Please Note: As of January 1, 2023, I have retired.
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Domestic Violence
This post contains information supplemental to my presentation, “Emotionally Close While Physically Distant,” part of the webinar “Helping to Stop Abuse During COVID” sponsored by Temple Sinai Toronto, Live streamed: April 20, 2021, 7:30-8:30pm.
Domestic or family violence is an abuse of power – a betrayal of trust. It is common for people who are abused to feel at fault – and to feel that they deserved to be hurt – to feel guilty and ashamed. These feelings flow from irrational thoughts. The person who is abused is NEVER responsible for the abuse no matter how much that person believes he/she provoked the abuser. It is ALWAYS the person who chose to abuse who is responsible. The only person who should feel guilty and ashamed is the abuser who has failed to control their behaviour. Abusive behaviour is a choice.
Types of Abuse
(1) Physical Abuse is any type of physical assault or physical form of harm. Included are punching, kicking, spitting, hitting, or using an object to cause pain. Other examples are forcing a person to use drugs or alcohol, forbidding a person to eat or sleep, physically blocking a person from leaving a room or house, and physically restraining a person from moving.
(2) Sexual Abuse is a form of physical abuse. It is forcing another person to engage in any type of sexual activity without their consent and engaging in sexual activity with a minor. This might include forcing the person to dress in a sexual way against their will, restraining a person against their will during sex, causing pain with an object during sex, and inviting others to witness sexual activity without the person’s consent.
(3) Physical Neglect is another type of physical abuse. Examples are failing to provide the basic necessities of life to another person – for example, not providing food, water, heating, freedom of movement, or health care and failing to protect someone from physical harm.
(4) Emotional Abuse can be difficult to recognize. Some examples are name-calling, put-downs, intimidation, swearing at the person, threats to harm the person or their children or pets, public embarrassment, preventing the person from communicating with family and friends, and blaming the survivor for the abuse.
(5) Digital Abuse is a form of emotional abuse using technology. Examples are sending abusive messages to the person, using social media to track the person’s activities, posting unflattering photos or videos of the person without their consent, pressuring the person to post unwanted photos or videos online, stealing the person’s passwords, constantly texting the person and pressuring the person to respond immediately, creating a fake social media identity, and sending messages to others pretending to be the other person.
(6) Financial Abuse involves using money or property to control and exploit someone. Examples are taking money without consent, withholding money to control someone, depositing pay in an account that only the abuser can access, getting the person fired from a job, preventing the person from going to work, maxing out a person’s credit cards without permission, pressuring someone to sign documents, pressuring the person to change their will, or pressuring them to sell something.
Continue readingBe Proud of Yourself
“Change is Possible” appears at the top of my website. I should probably follow that up with “Change is Hard.” We are all creatures of habit. It is really hard to change our thoughts and behaviours which, over time, become habits. Even when we recognize that our habits are self-defeating and bad for us, we still resist change because change is so difficult. There is nothing harder than changing and improving ourselves. We are our most challenging project.
It is for this reason that we should feel proud of ourselves and give ourselves credit for any improvements we choose to make in our lives, however small they may be. Deciding to help someone who is close to us, deciding to communicate more honestly and openly with others, deciding to express our needs and wishes more assertively and respectfully, deciding to exercise, deciding to think more logically and rationally, deciding to focus on our strengths and not only on our faults, deciding to forgive ourselves for our mistakes and others for theirs, deciding to take better care of our health, physically, and emotionally – the key word in all of these examples is “deciding.”
We are often told that we should be grateful. Gratitude is powerfully important. There is research suggesting that when we feel grateful we are happier. But we are not told often enough that we should feel proud of ourselves for deciding to improve. Since change is so difficult, we really should pause and give ourselves credit for making the decision to change.
I often suggest to my patients that they keep a journal entitled “Things I’ve Chosen To Do That I’m Proud Of” and that they read and add to it each day. The entries may be small; for example, calling a friend who is going through a tough time, going for a walk to get some exercise, apologizing for something that they regretted saying, eating healthier, or taking time out to relax or enjoy some activity. The entries may also involve major accomplishments such as seeing a difficult project through, completing an educational program, resolving a conflict with another person, leaving an abusive relationship, giving an important presentation, or scheduling an appointment with a psychologist or another professional to seek assistance.
One of the most important attributes we have as humans is free will. No matter what our circumstances, many of which are beyond our control, we can decide how we will cope and how we will live and ultimately what kind of person we will be. We deserve credit for every one of the good choices we make.
Moving forward, my hope is that we will all take more time to feel proud of the good decisions we have made and are making today, especially if they lead to improvements in our mood, lifestyle, and relationships with others.
It may seem strange to pat ourselves on the back and say “Good for me,” but it is as powerfully important as being grateful for the good things we have that just came our way by chance.
Guest Appearance on Voice America: Preparing for the Unexpected
I make a guest appearance on the March 3, 2018 Voice America Podcast. You can listen to the episode here.
Episode Description:
The 2018-03-08 episode will dig a bit deeper into how disasters impact our behaviors and ongoing responses to traumatic situations. We’ll talk with Clinical Psychologist Dr. Rickey Miller, who will discuss the various ways in which people respond to situations and how we can help people overcome their anxieties and stresses related to the disasters they have experienced or witnessed. Many organizations will have emergency response plans to address evacuations and basic employee safety concerns. This episode will take BCM professionals to a deeper level and provide insight on other topics that may need to be addressed in their employee plans to ensure ongoing support for employees when faced with traumatic situations.
