OCD Honesty and Hyper-Responsibility

OCD – Obsessive Compulsive Disorder has many manifests which ranges from hypersensitivity which is very common to other behaviour like hyper-responsibility, lying and honesty. The inflated sense of responsibility, and honesty becomes too much to handle and often leads the person to suffer even more.

Hyper-Responsibility and OCD

The inflated sense of responsibility makes the person believe that they are controlling the things which are happening in the world, although they have very little control on their surroundings. There could be many ways in which the hyper-responsibility starts showing its effects. In some cases it shows in terms of the relations to other’s feelings. The person thinks that they are responsible for everyone else’s happiness, and all the times neglects their own feeling. Sometimes, people think that their presence can hurt others, so they isolate themselves from their friends and peers. Another symptoms of responsibility going out of control is people start giving charity and that too an exorbitant amount. All the mails are generally answered by checks and stop saving any money for themselves. They think the world can be saved by their charity.

The below serenity prayer says it all for the inflating sense of responsibility among OCD sufferers:

God grant me the serenity to accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.

Lying and OCD

Another manifest of OCD is lying and often to hide the Obsessive nature about many things. Like one of the kid always lied about his hunger and appetite, making excuses of being tired, etc. The real reason was OCD which made him think that there are finger prints all over the walls and places. These people even though diagnosed with OCD, always lies and say, they are fine, although deep inside they have some thought of obsessive nature. The children lie about taking medicines, all the things which are related to disease and its cure can be lied for. It can be fear of being found out, the fear of what others will think, OCD sufferers lie a lot and it is one of the major manifest of the symptoms.

Honesty and OCD

The above manifest of OCD on Lying has another dimension as well in the form of Honesty. Many of the OCD sufferers has a honesty issues as part of their disorder. They are so afraid of lying that daily they review their entire day within their minds to ensure all what they said was true or not. They many a times accept all the wrongdoing as well as things which they do not do, thinking they might have done it accidentally. Their sense of honesty comes along with hyper-responsibility to keep their loved ones and the world, of course, safe and protected. They have a heightened sense of morality as well.

The Connection Between OCD Psychosis

OCD or obsessive-compulsive disorder has some traditional symptoms which assumes that the patient is aware about the obsessions or compulsions are excessive and they are more than the normal range of feelings. It is often present in the category where the person suffering knows about the condition he is in., i.e. Neuroses. There are some points of contention though. The patients of OCD displays varying degree of insight into their condition. DSM-IV (American Psychiatric Association, 1994) has some mention to this where it is stated that there are cases of people “with poor insight” who “for most of the time” while experiencing an OCD episode do not recognise about their compulsion being excessive or unreasonable. ICD-10 (World Health Organisation, 1992) has no mention of such obsessional symptoms in the presence of schizophrenia.

There are many cases where person suffering from OCD is also diagnosed with some form of borderline Psychosis. Here the OCD is present along with out of touch with reality behaviour. The person suffering is not fully aware about their reactions/behaviour and actions being unreasonable or non-realistic. Psychosis makes anyone think about schizophrenia, although the doctor never mentioned this name. But psychosis in itself is a big symptom of schizophrenia, making things tougher for people who are less aware. The connection of OCD here with psychosis can be described in one line as OCD with poor insight.

People with OCD with Poor Insight

Most of the time people with OCD knows that they are suffering from some kind of obsession which is not normal and there is certain amount of hyper criticality in their behaviour. They are aware that if they tap a wall for 5 times is not going to change anything, but they still do it. They although could not control it, but they are aware about it.

On the contrary if there is OCD with poor insight, such people do not clearly believe that they are irrational or illogical in any way. They think their thoughts and behaviours are not unreasonable, and consider the obsessions and compulsions as normal and stay safe behaviour. The important inclusion in DSM5 says it all. As per Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, OCD should be seen with good or fair insight, poor insight, or delusional beliefs.

Why it is important to differentiate OCD with Psychotic Disorders?

The answer to this question lies in the fact that the treatment of Psychotic disorder has some drugs and therapies which enhances the symptoms of OCD. They tend to induce or exacerbate OCD. There are many side effects as well both firm physical and mental aspects.

There is a lot of work for caregivers here to find the comorbid existence of OCD with Psychosis due to obvious readons like the presence of Depression with ADHD. Do not jump to conclusions and specially think about the treatment you think would be suitable for the comorbid conditions. The treatment options of one condition can adversely affect the other condition.

