easier and easier to make, but the bottom line remained the same, I was scared.

I felt like I was too out of shape and too old, but the truth was, none of that was going to change. I was only getting older and while I went to the gym often, I was lifting weights for strength and size so I was only getting bulkier.

Finally one day I decided to sign up for a free week at a school that was near my house, offered classes at times that worked with my schedule and was recommended by a friend who had been training for a few years. 

I could go into what it was like my first days, weeks or months training BJJ, but I want to focus on what I learned psychologically over the past twelve months of training and why you, if interested, should give BJJ a shot as well. 

(For the rest of this post I will be using the terms Brazilian Jiu Jitsu, BJJ and Jiu Jitsu interchangeably)

It’s Okay To Be A Beginner

One of the first things I had to learn in BJJ is to embrace being a beginner. The very first time I put on a Jiu Jitsu Gi (what we wear to most classes), I put my pants on backwards and didn’t know how to tie my belt. I felt embarrassed, but I shouldn’t have. I was clueless and that’s okay.

Jiu Jitsu evolves a lot of complex body movements that I know I looked and probably still look weird doing. I’m not coordinated and certainly I’m not acrobatic. At first I was worried about looking like a clumsy gorilla tumbling across the mat, but now I couldn’t care less about how I look to other people. No one has ever made fun of me, nor are they likely to. You’ll find that Jiu Jitsu people are some of the nicest and most helpful people. They love to see new people and want you to keep showing up and getting better.

Don’t be afraid to start something out of fear of looking foolish or of not knowing what you’re doing. You’re new, you’re a beginner, you’re not supposed to know better. That’s the beauty of being a beginner. Embrace it.  

You’re Not Too Old

I read a meme that said something like, “The best time to start training Brazilian Jiu Jitsu is age 9 and now.” Like I said earlier, I was afraid that I was too old to learn something that was so physical and complex, but the truth is, you’re never too old.

I am 40 years old, I know I am never going to be a World Champion Brazilian Jiu Jitsu player and once you understand that and why you are training, age becomes less of a factor. I’m training to learn a new skill, for physical activity and self-defense. There is no age limit to any of those things. Sure there was a time when every part of my body was aching (very common as BJJ is a total body sport) and I started to wonder if I was too old for this stuff, but eventually my body adjusted and now, I move better and have more endurance than I did ten years ago.  I get to exercise my competitive side which I hadn’t done since playing football in my early twenties and I can even compete for medals or for fun if I ever want to. 

The Way You Are In Jiu Jitsu Tends To Be The Way You Are In Life

When I first started rolling in Jiu Jitsu (what we call sparring), I was very reactionary, timid and didn’t try to win because I always assumed I would lose. Jiu Jitsu teaches you a lot about yourself which is one reason I think so many people love it. After a few months of trying to figure out why I was sucking so badly, not counting the limited skills I knew, I realized I needed to be more assertive and confident. As soon as I did that, my Jiu Jitsu not only got a lot better, but so did the way I lived my life. There is something about dominating, surviving or even withstand the onslaught of another person’s attacks on the Jiu Jitsu mats that make being confident, speaking up for yourself and tackling problems at home and work seem a lot easier. Some of my teammates even say how they are nicer people, better parents and better partners after Jiu Jitsu class. 

I feel like I walk with more confidence now and it’s not that because after one year of training I feel like I am a martial arts expert, but I do feel like I can handle and protect myself much better if need be. Even more importantly, because I feel more confident overall, I am more calm and I think that energy of confidence radiates out like energy into other parts of my life.

It’s Addictive

They say BJJ is for everyone and that is true to an extent. Anyone can learn BJJ, but not everyone is going to like it. People I know who tried it and quit within a month say that they didn’t like the physical contact and closeness that is essential in training BJJ.

For those people, BJJ may not be the way to go, but that closeness and physical contact of BJJ is just what makes it so enjoyable. Many of us long for physical contact in a way that we can’t get in our day to day lives.

In BJJ, that human contact is there in a way that is both competitive and connecting at the same time. Never in my life had I had other men welcome me to straddle them or get so close to them that I can feel every muscle and bone in their body. It quickly made me become comfortable with not just my own sexuality and my beliefs about how close and connected two men can be, but it taught me that my training partners were also comfortable in their own skins and felt comfortable and safe with me in ways that most people would not.

It’s that trust, that openness and closeness that helps build a special bond with the men and women I train with. One that can’t be explained, but keeps me coming back to become better at BJJ for myself and my training partners. After rolling with a good training partner for the first time, you just feel connected with them in a way that’s special to Jiu Jitsu and that helps build bonds and friendships. If you don’t have many friends, BJJ is a sure way to gain a whole community of friends.

Being in the Moment

In BJJ we do a lot of rolling and when you’re rolling, you’re attempting to submit your partner while trying not to get submitted. It’s exhausting. It takes all of your physical and mental power to compete in this human chess match. There is no room for any personal problems, stress at work or even any minor aches and pains. You have to be totally in the moment and present.

