Treatment for Anxiety: Options Without Medication

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Anxiety is oftentimes crippling and causes excessive worries that can lead to physical effects like sweaty hands, a racing heart, sleeping problems, and many other unwanted symptoms.

Clients who are dealing with anxiety disorders often make an initial appointment to inquire about non-pharmaceutical methods that can be tried first. It is always beneficial to learn methods of managing anxiety as well as uncover underlying problems and triggers.

Treatment for Anxiety Without Medication

Some methods of treating recurring anxiety without medication include:

  • Cognitive behavioral therapy
  • Yoga
  • Acupuncture
  • Massage
  • Self-care

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy, or CBT, is a widely used and very effective way of treating anxiety before trying medication. Clients go through this type of therapy in the therapeutic setting of a counselor’s office.

Anxiety tends to make someone worry excessively that the likelihood of something bad is destined to happen, and CBT works to re-frame these thoughts and help clients understand the patterns of their behavior. Through CBT, patients learn ways to identify detrimental thinking patterns and transform them into rational thoughts that will help improve the regulation of emotions.

Progressive muscle relaxation is also part of CBT. Clients can learn breathing techniques to use that will relax them and assist them in dealing with the unwanted physiological consequences of anxiety, which include psychosomatic symptoms and muscle tightness.

Yoga

Some therapists have decided to incorporate yoga into treatment plans for clients. Since they are Christian counselors, their understanding of yoga refers to relaxation principles and mindfulness instead of non-Christian practices or Buddhism.

The popularity of yoga continues to increase, and this is partially because it can work to modulate one’s stress response. Yoga can improve mental clarity by using breathing techniques and different poses.

Acupuncture

One of the most common alternative forms of medicine is acupuncture. In this form of Chinese medicine, sterile, long needles are placed in different areas of the body close to nerves. This activates a body’s chemicals that work to reduce or eliminate pain. Despite the belief that acupuncture is a pseudoscience that has mixed results regarding efficacy, many people prefer to test it out before opting to take medication, and many people experience positive results.

Massage

Massages are great for reducing tension and lessening anxiety, but they cannot solve any underlying issues that are causing a client’s anxiety. Typically, people complain about muscle tightness and tension when they are experiencing anxiety, and a massage has the ability to provide a little bit of physical relief for at least a brief period of time.

Self-Care

Managing anxiety without the use of medications is impossible without spiritual, physical, and mental self-care.

Spiritual self-care includes making time for God through Bible study, Church, or prayer; physical self-care includes any form of exercise; and mental self-care includes things like journaling or breathing exercises.

The goal of self-care is to use techniques that make you aware of your feelings and responses to stimuli or unwanted stressors as well as cause you to simply be “present.”

In some cases, medication might still be necessary if someone’s symptoms of anxiety are severe, but using things like prayer, breathing exercises, self-care, or any of the other aforementioned options would be a great addition to medication. The first place to start is to find a professional therapist who can help you find the best treatment plan for your specific needs.

Photos:
“Hiding”, Courtesy of Claudia Soraya, Unsplash.com, CC0 License; “Stressed Out”, Courtesy of Ayo Ogunseinde, Unsplash.com, CC0 License; “Yoga”, Courtesy of Matthew Kane, Unsplash.com, CC0 License; “Coffee Time”, Courtesy of Nathan Dumlao, Unsplash.com; CC0 License

OCD in Children: What Parents Need to Know

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When someone seems overly concerned about being clean, others might call them “obsessive.” When a person insists on specific behaviors or requires a certain order of things, words or actions, people may say they’re “compulsive”.

People may use the term “OCD” in an almost light-hearted manner to justify behaviors or rules which they themselves practice. But for anyone diagnosed with real Obsessive Compulsive Disorder (OCD), there is nothing light-hearted about their struggles. For them, the condition often brings distress and places limits on their every day lives to varying degrees.

According to information released by the American Psychiatric Association (APA), the best estimates are that about 1.2% of the American population struggles with OCD. It occurs in adults, teens, and children and it is likely that at least a million U.S. children wrestle with OCD symptoms (OCFMC, 2006).

Other studies predict that one child or teenager out of every 200 will develop OCD (AACAP, 2013). The average age when OCD begins is 19-1/2 years old, and 1/4 of all people who were diagnosed with OCD had developed obvious symptoms by the age of 14 (American Psychiatric Association, 2013).

Parents are overwhelmed and confused when one of their children develops the symptoms or begins to live under the dark cloud of the fears that are a part of OCD.

It’s difficult to know what to do when a child has an emotional meltdown or battles with someone who has (probably without realizing it) interfered with a “necessary” order of items and actions.

It should be good news to know that effective treatment is available. Parents should begin by learning all that they can about OCD with the goal of becoming better able to understand what a child with OCD is facing and how and where to find the right help.

What is Obsessive Compulsive Disorder?

OCD is a mental health issue that is diagnosed by looking for genuine obsessions and/or compulsions.

