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Happiness and Autumn

September kicks-off one of the most magical times of the year as leaves begin to change colors, children laugh on school playgrounds, trumpets roar during high school football games and morning beverages taste more like pumpkins than actual lattés. Our senses switch into overdrive as we indulge in the sights, sounds and tastes of the season.

What is most notable to me is how our senses rekindle memories and activate our happiness. Perhaps the taste of hot chocolate warms your heart on a crisp morning. Maybe the smell of the nutmeg candle on your coffee table takes you back to your grandmother’s house where fresh cookies are coming out of the oven. These memories and feelings reconnect us with our past and revitalize our happiness for the future. So take a minute and reconnect with your spirit. After all, waiting 10 minutes at the coffee shop for the first taste of your favorite specialty coffee may reinvigorate you for the day (or the week).

Lindsey Ohler, Psy.D.

LindseyDr. Lindsey Ohler is a licensed psychologist; she has a doctoral degree in Clinical Psychology from Xavier University in Cincinnati, OH and has worked with children, adolescents, young adults and adults. Dr. Ohler has practiced in a variety of settings including private practice, businesses, community mental health centers, the juvenile court system, college counseling centers, inpatient facilities, outpatient hospitals, and a clinical research lab investigating the neurocircuitry of eating disorders.

Intervention Style: Dr. Ohler has an integrative style to therapy and individualizes treatment to meet each client’s unique experience. She utilizes a client-centered approach while incorporating Behavioral, Cognitive Behavioral, Dialectical Behavioral, and Mindfulness-Based therapies. Dr. Ohler begins the therapeutic process by gaining an in-depth understanding of the client’s life and experiences and then collaboratively designs treatment goals to meet the client’s distinctive needs. Dr. Ohler is extensively trained in Dialectical Behavior Therapy and Radically Open Dialectical Behavior Therapy, participating in experiential-based training and co-facilitating Dialectical Behavior Therapy Skills Training groups. She values how DBT skills are wonderful tools that can be beneficial to most people, and integrates aspects of DBT into her therapeutic approach, particularly when clients experience interpersonal challenges and/or want to improve how they experience and handle their emotions.

Therapy Experience with Adults: Dr. Ohler has provided brief, solution-focused treatment for specific symptoms in addition to long-term treatment depending on the problem at hand. Her clinical experience has involved working with adult clients confronted with a broad array of challenges including anxiety, depression, self-injurious behavior, interpersonal/relationship difficulties, social skill deficits, self-confidence, sexual identity development, drug and alcohol problems, stress during major life transitions, sexual trauma, emotion dysregulation, disordered eating and body image concerns. Dr. Ohler has co-facilitated groups for Dialectical Behavioral Skills Training, substance abuse, and disorder eating. She has also worked with couples and families that have a loved one struggling with an eating disorder. In addition she has extensive experience with executive coaching and facilitating leadership development of managers.

Therapy Experience with Children: Dr. Ohler has worked in therapy with children of all ages. Some of her specialized experiences include milieu therapy for children on the autism spectrum and individual therapy for teenagers transitioning into college. Her broad work with teenagers has included challenges such as transitioning from family life to independence, developing self-identity, and navigating both social and intimate relationships. She enjoys collaborating with teenagers as they embark on defining their core values, sense of identity and personal mission as well as developing their personal views of the world. Dr. Ohler has also provided competency attainment educational interventions with children and adolescents in the criminal justice system.

Assessments: Dr. Ohler has experience completing psychological, educational, and neuropsychological assessments with children and adults of all ages. She has conducted psychological and neuropsychological evaluations assessing emotional functioning, eating habits, suicide and self-injury and executive functioning. Dr. Ohler is highly competent in assessing intellectual and adaptive abilities, personality, diagnosis, emotional functioning, behavioral functioning, eating behaviors, body image concerns and self-injurious behaviors. In additional to the more standard psychological and educational assessments, her specialty experience has included psychological evaluations of children and adolescents at an inpatient facility and autism spectrum evaluations of children at Cincinnati Children’s Hospital as well as dispositional, bindover and competency-to-stand trial evaluations in the juvenile court system.

Research: Dr. Ohler has an active research career with multiple conference presentations and is published in the Casebook of Evidence-Based of Eating Disorders. Dr. Ohler has investigated and provided therapy for clients with body image concerns and disordered eating. Her doctoral dissertation evaluated how young adults perceived varying female body shapes in the absence of aesthetic beauty. Dr. Ohler has also served as a therapist and assessor in clinical research investigations evaluating therapeutic approaches for addressing disordered eating. In another area of research, she has research and consultation experience in both government and private sectors, completing program evaluations of community services, coaching and facilitating leadership development of managers, and conducting research on workplace environments.

