Jenna J. Torres

Hi,

Thank you for your question. Yes, a psychologist can help treat chronic pain. Since the severity and frequency of chronic pain can differ among individuals, a mental health professional would help you to create a pain management plan specific to you that depends on your symptoms and any underlying health conditions. In addition to psychotherapy, the plan may also include medical treatments such as medicine, relaxation therapy, physical therapy, and acupuncture, and it may also include lifestyle remedies, such as getting enough sleep, not smoking, massage, meditation, yoga, art and music therapy, and pet therapy.

There isn’t a cure for chronic pain, but the condition can be managed successfully. It’s important to stick to your pain management plan to help relieve symptoms. Physical pain is related to emotional pain, so chronic pain can increase your stress levels. Building emotional skills can help you cope with any stress related to your condition.

Hi,

Thank you for your question. There are a lot of stress management strategies that you can try, including deep diaphragmatic breathing, progressive muscle relaxation, mindfulness and meditation, and other coping strategies such as journaling, reading, drawing or other forms of artistic expression, listening to music, exercise or going for a walk, petting your dog, reaching out for support from a trusted friend or family member, etc. I would also recommend seeking professional help through therapy to explore other ways of dealing with stress that you can try.

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. There are many forms of therapy to treat depression, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychodynamic therapy, humanistic therapy, Interpersonal Therapy (IPT), Eye Movement Desensitization and Reprocessing (EMDR), and Mindfulness Based Cognitive Therapy (MBCT). I would recommend you seek services from a mental health professional to help guide your therapeutic process to treat depression.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. There are many ways to reduce physical symptoms of anxiety. Anxiety reduction and relaxation techniques include deep diaphragmatic breathing, progressive muscle relaxation, grounding exercises, mindfulness meditation, practicing positive mantras or positive self-talk, guided imagery and visualization, and journaling or stream of
consciousness writing.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Behavior therapy is especially helpful for people dealing with depression or anxiety. One of the main techniques used in Behavior Therapy are behavioral experiments, which are planned activities to test thoughts that are in the form of predictions. The therapist and client will collaboratively design an experiment, specifying precisely what the client is to do, how to do it, and when to do it. After the experiment, they will discuss what happened, what conclusions they drew, what they learned, and how much they believed the thoughts now. Another technique is Exposure and Response Prevention, which are exercises to expose clients to objects/situations/stimuli that they usually avoid and to have them do it without escaping or avoiding parts of it. By confronting feared experiences that are highly valued, the client corrects inaccurate automatic thoughts and increases ability to cope. Another technique is Behavioral Activation, which helps clients to re-engage in life, improve mood, experience pleasure, and counter isolation. The therapist will help the client to schedule activities, motivate clients to follow their schedule, address problems that could interfere, and give themselves credit for following their schedule.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. While there is no cure for specific learning disorder, there are many ways to help someone who has learning disabilities to improve reading, writing, and math skills, including to explore visual, auditory, and kinesthetic multimodal learning styles, to practice various strategies (repetition, mnemonic devices, visualization), and to explore new adaptive responses for self-awareness and self-confidence. Treatment usually includes both strengthening the skills and developing a learning strategy tailored to take advantage of the person's strengths. For example, repetition and mnemonic devices might make it easier to memorize a math formula, and drawing a picture to illustrate a word problem might help to
visualize what is being asked. Treatment for specific learning disorder often also involves multimodal teaching. If the person has trouble comprehending a subject with his or her eyes and ears alone, other senses such as touch, taste, and even smell can play a role in the learning process. Similarly, learning to convert one sort of problem into another format may help (e.g.,
changing a traditional math problem into a word problem). A learning specialist can help determine the services or accommodations a person might benefit from. Psychotherapy, cognitive behavior therapy in particular, may also be helpful in treating the emotional and behavioral problems that can accompany specific learning disorder.

For *impairment in reading*:

· *Special teaching techniques.* These can include helping the person learn through multisensory experiences and by providing immediate feedback to strengthen the person's ability to recognize words.

