Dr. Roher Psychotherapy – Blog

In these very trying financial times, it is not uncommon for individuals and families to run out of money and become desperate for financial help. Borrowing money from people they know is something most of people dread to do, so they try everything possible and leave this option as the very last. Most people who borrow money are young and the most common person they go to for money is their parents. Lately however, even middle aged and older people have felt the stress and strain of losing a job, depleting their savings, seeing their home equity vanish in thin air and they too become desperate and borrow money from family and friends.

Families are the most typical places people go to in order to borrow money, yet family relationships are also the most sensitive to money matters. Adult children may see borrowing money as embarrassing and humiliating, after they finally achieved independence from their parents. Now the boundaries they set up with their families in the past – respect my privacy; don’t pry; don’t push; don’t preach – no longer hold. Lenders may ask questions before deciding whether or not to help the person in need. Borrowers feel forced to disclose where their money goes, what they buy regularly, what they could do without… The balance of mutual respect, privacy and distance that previously existed between them is now being shaken to its core. Now dad, for instance, or an older sibling or a close friend may ask them very specific and detailed information about how they got to this place or why they have not found a job yet. They may feel entitled to give them unrequested advice about what they should do to improve their finances, where they should live, and so on. In other words, they are treated like children who still need to be guided and supervised.

At the other end, the person or persons who lend the money may also feel awkward.  They may want to help, but find hard to discuss borrowing money with someone with whom they had a different kind of relationship. They wonder whether their relationship will remain the same, or if money will change it in some basic way.

Additionally, at times when a person, say a relative, asks for money, this situation can create tension with other members of the family. For instance, in a marriage the husband may want to help his younger brother who lost his job and is getting evicted if he does not find some money real soon. The wife, however, may feel quite differently. Helping her brother-in-law may tie up some money that had been ear- marked for a family vacation, for a new washing machine, or something special for the kids.

Is there a healthy way of dealing with these situations?

The most important thing to do is to keep clear arrangements, as much as possible. When you borrow money, make sure you offer a time table within which you will repay your debt. Be frank: think about your situation and give yourself a realistic deadline for repayment. Don’t make this deadline too tight, because you may not be able to achieve your goal. But even if you don’t, it is often better to re-negotiate the deal than to leave arrangements about repayment open ended. Write a contract if you can. Offer to pay interests. Make sure to say that you will work hard at preventing this transaction from affecting the relationship. Tell the lender that your relationship with them is very valuable to you and you will work your hardest to treat borrowing as a business deal, with expectations and obligations. Do not avoid this person after you get the money. Embarrassment and shame may push you to hide. However, if you avoid the other person, they may wonder about your intentions. Don’t wait for them to ask you questions. Whenever there is an opportunity, make some comments about what you are doing to improve your financial situation. You don’t have to report your progress to them blow by blow, but you may want to share as much as you are comfortable, so they are kept in the loop by you. All of this means that you now need to see borrowing money as part of your relationship with them, a part that you acknowledge, take seriously and handle responsively.

Tags: Dr. Roher, manage stress, psychotherapy

An increasing number of young people are moving back home with their parents, mainly due to financial reasons.

Even before this recession occurred, the percentage of adult children moving back home was on the increase in this country. A New York Times survey indicates that between 2000 and 2008 the number increased by 32% nationwide (New York Times, 3/22/10.) As of 2008, 20% of adult children were back home with their parents, or had never left. These figures are likely to continue to increase, as young people cannot find employment, are saddled with huge student loans they cannot repay, or are going back to school to increase their employment opportunities in the future.

What are some of the implications of this trend?

It is part of the American culture to be independent, to seek one’s fortune and move out of one’s parents’ home to go to college, or to find a job, at times very far away from the parents’ home. This is very different than what happens in a lot of other countries, particularly more traditional ones, where adult children continue to live at home. In Italy, for instance, most adult children, male and female, continue to live at home well into adulthood. There seems to be little social stigma in these familiar arrangements, which are seen as indications of strong family ties and sound cultural traditions rather than failure on the part of adult children to succeed independently.

