Has Your Habit Become Your Addiction?

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You have probably taken those addiction tests – we tend to label everything from shopping to sex to time online as an addiction.  On the downside, the addiction model takes personal responsibility away from the individual and puts the problem in some neurological grey zone.  It has a slippery slope that leads to the very dangerous victim mentality.

However, the addiction model has some useful pieces when we think about everything as an addiction – some things negative and other things positive.  Addictions can lift us out of our everyday boredom.  Alcohol can do that, and so can distance running or meditation.  Addictions can be used to calm or soothe jangled nerves.  Smoking can do that and so can chanting and yoga.

Body-focused Repetitive Disorders can be thought of as behavioral addictions.  Hair-pulling can calm and soothe.  Non-suicidal cutting is generally done in solitude.  Pulling, picking and cutting interfere with daily life and relationships.  The negative effects range from cosmetic to life-threatening ( trichobezars, deep infection).

The key to stopping a behavioral addiction is to replace it with a positive behavior that is a satisfying as the pulling or picking.  Bored?  Try to remember what you used to do thaaddictedt made you feel happy and alive …. try some activities offered in your community.  You can always sign up for starter sessions.  Keep with it for 3-6 weeks to give yourself enough time to make the new behavior a new habit.   A positive addiction if you will.

Not every activity has the potential to become a positive addiction. The behavior should take effort – you have to make time to fit it into your schedule.  You have to be able to get better at it – there are levels of proficiency that you can reach with effort and practice.  It is something you do alone – you can do it with a group (Zumba class), but the activity itself is not dependent on the group.  It isn’t a team activity – every member of the group acts individually.

Has you habit become an addiction?  Yes, if it relieves boredom, soothes you, takes time away from regular activities, causes problems in your relationships, feel anxious whenever the topic comes up or someone asks about it.

Do you regret that you can’t stop?  Have you tried to stop and failed? Finally, do YOU think it is a problem?  If so, make a decision to reach out for help, learn more about your behavior and how to cut down or quit.

Visit http://www.travisps.com for more information

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What Opportunities does Summer bring?

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Dear Parent,

Summer is a perfect opportunity to do some of the academic work you have been putting off due to your busy schedules.  You want next year to be the year you are managing an independent learner, happy in school and thriving in after school activities.  You don’t want another year of homework wars, late nights and anxious moments.  Once you and the kids have a chance to relax and unwind from school, take a little family vacation and enjoy some unscheduled time – you can get those evaluations completed.  This is a perfect time to test for the gifted program and get the meeting scheduled for August so they start the year off right.  It is also a good time to test for a learning or attention problem.  A meeting before school begins helps your child and the teachers get started on the right track for the next grade.  If you want some accommodations for SAT or any high stakes testing, it is best to get those numbers and have the meeting with school personnel early.

cogmedSummer is an ideal time for the 5 weeks of cogmed.  Deficits in working memory often underlie difficulties with reading comprehension and math in children I evaluate.  A working memory deficit makes it difficult to stay focused, plan what to do next, remember instructions, get started on a task and stick with it to completion! The problem exists across age levels.  Adults use Cogmed to improve professional performance and increase attentional stamina in the workplace.  Older adults use it to maintain and improve their brain function.

The complete program includes:

  • Initial interview
  • Start-up session
  • Five weeks of training with weekly coach calls
  • Wrap-up meeting
  • Six month follow-up interview
  • Access to the Cogmed training web
  • Cogmed extension training (12 months)

Summer is also a good time to address counseling issues for Trichotillomania, Skin Picking, or  Non-Suicidal Self-Injury.  It is also a good time to finally get a handle on anxiety and/or depression. Please call for more information and share this blog with your friends.

Get more information from my website  www.travisps.com or the Cogmed site www.cogmed.com/Mary Travis.   You can also go to our Facebook page “Travis Psycho Educational Services”.

Warmly,

Mary Travis, PhD

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Speaking of Shame: Eating Disorders

fatkidsFebruary 22-28th was Eating Disorder Awareness Week.  Eating disorders are yet another Body-Focused Repetitive Disorder, different from hair pulling, cutting and skin picking, and yet somehow the same.  In my opinion, eating disorders also belong under the shame umbrella.  They are in many ways about appearance and beauty – never being the right size or the right weight.  My young lady clients talk about the “thigh gap (good), the visible collar bone and upper ribs (also good).  However, this original focus soon becomes tangled with other factors.

