The Benefits of Telehealth

Over the last several years, many people have been hesitant to engage in therapy via telehealth. Why? Because it is a new concept and some fear that it will lead to feeling disconnected from their provider and their treatment goals. Others may fear that their therapy will be less effective if conducted via telehealth. However, I have been providing telehealth mental health services since prior to the pandemic. Not only have I felt equally connected to my patients, but also I have witnessed equally effective and focused treatment via the telehealth modality. This is, in part, because I provide evidence-based, often manualized care. What exactly does that mean? It means that I am often using a structured guide or tool, such as a manual, worksheet, or specific activity/exercise, to ensure that your treatment is effective and supported by research, no matter where you are sitting. Here at Oakheart we value using evidence-based approaches for this reason. When providing evidence-based care via telehealth, treatment has remained highly effective for several reasons and many of my patients have reported the following benefits of completing their treatment virtually. 

Time and emotional energy: Patients save time commuting to sessions and therefore they do not need to reserve as much time for sessions if they are conducted via telehealth. If you can carve out exactly 1 hour for your mental health every week, you can engage in effective therapy. After sessions, you can quickly return to your busy life. 

As noted earlier, evidence based and/ or manualized treatment can be completed anywhere. Most of the time, you will have copies of the worksheets or handouts I am referencing or we will be working on skills application, thought challenging, or homework planning together in sessions. I will ask you to complete many assignments and most practicing will take place outside of the session. In part, this is because each session is only one hour of each week and permanent psychological, behavioral, and neurological changes are only possible if some of the other 168 hours in the week are utilized for practicing skills learned in treatment. 

If you are participating in exposure-based treatment with me, we will sometimes use the treatment time for completing exposure work, much of which is more effective outside of an office space. Exposure work consists of gradually and repeatedly approaching feared situations, thoughts, memories, sensations, etc. in order to overcome the fear. Many feared situations are present outside of my office space. Therefore, telehealth has allowed me to help my patients with an exposure that required situations in their home or in another space beyond my office. I believe this is why telehealth has actually been a better option for many of my patients with anxiety disorders or OCD, as I have been able to more effectively assist with the exposures. 
 
Service access: I work with patients who reside all over Illinois. As long as you are in the state of Illinois, you can access any telehealth provider in Illinois. As a specialist in trauma disorders, anxiety disorders, and OCD, I am able to access so many patients who need specialized care who typically would not be able to work with me due to the location barrier. 

Flexibility: Wherever you can carve out an hour that aligns with your provider’s availability, you can schedule your session. Telehealth has allowed me to be much more flexible as a provider as well, as I can also work remotely, as needed. Also, when someone needs a session more immediately, I am often able to find a time for them to be seen quickly. 

Effectiveness: Many patients worry that treatment will be less effective if completed via telehealth. However, my experiences as a provider and research suggests that evidence-based treatments remain highly effective via telehealth, including cognitive behavioral therapy for anxiety disorders (Karpov et al. 2023) and depression (Komariah et al, 2022), exposure and response prevention treatment for OCD (Feusner et al., 2022; Rees et al., 2016), and cognitive behavioral therapy for PTSD (Bisson et al, 2022). 

In sum, if you are considering telehealth services at Oakheart or with another practice or hospital, your hesitation about this new modality is remarkably valid. However, it appears that telehealth may be the best fit for many patients and that the research corroborates my hypotheses in its effectiveness. It is my commitment as an evidence-based provider to ensure that the modality of treatment I am using will not compromise the care of my patients and I believe that telehealth will remain a fantastic option for effective and expansive mental health services for all individuals in need. 

