New Year, New Career?

There will be millions of New Year’s resolutions made and broken within the next two weeks. Have you recently been struggling with your job? Do you have a job or a career? Do you love going to work? Are you passionate about your work? For the lucky ones, going to work every day can bring a sense of accomplishment and personal development. If you are currently struggling with what to do next with your job/career, then this blog is for you.

Most people do not realize that therapist can be a great resource for career counseling. Each individual functions on his/her own continuum and evolves emotionally, spiritually, intellectually and professionally. Therapists can help you decipher whether or not your current work conflicts are related to interpersonal struggles, past traumas, or even just a desire to find a more fulfilling career. As we transition through developmental phases we have different financial, emotional and personal needs. A trained professional can help you determine where you are on the life cycle, assess your vocational maturity, provide you with resources to determine what type of training you might need and help you plan action steps to reaching your desired end results.

At Central Florida Mental Health Associates we have a team of dedicated, licensed, trained professional who are eager to assist you in career counseling. If you are interested in a free 15 minute free phone consultation, feel free to give us a call at 386-736-9165.

Jennifer Nadelkov, MA, LMFT

Positive Self Talk for Parents

After hours of meetings, a cranky boss, and lots of traffic, coming home to our children/family should be the best part of our day. Let’s be honest, it doesn’t always work out that way. Your teenager is age appropriately self absorbed and honestly does believe their world will come crashing down if you don’t immediately drive them to the movies. Your three year old does believe he or she has the strength to pour his or her own glass of milk, which you and I both know will end up on the floor. Your significant other does believe his or her funny story from their work day is so important you should sit down, smile and laugh, despite your own exhaustion level. The dog that has obediently waited all day to be walked, will gladly relieve himself on your shoes at its earliest convenience. Life is not always the storybook we imagined it would be. While there are very rewarding days with our families, there are also stressful, exhausting days when we just aren’t really sure how to manage our “home” responsibilities.

There are a ton of articles that will tell you what to say to your children and what not to say to your children. You can also find a ton of research on all the right things to say to let your significant other feel valued and supported. While those are very important tools to have in your tool bag, that is not the intention of this blog. This short blog is a helpful list of things you can tell yourself to get through a stressful evening after a stressful work day to avoid resorting to maladaptive patterns of self destructive behavior.

1. “I matter”
2. “I am an important part of this family”
3. “I can do this”
4. “I am willing to do whatever it takes”
5. “I can handle this”
6. “Its ok if I’m not good at this”
7. “I will not give up”
8. “I’m going to be OK”
9. “I will have a better day tomorrow”
10. “I am capable”
11. “I am valuable”
12. “I am learning and growing”
13. “I can solve any problem”

Repeating these positive statements to yourself may seem a bit silly at first, but I promise you there are countless benefits to taking care of yourself. In your chaotic day to day life, taking a few moments to remind yourself that you matter, are important and have value can make all the difference. The next time you take a phone call and the children have turned dinner time into a food fight, take a brief second and practice some positive self talk. Good luck!

Jennifer Nadelkov, LMFT

Fight Fair

Inevitably, at some point during your relationship with your partner you will have an argument. It is part of life. However, have you ever had the argument that spiraled out of control? Or the argument that lasted two days? A week? Longer? One of the important things to learn, in order to maintain a healthy relationship is how to "fight fair."

Arguments will happen, so accept that. When they do, be sure to have the argument in a respectful way. Be focused on the problem, and don't bring previous problems or events into the argument. Do not try and tackle multiple problems at once, one thing at a time so that you don't overwhelm yourselves.

Make sure that you utilize time outs. Time outs are not just for children, they are for adult use as well. There are two keys to using time outs as adults, the first is that you have to allow your partner to walk away if they ask for a time out, do not follow them down the hall continuing the argument, let them go. However the time out is not open-ended, set a time that you both agree to return to the discussion, say for example 15 minutes, this gives everyone a chance to calm down some. Then you can return to the discussion and try and create a solution for the problem.

Listen to what the other person has to say, and allow them to complete their thought. Regardless of how many times you may have had an argument, and how each time your partner says the same thing, this might be the time they take a different perspective, and have something different to say. And if you cut them off prior to their completing their thought, you are ensuring that you will have the same argument over again. None of us are mind readers, so don't play that role in your argument.

It is also important to try and understand things from your partner's perspective. Not that you have to agree with their perspective, but if you can understand where they are coming from it will help you both in the development of a solution.

And finally, remember to forgive one another.

Facts

Paying attention to facts becomes invaluable especially under stress or when we are faced with an important decision. Often times, stress, and vigorous anxiety (i.e., breakup of a relationship, divorce, important business decision) encourages us to feed into irrational thinking, which in turn, only turns up the volume of our stress and anxiety. Paying attention to facts can often inoculate us from experiencing severe levels of anxiety and stress by keeping us rational, logical and from feeding into our negative thinking patterns. *Feel free to leave your comments

Travis McBride, MA, LMHC

Owner/Therapist

Central Florida Mental Health Associates, LLC

386-736-9165

You Are Not Your Illness

Serious mental illness affects approximately 14 million people in the United States, according to the National Institute of Mental Health. And mental illness is the second leading cause of disability in the United States, according to MentalHealth.com. Yet, 2/3 of people who have mental illness do not seek treatment. Some of the reasons people do not seek treatment are due to lack of resources, insurance, and for some people it is the stigma that is connected to mental illness. There are some who believe that mental health disorders are due to not having enough will power, moral failings or weakness - ALL of which are untrue.

Here are a few people throughout history who have dealt with mental illness. You decide whether or not they lacked will power, morally failed or were weak:

Winston Churchhill - depression
Abraham Lincoln - depression
Princess Diana - bulimia
Earl Campbell - panic disorder
John Madden - phobia of flying

The reality is, if you were diagnosed with cancer, you would go to the doctor. Mental health disorders are no different. If you are struggling with a mental health disorder you should go see a therapist, psychiatrist, or your family physician. If your doctor gave you medication for the treatment of the cancer, most likely you would take it, which is no different than a psychiatrist prescribing medication for a mental health disorder. You might have to do some physical therapy as part of the treatment for the cancer, just like you might need to talk with a therapist to help you process what you're dealing with as part of your treatment for a mental health disorder. The bottom line is, regardless of the type of illness that you have, it is important to obtain the proper treatment to help you live your life to the fullest.

Regardless of whether you are dealing with a medical illness or a mental health illness, it is important to remember that you are not your illness. You would not introduce yourself to someone and say "hi, I'm cancer." Neither should you introduce yourself to someone and say "hi, I'm bipolar." Yet when I counsel clients the second statement is very common. It is important to remember that you have cancer, or you have bipolar disorder. If you have an illness, you can seek treatment, and make progress toward overcoming the illness. If you ARE the illness it becomes harder to make change. Remember, at the end of the day it is about your quality of life.

If you feel you might be dealing with a mental health illness, and you would like to seek help, please contact our office.