Obsession: Obsessions may be defined as urges, thoughts, or images that intrude on a person’s mind and life in a way that becomes difficult or impossible to ignore (APA, 2013). For example, someone can become a germophobe. A child may become driven to seek perfection. Another lives with the constant fear of harming themselves or others.

Compulsion: Compulsions, on the other hand, are behaviors or mental acts that a person is driven to repeat again and again. Compulsions may grow out of obsessions (APA, 2013). People with OCD find themselves compelled to continually wash their hands, perform special rituals, engage in what is known as “checking” behaviors, count things, or even pray because they believe they must.

When a person suffers from OCD, they carry out certain acts (compulsions) to try to relieve anxiety or tension (American Psychiatric Association, 2013). Often the anxiety for which the person desperately wants relief is driven by an obsession. The compulsive behavior brings a measure of relief but it’s only temporary, so when the anxiety returns, the person must perform the action again to get relief. This develops into a cycle where relief from the anxiety reinforces the need to repeat the compulsive behavior in order to experience another brief period of relief.

The obsessions and compulsions are often connected, such as germophobia and washing one’s hands. Or, a student is so afraid of failing that he or she keeps on checking and checking his or her test answers even to the point of missing recess or lunch.

In other cases, the obsessions and compulsions may not seem to be related. Think, for example, of a child who counts a certain number of cracks in a sidewalk thinking it will keep his mother from being hurt. So, a diagnosis of OCD does not always mean that the obsessions and compulsions are related. A child may have one without the other.

How OCD develops and manifests itself can also vary. Also, the focus of obsessions and compulsions shift over time. For some people, obsessions and compulsion come out more obviously and intensely when they are under stress (APA, 2013). Those same people may experience fewer or less intense symptoms in situations where stress levels are low. And often, when one obsession or compulsion is eliminated, others may change.

True OCD symptoms are not simply small irritations. They consume a major portion of the time in a child’s day. Further, they may increase a child’s level of stress, bringing layers of problems.

For example, a germophobic child may wash their hands to the point that they become dry and cracked, and may even start to bleed. Then, he or she may also become terrified of being around sick people or having physical contact with someone who has even been close to a sick person.

This can disrupt relationships, or bring on peer harassment if the fears or behaviors become known. Brothers and sisters may feel rejected by the child who struggles with germophobia because he or she may avoid giving hugs or express fear which the siblings may take personally.

OCD not only affects the person who struggles with the obsessions and compulsions, but also impacts their family and friendships. Then the OCD sufferer feels shame over their compulsive behaviors. A child’s need to carry out these compulsions often builds more shame. The emotional distress that often comes with OCD can become so heavy that depression also develops.

OCD in Children: Catching it Early

Early warnings of OCD in children may go unnoticed. Children may find certain behaviors embarrassing and may try to hide them. But parents who observe some of the following in their child’s life may have reason to seek further assistance in checking out the possibility of OCD (OCFMC, 2006; AACAP, 2013):

1. Repetitive behaviors (washing their hands over and over, touching things in a specific order, anxiously rechecking school work, or repeatedly checking doors, etc.

2. Continuous fears that become extreme (such as unusual fears surrounding germs or dirt, or anxiety about the well being of the family).

3. Often repeated statements that go beyond reasonable concern and obsessively express worry outcomes that do not necessarily follow. “I must touch [this object] 10 times so that my sister will still like me” or “When I fail to pray a certain way, our team loses.”

4. Habits and behaviors beginning to get in the way of normal life or friendships.

5. Needing reassurance too much and too often (“will I be okay if…?”; “will it be okay…?”).

6. Constantly compulsion to carry out an action until everything feels “correct.”

7. Often driven to confess bad thoughts, like sexual imagery or thinking unkind thoughts about other people.

8. Avoiding more and more activities not connected to obsessions or compulsions

9. Always seeming to be behind (because obsessions and/or compulsions demand time).

10. Increased physical symptoms of anxiety, such as headaches and stomach aches.

What Causes Obsessive Compulsive Disorder?

As is typical of much of the world of mental illness, the exact causes of OCD are still largely a mystery. In fact, a number of different factors acting in combination, including environmental and biological factors, may be behind a child’s OCD.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), states that for those individuals who have a member of their immediate family that has OCD there is a 200% greater likelihood that they will develop OCD over those whose first-degree relatives are not OCD (APA, 2013).

What’s more, they also found that when the immediate family member has experienced childhood-onset OCD, the likelihood of developing OCD increases by 1000%. Other possible causes of OCD include significant life transitions (divorce, changing schools, etc), abuse, and loss (AACAP, 2013; APA, 2013).

Whatever the cause may be in a given instance, it has become clear that OCD has a significant effect on the brain. Brain scans have shown differences in brain activity between people who have OCD and those who do not (Scharwtz, 2016).

OCD may also have physical causes, so an evaluation by a medical professional is always a good idea. Physical causes may be addressed to help reduce contributing factors. For example, Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal (PANDAS) can trigger a sudden and severe onset of OCD or tic disorder symptoms (National Institute of Mental Health, 2016). In these cases, the streptococcal infection would require medical treatment.

