We have all encountered trying to build relationships with people and becoming confused when it is not working. We may be trying so hard to connect and not being successful. It is important to recognize when this is due to forces outside our control.

A study in “Sexual and Relationship Therapy” (Betchen & Ross, 2010) discusses common dynamics that should be avoided in relationships. Although the study researched intimate relationships, the same can be said for friendships. The article talks about the difficulty of pursuing relationships with emotionally unavailable people, non-apologizers and status seekers.
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Of course there are many other reasons people may not include you in their lives. Sometimes you are experiencing implicit racism, xenophobia, homophobia, transphobia or other prejudices, biases or projections. The list goes on.

Regardless, it is important to know that it is not necessarily you who is to blame, so don’t give up on the idea of having meaningful relationships. What it does mean is giving up on pursuing relationships with people who are committed to not investing in you or are committed to keeping you at a distance—for whatever reason. You may get stuck in a cycle of either trying so hard to make a relationship work with no success, disengaging completely from the world to keep yourself safe or beating yourself up when rejection happens. And this is a lot of wasted energy. Use this energy instead to foster new relationships with people who have an open heart. And this starts with trust. But how can I do that when I don’t trust others, you might ask? Well, you don’t have to trust others. The trust that needs to happen is within yourself—trusting yourself in your ability to discern others' intentions.

And we become good at this when we learn to understand and trust our emotions. We can feel it when people are genuinely curious and interested in getting to know us. When you learn to trust yourself, you are not calcifying yourself with fear, but allowing yourself to flow, to move, to respond and to continue engaging in the world.

To start this journey, you must try to understand yourself deeply. It is why we therapists ask: So, how does that make you feel? 


Reference:
 (https://www.tandfonline.com/author/Ross%2C+Joellyn+L)

When tragedy happens, like the recent school or grocery store shooting, the war with Ukraine, or any other stressful event, it is normal to feel overwhelmed. Be compassionate with yourselves and others as you are trying to process events that are just impossible to comprehend.

When tragedy happens, it helps to allow ourselves to feel our emotions, without judgment. We must allow ourselves to grieve and process the unthinkable. We have to work toward accepting that we may not be able to make sense of it. But we can still move forward and feel safe again. 

Remember, our kids are listening. They are looking at adults around them to help them comprehend and make sense of a scary event. So we want to be present and help them through, even when they don't have the words or may have shut down. Instead of asking them if they are ok, to which they may quickly answer "yes" to, we want to let them know that it is ok if they are not ok. You can start the conversation in an open-ended way, maybe talking about your own feelings. This will allow kids to open up as well.

Encourage them to ask questions and be gentle and curious in understanding their perceptions about what happened. We have to be able to hear their pain and worries. Unfortunately, these are earned. It is ok to let our kids know that what happened was serious. We don’t want to sugarcoat, as this will feel more confusing. What happened was scary. Our kids -- and us all -- have earned the right to feel scared. But the adults can be there to help kids process, and create a sense of meaning that may have been shattered as a result of the scary event. To do so, we have to start by listening and leaning into feelings that are painful and confusing. The answers will come. The world will make sense again, and our kids will begin to regain a feeling of safety. 

As Fred Rogers said, “When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’ To this day, especially in times of ‘disaster,’ I remember my mother’s words, and I am always comforted by realizing that there are still so many helpers - so many caring people in this world.” 

So look for the helpers. And lean into the good. There is truly more good in our world than bad. We just have to notice it, and remind ourselves of it. Take little steps that feel healthy. Turn off the news, and do something that feels nurturing and grounding. Make bread, play a board game, or feel the earth under your fingernails as you plant something in your little corner of the world. And watch it grow. 

If you need to speak with someone, our therapists are here to meet you where you are. If you are struggling right now, reach out for help. The National Suicide Prevention Lifeline is available 24 hours a day at 800-273-8255. 
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Please welcome Dr. Valeria Serban, MD, PhD to our team! She is an experienced board certified psychiatrist who is currently accepting new patients. Dr. Serban has experience with adults age 18 and up. She is licensed to see patients in Ohio and looking forward to getting to know her patients via telehealth. 