· *Use of technology.* People with impairment in reading may benefit from listening to books on tape or using word-processing programs with spell-check features.

For *impairment in written expression*:

· *Use of technology.* A person can be taught to use word-processing programs or an audio recorder instead of writing by hand.

For *impairment in mathematics*:

· *Use of memory aids*. Rhymes and music are among the techniques that can be used to help a person remember math concepts.

I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Narcissistic personality disorder is a mental condition in which people have an inflated sense of their own importance, a deep need for excessive attention and admiration, troubled relationships, and a lack of empathy for others. But behind this mask of extreme confidence lies a fragile self-esteem that's vulnerable to the slightest criticism. A narcissistic personality disorder causes problems in many areas of life, such as relationships, work, school or financial affairs. People with narcissistic personality disorder may be generally unhappy and disappointed when they're not given the special favors or admiration they believe they deserve. They may find their relationships unfulfilling, and others may not enjoy being around them.

Symptoms:

- Have an exaggerated sense of self-importance
- Have a sense of entitlement and require constant, excessive admiration
- Expect to be recognized as superior even without achievements that warrant it
- Exaggerate achievements and talents
- Be preoccupied with fantasies about success, power, brilliance, beauty or the perfect mate
- Believe they are superior and can only associate with equally special people
- Monopolize conversations and belittle or look down on people they perceive as inferior
- Expect special favors and unquestioning compliance with their expectations
- Take advantage of others to get what they want
- Have an inability or unwillingness to recognize the needs and feelings of others
- Be envious of others and believe others envy them
- Behave in an arrogant or haughty manner, coming across as conceited, boastful and pretentious
- Insist on having the best of everything — for instance, the best car or office

At the same time, people with narcissistic personality disorder have trouble handling anything they perceive as criticism, and they can:

- Become impatient or angry when they don't receive special treatment
- Have significant interpersonal problems and easily feel slighted
- React with rage or contempt and try to belittle the other person to make themselves appear superior
- Have difficulty regulating emotions and behavior
- Experience major problems dealing with stress and adapting to change
- Feel depressed and moody because they fall short of perfection
- Have secret feelings of insecurity, shame, vulnerability and humiliation

Treatment for narcissistic personality disorder centers around talk therapy. Psychotherapy can help:

- Learn to relate better with others so relationships are more intimate, enjoyable and rewarding
- Understand the causes of emotions and what drives the person to compete, to distrust others, and perhaps to despise self and others
- Accept and maintain real personal relationships and collaboration with co-workers
- Recognize and accept actual competence and potential to tolerate criticisms or failures
- Increase ability to understand and regulate feelings
- Understand and tolerate the impact of issues related to self-esteem
- Release desire for unattainable goals and ideal conditions and gain an acceptance of what's attainable

I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. One of the main techniques used in Behavior Therapy are behavioral experiments, which are planned activities to test thoughts that are in the form of predictions. The therapist and client will collaboratively design an experiment, specifying precisely what the client is to do, how to do it, and when to do it. After the experiment, they will
discuss what happened, what conclusions they drew, what they learned, and how much they believed the thoughts now. Another technique is Exposure and Response Prevention, which are exercises to expose clients to objects/situations/stimuli that they usually avoid and to have them do it without escaping or avoiding parts of it. By confronting feared experiences that are highly valued, the client corrects inaccurate automatic thoughts and increases ability to cope. Another technique is Behavioral Activation, which helps clients to re-engage in life, improve mood, experience pleasure, and counter isolation. The therapist will help the client to schedule activities, motivate clients to follow their schedule, address problems that could interfere, and give themselves credit for following their schedule.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Yes, therapy can help after divorce! It is a safe place to process any thoughts or feelings you may be experiencing, work through grieving the loss of your marriage, and get support regarding potential legal issues.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thanks for your question about breaking a binge cycle. Here are some tips that might help:

