Tuesday, December 14, 2010

10 Things to Discuss Before Marriage

Marriage is one of the most wonderful life experiences that two people can share.  However, a great marriage is based on much more than just love.  Below are ten important things for a couple to discuss before deciding to tie the knot.  Matching or being similar in these areas will make wedded bliss more likely.


1.   Life goals

2.   Spending/saving personalities

3.   Physical activity/energy level

4.   Children & Family

5.   Intellectual & Cultural interests

6.   Vocational interests/work ethic

7.   Friends

8.   Religion/ Spiritual interests

9.   Communication skills and styles

10. Roles and expectations


Monday, November 29, 2010

Awesome New Resource for Kids with Asperger's

Southeast Psych's own Frank Gaskill ("Dr. G") and University of South Carolina doctoral student Ryan Kelly have completed work on Max Gamer, a graphic novel about a boy with Asperger’s Syndrome who uses his special abilities to become a superhero.


The graphic novel is the first in a series of Max Gamer books, all intended to promote a positive view of Asperger’s.  While those with Asperger’s—or “Aspies”—are the main target audience for the series, Dr. G. believes anyone interested in superheroes or those with special abilities will enjoy the books.  “Max Gamer has special abilities, but rather than having them become burdens, they become ways to help himself and other people around him.  He’s awesome, just like most Aspies I know are awesome.”

Dr. Temple Grandin, the internationally-known autism pioneer, said of Max Gamer, “This comic would have helped me when I was a teenager who was being teased.”  She added, “I think it will help the smart Aspie kids to feel proud of themselves.”

Published by Hero House, a division of Southeast Psych, Max Gamer is available starting tomorrow through MaxGamerOnline.com.  Check it the website to see the making of Max Gamer and a great Aspie blog.

Sunday, November 7, 2010

New Moms Need Love, Too

by Dr. Barrie Morganstein

As a new mom, I am learning firsthand how hard it is to take care of a baby and take care of myself (not to mention also taking care of a husband and a dog). I have always been notoriously bad at getting to bed at a reasonable hour and my baby’s arrival has made it even worse. With our little bundles depending on us, our good health is even more important; here are some things that new moms can do to manage stress and feel good:

· Get out of the house. After my baby was born, I stayed in the house a lot. Although I needed the rest and recuperation, I definitely found myself going stir-crazy. Getting out of the house -- whether its outside for fresh air or to the mall -- will do a lot to lift your spirits and invigorate you.

· Get some exercise. As hard as it is to get up off the couch and as tired as you are, get moving. Walking slowly on the treadmill, doing a light yoga class, or even just stretching in your living room, moving your body will make you feel better physically and mentally.

· Keep in contact with friends. It can be helpful to speak to your friends and commiserate about your new parenting trials and tribulations. However, it can be just as helpful to simply talk about girl-stuff. Being a mom is just one of our many roles, so we may find pleasure in discussing things other than the kids (such as what happened on The Real Housewives of New York).

· Don’t be afraid to say “no”. We often try to be superheroes and take on too many obligations. The added strain and fatigue that comes with baby care makes you more vulnerable to stress and emotional overload. Nicely explain to others why you are not able to take on a certain project – supportive people will understand.

· Ask for help. Women are capable of a lot, but even Wonder Woman had a sidekick (not to mention help from the rest of the Justice League). Don’t be afraid to ask your Superman for help with whatever you need, whether it be baby’s bedtime, laundry, bills, etc.

· Remind yourself what a great job you are doing. We are often our worst critics; chances are you are not only keeping up with your new babe, but excelling in your new role.

· Get help if you need it. If you are feeling stressed, overwhelmed, anxious, or depressed, talk to someone. Let your significant other, family member, or friends, know that you need some extra encouragement. A psychologist or counselor can also be a valuable addition to your support-network. 

Dr. Barrie Morganstein is a psychologist and new mom at Southeast Psych.  You can contact her at 704-552-0116.

