Our country, and the world, has been racked with pain over the last week and a half as we’ve heard about the horrible mass shooting that occurred in Las Vegas, Nevada. Nearly 60 people had their lives taken that night and hundreds more suffered gunshot wounds and other injuries requiring hospitalization. Stories of heroism, as well as tragedy have been shared, and for days the event has been at the forefront of the media’s attention. Repeated video exposure of the gunfire and people running in fear for their lives has made us vicariously experience the horror and brought the impact of the shooting in our own homes and workplaces. The effects of the shooting, as a result, go much farther than just those present that evening who lived through it.
For this reason, it is fitting for us to write about what we can do in response to this event to protect ourselves from its negative effects. Having lived through such an event myself, as a father of one of the victims of such a shooting, I am aware of the trauma brought on by such events. As a mental health professional, I can offer some advice to help you cope with this news, as well as provide practical help for those who experienced it first or second hand.
Suggestions for Those Affected Second Hand
First of all, we can all benefit by protecting ourselves from over-exposure to the messages and images that maintain the presence of this tragedy in our lives. We can do this, by turning off our televisions and radios when coverage of the shooting is part of the broadcast. The risk to our well-being from seeing and hearing the story over and over again far outweighs the benefit of keeping up with the latest in the death toll and details about the shooter. The repeating of the story and thinking of what happened on an hourly or even daily basis can exaggerate our sense that the world is a dangerous place. This has the potential to increase our anxiety, distrust, anger, and depression.
Instead, focus on what is going on in your own life and in your own community, giving thanks for what is good and pleasant in your life, and by working on improving those things in your personal life that are meaningful to you. For most of us, the world is a much more beautiful and harmonious place than the news media communicates. We are not criticizing the news media; we are merely saying that their job is not to give us the complete picture that we actually need to live by. It is up to us to put the news in perspective.
Suggestions for Those Affected First Hand
For those who know people whose lives were directly affected by the shooting and want to know how to help and support them, here are a few helpful things to keep in mind and to do:
Grief is a normal reaction to losses of many kinds. It is not a flaw or weakness. Grieving people are not broken (though their hearts may feel that way). Thus, grieving people do not need to be fixed; they need to be listened to with respect, kindness, and empathy.
Each loss is unique. Comparing what you have been through with what they are feeling is like comparing apples with motorcycles. Similarly, being told by someone “I know how you feel” shuts down conversation and does nothing to help the person you want to help. It can lead that person to feel more isolated and discourages them from telling their story.
Many grieving people want to tell their story. They just haven’t found the person who will show an interest and have the ability to listen (without analyzing, giving advice, or comparing losses). If someone you care about does not want to talk, that is also okay. Just let them know you care and will be there when they need you. Then be sure to be there when they reach out.
Avoid clichés. Time worn and inaccurate statements like “Just keep busy,” “You never get over the loss of a child,” and “It just takes time” may lead to putting off getting support when they really need the help and encouragement to heal.
Finally, be encouraged it is possible for people to recover from events such as the shooting in Las Vegas, to experience growth in their lives, a deepening of relationships, and a greater appreciation for the daily blessings of life. It is our hope at Fox Valley Institute that you will experience these things in your life, and feel confident in knowing you can always call on us.
When you are literally pulling your hair out, finding yourself constantly and compulsively checking if your front door is locked, or perseverating endlessly on an experience, it may be time to explore if OCD (Obsessive-Compulsive Disorder) is at the root of these behaviors.
Definition of Obsessive-Compulsive Disorder:
The International OCD Foundation defines Obsessive-Compulsive as a mental disorder in which people have unwanted and repeated thoughts, feelings, ideas, sensations (obsessions), and behaviors that drive them to do something over and over (compulsions). Often the person carries out the behaviors to get rid of the obsessive thoughts.
Characteristics/Symptoms of Obsessive Compulsive Disorder:
• Repeated unwanted ideas, thoughts, or imagery
• Fear of contamination
• Aggressive impulses
• Persistent sexual thoughts
• Thoughts that you might be harmed or cause someone else harm
• Religious and moral fears
• Extreme need for symmetry or exactness
While testing isn’t always necessary, a clinical psychologist may conduct psychological testing to determine the impact the OCD symptoms are having on the individual’s ability to function. A comprehensive psychological assessment provides feedback on the strengths and limitations of the individual. Psychological testing can help lead to a diagnosis and addressing the underlying factors of a problem. Following testing, accurately tailored treatments and interventions can be recommended.
Additional assessment factors to consider:
Since there can be a genetic component, a family mental health history should be gathered along with identifying what medications have and have not been useful to treat the family members’ OCD. Further exploring the family stressors that may exacerbate the OCD symptoms can be very beneficial.