That’s what makes BJJ so much like meditation. When I am rolling I feel totally alive. I am not worried about anything else other than my opponent. Sometimes I even go to class not feeling 100%, but once once we start rolling, all the pain goes away. It’s almost therapeutic. It’s almost like you’re in a life and death situation, but in a controlled and safe environment. It’s an experience that’s hard to get anywhere else without actually putting yourself in real danger. 

It’s great exercise

One of the reasons I started training BJJ was because I was getting bored with my normal gym routine. Training BJJ is like no other workout because it is a total mind/body workout mixed with cardio. After a few weeks of training you’ll realize your cardio and ability to move has improved and even your strength. I realized this unexpectedly when I gave two different people hugs on the same day and they said I squeezed them too hard. It wasn’t on purpose. In BJJ we do a lot of squeezing, holding and controlling each others bodies and over time that squeezing starts to feel normal, but not on normal people who don’t train BJJ and aren’t used to what is often called a BJJ hug.

Progression

Another reason I started training was that I was bored in my life. I wanted to do something where I felt like I could see some improvement. Well, progression in BJJ is both fast and painfully slow. At first when you’re new there seems like so much to learn and you’ll never learn just the basics, but before you know it, you’re doing stuff you thought you’d never do.

When I got my first stripe on my white belt I was thrilled. It meant I was more than just the new guy who walked through the door. When I got my second stripe I was even more excited because it meant to me that my BJJ coach noticed my progress.

Stripes and belts are the way that you get promoted in BJJ and they are far and few in between so you have to have other internal factors motivating you to keep going and for me, it’s being better today than I was three months ago. Sure, I hope to have my blue belt this time next year and I’m going to work hard to get it, but when I look at how good I am today at BJJ compared to day 1, I can’t believe it’s only been a year. The guy I am today would destroy the guy I was on day 1 without breaking a sweat.

I can’t wait to see what the next year looks like and if you’re interested in learning a new sport, learning self defense and making new friends, I encourage you to find a good school and give BJJ a try. 

Declutter To Improve Your Mental Health

Declutter To Improve Your Mental Health

Recently I observed a client’s home that was very cluttered, unorganized and messy. It wasn’t filthy, meaning it wasn’t something you’d see on an episode of Hoarders, but it definitely was chaotic. I also noticed that the two small children in the house appeared to run amok, the wife was frustrated and tense and the husband appeared overwhelmed and mentally checked out.

I suggested, as an experiment, that the couple clean up their home, get rid of toys and other items no longer in use and focus on making their house much more simplified and organized. I urged them to try this for a week, not allowing things to get out of hand once the house was clean so that cleaning in itself wouldn’t become another stress inducing task. What we found out during that week was almost a night and day difference.

The children, while still children and occasionally rough housing and dragging toys from one room to the other, weren’t nearly as hyper or overly stimulated as they had been. They appeared much calmer and threw less tantrums.

The mother also appeared happier, less stressed and admitted to spending more time around her kids and husband in the family room (because it was clean) instead of isolating herself in the bedroom.  The father was also more engaging with the family and more present.

The house was much calmer, quieter and in terms of energy, appeared lighter. The entire family appeared happier, less stress and less out of control and the parents vowed to attempt to continue living their lives in this more organized, decluttered state.

How Clutter Affects Your Mental Health

Clutter in itself can cause stress and be a symptom of feeling stressed or poor mental health. Cluttered environments are often a sign of cluttered minds. Also, when you are surrounded by clutter, you can start to feel overwhelmed, anxious, agitated, crowded and tense. Sometimes to the point where you feel like giving up on even attempting to get organized so you let the chaos build on itself or check out mentally.

This clutter not only affects you, but it can affect those around you such as your partner, your children, your friends and coworkers. Think about it. If you never invite people over to your house because you’re embarrassed, if neighbors are complaining about the junk in your yard or you can’t find that report you were working on because it’s lost among a thousand other papers, clutter is probably affecting you more than you realize it.

This doesn’t mean that you are a hoarder on a clinical level, but our physical space and how we choose to live in it is usually a reflection of who we are on the inside and too much clutter can be a sign of a lack of control and can worsen our mental health.

Where do you start

Judih Kolberg, chief organizer at FileHeads Professional Organizers suggest playing what she calls the “Friends, Acquaintances and Strangers Game”.

“As you go through your closets, drawers and big old storage containers, immediately get rid of the ‘strangers’, those items you definitely don’t want and, in some cases, might not even recognize. Donate ‘acquaintances’, useful items that just aren’t your favorites and are never used, to a thrift shop, and keep the true ‘friends’, the favorites you can’t live without”.

My advice is to start small. One room at a time, one drawer at a time and one item at a time. Solicit friends and family for help if you have to and in the end, don’t feel like you have to give up anything you really, truly don’t want to give up. Somethings have emotional value to us, even if they don’t to anyone else.

In the end, try to only keep things that bring positivity and joy into your life. Get rid of anything that brings no value or worse, negativity.

Clearing your space will definitely help clear your mind and improve your overall mental health.

“I’m Good Bro”: Men and Mental Health

“I’m Good Bro”: Men and Mental Health

Like most people, there have been times in my life where I was really down, even depressed. Things in my life just weren’t going the way I wanted them to go and most often for me, that boiled down to my love life.