Monday, November 1, 2010

Can You Hear Me Now? The Basics of Central Auditory Processing Disorders



Central Auditory Processing Disorders (CAPD) is a learning disability that is not very well known and is often under-diagnosed and misdiagnosed.  CAPD is also confusing because there are many signs and symptoms that are often attributed to other disorders, especially Attention Deficit Hyperactivity Disorder (ADHD) or severe anxiety.  Below are some of the most common signs that can suggest CAPD.  An individual with CAPD may…

  • have poor expressive or receptive language
  • have difficulty with reading comprehension, spelling, vocabulary, and/or foreign languages
  • have difficulty following long conversations
  • have difficulty following verbal directions, especially when involving multi-step directions
  • need extra time processing information
  • have decreased comprehension in noisy environments
  • have difficulty with phonics or speech sounds
  • talk less than peers
  •  “tune out” or seem to be in a “world of her own”
  • be less social because of comprehension problems

It is very easy to determine the presence of CAPD.  Many audiologists are trained to identify CAPD.  It is also very important to consider having a psycho-educational assessment completed by a psychologist to rule out the presence of other issues (e.g., ADHD, anxiety, other learning disabilities, etc.).  These professionals are also likely to help you determine the best approaches for intervention.  Some excellent books about CAPD are When the Brain Can’t Hear: Unraveling the Mystery of Auditory Processing Disorder – Teri J. Bellis, Ph.D. and Like Sound Through Water: A Mother’s Journey Through Auditory Processing Disorder by Karen J. Foli & Edward M. Hallowell.  

Dr. Barrie Morganstein is a psychologist at Southeast Psych who sees a wide range of clients and has a specialty in the assessment and treatment of central auditory processing disorders.

Wednesday, October 13, 2010

Parenting Stress: How to Take Care of Yourself


You know the saying, “If mama isn’t happy then nobody is happy.” There is some truth to this old adage and it applies to fathers too. It’s easy for parents to focus all of their attention and energy on their children and family and neglect to take care of themselves. However taking care of yourself is just as important as taking care of your family. It’s a lot like the emergency landing instructions that you get on airplanes. You have to put your own oxygen mask on first in order to be able to help others. Here are some tips for taking care of yourself.

1) Do one thing every day that makes you happy. You deserve and need time for your own enjoyment. Carve out at least 15 to 30 minutes a day where you are doing something that you enjoy that’s just for you.

2) Know your limits and stick to them.  It is okay to multitask sometimes, but we also need to know when enough is enough. Cut back on things that aren’t necessary and make your life more manageable.

3) Practice what you preach. You help your kids eat a balanced diet, get enough sleep, encourage them to be physically active and take care of any illnesses they have. You need to take care of your physical needs as well. Poor nutrition, sleep deprivation, lack of physical activity and illness are all vulnerability factors to stress.

4) Put things in perspective.  It’s easy to get caught up in the day to day and think that everything is important. Step back and take a look at what really matters to you. This will help you let go of little stressors and annoyances and instead focus on the big picture.

5) Remember you are a role model.  By taking good care of yourself and managing your own stress you are setting a positive example for your children. Good self-care brings happiness to the whole family.

Dr. Amanda McGough is a licensed psychologist with Southeast Psych in Charlotte. She treats children, adolescents and adults.

Monday, October 4, 2010

Is Recovery From an Eating Disorder Possible?


In working with families that have a loved one struggling with an eating disorder, one of the most common questions asked is about recovery. Can a person truly recover? 

The short answer to this question is: Yes, a person can fully recover with appropriate treatment. Research has demonstrated that while some people may struggle lifelong with an eating disorder, a majority of people can make a full recovery.

Here are four factors that can help lead to a full recovery:

1. Early Detection. Like other illnesses, the sooner a person begins treatment, the better likelihood of recovery. The longer a person engages in eating disorder symptoms, the more difficult the recovery can be.

2. Treatment Team Approach. Since eating disorders are complex illnesses that involve both medical and psychological issues, treatment should involve a therapist, physician and dietician. All of your care providers should have experience in treating eating disorders.

3. Type of Therapy. There are many different types of therapy for eating disorders. Choosing a therapy supported by research promotes the best chance for recovery. For children and teens, this therapy is called Family Based Treatment or the Maudsley Method. For adults, Cognitive Behavioral Therapy is the treatment of choice.

4. Appropriate Level of Care.  It’s imperative that a person receive care at the most appropriate level based upon their symptoms. This can be outpatient, day treatment or inpatient care. Your treatment providers should help you determine which level is appropriate.

Intervening early with a treatment team approach using a proven and research-supported therapy model at the appropriate level of care increases a person's chances of a full recovery from an eating disorder.

Dr. Heidi Limbrunner is a licensed psychologist with Southeast Psych in Charlotte. She specializes in the treatment of eating disorders.  You can contact her at 704-970-4791.

