As COVID-19 cases increased around the United States toward the end of March 2020, governmental regulations issued stay-at-home orders, school closures, and caused many individuals to be laid off, furloughed, or to work from their homes. Although stay-at-home orders were intended to reduce the spread of COVID-19 and keep our communities safe from contracting COVID-19, home is not always a safe place for individuals to live, especially for adults and children who reside in homes where domestic and familial violence occurs. For these individuals, home environments are often a place where power and control predominate, and where significant others who perpetrate violence or abuse, can assert their power without intervening with others outside of the family unit. COVID-19 restrictions on movement and outside activity reduced access to escape, help-seeking behaviors, and mechanisms to cope for victim-survivors. Additionally, social norms and attitudes, with respect to family life and connectedness during the pandemic, likely contribute to increased challenges for victim-survivors to seek help, speak out, and/or leave due to increased feelings of shame, guilt, and embarrassment. As the pandemic and its restrictions continue, it is important to understand that positive conceptions of home and family life can contribute to increased marginalization and silence for individuals that live and have connections to a home life that is unsafe and may be fraught with violence.

So, how can we help deal with Domestic Violence?

What Friends, Family, and Significant Others can do to curb Domestic Violence:

Friends, family, and significant others can support others who are struggling with domestic violence by having conversations with victim-survivors. Though these conversations may be difficult, several tips can help support victim-survivors.

1. Acknowledge the situation is difficult and scary, and the violence or abuse is not their fault.
2. Let the person or family know that they are not alone and that there is help and support available to them.
3. Listen and be supportive. Telling victim-survivors what they should do or should not do will likely lead to further isolation and disempowerment. It is important that friends of victim-survivors make known that they support the individuals and their decisions.
4. Don’t be judgmental or harsh. Individuals have many reasons for why they stay in violent or abusive situations and/or leave and return to these situations. Perpetuating further shame or guilt to these individuals not only contributes to the shame and guilt they likely already feel, but can contribute to increased sensations of loneliness, isolation, and helplessness that their abusive situations already cause.
5. As much as we may want to “rescue” a person or family from violence, the only person that can save the person is themselves. Abuse and violence are about power and control, and we must do everything to empower these individuals to make helpful decisions for themselves.
6. Develop and collaborate on a safety plan with a person or family struggling with violence or abuse. A safety plan is an individualized, practical plan that can improve the person or family’s safety while experiencing an unsafe or abusive situation. This can be helping the person or family cope while remaining in the home, preparing the person or family to leave, or helping problem-solve after they leave. Safety plans include strategies to remain physically safe, emotionally safe, and sometimes involved with legal protections.
7. Help the person or family identify and build support from other family members, professionals, or people to increase the person or family’s recognition and access to safe people or places.
8. Suggest, identify, and collaborate with the person or family to find a local service provider, supportive professionals, or referral to a mental health care provider.

What Medical and Mental Health Professionals Do to Treat Domestic Violence:

1. Professionals should attend to and screen every patient for domestic violence at the beginning of visits while ensuring patient privacy by screening patients without the patient’s partner or children present, if possible.
2. Patient confidentiality should be reassured and sensitivities must be given to confirm if the patient can and has access to a private and safe place to talk.
3. Alternative methods of communication may need to be provided, and if possible, professionals should know how to provide comprehensive screening with yes/no questions. When applicable, professionals should provide nonverbal communication tools.
4. Referrals should be provided for patients who screen positive for intimate personal violence or domestic violence within their communities. Referrals to community resources can reduce psychological harm from IPV and offer support to victim-survivors. Additionally, barriers of access to resources provided should be assessed and problem-solving should be included to allow patients the opportunity to utilize the resources given.

Medical and Mental Health Professionals can search for local shelters at https://www.domesticshelters.org, search for resources by the state at https://www.womenshealth.gov/relationships-and-safety/get-help/state-resources, and find resources to use during the COVID-19 pandemic at https://www.futureswithoutviolence.org/get-updates-information-covid-19/.

If you need immediate help or need a discreet way to reach out for help regarding domestic violence, please visit The Domestic Violence Hotline   and call 800.799.SAFE (7233).

