Really sugar is shaky because it originates from a straight stick see the play is Granny yes Grandma plus new style luv MaryJane so listen (Granny Apple last years blue ribbon production winner AKA) I, I, I ain't on the right side of my house Jane something or the other is in my room: finally after an extermination Grannie speaks once more "let my (old man) Pacman step on it". See it is home on the range so solo as it be truity speaks got a problem it is your own. But alter scenario: Z/n time; narcotics I got that candy s.p.ee..d360 Bar itch its' and Mickey Mouse for the Sultan 7 1 4er well a hem a hem, it went early in the morning like a smack chanting sugar structure 7 -one 1 +eleven and 4 do an ate 'er 8 eight 'er? Well that aint nice. NARCO says do you know them numbers change (response) Yes it is a FiX they are MF's Ope yeah Ope Douglas is it.
Surrounded by Alkaloid is both Mary and Grandma in an never ending circle of membership. French mandates declare put up their dukes... ZEN Pepsi can talk half Chocolate and your ole man Pacman down in Cuba posing as the worlds one and only Coffee Wizard "back 1:1" tis Coffee time... ||
Hi, I m Lynette from PanicAttackRecovery com. We are a collaboration of former sufferers who are helping current sufferers of anxiety, panic attacks, and agoraphobia.
If you are a consumer of caffeine and a panic, attack, or anxiety sufferer, then you might consider this video to be an important one, To begin with.
What are the effects of caffeine, Caffeine s effects include stimulation of the central nervous system, CNS, and stimulation of the cardiac muscle.
It has been suggested that caffeine can lead to jitters, headaches, irritability, confusion, muscle, aches, heartburn, increased blood pressure, and other effects on the body.
However, you might be asking the following question: is there any real connection between caffeine and anxiety, Authors of an article in the Journal of Caffeine Research completed a thorough literature review. The authors indicated that their review showed that caffeine produces behavioral and physiological effects similar to those produced by other drugs of dependence.
The article points out that caffeine consumption has been associated with several negative health consequences, including anxiety, insomnia, hypertension, myocardial infarction, bladder instability, gastroesophageal reflux spontaneous abortion, and reduced fetal growth.
So should you consume caffeine, You might be able to consume caffeine in moderation.
However, it s important to become aware of all of the foods and drinks that contain caffeine and to consider the level of caffeine in each of these foods and drinks, For instance, consider the following caffeine levels: according to the Mayo Clinic Brewed cup 8 oz of coffee 95 200 mg Cola, 30 40 mg, Black tea, 14 61 mg Energy drinks, such as Red Bull, 80 mg.
The Mayo Clinic indicates that you might consider reducing your intake of caffeine if you are consuming more than 500 mg of caffeine per day.
However, ultimately, we would suggest that you may want to determine your tolerance levels to caffeine. We certainly don t recommend that you quit caffeine or cold turkey.
If you are trying to quit, If you are trying to cut back, you should gradually reduce your caffeine intake levels.
Instead of making big changes all of a sudden, You should remember that caffeine is a drug, so you may initially go through some withdrawal symptoms when levels are reduced.
Withdrawal symptoms have been reported, such as headache, irritability, sleeplessness, confusion, nausea, restlessness, tremor palpitations, and raised blood pressure.
You might be asking how to kick the caffeine habit or reduce the amount of coffee you consume.
We would suggest you may want to think about two things.
1 Become aware of all your sources of caffeine by taking an inventory of all of your caffeine levels and 2.
Consider substituting green tea in place of all or some of your daily coffee.
Why green tea? Although green tea, has some caffeine? It s not nearly as much as coffee As mentioned, while a brewed 8 oz cup of coffee can have about 95 200 mg of caffeine.
Green tea has about 14 40 mg of caffeine. Only In addition to subscribing to our YouTube channel, you can visit our website and Sign up for our free email newsletter, Obtain a range of articles about panic, attacks, anxiety, and agoraphobia, and Follow us on Twitter and Facebook.
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this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs registered at all
CEUs comm slash counselor toolbox I’d like to welcome everybody today to the
presentation love me doesn’t leave me addressing fears of abandonment the purpose of this
presentation is really to help us help clients increase their awareness of their story including
beliefs about behavioral reactions to situations that trigger their fear of abandonment so how
do we do that well the first thing we need to figure out is what fear of abandonment is and how
can we identify it in a clinical set setting then we’re going to explore the concept of schemas or
core beliefs and these are things that are formed in early childhood you know if you remember
prior classes we’ve talked about early childhood cognition is generally very dichotomous in children
young children don’t have the ability to look at that gray area so these schemas if they’ve gone
unchecked can lead to some very extreme belief patterns which lead us into common traps in
thinking reacting and relationships if your schemas are based on all-or-nothing you either
love me or you’re going to leave me hence the name of the book then your reactions are going to
tend to be more extreme and more all-or-nothing which increases anxiety because then anytime
a person who perceives any amount of disapproval obviously is going to go to that extreme so we
want to talk about bringing it more toward the middle line and helping people learn to appreciate
and love themselves for themselves while they may not approve of the behaviors of other people they can
still love other people so just because somebody doesn’t approve of your behavior doesn’t mean
necessarily that they’re going to abandon you so we’re going to talk about that and then we’ll
learn skills necessary to help people accept their past as part of their story maybe they do
have a lot of abandonment issues and you know some people do and it really is painful it cuts
to the core especially when those abandonment issues occur in early childhood when kids going
what that does so we’re going to talk about that and help people learn how to integrate it into
their present and we’ll learn the skills necessary to acknowledge that their past does not have to
continue to negatively impact them in the present so if they were abandoned when they were a child
you know we need to deal with that however if they continue to expect that every significant person
in their life will abandon them notice I use the word every because we’re still in those extremes
then they’re going that the past is negatively impacting them in the present so we’ll talk about
how to sort of moderate those belief systems how does this impact recovery whether you’re talking
about addiction or mental health issues connection is a basic human need we are not meant for the
most part to be Hermits in the middle of the woods there are introverts and in my husband’s an
introvert he has a couple of really good friends he needs quiet time each day he doesn’t need to
be surrounded by people and he’s fine but I mean we’ve got human connection he’s not going to be
one that’s just going to you know move out to the middle of nowhere I’m an extrovert on the other
hand and I tend to have a lot of acquaintances and a lot of friends I draw energy from
being around other people so just because someone doesn’t have 150 acquaintances doesn’t
necessarily mean they don’t need connections so we want to recognize that connection is a basic
human need when infants are born they are put on their mother’s chest when we embrace each
other whether it’s mother and child or friends or whatever a chemical called oxytocin is released
and it’s our bonding chemical we are programmed we are hardwired for connection and oxytocin is a
very rewarding chemical so we want to recognize this that if people are so afraid of abandonment
that they push everybody away what are they losing as far as quality of life as infants and children
survival is dependent upon the relationship with the primary caregiver so if mom or dad wasn’t
happy if mom or dad was rejecting the young child was pretty much helpless to think about a child
who’s growing up in a family that’s just riddled with addiction and mental health issues and the
primary caregiver or caregivers are completely emotionally unavailable they may be physically
there but they may be so high or so depressed or so psychotic that they cannot attend to the
children’s need what does that communicate to the child feels abandoned the child
feels a sense of neglect for people’s beliefs about other people and relationships were formed largely
based on their interactions with their caregivers so if this child was going mom I’m hungry and
nothing happened or worse yet child was going mom I’m terrified and nothing happened or they
were just given a pacifier and told to shut up then that is they were told they were communicated
to that their beliefs their feelings their wants and their needs were not important so they were
being rejected healthy relationships serve up as a buffer against stress so even if they had all
these negative experiences in early childhood teenage years you know maybe up until
they walked into your office it doesn’t mean it has to continue and how much can they gain from
having healthy relationships with a lot of clients that I work with who have pretty significant
abandonment issues can’t even fathom trusting someone enough to be in a healthy relationship so
we’re going to talk about how to sort of ease into that because you’re not going to say don’t let
your past influence your future and we’ll wave a magic wand and they’re ready to trust people
even once you point out that what happened in the past was largely not their fault or maybe not
even their fault at all they’re still going to have difficulty not accepting responsibility
and going everybody leaves me so what talk about that addressing beliefs that formed as a result
of these relationships the past dysfunctional relationships we can help people create a
new understanding of events was mom or dad or caregiver really being rejecting were you being
abandoned emotionally and physically because of you or because mom or dad just was able to do what
they needed to do to be a caregiver at that point in time they were doing the best they could with
the tools they had but it wasn’t enough to meet your needs so we want to talk about alternate
explanations for why parents and caregivers may have behaved in that way if you have a young child well
an adult now but who was put up for adoption or abandoned by their caregivers at a young age the
a young child was probably very confused because one moment their caregiver was there in the
next moment they were in the system so they were trying to figure out what did they do wrong and why
doesn’t that person love me anymore it must be me because children really can’t see well you
know mom is not able to function as a parent right now or dad is having difficulty coping we
want to help people better understand themselves in their reactions so that when they start getting
this urge to just cut all ties and be like you know what fine you know I’ll take my ball and go
home no problem what does that mean at there’s a certain point in all relationships in all healthy
relationships that you know sometimes people have to distance themselves from one another because
it’s becoming dysfunctional but for the most part, people will in relationships encounter
hiccups will encounter disagreements but in healthy relationships, they can work through
them in relationships with people who fear abandonment there are going to be two extremes
there’s going to be complete compliance and please don’t leave me or complete disengagement
and whatever I don’t care the final thing we want to do is help make people more conscious of
what they’re doing so they can make healthy decisions in their current relationships so when
they get that urge to either comply or disengage is that a healthy normative reaction right now
or are you reacting out of your past experiences the abandonment experience in childhood survival
depends on caregivers a four-year-old left alone for five days is not going to do so well you
know they may be able to scavenge food but once the food runs out where do they get it you
know there’s only so much that a child can do an infant can’t even get their own food
so survival depends on their caregivers and if their caregivers fail to meet those needs there are
high levels of anxiety and I will refer regularly to caregivers who are emotionally unavailable
and emotionally absent in addition to physically unavailable or absent because some parents and I
worked in the field of co-occurring disorders for over two decades and some parents just they are so
overwhelmed and so paralyzed by life itself they can’t even attend to anything else that’s going
on they’re doing good just to be breathing but if they have a child and that child’s needs are
getting neglected and fear of abandonment is a natural survival response when your food source goes away
what happens you start to freak the freak out so this is normal we look at this and say that that’s
that’s natural if a child thinks about the first time you take a child to kindergarten or pre-k
or daycare or whatever it is and you drop the child off even if they’re securely attached what
do they cry because they’re afraid that mom or dad won’t come back and they’re afraid of
this new situation that’s changed securely attached children will you know adjust and then be happy to
see mom or dad when they come back but the point is there’s that initial oh crap reaction meeting
biological needs and safety are key triggers for anxiety at any age so we’re talking about housing
we’re talking about safety we’re thinking about Maslow’s hierarchy if somebody is not meeting the
child’s needs or if the person is not getting their needs met then they may have high levels
of anxiety and I add to the safety concept not only physical safety but also emotional safety
people need to feel safe in their own heads and they need to be free from emotional abuse when
focused on survival people can’t focus elsewhere so if they’re not getting their physical needs
met guess what you know if you take somebody who is in pain who is sick who is hungry and who is
homeless are they going to work on self-esteem are they going to work on relationship skills
no, they’re focused on survival they need to have those basic needs met they need to have a certain
sense of security if they are in a situation that is dangerous physically obviously they’re not
going to be focusing on how can I better myself when they’re worried about somebody coming in
and hurting them physically likewise it’s hard to focus on how can I better myself when everywhere
they turn they perceive someone telling us you’re not okay you’re stupid you’re lazy you’re bad
you were the worst decision I ever made in my life they can’t focus on personal growth when
all they’re getting is these verbal beatdowns all the time so people need to have acceptance if
they don’t have acceptance kind of the opposite of acceptance is abandonment two kinds of extremes
again we’ll bring it back to the middle every stressful situation becomes a crisis the in
securely attached child now you can go back to and read Bowlby’s work on secure and all that kind
of stuff great reading but for the short version of this presentation remember that certs securely
attached children feel anxiety when their parents leave but then they can adjust and they’re happy
to see the parents return in securely attached children feel a great amount of anxiety when
their parents leave and are terrified that mom or dad won’t come back and then when mom or dad does
come back it’s your very very clingy or very very rejecting so with this child that’s in securely
attached it’s just like one to a hundred as soon as something happens that they think they may be
abandoned you see this pattern again in adults who are still struggling with these abandonment issues
that schema that they’ve formed and I’m getting a little ahead of myself that schema that they form
says if you let this person at your site or if this person disagrees with you or if this person
criticizes you they’re rejecting you and they’re going to abandon you so we want to you know check
in with those cognitions and look for trying to make those thoughts a little bit more helpful in
infancy or early childhood if caregivers were away for long periods of time because of work because
of military, if they were in jail if they just chose to be away or if they passed away children
may experience some abandonment issues now if the parents are away because a parent is a way
because of work or military or even jail and the other parent can help the child work through it
there’s much less drama if you will there’s much less issue with abandonment issues in totality
now if it’s whatever parent it is if the pay, if the father happened to be the one, went away
that person may have some residual issues with adult figures in their life that they need to deal
with but they may not know I’m not saying that every child of a soldier or a service person
is going to have abandonment issues that are so not true however if the experiences of the time
apart was not handled in a way where the child felt secure then it could have consequences that
are going into present-day if in early childhood caregivers were inconsistently or unpredictably
physically or emotionally present so think about a parent who has major recurrent major depressive
disorder addiction or is just ill-equipped to deal with a child when I was working at the treatment
center in Florida I had 14 15 16-year-old young women coming in and having babies and you know
what does a 14-year-old know about giving birth and raising a child so it’s not that they weren’t
necessarily trying you know they didn’t have great role models raising them in most cases and so they
don’t have anything to work with they don’t know how to be a parent they’ve never been taught so
it’s not always I don’t want to pathologize or make the parents look like bad people because
I believe that people do the best they can with the tools they have at any given time parents
don’t choose to be sucky parents sometimes it happens but I really don’t believe they choose to
anyhow off my soapbox in later childhood as the child becomes elementary school middle school
age if they’re a poor family fit or they feel like they’re the black sheep they just don’t
have the same beliefs that the other people do they don’t seem to have the same interest that
their family does they may not feel accepted especially if the family’s going no that’s wrong
to believe and invalidate them so going back to that psychological safety if they’re constantly
being told their ideas are stupid they’re wrong they have the wrong point of view and they can
feel very isolated something can happen that ruptures the relationship with the primary care
giver whether it’s abuse or you know some kind of other trauma and introduction of a new less
an emotionally or physically safe caregiver can also lead to abandonment if the child feels like the
biological caregiver chose a new spouse over him or her say if you see where I’m going with that
because if this new person comes in and is less safe is abusive in some way emotionally physically
sexually it doesn’t matter the child is going to feel like they didn’t have a voice the child
is going to feel like the biological caregiver didn’t care and brought this other person in
any way which leads to feelings of rejection and abandonment so what are the reactions
fight-or-flight whenever there’s a threat we fall back to fight or flight or freeze but we’ll
talk about that when there’s a threat our anxiety goes up and we say in the past in these kinds of
situations, if I fought, did I succeed if so then we’ve got fights in the past did I succeed and if
the answer’s no then the response is to flee pretty simply so anger towards someone who’s unavailable
if they got angry and felt like it got them some sort of acceptance from somewhere that might
be the prevailing reaction sadness when someone goes away a sense of helplessness this person
just left me shame or self-anger about feeling needy or about pushing someone away fears related
to rejection and isolation, nobody will ever love my loss of control or the unknown everybody
always leaves see how I’m using these extreme words again and fear of failure I can’t maintain
a relationship nobody wants to be with me because I’m not good enough so the questions for clients
in these situations what caused these fears as a child so when someone starts to have these fears
about a relationship if the relationship starts to get rocking first question is what is it that
you’re afraid of in this situation if you stay together what is it that you’re afraid of if this
the person leaves what is it you’re afraid of and how likely is it that this person is going to leave
based on whatever is going on right now so let’s get some objective evidence here and another
the tool you can use is the challenging questions worksheet in cognitive processing therapy if
you google it challenging questions worksheet CPT or cognitive processing therapy really helps
people walk through the logic in some of their cognitions and identify some know unhelpful
distortions so then after you figure out kind of what the fear is then we say what caused that as
a child in the past when you felt like this what caused that and how was this reasonable or helpful
you know in the past when you felt like this and you reacted in anger what was the outcome and
how was it helpful in some sort of way you know did it get somebody to pay attention to you did
it gets somebody to come comfort you, okay so you were identifying the function of the current
behaviors and then we want to say what causes these fears now a lot of times it’s the same symp
or similar stuff but we could say how are these reactions now unhelpful because as independent you
know adult-type people we can fend for ourselves we can put food on the table we can go to work we
can do we can function independently whereas this is a child we couldn’t you know there were just
some barriers to that does that mean again that we should live in isolation and say well
I don’t need anybody no that’s not what I’m saying what I’m saying is is these fears that
are overwhelming about abandonment that causes people to push others away or cling on like you
know whatever clings on uh are these reactions helpful in the present day you know do you still
need to hold on to people like there’s no tomorrow temperament based on their temperament children
need different types and amounts of caregiver interaction um some children are wide open and
easily overstimulated you know my son was that way when he was born well to this very day um
when he’s awake he is like the Energizer Bunny on methamphetamine I’m he’s just going going
going and talking and talking to himself and he needed a lot of structure and he would get
overstimulated easily but we were able to help him figure out how to handle that instead of
getting mad at him for what seemed to be acting out we were able to help him channel and figure
out when he needed to take a break the introvert may not need as much one-on-one attention with
the caregiver may need a comforting word here and there but they may not need the amount of
the attention that an extrovert may need an extrovert tends to need more interaction with parents with
family with other people because they draw energy and they think while they talk and they think
while they talk with other people so they feel a lot more isolated if they are isolated so we
want to understand the person’s temperament and how they may or may not have gotten their needs
met how they may have been told they were wrong and invalidated when they were younger and you
can hear some of this is kind of going towards Linda hands DBT environment um but what we want to
look at what do you need now how can we create an environment that’s accepting and welcoming
to you now based on their needs and caregivers’ reactions children form schemas or core beliefs
about the world and others so if they state their opinion and it’s squashed or it’s ridiculed then
they’re going to form this core belief that it is not safe ever to share my opinions because I am
always wrong now we’re talking about children here but a lot of times think back for yourself there I
think most of us have at least some all-or-nothing dichotomous thoughts that come in every once in
a while and you know we can catch them but if these dichotomies go unaddressed the person starts
feeling very lost and very abandoned because it’s all-or-nothing important points about children
under 7 from 8 to 12 children are developing alternative cognitive skills they’re
starting to be able to think abstractly they’re starting to be able to see the gray area and
alternate explanations but even you know during that period so zero to 12 children are having
difficulty envisioning all the possibilities so anything that happens before that we want to
encourage them to look at the schemas that were formed and challenge them to examine whether they
are currently accurate and helpful children think dichotomously when they’re that young it’s all
or nothing it’s good or bad it’s not kind of sort of something it is what it is I mean even think
about thinking back to grades that we would get it was satisfactory or unsatisfactory there was
no ABCD F when we were in elementary school and I don’t remember middle school then it was a
dichotomous grading scale you either did it or you didn’t children are egocentric so whatever happens
they say what was it about me that made this happen if mom’s in a bad mood what did I do if
you know Mom is rejecting well that was stupid I’m stupid children are very egocentric so you take
all or nothing combined with all about me and you can see we’re creating the perfect storm of children
can only focus on one aspect at a time when I work with adult clients you know they come in and they
tell me that they had an interaction with their boss he was walking down the hall and he was in a
bad mood and I just knew I did something and so we talked about that and I’m like how do you know
that because he had it he had angry look on his face okay what are some other possibilities what
else might have been going on with him at that point in time and a lot of times we can brainstorm
ideas about a call he just got or where they just left a meeting that didn’t go so well or who
knows what else in this day and time when we’ve got our cell phones and PDAs and everything
