Here you can find all kinds of useful resources like articles, bibliographies and reference lists on a wide variety of psychology topics.

The Anatomy of Anxiety

In my capacity as an outpatient psychologist, I have seen clients with
anxiety for twenty-five years. That and depression seem to be the number
one and number two presenting complaints.

Anxiety accompanies major depression seventy-five percent of the time,
not because it is a separate syndrome in this case, but because it appears to
be part of the depression problem. So, treating the depression, with
psychotherapy, medications, or both, usually resolves a significant part of
the anxiety. This is diagnostic, because if the anxiety lifts in rough
proportion to the depression, then it probably is really about depression,
not anxiety, proper.

However, we all know there are anxiety "experiences" that do not
correlate with depression. Panic attacks and phobias are two. OCD and
PTSD can occur separately, too, but often are accompanied by depression.
Or, there can be what psychologists call "co-morbid" conditions. This
is when anxiety and depression co-exist as separate entities, not necessarily
one causing the other.

It is a little confusing, but necessary to distinguish, because in this
article I'm going to talk just about anxiety of the panic and phobia kinds,
even though OCD sufferers will be able to "relate."

What is the role of anxiety? Anxiety is the harbinger of feeling out
of control. It is a "red flag" from the back of your mind (think
subconscious) to the front of your mind (think conscious). It's telling you
that if you keep doing what your are doing, or thinking what you are thinking,
something bad is going to happen and you are not going to be in control.

What is the response to anxiety? Most of us stop doing what we were
doing or thinking what we were thinking, and then our anxiety diminishes.
Presto! Instant reward for avoiding! We no longer have to deal with those
pesky "background" thoughts or feelings because we removed ourselves from the
triggers (think "cues") that elicited our anxiety. In other words,
something in our environment reminded us of something we don't like (memory,
feeling, situation, etc.), but we didn't really want to consciously pay
attention to it. So, when our subconscious mind perceived that this was
going to be stimulated (memories, feelings, thoughts, etc.), it directed us
to steer clear and "disconnect."

This is a neat trick and an almost automatic defense mechanism. We all
do this every day. The subconscious is very, very good at picking up
potential threats, way before the conscious mind catches on. Panic and
phobia sufferers have perfected this escape trick, and at the same time have
buried lots of feelings, memories and other associations (to the trigger).
They have very high internal "pressure" due to such a load of background
feelings, memories, etc. Precisely to the extent they have an overload of
repressed material and precisely to the extent they strive to avoid it
dictates the strength of the panic or phobia.

-Dr.Griggs

http://www.drgriggs.org

As mandated reporters, clinicians must report allegations of child abuse to child protective services (CPS).  If the clinician has been working with the client or clients for a significant period of time and developed a good client-therapist relationship, reporting is undoubtedly a stressful event.  To complicate matters, when a mandated reporter is contacted by agencies other than CPS requesting additional information, the question is, has the assumed confidentiality been breached?  Although regulations have been written to address such cases, in real practice, mental health professionals may find themselves in difficult situations where the path to proceed is unclear.

In this blog/article, I will explain how I believe some of those situations should be approached. Please be aware that my opinions and assumptions may be flawed, but such opinions and assumptions are just that, opinions and assumptions. Please consult with another colleague, your state board, or/and get legal advice if you find yourself facing such dilemmas.

AGAIN, LET ME CLARIFY, IN NO WAY AM I EXERTING THAT I AM AN EXPERT IN WHAT I AM ABOUT TO WRITE.   ON THE CONTRARY, IT IS MY OWN CONFUSION ABOUT SUCH INCIDENTS THAT MOTIVATED ME TO WRITE THIS BLOG/ARTICLE.

This is how I understand the written regulations and ethical guidelines: The identity of a mental health professional must remain confidential when in the duty of acting as a Mandated Reporter he/she reports allegations of child abuse to Child Protective Services. Thus, I believe the Mandated Reporter should only be contacted by CPS if additional information is needed, and should not be contacted by other individuals or agencies involved in the investigation. And if a professional is contacted by such individuals or agencies, the clinician should not breach confidentiality unless mandated by a court of law to do so, and in a court of law.

It is probably fair to say that mental health professionals understand that the Mandated Reporter is obligated by law to contact CPS and make a report if there is reasonable suspicion that child abuse has occurred. After the report has been made, if the alleged victim is referred by CPS to another agency (e.g., law enforcement), or to a hospital for further evaluation, that referral becomes part of the follow up investigation, and such follow up investigation should be separate from the obligated act of reporting by the Mandated Reporter (initial report). And I think this is the part that is most confusing for some clinicians. I believe most – if not all - clinicians understand that it is standard protocol for CPS, law enforcement, and hospitals/clinics to share relevant information, so that they can ascertain whether child abuse has occurred. Additionally, if the alleged victim is referred by CPS to a hospital and/or to a law enforcement agency, personnel from such agencies are by definition going to conduct an investigation.  If these agencies attempt to contact the Mandated Reporter during the course of the investigation, that act of contacting the Mandated Reporter indicates that the identity of the mandated Reporter has been compromised.