​If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References

Bisson, J. I., Ariti, C., Cullen, K., Kitchiner. N., Lewis, C., Roberts, N. P., Simon, N., Smallman, K., Addison, K., Bell, V., Brookes-Howell, L., Cosgrove, S., Ehlers, A., Fitzsimmons, D., Foscarini-Craggs, P. Harris, S. R. S., Kelson, M., Lovell, K., McKenna, M., McNamara, R., Nollette, C., Pickles, T., & Williams-Thomas, R. (2022). Guided, internet based, cognitive behavioural therapy for post-traumatic stress disorder: Pragmatic, multicentre, randomised controlled non-inferiority trial (RAPID). BMJ,  2022; 377, e069405. doi:10.1136/bmj-2021-069405
Feusner, J. D., Farrell, N. R., Kreyling, J., McGrath, P. B., Rhode, A. R., Faneuff, T., Lonsway, S., Mohideen, R., Jurich, J. E., Trusky, L., & Smith, S. M. (2022). Online video teletherapy treatment of obsessive-compulsive disorder using exposure and response prevention: Clinical outcomes from a retrospective longitudinal observational study. Journal of Medical Internet Research, 24(5), e36431. doi: 10.2196/36431

Karpov, B., Lipsanen, J.O., Ritola, V., Rosenström, T., Saarni, S., Pihlaja, S., Stenberg, J., Laizane, P., Joffe, G. The overall anxiety severity and impairment scale as an outcome measure in internet-delivered cognitive behavioral therapy for anxiety disorders: observational study. (2023). J Med Internet Res, 25, e45362. doi: 10.2196/45362

Komariah, M., Amirah, S., Faisal, E. G., Prayogo, S. A., Maulana, S., Platini, H., Suryani, S., Yosep, I., & Arifin, H. (2022). Efficacy of internet-based cognitive behavioral therapy for depression and anxiety among global population during the COVID-19 Pandemic: A Systematic review and meta-analysis of a randomized controlled trial study. Healthcare (Basel). 30;10(7), 1224. doi: 10.3390/healthcare10071224

Rees, C. S., Anderson, R. A., Kane, R. T., & Finlay-Jones, A. L.(2016). Online obsessive-compulsive disorder treatment: Preliminary results of the “OCD? Not Me!” self-guided internet-based cognitive behavioral therapy program for young people. JMIR Ment Health, 3(3), e29. doi: 10.2196/mental.5363

September is a month dedicated to suicide awareness and prevention, and this week of the 10 - 16th in particular has been designated as National Suicide Prevention week. I like to associate the word prevention with proactivity - meaning, in order for people to stop attempting and dying by suicide, they need to be first empowered to obtain and/or maintain an increased quality of life. Getting ahead of a suicidal crisis also means that other people, places, and things need to be set in motion before the crisis has an opportunity to occur. I believe that suicide attempts and deaths by suicide do not happen in a vacuum - I think it’s helpful and OK to explore and ask why they occur - and l also believe that no person is to blame for someone’s death by suicide. Suicide prevention is complex and possible. 

So, what does it mean to be empowered to keep living, and to empower someone to stay alive? According to Oxford, empowerment can be defined as “the process of becoming stronger and more confident, especially in controlling one's life and claiming one's rights.” To me, this sounds a lot like an individual growing in self-esteem and self-compassion and having their personhood acknowledged and respected by others. Below are some practical ways I think together we can work toward creating a world with fewer and fewer deaths by suicide - check it out:

​If it’d be helpful, I’d invite you to print out this chart and pick a handful of these items to implement into your weeks moving forward to help create a world where more and more people are empowered to keep living, and living well. Suicide prevention is complex and possible. 

​If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

Back-to-school time is upon us once again and it can be easy to get caught up in the hustle and bustle of the season. Below are some quick tips to help keep your mental health in check while adjusting to a new school year. 

1. Get Sleep: It's easy to let sleep slide when you're cramming for exams or spending time with friends; however, not getting enough sleep can take its toll on your mental health. Having a good sleep hygiene plan can increase your chances of being able to fall and stay asleep allowing your brain time to rest and restore itself for another day.  
2. Be Mindful: A new school year can come with new challenges that can easily become overwhelming if we don't pay attention to what's going on. Practicing mindfulness can allow you to focus on being in the present and can be as simple as taking a few deep breaths to recenter yourself or taking a hike in a new park while taking in the sights and sounds of nature. 
3. Have Fun: Engaging in new or existing hobbies is a great way to increase your social support and help maintain your mental health. This is a great time to seek out opportunities provided on campus to engage in clubs, sports, or hobbies. 

