Doubt is thought's despair; despair is personality's doubt. . .;
Doubt and despair . . . belong to completely different spheres; different sides of the soul are set in motion. . .
Despair is an expression of the total personality, doubt only of thought. -
Søren Kierkegaard

doubt 1 a : uncertainty of belief or opinion that often interferes with decision-making b : a deliberate suspension of judgment 2 : a state of affairs giving rise to uncertainty, hesitation, or suspense 3 a : a lack of confidence : DISTRUST b : an inclination not to believe or accept dis·or·der 1 : to disturb the order of 2 : to disturb the regular or normal functions of Definitions from Merriam-Webster Dictionary

"Michael"

My story is this...

When I was in sixth grade, I was first introduced to a "new" virus called HIV. It was during a Health/Sex Education class where we learned about this disease. After the teacher finished her lecture she opened up the floor for a question and answer period. Up until this point I was o.k., however, by the last question by the last student I felt extremely anxious. "What about mosquito bites, Miss?" Despite the fact that mosquitoes can not transmit the virus, I still had doubts and visioned myself dying from this horrible disease.

Over time the anxiety decreased, nothing much happened until my second year of High School. It was after my first sexual experience, an older girl who lived across the street from me. As a teenage boy, this was a thrill, after the episode was over, I rushed home to call my best friend Dan, and "brag" of my conquest. Rather than congratulate me, Dan's first question was did you wear a condom? My answer was "No". His reply was, "Are you stupid, that's how you get AIDS?" I freaked. I felt four years of anxiety hit me like a ton of bricks. All the worrying I managed to avoid since the mosquito episode, came on 10 times over. Tears, confusion and sadness we're an everyday battle. Over the next few years, I was able to "control" my anxiety, I simply pretended that the situation never took place. This method of reassurance was good in the beginning but as time went by and events took place, my wall of denial was soon destroyed by my fears of death. Routine blood work kept me in tears and in prayer until the results came back. Even though this blood work wasn't for HIV, I always feared that the lab would stumble upon the virus.

By the time I hit 19 years old, my mind had had enough. I it was during my first year of college, I met Angie, a great girl from a good family. She had alot of self-respect and was a virgin, too boot. By the time her and I had our first intimate experience together, many months had passed and I was in love. A few hours after our first experience, my mind began to drift. "What if I have HIV?", "What if I infected Angie with HIV?", "We're both going to die...". From this day forward it would get worse. Despite Doctors reassurances that my risk was very, very low, I was certain that I had this disease. Even after I worked up the nerve for a bloodtest, I had doubts. Negative results only seemed to comfort me when I wasn't sexually active. When I was, it was always a matter of "What if...".

This fear affected every aspect of my life. My college grades, my ability to hold a job, family and friends, everything! Eventually, even my relationship was lost because my low self-esteem and negative outlook on life would be too much to bare. Even though I was "Clean", I still had fear and doubts. Any situation that could be considered a "Risk" created havoc in my life. Even protected sex (when I began dating again) was too much to bare. By the time I was 23, my family Doctor diagnosed me with depression, which lead to a professional diagnosis of OCD a few months later. I began treatment in a group environment with a team of Psych Doctors and other O.C's and finally faced my fear head on this past January. One more negative HIV test and I was home free. For the past few month's I have been feeling great. I'm now in a serious relationship and hope to marry and spend the rest of my life with her. Joan is extremely supportive and cares for me a great deal.

Recently, a friend and I decided to visit a pro and get a tattoo. My reason for doing this was sort of a reward for overcoming my problem - a reminder that I can get through life's difficulties. My plan backfired though, and now I'm experiencing my OCD symptoms full force. "What if the tattoo artist infected me?" "What if he's lying about safe practices?" I'm even doubting the sterilized equipment the artist opened right before my eyes. Every time, I tell myself that I'm being ridiculous, that there's nothing to worry about, a voice inside says "How do you know?" "What if...". I can't stop and I'm terrified. I'm afraid that I've infected Joan, I fear that my future plans and goals are doomed and unattainable. No matter how many Doctors and experts reassure me that everything is o.k. - that it's my OCD, I can't relax. I can't stop worrying. Over and over and over again... HIV / AIDS. I've even began doubting that I have OCD. By accepting this fact means accepting that the HIV threat isn't real. Then the voice starts again... "How do you know?"

They say that I'm a "Pure Obsessionist", my compulsions are inside my mind rather than external or physical. I need some relief and don't know where to begin. I hate living this way but I am unable to just "let it go". If anybody who reads this can relate or feels the same as I do, please, for both of us don't give up. I keep fighting if you will.

I am not a doctor, therapist or professional in the treatment of CD. This site reflects my experience and my opinions only, unless otherwise stated. I am not responsible for the content of links I may point to or any content or advertising in HealthyPlace.com other then my own.

Always consult a trained mental health professional before making any decision regarding treatment choice or changes in your treatment. Never discontinue treatment or medication without first consulting your physician, clinician or therapist.

