The Mental Health Place - A Mental Health Blog is Moving

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I am excited to announce big changes to the Mental Health Place - A Mental Health Blog. The reality is, I've been managing far too many blogs and websites - which for me has caused a big problem with "life balance." The solution is coming in the form of the re-launch of my biggest website, The Toolbox at LisaKiftTherapy.com - which now features all of my mental health and relationship articles, blogs (including this one) and even more resources.

What this means is that you will find this blog in a new home - and with my reorganization efforts will come a higher output of mental health articles! I am looking forward to continuing to provide high quality mental health articles by other professionals.

You can continue to receive the blog on the new site by subscribing to the RSS feed attached to it - or follow me in other ways such as social networking or my monthly newsletter! I hope you'll join me in my next big step:

The Mental Health Place - A Mental Health Blog

Warmly,

Lisa Brookes Kift, MFT
The Toolbox at LisaKiftTherapy.com: A Resource for Emotional and Relationship Health

The Mental Health Place Blog: The Power of Procrastination

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Dr. Michael G. Rayel challenges us to consider the possibility that "procrastination" can be a good thing sometimes.
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“That’s impossible. I can’t believe it. You’re just kidding.”

“No, I’m not. I really believe that procrastination can be positive at times. And I mean it,” I argued with a friend who just read “How to Overcome Procrastination in 21 Days or Less.” He believes that procrastination has to be conquered sooner rather than later.

In fact, he questioned whether I was just making this technique up for some media mileage.
But can procrastination ever be positive? Can procrastination help you succeed in life? Is procrastination the missing ingredient in achieving that elusive promotion?

Contrary to people’s beliefs, procrastination if used properly can be an effective tool for success — build rapport, attain goals, and achieve long-lasting relationships.

But how can it be effective when it connotes negativism and surrender, when it means delaying what needs to be done?

Let me give you some examples on how procrastination helps.

In my practice, I’ve seen individuals who worry excessively the whole day, almost paralyzed to do anything. They’re anxious about things that they should not worry about — clothes to wear, family safety, food to eat, bad weather, etc. They even worry that they’re worrying too much!
Excessive worry drains their energies and interests away from pursuing more important things in life. Such preoccupation is not only counterproductive but is destructive because they can’t do anything except to worry.

As part of treatment, I teach them to procrastinate, on how to delay their worries. I encourage them to schedule their worries at a later time, for example from 5 to 7 PM, after finishing their chores or after accomplishing more essential activities during the day.

By postponing their worries, they’re able to channel their energies — from unnecessary preoccupation to more productive endeavors.

My friend’s predicament also illustrates the power of procrastination. Harry, a close friend since college, faces a huge problem in his new job. His boss, known for being “harsh and insensitive,” can castigate anyone in front of others, even for minor issues. One day, his boss insulted him for coming unprepared, for failing to present an accurate quarter sales. He yelled at him and threatened him with a pink slip.

Instead of lashing out, Harry absorbed hurtful accusations like a meek lamb, postponed his response, and patiently listened to his boss’ tirade.

A day after, he met his boss and politely confronted his inappropriate behavior. This whole time, Harry was composed and in control of his emotions. Without showing signs of wrath or agitation, Harry had expressed his concerns and displeasure. By delaying his reaction, Harry succeeded in modifying his relationship with a difficult boss.

Both above examples have shown how procrastination can be powerful, how delaying certain emotions and behavior can be positive.

When people, situations, or other stresses are pushing you to the limit, don’t hesitate to procrastinate. Wait for the right time to respond. Delay your impulses until you’re in control of your emotions. Postpone your responses when you can think clearer. Delay your decisions until you get enough information to make that critical move.

When you feel anxious or angry, try to procrastinate. Schedule your emotions at a time that’s convenient for you. Tell yourself, “I’ll worry about this later after work, and I’ll devote two full hours today just for worrying.” Also, delay your anger by promising yourself that you’ll devote one hour this evening chastising your unfaithful partner.

Don’t get me wrong. It’s not easy to be always in control and it’s difficult to delay brewing emotions. But at times, you have to do what’s necessary even to procrastinate just to be sane in this complex world of ours.

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Dr. Michael G. Rayel - author (A 31-Day Series and First Aid to Mental Illness) psychiatrist, and inventor of emotional and social skills games -- The Oikos Game Series, Actus Tale, and Fikloo. Check http://www.oikosglobal.com/ to learn about these games. Since 2005, he has published Oikos’ Insights! http://www.oikosinsights.com/ as an online resource for personal development.

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Lisa Brookes Kift, MFT, is the creator of The Mental Health Place - A Mental Health Blog. See her Mental Health Articles, Tips and Tools in The Toolbox at LisaKiftTherapy.com.