If reading the information provided above resonated with you and you may be a good fit for one of my specializations reach out. I’d like to connect and find out more about how I can support you on your journey.

​If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

Simplifying our lives is not an easy task especially when it feels like we can never catch a break. Trust me…I get it. Life happens. It happens big. And it can be distracting. Other people rely on you. Things happen outside of your control. And usually not just one thing at a time. But a lot of stuff all at once. It can be overwhelming which makes it hard to stay focused. But you know, that is really what life is….a series of events that just happen – many of which we can’t control or even prepare for! And if we aren’t careful, we can let all the things that happen derail us from what we really want in life. So, how do we stay on track?
   
The key is to make a daily practice of remembering what you want. And not just the goals that you want but the feelings that you want to feel. For the most part – we are all emotional creatures. All the goals we set, we set because we want to feel a certain way. 

When you think about the goals you want to set – ask yourself – what are the feelings you are actually going for? Perhaps the finances you want to create are because you want to feel protected and free. Perhaps you want the relationship so that you can feel love and connection. Maybe you want the promotion or ideal job so you can feel worthy. 

Don’t get me wrong…these are all wonderful things. But – we must also look at the actual end goal. We must start from where we want to end, instead of the other way around.
 
So, look at your goals. Try to find the emotions you are looking for in setting these goals. Let’s say it’s – feeling worthy. So instead of going out and chasing a sense of worth. Ask this question: What can I do today to feel worthy? The answer may surprise you! And how can you remember to never forget this? How can you not get caught up in life?
 
By making this a daily practice…maybe it will be the new way you start each day…and knowing that it will take time to shift the perspective. Be patient! So – what do you want to feel today? And what can your new daily practice of remembering be?

If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

The dictionary definition of the word self-love is defined as an appreciation of one's own worth; proper regard for and attention to one's own happiness or well-being. In my professional experience, I have noticed that a lot of individuals worry that loving and having pride in themselves equates to being conceited or narcissistic. 

When working on improving your own self-love, that means working on accepting yourself fully, treating yourself with kindness and respect, and helping facilitate your own growth and wellbeing. It not only encompasses how you treat yourself, but also your own thoughts and feelings about yourself. I have to point out that this does not mean having a 24/7 positive view of self, as that may be unrealistic, but we want to get to a place where we can have a majority of positive views and positive treatment of oneself than not. 

When we are lacking in our own self-love, we often place everything first (i.e., family, friends, community, even career goals) and this is at the expense of our own needs. If this happens then it can manifest into working too hard which can result in burnout and feeling overloaded. It can also cause individual health and wellness issues. Something I have often heard many clients say is, “If my husband/kids/family are happy, or once I reach this career goal, then I will be happy with myself.” You may have even heard yourself say something like, “when I lose X amount of pounds then I will be able to love myself.”  Unfortunately, what can happen is that we work hard to achieve this goal without working at the root of the issue, so when that goal is met, we still are unsatisfied with ourselves because we lack love and compassion for ourselves. 

The importance of self-love is that it is the foundation that allows us to be assertive, set boundaries and create healthy relationships with others, practice self-care, pursue our interests and goals, and ultimately feel proud of who we are. 

The concept of self-love is simple: it means valuing and caring for your own needs, wants, and desires. It isn’t about being selfish. It is ensuring that you are giving yourself the time and space to recharge, set boundaries and advocate for yourself. 

With that said, something I say in just about all my sessions at one point to help a client understand fully, is using this example: When you are on a plane, flight attendants remind us the importance of playing with your own oxygen mask first before helping anyone else. They say this because if you were to skip yourself and help others first, you will likely run out of air. When that happens it becomes harder and potentially impossible to help anyone else, including yourself.

