Archives for February, 2012
When your partner, friend, sister, or other person in your life asks the question, it might seem as if the only appropriate answer is "No." It's a damned if you do, damned if you don't moment because it's also likely that if someone is asking you that question, she isn't going to believe your answer anyway. What you need to know is that the person asking the question isn't actually looking for a yes or no. She may think she is, but there's more behind the question, and it's your job to help her figure out what she really needs: Validation? Reassurance? Love? Here are five ways to approach answering the question:
February 26th through March 3rd is National Eating Disorders Awareness Week, and the posts on Partners in Wellness this week will address how eating disorders may be impacting your partner and your relationship. The theme for this year's NEDA Week is "Everybody Knows Somebody." As the incidence of eating disorders increases, it is likely that everybody knows somebody who has (or has recovered from) an eating disorder, whether that is anorexia, bulimia, binge eating disorder, or an eating disorder that doesn't meet the full criteria for a specific diagnosis (called Eating Disorders Not Otherwise Specified, or EDNOS). If your partner has an eating disorder--diagnosed or not--your role as their partner is essential for recovery, but it is also an extremely challenging one. No one can recover from an eating disorder alone, nor should they try to. It takes a team, which includes mental health professionals who specialize in eating disorders, and supportive, educated family and friends.
Sociopaths are all around us. When we hear that term, people like Jeffrey Dahmer, Ted Bundy, and Bernie Madoff come to mind, but reality is that most of us will encounter someone who is a sociopath during our lives. Some of us will get sucked into a relationship that is very hard to get out of and is very dangerous; others of us will escape unharmed, but potentially have interesting stories to tell about the insane things the sociopath talked us into doing. At first, your partner may have seemed too good to be true. Sociopaths are fabulous at making people feel special, oozing charm, wit, humor, and (what appears to be) affection. Once they have reeled you in, though, some of the more noticeable features that will surface are manipulation, grandiosity, lack of emotions (including the ability to love), pathological lying, lack of remorse, and the need for stimulation. Sociopathic characteristics start before the age of 15, and does not seem to be influenced by upbringing, so if your partner is indeed a sociopath, chances are there is a history of these behaviors long before you came into the picture. You are likely not their only partner, either.
Katy spends hours each day in front of the mirror, focused on her nose. She applies and reapplies makeup several times before leaving the house, and checks herself in her car's mirror again before driving to her destination. She is never satisfied that her makeup hides her "ugly" nose. Throughout the day, she feels compelled to look in the mirror again and again, and has recurring thoughts that people are staring at her "hideous nose." She has even consulted with several plastic surgeons, only to be told there is nothing cosmetically wrong. She is currently on the search for yet another plastic surgeon who might take her seriously and agree to perform a rhinoplasty. Her family and friends are unable to see the "flaws" Katy claims are there, and she's missed work and social events because of her unhappiness with her nose's appearance. Most people have certain parts of their appearance they are not happy with, but those with body dysmorphic disorder (BDD), like Katy, take it to an extreme. People with BDD spend hours every day obsessing over "flaws" that are either very minor or non-existent. They are unable to control these negative thoughts, and are not reassured by others telling them that they look fine. These thoughts cause severe emotional distress, and interfere with the person's ability to function in daily life, as they need to constantly check their appearance and/or do something to try to "fix" the problem. As a result, people with BDD also often avoid going out in public in order to avoid perceived scrutiny. They fear that others will also notice the "flaws" and judge them for it. Does that sound like your partner?
One of my three cats, CJ, has a unique purr. Her purr can be heard across the house, or over the phone by unsuspecting callers, and her sound has been compared to a pigeon or turtle dove. It's nearly impossible not to smile when she is purring (unless it is 3 a.m., because if she wakes up, she purrs then as well!) My other two kitties like to snuggle--often at inconvenient times, such as when I am trying to type a blog post!--but there is no doubt they love me. They tend to stick especially close when they sense I am unhappy or not feeling well. One of my colleagues at Duke, Jennifer Strauss, was featured recently about volunteer work she, her husband, and their dog, Murphy, do at a camp for children who have lost a parent, sibling or other significant person in their lives within the past two years. In the article, Jennifer discusses the connections the children make with Murphy, and how his presence seems to allow them to express feelings that may not be so easy to share with adults. The physical and mental health benefits of having pets are numerous. If you and your partner already have pets, are you getting the most benefit? If you don't have pets, is it time to consider getting one?
If your partner has been taking medication and going to therapy, yet is still struggling with severe depression, there is hope. Sometimes, therapy and medication for depression is not enough. Treatment-resistant depression does not have to be the life sentence it sounds like, however: there are other options that are safe and effective. Recently, The Dr. Oz Show did an episode on electroconvulsive therapy (ECT) for depression. My department chair at Duke, Dr. Sarah Lisanby, was one of the panel experts. Besides being an expert on ECT, she is also a leading researcher on another alternative treatment for depression, called transcranial magnetic stimulation, or TMS. A third option is vagus nerve stimulator therapy, or VNS. If your partner is not getting relief, one of these three other options might be worth considering.
Bringing up the topic of a partner's mental illness with family and friends can feel tricky. In some cases, it might be obvious that there is something wrong, but many mental illnesses can't be detected from the outside. However, that doesn't mean you and your partner don't need and deserve support from understanding family and friends. Asking for that support can feel uncomfortable, though, given the stigma that still exists around mental illness, and cultural perceptions that we should keep personal problems to ourselves.
You may have noticed changes in your partner after a significant life event, such as a job change or loss, the development of a physical illness, death of a loved one, having an accident, having a baby, or surviving a traumatic event. Some of the symptoms you may have noticed in your partner are a low mood, trouble sleeping, little or no appetite, anxiety, stomachaches or headaches, missing work or school, and less interest in activities that used to be fun. Sounds like depression, right? Maybe. Or maybe not. It could be adjustment disorder.
Oh, that tricky word: "normal." What does that mean, anyway? When I hear my clients ask, "Is it 'normal' for [fill in the blank] to be happening?" or "Why can't my life/relationship/job/thoughts/feelings/etc. be 'normal'?", I always ask for what their definition of "normal" is. Of course, there is no definition that fits every scenario. What is "normal" for one person would be "abnormal" for another. Many clients come to counseling because of relationship difficulties. People look at what other couples are doing and think something is wrong with their own relationship. Or they have ideas about what should be happening in their relationship, and decide it is somehow flawed. Or they think that the problems they have with their partners is unique. That may be true, but it is rare. So, are you wondering what it is people talk about regarding relationships in counseling offices?