Anxiety Articles

The Ohio Kidnapping Case:The Moral Injury of Witnessing Atrocity

Thursday, May 16th, 2013

oldcoupleonbenchIn the past two weeks it has been difficult to be anywhere without reading or hearing about the Ohio Kidnapping, 10 year captivity, sexual abuse, torture and beatings causing miscarriages to three young woman and one daughter, locked in a neighborhood house by one man.

Both in and outside of my office people have commented and questioned:

  • How does something like this happen?
  • I can’t watch the news anymore.
  • How could the neighbors not know?
  • Why is there such evil in the world?
  • I could never have survived. 
  • Can these women ever be the same?

Judith Herman tells us that a traumatic event is one that has the capacity to provoke fear, helplessness, or horror in response to the threat of injury or death, or witnessing that in another.

When the trauma is that of nature, we speak of disaster.

When the trauma is man-made, we speak of atrocities.

It is worth considering that in face of this Ohio atrocity, whether we live in that neighborhood or witness the horror in the virtual community of viewers, we cannot easily shake this inhumanity because it is not only traumatizing— it evokes moral injury.

According to psychologist Brett Litz, moral injury is the (social, psychological, spiritual, behavioral) impact of perpetrating, failing to prevent or bearing witness to acts that transgress our deeply held moral beliefs and expectations.

Much like the impact of bearing witness to the horror of the Holocaust, the Genocide in Rwanda, or the modern slavery of human sex trafficking, the Ohio kidnapping transgresses our moral code.

  • We are compelled to talk about it, read about it, rage and despair in face of it because it assaults our beliefs and implicates our humanity.
  • We not only identify with the fear and terror of victims, we fear that we could resonate with the guilt and shame of perpetrators.
  • It disturbs us on many levels.
  • As humans it is beyond us to accept that one of us could do this to another.
  • Yael Danieli suggests that in face of moral horror, we suffer the “Guilt of the Just.”

How Do We Deal …

When Couples Stop Talking: Reasons and Remedies

Wednesday, April 24th, 2013

couplecrpdMost couples know the positive sounds of silence–the mutual experience of sharing time and space together without needing words. Be it walking the dog together, cooking side by side or listening to music–it is the silence of connection and love.

Many couples also know the silence that reflects tension, conflict or disconnection. Unable to speak beyond the necessities of daily life, these couples report, “ We just don’t talk anymore!”

If we recognize “ talking together” as a metaphor for the communication of confidantes, the special interest of partners and the pillow talk of intimates, then we understand that this is a silence that can start to feel emotionally deafening.

Why do couples who once had so much to say end up feeling this way? Is it inevitable as time passes in a marriage? Is there a way back?

Years together need not result in negative sounds of silence.

Yes, events can disrupt harmony and patterns can erode vitality, but if couples are curious rather than blameful about the silence between them, they may find some reasons and remedies to speak together again.

The Reasons:

If we look closer at those partners who end up sitting in a restaurant with nothing to say, painfully aware of the couples happily chatting around them, we find that partners are often unaware of what they may be doing or what has happened to shut down the verbal connection.

Here are some possibilities:

  • The Monologue: Sometimes a partner is in so much need of attention, affirmation or containment by the other that they never stop talking. More interested in what they have to say, they barely realize there is no space for dialogue. The listening partner often complies as audience for a time but there is no real ” we sharing ” and eventually no reason to continue talking.
  • The Critique: Sometimes speaking has become unsafe if one or both partners imply by verbal criticism, overt disinterest or non-verbal gestures that what the other is saying is of little interest or importance. Some are embarrassed or enraged into silence. Some give-up. Some find outside confidantes who want to listen—while the silence at home …

An Asset to Couple Intimacy: The Capacity “To Be Alone”

Tuesday, April 2nd, 2013

capacity to be aloneWhile the definition of intimacy may vary depending on the relationship, it is generally felt to be the “ authentic” connection between two people. As such, the connection reflects a mutuality of loving feelings shared and expressed in thought, affect and behavior.

A host of factors including safety, trust, effective communication and sexual exclusivity have been identified as important for intimacy between partners.

Less discussed and perhaps surprising, is the importance of the “capacity to be alone” in establishing true intimacy.

What Is The “Capacity To Be Alone?”

  • Originally coined by the British pediatrician/psychoanalyst, Donald Winnicott, the “capacity to be alone” refers to the development of individuality that starts with the infant’s ability to be alone in the presence of the mother.
  • It is the child’s ability to move from the sense of the mother’s compassionate, comforting and loving presence, to his/her ability to hold on to her presence, even when alone.
  • This internalized sense of the comforting mother develops into the psychological capacity to regulate anxiety, self-soothe, and experience a true authentic self. In essence, this is the capacity to be alone.

