Dr. Christine Fernandez | Christine Fernandez, PhD

Fending off Depression

May 8, 2013 By Dr. Christine Fernandez Leave a Comment

Some people have certain susceptibilities, such as getting depressed or overly anxious, and rather than denying these susceptibilities, it’s best to accept them and learn to manage them better. Take depression, for instance. Studies show that people, who have experienced a Major Depressive Episode (MDE), have a 50% likelihood of reoccurrence. So if you have gone through depression in your life, then chances are that you will go through a similar episode at some point again. While you don’t need to be nervous about it all of the time, which would only add anxiety to the mix, you can accept the likelihood and do your best to recognize and manage the precursors to a MDE.

If the best predictor of the future is the past, then take a careful and honest look at your previous depressive episode(s). What thoughts, feelings, and behaviors preceded them? For example, did you lie in bed for a half hour after the alarm went off in the morning? Did you start taking longer to return people’s calls? Did you let your home get messier? Did you start ruminating about how you were a “failure, hopeless, single forever,” etc.? Were you feeling overwhelmed or stressed in at least two key areas of your life, such as relationship, career, or health?

Take note of what preceded the last time you became depressed so that you can take preemptive measures while you are still near the top of that slippery slope, before you slide fully downhill and land in a Major Depressive Episode. You know how hard it is to pull yourself out of there. Studies also show that MDE’s can end within 6 to 9 months without any kind of treatment. However, no one wants to feel depressed for months. And, no one wants to see a loved one depressed for months.

Understanding what thoughts and behaviors precipitate a MDE is imperative. If your memory is a bit hazy regarding this time prior to a depressive episode, then ask your spouse, a close friend, or family members. I guarantee you that they will remember a change in your behavior that they either took note of were concerned about before they realized that you were depressed. Then once you can see your pre-depression pattern more clearly, you can fashion some sort of a preemptive plan to halt your downward spiral. Again, look to your supportive partner, family, and friends. Speak with them and give them permission to call you on your “pre-depression behavior” as soon as they see it.

If you can remember how terribly you felt while depressed, write it down somewhere. Write the worst of it: how you felt, the painful thoughts you had. Keep it somewhere as a tool that you or a loved one can use when necessary to remind you of how bad it can get, so that you realize it’s better to head it off at the pass. People forget the depths of their feelings; they remember in theory but don’t remember exactly how they felt. It’s a funny phenomenon that we think that whatever we are currently feeling will just go on forever. (If we’re in love, we think it will never end, and if we’re depressed, we think it will never end.) But if you read about a past difficult time in a diary, it can help you remember exactly how badly you felt and motivate you to do whatever you need to in order to avoid that dark place, for your sake and that of your loved ones.

Then what do you do? There is no magic “snap out of it” formula for everyone. You will have to figure out what helped you in the past and be willing to try things that have helped others. Some suggestions are:

- reconnect emotionally with your partner

- get some aerobic exercise

- see a therapist or revisit a previous one

- take a quick trip to get a change of scenery and perspective

- spend time in nature

- learn something new and creative

- do some charity work and see that your life is not so bad and that you have something to contribute

- spend more time with friends and family so that you can see that people love and appreciate you

Act on these preemptive moves quickly, before the lack of energy and motivation that usually accompany MDE’s hit you.

You don’t have to live in fear of getting depressed again, but you need to be realistic. You survived depression before and you can survive again. But you may be able to save yourself and your family the pain of your experiencing a depressive episode again if you can put some carefully thought out preventative measures in place beforehand.

Filed Under: Dating and Relationships, Depression Treatment, Stress Management Tagged With: depression prevention

The Many Faces of Love: Caring for the Sick Loved One

April 24, 2013 By Dr. Christine Fernandez Leave a Comment

I talk to my patients about the many faces of love, whether romantic or non-romantic love. There is the “It’s early on and everything you say is fascinating” love, the “We know each other so well and can finish each other’s sentences” love, the “Wow, you can still surprise me” love, and then sadly, the “You’re really sick and I’m terrified of losing you” love. I’ve gone through the last one and it was so terribly painful, and yet in the midst of that pain there were moments of joy too. I was caring for someone, who was very sick and diagnosed with a serious illness. (Thankfully he is stabilized now.) There were days when just the thought of losing him made me tear up. One day I even had to put on my sunglasses because the tears just started rolling down my face while I was walking outside. Other days, my fear would turn into anger when he wouldn’t eat despite my best efforts and cajoling. Yet throughout this, I would experience unexpected moments of profound beauty when he would allow me to take care of him and I realized that caring for a sick loved one can be an honor and a gift. I was awed by his vulnerability, trust, and acceptance. It takes real strength to show your vulnerability to someone. Then there were moments when I saw that he was trying to survive and my heart felt like it would explode with love, joy, and gratitude at finding him alive for another day.