Content of Doubt and Other Disorders
copyright ©1996-2009 All Rights Reserved

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Doubt is thought's despair; despair is personality's doubt. . .;
Doubt and despair . . . belong to completely different spheres; different sides of the soul are set in motion. . .
Despair is an expression of the total personality, doubt only of thought. -
Søren Kierkegaard

doubt 1 a : uncertainty of belief or opinion that often interferes with decision-making b : a deliberate suspension of judgment 2 : a state of affairs giving rise to uncertainty, hesitation, or suspense 3 a : a lack of confidence : DISTRUST b : an inclination not to believe or accept dis·or·der 1 : to disturb the order of 2 : to disturb the regular or normal functions of Definitions from Merriam-Webster Dictionary

"Mary"

I've never known life without OCD (Obsessive-Compulsive Disorder). From as far back as I can remember intrusive, unwanted thoughts and fears have plagued me.

The first "episode" of OCD that I can clearly remember was when I was about 5 years old. I became totally obsessed with thoughts about heaven, hell and eternity. I was raised in a church going home where religion and spirituality were very important. I would spend hours trying to figure out "eternity". I felt that if I could somehow "figure" it out, I would be okay.

The concept of not having an end, as is the case with eternity, was far more than my 5 year old mind could handle. I was "scared" of eternity. I prayed to both God and the Devil at the time, asking, no begging them to help me, to help me STOP thinking and worrying about eternity. In time, the "eternity obsession" faded and about the same time an entirely different set of symptoms appeared. I began feeling compelled to do certain physical motions, such as eye blinking and making "clicking" noises with my tongue. Even at the tender age of 5 or 6, I fully KNEW that there was something WRONG with me, that this behavior was not "normal", but I couldn't quite figure it out. I did my very best to hide what I now know to be "tics," holding it all in for as long as I could and then finally releasing it all once I was alone. I usually did this in bed at night, which is also a darn good place to have obsessions. Bed time was not my friend.

I can remember standing back and watching other children, looking to see if they were doing the same kinds of things I felt so compelled to do. They were not. It messed with my self-esteem alot and I pretty much suffered alone as I did not really want to tell anyone about the weird and constant thoughts I had or the repetitive, senseless physical motions I felt "compelled" to do.

By the time I was 7, I very much had a "secret world" going on inside myself, one that I dared not share with anybody. At times, I thought I was crazy, at other times I thought I was just a "bad person" or a "stupid person", anyway I looked at myself, I definitely wasn't who I wanted to be.

Obsessions, fears and panic attacks would plague me off and on during my adolescent and teen years, but it wouldn't be until I was 20 when I had symptoms bad enough to put me on the Psychiatric ward. This would not be my first experience with Psychiatrists, as I spent a part of my teen years seeing one. Unfortunately, at no time was I diagnosed with OCD or Tourettes, those diagnoses would come much later. During my time in the Psych ward, I was given several different medications including tria-vil, elavil, sinequan, ativan, valium, zanax, desaryl and others that I can't even remember. What was my "official" diagnosis at that point? "Schizoid Affective," which looking back now and having the knowledge that I have now, that diagnosis would be a huge laugh if the whole thing weren't so sad!

Although I had always thought of myself as very intelligent, I found myself at the age of 20, sitting across the desk from Social Workers who told my Mother that I would NEVER live a normal life. That the most independence I could ever hope for was to live in a half-way house. Thankfully, I NEVER believed any of that for one second. I was definitely down, but not out. When everyone else wanted to "give up" on me, in no way, shape or form, was I willing to give up on myself. Looking back at my life and the tremendous struggles that I have had, my "fighting spirit" is probably what saved me. I partially attribute that to having Tourette Syndrome, where "tenacity" and "perseverance" are well-recognized tourettic traits.

I would struggle with Obsessive-Compulsive Disorder pretty consistently for the next 15 years, with most of my obsessions now revolving around the fear of acquiring HIV and AIDS. Although I had no risk factors for getting AIDS, I became absolutely obsessed with the fear of being "contaminated" by the HIV virus. During a 8 year period, I would have more than 40 HIV tests, all negative of course. But due to the doubting nature of OCD, I would no more than hear a "Negative" result from the clinician, that I would doubt what I actually heard, doubt the accuracy of the test, doubt the honesty of the Doctor and doubt that the test was even performed. I could think of a million scenarios of "why my negative test result could not possibly be accurate."

And so it goes with OCD. It's a never ending circle of doubt and deception. On the very off -chance that I received my "negative" test results on a rather good OCD day for me, I would then walk to my car, perhaps see a bandaid lying on the ground and somehow "convince" myself that I now acquired HIV from that bandaid. A reason for another test!

---

Like most people with OCD contamination fears, I clearly knew that I was being irrational, but it didn't matter, the OCD had a life of it's own and it would always win. And those of us with OCD contamination fears can come up with the most far-fetched and crazy "beliefs" on how we could become contaminated, most of them totally flying in the face of reality. That's one of the hardest things with OCD is that for the most part, we are completely lucid. We KNOW what we are thinking and doing is crazy, but we can't stop. So not only do we deal with the horrors of the OCD, we struggle greatly with our own sense of self esteem because we cannot control the OCD.

Somehow during all this HIV/AIDS craziness, I was still able to marry, work and have a child. It was not easy, it never was. Medical treatment for me was a nightmare and I did absolutely everything I could to avoid it. Just walking into a physicians office for me, meant a future HIV test. At this time, I was under the care of doctors who were well aware of the problems that I had although it would be some time before I would hear "OCD". My internist kept me on an antidepressant called "Sinequan" and I did receive some small measure of relief from that.

