Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Barry Erases Valerie Again

Valerie was hurt and upset. Barry dismissed her plans for the Thanksgiving holiday but supported the same proposals coming from cousin Ruth. What made it even worse was that Barry seemed oblivious to the stinging rebuke he had dealt his wife. Silenced by the lump growing in her throat and the hot tears pricking her eyes, Valerie pretended to be busy in the kitchen. She had to get a grip on herself for the sake of her guests.

Nothing Valerie Says Counts

" I think we should go to the Mountains with Ruth and her family this year. We won't have to worry about our parents competing with one another for the best pies and stuffing." Barry commented as he got ready for bed.

" I've been telling you that for the last couple of weeks, but you only listen to Ruth." Valerie huffed getting under the covers.

" It's not true. You are just hypersensitive," snubbed Barry while reaching out to caress her.

Valerie Lets Barry Have it

Valerie pushed Barry's hand away and let him have it. "You really hurt me Barry. You do this all the time. Nothing I say counts. You ignored me when I asked you to pace yourself with the weight training. Yet when your mother warned you to slow down you immediately altered your schedule. I begged you not to feed the cat the remains of the Chinese food because she would throw up all night. You told me it was nonsense. But you believed your golf buddy when he cautioned you about the same thing."

"You are making a big deal out of nothing! What's got into you? Are your hormones playing up?" Barry countered, defending himself against the unexpected attack.

" I don't know why you bother asking my opinion on anything. You don't take me seriously. You make me feel that my ideas are worthless, until of course they are corroborated by someone else who has authority in your eyes. If I am so dumb why did you marry me?" Valerie pleaded.

The Marital G.P.S. Gets Hit By A Brown Out

Valerie felt disregarded by Barry and banished him to his own planet. Barry felt locked out without a key. Alone in their own kingdoms, the couple orbited around their relationship on different pathways. The martial G.P.S. got hit by a brown out, and neither of them had a flashlight to help them mend the fuse.

Valerie and Barry Are Both Scared

Scared in the darkness of conflict and misattunement, neither felt safe taking a step toward the other. Valerie insisted Barry had to jump onto her planet. She needed him to validate her foresight and wisdom by valuing her opinions. She wanted to feel like an equal player, not an extension of her husband. She was fighting for her individuality.

Valerie's Opinions Feel Threatening to Barry

Barry wanted Valerie to leap into his world and recreate the feeling that they were joined at the hip. That would provide the ultimate security blanket. It was unsettling and somewhat of a threat to have Valerie out there separate from him, with thoughts and feelings that were alien to him. That was the first step along the slippery slope leading to the break up of their marriage.

Barry Choices For Reconnecting with Valerie

Torn apart and distant Valerie and Barry feel lonely, and misunderstood. Each has a choice. Barry can sit on his throne, waiting for Valerie to come around, apologize, make up and feel victorious. Or he can choose to broaden the vista through which he looks at his marriage. He can chose to be curious and talk to her about her feelings. He can take a step toward reconnecting with her by understanding his part in contributing to Valerie's sense of devaluation. He can talk to her about how devalued he feels when he is cast off from her kingdom.

Valerie's Menu For Creating an Equal Partnership

Valerie also has a choice. She can wait for Barry to get so scared of being without her that he comes crawling with false apologies. She may feel vindicated at that moment, but it does nothing to ensure that this problem is solved. Alternatively Valerie can put on a cloak of empathy for Barry's sense of insecurity. She can encourage him to share his fears and educate him about similar concerns she faces about their marriage.

Trading the Tug Of War For a Partnership That Works

If Barry and Valerie choose to put themselves in each others' shoes, they create a third planet called partnership. In this sphere there is no tug of war, but a blending and enriching of each of them. They forge a strong resource that both can tap into when challenged by fears and insecurities.

Valerie's Planet, Barry's Planet, and the Marriage Planet Orbit Together

A healthy partnership has three planets in orbit all the time, touching and moving away as necessary to keep the marital universe stable. Each partner operates from their unique sphere, coming together and overlapping in the third realm of marital union, where the two trajectories meet, exchange, cross fertilize and flourish.

Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Reuben's angry that he has to hide his anger

A barrage of customer complaints roused Reuben’s anger. It wasn’t his fault that the city was doing sidewalk repairs and making it difficult for people to enter his cafe for lunch. His anger got worse when his regulars didn’t pay attention to the signs he had put up to warn them of this inconvenience. Each customer had a few minutes of frustration , but he had to suffer entire days of it!

Reuben expresses his anger only in his fantasies

After the cafe closed at night Reuben would go over the complaints he had forced himself to sympathize with earlier. He retaliated in his imagination, telling the complainers that they were selfish, whining individuals who couldn’t tolerate anything out of the ordinary. He yelled at them in his fantasy, threw their meals in their faces, and hiked up their bills in an effort to feel powerful and in control. The fantasy could be called up anytime he needed to feel strong.

What family members did once, Reuben continued indefinitely in his psyche

It was a familiar experience, this rehashing and doing it over in his mind, going all the way back to his early childhood. As a child he would imagine hitting and wounding people who didn’t see his side of things. As an adult he had visions of cutting out his father’s tongue, stuffing his wife’s hurtful words down her throat, and muting his brother by taking out his voice box!

