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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5100
Experience:  Dr. Mark is a PhD in psychology in private practice
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I am 28 years old, am unemployed, and have a chronic illness.

Customer Question

I am 28 years old, am unemployed, have a chronic illness, and struggle with anxiety and depression. I want to stand on my own two feet and have the freedom to live my own life. Five years ago that seemed possible. With the help of friends I got out of an abusive home environment. With their encouragement I learned to drive, got my license, purchased a car, and moved out within just a few months. I grew up isolated and was not allowed to experience much so this was exhausting and frightening. <br /><br />Not even a year later my abuser died, I became sick, and my Mom moved in with me. I thought it would be a chance to have a positive relationship, but I was wrong. I don’t like my Mom. I grew up feeling that it was my duty to take care of my Mom. But I also hated her because she didn’t stop the abuse. She ignored it and walked on by. She still is that way. I don’t hate her now, but neither do I really love or respect her. I want my life to be different and I want to feel good about my Mom, but I feel stuck. I don’t feel free to move forward with my mother there. <br /><br />The abuser was my grandmother. She was raped at eighteen. Because she got pregnant (with my Mom) she was pushed to get married. My grandfather abused her severely for the rest of his life. She took it out on her children, with my Mom as her special target. Her siblings picked on her too. She never got over that and never learned to take care of herself. For some time she wasn't around my grandmother. But not long after she had me, she brought me into that same abusive environment. And it became MY turn to be my grandmothers target. She beat and verbally abuse me, but her favorite thing to do was play games of psycological torment. <br /><br />I know that the answer is simple. Get a job, find a place of your own, stand up for yourself. But I don't know how or what that means. And how can I do that when I have to worry about my mother? She doesn’t drive, has no job, has never learned how to function on her own, and has no personal support system. She’s inexperienced, procrastinates, is self defeating as well as emotionally needy. She's suffocating to be around. And I am just like her. I have to fight hard to be different, but when I’m around her it’s twice the battle. She's an emotional octopus and I'm drowning. What do I do? I’m at the end of my rope.
Submitted: 3 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 3 years ago.

Hi! I believe I can be of help with this issue.

Let's start off the answer: What I am going to say I can sense from your writing that you already really know within yourself but don't feel confident about. Your mother has to leave your home. That is not cruelty nor is it ingratitude. That is the reality of life in today's world for all families. Single children cannot create their lives by being caretakers to their parents even if the family life had been ideal. So, you need to establish your independence. How you do that will depend on a number of factors.

Thus, to be able to give you the best, XXXXX XXXXX and most comprehensive answer possible I need more information from you.

How old is your mother? Is she disabled in any way?

 

Does she have insurance? Is she on Medicaid or Medicare?

All these things will influence how you can help her move out or whether she needs to find her own way.

Okay, that information will help us. If this was enough of an answer, please remember to click the green ACCEPT button if you haven't already. And, thank you! Dr. Mark

 

Customer: replied 3 years ago.
My mother is 59 years old. She has recurring cataracts, but I don't believe enough so to be considered disabled.

She has no insurance and is not on Medicaid or Medicare. She tried applying for welfare, but at the time did not qualify because her assets were in excess of the $2000 limit. This is because she is named on a joint account with her sister that she does not use. She does receive some retirement from Tahiti about $300. We currently live in Hawaii.

Thanks.
Expert:  Dr. Mark replied 3 years ago.
Okay, let's begin our answer.

There are two parts to what we have to discuss in my answer to you. The first is what your obligation is to yourself. The second is what your obligation is to your mother.

There is of course no legal obligation in the US for children to their parents. There is a moral obligation but that depends on your religious and ethical system. The Biblical responsibility is to help as long as your life is not jeopardized. I believe it can be summed up, as well as most moral systems' view, very briefly like this: you know how on planes they tell you, In case of sudden loss of cabin pressure, put on your mask first and then put on the mask of those next to you who need your help.

So the fist obligation is to yourself. If you can move away from Hawaii to the mainland, that would be the best option. And I urge you to do this if at all possible. Why? Because you are tied by not just loyalty but by emotions carried over from a childhood of abuse. Those are feelings that can suffocate a person. And to add to that, you have generations of this type of misuse of family loyalties as an inheritance. You need to create some distance, start your own therapy, and create your life.

All of the above is true even if you stay in Hawaii. If you can move to a different island than she is in, second best. If you have to stay on the same island, okay. You still need to apply the principle of distance, therapy, and creating your life.