The Mental Health Place Blog: Where Has All the Anger Gone?

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John C. Flanagan, LCSW, takes a close look at anger as it relates to trauma.
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"Little Things Upset Me, Yet I Feel No Anger About My Trauma. How Come?"

"A lot of bad things happened to me. Shouldn't I be feeling more angry about it?"

The dictionary defines anger as a strong feeling of displeasure and belligerence aroused by a real or supposed wrong. Often times in PTSD, in spite of an extensive history of real and imagined wrongs, we don't feel much anger. A person develops PTSD as a result of having a difficult childhood. The person has either been abused in one or more ways, or suffered some sort of traumatic rejection or neglect. When such things happen to a person, it seems perfectly natural for that person to feel angry. Yet often times we don't feel angry or can only get in touch with our angry feelings through much effort. When bad things happen to us as children, what sort of emotional responses do we have? Did we feel anger then? Do we feel angry about it now? What did we do with our anger? What do we do with our anger now?

In spite of the fact that trauma is potentially a great source of anger, we often don't feel much, if any, anger. Partly this lack of angry feelings is the result of programming. We were taught that getting angry was bad, unwelcome or even dangerous. We also learned, or thought that we learned, the same lesson by observation, if we lived with one or more angry persons. Their anger seemed really wrong, bad, we didn't welcome it and in some cases it seemed extremely dangerous. We may also have observed the perpetrator or another victim in denial about their anger. And, so in turn we learned to deny our own anger. And maybe we even decided to buy into their denial of their anger.

As one client pointed out during a group discussion of this topic, "Anger has a righteousness about it. You have to have a knowledge of right and wrong to feel righteous." When we have grown up with so much chaos and confusion, we may not have a very clear sense of right and wrong. We often don't feel very righteous about anything and consequently we aren't able to get up much of a head of steam about anything either.

Then there is the issue of overwhelming affect. In cases of severe abuse, neglect or rejection, the emotions and accompanying bodily sensations can be so unpleasant and overwhelming to us that we have to find a way to shut them off. And, of-course, our anger gets shut off along with the rest of our emotions. We may have no outlet for our anger, no way to express it and no one to express it to. When this is the situation, then it adds to how overwhelming and how powerless our anger feels.

In these situations, there is usually no one who is helping us learn how to express our anger appropriately. I have seen many clients with histories of trauma who see the appropriate expression of anger as an oxymoron, a contradiction in terms. To them, anger feels like it is never appropriate. They feel like they are a bad person whenever they have some anger that breaks through their defenses against it. No one has taught them that anger is okay, that anger is a normal human emotion. No one has taught them how to express their anger constructively. They think constructive expression of anger is another oxymoron.

I am no advocate of expressing anger willy-nilly. I think that too often this sort of behavior very rapidly becomes counterproductive. What I do strongly advocate, however, is allowing yourself to be aware of your anger. Sometimes we confuse anger with power. It seems that angry people have a lot more power than people who are not angry. And, we ourselves feel more powerful when we get up a good head of steam. It's not actually steam. It is brain chemicals and adrenaline, and to this extent, at least, there is a sense of power. But this is not true power, this is just bluster. Real power comes when we have harnessed our anger and when we have conscious rational control over our behavior, i.e., when we are making good choices to bring about all the things that we want. What we really want, if we are honest with ourselves, includes the various outcomes that we seek and the good will of those from whom we seek them. This cannot be obtained with bluster.

Anger also comes out in a variety of forms that are not so much destructive to relationships or to those around us as to ourselves. We act it out in a variety of ways that are at the very least counter-productive and at worst self-destructive. I believe that probably all addictions have a fairly large component of anger. I have never met an addict that wasn't struggling with a lot of anger.

It also needs to be said that anger is a normal and natural part of grief. Of course if we are honest we must recognize that we have a lot of this grief over what happened to us. We may not feel very attached to our perpetrators. We may not feel attached at all now. But at one time we wanted to feel a sense of attachment to them. The loss of that wished for attachment is an occasion for grief. And of course a part of that grief is anger.

The challenge is to get in touch with our anger, past and present. We need to allow ourselves to feel it and to express it appropriately, at least to ourselves and ideally also to a trusted close confidant. Next we need to assess what our wants and needs are. Then we can set about figuring out how best to get them met. This is what I mean by the constructive use of anger.
Desired Outcome: To help facilitate our healing process by reconnecting with the anger that we necessarily must have had due to the difficulties we suffered as children, and then, to learn to use our present-day anger constructively.

