Spur Counseling

Author: Miriam Iken Goodman, LICSW

  • Reflecting on Coronavirus Quarantine

    Feeling stuck inside during COVID19 quarantine
    A girl looking out her window wishing to go outside during Coronavirus crisis.

    Today marks 8 full weeks of quarantine; of social distancing; of working from home. Each week seems to have a personality. Week 1: A bit exciting! Week 2: Repetitive. Week 3: Smooth…. Week 6 seemed to hit hard, and week 7 felt a bit lighter. With each week, we get closer to the day where stores, restaurants and businesses open up again, while acknowledging the potential to be delayed yet again. 

    There are many unanswered questions that arise, including ‘when will this end’ and ‘when will I see my friends’ and ‘when will I hug my family?’ ‘When will they get married’ and ‘when do we get to travel again?’ With time, the answers will come; for now, we practice coping with the distress of the unknown, and finding new indoor hobbies.

    It is easy to get caught up in the discomfort and anxiety of the situation, and this makes it extra important to find gratitude whenever possible. We should not neglect the negative as it arises, the events missed and the connections strained, but we can make space for the positive aspects of this time.

    Things I am grateful for during Coronvirus

    I bring awareness to gratitude when noting the following:

    • Reading. Over the years my reading list has grown exponentially, and I finally have had the time to work through these books. I am taking advantage of this time, and the extra time without a commute, to focus on this list. Choosing books in which I am interested has helped me to have something to look forward to on most if not all days, as well as exercise my mind in a different way.
    • Video calls. In order to stay close to loved ones in a time of separation, I have used video calls for communication. I’ve been able to celebrate birthdays and play games with friends and family members through video. Though we discuss the events in the world, it has lessened when we have other activities to keep us occupied. This is an excellent way to challenge the feeling of isolation, and switch up the daily routine. One way to stay connected and feel less lonely is to seek a therapist through video call.
    • Family. Mother’s Day has typically been a day of praising my mom and being able to acknowledge all she does for her family. This year was no exception. I am grateful for pleasant weather and masks that made it possible to spend time with family.
    • Colleagues. Despite the challenges of working from home, I am grateful for a group of colleagues that collaborate as well as my team does. We all have different home environments with differing schedules, and we work together to accommodate each other’s needs in order to maintain a healthy work-life balance and accomplish all of our tasks.
    • Partner. On a typical day, my husband and I part ways early in the morning and reconvene later in the evening, as many couples do. Working from home has given us the opportunity to spend lunch together, take walks, and see each other’s work ethics. We’ve been able to give each other the space we need to work, while being in the same environment throughout the day. In a way, being together daily reminds me of our honeymoon, which is time we cherished together.

    Sooner or later, life will open up and return to a busy pace. I look forward to those times ahead, while realizing that I do appreciate aspects of the current climate, and try to stay mindful and present when finding gratitude.

  • Preparing for Passover during COVID-19 Crisis

    Preparing for Passover during COVID-19 Crisis

    Due to the coronavirus, we have all spent the last month adjusting to a new (temporary) normal of staying indoors, refraining from socializing, and taking extra precautions for sanitation. Couples are postponing their weddings, and parents are learning to homeschool their children. Trips are being canceled, and all meals are being eaten at home. Although the days are passing and blending together, people that celebrate the Jewish holidays may be aware that Passover will begin this week. 

    Passover is a Jewish holiday that begins on the 15th of the Hebrew month of Nisan, this year coinciding with Wednesday, April 8th at sundown. The story of Passover is found in the book of Exodus, and describes the Israelites escape from slavery in ancient Egypt. The story explains that God inflicted 10 plagues onto the Egyptian people under the Pharoah’s rule, and when the last plague (the death of the Egyptian first-born) occurred, Pharoah agreed to let the Israelites go and be free. Israelites were instructed to mark their homes so that their children would be saved, and their homes would be “passed over,” therefore giving the holiday it’s name, Passover. Jewish people all around the world will celebrate by having a seder (which means “order”, since the story of the holiday is told in a specific order) on the first (and second) night of Passover.