How to help people handle perfection urge?

Perfection is good, but it is good if it is not impacting your life and making you go nuts over getting things in perfect shape and order. Nothing in this world is going to change if things are not done the way you would have thought them to be. So relax, take a break and leave that perfection nature making good amount of breathing space for you and people near you.

Here are some of the top ways and tips to combat the urge of being perfect.

Top tips for Handling Urge of Perfection

1. You need to expose your worries – You need to be talking about your worries and what will happen if the things are not perfect. You can talk to your parent, spouse, friends, co-workers, etc. This will help you build the emotional definition to all your worries and you will get a different perspective of things. The exposure will help you in getting in terms of your worries and recude them to a great extent.

2. Change your perspective about the outcome. Think that out of many outcomes and possibilities, there is only one dire consequence which you are too much worried about. If you judge the possible outcomes and think rationally about the perspective, you will be able to counter the urge of perfection.

3. Try and examine the evidence against your worst fear. Let us assume that you think if your shirt is not pressed perfectly you will have a big set back. Now try doing this one day and try to wear a wrinkled shirt. Check on your day and find out what went bad and what not. For all the things that went bad are worth so much of anxiety you are picking up in life due to this? Check on your own.

4. Mistakes and failures are opportnity to learn and move on. Have this thinking and start improving yourself rather than spending days and nights worrying about the final goal and its outcome. It’s not always the case that your worst nightmares come true. Have faith and move on.

5. Keep your focus on learning new things and skill, rather than being the best in everything you do. Every person in this world cannot be Pele and Ali at the same time. You cannot be a movie star and a Governor at the same time.

6. Take help to find the faults and unhealthy logic in your thinking. You can discuss with support groups, professionals and therapists if you cannot find solace in your relatives, or family members.

7. Watch movies and read boooks on how people have struggled and had multiple failures before they eneded up doing something which brought changes in people’s lives. There are many such personalities which helped us in every possible aspect of life and they taught an important lesson too – that things do not come easy. There are failures, mistakes, set backs and hardships along the way. And not all the stories are part of books and movies – there are cases where the end result was not that bright. And I mean it, these cases are far too many, than you think.

Get rid of the negative self-talk

You can be your own worst enemy. Negative critical messages you say to yourself can rev up your stress, hold you back, and take you down!

Negative self-talk are messages like:

  • “You’re stupid.”
  • “You can’t do anything right!”
  • “You’re ugly.”
  • “What a loser.”
  • “You’ll never amount to anything.”

The messages in your head may be generated from low self-esteem or be repeats of messages voiced by flawed parents.

All too often, parents who don’t deal with their own shortcomings put them onto their children.

If you were repeatedly put down by a parent or other important adult—that was their stuff, not yours.

I noticed that I would say “You’re stupid” whenever I was disappointed in something I thought or did.

That message had haunted me for years but letting myself hear it clearly led me to being able to banish it from my inner repertoire.

In bringing the message up from my subconscious to my conscious in such a clear way I knew immediately where the message came from. My mother sent me that message in a myriad of ways including saying “You’re so stupid!”

I also realized “I’m not stupid.” This was mom’s stuff. She had her attributes but she had an 8th grade education and—as she would say about other people but not herself—she was not the sharpest knife in the drawer.  Mom overcompensated for her own ignored inadequate feelings by putting me down.

I developed a system for countering the message.

I came up with a list of evidence that I’m not stupid.

Whenever I heard “You’re stupid” in my head, I would say to myself “Reality check.” Then I would recount the list of evidence that I’m not stupid.

Eventually, I didn’t need to use all the items on my evidence list before I would feel myself snap out of feeling inadequate.

A short time later, I didn’t need the list anymore. Just saying “Reality check” would undo the “You’re stupid” message.

And soon, “You’re stupid” went away.

I had been rid of the “You’re stupid” message for over 20 years when one of my sisters told me she too had been haunted by “You’re stupid.”

I said to her “You too?” to express my surprise.  And she replied “With our mother, how could you not.”

