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James J. De Santis, Ph.D.
138 N. Brand Blvd., Ste. 300, Glendale, CA 91203
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May 2020

Coping with Isolation During a Quarantine

Many people are struggling with the stress of isolation during the COVID-19
quarantine. Here are number of practical suggestions for managing with
isolation.

Structure

Create structure and routine. Keep to a schedule.
Go to bed and wake up at the same time each day.
Plan your day the night before.
Set small goals. What are three things you will accomplish today?
Put your work away after regular office hours.
Spring clean your home or garage. Organize your belongings.

Rest, Exercise, and Nutrition

Eat well-balanced, nutritious food. Drink plenty of fluids.
Find a new recipe and cook or bake.
Treat yourself, but don't overindulge.
Get a good amount of sleep.
Avoid alcohol and recreational drugs.
Get time outdoors. Get sunshine.
Move your body. Get exercise. Take walks.
Live stream an exercise class.
Practice relaxation or mindfulness with guided instruction on the internet.

Limit Media Consumption

Take a break from your computer and your house.
Set a limit or take breaks from your news-feed, television, and social media.
Only consult trusted news sources.
Pay attention to upbeat news.

Social Activity

Physical isolation doesn't mean you must also emotionally isolate.
Get social interaction through video conference platforms.
Reach out to friends and family as a regular check-in.
Talk to people you trust about your feelings.
Create a video happy hour or dinner date.
Play games with others over video, like charades or password.
If you quarantine with others, spend time talking.
If you quarantine with children, talk and listen.
If you quarantine with others, play a board game, dance, sing.
Be kind to other people around you.

Creative Pursuits

Do something creative: journal, paint, craft, play an instrument, dance.
Create a gratitude list. Add to it once a day.
Listen to music. Read a good book. Listen to a good audio book.
Learn a new hobby or skill. Scrapbook. Learn about a new subject.
Start a project you have been putting off.
Plan something for the future.

Psychological Support

Label and validate what you're feeling.
Avoid judging or criticizing yourself, especially if you are feeling guilt.
Realize that you are not alone.
Remember that this quarantine is temporary.
Remember why you are staying home.
Remember that quarantine is for the greater good to help others.
Give yourself a pat on the back for helping society.
Talk to a therapist in a virtual session.

April 2020

Redefining the Meaning of Sick Days To Include Students

A "mental health day" is defined as a day that an employee takes off from
work in order to relieve stress or renew vitality. Although this definition
covers those within the workforce, there is an increasing use of the phrase in
schools. Students are just as stressed as those who are apart of the labor
force, and many require similar days in order to feel as though they are able
to continue with their education in a constructive manner. The one difference
between someone with a job and a student is a set district policy on
absences, as students are required to attend classes by law.

School districts track absences in order to note truancy and patterns of
nonattendance, and most require a viable reason for missing classes. Mental
health does not traditionally fall into that category. It seems as though the
current movement is to integrate mental health days into a student's arsenal
of district approved absences, and many are responding to this sentiment. In
the state of Florida, legislation is being passed that allows a mental health
day to be considered a viable reason to miss school. House Bill 315 notes
that systems are in place across school districts nationwide in order to track
a lack of attendance as this has been linked to poor academic performance,
but also works to allow up to one mental health day per semester as an
official excused absence. This bill, and many others like it that are being
formed in Utah, Oregon, Virginia, and New York, puts the mental health of
students at the forefront, acknowledging the need for these types of
absences in this day and age.

Many young people are struggling with the effects of anxiety and depression,
and many come to a point during the school year where a day off would be
extremely helpful for their mental health. Until this point, absences recorded
without verification from a doctor or a similar type of note went as
unexcused, harming the student's ability to perform well in their classes due
to a lack of allowances for unexcused absences in regard to missed
schoolwork. Bills such as the one being developed in Florida discern the
difference between mental exhaustion (due to the effects of conditions like
anxiety and depression) and truancy, while opening a dialogue between
districts and students to form and utilise mental health resources.

