What is OCD?

Obsession Compulsive Disorder (OCD) is an anxiety disorder where a person has recurrent and unwanted ideas or impulses (called obsessions) and an urge or compulsion to do something to relieve the discomfort caused by the obsession. The obsessive thoughts range from the idea of losing control, to themes surrounding religion or keeping things or parts of one’s body clean all the time. Compulsions are behaviors which help reduce the anxiety surrounding the obsessions. Most people (90%) who have OCD have both obsessions and compulsions. The thoughts and behaviors a person with OCD has are senseless, repetitive, distressing, and sometimes harmful, but they are also difficult to overcome.

OCD is more common than schizophrenia, bipolar disorder, or panic disorder, according to the National Institute of Mental Health. Yet it is still commonly overlooked by both mental health professionals, mental health advocacy groups, and people who themselves have the problem.

You Are Not to Blame

Many people still carry the misperception that they somehow caused themselves to have these compulsive behaviors and obsessive thoughts. Nothing could be further from the truth. OCD is likely the cause of a number of intertwined and complex factors which include genetics, biology, personality development, and how a person learns to react to the environment around them. What scientists today do know is that it is not a sign of a character flaw or a personal weakness. OCD is a serious mental disorder which is more treatable than ever. It affects a person’s ability to function in every day activities, one’s work, one’s family, and one’s social life.

Features of OCD

Obsessions

Obsessions are unwanted ideas or impulses that repeatedly well up in the mind of a person with OCD. Common ideas include persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly. Again and again, the individual experiences a disturbing thought, such as, “My hands may be contaminated — I must wash them” or “I may have left the gas on” or “I am going to injure my child.” These thoughts tend to be intrusive, unpleasant, and produce a high degree of anxiety. Sometimes the obsessions are of a violent or a sexual nature, or concern illness. (NIMH)

Compulsions

In response to their obsessions, most people with OCD resort to repetitive behaviors called compulsions. The most common of these are washing and checking (e.g., making sure the gas is off for the oven). Other compulsive behaviors include counting (often while performing another compulsive action such as hand washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment with each other. Cognitive problems, such as mentally repeating phrases, listmaking, or checking, are also common. These behaviors generally are intended to ward off harm to the person with OCD or others. Some people with OCD have regimented rituals while others have rituals that are complex and changing. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary.

courtesy of The National Institute of Mental Health

Treatment of OCD

Psychotherapy

For many years, OCD was seen as a purely psychological disorder, related to a desire to control one’s environment or to undo some perceived wrong action. Insight oriented psychotherapy has been singularly unsuccessful in treating this group of disorders, however. Behavior therapies have had much more success, especially those with specific small steps geared to the exact obsessions.compulsions involved in the individual case.
Behavior therapy has a lot to offer individuals with this disorder. Two common and popular techniques are systematic desensitization and flooding. Systematic desensitization techniques involve gradually exposing the client to ever-increasing anxiety-provoking stimuli. It is important to note here, though, that such a technique should not be attempted until the client has successfully learned relaxation skills and can demonstrate their use to the therapist. Exposing a patient to either of these techniques without increased coping skills can result in relapse and possible harm to the client. Relaxation techniques may include imagery, breathing skills, and muscle relaxation. It is important for the client to find a relaxation technique which works best for them, before attempting something like systematic desensitization or flooding. Flooding allows the patient to face the most anxiety-provoking situation, while using the relaxation skills learned. Systematic desensitization is the preferred technique of the two; flooding is not recommended except in rare uses. Flooding’s potential harm usually outweighs its potential benefits (e.g., traumatizing the individual further).

Additional behavior and cognitive-behavioral techniques which may have some effectiveness for people who suffer from this disorder include saturation and thought-stopping. Through saturation, the client is directed to do nothing but think of one obsessional thought which they have complained about. After a period of time of concentration on this one thought (e.g., 10-15 minutes at a time) over a number of days (3-5 days), the obsession can lose some of its strength. Through thought-stopping, the individual learns how to halt obsessive thoughts through proper identification of the obsessional thoughts, and then averting it by doing an opposite, incompatible response. A common incompatible response to an obsessive thought is simply by yelling the word “Stop!” loudly. The client can be encouraged to practice this in therapy (with the clinician’s help and modeling, if necessary), and then encouraged to transplant this behavior to the privacy of their home. They can also often use other incompatible stimuli, such as tweaking a rubber-band which is around their wrist whenever they have a thought. The latter technique would be more effective in public, for example.

Medications

In the last 25 years, medications have been found to be fairly successful in the treatment of OCD. First was the tricyclic antidepressant clomipramine (Anafranil). This has been followed by several of the newer SSRI class anti-depressants that act selectively on the re-uptake of serotonin, a neurotransmitter. In the last few years, neuro-imaging studies have begun to disclose the underlying pathophysiology of OCD. The area of the brain that functions abnormally is directly next to those areas that relate to tick disorders such as Tourette’s Syndrome and to Attention Deficit Disorder. It now seems that variable amounts of dysfunction produce clinical symptoms that may be virtually all in one of these areas, or may be overlapping. Many people with ADD also have tics, as do many people with OCD. Most unexpected is the finding that children who have Rheumatic Fever and develop Sydinham’s Chorea have a significantly increased risk of OCD. Therefore treatment with antibiotics early in an infectious illness may reduce the chances of future obsessive thinking.

Summary

Imaging studies have also demonstrated that both medications and behavior therapy alter brain metabolism in the direction of normalcy. This then is one of the few areas in all of mental health where clear proof exists for the efficacy of multiple types of treatment.

With medications, generally the dose used to treat depression is not enough to control OCD symptoms. Patients often will take 2-4 times the amount used to treat depression. Behavioral therapy with medications seems to offer the best long term improvement.

The illness is cyclic, and worsens when the individual is under stress.

As of January, 2001, OCD is considered a Major Mental Illness in California which now entitles it to coverage by the medical portion of most insurance plans, often providing better benefits than those allowed under the regular mental health provisions of the insurance plan.

Fritz Hershey and Anita Castle specialize in treating OCD.

Women’s Risk for Depression

In a sense, all women are at risk for depression. Depression cuts across all class, race and social lines.

Women are at higher risk than men for major depression (although some researchers maintain that depression is under diagnosed in men.) One in four women is likely to experience severe depression. Yet of all women who suffer from depression, only about one-fifth will get the treatment they need.

What Are the Risk Factors for Depression?

Reproductive issues: Menstruation and pregnancy generally do not lead to depression. Infertility, however, can be a source of depression for women who want children. Miscarriages and surgical menopause can also cause depressive symptoms.

Personality styles: Women who are more passive, dependent, pessimistic, or negative in their attitudes are more likely to become depressed, particularly if they dwell on their bad feelings.

Sexual and Physical abuse: At least 37% of women have had a significant experience of sexual or physical abuse by the age of 21; some experts actually believe that the rate may be closer to 50%. Violent episodes such as battering and rape may leave women with Post-Traumatic Stress Disorder (PTSD). Also, undiagnosed head trauma from battering can cause depressive symptoms.

Marriage and children: Marriage protects men against depression much more than it does women. Mothers of young children are very vulnerable to depression, and the more children a woman has, the more likely it is that she’ll be depressed.

Poverty and minority status: Poverty is a pathway to depression. 75% of people living in poverty in the U.S. are women and children.

Women who are minorities experience great stress from discrimination. In addition, poor women or minority women often do not have access to basic mental health care.

Other high-risk groups: lesbians, adolescents, and women who are alcoholics or drug abusers are all at high risk for depression.

In short, almost all women are vulnerable to depression, regardless of their circumstances.

Why are Women More Likely to Experience Depression?

The APA’s Task Force Report on Women and Depression found that women truly are more depressed than men, not primarily due to biological causes, as was once believed, but to a variety of biological, social, and psychological causes, such as those discussed above.

One reason that men may suffer less from depression has to do with different coping styles. Men are more likely to employ action and mastery strategies, that is, to involve themselves in activities (work, sports, going out with friends) that both distract them from their worries and, perhaps more importantly, give them a sense of power and control. Women, on the other hand, tend to ‘brood’ and dwell on their problems, often with other women. This is one reason why many therapists prescribe exercise (especially aerobic exercise) as a partial antidote for depression; it gives women an increased sense of self-discipline, control, and mastery.