So how do we start to work on and practice self-love? Well we start with baby steps and work from there.  Listed below are some ideas of ways to improve the love for yourself.

For starters working on saying at least one (1) nice thing to yourself daily. I typically have my clients work on identifying three (3) things they did well that day. Work on assertiveness skills, as well as boundary setting. This can look something like saying ‘no’ to others or plans. I think this is a great way to work on respecting and loving yourself more. Additionally this allows the opportunity to only take on things we can handle and reduces the frequency of that feeling of burnout or feeling overloaded.  

For many, they look at self-love as self-care. To practice self-care we need to go to basics and listen to our body, take breaks, and have alone time when needed. Also reconnecting with hobbies and interests. Work on ways to accept your imperfections and live life in accordance with your own personal values and beliefs. Moreover, acknowledge any progress and efforts you have been making. This goes for all areas (i.e., work goals, personal goals, relationship goals, etc.)

I think a good way to end this post is with a quote. When we struggle to love ourselves we often talk down to ourselves in a degrading manner. When we love someone, yourself included, we never talk to them in a shameful or humiliating way, so work to treat yourself the way you want to be treated by others and the way you treat your loved ones. 

Muscle Dysmorphia (MD) is a subtype of body dysmorphic disorder that primarily affects men. It is characterized by excessive concern that one’s body is too small and not muscular enough. While MD has some overlap with eating disorders, it is not considered an eating disorder. Individuals with MD may engage in strict eating habits, such as repeatedly counting calories or attempting to establish the perfect balance of carbohydrates, proteins and vitamins in their diets. However, the aim is to bulk up and appear more masculine as opposed to concerns with weight loss as seen in individuals with eating disorders. Additionally, not all individuals with MD have disordered eating (International OCD Foundation).

Compulsive behaviors in those with MD often include camouflaging such as wearing extra layers of clothing to appear larger or baggier clothes to hide a frame that is perceived as too small. It is also common for individuals to engage in excessive weight-lifting, often for several hours a day. Excessively checking mirrors or avoiding them are typical behaviors in MD. Often, social situations where one’s body will be on display, such as beaches or pools, are avoided. As with other forms of body dysmorphic disorder, MD can lead to missing school, work, discontinuation of athletics, or becoming housebound. Some individuals also use anabolic steroids or other performance-enhancing drugs (Phillips, 2005). 

Cognitive-Behavioral Therapy is considered an effective treatment for muscle dysmorphia. Similar to treatment for other forms of BDD, treatment goals for muscle dysmorphia would include providing psychoeducation, cognitive restructuring, exposure and response prevention, and regular completion of homework assignments. 

Psychoeducation for muscle dysmorphia would include information on how media and culture influences body image. Strategies for promoting long-term health would also be discussed. This includes helping the client develop realistic expectations regarding nutrition goals and exercise. Cognitive restructuring for MD would involve working with the client to develop more helpful, accurate beliefs about body size and shape. Additionally, it would target unhelpful thoughts, beliefs and behaviors related to altering body shape and weight (Wilhelm, et. al 2013). Exposure and Response Prevention is another important part of treatment. As with BDD, exposures would target situations the client is avoiding such as school, work, or other valued activities. Response prevention would assist the client with identifying all compulsive behaviors related to weight, shape, or muscularity concerns. As previously mentioned, common compulsions may include mirror-checking, comparing, frequent weighting, wearing many layers of clothing to appear bigger, and following an excessive exercise regimen. The therapist and client would develop a plan to help the client stop the compulsions (Wilhelm, et. al 2013). The client would be expected to complete weekly homework assignments associated with these treatment goals.

While much research is needed in the areas of BDD and MD, Cognitive-Behavioral Therapy has been shown to be an effective treatment. The references listed below are helpful resources to gain more information on these disorders and on effective treatment. 

If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

​References:

International OCD Foundation (n.d.). Subtypes of BDD. 

