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Clinical Commentary: Are you too sensitive? Do you experience your emotions too strongly?

10/31/2013

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There is a really interesting video that has gone viral. The video shows a 10-month old girl who is sitting happily and then becomes sad and eventually cries as her mother sings a sad song (mom can sing, by the way). The mom finishes her song and her daughter visibly shifts from a state of sadness to content to happiness (with mom's comfort). 

The video comments range from amazement at the baby's emotional development to criticism of the mother for eliciting a crying response from a baby. When I watched it, I was in awe by how easily this infant girl accessed her emotions, so much so that she became tearful. I also thought the mom did well in helping her daughter return to a content emotional state with her words, tone, and most likely her body language. 

The topic I want to focus on is can you be too sensitive or access your emotions too readily. I regularly tell patients there is nothing wrong with a feeling, the problem arises when poor decisions and actions happen because of the feeling. So how do we find that balance?

A behavior or thought becomes a problem (clinically) when it impacts your daily life in an intrusive way. If you double-check the alarm system, that's not intrusive. If you double-check the system and then come back to check it again, causing you to be late for work, then it's intrusive. The same concept of intrusion applies to emotions. You still want to experience and acknowledge emotions, the problem arises when the emotion can't be contained. If you find yourself overwhelmed by emotions to the extent that it negatively impacts your thinking, productivity, and/or relationships, then you might be experiencing your emotions too strongly. 

Last thing on the video. If I had a concern, it would be that this little one may be more emotionally developed than her peers and that trend may continue. Most may think that is a good thing, but it can lead to trouble. Imagine being 10 and having the ability to empathize with your peers, but your peers are still struggling with empathy (which is developmentally normal into the teen years). It would be heartbreaking at times to not understand why you are sensitive to others' needs but your peers aren't that way. I've worked with kids and adults like this. I find myself telling them that they will have an easier time as they get older, but for now we have to find a way to feel and contain the emotional impact of an experience.  

Containing emotions is actually a part of therapy. You may think therapy is a space to dump your emotions out like a psychological landfill. This happens and is appropriate, but another part is helping the patient regroup during and at the end of the session. This process includes learning how to express and contain emotions. If a patient is emotionally fragile, I'll spend the last part of the session helping the person return to a sound emotional state. This may happen by processing the experience, by shifting topics, or even by saying stop. You'd be surprised by the power of saying “stop” or “no”. In the end, you have to find what works for you. Whether that is going for a walk, changing the subject, listening to music, venting to a friend, or even smiling. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!



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Remember who you are talking to

10/28/2013

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In this final post for this communication series, let's focus less on you and more on your audience. Mentioned in previous posts, you can express yourself clearly, but that doesn't mean that you will be understood or even heard. If you aren't communicating in a way that can connect with the other person, then you're wasting your time. Here are some things to consider about the other person:

Age. The age of the person you are talking to matters. You speak differently to children, teens, and adults. If you are speaking to a child or even teens, try to use short, succinct statements. Avoid sentences with multiple steps unless the person has shown an ability to multi-task.  

Especially for young children, body language and tone are important. I strongly recommend when talking to a child, come down to their level, literally. Adults are intimidating to children, sit down or even kneel down when speaking to a child, even if you are angry. You are already in charge, there isn't a need to be physically intimidating as well. 

One of the biggest complaints from teens is their parents talk to them like they are children. I know for parents, their kids will always be children. But a conversation can be much more productive if you speak to your teen like they are a young adult. That doesn't mean you agree with everything they say, it just means be aware of your tone and potential for speaking in a condescending manner. 

Communication Style. This is a part of communication that gets overlooked. Is the person you are talking to a visual or auditory learner? Some people prefer to have written directions while others can listen to directions and perform flawlessly.

Are you assertive or passive in your communication? How about the other person? Sometimes the message can be lost in the presentation. Be aware of how you present yourself and how the other person presents to you. Sometimes a video of a conversation can provide incredible insight into personal mannerisms.

Previous experiences. History has a tendency of repeating itself. Reflect on what has lead to productive versus unproductive conversations. Share your thoughts with the other person and compare notes. Even if it is unconventional, it may work for you. 

Everything that I write about is based from my training and experiences. The writings are more of a guideline than manual. Go with what works for you, as long as there aren't unhealthy consequences. 

I've attempted to capture some of the major themes and hurdles to effective, healthy communication in this series. I hope these 4 posts on communication have been helpful. This doesn't mean the posts on communicating are over, there will certainly be more. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!
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Fighting fair: How to have an argument in a healthy way

10/24/2013

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This is the 3rd post in this series on communication. The first post (here) focused on what to do prior to a conversation. The second (here) centered on tips to consider while communicating. This post is how to fight fair, specifically how to have healthy communication during a argument.

