Dr. Roher Psychotherapy – Blog

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

I have decided to give my readers an extra treat on this blog! If you look up at the navigation button at the top of this blog, click on “A Marriage Story.”

I am about to begin a mulitple post “journey” of a recently married couple, Paul and Francesca. We are going to post each week for a total of 52 weeks on this blog.

Please come back often to visit and see how this wonderful story unfolds. I don’t want to spoil the storyline, but I want to tell you that you will thoroughly enjoy it!

Tags: Dr. Roher, relationships

Almost 50% of affairs for women occur with co-workers and more than 60% of affairs for men begin in the office. This is a clear indication that it is people in our daily lives that ignite passion and create situations where lust can be experienced, even if people do not realize what is happening until much later.

More recently, online affairs have become as popular as office affairs, as virtual proximity and accessibility substitutes for physical proximity and daily interactions. We have already discussed the characteristics of online affairs, so here we focus on real time infidelity.

An office co-worker can become attractive for different reasons. These reasons can occur concurrently or individually. The following are some of the most common:

• The friendly ear;

A person can become the friendly ear that listens and empathizes with one’s stories of dissatisfactions and unhappiness. He or she seems to be available when needed, with unlimited patience, interest and empathy. It becomes comforting to get together and support each other. From here, the relationship can grow and morph into something more personal, more special and intimate. 

• The unexpected;

At times at the beginning of an affair neither person plans to get deeply emotionally entangled with one another, but this happens gradually, almost unnoticed. Intimacy develops with increased sharing, a sense of being understood, valued and appreciated. The step from being friends to being lovers is often quite short.

• The sexual allure;

At times a person is seen as sexually attractive and alluring from the very beginning. When this person is around, there is an electricity in the room that cannot be ignored. Thoughts about that person start to creep up even when he or she is not around. Obsessive thinking and fantasizing develop, with increasing intensity and frequency. If the other person responds to this attraction, an affair develops and blooms. This relationship may evolve into a deeper one or remain exclusively sexual. If it remains strictly sexual, typically is short-lived.

• The soul mate;

Often this is the evolution of the friendly year scenario we discussed before. As the couple gets to know each other more intimately, they discover they think the same, they like the same things, they have similar goals and views of life. They seem to be on the same wavelength, so there is little need for words to communicate to one another. This relationship can become sexual, but does not have to in order to become powerfully attractive and highly emotional for both people involved.

• The attraction of youth;

For someone who is reaching middle or late middle age and sees his or her looks change, the allure of a younger person can be quite powerful. These types of relationships typically don’t last for a long time, as differences in age and being at different points in life create a wedge that later on affects the relationship, often dooming it.

• The High School sweetheart;

People look up old friends on line of see them at reunions. These are friends from a time in their lives that felt good, pregnant with possibilities and the whole future still in front of them. When people reconnect, old feelings are at times rekindled. Couples feel they already know each other quite intimately, even if they have not seen each other for over thirty years. This feeling of familiarity provides comfort and encourages trust. Often, when old High school or College sweethearts see each other again, they don’t see who they are today but who they used to be. This experience seems to occur in a time warp, catapulting the people involved to earlier and happier times. It is the wish to recapture this time and the feelings associated to it that makes these relationships bonding because they have deep roots and very intense emotions and enduring.

Can you think of other scenarios that reflect common coupling in affairs? Please share your thoughts and views by clicking on the comments button below.

Tags: Dr. Roher, psychotherapy, relationships

Valentine’s Day, February 14^th, is a celebration of lovers. But, if we go beyond the commercialization of this day, with red roses, fancy dinners and pajama-grams, we can see a deeper, more significant meaning to this day.

Valentine was a bishop who married Romans in secret, celebrating their love for one another, at a time when marriage was forbidden by law. When arrested by the same Roman emperor who had forbidden marriages because he believed they did not allowed men to be valiant soldiers, he chose to die rather than change his views on love. In addition, while in jail he fell in love with his jailer’s daughter and, just before his execution, sent her a “Valentine Note.”

The message we derive from these historical events is: love counts, love needs to be acknowledged, cherished and celebrated. Two thousand years later, we are still acknowledging this day and the person who started it, because we still believes that love counts and is worth celebrating. 

What does this day mean to you?

I hope not only another time to buy a gift and make reservations to a nice restaurant, and nothing more.

