The Highly Sensitive Person & Why it Works

Fox Valley Institute - Counseling for Marriage, Teen, Family, Depression, Anxiety - Therapy and Psychological Testing - Located in Naperville IL

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Meet Karen Cynkar, MSW, MS, LCSW

Fox Valley Institute - Counseling for Marriage, Teen, Family, Depression, Anxiety - Therapy and Psychological Testing - Located in Naperville IL

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A Starting Point For Our Dreams

Remember those resolutions you made?  – Good or Bad – Media tells us 80% of people do not follow through with their resolutions. Well of course we don’t – Creating a resolution is only the beginning and it is a great place to start.

I like to think of resolutions as a starting point to the creation of our dreams, wishes and heartfelt desires. What many of us tend to do though is to not create the specific steps needed to make our dreams come to life. We end up letting our dream be just that– a dream. If we want to be part of the 20% that accomplishes our resolutions we need to be mindful of these five steps:

1. 1) Dream Big – whatever “big” means for you
2. 2) Check your passion/excitement gage – A goal needs to scare you a little and excite you a lot
3. 3) Be specific and write down goals using SMART (specific, measurable, attainable, realistic and time-bound)–this method is excellent to use
4. 4) Tell people who are going to support you about your goals
5. 5) Celebrate every success along the way!

It’s not too late for resolutions. Now go and start dreaming big…..

-Dr. Bokar

A Regular Checkup Is Good for the Mind as Well as the Body

EVERYONE is familiar with the concept of a periodic medical checkup - some sort of scheduled doctor's visit to check your blood pressure, weight and other physical benchmarks.

The notion of a regular mental health checkup is less established, perhaps because of the historical stigma about mental illness. But taking periodic stock of your emotional well-being can help identify warning signs of common ailments like depression or anxiety. Such illnesses are highly treatable, especially when they are identified in their early stages, before they get so severe that they precipitate some sort of personal - and perhaps financial - crisis.

"Absolutely, people should have a mental health checkup," said Jeffrey Borenstein, editor in chief of Psychiatric News, published by the American Psychiatric Association. "It's just as important as having a physical checkup."

About a quarter of American adults suffer from some type of mental health problem each year, according to the National Institute of Mental Health, and 6 percent suffer severe ailments, like schizophrenia or major depression. When left untreated, mental health illnesses are more likely to lead to hospitalization - something that could mean time lost from work.

Ideally, doctors should ask patients about their moods as part of a regular wellness visit, Dr. Borenstein said - there doesn't necessarily need to be a special visit to gauge mental health. But if the doctor doesn't bring it up, patients can educate themselves and start the conversation with their physicians.

Jeffrey Cain, president of the American Academy of Family Physicians, said family doctors were trained to spot symptoms of mental illness, like depression, and he encouraged patients to bring in questions or concerns for discussion. But people don't necessarily go to their family doctor and say they are depressed, he said. Rather, they say they're tired, or that they lack energy, that they're having trouble concentrating or that their body aches - all of which can be symptoms of depression or anxiety.

There are some well-known screening tools that patients can use as a starting point to assess themselves, to help prompt a conversation with their doctor. Dr. Borenstein mentioned a common tool used by doctors to assess patients for depression: a "P.H.Q.," for "patient health questionnaire" He cautioned that the idea here was not to self-diagnose using such forms - there are several versions, varying by number of questions - but rather to self-assess, and then discuss your concerns with a professional.

The P.H.Q.-9, which asks nine questions, was developed by researchers at Columbia University and Indiana University, with help from a grant from Pfizer Inc. The form is available on several Web sites. It asks about the patient's outlook and health habits over the previous two weeks. The first question, for instance, asks patients whether they have had "little interest or pleasure" in doing things and asks them to check a box ranging from "not at all," which scores a zero, to "nearly every day," which scores a 3. A professional computes a total score, which gives more weight to frequent symptoms; the higher the score, the greater the likelihood of significant depression.

