Tag Archives: Psychotherapist

Stress & Schizophrenia: How To Help Your Loved One & Yourself?

A common cause of relapse in schizophrenia is “difficulty managing high levels of stress,” according to Susan Gingerich, MSW, a psychotherapist who works with individuals with schizophrenia and their families.

Learning to manage stress isn’t just important for preventing relapse; it’s also important because stress is an inevitable part of facing new challenges and working to accomplish personal goals — “what recovery is all about,” write Gingerich and clinical psychologist Kim T. Mueser, Ph.D, in their book The Complete Family Guide to Schizophrenia.

Learning to navigate stress healthfully is key for family and friends, too. Having a loved one with schizophrenia can be stressful. Taking care of yourself enhances your well-being and daily functioning. And it means you’re in a better, healthier place to help your loved one.

In their comprehensive book, Mueser and Gingerich share excellent tips for helping your loved one and yourself cope with stress (along with valuable information on schizophrenia and how you can support your loved one).

Here are those suggestions and insights on managing and alleviating stress.

Recognizing Stress Signs

What one person finds enjoyable, another can find stressful. In the same way, how people respond to stress will differ. For instance, one person might exhibit changes in mood, such as becoming depressed and anxious, while another person will show physical signs, such as experiencing headaches and a heightened heart rate.

So it’s important to talk to your loved about their individual signs of stress. Talk about your personal signs, as well. Create separate lists for each of your reactions to stress.

Reducing Sources of Stress
The authors suggest thinking about what situations were stressful for your loved one in the past. Then try to avoid that situation or modify it. If your loved one had a tough time at Thanksgiving last year, it might help to shorten their stay or not go next year.

It’s also helpful to support your loved one in creating a stimulating environment with reasonable expectations. For instance, rather than attend a day program three times a week, one man preferred volunteering twice a week delivering meals to housebound seniors.

Plus, it’s important that you take care of yourself. Eat nutrient-rich foods, get enough sleep, participate in physical activities and engage in fun hobbies. Help your loved one identify what kinds of activities they’d like to do, too.

As the authors point out, because of the negative symptoms of schizophrenia, individuals can have a hard time thinking of enjoyable activities. Talk with them about the activities they’ve enjoyed in the past.

Be sure to give yourself and your loved one credit. (Being self-critical just spikes your stress.)

Mueser and Gingerich note how one father acknowledges the positive things that happen on a daily basis: “I’m proud of how persistent my daughter has been in pursuing her art career in spite of the many difficulties she’s encountered. We both have a lot to learn about coping with this illness, but we’ve also come a long way.”

Learning to Cope with Stress

Emphasize the importance of your loved one communicating with others when they’re feeling stressed, since “these feelings can be an early warning sign of relapse,” according to the authors. Make sure you, too, are able to turn to individuals who understand your situation.

Have family meetings to talk openly about the stressor and brainstorm potential solutions. Learn to use relaxation techniques, such as deep breathing, progressive muscle relaxation and visualization (such as imagining a serene beach scene).

Self-defeating thoughts only bolster stress for both of you. Try to practice positive self-talk and teach your loved one to do the same.

Mueser and Gingerich share the example of a father helping his daughter reframe her hospitalization, which made her feel like a failure: “I’m sorry you had to go through that, but I’m proud of you for getting help when you needed it and for being so strong in dealing with this illness. You’re a survivor.”

Don’t underestimate the power of humor. Try to find the lighter side of a stressful situation, according to the authors. It’s not always – or usually – easy, but it helps with stress. Plus, you and your loved one can enjoy a funny film or sitcom to lessen stress.

For some people, religious services and prayer can be very helpful. For others being in nature may feel like a spiritual experience and shrink stress.

Again, regular exercise — around three times a week — that you enjoy is important for both of you. Journaling can provide a great source of stress relief. “Many people with schizophrenia say that writing down what they experience, think, and feel is an important outlet.”

See if your loved one is interested in listening to music or making music themselves, such as singing or taking lessons; visiting art exhibits or creating their own art; playing games with family and friends, and pursuing other hobbies.

As the authors emphasize, people with schizophrenia are “more sensitive to the effects of stress because it can trigger symptom relapses and rehospitalizations.” Helping your loved one deal with stress in a healthy way helps them pursue their personal goals and improves their life.

Plus, working together to develop healthy coping strategies can strengthen your relationship and gives you plenty of opportunities for savoring quality time.


