Archive by Author | ebba

DESTRUCTIVE RELATIONSHIPS

Apr20

In my office I meet a lot of wonderful people. They often come to me because they are in a destructive relationship they aren’t able to get out of. Although they know pretty well that the relationship is not good for them. The combination of their nonfunctional behavior with partner’s destructive patterns create toxic codependent relationship.
Codependency doesn’t only happen in a romantic relationship. It can occur in any type of a relationship, including family, work, friendship, community etc. Although in this article I write from women’s perspective men find themselves in this type of relationships as well.

Why are we attracted to the codependent relationships?
Destructive behavior is learned. Typically we find ourselves in dysfunctional relationships because we come from dysfunctional family, where we haven’t recited enough nurturing.
In general people who are raised in a dysfunctional family environment are used to chaos, unpredictability, fear and drama. Being in such a love relationship feels right to them because of familiarity. As adults we are compelled to recreate similar situation throughout our lives, in an unconscious drive to finally change the outcome and brake the pattern.
As a child you were unsuccessfully trying to please your parents in a hope that they will finally give you the love you need. In a codependent relationship you are a slave to the same dynamic. You are willing to wait, hope, plead, change and help just to maybe someday get a love form your unloving, avoidant, addicted, uncaring and inappropriate partner. The more he refuses you the more you want him.
Even though often we see the real problem in our relationships, we still look for excuses and “reasonable” explanations. An often occurrence is blaming his past for all the problems. We are determined to save him from his own demons through our love. Sex is one of the primary ways of trying to bringing him back to health.
We stick to the same partner because we want to prove we are not like “the others” and we would never leave him. We are much more in love with his potential “what it could be” then we are in touch with the real situation.
Also we can be addicted to the emotional pain that is a part of the codependent relationship. Consequently we find a good man who treats us well boring.

Codependent dynamic in relationship
A common theme in these types of relationships is that the beginnings feel like we have known each other for a long time. We fall head over heels in love with each other and everything is starting to happen really fast. “On my first date with him, I felt it in my guts, I met a soul mate. I did everything to stay with him, even loose myself in the end.”

There are different dynamics in relationships that reflect codependency:

  • One of them is passive-controlling behavior were one person is submissive, can’t make decisions and tries to please their partner. Other is controlling, makes all the decisions and tries to change their partner.
  • Some find themselves in a role of a rescuer. That is especially evident in relationships where one of them is addicted because the rescuer makes everything instead of the partner. Partner can remain irresponsible, negligent and addicted. At the same time the rescuer focuses so much on other person and avoids taking responsibility for her own actions. We avoid our own pain, emptiness, fear and anger. We use our relationship as a drug to do that.
  • Another occurrence is that both partners are having people pleasing behavior. It feels like they are glue to one another in a great harmony without any fights in relationship. Both of them can’t really function without the other. There is no place for individuality.

Bringing focus back to yourself

The way of breaking the cycle that started in our childhood is bringing the awareness back to ourselves. It takes a long time before new, healthier ways of living feel right instead of forced. Despite all the chaos in this types of relationship they can be pretty hart to end untill we don’t take time and do some serious work. There are some areas which are often problematic amongst people who find themselves in codependent relationships. Focusing on them play the important role in psychotherapy:

  • Fear of being alone: Our fear of ending up alone is so big that we rather stay in codependent relationship. If the relationship somehow ends we tend to find another partner right away or even before the old relationship ends. The fear of being without a man can be so severe we experience some of the same symptoms as during drug withdrawal. “When the relationship is over I can’t sleep, I start to shake and feel cold. I get depresses and neglect my kids. The fear of these symptoms makes me rather stay in the relationship that I know is not right for me.”
  • Deep feelings of emptiness: We stick to the relationship just to avoid the emptiness we feel deep inside. We believe that when we will be with someone the emptiness will go away and the life will have the meaning again. Sadly most people in codependent relationships feel alone and empty most of the time.
  • Low self-esteem: We don’t see our self as someone worth of love, success and happiness. We believe that we need to earn love. Perfectionism goes often hand in hand with low self-esteem. If everything is perfect, you can’t feel bad about yourself. On the other hand everything that is not perfect brings feelings of guilt and feels like people will stop loving us.
  • Poor boundaries: We don’t develop the feeling for our own as well as for other person’s boundaries. We can’t say no just as well as we have trouble hearing the other person’s boundaries. Setting boundaries would put the relationship at risk or it would mean that it needs to end.
  • Control helps us feel safe and secure due to the little control we’ve had during our childhood. Some mistaken control as being helpful. With controlling others close to us we are not facing our own pain. We can also find ourselves on the opposite side of the spectrum and we are the controlled one. Which can feel safe at first but soon turns to drama. Self-blame also give us feeling of the control. By blaming ourselves we have a hope that we will eventually figure out what we are doing wrong, correct it and stop the pain.
  • Care-taking: We put others ahead of ourselves. This can be the role we have learned while emotionally and/or physically taking care of incompetent parent. We lean towards people pleasing behavior but at the same time can be offended if somebody doesn’t want our help. This is the only way we know how to show love and hope for love in return.
  • Obsessions: The root of obsession in fear. Fear of being alone, unlovable, unworthy, ignored or destroyed. We hope that the man whom we are obsessed with, will take care of our fears. We are occupied with thinking about him or our own mistakes in the relationship.
  • Denial: We are in denial about the problematic relationship and our own responsibility for it. What all unhealthy families have in common is their inability to discuss root problems. Which is reoccurring in romantic relationship.
  • Intimacy: We have trouble being in healthy intimate relationship. We fear true intimacy because we feel that if person would truly know us they would reject us. We take control of that through controlling how close we get to others.