Personal: Dr. Ohler spends her time exploring new areas by bicycling and hiking around the Triangle. She enjoys attending cultural events such as galleries, concerts and art fairs. Her creative passion is designing and creating stained glass panels and novelties for friends and family.

Happiness and Tending the Garden

Standing in your new house you look out at the garden. Your own garden. Maybe your very first garden. It’s new, it’s exciting, it’s lush and green… and perfect. You buy some tomato cages and gently wind the plants through so they’re supported as they grow. You buy the right pesticide for those pesky green bean bugs. You go out there every night for a few minutes to weed, and you water when it hasn’t rained in a while. Sometimes you even spring for some special nutrient-rich soil. You spend the summer caring for and enjoying the fruits (and vegetables) of your labor.

By the next summer you have a baby and a dog and a new job and there is less time for the garden. It doesn’t bother you – you’re too wrapped up in the things demanding your attention – and even when you catch a glimpse of a gangly, fruitless tomato plant you aren’t really bothered and just tuck it away as something to work on next year.

One day you happen to glance out the window and it hits you. The garden is a complete mess. The weeds are taller than the plants, which have mostly rotted away or been eaten by grateful deer. The rusted cages are all bent and there are more leaves than soil now. Come to think of it, you haven’t seen a bean or a tomato in a few years.

Marriages, like gardens, don’t grow if they’re not tended to. Neglect can creep up slowly and sometimes irreparable damage can be done when you aren’t looking. Get back in the habit of tending to it – and enjoying it – every day. You both deserve it.

Alcoholism – September 2015

Q: My spouse, in my opinion, is an alcoholic. I have a therapist and support around how to talk to him about this, and I am trying to do so with limited success so far. My question is about my children. I worry about the impact this is having on them. Should I take them to therapy? Should I talk to them about the drinking? It’s kind of this known negative ‘secret’ of sorts we all see and avoid commenting on.
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A: Alcoholism is a large problem in our society. It is estimated that one in five children are exposed to substance abuse within their home. Children who grow up with parents who are alcoholics are at greater risk for developing behavioral and emotional difficulties. Children respond to dysfunction in the home in many different ways.

Difficulties can include anxiety, depression, anger, guilt, embarrassment, and failure to form friendships. The child will often try to keep problems at home a secret from other adults and peers. Some behaviors to watch for include, but are not limited to, truancy or failures at school, withdrawal from friends, risky or delinquent behavior, aggression, depression, and substance use.
Some children of alcoholics may show no difficulties while others become the “parent” in the home. They may look out for the well being of themselves and others in the home, including their parents, and be very successful at school to compensate for the difficulties at home.
These children often live in fear of their parents and of what may happen to them if others discover their parent’s alcoholism. They may also feel guilty that they are unable to change their parent’s behavior. Although these children may present well, they tend to have poor self image and are insecure in relationships.

It can be difficult to intervene effectively in this situation for many reasons. The problems associated with alcoholism are often kept “secret” from others, so sometimes the drinking parent does not want the sober parent to take the child to therapy. The child may feel that they are betraying their parent if they seek out assistance for themselves, such as talking with a school counselor. The parent may be in denial of the problem or have no desire to change their behavior; certainly it is easier when the drinking parent agrees to treatment. Then the whole family enters treatment and begins the recovery process; however when this is not possible, provide children with support and help them in building meaningful relationships with others. It is important for these children to understand that they did not cause their parent’s alcoholism and they are not responsible for curing it; so that end, you do not have to avoid the topic with them, but talk about it in a straight forward way that does not demonize your spouse, i.e., no person is perfect and this is a weakness we are trying to address. Older children may benefit from participation in groups such as Alateen which focuses on social connectedness and community involvement. Professionals can also treat disorders that commonly occur in children of alcoholics such as anxiety and depression, and therapy would be ideal both to address any issues the child has, but also as preventative medicine to not develop any if the myriad of issues often seen in adult children of alcoholics.

