Why Psychologist?

In past times, it was generally thought that only someone who was “crazy,” or someone who had a “nervous breakdown,” had reason to see a psychologist.

Today, psychologists still treat serious mental disorders, but they also can provide services for other reasons as well. Many of us today feel lost or empty in a world with a cultural emphasis on superficiality and immediate gratification. In fact, a healthy, meaningful, and spiritual life should be the core of human existence. Anyone can benefit from psychological services that enhance and maintain physical and mental health, and that promote honesty and intimacy in daily life.

Problems and Symptoms

Even though everyone could benefit from psychological guidance, not everyone wants to see a psychologist. Here’s why some people need psychological help.

Problems

Let’s begin by defining the nature of a problem. A problem exists when there is a discrepancy between what you are doing and what you would like to be doing.

If you can put things into concrete terms as clear as that, then not only do you know you have a problem, but you are already on the way to solving it as well. And you probably don’t need professional help.

Sometimes, however, there can be complications that interfere with your ability to solve your own problems:

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It may happen that despite your best intentions to change things, you still can’t make any progress. In psychological language, you have encountered an unconscious block to your progress. With the help of a psychologist you can get over a block like this.

2.

It might also happen that you simply feel vaguely dissatisfied with your life, but you can’t get a clear sense of what the problem is. In this case you might consult a psychologist to help define the problem. Once the problem is clearly defined, you might be able to proceed on you own, or you might discover an unconscious block as well.

The good news is that once you have learned this basic strategy for defining and solving problems, you aren’t likely to need professional help any more.

Symptoms

If a problem cannot be solved cleanly and simply, it can turn into a symptom. A symptom is an illusion created by your unconscious to hide from yourself the ugly truth of your own life.

Many persons try to “get rid” of symptoms by drowning them with work, with entertainment, with sexuality, and with substances (such as food, or alcohol, or drugs). But, ironically, these things only cause more problems that usually degenerate into more symptoms. The only genuine solution for a symptom is to do the hard psychological work necessary to face up to the truth of your life that you so desperately dread to admit.

Below are several topics that will be discussed on this page:

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Anxiety

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Depression and Mania

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Family Issues

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Health Issues: Addictions / Dentistry / Eating Disorders / Illness and Somatoform Disorders / Pain Management / Smoking Cessation / Stress Management / Wellness

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Performance Enhancement

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Phobias

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Spiritual Issues

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Trauma / PTSD

Note. This is not meant to be a comprehensive list of all applications of psychology. The topics below simply represent some of the varied applications of clinical psychology. Not all psychologists can be expected to be familiar with all these topics; you may have to “shop around” to find a psychologist with expertise in the area with which you need help. Feel comfortable asking questions.


Anxiety

Let’s begin with a simple graphic explanation of anxiety. First, consider the concept of fear, which must be distinguished from anxiety. If you were sitting in a room and suddenly a large rattlesnake crawled through the door, you would have good reason to be afraid. That’s fear because it refers to an actual threat. Fear, in some cases, can be healthy because it often keeps us alive.

But if you were always worried that a rattlesnake might crawl into the room, even if no rattlesnakes were anywhere in sight, that’s anxiety. Anxiety is most often not helpful because the threat is imaginary, and a lot of time and energy can be wasted worrying about things that might—but not necessarily will—happen.

  

The psychological basis for anxiety can usually be located in childhood experiences that lack clear explanations and guidance from parents who tend to be disinterested, critical, or abusive. Hence the children grow to dread circumstances that have unknown or unpredictable aspects.

  

Some individuals live with a constant, general sense of worry and anxiety, as in Generalized Anxiety Disorder. Typical symptoms are tension, restlessness, fatigue, irritability, sleep disturbance, and difficulty concentrating.

Other persons feel a more focused anxiety, as in a Panic Attack, where their heart beats faster and faster, and there is a sudden onset of apprehension, terror, or impending doom, to such an extent that they might feel they are going crazy—or having a heart attack. In fact, it’s quite common for patients to appear in hospital emergency rooms complaining of having a heart attack when they are really experiencing a panic attack.

