Tuesday, June 26, 2012

Coping With the After Shocks of Sexual Abuse-- Beyond The Sandusky and Catholic Church Scandals


"Every day, do something that will inch you closer to a better tomorrow"
                                        -Dough Firebaugh

     The recent convictions of Pennsylvania State University football coach Jerry Sandusky and the former Philadelphia Archdiocese secretary sheds light on the sad fact that the abuse of children by adults in positions of authority continues to occur. Many articles have been written about the disturbing psychological profile of the perpetrators but few about victims and their difficult road to recovery. Despite the recent increase in media attention on this societal ill, child sexual abuse is largely under reported. It is not uncommon and remains a serious problem in the United States. Many victims of child sexual abuse do not acknowledge, tell anyone, or work on psychological issues stemming from their past abuse until they are adults and well beyond childhood.

     Sexual abuse victims suffer from a series of psychological aftershocks. Research has shown victims to have higher levels of sexual disturbance and dysfunction, sexual identity confusion, poor adult functioning, higher levels of depression, lower levels of self-esteem, and are more likely to be re-victimized than non abused individuals. Survivors tend to feel isolated and stigmatized. They engage in self-destructive behaviors such as alcohol and drug abuse, gambling, and participate in risky and impulsive sexual encounters. Female  victims of sexual abuse are at greater risk for developing eating disorders, personality disorders (borderline personality disorder), and drug and alcohol dependencies. Another aftershock is the fact that child sexual abuse victims are much more likely to become perpetrators as adults and many victims suffer life long symptoms associated with Post Traumatic Stress disorder.

      It is important for survivors to relinquish any feelings of guilt they may have connected to the abuse. Through counseling and support groups, victims can let go of the illogical feelings of responsibility that they often experience associated with their abuse. Furthermore, much research has shown that the passage of time is an important element to one's recovery. And "recovery" may not be the same for all individuals. The type, degree, frequency, and level of violence that victims experienced greatly impacts their recovery.

     Survivals of sexual abuse have difficulty forming and maintaining intimate relationships and are at higher risk for divorce. Victims will often have great difficulty trusting others close to them. Abusers are most commonly a well known and trusted adult, such as a close family friend, teacher, religious leader or sporting coach. Recovery involves rebuilding the ability to trust. Once victims are able to accomplish this fundamental human need and task, they can look forward to experiencing rewarding and fulfilling relationships.
     If you or someone you know is a survivor of childhood sexual abuse it is important to get the proper help from a trained mental health professional. A mental health professional who is specifically trained in sexual abuse trauma can help victims to work on issues of trust and intimacy. It is important for all survivors to realize there is hope for them to be able to lead happy and satisfying lives.

Below are four tips for victims and their loved ones:

1. Be patient with yourself-recovery takes time, effort, and lots of emotional energy.

2. Consider joining a support group. Being with other survivors can help rebuild trust. www.rainn.org

3. Learn about the signs and symptoms of Post Traumatic Stress Disorder. Being aware of them can help you with getting through the tough times and bad days.

4. Mediation and relaxation exercises can help you cope with your negative feelings such as anger, stress, and anxiety associated with abuse.

If you have other suggestions for helping victims of sexual abuse please share them here. I want to hear from you.

This article was written by Paula Durlofsky, Ph.D., a practicing psychologist in Bryn Mawr, Pa. To learn more about me and my practice please visit my web page at www.drpauladurlofsky.com.

Sunday, June 24, 2012

Whoever Said We Could Have It All-Comments on The Atlantic's Article by Anne-Marie Slaughter

