Addiction & Compulsion

/Addiction & Compulsion

SMARTPHONE ADDICTION PART II

What are the signs of Smartphone Addiction?

By Dr Eva Fisher C Psych

In case you haven’t noticed, there are definitely warning signs of Smartphone overuse. Most people easily admit that they are “addicted” to their Smartphone simply because they are so dependent on this one little device that connects them to the outside world from the minute they wake up to the moment their eyes close.

Smartphones help us stay in touch with family, check in with friends, keep all their work info and contacts in one place, instant message, facetime, social media, music, news and everything else going on in the near and distant world.

So, are you a Smartphone Addict?

Let’s look at the signs. Are you:

Increasing amounts of time spent on your Smartphone, and less time with others?

Compulsively having to check your Smartphone;

Finding it impossible to ignore an alert on your Smartphone;

Spending more and more money on Smartphone data plans, online gaming, freemium apps, apps, Accessories, protective cases, etc?;

Using your Smartphone while driving your car despite laws prohibiting such activity?;

Finding all or almost all your upsets happen from events involving your Smartphone;

Near-death experiences like almost getting hit by a car while wearing your device earbuds;

Going to sleep with your Smartphone under your pillow, beside your bed;

Using your Smartphone to help you fall asleep;

Using your Smartphone when you can’t sleep;

Getting into conflicts with your close family, friends, romantic partners because you’re always using your Smartphone and ignoring them;

Having to check your Smartphone when you’re in a session with your therapist;

If you answered yes to two or more or these signs, it would be a good idea to schedule an appointment with a psychologist.

Social Anxiety in the Digital Age & IRL

Dr Eva Fisher M.A., D.Ed. C Psych

When you spend most of your waking hours and your twilight pre-sleep hours in front of a small lit screen, how will feel when making eye contact with a real life person?  What if it’s a person you recently met and who you want to get to know better?

This scenario is a perfect storm for an anxiety attack, above and the usual panic, that you are now being judged and rejected as a nerd of the highest order who can hardly put two words together without stammering and getting red in the face?

The chances are good that you feel awkward, weird, tightness in your chest, have some shallow breathing and find it hard to speak naturally?

You may start to wonder if others notice that you’re tense, and wonder if they are judging you, rejecting you and deciding that you’re a loser?

You have just experienced an anxiety attack IRL, that may be made a lot worse because of your habitual smartphone isolation.

The DSM-5 describes the signs of such attacks as social phobia, a persistent or strong fear of one or more social or performance situations where you are exposed to unfamiliar people or to possible scrutiny.  You may fear that you will act in a way (or show signs of anxiety) that will be humiliating or embarrassing.  You may be aware that the intensity of your fear is exaggerated or excessive.

Ruling out the cause of your distress as due to a chemical substance, or a medical condition like stuttering, trembling, or palsy, you have a real time case of social anxiety.

Is there an antidote?

The good news is yes, and the bad news is – it may not be fast and will require some work.

Overcoming social anxiety can be managed with some help.  You need to face reality. Here are some questions to ask yourself:

  1. Do you feel more comfortable (safe, secure, at ease) when you are alone with your smartphone and inter-relate with your friends with text messages only?
  2. Do you feel, or have others told you, that you spend too much time playing with your smartphone?
  3. Whose mind is having the thoughts that other people are observing you and judging you a social cripple? Is it yours alone?
  4. Do you think you can train or trick your mind into calming down?
  5. Are there some mental tricks you ever use to feel relaxed in social settings?

If any of these questions (or answers) are causing issues in your life, contact us for a consultation.

 

And tune in next week for the next installment of Social Anxiety IRL.

Smartphone Addiction – Part I

By Dr. Eva Fisher, c. Psych.

How your Smartphone trained your brain.

Smartphones are smarter than you are. Really. What’s the last time you got a notification and simply ignored it? Bet you couldn’t keep concentrating until you checked it out.

