Dr. Goschi's Blog

Stages of Sex Addiction

Posted on August 13, 2018 at 3:45 pm in Addiction Counseling Chicago, Addiction Therapy Chicago, Cyber-sex addiction Counseling Chicago, Individual Coaching & Counseling

Process addictions, in particular sex addiction, causes much confusion.  People tend to lump those individuals who act out sexually as “sex addicts.”  Or, even put sex offenders and the paraphillias in the same category as sex addicts.  There is a huge difference. Sexual addiction is defined as a loss of control, having a negative impact on your life, developing a tolerance for the behavior, denying it’s a problem, and blaming others for your acting out.  Individual therapy helps define whether the person is struggling with an addiction and if they require the help of therapy to recapture their lives.

According to many expert’s sex addiction/process addictions can be broken down into discrete stages.  The individual struggling with an addiction moves through these various stages one after the other often feeling trapped.  One stage feeds into the next causing a negative spiral of emotions and inappropriate behaviors often leading to self-loathing.

Robert Weiss in his “Sex Addiction 101” book outlines the various stages of sex addiction.  Many addicts share these six stages. The first stage is the triggers. Triggers are those actions, thoughts, places, visual cues, even smells which act as catalysts for the inappropriate behavior.  Emotions, such as anger, sadness, shame, anxiety and loneliness can also be powerful triggers.

The second stage involves fantasizing about past encounters and the enjoyable memories.  These thoughts become obsessional over time growing in strength. Individual therapy helps the person explore the reasons for the fantasies while coming up with strategies to stop them.

Stage three involves ritualizing the sexual acting out.  Fantasy begins to dictate behavior. The addict goes to their favorite bar or begins looking at postings on Craig’s list.  The addict describes this experience as lost in a bubble without concerns for the real world or their action’s consequences.

Acting out occurs in stage four.  The addict perceives this stage as the most desired aspect of the addiction.   The individual consummates the sexual act. But, the addict really desires escape and dissociation.  The sexual enactment ends the fantasy abruptly.

This sudden end leads directly to stage five.  During this phase the addict feels numb attempting to distance themselves from what has just taken place.  Justification or even blame enters the addict’s language. Individual therapy helps the addict stop blaming others or justifying their behavior rather than taking full responsibility for their actions.

The last stage of sex addiction results in self-loathing and other terrible emotions including shame, guilt, anxiety and depression.  At this point they may seek individual treatment given the hopelessness they feel. Or, it may simple foster a repeat of the process all over again.  Individual therapy can help break the cycle for the addict, so they can gain some true insight and alternative ways of coping with the disruptive triggers that begin the cycle.

If you or a loved one are struggling with a sex addiction don’t hesitate to call or email Dr. Goschi at (312)595-1787 or barbara@drgoschi.com.  Your healing can begin today!

Stress, Pot and Addiction

Posted on July 16, 2018 at 9:02 pm in Addictions Counseling, Anger Anxiety Counseling Chicago, Anxiety Counseling, Depression Counseling Chicago, Individual Coaching & Counseling, Individual Counseling

Stress, Pot and Addiction

New research in the journal of Abnormal Psychology (May, 2018) highlights how heavy marijuana users deal with stress. Chronic pot smoking leads to an overreaction to stressful situations. Research found that these individuals easily became stressed and unable to problem solve versus moderate consumers. Most pot smokers say they smoke pot to “relax” or escape a stressful job. Perhaps recreational marijuana consumption leads to relaxation but not habitual heavy use.

Researchers Hefner et al from University of Wisconsin in Madison found heightened startle responses to even the anticipation of stress among heavy marijuana users. Heavy pot usage involved daily use sometimes as much as twice a day. This finding contradicts self-reports from fifty percent of pot users that claim marijuana reduces their stress. Why is this important? Because, addiction relapse for many addicts can be traced to the person’s inability to manage stress.

Hefner et al reported physiological responses in abusers. They claim “heavy and chronic (marijuana) use contributes to heightened behavioral and affective response(s) to stressors via central nervous system…” Indeed, these “stress neuroadaptations” result in poor emotional reactions to stress. Maladaptive responses escalate even more when the individual stops using the drug. Heavy marijuana abuse leads to long term changes in the users central nervous system. This implies that the addict won’t cope well with stress going forward until they make some serious and lasting changes to their lives.

The research supports using the word addict to describe the heavy marijuana abuser as they show signs of addiction. Many debates insist that marijuana does not possess addictive properties. Yet, withdrawal from pot shares many similarities to other addictions, “marijuana withdrawal syndrome … involves increased affective symptoms (irritability, anger or aggression, nervousness or anxiety)…” It becomes a viscous cycle for the abuser, one of an inability to cope with stress leading to mounting stress resulting in increased drug usage. Minimal indulgence in marijuana (only occasional use), did not show greater reactivity to stress.