there are a lot of things that can trigger a mood besides just whoever you pass in the hallway
children can’t think about those other things that might have triggered the mood they see somebody
unhappy and they’re like I’m sorry um so we want to encourage as adults we want to encourage them
to say all right what are the other possibilities even as children I try to work with my kids
to encourage them to look at alternate reasons why somebody may be acting a certain way children
can’t think abstractly and consider those possible options um even with kids you know knee-high
to a grasshopper, if you’re in a situation and maybe in a store and somebody behaves not kindly
to you, you can talk about that later with the kids and say you know that was kind of unpleasant to go
through what you think might have caused that and brainstorm three ideas my favorite number is
three I don’t know why but brainstorm three ideas for alternate explanations for why that person
may have been in an unpleasant mood if children learn to do this when they’re younger it’s a
a lot easier to transition to as adults schemas are a broad way of perceiving things based on
memories feelings and thoughts basically it’s our go-to perception of what something’s going
to be like we have schemas about everything if you go to church you have a schema about what’s
going to happen when you go to your mother’s house you have a schema about how mom’s going to
behave and what’s going to happen we form these it’s our brain’s short shortcut instead of having
to analyze every situation it says oh I remember this been here before it’s probably going to be
like X Y Z unfortunately sometimes things change and one of the things we see in addictions
treatment as is as caregivers into recovery and really get a hold on it and start working that
a new way of life and sobriety and all that stuff old family members or family members still expect
that old behavior they have that schema that when Jane comes in this is what’s going to happen
because they’re remembering how she behaved and acted in her addictive self so we want to help
people identify their schemas and check them sometimes they’re still accurate sometimes not so
much schemas that trigger abandonment fear center around the cell acceptability is this person going
to like me which is one of the reasons we do a lot of self-esteem work in reducing abandonment fears
because we want to reduce the need for people to solicit external validation we want them to say
I’m all that and a bag of chips and I would love to play with you but if you don’t want to play
I’m okay with that love ability if they were told they were unlovable if they perceived
they were unlovable then in the present they may fear isolation they may fear that they’re not
lovable so they will try to do whatever they can or likewise they will build a lead wall that is 5
feet thick all the way around them so nobody can hurt them they may have fears about their own
the competence you know thinking back to Erikson you never thought some of these theorists from the
past would keep coming up even in current practice but they do if a child going through that period
of industry versus inferiority Erik Erikson’s stages of psychosocial development and they felt
like a failure, all the time or they were never good enough the parents never recognized their
positive achievements then they may question their own competence and feel like a failure if they
feel like a failure they may feel they may believe that nobody wants to be around them so they will
leave so if I fail they will leave and fears may center around adaptability some people are not
able to tolerate any loss of control they’re just like that they’re holding on with a death grip to
the relationship to anything that’s going on and it starts to go wonky they are going to freak out
so we want to look at what it means if you’re not in control of everything what does it mean
if you trust that this person is going to do the next right thing if you are doing the next right
thing as well schemas that trigger abandonment fears can also be sent around center around others
if someone is rejecting distant cold or is unable to handle the person’s needs then the person may not
feel acceptable so if they are in relationships with people like this then we need to look at is
Is it you who’s not acceptable or is something else going on with that person that may be making
them unable to deal with anybody else’s stuff right now the person may feel isolated if other
people are absent if people fail to keep promises they may feel like nobody’s ever there for them
competence if other people are always critical then the person will question their own competence
and if others are unpredictable a lot of the time when people who have anxiety about abandonment
they come from situations where other people have not been predictable or if they were they were
unpredictably absent and relationship of self to others if they are afraid about their ability to
relate with others if they’re afraid of rejection if they’re afraid that if they start to love they
will be rejected and then they will be isolated forever if they are afraid of the unknown and they
I just want consistency more than anything and as soon as consistency starts to waver a little
a bit because as we grow things change and people with abandonment issues don’t like things to
change because that’s not predictable and that’s not consistent so they may have difficulty if one
the person starts to change what they do I see this a lot not saying that it’s an abandonment issue
necessarily but when law enforcement officers retire you know because they can retire after
20 years so they may start a new career and that causes a lot of change schedule changes
they’re not law enforcement anymore and the spouse sometimes has culty adjusting to it as
does the retired officer but controllability if the person holds on to relationships and
everything in their life with white knuckles because they’re so afraid if they let go of
control that they are going to disappear or disintegrate then if something seems like it’s not
in their control, it’s going to be a catastrophe so attachment Styles secure if there’s an
emotionally available caregiver the child will seek the caregiver for comfort and guess
what the caregiver will be there and will more often than not meet the need for comfort with the
the correct type of comfort so hungry cold scared kind of following the child’s upset when the caregiver
leaves especially in new situations but the child gets over it it’s not a child that’s going to sit
there and cry for eight hours and then the child’s happy when the caregiver returns in this kind of
attachment the child learns to trust others will be responsive to their needs and validate their
needs a child learns to be self-reliant and try new things but if they fail they know they can
return to the home base they can go out and go well that didn’t go as planned and the caregiver will be
there to say alright let’s figure out what to do next not you are such a failure the child learns
to adapt to a variety of situations because when they’ve been faced with something that’s a little
scary caregivers been there to kind of coach them on and go you got this it’s scary I got it but
you can do it the child learns to deal with stress because the caregivers are there to coach them
or to process it with them afterward because the caregiver is not always physically there but if
you’ve got children you know sometimes they’ll come home from school and they’ve had a really
bad day and you’d pull them aside and go you know what’s going on let’s talk about it so in this way
the child learns to deal with stress and the child learns to have accurate expectations of others
in the secure attachment, emotionally available situation remember children are egocentric so
if mom’s upset the child goes what did I do or oh my gosh I hope mom’s not going to leave in
a secure situation sometimes the parent has to say something like mommy had a really bad day at
work today has nothing to do with you I need to go take a timeout that helps a child understand
that you know what it’s not all about me and I can understand that sometimes moms upset for
something besides me and I can understand that if moms up said it doesn’t mean she’s going to
leave so obviously this is the ideal situation avoidant attachment styles the rejecting or harsh
caregiver the person depends less on the caregiver for security because every time they go saying, mom
mom, I had a nightmare can I come into bed with you they’re met with going back to your own bed and the
caregiver rolls over it’s not oh I’m sorry you had a nightmare let me walk you back to your room
when the child is separated from the caregiver there’s little response when the caregiver leaves
or returns because the kids like what uses that person to me the child learns not to depend on
a caregiver for comfort connection or security now imagine yourself a four-year-old child or a
six-year-old child thinking I can’t count on my caregivers for comfort connection or security
that must be a terrifying place to be and I can see why you would develop some pretty strong
defense mechanisms the ambivalent relationship between the cave caregiver is inconsistent or can bow can’t
talk caregiver is inconsistent or chaotic this is really true in a lot of homes where there are
at least one parent who is battling some sort of addiction or mental health issue so the parent
may or may not be available you don’t know what the good days are going to be you don’t know what
the bad days are going to be so the child may be anxious and afraid to try new things or explore
because they’re like things are going good right now I don’t want to top will be an applecart just
going to sit here and ride it out a child may be clinging and demanding trying to elicit a response
remembering negative attention is better than no attention at all and the child is upset when the
caregiver leaves but also inconsolable when the caregiver returns because you know I was upset
I was scared you went away but you came back and that’s good but I don’t know when you’re going
to go away again and if you’re going to come back so it’s this constant anxiety of abandonment
core abandonment beliefs all people leave so we want to challenge that by identifying exceptions
mistrust people will hurt reject take advantage of me or just not be there when I need them you
know what that’s true sometimes because people have their own stuff so when this happens let’s
look at whether it’s happening all the time and/or let’s also look at what else might be going on
with that person that caused them to hurt reject take advantage or not be there when you needed
the emotional deprivation I never get the love I need nobody understands me cares about me or even
ever tries to meet my needs here how dramatic and extreme that is so one of the things as clinicians
we can do is say if you are getting the love you needed what would it look like what
would be different what is it that you need that you’re not getting once we identify
then we can create a plan to get it but a lot of times other people don’t understand or may not
be able to interpret what you need so let’s help let’s try to figure out how to make this happen
nobody understands me alright let’s talk about why that might be and you know let’s look at some
people who’ve kind of gotten a grasp sometimes with clients with abandonment beliefs nobody
understands me translates to I don’t give a buddy a chance and I cut them off as soon as they become
confused and because they associate confusion with the rejection so we might talk about communication
skills we might work on what it is that people don’t understand and how to better communicate
that and where to find people who have similar interests nobody ever even tries to meet my needs
you know here I would really look for exceptions but I would also challenge the person and I would
say when do you meet your needs what do you do to take care of yourself a lot of times
clients with abandonment beliefs are so freaked out and afraid of being abandoned that they’re
not taking care of themselves either they’re just living and are paralyzed going back to fight
flee or freeze they’re living a paralyzed state of I want to be loved but if I love I’m gonna get
hurt and I don’t know what to do they don’t even love themselves so we want to start talking about
if you had your best friend you know create this best friend persona what would he or she say to
you what would he or she do right now let’s try to help you understand yourself with mindfulness exercises
are really good here because a lot of times these clients don’t understand themselves they’ve got
so much anxiety they’re so afraid and they don’t know where it’s coming from because a lot of
it has been going on for so long defectiveness if people knew me they would reject me you know
not everybody’s going to like you why do you need everybody to like you why is it important that
everybody likes you and failure I don’t measure up and I’m not able to succeed I usually put pull
out the obnoxious quote that if you haven’t failed you haven’t tried and we talked about what it
means to get outside your comfort zone and you’re not going to be perfect at everything you’re not
going to be Michael Phelps you’re not going to be the president of the United States that doesn’t
mean that you’re a failure that definitely doesn’t mean you’re a failure so what things are you
good at what can you and have you succeeded at and go back and look over things like you graduated
high school, not everybody does that you know raised a family not everybody does that so we
want to challenge all nothing’ languages we want to look for exceptions and we want to look
for in what ways can you provide yourself the validation so you don’t fear abandonment you don’t
need other people to tell you you’re okay because guess what you’re telling yourself I’m okay and
before I go on to unhelpful reactions I do want to point out that if we tell people to tell
themselves you know I’m okay that sounds great but if they don’t believe it if it’s not supported
with evidence, it’s actually probably going to slow their growth because they’re sitting there going
telling themselves I’m okay and in the back of their head going you know you’re not so we need
to get that internal critical voice to kind of hush up by providing the person with the objective
evidence of why they’re okay why they’re good enough and that’s a slow process it’s not going
to happen overnight but encourage people to figure out why they believe what they believe and then
you can work from there okay unhelpful reactions fighting with someone you don’t want to leave
me because so the person may engage in dominant sort of posturing behavior aggression hostility
blaming and criticizing trying to tear down the other person to say you know what I don’t care
and you should be grateful that I’m in your life recognition seeking to get attention validation
or approval so if they feel something’s going wrong in a relationship they may start trying to
do something to gain recognition to prove that they’re worthy of a relationship for what they do
versus who they are manipulation and exploitation said lying justifying I did this because you made
me so sometimes we all occasionally do things that aren’t the nicest people who fear abandonment
have difficulty saying you know what I screwed up and they’re more likely to go you made me do
I wouldn’t have done it if you would have X Y & Z people again who are worried about a relationship
is going to fall apart and may also make excuses for other people’s inappropriate behavior it’s like
you know I really hate what this person does but if I don’t make excuses for it if I condemn it
then this person is going to leave in counseling we can talk about the difference between loving a
person and loving a person’s behavior you know I love my kids to death there is no question about
that but some of their behavior makes me want to climb a wall I’m very clear to separate from them
the difference between the behavior that I dislike and them because you know like I said I love them
to pieces and we want to help people start making this differentiation if they don’t do it already
and clinging and chasing is the other fight reaction stalking and messaging somebody 47 times on
Facebook in an hour all these kinds of behaviors and even online bullying those sorts of things can
be fight reactions in response to feeling like there’s a threat of abandonment flight is more
of the I don’t care if you leave so the person will withdraw physically and emotionally and
maybe even numb themselves with some sort of addictive behavior or distract themselves with
something completely different or find a new person just proof that you know what I didn’t
need you because I’ve got this new person now questions for clients about core beliefs
all people leave okay so what does it look like if somebody’s available to you if they
don’t abandon you who in your past left you or was unavailable emotionally now a lot of
I find it helpful for mental health and addiction clients to have them write an
autobiography because then we can go back and kind of review it and identify the core
people at certain stages in a person’s life what did the person who left you do to make you
feel rejected or abandoned in retrospect you know it was hard to see the difference what
was going on back then because you were a kid in retrospect what are the alternate explanations
for why this may have happened was it really you or was it more about them who in your past
has been available to you emotionally most of the time people can point to one maybe two people
who have generally been there it’s unreasonable to expect someone to always be there who in your
present is available to you emotionally you know maybe they’ve only been in your life for six
months or a year but they are available and I say emotionally because you know not everybody can
be available physically all the time we’ve got jobs kids all that kind of stuff but can you pick
up the phone and call them or text them and say hey you know what I’m really struggling right now
what do you do in your current relationships that cause people to leave do you push them away if so
how what are alternatives to pushing them away cutting all ties and just saying fine be that way
I wipe my hands off you if you cling how do you do this in what ways do you perceive yourself as
being clinging and what are some alternatives to holding on with all desperation and mistrust people
will hurt reject or take advantage of me or just not be there when I need them so again what does
it looks like when somebody’s or what does it feel like when someone is trustworthy and safe who in
your past was untrustworthy or unsafe what do they do they taught you this and what are alternate
explanations who in your past has been trustworthy and safe who in your present is available and
trustworthy what do you do to yourself that is unsafe or dishonest that’s one of those tricky
questions you’re there talking about other people other people then it’s like what
do you do to yourself how do you lie to your self or how are you mean and hateful to yourself
how does your distrust of other people or even yourself impact your current relationships some
people distrust their own internal intuition so much that they don’t want to make friends with
other people they’re like I can’t tell who’s going to hurt me and who won’t so just yeah I’m
going to wipe my hands of it all what could you do differently what do you think you could do
in order to start building trust and what does it look like to build trust because Trust doesn’t
just appear it builds gradually emotional deaths deprivation I don’t get the love I need nobody
understands me so again what does it look like when somebody understands you and meets your
needs who in the past failed to meet your needs emotionally and how can you deal with that now
you know it may have been mom it may have been ex-husband it may have been you know who knows
how can you deal with it now yourself so you can put it to rest who in your past is understood
you who in your present understands you how can you start again better understanding yourself
because it’s hard for other people to understand us when we don’t even understand ourselves and
what can you do to start getting your needs met you one of the things was starting to get your own
needs met is to figure out what your needs are and this is one of the exercises I have people do as
a homework assignment they keep track of what is it they want on a daily basis keep a log and then
let’s talk about what common themes were seeing if people knew me they would reject me okay so how
do you know when you’re accepted or acceptable to someone who when you’re past may make you feel
defective are there alternate explanations and how can you silence those old tapes because
that person that statement stays as a heckler in the gallery we need to hush the heckler what
can you do part of it could be talking back and saying you know what I’m not going to listen
or I don’t have time for this right now who’s been accepting and supportive who is in your life
that’s accepting and supportive and how can you start accepting yourself and being compassionate
so some compassion focus training mindfulness work to help people understand themselves and start
being compassionate with themselves understanding their vulnerabilities and cutting themselves some
slack I don’t measure up I’m not able to succeed okay that’s a pretty big success you know what
is what success means success means different things to different people so what does it look
like to you to be successful let’s kind of hammer that out what is it if you are successful what
would be different what in your past has made you feel like a failure what are some alternate
ways of viewing it such as a learning experience or something I had to go through to grow or you
know brainstorming alternate explanations for why people fail they don’t have a response to
sometimes I ask them to kind of take on a flip role and say pretend you’re a parent and
your child comes home and they’ve tried out for the football team and they didn’t make the team
they failed what are you going to tell on what have you succeeded at doing in the past what are
you good at in the present and we really want to pay attention to minimization here because a
a lot of our clients are not good at identifying their strengths what does being successful mean in
terms of your relationship with others do you have to be successful in order to be loved and be a
the good relationship you know obviously you’re going to be successful in a relationship if you’re
but do you have to be financially successful and powerful all whatever you define success as in
order to be in healthy relationships who are three successful people you know and what makes
them successful in your eyes does success equal happiness you can do a whole group on that and
what do your kids need to do to be successful in life you know we want our kids to succeed in us
want our kids to be happy so what is it that I envision my child’s life to be 10 to 15 years from
now triggering relationships the abandoner is unpredictable unstable and unavailable the
an abusive relationship is untrustworthy and unsafe the deprived err depriving relationship the
a person is detached or withholding the Devastator is always judgmental rejecting and critical and
the critic is critical and narcissistic usually a lot of times people replay their past to try to
kind of get it right the second time so we want to look at do you have a habit of getting into
relationships with people who are not safe we can also ask them how do you exhibit these behaviors
in what ways are these behaviors present your current relationships and in what ways were these
present and your primary caregiver relationships behavioral triggers abandonment and mistrust
if somebody starts acting differently they change their behavior in some way a person who fears
abandonment goes oh that’s not good if they’re not getting constant reassurance that’s
that external validation can trigger abandonment fears so again we want to work
on internal validation and why is it that you feel you need constant reassurance from the other
person’s relationships feel threatening so work relationships those sorts of things the
a person who has abandonment issues won’t want their significant other around other people
and they become hyper-vigilant to rejection and disconnection even if it’s just somebody
going I had a really bad day I need 20 minutes and go into the room and shut the door
the person with abandonment issues will likely have a high level of anxiety so we want to ask
how these behaviors have threatened them in the past what are alternate explanations for why this
is happening with this person right now and what would be a helpful reaction to these behaviors
now so this is happening what would be a helpful reaction instead of assuming that the sky is
going to fall defectiveness and failure so if somebody is critical if they have unexplained time
apart there’s absent or inconsistent reassurance or if the person tells them they’re a failure
these or they fail at something these could all be behavioral triggers they could be like I
failed at something I’m not getting reassurance that this relationship fixing to end question how
is this threatened you in the past alternate explanations and what would be a helpful
reaction to this particular situation right now envisioning activity what does a healthy
the relationship looks like presence versus abandonment acceptance versus rejection emotional support
versus emotional unavailability trustworthy versus untrustworthy and safe versus harmful
these are extremes what does it look like to be a middle ground there are going to be exceptions
you know things are going to happen so what does a healthy relationship look like and how to do you
deal with exceptions if somebody’s not always present how can you create this relationship with
yourself that’s the big one and then how can you create this relationship with others’ mindfulness
questions what am I feeling what’s triggering it am I safe right now and if not what do I need to
is this bringing up something from the past if so how is this different how am I different
then I was when I was six or four and how can I silence my inner critic finally what
would be a helpful reaction that would move me more toward my goals and toward a positive
emotional experience summary core beliefs about the self and others are formed in early
life due to children’s lack of knowledge of other experiences and primitive cognitive abilities
these core beliefs are often very dichotomous core beliefs can be formed around events or
experiences outside of the conscious memory identifying and being mindful of abandonment
triggers in the present can help people choose alternate more helpful ways of responding in
the present in secure and loved me don’t leave me are two really excellent books
