Category Archives: Dealing with Emotions

BARIATRIC SURGERY – THE UGLY SIDE THAT NO ONE TALKS ABOUT

videoblocks-young-woman-looking-at-her-mirror-reflection-with-disgust-ashamed-of-fat-body_rvhbqgrcx_thumbnail-small01I am noticing more and more that weight loss surgery as a solution for obesity is all the rage. It used to be that only people severely obese (on the verge of death due to major health complications and no ability to exercise anymore) would have Bariatric surgery performed to save their life. Its original purpose was to help save lives of those who were struggling severely and had no other options.

Today, there are young people and relatively healthy people having this operation and they sometimes weigh in at 250 or less pounds.

While these operations can be a really good option for folks who really need it, they should not be used as an easy way out of weight loss for healthy people who still have the ability to exercise and diet and lose weight using other tools.

What people do not realize is that there may be major psychological, social, and spiritual affects (depending on your own belief systems).

In the United States, we’ve developed a system of psychological evaluation to address the reasons why someone is having the surgery and test their mental competence, but it can be difficult to impossible to predict what will happen to a person following the operation. The body is not the same as it was before. Drastic physical and emotional changes occur within the body following Bariatric surgery.

Patients have to be extremely disciplined and militant in their self-care following these operations to just live a relatively normal life. The reason is there are going to be vitamin deficiencies and limitations in the body that were not previously there. That means they have to have regular vitamin injections and eat several times a day with extremely small portions among other things like further psychological evaluation and support after the operation. They may be told that they cannot exert themselves like they used to because they could deplete the small amount of water or vitamins they ingest in the small portions they are now forced to live with.

Most patients who decide to go through with the operation may say they are committed to all of this, but are they?

Let’s think realistically. We have busy lives and live in a society that is constantly busy and offers limited time for breaks at work or even at home. This makes it very challenging to stay on top of special diets and other practices that are suddenly part of life post op. And, if someone didn’t do a good job of disciplined dieting and exercise before the operation, it’s not likely they will follow a stringent plan after surgery either, and not doing so could cause major damage to the body and even become fatal.

People who choose to do these operations are choosing to give themselves a health condition with life-long consequences, and they need to be aware of that.

There are hormonal changes related to vitamin deficiencies that could even push people into old age.

There can be profound psychological impacts, some of which are still unknown.

What does the mother with 3 kids do when she has run out of energy and can’t keep up with her kids because she can’t consume enough nutrients?

Further, some people are traveling to other countries to have these operations performed for less money, but the healthcare is not as good and the pre and post op activities are not nearly as stringent as they are in the U.S. They cannot be held liable if they cut too much away or do something that causes a major internal infection in the stomach.

Let’s also take a step back and think about what happens physically, emotionally, and spiritually as well.

To put this into perspective, we have a second brain in our gut. Our gut brain is directly connected to our real brain via the Vagus nerve that runs through the body. When we are excited, scared, angry, nervous, in love, or making major decisions, we always feel it in our gut, right? When our bodies go into fight or flight mode to protect us, we release adrenaline that is felt in the gut. So, what happens when we cut away 80% of our guts, which is the system our body was designed with to process nutrition AND emotion?

Patients simply may not have the capacity to have the stamina or health level they were able to achieve prior to the bypass.

It’s no surprise that losing tons of weight in a rapid amount of time would have a psychological impact on patients. However, it isn’t known how deep that rabbit hole can go. We do not have all the stats we need yet, and there are variables involved as well, so information is not being publicized enough. Medical information around these procedures is in its infancy.

That said, it has been known for years that stomach surgery for obesity frequently has long-term neuropsychiatric effects including Wernicke’s and other encephalopathies (Neurology 1987;37 196-200), depression and substitute addiction.

In the relatively small number of cases I’ve observed, there were instances of stomach infections and other stomach and digestion-related health issues on top of deficiencies. This even resulted in death for some.

The body simply cannot operate the way it did before in many cases. This makes logical sense, as the amount of water that can be ingested by a human who hasn’t had this operation is drastically reduced after because of the size of the stomach. So, people have to choose to eat or drink and have expressed that they are either hungry or thirsty most of the time. This means nutrients is not handled the same way it used to be and that can cause the immune system to have to work harder as well.

