Transcendental Meditation May Help Vets with PTSD

Therapy | August 19, 2011

What The Evidence Shows

A recently study from Georgetown University Medical School suggests that Transcendental Meditation (TM) can reduce some of the symptoms of Post-Traumatic Stress Disorder (PTSD). The study found that Transcendental Medication produces reductions in stress and depression, with improvement in overall quality of life. The results were concluded after the participants engaged in three months of twice a day TM practice. The results were corroborated by a similar study conducted at the University of Colorado School of Medicine. The researchers believe that TM may be helpful with those suffering from PTSD because it produced long-term changes in the sympathetic nervous systemic activity. TM can quiet down the nervous system slowing down the fight-or-flight response. It results in a lowered blood pressure, and decreased reactivity to stress.

My Thoughts on The Study

My thoughts are that while this study is good news, Transcendental Meditation should be used to treat PTSD suffers only in conjunction with psychotherapy. First, both studies involved only very small population samples, and not enough research has been done. Second, while TM can calm the nervous system, the issues that cause the PTSD still remain if they are not processed, and the symptoms will continue to leak out if not addressed. PTSD, in my opinion, is best treated by psychodynamic psychotherapy with supportive couples counseling when needed. That being said, given this new study and my experience with meditation in general, I would encourage my patients with PTSD to begin a meditation practice.
If you are suffering from PTSD and are interested in psychotherapy, marriage counseling, or couples counseling, please contact Jennifer De Francisco of Newport Beach at (949) 251-8797.

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Understanding PTSD through the Lens of 09/11

Therapy | August 18, 2011

PTSD is a terrifying, debilitating, and often isolating condition that is little understood among the population at large. In this blog, I would like to examine what is PTSD, why it is so often misunderstood and misdiagnosed, and what can be done to help those that suffer from it. I have used statistics and examples from 09/11 because most people felt some sort of trauma from just having to live through that particular time. Understanding how traumatic it was for those that were actually present can help us be more sensitive to those that suffer from trauma in general.

09/11

One method for assessing the psychological effects of 09/11 is by examining the following: 9/11 is still having a psychological impact on people who were there at or near ground zero eleven years later. By conservative estimates, at least 10,000 police officers, firemen, and civilians exposed to the terrorist attacks have suffered at some point or another from post-traumatic stress disorder, commonly known as PTSD. A conservative estimate calculates that 4,000 of these people still suffer from the condition.

What is PTSD?

The 09/11 survivors often report classic PTSD symptoms to this day, such difficulty sleeping and concentrating, with sleep being disturbed by very lucid, terrifying dreams. They ruminate over the disaster, as if it were a tape inside their head playing on a loop that they cannot turn off. They have what is called a “startle response” in which they jump or startle to loud noises, and are generally hyperalert to their surroundings. They try, usually without success, to avoid thinking about the traumatic event; unfortunately, even the smallest things can be triggers, reminding constantly them of the trauma.

PTSD also has negative consequences on family life and relationships as sufferers feel like they are in a “fog” and disconnect with loved ones. Loved ones often hear incredibly frightening thoughts expressed from the sufferers such as the idea that they are going to die soon, or that they do not deserve to live. Survivor’s guilt is common. Loved ones of PTSD sufferers are also frequently disturbed by the dark, negative, and frightening lens through which they view the world; they think bad things happen to good people and are pessimistic about not only their own future, but about the future of all of humanity.

Why PTSD Is So Misunderstood and Misdiagnosed

PTSD, which was first conceptualized in the late 1970’s after experts studied the psychological affects of war on Vietnam veterans, is often misunderstood and the people that suffer from the disorder often do not get the help that they need. Since PTSD symptoms sometimes have a delayed onset, suffers think that they are suffering from simple insomnia, stress or burn-out. With the symptoms occurring months or even years away from the time the trauma took place, a causal relationship between the event and their psychological stress is often missed.

This is compounded by the fact that PTSD is the only psychological condition that is brought on clearly by an “event”, and the event must be experienced as traumatic. What is traumatic for one person may not be for another; individuals have different levels of resiliency and coping mechanisms, so not everyone is going to suffer from PTSD even if the event is something most people would experience as psychologically injurious. Furthermore, some people are so vulnerable to traumatic loss that even something like a fender-bender can trigger PTSD symptoms for these individuals. Some people, including loved ones, who they themselves are not sensitive to trauma, are often dumbfounded by such sensitivity. Since they do not experience such events as traumatic themselves, they can get exasperated with the sufferer‘s morbid preoccupation and emotional debilitation. It can be incredibly confusing and frustrating for the loved ones since the sufferer never wants to talk about “the event” with them in any meaningful, productive way, but then seem to be able to think about little else since.

