Freedom From Verbal Abuse

A home should be a happy place, or at least a safe place. Dealing daily with the outside world, with its tensions, pressures, and surprises, can be difficult. The home is a place to come back to, a place to feel free, relaxed, and comfortable. The home should be the place where we feel loved and accepted just for being ourselves. This is, of course, an ideal description of what a home can be.

In truth, home is also the place where our personal conflicts are worked out, sometimes in destructive ways. Our internal conflicts may involve issues of anger, power, and control – all of which can lead to verbal abuse. The verbally abusive household is usually not a happy place, and, in extreme conditions, it might not be a safe place. It is important to recognize verbal abuse when it occurs – and then do something about it. Fortunately, there are effective ways of dealing with such situations and making the home a safe haven.

Verbal abuse leaves no physical scars, but the emotional wounds can be just as deep and recovery can be prolonged. On the surface, others may see both the verbal abuser and the victim of the abuse as a happy couple, the nicest of people. But behind the scenes there exists a subtle pattern of manipulation and intimidation, unreasonable demands, sarcasm, and angry outbursts. At the onset of these relationships, everything may seem wonderful. The person who later becomes verbally abusive may shower the eventual victim with gifts and compliments and make that person feel like the most important person in the world. Gradually, however, the relationship deteriorates.  The abuser’s anger and need for control are projected onto the victim. The victim is blamed for not being “good enough,” and the relationship gradually turns into an emotional roller coaster. When things seem to be going well, a fight emerges unexpectedly.

The victim may adjust to this situation over time, so that he or she is unaware of the extent of the abuse. Victims may come to see themselves as not “good enough.” They may feel that they are truly at fault, and if only they could change their behavior, the abuser’s anger would stop. The abuser usually fails to take responsibility for creating the problem and it is the partner who takes the blame. These relationships, then, are characterized by denial, poor interpersonal boundaries, control and power issues, trust issues, and unresolved anger.

Codependence and Verbal Abuse
The partners in a verbally abusive situation are usually involved in a codependent relationship, and neither partner may realize that verbal abuse exists. But they do know that something is wrong. Codependence exists when the partners in a relationship have grown up in dysfunctional families. In these families, the needs of the parents are usually put before those of the children, there is great instability, and interpersonal boundaries are poor. The children may be verbally battered so that they grow up with unresolved anger and a negative image of themselves. People who grow up in this sort of household may find themselves in a verbally abusive relationship in adulthood. The abuser is charming at first and the victim is eager to please. Neither party is clear about his or her own boundaries, so the abuser feels justified in imposing anger on the victim while the victim in turn tries to win love and approval – often by accepting blame and adjusting his or her reality to conform to what the abuser demands. The agenda for the victim is to be loved by taking care of the abuser. The agenda for the abuser is to control the victim into taking care of him or her. And both parties want to end the pain associated with negative self-esteem. The victim seeks to win approval, which provides some semblance of self-esteem. The abuser, who also suffers from damaged self-esteem, sees him or herself as the victim and uses power and control over others as a way to survive in what he or she sees as a threatening world.

Recognizing Verbal Abuse
Verbal abuse can almost always be seen as a control issue. Ironically, it is the abuser who sees him or herself as the victim. Thus, the abuser feels the need to control the partner in order to allay his or her own insecurities. The victim, hoping for closeness and approval, goes along with the control and may accept blame for causing the problems. In a sense, then, roles become confused – the abuser is the victim and the victim is the abuser. The situation becomes murky and perpetuates the conditions which breed abuse. To confront verbal abuse we need to become aware of the conditions which lead to abuse. Consider the following examples.

Blaming: The verbal abuser will accuse the partner of inciting trouble. “Dear, let’s talk about who will drive the kids to practice tomorrow.” “You’re always planning out my life! Can’t you just give me a break once in a while?” (Notice here how the abuser feels like the victim.)

Denial: The abuser claims that the reality of the partner is invalid. “Hon, remember when we were talking about taking a weekend just for ourselves?” “We never talked about that. You’re making it up.”

Discounting: Similar to denial, discounting trivializes the feelings of the partner. “Larry, I don’t like it when we fight like this.” “You’re just too sensitive, always making problems when you could just leave well enough alone.” (Notice that the abuser retains the control, especially if the partner then goes along with his suggestions.)

Blocking Discussion: The abuser refuses to respond to a communication, thereby blocking resolution of a problem. “Joyce, let’s go through the bills tonight and see how much we can put into savings this month.” “Who asked for your opinion? Get off my back, buster!”

Countering: The abuser sees the partner as the enemy and immediately counters anything the partner has to say without thinking it through. “Look at that lovely vase of zinnias.” “They’re dahlias, dummy.” (Notice here that Name Calling is also an especially destructive, and obvious, form of verbal abuse.)

Withholding: Refusing to communicate and share thoughts and feelings can also be seen as a category of verbal abuse, especially because it damages the chances of achieving intimacy and empathy. Withholding occurs when the abuser distances him or herself and reveals as little as possible to the partner. This is a way of keeping control and leaving the partner feeling frustrated and lonely. The partner may excuse this behavior by believing that the abuser is just a quiet person.
(This is also known as passive-aggressive behavior.)