Please understand that I am not judging. If you’ve had this operation or your loved one has, please don’t be angry with me. This operation has saved lives of people who would have died from high cholesterol, high blood pressure, and a number of other heart and health complications. I get that.

All I am saying is people need to consider choosing surgery ONLY when they absolutely need to have it and not as a means to lose weight faster or look more beautiful or handsome. Doing that is like burning the whole house down because it’s a mess. There are many options out there for weight loss, which include dealing with the emotional component of eating as well.

I have a short course about dealing with emotional eating, which you can find HERE.

There is still MUCH more work to be done in researching and documenting long-term effects of weight loss surgery. Below are some links to articles on the subject.

(Current Opinion in Psychiatry: September 2014 – Volume 27 – Issue 5 – p 374–379),
(https://www.psychologytoday.com/us/blog/the-truth-about-exercise-addiction/201611/the-mental-health-struggles-weight-loss-surgery)

self-harm (https://www.medscape.org/viewarticle/894158https://www.health.harvard.edu/newsletter_article/Psychological_aspects_of_bariatric_surgery), new-onset mania (Psychiatry Investig. 2015 Jan; 12(1): 152–154.),

and vitamin B1 and B12 deficiencies
(https://jamanetwork.com/journals/jamaneurology/fullarticle/786290).

**This article should not be used to treat or diagnose any condition related to bariatric surgery. This is written from one perspective based on observation and personal opinion as well as some research. You should seek medical advice from your doctor if you are considering this type of operation.

The Importance of Being Happy First

choosehappyWe have a list of things in our head at all times about what will make us happy…. “If only this would happen…” or “when that happens…”, I’ll be happy. Do you really want to put happiness on hold until those things are satisfied?

In this article, I am going to use writing as an example, but you can fill in your own blank about what you want to happen. Writing more, writing better or–fill in-the blank — will NOT make you happy if you aren’t happy now.

That’s not to say that implementing something you love won’t help you walk down the road to happiness, but you can’t expect an immediate cure for unhappiness.

It pains me to write this. The reason is we keep changing our goal posts. We want more.

Check out this TED talk about the importance of being happy first . Shawn Achor has done lots of research on the topic and I find his evidence convincing. Writing more is not going to make you happier, but giving yourself time to do things for yourself and others (offering help to others, meditating, gardening, taking a long walk) will likely make you happier, therefore, a better writer.

 It’s better to do something to work toward your goal a little bit every day than a whole lot of things on an inconsistent basis.

Michael Ferris Smith said his novels started with one sentence or one idea and he wrote every day letting his mind create the story. When someone asked when he thought of a character or scene, he said “When I thought of it.”

Whatever you are working towards (writing, exercise, cleaning out a dresser drawer), start with 5 minutes a day. This takes away your argument that you don’t have time. You may come up with other arguments but try it. It becomes a habit and you will feel successful (and could decide to do moreJ

In general, the best time to do your thing is first thing in the morning.  I can hear you groaning. Your energy and focus may be in the evening.  But there are legitimate reasons to try the morning time. Your creative brain is awake, you have more energy, you’re in a better mood, and you’ll feel good all day about fitting in your 5 minutes.

Depending upon your goal, give yourself permission to “just do it.” without being perfect. If you are writing a story, write a paragraph and allow it to simmer in your mind during the day. It is likely you may rewrite that paragraph every day during your 5 minutes. Give yourself time to rewrite without feeling guilty about rewriting. The best writers in the world are always the best re-writers. This applies to art, dancing, cooking, and such.

The bottom line is that when we are happy, we are better at whatever we do. What do you know would make you happy if you gave it a little time and energy each day?

 

 

The Experience of In Between

Kaleidoscope_ViewpointsNobody likes being left out, abandoned, different, and unwelcomed. Yet, it is a common experience when we are “in-between.”  Not where we were and not where we are yet to be.