Monday, September 27, 2010

Sports Injuries Don’t Just Hurt the Body



Most of us who play a sport consider “athlete” as one aspect of our identity.  How important playing a sport is to us can greatly affect how we deal with an injury.  While healing the body is important, the injury to our identity as an athlete can be equally significant.  Some of the possible psychological impacts of sport injuries include:

Temporary loss of identity:  Many athletes connect the way people view them (popularity, respect) to their role in sport.  During the rehabilitation process, there may be a constant comparison to things that they could do, and the way that others used to view them.  These negative thoughts may work against them in their efforts to heal the body.

Feelings of isolation and being left out:  Athletics presents an important social role, and as a result, injured athletes may feel left out of the interaction with teammates, both competitively and informally.  This loss may be as significant as what we would consider a true “loss” such that a grieving process may take place. This will be especially true in the situation of a career ending injury.

Decrease in self-esteem:  For many athletes, self-esteem is connected to performance ability and achievement.  Injury for some athletes may have a significant impact on self-image and long term goal achievement.  This decrease in self-esteem may carry over into academic performance and personal relationships. 

Depending on the severity of the injury, other possible psychological impacts include anger, guilt, post-traumatic stress disorder, helplessness, and depression.  Each of these concerns may contribute to an athletes’ ability to recover well and return to post injury performance, which again can result in depressive symptoms and repeat the psychological pattern.

Here are a few things that parents and coaches can do to help injured athletes heal their minds. 

* Help athletes to acknowledge and recognize the trauma and loss that has occurred, and provide support as they experience the grieving process.  Athletes (and even coaches) sometimes engage in denial regarding the true impact of a sports injury.  This denial can result in additional injuries or negative psychological impacts.

* Provide encouragement and support during the rehabilitation process.  Due to many of the psychological impacts of sport injury, athletes may not be as motivated to engage in the rehab process.  Providing support and acknowledging the barriers may be helpful.

* Normalize their experiences of fear of re-injury.  Athletes may be apprehensive to express their concerns and fears.  Allow them to recognize that fear is a normal reaction, and that they are not alone in that experience. 

* Particularly for career-ending injuries, help athletes re-orient to alternative options.  Many athletes, particularly those who have been playing sports since early childhood, have not had the opportunity to fully develop other identities and options.  Exposing them to those possibilities is important in helping them to feel as though they have a path and some direction. 

* Finally, some athletes have such a difficult experience following a sport injury that counseling or professional support may be necessary.  Keep an eye out for signs of more significant psychological concerns such as increased isolation, poor concentration, changes in appetite, and feelings of hopeless or worthlessness.  These signs indicate that there is a need to go beyond the training room in the healing process.   

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych with a Ph.D. in counseling psychology and a master's in sports psychology.  She sees clients of all ages and specializes in performance enhancement, relationship concerns, diversity issues, and the treatment of anxiety and depression.  She can be contacted at 704-552-0116.

Monday, September 13, 2010

Helping Your Teen Through Dialectical Behavior Therapy (DBT)



Many of us know, or remember from our own teen years, that being a teenager isn’t easy.  Developmentally, adolescence is a time of growing independence, developing a sense of self, learning to navigate social relationships, and increasing responsibility.  On top of these developmental tasks, teens face pressures from school, peers and family responsibilities.  Teens can be under a significant amount of stress and that requires them to find ways to cope.  

Some teens may lack adequate coping skills, which leads to trying to cope with their stress in unhealthy, even harmful ways.  For example, they may have difficulties with self-injurious and life-threatening behaviors, suicidal ideation, poor impulse control, running away, stealing, lying, low frustration tolerance, interpersonal conflict, poor sense of self, high-risk sexualized behaviors, disordered eating, and substance abuse.  

However, the problems that teens face can be successfully navigated if they have healthy coping skills and support from caring adults.  Dialectical Behavior Therapy (DBT) is a form of therapy that has been widely researched for approximately 30 years.  It has proven to be effective in helping teens to reduce risky behaviors, manage emotions more effectively, create a more balanced life, and improve the overall quality of life.

What coping skills can DBT teach your teen?  DBT focuses on skills in five main areas:

1)    Mindfulness: Learning how to be focused in the present moment, how to balance emotions with rational thought and how to do what is effective in the moment.

2)    Distress Tolerance: Developing skills to help teens cope with stress in healthy ways through distraction, self-soothing and looking at the pros versus cons of choices in each situation.

3)    Emotion Regulation: Helping teens better understand emotions, reduce the intensity of their emotions, and learn how to ride the wave of emotions without acting out on them.

4)    Interpersonal Effectiveness: Developing strong relationship skills, learning how to communicate and listen in a way that is respectful towards others and themselves, learning how to say no, how to deal with difficult people and how to repair relationships.

