Assertiveness and Anxiety: How Expressing Yourself Can Lead to a Happier Self

By: Sanjita Ekhelikar

“Communication is key” is a phrase we are all familiar with, yet many struggle with actually acting on it. The most effective form of communication is through assertiveness, which involves expressing one’s views in a straightforward manner, and in standing up for one’s needs while still being considerate of others. This differs from aggressiveness in that it does not involve being outwardly emotional or insulting to others, and differs from passivity in that the individual clearly states their feelings and desires. Being assertive involves open communication, which can be difficult to engage in, especially for people struggling with anxiety. However, through practicing and learning assertiveness, people with anxiety can actually feel less worry and more confident in themselves.

Anxiety describes the uncomfortable feelings of turmoil and dread that one might have in anticipation that results in physical sensations such as rapid heartbeat, sweating, and rumination. For many who struggle with anxiety, the thought of being assertive with others makes them anxious. They often worry that being assertive will come off as being mean, creating conflict, and being inconsiderate. Therefore, many choose passive communication, and never voice their views or feelings. This worsens their state of worry, as they are not properly understood by those around them and can easily be taken advantage of. They are often misunderstood which increases their worry. Others often take advantage of them because of their meek manner and visible anxiety.

Contrary to what those with anxiety believe, assertiveness can actually help them feel better. Often times, those with anxiety create situations in their mind about everything that will go wrong if they voice themselves to another person. However, such a form of open communication can create a better understanding between two people. It allows the person with anxiety to be properly understood, to dispel the fearful thoughts in their head, and become more confident in themselves and their views.

How can people with anxiety begin working towards being more assertive? By stating their views using “I,” individuals can avoid putting blame on others by expressing their own opinions. In addition, reminding themselves that their fears are not rational and that it is their anxiety talking to them can help them become increasingly comfortable with being assertive. Finally, practice makes perfect – keep trying and speak up!

If you or someone you know is suffering from anxiety, please contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, or psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, please visit http://www.counselingpsychotherapynjny.com/.

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Neurofeedback

Leah Flanzman

There has recently been a great deal of discussion on a psychological treatment called neurofeedback. Neurofeedback assists people in consciously controlling their brain waves by attaching subjects to an EEG machine that extracts various brain-activity components and feeds them back to the patient.  The most common protocols used in neurofeedback training are alpha, beta, theta, and alpha/theta protocols.  The way that you select the placement of electrodes on a patients head depends on their specific brain functions and specific symptoms.  The goal is to allow the subject to assess their progress and adjust their brain waves accordingly to achieve optimal performance.  However, the effectiveness and practicality of the treatment is under debate.

According to the Basic and Clinical Neuroscience journal, many studies conducted on neurofeedback therapy reveal methodological limitations that question its effectiveness. For example, with the alpha treatment protocols, it remains unknown exactly how many treatment sessions are necessary before patients can consciously possess the ability to control their alpha waves.  Once an optimal performance is achieved, it’s difficult to study the long-term effects of these treatments, in other words how long the effects last without feedback.

The pros of neurofeedback are that it’s a safe and non-invasive procedure that has been proven effective in treating certain disorders such as ADHD, anxiety, depression, epilepsy, insomnia, drug addictions, and learning disabilities. Despite this, more scientific evidence of its effectiveness must be conducted before we can consider it a valid treatment.  It’s also important to keep in mind that it’s a very expensive procedure that is not covered by many insurance companies, and is very time consuming to complete.

If you or someone you know thinks they have ADHD, anxiety, depression, or drug addictions, or learning disabilities, the psychologists, psychiatrists, and psychotherapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.counselingpsychotherapynjny.com for more information.

Narcissistic Personality Disorder

Isabelle Kreydin

You’ve heard about bipolar personality obsessive-compulsive disorder, paranoia disorder, and probably a handful of other ones. One of the less uncommon and less discussed one is narcissistic personality disorder. This is a mental condition in which a person has an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others.

What lies behind the disorder? Behind the mask of extreme confidence, arrogance and/or pompousness there is a fragile self-esteem that’s vulnerable to the slightest criticism, insult, or contempt. They may find their relationships unfulfilling, and others may not enjoy being around them when they feel the persons need for superiority which can lead to actions and words of disrespect.

Why does this disorder get diagnosed? Most believe that the causes are due to genetics as well as social factors, and the person’s early development such as family, personal temperament, school system, and learned coping skills to deal with stress.