Joking and Verbal Abuse: The abuser claims that he or she was only joking and then blames the partner for not being able to take a joke. “Did you really mean it when you said my mother couldn’t come here for the holidays?” “You just don’t have a sense of humor. Like, duh....”

Dominating: Commanding the partner to do something undermines the equality of a relationship and puts the abuser in the dominant position. “You get dinner on the table right now,” or “You are going to my office party and I want you dressed in ten minutes.”

Changing the Verbally Abusive Relationship
Because the partners in a verbally abusive relationship have usually adapted to their situations, as painful as this may be, it might require the intervention of a trained therapist to interpret the communication patterns objectively and empathically. In therapy the partners in the relationship may learn how dysfunctional families breed codependence, as well as how negative self-esteem and lack of adaptive interpersonal boundaries can lead to a verbally abusive relationship. New and healthier ways of communicating can be learned, along with the issues of control, the need for equality in a relationship, and how to trust and respect one’s partner. Learning assertiveness and refusing to participate in the cycle of abuse are crucial steps in coming to terms with the destructiveness of the verbally abusive relationship. Our homes can, and should, be happy, loving and safe. We owe it to ourselves, and to our partners, to confront the issues which prevent us from making trust and love essential ingredients in the recipes of our lives. The rewards of doing so are immeasurable.

The Cycle of Abuse
The typical abusive relationship falls into a three stage cycle, and the participants may not be aware of the cycle. One of the main ways of coming to terms with verbal abuse in a relationship is to increase your awareness of this cycle so that you can respond more appropriately.

1. The Buildup of Tension.
   The verbal abuser during this stage becomes increasingly critical, detached, preoccupied and contemptuous. The abuser becomes jealous and controlling. They may try to make the victim account for his or her actions and criticize how the victim dresses, talks, or cleans house. The abuser usually places limits on the actions of the victim in an attempt to assuage his or her own insecurities. It is during this stage also that the victim tries to accommodate the abuser by going overboard to please him or her in an attempt to keep the peace. The tension increases until the next stage of the cycle, the abuse stage, erupts.
2. The Abuse Stage.
   A major fight erupts and it is usually over a trivial incident, an incident so minor that the participants may not recall later what the fight was all about. There may be a great deal of yelling and threats, and sometimes the abuse can turn physical. One characteristic of growing up in a dysfunctional household is that people never learn to process their anger adaptively as a problem-solving tool, and in the verbally abusive household this anger may erupt as uncontrolled rage. Words which are very damaging, but which usually have no basis in reality, are hurled at the victim. The victim is left confused, hurt, and in need of retreat from the painful interaction.
3. The Regret Stage.
   Once things calm down, the victim feels distanced from the abuser and the abuser feels remorseful. The abuser may promise never to lose control again and then makes an extraordinary effort to win back the approval of the victim. The more distant and self-protective the victim is from the abuser, the more the abuser becomes conciliatory. The abuser uses all of his or her charm to make things right again, and because he or she is in the controlling role, is usually successful. This honeymoon stage lasts until tension begins to build up again – and the cycle is repeated. Unfortunately, over time the cycle can repeat itself more rapidly and usually with greater intensity – with the abuser taking less and less, or no, responsibility for the pattern.

At Dr. Quintal & Associates, we specialize in relationship and marriage counseling.  If you think you are in a relationship that involves abuse or verbal abuse, please contact us for a free consultation.

http://www.drquintal.com

Developing a Plan for Building a Strong Family

Some people believe that their families are too troubled to change. They feel that their families bring out the worst in each other and that they are plagued with insurmountable problems. They feel hopeless about changing their family life. However, many strong families have emerged from this place of despair, often in the face of a family crisis, to achieve a quality of strength, support, and vitality that they never thought would be possible. People can learn from their failures.

It may take the trained eye of a professional therapist to help a family move from this feeling of failure to one of success. An outsider can often observe patterns that family members themselves are not able to see. The support of a therapist can lead a family, one step at a time, through the process of identifying problems, developing strategies for dealing with each problem, and then following through. Even the most troubled families can grow with this type of support. A family has everything
to gain by deciding to work on building its strength. Home should be a vital, secure, and enhancing place – where comfort and support reside.

One way to start the process of strengthening your family is to try the following steps:

1. Look at the strengths your family already has.
   Each member of the family can identify positive qualities that exist in even the most troubled of households. Let each person in the family discuss these strong points without condemnation.
2. Visualize what you would like your family to become.
   Let each family member make up a “wish list” of things they would like to see in the family. Discuss these points and let the feedback be warm and accepting.
3. Identify specific goals.
   Each family member should come up with a list of specific goals that they would like to see the family aim toward. These should be things can be accomplished (like going to a movie together or having dinner together every night). Then agree on five of the most important goals and put a date beside each goal. 
4. Put people in charge of each of the goals.
   One person will be responsible for ensuring that his or her assigned goal is accomplished by the agreed upon date.
5. Understand that this is only the beginning.
   Strengthening a family takes time. It is a process, not a one-time event. And we take it step by step.