Setting healthy boundaries

As William Shakespeare put it, “Give a man health and a course to steer, and he’ll never stop to trouble about whether he’s happy or not”. I think the “course” that Shakespeare is referring to is the establishment of healthy boundaries. For our own emotional and physical well being, establishing clear boundaries can give us a “course” that we are now in control of and can “steer”. While it is easier to identify our physical boundaries, by posting “No trespassing” signs, it can be more difficult to establish emotional and intellectual boundaries.
Ever had a boss walk into your office without knocking? Ever been afraid to tell a friend that you do not want to take care of their dog while they are out of town for fear they will not like you anymore? Ever feel like you are powerless in the decisions that are made in which you silently suffer the consequences someone else made for you? Ever had your own happiness dependent on someone else’s happiness? If you answered yes to any of these questions, you may have unhealthy boundaries.
The solution to unhealthy boundaries is not establishing rigid boundaries in which you always say no or completely shut others out emotionally. This could result in loneliness, anxiety and dependency. The key to establishing healthy boundaries is to identify your current level of self esteem and assertiveness. After identifying your (key word here Your) beliefs, morals, and values you can begin assertiveness training and self esteem building. Establishing healthy boundaries can be an empowering experience that allows you to create mutually beneficial relationships with others.
There are countless self help books on assertiveness training and self esteem building. If you have a loved one that has ever struggled with alcohol or substance abuse, you most likely have been faced with how to establish healthy boundaries. If you have a long history of poor boundary setting or believe that you are in a co-dependent relationship, be assured there is help out there. Our office is happy to answer any questions you have regarding boundary setting through a free 15 minute phone consultation at 386-736-9165.

Jennifer Nadelkov, MA, LMFT

Positively Positive

"I have not failed. I have just found 10,000 ways that won't work." - Thomas Edison

I chose this quote this week because it emphasizes the power of perspective and staying positive. Our lives are shaped on a yearly, daily, hourly, even minutely basis by our perspective on things, places, people and situations. By maintaining a positive focus and perspective, it will greatly impact our mental focus, stability and level of overall happiness. For example, if you pulled into a parking lot and got a flat tire what would your thought be? Would it be, oh darn, this is going to cost me money, time and frustration...or would your thought be, well I got the flat at the grocery store, so at least I can shop while waiting for the tow truck...or at least I didn't get a blow out while driving on I-4? While not rainbows and roses, the last two answers are more focused on a positive outcome of what would normally be viewed as a bad situation.

Here are some suggestions to help you stay positive:
1. Make a conscious effort to look at the positive side of all situations.
2. Think, feel and believe that positive thinking will result in positive results.
3. Surround yourself with other positive people.
4. Helping other people can help us by highlighting our strengths, helping us feel useful/needed
and providing us with new perspective.
5. Practice gratitude and thankfulness daily. Even if things seem bad, they could be worse, and
while it may be hard to see that during those bad times, if you can focus on being
grateful/thankful for what you do have, it can help provide hope, optimism and strength.
6. We have all heard the phrase "laughter is the best medicine." Well it's difficult to be laughing
and negative/depressed at the same time. Fill your life with laughter as a natural support for
positivity.
7. Let go of the negativity in your life in whatever form it comes in, people, things, stress or
whatever.
8. Practice self-care on a daily basis. Make sure that you are getting enough rest, eating
properly, and exercising regularly.
9. Use relaxation techniques and meditation to keep yourself relaxed and focused.
10. Be aware of the power of words. In counseling we work with our clients on eliminating words
such as can't, won't and hopeless and replacing them with words like can, will, and
opportunities.

By working on our perspective daily, and trying to maintain a more positive focus, we can improve the overall quality of our lives. Stay positive.

Tips for reducing holiday stress for children

While the grownups hustle and bustle to prepare for the holidays, children often feel the stress their parents feel. Here are some useful tips on how to reduce the stress children may experience during the holidays:

1. Emphasize the reason for the season: If your family is celebrating the birth of Jesus Christ, take advantage of this opportunity to slow things down a bit and teach them about the birth. If you celebrate Christmas for nonreligious reasons, explain the reasons you exchange gifts and spend time with family. This is a great time to help children learn about the family’s belief system and traditions from previous generations.
2. Maintain routine: All parents know about the inevitable meltdown that occurs when an eighteen month old is expected to sit on Santa’s lap two hours past their normal nap time. As much as possible try to keep meal and nap times at their normal times.
3. Make children little helpers: Of course it takes twice as long when a six year old wants to help wrap Grandpa’s present. However, in allowing your child to wrap that present he/she is now a part of the gift giving process and feels that they have helped you in some way. Children also love to help in the kitchen. Rinsing vegetables in the strainer, snapping green beans or making cookies are all child friendly activities.
4. Let them know the day’s agenda: Prepare your children for large crowds, long wait times, being at a coworkers home that the child may have never met or even just the fact that there will be three different family members they will visit that day.
5. Start or continue family traditions: Remind your child that last year they placed the star on top of the tree or that your father used to hold you up so that you could place the star. It is never too late to start a family tradition.
6. Bring comfort items: Allow children to bring their favorite blanket or stuffed animal. An unfamiliar home may not be child friendly, keep this in mind and pack toys that the children can play with.
7. Praise positive behavior: While this is a year round task, at the holidays it is very important to praise pro social behavior, use of manners and overall good behavior.
8. Role Model a positive attitude: If Mom or Dad doesn’t want to go Aunt Ruth’s house, the children will not want to go either. Express your joy and gratitude for the time to spend with friends and family and your children are more likely to do the same.
9. DO NOT OVERSCHEDULE: Children tire easily. Too many activities in one day is stressful for the entire family, especially infants and toddlers.

As we are now officially in the holiday season, remember to take time to enjoy the time off of work, the time spent with family and friends and the time to watch your child experience the magic of Christmas.
Jennifer Nadelkov, LMFT

What changes will you make?

"Be the change you want to see in the world" - Mahatma Gandhi

Each one of us has the power to make the world a better place. I chose this quote by Mahatma Gandhi because I know that sometimes I lose sight of that. The great thing is that not only do we each have the power to make the world better, we have the ability to do it on an everyday basis. I know that sometimes I have thought "if I do.....what difference will it really make?" The reality is that everything we do impacts events and people. There is no such thing as small change, and while we might not always see the result of the changes we make, it does not diminish the significance of those changes.

Here are a few simple daily changes/activities to help make a positive change in the world:

- give your leftovers from restaurants to a homeless person

- use please and thank yous

- smile at people passing by

- hold the door for someone

- put your phone away when checking out at the store

- let someone in during traffic

These changes may not seem significant on the surface, but their impact could be huge. Your leftovers could prevent someone from starving. A simple please and thank you could alter the course of someone's day. A smile could provide someone with that extra little bit of self-esteem to help get them through their day. Holding the door could be taken as a sign of respect, and I know it makes me feel better when I feel respected. Same thing goes for the cashier at the checkout. Letting someone in during traffic could help prevent an accident, possibly save someone's life. At the very least, each one of those ideas would be enough to brighten someone's day, and isn't that alone worth doing it?

The thing about change is that we have to take personal responsibility for it, we cannot push it off on others. In Michael Jackson's song "Man in the Mirror" there is a verse that goes "if you want to make the world a better place than take a look at yourself and make a change." I challenge myself to start making daily positive changes. I challenge you as well to make positive daily changes, that WILL improve the quality of life for ourselves and others.

Play Therapy

What is play therapy? Play therapy is the belief that a child’s play is their message. Play therapists believe that a child innately knows what they need to work on and provide an environment in which the child can use their play to work through their difficulties. The process is to assist the child in tapping into his/her own creative process and then therapy happens. A play therapist does not focus on the child’s problem, rather will focus on the child as a person. The purpose of play therapy is not to engage the child in play that is preparation for something else, like disclosing the cause of their anxiety. Rather the purpose of play therapy is to allow the child to decide what he/she needs to work on.

