Category Archives: anxiety

What is abandonment anxiety?

People with abandonment issues may experience problems in relationships because they fear that the other person will leave them.

Signs and symptoms of abandonment issues in adults include:

  • always wanting to please others (being a “people pleaser”)
  • giving too much in relationships
  • an inability to trust others
  • pushing others away to avoid rejection
  • feeling insecure in romantic partnerships and friendships
  • codependency
  • a need for continual reassurance that others love them and will stay with them
  • the need to control others
  • persisting with unhealthy relationships
  • the inability to maintain relationships
  • moving quickly from one relationship to another
  • sabotaging relationships
  • lack of emotional intimacy

Individuals who experienced abandonment in childhood may find themselves drawn to people who will treat them poorly and eventually leave them. When this occurs, it reinforces their fears and distrust of others.

Signs and symptoms in children
In children, some degree of worry about caregivers leaving them alone is common. Separation anxiety is a normal part of development in infants and very young children. It typically peaks between 10 and 18 months and ends by the age of 3 years.

Separation anxiety and abandonment issues become a concern when the symptoms are severe or continue for a long time. In children, a fear of abandonment may manifest itself in the following ways:

  • constant worry about being abandoned
  • anxiety or panic when a parent or caregiver drops them at school or day care
  • clinginess
  • fear of being alone, including at bedtime
  • frequent illness, which often has no apparent physical cause
  • isolation
  • low self-esteem
  • In severe cases, such as those in which a child has experienced the loss of a parent or caregiver, they
  • may develop unhealthy ways of coping, such as:
  • addiction
  • disordered eating
  • lashing out at others, either physically or verbally
  • self-harm
  • sleep problems

When you feel abandonment anxiety rising, say this:

  • They are busy
  • They did not leave
  • Space is healthy
  • They do not always have to respond
  • I did not do anything wrong
  • It is OK
    Repeat.

Also see the The Anxiety Toolkit.

Shades of Gray

Black and white thinking – also known as all-or-nothing thinking – splits your world neatly into one category or another. If you’re experiencing depression, it’s common to fall into black-and-white thinking. You might focus a lot on your perceived failings, what you should have done differently in a situation and not surprisingly you end up feeling low. Black-and-white thinking also plays a role if you’re experiencing anxiety. A panic attack can make you think about a situation as either completely safe or completely unsafe.

Why Thinking in the Gray is Important

  • Black and white thinking can negatively impact your relationships
    Your partner is the most wonderful person in the world — until they’re the worst. This cycle of love/hate, down/up, good/bad can be seriously stressful for any relationship. In some cases, these wild lows and highs can be a sign of something more serious, such as mental health problems. In family relationships and friendships, quickly changing from thinking a loved one is perfect to feeling they’re awful can erode intimacy and trust. By seeing your loved one as either all good or all bad, you’re not letting yourself see them for what they are: a normal, fallible human.  See also How Mental Flexibility Helps Romantic and Family Relationships.
  • Binary Thinking Leads to Poor Decisions
    According to psychological research, thinking in binary terms can actually change the way we perceive the world, effectively conditioning us to miss nuance. In a 2016 study, Pomona College researchers found that participants’ perceptions of how someone was feeling changed depending on whether they were given black and white, or more fluid categories, to understand emotion. By conditioning a person to see things in more binary terms, black and white thinking can become a self-fulfilling prophecy, making it even harder to perceive nuance.
  • It can signal a deeper problem
    While everyone experiences black and white thinking to some extent, extreme black and white thinking can also be a symptom of mental illness. People with Borderline Personality Disorder, for example, experience intense black and white thinking, which can in turn affect their perceptions of their relationships with others and with themselves.

How to challenge black and white thinking
Shifting your thinking can be difficult but with the right support, you can learn some helpful strategies. Cognitive BehavioralTherapy (CBT) and Mindfulness based therapy are effective ways to address black and white thinking. It is a process where you are encouraged to replace unhealthy patterns of thinking and behaving with more helpful approaches. It certainly doesn’t happen overnight but with time and professional help, it is a very effective treatment.

How to Be In The Gray
Reframe your thinking. Catch yourself in the middle of a thought and challenge whether it is true or not. Are you really a terrible partner? Does your boss really hate you? Is your best friend actually ignoring you? Is it more accurate to think: ‘I might not have been at my best today, but my partner loves me and I can work to communicate better.’ Or ‘My boss doesn’t need to constantly reassure me, they will tell me if there’s an issue.’

