Dana Nolan, LMHC
Making the Resolution
The new year is a time of reflection on the past and looking forward to the future. It has become commonplace to resolve to make changes in the coming year so that we are somehow a better person (thinner, happier, healthier, richer….etc.) Many times these resolutions are related to the “shoulds” that we have bouncing around in our heads. “I should be able to fit into a size 6 jeans.” “I should stop smoking.” “I should spend less money on coffee at Starbucks.” “I should have more fun.” “I should go to church more.” “I should stop texting while I drive.”
As a therapist, I notice “shoulds” when I hear my clients talk about their perceived failings or their goals. My philosophy is not that all “shoulds” need to be accepted as truth, but that we need to question their validity and ask if those shoulds are in line with our values as a person. Sadly, sometimes we accept the “shoulds” that we hear from others (or in the media) about how we should act or what kind of person we should be.
Before you jump on the band wagon on making New Year’s resolutions, stop for a minute and think about what is important to you and if anything is missing in your life that would make you feel happier. Are you missing out on time with family and friends? Are you tired of feeling out of breath easily and not having energy to have fun? Do you wish you could find time for a hobby? Do you wish that your sex life was more satisfying? The answer to these questions of self-reflection should guide you towards the changes you may want to make.
Keeping the Resolution
Once you have figured out what change you want to make, then the challenge can be to take the steps to make it happen. You may have noticed that I just mentioned “change” and not “changes” to make. In order to increase our chances of being successful, it is best to try to one change on thing at a time. We are creatures of habit and we need to focus on changing one habit at a time. When we have had several months of establishing a new habit, then we are ready to add in another lifestyle change.
Small, incremental steps towards an attainable goal is vital. Sudden, sweeping changes towards an unrealistic goal just don’t work. Telling yourself that you are going to get up at 5 a.m. every day and go to the gym is just not realistic. It is better to start with setting a goal of exercising 2-3 days per week. If you are able to achieve that goal, then add an extra day or more time per workout. Don’t tell yourself that you are giving up your daily Starbucks habit all together, but tell yourself that you will treat yourself 1-2 times per week.
Don’t expect perfection or berate yourself if you slip up. Change is hard and there will be times that old thought patterns or behavioral habits will trip you up. Don’t throw in the towel. If your goal was to do one fun thing each weekend and you have a weekend where it just isn’t possible, don’t let the negative self-talk take over. Just resolve to plan something fun next weekend and move on.
Happy New Year to all my friends, family, clients and colleagues. !
Dana Nolan, MS LMHC
Licensed Mental Health Counselor
Imagine being told that all the things you plan, all the moments you hope to have and all the achievements you aspire to may not happen. That’s what it is like when you hear a doctor say, “You have cancer.”
While many people know others who have battled or are currently battling some form of cancer, hearing those words never gets easier. Just because medical advancements have greatly improved the chances of remission and a long, healthy life doesn’t mean that diagnosis won’t drastically change your life. Because that’s the thing about life-changing diagnoses like cancer: They change everything.
When people imagine the experience of a typical cancer patient, what often comes to mind are physical symptoms like hair loss, nausea and fatigue. However, some of the biggest challenges a patient and their loved ones have to face are mental.
“When I was diagnosed with stage 3 breast cancer, I had a six-week-old baby. I wondered whether I’d see her grow up, whether she’d remember me when I was gone,” my mom explains. “I was told to get my affairs in order and hope for a year. What did that mean for my family? How would my 12-year-old son cope?” Fortunately, my mom beat the odds and is now entering her 24th year of cancer survivorship.
The types of thoughts my mom had after receiving her diagnosis can take a toll on a patient’s mental health and overall well-being, according to Dana Nolan, a licensed mental health counselor in central Florida.
Being diagnosed [with cancer] does not make someone mentally ill. But, in my experience, most cancer patients develop symptoms of anxiety and depression at some point during or after their treatment. While it is normal to experience mental health challenges, it is not necessary to simply suffer through it.
No two people respond the same way to difficult news, but there are several common mental health issues that may develop after any type of cancer diagnosis.
Cancer offers plenty of chances to worry both during and after cancer treatment. After you or someone you love is diagnosed with cancer, anxious thoughts and worries like these may become impossible to ignore:
- Is my prognosis accurate?