How did I get through this difficult period and remain sane? Well I relied on wonderful, supportive friends, who would take my despondent, late night calls. I contacted my old therapist, who was willing to work with me on an as needed, weekly, or even telephone basis. I practiced forgiveness with myself when I fell short of my expectations of being “the compassionate, wise, and calm caretaker.” That meant that when I was unreasonably angry because he was too nauseous to eat and I accused him of reneging on his promise to try, I later forgave myself. (Of course, I apologized to him too.) I knew it wasn’t my finest moment, but I knew it was my own fear of losing him that led me to be so childishly angry. Also, I had to acknowledge that I was doing my best under difficult circumstances. Even after clumsily giving him shots with trembling hands, I had to be grateful that I had gotten it done and tried to believe that I would get better with every shot. I tried to take care of myself. On those days when even I didn’t want to eat, I made sure that I did and tried to get enough rest because it wouldn’t help either of us if I got sick. And lastly, I was grateful for every day that he stayed alive. It forced me to stay in the present because looking too far ahead was scary and made me miss out on the joy of having today together.

So if you are taking care of a seriously ill loved one, my heart goes out to you and my advice is: Cut yourself some slack; you’re doing your best under extremely difficult circumstances. Be sure to:

Have a support system, such as friends, family, and a mental health professional
Be compassionate with yourself and forgive your shortcomings
Take care of yourself also
Be grateful for the time you do have

Thankfully my loved one is stabilized and I wish you and your loved one all the best.

Filed Under: Couples Therapy, Dating and Relationships, Depression Treatment, Individual Psychotherapy, Relationship Patterns, Stress Management Tagged With: cancer, caretaking

How Clearly Do You See Yourself?

April 19, 2013 By Dr. Christine Fernandez Leave a Comment

Dove, in continuance of its “Real Beauty” campaign, recently came up with another great commercial. (The link is below.) They have a sketch artist draw a woman based on her own verbal description of herself. The sketch artist can’t see her. Then the artist draws the same woman based on a description of her by someone who just met her. The artist also doesn’t know when he is redrawing the same woman.

The outcome is that the women who were sketched tended to point out their flaws. While the strangers, who just met them, described them in more glowing terms, such as, “She had nice eyes. They lit up when she spoke.”

What a clever way to demonstrate that we are too hard on ourselves and have trouble seeing ourselves clearly for who we are. People often come to me and want me to “fix” them. But, to me, therapy isn’t about fixing, it’s about uncovering the real you, which you have been disowning for so long. I see my clients more as diamonds, who have gotten dusty and dirty and who can’t clearly see their own brilliance and their many facets.

This reminds me of a man I worked with who came in because he had not passed the Bar Exam for the second time. He was planning to take to take it again, but he had lost his self-confidence and his anxiety about not passing again was sky high. Through the course of therapy not only did he regain his confidence – there was so much evidence in his life that he was clearly intelligent enough to pass – but he realized that he didn’t even want to be a lawyer! He finally admitted to himself that he really wanted to get an MBA. And, he even realized that he didn’t even want to live in NYC anymore; he wanted to live in a warm Southern state.

Through his efforts in therapy, he was able to brush off the dust of failed exams and other people’s expectations and see himself clearly for the intelligent, highly competent man he was. He admitted to himself and others what he really wanted out of life. By the time therapy ended, he was accepted into an MBA program, was moving down south, and had retaken the Bar Exam. He wanted to prove to himself that he could pass it – and he did!

One reason why people don’t see themselves clearly is because they give their personal power away to others; they let others define them. Even in the Dove commercial we hear a woman describe herself by saying, “My mom told me I had a big jaw.” As the saying goes, “Don’t let others decide who you are; that’s your job.” Therapy is just one of the ways in which people can begin to see themselves more clearly and own their beauty, strength, and power. So whatever method you choose to get to know yourself, whether journaling, yoga, art, meditation, therapy, etc., it’s time to start seeing your brilliant, multifaceted self more clearly!