     Yes, some truths will "piss us off" because they make us aware of the cold realities that we had imagined were not there to begin with. In the Atlantic Magazine article, "Women Still Can't Have It All", Anne-Marie Slaughter outlines reasons why it is impossible for women today to both reach the pinnacle of their career and still lead satisfying lives as mothers and partners. She believes only women who are superhuman, rich or self-employed are capable of achieving these goals, meaning it is unattainable for most of us. I enjoyed reading her article and believe she has opened up discussions that hopefully will lead to positive changes for both women and society at large. As a psychologist I find her article to bring up the existential reality that we all wrestle with and need to accept in order to lead satisfying and happy lives: no woman, man, or child can have it all.  
     This reality is difficult for us to accept, especially because it involves mourning our losses, what it is we can not have. For example, when children become conscious of themselves and their surroundings they also become aware of their own limitations-their dependencies upon their care-takers and their inability to make their own choices (even when they are rational). The child comes to realize they are not the master of their universe. However, if the child is supported by sensitive parents who are aware of this inevitable frustration their child will face, they can help him or her come to accept the reality of what life is ultimately made-up of, negotiating and compromising. All of which helps us to mature and grow emotionally. This doesn't mean we do not have any control over our own destiny and can't live out the dream of having a certain career or achieving a personal goal. Rather, it means we need to be conscious of how our expectations will match-up with the realities of life. Chances are our expectations will not align 100% with our dreams-but should this make us unhappy? I don't think so. In fact I believe the opposite is true, as Gloria Steinem said, "The truth will set you free".
     Leading happy and satisfying lives involves being aware of and mourning the losses that each choice and decision we make entails. Once we become conscious of this, our expectations will be more in synch with our realities, thereby giving us the ability to make informed decisions. Informed and well-thought out decisions lead to emotional maturity, growth, and empowerment. Informed decisions also allow us to reach our full potential within the scope of our realities and abilities. This unequivocally maximizes our sense of happiness and satisfaction with life. Is this having it all? No, but it may just be the closest thing to it.

What does "having it all" mean to you? I would like to hear from you.

This post written by Dr. Paula Durlofsky, a psychologist in private practice in Bryn Mawr, Pa. To learn more about me and my practice, please visit my web page at www.drpauladurlofsky.com.

Wednesday, June 20, 2012

Mondern Legal Tactics-Histrionic Personality Disorder In the Sandusky Trail.

     You are most likely aware of the Jerry Sandusky defense team's decision to use a personality disorder to explain their client's seductive letters to his alleged victims. Personality disorders are psychiatric conditions that are considered "functional" illnesses rather than debilitating mental illnesses such as major depression, bipolar disorder, and schizophrenia. Personality disorders result from inadequate parenting and a deprived family environment.
     The word histrionic is derived from the Latin word histrionics which means having to do with acting or dramatics. Individuals suffering from histrionic personality disorder exhibit a pervasive pattern of excessive emotionality and attention seeking behaviors and act in the following ways:

- are uncomfortable in situations where they are not the center of attention.
- interactions with others are characterized by inappropriate sexually seductive or
   provocative behavior.
- display rapidly shifting and shallow expression of emotions.
- consistently use their physical appearance to draw attention to self.
- display self-dramatization, theatricality, and exaggerated expression of emotion.
- are suggestible and easily influenced by others or circumstances.
- consider relationships to be more intimate than they actually are.
      The attention seeking behaviors of individuals suffering from histrionic personality disorder stems from their lack of receiving adequate attention and emotional connection from parental figures. They spend their lives desperately searching for attention from acquaintances, friends, and family members in the hopes of feeling validated and acknowledged. Treatment for these individuals involves a minimum of one to two years of intensive psychotherapy (medications have not been found to be effective in treating this disorder) with the goal of having the therapist provide parental affirmations and the emotional connection that we all need in order to thrive and grow. 

Do you know someone who has histrionic personality disorder? Do you find yourself seeking attention from others? What are your thoughts about histrionic personality disorder? I would like to hear from you.

To learn more about me and my practice please visit my web site at www.drpauladurlofsky.com.

Monday, June 18, 2012

Decisions, Decisions--Breaking The Cycle of The Ambivalent Mind.

