Sunday, January 9, 2011

We say the darndest things

Q: This question comes out of numerous recent discussions I have had. Why is it that we sometimes say the meanest things and hurt those we care about? Why do they do it to us?

- Signed,
Sorry

A: Dear Sorry,

This is a great question and I want to remind you that your personal information will be kept strictly confidential.

There are many reasons for saying hurtful things to those we love, and we are all subject to it.

One reason has to do with our state of mind. Our state of mind can vary from day to day or sometimes within an hour. Some of us have steady state of mind, most of the time. But no one has the same state of mind all of the time. Sometimes we feel stressed out, tired, vulnerable or just simply more fragile. Maybe it is from a bad night's sleep, financial worries, a hard day at work, skipping a meal, or PMS. Being caught off guard, especially when our state of mind is not ideal can cause us to snap at people or even bite someone's head off.


We also have basic instincts. If someone says something that we misinterpret or maybe they say something that is insensitive or a bit on the cruel side, our most immediate response will be to retaliate. If we feel attacked, we tend to want to attack back. This is basic in the animal kingdom, but humans have a frontal lobe lending to our capacity to stop ourselves, think things through and not attack. But if we are in a vulnerable state of mind, we may not always catch ourselves. Of course there are things that can interfere with this capacity like drinking or drug use or maybe just being overly tired, hungry or stressed.

Most remarks are made due to misunderstandings; something left over, not communicated or plain old misinterpretation. There is also what is known as displacement. This happens when you are really upset with someone or something else but you take it out on the person closest to you. If you find yourself snapping at others or saying hurtful things, the first step is to evaluate your own state of mind. Are you run down, in need of a break, overly stressed? Or maybe your problem is situation or person specific, in this case look inside yourself for built up resentments. Resentment literally means feelings re-sent so look for old hurt or anger that keeps coming back. See what you can do to clean your own house so to speak.

Sometimes writing is a great tool. Make a list of the ways that you feel you have been wronged and evaluate it. It's best to read this with someone you know you can trust. Talking about what's on the list, if you believe in prayer, praying about it or actually just being honest with yourself can take you a long way. Maybe just write yourself a note about what is troubling you. Once you have done this, you may discover that there is something to talk over with the person you have been short with or the people involved in your troubling situation.

Perhaps you start with an amends; "I am really sorry that I snapped at you the other day or I am sorry that I said that to you. I have been doing some soul searching and realized that I have been upset over -----; I am hoping that we can resolve this." While this takes courage it almost always results in understanding and a better relationship.

There are few people who can say that they have never lashed out or snapped at someone. Most of us have said things that we regret to the people we care about the most. This may be worse these days when most of us are overly busy and have difficulty handling all the stress in our lives. It's important to forgive ourselves and to make amends, to say you are sorry and mean it. Otherwise, my only advice is to do your best to take care of yourself, be reflective about your state of mind so that you choose the best times for sensitive conversations, and be as honest with yourself as you can be on an ongoing basis, so that you do not build up unnecessary resentments. Know that our basic instinct is to retaliate so we must learn to count to 10, take a deep breath or think things through before opening our mouths. That way no biting tongue can ever come out!

Dr. JoAnne Barge

**Originally published in the Santa Monica Daily Press

Friday, January 7, 2011

Friend or not a friend?

Dr New Shrink,

I have a friend who constantly criticizes me. He has a very sarcastic personality so he plays it off as humor. Recently he's been blatantly ignoring me when we are in a group situation or making me feel as if I am not welcome. Then all of a sudden, he's really nice to me.

As far as I can tell, I'm not changing my own behavior. I have no idea why his attitude toward me swings so much. I can't really approach him because he will laugh it off and say I'm being overly sensitive and can't take a joke. Why do friends feel the need to bring each other down or be so competitive?