People feel in-between while they are waiting for a divorce, retiring from work, getting sicker, moving to new homes, or changing jobs. We like the familiar and will often stay with the familiar (spouse, job, church, neighborhood, country) until something motivates us to change. If you watch “Naked and Afraid,” you have seen them land on a beautiful beach, they choose to enter the treacherous jungle with no guarantee there will be food or they will survive. They have to transition themselves into a very humble way of being in order to just survive the challenge.

That’s what we do. It’s always been like that, right?

Perhaps you’ve sent in your DNA sample to find out your genetic heritage. We’re all so excited to see if what we thought is true and to see what we didn’t know about ourselves. I had been told we were “Scotch Irish’ and from England but I wasn’t expecting Finnish and Northern Russia!  Probably a few brave or desperate souls traveled across Europe. I’d like to know their stories. Wouldn’t you like to know your ancestors’ stories? Our country is full of them. We all came from somewhere. They had to leave the familiar. They were not always welcomed. They were different from those who were already here. They lived in-between trying to find “there.”

It’s always been that way.

Our world population can be compared to a kaleidoscope that is constantly changing. A kaleidoscope can be beautiful and every change can be amazing or it can feel confusing and busy.

Wars, fires, famines, floods, hurricanes, and heat force people to move and change. Almost everyone has stories of people who moved into your neighborhood after these events, even if it was temporary. Katrina changed the landscape, for example. Help was available. Were the strangers welcomed? Not always.

It takes courage to wait and be patient or live through challenges and struggles to get to a better state of being.

It’s always been that way.

Now, we see people fleeing their familiar on our southern border. They must feel as though they’ve entered a jungle with no promise of anything. They are in-between.

Can we find compassion for someone different? Can we remember our own ancestors and the stories we learned about who we are, celebrating our DNA strands? Or will it take another hundred years to understand human tribal behavior?

Sometimes, there is hope on the other side of the “in between”. I’d like to see everyone come out of their in between in a better state of being. In our human history, that hasn’t always been the case. We can choose to make the other side of in between better.

Does it always have to be that way? 

If you need help with your in between, you can schedule a consultation here.  You may also contact me at 601-684-9657 or e-mail me at patriciabrawley@earthlink.net

Personal Safety – Why It’s Worth Thinking About

1599992845_80eb53df27_bIt’s not going to happen to me. Or so we think. When something happens…a person is assaulted, kidnapped, robbed…we always think we won’t be next.

We are SO busy. We don’t want to think about this.

It’s possible you won’t be next, and I hope you aren’t! BUT there is always a chance you could end up in the wrong place at the wrong time. Or your loved ones can be.

If that happens, there are some things you can do to protect yourself. Here are 6 tips:

1.) Carry a mini taser in your bag, briefcase, or purse. They have ones that are so small that they are lipstick sized. They come with cases and you can stowe them easily and they stay charged for a long period of time. You may never need it, but it’s good to have!

2.) When getting into your car, especially in an isolated area or at night, look in the back seat and under the car when walking up to it.

3.) If you stay late at the office, let security know you are there and let them know when you leave.

4.) If you have an office visitor late in the day, put sharp objects away, wallets, and anything confidential just in case.

5.) Get a doorbell camera or home safety system. Your local cable company should have an option for you. Ring is one option. 

6.) Trust your intution! We so often don’t do that, and it’s usually right. If it turns out to be nothing, that’s okay, but check it out.

If you are the victim of an attack or assault and you need help, you can schedule a consultation here.  You may also contact me at 601-684-9657 or e-mail me at patriciabrawley@earthlink.net

When Everything Is Not Smooth Sailing – Challenges of Adoption


STORM-BREAKAs a licensed professional therapist, I incorporate adoption work into my general practice. Most of the time couples are excited to adopt a child even though it is mentally exhausting.

Sometimes adoptive parents are afraid to talk about the challenging side of adoption because they are so grateful to be parents that they don’t want to “complain” about the negative aspects of the process. I’m here to tell families that it’s totally okay to be exhausted, scared, unsure, etc. and still be GREAT parents.

There are factors that make parenting a bit more stressful than regular parent stressors, such as adopting an older child or a special needs child. Some children arrive with a history of abuse and showing symptoms of Post Traumatic Disorder.

