Ask Me Anything About Mental Health and Wellness! Live Q&A

Foreign. Hey there everybody and welcome to today's live Q& A. I don't have a lot that's really pre prepared today, but I wanted to be available to answer questions for you about mental health, about disaster recovery, about handling grief and trauma because we're getting ready to go into the holidays, whatever it is. Want to talk about today While we're waiting for some more people to join us, I will provide a few little tidbits that might be helpful to you. Remember, when we talk about emotional intelligence, we're not talking about how smart you are. We're talking about how effective you are at understanding the function of emotions, at identifying the triggers, at identifying what the emotion is when you're feeling it and the triggers for that emotion. About your ability to down regulate that emotion so you can get into your wise mind. Then explore the response options that are available to you and act accordingly. So that is the mnemonic idea. Identify the emotion and the triggers for that emotion. Down regulate to get into your wise mind, explore options to use your energy to address that in the best way to move toward your rich and meaningful life, and then act. Good morning DL Good morning Cher, Good morning alive. And as always, good morning Chuck and Adriana. What questions do y' all have for me today? I see we have 29 people out there that have just logged in. So welcome. Always glad to have people join us for these live Q and as. Why do I want to harm myself or wishing to have a chronic illness so that my parents can give me attention and care. And the person says I used to do self harming behavior in childhood to get attention and care. So I think you've identified it as unsatisfying as that may be. You found a behavior that you used when you were a child to get what you needed to get that consistency, to get that responsiveness that you were craving and to feel safe, to feel like somebody was there. And that continues to happen where instead of feeling like people hear you, instead of feeling like people notice you, you they you may feel like unless you need something or unless there's a crisis, nobody pays attention to you. I would encourage you to write down your beliefs for and against that thought and also examine whether you've been communicating what your needs are to those people. If you're effectively communicating I need to to talk, I need a shoulder to lean on right now, I need whatever you need, then that and they're ignoring that, then you may need to take some additional steps. But if you're just assuming that they can read your mind and know what you need, then you are probably setting yourself up for disappointment because you're right. They may be too embroiled in their own life to really be paying a lot of attention. Not because they don't care, but because, you know, a lot of us are caught up in our own stuff unless we notice that there is a crisis going on. And recognizing. Using some mindfulness tools to identify your own thoughts, wants and needs. Marsha Linehan developed dialectical behavior therapy in order to help people address just this. Recognizing that many times self harming behaviors are designed to get attention and care and not actually a sign of wanting to die. And, and that's really important because yes, self harming behaviors can go too far and can cause permanent damage or death. Don't get me wrong, it's not something to play with. However, for a lot of people, they, for example, self harming, they may do it in a way they know is not going to be dangerous, but it is to try to get people to stand up and pay attention. Family therapy could be helpful. I'm not sure how old you are, but even if you're an adult, family therapy could be helpful to get all of y' all in a room and encourage you to share your feelings about being neglected, about being overlooked, about being invisible to them and how that hurts and what you need from them. They may not be able to provide it, they may not know how to provide it, but a therapist can help them work on that. My belief, and I really try to cling to this as hard as I can, is that parents don't intentionally ignore or mistreat their children. They may just be too overwhelmed with their own stuff to recognize and acknowledge the good things. So the only way the child gets attention is when they're sick or when they're injured, which leads to teaching that child, the only way I can get your attention is if I'm sick or injured. And that's another important point to bring up. That, you know, I don't want to be sick and injured. I don't want to be doing this. But I need to know that you, you know, I'm here. I need to know that you've got my back. And that's where. When we talk about secure attachments, that's where consistency comes in. Parents and loved ones that are consistently there for us, not just during the bad times, not just when we're a crisis, but they're there to celebrate the good times. They're there when it's not a good time or a bad Time, it just is a time. And they're checking in on us, they're seeing how we're doing, they're wanting to spend time with us. All of that is important. Inconsistency and then the responsiveness is also important. Again, not just responding when there's a crisis, but responding when something good happens and go, oh my gosh, you got into university. Congratulations. I'm so proud of you. So many children never hear those words from their parents. I'm so proud of you that, you know, it's really heartbreaking because the only time the parents really look up from their own stuff is when there's a crisis. They want to try to protect the child, but they forget to nurture the good part. And I'm sorry you're going through this that right now because it sounds like you do feel very isolated and disconnected. Getting rid of, rid of porn addiction is a great goal. I do have a 13 week or a 13 unit porn addiction recovery self help program on doc snipes.com basically, recovering from porn addiction is very similar to recovering from any addiction. There is a detox period, then there is a period where you've got to heal your nervous system from the damage that was done. And then you're going to need to address the emotional impacts it's had on you. What if you feel guilty about it, if you're angry at yourself, if you are angry at others or resentful of others for making you turn to porn, Whatever