 

TWO LAYERS OF ANXIETY*

Jul13

*the article is based on my private practice observations

Anxiety is often a reason why people knock on my door. It is also the subject that I am most drawn to. That’s why I would like to write a short article based on my work experiences about dealing with anxiety.

In short, I approached anxiety in two levels:

  1. Dealing with symptoms: In the Internet era, people educate themselves about panic attacks and how to ease symptoms. Consequently this level is the most accessible for self-help. Cognitive-behavioral psychotherapy is mainly focused on this level. Many people come to psychotherapy equipped with the knowledge and exercises how to help themselves with panic attacks. But why do those people still come to therapy? I believe focus in this level is not enough for the long term anxiety relief. In my practice, I focus 80% of my time on second level:
  2. Deeper approach: Psychotherapeutic relationship offers safe, understanding, trusting environment which is especially important for people with anxiety. For them, knowing that they have safe place, whit expert who they can trust, play enormous role. I notice that people with anxiety often keep their fears and worries to them self, they are overly consider with other people’s emotions and are on the mission not to hurt others, their true content is locked inside them which one day explode into panic.
    In time, the therapeutic relationship is safe enough for all the hidden content to come to light, having somebody to talk about it, relieves the burden that is kept inside and coses stress. Often we are so used to carrying a burden that we don’t realize how anxious our mind and body are feeling.

What (not) to expect in therapy

A lot of people believe that there is some kind of recipe for panic attacks solution. And they expect to get it from therapist. There is not just one anxiety, I see different kinds of it, some overwhelming others »just« as symptom form some other mental disorder. Therapy needs to get to its core and there is no recipe for that.

I don’t believe that you can cure anxiety response 100%. Let’s not forget that no matter how unpleasant it is, it is still a normal human response. The only difference it is that by people with anxiety, the centers for danger are triggered where there is no actual life threatening situation. The difference after therapy is that less things are causing us stress. Before it was stressful to go to the grocery store, now it would be stressful when having an accident. That’s a normal body/mind response.

HIGHLY SENSITIVE PERSON (*HSP)

Jul13

In this article I will summarized the work of Elaine N. Aron, Ph.D. book, The Highly Sensitive Person. In her psychotherapy practice she worked with HSP for decays and come to an interesting conclusions.

In connection to anxiety: HSP often treats his high arousal as anxiety. He got false messages form the environment that unpleasantness he is experiencing (due to high arousal) is actually fear. Consequently when they get aroused (annoyed, tired…) that automatically triggers fear.

Twenty percent of the population is born with HSP, 30% of them are extrovert and it effects women and men equally. The author distinguish between two subtypes:

First one is calm, quiet and satisfied quickly the other is slightly contradictory, for example he is curious but careful, cheeky but scared, he gets bored very quickly but at the same time, he is quickly overstimulated.

Hypersensitive nervous system
HSP have a hypersensitive nervous system. Exposed to the same amount of stimulus, they tend to absorb more and consequently they get aroused faster. Also they process everything very deeply and get easily overwhelmed.

They pick up the stimulus form the environment that many others would normally overlook. Some people call that good intuition. Their delicate sense make them a good writers, historians, philosophers, judges, artists, researchers, theologians, therapist, teachers, conscious parents and citizens.

