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

Integrative Medicine, Massage Techniques Explained

The Energetics of Making Baby

This is an addendum to my previous post about Fertility Massage.

Keeping that bun in its oven is harder than most people think!

Chinese medicine teaches that in order for a woman to conceive and maintain a pregnancy, a combination of organs need to work in harmony. Any weakness in either one or all of these organs makes baby making all that much harder, if not impossible. However, unlike the fertility treatments of the Western medical world, the Eastern approach is much more cost effective, easily accessed and non-invasive. One of these approaches is the acupressure massage known as Shiatsu, which is performed by yours truly and a host of massage therapists in this hemisphere of the world.

Much like acupuncture, acupressure massage addresses specific points along meridians that form pathways of energy or Qi (Chi). These pathways correspond to twelve vital organs in the body, as defined by Chinese medicine. The organs, represented by their meridians, serve a particular physiological and spiritual function. Any state of disease or imbalance can be explained by either an excess or a deficiency. In order to understand how Shiatsu can help with fertility and beyond, here is a brief overview of the energetics of making baby.

One word – JING. This is your life force; the Qi that you have stored up from birth given to you by both parents. The organ responsible for storing this prenatal energy reserve is the Kidney. As we age, our JING begins to deplete naturally, but those who live hard and abuse their bodies deplete it faster. In general, any lifestyle or chronic condition that taxes your body, depletes your life force. When a person dies, the Chinese say it is because their JING has run out. Hence, when a woman has a depleted or weak JING, there is simply not enough to provide for the prenatal Qi necessary to conceive a baby. If she is able to conceive, JING is necessary to consolidate the pregnancy; therefore, the fertilized egg would have trouble planting itself in place.

Speaking of baby staying in place, the womb-home needs to be in tip top shape and position in order for the fetus to develop and grow those 9 months. The organ that is responsible for holding things in their proper form is the Spleen. The additional role of this organ, according to Chinese medicine, is to create blood. The walls of the womb are a dense network of bloody tissue (i.e. the placenta) which both cushions the fetus and feeds it by way of the umbilical chord. If the Spleen is weak, the womb and food source will be compromised making a miscarriage all that more likely.

While the baby develops physically, it is necessary for it to also do so spiritually. The baby’s consciousness comes from the Heart, the organ responsible for housing the spiritual soul. The Chinese believe that the soul comes into the body on the 81st day of life, which would be around the tail end of the 1st trimester. If we take Judeo-Christian debate out of this, essentially the first trimester is almost like a trial period; make it out of that third month and your risk of miscarriage drops significantly. I found that most women I know were reluctant to announce their pregnancies until they were out of their 1st trimester, so as not to “jinx” them. This mentality is rooted in medical fact. Miscarriage is the most common type of pregnancy loss, according to the American College of Obstetricians and Gynecologists (ACOG) with most occurring within the first 13 weeks of pregnancy. (http://www.americanpregnancy.org)

Lastly, pregnancy can be very stressful on the body. Not only does blood and nourishment need to flow freely to the developing baby, but the musculo-skeletal system of the mother needs to be able to adapt to its growth. The Liver is the organ the Chinese say governs the muscles and sinews of the body. It regulates the flow of blood/Qi to wherever it is needed, as it is needed. The ever changing state that is pregnancy demands a lot of the Liver. Therefore, this organ needs to be kept strong. A difficult pregnancy (i.e. limited mobility, muscular insufficiency, structural deformities, etc.) and even more difficult delivery are usually associated with weakness in the Liver.

Unlike other forms of massage, Shiatsu is performed with the client clothed in comfortable attire that does not restrict movement. The work can occur on either a mat or a table, depending on the client’s comfort and needs. The main goal is to tonify or strengthen the above organs involved in conception, maintenance of pregnancy and the health of the mother. Should you have a history of infertility and/or chronic miscarriage, the Spleen and Kidney would be the main focus of treatment. Their pathways of energy run along the lower limbs. So does that of the Liver. To tonify, the therapist would likely employ slow, deep and broad pressure to these points along with various stretches to unblock any stuck energy. Of course, each session would be customized to the client based on a detailed assessment and re-evaluation post treatment. The price range for a Shiatsu session varies depending on where you live, but expect that most will be priced between $65 and $120 US for a 60 min session. If this seems like a lot, know that many practitioners provide packages at a discounted rate or sometimes even sliding scale. In addition, many schools of acupuncture and massage have student clinics where treatment is offered at a heavily discounted rate. There is an application process involved and sometimes there can be a waiting list, but once you are accepted into the clinic, the quality of treatment is held to a super high standard. Students have to keep detailed records and write treatment plans, all the while consulting with supervisors on client cases. This option is a great learning experience for them and a cost effective opportunity for you.