Another set of screening tools for depression and other mental health disorders were developed by Screening for Mental Health, a Boston-area nonprofit that creates assessment tools for use by health plans, colleges, the military and the general public. Founded by Douglas Jacobs, an associate clinical professor of psychiatry at Harvard Medical School, the organization grew out of the first National Depression Screening Day, which is held annually each October during Mental Illness Awareness Week.

Mental illnesses have specific signs and symptoms, much as a disease like diabetes does, Dr. Jacobs said, and those symptoms can be identified and treated. Take depression, again, as an example. It's normal to be sad for a while after a personal loss or a traumatic event. But when the effects linger and begin to affect your self-esteem, or interfere with your ability to do your job or handle other responsibilities, he said, you may want to consider if you are suffering from a more serious depression that should be treated professionally - with behavioral therapy, medication or both.

A version of this article appeared in print on November 14, 2012, on page F2 of the New York edition with the headline: A Regular Checkup Is Good for the Mind As Well as the Body.

Finding Your Step In Your Stepfamily Life

Stepfamily Life – Understanding The Dance


You might be thinking that your own blended family looks like a chaotic group of people all dancing to a different tune, stumbling over one another and out of step. It can feel like your partner keeps stepping on your toes. You glance at the kids and find that one of them is drifting away from everyone and lost to their own rhythm, another one is a wallflower who refuses to dance, and yet another child resembles a whirling dervish.

Sometimes it feels like the faster we dance, the more the tempo increases until we are moving at a breakneck blur. It becomes a challenge to just stay on our feet.

I am familiar with all of the missed cues and often clumsy results of this particular dance because I have been part of a blended family.

There is nothing like lived experience to get a crash course on mixing the past with the present. Although each blended family is comprised of unique individuals, circumstances, and challenges, all of them are learning new steps in changing choreography. I remember each stubbed toe, sprained ankle, and bruised shin from trying to get it right. How in the world is it possible for everyone to dance to the new beat?

Psychological flexibility is a hallmark of mental health and it is particularly essential in a blended family. It sure would be great if there was a template to obtain that state of mind. A set of instructions would come in handy when everyone is trying to learn how to dance in a new way.

At one point I would have been thrilled to find a package of dance by number footsteps to stick on the floor. Anything that would provide clues about how to manage the process of where to move without stepping on someone’s toes.

Acceptance and Commitment Therapy (or ACT like a word) is an approach that offers a way to support a healthy and functional blended family.

ACT falls under the cognitive-behavioral umbrella and is a mindfulness-based way of managing life. ACT has decades of research that support it as scientifically valid and effective with a wide range of challenges. At the center of the ACT model is psychological flexibility which is defined as the ability to be present, open up, and do what matters. If your family is determined to learn how to tango, waltz through your time together, or even if your clan seems more suited to a good old-fashioned square dance there is a way to learn the steps.

There are six core processes that support psychological flexibility in ACT. An acronym that reflects how these processes work in our relationships is LOVE

L – Letting go (of resentment, blaming, criticizing, demanding)

O – Opening up (allowing difficult thoughts and feelings)

V – Valuing (i.e. taking action guided by your values such as caring, contribution and connection)

E – Engaging (being psychologically present and available)

Like any new skill set, it takes practice to learn and put these skills into everyday practice. Life in a blended family is filled with changes. With psychological flexibility no matter how many times the music changes everyone is able to keep in step. Using ACT techniques blended families are able to create some exciting new dances to enjoy together. There are resources for ACT online and in print materials. Here are a few I recommend for adults. In addition, there are ACT books and materials tailored for children and adolescents. A mental health professional can also be a great resource to help blended families learn new “choreography.”

Cynthia Avers part of the professional team of counselors at the Fox Valley Institute in the Chicago land area where their mission is to help families grow in health and wellness. Fox Valley Institute is comprised of sixteen professional and dedicated individuals offering individual, children, adolescent, marriage, family and group counseling services. They pride themselves on getting to know each one of their clients personally so that they may help them reach their goals to live a happier and healthier life.