there are google previews if you want to look at them to see if it’s something that you like
but they do take what we talked about in this presentation and expand upon it a whole bunch
more if you enjoy this podcast please like and subscribe either in your podcast player or on
YouTube you can attend and participate in our live webinars with doctor Snipes by subscribing
at all CEUs comm slash counselor toolbox, this episode has been brought to you in part by all
CEUs com provides 24/7 multimedia continuing education and pre-certification training to
counselors therapists and nurses since 2006 used coupon code consular toolbox to get
a 20% discount off your order this month you
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this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs registered at all
CEUs comm slash counselor toolbox I’d like to welcome everybody to today’s
presentation on common co-occurring issues exploring the interaction between mental health
physical health and addiction so we’re kind of putting together the stuff that we’ve been
talking about for a couple of sessions now we’re going to start by talking about some
questions and then reviewing what a healthy person needs and then going through and talking
about how different addictions may cause or be caused by mood disorders and physical health
issues and we’re going to talk about things that you may see in private practice or the
a facility that you’re working in just real quickly for those of you who are here how many people if
you would just type in the chat window if you’re a mental health counselor type mhm if you are a
addictions counselor type SI or whatever so just kind of so and know who I’m talking to you okay
so mostly mental health ok cool so what we’re going to look at is what you may
see in private practice or a mental health setting because these clients a lot of clients
that have substance abuse or addiction issues and I use the term addiction because we’re
talking about behavioral addictions too many times they don’t meet the criteria for admission
for substance abuse because they don’t meet that threshold of a substance use disorder tolerance
withdrawal yay yay so substance abuse agencies can’t get funding to provide the treatment so
they end up in a mental health facility or a mental health counselor’s office and they may
be dealing with some of these addiction issues and wanting to address them or they may not be
but those issues are out there and exist so we want to know how they interact so told you
we’re gonna have a couple of questions to think about and I’m just asking you to ponder these for
right now and you can add throughout the class if you want but we’re gonna talk about it more at
the end how can we and why is it important to address chronic illness and disabilities
that result from or that cause mood disorders or addictions so thinking about you know like
HIV or hepatitis are two of the big one’s cirrhosis of the liver chronic obstructive
pulmonary disease from smoking so these are things that can result from addiction why or how
is it important for us as clinicians mental health clinicians mainly to think about addressing these
how can we address depression and/or anxiety kind of our mood disorder genre and hopelessness that
results from or causes depression and anxiety so we know that thinking back affects acceptance
and commitment therapy there’s clean discomfort which is what he calls your initial emotion
when you feel something if you feel depressed if you feel anxious that’s how you feel and
it’s uncomfortable but it’s clean it is it is what it is and then he calls dirty discomfort
the feelings that we have about those feelings so we can get angry that we are depressed we can
get depressed that we’re still depressed and he calls that dirty discomfort because we’re kind of
layering on and piling in think about just kind of throwing somebody into a hole and piling more
dirt on top of them so we want to think about how can we address these issues that result from
depression or anxiety or sleeping eating or energy changes so if you’ve got somebody who is dealing
with a chronic illness or something else has happened or they’re they’ve got some sort of
an addiction and they are not eating well not sleeping well it could trigger depression or
anxiety so we’re going to talk about that how can we address sleeping eating and energy changes
seems like we’re getting repetitive we’re looking at how each one interface and how can we address
these things that are caused by or cause mood disorders or addictions because we know when we
look at the diagnostic criteria for depression for example sleeping eating and energy changes
primary in there and how can we address guilt and regret which may accompany addiction recovery
or the diagnosis of the disease as the result of addiction such as lung cancer or HIV or cirrhosis
of the liver and people who have liver disorders cirrhosis of the liver and hepatitis are at a
greater risk of liver cancer so that can they can have some additional anxiety that is related
to that so they may look back and go I wish I hadn’t well you have so how can we help you deal
with that and come to some level of acceptance so my little editorialized soapbox when we’re talking
about addictions I mean sometimes we don’t want to think that they exist we want to pretend that our
clients are coming in their mental health clients otherwise their perfectly healthy things are
going great well that may not be the trick the case a lot of people begin to use and I mean
think about ourselves when we’re when we were in high school and college or you know even later
some people use it for recreation you know they want to go out have a few beers do whatever cool you
know that’s fine some people drink or use it for relaxation my son has a love of we will use that
word videogames and he will get on his videogames and we’ll kind of get lost in it it helps him
escape from you know life as we know it for a little bit of time some people use
because of peer pressure you know it’s everybody’s doing it or you know you’re at a football party
or something and everybody’s having a beer and somebody offers you one and you don’t want to be
rude things like that can happen and some people begin to use straight up for self-medication
they’re like I feel crappy I need something to help me feel better or numb the pain so there’s
a lot of reasons people begin to use so then you might say well why don’t they just say no because
it’s easy to say no well it’s not some people start to use it because they’re bored and
they want something to bring some excitement some euphoria to their life and we’re talking about
everything from sex addiction to internet addiction to cocaine use I mean we’re running the gamut here
they may lack the awareness of the dangers or how quickly you can become addicted I know when I was
working in the facility in Florida there was the sort of knowledge if you will and knowledge is not
the right word rule I guess that with crack cocaine for some people, it was a one-hit wonder
you did it once and you were hooked and several drugs can be highly addicting
quickly especially if they’re taken either through injection or inhalation but we’ve talked
before about the fact that our bodies can start developing tolerance to opiates within 3 to 5
days so you know people may not a lot of people don’t realize when they go in and their doctor
writes him a script for two weeks of opiates and they take it as prescribed that they’re actually
becoming somewhat addicted to those opiates if they take the whole prescription so they may not
understand that some people don’t say no because they have low self-esteem so they’re looking for
comfort to help them relax to help them loosen up so they can be more fun at the party and or
to peer pressure somebody tells them why don’t use or why don’t come out and go drinking
with us or whatever the case may be so to fit in they may try to use it to fit in to feel
part of a crowd and part of it can also be you know with that peer pressure just generally the
culture promoting this kind of behavior going it’s ok I think I’ve shared with you before at
At the beginning of some of the original Beverly Hillbillies episodes they still advertised Winston
cigarettes, like they are the greatest thing and cool people, have them and that’s the thing to
do so if that message gets out people may start believing it and not do their research so to
speak on what the true problems or risks may be and then again self-medication some people may
be struggling just to get by from day to day and this helps them survive the best they can with the
tools they have until we give them some new tools so just saying you know I had I grown up
during the era of Nancy Reagan and you know God loves her she was trying to help and for a certain
small percentage she probably did but for a larger percentage just saying no is not that easy we need
to give people the tools so they can say no so they don’t so they aren’t relying on these drugs
for some reason because when people start using it for recreation and relaxation some people may not
have a big big issue with it other people may start throwing their neurotransmitters kind of out
of whack depending on how much how often they use what combinations if they’re on any medication so
people may inadvertently start messing with their neurotransmitters and creating and we’ll talk
about this creating depression or anxiety that they end up trying to self-medicate so that
that is my soapbox for it is not that easy to just say no we as a culture not just as clinicians
have some work to do so what do we need to do to help people be able to just say no
they need to have access to healthy nutrition and knowledge of what that means my son and it’s
still like drawing fingernails on a blackboard to me today this week, I told his sister that you
no, he didn’t understand why she was so concerned with the nutrition he’s a guy he doesn’t need to pay
attention to nutrition it’s just whatever and I was just like oh my gosh you know everything I’ve
said has fallen on deaf ears but okay we’ll back up and figure out a way they need access to
it and then they also need to eat it you know if we have healthy foods available but people are
still eating peanut butter and jelly sandwiches for every single meal it’s not going to help so we
need to make sure people understand what a healthy diet looks like and how to do it in a way that’s not
painful you know we’re not asking you to just eat rabbit food as my daddy used to say but so what
does it look like to eat a diet or nutrition that makes you feel good that’s happy that makes you
feel happily fulfilled you like it tastes good whatever you want to say but that’s also
healthy you know it’s not just pizza or just peanut butter we need to educate people and a
lot of adults that I work with have no clue about sleep hygiene you know they know they’re supposed
to try to go to sleep but they don’t know anything about turning off the blue turning on blue light
filters so the blue lights are not keeping them up so we need to do some education here ideally in
elementary schools but if we can get it out to the community so they can pass it on to their little
minions we’ll be on a good path to pain control we need people to start having pain control but
we need to also have them have alternatives to pain control besides opiates and there are a lot
of them out there again people don’t know about so we must educate and we’re not
prescribing pain control that’s not our job but if we have a client who’s in chronic pain we can
suggest that they work with their doctor that they look into options for pain control you can google
it and find a lot of different alternatives now if they don’t want to go to the doctor but you
know there are a lot of different things from acupressure it attends units to things that are
nonpharmacological that can help people manage their pain so they can sleep which will help
the rest and rebalance to deal with fatigue and be able to deal with life kind of on life’s terms
because they won’t be in this constant state of stress people need access to regular medical care
to prevent problems so you know we want to prevent this thing on your face from becoming skin cancer
we want to prevent anything else that that might trigger problems and early intervention so like
with Lyme disease, if people get early intervention mentioned they don’t end up with the chronic
problems with HIV the earlier the intervention the better same thing with hepatitis you know
the list goes on so we want to make sure that if people have some sort of issue that’s disrupting
their ability to get enough sleep process nutrition go to work do any of these things that
they have access to some method whatever method they need to address it so sometimes it’s medical
sometimes it’s mental health it’s social services they need safe housing so we’re on to
social services now and that includes a roof over their head that they’re not worried when
they go to sleep at night but also being safe from domestic violence and things like that safety
and this kind of goes with safe housing and I put internal and external because you know the first
part is external safety we want to be able to know that our patients can relax wherever they’re at
they have enough money to keep a roof over their head in a safe place and you know typically that’s
not something that we think about as mental health counselors we think about helping them deal with
their anxiety but if they can’t get enough sleep and they never feel safe when they’re at home
they’re not going to be able to rest and they’re at best their recovery is going to be impeded at
worst you know it’s going to contribute to the issue that they’re seeing us for so safe housing
is important we’re not going to get it for them but we can point them in the right direction your
local United Way which is 2-1-1 and most places generally has a listing of different resources
for accessing safe housing if you don’t work in a facility that’s used to dealing with that
and then internal safety that’s shutting up that internal critic that’s being able to go through
a day without being derogatory to yourself and that’s something that we definitely can
help with we can help people shut down that internal critic or that internal person that
is always calling gloom and doom and you know waiting for the other shoe to drop or whatever
the case maybe we can help clients change their cognitions so it’s safe inside their head
and then people need love and acceptance and this should sound pretty familiar are you
know Maslow’s hierarchy here kind of in Reverse but people need love and acceptance but in order
for love to have love and acceptance in many cases they also need to love and accept themselves so
we’re gonna work on self-esteem we’re gonna help people develop relationship skills hopefully there
are some people in their life that have provided some level of love and acceptance maybe not the
unconditional positive regard we’ve hoped for but they’re there so these are things that the healthy
happy person needs and these are things in large part we can do through education referral and direct
services help people get so why do we care about co-occurring issues as mental health counselors
well 35 percent of people with anxiety disorders have according to one of these studies abused
opiates so that’s a lot if you’ve got somebody with an anxiety disorder this isn’t just panic
this isn’t just something you know severe this is you know any of your anxiety disorders
one in three roughly have abused opiates they’ve used some sort of opiate drug to help them kind of
chill out of opiate or alcohol dependent patients 20% have major depressive disorder so of that
35% you know there’s going to be a percentage of them who may be opiate or alcohol dependent
and there are a lot of our clients that we see in mental health treatment who are not willing to be
truthful about how much they really drink or how often they drink because they might be
suspecting it’s a little bit of a problem but they’re not wanting to go there yet they’re in
what we call pre-contemplation okay so let’s just go with this in mind that there may be some
underlying other stuff that they haven’t told us about opiate or alcohol-dependent patients 20%
have major depressive disorder so you know we’re taking them and we may be seeing them in the clinic
for depression and we do want to be suspect of whether there’s either some opiate or alcohol
issues there depression and opioid-dependent patients including pain management patients so
those who are opiate-dependent by prescription have been associated with poorer physical health
decreased quality of life increased risk-taking behaviors and suicidality am I saying that pain
management clinics are bad no but what I’m saying is those who are in pain management clinics for a
variety of reasons are at a high in a higher risk category I mean think about it if your pain is
bad enough that you need to be going to a pain management clinic think about how much that must
hurt think about how much that must impair your daily life think about the impact of the drugs
that you’re taking on your mood your energy levels and the stigma in some cases associated with it
some people here suboxone and they’re like yeah whatever my neighbor takes that other person here
suboxone and they’re like ah you can’t be taking that so there is still a lot of social stigmas that
goes along with medication-assisted therapies so there are a lot of things that may contribute
to depression in opioid-dependent patients the prevalence and severity of depression tend to
decline within the first few weeks after treatment initiation so if they are trying to get off of
you know ideally their detox and they’re trying to you know remain sober the prevalence
and the severity of depression tends to decline so we need to get them off of it first and get them through
that acute withdrawal from a depressant including alcohol and I know this slide is boring
but we’re gonna be through in a second withdrawal from depressants including alcohol opioids and
even stimulants invariably include potent anxiety symptoms so it’s important to pay attention and
withdrawal from stimulants can also include potent depressive symptoms if they’ve been on a crack
binge for you know five days that won’t sleep for a while many people with substance use disorders
may exhibit symptoms of depression that fade over time and are related to acute with drawl well we
talk about acute withdrawal we’re talking about the first three months we’re not talking about
the detox period which is generally three days so encourage people who’ve gone through detox and
maybe they’re seeing you on an outpatient basis encourage people to you know be patient and work with
the treatment team if they need to but the first three months is always the hardest so chicken or
the egg you know did the person start using and become depressed or was the person depressed so they self
medicated does it matter depression and anxiety are associated with addiction because because
if you have stimulant withdrawal or recovery that period after you quit using that’s maybe
a week maybe two weeks where your body is going whew that was a run people may feel depressed
fatigued have difficulty concentrating which can impact how well they eat it’ll impact
their sleep they’re gonna sleep a lot more but the quality of sleep may be poor so they can mess
up their circadian rhythms and you know they may not have access to the social support that
they wanted they may but really with stimulant withdrawal we’re looking at nutrition
and sleep so we want to educate patients if they decide to stop taking stimulants what they need
to look at stimulant use can also be associated with depression and anxiety because many people
not you know the majority but a lot of people out there will self-medicate depression with
stimulants from anything from caffeine which you know maybe like mild dysthymia but if you
abuse enough caffeine you know it starts getting into your system you become dependent on it but if
you start combining caffeine and nicotine plus oh let’s add in some workout supplements or you know
the occasional Ritalin or something not suggesting it then it’s these things can wear the body down
which can lead to additional depression but people may use these things to try to feel better because
think depression is related for some people they may not feel like they can wake up they’re
fatigued they’re lethargic all the time and they’re feeling blue so if they take stimulants
they get that dopamine rush they’re starting to feel good and they’re awake stimulant
use can cause anxiety well the so if you’ve got somebody who already has maybe they are depressed
but they’ve also got some anxiety and they start using stimulants which may make the anxiety way worse
alcohol or opiate use some people use these things to numb or to forget and that’s just your
the standard used the depressant some people will use either one of these but especially opiates to
deal with physical pain to medicate depression or anxiety remember there are a lot of trials not
several trials right now that are looking at using opiates to treat intractable depression
but a lot of people also use opiates off-label illegally to address anxiety so if you’ve got a
client with depression or anxiety just kind of be alert for how they’re behaving if they’ve
got pinpoint pupils or if they’re itching and picking all the time I mean not the occasional
are winter and the heat just turned on I’ve got dry skin itch but constantly itching and picking
and you know where you’re like please just settle down detox from opiates can all often produce
depression produces a lot of flu-like symptoms which can make people feel crappy and the
flu-like symptoms I won’t get graphic impaired nutrient absorption impaired sleep you know
they’re sleeping a lot because they feel like crap but they’re also having to get up every
10 minutes to go to the bathroom sometimes so this first week or so during the initial if they
go cold turkey so to speak can be rough detox from alcohol as I’ve talked about before
can produce anxiety symptoms so understanding that when people are going through detox whether
they are alcohol dependent and have been drinking a whole lot which needs to be medically monitored
I can’t say this enough and I’ll say it a lot more tomorrow when we talk about where Nikki Korsakoff
syndrome but people who are detoxing from alcohol will have anxiety symptoms and a period of high
blood pressure and sometimes depression and anxiety are associated with addiction just because they
sober up one morning and they look at their life and they’re like what the hell have I done so
you know and you’re looking at them going yeah I don’t blame you for feeling that way now let’s
see what we can do to improve the next moment so make sure that we understand that these
things are going to go hand in hand and to be on the lookout because like I said a lot of people
aren’t forthcoming even about alcohol use which is legal but if they’re using something illegally
or using maybe their kid’s Ritalin or something they’re pretty much almost guaranteed not to tell
you so we want to be on the lookout for signs and symptoms bipolar disorder can be triggered by drug
use so we just know that we can the person could get worn down mess with the neurotransmitters
enough they’re not exactly sure how it happens but we have seen the initial acute episode of
bipolar disorder-triggered mania triggered by drug use it is more common for people with bipolar
to use stimulants when they’re depressed and just about anything when they’re manic now if you’re
working with somebody with bipolar you know you’re probably already having these discussions
about how you stay safe when you’re in a manic episode people with ADHD may use to self-medicate
and we’re talking cannabis is a big one for ADHD to help people feel like they’ve got more focus
and not feel like they’ve got so much coming in and so much stimulation all the time which can be
exhausting and after the use of any of the substances of abuse the disruption and neurotransmitters
can make people feel like they’ve got ADHD-type symptoms faculty concentrating difficulty
following through with things etc so understanding that even if things don’t meet the threshold for
DSM-5 diagnosis we want to look at what symptoms are there and how can we help people manage them
so they’re getting adequate sleep nutrition pain control social support and safety borderline and
antisocial personality just kind of threw those in there because we see those a lot when we’re
working in dual diagnosis facilities more people are more likely to use addictions to cope with a
lack of sense of self and their emotional lability if they’re borderline so I mean their world is so
chaotic many people with borderline personality disorder are likely to use to try to get some calm
in the storm now I will put out my other soapbox here with both of these personality disorders
when you see somebody in active addiction or early recovery they probably have symptoms that
would meet diagnosis you know their symptoms are pervasive in multiple areas of life their
symptoms would meet the diagnosis for one of these two personality disorders during this period
but it resolves as recovery becomes the norm as the neurotransmitter stabilizes they develop
interpersonal skills so you know giving people a little bit of time before we say it’s borderline
personality disorder versus borderline personality characteristics if you will be helpful because
both of these diagnoses can block people from getting into certain treatment centers and getting
some of the services they need okay so we’re going to move on to some of our more common addictions
alcoholism is associated with eating disorders there’s a really strong Association and it usually
flip-flops between bulimia and alcoholism so if somebody’s symptomatic for bulimia they may not
be drinking a lot of alcohol but they may during periods of remission from the bulimia drink a lot
more alcohol become alcohol dependent so there’s a lot of research out there that shows there’s
a strong correlation between these two things and it’s also associated with binge eating disorder
but especially bulimia nutritional deficiencies from alcoholism can cause mood disorders so
even if somebody is not and I use the term I should have put alcohol instead of alcoholism
because even the term heavy use without physical dependence can cause nutritional deficiencies that
can cause ulcers it can cause physical problems physical exhaustion which can disrupt sleep
alcohol impairs sleep quality alcohol makes apnea worse so if you’ve got a client who has
sleep apnea they’re drinking they’re probably gonna sleep even worse than they normally do
depression is the result of using well alcohol as a depressant so what do people expect well most
people expect to relax they don’t think about the rest of the stuff that’s going on in neurochemical
imbalances because the alcohol exits our system a lot faster than our brain can catch up and go okay
