Kessler Psychological, LLC

Psychotherapy and Evaluation Services

Virginia Beach, VA

KP's Weekly Mental Health Tips:

This week brought to you by Lindsey Wright.  


Have you ever felt that when you’re upset your actions actually tend to make things worse? For example, if you’re depressed, you may sleep all day, which in turn makes you feel even more unmotivated and fatigued.

     There is a helpful concept from Dialectical Behavioral Therapy called “Acting Opposite to Your Urge,” that may be helpful in these situations. This skill can best be used when your emotional states do not fit with “the facts” of a situation. For instance:

-Anger: If your urge is to scream at someone or to attack them due to a perceived injustice, acting opposite to your urge may look like trying to empathize with the person you are upset with or taking a break until you’ve had time to let your anger die down.

-Depression: If your urge is to criticize yourself, try highlighting ways in which you are doing well. If your urge is to isolate yourself from others, then try and reach out to a trusted friend or family member.

-Anxiety: If your urge is to ruminate on what is causing anxiety, then try to meditate using mindfulness to focus on your body in the present moment, as opposed to focusing on thoughts of what has happened or what is to come.

-Guilt: If your urge is to apologize, try instead to give yourself grace and acknowledge that all people make mistakes. If your urge, however, is to avoid your guilt, try confronting your guilt head on by asking for forgiveness with the understanding that others may not be ready to forgive. That’s ok. Everyone has their own process and time required to forgive and forget.

In moments when you may be unsure if you should act opposite to your urge, it is always helpful to ask yourself, “Is this action or thought helpful to me?” You might surprise yourself at how often your actions are counterproductive to yourself and your needs.


LOOKING FOR MEDICATION MANAGEMENT? We do not currently offer this service, but here is a list of a few places to which we refer our clients:

  • Leva Psychiatry in VB: 453-5508
  • David Reid, MD in VB: 456-0505
  • Family Insight in VB: 233-0003
  • Alpha Psychiatric Svcs in Chesapeake: 413-5444
  • Norfolk Psychiatric Svcs: 461-3313
  • Balance Behavioral Health in Norfolk: 626-3733
  • EVMS Psych./Beh Sciences in Norfolk: 446-5888
  • CHKD in Norfolk: 668-8866

GUIDELINES ABOUT REACTIONS TO TRAUMA

WHAT IS TRAUMA:

1. Most importantly, trauma is different for everyone. There are a lot of reasons why the same two people have vastly different reactions to the same event. So, just because you're fine today, you might be struggling tomorrow; and just because someone you know has had no problems after a traumatic event, doesn't mean you shouldn't or won't. There are no rules, just human reactions.


2. Generally speaking though, those moments that have traumatic effects on people, tend to be scary. Witnessing or experiencing threats to life, limb, or general sanctity of body or way of life. These could be in one moment or over many years.


What do REACTIONS look like:

1. There are sort of three distinct reactions to experiencing traumatic events.

                    A. NORMATIVE: worry, disruption of your day to day, wanting to be close to others or wanting to be alone, wondering or questioning, crying, over- or under-eating, sleeping too much or having insomnia, nightmares/distressing memories, strong drive to help/do something productive, fear. Overall though, here, you are able to maintain some semblance of normalcy and functioning. Keep doing what you're doing and be patient with and kind to yourself. Try to exercise/walk/bike ride, eat well, stay hydrated, get good sleep, because your body needs resources to move through this and be okay. Open up to others. Go to support meetings. Treat yourself to something healthy or enjoyable. Rest.


                    B. STRUGGLING: Oftentimes, people have some symptoms and impairments in their lives that don't quite meet the criteria for PTSD, but nonetheless, life is not getting back to normal and there's stress and disturbance. This is a time to get professional support. While sometimes this goes away on its own eventually, why prolong the struggle??? Also, sometimes this doesn't go away on its own and unfortunately, it usually gets worse, becoming more chronic and far-reaching.


                    C. ACUTE STRESS DISORDER and POSTTRAUMATIC STRESS DISORDER (PTSD): This is a mixture of symptoms that can last any where from three days to one month after a trauma. After the one month mark, it turns into PTSD. The symptoms between this and PTSD are therefore quite similar, while due to the duration of symptoms, PTSD becomes more complex and far-reaching. Generally speaking, the symptoms occur in the following categories: INTRUSION: persistent, disturbing memories, images, dreams, re-experiencing of events; AVOIDANCE: of the topic or any reminders; MOOD/BELIEFS: persistent negative emotional state, and moreso with PTSD detachment, isolation, mistrust, distorted beliefs about self/others/the world; AROUSAL: difficulty sleeping, hypervigilance (always being on the look out), exaggerated startle response, irritability; DISSOCIATION: generally an anxiety symptom wherein you feel detached from yourself or your surroundings, a sense of unreality. 

GENERAL GUIDELINES:

1) There's no right or wrong.

2) Reactions from minutes, days, or even weeks after likely won't last forever. Give yourself time and be patient.

3) Judgment, criticism, and shame are understandable but not helpful. There will be time to re-evaluate yourself or others once you've processed the difficult emotions.

4) Be kind to yourself. Give yourself a break. Rest and relax. Do something fun. It's okay to not have your mind on the trauma all the time. Binge watch something on tv, go see a movie, take the dog for a long walk, catch up with a friend, eat what you want, do some yoga. Connect with yourself.

5) Sleep, mood, interpersonal, and eating disturbances are normal.

6) Do what you can to give yourself relief. As long as it's not harming yourself or others, it's okay. Try to keep drinking/substance use, etc. at a minimum just because it's hard to know how that will mix with your reactions.

7) When your thoughts and feelings feel or are impairing any aspect of your life, seek help.

8) It takes strength of character and confidence to ask for help. Weakness has no place there.