Anxiety & Stress

/Anxiety & Stress

Overcoming Anxiety

Everyone experiences anxiety from time to time. But some people experience anxiety too much of the time, often for no real reason.

Anxiety invades their lives with distressing images, painful feelings, or thoughts of impending doom.  Most are fully aware of the unpleasant feelings resulting from their anxieties, but often the anxieties themselves are subconscious. Yet these anxieties could become recognizable if they could learn to stop and reflect on them when they experience these feelings.

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Couples Troubles

Many couples enjoy the change of pace that summer brings. Vacations, musical festivals, cottage getaways with family and lots of outdoor BBQs are occasions to enjoy life and create happy memories. But these can also be times when relationship troubles are camouflaged, then dealt with later.

Is this you? Sad but true, a time to away, meant to grow as a couple, can also be a time of deepening relationship distress. Couples Therapy is an effective way of overcoming a communications impasse.

A recent report on BBC.com states that people between the age of 16 and 44 are having less sex than ever before. Is there something about life today? Are there new ways to hide problems?

Some modern indications of unhealthy couples behaviors include:blog-fighting-loving

  • Excessive smartphone/tablet use/social sites
    • Often in the presence of their partners
  • Excessive organized family activities
    • E.g. not enough free time for individual interests
  • Excessive amounts of time viewing adult web sites (Pornography)

These are ways to fill time and maintain distance when unspoken issues lie beneath a superficial calm. Couples unconsciously collude to maintain the status quo of parallel lives – like railroad tracks going in the same direction but never intersecting.

The issues below are still the ones most often involved in couples’ communication breakdowns:

  • Money
  • Sex
  • Parenting
  • In-laws

These issues are caused and often complicated by values that you and your partner may not always share. Values are personal perceptions about the right way to live your life.  For example, you may believe that it’s better to enjoy life while you have the freedom and resources to do so. Your partner may argue that it’s more important to save money for a nest egg as the priority. Issues become more entrenched when they conceal emotional issues such as insecurities about money or phobias that lead to recurring impasses of communication.

Despite the summer distractions, if you and your partner are stuck in a communication breakdown, it is a good idea to consult a psychologist trained in couples therapy to help you accomplish your goals together.

 

Dr Eva Fisher is a registered psychologist trained in Ottawa, Canada with training in couples and family issues.

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.

Headaches and Medically Unexplained Symptoms

Headaches and Pain

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

It’s upsetting to go to your family doctor for help with headaches, or any pain, and to be told that there is no obvious cause or medical reason for them. You might consider seeing another doctor, only to hear similar conclusions.  Since the headache (or pain) feels real, why can’t doctors find a “real” cause or fix for it?

The fact is that psychological pain can feel just as real as physiological pain, only the cause cannot be found by standard medical testing such as X-ray/MRI or other imaging technologies. It can be additionally frustrating that in many cases, pain medications help little, if at all.

If you are  provided with a referral to a psychologist with training in psychotherapy for medically unexplained symptoms, you may have found new hope for a solution.

A new field of treatment, called Intensive Short Term Dynamic Psychotherapy, or ISTDP, is re-visiting the relationship between emotion suppression and pain. Psychiatrists working in this area have determined that psychological or emotional issues may indeed be implicated in symptoms of headaches, as well as back pain and digestive disorders.

If you or someone you know suffers from unexplained medical symptoms, it may be helpful to schedule an appointment with a psychologist with training in ISTDP.

Dr Eva Fisher is a clinical psychologist with ISTDP training, in private practice located at 436 Gilmour St., Ottawa, Ontario, Canada.

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.

Stealing the spotlight from performance anxiety

Finally, it’s time. The moment you have been preparing for and dreading is here. There are butterflies in your stomach, you begin to perspire and you feel a little breathless.

It’s your time to perform.

While many people, even seasoned performers have butterflies, there is a difference between nervous anticipation and paralyzing anxiety.  Paralyzing anxiety impairs performance and is generally known as stage fright although psychologists refer to it as performance anxiety.

Performance anxiety is a type of phobia but it is more than just a fear of being on stage. It is classified by the American Psychological Association as a social phobia that can cause crippling fear of social or performance situations where the person is exposed to unfamiliar people or possible scrutiny by others. For certain people, exposure to the social setting produces anxiety and irrational fears of being publically exposed, shamed or humiliated.

Usually people with performance anxiety do all they can to avoid the spotlight.  Rationally, they know they are well prepared but their anxiety overwhelms their ability to think clearly. And so they avoid being in the spotlight as a way to avoid feeling anxious.

Psychologists now know that performance anxiety is very democratic – whatever your age, experience or occupation, performance anxiety can deter you from pursuing your professional or personal goals.

Keep calm and carry on?

So what is the best way to deal with this? The typical advice is to picture your audience naked, but unless you have exceedingly good visualization skills and would be undisturbed by that absurdity, it might not do the trick.

For those a little more serious, the general advice is, “breathe, calm down, relax, you’ll do great, everything will be fine.” Although reappraisal of the anxiety is much more effective than repressing it, a new study shows that reappraising anxiety as calmness isn’t necessarily the best way to go. Alison Wood Brooks is a psychologist from Harvard Business School and the author of the study which was published by the Journal of Experimental Psychology. 

“Anxiety is incredibly pervasive. People have a very strong intuition that trying to calm down is the best way to cope with their anxiety, but that can be very difficult and ineffective,” she told The Monitor (a publication of the American Psychological Association) in an interview. “When people feel anxious and try to calm down, they are thinking about all the things that could go badly. When they are excited, they are thinking about how things could go well.”

Get excited!

In her study she looked at people in a variety of stressful situations like karaoke singing, solving math problems and public speaking and found that re-evaluating the situation as exciting instead of something to calm down about, really can reduce anxiety and improve performance.

In the karaoke section of her research, participants were told to feel anxious, calm, excited or sad before making their big singing debut on a Nintendo Wii console. Those participants who tried to channel excitement performed the best with singing scores of 80% based on pitch, rhythm and volume. Participants who said they were calm, angry or sad scored lower and those who said they were anxious rated the lowest scores.

Similar results were seen in the math and public speaking areas of the study, drawing a strong correlation between the effectiveness of saying “I’m excited” and reducing anxiety.  It is persuasive since excitement and anxiety are physiologically similar, therefore it may be easier and more effective to reappraise anxiety as excitement than as calmness.

The performance anxiety experiment also supports other studies about re-evaluating stress. A recent TED talk reported that people who thought stress was bad and negative were more likely to be affected negatively by it. Those who looked at stress as something positive received positive benefits.

Norman Vincent Peale got it right a long time ago when he wrote “The Power of Positive Thinking,” which sold 5 million copies and stayed at the top of the New York Times bestseller list for 186 weeks.  By switching your perspective from “I’m anxious” or “stress is bad” to “I’m excited” and “it’s only excitement” you may actually improve your chances of getting the outcome you really want.

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.

photo credit: BenRogersWPG
via photopin cc

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