it’s not in there anymore so I need to adjust the temperature and in sleep disruption anxiety can
also, be triggered as a result of use I’ve said before say it again after that initial period
where people feel the depressant or relaxing effects of alcohol there is an upsurge in anxiety
so a lot of people have another drink to kind of quell that anxiety feeling but you know people
with anxiety disorders are gonna feel it more prominently and the neurochemical imbalances
that alcohol use causes can worsen pre-existing anxiety conditions or trigger anxiety conditions
nicotine is another one that we see a lot even in just straight-up mental health clinics not
co-occurring so what effect does nicotine have well anxiety and depression are 70% more likely in
smokers so that’s one of those statistics we want to look at nicotine triggers dopamine release okay
so nicotine is one of the most addictive drugs on the planet and you’re thinking I thought that was
opiates well opiates are in there but nicotine not only is nicotine legal but it’s also one of
the most addictive drugs on the planet so that’s another important point to think about people are
using their trigger and dopamine release their brain gets used to being flooded with dopamine so
their receptors on the other end start sensitizing so we’re creating an artificial environment
basically when people are smoking blood vessel changes when people smoke it causes blood vessel
changes that can cause high blood pressure as well as depression and fatigue and confusion in the blood
vessels narrow and get stiffer so the oxygenated blood has a harder time getting to where it needs
to be so people start feeling blah and that can cause them to think that they’re starting to feel
depressed can also cause those cause loss of energy people with severe and persistent mental
illnesses are two to three times more likely than the general population to use nicotine so that’s
just an interesting little fact to have out there if you work with people with SP MI and people
with ADHD may smoke because it increases their concentration and attention for about five minutes
literally, for about five minutes but during that five minutes they’re like oh my gosh it’s a relief
I can like focus for half a second so we want to look at what else is going on whether the
a person has adult ADHD for example physical health mental nicotine is linked with COPD and emphysema
and lung cancer so you know all kinds of lung and cardiopulmonary stuff well when that happens
you know we have less oxygenated blood efficient efficiently getting through the system we’re going
to have increased fatigue increased confusion some grief that may go along with that especially if
people are starting to have to carry an oxygen tank around with them or something you know we may
have to help them deal with disability acceptance and depression and stroke because smoking like
I said increases blood pressure and reduces circulation so cutting off or greatly reducing
circulation to the brain they have shown that people who smoke especially heavy smokers are at a
much greater risk of stroke and addiction nicotine is strongly correlated with other addictions a
a lot of people when they’re in the bar well not so much anymore since smoking is not allowed in
public places but used to be when they were in the bar they would also be smoking but a lot of
people associate alcohol and nicotine or nicotine and other drugs so if somebody is using other
drugs likely they’re smoking now it doesn’t work the other way around just because they’re smoking
doesn’t mean they’re likely using other drugs the reason this is more important is that people
who continue to smoke after they have gone into recovery for their drug of choice have a relapse
rates as high as 68 percent higher than for people who quit smoking so we start thinking about that
and we say well why is that well because nicotine is a mood-altering substance you know we don’t
think of it as such because it’s not a woohoo it’s Marva hey okay it’s not as prominent
of interaction as maybe cocaine or something but it does change the balance and people still
do use smoking to cope with life when things get stressful they smoke well if things get stressful
and you know they’re too stressed for smoking to handle then they may start going back to what
else can I take use or do that will make this feeling go away right now we know also that was
smoking and that repeated release of dopamine they’re messing with the neurochemical balances
in their brain, so it makes sense that eventually just like tolerance to other drugs happens it may
not be enough at a certain point and they may fall back into other habits nicotine has been known to
suppress appetite and but whether it keeps weight off or not they haven’t shown alcohol
and nicotine both are appetite suppressants which is another reason people with bulimia tend to
drink and one of the reasons why people quit smoking they tend to be hungrier so helping
them get through that period now whether it helps them keep weight off the party that deals with
the reason that they eat it’s not really that it’s suppressing their or increasing their metabolism
so much its nicotine suppresses the anxiety and sometimes the desire the hunger but if people
are still eating out of anxiety if they’re still eating under stress eating then you know when they stop
smoking and they don’t have a cigarette to put in their mouth when they’re stressed they tend to
go for other things and so we need to help people figure out when they stop smoking are you
eating because you’re hungry or are you eating because you’re stressed if they’re eating
because they’re hungry and they’re getting heavier than they want to be they need to talk with their
doctor about you know thyroid tests and also let their doctor educate them on biological setpoint
theory of you know not everybody’s going to be a zero so you know that may be something we can
help them deal with body acceptance issues if you know maybe they’re programmed genetically to
be you know a size X whatever that is and they’re not happy because they want to be a zero which our
culture does tell us to do as clinicians we can help them look at you know the costs and
benefits of continuing to smoke and what being you know a size zero means for them to opiate
abuse there’s a lot of physical stuff and we’re just gonna run through it real quick because
you’re not as concerned with it the physical stuff the doctors are gonna see but we need to be
aware of from a clinical point because it can keep people from getting their basic needs met blood
and injection site infections you know that’s probably going to lay them up for a while but if
they have repeated infections and are repeatedly out of work they can lose their job they can lose
their housing they can you know get some sort of MRSA or something else which can be really
expensive it can be life-threatening ya-ya collapsed veins and this is more common obviously
this is only for injection drug users but collapsed veins just as you would expect keep the
oxygenated blood from getting where it needs to be so people are more likely to experience strokes
and may have certain forms of vascular dementia because of the strokes dementia we’re familiar
with endocarditis is the inflammation around the heart so again this is only for needle
drug users but if you’ve got a client who is using needles to inject any kind of drug be aware
of that and what they get and what they inject is rarely pure so knowing what else they’re injecting
into their system if they’re you know crushing pills from the pharmacy you’re a little bit more
sure about what they’re getting as opposed to if it’s from the corner dealer and sometimes
they’re cut with really nasty things like you know comic bathroom cleaner and stuff HIV if
people get HIV from injection or some other risky behavior they’re probably going to experience
some depression and a lot of times HIV from opiate abuse they’re gonna experience depression
remorse regret all that kind of stuff anxiety about how long they’re going to live what’s
going to happen and oh those medication side effects those the antiretroviral medications that
they have to take are doozies I’ve seen people go through the induction weeks on their medications
and it is a rough time so helping people get through it so they are medication compliance
so they can continue to live we need to help them maintain hope and self-efficacy and all that kind
of stuff to maintain that forward movement to get through the induction period liver damage from
acetaminophen can set people up for you know physical pain among other things and it decreased
pain tolerance now this generally the decreased pain tolerance goes away after the
the body starts producing its endorphins and natural painkillers again but that initial period
if somebody quits using and maybe you know you are seeing them as a mental health client and
they had an accident or had surgery or something they started using pills they got a couple of
refills then the doctor said no I’m cutting you off and now they’re going through a detox period
detox from opiates is unpleasant but it is rarely life-threatening unless somebody becomes their
electrolytes get imbalanced because of the flu symptoms but we still may see this in private
practice in mental health practice because of the scenario I just told you people can start
taking painkillers as prescribed for something they may get addicted you know take them for
a month or so then when they get off of them not only do they feel like you know really bad
but their pain is also back and it may be they had their wisdom teeth out that pain may be gone
but other aches and pains and everything you feel is probably going to be intensified until the
body kicks back in so educating clients about this is what happens you know it’s not uncommon
if you think it’s too bad go see your doctor helping them make sure they’re getting
good nutrition you know it’s hard if you’ve got flu symptoms to feel like you want to eat or
hold anything down so what can you do to make sure your body has the building blocks to make the
stuff that it needs to help you feel better what can you do to improve your sleep and a lot of our
clients and you know where I used to work we had a methadone clinic and we also had a mother
baby unit and as soon as the mothers would give birth then the doctor would start them on
their detox from methadone and he didn’t believe in the kinder gentler taper he was just like okay
baby’s gone threats gone because you can’t detox from somebody from opiates when they are pregnant
because it can cause the baby to die anyway so as soon as they would stop or as soon as
they weren’t pregnant anymore he would just D see them and they would feel really bad I mean
not only did they just push an 8-pound something out of their body but they also are experiencing
a decreased pain tolerance because they’re not on the opiates anymore and all they want to do is
sleep it’s just like please so understanding that is important in helping people get through
that period even though they may want to sleep all the time helping them understand that it’s
important to maintain their circadian rhythms if they have to take two or three ten-minute
power naps throughout the day to get through the day you know more power to them but if they
can practice good sleep hygiene they’re gonna be way better off in the long run OPD opiate
abuse is also or opiate use is also associated with the treatment of depression but it can cause
depressive symptoms due to its pharmacological properties I mean it slows everything down from
you’re gastrointestinal to your heart rate to your respiration you’re not breathing as much you’re
not getting as much oxygen in you’re gonna have more fatigue you’re gonna have more confusion
you’re going to have more of those symptoms of depression for some people they find it is and
certain opiates they find it is a powerful way to reduce anxiety it makes them feel like they’ve
got a ton of energy because they’re not stressed out anymore and this last one is one of the
The main reason that I find people don’t want to give up opiates is that they finally feel better when
they’re on the eating disorders commonly a coat co-occur with depression and anxiety which can
be caused by nutritional deficiencies you know you’re not giving your body the building blocks
so it can’t make the neurotransmitters it needs and it also probably disrupts your sleep some
and depression anxiety can cause or trigger or whatever you want to say eating disorders because
people with eating disorders may fear becoming fat have low self-esteem have a sense of lack of
self-control or have body dysmorphic disorder so we also want to be aware that there are mental
health stuff that can trigger dysfunctional eating patterns there’s about a 24% prevalence of PTSD
among people with eating disorders so if you’ve got a client with eating disorders especially
bulimia be on the lookout for depression anxiety body dysmorphic disorder alcoholism and PTSD they
maybe smoking too but of the things, I just listed that’s probably the least of their worries it’s
all eating disorders are also associated with alcoholism and smoking I said physical health
issues now you’re seeing somebody with an eating disorder it’s a mild eating disorder you’re seeing
them once a week outpatient so you’re not and you have you know you have training and
working with eating disorders or maybe it’s mild enough that you’re just getting supervision
on treating this issue whatever being aware that people with eating disorders anorexia or bulimia
can have irregular heartbeats and cardiac arrest due to potassium imbalances and electrolyte
imbalances so if they’re not eating or if they are binging and purging in some way shape or
form and that includes excessive exercise which can trigger a lot of heart problems they may have
loss of bone mass and osteoporosis so they may break bones a little bit easier going back up to
the heartbeat not to belabor the point but again heart problems mean a lack of available oxygen
mean confusion fatigue potential difficulty sleeping depressive symptoms and you know cardiac
arrest in and of itself is bad kidney damage from Doretta caboose and low potassium can also
potentially drain damaged the adrenals which are on the kidneys and so it’s important to be
aware of what people are using a lot of people with eating disorders are going to creatively
use stimulants to suppress their appetite think about any of your diet drugs your enter mean I
think it’s one of them the ones they give to help people lose weight they’re stimulants
they’re intense stimulants so people who are struggling with eating disorders are likely to go
towards abusing stimulants or at least using them which can drain the adrenals it can in some
cases have been linked to the development of Addison’s disease liver damage from not eating
or binging and purging causing toxin buildup and possibly pain we can help people deal with it
as much as we can anemia which can cause symptoms of depression in and of itself so goes back to
that nutrition making sure they’re getting enough infertility which in and of itself can be
devastating for young women if they can’t have children anymore or can’t have children
ever that may be a grief issue that we need to help them deal with cathartic: and this is
an important one to be aware of because you don’t have to have somebody who uses laxatives
all the time but people who regularly use or abuse laxatives can become dependent on them so
when they don’t use them they have a feeling of bloating feeling full and abdominal pain which
especially in people with eating disorders or body morphic disorders surrounding just general
body fit bad back body fat can greatly increase anxiety depression hopelessness and in some
cases of suicidality so again educating people is the first step to helping them understand what’s
going on and how dangerous laxatives can be but also if somebody is trying to cut back on their
use of laxatives or just recently stopped using laxatives like when people stopped using
opiates it takes the body a while to get back online but for most people it eventually does
people with eating disorders also have chronic ulcers which are painful and can keep you up at night
As you know gastric reflux and pancreatitis which can flare up at a moment’s notice will is
extraordinarily painful and can cause people to lose time from school or work social activities
feel bad about themselves and also pancreatitis causes a lot of bloating
which in eating disorders is a huge trigger for anxiety and depression pathological gambling
is associated with stimulant abuse especially cocaine methamphetamine and Ritalin to stay
focused disrupted sleep and rebound depression when they quit taking that stuff they wake up and
they’re like oh wow what did I just do alcoholism is also associated with pathological gambling
some people drink to calm their nerves some people drink because it’s the culture if you go
to any of the casinos you know their hand-and-out drinks, they’re trying to get you drunk so you
keep gambling more and there’s as we spoke about earlier rebound depression or anxiety smoking
may help people increase their focus or make them think they can increase their focus so if
you can’t smoke in public places this is more of an issue if you have somebody who does a lot of
online gambling or they gamble at their friend’s house or somebody’s house where there’s poker
games and stuff smoking has some anti-anxiety anti-anxiety properties and may be part of the
the culture I know when my daddy used to have his poker games everybody would smoke cigars and even
the one woman who went there would be smoking a cigar with everybody else and it was just the
culture of being there so there are a lot of different reasons that people may use substances
in addition to gambling mental health issues from gambling anxiety from the stimulant use or from
the tension and release of am I going to you know I’m down $20,000 am I going to make it back ADHD
is also strongly associated with pathological gambling bipolar disorder, especially during manic
phases are associated with pathological gambling generally you see them co-occurring it’s not
like gambling causes it it’s you will see co-occur depression can occur due to losses and
gambling can start because somebody’s depressed because of their financial situation and their
trying to figure out a way to you know borrow from Peter to pay Paul and get ahead you also see
pathological gambling is more strongly associated with people who have obsessive-compulsive
disorder if you’ve got clients with these diagnoses just kind of you know be attentive to
the fact that they are more likely to engage in pathological gambling or if they start gambling
it’s more likely to become a problem than for people who don’t have these issues internet
an addiction that is diagnoseable so you know I’m not just making something up
depending on your resource affects eight point two percent to thirty-eight percent of the
general population now obviously we were looking at you know like games versus you know games plus
Facebook plus shopping or something so depending on the study you looked at their parameters
were a little bit different but either way up to 38 percent of the population has sacrificed
significant personal recreational activities to engage in some sort of internet
behavior Internet addiction can cause anxiety or depression due to eyestrain and chronic headaches
you know if you’re hurting all the time it can make you feel wonky it can also interrupt your
sleep can cause circadian rhythm disorder which can trigger depression fatigue reduced stress
tolerance this is a condition when your body doesn’t know whether it’s supposed to be awake
or asleep because a lot of people who engage in internet-addictive behaviors do so in the dark or
you know they don’t pay attention to whether the lights are on or not they may just sit there kind of
in their cave carpal tunnel contributes to pain and sleep disruption because carpal tunnel does
wake you up at night back ache again may disrupt your sleep and can cause chronic pain during the
a day which can interrupt your daily activities poor nutrition I know a lot of gamers that will sit
there for an entire weekend and not get up to go eat so if it’s not brought to them they don’t eat
they’ll even wear adult diapers so they don’t have to get up to go to the bathroom reduced immunity
due to exhaustion from not sleeping and job or relationship problems I know uh several people
whose marriages ended over a world of warcraft’ so internet addiction is a real thing and it’s
something that we need to be cognizant of because it does cause a lot of problems and a lot of
relationships and it may be one of many problems but it’s something to look at sex addiction
can cause hepatitis and a variety of different STDs which if not treated can cause systemic problems
it’s related to anxiety and depression because sex addiction may begin in order because somebody
wants to feel loved or connected maybe after a breakup or because they never felt loved you’re
connected and then they feel that rush and they’re like oh I like that I want to do that again part
of it could be engaging in that behavior which is so thrilling you know depends on the person
psychological withdrawal from sex addiction people who have been engaging in sex addiction
type behaviors and I include pornography addiction in it for this presentation if they’re not able to
access that may start feeling anxious or depressed they can’t get to that they can’t get to the
the thing that’s gonna cause the dopamine rush and reflection on behaviors that they’ve engaged in
as a part of their sex addiction can also prompt anxiety about a spouse finding out you know am I
going to develop an STD and am I you know how I feel about what I’ve been doing so as clinicians
if we’re working with somebody who has compulsive sexual behaviors even if you know anywhere about that
the spectrum we need to be aware that these things may exist and figure out or help them figure out
how they feel about it and what they need to do to make sure that they’re getting good sleep
that they’re dealing with their depression and their anxiety so that they can have a safe internal
and external environment so back to that global perspective how can we and why is it important
to address chronic illness and disabilities that result from or cause mood disorders or
addictions how can we address depression anxiety and hopelessness that results from or causes
depression anxiety or physical problems how can we address physical problems that are caused
by mood or addictions and how can we address guilt or regret which may accompany addiction
recovery or the realization of a diagnosis of a disease caused by the addiction so while you kind
of ponder those there was a question that came in so question what about robbing Peter to
pay Paul in association with trauma specifically childhood trauma so if you could clarify that
for me a little bit I had mentioned robbing Peter to pay Paul in terms of gambling so I’m just so
mental health issues can be caused by or trigger addictions or physical health issues addictions
can cause or trigger mental health issues or physical health issues that can
be caused by addictions or mental health issues so again chicken-or-egg we don’t necessarily know
which one came first when you have any one of these it’s probably going to or likely impact
each other person or each other area common issues are seen in all three changes in sleeping
changes in nutrition fatigue and grief effective treatment requires addressing the underlying
causes as well as the ripple effects you know so yes after childhood trauma or trauma
of any sort, some people may spend a lot of time feeding the addiction as you put it or
engaging in addictive behaviors to avoid some of the PTSD symptoms to avoid thinking about it
to deal with the grief to deal with the shame so they may engage in something that makes them
feel better or helps them forget to cope with the trauma that happened until they
have other tools so they can come to some sort of terms with it and you know as I
say close that chapter in their book already if there are no other questions tomorrow’s
the presentation I learned a lot creating is on alcohol-related dementia and vascular dementia
and fetal alcohol spectrum disorders all three of which are issues that are caused by substance
use and specifically alcoholism and then I’ll give you a hint about where an acute Korsakoff a
a lot of clients who abuse alcohol but they’re not alcohol dependent who decide to stop drinking can
trigger where Nikki Korsakoff syndrome and causes alcohol-related dementia-type symptoms
so again in mental health, we need to be on the lookout for it if we hear that our clients
are trying to cut down on their alcohol use alrighty everybody and so tomorrow is that
presentation and then Thursday we’re going to look at different models of new bottles of
treatment if you enjoy this podcast please like and subscribe either in your podcast player
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This episode was pre-recorded as part of a live continuing education webinar on demand. Ceus are still available for this presentation through all CEUs registered at allies com, counselor toolbox, hi everybody, and welcome to today’s presentation on emotional eating and making peace with food during the next hour.
So we’re going to define emotional eating and differentiate it really from eating when to celebrate and when it’s a problem and also differentiate, differentiating it from eating disorders will explore emotional eating in terms of its, beneficial functions and rewards and discuss.
Why restrictive diets, don’t resolve emotional eating a lot of times? People will say you know, I have been on this diet forever and it doesn’t seem to be working or I can’t seem to stick to any diet that I try and we’re going to look at different reasons why this might Be what is emotional eating and it’s exactly what it sounds like it:’s eating in response to emotions and feelings other than hunger.
So if you’re eating, because you’re bored, if you’re eating at someone and sometimes especially if you are angry at someone or disappointed in someone, you may eat and sort of be eating and thinking you made me do this so eating At someone eating to forget or distract yourself eating, to feel better because when you eat, regardless of what you’re eating, but especially if you eat high sugar high-fat foods, you’re going to release serotonin and dopamine eating out of boredom.
You know hand to mouth bang, eating out of habit and, as I said a few minutes ago, not all emotional eaters have an eating disorder um and we want to differentiate that.
Does it mean that their eating is not problematic to them? No, not at all.
If they’re telling you it’s a problem, then it’s a problem.
They may not meet the criteria for binge eating disorder or bulimia, but it’s important to address it because they understand that they’re eating for a reason.