Furthermore, some persons have such anxiety that they develop Agoraphobia or Social Phobia.

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Agoraphobia, sometimes referred to as a fear of open spaces, really is more a fear of fear itself. That is, the agoraphobic tends to avoid situations which might cause fear—and eventually so many situations are avoided that the agoraphobic cannot even leave the house. A common consequence of agoraphobia is depression, and common associated symptoms are drug or alcohol use, as self-medication.

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Social Phobia involves a persistent fear of situations which might involve being scrutinized by others. Common social phobias are a fear of public speaking, of participating in meetings, of using public restrooms, of eating in front of others, of interacting with strangers, and of interacting with authority figures. Note that a fear of interacting with authority figures (such as psychologists) can make it very difficult to seek treatment for a social phobia.

Specific Phobias are also a form of anxiety (although they are sometimes mixed with fear). There are many kinds of phobias, including anxiety about animals, natural events, blood or injury, situations (such as elevators, tunnels, heights, flying, etc.), or germs and illness.

All specific phobias have three basic elements:

1.

Excessive fear cued by the presence or anticipation of a specific object or situation.

2.

Exposure to the object or situation provokes an immediate anxiety response.

3.

The object or situation is avoided (or tolerated with intense distress).

Thus, because the anxiety comes and goes with the situation, it would be possible, for example, to have a phobia about encountering persons who are blind, but it would be impossible to have a phobia about becoming blind. You might develop a phobia about specific objects or situations that could cause blindness, but a general fear about injury to your own body would not be a psychiatric disorder; instead, it would be considered psychoanalytically to be a form of castration anxiety.

The Psychological Basis for Phobias

Psychologically, many phobias can derive from conflicts and terror about one’s dark inner reality.

  

For example, in one case, a man had a fear of heights. His life tended to follow the status quo and he avoided taking any creative risks to improve himself. Hence his fear of heights: he was afraid to “rise above himself.”

In another case, a man had a fear of crossing bridges and going through tunnels. He had been preparing all his life for a career in sports, and then suddenly he had an injury that ended his dreams of how he wanted his life to be. Yet he didn’t know what to do with his life thereafter. He felt like he was in the dark, not knowing where he was going, and he was afraid to make any changes. Hence, his fear of “dark tunnels” and of “crossing bridges.”

  

For information about desensitizing phobias, see my page on
Self-administered Systematic Desensitization.

For more information about the fear of flying, see my page on
Fear of Flying
and its associated page,
Basic Principles of Aircraft Flight.

In Obsessive-Compulsive Disorder (OCD) anxiety takes the form of either obsessions or compulsions.

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Obsessions are recurrent and persistent thoughts, impulses, or images which are experienced as intrusive or inappropriate.

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Compulsions are repetitive behaviors (e.g., hand washing) or mental acts (e.g., repeating words) which a person feels driven to perform in response to an obsession. These behaviors or mental acts are intended to avoid harm and so are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event. 

Compulsions should not be confused with disorders of impulse control, in which a person fails to resist a temptation. In some ways, this distinction as made by the DSM-IV can seem confusing. Note that the DSM-V has clarified this.[1]. The point is that an Impulse Control Disorder can be diagnosed only if the the lack of impulse control occurs apart from any other disorder. Thus, Intermittent Explosive Disorder is characterized by discrete episodes of failure to resist aggressive impulses such that serious assaults (often as domestic violence) or destruction of property results; Kleptomania is characterized by recurrent failure to resist impulses to steal objects not needed for personal use or monetary value; Pyromania is characterized by a pattern of fire setting for pleasure or relief of tension; Pathological Gambling is characterized by recurrent and persistent maladaptive gambling behavior; and Trichotillomania is characterized by recurrent pulling out of one’s hair.