This is also why women who have multiple roles (e.g., a job, children, a marriage, volunteer work, all at once) may suffer from much less depression. This is because these women have many different support sources and lots of outlets for their competence: if things aren’t going well in one area, they can compensate by feeling satisfied with their successes in other areas.

Treatment and Therapy

When should I seek therapy?

We all get ‘the blues’ now and then. This kind of mild, infrequent depressive mood often passes quickly, particularly if you employ some reliable strategies to get through them (going out with friends, settling down into a good book, whatever works for you.

Sometimes, however, depression can be severe, and stronger measures may be called for. If you are experiencing the symptoms shown on page 3 to a marked degree — i.e. if they last more than 2-3 days or if they are interfering with you normal life and your professional help.

In its most extreme form, depression can lead to suicide. If you have any thoughts connected to suicide, you should get therapy AT ONCE.

How Can I Find a Therapist?

Getting a recommendation for a therapist is not difficult, but finding a good therapist might take a little more work.

The recommendations should be from someone you trust. The following people can probably can probably help:

* A friend or relative who has been in therapy

* Your doctor

* Your priest, rabbi or pastor

* A guidance counselor at your school or at a nearby college or university

You can also check with your state psychological association or your local community mental health clinic.

How Do I Know If the Therapist is Any Good?

The best indicator of successful therapy is you sense of comfort with the therapist. You should feel at ease with the person, at the same time understanding that therapy will often require you to talk about painful or uncomfortable subjects.

He or she should have the proper credentials (Ph.D., Psy.D., M.F.T., L.C.S.W., or M.D.) and also be state-licensed. Most insurance companies will only pay for therapy from a licensed practitioner. You have a right to ask your therapist about his or her credentials, therapeutic orientation and any other questions that come to mind.

After your initial consultation, you can decide whether or not you want to see this particular therapist on a regular basis, or whether you’d go talk to some others. You are completely entitled to do this ‘shopping around’ until you find someone with whom you want to work.

What Types of Therapy are Available?

There are as many ‘styles’ of therapy as there are therapists. You therapist can give you more detailed information about the type he or she is using. The basic kinds are:

* Behavior therapy: seeks to change behavior rather than underlying personality, teaches new ‘coping’ techniques.

* Interpersonal psychotherapy: focuses on interpersonal relationships and coping with conflicts in relationships.

* Feminist therapy: views symptoms as the response to cultural oppression, focuses on ’empowering the client’.

* Cognitive-behavioral therapy: in addition to correcting the behavior, seeks to correct negative thinking patterns.

•Psychodynamic therapy: focuses on underlying drives and desires that determine behavior.

In addition, there is group therapy, led by a psychotherapist, which provides the additional support of a group that some people may find especially helpful, and there are support groups, led either by a therapist or by group members who take turns as leaders.

The best short-term therapy for depression is action-oriented. Therapy should be focused and concrete; you need to know two things – What is making you unhappy? and What can you do about it? When the therapy includes a clear action plan (for example, homework assignments such as journal writing or brief art therapy sessions, the success rate with depression can go up as much as 80-90%.

How Long Will Therapy Take?

The good news is that therapy for depression can show results quickly, usually in a matter of weeks. You may opt for brief therapy, to help you get through a rough period and learn skills for coping in the future, or you may choose to stay in therapy as a means of continued personal growth.

What About Drug Therapy?

Pharmacotherapy can be useful for people suffering from severe depression (it may even be necessary in some cases). Caution is needed, however, since drugs are often overprescribed for women. Women who are drug or alcohol abusers are at risk for harmful drug interactions, as are the millions of women who take diet pills. In addition, many of the psychotropic drugs can have serious side effects, particularly if the patient is taking other prescription medications. Finally, the rate of noncompliance (patients not taking their medication) is pretty high — about 60-70%.

On the other hand, for people who are so depressed that they cannot function, or are suicidal, antidepressant drugs can literally be a lifesaver. It is extremely important that the prescribing doctor be very will trained in psychopharmacology and fully understand the proper dosages, possible side effects, and interaction with other drugs, and that he or she explain all of this very clearly to you.

Special Issues for Minorities

What Kind of Therapy Should Minority Women Look For?

Therapy for women of different ethnic backgrounds must be ‘culturally embedded,’ in other words, it must translate the concepts into a cultural context that is meaningful. For example, Asian women are taught to value an indirect approach to expressing their needs and feelings, thus traditional ‘assertiveness training’ will seem strange and inaccessible to them; Latino women often reveal their depression not in psychological symptoms but by developing chronic physical illnesses such as headaches, backaches, and so on.

Interpersonal therapy seems to be an effective type of treatment for minority women since, for many of them, their personal relationships are extremely important, and often the focal point of their self-definition. This tends to be true for all women, but particularly for minority women. In addition, this therapy is often brief, a factor that many women will appreciate because they may believe that others rely on them to much to allow for a lot of time away from family and other responsibilities.

You should look for a therapist whose training has made him or her culturally sensitive.

Medication

It is extremely important that the prescribing physician understand biological differences in ethnic groups because people from different ethnic backgrounds metabolize drugs differently. The dosages may need to be quite different. The doctor in this case must have specialized training and/or experience in prescribing drugs for different ethnic groups.

Warning Signs of Depression:

* Depressive mood; feelings of helplessness and pessimism

* Sleep disturbances — inability to sleep, or sleeping too much; irregular sleep patterns

* Appetite disturbance, eating far less or far more than usual

* Social withdrawal; refusal to go out, to see friends

* Blaming yourself for your problems, or feeling that you’re worthless

* Inability to concentrate, even on routine tasks

* Substance abuse — alcohol or drugs

Symptoms of Post Traumatic Stress Disorder (PTSD), which sometimes occurs after exposure to violence, are similar to those for depression and can also include:

* Nightmares or flashbacks of the terrifying past events

* Increased aggression, and feelings of uncontrollable anger

* Emotional numbing

* Avoidance of the outside world, especially of anything that reminds you of past traumas

This article was reprinted with the permission of the American Psychological Association

Post-Traumatic Stress Disorder

What is post-traumatic stress disorder or PTSD?

Post-traumatic stress disorder, which is commonly referred to as PTSD, is a condition which some people develop after they experience a very traumatic or life threatening event. For instance, a person might develop PTSD after observing another person being seriously injured or killed. Natural disasters and wars are likely to cause some of its victims to experience post-traumatic stress disorder. Childhood traumas and workplace traumas can cause PTSD. Car accidents, being robbed, and being raped are frequent causes of PTSD.

How soon does post-traumatic stress disorder develop?

In some people PTSD develops immediately after they experience the unusually traumatic event. However, in other people, signs of the disorder do not develop until several weeks, months, or even years after the event.

What characteristics are associated with post-traumatic stress disorder?

PTSD develops when a person witnesses or experiences a traumatic event and later experiences some of the following for a prolonged period of time:
Relives the traumatic event by thinking or dreaming about it frequently
Is unsettled or distressed to the point of impairment in other areas of his/her life such as in school, at work, or in personal relationships
Avoids any situation that might cause him/her to relive the trauma
Demonstrates a certain amount of generalized emotional numbness
Shows a heightened sense of being on guard (is easily “freaked”)
PTSD victims often have such additional emotional manifestations as a sense of hopelessness, a sense of fear, insomnia, irritability, and/or difficulty in concentrating.

Children with PTSD may show unexplained emotional distress, or they might complain of pain.

Examples of traumatic events known to lead to PTSD include:
Military combat
Violent criminal attacks
Sexual assaults
Serious accidents
Life threatening natural disasters
At what age does post-traumatic stress disorder appear?

PTSD can occur at any age.

How often is post-traumatic stress disorder seen in our society?

PTSD is very common in the United States. Some studies report that more than ten percent (10%) of the population will suffer from post-traumatic stress disorder at some point in their lives.

How is post-traumatic stress disorder diagnosed?

In adults, PTSD is usually diagnosed when they seek professional help because they are suffering, and their emotional state is having a negative impact on their schoolwork, on their job, or in their social relationships. Children may be brought in for evaluation because of unexpected behavior changes or unexplained physical problems.

How is post-traumatic stress disorder treated?

Individual or group therapy, in addition to some medications, may be used in the treatment of PTSD. Therapy helps those with post-traumatic stress disorder work through the traumatic event that caused the condition. With the help of the therapist, the person with PTSD can gently examine and review the traumatic events of the past and learn to conquer his/her feelings of anxiety. E.M.D.R. (Eye Movement Desensitization & Reprocessing) is a very effective treatment for PTSD. Certain antidepressant medications and mild tranquilizers are sometimes prescribed to help lessen some of the painful symptoms associated with PTSD.

