Tag: emotions

Sometimes it’s hard not to get jealous

Being a cancer patient definitely has it’s challenges. I think we all can agree. Feeling sick, fatigue, nausea, loss of appetite, hair loss, shortness of breath are the things that we tend to think of first as the top issues that cancer patients face. However, there is another challenge that insidiously creeps it’s way into your life: envy and resentment. It’s not good. It affects your mood and your relationships. It is just as unpredictable as the cancer itself. It can make you wallow in self pity, even when you don’t mean to. It can make you lash out at the people that care about you and are trying to help you. What am I talking about exactly? I am talking about that feeling of jealousy and resentment that creeps up on you over time that you misdirect toward anyone in the way. What do you become jealous and resentful of?: anyone that is living a full life and doing what they want when you can’t! You become like that puppy dog at the window hoping to go for a ride in the car somewhere, anywhere. The real you spends your time encouraging everyone around you to keep living and do what they love, even if you are sick. Then the other you starts muttering under your breath, crying and cursing them as they leave you. It is completely ridiculous I know and it’s unfair both to you and the people in your life. It basically boils down to emotional abuse for all of you. Nothing good can come of it. I have done it myself.

However, as I sit chastising and judging myself for doing it, I also have to realize that some of these confusing emotions have to come with the territory. It is only natural for you to feel out of control emotions in a pretty out of control situation. I mean c’mon, the cancer is already unpredictably calling most of the shots when it comes to day to day physical living. Why wouldn’t your emotions be all over the place? I think the key is not that those emotions are there, but what you do with them. You can’t erase your feelings, but you can try to control yourself so they don’t run other people over like some kind of freight train. Don’t bite the hand that feeds you. Don’t lash out at the people trying to help you. That won’t help resolve the feelings and only leaves you feeling bad about yourself. That certainly won’t help you heal any faster. Here is where therapy has come in very handy, at least for me. I highly recommend it and I think every patient facing serious illness should have it. It is a much better option to let out those feelings to a paid professional who is trained in how to help you deal with them, rather than blasting your family who is only trying to help you. It might just save your relationships.

Dr.Katz

You can never be “too Allen.”

Image result for Friends

With the launch of HBOmax the other day, my world was rocked to discover that Friends had jumped ship to HBO after disappearing from Netflix. Life was whole again! I, like much of America, still hold on to my love for that bunch of 20 somethings who modulated flawlessly into 30 somethings while still looking fabulous and maintaining a lifetime of friendships. I started with episode 1 and just kept going…for the 100th time. I go to the episode when Monica finally was dating a guy named Allen that the whole group liked…a little too much for Monica’s comfort. They couldn’t get enough of him and even hung out with him when Monica was not around. This should have made Monica ecstatic right? She had been saying for years( as far as we know, because this was only 3 episodes in…lol), that she really wanted to find someone that her friends liked. Instead, she broke up with him right away, devastating her friends and then went on to her next series of unhealthy, unhappy relationships. It seemed like she was so intent to take complete ownership of her relationship decision that she was willing to sacrifice potential happiness rather than give her friends credit for perhaps seeing something that she wasn’t able to.

This brings up several questions. Do we really want the approval of our friends as much as we say that we do? Does that outweigh our own need to make our own decisions? Are we always able to make healthy decisions for ourselves without input? Do we sometimes make a bad decision intentionally just to say that we did it on our own? Do our friends know us better than we know ourselves? Do our emotions rule our decisions?

Ok, that is a lot of questions. Let’s break this down. All human beings have an innate inclination toward having some kind of control over our lives. We like to be in charge of our own decisions, no matter how trivial they may seem. We say we want our friends’ input, but really our natural impulse is to ultimately make the decision of our choice, not theirs, regardless of the consequences, just to say that we did it. That’s who we are. Even the most collegial of humans have a need to have the final say in the topic of choice.

