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Dr. Cesar Vasconcellos de Souza

Psychosomatic Diseases – The Body Speaks

June 4, 2021 by Dr. Cesar Vasconcellos de Souza - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Psicossomático - O Corpo Fala

Body and mind always work together. You have a suffering in your body, your mind participates. You have suffering in your mind, your body participates. Today we want to understand psychosomatic diseases, how the body and mind work together in health and illness, and how one affects the other.

Psychosomatic Diseases - The Body Speaks

I would like to start by quoting some interesting phrases:

The sympathy which exists between the mind and the body is very great. When one is affected, the other responds.((Ellen G. White. Medical Minstry p. 105))

That´s an interesting concept! Look at the next text:

Great wisdom is needed by the physicians at the Institute in order to cure the body through the mind. But few realize the power that the mind has over the body. A great deal of the sickness which afflicts humanity has its origin in the mind, and can only be cured by restoring the mind to health.((Counsels on Health p. 349))

And this author still says the following:

Sickness of the mind prevails everywhere. Nine tenths of the diseases from which men suffer have their foundation here.((Ellen G. White. Mind, Character and Personality Vol. 1 p. 59))

Isn’t this interesting? According to this text nine out of ten illnesses originate in the mind. Is this an exaggeration? Dr. Herbert Benson, a clinical physician at Harvard University in the United States says the following:

60% to 90% of patients who seek doctors at the (outpatient) clinic have their illnesses due to physical and mental stress. These are people who have had physical symptoms as a result of social and emotional problems. The average could be 75%.((Herbert Benson, Harvard University, “Timeless Healing – The Power and Biology of Belief”, 1998))

An he goes on to say:

Emotion plays a more crucial role in our physiology than most of us can understand.

According to him, feelings and emotion influence physiology, and how the body works.

Hippocrates, the so-called father of medicine, a Greek physician who lived between 460 and 370 BC, said something interesting that relates to psychosomatic diseases:

 It’s far more important to know what person the disease has than what disease the person has.

Interestingly, he recommended for example that people with asthma learn to better express their anger, in addition to other procedures that he prescribed. So it is more important to try to understand what kind of person has a certain disease, than what disease that person has. Of course, this doesn’t diminish the importance of a proper diagnosis. The diagnosis needs to be made by a doctor, so that the treatment is well indicated. But what Hippocrates was wisely trying to say, is that the professional who seeks a complete view of the person with a certain illness, can achieve better results in the treatment. So a well rounded view of the patient means researching the physical, mental, spiritual and social factors in that person’s life, rather than just focusing on that isolated symptom.

A doctor taking an anamnesis in order to prescribe a well rounded treatment - Photo by Thirdman from Pexels

It’s important to understand that we don’t get sick by compartments. The body affects the mind and the mind affects the body. Nothing is just physical and nothing is just psychological. In the development of a disease, as well as in health, there is a combination of factors in the individual’s lifestyle, which has to do with how you think, how you feel, how you express your feelings, it has to do with the way you deal with people, it has to do with your diet, whether you exercise or not, the quality of your sleep, the stress you experience at work, whether you live in a big city or a small town, it’s about all the aspects of your lifestyle.

When you have a physical symptom, it can be headache, dizziness, back pain, among many others, and you go to a medical appointment, do complementary tests, blood tests, urine and stool tests, X-ray, EEG, CT scan, magnetic resonance, ultrasound, and the doctor says you have nothing, that the results are normal, but you still have that symptom that motivated your consultation, you are dealing probably with a psychosomatic symptom, which can develop into a psychosomatic disease.

What is a Psychosomatic Disease

A psychosomatic disease is one that manifests itself in the body with physical or functional symptoms and injuries, but whose main cause originates in the mind. That means the main cause comes from emotional conflicts, psychological conflicts and mental stress. This is different from somatization, because in somatization there is no detectable disease process, either by a medical exam or a lab test. So when a person has a lot of emotional stress, he can manifest some of that stress in his body, because the body is a helper to the mind and both work in an indivisible and inseparable union. In this sense, we can say that every disease, regardless of its origin, is to a certain degree psychosomatic.

The body and mind work in harmony in such a way that when something is burdening the mind like nervous tension, sadness, excessive anxiety, it is as if the body says to the mind: Do you need help? So the mind says: Yes help me, because it is hard to deal with this suffering here. Then we throw part of our tension onto the body, and the body starts to show psychosomatic symptoms.

