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Ten Secrets Your Therapist Won't Tell You

A very interesting discussion is going on over at PsychCentral. Once again John Grohol, the CEO and main writer on the PsychCentral blog, struck a nerve. He writes that therapists sometimes don't tell their patients everything, either to protect them or because they just don't see it as relevant to therapy. I try my best to be up front with my patients but I'm not perfect either. And he's right, there is sometimes a discrepancy between what we learn in graduate school and what we intuitively find works for us and for our patients.

Most interesting to me was that so many of his points are about the fight between therapists and insurance companies. It's all absolutely true. I thank God every day that my practice is set up so that I do not have to put up with their nonsense, well at least not as much.

Here's Dr. Grohol's introductory paragraph...

Psychotherapists are a unique profession in the world because they are paid to listen and help people improve aspects of their lives or combat a mental health issue that’s affecting them. But there’s some stuff that goes on in the therapy office that you should know about before you decide to take the plunge (or if you’ve already taken it, well, better late than never!). Here’s a few…

To read the entire article click here.

'Diva' Knows How to Make It Work!

Drop Dead Diva is my new video obsession. If you haven't heard about it yet, here's the run down, excerpted from Some Reality On Weight,  a New York Times article published last week:

... a heavenly mix-up leaves Deb, a vapid but good-hearted size zero model, trapped in the overweight body of Jane, an intelligent, hard-working lawyer played by Brooke Elliott. (Think “Heaven Can Wait” meets “Ally McBeal” and “Legally Blonde.”)

Josh Berman, the show's creator, recalls how his parents were intensely focused on appearance.

His father, a plastic surgeon, and his mother, a nurse, made frequent trips to the Pritikin weight-loss resort in Florida.“Everything in my family was about health and weight,” he said. “My mom didn’t let any of the kids eat sugar. Even at birthday parties we were denied cake. All of those issues were in the back of my mind when I wrote the show.”

So he wanted this series to make a statement about diet, weight and beauty.

“I don’t believe it’s about willpower,” Mr. Berman said... “If it were, then the assumption would be that if we all wanted to be a size zero, we could be a size zero. Everyone has different needs and desires. If someone finds a doughnut to be comforting, who are we to judge them?”

Brooke Elliot is the actress who plays Jane. Her performance is intelligent, assertive, fun and charming. Margaret Cho plays her assistant and the two of them together are dynamite!

“The show is supposed to blow open the stereotype of what we believe about weight or the roles overweight actresses have to play,” Elliot said. “I’m just trying to play this character honestly and make sure we’re sending the right message.”

Mr. Berman said his show would continue to try to be nonjudgmental about weight and focus on issues of self-esteem and identity.

“This show is not telling people they need to lose weight,” he said. “I feel there are enough shows that make people feel bad about themselves. If you want to lose weight, fine. Just don’t hate yourself if you’re larger than average.”

Great message! And such a refreshing take from Hollywood! If you want to see full episodes go to Drop Dead Diva and enjoy! Here's a sneak peak:

Life = Risk

Life Candy Friday: Twirly Skirts

I love my twirly skirt. When I put it on I feel youthful and light. Do you have a twirly skirt? Was there a twirly skirt in your past?

I remember my sister's poodle skirt. It was nothing more than a black felt disk with a hole in the middle for the waist and a white poodle applique, complete with pink collar and leash. Boy could my sister twirl in that skirt!

My mom made a kilt for me when I was in high school. Kilts are classic twirly skirts. I wore that skirt all the way through grad school.

All cultures, it seems, have their version of the twirly skirt. Why? Because they make the biggest impact on the dance floor. And dancing is an international language everyone speaks!

Flamenco dancers, Polish dancers, Irish step dancers, cheerleaders, post war bebop flounces, and yes, kilts! Yeah, even guys like twirly skirts. They are fun, and they make you feel like you're flying.

If you have a twirly skirt, put it on (along with your prettiest underwear) and pirouette the day away!

