Dr Stephanie

I was recently interviewed for this story in the Philadelphia Inquirer about whether and how Facebook use affects self esteem.  The cool thing about the article was that it was written by a high school student.  And while I think of myself as young, and try so hard to be cool and relevant; I just can’t keep up with a teenager in terms of technology and social media and their effects on our psyches.

I’ve written about stress, self esteem and Facebook before, but was interested to read this author’s take on how Facebook use can affect self esteem in teens specifically.  She brought up some points I never would have thought of.  The number of “likes” one receives on posts or pictures, and the number of “friends” one racks up for instance.  As someone who is long past the teen years, I notice other things affecting my self esteem.  Things like friends’ vacation destinations, career accomplishments, and children’s behavior.

Of course Facebook is not all bad.  Connecting with long lost friends and family members is great, and so are the birthday wishes that come through on our timelines.  How does Facebook affect you? What about the teens in your life – does it affect them differently?  Check out the full article below:

The Philadelphia Inquirer: Debate over Facebook’s effect on self esteem 04/07/2013

Yesterday I wrote an article about Facebook Addiction*.  Namely, I provided some questions to ask yourself to determine if your Facebook use is having a negative impact on your mental health.  Take a look.

Today I am thinking about how to make changes in our Facebook use.  Keeping in mind that Facebook is not necessarily an evil force in all of our lives, but that for many of us it can cause some pretty negative and unnecessary emotions.

Some tips for changing your Facebook use so that it adds to your mental health (rather than taking away from it).

• Set a time to check your Facebook account.  For example, check it on your lunch hour only.  The rest of the day is Facebook-free time.
• Set an amount of time to check/post to Facebook.  For example, set aside 3o minutes/day to read and post – the timer on your phone or computer can come in handy with this one.  When the time is up, leave it alone until the next day.
• Hide people whose posts upset you.  Why do I still read the “friend’s” posts that make me mad? We all have friends who post things we would rather not read.  Take the control Facebook gives you and hide their posts from your feed.
• Don’t accept every friend request.  This may be a generational thing, but I don’t think we need to be “friends” with everyone.  As in the above tip, use the control you have and be selective of the people you let in to your Facebook world.
• Consider a Facebook holiday.  I have a friend who is giving up Facebook for Lent.  If you really want to know how Facebook is affecting you, run an experiment and notice your mood now, and then after giving it up for a few days or a week.  See a big change for the better? Perhaps it’s time to give it up for good.

*Please note that Facebook Addiction is not an official diagnosis in the DSM-IV (or V as far as I know).  While it is not a “real” diagnosis, overuse of Facebook can certainly be detrimental to mental health.

I recently had a conversation with a colleague about Facebook.  She was wondering why so many of us continue to use Facebook when it makes so many of us “crazy.”  And by crazy I mean: frustrated, sad, unworthy, annoyed, angry, jealous, and/or pissed off.  You know what I’m talking about: Facebook use can result in all types of emotions, many of them not so great.  For example, spending just a few minutes looking at my Facebook account this morning resulted in the following emotions:

• excitement over a friend’s news that she is pregnant with baby #3
• bewilderment/irritation over a couple distant friends and family member’s persistence in posting potentially offensive religious and political posts
• jealousy over a friend’s pronouncement that she can still fit into her senior prom dress
• revulsion/anger at the NY Times article about junk food science making the rounds in social media

So why do we continue to subject ourselves to this? Do we really need this extra stress in our lives? How do we know if we are “addicted*” to Facebook?

Some important questions to ask ourselves:

• Is my time on Facebook keeping me from fulfilling my other duties in life (taking care of self and/or children, doing my job, etc)
• Does my time or activity on Facebook cause problems at work?
• Does my time or activity on Facebook cause problems in my interpersonal relationships?
• Do I neglect “real” people or responsibilities in order to spend more time on Facebook?
• Does what I read on Facebook have a significant impact on my mood everyday or most days?
• Do I ever lie about my Facebook use, or hide it from others?