What happens to someone with post-traumatic stress disorder?

The course of PTSD is quite variable. With adequate treatment, about one-third of the people with PTSD will recover within a few weeks. Some of these people have no further problems. Many people take longer, sometimes a year or more, to recover from PTSD. Despite treatment, other people continue to have mild to moderate symptoms for a more prolonged period of time.

What can people do if they need help?
The first step is to obtain a thorough history and diagnostic assessment.

David Britton specializes in the treatment of PTSD.

List of Phobias

Sometimes our unconscious mind starts to overreact to things that it believes could be dangerous or unpleasant, because it is trying too hard to protect us. When we become unreasonably afraid of something it is called a PHOBIA. Here is a list of EVERY phobia that has a name.

DAVID BRITTON is a Phobia specialist.

How Many Names Do You Recognize?

FEAR OF:

13, number- Triskadekaphobia.
8, number- Octophobia.
A-
Ablutophobia- Fear of washing or bathing.
Acarophobia- Fear of itching or of the insects that cause itching.
Acerophobia- Fear of sourness.
Achluophobia- Fear of darkness.
Acousticophobia- Fear of noise.
Acrophobia- Fear of heights.
Aerophobia- Fear of drafts, air swallowing, or airbourne noxious substances.
Aeroacrophobia- Fear of open high places.
Aeronausiphobia- Fear of vomiting secondary to airsickness.
Agliophobia- Fear of pain.
Agoraphobia- Fear of open spaces or of being in crowded, public places like markets. Fear of leaving a safe place.
Agraphobia- Fear of sexual abuse.
Agrizoophobia- Fear of wild animals.
Agyrophobia- Fear of streets or crossing the street.
Aichmophobia- Fear of needles or pointed objects.
Ailurophobia- Fear of cats.
Albuminurophobia- Fear of kidney disease.
Alektorophobia- Fear of chickens.
Algophobia- Fear of pain.
Alliumphobia- Fear of garlic.
Allodoxaphobia- Fear of opinions.
Altophobia- Fear of heights.
Amathophobia- Fear of dust.
Amaxophobia- Fear of riding in a car.
Ambulophobia- Fear of walking.
Amnesiphobia- Fear of amnesia.
Amychophobia- Fear of scratches or being scratched.
Anablephobia- Fear of looking up.
Anatidaephobia-Fear of constantly being watched by a duck Ancraophobia or Anemophobia- Fear of wind.
Androphobia- Fear of men.
Anemophobia- Fear of air drafts or wind.
Anginophobia- Fear of angina, choking or narrowness.
Anglophobia- Fear of England, English culture, etc.
Angrophobia – Fear of becoming angry.
Ankylophobia- Fear of immobility of a joint.
Anthrophobia or Anthophobia- Fear of flowers.
Anthropophobia- Fear of people or society.
Antlophobia- Fear of floods.
Anuptaphobia- Fear of staying single.
Apeirophobia- Fear of infinity.
Aphenphosmphobia- Fear of being touched.
Apiphobia- Fear of bees.
Apotemnophobia- Fear of persons with amputations.
Arachibutyrophobia- Fear of peanut butter sticking to the roof of the mouth.
Arachnephobia or Arachnophobia- Fear of spiders.
Arithmophobia- Fear of numbers.
Arrhenphobia- Fear of men.
Arsonphobia- Fear of fire.
Asthenophobia- Fear of fainting or weakness.
Astraphobia or Astrapophobia- Fear of thunder and lightning.
Astrophobia- Fear of stars and celestial space.
Asymmetriphobia- Fear of asymmetrical things.
Ataxiophobia- Fear of ataxia (muscular incoordination)
Ataxophobia- Fear of disorder or untidiness.
Atelophobia- Fear of imperfection.
Atephobia- Fear of ruin or ruins.
Athazagoraphobia- Fear of being forgotton or ignored or forgetting.
Atomosophobia – Fear of atomic explosions.
Atychiphobia- Fear of failure.
Aulophobia- Fear of flutes.
Aurophobia- Fear of gold.
Auroraphobia- Fear of Northern lights.
Autodysomophobia- Fear of one that has a vile odor.
Automatonophobia- Fear of ventriloquist’s dummies, animatronic creatures, wax statues – anything that falsly represents a sentient being.
Automysophobia- Fear of being dirty.
Autophobia- Fear of being alone or of oneself.
Aviophobia or Aviatophobia- Fear of flying.
B-
Bacillophobia- Fear of microbes.
Bacteriophobia- Fear of bacteria.
Ballistophobia- Fear of missles or bullets.
Bolshephobia- Fear of Bolsheviks.
Barophobia- Fear of gravity.
Basophobia- Inability to stand. Fear of walking or falling.
Bathophobia- Fear of depth.
Batonophobia- Fear of plants.
Batophobia- Fear of being close to high buildings.
Batrachophobia- Fear of amphibians.
Belonephobia- Fear of pins and needles.
Bibliophobia- Fear of books.
Blennophobia- Fear of slime.
Bogyphobia- Fear of bogies or the bogeyman.
Bolshephobia- Fear of Bolsheviks
Bromidrosiphobia- Fear of body smells.
Brontophobia- Fear of thunder and lightning.
Bufonophobia- Fear of toads.
C-
Cacophobia- Fear of ugliness.
Cainophobia or Cainotophobia- Fear of newness, novelty.
Caligynephobia- Fear of beautiful women.
Cancerophobia- Fear of cancer.
Carcinophobia- Fear of cancer.
Cardiophobia- Fear of the heart.
Carnophobia- Fear of meat.
Catagelophobia- Fear of being ridiculed.
Catapedaphobia- Fear of jumping from high or low places.
Cathisophobia- Fear of sitting.
Catoptrophobia- Fear of mirrors.
Cenophobia or Centophobia- Fear of new things or ideas.
Ceraunophobia- Fear of thunder.
Chaetophobia- Fear of hair.
Cheimaphobia or Cheimatophobia- Fear of cold.
Chemophobia- Fear of chemicals or working with chemicals.
Cherophobia- Fear of gaiety.
Chionophobia- Fear of snow.
Chiraptophobia- Fear of being touched.
Cholerophobia- Fear of anger or the fear of cholera.
Chorophobia- Fear of dancing.
Chrometophobia or Chrematophobia- Fear of money.
Chromophobia or Chromatophobia- Fear of colors.
Chronophobia- Fear of time.
Chronomentrophobia- Fear of clocks.
Cibophobia or Sitophobia or Sitiophobia- Fear of food.
Claustrophobia- Fear of confined spaces; Fear of St.Nicholas.
Cleithrophobia- Fear of being locked in an enclosed place.
Cleptophobia- Fear of stealing.
Climacophobia- Fear of stairs, climbing or of falling downstairs.
Clinophobia- Fear of going to bed.
Clithrophobia- Fear of being enclosed.
Cnidophobia- Fear of strings.
Cometophobia- Fear of comets.
Coimetrophobia- Fear of cemeteries.
Coitophobia- Fear of coitus.
Contreltophobia- Fear of sexual abuse.
Coprastasophobia- Fear of constipation.
Coprophobia- Fear of feces.
Coulrophobia- Fear of clowns.
Counterphobia- The preference by a phobic for fearful situations.
Cremnophobia- Fear of precipices.
Cryophobia- Fear of extreme cold, ice or frost.
Crystallophobia- Fear of crystals or glass.
Cyberphobia- Fear of computers or working on a computer.
Cyclophobia- Fear of bicycles.
Cymophobia- Fear of waves or wave like motions.
Cynophobia- Fear of dogs or rabies.
Cypridophobia, Cypriphobia, Cyprianophobia, or Cyprinophobia – Fear of prostitutes or venereal disease.
D-
Decidophobia- Fear of making decisions.
Defecaloesiophobia- Fear of painful bowels movements.
Deipnophobia- Fear of dining and dinner conversations.
Dementophobia- Fear of insanity.
Demonophobia or Daemonophobia- Fear of demons.
Demophobia- Fear of crowds. (Agoraphobia)
Dendrophobia- Fear of trees.
Dentophobia- Fear of dentists.
Dermatophobia- Fear of skin lesions.
Dermatosiophobia or Dermatopathophobia- Fear of skin disease.
Dextrophobia- Fear of objects at the right side of the body.
Diabetophobia- Fear of diabetes.
Didaskaleinophobia- Fear of going to school.
Dikephobia- Fear of justice.
Dinophobia- Fear of dizziness or whirlpools.
Diplophobia- Fear of double vision.
Dipsophobia- Fear of drinking.
Dishabiliophobia- Fear of undressing in front of someone.
Domatophobia- Fear of houses or being in a house.
Doraphobia- Fear of fur or skins of animals.
Dromophobia- Fear of crossing streets.
Dutchphobia- Fear of the Dutch.
Dysmorphophobia- Fear of deformity.
Dystychiphobia- Fear of accidents.
E-
Ecclesiophobia- Fear of church.
Ecophobia- Fear of home.
Eicophobia or Oikophobia- Fear of home surroundings.
Eisoptrophobia- Fear of mirrors or of seeing oneself in a mirror.
Electrophobia- Fear of electricity.
Eleutherophobia- Fear of freedom.
Elurophobia- Fear of cats. (aka: Ailurophobia)
Emetophobia- Fear of vomiting.
Enetophobia- Fear of pins.
Enochlophobia- Fear of crowds.
Enosiophobia or Enissophobia- Fear of having committed an unpardonable sin or of criticism.
Entomophobia- Fear of insects.
Eosophobia- Fear of dawn or daylight.
Epistaxiophobia- Fear of nosebleeds.
Epistemophobia- Fear of knowledge.
Equinophobia- Fear of horses.
Eremophobia- Fear of being oneself or of loneliness.
Ereuthrophobia- Fear of blushing.
Ergasiophobia- 1) Fear of work or functioning. 2) Surgeon’s fear of operating.
Ergophobia- Fear of work.
Erotophobia- Fear of sexual love or sexual questions.
Euphobia- Fear of hearing good news.
Eurotophobia- Fear of female genitalia.
Erythrophobia- 1) Fear of redlights. 2) Blushing. 3) Red.
F-
Febriphobia or Fibriophobia- Fear of fever.
Felinophobia- Fear of cats.
Francophobia- Fear of France, French culture. (aka: Gallophobia, Galiophobia)
Frigophobia- Fear of cold, cold things.
G-
Galeophobia or Gatophobia- Fear of cats.
Gallophobia or Galiophobia- Fear France, French culture. (Francophobia)
Gamophobia- Fear of marriage.
Geliophobia- Fear of laughter.
Geniophobia- Fear of chins.
Genophobia- Fear of sex.
Genuphobia- Fear of knees.
Gephyrophobia- Fear of crossing bridges.
Germanophobia- Fear of Germany, German culture, etc.
Gerascophobia- Fear of growing old.
Gerontophobia- Fear of old people or of growing old.
Geumaphobia or Geumophobia- Fear of taste.
Glossophobia- Fear of speaking in public or of trying to speak.
Gnosiophobia- Fear of knowledge.
Graphophobia- Fear of writing or handwriting.
Gymnophobia- Fear of nudity.
Gynephobia or Gynophobia- Fear of women.
H-
Hadephobia- Fear of hell.
Hagiophobia- Fear of saints or holy things.
Hamartophobia- Fear of sinning.
Haphephobia or Haptephobia- Fear of being touched.
Harpaxophobia- Fear of being robbed.
Hedonophobia- Fear of feeling pleasure.
Heliophobia- Fear of the sun.
Hellenologophobia- Fear of Greek terms or complex scientific terminology.
Helminthophobia- Fear of being infested with worms.
Hemophobia or Hematophobia- Fear of blood.
Heresyphobia or Hereiophobia- Fear of challenges to official doctrine or of radical deviation.
Herpetophobia- Fear of reptiles or creepy, crawly things.
Heterophobia- Fear of the opposite sex. (aka: Sexophobia)
Hierophobia- Fear of priests or sacred things.
Hippophobia- Fear of horses.
Hippopotomonstrosesquippedaliophobia- Fear of long words.
Hobophobia- Fear of bums or beggars.
Hodophobia- Fear of road travel.
Hormephobia- Fear of shock.
Homichlophobia- Fear of fog.
Homilophobia- Fear of sermons.
Hominophobia- Fear of men.
Homophobia- Fear of sameness, monotony or of homosexuality or of becoming homosexual.
Hoplophobia- Fear of firearms.
Hydrargyophobia- Fear of mercurial medicines.
Hydrophobia- Fear of water or of rabies.
Hydrophobophobia- Fear of rabies.
Hyelophobia or Hyalophobia- Fear of glass.
Hygrophobia- Fear of liquids, dampness, or moisture.
Hylephobia- Fear of materialism OR the fear of epilepsy.
Hylophobia- Fear of forests.
Hypengyophobia or Hypegiaphobia- Fear of responsibility.
Hypnophobia- Fear of sleep or of being hypnotized.
Hypsiphobia- Fear of height.
I-
Iatrophobia- Fear of going to the doctor or of doctors.
Ichthyophobia- Fear of fish.
Ideophobia- Fear of ideas.
Illyngophobia- Fear of vertigo or feeling dizzy when looking down.
Iophobia- Fear of poison.
Insectophobia – Fear of insects.
Isolophobia- Fear of solitude, being alone.
Isopterophobia- Fear of termites, insects that eat wood.
Ithyphallophobia- Fear of seeing, thinking about or having an erect penis.
J-
Japanophobia- Fear of Japanese.
Judeophobia- Fear of Jews.
K-
Kainolophobia- Fear of novelty.
Kainophobia- Fear of anything new, novelty.
Kakorrhaphiophobia- Fear of failure or defeat.
Katagelophobia- Fear of ridicule.
Kathisophobia- Fear of sitting down.
Kenophobia- Fear of voids or empty spaces.
Keraunophobia- Fear of thunder and lightning.
Kinetophobia or Kinesophobia- Fear of movement or motion.
Kleptophobia- Fear of stealing.
Koinoniphobia- Fear of rooms.
Kolpophobia- Fear of genitals, particularly female.
Kopophobia- Fear of fatigue.
Koniophobia- Fear of dust. (aka: Amathophobia)
Kosmikophobia- Fear of cosmic phenomenon.
Kymophobia- Fear of waves.
Kynophobia- Fear of rabies.
Kyphophobia- Fear of stooping.
L-
Lachanophobia- Fear of vegetables.
Laliophobia or Lalophobia- Fear of speaking.
Leprophobia or Lepraphobia- Fear of leprosy.
Leukophobia- Fear of the color white.
Levophobia- Fear of things to the left side of the body.
Ligyrophobia- Fear of loud noises.
Lilapsophobia- Fear of tornadoes and hurricanes.
Limnophobia- Fear of lakes.
Linonophobia- Fear of string.
Liticaphobia- Fear of lawsuits.
Lockiophobia- Fear of childbirth.
Logizomechanophobia- Fear of computers.
Logophobia- Fear of words.
Luiphobia- Fear of lues, syphillis.
Lutraphobia- Fear of otters.
Lygophobia- Fear of darkness.
Lyssophobia- Fear of rabies or of becoming mad.