        Some people are able to make decisions with out being bogged down by uncertainty. To them decisions seem clear-cut. They make them quickly and with minimal amounts of anxiety and fretting over whether or not they made the wrong choice in the first place. For others everyday decisions, small or large, are filled with angst and worry. Their ability to make any decision is stopped dead in its tracks by what is known as ambivalence. Ambivalence is what we experience when we have two opposing feelings simultaneously toward an individual, situation, or object. Although all of us have experienced ambivalent feelings at some time or another, chronic feelings of ambivalence can be emotionally debilitating. Ambivalent thinking leads to avoidance, procrastination, inhibits emotional growth and maturity, and prevents us from reaching our full potential.
     So where does ambivalence come from? Many psychologists and social scientists report that certain  personality traits tend to be associated with the ambivalent stance, such as obsessive compulsive tendencies, unhealthy psychological defensive styles (such as splitting), and under developed problem solving skills. Ambivalent thinkers systematically over-evaluate all sides of a situation. They carefully consider all potential options and outcomes yet remain unable to make decisions. Ambivalent thinkers also have a great fear of  making a "wrong" or "bad" decision. This pattern of thinking contributes to constantly moving from one side of the decision fence to the other.
     A certain degree of ambivalence is normal and healthy-in fact moderate ambivalent thinkers are thought to be emotionally and intellectually mature. Moderate ambivalent thinkers are able to recognize and appreciate the world with all its complexities and imperfections. Chronic ambivalence, however, is what interferes with our ability to move forward. Chronic ambivalence results in a rigid cycling pattern where we find ourselves constantly moving from one side of the decision fence to the other and when this happens, ambivalence becomes an emotional and psychological barrier to achieving genuine happiness.
     Psycho-dynamic therapy can help with examining and resolving issues underlying the ambivalent stance.  Issues surrounding intimacy, separation, trust, and self-confidence are commonly at the root of chronic ambivalence. Treatment that focuses on resolving these internal conflicts should help one to develop the courage to take action, make decisions with less fear, and have a "go for it" attitude.

Here are four tips to help you cope with ambivalence:

1.Write down your ambivalent feelings and the circumstances in which they occur.

2. Remind yourself that no person or situation is perfect and that all people and circumstances have both positive and negative aspects.

3. Recognize and accept your ambivalent feelings. Do not force yourself to make a rash decision.

4. Consider seeking professional help in order to help you examine and sort out your ambivalent feelings.

Do you suffer from ambivalence? How do you make decisions when you are ambivalent? Do you find yourself unable to move forward in life because of your ambivalence? I would like to hear from you.

Wednesday, June 6, 2012

The Mood Roller Coaster. Understanding Bipolar Disorders.


     Variations in our moods and energy levels are normal. We all have our share of days when we feel happy and excited, days when we feel sad and down, and even days when we feel both. On our "happy days" we may feel invigorated, joyful, and have an extra dose of self-confidence. On our "down days" we might feel blue, less energetic, and may have fleeting moments of sadness. For most people variations in their mood and energy do not prevent them from taking care of their daily responsibilities or interfere with their relationships and careers. Their "swings" in mood are far and few in between. People with bipolar disorder, on the other hand, have significant and frequent variations in their moods and energy levels. They rapidly go back and forth between periods of feeling very "high" to periods of feeling very "low". The disease is called bipolar disorder because the person affected with it alternates between two completely opposite poles-euphoric happiness and extreme sadness. Bipolar disorder affects men and women equally. The average age of onset is between late teens to early 20's. The disease has also been shown to run in families, so a person that has a relative diagnosed with bipolar disorder has a higher risk of developing the disorder at some point during his/her life time.
     There are two types of bipolar disorders: bipolar type I and bipolar type II. In bipolar type I the person has had at least one manic mood along with periods of major depression. A manic mood is described as feeling "unusually high" and euphoric. Some people during a manic period will go on shopping sprees, gamble, drink more alcohol than usual, participate in recreational drug use, and have numerous and risky sexual encounters. They may also experience disturbances with their sleep, have racing thoughts, and become hyper-verbal. A manic period can also be experienced as a persistent irritable mood.

     Bipolar type II disorder is less extreme than bipolar type I. People with bipolar type II have never had a full manic episode. Instead they experience elevated moods (hypo-mania) and high energy with periods of depression, but their "highs" are not as extreme as they are in bipolar type I disorder.  And people with bipolar disorder type II are often wrongly diagnosed with clinical depression. Furthermore, in both bipolar type I and bipolar type II manic states can occur in rapid succession to depressive moods and this is called a "mixed" state.
     The good news is that with proper treatment, often including medications, this disease can be effectively managed. A combination of mood stabilizers, psychotherapy, and cognitive-behavioral therapy (CBT) has been shown to be the most successful combination of treatment. Psychotherapy and CBT aims to alleviate core symptoms by helping the individual to recognize mood triggers, reduce negative expressed and felt emotions, and practice coping strategies that may lead to remission.
    It is important to get an evaluation by a mental health professional if you think you have either bipolar type I or bipolar type II disorder. With proper treatment this diease can be successfully treated and managed. Below are four tips to help those with bipolar type I and bipolar type II disorder:

1. Make sure you get enough sleep. Not getting proper rest can trigger a manic episode.

2. Get regular physical exercise. Exercise has been shown to reduce symptoms of depression.

3. Make sure you have a plan in place for when your symptoms return.  This will help reduce the severity of consequences that can occur in a manic or depressive state.