Psychologists all over the world have studied human decision making. There are multiple theories about the decision making process. One theory says that the decision making process involves 7 steps: 1) Identify the decision to be made, 2) Gather relevant information, 3) Identify the alternatives, 4) Weigh the evidence, 5) Choose among alternatives, 6) Take action, and 7) Review your decision. Other theories do not break down decisions into steps. They say that there are only two types of decisions: Habit decisions and Goal-directed decisions. Habit decisions are made on a more impulse-based process. Goal-directed decisions are made based on information and logical thinking, but research shows that you can’t give a person more than four pieces of information to evaluate without actually slowing down the decision making process or stopping it all together.

We like to think that we are logical in our decisions and that we carefully weigh the alternatives, we gather info and look at our options. However, it is just not possible that we are logical in all of our decisions. Our brain actually makes hundreds of decisions per day without any kind of logical think through. Here I go bringing up research again, but, it shows that the bulk of our decisions are actually unconscious and actually involve emotion over logic. Researchers have studied brain activity during decision making. They were actually able to determine what choice the subjects were going to make on average of 7 to 10 seconds before they even realized that they made a decision or verbalized it. Let’s take a look at the emotional component of decision-making. The somatic marker hypothesis also suggests that decision making is a process that depends on emotion. We know that the ventromedial prefrontal cortex (vmPFC) of our brain is key in processing emotional signals that are essential for guiding our decisions to our advantage. The vmPFC helps regulate fear. and stops you from continuing to be afraid in certain situations. It modulates conditioned fear and helps you let go of it and be able to make a decision. Our amygdala is also a key component in processing emotional signals but it’s role differs slightly from our prefrontal cortex. The amygdala is where conditioned fear responses are created and continued. Damage to either of these areas affects decision- making. There you go: more evidence that decision making depends on emotion. I will take this a step further and add that emotion plays a role in helping others with their decisions. For example, you can’t effectively help someone change their mind about something unless you begin to truly understand how they feel about it in the first place. Otherwise, you cannot really make any arguments of influence. It makes sense, doesn’t it?

I am glad that we have established that we are not robots and that we do not make cold, calculating emotionless decisions every day. I personally view this as a positive but I am in the minority. It is interesting to me that the concept of emotionally -influenced decision making is still vastly greeted with skepticism and negativity. This is exemplified in phrases like “clouded by emotion.” Gender discrimination in the work place abounds based in large part by the misconception that women are more inclined to utilize emotionally based decision making more often than men. Therefore, women are often looked over for high powered management positions if a male candidate is available. This has a negative connotation implying that the weighing of emotional factors implies a sense of weakness or irrationality somehow. Based upon what I’ve told you this bias does not make any sense. All humans make decisions based on emotional input, regardless of chromosomes and regardless of whether they are aware of it or not. It is a scientific fact. Does emotional have to equal irrational? Absolutely not. Emotions are just part of what makes us human. Emotions and decisions are intertwined and not likely to become untangled anytime soon and that’s what makes life interesting and unpredictable. Have a fantastic day everyone!

Dr. Katz

Crying by the dumpster outside of Olga’s

I just have to relay this story a patient told me the other day. Let me set up the scenario. So, this patient has a large family. Her children’s ages range from elementary school to college. Some of them are still at home. Some are off at college. She has always had a close relationship with her kids. You could even say that she values them even more than she values herself. She is a perimenopausal woman with let’s say more than her share of hormonal and mood lability, as all of us perimenopausal and menopausal women do. To say that she can be oversensitive at times is probably true. We all can. Let’s add to that the fact that college age kids who have moved out have a very different sense of what is appropriate and acceptable with regard to conversation and “house rules” than elementary age kids do. It’s a recipe for absolute peace and harmony right? That was rhetorical. Of course it isn’t.

Ok now that I have the stage set, let’s look at what happened. The college kids came home for the weekend, one of whom had not been home in months. The whole family goes out to dinner. My patient is super excited to see everybody and hang out. She has already had an emotional day and she can’t to hug the college kids and maybe even play with her daughter’s hair like she used to. She gets totally rebuffed. Now she is already hurt and trying to hide it while they are all sitting there eating, but the hurt is slowly welling up, threatening to take over just the same. Then the conversation starts and she hears her older children making conversation that is just plain uncomfortable for her. She is not sure if they are just trying to be sarcastic and funny or just plain hurtful. When she tries to interject, they just look at her like she is from another planet with that “What’s the problem” expression. Finally, she feels herself losing emotional control and announces that she is going to just go home rather than cause some sort of fight during what was supposed to be a nice family night out. They look at her and laugh and remind her that she doesn’t have a car because they drove. By then she is really embarrassed but can’t back out now and leaves the restaurant, only to find herself crying outside by the restaurant dumpster.

