Author

freudandfashion

I'm a newly graduated psychiatrist who believes it's stylish to talk about mental health. Welcome to my diary, Freud & Fashion, created in 2010 to document my life as a psychiatrist-in-training and share knowledge and psychotherapy pearls that I learned along the way.

therapy

Thankful Thursdays

written by freudandfashion

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Malibu Beach

People who meet me tend to perceive me as a positive person, but I’ll admit that I wasn’t always that way. I was quite the complainer growing up and blamed others if things didn’t go my way. My negativity improved through maturation over time, but my four years of psychiatric residency training certainly helped me become more self-aware. Learning about different psychotherapy techniques sharpened my skills even further, and one modality that I use involves Positive Psychotherapy.

What is Positive Psychotherapy (PPT)?

In a nutshell, Dr. Martin E.P. Seligman spearheaded the development and research of PPT as an intervention for treatment of depression and the theory consists of some of the following concepts:

– focus on the POSITIVE (factors that contribute to happiness and build upon one’s strengths)

– build POSITIVE EMOTIONS (about the past, present, and future)

– identify and utilize your STRENGTHS

for example, if you’re a creative person, do things that bring out your creativity (such as writing, photography, etc). If you’re competitive, consider joining a recreational group or league

– instead of letting your strengths and talents go to waste, apply them towards something MEANINGFUL (such as in your job, community, family, religious institution, etc)

Naturally, this can take a lot of work/effort especially since our minds may automatically take us down a negative spiral in the face of challenge and negativity. With our often stressful and hectic lives, when something goes wrong, it seems like it requires more time and energy to switch to a positive mindframe. With that in mind, Seligman’s team developed a series of exercises to help shift your mind towards more positive thinking, one of which includes listing “3 good things” that went well during your day.

So, with a slight twist and in the spirit of PPT, I created a new series on my blog called “Thankful Thursdays” where I will list 3 things I’m thankful for from the week and I encourage all of you to do the same!

Here’s my list from this week:

1. Took advantage of living a few miles away from the beach and spent some time there to escape the triple digit California heat wave (picture above).

2. I’m thankful for my family stopping by my office to visit and instead of my usual routine of going home to check email and watch tv, I enjoyed quality time with them over a delicious meal.

Dinner in West Hollywood

3. Received a “sign” today which steered me in a different direction regarding a work project. I truly believe that when one door closes, another one opens, so I’m staying focused and optimistic!

On a boat in South Lake Tahoe

What 3 things are you thankful for?

References:

Seligman, M. E. P., Rashid, T., & Parks, A.C. (2006). Positive psychotherapy. American Psychologist, 61, 774-778.

Photo Credits: Marlon Santos (Diamond Reel Media), Alex Manipod

Disclaimer: this post describes one therapeutic technique and should not be used to replace treatment with your primary clinicians

September 18, 2014 9 comments

Psychiatry therapy

Stay or Leave?

written by freudandfashion

Office Balcony Sunset

I recently made a difficult decision regarding my job, which triggered feelings of uncertainty, fear, and self-doubt. In the process of contemplating my decision, I recalled one of my patients, a college student who struggled with depression. Despite going to a prestigious university, his overwhelming fear of not getting accepted into law school further exacerbated his depressive symptoms. I responded with seemingly consoling statements such as “you’re still young…you’ll get there…you have a lot going for you…I went through the same situation and it worked out okay.” However, my attempts to reassure really weren’t reassuring at all (it’s well known in psychiatry that reassurance generally doesn’t reassure mostly because the statements fail to validate the patient’s current experience). Reflecting back, I realized that in the moment I didn’t want to relive my own pain, uncertainty, and fears that I experienced in my process of applying to medical school. I recalled the discouragement I felt with each rejection letter I received. And I was still feeling discouraged at my current job. Since I gained insight from connecting his experience with my own, I looked forward to validating his feelings at his next appointment. Unfortunately, he cancelled his appointment and never returned.

I realize that contemplating decisions regarding a career path, relationships, love, and pretty much anything pertaining to life in general, makes us vulnerable and uncomfortable. The idea of change can trigger fear and act as a barrier towards future ventures. After a year long process, I finally decided to resign. My anxiety peaked even more because I felt uncertain of the next step to take. Where do I go from here? Will I feel happier? Will I regret my decision?

Seeking motivation to push forward and take risks, I read quotes by famous writers, all with similar themes to never give up, choose the “road less traveled,” try new things, and learn from your mistakes.

The dangers of life are infinite, and among them are safety. ~ Goethe

Yet, it took being on a plane last night watching The Amazing Spiderman 2 hearing Gwen Stacy (played by Emma Stone) give her valedictorian speech to make me realize how mainstream and pervasive this dilemma is:

“…I say it today of all days to remind us that time is luck. So don’t waste it living someone else’s life, make yours count for something. Fight for what matters to you, no matter what. Because even if you fall short, what better way is there to live?”

