When Fear Rules !

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When Panic and Obsessive Thoughts Return

by on Oct.16, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

Relapse: When the Panic or Obsessive Thoughts Return

Yes, as frustrating as I know it must be to hear this, it is true. Symptoms of panic attacks or obsessive/intrusive thoughts can return. However, this does not mean you cannot gain control and eliminate these symptoms.

What does it mean ?

Well, if you have not done  any therapy, it may mean that the sources for your panic or intrusive thoughts had temporarily passed, or that you are taking medication that helped you over-ride your symptoms for a while, or maybe that you have been so distracted by other significant issues in your life that the symptoms took a back seat in your life. But obviously, if you have not done the work to identify the true causal factors, the real sources as well as gone through a process of desensitizing to your symptoms through therapy, then the band-aid you used to deal with these symptoms has come off.

If you have done therapy, but did work to desensitize step by step to your symptoms so that you are less fearful, but have not really dealt with the sources of your symptoms, then it is just a matter of time when they will return as those sources rear their ugly heads someday.

As an example, let’s imagine a woman who was so plagued by intrusive thoughts that her husband was or would cheat on her that she was obsessed with checking his cell phone for unknown callers. The more she gave into this urge, the stronger the need became. Since she was able to feel immediate relief when she found no strange numbers on his cell, her behavior was internally rewarded. However, she also realized she was taking a serious risk in that if he found her checking on him, it would damage his perception of his wife, causing HIM to distrust HER.

She was able to show more control of her urges to check by recognizing them quickly, postponing giving in to them and then giving herself something else to focus her mind on, like calling a friend, working on a project, or going out with friends.

She made some progress, then, without warning, the urges became so strong again that the obsessions and need to check returned with a fury.

The issue ?  She also needed to understand the source of her fears and  deal with them. She came to understand that her fears of his cheating on her were really without evidence, but were there because she, in fact, was rather needy emotionally and wanted and needed a more open show of affection to feel good about herself.

Her husband loved her, but was not one to initiate affection. So her mind drifted and she had fantasies of other being with other men.. Her fantasies caused her some guilt, but also led her project her  needs on her husband. “If I have these thoughts, HE  must be having these thoughts too !”

Once she clearly understood it was HER insecurity and neediness that was the source of the problem, we set up a plan to build on his self-esteem.

She lost wait through exercise and changes in her diet.

She got involved with projects she enjoyed but had avoided.

She tried new things and initiated going more places with her husband.

All these things just made her look even better to him. She felt better about herself, and her throwing so much energy into personal growth stimulated her husband’s positive reactions and comments.

Instead of focusing on her fears, she focused on both self-improvement as well as being a loving but less needy wife.

As she became more comfortable with this game plan and saw his response, she was able to see her own fantasies change in that they were more about things to do with her husband. As the husband responded more positively and openly because of changes he was seeing in her, she was receiving the feedback she needed to refute her fearful thoughts.

Any thoughts ?

 

Gene Benedetto , Psychologist

Coach

 

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If Someone Would Only Have Listened !

by on Aug.21, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

I received a frantic and very emotional call from a man who was at “his wits end” not knowing where else to turn. His wife, Traci, was suffering from obsessive thoughts that were ruling her life.

He reported that she had been this way most of their marriage, and actually most of her life, but the only treatment she had received was in the form of at least two hospital sessions that ended up to be in-patient programs, basically, the psych ward
. She was apparently on a relatively low dose of an SSRI, he thought is was Celexa, but she was getting worse. What could he do?

I promised to come in early the next morning to talk with her on the phone. I needed to see whether SHE saw her thoughts as a problem, or whether she was being pressured by her husband to call. It is almost impossible to work with an OCD client if they do not feel there is a problem.

But yes, it was a problem, and her thoughts did rule her life. She had never really had any therapy, just medications. Nothing was working and her fears were becoming more bizarre by the hour.

Most of her fears seemed to be related to religious fears and associations. She feared she would somehow be taken over by the devil if she touched things that were dirty or germ infested. However, the intrusive thoughts had grown and festered to the point that being near one of her grandchildren with a potentially soiled diaper would set her off. Then, even if the baby had sat on the floor and had wet diaper, the floor was now so contaminated that she could not be in the same house with the kids. On and on it had grown, to the point that as much as she felt it was all so crazy, she could not stop herself.

Of course, then I find that this started as a child, as early as six years of age where she would have such guilt over any thought that was ever so slightly frowned upon by her family.