Seeing as mental health days are being worked into legislation, it appears
that districts are working to expand the meaning of "sick" to include mental
health, but this legislation cannot stand with just students and schools at
the helm. Mental health professionals must advocate for mental health days
because they will provide tangible and accredited support to the movement.
The National Alliance on Mental Illness has already worked to provide this sort
of support by developing an online resource for parents in the form of a free,
six session education guide, but so much more could be done by an entire
network of professionals across the country who have the ethos to make a
real difference in the ways that schools and states respond to a student's
need for mental health days.

Links:

https://www.yahoo.com/lifestyle/schools-nationwide-are-offering-mental-he
alth-days-to-addressgrowing- issues-among-teens-185153235.html

https://myfloridahouse.gov/Sections/Documents/loaddoc.aspx?FileName=_h0
315__.docx&DocumentType=Bill&BillNumber=0315&Session=2020

https://publiccourseapi.nami.org/Learner/Login?ReturnUrl=%2F

March 2020

Children of Alcoholics, From Childhood to Adulthood

It can be seen that no fully pleasant mental state ever truly drives anyone to
alcohol. The joys of inebriation can only take someone so far, and when
these joys turn to problematic behaviors outside of the usual drunken mishap
is when some irreparable damage is done. Some people take the consumption
of alcohol too far into a territory where stopping this behavior seems like an
illogical and unbearable feat, and that is when the repercussions of such a
behavior begin to affect more than just the person who drinks.

There is much to be said of the effects of alcoholism on the children of
alcoholics, specifically the ways that living that life manifest in adulthood,
and there is an existing trend of the children of alcoholics allowing for old pain
to be transported to new relationships and experiences that robs them of a
full life in the same way alcohol did to their parents. The interpersonal effects
of being the child of an alcoholic are numerous, as those relationships can
lead these children to difficulty recognizing their own needs, a maintenance
of inappropriate balances in their relationships with others, and life in a space
and cycle of insecure attachment patterns. Such patterns include:

Avoidance of intimacy or emotional closeness/connection
Difficulty or being unable to share vulnerable thoughts and feelings
Limited or lack of emotional response to others
Limited or lack of empathetic response
Neediness along with emotional distance
Overly critical
Excessively rigid and perfectionistic
Intolerant of uncertainty or changes in the environment
Chronic anxiety and sense of insecurity
Feelings of helplessness
Feelings of excessive guilt
Controlling towards others
Excessively blames others
Erratic, impulsive, and unpredictable
Superficially charming or engaging
Insensitive
Abusive

Links:

https://www.mentalhelp.net/parenting/what-happens-to-children-of-alcoholi
c-parents/

February 2020

Dopamine Fasting

The culture of Silicon Valley comes up with self-improvement fads frequently
in order to boost productivity and efficiency, the most recent being
"dopamine fasting." These tech innovators participate in dopamine
fasting--avoiding stimulants like social media, tech, and even food--as a way
to counteract what they perceive as overstimulation by "quick hits" of
dopamine. It seems that they find the exact things they abstain from more
enjoyable and engaging after a fast, and many have noted that dopamine
fasting helps them to curb the suppression of negative emotions and
rebalance their high stress jobs and lives. This then allows for engagement in
other, healthier behaviors.

While participation in such a fad may have personal benefits for each
individual, the science behind this activity is anything but concrete.
Dopamine is a compound present in the body as a neurotransmitter, and
many brain networks rely on this compound in order to function properly.
According to the Incahn School of Medicine at Mount Sinai, dopamine is
required for the proper function of the mesolimbic reward pathway, which is a
dopaminergic pathway that releases dopamine into the nucleus accumbens.
Each of these plays a significant role in the reward circuit, as the nucleus
accumbens' proper modes of operation rely heavily on dopamine in order to
promote desire. The interruption of this process through dopamine fasting has
yet to be classified as a functional practice, since dopamine does not have
as straightforward a relationship to happiness or pleasure as many who fast
from it assume.

Dopamine fasting has not be subject to a controlled study, and many
professionals have noted that participants in this fad have oversimplified the
role of dopamine in the brain. Dopamine levels cannot be lowered, but it also
seems as though this is not the intention of the fast. Instead, dopamine
fasting can be classified as more of a stimulation fast that works to temper
the consumption of addictive substances. It is almost as though a dopamine
fast is a form of social media and tech detox more so than it is a complete
disconnect from dopamine, allowing the brain's receptors to calm down and
reset its reward system. Seeing as there is no tangible evidence that a
dopamine fast (as defined by those in Silicon Valley) works as assumed, it is
important to rework its definition due to the credulous nature of certain
people who may look to these innovators as tenable sources.