I remember one time in particular when I was going through a break up and was battling anxiety and depression to the point where I couldn’t concentrate on much nor could I eat or sleep much at all. It felt like the emotional pain would never go away and I just continued to isolate myself and ruminate on my problems more and more.

Finally, my best friend called me and asked me if I were okay. My response was, “I’m good bro.”

I’m good bro? Why in the hell did I say that when I clearly wasn’t good. As a matter of fact, I was at one of the lowest points in my life. I had lost several pounds from not eating, laid in bed praying for sleep to take the pain away, but the anxiety kept me awake with racing thoughts and fear. I was in pretty bad shape, yet my response was, I’m good bro.

Even then I wondered, why did I say that? Why didn’t I just tell him what was going on with me? The answer was because I didn’t want to appear weak. I didn’t want to appear emasculated. I didn’t want to burden anyone. I didn’t want anyone, especially another man to know that I was depressed.  I felt shame in that. That shame kept me from asking for help. It nearly killed me.

From my experience, depression has a way of sneaking in, unassuming and nonthreatening. It has a way of making you feel comfortable with it, almost like an old friend or warm blanket, until it starts to suffocate you. Only then do most people realize that they are in danger and need help. Sadly, too many people realize it too late and pay the ultimate price.

Still as I was getting suffocated by depression, I muttered, “I’m good bro”, and effectively rejected any help my friend could have offered.

As a mental health professional, what I have learned over the years is that most men who suffer from anxiety, depression and stress will also respond “I’m good bro” when they really aren’t.

Men don’t like to talk about their feelings and are slow to ask for help. For many men it takes thoughts of suicide to compel them to reach out for help which usually means they have been suffering alone for quite a while.

While these men are suffering and attempting to “hold it together”, their suffering not only has negatively affects on them, but also on their work performance, parenting ability and relationships in general.

Men like to think of depression and anxiety as problems women have, but men and women both suffer from these common problems. It may look differently in men than it does in women as men tend to isolate themselves more, become less motivated, become angry, aggressive or turn to drugs and alcohol more.

Reasons Men Don’t Talk About Their Mental Health

There are many reasons men don’t talk about their mental health issues, but according to one study, the top reasons are:

  • ‘I’ve learnt to deal with it’ (40%)
  • ‘I don’t wish to be a burden to anyone’ (36%)
  • ‘I’m too embarrassed’ (29%)
  • ‘There’s negative stigma around this type of thing’ (20%)
  • ‘I don’t want to admit I need support’ (17%)
  • ‘I don’t want to appear weak’ (16%)
  • ‘I have no one to talk to’ (14%)

When men do want to talk about their feelings, most report that they would prefer to talk to their romantic partner, but not everyone has a romantic partner and even those who do may be uncomfortable feeling vulnerable. That’s why it is important that men feel comfortable asking for professional help if needed.

In order for us to get men to feel comfortable seeking help, it’s important that we normalize men’s mental health problems much in the way that we have normalized treatment for erectile dysfunction problems. When we do this we remove the stigma surrounding men’s mental health problems. By helping men feel comfortable talking about their thoughts and feelings, we not only positively impact their lives, but the lives of everyone around them.

Why Are There More Suicides In Jails Than In Prisons?

Why Are There More Suicides In Jails Than In Prisons?

Suicide prevention of  inmates has been the main focus of my job for the last five years. It is such an important topic because in the United States suicide is the leading cause of death to inmates in jail.

This gets little attention because when most people think about inmates committing suicides, they tend to think about inmates in prison and for obvious reasons:

  • Prisons are usually bigger and overcrowded
  • Inmates in prison are usually there for more violent/serious crimes than inmates in jail
  • Inmate in prison are usually serving longer sentences, sometimes life sentences

While those reasons are valid points, the facts are that inmates in jail are more at risk of suicide than inmates in prison. This is important to know because family members are often shocked when their jailed loved one commits suicide often before they have even been to trial.

One reason jails have a higher suicide rate (46 per 100,000) than prisons (15 per 100,00) is that people who enter jail often face a first-time “shock of confinement” situation. They are suddenly removed from their daily lives, their support system, stripped of their job, housing, and basic sense of normalcy.

Also for some there is the fear of the unknown and perceived lack of control over the future that causes extreme anxiety and depression. They’re not sure how long they will be incarcerated or if their loved ones will stand by them. That isolation from their family and significant others can cause tremendous anguish for many inmates.

Many have a distrust of an authoritarian environment. They may fear for their safety, of being assaulted physically and/or sexually.  The living conditions and perceived dehumanizing aspects of incarceration are also difficult for many inmates to accumulate to. Some have to strip search in front of officers, are housed with inmates they would never associate with in the outside world and have to deal with the sleeping, showering and using the bathroom in not so private settings.

Depending on the person and the crime, many inmates experience a great sense of shame about being incarcerated. I have met doctors, law enforcement officers, pastors and prominent members of society who got arrested for everything from domestic violence, DUI to child molestation and stalking charges. They all had a very hard time dealing with not only being in jail, but with the affects it had on their social status.