“A human being has so many skins, covering the depths of the heart. We know so many things, but we don’t know ourselves!” ~ Meister Eckhart

Here is the video link: http://ti.me/13t1Spe

Filed Under: How Therapy Works, Individual Psychotherapy Tagged With: Dove, Dove campaign

Teaching Young Men How to Manage Their Sexual Energy

April 17, 2013 By Dr. Christine Fernandez Leave a Comment

Young men, and I’m referring to men in their 20′s, have a lot of sexual energy. (Yes, I know that’s the understatement of the year.) It’s such a fact of life that people tend to joke about how young men are ruled by their hormones and nothing can be done about it. But that’s not necessarily true; young men can actually learn to channel and focus that sexual energy. Of course there will be times when the sexual urges will end in sexual activity and that’s fine. I’m not at all saying that sex is a bad thing or that young men shouldn’t have sex or engage in any sexual activity. But the fact is that young men don’t get to have sex every time they want it. (When would they ever get anything done?) So what happens to all of that sexual energy when they don’t get to have sex or engage in some sexual activity? It gets dissipated and wasted because young men aren’t taught how to channel and better utilize the energy when they can’t have sex.

Do you remember the movie “Rocky?” There’s a scene in which Burgess Meredith, Rocky’s manager, tells Rocky that he has to abstain from sex before the big fight because, “women weaken legs.” It’s a funny way to state it, but male athletes know exactly what he means by that remark. He is saying that if it is not released, then the sexual energy will be pent up and explosive (no pun intended.) In fact, both Mohammed Ali and Rocky Marciano claimed to abstain from sex for long periods before a fight.

Now I’m not saying that having sexual urges and denying them is comfortable. What I am saying is that discomfort isn’t the only option. Instead, young men can learn to channel that energy into other areas, whether it’s sports, creative arts, spiritual activity, or any other area that could use some powerful energy to charge it or bring it to another level.

Eastern and Indigenous cultures do a much better job of teaching young men to do this than Western culture. In Western culture, we tend to believe that young men are at the mercy of their libidos, making this one aspect of the young man seem larger than the whole of him and resigning him to feeling out of control. We often see young men’s plight as facetious, when in fact their perceived powerlessness actually causes them emotional pain too. If older men look back at their 20′s, they’ll agree with me.

So what happens in these Eastern and Indigenous cultures? These cultures tend to believe in some things that can’t be seen under a microscope, such as energy centers in the body. You don’t need to learn much about these centers to understand the general principle of moving sexual energy upward. The growing yoga movement in the US has one modality, kundalini yoga, which specifically focuses on moving this energy upward.

In South America, young men who are in training or apprenticing to become a shaman go through long periods of time on restricted diets, while also abstaining from any sexual activity or release. They learn how to work with this energy.

Also, meditation, a long-standing tradition in Asian countries, such as India, Japan, and China, teaches focus and self-control over some areas, like physical movement, while also teaching how to let go in other areas, like attachment to thought. Indeed Buddhist monks, who are celibate, do not deny that they have sexual urges. As one Buddhist monk stated, “Sometimes you think the energy is so strong you think you are going to run outside the monastery and have sex with the first woman you see. But if you stay with it, you notice it changes. You learn to transform that energy into unconditional love, into the fuel for transformation of one small self to something beyond that.”

Other practices that can help with moving and focusing sexual energy are chi kung, tai chi, and mindfulness techniques.

While I don’t give specific instructions in this article, I do encourage young men, and those people who care about them, to do a little research and help them through a phase of life that can be difficult to begin with, but which becomes even more difficult when they are overwhelmed by their sexual urges and end up making unhealthy choices. We do a disservice to young men when we leave them to flounder in their sexual energy without guidance. Teaching young men to both control their bodies and channel their sexual energy would help them feel less lost, overwhelmed, and powerless in the face of what is one of their greatest gifts, if they could only learn to use it and channel it in a direction of their own choosing.

Filed Under: Individual Psychotherapy Tagged With: male sexuality, sexuality

Meditation: Your Daily Dose of Vitamin Calm

April 10, 2013 By Dr. Christine Fernandez 2 Comments

Why meditate? Well my answer would be, why not? You have nothing to lose and everything to gain. I often encourage my patients to meditate. It’s great for relaxation, stress reduction, decreasing anxiety, and calming yourself down at bedtime. At the very least, meditation does all of these these and, at the most, it does so much more. Meditation is simple yet profound, easy yet difficult, restrictive yet liberating. I simply can’t describe everything that meditation can be and all it can give you because I haven’t experienced all of its gifts and benefits yet myself, and I doubt I ever will because I suspect they are unending.

What is the goal of meditation? Well there are many goals you can set ranging from calming down to achieving enlightenment. I would aim for calming down. Begin with that and allow meditation to reveal its gifts over time.

