anxietyTag Archive -

Watch out for Green Trucks!

When I was about 9 years of age I saw my cousin get hit by a car. This was one of those moments when time felt as if it was placed in slow motion. I remember we were both playing outside in the middle of a residential street. I remember crossing to the other side, turning around and signaling to my cousin to wait as I saw a green truck quickly approaching our direction. But being the little dare devil that he was, he decided to take his chances against the moving green truck.

My cousin John is a couple years younger than I am and because of our age difference I always felt the need to protect him. On this day however, I failed him miserably, or so I told myself for many years.

The truck was not able to stop in time.

::: heart beat ::: ::: heart beat ::: and then a deep breath which I held until I felt someone’s hands on my shoulders.

The front bumper hit his upper body which was thrown about 10 feet up in the air and rolled an additional 20-30 feet in front of the truck.

For years, I could smell the rubber, close my eyes and see the pattern of the tire marks on the asphalt. I stood there in disbelief as I heard screams coming out of the house that were rushing towards his damaged body.

He survived but for the longest time, I played the “if only…” game.

If only I had not crossed the street…
If only I had decided for us to play indoors rather than outdoors.
If only I had more persuasively urged him to stay on his side of the street…
If only…

I am convinced that one of the things that keeps us emotionally, relationally and spiritually stuck is this type of mental gymnastics. We’ve bought into the lie that ruminating, carefully studying past events or rehearsing what we wish we had said after the fact could perhaps better equip us for the next time. We convince ourselves that reviewing these mental tapes will prevent future hurt, rejection or loss.

Yet, no matter how much we strategize our worry, many of us end up jobless, childless, spouseless or joyless. Maybe you can empathize with the man who gets anxious about dropping off his resume at a new place because doing so reminds him of what it felt like to hear those dreaded words, “we’re gonna have to let you go.”

Maybe you can empathize with the couple who isn’t ready to give up on the idea of becoming parents but who’s pain from their recent miscarriage injects them with fear, anger and insecurities about trying again.

The truth is that so many of us live in the regrets of the past or the anticipation of the future and it’s keeping us from fully showing up in our present.

What about you?

  • What past life events are defining your present and dictating your future?
  • Who are the people and what are the circumstances that have kept you from dreaming, trying or risking again?
  • When will you give yourself permission to put down the internal remote control that keeps replying certain life moments and triggers your deepest “if only” moments?
  • What’s been a green truck moment in your life?

Image credit: Clare Carver

When Perfect Isn’t Good Enough

During our family vacation this year, I picked up a copy of the book, When Perfect Isn’t Good Enough.  It caught my attention because I have not seen very many titles addressing the issue of perfectionism.  To tell you the truth, for many years I have rationalized, minimized and relabeled my own perfectionistic tendencies and inner struggles.  I’ve described myself as a person who is driven to excellence, passionate or as someone who cares about quality.  While there is an element of truth to those descriptions, hidden between those words has been a noticeable presence of subclinical perfectionistic ideals and standards that over the years I’ve had to challenge and change.  So whenever an individual comes to my office, it’s fairly easy for me to spot those perfectionistic tendencies as they begin sharing with me their life struggles.  But have you ever wondered what is the difference between having appropriately high standards versus suffering from perfectionism?

In his Psychology Today article, psychiatrist David Burns defined perfectionists as people “whose standards are high beyond reach or reason” and “who strain compulsively and unremittingly toward impossible goals and who measure their own worth entirely in terms of productivity and accomplishment” (2).  According to Martin Anthony, Ph.D. and Richard Swinson, MD., there are several factors that measure the appropriateness about performance including the excessiveness of the standard (i.e. is this an attainable and realistic goal?), the accuracy of the belief (i.e. must this standard be met?), the cost and benefits of imposing the standard (i.e. is it helpful or beneficial for me to have this belief or standard?) and the flexibility of the standard (i.e. can I adjust and change if and when necessary?) (1).