    Notably, this holiday requires a restriction on certain types of food. The story of Passover explains that once Pharoah agreed to let the Israelites go, they did not have much time to prepare for their departure. Due to their rush, their bread did not have enough time to rise. The interpretation is celebrated in modern times as not having food and beverages that contain leavened bread and yeast. For those observing Passover, there is an intense preparation period, where the house gets cleansed from all of the forbidden foods, which are replaced with Kosher for Passover food. For anyone, it is a challenge to change your diet for 8 days when you are accustomed to eating popular and delicious foods regularly, such as bagels, bread and pizza. For those with an active eating disorder, or a history of an eating disorder, the challenge increases.

    Many Jewish holidays and traditions have a strong food component to them, whether it is latkes (potato pancakes) and sufganiyot (jelly doughnuts) on Chanukah, challah and matzo ball soup on Shabbat (weekly Holy Sabbath), or a big feast after Yom Kippur concludes. On Passover, there is typically a festive dinner that commences the holidays. For someone who is constantly thinking about food and weight, these holidays can be triggers for emotional escalation and maladaptive behavior use. The limited food options and focus around food can be reminders of restricting food intake and over-eating. 

    On a typical Passover, people are able to leave their homes to engage in a normal routine. Why is this Passover different from all over Passovers? This year, we are staying indoors, working from home, and refraining from outdoor activities. This can be challenging for someone with a history of an eating disorder, due to the increased isolation and focus on foods. If you or a loved one can relate to this, here are some helpful reminders in staying hopeful this Passover season.

    1. You may be isolating, but you are not alone in this. The prevalence of eating disorders is on the rise, and they do not discrimiate based on race, gender, sex, ethniciity or otherwise. There are virtual support groups nearly every day of the week where you can connect to other people with similar struggles, as well as professionals for additional support. Refer to the NEDA website for information.
    2. Your support system is there for you. Communicate with your loved ones – tell them how they can support you. Communicate with your providers – be honest about how you are feeling. Communicate with yourself – listen to what your body and mind need. 
    3. You can engage in self-care from home everyday. Due to the current limitations, we may have to get creative about how to relax in the confines of your neighborhood. Choose a show to watch and a book to read; take walks while listening to music; play a board game or a card game.
    4. You do not have to follow the guidelines of Passover if it is a matter of life and death. When it comes down to it, health comes first. If following the Passover food restrictions has the possibility of bringing back eating disorder behaviors, I encourage you not to follow the traditional rules.
    5. This too shall pass. Emotions come and emotions go. Passover will start and Passover will end. We are sheltered at home now, and that will conclude as well. Try to stay present each day. You have had challenging days that you made it through, and you can get through this storm too.

  • Body Image Advice for Springtime

    Body Image Advice for Springtime

    Now that Daylight Savings has passed, we are officially ‘springing ahead’ to spring. While many people look forward to wearing jean jackets and flowy dresses, people with body image issues may be hesitant to ditch their winter jackets and gloves. Those who suffer with eating disorders (or struggle with body image) may be thinking less about the increased light, and more about their wardrobes and bodies. 

    A common side effect of having an eating disorder is poor body image, and some people will experience body dysmorphia (hyperfocusing on the “flaws” of one’s own body, and often seeing a different image of one’s body than others see). With the inevitable changing of the seasons, thoughts about wearing less clothing and showing more skin can increase the prevalence of anxiety and depression.

    If you’re struggling with thoughts of warmer weather, consider these tips for the seasonal adjustment:

    DO NOT

    • DO NOT Compare your body to anyone else’s body, or “your old body”… Your body is your own, and it naturally changes with time. Comparisons generally lead to negative thoughts!
    • DO NOT spend too much time looking in the mirror… The more time you look at yourself, the more likely you are to find details that bother you. Limit your time in front of the mirror to the essentials, like brushing your teeth, hair, and other basic needs. Staring at your body will not change your body! 
    • DO NOT implement food rules and weight loss goals… This can lead to feelings of failure and self-deprecation. Ie: if your goal is to “not have any chocolate this week,” how will you feel if you have a piece of chocolate?
    • DO NOT neglect your activities of daily living… Go to your appointments, talk to your support systems, engage in self-care, take mindfulness breaks, or seek the help of a counselor.