Sincerely,
Confused

Dear Confused,

This question is a loaded one! It has me spinning a bit. My first question to you is what is your definition of friendship? I think most would agree that friends do not act this way. Oh sure, we can step on each other's toes, hurt each other's feelings and at times want to get even with one another. But friends talk to each other, at least real friends do. When a relationship is important to us, we talk things out. There may be times we simply cannot muster up the courage, so we act "strange," in hopes that the other will ask us what is wrong. But you say that you cannot even talk to this friend. He will only use it as a reason (weapon) to put you down again and make fun of you. If this is true, this is not a real friend.

The way that you describe all of this sounds like a very immature way of getting even, or actually it sounds a bit more like a lover's quarrel.


Perhaps the problem resides in you more than you would care to admit? Do you just go along with these mood swings? Are you there when this supposed friend is nice but yet say nothing when he is treating you badly? Do you confront him?

Have you hurt him in some way that you are not admitting to or are aware of? This may take some thought, but think hard, consider everything. Is he attracted to you but you are not attracted to him? Have you slighted him in the past? It sounds like he may want you to feel what he is feeling.

Some people are simply emotionally immature and so disturbed that they can only participate in what pop psychology calls "toxic relationships." What are his other relationships like? Perhaps he is one of these "toxic" people and if so, he needs some serious help.

Perhaps none of this applies, although I cannot help but wonder why he has picked you to pick on?

How much interest and fascination do you have with this guy? Do you have some internal battle you are fighting and hoping to win through him? Do you secretly enjoy some part of this drama? Does it make you feel special albeit in a hurtful way? What would happen if you let go of the energy you have attached to this and simply ignore his mood swings? What's more important to you, drama or connection?

Finally, I feel that it is important to address the last part of your question. When we are young and striving to get ahead, we sometimes are competitive without knowing it. But as we mature, we usually come to recognize that competition at the expense of another, especially someone we care about, someone we call a friend, is simply not worth it. We value our friendships and learn that we can all compete for what we want in the world without stepping on each other. Friends have each other's back. They truly care about each other and do what they can to contribute to each other's welfare.

As life marches on, you will find that your true friends will consist of a very small inner circle. Your social friends will form a circle just outside of that; still friends but just not as close. True friendships require time and work. It's nearly impossible to have very many. In any event, friends become an integral part of what is known as our social support network. Studies have consistently found that having a solid social support network contributes to our overall success in life and is very instrumental in maintaining good health and/or surviving a serious illness. Define your idea of friendship and classify your friends. Put people where they really belong in your life and you will be happier and healthier for it.

Dr. JoAnne Barge

**Originally published in the Santa Monica Daily Press SMDP Dr Barge

Wednesday, January 5, 2011

Living with an addict can be difficult

Learn some tips to cope from Brentwood Psychologist Dr. Barge

Dear New Shrink,


My husband is an addict. He's been to rehab but is back on drugs again. We have two small children. I feel helpless, hurt, angry, and I am confused. I love him; I hate him. I want to leave but I don't. I cannot believe he is doing this to us. Please help.

Signed,
Helpless and Hopeless

Dear Helpless and Hopeless,


Living with an addict is a very hard thing to do. If you are anything like the other men or women who live with this, you are scared, you are disgusted and feeling increasingly depressed. You do not know what to tell your children, parents or friends. You think it is your fault but you are pretty sure that it is not. You think you can change it, if you can just find a way to make him happier.

You try everything you can think of to "make things better." You take it very personally. If he loved me, he would not do this to me/us. There are so many broken promises. Strange behaviors and terrible mood swings have turned your loved one into an unpredictable and frightening stranger. Unfortunately, many addicts have to do rehab more than once before it takes.


Perhaps you have read or heard the media say it is a "disease," an illness. It can be hard to believe and understandably so because, there is that element of volition. Obviously, if he would just not take a drink or use that drug, there would be no problem.

Unfortunately, choice, volition, is not in charge! It is at best, a small piece of the picture.

This is because the brain is involved and becomes impaired. With receptor sites wide open and on fire, neurological pathways coding both tolerance and euphoria, the central nervous system rebounding like a jack in the box each and every time the addict uses, addiction is just like a dog chasing its own tail!