There is much to be said about the ways in which those on the cutting edge
of technological development have garnered interest in their wellness
initiatives by those outside of Silicon Valley, and mental health professionals
definitely have a place in this conversation. If the true intention of dopamine
fasting is to overcome certain problematic or addictive behaviors, then there
is work to be done in employing cognitive behavioral therapy to help those
who believe in dopamine fasting to address the roots of their addictive
behaviors.

It is obviously not healthy or realistic to completely cut oneself off from
pleasurable experiences through the transmission of dopamine, but many
either do not know this or do not care to know. The practice may continue,
and it is important that mental health professionals are aware of its existence
so that they can combat the assumptions made about its effectiveness and
provide credible methods of therapy for patients who may view fasting from
dopamine as a viable option in their search to mitigate certain addictive
behaviors in favor of a more balanced life.

Links:

https://www.livescience.com/is-there-science-behind-dopamine-fasting-tren
d.html

https://www.bbc.com/worklife/article/20191115-what-is-dopamine-fasting

January 2020

Are You Addicted to Suffering?

No one wants to suffer. At the end of the day, people are most concerned
with being happy and healthy, but sometimes our own patterns of behavior
can get the best of us, and we find ourselves repeating cycles in order to
confirm our own stories and truths. There are certain systems in place that
work to help people support their own stories, and even negative emotions
like suffering find ways to repeat themselves through these systems.

You may find yourself participating in self destructive behaviors that allow
you to continue to help yourself feel the emotions that make you unhappy,
and this is sometimes because these feelings are all you know. Being
comfortable is equated with being happy, and if that comfort rests on the
back of suffering, then you may be susceptible to feelings that are not
particularly desirable or constructive. When you spend your time searching
for reasons to suffer, you simultaneously harm relationships that you have
with others and the one that you have with yourself through unhealthy
coping mechanisms. If you find that you are struggling to find resilience from
certain circumstances, that you are enslaved by your emotions, or that you
are powerless to change, you may be addicted to suffering.

To come out on the other side of this addictive behavior, you have to sit
down and ask yourself:

Who are you without this chaos?
Are you loyal to past truths that created your story?
Do you have a pattern in your life of struggling?

Of course, a simple series of questions are not going to fix this kind of
emotional addiction, but it is worth wondering if your loyalties lie in the wrong
places. The first step is to create a new way of living that both donors your
past experiences and allows evolution from that past and the version of
yourself that it created.

Links:

https://www.huffpost.com/entry/are-you-addicted-to-suffe_b_9744416

December 2019

The People Pleasing Instinct

People pleasing can initially seem like an admirable trait. Presumably, the
desire to please those around you comes from a place of care and respect,
but what is often forgotten is that sometimes this inherent need to please
can also stop you from receiving. Receiving in the same way is not selfish,
but equitable, and when you are so focused on pleasing those around you,
you often forget to do the same for yourself. This pattern of behaviour is
pervaded with problems for not only the person who feels they must please
everyone but also those that they are trying to please. This could manifest in
future interactions where the people-pleaser feels as though they have no
other recourse than to succumb to what they perceive to be the
expectations of others, resulting in the harboring of resentment and, at
times, self hatred. Expressing your authentic needs and expectations as a
people pleaser is difficult. You may tend to put on a facade when introduced
to situations where, if you were to say no or not execute, you may begin to
feel the recessive effects of a life spent terrified of a lack of acceptance.

Alexandra D’amour, blog writer for On Our Moon, put it best when she said
that “people pleasers often start off as parent pleasers.” There is an origin
story to all human behaviours, and many rest in childhood during the early
stages of development. When the safest space you have seems to be
crashing and burning, it is possible for the child to place the weight of solving
the problem on their shoulders. In environments like this, it is really easy for a
child to become small, default to whatever makes a parent happiest, and try
to stay under the radar. The child adapts to finding ways to take on their
parent’s emotional regulation, and this sort of damage control can become a
lifestyle. Questions to ask yourself as you identify your people pleasing
instincts are:

1. What do you do in the current moment to betray yourself when the results
of your decisions ask you to?
2. Who/what function does this serve?
3. What role did you take on in your family unit to keep order for yourself and
others?
4. What have you taken with you?
5. How does it adversely affect you?