I am not the best at meditation myself, meaning that I don’t meditate every day (although I do on most days.) I don’t sit for too long (30 minutes at the most.) And, I can’t manage a full on lotus position (just sitting cross-legged leaves me hobbling for several minutes afterward.) Worst of all, while meditating my mind runs amok like a drunken monkey suddenly let out of a cage. So, not surprisingly, I haven’t achieved enlightenment yet. I haven’t even rid myself of all anxiety. Yet I persevere and plunk myself down on my meditation pillow. Why? It’s hard to say. All I know is that I miss it when I don’t. Meditation changes something on a level that I can’t see, but I can feel it. If I had feathers, I would say that it takes my ruffled feathers and smoothes then down and sets them all in the right direction. Maybe this isn’t profound, but it’s better than where I started.

As for my chattering monkey mind, well that’s always interesting to watch. It has transformed, with time and practice, from thoughts of judgment (mostly about how bad I was at meditating) to anxiety (mostly about everything that I had to get done but couldn’t because I was meditating) to being watchful (mostly watching how I get lost in my thoughts while meditating.) But I have also had some moments of inspiration and helpful advice (to myself from myself) and those moments are wonderful. So enlightenment may be a ways off, but meditation is my daily dose of vitamin calm in a hectic world filled with costly meds trying to do the same.

So I encourage everyone to meditate. Do some brief research, if you like. There are plenty of instructional websites and videos online, as well as plenty of modalities, such as zen, transcendental, kriya, mindfulness, vipasanna, etc. to choose from. But don’t put it off by looking for the perfect modality, the perfect instructional class, or the perfect spot in your home. What’s most important is to just do it. Practice, practice, practice and one day you may get to Carnegie Hall, or achieve enlightenment or, at the very least, feel calmer.

Filed Under: Anxiety Treatment, Individual Psychotherapy, Stress Management Tagged With: meditation

How Do You Comfort Yourself?

July 25, 2012 By Dr. Christine Fernandez Leave a Comment

In psychology, we talk about people’s self-soothing skills. Really what it means is: what do you do to comfort yourself when you are feeling badly? Take a moment to think about it. Do you know yourself enough to know what you do to make yourself feel better?

If you take a look around, we do all sorts of things to soothe ourselves when our emotional feathers get ruffled. For example, there’s drinking, eating a pint of Haagen-Dazs, using drugs, shopping, having a cigarette…etc. Or, if you’re someone who knows how to self-soothe in a healthy way, maybe you go for a walk, play with your dog, go to the gym, or breathe deeply.

I think of it as a range that spans from “healthy” (yoga) to “not so great but won’t do permanent damage” (Haagen-Dazs) to “completely self-destructive and will ruin your life” (drugs.) Where do you lie on this spectrum?

I’ve asked patients how they comfort themselves and I often get a blank stare or sadness at the realization that they never learned how. If you didn’t grow up with someone who comforted you, you may never have learned how to do it yourself. (I’m not blaming your parents. It may have been something they didn’t know how to do for themselves, so they couldn’t do it for you.)

Here’s an example of someone who knew how to comfort: I once saw a mother and her little boy walking along the sidewalk and he fell. She, with a laugh, gently said, “Aw, come here,” as she helped him up and gave him a smile and a quick hug. He followed her cue and smiled back – crying crisis averted. But I’ve also seen kids fall and get a response that isn’t comforting but adds anger and blame to the injury, such as, “Ugh, I told you not to run!” Now the child is upset about falling and getting scolded.

As adults, we often continue our childhood traditions. When you make a mistake, what do you tell yourself? Is it something like, “Ugh, that didn’t work out, but I really tried my best,” or is it more akin to, “You’re so stupid, nothing is ever going to work out for you!” We can be really cruel to ourselves, often more cruel than anyone else is to us.

If you don’t know how to comfort yourself or are in the self-destructive range, then you may want to try something new. One thing you can do is to talk to yourself as if you were a child (because really aren’t there times when we all feel like a child?) Picture a 7-year old version of yourself in front of you looking scared, upset, and oh so small. Would you yell at this child? Maybe you would hug him or her, and you would probably say some version of, “Everything is going to be okay,” knowing that this little one needs reassurance. Try telling this to yourself. It sounds strange, but try it next time you need some comforting.

No one’s parents were perfect and at some point we have to move beyond their limitations and give ourselves what they didn’t. No blame, no judgment, and no shame. Just acknowledgment that we all need some kindness and compassion, and we can actually give it to ourselves.

See what words resonate with you, what words you longed to hear in times of pain. See what actions make you feel better. Then take a deep breath because everything is going to be okay.