Phillips, K.A. (2005). The broken mirror. Understanding and treating body dysmorphic disorder. Oxford University Press.

Wilhelm, S., Phillips, K.A., & Stekette, G. (2013). Cognitive-Behavioral Therapy for Body Dysmorphic Disorder. The Guilford Press.

If you find that you're often putting yourself last in order of priority, then some lessons in self-nurturing may be helpful. Since we often give every last bit of our energy and time to our families, jobs, and daily responsibilities…nurturing ourselves becomes even more of a priority. 

Why is self-nurturing important? That’s a great question! As popular as the term “self-care” has become, too many of us still tend to forget ourselves in favor of others. Yet, ironically, the more we neglect our own needs, the less able we are to care for our family, our friends, our volunteer causes, and other important areas in life. 

Let’s remember what the word “nurture” actually means. Originally, it meant “to feed or nourish,” and I believe that can be interpreted both literally and figuratively. 

You can self-nurture quite literally through the food you eat, but there are so many self-nurturing activities that go far beyond that physical meaning. You can feed your soul by doing the things you love, spending time with people you love, and getting the rest your body needs. 

If you’re still struggling with the concept of self nurture, think about this. If you’re constantly running on empty, you’re more likely to be impatient with your families or to miss an important deadline at work. 

Self-nurturing can take a lot or a little bit of time, but all of us need it! Why not think about some of the activities you find refreshing or encouraging, and try to incorporate them into your life today? Here are a few steps you can take to start practicing self-care today: 
​

1. Identify your feelings. If this is difficult, pay attention to your inner dialogue. Notice your thoughts. Do they express worry, judgment, despair, resentment, envy, hurt, or wishing? Notice your moods. Are you irritable, anxious, or blue? Try to name the specific feeling. (“Upset” isn’t a specific feeling.) Do this several times a day to increase your feeling recognition. You can find lists of hundreds of feelings online. 
2. Honor your feelings. When you have uncomfortable feelings, put your hand on your chest, and say aloud, “You’re (or I’m) ____.” (e.g., angry, sad, afraid, lonely). This signifies acceptance of your feelings.
3. Uncover the cause. Think and/or write about the cause or what triggered your feeling. 
4. Meet your needs. Once you discover the cause, think about what you need that will make you feel better. Meeting your needs is good self-parenting. 
5. Express your feelings. Journaling about your feelings has been shown to alleviate depression and increase your self-knowledge. If you’re anxious, practice yoga or martial arts, meditation, or simple breathing exercises. Slowing your breath slows your brain and calms your nervous system. Exhale 10 times making a hissing (“sss”) sound with your tongue behind your teeth. When you’re angry, do something active to release your emotions. 
6. Giving yourself comfort. Write a supportive letter to yourself, expressing what an ideal parent would say. Have a warm drink. Studies show this actually elevates your mood. Swaddle your body in a blanket or sheet like a baby. This is soothing and comforting to your body. 
7. Find pleasure. Read or watch comedy, look at beauty, walk in nature, sing or dance, create something, or stroke your skin. Pleasure releases chemicals in the brain that counterbalance pain, stress, and negative emotions. Discover what pleasures you.
8. Play. Adults also need to play. This means doing something purposeless that fully engages you and is enjoyable for its own sake. The more active the better, i.e., play with your dog vs. walking him, sing or collect seashells vs. watching television. Play brings you into the pleasure of the moment. Doing something creative is a great way to play, but be cautious not to judge yourself. Remember the goal is enjoyment–not the finished product. 
9. Coach yourself. Practice complimenting and encouraging yourself – especially when you don’t think you’re doing enough. Notice self-judgment for what it is, and be a positive coach. Remind yourself of what you have done and allow yourself time to rest and rejuvenate. 
10. Forgive yourself. Healthy parents don’t punish children for mistakes or constantly remind them of what they are doing wrong…and they definitely don’t punish willful wrongs repeatedly. Instead, learn from mistakes and make amends when necessary.
11. Keep commitments. Honor commitments to yourself as you would anyone else. When you don’t, you’re in effect abandoning yourself. Imagine how it feels to have someone repeatedly break promises to you. Love yourself by demonstrating that you’re important enough to keep commitments to yourself. 
12. Listen to a self-love guided meditation regularly. It will give you words of kindness and acceptance to say to yourself.