The underlying dynamic of obsessive-compulsive behavior is usually the unconscious attempt to neutralize feelings of guilt that derive from hidden experiences of anger which are perceived by the afflicted person as objectionable and shameful. (In contrast, a disorder of impulse control often involves blatant acts of hostility, destructiveness, danger, or risk.)

In this regard, psychological research into early infant development has shown that experiences of rage, and subsequent feelings of guilt, happen to us all right from early infancy. Every parent will make mistakes in empathic bonding with a child, and every child will feel emotionally hurt by those mistakes and will crave the satisfaction of revenge: to hurt the other “as I have been hurt.”

These impulses to hurt others are universally human and do not mean that anyone experiencing them is “bad.” As adults, anyone—even those we care about, and even innocent babies—can irritate us. As such, we experience thoughts of resentment, hostility, or violence because we feel injured, insulted, obstructed, or hurt in some emotional, physical, or material way. OCD, however, is a neurotic way of coping with feelings of guilt that seem too “bad” to admit to anyone—not even to yourself.

The solution to all of this is amazingly simple (and is actually a form of cognitive-behavioral treatment): admit those frightening thoughts to yourself openly, rather than try to deny them; then tell yourself that even though some part of you finds them satisfying, you have no intention of actually carrying out any of those impulses; then resolve to act with kindness and forgiveness. Remember, the fact that you can have “bad” impulses does not mean that you are “bad.”

But if you try to hide your frightening thoughts and impulses, they will get driven into your unconscious where they will turn into unconscious anger. So there’s an irony: if you admit those frightening thoughts to yourself, and deal with them gracefully, it’s proof you love others, but if you try to hide those thoughts and impulses in fear of them your drive them into anger—and that unconscious anger is what harms others and causes you to feel so guilty.

  

OCD should not be confused with Obsessive-Compulsive Personality Disorder, which is characterized by a pervasive pattern of preoccupation with orderliness, perfectionism, and mental and interpersonal control. Such a personality can be inflexible, rigid, stubborn, and miserly.

The underlying dynamic of excessive orderliness is usually the unconscious desire to see justice for the offenses committed against you. Thus you cannot tolerate anything crooked or out of place because the yearning for “law and order” preoccupies your mind in the context of unresolved emotional hurt from childhood.

  

Anxiety can also be the basis for mental disorders after exposure to a traumatic event such as abuse, an accident, a crime, a natural disaster, etc. which involved death or serious injury, whether actual or threatened. If symptoms persist for several days and cause a serious impairment in normal daily functioning, a diagnosis of Acute Stress Disorder may be made.

Posttraumatic Stress Disorder (PTSD) may be diagnosed if symptoms persist for longer than one month and fall into the following characteristic categories:

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Abnormal arousal (e.g., difficulty sleeping, irritability)

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Avoidance/Numbing (“spacing out,” avoiding situations associated with the trauma)

For more information, see my page on Trauma and PTSD.

Also, trauma can affect one’s sense of identity, and the trauma of severe child abuse can lead to the development of multiple personalities or of self-mutilating behaviors. Finally, you might want to know something about the controversy surrounding the concept of repressed memories of trauma, and you might be interested in some trauma support groups that have sites on the Internet.


Depression and Mania

Most people experience periods of depression off and on throughout life. We all have days when we feel “blue” or “down,” and these distressing times usually pass. Also, the death of someone close can involve feelings, called bereavement, that are similar to symptoms of depression.

Major Depressive Disorder is another matter, and it usually requires psychological treatment. Characteristic of this disorder is at least one Major Depressive Episode (see below). Although most episodes of Major Depression (unipolar depression) usually resolve in about six months, even without treatment, those six months or so can be quite difficult—work and family life can be seriously disrupted, and there is a high risk of suicide.

Though a Major Depressive Episode can be treated psychologically without medication, sometimes medication can be especially helpful. If your psychologist believes that medication might be helpful as an adjunct to psychotherapy, he or she will discuss the matter with you and perhaps make a referral to a physician (generally a psychiatrist) for a medication evaluation.

