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

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medical residency

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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Psychiatrytherapy

Stay or Leave?

written by freudandfashion
Stay or Leave?

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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
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Putting in work at my new office in West Hollywood
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Photos courtesy of Marlon Santos (Diamond Reel Media)
September 10, 2014 24 comments
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Psychiatrytherapy

New Beginnings

written by freudandfashion
New Beginnings

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
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Psychiatrytherapy

Laziness

written by freudandfashion
Laziness

{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
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Travel

Sunset, Sunrise

written by freudandfashion
Sunset, Sunrise

{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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FoodPsychiatry

Birthday Wish

written by freudandfashion
Birthday Wish

I’m feeling overwhelmed after a nonstop day at work.  To brighten my mood, I looked at photos of my recent birthday celebration and read my blogpost from last year (here).  In contrast to last year, I feel more comfortable being myself (well, I’m still in the process of discovery, which is life-long, but at least I’m less embarrassed to admit my weaknesses, demonstrate pride in my strengths, and bring out my valley-girl twang at work).  In addition, I wasn’t carded…not even once, even though I still look like the same, questionably-legal-to-drink young girl.  Perhaps I exude more confidence?  Well, I know for sure that I’ve matured, for when my patients call me “sweetie,” “young lady,” and “hun,” I no longer take offense nor do I view myself as inexperienced and incompetent as I felt last year.  Now that I’m no longering pondering ways to look older, I plan to focus more on improving my stress management skills (to reduce development of wrinkles).

{Birthday at Nobu West Hollywood}

I know my last post was awhile ago, but I’m back from travels and life-changing experiences, which I plan to share in future posts!

June 10, 2011 2 comments
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Uncategorized

Winter Treat

written by freudandfashion
Winter Treat

I’m ecstatic that it’s Spring, though the stormy weather in Oregon makes me feel like I’m still stuck in Winter.  I was proud of myself for getting through my second Winter in Oregon with minimal complaints (for those who know me, that’s major improvement), though my survival required several trips back home to California.  A few highlights from my travels this past holiday season include discovering on Christmas day that I had won the Alexander Wang Anita handbag from Beso’s “The Hold Everything Sweepstakes” (see my winning entry here) .   I recently went to San Francisco to help my sister pick out the perfect wedding dress and felt the bag was perfect for carrying my necessities while strolling through the gorgeous city.

Photos by Marlon Santos

March 17, 2011 3 comments
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Travel

New Year’s Resolutions

written by freudandfashion
New Year’s Resolutions

I spent New Year’s weekend in Los Angeles and had a perfect, relaxing New Year’s eve at home and away from fixe prixe restaurants and nightclubs (I truly believe Oregon life has changed me).  I initially told myself that I wouldn’t create resolutions for the new year, but later sided with tradition and the need for goals to strive towards personal improvement.  Here are a few from my list:

1.  Make daily efforts to de-clutter my apartment.

2.  Master techniques using my D-SLR.

3.  Spend less time vegging on the couch watching tv after work.

4.  Write blog posts more frequently.

{Santa Monica sunset}

January 9, 2011 1 comment
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PsychiatryTravel

Back to Work

written by freudandfashion
Back to Work

After returning from a week-long vacation, I dreaded the pile of catch-up work and voicemails waiting for my much-needed attention.  I assumed that I’d be in vacation-mode and perform sluggishly on my first day back, but surprised myself at how easily I resumed my normal routine.  Even more surprising was noticing the level of comfort I had while interacting with new patients whereas in the past I’d be concerned about whether or not my patients would feel connected to me or question my knowledge being a mere resident instead of a full-fledged Psychiatrist.  One word to describe this new-found feeling? — Confidence.  Confidence may come easily for some, but for me (and most, I assume), it required self-evaluation and rising after feelings of inadequacy and failure.  Once that feeling is obtained, savor the moment the way you savor a great vacation.

November 17, 2010 1 comment
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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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