If you answered “yes” to more than 2 or 3 of these questions, it sounds like your Facebook use has a pretty huge impact on your daily life.  This might not be the best thing for your mental health.  Perhaps it’s time to change the way you use social media, and Facebook in particular.  Stay tuned for tips on how to cut back on Facebook.

*Please note that Facebook Addiction is not an official diagnosis in the DSM-IV (or V as far as I know).  While it is not a “real” diagnosis, over use of Facebook can certainly be detrimental to mental health.

Last weekend What Brand Is Your Therapist was published by the New York Times.  Lori Gottlieb, the author, interviewed me and a couple of other psychologists for the piece.

In her article Ms. Gottlieb writes about her journey as a new therapist setting up a practice in the congested California market.  As she struggles to find clients, she looks to other, more established clinicians for advice.  Some say find a specialty area, others tell her to focus on consultation and/or coaching work rather than traditional psychotherapy, still others (me) tell her to increase her social media presence.

With this advice in mind, Ms. Gottlieb wonders if Americans have moved past the need for psychotherapy, citing statistics indicating that fewer people have sought talk therapy in recent years.  She also wonders if our super-fast, I-want-results-now culture makes the slower paced psychotherapy process outdated.

After stewing about it for a few days, I have gathered my thoughts, and offer this response proving that psychotherapy is not dead, in fact, it is alive and well.  With this caveat: it is essential that we change (at least a little bit) with the times.  Here goes:

Having been married to an architect for nearly 15 years, I have come to know a bit about that profession.  While it may not seem that a psychologist and an architect would have much in common professionally, I have come to realize that we do – and more than it would seem.  In addition to the arduously long training process involved in both fields, many of the current dynamics and changing business models are similar.  Take a look:

Fads Come and Go.  Colonial, craftsman, beaux arts, mid-centurn modern – these are just a few of the hundreds of styles of architecture around us.  While I might like classical design, others might prefer more contemporary; the one thing we can be sure of is that styles, tastes, and fads will change.  This is a good thing in architecture – it makes our communities more interesting.  What is critical, however, is that the structure underneath is sound.  Any architect would agree that a comprehensive understanding of history, as well as a mastery of structural and construction principles is necessary before good design can emerge.

The same is true for us in the field of psychology.  There is nothing wrong with new ideas, and unique and innovative treatments – so long as there is first a fluency in psychological science.  New treatment strategies, rooted in sound science and disciplined training, can (and should!) be constantly flowing into our daily practice.  Would we accept stagnant, non-innovative care from any other field?

Gray and Green – The New Black?  Some architects have continued to design and draw only by hand, have resisted integrating technology into their firms, and have refrained from embracing environmentally sustainable design and materials clamored for by clients.  Guess what has happened to those architects in this tough economy and competitive world? They are no longer practicing – or at least not at the level to which they would like.  Successful firms have had to innovative, be responsive to the marketplace, and have had to find a way to stay productive and flexible in a time when their clients demand more, have shorter time frames, and more restricted budgets.

Psychologists are no different.  To stay relevant and helpful (that is our mission after all) we must also innovate and find new ways to give people what they want (psychological help) and need (psychological health).  A colleague of mine, June Ching, PhD, recently wrote: “I see a…theme with the ‘old ways’ juxtaposed to the newly emerged technological advances. If the mission is still the same, perhaps joining forces with the ‘grey’ and ‘green’ is a viable option.”

Merging The Old School (“gray”) with the New School (“green”) is the only way to continue to provide the type of help and care we all desire.

Everyone Deserves Mental Health.  Most of us can’t afford to live in a house designed by an architect.  Instead, most of us live in houses that were mass-produced by a CAD-wielding draftsman employed by a large construction company.  Yea, it’s kind of a bummer from a design perspective, but guess what?  The roof still keeps out the rain and the walls still keep us warm at night.  And the price is right.

