Issues in Depth
Attention-deficit/hyperactivity disorder, or ADHD has been diagnosed for decades now, and depending on the source, roughly 5% – 15% of the population are estimated to have some degree of ADD symptoms, and to a lesser degree, the hyperactivity included in ADHD. Even though this diagnosis has been researched, studied, and observed by many, it still remains confusing to most, and to others, controversial that it even exists. As much as over-diagnosing and potentially over-medicating is problematic, the National Institute of Mental Health (NIMH) has concluded that it is the underdiagnosing and under treatment of ADD that is the bigger problem in the United States. So many lives have been negatively affected, relationships destroyed, and jobs lost due to ADD. There are a number of criteria that must be met to make an adequate diagnosis, such as having consistent difficulty sustaining attention, leaving tasks undone, difficulty organizing activities, forgetful, and consistently losing things, but it’s probably the toll it takes on self-esteem, relationships, and school and work performance that can create tremendous stress in the person’s life. It can be heartbreaking for the individual or the parent of an ADD child, or nerve-wracking to the friend, coworker or spouse. Children and adults with ADD often experience difficulty with delayed or deferred gratification, difficulty controlling impulses, and are often labeled as lazy, irresponsible, and undependable. In some cases they can also suffer from anxiety and depression. Fortunately, there are a number of different treatment options that can greatly improve lives of the individual with ADD, as well as the lives of those who care about them.
Dementia, whose forms include Alzheimer’s disease, generally refers to a number of symptoms that contribute to cognitive deficits. These can include memory impairments, language impairments, and decreased sensory and motor functioning. Our ability to process short-term memories normally and gradually declines from our early thirties, with our long-term memories remaining relatively intact well into old age. It is important to be assessed by experts to discern if a person’s memory impairment is normal or the beginnings of dementia, Alzheimer’s, or other intervening factors which can contribute to or worsen a person’s condition. Alzheimer’s is generally different than dementia, in that there is often a greater increase of deficits in language and motor skills, as well as agnosia, or the inability to recognize or identify objects. Presently there is no known cure for dementia or Alzheimer’s, but much can be done to slow their progression, and especially help and support the individual suffering from these symptoms, as well as their loved ones and caretakers.
We will spend more time at work in our adult lives than any other single activity. Sometimes jobs can be very challenging with a combination of stressors and pressures to perform, along with potentially negative or dangerous working environments, as well as having to work with difficult people, or ineffective supervisors or bosses. If we are choosing a career that requires extensive skill training or college degrees, the decision can be a very important and challenging one; it can require a tremendous financial and time investment. It can be extremely helpful to work with an expert to either help you cope more effectively with workplace stress, or to choose a career that most suits your unique skills, strengths, and personality. In some cases, a person may benefit from working with a career counselor in deciding to change careers to one that is more lucrative and/or fulfilling.
This term has been around for a while, but simply refers to a person who needs to help someone in a way that takes responsibility from that person, and in some cases will encourage that person to be dependent for one or more needs. Most people like being helpful, and have a general healthy sense of where their responsibility ends and the other’s begins. The codependent consistently crosses this line, either with one or a few people, or as a rule with all they meet.
The codependent has the intent to be helpful to others, but does not appreciate that they may actually be rescuing the other, and at the same time ignoring their own needs. The result of chronic codependency leaves the codependent feeling frustrated, resentful, unloved, or manipulated. Fortunately, there is effective treatment for these individuals, so that they may be able to lead happier, more fulfilled lives, with healthier, balanced relationships.
No one gets married planning on divorce, but unfortunately, many (roughly 40% per year) end up making that extremely difficult and painful decision to break their vows of “till death do us part”. Sometimes, in the process of marriage counseling, one or both spouses may become aware that they have lost the willingness to continue to attempt to fix a marital relationship that in some cases may have emotionally ended long ago. Most do not come in for divorce counseling, per se, but are coming in for marriage counseling as one last attempt to fix a severely damaged marriage. Many will discontinue counseling once a decision to divorce has been made. I strongly encourage my clients to continue the counseling process, not only to begin the long healing process, but to begin to redefine their relationship, and rebuild their often dysfunctional and destructive communication, so that they may work cooperatively through the emotional and legal divorce. If they have children together, their mutual cooperation and effective planning is imperative in order to reduce the unnecessary suffering all too common in divorces that are already painful.
