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This entry is part 5 of 9 in the series Anxiety

Social phobia, also called social anxiety disorder, is diagnosed when people become overwhelmingly anxious and excessively self-conscious in everyday social situations. People with social phobia have an intense, persistent, and chronic fear of being watched and judged by others and of doing things that will embarrass them. They can worry for days or weeks before a dreaded situation. This fear may become so severe that it interferes with work, school, and other ordinary activities, and can make it hard to make and keep friends.

While many people with social phobia realize that their fears about being with people are excessive or unreasonable, they are unable to overcome them. Even if they manage to confront their fears and be around others, they are usually very anxious beforehand, are intensely uncomfortable throughout the encounter, and worry about how they were judged for hours afterward.

Social phobia can be limited to one situation (such as talking to people, eating or drinking, or writing on a blackboard in front of others) or may be so broad (such as in generalized social phobia) that the person experiences anxiety around almost anyone other than the family.

Physical symptoms that often accompany social phobia include blushing, profuse sweating, trembling, nausea, and difficulty talking. When these symptoms occur, people with social phobia feel as though all eyes are focused on them.

Social phobia affects about 15 million American adults. Women and men are equally likely to develop the disorder,10 which usually begins in childhood or early adolescence. There is some evidence that genetic factors are involved. Social phobia is often accompanied by other anxiety disorders or depression, and substance abuse may develop if people try to self-medicate their anxiety.

Social phobia can be successfully treated with certain kinds of psychotherapy or medications.

(Adapted for the National Institute of Mental Health.)

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This entry is part 5 of 8 in the series Depression

There is no single known cause of depression. Rather, it likely results from a combination of genetic, biochemical, environmental, and psychological factors.

Research indicates that depressive illnesses are disorders of the brain. Brain-imaging technologies, such as magnetic resonance imaging (MRI), have shown that the brains of people who have depression look different than those of people without depression. The parts of the brain responsible for regulating mood, thinking, sleep, appetite and behavior appear to function abnormally. In addition, important neurotransmitters–chemicals that brain cells use to communicate–appear to be out of balance. But these images do not reveal why the depression has occurred.

Some types of depression tend to run in families, suggesting a genetic link. However, depression can occur in people without family histories of depression as well.  Genetics research indicates that risk for depression results from the influence of multiple genes acting together with environmental or other factors.

In addition, trauma, loss of a loved one, a difficult relationship, or any stressful situation may trigger a depressive episode. Subsequent depressive episodes may occur with or without an obvious trigger.

(Adapted from the National Institute of Mental Health.)

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This entry is part 6 of 8 in the series Christian Counseling

An individual may come to counseling expressing a desire to overcome problems with depression. A counselor needs to hear their client’s own theory about what may be contributing to their depression. The counselor also may help the client investigate new areas they have not considered. In counseling, clients may be helped to discover their blind spots about the problem that brings them to counseling. After goals are established, the counselor then helps the client plan a strategy for resolving the problem.

Counselors use a variety of tools and techniques to help people change the things that they seek to change. At times a skilled counselor may ask a series of diagnostic questions or administer tests designed to assist them and their client in gaining greater insight into the nature of the problem. At other times counselors recognize that clients may lack life skills such as communication skills, conflict resolution skills, skills to enhance and sustain intimacy, and skills in the management of their thought life and emotions. Counselors may teach clients new skills to help them overcome the problem that brings them to counseling.

Counselors often use homework assignments as a tool for enabling clients to translate learning from the counseling session into their daily life. If clients are open to what the bible has to say, and if clients are receptive to prayer, the Christian counselor may utilize teaching from scripture, bible study assignments, and prayer as tools to assist people in growing in their knowledge of God’s will, and in their relationship to Him and others.

Occasionally a couple comes to counseling where the Christian spouse has coerced their non-Christian spouse to come to a Christian counselor. Occasionally the Christian will attempt to align themselves with the counselor, hoping they will side with them against their partner. Sometimes the Christian has been preaching and judging their spouse, and their secret hope is that the Christian counselor will join them in preaching to their non-Christian partner. It is extremely important that the Christian counselor assist these clients in learning a more effective way to disagree with their partner. It is also important for the Christian counselor not to take sides against any family member, but to always show respect to all family members.