Therapist utilize empirically proven techniques:
Reflection of the child’s action and affect
Empathetic Reflection
Empowering child to make choices in session
Helping child develop internal source of approval
Tracking
Self esteem building


Objectives: To help child
Develop more positive self concept
Assume greater self responsibility
Become more self accepting
Become more self reliant
Engage in self determined decision making
Experience a feeling of control
Become sensitive to the process of coping
Develop an internal source of evaluation
Become more trusting of self

If you are interested in learning more about play therapy, or feel that there is a child in your life that may benefit from play therapy, please contact our office for more information, 386-736-9165.

Jennifer Nadelkov, MA, LMFT

Live Everyday to the Fullest

How do you treat your life? What about the relationships in your life? The relationships and interactions that we have with ourselves and others plays a big role in our lives. How is your relationship with yourself - emotionally, mentally and physically? Do you exercise and eat right? Do you exercise your brain daily? Are you emotionally mature enough to express your feelings and communicate with yourself and others? Are you confident enough to challenge yourself? How are your relationships with your friends? Do you have "good" friends that you haven't spoken to recently, or told them how important they are to you? What about family? Any family rifts that one or both parties are too proud to be the one to apologize? Have you recently told your family members how much you appreciate what they do for you?

I ask these things because life is a fragile thing. According to www.dictionary.com the definition of regret is: to feel sorrow or remorse for an act, fault, disappointment, etc. In other words, feeling sorrow or remorse because we did or didn't do something. Life is too short to live with regret. Harness your inner strength and take on the things that you might look at with regret. Go back to school.....mend a broken or struggling relationship.....strengthen your relationship with yourself, get to know yourself.

To borrow a line from the movie "Scrooged," "it's not too late, it's never too late."

If in any way, we at Central Florida Mental Health Associates can assist you on your journey, please don't hesitate to give us a call.

Saying Goodbye

Saying good-bye can be bittersweet. Ending a relationship, moving away from loved ones or switching jobs are all situations in which the dreaded "good-bye" comes into play. After working for five years at the same agency I resigned. While it is exciting to look forward at all the possibilities that lie ahead, it is also sad to leave the co-workers I have been with for so many years.
This morning I began packing up some of my belongings. I felt like a college student packing their dorm room days before graduation. There is a sense of excitement and anticipation about the future and also a sadness for the friends that will be left behind. With the best of intentions we say our typical "I will miss you" or "Let's stay in touch" or my favoritie, "Let's do lunch soon". The reality is that as you move on, you often lose touch with the majority of the people that have been a part of your daily life.
I have been dreading the "good-bye" process. I would prefer to slip out quietly while everyone else is out to lunch. This afternoon a co-worker thanked me for something very minor that I had done for them. That is when it suddently occurred to me that while we say "good-bye" and will move on our separate ways, we never lose the experience we had in that relationship. I smiled to myself as I began taking messy finger painting off of my office walls, each lovingly created by a child. Each of those paintings are a story of a child who came to me for help. Each of those children had the couarage to do their work in my office and bravely say good-bye when their work was done.
Today I wasn't ready to take all of the paintings down. I need to finish my work where I am at. When my work is done I will bravely say good-bye, cherishing the wonderful experience I had.

The Counseling Process

Arriving for a counseling session for the first time can be a challenging experience. What will I be asked?
What will my counselor / therapist be like? How will I know what to say? What will it cost? Will my insurance pay for this? These are just a few of the questions that run through people’s minds when they first enter into the process called counseling or therapy.

People come for many reasons; often because a situation in their life or within them has become painful. It has become ineffective to unload on friends or family or perhaps there are things going on that need to be divulged in a safe place. Ultimately, that is what the arena of the counselor’s office becomes, a safe place in which to speak your reality and be supported in determining if changes would be helpful.

The first counseling session often feels like a huge question / answer session, which can be difficult for first time clients. Each question is designed to give the counselor information that will be used to help determine the problem and how it might be approached in a helpful and productive fashion. Questions regarding the person’s history with other counseling experiences and treatment will be asked as well as details about their medical history, family history, and habit and patterns of behavior. A history of previous treatment and the dynamics of the family will be taken. All questions are asked with the well-being of the client in mind. The counselor will guide the session and focus on your answers and concerns to determine with you, the focus of treatment.

Counseling sessions are confidential. The limits of confidentiality pertain to any verbal or physical abuse towards the client or perpetrated by the client as well as any homicidal or self-destructive indicators. These will be addressed in session with the client and will be reported in the proper method in accordance with the mandates governing these situations.

The costs of treatment are varied. Many counseling centers have set rates for services and take insurance. Some agencies use a suggested fee scale in which the clients’ rate of pay is determined by income and verified by proof of income or have contracts that help to pay for clients’ services. Private centers can allow clients to determine their own pay scale or have set fees. These questions can be asked at intake (the process in which you register for treatment) which may be covered when you arrive for your first session or over the phone.

The fit between counselor and client is personal and as different and varied as the many counselor and client combinations that are made. The important elements are that there is a feeling of trust, communication, and comfort that your best interest is foremost in priority. Sessions will bring about a panorama of feelings and thoughts, depending on the issues being addressed and the work being accomplished. Treatment is work in the sense that effort is put forth by the therapist (licensed counselor) and by the client to implement a change in thoughts and behavior which ultimately result in a change in feelings. All of this is a process and length of treatment varies depending on whether the issues are on-going or due to a specific situation.

Being informed is a great way to feel more comfortable in approaching a new activity. Counseling can benefit everybody. You do not have to have a crisis or be diagnosed with mental health disorder to benefit from counseling. Stay informed and live healthy!

Take the First Step

One of the most difficult things in life sometimes, is simply getting started. Taking that first step can often feel overwhelming, frustrating, paralyzing, and flat out scary. So what happens? We end up not taking that step. I can't tell you how many times I have wanted to improve my health and said, "I'm going to stop drinking Coke," "I'm going to start dieting," and "I'm going to get back to the gym." Well, I just ate a candy bar, had a Coke with lunch and haven't visited my gym in three weeks.

Typically in my posts I provide helpful tips on whatever topic I'm discussing. Today in addition to the tips at the end, I'm going to provide some sayings/quotes that I find to be very helpful in overcoming the difficulty of getting started.

The first saying is....do you know how to eat an elephant? One bite at a time. The point is, if your plan was to eat an elephant, and you went up to the elephant and looked at it in all of its enormity, you would psych yourself out before you even started. If you simply looked at the section that was placed in front of you and started eating bite after bite, at some point, you would finish.

Next saying....nothing changes if nothing changes. If you continue to do the same thing over and over again, you are not going to get different results. So if you are trying to accomplish something or to make a change in your life and you are not getting started or making progress, you have to start changing the way in which you are attempting to achieve your goal. For example, if I am trying to get back into going to the gym, but every night I say I'm going to go after work, and then every night I say "I'm tired I'll go tomorrow," I have to change something. One thing I might do, is get a workout buddy, so that I have more accountability.