Again, the similarities with psychotherapy are striking.  Therapy is kind of a weird thing.  Sitting in a room with a stranger spilling your guts week after week, while learning little to nothing about said stranger.  Bizarre.  Not to say we strangers don’t have a lot to offer – we do! But psychotherapy isn’t for everyone.  It’s a significant commitment in terms of time and money, and frankly not everyone is helped by talking about their problems.  Some folks prefer the self-help methods of reading books or watching Oprah to aid their mental health.  Others might find comfort at church or in a peer support group.  Still others may prefer to use pharmacological treatment.  Guess what?  That’s OK!

Psychotherapy has never been a treatment utilized by the masses, and my guess is that it never will be.  The great thing is that it gives us lots of opportunities to reach out to folks who will never sit on our couches.  Podcasts, books, blogs, talks, articles in the New York Times – these are all means by which we can get the word out about the importance of psychology and good mental health.  Realizing that the 50 minute psychotherapy hour isn’t our only means of providing solid, responsible, and useful mental health care should make us feel excited and energized to meet folks in need – wherever and whoever they are.   Because in the end, everyone deserves mental health, not just those who meet us on our own, narrow terms.

It is my opinion that psychotherapy is enjoying a particularly robust period in its history.  The stigma against treatment is down, the access to care is up (thanks to changes in the insurance industry, as well as technology) and psychology, mental health, and emotional wellness are a part of the language of everyday life.  Psychotherapy is far from dead – it is very much alive and growing.  It is up to us to determine how and when to best maximize this growth, for our clients and ourselves.

A  study in the journal Human Reproduction recently concluded the following:

Antidepressant use during pregnancy is associated with increased risks of miscarriage, birth defects, preterm birth, newborn behavioral syndrome, persistent pulmonary hypertension of the newborn and possible longer term neurobehavioral effects. There is no evidence of improved pregnancy outcomes with antidepressant use.

This is an important study for several reasons:

• Pregnant moms who are depressed can be at risk for not taking care of themselves or their unborn baby (not eating well, not taking prenatal vitamins, not going to OB visits).
• Moms whose depression is not well managed during pregnancy are at a greater risk of developing postpartum depression
• Moms who are depressed risk other physical and mental health problems
• As most families know, mom’s mental health and mood has an impact on everyone else in the family

So what do the results of this study really tell us?  Antidepressant use during pregnancy needs to be evaluated carefully.  But to me (as a psychologist, of course) the more important conclusion of this study is this statement right here:

There is some evidence that psychotherapy, including cognitive-behavioral therapy as well as physical exercise, is associated with significant decreases in depressive symptoms in the general population; research indicates that some forms of counseling are effective in treating depressive symptoms in infertile women.

In fact, psychotherapy can be highly effective for many mood disorders, including for depression before, during, after pregnancy.  This is great news because, unlike medication, psychotherapy has few (some would say zero) side effects.  An effective and safe treatment option for moms and their families – now that is an important conclusion.

Fore more information about finding and visiting a psychologist, go here.

Have you heard about the dad who recently shot up his teenage daughter’s laptop because of some unflattering things she wrote about her parents on Facebook?  Not only did he fire shots into the computer, he also filmed himself doing it and posted the video online.  As someone who does not see a lot of gunfire in everyday life, I have to admit the footage is a little alarming.  The dad’s rage, anger, and disappointment are clearly visible in his rant before the shooting, but after watching this interview with the dad and his family I’m wondering if he is much different than any other overwhelmed parent?  It’s easy to criticize other people’s parenting styles from afar, but is all the criticism of this dad really justified?  Sure firing a gun at anything can be scary, and his tactic of “you’re criticizing me in public, so now I’m doing the same to you” is a little childish, but really – what parent hasn’t reacted in a childish way when pushed?

Some things to keep in mind when judging the laptop (or any other) dad:

Being a parent is super hard, and we all get pushed further than we’d like sometimes.  This is not to say that all parents are abusive, or do harmful things to their kids (and I’m certainly not ok’ing abusive parenting techniques).  But I know there isn’t a parent around who hasn’t said something or done something they regret in a moment of frustration or anger.  Heck, just last week I told my daughter I didn’t care if she ever completed any of her homework again.  Oops!