If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

Before we begin explaining ways to move past trauma experiences, I think it is important to first go through and better understand what trauma is, and the various events that it can present from. 

For those who do not know what trauma is, it is the result of an extraordinarily stressful event that usually involves a threat to life or safety. After experiencing a traumatic event, it can leave the individual feeling numb, disconnected, and unable to trust others. It may also leave you feeling overwhelmed and cause you to begin to isolate yourself from others.

Trauma can come from a one time event, or it can be from recurring events that continually cause significant distress. When researching trauma and ways to heal,  it was an eye-opening experience to learn about the statistics. We are talking approximately 70% of American adults report at least one traumatic event, and two-thirds of children experience trauma before the age of 16. Of that, 20% will go on to develop Posttraumatic Stress Disorder (PTSD). Something not talked about nearly enough is military trauma. About 1 in 4 veterans have been diagnosed with a mental health condition, such as PTSD, depression, and anxiety.

If trauma is not properly dealt with and managed it can then go on and become one of the leading factors in the development in various behavioral and substance use disorders. Trauma comes in many forms, most individuals associate trauma with emotional, physical, or even sexual abuse. However, trauma can also be caused from loss (death) of a loved one, divorce or the end of a long term relationship (your own, or parents), being a victim of bullying, military, war, combat, experiencing domestic violence, child neglect, natural disasters, accidents (i.e., car accident), etc.. 

Trauma can affect mental health in various ways, it can contribute, as mentioned earlier, to the development of PTSD, abuse of substances, panic attacks, depression, anxiety, eating disorders, non-suicidal self-injury (NSSI), or suicide. 

It is important to seek out and find a therapist that can provide you with the proper care and treatment needed to begin working through and healing from your trauma. When I work with clients, I find it is important to consistently provide education on trauma and the various forms it can take. There is no right or wrong way to think, feel, or react when it comes to trauma. It is important for my clients to understand that their individual responses are normal reactions to an traumatic event. 
 
Symptoms individuals may experience due to their experience with a traumatic event can range from denial, anger, mood swings, isolation, feeling disconnected from any and all emotions, insomnia or hypersomnia, difficulty concentrating on the simplest of tasks, restlessness, and feeling on edge. You may also experience nightmares, flashbacks, and finding yourself to be easily triggered. 

Now, for the answer to the most common question, “How can we begin to heal from trauma?”  When it comes to healing and moving past your trauma, we first have to understand that in order to move past it, we have to first unpack and go through all the heavy stuff. This is necessary for many people in order to be able to get to a place where an individual can begin to move forward and lead a happier life without their past traumas holding them back. Not everyone will fit perfectly into one category. For some, they may need more intensive treatment (i.e., group therapy) while others may only need individual outpatient therapy, while another individual may need medication in addition to therapy to help support to help them.  *disclaimer* always consult a psychiatrist or other medical professional should you want to explore the possibility of adding any form of psychotropic medication. 

When working with clients I make sure my clients are actively working on these select areas while we process and unpack their trauma. 

TIP #1 Experiencing a traumatic event can cause disruption to the body's natural equilibrium. So to repair the body, we have to get ourselves moving. This can be as small as exercise/walking for 30 minutes daily. Exercise that is rhythmic that engages both arms and legs is best as this requires your focus and attention on moving your body in certain directions. These types of exercises include but are not limited to, rock climbing, boxing, martial arts, and weight training. 