M-
Macrophobia- Fear of long waits.
Mageirocophobia- Fear of cooking.
Maieusiophobia- Fear of childbirth.
Malaxophobia- Fear of love play. (aka: Sarmassophobia)
Maniaphobia- Fear of insanity.
Mastigophobia- Fear of punishment.
Mechanophobia- Fear of machines.
Medomalacuphobia- Fear of losing an erection.
Medorthophobia- Fear of an erect penis.
Megalophobia- Fear of large things.
Melissophobia- Fear of bees.
Melanophobia- Fear of the color black.
Melophobia- Fear or hatred of music.
Meningitophobia- Fear of brain disease.
Menophobia- Fear of menstruation.
Merinthophobia- Fear of being bound or tied up.
Metallophobia- Fear of metal.
Metathesiophobia- Fear of changes.
Meteorophobia- Fear of meteors.
Methyphobia- Fear of alcohol.
Metrophobia- Fear or hatred of poetry.
Microbiophobia- Fear of microbes.
Microphobia- Fear of small things.
Misophobia- Fear of contamination with dirt or germs.
Mnemophobia- Fear of memories.
Molysmophobia or Molysomophobia- Fear of dirt or contamination.
Monophobia- Fear of solitude or being alone.
Monopathophobia- Fear of definite disease.
Motorphobia- Fear of automobiles.
Mottephobia- Fear of moths.
Musophobia or Murophobia- Fear of mice.
Mycophobia- Fear or aversion to mushrooms.
Mycrophobia- Fear of small things.
Myctophobia- Fear of darkness.
Myrmecophobia- Fear of ants.
Mythophobia- Fear of myths or false statements.
Myxophobia- Fear of slime. (aka: Blennophobia)
N-
Nebulaphobia- Fear of fog. (Homichlophobia)
Necrophobia- Fear of death or dead things.
Nelophobia- Fear of glass.
Neopharmaphobia- Fear of new drugs.
Neophobia- Fear of anything new.
Nephophobia- Fear of clouds.
Noctiphobia- Fear of the night.
Nomatophobia- Fear of names.
Nosocomephobia- Fear of hospitals.
Nosophobia or Nosemaphobia- Fear of becoming ill.
Nostophobia- Fear of returning home.
Novercaphobia- Fear of your step-mother.
Nucleomituphobia- Fear of nuclear weapons.
Nudophobia- Fear of nudity.
Numerophobia- Fear of numbers.
Nyctohylophobia- Fear of dark wooded areas, of forests at night.
Nyctophobia- Fear of the dark or of night.
O-
Obesophobia- Fear of gaining weight.
Ochlophobia- Fear of crowds or mobs.
Ochophobia- Fear of vehicles.
Octophobia – Fear of the figure 8.
Odontophobia- Fear of teeth or dental surgery.
Odynophobia or Odynephobia- Fear of pain.
Oenophobia- Fear of wines.
Oikophobia- Fear of home surroundings, house.
Olfactophobia- Fear of smells.
Ombrophobia- Fear of rain or of being rained on.
Ommetaphobia or Ommatophobia- Fear of eyes.
Oneirophobia- Fear of dreams.
Oneirogmophobia- Fear of wet dreams.
Onomatophobia- Fear of hearing a certain word or names.
Ophidiophobia- Fear of snakes.
Ophthalmophobia- Fear of being stared at.
Optophobia- Fear of opening one’s eyes.
Ornithophobia- Fear of birds.
Orthophobia- Fear of property.
Osmophobia or Osphresiophobia- Fear of smells or odors.
Ostraconophobia- Fear of shellfish.
Ouranophobia- Fear of heaven.
P-
Pagophobia- Fear of ice or frost.
Panthophobia- Fear of suffering and disease.
Panophobia or Pantophobia- Fear of everything.
Papaphobia- Fear of the Pope.
Papyrophobia- Fear of paper.
Paralipophobia- Fear of neglecting duty or responsibility.
Paraphobia- Fear of sexual perversion.
Parasitophobia- Fear of parasites.
Paraskavedekatriaphobia- Fear of Friday the 13th.
Parthenophobia- Fear of virgins or young girls.
Pathophobia- Fear of disease.
Patroiophobia- Fear of heredity.
Parturiphobia- Fear of childbirth.
Peccatophobia- Fear of sinning. (imaginary crime)
Pediculophobia- Fear of lice.
Pediophobia- Fear of dolls.
Pedophobia- Fear of children.
Peladophobia- Fear of bald people.
Pellagrophobia- Fear of pellagra.
Peniaphobia- Fear of poverty.
Pentheraphobia- Fear of mother-in-law. (Novercaphobia)
Phagophobia- Fear of swallowing or of eating or of being eaten.
Phalacrophobia- Fear of becoming bald.
Phallophobia- Fear of a penis, especially erect.
Pharmacophobia- Fear of taking medicine.
Phasmophobia- Fear of ghosts.
Phengophobia- Fear of daylight or sunshine.
Philemaphobia or Philematophobia- Fear of kissing.
Philophobia- Fear of falling in love or being in love.
Philosophobia- Fear of philosophy.
Phobophobia- Fear of phobias.
Photoaugliaphobia- Fear of glaring lights.
Photophobia- Fear of light.
Phonophobia- Fear of noises or voices or one’s own voice; of telephones.
Phronemophobia- Fear of thinking.
Phthiriophobia- Fear of lice.
Phthisiophobia- Fear of tuberculosis.
Placophobia- Fear of tombstones.
Plutophobia- Fear of wealth.
Pluviophobia- Fear of rain or of being rained on.
Pneumatiphobia- Fear of spirits.
Pnigophobia or Pnigerophobia- Fear of choking of being smothered.
Pocrescophobia- Fear of gaining weight. (Obesophobia)
Pogonophobia- Fear of beards.
Poliosophobia- Fear of contracting poliomyelitis.
Politicophobia- Fear or abnormal dislike of politicians.
Polyphobia- Fear of many things.
Poinephobia- Fear of punishment.
Ponophobia- Fear of overworking or of pain.
Porphyrophobia- Fear of the color purple.
Potamophobia- Fear of rivers or running water.
Potophobia- Fear of alcohol.
Pharmacophobia- Fear of drugs.
Proctophobia- Fear of the rectum.
Prosophobia- Fear of progress.
Psellismophobia- Fear of stuttering.
Psychophobia- Fear of mind.
Psychrophobia- Fear of cold.
Pteromerhanophobia- Fear of flying.
Pteronophobia- Fear of being tickled by feathers.
Pupaphobia – fear of puppets. Pyrexiophobia- Fear of Fever.
Pyrophobia- Fear of fire.
Q-
None
R-
Radiophobia- Fear of radiation, x-rays.
Ranidaphobia- Fear of frogs.
Rectophobia- Fear of rectum or rectal diseases.
Rhabdophobia- Fear of being severely punished or beaten by a rod, or of being severely criticized. Also fear of magic.(wand)
Rhypophobia- Fear of defecation.
Rhytiphobia- Fear of getting wrinkles.
Rupophobia- Fear of dirt.
Russophobia- Fear of Russians.
S-
Samhainophobia: Fear of Halloween.
Sarmassophobia- Fear of love play. (aka: Malaxophobia)
Satanophobia- Fear of Satan.
Scabiophobia- Fear of scabies.
Scatophobia- Fear of fecal matter.
Scelerophibia- Fear of burglars.
Sciophobia Sciaphobia- Fear of shadows.
Scoleciphobia- Fear of worms.
Scolionophobia- Fear of school.
Scoptophobia- Fear of being seen or stared at.
Scotomaphobia- Fear of blindness in visual field.
Scotophobia- Fear of darkness.
Scriptophobia- Fear of writing in public.
Selaphobia- Fear of light flashes.
Selenophobia- Fear of the moon.
Seplophobia- Fear of decaying matter.
Sesquipedalophobia- Fear of long words.
Sexophobia- Fear of the opposite sex. (aka: Heterophobia)
Siderodromophobia- Fear of railroads or train travel.
Siderophobia- Fear of stars.
Sinistrophobia- Fear of things to the left, left-handed.
Sinophobia- Fear of Chinese, Chinese culture.
Sitophobia or Sitiophobia- Fear of food or eating.
Snakephobia- Fear of snakes. (aka: Ophidiophobia)
Soceraphobia- Fear of parents-in-law.
Social Phobia- Fear of being evaluated negatively in social situations.
Sociophobia- Fear of society or people in general.
Somniphobia- Fear of sleep.
Sophophobia- Fear of learning.
Soteriophobia – Fear of dependence on others.
Spacephobia- Fear of outer space.
Spectrophobia- Fear of specters or ghosts.
Spermatophobia or Spermophobia- Fear of germs.
Spheksophobia- Fear of wasps.
Stasiphobia- Fear of standing or walking.
Staurophobia- Fear of crosses or the crucifix.
Stenophobia- Fear of narrow things or places.
Stygiophobia or Stigiophobia- Fear of hell.
Suriphobia- Fear of mice.
Symbolophobia- Fear of symbolism.
Symmetrophobia- Fear of symmetry.
Syngenesophobia- Fear of relatives.
Syphilophobia- Fear of syphilis.

