Shame Attacking Exercises Reduce Social Anxiety

It’s not uncommon to think of treating a problem by introducing a little dose of that same problem to the system. Antibodies are the best example of such interventions. When it comes to anxiety disorders, the same principal applies. Even though the anxious person’s automatic response might be to avoid the anxiety-provoking situation, in the end, exposure to the anxiety making situation is the best treatment. In this link below, you will see a video of someone standing on the corner of the street, singing “Mary had a little lamb” to reduce social anxiety. You will read a few clips about some of the best ways to reduce social inhibitions, such asking a librarian that you are looking for a book on the art of farting!!

Have fun reading.

http://nymag.com/scienceofus/2016/11/how-to-get-over-social-anxiety.html?mid=fb-share-scienceofus

 

Published in: on November 17, 2016 at 12:08 pm  Leave a Comment  

When Doctors Don’t Know What is Wrong

by: G. Katie Dashtban, Psy.D.

A small percentage of people experience an array of conditions and symptoms that cannot be grouped in one category to meet any known medical conditions. The illness of these people is often non-treatable with conventional or even un-conventional medicine. The following are often reported as symptoms that occur in conjunction, although not always in an organized manner.

Pain symptoms that persist such as joint pain, headaches, abdominal pain, rectum pain, pain during intercourse or urination or during menstruation. Gastrointestinal symptoms that show up unexpectedly and don’t respond to medicine or medical findings such as nausea, bloating, vomiting, diarrhea, and intolerance of several foods. Sexual or reproductive symptoms that are non-responsive to medications such as sexual indifference, erectile or ejaculatory dysfunction, irregular menses, painful intercourse and difficulty achieving orgasm.

Exceptionally unusual neurological symptoms like paralysis or localized weakness, difficulty swallowing, urinary retention, double vision, dizziness and or impaired coordination, and general fatigue and sleep disturbances.

There used to be a name for the above cluster of symptoms in the diagnostic book of mental illnesses, (DSM-IV), it was called Somatization Disorder. Suffering from the above conditions can sometimes be due to psychic pain. Psychic pain is REAL; but its treatment is specific.

In modern psychology there is less mention of psychic pain primarily because such concepts cannot be easily verified by evidence-based research and methods. Most recently however, a different phrase, Hidden Emotions, which was first cited in the research of David Burns, M.D, unveils a lot. Hidden emotions are clearly “hidden” from the conscious awareness, and yet they are the driving force for many behavioral, cognitive and in this case medical symptoms. Patients with history of trauma or childhood adversarial conditions, those with history of sexual abuse and sexual trauma, and those with significant history of drug and alcohol abuse are more likely to fall victim.

In my clinical practice patients who are diagnosed with Somatization Disorder often do report a significant history of struggles with chronic traumatic events or self-destructive coping mechanisms. When left untreated and unaddressed, such struggles can morph into Somatization Disorder over the years. The hidden emotions are often in the form of some type of disappointment over the way things have turned out, or some type of severe grief that has not been healed, but has instead been forced upon the person. It is also a form of maintaining one’s opposition or anger toward someone, something, or some turn of events in the past.

One way to examine if your incurable medical symptoms are potentially due to unresolved hidden emotions is to use a Cost Benefit Analysis (David Burns, Feelinggood.com) where you would examine the advantages and disadvantages of changing your negative feelings such as anger or sadness against your medical symptoms. You might be surprised to notice the number of disadvantages in getting rid of your anger or sadness against your medical conditions. In other words, your somatization disorder is acting as a protective layer against facing those hidden emotions that are particularly painful. Careful psychotherapy can help address those unresolved hidden emotions such as grief, anger, disappointment, despair, fear and sadness. At that point, the psychic pain is no longer un-addressed, therefore it will no longer be poking itself out through un-organized and vague and incurable medical symptoms.

