Illness and Conditions, Uncategorized

Diagnosis Catfish

The face made when you learn who and what is behind the CATFISH!

What began as an MTV reality show documenting the use of fake online profiles to hook people into romantic relationships has become a widely accepted term for a clinically relevant phenomenon. It wasn’t until the second season of its airing that mental health awareness PSA’s started appearing in some of the episodes. Many of the “catfish” and their victims suffered from mental health issues, which made them vulnerable to engaging in the behavior as well as falling prey to it. The emotional impact of revealing the deception also had an adverse effect on mental health. This only served to intensify the drama and pain being witnessed and made it almost irresponsible for the network and viewers to ignore for the sake of entertainment.

Want to know what kinds of mental health issues breed a catfish? Keep reading.

After watching all seven seasons of the show and using criteria from The Diagnostic & Statistical Manual of Mental Disorders, 5th Edition (DSM-5) it became clear that a handful of conditions perpetuate and maintain catfish behavior and falling prey to it.

Anxiety

Anxiety is a mental health condition that’s easy to empathize with because fear can be such an overwhelming emotion. It has the ability to paralyze people from interacting with each other in order to avoid the rejection or ridicule they fear will happen if they do. This was the case for the catfish who reported creating fake online personas to have anxiety free social contact. Diagnoses like Social Anxiety and Panic Disorder can close people off from the outside world. Creating a profile where they don’t have to be themselves is a relational strategy to create “safe” connections with people. Unfortunately, this safety behavior can still have negative consequences even if the person’s deception isn’t revealed. The avoidance of authentic connection to manage anxious distress keeps a person trapped in their negative and fear based thought spirals. And when a meaningful love connection occurs through deception, self-esteem takes a hard blow because the person hasn’t really fallen in love with the real YOU. This painful truth reinforces core beliefs of being unlovable and the fear that if people knew the real you they would run the other way. Imagine how that fear is confirmed when the catfish is confronted and “rejected” by their online romantic partner. When you behave in a way that elicits the negative thing you believe in or fear the most it is known as a self fulfilling prophecy. The only way to prevent that from happening is to challenge or reality test the fearful beliefs and change the behaviors that supports them. It’s hard to do that when trapped behind a screen.

Depression

Anxiety and depression go hand in hand. Some symptoms of depression that underlie catfishing are low self-esteem, social isolation, worthlessness, and persistent negative and distorted thinking about self and others. One of the catfish in Season 1 had used his online connection of ten years to a girl he never met as a means of coping with depression and suicidal thoughts. He felt self-conscious and suffered from low self-esteem due to his weight. He assumed what the girl would probably think and feel about him if she saw what he really looked liked. This is a type of cognitive distortion known as mind reading. Finally meeting her in life challenged a lot of the beliefs that were keeping him from video chatting and meeting up with her. Another catfish had adopted an identity that she felt represented all the things she wished she was and got to live that imaginal “perfect” life through the profile to escape her depressive reality. On the flip side, some of those hooked by catfish also suffered from low self-esteem and depressive thinking. When an awesome, exciting, and beautiful person started complimenting them, they wanted to believe it was the real thing. Their mood and self worth became dependent on the external validation provided by the catfish. Revealing the deception triggered a downward spiral of hopelessness, worthlessness, and despair for some of the victims. Sadly, they are likely to fall prey again if they don’t learn how to cultivate validation from within. Sorry, Nev and Max, but those two month follow up video chats where everyone reports how great they’re doing – probably not that accurate.