T-
Tachophobia- Fear of speed.
Taeniophobia or Teniophobia- Fear of tapeworms.
Taphephobia- Fear of being buried alive or of cemeteries.
Tapinophobia- Fear of being contagious.
Taurophobia- Fear of bulls.
Technophobia- Fear of technology.
Teleophobia- 1) Fear of definite plans. 2) Religious ceremony.
Telephonophobia- Fear of telephones.
Teratophobia- Fear of bearing a deformed child or fear of monsters or deformed people.
Testophobia- Fear of taking tests.
Tetanophobia- Fear of lockjaw, tetanus.
Teutophobia- Fear of German or German things.
Textophobia- Fear of certain fabrics.
Thaasophobia- Fear of sitting.
Thalassophobia- Fear of the sea.
Thanatophobia or Thantophobia- Fear of death or dying.
Theatrophobia- Fear of theatres.
Theologicophobia- Fear of theology.
Theophobia- Fear of gods or religion.
Thermophobia- Fear of heat.
Tocophobia- Fear of pregnancy or childbirth.
Tomophobia- Fear of surgical operations.
Tonitrophobia- Fear of thunder.
Topophobia- Fear of certain places or situations, such as stage fright.
Toxiphobia or Toxophobia – Fear of poison or of being accidently poisoned.
Traumatophobia- Fear of injury.
Tremophobia- Fear of trembling.
Trichinophobia- Fear of trichinosis.
Trichopathophobia or Trichophobia or Hypertrichophobia- Fear of hair. (Chaetophobia)
Triskaidekaphobia- Fear of the number 13.
Tropophobia- Fear of moving or making changes.
Trypanophobia- Fear of injections.
Tuberculophobia- Fear of tuberculosis.
Tyrannophobia- Fear of tyrants.
U-
Uranophobia- Fear of heaven.
Urophobia- Fear of urine or urinating.
V-
Vaccinophobia- Fear of vaccination.
Venustraphobia- Fear of beautiful women.
Verbophobia- Fear of words.
Verminophobia- Fear of germs.
Vestiphobia- Fear of clothing.
Virginitiphobia- Fear of rape.
Vitricophobia- Fear of step-father.