In this country, however, there often is a sense of discomfort, even shame, in an adult person admitting he or she is still living at home.  Some of them complain it is difficult to date, as it is embarrassing to tell they don’t have a place of their own. So their romantic life can be quite affected by these arrangements. It is also difficult to feel like an adult when your parents are asking you at what time you will be home. Some of them, before they had to return home, may have had some time on their own. For them, being back home may feel like they are regressing and being treated as children again. This can have serious implications for their self esteem and self image.

With some adult children, however, living at home with their parents is not a strenuous experience. They are glad they can spend more time with family and don’t have to worry about making ends meet. There is some comfort that comes from being with someone who loves them. But these people seem to be a minority.

One way or the other, there are some boundaries that need to be established for these arrangements to work for everybody involved. Both parents and adult children need to sit down and talk about each other’s needs and discuss how they can be sensitive to them. Parents need to remind themselves their children ARE adults, even if they live with them at the present time. This means they need to give them the space they need, and respect their abilities to make decisions for themselves. Adult children, in turn, need to respect parents’ lives as being different now that when they were little. Parents need space to pursue their own interests and activities, and may not want to be thrown back into the full time parenting. With regular conversations about how to make these arrangements work for everybody, conflicts and strains can be managed, and all people involved can actually enjoy this opportunity to reconnect and get to know each other as ADULTS.

Give us your thoughts below by clicking comments.

Tags: Dr. Roher, manage stress, relationships

The first “happiness study” was published in 1978, in the Journal of Personality and social Psychology. The question the researchers asked of people who were interviewed was: what do you think will make you happy?

The researchers thought this would highlight some fundamental elements that contribute to happiness in most people’s lives. They assumed money and comfort would probably be mentioned as main contributing factors by the people interviewed. What they found, instead, was that people often mispredicted which future events would make them happy. They predicted material possessions, financial improvements, a vacation, etc would affect how happy they would feel. In reality, though all these things can make one feel better, at least temporarily, they didn’t make them HAPPY. People who had good things happen to them seemed to be as happy as people who did not.

Some more recent books in this field (The Politics of Happiness by Derek Bok, Happiness around the world: the Paradox of Happy peasants and Miserable Millionaires by Carol Graham and Stumbling on Happiness by Daniel Gilbert) reached similar conclusions, thirty years or so later. Peasants in Bangladesh, for instance, report twice the level of happiness as the Russians, who make four times as much income, one of the books quotes.

Clearly, according to these studies, there seems to be no direct connection between the amount of income (though having more money of course can make life easier) and one’s level of happiness.

I am not surprised by these results, as the people who come to my office feeling unhappy come from all different socio-economic backgrounds and yet they express similar feelings about how they see their lives. Happiness is very complex concept difficult to define, and the factors that contribute to it are many.

One element, for instance, that is absent in these studies is the level and quality of social and emotional connections a person has in his or her life. We know people who are alone tend to be unhappy and more vulnerable to depression and other emotional symptoms. We know they tend to have poorer health than people who are in happy relationships. If we measure wealth not as G.D.P. but as social capital, perhaps a different picture may appear.

If we go back to the Bangladeshi peasant, for instance, we may see that his strong family and social networks may create a positive counterbalance to the challenges and stressors that come from his low income. Looking at this problem this way, we may discover that this peasant is actually “richer” than the wealthy American who lives in a huge suburban house all alone and disconnected from his family and community.

Jean Baker Miller, a psychologist who became quite known in the seventies, was the first to point out the value and “wealth” offered by healthy, supportive, accepting social connections for individuals. The lesson here is that, in addition to all the elements that these books studied to determine what creates happiness in people,  the importance of healthy social connections should be ignored when we research what makes people happy.

Let us know your thoughts. Click on “comments” below.