  

As with any psychological complaint, it is advisable that psychological treatment for depression not begin until you have had a thorough medical exam and blood test to rule out obvious medical causes of depression. For example, depression can be caused by elevated TSH (Thyroid Stimulating Hormone) levels resulting from a hypothyroid disorder. Vitamin deficiencies (such as a lack of Vitamin D3) can also contribute to depression.

  

The good news is that psychiatric medication for depression, if required, can often be discontinued (on the advice of the prescribing doctor, of course) after several months when lifestyle changes (such as brisk exercise; managing negative thoughts; caffeine reduction; stress management and anger management techniques) can incorporated through psychotherapy while taking the medication.

A Major Depressive Episode has the following characteristic symptoms:

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Depressed mood. Note, however, that children and adolescents tend to show signs of irritability rather than depressed mood.

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Anhedonia; i.e., a lack of interest in usually enjoyable things

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Weight loss or loss of appetite (although some individuals overeat because of depression)

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Trouble sleeping

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Psychomotor Changes:
Retardation (e.g., slowed speech, thinking, or movement)
Agitation (e.g., inability to sit still; pacing)

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Fatigue, or lack of energy (e.g., staying in bed most of the day)

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Feelings of extreme worthlessness or guilt

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Trouble concentrating

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Thoughts of death, or feeling suicidal

Exogenous depression is a term which describes depression triggered by obvious external social losses and problems. Endogenous depression is a term which describes depression that appears to happen for “no apparent reason” and so is commonly said to be genetic and chemical in nature, but, in my opinion, every symptom has an unconscious cause, although persons untrained in the psychology of the unconscious will not be able to recognize unconscious causes.

Dysthymic Disorder is a form of depression, less severe than Major Depression, in which a person feels depressed most of the time but is still able to function socially and occupationally. A Dysthymic Disorder usually does not require medication, but it is becoming quite fashionable, sadly, to take the newer SSRI drugs (Prozac, Zoloft, Paxil, etc.) anyway. Even though there can be a biological aspect to any form of depression, the psychological cause of a dysthymic disorder often has its roots in unexpressed emotions regarding social situations. Many persons, however, cannot even identify their own emotions, so psychotherapy may be needed, first to learn to recognize your inner experiences, and then to learn to express them openly and appropriately.

A Dysthymic Disorder has the following characteristic symptoms:

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Depressed mood for most of the day, for more days than not. Note, however, that children and adolescents tend to show signs of irritability rather than depressed mood.

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Poor appetite; or overeating

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Insomnia; or hypersomnia (sleeping too much)

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Low energy or fatigue

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Low self-esteem

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Poor concentration or difficulty making decisions

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Feelings of hopelessness

“Double Depression” refers to a Major Depressive Episode superimposed onto Dysthymic Disorder. So even though a person may recover from the severe effects of the Major Depression, he or she may rarely feel “not depressed.”


“Postpartum Depression” is sometimes used as a popular term, but it isn’t really a DSM-IV [2] disorder. The phrase “With Postpartum Onset” can be used as a specifier for any of the depressive disorders or manic disorders. Nevertheless, the idea of a postpartum depression deserves some mention. In case you haven’t guessed, postpartum refers to childbirth, and it often happens that a woman will feel depressed soon after giving birth. And here things can get complicated. On the one hand, the nature of a woman’s labor can significantly affect her emotional state after delivery. If a woman perceives a low level of support from her family or the hospital staff, if there are elements of blame or being blamed involved in the pregnancy (especially if it was unwanted or unplanned), or if she perceives a lack of control or high levels of fear for her own well-being during the course of the labor, she can experience some of the symptoms (including depression and anxiety) characteristic of Posttraumatic Stress Disorder (PTSD). [3]

On the other hand, “postpartum depression” need not be a clinical depression, and it need not even be associated with childbirth. In fact, many events in life, when successfully completed, can bring on a sense of temporary “depression.”

