I know many of you are probably exhausted right now. Physically, mentally and emotionally. This may have been one of the most challenging weeks in your entire career. I’m going to go out on a limb here and say most likely in your training you never had a class titled, “How to Deal with a Pandemic”. If you did then I’m going back to school to become a therapist. I think you deserve one hell of a pat on the back. Seriously pat yourself on the back right now, and then keep reading. As a mental health sufferer, who currently sees two therapists weekly, I just want to say a few things to you all:
Thank you for quickly adapting and continuing to serve clients. This week challenged our entire country’s work force (regardless of profession), and continues to do so. I was amazed at the seamless ways…
First of all, I’d like to thank all of the people who have followed this blog over the years. I appreciate your reading my posts and commenting on them, and your participation has been very meaningful to me. Hopefully, it has been so for you too.
I have decided to stop writing on this blog, as I have too many projects and blogs going on. Fear not, however! The material will migrate to my website’s blog, which you can find here. You can also find out about my practice and the various new features I offer, like online counseling and coaching. I will be posting fresh material to that blog from now on, and will not post here. The final date of expiration for this blog will be 6/15/18. At that point, this blog will join the other blogs in the cyber-void and someone else might have my domain. That’s okay with me; I’m sure there are many other terrific Lisa Larsen’s out there in the world.
Again, this is just a notice that this blog will be no more as of the middle of this June and that my (old and new) blog entries will now be available at http://www.lisaslarsen.com/blog. Thank you for participating in this blog and I hope you join me at this new location. I look forward to seeing you there!
There are three basic blockages to communication that I see causing pain in peoples’ lives. These are assumptions, unrealistic expectations, and shutting down. I will explain how these muck up relationships with our friends, family, and lovers. I will also make a few suggestions for how to overcome these obstacles.
Assumptions can be small, like thinking someone is going to call you rather than text and getting angry when the person texted you instead of calling. Alternatively, they can be big, like your fiance thinks you want kids because he does and is very disappointed when he discovers that his assumption was incorrect. Clear communication on an ongoing basis is the easiest antidote for this. There’s a silly old saying that says assumptions make an ass out of u and me. It sounds goofy but it’s true; when we think that other people see the world exactly as we see it, we’re begging for an argument or painful discovery.
This leads me to unrealistic assumptions, which may be largely based on unmet needs from our childhood. They can also be based on biases and difficulty trying to put ourselves in others’ shoes, seeing the world from their perspective. I see this especially with young people and social media. They get very offended if someone doesn’t respond to them immediately and jump to all kinds of horrible conclusions about the other person’s intent. Sadly, this leads to ending relationships prematurely and unnecessary arguments.
This problem can be a little trickier to solve, as you can’t always see your biases and blind spots. You might not understand that something from your past is influencing your current behavior. Therefore, it can be helpful to talk to a professional psychotherapist to learn more about your unconscious mind and what factors motivate and control your behavior. This can help you release the past influences and live more happily and realistically in the present.
Finally, we come to shutting down. Sometimes people get overwhelmed by hurt, or they don’t know how to cope with something. They might lack the skills or doubt themselves in how to respond to a situation. Or, they might lose interest or decide that interacting further is not in their best interest. There are many reasons for shutting down communication. It’s painful to be on the receiving end of this, and it can be painful to shut down as well. It leaves the recipient of this behavior wondering what happened. Naturally, they want closure, they want to understand what happened so that they can avoid that type of interaction in the future.
From the recipient’s perspective, there is not much you can do in this situation but ask for closure (not demand, not force but ask) and hope that the other person will have the courage and kindness to respond. If the other person’s response is no response, then that can be hard to take, but eventually, it must be accepted for you to have the freedom to move on.
If you are the person shutting down, it is important to learn how to communicate even when it’s difficult so that it doesn’t prematurely end or damage your relationships. It’s also important to be conscious of your effect on other human beings and to at least give the person some kind of answer when they ask for it. You don’t have to remain involved with other people when you don’t want to, but it is much more respectful to let a person know when you want to change or end the relationship.
These are just a few tips on how to have less pain and more joy in your relationships. If you’d like to find out more and schedule a psychotherapy session, please call me at 661-233-6771. Thank you.
