<![CDATA[clinical psychologist - Blog]]>Sat, 11 Feb 2023 05:54:09 -0600Weebly<![CDATA[Loneliness]]>Mon, 16 Feb 2015 19:11:23 GMThttp://www.jenelramos.com/blog/lonelinessRecently I have been hearing and reading a lot about loneliness. You would think that in an age of unsurpassed technology we should be feeling more connected, not more isolated. Nevertheless, despite advances in communications technology, isolation and loneliness continue to persist. Perhaps it’s the illusion of connectedness that fools us in the first place. We have hundreds of “friends” on Facebook, it takes minutes to scroll through our contacts list on our smart phones, and we receive dozens of e-mails a day. Yet we can still feel all alone. Even when we are surrounded by people, we can feel alone in our experience.

A stay at home mom living in the “perfect” home on a cul-de-sac amongst other stay at home moms may feel all alone. A therapist who sees patients for hours at a time may feel all alone. A pastor serving a congregation day in and day out may feel all alone. Just because we are around others, does not immunize us from feelings of loneliness.

As a practicing psychologist, I often see the impact of loneliness on many of my clients who suffer from depression and anxiety. The sense of isolation is not only painful, but can be debilitating as well. Loneliness contributes to a negative sense of self and others, which can result in feelings of inadequacy, failure, guilt, hurt, and anger, and unconscious behaviors that push others away instead of drawing them in. Loneliness can also be extremely exhausting, particularly for those with mental health concerns, because most functioning individuals have to maintain a public appearance that “everything is OK.” For the most part, in our culture, it’s not acceptable to show “weakness” or even need. Wearing a “mask” everyday can be fatiguing and incur an increase in pre-existing disdain and hatred of one’s self. After all, none of us want to face the possibility that we could be impostors – that we have not achieved the expectations we perceive others have of us or the ones we have set up for ourselves.

For those of us unburdened by psychological difficulties, loneliness is a passing thought or emotional state. We have the capacity to pick up our phones and call a friend or we feel safe enough to disclose our vulnerabilities to a close circle of friends. In other words, we can access the parachute when we feel ourselves falling. However, for those individuals who struggle with anxiety or depression, most are aware of their current situation but feel there is a near insurmountable hindrance actively “swatting away” at their efforts to reach out for that parachute. In severe cases, they may believe the parachute isn’t even there, so why bother? Seeking professional help from a counselor is a true act of bravery and a first step towards reestablishing relational intimacy for these persons.

So, how can we support one another in our human quest for connectedness and belonging? First, use technology to serve your purposes, not the other way around. Skype with a friend, use the “off” button or the “do not disturb” function on your phone when you’re interacting face-to-face with people in your life, experiment with “electronics-free time” when you’re hanging out with your family or sharing a meal. Second, identify the people in your life who you want to maintain healthy, intimate relationships with as this will serve to be an important motivating factor. With this in mind, take an inventory of your schedule, and allot time to nourishing those existing relationships. Remember that mutual vulnerability is a critical component to removing those daily “masks” we put on everyday to face the outside world and allows us to interact with one another on a deeper level. (You may have to take the initial step!) Third, expand your community and social support network by finding other like-minded individuals who share your passions and give back to others. Discover your interests and gifts and find ways to volunteer. Serving other people jolts us out of our “me, me, me” bubbles, broadens our perspectives, and provides us the opportunity to find purpose and meaning in our lives and, if we’re fortunate, meet some interesting people along the way.

If you have questions or difficulties engaging in the suggestions above or if you’ve been experiencing depression, anxiety, or enduring and isolating feelings of loneliness, talk to a counselor today. They can help you on your journey towards greater connectedness.
]]><![CDATA[Baby Hand Movement]]>Thu, 06 Nov 2014 23:38:49 GMThttp://www.jenelramos.com/blog/baby-hand-movementhttp://media.clinicallactation.org/fall10/CLGenna.pdf

If you are a breastfeeding mom like me, you probably have scratch marks, at various stages of healing, across your chest. Well, a few weeks ago, I was surfing the Internet and came across an interesting article titled, “Facilitating Autonomous Infant Hand Use During Breastfeeding” by Genna and Barak (see this link for the full article: http://media.clinicallactation.org/fall10/CLGenna.pdf). Apparently, those seemingly random hand movements your baby engages in while nursing are not so random after all! I attended a lactation consultation class three years ago where I was taught to tuck my baby’s hand between my arm and body so his hands would not “get in the way of a good latch.” In this article, Genna and Barak review literature that suggests infants begin the process of developing deliberate, goal-directed 

 (albeit uncoordinated) hand-mouth movements in utero in the following sequence: mouth opens, arm moves, hand touches face or mouth before swallowing amniotic fluid. After birth, babies use their sense of sight to lift and guide their hands to the breast, in spite of gravity. Newborns use their hands to shape and draw the nipple into the mouth to facilitate latch and to massage the breast stimulating the ducts to release milk. Genna and Barak found that when an infant’s face is touching the breast, the baby may push or pull the breast to bring the nipple to the mouth or stimulate the nipple to become more erect for an easier latch. If the infant’s face is not touching the breast, the baby may push away to get a better look at the mother’s nipple or use the hands to find the nipple. When the hand finds the nipple, the baby may mouth the hand, as a self-calming behavior, before removing the hand and latching on at the same spot. In sum, mothers can trust that their babies, if given the time, can and will use their hands to “identify, move, and shape the nipple area.” Babies who use their hands to search for the nipple may often suck on the hand to self-soothe prior to removing the hand and latching on to the nipple. This is a natural step in the process that does not need to be restricted or rushed. For mothers with sore or damaged nipples, ensuring baby’s face is touching the breast will increase oral searching and decrease tactile searching (i.e. pinching or squeezing). 