Fighting is healthy. Disagreeing is healthy. What is unhealthy is when fighting and disagreeing turns into emotional, verbal, and/or physical abuse. You have two responsibilities during a conversation: 1) be aware of your own actions 2) be aware of how the other person's actions are impacting you. If these seem overwhelming, try being aware of what is manageable, especially during an argument. Here are some suggestions for how to fight fair.

Focus on one issue. Have one argument at a time. If you are talking about finances, talk about finances. Don't throw intimacy or other issues into one conversation. If there is a repetitive pattern of a behavior (e.g. dishonesty, forgetfulness, insensitivity), have the conversation about one instance. It's usually not productive to recall something that has happened months or years ago.

You might be thinking that you have to bring up other examples of the behavior to show that it's been a problem for a long time. There are instances where this might apply. If you feel it is necessary, bring it into the conversation as a way of showing a pattern, not as a way of punishing the person repeatedly and endlessly for past mistakes. If this is difficult for you, read my previous posts about letting go and grudges.

If you find yourself bringing up specific instances from the past, it may very well be you are presenting these issues to show a pattern of behavior. However, it may be these issues are still memorable because you have unresolved feelings about what happened. If there are unresolved feelings, then set a time to talk about them after reaching a resolution about the current issue.

No name calling or insults. Name calling and insults happen when you have been hurt. If you are tossing insults, it's usually to hurt the other person.  Once insults and sharp criticism enter the conversation, the actual issue is lost in the back and forth. Also, you might use a name or insult that you really regret later. I've worked with many couples where one person had a very difficult time healing from a specific insult that happened years ago.

Listen. Listen. An argument usually intensifies when there is a breakdown in listening and message comprehension. If you find yourself preparing your response before the other person has finished speaking, then you are probably more interested in debating your perspective than listening to theirs. If someone has ever told you, “You'd be a really good lawyer”, then this might apply to you. 

Take a break. If things get too heated or unproductive, take a break. If you are feeling overwhelmed or unable to express yourself, say so. When you take a break, set a time or day to come back and reengage. Many people feel dismissed and angry if someone asks for a break without a timetable for returning to the issue. So when you say, “I need a break”, add a “let's talk about this after dinner or on Wednesday after my presentation.” Setting a time shows that you are still invested on solving the issue. Taking a break isn't giving up, it's being human. 

Find what works. Not to undermine what I just wrote, but find what works for you and your relationship. I always recommend having the conversation in person. If that's too difficult, try email, a letter, phone call, or even including another person. Those aren't ideal but if they are more effective than talking in person, go with what works. Relationships are complex, sometimes there is no black and white solution.

Again, it is healthy to disagree and fight in your relationship. I'd be weary of a relationship where there is never a disagreement. Fighting can strengthen your relationship as it shows that you trust the other person to engage in something that might be uncomfortable, as long as you fight fair. 

The final part of this communication series will focus on being aware of who you are talking to.  


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!


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How to communicate respectfully

10/21/2013

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The first post in this 4-part series focused on things to consider before engaging in a conversation. If you missed it, you can read it here. Let's focus on what you can do while you are communicating that will allow for and maintain respectful communication. 

Check in and get feedback. Respectful communication isn't rocket science. Keep it simple. Ask the person you are talking to if you are being respectful. If they request you to do something (e.g., sit down, step back, lower your voice), comply if you feel it will help the conversation. By considering a request, you are showing you care about making the other person feel comfortable. It can be the difference between a good and bad conversation.

Body language, The common saying is communication is over 90% body language (nonverbal communication). Pay attention to physical cues. If you or your partner are exhibiting any cues of frustration (e.g., arms crossed, eyes rolling, clenching fists, tone), then address it or take a break. This applies to any feeling. Our body is always presenting signals about how we are feeling (For more on the body-emotion connection, click here). Body language is a great way to assess how a conversation is progressing or deteriorating. 

Give your undivided attention. Put down the laptop or smartphone and make eye contact. If you are multi-tasking during a conversation, you are asking for trouble. For you, multi-tasking may mean you are doing your best to make time to talk while meeting other demands. For the other person, multi-tasking might mean that they aren't important enough for your undivided attention. Everyone is busy, but taking 5 minutes out of your day may prevent an argument that lasts hours or days.