I realize not everyone who reads this blog has children or is getting a divorce. However, I see quite a few children who are in the midst of ugly custody battles and I want to let readers know about the negative impact it has on children. Even if children and adolescents don’t exhibit signs of Post-Traumatic Stress Disorder, the stress from a disrupted family can worsen existing mental health issues or give rise to new symptoms. Such symptoms can include acting younger than their chronological age (bed wetting, soiling, temper tantrums) and aggression. I have seen a few things that parents do in the midst of a divorce, or even during ongoing custody battles, that can really damage children’s sense of security and wellbeing.
Divorce is usually painful for everyone involved. The partners who are divorcing are in pain because their vision of happily ever after is being broken. Sometimes divorce is a mutual decision that is handled with dignity and grace. Yet often it’s a rough, scary, painful, maddening experience. Infidelity, substance abuse, failed promises and dashed expectations often further complicate the situation. The focus can easily become the parents’ pain; when this happens children get short shrift.
It’s very hard for adults to cope with this. If a parent is having a hard time with the pain, it’s a good idea to get some professional help so that it doesn’t impact their children. That seems the responsible thing to do. Some people also find it helpful to lean on religious leaders in their place of worship or trusted friends and family members. Relying on family and friends can be tricky, however, as such sources of support may not be able to stay objective and be completely honest the way a professional can.
That being said, it is important to remember that in most cases, children do not want their parents to divorce. They want security, predictability, consistency, and support. Many children and adolescents complain to me about having two separate homes with two separate standards of living, rules, chores, etc. Unless their parents are constantly arguing viciously in front of them or ignoring each other, it is not a relief for them to be in the middle of a divorce. For children and adolescents, divorce can be the end of their security and a big upheaval.
Depending on their developmental stage, children usually do not understand what is going on a lot of the time. They are confused, sometimes blaming themselves, and at other times blaming one or the other parents. Children and parents alike often feel angry, sad, scared, lonely, hurt. It is important to not add the parents’ turmoil and hurt feelings to what the children feel. Adults generally have better coping skills and resources than children do, and so it is important for parents to be a resource and not a burden to their children during these trying times.
It stands to reason that this is a good time to think about children too and how parents’ actions affect the children. Here is a list of don’ts that will hopefully prevent harming children during divorce.
1. It may seem obvious to some, but one parent speaking negatively about the other parent is a really bad idea. This may not necessarily take the form of outright insults, but also look like encouraging the children to not listen to their other parent, disobeying them, disrespecting them, and gossiping about the other parent as if the children were peers or friends that the parent could vent to. That is not the case. When you insult or disrespect the other parent, you are a) insulting half of the child, because he or she was raised, until now, by both parents; b) encouraging the child to rupture and/or degrade their relationship with their other parent; and c) dumping your negative opinion of the parent onto the child. They don’t need to know what happened between you, or what complaints you have about the other parent.
2. In the same vein, treating the child as a personal confidante is hurtful. When parents use children as their friends or tell children too much information about the divorce, it forces them into an adult role and makes them take care of the adult, which is sometimes called “parentification.” Parents need a calm, objective, wise adult to talk to, not a child. The child needs to be allowed to be concerned with his or own well being. Children don’t need to know about how much money mom or dad is paying to the other parent, whether parents cheated on each other, how much their activities and needs cost, or what the parents think about each other. Their job is to go to school, do their activities, have friends, do their chores, and grow up to be healthy and happy. That’s it. Too often I see parents pulling their children into the middle in various ways, including disclosing unnecessary details of the divorce to the child or adolescent. If the parent is bitter, angry or hurt, get professional help to sort through the pain of the divorce without foisting it onto the child.
3. Spoiling the kids with gifts and trips is another way that parents can manipulate children into choosing one side or another. This is almost a cliche by now, so many parents try to buy their children’s affection and manipulate the child into taking his or her side against the other in the divorce. This behavior coerces the child’s allegiance when there is no need for such false loyalty. Additionally, spoiling makes it very difficult for the parent who can’t afford it and creates unrealistic expectations for the children. Another way parents can spoil their children is a lack of boundaries and rules. If a child can do whatever s/he wants at Dad’s house but has to do homework and chores at Mom’s, whose house do you think will the child want to visit more often? This is even more hurtful because it can create confusion and behavioral problems that “only happen at your house, not mine.” No one is a winner in this situation.
