Self-Esteem and Shaming Parents

By Stephanie Osuba

We have all felt, in one way or another, like we weren’t good enough or even felt embarrassed after making a mistake at work. This is healthy in that we are expressing sadness or just reflecting on a situation that could have been handled differently, but we move on and eventually feel valued and confident again. However, for some, that feeling of shame and guilt never goes away. Some believe they are inherently flawed, worthless, and inferior to everyone else. These negative emotions and lack of self-esteem are largely rooted in repeated childhood and adolescence trauma that is often left unprocessed. Internalization of this emotional abuse leads to a conditioning of sort, usually by the primary caregiver, that the negative emotions constantly felt reflect who one is as a person. This person comes to genuinely believe that he or she is a bad person, unlovable, never good enough, and deserves to be treated with disrespect.

The constant shame is also accompanied by a constant feeling of guilt. Everything is his or her fault, regardless of the context. There is a sense of unjust responsibility for other people’s emotions and the outcome of all situations. Its no wonder why low self-esteem can manifest itself in anxiety, self-harm or poor self-care, or on the other extreme, narcissism and antisocial tendencies. Here are some behaviors that can be a manifestation of low self-esteem:

  • Lack of healthy self-love: poor self-care, self-harm, lack of empathy, and inadequate social skills
  • Emptiness: loneliness, lack of motivation, and finding distractions from emotions
  • Perfectionism: this is often a behavior that manifests as adults because of the unrealistic standards these children were held to by their parents and were punished for not meeting
  • Narcissism: grandiose fantasies of who they want others to perceive them to be; even if they do succeed however, this protective personality doesn’t numb the negative emotions they truly feel.
  • Unhealthy relationships: people with low self-esteem are incapable of building and maintaining a relationship with others, largely because they don’t know what a healthy relationship looks like. Both parties are usually extremely dependent.
  • Susceptibility to manipulation: the constant self-doubt, shame and guilt make it too easy to bend a person with low self-esteem to an experienced manipulator’s will.

Source: Cikanavicius, D. (2018, September 03). A Brief Guide to Unprocessed Childhood Toxic Shame. Retrieved from 

If you or someone you know is struggling with self-esteem, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. 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


Nicotine Addictions

Isabelle Kreydin

People living with mental illness have a high rate of tobacco addiction. In America, 44.3% of all cigarettes are consumed by individuals who live with mental illness and substance abuse disorders. What’s it mean to be addicted? You might have problems paying attention, trouble sleeping, appetite change, and/or powerful cravings for tobacco at least once a day.

The nicotine in any tobacco product absorbs into ones blood when a person uses it. Upon entering the blood, nicotine stimulates the adrenal glands to release the hormone epinephrine, otherwise known as adrenaline. Nicotine increases levels of the chemical dopamine, which affects parts of the brain that control reward and pleasure. Those who suffer from mental illnesses such as depression, anxiety, schizophrenia, etc. commonly lack a consistent flow of dopamine (as well as other neurotransmitters), and the nicotine can therefore be a sort of temporary enhancer and mood booster.

The addiction itself however, is more about the lies one feeds to himself, the subconscious thought that the cigarettes, e-cigarette or other drug will truly fill a void in the addict’s mind or body. Those struggling with addiction have something in common: an ache that they believe can be dimmed. Whether it’s simply a drug to relieve temptation, or tension in the mind or of thoughts, it’s still an unhealthy coping mechanism.

Like most drug addictions, nicotine only provides one with temporary relief or a brief time away from reality. Every year, smoking kills about 200,000 people who live with mental illness. Please do not be one of those statistics.

Smoking is known to cause heart disease, stroke and lung disease, among other medical problems. Second-generation atypical antipsychotic medications (SGAs) cause an increased risk of heart disease, so it’s important that individuals living with mental illness quit smoking. Like an e-cigarette, smokeless tobacco products contain 3 to 4 times more nicotine than cigarettes and contain substances that increase risk of oral and oropharyngeal cancer. If you ever wanted to quit your addiction in the future, it would only be more difficult, as your body becomes dependent on the chemicals and drugs you chose to feed it. Recovery is a long process, however very possible.

If you are struggling with substance abuse or any other kind of addiction, 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 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 for more information.

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Seasonal Affective Disorder: What is it?