- plan and establish regular eating patterns including meals and snacks, try to go no more than 3-4 hours between meals
- identify your triggers to binging, make note of when you binged or ate without being hungry
- recognize the cycle, keep a journal and document how you feel before and after each meal or snack
- find alternatives to triggering situations
- learn to listen to your body, it will signal physical hunger and fullness cues
- seek out therapy to get support from an eating disorder professional to help change your thoughts about food, your body, your weight, your shape, etc. (You can ask your primary care doctor or call your insurance for referrals.)
- CBT, DBT, and interpersonal psychotherapy have been found to be successful forms of therapy
- consult with a doctor or psychiatrist regarding a medication evaluation to determine if that could be helpful
- speak with a nutritionist or dietician about a healthy meal plan and/or nutritional supplements
- stop labeling foods as "good" or "bad" which can increase feelings of guilt and make you more likely to binge
- stop dieting! get rid of any books or magazines that make you feel inadequate or judge yourself to unattainable ideals
- ditch the rigid rules and "cheat days" since no foods are "off limits"
- stay off the scale, as the number on the scale does not reflect your self-worth as a person, your weight does not define you!
- make self-care a priority, including maintaining a healthy, nutritious diet
- engage in positive self-talk and be kind/compassionate to yourself
- reach out for help from trusted friends and family members in your network of social support
- find some joyful activities that help give meaning and pleasure to your life
- practice mindful or intuitive eating
- practice gratitude and positive affirmations about yourself regularly
- focus on actions, not outcomes
- celebrate your victories and don't dwell on minor setbacks
- be patient and manage your own expectations
- don't try to be perfect, it's about progress not perfection!

I hope this is helpful!

Best,

Jenna Torres, PsyD

Hi,

Thanks for your question. Overeating does not necessarily mean that you don't care about yourself. Oftentimes, you do care about yourself, but tend to overeat from other underlying issues such as depression, anxiety, stress, boredom, trauma, relationship problems, school or work issues, etc. I would recommend you seek out services from a mental health professional who can support you in identifying the triggers to overeating and helping you to develop healthy coping skills.
I hope this is helpful!

Best,

Jenna Torres, PsyD

Hi,

Thanks for your question. It is possible that you have gained extra weight during the lockdown even though you are not eating much differently from before due to being less active. Usually, people walk around the school or workplace during their normal day and all these steps add up to help with weight loss from keeping the body moving. I would recommend that you continue to try to stay active by going for a 30 minute walk daily or engaging in another type of activity that involves movement, such as sports, dance, yoga, pilates, biking, hiking, swimming, running, etc.
I hope this is helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. To help your husband with social anxiety, it is important to understand what social anxiety is. Someone with social anxiety has fear about one or more social situations in which others will scrutinize them and fear that acting in a certain way or appearing anxious will lead to being negatively evaluated. Social situations almost always provoke anxiety or fear, which are avoided or endured with dread, and the anxiety is out of proportion to the actual threat posed by the situation. A person with social anxiety will make negative predictions about what the experience will be like in a social situation and maintain core beliefs about themself that get in the way of successfully managing social situations. They will monitor their own emotional, physical, and behavioral signs of anxiety to try to avoid showing anxiety, which actually makes their symptoms intensify. They assume other people notice too and judge them negatively without paying attention to those around them so they can't collect data to disconfirm their assumptions such as positive or neutral facial expressions.

