All posts by gabbert2013

About gabbert2013

I have been a psychotherapist for 20+ years. I specialize in Marriage & Family Therapy and addictions. My practice name is Interactions Therapy Center. I've learned a few things over the years and hope you'll find these blogs interesting.

Want to Feel Less Stress? Turn Off the Noise

It is said that the eyes are the windows to the soul. In fact, the eyes do provide lots of information about a person’s emotional state. But research now points to the ears as a source of information about one’s inner world. To be more specific, earwax can reveal stress levels.

One study demonstrated that a build-up of the stress hormone cortisol can be measured in earwax. Cortisol is a “fight or flight” hormone that sends out alarm signals to the brain in response to stress. Cortisol can be measured in blood, but this provides a snapshot of one’s hormone level in time, whereas earwax shows a build-up of the stress hormone. Researchers are hoping that earwax can provide a measure to supplement or inform diagnoses of depression and anxiety. It will make mental health assessments more accurate.

Noise itself is stressful. Have you noticed the high number of people blowing leaves in your neighborhood? Many of us who work from home, thanks to COVID-19, are annoyed by the sound. Leaf blowers are at the top of noise complaints. It’s distracting to be in a Zoom meeting and have a loud, irritating leaf blower outside your door.

“Exposure to noises from crowds, traffic, and other everyday sounds can become harder to tolerate and increase stress levels, leading to anxiety and a reduction in overall quality of life”, according to audiologist Dr. Stephanie Tompkins. She also suggests that noise sensitivity can lead to isolation as an attempt to avoid noisy situations.

Did you know that people often become more sensitive to noise as they age? This can affect their mental and physical health such as a higher risk of heart attacks and strokes. As we age, it is normal to become less tolerant of certain noises that feel too loud and jarring.

It is difficult to feel calm and centered in the midst of noise pollution.

What can you do? Reduce your time in loud places. Reduce the noise in your home. For example, I mute commercials when watching TV. Mute general noise in your home by absorbing it with carpet, drapes, and rugs. Plants soak up sound waves. Wear filtered earplugs and noise-canceling headphones. Keep in mind that not all noise is bad noise. Using a white noise machine to minimize the impact of outside noise can reduce stress caused by noise pollution. Set aside noise-free times. You’ll feel better.

Let’s Not Be Gridlocked on our Differences

One takeaway from the Trump-Biden presidential election is the polarization of America. In viewing social media, many people voiced surprise, even shock, that so many people were on the opposite side of the divide. How can this be such a close race?

Social media has turned into a format to share preferred world views. When these world views collide, they can create animosity. How could you believe that? Lines have been drawn in the sand in terms of what we cannot tolerate. This election has caused us to clarify which friends we are most aligned with and which we most different from. I have a friend who took a Facebook hiatus to establish some distance from views that she did not support or condone. She then purged 150 “friends” from her network. Another friend expressed himself passionately that he cannot and will not remain friends with people who share the values of his opposing candidate. Should we draw a line in the sand and block contact with people who were previously in our social circle?

The United States needs another reconstruction from what seemed at times like political civil war. Joe Biden will take the helm of a divided country to bridge the divide. He will embrace the nation as a whole, not just Democrats. He understands that compromise is good, and modest progress is still progress. While Joe Biden is tasked to bridge a political divide, the rest of us are tasked with bridging the divide on a personal level in our social circles. If we don’t, our country will continue to polarize. I believe it is our civic duty to engage in dialog to move our country forward.

That said, there may be times when we are best served to terminate abusive relationships in which we are bullied or disrespected. Political extremists are generally not interested in the give and take of dialog. They may be overconfident in their positions and intolerant of differences.

Spencer Critchley is the author of “Patriots of Two Nations: Why Trump Was Inevitable and What Happens Next,” about why Americans have such polarized views of the world. “We must learn to respond to people in a more intuitive way,” Critchley says. “We must build trust. Connect first, debate later.” He makes several suggestions for talking with fellow Americans of opposing political beliefs.