To get rid of negative self-talk take these steps:

  1. Begin to notice it. Pay attention to what you say to yourself. Rather than push it away, bring it up to full awareness and hear the message clearly. Possibly write it down so you’ve really got it.
  1. Counter the message. The phrase “Reality Check” worked for me as a signal to counter the message. That may work for you too. Whether or not you use that signal, you want to challenge the message and provide yourself with evidence to the contrary. It may be helpful to write out the evidence.
  1. Replace negative with positive. Possibly replace the negative message with its positive counterpart. “You’re stupid” can be replaced with “You’re not stupid” “You’re smart” “You can do this” “Academics aren’t your thing but there’s more to smart than school grades” or something else that empowers you.

Exercise

Reflect on whether you have any negative self-talk.

Where did that message come from?

How has the message gotten in your way?

Use the steps to practice riding yourself of the counterproductive message.

Anxiety Symptoms: Woman share her own experience

We feel anxiety emotionally and we feel anxiety physically.

Anxiety symptoms can be both emotional and physical.

What anxiety feels like emotionally?

Anxiety is a fearful feeling that seems to get a hold of you and not let go.

It can drive you to act in a demanding or irrational way as you attempt to get relief from the fear. Or it can narrow your world as you reduce your exposure to situations that stimulate the fear.

The emotional side of anxiety can be felt as:

  • fear,
  • apprehension,
  • tension,
  • agitation,
  • angst,
  • stress,
  • uneasiness,
  • worry,
  • nervousness,
  • a sense of impending doom,
  • trepidation,
  • foreboding,
  • panic, or
  • being trapped, controlled, or overwhelmed.

Where your anxiety falls on this list of emotion descriptions may be determined by how intense the anxiety is at any given time. (For example, panic is more intense than worry.)

What anxiety feels like physically?

The physical side of anxiety can also be felt at different intensities, from an uneasy jittery physical feeling that accompanies worry, to full bore panic that feels like you are dying.

In fact, panic sends many people to emergency rooms because it can mimic the symptoms of a heart attack.

When anxiety hits its most intense form it is often called a panic attack. (Some call it an anxiety attack, but I think that panic attack is a better label. I see anxiety as less intense than a panic attack.)

A panic attack is very intense for a time—at least 10 minutes—but then usually subsides within an hour. After the panic feeling is reduced, an anxious feeling can remain, but the severity of physical symptoms is not as great as during the panic attack.

Physical symptoms of anxiety can include:

  • muscular tension, aches, and pains,
  • headaches,
  • upset stomach,
  • gastrointestinal problems (diarrhea, constipation, gas),
  • loss of appetite or increased appetite,
  • sweating,
  • trembling or shaking,
  • dry mouth,
  • feeling hot or cold,
  • hyper energy or low energy,
  • a lethargic worn-out feeling,
  • weakness in legs,
  • sleep disturbance (difficulty getting to sleep or staying asleep),
  • inability to relax,
  • brain fog or difficulty concentrating,
  • hypersensitivity to noise or touch, or
  • a closed down feeling in throat.

Physical symptoms of a panic attack can include any of the above plus:

  • chest pain,
  • increased heart rate,
  • shortness of breath,
  • extreme nausea,
  • extreme shift in body temperature, or
  • feeling faint or light-headed.

My own experience

I have experienced two panic attacks myself. They definitely are no fun.

Panic attacks are scary multiplied: they are caused by something scary and they are scary.

My first panic attack lasted about a half hour. It was spurred by my receipt of a threatening email from an ex-boyfriend. The panic reduced when I called someone to help me deal with the situation and I felt more secure.

The second panic attack occurred about a week later when I received another email in which his threats escalated. That attack lasted for about an hour. During that attack, I laid down on the floor because I was worried that I might pass out and I figured if I passed out on the floor at least I wouldn’t fall and hurt myself.

After the second attack, I took myself to a hypnotherapist friend. She fixed me up and I never had another panic attack.

I think that my personal experiences with anxiety and panic, combined with my professional education and experience as a counselor, give me an insight into anxiety that is more complete than most.

I know that my clients are often relieved to discover that I have experienced panic first hand and so have an understanding of what they have been through.

Donald Trump and the Narcissistic Illusion of Grandiosity

Donald Trump has grown an empire of wealth and power, but is it enough? He admits that it isn’t the money that motivates him (The Art of the Deal, 1987). What drives narcissists are their fears of feeling weak, vulnerable, or inferior. Consequently, for male narcissists in particular, achieving power is their highest value at any cost. Trump is “certain about what he wants and sets out to get it, no holds barred” (Trump on Trump).

