Social Anxiety Disorder

By Tanya Ruckstuhl-Valenti LICSW, MSW

Image by benchilada via Flickr

I’m writing a book, tentatively titled “From Misfit to Ms Wit” about social anxiety disorder because in my work with people with PTSD, depression and ADHD I’ve noticed that social anxiety disorder is like a backpack condition: it often comes along with other mental health conditions and it slows healing down.

Why?  Because without a tribe of people to check out our experiences and perceptions with, we are left trying to figure everything out on our own, or trying to solve issues with the limited perspective of immediate family members, so the effect of social anxiety disorder is greater than mere loneliness:  it decreases functioning.

Additionally, because we humans experience ourselves relationally (meaning we form our identities based upon the qualities we are told we contain) limited social connections amputate a major venue for self awareness.

I belong to no less than three consult groups and on top of that have weekly lunch dates with various therapist friends.  I tell folks that I do this so that I can appear more intelligent than I really am, but it really does make me better at what I do.  Hearing what trainings my friends are attending, the outcomes of research they are reading and creative interventions they have successfully used allows me to expand my knowledge and abilities.

My goal is to try to post excerpts of the book on this blog every two weeks as a way to help me stay productive because it’s amazing how appealing doing laundry is when I have time I could spend writing.

Any comments, questions, disagreements etc… are welcome!

 

Related articles

• What is social anxiety disorder? (zocdoc.com)
• Blog for Mental Health 2012 (gypsy116.wordpress.com)

A New Vision in 2012

By Tanya Ruckstuhl-Valenti LICSW, MSW

Welcome to the New Year!  If you have been following the news, or even if you haven’t, there is plenty of gloom and doom out there:  the wonky economy, the political smear campaigning, the state of the environment, Middle Eastern instability, etc…

In the midst of upheaval and transition it can be helpful to retract our focus from background to foreground and simply focus on what we can influence.

The small, immediate circle of our own choices, behaviors and attitudes is the only place we can consistently exercise power.  This weekend I am creating a vision board for the year which will include my intentions for 2012.

A vision board is a fancy grown-up way of saying collage.  But it’s not just any collage:  it’s a collage with images and words that represent what we want to do, be, and have.

Vision-boarding is a powerful way to shift consciousness because most adults are left-brained and images (as well as emotions) exist in the right brain.  So a vision board acts like a silent mantra or an affirmation, drilling into the brain in ways that our internal critic (left brained fellow that he is) cannot touch.

If you would like to make a vision board, start out by gathering up a variety of magazines, calendars, cards and books that you don’t mind disassembling and cut out pictures that you like.  If you like to draw you can just make your own images.   Don’t think during this phase, just look at and snip everything you like.   If you have a lot of internal chatter you can play really loud music to distract the critic.

Next, once you have your pile of images think about the areas of your physical, emotional, relational, professional, educational and environmental experience of life.  Pick images that represent shifts you want to make in those areas.

Put the images together and glue them all to a big piece of paper or poster board and prop it up where you can see it regularly.

It works like crazy.  If you have “practical” wet blanket naysayers in your family/social circle (and we all have a few), don’t let them see or hear about your vision board.  Your goals and intentions are vulnerable and precious.  As such they need to be protected until they have fully gestated and been delivered into your life.

Happy Transformation!

 

(the cool image at the top came from a google image search for “vision boards” and the website it came from is http://www.usingmindmaps.com/mind-map-vision-boards.html )

Related articles

• The Year of Being You (the-gypsy-life.com)
• Creating a Vision Board: A Tool for New Year’s Resolutions (bizfilings.com)
• Complementary Image Processing In The Cerebral Hemispheres (medicalnewstoday.com)

Constructive Conflict

Tanya Ruckstuhl-Valenti LICSW, MSW

A close childhood friend of mine just adopted a baby girl.  This is epic news because ever since my best friend’s twin girls outgrew their velvet-and-ribbon princess dress phase, I’ve had only had male children to buy clothing for.  Shopping for boy clothes versus girl clothes is the sartorial equivalent to traveling by roller skate when you really want a Porsche.