W-
Walloonphobia- Fear of the Walloons.
Wiccaphobia: Fear of witches and witchcraft.

X-
Xanthophobia- Fear of the color yellow or the word yellow.
Xenophobia- Fear of strangers or foreigners.
Xerophobia- Fear of dryness.
Xylophobia- 1) Fear of wooden objects. 2) Forests.
Y-
None
Z-
Zelophobia- Fear of jealousy.
Zeusophobia- Fear of God or gods.
Zemmiphobia- Fear of the great mole rat.
Zoophobia- Fear of animals.

PSYCHOTHERAPY USING E.M.D.R.

Though it has now been in use for almost 10 years, EMDR (Eye Movement Desensitization and Reprocessing) is getting a lot of attention as an exciting, new modality, for short-term psychotherapy because of the extensive research, in the last 5 years, that has proven it’s effectiveness. There are now  more controlled studies on EMDR effectiveness than on any other method used in the treatment of trauma relief. Designed originally to help relieve symptoms of P.T.S.D. (Post Traumatic Stress Disorder), EMDR has also proven to be exceptionally useful in the treatment of self-esteem issues resulting from past and present life conditions, stop smoking programs, sexual dysfunctions, chronic pain, depression, and anxiety disorders, especially phobias.

EMDR was initially ridiculed because of the way a therapist waves their fingers in front of the eyes of a client, evoking comparisons to Mesmerism, popular in the 19th Century.  EMDR is in no way related to Mesmerism or any other form of hypnosis. It does not rely on a therapeutic trance state. It does utilize the natural healing abilities of our unconscious mind. If our brain was like a computer, this would be like the computer finding software that was corrupted or damaged and reprogramming the software all by itself.

We are just beginning to understand how the brain processes intense and/or painful events that occur in our lives. It is believed that when an intense single experience is overwhelming or when the cumulative effect of a recurring experience is overwhelming, there is a disruption of the brain’s ability to properly assimilate and understand the experience, causing a flaw in the belief system and emotions that underlie much of our personality and behavior.

The movement of our eyes back and forth manages to activate the neurophysiological mechanism responsible for processing our life  experiences and allows the memories, thoughts, and attached emotions to be reprocessed. This is the same system in the brain that looks at our life experiences and tries to make sense of them (process them) through dreams. It is no coincidence that while we are dreaming our eyes move rapidly back and forth. This is why deep sleep is also called REM sleep (Rapid Eye Movement).

The back and forth movement of the eyes is not critical to the success of triggering the brain’s ability to reprocess. With a 5 year old boy that couldn’t sit still for long, relief from  symptoms of P.T.S.D. was achieved in two visits by following him around the office, snapping fingers, alternating, near each ear.

With the therapeutic guidance of a trained EMDR clinician, clients begin to rethink and re-experience their world in new, more adaptive ways. Memories of childhood fears or abuse lose their emotional intensity. Persistent obsessions lose their importance. Images that triggered intense emotional responses become neutral. New behavior patterns become possible.  Hopelessness and frustration gives way to opportunity and change.

Because the treatment is effective almost immediately, EMDR has become the modality of choice for therapists dealing with trauma victims.  Anyone who has witnessed or been involved in a crime, auto accident, physical/sexual/marital abuse, dysfunctional childhood, or war atrocities can find themselves struggling with the emotions and memories of these tragedies at inopportune times. Maladaptive behaviors and defense mechanisms are the sign of the brain’s inability to properly come to terms with the experience.

Many other conditions can also be treated with EMDR by a therapist that understands the mechanisms by which it accesses and reprograms unconscious material.  We have been able to successfully treat bed wetting, addiction to cigarettes, chronic depression, many different phobias, and secondary sexual impotence. All using EMDR. Last year’s International Symposium on EMDR Treatment included many therapists that have found interesting and innovative ways to include EMDR protocols in the treatment of a wide variety of disorders.

Managing Stress

Stress Can Help Us Convert Problems into Solutions

All of us experience stress, to one degree or another, in our everyday lives. Stress is the body’s reaction to an event that is experienced as disturbing or threatening. Our primitive ancestors experienced stress when they had to fight off wild animals and other threats. In the contemporary world we are more likely to experience stress when we face overwhelming responsibilities at work or home, experience loneliness, or fear losing things that are important to us, such as our jobs or friends. When we are exposed to such an event, we experience what has been called the “fight or flight” response. To prepare for fighting or fleeing, the body increases its heart rate and blood pressure. This sends more blood to our heart and muscles, and our respiration rate increases. We become vigilant and tense. Our bodies end up on full alert, ready to protect us from danger or threats, whether real or not.

Stress is adaptive when it prompts us to take action to solve a problem. We can use our perceived stress as a cue that there is a problem and that we need to confront it. Public speakers, athletes and entertainers have long known that stress can motivate them to perform much better. The real difficulty occurs when we feel blocked. For various reasons, we may be unable or unwilling to solve the problem — perhaps because we don’t realize that there is a problem or we don’t have the tools for solving it — and we continue to expose ourselves to the stress. In these instances, stress becomes a negative experience.

Negative stress is demanding on our bodies and our lives in general. When our bodies are in a constant state of readiness for prolonged periods of time, we end up with heart palpitations, increased blood pressure, sweating, high stomach acidity, stomach spasms and muscle spasms. There is evidence that prolonged stress can lead to heart disease and a compromised immune system. Stress can deplete our energy and interfere with our concentration. It can lead us to become abrupt with other people and to engage in emotional outbursts or even physical violence. Our relationships and job security can be jeopardized. People who experience unresolved stress are more prone to self-destructive behaviors such as drug and alcohol abuse.

Those who deal with stress in a positive way usually have:

a sense of self-determination

a feeling of involvement in life’s experiences, and

an ability to change negatives into positives.

Self-determination refers to an ability to control or adapt to the events of everyday living. Rather than seeing ourselves as helpless in trying to overcome obstacles, we can begin to define ourselves as problem-solvers. We can remember times when we have been successful in solving problems and then see ourselves in those terms. We can learn to trust that we will have success in meeting life’s difficulties. When we take this approach, we can begin to face problematic situations as a challenge which, when resolved, can bring new and exciting opportunities into our lives.

Involvement means opening ourselves up to the world around us. It means letting friends and family members into our personal lives and sharing our private experiences with others when appropriate. Cultivating a social network serves us well when we are dealing with stressful situations. Talking our way through a crisis in the presence of a supportive listener, rather than holding it in alone, is one of our best ways of gaining helpful feedback, putting the situation into perspective, and sensing that we are not alone. When we lack involvement with others, we often feel vulnerable and may question whether we have the resources to cope with stressful experiences.