    DO

    • DO wear clothing that makes you feel comfortable.
    • DO talk about things other than dieting… There is so much more in the world to talk about that does not have to do with food and weight.
    • DO make plans that do not include food… For example, you could go to a museum, a parks, or a show. Naturally, in the warmer weather, there are ample options of outside activities. If going to a restaurant is triggering and anxiety-producing, know your (temporary) limits; this too shall pass.
    • DO the opposite… If you feel like avoiding a beach trip with your friends, go! If you feel like skipping dinner, have dinner! It can be challenging to push through the initial anxiety, but the end result will give you confidence that you are capable of engaging in your life, even when you have thoughts telling you otherwise.
    • DO reflect on your personal growth since last spring… and, disregard the number on the scale. What have you accomplished in the past year that did NOT have to do with your weight and shape?

  • 10 Signs of Depression

    Wondering whether you have signs of depression? It may be tough to tell if the symptoms you are feeling are signs of depression or a different medical issue.  One of the reasons depressions signs are not well known is due to the stigma in discussing depression.  Further, symptoms of depression can look very different in men and women.

    Unlike some medical diagnoses, depression symptoms are not always explicit and a doctor or therapist needs to look at the totality of signs to make a diagnosis.  Could you be depressed without know it?  Below are 10 signs of depression

    Weight Changes

    Depression can cause a loss of interest in eating or a loss of appetite.  On the flip side, it can also result in overeating or bingeing food.  If you notice a change in your eating habits, this could be a symptom of depression.

    Sleep Changes

    Are you sleeping more than 8 hours a day or unable to fall asleep at night?  Changes in typical sleep patterns can be related to depression.  These changes may swing from side to side and are worth monitoring. Either symptom may be accompanied by waking up consistently in the middle of the night.

    Difficulty Focusing

    You may find yourself having difficulty concentrating at work or focusing on a specific task. If you always have this issue, it can be hard to tell that this is connected with depression.  But, if this is a change from the norm for you, make sure to tell your doctor about it.

    Body Pains

    Body aches and pains can be symptoms of many issues.  For that reason, it is often missed as a sign of depression. Because of the stigma of depression, many people are unaware that physical pains may be a symptom of depression. Stomach aches, decreased immune ability, and other physical symptoms can result from a depressive episode.

    Anger and Irritability

    This one is especially prevalent in men.  Feeling like little things set you off could be a sign of depression turned inward. If you cannot let things go like you used to, you may be feeling the effects of depression.

    Increased Drinking or Drug Use

    Use of alcohol or substances is a common method of numbing the pain associated with depression. People suffering from depression often use these substances to mask the pain of their emotions.  If you notice an increase in your use of drugs or alcohol, consider whether depression may be present.

    Desire to Stay Home

    Not interested in going out like you used to be?  Feeling like you just want to stay in bed all day and watch Netflix? A change in your desire to interact with others may be depression.

    Changes in Sex Drive

    Not as interested in sex as you used to be? Depression can lower or completely eliminate your sex drive.  This lack of desire can create a positive feedback loop that increases your feelings of sadness or worthlessness. In addition, a dip in your sexual desire could affect your partner and feed into your depression.

    Over- or Undereating

    Like the other depression signs, a change in eating behavior can swing in either direction.  If you are eating too much or bingeing, this could be a sign of depression.  Similarly, a loss in appetite or an inability to eat can signal depression.

    Thoughts of Suicide

    The most important sign to pay attention to are suicidal ideation.  If you have thoughts of ending your life or feelings that things would be better off if you died, it is important that you immediately seek professional help. Suicidal thoughts are the most serious sign of depression and should be treated seriously.  Depression like other medical ailments can be treated!

    As noted in a recent PhillyVoice article, Google has made a screening tool available in its search results when a mobile user searches for a term like “clinical depression.” If these signs seem familiar to you, you should conduct a screening test or be assessed by a physician or mental health counselor.

  • Six Tips for Overcoming Perfectionism

    If you are reading this, you may be someone who wishes they could overcome perfectionism. Overcoming реrfесtіоnіѕm isn’t juѕt about ассерtіng that you’ll nеvеr bе perfect. It’ѕ аbоut embracing your іmреrfесtіоn, flаwѕ, wеаknеѕѕеѕ! The things you may consider flaws are actually what mаkеs уоu unique аnd, ironically, mоrе lоvаblе.