- What if I made the wrong treatment decision?
- What if my next scan shows the cancer has grown?
The last question represents a special category of anxiety nicknamed “scanxiety” by the cancer community. In an article on Medscape, author Nick Mulcahy explains, “Scanxiety is cancer patients’ fear and worry associated with imaging, both before and after a test (before the results are revealed).”
It’s normal to worry about the future sometimes, but when those worries begin to impede your ability to fully live your life, it’s time to ask for help.
A mental health counselor or therapist can help you determine what you are dealing with and how you can manage it. They may also recommend anti-anxiety medications such as Ativan or Xanax.
Depression affects an estimated 15% to 25% of cancer patients, according to the National Cancer Institute. Patients and their loved ones may develop depression because of the diagnosis itself, anxiety about the future, a changing self-image or even the side effects of certain cancer treatments.
It’s important to note that depression is not the same thing as feeling sad. Clinical depression often manifests in mood swings, fatigue, feelings of emptiness that last for more than a few days and feelings of helplessness or worthlessness. This may require medical attention.
Depression can affect all those around, not just the patient. Melanie Ball, who lost her dad to mesothelioma in 1993 when she was only 14 years old, also had to witness her mother sink into a deep depression that lasted for years after his death. Melanie’s mother chose to suffer in silence, but no one should have to face a life-changing illness, such as cancer or depression, alone.
If you or someone you love is suffering from depression, there is help. Many kinds of medical professionals can treat this condition through counseling, therapy or medication. Joining a support group can also make a big difference for those affected by cancer. In fact, studies show people with terminal cancers who participate in support groups have higher survival rates and increased quality of life.
People may grieve at many different times during and after a cancer battle, and grief is often shared by a patient’s entire support network. Lorraine Kember, a mesothelioma widow, explains how a cancer diagnosis can start the grieving process:
Anticipatory grief is the name given to the mix of emotions experienced when we are living with the expectation of a personal loss and grieving because of it. Anticipatory grief is particularly relevant to anyone who has received a terminal medical diagnosis and for people who love and care for that person.
Living with the expectation of death or loss can cause us to experience the same array of emotions that develop after the loss actually happens, including shock, denial, helplessness, sorrow, anger and physical pain.
While grief is normal during and after a cancer battle, you don’t have to grieve alone. Spend time with your family; they may be experiencing the same thing. Seek out grief support groups, which are often available at local hospices. And above all, remember to take things one day at a time.
If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HELLO to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.
People are talking a lot about sexual harassment these days after it has been revealed that several rich, powerful men have been accused of using their position of power or authority to abuse or harassment many, many women AND men. There is a current trend on social media to post “#Metoo” if you have personal experience with sexual harassment or abuse to show just how wide spread this type of crime is.
“Why didn’t she report it?”
“Why didn’t they fight back?”
“She shouldn’t have put herself in that situation!”
These are all questions or comments that have been heard when the topic of sexual harassment or sexual abuse comes up. It is called “victim blaming” and sadly it’s is a phenomenon that has been around for centuries. Some gender and cultural stereotypes have supported the idea that “boys will be boys” and that it is human nature for men to pursue women aggressively in any setting for their sexual fulfillment.
Blaming the person accusing someone of sexual harassment or assault is a common response after being accused of this type of activity. Shifting the focus of blame from the abuser to the victim is a classic defense and it is unfortunate that many abusers have successfully used this defense to save their job or avoid punishment. The more victims see that those accused of sexual misconduct avoid serious consequences, the more helpless they feel that anyone will believe them when they report it.
As a therapist, I have worked with far too many people who were harassed, assaulted or raped and didn’t report the incident to authorities for fear that they wouldn’t be believed or would be blamed for being assaulted. Many times abusers threaten their victims with being fired, being slandered, being physically abused or worse if they report the abuse to others. Those who perpetrate sexual abuse are skilled at targeting victims that they believe can be overpowered by threats.
What can you do to support victims of sexual harassment or abuse?
*Believe them! Many victims have had their complaints ignored or minimized, so they come to accept that sexual misconduct is normal and accepted behavior. If someone tells you that they have been sexually harassed or assaulted, let them know that you believe them and that it is NOT okay.
