Tuesday, May 26, 2015

Coping With Boundary Pushers

As many of you know, boundaries is one of my favorite words.  There are two types of boundaries that we need to develop and they must be in sync with each other for us to be truly empowered. Internal boundaries consist of our self-talk.  If we do not give ourselves permission to say no to someone even when it is not only not in our best interest to say yes, but also harmful, than we are not protecting and valuing ourselves.  We can say no to something and still be a very good person.  Just because we can do something does not mean we should.  Shouldn’t we help people and be willing to do so?  Absolutely!  That being said, however, we also need to put ourselves in the equation.  We can work as hard as the person we are trying to help, but not harder. When we work harder, we are enabling the other person. If a friend or family member is in crisis, be there for them.  If they are in the hospital, visit them.  If they want you to do errands for them because they are busy, and you are also busy, it is perfectly ok to say no.  If they want you to pick up a prescription or some groceries for them and they do not pay you back or get annoyed with you when you ask for the money or can’t help them, then they are entitled and you are not taking care of yourself.  

 When you find yourself feeling guilty when you tell someone no, did the other person make you feel guilty or did you make yourself feel guilty?  If the other person made statements to induce guilt, that is manipulation and the agenda behind the manipulation is not in your best interest.  If you made yourself feel guilty, you need to learn to challenge the concept that you are not allowed to say no or take care of yourself.  What about the external boundaries I mentioned earlier?  The external boundaries will stem from the internal boundaries.  If you do not give yourself permission to set a boundary, you won’t.  If you give yourself permission to set boundaries, you are more likely to say no.  When your internal boundaries are becoming healthier, it sometimes takes longer for the external boundaries to follow.  Most of us do not like to disappoint others or feel that someone we care about thinks negatively about us.  That is when we have to remember that people’s reactions are about themselves and not us.  Our reaction is about us.  We cannot control what another person thinks or feels.  We can only control what we think and feel.  With healthy and strong internal and external boundaries, we usually feel much better about ourselves and our confidence and self-esteem grows and grows, making us less susceptible to manipulation and guilt, which, of course, reinforces the good boundaries.

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Friday, May 22, 2015

When Someone You Love is Diagnosed With Cancer

    Even today, with so many successful treatments, cancer is still a very scary word.  Most of us, when we hear cancer, we automatically think about nasty treatment that makes people feel sick, and then we think about death.  There are so many different types of cancers and treatments that we just can’t make assumptions.  Prognosis depends on the location of the cancer, what stage it is in, how quickly it was caught, whether or not it has spread and where it may have spread, and what treatments are available.  I think one of the most important factors is the attitude and mind set of the person with the diagnosis.  Over the years of working with people diagnosed with cancer, I have met people that were told their cancer was terminal and I have met people that were expected to survive and did not.  What is the psychological difference and why does it even matter?  The mind and the body have what is called a symbiotic relationship.  This means that the mind and the body are interdependent upon each other for survival and what affects one will affect the other.  We can never underestimate the power of the mind.  The person with the diagnosis is going to be scared and overwhelmed and confused.  They need to be in survival mode and focus on getting better.  How can you help them?  Be there for them and ask them what they want or need.  If they are the type of person that will not ask, then think of ways to make their lives less stressful.

Go to appointments with them, include them in social invitations, take them out to lunch or bring them lunch (finding out what they can eat of course).  Help them with research, take notes for them at the Dr. appointments, take them to chemo and wait with them, remind them how much they are loved.  When they are tired, give them positive feedback about how hard they are working to get better and how proud you are of them. Let them rest when they are tired and respect that they may need alone time because visiting or talking is too much of an effort.  Bring them pictures, videos, sayings that give hope and can make them laugh.  Visual imagery is so powerful and if they do not know what this is or how to do this, help them find a therapist that works with patients coping with cancer.   I have had patients imagine that they have dragons in their body burning the cancer cells, or armies going into combat and the cancer cells are the enemy.  One patient even visualized tiny angels in her body fighting the cancer cells.  The patient fighting cancer also needs someone to talk to that they don’t feel they have to protect and therefore censor what they say.  That is another reason to suggest they see a professional.  It is their safe place to talk, express fears, cry, get angry, and get strong.  If they ever express any hopelessness, remind them that the mind can do amazing things and they can be the one that is in the percent that beats the odds.