Shrink Yourself To Free Yourself From Overreacting.

Overeating, binge eating, stress eating, and emotional eating are powerful coping mechanisms because they help people escape whatever uncomfortable feelings are in front of them.

I define emotional eating as using food to deal with your experience of powerlessness over the struggles and stresses of life. Something always triggers you to overeat, perhaps some friction with someone or an emotionally relevant event in your life.

It’s not the person or the event that sets you off but how those things made you feel. At first you may not even know how you feel. As you work on being your own psychotherapist, you’ll observe the places you’re at or the people you’re around when you tend to overeat. Then you’ll pay close attention to what feelings come up for you around those people or situations.

Simply identifying the times you overeat is a huge first step. It’s a huge step because as things start to come in to focus you’ll be able to put a spotlight on them and that will allow you to analyze them. Inevitably, you’ll have to confront the bad feelings that, up until now, you’ve been trying to get rid of by eating.

Let’s face it; there isn’t anyone who welcomes bad feelings. We look to do something with them, like wish them away. We try to forget them. We take a nap, go for a jog, talk to a friend, distract ourselves with television or a book, have a drink, smoke a cigarette, have sex, or eat a snack.

Ideally, you can get to a point where bad feelings are like bad weather — you know they’ll pass. Just like when you know it’s going to rain and you bring your umbrella, you’ll know how to predict your feelings and what you’ll need to get through them. If you haven’t yet arrived at this place of acceptance, where even bad feelings are a part of you to include rather than to banish, then food will remain your preferred method of medicating yourself.

Why has food become the thing that you consistently turn to when feelings triggered by people or events feel unbearable?

Food serves two very effective purposes. First, it helps you avoid feelings. I call the desire to avoid emotions the “feeling phobia.” Also, food gives you a way to replace bad feelings with the pleasurable experience of eating. I call the pleasurable experience that food provides the “food trance.” In short, eating protects you from the feelings that you don’t want to feel.

If your feelings open the door to your interior world, then eating slams the door shut. It keeps you functioning on a surface level. Although you’re feeling powerless to control what and how much you eat, at least you don’t have to focus on the deeper things that really make you feel powerless (failed relationships, unsatisfying careers, difficult children, etc.).

Many people report to me that as they’re approaching their goal weight they often sabotage themselves and all of their efforts. They wonder why that is. It doesn’t seem to make any sense. You may be able to relate to that experience.

The answer, time and again, proves to be simple: if you didn’t have your weight to think about you might have to think about what’s really bothering you and that’s very frightening. It’s frightening because you feel powerless to change the things that really bother you. You’ve made what I call the “unexamined powerlessness conclusion.” It’s the conclusion that you’re powerless over your feelings and the circumstances in your life that the feelings point towards, so why not just eat instead.

Eating takes you to an earlier place in your development, predominantly because, as infants and children, food is often associated with comfort and love. However, childhood is also associated with powerlessness. As a child, you were, in fact, powerless. You might have been mistreated. Maybe you couldn’t control your impulses. Perhaps you were subject to abandonment or dependent on others to protect and nurture you.

Even if food provides you with some of the comfort of infancy by taking you back to that state of mind, when you use food in this way you’re reverting back to a childish way of dealing with the world. And that reminds you of the powerless feeling of being a child.

You’re an adult now and you have choices. You can be the powerful agent of your own life by facing your feelings and hearing what they have to say to you. Or you can continue eating to cope with emotions, knowing that it actually keeps you stuck in childhood, a place where you were powerless.

Facing your feelings brings you to adulthood, the only place where you have the possibility to finally be powerful.

Emotional eaters can’t see the forest through the trees. In the moment when feelings have been triggered and an unexamined powerlessness conclusion has been reached, eating feels like a life or death decision.

When you distract yourself with food it’s not an apple or a simple cookie. It tends to be large quantities of food, typically unhealthy foods, and the foods are eaten in a voracious aggressive way –- more like stuffing than eating. By the time the eating frenzy has ended the bad feelings have vanished; but they aren’t really gone. They’re just buried under food almost like lost files on a hard drive. They exist somewhere but are temporarily irretrievable. You’re addicted to the escape that the food provides more than the food itself.

You can stop using food as an escape. By finding the upsetting feeling or situation and addressing it directly you can avoid overeating and recover your power at the same time.