No, I’m not trying to lose weight

My husband and I went to an event where we live on New Year’s Eve with our seven year-old daughter. My husband made a comment about walking around enough to burn off calories from eating Christmas candy. Daughter didn’t get the joke. I quickly said, “I’ll explain it later” and told her to enjoy her elephant ear. Of course when we got home to watch the ball drop, everyone in Times Square was crowned with a Planet Fitness ad. She didn’t get that one, either, but was more interested in getting into pajamas at that point in the evening.

By Sunday afternoon, the ratio of fitness goals to political discussions on my Facebook feed has skewed to the former. The inauguration will come right around the time people ditch their resolutions, so that will change by the end of the month. There may be a slight upswing in dieting when Lent starts, but it will die off soon enough.

Except for some people. For some the pursuit of perfect eating and perfect body doesn’t stop easily. Much of eating disorders is biology – more than most people realize – but New Year’s resolutions are a delightful environmental factor.

I didn’t make any resolutions. So no, I’m not trying to lose weight. Nor will I be trying to help anyone do so.

 

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The Day After Christmas and This Book I’m Reading

The cover of the book I’m reading has a picture of someone cutting grass with a pair of scissors. It’s called Cognitive-Behavioral Treatment of Perfectionism, and it has the most amusing cover of any  clinical book I’ve read to date. The content is not particularly humorous, but it’s interesting.

Reading the section on the causes of perfectionism prompted my mind to go back to Monday, when I was having talking to my dad about cloned lifeforms, identity, family skeletons that paraded out of that closet years ago, and personality traits. And a slew of other things, but the personality discussion sticks out. My dad and I tend to be competitive and tend to make it a point to focus energy on things in which we are skilled at. We differ in that my dad used to be impulsive – things change with age – and I am not.

At all.

Avoiding risk isn’t entirely an anxiety thing with me – it’s lack of interest. I just don’t find impulsive behavior appealing. I can put off enjoyable things for extended periods of time. My idea of a good time after work is looking at pictures of cats on the Internet. I’m not sure if I can explain it any better than just saying meh.

Nature and nurture is a funny thing.

Autism, Empathy, and Something About Accountants

I finally watched The Accountant. To summarize, it’s a thriller movie with a bunch of the usual thriller tropes, except the anti-hero is an attempt at portraying diversity but instead ends up an amalgamation of clichés about people on the spectrum. Pro Tip: If you’re making a film with an autistic character, consider spending more time consulting with autistic people than time with neurotypical people.

Anyway, the film got me thinking about empathy. Especially the way in which people who do not appear to have much empathy are filed in with abusive spouses, serial killers, and those who maim kittens. While abusive spouses, serial killers, and those who maim kittens are often low on empathy, it does not mean that all who are low on empathy are any of those things nor does it mean that abusing, killing, and maiming requires low empathy. Empathy is not the same thing as compassion or sympathy or pity or loving-kindness or being moral or whatever other nice-sounding quality you think is associated with empathy.

Empathy is, per Merriam-Webster, “the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts, and of another of either the past or present without having the feelings, thoughts, and experience fully communicated in an objectively explicit manner; also :  the capacity for this”

Empathy can be broken down into cognitive (being able to take the perspective of real and fictional people), affective (being able to respond to someone else’s emotional state), and somatic (having a physical reaction). Deficits in these types of empathy are found in yes, autism, as well as anorexia, all personality disorders, psychotic disorders, OCD and a few of the related disorders – a significant number of people, the majority caring and welcome in society.

Deficits in empathy makes violence and cruelty easier, no doubt. What often happens, though, is that people with a lower ability to be empathic feel disconnected from others, lonely, and depressed. It is harder to communicate effectively with empathy is lower. People are punished for being being different, and those punished withdraw from others.

 

 

#OCDweek

Today is the last day of OCD Awareness Week. I have been putting up links to informative websites on my Facebook page to, well, bring some awareness. I have also spent some time reflecting on how U.S. views OCD, which is pretty warped.

OCD is a neuropsychiatric disorder, which means the cause is attributed to abnormal brain function. It is not caused by weak will, lack of exercise/nutrition, or difficulties with mothers. It is likely caused by a mix of genetic and environmental factors, with an emphasis on the genetic part. It is treatable with therapy and medication.

