Anxiety is a problem that the majority of people deal with in one form or another. Yet anxiety is a broad category of disorders which range from generalized anxiety disorder, to social anxiety, to various forms of panic disorders, to mild stress. Keeping in mind, some forms of anxiety are normal, for instance, regular stress can sometimes be beneficial, as it keeps us aware of important things like deadlines and can even motivate us to work hard and excel. However, some forms of anxiety and anxiety disorders are defined as a problem when they begin to interfere with your ability to thrive, achieve your goals, go about daily life and feel well. Some symptoms of anxiety are muscle tension, sleeplessness, worry, agitation, and increased heart rate. Yet some people have a baseline of anxiety that is their normal and they have many coping strategies so that they learn to manage even high levels of anxiety while still managing to function well enough that few people even notice that they are struggling at all. We call this high-functioning anxiety.
Anxiety can be intense, but today I’d like us to learn this difference between stress and high-functioning anxiety. High functioning anxiety is when someone is able to maintain the appearance of calm connectedness by going about their life with the appearance of normalcy, but still the anxiety tends to leak out in subtle ways. Here are three ways to tell if you may have high-functioning anxiety:
- You have a hard time sleeping. When you’re able to internalize your anxiety and hold it together during the day, your anxiety may come out in the form of sleep disturbance. This can include tossing and turning, having trouble falling asleep, or waking up in the middle of the night and having trouble getting back to sleep.
- You focus on perfection. Self-improvement is great; however striving for perfection can be a result of anxiety. This can create issues when you focus on perfection at work, in personal relationships, or expectations of your physical appearance. Perfectionism is a tell tell sign of high functioning anxiety because an anxious person will tend to try to make things perfect as a tool to decrease their anxiety.
- You can’t relax. When there are too many issues on your mind, you may neglect self-care or not even know how to be calm. Nothing is wrong with staying productive, yet some people use endless projects as a diversion from their feeling of inner anxiety.
- Having difficulty letting go of control. There are several personality types and persons with symptomology whom struggle to let go of control, but this can also be a part of high functioning anxiety.
There are other signs of high functioning anxiety. If you find yourself experiencing this, take some time to engage in self-care or get a mental health assessment. Be intentional about relaxing and find ways to come to terms with not being perfect. Remember that the mind and body are connected, there are many physical and mindfulness exercises as well as breathing strategies that you could try to release some of the stress, and other things like working on your sleep hygiene. Ultimately, if you have any concerns about your level of anxiety you should seek out an assessment with a mental health professional who can help you to determine which parts of your anxiety are normal and which parts might be helped with counseling such as cognitive behavioral therapy.Learn More
by Counseling and Wellness Center of PittsburghNovember 28, 2019 gratitude, gratitude challenge, reframing cognitive distortions, thanksgiving0 comments
The Real Gratitude Challenge
It’s Thanksgiving and everyone wants to talk about turkey and gratitude. Newsfeeds and flyers encourage us to take the ‘gratitude challenge’ by sharing how happy we are for our kids, our marriage, families, our job, our house. Nowonder, according to the National Institute of Health, gratitude can help us increase our life satisfaction and mental health! Oh, how nice that is! Things really are so well and good through the lens of this gratitude, but isn’t it almost too easy when we simply share what is great? I want to talk about a different kind of gratitude, the dark side of gratitude if you will, this is what I call a gratitude challenge. It is not the shiny happiness and gloating we feel when everything works out just the way we want it, but instead, this gratitude challenge, is the kind of gratitude that we can choose to cultivate when we are sitting on a big tall mountain of suck. In this vast beautiful adventure of life, reality more often than not smacks us in the face, universal are the experiences of hurt, loss, and grief. Yet, even more important than making a mental note of gratitude for all of the ways that we are blessed, our mindset truly evolves when we deliberately choose to frame our losses in one beset by gratitude.
Of course on the day that you get the job, and then again when you land the promotion, you are elated, but can you be grateful for those years of success and comradery even when you get the news that company is downsizing and you are handed your severance? Of course, you are beaming at the altar on the day that you say “I do” to the love of your life, but can you still find gratitude when you are headed to marriage counseling because you’re in conflict and bickering about who is doing more cleaning around hte house? Of course, you will be joyful on the day when you learn that you have finally conceived the child you have been yearning for but can you still be grateful that it has happened when their little heart stops beating in utero? Of course, you are thrilled when you finish the marathon in 2nd place, but what can you choose to be grateful for when you have knee replacement surgery from all of that running?