Jails Usually Don’t Know Who They Are Getting

Jails get people right out of their personal lives, meaning that they get severe alcoholics and drug addicts who end up going through excruciating detoxes that sometimes end with them taking their own lives. They get chronically mentally ill individuals who may be off their medication or highly suicidal. They get people in the middle of a divorce or custody battle that they can’t fight from behind bars. Jail staff may not have a clue about these issues until the inmate starts exhibiting symptoms or attempts suicide.

Because jails are getting people right off the streets, they face a higher risk of inmates dying from drug and alcohol related complications as well.

By the time these inmates are sent to prison, the prison staff already have a detailed history of the inmate from the jail. Inmates have been detoxed and ideally mentally ill inmates have been stabilized on medication.  Also, inmates usually have acclimated to being incarcerated and come to terms with what’s ahead for them.

Many inmates who commit suicide do so before they have even been convicted. They’ve already thought of the worse case scenarios, i.e., “My wife is going to leave me”; “I’m going to get beat to death by other inmates”; “I’m gong to get raped”; “I’m going to prison forever” and decided that death was the better alternative.

The rise of inmate suicides is also partially due to the increased number of mentally ill inmates being jailed. Jails have become the new de facto mental health institutions, but they simply are not equipped to handle inmates with serious mental illnesses and other behavioral factors. These inmates are not only at a higher risk of committing suicide, but are at higher risk of being assaulted, raped and taking advantage of by other inmates. They are also more likely to end up in disciplinary confinement situations due to their behavior and lack of understand or following rules. 

It is equally unfair to severely mentally ill inmates and corrections officers who aren’t adequately trained to deal with them.

Educating jail staff on recognizing signs and symptoms of mental health problems to include signs that an inmate may be suicidal is invaluable. Also, addressing a jail culture that may be toxic or conducive to worsening mental health symptoms and increasing the likelihood that an inmate will attempt suicide is crucial.

Unfortunately I’ve had to deal with numerous inmate suicides and attempted suicides.  We never want to lose an inmate to an untimely death, especially one that could have been avoided, no matter if it’s an assault, a medical condition or suicide.

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Survivor’s Guilt: Dealing With Being “One of the Lucky Ones”

Survivor’s Guilt: Dealing With Being “One of the Lucky Ones”

Imagine being in a tragic event such as an earthquake that killed dozens, hundreds or even thousands of people, but you survived. Yet you had to bury family members and friends. You were right next to someone who didn’t make it, and you don’t understand why them and not you?

Days, weeks and months go by and you can’t shake that feeling of guilt, loneliness and wondering if you could have done something different to save someone else. When everyone is telling you that you should be happy that you survived, you don’t feel lucky. You may even feel undeserving of having survived.

You may feel like you can’t talk to anyone about what you are going through, after all, what do you have to complain about? You lived! You survived. You were one of the lucky ones! However, for many people who survive such horrific events, being a survivor is just the beginning of what can be a life-long, debilitating relationship with survivor’s guilt.

What Is Survivors Guilt?

Survivor’s guilt is something that may develop in some people who experience and survive a traumatic, life-threatening event. It is something that is common in war veterans, airplane crash survivors, survivors of natural disasters and mass shootings.

In her blog on Psychology Today, the Stoic Warrior, Nancy Sherman, PhD states that survivor’s guilt begins with an endless feedback loop of “counterfactual thoughts that you could have or should have done otherwise, though in fact you did nothing wrong”.

Recently two of the Parkland mass shooting survivors killed themselves a year after the tragedy and one of the father’s of a girl killed in the Sandy Hook school shooting also committed suicide. According to their family and friends, they all had a very difficult time coping after the tragic event and appear to have been suffering from survivor’s guilt.

While not everyone who survives such tragedies will experience survivor’s guilt, some signs and symptoms include:

  • Having flashbacks
  • Feeling irritable
  • Having difficulty sleeping
  • Feeling numb or disconnected
  • Feeling unmotivated
  • Feeling helpless
  • Feeling an intense sense or fear or anxiety
  • Experiencing physical symptoms such as headaches, stomachaches, and heart palpitations
  • Having suicidal thoughts

Survivor’s guilt is a normal response to loss, even if it may appear abnormal to someone from the outside looking in. They may be bewildered to why this seemingly “lucky” person is suddenly withdrawn, depressed or even suicidal.

Some studies suggest that individuals who suffer with depression or have experienced childhood abuse may be more susceptible to survivors remorse since both issues appear to break down a person’s healthy defenses and coping skills making dealing with such tragedies even more difficult.

If you or anyone who know may be suffering from survivor’s guilt, I  have gathered these helpful tips from the Psychology Today website:

  • Give yourself time to grieve.
  • Consider thinking about who was really responsible, if anyone.
  • Remember to take care of yourself physically and psychologically.
  • Think about what those who are close to you are feeling about the situation.
  • Remind yourself that you were given the gift of survival and feel good about it.
  • Try to be of service to someone or something.
  • Remind yourself that you’re not alone.
  • Be patient.
  • Share your feelings with those you trust.
  • Try to stick to a daily routine.
  • Consider journaling your feelings.
  • Get professional help, as needed.