Filed Under: Anxiety Treatment, Individual Psychotherapy, Stress Management Tagged With: bride anxiety, self destructive, stress

4 Tips for Handling Pre-Wedding Stress

July 22, 2011 By Dr. Christine Fernandez Leave a Comment

I’m happy to know and work with some people who are now engaged and looking forward to being wed within the year. You would think that this engagement period, leading up to the realities of marriage, would be such a happy, idyllic time. That big question mark about who you’ll be sharing your life with has been answered and you can relax in the knowledge that you’ve found “The One” for you. Unfortunately, this is far from the truth for most couples because engagements periods tend to be very stressful.

At this time, people who are already busy and already have a full-time job take on what can feel like the second job of planning a wedding. There are engagement parties, bridal showers, rehearsal dinners, and lots of vendors – all looking to get the most money from you – to deal with. This is definitely a time when you see who, whether friends or family, steps up to help you with details from large, such as finding a dress or helping with expenses, to small, such as picking place settings and bridal party gifts. Just as important, it’s a time to see how you and your fiancé handle problems together. Adding to this mix are parents who may be acting out their own issues regarding your wedding.

So here are some tips to help you keep sane during your engagement:

1. Focus on the meaning of your wedding.

The real meaning of your wedding is that you are declaring your love for this person and that you intend to walk through life together. You are inviting those people who are most important to you and most supportive of you to witness and share in this joyous event. That is the meaning that you have to hang on to when family, friends, and vendors are pulling you in different directions. Nothing else is as important as the fact that you have made this decision, and colors and flowers and seating arrangements pale in comparison to the grand scheme of this underlying message, which you can’t lose sight of. In those moments of exhaustion, anxiety, or frustration remember what you have in the person you are marrying and that you are lucky indeed to have found this person. Put into your own words what the deeper meaning of your wedding is to you and let it guide your way like a bright light on what can be the gray days of wedding planning.

2. Be clear about your vision for the wedding

Perhaps you are someone who has been dreaming about your wedding since you were a child. Or, perhaps you’re someone who figured it would happen someday but never really thought about the details. Well the time has come to envision what you want your ceremony and reception to be like. (I’m going to write as if your format will be a separate ceremony and reception as this is the most common.) Your vision is unique and may include colors and seasons, such as a fall wedding with yellow and burnt orange hues. Or, it may include the feeling that you’d like everyone to experience, such as joy and celebration through fun music and decadent food. Or it may have to do with a place that you enjoy, such asVenice, and having food and wine that evokes that location. Or, it may have a theme built around an activity that you and your fiancé enjoy, such as sailing. You don’t have to become a certified wedding planner, you just have to remember the underlying message of your wedding and think of how you would like to present it. Part of what makes weddings so difficult to plan is that there is no limit to your options. That’s why it’s important to have a clear vision before you start dealing with vendors or planners, because you won’t be so easily swayed to have the large extravagant and formal wedding when what you really envisioned and wanted to share with your loved ones was a huge outdoor picnic with relaxed food and a great band. Your budget must also be incorporated into your vision; you could say it’s the reality check on your vision. To begin with just let yourself freely imagine what you would like for your wedding, and then be prepared to make adjustments as your see how much things cost. Keep your budget realistic because going over budget will only increase your stress and keep in mind that you’re planning to have a life together, not just one big party together. There’s a great quote by Maya Angelou: “I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.” Remember that people won’t necessarily remember the wine vintage or the cake filling or any other small details. What they will remember is how they felt at the event, hopefully happy and having a fun time celebrating.

3. Communicate with family and maintain firm boundaries

Ah parents, no matter how old you get they still see you as a 10-year old. The fact that you are getting married and there is going to be a ceremony that says in essence, “These two people love each other and are now going to be their own family,” can be hard for a parent to bear. It usually boils down to an issue of control. You are no longer someone’s little girl or the son for whom no one is good enough. One way of hanging on to you is for a parent to act out their feelings – often around wedding planning details. It’s almost shocking to hear the stunts that some parents pull. So instead of making planning easier for you they are adding to the stress. If you are receiving financial help from your parents for the wedding, then you may be in a tougher spot as you try to make decisions to please them and yourself.

As in all relationships, the situation can be helped by honest and straightforward communication. If you have a good relationship with a parent or parents, you can speak to them about the stress that you are feeling. Let them know if what they are doing, even though well-intentioned, is making your feel more stressed, anxious, tense, or whatever you are feeling. You can ask for their help, whether it’s helping you with planning or relaxing about what it is that they want incorporated into the wedding. You can address the underlying issue directly by letting them know that you love them and always will. Acknowledge that although marriage is bound to change some things that your love for them will never change and they will always be in your life. Even though they are your parents they can still regress to childlike states due to fear that they are losing you and they just need some reassurance that they will still be in your life and aren’t losing you. If you suspect there is another issue going on, such as disapproval of your fiancé or problems in their own relationship, then you can also address that directly and clear the air so that the issue is not being acted out within your wedding process.