Personality Disorders

Some of the most dramatic episodes involved people who catfish for revenge, to get a boost of attention, or to manipulate the victim into providing them monetary support. These catfish are in line with the cluster of personality disorders characterized by their “erratic and dramatic” behavior. Now for the disclaimer – in order to properly assess and diagnose someone with a personality disorder a mental health clinician has to take into account a lot of information including developmental history, family dynamics, trauma exposure, and a host of “rule outs” of other disorders that better explain the problem behavior(s). Moving on…

The three most commonly known disorders in this cluster are Borderline, Anti-Social, and Narcissistic Personality Disorder(s). Catfishing as an act of vengeance for being “wronged”(e.g. one catfish created a fake profile for the purposes of emotionally and financially destroying an ex who had cheated) or to test the limits of one’s love without regarding how that will impact the other person could be interpreted as “borderline” behavior. That shift from love to hate and back again speaks to that erratic emotional state experienced by someone with the disorder in response to perceived abandonment or rejection. The resulting behavior could include threatening to commit suicide or self-harm to keep the other person concerned about them, creating an illness or injury (i.e. what Max referred to as the two C’s – cancer or a car crash) as an excuse that will prevent the person from rejecting or abandoning them, or giving ultimatums such as demanding that the person move, travel large distances to meet them, or make grand gestures to show that their love is “real” only to have the catfish stand them up or disappear for a time. This kind of emotional roller-coaster and instability is a disaster for both the catfish and the people they hook. They aren’t capable of stopping cold turkey without truly wanting to get off the roller-coaster. They will also need some intense therapeutic support to learn to manage their emotions and change their behavior.

Credit: https://www.talkspace.com/blog/borderline-personality-disorder-impacts-relationships/

And now for the scariest of catfish…

Both Anti-Social and Narcissistic Personality disorders have some level of what is known as schadenfreude or deriving pleasure from someone else’s misfortune. Criminal behaviors like assuming someone’s identity to commit fraud (e.g. one catfish manipulated multiple victims to pay her bills and buy the things she wanted, then glibly blamed them for falling for it) or to slander a person’s reputation for “fun” (e.g. one catfish was arrested when she orchestrated a sexual encounter between a well-known athlete and a woman she didn’t know was a minor resulting in him being labeled a pedophile and almost destroying his career) display a lack of empathy and manipulation of people’s emotions to inflate a fragile sense of self. In one of the episodes, a victim whose identity was being used by a number of catfish expressed how a stranger grabbed her on the street and demanded to know why she had stopped talking to him. The woman became so guarded that she barely socialized or went out alone. While one of her catfish was confronted and the fake profile dismantled within a few days, this woman’s hypervigilance and the blow to her sense of identity will probably take a much longer time to undo.

The Catfish relationship take away…

The show identifies a number of “red flags” (see above) to look for when talking to someone online, whether you’re interested in dating or friendship. It also provides a few helpful investigative strategies to use if you suspect that the person might be a catfish. That being said, I think it’s important to also set what I call safe expectations before trying to date anyone on an online platform or app.

Your safe expectations should keep in mind the following three statements:

  • If it’s too much and too soon, it’s misattuned!

Don’t question your judgment with this. It takes time to get to know someone and that offer of all your hopes and dreams in a “perfect” package right from the beginning is just not realistic. If it’s the real deal, this person will not become upset if you slow the pace down. They will also not react with anger or ghost you when you set a limit. Using the phrase, “I’m really enjoying the process of getting to know you” followed by the limit you want to set shows a healthy boundary and sets the pace by which you want to open yourself up to this person. Don’t fall prey to statements that push back at that limit with “loving” manipulation such as “but you’re the perfect woman and everything I’ve been looking for…why are we waiting?” or “we’re adults and don’t have to play games.” Some version of these two repeat themselves in a variety of online dating courtships. If they get mad or ghost you, ’twas your gain in the end.

  • Your time is precious and your own to give.

This is the opposite of “too much, too soon.” If you find that you’re spending a lot of time trying to make something as basic as a phone call happen, you need to take back your most precious commodity. It’s wasteful and emotionally exhausting. Use that time to engage in self-care and to meet someone who’s more present and available…and real.

  • If it doesn’t feel good in your mind and body, it isn’t.

Powerful is the mind and body (gut) connection. Our bodies sometime react before our minds have a chance to process the “warning.” If you find that you’re experiencing some kind of somatic reaction when interacting with someone, check in with yourself. I’ll share my own experience with this one.