those emotions are dealing with cognitive changes about yourself, about how you view others, about even your attention and your concentration, that's going to be kind of not so great during the early recovery period. So developing tools to manage that until your autonomic nervous system heals is going to be important. And then addressing those relationships. How did watching porn impact how you view other people, how you interact with other people, how confident you feel around other people? How did it impact your ability to communicate, your self esteem? And all of those things are aspects that I go over in the porn porn addiction recovery program that's on Doc Snipes. And it's important not to go through it too quickly. Or some people go through it really quickly the first time just because they want to see everything. And then they go back and they do it to really get a deep understanding of what's going on with them. Porn recovery, like any addiction, is going to have a post acute withdrawal syndrome stretch while your nervous system heals. And that could be six months, it could be two years. It depends on how intense the Porn use was, how frequent the porn use was and when you started using and how long you've been using for. If you started using as an adolescent or as a child, the damage to your nervous system is likely going to take longer to heal than if you started using as an adult. My husband passed away on June 1st. My condolences. That's. That's heartbreaking. After that, I got really angry, and I pop off easily. I don't know how to regulate that anymore. All right. When we look at grief, grief is a reaction we have to a loss. Grief is a reaction we have, I dare say, to a trauma. When we experience trauma, we feel unsafe and powerless. Okay? So something happens. You experience a loss that's traumatic. You feel unsafe and powerless. You get out of that denial phase, because we can't stay there forever. And we move into grief or we move into anger. I'm sorry. And anger is your body's response to that threat. Your brain is going, you were out of control in that situation. You need to regain control. You need to try to figure out how to manage this. You need to try to figure out how to feel safe again. And when a loved one dies, we don't want them to die, obviously. And our inability to prevent that is very disempowering. Our inability to prevent the changes in our life that are going to occur as a result of our loved one dying is something that we can't necessarily control. We can mitigate that a little bit, but a lot of stuff is going to change. People also may have anger at their loved one for dying. You know, how dare you leave me first. I was supposed to go first or whatever. And we went through this not too long ago with. With my mother and my stepfather when she passed on. And there was just a lot of anger at the world, Anger at God, anger at the disease, anger at the doctors, anger at my mother for leaving, anger at himself. He felt very guilty. The things he could have, should have, would have done. You know, there's a. There was anger to go around for days or weeks. Acknowledging that anger is a response to feeling vulnerable. And the disregulation that's occurring is you have all these things. I don't know what your things are. But typically people have all these things that they're angry about, and they're just barely treading water. You know, they. They haven't adjusted to their, quote, new normal, if you will, and they're just barely treading water. So they have these 15, 20 things here that they're angry about. They're frustrated about and somebody says something or cuts them off in the grocery store and they just lose it. Well, that's the top blowing off. And if you think of a pressure cooker, you've got all these things building up heat in your pressure cooker right now that you're trying to deal with, but it takes time. It takes a min. And then somebody adds just one more thing. That straw that broke the camel's back. And all of this anger, because it's cumulative, all this anger just comes popping out. Acknowledging that, recognizing that, that's a very normal reaction. It's a crappy reaction. Don't get me wrong, I hate it. I've been through the grief process and I feel when I get to that stage where I just pop off for no reason or very little provoc. I feel guilty and I get angry at myself. And that just compounds the anger. And I'm like, I. I can. I can. Don't. I can do this. I don't need to get angry all the time. Well, I'm angry all the time. I may not be angry at the person who cut me off in the grocery store, but I'm angry. Acknowledging that and working through that anger processing. Write down everything you're angry about. And, you know, just start writing 20 minutes, start writing all the things that you're angry about and get it down on paper. And then look and figure out which ones you have any control over right now. You know, if you're angry about the fact that you've got to go through. And I remember it was a huge thing when my. My stepfather had to go through and cancel my mother's credit cards and the bank account and, you know, all the other stuff. And he would get so frustrated getting put on hold and dealing with people and getting the run around. And it was just more than he had the chutzpah to deal with at that point because he was literally using every ounce of energy he had to hold it together. And so recognizing. Does this need to happen? Okay, yes, it does. Does it need to happen today? If it does? And Walter felt like it was imperative that he start getting those things canceled, like, right away. Alrighty, fine. Is there somebody that can help you with it or do it for you? And that's where social supports can come in really handy if you have someone you trust that can help you. If you're feeling exhausted. Exhaustion triggers our stress response. So you've got all kinds of things triggering your stress response. And that exhaustion can cause you to be more vulnerable to losing your temper to feeling vulnerable. Can people, for example, do your grocery shopping for you so you don't have to deal with getting cut off in the grocery store? You get the idea. That's one of my pet peeves. Or driving or. Or something else. What can you do and what can you ask other people to do to simplify your life right now so you can start regaining the energy? Your battery is on like minus three, and you need to be able to charge