Dr. Serban received her MD from Cluj, Romania. She holds a PhD in Neuroscience from the NYS Institute for Basic Research. She completed a Clinical Neurophysiology fellowship at Harvard Medical School. 

​Dr. Serban is bilingual in English and Romanian, and speaks other languages fluently including Italian, French, Spanish and German. ​

We are excited to announce that we will be in network with Aetna health insurance starting June 1st, 2021! Looking forward to working together!

We are happy to welcome Dr. Ranada Cooper, PsyD to our team (please see her bio under "Meet Our Team"). We are excited to have her work with us! She is a wonderful, caring therapist with a great deal of experience doing therapy and assessment with adults, adolescents and children. She is now credentialed with various insurance companies and seeing clients Saturday and Sunday! 

Please welcome Dr. Thomas Mraz, PhD back to our practice and Dr. Jane Gardner, PhD, LPCC-S to our team! You may learn more about them under the "Meet our team" page of our website. They are both wonderful providers with a great deal of experience! So glad to have you on board!

As the reality of a world pandemic sets in, people naturally feel increasingly anxious. It is normal to feel this way. Being in denial is not helpful. If people go about their day the way they did before COVID-19, they may become infected or infect others. So we want to work on acceptance of this strange reality, without a sense of panic—and without denial of facts.

Life feels uncertain and our world as we know it has changed, replaced by a confusing and surreal situation. We want to be compassionate toward ourselves, validate our own emotions, as well as be compassionate with others who may be struggling emotionally. It is a stressful time for our world, and we need to be patient with ourselves, as well as others.

Experiencing stress may result in a wide variety of symptoms of anxiety and depression:

• Sadness, feeling tearful
• irritability, anger
• feeling agitated, feeling slowed down
• decreased concentration, confusion
• Increased heart rate
• difficulty controlling worry
• Feeling lonely due to social isolation
• Body aches and pains (e.g., headaches, jaw pain, stomach aches, muscle tension)
• Appetite loss or overeating
• Panic, sense of impending doom
• Fatigue
• Insomnia, nightmares, restless sleep
• loss of interest in pleasurable or fun activities
• Suicidal thoughts--always take these thoughts very seriously. Please call the National Suicide Prevention Lifeline 1-800-273-8255 if you are having these thoughts. If you feel like you are a danger to yourself or anyone else, please go to the nearest emergency room or hospital or call 911.

 
For people who have a history of trauma, current events may feel retraumatizing. They may be experiencing an increase in symptoms of post-traumatic stress disorder (PTSD). For nurses, doctors, or other health providers fighting to save people’s lives, symptoms of acute stress disorder (ASD) may emerge. These symptoms of PTSD/ASD include:

• Experiencing intrusive thoughts or memories of trauma; distressing dreams; or flashbacks of trauma event.
• Avoiding reminders of the traumatic event; this may include avoidance may include people, places, activities, objects and situations that trigger distressing memories.
• Engaging in persistent negative evaluations about oneself, others, or the world (for example, "I am unsafe," or "The world is a scary place”; experiencing feelings of fear, horror, anger, guilt or shame; decreased interest in pleasurable activities; or feeling detached or estranged from others.
• Experiencing irritability, angry outbursts; increased impulsive or self-destructive behavior; being easily startled; poor concentration or sleep problems.

If you are feeling depressed, anxious or traumatized, talk with someone, seek psychological help, but don’t suppress how you feel. It is tempting to tune out and avoid emotions which feel scary and threatening. Nobody likes to feel distressing emotions. However, ignoring or dismissing our emotions can cause us more psychological harm. The numbness that may set in will eventually feel even more distressing. The more we push our emotions down, the more they tend to bubble up to the surface in other unhealthy ways (e.g. feel irritable, engage in unhealthy habits, abuse substances, etc.).

Understanding and listening to emotions can be effective in decreasing distress. Many people have the impression that listening to distressing emotions is the same as being ruled by these emotions. This is not accurate. Having an awareness of the emotional pain we are experiencing, is not the same as being helpless in the face of this suffering. It means that we can allow important information to come to the surface, which can then be processed. This can help us understand the way we are perceiving ourselves, our world, and others, and can help guide us in making wise decisions. We want to allow our emotions to tell us a story--to inform us about what our needs are right now. This narrative can suggest a healthy action tendency.