Sure I (falsely) fancy myself non-materialistic but if there is a substance on this planet more adorable than baby girl clothing—especially baby girl clothing plus a baby girl—I have yet to discover it.

Using the magic of technology, via teleconference I asserted sovereign dibs on getting baby girl her first set of fairy wings.  My friend looked disappointed until I consolingly pointed out she could place dibs on both the tutus AND leggings.  We haggled over clothing rights (okay maybe it was just me) the way some people might haggle over business acquisition contracts.  In our circle, clothing is very important.

My friend wisely remained silent throughout this exchange, knowing that she is the one who will actually dress her child as I live far away.   For all I know she already has a stash of fairy wings sorted by glitter pastel shade and size.

This blog entry isn’t just about my brand new, exceptionally well dressed friend’s baby.   Ok maybe it mostly is.  But this blog entry is also about a principle of constructive conflict:  Constructive conflict includes three key ingredients:

1. 1.        An issue you care about
2. 2.       Repetition of a behavior that upsets you
3. 3.       Participants who are capable of considering more than one point of view. 

Think about these points prior to going home for the holidays.   If you encounter some unhealthy family dynamics and you do not have all three pieces in place, you are better off saving your energy for self-care rather than engaging in family arguments.   In particular the third key is important because if you have family members who simply don’t have space in their minds for your perspective, bringing up issues will only be an exercise in futility.  Better just to get real exercise instead.  Or might I suggest shopping… for fairy wings?

 

Related articles

• Growing Up Again (seattletherapist.wordpress.com)
• Winter Mental Health Survival Tips (seattletherapist.wordpress.com)
• The Leapers and the Waiters: Embracing Diversity from a Prokaryote Perspective (seattletherapist.wordpress.com)
• Recovering from PTSD and Depression: What You Can Do (seattletherapist.wordpress.com)
• Good Intentions Don’t Always Pan Out (seattletherapist.wordpress.com)

Winter Mental Health Survival Tips

Tanya Ruckstuhl-Valenti LICSW, MSW

In the northwest at this time of year there is a dramatic shift in natural light.  We go from having sunny days to gray days–even weeks–without seeing sun or blue sky.  People respond by burrowing into work, homes, and offices and avoiding being outside for longer than it takes to get in or out of their cars. 

It’s no fun to be outside when it’s raining, cold, and windy.  But we still need light and fresh air.  One inexpensive way to add light is to get white Christmas lights and string them up in your home for additional sparkle.  It’s also a good idea to figure out where you sit the most and buy a full spectrum bulb for the light fixture illuminating that spot. 

The need for fresh air is both literal as well as symbolic:  we need freshness in our lives to keep our sense of vibrancy.   Learning something new, returning to a neglected creative activity that once gave us joy, and practicing self care are all life-fresheners.   Self care can be defined simply any activity whose sole goal is pleasure. 

For my fresh-air practice, I decided to expand my musical horizons.  My taste in music is lame.   I was in the sound equivalent of a cooking rut, where I kept reaching for the same three or four CD’s, not because I really liked them but because I kind of liked them and didn’t know what else to try.   Deepening the rut was the fact that my kids take piano lessons so I rarely play music at home because they need to practice morning and afternoon. 

The idea I came up with is to go to the library each week and select a musical genre I know nothing about, check out a CD, and play music at work while I write chart notes, blog, and write monthly receipts.  Over the past several weeks  I have enjoyed piano composed by prisoners at Theresienstadt, a concentration camp in Germany during World War Two, music by King Bennie Nawahi, a Hawaiian slack key guitar virtuoso from the 1920’s, and as I write this I’m listening to a modern jazz saxophonist named Houston Person.   It’s fun, fresh and free. 