There is a way to be amiable without pleasing everyone. Although it is easier
said than done, the first step is recognising that you are unhappy with these
interactions, finding their origin story, and noting where you could best
please yourself.

Links:

https://www.theschooloflife.com/thebookoflife/people-pleasing-and-how-to-
overcome-it/

https://onourmoon.com/about/

November 2019

How to Feel Comfortable Drawing Boundaries

It is important to recognise that everyone has their personal limits, including
yourself. These limits can be translated into boundaries, and setting these
requires practice. Perpetuity is important here, although it is also key to
remember that a large part defining your relationships on your terms rests in
discussion. It is very easy to mistake boundaries for distance, and effective
communication makes all the difference. I have found that, at least in the
initial efforts, there is solace to be obtained in the act of eliminating those
facets of life that cross your boundaries. Completely cutting someone or
something off can be freeing, but it ultimately doesn’t last. These behaviors
are bound to be repeated in the same relationships or entirely different ones
as long as boundaries stay miscommunicated. These things are typically
sempiternal without some real intervention on your part.

As far as feeling comfortable engaging in the act of drawing boundaries goes,
there are some crucial things to remember. The first is that these lines you
draw are not permanent. You are allowed to change, and so are your
boundaries. If something that made you uncomfortable before no longer has
that same effect on you, then it is more than fine edit your own decisions.
That is another thing — boundaries are decisions, and every decision has
some sort of chain reaction. To draw a boundary is to take even a small bit
of personal responsibility for your life, and that is something to be celebrated.
Not everyone will agree with you or like your decision, especially if it
interferes with the way that they engage with you, but this practice is
ultimately bound to garner nothing but respect from those who actually
deserve to be in your life and have your energy used on them. The final thing
to remember is that there are many kinds of boundaries to be set, whether
they be mental, physical, emotional, material, or time and energy based. If
you can identify what is important to you, the next step is to voice your
concerns with those who may be crossing these lines and hope that they can
be receptive. Failure to set boundaries and hold people accountable can
result in feelings of being used and mistreated, and no one deserves to have
that be the case.

Links:

https://positivepsychology.com/great-self-care-setting-healthy-boundaries/

https://blogs.psychcentral.com/imperfect/2016/07/how-to-deal-with-people-
who-repeatedly-violateyour-boundaries/

October 2019

Considering Your Own Emotional Reactivity

The state of being reactive can be characterized by thoughts or execution of
acting in response to a situation as opposed to controlling it. It is a cogent
indicator that a boundary has been crossed, and it’s possible to be reactive
to situations involving you with you or you with someone else. In any case,
reactivity begs attention from yourself to your internal system of processing
information and situations. There is some real introspection that comes with
the ability to be reactive, and paying attention to your patterns in the way
that you handle uncomfortable situations is key.

In considering your reactivity, there are some questions to ask yourself that
may lead you to understand and bring awareness to your reactivity. Marriage
and family therapist Vienna Pharaon (@mindfulmft) posted these on her
Instagram page:

What story am I telling myself about what just happened?
Why is this familiar? When else and with whom have I experienced this
sensation before?
How was reactivity dealt within my family system?
What boundary of mine got crossed?
Where do I feel this in my body?
What do I need to own or claim about my reactivity to move forward and
learn from it?
Do I want to share this with someone?

Overall, being in a reactive state is something that causes emotions to come
forward with such intensity that it can result in victimization and/or
uncontrollable reactions. Repressed emotions can inform you of their
existence in this state, and that is ultimately where you may fall victim to
your emotional reactivity. Taking a look at these questions, it is worth asking
yourself about the origins of your feelings and what eventually led you to the
point where you felt recalcitrant to your normal modes of behavior. Our old
patterns become near obsolete as we mature, and to stand in the truth of
your emotional reality is the only way to move forward while still maintaining
personal growth. There is no shame in reactivity, only in repeatedly allowing
your unconscious pain to overshadow your ability to speak from the present
moment.

Links:

https://www.desert-alchemy.com/article/reactivity/

https://www.instagram.com/mindfulmft/?hl=en