Personality Disorder? There Is Hope!

When therapists attempt to achieve behavior changes in their clients, they usually assume the absence of a personality disorder. 

It is, after all, a major task to work with clients in making significant life changes without going through the hurdle of addressing a personality disorder as well. People with personality disorders often lack the feeling of distress that motivates major changes within the therapeutic setting.

However, when the focus is on specific behaviors that can be changed to bring about smoother life adjustments, therapists can have great success in working with people who have personality disorders. People can recognize when they have a recurrent pattern of difficulty in their lives – and this recognition can serve as the motivator for change in therapy. A trained professional therapist is able to find those areas that help a client recognize the need for change.  For example, people with dependent personality disorder may come to understand that they may well lose their significant relationship unless some changes occur in their need to be taken care of. While the person’s internal needs for dependency may persist even after the therapeutic intervention, changes in the person’s overt behavior can go a long way in resolving the situation. When the outer behaviors are changed, the internal needs may then undergo adjustments in a healthier direction.

People with paranoid personality disorder, for example, can activate their sensitivity so that they become attuned to the needs of other people in a productive way. People with schizotypal personality disorder can transform a pattern of odd beliefs into a more creative and socially approved set of responses. Those with borderline personalities can use their tendency toward rapidly shifting moods to being more spontaneous (and sensible) in their responses toward others. Negative symptoms associated with these disorders can be turned into positive qualities which help the person in adapting to life’s demands.

A trained professional therapist is able to provide a setting in which seemingly intractable problems can be addressed. A feeling of safety and trust is built between the therapist and client – and this opens the door to trying new behaviors, with support, which have seemed impossible until now. A whole new world awaits those who give it a try.

Do you think you or someone you love suffers with a personality disorder? We can help. Please visit our site at www.DrQuintal.com or call us at 941-907-0525 for a free phone consultation.

Struggling with Low Self-Esteem?

If you struggle with low self-esteem, we can help!  Please visit our site at www.DrQuintal.com or call us at 941-907-0525 for a free phone consultation.

Understanding and Managing Chronic Pain

Estimates based on research indicate that from ten to thirty percent of the American population suffers from chronic or recurrent physical pain. Pain sufferers often feel that their doctors are not able to give them the treatment they need to alleviate their pain. They may have been told that it is all in their head, and they feel very alone when nobody can seem to give them support for being in pain. They feel helpless, anxiety-ridden, depressed, angry, frustrated, and out of control. They often turn to prescription pain medication, drugs or alcohol for relief – only to find that these quick fixes can cause more complications and devastation in their lives than the original pain.

Tips For Managing Chronic Pain and Regaining Control of Your Life

The first step in taking charge of chronic pain is to learn more about our experience of pain in a structured way. When we live daily with pain we sometimes lose track of just how severe the cycles can be, and we also tend to forget the better periods. We need to increase our awareness of the cycling of pain throughout the day and what we are doing to manage it. We also need to distinguish between the actual pain we experience and our emotional distress associated with this pain. Thus, it is important to keep a pain diary. This allows us to record our level of pain at various times throughout the day – and to see how pain is related to the time of day, mood, fatigue, stress, what we are doing, and whom we are with. It also encourages us to become aware of the crucial question of whether the pain is physical or more associated with our subjective experience of emotional distress.

Negative thinking can greatly increase a person’s experience of felt pain. When we think that our life is over, we will never have fun again, and our plans for the future are destroyed, we are undermining our own sense of control and are setting ourselves up to experience more pain. We need to challenge these negative ideas and replace them with positive thoughts. Examine your negative thoughts and change them to more positive, assertive ideas. Rather than saying, “I am totally incapacitated and will never have pleasure again,” replace it with, “I need to learn what I have done wrong in the past so that I can go on to accomplish things in the future that I have always wanted to do.” These are but a few of the techniques that can be explored in dealing with chronic pain. You are invited to explore the many alternative ways of dealing with pain that therapy has to offer. Please visit our site at DrQuintal.com or call us at 941-907-0525 for a free phone consultation.

You can also receive more information by following us on Twitter and Facebook.

