Live Chat with Dr. Dawn-Elise Snipes

Foreign, Everybody. So we did. I did get one question for today's show, so I will be talking about that in just a minute. But I want to give people a chance to log in if they haven't had a chance to do so yet. While we're waiting, please remember on Mondays that this show is dedicated to answering your mental health related questions. Remember, this is not counseling. This is only education. If you are in need of counseling, it's important to reach out to your insurance company who might be able to provide you a referral or somewhere like Psychology Today's therapist locator in order to locate a therapist near you that takes your insurance. Alrighty, so I see that we've gotten a few more people that have logged in, so let's go ahead and get started. I'd like to welcome everybody to today's presentation on integrative behavioral health. Mondays are dedicated to question and answer. And the question that I got from y' all last week from one person was on scapegoating and mental illness. So scapegoating, as you can probably put together, is a behavior in which one person in the family usually gets blamed for anything bad that happens. And when you grow up in a family in which you are the scapegoat, you often recreate that dynamic in future relationships. So you may end up being the scapegoat at work, you may end up being the scapegoat in future romantic relationships. And it's important to examine how that behavioral pattern may be repeating throughout your life. Why does it repeat? Well, because it's what you know. It's because what it's what you grew up with, kind of what you learned. It's very common in families in which someone has either an addiction or a personality disorder. In both of those groups of conditions, the person who is has the addiction or the personality disorder who is the quote identified patient often has difficulty accepting responsibility for their own behavior, so they need to project it onto other people. And they find often a scapegoat, which is often tends to be a person who doesn't fight back. It tends to be a person who takes it for whatever reason. For as. As a result, scapegoating is a form of aggression. Obviously, if you're getting blamed for something that is not your fault and can result in excessive feelings of worthlessness. If you are constantly being told this bad thing happened because of you, or this bad thing wouldn't have happened if you would have, only then people can start feeling that they are very worthless in relationships. And as human beings so that's going to be a focus for treatment. They can feel very helpless. When people are scapegoats, they don't know what they're going to get blamed for next. So at a certain point they may feel like they don't have, you know, any ability to do anything right. When they are scapegoats, they often feel like they don't have the ability to escape, escape being blamed for things. So they just kind of have to endure it. And when you're a scapegoat, when you're told consistently that bad things are happening because of you, then you may start feeling guilt. You know, no surprise there. You can be angry at yourself because you feel like whatever it was is your fault. And there are lots of different types of guilt. But we're really just focusing on the impact of scapegoating on people today. Well, so what do we do with scapegoating? Scapegoating can be an, can have impacts including extreme anxiety, fear of abandonment, fear of rejection and depression. So we do want to recognize that it does have long standing impacts in treatment. Some of the things that we want to look at include externalizing the scapegoating inner voice. A lot of times when we have grown up with being scapegoated, we internalize that voice. So there, there becomes a very critical inner voice that's taken telling us with regularity, bad things are your fault, this is your fault somehow. So it's important to name that voice, to identify that voice, to name it and to externalize it, to recognize that it does not have to be part of you. And we've talked about silencing the inner critic before in other videos. And there are a lot of tools that people can use to do that. But that is one of the first steps towards improving self esteem and feeling more empowered if, if you stop having that voice in your head telling you consistently that all bad things are your fault. The second thing we do is focus on identifying what the person is actually responsible for in the present context. Now, scapegoating often goes on for a long time. And when you are a child and you're being scapegoated, a lot of times you are blamed for things that there was. In no version of reality would you be expected to be responsible for. For example, being scapegoated for a parent's depression, for a parent's addiction, being scapegoated for a divorce, you know, that's not on the child, but the adults can blame the children for, for their distress. And that's that Scapegoating. So it's important to recognize that you've internalized those scapegoating behaviors and guilt sort of mantras in your mind. And it's important in the present to identify what you are actually responsible for right now. You know you're not responsible for how others feel. You know, you can care about them, you can empathize, you can be supportive, but you are not respons. You can't control other people. You can be supportive and encouraging, but you can't control them. You are not responsible for the weather, you are not responsible for. And you can fill in the, fill in the blanks. But when I work with people who have been victims of scapegoating, one of the things I encourage them to do is develop the I am not responsible for mantra because they have too often taken on the responsibility responsibilities that are really not theirs, that they have no ability to control. In therapy, we often will move toward reviewing the past to examine guilt related beliefs, examine things that in the past they have been scapegoated for that they're still feeling guilty about, and explore it in terms of what are the facts in that situation, what were the facts that supported and that went against the notion that it was your fault in the past in that situation, in that context, was it reasonable to put the responsibility on you? And a lot of times the answer is no. So things that people are still feeling guilty for today as adults may be things that they were blamed for in the past that were completely out of their control. And it's important for them to examine those with fresh eyes when they can take a step back now that they're in a safer environment where they can explore that and determine which parts they may need to make amends for, if any, and which parts were not within their control and not something that they're responsible for. Ergo, not to be guilt ridden about. Everybody has to process that in their own way. We also work on developing