Helping Your Child

If your child exhibits symptoms of OCD, there are a number of ways to find help and give good support.

  • Get immediate professional help and counsel. There is no reason for you to try to handle this alone!
  • Don’t fall into the trap of merely using reassurance as your tool to try to calm your child. This is not an effective way to reduce the symptoms nor does it teach your child to fight and manage them.
  • Don’t try to avoid everything that your child fears or is obsessed by since this only tends to reinforce their symptoms.
  • Give your healthy coping skills, like memorizing relevant Bible verses, relaxation techniques, evaluating the rationality of their thoughts, soothing activities, and learning to live in the moment. Stress tends to trigger and magnify symptoms, so being able to use effective stress management tools makes a real difference.
  • Demonstrate how to set proper boundaries. These can help your child handle stress.
  • Teach your child how to take care of themselves, like eating healthy foods and getting enough sleep,
  • Teach your child to recognize their obsessions and compulsions. Knowledge is a power.
  • Do not shame! There may be no logic behind OCD symptoms, but they are quite real and your child is not to blame.
  • Provide a time and place for your child to express and process negative feelings, like embarrassment and shame, that go along with OCD symptoms.
  • Find support for yourself and a place to process your own feelings about your child’s OCD symptoms. You may experience frustration and fear, along with any number of other difficult but typical emotions. Learn to take care of yourself so that you can take care of your child.

Treatment for OCD in Children

To confirm a diagnosis of OCD in children, parents should seek an evaluation by an experienced mental health professional. The DSM-5 states that OCD left untreated unlikely to go away and the symptoms will fluctuate as time goes on (APA, 2013).

Several different therapies exist for treating OCD in children. Cognitive behavioral therapy (CBT) is one of the most recommended. One kind of CBT applied quite often is known as Exposure and Response Prevention (ERP).

Much like it sounds, ERP is a type of therapy where a patient is taught not to act on any compulsion in order to ease their anxiety. Counselors will then teach a child various tools to deal with the difficult emotions.

Though the idea of asking a child not to use his or her compulsive behaviors in the face of anxiety may sound frightening, therapy can be paced so that anxiety does not become unmanageable.

Other methods of CBT, include “imagined exposure” and learning to overcome negative and illogical thinking patterns. For some children, play therapy may be a part of treatment.

Along with counseling medical, evaluation is crucial. A medical professional can help determine whether medication might help.

It may also be necessary to ask your child’s school for any help or support they may be equipped to offer. You should talk to your counselor about this.

Remember, you need not try to parent your OCD child alone! Reach out to a counselor today to ask questions and discuss the many options available.

There is hope and healing!

Photos:
“Jenga,” courtesy of Michel Parzuchowski, unsplash.com, CC0 License; “Brain”, Courtesy of GDJ, Pixabay.com; CC0 License; “Tablet Time”, Courtesy of Annie Spratt, Unsplash.com, CC0 License; “Knowledge is Power”, Courtesy of Geralt, Pixabay.com, CC0 License;

How to Find the Right Family Therapist for You

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Could your family benefit from getting counseling together? If so, how do you find a family therapist that’s right for you? It’s normal to feel hesitant about finding a good match for your family. A therapist can make or break the entire counseling process.

By reading this article you’re taking the first step in what can be a journey of healing and hope. We’ll discuss different types of family counselors, how to select one who’s right for you, and how to budget for counseling. Take the time to consider each point in the selection process, and you’ll be equipped to make an informed decision.

Does My Family Need Therapy?

Just as with physical illness, early treatment for family issues can prevent many problems later on. Unfortunately, many of us don’t seek relational help until we are at our wits’ end.

You’ve probably made several attempts to heal the brokenness in your family. Maybe you feel like you’re in crisis mode now. Counseling becomes the last resort when you’ve done everything else. If you’re at this point, there is hope.

Secrecy empowers sin and strife. As painful as it can be to talk about what’s going on, verbalizing the issues can offer massive relief and help you figure out what to do next.

If you’re not in crisis yet, be encouraged. It’s wonderful to seek help early. Your problems are not too small; rather, they have huge potential for healing when they’re brought out into the open before they’ve taken over and destroyed lives.

What is the first thing to consider in your search for a counselor? Take a step back and assess your family’s most pressing needs. Although not everyone will immediately let their guard down in counseling, each member of the family should feel emotionally safe and honored in therapy.

What Are Your Family’s Specific Needs?

Do your best to nail down your family’s specific counseling needs, because some family counselors specialize in specific areas of treatment.

What areas of your family life need the most help? Many families seek help for their children in a group setting to offer their support. Sometimes couples need help with communication issues, or parents feel overwhelmed and want to set new and healthier patterns.

Read through the following types of therapy and think about which one(s) may meet your needs:

Couples Therapy

Counseling for couples can really run the gamut from neutral to desperate situations, but it’s not just for the desperate situations, even though many people associate marriage counseling with imminent divorce.

Couples therapy can apply to you if you are in a relationship or engaged or married. Maybe you’re in a destructive conflict cycle, or you just need help communicating effectively, or you want to strengthen your relationship even though you’re not having any major issues now.