Choosing gratitude amidst the sucky moments of life doesn’t mean that we pretend it’s all ok. Instead, we do not try to block the hurt of our losses, we feel the devastation and despair deeply because let’s be honest here, we have no choice! Some things in life will rip the wind right out of our lungs and bring such agonizing hurt that we will fall to our knees in the pain of it. Yet, the difference is that we choose to live in the memory of the joy that they brought us, we choose to be grateful that the wonders in life have happened no-matter how long or short they stay with us. Cognitive behavioral therapy instructs us to reframe the despair of our cognitive distortions, we do not allow misery or grief to frame the pictures of our memories or the loss in our life. The gratitude challenge is to be penetrated by the suffering of a life well lived but then to hunt like a little scavenger for every little bit of joy, peace, and hope that our experiences have shown to us. Some days that might mean that we are grateful to know that they pain won’t last forever and allow ourselves to contemplate the gratitude for that. When you get here and can nurture this sort of perspective, you take a little bit of power and direction back to your life. On Thanksgiving and every day, the decision to live a life peppered in gratitude is yours. So go ahead, take the challenge, how grateful can you be, what about your pile of suck can you be grateful for?
by Counseling and Wellness Center of PittsburghMarch 4, 2019 Behavior Therapy, CBT, cognitive behavior therapy, Cognitive behavior therapy near me, cognitive distortions, Cognitive therapy, maladaptive assumptions0 comments
Cognitive Behavioral Therapy, or CBT, is a common buzz word and psychological term, but what is Cognitive Behavioral Therapy? According to the Beck Institute, In clinical terms, it is a specific theoretical therapy that is used as a psychological treatment. Since its creation in the 1960’s by Dr. Aaron Beck, CBT has been proven to help reduce the symptoms associated with a range of mental health concerns including diagnoses like Anxiety, Depression, Substance Abuse, Marriage and Relationship issues as well as many other chronic mental health concerns. CBT has been clinically proven to be as effective as medication in many instances. At other times CBT is a helpful adjunct to medication therapy. Specifically, CBT helps the patient or client to identify the ways in which their thoughts and behaviors contribute to their mental health concerns.
The basis for cognitive behavioral therapy is embedded in the idea that psychological problems are at least partially influenced by maladaptive thought patterns. Furthermore, CBT recognizes that mental health issues are further solidified within unhealthy patterns of behavior that make our mental state feel worse. Finally, CBT provides a way to manage this and develop more helpful and constructive ways of dealing with patients’ lives and the issues that come up in them.
Changing the way that we think has a profound effect on our well-being. Remembering; thoughts become feelings and our emotional state affects even our heart rate and breathing patterns. A common way to enact CBT involves several steps.
First the patient begins to recognize their distorted thinking patterns, particularly the ones that are “created” emotional reactions.
An example would be: ‘I always mess up relationships.’
The next step becomes to challenge the maladaptive thought with a more healthy or realistic thought. In the example above it would be helpful to examine the use of ‘always.’ Instead, a healthy way to frame the above thought might be to make the statement, ‘My last relationship didn’t work out but I learned a lot from it.’
By managing our thinking instead of being overcome by it we empower ourselves and set up a more positive feedback loop to our thoughts, feelings, mind/body connection and even into our relationships. Another benefit to CBT is that problem solving skills are enhanced. Cognitive behavioral therapy is very much focused on the present, in contrast to psychoanalytic counseling which will spend a lot of time fostering informed connections between early childhood experiences and present day defense mechanisms and mental health concerns. In CBT, your therapist is most concerned about what is happening in the here and now, and it is within the present moment that we have the opportunity to change.
The therapist and client collaborate in a mutual fashion by challenging unhealthy thinking, enhancing the development of positive emotional feedback loops and by planning for enhanced wellness. Just as with all forms of counseling, it is not just about the therapy that happens in the 53 minute hour, but CBT especially uses homework exercises to help the clients solidify the changes that they are working on. CBT is one of the most effective tools and some therapists will use it along with other forms of therapy to further benefit the clients’ needs.
To learn more about how CBT can help you, contact our counseling centers!
by Counseling and Wellness Center of PittsburghDecember 28, 2018 how to reach your goal, new years resolution0 comments
Live Your Best Life, How to Slay anything in 2019.
New year, new you? Well, maybe, whether you will be a wistful dreamer or a winning achiever of your New Year’s resolution really dwindles down to this; ‘How do you mentally prepare yourself for the process of change?’ We all look forward to the prospect of a new year, we start off with a fantastically shiny hope, we can do anything with these next 365 days of our life. Yet, for all of this hope and enthusiasm, why do the majority of New Year’s resolutions fail in the first month? We can explain some of these failed resolutions by applying the theory of behavioral psychology. We wellness warriors, trudging onward to 2019, sails full with the winds of enthusiasm, need to be sure we are beginning our voyage with the right motivations, or we just might end up deflated and completely off course. If we have an internally damaging way of nurturing our New Year’s whispers of inspiration, we can rest assured our achievements will fall as flat as the last sip of kombucha that lines our almost empty cup. Our counselors have worked together to create a sequence of effective pieces of psychological advice which will kick-start any of your New Year’s wellness goals.
