Ask Ellen Anmuth, Psychotherapist: Coping With A Cancer Diagnosis

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Ask Ellen Anmuth, Psychotherapist

Ask Ellen Anmuth, Psychotherapist

A cancer diagnosis can be terrifying. The journey can begin with a swollen lymph node, a breast lump discovered while showering, or a visit to the doctor, where the words “we need to get this biopsied” reverberate in you head in stunned panic.

This blog series answers email questions from readers. Robin from Westchester, NY writes:

Dear Ellen Anmuth, Psychotherapist: I had a mammogram a month ago, and was called back for another scan, because they found something that concerned them. Yesterday, I went back for a repeat scan, and they found some abnormality…not sure, but I think they said something about calcification. I set up a biopsy for next week, and I am really afraid that this may be cancer. Please help me.

Ellen Anmuth, Psychotherapist: Dear Robin….It is normal to feel anxiety when told that you need a biopsy. The fear of cancer looms heavy when told that we need to do a biopsy, which is an invasive procedure. Let’s outline some approaches:

1) You live in Westchester, NY which is very close to New York City, with some of the best Medical Schools and Universtiy Medical Centers in the world. Many people like to take their mammogram scans to a University Medical Center, and get a second opinion. You may even want to get another mammogram at the medical center in New York City, and get a second opinion from a specialist in this area. Often times, the University Hospitals are aware of the current research, and if you find a world renowned expert in the diagnosis of breast cancer, you may feel more comfortable. It would be a shame to undergo a biopsy if an expert has an opinion different from  your community doctor. Of course, you can always get a third opinion if the first 2 doctors disagree.

2) Let’s look at some emotional coping skills. First, a cancer diagnosis is no longer is a death sentence. There are many approaches to breast cancer, and treatments are improving all the time. Even in a serious cancer diagnosis, there have been people who have defied the odds, and survived. Dr. Bernie Siegel wrote a book called “Love, Medicine and Miracles” in which he documented cancer patients who told their doctor that they were not going to die, and survived. Remember….the journey of a possible cancer diagnosis is a challenging one, and yet if you are open to support, the journey can be easier. The hospital social work services department can refer you to cancer support groups and licensed mental health providers who can help.

One approach emotionally is to “stay in the moment” and notice if you are visualizing a disaster scenarios. If you start to imagine death and pain, stop and ask yourself if there is fact to support your catastrophic images, or just your fear. Yes, fear is understandable, but try to manage the tendency to imagine the worst. Think back on your family of origin coping skills. Did your parents have a pessimistic tendency, always jumping to the worst possible conclusion? Or, did they tend to be optimists or realists? Reflecting on some automatic patterns you may have learned can be helpful. Finally, some people like to seek religious and/or spiritual support, and find comfort by doing so. Remember that current crises can bring up some repressed memories of past unresolved issues. A licensed mental health professional can be of help with coping with the wide array of issues that emerge when faced with a possible cancer diagnosis.

Ask Ellen Anmuth, Psychotherapist: PTSD and the Trayvon Martin Trial

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This blog series was designed to answer questions from readers. In keeping with the current news, a young man named Sam writes in. His  brother was murdered in a violent crime with a handgun, and the news about the Trayvon Martin trial has triggered many feelings of distress.

Sam from Detroit writes: Dear Ellen Anmuth Psychotherapist: My older brother was killed about nine months ago in a violent crime  with a handgun. I am too upset to go into all the details about his murder, but all this news about the Trayvon Martin case has caused me alot of suffering again. I was getting to the point where I could block out some of the bad memories, but all this news about this case on TV has made me remember alot of things that I am trying to forget. I am jumpy, have trouble sleeping, feel angry most of the time, and cannot seem to stop the bad memories. I think they call them flashbacks. Can you help? Thanks, Ellen.