Coping with Injury
Car accidents, work-related accidents, slips and falls, and other types of accidents can have a major effect on our lives. The impact does not necessary correlate with the extent of our physical injuries. Some people who suffer severe physical injuries experience little long-term emotional effects, while others who suffer only minor physical injuries experience serious emotional effects. Why does this occur?
The way we experience any event depends on a complex interaction of our unique psychological and physical factors at that point in time. Our experience of events and reaction to them depend on our previous experiences, our mood, our beliefs about ourselves and the world, our personality characteristics, our emotional and physical resources, the reaction of other people, and a myriad of other psychological and physical factors. For these reasons, it is difficult to predict a person’s experience in a car accident if we look only at the damage to the vehicle. Many times people walk away from totalled cars with little long-term anxiety, while others may experience long-term post-traumatic anxiety after an apparently minor accident.
Whatever emotions we experience following any type of personal injury or accident, we have a right to feel them. They are not a reflection of personal weakness, but rather a reflection of the unique psychological and physical factors that combined to produce those emotions. Our goal at such times is to use our inner resources to cope better and to help our bodies and minds heal.
Pain Problems (see also Pain article)
Some people who are involved in accidents experience acute pain that becomes chronic. When the person has healed outwardly and appears to be physically normal, family, friends, and coworkers may relate to the person as if there is no pain problem. This can create enormous stress for the person with pain and can lead to self-doubt, self-denigration, and depression.
Migraine and the Brain: Men and Women are Different
Recent research conducted at Harvard Medical School in Boston has shed light on the differences in both brain structure and function for men and women with migraine headaches. We have long known that pain disorders are more prevalent among females than males and that about twice as many females than males suffer from migraines. Are there differences in the brains of men and women that reflect these differences?
Maleki, Linnman, Brawn, Burstein, Becerra and Borsook matched female and male subjects who suffer from migraines for age, age their migraines began, medication type and the frequency of their migraine attacks. The study also included healthy controls. Maleki and his colleagues assessed pain threshold and tolerance for the subjects using a heated bar. They used MRI scans to examine the brains of their subjects when they were at rest and not having a migraine attack. They also did MRI scans when the heated bar was applied to their subjects’ hands to cause some level of pain. They wanted to investigate both differences in the brain at rest and when some type of painful stimulation was provided.
Emotional and Motivational Brain Connections Predict Chronic Pain
An exciting study reported in the latest issue of Nature Neuroscience from the laboratory of Dr. Marwan Baliki at Northwestern University in Chicago casts light on the changes that occur in the brain when acute pain becomes chronic. The study strongly suggests that subjects’ emotional responses to acute pain play an important role in predicting these changes in the brain. Subjects who are more distressed about their acute pain not only tend to go on to develop chronic pain but their distress actually caused changes in the brain that were observed on brain scans. To my knowledge, this is the first time we have actual observations of the changes our attitude and feelings can cause in the brain over time that can lead to the development of a chronic pain problem.
Dr. Baliki and his colleagues took brain scans of subjects with acute back pain. They also measured pain intensity and the level of distress the subjects were experiencing. These data were obtained 4 times over the course of one year. During this time, some subjects experienced a resolution of their back pain whereas others continued to experience significant back pain which by the one year mark, had become chronic.
Chronic Fatigue Syndrome
Imagine that you go through the day carrying two extremely heavy suitcases and wearing ankle weights. You constantly feel tired, weak, exhausted, and heavy from when you wake up in the morning to when you go to bed at night. This goes on for months or years on end. Imagine that no matter how little you do, you still feel terribly exhausted and that no matter how much sleep you get, you still feel extremely tired. These are the hallmark symptoms of Chronic Fatigue Syndrome (CFS) otherwise known as Myalgic Encephalomyelitis.
How is CFS diagnosed?
CFS is diagnosed by excluding other illnesses and disorders that cause similar symptoms such as thyroid disorders, diabetes, and infections. You should consult with your family physician if you have symptoms of CFS and have not had them investigated to rule out some other disorder or illness.
Headaches
Most of us experience headaches from time to time but when they occur frequently and with an intensity of pain that interferes with our lives, they become a serious, life-altering problem. If you develop a headache problem it is important to consult with your family physician in order to rule out causes related to illness, medication side effects, or other factors that can be investigated and treated medically.
Types of Headaches
There are many different types of headache. The International Headache Society has grouped headaches into two major categories: primary and secondary. Primary headaches do not have a clear link to another disease or injury, secondary headaches do. Primary headaches occur more often than secondary headaches, and include, migraine, tension and cluster headaches.
Diabetes
When people have diabetes, their bodies do not produce enough insulin or are not able to effectively use the insulin they do produce. Insulin is a hormone. It is used to turn sugars into the energy that our bodies need to run on a day-to-day basis. When everything is working normally, insulin is produced as needed to control the level of sugar that is released into the bloodstream. When not enough insulin is produced or when the body cannot use the insulin properly, the level of sugar and insulin in our bloodstream rises. If this condition continues over a period of time, diabetes can develop.
Research has indicated that there is a genetic link for diabetes. We also know that certain ethnic groups appear to possess genes that increase their risk. These include people whose families descend from Aboriginal, Hispanic, Asian, South Asian, and African populations.
It is a challenge to live with any chronic illness such as diabetes, because to do so effectively requires us to make lifestyle changes. Most of us find this very difficult. As humans, we are creatures of habit. We get used to living a certain way, and we resist change it even when we know it will be good for us. The true challenge in effectively coping with diabetes is in making the necessary lifestyle changes.
Psychologists are specialists when it comes to lifestyle change. We help people implement the changes they want to make even if they have mixed feelings about those changes. We help people resolve the inner conflict that we all experience when confronted with changes we need to make.
Dr. Rickey Miller, Psychologist 