  1. Right from the start, show respect, goodwill, and vulnerability. Leave your defenses behind and show you’re ready to be honest and authentic.
  2. Control the natural human instinct to judge people who disagree with you. Just be aware of what they’re saying without trying to correct them. You can return to your differences later, maybe, after you’ve established trust.
  3. Look for your points of agreement. De-emphasize the differences. Trust can grow from shared values.
  4. Focus on building trust, not making points. When ideological opponents can stop vilifying each other, and can stop viewing different viewpoints as evil, American society can resume the work of compromise and progress.
  5. Don’t expect opposition to disappear. The point is not to eliminate conflict but to repair our society’s ability to handle it constructively.

 Our goal should be to establish a dialogue about our differences that communicates respect rather than allowing our differences to fall into a gridlock.

It Is Our Moral Duty To Warn

As a mental health professional, I am a mandated reporter and have a duty to warn potential victims if I believe that my client may be in imminent danger of harming others. In fact, it is my duty to warn the victim even if it means breaking confidentiality. The danger must be imminent and the report should be made to someone who is in a position to reduce the risk of the danger, such as law enforcement and the intended victim. I have not been told that the duty extends to Covid19 and the duty to protect others from communicable diseases. But don’t we all have an ethical duty to prevent harm to others?

Our current knowledge of Covid19 leads us to believe that it is a highly contagious and potentially deadly virus. Even asymptomatic carriers can be contagious.

My sister-in-law told me of her concern while frequenting an outdoor restaurant with friends. The owner of the establishment chose not to wear a mask while preparing or serving food, and also chose not to enforce these precautions with her staff. My sister-in-law felt unsafe and wondered who to address her complaints to.

What happens when a business won’t follow the guidelines? People may file complaints if businesses are not following mask guidelines to prevent the spread of COVID-19, but local health agencies have limited power to enforce rules. Their actions generally take the form of education and requests, rather than enforcement.

I intended to gather with my family for pumpkin decorating last weekend. It was canceled because the hosts didn’t feel well. They wrongly assumed that they were experiencing side effects following a preventative flu shots. However, they subsequently learned they had been exposed to Covid19 on the job without realizing it. They both tested positive for Covid19, having been exposed on the job, but neither had been warned about the exposure from their employers.

Employers are caught between a duty of privacy and a duty to warn. Covid19 presents new, unanticipated liability risks for employers. An employer’s duty to warn of a known risk of Covid19 infection needs to be weighed against another legal duty placed on employers – the duty to maintain the medical privacy rights of its employees.

My Covid19 positive family members did not wait for their employers to take action. They took it upon themselves to contact their co-workers with whom they had had close contact. This then allowed their co-workers the opportunity to quarantine and get tested to safeguard their circle of contacts.

Contact tracing is used by health departments to prevent the spread of infectious diseases. It slows the spread of infection. For contact tracing protocol, see Contact Tracing by the CDC, June 21, 2020, cdc.gov.

It’s a moral responsibility to protect others from coronavirus.  Even if we are not worried about our own health, it is our moral responsibility to protect others whose bodies may not be able to fight off the virus as easily. Covid19 symptoms are mild for most, but severe for some.

If you witness regulation violations, consider reporting it to your local health department. If you suspect you have Covid19, self-isolate, and get tested. Give your contacts a heads up on a possible spread of infection.

I Wish You Enough

There is a poem attributed to author, Bob Perks, which goes like this:

“I wish you enough sun to keep your attitude bright no matter how gray the day may appear.

I wish you enough rain to appreciate the sun even more.

I wish you enough happiness to keep your spirit alive and everlasting.

I wish you enough pain so that even the smallest of joys in life may appear bigger.

I wish you enough gain to satisfy your wanting.

I wish you enough loss to appreciate all that you possess.

I wish you enough hellos to get you through the final goodbye.”

We are rarely fully satisfied with what we have. Whether it is love, money, friends, or toys, we always seem to want more. We are content with what we have until it is no longer new. It becomes commonplace, and we want newer, bigger, and better things. We are happiest when we don’t want.

I’m reading The Big Tiny, by Dee Williams, which chronicles her journey of downsizing from a spacious single-family house to an eighty-four-square-foot tiny house on wheels. It caused me to wonder if I could live a minimalist life. Could I strip myself of materialistic possessions as a trade-off for financial freedom, time with family and friends, and peace of mind? I’m not sure.