up. You need to be able to process all this grief so it's not draining your battery, this anger that you're experiencing. Think of it like one of those apps that constantly runs in the background and just drains your phone battery. That's what that anger is right now. And you're going to have to figure out how to turn that app off slowly, slowly. And I don't mean just ignore it, bottle it up and make it go away. I mean, go through that list of things that you wrote down that you're angry about and start processing those with your signi. You know, somebody who's significant in your life with a support person, spiritual leader, therapist, whomever, so you can start feeling like you can breathe again. This is not going to change quickly. And I do have a video on, I have a couple of videos on grief, but one of them has a grief bill of rights in it. And in that grief bill of rights, some of the salient points are we all have the right to experience grief in our own way. We all have the right to not talk about it or to talk about it as much as we need to. We all have the right to have grief bursts. And grief bursts are those dysregulation moments that occur because we're under so much stress, because we feel so disempowered. After you move out of grief, out of anger, you'll go into depression for a while where you feel hopeless and helpless and powerless and energyless. Your body's just going, I can't do it anymore. I. I don't know what to do. And you'll recharge there for a little bit, and then you may go back to anger. And you'll likely bounce back and forth between anger and depression for a while. And that's okay. It sucks. I mean, I wish I could tell you something that would magically make it go away. It sucks. But if you're having to go into a situation where you think you might be triggered, set off, what. Whatever word you want to use, making sure going into it, you take some, you know, deep breaths ahead of time, just, all right, I got this. That sort of thing. You don't have to make a big production of it. Remind yourself compassionately that you are exhausted, you are overwhelmed, and you feel vulnerable and that it's going to be important to recognize that and to let people in your life know. I get, I'm guessing most of them know already that you've gone through this so they can be empathetic to where you're at. So they can recognize, oh, she's having a bad day today, but that's not about me. You know, she's angry today. And that anger is just kind of coming out, it's seeping through. And a lot of most people can be empathetic with that and recognize it, not hold it against you. If you're worried constantly about upsetting other people, then that's another thing that's going to drain your energy. Get a good support system, minimize unnecessary stressors, whatever that looks like. Recognize that your, not only your heart, but your mind, your body, your nervous system, everything has been through a marathon for, you know, a while. I don't know how long your husband's illness lasted. And acknowledge you don't have to be happy. Acknowledge you can be angry. You have the right to be angry. And it's up to you to decide when you're ready to let certain things go and when you're not. You don't have. You're not on anybody else's timetable. Hello, Vlad. I'm glad you're here, even if you're two minutes late. How to stop people pleasing. And I actually guess what, have a video on that. I think it's titled something like how to keep people pleasing from ruining your life. But the short version is recognizing the function of that people pleasing. Why are you doing it? What do you get out of it? And it could be that you've always been taught that you have to people please in order to be safe. And if that's what you've been taught. All right, let's examine that belief in the current context. What would happen in the current context if you stood up for yourself or if you took care of yourself instead of people pleasing or you started balancing self care with other care? In the current context, is that safe? In the current context, what would that look like? And what would be the consequences? And then you can decide again, it's not for me to tell you what to do, what not to do, or what to feel or what to think. Taking the context into consideration, you know, understanding why you're doing it. Is really important. And then you can decide what needs to happen. Now at work, for example, you may have a situation and I used to have a boss who would ask me to do things and I was fine with that, but then he'd asked me to do something else and something else on top of that. And I'm like, yes, sir. Yes, sir. Let. I'll get right on it, sir. And I just, yes, sir so much. Then I would get to the point where I was completely overwhelmed and I'd be back in his office going, I took on too much. I need you to help me prioritize what is it you need done first and. Or I need help getting this done if we're going to get it all done by next Tuesday. And recognizing that was really important in my personal growth, that I needed to be more cognizant of what I could do. And if I couldn't do something to tell him, was he going to fire me if I said, you know, I can't do that right now. I've just got too much on my plate? Probably not. Would he have been unhappy for a minute? Yeah, of course, because he'd have to go find somebody else to do it. But that's okay. That's not my responsibility. How he feels People pleasing can also be done or learned as a behavior because somebody felt like they needed other people's approval. Their self esteem was so low that they need to prove to others, you need me in your life because I'll do this for you. I can, I can make this happen for you instead of, you need me in your life because I'm awesome. I don't know what is spurring your people pleasing, but understanding where that's coming from, why you feel the need to people please is the first step. What thoughts do you tell yourself when you start thinking to yourself, you know, I really don't want to do that or I want to say no. Then what? Then what comes after that? What do you tell yourself if I say no? Then start writing those down and process them based on the facts in this context at this time. That fit. Cat Mnemonic if it's something that you learned as a child because you grew up in a dysfunctional environment, those thoughts, those beliefs, those habits, those are not going to change quickly. They can be