Wounding words from family members would repeat like a tape that looped over and over again, punishing him with their stinging insinuations. Each time the words replayed it was as if he were being wounded afresh. What family members did once, Reuben continued indefinitely in his inner world.

Reuben fears the consequences of his anger and decides to deal with his problem

Reuben’s business became just another place where he had to be prepared to ward off undeserved bullets and poisoned arrows. Fury and resentment prodded Reuben to be short, rude and hostile to staff and customers. When he saw that he hurt people with his angry and impatient demeanor, he became afraid that he would end up alone, hated and penniless. Reuben decided to take notice and he came to psychotherapy. He was about ready to burst anyway and had known for some time that it was becoming impossible to control.

Refocusing the angry lens makes Reuben feel fortunate and grateful

It was hard for Reuben to have a therapeutic comrade with whom he could look at and understand his experiences. He discovered that he expected people to be mean and hurtful and interpreted their communications in line with that view. The breakthrough came one day when he shared his experience of feeling angry and hurt when his father said “ we never see you and your family on Sundays!” What Reuben heard was a criticism and reprimand insinuating that Reuben and his family were not doing their duty and were bad people. In his therapeutic work he was awakened to other interpretations, such as

1.the possibility that his father missed him

2.that his father may be jealous of how self-contained Reuben’s family could be

3.that his father may be giving a compliment about Reuben’s dedication to his café on Sunday’s

4.that his father wanted to have the discipline that Reuben displayed towards work

Reuben uses his new perspective to build good relationships

Reuben found a whole new more comforting and inviting world when he re focused his lens from ‘hurtful’ intent to ‘benign or positive’ intent.

Reuben used his new perspective to advantage with his complaining customers. He put a big sign up in his window acknowledging and sharing in their frustration. Included in that message was an invitation to look at the benefits of the work being done on the sidewalk. The customers would have a beautiful patio dining area with greenery and fountains to enjoy. There would be areas for children and pets, all at no financial cost to the public or to Reuben. He described the benefits as a gift that would last for ever, if everyone could endure a few weeks of frustration and inconvenience.

Using anger positively gains Reuben four long term advantages

By refocusing his lens of anger Reuben:

A.Connected with others who were also angry.

Benefit Reuben made himself an equal rather than a victim.

B.Created a unifying purpose for staff and customers.

Benefit everyone’s anger shifted towards an expectation of a positive goal.

C.Promoted a sense of cohesiveness where everyone could express frustration.

Benefit shared experiences detoxify the anger, promoting safety and security during difficult times.

D.Opened up a pathway for others to see and hear him through a joint experience.

Benefit: negative and self-destructive anger was transformed into positive, liberating and connecting emotions which built strong bonds among all concerned.

  Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Hollow praise turned Paul's pride into an angry rage of betrayal

Paul’s heart filled with pride as his year end performance review glowed with positive and encouraging feedback. His heart sank to his boots when the expected raise didn’t materialize. The praise and recognition that made him feel validated turned into a silent, choking, disappointing rage of betrayal.

Shock and disbelief made Paul behave go through the day snapping at his colleagues, impatient with customers and dismissive with his wife and child when he got home. What was the point of all the overtime, taking on extra work, and covering for others? Why had he bothered to take classes and do exams to get certified at a level that enhanced the software company’s credibility and marketing potential?

Anger and disappointment makes Paul want to stop trying

Paul began to recall all the times his boss gave him signs that his efforts were being noticed and would be rewarded at the appropriate time. Was that a dream? Did he misread the signals? How could he be so easily fobbed off with a few sweet words?

Work became a burden. Paul lost all interest in his job and isolated himself from everyone else. If they treated him as if he were expendable, then that’s exactly what he would make himself – a mere cog in the wheel! His anger created a wall around him that no one could penetrate. If he wasn’t good enough to get the raise he believed he was promised then he wasn’t going to give them anymore of himself than he had to.

Fury at his boss made Paul a mean demanding husband

Paul took his bitter resentful protest out on his wife. Paul made her pay for the mistake of his boss, demanding that his wife read his mind, and do everything to make up for his disappointing experience at work. She refused to play the game and made Paul even madder. Now no one was giving him what he deserved and he was furious, frustrated, sad and afraid that he was never going to get what he was entitled to in any area of his life – no matter how much he did his part.

How Should Paul Use His Angry Energy?

Anger sets off a slew of physiological reactions in the body that prepare it to fight for survival. From stress hormones to increased blood flow in certain regions of the brain, anger acts as a fuel, providing the energy that motivates you to act in your own best interests. How you decide to use that energy determines whether you have a positive or negative outcome.

The energy produced by the rage at not getting his fair share of goodies motivated Paul to do something different. Instead of just using up his energy in the gym he decided to make sure he was never blindsided again. Isolated and left to stew in his own juices, he realized that no one was going to come to his rescue and cajole him back into relationships.

Paul used the potent energy of anger to stop feeling sorry for himself, be proactive and fight for himself. Instead of wishing and hoping in vain that his boss, his colleagues and wife would sympathize and make amends, he chose to work on using the massive amounts of energy he felt to empower himself.