Behavior Intervention

Behavior intervention applies to children who are struggling with problem behaviors, or to adults who are behaving inappropriately either in public or at home. In the family therapy setting, parents and the child will work with the counselor to identify unacceptable behaviors, set boundaries, and create rewards systems, along with other helpful skills.

This type of therapy really thrives on parental involvement. The parents can witness the tools the therapist uses during sessions, and then practice applying those skills at home with their child.

Behavior intervention for children usually starts with a conversation between the therapist and the parents. The therapist usually asks about three components of problem behaviors:

  • What happens before?
  • What happens during?
  • What happens after?

Once the parents explain how these situations normally transpire, the therapist will work with them and their child to change everyone’s behavior in all three areas by using education and practical skill development.

Parent Coaching

Behavior intervention focuses on both parents and children, but parent coaching focuses on the parents and how they can improve their skills. Children may be present for sessions, but the therapy won’t focus primarily on their behavior.

As opposed to an interventional approach, coaching helps parents develop positive skills to become more effective in nurturing their child(ren)’s physical, emotional, and social wellbeing. Coaching will address discipline, helping children to listen and obey, and setting appropriate boundaries for each member of the family.

Parent/Child Issues

Do you feel that your relationship with your child has had a breakdown, and you’re not sure where to turn to fix the damage? Family therapy can help rebuild your relationship and find the right parenting method for this particular child.

Children going through puberty or experiencing life stress or mental health issues may struggle to have a good relationship with their parents. They may exhibit disrespect and dislike. Parents also deal with life stressors, mental health issues, and other factors that can make positive parenting difficult.

Counseling can help stop unhealthy patterns and replace them with healthy habits that will facilitate a thriving relationship between parent and child.

Navigating Systems Involvement

Child Protective Services, law enforcement, or the schools may involve themselves in family life for a number of different reasons. Families in crisis often have experienced intervention in one or more of these areas. How do you navigate these systems? A clinical social worker can provide advocacy and therapeutic support.

What’s Most Important in a Family Therapist?

In large part, the success of your counseling experience depends on your comfort level with your chosen therapist. Therapists have different beliefs, skills, and temperaments. Some use tough love, while others have a gentler approach. Not everyone’s personalities will mesh well together, so it’s important that yours is a good fit with your counselor’s.

It’s not unusual to meet with a couple of therapists before you find the best one for you. Remember, you can interview them by asking questions about their practice and what the process usually looks like.

Before you even meet with them, you can screen out potential problems online by reading about their practice and any articles or blogs they’ve written. Finding the right personality and specialization will help you get the most out of therapy.

What kind of practice does your potential therapist work in? What are their specializations? Maybe you have young children, but your potential therapist is most experienced in working with adult children and parents. A therapist with child-specific experience may be skilled in using play therapy in the family counseling setting.

If you are looking for a faith-based counselor, you’ll want to carefully screen therapists to make sure you won’t be working from conflicting worldviews.

Other Considerations

Budgeting for therapy can concern potential clients quite a bit, so it’s important to discuss this practical side of seeking counseling.

First, consider the value you place on therapy and the perspective that it can preventative medicine for your family relationships. Yes, therapy is expensive, but as counselors, we truly believe it’s worth it.

Next, sit down and figure out exactly what you can afford to spend. When a therapist bills insurance directly, they are considered an in-network-provider. These providers will take payment from you and bill your insurance for you.

Some therapists will directly bill your insurance, making them an in-network provider. But many therapists don’t take insurance due to high operating costs; instead, they operate as out-of-network providers.

With an out-of-network provider, you will pay a fee for each session and receive a receipt. You can give the receipt to your insurance provider, and they may reimburse you for some or all of the fee.

Before you attend your first session, please call your insurance provider to find out if they will reimburse you for any counseling services rendered.

What if you don’t have insurance, or your insurance won’t cover counseling? You can choose to pay out-of-pocket for each session, most of which run between $150 and $200 each. Some therapists may have different fees or operate on a sliding scale based on income.

Both fees and sliding scales vary widely among individual therapists and practices, based on operating costs, client income, practice size, etc., so don’t hesitate to look in several places to find an option that meets your family’s needs.

If you don’t think you’ll be able to make private therapy work for your family, you may be able to find a non-profit provider who takes state insurance or a local clinic that offers inexpensive therapy. Some people are able to meet with counseling interns who are in the process of receiving their master’s degree or licensure and can offer therapy at a reduced rate.

Where Can I Find a Family Therapist Near Me?

Now that you’ve considered some of the most important factors of finding the right family therapist for your needs, a good first step is to call your insurance company to discuss in-network providers who will bill sessions to them.

If you are looking for Christian counseling, you may be interested in our practice at Newport Beach Christian Counseling. We are one of the largest faith-based counseling practices, offering skilled, compassionate therapy for families, couples, and individuals. Visit our website to find a family therapist near you.