changed, but those are core beliefs that you formed about how to stay safe. So it will take time. And if you find yourself in the present saying yes to something you didn't want to say, say yes to. It's like, okay, you know I got into people pleasing. I'm mindful of it. I acknowledge it. Now what am I going to do about it? You may be able to say, you know what, I really need to back out. Or you may have to follow through with it, depending on the time span and everything. But you learn from that and you can recognize in the future what you're doing. Taking a breath before you say yes is another important thing. If somebody asks you to do something, let me check my calendar. Or, you know, I'm not really sure, let me get back to you on that. That gives you a minute to think, so you don't have to say yes on the spur of the moment. Then there's people pleasing, like just doing random nice things for people. And there's a continuum. Random acts of kindness are great, but when you're using all your energy to do random acts of kindness, to try to convince people why you're worthy, why you're lovable, that's on the not helpful end of the spectrum. Is it nice to send somebody a card on their birthday or to do something? Sure, that's not a problem. Is it nice to go over and mow their lawn and paint their house? Well, maybe, but that's kind of a little overboard. Even if they needed their lawn mowed and their house painted, that is over and above what is expected. You can also turn it around and ask yourself, would I expect someone else to say yes if I ask them to do this, or would I expect someone else to do this out of the kindness of their own heart? And how you answer that is also going to shape what you define as pathological people. Pleasing versus random acts of kindness. Stopping repetitive thoughts. There are a lot of different approaches to doing this. Some people will tell you just ignore them. When you start having that repetitive thought turn your attention to something else. And watching a TV show, reading a book. If you still can't stop those repetitive thoughts, you may try something more intense, like putting your hands, putting your wrists in a bucket that has ice water in it, you're not going to think about much while your hands are in that ice water. And that can break the train of thought. If you're of the notion that one should just ignore them and they won't come back. There's another school of thought that says that we may have repetitive thoughts because our brain thinks that it's trying to warn us about something, something. And if that's the case, then it's important to check out the facts in this context at this time. If I'm Getting ready to go out, out and do a speech. And somebody said, and I start having this repetitive thought that you're going to make a fool of yourself out there. You're going to forget what you're saying. You're going to, you know, burp in the middle of your presentation or something. And I start having these repetitive, catastrophic thoughts. I might say, all right, those things are not accurate. There is no evidence that supports the notion that I'm going to forget what I'm going to say. There's no evidence that supports the notion that I'm going to have an episode of flatulence. I can't predict the future. Other repetitive thoughts, you know, my girlfriend is cheating on me. Okay, looking at the facts in this context at this time, what do you know? Not what are you assuming, not what are you inferring, but what do you actually know to be fact and in this context at this time, and then how can you address it? And then there is yet one other school of thought that says to write down that intrusive thought so it's not in your head, and then have time each day where you go over your intrusive thoughts or your worry thoughts, and you examine the facts for and against them in context. So those are three different strategies to handle intrusive thoughts. If you're having intrusive thoughts about a variety of things most of the time, then that's a symptom of generalized anxiety. And ultimately, when I work with people with generalized anxiety, we work backwards because when people feel generally anxious about most stuff, most of the time, that tells me they feel unsafe. They feel powerless to keep themselves safe. So we back all the way up to then and we say, what do you need to do so you feel safe in the moment, and what things are you worried about you're going to lose or are going to go bad or that are going to, you know, end up in a catastrophe. And then let's look at those based on facts and context and let's, you know, once the person starts feeling a little bit more empowered to keep themselves safe, we may look even further back to identify when they first started feeling unsafe and anxious and what that was about. Because a lot of times that traces back to adverse childhood experiences and childhood trauma. Sometimes it can trace back to trauma in adulthood. Don't get me wrong, it's not always about childhood, but generally anxiety, especially generalized anxiety, traces back to some sort of trauma and that or traumas that need to be addressed because the person is still feeling uneasy, out of balance, unsafe in terms of supporting someone with binge eating disorder, the first step, obviously I'm assuming, well, I'm, I'm using that word that I hate, but I'm going to do it anyway. I'm going to assume that the person is aware that they've got binge eating disorder and that they're trying to get better and that they want help. Great. So empowering them. Part of a lot of eating disorders is the need to control. It may be the need to control feelings, it may be the need to control my body, it may be the need to control something else. But empowering them and saying, what is it that I can do to help you when you feel like you're going to binge? What is it that you can do or we can do in your environment to remove binge triggers for you? Let's develop a relapse prevention plan. Hopefully they're doing that with their therapist, but if they're not seeing a therapist, let's develop a relapse prevention plan. Let's look at when you binge. Okay, so the binge is here. Let's work backwards. What led up to this binge? And it's generally not one thing, it's generally a bunch of things that led up to it. And then the person's just like, I gotta, you know, I, I've got to get some relief. Binge eating disorder generally involves consumption