Each person will have the manifestation of emotional distress in one or more than one of what we call a shock organ. The shock organ is the part of your body that is most sensitive to emotional stressors. For some people, the shock organ may be the stomach, hence when there is too much stress, too much tension at work or in the family, these people feel, for example, a burning sensation in the stomach area. For others, the shock organ could be the immune system. A person experiencing a lot of tense relationships, a lot of stress, may have frequent infections, develop an autoimmune disease, who knows. In other individuals, the shock organ can be the muscular system, for example, and in the face of life pressures, these people feel muscular pain. According to studies by Dr. Dean Ornish, a cardiologist at the University of California in San Francisco, he said:

People with a heart attack have a fourfold risk of dying within six months if they remain depressed and alone.((Dean Ornish, Saving Your Heart, 2002))

He is saying here, that people who have already had the attack but survived, if they remain alone, isolated, they have a much greater risk of dying. And he cites a study at the Case Western Reserve University, and in that study he verified the following:

They surveyed 10,000 married men and found that those who answered yes to the question, “Does your wife express love to you?” had significantly less angina.((Dean Ornish, Salvando o Seu Coração, 2002))

Years ago there was a book that was a bestseller in Brazil. That’s the title of the book: “Whatever it is”. It was written by a woman, an executive secretary who had a daughter and she was a go-getter, very proactive, very active in life to take care of her daughter, excel at work, be a high-profile professional in the company, then she had breast cancer. First she was stunned: How can that happen to me, a strong woman, so powerful, has breast cancer! She started researching what breast cancer is, and wrote this book: “Whatever it is”. A book where she opens her heart, opens her life, even private things in her life, and she says: “The cancer did not come to kill me, the cancer was a beacon, a red light ascending in my life, saying: Hey, stop, stop to reevaluate your life.”

A cancer survivor - Photo by Klaus Nielsen from Pexels

I even got in touch with her at this time, and we sat together at a bar in Rio de Janeiro to talk about this subject of mind and body and the relationship to psychosomatic diseases. So she explained it this way: “We have to learn to look at the disease as an alarm. The symptom is an alarm, the symptom is talking to you. It’s like when you have a car that you’re driving, and a red light is lighting up on the dashboard, is that red light a good thing or a bad thing? Well, it has both sides, it’s bad because you have a problem with your car, but it’s good because it’s warning you.”

So when you have any symptoms, of course you’re going to seek medical help, consultations, tests, all of that, but if you went to the doctor, you did evaluations, did the tests, and he says you have nothing, you’re fine, but you still have that symptom with that same kind of pain, so you need to start thinking about what’s going on with your emotional life. What will you need to do to alleviate the emotional tension and stress? As I explained, the mind always works hand in hand with the body, and often when you’re not ready to deal with the emotional pain, give it a name, face it head-on, your body starts to absorb, because you’re asking for it, you’re saying: I can’t handle dealing with this emotional pain, I can’t handle dealing with this loss, with this frustration, so the body comes in to help to alleviate this load.

The Power of the Mind

The way you think influences your body. This very simple statement shows just that:

If your mind is impressed and fixed that a bath will injure you, the mental impression is communicated to all the nerves of the body. The nerves control the circulation of the blood; therefore the blood is, through the impression of the mind, confined to the blood vessels, and the good effects of the bath are lost. All this is because the blood is prevented by the mind and will from flowing readily and from coming to the surface to stimulate, arouse, and promote the circulation.

For instance, you are impressed that if you bathe you will become chilly. The brain sends this intelligence to the nerves of the body, and the blood vessels, held in obedience to your will, cannot perform their office and cause a reaction after the bath.((Ellen G. White. Mind, Character and Personality Vol. 2 p. 397, 398))

That’s a very interesting statement! It is saying that the blood is impaired to circulate, because the mind is in emotional strain because of the way you think. Now the way you think then influences your body? That is what is being stated there. Now look at this other text that shows that the way you feel affects your body. It says:

 It is the duty of everyone to cultivate cheerfulness instead of brooding over sorrow and troubles. Many not only make themselves wretched in this way, but they sacrifice health and happiness to a morbid imagination. There are things in their surroundings that are not agreeable, and their countenances wear a continual frown that more plainly than words expresses discontent. These depressing emotions are a great injury to them healthwise, for by hindering the process of digestion they interfere with nutrition.((Ellen G. White. Mind, Character and Personality Vol. 1 p. 62, 63))

Very interesting, depressing emotions harming nutrition! Years ago a Nobel Prize winner in medicine showed in his scientific work with his team that there is a connection between cells of the central nervous system and immune cells.

Dr. Wildemann and his collaborators from the Stress Lab at the University of Arizona, proved that people experiencing significant losses, such as the death of their spouse, can experience several months of immune system deficiency resulting from this sadness. He explains in the study that some defense cells, such as natural killer cells, T and B lymphocytes, may become reduced or less active in their work to fight viruses and bacteria, because sadness affects immunity, it affects these defense cells.

