Holiday Blues, Comfort Food, Rituals; I Want Out!!!

When it comes to this time of the year, we are bombarded with emotionally charged messages by song lyrics, colors, smells, and traditional rituals. Ask almost anyone what does celebrating the holidays mean to them and you’d hear a slew of things they do (gift buying, planning parties), things they prepare to eat or serve others (sweets, special recipes), and how they plan to spend time with families, friends, coworkers.

I personally happen to like several aspects of the holiday season and I am guessing many of you do too. But I know many of us feel a sense of sadness, tenderness, vulnerability, and even anxiety during these very times. Ever wondered why that is the case?

Socrates said “An unexamined life is not worth living” as he was on trial for encouraging his students to challenge the accepted beliefs of the time and think for themselves. So I encourage you to ask yourself, how come I don’t think I must spend time and money in offering gifts at other times of the year. Or why is it that I particularly crave things with cinnamon, clove, nutmeg, and ginger during December, and not much in July? And, how come I don’t have this expectation that I should be with my family on any particular evening of the year except on December 24th? And though you feel tender and sad when you think of the loss of a loved one, how come you particularly allow yourself to grief your worst during this month?

I am going to take a risk of sounding insensitive and say the answer to the above questions is: because you let yourself.

As I’ve treated persons feeling depressed, anxious and lonely during these months over the years, I’ve learned some typical negative beliefs that fuel the negative emotions experienced by most. Here is a list of commonly held beliefs:

  • Black and White Thinking: Christmas is a special time of the year. If you don’t have a special someone you are bound to have a bad time.
  • Falling For Tempting Thoughts: I get to have all these amazing treats because they only come along once a year, I deserve it because I’ve worked so hard.
  • Fortune Telling, Mind Reading, Discounting the Positive: If I don’t make it to all the holiday events at work and at home, people might think I don’t respect them; or that I am not a team player; or I might not get that promotion or close that sale.
  • Self Martyrdom:  I miss my loved ones at this time of the year and grieve their absence because I really care about them. So being depressed right now means I am loyal to them.

So, the take-home message here is that I’d like to suggest that you examine your own beliefs and see if you still agree with them. Perhaps once you recognize the thinking errors, you’d see the more liberating thought pattern come through, and you’d be able to find relief from those negative thoughts.

I am Dr. G. Katie Dashtban, a licensed clinical health psychologist. I have offices in Santa Cruz and Fremont, CA. I can be reached at 831-621-1150 and by visiting www.feelinggoodtherapy.com

When Doctors Don't Know What's Wrong

The Imperfect Aspects of Perfectionism

One of the most common causes of emotional suffering is perfectionistic tendencies.

We fall for, and get mesmerized by, the sound of voices in our head that point out our vulnerabilities, convincing us that we will sustain extreme humiliation or even death if we didn’t protect our egos in a defined way. This wisdom is not particularly apparent to most of us. The mesmerizing quality of these threatening voices fool our solid self. We often don’t realize that the thought is nothing but an over-generalization, or mind reading, or fortune-telling.

In the following scenario, I have developed a hypothetical situation where a person experiences anxiety, anger and depression over the observation that they have a medical problem that makes it hard for them to work. The following sentences are those that this person might say about their circumstance:

If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

People might think I’m loosing my grip.

Then I won’t be a candidate for that promotion.

And if I don’t get promoted, it’d mean I was just being mediocre all along.

And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

And that would mean I’m a loser, someone that is unworthy of even being alive.

Now, imagine a friend of yours has just approached you with the problems mentioned in the above scenario. This friend is quite dear to you and has come to ask for some help, wishing to feel better. The conversation between you and your friend might go something like this:

Friend: If I go to work with this migraine, I’ll make a bunch of mistakes and that’ll be super embarrassing.

You: Oh dear, well you do sound like you are in a great deal of pain and yes people aren’t usually at their best when in pain. But is there anyone at work that might understand your situation and be a little helpful? Or perhaps you could just call-in sick today, or maybe just do some basics that would not be too tedious, making it less likely to make mistakes.

Friend: But then I won’t be a candidate for that promotion.