Emotional Unavailability

“Fasten your seat-belt. It’s going to be a bumpy ride” – Bette Davis

When we commit to a relationship, we usually expect that our partner will reciprocate with roughly the same level of emotional involvement that we put into it. Many of us hope to find a soulmate, a partner who can share and understand our feelings and ways of thinking on an intensely personal level. Others don’t expect such an intense level of involvement and feel more comfortable maintaining personal privacy within a more boundaries relationship. Conflicts may arise when the two partners differ in their expectations of how close they should become. One partner may feel emotionally stranded, feeling abandoned and craving more closeness, while the other partner may feel smothered or pressured into providing more of his or her emotional self than can possibly be given.

The course of a relationship follows a predictable path. The early weeks, months, or even years of a relationship, in fact, are a time of togetherness – when partners search for and experience the similarities that bring them together. It is common for a couple during this first phase to experience a level of emotional sharing so intense that they want to carry their relationship to a more committed level. The next stage, however, is when boundaries are established, when we focus on our differences and in maintaining our own individuality. Couples who can negotiate their way through both of these stages are moving toward a successful long-term commitment. Both of the initial stages typify a good relationship – the coming together phase, followed by the firming up of our own identities within the relationship. A solid relationship is one in which feelings can be readily expressed and shared while each of the partners is able to experience a sense of their own identities.

All too often, however, there is a discrepancy between the two partners in terms of how much of their emotional life they make available to the other. When one partner is able to share emotionally and the other is not, it is usually the emotionally available one who feels more pain. Take the classic example of a couple who have an intense courtship. One partner lavishes the other with flowers, expensive dinners out, and intimate phone calls. Sweetness fills the air and it feels like a dream come true. You have finally met “the one” you had always hoped to meet. But then, almost as quickly as it began, your partner fails to reciprocate when it comes to sharing emotional feelings. Dating comes to a stop, voicemail messages are not answered, and it’s over. There is no fight. There is no discussion about why things are coming to an end.

After you accept that it’s over, you struggle to make sense of the relationship and notice that the focus was always on you, and that’s why it felt so good. In fact, your partner knew a great deal about you, but you knew virtually nothing about him or her. You confused flattery and attention with emotional involvement. You may finally realize that your partner was unable to connect with you or anyone on an emotional level. He or she was an expert at luring people in, but had no ability to sustain an emotionally available relationship over time. It is a painful ride, but you can learn a valuable lesson from it – that relationships entail reciprocal self-disclosure and sharing. The next time, you’ll have the wisdom to know this before being drawn in.

There are many other examples of partners who are emotionally unavailable. Consider a few of them –

•     Some people seem to live to do things, the more exciting the better. They are adventure seekers. There’s always one more trip to take, one more skydive, one more mountain to climb. These people get their attention from their conquests, and not by making themselves vulnerable within an emotional attachment.
•     Beautiful people, unfortunately, sometimes grew up with the message that their looks are everything. They may have difficulty engaging in the mutuality of a sharing relationship because they have learned to search for gratification elsewhere. Time may change this, however.
•     Addicts are attracted to a number of different objects (alcohol, drugs, work, food, television, shopping, gambling, sex…), and may not be able to sustain an emotional relationship – not with you, anyway.
•     Some partners are more influenced by their over involved parent than they are with you. You may be seen as an appendage to the primary relationship – which is with the parent.
•     To the intellectualize, emotions are turbulent and unpredictable. Everything has to analyzed, quantified and categorized. Control is everything. Sharing feelings within a relationship is seen as dangerous folly.
•     A relationship with a person suffering from narcissistic personality disorder is one-sided, in favor of the narcissist. They have a sense of grandiosity, a sense of entitlement, and a lack of empathy – so that they are more interested in self-love than love based on mutual sharing.
•     The keeper of secrets probably has some strong boundaries – or walls – in place, and is unable to engage in an emotionally available relationship. If your partner has a private life from which you are excluded, there are probably serious trust issues which undermine the success of a sharing commitment.

