How well are you coping with your chronic illness?

Take this quiz to find out:

Quiz: How well are you coping with your chronic illness? Click here

SCORING: To score this quiz, add up the points from each answer you selected.

Under 20:  means you're doing pretty well with coping with your chronic illness and/or you do not consider your illness to negatively affect your life very often. 

A score between 20-40 indicates you are somewhat able to cope with your chronic illness but you could probably use some more support in your life, as well as develop more coping tools to help you manage your illness, your relationships, and your overall emotional well-being.

A score of 40 or higher indicates you may be suffering from anxiety and/or depression due to your chronic illness, which unfortunately can be very common.  You may have a very difficult time engaging in activities, accomplishing your goals, or maintaining your relationships in your life due to being ill so much of the time. 

If you're in Ventura County, California and are interested in joining a therapy group for chronic illness, please visit our web site:

New Beginnings Chronic Illness Group

This quiz is not designed to make a diagnosis or take the place of a professional assessment, but it may give you some insight into how you're currently managing your physical and emotional well-being while living with a chronic illness.  If you suspect you are anxious or depressed, please consult with your doctor or a mental health professional as soon as possible, for more help and support.

Getting Better and Losing Relationships

This article was re-posted from  http://eatingdisorderrecovery.net and was written by Joanna Poppink.

When a person is seriously ill with her eating disorder, the people who are close to her were attracted to her and maintain a relationship with her as she lives and responds in life with her eating disorder intact. *
Being in harmony with your true self attracts new and more healthy relationships.
Changes in recovery
When you are deep in your eating disorder your friends and associates have a relationship with a sick person.  When you start to get well your attitudes, choices and responses change.

-  You are more caring and respectful of yourself.  -  You resist sacrificing your personal resources (time, money, skills,energy) because you no longer believe that others are more important than you.

-  You begin to use your resources to make your own dreams come true,dreams you didn’t know you had because they were buried by the eating disorder.

-  You no longer engage is high risk behavior for thrills or because you are going along with everyone else and are numb to your fears.

-  You feel.

-  You regain your mind.

-  You have opinions.

-  You have a point of view.

-  You matter to yourself.

-  You say, "No," where you used to say, "Yes."


Objections to Recovery
The people in your life who were attracted to you with you eating disorder symptoms and, for reasons of their own, are psychologically matched to you based on those symptoms, may object to the change toward health in your life.
They can be ruffled, disappointed and then hurt and angry.
If they can grow themselves and accept your healthy attitudes then the relationships change and grow.
If they cannot grow and adapt, if they need a relationship with a person who goes numb, who says yes, whosacrifices and feels guilty and responsible for other people's needs, then they will grow both resentful and bored.
If you do not go back to how you were when you were ill so the relationship is the same as it ever was, therelationship will fall apart. If you are truly in recovery, you will not or cannot go back to your illness to support people who require a self sacrificing person to fulfill their needs.
Getting Better and Gaining Friends
If this is you now, then just wait and live your life in recovery. People who are attracted to health will be attracted to you.
People who have their own solid self esteem and are willing to be responsible for themselves will become visible to you as you become visible to them.
In recovery and growing health, you have more choices and can have more satisfying relationships based on who you are now.
How have your relationships changed as you move on your recovery path?
*Harmony of Creatures, painted by Margret Hofheinz-Döring

LEARNING YOUR OWN BOUNDARIES, PART 1

As a brand-new Marriage and Family Therapist Intern, my first instinct is to immediately accept new responsibilities and opportunities without a second thought.  With a smile, I've said to a client, "Sure, I can see you on a weekend!" Then when a client doesn't show up, I find myself feeling very resentful, first toward them-- "How could they be so inconsiderate? I came in on a weekend for them!" When they didn't show up for whatever reason, I resented them for not appreciating the "huge sacrifice" of my time and not honoring their own commitment to be there. Then I start to mostly just resent myself because I start to realize that I didn't have to give up these more valuable chunks of time or plans for someone else-- I chose to give them up to please others. I had decided another person's needs were more important than my own.

As a therapist, my job is to help others feel better.  It's easy to forget that in order to do so, I need to feel good too.  This means that if I'm going to preach self-care to clients, I have to provide my own self-care!  I have to regularly ask myself what my boundaries are.  I need to learn to carve out time for myself, then commit to honoring that self-care time and not giving it up to please someone else.

I've been reading Joanna Poppink's book, Healing Your Hungry Heart, which has been a valuable tool in learning how to help clients recover from eating disorders.   She has a chapter on boundaries that I found to be poignant.  Here are some highlights from that chapter that I found to be particularly helpful:

Boundaries and Authority
- "Boundaries are inextricably connected to the source of authority."
- "To develop and maintain a relationship, you need to respect your boundaries and the boundaries of the other person...This includes possessions, time, money, expertise, connections, relationships, even personal energy."
- "When you cross someone's boundary, you defy their authority.  When they cross your boundary, they defy your authority."

Saying No
- "Your ability to say no is critical.  If you agree to a boundary crossing just because you want to please someone, you are crossing your own boundaries."