Photos:
“Family”, Courtesy of Laurel Harvey, Flickr.com, CC BY 2.0 License; “Resting”, Courtesy of Ardanea, Morguefile.com, CC 2.0 License, “Her own girl”, Courtesy of Ian Dooley, Unsplash.com, CC0 License; “FlattopFamilyTime,” Courtesy of Flattop341, Flickr CreativeCommons (CC BY 2.0)

Struggling with Anger Issues? Help is Available

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Sometimes a couple can look like they have it all together on the outside, but really be struggling on the inside. This was true of Sarah and Zach. They were engaged and in the process of planning their wedding. They picked a date and a venue and had even announced the news to families and friends. All seemed to be going perfectly, but in private, they were struggling and second guessing their decision.

Their arguments weren’t healthy. They would begin small and escalate to nasty fights filled with loud outbursts. It usually ended with Sarah shouting, while Zach left. Sarah felt dismissed and ignored by Zach, which irritated her, while Zach felt disrespected and was upset because Sarah would stew on things and then explode.

They were caught in a vicious cycle. The more Zach dismissed Sarah’s emotions and thoughts, the more angry and aggressive Sarah became and things continued to spiral downward.

Finally, they decided to see a counselor named Megan. They hoped that a therapist would help them deal with the conflict in their relationship. When Megan heard their story, she recommended that Zach and Sarah begin seeing her on an individual basis.

In the first few sessions, Sarah’s anger issues surfaced and Megan shocked Sarah by suggesting that she should explore how to express her anger. Sarah laughed at her, outright, saying “I don’t have any issues expressing anger! I’m usually a hothead.”

Patiently, Megan explained that these expressions of anger were not the core of her anger, but only symptoms of it. The deeper issue was manifesting as rage, but the real issues weren’t being dealt with in a way that could be considered healthy.

Megan also explained that her angry outbursts were hiding the true feelings she was having, keeping her from understanding what was really going on in her heart. When Megan asked her to try to explain and describe the underlying feelings associated with her anger, Sarah didn’t know what to say.

The most Sarah could do was share that she had been raised by a father who punished her for any expression of anger because it was “disrespectful.” At the same time, her father would hypocritically excuse his own angry and abusive outbursts, placing the blame on Sarah or on her mother.

To make things worse, Sarah’s mother passive-aggressively took out her anger on Sarah and taught her that anger was unladylike and needed to be avoided by women. This unhealthy message made it hard for Sarah to understand her anger or express it well, while simultaneously making her feel anxious and guilty about her anger. Her inability to cope with and express her anger, combined with her anxiety regarding it, created the cycle of anger she was experiencing.

Megan also explained to Sarah that both Zach and herself were ignoring her feelings. Sarah tended to resist any feelings of anger and push them away until she couldn’t control them. Before Zach could ever dismiss them, Sarah’s feelings had already been ignored and rejected by Sarah.

This created issues before Zach even got involved and explained why Zach felt that Sarah would wait until it was too late to express her emotions. She wasn’t just hiding them from him, she was hiding her feelings from herself but the anger would come out at Zach when Sarah accused him of something or exaggerated a relational misstep.

When this happened, Zach would walk away, albeit against his will. He knew she was hurting, but by her anger and intensity was sometimes more than he could take.

Anger Issues: Indicators

It is possible for typical indicators of anger issues to go unnoticed in a relationship for a long time. Here are a few examples:

1. Poor, or lacking, emotional awareness

Sarah’s inability to express her underlying emotions related to anger showed how out of touch she was with her own feelings.

Psychology Today says “Emotional intelligence is the ability to identify and manage your own emotions and the emotions of others. It is generally said to include three skills: emotional awareness; the ability to harness emotions and apply them to tasks like thinking and problem solving; and the ability to manage emotions, which includes regulating your own emotions and cheering up or calming down other people.” (https://www.psychologytoday.com/us/basics/emotional-intelligence)

Learning to empathize with Zach’s feelings and coming to understand her own was one of the most important steps for Sarah to begin controlling her outbursts. Feelings are transitory. One day they are here, the next day they are gone. When we attach negative associations to different emotions, we can prevent ourselves from dealing with them properly.

2. Unproductive communication styles

“The medium is the message” is the idea that means by which a message is delivered is actually part of the message itself. Sarah didn’t understand what she was experiencing and, as a result, she communicated about the issues in a counterproductive way.

As she became able to understand her feelings and needs, she learned how to communicate them in a useful way. Even if she knew what she needed, screaming about it wasn’t an effective medium of communication.

People who struggle with anger have predictable modes of communication when they are angry. Consider the following excerpt from the article “Assertive Communication and Anger Management” by Harry Mills, PH.D.

“As a social emotion, anger is experienced through communication. Angry people tend to have distinct communication postures that they habitually take up when communicating with others. Psychologists have described four of these communication postures, each possessing its own motto: The Aggressive communications posture says: I count but you don’t count.

“The Passive communications posture says: I don’t count. The Passive-Aggressive communications posture says: I count. You don’t count but I’m not going to tell you about it. The Assertive communications posture says: I count and you do too.