Perhaps you have heard of an elderly person who was in good health and a few months after the death of his husband or wife, he himself had a major infection and died too. You surely have heard of such a case, it’s not uncommon. The old couple lives together and they’re fine, but suddenly one gets sick and then the other one that was healthy, but after the death of that dear one, within six months he dies too. Because sadness undermined the strength of that individual’s immunology, so a virus or bacteria took advantage of the situation and caused a serious illness.

An elderly couple enjoying companionship

So it seems that the more a person has difficulties becoming aware of their emotions, especially painful or unpleasant emotions, the more likely they are to present psychosomatic symptoms, because the body absorbs such feelings that the person feels unfit to deal with in a conscious level. This means that the more a psychosomatic symptom is buried in the body, the further a person is from the truth about the repressed and somatized feeling, or about those painful thoughts that the person doesn’t want to think about at that moment.

Dr. Diana Fosha from Adelphi University in New York says that for every type of emotion there is a visceral component, that is, a feeling always expresses itself in some organ in the body. I’ve already talked about shock organs here, so if you have difficulty expressing anger, it can come out in form of asthma or high blood pressure. People who have difficulty expressing any feelings, may present for example constipation. Perfectionists and stressed individuals can have a lot of migraine headaches. Some people with a tendency to repress their emotions for many years may facilitate their body to develop cancer, according to studies by scientists such as Dr. Bernie Siegel, Lawrence LeShan and the Simonton scientist couple.

Of course I’m not saying and neither are they, that the cause of cancer is an emotion. In fact, they explain that unresolved conflicts or major losses, can be factors that affect immunity and favor the emergence of cancer, when the person already had other factors that induce the mutation of a normal cell to a cancer cell.

A person with a lot of difficulty to cry, according to some scientists, may cry through the skin, through dermatological lesions, which produces a type of secretion. Individuals who repress their feelings a lot, they tend to have degenerative diseases such as cancer, diabetes, multiple sclerosis and other pathologies, while more explosive people tend to have other diseases such as heart attack or stroke. It’s like the more melancholic, introverted people they implode and the more short tempered people they explode, so the diseases are more cardiovascular for the explosive and they are more degenerative in the more introverted people. It’s common for people who develop fibromyalgia, for example, to take exaggerated responsibilities in the family. I’ve seen a lot of people with fibromyalgia, and I realized that in all of them there was a behavioral characteristic of exactly that: carrying the piano for everyone.

Psychological disorders are not weakness or lack of faith if you have lived or are experiencing major stresses in your life. Mental sufferings such as strong anguish, deep sadness, excessive fear are expressions of suffering, which often manifests through the body. These are so called psychosomatic disorders, which are defenses used by the body to relieve the mind. If you have physical symptoms, if you’ve had several evaluations with different doctors and they all say you have nothing, because no diagnosis was found and your exams are normal, you need to start to think whether there is something unresolved in your life, in your emotional life, in your relationships with people, are you guarding some resentment, do you need to resolve an issue with someone who has been eating you from the inside for many years? If you have some repressed emotions, or one of those situations I talked about, it might manifest itself in your body. You may also consider that a professional psychological evaluation may be needed. It may depend on the level of suffering you are having.

A psychologic consultation - Photo by cottonbro from Pexels

Sometimes emotional problems get resolved with life. A friend of mine, a psychoanalyst, once said an interesting phrase: “Life is therapeutic”, meaning life, the events of life, they teach us many things by themselves, and can help us to achieve healing from some situations.

Sometimes life doesn’t solve everything, so we need some technical help. Don’t suffer without taking an attitude to improve, because actually health, for you to develop health, it depends on you to practice some habits, it depends on you to improve your lifestyle in relation to food, in your thinking patterns, in the relationship with people, your sleep, your physical exercise, but it also depends on the attitudes you take, on you assuming responsibility for taking good care of your body and mind.

So it’s important that you do something for yourself instead of always waiting for people to do something for you, or even waiting that the doctor will cure you. The doctor does not cure people, the doctor indicates some paths to health, sometimes they prescribe a medicine that will be temporary to alleviate a symptom, that suffering you are going through, but there are attitudes you take in life, there are decisions you make to take better care of your health and your mind, that will determine whether you are going to take the path of health or the path of illness. Professor Dr. Adalberto Barreto, who works with community therapy, said:

When the mouth shuts up, the organs speak, and when the mouth speaks, the organs heal.

Look how interesting it is, showing the importance of talking, of letting off steam, so that you don’t get somatized, so that you don’t keep swallowing things, without putting a limit, and you end up suffering on your body. Make the necessary changes in your thoughts and emotions for you to have a better life and health!