TIP #2 It is important to NOT isolate. Withdrawing and isolating from others will make symptoms worse in the long run. Remember, surrounding yourself with support from loved ones does not require you to always talk about the trauma; being surrounded by others is the comfort that may be needed to not feel alone. Remember you are in charge of who you feel comfortable talking to when it comes to processing and sharing the experience. It is important to find someone who will listen attentively and without judgment. This is where seeking a therapist can be helpful. Not isolating can also look like joining a support group for trauma survivors. This often will help reduce a sense of isolation and feeling alone, where you will be met with others who understand the emotions and feelings that you may be experiencing and help to normalize the process.  

TIP #3 Regulate your nervous system. While in therapy your counselor will work on teaching you how to utilize and implement helpful tools such as grounding techniques or mindfulness skills. This can look like diaphragmatic breathing, sensory input/identification, journaling, yoga, guided meditations, and importantly allowing yourself to feel the feelings as they present themselves. Making sure you are getting an appropriate amount of sleep, and eating a well balanced diet is important while working through trauma, as well as making time for hobbies or other activities that bring you joy (e.g., coloring, reading, knitting). 

TIP #4 Learn how to identify your triggers. A trigger is a stimulus that elicits a reaction. Some examples of triggers can look like hearing certain sounds, sights, particular smells, or tastes related to the trauma. Hearing loud voices or yelling, being in the vicinity of loud noises, witnessing someone having an argument are other examples. While working diligently with your therapist, you will learn about your own trauma triggers in more detail, what may set them off, as well as ways to manage when you do feel triggered. By having a better understanding this will help you learn how to create healthy and appropriate boundaries and a healthier relationship with those triggers.

​If you are interested in counseling for trauma, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

Have you ever noticed how frequently our responses to the question “how have you been” involve variations of “staying busy”? What about hearing someone talk through a large list of things they currently have going on in their life? For many of us, our reactions involve shock (that one person could manage all of those items) and admiration. We have learned to admire those who don’t seem to have a minute to themselves. This is exactly what is meant by “glorification of busyness.”

As a society, we have been encouraged to be active participants in every aspect of our lives. We are to work hard and excel in our chosen field or profession, be fully present and active in our families, train and care for our pets in their every need, eat healthy, exercise, have a spotless home, on and on it goes. The reality of this encouragement is that it is simply not possible. No one person can accomplish all of these feats without significant sacrifice in one or more other areas. Being stretched in so many different directions at once can result in problems one way or another.

With these impossible standards before us, how do you go about achieving any form of balance?  How do you decide what to keep and what to decrease or decline completely?  

Consider some or all of these questions, they may help you narrow it down:

What is important to you?
Does it align with your personal values? (I recommend this worksheet for clarifying your values)
What is a current priority and why?
Are you the only one who can take care of this?
Does this need to happen right now or can it wait?
If this is something you have enjoyed in the past, is that still the case?
When you close your eyes and think of the best possible scenario, what does balance look like for you (and your family)?

This is not an easy process to do, but it can be very worthwhile to help you modify some of your expectations for yourself and others.

​If you are interested in counseling, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

What is Body Dysmorphic Disorder?
Body Dysmorphic Disorder (BDD) is a mental health condition in which an individual is preoccupied with a perceived defect in his or her appearance. This preoccupation causes significant distress and/or impairs functioning. Often the perceived flaw is unnoticeable to others. An important distinction between BDD and body image concerns is the amount of preoccupation and disruption in an individual’s functioning. People with BDD generally spend at least an hour a day thinking about their perceived defect and in the average case, the individual spends between 3 and 8 hours per day. Additionally, they engage in avoidance and/or compulsive behaviors in an effort to alleviate anxiety about their appearance. Current studies suggest that millions of people in the U.S. alone have BDD (Phillips, 2005).

Underdiagnosis of BDD
BDD can be difficult to diagnose for many reasons. Body image and appearance concerns are common. In a recent survey of 30,000 people in the United States, findings suggested that 93% of women and 82% of men care about their appearance and work to improve it (as cited in Phillips, 2005). When people express concerns about their appearance, this may be overlooked since it is a common problem in our culture. Worries about being seen as vain, drawing more attention to the perceived defect, and receiving reassurance that one’s appearance is fine are other reasons BDD is underdiagnosed. Although reassuring comments are typically well-meaning, individuals with BDD may feel that their concerns are dismissed as foolish or invalid (Phillips, 2005).  