5)    Walking the Middle Path: Learning how to validate one’s self and others, how to find the kernel of truth in different points of view, create a more balanced way of thinking and living, and how to reinforce behaviors in both self and others.

Learning effective, healthy coping skills now can benefit teens in their present life and in the future.

Dr. Amanda McGough is a psychologist at Southeast Psych who specializes in using DBT.


Tuesday, September 7, 2010

Top 10 Things that Make for a Stellar Psycho-Educational Assessment


As kids head back to school, we start to notice some struggle to learn more than others. Parents who take a closer look can make a big difference in the childrens’ education. Psychologists can give parents peace of mind through a psycho-educational assessment to help figure out why a little boy or girl is struggling in school. Such assessments or “testing” can help kids learn more effectively.

Not all assessments are equal. A good assessment should do the following:

1) Provide a neurodevelopmental profile, and not a label. Just giving a child a label is not helpful. It’s too easy to say that a child who struggles with reading has a Reading Disorder. That label doesn’t really tell us why the child has difficulty in that area. It’s really more important to figure out why he or she is struggling in a particular area. Is reading difficult for a learner because of weak active working memory (the size of a person’s mental desk) or because they struggle with phonological processing (oral language function involving identifying, distinguishing, and manipulating the individual sounds in words)? Obviously, different learning profiles are going to be helped by different strategies which should be designed by a good assessment.

2) Must include strengths as well as weaknesses. Too many kids who struggle in school don’t get to hear enough about the awesome tasks they can complete. These strengths need to be incorporated into the feedback session, so kids, parents, and teachers have a realistic sense of hope.

3) Assessments should incorporate multiple sources of information. They should include a broad range of qualitative information (review of work samples, interview with students, information gleaned from discussion with parents and teachers), integrated with quantitative information (such as one gets from psycho-educational tests). The person writing the report must look for a pattern of strengths and weaknesses that emerge across several tests.

4) The feedback provided should give both you and your child a much clearer understanding of what’s causing his or her difficulties in school. Students need to be given age-appropriate feedback about how they learn.

5) Must include specific learning strategies based on each child’s individual profile. This should include a customized learning plan. Avoid clinicians who provide boiler plate learning plans. If they’re giving boiler plate learning plans, they’re probably not really understanding the unique aspects of your child, and they’re not helping you, either.

6) The feedback must connect neurodevelopmental function and academic skills. It should explain why Johnny can’t read and why he’s so good at math.

7) For public school children, assessment should not be so focused on determining eligibility for services that the child’s profile isn’t revealed.

8) The process of assessment should be an ongoing process of consultation. The goal is to find strategies for better success. There’s the need for on-going follow-up and tweaking of strategies as needed. Your assessor should be available to help you with this process and make sure that you, your child, and the school stay on track.

9) It’s great when the assessor can provide feedback directly with the child’s school—their teachers, learning support teachers, school psychologist, etc. This helps ensure that everybody is on the same page and allows for brainstorming what is feasable within a particular school.

10) Prioritization of weaknesses. If a child has several weak areas, it can be overwhelming to try to address them all. A good assessment should let you know what are the really important areas to address first.

And another for good measure...Make sure the report has clear explanation of the technical jargon.  It's especially helpful if it uses metaphors to help explain the concepts.


Dr. Kyra Grosman is on staff at Southeast Psych and we think she does stellar psycho-educational assessments.  She also sees clients for therapy for a range of issues.

Monday, July 26, 2010

The Problem of Perfectionism: Part 2


Last week, I talked about the problem of perfectionism and this week, I want to give you some practical tools for overcoming it.  There are a number of ways to begin to break the cycle of perfectionism:

· Knowing is half the battle: If you find yourself identifying with some of these symptoms, that’s the first step. Awareness is necessary in order to begin to change.

· Stop worrying and start doing: Many times, it is taking that first small step that seems to be an insurmountable task. Usually, once a task is started, much of the anxiety and worry decreases.

· Start small: Break the task into “bite size” pieces. This will actually help you to “stop worrying and start doing”, and makes the task as a whole more manageable and less overwhelming. If your challenge is beginning, convince yourself to sit down for 20 minutes rather than the entire three hours that the task will take to complete.

· Encourage acceptance of limitations, performance, and mistakes: Perfection is an impossible goal. There will always be areas of possible improvement, and there will be days when “good enough” is often “more than okay”.