You: Well, I suspect they make those decisions based on your overall qualifications, not just your need to mind your health one day. I see that in general you have such a high work ethic and do the job in the most amazing way. In fact, you worry about making mistakes if you went in with this migraine, which suggests your high work ethic–isn’t that what they factor in when looking to promote someone?

Friend: But if I don’t get promoted it’d mean I was just being mediocre all along.

You: Well, to my way of thinking, someone being mediocre might not really care much for the quality of work they offer, whereas your job performance has seemingly been amazing so far.

Friend: And that would mean I’ve wasted all these years at school, the training and all the hard work would mean nothing.

You: Well, yes sometimes people wake to realize that they don’t really care for their work and feel they have wasted years of training and hard work. You on the other hand seem to love this work since you put such high value into doing it to the best of your capability.

Friend: And that would mean I’m a loser, someone that is unworthy of even being alive.

You: Oh dear, I can see that being sad and disappointed over having this migraine has taken a toll on you. But all I see in front of me is a carrying and responsible worker who puts lots of heart into the work they do. To me that is quite worthwhile.

And, the kicker is, this is a Double Standard that we play against ourselves. We are so likely to speak with compassion for a friend. My question for you is: Wouldn’t you choose to offer the same level of compassion for yourself?

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Why Are Patients With Body Dysmorphic Disorder So Self-Critical?

Anxiety or Eating Disorder?

Body dysmorphic disorder (BDD) is actually a type of anxiety disorder, not a type of eating disorder. The affected individual focuses on physical flaws that other people may not notice. The cause of BDD is still unknown. But most likely it results from an inborn biology plus environmental factors.

Brain studies have confirmed that brain imaging results differ between subjects diagnosed with BDD and others who have not been diagnosed with this disorder. For example, BDD individuals are more likely to report feelings of disgust or repulsed when viewing images of their own faces versus control groups. Similarly, brain-imaging studies show alterations in two areas of the brain of persons with BDD: the visual processing center in the orbitofrontal cortex, and the frontostriatal system, which affects emotional reactions and behaviors. Theses studies suggest that brains of people with BDD are processing visual information differently in their brain, and this finding might explain why their perceptions differ from those of other people.

Exposure Therapy

A good majority of persons affected by this type of anxiety disorder might mistakenly resort to restricting their caloric intake in an effort to lose weight and therefore look better (in their own eyes). Clinicians might even mistakenly look at this issue as an eating disorder. Unfortunately, no amount of weight loss, or plastic surgery, or covering the body with make up, clothes, jewelry, etc. will present relief.

Just like many other anxiety disorders, the most effective treatment is exposure therapy (read more). The idea is to desensitize the brain at the site or image or thought of the dreaded object, in this case the part(s) of the body that brings out the most disgust in the mind of the person until such time that the brain will no longer react by the same emotional intensity as it did before. It is as if we have over charged the circuitry to the point of disconnecting the relationship between emotional disgust and the site of the dreaded body part.

I am Dr. Dashtban and in my practice I treat anxiety and depressive disorders associated with medical conditions. If you have any questions regarding successful treatment of BDD, give me a call at 408-458-8222, 831-621-1150 or write to me at [email protected]

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

The Fears You Don’t Face Keep Frightening You For An Eternity, Want A Short Cut?

I have learned of a legend in the Tibetan Book of the Dead by reading about it in Dr. David Burns’s book titled “When Panic Attacks,” (p. 251). Here is a short version of it:

Facing a Monster

According to this legend, you wake up in a dark place after you die. A scary monster appears from the dark that represents your worst fears. Facing this monster, you have the choice of surrendering to it, which is going to bring you the relief of defying it for good, or you may run away which gives you the momentary relief of the fear you are facing. But if you run away, out of the darkness comes another monster that requires you to make the same choices, surrender so you can find relief forever, or run away from it for now. Naturally, the option of running away will eventually wear you out, and you will feel defeated by the monster while remaining frightened for life. However, surrendering to it gives light to the fact that it was a toothless monster, that indeed it was only an illusion and that it might even turn out to be funny that you held such a strong conviction about it even being a scary monster in the first place.