Using anger as a positive source of empowerment

Once Paul put himself in the driving seat he began to understand that he had let his magical wishes interfere with his participation in life. Paul figured out that his assumptions about raises and promotions were just that – assumptions that he believed were identical to the thoughts of his boss – as if there were only one mind involved in this process. He learned that he has to check things out and correct false assumptions on both sides. He discovered that he has to be actively involved in ensuring his success. The overwhelming energy from anger when his hopes were shattered brought Paul to his senses.

Five ways for Paul to use angry energy to empower himself

1. Paul can use his anger as motivation to clearly express his wishes and expectations.

Benefit: taking his share of the responsibility for his future by reducing uncertainty.

2. He can ensure that he gets a clear idea of what rewards his boss has in mind at the outset, and negotiate on his own behalf.

Benefit: solid information that takes him away from victim hood to proactive mastery.

3. Paul can make sure his boss is aware of his achievements instead of hoping they will be noticed, and be devastated when they go unseen.

Benefit: certainty that his boss recognizes Paul’s value, with increased likelihood that he is compensated accordingly.

4. He can discuss reward options when he covers for his colleagues or does extra shifts, such as time off, alternating shifts, money etc.

Benefit exercising autonomy rewires the brain making it more likely that he will engage in using anger beneficially rather than as a downward spiral of protest and negativity.

5. Paul can ask for monthly and quarterly projections of tasks and decide whether the incentives to take part in extra work are worth it to him.

Benefit: taking an active part in the decision making process in advance makes the consequences more satisfying and frees him up to have a healthy and satisfying relationship with his wife.

Paul no longer waits to see whether people in his life will “see” how great he is and magically reward him. He makes sure he tells and shows them what he wants them to know, and what he expects from them. It took the energy of intense anger and frustration to motivate him into actively shaping his life for the better. The rewards are consistent, sustained and very fulfilling.

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  Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Careless Terry is Mortified

Terry couldn't get over himself. He had hit his neighbor's car while pulling into his driveway. He was mortified at this inexcusable mistake. How could he be so careless? He wasn't unusually tired, so why hadn't he been more alert?

If Only the Clock Could Be Turned Back!

The damage to the car was the least of Terry's worries. Shocked, he was unable to take in any words of comfort or reassurance from his wife. He was oblivious to the affectionate nuzzling of his dog, and the adoring smile of his two year old daughter. He replayed the scene in his head a million times. Each time he pressed the rewind button he rehearsed ways in which he could have avoided this disaster. If only the clock could be turned back.! But life wasn't that kind, and neither was Terry. He tortured himself for not paying attention and bringing shame on himself.

Terry Wants To Hide In Shame

Visions of being chewed out by his neighbor flooded his mind. He imagined being shunned when he walked his dog. Everyone would know what he had done, and think badly of him. How could he hold his head up around the apartment complex again? Choked with horror he couldn't eat dinner. He couldn't sleep either. As the next day approached, all he wanted to do was to numb his feelings and hide from the world.

Terry's Wife Becomes Impatient When Terry Shuts Her Out

The next day was a blur. Terry called in sick to work and didn't take calls from friends or family. He exiled himself from the world in a depressive funk. One day turned into five weeks – thirty five days of shutting himself off from everything except his self-recriminations. His wife at first sympathetic and understanding became impatient and irritated.

"What's up with you? You're not interested in our child anymore, you're mean to the dog, and you avoid me like the plague. It's intolerable. You won't talk to anyone or let me help you. I'm fed up with being shut off. I'm moving in with my mother."

The Worst Imaginable Scenario Is About to Happen

In a flash Terry's wheels started turning. The worst imaginable scenario was about to become a reality. He must be an ogre for his wife to threaten him with the one thing that mattered more than anything in the world- being a good dad. Terry felt powerless. His wife had all the cards and he had no bargaining chips.

Terry Recalls Being Made Fun Of

The hollow pit in his stomach growled as he recalled his father punishing him by taking him out of the school he loved when he missed getting chosen for the football team. At that moment he had felt like a moron that wasn't fit to be alive, never mind a part of his family. Terry tasted the bitter cruelty of kids taunting him as he relived that humiliating experience. He wanted to disappear then as much as he wanted to evaporate now.

Terry excelled himself in math at his new school. Gradually he won the respect of his teachers and class mates. He was nicknamed "super-math-man." Kids asked for his help with homework. This superman thing was quite something! It got him noticed, made him popular and gave him a reason to take up space. But the one thing it didn't do was get his father's attention. Terry's confidence was squashed by his father's mocking tone calling him a nerd.

The Old Familiar Battle Begins Again

Accidentally hitting his neighbor's car rolled out this old familiar battle. The battle to win approval by being superman. Losing concentration and hitting the car burst the superman bubble. All that was left was the reincarnation of the ridiculing remarks made by the brats at school, and his father's belittling comments.

Terry played both roles. He was Superman until he hit the car. At that moment he forfeited his right to be a husband, father, friend and colleague. Terry the brat took over, gloating at Superman's downfall. The brat was in his element, enjoying this moment of superiority, laughing as Superman became hu-man!

Terry's Desire To Be a Good Dad Rescues Him From Depression

Superman Terry's refusal to eat, take calls or be comforted was his way of going off to die having lost his battle. But Terry's daughter saved the day. His strong desire to be a good dad made him put the old battle back in it's box, and try a different playing field. He took the plunge and come to therapy with me.

