Stephanie Livingston–Psychologist

ARTICLES

High Blood Pressure–Are you working yourself to death?

by on Jan.19, 2013, under ARTICLES

HIGH BLOOD PRESSURE
ARE YOU WORKING YOURSELF TO DEATH?

Hypertension is a chronic medical condition that is characterized by an elevation in arterial blood pressure. Blood pressure is measured by systolic (top number) when the heart muscle is contracting or diastolic (bottom number) when the heart muscle is relaxed between heart beats. A reading of 120/80 is typically thought of as normal blood pressure, but can range between 100-140mmHg systolic, over 60-90mmHg diastolic. If a person’s reading is consistently at or greater than 140/90 hypertension exists. Most people have primary or also known as essential hypertension, with no underlying medical cause. Less than 10% of the population have secondary hypertension, which is caused by some other medical condition. Essential hypertension, can be the result of many factors such as age, weight, eating and exercise habits, genetic predisposition, and stress. Stress can influence blood pressure because the chemicals that are released during the stress/fight or flight response results in a constriction of the blood vessels, which raises blood pressure. Over time, the daily hassles of life can add up and cause prolonged elevations in blood pressure, which can result in hypertension and many other associated medical problems, such as stroke and kidney failure.
My dissertation research at The University of Chicago Hospitals revealed some interesting things with respect to hypertension and psychosocial factors in black women. Specifically I looked at a concept proposed by Sherman James called, John Henryism, an active coping mechanism used to deal with exposure to prolonged stressors, such as social discrimination. As the legend goes, John Henry was a slave, who could reportedly out- perform the mechanical steam drill, but at the expense of dying from over exertion. James, an epidemiologist, during his data collection for his research, interviewed a man named John Henry Martin, who had characteristics similar to the legendary John Henry. John Henry Martin was a black man who freed himself from the sharecropper system to successfully farm 75 acres of his own land through hard work and determination by age 40, but at the cost of serious health problems by age 50, including hypertension, arthritis, and peptic ulcer. James developed the John Henryism Scale to measure the degree to which a person relies on hard work and determination to achieve their goals. My research findings using female subjects were consistent with James’ research with males, which revealed that those women who scored high on John Henryism tended to have higher blood pressures than those who scored lower.
I have learned over the years as a psychologist that sometimes trying too hard can be detrimental in the long run. For instance, relaxation techniques, which are meant to calm the body and mind and counteract the effects of stress, require a person to give up control. Trying too hard to relax, like trying too hard to go to sleep just doesn’t work. It is not until the person gives up control that sleep comes. Pushing too hard can elicit a stress response which counteracts the relaxation response. There are times when taking control in an active way is beneficial, like when trying to complete a task or playing a sport. It is important to know the difference when you need to take control or give up control.
Many studies have shown the benefits of relaxation techniques (e.g., biofeedback, meditation, diaphragmatic breathing, imagery) in reducing blood pressure. I have used a self-regulation strategy called heart rate variability (HRV), which involves using computer software that is able to measure a person’s heart rate (HR) and HRV—what happens between heart beats. This activity occurring between heartbeats can be affected by negative emotions such as anxiety, stress, anger, and frustration. A clip is attached to the individual’s ear lobe, where the HR and HRV are transmitted through a wire into the computer and the software transforms this information into a graphic that gives feedback as to the level of these physical activities. The trainee uses breathing and imagery techniques to learn to control their HR and HRV. Oftentimes imagery techniques involve thinking of something relaxing and your body responds by becoming more relaxed. In the case of HRV training, the trainee is taught to think of images of love and appreciation, because studies show that it tends to have a more positive effect. My patients who have used these techniques have been very encouraged in learning to control their blood pressure.
At our clinic, BioSynergy, this process involves taking the blood pressure first to get a baseline. Next, the trainee goes through a round of HRV, and then takes their blood pressure again. A training session of HRV involves playing games on the computer where the trainee is able to achieve a goal, like having images on the screen do certain things like having a rainbow go into a pot and fill up with coins or keeping a balloon afloat, as a result of making the HRV go up or down. The goal is to obtain coherence, meaning a smooth HRV pattern. High coherence guarantees success in playing the games. As mentioned previously negative emotions can have an adverse impact on coherence, making the HRV patterns more erratic. Low coherence can result in a stress response being elicited and all the things that go along with this response, such as release of stress hormones, which can in turn increase HR, HRV and a host of other physiological responses.
Most people are not aware that the heart has a brain of its own that sends signals to the rest of the body, just like the brain in your head sends messages down to the body. Therefore, by controlling the heart, one can learn to control other systems in the body voluntarily. You can try this for yourself at home, by taking your pulse or blood pressure, try thinking of something relaxing or a situation where you felt loved or appreciated for ten minutes, and take your measurements again and see if there is a difference. Keep in mind that you are doing this without the benefit of technology. Imagine what you could do, if you had a little help. The mind is a powerful tool, the body is a highly efficient machine, and computers are intelligent devices. Learning to control the interaction of these three entities, create a dynamic force that can take your mind and body to new levels.
These techniques are not meant to be used in replacement of medication or other medical advice. Consult your doctor before considering using these strategies to manage your blood pressure. DO NOT STOP TAKING YOUR MEDICATION WITHOUT YOUR DOCTORS CONSENT. Contact us today for an appointment. We have offices in Illinois and Indiana and take most insurances.