What are some more possible symptoms? It’s their way or the highway, they won’t ever be wrong in situations, and if they admit to be wrong, they will put another down just in order to convince themselves that they are in the right, they can have ease lying; they can charm, falsely accuse, mooch, betray, mirror, compete, destroy, and manipulate easily. They are known also to commonly abuse drugs, alcohol or nicotine.

What problems does this disorder cause? It causes unstable and trouble in relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy, and may take this out on another human and gain the personality trait that is sadistic.

How can we help the issue? After acceptance, treatment of this personality disorder typically involves long-term therapy, possible medication, and continuing to relate better with others in relationships, working towards empathy, understanding the cause of ones emotions and what drives one to compete and distrust, practicing tolerance, and trying to release ones desire for unattainable goals and ideal conditions.If you or a person you know is struggling with a narcissistic personality disorder, or any personality disorder, it may be beneficial to have them contact a mental health professional and receive therapy for their illnesses. The psychologists, psychiatrists, and therapists at Arista Counseling and Psychiatric Services can help.  Contact the Bergen County, NJ or Manhattan offices at (201) 368-3700 or (212) 722-1920.  Visit http://www.acenterfortherapy.com for more information.

To find out more information, visit: https://www.mayoclinic.org/diseases-conditions/narcissistic-personality-disorder/symptoms-causes/syc-20366662

Anxiety: Exposure Therapy Helping Teens Combat Anxiety

By Hannah Pierce

Exposure therapy is a cognitive-behavioral therapy technique in which a person is exposed to a feared object or situation to overcome their anxiety. A majority of researchers and clinicians believe that exposure therapy is the most effective treatment for many anxiety disorders. One study even found that people improved more using this technique than taking antidepressants.

Although exposure therapy is proven to be very effective, it is not frequently used with teens. Many teens suffering with anxiety are prescribed medication rather than receiving therapy. It is difficult for people to consent to exposure therapy because they do not want to do something that will make them feel even more anxious.

One article documented teens’ experiences with exposure therapy. A 14-year-old suffering from social anxiety, depression, OCD, and binge-eating agreed to tackle his social anxiety through exposure therapy. On a busy college campus he sat on a bench next to a stranger and initiated a conversation. To some people this may seem simple but to a teen suffering from social anxiety, the task is very daunting. He sat on the bench and tried to talk to the stranger but the stranger just kept texting and playing with his phone. Although the exchange did not turn into a conversation, at least the teen faced his fear and realized it wasn’t that bad.

Another teen’s exposure involved him holding a sign that read “I’ve been bullied. Ask me.” Thomas hoped to combat his anxiety while also educating people on bullying. Most students on the campus walked by him without giving him a second glance. After a while, a couple stopped to talk to Thomas. The man empathized with him, sharing that he had been bullied as well and the woman applauded Thomas for his bravery.  After the exchange Thomas was very pleasantly surprised and realized he did not have much to be so anxious about.

If you or someone you know may be experiencing anxiety, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit http://www.counselingpsychotherapynjny.com for more information.

Source: “The Kids Who Can’t” by Benoit Denizet-Lewis

OCD: What It’s Really About

By Miranda Botti

Obsessive-Compulsive Disorder, or more commonly referred to as OCD, is a psychological disorder in which those afflicted experience recurring distressing, intrusive thoughts, images or impulses (obsessions) and attempt to remedy and alleviate such thoughts with repetitive actions (compulsions).  Such intrusive, repetitive thoughts are often constant worries about one’s health or the health of family members or loved ones, as well as fears about bad things happening to loved ones. Common compulsions include but are not limited to: repeatedly checking things, such as if an oven is off or if a door is locked, excessively cleaning oneself and/or handwashing, and compulsive counting. Many OCD patients are able to understand that their thoughts are irrational and unlikely to be remedied by their compulsive actions but continue to struggle to control their obsessions. Most people are typically diagnosed with OCD in their late teens to early 20’s, although onset at any age is possible.

The knowledge of the causes of Obsessive-Compulsive Disorder is still yet to be discovered however, risk factors include: genetics, brain structure and functioning, and/or the environment. Treatments include medications that act to inhibit the reuptake of the neurotransmitter called serotonin (SRI’s and SSRI’s), as well as the less frequently prescribed antipsychotic medication; psychotherapy such as cognitive behavioral therapy (CBT); the approach of a combination of medication and psychotherapy. Research for treatment of OCD is up and running and clinical trials look to determine the effectiveness and safety of new treatments in order to help individuals in the future.

 

If you or someone you know is suffering from OCD, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.