Working on Emotional Availability

Emotional availability refers to the ability of a person to share feelings with another person. In order for this to happen, a person needs to be in touch with his or her own emotions and able to define them. This person would have a good working knowledge of his or her own feelings and be able to identify when he or she feels angry, afraid, hurt, sad, happy, or content. Furthermore, the person needs to be able to read these feelings in other people. When these factors are missing, it is impossible for two people to experience an emotionally available relationship. Since people connect through their feelings, one who is out of touch with the emotional realm leads a lonely and isolated life, unable to engage in the processes of nurturance and trust that can be found within a healthier relationship. Fortunately, this condition is correctable.

We learn about emotions starting in childhood, and we continually refine our relationship with our emotions throughout our lives. We learn subtler versions of our basic childhood emotions during adulthood. We learn how to define them, how to categorize them, and how to express them appropriately throughout our development.

An Exercise: If you (or your partner) feel that you need some work in developing your familiarity with your emotions, you might try the following –

Throughout the day, keep a record of anytime you feel a certain emotion. Keep your list of emotions simple (e.g., “glad,” “sad,” “mad” or “bad – afraid or guilty”). Anytime you feel one of these emotions, identify the time of day, the emotion you’re feeling, and the circumstances surrounding the emotion (i.e., what was going on when you felt the emotion). Later, with your partner, a trusted friend, or your therapist, go through your list and share what you’ve written down. First identify what was going on when you felt a certain emotion. Try to understand why the event led to this emotion. Next, describe how the emotion feels within your body. Finally, after you have completed your list, talk about how it feels to share your emotional feelings with another person.

In addition to becoming familiar with your emotions, there are three other elements that are related to developing the capacity to be emotionally available –

Good Self-Esteem – The messages we have heard from other people throughout our lives – but especially during childhood when we are most vulnerable to the impact of these messages – have a profound influence on how we see ourselves. If people tell us that we have negative qualities, we eventually internalize this message and begin to see ourselves in a negative light. On the other hand, if we are treated with high regard from others as we grow up, we can develop positive self-esteem. People with good self-esteem value themselves, are confident in expressing themselves, and can engage in healthy reciprocal relationships with other people. Positive self-esteem allows a person to treat other people with high regard and to value the accomplishments and achievements of other people without feeling threatened. People with positive self-esteem like themselves, and, in turn, can like other people as well. They can make themselves emotionally available to another person.

Healthy Boundaries – Good boundaries show that you respect the individuality, personal space and privacy of other people – as well as your own. This ability, again, is developed most strongly in childhood, but is refined throughout our lives. People with poor boundaries intrude into the lives of others so that other people don’t feel safe around them. They gossip, reveal secrets, meddle into the private affairs of others, and, in general, fail to show respect for the dignity of other people – as well as themselves. People who grew up in households with poor boundaries have never been able to develop a sense of their own individuality or a sense of separation from their family members, so in adulthood they have difficulty honoring another person’s space. A person with porous boundaries may be emotionally unavailable because, in a sense, they are too available – so available, in fact, that they lack a clear sense of who they are. In order to be emotionally available to another person, you need a good sense of your own self that you protect. When you have good boundaries, you are able to protect the healthiest parts of both yourself and your partner.

The Ability to Trust – One of the core attributes we develop from the families we grow up in is a sense of safety. When we feel safe, we are able to trust in the world. But when we feel abandoned, rejected, or controlled, trust can become an issue for us in later relationships. And when our ability to trust is damaged, we may feel safer by walling ourselves off from our partner – and thus become emotionally unavailable. Trust is a deep issue that requires exploration and understanding, as well as some courage when we are finally ready to attempt to trust other people. The development of trust can be facilitated by working with a professional therapist in a setting that feels safe, and it may be a necessary step in making yourself emotionally available to your partner. When a person makes a commitment to us in a relationship, we owe that person respect – and that means making ourselves emotionally available to those who love us.

