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A Veteran's Day Salute to Women in Uniform

Dr. Aletta — Wed, 11 Nov 2009 08:25:23 -0500

When I heard that the police officer who took down Hasan at Fort Hood was a woman, my heart swelled with pride for my gender. Not only a woman; Kimberly Denise Munley is a 5 foot four inch tall firearms specialist and SWAT team member, nick-named 'Mighty Mouse' by fellow officers after she saved partner from an assault while on duty.

Then I remembered a compelling photograph (#2 in the series) I saw recently on the front page of the New York Times. Attributed to David Furst of Agence France-Presse, the caption read: "United States Marines settled into a makeshift patrol base at the start of Operation Germinate in the restive Bhuji Bhast Pass in Farah Province, in southern Afghanistan."

All four Marines in the photograph are women.

My heart goes out to all veterans of all wars. I could never do what they do everyday, have done and will do. I am especially proud of the women. I can't help it. When I was a kid playing 'Kill the Nazis' with my brothers and the neighbor kids, I was often relegated to being the nurse, "Because that's what girls do." It burned me.

They made it sound degrading.

If only I knew of the battlefield medical corps during the Civil War, WWI and II, Korea MASH officers; the WASPS flying troop carriers and supply planes behind the lines; the WACS and USO workers putting themselves in harms way doing everything and anything that needed doing.

The United States Department of Veterans Affairs estimates the total number of women veterans to be 1,824,198 as of September 2009. I'm assuming this number represents women vets alive today. The real number must be far greater. There was nothing degrading about their sacrifice, discipline and bravery.

Today women participate in every war-time job alongside men. This puts a new and special burden on our society to care for them, the men, the women and their families. We are still adjusting this new paradigm. I hope we get it right soon, for all our sakes.

Image: The Vietnam Women Veterans Memorial. Photo courtesy jcolman via Flickr

Thoughts on Rules to Live and Eat By

Dr. Aletta — Mon, 09 Nov 2009 10:06:21 -0500

Two months ago I wrote Eight Mental & Physical Fitness Principles I Can Live With. I just re-read them because I needed a reminder. For whatever reason I am forever slipping and picking myself up again. Maybe the lesson here is that that's not so bad. Maybe slipping is OK as long as there's that golden mean we keep striving for. Perfection is a mean taskmaster, reasonableness is kind and nurturing.

Following that thought and guided by the sweet support from many friends on this blog and elsewhere, I am not going to get down on myself for being a bit up on weight. Like many people I went through a tough seasonal transition where the hibernation instinct pulls us to eat great big mounds of pasta and mashed potatoes. Deciding I'm beautiful no matter what the scale says (Principle #8), I didn't chain myself to the calorie counter for a month. Instead I listened to an inner voice of reason that allowed some indulgence (big bowls of popcorn traditionally popped in veggie oil) but drew the line when it came to cookies and brownies. I eat less cheese, upped my fruit intake and gave up coffee, not because of weight but because my insides feel better for the change.

Now I'm ready to go back to food journaling and exercise only in a kinder, gentler manner. This suits me, for now, until I slip again. Or maybe it's not a slip. Maybe it's a tactical realignment. Hm...something to think about.

As a non-caloric treat today I want to share this article by Michael Pollan: Rules to Eat By. It appeared in the New York Times Magazine last month. Pollan has been featured on this blog before (An Omnivore's Deduction). His writing on food and Americans' relationship to it, is simple, direct and plain spoken. He's like the Mark Twain of food journalism. His article shared twenty "rules to eat by" from the thousands that he's collected for his new book, Food Rules: An Eater's Manual (out in January '09). Here are five of my favorites:

"My parents are both from Italy, and one of our family rules was that you could not leave the table until you had finished your fruit...It was a great way to incorporate fruit into our diets and also helped satiate our sweet tooths, keeping us away from less healthful sweets." ~Marta C. LaRusso
"Never eat something that's pretending to be something else...no textured vegetable protein or veggie burgers (fake meat), no artificial sweeteners, no margarine (fake butter), no 'low fat' sour cream, no turkey bacon, no 'chocolate flavor sauce' tat doesn't contain chocolate...If I want something that tastes like meat or butter, I would rather have the real thing than some chemical concoction pretending to be more healthful." ~Sonya Legg
"Make and take your own lunch to work. My father has always dome this and so have I. It saves money, and you know what you are eating." ~Hope Donovan Rider
"One of my top rules for eating comes from economics. The law of diminishing marginal utility reminds me that each additional bite is generally less satisfying than the previous bite. This helps me slow down, savor the first bites,stop eating sooner. It also helps get plenty of variety in my diet because this rule also makes a meal of small plates more exciting..." ~Laura Kelly
"After spending some time with people with eating disorders, I came up with this rule: Don't create arbitrary rules for eating if their only purpose is to help you feel in control. I try to eat healthfully, but f there's a choice between eating ice cream and spending all day obsessing about eating ice cream, I'm going to eat the ice cream!" ~Laura Usher

You can read the entire article Rules to Eat By.

Photo courtesy of artnbarb via Flickr

Christine Stapleton on the Fort Hood Massacre: A disturbed psychiatrist, a gun and the reality of war

Dr. Aletta — Fri, 06 Nov 2009 12:30:14 -0500

In our efforts to wrap our brains around a senseless event, we look for cause and effect. We desperately want to to see if we could have prevented it somehow. It's only human to wish to control. Unfortunately that process can mean demonizing the perpetrator, making him a monster, something, anything, 'not me.'

This morning I learned the gunman was a Muslim and a psychiatrist. While I have deep sympathy for the families of those killed and injured, I also have concern about possible backlash for Muslims and for mental health professionals as well.

Christine Stapleton, a reporter for The Palm Beach Post, expressed some of my concern in the wake of this horrible incident. As a therapist I have to be very aware of whether I am metaphorically putting the oxygen mask on myself first so that I am capable of helping others. The US military is just now beginning to incorporate state of the art diagnosis and treatment of Post-Traumatic Stress Disorder for our combat troops. How are our front-line caregivers cared for?

Here is Ms. Stapleton's article originally published today at Depression On My Mind. It's too soon to know the answers to the hard questions she poses, but it is good that we ask.

I will go to my therapist’s office this afternoon. I will sit in the waiting room and read an old magazine. Another client will walk from a hallway that leads to my therapist’s office, pass through the waiting room and leave. My therapist will poke her head out, smile and say: “I’ll be with you in a minute.” After a few minutes she will come back and invite me into her office. I will walk in, notice Kleenex in the waste basket and sit on the couch beside the box of Kleenex.
After a few pleasantries I will start unloading the detritus of my soul. She always pays attention and looks interested. I am her last patient on Friday. I cap off her week of listening to the detritus of other peoples’ souls. I ask myself, who in their right freakin’ mind would do this for a living? Hour after hour, day after day, week after week, year after year, listening other peoples’ misery.
So I asked her. ”It does get to you,” she said and explained how she takes care of herself. Burnout is a big problem among mental health care providers, she said. Then I remembered Tony Soprano’s therapist who had her own therapist on The Sopranos. It never dawned on me that a therapist might have a therapist.
This morning I got to thinking about this after reading about the gunman and his horrible rampage at Fort Hood yesterday. His name is Maj. Nidal Malik Hasan and he is an Army psychiatrist. He also is Muslim. Before he opened fire and killed 12 and wounded 31 people yesterday he had been assigned to counsel soldiers returning from the battlefields with post traumatic stress disorder. Hour after hour, day after day, week after week he listened to the horrors and atrocities of war. The soldiers he counseled were emotionally raw - just off the battlefield.

Then Dr. Nidal Malik Hasan learned that the Army wanted to send him to the very place where those horrors and atrocities occur. There was the “Muslim issue”, too. The doctor is a practicing Muslim and he took a lot of heat for it from his fellow soldiers. So much so that a couple of years ago he retained a lawyer to help him get an early discharge but learned he could not. He thought the U.S. should pull its troops out of Afghanistan and often argued with others who supported the war.
The Army thought it was best to send Dr. Nidal Malik Hasan to the battlefields where our soldiers are trying to kill terrorists who practice that same religion as the doctor. And we all know how devoted the terrorists are to their religion.
I am not condoning what Dr. Nidal Malik Hasan did yesterday. I am not making excuses for him. I don’t know if any of this contributed to what happened yesterday but I can see how it might have. I just want to why. I want to know if it could have been prevented. I want to know if the Army has anyone taking care of the people who take care of soldiers who are devastated by war. Maybe it is time we all looked at our caregivers and asked, what do THEY need? How are THEY holding up? Do THEY need help too?

