By: Oumaima Mansouri
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According to Faces of Abnormal Psychology Interactive website, 2% of adults in the United States have been diagnosed with obsessive-compulsive disorder (OCD) and about 4% will experience the disorder at some point in their lives. Obsessive compulsive disorder can begin at any time from preschool to adulthood. Symptoms of the disorder begin gradually, often during adolescence or early adulthood. In children, the compulsive actions often appear first and the obsessive thoughts develop later. Children may express obsessive compulsive symptoms, however, they typically have poor insight and seldom perceive that their compulsive behaviors are excessive. In adults, about one third diagnosed with obsessive compulsive disorder report having symptoms during their childhood. Unfortunately, in most cases it went unrecognized.

Diagnosing an individual with obsessive compulsive disorder can be difficult. Research shows that it takes the average person seventeen years from the onset of obsessive compulsive disorder to begin receiving appropriate treatment. This delay can be accounted for by individuals attempting to hide their symptoms, as well as many healthcare providers being unfamiliar with the clinical disorder. Obsessive compulsive symptoms cause distress, take up a lot of time, and may  significantly impact the person’s work, social life, and/or relationships. Many adults with OCD have a good insight into their problem and are able to recognize that their obsessive thoughts and compulsive actions are irrational. However, there are certain individuals that lack insight into their disorder. 

In children obsessions and compulsions symptoms can often appear related. For example, a child with an obsessive fear of intruders may check the door locks repeatedly. A child with an obsessive fear of disease may wash their hands excessively. She/he/they may fear that harm will come to their family unless they engage in a particular habit or pattern such as, avoiding using certain numbers or retracing their steps. Parents may not be aware of the full extent of a child’s symptoms because many of them occur in the child's mind and others are hidden. A parent may notice that their child avoids certain things, seems distracted, inattentive, or irritable, repeatedly seeks reassurance, or has difficulties tolerating uncertainty. A trained cognitive behavioral therapist can help the child and the family assess if these symptoms are caused by OCD.

During the assessment process, it is important to obtain the family history of any mental illness, particularly OCD from the client. If they had obsessive thoughts as a child, their current compulsive behaviors and obsessive thoughts and symptoms, and how the disorder affects their daily functioning. Assessment can help therapists plan interventions, identify risk factors, and most importantly highlight a client’s strengths. Instead of looking at the assessment as a way of gathering information to find or identify issues, one can focus on gathering information to identify resources that can be put in place for the client in order to reinforce solutions.  

There are many effective treatment options for individuals that suffer from OCD. Some of the more popular treatments include Psychoeducation, Cognitive-Behavioral Therapy (CBT), and medications (antidepressants and anti-anxiety medications). CBT can help the person recognize their obsessive actions and help them challenge and cope with their obsessive thoughts. Stress can cause obsessive compulsive disorder to become more exaggerated or exacerbate symptoms. Practicing mindfulness techniques in addition to the above treatments has also shown to be effective in reducing anxiety and stress levels. Mindfulness can also help an individual with OCD become more aware of their triggers.  

Obsessive Compulsive Disorder is a chronic condition. Symptoms can be managed, but they may reappear in the same or a different form several years later. Therapy can aid individuals recognize,  respond to new or existing OCD symptoms, and cope with their obsessive thoughts particularly during stressful times. 

References:
Faces of Abnormal Psychology. (n.d.). Retrieved from 
http://www.mhhe.com/socscience/psychology/faces/lowSpeed.html

By: Suma Hiremath, Clinician

It’s a commonly heard phrase when conversing with a friend, at work, or even in a therapy session…“not that this is anything like what you are going through” or “I know others have it worse, but...” We are living in an extraordinary time, where societal limits are being tested daily and everything feels surreal. Mental health difficulties, social isolation, and increasingly apparent income and socioeconomic disparity have surged. 

Positivity isn’t all bad…recognizing and understanding privilege and being able to put struggles into perspective can help foster positive thinking and promote gratitude. This can help to promote a more positive worldview and encourage the development of positive patterns of thinking. The brain is a muscle and can be, “worked out” much like any other muscle in the body. It is because of this that negative patterns of thought and maladaptive behaviors can be pervasive and take a considerable amount of time to unlearn. However, when it comes to processing our own struggles, emotional qualifiers can often do more harm than good. 

