Stress Management

Stress is a state of emotional strain resulting from a variety of circumstances. Family, work, friends, school, and various new life changes can contribute to stress. Signs of stress include feelings of sadness, anxiety, bodily pain, changes in sleeping patterns, illness, digestive problems, skin conditions, increased blood pressure, fluctuation in weight, reproductive issues, difficulty focusing, or trouble recalling memories.

With all these symptoms, it is important that you have an outlet to remove, or relieve, their stress level as it can have negative emotional and mental effects. Sustaining the emotional strain for too long can cause more serious symptoms, such as depression and chronic illness.

Techniques to Reduce Stress

1.      Name It: Dig deep and uncover what it is that is causing the stress. In what area of your life are you most stressed? Is it a particular person, place, or time of day? Is it caused by your own expectations about yourself or by the demands of others? Where in your body do you feel the stress (i.e. stomach feels nauseous)? Think about the times when your body tells you it is stressed; what are you doing / who are you with? Often, just by naming the stressor we begin to feel relief as it takes away its mystery and complexity thus allowing for clarity to the solution.

2.      Identify What is in Your Control: Take note of those things in which you can change to reduce stress. You may not be able to quit your job tomorrow but maybe you can organize your week so you do only do the stressful tasks a couple hours a day and more enjoyable tasks the majority of the day. Or perhaps you can hire a gardener to free up time on the weekends.

3.      Just say NO: Your time is valuable and precious. Understanding this will enable you to say no to the demands of others with confidence. There is no need to make excuses, apologize, or worry about disappointing others because it is your life priorities that come first.

4.      Treat Your Body Well: Countless studies have been conducted concluding that when people eat healthier, sleep well, and exercise (at least three times per week) they are more prepared to handle future stressful situations, reduce current levels of stress, and increase your energy level throughout the day.

5.      Schedule Play Time: Engaging in activities that you enjoy may seem like an inefficient use of your time however, research shows that when adults schedule in time to play (such as singing in the car, dancing while cooking, watching a movie, or engaging in a hobby) every day they experience reduced levels of stress, anxiety, and depression. 

6.      Mindfulness: Brotto (2013) defined mindfulness as, “present moment, non-judgmental awareness” (p.63). This state of being requires one to stay focused on the present, and to consciously shift away from any intrusive thoughts, good or bad, that may come into mind, so as to not stray from the present moment. Mindfulness and relaxation skills (such as deep breathing) have been found to reduce stress, depression, and anxiety by placing the individual in the present moment, and thereby allowing you to view stressful thoughts as fleeting events.

7.      Let it All Out: Talk therapy allows you to bring all your life stressors to the surface in a safe and confidential environment. Once this is done, you and your therapist work together towards reducing your stress level and increasing health and positivity in your life.

Therese Schmoll treats patients experiencing high stress levels in her practice. To schedule an initial consultation, please call her office at (310) 281-9677.

Resources

Brotto, L. A. (2013). Mindful sex. The Canadian Journal of Human Sexuality, 22(2), 63-68. doi:10.3138/cjhs.2013.2132

Brown, B. (2015). The gifts of imperfection. Tullamarine, Victoria: Bolinda Audio.

Relaxation techniques: Try these steps to reduce stress. (n.d.). Retrieved from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/relaxation-technique/art-20045368

Stress Management - Ways to Relieve Stress. (n.d.). Retrieved from http://www.webmd.com/balance/stress-management/stress-management-relieving-stress

Why The Narcissist Cheat

The Narcissist:

According to the Diagnostic and Statistical Manual of Mental Disorders (2013) Narcissistic Personality Disorder diagnostic criteria are as follows:

·         Persistent pattern of grandiosity

·         Requires disproportionate admiration.

·         Largely lacking in empathy or unwillingness to recognize others’ feelings.

·         Self-importance (unjustifiably high importance of ones self, their accomplishments, their abilities)

·         Requires acknowledgment of their preeminence with little corresponding accomplishments.