"First the person takes the drug, then the drug takes the drug, then the drug takes the person." This modern version of a very old Japanese proverb, could not be truer. There are many reasons why someone may start drinking or taking other drugs: social or peer influences, medical reasons, or self-medicating emotional pain. However, it no longer matters what started it. Once the "drug starts taking the drug," your addict has crossed a fine line and the brain has now taken over. Addiction takes on a life of its own and stopping is not so easy. In fact, it is nearly impossible, on one's own.

Denial, the hallmark of addiction, makes the problem almost surreal. When you tell yourself that the problem is just temporary, due to stress or that you alone can turn things around, this is denial. Your countless failed attempts to control things have all been forms of denial.

Addicts deny the seriousness of their addiction, they blame others and they lie to themselves about their impact on others. When they do glimpse reality, they tell themselves they will quit tomorrow. They mean it, they believe it. It is all denial. In the same way that you think you might find a way to turn things around, addicts think they will "get a hold of" themselves.

As addiction progresses, nothing makes sense. More importantly, it has little or nothing to do with you and actually, at this point, it has very little to do with him either. It is all much bigger than either one of you and you are both in its grip!

What can you do? What should you do?

• Learn the three Cs: You did not cause this, you cannot control it and you surely cannot cure it!

• Know your addict needs help, not from you, from professionals and other addicts and alcoholics.

• Stop taking it personally!

• Learn compassion without guilt.

• Start focusing on taking care of yourself.

• Contact Al-Anon family groups, help for the family and friends of alcoholics and addicts. Their Web site is www.al-anon.alateen.org

• Consider an intervention.

• Look for a psychotherapist who specializes in family problems and knows addiction treatment. Do not take their word for it, get some proof. Addiction is tricky and many well meaning therapists have done more harm than good because they simply did not grasp what they thought they understood.

• Finally, stay positive, there are thousands of recovering addicts and alcoholics.

Dr. Barge

**Originally published in the Santa Monica Daily Press SMDP Dr. Barge

Monday, January 3, 2011

Are you perhaps addicted to food?

 If so, diets may do nothing to curb your addictions.  Dr. Barge gives her thoughts. 

Dear New Shrink,

For most of my adult life I have struggled with weight and body image issues. Over the last two years I have gained over 50 pounds and can't seem to kick my unhealthy habits. I have tried a number of different diets and weight loss plans, all with only short-term results. During a recent doctor's visit, my physician asked me to think about the reasons I eat, and in particular the occasions or things that might cause me to overeat. This helped me to think about the underlying causes but do you have ideas of what I can do to take my mind off eating and help me to commit to losing weight for good?

Signed,
Overweight and Unhappy


Dear Overweight and Unhappy,


Congratulations to your physician! Most people think that the incredible weight problem and epidemic of obesity here in America is simply the result of poor food choices and bad lifestyles. While this is certainly part of it, it is anything but the whole picture. People that go on and off diets, gain and lose weight and feel bad about themselves like you do, are most likely struggling with food addiction.


Diets don't work! The weight loss industry is one of the biggest industries in our country precisely because diets do not work for most people. Those who lose weight and keep it off are the ones who adopt a lifelong food plan that means "eating to live rather than living to eat."

If you find yourself feeling ashamed and embarrassed because of your eating — hiding your food, eating until you feel sick, vomiting or using other unhealthy ways to lose weight quickly or varying three sizes in your clothes closet — odds are you have a food problem. Weight, which is the consequence of your problem with food, is not the primary issue.

Food is meant to fuel the body and while we all enjoy our comfort foods from time to time, when you find yourself eating for the wrong reasons, i.e., to self-soothe, to avoid feelings of loneliness, emptiness sadness or anger, you have a food problem and you need help.

As one of my successful patients says, "I am a food addict!" "I have an emotional attachment to anything I put in my mouth. I was afraid of my feelings and would use food to avoid them." She now attends Overeaters Anonymous, and does not eat sugar one day at a time. She is also working on herself in therapy.