4. Along the same lines, children often respond negatively to the parent who enforces rules and expectations. S/he may tell the parent, “I don’t have to do this at Mom’s/Dad’s house!” This may seem on the surface an attempt to get his/her way. But it is also a way to test boundaries and see if there is consistency in his/her environment. What can a parent do if a person’s ex-spouse’s parenting style is completely different? A responsible parent can explain to the child that the reason for his/her chosen form of discipline is so that the child can grow up to be healthy, responsible and ultimately have a good life. Sometimes that means that children do not get to do what they want right now. However, there’s no need to be too strict with children, so do give them their own free time when they have earned it. All humans, regardless of age, need to be able to play and work throughout their lives.
5. Parents are sometimes more concerned about what lawyers and judges think of them than doing what is right for their children. Their desire to “win” in court (whether it means more custody/visitation or paying less child support) comes at the expense of your child’s development and well-being. In this situation, parents can easily lose sight of what children need, such as children spending time with an attentive, stable, consistent parent instead of being with a babysitter or by themselves. Such parents often are very conscious of how things appear to judges and lawyers in Family Court. They act superficially and bend the truth, or worse yet get their children to lie. These parents lose sight of the fact that the human beings involved — their children — don’t care who wins. Such parents are usually competitive, less than mature, and not open to compromise for the best interests of the children. As a result, the children once again suffer because their parents are caught up in their own insecurity and pain. I have also seen parents stoop as low as to coach their children what say in therapy and make up false allegations of child abuse. The child abuse social workers have plenty of work with real cases to investigate without using Department of Child and Family Services to smear the other parent.
In closing, here are some things to remember. The primary goal is to make divorce and separation less stressful on children and adolescents and to help children avoid blaming themselves or the other parent for the divorce. Blaming rarely solves anything in life, and least of all in matters of the heart. The divorce is between the two adults, and the children are just unfortunately along for the ride. Adults who are hurt from the divorce should get their own psychotherapy so that they can cope effectively and not let this negatively impact their sons or daughters. It is important to think about the bigger picture – what will help the child, above everything else.
When parents claim they are perfect and never have any problems with discipline, they do not fool anyone. Every parent, no matter how good, has times when they are frustrated with their children. Sometimes the frustration gets the better of them. If they can take a step back and keep their tempers in check, that is what is important. Children do best when their parents can communicate civilly and effectively with ex-spouses when necessary. This helps the child have consistency and security. Children like to know that someone is in charge and that their parents are going to keep them safe. Sparing them drama is crucial to reducing stress for the child.
We can learn from other cultures how to have different perspectives and attitudes towards loss and grief. Memorializing the deceased in this way seems to honor them yet also see death in an irreverent way.
With November 1 and 2 arriving soon, I thought about how differently we handle memorializing the dead in the dominant culture of the United States versus Latin America. They hold celebrations every year called Dia de Los Muertos on the day after we celebrate Halloween. I realize that there are also funerals for individual deceased people in both Anglo and Latin American cultures, but we in the USA don’t have the same kind of mass celebration for our dead loved ones.
The celebration is most strongly associated with Mexico, although other Latin American countries celebrate it as well. It is a combination of the celebration that the Aztecs have and the Catholic celebrations of All Souls Day. Offerings are given to the souls of deceased family members, and the occasion is very festive with music and feasting. The celebrants believe that the deceased would be offended by sadness and somber behavior, so instead, they have a lively gathering in the deceased’s honor.
In the USA it seems more somber and staid when a loved one passes, and while we have fanciful notions of ghosts coming back from the dead at Halloween, the actual celebration of a loved one’s passing is usually a very sad funeral wherein people speak mournfully about the person. There are wakes, which in Celtic cultures are meant to be a time to view the body of the deceased before they are buried and I wonder how we would respond to someone having a party in honor of the deceased or going to the person’s graveyard with a big picnic and speaking to the dead as if they were still alive?