  

I myself felt sick and “depressed” when I successfully passed all my comprehensive exams on the way to my PhD; the same thing happened when I passed my licensing exams for my psychologist license. And on the very afternoon that I passed my flight exam for my private pilot’s license I developed flu symptoms that lasted for two days of misery. All of this really relates to the existential experience of investing tremendous energy to achieve something—and then, when it is finally achieved, feeling a profound inner void. I now understand that this is a spiritual problem, for when we fail to live with devout humility and emptiness of self—as I sadly failed to do in those years—we are blind to any grounding in spiritual stability, and we instead skip from one social accomplishment to another, with gaps of despair in between. 

  


Bipolar Disorder can take several forms. Bipolar I Disorder hinges on the history of at least one Manic Episode (see below) with several variations regarding the most recent episode, which can be Manic, Depressed, Mixed, or Hypomanic. Bipolar II Disorder hinges on the presence (or history) of a Hypomanic Episode (see below) and the presence (or history) of a Depressive Episode (see above). The old diagnostic term, Manic-Depressive Disorder is not used in the DSM-IV [4]; it referred to the clinical presence of both mania and depression—not both at the same time, of course; usually, the depression follows the mania.

Some of the following can help to distinguish bipolar depression from unipolar depression.

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History of treatment resistant to antidepressants

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Family history of bipolar disorder

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Psychotic symptoms

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Symptoms such as hyper-somnia (excessive sleeping), extreme fatigue, and increased appetite

 

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A Manic Episode refers to a period of elevated, expansive mood, lasting about a week. A Hypomanic Episode refers to a period of elevated, expansive mood, lasting a shorter time than a manic episode, but that can lead to an intense manic episode of severe grandiosity, delusions, being out of control, and poor judgment. Both consist of some of the following:

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Inflated self-esteem or grandiosity

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Decreased need for sleep

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More talkative than usual or pressure to keep talking

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Less shy or inhibited

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Overly optimistic

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Surging feelings of lust

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Flight of ideas, or subjective experience that thoughts are racing

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Distractibility

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Irritability and impatience

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Increase in goal-directed activity or psychomotor agitation

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Spending too much money


Cyclothymic Disorder is to Bipolar Disorder what Dysthymic Disorder is to Major Depressive Disorder; that is, similar in nature, but far less severe. It involves numerous periods of depressive symptoms alternating with hypomanic episodes (see above). The most common treatment (that is, aside from intensive psychotherapy) for a cyclothymic disorder, like a bipolar disorder, is often a mood-stabilizing medication.


Family Issues

Many family conflicts can best be treated in family therapy because, curiously enough, the family’s own attempts to solve a problem can actually cause new problems.


Health Issues

Many health issues can be addressed through the use of psychology. In fact, the field of Health Psychology is a new and fast-growing application of psychology. Following are several treatment applications of this field.

Addictions. The word addiction is actually a popular term which tends to get applied to either of the two DSM-IV [5] diagnoses regarding Substance-Related Disorders.

Substance Abuse is an indication of a serious growing problem in someone, and it refers to a maladaptive pattern of substance use leading to clinically significant impairment or distress characterized by such things as

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Recurrent substance use resulting in failure to fulfill major role obligations (e.g., work, school, family);

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Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile);

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Recurrent substance-related legal problems;

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Continued use of the substance despite having persistent problems caused by its use.

Substance Dependence reflects a grave problem more serious than Substance Abuse and refers to a maladaptive pattern of substance use leading to clinically significant impairment or distress characterized by such things as

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Tolerance (a need for increased amounts of a substance to achieve the desired effects, or diminished effect with continued use of the same substance);

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Withdrawal (see below);

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Taking the substance in larger amounts or over a longer time than was intended;

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Persistent desire or unsuccessful efforts to cut down the substance use;

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Spending a great amount of time in activities necessary to obtain the substance;

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Giving up or reducing important social, occupational, or recreational activities because of substance use;

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Continuing the use of the substance despite knowledge that its use is causing problems.