Side Effects of Growing Up in a Dysfunctional Family

Over-Responsibility and Guilt

One characteristic of growing up in a dysfunctional household is that we may learn to feel guilty if we fail to ensure the success and happiness of other members of the household. Thus, in adulthood, we may come to feel responsible for our partner’s failures. The guilt we feel when our partner fails may drive us to keep tearing down our personal boundaries so that we are always available to the other person. When we feel overly responsible for another person’s life experiences, we deprive them of one of the most important features of an independent, healthy and mature life – the ability to make their own life choices and accept the consequences of their decisions. At Dr. Quintal and Associates we offer Accelerated Healing Therapy that can remove the feelings of unwarranted guilt and feeling overly responsible for others behaviors.

Fantasy vs. Reality

Children from dysfunctional households often feel that things will get better someday, that a normal life may lie in the future. Indeed, some days things are fairly normal, but then the bad times return again. It’s the normal days that encourage the fantasy that all problems in the family might someday be solved. When they grow up, these adults carry the same types of fantasy into their relationships. They may portray to others the myth that they have the perfect relationship – and they may believe, to themselves, that someday all of their relationship problems will somehow be solved. They ignore the abuse, manipulation, imbalance and control in the relationship. By ignoring the problems, they are unable to confront them – and the fantasy of a happier future never comes to pass. Unhealthy boundaries, where we collude with our partner in believing the myth that everything is fine, make it difficult to come to terms with the troubles of the relationship.

Healthy boundaries allow us to test reality rather than rely on fantasy. When problems are present, good boundaries allow us to define the problems and to communicate with our partner in finding solutions. They encourage a healthy self-image, trust, consistency, stability and productive communication.

Learning to have healthy boundaries is an exciting adventure, an exercise in personal liberation.
It means coming to know ourselves and increasing our awareness of what we stand for. It also means
self-acceptance and knowing that we are OK as we are and worthy of the good things in life. When two people with healthy boundaries enter into a relationship, they encourage wholeness, independence, and a zest for life in their partner. They know that trust is possible and that the normal expected difficulties found in all relationships can be worked on constructively. They can find true intimacy as whole, complete and equal people. The journey to a sense of healthy identity is not always easy – but it need not be all that difficult. It often means letting go of some of our old misconceptions about the nature of the world. It means treating ourselves with respect and
appreciating ourselves for what we really are. When we can do this for ourselves, we can take the same approach toward our partner – and then the true happiness and love that our relationship deserves can become a reality.

For additional information on these subject you can follow us on Twitter, like our Facebook page, or contact us for a free phone consultation at 941-907-0525.

Relationship Boundaries - Building Fences and Opening Gates

Unhealthy boundaries often emerge from dysfunctional family backgrounds. The needs of parents
or other adults in a family are sometimes so overwhelming that the task of raising children is demoted to a secondary role, and dysfunction is the likely result. Consider the role of the father who screams at his children or becomes physically abusive with them as a way of dealing in a self-centered way with his own anger. His needs come first, and the needs of the children for safety, security, respect, and comfort come second. What the children are likely to learn in this situation is that boundaries don’t matter. As they grow up, they lack the support they need to form a healthy sense of their own identities. In fact, they may learn that if they want to get their way with others, they need to intrude on the boundaries of other people – just as their father did. They would likely grow up with fluid boundaries, which may lead to dysfunctional relationships later on in life. They would have a hazy sense of their own personal boundaries. Conversely, they may learn that rigid and inflexible boundaries might be the way to handle their relationships with other people. They
wall themselves off in their relationships as a way of protecting themselves, and, as a consequence, may find it difficult to form close interpersonal bonds with others in adulthood.

Here are a couple ways in which unhealthy boundaries may show themselves in our relationships, along with some remedies:

Lack of a Sense of Identity

When we lack a sense of our own identity and the boundaries that protect us, we tend to draw our identities from our partner. We can’t imagine who we would be without our relationship. We become willing to do anything it takes to make the relationship work, even if it means giving up our emotional security, friends, integrity, sense of self-respect, independence, or job. We may endure physical, emotional or sexual abuse just to save the relationship.