Looking for family counseling services in Tampa, Sarasota or Bradenton? We treat depression, anxiety, PTSD and more. Call us today for a free phone consultation: 941-907-0525 or visit us on the web at http://www.drquintal.com

Do You Have PTSD?

Do you have any of the following problems?

If you check at least seven of the following items and it is several months after you have experienced a catastrophic event, it is advisable to have a professional consultation to determine if therapy for PTSD is indicated.

1. I have strong physical sensations (e.g., sweating, rapid heart beat) when I think about the event.
   
   
2. I try to avoid having upsetting thoughts or having contact with things or places associated with the event.
   
   
3. My feelings are numb and I have difficulty experiencing normal pleasure and happiness.
   
   
4. I am always watchful to make sure I don’t experience the same event again.
   
   
5. I have feelings of guilt associated with the traumatic event
   
   
6. I have the feeling of being unreal or that the world is unreal.
   
   
7. I feel alienated or isolated from others.
   
   
8. I get irritated or angry a lot.
   
   
9. I have flashbacks of the event (feeling like the past event is happening all over again in the present).
   
   
10. I have trouble falling asleep or staying asleep because memories of the event come into my mind.
    
    
11. I have memory difficulties and trouble concentrating these days.
    
    
12. I am easily startled when I hear a loud noise or when danger seems imminent.
    
    
13. I have been relying increasingly alcohol or drugs to get through the day.
    

If you or someone you love is suffering from the symptoms of PTSD, please contact us for more information about how we can help.
Dr. Quintal & Associates
941.907.0525
www.drquintal.com
Successful treatment of PTSD is possible.

Patient Testimonial After Treatment for Anxiety

Hi Dr. Quintal,

Just wanted to touch base about how I was doing. Well it has taken time to get use to NOT having anxiety. I figured I have probably had that horrible anxiety like that for about 39 yrs and it just got worse as time went on. After my treatment it felt weird because I had to get use to the voice in my head not being there felt like something was missing. Now I feel better not missing it so much anymore don't really think about it that much or not at all. So it has been 5 weeks since I started my new job it was an adjustment a bit scary and overwhelming a new place and new people.

What is nice at my new job for me is I am not focusing on my new co-workers and scrutinizing them thinking they are up to something. I do like my new job and it is a very professional and respectful work atmosphere no ridiculous nonsense goes on there. When my co-workers act different sometimes I say thats about them not me and walk away and not think about it again and that works. So without all that anxiety I am able to focus on my job and start to enjoy my life a lot more without all that worry.So that's about it and thanks it sure has changed my life for the better!

Sincerely,

Maureen M.

Some PTSD Statistics

Most people who are exposed to extreme stress are able to process their way through their reactions and never develop PTSD.

• It has been estimated that 70 percent of people will be exposed to a traumatic event in their lifetime.
  
  
• Of those people, 20 percent will go on to develop PTSD.
  
  
• At any given time, an estimated 5 percent of people have PTSD.
  
  
• Approximately 8 percent of the population will develop PTSD during their lifetime.
  
  
• Women are about twice as likely to develop PTSD as men, mostly because women are more susceptible to experience interpersonal violence, including rape and physical beatings.
  
  
• Victims of domestic violence and childhood abuse are at tremendous risk for PTSD.
  
  
• Rape is the leading cause of PTSD.

Are you or a loved one suffering from PTSD? Contact us today for information about PTSD treatment options: http://www.drquintal.com or 941-907-0525

Recovery from PTSD with Rapid Resolution Therapy

Recovery from Anger, Resentment, Panic & Anxiety with Rapid Resolution T...

Social Anxiety : Overcoming Shyness

Ask people what they fear the most and many of them will answer, “speaking in public.” In surveys that ask people about their fears, about one person in five reports an extreme fear of public speaking.

Shyness and other forms of social anxiety are common – and they prevent people from fully experiencing life. Shyness refers to a tendency to withdraw from people, particularly people who are unfamiliar. Everyone has some degree of shyness. In fact a person without any shyness at all is probably one who does not make good judgments about maintaining appropriate boundaries between people. A bit of shyness is a good thing. But when a high level of shyness prevents a person from engaging in normal social interactions, from functioning well at work, or from developing intimate relationships, it presents a problem – which, fortunately, can be alleviated.

Shyness is one form of the broader term, social anxiety. This concept, also known as social phobia, refers to a special kind of anxiety that people feel when they are around other people. It is associated with concerns about being scrutinized. Shyness and social anxiety are closely related, but social anxiety includes other situations such as speaking in public, taking tests, sports performance, and dating. Closely related to the concepts of shyness and social anxiety are embarrassment and shame. Embarrassment is what a person feels when something unexpected happens and draws unwanted attention (such as knocking over a glass of water in a restaurant). This creates a temporary feeling of discomfort. Shame, on the other hand, is more long-lasting. Shame is a feeling that comes from being disappointed in oneself.