of highly processed, high fat, high sugar foods which cause the release of dopamine and serotonin. For some people it can be a mechanism of self medicating because their neurotransmitters are out of whack. There are a lot of reasons for it besides self medication. What's important for being supportive of someone who has binge eating disorder is to have them help you identify or have them identify for you. I guess what you can do to be supportive when they call you at 8 o' clock at night because they really want to order a pizza, what is it that you can do that would be most helpful to help talk them down? Encourage them to look into urge surfing, riding the wave, distress tolerance skills. Those are really important. Binge eating, just like binge drinking and you know, a lot of other addictions, they are a response to a compulsion, they're, they're a response to an urge. And those urges come in and peak and recede generally in 10 to 20 minutes. Okay. But tolerating that 20 minutes while the wave comes in and crests and recedes can be really difficult. Encourage them to explore strategies. And again, DBT is really good for this. But explore strategies that can help them tolerate the distress for 20 minutes. If it's during the day, maybe they can go outside and walk around and I go outside and I pull weeds. That's one of my big distress tolerance skills. If I'm feeling really triggered, I'll go out and pull weeds for a while and that kind of gets me into my Zen place, if you will. But whatever works for that person. The tool I suggested earlier for the intrusive thoughts, putting your hands in a bucket of ice water, that will certainly distract you from those other thoughts quite a bit. For a lot of people who are in early recovery from binge eating disorder, I encourage them to at least initially remove any of their high target binge foods from their house. Don't have chocolate in the house. Don't have, you know, white bread. Don't have things that you can easily access and consume quickly. Have things in your house that you've actually got to cook. It's going to take a minute. A lot of times by the time you're finished cooking it, the urge has passed. But I digress. Those are my best tips for helping someone with binge eating disorder who's struggling with that period between when they feel the urge to eat and when they start eating. What are some reasons why I notice or feel as though I am treated differently than others? It's a really painful and challenging issue to navigate. Without knowing more about you, Kayolor, the first thing I would encourage you to do is to reflect. When this happened today, maybe you were treated different. Feel like you were treated differently than somebody today. Okay, so at some point later when you can sit down and really reflect on what happened, examine what happened and identify the facts for and against the belief that you were treated differently. If you think your boss treats you differently, then other people examine the facts for and against that and then talk to your boss if you feel like you are justified. If you feel like they are actually treating other people differently, you may talk with them and go, what's up? You know, why did this happen? It may be that those people over there have different skills. So your boss is giving them different tasks they than they than they give you. I don't know people with ADHD particularly, but there are a lot of people out there who have high rejection sensitivity and so they are hypervigilant to signs that they're being rejected or being treated differently. And it could be that in the past they had been rejected or treated differently. So they learned how to spot those things or what they think to be those things in the present. And recognizing if you do have a history of being treated differently than other people for some reason, processing what that means to you, the grief, the anger that you're being treated differently or that you're being rejected and somebody else else isn't is really important. Explore your self esteem. How do you feel about yourself? Is your self esteem based on how others perceive you? Or do you perceive yourself pretty in a pretty steady state? And yeah, some people may not like you, some may, some people may interact with you differently than others. How much of that has to do with you versus them? Maybe there's something about you that is intimidating to them so they act differently around you. Again, without any more data to work with, the best I can say is to really examine the facts in context to see if you are actually being treated differently. And if you are, then try to figure out the reasons why. And it could be something completely benign. Like I said, your boss or somebody says other people have different skills and talents. Oops. All right. I hate when this thing jumps on me. Repetitive thoughts. Cognitive diffusion is not working as I know the thought is not mine, but it is also repetitive and interrupts the natural flow of my thoughts and I am unable to work. And part of that will be trying different tools if cognitive diffusion's not working. Trying different tools to address those thoughts that are going on and examine the frequency, intensity and duration of the interruption. It sounds like when the thoughts interrupt you, you get angry and then that just opens the, the floodgates for that thought to take over and, and learning how to acknowledge the thought and compassionately turn your attention without triggering that stress response might be helpful. Donovan says that they are a abuse survivor. They are on have a part time job on ssi living with a very toxic family. Do I self improve, heal so I can move out or vice versa? That depends. Ultimately, can you move out? If you cannot move out right now for some reason, then starting to figure out what you do have control over on healing and helping yourself can help you feel more empowered to move out. Yes, in an ideal situation you would move into a healthy environment where you didn't have to feel unsafe so you could focus your energy on health and recovery. My childhood trauma and abuse was unlocked suddenly in my autoimmune and chronic diseases I now know came from my false beliefs and codependency. I'm in trauma therapy. It's in the moment. So hard. Yes it is. Yes it is. And remember when you're in trauma therapy you are empowered. You are the one that is choosing to work on that and