As professional Christian counselors, we are committed to respect each person’s right to self determination and the exercise of free will. Though we attempt to steer our clients in a biblical direction, we never take responsibility for their life. We never coerce anyone to take a particular position. Advice may be given in the form of helping people identify alternatives and assisting clients in considering the pros and cons of each possible course of action. Counselors may assist clients by suggesting steps that may be taken to achieve a particular outcome. Counselors may gently and respectfully challenge myths, faulty thinking or reasoning, inconsistencies, and immoral behavior.

Though Christian counselors recognize man’s need for God, Christian counselors are not primarily evangelists. As is the case with all Christians, we are commanded in the great commission to go and make disciples. We at Christian Family Institute take a relational evangelism perspective. We hope to build loving and respectful relationships with all people, and to let our Lord’s light shine from our Christian lives. We show compassion for the struggles that people experience. We never give advice contrary to scripture.

Some Christians have defined “Christian Counseling” as only giving “spiritual and Biblical counsel”. This model assumes that the only tool a Christian needs is to read scripture to clients, and this is then called “Christian counseling”. We believe that whenever we help a client live an abundant life that is more conformed to the will of God, or find practical answers to problems, this is Christian counseling. Therefore, there is no distinction between the “secular” and “spiritual” realms. If we help a single parent manage impulses to mismanage money, this is “spiritual” counseling. We believe “secular counseling” is done without regard for spiritual and Biblical truth.

(Adapted from our corporate web site.)

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This entry is part 4 of 8 in the series Depression

Depression often co–exists with other illnesses. Such illnesses may precede the depression, cause it, and/or be a consequence of it.

It is likely that the mechanics behind the intersection of depression and other illnesses differ for every person and situation. Regardless, these other co–occurring illnesses need to be diagnosed and treated.

Anxiety disorders, such as post–traumatic stress disorder (PTSD), obsessive–compulsive disorder, panic disorder, social phobia and generalized anxiety disorder, often accompany depression. People experiencing PTSD are especially prone to having co-occurring depression. PTSD is a debilitating condition that can result after a person experiences a terrifying event or ordeal, such as a violent assault, a natural disaster, an accident, terrorism or military combat.

People with PTSD often re–live the traumatic event in flashbacks, memories or nightmares. Other symptoms include irritability, anger outbursts, intense guilt, and avoidance of thinking or talking about the traumatic ordeal. In a National Institute of Mental Health (NIMH)–funded study, researchers found that more than 40 percent of people with PTSD also had depression at one-month and four-month intervals after the traumatic event.

Alcohol and other substance abuse or dependence may also co–occur with depression. In fact, research has indicated that the co–existence of mood disorders and substance abuse is pervasive among the U.S. population.

Depression also often co–exists with other serious medical illnesses such as heart disease, stroke, cancer, hiv/aids, diabetes, and Parkinson’s disease. Studies have shown that people who have depression in addition to another serious medical illness tend to have more severe symptoms of both depression and the medical illness, more difficulty adapting to their medical condition, and more medical costs than those who do not have co–existing depression.

Research has yielded increasing evidence that treating the depression can also help improve the outcome of treating the co–occurring illness.

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This entry is part 5 of 8 in the series Christian Counseling

Prospective clients have formed their expectations of counseling based on what they have heard from other people, read, and seen on television and in the movies. When a client comes to counseling, all of these previous experiences lead the client to have a certain set of expectations about what the experience will be like. If a person has watched One Flew Over the Cuckoo’s Nest, they may fear that psychiatric and mental health services are primarily for the seriously disturbed, and that those services may involve abuse of the client. In recent years, society has come to view counseling in a more positive light. Counseling is now seen as a service that is socially accepted and not just for those who have severe emotional disorders.

Some clients come to counseling expecting the counselor to be a judge in settling relational conflicts. Clients who come with this expectation attempt to present their case in a convincing way, expecting the counselor to rule in favor of one or another. Other clients come to counseling expecting that counseling will involve the counselor listening only. This expectation has been fostered by the writings of Carl Rogers in his humanistic psychology. Most clients today find the client-centered non-directive approach disappointing, and do not find it satisfactory. Others who have read Jay Adams work Competent to Counsel, expect that the counselor hunt down “the sin” that is the cause of the problem.