The bottom line was , I told her she needed an intensive in-patient OCD program that would regulate her meds and work with her on a daily basis to re-establish some trust in herself and her ability to control her thoughts. I wanted to work with her, but I know this had gone for too long, over fifty years, and out-patient therapy was just not going to cut it. I promised her that I would work with her once she was stabilized to the point that she could work one on one with me, but at this point, the thoughts were so overwhelmingly intense that in-patient was a must.

I know she was disappointed, but yet heard me say I would be there when she got back. She seemed to take heart in that, so I KNOW she wants to have control and get better. I recommended a few specific OCD treatment centers.

It reminded me of a few of the newer children I am working with who are experiencing OCD symptoms. Each one was so different, yet they were the same in that they felt controlled by their obsessive/intrusive thoughts. Whether germ related, thoughts of the devil or evil, sexual obsessions or a child who could not talk due to obsessive fears that something evil would come out of her mouth, these kids were suffering and many of the parents just wanted to treat the symptoms. “Maybe if you just put him on medications, he would stop thinking these weird things”.

These kids, each one of them, were reacting to conflicts, angry emotions and issues that they did not know how to deal with. It was their anger and frustration, and not knowing how to deal with their conflicting emotions that caused guilt feelings, and the guilt feelings led to them feeling they were bad, and therefore something bad would happen to them….or that they would do something bad to another.

These children can be saved from a lifetime of pain if they are worked with now, not just with medications. Here is a unique and novel idea, let’s listen and find out what the children are actually feeling and thinking !

I wonder if someone had heard Traci and took time to feel her pain many a year ago, would she be going through what she is now ?

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Children with OCD

by on Aug.16, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

I have very strong and yet mixed emotions when I see a new client suffering with obsessive-compulsive symptoms, but never more than when the client is a child.

Can you imagine what a child feels when he or she finds herself {or himself} compelled to carry out some ritual like repeated hand-washing.

Even at a young age, they fear ridicule. They often feel they are crazy, or that something is really wrong with them. Children have enough issues of acceptance or rejection to deal with, but can you imagine what this must be like for them.

And since many parents do not understand what the child is going through, they become upset and frustrated with the child, often telling the child to just stop. Feeling a parent is angry with you for something you feel no control of is especially stressful and usually exacerbates the symptoms.

If you have or know a child experiencing obsessive-compulsive symptoms, back off, talk to him, don’t show anger or frustration. Instead, LISTEN, and look for what might be creating the symptoms. Look for conflicts and overwhelming emotions that might be causing the child to feel out of control, like significant conflict with peers, or trying to fit in by mimicking behaviors that the child knows are wrong. Conflict and anger will create the atmosphere for both panic attacks and OCD.

Coach

Gene Benedetto, Clinical Psychologist

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Holding on to Fear !

by on May.22, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

Holding on to Fear !

One typical behavior I see among most of my clients who experience panic attacks, or intrusive/obsessive thoughts is that they hold on to their fears.

I am not saying that they are fully conscious of what they are doing or why, but nonetheless, this can be at the heart of why they experienced panic or OCD to begin with.

Many times I have expressed that when a person experiences conflicts in his or her life, especially when there is a habit to avoiding or ignoring the conflicts, that an inner sense of weakness develops. We have all made some bad decisions in life, and most of us have had experiences where we feel we did not handle a situation well. Many of us have felt we have been bullied or found ourselves controlled or manipulated by another person. If we never take steps to deal with the people or situations, if we allow ourselves to repeatedly avoid conflict, what is the result ?

Avoiding conflicts leads to an erosion of self esteem for sure. When faced with conflicts, we feel fear. We often feel anger towards the person or situation that presents us with conflict, but we are often angry with ourselves for allowing the situations to persist. With the erosion or self-esteem comes the equally painful erosion of trust in ourselves. This begins a never ending and blinding cycle of avoidance…deflating of self-esteem…anger with self….lack of trust in self….and then more avoidance.

Sometimes the reality of this cycle existing in our lives is just more than we want to admit to, except in our most private thoughts. As a result of this emotional cycle, many will experience the symptoms of panic , intrusive thoughts or the menacing pattern of compulsive or ritualistic behaviors that seem to run our lives. What happens then is that the symptoms become the focus of all our attention. The symptoms, the result of our fears, allow us to further avoid recognizing or dealing with the source of our pain…..avoidance.

It is never easy facing our fears. However, when lack of self-trust and a fragile self-esteem take root, holding on to our fears allows us to further avoid.

Yes…there is an answer…a solution. No quick fix, but a step by step approach to realizing and facing your fears in real life. You will most likely need a very close friend, an ally or a coach to help you through this process, because you have allowed yourself to be Ruled By Fear.
But, it can be done.