What are my emotions telling me I need in order to feel less distressed? Here are some examples of emotions and action tendencies:
 
I feel lonely. This tells me that I would like to be around others. I can’t do it in person due to current restrictions, but I can call or facetime a friend.
I feel unsafe. This tells me that I understand there are some health risks. What are reasonable things I can do to help myself be safe? I can wash my hands, socially distance, and keep myself safe.
I am overwhelmed. I feel paralyzed. This tells me that I am exhausted, that I am carrying a huge emotional load. How can I set some of this burden down? Is it necessary to carry it with me all the time? I can turn off the news. I can remind myself that I am doing my best. I can try to do something small that feels productive (e.g. put dishes away) or do something that is self-caring (e.g. listen to my favorite music) and see if this helps.
 
There are various mental health strategies that may help decrease symptoms of depression and anxiety. Here are some ideas for coping with distressing emotions:

• First, don’t panic (yes, that’s a Hitchhiker’s Guide reference): Protect yourself from emotional contagion (a phenomenon involving adopting the emotional state of another person, sort of like empathy).  Yes, people are buying all the toilet paper. Just because some people are panicking, it doesn't mean we all should. And perhaps see the humor in this situation. Who needs so much toilet paper?
• Be proactive: If you think you have COVID-19, talk to your doctor or advice nurse at a hospital, rather than ruminating, worrying, googling symptoms or asking a friend. Go to the experts!
• Don't obsess: Take a break from constantly watching the news, reading articles or researching every detail about COVID-19. This behavior won’t be productive, and it will lead to increased feeling of anxiety.
• Don't jump to conclusions: If you are sneezing, and certain this means you have COVID-19, could you be jumping to conclusions based on little evidence? What else could be going on? Do you normally sneeze this time of the year? Could it be allergies?
• Decrease unnecessary worry thoughts:  Many of us engage in anticipatory anxiety, or predicting that something bad will happen in the future, which makes us feel unnecessary suffering. By holding on to our thoughts lightly, we can learn to tolerate uncertainty, and go with the flow a little more. We can let go of rigid beliefs about what might happen. As our mind runs away creating a scary future scenario, we can bring ourselves back to the present moment, and allow ourselves to experience our emotions from a place of curiosity.
• Decatastrophize: Imagine the worst-case scenario, and how you might cope with it if it were to occur.  Bringing worries that you may be suppressing to the surface, and make them overt, can help us feel increased sense of calm and agency. This will help us come up with solutions that feel proactive.
• Be solution focused:   Forgive yourself for perceived mistakes (e.g. You are the only person in the world who forgot to stock up on toilet paper, and now it’s sold out everywhere). Try to find a solution instead of beating yourself up (e.g. Do you have tissues in the house?)
• Stay emotionally connected: Call or email a friend, co-worker or family member. Social isolation does not have to mean emotional isolation.
• Give yourself a sense of structure: None of us do well without a sense of structure, which our work or school previously provided. Come up with a routine/schedule for yourself or your child and follow it.
• Decrease arousal: Engage in diaphragmatic breathing, or deep abdominal breathing. Breathe out more slowly than you breathe in.
• Do something soothing: take a shower/bath, smell something nice, have a cup of tea, pet your dog/cat, play with your kids, or talk with a friend or partner
• Stay busy: Take up an old hobby or activity or try a new activity: bake cookies, try a new recipe, learn a language, paint a picture
• Increase endorphins:
  1. Do something that is physically active: go for a walk, yoga, stretch, run on a treadmill, dance.
  2. Or do something that makes you feel good: watch a TV show, Tic Toc or YouTube video to make you laugh out loud.

 

• Be present-focused and mindful:  Anxiety can result in disconnecting from thoughts, feelings, and the present moment. To disrupt this process, use a mindfulness technique, such as paying attention to your five senses. This can help to ground you in the here and now, rather than ruminate about current events or what the future might bring. Keep gently bringing yourself back to the present moment.
• Practice good sleep hygiene. Make sure you go to bed at the same time, wake up at the same time, and turn off electronic devices one hour before bed. Dim the lights an hour before bed, don’t work out two hours before bed, and don’t have your biggest meal before bed.
• Be gentle with your self and others. If you are working from home, perhaps you don't have as much time as you would like to help kids with their online learning. Perhaps you can't produce the same quality work at your job due to distractions, and are not as productive as you would like. Understand that the stress you feel may affect your mood. For instance, it is normal for people to experience increased irritability. Forgive yourself for losing your temper, and forgive others as well. Apologize and make amends, as needed. We are all doing the best we can during this scary and difficult time.