A positive approach toward life is one of the main attributes of those who deal well with stress. Rather than seeing life’s difficulties as situations to complain about, the more adaptive person sees them as challenges that can be met with success. Losses can be seen as opportunities for gain. The life process is one of loss and gain — it’s as natural as night and day. When we trust that our losses will give rise to new gains and life experiences, the stress associated with loss need not be devastating. For example, the loss of a job can open the door to more satisfying employment and the opportunity for more fulfilling life experiences. The clue is to change our negative thoughts about situations into more positive thoughts — and positive feelings will usually follow a change in thinking. For example, if a close friend moves away, rather than harboring negative thoughts about how lonely and devastated you will feel, think about the good memories you will always have, how your friendship will leave a positive legacy that will always touch your life, how you can still keep in touch and visit, and how you can now spend your time in new and positive pursuits. There really is no need for stress in this situation. We can choose to move toward the open doors of life rather than futilely knocking on closed doors.

The clue to handling stress adaptively is to acquire the skills we need to feel empowered. This requires a good, honest exploration into our lives. We need to explore the strengths that we already have for coping with stress, as well as to learn new skills. We need to be able both to comfort ourselves and to let others nurture us as well. All of us can learn, with some healthy exploration, to manage stress successfully.

The Top Life Stressors

Researchers have identified a number of life stressors that are associated with vulnerability to anxiety, accidents, and physical problems. Here are the top fifteen on the list, along with a rating which indicates the severity of stress associated with each of these life events. The higher the number, the more likely a person will be prone to stress related problems. Even good events, like marriage, can bring on stress.

1. Death of a Spouse, 100

2. Divorce, 73

3. Marital separation, 65

4. Detention in jail or other institution, 63

5. Death of a close family member, 63

6. Major personal injury or illness, 53

7. Marriage, 50

8. Being fired at work, 47

9. Marital reconciliation, 45

10. Retirement from work, 45

11. Change in health of a family member, 44

12. Pregnancy, 40

13. Sexual difficulties, 39

14. Gaining a new family member, 39

15. Major business readjustment, 39

Some Proven Ways to Cope with Stress

The first step in learning how to manage your stress is to increase your level of awareness in two areas — first, your level of experienced stress in your body, and second, the nature of the events which bring on your stress. You need to do the first one before you can effectively do the second. In order to increase your level of awareness in your body, check your stress levels throughout the day and rate yourself, perhaps on a ten-point scale, on the degree of stress you are experiencing at that time. To do this, check out your body. Are your muscles tense? Is your heart pounding? Are your hands cold and clammy? Are you able to concentrate normally? When you become adept at recognizing the degree of stress you are currently experiencing, work on increasing your awareness of the people, things and events that are triggering your stress. These can also be rated on a ten-point scale. This exercise can yield a lot of surprises. For example, you might find that a close friend, a family member or your job may increase your stress levels dramatically. You may learn to avoid the stressors or else to deal with them more realistically. Doing this exercise within the context of therapy may lead you to explore life issues that can finally be resolved.

The second step in learning to deal with stress is to take positive action to reduce your tension. Learning any of the following techniques can serve as an effective tool for combating unnecessary stress, and they may even change how you live your daily life.

Relaxation. There is a wide range of relaxation techniques available for coping with stress. Most of these methods can be learned in therapy, but the most important point to keep in mind is that you should find a technique that works for you. The list of choices includes breathing exercises, yoga, stretching exercises, biofeedback, meditation, massage, visual imagery, and progressive muscle relaxation (which is an especially effective tool).

Exercise. Regular physical exercise helps reduce stress, and it also raises self-esteem. It primes your immune system and plays a crucial role in preventing disease. Physical exercise need not be strenuous. Walking at a brisk pace for 20 or 30 minutes daily decreases stress just as effectively as vigorous jogging.

Self-Rejuvenation. Find things you enjoy that make your spirit soar. This could include listening to music, meditation, prayer, sports, dance, painting, visiting nature, hiking, or writing. Take time for recreational and spiritual pursuits on a regular basis. This will help you to maintain balance and perspective in your life —and it gives you better control over being stressed out.

Setting Limits. Much stress, especially these days, comes from biting off more than we can chew. We often embrace faulty expectations about how much we should accomplish in life. Unfortunately, this is a prime culprit in increasing our stress levels. It may help to examine what is really important in our lives, scale back, think smaller, and give our time more completely to the things that matter the most. Bringing expectations into line with reality and learning to say no when we choose to offers immediate relief.

Effective Communication. If you are too passive with others, you may come to feel that everyone is taking advantage of you or controlling you. On the other hand, if you are too aggressive in your dealings with other people, you may antagonize them and create more stress for yourself. Assertiveness training is one way of expressing your needs without feeling ignored or offending others. A number of effective communication techniques can be explored in therapy.

Social Support. Find people who can nurture and support you, and learn to trust appropriately in them. Our stress levels increase when we try to deal with life’s difficulties alone. Talking things through with a good listener can help us to put things into a more realistic perspective — and the mere act of talking about issues that we usually hold inside serves to reduce our stress levels. When stress decreases the quality of life, remember that professional help is available. Therapy can help us to take charge of our lives in an effective way — and this is a much better alternative than living under the control of stress.

The Many Faces of Stress

Stress comes in many forms. Generalized anxiety disorder occurs when a person has endured for at least six months a state of being excessively worried, being on edge continually, having sleep difficulty, and finding it hard to experience pleasure and relaxation. Post-Traumatic Stress Disorder happens if a person has been through a serious, life-threatening event, and may for months or years afterward experience severe stress, nightmares, hypervigilance, avoiding similar situations, and angry outbursts. Phobias are intense fears that occur when a person is exposed to a certain type of situation, like the dark, or heights, or snakes, or the sight of blood, or certain social situations like public speaking. Obsessive-Compulsive Disorder happens when stress or chaos in one’s world causes a person to think and worry repetitively about something (these are called obsessions) or else to engage in repetitive behaviors, like hand-washing or checking on things excessively (these are called compulsions).

One of the most debilitating manifestations of stress is the panic attack. These dramatic episodes of stress seem to come out of the blue and happen even when there is no real danger. They are usually intense for a few minutes and then they subside. The sufferer may experience chest pains, the feeling of smothering, dizziness, heart pounding, sweating, numbness, or nausea. These symptoms may be accompanied by fears of dying, going crazy, and losing control. Those who experience panic attacks often live in fear of their next attack, and this may prevent them from leaving the house, being alone or driving.

If you feel a panic attack coming on, it is helpful to just let it happen, as uncomfortable as this may seem. If you don’t tense up, the symptoms will generally subside within a few minutes. Tensing up will perpetuate the episode. You may feel faint, but you won’t really faint (blood is going to your muscles as you tense up and not to your brain, and this may bring on the sensation of fainting — but your blood pressure and heart rate have increased, so you’re actually less likely to faint). During a panic attack, try to contain your thoughts. Challenge your negative thinking (you are not having a heart attack; you will not suffocate; you are not going crazy). Trust that this will end soon. Tell yourself the following: “Well, here it is again. Let me watch my body respond to this, just like I’ve done before. I will survive this and I can handle it. This may be unpleasant, but it’s only anxiety and it will pass. Let me flow through this.”

What is an Eating Disorder?

Eating Disorders include a range of conditions that involve an obsession with food, weight and appearance to the degree that a person’s heath, relationships and daily activities are affected.

Though commonly affecting young women, eating disorders are widespread and can impact people of all ages and sexes. It is estimated that several million people in the United States suffer from an eating disorder, and the statistics are growing. The number of men with an eating disorder has more than doubled in the last ten years.

Whether a person restricts food intake, binges and purges, binge-eats, compulsively overeats, excessively exercises, or abuses laxatives, these behaviors often are symptoms and not the problem. They often develop as a way of coping with stress or trauma, emotional pain, conflicts related to separation, low self esteem, depression.

Bulimia

Bulimia is a cycle of uncontrolled binge eating followed by purging through vomiting or the use of laxatives. Individuals with bulimia are often of normal weight or even slightly overweight. Bulimia can range from a mild and relatively infrequent response to stress to an extremely debilitating pattern that absorbs nearly all of a person’s time, energy, and money. In its most severe forms, binge eating and purging may occur ten or more times a day.

Bulimia usually begins innocuously as an attempt to control weight. Purging may seem to be a convenient means for a person to overeat without gaining weight. It can quickly become a destructive process that cannot be controlled. Persons with bulimia are often aware that their eating patterns are abnormal and out of control and that their lives are dominated by their eating habits. They may feel guilty and depressed after a binge. Over time, the cycle becomes more and more dominant in the person’s thoughts and behavior. It may impair personal relationships and interfere with other activities, leading to depression, isolation, and lowered self-esteem. Once caught in this pattern, the resulting shame and sense of helplessness may make it difficult for the person to seek the help that is needed.