Get real with yourself, meaning where are you right now and where do you want to be?
This is about stepping away from the potential delusions of your thinking and recognizing where you are, honestly. If you are an echoing scream away from your goal, it is going to take some time to get there. Using weight as one example, if you are currently 300 lbs, and you aspire to weigh in at 150 lbs, it will take many years and much effort for you to arrive at that destination. Maybe you want to start with making an appointment with a personal trainer and a nutritionist or a dietitian. Another example might be that you want to have better boundaries with other people in your life. Be ‘real’ about while jotting down your list. It takes gusto and strength to record your truth about areas for growth such as your inability to say ‘no’ to others and the amount of inexplicable guilt that you feel when you attempt to draw boundaries. Yet it is by insight that we can make great progress toward our goals.
The second part of this sequence is that after you examine where you are and where you would like to be, your goals must be broken down into achievable units. We humans don’t do well with goals that are too large. If for instance you want to write a book this year, instead of focusing on the larger goal of completing the whole text you will do best by focusing on small goals daily. Writing 500 words a day is a well achievable micro goal that will inch you toward the end result. Why does this work? According to Psyche Study, ‘Behavioral psychology defines the mechanism of ‘shaping’ to describe the slow process of behavioral change where we are rewarded for each step toward reaching the final goal.’ We nudge ourselves toward the finish line. In the process of shaping these small changes, we feel empowered by the daily act of achieving our successes instead of potentially losing focus if our overarching goal is so big that the reward for making it there is too far off.
Give yourself rewards
There is a long standing debate and research query which examines whether punishment or reward is better to help us change our behavior. According to recent research from Harvard Business Review, if you are going to maintain the enthusiasm and hope that is driving your desired progress towards change, you must create rewards for yourself. In this particular study, it was noted that punishment, and the fear that it evokes, can cause people to ‘freeze’ instead of act. Think about the proverbial deer in the headlights. Again, with reference to behavioral psychology and the field of human learning and behavior, humans and animals are more inspired by positive reinforcement than punishment. We move toward what is pleasurable, especially if the reward is well timed to be given right after reaching each small segment of our goal. That means that when we have that internal voice which tells us we are slugs because we didn’t reach our goal, we are not helping our situation. It is the promise of something that is rewarding which really propels us to go harder and longer in the journey to ‘live our best life.’
What is it that you are planning to work on for your New Year goal? Always first ask yourself this, we all want to achieve things but are you ready to put in the work to achieve your goal? If the answer is yes, move onward and use this as a template to assess your goals and move yourself one step closer to where you want to be!
In relation to your goal, where are you now?
What do you hope to achieve, what is your long term goal?
Break the above mentioned goal into daily, weekly, and monthly goals.
How can you reward yourself on a daily, weekly, and monthly basis?
Wishing you and yours a happy and healthy year of wellness,
Harvard Business Review, What Motivates Employees More, Rewards or Punishments? https://hbr.org/2017/09/what-motivates-employees-more-rewards-or-punishments
Psychestudy, Online Journal on human behavior and psychology. What is shaping behavior? https://www.psychestudy.com/behavioral/learning-memory/operant-conditioning/what-is-shaping-behaviorLearn More
by Counseling and Wellness Center of PittsburghOctober 30, 2018 compassion, pittsburgh, positive psychology, resilience to trauma0 comments
Trauma; Honor For Your Healing Journey
The four things your therapist wants you to know about your healing journey. When you’re healing from a grief, trauma, or resultant PTSD, you must be thinking about ‘how will I ever move on from this horrible, unexpected, agonizing reaction to the traumatic situation that I have experienced?’ Remember, PTSD is a reaction to witnessing or experiencing a sudden and unexpected event which caused one to feel powerless by delivering, threatening, or witnessing harm. How can I rise above these feelings and thoughts and create meaningful and complete healing? Maybe you want to go backwards in time and undo all of the harm that you have experienced. A common and reasonable response to all of these above disorders, particularly PTSD, is to try to avoid all triggers associated with the situation which evoked the trauma, hypervigilance, intrusive memories, nightmares, flashbacks and an increased risk for anxiety and depression. This disorder presents a mountain to ascend, and whether you have spend years in therapy or are only beginning to acknowledge the depth of the effects this has had on you, these are some points to keep in mind. These are the 4 things that your therapist wants you to know about healing that are not immediately evident.