I would recommend that your husband seek out Cognitive Behavioral Therapy (CBT), which has been found to be one of the most effective treatments for social anxiety. CBT will help him to practice emotional acceptance of anxiety, restructure his negative core beliefs by gathering evidence to the contrary, train himself to focus on external cues rather than internal sensations to interpret his performance more accurately, and develop more adaptive ways to evaluate his performance to reduce post-event processing. A CBT therapist will also likely develop an exposure hierarchy of his feared situations and help him prevent his social anxiety responses by starting with the lowest level and working up to the most feared social situation.
I hope this information has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. There are many forms of therapy to treat depression, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychodynamic therapy, humanistic therapy, Interpersonal Therapy (IPT), Eye Movement Desensitization and Reprocessing (EMDR), and Mindfulness Based Cognitive Therapy (MBCT). I would recommend you seek services from a mental health professional to help guide your therapeutic process to treat depression.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Nightmares can be resolved through different therapeutic approaches, including Somatic Experiencing (SE), Eye Movement Desensitization and Reprocessing (EMDR), and Cognitive Behavioral Therapy (CBT). Medications have also been found to be helpful, particularly antidepressants with the strongest evidence supporting Selective Serotonin Reuptake Inhibitors (SSRIs).
I hope this information has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. There are a lot of stress management strategies that you can try, including deep diaphragmatic breathing, progressive muscle relaxation, mindfulness and meditation, and other coping strategies such as journaling, reading, drawing or other forms of artistic expression, listening to music, exercise or going for a walk, petting your dog, reaching out for support from a trusted friend or family member, etc. I would also recommend seeking professional help through therapy to explore other ways of dealing with stress that you can try.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Psychologists treat Bipolar Disorder in the following ways. Three types of therapy are especially helpful in the treatment of bipolar disorder:

*Cognitive Behavioral Therapy*- In CBT, you examine how your thoughts affect your emotions. You also learn how to change negative thinking patterns and behaviors into more positive ways of responding. For bipolar disorder, the focus is on managing symptoms, avoiding triggers for relapse, and problem-solving.

*Interpersonal and Social Rhythm Therapy*- IPSRT focuses on current relationship issues and helps you improve the way you relate to the important people in your life. By addressing and solving interpersonal problems, this type of therapy reduces stress in your life. Since stress is a trigger for bipolar disorder, this relationship-oriented approach can help reduce mood cycling. Interpersonal therapy is often combined with social rhythm therapy for the treatment of bipolar disorder. People with bipolar disorder are believed to have overly sensitive biological clocks, the internal timekeepers that regulate circadian rhythms. This clock is easily thrown off by disruptions in your daily pattern of activity, also known as your “social rhythms.” Social rhythm therapy focuses on stabilizing social rhythms such as sleeping, eating, and exercising. When these rhythms are stable, the biological rhythms that regulate mood remain stable, too.

*Family Focused Therapy*- Living with a person who has bipolar disorder can be difficult, causing strain in family and marital relationships. Family-focused therapy addresses these issues and works to restore a healthy and supportive home environment. Educating family members about the disease and how to cope with its symptoms is a major component of treatment. Working through problems in the home and improving communication is also a focus of treatment.

Other therapies may be helpful as well:

*Electroconvulsive Therapy*- ECT is a brain stimulation procedure that can help people get relief from severe symptoms of bipolar disorder. In ECT, electrical currents are passed through the brain, intentionally triggering a brief seizure. ECT seems to cause changes in brain chemistry that can reverse symptoms of certain mental illnesses. With modern ECT, a person usually goes through a series of treatment sessions over several weeks. ECT is delivered under general anesthesia and is safe. It can be effective in treating severe depressive and manic episodes, which occur most often when medication and psychotherapy are not effective or are not safe for a particular patient. ECT can also be effective when a rapid response is
needed, as in the case of suicide risk or catatonia (a state of unresponsiveness). ECT may be an option for bipolar treatment if you don't get better with medications, can't take antidepressants for health reasons such as pregnancy or are at high risk of suicide.

*Transcranial Magnetic Stimulation*- TMS is a newer approach to brain stimulation that uses magnetic waves. It is delivered to an awake patient most days for 1 month. Research shows that TMS is helpful for many people with various subtypes of depression, but its role in the treatment of bipolar disorder is still under study.