Who are the people most likely to suffer from social anxiety? Parents recognize that some children are easily frightened from birth on and cry a great deal, while others seem more resilient by temperament (they seldom cry, hardly ever get upset, and are less easily frightened). Some children love to explore the world around them. Others are cautious and don’t tolerate change well. Children who are inhibited are more likely to have a parent with social anxiety disorder. An anxious person is more likely to have a parent or sibling who suffers from depression. Many people with social anxiety disorder report having one or both parents who have a substance abuse problem such as drinking or come from a family in which:

1. there is substantial conflict between the adults,
2. parents are overly critical of the children (where things are never good enough), and
3. there is excessive concern about what other people think.
   

National surveys find that about five percent of children and adolescents suffer from a social anxiety disorder. Children with an anxiety problem seldom report that they are feeling anxious. Instead, they report the presence of physical symptoms, which include headaches, stomach aches, nausea, rapid heartbeat, dry mouth, blushing, dizziness, and shortness of breath. They try to avoid the following situations – speaking in class, taking tests, reading aloud, writing on the board, inviting friends over to play, eating in front of others, going to parties, and playing sports. Children and adolescents with social anxiety disorder may go on to develop other related problems, such as loneliness, depression, and low self-esteem. Although some children will overcome their shyness in time, as interactions with others cause their fears to dissipate, others will experience a worsening of symptoms. If a child shows symptoms by the age of six that have not improved by the age of ten, it is probably time to seek a professional intervention.

Next week we'll discuss overcoming social anxiety.

Are you suffering from social anxiety? We can help! Contact us at www.drquintal.com or 941-907-0525

PTSD - Post Traumatic Stress Disorder

Most of us build our lives around the belief that we will be relatively safe. Granted, normal daily life involves many stressors, especially in these hectic times, but we expect these pressures to happen and we become accustomed to handling them. The more flexible we are and the more we know ourselves and are in touch with our abilities, the easier it is to deal with normal everyday stress.

Sometimes, however, any of us could be subjected to catastrophic stress. Our feeling of safety in these circumstances can vanish. We could experience terror and a complete inability to know how to handle these situations that are outside of the ordinary realm of experience. These catastrophic events can include rape, physical or sexual abuse, physical attack, mugging, car-jacking, natural disasters (earthquakes, hurricanes, tornadoes, floods, etc.), fires, car accidents, plane crashes, hostage situations, school shootings, military combat, or the sudden death of a loved one. It is not only the victims of these events, but also witnesses, families of victims, and helping professionals who can develop severe stress symptoms that can last for months or even years after the event.

Post-Traumatic Stress Disorder (PTSD) is the term used to characterize people who have endured highly stressful and frightening experiences and who are undergoing distress caused by memories of that event. It is as if the person just cannot let go of the experience. The event comes back to haunt them. The anxiety experienced during or immediately after a catastrophic event is called traumatic stress. When the symptoms last several months after the event, it is called post-traumatic stress. PTSD can last for years after the original trauma and may not become evident initially. For example, an individual may witness a murder as a child, but not experience the associated stress until mid-life.

Some people are more likely to develop PTSD than others. Experts are not sure why some people develop PTSD after a relatively minor trauma while others exposed to great trauma do not. Those who are very young or very old are more vulnerable. PTSD is also associated with intelligence (those with a higher level of intelligence are less likely to suffer from PTSD). Individuals who already suffer from anxiety disorders, some personality disorders, or depression seem more likely to get PTSD after extreme trauma. It seems that the more vulnerable one feels in dealing with the world, the more likely one is to develop PTSD.

Trauma of great severity is more likely to produce PTSD than lesser traumas. For example, it was found with Vietnam War veterans that prolonged combat with sniping and air bombardment produced PTSD more often than brief exposure to combat with few weapons. It has also been found that traumas between people (such as sexual assault and muggings) are more likely to produce PTSD than natural disasters like earthquakes or floods.

Symptoms of PTSD
People can be considered to have PTSD when they have been exposed to an extreme trauma, the symptoms last at least a month in duration, and the symptoms cause excessive distress so that social functioning and job performance are impaired. One sign of PTSD is that the traumatic event is relived repeatedly in the person’s mind – and this appears in the form of “flashbacks,” recurrent images, thoughts or dreams about the event...and even nightmares. Reminders of the event can cause distress – so many people go out of their way to avoid places and events that remind them of the catastrophic occurrence. Many people experience anxiety, restlessness, concentration difficulties, decreased memory, irritability, sleeplessness, hypervigilance, or an exaggerated startle response. Some people even experience what is called “survivor’s guilt” – because they survived and others did not or because of certain things they may have had to do in order to survive.

There are three main clusters of PTSD symptoms, and all three of these groupings must be present for a diagnosis of PTSD.

Intrusive Symptoms: Intrusive and repetitive memories which stir up negative feelings experienced during the trauma can overwhelm a person. These memories can appear in the form of:

• flashbacks (a feeling of reliving the trauma)
• frequent, distressing memories of the trauma
• nightmares
• emotional and physical distress when traumatic memories are triggered.
  