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GET YOUR HEAD TOGETHER

by on Feb.02, 2011, under ARTICLES, Articles

GET YOUR HEAD TOGETHER
Psychological approaches to male sexual dysfunction
Every night we are bombarded with commercials pushing drugs that claim to improve a man’s sex life. We see a middle aged couple sharing a moment together in a bathtub, on the beach, with running water everywhere. The good looking aging baby boomer, who has taken one of these sexual enhancing drugs, is comforted by the notion that when the moment arises, will be ready to perform in the bedroom. He is guaranteed an erection to meet his partners’ needs. But let us not forget the disclaimers (eg, you may have an erection for several hours, numerous side effects, contraindications). These commercials play on the fears of men who are growing older and fear not being able to have a satisfying sex life.
Are you taking one of these sexual enhancing drugs, used to address erectile failure, or are you considering taking one of these drugs? Before you make this decision, first discuss with your physician non-medication approaches to this problem. Erectile Dysfunction (ED) is defined as the inability of the penis to maintain and full and firm erection sufficient for penetration during intercourse. ED can include premature ejaculation and erectile failure. ED can be caused by a number of different things such as: the side effects of certain medications (eg, anti-hypertensives, narcotics), disease (high blood pressure, diabetes), depression or anxiety. Your doctor will help you to rule out any medical reasons for having this problem. If your doctor says that there do not appear to be any physical ailments that seem to be causing the problem, then you might consider psychological explanations. In fact sometimes ED can begin as the result of a medical issue, such as side effects from medication, but later be maintained because of psychological reasons, even after the medication has been stopped. For example, I once treated a 45 year old male in the Hypertension Clinic at The University of Chicago Hospitals for sexual dysfunction. He complained that the high blood pressure medication that he had been given was causing him to lose his erection. He had become very anxious about having sex, for fear that he would not be able to maintain an erection sufficient for intercourse with his wife. His wife was supportive and encouraged him to see his family doctor, but for many months he refused because he was too embarrassed. Finally, she made the phone call and he had a check up and told his doctor about the problem he was having with the medication. His doctor, changed his medication to a drug that had fewer sexual dysfunction side effects and sent him on his way. Unfortunately, this change in medication did not solve the problem, because by this time his performance anxiety was so high that he was afraid to try sex for fear of failure. The medication issue had resolved, but now it was the anticipatory anxiety that triggered the problem. At this point he agreed to try psychotherapy to address this problem.
He and his wife were evaluated, and it quickly became apparent that anxiety was playing the predominant role in his ED. After several sessions of treatment using cognitive-behavioral therapy, relaxation training, and biofeedback he was able to manage his anxiety and was able to perform sexually without difficulty. Those ED problems that are organic in nature (eg, prostate cancer, uncontrolled diabetes) will not likely be resolved with these psychological approaches alone. However, there are many options available to those with disease that has affected sexual functioning, including penile implants and sexual enhancing drugs, such as those previously mentioned. If you have discussed your problem with your doctor and he/she has recommended these approaches, then proceed. Otherwise, psychotherapy and marital therapy can be helpful in treating the patient and/or couple cope with diminished sexual functioning. There are also good self-help books that can step you through dealing with this problem.
With the prevalence of sexual enhancing drugs, that we see on television commercials almost every night, many men are falling into the belief that there sexual functioning should be enhanced even if they are not middle age or older. Some men in their thirties, who are healthy and have no disease processes are taking these drugs because they feel they need a boost. Chances are their issues could be resolved with psychotherapy. Oftentimes, these are men who have issues of self-confidence or they merely want to increase their sexual desire and performance, even if it is at a normal level. Those who seek out these drugs need to be aware that all drugs have side effects and the risks of taking such drugs should be discussed with your doctor. But more importantly, if there is another way to achieve sexual satisfaction without medication, why not give it a try. In the absence of disease, sexual desire and orgasm is 99.999999% psychological. Focus on getting your head together. That is, the one on your shoulders.