The Continual Helper
- Poppink describes "the continual helper" as someone who is thoughtful, generous, and gives more than they can afford, leaving little time and energy or money for himself/herself.
- "The Continual Helper may make others feel overwhelmed and uncomfortable by their generosity because the others know they can't reciprocate at the same level."
- "Some people may by glad to take what is offered and consider the Continual Helper a reliable source who never requires repayment."
- "People may feel sorry for the Continual Helper, who seems needy and desperate for involvement, charitable toward the Continual Helper and give [them] tasks to do so [they] don't feel alone, or superior to the Continual Helper and experiment with just how far they can go in taking advantage." - "This reflects a lack of authority in the Continual Helper about establishing and maintaining [their own] personal boundaries."

To read an excerpt from Joanna Poppink's chapter on boundaries, go to: http://eatingdisorderrecovery.com/index.php/hhyh/924-healing-your-hungry-heart-chapter-excerpts/1066-qboundaries-a-challenge-in-early-recoveryq-chapter-5-excerpt

LEARNING YOUR OWN BOUNDARIES, PART 2

Are you a big people pleaser?

Do you have trouble saying no?

Do you overextend yourself, then feel resentment later?

Do you feel drained from using your time and energy for others without taking time for yourself?

Being someone who struggles with this nearly every day, I found this list to be very helpful:

20 WAYS TO SAY NO

By Ramona Creel

1.  I AM IN THE MIDDLE OF SEVERAL PROJECTS

• let people know when you have accepted other responsibilities
• no need to make excuses if you don't have any free time
• no one will fault you for having already filled your plate

2.  I AM NOT COMFORTABLE WITH THAT

• you might be uncomfortable with any of a number of issues
• the people involved, the type of work, the morale implications, etc.
• this is a very respectful way to avoid a sticky situation

3.  I AM NOT TAKING ON ANY NEW RESPONSIBILITIES

• you aren't saying that you will never help out again
• just that you feel your schedule is as full as you would like now
• understanding your limits is a talent to be expected

4.  I AM NOT THE MOST QUALIFIED PERSON FOR THE JOB

• if you don't feel that you have adequate skills, that's okay
• it's better to admit your limitations up front
• the best way to avoid feeling overwhelmed down the road

5.  I DO NOT ENJOY THAT KIND OF WORK

• life isn't about drudgery -- if you don't enjoy it, why do it?
• don't be afraid to let someone know you just don't want to
• someone else is bound to enjoy the work you don't

6.  I DO NOT HAVE ANY MORE ROOM IN MY CALENDAR

• be honest if your schedule is filled
• "filled" doesn't have to mean really filled
• know when you are scheduled as much as you are willing and stop

7.  I HATE SPLITTING MY ATTENTION AMONG PROJECTS

• let people know that you want to do a good job for them
• but you can't when your focus is too divided or splintered
• you will be more effective if you focus on one project at a time

8.  I HAVE ANOTHER COMMITMENT

• it doesn't matter what the commitment is
• it can even simply be time to yourself or with friends or family
• you don't have to justify -- you simply aren't available

9.  I HAVE NO EXPERIENCE WITH THAT

• volunteering shouldn't mean learning an entirely new set of skills
• suggest that they find someone who has experience in that area
• offer to help out with something that you already know how to do

10.  I KNOW YOU WILL DO A WONDERFUL JOB YOURSELF

• people often ask for help because they doubt their own abilities
• let them know that you have confidence they will succeed
• you are actually doing them a favor in the long run

11.  I NEED TO FOCUS ON MY PERSONAL LIFE

• don't be ashamed of wanting to spend time with your family
• having a strong family is an important priority in and of itself
• be willing to put your personal needs first

12.  I NEED TO FOCUS ON MY CAREER RIGHT NOW

• often, you have to focus your energies on a work-related task
• you may have to give up some civic or community duties
• if you don't do it, someone else will take on the task

13.  I NEED TO LEAVE SOME FREE TIME FOR MYSELF

• it's okay to be selfish -- in a good way!
• treat your personal time like any other appointment
• block off time in your calendar and guard it with your life

14.  I WOULD RATHER DECLINE THAN DO A MEDIOCRE JOB

• know when you aren't going to be able to deliver a quality product
• the reason doesn't matter -- not enough time, wrong skills, etc.
• whatever the reason is enough for turning a request down

15.  I WOULD RATHER HELP OUT WITH ANOTHER TASK

• saying no doesn't mean that you can't help at all
• if someone asks you to do something you really despise, refuse
• then offer to help with something you find more enjoyable

16.  LET ME HOOK YOU UP WITH SOMEONE WHO CAN DO IT

• if you aren't available to help out, offer another qualified resource
• helping to connect people is a valuable service to offer
• make sure the person you refer will represent you well

17.   NO

• sometimes it's okay to just say no!
• just say it in a way that expresses respect and courtesy
• leave the door open for good relations

18.  NOT RIGHT NOW, BUT I CAN DO IT LATER

• if you really want to help but don't have time, say so
• offer to help at a later time or date
• if they can't wait for you, they'll find someone else

19.  SOME THINGS HAVE COME UP THAT NEED MY ATTENTION

• unexpected things happen that throw your schedule off
• accept that you may need to make a few adjustments
• it is temporary and you will have more time when life stabilizes

20.  THIS IS REALLY NOT MY STRONG SUIT

• it's okay to admit your limitations
• knowing what you can handle and what you can't is a skill
• your time will be more efficiently spent on something you do well

Content provided by OnlineOrganizing.com-- offering "a world of organizing solutions!"