Eradicating Anxieties and Fears

Learning from the wisdom of this legend, there is a very effective technique of eradicating anxieties and fears called the “Exposure Technique.” The trouble is that most people get mesmerized by the fear, say the fear of heights, and avoid going to high places because they don’t like to feel dizzy and anxious. Or in the case of shy people, they would avoid parties or people altogether, because they don’t like to feel insecure and inadequate. This avoidance unfortunately only fuels your fears however. In order to be relieved from the anxiety, you will need to get exposed to it, over and over, until it no longer triggers those uncomfortable feelings anymore.

Confront Your Fears

Exposure therapy can be done in several ways. One way is to literally confront your fears in a real form. For example, someone who fears getting sick and dying would purposefully shake hands with someone who has cold symptoms. They will then see in real life that even if they do catch the cold virus, at most they would feel under the weather for a few days, but they won’t indeed die.

Another form of Exposure Therapy is Cognitive Exposure. In this form you face your fears in your mind’s eye. You think and visualize the dreaded time or the dreaded experience, and you stay with it in your mind’s eye and maybe repeat to yourself a verse such as “I am not afraid of you” and you do this so many times until the fear finally goes away.

Repeated Exposure

Lastly, there is the Interpersonal Exposure technique. For example, in the case of someone with Social Phobia, they might have to actually go to a crowded place such a coffee shop, and scream: “I am shy.” They might have to stand a grand feeling of shame and humiliation at first, but repeated exposure to various social situations and indeed starting a conversation with people, will give the brain a chance to see that it needs not call the “fire department,” nothing bad is happening, so the fear will subside.

In short: Exposure Therapy is the short cut to what otherwise can be a lifetime of fearfulness and anxiety.

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

5 Tips to Keep Pain And Sadness At Bay During The Fall Season

If you are someone who can tell the weather is changing not by looking out the window, but by the way your mood feels or the way your body feels, then you know about the effects of season changes.

Some people are particularly sensitive to low levels of sunlight and react to overcast days by feeling blue. This condition is called Seasonal Affective Disorder or SAD. Moreover, people with chronic pain such as fibromyalgia, arthritis, or general muscle pain are often particularly sensitive to feelings of depression. In other words, depressive feelings make their pain worse. And when you have increased pain, you are likely to feel more depressed.

It’s like we are talking about a circular motion, where one condition makes the other worse and vice versa.

It does not really have to be this way. Here are some tips to keep this circular motion from starting off in the first place:

  1. Develop a conscious understanding about two links: A) the link between the weather and mood, B) the link between mood and pain. Be prepared; acknowledge within yourself that these links exist.
  2. Become good friends with the weatherman! Check the weather’s patterns and begin to learn the patterns of sunny hours or sunny spots. Then go out of your way to schedule an hour of being out in the sun on a daily basis, or at least 3 times a week.
  3. Ask yourself “what thoughts are just going through my mind.” Examples of negative thoughts that affect your mood and therefore your pain are: “I hate Fall and Winter, I just have to suffer through them.” Notice a strong element of All or Nothing Thinking in there. Instead, replace that thought with something like: “Although the overcast weather makes me feel down and my pain gets worse that way, but I will find sunny patches when I can allow the sun rays get absorbed in my body, then my body won’t have that negative reaction and I can get through the season without necessarily feeling worse.”
  4. Remain physically active. Even though the warmth of the summer days make the idea of being physically active more enticing, but you know that you owe it to yourself to give yourself the benefit of keeping your joints and your muscles active. Hibernating, staying in bed, resting more than what your actual rest times are will backfire. Look into going for a walk, sign up for some gentle swimming, see about taking up Pilates or yoga or both. You’ll be doing your pain condition and your mood a lot of good this way.
  5. Talk openly about your condition and ask for help. There is no shame or stigma on how you are genetically formed. So, your brain reacts to overcast conditions. That is the same as indicating the color of your eyes. Let people know how you are planning on taking charge of your needs by scheduling “sun times” and by maintaining a positive attitude about the whole thing and by scheduling physical activities.

I am Dr. Katie Dashtban. As a Health Psychologist, one of my jobs is to help people make attitudinal and behavioral changes that help them in coping ideally with their medical conditions.

Call me or write to me with any questions: 831-621-1150 or 510-400-6160.

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Why Stress Causes People to Overeat and What to Do?

