SOURCE CREDIT: PsychCentral
9 Ways to Reduce Anxiety Right Here, Right Now
September 14, 2013 at 10:35 am
Written by Margarita Tartakovsky, M.S.
When you’re feeling anxious, you might feel stuck and unsure of how to feel better. You might even do things that unwittingly fuel your anxiety. You might hyperfocus on the future, and get carried away by a slew of what-ifs.
What if I start to feel worse? What if they hate my presentation? What if she sees me sweating? What if I bomb the exam? What if I don’t get the house?
You might judge and bash yourself for your anxiety. You might believe your negative, worst-case scenario thoughts are indisputable facts.
Thankfully, there are many tools and techniques you can use to manage anxiety effectively. Below, experts shared healthy ways to cope with anxiety right here, right now.
1. Take a deep breath.
“The first thing to do when you get anxious is to breathe,” said Tom Corboy, MFT, the founder and executive director of the OCD Center of Los Angeles, and co-author of the upcoming book The Mindfulness Workbook for OCD.
Deep diaphragmatic breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. It helps the body go from the fight-or-flight response of the sympathetic nervous system to the relaxed response of the parasympathetic nervous system, said Marla W. Deibler, PsyD, a clinical psychologist and director of The Center for Emotional Health of Greater Philadelphia, LLC.
She suggested this practice: “Try slowly inhaling to a count of 4, filling your belly first and then your chest, gently holding your breath to a count of 4, and slowly exhaling to a count of 4 and repeat several times.”
2. Accept that you’re anxious.
Remember that “anxiety is just a feeling, like any other feeling,” said Deibler, also author of the Psych Central blog “Therapy That Works.” By reminding yourself that anxiety is simply an emotional reaction, you can start to accept it, Corboy said.
Acceptance is critical because trying to wrangle or eliminate anxiety often worsens it. It just perpetuates the idea that your anxiety is intolerable, he said.
But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence.
“It just means you would benefit by accepting reality as it is – and in that moment, reality includes anxiety. The bottom line is that the feeling of anxiety is less than ideal, but it is not intolerable.”
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3. Realize that your brain is playing tricks on you.
Psychiatrist Kelli Hyland, M.D., has seen first-hand how a person’s brain can make them believe they’re dying of a heart attack when they’re actually having a panic attack. She recalled an experience she had as a medical student.
“I had seen people having heart attacks and look this ill on the medical floors for medical reasons and it looked exactly the same. A wise, kind and experienced psychiatrist came over to [the patient] and gently, calmly reminded him that he is not dying, that it will pass and his brain is playing tricks on him. It calmed me too and we both just stayed with him until [the panic attack] was over.”
Today, Dr. Hyland, who has a private practice in Salt Lake City, Utah, tells her patients the same thing. “It helps remove the shame, guilt, pressure and responsibility for fixing yourself or judging yourself in the midst of needing nurturing more than ever.”
4. Question your thoughts.
“When people are anxious, their brains start coming up with all sorts of outlandish ideas, many of which are highly unrealistic and unlikely to occur,” Corboy said. And these thoughts only heighten an individual’s already anxious state.
For instance, say you’re about to give a wedding toast. Thoughts like “Oh my God, I can’t do this. It will kill me” may be running through your brain.
Remind yourself, however, that this isn’t a catastrophe, and in reality, no one has died giving a toast, Corboy said.
“Yes, you may be anxious, and you may even flub your toast. But the worst thing that will happen is that some people, many of whom will never see you again, will get a few chuckles, and that by tomorrow they will have completely forgotten about it.”
Deibler also suggested asking yourself these questions when challenging your thoughts:
- “Is this worry realistic?
- Is this really likely to happen?
- If the worst possible outcome happens, what would be so bad about that?
- Could I handle that?
- What might I do?
- If something bad happens, what might that mean about me?
- Is this really true or does it just seem that way?
- What might I do to prepare for whatever may happen?”
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5. Use a calming visualization.
Hyland suggested practicing the following meditation regularly, which will make it easier to access when you’re anxious in the moment.
“Picture yourself on a river bank or outside in a favorite park, field or beach. Watch leaves pass by on the river or clouds pass by in the sky. Assign [your] emotions, thoughts [and] sensations to the clouds and leaves, and just watch them float by.”
This is very different from what people typically do. Typically, we assign emotions, thoughts and physical sensations certain qualities and judgments, such as good or bad, right or wrong, Hyland said. And this often amplifies anxiety. Remember that “it is all just information.”
6. Be an observer — without judgment.
Hyland gives her new patients a 3×5 index card with the following written on it: “Practice observing (thoughts, feelings, emotions, sensations, judgment) with compassion, or without judgment.”
“I have had patients come back after months or years and say that they still have that card on their mirror or up on their car dash, and it helps them.”