Some tips for getting started are:

1. Tell others, accountability can be a big motivator.

2. Break tasks that might feel overwhelming into small projects and tackle them one at a time.

3. Set yourself a schedule and due dates.

4. Praise yourself for the progress you make....all progress is praise worthy, and set-backs are simply a learning tool for your next success.

At the end of the day, it boils down to how much do you want to achieve your goal, complete the task or tackle whatever project. These ideas and tips can be applied to your physical health, your employment status, school and your mental health. If you are unhappy with where you are mentally (depressed, anxious, in an unhealthy relationship) what steps are you going to make change? Start exercising...utilize relaxation exercises...learning about assertiveness skills...maybe start counseling? If there is anything that you would be interested in speaking with one of our therapists about, take that first step, give us a call.

Sibling Rivalry

While we have all learned that sibling rivalry is normal, it can be a difficult task for parents to manage. As I child I remember our father making us "hug it out" until we "felt the love". This tactic never actually caused us to stop fighting, although it did help us to fight quieter so that he could not hear us.

Some issues that influence sibling rivalry are personality, parental treatment, birth order and extended family. There are special circumstances that require extra consideration, such as handicapped or gifted siblings. Additionally, physical or emotional abuse is not considered normal rivalry and demands immediate attention.

Helpful tips for parents on Managing Sibling Rivalry

-Do not take sides or play favorites
-Validate feelings, rather than dismiss them. "talk it out"
-Praise healthy sibling interaction
-Do not make comparisons between siblings
-Encourage siblings to celebrate each other's success
-Role Model how to share and take turns
-Celebrate each child's unique qualities
-Teach and Role Model problem solving skills
-Plan Family activities to include ALL family members

It is important not to intervene in the sibling conflict and allow children to work out their own problems. However, when dangerousness becomes of concern immediate intervention is required. If a child's daily functioning is impaired or if there has been or is potential for physical harm, it is suggested to seek help from a mental health professional.


Jennifer Nadelkov, LMFT

Interacting with your children

When we think about our average interaction with our children, most of them involve some kind of negative interaction like "make your bed, take out the trash, take a bath, do your homework, wash the dishes, get off the phone, get off the TV, get off the computer!!!!!!" and followed by the famous taking away of privileges as the most common consequence used by parents. Then, we yell at them and they yell back "I hate you!

So, what if we really choose wisely when to interact negatively with our children and maximize the positive interactions?

Positive interactions involve: talking, playing, exercising, singing, playing a musical instrument, watching a movie/TV all of these together with your children.

Feel free to post more positive interactions to this list.

Enjoy The Holidays

As I sit here passing out Halloween candy, I have caught myself thinking about the other holidays that are fast approaching. The wonderful big meal my family prepares at Thanksgiving, my favorite holiday Christmas, and the fact that I will have the opportunity to spend time with my family and friends.

Thanksgiving, if you are not the organizer of the family/friend gathering, the chef, or traveling, is more or less stress free. However if you are performing one of these tasks, Thanksgiving can be quite stressful. Then comes the December holidays. With Christmas comes the stresses of planning, cooking, traveling, different holiday parties, decorating, gifts and a hundred other little things.

However, remember when the holidays were nothing but joy, family, celebration and love? Holidays can be that again, the thing to remember is to manage your stress so that you can enjoy yourself. Here are some helpful tips to help you with holiday stress:

1. Be sure to take care of your health. While the holidays are filled with great food, limit your portions instead of stuffing yourself, make sure to limit your "junk" food intake, and get plenty of sleep.
2. Utilize exercise, meditation and relaxation techniques. Whether you take a walk around the block, hit the gym, utilize Yoga or Tai Chi, or implement deep breathing or guided imagery.
3. There are two different types if time management skill that are important. First, be sure to coordinate with each family members' schedule of holiday events. Also set a schedule to assist you in accomplishing whatever tasks you need to do. Second, take time for yourself. Sometimes there can be TOO much togetherness with family and friends. On the flip side, do not isolate yourself, be sure to engage with your family and friends. The key is to find a healthy balance.
4. Finally, understand that it is okay to say "no." For example, if you do not have the time to bake cup cakes for your child's class, say so. Or compromise and buy already-made ones from the store. One of the fastest ways to increase your stress level is to take on responsibilities that you cannot handle.

Hopefully you will find these tips helpful this holiday season, and be able to enjoy yourself to the fullest. Let the holiday seasons begin!

Codependency

     Have you ever found yourself frustrated in a relationship, had that "stuck" feeling and wanted things to be different but have no clue how to change?  This is a common trait of those who find themselves reacting to those they love in ways that either take care of them, gripe, whine and cry at them or generally have hurt feelings because of the way the are treated (or not treated) by their significant other.  The relational trap referred to as codependency, is very unconcious.  It creates a pattern in which one finds themselves reacting instead of choosing to ct in a mindful and concious way.  It results in one being limited to behave in one of three roles:  caregiver (enabler, rescuer), victim (martyr), or abuser (bully, intimidator, whiner, griper). 

 When one is limited to one of these three roles in their significant relationships, one tends to find others who also are most comfortable acting in one of these three roles as well.  People who have a need to be in one of these three roles to feel comfortable in relating to others are mosst comfortable seeking out others who also operate out of one of these roles because they automatically know "the rules" and fit into the pattern of the other.  These roles become very comfortable and familiar.  In actuality, it is highly discomfiting to behave outside one of these familiar roles.  Thus lies the challenge.

In order to make a change, one of the partners must break the pattern and learn to live in a mindful way, making decisions and choosing behaviors that are independent of the others reactions. 

If you would like to learn this way of relating and believe you have a "stuck" relationship, give the office a call and allow one of our qualified counselors to assist you in finding a new way of interacting.

How to Help a Grieving Child

“What happens when we die?” “Where is heaven?” “Does everybody die?” These are all very common questions for children following the death of someone or something they love. The majority of children will have their first death experience through the death of a pet.
A child’s hunger for understanding about death can be a difficult dilemma for parents to deal with. Parents sometimes are stuck in their own grief, or simply lack the skill set to address the seemingly complicated questions posed by their children. Prior to going into a complex explanation about death, try to take time and think about why the child is asking the question. Is it simple curiosity? Are they seeking safety and emotional security? Are they afraid? Sometimes figuring out why your child is asking the question can guide you in how to answer their question. Always answer their questions honestly, in age appropriate ways and reply with “I don’t know” if you really do not know the answer. Adults cannot make the grief go away and cannot bring the loved one back. Adults should recognize that grief is a normal and healthy process that for their child to experience.
Children of all ages struggle with a constant need for reassurance that they are loved, safe and well taken care of. During time of grief, these needs become as important as food and water for the child. The underlying fear and/or anxiety of his or her own mortality is something they yet have the ability to verbalize. Instead children often act out behaviorally, have more crying spells and whine when they do not get their way. Children engage in these attention seeking behaviors because they lack the ability to verbalize the underlying need of wanting reassurance that they are loved, safe and cared for. Take time to reassure your child that you love them, will protect them and meet their basic day to day needs.
How your child understands death will have a lot to do with how you understand death. Speak with your child honestly and remind them that they are surrounded by many adults who love them and care about them. Children often are in tune with how the adults around them are feeling. If you feel sad it is ok to let the child know you are sad. Normalizing the sadness in losing someone we care about is a great way to help children understand not to be ashamed of how they are feeling. Also, we can role model for children how to continue living, meeting our daily obligations and loving those that are still in our lives. This not only teaches the cycle of life, it also teaches the child that things in their world are still stable.
Sometimes there is a sudden death or a family tragedy that affects multiple family members. There are times when a child has a significant impairment in their ability to function after a death. Some children experience clinical levels of anxiety, depression and may seek unhealthy coping mechanisms. If you are a parent of a child experiencing grief, please contact our office for more information on how we can help your child, at 386-736-9165.
Jennifer Nadelkov, MA, LMFT

Communication

I was reminded this evening about how important it is to pay attention to the tone of your voice when speaking. It can really change the message you are trying to send (or annoy the other person) when your tone is aggressive, overly assertive, condescending or if you are speaking to loudly. Remember, 70% percent of our communication is done through our non-verbal behaviors and the tone of our voice. So be aware of not just the words you are saying, but how you are conveying those words and expressing them non-verbally.