Attention Deficits – Living with ADD and ADHD

Most people with Attention Deficit Disorder don’t know they have it. Indeed, the disorder was not recognized until the 1980’s, and it was not until the 1990’s that the recognition of adult ADD was established. However, it is a condition that can have a significant impact on the way a person functions in the world. Unfortunately, Attention Deficit Disorder is poorly named. It is not so much a disorder as it is a difference in the way some people process information and focus their attention. And to call it a deficit fails to recognize the many strengths that these people have. ADD, however, is perhaps a better name than the old word for it – minimal brain dysfunction.

Researchers used to think that what they called “hyperactivity” was a condition found in childhood that was outgrown during adolescence. We know now that about one-third of children with these symptoms outgrow them during adolescence, and the other two-thirds continue to show symptoms into adulthood. Adult ADD is the topic of much current scientific research, and many adults are now able to put a name on what for them has been a lifetime of feeling misunderstood. The professional community now recognizes two variants of this condition – the “hyperactive” type (often referred to as Attention Deficit Hyperactivity Disorder or ADHD) and the “inattentive” type (commonly referred to as ADD).

Although not much is known today about the causes of ADD and ADHD, researchers agree that it is a neurochemical disorder, and it likely has a genetic component. That is, it tends to run in families. In fact, many adults with these symptoms don’t know that it has a label until one of their blood relatives is diagnosed with the disorder. It occurs in women and men, boys and girls, adults and children. It cuts across socioeconomic strata, income levels, educational levels, and levels of intelligence. It is not the same as a learning disability, dyslexia, or a language disability, and it is certainly not associated with low intelligence. Poor parenting, early trauma, labeling, or other psychological factors do not cause ADD. There may be, however, significant psychological problems that develop from growing up with the disorder.

The ADD/ADHD Experience

Think of ADD and ADHD as the inability to turn off stimuli. Most of us are able to block out information from our environment, and this keeps us from becoming overwhelmed. For example, if we are trying to concentrate on a book, we tend to block out sounds from music or television in the background. If we are trying to listen to a teacher’s lecture, we don’t pay attention to what we see outside through the window. We tend to focus on one line of thought at the time to keep ourselves from becoming confused and chaotic. The person with ADD or ADHD, on the other hand, cannot turn off these external stimuli as well as most people (although they certainly block out most stimuli). Their lives become a struggle to filter out and manage the oversupply of information they have to deal with. What they are trying to do is to protect their sensitive inner selves. If the amount of information from their environment becomes overwhelming, they can become overstimulated. “Hyperactivity” is simply the response of the nervous system to an onslaught of stimulation.

This brings us to the three defining symptoms of ADD and ADHD –

Distractibility – is usually associated with the “inattentive” type of attention deficiency, although it is found in both ADD and ADHD. Rather than focusing on one thing, the mind wanders to different arenas. Daydreaming is one of the defining characteristics of ADD. In conversation, the person may jump from topic to topic. In class, a student listening to a lecture suddenly finds herself looking out the window and then having fantasies about her upcoming summer vacation.

Other symptoms associated with distractibility include:

Inattentiveness to details

A tendency to misplace belongings

Difficulty in completing tasks once they are started

Avoidance of tasks that require concentration

Poor ability to plan

Forgetfulness

Disorganization

Impulsivity – is found in both types of attention deficit, ADD and ADHD. Most of us have the ability to insert a thought between a stimulus and our response to the stimulus. That is, we are able to inhibit our responses by thinking things through. Although people with ADD/ADHD are able to inhibit their impulses most of the time, at times they feel overwhelmed with stimulation and they simply take action without thinking about the consequences. This is why people with ADD or ADHD are quickly aroused to anger.

Other traits associated with impulsivity include:

Poor interpersonal boundaries (e.g., intruding when somebody is speaking)

Blurting out a response before a speaker is finished

Difficulty in waiting for one’s turn

Hyperactivity or Excess Energy – is found more frequently in ADHD than in ADD, by definition.It occurs when the nervous system is unable to cope with an oversupply of stimulation that cannot be controlled or filtered out. Rather than channeling this energy into daydreaming, the person stays connected to the energy and increases bodily activity.