Another self care practice I heartily recommend is getting massage.  My latest happy discovery is the 90 minute massage available through New Leaf Massage in Freemont http://www.newleafmassage.abmp.com/.  The massage therapist, Camille, specializes in working with other massage therapists so you KNOW she’s good.  She starts out with a hot neck pack and foot soak beforehand and it only gets better from there.    When you leave your entire body feels like a giant buttered noodle.   She also sells gift certificates, so if you are looking for a holiday present for your sweetie you could get them a massage or if you want them to get one for you; you can forward them this blog.

No matter what demands your life makes, you deserve to take good, loving care of yourself. 

The Importance of Being Ernest…About Self Care

Image via Wikipedia

I just did my very favorite November activity: I trekked down to the University Book Store to buy next year’s daily planner. For therapists, our daily planner is exactly as important as the Bible to a fundamentalist preacher.  Except we don’t tend to go around shaking it at people.

I slowly poked around the stacks and aisles of planners, comparing sizes and lay outs and covers and brands and arrived, as I always do on my very favorite type: a wildly overpriced weekly planner.

I’m proud to report that I went full-on tacky this year, with a fake alligator (!) pink (!!) cover which says both “attempt at sophistication” as well as “wishes she were a Vegas show girl.” If they had had one with peacock feathers and rhinestones, I would have gone with that in a heartbeat.

Even though I am most of the time a mature adult, I still need outlets for the googly-eyeball-loving kid in me. During this time of shrinking daylight, increased Seasonal Affective Disorder, and the stress of holiday commitments, engaging in little acts of self care can make all the difference between feeling merry and feeling quite contrary.

Right now is a great time to find a self-loving annual November ritual. Do it quick before your calendar is covered with commitments you are too busy to get away from.

Related articles

• Do You Suffer From Seasonal Affective Disorder? (hethercrawford.wordpress.com)
• Light Therapy (loseweightandkeepitoff.wordpress.com)

Growing Up Again

Image via Wikipedia

by Tanya Ruckstuhl-Valenti LICSW, MSW

I am currently enjoying a book a client of mine recommended, Growing Up Again, by Jean Illsley Clarke and Connie Dawson.  In it, Illseley Clarke and Dawson gently connect childhood trauma with non-productive adult patterns of behavior.  I really appreciate the “gentle” part of this, because many self help books can come across like a megaphone-weilding cheerleader’s manual to wellbeing.

Chapter 2, focused on the need for Stimulation, Recognition and Safety which the authors depict as a triangle of equal sides and importance, is beautifully explained.  Essentially, people–young and old–need to feel engaged with life (stimulation), valued by others (recognition) and to know that their needs will be met (Safety).

When children act out, when marriages fail, when people experience a gnawing sense of discomfort that they cannot manage, it can be useful to ask which of these three needs is not being met.

I recommend this book!

Related articles

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• Recovering from PTSD and Depression: What You Can Do (seattletherapist.wordpress.com)
• Good Intentions Don’t Always Pan Out (seattletherapist.wordpress.com)
• Is There a Link Between Chronic Fatigue Syndrome and Childhood Trauma? (everydayhealth.com)
• Can Childhood Trauma Cause Bipolar Disorder? (everydayhealth.com)

Nothing Like Late Notice…

Tomorrow night I will be teaching a FREE webinar “Creating Contact: Choosing Relationships” for ADD resources.

Do you struggle with prioritizing time with your loved one over the many tasks that seem to call your name? Are you inattentive, perpetually behind and overwhelmed? If so, welcome!

We will be exploring what the influence of ADHD is on intimacy, the role of society on long term relationships, the three “Relationship Killers” and why they are so deadly to intimacy, and ways to enhance our relationship skills.

The webinar is at 6pm Pacific time, and details about how to register are here: http://www.addresources.org/?q=ADHD%20Webinar-How%20to%20Connect%20with%20Others

The Leapers and the Waiters: Embracing Diversity from a Prokaryote Perspective

Image via Wikipedia

 

(Admittedly the lamest title ever)

By Tanya Ruckstuhl-Valenti LICSW, MSW

I was paging through a science magazine a few months back
and came across an article about the evolutionary advantages of action versus evaluation.  It turns out that in times of abundant food,
evolution favors those microorganisms that “leap” or readily eat what’s
available.  Except when what’s available
is poisonous, in which case those ready leap-er types die.  That’s when the waiting type organisms
survive to pass their genetic code—all one cell of it—to their offspring.