Chances are you have heard of the phrase “stress eating.” You probably know of the comforting effects of “Comfort Foods” such as sugary and high fat foods as well. So, indeed, when you feel stressed out, certain stress hormones produce higher than normal levels in the body. In the short term this surge of stress hormones actually suppresses the appetite. This is also know as the fight or flight response. This is when you don’t feel hunger in the middle of a crisis. This is when the brain sends messages to the adrenal glands to pump out the hormone known as adrenaline, a revved-up physiological state that temporarily puts eating on hold. But when you are chronically feeling stressed, it is a different story. Then the adrenal glands release another hormone called cortisol, and cortisol increases appetite and may also ram pup motivation in general, including the motivation to eat. So if the stress doesn’t go away or if you don’t know of ways to reduce your bad feelings and your stress response stays stuck in the “on” position, cortisol may stay elevated. High Cortisol level also has been shown to increase the intake of high fat and high sugary foods. Once high sugary or high fat food is taken, they do reduce the activity in the parts of the brain that produce and process stress, in other words these “comfort foods” really are comforting!!! That is perhaps another reason why people who report having high stress levels crave comfort food, they actually crave not having stress!!

What to do:

  1. Psychotherapy – When you notice that your eating is because of feeling bad not because of the need to eat, then asking the help of a psychologist who is familiar with this pattern can be a life savor. They can help you learn what your stress triggers are and they can help you develop skills to get rid of those triggers, hence your emotional eating will decrease by itself.
  2. Social Support – Receiving support from a support group, friends, family and even social media can have a buffering affect on the stress that people experience.

I am Dr. Katie Dashtban and I specialize in Medical Psychology, where people’s physical and mental health have both been affected by one another. Let me know how I can help you or someone you know. Go to www.medicalpsychologyservice.com or www.gettingpastpain.com. Call 831-621-1150 or 408-458-8222.

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

When tempted for food…

When tempted for food, is it easier to eat and be done with the temptation or not eat and be done with the temptation?

If you are a foodie or just find it too tempting to do away with high calorie foods then you have probably experienced the pain of being tempted, not wanting to give in to it, and then finally giving into it.

Emotions such as guilt, disappointment, sadness and even anger are common when people give into their temptations. Similarly, sadness, feeling lonely, and rejected are commonly experienced when one does not give in to temptation. So it is almost a double aged sword, you get hurt whether you give in or not. Right? ..Not so right!!

Human mind has a strong tendency for wanting to be sure and knowing exactly what to do. That “in between” feeling is what drives most people bunkers. It is called Cognitive Dissonance, or in plain English, the pain of being in a limbo.

Here is the break down of Cognitive Dissonance when facing a food temptation: At first you are not thinking of the food, then suddenly you sense its smell, see its sight, or just imagine its texture in your mouth. You think to yourself how lovely it would be to have it. Then right away, you think of all the reasons why you should not have it, “its too heavy, it’ll throw you off your weight loss plan, it’ll take so much time to burn it off, etc.” It is in that moment of indecisiveness or being pulled to two different yet equally strong points of view that you experience anxiety, sadness, guilt, loneliness, feeling rejected, etc. These negative emotions are associated with that cognitive dissonance or that state of being in a limbo. So taking the food or not taking the food are not the real causes of negative emotions, being in a state of cognitive dissonance is the cause of those negative emotions.

So what to do:

Deciding not to take the tempted food and willfully walk away (literally or mentally) from the food will help you out of that limbo state, back into a state of knowing what is ahead. Once you are in that state of knowing what is ahead, then the pain of temptation is gone and you are once again able to be back to where you were in the beginning: all fine and care-free.

For more information regarding this article or related topics visit www.medicalpsychologyservice.com or write to Dr. Dashtban at [email protected]

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Spinal Cord Stimulator

When it comes to successful management of chronic back pain, sometimes extreme measures such as surgery on the spinal cord is necessary. In this type of surgery a device is used to exert pulsed electrical signals to the spinal cord to control chronic pain.

Often patients are asked to obtain a psychological evaluation before the surgery can be offered. The purpose of the psychological evaluation is to assure that patients’ mental and emotional health as well as their beliefs regarding successful pain management are predictive of successful outcome after surgery. In other words, surgeons and often insurers would like to offer the surgery to candidates that seem likely to highly benefit from it, otherwise the risks may outweigh the benefits.