I think it it important that after such tragic events, especially man made, horrible events like mass shootings, that while we are grieving for the ones we loss and reaching out to their families, that we don’t forget those who survived, the “lucky” ones, and reach out to them as well and continue to reach out and support them.

As you can see by the recent suicides, it can be a year or several years after the incident where the survivor reaches his or her breaking point. It also goes to show the bigger pictures of such tragedies and the very far reaching affects they can have on our society.

 

A Personal Note On Suicide

A Personal Note On Suicide

***TRIGGER WARNING- This article contains information about suicide which may be upsetting to some people. If you or anyone you know is struggling with thoughts of suicide please call your local suicide hotline or visit http://www.iasp.info/resources/Crisis_Centres/

Suicide sucks. Plan and simple. It always seems to hit us when we least expect it and it always hurts. It doesn’t matter the age, the circumstance. It always feel like a life was taking before its time.

The last half of 2018 has been a helluva time for me. Over the past 6 months I have dealt with the deaths of five people who were either directly or indirectly under my care. One died of an accidental heroin overdose, the other four were suicides by hanging.

I have seen CPR performed heroically and tirelessly, but in vain on two of those deaths and it is an indescribable feeling to see someone I knew, someone I had spoken to earlier that day, laying on the ground motionless. Someone so young (one was in her twenties, the other in her thirties) and so full of life at one point, now lifeless.

Suicide is an unfortunate evil we have to deal with in the mental health field. My current job puts me in the role of dealing with suicidal patients all day long.

I am used to dealing with suicidal patients, even patients who attempt suicide or self-injure, but I am and never will be used to dealing with completed suicides. I take each death personally, even if professionally and ethically my staff and myself did everything we could to prevent it.

Suicide is often an impulsive act. At least one of the suicides appears to have been the result of rage. Suicide is often thought of as anger turned inward.

Suicide sometimes builds overtime and is the result of unbearable psyche pain. Three of the suicides, at least on the surface, appear to have been thought out. One woman was grieving over the loss of her sister and blaming herself for her sisters death. She was filled with depression and guilt she found insufferable. Another man was facing a lengthy prison sentence and decided he would rather die than go back to prison and spent years locked away. He was the only one who left a suicide letter behind. It was obviously something he had given some thought to.

Suicide, as we have seen too often lately, is sometimes the result of bullying, which appears to have been the case in the last suicide and another serious suicide attempt a couple of weeks after that one. Adults in correctional settings who are exposed to bullying are at high risk for suicide.

There weren’t any obvious warning signs that could have prevented any of these deaths. Accept for the accidental heroin overdose, these individuals seemed to have been determined, in those moments, to end their lives. I wish I could have saved them. I wish I could have saved them all. I cried after each of those suicides because I knew those individuals, maybe not terribly intimately, but as close as you can professionally under these circumstances.

I even thought about resigning because I felt like we failed them although multiple internal and external reviews showed that we did not. However, I know that for these five lives lost, there a countless numbers of suicides we have prevented. And that’s what keeps me going. That’s what keeps us all going.

 

 

 

 

Sometimes We’re The Toxic Ones Too

Sometimes We’re The Toxic Ones Too

“You gotta be mature enough to understand that you have some toxic traits too. It’s not always the other person”. -Word Porn

I read this post the other day on Facebook and thought it to be one of the truest statements I have ever read. Too often in relationships, no matter if it’s personal relationships, familial relationships or romantic relationships, it’s easy to place all the blame for the dysfunction that goes on in that relationship on other people. It’s natural. It’s much easier to say that someone else is the cause of our unhappiness, the chaos that sometimes happens in relationships or the failure of a relationship than it is to be introspective and look at ourselves. It’s much less painful to put the blame on the other person than it is to admit our responsibility in why things are the way they are.

If you ask anyone in a relationship that failed or became extremely dysfunctional, they can easily tell you what the other person did wrong, but we all know that it takes two people to make a relationship work and so unless the other person was a complete narcissist or sociopath (and even then the other person usually still plays a role in maintaining the dysfunction of the relationship), we have to see both sides of the coin if we are going to come out of the relationship better and healthier than before.

When I think back to many of my past relationships that went south, I can easily name a dozen things the other person did to help drive our relationship off the cliff. I can tell you how they were selfish, inconsiderate, detached, mean, controlling and took me for granted. However, if you ask them, I am sure they can just as easily name a dozen things I did that were not supportive of a healthy relationship. What’s more important is that we discover for ourselves what we did to hinder those relationships (or maintain the dysfunction and toxicity) so that we don’t carry them into our future relationship and more importantly so that we can grow and change whatever qualities about ourselves that are holding us back and putting us in these toxic situations.

Thinking about my past relationships, I can spew out all the toxic qualities she had, but in reality, but what I know about myself is that I was codependent, at times insecure, controlling, neurotic, enabling and possibly lazy when it came to a number of things that eventually would have put a strain on even the healthiest relationship. I maintained much of the dysfunction in our relationship and kept it toxic because of my toxic qualities. At the very less I should have walked away before it became so engulfing and before bitterness and resentment on both sides set in.