There is great disparity between what narcissists show the world and what goes on inside. Despite their big egos, they’re frightened and fragile just the opposite of their grandiose, powerful façade. They must work hard to keep up their image, not only for others, but for themselves. In fact, their immodesty and exaggerated self-importance are commensurate with their hidden shame. Shame is paradoxical in that it hides behind false pride. Its defenses of arrogance and contempt, envy and aggression, and denial and projection all serve to inflate and compensate for a weak, immature self. Like all bullies, the greater their defensive aggression, the greater is their insecurity.

Shame fuels their needs for admiration, attention, and respect. “If I get my name in the paper, if people pay attention, that’s what matters” (Donald Trump: Master Apprentice, 2005). Trump wants “total recognition” as when “Nigerians on the street corners who don’t speak a word of English, say, ‘Trump! Trump!’” (New Yorker, May 19, 1997). Praise and success never fill a narcissist’s inner emptiness, nor compensate for deep-seated feelings of inadequacy.

To gain recognition and validation of their worth, narcissists brag and exaggerate the truth. They imagine themselves to be more special – more desirable, more intelligent, more powerful, more invincible – than others. “Some people would say I’m very, very, very intelligent” (Fortune, April 3, 2000). “My I.Q. is one of the highest!” (Twitter, May 8, 2013). “All the women on ‘The Apprentice’ flirted with me  – consciously or unconsciously” (How to Get Rich, 2004). “It’s very hard for them to attack me on looks, because I’m so good-looking” (NBC’s “Meet the Press,” Aug. 9, 2015). Trump announced his grandiose, unrealistic ambitions to Scott Pelley to force businesses to close foreign plants, to compel the Chinese to devalue their currency, and to build a cheap, impenetrable wall paid for by Mexico. (Estimates are $28 billion a year.)

It’s all or nothing with narcissists. For Donald Trump, there are winners, like himself (TrumpNation: The Art of Being The Donald, 2005), and losers, and he “doesn’t like to lose” (New York Times, Aug. 7, 1983). “Show me someone without an ego, and I’ll show you a loser” (Facebook, Dec. 9, 2013). Trump must stay on top and thrives on the challenge. “You learn that you’re either the toughest, meanest piece of [expletive] in the world or you just crawl into a corner … Guys that I thought were tough were nothin’” (New York magazine, Aug. 15, 1994).

Losing, failing, being second aren’t options. “Life to me is a psychological game, a series of challenges you either meet or don’t” (Playboy, March 1990). He “lies awake at night and thinks and plots” (New York magazine, Nov. 9, 1992). These high stakes make for vicious competitiveness, where offense is the best defense. “Sometimes, part of making a deal is denigrating your competition” (The Art of the Deal, 1987).

Narcissists have a “my way or the highway” attitude and don’t like to hear no. Others’ limits make them feel powerless as they did as a child, which is very frightening. They can throw a childlike tantrum when others don’t comply. When their imagined omnipotence and control is challenged, they manipulate to get what they want and may punish you or make you feel guilty for turning them down.

By projecting their aggression outward, the world appears hostile and dangerous. “The world is a pretty vicious place” (Esquire, January 2004). People who are seen “as out for themselves” (Playboy, March 1990) become adversaries to defeat or control. To keep safe, they push others away, fending off threats and humiliation, and they do so aggressively. Women “are far worse than men, far more aggressive … ” (The Art of the Comeback, 1997). “You have to treat ’em like [expletive]” (New York magazine, Nov. 9, 1992). Nevertheless, narcissists are exquisitely sensitive to any sign of disrespect or imagined slight that threatens their self-concept. When Trump says, “The rich have a very low threshold for pain” (New York magazine, Feb. 11, 1985), he includes himself.

Trump learned to attack from his father, who “taught me to keep my guard up” (Esquire, January 2004). When attacked, narcissists retaliate to reverse feelings of humiliation and restore their pride. “If someone screws you, screw them back. When somebody hurts you, just go after them as viciously and as violently as you can” (How to Get Rich, 2004). “If somebody tries to push me around, he’s going to pay a price. Those people don’t come back for seconds. I don’t like being pushed around or taken advantage of” (Playboy, March 1990).