Arousal Symptoms: PTSD sufferers experience physiological reactions, which indicate that they don’t feel safe and they are physically on the alert to deal with danger.

These can include:

• being easily startled or feeling jumpy
• hypervigilance (feeling “on guard” even when the situation is safe)
• concentration difficulties
• outbursts of anger and irritability
• problems in falling asleep or staying asleep.
  

Avoidance Symptoms: People suffering from PTSD go out of their way to escape the overpowering memories and arousal symptoms. This pattern of behavior can include:

• avoiding places, people or situations that serve as reminders of the trauma
• avoiding thoughts or feelings associated with the trauma
• memory loss about some aspects of the traumatic event
• feeling emotionally numb
• feeling estranged or detached from other people
• feelings of hopelessness and helplessness about the future
• decreased interest in pleasurable activities.
  

There are other emotional and physical problems that may accompany PTSD. Unfortunately, some people seek relief from these symptoms without dealing with the root cause so that the symptoms persist. These problems may precede PTSD, in which case they become exacerbated, or they might develop after the onset of PTSD. The emotional problems include panic disorder, agoraphobia (fear of being out in public), social anxiety (speaking in public), depression, obsessive-compulsive disorder, sleep disorders, suicidal thoughts and substance abuse (drug or alcohol abuse). The physical problems can include skin problems, pain, gastrointestinal disorders, fatigue, respiratory problems, low back pain, muscle cramps, headaches, and cardiovascular problems.

It is important to remember that PTSD is a normal reaction to a very abnormal situation. There is no shame in experiencing these symptoms, nor is having these symptoms a sign of weakness. Help is available from trained professionals so that in most cases, with the appropriate effort and courage, the symptoms can disappear completely, or at least substantially decrease and become more manageable.

Next week we'll post about getting help for PTSD. You can also visit one of our websites for more information: Dr. Quintal & Associates - Sarasota Counseling or PTSD Treatment

Dealing With Emotional Pain

When a person undergoes a life disruption, it may not advisable to take medication that will alleviate the pain immediately. When pain is alleviated with medication, the person’s motivation to make changes is reduced. And there is a great deal to learn from the process of managing emotional pain. (Of course, there are times when medication becomes necessary, especially with the suicidal thinking that may accompany a major depression. Many other life crises can be endured better with the use of medication. This is a medical decision.) When you undergo a major life crisis, you need time to gain insight into what has gone wrong and achieve integration again. Emotional pain, while unpleasant, serves its purpose, just as physical pain does in alerting us to something that is going wrong in our bodies. It prompts us to take action. Similarly, drugs and alcohol may help to alleviate emotional pain – but then the opportunity to learn our life lessons vanishes. Reinforcing pain chemically may allow old patterns of behavior to continue – in which case, paradoxically, the pain you are trying to escape will persist into the future. Pain spurs us to learn new ways of coping.

There are tactics that people in crisis can use to get through the crushing periods of pain that accompany a life disruption. These methods do not end the pain, which has value, but they allow us some relief for a time.

First is diversion. Sometimes we need to remove ourselves physically or mentally from our emotional pain for a while. We can take a weekend trip, read a book, watch an engrossing movie, talk to a friend, take a walk or get some other physical exercise. Diversion allows us time to heal and it may give us sufficient distance from a problem that we can come back to it again
and perhaps see it in a new light.

The second tactic for dealing with emotional pain is to stay in control over those aspects of your life that you still have some ability to control. A major life disruption can leave you with the feeling that you have no control over events. However, you can use self discipline to clean your residence, bathe, feed the dog, water your plants, and pay your bills. Stay in control of those things that you can control, and let those things which are uncontrollable run their course.

Finally, find someone who can show you empathy. There is no better way to relieve emotional pain than to talk to a trusted friend or therapist who can say with conviction, “Yes, I understand – and I care.”

Patient Testimonial

Dr. Quintal's Rapid Resolution treatment was a life changing experience for me. The love of my life passed away suddenly and I was left with nowhere to turn. A friend of mine suggested I contact Dr. Quintal and gave me some information about him. I had already talked to numerous psychologist which up to that point had not helped, and was apprehensive about trying another, but decided to make an appointment. My feelings before the appointment were sadness, depression, anger, lonliness, heartache and the unwillingness to be able to change it.

From the moment I spoke to Dr. Quintal I knew immediately that I had made the right decision and that his rapid resolution therapy was completely different than anything I had previously tried. I felt at ease from the beginning and felt the burdens and emotions begin to lift as he spoke to me and helped me through my loss. Dr. Quintal is an amazing therapist who was able to bring me out of such a dark place that I never thought I would get out of. After speaking with Dr.
Quintal, I left his office with a smile, a senses of hope and a feeling that I had not had since before my loss. His Rapid Resolution therapy had an impact on me that I never imagined possible. I would highly recommend Dr. Quintal to anyone who is going through a hard
time and feel that they have no where to turn. I am grateful to Dr. Quintal for his ability of getting me through my loss.

Thank You!

Shelley

James Recovers from Trauma, Depression and Child Abuse After Rapid Resol...