If I go around, only seeing the things the other people did to screw up our relationship, then I will most definitely repeat the same pattern in future relationships and wonder why they too did not work out, or why I became so miserable in the relationship, yet stayed because I’d rather feel pain than nothing at all (a line from a Three Grace Song “Pain”, but also something I have come to realize to be painfully true about myself).

Too many of us do that. As a therapist, I often hear people complain about the same issues in their last relationship or even job. They think, they will just leave this person or that company and things will be better. Some even change physical locations such as the state and city they live in thinking that this will solve the problem, but a large part of the problem is within them and they take themselves wherever they go so they are likely to continue to repeat the same pattern regardless of who they are with or where they are unless they themselves change.

For instance, a woman whose last three relationships ended because the other person cheated may come to the conclusion that monogamy, trust and honesty are all dead and there are no good, faithful people out there.

In reality, she may be subconsciously choosing individuals with a certain trait or creating environments that are conducive to increasing the chances of someone being unfaithful.

Think about it, if she met her last three partners while they were in relationships with other people and she “stole” them away, she can’t be too surprised if that person later ends up being “stolen” away by someone else.

The same is true if she met someone who gave her reasons to doubt their loyalty in the beginning, but she thought she could “change them” only to realize later that she doesn’t have the power to change anyone. It’s a lot easier to just blame those individuals for being who they are and ruining the relationship instead of accepting that she herself has some flaws she needs to investigate.

Often we sabotage ourselves. Somewhere, somehow we may get a notion that all people suck so we subconsciously go out and seek relationships with people we know suck so that we can validate our notion.

We may rush into relationships and create an image about a person that they can’t possibly live up to and feel cheated or let down when they don’t, or they may feel so much pressure and/or smothering that they leave and we justified that by saying that we weren’t good enough or “everyone always leaves me”.

I once dated a woman who thought that everyone always abandoned her, including family, friends and romantic partners. During our relationship she did a number of things attempting to push me away, testing my loyalty and durability and I fought hard to prove to her that I was different than everyone else, but the harder I tried, the harder she pushed and in the end, we both were miserably, unhappy, and resentful. Her personality traits match up well with my codependent personality traits and created a toxic, dysfunctional relationship that lasted way too long.

The same issues in different ways can happen at work. Many of us spend more time at work and with our co-workers then we do with the people we live with, love and/or are in intimate relationships with.

Work can often feel like being in not only a toxic environment, but a toxic relationship. Sometimes we stay in a job we hate too long and become resentful, or we give so much of ourselves at work that we feel used and unappreciated, yet we still show up and won’t look for another place of employment. We may feel stuck there just like we may feel stuck in a relationship. We can blame everything on our employer or co-workers, but that won’t change anything. What will change everything is when we take responsibility for what it is that is keeping us there. It could be our refusal to look for another job, to stand up to a certain person, to demand what we know we deserve or to look for opportunities for advancement because of our fears that we aren’t good enough or don’t deserve better.

The bottom line is, nothing positive will happen for us if we don’t recognize the qualities about ourselves that need to be worked on. We can blame everyone else for the things that make us unhappy, but nothing will change unless we recognize our flaws, as uncomfortable and painful as they may be to admit to ourselves and change them.

What I Learned From Dating Someone With Borderline Personality Disorder

Not too long ago I was madly in love with a beautiful, charismatic and outgoing woman. She was funny, sexy and seemed to be the center of attention wherever we went. She also had Borderline Personality Disorder.

When we first met, this was not something I picked up on right away. She appeared to be everything I was looking for in a girlfriend. She was extroverted, independent and most of all fun. Her laugh and smile were infectious. She was the opposite of my quiet, reserved and introverted self. She was what I thought I needed in my life. Someone different than the women I usually dated. Different from myself.

In The Beginning

Things with us started off fast and intense. We went from getting to know each other, to being intimate, falling in love and living together in just a few weeks. She went out of her way to shower me with love and attention. It made me feel special, especially in comparison to my last relationship where I often felt neglected. She made me feel like no other woman had ever made me feel before or since.

What I didn’t realize was that part of what I was experiencing is what is called love bombing. Love bombing is when someone tries to influence a person with demonstrations of love and affection. They usually do this by going overboard with efforts of love and admiration. It’s a way to quickly leap frog over the getting to know you, courting stage in a relationship and get to the “I love you” stage and it worked.

I had never fallen for someone so intensely so fast, which is why I think I didn’t see some of the red flags I should have or, as a therapist, realize what I was getting into. Love and beauty have a way of blinding us.

As a mental health counselor, I have a habit, good or bad, of always analyzing people and a month into our relationship I started thinking that she might have bipolar disorder. I started recognizing that she had some mood instability and for some reason, that’s where my mind took me, but after awhile I dismissed that altogether because she simply didn’t meet the criteria. Still, I knew there was something I needed to pay close attention to, I just wasn’t sure what it was.

