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Dr. Mark
Dr. Mark, Psychotherapist
Category: Mental Health
Satisfied Customers: 5087
Experience:  Dr. Mark is a PhD in psychology in private practice
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i dont know where to start, i always seem to be verbally harassed

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i dont know where to start, i' always seem to be verbally harassed at work and in school by other coworker day by day, when i try to get even the harassment gets worse. it doesnt take much for a person to dislike me, i'm extremely neurotic, i always seem to get on peoples bad side without me knowing, i've tried to pin down why since it happens so often, and realized im self-centered, as they say "a one upper", not a team player, they've said i'm an "asshole". I dont know why, always thinking what would people would say about me, i'm having lots of suicide thoughts, but the thought of my son and family stop me. i feel sick to my stomach constantly, and rapid heart beats. i seem to lose my cool very easily, i dont have many friend and the ones i have i push away. i got divorced in 2005. i had a head injury in 2008 with slight veritgo. I always end up losing sleep thinking about what the person that might have offended me said, and i say to my self what i should have said in that moment, which i didnt say.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Mark replied 2 years ago.

Hi! You know, to give you the best answer, I think I should ask you a few questions first that will help define the problem and the situation.


Your very impressive insight into yourself is very important here. It is a tremendous strength you have that you will need to use as the basis for making the life you would like to have be yours.

Could you describe and/or explain what you mean by your being very neurotic?

The head injury, was there a TBI (traumatic brain injury) incurred? If so, to what extent? What cognitive damage was caused or personality changes?

Back to the neurotic aspect: Was there trauma or abuse in your childhood? What about alcohol or dysfunction in your family when you were growing up?

Are you getting any treatment right now? If so, for what mental health issues. And what type of treatment? How is it going?

If not, when was the last treatment? What type of treatment was it? Was it helpful?

Any extra information that will help, feel free to share.


Dr. Mark

Customer: replied 2 years ago.
sorry for the lack of details, i was feeling down, while i was typing, and could not concentrate easily and my heartbeat was racing, i had just got off from school where one of the students was talking about me in innuendo about me being "this and that". usually when i get home at night after long day of bad thoughts and animosity at work and school i feel this way.
My family came from Mexico to the US back in 1993. all of us had a hard time adapting to the social life in this country, from my point of view i suffered the most, i had issues making friends, not very confident, self conscious about not speaking the language, and other students making fun of me and i don't think i ever over came that, but it was something i could not speak to my parents about since my problems never seem as important as they had their own issues adapting to the new life. so i went on, thinking i left who i was in Mexico up to this date.
I suffered a concussion and laceration to the left side of the face, at a club/bar back on 2008 trying to defend a friend of mine from getting jumped, that left a scar 6 inches from my temple to the neck, and vertigo, which is not as pronounced as after the injury, i had no brain damage, but i haven't been the same since then, my social life is horrible, can seem to get along with anybody, i don't like to start conversations with anybody if i don't have to, i am the guy that sits in the back of the classroom so that people don't notice me, I've had problems holding erections since then, i was self conscience about my scar but lately i don't pay attention to the stares or what people might think about it. About being neurotic, i am always think negative thoughts, i always think if people are out to get me, to hurt me, too sensitive or damage my personality, to the extent that i think i cause these problems into myself. The treatment is about the low testosterone , not mental. this would be the first time i open up to someone about all this, i always thought i was strong enough to deal with i myself, but i nothing has worked. there never was any kind of abuse, just the lack of communication, and the father figure that my dad could not provide, since all i know is that he was a provider, and that he had to be left alone when he came from work, very unapproachable.
Expert:  Dr. Mark replied 2 years ago.

Thank you for the added information. It helps a lot. I believe I can now be of help with this issue.



First let me say that I can imagine how distressing and frustrating this situation must be for you. That you are seeking help is a very good thing. I will also at the end of the posting give you a technique you can use to help with your anxiety from the post traumatic stress disorder (PTSD) you are suffering. It will help you find some temporary relief with your anxiety.

I mentioned PTSD but I don't want you to get frightened at the word "disorder". You had one incident that has traumatized you and you need to treat it. That's all. But it is important for you to recognize that your symptoms do indeed sound very much consistent with PTSD. And untreated PTSD can lead to further and further social irritability and isolation and further exacerbation of your other symptoms.

This focus on my part on the trauma you experienced and the PTSD subsequent to that very real trauma is not meant to minimize or deny the self-worth and "inferiority" issues you seem to have been trying to deal with for so much of your life. They also need to be addressed. I am only stating a priority for treatment: the PTSD needs to be addressed directly and the self worth issues need to be addressed more slowly. Fortunately, they both require the same effort: psychotherapy. There are no medications for the direct treatment of PTSD, only the anxiety that comes with it.

Psychotherapy that is helpful for PTSD is some form of Exposure Therapy. I have found EMDR can be very useful especially for one time traumas. It is a type of therapy specifically for PTSD originally. Here is the International Society's website:

http://www.emdria.org/

On the web you will find many opinions on EMDR both for and against. I am trained in it and have found it useful. Exposure therapy is also very helpful. I have found that you need to combine these types of therapy with a more introspective, humanistic or psychodynamic approach. If we actually look inside, we can find great relief and meaning. And we can feel whole in ourselves in ways that we haven't for decades. But many EMDR practitioners and therapist working with Exposure Therapy do not take the time to insure the emotional safety of the patient and so that's why you need someone who is more humanistic or psychodynamic in approach.

If you don't have a good referral source, 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 (you can see a photo of the therapist!) look at the listing and see if they list working with PTSD and EMDR and also some form of psychodynamic or humanistic therapy in their orientations. You will need this for the work on the self worth problems as well that you need to address. And make sure you are confident in them as a therapist and they share your values.

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

I wish you the very best!

Finally, I am going to put here a protocol that is used for anxiety. It's often that there's an underlying anxiety we have to address. So I want to give you this technique to help you!

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 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 as well.


I want to stress the importance of breathing as well. Part of the physiology of what is happening to you in anxiety and negative thinking 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 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: 5087
Experience: Dr. Mark is a PhD in psychology in private practice
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