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Filed Under: Mental Health, Psychosomatic Diseases

Anxiety and Panic Attacks

April 24, 2021 by Dr. Cesar Vasconcellos de Souza - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Anxiety and Panic Attack

One day, I was riding in a subway train. The train was packed and I was sitting in the chair next to the window, when the train suddenly stopped in a way that when I looked at the window I saw a wall, nothing more. It came to my mind what could happen to people with panic disorder and phobias. I thought, if such a person would be here now and looking out the window, and saw this wall with a full train, so that on one side there are a lot of people wanting to get out, and on the other side a window of the train that doesn’t open, a wall, the person starts to think about it and let his fearful thoughts take over her mind, thinking that there would be no way out, that there could be shortness of breath for everyone, because the train was full, and it would be impossible to get out of there, in addition to other tragic thoughts, the panic attack would probably be triggered in this person. What we think about most, we become, even if what the thoughts are suggesting is not true. The quality of our thoughts influence what we feel.

Anxiety and Panic Attacks

What is a Panic Disorder?

A panic attack is a sudden, very strong reaction of anxiety and fear. It is unexpected and produces symptoms of physical and emotional discomfort, causing the person in the time of the crisis to escape from that place and seek a medical emergency room, or an environment in which they will feel protected, or to be with someone with whom they will feel more secure. If you are experiencing a tragic situation such as a shootout between bandits and police, it is normal to be in a panic at that moment. But the person with panic disorder is terrified of dying or losing self-control, a feeling of depersonalization, even when there is nothing in the environment that favors this. For the diagnosis of the panic disorder, there must be repeated crises in the last weeks or months, an exaggerated concern about having new crises and at least four of the following symptoms:

  • Tachycardia, which is an acceleration of the heart
  • Tremors in the limbs or in the whole body
  • Sweating all over the body, or just the hands and feet
  • A feeling that you are going to faint
  • A feeling of suffocation or difficulty in breathing
  • Chest tightness or chest pain, which is usually interpreted by the person as a heart attack
  • Dizziness or feeling of light-headedness
  • Fear to die
  • Fear of going crazy and other symptoms

About 2% of the population suffers from this disorder. It is twice as common in women as men, and usually occurs around the age of 30. However, it can happen in any age. The cause of panic disorder is not well understood by science, and there are different theories. Among them is that in the brain physiological reactions occur, starting at the place called locus cerulean. This brain center is connected to the vagus nerve, which extends to the chest and abdomen, hence the feelings of suffocation, chest tightness, gastric discomfort. If something activates this neurophysiological system in an exaggerated manner, it is generating symptoms of the panic attack. It seems that when the person is moved by phobias or by very high exaggerated anxiety, this nerve called vagus or pneumogastric nerve is activated and produces these sensations.

The person can concentrate on these bodily reactions such as the acceleration of the heart, butterflies in the stomach, and feeding tragic thoughts: I am going to die, I am having a heart attack, and the cycle closes, so the person thinks tragically, increasing the reactions. So she enters the cycle of fear of dying, and symptoms get stronger and stronger.

It is also believed that in panic disorder, crises can be developed from mental conditioning, which the person has been doing over time, interpreting symptoms or events in a tragic, catastrophic, imaginary way, in a way that triggers all this reaction of the panic in the future. For example, one day the person who tends to be very anxious when going up in the elevator, felt a strong pain in his chest. From then on, he associates chest pain with going up or down the elevator, and then he develops this fear of an elevator, and he can expand that fear to other closed places.

Another theory has to do with psychodynamics, the history of your emotional life. In this psychodynamic theory, the emotional conflicts of childhood and adolescence, which for some people were very difficult, can favor the emergence of very high anxiety in more vulnerable individuals. Childhood traumas, such as verbal abuse, emotional abuse, parents’ divorce when the child is young, in a very sensitive child facilitates increased anxiety, which can manifest itself by the panic attack years later. A panic attack is like an overflow of anxiety. This overflow can occur, because the person is stressed, represses feelings that need to be verbalized, or because he has conditioned himself to make a tragic interpretation of the events, and this can be modified. You can learn to think, feel and act in a healthier way.

Panic Syndrome Treatment

Excess anxiety that triggers a panic attack may decrease or not, but the person may develop healthy attitudes in self-defense. This means, that he can learn to rest, to relax, instead of always being busy, he can learn to relax even to set limits, also to say no to people. Many people mistreat themselves, they devalue themselves, they do not protect themselves from abuse, they suffer from very high anxiety, which can manifest itself in a panic attack. High anxiety and exaggerated anxiety can be the warning light, saying to the person: “Hey, you need to stop treating yourself badly, and start respecting yourself.” The treatment of panic disorder involves a few things:

  • Temporary medication, for those who are experiencing excessive anxiety, which is disrupting their work and social life
  • Psychotherapy
  • Lifestyle care
  • Orientation for family members, so that relatives understand this suffering

The medication, if necessary, must be prescribed by a psychiatrist, who will also do psychotherapy, if he is trained to do so, or he will refer the person to a psychologist. Psychotherapy is the use of psychological techniques aimed at increasing self-knowledge, and learning how to deal with your emotions. It involves also an analysis of thoughts, trying to localize negative and distorted thought patterns, often full of prejudice, and replace them with positive thoughts, of hope, of acceptance, of self-protection, of forgiveness for oneself and for other people. Psychotherapy or psychological therapy also helps the person to speak and experience repressed feelings that cause mental tension. It helps to make connections between the current suffering that the person presents, and problems in the past due to the family history.