·         Consumed with fantasies of unparalleled beauty, success, intelligence, love and wealth. 

·         Feelings of being outside the norm and therefore can only be understood by those of prominence.

·         Self-entitled and expects special treatment.

·         Manipulative and exploitative of others for selfish needs.

·         Jealous and resentful of others and believes others are jealous of them.

 “Narcissism” originated from the Greek myth of Narcissus, who was a handsome young man who fell in love with his own reflection from the river water and remained there until he died (Editors of Encyclopedia Britannica, 2014). 

Narcissus, wall painting; from the House of Lucretius Fronto, Pompeii, Italy, ad 14-62.

Alinari/Art Resurse, New York

Freudian psychoanalysis of narcissism suggests that it is a necessary for all people to be narcissistic.  He believed that we are all driven by personal agendas and survival instincts; which he called primary narcissism.  In terms of personality and relationships Freud spoke of narcissistic love suggesting,

“A person may love: According to the narcissistic type:

·         What he himself is (himself)

·         What he himself was,

·         What he himself would like to be,

·         Someone who was once part of himself” (Jackson, 1995, p. 27)

It is because of this need for self-love and superiority at the expense of others, narcissism is often a predictor of infidelity.

Why Narcissist Cheat

Narcissistic people need to feel in control, have power over people, constantly requiring the admiration from others and their short attention span are just a few of the reasons narcissists are often not able to commit.  They often idealize their mates in the beginning of a relationship and set unreachable expectations for them.  Believing that their mate, "should meet his every sexual and emotional need 24/7/365, without fail. In his narcissistic and self-focused way, he doesn’t understand that his spouse may be juggling multiple priorities in addition to him and the relationship" (Diamond, 2010).  Once their partner does not meet their impossible expectations they feel entitled to look to someone else for someone who fills their needs. 

Another reason is that true intimacy cannot exist for them because they are not able to empathize with another person.  According to the investment model, commitment is made up of satisfaction, investments and alternatives.  “Narcissists perceive greater alternative to their relationships and this leads to lesser commitment (Campbell & Foster, 2002 in vous).  It is because narcissists are always looking for more admiration they are very aware of their alternatives and therefore seek them out. 

            From the admiration of others, a narcissistic person may gain an emotional high or rush.  Similar to a drug addiction, they are constantly looking to increase the high once they are desensitized to it.  Cheating then becomes sport like and can be described as “fun” by a narcissistic person.  They are energized from it and therefore are in a constant quest for praise and admiration.  Knowing they need admiration, like a car needs gas, a narcissistic person is always putting their best foot forward in order to attract their current or their future romantic conquests (Wood, 2008).

Rationalizing “Bad” Behavior

According Sperry (2003), when a person with Narcissistic Personality Disorder is confronted with their moral mishaps they rationalize their behaviors using eleven defense mechanisms such as, but not limited to, the following:

-Intellectualization: The client uses excessive abstract thinking, intellectual reasoning, or generalizations to control or minimize emotional discomfort.

-Repression: The client expels disturbing wishes, thoughts, or experiences from consciousness. The emotions may remain.

-Devaluation. The client attributes grossly exaggerated negative qualities to themselves or to others.

-Projection. The client falsely attributes to another person their own unacceptable feelings, impulses or thoughts. This is a protective measure to prevent the erosion of self.

-Rationalization. The client conceals their true motivations for their own thoughts, actions, or feelings through the elaboration of reassuring or self-serving but incorrect explanations” (Sperry, 2003).

From the narcissist’s perspective using these defense excuses their behavior and those around them accept it and will not prosecute them for it.  The narcissist, in turn, has gotten all he/she needs from the relationship and will continue to commit the bad behavior as long as they can rationalize it.  

            Although people with narcissistic personality traits feel little empathy for those they cheat on they are not purposely trying to hurt their partner.  It has very little to do with the partner at all because the narcissists does not naturally put themselves in the other persons shoes and therefore does not comprehend the trauma and pain they have caused their mate.