Ellen Anmuth, Psychotherapist writes: Dear Sam, I am so sorry to hear of this tragedy in your life. Yes, you are right when you call the bad memories “flashbacks”. Sometimes, when we have experienced a trauma, like the violent murder of someone we love, recurrent thoughts, feelings and visualizations may recur. There is a phenomenon called “Post Traumatic Stress Disorder” that you may be experiencing. Would you be open for seeking some professional help to  better cope with this loss? If you call the social services department of a local hospital, they may be able to refer you to some help… either free help, or with a sliding scale based on your ability to pay. With the proper counselor, you could be helped to work through this very complicated bereavement process. I will explain more below.

I use the word “complicated bereavement” because it contrasts with “uncomplicated bereavement”. All deaths involve emotions and thoughts for most of us. For example, if a very elderly person dies of natural causes, and you had a happy relationship, you will grieve, but will likely not be tormented. On the other hand, if a young person is murdered, the survivors are left with a “complicated bereavement” process, needing to work through a series of complicated thoughts and feelings. For this reason, finding a licensed counselor who specializes in complicated bereavement processes would be a helpful strategy.

 

Ask Ellen Anmuth, Psychotherapist: Coping With Financial and Health Stress

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This article series addresses questions from emails. Today’s topic is “Coping With Financial and Health Stress”.

Anthony from Brooklyn, New York writes: Dear Ellen Anmuth, Psychotherapist: I am a waiter, and have to share an apartment with another guy, because I cannot afford a rental on my own. I am 21 years old, and wish I could afford my own place. I would like to go to school at night, to get a BA in Criminology, but I do not know how I could afford it. Any ideas how to cope with this stress and worry? I am having trouble sleeping.

Ellen Anmuth, Psychotherapist: Anthony, I can understand how financial stress can affect your life. However, the positive that I read in your email is that you have a desire to go to school to study Criminology. Have you identified a school that you would like to attend? In the New York City area, there are likely many colleges that offer that training. Perhaps you could contact the Admissions Office, and inquire about any student advisory services that may be able to help. In addition, there are usually financial aid departments, who may know of scholarships to help you get through school.

Regarding your sleep problems, anxiety and depression can cause sleep disturbances. If you contact the Social Services Department of any local hospital, they will be able to provide a list of agencies that offer counseling at a sliding scale to help you learn to manage the stress more effectively. I know many people who have had jobs and have also gone to school at night. As a waiter, perhaps you could attend day classes, and wait tables at night? If you are creative and flexible, you can create a schedule that works well for you. Keep the vision of your goal, and that will help you through the stressful moments. Also, if you contact Police Departments, they may have ideas of how you might find scholarships for your education.

Beverly in Colorado writes:  Dear Ellen Anmuth, Psychotherapist: I am trying to cope with an elderly mother who is declining. She is 72 years old, and is dealing with a new diagnosis of Leukemia. I am fearful of the course of this illness, and how I might cope with this, and be of help to her.

Ellen Anmuth, Psychotherapist:  Beverly, there is a national organization called “The Leukemia and Lymphoma Society”, and their website is LLS.org.  They provide information regarding  Leukemia and other blood cancers. Experts are available by phone who you could speak with to learn more about this disease. They also know about  community resources  to help you cope better with the stress of this illness in your family.  Good luck with this challenging issue. Make sure that if you are a caregiver of your Mom, you also find time to take care of yourself.

Ellen Anmuth Commentary: The Tornado in Moore, Oklahoma

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What can the notion of “Crisis” and “Loss” in this time of the devastating tornado of Moore, Oklahoma, teach us about gratitude and living in the moment?

The news today is filled with the sad story about the devastation of the tornado in Moore, Oklahoma. I lived in Miami in 1992, and I was in the direct path of Hurricane Andrew until, at the last moment, it veered south. After it hit, I visited friends in South Miami, and the streets were unidentifiable. It looked like a bomb was dropped. Some people theorized that Hurricane Andrew was not just a hurricane, but that there were tornadoes, as well, tearing up homes, cars, planes and trucks. Yes, airplanes were picked up and lifted to other locations. Even the National Hurricane Center went dark at one point, and lost its power.