Humans are blessedly more complex than prokaryotes (a common
type of single cell organism), what with our capacity to invent the stock
market and to develop a penchant for no-foam extra-hot caramel lattes.

But there’s something we have in common with our simple
microscopic friends:  we too have a
tendency to be leap-er types or wait-er types.
And unlike our teensy little buddies, we trillions-of-cells organisms
partner up with other trillions-of-cells organisms, and usually we do it with a
bunch of cells with the opposite disposition.

And that really pisses us off.

So let’s consider the ensuing conflict from an evolutionary
perspective.  First, I’ll lay out a few
premises:

1)
The best evolutionary response to opportunity
and/or possible threat includes a range of multiple response options

2)
And the flexibly and discernment to
appropriately exercise them.   

Next consider our primary directive:
Second only to individual survival, we are
biologically programmed to increase the likelihood of the survival of our
offspring.  

Call it nature or the universe or God or
the whiz-bang programming in our cellular structure, what better set up for our
children to learn and benefit than from two strong teachers, each providing a
different adaptive response pattern/example of the wait-mentality (aka:
deferred gratification) as well as the leap mentality?

Our distinct and different examples teach a
range of response patterns.  Parents
disagree with one another in front of the kids, each articulating the
importance of their particular disposition and decision making.  Viola!
Their children are imprinted with not one type of response pattern, but
a subtle web of multiple considerations, circumstances, and approaches.  Thus they are better equipped to make
decisions of their own, eventually passing the genetic torch and ensuring the
survival of the human species.

And here you thought you were just arguing
about going out for dinner versus saving money!

Related articles

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Recovering from PTSD and Depression: What You Can Do

Image via Wikipedia

By Tanya Ruckstuhl-Valenti, LICSW, MSW

Folks with Post-Traumatic Stress Disorder, or PTSD almost
always suffer from depression as well.  PTSD
causes depression for a couple of reasons:
One, because trauma(s) creates a loss of trust in care takers/authority
figures/God/the world at large, and that is a devastating thing.  Two, hyper vigilance (aka the
fight-flight-freeze mechanism) is neurologically and emotionally
exhausting.  It’s like running:  a bit of it on a regular basis is great, too
much wears out the body.

Eye Movement Desensitization and Repatterning, or EMDR, the
type of treatment protocol I use and recommend for PTSD, is effective both for
the treatment of trauma as well as depression.

In addition to seeking treatment with a quality mental
health professional, there are things that a person with PTSD and depression
can do to speed up their recovery and return to or create a sense of comfort
and safety.

1. Exit abusive
   relationships.   Be physical or

   emotional abuse.  Be it a romantic

   partner or an employer or a biting dog, unless they are getting treatment:  Get. Away.

2. Address
   avoidance:  Be it the pile of bills

   in the office or the pile of dishes in the sink or the incomplete project in

   the basement, take on and finish your work.

   If it’s overwhelming/boring/confusing or otherwise onerous, ask a friend

   to keep you company or better yet offer to swap cleaning with them, or set a

   date and tell others when you will have your project done in order to increase

   your accountability, or hire a personal organizer to help, or download a really

   interesting podcast to keep you company while you get to work—whatever it

   takes!  Self esteem comes from esteem-able

   acts.  Give yourself a self esteem

   boost.

3. Exercise:

   I don’t know of any other anti-depressant on the market which is free,

   self-administered, constantly available, and the only side effect besides making

   you feel better is making you look good.

4. Beautify
   your environment: at work and at home, you deserve to look at lovely

   things.  Even if you live in a cockroach

   infested hovel, you can string up some twinkly lights.  That way at least the cockroaches will glow

   nicely.

5. Avoid
   birth control with hormones:  If you

   already struggle with PTSD and depression, avoid medication that may cause

   depression as a possible side effect.