7. Use positive self-talk.
Anxiety can produce a lot of negative chatter. Tell yourself “positive coping statements,” Deibler said. For instance, you might say, “this anxiety feels bad, but I can use strategies to manage it.”
8. Focus on right now.
“When people are anxious, they are usually obsessing about something that might occur in the future,” Corboy said. Instead, pause, breathe and pay attention to what’s happening right now, he said. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation, he added.
9. Focus on meaningful activities.
When you’re feeling anxious, it’s also helpful to focus your attention on a “meaningful, goal-directed activity,” Corboy said. He suggested asking yourself what you’d be doing if you weren’t anxious.
If you were going to see a movie, still go. If you were going to do the laundry, still do it.
“The worst thing you can do when anxious is to passively sit around obsessing about how you feel.” Doing what needs to get done teaches you key lessons, he said: getting out of your head feels better; you’re able to live your life even though you’re anxious; and you’ll get things done.
“The bottom line is, get busy with the business of life. Don’t sit around focusing on being anxious – nothing good will come of that.”
Margarita Tartakovsky, M.S. is an Associate Editor at Psych Central and blogs regularly about eating and self-image issues on her own blog, Weightless.
APA Reference Tartakovsky, M. (2013). 9 Ways to Reduce Anxiety Right Here, Right Now. Psych Central. Retrieved on September 14, 2013, from http://psychcentral.com/lib/9-ways-to-reduce-anxiety-right-here-right-now/00017762
Last reviewed: By John M. Grohol, Psy.D. on 12 Sep 2013 Published on PsychCentral.com. All rights reserved.
SOURCE CREDIT: PsychCentral News : Research Finds Proven Strategies to Up Happiness, Life Satisfaction By RICK NAUERT PHD Senior News Editor : Reviewed by John M. Grohol, Psy.D. on September 11, 2013
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE FOR MORE DETAIL
Researchers have created four affective profiles that may help individuals improve the quality of their lives.
The profiles came from a research study of the self-reports of 1,400 US residents regarding positive and negative emotions.
Investigators believe the affective profiles can be used to discern differences in happiness, depression, life satisfaction and happiness-increasing strategies.
A central finding is that the promotion of positive emotions can positively influence a depressive-to-happy state — defined as increasing levels of happiness and decreasing levels of depression — as well as increase life satisfaction.
The study, published in the open access peer-reviewed scientific journal PeerJ, targets some of the important aspects of mental health that represent positive measures of well-being.
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Happiness, for example, can be usefully understood as the opposite of depression, say the authors. Life satisfaction, another positive measure of well-being, refers instead to a comparison process in which individuals assess the quality of their lives on the basis of their own self-imposed standards.
Researchers posit that as people adopt strategies to increase their overall well-being, it is important to know which ones are capable of having a positive influence.
“We examined 8 ‘happiness-increasing’ strategies which were first identified by Tkach & Lyubomirsky in 2006″, said Danilo Garcia from the University of Gothenburg and the researcher leading the investigation.
“These were Social Affiliation (for example, “Support and encourage friends”), Partying and Clubbing (for example, “Drink alcohol”), Mental Control (for example, “Try not to think about being unhappy”), and Instrumental Goal Pursuit (for example, “Study”).
Additional strategies include: Passive Leisure (for example, “Surf the internet”), Active Leisure (for example, “Exercise”), Religion (for example, “Seek support from faith”) and Direct Attempts (for example, “Act happy and smile”).”
The researchers found that individuals with different affective profiles did indeed differ in the positive measures of well-being and all 8 strategies being studied.
For example, individuals classified as self-fulfilling — high positive emotions and low negative emotions — were the ones who showed lower levels of depression, tended to be happier, and were more satisfied with their lives.
Researchers found that specific happiness-increasing strategies were related to self-directed actions aimed at personal development or personally chosen goals. For example, autonomy, responsibility, self-acceptance, intern locus of control, and self-control.
Communal, or social affiliations, and spiritual values were positively related to a ‘self-fulfilling’ profile.
“This was the most surprising finding, because it supports suggestions about how self-awareness based on the self, our relation to others, and our place on earth might lead to greater happiness and mental harmony within the individual” said Garcia.
READ THE COMPLETE ORIGINAL RESEARCH ARTICLE HERE FOR MORE DETAIL
Are your child’s moods normal? Lisa Meyers McClintick, USA TODAY Guide to Kids’ Health, USATODAY 8 Sept. 2013
Any parent knows: An evening can go to heck in a matter of minutes.
Our 9-year-old daughter pipes up suddenly that she needs a pink dress to play Sleeping Beauty in class the next morning. It has to be pink. It has to be pretty. And she needs it now!