My name is Dr. Katie Dashtban, licensed clinical health psychologist. I have offices in Santa Cruz, Mt View and Fremont, CA, where I am the co-founder of Feeling Good Therapy & Training Center of Fremont. For more information visit: www.medicalpsychologyservice.com and www.feelinggoodtherapy.com or call: 510-400-6160

Published in: on June 23, 2016 at 6:56 pm  Leave a Comment  

An Overview of Aspergerian Versus A Neurotypical Mindsets

Persons with Asperger’s syndrome or high functioning autism could list a long list of challenges in their relationships. They often would tell you about their fear and anxieties of not fitting in, of feeling estranged and even unlovable. Likewise, Neurotypicals complain of their relationships with Aspies, often reporting feelings of rejection and being uncared for.

In this article the two mindset are examined. What is highlighted is the way things are Lost in Translation. Through two scenarios I describe what each mindset hears or interprets. I will refer to Asperger mindset as (Aspie) and the Neurotypical mindset as (NT).

Scenario1: It’s the day after a heated argument between a NT and an Aspie.

Typical thoughts of the NT: “I’ll just be cold and dismissive so that s/he can see how much they’ve hurt my feelings, and will come and want to talk about it. S/he will apologize to me.”

Typical thoughts of the Aspie: “By looking at the way s/he is gazing away and pouting, it is obvious they need some alone time. I will just stay out of the way. Besides, I wouldn’t know how to engage them, so might as well wait till they talk.”

Scenario 1: Revisited:

Aspies mindset forgives easily, is free of prejudices, less likely to engage in social manipulations, takes things as they are.

NT mindset needs time to forgive and sometimes cannot forgive without the support of the other person. Is more likely persuaded by prejudices like gender roles, and ageism. More likely to think of social situations in a creative way, therefore more likely to make up scenarios that might not be true, but hurtful to them.

Scenario 2: On a long road trip together.

Typical thoughts of the NT: “We can talk about things, sing songs and choose music together, we can pull over whenever we want and spend time wherever we like.”

Typical thoughts of the Aspie: “I’ll plan the route ahead of time, make sure we make it through our destination with specific number of stops and I’ll be sure we won’t run out of gas or food or get fatigued by carefully arranging our stops and rests.”

Scenario 2 Revisited:

Aspie’s mindset is excellent in planning ahead and taking specific precautions against mishaps. Therefore safety and reliability are Aspie’s forte.

NT mindset calls for spontaneity and readiness to deal with the unexpected. What is considered safety and precision for the Aspie can be translated to overly stuffiness for the NT.

So the take home message here is that the two mindsets have advantages and disadvantages. Those who are struggling with depression and anxiety in their relationships with an Aspie or a neurotypical might benefit from learning about each other’s mindsets. This learning could alleviate many misunderstandings and therefore bring Aspie’s and NT’s closer to one another.

Dr. Dashtban, Psy.D. can be visited on www.medicalpsychologyservice.com with offices in SC, Mt View, Fremont.

 

 

Published in: on April 29, 2016 at 9:50 am  Leave a Comment  

Mood disorders, like diabetes and obesity, found to be risk factors for heart disease and stroke.

Are Mood Disorders And Metabolic Syndrome related?

by: G. Katie Dashtban, Psy.D. Licensed Clinical Health Psychologist

Metabolic Syndrome is characterized as a cluster of several health conditions such as diabetes, heart disease and obesity. According to Wikipedia, The word “syndrome” means a set of medical signs and symptoms that are correlated with each other and often with a specific disease. It derives from the Greek language, which translates to “concurrence “.

Patients often don’t know they are candidates for this syndrome, because they are likely to look at each of their conditions as a single problem. For example, most patients are told by their physicians that their blood sugar is at the cusp of being considered a diabetic, and that if they exercised more and ate less sugar promoting foods (starches, simple carbohydrates) they can reduce their blood sugar and be on the good side again. However, metabolic syndrome is not one disease, rather, it’s a combination of different kinds of diseases, including psychiatric mood disorders.

Over the last decade, several bodies of research are showing that there is a strong correlation between mood disorders and metabolic syndrome. Patients diagnosed with major depressive disorder are at increased risk of becoming overweight, and patients with bipolar disorder may have increased risk of abdominal and overall obesity. Conversely obese persons seeking weight-loss treatments may have increased rates of depression and bipolar disorder.