Other than hunger, they want to stop because they want to eat, for hunger, but not otherwise, and for us as clinicians.
The first thing we need to do is understand: why is it that they’re eating? Is it boredom? Is it a habit, so they need to keep a food log or a food journal for over a week or two weeks, and sometimes when people come in for an assessment, especially if that’s one of their main presenting issues? I’ll start by just doing a retrospective of the last three days to get an idea of what may be triggering some of their eating episodes.
And then we can look at some of the habits or bad habits, maybe that they’ve gotten into, and start talking about ways to address those remembering that Rome wasn’t built in a day this isn’t going to go away overnight.
But a lot of times, if you give people some tips, tricks, and tools to think about implementing when they walk out of your office after the assessment before the first official session, it provides them some hope and gets the momentum going and again you don’t Have to binge to be an emotional eater, some people graze all day long.
Some people will eat and it’s not what would be considered technically a binge, but it’s more than they had anticipated.
Maybe they go back for second helpings or third helpings when they weren’t hungry, but it was good.
So why is eating so soothing? There are a lot of reasons.
Now there’s obvious it’s, tastes good, so that’s.
You know the big obvious bonus, but thinking about the function eating serves, we have to eat to survive.
When you were an infant, it eating involved a closeness with your parental unit, which could release oxytocin, and I say, parental unit because even if it was dad feeding the baby a bottle there was that connection.
There was that contact that caused the infant and the parent to release oxytocin. This is our bonding chemical, so eating was associated early on with bonding food may also have been associated with sleep.
If the infant or child was given a bottle every night to go to sleep, then they may start thinking or they may be in the habit of eating to wind down or calm down, and we need to help them figure out different ways to do That as a toddler, what eating mean think about when you went from well, we probably don’t, remember that, but think about when your kids went from eating.
You know food out of a jar to even their first Cheerios.
That was a huge figure out.
How to pick up that little cheerio and get it in their mouth and it involved exploration and mastery.
They were discovering all different types of textures and tastes and figuring out what smell went with what taste, and it was a cool and exciting time for kids, and I mean think about it.
They’re like a year old, so it doesn’t take much to amuse them, but this was the rewarding reward.
Equals dopamine equals let’s do that again.
It involved power and control of the child.
At this point was starting to be able to feed himself or herself and was starting to be able to be somewhat independent of the parent when it came to the basic physiological function of eating. So eating itself had its rewards and it was self-esteem building because the child started learning.
You know how to feed yourself and how to ask for what he or she wanted, at least in terms of food.
There are formations of memories around foods, even as early as toddlerhood.
You know we have celebrations, we have birthdays, we have different things and most children have certain foods that they like, and it could be because the first time that ate that food was a really happy experience or it could be just that’s, their favorite Food and that’s all they want to eat, but they remember that food and they remember when they ate it, they felt good.
They felt happy so as an adult there,’s a part of their brain going chicken nuggets.
Make me happy now that’s, how the toddler thought as an adult.
We can understand that chicken nuggets themselves, aren’t making you happy, but you see the connections that we’re making.
Here there’s been an association between happiness and chicken nuggets unhealthy foods, especially for children when, as adults, we’re still able to control what they eat.
Your sugary foods and your unhealthy foods are usually reserved for treats or rewards.
So when you’re feeling like you need to be rewarded when you’re feeling like you want to feel good, sometimes you’ll resort to those things. When you were a kid that made, you feel good like chocolate, chip, cookies, Haagen Dazs, or whatever it was for you.
We’ve talked in the past, about associations and conditioning, and this is all coming back kind of full circle now because we need to understand that our brain has associated pleasure and reward with food for a lot of different reasons.
Not just because of nourishment looking at the reasons why your patient eats is going to help you understand what underlying issues you may need to address in treatment.
Culturally, we associate eating with caring and celebration and think about birthdays and holidays.
What do we get together? We have buffets, we have pot Luck,’s.
When someone passes away.
What do you bring food over when somebody’s sick? What do you bring food over to in our culture? There is a lot of emphasis put on eating and nourishing, and that’s, true of a lot of different cultures.
Low blood sugar can cause feelings of depression and anxiety which are quelled by food.
So if somebody typically doesn’t eat well during the day, you know they go long periods without eating or if they have blood sugar issues, to begin with, and then they eat they feel better.
So when they start feeling not so good, what do you think their first reaction is, let me eat and see if that helps evolution, predisposes the human body to crave high sugar, high fat, high-calorie foods for quick energy and to prepare for a famine. Our bodies are cool and frustrating at the same time because you know your body takes in this these foods and it says we’re going to secrete, the most amount of dopamine and the most amount of reward for these high-calorie foods because We want to make sure we’re prepared in case there’s a famine back.
You know in the day many many many years ago, hundreds of years ago we couldn’t guarantee.
We would have a meal every day, let alone three meals every day.
So the body prepared – and it said alright – we need to get whatever we can when we can.
So we’re going to make this higher fat higher calorie food more rewarding.
Now I said it:’s also can be a blessing and a curse.
Today, there’s still a little part of our primordial brain.
That says, if it thinks there’s a famine, it will slow down your base metabolic rate, which causes people to gain weight.
We see this a lot in people with eating disorders, who tend to not take in very many calories, or if they take them in they purge them.
So the body goes well. I can’t guarantee I’m gon to get enough food.
I’m going to get enough energy to survive.
So I’m just going to turn down the thermostat a little bit and turn down the base metabolic rate, which compounds the problem for the person with the eating disorder.
So it’s important to understand that the brain is somewhat active in what’s going on.
So I keep saying we need to figure out what’s behind or underlying the craving.
First, we need to rule out physical causes for some people.
It’s as simple as this.
If they’ve got low blood sugar because they’re not eating too often and obviously as counselors, we’re not going to diagnose this their doctor or their nutritionist will, but we can start exploring and go.
It sounds like you might need to look at having your blood sugar checked or talk to your doctor about how frequently you need to eat because some people – and I know I’m – are very guilty of it.
If I get into it into a groove doing something I’ll eat breakfast and then I’ll get into a groove and before I know it, it’s 3 00 in the afternoon and I haven’t eaten for like a whole bunch of Hours I’m not doing math today and my blood Sugar’s low and I’m starting to get foggy, headed and irritable and tired. So it’s a real, simple fix there in our society we are so driven and we are so.
We get so caught up in things because that’s such a fast pace that it’s easy to forget to eat or is easy to avoid eating so that’s.
The first thing we want to rule out.
Are you eating in response to low blood sugar, which is making eating, seem more rewarding when you eat in response to low blood sugar a lot of times, people who do that end up eating more than they normally would because they start eating fast.
It’s like I’m going to shovel, in as much as I can.
Your brain doesn’t register you’re eating for 20 minutes or so so, before their brain, even registers.
What’s gone on and gets the blood sugar back up? They’ve already eaten a whole ton of food.
Why is this under-emotional eating? Well because generally, when they go in to just start eating, yes, they’re hungry, but they’re, also cranky and irritable, and most of the time they’re.
Not thinking about I’m eating for the nourishment it’s, I’m eating, feel better lack of sleep, and this is so true for shift workers as well.
As you know, new parents and college students, and anybody who’s not getting enough sleep. If we are surviving on sugar and stimulants, we’re going Peak and Lower Valley, Peak, and Lower Valley, and you just keep going up and down until you just crash, because every time you crash you crash a little bit lower.
So if somebody’s on that roller coaster, they’re going to feel worse between you know: eating episodes they’re going to feel tired.
They’re going to feel a flood of sluggish irritable fatigued and, to a certain extent, maybe depression, and they may be missing attribute those feeling, those emotional feelings to emotions versus physical causes, and likewise we also want to make sure that you know we’re addressing The emotional causes because there’s probably stuff there too, but if they’re not getting enough sleep and they’re living on sugar and stimulants their body is kind of in a state of hyper-vigilance, a lot of times it’s exhausted.
So they’re going to be tired and cranky.
So those are a couple of things that we want to look at.
Those are relatively easy fixes or at least relatively easy things to point out and go let’s think about this.
One of the things that I suggest for a lot of my clients is just to take a week and mindfully and it is difficult but try to eat healthfully.
You know try to eat a few times a day.
You know try to eat like three meals a day and get enough water and try to get enough sleep and try not to overdo it.
On the stimulants at the, beginning I, 39, am not going to say cut out anything because that 39, is not, realistic and it’s not fair, and they 39, are probably already struggling if they’re coming in to see me, so if I go hey Let’s just turn your world upside down and guess what you’re not going to drink any caffeine anymore. It’s not going to create a happy person, so I asked them to try to make some small changes and see if that starts, to help dehydration causes fogginess and symptoms of depression
We want to make sure that they rule that out and too many stimulants
Also causes dehydration, so you know we’re looking at some of the physical causes of irritability and fatigue and cravings because again we’re going back to when I felt this way before not looking at it.
Why I felt this way.
But when I felt irritable depressed cranky, what made me feel better and generally food, and generally it’s, not good food.
For me, it’s M Ms.
I love my M Ms, especially the ones with almonds, but I digress.
Nutritional causes of cravings, high carbohydrate, and high starch foods caused a greater release of serotonin and endorphins.
So if you’ve got somebody who’s depressed for whatever reason that they may crave these kinds of foods to increase their serotonin level or increase the endorphins, their energy levels, chocolate people who crave chocolate may be low in magnesium.
It also um the level of magnesium affects how much serotonin is available again. Just I keep saying this just for legal reasons.
We want to make sure their doctor or nutritionist goes in and makes this diagnosis, but if there are particular foods that they do crave, they need to bring that up with their medical provider if they’re craving fatty foods.
Now again, fatty foods are just good.
I love fried foods, but it also could mean that they’re not getting enough Omega threes, Americans, typically don’t and interestingly, if they crave soda, they may be calcium deficient, who knew so?
These are things to take a look at to ask people.
You know if they’re craving soda, maybe cutting back on their soda a little bit and seeing what happens and or getting blood work done.
Once we’ve ruled out the obvious physical causes.
They’ve gone to the doctor.
Gotten blood work done everything I’m coming back happy.
They’re getting enough sleep, but they’re still eating when they’re, not hungry, we need to rule out habits. Is there a particular time or activity that makes you crave this food? When I was growing up, I would go to the grocery store with my mother, and on the way back home from the grocery store.
She would always we would always get junk food and she would get a bag of chips and put them in the front seat.
It was like a 20-minute drive from the grocery store to our house and by the time we would get back to the house.
We would have put a good dent in those potato chips.
That being said, I got into the habit of whenever I went to the grocery store.
I would get something out of the bag and put it in the front seat and eat on the way home.
Now am I paying attention to what I’m eating? No likely am I eating, because I was hungry, probably not so.
We want to look at habits.
A lot of people will eat when they are watching TV.
It’s a huge one. So we want to not do that or if you’re going to eat when you’re watching TV make sure you sit at the table.
At least that makes you a little bit more mindful so think about whether are there particular times or activities that you eat and you’re just not hungry.
Are there particular times that you mindlessly eat, like, like, I said when you’re driving or when you’re watching television? Those are both habits and can be mindless because you’re not paying attention to how much is going in your mouth.
You’re not probably paying attention to the taste and you’re not paying attention to whether you’re full or not.
So if you’re mindlessly eating, then there’s going to be a lot more calorie consumption.
In addition to the fact that you’re not eating because you’re hungry, you’re just eating to eat, are you going too long between meals than needing a sugar boost which leads to a sugar crash? So again that’s a physical cause? But we want to rule it out.
These are bad habits that we can tend to get into other things that can be construed as bad habits are eating without putting food on a plate.
If you eat straight out of the bag, you’re going to eat.
More than if you put it on a plate, so put it on a plate, sit down, try not to watch TV, all the things that your grandmother would have told you.
So what do we do about it? Emotional eating interventions? I talked earlier about the food diary. Do a retrospective during the assessment if they want to get a jumpstart on things, but have them keep a food diary, preferably for the duration of treatment, but at least for a week.
What time did they eat? Were they craving just any old food or something salty, something that was sweet, something that was sour? This will give you a general idea and can give their medical provider a general idea if there are any nutritional imbalances or if there are particular associations.
What emotion or state were you in, I say state because being exhausted is not necessarily really an emotion.
Were you happy sad, mad glad exhausted drained whatever state feels like it would work, and then, because of why were you feeling this way it doesn’t have to be a dissertation? It can be short and sweet, but I encourage clients to write down everything.
They eat before they eat it during the first week, or you know, like I said, preferably throughout the entire course of treatment why, before they eat it because it’s a stop, remember we’ve talked before about how we have an urge.
We have a craving, we have an urge and then we engage in the behavior oftentimes without stopping mindfully.
Think is this what we want to do this provides that stop.
It says: okay, I’ve got it to write down the time, and then I’ve got to think about why I’m eating, and honestly a lot of clients notice, a reduction and their habit of eating when they have to do this, just because they don’t want to record-keeping that up for a month or two months helps break some of the habits, eating that they might do like.
I said before when they’re eating, I encourage them to use a plate.
Sit down. Don’t walk around don’t stand at the counter, eliminate distractions as much as possible and focus on the food you’re eating that goes with mindfully eating.
What does it taste like? Is it good to take small bites when my son was young, I think I’ve shared this before he had gastric reflux and we would sit down at the table and I would shovel in food as fast as I could get it in my mouth because He couldn’t be put down for too long before he would start to get fussy, at least until we figured out that he had gastric reflux and Zantac was just a lifesaver.
I developed that habit when he was little and I kept it up for a while.
It took a while to learn for me to learn to go back to take.
You know reasonable bites and tasting my food, and even today, if I’m not paying attention too much, I’ll eat my dinner fast and then I’ll sit there and I’ll be like well.
Yes, I’ll taste that a little bit later, because I didn’t taste it when I ate it encourage clients to be aware of their eating habits, and try to avoid setting up a binge by restricting certain foods.
Now.
Does that mean you have to have cakes and candy and whatever your trigger foods are in your house all the time and in your face? No, I would encourage people not to do that, but to say you know, I said for me M Ms, is one of my favorite reward foods.
If you will, I don’t keep them in the house, but I will allow myself occasionally to buy a small snack-size pack of M Ms, when I’m out or I will get a regular-size pack and I’ll share it with my daughter, so I’m not restricting it.
I’m not saying I can never M. Ms again, I’m just not making it available to myself when I might have some unrestricted time, try to avoid buying a bunch of comfort foods and keeping them around the house, and when you’ve got kids when you’ve got family, it’s not entirely possible, usually to not have some of that stuff around but try to avoid having the things that you particularly used for comfort, because if it’s not readily available, then you’ve got to focus on guess what dealing with the emotions.
Instead of stuffing them with food, try not to go too long without eating.
Like I said earlier, if you go too long, then by the time you get to the food, your blood, Sugar,’s low and you’re just shoveling it as fast as you can initially distract.
If you know that you’re getting you’re eating and you’re, like I’m – really not hungry, but I want to eat, take a bath, take a walk, call a friend, heaven forbid get on Facebook.
Whatever it is, you can do to distract yourself for 10 or 15 minutes if, after 10 or 15 minutes, you’re still going, I want whatever it is, then you can decide what to do about it.
Then, most of the time when people stop and go, I’m not hungry.
Let me distract myself.
They get caught up in that distraction and before they know it, they’ve forgotten about the craving, and identify the emotions.
If you know that you’re not hungry, but you want to eat, then say: okay, what’s going on what’s going on with me? It doesn’t mean that the person is never going to eat when, when they’re upset, because a lot of people do, and is it the end of the world, probably not necessary if they can start reducing the frequency of times that they eat.
In response to emotional distress that’s, what we want, we want to progress, not perfect if it’s, depression, what’s causing them to feel hopeless or helpless right now, if it’s, stress, anxiety, or anger, remember our big kind of lump together stuff. What are they stressing out about? Do they feel like they’re overwhelmed? Are they afraid of failure, rejection, and loss of control of the unknown? We’ve gone through those things.
We want them to identify what’s going on with them, and then they can make better choices about how to deal with it.
So general coping helps them develop, alternate ways of coping with distress.
Distract we’ve, already kind of gone over that one.
I encourage people – and you know it’s – one of those DBT things – that a lot of therapists encourage their clients to keep a list of things.
They can do to distract themselves because it’s not always practical to get up and go on a walk.
If you’re at work or it’s, you know two in the morning.
So what else can you do to distract yourself? Talk it out with a friend with yourself with your dog? Sometimes you just got to get it out.
People who are more auditory will prefer talking it out as opposed to journaling it now.
If they talk it out with themselves, they can record it if they want to, or sometimes it’s just better to have a dialogue with themself. If it worked for Freud, it can work for other people journaling.
If your clients are inclined to journal, encourage them to write it down.
Sometimes just getting stuff out of your head and onto paper will help the feelings dissipate a little bit.
So you’re not mulling them over and obsessing over them and getting stuck in those thoughts and feelings.
Additionally, while you’re distracted talking it out or journaling, this is also your break.
Your stop between the urge and the behavior make a pro and con list of the de-stress, not the eating whatever it is, that’s stressing you out and how can you fix it or what are the pros of this situation and what are the downsides To this situation, encourage them to focus on the positive.
You know.
If something stressing you out at work, you know you’ve got a big meeting coming up or something you don’t want to do or what it is.
You can get stuck on focusing on that or you can focus on the positive that you do have a job.
That meeting only comes around once a month. You can it’s time you don’t have to be doing paperwork whatever the pros are for that person encourage them to focus on the positive.
If you’re distressed because of some kind of a failure or perceived failure, figure out what you learned from it, whether it was a relationship failure, or maybe you learned what not to do in a relationship anymore. Maybe you learned things that you may have ignored.
Maybe you learned what you should have done instead, but how can it be a learning opportunity, instead of somewhere to stay stuck and finally, if something’s making you upset if something’s causing anxiety, depression, hopelessness, helplessness, whatever the negative feeling figure out.
If it’s worth your energy to get stuck here, is it worth the turmoil? Is it worth you know having to pacify yourself with food or whatever? It is a lot of times people say you know what now it’s, just it’s, not even worth my effort.
It’s not worth moving me away from my goals, because my goal is to stop emotional eating.
My goal is to eat for hunger, so I can go to dinner with people and feel comfortable.
I can be at a party where there’s a buffet and not feel stressed out that I’m going to go and eat half the stuff on the buffet that’s my goal so is holding on to whatever this de-stress is getting me Closer to being able to do those things and generally the answer:’s no develop alternate ways of coping with the stress the ABCs, the a is the activating event.
What is stressing you out and what’s causing the de-stress C is the emotional reaction.
Angry depressed stressed, whatever be: are your behaviors? What behaviors or B are your beliefs? Sorry, what are the beliefs that are in there that may need to be addressed? What kind of things are you telling yourself, and, and how can you counter them? Cognitively eliminate your vulnerabilities.
You knew we couldn’t get through a presentation without talking about vulnerabilities. If someone is well-rested.
Well, the fed has a good social support network, not stretch timewise.
Then it will be easier to deal with stress or stressors when they come your way.
You’ll have more energy to deal with it, so there won’t be this overwhelming feeling of I just want to bury my head in a jar of peanut butter, be compassionate with yourself.
Some days, you know you’re, just going to feel anxious.
You’re going to feel depressed.
You’re going to get angry.
You can beat yourself up over it and you know a lot of people do.
Is that the best use of your energy or can you be compassionate? Can you learn from it? Can you give yourself a break and go? You know what I’m having a bad day today and that’s okay, I’m not going to unpack and stay here, but I’m not going to fight.
It either helps clients learn how to urge surf help. They understand that, just like a panic attack just like a wave just like a lot of other things in life, it will come, it will crest and it will go out again, so they can sort of identify where they are on the energy of that Urge other tools people can use close the kitchen once I have the kitchen cleaned and you know all the dishes are done and it looks pretty.
I hate going in there and finding dishes in the sink again now I’ve got teenagers, so we always have dishes in the sink.
But before I had children, you know at seven o’clock.