Often times the emotional impact that alcoholism had in the child’s life will surface during adulthood. Adult children of alcoholics often have difficulty maintaining relationships, overreact to change, seek constant approval from others, have difficulty following through with tasks, are very hard on themselves, and have poor problem solving skills. It is important for adult children of alcoholics who are having difficulties to seek the assistance of a professional when having difficulty achieving success, developing healthy social and romantic relationships, or having difficulty coping with life’s stresses.

Acceptance and Commitment Therapy

“If I continue to do what I’ve always done, then I’m going to get what I’ve always got. “ –Acceptance and Commitment Therapy.

I sometimes catch myself grumbling about how something I dislike in my life never changes, like how dishes always manage to pile up in the kitchen even after one day. For a while I was blaming my partner for not cleaning, but then he went away for a weekend where it was just me in the house, and the dishes still piled up. So then I blamed the small size of my kitchen believing that if I only had a bigger kitchen then it would be easier to clean. The more I blamed the mess on something external, the more frustrated I became.

Then I remembered what has now become my mantra: if I  continue to do what I’ve  always done, then I’m  always going to get what I’ve  always got. I finally took a step back and looked at what I  was doing. The problem was that I disliked dishes piling up yet I was not washing/putting away my dishes right after using them and I was allowing them to pile up. I wanted my partner and my kitchen to change for me, but I wasn’t changing myself. So I changed what I had been doing (by the way, it was not easy accepting that I was the cause of my own frustration, I got defensive and wanted to find fault with anything other than myself). I put the dishes away right after using them and the kitchen stayed much cleaner, and I was much happier at the end of the day! I’d like to say that I kept that habit, but I didn’t, the dishes still pile up because I get lazy. But I do feel less irritated about the mess because I feel empowered knowing that if I want something to be different, I can choose to do things differently.

Happiness and Being Good Enough

When I was younger (and fitter) I decided to take up mountain biking. I hadn’t been on a bike for a couple of decades but I had this new friend who was a hard-core biker and he promised to show me the ropes. So one day we went out on a trail where I could learn to jump logs. He demonstrated it for me – it looked smooth and effortless and above all, fun. My turn. Ouch. Try again. And again and again. Even when I stayed upright it was neither smooth nor effortless because my pedal would hit the log or I’d land with a turned wheel and careen off the trail. As for fun – it wasn’t, since I wasn’t doing it perfectly and that seemed pretty important at the time. My friend, a tireless cheerleader by nature, eventually sat down and his cheering turned to encouragement to move on. I frequently had to step to the side to allow other riders to pass before tackling that log again and again. I watched another newbie tentatively approach the log. He awkwardly made it over (pedal scraping, landing askew)… and continued on. Suddenly it hit me. There were lots of other logs on this trail, and other sights, smells, dips and turns that make the trail so amazing. And I was missing out!

There is very little in life we need to be perfect at. Hop on, do your best, know when “good enough” is actually good enough, and enjoy the ride.

Post-Traumatic Growth: Suffering Meaningfully

Almost everyone has heard of post-traumatic stress and PTSD (post-traumatic stress disorder), but a related and new area of research has been on post traumatic growth. The idea of post traumatic growth is a more recent phenomenon that offers a positive approach to dealing with traumatic events. It is both a process that people undergo after experiencing trauma and an outcome where positive changes are experienced in response to struggling and making sense of that major crisis or traumatic event. It is a new, optimistic perspective on suffering and transforms a person into someone significantly different than who they were before. The struggle, not the trauma, engenders these changes. Researchers have found when questioned about trauma, more people report growth experiences as long term effects rather than stress disorders.

Post traumatic growth appears to develop in five broad areas: new possibilities, change in relationships, personal strength, philosophy on life, and spiritual or religious change. People may be more open to opportunities, find that they are more resilient, and appreciate the preciousness of life. The advocates for post traumatic growth emphasize that while changes or growth can be beneficial, all problems or stress are not dissolved. Rather, post traumatic growth occurs in the context of suffering. In addition, post traumatic growth is not universal.

Dr. Talya Rabina is a psychologist who researched the experiences of the Hurricane Katrina helper population. There have been numerous studies conducted on the negative effects of participating in relief efforts, but less research on positive effects such as learning and feeling rewarded for voluntary efforts. Dr. Rabina explains that post traumatic growth involves finding meaning out of an experience that throws one’s whole understanding of the world on its head. In her experience, she found that changes in relationships and adjustments of philosophies were the most transparent. People needed other people who had the same experience to reflect and understand that event. In addition, people redefined their values and goals and thus revised their perspective on life; this especially related to developmental stages. People who were in their twenties considered how they were going to proceed in their career. An older generation who already had an established career pondered more deeply the way in which they performed their work. Traumas, such as Hurricane Katrina, instigate post traumatic growth.