Misconceptions about OCD are abound. I don’t expect people in general to understand everything about the disorder, but it would be nice if people could at least tone down the judgments to be on par with epilepsy or cancer. OCD isn’t anyones fault, even if individuals with OCD (and sometimes their families) have to solve those problems anyway (DBT reference). And of the things I’ve learned in my personal and professional life, the inclination to psych problems would be higher if fear of being judged weren’t an issue. Instead, people may wait to get treatment until it’s unbearable, or worse commit suicide.

Yes, OCD can cause people to be miserable to the point of killing themselves.

It’s not a personality quirk.

It’s mental torture.

Stigma continues to decrease as people continue to speak out. OCD Awareness Week is one way to do that. Having OCD does not mean someone is defective. It just is what it is.

 

 

 

 

OCPD Legos and Building Change

(I give away the ending to The Lego Movie. You’ve been warned)

A local theater was showing The Lego Movie, with the proceeds of low-cost tickets going to charity. It sounded like fun, so my daughter and I went on a whim. I have reached point where I can generally ignore the part of my brain that is The Therapist, but sometimes it flips on anyway.

As we find out at the end, a young boy is playing with Legos and the tyrannical villain is inspired by his father. His father constructed an elaborate Lego city, which is meant for looking and not touching. Just as the father reaches for a tube of Krazy Glue to preserve the perfect city, he feels guilty, gets in touch with his value as a caring parent, and starts to play Legos with his son.

People with Obsessive-Compulsive Personality Disorder (OCPD) can get caught up in how things should be. Like, really really caught up. As we see in The Lego Movie, which has a surprisingly good depiction of OCPD, getting caught up in how things should be results in a lot of anger, hurt feelings, and pretending like Everything is Awesome when it’s not. OCPD isn’t particularly fun for all involved.

The bright side is that people learn and grow and strive to live within their values. Most of us have a warm and fuzzy side, including adult perfectionists who want to use permanent adhesives to hold Legos together. And when our environments give us feedback that “Hey, not okay,” sometimes we get the message and respond accordingly.

 

 

 

 

You’re Not In DBT, part 2

In You’re Not in DBT, part 1, I gave a brief definition of Dialectical Behavior Therapy (DBT) and suggested your therapist may be engaging in dishonesty behavior if claiming to provide DBT services when they are not providing all modes of DBT service delivery.

Today we’ll talk about what to expect from DBT and how to find a provider.

What to Expect (Briefly)

  1. Providing a commitment not to kill yourself or engage in self-harm – and keeping that commitment.
  2. Avoiding psychiatric hospitalization like the plague.
  3. One hour of individual therapy and one to two hours of skills training per week, with homework.
  4. It’s behavioral, so you change your behavior – yes, that’s easier said than done, but the plus side is you get guidance on change.
  5. And there is a big emphasis on acceptance – you are where you are.
  6. Getting comfy with what seem like contradictions – dialectics.
  7. Tracking emotions, symptoms, and skills used on a diary card on a daily basis.
  8. Acronyms upon acronyms.
  9. Structure – all sessions have an agenda, starting with keeping you alive followed by sticking with therapy and ending with everything else. You don’t get much time to ramble.
  10. Being viewed as capable – which means you’re held accountable for your actions.
  11. Many, many “Assumptions,” a noteworthy one being the relationship between the therapist and client as a relationship between equal people. Yep, your therapist is a human, not unlike you.

Where do I find a DBT therapist?

Check the Behavioral Tech “Find a Therapist” directory

Also check the DBT-Linehan Board of Certification website

You can also ask your psychiatrist or get a referral from an inpatient program, if applicable. Chances are pretty good they’ll suggest it before you ask if there is a program close to you, and your risk of committing suicide is high.

Next in the series will feature alternatives to DBT, for those who find DBT ineffective, don’t have access to it, or just don’t plain care for it.

Accepting Suicide

Attempt, thoughts, knowing someone who had an attempt or thoughts – you will be hard pressed to find a person who hasn’t been impacted by suicide. If they talk about it. A lot of people won’t out of fear of being judged.

It’s World Suicide Prevention Day. Suicide can be prevented. In order to do so, however, it’s necessary to accept – which means without judgment – that it exists and needs to be addressed. No calling it a sin or a sign of weakness. No keeping it quiet. No more stigma.

As long as there are psychiatric disorders, trauma, addiction, chronic health conditions, and loss, there will be suicidal thoughts and suicide attempts. It is what it is, and it needn’t be.

Check out these resources:

International Association for Suicide Prevention

National Suicide Prevention Lifeline

10 Things Not to Say to a Suicidal Person

Finding a Mental Health Professional