 

 

 

Illness and Conditions, Massage Techniques Explained

Trigger Points – the baggage our muscles hide!

Is this your back?

If the above image gives you the impression that a group of assassins  are ready to fire on you, stay with that feeling.  No one is immune. They hide in your muscles and sinews waiting for something or someone to activate them. Some gather in groups while others migrate to new territory, but more often than not they refer their pain elsewhere to trick you. They are trigger points.

A trigger point is defined as a hyper irritable spot within a taut band of skeletal muscle that elicits pain locally when compressed, but can also refer it elsewhere or be accompanied by muscle spasm. When touched, these spots can feel like hard nodules ( i.e. the “knots” we so often refer to in our backs and other body parts). It was Dr. Janet Travel, physician to the late president John F. Kennedy, that first came up with the term when she noticed that these points of pain tended to happen in predictable patterns that could be mapped out on the body. Her maps can be found in the 2 Volume book she wrote with David G. Simons, “Myofascial Pain and Dysfunction: The Trigger Point Manual.”

How do you know if you have one or more of these bad boys lurking in your tissues? There are a few characteristic symptoms which include sensitivity to pressure in a muscle, stiffness accompanied sometimes with a pulling sensation emanating from a particular point in the muscle, pain that refers from the point compressed to another area of the body and pain that has a dull, aching or burning quality to it.  Other symptoms sometimes experienced are various autonomic phenomena like dizziness, sweating and fever as well as headaches, numbness, loss of range of motion and dysfunction of the muscle involved. While the cause of trigger points remains a much disputed medical topic, it is safe to say that they most commonly occur when muscles are chronically overloaded, as in the case with occupational and exercise overuse, injury and poor posture. Also, chilling of a muscle (i.e. catching a draft or having an air-conditioner blow on you) and the position in which you sleep can also create these points. Sometimes these points are even triggered by emotional and stress related events.

Any qualified massage therapist (ME!) possesses the skills needed to deactivate these points and treat the surrounding tissues. In my opinion, your first course of action should be massage therapy. Thereafter, if the points do not resolve within a few treatment sessions, you should be referred to a chiropractor, osteopath or physical therapist, all of whom employ more aggressive treatment measures. The protocol used to address trigger points via massage is a combination of sustained compression of the point followed by cross fiber friction and deep strokes in the direction of the muscle fibers to clear out metabolic wastes and encourage the flow of blood into the affected area. I am a huge fan of a myofascial technique known as skin rolling. It literally involves me picking up your skin and rolling it along different angles between my fingers, almost like cookie dough. This is an important diagnostic tool for me to find these stuck points, especially if a client is unsure of the location of their discomfort. The sustained compression of these points temporarily stops the pain signal coming from the brain and the flow of blood to the area, so that when it is released, blood literally floods the point and washes wastes away. The first compression is always the worst because the pain level will be greatest then. It is super important to breathe through the 8-10 second count, as the point is held. On a scale of 1 to 10, the pain/discomfort should be around an 8. With each subsequent sustained compression (about 4 in total) the pain level will dissipate while the force of compression stays about the same. During these compressions, many clients will break into a sweat or become hyperemic (flushed) in the area of the trigger point. Sometimes there are twitches in the muscle or surrounding tissues near the point being worked on. Even stranger, the point can move while I am compressing and I literally have to chase it through its migratory path until I shut it down. Once the compressions are finished, the point is rubbed vigorously in a cross fiber pattern between 1 to 5 minutes and then all the fibers of the muscle get treated to a nice and slow, deep rub down. I like to then apply a bit of heat in the form of a heated dry towel (no more than 10-15 mins on) or a topical irritant like Tiger Balm.

Best case scenario, trigger points will get resolved in one intense session, but more often than not, multiple sessions are needed to deactivate years of evil. It’s extremely important to assess what is going on or has happened in your life, both physically and emotionally that, although your brain might have dismissed, your muscles and tissues beg you to notice. This awareness will help you focus your attention back onto yourself and deal with the baggage at hand because trust me, your muscles have better, more productive things to do than carry the weight of the world in their nooks and crannies.

Additional reference available at:

http://en.wikipedia.org/wiki/Trigger_point

NOTE **Read personal trainer, running coach and kayak instructor, Jeanne Andrus’s post about her experience with Trigger Points. I think it to be a helpful read:

Trigger Points