Furthermore, it has been proposed that the central nervous system, very similarly to the pancreas, is affected by chronic abnormalities in metabolic processes. The phrase “Metabolic Syndrome Type II” has been used in the literature as a neuropsychiatric syndrome in which alterations in metabolic networks define the course of the disease.

What all of this means to the general population is two folded. First, recognizing that symptoms of diabetes, heart failure, obesity, and high cholesterol are not independent from one another, but instead each are different manifestations of the same disease. Secondly, mood disorders can and sometimes are part of the same disease and they can increase the risk of fatal heart disease and stroke.

In conclusion, seeking professional help for the treatment of depression, anxiety, unexplained irritability and similar mood issues might prove to not only improve your quality of life, it might even help save your life.

I am Dr. Katie Dashtban, Licensed Clinical Health Psychologist. I am co-founder of Feeling Good Therapy and Training Center and the founder of Medical Psychology Services, with offices in Santa Cruz, Mt View and Fremont. Visit medicalpsychologyservice.com or like my Fb page at facebook.com/MedicalPsychologyServices/

 

Published in: on March 22, 2016 at 7:16 pm  Leave a Comment  

Identify Your Self Defeating Beliefs

Identify Your Self Defeating Beliefs
by: G. Katie Dashtban, Psy.D.

It is quite common for most of us to have a set of commonly held core beliefs about ourselves, about the future and about people in our lives. These core beliefs are often so deeply embedded in our, where else, “cores,” to the point that we are not consciously aware of them. In this article I am going to point out 7 common self defeating core beliefs and your job is to pause with each and wonder to yourself if you hold such core beliefs and if so, ask yourself “what is it worth to me to change that core belief?”

1) Achievement
a) Perfectionism. Believing that you must never fail or make a mistake. That people will not love and accept you if you have flaws or show vulnerability. That your worth as a human being is based on your achievements, income, looks, talent, or some other type of status.

2) Love
a) You believe that you must receive everyone’s approval in order to be worthwhile. That you will not taste happiness unless you have someone in your life who romantically loves you. And, that if you receive criticism or rejection it proves that there is something inherently wrong with you.

3) Submissiveness
a) You believe that you should do your best to please others and you are willing to sacrifice anything for it. You are afraid of conflict and think people who care for one another should never be at odds with one another and should certainly not have arguments. And you believe all the problems in your relationships are somehow your fault.

4) Demandingness
a) When in conflict, you put the blame on others. You feel entitled that others should always treat you in the way you expect. And you believe you are right and everyone else is wrong.

5) Depression
a) You believe your problems could never be solved and that you will never feel truly happy or fulfilled. And you believe that you are basically worthless, defective or inferior compared to others.

6) Anxiety
a) You believe that you should always feel happy and confident and in control. That anger is dangerous and should be avoided at all cost, and that feeling intense emotions such as depressed, angry or jealous should be avoided. You believe people are powerful, demanding and manipulative. And, you are under the spotlight; everyone is looking at how you carry yourself and is ready to criticize you. And lastly, you engage in magical thinking: “If I worry enough, everything will turn out okay.”

The above commonly held self-defeating beliefs are strongly associated with most of human suffering. Learning to recognize them can be tremendously helpful.

I am Dr. Dashtban, licensed clinical psychologist with practices in Santa Cruz, Mt View and Fremont California. Call me at 831-621-1150 or post on my facebook page: http://www.facebook.com/MedicalPsychologyServices

Published in: on January 17, 2016 at 3:11 pm  Leave a Comment  

Holiday Blues, Comfort Food, Rituals; I Want Out!!!

When it comes to this time of the year, we are bombarded with emotionally charged messages by song lyrics, colors, smells, and traditional rituals. Ask almost anyone what does celebrating the holidays mean to them and you’d hear a slew of things they do (gift buying, planning parties), things they prepare to eat or serve others (sweets, special recipes), and how they plan to spend time with families, friends, coworkers.