If you or someone you know is struggling with domestic violence or interpersonal violence, the trauma program at Specialized Therapy Associates can help. STA offers individual and group counseling by experienced, highly trained therapists to help individuals process trauma, reduce isolation and shame, and promote healing.

References:

1. Bradbury-Jones, C., & Isham, L. (2020). The pandemic paradox: The consequences of COVID-19 on domestic violence. Journal of clinical nursing, 29(13-14), 2047–2049. https://doi.org/10.1111/jocn.15296

2. Evans, M. L., Lindauer, M., & Farrell, M. E. (2020). A Pandemic within a Pandemic — Intimate Partner Violence during Covid-19.N Engl J Med, 383(24), 2302-2304. https://doi.org/1056/NEJMp2024046
3. Moreira, D. N., & Pinto da Costa, M. (2020). The impact of the Covid-19 pandemic in the precipitation of intimate partner violence. International journal of law and psychiatry, 71, 101606. https://doi.org/10.1016/j.ijlp.2020.101606
4. Naional Domestic Violence Hotline . (2021, January 4). Talking About Relationship Abuse. https://www.thehotline.org/resources/talking-about-relationship-abuse/.
5. Smith SG, Zhang X, Basile KC, et al.; Centers for Disease Control and Prevention; National Center for Injury Prevention and Control. National Intimate Partner and Sexual Violence Survey: 2015 data brief – updated release. November 2018. Accessed June 30, 2020.
6. Ver, C., Garcia, C., & Bickett, A. (2021, January 1). Intimate partner violence during the covid-19 pandemic. https://www.aafp.org/afp/2021/0101/p6.html.

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Have you been experiencing difficulty focusing, or been having difficulty with your motivation to do things you used to do or to plan for your future? These executive functioning skills are how our brains help us to set goals, create plans, and to carry out those plans. When we are experiencing a high level of stress, we hit a brick wall and all of those skills stop functioning properly.
With stress, an individual may feel overwhelmed and cannot make decisions, they may experience difficulty with organizing, planning, and getting started. An individual under extreme stress may lose interest in activities, have mood swings, and be unaware or deny poor decision-making.
To regain temporary focus, an individual might want to work on simple problem-solving strategies:
– First, they will need to identify what the problem is.
– Next, they can consider some alternatives and options and create a list of strategies to move forward.
– Next, they can create an effective plan by laying out the steps to that plan.
– Finally, they may consider creating the plan in writing and planning and initiating action for that plan.
Sometimes it is difficult to initiate these steps on your own and we can help guide you through that process. At Specialized Therapy Associates and Fx Med Centers, our therapists and specialists are trained to help guide individuals to carry out these goals and plans.
You may also be concerned about the way you are processing information, and at Specialized Therapy Associates we can evaluate the way you learn information for planning and processing potential. (What does she mean by processing potential?) Some of our evaluations include neuropsychological evaluations, ADHD evaluations, and dementia identification.
If you are interested in an evaluation, you can contact our offices at (201) 488-6678. All evaluations are being conducted virtually at this time.

Author: Jill Caruso, PsyD
Assistant Director, Specialized Therapy Associates
4 Forest Avenue, Paramus, NJ 07652
(201)488-6678

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This week is National Eating Disorder Awareness Week! Did you know that eating disorders are among the deadliest mental illnesses second only to opioid overdose? 10,200 deaths each year are the direct result of an eating disorder (1).

Some common myths surrounding eating disorders are:

1. “People who have eating disorders must be underweight”. Eating disorders look different for everybody and present themselves in many different ways. Less than 6% of people with eating disorders are actually diagnosed as being underweight (2). Just because someone doesn’t look physically sick, doesn’t mean they aren’t suffering.
2. “Only women can have eating disorders”. Men can have eating disorders, too, and the number of cases has increased in recent years. From 1999 to 2009 the number of men hospitalized for eating disorder-related causes increased by 53% (4). Males account for 25% of individuals with anorexia or bulimia eating disorders. Gay men represent almost half of men with eating disorders and are more likely to fast, vomit, or take laxatives or diet pills to control their weight (5).
3. “Eating disorders are a choice”. Eating disorders are serious mental illnesses, not lifestyle choices.