Words like ‘never’ and ‘every’ are not helping you. Catch yourself using ‘absolute’ words and rethink them as ‘sometimes,’ maybe,’ or ‘every now and again’. Acknowledge and accept that life is filled with uncertainty. You don’t have all the answers all of the time. It’s completely fine to say, ‘I don’t know, I need to think about that more.’

How to keep your mind busy when you’re anxious

How to keep your mind busy when you’re anxious:

Personal

Have an empathy buddy. Check in daily for each other.
Binge watch a show that feels engaging, make it a personal choice.
Organize. Make your desk, room, closet, and kitchen a reflection of what you want.
Try an online workout.
Go outside. The majority of us have a vitamin D deficiency. Sunlight helps us, both mentally and physically.
Try a new recipe. The steps of cooking are great for our frontal lobe functioning.
Find the foods that make you feel good. Simple carbs give us a lift and a crash. Complex carbs and proteins keep us going.
Deep clean your home.
Listen to, read, or watch things that make you laugh and feel uplifted.

Work

Plan, create, and consolidate social media and web content.
Revise, edit, refresh your product and service descriptions.
Volunteer your time and talents. What can you offer to your community, from meal delivery to services online?
Simplify and streamline areas of your life that you can automate. Do you need a cleaning service, a driving service, office help, or even daily help for groceries and errands? Saving time adds to peace of mind.
Build or update your website.
Take an online course. Adding a certification or learning something new creates self efficacy and confidence.
Write a cover letter. Even above your résumé, your networking, and your social media, having a specific letter that emphasizes who you are helps others to really see you.

Seven Subtle Signs of An Anxiety Disorder

Seven signs of an anxiety disorder that are hard to recognize:

  • You feel mentally exhausted. Even the simplest tasks feel huge.
  • Everything annoys you. You feel easily irritated and frustrated by seemingly small things.
  • You feel nervous, even when there is nothing threatening happening in the given moment. You might even wake up feeling a sense of dread.
  • You don’t feel like doing anything. Even things that you usually care about.
  • You feel like numbing out. This might include scrolling through social media or watching Netflix for hours.
  • You feel scattered.  In the middle of doing something, you remember something else that you should’ve done, or something you need to do.
  • Your body isn’t happy. You might have trouble sleeping, waking up, going to the bathroom, or just generally feel sore and achy.

Social Anxiety and the Art of Conversation

One of the questions I frequently receive from clients is how to start conversations. This is particularly difficult for people who have social anxiety and have to meet or get to know someone new. Some tips to make conversation more comfortable:

Ask something personal
We need a few minutes of small talk to warm up. But to make sure you don’t get stuck in trivial chitchat, ask something personal related to the topic. A rule of thumb is to ask questions that contain the word “you.”

Be genuinely curious
I work with clients both in the office as well as IRL social situations. I have them come up with three questions to ask people over the course of a conversation. Here are 3 examples of things you can try to learn about someone:

  • What they do for their work or craft
  • Where they live and what it means to them
  • What their future plans are

Share something slightly personal
One of the most popular conversation tips is to let the other person do most of the talking, but it’s not true that people ONLY want to talk about themselves.

Focus your attention on the conversation
It’s easy to become distracted by what you think you should say next, notifications on your phone, or your own discomfort. When you notice yourself getting self-conscious, bring your focus back to the conversation. This makes it easier to be curious. It is easier to make interesting conversation when you focus on what the other person is saying instead of yourself.

Circle back
Good conversation doesn’t have to be linear. It’s completely natural to revisit something you’ve already talked about if you reach a dead-end and there’s a bit of a silence.

Steer the conversation towards passions
It’s more fun to talk about passions instead of swapping facts about work. If it turns out that you have similar passions, delve into those. They can be a strong basis for connection.

Ask open-ended questions
Closed-ended questions can be answered with a “Yes” or “No,” whereas open-ended questions invite longer answers. Use open-ended questions when possible.

Ask for their personal opinion
It’s fun and engaging to get asked about one’s opinion. Getting into a debate if you disagree is not the point; it’s about stimulating genuine conversation.

How to ask for help without feeling weird

‘I Have Your Back’

Reaching out for support is a skill we’re somehow expected to know, yet it’s never taught and rarely modeled for us. When you need help -no matter the kind of help you need, or the person you need it from -to simply state “Can you help me?” can be fraught with tension.

A seemingly simple request for help can bring huge implications with it. You may have been raised in a family where asking for help, or letting others know that you need support, was considered a sign of weakness and was frowned upon for suggesting a lack of privacy regarding personal difficulties.

Asking family members, colleagues, friends, community, and partners for help may reflect a larger cultural dynamic of communication and give-and-take.

Saying, “Can you help me?” speaks powerfully to an instinctive desire to be of service to other people and to receive reciprocal attention. But “Can you help me?” also makes you vulnerable.