*Don’t be complicit when observing others making inappropriate sexual comments or using their strength or power to harass someone. Silence equals agreement.
*Be proactive with children and teens in your life and tell them that NO ONE should ever be permitted to make inappropriate sexual comments about you or touch you without your permission.
*Refrain from making offhand comments about someone “asking for it” because of the way they are dressing or behaving.
*Offer to support the victim in reporting the abuse to the proper authorities and tell them that you will stand by them through the process of holding the abuser accountable.
When perpetrators of sexual abuse think that no one will believe their victims, they will continue to continue to harass and assault. So, anything that we can do let victims know that they will be believed and supported will begin let would-be abusers know that they won’t get away with it.
Many times we feel stuck in unhealthy habits, relationships or emotions. Try as we might, sometimes we just can’t get unstuck. That is when most people seek counseling. Our practice focuses on helping our clients reach their personal life goals and feel their best emotionally and physically….what we like to call Healthy Living!
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As a therapist, I am certainly not immune to emotional distress and trauma. The biggest mass shooting ever to occur in the United States just took place in my hometown of Orlando at a nightclub that I have been to before. My friends/colleagues in mental health work at the very hospital where over 53 injured victims were taken and they are frantically trying to comfort distraught shooting victims and the family members who are looking for their loved ones who may be injured or dead. All the first responders who attended the scene may have trouble getting the picture of what they saw in the nightclub out of their heads. My own brain is struggling with the enormity of it all as this huge loss to our community sinks in even though I was safely home in bed when the whole event occurred.
A big part of my practice these days involves using a type of therapy called Eye Movement Desensitization and Reprocessing (EMDR) in my work with clients who have survived a trauma of some kind like rape, plane crashes, car crashes, physical abuse or witnessing a violent death. These clients have developed post-traumatic stress disorder (PTSD) and their symptoms include:
-Experiencing intrusive flashbacks or re-experiencing the traumatic event
-Avoiding the place where the trauma occurred or anything that reminds them of the event
-Feeling hyper-aroused which means they have trouble sleeping and feel jumpy and/or irritable
-Dreaming about the traumatic event
-Having panic attacks
When I think about all the recent victims of this mass shooting, I know that many of the survivors will develop PTSD in the coming weeks and months. Family members and loved ones of those who perished may also develop PTSD as a result of having to identify their bodies of their loved ones and grieving their unexpected and tragic loss. Not everyone develops PTSD as a result of experiencing or witnessing a traumatic event and we don’t really know why that is. But, what I do know is that many people with PTSD suffer in silence for a long time before they go to their physician or a mental health professional for diagnosis and help.
If you or a loved one begins experiencing symptoms of PTSD after a traumatic event or loss, please don’t ignore the symptoms or tell yourself that you just need to “suck it up and be strong.” PTSD is a very treatable condition and the impact that untreated PTSD has on one’s quality of life is profound.
My thoughts and prayers go out to all the victims of this senseless tragedy. I work with a lot of LGBT clients in my practice and I take comfort in knowing that our local LGBT community is very strong and that they will support each other as they heal.
Dana Nolan MS LMHC NCC
Licensed Mental Health Counselor
Altamonte Springs — Orlando
April is Child Abuse Prevention Month. Sadly, child abuse occurs far too often. Some families seem to pass on the legacy of physical, sexual and psychological abuse because many times victims of childhood abuse grow up to abuse their own children. This pattern can be halted if victims of abuse seek and receive professional help to deal with their trauma.
Commonly, a survivor of abuse will “stuff” their emotions and the memories of the traumatic events when they arise. They may turn to drugs or alcohol to numb the pain or to make the memories of their abuse disappear. These strategies work in the moment, but the thoughts, feelings and memories will keep coming up unless they are processed therapeutically. Quite often, my clients have told me that they have tried on their own for many years to get rid of their traumatic memories, anxiety and negative thoughts before they seek counseling.
There are a variety of therapeutic models to deal with the trauma of childhood abuse.
Trauma-Focused Cognitive Behavioral Therapy– helps victims of abuse to reframe the irrational and negative thoughts/beliefs that are often formulated after surviving childhood abuse.
