Cutting

     Cutting yourself is never good.  It is a dangerous and dysfunctional way of coping with stress and emotional pain.  Why do people cut themselves?  Some claim that the physical pain replaces the emotional pain and makes them feel better. Others report that it is self-punishment for real and perceived faults and “crimes”.  Whatever your reason, you will have a very difficult time stopping if you do not develop more effective coping skills to replace the cutting.  Try to intervene before you reach for the knife or razor.  Make a list of your safe people and reach out to one of them and talk about what is hurting you.  Sometimes just the act of sharing can help so you do not feel so alone.  Also think about activities you can do to distract yourself from the urge to cut until the urge passes.  Journaling, music (upbeat only), art, and physical activity can often be positive diversions. 

Seek out therapy and work through the issues that are causing you so much pain.  Therapy is also helpful to make you feel less alone and isolated.  Make a contract with a trusted person that you will call them rather than cut and the person you call will listen and not criticize.  Remember, cutting leads to physical and emotional pain, not pain resolution.  Whatever your issues, you do not deserve to be punished by cutting and you will not relieve your pain by cutting.  Learning to accept yourself and building confidence is your greatest defense against emotional pain. 

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Being Single is not a Crime

 Some people embrace being single and others find it scary and lonely.  Which category you fit into depends on your outlook and interpretation of what single means.  If you interpret single as meaning alone, lonely, and unwanted, just waiting for life to start, then you will most likely experience a host of negative emotions.  However, if you look at single as just where your life is right now and accept and embrace it, you will most likely live richly.  Whether single or in a relationship, it is your responsibility to make your life have meaning.   You have to be the proactive person in guiding your life.  Reach out to people by doing the things you like and exploring activities you think you might be interested in.  Join a club or an organization, take up a sport, and go to events in your community. 

You are more likely to meet someone with similar interests if you do the things you like.  Also, as you gain in confidence you are more likely to meet someone else who is healthy and confident.  Whatever you do, don’t settle.  Selecting a life partner is one of the most important decisions you will ever make in your life.  Do you really want to spend your life with someone you don’t really love or respect?  That would be so unfair to both of you.  Patients often ask me, “What if I never meet anyone?”  If you never meet anyone you want to spend your life with, accept it and go on and make your life amazing.  When you work on expanding and enjoying your life and bringing meaning to your life, so may opportunities will open up to you that you probably can’t even imagine right now. If you are embarrassed or ashamed about being single, challenge those negative thoughts.  The best way to challenge those thoughts is to look for evidence in your own life to support the meaning your life has.  Make a list of things you want to experience and places you want to visit.  You have to be the one to make your life worth living, not someone else.

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Dating Rules For Success

1.      Do not pretend to be someone other than who you are.  If you don’t like heights, don’t agree to go bungee jumping just because you told your date that you won an award for bungee jumping.  Pretending can get you into all sorts of trouble.

2.      Do not pretend to like something that you do not like.  If you don’t like brussel sprouts, don’t pretend as you could spend the rest of your life trying to feed them to your dog or hiding them in nearby house plants.

3.      Do not complain about your current or past dates or your life. Nobody likes a whiner.

4.      Do not talk badly about other people.  If you do talk badly about others, your date that you like so much, may be wondering what you will say about him/her and there may not be a second date.

5.      Be kind.  Kindness is under rated and people of all backgrounds respond positively to kindness.

6.      Be interested.  Everyone has a story.  Really.  Any story can be interesting if you listen.  And if it is not interesting, than share your interesting stories.  At least you will get practice talking about yourself.  When their eyes glaze over, it is probably time to move on to another topic.

7.      Be patient, as your date may be nervous.  Nervousness is cute and tells you that the date is important to the other person.

8.      If asked what you would like to do, make a couple of suggestions.  Have a couple of ideas for later in the date that don’t involve a lot of money.  That shows consideration on your part.

9.      Ladies, eat something.  Everyone knows that females do eat. Guys, don’t comment on what she is eating.  This is self-explanatory and if you don’t get it you may not deserve a second date.

10.  Thank your date for the date and let them know if you are interested in seeing them again.   If you don’t drop a hint, like “I look forward to seeing you again” or “It is ok for you to call me again”, your date may not realize you enjoyed yourself.

11.  Do not have unrealistic expectations of this date.  It is just a date.  For those of you with some co-dependency issues, a date is just a date and not a lifelong commitment.

12.  Follow your instincts about another date.  If your instincts say yes, go out again.  If your instincts say no, do not go out again.  It is important to trust yourself.