Summarize what has been said. Summarizing what the other person says is a great way to show that you are paying attention. It's an effective technique to ensure you comprehend the other person's message. If you have trouble focusing, repeating the information can save you from frustration and misunderstandings. Summarizing what has been said allows for the other person to determine if they are accurately expressing their thoughts and feelings. If you have ever said or thought, "That's not what I meant" or "You took that the wrong way", summarizing what someone says might be beneficial. 

Conversations can be positive, negative, or both. But each person can ensure that respect is maintained throughout the conversation. Staying respectful keeps your relationship strong, even if there is a disagreement. 

The next post will focus on when conversations deteriorate, and the guidelines that can help you have a healthy argument. 


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!
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TipsĀ for how to effectively communicate your thoughts and feelings

10/16/2013

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Recently I was a part of a community forum that focused on increasing and maintaining happiness in the home. The topic was effective and healthy communication. The topic is too complex for one post, so the next 4 posts are going to discuss the intricacies of communication. Let's start with general tips for how to effectively communicate.

Check in with yourself. It's incredibly important to be in the right state of mind before expressing yourself. Whatever the feeling, take a moment to make sure you are capable of having a conversation without becoming overwhelmed by your emotions.

Calm down. If you feel on edge, find a way to relax. Grab a glass of water, go for a short walk, listen to calming music, do what is calming. Taking a moment to calm down also gives you time to think about what you want to say and how you want to say it. The last thing you want to do is say something that you will later regret.

Use "I" statements. When you express yourself, use statements that start with "I". Even if you are mad at something the other person did, you can express yourself by saying, "I am feeling mad by what happened." It's less confrontational than "You made me angry." You are still sharing your feeling, and utilizing a less confrontational technique will allow for a more open dialogue.

Timing is everything. Maybe you've read up to this point and checked all three tips off the list. You're feeling ready to have that conversation. It might not matter, if the other person isn't ready. Ask if it's okay to talk. If it isn't, try to find an agreeable time. Even if you want talk right now, recognize that the conversation might be more harmful than helpful if both people aren't mentally prepared.

Location, location, location. Just like in real estate, location is everything. Reflect on past conversations. If you believe the conversation will be difficult, find a setting that is comfortable for both participants. Some people prefer a quiet room, a public place, or a certain time of day. A comfortable environment decreases anxiety which increases listening and message absorption.

You've probably noticed these tips focus on things to consider before you initiate a conversation. The next post will focus on what to do during the conversation.


As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN. If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville on facebook here or can follow me on Twitter here. Thanks for your support!



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Why premarital counseling should be in your wedding budget

10/10/2013

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In an earlier post, I wrote extensively about the value of premarital counseling, and how I believe premarital counseling should be a part of wedding preparations.

Think about it, $100s on a cake, $1,000s on a photographer and other expenses. The average wedding costs well over $10,000. Premarital counseling would be a very thin slice of the marriage budget pie.

Counseling has a negative connotation, and I’m not sure anything can change that. Premarital counseling isn’t a bad thing. It’s actually an incredibly pro-active, healthy process to ensure that the most important relationship in your life starts on solid ground.

I’ve worked with many engaged couples who have come for a few sessions to talk aloud about their relationship, and to see if they are missing any potential issues. Having kept in contact with these couples, they for the most part continue to report having satisfying, happy marriages. Unfortunately these couples are few and far between.

The vast majority of couples come to therapy during a crisis or when there is such emotional distance between one another that the relationship seems beyond repair. Instead of repeating the ideas and points from the previous blog column, I wanted to give three examples of major issues couples face in the first year of marriage: compromise, money, and the extended family.

Compromise. The biggest adjustment for most is the actual process of merging two lives into one home. Furniture, TVs, kitchenware, clothes, beds, etc. What to keep, what to get rid of, where to live. It’s endless. The important part is finding compromise. The foundation of compromise is each person partially sacrifices what they want. Compromise promotes two things: 1) each person is flexible in their wants and needs, and 2) there is mutual care and respect in the relationship.

Money. It doesn't buy happiness, but it can certainly bring stress. Money matters, and it's one of the biggest causes of conflict and divorce. Talk about money so that both people are comfortable with the finances. Talk specifics. Is your household going to have one earner or two, for how long, what are your financial goals? Many couples meet weekly or monthly to talk about household income and expenses. Even if money is not an issue, talking about it builds a comfort level which is important if finances ever do become an issue.

Extended family. Better known as “the in-laws”. Talking about families can be very difficult, because there are a lot of emotions attached to family, and rightfully so. The underlying issue with extended families is boundaries (click here for more about boundaries). When you get married, you are a part of a new family born out of two existing families.