Healed but not Forgotten
Some people have the unrealistic expectation that when they reach the end of their healing journey they shouldn’t have any emotional reaction to their memories of the traumatic event which led to grief and loss. That is not how healing works. It is quite likely that you will always have some sort of reaction to the memories and thoughts associated with your grief or trauma. In fact, according to a 2011 study published in NIH by Sherin and Nemeroff, and according to all of science and psychology support the fact that there is potential for long term neuroanatomical and neurochemical changes to the central nervous system resulting from trauma. These changes are especially evident in the way we respond to triggers or trauma associated stimuli. What we should be striving for in the healing from trauma is a ‘new normal.’ Healing means that you are able to function in professional or personal settings and that you are practicing resilience and positive coping when waves of thought and emotion do come.
Healing means Acknowledging Feelings
One of the ways that therapy works is by creating an intentional space for healing warriors to be honest with themselves, to create an understanding of their emotions. After an awareness has been formed adaptive responses to feelings and thoughts can be generated. We create psychopathology by being critical and attempting to repress our internal honest responses. For some people like first responders, police, and paramedics, there may be an extra layer of difficulty and stigma attached to acknowledging ones feelings and seeking mental health support to manage trauma. This can cause further damaging denial of the effects of traumatic experiences, One of the core tenets of psychological theory present in every form of therapy is that the more we repress, judge or avoid our feelings, the more we cause problems. Repression elicits tangled feeling constellations, blocked energies, incomplete and unintegrated shadows. Mindfulness based stress reduction, EMDR, and Cognitive Behavioral Therapy, and Exposure Therapy, have shown efficacy in treating PTSD. Our feelings can turn into psychopathology that are bigger and sometimes socially unacceptable forms of the original emotional response.
Healing Happens in Relationships. Find your Healing Tribe
It is especially true for trauma that happens in relationships, that this same trauma is healed in relationships. When trauma survivors open up to those people who they consider to be safe, there is an incredible potential for healing to happen. Healing relationships are those that resonate compassion, gentle acceptance, warmth, and non-judgement. Think about it, we become close to those who we can be really honest with, those who ask about our feelings and can share in a compassionate interchange, (Mgrath, 2001). Sharing trauma should be exercised with caution. However well-intentioned our healing tribe may be, its members may inadvertently respond in less constructive ways that judge, shame, or put down the survivor for having the pain or scars of trauma. Another risk is not being able to hear or understand what is being shared. What is really needed is non-judgmental acceptance, understanding, and compassionate warmth.
Positive Psychology, Pop Culture and Non-Reality
You may have survived a trauma
but that doesn’t mean you have to fall victim to meme reality. Scroll through a social media forum and you will see many posts and memes which declare that everyone should be happy all the time. That isn’t honest or possible. The healthiest among us are those who are honest with themselves about what they experience and then respond to their vulnerable reality in a constructive way. According to a 2016 study by Elizabeth Kneeland,pop cultures layman positive psychology is damaging. When pop culture got its hands on positive psychology its representatives distorted the message, and now laymen perpetuate unrealistic and uninformed messages which imply that we can think our way into a good mood. It suggests that if we blink our eyes we can make trauma and psychological distress evaporate. Your therapist knows differently. Its ok to be outraged, disgusted, sad, hurt, angry, confused, and it is important to acknowledge where you are in your healing journey today.
No matter where you are today, the best we can do is to risk opening to ourselves, to create an honest internal dialogue that we are eventually able to share with others. We should unabashedly honor our own processes, giving relentless permission to feel, think and be; in reverence of joy, in honor of glorious fury, to the fullest expression of gaiety, to the utterance of insuperable hurt, to fully hone in on repugnant disgust. Keep developing your divine awareness, and eventually you will have created the unique meaning which understands with a lens of compassion, acceptance, and self love all that has happened to you.
With love and hope for resilience,
Stephanie Wijkstrom, MS, LPC, NCC
- Counseling and Wellness Center of Pittsburgh
830 Western Avenue Pittsburgh PA 15233
- Counseling and Wellness Center of Pittsburgh
4108 Monroeville BLVD, Monroeville PA 15146
Accepting new clients, our therapists accept UPMC, Highmark BCBS, United, Cigna, Magellan, Aetna, HSA, Self Paying and Sliding Scale.
Thank you to our Editor, Dr. Stellan Wijkstrom for his ever helpful alterations and contributions.