13.  Ask questions, don’t just talk about yourself.  If you monopolize the conversation, you may come across as boring and narcissistic and you miss the opportunity to get to know more about the other person. 

14.  Be on time.  This is a pet peeve for many people and can kill a second date.

15.  Be courteous.  Old fashioned though it may be, “thank you” and “excuse me” still go a long way in impressing other people that you have some social consideration.

16.  It is reasonable to date multiple people, but don’t discuss other dates with your current date and once monogamous, outside dating is discouraged.  This is self-explanatory.

17.  Expect the man to pay, but offer to contribute.  If he takes your money, he may not merit a second date.  This is an individual decision, but I think the guy should show you that he is really interested and also generous. 

18.  Let the man make the initial date.  Hints are fine. “We should get together some time” is a good old standby.

19.  Don’t have sex on the first date.  You don’t really know who you are with yet and what are you telling the other person?  You are telling them that you don’t really respect yourself.

20.  If you have children, don’t keep it a secret.  Children are part of a package and some people are just not interested in a package.  

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How do I find a therapist?

     There are many different therapists out there to choose from.  Some are wonderful and some are not so wonderful.  The first step is to make an attempt at clarifying for yourself what you want to accomplish in therapy.  For example, do you want help with depression or anxiety, or do you really need a diagnostic workup because you suspect the problem but are not really sure?  Do you need help and guidance dealing with an external issue, such as a work struggle or friendship issue?  Do you lack the confidence or self-esteem you feel you should have?  Are there past childhood issues that need to be resolved or are you experiencing marital conflicts?  The second step is to decide if you want individual, couple, or family therapy?  The third step is to do some research on the different types of therapy that are being offered from psychoanalysis to cognitive behavioral therapy, with many options in-between.  Next, be open and honest with your Primary Care Physician (PCP) as that is the first place to obtain a referral to a psychologist or psychiatrist.  Your Dr. probably knows a few mental health professional that he/she can recommend, which is better than just picking out a name from an insurance list.  If your Dr. can’t make a recommendation for you, than call your insurance company and get a list.  Try and look up the professionals on the list and get a feel for their specialty.  It does not make sense to want couples counseling and find out in the first session that the therapist you chose does not do couples counseling.  

When you call to make your first appointment, be clear with the office staff about what you are looking for.  It is also reasonable to have a preference for either a male or female psychologist.  If you know a family member or friend who is seeing someone, that is sometimes the best recommendation because your family and friends will be honest with you about whether or not the therapy seems professional and helpful.  All that being said, therapy is like dating.  If you don’t click with the first psychologist or psychiatrist, meet with another one.  You can be a wonderful person and the therapist can be a wonderful therapist, but the chemistry just may not click and much of the therapy is intertwined with the personality of the therapist.  Also, for those of you who are not sure, a psychiatrist is a medical doctor and treats with medication (also called the biological approach) and the psychologist treats with talk therapy. Therapy is a safe place to work on resolving whatever issues you want to address, and don’t worry, the therapist has heard it all before and you will not shock them.   

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No Children, No Carbohydrates, Not Retired

    Many people call this the empty nest syndrome and it can hit a person at many different stages in life.  In some ways, it may be more difficult for the individual who had their children later in life.  This is very common among professional women.  You may have spent your twenties and early thirties developing your career and then you decided to have children.  Now you are in your fifties and your last child is leaving for college and you have to decide what to do with the rest of your life.  Unlike your younger counterpart, you do not have twenty to thirty working years ahead of you, but maybe only ten or fifteen.  Have you stayed in your career all along and do you want to ramp it up or slow it down?  Did you stop working and now feel you need a sense of productivity and meaning in your life and if so, how and where to start?  There really are no right or wrong answers.  Everyone has to find the answer that works best for them.  Whatever direction you go, realize that life is not over.  Your children still need you, just in a different way.  You need to play with ideas of what you might want to do.  The career you had before children may no longer seem attractive to you or you may need to be retrained and just not feel that is what you want to do. Do you want a career or a fun job?  If you really want a career, begin to do your research and weigh all your options.  I have met people who have gone to graduate school after children have left and I have met people who left careers and taken on part time, low stress jobs that they loved. 

I have also met people that enjoyed volunteering and people who embraced an early retirement.  Just don’t sit home and wallow.  Think about the things you did not have time to do while raising children.  Get healthy, eat better, find exercise you actually like, and take a class or pursue a hobby.  Your post children life can go in so many different directions.  If you don’t like the one you are in, pursue another one.  Life is not over.  You are at the beginning of   a new chapter.