 
I hope some of these suggestions help. Please take care of yourselves during this uncertain and difficult time. And remember that we are all in this together, and that we will get through this together. Our humanity binds us. Throughout this storm that has taken over our world, it is inspiring to see acts of courage, altruism and compassion. It is amazing to see people jump into action to help others, or jump into song in Italy as an act of solidarity. It is encouraging to know that there are research scientists working around the clock to come up with a solution. So when life feels at its scariest, remember Fred Roger’s words, and “look for the helpers.”  Look for the good. Because it’s all around us—and because that’s how we bring back hope.
 
References:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:  Author.
 

The world is dealing with a threat that is impacting our physical, economic and emotional security. We have never been through this kind of situation before.  It is difficult to grapple with the uncertainty this pandemic brings. As I write this, and as you read it, we are physically isolated from our normal routines and many, if not most, or all of our friends and family.

Under these circumstances it is normal to have various emotional responses. It is normal to feel afraid, isolated, shocked or confused. These feelings are valid. We are all feeling this way. But we are not alone. We are all in the same boat. Remember that it is healthy and normal to acknowledge our emotions.

As people, we are inherently social animals. None of us can avoid the feelings of isolation that come with physical separation.  While it may be necessary to go through physical separation, we shouldn’t deceive ourselves that this is normal, or healthy. Connections, especially deep emotional connections, are what give our lives meaning.

Although we need to socially isolate, this does not have to mean true "aloneness." Most of us are privileged to be able to use technology to reach out and maintain strong emotional connections. It is most important that we check in, support, and receive support from our loved ones, friends, acquaintances and colleagues. At times of stress, emotional support and intimacy that come out of an honest exchange are essential. We all cope with stress differently, and it's important to show understanding and empathy for the variety of responses that people may have.

Finally, continue to utilize mental health resources if stress/anxiety escalate. We are here to help. Our practice will continue to see patients throughout this time. If you are concerned about financial resources, Dr. Faur has taken on several additional spots of psychotherapy pro-bono. This will be provided to people who have lost their jobs as a result of COVID19 and fall below the poverty line, and thus cannot pay for sessions at this time. Dr. Faur is currently only seeing patients via telemental health, utilizing a HIPAA compliant video platform. Please contact us for more information.

Please take care of yourselves, and each other. We will get through this together.

Wishing good health to all,

IPH

.Integrative Psychosocial Health is dedicated to the health and safety of our patients and staff. IPH is aware and responsive to the growing concern of Coronavirus in our community. Management of IPH has been following the Center for Disease Control (CDC) and the Joint Commission for best practices.

We will continue to follow the CDC's recommended guidelines for COVID-19 and are actively implementing new procedures into our daily routine. This includes increased disinfecting and hygiene practices to help prevent the spread of COVID-19. It also includes the use of telemental health technology in lieu of coming into the office for appointments.

Telemental health sessions can be conducted via a HIPAA compliant, encrypted video platform, and can be done on your smart phone or computer. It is easy to set up, and free. If you are interested in this option, please call or email us at iph@ipsyhealth.com. Some of our providers are using the telehealth platform called VSee: https://vsee.com/

For those who do not own a computer or smart phone, we can have sessions via regular phone.

Utilizing telebehavioral technology to have sessions isn't ideal, but appears to be necessary for the time being, in order to decrease the spread of COVID-19. We hope we can partner together to keep those who are at risk of serious illness safe.

Please call or email us with any concerns. We are available at 216-801-4656 or psy@ipsyhealth.com.

Warm wishes for good health,

IPH

How do we heal following  a life-changing event, such as the death of a loved one, loss of a job, relationship break up or any other stressor? 