Did you know that the self-storage industry has skyrocketed in the last 20 years? Americans need 2.3 billion square feet of extra space just to fit their stuff. Our homes on average are three times the size of the average household 50 years ago. But it’s not enough. We have more cars per person, eat out twice as much, have big-screen TVs and multiple devices, yet we are not happier.

Have you heard the term “hedonic treadmill”, also known as hedonic adaptation? It is the tendency of humans to return to a set point of happiness despite major positive or negative events or life changes, once our needs for food, shelter and water are met. As a person makes more money, expectations and desires rise, which results in no permanent gain in happiness. You may have heard studies of people who have won lottery jackpots who are initially thrilled, but who say that they are no more or less happy than before winning the lottery a few years later. The happiness boost doesn’t last that long or wasn’t as intense as you’d imagine.

But here’s the thing. The anticipation of more is what makes us happy. The anticipation phase causes an increase in happiness chemicals. When the allure of the acquisition fades, it no longer boosts our happiness quota. We need something to replace it. This perpetuates the hedonic treadmill.

I’m told that in Buddhism, suffering is caused by craving. One element in the state of enlightenment is eliminating craving, being free from desire, being content, and being sufficient within oneself.

I feel challenged to want less. I want to learn to control my impulses and stop purchasing things, eliminate clutter, do more of what I love, spend more time on the things I love. Cravings for more will come and go, but the moments will pass.

What is enough for you?

What’s Your Conflict Style?

President Trump and presidential challenger, Joseph R. Biden Jr., held a debate on Sept. 29 that was described as a chaotic disaster. The candidates were instructed to stick to the subject of the question, “to encourage deep discussion of the leading issues facing the country.” The debate descended into chaos almost immediately. Voters overwhelmingly called the debate’s tone negative. President Trump was described as having bullied, bulldozed, and obfuscated his way through the 90-minute showdown. President Trump took every opportunity to speak over the former vice president. Over Trump’s interruptions, Biden responded by mocking the President, calling him a “clown,” a “racist” and “the worst president America has ever had.” Biden largely responded to Trump’s interruptions with eye rolls, head shakes, chuckles, and “C’mon, man” comments. He never lost his temper — but he made glaringly clear how little he thinks of Trump. Biden responded to a series of Trump interruptions by saying: “Will you shut up, man?”

This exchange is not unfamiliar to me as a Marriage & Family therapist. I often witness couples in conflict expressing themselves in the worse possible way as they re-enact their arguments in my office. I saw a Facebook post illustrated by a football referee calling fouls, intending to be humorous, that pointed out problems in the debate. Unfortunately, this is often what I see in the first session of couple’s therapy.

  1. Personal foul; attacked the opponent instead of his argument.
  2. Circular logic; argument has no supporting evidence.
  3. Defense demanded more proof after the offense successfully proved their point.
  4. Attempted proof by intimidation. Player failed to understand the difference between refuting a point and just shouting it down.
  5. Player provided no source.
  6. Play caught in an echo chamber. They refuse to accept any facts contradicting their own bias.
  7. Coincidence illegally substituted for proof.
  8. Illegal use of a word that does not mean what they think it means.
  9. Player here just to create trouble. Player is ejected with prejudice.
  10. Refused to accept any solution that was not absolutely perfect.
  11. Offensive foul, false dichotomy. There are more than two options.

Moderator, Chris Wallace struggled to maintain control. He repeatedly admonished Mr. Trump for speaking over Biden and disregarding the rules both sides had agreed to. My role as a therapist is not unlike a referee as I attempt to provide structure and guide the communication toward a productive and helpful engagement.

This debate made clear that additional structure should be added to the format of the remaining debates to ensure a more orderly discussion of the issues. Common debate ground rules are:

  1. Treat each other with respect. Name-calling, accusations, verbal attacks, sarcasm, and other negative exchanges are counter-productive and won’t be tolerated.
  2. The purpose of discussions is to generate greater understanding. Dissenting views accomplishes this goal. However, in expressing viewpoints, you should try to raise questions and comments in a way that will promote understanding, rather than defensiveness and conflict in others.
  3. Communicating is both about sharing different views and actively listening.
  4. Keep the discussion and comments on the topic, not on the individual. Don’t personalize the dialogue.
  5. Remember that it is OK to disagree with each other. Let’s agree to disagree.

