Impatient: (Re)Learning Emotion

im·pa·tient

adjective

1. not patient; not accepting delay, opposition, pain, etc., withcalm or patience.
2. indicating lack of patience: an impatient answer.
3. restless in desire or expectation; eagerly desirous.

Idioms

4. impatient of, intolerant of: impatient of any interruptions.
       Today I am choosing to blog on relearning the feeling of impatience. So why today? Well, you guessed it, I am feeling IMPATIENT! I recently ordered myself my first apply IPad. It is sitting at FedEx, and I am stuck in my office. Waiting.
      There are many things in life that cause us to feel impatient: the excitement of something new, the wait before an upcoming vacation, or when an ending of something dreadful is nowhere near sight.
     This last example is the one that I frequently hear from individuals in recovery (and from myself when I am faced with a change). Impatience is often expressed in the midst of recovery towards people. For example:
I am impatient towards my therapist who just wont answer my question or refuses to push me further.
I am impatient with my dietitian who just doesn’t understand that I cannot and will not do (fill in the blank).
I am impatient that my team is not listening to me or considering my point of view on a situation.
and the real biggy
I am impatient with myself. Why is my recovery not happening, right, NOW?
I know it is frustrating to sit with this feeling but it shows incredible growth and progress! It shows that you are willing to push forward, that you are not content in your disorder or negative coping behaviors, you are MOVING FORWARD!
So, instead of allowing these feeling of impatience towards yourself or others aiding in your recovery, embrace the feeling (cliche I know) and yet it is true. Embrace the feeling that accompanies change, and growth, and new experiences. This to shall pass.

Rejected : (RE)Learning Emotions

re·ject

verb (used with object)

1. to refuse to have, take, recognize, etc.: to reject the offer of a better job.
2. to refuse to grant (a request, demand, etc.).
3. to refuse to accept (someone or something); rebuff: The other children rejected him. The publisher rejectedthe author’s latest novel.
4.to discard as useless or unsatisfactory: The mind rejects painful memories.
5.to cast out or eject; vomit.
Feeling rejected is probably one of the most common emotions felt by those in recovery. Rejected by our friends, our families, our co-workers, our peers, even ourselves. We all have those memories of waiting to someone to come around, and they simply do not.
So let us break rejection down:
Who: friends, peers, co-workers, family, ourselves
How:  a) intentionally- although we like to believe that others would treat us fairly and not internally reject us, it does happen. Sometimes it is circumstances we are prepared for such as a rejection of a job position and other times it is just bullying or somewhere in between the two.
        b) unintentionally- sometimes (and most often) our rejection or feelings of rejection were not intentional. For instance, you waited for hours for you friend to call you back, you felt rejected when he/she did not call you, and yet in reality, your friend had a family crisis and simply could not get in touch with you. **This does not make you feeling of rejection any less real or valid**
We all feel rejected from time to time- the question is: how do we handle this emotion? how do we react? or respond? what self-talk do we use?
Feel free to comment on your own rejection stories, how you responded/reacted, and what helped you get through it.

Food & Emotions

**Giving credit for this blog in part to the “Food and Feelings Workbook” by Karen R. Koenig, LCSW, M.Ed. Thank you for your amazing work**

The 7 most difficult feelings for disordered eaters:

20130226-092707.jpg

Have you ever considered that maybe your eating habits affect your emotions and your emotions affect your eating habits?

I highly recommend, if you are noticing that this may be true for you, keeping a food log. Write when you eat, what you eat, the emotions you have when eating, and the emotion you have an hour after eating. **yes, I know, this is time consuming and not easy. but it will give you an idea if how your eating habits are truly affecting every aspect of your life**

For Example:
You may realize that when you are upset you tend to eat a lot if high carbohydrate foods. A few hours later you are fatigued, depressed, or even purging. Another day you may see that eating a certain fruit made you feel happy or energetic an hour later.

Why Does This Help?
If you know that craving carbohydrate foods is likely because you are upset, you can CHOOSE to eat the fruit that tends to make you happy instead. Suddenly, your mood has changed, you are happy, and less likely to indulge in disordered eating behaviors.