Click here to fill out our Eating Disorder Self-Assessment checklist.

If you feel like you or someone you know is suffering from an eating disorder, we are here to help! Our staff offers a unique holistic and integrative approach to eating disorder treatment using psychological therapy and a functional medicine approach to regain health.

Call 201-448-6678 to make an appointment or click here to enter your information and learn more about how our team can help!

By Taylor Groff, MS Functional Nutritionist

References:

1. Deloitte Access Economics. The Social and Economic Cost of Eating Disorders in the United States of America: A Report for the Strategic Training Initiative for the Prevention of Eating Disorders and the Academy for Eating Disorders.June 2020. Available at: https://www.hsph.harvard.edu/striped/report-economic-costs-of-eating-disorders/.
2. Arcelus, Jon et al. “Mortality rates in patients with anorexia nervosa and other eating disorders. A meta-analysis of 36 studies.” Archives of general psychiatry68,7 (2011): 724-31. https://doi.org/10.1001/archgenpsychiatry.2011.74
3. Zhao, Y., Encinosa, W. Update on Hospitalizations for Eating Disorders, 1999 to 2009. HCUP Statistical Brief #120. September 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb120.pdf
4. Hudson, J., Hiripi, E., Pope, H., & Kessler, R. (2007) “The prevalence and correlates of eating disorders in the national comorbidity survey replication.” Biological Psychiatry, 61, 348–358.
5. Eating Disorders in LGBTQ+ Populations. (2018, February 21). Retrieved February 22, 2021, from https://www.nationaleatingdisorders.org/learn/general-information/lgbtq

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The impact of holiday stress and pandemic stress on your immune system and the role of perception.

We are undoubtedly living through a stressful time in history. The coronavirus has proposed new and unforeseen challenges to each and every one of us as individuals and collectively as a nation. Suddenly, our daily routine built on stability and predictability has taken a deep dive into uncharted turbulent seas and we have been left to tread water. Between staying on top of the rapidly evolving CDC guidelines, managing our newly virtual careers, keeping small businesses afloat, online schooling, and trying to stay socially connected at a physical distance, it is no wonder we are more stressed than ever!

On top of all that, the holiday season is upon us which proposes a whole new set of challenges. Stress levels tend to be higher this time of year due to the demanding nature of the holiday season. This increase in stress comes with an increase in the incidence of cold and flu, especially as we transition into the winter months. This is no coincidence because stress suppresses the immune system which increases our susceptibility to cold and flu⁴.

This year, we must consider the double affliction of holiday stress and pandemic stress on our immune system’s ability to cope with potential invaders like COVID-19. Therefore, in addition to eating healthy, getting enough sleep, and taking immune-boosting supplements like vitamin D, we must make sure we have our stress levels under control this holiday to make sure our immune system is in fighting shape.

To do this, we must first understand how stress suppresses the immune system so we can determine where and how we can intervene to alleviate its effect.

When we perceive emotional or environmental stress, our hypothalamic-pituitary-adrenal (HPA) axis becomes activated in our brain¹. Once activated, the brain sends a signal to the hypothalamus to release corticotrophin-releasing hormone (CRH) which signals the pituitary gland to secrete an adrenocorticotrophic hormone (ACTH)¹. ACTH signals the adrenal gland to produce and excrete cortisol, the primary stress hormone^1,2. Cortisol is a steroid hormone that normal physiologic levels is anti-inflammatory ². This should be considered a good thing… right? In acute situations, yes! Glucocorticoids are so effective at reducing inflammation that they have been reverse-engineered into pharmaceuticals to be prescribed in conditions caused by inflammation like allergies, asthma, and autoimmunity.

However, in today’s world, we are faced with chronic stress which keeps our cortisol constantly activated, and our immune system chronically suppressed. So, the hormone with the initial intention of protecting us by lowering inflammation is causing more harm than good by chronically suppressing our immune system. The current state of the coronavirus pandemic on top of holiday stress comes at an incredibly high price to our immune system. So, what do we do?