Inappropriate and Intense Anger

I remember the first fight we had, it was over something very trivial and should have just been a conversation, but instead she EXPLODED! I mean her eyes narrowed, face turned red, nostrils flared. She got so angry so quickly that it scared me and I feared for my safety. What shocked me the most was that the intensity of her anger was way out of proportion to the situation.

I don’t like to fight, I don’t like to argue. When I realized how volatile that situation became over something so small, I should have left and never looked back. That was actually my plan, but later that evening she came back and apologized. We made up. I loved her after all and maybe part of my “you can fix her” thinking kicked in and I actually began to feel sorry for her.

I knew she come from a pretty traumatic childhood, that she went through periods of her life where she felt abandoned and I felt that her blow up was a test to see if she could push me away and I would abandon her too. I decided to prove her wrong and to stay and make it work out. I had the rescuer syndrome going on full strength.

Frantic Efforts to Avoid Real or Imagined Abandonment

After that first explosion, many more followed. She began accusing me of wanting or looking at other women. Out of the blue her entire mood would change and I wouldn’t know why until she was ready to blow up at me for looking at someone I usually had no clue who she was talking about.

I got accused of looking at random women all the time like our waitress, some woman across the street that I never even noticed in the first place or another across the room simply because she was there. As beautiful as she was, she was very insecure.

It got so bad that at one point I found myself walking around with my head down just so I wouldn’t accidentally appear to be looking at another women, but even that didn’t work.

So many dates and even a Valentines Day were ruined by her accusing me of looking at other women and her explosive, increasing inappropriate anger.

And yet there were times when she begged me to never leave her. When I told her this wasn’t working for me and I wanted to break up, she simply replied “no” and then clung to me like a frightened child.

Uncontrollable Anger and Physical Violence

As her angry explosions became increasingly unpredictable (yet predictable), she began to get physically violent. It started with her getting so angry that she would slap me and on at least two occasions she punched me in the face with a closed fist, all the time I was trying to calm her down to keep her from getting even more angry and out of control, which only made things worse.

At the same time, I noticed that she was also getting into conflicts with other people when we went out. Men, women, it didn’t matter. It was as if she had two sides to her; this sweet, outgoing, social butterfly that everyone loved and this angry bitch that everyone hated. Still, the most intense anger and rage were reserved for me.

It got so bad that whenever we went out, no matter how happy we were in the beginning of the evening, there was a 90% chance that by the time the night was over, we’d be fighting over something. I started thinking that she was allergic to having a good day. It was like, the more I tried for us to have a great day, the more I did for her, the more intense her anger would be when she decided it was time to ruin our good time.

She could literally pick a fight out of thin air which made it so much more unpredictable. It was literally, as the cliché goes, like walking on eggshells.

I remember one day we went to the beach, swam in the ocean and I painted her toe nails while laying on a beach blanket. Afterwards we went to the pier and had lunch before driving back home, changing and going to a jazz club. Later that night we stopped on our way home to get something to eat and she started yelling at me (out of the blue) because I hadn’t unfriended her best-friend that she accused of wanting me. The same best friend I knew before I knew her. The same best-friend that had introduced us.

I was so hurt and disappointed that we had such a great day ruined in five minutes by some random thought that came into her head.

Alcohol Abuse

I totally ignored and even enabled her substance abuse issues. When we met I knew she smoked, but I didn’t realized she was also a binge drinker and probably an alcoholic.

It seemed ass if she had to constantly be smoking or drinking in order to be marginally happy. She didn’t just drank to get buzzed, she drank to get white girl wasted as they say.

So many weekend nights she drank until she passed out or until she started flirting with everyone or lashing out on everyone with me of course as her favorite target.

One valentines day she drank a whole bottle of wine by her self at dinner and then another at the movie theater and then passed out before the movie even started.

She would promise to stop drinking, but she never did and to be honest, I was usually the one buying her drinks because I knew one or two drinks made her happy, but by the time she got to her fourth drink, she was a loaded gun ready to go off.

It wasn’t uncommon for her to go from happy to infuriated within minutes.

Idealization and Devaluation

Some days she would tell me that I was the best man ever and I would feel like a prince and by the end of the night, she would be enraged over something minor and yelling at me “you’re just like every other man” or telling me how I was the worst person ever.

At first I was really confused. I was either the best man she’d ever been with or the worst man she’d ever been with, but I couldn’t be both. It was starting to give me an identity complex.

I did noticed a pattern however. If she started telling me how I was the love of her life, the best thing that ever happened to her, blah, blah, blah, I needed to hold on tight because by the end of the day, the other shoe was going to drop.

Whenever she started inflating my ego, she would create a fight by the end of the day and tear me back down to scum under her shoes. I remember one night when not too many hours earlier I had been her moon and stars, she yelled at me that she hated and resented me. That really took me aback. In all my life I had never had someone tell me that they resented me. I didn’t even know how to take it, but I never forgot how much it hurt .

Those words were probably the biggest factor in causing me to start emotionally withdrawing and re-evaluating our relationship. Sure this was after we were about three years into this roller-coaster ride, but what can I say, I was in love.

