mental health treatment

Self-Soothing

Posted on by vlaw759

“Self-soothing” refers to behaviors people use to regulate their emotional state by themselves. It’s a strategy used to regain equilibrium after an upsetting event, or when facing a stressful situation. (For example, when a child’s parents argue, or an older person has to make a public presentation.)

Self-soothing behaviors are often apparent early in life, and are calming or comforting for a child or adolescent. Infants, for example, may be seen repeatedly sucking fingers or thumbs, hugging a toy or blanket. These habits may continue for years.

Self-soothing behaviors are repetitive/habitual in nature—and are often not consciously applied. Do you touch your hair, twist a ring, straighten your tie, etc.? Noticing when you engage in such behaviors can help you recognize mildly tense or stressful situations. It’s another form of self-awareness.

Following a shock, a traumatic or upsetting event, all people need soothing. In these more intense situations, two common self-soothing behaviors include reaching for an alcoholic drink or a tub of ice cream or other emotional eating. However—as you no doubt know—these kinds of self-soothing behaviors can cause additional problems.

Several self-soothing behaviors can lead to other problems: binge-watching TV, compulsive gaming, or internet surfing. Many superheroes have unhealthy self-soothing behaviors, including Jessica Jones and Iron Man.

Constructive Methods of Self-Soothing

Positive Psychology published an article suggesting several more positive strategies: “24 Best Self-Soothing Techniques and Strategies for Adults.” The following 7 suggestions quoted below are included in that article.

1. Change the Environment

If possible, just change the environment for a few minutes. Go outside and focus on greenery or find a soothing indoor space with a pleasant view or ambiance.

(The origin of the “Green Room” in theaters may stem from Elizabethan actors resting “on the green” between scenes to calm their eyes and their nerves. As the wavelength of green light causes the least strain on the human eye, those Elizabethans may have been on to something!)

2. Stretch for Five Minutes to Move Any Blocked Energy

For best results, try to put your chin between your heels.

Often, after upsetting news or a shock, our bodies respond by freezing and energy gets blocked. A few simple trunk twists, neck rotations, or bends at the hip to touch the toes can help shift stagnant energy.

(Even without a shock, our bodies tend to store tension and stress in our backs, shoulders, and necks. Stretching these areas can prevent headaches and improve circulation.)

3. Take a Warm Shower or Bath

Treat yourself with soothing body wash or bubbles and a fresh, soft towel afterward.

(For best results, do not use overly hot water and avoid scrubbing too hard. If hot water is not available, you can turn to oil, smoke, some types of mud, or simple cold water to achieve cleanliness and promote peace of mind.)

4. Soothing Imagery

Find soothing things to look at such as a burning candle, soft lights, pictures of loved ones, favorite places, or perhaps some framed inspirational resilience quotes or affirmations.

(The color green is most restful to the human eye, but some evidence suggests that other colors may have a calming effect on stress and mood. According to the principles of chromotherapy, surrounding oneself with blue, purple, or white can calm, soothe, and relax the central nervous system.)

5. Soothing Music

Harpist Carlos Reyes

Listen to favorite tracks that have a calming effect or one of the many relaxing music videos for stress relief that are available online.

(Harp music in particular has a soothing effect on the body as well as the mind. Research has shown that listening to harp music improves pain management, blood pressure, and heart rate regularity.)

6. Soothing Smells

Create pleasant smells by using an essential oil diffuser, scented candle, or incense. Also, try using scented hand lotion.

(The most soothing scent of all!)

7. Self-Compassion

Speak compassionately to yourself aloud. Talk to yourself like a good friend would. Give yourself the grace to be off-balance and the space to just be as you are for a while.

Soothing Every Sense

When people experience high levels of stress or discomfort often, some therapists recommend making a self-soothing box that includes objects or reminders of how to soothe all five senses:

  • Comforting smells such as scented candles, essential oils, or body lotion
  • Pleasant tastes such as herbal teas or favorite snacks
  • Soothing things to touch such as a favorite sweater, wrap, or stress ball
  • Comforting sights such as photos of loved ones, pets, or favorite places
  • Soothing sounds such as a favorite piece of music or guided meditation track

Most of us are familiar with people soothing other people—a hug, a back-rub, a shoulder to cry on. During COVID, when interpersonal soothing was less available, researchers studied the benefits of self-touching (Dreisoerner et al., 2021). They found that both self-soothing touch (in this study, most participants chose to place their right hand on their heart and their left on their abdomen while focusing on the rising and falling of their breath) and receiving a hug from another person were equally effective at lowering stress levels.