Think about the last time you had a conversation with someone, you disclosed that you were struggling with something, and were gas lighted or dismissed. Maybe the individual said something along the lines of, “back in my day, our struggles were tenfold.” Or, “people elsewhere have it much worse.” How did this make you feel? Likely invalidated or embarrassed? There also seems to be a social trend of romanticizing struggling and shaming people for empathy, sensitivity, and expression of emotion. For example, there were recent debates regarding student loan forgiveness and how alleviating the debt of millions of students would somehow be unfair to those who had already paid their loans off. 

​Although not all adversity is equal, it is important to not constantly compare your negative experiences to others’ negative experiences. It is important to allow yourself emotional space, particularly with negative emotions. This is a crucial step in being able to effectively process adversity in a healthy and productive way. In other words, although it is ok to feel grateful that you are still employed and able to provide for your family, it is also ok to feel lonely, isolated, or trapped in your home. Although it is ok to recognize your privilege in having a healthy family and children, it is also ok to feel overextended and in dire need of a break. No single struggle invalidates another, particularly in these unprecedented times. Make your emotional and mental health a priority and begin by allowing yourself grace and validation for your struggles, whatever they may be.

Rhain Toussaint, SSCFC Student Intern
“While I am happy to see my child smiling, is there a point to them playing around in therapy”. This thought has probably came up once or twice when taking your child to a counseling session. To you it might be playing around but for children, playing is more than building a fort, smashing G.I Joes together or jumping rope. Playing has numerous amount of health benefits from reducing stress, fear, anxiety, and irritability to increasing levels of compassion and improving non-verbal skills. Playing provides an opportunity to allow children to develop their sense of self. Playing also is a method to gain and build coping skills, strengthen one’s abstract thinking and problem solving. Playing has the opportunity to strengthen child development and improve social relationships. According to the article, Play in Children’s Development, Health and Well-Being, Active play that involves running, jumping, climbing keeps children physically healthy while discovering  their environment. This helps prevent obesity, depression, stress and other negative effects. 

Through the act of play, children weave a story and sometimes it is about themselves. This activity enables a child to express their feelings, show what happens during their daily lives and visualize their dreams or fears. A mental health professional can learn a lot about what is occurring in a child’s life just by watching them play. One can learn what areas a child struggles or excels with or how they are doing emotionally, physically and mentally. Most think playing is just a waste of time but play allows a child to expand and share their world with others. 

Just like vegetables can help with your child’s physical development, different types of toys and games promote and establish different skills. At an early age,  blocks, Legos, puzzles, and other toys grow spatial, language, decision making, creativity, attention span, memory, and motor skills. Playing can also stimulate brain growth, increase emotional intelligence and so much more. Toys that encourage children to share or cooperate with others is called social play, so your child wanting you to participate in activities such as tea parties teaches them how to interact with others. Altogether, toys help boosts amusement and expand play, so make sure you have variety for your child to choose from so they can have an array of techniques. 

Play can be beneficial for a better quality of life. If children are not given the opportunity to play, it affects their daily and future lives. According to the article, Play in Children’s Development, Health and Well-Being, those who are not playing daily are at risk to suffer from poor physical health and mental health issues later on in life. Those who do not play at all suffer from not developing at the same rate as other children either emotionally, mentally, and/or physically.  Make sure that you are are aware that play overall and in therapy is a helpful tool in your child’s development. And, remember you can always join in on their play sessions when necessary. 
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Reference:
Goldstein, J. (2012). Play in Children’s Development, Health and Well-Being,. Retrieved from https://www.ornes.nl/wp-content/uploads/2010/08/Play-in-children-s-development-health-and-well-being-feb-2012.pdf.

By: Laura Bishop, Clinician

I recently confessed on social media that I watch my fair share of Hallmark movies. The station has gotten very savvy with their movie promos and basically you can follow them through all four seasons.  Granted, the plot lines and actors are often recycled. These movies are more wholesome in nature and you don’t really have to think that much, which is why I like them. After all, working as a Mental Health Therapist can be stressful. I hold sacred the real life struggles people share with me daily and can run the risk of experiencing second-hand trauma of hearing these stories. I also don’t like to watch movies that contain gore or zombies, or other graphic images that are going to keep me up all night. So yes,  Hallmark movies seem to be a good alternative. 

However, there was part of my social media confession that got me in a little heart. I posited that long term exposure to these movies could actually be harmful to one’s mental health. Over the years, I have worked with many survivors of trauma. They face abundant triggers as they navigate through each day and learn to cope with what has been as they hope for what will be. Many have struggled for years with debilitating depression, anxiety, and symptoms of Post-Traumatic Stress Disorder. In addition, I have seen those who have broken relationships and lost jobs or mourn the loss of loved ones and can’t seem to come out from under their blanket of grief. For them, their lives cannot be magically transformed in 2 hours time. They may  not lose a job and find another in the same day, or be whisked off to a palace in a magical (albeit unheard of country) and marry a prince or princess in time for Christmas, or get a ring by Spring (when it is already January and they have not met their person yet), or… you get it, right?