Tags: Dr. Roher, psychotherapy

The Center for Disease Control and Prevention informs us that about one third of all children in this country are overweight, and 17% are clinically obese – more than triple the rate from 1976. At the other end of the spectrum, rates about anorexia and bulimia, particularly among teenage girls but not exclusive to them, are alarming as well. The National Institute of Mental Health reports that about 5% of girls and women and 1% of men suffer from anorexia. For 10-15% of anorexics, their eating disorder is fatal. Of the ones who survive, about 50% become bulimic! The saddest part in this picture is the fact that these problems seem to show up earlier and earlier in people’s lives, starting from childhood. These are shocking figures, and there seems to be no end in sight.

What are the underlying causes of this dismal situation?

Of course there are multiple reasons why people develop problems with weight, ranging from genetic, to emotional, psychological, environmental and cultural. Neuroscientists are studying brain chemistry to determine what if any are the connections between neurotransmitters and appetite.

Emotionally, food is associated with different meanings that go beyond its dietary value. Food can be company, comfort, love, acceptance and, always, immediate gratification, as most of us look forward to eating and enjoy food. We eat when we are sad; we eat when we are lonely; we eat when we are bored; we eat when we are nervous, excited and so on. Because of the central role weight plays in most of our lives, however, often food intake is associated with shame and or guilt. We sneak food in our bedroom because we don’t want anybody else in the family to see what we are doing. We gulp things down quickly while at work, again because we don’t want our colleagues and friends to see us eating and see what we are eating.  We eat and feel bad at the same time because we know what we eat is often not what we SHOULD eat. We give ourselves rationalizations to justify why we eat what we eat; we make promises about changing our patterns, we make commitments… but we often fail them.

80% of American women are dissatisfied with their bodies and their shape, and 50% are, at any time, on some kind of diet. No wonder why eating is such a conflictual issue for most people, and for women in particular!

From a cultural point of view, we are constantly bombarded with mixed messages about food and body shape. Models are all ultra-thin, some of them borderline anorexic, and these are the models young girls look up to and want to emulate. Most women, however, will never have models’ bodies no matter how hard they try. So, we set ourselves up for disappointment because we set goals that are impossible to achieve and sustain. At the same time, however, we cannot watch television for more than half an hour without being bombarded with food ads. Food is all around us, all the time, so we are constantly tempted by it

Fortunately, there are things that can be done to reduce the problem and create healthy ways of dealing with food.

In the next post we will discuss how we can get better control over our eating patterns and how our families and support systems can help us achieve that goal.

Give us your thoughts by clicking on the comments button below.

Tags: Dr. Roher, psychotherapy

We all know that stretching is good for our bodies. It allows us to become more flexible and it makes us feel good, particularly in the morning, as we wake up, or when we prepare for a run, exercise, or move from a position we held for a long time. Now research is pointing to the value of a different kind of stretching, one that applies to our brains.

For a long time scientists believed that neurons, the cells that make up our brains, do not regenerate. We are born with a limited number of neurons, it was thought, and no new ones could be created. About 30% of them would die through the course of our lives, and nothing could be done to stop or reverse this process.

As brain research has become more sophisticated in the last ten years, these beliefs have been challenged. Neurons can and do regenerate, as shown by the healing process that occurs in the brain of people who suffered from a stroke, for instance. And more studies are being published showing how the brain stays active, healthy and sharp, and how it grows.

And here is where stretching comes in.

Growth in the brain is produced by exposure to experiences that stretch us, pushing us into unknown areas where we have to embrace new challenges and explore new paths. In so doing we learn to integrate new information with the old, solve new problems and use new approaches in dealing with them. It is this stretching out of our comfort zone – where we feel competent and knowledgeable – and taking a risk in areas where we don’t know much that creates new connections between neurons. And it is the development of new connections that creates growth.