He discovered Terry the gentle, sensitive, loving and smart human being, who could forgive and learn from his mistakes. The turning point came when he got accepted and cared for because he was human enough to make mistakes. Receiving compassion enabled him to put it on his menu. Now he takes calls and responds to his wife. Terry was glad he got depressed because it gave him the impetus to let go of the superman versus brat battle and sign the hu -man peace treaty.

  Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Road rage nearly causes Garret a heart attack

Just as he was about to turn right and head for home, a driver on his left zoomed in front of 35 year old Garret’s car and raced through the traffic lights. One moment he was smiling at the thought of telling his wife about his big sales deal, and the next he was stomping on the brakes to avoid a head on collision. He swore and cursed and made faces. He hit his steering wheel and shook his fists in the air. Road rage overcame him, sent his blood pressure sky high and stress hormones coursing through his blood stream. He chased the driver, blew his horn at him, and wove in and out of lanes to irritate the guy who had nearly caused him a heart attack.

Forgiveness would mean being a wimp and that’s not an option!

Garret found it hard to move on from the experience. He made abusive statements about the driver who cut him. His body became tense and stiff as if he was protecting himself from being taken off guard again. Garret got another attack of low back pain that always seemed to affect him when he was angry and unable to do anything about it. It reminded him of that feeling of outrage and helplessness when Astrid broke her promise by choosing her family over his for the big holiday celebrations. He had felt deeply betrayed and disregarded. He had never forgiven her disloyalty. He wasn’t going to let that happen again this year. He couldn’t allow himself to forgive and forget because that would be asking for more. He couldn’t let her think he was a soft touch, and allow himself to be treated like a second class citizen. She had to be reminded about the pain and suffering she caused him, so he could feel avenged. Forgiving would mean pardoning and that would make him a wimp.

Nothing eases Garret's chronic low back pain for several weeks

The back pain lasted a good three weeks, despite Garret’s visits to the chiropractor and the pain medication. It was persistent and interrupted his sleep. This attack felt a lot worse than the many others he had suffered all his adult life. Alcohol numbed his back pain for short periods and also relieved him of the churning feelings of bitter disappointment that people just trampled over his feelings. He resented the fact that they got ahead at his expense. He couldn’t forgive them for not considering the impact of their behavior on him.

How is Garret's refusal to forgive influencing his chronic low back pain?

Research has discovered several important links between chronic low back pain, anger and forgiveness. The most important findings are summarized below.

• Expressing anger lowers level of pain and increases recovery time.

In 2008 research at the Rosalind Franklin University School of Medicine revealed that among those who were frequent sufferers of chronic low back pain, those who didn’t express anger had the highest levels of pain, and the slowest recovery times.

• Comfort with forgiveness reduces pain, and distress

Studies published in 2005 by researchers at Duke University show that chronic low back pain sufferers who are comfortable with forgiveness have lower levels of pain, anger and psychological distress. Those that are not comfortable with forgiveness experience higher levels of pain, higher levels of psychological distress, unhappiness and a lower quality of life.

Those who experience frequent and intense road rage are less likely to forgive and are more prone to suffer from bouts of chronic low back pain.

• Muscle tension from anger strains the lower back inducing pain

Holding onto anger, hostility and resentment creates tension in the muscles, strains the lower back and results in low back pain. The repeated pattern of refusal to forgive over a long period of time creates a condition chronic of low back pain which is greater in intensity and lasts longer.

The role of forgiveness in easing pain and distress is significant. In 2005 neuropsychologists at the University of Arizona suggested that forgiveness breaks the pattern of fear and stress in the emotional brain. Less stress equals less muscle tension, less stress hormones, and therefore less intense lower back pain.

Forgiveness dampens the charged emotional brain that causes pain

Forgiveness comes from the logical brain which acts as a brake on the emotional brain from laying down yet another memory of pain and distress. Forgiveness helps lay down new and less traumatic memories, making recovery quicker and longer lasting.

Forgiving is not pardoning – it eases pain and boosts comforting relationships.

The biggest obstacle to forgiveness comes when it is confused with pardoning inexcusable behavior. Garret doesn’t have to approve, discount, or erase the irresponsible or disloyal actions of other drivers or his wife. What he can do for his personal health and psychological well-being is to:

1. Try to express his feelings to his wife, rather than hold it in. That release of tension will reduce the likelihood of lower back pain. Any back pain he does suffer will be less severe and he will recover faster.

2. Open up a dialogue so that they each step into each others shoes and empathize with one another. That will promote emotional intimacy and lessen the distress Garret feels. If he understands both sides he won’t feel as unseen and mistreated. He will be more inclined to forgive and calm his emotional brain. A less reactive emotional brain will in turn protect him from the agony of chronic low back pain.

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   Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Starting the day with fibromyalgia pain made Vera angry

Fibromyalgia made it hard for 46 year old Vera to get her legs out of bed in the morning. As she moved toward the bathroom and began her toilette the pangs of pain moved to her hands, head and neck. It brought tears to her eyes. It made her angry to think that Kurt hadn’t even thought of organizing things around the house to make life a little easier for her. Vera remembered the arguments about accompanying her on doctors appointments and got even more angry. But she never said anything to him. She turned her mind to the support group she would attend later that day, although it wasn’t successful in easing her physical discomfort.