According to the marital researcher, Dr. John Gottman, the Four Horsemen of the Apocalypse are considered to be the destroyers of relationship satisfaction and can be the slippery slope that leads to divorce. These Four Horsemen are: criticism, defensiveness, contempt, and stonewalling (which occurs when one partner shuts down).

Through his research, Dr. Gottman determined that newlywed couples who displayed the Four Horsemen were, on average, more likely to divorce 5.6 years following the wedding. In contrast, couples who didn’t have escalating conflicts but exhibited emotional disengagement divorced 16.2 years after the wedding.

Couples who present to therapy often display the Four Horsemen during conflict discussions. Therapists are trained to help couples find more adaptive means to communicate during these occurrences. In the face of the Four Horsemen, these therapists help clients learn and implement the antidotes to these destructive patterns of interaction:

Criticism – Gentle Start-Up

Defensiveness – Take Responsibility

Contempt – Build a Culture of Appreciation

Stonewalling –Self-Soothing, in order to stay calm and engaged

If your relationship conflict begins to resemble a Trump v. Biden debate, it is time to seek counseling.

Are You A Courageous Person?

Physical courage is overcoming a fear of death or physical harm. Firefighters, soldiers, and police officers are brave. Moral courage is acting against social behavior such as facing a fear of social ostracism, i.e. confronting a peer group over a racist joke. Psychological courage can be the most intimidating form of courage. It is the strength to confront the truth of ourselves and our behavior and is found when we make ourselves vulnerable to others. It is terrifying for most of us to share our private stories of fears, faults, and embarrassing moments.

13-year-old Brayden Harrington spoke shortly before Joe Biden accepted the presidential nomination at the Democratic National Convention on August 20, 2020. I was impressed beyond measure by this adolescent boy’s bravery to do so. Brayden stutters, and finds a companion in Joe Biden who also stutters. Brayden made a moving speech even while struggling to get the words out. Joe Biden had talked about being mocked and humiliated as a child by classmates and a nun, but overcame it. Most stutterers would decline the invitation to speak on a national platform, exposing a vulnerability to people who could also mock and humiliate him. But he did so with a smile and won the hearts of many.

I recently read a Facebook post from a woman who had been drugged, raped, and abandoned on the side of a road. On this, the 7th anniversary of the trauma, she told her story on a public platform. Again, I was impressed beyond measure at her bravery in speaking her truth. Her truth elicited similar stories of abuse from readers who had suffered rape, kidnapping, and domestic violence.

As a third example of courage, I have witnessed rigorous honesty within AA meetings. People in recovery are refreshingly honest in sharing their stories, from their weakest and most humiliating moments to the stories of hope that keep them sober. They share what is true and accurate as they come to accept and admit the hard-truths to themselves and others. This type of self-examination is truly brave.

There are benefits to vulnerability:

  1. A sense of social connection. If you share your vulnerabilities with people and are met with acceptance, you experience a sense of belonging. Shallow relationships become richer.
  2. Emotional support. Sharing your joy, sorrows, and frustration can lessen your pain.
  3. Encouragement. Those who hear your story can offer you encouragement to stay strong and endure.
  4. Practical help. By sharing your struggles, you gain access to resources.
  5. Health benefits. People with strong social connections recover quicker and have a longer life expectancy.

There are also downsides to vulnerability. Too much self-disclosure to the wrong person at the wrong time could be damaging.

Being psychologically courageous can bring new opportunities for healing and life satisfaction.

Suicide Prevention

September is National Suicide Prevention Month. All month, mental health advocates, prevention organizations, survivors, allies, and community members unite to promote suicide prevention awareness.

Suicide is the 10th leading cause of death among Americans, and it’s getting worse. From 1999 to 2018, the suicide rate has increased by 35 percent, according to the CDC. People of color have higher rates than other groups, such as American Indian and Native Alaskans, who have the highest suicide rate among all Americans. And there are rising suicide rates among black youth, especially boys. Their suicide rates are increasing faster than any other racial/ethnic group.