Then, you have regular family stressors like making sure a child is comfortable, well-adjusted, healthy, and feeling loved.

There is the added twist of when to tell a child he/she is adopted and how to tell the adoption story. You have to be prepared for “You’re not my real Mom.” stuff similarly heard from blended family children. This tends to happen when the children get older.

Then, we have family and cultural dynamics.

You’ve seen TV shows around adult children wanting to find birth parents and vice versa. Whether or not adoptive parents want to see their children or vice versa, there are always a mix of complex feelings for everyone involved in that situation.

There is an increase in lesbian and gay couples adopting children. That comes with its own set of societal challenges.

We’ve seen shifts in the counties US parents are adopting from. For a while, the trend was Asian children, then Russian children, then South American and Chinese children.  This sometimes has to do with regulations involving permission to adopt the child. This can be a very difficult process. Sometimes, the adoption process can take months (or even years) even though an adoptive couple knew they were going to adopt a child before it was born. There is a lot of red tape. In the meantime, a child can be kept in the horrid conditions of an orphanage in a dangerous part of a foreign country. This leaves a physical and mental impact on the children and adoptive parents that has to be dealt with once the process is complete.

We’ve learned that introducing the adopted child’s culture is important. The Little Couple (a TV show documentary series, which follows two little people who adopted two kids that were little people from different countries) educates us about how understanding and experience helps their children. Their little boy is from China and their little girl is from India. The visited China to introduce their won, Will, to their own culture and will soon schedule a trip to India to introduce their daughter to her culture.

We know more about Attachment Disorder in adoption population of all ages.  They are probably going to have some issues with abandonment no matter how well-adjusted they are in their new family. There is a lot of stress for everyone. For people who work with agencies, there are home studies and inspections and endless evaluations. In private adoptions, the birth parents can change their mind or even take the child back. It’s a lot to prepare for and understand.

A counselor can help couples work on dealing with stress and keep their relationship healthy. In fact, I can’t imagine a family going through this process without counseling assistance at some point.

It is okay to admit that this process is daunting but it’s worth it because of the result. It’s okay for the family to need ongoing counseling and support for a healthy family and home. Please talk about your fears and challenges and get help when you feel overwhelmed. Or, if you know a family on this journey, please share this with them.

If you feel stuck and need a sounding board to help you plan,you can schedule a consultation here.  You may also contact me at 601-684-9657 or e-mail me at patriciabrawley@earthlink.net

How Getting Seasonal Depression is as Common as Catching the Flu

cs-depression-roundtable-what-depression-feels-like-400Imagine this scenario…

After yoga class with friends, you notice Annabelle is acting unlike herself. You can’t put your finger on what it is that you notice, so you keep it to yourself. The next day at work, you notice that Annabelle is not walking the way she usually does, she seems frustrated and sighs when the phone rings. You ask her if she is okay and she tells you she is fine, just tired.  This continues until a week later you ask her again and this time she tells you she has a pulled muscle in her back and a sprained wrist. You had no idea. Annabelle tells you she is embarrassed and didn’t want the boss to know because she hasn’t been finishing her work. You don’t want your friend to suffer, so you take it upon yourself to make an appointment and offer to drive her to see the doctor.

Now, what if were to replace “pulled muscle” and “sprained wrist” with “depression”? Are you as likely to take the same action for your friend?

Did you know that depression is the leading cause of disability worldwide? Only about half of those diagnosed receive treatment – in many countries this is fewer than 10%. Although getting help from health care professionals is always a recommended approach, many people lack the resources, time and access to such care.  Depression makes it even harder to follow through with plans. Some even turn to detrimental forms of self-medication, such as drinking alcohol.

How do you know when someone has depression? The National Institute of Mental Health defines depression as a “mood disorder that causes severe symptoms affecting how you feel, think, and handle daily activities”. The combination of environmental factors, personality, genetics and biochemistry can lead to its onset. It’s been compared to catching a cold. It can affect anyone at any time.

Although not all of these factors can be easily changed, there are things we can do to reduce our susceptibility. The habit of washing your hands comes naturally and we do it for the sake of our health. Is there anything you can do similarly to help reduce the symptoms of depression? It turns out there is.