There’s no shame in it, your Smartphone really wants you addicted. It’s deliberately designed to do that.

The technique that Smartphones use to get you hooked, and keep your hooked, is called Classical Conditioning, and a scientist called Dr. Pavlov dreamed it up. Here’s how.

In the 1920s, Dr Pavlov discovered that he could get dogs to salivate at his command.

The first step was this. When the animals got a bowl of food, he arranged it so a bell would ring at the very same time. Each time they were fed, he rang the same bell.

Within a week, the animals learned that when the bell rang, food was on the way.

It worked.

But then, Dr Pavlov tried something different. He was curious what would happen if he rang the bell, but withheld the food.

What happened? The animal’s salivary glands became active at the sound of the bell alone, whether or not there was food, and whether or not they were hungry.

The animals had learned to associate the sound of the bell with just the *MEMORY* of the food. Their brains had become conditioned to associate the sound of the bell with the anticipation of the reward, e.g., the food.

And so, learning theory, called Conditioned Response came into being.

Smartphones use this same Conditioned Response to train you to pay attention, and to have you anticipate a reward whenever your Smartphone notifications, or alerts, go off. Doesn’t matter whether you choose the bells, chimes, or your fave song, it always works.

Your brain has been trained to respond, even when there is no message waiting from your bae or BFF.

You can’t turn your brain off, but you can definitely turn off your Smartphone.

But I bet you won’t.

Smartphone addiction help

Smartphone addiction

Post-traumatic Stress Disorder

Cory, a veteran police officer, draws his gun just as a bullet whizzes through his hair, grazing his scalp.

Emma, a bank employee freezes when a gunman holds her hostage for several hours in the safe room.

Anthony, a military officer in Afghanistan, runs through crossfire to retrieve the corpses of his buddies.

 

These images are all too familiar to TV audiences, but nothing can simulate a near-death experience like the ones described by Cory, Emma and Anthony.

They all suffer from Post Traumatic Stress Disorder.

Posttraumatic Stress Disorder (PTSD) occurs after someone is exposed to a life-threatening traumatic event. Commonly this happens after coming back from a war zone, but it can happen after any traumatic or life-threatening event.

Although many people experience very disturbing things in war or security situations, not everyone will develop PTSD. Both the Canadian Department of National Defence, and the United States Department of Veterans Affairs that 11 to 24 percent of veterans from the Iraq and Afghanistan wars have PTSD.

The prevalence of PTSD in the general population is about 7 to 8 per cent.

What are the signs?

Fight or flight is an instinctual human reaction in the face of extreme danger, when you have milliseconds to decide whether to run away to safety or to fight to defend yourself. After a traumatic event, this ”flight or fight” reaction in the body is damaged and the person freezes up when sensations, images, or feelings they had at that time recur in the here and now.

Physiological signs of fear, like rapid heartbeat and profuse sweating activate emotions of acute fear and strong normal responses to threatening situations often appear in PTSD sufferers in situations where there is no danger present.

PTSD usually develops within three months of the traumatic event, but can occur much later in life.

Flashbacks

Some of these symptoms are referred to as Re-experiencing symptoms. These include flashbacks of the event, which can bring extreme stress on not only the mind, but also the body in terms of sweating or a racing heart. Bad dreams and frightening thoughts are also typical. The traumas from the past become torturous again, in the present.

Avoiding Triggers

The next category is Avoidance symptoms. This is when the sufferer goes to extremes to avoid reminders of the traumatic event. This can cause people to change their clothing, hair, and even to quit their job to avoid things that trigger memories and to have deep feelings of shame or guilt.

Hyper-vigilance 

The last category of symptoms is called Hyper-arousal symptoms. This is when a PTSD sufferer becomes very easily stressed or fearful for their safety, such as checking that doors and windows are locked, feeling suspicious of parked cars, strangers and anything they used to consider benign.  This effect of being easily startled can also lead to angry outbursts, constant vigilance for possible signs of danger, and difficulty falling asleep or staying asleep. These symptoms make people more vulnerable to overuse of drugs and alcohol.