 

Information taken from: https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml

What exactly is a “Panic Attack”?

by Sarah Moore

Panic Attacks: What are they?

We’ve all heard of panic attacks before, on television, in the movies and even in day-to-day conversation. In today’s age, people tend to use the term lightly, as an expression of a reaction to a stressful event or fearful encounter. One might say, “When I heard that the company was planning to downsize next year, I just about had a panic attack”. But to use the term this way does not describe what a panic attack truly is: a sudden, unexpected feeling of overwhelming and disabling anxiety, often with no premeditating cause.

So what exactly does a panic attack involve? The DSM-5 defines a panic attack as involving four (4) or more of the following symptoms:

  • Palpitations, pounding heart, or accelerated heart rate
  • Sweating
  • Trembling or shaking
  • Sensations of shortness of breath or smothering
  • A feeling of choking
  • Chest pain or discomfort
  • Nausea or abdominal distress
  • Feeling dizzy, unsteady, lightheaded, or faint
  • Feelings of unreality (derealization) or being detached from oneself (depersonalization)
  • Fear of losing control or going crazy
  • Fear of dying
  • Numbness or tingling sensations
  • Chills or hot flushes

While it’s true that anyone can experience a panic attack, they are most commonly associated with Generalized Anxiety Disorder, Post-Traumatic Stress Disorder or Specific Phobias. Does this mean someone who experiences a panic attack has one of these conditions? Not necessarily. The DSM-V defines the diagnostic criteria for Panic disorder as suffering from frequent, often unexpected panic attacks. In addition, at least one attack must be followed by the fear that more attacks will occur, causing an individual to change his or her behavior in order to avoid triggering such attacks. It is important to note that other possible causes for panic attacks, such as side effects from drugs or medications must be ruled out before someone can be diagnosed with any of the above disorders. Panic attacks can be debilitating, but with the right treatment, recovery is possible.

If you believe that you or a loved one has or may be suffering from panic attacks, the psychiatrists, psychologists, psychiatric nurse practitioners or psychotherapists at Arista Counseling can help you. Please contact our Bergen County, NJ or Manhattan, NY offices respectively at (201)-368-3700 or (212)-722-1920 to set up an appointment, or visit http://www.counselingpsychotherapynjny.com for more information.

Good Grief: Part 4

By: Sam Reiner

Over the last few parts we have been discussing the 5 stages of grief, using Zelda to further explain each stage. Now that we are done with the stages and Zelda we must now move on to the next topic, “How long does grief usually last?” Seems simple, but really this is an extremely difficult question to answer for the simple fact that people experience grief in different ways. Some people are able to feel better after 6 weeks while others can take up to 4 years to really get over a loss. In reality, the only one that really knows when you should be done with grieving is you. It is a process whose time table only you can decide. That being said there are ways to help you get through the grieving process a bit quicker. Some ways include:

  • Talk about how you’re feeling with others.
  • Try to keep up with your daily tasks so you don’t feel overwhelmed.
  • Get enough sleep, eat a well-balanced diet and exercise regularly.
  • Avoid alcohol. Alcohol can make you feel more depressed.
  • Get back into your normal routine as soon as you can.
  • Avoid making major decisions right away.
  • Allow yourself to cry, to feel numb, to be angry, or to feel however you’re feeling.
  • Ask for help if you need it

Now before I wrap this part up I have to mention that it is important to tell the difference between normal grieving and depression. Although they share very similar symptoms, the feelings associated with grief should be temporary. If you don’t start to feel better over time, it is very likely you have depression. But how long is too long? Again, that’s up to you as when you are grieving it is important to be self-aware of your emotions. The only way to know it’s been to long is when you feel that it’s been too long.

If you or someone you know is grieving, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/

Good Grief: Part 3

By: Sam Reiner

(once again to understand what I am talking about read the first 2 parts)

Despite all your bargaining, you eventually realize that there is nothing you can do to stop or reverse what happened. With the realization that there is no escaping fate comes the desire to disconnect and retreat inward, which leads to stage 4: Depression. The sadness sets in as you begin to understand the loss and realize its effect on your life. This is when you will feel overwhelmed, regretful, and lonely and in the game, this can be seen at the Great Bay. It is here that you me Lulu, a Zora who has lost her egg, simply standing in silence gazing out to the sea. The loss of her eggs has caused her to retreat inward and become depressed, which is very common for people who have just lost a loved one.