PTSD is cumulative, meaning that successive traumatic events eventually catch up with a person psychologically. Sometimes a person has been through several traumatic events and seems able to brush them off quickly. But if there is emotional scar tissue that has been unprocessed then something apparently non-traumatic can flip that person into full PTSD symptomotology. For example, Vietnam veterans have been known not to suffer from PTSD after coming back from duty can sometimes be flipped into the condition by an illness or a natural death of a friend. Individuals that have a history of abuse, neglect, or childhood trauma are more prone to PTSD, and to suffer from PTSD when a traumatic event is less serious.

What Helps

There are a number of treatment options now available for those suffering from PTSD, and the results are often quite positive. I find that psychodynamic psychotherapy is most effective in treating PTSD. Supportive couples counseling can be very beneficial as well, especially if the spouse is having difficulty understanding what their partner is experiencing, and the marriage is suffering. In more treatment resistant cases, a combination of psychiatric medication and psychotherapy is the best approach, but this method is not for everyone and depends on the severity of the symptoms and whether the patient is open to medication management.

If you are interested in learning more about my approach to treating PTSD and live in the Newport Beach, Irvine or Orange County area, please contact Jennifer De Francisco at (949) 251-8797.

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Thinking about a Nose Job? You Might Want To Visit a Therapist First

Therapy | August 3, 2011

Seeking plastic surgery, especially a nose job, may be an indication of Body Dysmorphic Disorder (BDD), which, in essence, is an obsession or preoccupation with imagined or slight defects in appearance, causing significant impairment in relationship and occupational functioning. A typical person suffering from BDD will generally look to plastic surgery before looking to therapy, as they see their suffering coming from an external source rather than from obsessive and intrusive thoughts. Furthermore, studies have shown that even if the surgery is considered successful, they are more likely to be dissatisfied with the outcome and seek a revision.

New studies have given us a better understanding of how prevalent BDD is among those who seek plastic surgery; in fact, it is far, far higher than ever thought – particularly for those interested in rhinoplasty. Among those who seek plastic surgery, specifically rhinoplasty, otherwise known as a nose job, there is a high level of BDD among patients seeking plastic surgery.

Previous studies have put those that suffered from BDD and sought plastic surgery at about ten percent of plastic surgery patients. A new study from the University of Pennsylvania shows that of the individuals seeking rhinoplasty for cosmetic reasons only, almost fifty percent meet criteria for Body Dysthymic Disorder, which is an exceptionally high correlation. On the flip side, those seeking surgery for only medical reasons have a prevalence of just two percent. The researchers concluded that the preoccupation with the nose was significant because a preoccupation with its “defects” had no correlation to any level of abnormality in the nose, but instead was related to poor self-esteem and self-worth.

What Is the Difference Between Just Being Vain and Having BDD?

If a person seeks out a plastic surgeon for a nose job, there has to be some level of dissatisfaction with their appearance that leads to contemplating such a serious solution. Body image dissatisfaction does, however, fall on a continuum: those that struggle with BDD severely struggle with social relationships and have difficulty staying employed. Someone who is simply “vain’ might look in the mirror and wish some things were different or “better”. People suffering from BDD have difficulty thinking of little else; they obsess about the offending body part, stare in the mirror for hours, and try to avoid having people look at them directly.

If a patient is suffering from BBD, operating on the BDD patient can be a mistake. After trying to “improve” one area of dissatisfaction, they very often find a new physical trait to preoccupy themselves with. Since the problem is psychological rather than external, the possibility of satisfaction with the surgery is very low. Preoccupation often sets in with what the BBD sufferer considers a bad result and they begin to obsess about their next surgery.

Relationship difficulties and BDD

People who suffer from BDD often have troubled, chaotic relationships and are so obsessed with their perceived physical defects that they have difficulties connecting with loved ones, often spend huge amounts of money on surgeries and their appearance, and often do not want even their spouse to look closely at them. What BDD sufferers need most is individual therapy, but can often be more easily engaged in couples counseling since it is perceived as less threatening.

If you are interested in treatment for marital therapy or individual counseling in Orange County, Newport Beach, or Irvine, please call Jennifer De Francisco, LCSW at (949) 251-8797.

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The Benefits of Marriage Counseling with a Professional Therapist

Marriage | July 29, 2011

In the current economic climate, anyone is susceptible to being affected by stress or frustrations, and Orange Country residents are no different. In a marriage or relationship, these pressures can build resentment leading to unhappiness and martial discord. Those looking to save a marriage or improve their relationship, owe it to themselves to try marriage counseling with a Newport Beach professional .

A marriage counselor  or psychotherapist can help you enhance a healthy relationship or assist in processing and resolving marital problems in therapy sessions, as a couple together or individually, which are uniquely developed to your goals. Since few of us are fully equipped with the relationship skills needed to overcome difficult interpersonal conflict, a therapist can help each person develop these skills so that in couple counseling sessions, they begin to cooperate on rebuilding and improving their relationship.