    The strive for реrfесtіоnіѕm often lіmіtѕ your ѕuссеѕѕ аnd hарріnеѕѕ and stymies creativity. Evеn when іt doesn’t, іt can ѕtор уоu frоm аррrесіаtіng the things you have асhіеvеd in life.

    A growth mindset requires you to ассерt fаіlurе аѕ part оf lіfе, and enjoy the process іnѕtеаd of only fосuѕіng on асhіеvіng уоur gоаlѕ and rеасhіng your dеѕtіnаtіоn. Perfectionism creates ѕtrеѕѕ аnd anxiety; self-acceptance leads tо hарріnеѕѕ аnd реасе.

    Perfectionists оftеn procrastinate, bесаuѕе they are afraid they wоn’t dо a perfect jоb on a task. Thеу would rather fаll bасk оn thе еxсuѕе of “oh, I only hаd twо hours tо dо this, ѕо іt’ѕ nоt thаt gооd” іnѕtеаd of trуіng hаrd аnd potentially fаіlіng.

    As a result, pеrfесtіоnіѕtѕ ѕеt themselves uр fоr emotional аnd mеntаl health рrоblеmѕ such as еаtіng dіѕоrdеrѕ and аnxіеtу аttасkѕ. Thеу dоn’t еnjоу their ѕuссеѕѕ….аnd thеу constantly lіvе іn fеаr.

    Bаlаnсе high hореѕ wіth harsh rеаlіtу

    Pеrfесtіоnіѕtѕ hаvе еxресtаtіоnѕ аnd gоаlѕ thаt simply саnnot bе met! Tо overcome perfectionism, уоu nееd tо bаlаnсе grеаt expectations wіth rеаlіtу. Accept that уоur lіmіtѕ – аnd оthеr реорlе’ѕ lіmіtѕ – are rеаl. Yоu simply саnnot ever be perfect. Sorry!

    Prасtісе bеіng іmреrfесt

    Thе bеѕt wау to ѕtор trying tо bе реrfесt іѕ tо lеt уоurѕеlf (аnd оthеrѕ) release іmреrfесt work tо thе world. Bе imperfect in уоur parenting, your profession, and your rеlаtіоnѕhірѕ with others. Thе more you рrасtісе being іmреrfесt, thе mоrе соmfоrtаblе you’ll be with іt! When you are attempting to overcome perfectionism, practice makes (im)perfect!

    Savor ѕаtіѕfасtіоn fоr what уоu’vе асhіеvеd

    Lеаrn tо аррrесіаtе аnd hоnоr уоur еffоrt, thе process, аnd your ассоmрlіѕhmеntѕ. Thе bіg рісturе mаttеrѕ more thаn the tіnу dеtаіlѕ: the fасt that you’re hоѕtіng a dіnnеr раrtу mеаnѕ more thаn whеthеr the dishes match, аnd the fact that you fіnіѕhеd the rероrt at work mаttеrѕ mоrе thаn a few grаmmаtісаl еrrоrѕ. Start to practice daily gratitude for the small successes.

    Express уоur emotions!

    Tо overcome perfectionism, you must lеаrn tо ассерt уоur painful еmоtіоnѕ (rеgrеt, dіѕарроіntmеnt, worry) – but you do not need to dwell in thеm. If your thoughts of imperfection are running on repeat in your head, get them onto paper or record them on your computer.  The process of verbalizing these thoughts will force you to look at them differently.

    Take action tоwаrdѕ уоur gоаlѕ to overcome perfectionism

    Whаt have you always wаntеd to do, but never tried because уоu wеrе аfrаіd of fаіlіng? Try іt now! Audition for a play, do improv comedy, ѕеnd a resume fоr a jоb, or аѕk ѕоmеоnе оn a dаtе. CEOs in Silicon Valley often look at failure as a badge of honor. Adopt this mindset.

    Figure оut why уоu ѕtrіvе to be реrfесt

    I had a client that always wanted tо bе реrсеіvеd as perfect because she grew up thinking thаt оnlу реrfесt people аrе lоvеd. This slanted thinking can lead to a negative life view. These issues often stem from your family of origin or other anxiety in your others systems.  Seeing a therapist can help you analyze what makes you strive to be perfect all the time.