He told Scott Pelley that his father was “a tough cookie” — a strict, “no-nonsense kind of guy” (Playboy, March 1990). There are many ways parents can shame their children and instill the belief that they’re not worthy of love. Scolding feelings and needs or emphasizing high expectations convey conditional, tough love, which makes a child feel unaccepted for who they are. Sadly, the implication is that without success (or for a female narcissist, often beauty), no one would care about me. “Let’s say I was worth $10. People would say, ‘Who the [expletive] are you?’” (Washington Post, July 12, 2015). Instead, they must earn their parents’ acceptance. Ted Levine, Trump’s high school roommate, described the kind of pressure to excel that the boys were under. “He had to be better than his father. We were sent here to be the best of the best, and we knew what our job was.”

To compensate for insecurity and shame, narcissists feel superior, often expressed with disdain or contempt. Arrogance and putdowns bolster their egos by projecting the devalued parts of themselves onto others. Trump has disparagingly and publicly labeled various people a “dog,” “bimbo,” “dummy,” “grotesque,” “losers,” or “morons.” Narcissists’ invectives are made worse by their lack of empathy, which enables them to see people as two-dimensional objects to meet their needs. “It really doesn’t matter what they write as long as you’ve got a young and beautiful piece of [expletive]” (Esquire, 1991). Objectifying others demonstrates how insensitively they were treated growing up.

“Not the quarry, but the chase; not the trophy, but the race” inspires Trump. “The same assets that excite me in the chase, often, once they are acquired, leave me bored. For me … the important thing is the getting, not the having” (Surviving at the Top, 1990). Conquest and winning reaffirm a narcissist’s power. “It’s all in the hunt and once you get it, it loses some of its energy. I think competitive, successful men feel that way about women”.

Victory also bolsters unexpressed feelings of insufficiency. Trump so hinted, saying, “Oftentimes when I was sleeping with one of the top women in the world I would say to myself, thinking about me as a boy from Queens, ‘Can you believe what I am getting?’” (Think Big: Make it Happen in Business and Life, 2008).

However, power and love don’t easily coexist. “Intimacy requires vulnerability, letting down one’s guard and being authentic to get close emotionally — all signs of weakness that are frightening and abhorrent to a narcissist. Rather than give up power and control, which risk exposure of their false persona, many narcissists have short relationships or are distancers when more than sex is anticipated”

Love relationships are about connecting — something herculean for a narcissist. “For me, business comes easier than relationships” (Esquire, January 2004). “I’m married to my business. It’s been a marriage of love. So, for a woman, frankly, it’s not easy in terms of relationships” (New York magazine, Dec. 13, 2004). “I was bored when she (Marla) was walking down the aisle. I kept thinking: What the hell am I doing here? I was so deep into my business stuff. I couldn’t think of anything else”.

Science of Personality of Donald Trump

The fate of any organization is largely a function of that organization’s leadership. The “organization” of the United States is no exception to this rule. While he leads in the polls for the Republican party candidacy, it seems only appropriate that we understand and think about the type of leader Donald Trump would be for the United States.

I do not know Mr. Trump personally and I have never had the opportunity to assess his personality professionally (though I’d be happy to do so if he were willing). Thus, my views are based purely on watching his behavior. His personality is captured by his reputation, which is the sum of his behavior, and organized by a standard set of themes as follows.

We can look at both sides of Mr. Trump’s personality. The Bright Side (how he typically behaves when he’s at his best) and the Dark Side (how he typically behaves when he lets down his guard).

Beginning with the Bright Side we can expect Mr. Trump to be:

  • Highly Adjusted. Mr. Trump seems not at all anxious or nervous. He will appear calm under pressure, won’t take criticism personally, and is quite pleased with himself as a person. The downside is that he will be reluctant to listen to feedback — especially negative feedback — from others.
  • Highly Ambitious. Mr. Trump seems competitive, wants to win, and wants to be in charge. He will be concerned about results and getting things done. On the downside, he may tend to compete with those who are actually on his team and potentially alienate his staff if he does.
  • Highly Sociable. Mr. Trump likes to entertain, to be the center of attention, and to talk…a lot. The obvious downside is that he can be unwilling to listen, overbearing, and shoot off at the mouth without thinking.
  • Low on Interpersonal Sensitivity. Mr. Trump is direct, doesn’t shy away from confrontation, or really care much about peoples’ feelings. The upside is that he is willing to let people go when needed (e.g., “You’re Fired”). The downside is that he is hostile and alienates others.
  • Low on Prudence. Mr. Trump doesn’t care much for rules and tends to avoid them. He is independent minded and seems unconcerned with details. The positive side is that he will be quick to make decisions and to make things happen.
  • Highly Inquisitive. Mr. Trump has a lot of ideas and a big imagination. He’ll have all sorts of ideas for solving problems, but he may have problems implementing them and can be a bit unpredictable.