The more rational alternative is to find out who we are and what makes us unique, and to rejoice in this discovery. Realize that your value and worth as a person are not necessarily dependent on having a significant other in your life, that you can function well as an independent person in your own right. When you move into accepting yourself, your relationships will actually have a chance to grow and flourish. This journey
of self-discovery can be challenging – but highly rewarding. Working with a trained therapist can provide the structure and support we needed to take on this task.

The Difference Between Love and Rescue

People who grow up in a dysfunctional family may fail to learn the difference between love and sympathy. Children growing up in these conditions may learn to have sympathy for the emotional crippling in their parents’ lives and feel that the only time they get attention is when they show compassion for the parent. They feel that when they forgive, they are showing love. Actually, they are rescuing the parent and enabling abusive behavior to continue. They learn to give up their own protective boundaries in order to take care of the dysfunctioning parent. In adulthood, they carry these learned behaviors into their relationships. If they can rescue their partner, they feel that they are showing love. They get a warm, caring, sharing feeling from helping their partner – a feeling they call love. But this may actually encourage their partner to become needy and helpless. An imbalance can then occur in the relationship in which one partner becomes the rescuer and the other plays the role of the helpless victim. In this case, healthy boundaries which allow both partners to live complete lives are absent. Mature love requires the presence of healthy and flexible boundaries.

Sympathy and compassion are worthy qualities, but they are not to be confused with love, especially when boundaries have become distorted. Healthy boundaries lead to respect for the other and equality in a relationship, an appreciation for the aliveness and strength of the other person, and a mutual flow of feelings between the two partners – all features of mature love. When one partner is in control and the other is needy and helpless, there is no room for the normal give-and-take of a healthy relationship.

For help in establishing healthy boundaries within your relationships contact Dr. Quintal and Associates at 941-907-0525. We will provide a free phone consultation.

The Ability To Trust

It is difficult to achieve intimacy in a relationship unless we have the ability to trust. We tend to focus on other people when we think about trust – that is, we might ask, who out there can be trusted and who cannot? But it may be more helpful to look inside and to think about trust also as something that we do well, or not. Some people grow up with a good ability to trust appropriately, and others, because of their needs and life experiences, have more difficulty with this issue.

Having a good eye for trust involves having a healthy sense of our own identities – and this means having a positive self-image, the ability to value ourselves and our decisions, and a good sense for protecting our own boundaries. We need to know what we stand for and what is best for us. Trust also involves acquiring a knack for making good judgments. When we have the self-confidence that comes with knowing and liking ourselves, as well as the ability to make life-enhancing decisions, we should be able to decide fairly easily about whom to trust.

Trust between two people emerges from a process of mutual self-disclosure – we gradually reveal more and more about ourselves to the other person until the relationship achieves a sense of intimacy. The first person self-discloses only to the degree that the other person has, in a series of steps.  A good balance is maintained between both people. If this balance is disrupted, it is difficult to maintain trust. For example, if one person reveals everything all at once and the other person reveals nothing at all, the balance is broken – and neither party will be able to trust the other. The building of trust is a mutual process that takes time. We feel comfortable revealing things about ourselves when the other person has shown that he or she is willing to take the same risk.

Some people trust blindly. They reveal everything all at once, expecting that the other person will be able to reciprocate immediately. What is more likely is that the other person will feel overwhelmed and may back off from closeness. People who trust blindly may want to look into issues like boundaries, self image, and why they need to be so close so quickly.

Other people find it difficult to trust at all. They may feel protected, but the walls are so high that they may never find an intimate relationship – and what a price to pay for protection! People who have difficulty with  opening themselves to trust may want to look into the pain that may have closed them off– and they may want to look into ways of improving their communication skills. The rewards of intimacy are well worth it.

A most exciting way to live is in true connection with your partner, family, friends and business associates. Dr. Quintal and Associates can help you find the path to living a fulfilled life and allowing trust to be a integral part of your relationships. Please contact us if you would like a free phone consultation at 941-907-0524. You can also follow us on Twitter and Facebook and Google+.

Worry..Oh, Worry....