I believe timing plays an important role in how clinicians react to such inquiries from non-CPS agencies. For example, if the Mandated Reporter is contacted one month after the report was made, most clinicians would assume that any disclosure at this point would indicate that the clinician would be breaching confidentiality, regardless of how his or her identity as a Mandated Reporter was compromised.  But when the clinician is contacted within, let’s say, 24 hours to 48 hours by law enforcement or by a hospital after the report was made, that may become confusing to even the most experienced clinician, because the clinician could assume such inquiry as part of the initial report.

If the clinician is contacted by agencies other than CPS, I believe the clinician should not disclose any information and instead contact CPS management and request clarification about what’s the agency’s policy regarding protecting the mandated reporters or reporting party’s identity. Additionally, in such cases, I believe the Mandated Reporter must request an explanation as to whether CPS staff have any information how the identity of the Mandated Reporter was breached. 

To conclude, as a final reminder, please remember that my opinions about how the reporting process should develop are just that, personal opinions.

Written by Julio Reyna, Psy.D.

  We are living in a fast speeding society, which increases the competitiveness and pressure. Burn out, anxiety and feeling stressed are increasing and impairing the relationships and mental, social, and academic functioning. So I decided to write about stress.

 

• How do you manage stress? How do you cope with it?
• Do you feel overwhelmed?
• Do you feel like you cannot handle it anymore?
• Do you resort to eating as a means to cope? Does it work?
• Or maybe you stop eating because you lose your appetite?
• Do you try to give yourself a break by drinking alcohol? Does it make the problems disappear?
• Do you become irritable, short tempered, and even aggressive (verbally or physically)?
• Or you rather sleep off your stress and just want to be in bed?
•  Do you stop your healthy routine such as exercise, good eating habit, and relaxation and just focus on the problem on hand?

 

 If you say yes to one or more of the above listed coping strategies, you are not alone. Many people cope with stress by eating, drinking alcohol, or distracting themselves in other ways. The problem is that all these coping skills may help for a brief moment but in general they are maladaptive behaviors that usually, in long term, magnify and worsen the problem. Let’s start by looking at what stress is. Why do we have such negative perception about stress? Why are we running away from it?

 

Wikipedia defines stress as “a biological term for the consequences of the failure of a human or animal to respond appropriately to emotional or physical threats to the organism, whether actual or imagined. It includes a state of alarm and adrenaline production, short-term resistance as a coping mechanism, and exhaustion. Common stress symptoms include irritability, muscular tension, inability to concentrate and a variety of physical reactions, such as headaches and elevated heart rate.”

 

Stress can be in response to positive or negative events. For instance getting married and preparing for the wedding or buying a home can be stressful but they are considered as positive stressors. Nonetheless, a person going through theses type of experiences may feel overwhelmed, irritable and not in control.

Stress can also be negative. For instance going through divorce, facing court-related issues, and financial difficulties are considered negative stressors because they involve feelings such as guilt, shame, fear, worries, and anxiety.

However, often we may feel overwhelmed and stressed out just going through day-to-day responsibilities.  This means that our threshold to cope might have decreased due to various factors related to our past such as, suppressed feelings, and unresolved conflicts.

 

How to manage stress

There are various skills to mange stress and each of these skills can be more effective than the others depending on your needs and circumstances. And as the old saying goes” don’t put all your eggs in one basket”, often a combination of these skills produce better results.

 

1. Change your perception

It often helps to take a new perspective in viewing our life, our problems and circumstances. Often we have an unrealistic expectation that life should be smooth and without problems. Aboriginal people believe that life means problems, and as such problems and difficulties are expected and accepted as part of life. That means that we can perceive our problems as “problem” and feel overwhelmed or perceive them as challenges and feel motivated to overcome them. The benefit with the latter view is that we shift from a problem-oriented view to a solution-oriented one, and naturally feeling encouraged searching for solutions.

 

“Maturity is achieved when a person accepts life as full of tension.” Joshua L. Liebman

 

 

2. Understand and identify the stressor

Very often our feelings signal us that we are facing a problem without exactly knowing what the problem is, and as such feeling more confused and overwhelmed. In order to be solution-oriented, we first need to identify the problem. Do not ignore your feelings of being overwhelmed, tired, and experiencing insomnia. Even though you might not be directly aware of the source of the problem, your mental and physical state do communicate with you. Try to understand the language and do not just accept them as a “normal-for-me-state”.