The Christian Family Institute model of counseling involves listening to clients tell their story. Clients are asked in the early phase of the first counseling session what brings them to counseling. Clients are encouraged to share the distress of their life that has caused them to seek professional services. Clients are also encouraged to bring other involved family members to the counseling session when possible. Unlike individual approaches to counseling, a family systems approach attempts to respect each person’s unique perspective on the problem. Family and marital counseling also encourages family members to talk to one another and to resolve their disputes with one another. Individual counseling sometimes fosters a belief that the counselor is siding with one person against another and may put the counselor in a position of operating with only half of the facts.

As counselors listen to each family member’s perspective on the problem, the counselor attempts to establish counseling goals in collaboration with family members that meet their needs and expectations. In a marriage counseling session, one partner may complain that there is not enough communication while another partner complains that there is not an adequate sexual relationship. The counselor attempts to establish mutually agreeable goals for the resolution of the problem to both partners’ satisfaction.

An individual may come to counseling expressing a desire to overcome problems with depression. A counselor needs to hear their client’s own theory about what may be contributing to their depression. The counselor also may help the client investigate new areas they have not considered. In counseling, clients may be helped to discover their blind spots about the problem that brings them to counseling. After goals are established, the counselor then helps the client plan a strategy for resolving the problem.

(Adapted from our corporate web site.)

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PTSD

by admin
This entry is part 4 of 9 in the series Anxiety

Post-traumatic stress disorder (PTSD) develops after a terrifying ordeal that involved physical harm or the threat of physical harm. The person who develops PTSD may have been the one who was harmed, the harm may have happened to a loved one, or the person may have witnessed a harmful event that happened to loved ones or strangers.

PTSD was first brought to public attention in relation to war veterans, but it can result from a variety of traumatic incidents, such as mugging, rape, torture, being kidnapped or held captive, child abuse, car accidents, train wrecks, plane crashes, bombings, or natural disasters such as floods or earthquakes.

People with PTSD may startle easily, become emotionally numb (especially in relation to people with whom they used to be close), lose interest in things they used to enjoy, have trouble feeling affectionate, be irritable, become more aggressive, or even become violent. They avoid situations that remind them of the original incident, and anniversaries of the incident are often very difficult. PTSD symptoms seem to be worse if the event that triggered them was deliberately initiated by another person, as in a mugging or a kidnapping.

Most people with PTSD repeatedly relive the trauma in their thoughts during the day and in nightmares when they sleep. These are called flashbacks. Flashbacks may consist of images, sounds, smells, or feelings, and are often triggered by ordinary occurrences, such as a door slamming or a car backfiring on the street. A person having a flashback may lose touch with reality and believe that the traumatic incident is happening all over again.

Not every traumatized person develops full-blown or even minor PTSD. Symptoms usually begin within 3 months of the incident but occasionally emerge years afterward. They must last more than a month to be considered PTSD. The course of the illness varies. Some people recover within 6 months, while others have symptoms that last much longer. In some people, the condition becomes chronic.

PTSD affects about 7.7 million American adults,1but it can occur at any age, including childhood.  Women are more likely to develop PTSD than men, and there is some evidence that susceptibility to the disorder may run in families. PTSD is often accompanied by depression, substance abuse, or one or more of the other anxiety disorders.

Certain kinds of medication and certain kinds of psychotherapy usually treat the symptoms of PTSD very effectively.

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This entry is part 3 of 8 in the series Depression

People with depressive illnesses do not all experience the same symptoms. The severity, frequency and duration of symptoms will vary depending on the individual and his or her particular illness.

Symptoms include:

  • Persistent sad, anxious or “empty” feelings
  • Feelings of hopelessness and/or pessimism
  • Feelings of guilt, worthlessness and/or helplessness
  • Irritability, restlessnessLoss of interest in activities or hobbies that were once pleasurable (including sex)
  • Fatigue and decreased energy
  • Difficulty concentrating, remembering details and making decisions
  • Insomnia, early–morning wakefulness, or excessive sleeping
  • Overeating, or appetite loss
  • Thoughts of suicide, suicide attempts
  • Persistent aches or pains, headaches, cramps or digestive problems that do not ease even with treatment
Categories : Blog
This entry is part 3 of 9 in the series Anxiety

People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.

Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.

Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.

OCD affects about 2.2 million American adults and the problem can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.

The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.

OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them.