Withdrawal refers to

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The development of a substance-specific syndrome due to the cessation of, or reduction in, substance use that has been heavy and prolonged;

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The substance-specific syndrome causes clinically significant distress or impairment in important areas of functioning.

  

By the way, it should be noted that, in regard to withdrawal, stopping nicotine “cold turkey” can be a nuisance, and stopping heroin “cold turkey” can be grueling, but stopping alcohol “cold turkey” can be fatal. Therefore, withdrawal from alcohol requires proper medical supervision—that is, if you want to survive the process.

  

If you can answer “Yes” to any of the Substance Abuse items, you may be headed for serious trouble unless you get help. If you can answer “Yes” to three or more of the Substance Dependence items, you’re already in over your head and need help immediately.

Treatment

Alcohol and street drugs are often used as self-medication for undiagnosed psychiatric problems such as depression, mania, or anxiety, so any substance abuse treatment should look carefully for other underlying disorders.

Although the initial treatment for an addiction to drugs or alcohol is usually undertaken in an inpatient detoxification treatment program, a psychologist can be of help in the later stages of recovery. Psychological treatment can be a cognitive-behavioral form of support to maintain a healthy lifestyle, or (after recovery is well established) it can focus on the underlying despair which fueled the addiction in the first place.

The core of any addiction involving intoxication or euphoria is your feeling so deprived of your primal desire—real love from your parents, especially through the lack of your father—and so angry about it, that you use the addiction to wash away the “stain” of the anger. Thus you settle for any satisfaction of excitement and intensity, and then, because the intensity of the satisfaction is short-lived, you crave it all the more.

Addictions draw their strength from your lack of believing in anything greater than yourself. When you lack having something greater than yourself to define the addiction as harmful, and when despair is therefore the unconscious essence of your life, then nothing in you can stand up to the overwhelming urge for momentary pleasure and say, “Wait! This isn’t right.”

Note that the 12-Step abstinence programs can be useful adjuncts to psychological treatment for recovery from addictions to alcohol, drugs, and gambling. Of course, total abstinence from food is not an option for recovery from bulimia (see below). And then, for sexual addictions, sexual abstinence is often rejected outright. “I’ll die if I can’t have sex,” people say. And then, sadly, many die because of it.

Alcoholism as a Disease

It’s true that some persons have a genetic predisposition (a) to craving alcohol as a defense against emotional vulnerability or (b) to becoming addicted to alcohol once it is used as such a defense. And once addicted, such persons can be subjected to changes in body chemistry that are beyond their conscious control.

Still, if alcoholism is a disease, it’s an unusual one. A person with brain cancer, for example, can’t just wake up one morning and say, “You know, I’m sick of this illness. Today I’m going to stop having cancer.” Yet an alcoholic has to do almost precisely that. He or she has to say, “Today I’m going to stop drinking. And if I can’t do it myself, I will get into a treatment program that will force me to stop drinking.” In other words, treatment for alcoholism is behavioral. If you’re an alcoholic, your behavior has to change. You have to stop drinking. And, once you get clean and sober, in all likelihood you will have to continue to refrain from drinking thereafter. It’s all a matter of personal choice, regardless of genetics or brain chemistry.

Dentistry. Many persons get anxious just thinking about a visit to the dentist, and they become terrified of major dental procedures. Imagine how nice it would be to sit comfortably in the dental chair, completely relaxed, and free of pain. Sure, you could use “laughing gas,” but why not use the resources of your own mind to stay calm? When I visit a dentist, I can even stop bleeding when my dentist requests. More and more today, dentists and their patients are utilizing the services of a psychologist to learn these remarkable techniques.

Eating Disorders. Two common eating disorders are Bulimia Nervosa and Anorexia Nervosa.

In Bulimia Nervosa, a person binge eats and then uses compensatory behavior to control weight.