If you don’t have a good relationship with one or both of your patents, then you still have to communicate clearly by words and actions and maintain firm boundaries about what behavior you’ll tolerate. If you’ve tried talking with them in the past only to find that it makes no difference and only leaves you feeling hurt, disappointed, and unheard, then go ahead and make your decisions based on what you think is best and what your vision for the wedding is. If it seems necessary to give an explanation, keep it brief. It can be given before, or even better, after the decision is made. Like the saying, “It’s easier to apologize than to ask for permission.” You have a lot to do and have limited energy and patience to deal with nonsense. If your parents are very controlling and throw their own version of a tantrum, then realize that this is likely always their reaction to not getting their way, i.e. you’ve seen them do this before, and you’re not going to change them at this late date. You can still try to talk to them about how they will always be in your life, but it’s not necessary to set yourself up for disappointment if you know how the conversation will go because you’ve already tried this before.

4. Always consider your fiancé your ally

These wedding preparations are just the first in many stressful events that will occur during your marriage. It’s good practice to start dealing with problems as a team rather than turning against each other. Right now you’re in love and the wedding is of your own choosing, but life is going to send you unexpected problems that you are going to have to handle. If you want your marriage to last, you had better start learning to handle them together. When huge problems or tragedies strike couples either turn toward each other for strength or turn away from each other; there’s just no in between in times of crisis. Planning a wedding certainly isn’t a time of crisis, but it is stressful and I see how couples in love begin to make small, seemingly innocent, disparaging remarks about each other, which they think are harmless. Such as, “He doesn’t know how to handle his mother,” or “She freaks out when she has one too many things on her plate.” These remarks do not build an attitude of “Thank goodness it’s you and me in this together.” They instead demonstrate an attitude of, “I now have more work because I have to handle you too.” If you have opinions about how he handles his mother and some suggestions, then voice them because otherwise this irritating situation will continue into your marriage. If you think she gets anxious easily, then speak to her about it and how the two of your can best handle things together when things are stressful. Through openly discussing these issues with each other, rather than making small snide remarks to others, you can figure out better ways to handle these situations. I’m not saying that you can change who they are, if he’s someone who really values his mother’s opinion or if she gets anxious when under stress then this isn’t likely to change, but their behavior can change. He can refrain from immediately saying yes to his mother’s suggestions and she can learn to ask for help when she begins to feel overwhelmed by too many tasks. You hopefully love and accept your fiancé just as he or she is on the inside, but behavior on the outside can be changed if it’s beneficial for your relationship.

So congratulations to all of you engaged couples! I hope that these tips are helpful to you during a time of stress and keep you focused on the joy of finding that wonderful person with whom you’re going to share your life.

Filed Under: Dating and Relationships, Engaged and Newlyweds, Stress Management Tagged With: bride anxiety, engagement, wedding stress

Insight Alone Isn’t Enough – How the Best Therapy Works

June 23, 2011 By Dr. Christine Fernandez Leave a Comment

There’s a longstanding debate in psychology between analytic (insight-oriented) therapy and behavioral-based therapy. Back in the early days of psychoanalysis, it was believed that insight was enough to “cure” a person of their ills. It was thought that if a person realized what was the fear or traumatic incident that first initiated the problem, then this new knowledge alone would enable the person to feel and behave differently. Not to knock the brilliance of Freud, but insight alone isn’t enough to effect real change in your life. Insight, or what Oprah would nowadays call an “aha” moment has to be coupled with behavioral change. Then the behavioral psychologists, who would focus mainly on changing behavior without gaining understanding about the underlying issues being addressed, left out the important insight component. Why is insight important? Because the things that we do make sense to us. Even if they seem crazy or self destructive or prevent us from reaching our goals, on some level – consciously or unconsciously – they make sense. And, until you figure out why, you’ll be hard-pressed to give the behavior up.