By this time I had known she had borderline personality disorder for over two years. The signs were all there. I even had her take an assessment and she scored perfectly and even agreed with me that she thought she had borderline personality disorder, but she didn’t want to go to therapy.

In The End

My friends, people who knew me and knew us often asked me why did I stay. They didn’t know why I put up with the chaos, the anger, the numerous precarious situations she had put me in.

The answer is love. I really did love her. Being a mental health professional didn’t help. I thought I could help her overcome her issues, helping people is my job. And she really was and is an awesome person. If she was a totally horrible person of course I would have left a long time ago.

Would I have done anything different knowing what I know now? Of course I would. I would have chosen to just be her friend and to keep a safe distance so that I wouldn’t get caught up in the chaos.

I learned a lot through this tumultuous relationship, but mostly about myself. I learned that I was more codependent than I ever realized. I learned that I had a sort of six sense and sort of a curse for spotting people with issues and trying to fix them. I also learned what it was like to be in love with a beautiful woman, to have some of the most fun I’ve ever had in my life, to be adventurous, to feel like I couldn’t live without a person and then learn to live without them.

Talking To A School Shooter

Talking To A School Shooter

The other day I had the privilege of talking to a school shooter. When I say privilege, I don’t mean it in a way to glorify what he did, but it’sThe other day I had the privilege of talking to a school shooter. When I say privilege, I don’t mean it in a way to glorify what he did, but it’s not everyday that an opportunity presents itself for me to try to get into the mind of someone who was determined to carry out mass murder. Often these people kill themselves or are killed before anyone has a chance to understand why they did what they did, or like the Parkland shooter, are kept very isolated with only the psychologist and a handful of corrections officers having regular contact with him.

As a psychotherapist, this intrigues me. In undergrad I excitedly took classes such as Profiling Serial Killers, Understanding Mass Murder and The Anatomy of Violent Crimes. Yet, I had never been able to actually study someone in person so that I could better understand how to try to help others before they commit violent crimes as well as identify potential ticking time bombs.

With the nature of my job currently revolving a lot around criminal psychology, I end up talking to some of the worse of human kind on a daily basis. On a regular day I talk to murderers, rapists, child molesters and have even on multiple occasions attempted to talk to a hit man for a Mexican drug cartel accused of over a dozen murders. So far he has refused to talk to me or anyone else for that matter.

Without going into too much detail because this case is still pending, I would like to share some of what I have learned from talking to a school shooter.

The first thing I noticed about this particular school shooter was his small, non-threatening stature. He looked like your typical high school student, except there was no light behind his eyes. When he looked and talked to me, there wasn’t any emotion there.

I won’t go into if he has a mental illness or not, but he says he grew up in a family that was full of mental health issues, namely untreated bipolar disorder and schizophrenia. He says he was never physically or sexually abused, but witnessed a lot of family violence. As he says, his earliest memories are those of violence and conflict.

He had isolated himself at a young age. He didn’t feel attached or loved by his family. He had a lot of anger inside of him. He attempted to channel that anger by going into the military, but as a teenager he had gotten involuntarily committed to a mental hospital for a yet unknown reason, something that would later prevent him from joining the military.

Feeling even angrier, depressed and rejected because of that, he turned to Mixed Martial Arts as an outlet for his violent thoughts, but a knee injury caused him to have to stop training for awhile. It was during this time that his anger, depression and feelings of isolation grew and he started planning a mass shooting.

Planning included finding a way to legally buy a gun without a background check through a certain loop hole in the system. Planning included blending in with students of a high school he had dropped out of a couple of years ago, smuggling his weapon in using a musical instrument case and then going into the bathroom and putting on a tactical vest and gloves.

Before and during the incident, he reports he felt no anger or fear, just an adrenaline rush. He denies having any specific targets, any hate or anger towards any individual or group of people.

Although he says he feels remorseful, there are no emotions with his words. Yet he says the incident could have been a lot worse if it wasn’t for a girl’s screams that broke him out of his trance. He says it was her screams that made him feel horrible about what he was doing. Her screaming triggered memories of his childhood and made him and everyone around him, human again.

Some of the signs I’ve learned to look for from talking to him and studying other school shooters include:

  • Leakage- which is when people leave behind often unconscious clues, sometimes as a cry for help such as violent themes in their artwork or writing.
  • Low tolerance for frustration.
  • Poor coping skills.
  • Lack of resiliency.
  • Depression
  • Alienation
  • Dehumanizing others
  • Lack of empathy
  • Family appears to lack intimacy and closeness.
  • No limits or monitoring of TV and internet
  • Turbulent parent-child relationship

While it’s too late to have prevented this incident, I do hope that by continuing to learn from this individual and others, we’ll be able to prevent future tragedies. As long as I have access to him, I will continue to attempt to understand the mind of someone who would shoot up a school in Parkland, Florida, a movie theatre in Aurora, Colorado, a church in Charleston, South Carolina, a restaurant near Nashville, Tennessee, a music festival in Las Vegas or a nightclub in my hometown Orlando, Florida.