I personally happen to like several aspects of the holiday season and I am guessing many of you do too. But I know many of us feel a sense of sadness, tenderness, vulnerability, and even anxiety during these very times. Ever wondered why that is the case?

Socrates said “An unexamined life is not worth living” as he was on trial for encouraging his students to challenge the accepted beliefs of the time and think for themselves. So I encourage you to ask yourself, how come I don’t think I must spend time and money in offering gifts at other times of the year. Or why is it that I particularly crave things with cinnamon, clove, nutmeg and ginger during December, and not much in July? And, how come I don’t have this expectation that I should be with my family on any particular evening of the year except on December 24th? And though you feel tender and sad when you think of the loss of a loved one, how come you particularly allow yourself to grief your worst during this month?

I am going to take a risk of sounding insensitive and say the answer to the above questions is: because you let yourself.

As I’ve treated persons feeling depressed, anxious and lonely during these months over the years, I’ve learned some typical negative beliefs that fuel the negative emotions experienced by most. Here is a list of commonly held beliefs:

  • Christmas is a special time of the year. If you don’t have a special someone you are bound to have a bad time.
  • I get to have all these amazing treats because they only come along once a year, I deserve it because I’ve worked so hard.
  • If I don’t make it to all the holiday events at work and at home, people might think I don’t respect them; or that I am not a team player; or I might not get that promotion or close that sale.
  • I miss my loved ones at this time of the year because I really care that they are gone, this means I am loyal to them.

I’d like to suggest that you examine your own beliefs and see if you still agree with them.

Mark your calendar for Saturday December 19 from 10:30 to 12:00 to come to my free seminar at the Center For Health to learn of ways to examine your own upsetting thoughts regarding the holiday season. RSVP to www.facebook.com/MedicalPsychologyServices

I am Dr. G. Katie Dashtban, licensed clinical health psychologist. I have offices in Santa Cruz, Fremont and Mt View. I can be reached at 831-621-1150 and by visiting www.medicalpsychologyservice.com

Published in: on December 16, 2015 at 11:18 pm  Leave a Comment  

The Imperfect Aspects of Perfectionism

One of the most common causes of emotional suffering is perfectionistic tendencies.

We fall for, and get mesmerized by, the sound of voices in our head that point out our vulnerabilities, convincing us that we will sustain extreme humiliation or even death if we didn’t protect our egos in a defined way. This wisdom is not particularly apparent to most of us. The mesmerizing quality of these threatening voices fool our solid self. We often don’t realize that the thought is nothing but an over-generalization, or mind reading, or fortune-telling.

In the following scenario, I have developed a hypothetical situation where a person experiences anxiety, anger and depression over the observation that they have a medical problem that makes it hard for them to work. The following sentences are those that this person might say about their circumstance:

  1. If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

  2. People might think I’m loosing my grip.

  3. Then I won’t be a candidate for that promotion.

  4. And if I don’t get promoted, it’d mean I was just being mediocre all along.

  5. And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

  6. And that would mean I’m a loser, someone that is unworthy of even being alive.

Now, imagine a friend of yours has just approached you with the problems mentioned in the above scenario. This friend is quite dear to you and has come to ask for some help, wishing to feel better. The conversation between you and your friend might go something like this:

Friend: If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

You: Oh dear, well you do sound like you are in a great deal of pain and yes people aren’t usually at their best when in pain. But is there anyone at work that might understand your situation and be a little helpful? Or perhaps you could just call-in sick today, or maybe just do some basics that would not be too tedious, making it less likely to make mistakes.

Friend: But then I won’t be a candidate for that promotion.

You: Well, I suspect they make those decisions based on your overall qualifications, not just your need to mind your health one day. I see that in general you have such a high work ethic and do the job in the most amazing way. In fact, you worry about making mistakes if you went in with this migraine, which suggests your high work ethic–isn’t that what they factor in when looking to promote someone?

Friend: But if I don’t get promoted it’d mean I was just being mediocre all along.