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This entry is part 4 of 8 in the series Christian Counseling

Basic Assumptions. The counselors I work with have worked together to compare ideas about the integration of psychology, and marriage and family therapy with biblical theology. Counselors recognize that Christian counseling must first start with a Christian who has been brought to new life in Christ. Prior to our conversion we were dead in our sins and transgressions (Eph. 2:1). “But because of His great love for us, God, who is rich in mercy, made us alive in Christ even when we were dead in our sins and transgressions” (Eph. 2:4). As counselors we recognize that spiritual things can not be understood unless one is born of the spirit of God. To the non-Christian, spiritual things seem foolish (I Cor. 2:14). After one has become a Christian and begins to grow in faith and a knowledge of God’s Word, our entire value system is shaped by our Christian faith, our bible study, and our life of prayer.

As we grow as Christians, all of our principles are transformed by scripture. Whatever other wisdom we might find useful from psychology and other sources must be judged by scripture.

Counselors are called to counsel.
Counseling is not a profession unrelated to our faith. Just as ministers are called to the ministry, Christian counselors are called to the ministry of counseling. The scripture indicates that each Christian is given spiritual gifts for the purpose of ministry to the Body of Christ (I Cor. 12:7). For Christian counselors, spiritual gifts will be manifested in the style of counseling that the counselor provides.

Christian counselors must recognize that all people have a need for Christ. As Christian counselors we recognize that God’s Word is absolutely reliable and authoritative in all it speaks to, particularly matters of faith, lifestyle, and morality. Christian counselors derive their sense of morality from God’s absolute Word. In practice we are committed to loving all persons whether or not they are Christians.

Human beings function and malfunction as a result of a complex and seamless interaction between biological, psychological, social, and spiritual forces. Malfunction in any one of these areas produces a ripple effect. If a person has a cavity in one tooth, the pain may radiate to many surrounding areas. So also do symptoms spread in any of the bio-psycho-social-spiritual dimensions.

As Christian counselors we also recognize the value of psychology, marriage and family therapy, counseling, psychiatry, and medicine. Persons who consult with us are often concerned about problems these disciplines may address. For one client the issues that bring them to counseling may be of a moral nature involving guilt and confusion. The next client that comes to us may be experiencing the consequences of sin in their life. The next person who comes may have been sinned against by others who were abusive and are attempting to recover from the damage that was done to their life. The next client who comes to counseling may be experiencing psychological symptoms related to a genetic or medical condition. As Christian counselors we depend on the Holy Spirit as well as our training in these disciplines in order to be effective in helping people with their concerns.

This approach would be classified by Collins (1975) as a “Christian Professional” model. We would classify it as a “spoiling the Egyptians” approach according to the Crabb (1977) model.

(Adapted from our corporate web site: cfitulsa.com.)

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This entry is part 2 of 8 in the series Depression

There are several forms of depressive disorders. The most common are major depressive disorder and dysthymic disorder.

Major Depressive Disorder, also called major depression, is characterized by a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat, and enjoy once–pleasurable activities. Major depression is disabling and prevents a person from functioning normally. An episode of major depression may occur only once in a person’s lifetime, but more often, it recurs throughout a person’s life.

Dysthymic disorder, also called dysthymia, is characterized by long–term (two years or longer) but less severe symptoms that may not disable a person but can prevent one from functioning normally or feeling well. People with dysthymia may also experience one or more episodes of major depression during their lifetimes.

Some forms of depressive disorder exhibit slightly different characteristics than those described above, or they may develop under unique circumstances. However, not all scientists agree on how to characterize and define these forms of depression. They include:

Psychotic depression, which occurs when a severe depressive illness is accompanied by some form of psychosis, such as a break with reality, hallucinations, and delusions.

Postpartum Depression, which is diagnosed if a new mother develops a major depressive episode within one month after delivery. It is estimated that 10 to 15 percent of women experience postpartum depression after giving birth.

Seasonal affective disorder (SAD), which is characterized by the onset of a depressive illness during the winter months, when there is less natural sunlight. The depression generally lifts during spring and summer. SAD may be effectively treated with light therapy, but nearly half of those with SAD do not respond to light therapy alone. Antidepressant medication and psychotherapy can reduce SAD symptoms, either alone or in combination with light therapy.

Bipolar Disorder, also called manic-depressive illness, is not as common as major depression or dysthymia. Bipolar disorder is characterized by cycling mood changes-from extreme highs (e.g., mania) to extreme lows (e.g., depression).

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