Dealing With The Pain

Imagine after a long day of work or play that you lay down to sleep, but you can't sleep due to physical pain. Can you picture not being able to play with your children or grandchildren because you are simply in too much pain to do so? Or not being able to work? These scenarios and more are are the reality for over 76.2 million American who live with chronic pain, according to the American Pain Foundation.

Of those 76.2 million, of which I am one, an estimated 46 million people have been told by their doctor that they have arthritis, gout, lupus, or fibromyalgia, diseases that affect multiple parts of the body. The four most common pains reported are lower back pain, migraines/headaches, neck pain, and facial pain. Approximately twenty percent of American adults have reported having pain or physical discomfort multiple nights a week, so much so that it interferes with their ability to sleep. In addition to impacting people's quality of life, chronic pain also impacts the economy. The American Pain Foundation estimates that chronic pain costs the economy 100 billion doallars annually, due to healthcare expenses, lost income and lost productivity.

If you are one of the 76.2 million American, here are some tips to help you manage your chronic pain.
1. Be healthy. This includes eating healthy, stop smoking, reducing alcohol intake, and rest,
rest, rest.
2. After consulting with your doctor, exercise. In addition to the health benefits of exercise, when
you exercise, brain chemicals called endorphins are released which helps your mood and
blocks pain signals.
3. Develop your relationship with your doctor. Communicate with your doctor about your pain
and any questions you might have. Keep a pain and activities log and bring it to your doctor so
that they can get an accurate idea of your daily struggles. Write down any questions you
might have, do NOT simply think you will remember, you might get side tracked or the
doctor could be in a hurry that day. If you have questions written down, you will remember
to ask them.
4. Educate yourself about your disease/pain. In addition to reading about your illness, and
talking with your doctor, use your own knowledge. For example, if you are having back pain,
does using a heating pad help? What about ice packs? Those trial and error exercises can be a
huge help in how you manage your pain.
5. Try getting a massage to help reduce stress, relieve muscle pain, and increase circulation.
6. Try to reduce your daily stress, stress can intensify the body's sensitivity to pain. Learn about
relaxation exercises such as deep breathing, meditation, progressive muscle relaxation and
guided imagery.
7. Be open and honest with the people around you. Do not try to be Superman. Be willing to ask
for help on the days that you need it.
8. Try to maintain a positive attitude. Remember the things that you are able to do.
9. Find ways to distract yourself. Engage in hobbies, chores, exercise, reading, etc.
10. Finally, join a support group. Support groups serve a wonderful purpose in that in addition to
providing support, they are a wonderful place to find resources, share ideas, and they help
reduce the feel that no one understands what you are going through.

Hopefully some of these ideas will be able to help you better manage your pain. If you are struggling with chronic pain, and would like to talk with someone on a one on one basis, please feel free to contact our office at 386-736-9165.

Bipolar Disorder

Many who suffer from Bipolar begin to experience symptoms in childhood or adolescence but go through various treatment methods and diagnosis prior to being actually diagnosed and treated for Bipolar. Bipolar at onset is different for all who experience it. It may present as depressive or manic or both and even the depressive and manic symptomology can manifest as a range of varying degrees of mood instability. One may present as tired and withdrawn or irritable and be depressed. One may lose their appetite altogether or have very little need for sleep. Manic phases may be observed as a person being very impulsive and driven with a grandiose sense of self or suicidal and delusional, seeming out of touch with reality. There are as many manifestations of bipolar as there are individuals who cope with it. Patterns are there, criteria are met, but it all takes on the distinct flavor of those who must live within its scope everyday of their lives. It can be tough to face and a mystery to those to whom it is merely today’s disorder of note.

There is hope for those who are challenged with bipolar. There are medications that are highly effective, often taken in combination, to combat the diverse symptomology. There are psychotherapies (talk therapy) and cognitive behavioral treatments which address thinking errors. There are community support groups which can increase coping skills and allow participants to practice socializing in a safe and known environment. A weekly adult support group will begin on Monday, October 25 from 5:30 – 6:30 PM. If you or someone you care about could benefit from such a group, please call (386)747-9858 for details.

by: Janice Suskey, M.Ed. Ed.S. LMHC

Childhood Obesity

The Mayo clinic staff defines childhood obesity as occurring when, “a child or adolescent is well above the normal weight for his or her age and height”. The primary concerns of childhood obesity can lead to more serious health conditions such as heart disease, diabetes, high blood pressure, bone and joint issues, sleep apnea and high cholesterol. From a mental health standpoint, there is real concern about the child’s self esteem, use of emotional eating and depression.

According to the Center for Disease Control, childhood obesity has more than tripled in the last thirty years. Parents are often informed during routine physicals at the pediatrician’s office of their child’s BMI (body mass index). The BMI is calculated by measuring the child’s height and weight and comparing the child on a percentile rating scale to other child his or her age of the same height and weight. The center for disease control established the rankings that determine what is considered overweight.

Addressing childhood obesity should be done through proper consultation with your pediatrician. Involving the family in good eating patterns and a more active lifestyle is a win-win situation for the entire family.

The mental health issues that can arise from this problem can be quite serious. Obese children often become targets of bulling, shy away from activities that require wearing a bathing suit, have difficulty playing sports, develop body image issues, experience low self esteem, have nervousness or anxiety symptoms and even depression symptoms.

Signs and symptoms to look for that your child may be experiencing emotional problems related to obesity are:
You notice your child has become withdrawn, shy or self isolates
Your child does not want to go to school
Your child is showing a preoccupation with food
Your child is sleeping too long
Your child is cutting him or herself
Your child is verbalizing threats of harming him or herself

If you notice any of theses signs in your child, please contact our office to set up an evaluation for your child, at 386-736-9165.

Jennifer Nadelkov, MA, LMFT

How's Your Day?

Ever have "one of those days?" Maybe even one of those weeks? Sometimes it can feel as though our day gets away from us, and we are not even sure how. One thing for us to be aware of is our attitude and how we respond to certain situations. Here's an example.....

Have you had a morning, where in your waking up process you maybe stub your toe on the corner of the bed or dresser? I have, and generally I'm left with one of two trains of thought, either: that's a bad way to start today, my day will probably be bad; or ouch! well my day can only get better from here. On the days I go with the first thought process, everything has a negative shade to it, kind of like I'm being followed by Charlie Brown's rain cloud. Traffic is horrible, that person just cut me off, and I tend to be more sensitive to the way in which people talk with me (boy that person really has an attitude today). On the days when I take the mindset that things can only get better from here, the same traffic situation is now normal, not horrible; the person who cut me off, I'm paying more attention to and prepare for it, so it does not bother me; and I tend to see the way in which people are interacting with me in a more positive manner. The mindset I start the day with not only influences the way in which I perceive my day, but additionally it has either a negative or positive impact on my energy level for the day.