For More Reading
Kneeland, Elizabeth et al, Positive thinking Newsweek, 2016
McGrath, Ellen. Psychology Today, published November 1, 2001
Sherin, Jonathan E, Charles B. Nemeroff
Dialogues Clin Neurosci. 2011 Sep; 13(3): 263–278.Learn More
by Counseling and Wellness Center of PittsburghJuly 16, 2018 anxiety during pregnancy, depression in pregnancy, postpartum, stress pregnancy0 comments
Anxiety and Depression During Pregnancy, ‘Wellness For People Like Me.’
Writer, blogger, and art therapy graduate Angela Grace Wilt shares some of her experiences in recovering positive coping and mental health including ways to manage anxiety and depression during pregnancy. This is a part of the ‘People Like Me’ Series of our wellness blog, real people, real stories, real ways to incorporate wellness into stages and experiences of everyday normal life.
Being a woman comes with a lot of ups and downs. Women are prone to anxiety and it can be very hard to to admit. For example, women are closely tied to the monthly cycles that their body experiences. Things such as menstruation cause anxiety, depression, mood swings, and intense bodily urges with cravings. Men never will get us or grasp what we go through. We are just that unique. For as long as I could remember, I have felt that as a woman I am special and cursed all at once.
Then of course recently, as I have taken this jump into parenthood with the amazing biological potential of my body, quickly I have learned that while things like premenstrual dysphoria, and the normal anxieties and depression of menstruation are challenging, pregnancy holds a whole long list of unique and larger fears and physical difficulties. In fact, this is true for all women, and according to The American Congress of Obstetricians and Gynecologists (ACOG), between 14-23% of women will struggle with some symptoms of anxiety or depression during pregnancy. The shift in mental health have multiple sources, think about it, there is insomnia because our body is changing so fast that some women can be prone to rapid heartbeat, which makes it harder to fall asleep. There is also the whole list of ‘what ifs.’ Will my baby and I make it to full term? Will my baby be healthy? I can no longer drink alcohol, ride adrenaline driven roller coasters, lift heavy weights, or really take any chances of too adventurous tasks. With each decision I make, I consider the question ‘what will makes my little bump, a healthy or not so healthy baby.’
Physical and emotional changes are also thread within social fears and adjustments, I sometimes wonder, have I planned enough for this pregnancy that has in many ways, just happened. The truth is, I am not some 30 something who has been charting my cycle for 6 months to achieve conception, I didn’t plan to get pregnant just yet. I thought about it sure, but just like most couples we wanted to walk down the aisle with a white dress of lace and flowers all the scenery of our closest friends and family shouting us on, it was always my dream of being that princess and marrying my soul mate! We still will have that for our future, but it will be after we get through the current stresses. In addition to the changes in my timeline, I also care about what our parents think about our having a baby right now. Having a baby out before marriage can be shocking for some religious and cultural values. We were lucky because my family is just fine with it, and with a little time to adjust, my better half’s is now happy about the news.
The list of anxieties and real practical matters which accelerate my concerns are aplenty, even small things have caused me stress, I have had to shop for insurance as a pregnant women, because I am twenty-six, pregnant, and didn’t have any. Finally, babies are expensive, health insurance is also expensive, we have stresses of finding better jobs, I have to go on insurance yet because I am twenty-six and don’t have any. We are cleaning house and making a baby room. When all of these real life stresses start to mount very high, I can feel my heart beating faster, I try to stop and think of the things that we do have, I try to re-frame my anxieties and depressed thoughts in a positive light, I pause and I say to myself, ‘I have my boyfriend, our love together, and I have a supportive family. I have myself and my strengths, and I am strong and able.’That always seems to calm me down and help me to remember that there is much to be excited about as we move forward together as a young family.
With all of these anxious and depressed thoughts swirling in my mind, I have taken the time to put together a small list of ways that I manage and support my emotional health during my pregnancy. Of course if you are struggling with mental health during or after your pregnancy, talk to you PCP or Mental Health provider, get a screening for Postpartum or Baby Blues, every year women die or don’t bond with their babies due to maternal mental health factors. If you are like me and relatively healthy but feeling a little anxious or blue, then read on because these tips may help you as much as they helped me.
Use positive self talk, be your own biggest fan and encourage yourself like you would a friend
I say nice things to myself, I write little notes and post them through out the house, simple thoughts like,’ Rome was built in a day’ ‘We will get everything done in time.’ We’re already almost half way there at twelve weeks. It’s just a wild ride. My body is going through so many beautiful changes. Tune in, all of my emotions are heightened. Hunger is giving me nourishment now. Sleep is always appreciated. Sex is fierce and always wanted. Sadness and anger are intense. I have energy that comes out of nowhere. Its ok if sometimes I can’t stop crying. I love my baby and baby’s daddy and not want anything more than to be with just them and them alone. I want the best by our new child. I want to give it proper nutrition and a good home life. I want to be a good parent and my baby to grow in a family where love is the answer and anger is dealt with in a healthy supportive manner. I will protect this baby with all that I have. This child’s needs and wants are now first. I am ready to teach this baby proper education, morals, respect, and spirituality.