Here’s a case example to illustrate this point: Natalie* grew up with an angry, volatile father. He was not physically abusive toward her, but he was verbally abusive. She never knew what would set him off and tried very hard to be both perfect and invisible, the former so that she wouldn’t give him any reason to be angry and the latter in the hopes of his just not seeing her at all (if he didn’t see her he couldn’t yell at her). Smart as her little girl strategy was, Natalie couldn’t totally avoid her father and the fact was that he didn’t need any reason to get angry. Her father was an angry man and it was never really anything imperfect about Natalie that made him angry; he just came that way and anything and anyone could set him off. Well when he did catch her and began his tirade Natalie quickly learned that any back talk or expression of anger on her part enraged him all the more. He wanted her to take it and not say a word back. In fact, if she cried, he also became angrier. She learned that it was safest to show no reaction at all and that his tirade would end quicker if she was stoic and had no visible reaction. On the inside she was scared, hurt, and angry, but she learned not to show it. Afterwards she would run to her room and cry alone. This was the pattern the entire time she lived with her father.

Well in her romantic relationships as a adult, Natalie had a hard time ever saying anything that a partner might not like for fear of getting him angry. She continued to try to be Miss Perfect in her own way. She avoided obviously angry and volatile men, but certainly more even-tempered men are allowed to get angry from time to time and to voice it. Even when Natalie was with a calm man, she could never respond to anything that she perceived as anger, criticism, or displeasure with her coming her way. She had no idea how to respond or even defend herself; suddenly she would be a child again and she would freeze and show no reaction at all. Clearly it was standing in the way of her having a healthy relationship because disagreements can’t be resolved when one person is too scared and frozen to participate.

So Natalie came to therapy and discovered where her present day reactions originated. She realized that despite consciously believing that she wanted to make her relationship work, her silence was hurting it. But on an unconscious level her silence made sense – it was her way of protecting herself by shortening and preventing the escalation of what she expected to be an angry tirade. So Natalie had this great insight, but she still continued to behave in the same way because knowing what initially caused her reactions wasn’t enough to change them overnight.

So on to the behavioral change efforts. An important start to help Natalie change her behavior was to share her insights with her partner. He was happy to be supportive because he didn’t want to hurt or scare her and, being a fairly calm person, he didn’t want to be cast in the role of “angry, volatile man,” which is how Natalie would perceive him when he voiced any displeasure with something she did (and what displeased him most was her way of becoming silent when something important came up.) His knowing this about her made it easier for him to gently ask what was going on inside her when she became mute. He knew she was probably feeling scared and would do his best to help her feel safe.

However, his understanding and reassurance also wasn’t enough to effect change. Natalie had to practice a different behavior, i.e. say something at those moments when she was used to staying silent. It was very hard for her and very uncomfortable. She felt all of the same fear, even though this was no longer her father, but a calm person. What she had to do was actually speak and prove to herself that 1) she could tolerate the discomfort of this new way of behaving, 2) she could survive what would come if she “talked back”, and 3) that this loving man in front of her wasn’t her father and he was not going to react in the same way.

Her initial attempts were incredibly scary and awkward for her, but she practiced and did her best. She began with just saying things like, “I feel bad,” or at other times, just plain old, “Ouch.” But she eventually learned how to discuss things with her partner from the position of a grown woman rather than a frightened child. She discovered, to her surprise, that a man really did want to know what was going on inside of her during these moments, which, sadly, had never occurred to her before. Not only was Natalie helped by all of her hard work, but her partner was too. He felt grateful and relieved to be appreciated for the loving partner he was trying his best to be, rather than having some angry father image put onto him. He also felt heard because all of those times that Natalie would keep silent he would get upset thinking that she wasn’t listening to him.

I hope Natalie’s hard work was helpful in illustrating how the best therapy combines these two very important components of insight and behavioral change. If you want to really help yourself or a loved one, seek out therapy that fosters both.

* Name and exact circumstances have been changed.

Filed Under: Couples Therapy, Dating and Relationships, How Therapy Works, Individual Psychotherapy, Relationship Patterns Tagged With: relationship patterns, relationships, therapy

Three Tips for Handling The PMS Blues

June 14, 2011 By Dr. Christine Fernandez Leave a Comment

Ah the blues, I love ‘em only when Billie Holiday is singing them. But half our population experiences some version of PMS every month, and sadness is a common way. So here are some tips on how to handle the PMS blues when they arise.

1. Be kind to yourself.

This is good advice for any time of the month, but especially this time. That harsh, critical voice in your head can be at its loudest at this time. Don’t believe it! If you can’t ignore it then talk back to it. (No, that doesn’t make you crazy.) You can comfort yourself at these times, just say the same words to yourself that you would to a girlfriend who called you and was being harsh with herself. You would probably acknowledge if there was any truth in what she said but then you would also point out the positives about her.