A few years ago, I had been talking to someone for about a month and feeling what I thought was a deep connection starting to develop between us. As we were trying to lock down a date to meet up with much excitement coming from both ends of the phone, I ignored some clear physical reactions that only made sense after this person did the slow fade to ghosting. Mixed with his compliments and flirts were little passive aggressive statements. I wasn’t picking up on them consciously, but my body was reacting to them with what looked like a rash on my chest and neck. This rash had occurred in the past in response to a loved one splitting on me (i.e. shifting from loving to rejecting without understanding what I had done.) My body knew this person was going to split before my brain processed the evidence for it.

Trust in the wisdom of your gut – it’s primal and straightforward unlike the stories we weave and tell ourselves to rationalize or deny shit experiences. Leave the stories and the drama for reality tv.

 

Additional sources of information on the mental health issues discussed in this post:

https://www.mentalhealth.gov/

https://www.nimh.nih.gov/index.shtml

Fitness - Inside and Out, Illness and Conditions, Uncategorized

The Healing Decade

I started setting my intentions for 2018 last weekend.  Today’s blizzard and frigid conditions have made it possible to do a whole lot of reflecting on the events of years past, my growth from them and what obstacles still exist. I discovered something very interesting. The major shifts of my life have come in ten year bundles buffered by life altering events on either end. Rather than posting a year in review, I’m choosing to do more of a life in review starting with the significant event that set in motion all the things that have led me to where I am today.

The trauma decade (11-21 yrs)

At age eleven I had a serious car accident. My injuries confined me to a wheelchair and then required over a year of intense and painful PT to get me back on my feet, literally. All the activities that I engaged in prior to this accident which made me feel good within my body were now a source of intense fear and anxiety. I had serious psychological injuries that were never addressed. My self concept and my sense of independence were deeply affected by this accident. Complicating matters worse was a strict, authoritarian upbringing where verbal and corporal punishment were the status quo for relating to children and the wonderful world of puberty, where changes occurred outside of my control. I was a wounded child in a woman’s body with a mountain of responsibility and guilt placed on me for pretty much everything that was going wrong. The depression, post traumatic stress, anxiety and negative self concept all set the stage for my budding eating disorder, which manifested into full blown Anorexia at age 21.

The transformation decade (21-31 yrs)

Anorexia wreaked havoc on my body and mind in the first part of this decade, but my inner resilience helped me to pursue my childhood dream of singing and performing. Yes, I definitely had a very warped end goal when it came to music making. I needed heaps of external validation to feel “okay” with myself, so any drunk heckling from an audience member would upset me to the point where I couldn’t finish a song. I also modeled because I needed that attention to reassure myself that I was desirable and lovable. Of course, those two things do not go hand in hand. When I sought treatment, the onion began to unfold. I was forced to face a lot of vulnerability and insecurity. It was terrifying. I didn’t have any coping skills. My eating disorder and all this hyper-focus on my appearance and sexuality were the ways I dealt or didn’t with my issues. I turned the dial way down on all of that. I started to examine the reasons behind a lot of the things I was doing. I wasn’t ready to quit it all cold turkey, but a transformation was occurring. During this time, I entered into a serious six year relationship with a man whose personality pushed buttons of change for me. Coinciding with this was my Saturn Return. Even if you’re not a believer of astrology, many of us undergo a major reevaluation of priorities and cognitive growth between the ages of 28-31. This is proven by behavioral neuroscience. At age 31, I was successfully in remission from Anorexia and newly licensed in my chosen profession of massage therapy. I felt optimistic, but I had only cracked the surface. The floodgates were about to spew.