When adults are distressed, it’s difficult to regulate potentially disruptive emotions like anger, fear, and sadness, especially in a public space such as the workplace. If you want to explore self-soothing further, just look online. You will find lists of techniques from 8 to 100. Surely there’s something there for everyone.

Bottom Line: Everyone experiences distress of various sorts and at various levels. Self-soothing is a life skill worth learning.

ALCOHOL: OTC MEDICATION?

Posted on by vlaw759

Stress and alcohol go together like peanut butter and jelly—a burger and fries, mac and cheese, bread and butter, mashed potatoes and gravy, milk and cookies, or any other iconic duo you can think of. Yes, they can be separated but—oh, so often—you don’t have one without the other.

I started thinking about this when the Richmond Times-Dispatch ran a front page story (above the fold!) about liquor sales in Virginia. You will recall that ABC Stores have remained open as “essential” services. And according to numbers from the Virginia Alcoholic Beverage Control Authority, sales now hover around $22 million a week. 

In March, as the social distancing began, the ABC stores had more than $30 million per week.  Sales in April 2020 were up about 15% over a year ago. The article goes on to identify the top selling brands for the state and for the Richmond Planning District (City of Richmond, Henrico, Goochland, Hanover, Chesterfield, and Powhatan counties). I was less interested in the rankings than in the sheer volume!

Alcohol consumption is up all over the country. To look at one other location, in Tulsa, OK, one liquor store reported that looking at sales March 15 to April 15, liquor sales were up 56% and beer 48%. Compared to a similar date in April of 2019, one-day sales in April 2020 were up by 100%. 

According to one store owner, buying habits are changing in that people are buying more at a time, shopping more during the day and less in the evenings and on weekends.

In order to facilitate buying alcohol, providers are offering digital ordering and delivery, curbside pick-up, hosting, hosting virtual tastings and/or cocktail hours. And some are branching out by stocking hand sanitizers and face masks. Virtual cocktail parties among friends and families are now common.

If your aim is absolutely perfect, your cocktail parties with neighbors don’t have to be virtual!

Estimates of the increase in U.S. alcohol consumption from now to the same time last year vary from 25% (WHO) to 55% (Healthcare Home [//healthcare.utah.edu]).

The uptick in alcohol consumption is not solely a U.S. phenomenon. The World Health Organization has issued statements urging countries world-wide to try to curb drinking during the current pandemic. They cite several health reasons to try to control excessive alcohol consumption. No matter how bad a situation is, excess drinking can always make it worse!

Magic Snowman Tea is guaranteed to be 100% alcohol free.
There are other substances one can turn to in times of stress. This is one of my favorites.

Also according to WHO, alcohol-related deaths number 3 million every year—before the pandemic.  And the WHO now has the added difficulty of trying to quash the misinformation that has circulated to the effect that drinking can make someone immune to the COVID-19 virus and/or cure one if infected. The presumed medicinal value of alcohol has a long history (see below), perhaps with roots in the dulling of physical pain.

Jackie Chan is a master of Drunken Fist Kung Fu ( 醉拳 )

The link between stress and alcohol consumption is so well established that it’s actually called “self-medication.” In fact, such self-medication can be pretty effective, at least initially, in relieving anxiety and depression. Alcohol is a “downer” (i.e., a system depressant) so if people are wound up, rapid heart beat, etc., alcohol can definitely make those symptoms of stress go down. But as mentioned above, alcohol also depresses inhibitions, increases risk-taking, decreases logical decision making, increases violence, and — after all that — is still likely to interfere with restful sleep.

Being home all day with bored and curious toddlers is a very stressful circumstance.

COVID-19 presents a set of circumstances that are problematic with regard to alcohol consumption.

  • High levels of anxiety associated with the unknown
  • Isolation from one’s usual support system
  • Loneliness
  • Economic distress/job loss
  • Food insecurity
  • Fear of infection/death
  • Mourning the loss of a loved one
  • Stress at having to work from home
  • Stress of having to work in an “essential” job interacting with the public

COVID-19 is dominating today’s headlines, but it is far from unique. Research indicates that alcohol use and abuse increase during and after “violent conflicts”—e.g., wars, periods of martial law, government coups. Other psychotropic substances are also used to deal with psychic strains and trauma, but alcohol is generally the most likely to be readily available, legal, and (at least within limits) socially acceptable.

