Month: July 2017

Do you have a guilty conscience?

By Amy Morrison Psychiatric PA and Medical Director at the Morrison Clinic

 

 

Are you plagued by feelings of guilt?  Does your stomach churn when someone is upset with you?  Do you seek excessive reassurance from others?  Do you avoid conflict whenever possible?   When conflict is unavoidable do you find yourself  consumed by distress until a resolution has been found?     If you answered yes to any of these questions then you maybe suffering from false guilt.  

False Guilt

False guilt is pretty self explanatory.  It happens when you feel inappropriate guilt and typically occurs in people who were shamed in their past.  Not everyone reacts the same way to being shamed.  However people who suffer from false guilt tend to be people pleasers who do not cope well when other people are upset with them .   By pleasing the person who shamed them, People Pleasers found a path of least resistance that led to less conflicts.  However,  this unhealthy dynamic leaves them vulnerable to excessive feelings of guilt and shame.  In fact they often tend to find themselves in  relationships with people who are Shamers.  

Shamers

Shamers are people who manipulate others.  They do this  by casting their emotions and expectations onto another person or by shaming others in order to get the result they want.     Shamers do not stay in relationships with emotionally healthy people for very long because their bad behavior is not tolerated.  Instead Shamers tend to gravitate toward People Pleasers who avoid conflict.  People Pleasers do not set good boundaries and  own other people’s emotions and disappointments.    As a People Pleaser they look for ways to justify other people’s actions and like a bad habit, they too easily accept bad behavior.    

People Pleasers

So to all of those People Pleasers out there I have an easy rule of thumb to remember when it comes to feeling guilty.  The only time you should feel guilty is when you intentionally behaved in a manner that you knew would cause  either physical or emotional harm to that person.  In that circumstance you should own your bad behavior’s effect on another person.  You should not only apologize, but do your best to determine how you can repair the damage you caused.  However on the flip side you should not feel guilty if someone is physically or emotionally harmed by your actions if you did not intend for them to suffer pain.  You can express empathy for their suffering.   However you do not own their feelings and you do not feel guilty for your actions.  

 

I hope this simple rule of thumb can help you more easily determine when you should feel guilt.  By being able to draw a line on when you should feel guilty, you will find it easier to keep healthy emotional boundaries.  Healthy emotional boundaries will lead to less conflicts with friends, families, and co-workers.    Imagine how much healthier your relationships with other people can become if you learn how to stop owning other people’s emotions.   You can finally let go of the guilt  and shame that plagues you.  If you want to work on this more on your own you should consider taking steps to heal from the shame of your past.  I would recommend working with a licensed therapist and I also highly recommend this book:

 

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Psychiatrist vs Therapist: Which one do I need?

Amy Morrison Psychiatrist or Therapist

psychiatrist vs therapist
by Amy Morrison Psychiatric PA and Medical Director of Morrison Clinic

A psychiatrist or psychiatric PA can prescribe medication to help fix the chemical imbalance that leads to depression and anxiety.  In the most basic terms, depression and anxiety stem from low levels of serotonin and other chemicals in your brain. Antidepressants prescribed by a psychiatrist or psychiatric PA work by increasing serotonin in the brain.  After several weeks you should notice a significant improvement in your depression and/or anxiety.   However, medication is not the only effective treatment nor should it be. It is important to recognize that stress is part of the cause of depression and anxiety.

A Psychiatrist’s Role in Your Treatment

A psychiatrist or psychiatric PA should spend time during your appointment counseling you on ways to better manage the symptoms of depression and anxiety.  However the main role of a psychiatrist or psychiatric PA is medication management of depression and anxiety disorders.  While this is an important component in your treatment, it should not be the only focus of your treatment.

Stress is Bad For Your Health

Learning how to cope with stress is a very important part of your recovery.  Stress causes your body to release a hormone called cortisol which is hazardous to your health.   When cortisol is released excessively from stress it can lower chemicals like serotonin in your brain.   Low levels of serotonin have been known to induce depression and anxiety disorders. High levels of cortisol can have a negative effect on other parts of your body as well.  It can increase your blood pressure and make the vessels in your heart less flexible which can cause heart disease.  Stress can trigger pain disorders from general aches and pains to tension headaches from stiffness in your neck and shoulders.   Stress has been known to play a negative role in most illnesses that plague society today and a therapist can teach you coping skills which minimize the impact of stress.

Do Psychiatrists Counsel Patients?

Due to managed health care psychiatrists very rarely serve the role of therapist.   They are able to see more patients in a day for medication management and often times see as many as 20-30 patients a day.  Since there are many qualified and capable therapists, psychiatrists do not often do hour long sessions with clients.   Instead they refer their clients to a therapist.  However due to their very busy schedules, many psychiatrists do not  have the time to educate patients on how therapy works.   Instead they refer the patient to a therapist in hopes that the patient will trust their judgement and follow their treatment recommendations.   However, many patients do not want to invest the time and money to see a therapist each week until they understand how therapy is helpful.

What Kind of Psychiatrist is Best for You?

I have been treating depression and anxiety disorders since 2004.   My many years of experience  has led me to determine that my clients who work with a therapist stay healthy on less medication .    While my background is psychiatry and I love practicing the art of medicine,  my goal is to minimize the use of medication.  My treatment plan for my clients includes making lifestyle changes and  improving their emotional health.   Furthermore, I find more fulfillment in my work if I see less clients in a day.  I want to spend more time with each client and provide them with a more holistic treatment plan.  I recommend you research your medical provider to determine their care philosophy.

What Kind of Therapist is Best for You?

I recommend you find a psychiatrist or psychiatric PA who has close ties to local therapists.  Ideally your medical provider should offer good referrals both in their office and in the community.  Working with a therapist who shares office space with your medical provider offers many advantages.  However, a therapist in the community may better fit your needs.  The important thing is to be knowledgeable about your treatment options.  A good place to start is reading my article titled: Why is Therapy so Important? 

 

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