Therese Schmoll treats both narcissist and those in relationships with a narcissist in her practice. To schedule and initial consultation, please call her office at (310) 281-6977.

References

Campbell, W., & Foster, J. Narcissism and Resistance To Doubts About Romantic Partners. Journal of Research in Personality, , 550-557.

Diagnostic and statistical manual of mental disorders: DSM-5. (5th ed.). (2013). Washington, D.C.: American Psychiatric Association.

Editors of Encyclopædia Britannica. (2014, January 2). Narcissus (Greek mythology). Encyclopedia Britannica Online. Retrieved March 5, 2014, from http://www.britannica.com/EBchecked/topic/403458/Narcissus

Foster, C. A., & Campbell, W. K. (). Narcissism And Commitment In Romantic Relationships: An Investment Model Analysis. Personality and Social Psychology Bulletin, , 484-495.

Jackson, E. (1995). Calling the Question. Strategies of deviance studies in gay male representation. Bloomington: Indiana University Press.

Mayo Clinic Staff. (n.d.). Narcissistic personality disorder. Definition. Retrieved April 16, 2014, from http://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/basics/definition/con-20025568

Narcissistic Personality Disorder (NPD) Treatment, Symptoms, Causes - MedicineNet. (2012, May 31).MedicineNet. Retrieved April 3, 2014, from http://www.medicinenet.co m/narcissistic_personality_disorder/article.htm

Sperry, L. (2003). Handbook of diagnosis and treatment of DSM-IV-TR personality disorders (2nd ed.). New York, NY: Brunner-Routledge.

Wood, J. V. (2008). Narcissism and Interpersonal Self-Regulation. The self and social relationships (). New York: Psychology Press.

The Sandwich Generation: How Therapy Can Help

The Sandwich Generation refers to the 6.5 million Americans who are caregivers to both elderly adult and child recipients. These caregivers are involved, at varying levels, with the physically and emotional wellbeing of their care recipients and responsible to complete daily tasks such as managing medications, completing personal errands, keeping up their hygiene, household chores, preparing meals, and managing finances. The level of one’s responsibility to a care recipient directly effects the caregivers level of stress, financial burden and his or her health.

Time Stress

In addition to the general responsibilities of a dual caregiver they have the additional pressures of, “finding time, energy, and resources to balance the competing demands of the needs of aging parents, the needs of dependent children, and responsibilities associated with work/careers” (Bowen & Riley, 2005, p. 53).

Financial Stress

With dual caregiving comes the need to financially support a multigenerational household. As an elderly care recipient ages, the level of care they require increases. Consequently, many caretakers feel forced to leave his or her career, or cut down hours worked, to accommodate for this need.  It is for this reason, in addition to financially supporting both his or her children and the dependent elderly person, that According to the National Alliance for Caregiving and the American Association of Retired Persons Public Policy Institute (2015) 18% of caregiver’s report having high stress regarding their financially strain (p. 54).

Deteriorating Health Stress

Due to the chronic high stress of a dual caregiver it is, “estimated that close to 50% of sandwich generation caregivers suffer from anxiety and depression (Chisholm, 1999, p. 179). The chronic stress of a dual caregiver is not static; it is ever changing and transmissible throughout their household.

Effects on the Caregivers Marriage and Family

            The dual caregivers aren’t the only ones effected by the pressures of caregiving, it is a shift in dynamics that the entire family experiences. One study found that the stress the caregiver is under at work correlates with the couple’s marital satisfaction (Hammer, Icekson, Neal & Pines, 2011, p. 380). However other studies have show that caregiving can bring a family closer together as they then are all working toward one common goal; the comfort of their elder family member. Findings show that young adults care recipients are home more often and form stronger bonds with their siblings though caretaking (Naud, 2008, p. 12).

Therapy Can Help

Giving caretakers an opportunity to discuss how their new role will or has impacted their relationships and careers is an important aspect of self-care. Therapist can assist caregivers with reducing anxiety via relaxation techniques and managing maladaptive thoughts (Akkerman & Ostwald, 2004, p. 122).