One day, while reading a new book on AIDS (I amassed quite a library on the subject!), I read that there are some people that get tested over and over for HIV because they suffer from what is called - Obsessive Compulsive Disorder. The book further stated that HIV testing wasn't their "real" problem, the "real" problem was the Obsessive Compulsive Disorder. I could NOT believe it! They were talking about me! I felt the sky opened up to me at that moment! It would take a few more years and more research on my part to finally ask my Doctor about trying Prozac, which I had found out about by researching OCD and it seemed promising. Well, I can honestly say, that the from the very first day I took Prozac, I experienced a true miracle in my life.

Like many, if not most people with severe OCD, I have several OCD things that hang around in my life. I do some counting, I do ALOT of checking. I actually had one 5 year rather intricate nightly checking ritual that mysteriously disappeared by 2nd day on Prozac. It was AMAZING! And my contamination fears about HIV lessened and lessened and although not completely leaving me, the nearly incapacitating grip that it held over my life ceased. I was a new person, a fairly "normal" person, something that I never in my whole life thought I'd ever be. I was able to pursue my goals and dreams with wild abandon and I did and still do, just that.

I have an extremely HIGH level of functioning for ANYONE, much less someone with OCD. I am a dedicated athlete, I travel with my sport, I coach children. I have gathered alot of accolade and notoriety with my sport and what I have done in it and with it. I'm well known enough in my town and state, that for now, I choose not to reveal exactly what sport I'm in as I do coach children and at this point in my life, I would do nothing that could in any way jeopardize that. Unfortunately, we still live in a society that does NOT understand mental illness and neurological disorders and those of us with such problems are VERY likely to experience misunderstanding and prejudice.

Some day, I would like to come totally "clean" with my OCD and Tourettes because the vast majority of people that know me will be absolutely stunned. No one would ever guess what a struggle life has been for me. People see me as accomplished and very "together", many probably would not even believe me if I did tell them! But I think my story would be important for others out there who are also struggling with OCD. My story is one of hope and I hope that just by telling this small part of my story, that I can help someone out there with OCD who reads it.

Do I still have OCD? You bet! OCD is as much a part of me and who I am as the tics I have from Tourettes. I still count, I still check, I still wash my hands pretty darn good, but the level of which it interferes with my life is "acceptable" to me. Sure, it would NEVER be acceptable to a "normal" person (and I use that term loosely), but to me, it's a miracle! At least for me and my OCD, the right medication made all the difference in the world and I encourage everyone with OCD to NEVER give up. If you've tried all the medicines, try all the new ones that come out. We are gaining alot of information about OCD and I'm confident that new and even more promising treatments lie ahead.

Most of all, I would like other OCD'ers to know that you are NOT alone and you are definitely NOT crazy. If this is what your being told, ignore it, it is NOT the truth. Love yourself, believe in yourself and NEVER stop trying to tame this wild animal inside us called OCD.

Mary

I am not a doctor, therapist or professional in the treatment of CD. This site reflects my experience and my opinions only, unless otherwise stated. I am not responsible for the content of links I may point to or any content or advertising in HealthyPlace.com other then my own.

Always consult a trained mental health professional before making any decision regarding treatment choice or changes in your treatment. Never discontinue treatment or medication without first consulting your physician, clinician or therapist.

Content of Doubt and Other Disorders
copyright ©1996-2009 All Rights Reserved

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Doubt is thought's despair; despair is personality's doubt. . .;
Doubt and despair . . . belong to completely different spheres; different sides of the soul are set in motion. . .
Despair is an expression of the total personality, doubt only of thought. -
Søren Kierkegaard

doubt 1 a : uncertainty of belief or opinion that often interferes with decision-making b : a deliberate suspension of judgment 2 : a state of affairs giving rise to uncertainty, hesitation, or suspense 3 a : a lack of confidence : DISTRUST b : an inclination not to believe or accept dis·or·der 1 : to disturb the order of 2 : to disturb the regular or normal functions of Definitions from Merriam-Webster Dictionary

"Leah"

I am 24 and have been suffering from OCD as long as I can remember. It got extremely severe when I went away to college this past September. It got so bad that I had to take a sick leave.

My most tormenting and reoccurring thought was that my best friend was in a fatal car accident. I would wake up in the morning and think "how can I go to class if my best friend has just been killed". I would shudder at the thought and blink my eyes only to see the car crash more vividly. It's a full frontal collision, its at night because the headlights are on. She is wearing a grey sweater which is completely blood stained. Her face is pressed up against the steering wheel causing the horn to sound continuously. There are shards of glass in her beautiful face. There is gallons of blood pouring from a laceration in her scalp. My roommate walks in and sees me with a white ghastly look on my face. She knows the routine and says "Leah, go to class, I'm sure your friend is fine". I reply "how can you be sure that she wasn't in a terrible car accident, I'm almost positive that she was". She then hands me the phone to call my friends cell phone but I can hardly dial because my hands are trembling. I dial the number only to receive her voicemail and then I'm sure she has left this world. That's when the grieving process begins. I would lay in bed all day crying, miss all my classes and dining hall hours. My roommate would come home again and force me to try again. I would never do that on my own since I am so sure she is gone. I would dial her home phone only to get a busy signal. This would lead me to believe that her family was notifying people of her death. It could be the day of an exam and my roommate would say "I'm sure they are just on the phone for no reason and you have a Biochemistry exam in 10 minutes". I would reply that I'm sure my teacher would understand.