Silvia was a 32-year-old mother of two who struggled with clinical perfectionism.  From the moment she would wake up, she would have a running “to-do” list on the back of her mind.  Her routine was so predictable and extensive that any little interruption (i.e. salesman at the door, phone call and even from her children) would throw her into anger outbursts.  Daily, she would vacuum the house, change bed sheets, pick up toys, work on the yard, wash dishes, workout, make dinner, put the kids to bed and so on.  In fact, with tears in her eyes, she confessed to me that, if for some reason she would fall behind doing her chores, she would resume her duties after putting the kids in bed – meaning she would wash her windows till 2 AM.

Susanna was a 19-year-old college student who made it a habit to write all of her assignments in pencil saying, “That way I can erase if I make mistake.” She had a difficult time making decisions out of fear she might make the wrong one.  Even though she was a high achiever, she would often procrastinate work assignments out of fear she might do them imperfectly and then fail.

Lilyan was a 24-year-old single woman who was afraid of germs.  If she went out, she would plan her day around her perceived restroom needs because she would not allow herself to use public restrooms.  “Can you imagine how many millions of germs are in the doorknobs alone?” she would say with a tone of concern in her voice.  Lilyan would compulsively wash her hands because, in her perfectionistic thinking, doing so would mean avoiding contamination and potential death.

“A person who has perfectionistic thoughts about cleanliness may have excessive beliefs that are inaccurate, inflexible and cause more harm than good” (ibid).  For example, it is expected that a surgeon would wash his hands throughly before a procedure.  This scenario demands that his standards of cleanliness are raised; however, that same surgeon may lower his standards of cleanliness if he and his family camp in the wilderness for several days.  Although not preferable, a non-perfectionistic thinker would tolerate being less than clean and thus demonstrate flexibility in the midst of imperfect circumstances.

perfectionism / Family Insights / Cesar Gamez

Areas Prone to Perfectionism

Work and School

  • Do you become angry and frustrated when employees arrive a few minutes late?
  • Do you spend too much time doing a task – often checking and rechecking it?
  • Do you demand perfect performance from your employees or team members?
  • Are you constantly pushing your employees to do more, go faster, reach farther?
  • Do you have difficulty giving praise without also pointing out areas where growth is needed?
  • Do you experience depression and changes in mood that last longer than a week if you get less than an A on your report card?
  • Do you have a hard time delegating because you feel others won’t do as good of a job?

Neatness and Aesthetics

  • Have people commented about your rigid beliefs as to what looks good?
  • Do you have conflict with a roommate, friend or spouse because they are not cleaning to your standards?
  • Do you have a need to organize and categorize things in a particular way (i.e. color, texture, shape, etc)?
  • Do you make constant lists?

Physical Appearance

  • Do you have rigid views and standards about weight, body image, fashion, clothing and make-up?
  • Do you spend hours getting ready?
  • Do you have a difficult time picking outfits because you’re looking for “just the right one,” even if it’s an ordinary day?
  • Have you ever ended relationships because there was something “wrong” with them (i.e. their nose, their voice, their laughter, etc)?

Health and Personal Cleanliness

  • Do you sometimes restrict food intake if you feel that eating what’s being offered would be to compromise your health standards?
  • Do you obsess about organic and “pure” foods?
  • Do you struggle with over-exercising?
  • Do you avoid some electronics out of fear of radiation?
  • Do you wash your hands excessively or take multiple showers in a day?

The problem with perfectionism is that it tends to suck the joy out of meaningful endeavors.  A previously enjoyed instrument becomes a source of conflict in a family when perfect performance is demanded with every practice.  A previously enjoyed sport becomes a painful chore when perfectionistic beliefs by the athlete, the coach or the parents become the standard whereby approval is given or denied.  What was once a desire suddenly becomes a duty.  You see, there is a difference between perfectionism and excellence.  Perfectionism is rooted in the fear of failure while excellence is rooted in personal passion. Have you lost your passion?

If you suspect you may struggle with perfectionism, getting help and information is a good step towards addressing the issue.  You may want to pick up a copy of “When Perfect Isn’t Good Enough.”  Also, depending on the severity, inflexibility or interference of your beliefs and behaviors, you may consider visiting a licensed professional counselor in your area.  The danger with perfectionism is that it tends to spill into multiple areas of life such as relationships, commitments, career, school and even our “down time.”  In some cases, perfectionism shows up as a personality trait (Obsessive Compulsive Personality Disorder), not just in obsessive and compulsive behaviors.  Maybe it’s time you challenge your own perfectionistic tendencies.  Take a risk today!