Any sort of reasoning—like the suggestion to wear a wedding-worthy yellow dress—won’t work. Frustrations explode into shouting, timeouts and all-too-familiar rants of “this family sucks,” followed by heartbreaking rounds of “I hate myself!”
The next morning, when nerves calm, the yellow dress is perfectly fine and our daughter cheerfully chatters about Belle’s ball gown in Beauty and the Beast.
The difference? The anxiety attack is over.
Sneaky and insidious, anxiety seizes our daughter like a riptide pulling her out to sea. Her negative thoughts build like a tsunami, and it’s useless to swim against them with problem-solving logic.
Like a real riptide, the only escape seems to be diagonally. A surprise dose of humor—tough to summon in the midst of a blowup—can spring her free. As one therapist explained, “You can’t process anger and humor at the same time.”
It’s taken years of keen observation and research, plus the support of educators and psychologists to help our kids, ages 9 to 13, cope with mental health issues that also include Attention Deficit Hyperactive Disorder (ADHD) and depression.
Recognizing that something isn’t right and pursuing help isn’t an easy journey. But it’s necessary. In the same way you’d pursue cures and solutions to manage chronic physical conditions like cancer and diabetes for your child, you have to advocate for your child’s emotional well-being. It requires being proactive, persistent and patient.
“If you can intervene early and get proper treatment, the prognosis is so much better,” says Teri Brister, who directs the basic education program of the National Alliance on Mental Illness.
KNOW THE SIGNS
“One of the most difficult-to-recognize issues is anxiety,” says John Duby, director of Akron Children’s Hospitals Division of Developmental and Behavioral Pediatrics. “(Children) won’t say, ‘Hey, you know, I’m worried.’ You have to be tuned in.”
All-consuming worries—about parents’ safety, bullies or natural disasters, for instance—can look like a lack of focus at first. Some kids ask frequent questions about “what’s next” for meals or activities. Changes to the daily routine (a substitute teacher or a visit to a new doctor) can trigger headaches, stomachaches or a sleepless night.
At its most extreme, anxiety induces panic attacks. Kids break into sweats, have trouble breathing and feel their heart racing.
Depression may cause similar symptoms to anxiety with headaches, stomachaches, not being able to sleep or sleeping more than usual. “They may withdraw socially,” says Duby. Kids may head to their room after school and not emerge until morning. Some kids are constantly irritable and angry.
“We often think depression doesn’t happen in children, but it does,” he says.
Step 1: Trust your instincts
If you’re worried about your child’s mood, trust your instincts as a parent, recommends Brister.
The red flags of mental health disorders tend to pop up during school years when children have to navigate academic expectations, make friends and increase responsibilities at home.
“You have to look for (behavior) patterns,” says Brister. These can include impulsive acts, hyperactivity, outbursts, an inability to follow directions or recurring ailments that may impair how the child performs in class, extracurricular activities or simply sitting through dinner with the family.
Most concerned parents start with a visit to the pediatrician. (PETER’S EDIT For Australian parents your family GP is a good place to start) The family physician can help you analyze symptoms and understand whether there might be an underlying condition such as food allergies or a chronic lack of sleep.
Step 2: Seek professional help
(PETER’S EDIT: In Australia a referral from a GP to a psychologist via a mental health care plan or ATAPS will ensure an informed, appropriate and timely assessment. If the issue is developmental, a referral to a paediatrician may be preferred or if your GP has a serious concern a referral to a child psychiatrist may be made. Wait times for each option should be relatively short in the private sector.)
When our son was 5, we sought testing for ADHD with a referral from our pediatrician. Unfortunately, we couldn’t even get on a waiting list for a psychology appointment. We were told the list had backed up to a two-year wait, so it was eliminated. We had to call weekly and hope for an opening.
When our daughter needed help as her anxiety escalated, it took a school district triage nurse to get us an appointment with a psychiatric nurse.
This is, unfortunately, not an uncommon scenario for parents. You need to use all the leverage you have to access experts in the school system or mental health clinics to help with your situation. Stay persistent and be pleasant rather than pushy.
And when you do get an appointment, make the most of it by consistently tracking the concerns you have about your child’s behavior and putting them in writing for the physician to read. Have a list of questions ready, and always ask about additional resources you can tap into, from support groups to books.
Mental health practitioners will also be gathering resources and information about your child from report cards, checklists and questionnaires. These can help pinpoint whether a child has anxiety, depression, ADHD, bipolar disorder, is on the autism spectrum or may have a combination of these. “It allows us to have a more objective view,” says Duby.
Step 3: Find your normal
Once there is a diagnosis, families can decide how to move forward. That might mean trying medications, working with a psychologist or setting up an Individualized Education Program (IEP) at school.
Additional services that may help include occupational therapy, which can identify specific movements, such as swinging, spinning or brushing outer limbs with a soft brush that may help your child’s brain process and integrate sensory information.