 

 

3. Be diligent with your routine and self-care behaviors

During crisis and stress the first thing that suffers is the loss of our routine such as regular bedtime, eating, walking, and exercising. These aspects of our life get neglected because we switch to acute crisis and emergency mood. It is understandable that when you are in an emergency situation you need to react and not waste any time by doing other things. As such, our body and mind continues to be in crisis mood even in a chronic stress situation.

So remind yourself, that you are not in any emergency; your stress is chronic and as such your need for healthy routine such as eating well, going for a walk and exercise is even more crucial.

 

4. Increase pleasure

When overwhelmed and under stress, we forget that there is such a thing as pleasure. We don’t go out and socialize as often as we used to. We often believe that stress management means to reduce stressors. However, sometimes, we cannot change certain situations and we have to accept them as they are and as such increasing pleasure is a good strategy to cope with difficult situations as a means to recharge your batteries.

 

“Men for the sake of getting a living forget to live.” Margaret Fuller

 

5. Talk to someone

It is important to understand that there is no shame in feeling stressed and overwhelmed. Sometimes talking to a friend and/or a professional will help to put thing in perspective, feel normal and understood, which in turn helps us see solutions and strategies that we might have been overlooking. However, do not just rely on your friend or psychologist. The key is to learn and rely on yourself!

 

6. Do not assume! Delegate tasks!

Very often our stress is related to the fact that we carry too many responsibilities. Often we believe that others expect from us to be perfect and to do everything. Ask yourself this question: Did anyone ask me to do so much or is it really me having all that expectations and assuming that if I did not fulfill them others would be disappointed in me? Most often we find that it is really we having all these unrealistic expectations of ourselves being a superman or a superwoman. Stop! Do not assume! Ask the question and make a list of your responsibilities and delegate some of them to others such as family members, employees, and coworkers.

 

7. Relaxation techniques

Learn how to relax. Relaxation techniques such as deep and slow breathing and progressive muscle relaxation trigger the activation of the parasympathetic nervous system (“rest and digest” mood) and as such help shut off the sympathetic nervous system, also called the “arousal mood”. In other words, physiologically, you cannot be in stress and heightened arousal mood and be breathing slowly and deeply at the same time!

Try the relaxation techniques for 5-10 minutes, 2 or 3 times throughout the day if you are having difficulties keeping your calm going through your day. Or take 20-30 min at bedtime if you have difficulties shutting off your mind and falling asleep.

 

8. Live a balanced life

Balance is a key element in native culture. We are complex beings consisting of physical, mental, emotional and spiritual components. Find your spirituality weather it is religion, or nature or just being alone by yourself; whatever that gives you the inner peace. If you don’t know it, then explore and find it for yourself.

 

Don’t complain about life and remember everything happens for a reason. Without black we would not appreciate the white, without pain we would not appreciate the happiness.

  info@drbita.com

 

 

 

Be Proactive in Procrastination! Stop it before it starts for you. Here are some simple solutions to avoid procrastinating: *Be mindful. Take inventory of the sites and sounds of your environment before you start a project. Are you in a place that is productive? *Be self aware. Are you tired, cranky, having a bad day? What is your most energetic time of the day? Start then. *"Learn as a I do, not as I say". Actions speak louder than words. When you begin to hear your self defeating words of doubt, do not listen, just keep on going. A project finished is based on the behavior. Allow your body to go and your mind to listen to it. Act first, listen second, and you will see results. You will start to see how much power our minds have when we procrastinate. *Remember: Procrastination does not exist if you do not let it. When you see something that needs to be done, if it takes less than 5 minutes, do it now. That 5 minutes now will save you 5 minutes later. *Remember: You are in control of your life!

 Most simply stated, empathy is the ability to put oneself in another's shoes - and also the willingness to respond to the person's needs. I believe it's one of the most important components of a happy, healthy relationship. Lack of empathy is a very common problem with couples. Many people never learned how to be empathetic from their primary caregivers or weren't modeled empathy by other important people in their lives. The good news is - it can be taught.

Here are 5 steps to practicing empathic communication when discussing a difficult subject:

1) Listen without interruption as your partner describes his/her feelings about the subject.

2) Pause and imagine how your partner might be feeling.

3) Reflect back what the partner has said in regards to their feelings such as, "It sounds like you're saying you're upset because..."

4) Validate their feelings such as, "I understand that you're upset..." You don't have to get why - just allow them to have their feelings.

5) Offer support by saying something like, "Let's try to figure this out together."

This type of dialogue takes practice but the long term payoff of empathic communication is well worth it - and a key component of a strong relationship foundation.

To learn more about Lisa's therapy work or read more of her mental health and relationship articles and tips, go to www.lisakifttherapy.com.