My roommate would continue to dial her phone number while I was in the corner crying hysterically. Thinking about how I never got to say good bye. She would hand me the phone after she had tried my best friend's mother. I would slam down the phone as soon as I heard her Hello. I would then replay in my mind the tone of her voice and decide if she sounded like she had just lost a daughter. That still never consoled me but I was too scared to call back. My roommate would sometimes convince me to call back and make sure things were okay, or sometimes try her cell phone again and get through to her.

When I finally do get through to her, I ask "Are you okay?" Of course I am totally shocked to hear her voice because I truly believed that I would never hear it again. It takes me a moment to compose myself and then we carry on a normal conversation but I know my OCD got me again. I promise myself that I'll know next time that just like she's okay now she'll be okay then. when I'm woken in middle of the night to the same thought with the blood stained grey sweater the hell begins all over again.

I am not a doctor, therapist or professional in the treatment of OCD. This site reflects my experience and my opinions only, unless otherwise stated. I am not responsible for the content of links I may point to or any content or advertising in HealthyPlace.com other then my own.

Always consult a trained mental health professional before making any decision regarding treatment choice or changes in your treatment. Never discontinue treatment or medication without first consulting your physician, clinician or therapist.

Content of Doubt and Other Disorders
copyright ©1996-2009 All Rights Reserved

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Doubt is thought's despair; despair is personality's doubt. . .;
Doubt and despair . . . belong to completely different spheres; different sides of the soul are set in motion. . .
Despair is an expression of the total personality, doubt only of thought. -
Søren Kierkegaard

I am not a doctor, therapist or professional in the treatment of OCD. This site reflects my experience and my opinions only, unless otherwise stated. I am not responsible for the content of links I may point to or any content or advertising in HealthyPlace.com other then my own.

Always consult a trained mental health professional before making any decision regarding treatment choice or changes in your treatment. Never discontinue treatment or medication without first consulting your physician, clinician or therapist.

Content of Doubt and Other Disorders
copyright ©1996-2009 All Rights Reserved

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Doubt is thought's despair; despair is personality's doubt. . .;
Doubt and despair . . . belong to completely different spheres; different sides of the soul are set in motion. . .
Despair is an expression of the total personality, doubt only of thought. -
Søren Kierkegaard

doubt 1 a : uncertainty of belief or opinion that often interferes with decision-making b : a deliberate suspension of judgment 2 : a state of affairs giving rise to uncertainty, hesitation, or suspense 3 a : a lack of confidence : DISTRUST b : an inclination not to believe or accept dis·or·der 1 : to disturb the order of 2 : to disturb the regular or normal functions of Definitions from Merriam-Webster Dictionary

"C"

I know how you all feel, but in a different way.

It's like you can't believe anything you tell yourself because you might be wrong. Like just the thought or act of doing something wrong is such a big deal. But to me it is. I'm constantly obsessing if I said or did something WRONG. I might say something to someone and the minute I say it I worry that I might have said it in the wrong tone of voice or maybe I sounded stupid while I said it. So then I have to go back and try to explain to them what I really meant so I won't hurt their feelings and look stupid to them. Because sometimes I think I grew up thinking that everything was a big deal. Don't talk to loud or talk to much about yourself because it is wrong to do those things.

And being wrong is terrible. I feel like running through the streets saying "I'm wrong all the time so sue me and lock me up." I also obsess if I said what I say to my daughter every time I talk to her is in the right tone of voice or if I am giving her the "right" advice about things. I feel very anxious most of the time because I am afraid I will screw her up. I try to rationalize to myself that there isn't directions to life so I can relax, but then another thought asks "But there are directions to some things." I have this on going argument with myself all the time trying to come to a conclusion about things so I won't have anymore questions and then I will know it all so I would be at peace. I have a hard time excepting that there are no absolute answers to things. I also have to make sure I speak to my Mom and dad every day or kiss them everyday because incase they died I won't feel guilty for not having done that. But then I am always wondering if I talked to them enough that day. And what is "enough." Someone tell me so I'll know so I won't be wrong and won't feel guilty. Everyone says "just do your best" and the thought goes "well, how do I do my best?" as if there are specific directions for doing your best." How do you ever convince that questioning part of you that no one in the entire world knows what they are doing and that it just doesn't matter. And then I think "well what does matter." I feel like I'm nuts. But I think I'm just very afraid of screwing up. I have this conversation with myself every day while putting on make-up. "Why am I putting on this make-up? Is it because I think I'm ugly and I'm trying to hide myself? So I sit there and obsess whether or not to put this makeup on because if I did I would be afraid of betraying myself because wearing makeup just proves that you don't like yourself and not liking yourself is wrong. So I try to rationalize that I need to look decent for work, and then again argue with myself that you can look decent without it. Sometimes I wish everyone could just walk around with no teeth and look like crap and no one would care. I know sometimes I think of suicide from this nonsense but then I am afraid I would go to hell and have this go on for eternity whereas if I die on God's time frame I might go to heaven and find peace. Also I'm afraid if I killed myself I'd really screw up my daughter and I could never take the chance of doing that. So some fear is good. It's sometimes good that I cant make a decision! I pray for everyone in the whole world everyday that have these types of problems and more. This problem has made me a very compassionate person and I feel you can never judge anyone for anything because you don't know what they are going through. If we could all just learn to deal with the stupid fears that hold us back we could all be free. Good luck and prayers to you all.