The only way to mitigate activation of the HPA axis is to halt cortisol release is by intervening at the source- taking back control over how we perceive stress and what stressed us out. Of course, this is easier said than done, but research shows that people who are better equipped to handle stress with appropriate coping mechanisms have a heightened ability to fight off viral or bacterial threats to the immune system⁵.

There are thousands of studies that link mindfulness meditation to lowering stress levels and improved immunity. From a functional medicine perspective, this is an imperative intervention to bolster your immune response³. In addition, speaking to a licensed clinical therapist or making time for stress-lowering activities like biking, journaling, or painting are quintessential to prime your immune system’s defense and should become a non-negotiable part of your lifestyle- especially this year, this time of year, and always.

If you would like more guidance on how to beat the stress of the holidays, please contact Specialized Therapy Associates at (201)-488-6678 to make an appointment. You can also visit us online at Specialized Therapy.

By Taylor Groff, MS Functional Nutritionist

References:

1. Katz, D. A., Locke, C., Greco, N., Liu, W., & Tracy, K. A. (2017). Hypothalamic-pituitary-adrenal axis and depression symptom effects of an arginine vasopressin type 1B receptor antagonist in a one-week randomized Phase 1b trial. Brain and Behavior, (3). https://doi-org.uws.idm.oclc.org/10.1002/brb3.628. Retrieved from: https://uws.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edsgao&AN=edsgcl.485132319&site=eds-live&scope=site
2. Sapolsky, R. M., Romero, L. M., and Munck, A. U. (2000) How Do Glucocorticoids Influence Stress Responses? Integrating Permissive, Suppressive, Stimulatory, and Preparative Actions. Endocrine Reviews 21(1): 55–89.
3. Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1):13-24. doi:10.1111/nyas.12998
4. National Institutes of Health (US), National Institute of Mental Health. Fact sheet on stress
   [cited 2013 Aug 21] Available from: URL: http://www.nimh.nih.gov/health/publications/stress/index.shtml
5. Abdurachman, Herawati N. THE ROLE OF PSYCHOLOGICAL WELL-BEING IN BOOSTING IMMUNE RESPONSE: AN OPTIMAL EFFORT FOR TACKLING INFECTION. Afr J Infect Dis. 2018;12(1 Suppl):54-61. Published 2018 Mar 7. doi:10.2101/Ajid.12v1S.7

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We all know we have them but.. Do we really sit down and list them? Do we figure out an action plan on how to work on them? And even if we do, Do we stick with it without the accountability of a therapist? And lastly, Do we actually explore how our demons are preventing us from being in the present moment?

“Demons” do not always have to fall into what most people consider ‘negative’ qualities, like perhaps overindulging (eating, alcohol, gambling), being judgmental or jealous. They are just things that distract us from enjoying our lives fully. In fact, a lot of the time our ‘demons’ can be sneaky irrational thinking (that we usually don’t like to admit to anyone) such as..

1. An inability to internalize praise
2. Constantly doubting ourselves and our worth.
3. Thinking no one likes us and obsessing about our every move
4. Nervous thinking/imposter syndrome
5. People pleasing/codependency

A lot of individual’s struggle with a ‘perfect’ combination of ‘demons’ that leave them so consumed by what they need to do to be approved of by others that they do not learn how to approve of ourselves and are thus, unable to live in today.

If you find yourself struggling with being in the moment due to your ‘demons’ and would like some help finding your own intrinsic joy, Please reach out to Specialized Therapy Associates  and Fx Med Center today at 1-201-488-6678 and schedule an appointment today. We look forward to meeting you!

The post Are you ‘demons’ preventing you from being in the present moment? first appeared on Specialized Therapy.

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The 3 P’s

Martin Seligman, as cited in Sheryl Sandberg’s book, explains the 3 P’s that stunt healing as we process trauma & difficult life events. The 3 P’s stand for Permeance, Pervasiveness & Personalization. Permeance is the belief that this event will last forever. Personalization is the belief that we are at fault and Pervasiveness is the belief that this negative event will affect all areas of our lives.