· Be mindful of the conversations in your head: Our self-talk contributes to anxiety and depression and the internal drive for perfection more than we often realize. If the discussions in your head suggest that your entire self-worth (or my future, etc.) is based on how well you complete a task, your internal dialogue needs to be adjusted.

· Ask yourself, “Is it worth this amount of effort?”: Put your tasks into perspective. Is the paper that may be worth 10% of my grade really worth the significant number of hours I have already put into it? The effort put out should match the significance of the task at hand.

· Increase mindfulness: Finally, there is a great deal of talk about the benefits of mindfulness. Mindfulness allows us to be present and in the moment, less worried about yesterday (and the mistakes of the past) and tomorrow (and the fears about what may or may not happen). Being mindful will allow you to focus on the process rather than the outcome. Increasing mindfulness will help you begin, accept your limitations, and enjoy the process.

Perfectionism at it’s best may help you get the job done…eventually…but at it’s worst can contribute to depression, anxiety, and failure, and make the process of completing even a simple task much more difficult than it needs to be.

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement, as well as the treatment of anxiety and depression in teens and adults.

Monday, July 19, 2010

The Problem of Perfectionism: Part 1




Today’s society continues to demand increasingly high standards in virtually every arena. Unfortunately, we often interpret “achieving excellence” as “it must be perfect”. While maintaining a high standard is important, when it becomes confused with perfectionism it actually fails to lead to the desired consequences of success. The idea of achieving perfection is a goal that is impossible to meet, and the more we demand perfection from ourselves, the more the “finish line” moves, and the more overwhelming the task becomes.

It can be difficult to find the line between ‘perfectionism’ and ‘excellence’, and healthy motivation and striving. Burns (1980) defines a perfectionist as someone “whose standards are beyond reach or reason”, and “who strain compulsively and unremittingly toward impossible goals and who measure their own worth entirely in terms of productivity and accomplishment”. For perfectionists, thoughts and behaviors may be maintained by a number of factors, including fear of failure, inadequacy, or fear of disapproval and disappointing others. One way of locating that line is by asking yourself: (1) Is my goal attainable? (2) Are my beliefs in my ability to do this accurate? (3) Am I able to adjust my standards when necessary?

Perfectionism may look different in different individuals. For some, it is the attitude that “I’ll do it by myself…because no one will be able to do it as well as I can”. Other individuals may not take risks or try new things because they may not be good at it, while others become chronic procrastinators. Perfectionism may also look like overcompensating, excessive checking and seeking reassurance from others, difficulties making decisions, and avoidance of some activities and situations all together. The struggle to be perfect makes it difficult to recover from mistakes, and often leads to social and performance anxiety, depression, anger, and/or low motivation. It can also contribute to body image problems and eating disorders. 


Next week, I'll give you seven ways to break the cycle of perfectionism.

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement, as well as the treatment of anxiety and depression in teens and adults.

Thursday, July 1, 2010

The Importance of Early Diagnosis for Autism

by Lauren King, Psy.D.


1 in 110 children have Autism based on a report in December of 2009 (Centers for Disease Control and Prevention.)  Currently there is not a single known cause for Autism, although many theories are being investigated. Additionally, there is not a “cure” for Autism at the present time. Early intervention and diagnosis are the best tools at our disposal. Research reveals repeatedly that early treatment for Autism makes the biggest difference. When therapy is introduced at an early age, due to the brain’s plasticity (ability to change), the child is likely to progress more than if their therapy starts at a later age. 


Obviously, no matter what the age, children can still change and make progress. The issue is really that we now know the earlier the therapy, the more likely it is to have a large impact on the child’s life. For example, research shows that children who are provided intervention before 3-years-old are impacted more than children provided therapy after 5-years-old (Harris & Handleman, 2000). Research also consistently shows that diagnosis of Autism prior to 24 months is not as reliable as it is after 24 months because it can be easily confused with other developmental problems (Lord, 1995). However, some children with more clear markers are diagnosed at earlier ages.  


In order to access early intervention for children with Autism, a prompt diagnosis is needed. If you are concerned about Autism Spectrum behaviors in your child, the first step is a thorough assessment.  Oftentimes, the signposts of Autism are the lack of typically developing behaviors such as coordinating attention between people and objects, sharing emotions with others, following the point or gaze of another person, playing symbolically, using appropriate gestures, and having appropriate language development (Woods & Wetherby, 2003). However, these behaviors can also be signals of other developmental problems besides Autism, which is why it is important to have a professional in the field of Autism conduct a full assessment.  The assessment should include recommendations on where and how to access early intervention for your child. At southeast Psych, we perform such assessments, and we are passionate about getting families in touch with the services and support they need following their testing.  