Other Characteristics of ADD and ADHD

There are many other characteristics found in people with an attention deficit. (Most of us experience at least some of these in our day-to-day lives, so it is not advisable to conclude that you have ADD if some of these items describe your behavior.) These include:

• Problems managing your time (not giving yourself enough time for a task)
• A tendency to take on too many tasks at the same time
• Difficulty in concentrating when reading or watching a movie
• Problems managing finances and balancing a checkbook
• Difficulty controlling temper
• A history of underachievement and not meeting one’s goals
• A history of periodic depression starting in adolescence
• Depending on other people to take care of life’s details
• Frequent moving and changing jobs
• Difficulty with long-term relationships
• A low tolerance for frustration
• A tendency to stay up late and rise late
• Losing track of the conversation when someone else is talking
• Chronic procrastination
• Frequently searching for high stimulation experiences
• Hyper focusing at times to compensate for difficulty in maintaining attention
• A sense of insecurity
• Problems with negative self-esteem
• A tendency to worry
• Mood swings, especially when not engaged in an activity
• A tendency toward substance abuse (especially caffeine, cocaine or amphetamine)
• If you have many of these symptoms and are having difficulty in everyday living because of them, you might want to consider an assessment by a trained professional. Treatment for ADD and ADHD is generally effective and can have a highly positive effect on the quality of your life.

Other indicators of hyperactivity include:

Fidgeting (playing with fingers, feet constantly moving, toe tapping)

Restlessness

Difficulty engaging in quiet activities

A pressured need to talk

It may seem that having ADD or ADHD is a negative experience, but this need not be the case. In fact, many creative people and well-known historical figures probably had an attention deficit. For example, it has been speculated that Albert Einstein, perhaps the greatest mind of the twentieth century, suffered from ADD. He certainly had difficulty in his early school years, as do many people with ADD. But he also had many of the positive qualities found in people with this disorder. For example, people with ADD tend to be creative, energetic, talkative, socially aware, insightful, spontaneous, and enthusiastic. Once a person learns how to contain the symptoms that cause problems, the positive qualities can surface. In fact, with the proper treatment, people with ADD and ADHD can live productive, normal lives.

Some Considerations in Dealing with ADD and ADHD

People who suffer from ADD and ADHD, through no fault of their own, often cause difficulty for other people. Their minds might wander during a conversation, they might blurt out remarks, which are inappropriate to the situation, or they never show up on time for appointments. During childhood they might create difficulties for both parents and teachers, especially when their activity level is high. Schoolchildren with ADD may daydream frequently in class or may have trouble following a logical line of thought. They put off working on assignments and then turn them in late or not at all. It is easy to understand why people with attention deficits invite anger from other people. Other people often label the sufferer mercilessly and do everything in their power to coerce more appropriate behavior. The ADD sufferer is frequently treated in a thoughtless, and often brutal, manner by others.

People with ADD or ADHD are sensitive. They are highly aware and are bombarded daily with stimulation

that they need to manage. Their goal is to protect their fragile inner lives. Life becomes a struggle to maintain a balance between the integrity of the inner world and the onslaught of stimuli from the external. This struggle is intensified when they must deal with negative feedback from other people. Thus, people with attention deficit disorders often have to deal with self-image issues and depression. They constantly hear feedback telling them that they are intrusive, out of control, or low achievers. They end up feeling lonely and isolated. As they internalize the negative messages they hear from others, they begin to feel that way about themselves.

Because of the negative way the world tends to treat them, people with attention deficits develop psychological problems, even though ADD and ADHD have biological causes. Fortunately, a trained professional therapist is able to work productively with clients on these issues in a safe and understanding setting. Once a person with attention problems makes the decision to find treatment, a more normal and easier life lies just ahead.