Totally non-addictive!

During the 1918 Influenza Pandemic, bootleg whiskey was viewed as a respectable medicine. At the time, more than half the states in the U.S. had passed Prohibition laws and thus were “dry.” But for medicinal purposes, some officials decided to tap the vast stores of liquor that had been confiscated initially to aid the military, although the Army mostly remained silent about using it. In Richmond, Virginia—reportedly—two railroad cars of confiscated whiskey arrived for the benefit of Camp Lee. Over time, confiscated whiskey was distributed to civilian hospitals, too.

Medical isopropyl alcohol is now available at vending machines in Moscow.

The United States Pharmacopeia dropped whiskey, brandy, and wine from its listing of therapeutics in 1916. In 1917, the American Medical Association resolved that “the use of alcohol as a therapeutic agent should be discouraged.” Even so, more than half of physicians believed it was “a necessary therapeutic agent.” It continued to be available by prescription in dry states. To this day, strong alcohol is prescribed for medicinal purposes in some areas, even by doctors!

Besides the demand for alcohol, the Spanish Flu pandemic shared other characteristics with COVID-19:

  • Wearing masks
  • Social isolation
  • Use of disinfectants
  • Limiting group gatherings, including churches
  • Hospitals and funeral homes were overwhelmed
  • During Spanish Flu the treatment of choice was aspirin, up to 30 grams daily which is a toxic dose; currently, think ingesting bleach or disinfectants.
Bootlegger tunnels in Miami during Prohibition

Bottom line for writers: people use alcohol to self-medicate for stress. The current stressor is COVID-19 BUT consider all the other stressors out there, which might occur alone or in combination with COVID-19: death of a loved one, job loss, divorce, physical illness, mental illness, physical disability, too little money, going hungry, being homeless… Do you have a character who does—who could—self-medicate with alcohol?

INSIDE A MIND WITH PTSD

Posted on by vlaw759

Today’s blog is written by a fellow writer who wishes to remain anonymous for privacy reasons.

Among the many odd things I’ve done in my life, one that has had the most lasting impact is being a linguistic and cultural ambassador posted to a country that shall remain nameless here. Because of various regional disputes, a massive prison outbreak, less-than-polite national elections and regime changes, and a general culture of aggressiveness, I found myself living in conditions that were much more dangerous than I’d been led to expect.

When I eventually returned home, among the souvenirs and keepsakes I brought back with me, I found in my luggage a serious case of PTSD (post traumatic stress disorder). As Vivian’s blog is for writers and writing, I thought perhaps a guided tour inside the warped and broken mind of a person with PTSD might be of interest to you all.

Please keep hands and arms inside the cart at all times, and don’t feed the negativity gremlins as we go past.

Very Important Disclaimer: Neither Vivian Lawry nor this guest author are psychiatric professionals or are qualified to provide medical assistance. The information contained herein is not intended to be used for diagnostic or treatment purposes in any way, shape, or form.

This is basically what the inside of my mind looks like.
(It’s actually the Soul Cairn from the Dawnstar plug-in to Elder Scrolls IV: Skyrim by Bethesda.)

Before the ride begins in earnest, you can look to your left for some basic information about PTSD. The most common association people have with PTSD is of veterans of military combat, but it can result from many different experiences, including natural disasters, abusive relationships, assault (sexual or otherwise), prolonged insecurity, traffic collisions, and so on. People can even develop second-hand PTSD from witnessing these events in other people’s lives. A patient may develop PTSD immediately after an event, but sometimes symptoms don’t appear until well after the event itself.

Common symptoms of PTSD. As soon as I can cultivate a substance abuse problem, I’ll have BINGO! (That’s how it works, right?)

With all of these possibilities, there are loads of ways in which the inclusion of a character experiencing PTSD can enrich, complicate, drive, or drive, or even resolve your writing. There is a lot of information available about the causes and effects of PTSD, but remember that each case is different. Every person will have different triggers, coping mechanisms, involuntary reactions, etc.

You may notice the cart shaking violently as we enter the tunnel; this is simply the result of uneven neural pathways, nothing to be alarmed about.