Dr. Lauren King is a therapist at Southeast Psych who specializes in working with children with autism spectrum disorders and their families.  She also has a specialty in the treatment of eating disorders.  You can contact her directly at lking@southeastpsych.com.  


References

Harris, S.L., & Handleman, J.S. (2000). Age and IQ at intake as predictors of placement for young children with autism: A four to six year follow-up. Journal of Autism & Developmental Disorders, 30, 137-143.
Lord, C. (1995). Follow-up of two-year-olds referred for possible autism. Journal of Child Psychology & Psychology & Psychiatry & Allied Disciplines, 36, 1365-1382.
Woods, J. J., & Wetherby, A. M. (2003). Early identification of and intervention for infants and toddlers who are at risk for autism spectrum disorder. Language, Speech, and Hearing Services in Schools, 34, 180-193.

Monday, June 28, 2010

Are Most People Good at Multitasking?

Many people think they are good multitaskers, but are they really?  Actually, no.  Several studies have demonstrated that it is very difficult or impossible for most people to do two or more things at once very well, even if they think they are doing fine.

In a recent study, 200 volunteers were asked to drive in a driving simulator and concentrated on information given to them on a cell phone at the same time.  The majority of the participants did poorly on both tasks.  they were 20% slower to hit the brakes and also performed worse in responding to the information given to them over the phone.

However, the researchers uncovered a surprising discovery:  1 in 40 excelled at performing both tasks at the same time.  That's right, a whopping 2.5% of adults seem to be good at multitasking.  The author of the study, David Strayer, called these folks "supertaskers."  These supertaskers seem to be able to take on two or more things at once and do really well on them.

It's not clear if this is a skill that has only recently developed in human brains, thanks to the demands of our ever-increasing tech-culture, or if it is something that some people's brains just naturally have the ability to do.  Either way, it's still a rare skill.  You might be a supertasker, but it's a safe bet to say that the odds are against you.

Monday, June 21, 2010

8 Ways to Combat Performance Anxiety in Competition



Regardless of how we feel about it, anxiety is a necessary part of any competition situation. While it’s necessary, as it is often our level of arousal and anxiety that gives us the needed “adrenaline rush” for competition, it does not need to get the best of us. Research suggests that one of the differences between successful athletes and those that may not be as successful is in how they experience the symptoms of anxiety—elite athletes are more likely to interpret the symptoms of anxiety as excitement and the feeling that gets them “pumped”, while for less confident athletes, those same symptoms may create issues such as doubt, tension, and negative thoughts. 

For most individuals, anxiety related to competition is what we call “anticipatory” anxiety—the thoughts and worries that flood us before a situation or event.   Once the event, performance, or competition begins, that anxiety may disappear, or the level may drop.  For others, anxiety can remain throughout the entire event, resulting in increased heart rate, loss of breath, hands shaking, tension, concentration difficulties, not being able to “shake off” mistakes, and ultimately, a decrease in performance.  
There are several ways in which you can work to decrease your anxiety level in a competition situation, rather than allowing your anxiety to control you.  Here are just a few of them:

1.  Differentiate between “playing well” and winning:  Don’t focus on the outcome.  Focusing on winning increases the pressure you place on yourself and puts you in a “future” mindset.  Focus, instead, on those small things that you need to do that will allow you to perform well (“I know I need to focus on bringing my knees up in the last fifty meters”…“I need to make sure that I follow through with my shot”.) Focusing on the small things will contribute to the likelihood of creating the outcome you want:  winning.

2.  Set realistic goals to improve specific skills:  Goals should be measurable, challenging and attainable.  Vague goals such as “play well” do not offer much structure or direction.  Similarly, you don’t want them to be too easy…you want to have to work for them, but you also want them to be within your reach.

3.  Reduce uncertainty by preparing for “worst case scenarios”:  one of the biggest contributors to overwhelming performance anxiety is a lack of confidence, which can happen for a number of reasons—feeling unprepared or fearing repeating a previous mistake, for example.  One of the ways you can reduce uncertainty and increase the feeling of “being prepared” is to practice “worst case scenarios”.  Have a ‘back-up’ warm-up that you can do relatively quickly in the case you are ever short on time, for example…things happen…buses break down, matches run late,  meets run early. 