Why Is This an Asset To Intimacy?

  • True intimacy starts with a comfort in your own sense of self.  If you like yourself and feel comfortable, you will be able to relate in a real and genuine way with another person.

You won’t have to be what someone else wants or needs you to be.

  • True intimacy is possible when you have the “capacity to be alone” because it implies choice. You may want to be with someone. You don’t have to be with someone because you fear that being alone leaves you without stability or value.

You don’t have to cling to someone to avoid abandonment or avoid someone for fear of rejection.

  • True intimacy is possible when there is psychological separation or room for partners to come and go from each other physically and psychologically.
  • Couples often report that when they are apart from each other during the course of the day, they think more positively and romantically about each other than at any other time.

Neurochemistry supports …

When Injury Disrupts Exercise: Five Ways to Reduce Stress

Thursday, March 21st, 2013

sneakersThere is considerable evidence that exercise benefits our mental health. Research suggests that in addition to improving memory, lifting mood, moderating depression, and reducing attention fatigue, exercise is a significant stress reducer.

Whether you are a varsity player, a daily walker, a gym rat or an avid golfer, it is likely that the exercise you do helps you psychologically as well as physically. What happens when you get injured?

In most cases physical injury happens in the two minutes we never see coming.  It is physically and psychologically disruptive because it not only involves physical pain and concern about intervention and recovery; it reminds us of the unpredictability of life, and the reality of our vulnerability. For athletes, as well as those determined to exercise, it is a loss that insults our sense of self as well as our sense of mastery.

 “ I can’t be injured, we are in the semi-finals. I have to play!”

 “ I just got the motivation and the routine going and now I break my ankle?”

 “ What will I do if I can’t golf?”

  • If you have ever been taken off the court or out of your usual routine by injury, it is likely you have felt the constraints of a Catch 22.
  • At a time when you are feeling more pain and stress than usual, the one thing you can’t do is use your usual stress reducer–Exercise will make matters worse!

How Do You Proceed?

No matter what anyone says in the first hours, days or week of an injury, it won’t feel right.

“ So You Won’t Run Anymore- You will Do Something Else!” 

“ Don’t Worry—You will be back.”

It is difficult to suddenly adjust to the loss of something that has added value to your life and it is also difficult to suddenly believe you will be ok, when you don’t feel ok. But it does get better…

What seems impossible starts to become possible when you realize there are many ways to reduce stress if you are able to focus on healing, open options, risk possibilities, and draw upon your resiliencies.

Five Ways To Reduce Stress

Become …

Five Strategies to Reduce Excessive Worry

Monday, February 4th, 2013

Given natural disasters, school violence, unemployment, deployment, the fiscal cliff, the flu, erratic weather patterns and tax changes, there are plenty of things to worry about. Everyone worries. The question is how much?

Worry is the negative thinking we do when we are faced with a real or anticipated threat. It is the “ thinking” component of the physical heart racing, shallow breathing and sweaty palms that make up anxiety. “ What if I lose my job?”  “ What if we are hit with another storm? What if something happens to my child?”

Whereas a certain degree of worry may prompt us to plan ahead, ask for help, or change behavior patterns, experts tell us that excessive worry is toxic.

What Causes Excessive Worry

The common misconception that fuels excessive worry is the belief that worry actually accomplishes something positive:

“ I want to be ready when the other shoe drops.”

The Impact of Excessive Worry

  • In reality, excessive worry is not only ineffective as a strategy; but often sets in motion a vicious cycle of paralysis, poor problem solving and fear of coping which in turn escalates more worry.
  • Physically, excessive worry is costly. It trips the release of stress hormones, disrupts sleeping and eating patterns and often compromises the immune system.
  • Overall, spending time ” anticipating the worst” debilitates rather than prepares us for what may or may not happen.

Five Ways to Reduce Toxic Worry

Worry need not become a toxic cycle that takes more than it gives. Here are six strategies that wind down toxic worry:

Reconsider and Refocus

Are you worrying about “ What if” or “What is?” Most excessive worry is about  ‘What if’ – something that we have no proof will ever happen. Keeping you focus and energy on addressing ‘what is’ is not only more realistic but more likely to positively impact your life.

From Thought to Action

As a rule of thumb, if we are acting out too much, it makes sense to start thinking and if we are thinking too much, it makes sense to start acting.

