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5 Mental Health Tips for Coping with the Coronavirus


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Siegel, D.J. & Bryson, T. D. (2012). The whole-brain child: 12 revolutionary strategies to nurture your child’s developing mind. Bantam Books.

2) If your emotions are doing more harm than good try Dialectical Behavior Therapy’s (DBT) skill – taking opposite action. Find actions that might feel the “opposite” to the overwhelming emotion you might be feeling. For example, if you are feeling down or depressed, maybe that means you engage in things that might make you laugh, smile, or feel happy. That could mean listening to music that makes you feel this way, watching a comedian on Netflix/Youtube, or looking at old photos that make you smile. 

Linehan, M. M. (1993). Skills training manual for treating Borderline Personality Disorder. The Guildford Press.

3) Schedule “worry/anxiety/panic” time. This Cognitive Behavioral Therapy (CBT) skill suggests you schedule 30 minutes daily let yourself worry, maybe read news, or talk to others about it etc., just letting these emotions and thoughts be. Then limit your exposure to things that might increase anxiety/panic (i.e news, social media etc.) other times of the day. By scheduling time to worry, you can help yourself refocus the rest of the day to carry on with what you might need to do, knowing you have your “worry time” set aside for later. 

McGowan, S., & Behar, E. (2012). A preliminary investigation of stimulus control training for worry: Effects on anxiety and insomnia. Behavior Modification, 7(1), pp. 90-112.

4) This Acceptance and Commitment Therapy (ACT) skill, suggests you decide how you would like to live out your valuesin this situation. By focusing on your values, you can align what is important to you with your actions, creating meaning and purpose (in spite of a sense of chaos). For example, maybe you value social justice, so you can focus on addressing the Xenophobia that has been present in the news/social media. Maybe you value knowledge, so you focus on obtaining the best evidenced-based research and facts, or maybe you value your religious faith, so you focus on religious scripture and/or rituals.

Harris, R. (2009). ACT made simple: An easy-to-read primer on Acceptance and Commitment Therapy. New Harbinger Publications, Inc.

5) Self-care. Engage in activities that will reduce stress (exercise, yoga, meditation, hot shower/bath), etc.) daily. You can Youtube yoga classes (if wanting low-cost free or to avoid people 😉 ) or try some meditation/mindfulness apps:

Meditation/Mindfulness Apps:

Insight Timer

Over 30,000 free guided meditations, imagery, and mindfulness. Covers topics of sleep, anxiety, stress, etc. Faith-based guided meditation included. Option for payment for additional features.

Headspace 

First 2 weeks free. Guided simplified meditation app. Subscription covers guided meditation and mindfulness exercises that are great for busy schedules.

Liberate

Free meditation app made by and for Black, Indigenous, and People of Color. Includes topics on gratitude, body, micro aggressions, sleep, race, etc.

Breathe2Relax 

Free made by the defense health agency. Practice and learn diaphragmatic breathing. Can pair with Apple Watch and Health Kit to measure heart rate.

Calm

Free 7 day trial app with mediation, breathing exercises, and music and video scenery for relaxation and stress relief. Also includes sleep stories, with new stories added every week.

Relax Melodies: Sleep Sounds

Free download includes sleep background noises. 7 day free trial includes guided meditations, stories, and guided gentle movements.

Resolving Marital Conflict: A Roadmap on How to Fight Fair with Your Spouse


Introduction

Let’s face it, marriage can be hard! When two different personalities decide to intertwine their lives and establish an exclusive union that is expected to last into perpetuity, the potential for friction can be quite high. Case in point, studies have shown that on average, only 31% of marital disputes constitute solvable problems (Gottman, 1994). That means that issues will present themselves, the requisite solutions will be applied, and the problems will never appear again. That then suggests that a startling 69% of marital problems are considered perpetual problems, meaning issues arise, they’re temporarily resolved, and then they reappear again on an ongoing basis (Gottman, 1994). For example, it is an all-too-familiar occurrence for couples to argue because of their differences in orderliness, which is largely due to the contrast in how their personalities are constituted. Because the more orderly spouse may have a higher sensitivity to disorder, he or she may be more inclined to become agitated when an area of the house is in disarray. This spouse may then petition their partner to clean the area that was causing their unrest, only to find that a week later, there’s another area of the house that the less orderly spouse has left unkempt. This familiar scenario is evidence of how personality differences inevitably result in perpetual marital problems. Given that personality differences beset each and every marriage, it is then sensible that couples learn how to engage in tolerable conflict because disputes are bound to occur. In light of this, I will be discussing Gottman’s Four Horsemen of the Apocalypse, which are four relational patterns that ought to be avoided to increase the likelihood that one’s marital relationship will withstand the test of time. These horsemen include criticism, defensiveness, contempt and stonewalling. Dr. John Gottman, a leading research psychologist in the domain of couple dynamics, first published his research on the four horsemen in 1994. In his investigation, he found that if couples employed the horsemen regularly enough, the probability was quite high that the marriage would end in divorce (Gottman & Levenson, 2002). Within this article for essay structure, I will explain what the four horsemen are and also review their more effective alternatives or antidotes. With this information in mind, you’ll be able to experience greater marital satisfaction and increase the likelihood of your marriage going the distance.