4.  Use “cue” statements to refocus:  Develop a ‘cue’ statement that you can practice as a means of helping you to regain your focus.  A cue statement should be short, personal, and positive.  It should be a short phrase that creates a visual image of the athlete you want to be, and allows you to return your focus and concentration to the task at hand.     

5.  Cognitive rehearsal and visualization:  Many athletes find that visualizing themselves successfully performing or completing a certain skill contributes to an increase in confidence, and therefore a decrease in anxiety.  Cognitive rehearsal and visualization can both contribute toward feeling more prepared.

6.  Positive self-talk:  You may surprise yourself to realize how often the dialogue in your head becomes negative when you make a mistake. Recognize critical self-talk and the mistakes or actions that trigger negative conversations with yourself, and work to challenge those automatic negative thoughts and make them positive. 

7.  Breathing:  This sounds like such a simple strategy, but it is one most often overlooked.  Taking a deep breath during competition (or before certain moments—at the free throw line, for example, or before the race begins) can often be used as an opportunity to refocus and re-center.  In the middle of stressful situations or when anxiety runs high, there is often the tendency to resort to shallow breathing, which results in even more anxiety.  Taking a deep breath may allow you a moment to use additional strategies (positive self-talk, cue statements, goal reminders) that can also decrease anxiety.

8.  Prepare properly:  A significant contributing factor to performance anxiety may be the fear of being unprepared.  If you feel confident in your preparation—for example, you know that you have taken practice seriously and consistently given your best effort—the result is often a significant level of confidence that you can “trust your training”.  

Some degree of ‘performance anxiety’ is a necessary and helpful component of competition.   However, if you can turn your worry and anxiety into positive action, you increase your chances of success. 

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych who specializes in performance enhancement for athletes and other top performers, relationship concerns, diversity issues, and the treatment of anxiety and depression.

Monday, June 14, 2010

Violent Video Games Do Not Cause Violence in Most Children


Parents continue to ask me on a regular basis if playing violent video games will cause their children to be violent.  The answer is usually, "no."  Most kids--millions and millions of them--will have no increases in any meaningful long-term violent behavior because they played Modern Warfare 2 or other violent games.

In a recent Reuters article, one expert noted, "Recent research has shown that as video games have become more popular, children in the United States and Europe are having fewer behavior problems, are less violent and score better on standardized tests."

However, this doesn't mean that it is always a good idea to let your child play violent video games.  You have to take developmental maturity into consideration (i.e., your 7-year-old might not be ready to play Halo Reach when it comes out, but your 14-year-old probably will be), as well as your own child's unique temperament and personality traits.  Parents need to know their child and make specific judgments about whether it is good for him or her to play.  Engage your child, play video games with them--or at least show interest in observing from time to time--and talk non-judgmentally about them. 

Here are some likely risk factors for negative reactions to video games include the following:

1.   Low tolerance for frustration - If your child gets very quickly overheated and can't manage upsetting emotions well, especially when compared to other kids of the same age, then it's probably wise to limit the exposure to certain types of games.

2.  Frequent depressed or dark moods - If your child is prone to dark moods, isolation, or feelings of hopelessness. By the way, if this is true, you will probably want to consider seeking out professional help for them, as well.

3.  Indifferent to the feelings of others - Lack of empathy and lack of remorse are big risk factors that should not be ignored.

4.  Often breaks rules or promises to others - Again, you need to compare this to other children of the same age, but if your child breaks rules more frequently than his or her peers, especially big rules or does things that may negative affect other people (stealing, bullying, etc), then you will want to set some limits on certain types of gaming.

The best analogy I have heard thus far is that of a peanut allergy.  Most people aren't allergic to peanuts, but a few are.  The vast majority of kids who play video games are doing great, but a select few are “allergic.”  If you are allergic, then just don’t play or let your kids play.  At the very least, limit their exposure to too much gaming if your child has any of the risk factors.

Dr. Frank Gaskill is a licensed psychologist at Southeast Psych who works with children and their parents.  One of his specialties is helping parents understand and skillfully navigate the new technologies that are part of their children's daily lives.

Monday, May 24, 2010

Are You Living with "Pregret"?


Some might figure that, as a psychologist, it’s part of my job to validate the whole spectrum of emotional experience for people. I guess in a way I agree with that, but only to a point. While we all struggle with a whole slew of emotional states, both positive and negatively charged, some of them are simply unworthy of validation. In particular, I think regret is an utterly useless emotion – a waste of one’s emotional energy. Such a fixation on woeful events chains us to our past and prevents us from moving on. We need to learn to stop playing the “Coulda, Woulda, Shoulda” game and start living our lives. We need to seek forgiveness, atone, make reparations, and move on or life will certainly move on without us.