These tools and approaches can help families be proactive about preventing and managing mental meltdowns. It’s also essential to help children feel a sense of belonging at school and in community groups. Families need to build up their children’s strengths so they have the self-esteem and confidence to move forward, says Duby.
And parents should stay on top of the situation, watching for changes in behavior and mood, especially as children get older, says Brister.
Hormones may help or worsen conditions, which makes it important to have a diagnosis and support network before the teen years hit.
“I can’t emphasize enough how essential it is to recognize symptoms early and treat them,” she says.
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SIGNS OF DEPRESSION AND ANXIETY
Signs in children may differ from the symptoms we commonly associate with adults who have the disorders. Depression in kids may look like irritability, anger and self-criticism, says the National Alliance on Mental Illness. It could be as subtle as her making less eye contact with you than in the past.
School performance is another important indicator. Grades can drop off dramatically; students may also visit the school nurse more frequently with vague complaints of illness.
Children who suffer from an anxiety disorder may experience fear, nervousness and shyness, according to the Anxiety and Depression Association of America. They may worry excessively about things like grades and relationships with family and friends. They may strive for perfection and seek constant approval.
HOW TO CALM IT DOWN
Whether a child has mental health struggles or not, emotions inevitably boil over—especially as preteen dramas escalate. Here are ways to help de-escalate the situation and restore calm to your family life.
• Keep your body language non-threatening and stay as even-keeled as possible. Don’t get in the child’s face or use a raised voice.
• Teach kids how to breathe slowly through the nose, then exhale gently through the mouth as if cooling a hot bowl of soup.
• Create an “away space,” a place to cool down and take a break. Consider a quiet nook in a bedroom, a spot on the stairs for kids who don’t like separation or a backyard corner for those who find comfort in nature.
• Let kids know they can’t hit others, but it’s OK to punch a pillow or punching bag or to squeeze putty or a squishy toy.
• Figure out what’s physically comforting—feeling the softness of a blanket or stuffed animal, nuzzling the fur of a family pet or piling under heavy blankets.
• Listen to favorite tunes on a music player.
• Provide a journal for writing out frustrations or doodling when the words won’t come.
• When emotions simmer down, sit side by side to talk through how the situation could have been handled differently and work on solutions together.
(PETER’S EDIT: AUSTRALIA:
HeadSpace: headspace National Youth Mental Health Foundation Ltd is funded by the Australian Government Department of Health and Ageing under the Youth Mental Health Initiative Program. A great resource for parents and teens.
BeyondBlue : Resources for young people section )
HealthyChildren.org from the American Academy of Pediatrics has a section dedicated to “Emotional Problems.” Parents can tap into great information on how to help their child. Audio segments recorded by experts in the field can be used as a launching point for family discussions.
TheBalancedMindFoundation.org, founded by the mother of a daughter with bipolar disorder, provides help for families. Online, private support groups offer 24/7-support and online forums are a way for parents to connect.
WorryWiseKids.org, a service of the Children’s and Adult Center for OCD and Anxiety, has a wealth of information about the different types of anxiety disorders children can have, how to understand them and how to seek treatment for them.
Source: ScienceDaily (Sep. 15, 2010) — The millions of middle-aged and older adults who suffer from insomnia have a new drug-free prescription for a more restful night’s sleep. Regular aerobic exercise improves the quality of sleep, mood and vitality, according to a small but significant new study from Northwestern Medicine.
The study is the first to examine the effect of aerobic exercise on middle-aged and older adults with a diagnosis of insomnia. About 50 percent of people in these age groups complain of chronic insomnia symptoms.
The aerobic exercise trial resulted in the most dramatic improvement in patients’ reported quality of sleep, including sleep duration, compared to any other non-pharmacological intervention.
“This is relevant to a huge portion of the population,” said Phyllis Zee, M.D., director of the Sleep Disorders Center at Northwestern Medicine and senior author of a paper to be published in the October issue of Sleep Medicine. The lead author is Kathryn Reid, research assistant professor at Feinberg.
“Insomnia increases with age,” Zee said. “Around middle age, sleep begins to change dramatically. It is essential that we identify behavioral ways to improve sleep. Now we have promising results showing aerobic exercise is a simple strategy to help people sleep better and feel more vigorous.”
The drug-free strategy also is desirable, because it eliminates the potential of a sleeping medication interacting with other drugs a person may be taking, Reid said.
Sleep is an essential part of a healthy lifestyle, like nutrition and exercise, noted Zee, a professor of neurology, neurobiology, and physiology at Northwestern University Feinberg School of Medicine and a physician at Northwestern Memorial Hospital.