The amygdale is a part of the brain closely associated with depression. The amygdale modulates the fear response. In depressed people, the amygdale tends to be larger and overly active in response to negative stimuli, such as seeing something upsetting, or feeling sad. These feelings become more intense than usual. The brain has a “cold” and is now sneezing, metaphorically. Additionally, things that are usually fun and make you happy just don’t rise to the level of  “happy” anymore.

When researchers studied the overactive amygdale they found that meditation may counteract depression by reducing amygdale activity and by increasing activity in the hippocampus, prefrontal cortex and other brain regions associated with attention and emotional self-regulation.

 

Have you heard of Seasonal Affective Depression? Most people haven’t.

Kwan Yin Sabbatical 2When the Fall season arrives, it comes with warm, comforting recipes and new visual landscapes to admire. It can also bring Seasonal Affective Depression that creeps in like the cloudy skies.

Seasonal Affective Depression is thought to be caused by lack of bright sunlight. If you find yourself feeling blue and gloomy on days that are grey, it’s worth looking into. Most people who have it, may not even be aware that’s the cause of how they are feeling. On the other hand, rain and gloom cheers some people up. They find they have lots of energy on those days.

I also encourage you to practice meditation as a way to feel better. Meditation can be done anywhere, such as a walking meditation.

Sometimes a new environment or a porch swing can have a similar effect. Here are some pictures from my “sabbatical” in Ocean Springs, MS earlier this month with my beloved little cat, Kwan Yin. She was my sabbatical companion while I was there.

Class Is In – 10 Steps to Prepare for Daily Meditation

How to Meditate in 10 Easy StepsWe now know with overwhelming evidence that using meditation can help individuals achieve astonishing results in their physical and mental health. 

This space is too short to offer you a whole course in meditation, but I do want you to know about what meditation is and what it is not.

Recently, I asked my intern students if they were teaching their clients to meditate. I was surprised to hear one student say, “isn’t it just deep breathing?” or “relaxing with your eyes closed?” The simple answer is No.  Deep breathing is deep breathing and is useful to help when we feel anxious. Relaxing is relaxing. Also good for us, but it is not meditation.

What is meditation? It’s the act of clearing your mind of clutter and becoming grounded and focused. It is a mental and physical reset button.

It starts with posture.  You want to stay relaxed and alert and focus on the present moment. You let your breath do its own thing. You notice. Your breath may change or not. You just notice. Don’t judge.

A good attitude helps but as my teacher, Jon Kabat Zinn said, “you don’t have to like it to do it.” Chances are when you start you’ll feel awkward or uncomfortable. That’s okay.  Finding the ideal meditation posture and seating can take a while. There’s no one-size-fits all seat for meditation. You may think of seeing people seated cross-legged on cushions on the floor, but you can also meditate seated in a chair, or walking, or eating mindfully.

Your mind will chatter. It’s called monkey mind because it’s like a monkey jumping from tree to tree. Just notice, don’t judge, let it be. Try not to dwell on any thought. Let them come and go like clouds in a sky. Come back to your breathing over and over.

Here are 10 steps to prepare for daily meditation.

1.) Take a seat.

2.) Let your eyes gaze slightly downward, 4 to 6 feet in front of you or close your eyes. Try it both ways to see which you like best.

3.) Tuck your chin in slightly to keep your spine aligned.

4.) Sit upright and straight but not unnaturally stiff. Arching or slouching produces tension. To align your spine, bend forward then slowly straighten up. Try to feel each vertebra stack up as you go.

5.) Center your sitting bones. Don’t lean forward or backward. Allow yourself to “settle in.” Take your time to get comfortable. Rock back and forth and side to side until you feel the sitting bones loosen up. The rest of your posture will more easily fall into place now.

6.) Keep your arms parallel to your body, palms on your thighs. Some people like to place their hands together or one palm holding the other palm.

7.) Sit with your knees below your hips, legs loosely crossed. That’s why you see people sitting on cushions or meditation benches. You will want to experiment to find the right height.

8.) Come prepared with a shawl, socks, glass or water, and timer.