Fearful

I realized it has been awhile sense I added a (RE)learning emotions post. So here we go again: Fearful

fear·ful

adjective

1. causing or apt to cause fear; frightening: a fearful apparition.
2. feeling fear, dread, apprehension, or solicitude: fearful for his life;fearful lest he commit suicide.
3. full of awe or reverence: fearful of the Lord.
4. showing or caused by fear: fearful behavior.
5.extreme in size, intensity, or badness: a fearful head cold; fearful poverty.

02-07-2013
There are two types of fear that I would like to address, mainly because they seem so different from each other.
First is the fear of somethingSuch as I fear hight’s or I fear falling. This type of fear is usually rooted in some kind of belief about the consequence of the fear. For example: I fear hight’s because if I were to fall from something high I might brake a bone and not be able to function in my daily life like I currently do.
 Rational versus Irrational Fears
Sometimes these types of fear are rational fears (such as the example above) and other times they are irrational fears. Irrational fears usually lead a person to do or not do something that eventually harms or inhibits the functioning of that individual. For example: An individuals with an Eating Disorder fears eating because it will make them gain weight and if they gain weight they just couldn’t go on with life as it is.
Second is the fear of someone. Such as I fear my neighbor or I fear my God.
Defensive versus Respect based Fears
Typically if you fear someone (other than a Leader or Religious figure) the root of that fear is defensive. You fear being around them, being open or honest with them in order to protect yourself. Again, this is at times a legit and rational fear at other times it is not. When they persona you fear is a leader or religious figure such as your God it is typically based out of respect. For example: I fear my God because I understand and I respect his ability to change my life forever.
**Note, these are fluid categories of fear and not all encompassing by any means. Every situation is unique. But the point of this is to give some food for thought about feeling fearful and why we feel fearful**

Body Dysmorphic Disorder

I am currently working on a class presentation on Body Dysmorphic Disorder for my psychopathology class.

I will post the final powerpoint when it is done (which wont be until march or april) but here are some interesting stats and information I found in my initial search this afternoon.

Phillips, Katharine A (1997) Gender differences in body dysmorphic disorder. Journal of nervous and mental disease 185(9) 570-577

**Women more likely (than man) to be preoccupied with hips and weight, pick their skin and camouflage with makeup, and have comorbid BN.

** Men are more likely to be preoccupied with body build, genitals, and hair thinning, use hat for camouflage, be unmarried, and have alcohol abuse or dependence.

**Suggests that cultural norms and values may influence the content of BDD symptom

Phillips, Katharine A (july 2006). The presentation of body dysmorphic disorder in medical settings. Prim psychiatry, 13(7) 51-59. doi: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1712667/

  • Commonly misdiagnosed as major depressive disorder, social anxiety disorder, agoraphobia, ocd, trichotillomania, schizophrenia
  • Common is patients with substance abuse and eating disorders
    • Most common disorders are MDD (76: lifetime prevalence) social anxiety disorder (37) and OCD (32%) Substance use (48%)
    • Many will seek nonpsychiatric physicians such as dermatologists and surgeons seeking cosmetic solutions
    • Have unusually high rates of suicidal ideation, suicide attempts and completed suicide
      • 78% experienced suicidal ideations
      • 69% considered suicide as a direct result of BDD
      • 24-28% have attempted suicide
      • Gender ration ranges from 1:1 to 3:2 (female: male)
      • Usually begins during early adolescence however treatment seeking is delayed an average of 11 years after onset
  • Prevalence in community and nonclinical student samples range from 0.7% to 13%
  • On average, excessively preoccupied with non-existent of minimal appearance flaws. Skin is the most common area of concern (acne or scarring). 2nd most common: hair (hair loss, thinning, balding or excessive facial/body hair).
  • Tend to camouflaging with things as body position, clothing makeup, hat
  • Skin picking is found in approximately 1/3 of BDD patient