Healing starts with the truth. We do this when we practice compassion with ourselves as well as others. We can start by observing our inner experience, as well as observing others without judgement, with genuine curiosity. Our curiosity can help us become aware of our own filters, which may be altering our perception. Coming to a less tainted understanding can help us accept reality and experience increased compassion.  

Compassion doesn’t have to mean that we let others who have wronged us off the hook. It can mean quite the opposite. Our genuine curiosity can lead us to holding others responsible for the pain created, and letting ourselves heal, knowing we did our best to survive. Or it can mean understanding why we responded the way we did. We can come to realize that perhaps we did something wrong. This can help us figure out what we need in order to heal, such as make amends, and work towards self-forgiveness.  Or it can lead to understanding a situation or someone’s perspective on a deeper level. We may understand the pattern of inter-generational trauma, and realize the chain of suffering that was handed down.   Non-judgmental curiosity can help our perspective broaden. It can make it easier to grieve and lead us on a path to healing. 

​As human beings we are always in an emotional state. Thank your limbic system, or emotion center of the brain, for that. Most of us have been led to believe since we were kids that emotions are bad, and not to be trusted. Many of us have been punished since childhood when experiencing "bad emotions." "I'll give you something to cry about!" was a common refrain of the past by exasperated parents. We learned to suppress "negative emotions" and put on a happy face.

In our society, we are repeatedly given the message that emotions are good or bad. We are told that it is virtuous to feel happy or grateful or in love all the time. We are told that these are "positive emotions."  In fact, we now know that emotions are neither good nor bad in of themselves. Emotions are simply information meant to guide us. We should not be criticizing or qualifying them as positive or negative. We should however try to understand, from a curious, non-judgmental perspective, how our emotions are informing us. This does not mean wallowing in our emotions but coming to a deeper understanding. If we reflect on our emotions with curiosity, we can understand ways to improve our lives or to avoid bad situations. We can gain wisdom, and make choices that are more authentic, beneficial and meaningful to us.

The last thing we should do is ignore or dismiss some of our emotions, even those like sadness, anger, jealousy, etc. Imagine that you value spending time with friends but work so many hours that you don't have time to see them. Your sadness can inform you of the importance of your support system, which can allow you to create change in your life. 

But shouldn't I just be "rational?" Shouldn't I trust my thoughts? In fact, our thoughts may be less trustworthy than our emotions. Research shows that humans can be quite counterintuitive when it comes to making decisions based on their thoughts. Thoughts may be irrational, self-critical, critical of others, or maladaptive. The emotions behind them may be real, but the thoughts themselves may be unhelpful. For example, you may feel very sad because your best friend hasn't answered your text message in days. The sadness is real. Your belief regarding the unanswered text may or may not be true, helpful or adaptive. You may come up with a theory, such as "my friend is angry with me" which may be false. Perhaps your friend is not angry, but busy, lost their phone, or too depressed to answer the message. We don't know which theory is true. But your emotion is still real. And you can use it to propel an action tendency that is healthy. So, then how do I move forward when I feel sad that my friend did not text me back? Well, first honor the sadness. Of course it's sad. You value this friendship. Allow yourself to feel this sadness. And what would be a healthy action tendency? What would help soothe this emotion? You can text your friend to make sure everything is ok, you can hold on to your beliefs (theories) lightly in regard to why she is not texting back, and you can be compassionate with yourself. You can remind yourself that just because you think it, it doesn't mean that it's a fact. Our thoughts are just theories, which may or may not be correct.

But shouldn't I just dismiss my sadness? Shouldn't I just distract myself? Put it out of my mind? Well, by doing this, you risk holding on to this emotion longer. And it may transform into other emotions. After all, if you believe your friend is angry with you, perhaps you may also believe she doesn't value your friendship, and you may start to feel deeply hurt and angry. And this may translate into unhealthy behaviors. Instead of checking in with your friend, you may irrationally decide she was never your friend and ignore her when you see her at school or work. Or you may be terse with her when she finally texts back. She may then react to this negatively and stop talking with you as well. One simple misunderstanding can cause a downward spiral, which can hurt your relationship. And you may never learn the real reason your friend didn't return your message. 