It seems very different from Anglo culture, and no one culture is right or wrong. It is just a different perspective and approach. I think it is healthy to have a balance between allowing oneself to be sad and upset about the death, and celebrating the person’s life exuberantly and even with humor and a bit of irreverence. The sculptures of skeletons playing the violin and dancing say to me that some people are able to look at death in a whimsical, humorous way and not take it too seriously. The candy skulls and painting one’s face like a skeleton suggest to me a link between the living and the dead. We are part of a continuum of living and growing older and dying. We may be here on earth for a time and then pass on to some other state of being, but (depending on your spiritual beliefs), we leave a legacy behind, whether actual human beings or the work and impact we have on others. Others are affected by our passing and want to acknowledge that they knew us, that we meant something to us. Similarly, we want to do that for others.
It’s healthy to acknowledge that we miss people who are no longer able to be touched, heard, embraced. But the essence of our experience of them lives on in our hearts and souls. We carry them around with us, and some people even say they speak to their deceased loved one when they need comfort, advice or guidance. I think it is part of the tapestry of acceptance that we weave when people come into and leave from our lives. The tapestry has some bright threads and some darker colors, and we get to enjoy the totality of who that person was to us by acknowledging the spectrum of feelings that accompany his/her passing.
I’m not sure how you will celebrate this Halloween and the days after, but I am in awe of the diverse ways that we humans honor the dead. I think we can learn from all of them and be enriched by the different traditions.
While it’s understandable that people who suffer from PTSD and traumatic grief use alcohol or drugs to cope, it is ultimately self-defeating and harmful. There are better ways to cope, if you’re interested.
People who suffer loss and trauma often self-soothe by using alcohol and drugs. In one 2010 study, a sample of 587 patients with traumatic childhood events was found to abuse cannabis (44.8%), alcohol (39%), cocaine (34.1%) and heroin/opiates (6.3%).[i] It is understandable to try to ease one’s pain by numbing it with alcohol or drugs like cannabis, cocaine, and opiates. Post-traumatic stress disorder (PTSD) and grief can be very upsetting and painful experience. These experiences may involve reliving the traumatic experience or loss repeatedly, leaving a person feeling out of control and miserable. However, one of the many downfalls of self-medicating one’s psychological distress is that it never gets fully resolved because it is always avoided and shelved for a later time. Unfortunately, that later time never seems to come, unless a person has a crisis and is forced to get treatment because of his/her behavior. For example, people who store their pain and ignore it until they cannot stand it any longer can do self-destructive things like self-mutilation and suicide. Other people become so intoxicated that they have to be hospitalized or go to a rehabilitation facility. At that point, the person might be willing to give up his/her substance of choice and learn some new coping skills. However, even then, some people are not ready to stop and abstain completely.
When many people think of trauma, they think of veterans and people in the military. Indeed, there is a high prevalence of both PTSD and substance abuse in veterans[ii], but there are traumatic events that are not related to combat as well. Sexual and physical abuse, neglect, and emotional abuse in childhood can leave emotional scars on people that is tempting to dim with alcohol or drugs. Domestic violence, moving vehicle accidents, extremely contentious divorce, and being bullied as a child can also lead to post-traumatic stress.
Some of the things that people use alcohol and drugs for when they have PTSD or experience a traumatic loss are
Distraction from the disturbing stimulus
Decreasing the intensity of reliving the trauma through intrusive thoughts, body sensations or memories
Being able to be amongst people without being hypervigilant
Managing their energy levels
Being able to sleep at night
Many people are using drugs or alcohol to soothe themselves and try to function better in life. Wanting to change all these things is a positive sign of self-love in a person. However, alcohol and drugs only temporarily take care of these important psychological and behavioral functions. They are not a long-term solution.
I respect the pain that my clients suffer and understand that the coping skills they use when they come to see me are the best they could come up with so far. However, I also think that if we’re going to work effectively together, they need to be open to trying healthier ways to cope and to resolve the trauma or loss so it doesn’t keep bothering them. I find that letting go of drug or alcohol use, while difficult at first, makes it easier for them to make good decisions about managing their mental health symptoms. When a person is numbing their pain with drugs or alcohol, the exposure part of therapy can’t really happen, so that the person can’t learn to tolerate painful feelings and thoughts, and change their response to that. It can be a vicious cycle whereby the person avoids and avoids, never feeling ready or capable of confronting the pain, so the pain remains buried longer and longer. This makes it less and less desirable to face the music, so to speak, and the person who is actively trying to block the pain ironically lives with it longer. They often make the people in their lives unhappy in the process too, since there are many things the person cannot face, talk about or do because of their avoidance.