Eating disorders are complex phenomena that involve  biological, neurological, emotional, and social systems.  They may begin with a preoccupations with weight and weight control, but ultimately are much more.  Anxiety and control drive the conditions.  In many cases the conditions co exist  with major depressions and anxiety.

As early as age 3, kids know that “Fat is bad.  Thin is good.”  Eating disorders have been identified as young as age 7.  Some sports are particularly focused on control of weight – ballet, wrestling and gymnastics.  Currently anorexia is the 3rd most common chronic illness in adolescents.  Anorexia also has the highest mortality rate of all mental disorders.

Eating disorders affect 20 million females and about 10 million males.  Besides anorexia, there is Bulemia and Binge Eating.  Bulemics generally eat and then use compensatory behaviors (vomiting, enemas, laxatives) in order to control their appearance.  Binge eaters describe an emotional release that comes from eating  thousands of calories at a sitting.  They may restrict food at other times or compulsively exercise in order to compensate for the binge.

You can test your own eating using the Eating Attitudes Test.  It is online and free.  You can also check out the National Eating Disorders Association online.  There is also a super site called mental fitness for those of you who want to learn more about prevention and wellness.

Again, these disorders are about not being good enough, pretty enough, smart enough, social enough, athletic enough….simply not enough!

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STARTING TO STOP Part 2: Body-Focused Repetitive Disorders

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The first thing to do is make an appointment for a physical.  You want to be certain that there is nothing going to hold you back.  You need energy and vitality to put towards your recovery.  Don’t let low blood sugar or high blood pressure or mono sabotage your chances of success.

Next thing to do is find the right therapist.  The right therapist will know about BFRDs and when you leave the first appointment you will have two things.  The first thing you want from  a competent therapist is an action plan.  You do not  have to understand yourself to change.  You have to change to change.  Understanding follows change-not the other way around.

By the second or third appointment you will have a quit day in writing on a calendar.  It will be a few months away.  In between you will have  some trial runs of increasing length – you will prepare to succeed.   You will reassess your activities with an open mind.  You may have to slow down or drop an activity in order to succeed at quitting.  You don’t want a lack of sleep or a packed schedule to sabotage your success.

You will prepare to feel worse before you feel better.  You may get a pink cloud right after Quit Day, but soon your old shame-based thoughts and feeling will try to sabotage your success.  Prepare for them so you can argue with them – be your own best defense attorney.

Plan to quit and work the plan – you are moving out of your comfort zone and leaving old ways of thinking and being behind.  Real freedom

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STARTING TO STOP: Body-Focused Repetitive Disorders (BFRD)

“A journey of 1,000 miles begins with a single step.” Lao Tzu

Your habit has become a problem for you.  So far you have been successful at concealment, but it is getting more and more difficult to hide.  You have resolved to stop so many times and failed.  How do you start to stop once and for all?

first-stepIf you have ever read “Bridget Jones Diary,” you know she recorded events in painful and embarrassing detail.  This is your first step – writing exactly what you do and when you do it.  Everything matters as you write.  Your shame based habit/behavioral addiction will attempt to convince you that this or that doesn’t matter.  It will tell you not to be so silly as to be bothered by “that” whatever “that” might be.  Resolve to tell that voice to keep still and write as if everything that matters to  you matters.  Why?  Because it is important for you to start thinking that you matter.

After you have kept the diary for a period of time, read it over.  Look for what is missing in your life and your relationships.  It may be a sense of personal pride missing.  It may be meaningful friendships.  It may be a sense of worthiness (to be loved, to be cared for). Once you see what is missing, decide to change.

Once you decide to change, understand that the world will be happy to help you.  Change means reaching out and the internet is a perfect place to reach out.  Find a website, find an online support group – read and participate.  Finally, you have broken through the isolation!  You are on your way!

“The way to get started is to quit TALKING and begin DOING”

http://trichworld.ning.com/profile/MaryATravisPhD

http://travisps.com

http://www.selfinjury.bctr.cornell.edu/

Don’t forget to follow us on FB: Travis Psycho Educational Services Twitter: DrMary2003

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Under the Hurt Umbrella: Shame and Body-Focused Repetitive Disorders

Wall-of-ShameIn my work with clients who deal with Body-Focused Repetitive Disorders (BFRDs) I have gradually become convinced that in many individuals shame drives the behavior.  BFRDs manifest in compulsive pulling of one’s hair (Trichotillomania), picking at skin and scabs (Excoriation), cutting, carving, biting, and starving (Non-Suicidal Self-Injury NSSI). This shame results from an individual’s unrealistic(even grandiose) expectations of oneself. When expectations are not met perfectly and an individual cannot accept that the expectations were unrealistic in the first place, the system is overwhelmed with fear and anxiety that result in shame.