Consequences

Unfortunately there is still a stigma surrounding PTSD. Because it can be such a terrifying and disruptive mental state, sufferers can be labeled as “crazy,” “dangerous,” or “violent.” Other stigmas are general beliefs that since in today’s wars people chose to go to combat, in a sense they brought it on themselves.

Many PTSD sufferers reported that they avoided early treatment because they did not want to be considered to have a mental illness. However, PTSD can be cured through different forms of therapy.

Group treatment programs for PSTD are delivered over 6 to 12 weeks, while individual therapy is customized to each person’s needs.

What happened to them?

Cory was in psychotherapy for 11 months, and eventually retired from the force  to work as an investment advisor. He sometimes remembers the trauma, but can now deal with stressful feelings realistically.

Emma was off work for six months before she was able to step foot in the bank again.  With the help of a psychologist, she eventually felt strong enough to return to her job.

Anthony was released from the military after intensive individual and group psychotherapy.  He still has survivor guilt. He works part-time as a security guard.     

A psychologist can help you learn more about PTSD and its effects, deal with explosive anger, and help you become aware of the signs leading to a recurrence.

If you or someone you know is struggling with post traumatic stress it would be a good idea to schedule an appointment with a registered psychologist.

 


Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisherFacebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych
All rights reserved. Copyright protected.
Photo Credits: www.flickr.com/photos/copsadmirer/5141029384 Oscar in
the middle
http://www.flickr.com/photos/alancleaver/4446487398 Alan
Cleaver

Anxious Moms, Anxious Kids

“Your children are not your children, they are the sons and daughters of life’s longing for itself”

-Kalil Gibran

From the moment they realize they are pregnant, women often shift from being “me” to being a “mom-and-child”. This is re-enforced through the early years, and most mothers feel both pride and pangs of separation when their little ones go off to school.

Unfortunately there are moms who find it impossible to let go at any time.  These moms share and peer into every corner of the child’s life and act as if their child’s life is their own.  They cannot see the child as a separate person; they see their child’s identity as being one with theirs.

Moms who interfere with their child’s normal attempts at independence have anxieties of their own, that are triggered by the child’s growing away from her – really just growing up. Unconsciously they see their kids as an extension of themselves, and constantly feel the child doesn’t really know what’s best and so she must intervene.  In reality the child’s existence must make up for their own childhood failures and deprivations.  And so they relentlessly plan, schedule, car pool, push and prod their kids into a facsimile of “mini-me”.

In fact, even when the “kids” are forty-year-olds, these moms may still be like this, and still be anxious about their children making the “correct” decisions in every part of their lives.  These moms are “micro-manager moms”, and in trying to control every aspect of their children’s lives they create unnecessary stress for themselves and immaturity and dependency in their offspring.

Paula, a 13 year old, was referred to a psychologist by her pediatrician for anxiety and self-esteem issues. In therapy with children, confidentiality is most important to give the child a place to think and express  things that may be taboo at home.

She was brought to every appointment by her mother, although Paula could easily have walked there after school.  After a few sessions, Paula confided her fears that she might be gay and how these doubts affected her self-esteem. The following day, the psychologist received a call from Paula’s mother who was incensed that the psychologist had discussed sexual matters with her daughter, demanded a thorough summary of each Paula’s sessions, and promptly cancelled future appointments.

Paula’s mother illustrates the micro-manager mom’s issues with boundaries and respecting confidentiality.  She had intruded into her own daughter’s therapy, effectively destroying Paula’s attempt to establish her own identity and raising Paula’s post-treatment anxiety even higher than it was before.

As children grow up and see their mother’s worrying and micro-managing approach, they may take on this behavior themselves as they grow up. If they are used to their mom always interfering, asking details, criticizing, and saying how they should feel and what they should say or do in every life scenario, such behavioral copying and low self-trust becomes endemic. The results can become generational, almost like a family habit.