Seasonal Affective Disorder

Written by: Jinal Kapadia

Seasonal Affective Disorder (SAD) is a peculiar disorder. In fact in is not a disorder at all. It is actually a type of depression displayed in a recurring seasonal pattern. In order to be diagnosed with Seasonal Affective Disorder, the patient must meet the full criteria for major depression coinciding with specific seasons (appearing in the winter or summer months) for at least 2 years.

Some general symptoms include feeling depressed most of the day nearly every day, feeling hopeless or worthless, losing interest in activities that were once enjoyed, having difficulty concentrating, and/or having thoughts of death or suicide. There are also specific symptoms that vary based on either the winter or summer seasons. In the winter, a person with Seasonal Affective Disorder may experience low energy, hypersomnia, overeating, weight gain, cravings for carbohydrates, and social withdrawal (feel like “hibernating”). Although, summer seasonal affective disorder is less frequent, the specific symptoms for this season include poor appetite, weight loss, insomnia, agitation, restlessness, anxiety, and episodes of violent behavior. Forms of treatment for Seasonal Affective Disorder include medication, Psychotherapy (cognitive behavioral therapy and behavioral activation), and Vitamin D supplementation.

If you or someone you know has Seasonal Affective Disorder or seems to have the symptoms of SAD, and needs help, 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

Source: Seasonal Affective Disorder. (2016, March). Retrieved January 09, 2018, from



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

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


Post Traumatic Stress Disorder (PTSD): Making Sense of the Present

By: Emily Mulhaul

As an outsider, sometimes it’s difficult to understand what Post Traumatic Stress Disorder is and who gets to experience it and who doesn’t. To put simply, although we take in life’s moments with others around us, the emotional process is an individual experience, therefore anyone and everyone can at some point in their life experience Post Traumatic Stress Disorder even if others around them are not experiencing it. The variation in emotional experiences is so fascinating that it is the primary interest of social psychologists who study the way we process, store, and apply information to diverse situations. That being said, multiple individuals can be in the same place, at the same time, identifying the same series of events, but will interpret the situation completely differently. Individual interpretations may fall anywhere under the seven universal facial emotions noted by the American Psychological Association (APA): disgust, anger, fear, joy, happiness, surprise, and contempt. Diversity in emotional reactions to situations is normal, but there are times where it becomes an area of concern. For example, imagine it’s around the fourth of July, you’re at the beach and unexpectedly fireworks commence. One individual (twelve year old) may express the utmost joy, surprise, happiness or some combination of the three, whilst another individual (war veteran) darts to hide behind a bush in a trembling state, fearing for his life. The discrepancy between the reactions of these two individuals, the twelve year old kid and the war veteran, are not reactions one must brush off as varying personalities. Due to the war veteran’s time spent at war, he may be experiencing Post Traumatic Stress Disorder (PTSD), defined by the American Psychological Association (APA) as an anxiety problem that develops in some people after extremely traumatic events. His reaction (anxiety) may have been triggered by an association of the loud bang of the fireworks with that of a loud bang of a gunshot (traumatic event) he heard in the past.

Although the presence of PTSD in war veterans is the most commonly talked about, it is one form of PTSD, not the only. Other instances that have concluded with the diagnosis of PTSD include individuals who have experienced sexual assault, domestic violence, car accidents, crime, natural disasters, bullying, breakups, loss of a loved one, etc. Considering the following experiences do not necessarily mean that PTSD will be present, the APA highlights some recognizable signs in either yourself or others who may be at risk or experiencing PTSD: “reliving the event via intrusive memories, flashbacks, and nightmares; avoid anything that reminds them of the trauma; and have anxious feelings they didn’t have before.” If these signs sound familiar, it is to the benefit of the individual to seek therapy with a licensed professional because there is hope to diminish negative emotions for a resurgence of positive emotions!

If you or a loved one is experiencing signs of Post Traumatic Stress Disorder (PTSD), experienced psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling are here to help. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.


Relationships: Abusive Relationships: Why We Repeat the Past

“Why didn’t you just walk away?” “How could you let this happen to yourself again?” These questions are not uncommon for survivors of domestic abuse to hear. When a person has numerous maladaptive relationships, it leaves them and others baffled. Why on earth would someone put themselves in an abusive situation again? The answer to this lies in a psychological phenomenon called “repetition compulsion.” In repetition compulsion, a person either puts themselves into a situation where abuse is likely to happen again, or they reenact the past situation with another partner. Below are some theorized reasons why people repeat the past in their relationships.