Its normal to be overwhelmed, life is now changing!
Anxiety,stress, and fear are the norm when we are overcoming big changes. ways just important to remember that having a baby is a life changing experience. Normalizing the emotions that I am experiencing helps me by making me not feel the guilty, ashamed, or odd for having these dips and emotional shifts.
Reach for your Tribe!
Please remember, you are not alone. You are a powerhouse and you have many people who will listen and talk. Make a list of 5, if you can not list at least 5 people who will pick up the phone for you, see a therapist and talk about the feelings of isolation and loneliness. Mom, dad, best friends, siblings, make a list and think about who is the best person to talk with through the things that come up. It will likely be a different person for each of situations that one may encounter on the pregnancy journey.
Use your breath
The body and its breathing are powerful, breathing can be used to energize and manage our response to stress. Take some deeps breaths every day.
Make a Wellness Routine
Do calming relaxing type activities like yoga, walking in nature or just walking, stretch, journal, and keep time for yourself to collect your thought and consider the daily experiences that you are managing. Essential oils can help ease the mind and emotions and of course be sure to choose blends that are safe to use during pregnancy.
Bond with your baby
Talk to your baby while its in the womb, there will likely be a time after your baby is born that you are longing to be so closely connected to him or her again, try to cherish these moments and zoom out towards the big picture where you are nurturing a sacred bond right now in your womb. Being a woman is very special, and this connection, with baby snugly centered in my sacral area, right as my mother and my mothers mother have always done, this is something that men can not understand, but I am ok with that.
We are powerful, we are able to make changes that influence the outcomes of our life. Pregnancy like all things, is what you make of it. Do your best to stay positive by thinking of the new exciting things that can be done all in great fun with your new family together. Your love of baby and yourself will take you far. Be gentle with yourself when you notice the stress, anxiety, and fear of the 9 months ahead. This is a special time that can be used to get really healthy and in tune with your bodies needs. As always, seek medical help from a PCP, Gynecologist, or Licensed Professional Counselor if you have concerns about your mental health.
by Counseling and Wellness Center of PittsburghJune 21, 2018 counseling for PTSD, psychology, psychotherapy, ptsd, trauma, trauma informed care, trauma therapy0 comments
We have fantastic and astonishing memory abilities, the human mind and its processes, particularly in the way we store and retrieve the effective memories which then effect the way that we store and respond to our other memories and sensory input. Evolutionary psychology examines the way some things that can be problematic are often helpful to us in the past and as we evolved. This is especially true for trauma survivors. According to the American Psychological Association, Trauma is an emotional response to a event like an accident, rape, or natural disaster, abuse or assault. Immediately after the event, shock, emotional upheaval, loss of ability to function, and denial are typical. Trauma is especially present in situations where a person feels powerless and their sense of control are taken. Long term reactions include unpredictable emotions, flashbacks, strained relationships and even physical symptoms like headaches or nausea, nightmares, inability to rest or calm down, feeling tearful, experiencing fear and heightened startle response. While these feelings are very universal response to the paralyzing fear that is associated with trauma even if the survivor reports feeling neutral in the moment. Biology offers some rational for how we can feel afraid but work through it in the moment of the traumatic situation, but it is later when we are safe and comfortable that the panic can emerge, generally emotions are something that can be seen and felt most when everything is alright around us, meaning the traumatic event is over and we are safe. Some people have difficulty moving on with their lives because trauma can result in long term effects such as post traumatic stress disorder, acute stress disorder, anxiety, depression, and addiction.
There are so many events that we experience which are traumatic, whether these develop into the more complex constellation of behaviors which we identify as PTSD, really depends on an interplay of biological, social, and other environmental factors. Some of the situations which can cause a trauma response include, domestic violence, sexual violence or assault, car accidents, national tragedies, serving in war, robberies. It is possible that we can experience a traumatic response my witnessing these events even if we are not the direct recipient of the threatening attack.