What I say to patients: please practice asking for help.
For many, it’s a new activity, and it feels rusty, like anything novel.  Yet, so many people have recently lost their livelihood, had physical health problems, financial hardship, and even loss of home and identity. More than ever, asking for help is an art form that we need. As a society, we don’t always have the experience to ask for help. In my belief, that needs to change, but requires self compassion and practice.

Where to start:
1. Make a list of what you need help with: particular errands, chores, some cooking, walking the dog, getting food or groceries, yard work, job recommendations, assistance with letter or email writing, changing filters, moving furniture, tech support, maybe even a shoulder to cry on.

2. Write down the names of friends, colleagues, and relatives who have offered to help in the past.

3. Match people with tasks based on their interests, their strengths, their time flexibility and your comfort level with them, given the intimacy of the particular task. One friend may really enjoy cooking, another may check in on you via regular texts, another might upgrade your computer, or walk your dog.

4. Pick just one thing off the list and contact the person you’ve chosen. Be direct. See the next few points, below.

5. I always talk about timing and dosage. If you’re not sure whether or not it is a good time, just ask. You can say, “I’ve love to ask for your help with something. Is there a time that’s good for you to talk?”

6. Don’t be defensive. Instead, say what you can’t do.
Instead of saying, “I need to add a few graphic elements for a major key point power point presentation, say, “I’m concerned a few of my slides for my seminar look terrible.” You don’t have to emphasize how ‘important’ you are. Just ask for the help that you need.

7. Show respect. Without actually saying it, you’ve already said, “You know more than I do.” You’ve said, “You can do what I can’t.” You’ve said, “You have experience (or talent or knowledge) that I don’t have.”

Learning is not diminishing yourself.

8. Show trust. You’re vulnerable. You admitted to a weakness.And you’ve shown the other person that you trust them with that knowledge. You’ve already said, “I trust you.”

9. Show you’re willing to listen. Instead of saying exactly how the other person should help you, you give them the freedom to decide.

By showing you respect and trust other people and by giving them the latitude to freely share their expertise or knowledge, you don’t just get the help you think you want. You get more.

10. Be grateful. Acknowledge the help you received. Even though you might feel embarrassed that you needed help, don’t pretend like it never happened. Directly acknowledge that you appreciate what the other person did for you.

11. Be sincere. When someone is helping you, it’s okay to be a little bit vulnerable. The other person might appreciate knowing that they are genuinely helping you during a difficult time.

12. Gain credibility by helping others. People will be more likely to agree to help you if you have been known to help others. Build a reputation as a helpful person. You will draw others to you who share that same sentiment.

Eight tips to fight loneliness during holidays

Tis the season when we presumably spend our days sipping hot cocoa, eating delicious food, gifting, and doing all sorts of holiday fun-ness with our loved ones, these days, virtually. It’s the jolliest time of year. At least, that’s the lovely picture we’re all marketed for the holidays. The unfortunate reality is this sentimental holiday scenario is anything but the norm.

For many people, this time of year can be a painful reminder of the things they’re not surrounded by. Loneliness happens. And the painful feeling may grow, until you’re convinced you’re destined to be a lonely hermit whom no one wants to be around.

Part of that reason is simply because of our cultural expectations around what the holidays SHOULD be like. When we set our expectations to be one thing, and the reality is something different, we can see it as less than.

Think, for instance, about all of those holiday Hallmark family films that focus on the heartwarming ~feels~ that come from quality time with the fam.

The reality is, though, your IRL or virtual version could easily not match what you see on the screen or with what your neighbors with their beautiful lights and decorations might be experiencing. Coping with the loneliness and holiday blues can be challenging.

Mental health tips:

Recognize how much stress you might be under
Since the holiday season is short and goes quickly it creates a sense of urgency and overwhelm, making you feel like there’s so much to do and so little time to get everything done. Expectation is also a huge cause of stress during the holidays. Everything from holiday decorating to shopping and gift giving come with expectations that are most often unrealistic which causes you to stress about measuring up to those expectations whether they are your own or ones held by family and friends. When people get stressed or feel overwhelmed they can begin to feel alone in their struggles.

Comparison is the thief of joy
People can feel less than, especially when they see everyone else seemingly ‘happy’ and having everything under control. Social media can be a huge culprit of making it seem that everyone else has it all together except you with those happy/perfect pics. Even though social media is for “connecting” with others it can actually do the opposite and make you feel less connected and more alone especially when you compare your life to those you see. Try limiting time on social media.