A medical health history should be conducted for someone with OCD, especially in children and adolescents. Something that is quite different from Pediatric OCD is the appearance of Pediatric Autoimmune Neuropsychiatric Disorders (PANDAS/PANS) in this situation, OCD symptoms often emerge as a result of an infection, such as strep. Rather than developing gradually, this relatively rare sub-type of OCD manifests as a sudden appearance of OCD symptoms in children following an infection.
FVI DIGEST: OCD CASE STUDY
Dana is a 10 year old, white, 4th grade female. She lives at home with her mother, father, twin brothers, age 5, and her 12 year old sister. She noted experiencing a lot of unwanted ideation about symmetry and germs. She also has rigid nighttime rituals that are time consuming and impact her family. She’s a good student, who’s highly motivated, but her worries about germs have contributed to her not wanting to attend school. She attempts to minimize the anxiety about germs by washing her hands after she touches what she believes to be a contaminated object. She will wash her hands up to four times repeatedly which has led to red chapped skin. At school reading and writing have become time intensive because the OCD is demanding she balance her gaze by looking at one side of a book, and then the other for equal time. She gets mentally distracted by adding up the number of letters in words and reorganizing the words based on an even/odd pattern. Teachers describe her as having attention deficit. During her bedtime routine, she includes many rigid rituals like having to say good night in both a certain way and number of times, applying lotion in a particular fashion that includes pumping the lotion bottle two times, and organizing the blankets in a certain manner. She refuses to go to sleep if her parents are not home, thus her parents miss out on social events. Prior to her parents having an explanation of OCD for Dana’s behaviors, her parents viewed her behavior as defiant and disrespectful. OCD sends out a loud message for symmetry, so if her parents kiss her on one side of her face they need to balance it with a kiss on the other side of her face. If a person touches one of Dana’s arms, Dana will then need to touch the other arm in the same place. Dana has also experienced physical complications like teeth grinding at night, stomach pain, constipation, headaches, and irritated skin.
Dana has learned to view her OCD as a brain hiccup and to not feel guilt for her quirky behaviors. She named her OCD, “stupid thoughts” and she began to boss these “stupid thoughts” back, telling the thoughts she won’t respond to them or allow them to control her behavior. Dana learned diffusion techniques to externalize thoughts and to see the thoughts come and go, like leaves on a stream, allowing her a visual image to encourage flexibility and acceptance. Another technique that assisted Dana was learning to be “in the moment” and use her senses of smell, taste, touch, hearing, and sight to let go of being the “thinking self” and learn to be the “observing self”. Virtual Reality Therapy was beneficial in assisting with Exposure and Response Prevention. Dana visualizes someone touching something that to her was “contaminated” and then the person would proceed to go to lunch without washing their hands. To help her stay calm through the visualization exercise, Dana was taught deep breathing and progressive muscle relaxation. Dana was then able to utilize these calming strategies in her day to day activities. Eventually, she was able to practice Exposure and Response Prevention on her own. She is now able to touch a “contaminated” surface and not have to run immediately to the sink to wash her hands. Ultimately, Dana was able to go to school and not feel she had to respond to her obsessive thinking. Since her parents were seeing improvements in Dana they trusted she can regulate some of the distressful thoughts, which allowed Dana’s parents to feel more comfortable having date nights and trusting things would be ok.
Treatment for OCD:
Cognitive Behavioral Therapy (CBT) is the treatment modality which is the form of treatment recommended by National Institute of Mental Health, Mayo Clinic, and Harvard Medical School. CBT involves techniques related to Exposure and Response Prevention Therapy (ERP) and Cognitive Therapy. When you recognize that your behaviors may be becoming problematic and disruptive, a critical first step is reaching out to a qualified therapist, psychologist, or psychiatrist. They are here to help you. Break the stigma surrounding mental health by becoming more cognizant of these conditions. Once awareness exists, you can help yourself or support others in seeking out services.
Welcome back to school! Whether you are looking forward to it or anticipating it with trepidation, there is a high level of excitement. A new school year brings opportunities and challenges in balancing transition issues, academic pursuits, college life, home, and family. At this point in the year, you probably have a fair amount of adrenaline (and maybe caffeine) powering you through the day.
As I send my clients off to college each fall, I emphasize one point above all else: Watch out for the October Slide! Towards the end of September, the excitement draws to an end and reality sets in. The tests are more difficult, conflicts may be arising with roommates, and the colder darker days of winter are fast approaching. The steady diet of fast food, late nights, and lack of techniques to manage your stress may make the pressures you’re feeling seem overwhelming. These factors often result in an increase in depression and anxiety. Your impulse may be to curl up in bed and binge on pizza and Netflix while waiting for the semester to end. The October Slide can be prevented with your actions in September. I’m challenging you to be proactive.
Are you up for it? Take care of your health by following the simple acronym – MEDSS and my other recommendations below.