Dialectical Behavioral Therapy (DBT), developed by Dr. Marsha Linehan, can be useful in developing skills to tolerate negative feelings and thoughts. It is a combination of Cognitive-Behavioral Therapy (CBT) and Eastern principles such as mindfulness to learn to be with one’s pain while being able to observe it and make good decisions about how to respond to it. By gradually becoming aware of and tolerant of one’s internal experience, through awareness of thoughts, feelings, and body sensations, a person can build resilience to strong emotional pain. That resilience makes it easier to do the work of resolving trauma and traumatic loss.
If you are interested in learning about these methods, please give me a call at 661-233-6771. If you need help in becoming sober, I recommend that you use AA/NA to assist you in sobriety. Here is a link to an online group for substance abuse: https://www.aa-intergroup.org/.
[i] Khoury, L., Tang, Y., Bradley, B., Cubells, J. and Ressler, K. (2010). Substance abuse, Depression and Anxiety, 27(12): 1077-1086.
[ii] Meisler, A. (1996). Trauma, PTSD and Substance abuse. The National Center for Post-traumatic Stress Disorder PTSD Research Quarterly, 7(4): 1-3
As a culture, we are not big on identifying, naming and allowing for our own emotional responses to stimuli. We seem more prone to suppress emotions until they become unbearable to hold in, and then act them out in undesirable behaviors or until they become calcified into negative mood states and physical maladies. Wouldn’t it be nice to prevent that calcification and allow our feelings to flow through us instead?
I think that as early as possible, we should teach children how to identify their feelings accurately, tolerate them, and express them appropriately. Many children are taught that when they express their emotions, they are being “bad” or “naughty.” Really, they are doing their best to let the grownups in their lives know that something needs paying attention. We need to teach them better ways of expressing their feelings that are age-appropriate. If we teach them that their feelings are wrong, they grow up suppressing them or acting them out and cannot enjoy life the way they are meant to. It’s up to us to help them turn their emotions from these powerful forces they don’t understand, to acceptable and even helpful signals in their bodies that they can make wise decisions about.
Emotions are there to alert us to something that’s happening within us or in our environments. They can be powerful allies that protect us from harm, allow us to enjoy life, and grieve our losses. We do not have to fear them any more than we fear breathing, digesting food, or going to the bathroom. They are a natural, healthy part of our bodily systems and we need to make space for noticing and experiencing them. We do not need to act on them all the time, which some people mistakenly think is part of this equation. Instead, the more mindful we are of them, the better we can decide what to do with them when they arise.
Since many of you reading this blog may not have had emotional literacy training as children, it may be harder to make up for what you didn’t get as children. Nonetheless, I believe it’s never too late to learn how to deal with emotions in a healthy way. This is by no means a comprehensive piece on how to achieve emotional literacy, but I can put out a basic map of where your journey might lead you.
Identify your feelings
First, you need to be able to identify when emotions are coming up. Some people do not know the words that go along with the feelings so you might want to familiarize yourselves with the basics. Of course, there are sad, mad, happy, scared, the strong emotions that most of us are able to identify readily. But if even that seems foreign, then you can start with what’s happening in your body.
Mindfulness is a good place to start. When you feel tightness in your chest, your arms feel like moving outward, and you feel flushed in the face, what might that be expressing? If you feel like hurting someone else or hitting something then you’re probably angry. If you feel a fluttery sensation in your stomach, your breathing is restricted or rapid and shallow, and you feel light-headed as a result, then you’re probably experiencing fear. These are just two examples of matching physical sensations with emotions that can signal to you that your emotions are activated. Sometimes, people can just describe what’s happening in their bodies at first. That’s fine, it is a good place to start. As you become more emotionally literate, you start to link the feeling names to the body sensations… and then you’re cooking with gas!
What pushes your buttons?