Seligman goes on to explain that we cultivate the resilience we need to heal throughout our lives. Some people are psychologically more fragile, while others are born with a more innate ability to handle difficult events. That said, Seligman believes that we can develop resilience based on we surround ourselves with & the choices we make. He further elaborates that we need to get rid of “always” and “never” in our vocabulary of healing, ie: “I will always feel this awful” to “I will feel this awful sometimes”, especially if we hope to address “Permeance” (one of the 3 Ps).

Both Seligman & Sandberg discuss how difficult it is for people to process grief & change especially when people are so wary of ‘holding space’– They call these “non-question asking friends”, which is why therapy & group services are so important for people. They create an environment for healing which we would not have otherwise had.

If you or someone you know is struggling with letting go & needs some help navigating the 3 P’s and wants to live their best Option B, please call Specialized Therapy Associates today at 201-488-6678.

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“Don’t say it unless you mean it” is often the response to an offhand apology. When you are forced to apologize you may not do it in a sincere manner. Then it falls on deaf ears. It seems like more of an insult than a reparation. So a powerful apology benefits from sincere emotion. In order to develop that, you need to reach for empathy. Understanding how you hurt someone, feeling what it would be like if this transgression was done to you leads to a more sincere effort. Your sincerity is transmitted through your voice and body.

Reparations. Another important aspect of a powerful apology. 12 step programs talk about making amends to those you hurt.  But how do you fix the hurt or damage you caused? A card? Flowers? Taking responsibility for your actions? A public apology? Any of these may be called for depending on the situation.

Taking Responsibility

Taking responsibility for your actions. A good apology acknowledges what you’ve done wrong. “I’m sorry your feelings got hurt, but I didn’t do anything wrong” will not take you far in repairing the relationship. It may, in fact, trigger an argument and further conflict. This approach sounds like you’re blaming the person who was hurt. “You shouldn’t feel that way, you’re too sensitive” also blames the victim.  So, you need to validate the person’s feelings as well as identify what you did wrong. If you can’t see what you did wrong, you may just repeat it.

“You always say you’re sorry, but you just keep doing it. I can’t trust anything you say”. By recognizing and taking responsibility for your behavior, you can change it. If you use an offhand apology to Band-Aid the problem and continue your behavior, your words become worthless. People don’t forgive what you continue to inflict on them. In some cases, words are not enough. Look to the old saying – Actions speak louder than words.

And then there are those who just won’t say “I’m sorry” at all. They don’t seem to know how to apologize. Learning how to be comfortable with and to make a meaningful apology can improve your life and will certainly improve the quality of your relationships.

If you need help with making apologies or improving relationships in your life, call Specialized Therapy Associates at 201-488-6678 for more information. Or check our website at specializedtherapy.com

The post The Power of Apology first appeared on Specialized Therapy.

The post The Power of Apology appeared first on Specialized Therapy.

It is our experiences in life that shape who we are and how we see the world.    Everything that we believe about ourselves, about others, and about the world in general is learned through our personal experiences.  It is therefore not surprising that experiencing chronic trauma during childhood leaves deep marks.  The effects of chronic trauma on a child’s body and brain build on each other.   They reveal themselves in acting-out behaviors, school difficulties, somatic complaints, eating disorders, self-harming and withdrawal.   This results in issues including post-traumatic stress disorder, anxiety, depression and substance abuse.  Though the behavioral and psychological effects of trauma have long been known, more recently, researchers have begun to discover what happens in the brain following this kind of trauma.

Childhood is when the brain develops and becomes organized.   When the people who should be protecting, loving, and guiding young children expose them to trauma instead of care, children’s brain development can get derailed.   Children affected by recurrent traumatic experiences may suffer serious symptoms that interfere with normal emotional, cognitive or social development.  It has been noted that the neural connections in the area of the brain associated with regulation of emotion, attention and various other cognitive processes are critically impaired in adults who went through severe abuse as children.   Traumatized children often feel hopeless, confused, unlovable, unsafe, and are afraid to trust others or their environment.