How does BDD impact functioning?
People with BDD commonly become preoccupied with perceived problems with their appearance such as their hair, skin, and nose. They may worry about acne, scarring, wrinkles, thinning hair or having a large nose. To ease their distress, they engage in avoidance and compulsive behaviors. BDD frequently causes problems in interpersonal relationships and social activities. Individuals with BDD tend to miss school, work or in more severe cases may drop out of school or become unemployed (Phillips, 2005). The most serious consequence is suicide. In a study consisting of more than 500 patients, 80% of people with BDD endorsed suicidal thoughts and 14% reported they attempted suicide because of BDD (Phillips, 2005). Many individuals seek unnecessary cosmetic surgery and dermatologic treatment. While people with regular body image concerns may be happy with the result, individuals with BDD are typically dissatisfied with the outcome and blame themselves or the doctor (Phillips, 2005).

Therapy Recommendations
Currently, Cognitive-Behavioral Therapy (CBT) is the best-studied and most recommended form of treatment for BDD. This therapy approach consists of the following techniques: cognitive restructuring, response (ritual) prevention, behavioral experiments, and exposures. Cognitive restructuring involves helping clients to identify and challenge thinking errors regarding appearance concerns. The goal of response (ritual) prevention is to identify compulsive behaviors such as excessive grooming and mirror-checking. The clinician will assist with stopping unhelpful behaviors and help the client develop normal amounts of necessary behaviors such as grooming. Behavioral experiments involve designing and carrying out experiments to test out BDD beliefs. For example, if the belief is “Everyone will stare at me in horror if I go out in public without make-up,” an individual might go to the grocery store without make-up and collect evidence for and against this belief.  Exposures consist of gradually facing situations that are typically avoided.

Medication considerations
Numerous research studies have demonstrated that serotonin-reuptake inhibitors (also known as selective serotonin reuptake inhibitors) substantially improve BDD symptoms in a majority of people (Phillips, 2005). SRIs are a type of antidepressant medication that can also help to diminish obsessional thinking and compulsive behaviors (Phillips, 2005). Examples of these medications include: citalopram (Celexa), escitalopram (Lexapro), fluvoxamine (Luvox) and fluoxetine (Prozac). According to the International OCD Foundation, there are no medications that currently have FDA approval for treatment of BDD. However, research and clinical experience suggest these medications are safe and effective for most individuals who have BDD. Individuals diagnosed with BDD may benefit from working with a psychiatrist who specializes in BDD to determine whether to add medication to the treatment protocol.

Treatment outcome
Studies have suggested improvement in many aspects of BDD and related symptoms after CBT treatment. Some of the areas include: a reduction in obsessive thoughts and BDD rituals, reduced depressive symptoms, improved insight, body image, and self-esteem and decreased social anxiety (Phillips, 2005).

​If you are interested in counseling for Body Dysmorphic Disorder, call OakHeart at 630-570-0050 or 779-201-6440 or email us at Contact.OH@OakHeartCenter.com. We have counselors, psychologists, and social workers available to help you at one of our locations in North Aurora, IL, Sycamore, IL, and/or via Telehealth Online Therapy Services serving Kane County, DeKalb County, Dupage County, and beyond.

References

Body Dysmorphic Disorder Foundation (n.d.). Information. https://bddfoundation.org/information/

International OCD Foundation (n.d.). Medication Treatment for BDD: FAQ. https://bdd.iocdf.org/expert-opinions/medication-faq/

Phillips, K.A. (2005). The Broken Mirror. Oxford University Press, Inc.

Wilhelm, S., Phillips, K.A., & Steketee, G. (2013). Cognitive-Behavioral Therapy for Body Dysmorphic Disorder. The Guilford Press.