“As you might guess, angry people tend to use the Aggressive and Passive-Aggressive postures a whole lot. Aggressive communicators are more likely to start an argument than they are to get the results they want achieved, however.

“Being passive in your communications is also a mistake, as it communicates weakness and tends to invite further aggression. The Assertive communications posture is the most useful and balanced of all the postures as it is the only posture that communicates respect for all parties.

“Communicating assertively is the most likely way to ensure that everyone involved gets their needs taken care of. Learning how to become assertive rather than aggressive or passive-aggressive is an important step in discovering how to communicate appropriately with others.

People who are habitually aggressive tend to fundamentally misunderstand what it means to be assertive. Specifically, they tend to confuse assertiveness with aggression and think they already are acting assertively. This is frequently a mistaken impression, however.

“Both aggressive and assertive communications postures can involve fierce and persuasive communication. They are fundamentally different things, however, in that aggressive communication tends to go on the offense – it attacks and berates the other – while assertive communication uses anger and fierceness only in defense.

“Assertive people stand up for themselves and their rights and do not take crap from others. However, they manage to do this without crossing the line into aggressiveness; they do not attack the person they are communicating with unnecessarily. Assertiveness is “anger in self-defense” whereas aggressiveness is “anger because I feel like it”. (https://www.mentalhelp.net/articles/assertive-communication-and-anger-management/)

3. Unhealthy self-talk or distorted cognitions

Cognitive distortions are like the idea rose colored glasses. The idea that your lense, or view of the world, is not inaccurate. However, while rose colored glasses is the idea that you idealize everything, cognitive distortions are darker, distorted perspectives. There are 10 main distortions that often coexist with anger issues:

  • Personalization – This is when you take responsibility for a thing that wasn’t your fault. You personalize the problem. (David Burns’ book “Feeling Good: The New Mood Therapy. The Clinically Proven Drug Free Treatment for Depression”)
  • Labeling and mislabeling – An extreme type of overgeneralization, instead of describing your mistake, you assign a negative label to yourself.
  • Reasoning by emotion – You think your emotions are representative of the truth as if just because you feel it, it must, therefore, be true.”
  • Jumping to conclusions – Even though you don’t have facts to convincingly support your position, you refuse to withhold judgment and choose to make negative interpretations of the events. (Involves mind-reading and fortune-telling.)
  • Should statements – You are emotionally hard on yourself and attempt to motivate yourself with sentences containing “should” or “should not,” trying to punish yourself to make yourself do right.
  • Magnification and minimization – An issue of perspective, your view of what things are important or unimportant do not conform to reality.
  • Disqualifying the positive – Only negative experiences are accepted. Anything postive is rejected because they “don’t count” for some reason. Then you are able to maintain your negativity, despite positive life experiences.
  • Mental filter – You fixate on one negative detail and ignore everything else.
  • Overgeneralization– You aren’t able to see things in context. A single negative event is seen as a repeating, inescapable problem.
  • All or nothing thinking – There are only two options: success or failure. Any sort of mistake or shortcoming equals failure.

4. Minimizing behaviors

Those who struggle to manage their anger, like Sarah, can develop concerning behavior that needs to be addressed. A common trait of anger disorders is minimizing. Minimizing is when someone belittles what happened during the escalation of a conflict.

Refusing to accept or recognize personal behavior in a conflict is an obvious sign that the anger is not being dealt with well. Abusive behavior includes disgust directed at an individual rather than a problem, yelling, disrespectful speech, and physical contact, like hitting or kicking.

Let’s think back to the case study of Zach and Sarah:

Through counseling, Zach shared that during two instances of Sarah’s anger, she actually struck Zach in the middle of an argument. When confronted with this, Sarah became defensive, claiming Zach was “too strong for it to have hurt him.”

Megan saw that Sarah blamed her angry and violent actions on Zach and his dismissive behavior, so Megan calmly explained the issue of minimizing and blaming. Slowly, Sarah’s attitude changed, and she began to take responsibility for her own actions.

In more extreme cases of domestic violence, the perpetrators have been known to minimize and blame regularly. A good example was a moment during my time working with domestic violence offenders in the state of Georgia.

I worked with a participant during group counseling who was being confronted because his partner needed to get stitches as a result of his physical abuse. The perpetrator responded that “It was only a couple.” A very sad, but classic example of minimization.

Maybe the best starting point for evaluating anger issues is to be on the lookout for indicators that anger is being poorly managed or expressed. Psychguide.com offers a good description of the signs of the physical and emotional states of anger issues. If any of these indicators are present in your relationships, then perhaps anger management training or counseling is for you.

Some of these emotional states are recurring irritability, uncontrollable rage, anxiety, feeling overwhelmed, confusion, and fantasizing about harming yourself or others. The physical symptoms can include tingling, tightening of the chest, heart palpitations, heightened blood pressure, fatigue, and pressure in the head or sinus cavities.

Losing your temper doesn’t mean you have an anger problem. Anger is a powerful emotion that, at times, can trigger our adrenal system. It can move us to stand up for ourselves and our loved ones.