GET YOUR HEAD TOGETHER
Psychological approaches to male sexual dysfunction
Every night we are bombarded with commercials pushing drugs that claim to improve a man’s sex life. We see a middle aged couple sharing a moment together in a bathtub, on the beach, with running water everywhere. The good looking aging baby boomer, who has taken one of these sexual enhancing drugs, is comforted by the notion that when the moment arises, will be ready to perform in the bedroom. He is guaranteed an erection to meet his partners’ needs. But let us not forget the disclaimers (eg, you may have an erection for several hours, numerous side effects, contraindications). These commercials play on the fears of men who are growing older and fear not being able to have a satisfying sex life.
Are you taking one of these sexual enhancing drugs, used to address erectile failure, or are you considering taking one of these drugs? Before you make this decision, first discuss with your physician non-medication approaches to this problem. Erectile Dysfunction (ED) is defined as the inability of the penis to maintain and full and firm erection sufficient for penetration during intercourse. ED can include premature ejaculation and erectile failure. ED can be caused by a number of different things such as: the side effects of certain medications (eg, anti-hypertensives, narcotics), disease (high blood pressure, diabetes), depression or anxiety. Your doctor will help you to rule out any medical reasons for having this problem. If your doctor says that there do not appear to be any physical ailments that seem to be causing the problem, then you might consider psychological explanations. In fact sometimes ED can begin as the result of a medical issue, such as side effects from medication, but later be maintained because of psychological reasons, even after the medication has been stopped. For example, I once treated a 45 year old male in the Hypertension Clinic at The University of Chicago Hospitals for sexual dysfunction. He complained that the high blood pressure medication that he had been given was causing him to lose his erection. He had become very anxious about having sex, for fear that he would not be able to maintain an erection sufficient for intercourse with his wife. His wife was supportive and encouraged him to see his family doctor, but for many months he refused because he was too embarrassed. Finally, she made the phone call and he had a check up and told his doctor about the problem he was having with the medication. His doctor, changed his medication to a drug that had fewer sexual dysfunction side effects and sent him on his way. Unfortunately, this change in medication did not solve the problem, because by this time his performance anxiety was so high that he was afraid to try sex for fear of failure. The medication issue had resolved, but now it was the anticipatory anxiety that triggered the problem. At this point he agreed to try psychotherapy to address this problem.
He and his wife were evaluated, and it quickly became apparent that anxiety was playing the predominant role in his ED. After several sessions of treatment using cognitive-behavioral therapy, relaxation training, and biofeedback he was able to manage his anxiety and was able to perform sexually without difficulty. Those ED problems that are organic in nature (eg, prostate cancer, uncontrolled diabetes) will not likely be resolved with these psychological approaches alone. However, there are many options available to those with disease that has affected sexual functioning, including penile implants and sexual enhancing drugs, such as those previously mentioned. If you have discussed your problem with your doctor and he/she has recommended these approaches, then proceed. Otherwise, psychotherapy and marital therapy can be helpful in treating the patient and/or couple cope with diminished sexual functioning. There are also good self-help books that can step you through dealing with this problem.
With the prevalence of sexual enhancing drugs, that we see on television commercials almost every night, many men are falling into the belief that there sexual functioning should be enhanced even if they are not middle age or older. Some men in their thirties, who are healthy and have no disease processes are taking these drugs because they feel they need a boost. Chances are their issues could be resolved with psychotherapy. Oftentimes, these are men who have issues of self-confidence or they merely want to increase their sexual desire and performance, even if it is at a normal level. Those who seek out these drugs need to be aware that all drugs have side effects and the risks of taking such drugs should be discussed with your doctor. But more importantly, if there is another way to achieve sexual satisfaction without medication, why not give it a try. In the absence of disease, sexual desire and orgasm is 99.999999% psychological. Focus on getting your head together. That is, the one on your shoulders.

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