Here’s a new one; parenting is not supposed to be that difficult. That’s not to say that it is easy, but we are not the first generation to have successfully raised children. The thousands of techniques that have been practiced and written about over the millennia are not the problem. It is the principles or goals behind those techniques that make all the difference in the world. Given that you, like most, are a decent, loving parent that wants the best for their child, ask yourself this question: Out of the following goals for your child, if you could only guarantee just one for your child, which would you choose? 1) Intelligent, 2) Wealthy, 3) Healthy, 4) Happy, or 5) Good. If you chose good, you are more than halfway there in raising a decent adult. Think it through; have you ever heard of a rotten individual or criminal who was intelligent, wealthy, healthy, and happy? If our goal as parents is anything less than raising good, loving, and decent contributors to our society, we’re all lost. It is also important to be raising adults, not children. I certainly appreciate that there are many complexities and personalities to contend with, but following certain time-tested principles can contribute to making parenting more enjoyable and less unnecessarily painful. I can help you incorporate these essential principles and sort through the myriad of techniques that will best fit your unique family.
Stress, which is a complex of physiological, psychological, and emotional reactions, has gotten a bad reputation over the years. Most view stress as merely a negative state that would best be avoided at all times. Like pain, the experience of stress is our body’s way of warning us that we need to do something to take care of ourselves, or to avoid danger. The solution could be as simple as getting rest, or as complex as better balancing or organizing our lives. Unfortunately, I would agree with recent research which indicates that general levels of stress are higher now in our present culture and society than any other time in history. It’s not that people didn’t have it hard hundreds of years ago, but life was not as complex and under constant pressure. There is no rest; houses do not have front porches anymore. We are all familiar with acute signs of stress: irritability, anger, feeling rushed and under pressure, headaches, etc. If that’s all we experienced periodically, we would all be fine. It’s chronic stress that takes a tremendous toll on most of us. Most medical professionals will admit that one of the largest contributors to all illness and disease in people is chronic stress. This also holds true for mental illness. Chronic stress exhausts our immune system, contributes to severe depression and anxiety, and destroys relationships. Most will naturally attempt to deal with stress when aware of it, but after time, they merely try their best to adapt to it. If you’re aware that you may not be effectively dealing with the stress in your life, I can help you alleviate the negative symptoms of stress, or at least deal with it more effectively.
Addictions and Compulsions
In recent years, “addiction” has been used to describe almost any type of compulsive behavior. Some people can suffer from OCD or obsessive compulsive disorder, which manifests itself in persistent and recurrent thoughts, impulses, or images that result in severe anxiety or distress. These symptoms can occur in childhood and adulthood, and in the absence of any drug or substance abuse. Most people can understand when they hear of someone with drug addiction or alcohol addiction, but may be confused when they hear of television or internet addiction, or exercise or relationship addiction. The controversy over who is addicted and who is not is complicated by many factors, many of which are subjective. It is also important to distinguish between abuse and dependence, especially with substances. Generally, whether an individual is concerned about a substance, activity, or relationship, it is important to distinguish how much control the individual has over the issue, and the degree to which they need the substance or activity to cope with stress or other problems. There is much research and effective help for addictions and compulsions, and sufficient motivation and support are the key ingredients to overcoming these sometimes overwhelming and destructive issues.
Our ability to cope effectively with life falls on a very wide continuum, from maladaptive, unhealthy, and dysfunctional, to adaptive, healthy, and functional. Most of us cope with our lives just fine most of the time, but life is very difficult, stressful, and challenging at times. Given any number of stressors, along with acute or chronic conflicts, as well as personal, relational, or medical and health concerns, we may lose our ability to maintain mental and physical health. We can become not only unhappy, but develop a number of serious mental and physical symptoms. Depending on our circumstances and life events, it is essential to update and strengthen our coping skills to meet the needs and complexities of a full life, and to better deal with the continuing challenges in life, many of which are out of our control. In most cases, we can learn to become stronger and more effective in coping with life’s stressors, and therefore lead a happier, healthier, more fulfilling and productive life.