Don’t isolate yourself, no matter how tempting
When people feel lonely, sad or are struggling they may tend to isolate themselves or feel unmotivated to reach out or interact with others. They may also feel unworthy of someone’s time and that they would burden or inconvenience others by asking them to participate in an activity or by sharing their feelings. They get caught up in their low self-esteem and negative thoughts, and choose to isolate instead of virtually socialize or reach out. The best way to stop and change negative thoughts is by choosing to see them for what they are-as mental distortions, rooted in fear, self-doubt and low self-esteem. Their purpose is to keep us from pursuing relationships and opportunities.

Self compassion
Please ask yourself if this is a kind thought you are telling yourself. Flip the negative self statement to a positive thought, for example if you are struggling with worth and feelings of deserving ask yourself “Who am I not to deserve this?” Start repeating “I am worthy” multiple times throughout the day and you will begin to believe it and act from a place of feeling worthy and deserving. The more you practice positive thinking, the more empowered and less lonely you will feel. I actually have my patients write this down on index cards and carry it around to look at throughout the day. 

Process and be in your feelings
It’s okay to feel sad and to let yourself feel lonely. Everyone has bouts of loneliness at times and often it’s because family may be far away or maybe right now you don’t have a significant other or kids. Spend some time fully feeling your feelings until they dissipate. You can do this by practicing mindfulness. Mindfulness teaches you how to be aware of your feelings, to feel them in your body and to allow and accept them without creating a narrative around them. It is OK to cry or feel an intensity of emotions, and in accepting and inviting these feelings to be present they dissipate and more calm and peace prevails.

Engage in the practice of opposite action/emotion
Practice opposite emotion and action, derived from Buddhism, to change your mood by engaging in behavior that is opposite to what your current emotion is pulling from you. For example, if you are angry and feel yourself tensing up, then try to open your posture and uncross your arms. Stretch your body for release. Similarly, if you are feeling sad and lonely and want to withdraw, then make a point to reach out to friends or watch a funny or well loved movie to help mitigate sadness.

The theory behind the skill I teach in my clinical practice to patients that I call OPPOSITE EMOTION is that every emotion is accompanied by an urge to engage in certain behaviors and these behaviors perpetuate the emotion. For example, the most common action urge for anxiety is avoidance. The more you avoid something you fear, the more intense your anxiety will become, and so approaching what you fear will help reduce anxiety both because you learn the situation is okay and because you aren’t continuing to reinforce your fear by avoiding the situation. It is important to note that the goal is not to push away your emotion or suppress it, but rather to work on cultivating another emotion.

Community service and volunteering
Use your energy and resources on behalf of people who need your help. Volunteer to tutor students, as many are struggling with virtual learning; help at a homeless shelter or soup kitchen, make food for an elderly neighbor, or volunteer at an animal shelter.

Appreciate what you have
Send cards or a personal note to everyone who means a lot to you. Thanksgiving is about showing gratitude. Make your holidays a spiritual growth time, such as creating a personal ritual, prayer, meditation, or virtual gathering with close friends. I have several friends who have a personal altar at home, and engage in prayer to their ancestors and loved ones who are not present. Find something for you that is meaningful. 

The way is through, not around.

How to persist in hard times through mindful writing.

 

Write It Out
Did you ever write an emotional e-mail to an ex when you felt angry but then deleted it? Chances are you still felt better though you didn’t send it. If you’ve suffered an upsetting event, writing about it can actually make you feel better. That’s in part because writing organizes your thoughts, which makes the experience feel less chaotic. Writing also can offer you an emotional release, insight into yourself and the feeling that you can be more in control. Clinical psychologist, Dr. James Pennebaker, found that writing for 10 to 15 minutes per day reduces clinical depression, commensurate with taking medication.

Set aside 15 minutes a day to write about the event or the day, and how it made you feel.

Write in a journal, laptop, or phone, whatever feels most accessible to you personally.

Don’t worry about grammar or artistry. It’s called stream of consciousness. This is just for you. But get it down.

Stick with it. At first writing about an upsetting experience may be painful, but over time it can help you get past the upset. I have a friend who is a writer, who created a very popular blog and a successful writing career that evolved, starting from his own past losses and grief.

How To Start
Write down the problems or thoughts involved. On paper they may seem more manageable than swirling in your head.
Do not be your own critic. Just get it out, and you can edit it as much as you want later.
Make it a practice. Neuropsychology research shows that new neural pathways are formed by practicing an activity or exercise for at least a minimum of 21 to 28 days.

Don’t get discouraged if your first attempt at writing is not to your satisfaction. It’s the action, not the product.

As a published writer has told me, write about both the what and the why. It trains your brain to think about both.