I am not a doctor, therapist or professional in the treatment of CD. This site reflects my experience and my opinions only, unless otherwise stated. I am not responsible for the content of links I may point to or any content or advertising in HealthyPlace.com other then my own.

Always consult a trained mental health professional before making any decision regarding treatment choice or changes in your treatment. Never discontinue treatment or medication without first consulting your physician, clinician or therapist.

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When anorexia nervosa or bulimia nervosa patients are married or live together with a partner unmarried, the question arises as to what impact an eating disorder has on the relationship with a partner or, alternatively, how an intimate relationship with a partner influences the course of an eating disorder.

Despite valuable implications, the marital relationships of adult eating-disordered patients have not received much attention in the form of empirical research. One of the major impressions emphasized in clinical literature is that married eating disordered patients and their partners often report a significant degree of dissatisfaction with their relationships (Van den Broucke & Vandereycken, 1988).

Marital intimacy is one aspect of a relationship which may be conceived both as a process which includes empathy, (e.g., a characteristic way of relating of two partners), and as a state, (e.g., a relatively stable, structural quality of a relationship which emerges from this process) (Waring, 1988). Van den Broucke, Vandereycken, & Vertommen (1995) see intimacy as a quality of a personal relationship at a certain point in time primarily referring to a relational phenomenon, (e.g., the degree of connectedness or interdependence between two partners). As such it includes affective, cognitive and behavioral aspects. These three types of interdependence are reflected in the couples' emotional closeness, empathy and commitment, the validation of each other's ideas and values, and the implicit or explicit consensus about the rules which guide their interactions (Van den Broucke et al, 1988).

Additionally Van den Broucke, Vandereycken, & Vertommen (1995) suggest that there are two additional levels of intimacy, individual and situational. On an individual level, intimacy implies two aspects, one being authenticity, or the ability to be oneself in the relationship with the partner, and openness, or the readiness to share ideas and feelings with the partner. The situational level entails an aspect of exclusiveness: As the partners' individual privacy decreases with the enhancement of their intimacy, the dyadic privacy is likely to increase. Communication difficulties and the lack of openness in eating disordered patients' marriages were found and considered to be a serious relational deficiency, which may represent an important obstacle to the growth and enhancement of their marital intimacy. The intimacy deficiency of these patients' marriages does not necessarily imply that this deficiency is the cause of the eating disorder but probably more accurately is described as a circular enigma (Van den Broucke et al, 1995).

With empathy holding a key position in the construct of intimacy, Tangney's (1991) research discovering a positive correlation between proneness to guilt and empathetic responsiveness but inversely related to the tendency to experience shame, may provide some insight into the relational difficulties described by Van den Broucke, Vandereycken, & Vertommen (1995). Bateson (1990) defined empathy as including feelings of sympathy and concern, but distinguished empathy/sympathy from personal distress, the latter representing an observer's own feelings of distress in response to a distressed other. This other-oriented empathic concern, not self-oriented personal distress, has been linked to altruistic helping behavior (Bateson, 1988). Other-oriented empathy is generally viewed as the good moral affective capacity or experience because it is presumed to foster warm, close interpersonal relationships, to facilitate altruistic and prosocial behavior, and to inhibit interpersonal aggression (Bateson, 1990). Shame, an ugly feeling, draws the focus away from the distressed other, back to the self. This preoccupation with the self is inconsistent with the other-orientated nature of empathy. When faced with a distressed other, shame-prone individuals may be particularly likely to respond with a personal distress reaction, in lieu of a true empathetic response. The acute pain of shame may motivate a variety of intrapersonal and interpersonal processes that are incompatible with a continued empathic connection. Shame-prone individuals have a tendency to externalize cause or blame, as a defense maneuver against the overwhelming pain of the shame experience, in addition to making internal, global shame-type responses (Tangney, 1990; Tangney, 1991; Tangney, Wagner, Fletcher, & Gramzow, 1992).

While shame involves the self's negative evaluation of the entire self, guilt involves the self's negative evaluation of specific behaviors. Guilt's consequent motivation and behavior tends to be oriented toward reparative action. Guilt seems less likely to motivate the defensive maneuvers, antithetical to empathy, that are frequently associated with shame. Guilt-prone individuals are clearly not disposed to blame external factors or other people for negative events allowing room for empathetic responsiveness (Tangney, 1990, Tangney, 1991; Tangney et al, 1992). Tangney (1991) discovered that individuals who are generally empathic are also prone to feelings of guilt, exclusive of shame. The perspective-taking component of mature empathy requires the ability to make a clear differentiation between self and other. Guilt requires making a clear distinction between self and behavior, an ability to see behaviors as related but somewhat distinct from the self. Both guilt and empathy hinge on a capacity for differentiation, a more mature level of psychological development similar to such constructs as psychological differentiation, ego development, and cognitive complexity (Bateson, 1990; Tangney, 1991; Tangney et al, 1992). Shame-prone individuals may have difficulty maintaining an other-oriented empathic response, and instead may drift into a more self-focused personal distress reaction. They are likely to experience the resonant pain of personal distress as well as the pain of shame for "being the kind of person who would inflict such harm" (Bateson, 1990; Tangney, 1991). This wash of negative affect may be problematic as Berkowitz (1989) has demonstrated, negative affect in general can foster angry, hostile feelings and subsequent aggressive responses.