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“By improving a person’s sleep, you can improve their physical and mental health,” Zee said. “Sleep is a barometer of health, like someone’s temperature. It should be the fifth vital sign. If a person says he or she isn’t sleeping well, we know they are more likely to be in poor health with problems managing their hypertension or diabetes.” The study included 23 sedentary adults, primarily women, 55 and older who had difficulty falling sleep and/or staying asleep and impaired daytime functioning. Women have the highest prevalence of insomnia. After a conditioning period, the aerobic physical activity group exercised for two 20-minute sessions four times per week or one 30-to-40-minute session four times per week, both for 16 weeks. Participants worked at 75 percent of their maximum heart rate on at least two activities including walking or using a stationary bicycle or treadmill. Participants in the non-physical activity group participated in recreational or educational activities, such as a cooking class or a museum lecture, which met for about 45 minutes three to five times per week for 16 weeks. Both groups received education about good sleep hygiene, which includes sleeping in a cool, dark and quiet room, going to bed the same time every night and not staying in bed too long, if you can’t fall asleep. Exercise improved the participants’ self-reported sleep quality, elevating them from a diagnosis of poor sleeper to good sleeper. They also reported fewer depressive symptoms, more vitality and less daytime sleepiness. “Better sleep gave them pep, that magical ingredient that makes you want to get up and get out into the world to do things,” Reid said. The participants’ scores on the Pittsburgh Sleep Quality Index dropped an average of 4.8 points. (A higher score indicates worse sleep.) In a prior study using t’ai chi as a sleep intervention, for example, participants’ average scores dropped 1.8 points. “Exercise is good for metabolism, weight management and cardiovascular health and now it’s good for sleep,” Zee said. The research was funded by the National Institute on Aging
There are times when parents have to stay tough and Nigel Latta explains how best to do it
A COMMON question among parents of young children is: ‘‘ When does raising children start to get better?’’ The answer could be that it doesn’t get any better, it just gets different.
MADE TO ORDER: Keeping a firm hand but not rule by fear is the recommended way to go.It’s a theme Nigel Latta explores in his new book, Politically Incorrect Parenting. Latta will soon present a show of the same name on Channel 9.
While the issues he explores are hardly new, this is not your average parenting book. It doesn’t trade on a parent’s fear but on the reassurance that there are ways you can survive, keep a semblance of sanity and still enjoy the company of your little home-grown terrorist.
It’s battlefield wisdom from a therapist who’s seen more than most of us could handle and has some commonsense tools to help ordinary parents who need a hand.
Some of the chapter headings might give you a clue to his approach.
The preface ‘‘Never Mind the Kids . . . Save Yourself’’ is a pretty good hint, but there are also gems such as ‘‘How to Make Time Out and Sticker Charts Actually Work’’. Then there’s ‘‘Why You Should Never Negotiate with a Terrorist’’.
‘‘I just think parenting is such bloody hard work and the last thing you want to do is read a book on raising your children that’s boring and just makes you feel worse,’’ Latta says.
‘‘You want to read something that feels like a bit of time off.
‘‘What I try to do in the TV show and the book is to give people useful things that they can actually use to make things better but also just reassure people that life is not that complicated.
‘‘We all worry about damaging our children if we say the wrong thing, or send them to the wrong school, or don’t read them enough stories. It’s not about any of that stuff because it’s not stuff that matters.’’
Latta fears the modern world has done away with a lot of common sense. ‘‘I understand common sense as wise thinking,’’ he says. ‘‘If people have a problem with their children most will Google it and they come up with 26 million different opinions . . . and a lot of scare tactics.
‘‘Scaring people is a way to sell books because it works, but I just think it sucks. You don’t need to make parents any more afraid because as soon as you have children you start to worry and it never stops.’’
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After helping thousands of people crawl out of what they feared were bottomless pits, Latta has found a common theme running through the vast majority of cases.
‘‘By far the biggest issue is that people just need to toughen up and that invariably gets it sorted,’’ he says.
‘‘People come to me and say they have a four-year-old they just can’t control and I’m wondering if he’s a mutant six foot high fouryear-old.
‘‘And they become paralysed with all this modern doubt stuff that makes them wonder if they’re doing the right thing when really it’s pretty straightforward.’’
For example, what to do with a fussy eater.
Hungry children eat, Latta says, it’s as simple as that.
He has a key message for parents who are doing it tough. ‘‘Get tough on the behaviours you don’t like and praise them for stuff you do.
‘‘Do that and it fixes anything – a few simple things and it’ll all be fine.’’
Source: Tony Bartlett: The Courier Mail news.com.au
I have re-posted this article from psych central as it is a thorough, well written and balanced view of the impact of alcoholism in families, the hope for recovery and the role of families and the community in helping those with substance over-use illnesses: Please read!