My friends down there were in a “mental fog” for quite some time. A friend at the time was divorced woman with 3 sons under 8 years old, and she lived at other people’s homes for 8 weeks, until the water and power came back. She was one of the lucky ones that still had a home. Her 3 sons were quite affected by this.

I met a woman from Homestead, Florida at the Hurricane Relief Concert at a local stadium, where Gloria Estefan and other musicians donated their time to raise money. I asked her how her home was, and she told me it was no longer there, but she found her toilet hundreds of feet from her home’s foundation. Yes, toilets were lifted up and transported.

What happens to people in this crisis of devastation? Professionals call it Post Traumatic Stress Disorder. If they are dealing with friends or relatives who have been killed, there is a complex overlay of grieving on top of the “PTSD”.

What can moments like this teach us… those of us removed by watching it on TV? Perhaps this is a reminder to treasure the people in our lives, and to quote a wonderful author, Richard Carlson who passed away too soon, “Don’t Sweat the Small Stuff”.

Ask Ellen Anmuth, Psychotherapist: Dealing With Feelings of Isolation

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“Ask Ellen Anmuth Psychotherapist” is a series in which people send questions via email to Ellen Anmuth, Licensed Psychotherapist, and each month, a few  emails are selected for this blog series. Today’s topic is “Dealing with Feelings of Isolation”.

It is a very interesting time in history. Why are people feeling lonely, when the technology seems to connect people through social media? For example, people may have “Facebook Friends” who they have never actually met. The definition of “friendship” has been altered recently, to include strangers, perhaps loosely connected by business or by friends of friends. It is not surprising that people tell me that they feel disconnected, when they live in an illusion of being surrounded by “friends”.

If someone has  Facebook friends, followers on Twitter, or connections on Linkedin or on Google Plus, they may be feeling an undercurrent of loneliness, despite the illusion or appearance of connections. Additionally,the written Internet language has been reduced to micro abbreviations, and text messages have replaced phone calls for many. To what extent are deep emotions communicated digitally? Is “LOL” the mainstay and epitome of emotional expression? I think that the “glue” of relationships is  shared activities and the exchange of stories and deep feelings, to name just a few elements.The Internet often makes that difficult.

On the positive side, the social media does provide the potential for people to meet in person or on the phone, and to develop business and/or personal relationships. However, more often than not, if a person has 20,000 twitter followers, there is clearly not a connection with many of them.

How can people in this age of digital connection, address the sense of isolation that emerges from the lack of personal contact?

Diane from Ohio writes: Dear Ellen Anmuth, Psychotherapist: I have recently moved from the San Francisco Bay area to move to a small town in Ohio to take care of elderly parents. I miss my good friends and the vibrant, intellectual atmosphere of a big city, and I am feeling isolated here. I find it difficult to make new friends, and develop intellectual companionship. Any ideas?

Ellen Anmuth, Psychotherapist: Diane, you are dealing with many losses: It is likely that you are grieving San Francisco, a vibrant city with much culture and your group of friends. Allow yourself to go through a grief process, acknowledging the loss. Perhaps a grief and bereavement group may be helpful. In addition,    do you have hobbies and interests that you could get involved in? There is a website called Meetup.com, where people can search  for groups in their city, and you may find like-minded people. Many public libraries have discussion groups that you can sign up for. If caring for your elderly parents is taking up most of your time, could you hire a nurse part-time, so that you could develop new relationships and connections? Moving to a new town involves many adaptive tasks, and staying positive and optimistic is the first step toward bringing more friends into your life.

 

 

Boston Marathon Bomber Targets Runners’ Lower Extremities: A Study in Mental Illness

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To: Readers of www.TheLanguageOfSolutions.com/blog

From: Ellen Anmuth Licensed Psychotherapist

Re: This blog article is being updated due to the one year anniversary of the attack.  The power of human spirit to be resilient is evident in the countless survivors of this bombing who lost feet and legs. A recent TV interview showed the group of amputees vowing to support a young woman facing the amputation of her leg.  Many survivors described the uplifting spirit of support that helped to comfort, in light of this awful tragedy. Yes, the human spirit is so impressive.  Ellen Anmuth, LCSW.