Based on these findings, the researchers recommend mothers take advantage of these skillful hand movements while breastfeeding. They advise mothers lie in a semi-reclined position, fully supporting baby’s body and weight. In this laidback position, mothers can bring the infant’s unobstructed arms around the breast so the arms are in the infant’s line of sight. To get baby’s mouth to open up wide, they recommend baby’s chin touch mother’s areola while baby’s philtrum (the space between the upper lip and nose) touch the nipple. Nevertheless, every infant is different; some may prefer to begin the process with their cheek touching the breast above the areola or self-initiate attachment from the mother’s chest or shoulder.

As a psychologist, with strong ties to attachment theory, I loved this article because it reinforces the autonomy and interdependence of the mother-infant dyad. Post-partum can be a period when a mother tries to control as much as possible to ensure the safety and survival of her vulnerable infant. This can be a foreclosed perspective as absolute control is not only illusory and impossible, but it does not take into account what an infant brings to the relationship. Even a newborn baby has boundaries that should be honored and respected.  By tucking away my baby’s arm to “get it out of the way because I know best,” I am not saying that I caused permanent, irreversible damage (thankfully, kids are resilient!), but, unfortunately, I may have communicated distrust in an ability that was well within his scope of competence. After all, he had been practicing this skill specifically for weeks before making his official appearance! Reading this article has definitely caused me to stop and reflect on the ways I am modeling mutual trust both as a parent and a therapist. In what ways am I impeding the natural process of development?  And how can I actively communicate trust and support the facilitation and practice of ever-expanding skills in my children and clients?
]]><![CDATA[Ambidexterity and ADHD]]>Tue, 21 Oct 2014 20:32:19 GMThttp://www.jenelramos.com/blog/ambidexterity-and-adhdWhile scanning headlines on my Facebook news feed the other day, my eye caught sight of the words “ADHD” and “ambidexterity” and a surge of cortisol washed through my body. I will admit that being a psychologist definitely affects who I am as a parent. In many ways, my education, training, and clinical experience have provided me with a storehouse of knowledge that I have utilized in my quest to be a “good enough” parent. On the other hand, knowing all those things and having the capacity to access even more information with the tap of my finger via the worldwide web has seriously 
impacted my stress levels in regards to parenting my two young sons. As health care professionals we know we are not supposed to self-diagnose those close to us, but oftentimes I find myself wondering (and worrying) about my kids’ developments. 

You have probably guessed by now that my preschooler appears to be ambidextrous at this point in his life. He loves to switch hands when using a fork or spoon and colors with both hands too. Just when I think he is beginning to favor one hand, he throws me for a loop and starts using the other hand. In addition to his potential ambidexterity, my son happens to be a fairly active young boy. Granted, I grew up in an all girls family (minus my dad, of course), so in comparison to me and my sister, my three-year-old definitely seems hyperactive to me. If you’re wondering whether I’m just reading too much into things, I have tried to get more objective, neutral feedback from other people in my son’s life, including teachers, his pediatrician, his grandparents, his occupational therapist, etc. I’m pleased to say that, for the most part, these other observers have noted that although he can be “restless” at times he is, overall, a “sweet” boy. I’ve also gotten this response, “He is a boy.” I’m not sure that last one ever really sinks in for me because it doesn’t provide any comfort to a concerned mama, but, apparently, it’s the “go to” descriptor for many of my son’s behaviors. 

So, back to the article I mentioned above. Upon closer examination, the article reported some findings from a Finnish study on 8,000 mixed-handed individuals which demonstrated an “increased risk for linguistic, scholastic, and attention-related difficulties.” At age eight, these kids were “twice as likely to have language and academic difficulties” when compared to their peers and at age 16, they were “twice as likely to have symptoms of ADHD – and their symptoms were more severe” when compared to mono-dexterous teens. Fortunately, one thing I learned in my studies is that correlation does not equal causation. In other words, per the article, ambidexterity is not causing these problems, it is merely a crude measure of how the brain actually works, and is only one risk factor among many. The article concludes with some thoughts on how nurture affects the developing brain in utero – a 2008 study found that women who experienced stressful life events or depression during pregnancy were more likely to give birth to children who became ambidextrous – an excellent reminder to engage in active self-care to all those moms-to-be out there. (On a side note, yes, my mind did immediately flash back to my own pregnancy and being on-call during my last trimester while on internship – another cortisol spike, I’m sure!)  

I have vowed to not be one of those parents who has her head in the sand when it comes to my children, and, perhaps, I have swung over too far on the other end of the pendulum. But I still believe early intervention is key whatever the issue may be. In a culture where ADHD can be overly diagnosed, I choose to take a few deep breaths, wait, watch, get informed, consult and continue to unconditionally love my son’s “unusually symmetrical brain.” 

For the full article I am referring to in today’s post, see http://www.scientificamerican.com/article/ambidexterity-and-adhd/
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