The healing decade (31 yrs and counting)

When a train is approaching a station you feel it initially as a tiny flutter of air that gets progressively stronger until it practically knocks you over when the thing emerges from the tunnel. That’s exactly how this decade has been thus far. At age 31, something shifted for me – the flutter of air. My sister gave birth to her first child and holding him triggered a desire for family that overwhelmed me. Everything that I felt comfortable and complacent with needed to go and believe me, it WENT. The great purge gained momentum as the years progressed. This last year and a half, I experienced a mass exit of relationships that no longer served me and the pulling out of the many energetic hooks placed into me by the people I had chosen to give my time and my heart to. Despite all the loss and the ache I feel in many parts of my being, I have never felt lighter and more myself. It’s amazing how clear your intuition and wisdom become when you aren’t burdened by other people’s stuff. My graduate program has given me a lot of perspective on how I perpetuated and maintained some of the situations that plagued me in the first half of this decade. My inner circle consists of some really incredible, intelligent and supportive people who are doing the work on their end and who I admire greatly. The best advice I got this year came from an article a “soul” friend shared with me about reclaiming my power. I get to control who gets access to me. I can and will heal through all this loss and painful adjustment because I have reclaimed that energy for myself. I am surrounded by the best cheerleaders. These people show up. They reciprocate. They care. One of my intentions for this year is to continue to allow them to take care of me, even when I don’t always know how to ask. This vulnerability is a strength that will set the stage for the type of partnership I want for life; the pivotal event I know is coming.

In the meantime, I will keep my gaze on “the bandaged place” as the Sufi poet Rumi so eloquently put it because through that wounded place “the light” will enter me. Amen.

 

 

 

 

Illness and Conditions

What your poop has to say about your health

The practice of Haruspicy is common amongst African tribes. It is the practice of studying the entrails of a freshly sacrificed animal to tell the future – wealth, health and many cattle being the optimal reading. Of course, when it comes to Western society, all matters of the intestinal kind are barely discussed unless within the framework of a crude joke or when pressed by one’s gastroenterologist. Forget about looking into the toilet after the deed is done. All we want to do is flush.

Thankfully, in my family, all we ever did was examine and discuss. There is a saying in Greek that a person either dies by way of their head (i.e. mind) or their ass (i.e. intestines). Hence, the daily dose of TMI over breakfast and/or dinner. Based on my experiences and research, here are some of the things you should ask of your bowels followed by a cautionary tale.

Did you go today?

A human being should defecate at least once a day, but if your track record is less than 3 movements per week, you are officially constipated. Since the bulk of water absorption happens in the large intestine, the longer your poop stays in there the more water gets absorbed out of it and the tougher it will be to pass. Dietary issues that may cause constipation can include inadequate water intake; inadequate fiber intake; overuse of coffee, tea, or alcohol; a recent change in your diet; and ignoring the urge to defecate. Reduced levels of exercise may play a role as well. Other factors to consider are psychological issues such as depression, anxiety and eating disorders as well as medications whose side effects mess with the natural flow of things.

What should it look like?

Reference the amazing Bristol Stool Chart, a medical aid created by a doctor at the University of Bristol, England to classify human poop into 7 types. Types 1 through 3 indicate constipation. Normal poops are classified as Type 4 and 5. Types 6 and 7 indicate diarrhea and its precursor, respectively.

I love this thing!!!

Frequent bouts of constipation and/or diarrhea can be a warning sign/symptom of a number of conditions, such as IBS (Irritable Bowel Syndrome) and Celiac Disease. If diarrhea  lasts for more than a week, it can cause an electrolyte imbalance due to all the potassium and sodium loss. If not treated properly, that imbalance can lead to death. Listen to your poop and see your general practitioner if any of the above is the case.

What color is it?

The stool color spectrum is even more informative than the Bristol Chart. Heaps of information on one’s health habits can be gleaned from the color of their poop. Here are the notable ones.

Brown = Normal
You want your poop to be within the middle of the brown shade spectrum. This normal shade comes from bilirubin, the yellow biproduct of broken down blood cells, that enters the intestine by way of the liver and helps color the poop. It also makes our pee yellow in color. Darker brown poops can be a result of excess salt in one’s diet or from constipation.