Coach
Gene Benedetto,
Clinical Psychologist

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Why My OCD has Flared Up Again ?

by on May.08, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

Why My OCD has Flared Up Again ?

Drew had been gradually taking more and more control of his obsessive-compulsive symptoms. He was actually quite surprised that he had such control after years of being troubled by intrusive thoughts and fears and the need to “check” , to go back on anything he did to make sure it was right. He would, in the past, take hours out of his day to go back and do his work over again for fear he forgot something and check any reports over and over to make sure there were no errors. His checking was so out of control that it was effecting his ability to do his job.

However, Drew had learned in therapy that there was a reason for him falling into his obsessive –compulsive behaviors, and that the intrusive thoughts that he had to check for fear of somehow failing or being out of control was all part of his need to feel in control of his life. He learned that ANGER was his issue !

He was brought up in an atmosphere where he learned to never express how he felt, to suppress his emotions in order to prevent arguments, possible rejection and conflicts.
So, once he learned there was a reason, he made a very big effort to recognize his anger and deal with those feelings more effectively. As a result, his intrusive thoughts were minimal, and his urges to check were decreased to the point of being rare.

So when Drew came for a follow-up appointment a few months later expressing that his compulsive need to check things was showing up again, it was not hard to discover why.

Drew had slipped back into his old habitual patterns of avoiding conflict. Yes, even with all the progress he had made, with all his insight and successes, it was all to easy to fall back into the “avoidant” mode he had so often practiced most of his life.

As soon as he had felt better, he lapsed back into avoidance and did not realize the slide. As soon as I mentioned “avoidance” he responded, “ How could I not see this. I just got back from a family trip to see my parents and siblings, and while there I found myself getting angry as my sister and sister in law both kept yelling at my kids, saying things to them that I felt were hurtful. I would take my kids out to play when it happened, but I never said a word to the offending parties. How could I not see I was avoiding ? I told myself that I was doing good by protecting my kids in that I removed them from the situation, but I never expressed my frustration, I never said a word. Just talking about it now makes me so angry. I am angry with them, but I am so very angry with MYSELF for being weak, for not taking control.”

This is how our mind works. It does not make us bad people, but avoiding makes us think and feel thoughts that are very uncomfortable. Those thoughts of being angry with ourselves lead to inner conflicts that spawn a sense of being out of control. Hence, we find ourselves doubting ourselves, second-guessing, checking.

Drew took this all in, and began to redevelop a plan to discuss his feelings with the offending parties and his family, to take control. He had to feel more assertive, that he was not going to accept the feelings that came over him when he avoided. Those feelings would instead be what would stimulate him to take appropriate ACTION rather than AVOID.

Coach

Gene Benedetto, Clinical Psychologist

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Fear of Change

by on May.01, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

It is so very easy to settle for less when you yearn for more. Deciding what needs to be changed is a challenge in itself, but once realized, we are most likely to overwhelm ourselves at the prospect of what needs to change.

I have seen first hand, and repeatedly, that if I have the opportunity to guide my clients not only to the source of their anxieties, but also have to chance to help them set up a game plan for change, a step by step approach, there success is much greater. Left on their own, most people allow their need for approval and fear of failure, rejection and embarrassment to cause them to try to make change with bigger bites then they can swallow, which ensures the frustration and often, failure that they fear.

Most often, we have developed certain habits of avoidance that cause us to put off anything uncomfortable, so we spend many of our productive years comfortably-uncomfortable, trapped as our life is Ruled By Fear.

Breaking free of our self-imposed entrapment requires that the degree of fear related to potential change is felt to be outweighed by the emotional pain, and symptoms we experience as a result of our avoidance of the needed change.

Creating a reasonable plan to approach needed changes in reasonable bites, step by step, requires patience for sure, but allows you to create some emotional momentum to help you take the next step.

The needed changes most often have to do with learning to more effectively realize and then communicate your needs, learn to deal with difficult people who often realize your need for approval and take full advantage of your need to please, but mostly to see yourself doing things with your life that enhance your perceptions of yourself, your self-esteem.

Those personalities who are less wanting or needing of approval are able to rely of what they DO in order to foster their self-esteem rather than being as dependent of the nods and smiles and encouraging words of others. Now, those of us who do value approval from others may at times be at a disadvantage, but isn’t it better to have that emotional and intimate side of one’s personality, but realize the need to focus on our gifts and talents and seriously make an effort to realize the value of what we do ?

Coach
Gene Benedetto
Psychologist

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Trust…Listen to your Children

by on Apr.17, 2011, under STOPPING ABUSE

Trust…Listen to your Children

How many people in your life do you feel you truly trust ?

