Archive for November, 2009

Grandparenting Anxiety

Saturday, November 28th, 2009

Watching the children of our children–our grandchildren–fills us with thoughts about the meaning of life. We find ourselves more concerned about our environment, nuclear proliferation, war, politics, healthcare, and the deficit we are leaving for our next generations to pay. Those issues, though always smoldering, felt relatively dormant during the years of getting an education, raising a family, and working. Now, with a little more time to think, we also have more time to worry.

In addition to the existential concerns we have as elders (good grief, not us!), we also have the day to day challenges of being grandparents to families that are changing (that’s the politically correct way to say breaking up and reforming). Like many grandparents, we find ourselves frustrated and impotent; watching people we love make decisions that may have detrimental, yet unknown effects well into the future. At the same time, we have to say that our challenges are mild compared to those of other grandparents that we see in the work we do.

But, the similarities are there. Many grandparents are being asked to be quasi parents to adult children, with some of the same responsibilities, but none of the power. These young adults often ask for financial help from their parents, sometimes as innocent victims of the economy; other times, seduced into excessive spending by our culture of entitlement.

And grandparents increasingly are being asked to assume greater care of their grandchildren. In a nationwide trend, about eight percent of American children are being raised by their grandparents. That’s about 6 million children. Furthermore, many other grandparents are being asked to step in to help provide regular daycare for working parents.

These changing roles pose challenges for all concerned. Grandparents want to help and many times they must and should. At the same time, grandparents often harbor worries about how much help is too much. It’s all too easy to cross the line between providing truly needed assistance and fostering excessive dependency and lack of financial responsibility. When does helping morph into blurred boundaries and an enmeshed entanglement of lives? When do helpers’ efforts become self destructive, possibly even financially ruinous, in …


Psychotherapy: Art or Science?

Wednesday, November 18th, 2009

In recent weeks, several articles have appeared previewing the work to be published in November’s Psychological Science in the Public Interest. In this article, the authors allege that the majority of psychotherapists fail to use empirically validated treatments. Furthermore they suggest that millions of people are getting therapy based on the personal theories of their therapists rather than on the substantial research studies that support specific types of therapy for specific problems. Many of the strategies that the authors refer to are based on the premises of cognitive and behavioral theory but a few other approaches have received some empirical validation.

I have a couple of reactions to this news. First, there are effective treatments for emotional disorders such as depression, anxiety, Obsessive Compulsive Disorder, Post Traumatic Stress Disorder, and Borderline Personality Disorder. In fact, we regularly write about these treatments in this blog. If your therapist can’t identify what he or she is going to do to help you, find another therapist.

Imagine going to a medical doctor for severe headaches who tells you that she plans on meeting with you once a week, talking about your headaches and giving you lots of attention. For that, you’ll hand her some money and your headaches should improve. You’d likely run from her office. A psychologist, like a medical provider, should be able to describe a way to diagnose and treat your symptoms. Of course, in order to benefit from the plan, you must participate in the treatment.

Second, beginning with my bachelor’s and master’s degree at Wayne State University I was trained in the theory and principles of cognitive behavioral therapy. In fact, I can remember the professors making fun of penis envy in my introduction to psychology class (circa 1970). This training continued for another master’s and Ph.D. in clinical psychology at Fielding Graduate University. Like all licensed psychologists, I update my skills through continuing education. Most of the offerings I have attended over the years are focused on evidence based treatments. I often attend workshops given by the Association of Behavioral and Cognitive Therapies, a national organization that advances training and research related to cognitive behavioral …


When Dummies Get Together

Monday, November 9th, 2009

To our regular blog readers: Forgive us for indulging in some stray musings today.

We’re hanging out in the San Francisco airport waiting for our flight back home to New Mexico, reflecting on the unique conference that just wrapped up. Actually, it was an unconference, meaning that it was designed to be interactive and collaborative rather than a series of lectures. In addition, the participants were all proud to call themselves Dummies. That’s because we all have written one or more books in the For Dummies series.

What an interesting collection of people! The authors came from both coasts and all walks of life. The group included professors, computer geeks (umm, actually wizards!), business consultants, mathematicians, medical doctors, web designers, psychologists, a photography guru, and a very funny cartoonist. Our purpose was to collaborate on how to spread the word about the quality of the For Dummies series of books and the people who write them.

The weekend began with a cocktail party on Friday evening at the home of Diabetes, High Blood Pressure, and Thyroid For Dummies. We hitched a ride with Acne For Dummies. We were a little nervous about our own reception given our moniker, Borderline Personality Disorder, Obsessive Compulsive Disorder, Anxiety, Seasonal Affective Disorder, and Depression For Dummies (after all, who would want to talk with two people carrying so much emotional baggage?).