Consistent links have been found between proneness to shame and anger (Berkowitz, 1989; Tangney et al, 1992). Such anger may be fueled not only by the pain of shame itself, but also by the discomfort inherent in personal distress reaction to distressed others. The unpleasant interpersonal exchange may be so overwhelming that it may motivate a variety of defensive maneuvers that are fostered and reinforced by such anger. Finally, in the midst of a personal distress reaction the shamed individual may subsequently blame the distressed or injured party as a means of reducing their own pain. Thus shame-prone persons bring to their relationships a number of liabilities that may be particularly exacerbated during unpleasant interpersonal exchanges (Berkowitz, 1989; Tangney, 1991; Tangney et al, 1992).

Deborah J. Kuehnel, LCSW, © 1998

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by Mary Ellen Copeland

The Creating Wellness Video Series

This three-part videotape series - based on a workshop with renowned author Mary Ellen Copeland - presents simple, effective and noninvasive self-help strategies for anyone dealing with emotional, behavioral or psychiatric challenges. Used separately or together, these videos provide useful information about how to get well and stay well. They are invaluable for in-service trainings and for self-help and support groups.

Key Concepts for Mental Health offers an introduction to the underlying principles of Mary Ellen Copeland's recovery model. Lively and insightful discussions include hope (2 min.), personal responsibility (1 min.), education (2 min.), self-advocacy (4 min.), support (16 min.), health care (6 min.), and medication (11 min.). The videotape may be stopped between sections if desired. 50 Minutes.

Wellness Recovery Action Plan (WRAP) provides a simple system for monitoring and managing emotional and psychiatric symptoms, as well as avoiding unhealthy habits or behavior patterns. In this video, Ms. Copeland discusses with her group the steps to developing a "WRAP". In order to arrest symptoms and hasten remission and recovery, participants both learn and share personal strategies for dealing with each level of relapse. 32 Minutes.

The Wellness Toolbox introduces the concept of "wellness tools" - simple actions that anyone can do to feel better and to stay well. Participants discuss with Ms. Copeland how to create a personal "toolbox" for their own use in times of stress or increased symptoms. The video is organized into various topics including reaching out for support, peer counseling, focusing, relaxation and stress reduction, and journaling. 28 Minutes.

"CREATING WELLNESS is the leading edge of mental health education. This extraordinary video shows how you can find the support and resources you need, and how to chart a course back to wellness. This is a program full of compassionate help by someone who's been to the far side of depression and back - and knows what she's talking about."

- Matthew McKay, Ph.D.
Cofounder and Publisher, New Harbinger Publications
Author, The Relaxation and Stress Reduction Workbook

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WRAP CD ROM

Click here to order this CD

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Wellness Recovery Action Plan (WRAP) For Dual Diagnosis

A WRAP Workbook adapted for people with a dual diagnosis of psychiatric illness and addictive disorder by Mary Ellen Copeland, MS, MA

This special edition of the original WELLNESS RECOVERY ACTION PLAN book presents a system developed and used successfully by people with a variety of physical and emotional symptoms including addictive disorders. It has helped them use self help skills more easily to monitor their symptoms, decrease the severity and frequency of symptoms, prevent relapse and improve the quality of their lives.

Learning self help skills for dealing with physical and emotional symptoms, as well as addictions is a simple process... but it's a much greater challenge using self help methods during the most difficult times -- when they can help the most -- and incorporating them into daily life.

This book will help you:

• develop your own list of activities for your every day well being
• track triggering events and early warning signs
• prepare your personal responses if symptoms increase
• create a plan for your supporters to follow to care for you if necessary

Using the Wellness Recovery Action Plan, self management of addictions, physical and emotional symptoms becomes possible and practical.

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Mental Health Recovery including Wellness Recovery Action Planning Curriculum Facilitator Training Manual

The new Mental Health Recovery including Wellness Recovery Action Planning CURRICULUM: Facilitator Training Manual is now available. This program is based on years of research experience by Mary Ellen Copeland. Teta Hilsdon, Mary Ellen's associate, has been working tirelessly on compiling this manual for many months. Gene Deegan, a Recovery Educator from Lawrence, Kansas, developed the transparencies into a PowerPoint presentation which is included on a CD-ROM in the curriculum package. The curriculum package includes:

• Section I: a detailed chapter of specific instructions on all aspects of facilitating Mental Health Recovery including Wellness Recovery Action Planning groups and workshops,
• Section II: thumbnail sketches of each transparency included on the CD-ROM
• Section III: supporting activities, handouts and discussion topics, and
• Section IV: an extensive list of related resources for the facilitator. While not specifically intended for use in working with individuals, it can certainly be used in that way, and there are some notes addressing this possibility.