For more information on psychological evaluation for SCS visit http://www.medicalpsychologyservice.com

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Is there a difference between disease and illness?

In my practice as a medical psychologist, I have noticed that when a person experiences undesirable symptoms, for example pain, that there is often a distinction between what their physician calls a disease versus what the patient calls her illness. In other words, there is often a distinction made between disease and illness.

Clinical experience has shown that people categorize their ideas about an illness around 5 themes:

  1. Identity that is how do you see yourself now that you have this illness, for example do you say I am hypertensive, meaning I have high blood pressure, or do you say I watch how much salt I take because my blood pressure seems to go too high when I take up too much salt.
  2. Cause What do you think has caused your illness? Sometimes lifestyle choices do lead to some diseases, sometimes a disease happens on its own. So what is your belief system about what caused your illness.
  3. Timeline How long do you think your illness will continue? For example, do you think this is going to last a week, or do you suspect this is going to stay with you for a lifetime, or somewhere in between.
  4. Consequences How much does your illness affect your life? For example, now that you have this disease, in what ways has your life been affected by it?
  5. Cure or Control how much do you think your treatments can help your illness or how much control do you feel you have over your illness?

So once these 5 themes have been addressed, then you have a much better understanding of what your illness is, regardless of what the disease is all about. This means you might have a much better chance of going about treating your illness in a far more effective way. In other words, you will have the chance to do, what is called Self Management.

Self Management is the capacity of a patient to take appropriate responsibility for dealing with all aspects of their illness including the symptoms, the treatments, physical and social consequences and lifestyle changes.

As a medical psychologist, my job is to help people self manage their illness. For example, patients can learn how to monitor their condition and how to make whatever changes in their thought patterns, their behaviors and their emotions so that they can notice a satisfactory quality of life.

For help on best ways to self-manage your health and or the course of your illness, please contact me at www.medicalpsychologyservice.com or 831-621-1150

Warm regards,
G. Katie Dashtban, Psy.D. Licensed Clinical Health Psychologist, PSY22256

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.

Taking ownership of pain, a blessing not a curse

When it comes to chronic pain, the matter has clearly been bothering you for a while. You have been coping with pain for at least 6 months, sometimes even years. It is very likely that you feel sad, anxious and maybe even angry for the disruption that pain has brought into your life.

At this point, it might look like it is somebody’s fault that this is not going away. You might be blaming your physicians for not having had successfully been able to cure the pain, or maybe even blame your family members and loved ones for not doing anything to help you, or because of not showing an understanding or empathy about your problem. You may even find the society and your job to blame for causing the situation that put you in pain in the first place, and for not making it easier for you to seek help.

It is tempting to feel that others are to blame for the pain and that it is their responsibility for taking it away. People often put their lives on hold while they are waiting for doctors, family members, even society at large to do something.

There is one major problem with this way of thinking and that is it only prolongs your sense of powerlessness. It makes you feel out of control and at the mercy of others. It sometimes even leads to distortions in thoughts such as: “nobody cares how much I am hurting, or no one can do anything for me, I am all alone in this.”

It turns out that when you take ownership of your own pain , suddenly this feeling of powerlessness can turn into a feeling of being in power, being in charge of things. But now you might be thinking: so I’m responsible for my pain, I am the one to blame? And that is precisely what Is not being implied by taking up ownership of your pain. As you know, self blame, guilt and anger can be paralyzing emotions, they can make you feel so out of sorts, so hopeless that there would seem to be no point in doing anything at all. Taking ownership of your pain means acknowledging that you are a worthwhile person, that there is a point in doing something, and that you do have choices. It is very different than blaming yourself.

By taking ownership of the pain, you get to be the captain of the ship, the one that makes all the decisions about your lifestyle, how much and what kind, you are the boss of your body and in charge of your health.

For more information on managing chronic pain successfully, write or call me at www.medicalpsychologyservice.com or 831-621-1150.

Have a blissful moment.

This service is provided by Dr. Katie Dashtban, Psy.D.

Katie defines her role as a psychologist as one who holds a guiding light, while her patients choose the turns in this maze we call life. In her practice, Katie refrains from offering advice, but instead helps her patients overcome obstacles that cause emotional suffering, and shows them tools to use when deciding on the desired changes in their lives.