Multiple studies have been done on the effectiveness of talk therapy on a caregivers’ level of stress. Gaining further education about depression, dementia, stages of aging, coping skills and importance of self-care have been found to decreases stress level, depression and likelihood of elderly abuse (Pinquart & Sorensen 2006, p. 557). Caregivers who seek therapy, read self-help books, join a caregiving group or reach out to friends have been found to have lower levels of depression because they find they share similar experiences and have an outlet to express their feelings with others who can empathize (Pinquart & Sorensen, 2006, p. 581).

Resources

Akkerman, R. L., & Ostwald, S. K., (2004) Reducing anxiety in alzheimer’s desease family caregivers: The effectiveness of a nine-week cognitive-behavioral intervention. American Journal of Alzheimer’s Disease and Other Dementias, 19, 117-123. doi: 10.1177/153331750401900202

Bowen, C., & Riley, L.D., (2005). The sandwich generation: Challenges and coping strategies of multigenerational families. The Family Journal, 13, 52-58. doi: 10.1177/1066480704270099

Chisholm, J. F. (1999). The sandwich generation. Journal of Social Distress and the Homeless, 8, 177-180.

Hammer, L. B., Icekson, T., Neal, M. B., & Pines A. M. (2001). Job burnout and couple burnout in dual earner couples in the sandwiched generation. American Sociological Association, 74, 361-386.

Image. The Depression Tool Kit.(2016) Retrieved from

http://www.depressiontoolkit.org/news/depression_in_the_sandwich_generation.asp

National Alliance for Caregiving & AARP Public Policy Institute. (2015). Caregiving in the u.s 2015. Retrieved from http://www.caregiving.org/wp-content/uploads/2015 /05/2015_CaregivingintheUS_Final-Report-June-4_WEB.pdf

Naud, R., (2008). Caring for aging parents can bring families closer together: Sandwich generation. The Calgary Herald, p. 12. Retrieved from ibproxy.csun.edu/hottopics /lnacademic/?verb=sr&csi=8349&sr=HEADLINE(Caring+for+again+parents+can+bring+families+closer)%2BAND%2BDATE%2BIS%2B2008

Pinquart, M., Sorensen, S., (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects. International Psychogeriatrics, 18, p. 557-595. doi:10.1017/S1041610206003462.

Am I an Alcoholic? Self-Test

Am I Alcoholic Self-Test?

(Questions Provided by National Council on Alcoholism and Drug Dependence, Inc)

Do you try to avoid family or close friends while you are drinking?

YES or NO

Do you drink heavily when you are disappointed, under pressure or have had a quarrel with someone?

YES or NO

Can you handle more alcohol now than when you first started to drink?

YES or NO

Have you ever been unable to remember part of the previous evening, even though your friends say you didn't pass out?

YES or NO

When drinking with other people, do you try to have a few extra drinks when others won't know about it?

YES or NO

Do you sometimes feel uncomfortable if alcohol is not available?

YES or NO

Are you more in a hurry to get your first drink of the day than you used to be?

YES or NO

Do you sometimes feel a little guilty about your drinking?

YES or NO

Has a family member or close friend expressed concern or complained about your drinking?

YES or NO

Have you been having more memory blackouts recently?

YES or NO

Do you often want to continue drinking after your friends say they've had enough?

YES or NO

Do you usually have a reason for the occasions when you drink heavily?

YES or NO

When you're sober, do you sometimes regret things you did or said while drinking?

YES or NO

Have you tried switching brands or drinks, or following different plans to control your drinking?

YES or NO

Have you sometimes failed to keep promises you made to yourself about controlling or cutting down on your drinking?

YES or NO

Have you ever had a DWI driving while intoxicated or DUI driving under the influence of alcohol violation, or any other legal problem related to your drinking?