Overall, just love them and be responsive to their changing needs.  As you are doing all this, don’t forget to take care of yourself.  You are also scared and hurting and you need balance in your life.  You may find you feel guilty that you are healthy and not fighting cancer.   Remind yourself that guilt is misplaced in this situation and you also need to laugh and play and normalize your life as much as possible.  Don’t forget to reach out to the people you are close to in your life to talk about how you are feelings.  If you are really struggling and afraid of losing someone you love, you may also benefit from talking with a psychologist who can help you with coping skills and listen without judgment or needing to be protected.

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Monday, May 11, 2015

Living With A Mentally Ill Spouse

There are so many types of mental illness and so many levels of impairment within each mental illness, we would need a blog to address each specific illness and how that illness affects the spouse.  Therefore, this blog will be very general.  Maybe you married your spouse knowing they were mentally ill or maybe you found out later in the marriage or maybe the mental illness did not evolve until after you were married.  Regardless of the path you are walking with your spouse, your marriage has some extra stresses placed on it, for both of you and any children you may have.  The first step in living with mental illness is to have a working knowledge of the illness so you can both be good consumers and learn how to best manage the manifestation of your illness.  You need to read about the diagnosis, and from credible sources, not just off the internet.  Both of you need to work with a psychiatrist and psychologist (or therapist) to understand the illness and develop a system that minimizes and maximizes control over the illness.  For example, you and your spouse could benefit from learning the warning signs that a break through episode is about to occur.  If your partner has bipolar disorder, for example, and you want to try and avoid hospitalization if at all possible, write out a list together of all the warning signs/symptoms that would alert you that a medication change may be needed.

Be supportive of your spouse, they did not ask for the illness.  Support may come in the form of empathy, but also comes in the form of being involved in treatment and preventative actions.  You need to learn as much about the disease as your spouse, you need to know who is treating your spouse and also be comfortable talking to them about what you see, and you need to work closely with your spouse not only to try and avert episodes, but also the best way to minimize spousal and family distress and hurt during an episode or hospitalization.  Most importantly, treat your spouse with respect.  Just because they have a mental illness does not mean they are not smart and aware.  When at all possible, have your spouse involved in treatment decision making and pre-plan in case they have an episode that does not allow them to participate in the moment.   There are many communities that offer support groups to both the individual and the spouse and these are always worth checking out.  Be honest with your children at a level they can understand.  Being honest with children is so much better than your child filling in the gaps with their imagination.  To the youngest of children you may want to call the mental illness a boo-boo in the brain that sometimes makes that parent feel or act a certain way, but the parent always loves the child (children).  To an older child, explain that the parent has a chemical imbalance in the brain that makes them feel or act a certain way, and again, the child is still loved and wanted.  When your child is approaching becoming a young adult, share the diagnosis and the family history so that your child is aware of their genetic background and can be informed for themselves and their future family.  Remember, there is always help out there, you have to reach out for it and accept it.

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Wednesday, May 6, 2015

Fifty Shades of Grey

I have been asked by many parents of teenagers if it is alright for their child to read FIFTY SHADES OF GREY, and currently if it is all right for them to see the movie.  NO.  The book is about a young, naive, recently graduated college student with insecurity and abandonment issues.  She meets a slightly older, insecure man with even stronger abandonment issues who has learned to compensate by being beyond successful in business and becoming a billionaire.  The man is also into bondage.  Boy meets girl and they try not to fall in love as they are very different and the girl does not like to be controlled, punished, and given pain as part of their sexual experience and he feels that while he can give her some of what she wants sexually, his needs must be met.  As the story unfolds over the trilogy, there are very explicit descriptions of their sexual behavior and the basis of their relationship appears to be sexual.  He dominates and she tries to break free.  He loosens up some and they get married and live in a mansion and have a couple of children.  They engage in a sexual life style that is outside the norm for most people.  This is just not the book to introduce love and sexuality to teens, both boys and girls.  If you allow your high school student, who is probably already confused and conflicted about sexuality to read this book, you are providing a very slanted view. There is a part of the book where the girl, Anna, thinks about liking her partner’s control and protectiveness, as long as she can handle it.  Again, this does not reflect a healthy, mature relationship.  As for the movie, it is rated R, so it is not as sexually explicit as the books, but it also does not leave anything to the imagination and the dynamics in the movie are the same as in the book.  I would not introduce a young teen to this movie.  However, a young adult over the age of 17 has probably already formulated some idea of their sexuality based on their exposure to the media and their own initial exploration.  If your older teen does read the books or see the movie, it might be helpful for them if you have a conversation about the story and why it is not healthy and only represents a very small part of the population.

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