Discussion Starters: How in touch are you with your anger about your trauma history? What things have you done to try to get in touch with your anger? What hesitation have you felt about trying to get in touch with that anger? What things have worked? How do you feel about anger in general? How do you feel about angry people? Are you able to see, or at least allow, that anger might actually be a good thing, a positive force? Can you see that anger, directed constructively, can be the impetus for creating positive results? Do you need time to practice using anger appropriately and constructively? How might you go about practicing this?

Try This: If you don't feel much anger, or you don't feel your anger about your trauma history very often, think about how you would feel if similar things were being done today to a child that you care about. Now recognize that you are that child. Can you make the transition from outrage on behalf of another to outrage on your own behalf?

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John C. Flanagan is a LCSW in Portland, Oregon. He specializes in working with adults who experienced traumatic abuse or neglect as children. Learn more about John at www.johncflanaganlcsw.com.

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Lisa Brookes Kift, MFT, is the creator of The Mental Health Place - A Mental Health Blog.

The Mental Health Place Blog: Grief and Loss - The Topic of Death is Often Ignored

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Kim E. Terry skillfully explores ways to help those grieving the loss of a loved one.

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Losing someone is one of the most devastating experiences a person can go through. It does not typically get any easier after consecutive losses, and there is no way to be perfectly prepared for it even when notice is given prior to death. Just as each person leaves this world in a different way, each of you will experience each loss in your own unique way. Death is such an apparent and inevitable part of life. One way that I look at loss is by remembering that I only get to "borrow" everything and everyone. That includes my life and those around me. I try to spend each day appreciating the time I get to borrow. Giving back what we have borrowed, loved, and cherished to the unrelenting reality of death is one of the most challenging tasks in life. I empathize with all of you who have lost people in your lives and encourage you to seek solace in others during those difficult times. It is not necessary to go that path alone.

So, what about the healing process? In my professional and personal opinion, it is essential to healing to allow yourself to go through the grieving process at your own pace, on your own terms, and with emotional support in order to complete the process. The final stage of grief is acceptance, but acceptance does not mean being okay with the loss. You do not ever have to be okay with the fact that someone you loved has died. Acceptance means being able to move forward and function again at your previous level or close enough. It is okay to move forward with that person in your heart always, and there are various ways to continue to honor the lives of those we have lost.

Cultural Mores and Norms ... Something unusual exists in cultural norms related to the immediate loss ... I don't know anyone who has ever found comfort in being told, immediately after their loss, that their loved one was "in a better place now." That is typically not comforting to the person who has just lost someone, yet it is such a common (and of course a well-meaning) response. It is the kind of comment that, no matter how well-intentioned, fails to lessen the pain of bereavement. How about saying to the person who has just lost someone "what can I do for you to help you through this time?" That does not necessarily lessen the pain either, but instead of trying to "cheer up" the person attempting to grieve, it opens the door to an expanded external support system. With such an external care-team, the person will more healthfully reach their transcendence towards healing.

As Time Passes ...

I believe that it is truly important to remember that as time passes people forget to ask "how are you doing?" Perhaps the latter is due to assumptions that "enough" time has passed. Social norms also seem to relay the message that it would bring up hard times to inquire in such a way and hence, just make things worse. Well, perhaps for some it would. However, to err on the side of the possibility that it could help seems to be a safer bet, and if you are wrong, it is unlikely that you would do irreparable damage by asking someone how they are doing. In contrast, for many, it is exactly what they need --that open doorway to discussion of where they are at during each year's constant reminders, anniversaries, and holidays without their loved ones.

That being said, here's a scenario to exemplify checking in with the bereaved. Let's say a year or so has passed, and your friend brings up something such as "Johnny used to like this song." What would happen if you asked "How are you doing with that, by the way?" or "How are you holding up?" After all, they opened the door ... it is possible that they just might want you to walk in. Additionally, if they say "fine" and change the subject, at least they know that you'll ask that again, if they need you to, and they have learned that when they want you to ask that again, they will bring that person up again. For instance, a month later they may say "I used to come here with my wife." At that time you may ask how they are, and they may share quite a bit. You have learned how to create safety in your relationship to assist them in their grieving process, now and in the future as well. Likewise, they have learned from you how to safely elicit that question from you, allowing them that time to share.

In the meantime, remember that you do not have to and you cannot "fix" or "change" what has happened when someone has lost someone, but your ability to be "present" for them is important for their positive emotional healing. Also, being there for someone during their time of immediate need and maintaining a positive emotional support person for them without an expiration date is also beneficial for your own personal growth and emotional and moral development. To those of you who have already been aware of and have practiced these things and to those of you who now plan to, many many blessings to you.

