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Freud & Fashion

...BECAUSE IT'S STYLISH TO TALK ABOUT MENTAL HEALTH, ESPECIALLY HOW WE MAINTAIN OUR OWN.

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anxiety therapy

Psychiatrytherapy

Are you ready?

written by freudandfashion
Are you ready?

IMG_3253The Great Sand Dune, Point Mugu

I may prescribe psychiatric medications, but the one treatment I advocate for the most is psychotherapy.

Psychotherapy = general term for talk therapy, counseling; meeting with a mental health clinician for support, insight, and development of coping skills for life challenges.

Patients often ask me whether or not I think they should see a therapist.  My general answer: “I think everyone can benefit from therapy.  I think therapy will help you for (insert reason I believe patient will benefit from psychotherapy here based on my formulation of his/her issues).”  However, despite my recommendation of therapy, the more important question is: “Are YOU ready for therapy?”

Here’s a few reasons why I believe this question is so important:

– Therapy can be challenging.  As humans, we develop defenses to help prevent us from feeling the full extent of deep, emotional pain.  Therapy may lower your defenses, which allows you to experience and process painful emotions in a safe environment.  The well-known phrase “no pain, no gain” applies to therapy as well.  With pain = growth and healing.

– Talking about yourself can be uncomfortable.  You might feel like you’re being judged, which is especially difficult.  And if you’re one who loves talking about yourself, perhaps talking about yourself (and not acknowledging others) may be the reason for your problems (a good therapist should be able to point this out).

– You can never predict what might come up in therapy, so being open to the process can lead to development of great insights.  There might be times when you want to stop therapy or may question if it’s even helping.  Being open to processing your resistance may lead to great insights as well (i.e. any material that comes up in therapy may have meaning and be subject to processing during session).

I write this post not only as a clinician, but also as one who has experienced all I mentioned above in my own therapy process.  Even as a psychiatry resident physician, I resisted starting therapy because I feared what I might learn about myself.  I grieved the loss of my grandfather, struggled to adapt to my move to Oregon for residency, and felt depressed because I wasn’t performing as well academically, and various other reasons.  In effort to avoid therapy, I first turned to exercise, shopping therapy (not the best on your credit card), and talked to friends, which helped temporarily but didn’t help me learn to better cope with my issues.  I eventually gave in, faced my fears, and as a result I’m much more self-aware, insightful, and comfortable with myself as a person.  I’m also a much better psychiatrist to my patients (nothing makes you more empathetic towards your patients than putting yourself in their shoes and sitting in the patient’s chair).

P.S.  Not all therapists are the same.  If you don’t have a connection with your therapist, don’t give up on finding the right one! (stay tuned for a future post on how to find the right therapist)

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September 25, 2014 4 comments
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therapy

Thankful Thursdays

written by freudandfashion
Thankful Thursdays

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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.

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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!

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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
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PsychiatryTravel

Vacation Time

written by freudandfashion
Vacation Time

One thing I’ve mastered during residency is the timing of vacation and making the most of those few days of freedom.  Four months without vacation is far too long, one month intervals is too soon, but a vacation every 2.5 months comes out to be just right.  I’m at the point of yearning for some much-deserved time off, which I plan to spend soaking up sun to boost my Vitamin D and eating/shopping/partying in one of my favorite cities.  My key to surviving residency incorporates a balance of combining work, relaxation, and fun, because the former can easily dominate over time, resulting in high anxiety, struggles to get up in the morning, a shorter temper, less sleep, and less people wanting to be around me.

November 1, 2010 0 comment
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Psychiatry

Just Breathe

written by freudandfashion
Just Breathe

{driving on I-395 in Miami}

Two things that annoy me on a daily basis:  drivers who tailgate and drivers who drive too slow.  Being from California, I’ve learned to drive aggressively and posess a constant level of road rage.  I never thought a driver who followed traffic laws existed until I moved to Oregon where the average person makes full 3-second stops, drives below the speed limit, and is shockingly courteous towards other drivers.  Now that I’ve lived here for over a year, I admit to some appreciation for the overly-cautious driver though I constantly find myself in a tense, angry state every once in awhile.  On my way to work today, I noticed my tight grip on the steering wheel and my frequent glares at a speeding car through my rearview mirrow.  I felt my neck muscles tense and head start to feel heavy before I realized that I just needed to relax and BREATHE.  Take a deep breath…and another deep breath…then switch to the next lane and simply let the driver go.  Breathing sounds like a simple solution to high anxiety situations though plenty of people, including myself, have to remind ourselves to do so.   I wanted to attach a video demonstrating the diaphragmatic breathing technique, but the videos online have a cheesy 1980’s vibe.  I’ll find one eventually, or make my own.