boundaries so people can start recognizing, here's where I end, here's where my responsibility ends, and here's where you begin. And enhancing assertiveness in order to help people start protecting themselves when it's safe to do so, protecting themselves in relationships so they can say, you know what that is. Actually I'm not going to be scapegoated. That is not my responsibility. All of that sounds really easy, but it's not. It is a long process when you have been groomed this way or for years. It is not something that is easy to undo and it's Important to recognize that the guilt, the shame, the, the feelings of helplessness and hopelessness and worthlessness all contribute to, to issues like abandonment, anxiety and depression. So yes, scapegoating does contribute to the development of mood disorders in a lot of people and even addictions in a lot of people. And there are treatments that are available, there are things that people can do in order to address the impact of the scapegoating so they can start feeling again, safe where they're, they don't feel like they're being blamed for everything. They don't feel like they're going to be abandoned. So they start feeling safe, they start feeling empowered, and they start feeling worthy. Another question comes in is what are some ways to help a loved one experiencing grief? And there are a lot of videos on the, on the website on the grief process. It's important to recognize that they have their right to grieve in their time and have the thoughts associated and feelings associated with grief that they are experiencing. We can be supportive of them. We can do our best to help them improve the next moment. You know, what is it that you need right now? What is it that I can do to help you right now? But they are going to need to work through the grief process in their own time. Now there are phases of grief, and it's not linear. It doesn't just go denial, anger, bargaining, depression, acceptance, and voila, we're, we're over it. Um, you people often bounce back and forth between depression and anxiety. Remember, when we experience grief, it means we have experienced a loss of some sort of. It means we have experienced a loss of control in some ways. And people need to be able to move towards embracing a new normal or a new reality without that person, place, thing, experience whatever it is in which they feel safe and empowered. So grief produces, comes from loss. And that loss often triggers feelings of unsafeness and disempowerment. So we do want to help people figure out, you know, what is it that you can do now, moving forward that can help you feel safe, help you feel empowered? If they lost something or someone that was important to them, what can you do in order to keep the memories of that alive in your heart? And they're, you know, for each person, it is very different. And the length of time it takes to go through grief is very different. General rule says that for any significant loss, it's going to take at least a year and maybe three, four or five years. So there is no timetable that anybody has to adhere to if they are grieving to the point where it's impacting their activities of daily living, their ability to, you know, get up, shower, go to work, those sorts of things. Then it's important that they be put in contact with resources such as support groups or counseling that can help them deal with that to the point that they can manage their life on a day to day basis. And eventually, as they move through the grieving process, the grief bursts. The moments during the day where the grief feels overwhelming will gradually become less intense and, and shorter and fewer in number. And remember, with grief, there's complicated grief when things happen that are particularly out of order or unexpected. And complicated grief takes a long time to process. And grief, when we lose things that are truly important to us, they have a place in our heart. And over time, we learn how to live with that pain. Thinking that the pain is going to go away is probably not helpful for most people because, you know, pain of a significant loss is still going to be there. But you learn how to cope with it and hopefully are able to assign some positives to it. Like, when I think about my daddy, you know, it hurts that he's not still here and it's been 20 years since he passed. But I also, when I start to feel that hurt, I also turn my attention to the happy memories that I had with him instead of focusing on his final moments. That works for me. That is not necessarily going to work for everybody else. But it's important for people to recognize that grief and losing something important is going to leave a. A mark on our heart. And figuring out how to live your highest quality of life and acknowledge what happened is important. In terms of addressing guilt for past addictions. Guilt in addiction recovery is very common, and it's something the person has to work through on their own. When they are ready, when they feel like they deserve to stop being angry at themselves for what they did, then they're able to move forward. It's not something we can take away from somebody. They have to be ready and willing to address that issue. And you know, in particular you're talking about in addiction, some of the ways that people work through that, if they're working a 12 step program, is by making a list of wrongs that they have committed and then making amends for each one of those things to the extent that they can. And that can help people work through their guilt list, so to speak. But it is important, and it is important for them to do that because if they hold themselves accountable for everything and they continue to be angry at themselves for choices they made in the past. They're tying that energy up back, back there. They're keeping themselves from feeling okay. They're keeping themselves feeling guilty, which can be a huge relapse trigger. And you're right, it can contribute to physical health problems because increased stress increases inflammation, increases oxidative stress and is associated with a whole host of physical issues. So you are on point that holding on to that guilt is a relapse trap for a lot of people with addictions and it also can contribute to stress related illnesses. Now as we're talking about guilt for people, the other issue for a lot of people is they are afraid to let go of that guilt. If they let go of that guilt, they're afraid they might relapse. So that is another issue that is important for people to process in therapy or with their sponsor to identify ways that they think guilt may be helping them and maybe some alternative ways to achieve those same ends in recovery. For example, you know, if you, in 12 step programs, if you keep working the program, that keeps you on the right path, that keeps you moving forward in good orderly direction towards a recovery lifestyle. So by virtue of working the