Vera found it easier to focus on the fibromyalgia pain than her scary emotions

As she ate breakfast, flashbacks of her early family file flooded Vera’s vision. She relived the tension she used to feel coming home from school wondering if her parents would fight out loud or give each other the cold shoulder.  Her mother would take out her frustration on Vera the oldest and quietest of her kids. Her muscles tightened up as she recalled the fear of uncertainty and not knowing how to speak about her worries. It was the same thing now. She didn’t know how to talk about the anxiety of not being able to take care of herself. Vera had no words for the anger at her father for not making her mother happy, and at Kurt for being equally insensitive and uncaring. What she did have was body pain that ranged from dull aches to excruciating pain for which no specific organic cause had been found. Fibromyalgia was the diagnosis.  It came with fatigue, slowing down of actions and restricting her life. It was making Vera dependent on pain medication and on a husband who let her down, repeating the cycle of her childhood.

Stuffing her anger made Vera's fibromyalgia more acute and distressing

Vera’s struggles in talking about her anger and stress as a child and now as an adult make it more likely that her experience of pain when the fibromyalgia flares up will be more intense and debilitating. The European Journal of Pain, 2010 reported a study comparing female fibromyalgic sufferers who expressed versus those that repressed their anger. The greater the inhibition of anger the greater the experience of pain in women with fibromyalgia. Those who got angry and expressed it in the situation in which it was aroused experienced the least amount of pain.

No amount of positive thinking eased her excruciating  fibromyalgic pain

When compared to healthy women, those who avoid strong negative emotions like anger and let it fester unprocessed are more likely to suffer fibromyalgia. In addition focusing on positive emotions does not appear to be a sufficient buffer. According to a report in the 2008 Journal of Psychosomatic Research, it is the lack of processing of negative emotions that precipitates the cycle of pain in fibromyalgic sufferers irrespective of the amount or duration of positive thoughts. Vera wasn’t more sensitive than most women to negative emotions like anger, but she experienced them more often and never learned to express them in a healthy way. It compromised her neuroendocrine functioning, lowering her pain threshold both physically and psychologically, suggests a study on women with fibromyalgia published in Arthritis Care and Research, 2010.

Fibromyalgia is linked to chronic childhood stress and conflict with parents

Vera was typical of most adult women with fibromyalgia that have had stressful childhoods as reported by the Journal Stress and Health in 2009. Vera’s experience of verbal and emotional abuse from her mother, and the uncaring attitude of her father is another common thread in the life histories of women with fibromyalgia. Vera’s struggles with her mother and now her husband made her view life through a more negative lens. Conflict with parents and later with partners adds to the stress and contributes to the more negative perceptions of life by women with fibromyalgia  as indicated by the journal European Psychiatry in 2000.

Chronic childhood stress deregulates Vera’s neuroendocrine system making her more prone to fibromyalgia

Long term stress that is continuous and chronic affects the neuroendocrine system making it less effective over time. Vera’s childhood trauma created a permanent sense of uncertainty and unpredictability that impaired her ability to develop and use healthy stress management strategies. So with each new stress her neuroendocrine system got weaker and began functioning in an abnormal way. She lived in a constant state of stress such that her levels of stress hormone such as cortisol were elevated years after the stress of living with her parents was removed. Despite the struggle of living with a man who was argumentative and unsupportive, it was nothing compared to her previous stressful experiences. The early chronic experience of stress appears to exert a much larger influence in contributing to the pain of fibromyalgia than any current stressful life event, as a 2006 study reported in the journal Psychoneuroendocrinolgy.

Processing negative emotions can reduce the pain of Vera's fibromyalgia

Vera may not be able to change her history or her husband. But she can begin to process her emotions in her support group and supplement it with psychotherapy.  She can share her anger about her early life, as well as her fear of being helpless and alone in pain. She can take the pressure off her already overwhelmed neuroendocrine system by acknowledging, naming and expressing her feelings in the moment. A study in Arthritis Care and Research, 2010 suggests that Vera can expect between 50%-70% improvement in functioning and feel less pain if she does so.

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Copyright, Jeanette Raymond, Ph.D.

  Disclaimer: this article is for educational and informational purposes only. There is no liability on the part of Dr. Raymond for any reactions you have while reading it or implementing any of the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Raymond.

  Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Tinnitus is brought on by worry and fear  of disapproval

The thought of spending five hours at his parents’ anniversary party made Roger feel tired and anxious. That’s when the ringing in his ears started. It was barely noticeable while he was getting dressed, but the tinnitus became loud and jarring as he thought of having to endure the pointed questions, and being told what to do and how to do it.

He hated large gatherings which always made him feel on ‘show.’ He could hear the comments his mother would make about him going back to school to get an architecture degree. He rehearsed his fake smile and polite responses, while hurt and resentful inside.

Tinnitus is linked to not expressing feelings when emotionally distressed

Meeting up with neighbors and a couple of old family friends put Roger at ease for a short while. The tinnitus quieted down long enough for him to focus on the conversation and enjoy a joke or two. Other people joined his group and took over the conversation. He felt unsure of himself and afraid of looking like a fool. Roger’s discomfort made his tinnitus return. He felt dizzy and went out into the garden, trying to escape the hissing noise in his ears. But it persisted until he saw his nephews and nieces playing around the pool. He felt more comfortable in their company. The tinnitus abated as Roger’s comfort level returned to normal. He could say what he liked to the kids. They accepted him without question.