How intense does a trauma need to be in order to experience post traumatic growth?

Does it have to be a natural disaster or war, or can it be divorce or something similarly common? In order for post traumatic growth to develop, the trauma needs to threaten one’s mental security and how one perceives the world. Dr. Rabina notes that trauma needs to cause a significant amount of distress and dissonance, and this dissonance leads one to a psychological process of working through and sorting out this trauma: “the brain wants to feel even and good, and when something like trauma occurs, the brain is thrown off and needs to reformulate” which generates a new understanding of the self in relation to what’s happened. Dr. Rabina also mentions that people witness violence every day, whether in direct or indirect settings. These exposures to violence are all sort of mini traumas and our capacity for post traumatic growth depends on how we approach these traumas. Essentially, what constitutes trauma depends on the person who experiences it.

Influencing Psychologists, Individuals, and Society

Dr. Rabina finds the post traumatic growth concept useful in her clinical work. She explains that it’s easy to get pulled towards focusing on the negative because people typically enter therapy with problems. While value lies in dissecting the negative, exploring the positive side is necessary and broadens the perspective: “As a therapist we have power in the way we ask questions. If you’re asking only about the pathology and not about the potential for growth and strength then you’re not seeing the whole picture. What [post traumatic growth] has done for me is allow me to see the strength in my clients in a different way and maybe help them see it in themselves. I’m grateful for that.” She also describes that she knows the potential for growth is there in her patients but that this post traumatic growth model has provided her with a way to understand and capitalize on eliciting that growth.

The implications of post traumatic growth for individuals and society can be extremely constructive and stimulate positive change in our culture. There is a certain social transformation of trauma, where the results of trauma on individuals can produce collective social change. The founding of organizations such as Mothers Against Drunk Driving (MADD) and Alcoholics Anonymous are indicative of this. Even closer to home, the Eve Marie Carson Scholarship (which is awarded to students who have grown significantly in areas related to academics, social justice, and leadership) was established in response to the senseless murder of Eve Carson, UNC’s Student Body President.

Ultimately, post traumatic growth allows for an alternate, more optimistic view on life despite suffering through traumatic experiences. This is not to suggest PTSD and post traumatic stress are not real as well, and people experiencing this deserve empathy and help. Post traumatic growth work can be one way to move through the stress of the trauma and regain a sense of well-being.

Happiness and Avoiding the Slow Boil

Sometimes we find ourselves trying to live with something that is unacceptable but we don’t realize it because of its insidious onset – it crept up on us so gradually that we didn’t even notice the change. It’s like the (scientifically unsound) metaphor of the frog in the pot – it’ll jump out if put in a pot of boiling water, but if put in a pot of cool water that is slowly brought to boiling it will sit there until it boils to death.

We need to notice things creeping up on us but it can be hard since life is distracting. You focus on what needs immediate attention and then one day you turn back to yourself and notice you haven’t been happy in a while. Don’t accept unhappiness. Change the situation or change your mindset about it. Jump out before you boil.

Happiness and Un-hiding

We do a lot of hiding in American culture. Makeup, for example. Sometimes it’s just for fun but often (whether we realize it or not) it’s a real attempt to hide imperfections we don’t want others to judge. No one bats an eye anymore about someone coloring the gray away. Implants, botox, liposuction, veneers, and various anatomical lifts become more acceptable every year. We hide in other ways to escape judgment, like when we hold back our jokes, decline to share an idea, or fail to stand up for what we believe in.

When we’re afraid to show our true self it’s because we believe it would be terrible if someone saw the real us and decided they didn’t like it. So we cover up and know deep down that if they don’t like what they see it’s not that bad since it’s not the real us they’re rejecting. Plus, if they don’t like this better, hand-crafted version of us then thank goodness they didn’t see the real thing! The problem comes when we’re successful – when people see our façade and like it. We know we’ve sold them a fake so we live with the fear of being found out. We all have a desperate need to belong so we maintain the front and keep hiding. Paradoxically, we hide to belong. But:

“True belonging only happens when we present our authentic, imperfect self to the world. Our sense of belonging can never be greater than our level of self-acceptance… (in my research) fitting in emerged as the primary barrier to cultivating real belonging.” – Brené Brown, The Power of Vulnerability

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