   Stack the deck in your favor.  There

   are plenty of alternatives available.  (Disclaimer:  I am not a medical doctor.  I am a psychotherapist.)

If you take these steps in conjunction with receiving good
quality therapy, you are well on your way to a better life!

Do you have a mental health tip to share?  Click comment and send it my way.

Related articles

• Help yourself to help your child: Maternal depression and child trauma (child-psych.org)

• New PTSD Test Successfully Predicts Who Will Develop Condition (tricitypsychology.com)

Good Intentions Don’t Always Pan Out

By Tanya Ruckstuhl-Valenti LICSW, MSW

As a passionate and occasionally over-zealous professional helper, I sometimes lose the ability to differentiate between what I’d LIKE to be able to do versus what I actually CAN do.

This past year I had one of those learning experiences in my son Jonah’s classroom.

Jonah had a classmate; I’ll call him Bub, who was an emotionally disturbed little guy.
Bub called his teacher an idiot, and he pushed her.

I was appalled, but explained to my children that kids who behave in that way are not solely responsible for their behavior:  aggression is a learned response.   (Actually that’s not entirely true, aggression is instinctual but one of the requirements of living in society is to manage it
in order to get along.   It is the parent’s job to role model management of anger and aggression).

The thing about pre-pubescent males with violent tendencies is that there is a small window of time when they can learn new coping skills and develop some reflective, emotional intelligence before the stakes go way up and access to drugs, weapons and a higher concentration of fellow delinquents to hang out with and learn from occurs.  So my sense of urgency was triggered.

I sprang into action.
First, I created an empathy development program and started volunteering in the classroom to teach it.  It was basically worthless because Bub was almost never there on Mondays when I volunteer taught.

I encouraged my children to reach out to Bub and befriend him, thinking that if Bub had more
connections in his life he would develop more appropriate social skills.

Then, I reached out to his mother, inviting her out for coffee to try to both offer support and encourage her to get Bub into some type of mental health services.  As expected, Bub’s
mother was struggling with many issues:  poverty, recent homelessness, and history of domestic violence and probable alcoholism.

I explained how medical coupon holders can receive free mental health services through community mental health agencies, and how the therapists who work with children will drive to the schools or homes if the parents lack reliable transportation.

I gave her the phone number to set up an intake appointment for Bub and offered to drive her to and from the agency for the initial appointment.

Next I asked my children if they would be willing to have Bub over for a play date.  Bub had never had a play date in his life.  They agreed and the play date went well, so I suggested we have Bub over for a sleep over.

The sleep over was when the proverbial fecal matter hit the spinning blades.

Bub protested my requirement of fruit before desert.  He was rough with the pets.  He wouldn’t listen when it came time for bed, demanding to know,

“Why do WE have to go to bed when YOU aren’t?”  He was rude, loud, a basic nightmare of a
guest.

And tragically, he did not understand that his behavior was inappropriate.  In fact, he thought the overnight was great fun.

Bub told the kids at school proudly about how he had been invited to spend the night, which did not help Jonah’s own
social standing.

Bub’s mother never followed through with getting him into mental health services.  Bub continued to act out for the entire school year, hijacking the class with his demanding, inappropriate behavior.

I’d like to believe that if nothing else I planted seeds in the mind of Bub’s mother;  that options and support exist that she can take advantage of if/when she decides to.  Her son is bright and capable and develping some really awful tendencies.  One of the most painful things for me as a therapist is to see great potential being mistreated.  (okay, equally painful is that I’m not in charge!)

I had a huge apology to make to my kids for trying to socially engineer a behavioral intervention and using them along the way.  I promised to stop pushing them to make friends with disadvantaged children (because truth be told,  I have done this before).

My new boundary is if I can help to a reasonable degree, in a reasonable way, I will.  But I won’t
use my children to forward my social justice agenda.  Balancing the priorities of my children’s needs alongside a concurrent sense of community responsibity is sometimes hard for me.  I now know to check out my intentions with a more level-headed person before impulsively trying to intervene.

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