How can Marriage Counseling improve or save my marriage?

  • In a ‘safe’ and neutral environment with an impartial and educated therapist, you will learn to assertively communicate your needs and grievances in a non-offensive tone, without anger or fear of retaliation. You will also learn to use active listening to ensure your partner feels acknowledged. These are essential communication skills.
  • In order to resolve conflicts in a healthy manner, you might learn how to have productive arguments and problem solve together. These conflict resolution skills can alleviate present issues or be used to slowly process and diffuse unresolved or volatile issues over time.
  • Setting ground rules, expectations, immediate and future goals with your couples counselor can build a foundation for a happy and healthy relationship in after marriage counseling.

Marriage counseling is often short-term, where couples attend a few sessions to help get over a crisis – or some couples need a long-term commitment to rebuild a greatly deteriorated relationship with continual maintenance. The length of treatment will depend on the situation. Making the decision to see a marriage counselor is tough and the process can be difficult. But rather than silently cope with an unhappy situation, couples therapy can help you healthily cope, resolve or dissolve a troubled marriage.

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Finding a Therapist Online

Marriage, Therapy | July 18, 2011

Finding a therapist, psychotherapist or marriage counselor can be a  trying endeavor for many, but the results are well worth the effort.  In order to find a therapist, one must put the necessary work into making the right choices for your specific need.  It is important to remember that the decision you make when finding a therapist has a large impact on your future, so the time you put into the selection process in priceless.  You want to find the therapist or counselor that is going to be most successful at relating to you in a way that is conducive to evoking positive change.  This means putting in the time to find a therapist with the qualifications and experience for helping clients like yourself.

The Do’s & Don’ts of Searching for a Therapist on the Internet

One the first approaches to finding a therapist you may want to take, is searching the Internet for someone listed near your home/work or using a social network to get recommendations from friends.  Perhaps you need to find someone in your area who specializes in a particular type of therapy specific to your needs such as behavior modification or psychotherapy.

The following are some Do’s and Don’ts for weeding through online generalizations for specific information which can help you make the most informed decision in choosing your therapist…

Do

  • GET REFERRALS FROM YOUR DOCTOR AND/OR TRUSTED FRIENDS. Friends, family, doctors, and even social networking sites such as Facebook are great places to put out a general call for recommendations from people who know you well.
  • CHECK YOUR STATE PSYCHOLOGICAL ASSOCIATION’S WEBSITE.  Each state has their own psychological association such as the California Psychological Association or the Board of Behavorial Sciences which has a database of all members.  Search for one in your area or with the specialty you need.  Psychology Today is also another reputable site with a searchable database.
  • CHECK THE STATE PROFESSIONAL BOARD FOR IMPORTANT INFORMATION.  It’s vital to know that the therapists you are going to call are licenced to practice in your area.  Sites like the California Board of Psychology or the Board of Behavioral Sciences have information on licenced therapists such as complaints, suits, or revoked licence reports.
  • INTERVIEW YOUR POTENTIAL THERAPIST.  When you call around to potential therapists, get to know them better by asking important questions like: What are your areas of expertise?  What are your fees?  How long are most sessions?  Your counselor is going to be an important facet in your life and personal growth; take the time to get to know them too.
  • HAVE A CONSULTATION OR ASSESSMENT BEFORE COMMITTING.  Ask to have an initial consultation meeting with your therapist before committing to any treatment.  This will give you a chance to determine if the personality, environment, treatment methods and plans of your therapist is suitable to your needs.  Probably the most important characteristics for choosing a therapist are that you feel a sense of rapport with them, and that you trust their expertise and knowledge.

Don’t

  • DON’T NECESSARILY USE SAME THERAPIST AS A FRIEND.  The person who is best for your friend may not be best for you.  Only use the same therapist if you feel comfortable with their advice and that you will be confiding in the same person.
  • DON’T TRUST ONLINE REVIEWS.  Of course you can read these reviews, but keep in mind that therapy is not like retail shopping and a disgruntled client is more likely to write a review than a satisfied client.  Besides, the methods which fail one person may work well for you.  But if the reviews reinforce other red flags in the therapists professional background then it’s perhaps best to move onto the another listing.
  • DON’T GET DISCOURAGED.  If the local counselors and therapists you call cannot take you on or are not proficient enough in your special needs, ask them for a recommendation.  These people know the industry and may have some idea of a colleague who might be a better match.  If they don’t have any specific recommendations, then ask their opinion for how you might narrow your search for better results going forward.

Get to know your criteria.  Get online and narrow down your choices.  Get on the phone and start asking questions.  And finally, get face to face with your choice before you commit.  Taking steps towards better personal mental health is a challenging goal.  The Internet is a great tool to help you search for the best counselor to fit your needs.  Use it wisely and  begin your journey now.

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