Main characteristic of HSP Person:

  • Creative (unusual imagination), very empathic people.
  • They tend to have more vivid dreams and nightmares then others. Even if they didn’t have any traumatic experience it is not unusual for them to fear the dark. No wonder many of them have trouble sleeping.
  • They feel hunger very strongly.
  • They have hart time making decisions, especially because they are being more aware of consequences, wanting to make right by everyone and paying great attention to details.
  • If they had many negative experiences in life, they are more prone to anxiety or depression. HSP children can get criticized for their sensitivity, often the environment doesn’t know how to react to it. That’s why many of them feel like there is something wrong with them. In the environment that is in tune in with their sensitivity, they flourish to a confident person, viewing their sensitivity as a gift.
  • They react to criticism more intense than others which can result in avoiding criticism all together, by trying to please other people and putting others first.
  • They have lower pain tolerance. They feel changes in their body more profoundly, that’s why they are having trouble to brush the painful sensation off their mind.
  • They tend to be more sensitive to violence in the movies and real life. Due to their great imagination, they can vividly imagine what it would be like. The images can linger with them for weeks or even years.

Are you a HSP? Find out in these questioner: http://hsperson.com/

SKYPE THERAPY FOR PEOPLE WORKING IN HIGH STRESS ENVIRONMENT

Jul13

People working in busy environment or dynamic cities like London, New York, Singapore, Zurich, Frankfurt, where is no shortage of qualified therapists, often choose online therapy due to its convenience and flexibility. The comfort of having the therapy in your office and not being forced to travel to therapist office often weigh towards online psychotherapy.

Skype therapy has also turned out to be a great option for people whose part of their job is to travel. Regular therapy sessions are important part of progress in psychotherapy. Skipping them because of frequent business trips can become a problem at some point. Online treatment offers time and geographic flexibility which you can’t expect form face-to-face therapy.

LIVING ABROAD AND SEARCHING FOR A THERAPIST

Jul13

Adjustment to a new environment

Cultural shock is a part of experience when you move abroad. Moving can be a stressful. You can never really prepare for the changes that you are going to face. Even if you are moving to a similar cultural background there will be some bumps along the road. If you are new to the language, this can only deepen the feelings of loneliness, isolation and stress.

People forced to move when their spouse is transferred to a foreign country, with no job and limited support, may have an especially hard time.

Sometimes cultural shock doesn’t hit us right away. We can be in a so called “honeymoon phase”. When person gets used to new environment and novelty become less exciting, the shock can check up with us.

Having problems living abroad

Being a human means that we will have rough times. We can develop or face serious troubles anytime in our life time, no matter where we live. If we happen to be in a foreign country, this can cause us even greater distress. Not having access to a therapist that is not only able to understand our language, but also our cultural background, can be discouraging. Online therapy helps in this cases. In my experience, it is a great option for people living abroad.

TRAPPED IN MY HOME

Jul13

Online psychotherapy is suitable for people who due to temporary or permanent reasons can’t go out of their (safe) environment.

Temporary obstacles
In this category I am including temporary situations that require people to stay at home. Here we can talk about different kind of physical injuries that needs longer period of time to heal as well as risk pregnancies and Postpartum (postnatal) depression and/or anxiety and/or obsessive compulsive disorder. In the last case, due to a newborn baby, it is often easier for the new mother to be able to have therapy from home. In my personal experience, I also do therapy where the baby can be next to a mother if she doesn’t have babysitter or wants to have baby near her.

More permanent obstacles
In this category I am including social phobia, agoraphobia, anxiety disorder that leaves us with a bitter taste to go to the places where we experienced panic attacked and also other physical challenges that cost us difficulties to visit therapy face to face. Although the first disorders are not permanent per se, it often feels like they are to the person who is experiencing it. You don’t see the end of it. Isolation can become an issue for some when dealing with emotional difficulties and online treatment can help tremendously in that cases.

TYPES OF ANXIETY

Jul13
Types of anxiety Description
Panic disorder Panic attack feels like sudden attacks of terror which normally peaks within 10 minutes, but some symptoms may linger much longer. Attack can occur at stressful times or it isn’t connected to any particular situation. Many people have just one panic attack. In this case we can’t talk about panic disorder.
Common symptoms: pounding heart, sweating, weakness, faintness, dizziness, flush or feel chilled, tingle or numb hands, nausea, chest pain, smothering sensations, sense of unreality, fear of another panic attack, fear of dying, fear of losing your mind.
Panic attacks can limited us, especially if we don’t seek treatment before it develops into agoraphobia. Good news is that panic disorder is one of the most treatable of all the anxiety types.
Agoraphobia About one in three people with panic disorder develops agoraphobia. It is an outcome of repeated panic attacks. It happens when we avoid different situations because we have intense worry of attacks. We can define agoraphobia in two different ways. One is fear of going outside or to unfamiliar places. Other is fear that there is no escape. Early treatment of panic disorder can often prevent agoraphobia.
Generalized anxiety disorder (GAD)