On the Dark Side we can expect Mr Trump to be:

  • Highly Bold. This is Mr. Trump’s most defining characteristic. He seems unusually self-confident, and shows feelings of grandiosity and entitlement. These individuals tend to make a good first impression, but are difficult to work with because they feel entitled to special treatment, ignore their critics, and intimidate others. He’ll tend to overestimate his capabilities.
  • Highly Mischievous. Mr. Trump seems charming, interesting, and daring. He enjoys taking risks, pushing the limits, and seems to thrive on excitement. Such people are hard to work with because they are impulsive, downplay their mistakes, take ill-advised risks, and have no regrets.
  • Highly Colourful. Mr. Trump seems quick, fun, and socially skilled. He loves making use of his celebrity and having his accomplishments recognised. He’s very good at calling attention to himself. Such people are hard to work with because they are self-promoting, over committed, and easily angered.
  • Low on Diligence. See Prudence above, but multiply everything by two.
  • Low on Dutifulness. Mr. Trump likes to defy the status quo, doesn’t care about pleasing others, and is quick to make decisions. He won’t take orders (or advice) from many people (if anyone).

In summary, what we can expect from Mr. Trump is what we have already seen and know about his reputation. What does this mean for the United States? People tend to vote for leaders in their own image. Thus, the personality of Mr. Trump also highlights the characteristics of those who will likely support and vote for him. As such, Mr. Trump’s popularity in the polls also serves as an indicator of our current American culture.

How False Beliefs About One’s Self Can Play into Anxiety and Depression

What makes you, you? According to Brian Little, PhD, author of Me, Myself, and Us: The Science of Personality and the Art of Well-Being, there are five consistent traits humans embody.

“Many personality researchers have concluded that the hundreds of different trait dimensions can be reduced to five major factors that consistently emerge in data collected across different cultures and language groups. The so-called big five dimensions are: open to experience (vs. closed-minded), conscientious (vs. careless), extraverted (vs. introverted), agreeable (vs. disagreeable) and neurotic (vs. stable).”

Are these qualities cast in stone at birth or are they mutable?  It may come down to the question of nature vs. nurture. Those who take the former stance are referred to as ‘nativists’ who view personality traits as immutable, while others who are in the second camp are referred to as ‘empiricists’.  Each makes a valid point and yet, we are an adaptive species with daily opportunities to take a different path an alter our decision making by changing our beliefs about the person in the mirror.

In an article entitled “Identity Formation.” Boundless Sociology. Boundless, 26 May. 2016, “Identity formation is defined as, “development of an individual’s distinct personality by which he or she is recognized or known.”

Identity is delineated in several categories that include:

  • Cultural
  • Ethnic
  • Religious
  • National

Each is part of a puzzle that comprises the ways in which an individual is viewed by the world and even more importantly, by themselves.

Who Are You? Who, Who, Who, Who. I Really Wanna Know

Rock lyrics aside, an exploration of the ways in which we perceive ourselves and our place in the world, is worth attention.

A therapist who has worked with a variety of clients over three decades has observed that the hardiest and most resilient among them have been able to acknowledge their core essence, and cultivated the ability to become chameleon-like when needed. She recalls an older gentleman who grew up in a working class home, situated in a multi-ethnic neighborhood. He and his three siblings were first generation American born of immigrant parents who fled persecution in their homeland. They were told that they needed to assimilate in order to succeed; speaking their native language in the home, but only English outside the home. She witnessed that he was able to maneuver his way through nearly any encounter with people from all walks of life and socio-economic backgrounds. He had developed that ability by imagining ‘walking a mile in their shoes’.  Although he had a clear idea that he fit into each of the aforementioned categories identity based categories: Blue Collar-Russian-Jewish-American, he knew he was far more than that and as a result was highly successful in his relationships. He exhibited the open minded, conscientious, extraverted, agreeable and stable classifications.