Shock, Anguish, Disbelief, Anger, Fear, Grief….these words  only attempt to reflect the pain of yet another terrorist attack. The human experience can never be fully captured by language, which is merely symbolic representation of our thoughts and emotions.

As a Licensed Psychotherapist, a part of me is watching and analyzing this horrible event professionally, and  another part of me that is going through all the phases of the grief process, including sleep disturbances, agitation, tearfulness, and despair.

As I listened to descriptions of the bombs used, I heard that they were positioned to target the lower extremities. People had their legs blown off.  What causes a mentally ill person to create a sinister plan that attacks the legs of runners, and the legs of family members of runners?

One possible theory of this type of violence may be that people who were abused as children experience rage and a pervasive feeling of loss of control. These types of terrorist attacks may be fueled by the unconscious wish to get back at the world, and to feel some sense of control.  It may be, in the mentally ill person’s mind, that if they can hurt a runner so deeply that they can no longer run, that externalization of rage may temporarily numb their own inner pain.  I suspect, however, that  the numbing of the terrorist’s pain is only temporary, resulting in a cycle of violent attacks that never heal their anguish.

How can everyday people become more aware of the potential for violent or sociopathic behavior in another? Hurting another person without feeling remorse is one indicator. The lack of ability to feel empathy or guilt when inflicting pain is characteristic. If someone talks about hurting an animal, and laughs about it, that is another indicator. Often, these sociopaths can be charming, and when a person drops their guard and becomes vulnerable, the sociopath uses this moment of vulnerability to attack. The attack can take the form of stealing money or other types of interpersonal violations.

After hearing about the Boston Marathon bombing incident, I drove over to the water at sunset, to connect with nature and comfort my pain. I walked over to a dock on the bay (yes, that was a wonderful song title), and started talking with 2 college students who were fishing. We started talking spontaneously about the Boston Marathon bombing, and stories of people they knew came up. I told them I was a Licensed Psychotherapist, and I believe that, in my opinion, a large percent of criminal behavior stems from a lack of mental health prevention and treatment services. I told these fine students that I hope that as they grow into adulthood, they make an impact to try to encourage more money and attention to mental health treatment issues.

 

5 Quick & Simple Happiness Habits for Busy People

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Have you ever been so busy that you forget to center yourself, relax, de-stress and reach for a moment of happiness? Why did I use the expression, “reach for a moment of happiness”?

I think that feelings of happiness are transitory, as are all feelings, such as sadness, anxiety or anger, for example. Why not increase the moments of happiness, and decrease the other stressful feelings? Here are some quick and simple happiness habits for busy people:

1) Every so often, when your focus of attention is outside yourself–on another person or on a project or activity– do a “check-in”. Ask yourself, “What am I feeling?” and “What am I thinking?”

2) Take in a deep breath in while you do step #1, and on the exhale, release as many stressful feelings and thoughts that you can. Repeat this a few times.

3) Take a “60 Second Vacation”. That means to allow stressful thoughts and feelings to be suspended for 60 seconds, while you allow your thoughts and feelings to drift to a pleasant memory or peaceful image.

4) Then ask yourself, “What can I do now to nurture myself in this moment?” Perhaps you need some water or something healthy to eat, such as fruit. Perhaps you skipped lunch, and need a healthy meal. Perhaps you are exhausted, and need to rest for a longer time. If you have evaluated a situation that bothers you, maybe you have realized that you have no control over the issue that is flooding through your mind. Or, you may decide that you do have some control over an issue. If so, write down some ideas about a plan of action to address the current issue that is draining you. We usually feel better when we identify a draining issue and set up an action plan.

5) Do a Gratitude Exercise. Take a few moments to list in your mind, or write down the things you are grateful for. This has been proven to reduce stress and increase a sense of peace and happiness.