Do the best that you can and acknowledge that on some days your best is better than others. Then be kind to yourself by treating yourself to something nice that won’t make you feel guilty afterward. Being kind to yourself doesn’t mean eating an entire chocolate cake, running up your credit card bill, or anything else that will later bring on a lot of guilt. Try going for a walk in the park, listening to great music, or meeting a friend for coffee – anything that you enjoy and feels healthy for you. These small things matter and have a big impact on lifting your mood.

2. Pay attention to what is troubling you.

PMS doesn’t come up with issues out of nowhere; it makes what you already think and feel more intense. Pay attention to what pops up and give yourself the leeway to handle it later, maybe in a few days, when you are at your best and thinking and feeling more clearly. But don’t ignore what is troubling you because it will likely be back next month kicking and screaming for attention just as loudly.

3. Acknowledge where you are.

Acknowledge that this is a temporary state and that it’ll pass. One of the problems with sadness, and especially full blown depression, is the thought that this will never change. This mood, brought on by the temporary condition of PMS, will pass with a little time and just accept that this is where you are and how you feel for now. Our emotions change every day, throughout the day. Remind yourself that you’ve survived this before, and like everything in life, “This too shall pass.”

I hope this helps you handle this time of month in a kinder and more loving way toward yourself.

If you have any other tips on how to deal with PMS please feel free to share.

Depression Therapy NYC | Depression Counseling Manhattan | Depression Counseling NYC

Filed Under: Depression Treatment Tagged With: depression, PMS

Moving In Together Stirs Up Old Fears

June 1, 2011 By Dr. Christine Fernandez Leave a Comment

If you’re divorced and have moved on to a new, meaningful relationship, the prospect of moving in together can stir up a lot of fear related to your past marriage and its demise. Anyone who has gone through a divorce will tell you that it takes some time to get over it and move on (understatement of the year.) If you didn’t leave in order to be with someone else, then you have to begin dating, and then you hopefully find a new, special person with whom you want to give love another chance. That sounds pretty healthy and like it’s going in the right direction right? Then why do you hit a wall of fear when it’s time to take the new relationship to the next, deeper level, such as moving in together? Suddenly what seemed like a wonderful idea – spending more time with the person you love, sharing your life, and even building a new life together – has become terrifying. Doubts now creep up everywhere, whereas before you decided to move in there were none. You start to wonder if you really love this person. Does he or she really love you? Are your spending habits compatible? Are your food habits too different? What if you run out of things to talk about? You may begin to act out in small ways that somehow delay moving in or you may get tense about things that should be fun, such as picking out furniture together. But why? A week ago, before you decided to move in together, everything was fine and you were thinking that this person was the one you wanted to have in your life for a long time. “What’s really going on here?” you wonder in confusion and frustration. Well a lot of fears related to your past marriage and resulting divorce have popped up because moving in together is the first step toward something more serious. More serious as in may result in marriage again. And, marriage again could result in divorce again. Some of your fears may sound like this: “Will I be able to handle it this time? What if I screw up again? Have I actually changed, or am I the same person who couldn’t make marriage work before? My marriage failed, what makes me think this relationship won’t?” (BTW, “failure” is not how I see divorce, but I’ve heard enough people use that word to describe their divorce to think that you may see it that way too.)

Well there is no guarantee that this relationship will work out better. But the best chance you can give yourself and your new partner is to understand what happened in the old relationship. That past relationship was created by two people and there’s no getting around that reality by thinking that your ex was the only one who made mistakes. Frankly, most divorced people are able to see the truth in this. But the effort you’ve made to understand how you contributed to the end of your marriage will only help your new relationship. How? Well this new relationship will push your buttons just like the old one did. Why? Because they are your buttons and any partner will unknowingly, and hopefully unintentionally, push them from time to time. But if you know yourself enough and understand where and how you could have handled things differently, then you can feel more confident about not repeating the same mistakes. That’s where therapy comes in. Therapy isn’t about beating yourself up for past mistakes, but about understanding why you behaved in the way that you did, gaining some compassion for yourself, and learning how you can handle things differently. So when it is time to move on to a new meaningful relationship, you may still have fears about your past marriage pop up, but you are able to honestly look at yourself and say that you now know better. You can comfort and quiet your fears with some compassion and self-forgiveness that say, “I did the best that I knew how at the time, but now I know better.” As the saying goes, “When you know better you do better.” Will you go on to make some new mistakes in your new relationship? Sure. But they’ll be different because you’re now different. You’ve learned, and that knowledge alone can calm those “moving in” fears when they come up, allowing you to more confidently enter a new, important stage in your life.

Did you experience this kind of fear when you moved on to a new relationship?

Filed Under: Dating and Relationships, How Therapy Works Tagged With: divorce