you are empowered to set the pace. If it's getting too heavy, if it's getting too painful, then you may need to take a pause for a minute. That doesn't mean stop working and give up the gains that you've made. It means take a breath. Breath. Take a breath to solidify your gains, to reflect on how far you've come to improve your distress tolerance skills if you feel that they're inadequate to cope with what you're dealing with right now. Does Asperger's and fetal alcohol in a traumatized teen keep them at a younger inner age than most? Because it happened to me. I'm 38 and extremely smart, but lack the so called common sense. I don't know about the Asperger's part, but the fetal alcohol. Yeah. People with fetal alcohol syndrome often talk a, at much higher level than they understand. And they may be very smart about some things, but they can be very easily manipulated. They have less of an ability to recognize because they have difficulty foreseeing consequences. They have less of ability to recognize when somebody is getting them to do something that ultimately will have bad consequences. When we look at criminal justice records, not saying you have one, but when we look at criminal justice records of people with fetal alcohol syndrome, we often see them committing the same crime repeatedly. Now, normally there's a pattern of escalation that people start out with like car burglaries and then they work their way up over the course of time, usually in relation to the severity of their drug abuse. But people with fetal alcohol syndrome can be convinced to do things that are wrong and they can may continue to do them doing the same thing and kind of expecting different results, so to speak. So it is an interesting thing. And fetal alcohol spectrum is a spectrum. Some people have very little impairment from it. Some people have a whole lot of impairment from it and are unable to live independently. And no two people, just like no two people with autism or Asperger's are exactly the same. No People with 2 people with fetal alcohol syndrome have, or spectrum syndrome are exactly the same. They don't necessarily have the exact same, you know, levels of cognitive abilities or the exact same symptoms. So I don't know exactly what your symptoms are, but certainly I can see someone with fetal alcohol syndrome feeling like they are at a younger inner age because they're not as able to move into formal operational thought. Do I have any idea with how to deal with a narcissist adult? Kid, I feel like I seriously need to be completely cut family ties with them. I also believe he loathes, hates women, just uses and abuses them. Narcissist is a really broad term without knowing specific behaviors. And I would encourage you to write down what specific behaviors is this person doing that you are assigning the label narcissistic to? And so is grandiose, as evidenced by. And then give two or three examples of how that person is exhibiting grandiose behavior or lacks empathy as evidenced by. And so you can get an idea of what's going on. Ultimately, behavior is communication and something happened to that individual that caused them to loathe women and be abusive towards them. Was it something he learned from his peer group? Was it something he learned from video games? Was where did he learn that? I don't know. But there are a lot of behaviors that people may pick up that from, you know, school, peer group, media, whatever, that are hurtful, that are can be unkind, that can be somewhat narcissistic in. In flavor, and they don't realize they're being hurtful. And so a lot of it comes down to exploring exactly what behaviors are you having difficulty with and what function are those behaviors serving for that person? Are they aware of how their behavior impacts you? And if they are, have they been present? Have you presented them alternate? You know, it really makes me upset when you do this. Would you instead, when you get angry, would you please do this? It really makes me angry when you. Or upset when you get angry and you throw something across the room at me. And I would appreciate it if you get angry, if you would go out on a walk for a minute to down regulate and. Or get back to baseline, whatever you want to say. I avoid the word calm down and then come back and talk to me about it because I. I really care about what you have to say. So if you've presented the fact that you don't like the behavior and why, and you've also presented alternate responses and the person is not wanting to change, then that's a horse of a different color. We can't force people to change. And at a certain point we have to decide what. Whether their behaviors are toxic enough in our life that we need to distance from them. We love them, we want the best for them. But if they're not willing to change their behaviors, whether we're talking about addiction or narcissistic behaviors or anything else, if they're not willing to change that behavior, then we need to seriously limit how much contact we have with them. And, and I mean, it's ground rules in my house, my rules, so to. So to speak. I'm hung up on a traumatic event from April of 22 and have been in survival mode since spring of 2020. Had lots of lost peoples and things. I want to ask a about closure, ruminating, wishing, changing the things in the past. In my mind. It sounds like during the period of the pandemic, you experienced a lot of traumas and you may be struggling with complex post traumatic stress disorder. And I have a lot of videos on that that can help you examine your symptoms and figure out if they're coming from the trauma or from something else. But when people have experienced multiple traumas, they often continue to feel powerless and unsafe because it's like every time they think they've got it under control, another shoe drops. Processing that with a therapist can be really helpful. Emdr. Since it looks like there are a few distinct incidents of trauma that you're dealing with, EMDR might be very helpful for you as well. You are quite welcome, Mimi. The prefrontal cortex is where we do our executive functioning. I mean, it has a lot of other functions too, but that's where we do most of our executive functioning. And that is organizing, planning, problem solving, attention, concentration, even some interpretation of what's going on in, in the world. Your emotional interpretation takes place more in your hippocampus, amygdala, etc, Your