This is a bit like admitting you are an alcoholic, one drink is too many. There are countless success stories from people who have gone to Overeater's Anonymous. As long as they work the program, they not only lose weight but learn to identify and free themselves from the underlying causes of their food addiction. Members pick their own abstinence plan. Another one of my patients who is doing quite well has picked three meals a day, two snacks and nothing in between. The patient that I quoted above has chosen no sugar or white flour, one day at a time. For her, if she has one cookie or piece of cake, she will eat the whole box or cake. Eating right has led both to feeling better physically and psychologically. One had gained 60 pounds and the other 80. And yes, they have both lost and are losing weight. Both are feeling happy with themselves.

I realize that it is very hard to take the first step of admitting you are an addict and may need this kind of help. If you are, you will be so much happier for it, you won't be sorry. Ideally, you will get a therapist to help you process your feelings as well. If you have been afraid of them for a long time, relapse is less likely with the support of a good therapist although many do just fine with OA alone.

If you simply do not see this as an answer for you, Weight Watchers has a good success rate as well. They have meetings, education, weigh-ins and a lot of support, similar to OA.

The right therapist can help you with identifying fears or feelings that you have been avoiding and then along with their support, you may be able to stick with a lifelong food plan that you choose for yourself. The important thing is that you should not try to do it alone.

Good Luck! I promise you that this can work if you really want it.

Dr. JoAnne Barge

**Originally published in the Santa Monica Daily Press SMDP Dr. Barge

Saturday, January 1, 2011

Who would have thought?...

 ...that childbirth could lead to divorce.  Brentwood Psychologist Joanne Barge reacts to this unfortunate situation

Dear New Shrink,

I am very distraught. After 12 years of what I thought was a good marriage, I have discovered that my husband is having an affair. He blames it on me, but up until the time our child was born, we had a great sex life, were best friends and he never complained. Now with our child only 3 years old, it looks like we may not make it. I still love him and I beg him to go to counseling but he is completely shut down. Is this my fault? Am I crazy to want to make it work? Is there anything that I can do?

Signed,
Despondent

Dear Despondent,

I am so sorry to hear that you are experiencing this and it makes total sense that you would be depressed. After all this time and a child together, it is not "crazy" to still love your husband.


I can't say how much fault is yours. Generally, when it comes to relationships, I think in terms of 50/50 or close to it. But fault is too strong a word. No one wants their marriage to fail. Relationships are full of conflict and require a lot of attention and work. Love is never enough. Assuming you picked a good partner, one whose character you liked, someone you had a lot in common with, then the secret of staying in love is communication.

What I find interesting is that you were great for nine years but not so good the last three, which coincides with the birth of your child. Unfortunately, that first little bundle of joy does not always bring happiness to a marriage. In fact, it is often the beginning of marital conflict. For many if not most of the couples I have seen, their trouble started with the birth of the first child.

Having children is the great event most people look toward and children bring lots of joy to most families. But the sad truth is that when you have your first child, you go from being a dyad to a triangle. Triangles are very difficult to negotiate and infants cannot be negotiated. Someone is going to be left out and it is usually the father.

All those romantic walks you use to take along the beach, long talks over a glass of chianti, lots of time for each other is now replaced with dirty diapers, spilled milk and little time for one another. Lack of sleep doesn't help either. But the real problem, should it occur, is a kind of unconscious process that takes place. Fathers often feel left out. Feeling replaced, jealously and anger bubbles up in them but good men say to themselves, "I want my child to have a good mother; I want my wife to be a good mother. What kind of man must I be if I have these feelings?" They feel guilty about their "bad" feelings. The natural impulse is to suppress them but this is not good for the relationship.

The truth is that these feelings are completely natural and normal and if you anticipate them and keep the lines of communication open, they don't have to cause problems in the relationship. Unfortunately, most couples do not think this will happen to them.