We spend most of our time at our work, doing the same activities day in and day out. Because these activities are repetitive, they become very familiar to us, like second nature. At times we don’t even have to think about what we are doing, as we can perform them automatically.  In performing the same activities over and over again, we use the same neuronal connections, strengthening them. This proves, while it makes us more competent, does not cause our brain to grow. This, as we said earlier, can be achieved only by exposing ourselves to new experiences. So, it is very important to counter-balance the regularity and predictability of most of our daily activities with new challenges and explorations into unfamiliar territories.

We may feel hesitant to start something out of our comfort zone, and insecure at first. The rewards, however, will be well worth our initial discomfort. The more we do this, the easier it gets, and the more interests we develop and want to pursue. There is practically no limit to what we can do, if we just put our minds to it. But it is important not to focus exclusively on results but value the process because, even when we don’t achieve as much as we would have liked, our brains benefit from the exercise and grow new connections.

So, let’s take a class, start a new project, develop a new hobby, or venture into a new area. Let us not use your age as an excuse to stop learning and growing, or lack of time, or lack of energy. Brains that stay active remain healthier longer and contribute to more interesting and challenging lives.

Tags: Dr. Roher, psychotherapy

Arizona is one of the States that has been most deeply affected by the current economic recession. It was one of the first States to feel the impact of the economic crunch due to the crash of the real estate market, so dominant here up to a few years go, and one of the last ones to see any sign of recovery. In fact, very few signs of recovery are hardly visible even now.

Of course a lot of sectors have been and still are affected by this downturn. Lots of people lost their jobs, which means they lost their medical insurance coverage as well. Lots lost their homes. Lots still are currently on the brink of losing everything they have worked for.

While it is no mystery that all these losses have affected people in deep psychological ways, very little has been written on this compared to the volumes that have been written in other areas affected by the current recession. However, this is an extremely important area that needs to be addressed, because the psychological impacts of stress tend often to be longer lasting and more insidious than the economic ones, as they affect people at the very core of who they are. Self-value, self-confidence, sense of security and sense of identity, in fact, are deeply shaken and at times people never fully recover from these impacts.

In addition to the people whose psychological health has been deeply affected by the economic downturn, there are also people who were already suffering from mental illness and who struggled to function and be productive in their lives. For all these people resources have been cut to the point where a lot of them currently have no or very limited access to treatment. “Tens of millions of dollars in state budget cuts since fiscal 2009 mean there is less money to pay for patients’ hospitalizations, psychiatric and counseling sessions and medications,” reported the Arizona Republic (AZ Republic, 3/19/10.)

One sign of this dismal situation is the increasing number of people who go to emergency rooms for serious mental illness or suicidal problems. Again, the Arizona Republic reports that at Maricopa County Medical Center, for instance, the number of patients who go to their emergency room for psychiatric problems has grown from “fewer than 10 per week to between 20 and 25 per week.”

Too often when we talk about economic issues, we forget to look at the enormous psychological impact that an unstable situation has on the human mind. For those who suffer from severe mental illness, no access to treatment and medication can mean losing whatever relief they used to get from a system that, though inadequate, was nonetheless available to them.  Reports indicate that currently the system fails more than 80% of people who need their services. One of the results of this situation is that Arizona ranks number one in the country for the number of suicides. This is a terrible catastrophe that affects not only people suffering from mental illness, but their families and those who depend on them as well, and should affect all of us because it erodes the foundations of a democratic society based on the collective care for its citizens, particularly the ones who are ill and in need of help.

Tags: Dr. Roher, economic recession, manage stress

We have all experienced it at one time or another in our lives: we made a life-changing decision –we decided to get married as soon as we graduated from High School; move away from our families; have children, not have children – and later we regret these decisions and wonder what life would have been like had we chosen the path not taken. We torture ourselves about why we decided what we decided; we chastise ourselves for not having thought about it longer, or studied it more, or gathered more information. We can’t sleep at night, we are tormented by our thoughts that go over and over the decision we now regret, as though trying to undo what we did and get another chance. Is there a value in all this?