By William L. White, M.A. and Robert J. Lindsey, M.Ed., CEAP
On April 25th, Hallmark Hall of Fame will broadcast the movie “When Love Is Not Enough — The Lois Wilson Story,” starring Winona Ryder and Barry Pepper (CBS, 9:00 pm ET). The movie, which portrays the life of Lois Wilson, co-founder of Al-Anon Family Groups and wife of Alcoholics Anonymous co-founder Bill Wilson, is based on William G. Borchert’s 2005 book, The Lois Wilson Story: When Love Is Not Enough.
Borchert’s earlier screenplay was the basis of the acclaimed movie My Name is Bill W. which starred James Woods, James Garner, and JoBeth Williams. The premiere of the movie also falls during the National Council on Alcoholism and Drug Dependence, Inc.’s (NCADD) 24th Annual Alcohol Awareness Month with its theme, “When Love Is Not Enough: Helping Families Coping With Alcoholism.”
Lois Wilson fell in love with a man whose alcoholism brought his life and their relationship to the brink before he began his personal recovery and helped found Alcoholics Anonymous. Lois and many of the other wives of early AA members also began to band together for mutual support, formalizing these meetings into Al-Anon Family Groups in 1951.
When Love is Not Enough is the story of Lois Wilson and her life with Bill Wilson. The reach of her and their stories is unfathomable and inseparable from the larger stories of AA and Al-Anon and the influence their lives would exert on the larger story of the professional treatment and recovery of individuals and families affected by addiction to alcohol and other drugs. As William Borchert suggests:
“In the end, Bill Wilson’s alcoholism proved not to be the tragic undoing of this brilliant and loving couple, but rather the beginning of two of the twentieth century’s most important social and spiritual movements- Alcoholics Anonymous and Al-Anon Family Groups.”
There are presently more than 114,500 Alcoholics Anonymous groups (with a combined membership of more than 2 million) and more than 25,000 Al-Anon/Alateen groups (with a combined membership estimated at more than 340,000) hosting local meetings worldwide.
When Love is Not Enough is clearly more than a love story, though it is surely that. Readers of Psych Central and the people they serve will discover in this movie six profound lessons about the impact of alcoholism and alcoholism recovery on intimate relationships and the family.
1. Prolonged cultural misunderstandings about the nature of alcoholism have left a legacy of family shame and secrecy. Centuries of debates between those advocating religious, moral, criminal, psychiatric, psychological, medical and sociological theories of alcoholism failed to offer clear guidance to individuals and families affected by alcoholism. When Love is Not Enough is in part a poignant history of the hidden desperation many families experienced before the birth of Alcoholics Anonymous, Al-Anon, and modern alcoholism treatment. Lois Wilson and Anne Bingham helped change that history in 1951 when they organized 87 groups of wives of AA members into the Al-Anon Family Groups.
2. Alcoholism is a family disease in the sense that it also wounds those closest to the alcohol dependent person; transforms family relationships, roles, rules, and rituals; and isolates the family from potential sources of extended family, social, and community support. And, it has far reaching, long-lasting effects on the physical and emotional health of the family and children. When Love is Not Enough conveys the physical and emotional distress of those struggling to understand a loved one who has lost control of drinking and its consequences.
It vividly portrays the disappointment, confusion, frustration, anger, resentment, jealousy, fear, guilt, shame, anxiety and depression family members experience in the face of alcoholism. The recognition that significant others and their children become as sick as the person addicted and are in need of a parallel pathway of recovery were the seeds from which Al-Anon and Alateen grew.
3. The family experience of alcoholism is often one of extreme duality. When Love is Not Enough poignantly conveys this duality: brief hope-inspiring interludes of abstinence or moderated drinking, periods of peacefulness, moments of love and shared dreams for the future — all relentlessly violated by explosive bouts of drinking and their devastating aftereffects. Memories of that lost person and those moments and dreams co-exist even in the face of the worst effects of alcoholism on the family.
It is only in recognizing this duality of experience and the character duality of the alcoholic that one can answer the enigmatic question that is so often posed about Lois Wilson’s contemporary counterparts, “Why does she/he stay with him/her?” As clinicians, we can too often forget that these family stories contain much more than the pathology of alcohol or drug dependence (White, 2006).
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4. Family recovery from alcoholism is a turbulent, threatening and life-changing experience. The hope of all families and children wounded by alcoholism is that the drinking will stop and with it, the arrival of an idyllic family life. Lois Wilson’s story confirms what research on family recovery from addiction is revealing: recovery from alcoholism can destabilize intimate and family relationships. Stephanie Brown and Virginia Lewis (1999), in their studies of the impact of alcoholism recovery on the family, speak of this as the “trauma of recovery.”
People recovering from alcoholism, their families, and their children can and often do achieve optimum levels of health and functioning, but this achievement is best measured in years rather than days, weeks, or months. That recognition in the life of Lois Wilson underscored the need for sustained support for families as they went through this process.