​The most heat I received was from my own sister. She posted back to me in big letters that these movies are an ESCAPE after all. Yes, she effectively yelled it to me in type speak. While I agree with her on a surface level, I do carry reservations of using this logic over time. I believe that prolonged exposure could decrease one’s self-esteem by leading to questions like “Why isn’t my life like that?”, “Where is my prince/princess?”, “Where is my dream job?” or even “Why can’t I look this beautiful/handsome when just getting out of bed?” For many, the real world is full of more complex questions like “Why can’t I get out of bed at all?” 
So, if you plan on binge watching your way through the year with these Hallmark movies for simple entertainment and escape, go for it. Just be mindful of these fictional fairy tales and be good to your own and other’s mental health in the process.

By: Lujuana Milton, Owner and Clinician

Winter is coming…winter is coming…

More like winter is here and with the advent of the winter season come all sorts of wonderful things. The beauty of newly fallen snow, sipping hot chocolate on a cold winter’s day; or even witnessing the smiles of children as they play in the snow on a long awaited snow day.  For others, the winter season brings on a host of not so “Norman Rockwell painting” feelings that are much more than the disdain for travelling in a nasty, slushy, wintery mix. I’m talking about Seasonal Affective Disorder, most commonly referred to as SAD. It is highlighted by the increase in depressive symptoms usually starting in the fall and continuing throughout the winter.  According to the National Institute of Mental Health, SAD is not a separate disorder from depression, but is a type of depression that has a recurring seasonal pattern. 

The National Institute of Mental Health (NIMH), identified characteristics that put you at more risk for SAD including being female, living far from equator, family history of depression, having been diagnosed with depression or bipolar disorder, and being of a younger age. More recently, I’ve become more aware of my own emotional difficulties during the fall and winter months and realized I have checked off many of the above risk factors.  Given this information, I decided to do some research about ways to manage or improve one’s mood throughout the fall and winter season. While I am not completely adverse to medication as intervention because I recognize and have witnessed the transformation of others through the use of medication, I have committed myself to also finding alternative non medication ways to manage and improve mood. 

Most identified treatments for SAD include psychiatric medication, light therapy (a light box that mimics natural light), and psychotherapy.  Additionally, I have found that meditation, guided imagery, and relaxation techniques such as deep breathing or an activity like yoga have been found to be successful in managing mood. Being the therapist that I am, I try not to provide an alternative recommendation that has been found to be successful if I have not tried myself. This has led me to interesting places with more than enough funny stories, however, I believe it has made me a better therapist to say: “This is proven to work most times with most people and it has worked for me.” I can unequivocally say that meditation, guided imagery and relaxation techniques do work.

Along with the above recommendations, exercise or any sort of physical movement can help to regulate neurotransmitters impacting and regulating mood.  I know what you’re thinking, when its -1000 degrees outside, how the heck am I supposed to get up at the crack of dawn to go to the gym and exercise. Even more so, when you are feeling down and depressed.   I never understood those people that go to the gym because they absolutely love going. In fact, I have never had the pleasure of meeting these people because for most people its work to get up and do something when you really don’t want to do it.  But, I have a trick. You don’t even have to leave the comfort of your own home to exercise or move. There are countless paid or free resources to use to get moving and regulate your emotions. All it takes is a Google or YouTube search and you are connected to a world of movement.

So if you are struggling with symptoms of SAD and need some help improving your mood, take heed to all resources at your fingertips.  Even if one proves unhelpful to you, there may be others out there that can help, you have to keep trying. 
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Reference:
Seasonal Affective Disorder. National Institute of Mental Health, Mar. 2016, www.nimh.nih.gov/health/topics/seasonal-affective-disorder/index.shtml.