Often these feelings come out in sarcasm or he simply looks for other ways to get his emotional needs met. It can be anything from working long hours, drinking too much with the guys or having an affair. However, it doesn't just start there, usually there is some fighting and further distancing that occurs first. Mom being tired and needing extra support herself, may also feel abandoned. She probably doesn't even know what her husband is feeling, he may not know himself and with both feeling abandoned, arguments start over things that don't really matter. They don't even know why they are fighting. But increased feelings of alienation can lead to looking for getting needs met in other ways or places.

Clearly it could all be prevented and if there is not interruption of this downhill spiral, it can end in a bad way or at the very least yet best, in a counselor's office. Discovering the truth and realizing that you never stopped loving each other is the blessing that can come from talking this out and learning to enjoy your child together. The good news is that the second one is never as hard. There are no more triangles!

I hope you and your husband will consider this and that you can recapture what you had. Good luck.

Dr. Barge

**Originally published in the Santa Monica Daily Press SMDP Dr. Barge

Thursday, December 30, 2010

Paying attention to red flags is important

 Too often we avoid red flags and latter regret it.  Dr Barge weighs in on when we should listen to our intuition.

Dear New Shrink,

Why do people ignore "red flags?" I know I have done it in the past with relationships. I now know better but never really understood why I did it. And now we are hearing about it again and again on the news. Why are we all so stupid?

Signed,
Do Not Understand

Dear Do Not Understand,


You ask a really interesting question. Definitely with these shootings by the Army psychiatrist, the rape of a 15-year-old girl in Richmond, the paroled man who kidnapped, raped and fathered children with a young girl and may have killed a number of others, this is an important question. Even with our quieter suicides, unfortunate or unnecessary deaths, broken marriages, bad relationships, almost always someone or a number of people come forward to talk about what they noticed but yet said or did nothing about. Obviously in the end, it does seem stupid. But the real causes range from minding our own business, being politically correct, not wanting to cause a problem, being unsure of ourselves, not trusting our instincts to hoping that "it" will just take care of itself, work itself out or someone else will do something. Most of these sort of run together but in my opinion, we really need to rethink this. There are simply too many disastrous results when we look the other way and ignore, as you say, the red flags.


Usually if we take the time out to listen to our instincts, our gut, we will know what we need to know. But the mind can get in the way and tell us a hundred reasons why we are wrong or shouldn't do anything about what we are intuiting. It's best to tell the chatter to shut up, go away and listen to what that deeper part of yourself is saying and even ask it, what are you picking up on? Something is going on here, what is it?

Once you feel strongly about what you are feeling, the next step is deciding what to do about it. Depending on what it is, there are numerous alternatives. If it's a personal matter, or something with a friend or relative, ask yourself what might happen if you don't say anything. In a relationship, problems that are not addressed often lead to the end of it. If a friend is drinking too much or engaging in self destructive behavior or maybe just seems depressed, ask yourself whether you are really being a good and caring friend if you do not say anything. There are ways to say things. In these personal matters, coming from the heart and making sure there is no negative judgment, resentment or criticizing, can make a big difference. It can actually save someone's life.

In larger matters where it's a colleague, fellow student or neighbor, sometimes it's best to be less direct and seek help or guidance. Ask others that you trust if they have noticed anything unusual or go to a higher up and explain that you are not trying to cause trouble but at the same time you don't want to be part of a really bad outcome. Share your concerns.

Back to why do we ignore red flags? I have answered much of your question but there is another reason, and that is hope — hope that it will go away, work itself out or someone else will fix it. Hope is an interesting thing. We need it at times, for sure. It is similar to faith but not exactly the same. Hope always includes fear; the fear that something will not happen or that what is hoped for will. If you really think about it, it is like a drug. We use hope like a drug, to make an uncomfortable reality go away. It is very different from trust. Generally trust has a rational, more solid basis. This is not to say that we haven't had situations where it turns out that what we trusted, we should not have. But hope is not based on rationale; it's just hope. We use it when we need it and sometimes we get lucky but often we do not.