Girl Recovers from Anxiety, Pain and Childhood Abuse after Rapid Resolut...

Dr. Quintal & Associates Partner with Manatee Glens For Rapid Resolution Therapy Research Study

Dr. Quintal & Associates, in association with the Institute for Rapid Resolution Therapy and the University of Portland, have partnered with Manatee Glens to conduct a research study to scientifically demonstrate the effectiveness of Rapid Resolution Therapy (RRT) for the treatment of trauma patients, specifically those suffering from post traumatic stress disorder (PTSD).

The study that begins on Feb 26 and continues through May 30 will be conducted through Manatee Glens, a non-profit behavioral health hospital and outpatient practice. Participants in the research study can be anyone who has experienced trauma, big or small such as domestic violence, rape, or incest; a car accident, fire, gang fight or military combat; and/or unresolved ongoing grief. These individuals may be experiencing anger, resentment, guilt, shame, nightmares, phobias, and/or panic attacks. Registration is required with Manatee Glens. Manatee Glens screens all candidates prior to the study, where half will be placed with a RRT therapist and half will receive the traditional cognitive behavioral therapy (CBT) from Manatee Glens. Participants will receive pro bono services for RRT treatment, provided by Master Certified Practitioners at Dr. Quintal & Associates’ office in Lakewood Ranch.

The goal for the study is to provide evidence-based-research of the effectiveness of RRT as a treatment modality for trauma. “Rapid Resolution Therapy quickly heals the emotional wounds that don't get better over time or through traditional talk therapy methods,” says Dr. Jason Quintal, a certified Master Practitioner in RRT. Unlike other approaches to trauma treatment which require the client to experience painful emotions while reliving the trauma, RRT clears the effects of trauma gently and painlessly.RRT is an integrative and holistic approach that completely resolves the psychological and physiological effects of trauma.

Candidates interested in applying for participation in the research study may apply in person at the Manatee Glens Walk-In Center located at 371 6th Avenue West in Bradenton or Manatee Glens Access Center at 2020 26th Avenue East in Bradenton. For more information about this study, please contact Dr. Sharon Richie-Melvan at 352-476-5599. Rapid Resolution Therapy™ was developed by Dr. Jon Connelly. You can learn more about him and RRT at www.rapidresolutiontherapy.com.

Dr. Quintal & Associates opened their Lakewood Ranch, Florida counseling center in July 2008 in the Creekwood East Professional building near the intersection of I-75 and State Road 70. The center offers customized therapy, matching patients with a therapist and program specifically tailored to ensure their success. The center uses a variety of therapeutic approaches to create a personalized counseling plan for patients based on their specific needs. For more information Dr. Quintal & Associates, please call at 941-907-0525 or visit their website at www.drquintal.com.

Founded as a nonprofit in 1955, Manatee Glens is a state-of-the-art behavioral health institute located in Bradenton, Florida. Through their private hospital and outpatient practice, they provide personalized care to local patients as well as those from across the state and around the country. Manatee Glens helps families in crisis with mental health and addiction services and supports the community through prevention and recovery. For more information about Manatee Glens, please call 941-782-4150 or visit their website at www.manateeglens.org.

Assess Your Relationship

Understanding the sources of conflict in your relationship is one step toward resolving the differences between you. When we can get the problems out in the open and talk about them objectively, we can often find the solutions. Use the list below as a starting point for shedding some light on your relationship conflicts, which may now be hidden but which, with some thought, can become known and talked about constructively.

• Look for themes in your relationship conflicts, problems that keep reappearing time and time again. Focus on identifying the underlying theme in most of your arguments. Arguments usually focus on the surface aspects of the underlying conflict. Your goal here is to define the underlying conflict.
  
  
• Have these themes appeared in your other relationships with other people – both with friends and perhaps with other partners in the past?
  
  
• Can you identify your part in contributing to these themes? Every relationship takes two people and both contribute to the difficulties. What is your part? (This may be a hard question to answer since we tend to see the problems as lying within our partner rather than within ourselves.)
  
  
• What are the positive qualities in your partner that you may have forgotten about as time has gone by? Can you begin to define your partner in those terms again?
  
  
• What are the negative qualities in your partner that cause conflicts between you? Does your partner agree that these qualities are true? Has your partner changed over time, gradually starting to agree that the negative qualities may be true? Or, conversely, does your partner insist that these negative qualities are not true?
  
  
• Do you focus mostly on these negative qualities when you think about your partner?
  
  
• Is there anything from your past – from childhood on through adulthood – which reminds you of the conflicts between you and your partner? (This may be a clue regarding your unresolved conflicts which are the source of projections.)
  
  
• Does your partner project unresolved conflicts onto you? (These are probably easier to see than your projections onto your partner.)

Dr. Quintal & Associates
5460 Lena Road, Suite 103
Bradenton, FL 34211
941-907-0525
Visit our website for information about relationship and marriage counseling : www.drquintal.com

Our Typical Reactions to Loss

Elisabeth Kübler-Ross, an expert on adjusting to loss, identified five stages of adapting to loss. Not everyone goes through all stages and no two people will experience the process in exactly the same way. These stages should not be seen as sequential – that is, we don’t have to complete the first stage before we can move on to the second. Rather, we move in and out of each phase at various times during the adjustment process.