Tinnitus distracts Roger from fear of disapproval and rejection

At the dinner buffet Roger’s anxiety heightened. He saw his mother’s eyes on him, and got ordered around by his father to give an opinion. Put on the spot in that manner made him feel anxious and upset again. It was as if everyone was looking at him in a disparaging way. His body became tense and his jaw tightened. His heart started to race faster, he became sweaty and the tinnitus roared in his ears. Focusing on his physical discomfort took away the anger towards his parents. He excused himself by saying he wasn’t feeling well and went to his old bedroom.

The tinnitus was overwhelming. Putting his headphones on to listen to music on his ipod didn’t help. All he could hear was that scratchy high pitched rhythmic noise in his ears that made him want to destroy his hearing.

But alone again he felt safer. The tinnitus was by now familiar and predictable. Family and others were dangerous. They made him worry about getting hurt and rejected. He was always on guard and it was exhausting. He rarely had fun in the company of others. Life was much more tolerable and manageable when he was doing his architectural drawings and studying on the computer.

photograph copyright Jeanette Raymond, Ph.D.

Research shows that a Type D  or ‘distressed’ personality is linked to Tinnitus

Tinnitus is one of the most chronic Ear Nose and Throat (ENT) conditions experienced by between 10% -20% of people. It is experienced as a ringing in the ears in the absence of any external sounds. It can take the form of buzzing, whining, hissing, ticking or clicking sounds that can be very disorienting.

A study reported in the 2010 Journal of Psychosomatics found that compared to other Ear Nose and Throat patients, Tinnitus suffers had a greater likelihood of:

1. Type D personality – characterized by experiencing negative emotions for much of the time and not expressing them due to fear of disapproval and or rejection. This ‘distressed’ type of personality makes people lack self-assurance and reticent about speaking.

2. Having a negative outlook in life.

3. Having difficulty controlling and stabilizing their negative emotions like worry, irritability and gloom.

4. Being uncomfortable in social situations.

5. Being more introvert as opposed to extrovert.

How can Roger manage his tinnitus symptoms and enjoy life?

Roger is caught in a trap. He wants approval and acceptance so he can be more self-assured and confident. But he is fearful of disapproval and rejection if he dares speak his mind. The conflict is harmful to his health and quality of life. Tinnitus prevents him from being able to enjoy normal activities and reinforces his reluctance to participate in group gatherings.

Roger can help himself by:

•  Rehearsing the thought that his views are just as valuable as those of others.

•  Tuning into the evidence that people are listening and accepting him rather than only being in touch with past experiences of rejection.
  

• Ÿ         When he speaks up he will show his value and people will take him seriously.

Ÿ       

•   The more he speaks up rather than look for approval, the more confident and self-assured he will feel.

• Ÿ         Feeling good about himself will reduce the need for tinnitus to mask his fears and worries.

Copyright, Jeanette Raymond, Ph.D. 2010

 Disclaimer: this article is for educational and informational purposes only. There is no liability on the part of Dr. Raymond for any reactions you have while reading it or using any of the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Raymond.

  Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

 Rheumatoid arthritis disrupts Anita's career early in life

At the age of 44 Anita a fitness trainer and tennis coach was crushed by a diagnoses of Rheumatoid arthritis. She had always been the epitome of health and vitality. She watched her diet and weight and enjoyed her physically active life and career. Recently pain and stiffness in her fingers, wrists and knees was making it difficult for her to swing the tennis racket and get her clients bodies to work out effectively. She was getting tired more quickly, and finding herself fatigued even when she was at rest.

 Women are twice as likely to suffer from rheumatoid arthritis than men

Anita was scared. She had always done everything she put her mind to perfectly. She was efficient, well organized and thoughtful in managing her life. She had expected to slow down as she got older, but not this fast, and not this painfully. Unfortunately Anita joined the ranks of the 1.293 million adults aged 18 and older that have doctor diagnosed Rheumatoid arthritis in the United States. She is also among the women who are twice as likely as men to suffer from this disease, as reported by the Centers For Disease Control.

The pain of rheumatoid arthritis put Anita's focus mainly on her body

Fear and embarrassment kept Anita quiet. She was used to dealing with her problems herself and never felt the need to talk about her experiences with family or friends.  She researched her condition  and found out everything she could about it, including the bleak prognosis. Anita discovered that Rheumatoid Arthritis is an inflammatory process that develops from a faulty immune response, for which there is no cure. She constructed a strategy for herself involving supplements such as Glucosamine, fish oil and borage. She began the ‘arthritis diet’, high in fish and fresh fruits, while low in potatoes, eggplant, tomatoes and peppers. She added  specific exercises for her joints.

 Anita’s symptoms ebbed and flowed with each new change in diet and routine. But her general level of fatigue, pain and swelling hampered her work with clients. She became more self-conscious and less social as a result. Anita’s natural awareness and sensitivity to her body heightened to levels that made it difficult to focus and concentrate on anything else.