  1. Change can be a scary or anxiety-provoking thing. Most of us stick to what we know, even if it means regularly dating partners who are physically and/or emotionally abusive.
  2. Some think that by putting themselves in the same situation, they can change the outcome this time. They think that they will be able to master this relationship, and this will make up for the last bad one.
  3. We might believe that if we act in just the right way, our partner’s behavior will change and they will treat us right.
  4. We begin to internalize the beliefs that we are unlovable and deserve to be mistreated.
  5.  Unconsciously or consciously, we seek out abuse from others due to conditioning.
  6. “Winning” an argument with an abusive partner may lead us to believe that we are able to do this again and the abuse will stop.

Despite how terrible the situation may be, know that you are not alone, there is help available, and there are resources to begin the healing process.

The psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling can help you. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722-1920 to set up an appointment.

Visit for more information.

Further reading: “The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma” by Bessel van der Kolk, M.D.

Source: Esposito, Linda. “Why Do We Repeat the Past in Our Relationships?” Psychology Today. Sussex Pulishers, 22 Mar. 2016. Web. 07 Apr. 2016

By: Scout H

Relationship & Dating Tips

First dates can be exciting, enjoyable, and can open up a wide range of possibilities. If you’re about to spend time with someone new, make sure you keep your eyes open for some red flags that may predict the fate of your relationship down the road.

  • If they pay more attention to electronics than to you during the first date, you can easily tell where their priorities are.
  • If they spend the majority of the time talking about themselves during the date, it is possible you might end up with a narcissist.
  • Disclosing how much they hate their job or friend or relative, especially on a first date, should make you apprehensive. This shows that they have a history of tumultuous relationships.
  • Talking about an ex or comparing you to an ex is a huge indicator that your date is still hanging on to the past.
  • Asking if someone is enjoying the restaurant/music/movie is fine. You might find yourself becoming uncomfortable with how many times you need to reassure them. However, asking many times throughout the night how things are going may be a sign of low self-esteem.
  • If during the date they disclose a view that is fundamentally different from yours, don’t ignore it! Having different opinions is fine, but if your core beliefs are too different, this could make for some serious clashing in a relationship.
  • Being unnecessarily rude towards the waiter, a parking attendant, or other person in front of you is never a good sign. If they blow up on people for small things, imagine how they’d treat you if they thought you did something wrong!

If you learn to recognize the red flags, you will be able to know when to call a first date your last date!

If you’re dealing with relationship problems, consider reaching out to the psychiatrists, psychologists, psychiatric nurse practitioners, social workers, or psychotherapists at Arista Counseling. Contact our Paramus, NJ or Manhattan, NY offices respectively at (201) 368-3700 or (212) 722 1920 to set up an appointment.

Visit for more information.

Source: Degges-White, Suzanne. “13 First Date Red Flags.” Psychology Today. Sussex Publishers, 31 Mar. 2016. Web. 01 Apr. 2016.

By: Scout H

Fighting With Your Spouse: How You Indirectly Effect Your Child


Being in a relationship has its stresses, but what happens if those stresses are greatly affecting the people you love? Conflict is natural and should be discussed in private however sometimes we do not realize who is listening. It has been found that children who witness conflict between their parents experience more negative behaviors and emotions than that of the average child. These include: decrease in emotional security, feelings of defenselessness, increased aggression, increased distress, and hyperactivity. Parents are role models; their actions are closely observed and usually repeated by their child. There is a higher chance that the child will become easily upset and throw tantrums because that is what they consider to be a normal reaction. Fighting also relays the message to the child that intimacy involves conflict and turmoil, causing the child to stray away from future intimate relationships. Another lasting effect is misplaced guilt. If parents become hostile towards each other and coincidently the same day the child made a mistake or got in trouble, the child might blame him or herself for the altercation.

Interestingly, Brown University conducted a study involving 54 children and their sleep habits. This particular study also consisted of interviewing both parents and children about life at home and any conflicts that had occurred. Over a series of comparing family information and sleep habits, the team discovered that children witnessing moderate to severe conflict at home lost an average of 30 minutes of sleep per night. This loss of sleep can effect a child’s development especially at a young age.

Specialists highly recommend finding a solution by positively communicating with your partner in front of the child to teach that disagreement is normal and can be dealt with in a constructive way.

If you believe that you or a loved one has or may have conflicts with their spouse; 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 for more information




By: Jennifer Oscherician