So don't dismiss your emotions! They are just messengers meant to be understood--and honored.  And instead, learn to be gentle with your thoughts and not judge your own emotions. Be curious and open to understanding why you are experiencing an emotion. Make peace with the ambiguity of not knowing why people do the things they do. Heck...it's even hard for us to understand our own emotions. 

And finally, let me answer the title of article, "When is it ok to be angry?" The answer is: anytime. Anger is just information. It's what we do with it that matters. There is such a thing as good anger. Think Rosa Parks' anger. She was not tired when she sat down in the front of the bus and refused to get up. She was rightly angry and used this anger to inspire change. She inspired change not by beating people up, but by resisting laws that were unjust. Her anger was appropriate and adaptive. And her behavior was brave and inspirational. 

But shouldn't we just strive for being happy all the time? Well, not if it means suppressing how we feel. If we did that, we would live some pretty unhealthy lives. It would mean constantly dismissing information that was necessary for our happiness. We would stay in that terrible job too long, we would never strive for more; we wouldn't get the information we need to help ourselves or understand our situations. "Happy" is not always the right emotion. If you saw someone acting happy at a family member's funeral, would that be adaptive? You may rightly wonder what this meant. 

So, if it's called for: be angry. But learn to do what's right with it. Be sad: and find the beauty or the wisdom in it. And by allowing yourself to authentically feel, you will live a more meaningful, and ultimately happier life.

Check out our new therapists under the MEET OUR STAFF tab! Pictures coming soon! Please welcome social workers Ms. Klare Heston, LISW-S and Mr. Mike Joyce, LISW and psychologist, Dr. Katherine Kratz, PsyD! 

We are excited to announce more news for our practice. As many know, we have expanded and moved our practice from Fairview Park to Westlake! We have three wonderful new therapists who will be joining our practice! Their bios will be soon available on our website: www.ipsyhealth.com

Furthermore, we are starting several groups for teenagers and adults, including dialectical behavioral therapy for adolescents, resiliency groups for teen girls and boys, and anger management for adults and adolescents. Stay tuned for updates on meeting times!
We are grateful to continue being of service to our community and continue to decrease stigma associated with mental illness!

Warmly,

IPH
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#sparkchange #yourstorymatters #theresnousversusthem#justpartofbeinghuman

Here is a short article about telepsychology.  Telebehavioral health means using a HIPAA certified video platform in order to virtually meet with people who would otherwise not be able to access mental health treatment. 

https://www.psychologytoday.com/us/blog/two-takes-depression/201708/depression-and-telepsychology

October is national domestic violence awareness month. If you are in need of help, you may speak with a domestic violence trained peer advocate by calling 1-866-331-9474. Check out the "Break the Cycle" website below to learn more! 

https://www.breakthecycle.org/blog/it%E2%80%99s-national-domestic-violence-awareness-month

With the holidays upon us, this can be a peaceful and joyous time of the year. However, this can also be  a lonely, difficult time for many who have struggled with loss or isolation. 

At IPH, we are offering a support group to help those struggling with loneliness and loss.  We plan on providing this weekly support group over the next 4 months. The first meeting will take place this week Thursday 12/15/16 at 4:00 pm.  Please call us at 216-801-4656 to learn more, or email us at iph@ipsyhealth.com
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From the staff at IPH, we would like to extend our warmest wishes for a healthy and peaceful holiday season for all!

Just a reminder that we will be hosting our first support group for parents/caregivers/grandparents of children/adults with autism. Please see the flier under the "mental health services" tab! This group meets from 9-10 on Saturdays. Please call us at 216-801-4656 to register, or you may register through our website under the "Scheduling" tab. Looking forward to seeing everyone on Saturday at our Fairview Park location:
20800 Westgate Plaza, suite 103, Fairview Park, OH 44126

​https://www.psychologytoday.com/blog/anger-in-the-age-entitlement/201206/emotional-abuse-intimate-partners

Various group therapies are being offered at IPH, starting late August (parenting, anger management, social anxiety and more). In case you have any questions, here is an article about group therapy from APA. The most basic tenet to remember is that whatever is said in group, stays in group. Also, it wouldn't be a group without people in it, so attendance is important! Here is a bit more about what to expect.

​http://www.apa.org/helpcenter/group-therapy.aspx