Shame is different from guilt.  Guilt can be explained – you did something wrong.  You can confess and be forgiven.  Shame – you are wrong.  You can only hide and conceal your weakness.  The result can be a combination of blurred boundaries, depression and defensive rage.

The cycle is vicious.  Unrealistic expectations set up anxiety and fear of failure.  When anxiety and fear become overwhelming, self-harm temporarily offers escape from the uncomfortable and finally intolerable state.  Engaging in the behavior results in shame and  negative self-talk.  When efforts to conceal are discovered, and individual defends the secret behavior with narcissistic rage.  Once the cycle is complete, the individual resolves to “do better,” “to quit,” and to be the perfect self that set them up for failure in the beginning.

Shame is a challenge for therapists because it causes clients to hide and conceal.  Clients will often admit to feelings of aggression-feelings that have power.  When you first suggest shameful feelings – clients will deny them and try to escape the discussion.

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Cogmed Story: Jason Follows Through (Final Session)

You remember Jason the 26 year old young man who hope to return to college.  HeiStock_000003516561Small participated in Cogmed for Adults and his results are startling!  It has been awhile since he finished and we had our follow-up final session.  The reason for that  is that  Cogmed is set up to look for “far transfer,” or long term results.  We don’t have our final session until 4 – 6 weeks after the program is completed.

A criticism of other computer assisted programs for working memory and attention is that they measure how well participants did in the program, not necessarily how their achievements transferred to real world changes. That is why in Cogmed we meet after 4-6 weeks to talk about changes in real life as experienced by participants and others in their lives.

Training results can be described in three different ways.  First is a Training Index which is calculated continuously throughout the program.  Index Improvement is calculated by comparing the beginning index with the highest index achieved during training.  Average index Improvement of trainees aged 18 and above lies somewhere between 15 – 41 units.  Jason’s Index Improvement was 79!  He still attributes this to “…being really awful at the beginning….” but I don’t think so – I think he needed a disciplined training experience to tap into his real capacity.

The Cogmed Progress Indicator, the second way to describe results,  measures percentage of improvement on three separate tasks: Working Memory, Following Instructions, and Math.  Jason had a 26% improvement in Working Memory, 77% improvement in Following Instruction and a 26% improvement in Math.

The third way to describe results is by using Behavioral Assessments (rating scales) for the Executive Skills of Inattention and Impulsivity.  shapeimage_1The larger the decrease in severity the stronger the training effects.  Cogmed also takes into account verbal opinions in this case from Ryan and his mother.  Jason had a decrease of 7 points in a measure of Inattention and 5 point in Impulsivity.    Jason described the most prominent effects of his training this way:  “I feel more focused and aware.  I’m able to stay focused and I definitely remember more.”  His mother said that she doesn’t always have to keep reminding him to do things, and he does them well.  Jason takes care of an elderly relative’s medications and routines.  His mother used to always have to check to see it was done correctly, but she doesn’t feel she needs to do this anymore.  Jason has also started taking action.  He has enrolled in an online speed reading class to prepare to begin college in January.

Jason is also planning to take a face to face reading and reading comprehension class in about two weeks.  He says the face to face will be a challenge because, “I’ve always been uncomfortable in groups.” This social uncomfortablility is not uncommon in people with working memory and attention difficulty.  I predict Jason will be better able to focus on conversations and so respond appropriately to peers.  He will be better able to stay on topic and remember what has already been discussed.

Jason’s progress was impressive.  Better yet – he’s not finished improving.  Continuous follow-up with Cogmed trainings has taught us that 25% of training effects are subtle right after training. Transfer effects to areas like reading comprehension and math may take a few more months to establish. Also, research shows that many users continue to improve on different skills related to working memory up to one year after training.

We have another follow-up scheduled for March 15, 2015. collegestudent Jason’s new working memory capacity will offer him many natural opportunities to use his improved ability.  He will likely read faster so reading will be more fun and he will do it more often and for longer periods.  If he is able to remember what to do and is given positive feedback for this, he will be more engaged with others.  He will listen to them and follow-through on tasks and keep commitments.

I am so pleased with Jason’s Cogmed progress so far.  I predict more success in the future.  Will let you know in March of 2015 when college student Jason returns!

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