By: Lujuana Milton, Owner and Clinician

So you’ve decided to come therapy.  Maybe it’s for the first time, you’ve taken a hiatus, or you need to find a new therapist.  You’ve had your first or a few sessions and for whatever reason you are not feeling it. You are just not vibing with your therapist.  Maybe it’s his tone of voice, what she wore, or his approach was not what you were looking for. Well all those feelings or observations are pretty natural.  We are humans that have feelings about who and what we encounter daily and based on those feelings we are either going to go all in or not. The bad news is that when it comes to therapy, not going all in pretty much defeats the purpose.  Rapport and relationship are such an important aspect of therapy. There is even research that suggest that success in therapy is related to the relationship one has with their therapist. 
So we’ve established that the relationship with your therapist is important to your success and achievement of your goals in therapy, but what happens when you feel like the relationship with your current therapist is not helping you.  If this is the case, then I would suggest you speaking to your therapist. Be honest and don’t ghost us; I promise it won’t hurt our feelings. We recognize that our personalities or approaches may not be for everyone. We also trained to tailor our approaches to each individual and when we receive feedback from others we are better able to tailor our approaches to meet yours other people’s needs.  
Now what happens when that conversation doesn’t work? Or maybe you just really don’t want to work with that particular therapist.  That’s okay too! Again, it won’t offend us so don’t up and leave with no phone call. We want you to achieve your goals, even it isn’t with us specifically.  Tell us what you are looking for with regards to a therapist, your goals, and why it isn’t working. We can help you find another therapist that would be a good fit for you.  You see, as therapists we know other therapists. We know all kinds of therapists with different backgrounds and expertises and we can help you find the right therapist for you.  It can be daunting just scrolling through a sea of professional profiles to find a therapist that you think might be a good fit. And I don’t know about you, but when I was looking for my own therapists I read through profiles pretty quickly and make my judgement based on whether the therapist has a warm presence or a nice smile in their photo.  While I have happened upon some really great therapists this way, it is not the most reliable of methods. I would have much rather gotten a personal recommendation from another therapist who knows and/or has worked with that therapist. 
I can’t stress enough that as therapists we won’t be offended and most definitely shouldn’t get upset that it is not working for you.  Our goals is to assist you in anyway we can so if you are feeling that you are not really vibing with your therapist work with them to find the best solution for you.  All it takes is a conversation about it. 

By: Dana Meshil, Clinician

​The average person’s daily life has become one where being busy and always having too much on their plate has become the expectation.  It’s gotten to a point where most of us feel pressured to say yes to any task, favor, or social plan asked of us and yet constantly feel that we’re not doing enough. If we aren’t juggling multiple projects at once, we judge ourselves as being lazy as opposed to respecting our limits. This fast-paced, nonstop lifestyle has the notion of being productive, but in reality isn’t sustainable and lessens the quality of the things we invest our time and energy towards. When did being overwhelmed become synonymous with success? It’s time to change this falsehood.
The issue with our over-packed schedules is that we’re all scared to say no. We’re worried if we say no to our friends or family that we’ll be hurting their feelings or be letting them down. We’re worried that if we say no to extra responsibilities at work that we won’t seen as team players or it will hurt our chances of career advancement.  There’s this internalized pressure to be able to “do it all” and creates this sense of failure when we aren’t able to be superheroes. Let’s stop buying into the idea that more stress equates to greater achievement and learn how to set boundaries and maintain balance.
Children love saying no. it’s the first way we learned how to establish autonomy and assert our independence. Most of us probably had to go through that aggravating journey of accepting that sometimes no isn’t an option. Then our brains further developed and we adopted the idea that saying no is never an option.  Not being able to eat candy for every meal isn’t the same as scheduling 3 events in one day on a regular basis. That doesn’t mean we should throw a tantrum when there’s a social engagement we’d rather blow off; it means we should learn how to delegate our responsibilities. If we were meant to handle everything on our own then we would be solitary creatures. It’s okay to say “I don’t have time right now” and it’s okay to ask for help. So let’s ask our inner child to take the reins every now and then and use that adult brain to rationalize why such a choice is necessary for our wellbeing.
Working downtime into our lives is a necessity. Daydreaming and zoning out would not be widely familiar terms if our minds did not require breaks. Rather than working so hard to the point that your brain simply can’t focus during a team meeting, make a point to incorporate nothingness into your day. That doesn’t mean spending every weekend binge watching Netflix. Too much downtime leads to decreased motivation, but too much busy time leads to burnout. The secret is balance, that nonexistent concept in our all-or-nothing American culture. For every exertion period there needs to be a recuperation period. You aren’t actually doing anyone (most of all yourself) a favor when you take on too many things, so let’s start being the ones who are brave enough to say no. We’ll achieve greater satisfaction if we apply our energies towards quality, not quantity.
Let’s Start Actually Listening To Our Bodies