Another, who had experienced abuse at the hands of his alcoholic father, developed the belief that he needed to consistently prove himself and that he would never measure up. Although he presented as confident at times, deeply committed to excellence, affectionate and demonstratively loving, there was another aspect of himself that demanded loyalty and agreement with his world view. As a result, he was often at odds with his finer qualities. He saw himself as the reflection of his father’s perspective and it created conflict in relationships that he desired to be harmonious. Episodic depression and anxiety, as well as OCD behaviors infiltrated his home, work and social life. He exemplified close minded, conscientious, extraverted (with occasional introverted tendencies), disagreeable and neurotic traits. His identity was formulated, also as was the first man, Middle-Class-Irish-American-Protestant; although it had less impact on shaping his affect than did the personality traits.

How Do We Change Our Self -Assessment?

  • Ask yourself, “What am I believing about myself or this experience?”
  • Be aware of when you are making broad generalizations about your behaviors labeling you. An example might be, “I made a mistake vs. I AM a mistake.” Or “I have so many flaws, so I am not worth loving.”
  • Challenge those thoughts.
  • Be willing to re-write the narrative you have running through your head.
  • As is encouraged in the recovery community, do a ‘searching and fearless moral inventory,’ as you take an honest look at what you have done, the decisions you have made and how they impact your life.
  • Choose to change what you can.
  • Put down the proverbial whip which you have brandished at yourself.
  • Embrace your strengths.
  • Accept lovingly offered praise and critique.
  • Learn to offer yourself the same quality of love that you give others.

A Cautionary Tale: How Medications Can Increase the Feelings of Depression

Our bodies are miraculous self-regulating creations that when cared for with healthy food, activity, exercise, rest and proper hygiene, can last a long lifetime. There are times, however that they require chemical intervention to maintain function. There are a number of commonly prescribed medications that are saddled with side effects, including depression.

  • Accutane. Used as an acne treatment.
  • Alcohol. Although many report feelings of elation while drinking, it is a central nervous system depressant that anesthetizes emotions and represses inhibitions.
  • Antabuse: This medicine is used to treat alcoholism.
  • Anticonvulsants: These are used to control epileptic seizures.
  • Barbiturates: These are a group of central nervous system depressants that slow down brain function. These medicines have been used to treat anxiety and to prevent epileptic seizures.
  • Benzodiazepines: This group of central nervous system depressants is often used to treat anxiety and to relax muscles.
  • Beta-adrenergic blockers — Also known as beta-blockers, these medicines are used in the treatment of various heart problems, including high blood pressure, heart failure, chest pain caused by angina and certain cardiac arrhythmias. They may also be used to treat migraines.
  • Calcium-channel blockers: This group of medicines slows the heart rate and relaxes blood vessels and to treat high blood pressure, chest pain and congestive heart failure.
  • Estrogens: Female hormones are often used to treat symptoms of menopause and to prevent or treat osteoporosis.
  • Interferon alfa: This drug is designed to treat certain cancers as well as Hepatitis B and C.
  • Norplant: This is used as a contraception.
  • Opioids: This group of narcotics is used to relieve moderate to severe pain. These drugs have a high potential for abuse and addiction.
  • Statins: These medicines are used to lower cholesterol, protect against damage from coronary artery disease and prevent heart attacks; examples
  • Zovirax:  Doctors prescribe this drug to treat shingles and herpes.

Although it seems contradictory, people who experience medications as an antidote to depression sometimes experience a paradoxical effect and find it increasing.

In 1994 Italian psychiatrist Giovanni Fava, M.D, who is the editor of  Psychotherapy and Psychosomatics, encouraged his peers to accept that it might indeed be so. He wrote: “Within the field of psycho-pharmacology, practitioners have been cautious, if not fearful of opening a debate on whether the treatment is more damaging than helpful. I wonder if the time has come for debating and initiating research into the likelihood that psychotropic drugs actually worsen, at least in some cases, the progression of the illness which they are supposed to treat.”

He reported that, the brain is trying restore its “homeostatic equilibrium,” referring to this enigmatic response to a psychiatric drug “oppositional tolerance.”

This was reinforced by the work of researcher, Rif El-Mallakh, M.D.at the University of Louisville School of Medicine. In the June, 2011 issue of Medical Hypotheses, he offers “emerging evidence that, in some individuals, persistent use of antidepressants may be pro-depressant.” He refers to the term as ‘tardive dysphoria’.