As mentioned above, my decision involved resigning from my highly-desired, well-paid job in order to take control of my life, practice, and career. Since my last day, I have mixed emotions of feeling liberated, hopeful, excited, yet completely scared at the same time.

I made the right decision.

“…you can fail at what you don’t want, so you might as well take a chance on doing what you love.”

~Jim Carrey

Putting in work at my new office in West Hollywood

Photos courtesy of Marlon Santos (Diamond Reel Media)

September 10, 2014 24 comments

Psychiatry therapy Travel

Delayed Journey

written by freudandfashion

Sedona, AZ

Confusion about my career path, difficulties prioritizing, and a busy schedule are the only excuses I have for going eight whole months without writing a blog post. If you asked me one year ago to describe how I envisioned my life would be post-residency, I would have said “happy,” “free,” “liberated,” “fun.” However, a few months after buying my first house, getting my first paycheck, studying three straight months for the Psychiatry board exam, and passing the Psychiatry board exam, I thought to myself — “Is this it? Is this really what I spent 12 grueling years after high school working towards??” Survival was my primary goal throughout medical training, but once I gained confidence and knew I’d survive, I focused on sharpening my clinical skills. Then, finally, I prioritized my time towards getting a job (after all, who wants to spend > $200K on an education and not end up with your dream job?). Yet, throughout my education, there was never mention of the emotional toll that the transition from post-graduate school to real life could take. After graduation, I experienced some “happy” and “free” moments, but had an equal amount of depressing moments (if you’ve read past blog posts, you’ll know this usually involves immersing myself in reality tv and slacking off on workouts). At times, I wished I was back in the student role where you have a built-in support system of friends and supervisors to consult on a regular basis. I have a wonderful job, but am still waiting for some form of delayed gratification.

I eventually grew tired of sitting around and waiting, so I went on trips in hopes to gain clarity and direction on the next steps to take in life.

I stopped beating myself up about having a lazy exercise routine and joined a Crossfit gym.

Photos courtesy of CFA

Then, moved into my new home.

I’m not 100% certain of what’s next in my life journey, but I’m happy to say that I’m stronger than ever, finally moving forward, and excited to find out!

What types of things have you done to gain clarity when you’ve felt stuck?

September 5, 2013 18 comments

Psychiatry

Know Your Limit

written by freudandfashion

266

Came home from work late today…again.

I’m passionate about my job as a psychiatrist and spent about two hours with each patient that I was called to consult on the medical floor this weekend. Lunch and dinner were an afterthought. I felt the hunger pangs, but pushed on because the appreciation received from each patient for taking time to understand their situation made hypoglycemia worthwhile.

Today, I spent several hours on a complicated case. Coordination of care took place, notes thoroughly written, and necessary calls made. I left the clinic with a goal to leave work behind. However, the patient is still on my mind. Accepting that I can’t save a patient is one of the most difficult aspects of my job. No words of appreciation expected, no reassurance of their safety, no guarantee of tomorrow.

I can’t cure, I can’t heal, I can’t save, but it would be out of my character not to at least try.

December 4, 2012 30 comments

Psychiatry

Popular Party-Pooper

written by freudandfashion

{Port Hueneme Pier}

Introvert = energized by activities alone

Extrovert = energized by activities around people

Introvert tends to negatively associate with being a “loner” or “party pooper” and conversely, one may assume that an extrovert is “the life of the party.” Growing up in southern CA, I felt pressure to be an extrovert because who really wants to be viewed as a loner or party pooper? But then again, I was also quite young, naive, and superficial, with minimal sense of self-identity, at the time. Pretty standard for a growing teen.

I completed a Myers-Briggs personality test during residency and scores revealed that I was an extrovert. My past young adult self would’ve jumped for joy at the thought of having proof and objective data verifying that I am indeed an extrovert, and therefore NOT lame. But rather, my older, more mature self viewed the scale as demonstrating patterns observed over the last few years, which is that after a bad, exhausting day, I enjoy doing activities with others (such as dinner with a group of friends) to feel more like myself again.

I’ve had patients, especially college students, treated with meds for social phobia, but upon further questioning discovered that they were urged by family members or friends to seek help. Their desire to do solo activities were perceived as “abnormal” by those around them. I educate them about the misconceptions of being an introvert versus extrovert in hopes that they’ll feel less guilty about wanting to stay in for a quiet night at home rather than get wasted at the frat party down the street. Several introverts are also socially outgoing, but may prefer “down time” to relax rather than impressing partygoers with their best keg stand. Great introverted talents and leaders (Steven Spielberg, Julia Roberts, Warren Buffett, JK Rowling, to name a few) excel in different ways than extroverts, such as listening, problem-solving, thinking things through, and leading proactive group members.

Thought of the Day: Which type of activities energize you after an exchausting day?