When the person gradually understands the history of his life, in the family relationships that favored exaggerated high anxiety, he is more likely to learn to deal better with his fears, anxieties and griefs, and step by step he can learn to modify his way of dealing with suffering. Psychological therapy, counseling with experienced people, reading suitable books, participating in support groups, having moments to reflect in order to gain self-awareness, are ways of better understanding who you are, and thus facilitating emotional control.

Among the physical care that contributes to the improvement of panic disorder I can mention: first of all rest, then a balanced healthy nutrition, the practice of outdoor exercise, such as walking for example, growing a vegetable garden is extremely therapeutic for the human mind, and proper breathing. Breathing calmly and deeply, inhaling and exhaling slowly, concentrating on the breathing helps. Doing this helps to prevent the crisis from appearing or aggravating.

An anxious person sleeping - 
Photo by Ketut Subiyanto from Pexels

Types of Anxiety

Panic crises or panic disorder is a suffering linked to excessive anxiety in the person’s mind. It is like a water tank that has a problem in the float, thus not closing the water inlet, and the drain, who throws out the excess of water is clogged, so water spills over the sides of the tank. Everyone has anxiety, but not high anxiety. A panic attack is when excessive anxiety overflows in the person’s mind, causing unpleasant symptoms.

There is trait anxiety and state anxiety. State anxiety is when the person temporarily experiences high anxiety. It may be in the period of school exams, for example, in preparation for a wedding, in the days before an interview to apply for a job, and other situations. With state anxiety the person has a normal anxiety, temporarily it gets higher in the face of these events, and then it returns to its normal level. Now trait anxiety is as the name says a trait, the person already has anxiety higher than the average, higher perhaps than the siblings of the same family, even though they are children of the same father and mother. So a child with trait anxiety may be more sensitive, more vulnerable to these mental sufferings.

An Example

A young adult woman has been experiencing panic attacks and sought treatment, and the points worked with her in psychotherapeutic treatment are as follows: First she has learned to think, what kind of things accumulate tension and stress in her life that ends up in exaggerated anxiety. She was too concerned about everything, she lived with her worries, which were exaggerated, and she started to realize that. Too worried was a long-time trend in her life. It was the chronic way of living tense. Excessive worry increases anxiety, and increased anxiety can cause panic attacks. She was learning to reflect if she really needed to be so worried about too many things, she started to question herself in order to understand if worry changes something for the better, if her worry would change her reality. She started to think about these things, started to question her own too anxious mind, that is, she managed to start separating herself from the anxiety she experiences. She started to reflect on what she was thinking, this is an exercise that the person has to do, which is called self-analysis or self-observation. So she is learning to live one day at a time, one hour at a time, also learning to accept the inability to fix everything around her.

Another thing that is helping this woman a lot is talking to a family member or understanding friend about her fears, to vent her feelings. Someone who understands the problem, who is friendly, who is not the critical person and who is also able to keep a secret, because venting alleviates anxiety. This woman understood that the panic attack does not go much beyond ten minutes. She is learning to remind herself that the physical symptoms, besides the pain of the crisis, are not serious manifestations of health problems, such as that she will have a heart attack, or that she will have a stroke, or that she will be fainting, so she is learning that she has no physical disease, because she has already undergone clinical and lab tests with the results ruling out the existence of a physical disease. So if you have panic attacks and you haven’t had any exams yet, you haven’t been to the doctor, you haven’t had an appointment with a cardiologist and a general practitioner, it will be important to do that. Having verified that there is no medical alteration will help you next time so that you will not be afraid that you will die of a heart attack, because you will remember: I have already had an exam and the doctor said that I do not have any cardiac problems.

An anxious woman talking to a friend - Photo by Cliff Booth from Pexels

So she has learned that anxiety in a panic crisis is disproportionate to reality. Fear says that in a crisis she will die of a heart attack, or that she will lose her mind, or something that is not real, so she has been training to step back in her mind and look at the tachycardia, look at her breathlessness, observe this and think that the strong anxiety is producing this, and not a real physical failure of the heart or lungs or brain. So the moment the crisis seems to come, she can now remember this for herself, and she is making an effort to change her focus, taking that attention away from her body signals and observing objects around her, or making a rational effort to think of something else, or going to tidy up the closet, going to call a friend, she shifts the focus of her thoughts. She also tries to recall what the cardiologist said recently, that there is no physical illness, that the exercise ergometry or electrocardiogram was normal, as well as the other tests she did.