As a writer and a reader, I’ve found myself thinking of ways in which my warped thoughts and behaviors could fit in with other common narrative techniques. I have also found some absolutely infuriating stories out there in which a character has a traumatic experience (usually rape or sexual assault) simply so the hero can come to the rescue or to establish a villain as a villain… and victimized character goes right back to skipping through the tulips. Don’t be that writer!

by Albin Brunovsky

If you look out on either side of the cart, you may be able to make out (through the erratic strobe lights and general gloom) a few of the ways common behaviors of characters with PTSD could be very useful in your writing. Please remember that these are only glimpses from one mind and do not necessarily reflect every patient. Also, hold on to the lap bar as there are some sharp curves coming up.

Unreliable Narrator: What I see and hear is always filtered through the PTSD in my mind. If a story is told from the point of view of a character with PTSD, this is a good way to demonstrate the disconnect from reality. If another character is getting information from a character with PTSD, it could skew everyone’s opinions and affect the plot moving forward.

What it feels like to walk down the street.
  • Social interactions are a minefield of side-stepping physical attacks (handshakes, hugs, pats on the back).
  • Random strangers only ever approach me with violent intentions, such as petting my dog, asking me to reach something off a high shelf, or walking past me on a narrow sidewalk.
  • People waiting in parked cars are obviously armed, most likely on the lookout for potential victims.
  • Anyone who stands in a doorway must be trying to block the exit or prevent escape.
  • An approach from behind must be someone trying to sneak up on me, and anyone who surprises me from behind is an attacker and will be punched.
  • This isn’t helped by chronic sleep deprivation giving me the same symptoms as early-onset Alzheimer’s: How can I be trusted to provide accurate information when I lose time and forget everything?

Mistaken Motivations: Objectively, I know there is nothing wrong with mental illness, nor should there be any shame attached. Still, I try to hide it or play it off as no big deal. As a result, family, friends, and strangers all have reason to assume my coping behaviors are something very different. Having a character reveal midway through or near the end of a story that their actions were motivated by coping mechanisms could be a plot twist, a clue for investigators, a reset of other characters’ attitudes, or plenty of other ways of adding narrative interest.

  • Friends frequently ask if I’m cold because I can’t stop shaking.
  • Constantly scanning for threats and possible exits sometimes makes me look like I’m trying to find someone or looking for an excuse to leave a boring conversation.
  • Being hyper-vigilant in general makes me look twitchy, itchy, over-caffeinated, or paranoid, depending on who is providing their opinion.
  • My brother thought he’d done something to offend me when I repeatedly moved away from him or left the room when he entered.
  • After I repeatedly panicked and cancelled plans at the last minute, many friends thought I was just blowing them off.
  • Arriving late to social gatherings, hiding in the corner, and leaving early have all led acquaintances to assume I’m too stuck-up to mingle.
  • To make it through particularly important events that I cannot miss, I’ve sometimes taken extra doses of anti-anxiety medication. My slurred speech, unfocused gaze, less than ideal balance, and inability to follow conversation looks an awful lot like I’ve shown up to the baptism or wedding drunk as a skunk.
  • I escape to the bathroom a lot when things get overwhelming, sometimes for extended periods of time. Most of my family now thinks I have severe digestive issues.

Affects in My Life: In order to be diagnosed as a disorder (the D in PTSD) a patient must have symptoms severe enough to disrupt their ability to live a normal life. A character who develops PTSD midway through a narrative would almost certainly show changes in behaviors. These are some of mine.

This is perfectly normal.
  • Chronic insomnia and nightmares: Years later, I still sleep in a separate room from my spouse, with the lights on, with distracting or soothing music playing… and I still manage to wake the household at least once a month by screaming in my sleep.
  • My ability to concentrate and complete tasks on time severely impacted my job. Twice, I responded to a coworker trying to get my attention by panicking and attacking them. Going into the office grew increasingly difficult as it became harder to leave the house. I am now unemployed.
  • Weeks at a time go by when I cannot leave my house, even to go into the backyard. I feel threatened every time I open the door.
  • Side effects from different medications I’ve tried have included weight gain, headaches, heartburn, memory loss, drowsiness, etc. etc. etc. ad nauseam. These could also be examples of mistaken motivations!
  • I no longer participate in hobbies I once did, especially anything that involves leaving the house or interacting with other people.
  • Suicide and suicide attempts are very common among patients with PTSD.