Anger becomes a problem when it is recurring, minimized when the deeper emotions are left un-validated and unexpressed, when it affects your relationships, and when it leads to hateful attitude and abusive behavior.

Unaddressed, anger often becomes a harmful and corrosive force, emotionally and physically. If it remains unresolved, then it can turn into contempt. In the book Seven Principles for Making Marriage Work, Gottman explains the four horsemen, which are indicators of future marital failure. Contempt is the most dangerous of the four horsemen. So anger issues left untreated, are no small thing.

But there is hope. One can deal with anger before it gets out of hand and threatens your relationships. Both anger management classes and counseling are available and have been proven effective. These resources can help those struggling with anger issues and train them to manage their anger in a healthy way.

Photos:
“Beautiful Argument”, Courtesy of Vera Arsic, Unsplash.com, CC0 License; “Angry,” courtesy of Forrest Cavale, unsplash.com, CC0 License; “Fighting Mad”, Courtesy of PublicDomainPictures, Pixabay.com, CC0 License; “Married Fight,” courtesy of Gratisography, pexels.com, CC0 License

Obsessive-Compulsive Disorder: Signs and Symptoms

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Obsessive-compulsive disorder (OCD) is a mental condition that is becoming increasingly widespread. Fortunately, however, so is the research being done on the condition. Behavior Therapy is available and the best thing about it is that it works.

OCD can manifest itself in a number of ways and tends to manifest specific to the emotional and/or neurological structure of the individual who is suffering from it. It is characterized by a feeling of being stuck within repeating cycles of behavior and/or thinking.

Over a period of time, the individual begins to feel they have little or no control over their behavior and/or thinking. Feelings of depression and anxiety may arise and escalate. Not stepping on cracks on sidewalks, constant washing of hands, and checking and rechecking to make sure the stove is turned off are all examples of OCD behavior.

The condition of OCD is complex. Being diagnosed as having Obsessive-Compulsive Disorder warrants a visit to a mental health professional to discuss concerns and to explore solutions. If you feel you have symptoms where your OCD behavior is affecting yourself and/or your loved ones, it is crucial that you reach out for help.

Because the symptoms may be behavioral, neurological, or somatic, it’s vital to discover the root cause so you can find the treatment that best suits you. If you’ve received an OCD diagnosis from a professional in the mental health field, depending on the causality and severity, it may be able to be treated by Behavior Therapy.

Behavioral Therapy Help for OCD

As a rule, Behavioral Therapy, also known as (BT), embraces the use of operant conditioning as a tool to alter the sufferer’s behavior. It is through interventions that are structured especially with the patient in mind, sometimes employing the use of a reward or punishment or even extinction which is the abrupt halting of an unwanted, undesired behavior. Individually tailored treatment plans strive to make use of the interests and strengths of the person in order to optimize the effectiveness.

The following are some BT practice examples that are fictitious in nature, but whose scenarios ring very true to life where the condition is concerned:

  • A. is a male who is 24-years of age and is still residing with his parents. It has proven to be difficult for the young man to make it out the front door and arrive at college on time because he gets stuck sitting in his bedroom, obsessing over things that might go wrong throughout the day. His professional therapist has recommended that he pack his school things in his backpack the night before and set it beside the door, put a copy of his daily schedule on the refrigerator, and set his alarm before bedtime. In addition to these suggestions, A’s counselor is working with him to redirect his thoughts away from possible negative outcomes.
  • K. is a female who 32 years-old is. She was promoted in her job six months back but suffers from a touch of OCD, mainly the action of touching a light switch three times prior to turning it on. No other OCD actions were significant, however. Within the past few weeks, though, she has caught herself continually vacuuming her floor to the point where she is consumed with doing so any time she is at her house. Her therapist has recommended that she not vacuum after seven in the evening and suggested that her vacuuming should not go on longer than thirty minutes each day. She is to tie a ribbon on the doorknob of the closet that the vacuum is in to remind herself of the suggestion.
  • B. is a male who is 28-years-old who cannot get thoughts of a girl he had been dating out of his mind. She ended the relationship abruptly, without any explanation and refuses to return his phone calls. He is obsessed with her and constantly wonders what she is thinking, what she is doing, and why she ended things with him. He has not even been talking to his friends during this time. His therapist suggests that he pick a friend and set up an interaction such as going for coffee or to a movie. The counselor also tells him to put a rubber band around his wrist which he is to snap each time he finds himself thinking of the girl in order to distract his thoughts.

The above examples show how a therapist can use BT to help alter a patient’s thoughts and behaviors. These types of intervention may be helpful, depending, of course, upon the pathology that lies behind the behavior

If behavior modification worsens the situation or doesn’t work, other options will be explored such as psychodynamic psychotherapy for the purpose of finding the root cause, brain testing for possible neurological issues, and/or use of medication.

Underlying Structure

We are virtually completely emotionally unstructured at birth. Birth is generally the first traumatic experience that takes place and our response to it is typically to desire to control the trauma. Since infants, and even children, are helpless to control what is going on around them, they begin to create defense structures in order to protect themselves.