Don’t get me wrong here – I’m not saying that we shouldn’t take stock of where we’ve been. If we do look back from time to time I think that we should only do so with the intent of learning something from our experiences, not for providing evidence of our failures and wrongdoings. To focus exclusively on our missteps and past grievances surely contributes to a pervasive sense of shame and doubt. And why waste time focusing on something that has already happened and cannot be changed? If we expended more energy thinking about potential and possibilities, we may find ourselves feeling enervated, motivated, and hopeful about the future. This brings me to Pregret.

Pregret is a term I like to think I coined, but a Google search from some time ago revealed that it was floating out there on the internet in places. Maybe I can distinguish what I mean by pregret by my unique application of the term. When I say Pregret I’m referring to pre-emptive regret. In other words regret for something that hasn’t happened. Are you following me? No, I’m not making a case for our innate ability to foretell the future or to time travel, although that would be pretty cool. In practice I occasionally get clients to think about the people in their lives that truly matter – all the people with whom they share a connection, people who are kind, who treat them with respect – basically anyone who cares about them in some significant way. I then ask them to imagine if these special people were no longer here. Yeah, it’s a morbid thought, but it’s designed to be a thought exercise because my next question is this:

“Would you have any regrets?”

If the answer to that question is “Yes”, then we’re talking about pregret. Now the wonderful thing about pregret is that it concerns feeling regret about something that hasn’t happened yet, so the wonderful thing is that you have the opportunity to take action and do something about it. For instance, someone might have regrets about not spending as much time with the person in question, or calling them, or telling them certain things. Well then DO SOMETHING ABOUT IT! What are you waiting for - the time is now! So think about it….do you have any pregrets???

Dr. Jonathan Anslow is a licensed psychologist with Southeast Psych who practices at our Blakeney office.  He works primarily with adolescents and adults.

Sunday, May 16, 2010

Asperger's Conference 2010

Southeast Psych, together with Thompson Child and Family Focus and The Epiphany School, announces our first annual Asperger's Conference this Thursday, May 20th, from 9am until 1pm.  The conference will be on the campus of Thompson Child and Family Focus and registration is only $40 per person.  


Dr. Frank Gaskill, who is well-known in the Charlotte area and beyond for his work with children with Asperger's is the keynote speaker, followed by Dr. Craig Pohlman, the director of Mind Matters at Southeast Psych and the author or co-author of three books, including How Can My Kid Succeed in School?  


In the afternoon sessions, you will have a choice of "Marriage and Asperger's" given by Dr. Jonathan Feather and Josh Jensen or "Super Social Skills" given by Mary B. Moore.  


It's a great line-up of excellent presenters with great content.  We already have more than 100 people registered and there is still time to get on board.  If you are interested, please click here to send Patsy your information or call her directly at 704-552-0116.  We hope to see you there.

Monday, April 19, 2010

10 Ways to Protect Yourself From Danger


We know that the world can be a scary place, but we still need to live in it.  With a few smart behaviors, we can increase our personal safety.  Below is a list of ten smart safety tips that everyone should use.

1.    Don’t look vulnerable (e.g., stay off your cell phone, don’t hold your purse loosely, etc.)

2.    Identify potential dangers (e.g., people trying to distract you, ask for directions, ask for help, etc.) 

3.    Avoid dangerous locations (e.g., avoid empty parking garages, isolated locations, etc.)

4.    Be aware of your surroundings (e.g., check out people around you, identify areas that people can hide, look for escape routes, etc.)

5.    Don’t make assumptions that people are safe because they look “nice”

6.    Don’t tempt fate (i.e., why shop and run errands at night when you can do this in daylight?)

7.    Avoid going out alone (there is safety in numbers)

8.    Know the “tricks of the trade” that predators use (e.g., offering to help you so you feel indebted to “help” them, making unsolicited promises – “I’m a good guy”, “I won’t hurt you”, etc.)

9.    If  you carry a protection tool (e.g., pepper spray, a club, taser, etc.) make sure you know how to use it properly (don’t become your own victim)

10.Don’t be afraid of hurting someone’s feelings; if they look “sketchy” or make you feel uncomfortable, roll up your windows, lock your door, or cross to the other side of the street; hurting a stranger’s feelings is a small price to pay for your safety.

Dr. Barrie Morganstein is a psychologist at Southeast Psych who sees clients of all ages.