This curriculum is the training format that Mary Ellen uses to accompany her five-day Mental Health Recovery Seminar II: Facilitators Training. But it can also be used by anyone who is familiar with Mary Ellen's Recovery work, including her focus on Wellness Recovery Action Planning. The materials are specific to facilitating Mary Ellen's WRAP workshop, Mental Health Recovery Seminar I including Wellness Recovery Action Planning, and is not necessarily a resource to be used in developing other kinds of programs. However, some facilitators are using this Recovery/WRAP focus in combination with other programs.

This educational curriculum presents an approach which is complementary to, but not a replacement for, other mental health treatment protocols. Due to the wide differences in the amount of time and other resources available to individuals, agencies, organizations and sponsors, this is not a scripted curriculum. A wide variety of options are offered in formats, timelines and activities. You will have at your disposal a thorough framework that will allow you enough flexibility to design a program that best meets your needs.

The cost of the curriculum package is $129, plus $5 shipping.

Click here to order this manual

 

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Plan de Acción para la Recuperación del Bienstar

El aprender los metodos de auto-ayuda para abordar Los sintomas fisicos y emocionales puede ser facil... sin embargo es un reto mucho mayor utilizar dichos metodos durante los momentos mas dificiles -cuando pueden ser mas utiles- e incorporarlos a la vida cotidiana.

Este libro presenta un sistema desarrollado y usado con exito por personas con una diversidad de sintomas fisicos y emocionales. Les ha ayudado a usar metodos de auto-ayuda con una mayor facilidad para vigilar sus sintomas, para disminuir la severidad y frecuencia de los sintomas y para mejorar la calidad de sus vidas.

Este libro le ayudara a:

• desarrollar su propia lista de actividades para su bienestar diario anotar Los acontecimientos desencadenadores y señales de alerta
• preparar sus respuestas personales en caso de que se incrementen Los sintomas
• crear un plan para que las personas que lo apoyan lo puedan cuidar en caso necesario

Esta guia accesible incluye informacion sobre el desarrollo de un sistema de apoyo, El uso de consejeria mutua de pareja, la concentracion, actividades creativas, El uso de UN diario, la musica, la dieta, la luz, ejercicios de relajamiento y el lograr un buen sueño nocturno.

Cuando uno usa El Plan de Accion para la Recuperacion del Bienestar, El manejo propio de los sintomas fisicos y emocionales se hace posible y practico.

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The Loneliness Workbook

As Mary Ellen teaches around the country, she continues to find that loneliness is a strong contributor to depression and poor quality of life for people who experience psychiatric symptoms. In this book, Mary Ellen has described how to develop and keep a strong support system. In addition she has addressed many issues that make it difficult for many people to make and keep friends. As with her other books, this book was the result of a study of nearly 100 people to find out how they relieve loneliness in their lives.

"Loneliness is pervasive in our fast-paced culture. Since people tend to increase their sense of emotional distress when they are disconnected from others, the effects of loneliness are a serious problem. This excellent book takes a hands-on approach to relieving loneliness and offers people hope that relationships are a path to healing and growth."

- Sherry Mead, MSW
Founder of the Stepping Stone Peer Support Center

Click hereto order this book

Healing the Trauma of Abuse: A Women's Workbook

Mary Ellen Copeland co-authored the book Healing the Trauma of Abuse: A Gentle Woman's Guide with Maxine Harris of Community Connections in Washington, DC.

This important self-help book describes a weekly lesson process that women can use to relieve the effects of trauma in their lives, either when working in a group, with a counselor, or when - as many women must do - working on their own. It rebuilds self-esteem and gives back the personal power, trust and sense of connection that are taken away by a traumatic experience.

This book is based on the findings of an intensive study of strategies that help women who have been traumatized to heal from the effects of this trauma and make their lives the way they want them to be.

Click here to order this book

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Winning Against Relapse

Every recovery holds the potential for relapse. And for many who have fought their way back to health form a physical disorder or emotional trauma, the return of old symptoms can be even more devastating than the original crisis.

This workbook provides a carefully structured system that anyone can use to monitor symptoms and respond to them in a way that reduces or eliminates the possibility of relapse. You will identify those things you need to do every day to maintain an optimum level of wellness, how to recognize the daily events that can cause symptoms to increase, the early warning signs that problems might be recurring, the signs that the situation is worsening, and how to make personal action plans that can reverse the situation. It will also guide you through the process of developing a personal crisis plan for others to use if they need to take responsibility for your care.

"I am delighted that Mary Ellen Copeland has designed such comprehensive and easy-to-use guidelines. Winning Against Relapse can be used for a multitude of illnesses, including chronic pain states. It promotes the state of optimum wellness that should be our goal."

- Devin J. Starlanyl, co-author of Fibromyalgia and Myofascial Pain Syndrome and author of The Fibromyalgia Advocate

Click hereto order this book

Winning Against Relapse Program

"Winning Against Relapse Program" is a one-hour audio tape in which Mary Ellen Copeland talks the listener step-by-step through developing a Wellness Recovery Action Plan (WRAP). This tape can be used with or without her books describing the WRAP program: "WRAP" and "Winning Against Relapse".