How can individual therapy help the marijuana abuser/addict? Therapists should help the individual identify personal stressors. These events may involve finances, housing and/or relationships. Therapy should target these stressors by teaching better coping skills to minimize the impact of the stressor. Individual addiction therapy helps individuals “reshape” their environment while maximizing lifes predictability. Attending NA meetings and working the 12 steps is enormously beneficial in maintaining sobriety. Individual therapy assists the individual work through fears and anxiety which trigger the addictive response.

If you are struggling with addiction Dr. Goschi can help. Call today to set up your individual appointment at (312)595-1787 or email at barbara@drgoschi.com.

Suicide

Posted on June 14, 2018 at 2:29 pm in Anger Anxiety Counseling Chicago, Depression Counseling Chicago, Divorce and Infidelity Counseling, Individual Coaching & Counseling

Suicide

The focus moves to depression and suicide after Kate Spade and Anthony Bourdain took their lives.  But, the suicide rate has been going up steeply since 2008 and no one really talks about it. The British Journal of Psychiatry posted an article on January 2, 2018  written by Reeves, McKee and Stuckler talking about the 10,000 suicides related to the job losses and overall bad economy during the recession between 2008 and 2010. Somehow this disturbing information was mostly ignored.  Stuckler also discussed an alarming trend that talked about all mental health issues rising.

People don’t like to talk about mental health very much until some tragedy occurs.  I’ve seen this avoidant pattern for the 30 years that I’ve been treating couples and individuals.  Seeking individual therapy for depression, anxiety or some other issues can result in the individual feeling ashamed.  Individual’s worry about the stigma of seeking individual psychotherapy.

In this age of eating healthy and working out it still seems like people at large don’t focus as much on mental health.  We should speak more openly and encourage our friends struggling with depression to seek individual treatment. However, it can be awkward to speak with a friend about their mental health issues.  It feels like a boundary intrusion. We might even hope that the pain goes away once the person gains some distance from the seeming catalyst, such as a death or loss of job.

Some people experience unrelenting depression unrelated to a specific catalyst.  Despite the individual’s life seeming wonderful they still cannot experience joy.  Even a bad hamburger in an airport could trigger a relentless depressive episode for Anthony Buordain.  Peter Splendorio quoted Bourdain in his June 8, 2018 Daily news article as saying “It’s a hamburger but not a good one.  Suddenly, I look at the hamburger and I find myself in a spiral of depression that lasts for days.” Clinicians understand this symptom as anhedonia.  Anhedonia is the inability to feel joy over life events which would usually bring one pleasure.

In these instances, family and friends find it hard to be around their loved one who cannot experience joy.  It can be exhausting and stressful to always worry about your family member. If the person tries to put on a happy face in front of everyone it will cause further stress.  The person’s moods come crashing down when they get home. Couples and family therapy help the family members and spouses of such individual’s develop empathy and understanding for toward their loved one.

Our culture demands quick fixes.  Just take a pill and it will alleviate your woes.  Depressive symptoms respond well to medication. However, meds should never be prescribed without the therapeutic relationship to back them up.  Individual counseling augments the beneficial effects of psychotropic meds. If you take antidepressants, for example, you should also see a therapist in individual therapy weekly.  Seriously, no less! Your therapist develops an intimate relationship with you. They have eyes on their patients. The therapist often sees when things start going wrong.

Bottom line is that individual therapy should be encouraged for those struggling with some kind of mental illness, especially depression.  Let’s destigmatize therapy so more individuals reach out for help when needed. Please, if you know someone who needs help or if you are struggling don’t hesitate to seek individual treatment.  If it’s an emergency and you feel like taking your life call 911 or go to the nearest emergency room. I’m here to help. Call today at (312)595-1787 or email me at barbara@drgoschi.com

 

Working Out and Mental Health

Posted on May 23, 2018 at 2:34 pm in Depression Counseling Chicago, Family Counseling Chicago, Individual Coaching & Counseling, Licensed clinical psychologist Chicago, Personal growth Chicago

Working Out and Mental Health

Activity leads to a leaner, healthier body. But how much do we really talk about how physical activity affects our mental health. Exercise along with individual therapy helps move you along in the process of emotional regulation as well as a heightened self-esteem. Research now supports what many therapists have known for years – that working out leads to better psychological health.

It’s true that many people participate in physical activity in order to maintain their muscle mass, for a trimmer self, for weight loss or for cardio health. All of these reasons for working out make absolute sense. They provide great results for the individuals participating in the activities.

However, you don’t see or hear advertisements talking about how much exercise benefits your mental health. The drug companies push medication for treating depression and anxiety. These companies don’t say that exercise doesn’t help rather they just don’t mention that in some studies exercise and individual therapy can be as beneficial as some medication regimes. I’m not suggesting here that you dump your meds for marathon training. I would never go against what your doctor has recommended for your treatment. Instead, I’m suggesting that if you’re not already on meds why not try a different route and begin exercising along with individual therapy.