“The issue is that we need to get to know a man [or woman] and trust him to be who he proves himself to be. Instead, we trust people to be who we want them to be and when he is not, we hurt.”

There are people who trust no one, and although they are less disappointed when someone fails them, they live a life barren of emotional intimacy. Then there are the rest of us, who trust too easily, as we want closeness in our lives, in the form of support, approval and a sense of belonging.

I have seen many adult children of abusive and selfish parents wish so much to see the parent change and be more the loving and caring parent they always wished for, only to be terribly frustrated and angered to find that the parent never changes. Now again, we do not want to become paranoid and trust no one, but we do need to realize our wish to not look at the dark side of some people, to avoid conflict and angry feelings, does lead to a premature acceptance and trust of those who cannot be trusted.

People must prove themselves. My experience has been all to often that parents, siblings, relatives, friends, even teachers or other respected members of society who have been found to be abusive, emotionally, physically or sexually have a history of past behaviors that have been ignored, rationalized away, or excused when in fact they were bullet-proof examples of behaviors that should tell us they cannot be trusted.

Look at recent situations where teachers have been convicted of sexual relationships with their minor-aged students. I can site troubling cases where school principals, priests, ministers or coaches have sexually abused kids and yet on the surface, they are praised for their support of children’s causes.

Trust must be earned by those around you and justified by keen observation on your part. To this point, I would suggest that we LISTEN AND OBSERVE our children, taking nothing they say lightly. There are bullies of all ages out there, and we must not only teach our children that they deserve to be treated with respect, but that any time any behavior on the part of another child OR ADULT bothers them, causes them to feel fearful or guilty, those feelings are to be shared with BOTH of the child’s parents. The children need to know they will be heard.

When children or adults are abused, the abuser most often attempts to shame their victim into not exposing him or her, or makes the victim fearful of further abuse and harm. LISTEN AND OBSERVE any changes in your child’s behavior or demeanor. Open your eyes to the fact that among the many good people out there, there are truly dark people with needs that allow them to rationalize and justify some very sick behaviors.

Abusive people are cowards, insecure and needy in most cases. Don’t AVOID seeing people for who they truly are. Like the wicked witch from the “ Wizard of Oz ”, evil cannot be ignored or avoided. When it is avoided, it only grows stronger. While Dorothy caused the evil witch to melt away by dousing her with water, I see the water as a cleansing element that allows us to see the reality of the dark side of some people, and as exposing them to the light of day.

Coach

Gene Benedetto, Psychologist

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What Do Bullies Fear ?

by on Apr.12, 2011, under STOPPING ABUSE

What Do Bullies Fear ?

In one word, EXPOSURE !

There is no perfect human being. We all have faults and have made mistakes. Don’t tell me that you have not had one of those moments where you were daydreaming and said to yourself, “I can’t believe I did that, what WAS I thinking !” Part of our own personal development means we have to face our less proud moments and learn from them.

However, most of us, especially those who are approval seeking and adapting personalities who work hard to please, have a conscience and feel a responsibility to others around us, are especially targets for bullies. The bullies of the world have their own insecurities, usually rather deep and pervasive, which is why they tend to pick on others they feel they can dominate and control. In essence, they are protecting their own weaknesses from being exposed.

Something I have seen repeatedly when dealing with my clients who have or are being bullied, is that the bully almost always threatens his or her victim with more threats of harm or abuse. The bully or abuser has to make sure their victim is told that no one will believe her [or him] , and will use any knowledge they have of their victims past to shame her and render her fearful of exposure.

I have seen bullies and abusers do this even with a child victim. I have seen this repeatedly with male and female bullies and abusers of all ages. What the bully is telling you is that exposure is the enemy, it is what THEY fear and they are using it to frighten their victim so she will never expose him [or her].

If the bully actually realizes that he or she will be exposed, that the victim or potential victim can accept the mistakes or screw ups in their own life and those errors or past faults will not keep her from exposing the bully, all things change.

Ah yes, we must pick our battles carefully, and I would recommend talking to a therapist, minister or attorney to help document your experiences with a bully, but then realize that we have all made mistakes in our lives and that only makes us stronger. Unless of course, you have avoided dealing with issues and needed changes in your life. Then, because of the avoidance, your self-esteem is weakened and you are haunted by the past instead of feeling good that you have recognized and dealt with any chinks on the armor. Not dealing with issues and conflicts in the past makes you more vulnerable to bullies and abusive people.

We have all heard that some of the most successful individuals in our world have faced failures and turned them into opportunities. These people see life as experiences to work through, learn from, and then they move on to use what they have learned to do more worthwhile, meaningful and productive things. IF you do not want to be so VULNERABLE to bully types, DEAL with issues, people and situations you have avoided, learn from them, and grow stronger. Then the bullies have less of an opportunity to target you. But even if they do, the threat of exposure works both ways.