 Anita was a intelligent and conscientious person, self-sufficient and dedicated to her craft of body fitness. For Anita, a healthy body was the gateway to a healthy attitude, and balanced life. What Anita didn’t realize is that her emotional life also played a part in creating mind-body harmony.

The Mind-body connection in Rheumatoid Arthritis

A report in the Journal of Chronic Diseases as long ago as 1964 reviewed the research on personality among those with doctor diagnosed rheumatoid arthritis and found that sufferers tend to be self-sacrificing, masochistic, conforming, self-conscious, shy, inhibited, perfectionistic, and interested in sports and games.  The Journal of Psychosomatic Medicine confirmed these findings more recently, adding that when compared to their non arthritic siblings, rheumatoid arthritis patients were more nervous, restless, and sensitive to anger issues, making them more compliant and solitary.

 Rheumatoid arthritis sufferers are more sensitive to body sensations

Those with rheumatoid arthritis are acutely sensitive and aware of their bodies such that their focus is on physical sensations more often than not. “They have a heightened sense of reality that makes them more sensitive to bodily distress”, said one of the lead authors of a study reported in the Journal of Rheumatology in  2008.  This trait, known as ‘somatic absorption’ was persistent even when other factors such as disease severity, demographics, other illness and psychological distress were taken into account.

Disclosing emotions reduces markers of inflammation in the blood of Rheumatoid arthritis sufferers

The journal of Psychotherapy and Psychosomatics 2009, found that patients who took part in a study where they exchanged feelings and expressed their emotions had lower levels of inflammatory markers in their blood than those who kept their feelings to themselves.

Talking about your feelings has a huge benefit in most chronic diseases including those caused by compromised immune systems. Emotional restriction induces stress, and prolonged stress damages the effectiveness of your immune system. Expressing emotions and sharing feelings releases the body from dealing with the diseases linked to stress, such as auto-immune diseases like rheumatoid arthritis.

It may be difficult for Anita to open up and share her emotional life with friends and family. But taking that step can be the most important long term plan she can adopt. It will bring support that will ease the stress of perfectionism and shift the focus away from her body. Talking about her feelings and allowing others to understand and empathize with her, can boost her immune system, restore energy, and improve the quality of her life.

 Copyright, Jeanette Raymond, Ph.D. 2010

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 Disclaimer: this article is for informational and educational purposes only. There is no liability on the part of Dr. Raymond for any reactions you might have while reading the article or implementing the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Raymond.

Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Making The Same New Year's Resolution

Jim made a new years resolution to give up smoking for the umpteenth time. Last year it had worked for 3 months , until a bitter row with his best friend weakened his resolve. The familiar comfort of smoking saw him through many a lonely moment. Painful memories that were played over and over in his mind were dulled as he inhaled and let out sighs of smoke filled hurt and disappointment.

Water Tight Procedure – It Will Work

This time he was more determined to conquer the habit. This time he made contingency plans for dealing with temptations and ensuring that his iron will overcame any emotional calamity, no matter how dire. He joined a support group, devised rewards for not smoking, and extracted promises from his colleagues and friends to come down hard on him if they noticed any signs of lapsing. He got the nicotine gum and the patch to get his through the worst cravings. He would call his sponsor if he had a desire to smoke, go out for walks, go to the gym, meet with friends or start a new project that would distract him from thinking of smoking. Notes to himself were stuck all over his apartment, desk, and car. A recording of his own voice reminding him to be strong with lots of good affirming statements from his cell phone recorder greeted him each morning and repeated every couple of hours.

So Far So Good

He was good to go. The foolproof structure he had constructed supported him admirably. He glowed with success as he saved money, found new flavors exploding on his tongue, and jogged for a mile without getting out of breath. He was proud of himself, and so were his cheerleaders. He no longer had to worry whether a date would be put off by his smoky breath! In fact Jim found a great girl who joined him in sampling new cuisines, and walking off their hearty meals.

The Bombshell Drops

He celebrated his seventh month without smoking by booking a vacation with all the money he had saved. Then came the bombshell. He saw his girlfriend in a close embrace with another man at a café while he was out walking.

Life Came To a Halt

For a split second Jim's life came to a complete halt. His breath ceased, dizziness made him unsteady and there was a strange sound in his ears. The next thing he knew he was inhaling smoke from a cigarette held in his shaking hand. The smoke filled his lungs, and jolted his heart beat into frantic action. The tinny sound in his ears grew louder as he tried to deal with the scene he had stumbled upon.

The Resolute Jim Gets Wiped Out

The Jim of the last seven months had just been obliterated by the savage betrayal he had just witnessed. He felt as if she had been propelled into another world with no land legs, and no compass to find his way to safety. Some automatic part of him had rushed to the nearest store and bought a pack of cigarettes. Grasping the familiar white tube, lighting it, and inhaling it was like finding his way home. The rush of nicotine mobilized his survival instincts, uncorking his rage to fuel his fighting spirit.

Jim Plucks Up Courage To Figure Out Why It Failed

Jim was horrified that he had fallen off the wagon so easily. He realized that something more than just a lack of will was at play. He got up the courage to address his deeper issue in therapy with me.

Discovering The Hard Wiring

Smoking had brought a smile to his mother's face after long nights waiting for her husband who never came home. When his mother smoked she wasn't absent like his dad, but right there with her kids, being a loving parent.