As we all know, some people worry too much. Rather than solving a problem, too much worry becomes the problem. Not only does excessive worry create personal suffering, but it also affects the people around the worrier. Worry is a fairly common, but potentially serious, condition. A recent survey suggests that one-third of all office visits to primary-care physicians are associated with some form of anxiety. Furthermore, it has been estimated that one-fourth of all people, over the course of a lifetime, will at some point suffer from symptoms associated with an anxiety-related diagnosis. The stress which accompanies worry can have serious physical implications, including an increased risk for blood pressure and heart ailments, depression, immune system deficiencies, and cancer.

TIPS FOR MANAGING WORRY:

• Find Connectedness: When we feel connected to something larger than ourselves (a group of friends, our families, work, a sense of the past, ideas, and religious or transcendent faith), we are less likely to worry.
• Seek Advice and Reassurance: We all need supportive feedback from others from time to time. Other people may have solutions to problems that we haven’t thought about. For reassurance, find people who know how to give it. Many of us spend a lifetime looking in all the wrong places for approval•
• Understand the Difference Between Good and Bad Worrying: Good worry implies having a sense of control in solving life’s problems. It involves examining alternatives and then coming up with a systematic plan for meeting a challenge. Unproductive worry involves engaging in repetitively hashing over the same ideas time and again, negative thoughts, and no real plan for meeting the challenge.
• Try to Do the Right Thing: Maintain your sense of integrity whenever you do something. Tell the truth. Obey the law. Keep to your promises. Let your conscience be your guide. Granted, we might tell an occasional lie or break a promise, and this is fairly common – but it also can set the stage for worry. We may think sometimes that we can get ahead in the world the easy way – but the price we pay could be excessive worry, among other penalties.
• Keep Yourself Financially Secure: Live below your means and put money into a savings account. Pay off credit card debts. Consider ways to live more simply as a way of managing your finances.
• Learn the Value of Judicious Complaining: Sometimes it helps to talk your way through a prob-
  lem by complaining about it. Find a trusted friend
  and just let it all out. And then have a good laugh
  about it afterwards. If a friend is not available, write
  out your complaints.
• Add Structure to Your Life: Worry is often related to disorganization. Make a list of things to do each day and cross off tasks once they are completed. Leave early enough to make appointments on time. Put your keys in the same place every time you come home. Keep your house straightened up. When things are under control, there is less to worry about.
• Learn How to Let Go of Worries: This is a skill which might require some practice, and each of us will have our way of doing it. Some people do this by allowing themselves perhaps half
  an hour a day of worry time – and at the end of the allotted time period, they will be free of worrying until the next day. Some people give up their worries by writing them down on a piece of paper and then tearing up the paper. Some people prefer to hand them over to a higher power. There are mindfulness meditation techniques for letting go of your worrisome thoughts – just decide not to participate in anxiety-provoking thinking. Let the thoughts go (this method takes practice and uses techniques that increase your awareness through meditation or prayer).
• Sleep and Eat Properly: Lack of sleep and a nutritious diet can make us irritable, distracted, and anxious – all conditions that set the stage for worry. (Try to be mindful of the problem of overeating, however, as a way of making your worries disappear.)
• Exercise: Lack of sleep and a nutritious diet can make us irritable, distracted, and anxious – all conditions that set the stage for worry. (Try to be mindful of the problem of overeating, however, as a way of making your worries disappear.) 
• Minimize Catastrophic Thinking: Some people find it difficult to keep perspective when faced with even a minor stressor. Not every mole means cancer and not every bill is going to lead to bankruptcy. Test out the reality of these situations by talking them over with a trusted friend.
• Don't Sweat the Small Stuff: And, in a sense, if you think about it, it’s almost all
  small stuff.

At Dr. Quintal and Associates we specialize in helping you cope and manage stress and can teach you how to manage worry. We provide a full service of counseling methods to provide individual treatment for each client. Please contact us at (941) 907-0525 for a free phone consultation.

For insight on topics such as these follow Dr. Quintal on Twitter and Facebook.

The Serenity Prayer

God grant me the serenity
To accept the things I cannot change,
Courage to change the things I can,
And wisdom to know the difference.