You: Well, to my way of thinking, someone being mediocre might not really care much for the quality of work they offer, whereas your job performance has seemingly been amazing so far.

Friend: And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

You: Well, yes sometimes people wake to realize that they don’t really care for their work and feel they have wasted years of training and hard work. You on the other hand seem to love this work since you put such high value into doing it to the best of your capability.

Friend: And that would mean I’m a loser, someone that is unworthy of even being alive.

You: Oh dear, I can see that being sad and disappointed over having this migraine has taken a toll on you. But all I see in front of me is a carrying and responsible worker who puts lots of heart into the work they do. To me that is quite worthwhile.

And, the kicker is, this is a Double Standard that we play against ourselves. We are so likely to speak with compassion for a friend. My question for you is: Wouldn’t you choose to offer the same level of compassion for yourself?

Why Are Patients With Body Dysmorphic Disorder So Self-critical?

Anxiety or Eating Disorder?

Body dysmorphic disorder (BDD) is actually a type of anxiety disorder, not a type of eating disorder. The affected individual focuses on physical flaws that other people may not notice. The cause of BDD is still unknown. But most likely it results from an inborn biology plus environmental factors.

Brain studies have confirmed that brain imaging results differ between subjects diagnosed with BDD and others who have not been diagnosed with this disorder. For example, BDD individuals are more likely to report feelings of disgust or repulsed when viewing images of their own faces versus control groups. Similarly, brain-imaging studies show alterations in two areas of the brain of persons with BDD: the visual processing center in the orbitofrontal cortex, and the frontostriatal system, which affects emotional reactions and behaviors. Theses studies suggest that brains of people with BDD are processing visual information differently in their brain, and this finding might explain why their perceptions differ from those of other people.

Exposure Therapy

A good majority of persons affected by this type of anxiety disorder might mistakenly resort to restricting their caloric intake in an effort to lose weight and therefore look better (in their own eyes). Clinicians might even mistakenly look at this issue as an eating disorder. Unfortunately, no amount of weight loss, or plastic surgery, or covering the body with make up, clothes, jewelry, etc. will present relief.

Just like many other anxiety disorders, the most effective treatment is exposure therapy (read more). The idea is to desensitize the brain at the site or image or thought of the dreaded object, in this case the part(s) of the body that brings out the most disgust in the mind of the person until such time that the brain will no longer react by the same emotional intensity as it did before. It is as if we have over charged the circuitry to the point of disconnecting the relationship between emotional disgust and the site of the dreaded body part.

I am Dr. Dashtban and in my practice I treat anxiety and depressive disorders associated with medical conditions. If you have any questions regarding successful treatment of BDD, give me a call at 408-458-8222, 831-621-1150 or write to me at drdashtban@medicalpsychologyservice.com.

The Fears You Don’t Face Keep Frightening You For An Eternity, Want A Short Cut?

I have learned of a legend in the Tibetan Book of the Dead by reading about it in Dr. David Burns’s book titled “When Panic Attacks,” (p. 251). Here is a short version of it:

Facing a Monster

According to this legend, you wake up in a dark place after you die. A scary monster appears from the dark that represents your worst fears. Facing this monster, you have the choice of surrendering to it, which is going to bring you the relief of defying it for good, or you may run away which gives you the momentary relief of the fear you are facing. But if you run away, out of the darkness comes another monster that requires you to make the same choices, surrender so you can find relief forever, or run away from it for now. Naturally, the option of running away will eventually wear you out, and you will feel defeated by the monster while remaining frightened for life. However, surrendering to it gives light to the fact that it was a toothless monster, that indeed it was only an illusion and that it might even turn out to be funny that you held such a strong conviction about it even being a scary monster in the first place.

Eradicating Anxieties and Fears

Learning from the wisdom of this legend, there is a very effective technique of eradicating anxieties and fears called the “Exposure Technique.” The trouble is that most people get mesmerized by the fear, say the fear of heights, and avoid going to high places because they don’t like to feel dizzy and anxious. Or in the case of shy people, they would avoid parties or people altogether, because they don’t like to feel insecure and inadequate. This avoidance unfortunately only fuels your fears however. In order to be relieved from the anxiety, you will need to get exposed to it, over and over, until it no longer triggers those uncomfortable feelings anymore.

