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

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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.

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