Since the very young don’t have the capacity to think it all through because the neocortex is not mature enough to understand and reason, a child who has experienced great trauma may become catatonic or may disconnect from the feelings that are just too overwhelming to deal with.

Among the number of possible trauma responses are ones that have to do with OCD. Repeating actions can, in some strange sense, make us feel as if we have control over what is going on around us. When we reach our adult years, those behaviors and thoughts are actually hardwired in our brains. Thankfully, neurological studies reveal that we can rewire providing we’re willing to go through the effort and time it takes to do so.

Brain Rewiring

When we are dealing with our typical ways of thinking, awareness and identification are about half of the battle. Our system defenses are automatic so they don’t necessarily need to be in the forefront of our thoughts in order to be used, which ultimately means that if we want to make changes in our modus operandi, we must make a purposed, conscious effort.

For instance, if just seeing your neighbor causes you to be anxious, you may, unconsciously, distance yourself from him. If you take it a step further and explore why seeing him might may you feel nervous and anxious, much may be discovered by exploring such a question. Does he remind you of a relative who was abusive? Maybe you are intimidated by him? Perhaps you waved to him once and he didn’t wave back?

Once you figure out that your emotional response isn’t realistic, the next time you see him, you can remind yourself of that fact. With each and every breath, remind yourself of what is and isn’t the reality of the situation and become consciously aware of the goal of working through the anxiety rather than adding to it.

It is amazingly easy to take a perfectly normal situation and make it into a vendetta which is imagined. Picture a family reunion. Your cousin is there with her new husband who is an attorney. In the back of your mind, you are thinking of years ago when you actually had to hire an attorney to represent you for a misdemeanor that stemmed from a case of bad judgment.

You are introduced and reach out to shake his hand but he does not reciprocate the gesture. You immediately assume he thinks you are beneath him. For years, you carry the intimidating feelings and when you see him, you feel very anxious.

Later, when attending a relative’s funeral, you learn that he suffers from a phobia of germs and never shake hands with anyone. Your anxiety and feelings of insecurity were never legitimate but years have been wasted by your assumptions.

The truth of the matter is we can’t really know what anyone thinks or feels, even in the event that they tell us. We can decide to believe them if they tell us, but we can never know for sure. A child who has a father who is abusive may be apologized to, time after time.

Can the child believe that the father really was sorry? It is normal in such an event for the child to look for signs of sincerity or evidence otherwise. That’s why our defense mechanisms are always sending out feelers to second guess others and to go into defensive gear if things seem out of order.

Abused children are often pros at reading people in a room. They can immediately see who is emotionally stable and safe and who is not. This type of hyper-vigilance can be temporarily effective because it gives the illusion of being in control, able to control social setting and to choose who to talk to and who not to.

It also causes problems. It becomes exhausting and your thoughts can be way off track. Having your defenses up can interfere with relationships with friends and family and even with intimacy. When your defenses are always up, it is difficult to have meaningful relationships.

But when we start to develop internal awareness, we can stop and ask ourselves such things as, “What was that response all about?” We can dig down inside ourselves and figure out the roots of our feelings. That is where a therapist shines.

A therapist is trained to work alongside you to explore and discover and then to reach solutions that will free you from the bondage of OCD behaviors and OCD thoughts. If the BT route is not productive, your therapist will present other solutions to you.

Unprocessed trauma narratives don’t just go away. You may rearrange the thoughts and tuck them away for a time, but they will always resurface. When you reach out to a therapist, together you can work through, not around the issues and put those traumas into the past so you can move on without the OCD symptoms that are controlling your life. It will involve some work (there’s no denying that) but in the end, you will be happy that you chose to get help.

As we begin to recognize things that are emotional triggers, we can reflect on the situation and what is going on around us. We can pinpoint why a song makes us sad or why a neighbor makes us anxious. We can then work through it, separating the two.

Just as defenses have become the natural way you go about your life, so can the learned behaviors of dealing with OCD. Soon, you will be able to put an end to the destructive behaviors and thoughts like clockwork and replace them with constructive ones that promote mental health, life, and healing.

Recognize, Reflect then Redirect is a useful tool when it comes to relatively mild traumatic triggers. The more severe the trauma is, the more possible it will be for it to take professional help and time in order to work it through.

Behavioral Therapy has the potential to be a very valuable tool in the management of thought and behavior patterns that are undesirable. While it can be tempting to self-diagnose OCD, it is not wise.

It’s best to seek a therapist and to acquire a diagnosis from a professional standpoint so that if it is present, you can begin with a tailored treatment plan. Working through to experience health and emotional growth is very possible. Don’t put it off another day. Your new life awaits you.

Photos:
“Jenga,” courtesy of Michel Parzuchowski, unsplash.com, CC0 License; “Look”, Courtesy of Joshua Rawson Harris, Unsplash.com, CC0 License; “Brain”, Courtesy of GDJ, Pixabay.com; CC0 License; “Anxious Man”, Courtesy of Jessica Oliveira, Unsplash.com, CC0 License