As a new family, you have to find your own identity. This doesn’t mean extended family is excluded, it means you and your partner have to agree on the extent of family inclusion (if any). Once you find agreement, there has to be consistency. Both people have to abide by the agreed boundaries. Lastly, communication about extended family has to be open, honest, and respectful. Beliefs and feelings change, and healthy communication allows for open dialogue about what to do with shifting beliefs.

These are three examples of many issues that arise in the first year of marriage. If you and your partner are having difficulty adjusting to marriage, seek support and guidance. Whatever you do, don’t have children because you think it will fix the marriage.

As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

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Facebook can be detrimental to your mental health

10/7/2013

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Facebook’s impact on the world is undeniable. The ability to connect with someone on the other side of the planet with the click of a button is remarkable. Be careful though, because studies examining facebook show an inverse correlation between the amount of time you spend on facebook and psychological well-being. In essence, the more time you spend on facebook, the worse you feel about your life.

Now with that said, many people use facebook to stay connected with family, maintain friendships (by not directly talking to friends…that’s for another post), network, and find others with similar interests. These reasons can all be healthy and actually improve life satisfaction. When facebook is used to stay connected with others, it can be very rewarding and beneficial.

So what's the problem? People by nature compare themselves to others. There are a number of theories (e.g., Festinger’s social comparison theory) that suggest people get their self-worth and value based on comparing themselves to others. Again, that’s not unhealthy. It can actually be very beneficial to compare yourself to others. The problem arises when the comparisons are not based on completely accurate information.

Facebook allows for a filtered, biased representation of the individual. Profiles are full of pictures of home-made meals, exotic trips, and daily highlights (kudos to those who share daily lowlights). With enough facebook surfing, these snapshots can seem like the norm. You start comparing your "average" life to friends who just returned from a vacation, make meals from scratch, or always seem to be having success. That becomes your belief of what others around you are accomplishing. You start to question your value and negative thoughts creep in.

It’s important to keep an accurate perspective. For every picture of culinary masterpieces, there could be countless pictures of leftovers. For every picture of breathtaking views of the beach, there could be hundreds of pictures of a somber office cubicle. People tend to share the good and not the bad, especially on social media.

Facebook profiles are like reality TV. They're edited to show the eye-catching highlights as the mundane routine couldn't get the ratings. Keep that in mind.

In the 1900s it was don't judge a book by its cover. For the 2000s, maybe it should be don't judge a person or yourself by a facebook profile. Neither a book cover nor facebook tell the whole story.

If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

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What happens in therapy?

10/4/2013

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One of the first questions someone asks when they come for therapy is, "How long is this going to take?" It's a interesting moment as there really isn't an answer. For a lot of people, this is where setting goals is important. It's a way for people to track progress. It's measurable. Am I less depressed? Do I have more friends? Have I been better at coping with daily stress?

These questions are ways to assess the frequency of presenting symptoms (e.g., feeling sad, lacking energy, discomfort in social situations). The symptoms are what bring people to therapy. However, the cure for symptoms is examining the root causes. Getting to the root of a problem is complex, and it's the reason why it's difficult to answer, "How long is this going to take?" In my work, successful therapy is defined by attaining 3 goals.

Increased awareness of the self.

Before making real changes in your life, you have to better understand what changes need to happen. Part of that process is better understanding you. Everyone has their own behavioral patterns, relationship tendencies, stress management preferences, and a style in relating to others. Therapy helps the person gain insight into personal patterns.

Increased awareness of the other.

It's great to know why you do the things that you do, but life doesn't exist in a vacuum. Your behavior has an impact on others. The next step after increasing awareness of your behavior is making the connection to how your actions affect others. I'm talking about empathy again. I've written extensively about empathy, read a more detailed description here.

Understanding relationships.

Seems natural. Gain awareness of yourself and others and you'll be good to go with relationships. Right? Not necessarily. Relationships are Gestalt-like, the whole is greater than the sum of the parts. Understanding relationships is more than understanding yourself and the other. Relationships are a source for psychological well-being. Unhealthy relationships are usually associated with increased stress and psychological problems, whereas those with healthy relationships tend to be happier and more confident. For a more in depth read on relationships, click here.

Increased awareness will inevitably lead to a decrease in presenting symptoms, which is what most people want. However, increased awareness leads to a fundamental change in our core self, which is what most people need.

As usual, feel free to share this post via facebook, twitter, etc. Comments are welcomed!

If you are interested in being notified of future posts, you can “like” The Family Center of Knoxville facebook group by clicking here. Thanks for your support!

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    Salmaan Toor is a licensed clinical psychologist practicing in Knoxville, TN.

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