*Light and Dark Therapy*- Like social rhythm therapy, light and dark therapy focuses on the sensitive biological clock in people with bipolar disorder. This easily disrupted clock throws off sleep-wake cycles, a disturbance that can trigger symptoms of mania and depression. Light and dark therapy regulates these biological rhythms—and thus reduces mood cycling— by carefully managing your exposure to light. The major component of this therapy involves creating an environment of regular darkness by restricting artificial light for ten hours every night.

*Mindfulness Meditation*- Research has shown that mindfulness-based cognitive therapy and meditation help fight and prevent depression, anger, agitation, and anxiety. The mindfulness approach uses meditation, yoga, and breathing exercises to focus awareness on the present moment and break negative thinking patterns.

*Acupuncture*- Some researchers believe that acupuncture may help people with bipolar disorder by modulating their stress response. Studies on acupuncture for depression have shown a reduction in symptoms, and there is increasing evidence that acupuncture may relieve symptoms of mania also.

*Medications* may include mood stabilizers, anticonvulsants, 2nd generation "atypical" antipsychotics, and antidepressants including SSRIs.

Other things you can do to help relieve symptoms of Bipolar Disorder:

*Regular Exercise: *Regular aerobic exercise, such as jogging, brisk walking, swimming, or bicycling, helps with depression and anxiety, promotes better sleep, and is healthy for your heart and brain. There is also some evidence that anaerobic exercise such as weightlifting, yoga, and Pilates can be helpful. Check with your health care provider before you start a new exercise regimen.

*Keeping a Life Chart:* Even with proper treatment, mood changes can occur. Treatment is more effective when a patient and health care provider work together and talk openly about concerns and choices. Keeping a life chart that records daily mood symptoms, treatments, sleep patterns, and life events can help patients and health care providers track and treat bipolar disorder over time. Patients can easily share data collected via smartphone apps – including self-reports, self- ratings, and activity data – with their health care providers and therapists.

Coping with Bipolar Disorder

Living with bipolar disorder can be challenging, but there are ways to help make it easier:

- Get treatment and stick with it—recovery takes time and it’s not easy. But treatment is the best way to start feeling better.
- Keep medical and therapy appointments and talk with the provider about treatment options.
- Take all medicines as directed.
- Structure activities: keep a routine for eating and sleeping, and make sure to get enough sleep and exercise.
- Learn to recognize your mood swings and warning signs, such as decreased sleep.
- Ask for help when trying to stick with your treatment.
- Be patient; improvement takes time. Social support helps.
- Avoid misuse of alcohol and drugs.

I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. There are many ways to calm anxiety without medication. Anxiety reduction and relaxation techniques include deep diaphragmatic breathing, progressive muscle relaxation, grounding exercises, mindfulness meditation, practicing positive mantras or positive self-talk, guided imagery and visualization, and journaling or stream of consciousness writing.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. The length of time in therapy depends on what type of therapy you are doing. There are many forms of talk therapy that can help to reduce anxiety, including Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), psychodynamic therapy, humanistic therapy, Interpersonal Therapy (IPT), Eye Movement Desensitization and Reprocessing (EMDR), and Mindfulness Based Cognitive Therapy (MBCT). CBT, DBT, and EMDR are usually short-term, while psychodynamic, humanistic, and IPT are usually long-term. MBCT depends on how much you are practicing anxiety reduction and relaxation techniques outside of therapy sessions. These may include deep diaphragmatic breathing, progressive muscle relaxation, grounding exercises, mindfulness meditation, practicing positive mantras or positive self-talk, guided imagery and visualization, and journaling or stream of consciousness writing.
I hope this has been helpful!

Best,

Jenna Torres, PsyD

Hi,

Thank you for your question. Virtual counseling is an effective form of telehealth treatment in which the therapist will use a HIPAA compliant platform (such as Doxy.me) to communicate with the client through a smartphone, laptop, or tablet. It is similar to speaking with someone over Facetime, Zoom, or Skype where you will be able to see and hear the person via the device's audio/video technology.
I hope this information has been helpful!

Best,

Jenna Torres, PsyD