She now understands that even when the family member with whom she lives and who does not have panic attacks thinks that what she suffers is nonsense, she does not need to feel inferior for having these crises. She now accepts that she is not less valuable because of the crises she has.

She has learned to let go of attempts to control her life, to want to exercise control over other people’s lives and behavior, which is a very stressful thing. She is discovering that she wanted to control the uncontrollable, and that it increased anxiety, stressed her out and contributed to the panic attack. Now she is able to talk about the things that bother her, without feeling repressed, as if it was forbidden to comment on them. Often the difficulty to speak, to vent is in the person who has the panic disorder, and not because of the unwillingness of others to listen.

She is already able to set limits and protect herself from over-assuming responsibilities or tasks. She is better able to protect herself from abusive people, she recognizes better that there are people without boundaries, who abuse the goodwill of others, and that when she does not protect herself by saying I can’t, I don’t want to, it won’t happen this time, when that is the right thing to do, it accumulates stress that can trigger the crisis. She now asks for things, she asks for help, she delegates tasks, she does not keep assuming everything in her life, she does not commit herself to deadlines that are too short to meet, because she says this will not work, I cannot assume that here, so she respects herself better, she is reducing the posture of omnipotence that she had, that she can do everything, will do everything, resolves everything.

She is learning that already having had panic attacks, she was very afraid of having it again, but now she can remind herself that she is not her anxiety, she is not her fear, she is greater than this, she learned that fear is something in her, but it is not her second nature. Now, she can begin to view excessive anxiety no longer as something that will dominate her mind.

Thought Control

The person with panic disorder needs to train in their mind to self-control exaggerated concerns. What does that mean? When a concern comes, that if not overcome will create a lot of anxiety, and could trigger a new panic attack, he should say to himself: “Wow, look, I am very anxious now.” He starts to observe his own anxiety, then he says to himself: “It comes to disturb me again, but now I know that I don’t have a heart problem, that thought that says I’m going to die of a heart attack, I was already at the cardiologist, I did exams, everything is normal, so I don’t need to let the ideas of dying from heart attack take over my mind. Now I understand that I won’t get out of reality, I won’t freak out, I won’t go crazy.”

So when the person who has had panic attacks develops this type of reasoning, when a threat of a new crisis arises, it means that he is starting to control his tragic thoughts, and therefore the crisis can be avoided. Because disturbing thoughts need to be controlled, and this is done using reasoning. Using logic, using the information you already have, that you do not have heart disease, that the panic crisis is temporary, it is going away and does not lead to craziness. The truth can free and heal. So to improve any mental suffering that involves a wrong way of thinking it is important to understand what this author wrote:

The thoughts must be trained… The thoughts must be controlled… Right thoughts… do not come to us naturally. We shall have to strive for them.

Ellen G. White. Mind, Character and Personality, Volume 2 p. 656

Then you train to replace tragic thoughts with healthy ones. It may not be easy initially, but with training will become less difficult. It may not be possible to prevent the fearful or tragic thought from arising in your mind, because when you see it, it is already there in your head, but it is possible to prevent it from continuing in your mind to disturb you. So the practice of deciding to stop thinking about the negative or the tragic, will strengthen the mind of the person with panic disorder, so that these unpleasant thoughts become less disturbing and less frequent, because in doing so, he is learning to cultivate healthy thoughts that do not generate excessive anxiety. I want to leave a text for you who suffers from panic attacks:

Finally, brethren, whatever things are true, whatever things are noble, whatever things are just, whatever things are pure, whatever things are lovely, whatever things are of good report, if there is any virtue and if there is anything praiseworthy—meditate on these things.

Philippians 4:8

It is interesting that this passage has translations that say: think about such things. So which thoughts are controlling your consciousness? You can train to stop the tragic and cultivate the positive. Wishing you serenity and a clear mind.

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Filed Under: Anxiety, Mental Health

Six Tips to Set Boundaries

March 28, 2021 by Dr. Cesar Vasconcellos de Souza - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Como colocar limites?

Do you have a hard time setting boundaries? Do you usually say yes when you wanted to say no? You tackle things that you were not supposed to deal with? If so, then today’s topic is for you. Let’s get some tips that can help you set some boundaries.

Six Tips to Set Boundaries

The Importance of Boundaries

You may ask: Why is it important to set Boundaries?

First, because you may be a person who didn’t know how to do this since you were a child. You may have been a victim of other abusive, dominating children, or you suffered from adults who were not sensitive to your needs as a child, needs that you did not know how to claim. Father and mother need to teach children from an early age to know how to defend themselves from abuse. You may have become an adult who still struggles with the issue of setting limits. Hence you suffer unnecessarily, assuming tasks, responsibilities that you shouldn’t have, but since you take them on, your life gets stressful, heavy and unhappy.