 

 GAD is diagnosed when a person worries excessively about a variety of everyday problems for at least 6 months (health, money, family, work issues). If person worry just about one thing, we can’t talk about GAD.
Physical symptoms: fatigue, headaches, muscle tension or aches, difficulty swallowing, trembling, twitching, irritability, sweating, nausea, lightheadedness, frequent visits to the bathroom, feeling out of breath, hot flashes, difficulty concentrating, insomnia.
Specific phobia Intense fear of something that poses little or no actual threat (closed-in places, heights, escalators, tunnels, highway, water, flying, dogs, blood etc.). Even though people realize that fear is ungrounded, they can have panic attack or anxiety when facing or thinking of facing the situation.
Separation anxiety disorder (SAD) SAD is normal life stage and occur with 7 months, reach its peak between 10 and 18 months and usually disappear when the child is 3 years old. Parents have trouble with bedtime and time of separation (clinging, crying, anxiety). If parents help his child deal with the anxiety constructively, child outgrowth this phase.
If anxiety is unresolved its’ continue to adulthood. Around 7% adults have it. In compared to medications counseling is usually considered the best treatment method.
To be diagnosed with SAD, one must have at least 3 following symptoms: experiencing great stress when you separate form home or love (trusted) one; worry to lose love (trusted) one or sth. bad will happen to them; don’t want to go from home because of the fear of separation; don’t want to be alone or without love (trusted) one; nightmares about separation; trouble sleeping when not being near love (trusted) one.
Social anxiety disorder= Social phobia is a great fear in one or more social situations. They can worry for days or weeks before and after social situations. They are afraid of embarrass themselves, being watching or/and judge. As a result, they choose to isolate themselves from society. They often self-medicate with drugs, alcohol, food. More than 66% have other mental disorder (commonly depression or anxiety)
Physical symptoms can occur: blushing, excess sweating, trembling, palpitations, nausea, panic attacks, diarrhea.

POSTPARTUM ANXIETY

Jul13

With a new baby in the house some worries are expected. Especially if it is our first born. But what if worries are persistent and with little base ground? Probably you already heart about postpartum depression, but what about postpartum anxiety? According to Germany University of Heidelberg, 11% of mothers developed postpartum anxiety, while 6% developed postpartum depression. Overall this affects 1 out of every 7 women. Unfortunately, postpartum anxiety and depression often occurs together. Read personal story about that HERE.

What are the symptoms that shouldn’t be overlooked?

If you had a baby within the last 12 months and are experiencing some of these symptoms for at least 2 weeks or longer you might have postpartum anxiety. Anxiety can also appear during the pregnancy.

• Having trouble quieting your mind. You are worrying all the time. You feel like something horrible will happen.
• You are unable to relax. You feel tense and on edge. You feel that you have to do something all the time.
• Disturbing thoughts which can vary from “harming your baby” to “not being a fit mother”.
• Physical symptoms like stomach cramps, headaches, shakiness, nausea, panic attacks.
• Disturbances of sleep and/or appetite.
• Feeling that something is off with you.

Seeking help is important

In the culture where motherhood is represented as something joyful it is hart to seek help when you are experiencing postpartum anxiety (or depression or obsessive compulsive disorder). Never the less, you are not alone.
It is very important to seek help sooner than later even with mild symptoms of postpartum anxiety. Left untreated, can interfere with your ability to bond with your child. Many moms find it helpful to talk to psychotherapist. It is important to have someone who acknowledge your panic, gives you support and strategies to deal with anxiety. Use of medication is also possible, even if you are nursing. This is determine on a case-by-case basis.

Could I predict it?

Knowledge about postpartum anxiety can help to catch the disorder in early stages which make treatment easier. If you have family member with (postpartum) anxiety or previous history of anxiety you have greater possibility to develop postpartum anxiety.
But that can happen to every mother, no matter the history. There might be a physiological explanations for mood disorders during and after birth. During that time our body goes through drastic hormonal changes. Which makes pregnancy a particularly vulnerable time for conditions such as depression and anxiety.

Read some personal stories and wisdom’s on following links here and here.

You are not alone! Encouraging video from other moms