YES or NO

Are you having more financial, work, school, and/or family problems as a result of your drinking?

YES or NO

Has your physician ever advised you to cut down on your drinking?

YES or NO

Do you eat very little or irregularly during the periods when you are drinking?

YES or NO

Do you sometimes have the shakes in the morning and find that it helps to have a little drink, tranquilizer or medication of some kind?

YES or NO

Have you recently noticed that you can't drink as much as you used to?

YES or NO

Do you sometimes stay drunk for several days at a time?

YES or NO

After periods of drinking do you sometimes see or hear things that aren't there?

YES or NO

Have you ever gone to anyone for help about your drinking?

YES or NO

Do you ever feel depressed or anxious before, during or after periods of heavy drinking?

YES or NO

Have any of your blood relatives ever had a problem with alcohol?

YES or NO

Disclaimer:  The results of this self-test are not intended to constitute a diagnosis of alcoholism and should be used solely as a guide to understanding your alcohol use and the potential health issues involved with it. The information provided here cannot substitute for a full evaluation by a health professional.

To Take the actual self-assessment online and see your results go to:

https://www.ncadd.org/get-help/take-the-test/am-i-alcoholic-self-test

Ms. Therese Schmoll treats many alcoholics in recovery in her practice.  To schedule an initial consultation, please call her office at (310) 281-6977. 

Worldview Survey

(This survey is to be used for entertainment purposes only.)

Rate your world view:

1. I am optimistic about my future?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

2. People who care about me tell me that I have a lot of positive view points?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

3. If something can go wrong for me, it will?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

4. I expect more good things to happen to me than bad?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

5. I hardly ever expect things to go my way?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

6. I rarely count on good things happening to me?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

7. When something misfortunate happens to me, I begin to think that more

misfortune will come my way?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

8. I am more likely to see the strengths in myself than the weakness in myself:

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

9. If something can go wrong for me in the future, it will:

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

10. When I do not succeed at a new skill, I think that I am “stupid?”:

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

11. When some misfortune happens to me, I think that it is “my fault?”

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

12. I encounter more unhappy experiences than happy experiences?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

13. Things go my way most of the time?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

14. In uncertain times, I can expect the best?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

15. If something misfortunate happens to me, I expect the same outcome in

a similar situation?

a. strongly disagree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

16. I rarely count that good things will happen to me?

a. strongly agree;

b. disagree:

c. neither agree or disagree;

d. agree;

e. strongly agree

17. I see myself with more weaknesses than strengths?

a. strongly agree;

b. disagree;

c. neither agree or disagree;

d. agree;

e. strongly agree

18. During times of transition, I expect the worse?

a. strongly agree;

b. disagree;

c. neither agree or disagree;

d. disagree;

e. strongly disagree

19. Over the last several years I have had more positive experiences than I have had negative experiences:

a. strongly agree;

b. agree;

c. neither agree or disagree;

d. disagree;

e. strongly disagree

20. Over the last several years I have had more negative experiences than I have had positive experience:

a. strongly agree;

b. agree;

c. neither agree or disagree;

d. disagree;

e. strongly disagree

Here is how to score your answers:

For numbers: 1, 2, 4, 7, 8, 13, 14, 16, 17 and 19 assign points to your answers as follows:

a. 1 point;

b. 2 points;

c. 0 points;

d. 3 points;

e. 4 points

For numbers: 3, 5, 2, 9, 10, 11, 12, 15, 18 and 20 assign points to your answers as follows:

a. 4 points;

b. 3 points;

c. 0 points;

d. 2 points;

e. 1 point

So, what is your world view?

Point Scale

80 points-60 points: Optimistic: You tend to take the most hopeful views of a matter; 59 points-39 points: Realistic: You tend to look at the actual existence of a matter; 38 points-20 points: Cynical: You tend to find fault in the matter; 19 points-0 points: Pessimistic: You tend to take negative, skewed view of a matter.

Survey Created By: Therese L. Schmoll, M.A., LMFT MFC50082.