If you already work out I’m sure you’ve experienced the endorphin “high” that can be experienced after a hard workout. This reaction highlights how much a good work out can lift your mood. The positive emotional effects are more than just a one- time response; rather, regular exercise has positive long term implications for one’s mood.

Working out helps ameliorate depression, anxiety and anger alike. The added energy boost helps us face difficult emotional tasks with more energy and a clearer mind. Working out helps to externalize the more intense emotions we feel like anger and anxiety. Physical activity along with individual counseling also helps brighten moods for those who struggle with depression.

The benefits of working out often lasts for the remainder of the day. It can also help us sleep more deeply at night which also assists in mood control. Physical activity in addition with individual therapy works extremely well.

When physical activity isn’t enough to help you deal with your anxiety, depression or other troublesome emotions try adding individual therapy to your weekly schedule. Don’t hesitate to seek help. Call Dr. Goschi today to schedule your first individual therapy appointment at barbara@drgoschi.com or (312)595-1787.

Keeping Our 2018 Resolutions

Posted on January 18, 2018 at 2:16 pm in Individual Coaching & Counseling, Individual Counseling, Licensed clinical psychologist Chicago, Relationship Issues Counseling

Keeping Our 2018 Resolutions

Every year many of us set resolutions on New Year’s Eve only to be broken within the first three weeks. What’s happening? Can it be that so many of us have absolutely no resolve to meet the goals that we set for ourselves? Are we just all quitters?

Hardly! Many of us set unrealistic goals that are impossible to meet. Rather we should look at setting more attainable objectives for ourselves. Also, celebrating small achievements that lead to ultimately getting us closer to our targets becomes ever more significant.

So, what to do? Look at the goals that we set. Make sure they aren’t “pie in the sky” ideas. Our desired destination should be attainable. For example, when it comes to weight loss look at what is realistic for you. Not so glamorous but far more reasonable. Let’s say that losing a pound a week can be a highly attainable goal. This would include making some healthy changes to your diet without the severe deprivation that some diets require.

Individual therapy can help you identify what changes need to be made in your life in order to realize your dreams. Whether it’s finding a new job, more balance in your life, to increasing your social contacts. Individual counseling can help you attain these goals by looking at the desired result and work backwards from there (Covey, 1990). Divide the process in to smaller attainable objectives which ideally get you closer to your bigger objective.

Celebrate each achievement you complete along the way. One mistake we often make is when we beat ourselves up for imperfect execution. Maybe we’ve not met one of the benchmarks that we’ve set up for ourselves. Thus, we end up devaluing ourselves as incapable of staying focused on the prize. Individual therapy teaches you to forgive yourself. Counseling helps you look at what interferes with your goal attainment and controls for that going forward. We sometimes learn the most about ourselves through examining our failures. Use your failures as moments for growth.

Good luck in the New Year and may you reach all of your goals. If you need help getting there or have discovered something about yourself that you would like to change don’t hesitate to call Dr. Goschi (312)595-1787 to schedule your individual counseling. I’m here to help!

Dealing with loss in the New Year

Posted on January 2, 2018 at 7:40 pm in Anxiety Counseling, Depression Counseling Chicago, Individual Coaching & Counseling, Individual Counseling, Relationship Issues Counseling, Seasonal Affective Disorder

Dealing with loss in the New Year

Having lost someone in 2017 shapes the way we view the New Year.  We view everything through the lense of loss.  Rather than looking forward to upcoming events we see these functions as sorrowful, even meaningless.  “It’s the first celebration without them.”  Which, of course, diminishes the occasion. 

Feelings of sadness, anger, denial, isolation and sometimes guilt rule our days.  While experiencing these painful emotions can help us move through the grief process we need appropriate outlets so we don’t get stuck in any one of these stages (Kubler-Ross, 1969).  We want to eventually get to a place of acceptance so we can heal and once again tolerate positive emotions.  Guilt over feeling happy can interfere with our receptivity to love and support from others.  Try to open yourself to others kind works and gestures of love.

Normalizing your life helps you get beyond the grief.  Fill your life with plenty of positive activities.  Partaking in exercise, work, dinners with family move us forward.  Look for those situations that allow you to find balance between felling, self-expression and acceptance.  If we dwell only on the loss this keeps us stuck in the process of grieving.

Allow yourself to feel.  We move through various emotions while grieving.  Not surprisingly we feel sad one day and perhaps angry the next.  Embrace the fact that while grieving we feel many complex emotions which constantly fluctuate.

Don’t hesitate to call friends who can offer an empathic ear.  People worry that reaching out too often will burden their relationships.  True intimate relationships have a large capacity for love and empathy.  If you experience rejection when attempting to reach out then you probably need to assess the health of your friendships.

Lastly, be kind to yourself in 2018.   You will find your way out of the emotional fog.  Be patient it takes time to heal.  If you need more help don’t hesitate to call!  Dr. Goschi is here to help (312)595-1787.