Denial – Even when a loss is expected, the first reaction is usually a sense of disbelief, shock, numbness and bewilderment. The person may experience a period of denial in which the reality of the loss is put out of mind. This reaction is not necessarily maladaptive since it provides the person some time to deal with the pain that must inevitably be faced.

Anger – If we experience loss in the form of death, it is often difficult to express anger. Who do we get angry at? If the loss involves a divorce or losing our job, expressing anger is easier since we can target our anger at an identifiable source. In any case, we often engage in self-reproach for not doing enough prior to our loss, like saying the right things, making amends, or trying harder. When we are in the anger phase, we may become irritable and quarrelsome. We may interpret signs of good will from others as rejection. Normal everyday stressors may trigger off episodes of rage.

Bargaining – This is a period of self-reflection that emerges out of the grief process. We come up with ideas that help us forestall the inevitable grieving that must follow loss. “If I do good things for people, I won’t lose anyone else to death.” “If I keep a cleaner house, my wife will come back to me.” “If I’m friendlier to people, I can get my old job back.”

Grieving – Grieving must be endured. It is our way of saying goodbye to the old so that we can open our lives to the new. Grieving involves suffering, and it may be intense. There are periods of increased energy and anxiety followed by times of sadness, lethargy, fatigue and emptiness. The person in the grieving phase may find it difficult to experience pleasure and may want to avoid other people altogether. One’s dreams may be intense during this time. Physical symptoms may accompany the grieving phase – sleep disturbance, changes in appetite, weakness, headaches, back pain, and indigestion.

Acceptance – One day you wake up and realize that life is normal again. This is not necessarily a time of happiness – but it is normal. And if the adjustment has been carried out to completion, with support and personal reflection, you can emerge a stronger, wiser and
healthier person.

Dr. Quintal & Associates
5460 Lena Road, Suite 103
Bradenton, FL 34211
941-907-0525
Visit our website for information about Rapid Resolution Therapy, Sarasota counseling services and treatment for depression, anxiety and PTSD: www.drquintal.com

Guidelines for Dealing with Loss

The goal of the person dealing with loss is to move through the various stages of the loss process, to learn from and appreciate the impact of the loss, and to achieve closure so that life in the future can be experienced more fully with integrity, insight and wisdom. Here are a few suggestions that may prove helpful:

Don’t try to do it alone.
Isolation is difficult for most people, but it is especially challenging for a person adjusting to loss. Seek out people who can be trusted and can listen well. During times of loss we need to talk and share the intense thoughts and feelings we experience when we are alone. Many people seek the help of a professional therapist who may be better prepared than most to empathize and guide the process productively.

Submit to the loss in order to get through it.
Some people try to ignore their losses and refuse to think about them. They may feel that time itself will heal things, but this is not necessarily true. Accept the loss as an important and necessary part of your life experience. Integrating the loss into your life is a way of living completely and with integrity.

Realize that intense feelings are normal and expected.
We may feel during times of loss that we are losing our minds and that we will never be the same again. Our dreams, fantasies, anger, tears, guilt and loneliness may be more pronounced than we have ever experienced before. But we need to expect losses to dredge up these intense feelings. Sometimes we have not achieved closure on past losses so that another loss may mean having to come to terms with both the present and previous losses. If you process the loss productively, these feelings will pass in time.

Seek spiritual comfort during this time.
Spiritual support often makes our losses more meaningful. It is during times of loss that many people ask questions about the ultimate meaning and purpose of their lives. Meditation, prayer and reflection help us soothe the turmoil which accompanies loss.

If possible, avoid making long-term decisions.
Times of crisis decrease our ability to make rational decisions. We tend impulsively to come up with plans that we think will put an end to our pain – despite the ultimate consequences. Put important decisions off until you have achieved some closure on your loss and things have settled down to a more stable pattern. If decisions are necessary, seek the advice of people who can be trusted.

Take care of your health.
During our adjustment to loss we may be more prone to letting ourselves go – and this opens the door to health problems and even accidents. Try to get enough sleep, but don’t oversleep. Maintain a nutritious diet, but allow yourself some extra treats during this time since self-nurturing is also important. Be sure to exercise, even if it is only a daily walk. Avoid alcohol and drugs during times of adjusting to loss. They may provide temporary relief, but you need to stay aware as you process loss, and abusing substances will forestall this goal.

Next week we'll post about the typical reactions to loss.

Dr. Quintal & Associates
5460 Lena Road, Suite 103
Bradenton, FL 34211
941-907-0525
Visit our website for information about Rapid Resolution Therapy, Sarasota counseling services and treatment for depression, anxiety and PTSD: www.drquintal.com

Loss

Loss is embedded in the process of living. It happens to everyone and it is inevitable. There is no such thing as constant gain in our lives. Despite our wish to live in the security of abundance and perfect health, we necessarily must lose something, over and over again throughout our lives. Time itself eventually creates loss. We come into this world with everything to gain and leave it with everything to lose. And in between we go through a series of gains and losses, ups and downs. Learning to accept both is a sign of wellness, maturity – and even wisdom.