Photo courtesy of StevenV via Flickr

40 Inspirational Speeches in 2 Minutes

Dr. Aletta — Wed, 04 Nov 2009 21:32:14 -0500

This is what I love about Twitter.

Rachel Simmons shared this clip in a retweet from Julia Taylor. I not only got the benefit of watching a terrifically edited video, I was introduced to Julia, who, like Rachel does admirable work promoting empowerment for girls.

Guaranteed to lift your spirit in less time than it takes to microwave a burrito.

Validation: The Wind Beneath Our Wings

Dr. Aletta — Tue, 03 Nov 2009 06:46:58 -0500

Another sweet thing that happened to pick up my spirits last Sunday was an email from Gina Carroll, from Blogher.com. Blogher is a meta-blog, like PsychCentral or Huffington Post. It brings together women writers/bloggers from around the world. Gina wrote:

Hello Dr. Aletta,
I am a contributing editor for Blogher.com and am writing an article about parent infiltration of Facebook. I think your article, To Be or Not To Be My Kid's Friend on Facebook, posted on psychcentral.com is wonderful. I would really love to quote your VERY helpful list of suggestions for how to decide whether or not to invade your kid's Facebook space....We are doing a series on Digital Parenting and moms [who] are really struggling with this issue.

What a boost that was!

Validation... "the reciprocated communication of respect which communicates that the other's opinions are acknowledged, respected, heard, and (regardless whether or not the listener actually agrees with the content) that they are being treated with genuine respect as a legitimate expression of their feelings, rather than marginalized or dismissed."

And it feels so good!

Gina's article was published yesterday. Especially helpful to me (besides the spirit boost) is how well she describes the evolution of Facebook from the kid's perspective. It's really a good piece. Please take a look.

Parents' Facebook Infiltration: Why The Natives Are Still Restless

What, who validates you? How? Did it help you? Can validation ever be bad? Let's talk! Please leave a comment.

Getting Real: Facing the Greatest Fear of All

Dr. Aletta — Sun, 01 Nov 2009 12:50:34 -0500

Unexpectedly I faced one of my greatest fears yesterday. Of course it would be Halloween.

Feeling bouncy and full of myself I decided on a whim to publish the article I wrote about my name and Elvira, Mistress of the Dark, on PsychCentral. Something light for Halloween, I thought.

After the article was posted I went about my business. Later, when I checked on it again, my blood ran cold. Someone left a not-so-nice comment:

"Would you like cheese with your whine?"

Ouch. Well gee, I guess I could see someone looking at it that way. I let it go. Comments that aren't positive is part of the blogging territory, part of being "out there." I went back to work. Two hours later I peeked again, another comment, this one stopped me in my tracks:

"You're stupid."

Oh, boy. Now what do I do? Take down the post? Leave it and see what happens? Did I make a terrible mistake that was bound to destroy my reputation? Who did I think I was anyway?

Can you smell the panic?

I tried to breathe. It helped but my heart was still beating too fast. I drank a cool glass of water. Better. Quickly I texted a cry for help to my editor, Steve, and then drove home.

When I walked into my house I smelled the delicious aroma of dinner. My husband, who was cooking, greeted me, quickly followed by my daughter and my dog. Gratitude washed over me.

You may think I'm exaggerating this whole thing, it seems so silly, but these were my genuine feelings.

The tag line up on my flag head says "for those with courageous hearts but thin skins," because I suspect many of us who deal with anxiety and depression feel just like that. Never do I want this blog to be a vanity project. My mission is to help people be resilient, not just temporarily happy. Everyone deserves to feel strong and confident no matter what life brings, to know they can deal with anything and thrive. In order to do this effectively I fully admit, I'm not just a teacher, I'm also a student.