Eye Movement Desensitization and Reprocessing (EMDR)-a very specialized form of trauma treatment developed to address the flashbacks, memories and negative thoughts common in those with post traumatic stress disorder (PTSD).
Dialectical Behavior Therapy-a collection of therapeutic interventions that focus on helping victims of abuse learn to manage their emotions, cope with stress in interpersonal relationships and tolerate emotional distress.
Play Therapy-a therapy for children that helps them express and process their emotions and memories of abuse in a safe environment. Play therapy uses dolls and toys to teach about healthy relationships and boundaries.
Pharmacologic Therapy-many times survivors of childhood abuse develop sleep problems, anxiety disorders (generalized anxiety disorder, post-traumatic stress disorder or phobias) or a mood disorder. Psychiatrists can prescribe medications to help manage symptoms which allow the survivor of abuse to work through trauma in counseling.
In my practice, I work with adult survivors of childhood abuse and utilize trauma-focused cognitive behavioral therapy, EMDR and dialectical behavioral therapy and have found these modalities very successful. It takes a great deal of courage and trust to reach out and seek help. If you are a survivor of childhood abuse and are ready to start feeling better, ask you primary care physician for a referral to a mental health care professional in your area that specializes in post-traumatic stress disorder and interview a few therapists to make sure you feel comfortable talking with them
As we say goodbye to the year 2015 and welcome 2016, it is normal to reflect upon the past year and to plan for the future. We hope to leave behind the sad or hard times and wish for happier and healthier times in the coming year. The New Year is a time to pause and take stock of our life, our goals and our relationships with a view to make the future better.
The New Year is not the only time that we review our lives and try to make improvements. When we turn another year older, it is common to think about where we have come from and where we are going. Birthdays that end in a zero (like 40) or a five (like 65) may have more of an impact emotionally. When we are young, we imagine what our life will be like and what we will have achieved when we are 40 years old or if we will be able to retire when we are 65 years old.
Experiencing a loss like the death of a loved one or a divorce also leads to re-evaluating our life and re-adjusting our plans for the future as we adapt to our loss. It is important (both emotionally and psychologically) to pay attention to these times in life that lead us to pause and reflect .
Many times we simply begin down the road of life that starts when we finish high school and our life road may include college, military, career, marriage, kids, travel, etc. We can become so focused on staying on our “road” and getting to our destination that we forget to stop periodically and make sure that we are on the right road for us. When the New Year, our birthday or a loss makes us stop for a moment, it is a good opportunity to remind ourselves (or rediscover) what is truly important to us (our values) and our goals in life. Some people may find that they are not living their lives according to their values or that they find their goals have changed somewhat. We can use these pauses to re-adjust our path and maybe change our direction a little bit so that we are living our lives authentically and reach our goals.
As a therapist, I truly love working with clients who have discovered that they need to re-adjust their path in life. These adjustments could be a career change or shift; it could be deciding that a committed relationship has become unhealthy or unhappy; it could be that we are not being the parents that we wish to be to our children. In counseling we get to explore what is truly meaningful to us and forge a path to get there. When we set out in life as young adults, we may fail to take into account that what we truly want in life may change as we age. This is normal process and is only a bad thing when we fail to pay attention to how we have evolved as a person and fail to recognize that we need to change paths a little bit.
I hope that this holiday season and the New Year find my friends, family and clients happy and safe.
Happy New Year!
Dana Nolan MS LMHC NCC
Licensed Mental Health Counselor
Altamonte Springs — Orlando
We all tried very hard to pretend that the foamy bubbles floating from the sky were really snowflakes even though it was a balmy 65 degrees. It was fun to see the facial expressions of the young children in the crowd as the dancing lights came on for the first time! We told some families who had never seen the lights before about finding the Disney characters hidden within the lights. As a family we don’t have too many holiday traditions, but the few that we have mean a lot to us and we have always tried to find the time to make them happen and to be mindful as we celebrate.