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Kim E. Terry has a Master of Arts in Human Services in Counseling and 2 active LPCs (Licensed Professional Counselor licenses). She is also a Nationally Certified Counselor with the NBCC, Specialty Certified in Behavior Management and Specialty Certified in Anger and Depression Management. She is an active member of various Mental Health organizations and advocacy groups.

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Lisa Brookes Kift is a psychotherapist in Marin County, California and the creator of The Mental Health Place - A Mental Health Blog.

The Mental Health Place Blog: The Philip Brown Affective Disorder Rethinking Theory

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Philip Brown, LCSW, challenges us to rethink our views on the Affective Disorder spectrum (Depression and Anxiety) which in turn would categorize more people as NORMAL than "sick."

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Current research suggests at a least 1 out of 3 people (some 33%) will end up sitting on a couch talking to one of us about their Affective Disorder. I look at the Affective Disorder spectrum from Major Depression to Generalized Anxiety as one animal with many different heads. We have all seen mixed Affective Disorder, Depression with a side of Anxiety and Anxiety with a bit of Depression. Well the whole spectrum is treated psychopharmologoically with the same type of medications. Medications which reestablish a ratio of serotonin, norepinephrine and dopamine to some magic ratio to each other in the synaptic gap that gives symptom reduction and/or resolution. The Newest boys on the block are the SSRI's and SNRI's. We try modify mostly serotonin and norepherine levels to reestablish emotional harmony.

When I refer to the Affective Disorder I mean Major Depression, Dysthymia, OCD, Eating Disorders, Panic Attacks, Phobias, and Generalized Anxiety with all their NOS (Not Otherwise Specified) counterparts. They all seem to be modulated by the same electrochemical neuro pathway in the brain. Therefore, I look at them as all the same beast with different manifestations of itself at different times sometime within the same person.

Here is where it gets interesting. Remember the good old Normal Curve, the Bell Shaped One, with its three Standard Deviations above and below it's mean? We would measure the population of all college freshman, for height, weight, IQ (whatever that is) and so on and see a nice normal curve. Take IQ for example, mean at 100, SD=20, NORMAL RANGE=Mean+/- one SD (IQ's 80-120). I'll bet there is a Normal Curve for S/N/D ratio (serotonin/norepherine/dopamine). I'll also be if we measured it in the population today and had data from 100 or 150 years ago, it hasn't changed. Someone, dig up some 150 year-old tissue and then do a double tailed "T" test... I think that 68% of the population then and today would have a NORMAL S/N/D ratio. Just like height and weight I believe this level is passed on genetically.

Well if brain chemistry hasn't changed (evolved) in the past 100-150 years what has changed? Well, we had and Industrial Revolution and an Information/Technology Revolution. Thousands of metric tons of pollutants and chemicals have been added to our environment. We are now asked to multitask in 30 second bytes and have access to an almost unlimited amount of data. Could these revolutions have put an undue stress on our brains that make NORMAL people go "tilt"? Of the 68% of the population with NORMAL ratios, could it be the folks in the First Standard Deviation (34%) below the mean of the Bell Curve who are showing Affective Symptom? If we were bacteria, there would have been countless thousands of generations of us in the last 150 years, but how many Human generations have there been? Maybe our brain has not been able to evolve fast enough to keep up with the changes in our environment.

Perhaps we need to change the way we think, this would not be disease, abnormality or deficit. We would not label these NORMAL people as being "sick". Maybe they wouldn't label themselves as "sick" either

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Philip H Brown, LCSW has had over 25 years of experience in diagnosing Psychiatric and Neuropsychiatric conditions. His college education, at the University of Connecticut, included majors in both Psychology and Biochemistry. His Graduate Training was at the University of Connecticut's School of Social Work. He received his initial clinical training at Waterbury Hospital's Division of Psychiatry. While employed there for seven years he helped train Psychiatric Residents for Yale University School of Medicine and Yale University Post Doctoral Fellows in NeuroPsychology. For 10 years he instructed classes in both Psychology and Sociololgy at the University of Connecticut Regional Campus and Nortwaestern Connecticut Community College. He was a Field Instructor for the The University of Connecticut School of Social Work's Casework Program. He later became the Coordinator of Emergency Psychiatry for Day Kimball Hospital, training Clinicians to do after hours Psychiatric work-ups in the area's two Hospital Emergency Rooms. He has led training workshops for both Social Service and Emergency Medical responders.

Learn more about Philip at www.NEpsychotherapy.com.

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Lisa Brookes Kift is a psychotherapist in Marin County, California and the creator of The Mental Health Place - A Mental Health Blog.