5. We cannot change another person, only ourselves. If there is a central, singular message from Lois Wilson’s life and from the Al-Anon Family Groups program, this may well be it. Al-Anon’s defining moments came when family members stopped focusing on how they could change and control their addicted family member and focused instead on their own need for regeneration and spiritual growth, the overall health of their families and the comfort and help they could offer each other and other families similarly affected.
Their further discovery that AA’s twelve step program of recovery could also guide the healing of family members marks the birth of the modern conceptualization of family recovery. The 2009 Al-Anon Membership Survey confirms the wide and enduring benefits members report experiencing as a result of their sustained involvement in Al-Anon—irrespective of the drinking status of their family members.
6. The wonder of family recovery. As a direct result of Lois’s groundbreaking work in co-founding Al-Anon and the impact it has had on the field of alcohol and drug treatment, family recovery from alcoholism is a reality for millions of Americans today, and the hope, help, and healing of family recovery has become the most powerful way to break the intergenerational cycle of alcoholism and addiction in the family.
The growing interest in the lives of Bill and Lois Wilson — as indicated by a stream of memoirs, biographies, plays, and films — is testimony to the contributions that Alcoholics Anonymous and Al-Anon Family Groups have made to personal and family recovery from alcoholism and to the ever-widening adaptation of the Twelve Steps to other problems of living (Wilson, 1994).
Psych Central readers will find much of value in “When Love Is Not Enough — The Lois Wilson Story,” including the power of Al-Anon as a tool of support for clients living with someone else’s alcoholism. A DVD of the movie and a Viewer’s Guide, for use as a tool in family and community education, will be available at www.hallmarkhalloffame.com on April 25th, the day of the movie’s premiere.
Al-Anon membership survey. (Fall, 2009). Virginia Beach, VA: Al-Anon Family Headquarters, Inc.
Borchert, W.G. (2005). The Lois Wilson story: When love is not enough. Center City, MN: Hazelden.
Brown, S., & Lewis, V. (1999). The alcoholic family in recovery: A developmental model. New York & London: Guilford Press.
White, W. (2006). [Review of the book The Lois Wilson Story: When Love is Not Enough, by W. G. Borchert]. Alcoholism Treatment Quarterly, 24(4), 159-162.
Wilson, L. (1979). Lois remembers: Memoir of the co-founder of Al-Anon and wife of the co-founder of Alcoholics Anonymous. New York: Al-Anon Family Group Headquarters, Inc.
Al-Anon Family Group Headquarters, 800-4AL-ANON (888-425-2666), Monday-Friday, 8 a.m. to 6 p.m., ET.
National Council on Alcoholism and Drug Dependence (NCADD).
Compulsive collecting or Hoarding is a misunderstood and debilitating mental health issue. Many psychologists and counsellors never see someone with this condition as they very rarely present for help. This article from an Australian newspaper provides an excellent overview of the condition and issues underlying hoarding, and I have included links to two brilliant books co-authored by the researchers discussed in the article, who have developed a wholistic and novel approach to it’s treatment.
Credit: Kate Benson, Sydney Morning Herald April 8 2010
They may dress well or hold down a good job. But hoarders are unhappy people who suffer from a debilitating condition.
Every suburb has one. The elderly woman weaving through an overgrown backyard full of cardboard boxes, old tyres and discarded furniture. Cats perch on every surface; kittens roll about among the rusted drums and long grass.
Inside, behind closed curtains, the rooms are piled high with papers, cups, plates and bottles. Broken toys, old clothes and shopping bags spill across kitchen benches and floor, smothering the stove and filling the sink, neither of which has been used in years.
The stench of cat faeces, urine and food scraps fill the house.
To her neighbours, she is an oddity. Or a pest, bringing down house values and encouraging vermin.
But to therapists she is one of a growing band across Australia suffering from a debilitating condition known as compulsive hoarding, where people feel a need to collect and store items that seem useless to others.
Their homes become havens of insurmountable clutter and junk, often leaving them unable to sleep in their beds or use appliances. Many end up with electricity or gas supplies disconnected or their fridge and washing machines unusable because they fear their lifestyle will be revealed if they contact a tradesmen to make repairs.
This secrecy and shame make it difficult to know exactly how many people have the disorder.
Some experts think between 200,000 and 500,000 Australians compulsively hoard, but others put the figure closer to 800,000.
“It’s a sleeping giant,” Chris Mogan, a clinical psychologist and expert on hoarding, says. “There is no systematic estimate of how many hoarders there are in any Australian setting. I suspect there are many, many more out there than we are aware of.”
Louise Newman, the president of the Royal Australian and New Zealand College of Psychiatrists, agrees.
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“I’ve only seen one case in my career [because] these people usually only come to light when the council steps in and orders a clean-up. Hoarders desperately want to keep hoarding. They don’t want to be stopped.”