program, you are not going to relapse. And, and so it serves a similar purpose for some people who hold on to their guilt for fear of relapse. It's in recovery. It's so much more empowering to work towards something positive like a recovery lifestyle than to be constantly trying to avoid something negative like relapse and guilt. Alrighty everybody. Well, I appreciate the questions. And you know, it is devastating. I, I feel bad to hear that you lost your child, Amy. I can't imagine what that must be like. And so I would, you know, encourage you to be kind to yourself. You said up earlier that it had been, I think six years. Well, you know, yeah. And, and that child has a place in your heart and has, you know, has their little footprints on your heart and it may get easier on a day to day basis over time. But that pain, there, there will be some pain associated with those memories and it's finding out how to live the life that as, as best as you can, live as healthy and rich of a life as you can and have that memory, have that experience with you. My, I've shared with you guys before. My stepfather, many, many, many years ago lost his family on Christmas Eve and you know, it's almost 50 years later and it's still, Christmas Eve is still one of the hardest days of the year for him. You know, it got easier where he could you know, he, you know, had a very full and productive life, but there were always moments that occurred for him that were depressing and agonizing and he just learned how to deal with that the best way possible. In terms of recovering from narcissistic abuse. And a lot of narcissistic abuse also kind of couples with scapegoating. But a narcissist thinks that they know everything and that you don't. It's important to again, externalize that narcissistic inner voice that parrots what that caregiver or whomever was the narcissist kept saying to you. Externalize that and deal with the memories that are associated with that voice and explore the impact that the narcissist had on you, your self esteem, your health, your energy, and examine what steps need to be taken in order to repair those wounds. In terms of setting boundaries, when you believe that, when somebody believes they're deserving of pain and mistreatment from family and friends, foreign it's hard for family and friends to sit by while we watch someone who feels like they deserve to be punished. So it's really important to be assertive about what you feel, what you think, what you want in a situation. If they feel like they deserve to be punished, then they still feel guilty about something and it's going to be important for them to process their guilt. But we can't, again, we can't take that away from them. It's. They're not going to let go of it until it no longer serves them a purpose. All behavior has meaning, and if that guilt is serving a purpose for some reason, then we need to help them figure out, or they need to figure out what that purpose is and if it's helping them live the kind of life that they want and need to live. It's important for people who do feel guilty to be able to validate their feelings, but also acknowledge your perspective and doing that when it's safe. Obviously, you know, not all situations are safe to state your own opinion. But the best thing that you can do is respond in a securely attached way. Being consistent, being consistently there for that person, being responsive when they are struggling, you know, trying to be supportive and help them move forward, being attentive, you know, giving them attention for the good things. You know, you don't have to give attention to their self flagellation, but you can pay attention to them and create quality moments with them where you're doing things that are positive. Being, let's see, consistency, responsiveness, attention, validating their Feelings, you know, I hear you feel like you deserve to be punished. You know, that can be on point. It doesn't mean you're agreeing with them. You are just stating your observation, empathizing with how they feel, and, you know, trying to get walk a moment in their shoes and explore what is this behavior? Saying what is the function of this behavior? Or what must it be like to live in this person's head right now? And then providing support the best way that you can by asking them, what is it that I can do to be of assistance. In terms of enhancing assertiveness, assertive communication means, number one, setting boundaries, recognizing where I end cognitively, my thoughts versus your thoughts, my emotions versus your emotions, and my space versus your space. And once you recognize that, then assertiveness says that my thoughts, wants and needs are just as valid as your thoughts, wants and needs. It's not. My thoughts, wants and needs are not more important than yours. They're not less important. They're equally as important as yours. So being assertive may mean stating if you're talking to a significant person in your life and they have one opinion and you have another opinion, assertiveness, assertive communication would indicate that you both have the right to your own opinions. You don't have to agree, you can agree to disagree. As they say, I really hate that phrase, but it works. And, and that's where assertiveness comes from. You don't have to like what they say. You don't have to agree with what they say. But hearing what they say and validating from their perspective, that is reality or that is the, you know, that's their point of view. All of us interpret the world and interpret every single moment based through a filter, through a lens of our prior experiences. So two people can go through the same exact thing and have two completely different perceptions of what happened. And that doesn't mean that one's right and one's wrong. It just means they experienced it in a different way. And assertiveness is really important when you are dealing with a customer service manager. You know, being assertive means saying, I need to return this because it's broken and I would like a credit on my credit card. That's assertive. I'm saying this is what I want. And they may say, well, I need this, that, and the other thing in order to make that happen. Okay, so they're stating their needs. They're not saying that your needs are less important. They're telling you what they need in order to try to meet you halfway. And accomplish your goal. So it's important to be open and willing to hear what people have to say and use that assertiveness in order to help them feel empowered or not help them not feel disempowered. You know, when people feel like you are being aggressive, when they feel threatened, when they feel disempowered, they're going to typically respond in kind with aggression. So assertiveness can really help you get your thoughts, wants and needs stated so people can better meet them. Alrighty everybody. Well, thank you for such an active group today and I will see you tomorrow.