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A person with the Purging Type of bulimia engages in self-induced vomiting or misuses laxatives or enemas.

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A person with the Nonpurging Type of bulimia uses fasting or exercise to control weight.

In Anorexia Nervosa, a person fails to maintain a minimally normal body weight and exhibits a fear of gaining weight or becoming fat. As she looks at herself in a mirror, she may even see herself as fat, even though she may be so thin as to be near death.

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A person with the Restricting Type of anorexia does not regularly engage in binge-eating or purging behavior; thinness in maintained by restricting food intake or by excessive exercise.

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A person with the Binge-Eating/Purging Type of anorexia regularly engages in binge-eating or purging behavior while also restricting food intake or exercising excessively.

  

The dangers of Anorexia Nervosa are very real: loss of the menstrual period is a warning for women, and loss of bone mass and sudden cardiac arrest can be unfortunate consequences of the disorder.

  

Family conflicts, with issues involving identity and self-esteem, influenced by a desire to control feelings of anger— usually at a father who is lacking in gentleness and guidance because he is manipulative or controlling—are core factors of anorexia. In addition, the inability to understand one’s emotions—technically called alexithymia—can be a complicating factor. When anger, frustration, sadness, fear, and so on get confused with hunger, then the stage is set for disaster. Note that anorexia can be an occupational hazard for dancers, actresses, and models who must adhere to the ideal of a thin body type and at the same time cannot manage emotional setbacks very well. 

Obesity does not get classified by the DSM-IV as a true eating disorder because “it has not been established that it is consistently associated with a psychological or behavioral syndrome.” Thus the DSM-IV treats obesity as a general medical condition.

The general facts about weight gain, however, are governed by a simple law of physics: if you consume more calories than you expend in exercise, you will gain weight. There are two points to consider in this regard:

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Some persons have—or through yo-yo dieting have created—a metabolism that tends to store food intake as body fat, and for such persons it can be a trial—but not impossible—to maintain a normal body weight.

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Some obese persons will claim, in all seriousness, that they do not eat very large meals. But, if their eating habits are examined closely, it is often discovered that they “nibble” or “snack” almost constantly throughout the day. All of this points to the way that you can unconsciously deceive even yourself about your true behavior.

Psychological factors, therefore, can play a role in obesity, either as a primary cause, or as secondary causes underlying a medical condition.

Anger.  Unconscious anger can generate feelings of victimization, guilt, and self-loathing. Consider the following examples:

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Some individuals will resist physical exercise and disciplined eating habits (saying that it’s all “too much trouble” or “unfair”) because they lacked protection and guidance as children.

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Some individuals will use food as a way to stuff down feelings of irritation and resentment because they don’t know what to do with those feelings.

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Some individuals will eat to compensate for their emotional “hunger” for acceptance from their mother, a mother who criticized, neglected, or rejected them.

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Some individuals will overeat as a way to punish themselves, saying to themselves, “I don’t care how much this harms my body; I don’t deserve any better.”

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Some individuals will derive a certain satisfaction, and pride, from “throwing their weight around” as compensation for their feelings of social and emotional helplessness.

Body Armor.  Some individuals, usually women who have been sexually abused as children, use body fat unconsciously as a sort of body armor to deflect the sexual desires of others.

Deadened Emotional Awareness.  Some individuals, usually because of the emotional emptiness of growing up in dysfunctional families, have so deadened their emotional awareness, as a psychological defense, that they perceive all emotions as hunger. Anger, frustration, fear, sadness, loneliness—it all feels like hunger. But, at its psychological depth, it’s really a hunger for emotional acceptance, not for food.

Deprivation.  Some individuals who felt deprived of emotional or material resources as children will, as adults, resist the self-restraint of healthy eating because it feels like another form of deprivation.

Reward.  Some individuals have grown up in families that use food as a reward for being “good,” and so, as adults, they can use food for self-soothing when they feel “bad.”