Accordingly, another valuable strategy for reducing worry is to move from thought to action. No …

Understanding Anger in the Aftermath of Trauma and Disaster

Tuesday, January 22nd, 2013

“Is Anyone Else Angry?”

anger and traumaTrauma theorists tell us that while traumatic events are in themselves physically and emotionally assaultive, it is often the emotions suffered after the smoke clears and the media goes home that become painful and disruptive to our recovery. One of these is anger.

Anger in the aftermath of a traumatic event, be it the loss of a child, the destruction of one’s home, a life-threatening diagnosis or the sequel to combat stress is a common and complex response. It can be experienced as a physiological state, an emotion, a way of thinking, a behavioral response or a combination of these.

  • You are not alone if you feel angry about what has happened.
  • Essentially you are suffering. The problem is that when anger persists–it obscures everything else.
  • The ability to make meaning of it and redirect it, keeps it from holding you back and taking more from you.

Understanding some of the feelings and dynamics that underscore anger after trauma may be an important step in your journey forward.

Anger as Residual of Fight/Flight Response

It is to our advantage that our biological arousal system goes into survivor mode in face of danger causing an increase in heart rate, rapid shallow breathing, cold sweats, tingling muscular tension and often-antagonistic behavior.

The problem is that when the danger has passed, our body often remains in a state of hyperarousal, leaving us reacting with anger to what would ordinarily be mildly distressing stimuli.

  • We blow up at the relatives who keep asking if everything is starting to get easier.
  • We storm off the line that feels too long at Starbucks.
  • We find ourselves fighting over everything with our partner.
  • We are driving faster and yelling more than usual.

Because this is a physically driven anger, we need to work from the body out to bring it down. We need to re-set our body rhythms by moving, sleeping and eating well. Moving in any way (exercise, walking, re-building, cleaning, physically helping friends) is crucial.

One widow, who told me she was mad at God after 9/11, started walking and didn’t stop until the tears and …

How To Tell The Kids About Divorce? An Ongoing Parenting Process

Monday, January 7th, 2013

tell kids about divorcePerhaps even more difficult than the realization that a marriage is ending, is the realization that the children must be told.

Regardless of how different a couple’s views may be on what did or didn’t happen in their marriage, most agree that the children need to be spared as much disruption and distress as possible.

Accordingly, most will follow the recommendations of experts to tell the children together in words suitable to their comprehension level–that Mom and Dad will be separating; that they are loved by both Mom and Dad; that they are not to blame; that sometimes Moms and Dads realize that they are no longer happy together; that some things will change but lots of things will stay the same; that Mom and Dad will still be there for them; that everyone will try to talk about changes so that everyone can feel ok….

Since there are no perfect words to make the loss of the familiar family context sound great to a child, adolescent or young adult, it is worth recognizing that “ telling the children” is only the start of an ongoing parenting process that needs to keep unfolding after the first sit-down takes place.

As you take on this parenting process, here are some considerations to keep in mind:

It’s Not Just What You Say—It’s What You Do.

Be prepared to be ignored, rebuffed or heartbroken by your child’s initial response. Much like adults who are told about something that will change their lives–the initial reactions of children may well be their best attempt to cope.

  • Some young ones will say nothing and simply go play.
  • Some school age kids will burst into tears, or voice worry that everything in their life like school friends, sports, and the bus stop will now be lost.
  • Some teens will begin blaming one or both parents.
  • Some college age kids will validate the decision, “ It’s about time!”

Being patient, voicing understanding, allowing time, validating feelings, or just being a compassionate presence (to a little one who goes off to play alone or a teen who needs a …

Reducing Disaster’s Impact: A Simple Guide to Psychological First Aid

Thursday, November 8th, 2012

Nationally and internationally, the most endorsed response in the early aftermath of a disaster is Psychological First Aide.  Used by those responding to disasters, it is a set of guidelines that you can learn to use for yourself and others.

Just as knowing certain aspects of Medical First Aid can help you minimize injury and reduce future medical complications, knowing and using certain aspects of Psychological First Aid can help you reduce the emotional impact of a disaster and its consequences.

Here are Five Steps for Using Psychological First Aid

 I. Establish Physical Safety

  • Given the body-mind connection, it is necessary to secure physical and medical safety as a first step to psychological safety.
  • In securing what is needed to maintain physical safety (food, shelter, water, heat) it is often helpful to access options and then make a temporary or working plan that can be updated. This often mobilizes people to safety, as they know they are not making permanent decisions.  

 Families have moved in together in arrangements they never would have dreamed possible-as a way of keeping each other safe.