Confront Your Fears
Exposure therapy can be done in several ways. One way is to literally confront your fears in a real form. For example, someone who fears getting sick and dying would purposefully shake hands with someone who has cold symptoms. They will then see in real life that even if they do catch the cold virus, at most they would feel under the weather for a few days, but they won’t indeed die.

Another form of Exposure Therapy is Cognitive Exposure. In this form you face your fears in your mind’s eye. You think and visualize the dreaded time or the dreaded experience, and you stay with it in your mind’s eye and maybe repeat to yourself a verse such as “I am not afraid of you” and you do this so many times until the fear finally goes away.

Repeated Exposure

Lastly, there is the Interpersonal Exposure technique. For example, in the case of someone with Social Phobia, they might have to actually go to a crowded place such a coffee shop, and scream: “I am shy.” They might have to stand a grand feeling of shame and humiliation at first, but repeated exposure to various social situations and indeed starting a conversation with people, will give the brain a chance to see that it needs not call the “fire department,” nothing bad is happening, so the fear will subside.

In short: Exposure Therapy is the short cut to what otherwise can be a lifetime of fearfulness and anxiety.

5 Tips to Keep Pain And Sadness At Bay During The Fall Season

If you are someone who can tell the weather is changing not by looking out the window, but by the way your mood feels or the way your body feels, then you know about the effects of season changes.

Some people are particularly sensitive to low levels of sun light and react to overcast days by feeling blue. This condition is called Seasonal Affective Disorder or SAD. Moreover, people with chronic pain such as fibromyalgia, arthritis, or general muscle pain are often particularly sensitive to feelings of depression. In other words, depressive feelings make their pain worse. And when you have increased pain, you are likely to feel more depressed.

It’s like we are talking about a circular motion, where one condition makes the other worse and vice versa.

It does not really have to be this way. Here are some tips to keep this circular motion from starting off in the first place:

1-      Develop a conscious understanding about two links: A) the link between the weather and mood, B) the link between mood and pain. Be prepared; acknowledge within yourself that these links exist.

2-      Become good friends with the weatherman! Check the weather’s patterns and begin to learn the patterns of sunny hours or sunny spots. Then go out of your way to schedule an hour of being out in the sun on a daily basis, or at least 3 times a week.

3-      Ask yourself “what thoughts are just going through my mind.” Examples of negative thoughts that affect your mood and therefore your pain are: “I hate Fall and Winter, I just have to suffer through them.” Notice a strong element of All or Nothing Thinking in there. Instead, replace that thought with something like: “Although the overcast weather makes me feel down and my pain gets worse that way, but I will find sunny patches when I can allow the sun rays get absorbed in my body, then my body won’t have that negative reaction and I can get through the season without necessarily feeling worse.”

4-      Remain physically active. Even though the warmth of the summer days make the idea of being physically active more enticing, but you know that you owe it to yourself to give yourself the benefit of keeping your joints and your muscles active. Hibernating, staying in bed, resting more than what your actual rest times are will back fire. Look into going for a walk, sign up for some gentle swimming, see about taking up Pilates or yoga or both. You’ll be doing your pain condition and your mood a lot of good this way.

5-      Talk openly about your condition and ask for help. There is no shame or stigma on how you are genetically formed. So, your brain reacts to overcast conditions. That is the same as indicating the color of your eyes. Let people know how you are planning on taking charge of your needs by scheduling “sun times” and by maintaining a positive attitude about the whole thing and by scheduling physical activities.

I am Dr. Katie Dashtban. As a Medical Psychologist, one of my jobs is to help people make attitudinal and behavioral changes that help them in coping ideally with their medical conditions.

Call me or write to me with any questions: 831-621-1150 or 408-458-8222. www.gettingpastpain.com or http://www.medicalpsychologyservice.com

Published in: on September 12, 2012 at 12:39 pm  Leave a Comment  
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