Oh the humanity. That story completely sucks right? It embarrassing. It’s humiliating. There is miscommunication everywhere. The kids probably didn’t realize that the mom was already emotional. The mom probably didn’t realize that the kids were just trying to act grown up and show off their intellectual prowess. It’s just a no win scenario. You are thinking to yourself, I would never do that. I say au contraire! I am willing to bet that there are a lot of moms out there that have been in a similar situation. C’mon you can admit it. Being a mom to college age kids or any kids that have moved out of the house is way harder than you think. Whatever scenarios you thought you had handles when they were teens living at home have paved the way for a whole new set of scenarios to slog through best you can. They have been living on their own without supervision.( Yes that’s right. I am saying that dorm resident advisors are not all they are cracked up to be.) They have been setting their own rules and curfews. They are probably having sex. They have linked up with all kinds of kids from all over the world with all kinds of opinions that you probably don’t share. On top of that, those opinions may or may not be based on any known facts, but they sound cool to spout out with their friends. You as the mom are no longer their primary influence and you are definitely not as cool as they once thought you were now that their horizons have widened. Ugh! Now add on top of that the fact that you are probably at least perimenopausal if not postmenopausal with hot flashes, labile moods and fluctuating hormones and, even on a good day, you could rocket from singing with the radio to screaming or bawling your eyes out in less than 10 seconds. These are the kinds of elements that lead up to the story from above. These are the kinds of elements that foster miscommunications and misunderstandings of epic proportions if you are not conscious of what’s at play. My poor patient and her family were set up from the start from both ends. She was all emotional and ready to bond ” with her babies.” . The kids were ready to joke and act like their interpretation of grown ups. It was set up to fail.

Raising college age kids sounds like a misnomer doesn’t it? A lot of people think that once they are 18, your job is over. Likewise, a lot of college age youth think that they are ready to be fully in charge. Well, neither perspective is really accurate. Our kids will always be our kids and we will always be their parents. We will always have some level of investment in how they end up in the world. That being said, we also have to be ready to modulate our mutual roles in a way that is acceptable to both parties if possible. Sometimes it is not possible, but we have to at least try. As much as I miss picking up my kids and tossing them into the air or playing with their hair and cuddling, I realize that they are just not as up for it as they used to be. I can try to resort to emotional blackmail, but it won’t get me anywhere. I have to realize that these things don’t mean that they don’t love me or love me any less. They are just evolving in how they chose to bond with me. I can sit there hoping that one of them is going to jump into my lap one day and want me to read them a story, but it is not likely to happen. Instead, we might have a conversation about politics(yuck) or what’s going on at school or I just listen to long, what they think is eloquent, speeches about what is important to them at the time. I am just kidding, I love hearing about what is important to them an I love to watch how their thought processes change over time and the evolution of their responses to certain situations. What I don’t love, is if those speeches turn snarky, satirical and hurtful without purpose. If they do, it is up to me to remind them that no matter what opinion they have, it is still their responsibility to voice it responsibly and remain a good human being. Sometimes, as they are espousing away, they don’t even realize that the person listening might think they are just being a jerk, rather than impressing the with their intellectual brilliance. In terms of voicing things responsibly, I also realize now that I am better off if I give people a heads up if I know I am having a perimenopausal emotion buffet day before I head off to any family outings. This system is not fool proof, but it is worth the effort, if you want to still bond with your kids as they get older. The old adage by Khalil Gibran says that ” If you love somebody, let them go for if they return, they were always yours. If they don’t, they never were. ” I think this means that we have to loosen the reigns and adapt a bit within reason as our kids get older. Then hopefully, they will come back some day, realizing just how cool we really were the whole time! Have a fantastic day everyone!

Dr. Katz