There is little research on the condition in Australia and not much in the way of funding or treatment programs, but experts are hopeful hoarding will be included in the next (fifth) edition of the Diagnostic and Statistical Manual of Mental Disorders, the bible used by mental health experts to diagnose psychiatric conditions.
Many sufferers fall between the cracks because hoarding is not a clinical diagnosis in its own right, but is seen more as an offshoot of obsessive compulsive disorder, muddled with depression, anxiety, panic disorder and low self-esteem.
“But it is different to OCD and once we get it in the DSM-V, therapists, psychiatrists, psychologists and social workers can then be trained in the management of it [and] we can attract funding for research,” Mogan says.
Jessica Grisham, a clinical psychologist who specialises in obsessive compulsive disorder, also believes compulsive hoarding should be included in the next edition as it requires specialised treatment.
She cites recent neural imaging studies in the US that showed that different parts of the brain were activated in hoarders than in obsessive compulsive disorder patients.
Mogan and Grisham agree that cognitive behaviour therapy, where sufferers are slowly taught to change their thought patterns, is more effective than medication alone.
But hoarders responded better to a specially adapted version of the therapy, developed by the American hoarding experts Gail Steketee and Randy Frost. It had been achieving success with about 60 per cent of hoarders – far more than standard cognitive behaviour therapy.
“But it has to be a long-term project. You don’t go in to someone’s place and do a sudden excavation against their will,” Grisham says.
“That’s a violation and it’s very traumatic for them. It might make great TV, but it’s not good clinically.”
Mogan agrees. A pay TV show, Hoarders, was damaging to the public’s understanding of the illness, because it focused on forcefully cleaning houses in three days.
“Within six to 12 months that house will be recluttered because it is a compulsion … they suffer a lot of grief after things are taken away.”
Mogan makes weekly home visits to hoarders, and focuses on getting them to reduce the associated dangers by ensuring their home has two exits for safety, and working appliances and smoke alarms.
“Just as we do with drugs and alcohol, we’re into harm minimisation. Once the house is safe, we gradually set more goals. If they are comfortable with that, they will continue to stay in touch and not reject us.”
Sometimes the problem extends beyond mounds of paperwork and clothes. Mogan and Grisham know patients who hoarded urine or fingernail clippings. Some stored their own faeces or collected one particular item, such as bicycles. One sufferer was hoarding so much junk, the only access to the house was a 30-centimetre gap at the top of the front door.
But for Allie Jalbert, of the RSPCA, the most distressing hoarders are those who keep scores of cats and dogs, all battling for attention and food on a crowded suburban block.
She has been calling for years to have hoarding classified as an illness in its own right to allow more people to receive treatment and put an end to the 100 per cent recidivism rate.
“Often, we find that hoarders might be treated for peripheral symptoms such as anxiety or depression, but their core problem, the hoarding, is not addressed. So once we have cleaned out the house, they reoffend, which is very, very frustrating for everyone involved,” Jalbert says.
Some people threatened suicide and had to be removed by police when faced with the prospect of giving up their animals or clutter.
“There’s a mixed bag of emotion when you deal with hoarders. Firstly, there is the concern for your personal safety but there is also a degree of empathy because often these people are quite emotional and attached to the animals. But it’s quite frustrating to see animals living in such horrific situations,” she says.
“I’ve seen bathtubs full of faeces and rubbish, sinks that no longer work, homes with no heating or cooling. Sometimes it’s quite an overwhelming experience.”
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Who develops the condition and why?
Some studies have shown that many hoarders have been brought up in households where chaos reigned. Some were neglected as children and witnessed pets being treated poorly.
Mogan accepts the aetiology is mostly unknown, but cites an Australian study that found sufferers reported failing to connect with their parents or growing up in households lacking emotional warmth.
“The lack of attachment causes them to become ambivalent about their identity and about other people. As a compensatory mechanism, they link with things, which they find more compelling, more predictable and dependable and less rejecting.”
But Grisham believes there is no real trigger, apart from children of hoarders being rewarded for saving things and getting punished for discarding. “Sometimes there is a traumatic head injury but those cases are very rare.”
The condition affects slightly more women than men but is found across all occupations, age groups and ethnicities. “And they are in relationships,” Mogan says. “Albeit strained ones.
“Some are going out to work, but they make sure no one comes to their house. They’re not agoraphobic. On the contrary, many hoarders go out a lot to escape. But their children’s lives can’t be normalised because they can never sit down for a meal or find space to do homework. It’s a real impost on the family experience.”
Mogan runs group therapy sessions in Melbourne and says that many patients do want to be cured.
“This condition is a disability and the source of quite a lot of human suffering and neglect. A lot of these people are quite relieved to get help.”