Physical effects can also be serious. Frequent vomiting can cause permanent tooth damage from erosion of tooth enamel as well as damage to the tissues of the throat and esophagus. Kidney problems and seizures are also possible. Electrolyte imbalance with consequent risk of serious cardiac problems is also a significant danger and frequent cause of death.

Anorexia-Nervosa

Anorexia Nervosa is a disruption in normal eating habits characterized by an all consuming fear of becoming “fat.” It typically starts in teenage women as a normal attempt to diet but gradually leads to more and more weight loss, often more than 25% of original body weight. There is an intense preoccupation with food and body size, which may involve compulsive exercising. As this happens, many normal activities may stop. Menstruation ceases in women and there are a number of physical symptoms of malnutrition such as lowered heart rate, low blood pressure, decreased metabolic rate and sensations of coldness particularly in the extremities.

People with anorexia nervosa are obsessed with food and deny that they have a problem or that they are too thin. They may be able to work or study and have some social life but usually function far below their potential. Frequently they are also depressed. Some persons with anorexia starve themselves to death. Others check the downward spiral of weight loss and maintain a steady but seriously underweight condition. In all cases, even severe weight loss does not diminish the perception of being “fat.”

Binge Eating Disorder

An illness that resembles bulimia is binge eating disorder. Like bulimia, the disorder is characterized by episodes of uncontrolled eating or binging. However, binge eating disorder differs from bulimia because its sufferers do not purge their bodies of excess food.

Individuals with binge eating disorder feel that they lose control of themselves when eating. They eat large quantities of food and do not stop until they are uncomfortably full. Usually, they have more difficulty losing weight and keeping it off than do people with other serious weight problems. Most people with the disorder are obese and have a history of weight fluctuations. Binge eating disorder is found in about 2 percent on the general population–more often in women than men. Recent research shows that binge eating disorder occurs in about 30 percent of people participating in medically supervised weight control programs.

People with binge eating disorder are usually overweight, so they are prone to the serious medical problems associated with obesity, such as high cholesterol, high blood pressure, and diabetes. Obese individuals also have a higher risk for gallbladder disease, heart disease, and some types of cancer. Research at The National Institute of Mental Health and elsewhere has shown that individuals with binge eating disorder have high rates of co-occurring psychiatric illnesses–especially depression.

SOURCE:

U.S. Department of Health and Human Services – Public Health Service – National Institutes of Health – National Institute of Mental Health

GENERALIZED ANXIETY DISORDER

I always thought I was just a worrier. I’d feel keyed up and unable to relax. At times it would come and go, and at times it would be constant. It could go on for days. I’d worry about what I was going to fix for a dinner party, or what would be a great present for somebody. I just couldn’t let something go.”

— “I’d have terrible sleeping problems. There were times I’d wake up wired in the morning or in the middle of the night. I had trouble concentrating, even reading the newspaper or a novel. Sometimes I’d feel a little lightheaded. My heart would race or pound. And that would make me worry more.

Generalized anxiety disorder (GAD) is much more than the normal anxiety people experience day to day. It is chronic and exaggerated worry and tension, even though nothing seems to provoke it. Having this disorder means always anticipating disaster, often worrying excessively about health, money, family, or work. Sometimes, though, the source of the worry is hard to pinpoint. Simply the thought of getting through the day provokes anxiety. People with GAD can’t seem to shake their concerns, even though they usually realize that their anxiety is more intense than the situation warrants. People with GAD also seem unable to relax. They often have trouble falling or staying asleep. Their worries are accompanied by physical symptoms, especially trembling, pounding heart, muscle tension, headaches, irritability, sweating, or hot flashes. They may feel lightheaded or out of breath. They may feel nauseated or have to go to the bathroom frequently. Many individuals with GAD startle more easily than other people. They tend to feel tired, have trouble concentrating, and sometimes suffer depression, too.

Depression often accompanies anxiety disorders and, when it does, it needs to be treated as well. The feelings of sadness, apathy, or hopelessness, changes in appetite or sleep, and difficulty concentrating that often characterize depression can be effectively treated with antidepressant medications, and/or psychotherapy. People with more severe symptoms respond best to a combination of medication and psychotherapy. Treatment can help the majority of people with depression.

Usually the impairment associated with GAD is mild and people with the disorder don’t feel too restricted in social settings or on the job. Unlike many other anxiety disorders, people with GAD don’t characteristically avoid certain situations as a result of their disorder. However, if severe, GAD can be very debilitating, making it difficult to carry out even the most ordinary daily activities. GAD comes on gradually and most often hits people in childhood or adolescence, but can begin in adulthood, too. It’s more common in women than in men and often occurs in relatives of affected persons.

General Anxiety Disorder is diagnosed when someone spends at least 6 months worrying excessively about a number of everyday problems. In general, the symptoms of GAD seem to diminish with age. Successful treatment may include medication. Also useful are cognitive-behavioral therapy, relaxation techniques, and biofeedback to control muscle tension.

Internet Addiction

Internet Addiction

At the recent annual meeting of the American Psychological Association in Boston,Massachusetts, researcher and psychologist David Greenfield released the results of the largest study of Web surfers ever conducted. Responses were collected from over 17,250 different people. Almost 6% of Internet users suffer from some form of addiction to it. The 6% findings were somewhat lower than another study of college students which determined that about 10% of the young adults were addicted to surfing the Internet.

The findings bolster a growing acceptance of compulsive Internet use as a real psychological disorder. Internet addiction is similar to many other forms of addictive behavior. People participating in the study admitted to surfing the Internet to escape from their problems and were unable to lower their usage after realizing their behavior was becoming problematic in some way.

Participants in the study answered many questions in five different categories. The question, DO YOU USE THE INTERNET AS AN ESCAPE, was answered yes the most, by 30% of people answering the questionnaire. Greenfield’s analysis of the data suggests that Internet users’ feelings of intimacy, unstructured time and/or boredom, and lack of inhibition all contribute to the addictive force of the Internet.

Researchers are already labeling several different categories of compulsive Internet use: sex and relations, consumerism/shopping, gambling, stock trading, and obsessive/compulsive Internet surfing for its own sake.

Treatment of Internet addiction is similar to counseling for other addictive behaviors. The best results are often obtained using a mixture of education, insight oriented and behavioral techniques which are aimed at reducing a clearly defined set of behaviors.

If you need help curbing your time spent on the Internet, we can help!

The Internet Addiction Self-Test

Score each question:

0=Does not apply 1=Rarely 2=Occasionally 3=Frequently 4=Often 5=Always

1. How often do you find that you stay online longer than you intended?

2. How often do you neglect household chores to spend more time online?

3. How often do you prefer the excitement of the Internet to intimacy with your partner?

4. How often do you form new relationships with fellow online users?

5. How often do others in your life complain to you about the amount of time you spend online?

6. How often does your schoolwork or grades suffer because of the amount of time you spend online?

7. How often do you check your e-mail before doing something else that you need to do?

8. How often does your job performance or productivity suffer because of the Internet?

9. How often do you become defensive or secretive when anyone asks you what you do online?

10. How often do you block out disturbing thoughts about your life with soothing thoughts of the Internet?

11. How often do you find yourself anticipating or thinking about when you will go online again?

12. How often do you fear that life without the Internet would be boring, empty, or joyless?

13. How often do you snap, yell, or act annoyed if someone bothers you while online?

14. How often do you lose sleep due to being online late at night?

15. How often do you feel preoccupied with the Internet when offline, or fantasize about being online?

16. How often do you find yourself saying, “just a few more minutes” when online?

17. How often do you try to cut down the amount of time you spend online, and fail?

18. How often do you try to hide the amount of time you spend online?

19. How often do you choose to spend more time online over socializing with friends or family?

20. How often do you feel depressed, moody, or nervous when you are offline, which goes away once you are back online?

SCORING

20 to 49 points = you are an average online user. You may surf the Web a bit too long at times, but you have control over your usage.

50 to 79 points = You are experiencing occasional to frequent problems because of the Internet. You should consider the impact of these problems on your life and get professional help if you can’t resolve these problems on your own within a month’s time.

80 to 100 points = Your Internet usage is causing significant problems in your life. You should evaluate the impact of the Internet on your life and directly address the problems caused by your Internet usage. A support group or the assistance of a professional is probably necessary.

Julie Woltil,PhD and Fritz Hershey,PsyD have extensive experience in working with addictions.