 

3 Tips for Forgiving a Person Who Hurt You

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How do you react when you are hurt (emotionally) by someone else? Do you store up anger, and feel upset for days, weeks, months or years?  Believe it or not, some people go through a lifetime of resentment, being unable to shift out of feeling upset. Here are 3 tips for forgiving a person who has hurt you.
Tip #1–Ask yourself if the person who hurt you is mentally impaired. If you have been attacked or hurt by a person with addiction, psychiatric disorders, or other impairments, it is helpful to tap into any feelings of compassion for that person. Of course, it is not easy. However, the mentally ill person may have been severely abused as a child, and  may abuse others  as a result of their trauma.

Tip # 2–Acknowledge your anger, hurt or any other feelings. Write your feelings and thoughts in a journal or diary, or talk with a friend or therapist.  Discuss your feelings with the person who hurt you, if they are receptive or able.  If these steps do not work, it may be helpful to acknowledge your feelings, explore any childhood experiences of being hurt that may be activated, and honor your need to heal from being attacked or mistreated. For many, it is necessary to grieve the symbolic or actual loss before true forgiveness can be reached.

Tip #3–Read up on the concept of forgiveness. From what I have learned, forgiveness does not mean that you condone the hurtful behavior of the other person. Rather, it means that you release the anger, and perhaps, explore if there are any positive aspects of this unfortunate experience. This is not an easy journey, and honoring your feelings of anger and hurt is the first step toward healing and moving on.

 

Watch the Charlie Rose Show’s Tribute to Roger Ebert

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Roger Ebert ‘s life was discussed on the Charlie Rose show on April 8, 2013, by a panel who were articulate, eloquent and inspiring.

I grew up watching the Siskel and Ebert film reviews on TV and enjoyed their intellectually stimulating discussions about films. In retrospect, I think that they modeled for me a level of sophisticated conversation where two very bright people could disagree and argue with respect and kindness.

That  level of intellectual conversation was a training ground for me, of sorts. As a therapist, I learned to teach communication skills and conflict resolution skills, noting the difference between “content” and “process”. Yes, the “content” of the discourse between Siskel and Ebert was lively, smart and intellectually stimulating. The “process” of their interaction was a role model where each person maintained their passionate beliefs about a film, and yet, always in a manner that acknowledged the other person’s validity and right to their point of view.

I learned that two people can have very divergent opinions, and both can be right. When it comes to a film review, many points of view have validity. These two men modeled how to have a healthy relationship….a good role model of conflict management for marriages, friendships and the business world.

When I watched the Charlie Rose tribute to Rober Ebert, other aspects were discussed, such as his generosity to write letters to his viewers, responding to their questions. He had a strong Twitter following after he lost his voice to the ravages of cancer and had written numerous letters to TV viewers, who shared these letters on Twitter. The Charlie Rose Show paid tribute to his generosity and kindness, as he took time out of his busy week to personally answer letters. The impact on his viewers was profound to them, personally and professionally.

When he lost his voice to cancer, he began to use Twitter to continue to critique films, and expanded his analysis to life and his illness. He was such an entertaining writer, that his Twitter followers looked forward to his comments about life.

What an amazing legacy of intellect, kindness and exceptional work ethic. I will certainly miss him, and recommend that The Charlie Rose Show’s tribute to Roger Ebert is a must see.

 

Pastor Rick Warren’s Son Commits Suicide — A Call For Conversations about Gun Control

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I was listening to CNN, and  they just reported that Pastor Rick Warren’s son committed suicide by a self inflicted gun wound.

As a Licensed Psychotherapist, I immediately felt great sadness for the family, and felt distraught over the questions that flooded my mind. How does a young man with a history of mental illness, as his father Pastor Rick Warren reported, have access to a gun?

Clearly, we are failing as a culture to manage the access of guns to people with mental illness, who either kill themselves or kill others.

I appreciate any replies to this blog, so that perhaps a conversation might reveal some solutions.