By: Lujuana Milton, Owner and Clinician

On weeks like the one that I am currently having, it seems like there is no end to the struggles and I have to ask myself:
Is it a full moon?
How many more days until the weekend?
Is mercury in retrograde?
Rarely, I find that it’s actually a full moon and the weekend is days away.  Usually, during my Google search I find that mercury is indeed in retrograde. For those of you unaware of the mystical nature of mercury retrograde, it occurs during a three-and-a-half-week period in which Mercury appears to be moving backward. Following this period, the planet will reverse itself and move “forward” again. It is important to note that Mercury does not ever actually start to move backward, it just looks like it does based on its position relative to the Earth’s axis.
In certain circles, mercury is believed to hold power over things like communication and mental function. So it’s no surprise that Mercury retrograde tends to result in planned events going a little wonky. All this amounts to is that when the crap hits the fan, it really hits the fan. I find that when this happens, I need to protect my space as part of my self-care routine. Nowadays, self-care is one of those buzzwords that everyone is talking or writing about. Quick tips and lengthy articles that I often become too bored to finish reading attempt to teach us how to protect our emotional, mental, and physical space.  But, why do we need these reminders to take care of ourselves. Why? Because in this day and age, it’s so easy to neglect oneself and in some cases it’s often expected. Self-care is a necessary part when things are going well AND especially when things are going horribly wrong.
We need to practice better self-care in order to protect our physical, emotional, and mental well-being.  In order to do this, we need to remember to set better boundaries. I tell anyone that will listen to my sometimes coherent ramblings, to set emotional and physical boundaries with yourself and others. What are boundaries, you ask? Boundaries are rules and principles you live by that identify what you will or won’t allow.  Boundaries allow for the protection and maintenance of our personal space, privacy, body and emotions.  It would not be fair to have a discussion about self-care without including the use of coping skills. Coping skills are daily strategies that we use to help us deal with and work though our distressing thoughts and/or emotions.  Now let me be clear; coping skills can be both positive and negative. So, of course, I am talking about using positive, pro-social coping skills that include consistent exercise, regular sleep, healthy diet/nutrition, talking with others, involving yourself in social activities, engaging in hobbies, and other activities that help to manage distressing thoughts and/or emotions.
In theory, setting better boundaries and using coping skills is easy, but it’s a lot harder to do so in practice.  A bit of self-disclosure here, I’m a therapist who teaches these concepts for a living and it’s hard for me to do this consistently.  There are days when I feel like I’ve handled life’s struggles like a champion and then there are days when I hunker down on my couch and binge watch a show I would never usually watch while ignoring my piling work with a sleeve of Oreos.  So I guess what I’m saying is to try each day, especially during mercury retrograde, to set better boundaries and use those darn coping skills your therapist constantly talks to you about. But, give yourself a break because we are human beings that can’t always be perfect and respond appropriately in all situations.  We just have to try for as many situations as we can.

By: Lujuana Milton, Owner and Clinician

The topic of life and the perception that life is hard has been coming up a lot in my personal and professional discussions and has piqued by interest lately.  The question of why life is so hard is such a complicated topic to pursue. Whenever this question is posed to me directly, I am often tempted to do the typical therapist response of silence in order to catch my bearings because how the heck am I supposed to have an answer for why life is so hard?
After the initial internal panic passes, I continue to process this question and really started to think about this concept.  But, let me be clear, this post is by no means contains the answer to this complicated and often asked question. It is just a collection of my thoughts that I have developed as I struggle with my own life’s difficulties (because everyone does…yes even therapists!) and as I am able to bear witness to others attempting to process this age old question.
As a therapist, I listen to the life struggles of others. The single mother struggling to make ends meet; the young professional with a lifelong struggle with anxiety and depression; the woman who experienced childhood abuse that continues to effect their relationships. Life is hard and often sucks that’s for sure.  But, why is life so hard? Is this what we are destined to go through for the rest of our lives?
These questions resonate with me because how can one have answers to those questions? I am then reminded of a quote from Buddha stating “Praise and blame, gain and loss, pleasure and sorrow come and go like the wind. To be happy, rest like a giant tree in the midst of them all.”  A thousand people can read this quote and come up with a thousand different meanings, but I can only share what this means for me and those experiences I have had opportunity to witness in my life and the lives of others. Life is hard and yes it sucks sometimes, but that is part of the experience of humanity because if we are able to be still in the midst of chaos we can appreciate and experience the happiness that we so long desire.
It strikes me as ironic that the happiness we often search for in the midst of our struggles are right there present with us. Just like yin and yang, they are two distinct concepts complementing one another; we just have to mindful enough to recognize it and appreciate them.  I can attest that this is extremely difficult to do, but think about the happiness you can experience when you recognize even in your darkest moments.