I finished all the dishes and closed the kitchen, and that would be enough motivation for me to not go in there and at least not use plates and stuff to eat.
So if we’re saying that we’re going to only eat using utensils plates and sitting and all that stuff that we already talked about, then once you close the kitchen, you’re not going back in, there turn off the light.
That also helps so you’re not being attracted to the pretty lights, and you know all the goodies that are in the kitchen to brush your teeth.
This is something my grandmother used to do and it works.
There’s some research behind it.
Minty flavors reduce our appetite.
So if you brush your teeth, you get all the other flavors out of your mouth and it reduces your urges to eat because it again it’s clean and fresh. And do you really want to brush your teeth again, and meditate, sometimes just getting in a space where you’re, not obsessing about anything, can help people get past that urge to self-soothe by eating a CT for emotional eating.
What am I feeling or thinking about what’s going on with me right now? What is important to me? So if I am thinking I want to eat, I want to you know just dive into this jar of peanut butter, and then I think about what’s important to me.
Is it important to me to get control of this? Is it important to me to you know, be able to fit into my clothes in six months or not? So what is it in? What way is controlling my eating habits and eliminating emotional eating important to me, and how does that get me closer to other things that are important to me, and what other things could I do? That would get me closer to my goals.
So if the goal is to have improved relationships, be able to feel more comfortable around food reduce the stress around going out to eat, and just around food in general, what else can you do when you are stressed out? Somebody also suggested that adding a blue light in the refrigerator decreases the appeal of foods, which is interesting because yellow red and orange, and browns, I think Pizza Hut – are all foods that increase people’s, hunger and desire to eat.
But blue is just a completely different primary color, and adding a blue hue seems like that would be effective, so cool thanks for that.
Little tidbit there holiday help, and you know we’re coming into the holidays.
So I’ve got to bring that up at every single glass and choose lower-calorie foods.
If you tend to get stressed out or caught up or mindlessly eat when you are at family gatherings.
Okay, you know cut yourself a break, know that that’s, probably going to happen, and fill up on the lower-calorie foods.
The carrot sticks the broccoli, the white meat, turkey, anything that’s available, that’s, not like sweet potato pie or brownies, keep water or low-calorie beverage. In your hand, if you’ve got your hand full, you can’t eat at the same time.
So you know if you walk around with a cup in your hand, it helps talk to people.
Hopefully, you don’t talk with your mouth open or talk with food in your mouth.
So if you’re talking to people, you’re not going to be as inclined to go and get something to eat because you’re wanting to stay engaged in that conversation.
Stay away from the buffet, especially if you know that it could get stressful, or maybe you know for me, I turn into a pumpkin at like 7 30 at night.
I get up at 4 00, but I turn into a pumpkin at 7, 30 and a lot of times holiday parties and those sorts of things are at eight, nine, o’clock at night, and you know I’ve already turned into a pumpkin.
So I know that if I go to those I’m going to be more likely to eat just to kind of stay away because I’m tired and it’s a bad habit.
It’s not because I’m hungry.
So I know I need to stay away from the buffet during those times we rehearse refusal skills.
If somebody says. Oh, you, I’ve got to try it by two.
This figure out how you’re going to address that ahead of time, because there’s generally probably a lot of really good foods, and you may really want to taste some, but sometimes people who emotionally eat know if they start eating.
If they start eating high-fat high calorie foods, they’re going to want to eat everything.
So if I start with one bite of a brownie, I’m going to want to eat every suit that’s on the table.
If they know that, then they may want to choose to not even go down that road at that juncture, encourage people to stay mindful of their distress meter before they go back for another helping and ask themselves, am I hungry? Am I just wanting to taste what’s here and how do I feel about that? Or am I eating just because I don’t want to be here and I’m bored and I want to fill the time? Have people keep an index card with their coping mantra and two reasons they don’t want to emotionally eat, so I need to be here.
I can do this whatever the mantra is that’s going to get them through the night, whatever they’re.
Telling themselves that it’s going to help them plow through and make the right choices, but also two reasons that they don’t want to eat, or they’re going to get around it.
Maybe they’ve got something at home that they can eat when they get home eating before they go to.
The party may also help prevent some grazing holidays, bringing out a lot of emotions in people.
Some people struggle with depression, anxiety, jealousy, grief, and anger. You know the whole gamut during this time and during this time there’s food everywhere I mean starting at Halloween when your kids bring home the Halloween candy, which usually lasts about a week in our house baby.
Oh, Halloween candy followed by getting ready for Thanksgiving, followed by doing all the baking or whatever you do, and the holiday parties coming up on the December holiday season.
There’s just food everywhere, so it’s really easy to cope.
If you will, with stress being overwhelmed with being tired by not eating enough healthy food by binging on unhealthy and soothing food if you will so it’s, encouraged it’s important to encourage people to stay.
Mindful of why they’re eating what they’re eating, when constantly bombarded with high-fat high carbohydrate foods, people are tempted to eat to feel calm yeah.
I challenge anybody to say that they’ve never eaten and go okay.
You know I’m.
Just focused on this right now I’m not thinking about everything out here and it feels good um.
I’m good now, good, probably not the word I should use, but it does help people distract themselves sometimes when they eat, especially those high-intensity foods.
You feel happier serotonins are released. Dopamine is released.
You’re, like oh, that’s good.
I want to do that again or you just feel numb.
You can get into a zone where you’re just eating and not caring about it’s.
Not that you’re feeling calm, you’re just not feeling anything, and a lot of times when people get into that zone.
They’re not tasting the food either.
They’re just kind of on autopilot for emotional eating, like most other escape behaviors.
Never addresses the underlying emotions and their causes, so we need to look at them.
Are you feeling anxious? Are you feeling jittery? Are you feeling depressed because your blood Sugar’s low, because you’re nutritionally deficient because you’re not getting enough sleep or because there’s something cognitive going on, or all of the above emotional eating, often results in physical issues like weight gain Poor sleep and reduced energy weight gain, are you know in and of itself a few pounds here and they’re not a big deal, but some people can start emotionally eating to feel better.
They gained a lot of weight. Then they start feeling less energetic.
It starts being harder to move around.
They get to the point where they are clinically obese.
Then they’re going.
I’m never going to take all this weight off.
They feel hopeless and helpless.
You see where this is going, so they eat some more.
Can cause poor sleep apnea, it’s hard to get it’s also hard to get comfortable.
Sometimes, if you’ve eaten a whole bunch of food right before you go to bed, you know your bellies are all full, and little you wake up.
The next morning and your belly are still awful, which means you probably didn’t, sleep very well the night before and emotional eating often results in reduced energy because the foods we binge on the foods we eat for self-soothing often end up causing a sugar Crash some people try to undo emotional eating by restricting other calories which can lead to nutritional deficits and more cravings. I had a girlfriend when I was in high school and you know think back to I don’t know if they still do it, but when we were in high school there was always some kind of candy sale going on and she would always forgo all Other food, so she could have two chocolate bars each day and you know we’re not going to get into the all the other issues surrounding only eating two chocolate bars.
But the point I’m making it right now is the fact she wasn’t getting protein.
She wasn’t getting it.
You know most of her vitamins and minerals and stuff that her body needed to make the neurotransmitter.
So she could feel happy and she was contributing to a sugar crash, but I also know that it’s common around the holidays for people to do this.
They’ll let go all day without eating because they know they’re going to a party tonight and there’s going to be a lot of really good food doing that once in a while.
Not a big deal doing that 10 or 15 times in a month could start to have problems.
Emotional eaters need to first find a way to stop before they eat, so, whether it’s writing in a journal or adding.
There are a lot of apps on your phone that you can put your food in, even if you’re, not writing about your emotions and your cravings and all that kind of stuff.
Sometimes it’s enough to make people stop before they reach. For the food – or you know, kind of an extreme way to go is to not keep pre-processed or prepackaged foods in the house.
So anything that you’re going to eat you’ve got to make second identify the underlying reason for your eating figure out.
Do I generally eat in response to and then address the thoughts and emotions leading to the urges?
So if you figure out the underlying emotions for your eating or your depression, then what thoughts are maintaining that depression? And how can you address it once you address the underlying issues, some of the emotional eating will go away, but some of its habits?
We’re going to have to break that habit and, throughout you know, the past couple of decades of working with people.
My experience has been the majority of the time people don’t want to hear.
Well, once you deal with your emotional issues, the emotional eating will go away now.
They’re there because they want to stop that behavior right now.
So, yes, we need to work on all the underlying issues but give them a tip or a trick or a tool whatever you want to call it to use before they walk out of your office after every single session.
That way, they have something else they can put in their toolbox and feel more empowered to have control over what’s going on with them. And what’s coming their way, having the knowledge of what and why is 80 of helping them get to the recovery point now, if there’s co-occurring or if the eating issues are more than just emotional eating, if there’s, the person meets The criteria for binge eating disorder, bulimia or anorexia.
There are a lot of other underlying issues they’re going to have to be dealt with.
So I don’t want to trivialize that, but I do want people to feel like they’ve got some hope over what’s going on.
Are there any questions? If you enjoy this podcast, please like and subscribe either in your podcast player or on YouTube, you can attend and participate in our live webinars with doctor Snipes by subscribing at all CEUs comm slash counselor toolbox.
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This month,
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– Hey, Psych2Goers. Do you have trouble paying attention? For example, zoning out
while watching this video? Do you think you have
ADHD because of this? Oftentimes, people mistake
symptoms of anxiety for ADHD because of some of the
similar traits they share. According to the Centers
for Disease Control and Prevention data, about 3 in 10 children
with ADHD have anxiety. So to help you get a better understanding of the difference
between ADHD and anxiety, here are six signs to look out for. Number one, you have poor focus because of worrying thoughts.
Are you always distracted by your worries, so much so that you’re unable to focus on the things you’re doing? When fear and apprehension
dominate your thoughts, it may cause you to become restless, and have trouble sitting
still, paying attention, or staying focused in class. According to John Waldrop, MD from Weill Cornell Medical College, when you experience anxiety, your prefrontal cortex, the part of the brain which is essential for thinking, learning, and
remembering, is shut down. Your brain is concentrated
on staying safe.
In contrast with ADHD, you aren’t consumed by worrying thoughts. Instead, it has more
to do with an imbalance in your hormones: dopamine
and norepinephrine, which causes you to be distracted. Number two, you don’t tend to have as many problems with impulsivity. Do you often find yourself
speaking out loud in class without raising your hand? Perhaps you were even labeled
as the troublemaker in school because of the way you
can never sit still. According to Dr. John, a
person with ADHD may feel as if there are dozens of controllers trying to control their
brains at the same time without checking in with each other first. So if you find that you
don’t appear to have as many problems with impulsivity but just struggle to speak up or stand up because of your nerves, then you may have anxiety rather than ADHD. Number three, you have trouble
completing your schoolwork because of perfectionism. Do you have trouble
completing your schoolwork? Perhaps you find yourself procrastinating even if you only have just
one assignment to you.
This struggle could be because
you have so many points you wanna make in so many
ways to phrase the words that leave you wanting
to throw up your hands and ignore them. You’re avoiding starting your assignments because you can’t have
it is less than perfect. If you can relate to this, then it’s more likely you’re struggling with anxiety and not ADHD. Dr. John stated that
while people with ADHD may experience difficulty
completing their schoolwork or performing tasks, it’s often due to trouble
with concentration rather than perfectionism.
Number four, you are
generally more sensitive to social cues. Are you very sensitive to how you come across to other people? Do you find yourself often uncomfortable with your social environment? Perhaps you find it challenging to eat in front of other people, or tend to avoid speaking in public because of an overwhelming fear that people will judge you negatively. According to Dr. John,
if your answers are yes to the above questions, it’s more likely that you
have anxiety rather than ADHD. This is because people
with ADHD usually struggle with understanding or missing social cues rather than being hypersensitive to them. Number five, you experience
a racing heart, clamminess, tense muscles, headaches,
nausea, or dizziness. Do you often experience
headaches, nausea, or dizziness? These are just some of
the symptoms of anxiety. Dr. John stated that anxiety comes from a tiny almond-shaped part at the back of your brain
called the amygdala.
As a watchman for your brain, it is constantly watching out for danger. And whenever it detects danger, it triggers a fight or flight response. However, for anxious people, the amygdala is large and hypersensitive. Because of this, it ends up sending out
a lot of false alarms. You can think of it as a watchman
who cries wolf too often. As a result, your brain may sense threats even in non-threatening situations. And number six, you are unlikely
to show problem behaviors when you’re feeling calm, safe,
and doing things you enjoy.
How do you act when you’re having fun? Whether it’s listening
to your favorite music or playing video games, you
may find yourself feeling calm and safe while doing the things
that you genuinely enjoy. You are neither restless nor feel like you need
to catch your breath. According to Dr. John, anxious
individuals are unlikely to display any problem behaviors
when feeling calm and safe and doing something they enjoy. On the contrary, people with ADHD will experience problem behaviors even when they engage in a particular fun or exciting activity. For example, a person with ADHD may become so engrossed
with painting a picture that they tune out or completely
ignore everything else. This behavior is known as hyperfocus. Did you relate to any of
the signs we’ve mentioned? Let us know in the comments below. If you found this video helpful, be sure to like, subscribe,
and share this video with those who might benefit from it. And don’t forget to hit
the notification bell icon to get notified whenever
Psych2Go posts a new video. As always, the references and
studies used in this video are added in the description below.
Thanks so much for watching
and see you in our next video. (light music).
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this episode was pre-recorded
as part of a live continuing education webinar on-demand CEUs are
still available for this presentation through all CEUs register at allceus.com/counselortoolbox hi everybody and welcome to today’s presentation
on emotional eating making peace with food during the next hour so we’re going to define emotional
eating and differentiate it really from eating when to celebrate and when it’s a problem and
also differentiate differentiating it from eating disorders will explore emotional eating in
terms of its beneficial functions and rewards and discuss why restrictive diets don’t resolve
emotional eating a lot of times people will say you know I have been on this diet forever
and it doesn’t seem to be working or I can’t seem to stick to any diet that I try and we’re going
to look at different reasons why this might be what is emotional eating and it’s exactly what it
sounds like it’s eating in response to emotions and feelings other than hunger so if you’re eating
because you’re bored if you’re eating at someone and sometimes, especially if you are angry
at someone or disappointed in someone you may eat and sort of be eating and thinking you made
I do this so eating at someone eating to forget or distract myself from eating to feel better because
when you eat regardless of what you’re eating but especially if you eat high-sugar high-fat foods
you’re going to release serotonin and dopamine eating out of boredom you know hand-to-mouth bang
eating out of habit and like I said a few minutes ago not all emotional eaters have an eating
disorder um and we want to differentiate that it means that their eating is not problematic
to them no not at all if they’re telling you it’s a problem then it’s a problem they may not
meet the criteria for binge eating disorder or bulimia but it’s important to address it because
they understand that they’re eating for a reason other than hunger and they want to stop because
they want to eat for hunger but not otherwise and for us as clinicians the first thing we need to
do is understand why is it that they’re eating is it boredom is it a habit so they need to keep a food
log or a food journal over a week or two weeks and sometimes when people come in for an
assessment especially if that’s one of their main presenting issues I’ll start just doing
a retrospective of the last three days to get an idea of what may be triggering some of their
eating episodes and then we can look at some of the habits or bad habits may be that they’ve gotten
into and start talking about ways to address those remember that Rome wasn’t built in a day
this isn’t going to go away overnight but a lot of times if you give people some tips tricks and
tools to think about implementing when they walk out of your office after the assessment before the
first official session it provides them some hope and gets the momentum going and again you don’t
have to binge to be an emotional eater some people graze all day long some people will eat and it’s
not what would be considered technically a binge but it’s more than they had anticipated maybe they
go back for second helpings or third helpings when they weren’t hungry but it was good so why
is eating so soothing there are a lot of reasons now there’s obvious it tastes good so that’s
you know the big obvious bonus but thinking about the function the eating serves we have to eat in
order to survive when you were an infant it eating involved a closeness with your parental unit
which could release oxytocin I say parental unit because even if it was dad feeding the baby
a bottle there was that connection there was that contact which caused the infant and the parent to
release oxytocin this is our bonding chemical so eating was associated early on with bonding food
may also have been associated with sleep if the infant or child was given a bottle every night to
go to sleep then they may start thinking or they may be in the habit of eating to wind
down or calm down and we need to help them figure out different ways to do that as a toddler what an
eating means to think about when you went from well we probably don’t remember that but think about
when your kids went from eating you know food out of a jar to even their first Cheerios that
was huge figuring out how to pick up that little cheerio and get it in their mouth and it involved
exploration and mastery they were discovering all different types of textures and tastes and
figuring out what smell went with what taste and it was a cool and exciting time for kids
and I mean think about it they’re like a year old so it doesn’t take much to amuse them but this was
the rewarding reward equals dopamine equals let’s do that again it involved power and control of the child
at this point was starting to be able to feed him or herself was starting to be able to be somewhat
independent from the parent when it came to the basic physiological function of eating so eating
itself had its rewards and it was self-esteem building because the child started learning you
know how to feed himself and how to ask for what he or she wanted at least in terms of food there
are formations of memories around foods even as early as toddlerhood you know we have celebrations
we have birthdays we have different things and most children have certain foods that they really
like and it could be because the first time that ate that food was a really happy experience
or it could be just that’s their favorite food and that’s all they want to eat but they remember
that food and they remember when they ate it they felt good they felt happy so as an adult there’s a
part of their brain going chicken nuggets make me happy now that’s how the toddler
thought as an adult we can understand that chicken nuggets themselves aren’t making you happy but you
see the connections that we’re making here there’s been an association between happiness and chicken
nuggets unhealthy foods especially for children when as adults we’re still able to control what
they eat your sugary foods your unhealthy foods are usually reserved for treats or rewards so
when you’re feeling like you need to be rewarded when you’re feeling like you want to feel good
sometimes you’ll resort to those things when you were a kid that made you feel good like chocolate
chip cookies or Haagen-Dazs or whatever it was for you we’ve talked in the past about associations
and conditioning and this is all coming back kind of full circle now because we need to understand
that our brain has associated pleasure and reward with food for a lot of different reasons not just
because of nourishment looking at the reasons why your patient eats is going to help you understand
what underlying issues you may need to address in treatment culturally we associate eating with
caring and celebrating think about birthdays and holidays what do we do we get together we have
buffets we have pot Luck’s when someone passes away what do you do you bring food over when
somebody’s sick what do you bring food over so in our culture there is a lot of emphases
put on eating and nourishing and that’s true of a lot of different cultures with low blood sugar
can cause feelings of depression and anxiety which are quelled by food so if somebody typically
doesn’t eat well during the day you know they go long periods without eating or if they have
blood sugar issues to begin with and then they eat they feel better so when they start feeling
not so good what do you think their first reaction is let me eat and see if that helps evolution
predisposes the human body to crave high sugar high-fat high calorie foods for quick energy and
to prepare for a famine our bodies are cool and frustrated at the same time because
you know your body takes in these foods and it says we’re gonna secrete the most amount of
dopamine and the most amount of reward for these high-calorie foods because we want to make
sure we’re prepared in case there’s a famine back you know in the day many many many years ago
hundreds of years ago we couldn’t guarantee we would have a meal every day let alone three
meals every day so the body prepared and it said alright we need to get whatever we can when
we can so we’re going to make this a higher fat higher calorie food more rewarding now I
said it’s also can be a blessing and a curse today there’s still a little part of our primordial
a brain that says if it thinks there’s a famine it will slow down your base metabolic rate which
causes people to gain weight we see this a lot in people with eating disorders who tend to not
take in very many calories or if they take them in they purge them so the body goes well I can’t
guarantee I’m gonna get enough food I’m gonna get enough energy to survive so I’m just gonna turn
down the thermostat a little bit to turn down the base metabolic rate which compounds the problem
for the person with an eating disorder so it’s important to understand that the brain is somewhat
active to what’s going on so I keep saying we need to figure out what’s behind or underlying
the craving first we need to rule out physical causes for some people it’s as simple as this if
they’ve got low blood sugar because they’re not eating too often and obviously as counselors we’re
not going to diagnose this their doctor or their nutritionist will but we can start exploring and
go it sounds like you might need to look at having your blood sugar checked or talk to your doctor
about how frequently you need to eat because some people and I know I’m very guilty of it if
I get into it into a groove doing something I’ll eat breakfast and then I’ll get into a groove and
before I know it it’s 3:00 in the afternoon and I haven’t eaten for like a whole bunch of hours I’m
not doing math today and my blood Sugar’s low and I’m starting to get foggy-headed and irritable
and tired so it’s a real simple fix there in our society we are so driven and we are so we get
so caught up in things because that’s such a fast pace that it’s easy to forget to eat or easy to
avoid eating so that’s the first thing we want to rule out are you eating in response to low blood
sugar which is making eating seem more rewarding and when you eat in response to low blood sugar
a lot of times people who do that end up eating more than they normally would because they start
eating fast it’s like I’m gonna shovel in as much as I can your brain doesn’t register
you’re eating for 20 minutes or so so before your brain even registers what’s gone on and gets
the blood sugar back up they’ve already eaten a whole ton of food why is this under emotional
eating well because generally when they go in to just start eating yes they’re hungry but
they’re also cranky and irritable and most of the time they’re not thinking about what I’m eating
for the nourishment it’s I’m eating feel better after lack of sleep and this is so true for shift workers as
well as you know new parents and college students and anybody who’s not getting enough sleep if we