These words faith, trust and hope are used interchangeably but they are not the same. Hope has a dark side to it. If you are hoping that the chemotherapy of a relative is going to work, it's understandable but you should also prepare yourself. When you are talking about red flags, it's best to ask yourself "do I trust that my partner is faithful to me, or that the neighbor or professor is going to do something about what I am noticing? Or am I hoping?" If you are hoping, you should rethink it and maybe pay more attention. Red flags do mean something!

Dr. JoAnne Barge

**Originally published in the Santa Monica Daily Press SMDP Dr Barge

Tuesday, December 28, 2010

Excessive worrying can be a burden too big to bare

Dr Barge has some insight on when worrying can be a little too much to be healthy, and in fact, quite unhealthy.

Dear New Shrink,

For the last few years, I have been suffering from chronic stomachaches, heartburn and acid reflux. My doctor says he believes these symptoms are all related to my stress level. I will admit I am somewhat of a worrier. There isn't anything unbearable or tragic going on in my life right now but I do constantly find myself worrying about work, school and what's going to happen tomorrow. I find myself even worrying about the littlest things. How can I control this? How can I stop worrying so much?

Help,
Worrywart

Dear Worrywart,


A lot of people worry in an excessive way. There is often something that might cause worry for most people but to be healthy, to keep it in perspective, worry should not be so excessive as to cause symptoms such as these or something similar like headaches, ulcers, high blood pressure, insomnia or fatigue. Excessive worry is a complete waste of time; it does absolutely no good at all except that it can give us an illusion of being in control. In this sense, it is a defense mechanism. But as you point out indirectly in describing your painful symptoms, it is often a costly one. When you have stomach problems and acid reflux, your problem has become quite serious. Acid reflux can lead to cancer of the esophagus, one of the leading cancers in the United States right now. Worrying can also be easily classified as negative stress, which can compromise our immune systems. Not to mention, if you worry long enough and hard enough, you can drive your blood pressure up.


Sometimes, worrying is caused from an underlying anxiety disorder or what is known as obsessive-compulsive disorder. These conditions can be treated with a psychotropic medication from the SSRI group or with certain types of talk therapy. Meditation and yoga can also be helpful in teaching you how to control your own mind.

Certainly something needs to be done when it gets as bad as you describe. You said you are in school, so I wonder about your age and how long you have had these symptoms? The sooner you catch it, the better. You also say that nothing bad is going on "right now," so I wonder if something bad happened in the past. In a similar vein, I also wonder if something unexpected happened that was difficult for you to deal with. If so, you might have what is known as post-traumatic stress. There are a lot of questions I might ask if I were your doctor. For now, I would just say again, take this very seriously and find a solution that works for you.

Ask yourself why you think you might be worrying so much? Did something happen to you that you need to get over? Are you sure that there is nothing to worry about? Are your loved ones OK? Is someone close to you having problems that concern you? Is there anything that you can actually do? If so, do it but then work on letting it go.

Definitely ask yourself if you feel more in control when you worry. Does it really get you what you want? Ask yourself if it's worth it to worry so much; can you afford the consequences of these physical symptoms if they continue? Try to be as honest with yourself as you can possibly be. This alone can lead you to possible solutions.

Try exercise, which can eliminate stress, and try meditation or yoga. These things along with rigorous self-honesty can take you a long way. If you cannot stop this on your own, please recognize that you need help. The professional help you might need should be short and sweet, so to speak.

Most of all remember that worry is not an honest feeling. It is an emotion we design to give ourselves a sense of control. But it is only an illusion. What have you ever actually changed or even controlled with your worry? I recently wrote an article that included a similar sentiment about hope. Just like hope, worry can be used like a drug. It is not always used in good faith and it can either let us down or end up causing us unpleasant consequences. Use it if you need it, but learn to do so sparingly and appropriately but then, let it go. You will be better for it!

Dr. Barge

**Originally published in the Santa Monica Daily Press SMDP Dr Barge