During my work as a psychotherapist (mental health therapist), I find that this time of year brings a burst of clients wanting to get it in to see me. It is usually due to depression, anxiety or family/relationship stressors which seem to increase during this busy time of year. Why would so many of us feel emotionally distressed during a time that is supposed to be a joyous? Most of us already have busy schedules and too much on our plate without adding on gift shopping, annual holiday parties and decorating our homes for the season. It is easy to get wrapped up in our “to-do” list and feel stressed so that we aren’t really present during this time of year.
You may have heard of “mindfulness.” It refers to being as aware as possible in your current situation and place. Sometimes we float through life spending too much time ruminating on the past or worrying about the future which means that we aren’t enjoying today. There are many books and research articles about mindfulness and the emotional and physical benefits of practicing it. Rather than try and summarize all that information, I’d like to offer a few tips to help you be mindful during the holidays and all year round, as well.
1. Let go of trying to keep up with the “Jones” this season. Some people feel overwhelmed by trying to have the biggest or best holiday yard decorations or to make the perfect-looking Christmas cookies to give away to friends. Others feel pressured to get their children the latest must-have toys or gadgets (which are always on back order with Amazon!) Comparing our lives and possessions to others usually leads to a lower self esteem and feeling inferior which feeds pressure to “out-do” each other and can sometimes exacerbate underlying issues such as depression and anxiety. It is less stressful and more healthy to simply focus on those few activities that have the most meaning to your family and forget about trying to win the “best holiday decoration” award in your community.
2. Put reminders on your calendar to “Stop what you are doing and be aware of life around you.” Re-read my description above about my family’s visit to see the dancing lights. We stopped and watched the lights and listened to the music. We felt the temperature outside. My husband and I danced and sang in the middle of the crowd and didn’t care what anyone thought about us. We made the effort to interact with people around us that we didn’t even know and will never see again. THAT was how we were mindful…we stopped and simply paid attention and connected with what was around us.
3. Accept that you will probably feel some stress and anxiety in the next coming weeks. If we try to be more self-aware of our thoughts and feelings, then we can better cope with them. Unhelpful thoughts (I like to call them “shoulds”) can lead us to feel pressured to do too much or try and make too many people happy. It is a good idea to question where these “shoulds” come from because they lead us to feel stressed out and also keep us from enjoying the moments of the season.
I hope that all of you have a happy, healthy and MINDFUL holiday season this year!
Licensed Mental Health Counselor
From the Desk of Dana Nolan:
Because I closely monitor my teenage boys’ social media use, I was puzzled several months ago to find one of them refer to their new girlfriend as “Bae.” Concerned that this was something inappropriate, I investigated what it meant. I was relieved to find out that it is a acronym for “Before anyone else” and used like the term “baby” or “honey”…..Awe, isn’t that just sweet?
I do a lot of couples counseling in my practice and find it very sad to see and hear couples tear each other down in an effort to be “right.” They recount stories of their arguments where they verbally attack each other, call each other horrible names and even get physically aggressive. Defensiveness, contempt and dishonesty are all too common in unhealthy marriages. One client told me: “I don’t understand why my wife can be kind, generous and easygoing with neighbors, friends or even complete strangers, but then she comes home and begins to yell at me for not starting dinner or criticizing me for some other trivial issue. I am supposed to be the love of her life and I think she treats me worse than anyone else!” Day after day, couples who vowed to love, honor and cherish each other slowly descind into treating each other like the enemy.
One of the first steps in my marriage counseling sessions is to educate couples how detrimental it is to talk to each other with contempt, to call each other names, curse at each other or to treat their partner like they are lazy, stupid or ugly. Astoundingly, some couples tell me that being married means that you are allowed to talk to each other angrily or disrespectfully because you are together for better or for worse!
I really like the idea of “Bae” in committed relationships or marriage: The concept of putting your partner needs “before anyone else.” Of course, it only works when both people in the relationship make an effort to think of their partner before others. In the long run, I think its much more important that we treat our spouse/partner with respect and kindness and not care so much whether our neighbor thinks we are nice person. Our spouse is the one person we count on to be there for us through thick and thin, so it kind of makes sense that we treat our “bae” like we value their presence in our life.
Marriage is tough at times. Treating your spouse with kindness and respect is only one component of maintaining a healthy relationship. But, I promise that if you treat your partner like your “bae” that you will experience way more happiness than those couples who tear each other down!