are surviving on sugar and stimulants we’re going Peak and Lower Valley Peak and Lower Valley and
you just keep going up and down until you just crash because every time you crash you crash a
a little bit lower so if somebody’s on that roller coaster they’re going to feel worse between you
know eating episodes they’re going to feel tired they’re going to feel a flood of sluggish irritable
fatigued and to a certain extent maybe depressed and they may be missing attributing those feeling
those emotional feelings to emotions versus physical causes and likewise we also want to make
sure that you know we’re addressing the emotional causes because there’s probably stuff there
too but if they’re not getting enough sleep and they’re living on sugar and stimulants their
the body is kind of in a state of hyper-vigilance a lot of times it’s exhausted so they’re going
to be tired and cranky so those are a couple of things that we want to look at those are
relatively easy fixes or at least relatively easy things to point out and go let’s think about this
one of the things that I suggest for a lot of my clients is just to take a week and mindfully and it
is difficult but try to eat healthfully you know try to eat a few times a day you know try to eat
like three meals a day and getting enough water and trying to get enough sleep and try not to overdo
it on the stimulants at the beginning I’m not going to say cut out anything because that’s not
realistic and it’s not fair and they’re probably already struggling if they’re coming in to see me
so if I go hey let’s just turn your world upside down and guess what you’re not going to drink any
caffeine anymore it’s not going to create a happy person so I asked them to try to make some small
changes and see if that starts to help dehydration causes fogginess and symptoms of depression we
want to make sure that they rule that out and too many stimulants also causes dehydration so you
know we’re looking at some of the physical causes of irritability and fatigue and cravings because
again we’re going back to when I felt this way before not looking at why I felt this way but when
I felt irritable depressed cranky what has made me feel better and generally food and generally
it’s not good food for me it’s M&Ms I love my M&Ms, especially the ones with almonds but I digress
nutritional causes of cravings high carbohydrate and high starch foods caused a greater release
of serotonin and endorphins so if you’ve got somebody who’s depressed for whatever reason that
they may crave these kinds of foods to increase their serotonin level or increase the
endorphins in their energy levels chocolate people who crave chocolate may be low in magnesium it
also um the level of magnesium affects how much serotonin is available again just keep
saying this just for legal reasons we want to make sure their doctor or nutritionist goes in and
makes this diagnosis but if there are particular foods that they do crave it’s important for them
to bring that up with their medical provider if they’re craving fatty foods now again fatty foods
are just good I love fried foods but it also could mean that they’re not getting enough Omega threes
Americans typically don’t and interestingly if they crave soda they may be calcium deficient
who knew so these are things to take a look at to ask people you know if they’re craving soda
maybe cutting back on their soda a little bit and see what happens and or getting blood work done
once we’ve ruled out the obvious physical causes they’ve gone to the doctor gotten blood work done
everything I’m comes back happy they’re getting enough sleep but they’re still eating when they’re
not hungry we need to rule out habits is there a particular time or activity that makes you crave
this food when I was growing up I would go to the grocery store with my mother and on the way back
home from the grocery store she would always we would always get junk food and she would get a
bag of chips and put them in the front seat it was like a 20-minute drive from the grocery store
to our house and by the time we would get back to the house we would have put a good dent in those
potato chips that being said I got into the habit of whenever I went to the grocery store I would
get something out of the bag and put it in the front seat and eat on the way home now am I paying
attention to what I’m eating no likely am I eating because I was hungry probably not so we want
to look at habits a lot of people will eat when they are watching TV it’s a huge one so we want
to not do that or if you’re going to eat when you’re watching TV make sure you sit at the table
at least that makes you a little bit more mindful so think about their particular times
or activities that you eat and you’re just not hungry are their particular times that you
mindlessly eat like like I said when you’re driving or when you’re watching television those
are both habits and can be mindless because you’re not paying attention to how much is going on in your
the mouth you’re not probably paying attention to the taste and you’re not paying attention to whether
you’re full or not so if you’re mindlessly eating then there’s going to be a lot more calorie
consumption in addition to the fact that you’re not eating because you’re hungry you’re just
eating to eat are you going too long between meals than needing a sugar boost which leads to a
sugar crash so again that’s a physical cause but we want to rule out these bad habits that
we can tend to get into other things that can be construed as bad habits are eating without
putting food on a plate if you eat straight out of the bag you’re gonna eat more than if
you put it on a plate so put it on a plate sit down try not to watch TV all the things that your
grandmother would have told you so what do we do about it emotional eating interventions I talked
earlier about the food diary do a retrospective during the assessment if they want to get
a jumpstart on things but have them keep a food diary preferably for the duration of treatment
but at least for a week what time did they eat were they craving just any old food or something
that was salty sweet sour this will give you a general idea
and can give their medical provider a general idea if there are any nutritional imbalances or if
there are particular associations with what emotion or state were you in and I say state because being
exhausted is not necessarily really an emotion where you are happy sad mad glad exhausted drained
whatever state feels like it would work and then because of why were you feeling this way
it doesn’t have to be a dissertation it can be short and sweet but I encourage clients
to write down everything they eat before they eat it during the first week or you know like I
said preferably throughout the entire course of treatment why before they eat it because it’s a
stop remembering we’ve talked before about how we have an urge we have a craving we have an urge and
then we engage in the behavior oftentimes without stopping to mindfully think is this what we want
to do this provides that stop it says okay I’ve got it to write down the time and then I’ve got to
think about why I’m eating and honestly, a lot of clients notice a reduction and their habit of eating
when they have to do this just because they don’t want to record-keeping that up for the period of a
a month or two months helps break some of the habits eating that they might do like I said before when
they’re eating I encourage them to use a plate sit down don’t walk around don’t stand at the counter
eliminate distractions as much as possible and focus on the food you’re eating that goes with
mindfully eating what does it taste like is it good take small bites when my son was young and
I think I’ve shared this before he had gastric reflux and we would sit down at the table and
I would shovel in food as fast as I could get it in my mouth because he couldn’t be put down
for too long before he would start to get fussy at least until we figured out that he had gastric
reflux and Zantac was just a lifesaver I developed that habit when he was little and I kept it up
for a while, it took a while to learn for me to learn to go back to take you to know reasonable
bites and tasting my food and even today if I’m not paying attention too much I’ll eat my dinner
rest and then I’ll sit there and I’ll be like well yes I’ll taste that a little bit later
because I didn’t taste it when I ate it encouraging clients to be aware of their eating habits and try to
avoid setting up a binge by restricting certain foods now does that mean you have to have cakes
and candy and whatever your trigger foods are in your house all the time and in your face no I
would encourage people not to do that but to say you know I said for me M&Ms is one of my favorites
reward foods if you will I don’t keep them in the house but I will allow myself occasionally to buy
a small snack-size pack of M&Ms when I’m out or I will get a regular-size pack and I’ll share it
with my daughter so I’m not restricting it I’m not saying I can never M&Ms again I’m just
not making it available to myself when I might have some unrestricted time to try to avoid buying
a bunch of comfort foods and keeping them around the house and when you’ve got kids when you’ve got
family, it’s not entirely possible usually to not have some of that stuff around but try to avoid
having the things that you particularly used for comfort because if it’s not readily available
then you’ve got to focus on guess what dealing with the emotions instead of stuffing them with
food try not to go too long without eating as I said earlier if you go too long then by the
the time you get to the food your blood Sugar’s low and you’re just shoveling it as fast as you
can initially distract if you know that you’re getting you’re eating and you’re like I’m really
not hungry but I want to eat take a bath take a walk call a friend heaven forbid get on Facebook
whatever it is you can do to distract yourself for 10 or 15 minutes if after 10 or 15 minutes
you’re still going I rant whatever it is then you can decide what to do about it then
most of the time when people stop and go I’m not hungry let me distract myself they get
caught up in that distraction and before they know it they’ve forgotten about the craving to identify
the emotions if you know that you’re not hungry but you want to eat then say okay what’s going
on what’s going on with me it doesn’t mean that the person is never going to eat when they’re
upset because a lot of people do and is it the end of the world probably not necessary if they can
start reducing the frequency of times that they eat in response to emotional distress that’s what
we want to progress, not perfect if it’s depression that’s causing them to feel hopeless
or helpless right now if it’s stress anxiety or anger remember our big kind of lump together
stuff what are they stressing out about do they feel like they’re overwhelmed are they afraid of
failure rejection loss of control of the unknown we’ve gone through those things we want them to
identify what’s going on with them and then they can make better choices about how to deal with it
so general coping helps them develop alternate ways of coping with distress distract we’ve already
kind of go over that one I encourage people and you know it’s one of those DBT things that
a lot of therapists encourage their clients to keep a list of things they can do to distract
themselves because it’s not always practical to get up and go on a walk if you’re at work or it’s
you know two in the morning so what else can you do to distract yourself talk it out with a friend
with yourself with your dog sometimes you just got to get it out people who are more auditory will
prefer talking it out as opposed to journaling it now if they talk it out with themselves they
can record it if they want to or sometimes it’s just better to have a dialogue with themself if
it worked for Freud it can work for other people journaling if your clients are inclined to journal
encourage them to write it down sometimes just getting stuff out of their head and onto paper
will help the feelings dissipate a little bit so you’re not mulling them over and obsessing
on them and getting stuck in those thoughts and feelings additionally while you’re distracting
talking it out or journaling is also your break stop between the urge and the behavior
make a pro and con list of the de-stress, not the eating whatever it is that’s stressing you out
and how can you fix it or what are the pros of this situation and what are the downsides to
this situation encourages them to focus on the positive you know if something stressing you
out at work you know you’ve got a big meeting coming up or something you don’t want to do
or what it is you can get stuck on focusing on that or you can focus on the positive that you
do have a job that meeting only comes around once a month you can it’s time you don’t have to be
doing paperwork whatever the pros are for that person encourage them to focus on the positive
if you’re distressed because of some kind of a failure or perceived failure figure out what you
learned from it whether it was a relationship failure maybe you learned what not to do in a
relationship anymore maybe you learned things that you may have ignored maybe you learned what
you should have done instead but how can it be a learning opportunity instead of somewhere to stay
stuck and finally if something’s making you upset if something’s causing anxiety depression
hopelessness helplessness whatever the negative feeling figure out if it’s worth your energy
to get stuck here is it worth the turmoil is it worth you know having to pacify yourself with
food whatever it is a lot of times people say you know what now it’s just it’s not even worth
my effort is not worth moving me away from my goals because my goal is to stop emotional
eating my goal is to eat for hunger so I can go to dinner with people and feel comfortable
I can be at a party where there’s a buffet and not feel stressed out that I’m gonna go and eat
half the stuff on the buffet that’s my goal so is holding on to whatever this de-stress is getting
me closer to being able to do those things and generally, the answer’s no develop alternate ways
of coping with the stress the ABCs the a is the activating event that is stressing you out what’s
causing the de-stress C is the emotional reaction angry depressed stressed whatever we are your
behaviors what behaviors or B are your beliefs sorry what are the beliefs that are in there that
may need to be addressed what kind of things are you telling yourself and how can you counter
them cognitively eliminate your vulnerabilities you knew we couldn’t get through a presentation
without talking about vulnerabilities if someone is well-rested well-fed has a good social support
the network does not overstretch timewise then it will be easier to deal with stress or stressors when they
come your way you’ll have more energy to deal with it so there won’t be this overwhelming feeling
of I just want to bury my head in a jar of peanut butter be compassionate with yourself some days
are you know you’re just gonna feel anxious you’re gonna feel depressed you’re gonna get angry you
can beat yourself up over it and you know a lot of people do is that the best use of your energy
or can you be compassionate can you learn from it can you give yourself a break and go you know what
I’m having a bad day today and that’s okay I’m not gonna unpack and stay here but I’m not gonna
fight it either help clients learn how to urge surf helps them understand that just like a panic
the attack is just like a wave just like a lot of other things in life it will come it will crest and it
will go out again so they can sort of identify where they are on the energy of that urge
other tools people can use close the kitchen once I have the kitchen cleaned and you know all the
dishes are done and it looks pretty I hate going in there and finding dishes in the sink again now
I’ve got teenagers so we always have dishes in the sink but before I had children you know at
seven o’clock I finished all the dishes and closed the kitchen and that would be enough motivation
for me to not go in there and at least not use plates and stuff to eat so if we’re saying that
we’re going to only eat using utensils plates and sitting and all that stuff that we already talked
about then once you close the kitchen you’re not going back in there turn off the light that
also helps so you’re not being attracted to the pretty lights and you know all the
goodies that are in the kitchen brush your teeth this is something my grandmother used
to do and it works there’s some research behind it minty flavors reduce our appetite so
if you brush your teeth you get all the other flavors out of your mouth and it reduces your
urges to eat because it again it’s clean and fresh and do you want to brush your teeth
again meditate sometimes just getting in a space where you’re not obsessing about anything can
help people get past that urge to self-soothe with eating a CT for emotional eating what am I
feeling or thinking about what’s going on with me right now and what is important to me so if I am thinking
I want to eat I want to you know just dive into this jar of peanut butter and then I think about
what’s important to me is it important to me to get control of this is it important to me to you
know to be able to fit in my clothes in six months or not so what is in what way is controlling
my eating habits and eliminating emotional eating important to me and how does that get
me closer to other things that are important to me and what other things could I do that would
get me closer to my goals so if the goal is to have improved relationships and be able to feel more
Being comfortable around food reduces the stress around going out to eat and just around food in general
what else can you do when you are stressed out somebody also suggested adding a blue light
in the refrigerator decreases the appeal of foods which is interesting because yellow red and
orange and browns I think Pizza Hut are all foods that increase people’s hunger and desire to eat
but blue is just a completely different primary color and adding a blue hue seems like
that would be effective so cool thanks for that little tidbit their holiday help
and you know we’re coming into the holidays so I’ve got to bring that up at every single glass
choose lower-calorie foods if you tend to get stressed out or caught up or mindlessly eat when
you are at family gatherings, okay you know cut yourself a break know that that’s probably gonna
happen to fill up on the lower calorie foods the carrot sticks broccoli the white meat turkey
anything available that’s not like sweet potato pie or brownies keeps water or low calorie
beverage in your hand if you’ve got your hand full you can’t eat at the same time so you know if you
walk around with a cup in your hand it helps talk to people hopefully you don’t talk with your
mouth open or talk with food in your mouth so if you’re talking to people you’re not going to be as
inclined to go get something to eat because you’re wanting to stay engaged in that conversation stay
away from the buffet especially if you know that it could get stressful or maybe you know for me I
turn into a pumpkin at like 7:30 at night I get up at 4:00 but I turn into a pumpkin at 7:30 and a
a lot of times holiday parties and those sorts of things are at eight nine o’clock at night and you
know I’ve already turned into a pumpkin so I know that if I go to those I’m gonna be more
likely to eat just to kind of stay away because I’m tired and it’s a bad habit it’s not because
I’m hungry so I know I need to stay away from the buffet during those times we rehearse refusal
skills if somebody says oh you’ve got to try it by two this figure out how you’re going to address
that ahead of time because there’s generally probably a lot of really good foods and you may
want to taste some but sometimes people who emotionally eat know if they start eating if they
start eating high-fat high calorie foods they’re gonna want to eat everything so if I start with
one bite of a brownie I’m gonna want to eat every suite that’s on the table if they know that then
they may want to choose to not even go down that road at that juncture and encourage people to stay
mindful of their distress meter before they go back for another helping and ask themselves am i
hungry am I just wanting to taste what’s here and how do I feel about that or am I eating
just because I don’t want to be here and I’m bored and I want to fill the time have people
keep an index card with their coping mantra and two reasons they don’t want to emotionally
eat so I need to be here I can do this whatever the mantra is that’s gonna get them through the
night whatever they’re telling themselves that it’s gonna help them plow through and make the
right choices but also two reasons that they don’t want to eat or they’re going to get around
maybe they’ve got something at home that they can eat when they get home eating before they go
to the party may also help prevent some grazing holidays bring out a lot of emotions in people
some people struggle with depression anxiety jealousy grief anger you know the whole gamut
during this time and during this time there’s food everywhere I mean starting at Halloween when
your kids bring home the Halloween candy which usually lasts about a week in our house baby
Oh Halloween candy followed by getting ready for Thanksgiving followed by doing all the baking
or whatever you do and the holiday parties coming up on the December holiday season there’s just
food everywhere so it’s really easy to cope if you will with stress being overwhelmed by being
tired by not eating enough healthy food by binging on unhealthy and soothing food if you will so it’s
encouraged it’s important to encourage people to stay mindful of why they’re eating what they’re
eating when constantly bombarded with high-fat high carbohydrate foods people are tempted to eat
to feel calm yeah I challenge anybody to say that they’ve never eaten and go okay you know I’m just
focused on this right now I’m not thinking about everything out here and it feels good um I’m good
now goods are probably not the word I should use but it does help people distract themselves sometimes
when you eat especially those high-intensity foods you feel happier serotonins release dopamine
is released you’re like oh that’s good I want to do that again or you just feel numb you
can get into a zone where you’re just eating and not caring it’s not that you’re feeling calm
you’re just not feeling anything and a lot of times when people get into that zone they’re
not tasting the food either they’re just kind of on an autopilot emotional eating like most other
escape behaviors never address the underlying emotions and their causes so we need to look
at it are you feeling anxious are you feeling jittery are you feeling depressed because your
blood Sugar’s low because you’re nutritionally deficient because you’re not getting enough sleep
or because there’s something cognitive going on or all of the above emotional eating often results
in physical issues like weight gain poor sleep and reduced energy weight gain is you know in and
of itself, a few pounds here and they’re not a big deal but some people can start emotionally eating
to feel better they gained a lot of weight then they start feeling less energetic it starts being
harder to move around they get to the point where they are clinically obese then they’re going I’m
never going to take all this weight off they feel hopeless and helpless you see where this is going
so they eat some more can cause poor sleep apnea it’s hard to get it’s also hard to get
comfortable sometimes if you’ve eaten a whole bunch of food right before you go to bed you know
your bellies all full and little you wake up the next morning and your belly still awful which
means you probably didn’t sleep very well the night before and emotional eating often results
in reduced energy because the foods we binge on the foods we eat for self-soothing often end up
causing a sugar crash some people try to undo emotional eating by restricting other calories
which can lead to nutritional deficits and more cravings I had a girlfriend when I was in high
school and you know think back to I don’t know if they still do it but when we were in high school
there was always some kind of candy sale going on and she would always forgo all other food so she
could have two chocolate bars each day and you know we’re not going to get into the all the other
issues surrounding only eating two chocolate bars but the point I’m making it right now is the fact
she wasn’t getting protein she wasn’t getting you to know most of her vitamins and minerals and stuff
that her body needed to make the neurotransmitter so she could feel happy and she was contributing
to a sugar crash but I also know that it’s common around the holidays for people to do this they’ll
let go all day without eating because they know they’re going to a party tonight and there’s going
to be a lot of really good food doing that once in a while is not a big deal doing that 10 or 15 times
in a month could start to have problems emotional eaters need to first find a way to stop before
they eat so whether it’s writing in a journal or adding there are a lot of apps on your phone
that you can put your food in even if you’re not writing about your emotions and your cravings
and all that kind of stuff sometimes it’s enough to make people stop before they each
for the food or you know kind of an extreme way to go is to not keep pre-processed or prepackaged
foods in the house so anything that you’re going to eat you’ve got to make a second identity
the underlying reason for your eating figure out do I generally eat in response to and then
address the thoughts and emotions leading to the urges so if you figure out that the underlying
emotions for your eating or your depression then what thoughts are maintaining that depression
and how can you address it once you address the underlying issues of some of the emotional eating
will go away some of its habits we’re going to have to break that habits and over the course of
you know past couple of decades of working with people my experience has been the majority of the
time people don’t want to hear well once you deal with your emotional issues the emotional eating
will go away now they’re there because they want to stop that behavior right now so yes we need to
work on all the underlying issues but give them a tip or a trick or a tool whatever you want to
call it to use before they walk out of your office after every single session that way they have
something else they can put in their toolbox and feel more empowered to have control over what’s
going on with them and what’s coming their way knowing what and why is
80% of helping them get to the recovery point now if there’s co-occurring or if the
eating issues are more than just emotional eating if there’s the person meets the
criteria for binge eating disorder bulimia or anorexia there are a lot of
other underlying issues they’re gonna have to be dealt with so I don’t want
to trivialize that but I do want people to feel like they’ve got some hope over
what’s going on are there any questions if you enjoy this podcast please like and
subscribe either in your podcast player or on YouTube you can attend and participate
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As found on YouTubeHuman Synthesys Studio It’s Never Been Easier To Create Human Spokesperson Videos. No Learning Curve, So Easy To Use
– Hey Psych2Goers, welcome back. Think you've never
experienced anxiety before? Well, you might not have realized it because people experience
anxiety in different ways. Your idea of anxiety might not align with
how you experience it. And you may not notice anxiety in someone who grapples with it privately. So, it's important to
remember to always be kind because you can never know
what others are struggling with when they're alone. If you're dealing with anxiety, know that you're not alone
in facing these challenges. Anxiety is a normal part of life.