The Research

Decades ago, Gottman set out to determine what relational patterns were characteristic of marital relationships that remained together, and those that fell apart (Gottman, 1994). In order to assess this, he invited droves of newlywed couples to a bed and breakfast-like laboratory setting for a weekend, in which he outfitted the site with video cameras and physiological monitors so that he could examine their relational patterns and physiological responses to one another. Each couple participated in an oral interview in which they reported on their relationship history, they then completed a number of questionnaires and then they were video recorded engaging in neutral conversation, pleasant conversation, and conflictual conversation. The couples were then directed to review the video recordings, rate their emotional responses, and then expert coders categorized their behaviors. After several years had passed, the couples were invited to participate in follow-up interviews in order to discuss the state of their marriage. At the end of the longitudinal study, he dubbed the couples that stayed together and reported marital satisfaction, “Master Relationships,” and those that did not, “Disaster Relationships.” He discovered a number of interesting findings, but one of the most striking ones was that the “Disaster Relationships” regularly used the four horsemen when in the throes of conflict, whereas the “Master Relationships” used them minimally. Furthermore, the latter group was more likely to utilize the antidotes to the four horsemen. Naturally, you’re likely wondering what actions characterize the four horsemen and their antidotes, so without further ado, let’s get to it. 

Criticism vs. Complaining with a Softened Start-Up 

The first horseman is criticism, which is distinguished from the more effective alternative of complaining with a softened start-up. Criticism is characterized by attacking the character or personality of one’s partner and using absolute language such as “always” or “never” when expressing a gripe of some kind. For instance, after a wife asks her husband to take out the trash, and he fails to do so for two days, an example of criticism would be for her to angrily say something like, “Didn’t I ask you to take the trash out two days ago? You never do what I ask you to, and I’m so sick of having to tell you to do things over and over again all the time! It’s either you don’t care or you’re just lazy.” In response to this, the husband would likely become defensive or attack back. Furthermore, in reaction to his wife’s use of absolutes like “always” or “never,” the husband is likely to defend himself by expressing the exceptions to the overgeneralized mischaracterizations. This type of communication often doesn’t end well, and both partners end up hurt. With that being said, let’s take a look at the antidote to criticism. In the aforementioned scenario, an example of complaining with a softened start-up would be characterized by the following: 1) the wife leads with a term of endearment (i.e., sweetie); 2) she uses “I” statements rather than “you” statements; 3) she specifically describes the behavior that upset her, as opposed to her partner’s personality; 4) she articulates her feelings, and then 5) makes a positive request. So, she might say something like, “Hey, sweetie, so a few days ago, I asked you to take out the trash, and maybe it escaped your mind, but I just notice myself getting frustrated because it hasn’t been done yet. Do you mind taking out the trash tonight, please?” If she responds this way, the likelihood is much higher that the husband will happily meet her request. However, all-too-often, this is not how requests or expressions of upset are communicated, which often leads to the next horseman — defensiveness.

Defensiveness vs. Taking Responsibility 

Defensiveness is characterized by self-protective maneuvers that are meant to ward off a perceived attack. It often involves reverse blaming or excusing the behavior of oneself. For example, defensiveness in the aforementioned scenario would entail the husband saying something like, “You always talk about what I don’t do, you never talk about what I am doing for you. Sometimes I forget stuff, okay, but you don’t hear me breathing down your neck when you forget stuff, do you?” This line of conversation likely won’t go well; thus, an alternative is advised. The alternative or antidote to defensiveness is taking personal responsibility. In this case, the husband would be taking responsibility if he said, “You know what, sweetie, you’re absolutely right. I’m sorry, the trash escaped my mind. I’ve had a lot on my mind lately, but that was my mistake. I’m going to take the trash out right now.” This response is likely going to lead to a lot more peace as opposed to war and it’s a lot easier to keep one’s defensiveness in abeyance when one feels as though they’re not being attacked. Most people are not as virtuous as Jesus or Gandhi, so when the majority of people are attacked, the natural response is defense. With this in mind, if you want to decrease the likelihood that your partner will become defensive, you will have to be careful not to attack their personality or character. Instead, it’s key that the complaints that are made are related to specific behaviors. 