Anxiety Attacks, Panic Attacks, and Flashbacks: These can be triggered by almost anything, depending on the person and the situation. Smelling cigarette smoke, walking on an icy sidewalk, being in a room of people speaking another language I only halfway understand… any of these can send me spiraling. Being under stress increases the chance that something will hit that switch.

Ladies and Gentlemen, we’d like to remind you at this time that motion sickness bags can be found under your seats and to hold on tightly.

It doesn’t look quite as cute when I do it.
  • Anxiety or Panic Attack: It’s really bizarre to be terrified and not know why. Why is my heart racing? Why can’t I breathe? Why can I not stop screaming? When I have an anxiety attack, I don’t think rationally but I can speak and respond to people around me. When I have a panic attack, it feels like I’m about to die. I can’t feel anything but the absolute terror that completely takes over my body. Usually, I am able to leave a situation when I feel one of these about to happen so that I can mentally implode in the peace and quiet of a public urinal.
  • Flashback: These are even more bizarre. Anxiety attacks often segue into flashbacks. I am completely unaware of my surroundings and respond to threats that are long gone. I’ll switch languages to talk to people who aren’t there; I’ll be able to smell the food or feel the cold from specific memories. Sometimes, I have flashbacks that aren’t tied to precise events, more an amalgamation of similar threats that get lumped together in my head. It’s very embarrassing to come out of it and realize that I’m hiding behind a clothes rack in Target, desperately fighting off the attack of a stiff coat sleeve.

Treatment Options: There are many different types of treatments for PTSD, with varying degrees of accessibility, cost, success, and side effects. I’ve tried just about everything: some worked, some did not, some worked at first and then stopped. I can’t stress enough that every person will respond differently to different treatments. The information here is simply what undergoing the treatments felt like for me.

He still can’t change the printer cartridges.
  • Therapy Animal: My dog trained himself to be a therapy dog because he was just that awesome. Before I was eventually laid off, my boss let me bring my dog into the office with me. He learned to impose himself between me and anyone getting too close to my personal space. When I had anxiety attacks, he’d put his head in my lap and nudge my hand until I pet him. Focusing on the feeling of his fur, his cold nose, his super stinky breath worked to calm me down and remind me that I was safe. He passed away in April, and it felt like going through all the trauma again.
  • TMS (Trans-Cranial Magnetic Stimulation): It felt a bit like sitting in the dentist’s chair while a woodpecker tapped on my head. I went every day for three months, and the only side effect was a minor headache when I first started.
  • EMDR (Eye Movement Desensitization and Reprocessing): My eyesight is so bad that I couldn’t do the actual eye movement part of it; I held a buzzer in each hand and felt the vibrations in alternating hands at different speeds. In each session, I relived particularly traumatic events over and over while the therapist guided me through sense memories and varied the speed of the buzzing. By the time the hour was up, I was usually an exhausted, damp, shaking mess running to the bathroom to vomit.
  • Medication: I think by now I’ve tried every different medication type on the market. I can’t even pronounce most of them and have to stutter and hope at the pharmacy. Most gave some relief for a little while and then stopped working.
    • There is now a way in which doctors can send a sample of your DNA to a lab, where people in white coats and shiny goggles can magically determine which medicines will or won’t work for you. I have no idea how they do it; I assume it involves cauldrons and eyes or tails of newts.
  • Ketamine: I was very hesitant to try this method because there have been so few long-term studies. When I started, I went in every day for a week and a half. After that, I went in every three to four weeks depending on how the doctor thinks I’m doing. Ketamine treatment is available through aerosol or intravenously. I sit in a comfy chair with a needle in my arm for about an hour while geometry loses all meaning and everything becomes either fascinating or hilarious. Everything in the universe swirls in front of my face, and the feeling of my hair is the most amazing sensation I can remember. According to the nurse, I tend to wax rhapsodic about how much I love every person who comes through the door. For some reason, they won’t let me drive afterwards!
  • Healing Crystals/ Salt Lamps/ Essential Oils: I had a lumpy pillow, a pink wall, and everything tasted like lavender.
  • PTSD is expensive!

I hope you’ve enjoyed this tour through the mess inside my head. Please wait for the ride to come to a complete stop before unbuckling safety harnesses. Be sure to gather all personal items and take them with you as you exit down the ramp to your right. Don’t forget to check the photo booth for a hilarious souvenir memento of your trip. You can also find resources for actual help; as I’m sure you remember, this has just been an example of some personal experiences for your writing toolbox.