Losses can be catastrophic, such as the death of a partner, parent, child or close friend, or they can be minimal, such as losing a favorite houseplant or finding the first dent in your new car. Obviously, we usually accept minor losses quite well, but major losses can rule our lives for years with feelings of helplessness, confusion and overwhelming sadness. If our losses are not handled adaptively, they can drain us of energy and interfere with our ability to live fully in the present. If we are not able to deal with our losses and then let them go, we can spend our lives under the spell of old issues and past relationships, living in the past and failing to connect with the experiences of the present.

There are many reasons why we may find it difficult to deal with losses. In the first place, contemporary society does not prepare us with adequate rituals and support to help us handle loss. We focus on gaining, acquisition and the promise of the future – and there is little social support for grieving loss and letting go. Indeed, we often avoid those who suffer loss just at the time they need the most support. On a more personal level, we may have difficulty in coping with loss because we never gained the tools for accepting loss. If we have problems with self-esteem, unresolved anger, jealousy, depression, excessive dependency, or poor interpersonal boundaries, we may find it difficult to shoulder loss. When we experience a series of losses without resolving them as they come along, it may be difficult to handle yet another one.

We face numerous losses throughout the course of our lives. Some of our losses are built into the normal developmental milestones that are an expected part of the life process. Humans feel impelled to move on, to explore, to grow. But each time we move on to a new phase of life, we must lose something of the old.

Here are some of the typical lifetime losses that we experience:

Separation-individuation – The infant must inevitably break the early bond formed with a parent. Young children, to be healthy, must see themselves as separate beings with their own sense of identity. The separation-individuation phase is the child’s first introduction to loss. If it is facilitated by a supportive parent, the child may be able to handle future losses more adaptively.

Sibling rivalry – Little babies have a special place in the life of a family. They usually get lots of attention. Older children may feel abandoned when their place in the family has been replaced by a younger sibling, and they may show aggression toward the infant or signs of withdrawal and depression.

Adolescence – As we grow into teenagers, we lose the old family bonds we have always known. We may begin to give more attention to our friends than to our families. Adolescence is a time of tremendous growth with the acquisition of new social skills and life responsibilities, but it is at this time that we must necessarily say goodbye to the play, the pleasures and the nurturance of childhood.

Friends – Friends leave – especially in our mobile society. They move, or marry, or sometimes they just drift away from us. The loss of a close friend, one who has seen us through life’s ups and downs, can be devastating. We may feel that a lost friendship will never be replaced, but our challenge is to appreciate what we had in our old friendship, to retain our memories, and to carry our skills into other friendships in the future.

Marriage – Those who marry normally shift their attention and allegiance from the family they grew up in, as well as their old single friends, to the creation of a new family. Modifying the old ties to family and friends can create a severe crisis, but there is a world of exciting new possibilities to replace this loss.

Letting go of children – When parents watch their children grow into adulthood, they lose a part of their old sense of identity and purpose. To cling to the old parental roles past their time is to invite conflict, yet many endure this conflict rather than simply grieve their loss and then move into new life experiences.

Losing our parents – When our parents die, we must adjust to the stark truth that we are next in line. This can raise issues about our purpose in life and what we have accomplished. Saying goodbye to the ones who have known us the longest can dredge up very deep questions, both pleasant and unpleasant, but we can learn life lessons from this crisis and use this knowledge to build more meaningful and richer lives for ourselves.

Middle age – The mid-life crisis is a time of giving up those things we no longer need in life and consolidating and building on those things we value and want to make a part of the rest of our lives. The loss of youth and physical vigor can present a tremendous struggle for some people, but middle age can also be a time of sharing wisdom and pursuing pleasures one never had the time for before.

Growing old – The losses of old age can bring on depression. Our bodies are no longer what they once were, we retire from jobs that have been a crucial part of our lives, and we experience the deaths of family and friends. Those who have learned to deal well with loss, however, can gain from their wisdom and fully enjoy each day. For some, old age is the best time of life.

Facing death – The death of those we love can be the harshest loss of all. And ultimately, we must face our own death. Grieving death is a very personal experience and one of the most painful to endure. It takes time to get through it. Bereavement can be a journey into the depths of our lives that can ultimately reveal our strength of character.

Next week we'll post some methods of dealing with loss in its various forms.

Dr. Quintal & Associates
5460 Lena Road, Suite 103
Bradenton, FL 34211
941-907-0525
Visit our website for information about Rapid Resolution Therapy, Sarasota counseling services and treatment for depression, anxiety and PTSD: www.drquintal.com

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Dr. Quintal & Associates
5460 Lena Road, Suite 103
Bradenton, FL 34211
941-907-0525
Visit our website for information about Rapid Resolution Therapy, Sarasota counseling services and treatment for depression, anxiety and PTSD: www.drquintal.com