Next, you notice what you tend to do when emotions get activated. You notice that you might snap at people when you are mad, cry when you are sad, or avoid certain situations when you are scared. This awareness allows you to take the next step, which is noticing what the consequences of your behavior are, and deciding if they are helping you or hurting you in life. If your tendency is to self-harm or drink alcohol when you feel angry or sad, then that probably is not helpful in the long run. If you tend to lash out or snap at people, you may lose friendships or hurt other important relationships; that is also a behavior you might want to discard. There is no need to judge or insult yourself for having these behaviors. You simply notice them and their effect on your life.
Next comes the exciting part. Once you notice which behaviors go with which feelings, and which ones you want to keep or discard, you can start to make informed decisions about what to do when the feelings come up. When you get mad at someone, you might pause and say, “I’m feeling angry. I know this because my fists are balled up and I’m feeling flushed in the face. I want to hit this person, but I can’t because I’ll get in trouble. I also want to yell at them but that will damage our relationship. What can I do instead?” This is an important juncture in your decision-making ability that signals a more sophisticated level of emotional literacy. Instead of acting out (hitting, yelling) or acting in (self-harming, saying mean things to yourself), you can express your anger directly but respectfully. You might need assertiveness training to learn how to do this, but it’s great that you can get to this point when you can make wise mind decisions (to use a phrase from Dialectical Behavior Therapy). When you observe your feelings nonjudgmentally, you have a better chance of making decisions that will benefit you and the people around you.
Therapy can be a great place to start the process of gaining emotional literacy. It provides a safe place where you can risk expressing emotions that you might have learned were “unacceptable” or “bad” by caregivers growing up. It is helpful to identify these feelings, especially long-buried ones, with someone else’s help. It doesn’t feel quite as lonely and scary that way. When you have emotional literacy, you can do deeper levels of therapy more easily and resolve trauma and grief with more self-assurance that you will not get emotionally overwhelmed. Emotional literacy is also helpful for everyday life, keeping you from getting in trouble with people in your life like your boss, partner, friends, etc. If you need help achieving emotional literacy, please give me a call. I would love to help.
When I think of mothering, I think of protection and nurturance of ourselves and each other when we’re at our most vulnerable. Our culture does not look kindly upon people who are different, vulnerable, or sensitive. We value instead independence, self-reliance, and sturdiness. However, without sensitivity and vulnerability, we cannot enjoy intimacy, love, and openness to new experiences. A world without vulnerability and sensitivity would be a very harsh, sterile existence, I believe. On Mother’s Day, I hope that we can make space for the sensitivity in ourselves and in others.
How does one go about taking space for the vulnerable? I believe that all behavioral and conscious change starts with paying attention first and foremost.
What are the tendencies towards not making space for it? Impatience, judgment, harshness, and certain expectations all can hamper our making space for the vulnerable. We must that just as we are sensitive and would not want to be treated certain ways, other people are also sensitive in their own ways. Impatience comes up quite a bit when other people are not doing what we think they ought to, especially with children. However, we can be impatient with other adults. When we soften our gaze on other people and remember that everyone needs time and space to grow and learn, we can start to change this tendency.
Judgment is ubiquitous in our culture as well, and it’s very tempting to fall into thinking of other people who are different as inferior. In a divisive environment such as ours, it can be very easy to classify people into them and us, excluding people without perhaps giving them a chance to explain whether coming from. We may still hold onto our beliefs that we hold dear, yet give other people the respect of allowing them to feel and think differently from us. Instead, we can remember that we all struggle, we all falter, and we would not want to be treated as harshly as were treating either ourselves or the other person. What does the person in that moment need? What could help them achieve their goals and be a better person? How can you facilitate and nurture that in yourself and others?
Similarly, when we feel harshly towards other people and are in aggressive mindsets, we can ask what it is that we need to make more space for the other person. Anyone in the 12 step recovery culture knows the phrase HALT, which stands for hungry, angry, lonely and tired. We can check in with ourselves and see whether any of these conditions is fueling our aggression and harshness. Then we can lovingly take care of ourselves so that we can maintain kindness and compassion towards ourselves and others.