Contempt vs. Creating a Culture of Appreciation

The next horseman is contempt. Contempt is described as the act of not only speaking disparagingly to one’s partner but speaking in a way that communicates disrespect. Moreover, it is often characterized by insults or abusive language. The following statement is an example of contempt: “Sometimes I feel like I’m not just raising one child, but two – our son and you! You’re so irresponsible sometimes. Didn’t your mother raise you better?” This horseman has been found to have the most damaging effect on marital relationships, both psychologically and physically. Being the object of contempt has been found to increase the secretion of the stress hormone cortisol, which at high levels can undermine one’s immune system and cause a person to suffer from a greater degree of physical ailments. To avoid this, the antidote that’s advised is creating a culture of appreciation within the relationship. This is where one regularly expresses their gratitude towards their partner for the things that they’re doing well, such as taking out the trash, washing the dishes, cooking a meal, or running an errand. Often, partners do things that the other appreciates, but sometimes the requesting partner keeps their appreciation private and they fail to communicate their gratitude towards their loved one. It’s important to note that the expression of appreciation is not only crucial for the recipient but for the person doing the expressing as well, as it is a reminder to them that their partner is useful and worthy of fondness and thanks.

Stonewalling vs. Physiological Soothing 

The last horseman is what’s called stonewalling. Stonewalling is where one may be in the throes of an argument with their partner, but they’re disengaged and no longer giving the plaintive the cues that they’re listening. They’re not nodding their head, making eye contact, and their disposition is icy-cold. Although the listener may appear cool, calm, and collected on the outside, their internal physiological responses are often heightened. Interestingly, it turns out that if your heartbeat is around 100-beats per minute; your body is in a state called diffuse physiological arousal (DPA). This is when an individual’s body is in a state of threat protection or a mode known as fight-or-flight. When in this mode, the individual’s heart is racing fast, their breathing is shallow, and their adrenaline is pumping. It is challenging to accept influence from one’s partner when one is in a state of DPA, which is why being able to engage in physiological soothing is so important. Physiological soothing requires the listener to regulate their own emotions by breathing deeply from their diaphragm or taking a break for 20-minutes and then returning to the discussion. When taking a break from conflict, it is recommended that such breaks last no less than 20-minutes and no more than 24-hours if things are particularly tense. When both partners are calmer, they are a lot more capable of actively and civilly engaging in the dispute at hand.

Conflict as a Necessity 

As you’re taking stock of the horsemen and their antidotes, you may be worried that your marriage is headed for the dumps because sometimes you notice that you level criticisms at your spouse or become defensive at times, but Gottman discovered a finding that you might find encouraging. The couples that were considered master relationships were not perfect. Gottman and his colleague, Robert Levenson, found that the positive to negative interaction ratio for master relationships was 5 to 1 (Gottman & Levenson, 1999). This means that for every negative interaction, there were five positive interactions. However, the disaster relationships had a positive to negative interaction ratio of roughly 1 to 1, meaning every positive interaction was also coupled with a negative interaction (Gottman & Levenson, 1999). For most couples, the latter interaction pattern eventually becomes too chaotic, and the marriage ultimately dissolves. One might think that the best marital arrangement is one where there isn’t any conflict at all, but this isn’t true. Gottman and Levenson found that in relationships where the positive to negative interaction ratio exceeded 11 to 1, those relationships eventually dissolved too (Gottman & Levenson, 1999). This is likely because the partners in these couples avoided conflict and thus were not honest with one another. Consequently, these findings suggest that some conflict is necessary in order to keep a relationship going.