People who later feel the emotional and physical effects of trauma may wonder, what is wrong with me? Also, even if the event seemed manageable in the moment, it seems bizarre that they keep seeing flashes of it months or years later. The answer is while the effects of trauma can be debilitating, our cognitive processes are primed to be traumatized. Evolution explains that we and our ancestors are wired to hold tight to frightening or threatening experiences, imagine what happened to all of the humans who did not startle and produce massive amounts of cortisol and adrenaline at the sight of the saber toothed tiger just through the northern passage on the savannah. They died and did not evolve to have offspring in our gene pool. Having memory of dangerous events, people, situations, and gearing up to flee or protect one’s self is a sign of an evolutionarily healthy adaptation, it allows us to stay safe by avoiding possibly dire situations. In fact, our Vagal nerve which communicates directly to our bodies, without having to yield the advice of our logic, there are long term changes in the way that our Vagal nerve responds to triggers after we have experienced trauma. The vagal nerve is what allows healthy people to experience the ‘startle response’ for example when someone sneaks up behind you, usually we respond with a physical jerking motion in our bodies, and literally jumping. In domestic violence survivors, being ‘jumping’ and easily startled when a person raises their hand, is a well noted phenomenon that may last an entire lifetime.
We are wired to remember traumatic events. Survivors of trauma know that the sight of the perpetrator of their violence, even a coat that’s the same color as the one their attacker had worn can evoke the fear response. ‘Triggers’ are any stimuli which we associate with the traumatic event. These triggers and their associated memories can and do produce a jolt to the vagal nerve resulting in heightened, panicked, and anxious response in the person who is perceiving them. The biological response when we encounter a trigger are a plenty, our bodies enter a state of hyper-arousal, respiration becomes more shallow, heart beat rises, and fear settles in, even cognitive function is impaired as our higher order reasoning is impeded and all neurological resources are yielded to the hind brain and its motor and autonomic functions. The one and only thought becomes fight, flight, survive, and in some cases freeze. Remember, just like on the savannah in the seat of civilization, the extra energy our bodies create allow us to escape danger.
Cognitive behavioral therapy, systematic desensitization, and exposure therapy, and some therapies which aim to change the tone of the vagal nerve are recommended ways to work through the trauma and empower the survivor to be able to withstand exposure to triggers and regain emotional wellness. It is recommended that trauma survivors do their best to limit exposure to triggers as they heal from the event and associated memories. If you feel that you may be experiencing long term effects from a traumatic situation, it is recommended that you work with a therapist who is specifically trained in trauma informed care. Healing will allow the processing of the entire event, client and therapist will identify triggers, developing the capacity to respond to triggers with mindful balance, and work through the effects of any other psychological effects from the trauma.
Counseling and Wellness Center of Pittsburgh, Serving Western Pennsylvania with Individual Therapy, Couples Therapy, Family Therapy and Wellness Services.
by Counseling and Wellness Center of PittsburghApril 2, 2018 anxiety, anxiety therapy pittsburgh0 comments
Acute Stress Disorder
Acute stress disorder is a form of anxiety disorder which develops shortly or immediately after exposure to a traumatic event in which real or threatened harm or injury was experienced or threatened to the self or other. Acute Stress Disorder differs from Post-Traumatic Stress disorder in the time from in which the associated symptoms are exhibited. To reach the diagnosis of Acute Stress disorder symptoms should be exhibited less than one month after exposure to a traumatic event. Similarly to PTSD, symptoms involve flash backs, re-imagining, dreams, distress or anxiety at exposure to visual stimuli related to the traumatic situation or event, including hyper-vigilance, and anxiety about the possibility of the event or danger happening again. The duration of the traumatic event and time of exposure or repetitiveness of the exposure effect the likelihood that the person will experience Acute Stress disorder as there are certain internal risk factors which may affect resilience to the development of the trauma. Treatment for Acute Stress Disorder often involves trauma focused therapy, EMDR, short term psychotherapy, mindfulness based therapy approaches even including meditation, acupuncture, all therapy and counseling services should be performed with a licensed professional counselor or mental health specialist.Learn More
by Counseling and Wellness Center of PittsburghMarch 16, 2018 anxiety, anxiety therapy pittsburgh, cognitive behavioral therapy, counseling, counseling for anxiety, counseling pittsburgh, generalized anxiety disorder therapy pittsburgh, Help for obsessive compulsive disorder, licensed therapist monroeville, licensed therapist pittsburgh, obsessive compulsive disorder, OCD, searching for a therapist in monroeville, searching for a therapist pittsburgh, therapist in murrysville, therapists, therapy, Therapy and Counseling For Anxiety, therapy for anxiety, therapy pittsburgh0 comments
Obsessive Compulsive Disorder
Obsessive compulsive disorder is a type of anxiety disorder which afflicts .5-2.5% of the population. The disorder greatly effects the quality of life for the sufferer and becomes a consuming pattern of anxieties and rituals which are centered around both obsessional worries and compulsive behaviors. Most of the individuals who have this disorder at one time or another acknowledge or have insight that their worry is excessive or disproportionate to the actual fear or anxiety. An example of someone who may be experiencing Obsessive Compulsive disorder is that “It started when I was in my mid 20’s, I was always worried that I would get something wrong, I made lists so I could try to manage my daily living tasks. Soon lists became my life, I would write a list of everything that I needed to do while I was in the shower, then I would check the list 3 times after writing it, to be sure that I did get everything right. Then I would reread my list again 2 times before entering the shower and read it out loud, If I didn’t perform this task I was simply unable to take my shower for the day because I would lapse into such overwhelming anxiety.”