Parenting in the age of technology is something we’re all learning on the fly.  None of us parents now can refer back to how our own parents dealt with: at what age to buy kids cellphones, how much texting is too much, how to navigate privacy and safety issues on Facebook, etc.  Yea, there are resources out there, but in essence, we’re all making it up as we go, so it’s not a surprise that we make some (or a lot) of missteps along the way.

Being negative and criticizing others doesn’t do much for our mental health.  I have recently written a couple of posts (here and here) about the damaging effects of negativity in the workplace.  Negativity towards other parents and families is no different.  Resist the urge to badmouth others and use that energy to work on your on family’s challenges.

I hear people say this a lot: “I am soooo addicted to Facebook!”  I think they typically mean to say that they like Facebook and spend a lot of time on it.  But as one of my readers recently asked, is it possible to be really and truly addicted to Facebook?   As in, bad things start happening in life because of a user’s Facebook time?  This is a great question and one I have been thinking a lot about since my reader asked.  So, first things first:  What does “addiction” really mean?  According to the DSM-IV, ONE of the following things need to be present in order for one to qualify for a diagnosis of substance abuse (and let’s just assume for a moment that Facebook can be considered a substance):

1. Recurrent use resulting in a failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance related absences, suspensions, or expulsions from school; neglect of children or household). This one is definitely possible when talking about Facebook.  Again, this isn’t going to apply to the vast majority of Facebook users, even the die-hards.  But for those who find themselves constantly checking their friends’ statuses, playing games, searching for new friends – to the detriment of their other duties in life – they may indeed meet this criteria.
2. Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use). At first I thought this point wouldn’t apply to Facebook use, but then I thought of Facebook-ing while driving.  In very extreme cases, it would be possible for folks to have gotten into legal trouble because of Facebook-ing while driving and yet continuing to engage in the behavior.
3. Recurrent substance related legal problems (e.g., arrests for substance related disorderly conduct). I don’t know about this one.  Can one get into legal trouble on Facebook?
4. Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights). This is one I have actually seen in real life.  Husbands complaining that they never see their wives anymore because they spend so much time on Facebook.  Wives complaining that their husbands won’t stop playing Facebook games long enough to engage with their families.   Perhaps these things can be warning signs of troubled Facebook use, and the possibility of more serious problems down the road.

So, what’s the conclusion; can we become addicted to Facebook?  I think the answer is yes.  While Facebook is not a mood or mind-altering substance (like alcohol or drugs), its overuse can cause “clinically significant impairment or distress.”  Concerned about your own Facebook habit?  Try curtailing your use – or totally abstaining – for the next week or two.  Set specific “Facebook time” in which you can enjoy checking up on your friends, but declare Facebook off limits during other times of the day.

I love houses. I love talking about them, thinking about them, working on them, decorating them…they provide endless amounts of entertainment and challenge.  Usually I indulge my loves of houses in my free time.  But recently I have found myself doing more talking and thinking about houses and space in my work hours as well.  Specifically, can our homes affect our mental health?  Yes.  There are many, many ways your home can affect your mental health.  Think of these situations:

People who are home-less

People who live in un-safe areas

People who live in un-clean, cluttered, and/or un-sanitary homes (think: Hoarders)

People who live in homes they cannot afford

Today I am going to talk about another group of people whose mental health is being affected by their homes: People whose homes are too darn big.  How can this be a problem?  Aren’t all of us pining to get into a house with more square footage, more rooms, more SPACE!?!?  Maybe, but I am beginning to see that too much space can be a problem as well.

Think of a how a “typical” suburban family might spend their evening: Dad in the basement watching basketball, teenager in his/her room playing video games, tween in the living room watching the Disney Channel, and mom in her bedroom reading stories on-line about Robert Pattinson.  Am I the only one who sees a problem here?

I’m afraid our homes have gotten so big (and so wired) that we often miss out on time that could be spent as a family.  Remember the old days when there was only one TV in the house and we had to take turns choosing what we wanted to watch?  Remember when we actually watched shows as a family (think: Cosby Show) and then talked about the funny parts all week?  While having our own spaces is neat and cool, I wonder if it is the best thing for our mental health, and for the health of our families?  Will we one day wake up and realize we barely know the other people living under our roof?  I hope not.