Verbal vs. Non-verbal Communication 

Up until this point, I’ve mostly discussed the impact that the content of one’s speech can have on a relationship. However, there’s another element to consider when relating to one’s partner and that’s implicit or non-verbal cues. Interestingly, the right hemisphere of your brain is specialized at deciphering implicit cues like the tone of one’s voice (McGilchrist, 2009). Conversely, the left hemisphere is adapted to attune to the content of one’s speech, which is why the brain areas which undergird one’s productive language faculty (Broca’s area) and receptive language ability (Wernicke’s area), are nested in the left hemisphere (McGilchrist, 2009). Put another way, the left hemisphere is more concerned about what someone says, whereas the right hemisphere is scanning the environment for how someone says it. If you find your heartbeat increasing or a rush of adrenaline because someone speaks in an ornery tone, it may not be that you’re overly sensitive, rather your brain is sensing subtle threats in the environment and is thus recruiting your biopsychological resources in order to prepare you for aggressive confrontation or escape. Compared to the left hemisphere, the right one is a lot swifter, which is largely because the right hemisphere is more densely comprised of a greater number of neurons (brain cells), dendritic spires (neuronal extremities that extend from and connect to other neurons) and white matter (fatty sheaths that coat neuronal axons and speed up neuronal transmissions) (McGilchrist, 2009). In other words, the way in which your brain is constructed enables you to have an unsettling feeling a lot quicker than you may be able to articulate it with your speech.  

Closing Remarks

In conclusion, the words that you use in a relationship and how you use them (i.e., tone of voice, facial expressions) will influence how your relationship will fare. No relationship is perfect, but it’s incredibly vital that you make sure that when you’re conversing with your partner, it’s marked by good-will as opposed to antipathy. Peace is always better than war, as life is certainly a lot more pleasant when you’re at peace with your spouse.


References

Gottman, J. M. (1994). What predicts divorce? The relationship between marital processes and marital outcomes. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.

Gottman, J.M. & Levenson, R. W. (1999). What predicts change in marital interaction over time? A study of alternative models. Family Processes Journal, 38 (2), 143-158.  https://doi.org/10.1111/j.1545-5300.1999.00143.x

Gottman, J.M. & Levenson, R. W. (2002). A two-factor model for predicting when a couple will divorce: Exploratory analysis using 14-year longitudinal data. Family Processes Journal, 41 (1), 83-96. https://doi.org/10.1111/j.1545-5300.2002.40102000083.x

McGilchrist, I. (2009). The master and his emissary: The divided brain and the making of the western world. New Haven, CT: Yale University Press.

Eating Disorders 101


The term “eating disorders” refers to a group of disorders that are characterized by eating or eating-related behavior and significantly impairs someone’s physical health and/or psychosocial functioning. It is important to note that obesity is not considered to be an eating disorder, though it is associated with other mental disorders such as depression and binge-eating disorder. 

The main eating disorders outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) are anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED). AN is characterized by restriction of energy intake, intense fear of weight gain or becoming fat, and disturbance in one’s experience of body weight or shape. BN is characterized by binge eating, inappropriate compensatory behaviors (e.g., vomiting), and self-evaluation that is influenced by body shape and weight. BED is primarily characterized by binge eating (without compensatory behaviors) as well as distress regarding the amount, frequency, and/or pace of eating. 

There are many factors that can contribute to developing an eating disorder. These include genetic, biological, psychological, and sociocultural factors. Treatment of eating disorders must therefore address the factors that contribute to or help maintain symptomatology. Treatment modalities include individual, group, and/or family therapy. There are also various levels of care based on severity of symptoms. Inpatient treatment tends to be effective for medically and psychiatrically unstable individuals. Residential is suitable for individuals who are medically stable but psychiatrically impaired. Partial hospitalization is helpful for individuals who are medically stable but need daily assessment of their physiological status as well as those who are psychiatrically stable but are engaging in disordered eating behaviors (e.g., restricted eating). Lastly, outpatient or intensive outpatient is an option for individuals who are stable and do not need daily monitoring. It is also effective for those who are psychiatrically stable and can function in day-to-day situations.

Lexapro is my first medication when I was depressed and had various anxiety disorders. it only helped a little but since I was undergoing intensive therapy it was not enough in my opinion. Check out more info about Lexapro medication.

With regard to treatment options and theoretical orientations, clinicians, therapists, etc. have used the spectrum of options, from acceptance and commitment therapy (ACT) to psychodynamic therapy. There are some, however, that are shown to be particularly beneficial for individuals with specific symptomatology. For example, eye movement desensitization and reprocessing (EMDR) has been effective for individuals with a trauma history. Cognitive remediation therapy targets rigid thinking processes usually associated with individuals with AN.If you or someone you know is engaging in disordered eating behaviors or meets full criteria for one of the specific eating disorders in the DSM-5, it is beneficial to meet with a qualified health professional to address symptoms. Please feel free to contact us at 312-573-8860 to meet with one of our therapists or to receive additional resources for treatment.

Cornerstone Counseling Center of Chicago