However, as the old saying goes “This too shall pass.” Stage 5: Acceptance. This is when you finally accept the reality of your loss, and although you may still feel sad you can now begin to move forward with your life. In game, this is signified by the Land of the Dead, Ikana Valley. It is here that you meet Sharp, a ghost you help reach acceptance with his mistreatment of his brother. A very literal representation of acceptance, but a more symbolic example is the Stone Tower, where you climb up towards the heavens. As you climb you will also need to create 4 twin statues (one for each town) with the 4 being symbolic of the past 4 stages of grief. Much like these statues, during the stages of grief you feel dull and lifeless but they are essential in order for you to go through the grieving process. This is even shown in game as you must leave the statue behind when you go up to the next floor, symbolizing passing though the stages of grief. By leaving them behind you can make your way to the top in order to obtain enlightenment and then flip the tower putting the heavens at your feet, solidifying your acceptance. You even have to fight the Garo Masters, beings literally described as “Emptiness cloaked in darkness.” These are clear symbols to the internal battle between light and darkness on the road to acceptance and also shows your victory over the empty feelings that come with grief. By overcoming the darkness and emptiness inside you and reaching the top, you show that you have accepted the past and are ready to face the future.

And with that, we have reached the end of the 5 stages of grief. Now that you know what to expect when faced with grief, it now becomes a question of how long with it last? Unfortunately this is getting pretty long so I’m going to have to save that for next time.

If you or someone you know is grieving, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.

Good Grief: Part 2

By: Sam Reiner

(Read part 1 first to learn why I am talking about Zelda)

The 1st stage of grief is Denial. When you first learn of a loss it’s normal to think that it isn’t real or that it can’t be happening. It’s a way for you to deal with the torrent of overwhelming emotions. This is exactly what you experience in Clock Town, the 1st town in Majora’s Mask. In this game, you have 3 days to stop a giant moon from crashing down and destroying everything. However, even with this moon clearly inching closer every minute, no one seems to care. In fact, they are actually planning a carnival, openly laughing at the idea that the moon will fall. One person even goes as far to say that he’ll simply cut the moon to pieces with his sword.

Denial can only be temporary however, and when it is no longer possible you get angry. Stage 2: Anger. When reality starts to set in you may feel frustrated and helpless which later turn to anger, causing you to lash out at anything whether they deserve it or not. This is extremely prevalent in the game’s second location, Woodfall. Here you discover that the swamp has been poisoned, the Deku princess is missing, and the king is dead set on punishing a monkey who he believes kidnapped her. The problem is, the monkey is innocent. The king is just angry because of the poisoned swamp and his missing daughter and is lashing out at anyone.

Once the anger settles you then start to feel desperate which leads to stage 3: Bargaining. It’s during this stage you attempt to do anything that can either postpone or reverse the loss. In the case of Majora’s Mask, bargaining is on full display at Snowhead. Here is where the player encounters the Gorons, who are in the middle of mourning the recent loss of their chief, Darmani. Eventually you actually meet his ghost who then literally begs you to bring him back to life with your magic. This is a textbook example of bargaining as he is trying everything to delay the inevitability that is death. This can also be seen in the area itself. The paralyzing cold of Snowhead is basically a metaphor to how in this stage of grief you feel unable to move on, emotionally frozen. And for now, I’ll stop there, so for the next part we will be discussing the last two stages of grief.

If you or someone you know is grieving, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.

 

Good Grief: Part 1

By: Sam Reiner

Grief is something that is inevitable in everyone’s life. It is an emotion that can come from the loss of a loved one, moving to a new home, suffering a chronic illness, or even the end of a relationship. It is a feeling that hits hard and can make you feel completely empty inside. Although we all must face grief at one point or another, no one knows what to expect when they are actually faced with it. What will I feel, how long will I feel it, and how can I move on? Over the next few blogs I will try my best to answer these questions.

So, let’s go down the list and start with what exactly will you feel when you are face with grief. Although the process is different for everyone, doctors have identified 5 common stages of grief: Denial, Anger, Bargaining, Depression, Acceptance (DABDA). Now in order to explain it further I’m going to once again use a video game, this time Legend of Zelda: Majora’s Mask. I swear I didn’t even plan this but when it comes to examples of the 5 stages of grief this is probably the best example of it in pop culture as you actually play through all 5 stages of grief via the 5 locations. But I’m going to have so go into more detail on it another day. This is going to take a while to explain and deserves its own blog. In the next part I will be discussing the first three stages of grief.

If you or someone you know is grieving, contact our psychotherapy offices in New York or New Jersey to talk to one of our licensed professional psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.