Reference, Pennebaker, James, The power of expressive writing: https://journals.sagepub.com/doi/10.1177/1745691617707315

Election Hangover Symptoms

Vermont, 2016

Here’s some of what you might be feeling today (or into the next several weeks), from the psychological perspective.

Fatigue – Constantly thinking about politics and worrying about the outcome of the election can give you tunnel vision. We just don’t have the cognitive and emotional energy to expend any more thought or emotions without an effect on mental health.

Anxiety Having feelings of anxiety is common. Anxiety is an ancient response, stemming from uncertainty and a sense of threat. Give yourself space, but seek professional help if it feels extreme.

Gloominess – This is also a direct result of uncertainty about what the future will hold.

Mental fog – Constant, chronic, and building stress can cause mental fogginess. It interrupts concentration. So does high anxiety. Plus, sometimes, the fogginess can have a more simple cause: You stayed up too late watching the election returns, you forgot to eat or hydrate, and your brain is just wiped.

How to Recover
Some hangovers (including election hangovers in 2020) can take a little longer to shake than others. But there are a few things you can do to recover a little quicker this time around.

Remember that you did your part. You turned out to vote and hopefully encouraged your friends and family to do the same. Reminding yourself that you played an important role in a historic election and the democratic process can help give you a mental boost.

Distract yourself. If you feel especially anxious about the election results, That could mean reaching out to family and friends, reading a book, or binge-watching Netflix.

Consider disengaging with social media. Avoid aggressive and negative conflicts, drama, and toxic situations.

Get some sleep. I know getting quality shut-eye when you’re stressed can be a tall order. Try winding down your brain before bed with a (non-political) book, podcast, or listening to some calming music. 

Squeeze in a workout. Find time for some form of exercise. Moving your body helps release endorphins, which can help you feel more positive and alert. Even walking your dog is helpful.
Find some perspective. It can feel extremely difficult right now, but remember that no matter what the outcome, life will continue after the election. Just give yourself a little compassion. You’re hungover, after all.

Anxiety and Elections

Anxiety is an ancient emotion that can help us assess and respond to future risks to our safety and security, a basic human psychological need as Maslow taught us, in his hierarchy of needs.  Anxiety refers to a prolonged state of apprehension brought on by uncertainty about future threats. Past threats logged in our neural memories and unconscious can also influence our view of upcoming risk. As such, anxiety is a natural emotion and vital for survival.

In contrast to anxiety, fear is an acute or phasic response to an immediate and identifiable threat. Anxiety has apparently persisted over human history, indicating that it has an important evolutionary role. Simply put, the evolutionary advantage of anxiety could be that it leads individuals to take fewer risks, seek safety, and focus on doing things well. On the other hand, anxiety can limit the risk-taking that advances mental flexibility, growth, and adaptability.

Interestingly, across the data, anxiety has a curvilinear relationship with behavior. For example, if you are moderately anxious, it can spur action and involvement. However, once over the hump of the curve, when anxiety becomes excessive, it leads to destabilizing and even shutting down of behaviors that are productive.
There are certainly plenty of reasons to be anxious about the state of the nation: the coronavirus pandemic, the economy, climate instability, physician burnout, mental and medical health, homeschooling, and racism, among other societal and personal psychosocial stressors. Some mental health professionals are calling 2020 the most challenging year they’ve ever seen.

Also, partisan political warfare, civil unrest, and terrifying conspiracy theories on TV, news media, and the internet. The actual polls confirm intuition: we are a nervous nation. In May 2020, the US Census Bureau found major depressive disorder at the highest level since they recorded statistics. Earlier this year, my professional organization, the American Psychological Association, conducted a “Stress in America” survey, in which they found more than half (about 56%) respondents identified the 2020 election as a significant stressor. At the end of June, the Centers for Disease Control reported that the highest rising levels of anxiety were among young adults, as well as black and Latinx people of all ages.

The physical and psychological symptoms of anxiety, such as feeling tense or having trouble concentrating, can be so uncomfortable that they cause behavioral changes. Fight or flight stress responses range from avoidance to aggression, as well as self-medicating with alcohol and drugs. One can also have anxiety about one’s very existence and the purpose of one’s life. That is called existential anxiety disorders, as coined by the psychologist, Irvin Yalom.

In terms of evolutionary psychology, anxiety helps us survive. We look for threats. One way that anxiety can do this is to organize our cognitive functions quickly in response to danger. Another body of research indicates that isolation induces anxiety. For most of us, being with community helps alleviate anxiety. we need people. What else helps? Keeping to routines and schedules, self-care, engaged participation, and hope through improved mental well-being. And, when needed, seeking mental health professionals. 

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