Now the example I have given was stubbing my toe, but stubbing my toe could also be your children waking you up early, siblings arguing with each other, a comment from your partner, any one of a thousand things. It is important to be aware of how we are feeling, and if we are upset, identify why we are upset and try to reframe it through a more positive lens. The great thing about our attitudes and perceptions is that we have the power at any point throughout our day, to re-start our day. If we notice that we have allowed the negative thought processes to take over, we can stop, perform some sort of starting over process and begin our day anew. For me, when I have identified that I have allowed my negative mindset to take over, I try to get a minute or two to myself, take several deep breathes, and give myself a little pep talk. Whatever you do, make it personal to yourself, and give yourself the opportunity to have a great day!

In Control or In Charge?

An accident in the blink of an eye, a partner decides to leave the relationship, hurricane force winds destroy a home; these things happen so fast and are beyond our control. Depression, anxiety, obsessions-compulsions, these come on fast or gradually and are beyond are control.

We talk of “being in control” but the truth is that we are never as “in control” as we like to think we are. Life is cumulative. Events, reactions, and patterns form prior to the time we are even able to be conscious of them.

A better way for us to think, instead of control, is to learn how to be “in charge”. In charge implies something completely different than in control. In charge implies a willingness to make decisions about what happens to us and also invites input from other sources that can be taken into consideration or ignored. In charge is to delegate to others the responsibility that belongs to them and encourage them in that responsibility. In control is just the opposite.

We may not have control over things that come to us, but we can, with help and support, learn how to be in charge of the effect anxiety, depression, anger, obsessions, moods, other people and events has over us. Don’t hesitate. Do your life the honor of learning how to take charge, today.

Step Grandparents

There are a few different scenarios that might place you in the role of being a step grandparent. For the stepparent the expectations of how they prefer their stepchildren be integrated into the family could vary. To date there is little research on the expectations of step grandparents. The primary goal of stepfamilies is to build a bridge to unify two separate entities into one, while not building a wall that blocks the old family unit or unit(s) from being a part of the new family. As the step grandparent you may struggle with managing old loyalties while trying to build new loyalties.
Typically after divorce and remarriage a child will look to his or her Grandparents for support and a sense of normalcy among the many changes they are facing. Children that are not forced to relocate have an easier chance at maintaining those close bonds with Grandparents. Step grandchildren may be forced to relocate and may have limited access to their new step grandparent and biological grandparent. This factor can create difficulty in trying to establish a bond with the child.
Some Grandparents provide a lot of emotional, financial and even childcare responsibilities for their children’s children while the initial marriage is ending. This can cause caretaker fatigue, which can result in Grandparents being emotionally exhausted and “taking a break” while the stepfamily is bonding. This intergenerational dependency is not a new phenomenon, although is becoming more and more common as the divorce rate increases. The step grandchild is not usually around for the marriage dissolution, thus the child could experience some confusion as to why the step grandparent is not a part of their everyday life.
Step grandparents have often been blessed with the honor of being a part of their biological grandchildren’s births and subsequent major milestones. However, with step grandchildren, depending on their age, a lot of milestones have already happened. This can pose a difficult dilemma for the Grandparent who has adored their biological grandchild since birth and is now trying to bond with a step grandchild that they know very little about.
If you or a loved one has recently found themselves in the position of being a step grandparent, be assured you are not alone in your struggle to adjust to your new family dynamics. Redefining relationships can be a difficult task, although is not a hopeless situation. If you are interested in getting more information on this topic, please contact our office at 386-736-9165.

Jennifer Nadelkov, MA, LMFT

Don't put off until tomorrow, what you could do to....

Ever have an assignment at work, or a project at home, that always seems to be on your "to do" list, yet you never quite get to it? If you are anything like me, you do. This is commonly referred to as procrastination. Procrastination is defined by www.dictionary.com as "to defer an action; to procrastinate until an opportunity is lost." But what really are the negative effects of procrastinating?

There can be negative physical, employment and relational effects due to procrastination. Procrastination can lead to stress, depression and low self-esteem. Procrastination can have a negative economic impact as well. If people put off paying their bills, they might have to incur penalties, fees or maybe reconnection costs. Additionally, a person's credit score could then be impacted, thusly affecting a person's ability to purchase a car, home or other necessities. In the career world, procrastinating on projects can have a person labeled as lazy, lead to cluttered work areas, and missed career advancement. Finally, in relationships, people can become angry, annoyed, or frustrated when someone tells them they will do something and they don't come through.

Here are a few tips to help you overcome procrastination:

1. If a project or assignment seems overwhelming, break it into smaller tasks, to help you feel like it is more achievable. How would you eat an elephant? One bite at a time.

2. Set yourself a timer to accomplish tasks. For example complete all your phone calls within a thirty minute time period.

3. Be aware of the messages you send yourself, they impact your motivation. Instead of using phrases such as "I should" or "I have to" which can lead to a negative thought process, try using more positive phrases such as "I choose to" or"I want to."

4. Organize...organize...organize. Set yourself a schedule, and prioritize the things that need to be completed in order of time/importance.

5. Reward yourself for not procrastinating. Provide yourself with little incentives as a means of accomplishing your tasks.

Relationships

“You must pay the rent!” the Landlord rants, “But I can’t pay the rent” pleads the put-upon renter, enters the rescuer, “I will pay the rent”! Ah, peace reigns; but at what price?

These roles (that of victim, abuser, and caregiver) are often played out in stories, movies, plays, and music are the stuff of life. They hit a common thread with many people because the truth is, most of us, have played one or all of these roles more than once in relationships either at work, school, socially, or with our families. How many times have you complained and whined (victim) about a situation in your relationship with a friend or loved one, only to find yourself caving and giving in to whatever the demand, behavior or request is you are complaining about (caregiver), then griped (abuser) about the outcome and your sacrifice either to the person you caved in to or to someone else about the person you gave in to?

“That’s just human nature.” you say. True, but it is also one of the most ultimately destructive dynamics to human relationships there is. It is the push-me-pull-you of a no win situation in which neither party is satisfied however the dynamic keeps interaction going in such a way that it simulates intimacy by creating engagement without ever honestly taking ownership or straight forwardly asking for what one needs. In the long run, both parties will typically become worn out and disengage rather than go through profitless engagements or believe they are engaging and engage for engagements sake, repeating the cycle, whether or not it’s productive, for the sake of the habit which simulates intimacy at the price of never really getting close.

Our ultimate goal as evolved people is to be able to be clear with ourselves and our most important relationships as to our feelings, thoughts, and behaviors in a genuine way as we progress through and process life events. This requires us to know ourselves and be willing to take ownership of all the pieces of who we are (weaknesses and strengths) and risk letting others know us as well. Sounds simple but for many of us it is a huge undertaking. Often we have not had the equipping or role models to live in such a congruent and clear manner and knowledge never has created change without some type of implementation.

