Tag:

cbt

You Are Not Alone

{OCD Awareness Week}

As a kid, I guess I had strange habits: tip toeing on floors to avoid picking up germs, blinking each eye a certain number of times on each side, tapping my fingers as if I was playing an imaginary piano, and the list goes on. I never thought my habits were a problem until kindergarten when my mom was called to pick me up at school. Apparently, it was wrong for me to pee in my pants because I thought the bathroom in my classroom wasn’t clean enough to use. Fortunately, I outgrew most of these habits (yes, I no longer pee in my pants), but some of my symptoms still persist to some degree. Though I do NOT have OCD (Obsessive Compulsive Disorder), I have several patients who suffer from the disorder and feel tormented by their debilitating symptoms.

In support of OCD Awareness Week (October 13-19, 2014), I want to share some knowledge and facts about OCD.

In the United States, OCD is the 4th most common psychiatric diagnosis
- this means that 1 out of every 40 people in this country may suffer from OCD
Internationally, 1 in 100 adults, and up to 1 in 200 children likely have OCD

Therefore, if you have OCD YOU ARE NOT ALONE.

OCD is more detailed to discuss in one post, but the explanation I give my patients includes some of the following points:

Everyone experiences anxiety to some degree. Some may cope with the anxiety by cleaning, organizing, and checking behaviors (such as checking doors to make sure they are locked), but those with OCD repeat these behaviors to the point that their symptoms cause impairment in their day to day lives. Their symptoms can be quite distressing, time-consuming, and debilitating to the point that relationships, school, and work are negatively impacted.
One misconception is that people with OCD are perfectionists, rigid, controlling, domineering, and have a “my way or the highway” mentality. This is not necessarily true because most people with OCD recognize that their symptoms are excessive and problematic, and more often feel embarrassed, ashamed, and far from perfect.

Now, if you’re wondering about my mismatched socks outfit — I’m wearing them to show even more support for OCD Awareness Week. Though the week is almost over, you still have time to show your support and participate in promoting the discussion of OCD by wearing mismatched socks and posting a picture through social media (use hashtags #sockittoocd, #ocdweek).

For more details on OCD and its symptoms, please visit the International OCD Foundation website.

October 16, 2014 4 comments

Psychiatry therapy

Are you ready?

written by freudandfashion

The 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)

September 25, 2014 4 comments

therapy

Thankful Thursdays

written by freudandfashion

IMGP0257

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

Dark Light

written by freudandfashion

{Sunset in Waikiki}

Goodbye, Summer. Shorter days, raindrops on the window, dirt splattering onto my cream-colored slacks…just a few initial signs of gloomy Oregon weather. I’m already preparing for my period of weather-dependent laziness that starts around this time. I teach my patients some of the following simple strategies to feel a daily sense of accomplishment…or shed light on barriers towards accomplishing your goals (mine would be dark, rainy weather, which I documented here/):

1. Make a realistic daily task list, and check them off with pride as you complete each one.

2. Set a goal for the day, and if not accomplished, then write the reason why.

3. When you get overwhelmed, feel like you have no energy, or notice yourself making excuses not to complete a task, do something simple for 15 mins that brings you out of lazy-mode (take a walk, short run, read, journal, etc.).

What techniques do you find helpful? Please share before I turn into an even bigger couch potato this Fall.

September 18, 2010 0 comment

Psychiatry therapy

Leave It Behind

written by freudandfashion

When a patient dwells on a thought to the point of feeling extremely anxious and overwhelmed, I sometimes teach them to approach those thoughts with the following metaphor: Grab onto [the thought] briefly in your hand, then let it go like a feather. Perhaps I need to practice more of what I preach. I have several complex patients who require contant monitoring and found it difficult NOT to think about a few of them during recent trips out of town. Did I prescribe too high of a dose? Will my patient be suicidal and land in the ER? Will my supervisor think I was an idiot for giving that medication? No doctor is perfect, but I do need to learn how to leave work behind (for the sake of maintaining my own sanity).

September 8, 2010 3 comments