Some examples of symptoms and behaviors association with this disorder are as follows
according to the Diagnostic and Statistical Manual;
That the individual has either obsessions or compulsions and which the definition of these are;
- Thoughts which are recurring and persistent including images or impulses, these impulses are distressing and cause impairment including anxiety.
- These impulses, thoughts and images are not related to a threat or worry about a real life problem.
- There is an attempt to repress and ignore the distressing images, impulses and thoughts.
- The person who is suffering from this disorder is in recognition that these fears are in fact a product of his or her own thought process.
Compulsions are defined as
- Repetitive behaviors (e.g., checking, cleaning, cleaning,) and also cognitive acts such as (ie, ritualized prayer, tracing in the mind, taking count of objects or steps) the person feels compelled to enact the behavior in response to the obsession in a system of self created rules.
Obsessive compulsive disorder is a treatable anxiety disorder, the best form of therapy often involves both pharmacology including SSRI’s delivered in conjunction with long-term psychotherapy. Cognitive behavioral therapy has proven effective in managing the symptoms associated with this diagnosis as well as Behavioral Therapy such as Exposure therapy are all effective treatment or counseling models to progress beyond this disorder and take back control over life.Learn More
by Counseling and Wellness Center of PittsburghMarch 16, 2018 anxiety, anxiety therapy pittsburgh, counseling, counseling pittsburgh, educational, generalized anxiety disorder therapy pittsburgh, licensed therapist monroeville, licensed therapist pittsburgh, psychology, psychotherapy, therapist, therapist in murrysville, therapists, therapy, therapy for anxiety, therapy pittsburgh, wellness, wellness center monroeville, wellness pittsburgh0 comments
A phobia is a fear or anxiety response of heighted arousal, ie rapid heart rate, rapid breathing, and thoughts of intense worry and this most likely leads to avoidance of the situation or object. Some examples of typical phobias are fear of public speaking, fear of choking or vomiting, fear of spiders (arachnophobia), fear of enclosed spaces (claustrophobia), fear of bridges, fear of tunnels, fear of large crowds, fear of blushing, fear of water or other natural environments, fear of contamination or germs. Phobia is distinct and much more severe than a natural aversion, for instance in the example of arachnophobia, many people do not like spiders and insects but wouldn’t qualify for a disorder because this doesn’t interfere with their functioning and enjoyment of life. A person who simply doesn’t like spiders may sheik if they encounter one and quickly try to remove it from their environment. A person who has a phobia of spiders may feel anxiety if they think about a spider, they may never go into a forest or stay away from other natural environments, they may start to take precautions like spraying repellant everywhere and have continual intrusive thoughts about the possibility of encountering spiders and even stop leaving home or developing agoraphobia because their wish to avoid the spider is so powerful.
The Diagnostic Criteria for A Specific Phobia are;
- A continual, persistent, and excessive fear caused by the presence or anticipation of the situation and or object, examples may be choking, bridges, tunnel, flying, insects, fainting, speaking, blushing.
- When exposed to the object or situation an anxiety or hyperarousal response is invoked. This is also a different response in children.
- In panic disorder the persona experiencing the disorder does recognize that the fear is unreasonable and the response is excessive.
- The situation or object may be faced or endured but only with very visible and tangible fear, anxiety and distress.
- This fear and anxiety interferes with the enjoyment and participation of life, limiting professional, occupational, social, relational, and academic performance and functioning.
- This can be diagnosed only in individuals who are over the age of 18 and it must be experienced for longer than 6 months.
The best way to treat a phobia disorder is with psychotherapy, your licensed counselor can help you by using a very specific kind of therapy called Exposure Therapy. This is a behavioral therapy which a licensed therapist who specializes in treating anxiety disorders will be able to guide you through. In other instances, medication including anxiolytic medication, anti-anxiety and SSRI’s are best used medication therapy to treat and manage panic disorder. Other forms of therapy which may help to manage specific phobias including meditation, mindfulness, exercise and other integrative options like nutrition counseling and acupuncture.Learn More