For more information on how to improve your marriage (or serious relationship,) I highly recommend Dr. John Gottman’s book “The Seven Principles for Making Marriage Work.” I trained with John Gottman several years ago and have found his work to be very helpful to couples who are williing to do a bit of work (i.e. CHANGE THEIR BAD HABITS) to improve their marriage.
Licensed Mental Health Counselor
Owner at Healthy Living Counseling
All too often, there are reports in the news of children being abused or neglected. My heart breaks as I try to fathom what could possess an adult to physically or sexually harm or to fail to provide even most basic care to a child. As a psychotherapist, I am a mandated reporter of abuse or neglect and have made numerous reports to the Department of Children and Families (DCF) over the years. Those calls are never easy to make, but I take comfort in knowing that I may be the only person in a vulnerable person’s life to try to protect them.
Sadly, we tend to hear about reports incidents of abuse where DCF wasn’t able to help a child quickly enough or there wasn’t enough evidence at the time to warrant removing a child to prevent further abuse. However, reports that I have made to DCF have been investigated and acted on properly to further protect the child(ren) I was concerned about.
Governor Scott recently enacted legislation in Florida requiring ANYONE who suspects that a child is being abused or neglected to make a report to DCF. Failure to make a report in those cases is now a felony. I believe that this is a step in the right direction in making everyone accountable to report child abuse.
So what exactly do you do to make a report to DCF? Most people want to do the right thing but don’t know what steps to take. Some people are reluctant to make a report for fear of retaliation from the suspected abuser if they find out who reported the abuse. Others are unsure if they have enough “proof” of abuse and would feel terrible if they falsely accused someone of abuse without being absolutely sure there is abuse going on.
How does DCF define abuse or neglect of a child? According to the Florida Statute 39.01, child abuse means abandonment, abuse, harm, mental injury, neglect, physical injury or sexual abuse of a child. If you are unsure if a particular incident meets the criteria of abuse, review the statute online which provides a very detailed explanation of each term listed above.
Reports to DCF can be made anonymously unless you are a mandated reporter (for example: a physician, nurse, teacher, mental health professional, etc.) However, even if you give your name when you make a report, that information is NOT shared with anyone except the investigator who doesn’t disclose who made the report to the accused or the victim. It is usually helpful to provide your name in case the DCF investigator has further questions about the abuse allegations or has trouble locating the child.
You cannot be held liable if you make a report to DCF in good faith. Let’s say that your child’s friend discloses to you that her uncle molested her last week. It is not necessary to have observed the incident or to investigate if it really happened. All you are required to do is to make the report based on the information you have at that time.
Intentionally and maliciously making a false DCF report is a third degree felony and also carries a fine up to $10,000 per violation.
Making a report to DCF in Florida
There are three ways to make a report to DCF.
Before you make your report, it is helpful to write down as many details as you can about the incident of abuse and risk of further abuse. Here are some things you will be asked to provide to in your report:
Name, age or DOB, race, gender for all adults and children involved
Addresses or other means to locate the adults and children involved
Relationship of alleged perpetrator to the child
What abuse or neglect you observed or were told by the victim (when it happened, where it happened, extent of injuries, etc.)
If you do not have all the details listed above, don’t delay making a report using any information you do have. However, it is very helpful to provide as much detailed information as possible to help the investigator do their job. Personally, I prefer to call the Abuse Hotline (1-800-96-ABUSE) and speak to a person about my concerns rather than make a report online or by fax. When you call, you may have to wait on hold for a while before you speak with a DCF representative. After you provide all the details about the suspected abuse, the DCF representative will inform you during your call if your report was “accepted” and will be investigated. If your report was not accepted, it is because what you are reporting is not considered abuse or neglect according to DCF or there is insufficient information to proceed with an investigation.
There are more than 1 million children each year who are victims of abuse or neglect in Florida according to child protective agencies. Many of these victims don’t ever receive help because their abuse wasn’t reported. When parents don’t, won’t or can’t protect or care for their children, the Department of Children and Families step in to help in many ways. But, DCF can’t help if they don’t know about the abuse. Protecting our children is protecting our future!