Case Report: A Young Woman with Body Dysmorphic Disorder

Ms. A was an attractive 28-year-old Hispanic teacher who presented with a chief complaint of “I am obsessed with my appearance, and my plastic surgeon has been trying to get me to see a psychiatrist for 4 years.” Ms. A had undergone 15 cosmetic surgeries, which did not diminish her appearance concerns. These included rhinoplasties, liposuction, a chin implant, collagen implants, and other procedures, some of which were repeated because the patient was dissatisfied with the outcome of previous procedures. Because she thought that her appearance defects were real, she had been reluctant to see a psychiatrist. She believed that her appearance problems would be fixed by “just one more surgery.” However, Ms. A acknowledged that psychiatric treatment might be helpful for the anxiety and depression that her appearance concerns caused. Ms. A said she disliked everything about how she looked, including her supposedly scarred and discolored skin, flat hair, big and bumpy nose, receding chin, thin lips, high forehead, flabby thighs, fat stomach, and stumpy legs. She obsessed about these perceived flaws for 8 hours/day. Because she thought she looked so ugly, Ms. A did not date, avoided many social situations, and often missed work. She also drank excessively to diminish her distress and quell her anxiety in social situations. She was unable to see friends or participate in any social event without first becoming intoxicated, as she felt that this helped her focus less on her appearance flaws and feel more comfortable with the scrutiny that she perceived from other people.

Go to:

Case Report: A Young Man With Body Dysmorphic Disorder

Mr. B, a 23-year-old single white male, was obsessed with his skin. Throughout the day he thought about how his perceived facial acne and scars looked hideous. Because he felt so anxious and depressed over how he looked and thought he was too ugly for other people to see him, he dropped out of college, moved back into his parents’ house, and stayed in his bedroom. He saw no friends and did not leave the house. He felt too anxious about his skin to even eat meals with his family. As a result of his appearance concerns, Mr. B felt severely depressed and considered suicide. Topical and oral agents prescribed by a dermatologist did not diminish his appearance concerns. However, after 12 weeks of treatment with escitalopram, reaching a total dose of 30 mg/day, all of Mr. B’s symptoms were in complete remission. For the first time in years, he ate meals with his family, left the house, ran errands, saw friends, and made plans to return to school.

Chaos (again)

**After writing my previous post- The universe decided I needed to learn what I was preaching, again**

My life got a bit crazy these past few weeks and it finally caught up with me. I had to set boundaries and enforce them with people who I normally wouldn’t speak up too (aka my bosses). But I learned a few things

1. I have a need for some form of stability in my life. If it can’t be found, I will make it happen.

2. Nothing I do to “make stable happen” is actually going to help. In other words, wanting to be thinner, not eating, over eating, drinking, smoking, over exercising (whatever your addiction or go to coping method is) will NOT CHANGE the fact that other things in life are in chaos mode. It ultimately just makes things more chaotic

and

3. Sometimes, in the midst of chaos, the only stable thing we can “make happen” is how we choose to respond to chaos. Choosing to respond to chaos by taking care of ourselves and sticking with recovery can be the stable thing in the midst of chaos and uncertainty if we allow it to take that place.

bullied

bul·ly

noun, plural bul·lies, verb,bul·lied, bul·ly·ing, adjective, interjection.

noun

1.a blustering, quarrelsome, overbearing person who habituallybadgers and intimidates smaller or weaker people.
2. Archaic. a man hired to do violence.
3. Obsolete . a pimp; procurer.
4. Obsolete . good friend; good fellow.
5. Obsolete . sweetheart; darling.
12/04/2012
Bullying seems to be a “big word” these days, especially within the educational and academia worlds. I agree that it needs to be addressed but I think it is important to realize that bullying is not something new. I truly believe there are 3 directions of bullying that can occur: Others bully you, You bully others, or You bully You. So here are some brief thoughts of mine.

1. Others to you:

This is the direction of bully that most people talk about it. How others bully you, why they bully you, the effects bullying has on you. So what does it feel to be the one being bullied? When I feel bullied I feel disrespected, worthless, ugly, less-than, depressed, suicidal, hated, failure. Being bullied and feeling bullied is not an uncommon experience, but how you chose to respond with these emotions is crucial. Most people respond in 1 of 3 ways: Bully others back, Bully yourself back, or overcome it with the support of others.

2. You to others: Lots of people respond to bullying by bullying others. Its like the old saying “hurting people hurt people.”

3. You to you: Like I wrote earlier, typically being bullied results in feelings that lead to self-hate. Which usually leads to you bullying yourself. So how do you bully yourself? For some, it is just with our thoughts: I am so ugly, I am so worthless, I don’t deserve this ect. For others, it is physical such as starving, binging, cutting, burning, ect. Either way, it is self-destructive and does not lead to the change you want.