Black and Tarry, better safe than sorry!                                                                                       Blood, when digested, looks black and has the consistency of tar. The bleeding could be an indication of a stomach ulcer, a bleed somewhere in the upper GI tract or even cancer. Certain ingredients in medications and vitamins containing heavy doses of iron can also produce such poops. Best to visit your MD as soon as you become aware of this ominous color.

The Anemic Poop

If your movement is very light, almost grey in color and you didn’t just have a colonoscopy, then you may be experiencing some kind of blockage of a bile duct, gall bladder dysfunction and/or even liver disease.

Yellow like a newborn babe

Newborn babies that are breast feeding tend to have frequent poops that are yellow and slick in color because their bowel system is so fast and the content of their meal so fatty. Poop of this color and nature in adults can mean a few things. Assuming you haven’t consumed a whole lot of beta carotene rich foods or candy dyed with artificial yellow coloring, it could mean fat is not being properly absorbed and therefore, is getting excreted through the bowel. The poop will also stink to high heaven and float on the water’s surface like an oil slick. If you have recently traveled to a developing area of the world, it can also signify an infection known as Giardiasis, caused by a parasite that gives you yellow diarrhea. Another condition that causes poop to come out yellow is Gilbert’s Syndrome which is an excess of bilirubin, also making the person look jaundiced.

Going Green

If you are a person who loves their leafy vegetables, your poops will obviously represent that. But if your body is moving food too quickly through your system, as in the case when you have diarrhea, bile does not have sufficient time to breakdown and stays in the poop, dying it green. Also iron supplements can stain poop green (in higher concentrations, black) too. If you are going green consistently, you may want to get your liver/gallbladder checked out.

Now where things get a little serious…A Cautionary Tale of Colon Cancer:

For years my father dealt with bouts of constipation stemming from what he self diagnosed as a “bad stomach.” In his youth, he had very poor nutrition, as his family lived in abject poverty. Upon his 12th birthday, he left to work on the cargo ships where he ate whatever was canned and salted amidst dank conditions and constant stress. In his early twenties, he came to the U.S. and ate one meal a day while working 12 hour shifts at a restaurant. He worked like an animal going from dishwasher, to busboy, to food runner, to line cook and finally, head cook of a high end Greek eatery. Then he bought his own restaurant along with two other friends. The workload should have been divided by three, but my dad ended up working 24 hours shifts. He lived on black coffee and inhaled meals on the go. When he got married to my mom, issues with his partners ended up forcing him to carry the restaurant himself. He had to be everywhere at one time. He was always under slept, stressed and constipated. When he did poop, it would be very hard to pass or would come out in ribbon like pieces. He dropped to 125 lbs. He looked scary. Solution: my parents sold the business and moved to Greece. He ate well. He basked in the sun. He gained weight and pooped like clockwork. Everything was great, except for one detail. Island life in Greece circa 1980 was something my mother could not handle with two babies. There was only one phone in each village, no indoor plumbing and limited access to the things needed to take care of us. She wanted to go back. My father listened. In the years that followed, my father worked from scratch again, since the restaurant was sold before we moved. He learned he had an ulcer in his stomach. He had kidney stones. He was constipated. He put himself on special “diets” to cleanse his bowels and calm his sour stomach. He was angry and stressed all the time. Life was not pleasant. Then he retired from all work when he turned 50. Despite the lack of work related stress, he was still angry and preoccupied. The patterns of constipation continued throughout the rest of the 90’s and in the first decade of 2000’s. This past December, after experiencing some intense pain on his left side and being unable to eat, he went for his first colonoscopy. It indicated adenocarcinoma, the cancer that typically occurs in the colon. Thankfully, it was still in stage 2 and operable. He is now doing chemo, eating super well, and gaining back weight and energy. The doctors feel optimistic that he beat it. My point of outlining his whole story is that had he paid attention to what his colon was telling him all along with the bouts of constipation and digestive issues, he would have changed his lifestyle and eating habits for the better. He is lucky. Had he refused, as many old school European types tend to do, to go for that colonoscopy, he probably would have been well into stage 4 before it was detected. It would have been too late.

Listen to your poop…it could save your life.