Dr. Jonathan Singer, president of the American Association of Suicidology (AAS), makes a distinction between suicidal thoughts, attempts, and deaths. “There is an assumption that there is a linear relationship between suicide ideation, attempts, and deaths, but there’s not.” And not everyone who has suicidal thoughts or attempts has a mental illness. Many people who had attempted or died by suicide did not have a known pre-existing mental health condition at the time of death.

Suicide Prevention Lifeline, suicidepreventionlifeline.org, offers these recommendations:

Ask: Research shows people who are having thoughts of suicide feel relief when someone asks after them in a caring way. Findings suggest acknowledging and talking about suicide may reduce rather than increase suicidal ideation. In a recent workshop that I attended, we were encouraged to normalize suicidal thoughts and ask directly, “It is normal for many people who feel the way you do, to consider suicide. Is this true for you?”

Be There: Individuals are more likely to feel less depressed, less suicidal, less overwhelmed, and more hopeful after speaking to someone who listens without judgment. Give them permission to speak their truth.

Keep Them Safe: Take away access to weapons. Some studies have indicated that when lethal means are made less available or less deadly, suicide rates by that method decline, and frequently suicide rates overall decline.

Help Them Stay Connected: Studies indicate that helping someone at risk create a network of resources and individuals for support and safety can help them take positive action and reduce feelings of hopelessness.

Follow Up: Studies have also shown that brief, low-cost intervention and supportive, ongoing contact may be an important part of suicide prevention, especially for individuals after they have been discharged from hospitals or care services.

I saw an interesting Facebook post on suicide prevention. “It’s suicide prevention month and just a reminder that affordable housing is suicide prevention; livable wages are suicide prevention; universal healthcare is suicide prevention.” The point is that prevention is wider than the individual. Prevention is also addressed on a systemic level.

On the upside, for every one person who dies by suicide, 280 people move past serious thoughts about killing themselves. Of those who attempt suicide and survive, more than 90 percent go on to live out their lives. There is power in communication. Sharing positive stories has a beneficial effect. Studies indicate that the reporting of individual suicidal thoughts following recovery is associated with a decrease in suicide rates. Suicide prevention centers on hope. People need hope to increase their will to live. It is important to share recovery stories.

Cringeworthy Moments

The definition of cringeworthy is something so embarrassing, awkward, or upsetting as to cause one to cringe. Imagine you are having a fine day, going about your business, when you are suddenly hit with a memory, and let out a gasp at the stupidity of the incident. Your body may have an immediate and involuntary physical squirm. That’s a cringe. And that is part of the human experience. None of us get through life without these moments.

It seems that not a day goes by that I don’t recall something that I have said, done, or thought that makes me cringe. How could I have said that? Done that? Or thought that way in the past? The memory may be decades behind us or have happened that day. But no matter how long ago the incident occurred, we still cringe with embarrassment, shame, remorse, and humiliation. How can we be less affected by these intrusive and sometimes painful memories?

I saw a Facebook post that said “If you ever find yourself cringing at something you did in the past, it means you have grown as a person.” This post made me chuckle, but it also gave me a sense of relief over my cringeworthy moments. When the memories return, I can appreciate them as signs of growth. The idea that these memories mark my growth as a person rings true. I have learned from these moments. They have taught me to do things differently.

Lia Kvavilasvili, a psychology researcher at the University of Herfordshire, studies what she calls “mind pops”. These are thoughts that seem to come out of nowhere. She finds that memories are often triggered by something in the environment that takes us back to an incident. She also finds that interrupted moments stick with us longer than those that feel completed. For example, if we don’t have an opportunity to explain or correct the initial incident. And, our emotions dictate what our brains decide to hang on to. The stronger the feeling, the stronger the memory. The brain is saying, “Something important happened. Make a strong memory.”