Photo courtesy of Janks75 via Flickr

10 Steps to Lower Anxiety and Find Empowerment

1.  Knowledge is power. To tame anxiety the more you know about how your brain works the better.  So here's a little neuro-psychology lesson.

What you need to know is that the most primitive part of our brains, the inner bit in the middle, is the limbic system, also called the reptilian brain because it's the oldest most primitive part. Within that is the amygdala.  For our purposes it's enough to know that scientists believe that everything we need to keep ourselves, and therefore our species, alive originates here, including fear in its rawest form.

Our frontal lobes are in the newest part of the brain, the neo-cortex. Our ability to judge, to filter out right from wrong, to determine appropriate from inappropriate behavior, real vs. unreal, reasonable vs. unreasonable resides here. It's the part that keeps us civilized and steady, among other things.

Behavioral scientists theorize that when we are threatened we respond on a primitive, non-thinking level first, because survival is more important than being right or wrong. The amygdala sends the signal that 'there's a nasty threat out there!' to the adrenal glands. Adrenalin is released into the blood, kicking off the autonomic nervous system response, revving up the entire body to either run away, flight, or duke it out, fight, with whatever is about to kill us.

Anxiety occurs when this system goes into overdrive because there is no where for the body to run and nothing for it to fight. The threat is abstract. What's firing off the system are scary ideas, not a saber-toothed tiger. All that adrenalin and no quick way to metabolize it causes anxiety.

Medical and non-medical treatments for anxiety are all about keeping the amygdala from running amuck and the frontal lobes engaged.

2.  Know the Bad News:  The bad news is if you have been dealing with anxiety for a long time and you have a family history of people who have anxiety [or depression], chances are you will be dealing with anxiety in some way for the rest of your life.

3.  Know the Good News:  Anxiety is very treatable.  Once you have good treatment that empowers you and you learn skills to manage the anxiety, (and keep your frontal lobes engaged) it can never hurt you so much, ever again. Really!

4.  Immediate relief may be as easy as learning to breathe deeply, getting enough good quality sleep, cutting out alcohol and caffeine for a while, and starting an exercise regime. Many patients have reported that just making these healthy changes reduced their anxiety significantly.

Three Benefits to Reining In Food Addiction (none have to do with weight loss)

Since using my calories-in/calories-out journal three weeks ago, I've felt so much better spiritually and physically. Almost instantly my attitude changed from combative to relaxed...

Benefit #1:  Peace of mind.

Once I took the first Three Steps to food addiction recovery seriously I experienced a lessening of spiritual tension. What a relief!

1.  I admitted I was powerless over food – that my life had become unmanageable.

2.  I came to believe that a Power greater than myself could restore me to sanity.

3.  I made the decision to turn my will over to the care of my Higher Power as I understood It.

Now this might freak a few people out, so bear with me. My Higher Power right now is my calorie journal. I am a great believer in accepting our Higher Power as we understand it. Too many people reject the Twelve Steps program because it's too religious. Nonsense. If your Higher Power is your toaster and that helps you accept your path to recovery, so be it. Not for me to judge.

Letting something (or someone) else light the path so that all I have to do is follow, eases my mind. Does this mean I give up taking an active part in my recovery? Of course not. In fact, I have decisions to make every time I think of eating or drinking. That I choose to make those decisions with the benevolent guidance of my calorie journal leads me to...

Six Steps to Take Right Now to Improve Your Marriage

To nurture a happy marriage or to repair and revive an unhappy one take a look at these six steps, adapted from We Can Work It Out: Making Sense of Marital Conflict, by Clifford Notarius, Ph.D., and Howard Markman, Ph.D. 

1. Each relationship contains a reservoir of hope.  Dr. Notarius and Dr. Markman report that their research shows that even the most destructive fights and conflicts start with good intentions. These good intentions form the basis for a hidden reservoir of hope that a fully satisfying relationship can be achieved. The key: Vow to tap into the good intent and the reservoir of hope.