Anxiety is serious, and the best way to treat anxiety is with psychological treatment by a trained professional. This is particularly important with anxious families and micro-managing moms, as these are serious external influences affecting the anxiety in the child.

Anxiety can really degrade the quality of living as a result, and addressing it with a professional is an important and effective investment of time and money.


Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisherFacebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych
All rights reserved. Copyright protected.

Online dating facts and fictions 2015

In the 2012 Quebec film Roméo Eleven, a shy young man with cerebral palsy and a slight limp poses as a successful businessman in an evolving romance with an online girlfriend.  In real life, he is a part-time bus boy at his father’s restaurant.  Online he tells his girlfriend that important business trips and client requests prevent him from meeting her in person.

Romeo is the young man’s alter ego, his idealized version of himself.  In his fantasy life, he is the ultimate cool dude, with clothes and an attitude to match.  In contrast, his real life family treat him with the solicitousness that is reserved for the infirm, the aged and those deemed by society as “defective”.

Romeo’s story is a poignant depiction of the role of fantasy in online romance, where you can pretend to be your ideal self with little risk of exposure.  Online romances hold the promise of being admired as the person you wish to be, envied for the money and power you wish you had, if only nature and fate had been more kind.

Tell me lies, tell me sweet little lies

Most people don’t lie to the same degree as Romeo on their online dating profiles, but sneaking in some fibs to look more appealing to potential partners is common.  OKCupid.com, a very popular dating site, looked at data from about 1.5 million people to figure out which lies are most common.

In its findings the average person is about two inches shorter and 20 per cent poorer than they claim to be. Other ways people tend to deceive—putting up old pictures and women apparently claim to be bisexual more than they actually are. Other typical lies have to do with age, weight, marital status and employment.

People lie about these things, not necessarily to trick people, but sometimes to get through a search filter so they can have an opportunity to meet a wider range of people. The chart below shows how many messages a man gets, depending on his age and “reported” income. It shows men, especially older men, receive more messages if they report earning more money.

datingstats

Does online dating work?

Besides all the misrepresentations, online dating sites are among the most popular ways to meet a partner. In fact, statistically it is more likely to meet someone online than in more traditional locations such as bars, work or school.

At the University of Chicago, psychologists researched marriages from 2005- 2012 to see the correlation between online dating and happy marriages. They found that people who met online did tend to be slightly happier and more satisfied than their counterparts and were less likely to divorce. As a side note, the study was funded by the dating site eHarmony, but they claim is completely independent.

Dan Slater, who wrote a book called Love in the Time of Algorithms, asks an important question about how the technological revolution is affecting our love lives. One of the main questions: why should we settle for who we’ve got, when mouse clicks away there are thousands of people who we may be more compatible? He finds that although online sites usually produce first-time dates where two people hit it off, it is extremely difficult to predict long-term compatibility.

Online dating may have some flaws, but it’s still a go-to place to meet people in a tech-savvy culture.

Just beware of the sand traps before you leap in, and don’t disregard the warning signs when things don’t add up. If you keep meeting people who lie or exploit you, it would be a good idea re-assess.

Meeting  with a psychologist who has experience in these areas could be helpful.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisherFacebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych All rights reserved. Copyright protected.

The tight grasp of hoarding

“The price of anything is the amount of life you exchange for it.” -Henry David Thoreau

Many of us hold onto things that we don’t need. Even the most organized person might have a drawer full of expiring coupons, another full of little shampoo bottles from hotels, a basement full of souvenirs from childhood or notes from university.

Keeping items like these may be based on not wanting to waste, thinking of future use or for sentimental reasons. Yet, if these piles grow and start to overtake your home and you are can’t get rid of them, you may be hoarding.