How to Deal Assertively With Insults

All of us have had the experience of being insulted, and it is most uncomfortable and can be quite traumatic in some cases. An insult can easily mess up your day, if not your week. Insulting another person is a form of aggression (unless, of course, it can clearly be defined as banter between trusted friends). When you are insulted, you may silently punish yourself for leaving yourself open to the put-down. Or you may even agree with the insult as if it had validity (“Yes, I should take the tape off these glass- es”). Some of us simply cringe occasionally when we remember the put-down and think of it as one of our bad memories. A few lucky people seem to be able to let it go and move on.

Dr. Jason Quintal

Let’s say that someone gives you a verbal insult. In some ways, this type  of insult, though painful, is the easiest to deal with because everything is out in the open. For example, you accidentally step on some- one’s foot in a crowd, and, to your horror, you hear in an angry voice, “You jerk, can’t you watch where you’re walking?” What is the best way to handle this? First, let the person vent. They are probably having a hard time, and they might be phobic in crowds. So give the person that much. Then, verbally acknowledge the person’s feelings – “Oh, I’m sorry. You must have felt as if I did that on purpose and it upset you.” Admit when you have done something wrong if you receive an insult, even if it is accidental. Now it’s time to be assertive. In a calm voice and with good eye contact, say, “I would appreciate it, however, if you would not call me names in front of other people or shout at me, even if you are upset. I can understand your point without that kind of behavior.” And then bring the encounter to an end.

Sometimes insults are nonverbal. This can be seen with the rolling of the eyes, the silent chuckle as you are talking, pouting, obscene gestures, staring off into space, sighing. This type of insult is more difficult to handle because it is easily denied or it could simply be a mannerism of the other person. The aim in this case is to bring the nonverbal communication into the verbal realm. “Did I say something to offend you?” “I am having difficulty understanding your gesture. Could you please explain what you mean?” It is fair to you to get feedback if you have indeed said or done something to offend the other person. But now the confrontation is in the verbal realm, and the assertive responses appropriate to verbal insults can be applied.

Please visit DrQuintal.com for further information and an explanation of the mental health services we provide. We also offer a free phone consultation regarding any problems or issues you may be coping with in life. If you participate in social media please visit our Facebook and Twitter page.

What About Panic Attacks?

One of the most debilitating manifestations of anxiety is the panic attack. These dramatic episodes of anxiety seem to come out of the blue and happen even when there is no real danger. They are usually intense for a few minutes and then subside. The sufferer may experience chest pains, the feeling of smothering, dizziness, heart pounding, depersonalization, hot and cold flashes, sweating, numbness, or nausea. These symptoms may be accompanied by fears of dying, going crazy, and losing control. Those who experience panic attacks often live in fear of their next attack, and this may prevent them from leaving the house, being alone, or driving. Panic attacks are not triggered by a specific phobia.

One of the factors that perpetuates panic attacks is the fear of having another one. The perception that a panic attack is coming on can magnify an awareness of symptoms and then the person begins to tense up and harbor thoughts of doom – just the conditions that drive a panic attack.

If you feel a panic attack coming on, it is helpful just to let it happen, as uncomfortable as this may seem. As is true of any phobia, you have to expose yourself to the feared situation in order for the fear to decrease over time. If you don’t tense up, the symptoms will generally subside within a few minutes. Tensing up will perpetuate the episode. You may feel faint, but you won’t really faint (blood is going to your muscles as you tense up and not to your brain, and this may bring on the sensation of fainting – but your blood pressure and heart rate have increased, so you’re actually less likely to faint). During a panic attack, try to re-channel your thoughts. Challenge your negative thinking (you are not having a heart attack; you will not suffocate; you are not going crazy; you will not die). Trust that this will end soon.

Tell yourself the following – “Well, here it is again. Let me watch my body respond to this, just like I’ve done before. I will survive this and I can handle it. This may be unpleasant, but it’s only anxiety and it will pass. Let me flow through this.”