Copyright © 2009 Cesar G. Gamez, MA., All Rights Reserved Worldwide.

Note: The names and identifying characteristics of the people discussed in this blog (i.e. case studies or relationship examples) have been significantly altered and changed to protect their privacy and identity.

References

1. Anthony, Martin M., Ph.D., & Swinson, Richard P., MD. (2009). When Perfect Isn’t Good Enough. Oakland, CA: New Harbinger Publications, Inc., 12-13.

2. Burns, D. D. 1980. The perfectionist’s script for self-defeat. Psychology Today, November 34-57.

What You Need To Know About Orthorexia

In his 2004 American documentary film, Super Size Me, Morgan Spurlock embarked on the journey of taking an honest look at the obesity problem in America, pointing its finger at the unmoderated consumption of fast food as the culprit.

The saying, “you are what you eat,” reminds us of the importance of being mindful about what we put in our mouths within the context of balance, variety and moderation.  Considering the myriad of diet products and advertisements that we are constantly inundated with (promising big results if we can only stop “being bad” with food), being health conscious and vigilant about healthy eating patterns is unlikely to raise concern from our loved ones. However, in recent years, increased attention has been given to a new term to describe a fixation on healthy food and the obsessive pursuit of the perfect diet: Orthorexia.

Steven Bratman, MD, coined the term orthorexia nervosa to describe a fixation on pure or righteous eating.  Orthorexics, unlike anorexics or bulimics, are not enticed into restrictive behaviors in order to lose weight; instead, the goal is to achieve a feeling of perfection and purity.  This obsession with organic or biologically pure foods prompts rigid and restrictive eating patterns.  Foods that get categorized as unsafe, bad, or wrong, are both avoided and removed from meal plans.  If these foods are ever consumed, the person experiences guilt, shame and anger towards self. He/she is likely to self-punish for breaking their food rule and become stricter with their dietary plans.  Because these obsessions are real and hold meaning, individuals struggling with orthorexia have a difficult time enjoying social activities or family gatherings where a variety of food (unsafe food) is present.

Such people are sometimes affectionately called “healthfood junkies.” However, in some cases, orthorexia goes beyond a mere lifestyle choice. Obsession with healthy food can progress to the point where it crowds out other activities and interests, impairs relationships, and even becomes physically dangerous. When this happens, orthorexia takes on the dimensions of a true eating disorder, like anorexia nervosa or bulimia.

Source: http://orthorexia.com/Index.php?page=katef

According to Bratman’s research, orthorexia sometimes holds a spiritual component that drives this extreme healthy eating commitment.  These inner rules are often rooted in the belief that consuming organic foods will make a person cleaner, or in some ways, more righteous.  Some individuals admit feeling a sense of superiority over others and/or perceiving themselves as able to live by higher standards in obedience to God’s calling to pursue purity and perfection.  The obsessions and rigid food rules are often rationalized through overspiritualized statements such as, “I’m just a good steward of the body God gave me,” or “my body is the temple of God, so I need to take care of His temple.”  Therefore, the idea of consuming food that has been scientifically altered is experienced as an unwise and deliberate choice to mar what God created to be enjoyed in its original state.

Some of the following Biblical verses are often quoted to defend health-food obsessions:

Do you not know that your body is a temple of the Holy Spirit, who is in you, whom you have received from God? You are not your own; you were bought at a price. Therefore honor God with your body.

I Corinthians 6:19-20 NIV

So whether you eat or drink or whatever you do, do it all for the glory of God.

I Corinthians 10:31 NIV

We always carry around in our body the death of Jesus, so that the life of Jesus may also be revealed in our body.

II Corinthians 4:10 NIV

For it is written: “Be holy, because I am holy.”

I Peter 1:16 NIV

The children of Israel were given a set of strict dietary laws at Mount Sinai.  These were recorded by Moses in Leviticus chapter 11 and Deuteronomy chapter 14.  As you read through these laws, you will noticed some food items categorized as “clean” and “unclean.”  The food laws were ritualistic, and most theologians believe that one reason for giving the laws of clean and unclean meats was “holiness” (See I Peter 1:16).