default mode network is your autopilot. And generally for your prefrontal cortex to kick in, the default mode network needs to be turned off or down at least, so the executive control network can take. Take center stage. And I do have a video on the default mode network that might be shed some light on that. How can I help my teenage niece who was caught cutting herself and has depression? Her brother was recently admitted to a facility for substance abuse and her environment is not very positive. All right, Your niece is a teenager and obviously still living at home. So, you know, 18 or under, if you believe, I mean, obviously if you believe that she's in a situation that's dangerous enough to involve child protective services, that's something that, that can be done. You know, I, I hate to start out with that, but legally, you know, that would be. If you came to me in my office and told me about this, we would probably evaluate the situation to see whether we needed to get an outside agency involved. That being said, the brother has substance abuse issues and she is engaging in cutting behaviors. Those are all responses to trauma. And a lot of times, insecure attachment Helping your niece recognize that you are consistently there. You're there to hear her, you're there to be responsive and help her figure out how to get through things. That you care, you're attentive, you actually want to go to her school plays or whatever. That you are going to be encouraging, that you're going to be safe is all those things are really important for her because it sounds like she's not getting that right now. She's in an environment that is riddled with what we call ACEs. Adverse Childhood Experiences. There's mental health issues, there's substance abuse issues. There may be neglect, emotional physical neglect. There may be violence, verbal or, or physical aggression, either between parents or between parent and sibling or, or something else. Those are all adverse childhood experiences. Those are all traumatic, and those all will contribute to later life problems. Her cutting behaviors, I would encourage her to talk openly with her therapist about them. As I, as I said earlier, a lot of times, not always, but a lot of times, cutting behaviors and self injury, self injurious behaviors are not intended to be suicidal. They're intended to get somebody to pay attention. In the addicted family, it can be, hello, nobody's noticing me. Pay attention. Or it can be, I need to stop y' all from fighting and arguing, so turn your attention to me instead of fighting among each other because I'm afraid of what will happen there. So there's two different, like permutations of why that might happen. I, I have a video on self injury that might be enlightening to watch, just so you're aware of kind of all the neurochemical things. Injury promotes the release of endorphins. And when you're injuring yourself, not recommending it, please don't do this. But when somebody does injure themselves, they have control over how much pain, the intensity, the duration of the pain. And that gives them a feeling of control in an otherwise uncontrollable situation. Developing alternatives that your niece can use that are not as injurious. Again, it's one of my favorites. So it comes up all the time, putting your hand in ice baths, that is a controllable pain. So that can be an alternative that is not going to cause injury to her. One of my patients used to write on her arm instead of cutting. She would write in red ink because the pressure from the pen was just uncomfortable enough. And there was enough with the red pen. There was enough generalization that, that worked for her. I had another patient who would put on her headphones and listen to her favorite band loudly now, is that good for her hearing? Heck no. Is it better than cutting? Heck yes, in my opinion. So those are some things that we, we worked on together, but obviously that's something that they're. The therapist needs to help her with. Anybody who is engaging in self injurious behavior is at a crucial point, and they do need professional intervention, not necessarily residential. You know, outpatient is usually just fine, thank you very much. But it is essential to get somebody there that the youth can talk, that the person. It's not always a youth that the person can talk to and develop these plans with so you don't feel the responsibility all on your own. And. And Cynthia, one more thing. You know, you said you live in a different city, but you worry about her. Have you told her that that could be something that she actually needs to hear? Hey, somebody gives a damn if I'm breathing or not. And going a step further than that, saying, you can call me anytime. I don't care. Time, what time, day or night, you can call me if you need to talk, you can call me if you just want to scream for a minute or. But if you feel the urge to engage in that behavior, please call me first. And that can be really empowering. There was one client that I remember distinctly that I worked with at the crisis center many, many, many moons ago. And they would call in the evening because they didn't have anybody else to call, and. And they would talk to you. And unfortunately, they were a little bit more manipulative. But I do remember one night them saying that my responses were helpful and kept them from engaging in that behavior. Just knowing somebody's there can be huge for a lot of people who feel lost, who feel confused, who feel scared, and. And clearly her brother did, too. He was just trying to numb it up a different way. Well, I am so glad, DL, that you are working toward your rich and meaningful life. And unfortunately, crap happens. And there may be periods where you feel like you're kind of stuck or even sliding back a little bit, and that's okay. Just regain your footing and figure out how to use your energy to move forward. And I don't want to say that that's going to happen, but one of the biggest mistakes that a lot of people make is ignoring little hiccups in their progress forward until it becomes an absolute avalanche backwards. And I always say relapse happens long before you actually pick up, up, use again, or engage in that behavior or get clinically depressed. Whatever you're relapsing into, the relapse started way back when, when you quit taking care of yourself, when you quit, when your circadian rhythms got out of whack because you didn't