It alerts us to dangers
and helps us prepare for a wide variety of situations. But according to the Diagnostic and Statistical
Manual of Mental Disorders, DSM, anxiety becomes a disorder
when it starts to impact daily functioning and
different aspects of life. With that said, here are five things people with anxiety secretly do alone. Number one, overthink,
overthink, and overthink. Anxiety disorders are
characterized by excessive or disproportionate worry and fear that gets in the way of daily activities. It may not be as obvious to other people, but those who struggle with
anxiety tend to overthink while in the presence of
others and when alone. Many people who struggle with anxiety tend to dwell on negative thoughts about themselves and their past. They may replay these
past events in their head over and over, trying to think of what they
could have done differently.
And may also imagine
possible future events to try and anticipate
things that might go wrong. Two, confine themselves
to their comfort zone. Everyone feels anxious now and then, but those struggling
with an anxiety disorder constantly adjust their
lives to cater to it. They may stick to activities that calm their racing thoughts, or engage in pursuits that
allow them to avoid the things that make them feel anxious instead of choosing activities
purely for fun or interest. Like re-watching the
same shows over and over because they don't have to
feel anxious anticipating what might happen next. Some people may not even
be able to leave the house out of fear of being in
places and situations where escape may be difficult.
Or they may struggle to leave the house without a certain person
they're scared to lose. Three, withdraw from social interaction. Some people with anxiety may
have a limited social life and turn down invites, not
out of a lack of interest, but to stay home to calm
certain worries and fears. In some cases, the person
may seem uninterested in spending time with others due to a crippling fear of
feeling humiliated, rejected, or looked down on in social interactions. People with anxiety may withdraw socially to cope with their fears
and might avoid their phones or ignore or turn off their notifications to manage their feelings of anxiety, and then feel overwhelmed
and anxious later when they see the backlog of messages. Number four, procrastinate
or struggle to finish tasks. People with anxiety, especially
high functioning anxiety, may seem like completely
put together achievers, but they may also grapple
with getting their work done when they're alone, because anxious thoughts may
force them to procrastinate.
Anxiety also affects working memory, which makes it difficult
to focus long enough to complete tasks. And so, they may then have to rush to get things done on
time, adding extra stress. Then number five, tossing
and turning in bed. Having anxiety doesn't
immediately translate to nervous, jittery energy that
others can easily detect. Someone with anxiety can
seem calm and rested, when in reality, they might be
tossing and turning at night, unable to fall asleep because
of their anxious thoughts. If they do manage to get some sleep, they might be restless or
riddled with nightmares about their anxieties. For example, those with
separation anxiety disorder may have nightmares about being separated from their loved ones. Anxiety disorders are complex and varied, but remember that a certain
level of anxiety is normal and anxiety disorders are those that cause significant distress or impairment in different areas of life.
If you or anyone you know, are struggling with an anxiety disorder, please don't hesitate to
reach out to a qualified mental health care provider. Can you relate to any of these signs? Share with us in the comments and remember to like and share this video with someone who might benefit too. As always the references and studies used are listed in the description below. Until next time, take care friends..
(soft instrumental music) – [Amanda] Hey Psych2Go
family, and welcome back. If you’re new to this channel and by the end of the video
you enjoy our content, do consider subscribing and
joining the Psych2Go fam. Now, let’s begin. Narcissistic victim syndrome is a term that collectively
describes specific and often severe side effects
of narcissistic abuse. Many experts acknowledge
narcissistic abuse can have a serious long-lasting
impact on emotional health, although it is not recognized
as a mental health condition. As a result of chronic abuse, victims may struggle with
symptoms of PTSD or complex PTSD. If they had additional trauma such as being abused by
narcissistic parents. (beeping) (upbeat music) With that in mind, here are
10 signs that might suggest you have narcissistic victim syndrome. Number one, you felt like you
had a perfect relationship with that person in the beginning. When you’re in a romantic relationship, this type of abuse usually begins slowly and it creeps up on you
after you fallen hard and are in love with your partner.
In the early stages of the relationship, this is when the love
bombing usually occurs. They may shower you with
gifts and affections and it can feel very intense. Then slowly, manipulative tactics start to invade the relationship and will replace the love bombing. In the case of narcissistic parents, they might also offer
love, adoration, praise, and financial support, until you do something to displease them and lose their favor. They use tactics such as
gaslighting and silent treatment which can leave you
questioning your own sanity. And this is something that sticks with you even after you’ve cut
ties with that person. Number two, you feel like
you’re walking on eggshells. A common symptom of trauma
is avoiding anything that might make you relive
that particular trauma.
Whether it be people,
or places, or activities that pose the threat to you, you may feel like you’re
constantly worrying and being careful about what
you say or do around people because that is how you used to behave when you were around your abuser. You may present as
anxious and introverted, especially when in the
presence of other people, though you’re simply
acting out of extreme fear. Number three, you may have
experienced smear campaigns once the relationship ended. When breakups happen, it’s
common for people to take sides. This is no different when it
comes to a narcissistic abuser. They will twist your words and tell their version
of the story to others to try and get them to
feel sorry for them. They can often drum up
support from your loved ones by insisting that they only
have the best interest at heart.
Then when you try to talk
about the abuse that happened, your loved ones might side
with the abuser over you. This can drop barriers between you and the people
in your support network and leave you feeling isolated. Number four, you feel
isolated and vulnerable. When no one will listen
to you or your concerns, this can leave you
feeling very much alone. When you feel alone, you’re vulnerable to further
manipulation from your abuser. They may pull you back
in with fake apologies, a hand of kindness, or by brushing their past
abuse under the rock. This tactic, which is called hovering, is the perfect time to pounce when you’re lacking in support since you are more likely
to doubt your perceptions of the abuse when you can’t
talk to anyone about it. Number five, you’ve developed
a pervasive sense of mistrust.
Are you hypervigilant? Do you worry and get anxious
over other people’s intentions? The gaslighting techniques
used by the narcissistic abuser may have contributed to
how you view the world. And you may find that you have
a hard time trusting anyone, including yourself. Number six, you may
engage in self-sabotaging and self-destructive behavior. Victims often find themselves
ruminating over the abuse. This can enhance the frequency
of negative self-talk and the tendency towards self-sabotage. Malignant narcissists
will try and program you, conditioning you for self-destruction. This could potentially lead you to engaging in risky
behaviors such as self-harm or even suicidal ideation. You might’ve developed a
knack for punishing yourself because of the toxic shame you carry, put there by the hypercriticism and verbal abuse of your abuser. If you feel like you’re
lacking in any motivation to pursue your dreams and goals, then this could be a result
of narcissistic abuse. Number seven, you may experience unexplained physical symptoms. Narcissistic abuse can trigger
anxious and nervous feelings that can trigger physical symptoms.
The stress of chronic abuse may send your stress
levels into overdrive. And as a result, your immune
system may take a severe hit leaving you vulnerable to
physical ailments and disease. You may notice symptoms such
as appetite changes, nausea, stomach pain, muscle aches and
pains, insomnia, and fatigue. Number eight, you may have
issues setting boundaries. The experience of narcissistic abuse can often leave you with
little respect for boundaries. This may be because when you tried to set
boundaries in the past, you may have been met with
challenges from the abuser who gave you the silent treatment until you did what they wanted.
Once you end the relationship or gain distance from
a narcissistic parent, you promise yourself that
you won’t answer their calls or physically see them at all. However, even if you’ve tried to cut ties, your abuser is confident that they will eventually wear you down because you’ve set aside
your boundaries with them so many times before. If you’ve experienced narcissistic abuse, you might also have trouble
setting healthy boundaries in your relationships
with others in the future. Nine, you may be questioning
your own identity. When facing abuse, many people
adjust their self-identity to accommodate an abusive partner.
You may have stopped
doing things you enjoy or spending time with friends and family in order to better appease your abuser. These changes can often
lead to a loss of identity during and after the abuse. It’s not uncommon for
victims of narcissistic abuse to experience dissociation and attachment from the physical world. Dr. van der Kolk writes
in his book titled, “The Body Keeps The Score”: Dissociation is the essence of trauma.
The overwhelming experience
is split off and fragmented so that the emotions,
sounds, images, thoughts, and physical sensations
take on a life of their own. Oof! Number 10, you may find
it hard to make decisions. When there has been a negative pattern of devaluation and criticism in your life, you might have very little self-esteem and confidence in yourself. Narcissistic abusers can make statements that imply that you are
unable to make good decisions. Abusive partners may have called
you’re stupid, or ignorant, or they might’ve insulted you with a false and affectionate tone. They can manipulate you into believing you
imagine parts of reality making it seem less important
than it actually is. This type of controlling and deceitfulness can affect the way you
make future decisions. So, did you relate to any of the signs? Let us know in the comments below. I wanted to take a second
to say that I definitely… Um, sorry. Hi, it’s Amanda, the voiceover voice.
I’m reading the script for the first time and I really related to it. So I wanted to add a point that, in you taking the time to learn about narcissistic
victim syndrome, you’re empowering yourself. Once you know you can grow. Acknowledging the effects of being in a narcissistic relationship is the first step to healing from one. As we close out, we wanted to say that not all
abuse is linked to narcissism, and not all people with a diagnosis of narcissistic
personality disorder will engage in abusive behavior. However, if you feel you might be a victim of this type of abuse, we encourage you to reach out for help. Talk to someone you can trust, like a good friend, a family
member, or a therapist.
It’s not easy to leave
an abusive relationship, but with the right support,
you can move on with your life and start to heal from your past hurts. Like and share this video if it helped you and you think it could
help someone else too. The studies and references used are listed in the description below. Don’t forget to hit the Subscribe button for more Psych2Go videos, and thank you for watching.
We’ll see you in the next one..
.
As found on YouTubeHuman Synthesys Studio It’s Never Been Easier To Create Human Spokesperson Videos. No Learning Curve, So Easy To UseSo Easy To Use
Light music Narrator, Hey Psych2go ers. Before we begin, we would like to thank you all so much for your love and support for our channel Psycho2go.’s mission is to make psychology and mental health knowledge more accessible to everyone, and we hope we’ve helped you along the way.
Now let’s begin As a child.
I loved to be the center of attention.
I wasn’t afraid to introduce myself or speak up, but now there are days when I find it difficult just to look someone in the eye.
It was frustrating to watch my peers build relationships with ease.
While I struggled just to make a connection at all For years, I blamed shyness and lack of self-esteem for these changes, But it wasn’t until college that I truly learned about social anxiety, Just as with any mental illness.
Social anxiety affects everyone differently.
For me, it even changes from moment to moment.
Sometimes my nervousness reveals itself in stuttering or repetitive speech.
Other times I freeze, I’ve learned a myriad of coping mechanisms, some more helpful than others, and techniques to understand the root of my anxiety, but none have been more beneficial than therapy Finding communities such as Psych2go, where I have a voice, as well as the Support system to reach out and relate to, also help me practicing using my voice with confidence, Even when I feel so fragile that I could shatter It’s. Okay, if you don’t, feel ready to join a community or speak up about your experiences, but the team at Psych2go wants you to know that we are here.
Here are seven things: people with social anxiety will understand, Number one being social can be draining, While not everyone with social anxiety is an introvert.
Many people can feel exhausted after a social event.
Worrying can be tiring and trying hard to keep your anxiety under control while interacting with others can be enough for you to require time to recharge for the rest of the day.
It’s, okay, to push yourself to be social but be sure to know your limits and respect them.
Pushing yourself too far may end in more anxiety and exhaustion than you began with, And it’s important to take care of yourself and your needs.
First, Two: you prefer texting over calling.
Do you relate to the dread that comes when you receive a phone call For? They fear that calling someone will bother the other person For others.
They may not know who is calling or know what to say when they pick up.
Phone Calls can be sudden, disruptive, and unpredictable. So you may worry about what the other person is going to tell you Number three.
You feel anxious without direct interaction.
Sometimes you might feel anxious without directly talking or interacting with someone Just being aware that someone is watching.
You can be difficult For some that occurs when they’re eating or doing other simple tasks.
The fear can stem from judgment for doing something wrong or differently, but more often than not people don’t pay attention as closely as you think, Number four.
When it comes to friends, quality is greater than quantity, Not everyone.’s idea of fun includes hanging out with a huge group of people or going to a party.
It can be intimidating to be around a lot of people.
You don’t know, And you’d – much rather prefer to spend time with a few close friends.
The beauty of life is that no two experiences are the same, So there’s a friend out there for everyone, Even if you may be socially anxious.
Five, it’s, not all in your head. Social anxiety can manifest as physical sensations for a lot of people.
These symptoms are similar to feeling embarrassed, sweaty, hands, blushing hyperventilating, but can feel more intense and last longer.
Facing social situations can potentially lead to panic attacks for some people, while others feel physically ill or faint.
These physical symptoms may be scary, but they rarely are threatening to one’s immediate health Number.
Six, you feel, like everyone is judging you When you’re socially anxious it can feel like you’re under a magnifying glass all the time.
You feel overly conscious about yourself and project those worries onto other people about their perceptions of you, but just because you’re monitoring every detail about yourself, doesn’t mean everyone else is too In reality.
People aren’t as focused on you, as you think, and they likely have their worries too And number seven.
You are your harshest judge.
When you’re socially anxious, you might find yourself comparing how you think act, or look to others.
This self-criticism can seriously hurt your mental and emotional health and it’s important to treat yourself more kindly While it might feel like others, make connections more easily or have it so. Well, it’s important to remember that everyone is going through their things and they have worries and concerns.
Just like you do.
When it comes to social anxiety, it can be hard to interact with people or make friends when you’re overly worried.
The truth is, though, there is no normal when it comes to being social.
Everyone has their way of socializing with others, And you’ll find someone who you connect with on the same level.
There’s nothing wrong with leaving early or spending another night at home with your dog.
We hope you enjoyed this and found some comfort.
What have your experiences been with social anxiety? Leave a comment down below to share your thoughts.
If you enjoyed our video, please give it a like and subscribe to our channel for more content like this.
Thanks for watching – and we’ll see you at the next one.
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[Music] high functioning anxiety isn't actually considered a mental health diagnosis instead it's a term many people can relate to when they have anxiety and can still carry out everyday tasks at a functional level it could be the valedictorian in your class your co-worker who has an exceptionally polished resume or it might even be you it's no surprise that this has become widely relevant when roughly 40 million adults struggle with anxiety when someone tells you you're fine or always has a smile plastered on their face they might actually need your help here are 10 signs of high functioning anxiety 1.
You're an overachiever do you consider yourself a perfectionist type a and a planner people with anxiety always feel like they need control in order to feel at ease whether it means making big to-do lists showing up at a meeting early or staying up late studying for a test they already memorized by heart the individual stays busy in order to feel productive one research study shows that it's only when you feel in control that you can deal with stress two no is rarely used in your vocabulary getting things done becomes more important than your health if you sacrifice eating meals on time or cancel plans with friends to do someone else a favor you might have high functioning anxiety you'd rather suck it up and get the work done instead of saying no fearing that it might pile up otherwise you may also be afraid to reject others afraid that you'll hurt them so you bite the bullet and you hurt yourself instead 3.
What is sleep apparently never enough for people with anxiety how can it be when you're constantly tossing and turning in bed consumed by your worries anxiety doesn't need a reason to keep you up you have everything checked off your to-do list and still worry about a million other things 4. you crack cynical jokes for fun are you sarcastic or make jokes about dying chances are you aren't as happy as you seem when you tell the punchline if you're laughing and putting on a show when you're actually suffering this is anxiety it forces you to entertain and mask your intensities behind your witty combat remember you don't have to put up a front lower your guard and tell people what's going on 5. negative self-talk is common and it's so common that you don't even consider it negative just your usual way of thinking people with anxiety are the hardest on themselves they can stand in front of the mirror and pick out flaws at a snap of a finger or beat themselves up if they make one minor mistake they don't give themselves a break always seeking to be a better worker student citizen the list goes on six your coworkers consider you a mystery you might be the helpful reliable worker everyone loves so it's no surprise that you'll get asked to go out once it's time to clock out but you'll usually decline remaining an enigma other people will find it hard to read you not because you want to seem cold or detached but letting loose and socializing without preparing ahead of time actually terrifies you 7.
You're easily startled it's normal to get jumpy during a horror movie but are you startled even during the slightest disturbance afraid that others might find you spineless therapist and right says you may resort to unhealthy habits such as drinking drugs or endless social media scrolling as a distraction eight bad days are normal for you excessive ruminating panic attacks and an inability to relax have all become ingrained in your daily routines that good days become once in a blue moon but instead of outwardly complaining or calling up a friend to talk about it you might just bottle it up since it happens every week you worry that others will find you annoying or a burden nine you constantly seek validation anxiety makes rationality hard to achieve that's why the individual often seeks logic from others they fear their judgment isn't enough so they rely on the support and guidance of friends family and co-workers they don't mean to lean on people 24 7 but it significantly quiets down their loud thoughts on the flip side however some may worry about being a burden so they choose to suffer silently instead of reaching out to others 10.
You're afraid of letting people down you don't know how to break the news to your loved ones if you're not happy with your so-called dream career or don't want the same things as them you often succumb to other people's expectations working hard to be a role model and no matter how tired you are of being you your anxiety will push you to continue performing as if your whole life counts on it did you enjoy this video jaiden animations also covers her own personal struggles with anxiety we think her content holds value and will be helpful for you be sure to check out her videos and show some love thanks for watching you