I encourage you to go beyond these formalities, and think of ways in which you want to let your loved one know how much he or she means to you.

Valentine’s Day is, in fact, a day of acknowledgment and appreciation. We often don’t let people we love know how much we appreciate who they are, what they do for us, how they make our lives better and richer and how grateful we are for who they are. We may take them for granted, caught as we are in our frenetic lives and daily demands. But, if we don’t tell them our feelings, how will they know that we have them? Particularly if we are in a long term relationship, we may believe Valentine’s Day is only for new lovers, not for people like us. Wrong! Valentine’s Day is for all people who love, and this accounts for a very large part of the human population.

Can you think of meaningful ways of expressing your love feelings? However, you are going to do it – with flowers, a card, a gift, an evening together – remember that what is most important is being close. Hold your Valentine’s hand, sit closer to him or her than you usually do, remember what are the things he or she appreciates and provide them as a sign of your love. Above all, whatever you do, make sure it is special, out of the ordinary, because these special events create memories that make up our love histories together and will be cherished for many years to come. After all, what is our life if not a series of memories that give us the sense of who we are and who our loved ones are?

Don’t wait until the last minute to rush to buy a card, or to pick a bunch of flowers among the ones left over. Put some time and thought in it, it will show.

This is also a time when some couples choose to make important decisions about their lives together. Some men propose on Valentine’s Day; some couples marry. To all of them we wish they will be able to maintain these feelings for one another throughout their lives together. To those and all love couples who celebrate this day, we wish a celebration that takes heir love relationship to a higher level of closeness and intimacy.

HAPPY VALENTINE’S DAY!

Tags: Dr. Roher, relationships

Only 35% of couples with marital infidelity stay together. Hurt, humiliation, disappointment are very powerful feelings that often lead to blaming and attacking. Depression, anxiety and fear can occur following the betrayal. Trust is gone. There is a deep feeling of loneliness and shame, and concern about the future. Partners often don’t know how to deal with these intense emotions that create havoc in their lives. The very person who used to provide comfort and reassurance is now the very person who is now causing the pain. This situation is not very different from incest where the incestuous parent, who is supposed to provide protection and safety is actually breaking these rules making a child feel unsafe and alone.

Women in general tend to want to see if there is a way of repairing the damage caused by the infidelity. However, they tend to have a very difficult time with trust and with re-engaging in sexual activities with their partners. Men, on the other hand, are more likely to want out of the relationship if it is the woman who was unfaithful. Women are more likely to get depressed in these situations, whereas men are more likely to get angry (Spring.)

Forgiveness is what needs to take place for the relationship to survive in the infidelity. Forgiveness benefits both partners and can take the relationship to a deeper level of intimacy.

However, forgiveness is not an act but a process that requires certain elements to be in place in order to occur. These elements are:

 1) EMPATHY.

The person who had the oaffair needs to become aware of the full emotional impact of his or her actions on the other partner and feel what the other is feeling. Up until that point he or she might have minimized this impact, assuming that what is not known does not hurt. However, without open communication, the injuring partner won’t be able to achieve a full understanding and own responsibility for his or her actions. Once the two partners develop an honest way of communicating their feelings, they need to give each other all the time required to process the emotional impact of the affair. The length of this process vary from couple to couple, as a lot of specific elements may speed it up or slow it down. This part of the work requires patience, staying with the feelings, even and particularly when they are uncomfortable and, for the injuring partner, being emotionally available to the injured partner.

2) REMORSE.

There needs to be a reasonable expectation that this behavior won’t occur again in the future. I say “reasonable” because none of us has 100% security about what another person will or will not do in the future. However, it is important for the partner who was betrayed to begin to feel safe again in the relationship. And this is possible only if the person who had the affair becomes a changed person, fully aware of the seriousness of his or her actions and willing to do whatever it takes to change. Forgiveness applies only to those actions that occurred in the past, not to those occurring in the present or possibly happening in the future. It is only when the partner who had the extra-marital affair can provide reassurance that he or she is a changed person that the injured partner can start to rebuild trust. The injuring partner needs to feel and express regret and remorse and communicate these feelings appropriately to the injured partner.

Feel free to make your comment here on affairs by clicking on the comments button below.

Tags: Dr. Roher, psychotherapy, relationships