So before you buy a bigger home, or spread out to all corners of your existing house, think about what you are doing.  Share a TV, a couch, a bowl of popcorn.  Play Monopoly, or spend time just talking.  Enjoy your large spaces, but remember to spend time in close quarters with the ones you love, too.

photo by: Simplyeleganthomedesigns.com

Oh, Facebook.  Who knew I had so much to say about you?  Maybe it’s because you are involved in a large percentage of the conversations I have (inside and outside of my office).  Maybe it’s because I have some deep-seated psychological issues with you stemming from childhood?  I’m not sure.  Regardless, here goes another post…

Perhaps there are a few folks out there who have re-connected with old lovers, boyfriends, and crushes on Facebook and it has turned out great.  But more often, it doesn’t.  What do we really hope to accomplish when we “Friend Request” our old prom date?  Do we want to re-kindle the flame?  Re-hash old times?  Peer into their current life?  Are any of these worth the risk?

And believe me, the risks are many.  Chatting on-line with an old lover can be a slippery slope to other types of, huh-hum, communications.  Whether or not we are currently in a relationship, it is important to be aware of the temptations these on-line interludes pose.  Posting on each others walls, to IM’ing each other during work, to meeting for coffee, to meeting for other “things” can happen more quickly than you might imagine.  The lure of romance and the memory of youth can be difficult things to turn down, particularly if your current relationship has grown predictable and less than steamy.

And what about our emotional health?  How will re-living the glory days serve us?  For some it can be fun and nostalgic.  For others it can be a sad reminder that life didn’t turn out the way we expected.  Even if we are content in our current situations, there is nothing like seeing an old boyfriend on Facebook who lives in a mansion, travels the world, and has a supermodel for a wife to make us feel as if we don’t measure up.  Do any of us really need that?  I sure don’t.

photo by: jfiddler

I’ll be honest, I have never been a huge fan of Facebook.  It’s not that I am anti-social media – I love Twitter and read lots of blogs on a daily basis.  But I’ve never quite figured out how to use Facebook, maintain healthy levels of stress and keep up my self esteem at the same time.

Facebook-induced stress

It has taken me several years to realize the sneaky ways that Facebook can cause stress in my life if I give it a chance.  Am I logging on enough?  What am I going to miss if I don’t catch up on my “friends” today? Am I logging on too much?  Am I neglecting my duties (as a mom, wife, psychologist, friend) because I am spending too much time on Facebook?  Should I accept her friend request?  Un-friend him? Ahhh! Just writing about these things is increasing my blood pressure.

Facebook is a time-sucking machine that can take us away from our families and friends and replace them with long-lost high school crushes and distant relatives we’ve never met.  Do we really want to add to our already stress-filled lives in this way?

Facebook and self esteem

In just the last few days I have read about “friends” who:

• still fit into their wedding dress from 10 years ago
• had a great time at a party (that I was not invited to)
• “Puked [their] guts out 10 times”
• Just finished “another” triathlon
• Gotten a “huge” raise
• Named Girl Scout leader of the year

Now, these things are all wonderful (except maybe the puking one), but when I read them I don’t feel great.  Instead I feel lazy, or unpopular, or inadequate, or like a bad mom/wife/friend.  And here I thought connecting with all our pals was supposed to make us feel loved and energized about our social lives.  I know I’m not alone in feeling the opposite.

Perhaps it’s because the people I really care about don’t frequently post on Facebook?  Or perhaps it’s because when great, sad, funny things happen to the people I love they typically tell me in person – or at least via email – about the event?  Either way, reading about the lives of “friends” (read: not people I would consider a true friend) is typically not an experience that I would describe as pleasant or fulfilling. Instead it feels like snooping or eavesdropping on someone with a perfect life: Not fun.

So, instead of browsing around the profiles, pictures, and posts of our old flames and the neighbor down the street, maybe we can turn the computer off and interact with the real people in our lives.  I can feel my stress and self-esteem levels go back to normal just thinking about it.