Coach

Gene Benedetto, Psychologist

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Trapped by Fear

by on Apr.09, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD, STOPPING ABUSE

I remember a situation where a young lady that I had worked with in the past had contacted me again because she was experiencing a set-back where her panic attacks were returning with a vengeance, worse than ever. At first, she was just so overwhelmed and disappointed by her symptoms that I knew she could not even hear what I was saying. But, I allowed her to vent as i knew she needed to, then I began asking some probing questions.

As I listened, I recalled that she had become, for the most part, agoraphobic, very infrequently leaving her apartment. I recalled that she was living near her parents, and due to her anxiety, was somewhat dependent on them financially. She was in conflict with them as they would foster her dependency on them and yet embarrass her with comments that she should be out there on her own. I could see many co-dependency issues at the time where the mother, being unhappy in her marriage, wanted to keep her daughter close.

I thought about past sessions where she would be in such conflict over a boyfriend who was actually very psychologically controlling and was manipulating in order to have her dependent on him sexually.

When I had last talked with her, she had been taking on-line schooling and had an online job, Great steps toward gaining some financial security, but at the same time, making it terribly convenient for her to not have to leave her apartment, her comfort zone.

She dared to dream of being independent. She even cut off communications with the intrusive boyfriend, a huge step after all he did to create dependency of her on him.

Her panic attacks subsided.She was at least feeling some direction and hope.

I could see, as i listened to her, that as expected, her isolating herself had left her vulnerable still to her anxieties. She had become comfortably uncomfortable with her situation, but realized she was still trapped. The job did not pay enough for her to be on her own, the parents were still creating conflict with their mixed messages, and the ex-boyfriend, if one would call him a friend at all, was calling and texting her. In response to the latter, she was not answering his calls or responding to his texts, but she did hear and read his comments. Feeling very lonely, she imagined somehow it might be different this time with him, but then reality would hit and she would remember the pain he caused so often, and how he used her.

However, in her mind, this did not have anything to do with her panic. She was not in that relationship anymore, and her parents were just who they were and would never change.

And then she said that she cannot do anything about any of these issues because of the anxiety and panic. And my response was, you cannot stop the panic until you trust yourself to do something about those issues and conflicts.
The reality was that the panic attacks began again AFTER she started getting calls and e-mails from him. Besides the need to take steps to become less dependent on her parents and her need to have a plan for her life, she needed to trust herself that she would not be vulnerable to this man again. In truth, the one thing that kept her from letting him back in was her PAIN. I asked her one simple question. “If you were free of your panic attacks and any significant anxiety, would you be tempted to go back to him?” She responded, yes !

So, in truth, she was subconsciously creating the panic to prevent herself from forgetting the pain that he created and that she had been so vulnerable to. This is an example of a hidden agenda, a cause for anxiety and panic, where we do not trust ourselves to do what we need to do to protect ourselves, so we use our symptoms, our pain, to create a detour.

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When Approval Becomes and Obsession

by on Apr.03, 2011, under Anxiety, Panic Attacks, Agoraphobia and OCD

If you see yourself as an approval seeking personality, one who either tends try to fix and take care of others [caregiver] , tends to bend over backwards to do what you feel people expect of you [conformer], or stretch to the point of often overwhelming yourself in order to do the “shoulds” [perfectionist], you may be at risk.

Now, there is nothing wrong with wanting approval, and working hard to seek it as long as you are not sacrificing bits and pieces of who you are and what you need and want to truly feel a sense of fulfillment in your life.

The issue becomes more of a troubling one when the “want” truly becomes an “NEED”.
When a caregiving person needs to be needed to the degree that a dependency on being needed is formed and resentment or anger develops as people do not recognize that the caregiver also had needs. The caregiver may even deny their needs, or not recognize they exist so as to ensure their role as the caregiver.

The conformer may strive to do what is expected, or better yet, what they perceive people expect of them, but how far does a person go to seek that approval if in fact, he may not always agree with what others want ? What happens to a person’s personality and self-esteem when they avoid their own needs, sacrifice what they want or believe in only to please another ? What price does the conformer pay for that approval ?

The perfectionist, oh how she may strive to be the best at what she does. But, if as is often the case, at the heart of all that effort is the want for approval, what happens when all she does is taken for granted and expected? She tries even harder, of course. And then comes the burn-out.

No, there is nothing wrong with wanting or seeking approval. It is NEEDING it that becomes the obsession.

Coach
Gene Benedetto, Psychologist

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