Boundaries are attitudes you should have and need to practice, in order to protect what is good in your life, and not allow bad things to overcome you, whether in your home, your body, at work, in your religious community, in the neighborhood and in your own mind. Limits are important. Think of the boundary between your house or apartment and the neighbor’s house or apartment. The limit can be the door, the corridor, the sidewalk, the wall, the fence, right? And what about the limits between a town and another town, between a state and another state, between one country and another country. Look how important limits are, the border is important, isn’t it? I remember a saying I read a while ago: having a neighbor is good, but put up your fence.

The fence defining the property boundary of the house

An emotionally sensitive person, if he suffered a lot in childhood relationships, he may have built up tight boundaries on his personality, in order to avoid suffering pain again. Sometimes we hide ourselves to protect from the pains we have experienced in the childhood past, to make sure they are not repeated in adulthood. But we can exaggerate our boundaries that keep us away from more intimate contact with others, and even with ourselves.

Some children may not have learned to put limits during childhood against family abuse. They may have been criticized for wanting to be alone for a few moments when it was normal for their temperament. They may have been hampered in the process of delineating their self, in the construction of an identity that separates them from others. They may have had difficulty making decisions independently. Some children and teens may have suffered in their families for being aggressively repressed when they tried to complain about something unjust and cruel. Children who grow up without having learned to set just and necessary limits for the preservation of their own identity, become adults who are generally victims of abuse in marriage, with an authoritarian husband, with an authoritarian wife, or with a co-worker, boss, or abusive business partner.

Practical Tips

Now let’s look at some tips on how to establish healthy boundaries.

First make sure you express yourself clearly. Many sensitive people, more prone to not knowing how to set boundaries, often express themselves, but not in a clear and firm way. They may say something like this: yes maybe, I’ll try, if I can, when they really wanted to say no. You can be clear, firm, and at the same time polite and tactful.

A woman shrugging her shoulders, not saying what she thinks - Photo by Polina Zimmerman from Pexels

A second tip: you have no obligation of always needing to give a reason for your decision. Think about it: you can say no thanks, I don’t want that, and that’s it. Speak politely, without shouting, and if the person insists on wanting to know the reason for your decision, you can repeat your answer and say that you do not want to explain. You have the right not to explain yourself to an abusive person, who just wants to bog you down.

The third tip on setting boundaries. Only you know whether or not you are overwhelmed. If people know that you are overwhelmed, they may not ask you for another difficult task. So say you have a lot to do or too many responsibilities around your ears.

A fourth tip: You have the right to tell a person that you will need more time to think about the decision he wants you to take right away. If you feel not safe to take the final decision right now, say that you need to think and that you will get back to them as soon as you can.

The fifth tip for you to set boundaries and protect yourself. If you think it will be easier to say no by email, by phone, by the message on your cell phone or other means, without being face to face, then use one of these means of contacting the person.

The sixth tip has to do with respecting yourself and thinking that you are on same ground with another person, or you may even be better prepared, for example to perform a certain task. Someone who is bossy, with a dominant temperament, usually chooses the best seat, the quietest place, the largest office, dictates the rules, determines tasks, doesn’t he? So do not feel or place yourself as inferior to that person, but with the same rights if you are actually in the same hierarchy. If the person doesn’t see you as someone who has the same rights as he does, when in fact you have a right, see what you can do to change that.

Make an effort to say no when it is the right thing to do. When you arrive at the final judgment, God will not ask you why you were not the same as someone else. If you don’t take better care of yourself, putting boundaries on what God expects you to be, he will ask you why you have not been the best of yourself. So think about it. You have a right to set boundaries, and if you have not learned it in childhood, you can learn it now. Protect yourself and set boundaries!

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Filed Under: Stress Management

Burnout – What to do?

February 26, 2021 by Dr. Cesar Vasconcellos de Souza - [rt_reading_time label="Reading Time:" postfix="minutes" postfix_singular="minute"]

Burnout-What to do?

Have you ever heard of burnout? It is a physical and mental exhaustion, normally resulting from chronic workplace stress that has not been successfully managed. What are the symptoms and what can we do to solve it?

Burnout - What to do?

Burnout is the result of stress which lasts for a long time, leading to emotional and physical exhaustion, when there are a very stressful work style and difficult relationships with people, which could include the family.

The people who suffer most from this type of exhaustion are those who practice a profession where they are required to involve with people on a frequent and very close basis. They are service providers, especially caregivers and teachers, because their work involves many emotionally stressful situations. Burnout syndrome is manifested by emotional exhaustion, decreased personal fulfillment at work and lack of a human atmosphere. Let’s see how that works.