Hypertension (High Blood Pressure). Medical research [6] has demonstrated the efficacy of nondrug interventions in preventing and controlling high blood pressure (HBP).

The following are some behavioral life-style changes that can help reduce HBP:

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Lose weight.

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Increase physical activity.

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Eliminate alcohol intake, or limit it to 1 ounce per day.

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Reduce sodium (salt) intake to less than 1 teaspoon per day.

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Stop smoking.

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Consume adequate potassium (about 3.5 grams per day).

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Reduce “stress” by practicing a relaxation technique such as Progressive Muscle Relaxation or Autogenics. (We know that a stressful environment can produce a tendency toward HBP, and we know that relaxation techniques can lower HBP at least temporarily, but we have no conclusive evidence yet that any relaxation technique, by itself, can produce a lasting decrease in blood pressure. But dedicated practice of a relaxation technique in conjunction with the other items above may allow you to reduce your blood pressure without medication.)

  

 

  

Illness. Although a physician will be the primary care provider for any illness, a psychologist can assist with the treatment through hypnosis, guided imagery, biofeedback, and stress management to help with nausea and vomiting from chemotherapy, to help bolster the immune system, and to enhance communication and assertiveness regarding one’s own treatment.

Aside from illness whose cause is clearly physiological, there are several Somatoform Disorders whose basis is largely psychological (and unconscious):

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Somatization Disorder describes a condition of many physical complaints (including four pain symptoms, two gastrointestinal symptoms, one sexual symptom, and one pseudoneurological symptom) which cannot be fully explained by a known general medical condition.

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Undifferentiated Somatoform Disorder describes a condition of one or more physical complaints (such as fatigue, loss of appetite, gastrointestinal or urinary complaints) which cannot be fully explained by a known general medical condition.

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Conversion Disorder refers to symptoms involving voluntary motor function or sensory function which cannot be explained by a general medical condition. These symptoms (such as paralysis of an arm, or blindness or deafness) are preceded by psychological conflicts or “stress.”

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Hypochondriasis refers to a preoccupation with fears of having a serious disease. This fear is usually based on bodily symptoms which are really perceived but misinterpreted.

Pain Management. Psychologists often serve on Pain Teams in hospitals, as I have done, to make sure that acute (“new”) pain is properly managed. In addition, psychologists can help individuals cope with chronic (on-going) pain, especially when other forms of treatment have been ineffective

Note, however, that whether the psychologist uses psychological methods of pain management or assists in the behavioral administration of pain medications, the goal is not to eliminate pain but to reduce it to a level which permits a functional life. In other words, though we must all bear afflictions, we don’t have to be overcome by them.


Smoking Cessation. Psychologists can be of special help with overcoming the addiction to smoking.

“Stress” Management. With modern life becoming more and more fast-paced and demanding, techniques for relaxation are becoming more of a necessity. Rather than rely on tranquilizers, a person can get help from a psychologist to cope with the excessive “stress” of daily life.

Wellness. In contrast to the medical focus on illness, some persons now focus on the concept of wellness. This refers to the idea that health and well-being can be actively maintained. A psychologist can offer assistance in learning how to maintain this new kind of focus.


Performance Enhancement

Sports Psychology got started by helping athletes improve their competitive performance by mentally rehearsing their routines. Now almost every world-caliber athlete uses these techniques.

Performance Enhancement—as in autogenics training—can be used as well by non-athletes to improve concentration and composure in any area from work to recreation: test taking, speeches, presentations, stage fright, and so on.

Sometimes, quite a bit of the work of enhancing performance involves overcoming past “negative hypnosis.”


Spiritual Issues

Many, if not most, psychological problems have roots in issues such as coming to terms with mortality, finding personal meaning in life, and general life satisfaction and direction. Psychology, as a science, can only point out to a person that these “deeper” issues raise questions that somehow need answers. Although psychology cannot provide those answers, it is possible, from within the framework of psychotherapy, to discuss and explore spiritual aspirations.