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Coping with Procrastination 

     “I’ll do it later.” How often have we heard this or said it ourselves when we just really didn't want to do something. Why do people procrastinate and what can we do about it? People procrastinate for many reasons.  If something seems too hard or overwhelming, we have a tendency to put it off.  Maybe you don’t have enough information or guidance and are not sure where to start.  Maybe what you have to do is outside of your comfort zone and you feel insecure and concerned you will do the task incorrectly.  Maybe you would just rather be doing something else and maybe you just don’t like the task at hand.  Whatever your reason, think about what you have to do, whether or not you need help, guidance or training, the stress you will eliminate if it is not hanging over your head, the feelings of accomplishment that accompany completion of a task, and how you will create balance  in your life by rewarding yourself with something that you do enjoy.  Many patients have looked for guidance on how to get themselves to complete paper work such as bills and taxes (for those of you who love paperwork and numbers, we will come up with other examples).  If your project seems complicated and you are not that organized, enlist someone to help you organize so it is not so overwhelming.  If you just don’t know where to start and you are not sure what to do, obtain some training that will allow you to feel more comfortable.  

Break the project or task down into smaller chunks that do not seem so huge and overwhelming.  Making a schedule to keep a project flowing is often very helpful.  If you don’t like the task, reward yourself with something you really enjoy after completing the task (this is what I do with housework).  Give yourself praise for completing something that you were either afraid to do or just didn't want to do.  You know when you are making excuses.  It is so important that you be honest with yourself and not lie to yourself.  It would be healthier to acknowledge to yourself that you don’t want to do something and you are going to do it anyway so it might as well be now.  If you do it now you can have fun later but if you have fun now, it won’t be as much fun because you know what is waiting for you.

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Married  and Unexpected Pregnancy 

    I was recently asked how to cope with an unexpected pregnancy when you have your life situated and you have the number of children you want.  People can have many different reactions to this ranging from excited, depressed, anxious, and scared to a combination of all of the above.  If you are keeping this baby, than the main goal is acceptance.  First, take care of your health as denial will not help you.  Second, think about all the positives to having another child.  Another person to love and nurture and to love and nurture you in return.  Remember how you keep falling in love with your children when they tell you that they love you, draw a picture for you, make a mother’s day gift for you, overcome a challenge and succeed.  Yes, they are loud, noisy, and at times defiant and difficult.  But they are funny, loyal, and you get to re-experience the world through fresh new eyes.  For most people, there is never really a perfect time to get pregnant.  And yet, each pregnancy is at the perfect time if we allow it to be.  It is often the last “oops” baby that can bring us the most joy.  We are usually experienced and seasoned by the time we have our last child, which frees us up emotionally to enjoy them in a much more relaxed way.  We are not as focused on what every step is supposed to be about because we have already been there and we generally know what to expect.  If finances are one of your biggest concerns and you already gave away all your baby furniture and items, reach out to family and friends for help.  Most of our family and friends are happy to help prepare for a new baby.  If you are worried about the change in life style, the neat thing about a baby is that you really can bring them almost anywhere.  If you need a baby sitter and can’t really afford it, maybe you and another mother can co-opt some babysitting time.   If you have children who are not happy or receptive about the idea of a new baby in the house, let them know that this is the family’s baby and they will be great at teaching the new little one all kinds of things.  They get to be the big brother or sister, which will have certain privileges associated with it (such as being able to do something first).  If the new baby has to share a room, have that sibling help decorate and set up the baby’s area, and even help pick out some blankets and baby toys.  The more involved they are, the more acceptance you are likely to see.  I was asked how to accomplish this type of acceptance if you are already mentally and physically exhausted by caring for the children you already have. This is a good time to look what is currently not working and consider some changes.  If you have no idea how to start re-structuring your life, maybe consult with a professional for some guidance. 

 It is possible you are working too hard and not enjoying enough of your life.  If your current children are a handful, maybe reach out for some guidance on how to tighten your family system and parenting so your children behave in a more cooperative way.  For example, are you being consistent with your children or have they learned that you don’t really mean what you say (or threaten).  By the way, never threaten anything you are not willing to follow through on. If your fears are more personal, such as changes in your body, you need to address that with your Doctor and yourself.  Ask your Dr. for a healthy food plan and exercise plan during the months of your pregnancy.  If you take care of yourself, the body you became pregnant with should be the body you end up with post pregnancy (with a few months of special attention).  If your hesitation involves marital issues, you and your spouse need to communicate and resolve the issues prior to the new baby and you can certainly streamline this process with professional intervention.  Most importantly, every baby deserves to be wanted and loved, especially your baby. Remember, this baby may someday be the person in your life who gives you the greatest joy.

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