Nonetheless, we were warmly welcomed by LinkedIn, Starting an Online Businesses For Dummies, and Starting an iPhone Application Business For Dummies. We were engrossed in a surprisingly interesting conversation with Algebra I, Algebra II and Business Math For Dummies. Java For Dummies was delightful, though we never did quite figure out what Ruby on Rails For Dummies was all about. Accounting For Dummies talked about the old days of former publishers of the For Dummies series-Hungry Minds and IDG as well as his dreams for the future. Speaking of dreams, Dreamweaver & Creating Family Websites For Dummies arrived late accompanied by the 5th Wave (cartoonist). Those two perked up the evening so much that everyone chatted for …


Beyond Mindfulness

Tuesday, November 3rd, 2009

My wife, Dr. Smith, and I are big fans of mindfulness approaches to therapy and we’ve included discussions of mindfulness in most of our self help books within the For Dummies series (including Borderline Personality Disorder For Dummies). In brief, Mindfulness is typically described as involving focused attention on experiences in the present moment as well as acceptance and openness to whatever the present entails. Experiences are observed and noticed rather than evaluated and judged.

A real advantage of taking a Mindful approach to experience is that relatively few present moment experiences are truly “awful” or intolerable. In fact, the vast majority of things that gravely upset people have to do with imagined, future catastrophes or guilt, shame, and self loathing over past actions.

One of our favorite discussions was about me learning the value of mindfulness in our earlier book, Depression For Dummies and it goes as follows:

Charles never feels as grounded and at peace as when he takes our dogs on a long jog three or four times each week. He heads out the door and in just a few minutes makes it to the West Mesa overlooking Albuquerque. You can see the entire city laid out at the footstep of a majestic mountain range. The view is stunning and you can see many miles out to the horizon.

The mesa is laced with dirt roads and gullies created by occasional downpours that blow through the otherwise parched land. Rabbits routinely dart across the running path. And once in a while, you can spot a coyote in the distance. Charles connects with the experience by noticing the rhythm of his running, the obvious joy the dogs exhibit, the quiet, and the (usually) gentle breezes.

Because he runs a long way, sometimes predicting a sudden downpour is impossible. The first few times rain started to drizzle, Charles cursed his fate and picked up the pace to return home as quickly as possible. But frequently Charles got soaked before he arrived home, and he felt distressed at his soaked condition. After all, everyone knows it’s awful to get drenched in the rain.


OCD: Feeling, Thinking, Doing

Monday, November 2nd, 2009

 

Obsessive Compulsive Disorder (OCD) involves feelings, thoughts, and behaviors.
 
For the vast majority of people with OCD, the feeling of anxiety is prominent. A man with OCD might have an obsessive thought that a doorknob is contaminated and the thought of touching the doorknob causes him great distress. He takes a spray bottle of disinfectant and sprays the doorknob and his anxiety decreases. That momentary relief feels pretty good, until the next doorknob appears. The pattern repeats-an obsessive thought, an overestimation of danger or risk, increased anxiety, a compulsive action, and then feelings of relief.

 

OCD also involves thoughts. For some people with OCD their obsessions and compulsions are more in their heads than in their guts. Consider a woman who feels a compulsive urge to arrange her canned goods in a “certain, perfect” order. She doesn’t report feeling particularly anxious at all. It’s just that she feels things aren’t “right” if she doesn’t have everything in a just so order.

 

OCD can also show up primarily in behaviors. For example, a man might feel a driven need to go through doorways in a particular manner. Until he gets it “right,” he can’t let himself continue on his way. He can’t come up with any particular thoughts about why he needs to go through doors in this way; he just feels he must.

 

As these examples illustrate, OCD manifests itself in many widely differing forms. The prominent feature(s) may involve anxiety, thoughts, behaviors, urges, or distress. Although OCD is currently considered a type of Anxiety Disorder, many professionals believe it deserves its own separate diagnostic category.

 

The take home message is that this is a fascinating, yet quite complex disorder. If you “think” you may have it, consider seeking professional consultation. This is one problem that you don’t want to self diagnose. The good news is that usually treatments work very well for OCD.

 

 

 

 

 

 


Anxiety & OCD Exposed



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Laura L. Smith, Ph.D. and Charles H. Elliott, Ph.D. are authors of many books, including Overcoming Anxiety for Dummies and Child Psychology & Development for Dummies.

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