9.) It’s okay to take a break during your meditation session. Try bringing your knees to your chest, curving your spine forward to stretch out.

10.) If sitting is uncomfortable, take your seat in a chair. It’s easier on your knees and convenient. Resist the urge to slouch back in the chair unless you really need to. Sitting straight helps your breathing. Keep your feet flat on the floor. You may have to use a stool or something under your feet if the chair is too high off the floor.

Homework:

Practice with no expectations but notice the results.

The Unspoken Truth About Bipolar Disorder

bipolar-myths-factsAt some time or another you may have heard people say, that person is crazy. He / she is bipolar. So, we’ve learned to associate “crazy” with bipolar disorder. So many people use this term out of context.

I’d like to share with you what bipolar disorder is and what it isn’t. It IS a mood disorder marked for alternating periods of extreme happiness and depression. It is caused by a chemical imbalance in the brain. It can affect energy level, judgment, memory, concentration, appetite, sleep patterns, sex drive, and self-esteem.It can be treated with medication and healthy lifestyle choices.

Here’s what it IS NOT. Having bipolar disorder does not mean a person has split personalities. It does not mean they are crazy or violent. It does not mean someone had inadequate parenting. People with bipolar disorder CAN get better. Most people think they can’t. Having bipolar disorder does not mean someone is unfaithful or untrustworthy. Most importantly, bipolar disorder is not rare! It affects 5.7 million Americans each year, which is about 2.6% of the population. 

Another thing that most people don’t know about people with bipolar disorder is that they are some of the most sensitive, creative people in the world. In fact, scientists are starting to believe that bipolar disorder was a gateway to human evolution. Watch the video about that HERE. 

choosehappy

Are you living happily or just settling for so-so?

choosehappyDid you read Henry Thoreau’s book, “Walden”? He is famous for the quote “Most men live lives of quiet desperation.”

The quote comes from an essay on the pain he saw in most people’s lives. As a therapist, I see it too. It’s not the type of pain that comes from illness. That can strike any of us. It has more to do with good people doing the best they can but are stuck in a life where they aren’t terribly miserable but they aren’t very happy.

It feels like having a low-grade fever on the happiness scale. Thoreau wrote about people who worked all month to pay the bills with little to show for it. They worked in jobs that didn’t suit them. They had little beauty, humor, art or joy in their lives. He called it “settling” for less than life could be.

Thoreau, a keen observer, could see that people were bored and always looking for a temporary pleasure to distract them or make them feel happy for a moment. He wrote about people staying so busy with mundane tasks that they used up any time or energy they could have used to explore living a fuller life. This is the act of “desperation.”

This month, our culture’s distraction with the weather and storms made me think about these things again. Too often, we fall prey to the media’s desire to dazzle us with the bizarre that we forget to make the most of our own lives, here and now.

Of course, we are all fascinated by the unusual and the extraordinary. We live in a time when anything that happens, anywhere on earth, comes into our homes and shows up on our email and phones, in “real time.” Used appropriately, our access to instant communication is a wonderful thing! No one can deny that.

But don’t let the daily news plus your daily routine prevent you from expressing the highest and best that is in you.  There will always be worries about the economy, politics or threats of war. They are not substitutes for living according to your highest ideals.

Every day we have a choice of how we want to live. Do you choose to worry about everything or build the life you really want? Do you expend enormous energy on problems “out there” or proactively plan and address the challenges of living the life you choose? No one will tell you how to use your time and talents. That’s for you to decide.

Would you choose to build memories with your children or focus on tragedy? Would you read the best books ever written or watch more TV. Would you build your business, develop your skills or fret about the economy? Would you sing and dance to your own music or download more iTunes?

Throughout history, most people have worked to survive. We now live in a time when we have the best education an resources. We can enjoy healthy meals, great music, conversation, and listen to the smartest people on earth, often in person! And yet we so often let it pass us by.

In the coming month, make the choice to live your own life, in your own way, as best you can. Do one new thing or do at least one thing differently. Spend one hour exploring the highest and best that is in you. Then, take a moment to reflect on how it impacts your life. I’d love to hear about that.