So how do we become evolved to the point of genuine and honest behavior? Some will attempt to find reality in the most false God there is and turn to substances and alcohol in an attempt to “be who I am”. Others will create relationships that allow them to feel what they have always felt in the same way they have always felt it, thereby creating a “comfortable agony” in which the risk of change is not attempted at the price of upsetting the equilibrium of the known. What is clear is that the manifestation of a genuine and honest life is one we all know immediately when we encounter it. Our human interactions get bogged down in agenda, mistrust, and fear. To become genuine and honest takes practice and persistence. One must be willing to risk being real in relationship to another and that can be tough if you are not even sure what “real” is.

If you have not had relationships in which your feel genuineness has been possible in your family of origin (the family in which you grew up) it may be an uphill climb to create it for yourself as an adult but there is hope. If the dynamics written here strike home with you, call a licensed professional to learn how to break the circular pattern that keeps you in a cycle of ineffective, non-productive relationship.

Posted by: J. Suskey M. Ed. S.Ed. LMHC

What it's really about.......

If you are a sports fan, it is currently one of the best times of year. Most sports are in season, football - both NCAA and NFL, Major League Baseball, soccer, Nascar, PGA golf, basically pick a sport and you can watch it right now. Professional sports are not the only ones being played, there are little leagues, pee wee football, high school sports and many others. That being said what better time then now to discuss sportsmanship.

Dictionary.com defines sportsmanship as a person who exhibits qualities highly regarded in sport, such as fairness, generosity, observance of the rules, and good humor when losing. In a poll I took of five friends on sportsmanship, the ideas they brought up relating to sportsmanship were being a good loser, having fun and respect. Sportsmanship applies whether you are playing a game/sport, watching it on television, or if you happen to be attending your child's athletic activities.

The last example there is especially true. All too often in today's society, parents are becoming participants in the games their children play, due to their behavior watching the games. Watch the news or look on the Internet and there are numerous instances of parent's behavior being out of line to the point of being ejected from fields, assaulting officials, and berating the kids participating in the sports, including their own children.

Children learn the foundation of sportsmanship at home. Parents are their children's first role models when it comes to sportsmanship. Children observe how parents handle their favorite football team losing on television, or how they handle winning a board game with the family, and it begins to build that foundation.

Here are some ways to help teach/role model good sportsmanship:

1. If you are attending your child's game, remember only shout words of encouragement, they

know that they missed the touchdown pass, they do not need to be publicly humiliated. The

same thing if you are watching a professional sport on television, your children copy your

behavior.

2. If you are attending your child's game, remember that the umpires, referees and other

officials are normally volunteers, they do not get paid, and they are human, they will

occasionally make mistakes, it is not done on purpose and it is not a personal attack on you or

your child, this is your chance to teach forgiveness, understanding and acceptance.

3. Remember, it is just a game. And the game is just part of the experience, it teaches life skills,

how to deal with successes and failures, teamwork, helps them develop friendships, and

provides exercise.

4. Whether on the field, or on television, be sure to point out positive examples of good

sportsmanship.

And with tip number four, I will leave you with a story about my all time favorite example of sportsmanship. It occurred during a softball game between Western Oregon and Central Washington in 2008, with a trip to the post season on the line. In the second inning of the game with two runners on base, Western Oregon senior Sara Tucholsky, hit the first home run of her career. In her excitement rounding the bases, she missed first base, and as she went back to touch the base, she tore a ligament in her knee and fell to the ground. The umpires explained that the rules stated that no coaches or teammates could assist her or she would be called out. The other option was that they could substitute a pinch runner, but then the home run would only count as a single, and the pinch runner would be on first base. However Central Washington's Mallory Holtman had another option. Holtman asked the umpire if she could assist Tucholsky around the bases, and the umpire agreed. So Holtman, along with fellow teammate Liz Wallace, lifted Tucholsky - their opponent - off the ground, and walked around the bases, lowering Tucholsky enough at each bag so that her foot could touch the base.

What is Bipolar Disorder?

Bipolar Disorder, also known as manic-depression, is a serious condition that causes shifts in a person's mood, energy and ability to function. It is different from the normal ups and downs that everyone goes through from time to time. Symptoms of Bipolar Dosorder are severe and can result in damaged relationships, poor job or school performance, and even suicide.

Signs and symptoms:

Bipolar Disorder usually develops in a person's late teen to early adult years. Symptoms include dramatic mood swings from overly "high" and/or irritable to sad and hopeless then back again, often with periods if normal mood in between. The periods of highs and lows are called episodes of mania and depression.

Treatment:

A combination of medication and psychotherapy provides substantial stabilization in the person's mood. If you or someone you know seems to suffer from Bipolar Disorder, please call us at Central Florida Mental Health Associates at 386.736-9165 for a free 15 minutes consultation with one of our therapists.

To read the entire article go to www.nimh.nih.gov

Anxiety

I don’t know about you, but lately to me, it seems as if we are living in an increasingly anxious society. More and more people report having symptoms of anxiety as a quote unquote, “normal” part of their day. Check out the top 5 symptoms of anxiety, shortness of breath, heart pounding, chest tightening, numbness in extremities, and a sense of unease or apprehension. How many folks have, or maybe you have yourself, experienced one or more of these symptoms in specific situations.

The truth is there are specific situations that lend themselves to some type of anxiety producing symptom. Test anxiety, the anticipation of meeting new in-laws or confronting a partner with a relationship testing issue, all these situations can heighten our sense of apprehension producing anxiety symptoms in their wake. The difference between situational anxiety and chronic anxiety is just that. Many times anxiety is confined to a specific situation or set of events. If this is the case, it may seem expedient to simply avoid the situations which produce the symptoms. Avoidance, however, produces a new set of dilemmas which subsequently increases anxiety.

When symptoms themselves become less confined to specific incidences, there is reason to believe that anxiety has become more generalized, therefore manifesting in more frequent and perhaps less specific situations. Symptoms may become more chronic and there may seem to less of an instigating event or situation that brings them on. Anxiety manifests in the emotions, thought process, and body to present in such a way as to disrupt normal routine. In extreme instances, anxiety may interfere with life functioning to the point that the person suffering symptoms may become avoidant of certain situations, places, people, or events in order to attempt to control their symptoms. The reality is that symptoms are rarely controlled by avoidance.

In the treatment of anxiety, it is important to check with your primary care physician to rule out or treat any biomedical concerns underlying the condition. It is then important to consult a psychiatrist who may be able to recommend a regimen of medication. Finally, it is imperative you seek out a trained and licensed professional who can support you with cognitive – behavioral interventions and stress relieving techniques.

The good news is, that with treatment, most anxiety symptoms can be reduced to manageable proportions. Please contact 386-736-9165, to be put in contact with a professional who can support you or your loved one in managing this fatiguing and life impairing disorder.

by: Janice Suskey M.Ed. Ed.S. LMHC

What is Panic Disorder?

Panic Disorder is an anxiety disorder characterized by unexpected and repeated episodes of intense fear accompanied by physical symptoms that may include chest pain, heart palpitations, shortness of breath, or abdominal distress.

Signs and symptoms:

People with panic attacks have feelings of terror that strike suddenly and repeated without warning. During a panic attack, most likely your heart will pound and you may feel sweaty, weak, faint or dizzy. Your hands may tingle or feel numb, and you may feel flushed or chilled. You may have nausea, chest pain, smothering sensations, a sense of unreality or fear of impending doom or loss of control.

Getting help:

Effective treatments of Panic Disorder are available and you don't have to live with this disorder.