When I was able to talk with Steve he talked me down by saying, "You are trying to help people by not hiding behind an impersonal therapist facade. You admit you have foibles, you aren't perfect, you struggle, too. That's who you are, that's what people identify with. You can be a professional and still make mistakes, be human."

Then about writing, he said, "My artist friend, Farzad Kohan, says that as an artist you can work behind closed doors at which point no one is allowed to criticize. But once you put your art on a gallery wall, open it to the public, you can't protect it any longer. In a sense, it doesn't belong to you anymore."

Steve gave me something to think about. When I went back to PsychCentral I found someone, one of the editors, I guess, had taken down the nasty comments. I considered taking down the entire post. I decided not to.

In order to get over this 'stupid' incident I had to face my real fear. It wasn't a matter of toughening up. Ages ago I accepted I will always be sensitive. My sensitivity is in large part what makes me a good therapist. Tolerating this confrontation with my greatest fear was the challenge. And what is my greatest fear? My greatest fear is not being perfect and being rejected as a result. There, I said it. It's an old fear. The very first post ever on this blog was about just that.

Your core fear may be something else but I'll bet it messes with your life, too. Unless we can tolerate standing still long enough to face them, get through, around, over or under them, the fears win.

In addition to talking with Steve, these four things helped me a lot. I want to share them with you in the hope that maybe you can identify with what I went through and these might help you too:

> A blog post by new contributing writer to PsychCentral Lisa Brookes Kift, Psychotherapists Unmasked on the Internet.
> A post by Therese Borchard featuring an interview with Michelle Russel, who blogs Practice Makes Imperfect, on perfectionism.
> Remembering that no one really cares about this but me and I really shouldn't care so much. The good old, positive, GET OVER YOURSELF self-talk.
> Going to a boisterous, wine-and-good-food-embracing dinner party with friends and family who ground me.

Image from Where the Wild Things Are, by Maurice Sendak

This Halloween I Will Face My Greatest Fear

Dr. Aletta — Thu, 29 Oct 2009 20:58:43 -0400

Yes, that's Elvira, Mistress of the Dark. Also my long time nemesis. I hate her. She stole my perfectly good name and turned it into a joke. On her About Me page she says, "When you hear the name Elvira only one person comes to mind..."

Excuse me? And what does that make me? Chopped liver?

You might be thinking, "Gee, Elvira, why would it scare you to be associated, even loosely, with a slutty, Vampira wannabe in a cheap wig?

[Yes. Before Elvira there was Vampira (circa 1953), the first ever late night horror film hostess. She was featured in that wonderfully campy Tim Burton film 'Ed Wood', with Johnny Depp as the cross dressing Mr. Wood.]

Anywho...

I don't really mind that much...anymore...but once upon a time I dreaded hearing my name mispronounced and dis-respected. It hurt to hear people call me things like Velveeta cheese. God! Couldn't my name at least sound like a classy cheese, l don't know... Bree?

It doesn't take a psychologist to figure out why I would get defensive, not to say persnickety, or snotty, but maybe those, too. Your name is your badge of honor, your coat of arms, your flag. I went through years and years, ever since I could talk, correcting people about how to say and spell my name. [Does Growing Up With a Difficult Name Build Character?] If you have a difficult name you know exactly what I'm talking about.

But I'm not touchy about my name any more. No, no, no! Having it mangled before my eyes is nothing to me now. Being mature and of a certain age has its perks, one of which is you don't care as much. It's nice, really. Many of my comrades in middle-age-dom like to say they are in their F*#k you, Fifties (or Forties, or Sixties) and proud of it! Maybe there's something to that.

Could it be I've faced my fear of name abuse so many times and for so long that I've finally gotten to the other side of it? I don't correct people as much as I used to or wince the way I used to either. I like to think I've grown up about it, gained some perspective.

Besides, as I said to a friend recently, it could be worse. At least Elvira/Vampira is hot in a ghoulish, Morticia Addams kind of way. Ah, Morticia! Now there's a vampire with class!