Regrets can paralyze our lives and prevent us from moving on because they keep us stuck in a time warp. But they can also teach us something. As we reflect on our decisions, we can learn more about that particular situation, we find options, even if only in our minds, and imagine different scenarios. This is a painful but helpful exercise, because it provides us with valuable information so that, if a similar situation were to occur again, we would be better equipped to respond to it in a way that is most appropriate. This exercise could also reduce a tendency to make impulsive decisions , because it encourages more reflection on our part.

If we stay stuck in regrets, on the other hand, we can become so obsessed that we become unable to make decisions in the present because regrets cast doubts on our abilities to make good choices. Obsessive thinking about decisions we made in the past erodes our self-confidence and maintains insecurities and lack of closure. In conclusion, obsessing about past decisions won’t help us, but reflecting on them and learn from them is a valuable and growth-promoting experience all at any stage of life.

Regrets, seem to have a different value at different ages. When we reach middle age, for instance, there is a general tendency to evaluate what we have achieved and where we have failed so far. This is typically the time most susceptible to regrets. What is the best way to deal with them?

As always, a middle ground is the best way to be. We need to accept that whatever we did we cannot change now. We need to accept this as part of who we are. We need to stay in the present, not in the past, and focus on what can still be done, rather than what cannot be recaptured. We learn much more from our mistakes than our successes, so let’s look at what we did as a learning opportunity.

As we approach old age, we tend to become more tolerant of our past mistakes, and regrets play a less significant role in our lives. This is possibly because, at an older age, we are more focused on making the best of the present, as we have little time left. We have acquired the wisdom to know that life is made of good and bad decisions, that we are not perfect, and neither is anybody else. This allows us to live better with our regrets without letting them take center stage.

Any regrets? Post your comments by clicking on the comments button below.

Tags: Dr. Roher, psychotherapy

We use the term “Spring Fever” to refer to how our bodies feel at this time of the year: restless, ready to start something new, given to daydreaming, energized, not hungry.

Is this real or an invention?

Many scientific studies point to a very strong connection between our physical and mental wellbeing and the physical environment around us (Smolensky, M. The Body Clock Guide to Better Health”, 2001.)

There are both physiological and psychological reasons for Spring Fever:

A close correlation between longer days and shorter nights, warmer weather and hormonal levels in our bodies has been found. Two chemicals produced by our bodies seem to play a central role in Spring Fever: melatonin and serotonin.

Melatonin is the hormone that regulates our sleep-wake patterns. During the winter, when the nights are long, we produce more melatonin. In spring, the retina in our eyes detects the longer day light and signals the brain to produce less melatonin. The result is that we become more awake.

In spring there also is an increased release of serotonin, a neurotransmitter that affects our moods. This contributes to feelings of giddiness and happiness, which are typically associated with Spring Fever.

Also, people tend to eat less in spring. Anthropologists believe winter diets are heavy in carbohydrates because historically there was less access to proteins during the winter months. People survived the cold season by living in a state of semi-hibernation until the weather warmed up again, the days got longer and they could go out hunting and foraging again.

From a psychological viewpoint, this time of the year is particularly important because spring represents a new beginning. As nature re-awakens after the long months of winter, so are our hopes and wishes. We look forward to starting anew; we get excited about new projects and ideas, we feel revitalized and excited about new prospects, we open up to love again.

Exposure to the sun improves our moods and attitudes and, because in spring we tend to be outdoor more, and we have more in contact with nature, we feel psychologically better.

Aside from the positives listed so far, there are also negative factors that come with this season of the year.  In spring there is a spike in suicide rates and rates of depression. During the winter months depressed people may have held high hopes that things would get better for them once the weather improved. But when this does not happen, they become discouraged, lose hope and want to give up, as they think there is nothing else to look forward to.

Spring season is also responsible for high rates of allergies and other physical problems.