Visit www.onlineorganizing.com for organizing products, free tips, a speakers bureau, get a referral for a Professional Organizer near you, or get some help starting and running your own organizing business.

SUMMER BLUES IN COLLEGE STUDENTS

College students, now that Summer's here and you're back home, I think it's common to struggle with the transition from being on your own to being under your parents' roof and having to be accountable to someone again after that sweet taste of freedom and independence.  They might want to know-- "When are you going to get a job?" "What are you doing all day?" "Why can't you do more around the house?" And all you want is to do is relax and take a break after taking all those exams and writing all those term papers!

In addition to being back home, it might be very difficult to go from having a structured day of classes to.............nothing.  Every day starts to feel like the same thing, there's no real reason to get up in the morning, nothing you HAVE to do.  You find yourself watching old episodes of Grey's Anatomy on Lifetime and not showering until 4pm.  Maybe your friends are all back home at their parents' houses too (which is far away from yours), or they're traveling somewhere exotic, and now you don't have anyone to hang out with.  If you're used to living in the dorms or having roommates, it's easy to take for granted how you can stop in your friend's room and say, "Hey, want to grab something to eat?" or "Want to watch Gossip Girl?" or "My boyfriend/girlfriend is being a jerk and I need to vent."

Here's some information about depression, which can be especially prevalent (and undetected) in college students.  It can be hard to identify feelings of depression in the midst of classes, exams and papers because you're so busy and preoccupied.  Once school is over and you're home with nothing distracting you from your feelings, it might be important to check in with yourself to see if you might be experiencing symptoms of depression.

Check it out:
NIMH: DEPRESSION AND COLLEGE STUDENTS

10 WAYS TO HELP YOUR CHILD COPE WITH A CHRONIC ILLNESS

By Britt Fishman, MFTI

• Do you have a child struggling with a chronic illness?

• Do you find yourself constantly worrying about your child’s physical and mental well-being?

• Does your heart break every day to see your child suffering from physical and emotional pain?

1.  Don't panic about every symptom. It may be difficult, but stay calm in front of your child because if your child sees you scared, he will be scared too. Then as your child gets older, he may not want to tell you his symptoms out of fear of worrying you. 


2.  Show empathy and compassion when your child experiences symptoms but be careful not to make her feel fragile or helpless. When your child feels well, point it out and make a big deal so she can see there are ups AND downs to having the illness-- not just downs. 


3.  Encourage your child to start taking ownership of his illness and start doing things independently (when age-appropriate), like making his own doctor’s appointments or preparing and following his own medication schedule. 


4.  Don't criticize your child for not taking better care of herself, “considering her condition." The last thing a child wants is to feel different from the other kids, then to feel guilty for trying to fit in (which is what kids do!). Instead, find ways to encourage and reward your child for making positive, healthy choices. 


5.  Recognize that stress can be a huge factor that can exacerbate many types of illnesses, and stressors for a child may be more difficult to predict or recognize than stressors for an adult. Even "good" stress can trigger symptoms because your child is in a prolonged state of excitement. Positive and negative stressors may occur around the birth of a sibling, the start of a school year, holidays, birthdays, vacations, etc. 


6.  Help your child find ways to discuss his illness in a way in which he feels comfortable, and help him decide with whom he’s comfortable sharing it. Discuss with your child different ways of disclosing this information. Ask him who he’d rather give a brief description of his illness, like a teacher or a friend's parent (for safety reasons), and who he can confide in about what it's like to struggle with the illness, like a close friend or relative. 


7.  If possible, offer for your child the choice to go to individual therapy, family therapy, a support group, and/or a camp for children with a similar illness. If she is resistant, don't push it but encourage her to talk about what makes her uncomfortable about it. Check in once in a while to see if your child has changed her mind. 


8.  Help your child find and nurture his strengths and talents, so he can develop an identity other than just "the sick kid,” which is how he may see himself or how his friends, relatives, and teachers may see him. 


9.  Acknowledge and talk about how your other children and spouse may struggle with having someone in the family with a chronic illness, being careful not to blame anyone. This could help reduce resentment and guilt toward each other and strengthen relationships between family members. 


10.  Don’t let yourself get burnt out. You’re no help to your child if you’re not sleeping or eating, or if you’re breaking down emotionally. Ask a close family member or friend to watch your child so you can have a break or come with you to an appointment, etc. This is a way to model for your child how to take care of yourself while balancing the needs of others.

Welcome to my blog!


Here you will find articles of interest by myself and others that pertain to Marriage and Family Therapy, mental health issues, special topics related to children and adolescents, coping with chronic illness, families with special needs, and other subjects related to my special interests in this field.


Please note that these articles reflect my opinion and not necessarily the opinion of my supervisor or private practice where I conduct therapy.