Photo courtesy San Diego Shooter via Flickr

5 Emotional Vampires & How to Combat Them

Dr. Aletta — Wed, 28 Oct 2009 20:09:33 -0400

This post by my friend Therese Borchard was published just in time for Halloween. To visit her original post on Psych Central, click here. Here it is, reprinted in its entirety:

In the spirit of Halloween, I thought you’d all appreciate some vampire talk. In her new book, “Emotional Freedom,” UCLA psychiatrist Judith Orloff identifies five kinds of vampires that are lurking around and can zap our energy if we’re not careful. Here is an excerpt adapted from her book.

Emotional vampires are lurking everywhere and wear many different disguises–from needy relatives to workplace bullies. Whether they do so intentionally or not, these people can make us feel overwhelmed, depressed, defensive, angry, and wiped out.

Without the self-defense strategies to fend them off, victims of emotional vampires sometimes develop unhealthy behaviors and symptoms, such as overeating, isolating, mood swings, or feeling fatigued.

Here are five types of emotional vampires you’re likely to encounter, and some “silver bullet” tips for fending them off.

Vampire 1: The Narcissist.

This vampire is grandiose, self-important, attention hogging, and hungry for admiration. She is often charming and intelligent–until her guru status is threatened.

Self-defense tips: Enjoy her good qualities, but keep your expectations realistic. Because her motto is “me-first,” getting angry or stating your needs won’t phase her. To get her cooperation, show how your request satisfies her self-interest.

Vampire 2: The Victim.

This vampire thinks the world is against him, and demands that others rescue him.

Self-defense tips: Don’t be his therapist, and don’t tell him to buck up. Limit your interactions, and don’t get involved in his self-pity.

Vampire 3: The Controller.

This vampire has an opinion about everything, thinks he knows what’s best for you, has a rigid sense of right and wrong, and needs to dominate.

Self-defense tips: Speak up and be confident. Don’t get caught up in bickering over the small stuff. Assert your needs, and then agree to disagree.

Vampire 4: The Criticizer.

This vampire feels qualified to judge you, belittle you, and bolster her own ego by making you feel small and ashamed.

Self-defense tips: Don’t take what she says personally. Address a misplaced criticism directly. Don’t get defensive. Express appreciation for what’s useful. Bounce back with a massive dose of loving-kindness.

Vampire 5: The Splitter.

This vampire may treat you like his BFF one day, and then mercilessly attack you the next day when he feels wronged. He is often a threatening rageaholic who revels in keeping others on an emotional rollercoaster.

Self-defense tips: Establish boundaries and be solution-oriented. Avoid skirmishes, refuse to take sides, and avoid eye contact when he’s raging at you. Visualize a protective shield around you when you’re being emotionally attacked.

Judith Orloff, MD, is an assistant clinical professor of psychiatry at UCLA. Her new book, upon which these tips are based, is “Emotional Freedom: Liberate Yourself from Negative Emotions and Transform Your Life.”

Therese J. Borchard writes the daily Beliefnet.com blog Beyond Blue (voted by Psych Central as one of the Top 10 Depression Blogs) and moderates Group Beyond Blue, the Beliefnet Community online support group for depression. Her memoir “Beyond Blue: Surviving Depression & Anxiety and Making the Most of Bad Genes” will be released in January of 2010. Subscribe to Beyond Blue here or visit her at www.ThereseBorchard.com.

Trick or Treat? Halloween Peer Pressure!

Dr. Aletta — Tue, 27 Oct 2009 01:00:00 -0400

My daughter, a writer in her own right, told me about the surprising response she got from her friends when she decided not to go trick-or-treating. I asked her to write about it. Here are her thoughts:

Recently I reached a milestone in my life. I have finally transferred over from the horrid waiting room of middle school into the vast openness of high school. As we all know with milestones there are changes that have to be made and/or met. There’s the obvious stuff, like having to get up earlier then the sun and learn to navigate through a building with two-stories instead of one. Then there are other things, more personal things, that change as I come of age. For example, this is the time of year when little children dress up as ghosts, witches, and wizards and run up to houses and scream those three famous words:

TRICK-OR-TREAT!

Let’s be honest here for a second, when little kids run up to your door dressed up as pirates, cats, and anything else they can imagine, face paint smeared all over their faces and a small plastic Jack-o-Lantern in their hands, it’s pretty darn cute! So, obviously you can’t help but give them a handful of candy.