4. Join a support group. Getting support from other people diagnosed with bipolar disorder can help decrease feelings of isolation. A support group can also give you the chance to learn new strategies for coping with your symptoms.

 Do you have bipolar type I or bipolar type II disorder? Do you have a loved one that has been diagnosed with this disorder? Do you have useful tips to share? I would like to hear from you.

This article was written by Paula Durlofsky, Ph.D., a practicing psychologist in Bryn Mawr, PA. Please email all questions or comments to drpauladurlofsky@gmail.com. To learn more about me and my practice visit my web page at www.drpauladurlofsky.com. 

Monday, June 4, 2012

It's REALLY Okay To Be Angry.


     Anger is an emotion we are all familiar with. We have all felt it at times whether as a fleeting annoyance or full-fledged rage.  When we feel anger we experience it both physically and emotionally. Our bodies react with visceral responses such as increases in heart rate, breathing, and perspiration and our ancestral instinct of "flight or fight" kicks in.  Anger is necessary for our survival-it provides us with the drive and ability to defend ourselves. But not every circumstance warrants such a severe reaction and it would be destructive to lash out at every person that caused us to feel angry or every situation that irritated us. This does not mean we should deny our feelings of anger. It's REALLY okay to be angry. Problems develop when our anger is not effectively expressed and derailed anger can cause significant harm to ourselves, others, or both. 
     We all use a variety of psychological defenses to cope with anger, some healthy and some not so healthy. The two most common approaches to dealing with anger are repression and aggression.
      When we repress our anger we use behaviors that are passive, evasive, and obsessive (needing to be inordinately clean and tidy).  Repression can also involve emotional manipulation, self-blame, and self-sacrifice.  Defenses and behaviors of this kind prevent us from directly confronting our negative emotions and/or the source of it. This can be a "slippery slope" since repressed anger can easily turn into depression, anxiety, low self-esteem, and contributes to drug and alcohol abuse. 
     Individuals who have aggressive anger are often described as being "hotheads". They have difficulty  modulating negative emotions and they have a low tolerance for frustration. Common everyday life annoyances, inconveniences, and unexpected changes in routine causes exaggerated feelings of anger.  Bullying, being physically destructive to self or others, and overly punitive reactions such as refusing to forgive people that contributed to your anger in the first place are all forms of aggressive anger. Aggressive anger is a serious concern since it has a real potential to negatively impact important personal and professional relationships.
     No one sails through life without being touched by anger. Situations will arise where we will feel we are being unjustly treated or unplanned events will happen that require us to change our expected life course. This is why it is important to work on understanding the "why and what" that causes us to be angry and the "how to" constructively resolve it. Below are four tips to help you:

1. Simplify Your Life. If you find you are quick to get irritable or angry when you feel frustrated simplifying your life should help. Evaluate what responsibilities you can "give up" so you have less self-imposed reasons to be angry.

2. Learn Better Communication Skills. Angry people tend to jump to conclusions before they have all the facts. Learn to listen to other people by slowing down yourself and not responding too quickly when angry. 

3. Own Your Anger. If you cope with anger by repressing it learn to be able to identify when you feel anger and allow yourself to be angry. Individuals that repress their anger can feel powerless but when "get in touch" with their anger and express it in an effective way they feel empowered.

4. Make Personal Time For Yourself. Schedule time during the day to relax. We all get weighed down and irritated by our daily responsibilities. Making the time to relax by doing deep breathing exercises, meditation, and/or regular exercise helps reduce stress in general and improves our ability to better cope with those unexpected stressful situations.

How do you cope with your anger? Do you repress your anger or do you become aggressive? I would like to hear from you.

This post was written by Dr. Paula Durlofsky, a practicing psychologist in Bryn Mawr, Pa.  Email all questions or comments about this post or previous posts to drpauladurlofsky@gmail.com. You can also visit my web site at www.drpauladurlofsky.com to learn more about me and my practice.