Compulsive hoarding is a pattern of behavior that is characterized by the excessive acquisition of and an inability or unwillingness to discard large amounts of objects that cover the living areas of the home and cause significant distress or impairment.[1]

The recently revised Diagnostic and Statistical Manual of Psychiatric Disorders (DSM-V) has distinguished hoarding a category separate from Obsessive Compulsive Disorder (OCD) because people who hoard have treatment needs that are different from typical OCD treatments.

According to the DSM-V, approximately two to five per cent of the population has a hoarding disorder. It may start during childhood or in teen years but doesn’t usually become severe until adulthood.

While hoarders may find comfort in their piles of things, hoarding can be detrimental to health and safety and cause distress in relationships. Family members who live in homes full of stuff can be affected and others, such as landlords, can also be negatively impacted. Hoarders can become more attached to their stuff than to the people around them.

One investigation found that in the homes of hoarders 45 per cent could not use their refrigerators, 42 per cent couldn’t use their kitchen sink or bathtub, 20 per cent could not use their bathroom sink and 10 per cent couldn’t use their toilet.[2]

Cluttered lives

James hated going home after work. He tried to avoid being in the same room as his mother because it made him feel sick to be around her.

James couldn’t afford his own place yet, but was desperate to move out as soon as he had enough money.

James’ mother was a hoarder.  Every room in the house was filled with stuff – James called it junk – and even the corners had junk piled up to the ceiling.  It had been this way all his life growing up in that house where he was too embarrassed to ask friends over after school, so James just kept to himself most of the time.

James’ mother never cooked since the kitchen was too crowded and the counters were piled up with stuff that didn’t belong in a kitchen at all. They usually ate take-out or had pizza delivered. Sometimes he lost his appetite as soon as he got home and didn’t eat at all.

James’ mother and father didn’t’ have lives either.  James and his father usually watched TV together during the evenings since there was no room for another person to sit down because of all the clutter. James and his father felt hopeless that things would ever change.

The last time they had cleared out all the junk when James’ mother was out of town visiting her sister. But within 3 months, James’ mother had gone shopping, visited flea markets and garage sales, and the rooms were soon piled up with clutter all over again.

Why hoard?

The reasons why people hoard are varied. Hoarding often runs in families and frequently accompanies other mental health disorders like OCD, depression, social anxiety or bipolar disorder.

Hoarding is often about fear and perfection. Many hoarders are terrified that they will make the wrong decision about what to keep or throw out, so to avoid regret they will keep everything. The anxiety that comes with throwing things out can be paralysing.

In some cases hoarding can be in response to a traumatic event such as losing a spouse or child, found Dr. Jessica Grisham of the University of New South Whales. This is especially relevant if symptoms of hoarding appeared around the time of the event. This behaviour then becomes more about filling an emotional void with lots of stuff.[3]

Letting go

While parting with junk is a very emotional, anxious-ridden process for hoarders, there is treatment available. However, it is not as simple as getting rid of all their stuff because they could easily revert to old patterns.

Cognitive Behavioural Therapy has been found to work, although more so for middle aged hoarders than older ones. It can teach the person to deal with their emotions, understand why they do what they do and teach them how to deal with their emotions in a healthier way. This therapy has to be focused for the person’s specific needs and tends to use techniques of exposure and response prevention.

Medication can also be effective in dealing with hoarding, usually SSRIs in combination with Cognitive Behavioural Therapy.[4]

If you or someone you know is hoarding, the first step is to see a psychologist.

If you are interested in learning more, The New York Times recently produced a short video about a hoarder being evicted from his house.


[1]  Frost, R., & Hartl, T. (1996). A cognitive-behavioral model of compulsive hoarding. Behavior Research and Therapy, 34

[2] Ayers, Catherine R.  “Types of Hoarding,” http://www.ocfoundation.org/hoarding/types.aspx

[4] http://www.ocfoundation.org/hoarding/medication.aspx


Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisher, Facebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych
All rights reserved. Copyright protected.