M – Take MEDICATION as prescribed
E – EXERCISE
D – Follow a healthy DIET
S – Get sufficient SLEEP
S – Nourish your SOUL, be it in finding solace in your faith, nature, art, yoga or any activity that helps you to feel more relaxed and grounded
Develop a routine that keeps you healthy and organized. Write down your goals, and then use a planner to map out your week. Schedule your study time, work outs, and meals in advance. This planning time may seem taxing; I assure you it’s a great habit to form. It will help you to feel more focused and ultimately better.
Establish your support network. Check in with your family, friends, therapist, and mentors, even when things are going well. If you find yourself feeling more stressed or down than usual, make an appointment with your therapist. If you do not have one, seek one out before the symptoms become overwhelming. The important thing is to stay connected. If you’re struggling to make friends, find a club, activity, volunteer position, or job that will provide you the opportunity to contribute and surround yourself with other like-minded individuals.
Have fun in moderation. For some people, it can be tempting to say yes to every party, tailgate, or social gathering. Overdoing these things will wreak havoc on your health, leaving you drained, more prone to getting sick, and feeling anxious and depressed. Know your limits and give your body break. These breaks should also include making time for yourself away from technology: your phone, social media, and video games. Recognize your own personal need for time to yourself in an open space – allow yourself that break.
Your actions right now determine how the stressors impact you as you face and conquer the challenges a new school year brings. Believe in yourself and acknowledge that others care about you and are there to help if you need it.
Parents, here are three simple things you can do to help your student right now:
Check in with your student about their emotional wellbeing and the stressors they are facing.
Offer support in helping your student establish healthy and productive routines.
Assist in connecting your student with professional support if that will be beneficial.
Therapists at Fox Valley Institute are offering Telehealth services to their current clients, who are away at school in the state of Illinois. You will need to verify with your insurance provider that video conference (Telehealth) services are covered. Let us know if we can be of support in any way.
At times it may seem necessary to put off doing things we categorize as unpleasant, difficult, painful, time consuming, or relatively unimportant. In many situations “holding off” on an activity can prove to be more beneficial than problematic. We may consciously decide to delay the execution of a task when we know more time will be available. In this type of circumstance, putting a responsibility “on hold” will yield better results.
Procrastination, on the other hand is consistently delaying responsibilities that should be completed. This is an automatic behavior that can govern how one lives, works, and interacts with people. While procrastination is often joked about, it is no laughing matter. Many have suffered unpleasant consequences in their relationships, school, and work. Often times, people find themselves overwhelmed, frustrated, depressed, and anxious if they are unsuccessful in changing their procrastination tendencies. People also may begin buying into labels that they are “lazy” and “unmotivated” which further encourages procrastination in other area of their lives.
There is hope for overcoming this daunting habit! Here are some deeper insights into the behavior of procrastination.
• Procrastination is rewarding. Unpleasant feelings associated with a task diminish if the task is avoided, bringing a rewarding sense of relief. Later, one may rush to complete their avoided task at the last minute and face criticism from others about their choice to avoid the task. These are negative consequences associated with putting a task off. We experience these negative consequences separately from the initial choice of delaying something. Since we tend to experience the immediacy of the reward from putting off that task as separate from the consequence, it is the reward that builds the habit.
• When someone occasionally puts off doing something, they weigh the pros and cons of doing so, and are cognizant of the justification of their choice. In contrast, when someone procrastinates, it tends to be done habitually. Many times procrastinating is used to avoid feelings associated with the task. Procrastination is automatic, like a habit, it is done without conscious reflection.
• Procrastination comes in many forms, a simple behavior with complex and diverse triggers.
A.) Criticism or Perfectionism- The fear one may face of being criticized by others if they don’t do something perfectly.
B.) Overwhelmed – The task is perceived as overwhelming, often because it’s unfamiliar.
C.) Fear or Pain – The task involves some form or fear of pain, perhaps physical, emotional, or psychological that the individual would rather not face.
D.) Resentment- When asked to do something, the individual may feel they can’t control the situation, for example putting off filing taxes. The act of putting the item off is how one exerts control.
Do you want to break this habit? Here are some questions and suggestions that may help.
What are the feelings I have associated with the task? Keeping a procrastination log can be an effective tool that can help you be aware of the start of the procrastination cycle. Write down the feelings related to tasks that you have a tendency to avoid.
What is the immediate pay off for procrastinating? Record in the journal your initial feelings. Did doing something else make you feel more empowered or less anxious?
What did I do in place of the unpleasant task? This activity is often a reward in and of itself.
What are the long-term consequences of putting a task off? Log the after-effects of avoiding a responsibility. This helps to better tie the negative consequences to the habit.
With many habits that you seek to change, having someone to support you in this endeavor can be incredibly beneficial. This person may be a friend, family member, co-worker, significant other, therapist or life coach. This individual should provide support without labeling or criticizing you as you work through understanding and changing your habits. Having an individual to help you through can speed the process along and helps you build back your self-esteem and confidence.