Symptoms of Burnout

Burnout is a response to various stressors. Its symptoms are telling the person: stop. Re-evaluate your lifestyle. Review and change the way you deal with people. Take it easy on yourself. Put a limit on the abusive people you have to live with, or stay away from them. The person with burnout is not a weak individual. The demands from outside, and often from within themselves, are in general too much for any human being to deal with.

Do you know what symptoms a person with burnout syndrome has? I will mention the physical and mental symptoms. Among the main ones are physical symptoms: constant progressive tiredness, muscle pain, headache, gastrointestinal disorders, insomnia, repeated infections due to low immunity, cardiovascular disorders such as palpitation, high blood pressure, sexual impairments such as premature ejaculation, disinterest or frigidity, bone pain, menstrual disorders, migraine, asthma attack and others.

Mental symptoms of burnout syndrome include difficulty of thinking quickly, feelings of loneliness, helplessness, impaired short term memory, decreased attention and concentration, irritability, emotional lability, like crying easily, loss of self-respect and self-worth, depression, difficulty to relax, impatience, sudden change of mood, abuse of substances such as alcohol or prescription drugs, loss of interest in work, absences from work and others.

A woman with burnout crying

Many people who develop burnout feel compelled to succeed and perform well and experience demands that are too strong to compete with. They may have an ambition that may be linked to dysfunctional, that is, unhealthy psychological needs. It is easy to disguise the unhealthy obsessive ambition for professional and economic success in life through hard work that everyone applauds, that is, people do not criticize those who work too much, the employee is always praised, but it can be a compulsive worker and end up developing exhaustion, and behind a compulsion, there is always a history of emotional pain and spiritual conflict.

Exhaustion can arise from exaggerated profound ambition, or desperate need to be approved, thinking that our work is not adequate, a need to feel that we are in control all the time, or any behavior, desire or motivation that dominates us in an uncontrollable way.

Consequences of Burnout

What are the main consequences of this exhaustion called burnout in a person’s life? Loss of physical strength to work, stress in the family, which can cause discontent in the children, who may start to see the work of the father or mother in a negative way and revolt, difficulties in marriage because the husband or wife meets the demands of their work and leaves the affections of married life aside. In this case the person must learn to put limits on abusive work requirements and their own exaggerated desire to get involved with things outside the home.

A family relaxing at the beach

There are many who develop depression in response to exhaustion. Depression is a sign that there are losses. There is helplessness that is not being respected, perhaps by the person himself, in which case there is a need to regret, to cry, to ask for support from someone who can hear or understand, or accept him in his pain, in his struggle and in his emotional fatigue.

The other consequence of burnout is the loss of motivation due to pressure at work, pressure from the boss who sucks too much, generating stress, exhaustion, and everyone is harmed. The person is asking for sick leave, the production falls, but the costs are the same. Do you exploit your employees? Do you pay overtime and allow for an hour bank? Do you give vacations according to the law? Do you pay fair wages? Are you honest as an employee, and with a co-worker? Do you involve yourself in the company? Do you do your best, are you proactive? Good qualities in bosses and employees prevent burnout at work.

Burnout Prevention

Several scientists studying this syndrome cite that to prevent burnout it is important to take some actions, such as:

  • prevent the employee from feeling coerced, pressured by strict rules and policies.
  • to prevent workers with young children in school age from being frequently transferred from the city, so as not to cut the affective bonds, the friend, school, neighbors, creating stress in the family, the father, the mother, and the children.
  • to encourage individuals by showing them that their work is very important, whatever it is, and that it cannot, it does not need to be quantified by numbers, and that the goals are secondary.
  • promote human values in the workplace, remembering that people are more important than things, than goals, than reports.
A company working as a team - Photo by fauxels from Pexels

Each employee must think that his value as a person is given by God, that there may not be a positive return of kind words from colleagues and bosses, not because my work done is not good, but because that company or that institution may have a predominance of demanding, legalistic, cruel and jealous people. And another thing, you need to have friends, at least one with whom you confide your personal problems. To prevent burnout, you need to become responsible for your health, avoid developing burnout by placing limits on the exaggerated and unfair demands of others, without fear of being criticized. Because your conscience will be calm, remembering that there will be unpleasant critics.

The leader of an employee who is experiencing burnout can assist his team member with empathy, understanding, offering personal and institutional help, without paternalism, but with compassion. I want to leave a biblical thought for your reflection:

Do not be overly righteous,
Nor be overly wise:
Why should you destroy yourself?

Ecclesiastes 7:16

Peace and light, don’t be cruel to your employee, and don’t be cruel to yourself.

Do you need a guide to help you understand how to cope with Stress in an all inclusive approach? Learn how to combat stress, mentally, physically, emotionally and strategically in your life.

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Filed Under: Burnout, Mental Health, Stress Management

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