16832It is important to note that orthorexia is not a part of the current edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) and that much controversy and debate surrounds the idea of giving it its own designation in the manual.  While those of us who specialize in the treatment of eating disorders can attest this fixation is real in some of the people we treat, there is a recognition that due to the insufficient research data that currently exists, orthorexia may not have its own diagnostic category any time soon.  What is concerning is that orthorexic symptoms appear to be increasingly common.

If you or someone you know struggles with orthorexia, an assessment by a professional mental health clinician would be highly recommended.  Whether or not orthorexia is seen as an eating disorder type, the emotional distress, obsessions and compulsions surrounding orthorexia may be an indicator of anxiety or OCD issues.

Copyright © 2009 Cesar G. Gamez, MA., All Rights Reserved Worldwide.

How To Regulate Your Emotions

Feeling feelings feels uncomfortable for a lot of people.  The truth is that many of us grew up in families that somehow taught us that our feelings and the way we express those feelings are synonymous with each other.  As a result we’ve learned to think of anger as explosive, hurt as crying, anxiety as attacks and shortness of breath and depression as staying in bed.  However, our feelings and the way those feelings are expressed are not the same.  In fact, we can experience anxiety without attacks, emotional pain without crying and anger without punching walls.

Feelings these feelings can be scary for a lot of people for a couple of reasons.  First, many of us grew up in homes where we were taught or asked to control our emotions.  Some familiar statements might be, “suck it and be a man,” “don’t get too excited,” “stop crying,” and “stop your whining!”   And yet, what we discovered along the process of doing life is that shutting off emotional pain and tears is not as simple as making oneself stop.  Over time, many of us have learned to mask and hide our truest emotions like disappointment, anger and sadness behind a “poker-face,” workaholism, intellectualization or spiritualization.  Unable to control those feelings, many people punish themselves, become guilty or just choose to escape by numbing out.

Second, people who fear feeling feelings often times grow up in homes where feelings were explosive, chaotic and uncontrollable.  Therefore, the only genuine frame of reference they have is that anger = yelling, cursing, violence or that depression = drug abuse, prescription medication addiction, emotional detachment or abandonment.

The way emotions were modeled for us as children by our parents has an influential power in dictating how likely we are to manage similar emotions as adults.

If you are willing to develop a greater level of confidence over your ability to regulate and reduce your emotions, then consider the following steps.

1. Honor your feelings. This simply means that you stop fighting your emotions and you simply accept them.

2. Attach meaning to your tears. Feelings are sometimes manifested through tears.  When they show up, ask yourself, “what are my tears trying to tell me?”

3. Learn to label your emotions. Don’t settle for non-emotionally descriptive words like “good,” “alright” and “okay.”  Instead develop an emotional vocabulary so that you are able to identify a variety of emotional experiences.

4. Learn to identify emotional intensity. When people don’t develop proper emotional awareness, they often find themselves going from zero to sixty in a matter of seconds.  Have you ever met people who are content only to turn explosive in a matter of seconds after a simple comment?  When you develop an ability to rank your emotional intensity on a scale of 0 to 10 or 0 to 100, you will be able to notice when your emotion is getting to dangerous levels.

5. Learn to self-care. Work with your therapist to develop appropriate grounding skills like setting boundaries, breathing exercises and distracting techniques that will enable you to stay safe and in control of your feelings even when they become too intense and hard to handle.

Copyright © 2009  Cesar G. Gamez, MA.  All Rights Reserved.

Seven Ways To Decrease Your Child’s Back-to-School Anxiety

The end of summer is quickly approaching, and preparations for a new school year are underway.  While some children experience excitement about seeing old friends, going to a new classroom and having a new teacher, other children experience fear and anxiety about those same changes.

Over the years, I have studied how some families prepare their children in such positive and proactive ways that their efforts result in happier and more self-confident children.  Their intentionality has been both inspirational and contagious, so much so, that, as my own daughter begins her own academic journey this Fall, my wife and I have started implementing these important steps that I believe can ease a child’s concern and anxiety about going back to school.