Dr. Quintal & Associates

5460 Lena Road, Suite 103

Bradenton, FL 34211

941-907-0525

Visit our website for information about Rapid Resolution Therapy: www.drquintal.com

Patient Testimonial After Treatment for Depression

Dr. Quintal,

I wanted to think you soooooo much for meeting with my close friend, Julia. I have known her since she was four. I actually call her my ‘little sister.’

I want to give you some feedback due to her history: she was depressed, was not engaging in any of her hobbies, not seeking out friends, with low energy, and frequently haunted by the memories of trauma (abuse, theft.)

When she moved back to Florida from St. Thomas, her explanation of said symptoms was that she was getting re-acclimated. But I know it was much more than that . . . she was stuck.

Since seeing you, I now see the light in her eyes. She started swing dancing again after ten plus years, she has actively sought out and made new friends, is exploring dating again, is exercising regularly (never exercised and still managed to look fab.) She has lost weight and her business is picking up, and she has been able to create a healthy divide with her father. Most importantly . . . SHE’S HAPPY!!!

I can’t thank you enough for bringing her back to herself!  You’re amazing!!

Blessings to you and your family.

Thank you again Dr. Quintal.

Blessings,

Mary Evelyn

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

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

How Long Will the Results of Rapid Resolution Therapy Last?

Rapid Resolution Therapy lasts a lifetime. Once you are done, none of the traumatic experiences will ever be troubling to you again. You could be talking about them while eating a slice of pizza and never feel the pain from those past experiences. Because the work is being done at such a deep level it changes things permanently.

There was a time in your life that you believed in Santa Claus or the Easter Bunny and now you don’t. Can you go back to believing in Santa Claus or the Easter Bunny? No, because once you got it, you got it. As soon as your mind updates and gets the good news that the troubling experience is no longer happening there is emotional freedom.

I mean, think about it, there was a time in your life when you didn’t know how to ride a bicycle and all of the information and in-site and understanding and knowledge on how to ride a bicycle didn’t make any difference on whether you could ride the bicycle. And then there was the moment that you had an experience where you got balance and as soon as that happened you can go 20 years without riding a bicycle and still be able to hop on and ride. When the trauma has been cleared, it’s been cleared and will no longer trouble the person again.

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

Rapid Resolution Therapy vs. Traditional Therapy

Rapid Resolution Therapy represents a paradigm shift from traditional methods of talk therapy. Most therapy is client directed and the therapists job is to support the client, provide some insights, be an empathetic listener, help them realize they should have been treated better and encourage the client to take responsibility for their lives and actions so they can learn more about themselves and figure out a way to change themselves.

Many therapists will say things like, "You need to let go of the painful emotions of guilt and shame. You need to learn how to let go of the anger and resentment and figure out a way to forgive yourself or the perpetrator so you can move forward and live a healthy and happy life."

Most of us in the therapeutic profession and many of you reading this post might think that is a good thing. However, there is a problem with that way of thinking; it causes the person to feel stuck.

When you tell someone they need to figure out a way to forgive, you are telling them they need to feel a way that they can't feel and don't know how to do it. If you tell someone that they need to learn how to let go of a painful emotion like guilt, shame, anger or resentment, it's like telling a teenage girl who is getting ready to go to the prom and has a face full of acne that it is time for her to let go of those pimples. She would look at you confused and angry and say to you: I'm not holding them, they have got me!

We do not choose our emotions and if we don't choose them how could we decide to not have them? Emotions are caused by the primitive or automatic part of the mind. It makes sense why therapists would say those types of things. Almost all problems human beings encounter are solved by having more of an understanding about them.  My wife and I recently learned that our young daughter is allergic to wheat. The solution to this problem was for us to acquire more knowledge about what types of food have wheat and which types of food do not have wheat so we would know what to feed her.

However, emotional problems do not get better by having more understanding of why they are happening. Someone can learn and understand that the reason why they get triggered by this current event is because of some other experiences and other things they have gone through. That information may be useful for them after they get triggered and may lessen the time they are affected, but does not eliminate them continuing to get triggered.

Rapid Resolution Therapy changes the way the automatic part of the mind responds and heals the invisible emotional wounds.

To learn more about RRT and view the FAQ, please visit my website: www.drquintal.com