In cultivating mindfulness and self-compassion, we learn to be kinder to ourselves and to others. Without this, the world is not a very pleasant place to live. How empowering and exciting it is to know that each of us has the opportunity to become a beacon for nurturing, compassion, and positive growth. When enough of us develop this within ourselves, we spread the light of awareness and create a nurturing environment for all of Earth’s inhabitants.
Having a stigmatized chronic illness can make it more challenging to cope with illness. This is an introduction to CFS, FMS, and MCS, all medically unexplained illnesses. Having compassion and greater understanding for people with these conditions, may help sufferers reduce their stress.
Some chronic illnesses have specific titles, treatments and are much more easily understood by medical professionals. They have a consistent set of diagnostic criteria and so they are easy to diagnose, treat, and maintain. More research is done to find drugs and treatments that help with their treatment, and so while they are not curable, they are treatable and people can have a fairly decent quality of life with those illnesses. Some examples are diabetes, thyroid disease, osteoarthritis, and some psychiatric disorders like depression and Bipolar illness.
However, there are some illnesses, like Fibromyalgia (FMS), Chronic Fatigue Syndrome (CFS), and Multiple Chemical Sensitivity (MCS), whose symptoms are not well-understood by medical professionals, and since those symptoms overlap with other disorders and don’t lend themselves well to specific diagnosis, they don’t get as much research funding and effort. Their causes are also not well understood either. Some of the hypotheses about their origin include viruses, childhood trauma, injury, psychiatric disorders like depression and PTSD, and chemical reactions gone awry. The fact that the disorders are not well-understood does not mean that the disorders are any less distressing to sufferers. It also does not mean that they are simply “psychosomatic” (i.e., psychiatric symptoms masquerading or perceived as physical disorders). There has been a great deal of struggle to gain legitimacy in the medical field for people who suffer Medically Unexplained Syndromes (MUPS), as people with these conditions have an added stress of not being believed by family, friends and medical professionals. If they could point to a well-defined diagnostic label like cancer or arthritis, they might have a chance to be believed by others. Some prominent medical researchers have suggested that these disorders are purely psychological and that if they just got Cognitive Behavioral Therapy, they would be fine. However, as anyone who has coped with fatigue, joint pain, cognitive dysfunction (like poor memory and concentration), or extreme discomfort after chemical exposure can attest, it is not just “all in your head.” Other people demean MUPS symptoms as “just being lazy” or “the yuppy flu.”
Fibromyalgia is perhaps one of the relatively better-researched MUPS and is characterized by joint pain in 11 of 18 tender points on the body, fatigue, insomnia, and at times cognitive dysfunction, like mental “fogginess” that makes it hard to concentrate, focus, or remember things. Many people with Fibromyalgia are limited in what they can do, how they can move, and sometimes even their employment opportunities and capacities are severely hampered by their symptoms.
Similarly, Chronic Fatigue Syndrome can negatively impact fulfilling social and occupational roles, and sometimes they have to apply for disability as they struggle to even achieve minimal activities of daily living. CFS has many similar symptoms to FMS (fatigue, cognitive problems, joint discomfort) but also can result in tender lymph nodes, flu-like symptoms, and “post-exertion malaise” which means that if a person does too much during the day, s/he feels even worse for the next day to a week. You may be able to see how this could interfere with holding down a job, raising children, having a social life, or running a household. While these disorders usually affect women, men can also be affected. Children and adolescents can become ill with CFS and FMS too, although it is much rarer. Most of the studies on CFS and FMS that have been done involve adults from 40-60 years old. It affects all socioeconomic classes as well as ethnicities.
Multiple Chemical Sensitivities (MCS) is perhaps the most controversial of the MUPS and while it shares a few symptoms with FMS and CFS, it is more focused on negative reactions to exposure to chemicals in everyday products. Some of those products include cigarette smoke, gasoline, solvents, perfume, clothing dyes, dryer sheets, cleaning agents, pesticides, and hairspray. People have a range of symptoms when exposed to these types of chemicals, including respiratory problems, skin rashes, headaches, and cognitive problems. People with FMS and CFS sometimes have a sensitivity to smells, but it is not a defining feature of either of those conditions. Because there have been some studies where people failed to show increased sensitivity to certain agents in a laboratory, some medical professionals regard MCS as merely a psychosomatic illness. However, the reactions are real, cause physical and mental distress, and sufferers are not merely imagining what they experience. Instead of invalidating people’s experience, it seems more beneficial when doctors, friends, and workplaces can work with people who are sensitive to smells to make them comfortable, happy and productive. Other people might not perceive the same smells as threatening because they get no physical reaction. However, there are a number of factors that might contribute to some people’s extra sensitive reactions.