prioritize your well being. So, and, and I'm not saying you're doing any of this. I am just thrilled that you have felt empowered to move forward and, and you're being compassionate with yourself, recognizing that you can do this. It's hard and there are good days and bad days, but you can do this. I do have a video on chronic on fear on fomo. Fear of missing out. Examining what you're afraid of missing out on is really important. And then figuring out, looking at your rich and meaningful life. Watch that video on how to figure out how to define your rich and meaningful life. And then before you do something, ask yourself, yeah, I'd like to do it. Sounds like it might be fun. I don't, you know, I don't want to miss out on that, but is it the best way to use my energy to move toward my rich and meaningful life or is that just taking me on a wild goose chase? I have a client who has stage fright, social anxiety. I advised exposure. He never avoided the feared situation, always faced them, but his symptoms still persist. I would encourage him to work on a systematic desensitization for one. You know, first imagine that situation and feel the stress response kick in and use those, those distress tolerance skills to down regulate back to baseline. Once they can do that easily then move toward the next level of exposure. Instead of just, I'm not huge on just completely immersing somebody in it. I, I like to take the baby steps so they feel empowered to go to the next step. It's like, hey, okay, you know, I, I imagined being in a room with a spider and I was able to calm myself down. Okay, so that's one aspect of it. The other aspect of it is to examine what led up to. Anxiety to begin with. And a lot of times there's a trauma underlying that. It could just be inaccurate knowledge such as being afraid of spiders because you think all spiders are dangerous. No, that's not true. Once you realize that most spiders eat bugs and are totally harmless to humans. Yeah, they may be a little creepy crawly, but, but you stop being afraid of them and you can start looking at what's the probability that I'm going to run into a poisonous spider and it's going to bite me, you know, so examining the cognitions that are supporting those fears and where those cognitions developed from in order to help them start Feeling safer in. In their own skin. There are a lot of reasons for self injurious behavior, Fiona, and you raise a good point. Some people don't want others to find out. And it's not always about attention seeking. Sometimes it's about that control that I talked about where you can control the pain, you can control the duration. And sometimes it sounds like you may have been using it as a punishment for yourself so you could control the intensity of the punishment. But ultimately it was about control and it got compounded or reinforced, if you will, because you were controlling things which, you know, gave you a sense of accomplishment or. I'm not sure what word I'm looking for here, but that's what you wanted. And also you got that endorphin surge, so you got a double whammy. Reinforcement for a behavior that is not necessarily the most hopeful thing. All righty. I am going to answer one more question and then I will be. Ah, there we go then. I'm going to sign off for today. Can a chronically hyperactive amygdala inhibiting the prefrontal cortex make us forget how to actually use cognitive control when people are in fight or flight? When people are in fight or flight, whether it's persistent fight or flight, because they constantly feel unsafe and powerless, or episodic, people are not using their prefrontal cortex. You're either in fight or flee or think about it mode, so to speak. Most people, because the glutamate going through your system actually impairs your ability to think clearly. It's like we're focused on getting away from the hungry lion. So yes, people who have unresolved trauma, people who have chronic anxiety, often have a harder time engaging that rational mind, that wise mind, that prefrontal cortex. And it's important to help them develop better vagal tone so they can down regulate their emotional response and more effectively evaluate response options and take action. Okay, one more. My organization said I can't run ba run basic assessments for substance use disorder. I'm a certified AOD counselor, level three. This is a faith based recovery residential program in California. Does this sound correct? Unfortunately, it does and let me tell you why. It has nothing to do with you. If they start providing clinical services and they are not licensed by the state to provide clinical services, then they are running a foul of the law in California for what they need to do and they could get shut down, fined, worse. So yes, if you are a support professional in a faith based organization in most states, and I haven't done the research on all of them. But I actually am very involved with several Christian recovery ministries. And in most states, you cannot do anything clinical. You cannot assess, you cannot diagnose, you cannot write a treatment plan. You can write a. A goal plan, you can write a service plan, but not a treatment plan. So the words like assessment, diagnosis, treatment, and even counseling are generally forboden. You can provide coaching, support, consultation. There are a lot of other words that you can use. But as soon as you cross over into the things that are covered and only allowed to be done by licensed professionals in a licensed setting, then it starts getting. Getting hazy. You may choose to reach out to the association of Christian Recovery Ministries. I believe their website is still a a CM.com because it started out as the Alabama association of Christian Recovery Ministries. Now it's just the association of Christian Recovery Ministries. But great group of people. They have. Gosh, I think they've got 50 or more organizations under that under their umbrella and they have a lot of wisdom about what can and can't be done. But my sense is your organization is saying that because they're probably not licensed to provide clinical services. Alrighty, everybody. It's been a little over an hour. My voice is starting to go, so I am going to say goodbye for today and I will see you next Monday, probably the same time, same station. I just started a new job today, so I may have to move this to the evening. So just kind of stay tuned and I will let you know.