II. Establish Psychological Safety

  • Accept and normalize your feelings.Recognize that feelings of disbelief, fear, terror, helplessness, and anger are very common to the situation you have faced. For most people they may persist as difficulty sleeping, intrusive thoughts and memories, or a sense of numbing for a week or two and then dissipate.
  • In those cases where someone displays a sense of disorientation, unremitting panic or inability to cope, emergency medical care is warranted.
  • You have often heard the expression “ What doesn’t kill you makes you stronger.” – Well, Not So Fast.
  • Consider that while people differ, for most of us, it takes a while to adapt to a crisis situation. Even as people are busy surviving and helping others survive, survivors are often feeling a mix of relief, pain and uncertainty. It makes sense.
  • Recognize that in disasters – SMALL THINGS ARE BIG in making us feel less helpless.
  • Look for those things you can control. Set up achievable goals- be it playing a game with the children; finding …

What Presidential Campaigns Can Teach You About Your Relationship

Wednesday, October 3rd, 2012

campaigns and relationshipsIf you are human, in a relationship and living on this planet there will be decisions to make and problems to solve. They may be intrinsic to your circumstances, imposed upon you by outside factors, or a function of your personal needs and goals.

For most couples issues related to jobs, residence, children, socializing, religion, sex, money, in-laws and more demand decisions but often invite dissent.

If you want a clear example of the type of behavior to avoid when problem solving as a couple you have only to take a look at the presidential hopefuls.

Recognizing that they are, of course, contenders and putting aside the specifics of their platforms or the campaign engines that drive their rhetoric, they nonetheless offer a glimpse of the type of the exclusionary thinking and reactivity that erodes collaboration, jeopardizes problem solving and risks relationship success.

Dynamics to Avoid:

Consider avoiding the following as you and your partner build the platform for your life together.

  • Coming from an “all knowing position.” “ You know nothing about cars and have no experience buying them, I will choose.”
  • Blaming the partner for things outside of their control. “ Why would I want to go on another family vacation when the kids always get sick?”
  • Assuming the worst about your partner. “ I really want to socialize with the people from work but I know you will be uncomfortable.”
  • Looking only at what the partner has done wrong with respect to an issue. “ When it comes to money, you are the last person who should have anything to say. You used to have a bad credit rating.”
  • Negativity about the other in public. “ He has no idea of the kids’ schedules or what they need on a day to day basis.”
  • Coming into the problem solving with a solution. “ So I have it all figured out – we will buy a two family house with my parents.”
  • Refusing to see problem solving or decision making as a building process. “That won’t work, forget it.”
  • Seeing each other as one-dimensional. “ You are a city person. Why would you …

Reducing Marital Stress Helps Children Return to School

Monday, September 3rd, 2012

marital stress, back to schoolWhen children head back to school this year, they should not be carrying emotional baggage from home.

When we worry about how our children will handle school- what they will face and how they will cope, we often overlook the impact of marital strife on their physical, emotional and intellectual functioning.

It is difficult to feel confident, curious or open to new school friends or ideas when you are a young person weighed down by exposure to adult conflict and issues.

While we know that the impact of most traumatic events on children can be reduced if parents remain calm & learn to manager their own feelings, marital strife poses a bigger challenge. In the case of chronic marital strife, the very people who are supposed to offer safety are the ones creating the danger!

Don’t All Couples Fight?

Yes, in fact if a child never saw any discord or disagreement, he/she would have no model for conflict resolution or regulating a broad range of emotions.

Marital strife that creates a potential emotional crisis for a child of any age is a different animal altogether. It involves expressions of anger that can include chronic but subtle verbal abuse, the silent treatment, bitter fighting and at the extreme, domestic violence that warrants a 911 call.

Unregulated marital discord demands too much of children and teens.

  • Some children run in to rescue the parents and reduce the tension by engaging either or both parents in something fun, interesting, or attention getting.

Do they need this extra job as they face new appropriate childhood challenges?

  • Some children will draw the fire to themselves (consciously or unconsciously) by misbehaving or acting out in order to shift the emotional tone.

Is this a learned pattern of survival we want a youngster to take with them in life?

  • Older children will learn to escape into their rooms, their phones, or their computers- sadly some may learn to escape into drugs and alcohol.

In their necessary avoidance they tragically lose not only the connection with their parents, but a world of knowledge, relationships and …

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Suzanne Phillips, Psy.D., ABPP & Dianne Kane, DSW are the authors of Healing Together: A Couple's Guide to Coping with Trauma and Post-Traumatic Stress. Pick up the book today!

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Recent Comments
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