If you or someone you know are struggling with Panic Disorder, call us at Central Florida Mental Health Associates at 386.736.9165 for a free phone consultation. We can help.

Where do you focus your emotional energy?

Many of us waist emotional energy thinking about things that are pointless!

What if this happens? What if that happens? I should have done this, I should have done that. I have to. I must. If you find that your self-talk is contaminated with these cognitive distortions, you are misallocating your emotional resources.

Ask yourself this question: “How much of what I actually worry about actually happens?” If your honest with yourself, more than likely your answer will be that only a fraction of what I worry about actually happens. Then, determine how much of your thinking time you spend on these things. At this point, you probably have determined that you spend too much time on the what if’s, should haves, and must to’s. Start being more in the now. When you catch yourself feeding these irrational thoughts, tell yourself to stop. Divert your emotional resources to things that count. If you can do better at this you will be happier.

http://www.cfmha.com/

Grief

Grief is a common occurrence in our lives however, many of us do not recognize that there are definitive stages that have been researched to help guide us in our personal journey through this inevitable life happening. These stages, although distinctive, happen in each person's life in an individual way and in each person's unique timetable.

Five Stages have been identified in progressive states:

1. DENIAL - "I feel fine." or "This can't be happening to me." Denial is usually a temporary defense for the individual and is at times preceded by shock if the loss or news of the loss is unexpected.

2. ANGER - "Why me?!" "It's not fair!; "How can this happen to me?" In this second stage, blaming or looking to blame is common.

3. BARGAINING - "Just let me live to see my children graduate." "I'll do anything..." This usually takes place with a higher power and faith can be shaken when the bargain appears to be denied.

4. DEPRESSION - "Why bother with anything." "What's the point." This can be the response in order to allow the person to disconnect.

5. ACCEPTANCE - "It's going to be okay." This stage can include putting your loss in a bigger context, becoming functional and attending to practical matters, there is a general lifting of the depression.

Although this list appears to go in steps, it may be, and often is the case, that the stages will intermingle and at times seem to occur concurrently rather than at distinct separate times. What to do if you find yourself or a loved one experiencing stages of loss? Listen carefully to what they say and be respectful of their feelings. Although their reaction may make little sense to you, it is very real for them and it is an important step for them in moving through to healing. If you find yourself getting "stuck" and not moving through your grief as you expected, let me encourage you to call a caring professional at 386-736-9165, for support and encouragement. Grieving is a unique journey and can come at times when we least expect it. It can be attached to life transitions such as moving, changing careers, leaving home, job loss, loss of health, as well as death or dying, and loss of relationship. The important thing to remember is that you do not have to suffer alone.

By Janice Suskey LMHC

September 12-18 ADHD Awareness Week

What is Attention Deficit Hyperactivity Disorder (ADHD)?

It is one of the most common mental disorders that develop in children. Children with ADHD has impaired functioning in multiple areas including home, school, and in relationships with peers. If left untreated, the disorder can have long-term adverse effects into adolescent and adulthood.

Signs and symptoms:
-Impulsiveness: a child that acts quickly without thinking first.
-Hyperactivity: a child who can't sit still, walks, runs, or climbs around when others are seated and talks when others are talking.
-Innatention: a child who daydreams, seems to be in another world or is sidetracked easily by what is gong on around him.

How is ADHD diagnosed?

If ADHD is suspected, the diagnosis should be made by a trained professional such as psychiatrist, psychologist or mental health counselor.

Treatment:

The most effective treatment is a combination of behavioral therapy and medication.
At Central Florida Mental Health Associates we are dedicated to assist you. Give us a call at 386.736.9165 for a free phone consultation.

For more in depth information about this topic go to the National Institute of Mental Health www. nimh.nih. gov

Which door will you choose?

"When one door of happiness closes, another opens, but often we look so long at the closed door that we do not see the one that has been opened for us." - Helen Keller

I chose that quote this week for my blog to help remind us about the positive things that we might overlook in our everyday lives. Just because we might not reach a certain goal, or an outcome does not turn out how we planned, does not mean we cannot take positive things out of the situation. There are positives in almost any situation. Twenty years ago this past May, I was diagnosed with Lupus. Now on the surface being diagnosed with Lupus, well to be quite frank, it sucked. I was sick, in pain, and I was informed I was no longer going to be able to play baseball - which was my be all and end all at that point in my life. Now, I was lucky, I was lucky to have the type of supportive family who was there to help me see the positive things I still had going for me. You see, I have been asked time and time again, if I'm ever angry about being sick, or if I wish I could change it. The truth is, I don't get angry, and I would not change having Lupus. I have met many wonderful people that I never would have if I did not have Lupus. I believe that my illness, helped make an already close family even closer. Having Lupus has helped shape who I am as a person, and I like who I am. Having Lupus has helped me find strengths inside that I may never have found. I have discovered the true meaning of love and friendship thanks to having Lupus. The journey that I have taken in life, that was altered by my diagnosis, I would not change that for anything in the world. I share this with you this week in the hopes that you will take my story with you through your day, and when you face setbacks and challenges, instead of looking at what didn't happen, try and find what did. Instead of looking at why a situation is bad, find the good. Life happens, and you can choose to stare at a closed door all day, and be frustrated, or find the open door and be free.

Where does anger come from?

My blog today, is in response to a question posted on our Facebook page. Where does anger come from? Anger is a normal and healthy human emotion, that can range from mild annoyance to outright rage. Anger can serve to be a positive force in our lives, to motivate us to take a stand, makes changes, or address things we have been avoiding. When anger becomes "bad" is when the behavior or reaction to the anger is expressed in negative or aggressive ways, rather than in assertive and positive ways.

What is the difference between being aggressive or assertive? Someone acting in an aggressive manner might be hostile, infringe upon the rights of other and/or attempt to use intimidation to get their point across. Someone using assertiveness skills is able to stand up for themselves, express their perspective, and be confident and respectful, while not infringing over someone's boundaries or rights.

Anger can come from several sources, such as old memories, previously experienced trauma, the guy at your job, traffic jams, outrage at something witnessed, or it can be what is referred to as a secondary emotion. In our society and in our media, frequently the range of emotions that we see are fairly limited to the major ones, happy, sad, angry, and maybe a small handful of other emotions. Anger as a secondary emotion is where anger is the emotion immediately felt or expressed, but it is covering up or masking other emotions that we are either unwilling to or unable to identify at that time. An example of anger as a secondary emotion would be walking through the local cafe during the lunch rush, tripping over a crack in the sidewalk and spilling food all over yourself in front of everyone. Now, while you might be angry that there was a crack in the sidewalk, might you also be feeling embarrassed? Frustrated? Anxious to leave?

By being able to identify the emotions you are experiencing, and processing them in healthy ways, it will help you to better manage your levels of anger, and help you to ensure your responses/behaviors relating to anger are healthy. You can process your feelings by talking with someone or possible utilizing a journal. Another tip for managing anger is to develop a calming mantra that you can repeat to yourself as you feel your anger rising. For example, you might use "relax" and repeat it to yourself over and over again. You can engage in a variety of relaxation exercises such as deep breathing. Utilizing behavioral strategies like exercise and yoga can also be beneficial. When it comes down to it, every person is unique, and what might work for me, might not work for you. In the end, you have to listen to yourself and your body, and figure out what works best for you.