1. Talk about school positively.
Parents are very influential.  It’s important that your child hears you talk positively about the idea of returning to school.  Highlight the positive outcomes of the upcoming changes such as new friendships, having a new teacher and new learning experiences and opportunities.  Let your child hear and sense in your voice that education is something that you value.

2. Do learning projects together.
For some children, summertime is an opportunity to take advantage of experiential learning, such as going to camp; for others, it’s an opportunity to sharpen athletic abilities.  As a result, your child may be out of the habit of challenging her discipline and academic skills like she does in the classroom.  A few weeks prior to the start of school, consider completing learning projects together that will challenge her mind, such as simple writing assignments regarding what she enjoyed about her summer, a favorite memory and even hand-written letters to friends she met at camp.  Other activities may include art projects, scrapbooking, completing a puzzle, learning a new vocabulary word together and doing simple math assignments.

3. Get into a routine before school starts.
Waiting to get your child in the habit of going to bed the night before school starts is almost a recipe for disaster.  Start these necessary school habits a few weeks prior to the beginning of the new school year in order to get yourself and your family adjusted to the new schedule.  Doing so is likely to minimize tension, anxiety and frustration during the first few weeks of school which is also likely to have positive implications on your child’s ability to focus, concentrate and thrive in the midst of change.

4. Involve your child in back-to-school responsibilities.
Just like you want to be intentional about talking positively regarding the new school year, you also want to make this transition as much fun as possible.  You can accomplish this by involving your child in the multiple back-to-school responsibilities such as shopping for school materials, selecting new clothes and giving her the freedom to pick her outfits for the first week of school.  Even if your child attends a school with a strict dress code, there are typically many creative ways for your child to personalize her look (i.e. colored shoelaces).  Check with your school before making any assumptions.

5. Listen & validate your child’s emotions.
Your child is likely to fall under three categories: He will either be excited about going back to school, have mixed feelings or experience higher than normal levels of anxiety.  It is your job to find out where he is so that you know how to help him.  You can do so by listening to his concerns and validating his emotions through safe means like reading a child’s guide to anxiety book (refer to the resources at the bottom of the page).  Reading a children’s anxiety book together will go a long way toward normalizing their experience.

Do your best to avoid the common conversation pitfalls:

  • Aggressively questioning, “Why don’t you want to go back to school? What’s wrong? Tell me.”
  • Giving reasons, “You have a lot of friends there. What’s the matter?”
  • Giving advice, “Just do it. You did it last year and you got through it. Be yourself.”
  • Minimizing, “You’re afraid now, but you’ll be okay after your first week, and your fear will go away.”

Instead, listen. Invite your child to express her feelings, and give a strong dose of empathy in the process.  You could open the dialogue by doing one of the following:

  • Ask open-ended questions: “What about going back to school makes you feel anxious?”
  • Validate feelings: “You are feeling pretty anxious about returning to school.”
  • Invite your child to talk about her concerns in a safe home environment: “It sounds like you are concerned about returning to school. Help me understand what about going to school feels scary to you?”  Depending on the age of your child, invite her to problem-solve by asking her, “How can I support you during this difficult time?” or “What do I typically do or say that feels like support to you?”

6. Create an Affirmation system.
An affirmation system is a way for you to stay present and connected with your child even when you are not physically around to say, “You are safe. I love you.”  The affirmation system is fast and simple to implement.  Your system may include an “I love you” post-it note in her lunch box, a small family picture she can easily pull out from her backpack when feeling lonely, an electronic pen with a recorded voice message or an index card with a simple positive affirmation.

7. Keep balance in the home.
As much as possible, do your best to keep normalcy in the home by creating predictable routines such as eating dinner together, establishing a consistent bedtime and picking up your child on time.  Faith plays a significant role in many families, and it can be a “constant” in the home in the midst of change and perceived chaos. Some families pray together, attend a midweek service or read Scripture before bedtime.  Try to keep healthy patterns in your home as much as possible during the beginning of the school year.

Bonus: Host a back-to-school party
Consider hosting a back-to-school party within the first two or three weeks into the school year.  Doing so will give you an opportunity to socialize with other parents and get to know your child’s friends.  For some great party ideas, visit the Oriental Trading Company, Party America or PartyPro.

Copyright © 2009. Cesar G. Gamez, All Rights Reserved.