The good news is that children and adolescents can learn new ways of thinking.  In fact, the cortex, the highest part of the brain, continues to develop throughout adolescents and into adulthood.   By providing new, positive experiences we can reshape early patterns and help traumatized children and adolescents to build new neural pathways to bypass old ones.

Specialized Therapy Associates provides a wide range of Trauma Recovery therapeutic treatment and services for Children, Adolescents and Adults.  If you would like to find out more, please call the intake department at 201-488-6678, or visit our website at https://www.specializedtherapy.com

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Empowering Strategies:

1. Mentally: adopt new empowering beliefs. Start by examining 3 or 4 core beliefs. Are they serving you in a positive or negative way? If they are negative, develop a new mindset and if they are positive cultivate them further. Say positive affirmations to yourself on a daily basis; create vision boards or develop an action plan.
2. Socially/ Emotionally: acknowledge and express your feelings in a constructive way and seek support from family and friends. Start a gratitude journal or list. Let go of resentments or grudges and release toxic emotions such as shame and guilt. Engage in fun and stimulating social activities and periodically try new activities.
3. Physically: nourish your body by eating healthy food, doing regular exercise, engaging in relaxation, mindful or meditative activities to release physical tension in the body.
4. Spiritually: derive strength from your spiritual/ religious beliefs and community and if you don’t identify with spirituality or religion, adopt a life philosophy that speaks to a perspective about positivity or love. Participate in support groups and read inspiring materials.

Specialized Therapy Associates has a wide array of therapeutic services that can help support clients in their journeys towards true Self-Empowerment. Please call the Intake department at (201) 488-6678 to find out more information about available services.

The post Self Empowerment: An Achievable Goal first appeared on Specialized Therapy.

The post Self Empowerment: An Achievable Goal appeared first on Specialized Therapy.

One powerful way we learn is through reward-based learning. When we are exposed to a trigger, we move toward that trigger and get rewarded by experiencing something that feels good (positive reinforcement) or move away from that trigger and terminate a negative feeling (negative reinforcement). Habit loops get formed when this pattern occurs over and over- Trigger. Behavior. Reward. The more we repeat a behavior, the more we learn to see the world in a certain way- through a lens that is biased. Over time we get used to wearing a certain lens and forget that we are even wearing it.

Brewer defines addiction as continuing to use (or do) something despite adverse consequences. Engaging in abusive behavior hijacks the dopamine reward system in the brain. That pattern of Trigger. Behavior. Reward., which works well for all animal species in terms of finding food, mating and avoiding aspects of the environment that are dangerous, unfortunately lends itself all too readily to behaviors that are rewarding in the short term but not helpful to us in the long run. When you’re feeling nervous, you smoke a cigarette and then you feel less nervous, you’ve just strengthened that habit loop for yourself. When your smartphone signals you that you’ve gotten a message, you check it and then you feel good to see that someone has liked something that you posted, you’ve just strengthened that habit loop for yourself. The same goes for romantic love, which Brewer explains involves a focus on how you are feeling, which increases cellular activity in the posterior cingulated cortex (PCC), which is the brain region linked most consistently to self-reference. The book offers more interesting information about all of this, so if you’re interested, you’ll want to read the book.

What about the connection to Brewer’s meditating that I mentioned above? Well, when he launched the Yale Therapeutic Neuroscience Clinic with a smoking cessation study, he found that the results revealed a better outcome by those who used his program than those who used the American Lung Association’s gold standard Freedom From Smoking treatment. What did his treatment involve? Generally speaking, Mindfulness, that is, “seeing clearly what happens when we get caught up in our behaviors and then becoming viscerally disenchanted.” (You’ll have to read the book to see what Brewer says the Buddha had to say about all of this.) More specifically, mindfulness involves a series of behaviors that can be remembered with the mnemonic RAIN. Recognize/Relax into what is arising (for example, a craving). Accept/allow it to be there. Investigate bodily sensations, emotions and thoughts happening right now. Note what is happening from moment to moment. Sounds too simple to work? As Brewer says that the Buddha is reported to have said, “Don’t believe what I say, try it for yourself.”

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