Jim learned that smoking was an effective pick-me-up. He used it as his comfort food when his first girlfriend dumped him. Eventually it became his indispensable pacifier. The rhythmic actions of inhaling and exhaling let out all the tension. His brain and body recognized the nicotine and smoke as dollops of reassurance. They responded by reducing the unbearable emotions that betrayal created inside him. Support groups and sponsors helped with minor let downs, but were useless when the big betrayal hit. He was hard wired to use cigarettes to manage the tsunamis.

Jim Disconnects the Old Wiring and Kicks the Habit

Jim disconnected the wire from nicotine to relief. He made new connections allowing love and care to take the place of nicotine. It was hard work but he did it. The therapeutic dialogue created fresh new neural pathways in his brain. He got relief and comfort from people who were reliable, trustworthy and loving. Now hid chances of successfully sticking to his new year's resolution are excellent.

Anger and Stress Management Tips for Satisfying Relationships by Dr. Jeanette Raymond, Ph.D.

Mervin's Dream Betrays Him

The bidding war for Mervin's first musical score was through the roof. It was too good to be true. Hours before the contracts were to be signed the offers were dropped. It felt like an execution. Mervin gave away his guitar and burned all his original compositions. He started a new life in the food industry. He couldn't afford to nurture his talent if it betrayed him with such savage blows of disappointment. Mervin sealed the door to his musical skills, axed the desire to compose, and became a workaholic.

Mervin's Life Looks Like A Hollow Abyss

Two years later a severe respiratory infection turned Mervin's life upside down. He had to give up the buzz he got as restaurant manager, juggling staff shortages, customer complaints, temperamental chefs and advertising deadlines. The long term effects of stress compromised his immune system and made him sick. Without the adrenalin pumping, and the busy schedules to occupy his every waking moment, Mervin's life looked like a deep, dark, hollow abyss echoing words of condemnation.

Get Off Your Backside And Find a Job!

"You're a lazy waste of space, a loser just like your father predicted. You'll never make it. You ought to be ashamed of yourself lounging around watching movies, sleeping and eating. How can you even think of hanging out with your friends? You haven't worked in five months. You're acting like a spoiled brat who lost his favorite toy. Get off your backside and find a respectable job or else your family and friends will disown you, and you will deserve it."

Mervin Is Scared Out Of His Wits

Guilt spurred Mervin to beef up his resume and email it to acquaintances in the catering industry. Mervin interviewed with several companies, but his heart wasn't in it. He was off his game. Working for others to get up the conventional ladder held no appeal. Something else was brewing, that scared the living daylights out of him.

Mervin's Terrified Of Being Burned Again

Catchy tunes popped into his head, that stuck in his mind. Mervin found himself imagining new riffs and hooks for television shows that he liked. Terrified of being burned again, Mervin went into overdrive. He punished himself with sit ups to quiet the chords in his head. He re-decorated his house, cleaned out his garage and took on delivery jobs. Anything to keep those damn melodies from penetrating his fortress. He was out of luck. Musical conversations flowed through him, reminding him of his talent and longing to compose. They also brought back memories of the dropped contracts challenging him to make a choice.

Is Mervin's Passion A Pipe Dream?

Mervin was caught between a rock and a hard place. Should he take a risk and write melodies again, or should he play it safe and get a regular day job? His passion was to compose music and lyrics for movies and television shows. But what if he didn't make it? What if promises got broken again? What if no one liked his stuff anymore? What if he had missed the boat and had to face the hard facts of reality – that his passion was just a pipe dream?

Compromise Feels Like An Agent of Contamination

Taking a regular job would keep the dream alive and untainted. When life looked dreary he could call up the fantasy and imagine the thrill of hearing his music on movie sound tracks. No broken promises could mess with his fantasies. He could turn the volume up when he was sad, and turn it down when he felt good. It was the only safe way of hanging onto the purity of the precious dream. The idea of compromise felt like a contaminating agent that Mervin couldn't accept.

A Dose of Realism?

Mervin was tortured by his agonizing quandary. Together Mervin and I came to understand how painful it was to give up the image of his dream in pristine condition. As we explored his conflict he came to a crossroads. Was Mervin willing to let the dream come true even if it wasn;t exactly as he wanted it, or was he going to keep the dream safe, as an unsullied fantasy? He grew to realize that his wishes could come true, but he had to include a dose of realism into the mix.

Losing His Job Is A Blessing In Disguise

Adversity helped Mervin come down to earth without having to throw away his cherished dreams. He was able to bring the dreamer and the practical guy parts of himself to the table and hammer out a deal. Losing his job was the catalyst Mervin needed to develop some compromising muscles. He got a paid position that supported him in the short term, while he worked on his real passion. Getting his bills paid took the pressure off, and gave him freedom to compose unfettered by practical worries. Less stressed, he sold his compositions on favorable terms. Losing his job wasn't such a bad thing after all!

copyright, Jeanette Raymond, Ph.D. All rights reserved.

Disclaimer: this article is for informational and educational purposes only. There is no liability on the part of Dr. Raymond for any reactions you might have while reading the article or implementing the suggestions therein. Interacting with this material does not constitute a therapeutic relationship with Dr. Raymond.