So Spring Fever is truly a mixed bag and as such needs to be treaded carefully. This means we should not change our habits too drastically and too quickly. For instance, if we did not exercise for months during the winter, it is not wise to overdo it all of a sudden. We risk injuring our body and disappointing ourselves. The same is true with the level of energy in general. Just because we feel we have more energy, it is important not to over abuse it. Likewise, if we spent months and months indoor, it is not prudent to be out in the sun too much.

Enjoying what spring has to offer is great if we stay away from excesses and allow our body to GRADUALLY adjust to the change of season.

Tags: Dr. Roher, psychotherapy

“I feel depressed today.” We have all said this, at one time or another of our lives, or heard someone say it. But, what is depression? And, is there one form of depression or are there many?

Feeling blue and suffering from clinical depression are two very different things.

Clinical depression is a condition that affects our moods (we feel down most of the time; we have a bleak outlook of our future, we are not excited about anything, even things we used to enjoy) our thoughts  (we tend to ruminate on the same, negative things, we cannot concentrate, we have difficulties making decisions) our behaviors (we find it difficult to be with people, we are not interested in anything) and our body (we may eat too much or too little; sleep too much or too little; have no energy, no libido, we feel tired most of the time even though we don’t do anything to explain it.)

Mental health professionals differentiate between various forms of clinical depression: Major Depression, Low grade, chronic depression, or Dysthymia, Bipolar Disorder and Adjustment Disorder with Depression. Each of them may be have specific treatments and may have different causes: situational, genetic, histories of trauma, and medical problems.  

According to figures from the National Institute of Mental Health, about 20.9 million people in this country suffer from one form or another of clinical depression. This means 9.5% of all Americans age 18 or older suffer from depression! This is a staggering figure, and seems to be increasing. Major depressive disorder is the major leading cause of disability for ages 15-44, striking people in their most productive years. Of course, depression does not affect only people’s ability to work, but also their social interactions and family lives, disrupting not only those who are depressed, but also people around them. Additionally, depressed people may have other problems as well, such as substance abuse, anxiety, and various medical conditions which may have been the cause or caused by the depression, or are co-occurring with it. Women are twice as vulnerable to depression as men.

According to www.psychologyinfo.com, nearly two-thirds of depressed people do not get proper treatment. There are several reasons why this is so, but I will mention only two here:

1. Symptoms of depression do not develop overnight, but creep up gradually and at first unnoticeably, so people often do not realize they are depressed until they are in a lot of pain and unable to function as they previously did. And even then they may think there is something wrong with them physically, or blame their job, family situation, or other reasons for their symptoms.

2. There is still social stigma about depression. Some people, particularly men, may equate depression with weakness and failure, so they may resist acknowledging their symptoms for what they are and seek help.

What can be done?

The two most used forms of treatment are:

Psychotherapy. Providing support can reduce social and emotional isolation, reduce fears and hopelessness and helplessness and ease the pain. Also it helps reduce pessimistic thoughts and it facilitates the development of positive life goals. Furthermore, it helps assess which areas in a person’s life may be contributing to the maintenance of negative feelings and stress and change them. 70-80% of people in therapy report improvement in 20-30 sessions.

Medication. There are many medications on the market today. You may want to consult with your family doctor or see a psychiatrist to discuss which one may be appropriate to alleviate your symptoms.

There are also things you can do to help yourself: do not see depression as a reflection of who you are. There should be no shame about suffering from depression. Depression affects people of all ages, educational and socio-economic backgrounds. Do not blame yourself. Examine what is going on in your life and make appropriate changes. Exercise, even if you don’t feel like it. Be with other people, even if you want to be left alone. And give it time, as recovery from depression does not happen overnight, but over time. Focus on what makes you feel better and stick to it.

Above all, remember that there is light at the end of the tunnel, even if you don’t see it when you are in the tunnel.

Tags: manage stress, psychotherapy

Just added another post in the “Marriage Story” tab above. Make sure you read it and tell your friends! You are witnessing the writing of a book in progress!

Feel free to make a comment about it by clicking on the comment button below.

Tags: Dr. Roher, relationships