2. One "zinger" will erase 20 acts of kindness.  It takes one put-down to undo hours of kindness you give to your partner. The key: intimate partners must learn how to manage their anger and control the exchange of negative behavior by finding a way to express the feelings in a constructive manner. Constructive expression of gripes, criticisms, and annoyances is a matter of knowing how to express oneself and choosing the appropriate time and place for the conversation.

3. Little changes in you can lead to huge changes in the relationship.  The differences between happy and unhappy couples tend to be small and subtle.

Most couples in trouble think that for things to improve, extraordinary changes, if not a miracle, have to take place. And human nature being what it is, most of us who have relationship troubles think these changes need to be made by our spouse, not ourselves. But we often don't realize that we have no control over our partner's behavior.

As a result, we develop a sense of hopelessness and helplessness about the relationship. If only he or she would change, everything would be fine – or so we think. The breakthrough comes when we realize that by making even small changes in ourselves, we can effect big, positive changes that make us more optimistic and open to our partners.

Have You Ever "Faked It"? Sure! Who Hasn't?

Wasn't this question answered in "When Harry Met Sally"? The real question is why?

Dr. John Grohol over at PsychCentral published this article yesterday: Why Women (And Men!) Fake Orgasm?  The results of a study done at the University of Kansas (my alma mater) aren't exactly surprising:

The researchers found that the responses suggested a sexual “script” that most of us follow, or would like to follow. Boy meets girl, girl takes boy to bed, girl has an orgasm before the boy. And the boy [has an orgasm] in response to the girl’s orgasm (although not as much, vice-a-versa). Faking an orgasm is a predictable response to this set of expectations, to ensure the “script” goes as smoothly as possible.

Read the article. And then enjoy the video. It's a hoot.

The older woman at the end of the clip is the director, Rob Reiner's mother, Carl Reiner's wife, Estelle. She practically steals the scene in less than two seconds.

Today's Life Candy: A Message of Love

On this day, the eighth anniversary of the day the world changed, it doesn't feel right to be frivolous or silly. Instead today's Life Candy segment is a quote from one of my favorite movies, Love Actually. It is in the voice of UK's Prime Minister, as played by Hugh Grant:

"Whenever I get gloomy with the state of the world I think about the arrivals gate at Heathrow Airport. General opinion has it that we live in a world of hatred and greed, but I don't see it like that.

Seems to me that love is everywhere. Often it's not particularly dignified or newsworthy, but it's always there. Fathers and sons. Mothers and daughters. Husbands and wives. Boyfriends, girlfriends. Old friends.

When the planes hit the twin towers, as far as I know, none of the phone calls from the people on board were messages of hate or revenge. They were all messages of love.

If you look for it, I have a sneaky feeling that you will find that love actually is all around."

Photo courtesy of E>mar via Flickr

3 Reasons Not to be Disgusted With Myself Anymore

What happened to change things around from how I felt last week?

[Trying Hard Not to be Disgusted with Myself]

1) Healthier self-talk.
Shutting up the devil and allowing the angel some space. Doing my best to practice what I preach, I allowed myself some time to pout and then it was time to get real. I am not disgusting, I told myself. I'm good and I'm strong. Weight is only a small part (ha, ha) of who I am and who I am is pretty damn good.

2)  Help from my friends.
Every single person who responded to my cry for help was supportive and positive. One friend on Facebook wrote: "Love yourself thin, Dr. Aletta."

3) Trying something new.

I have a food addiction. That makes being relaxed around food (if I'm trying to lose weight) particularly challenging. It's not like I can 'just say no' to food. Neither can I totally trust my body to know when to eat and when to stop. People with a healthy relationship with food can eat normally, I can't. I'm powerless over it. I need help, but not a diet, anything but a diet.

As I was thinking about what I needed to manage my eating, a light bulb went off.