Commonly prescribed anti-depressants include:

  • Celexa
  • Cymbalta
  • Desyrel
  • Effexor
  • Elavil
  • Latuda
  • Lamictal
  • Lexapro
  • Pamelor
  • Paxil
  • Prozac
  • Pristiq
  • Remeron
  • Seroquel
  • Viibryd
  • Wellbutrin
  • Zoloft
  • Zyprexa

Do these findings point to encouraging discontinuing use of anti-depressant medications?

If you find yourself noticing and increase in depressive symptoms and before considering any change in medications, speak with your treating physician. Look to complimentary interventions, including psychotherapy, time in nature, a fitness routine, healthy nutritional plan, socializing as able, refraining from isolating, listening to music, interacting with animals, stretching comfort zones by engaging in new activities, volunteering, journaling, light therapy (for Seasonal Affective Disorder), acupuncture, a support group, yoga, meditation, saffron, fish oil supplements, SAMe, as well as St. John’s Wort. Adding these items to your recovery tool kit may ameliorate some of the side effects.

How Does Mindfulness Reduce Troubling Thoughts?

“I’ve got such a mess between my ears, like dishes in the sink. Stuff I don’t believe just tumbles in so I don’t have room to think”- David Wilcox (Empty Out the Inside of My Head)

This common experience is one that leaves in its wake, distress and is a fertile breeding ground for depression. What are some of the troubling thoughts that fill up your symbolic sink?

  • I’m a failure.
  • I’m not smart enough to go to college.
  • No one loves me.
  • I’m too much or not enough to be in a healthy relationship.
  • I don’t matter and have no purpose.
  • I’ll never get it right.
  • Everyone else is happy, except me.
  • I don’t deserve to have what I want.

As a therapist working with clients in an outpatient addiction and recovery practice, I recall a poignant and powerful statement from a single father of three teenagers. He was insistent that they clean up the kitchen after preparing meals, reminding them, “The sink is for washing dishes and not storing dishes.”  How often do we store the dishes that represent the disturbing beliefs we hold so that they, like literal dinnerware accumulate stuck-on stuff? Imagine instead, running soapy water over them and allowing the remains to go down the drain.

Another potent metaphor is that of a glass half filled with water. You can hold it still for only so long and then your arm begins to shake and with it, the liquid within. A few minutes more and the tremors may increase as the water sloshes over the edge, drenching your arm and the floor. It is only when you still your hand and the glass that it remains contained. So it is with our over active brains. That is where mindfulness becomes a helpful tool.

“Focusing on the here and now helps individuals become aware of their negative thoughts, acknowledge them without judgment and realize they’re not accurate reflections of reality,” says William Marchand, M.D., in his informative book entitled Depression and Bipolar Disorder: Your Guide to Recovery. Marchand is a psychiatrist who specializes in mindfulness as a therapeutic tool.

He adds, “When we practice mindfulness, we experience these difficult thoughts and emotions. But we experience them as an observer – rather than being washed away by the never-ending torrent of cognitions and feelings that flood our minds. By becoming moment-to-moment observers of our thought process, we learn to just watch the deluge without getting carried away in the current.”

Still Waters Run Deep

According to Jon Kabat-Zinn, PhD, author of Wherever You Go, There You Are, and the founder of Mindfulness-Based Stress Reduction (MBSR) “The best way to capture moments is to pay attention. This is how we cultivate mindfulness. Mindfulness means being awake. It means knowing what you are doing.”

So, how can we become mindful, instead of mind-filled to overflowing?

  • Remind yourself when pulled into the past which is generally where depressing thoughts are formulated, “I am here and now, not there and then.”
  • As simplistic as that might sound, consider how often throughout the day, particularly when in the midst of stress inducing circumstances, you hold your breath.
  • Observe what is around you. Remember the childhood game, “I spy with my little eye”? You can adapt it to, “I spy with my mindful eye,” and then state what you see around you.
  • Engage in object awareness. Hold a flower, stone or strawberry in your hand and experience it with all of your senses. Attempt to describe it as if to someone who has never seen it before.
  • Full sensory eating. Pick a favorite treat and smell, see, taste, touch and hear it in silence.
  • Wash the dishes or fold clothing with total attention to what you are doing.
  • Take a walk. This too can be meditative as you focus on each step as a distinct movement. A labyrinth can be an effective tool to assist in slowing your movement.