November 28, 2012 27 comments

Psychiatry therapy

New Beginnings

written by freudandfashion

Taking in the scenery from my balcony on my last day in Oregon

I’m currently sitting on my couch wearing gym attire contemplating whether or not to head to the gym. Five minutes into a repeat episode of “The Real Housewives of Beverly Hills,” I convince myself of an alternate plan to work out at 5am tomorrow before going to clinic (I confess that this is the 10th time I’ve created this plan, but have executed it only once).

My lackadaisical behavior doesn’t surprise me. Previous blogposts exhibit this behavior (here/) and I attribute the laziness to a recent move. My childhood memories relate the experience to the song “Kindergarten Wall:”

“And remember the seed in the little paper cup:

First the root grows down and then the plant grows up!”

I was uprooted when I moved to Oregon, then eventually established my community and made it my home. Moving is a huge transition. One may need to adjust to a new work environment or find a new job, meet new people, discover the least traffic congested roads, join a new gym, etc. I have several patients who present with depression related to a recent move. Though each case is unique, I don’t automatically treat the depression by adding a new medication because mood may improve over time. I empathize with their struggles and generally offer support through the adjustment phase.

It took me about six months to feel comfortable living in Oregon, though i criticized myself each time I felt sad, homesick, and overwhelmed with change. Now that I’m back in so-cal, it’s taking a bit longer than expected to create a daily routine, but I’m familiar with my pattern of establishing roots in a new area of residence (the exercise routine will get there…eventually).

November 21, 2012 4 comments

Travel

Oregon Trails

written by freudandfashion

The countdown of the last eight years of medical school and residency seemed never-ending, but the remaining seven weeks until graduation seem to fly by way too fast. So much has happened in the last six months since my latest blogpost, which includes securing a new job as an outpatient psychiatrist back home in southern California, finishing my final duties as chief resident, starting/leading a bipolar support group, gaining confidence in my abilities as a psychotherapist, and feeling sentimental about my treasured time spent in Oregon. I anticipate the next few weeks to be packed with fun-filled exploration of the great Northwest, which I plan to share with all of you, starting with a few photos from recent trips to Silverton and the Oregon coast.

May 8, 2012 4 comments

Psychiatry

A Life of Distractions

written by freudandfashion

{sunny skies in Los Angeles}

Life gets hectic. Projects fall to the wayside, self-care less prioritized, hobbies take a backseat, laundry piles up, house chaotically clutters — a reflection of our minds overly-stressed from numerous tasks and obligations. Neglecting my blog for the last 2.5 months was an unfortunate bi-product of accomodating my piling “to-do” list these past few months (in addition to less workouts and a messy apartment).

Awareness is key, followed by figuring out how to shift/balance your priorities (a tough task, though it’s possible). Hence, my waking up a half an hour earlier today to write a blogpost in order to reclaim my passion towards writing.

Which important activities (or people) do you pay less attention to during your most stressful, overwhelming moments?

{one of my fave places to think – the fountain at Beverly Canon Gardens}

November 8, 2011 1 comment

Psychiatry therapy

Laziness

written by freudandfashion

{Smathers Beach at Key West}

Staring at my “to-do” list makes me angry. Only two out of twelve items have been checked off over the course of two weeks. Even as I sit at my usual coffee shop, I’d rather listen to music and daydream of being a karaoke superstar (oddly, I had similar daydreams as a child) or taking a tropical beach vacation instead of doing work. Perhaps I’m tired…or miss my friends and family…or am so overwhelmed by work that I’m procrastinating until the very last minute before I get in trouble (something I used to do in grade school)…or a combination of everything plus life, in general.

Yesterday morning, I released some aggression at kickboxing class, and on my way out, I couldn’t help but smile. At the nearby park, a group of adorable kids were seated around a campfire, laughing and telling jokes. And at that moment, I realized — Sometimes life gets so stressful that we can’t help but revert to our childhood ways of coping, that is, until reality sets in. I’m a physician (not a karaoke dynamo) and I can no longer rely on teachers punishing me for late work submissions.

If only life could be as simple as a campfire during summer break.

August 21, 2011 2 comments

Travel

Sunset, Sunrise

written by freudandfashion

{another sunset in Waikiki}

Written on May 10, 2011…

I just returned from an extremely quick and busy trip to Oahu, then LA, then the Philippines, then nor-cal, and now back to Oregon. Overall, my trip was amazing, inspirational, sad, surreal, spiritual, traditional, and much more words I can’t even recall due overwhelming jet-lag. Unforgettable. I’ve watched the sun rise and set in many places, but never has the daily event inspired so much meaning…until the sun rose on the day of my grandmother’s funeral on May 7, 2011. Each day is marked by a beginning and an end, but the memory of my grandmother’s laughter and love I will never forget.

Happy Birthday Lola…I miss you…

July 27, 2011 1 comment

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