She is not as helpless as you believe. She will adapt to her environment. So, you have to prepare her that she needs to leave and find her own living arrangement. You may have to move also because she may not be willing to take steps to do anything until she is forced to. So, you may need to look for your own new living arrangement and let her stay there or find her own way. She needs to apply for state health insurance. Here's the website: http://www.med-quest.us/

You need to have your support system in place. Your friends need to know of your plan and that it's going to be tough for you. I'd like you to also begin therapy again. I would like you to interview psychologists who have a more humanistic focus and is experienced in PTSD work.Here is the web address for Psychology Today's therapist directory. You can sort by zip codes and when you see someone who seems like they might be helpful (they show you a photo of the therapist!) look at the listing and see if they list humanistic therapy and PTSD in their orientations and specialties.


http://therapists.psychologytoday.com/rms/

The idea here isn't that these types of therapy are magic. It's that I want you to find a therapist who will form a strong therapeutic alliance with you and will help you look at the sources of your emotions and the effects of the trauma. This work in therapy will help you prepare for your independence if you haven't been able to achieve that before you start.

Now, I want to give you a tool to use for when the depression is overwhelming or there is anxiety panic. Here are instructions on a therapeutic protocol called Progressive Muscle Relaxation (PMR). It's really quite easy to do almost anywhere. My patients suffering from depression or anxiety, when I teach them PMR at first are amazed how simple it is and that it is a psychological protocol. It was first used in the 1920s! Since then, of course, it has been refined and many studies have been done showing its effectiveness. You will practice PMR at first when you don't wake up with an attack so that you will be familiar with it. I want you to practice the PMR at least 5-6 times before an attack or feeling acute anxiety. Why? Because when you're in the throes of anxiety, you will only remember to do something you are very familiar with it. So practicing 5-6 times is really a minimum. And this is good also for just general anxiety without panic attacks and for feeling as though you are in a dark hole of depression as well.

I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in a panic attack is that your breathing is getting shallower. This reduces the oxygen in your blood to your brain. That increases the anxiety reaction, which strengthens the attack and you are in a vicious cycle! Not good. So breathing is the primary tool. I have found in my practice that learning breathing techniques can be helpful. But some of my patients are not interested in learning more than one thing at the beginning, so I have found that just reminding you to BREATHE deeply at the same time you are doing PMR is almost as good. If you are willing to take a yoga class for seniors and learn breathing techniques, that's the best. But, breathing deeply with your PMR will help.

So, we're ready for learning PMR. I want you to print my instructions below my signature and have a copy in each of the rooms of your home where you may be when you have an attack. And again, you need to practice this easy technique at least 5-6 times as soon as you can. It needs to become as natural to you as breathing. Ah, remember breathing?


INSTRUCTIONS:

  1. After finding a quiet place and several free minutes to practice progressive muscle relaxation, sit or lie down and make yourself comfortable.
  2. Begin by tensing all the muscles in your face. Make a tight grimace, close your eyes as tightly as possible, clench your teeth, even move your ears up if you can. Hold this for the count of eight as you inhale.
  3. Now exhale and relax completely. Let your face go completely lax, as though you were sleeping. Feel the tension seep from your facial muscles, and enjoy the feeling.
  4. Next, completely tense your neck and shoulders, again inhaling and counting to eight. Then exhale and relax.
  5. Continue down your body, repeating the procedure with the following muscle groups:
    • chest
    • abdomen
    • entire right arm
    • right forearm and hand (making a fist)
    • right hand
    • entire left arm
    • left forearm and hand (again, making a fist)
    • left hand
    • buttocks
    • entire right leg
    • lower right leg and foot
    • right foot
    • entire left leg
    • lower left leg and foot
    • left foot
  6. for the shortened version, which includes just four main muscle groups:
    • face
    • neck, shoulders and arms
    • abdomen and chest
    • buttocks, legs and feet

Quickly focusing on each group one after the other, with practice you can relax your body like ‘liquid relaxation’ poured on your head and it flowed down and completely covered you. You can use progressive muscle relaxation to quickly de-stress any time.

What You Need:

  • A comfortable place.
  • Some privacy.
  • A few minutes.

Again:

 

Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5100
Experience: Dr. Mark is a PhD in psychology in private practice
Dr. Mark and 3 other Mental Health Specialists are ready to help you
Customer: replied 3 years ago.
Dear Dr. Mark

I am printing out the med-quest application and will have my mom fill it out. I found a counselor on the list you recommended, a Ms. Nancy M Sallee. Her office is close to where I live and accepts my insurance. She specializes in Trauma and PTSD. She does not use humanistic therapy but does use eclectic, EMDR, and narrative. She also offers a free phone consulation. Is this good?

Also, why PTSD? Do you think I might have this? Thank you.
Expert:  Dr. Mark replied 3 years ago.
It sounds like it's right on. Just make sure you feel that she uses EMDR, which may become useful for you, not too quickly and as PART of your opportunity to talk through and learn from your trauma. And that you feel confident in her and comfortable. You have the right to change your mind if you don't. She sounds just right! I'm thrilled for you.

Dr. Mark

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