These workbooks and the audio tape provide a carefully structured system that anyone can use to monitor and respond to symptoms in a way that reduces or eliminates the possibility of relapse.

Mary Ellen focuses on the key concepts of her program and describes a progressive process for self-monitoring, staying well, and creating change in the way listeners feel or behave. She also includes descriptions of simple, safe, effective wellness tools that can be used to maintain health and help listeners feel better.

New Harbinger Publications, 1, $11.95.

Click hereto order this audio tape

The Worry Control Workbook

Is Worry taking up too much of your time and energy? Or is constant worry literally making you sick?

A little worry can actually serve a variety of positive functions, as it does when it helps us identify real problems or motivates us to take some needed action. But for some , worry is a problem, leading to difficulty sleeping, muscle tension, headaches and other physical complaints. Others feel perpetually tired, have trouble concentrating, or suffer from depression.

The good news is that you can learn to reduce your anxiety and deal with worry more effectively. The Worry Control Book is a supportive and comprehensive guide offering real help to anyone struggling with excessive concerns about health, money, family or work. The Worry Control Workbook

Download a sample chapter of this book

Recovering from Depression: A Workbook for Teens

This book was written to help adolescents who are

• depressed,
• sad,
• thinking about hurting themselves,
• feeling isolated from their friends,
• dropping out of their old activities that used to make them feel good about themselves,
• irritable and /or angry with their parents.

Used successfully by other young adults, this book will guide you though the process of finding help for yourself and getting on the road to feeling happy and healthy.

Click here to order this book

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Wellness Recovery Action Plan

Learning self help skills for dealing with physical and emotional symptoms can be simple ... but it's a much greater challenge using self help methods during the most difficult times - when they can help the most - and incorporating them into daily life.

This book presents a system developed and used successfully by people with a variety of physical and emotional symptoms. It has helped them use self help skills more easily to monitor their symptoms, decrease the severity and frequency of symptoms, and improve the quality of their lives. Paperback, $10.00

Click hereto order this book

The Depression Workbook: A Guide to Living With Depression and Manic Depression

From the best selling author, Mary Ellen Copeland, comes the Second Edition of The Depression Workbook. Learn and practice the latest research-based self-help strategies to relieve depression and address other mental health issues including how to:

• Take responsibility for your own wellness
• Use charts to track and control your moods
• Find helpful care providers
• Build a system of mutual support
• Increase self-confidence and self-esteem
• Use relaxation, diet, exercise, and light to stabilize your moods
• Avoid conditions that can worsen your symptoms

A new chapter guides readers through developing your own plan for managing symptoms and staying well. This process, known as the Wellness Recovery Action Plan (WRAP), was developed by a group of people who experience depression, or manic depression and/or have other mental health concerns and who now report that this plan helped them relieve their symptoms and improve the quality of their lives.

This edition is updated in all areas including new medical and holistic perspectives and extensive list of helpful resources and Web sites that will assist you in your journey to wellness. By letting you share more than a hundred case stories and empowering you with the most current therapeutic strategies, The Depression Workbook, Second Edition will give you insight, energy, and hope.

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Living Without Depression and Manic Depression: A Workbook for Maintaining Mood Stability

This workbook is not light reading. Neither, however, is it complicated, theoretical or esoteric. Living Without Depression and Manic Depression is a down-and-dirty guide for people who experience mood swings. It's a manual on how to wage guerilla warfare on emotional instability...hour by hour, season by season; in one's home or workplace; by using medication, diet, peer counseling, private and government agencies; and a host of other suggestions sent back from the battlefield.

Interactive exercises teach essential coping skills such as building a strong support system, fighting negative thoughts, finding appropriate professional help and using relaxation and exercise. Paperback $18.95

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Coping With Depression, Video Tape

There is a powerful message of hope in Mary Ellen Copeland's Coping With Depression. This video is for anyone struggling with depression: for family members, friends and health care professionals. Warm, helpful, and engaging, the video is the fruit of research and hundreds of interviews with depressed persons.

This tape shows how to incorporate into your life the strategies that the author and others have used successfully to keep their own depressive episodes at bay. An excellent educational resource, the video validates the feelings of people with depression and encourages a program of simple yet effective self-help techniques.

Well-known for her seminar and lecture presentations, Mary Ellen Copeland holds an MA in Counseling Psychology. Depression had a major impact on her life until she achieved long-term stability through the wellness program she describes on this video. Running time 60 minutes, VHS only. $39.95

Click here to order this video tape

Living With Depression and Manic Depression, Audio Tape

Depression affects over 10 million people a year in the US Over an average lifetime, over 15 percent of the population will experience serious depressive reactions. Yet 80 percent of all depressives and manic depressives get better with proper treatment. Living With Depression and Manic Depression offers many effective self-help techniques that can enhance wellness and mood stability.

This audio tape describes a program based on years of research and hundreds of interviews with depressive and manic depressive persons. It inspires confidence that you can achieve real breakthroughs in coping. Warm, helpful, and engaging, the video is the fruit of research and hundreds of interviews with depressed persons. One cassette in a rigid plastic box, running time 90 minutes, $11.95

Click here to order this audio tape

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