Pam Haag, Ph.D., encourages people to talk out the embarrassing moments. She wrote, “Embracing the cringe—for example, by sharing stories with friends of your biggest relationship failures or gaffes, or your worst professional moments—is a gift to your fellow humans. It sends a message that despite all of the imperfections and mortifications of the human condition, we survive. We’re flawed, and still worthy of care, love, consideration, and attention. This is a more humane, and humanist, way to think about personal failure than to try to spin it, (or) suppress it.”

I propose that any cringeworthy incident that occurred before the age of 21 is to be forgiven. Youth is about learning and making mistakes.

I also propose that anything that we have said, done, or thought that was taught and entrenched in a particular environment or ideology, and from which we had no other knowledge, should be forgiven. We are allowed to change over time.

And, I propose that we reflect on the things that make us cringe. Was anyone hurt? If so, we should make amends. Making amends is freeing.

We can never be free of our past selves, so it would be best to learn to be objective about the past and develop self-acceptance. Embrace your humanness.

What Causes Addiction and Who Will Recover More Easily?

I attended a training recently by Mark Sanders, LCSW, CADC, on best practices in mental health and substance abuse treatment. He raised some interesting points about dependence and recovery.

What makes for a better outcome for those people who have developed substance dependence? I learned that people who have greater resources before the problematic substance use will have greater resources for recovery. People with success before addiction – education, employability skills, healthy family support, and positive group affiliation – will have an easier time of recovery.

Which people will have more difficulty with recovering from addiction? People who slip through the cracks of the helping profession. Some people go back and forth between chemical dependence, mental health, criminal justice, and child welfare systems without recovering. This can also include multiple medical hospitalizations and periods of homelessness. Gabor Mate, M.D. says that drugs don’t cause addiction any more than a deck of cards cause compulsive gambling. There needs to be a pre-existing vulnerability. For some people, the seed of addiction is planted years before they use.

Some people fall through the cracks due to unresolved trauma. Complex trauma includes multiple layers and years of traumatic experiences. These experiences could include neglect, abandonment, unresolved grief, multiple placements, parental substance abuse, adult emotional unavailability, multiple losses, exposure to domestic violence, or other types of abuse.

Illicit drug use is an effective coping tool, until those substances create negative outcomes.

• They numb emotional pain

• They medicate psychiatric symptoms

• They provide constant companionship

• They are predictable

• They provide relief from trauma and abandonment

What can we do to help people along the path to recovery? The first thing we can do is give them hope. We can assist them in finding stable housing, employment, a stable therapeutic relationship, meaningful daily activity, and significant interpersonal relationships, including peer-based support. If we can give them hope and practical assistance, they can more easily recover.

What Causes Addiction and Who Will Recover More Easily?

I attended a training recently by Mark Sanders, LCSW, CADC, on best practices in mental health and substance abuse treatment. He raised some interesting points about dependence and recovery.

What makes for a better outcome for those people who have developed substance dependence? I learned that people who have greater resources before the problematic substance use will have greater resources for recovery. People with success before addiction – education, employability skills, healthy family support, and positive group affiliation – will have an easier time of recovery.

Which people will have more difficulty with recovering from addiction? People who slip through the cracks of the helping profession. Some people go back and forth between chemical dependence, mental health, criminal justice, and child welfare systems without recovering. This can also include multiple medical hospitalizations and periods of homelessness. Gabor Mate, M.D. says that drugs don’t cause addiction any more than a deck of cards cause compulsive gambling. There needs to be a pre-existing vulnerability. For some people, the seed of addiction is planted years before they use.

Some people fall through the cracks due to unresolved trauma. Complex trauma includes multiple layers and years of traumatic experiences. These experiences could include neglect, abandonment, unresolved grief, multiple placements, parental substance abuse, adult emotional unavailability, multiple losses, exposure to domestic violence, or other types of abuse.

Illicit drug use is an effective coping tool, until those substances create negative outcomes.

• They numb emotional pain

• They medicate psychiatric symptoms

• They provide constant companionship

• They are predictable

• They provide relief from trauma and abandonment

What can we do to help people along the path to recovery? The first thing we can do is give them hope. We can assist them in finding stable housing, employment, a stable therapeutic relationship, meaningful daily activity, and significant interpersonal relationships, including peer-based support. If we can give them hope and practical assistance, they can more easily recover.