I strongly believe that there is an ongoing challenge to balance the needs of our physical, mental/emotional, and spiritual selves. Sometimes, illness or suffering may lend itself to one part of our self as opposed to the others, yet our entire self is always affected. For example, a person can contract a chronic physical illness, which can then contribute to feelings of depression, and experience a lack of hope, and increasing feelings of being disconnected to friends, family, and God. Even though Christianity is my own faith background, I work with people of all faiths or no faith. Most of those who do espouse a spiritual faith or religious beliefs tend to derive many of their important values and principles from those beliefs, which then have a profound impact on many of the important choices and decisions that they are struggling to make. Through the years I have learned the importance of assessing and treating the entire person, even though your mental/emotional self will generally be the main arena through which we will work.
Grief/Bereavement/Trauma/Post Traumatic Stress Disorder (PTSD)
Loss, death, trauma, and unfortunate circumstances are inevitable parts of life. From the moment we lose our first toy, or our goldfish dies, to losing a job, or the death of a loved one, we must learn to effectively deal with these traumas and losses, or our lives will be engulfed by them. Again, whether we lose a wallet or our best friend, the process of grieving the loss is essentially the same. Of course, the difficulty level is incomparable. Most people learn to effectively deal with the normal losses in life, until they are confronted with a major, unexpected, or catastrophic loss. The skills they may have implemented before can be insufficient now. Unresolved grief can contribute to overwhelming obsessions, severe depression, chronic anger, and an increasing inability to function in everyday life. Supportive friends and family can often help a grieving individual through the grieving process, but sometimes they can become stuck, and their lives can begin to revolve around the loss or trauma. The individual experience of loss or trauma can be so overwhelming, the individual may experience severe symptoms of PTSD, which can lead to chronic suffering, even suicide. Professional help and support can, in most cases, help the individual, couple, or family learn to become unstuck, and greatly reduce painful symptoms. As we learn to grieve more effectively and better accept our losses, our lives are open to become fuller, richer, and stronger. Moreover, we can become free from paralyzing fears and anxieties, and begin to enjoy life again.
Marriage Counseling/Couple Counseling
Marriage is one of the most important institutions in any society. It doesn’t take a social scientist to observe the strong correlation between how marriages are doing in a given society, and how that society is doing. The ability to effectively bond and attach to another, especially the commitment to being partially responsible for the other’s well-being and happiness, is challenging at best. Throw in a combination of different personalities, culture, wants and needs, not to mention the inherent differences and challenges of the opposite sex, this challenge can appear insurmountable. Poets, philosophers, and social scientists have struggled with this seeming conundrum for eons. Fortunately, we are not the first generation to wonder about or confront this eternal struggle. Like parenting, there are many time-tested principles to guide you in developing healthy, fulfilling goals for your marriage or relationship. Marriage counseling is very similar to couples counseling or premarital counseling, in that commonly, couples are concerned about healing from past hurts, and developing more effective conflict resolution skills. It is the commitment in marriage, sometimes religious, to self, spouse, and society that adds a dimension that not only potentially strengthens the bonds in the relationship, but can also enable them to better weather the inevitable trials and tribulations of marriage and family life. After mutually agreeing on goals, and accurately assessing the couple’s strengths and weaknesses, I am able to not only help most couples work through whatever crisis brought them in to counseling, but then help them to develop more effective communication and conflict resolution skills. You owe it not only to yourself and your partner or spouse, to have the best, strongest, and most loving relationship or marriage you can have, but also to the betterment of our society.
The term “phobia” generally refers to an excessive or unreasonable persistent fear, brought on by the presence of, or anticipation of, any number of specific objects or situations. This fear can become overwhelming, resulting in extreme anxiety, panic attacks, or paralysis. Phobias are actually quite common, with most people either avoiding the phobic situation, such as heights, or adapting the best they can by enduring the intense anxiety and distress. Unfortunately, even though avoidance is understandably implemented as a defense, this paradoxically increases the fear reaction and makes the person worse, often increasing their vulnerability to developing additional phobias. Social anxiety, which can resemble shyness, often goes beyond the fearful anticipation of a negative response or reaction from another, to sometimes feeling anxious and overwhelmed with just the idea of being in the presence of another person, especially large groups. Needless to say, this debilitating illness can incapacitate and isolate an individual, leading to much unhappiness and depression. Fortunately, social anxiety, as well as most phobias, is relatively simple to treat, with the individual either completely or partially extinguishing the fear, so that they can lead a happier, more fulfilling and productive life.