This is been an overview of medically unexplained illnesses, which are often chronic and with uncertain prognoses. Many of these illnesses overlap in symptoms, but the sufferers have very real struggles in meeting their life roles and functioning well. Hopefully, with more understanding, research, and compassion, we can make their experience a little better and a little less stressful. I will be writing about them more in future blog posts, in specific the link between psychological factors and physical symptoms of these illnesses. If you need help in coping with your chronic illness, please do not hesitate to call me at 661-233-6771.
With the upcoming holiday, Valentine’s Day, much of the focus is on people who are involved with a loved one romantically or sexually. There is not very much attention paid to people who don’t have dates or romantic partners. People can feel pressured to either get into a relationship in order to not be lonely and be perceived as undesirable, or to feel inadequate because they are not romantically involved. There is a difference between being alone and being lonely, as Adrea Cope notes[i]. Being alone can be seen as a choice or a condition imposed upon a person by cruel circumstances. Loneliness is an emotional reaction to the state of being alone. It sometimes involves an element of grief about lost relationships or lost opportunities for being with people.
By contrast, one can view being alone as a choice or as a decision to be independent. Being alone is not necessarily a sign that you could not find a partner if you wanted one. Rather, it can be a deliberate choice to be autonomous, liberated, and free to live your life the way you want. Some of us experience being alone as a pleasurable experience, one they seek out to regulate the balance between being with others and being by themselves. Have you ever wanted to just have some “me” time?
Being alone can also be cleansing after a relationship that didn’t work out. I’ve seen a lot of clients rush into relationships after they break out because they don’t want to be perceived as “losers.” The implication is that if you’re alone, you can’t get a date. Sometimes it takes time to learn what went wrong in the last relationship. It also takes time to heal from the damage that relationship might have caused.
People who take the time to evaluate what went wrong, how they contributed to the demise of the relationship, and what they need to do now to grow and heal are well positioned to have a healthier relationship next time. It’s crucial to observe how you interpret your aloneness. What are you telling yourself about it? How are you interpreting it? That process of recognition and acknowledgment can make your alone time much more pleasant and productive. You can use journaling or meditation to explore what messages you’re sending yourself, and perhaps also open up to new ways of seeing your alone state. What self-valuing messages can you use to start replacing the criticism and pessimism?
There’s no rule saying you have to be in a relationship in order to be sexy, desirable, lovable, or a “winner.” In fact, some very likable, sociable, and interesting people are single, by choice. I believe it’s time we respected the diversity in people’s need or desire to be with another person. Some people feel very little need to be in a relationship and prefer solitude, while others have a strong desire and need to be in a relationship. The level of involvement is really up to each person, and I don’t think there’s a need to shame people for wanting what they want.
One caveat about being alone: Sometimes depressed people isolate, as do people who have Panic Disorder, Agoraphobia, and at times, PTSD. It’s important to distinguish between preferring to be alone because you like your own company and feel comfortable enjoying life that way, and avoidance. It’s understandable to avoid being hurt, as you have been in the past. No one can fault you for that. However, it often is accompanied by emotional misery and time spent either in self-reproach or immobilized numbness. If that is the case, I encourage you to get psychiatric care. You don’t have to be in contact with people all the time, but the time you spend whether alone or with people should generally be at least neutral, if not pleasant. If it’s hard to be around people and/or yourself, there’s a good chance that some healing needs to happen, to restore you to normal interpersonal functioning.
In closing, being lonely is a state of mind that crosses everyone’s path from time to time. It doesn’t need to be a constant visitor, and the way we view other people and ourselves can make a big difference in how long and how strong we experience loneliness. If you are without a romantic partner this Valentine’s Day, I strongly encourage you to embrace it and see it as a chance to spend time with a cherished loved one: yourself!