On the other hand, when a teenage boy of about sixteen years waltzes up to your door in some baggy jeans, a sweatshirt, face paint thrown on for good measure, with a pillowcase in his hands… it’s not so cute. In fact, it’s actually kind of creepy. Not to say that all teenagers just use Halloween as a ploy to get free stuff. There is just something wrong about a sixteen year old, and possibly older, showing up at your front door asking for candy.

This year seeing as I am a freshman in high school, four years away from graduation and then college, I automatically made the decision not to go trick-or-treating. I just felt too old. From my personal experiences with Halloween, moving between houses and passing by older kids with my small set of friends, I myself felt a sense of danger and discomfort. Also, I based my decision on the stories that my mother had told me about her encounters with older high school students showing up on Halloween, usually in large herds, at our doorstep and how uncomfortable it made her. I knew that I didn’t want to make anyone feel uncomfortable this year just because I wanted candy. So I decided: No trick-or-treating.

Simple enough right?

It seemed that way at first. My parents agreed with me when I told them that I didn’t want to go trick-or-treating and that I would be perfectly content with just heading to the grocery story and grabbing a small bag of assorted candies for myself. Even my older brother supported me on my decision to skip out on the tradition. So, yeah, I was off to a good start. I decided all my own and my family was behind me… but then I went to school.

On numerous occasions I was asked by friends “What are you going to be for Halloween?” to which I would simply reply that I wasn’t going trick-or-treating this year. Cue gasp and response of shock. I explained that I simply thought that I was too old and didn’t feel all that comfortable with it. To which they would respond by saying something like “You get free candy!” I would always conclude the conversation by shrugging it off, because obviously they didn’t understand, leaving me standing there feeling uncomfortable, unsure of myself, and slightly annoyed.

Then the topic of my not-going-trick-or-treating decision came up at my lunch table. Fantastic! Not. It was horrible! I hated it. My friends freaked out left and right saying things like “How can you not be trick-or-treating?” and “It’s a part of your childhood. You’re gonna miss out.” I was flabbergasted and really, really irritated! I didn’t like it at all that this huge thing was developing over a tiny decision that I made. It was my decision - not theirs! They have no say in the matter; it’s simply my choice. I also didn’t like how what they said made me doubt myself and made me feel basically like shit (excuse me!) and I even told them so! Some of them even waved things in front of my face to get me to go trick-or-treating. For example, one of my friends was going with a group, which included a few hot guys, and they could bring a friend with them and they would invite me but I’m not going trick-or-treating. Man, was I ready to scream!!!

Although walking around with my friend and cute boys was tempting I still didn’t feel comfortable. Even though my friends protested my decision and probably still do, I stand by it 100 per cent, because really, life is not about satisfying others. It’s about satisfying yourself and feeling comfortable enough with yourself to stand by your decisions and the things that help build who you are. Be they about not going trick-or-treating, your freakish obsession with musicals, or your massive pile of Beanie Babies that no one really knows about.

This is my story… what’s yours? ~Vanessa

Photo courtesy of Pumpkin Wayne via Flickr

The Challenge of Mental Health Care at Colleges

Dr. Aletta — Mon, 26 Oct 2009 10:45:09 -0400

National Public Radio (NPR) broadcast two stories on what colleges and universities across the country are trying to do to take care of the mental health needs of their
students.

More young people who live with the challenges of mental illness attend college. Advances in treatment including medication management, make secondary education possible for many who couldn't have even considered it before.

Like most new trends there's the good news and the bad news.

The good news: Worthy young adults get to experience the advantage, challenge and adventure of college life.

The bad news: Many colleges and universities are not well prepared for the increased numbers of kids who need behavioral health support or services while at college.

These two stories, linked below, especially the one aired today, report on what many forward thinking institutions are trying to do to address the bad news.

Once again, society shows signs of finally letting go of the notion that mental illness is something to shove under the rug, out of sight. The risk is too high, and too many of us are directly or indirectly effected by continued ignorance. Thanks to NPR for their excellent reporting.

Colleges See Rise In Mental Health Issues

A Push For Colleges to Prioritize Mental Health