Cutting Remarks

It takes a lifetime to learn how to handle disappointment, and being a teenager doesn’t help much when things get rough. I was wondering what would cause a beautiful, smart 15 year old like Briana to get a pack of her dad’s razors and some disinfecting lotion from the medicine cabinet and deliberately carve small evenly spaced slices up and down her arms and legs.

It didn’t help when her mom walked into her room and freaked out either. She couldn’t know that her mom would bring her to see me, and that she’d land up having to talk about what happened which was why she was sitting in my office. She couldn’t tuck herself any more tightly into the corner of the sofa without disappearing completely, trying to avoid my eyes and smoothing the long sleeves of her shirt.

And looking at the floor, she whispered that all she wanted was to escape from the bad feelings when her friends at school had turned against her.

In 1921, Freud proposed the pleasure principle is the instinctual pursuit of pleasure and the avoidance of pain. Maturity is learning to endure the pain of frustrated desires when reality requires it.

Self-Cutting

While many people abuse their bodies while indulging in smoking, drinking or recreational drugs, they can shrug it off the next day by remembering the fun and good times that went with their over-indulgence. With self-cutting, the pleasure principle – meaning, the avoidance of one kind of pain as a way of by-passing emotional pain however, results in bodily scarring and disfiguring while offering emotional relief.

Self-cutting is when the injury is intentional, as when as person makes small cuts with a sharp object that draw blood on the wrists, arms, legs, sexual organs or bellies. Unwanted and potentially dangerous side effects are infected wounds, scars, accidentally cutting too deep or uncontrollable urges that get in the way of daily activities.

Research shows that 90 per cent of people who engage in self harm begin during their teen and pre-adolescent years, however onset can occur at any age, including in elderly people.

In a survey by the Canadian Mental Health Association, approximately 13 per cent of adolescents said the engaged in self-harm activities. However, since this habit tends to be secretive, it is difficult to determine the exact percentage.

There is no single pattern or profile for self-injures, however the Canadian Mental Health Association shows that most are from the middle to upper-class, intelligent but suffer from low self-esteem. Almost all say they were discouraged from expressing emotions, especially anger and sadness.

Why do people self-cut?

There are many different reasons that people engage in self-cutting behaviour, but the primary reason is that it provides temporary relief to feelings of frustration, suffering and emotional pain. The flow chart below, shows two common patterns of why people injure themselves.

cuttingchart

Studies show that incidences of self-cutting are increasing. This may be due to cultural trends, where young people are told it is a normal way to express feelings of frustration, numbness or sadness. However, it is not new, in the 19th century some women in Europe became known as “needle girls” because they would cut themselves with sewing needles. Today, for example, there are many websites that give advice on how to go about cutting oneself. In order to fit in to a subculture, teens may try cutting themselves only to find that it is an addictive behaviour that can spiral out of control.

Contrary to the belief of some, self-cutting is not necessarily a ‘cry for help’ nor is it attempts at suicide. Cutting tends to become an impulsive, secret habit where the pain provides an illogical sense of temporary calm. Many self-cutters are ashamed of this habit and try to hide their scars.

Self-cutting is not a mental disorder but is usually a symptom of underlying emotional problems. There is a whole gambit of psychological problems that can be associated with it, anything from depression to borderline personality disorder to bipolar disorder.

If you or someone you know is self-cutting,  speaking to an experienced psychologist could help.


Patients in this story are a fictional composite of people who have sought help for this issue. Any resemblance to real persons, living or dead is purely coincidental.

Dr. Eva Fisher is an Ottawa psychologist who has been providing psychotherapy for a variety of issues for over 20 years. Follow her on Twitter @drevafisherFacebook or Instagram @dr_evafisher. Blog writing assisted by freelance journalist Alyssa McMurtry.

Written by Dr. Eva Fisher C Psych
All rights reserved. Copyright protected.

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