Tip of the day:  Next time you go into anxious or angry mode –remember to breathe!

October 19, 2010 1 comment
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Psychiatrytherapy

Mindfulness Candy

written by freudandfashion
Mindfulness Candy

I first tried Mindfulness to help with my attention issues, which I documented here .  Yet, Mindfulness can be applied to nearly any aspect of daily life.  Here’s a simple exercise you can try:

Do you recall the last time you truly savored a piece of food?  And no, I don’t mean devouring a mouth-watering morsel, but instead, actually truly recognizing each component…each ingredient…each texture…each burst of flavor.  Now, start by making an M&M (or Skittle if you’re not a huge chocolate fan like me) last in your mouth for about 2 minutes (or as long as you can) and be aware of every single sensation you experience in relation to that one piece of candy.  Be aware of its texture.  Notice your increase in salivation.  Feel how it changes from smooth to slightly bumpy.  Place it against the roof of your mouth with your tongue.  Sense its temperature change from cool to warm.  Recognize details of its flavor – sweet, rich, fruity, slightly bitter, etc.  Feel the breaking of its shell as it splits into little pieces.  Recall your sweet childhood memories of happily walking through the candy store, carefully selecting each yummy treat, sharing them with friends, or keeping it all to yourself.

Now apply this simple exercise to everyday life.  Instead of stressing about the next minute, hour, or upcoming events, savor what you experience in the present time.  Be aware of each moment.  Focus on one thing.  Let go of distractions.

 

Exercise derived from my residency’s associated Clinical Psychology Professor.  Image via flickr.

May 13, 2010 2 comments
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FashionPsychiatryTravel

Sweet Relaxation

written by freudandfashion
Sweet Relaxation

3 Simple things I did for me this weekend:

1.  Sipped refreshing watermelon lemonade on the sunny deck of a cute local cafe (http://lemonadela.com/).

2.  Shopped by the Santa Monica pier and bought the perfect white dress to pair with strands of blue beads (http://zara.com/#/en_GB/woman/collection/4).

3.  Slept in without the annoying buzzing sound of my alarm clock.

I’ve noticed that my weekend getaways back home to LA have become more relaxing (and less tightly packed with scheduled activities) over time.  With work being busy, my sleep has decreased and frequency of tension headaches have been high, but I keep chugging along knowing I’d be able to catch up on sleep once the work week was over.  I’m devoted to work and the quality of care provided for my patients so much that I’m willing to stay late for impromptu family meetings and do last minute check-ins on those struggling the most.  The second most common question I’m asked by patients and staff (after “Are you old enough to be a doctor?”) is “Wow, you’re still here?”  To address the stress and overwhelming feelings that some of my patients experience from devoting nearly 100% of their time towards caring for others is asking them to take time to do something for themselves.  It’s difficult to truthfully take care of  anyone until you take care of yourself first.  What little things have you done for yourself recently that makes you happy?

May 5, 2010 1 comment
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Psychiatrytherapy

A Moment of Clarity

written by freudandfashion
A Moment of Clarity

I’m a perfectionist who tends to be very sensitive to criticism.  As part of my residency, I began seeing outpatients 3 months ago to manage medications and provide psychotherapy, which was extremely anxiety-provoking during the first 2 months.  My heart rate rose each time a patient burst into tears, told me they wanted to die, and disclosed traumatic experiences suppressed for years.  Each time I watched my patient unravel, I felt immense pressure to say the magic words to make them feel better and provide a brilliant synopsis of their entire life story after a 30-minute session.  Even more intimidating was knowing my supervisor was watching me through a 2-way mirror evaluating each statement I made.  I felt dumbfounded each time I paused too long and resorted to asking the most annoying question in Psychiatry: “So how did that make you feel?”

Despite being so hard on myself, a moment of clarity came this week when I saw two of my very first patients that I’ve followed regularly since my outpatient clinic started.  Three months ago, they isolated in their homes due to severe depression, had low self-esteem, and felt hopeless about life due to past trauma and abuse.  Having the opportunity to observe even the smallest changes they’ve made is rewarding.  Simple things such as going outside for a walk, cleaning the house, putting makeup on, and going on their first job interview in years, might seem like nothing to others, but for someone who’s reached rock-bottom to the point of suicide means the world.  Perhaps I contributed somewhat to their improvement by providing an outlet for disclosure of pent up feelings or gave insight into how past events effect their current emotions.  Ultimately, they gained inner strength to make such progress, which makes all the stress, palpitations, and criticism worthwhile.  They demonstrate my purpose and the reason I went into Psychiatry.

April 19, 2010 2 comments
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