The Internet and Emotional Health: Online Resources for Everyone

How many ways has the “digital age” changed our emotional lives?

Judging by the lives of my clients as well as those of my family and friends, a lot.

People seem to live huge parts of their lives via text message now.  They will ask someone out by sending a text; they carry on huge arguments by text, and eventually they even break up by text.  Unfortunately, text messaging isn’t very good at expressing emotions and many misunderstandings do occur.

Thanks to the Internet, marriage proposals have become a huge industry.  It can cost $2000 or more to stage a marriage proposal that will go viral on Youtube, complete with flash-mob dancing chorus – and to some, that seems to be the only kind of proposal worth saying “yes” to!

Babies continue to be born the (more or less) old-fashioned way, but marriage continues to have its ups and downs with the help of the Internet.  Most of us probably know at lease one person who found their high school sweetheart on Facebook and ended up leaving their spouse for their first love.  We may discover that our spouse is cheating by looking up phone records online, or perhaps we find an incriminating text or photograph on their phone.  (Lipstick on the collar is so last century!)

The porn industry is now perhaps the first “sex educator” for many young people, with often unfortunate results: boys may expect their girlfriends to behave like porn stars, not to mention expecting their own bodies to live up to those of the men in porn videos.  Both men and women may think they are sexually inadequate compared to what they view so readily on the Internet.  And “porn addiction” has become epidemic with the ready accessibility of online porn.

On the other hand, some excellent sources of help exist online.  People may stop drinking with the help of Alcoholics Anonymous online, quit smoking pot with Marijuana Anonymous online, or lose weight with a free online support group (  There are countless sources of free online information on mental health topics, from suicide prevention (for example see to anxiety  and panic self-help (for instance,  Online support groups exist for those struggling with bipolar disorder (see the DBSAlliance online)  or schizophrenia (see, as well as many other problems.  A great online resource  and support group for all kinds of mental health problems is the website

And sex education online doesn’t have to be on pornograph sites, which are misleading at best.  For sex education appropriate to teens, see instead Scarleteen, or for adults, try

The Internet has changed our world, for better and for worse.  We might as well accept it – our children or grandchildren may learn to use a screen before they can turn the pages of a book – if books still exist!   If you haven’t yet seen this video of a baby trying to “swipe” a magazine as though it were an Ipad, please enjoy this  short clip, A Magazine is an Ipod that Does Not Work.

The Challenge: How an Exercise Program Changed Me

by Chris S., a Psych Choices client

Exactly 51 days ago I decided that I would begin to work out again after about 2 months of barely exercising at all.  During those 2 months I felt a lack of motivation and a lack of a good reason to exercise.  After watching a motivating YouTube video from an exercise/lifestyle guru named Elliot Hulse, I decided I would get up and start again.  Specifically, I would exercise my core, starting the next day.  This decision turned out to be very important.

I received a Facebook message from my friend the next day letting me know he started something called The 30 Day Ab Challenge the day before and asked if I was interested in doing it with him.  The 30 Day Ab Challenge, from the website, was a bit of a sensation as millions of people were doing it (and probably still are).  Each day of the challenge details a set of ab workouts you’ll have to do that increase in quantity as the days pass.  Coincidentally (or perhaps not, depending on your view on this sort of thing), my friend also hadn’t worked out in about 2 months until he chose to start again the day before.  When he asked if I wanted to join him, I was hesitant, since I’d never been one to commit to any kind of exercise regimen, but I agreed.  Looking back, I doubt I would’ve said “yes” had I not made the decision the night before to start working out again.

I was unusually determined to do this challenge and really took it to heart.  I sat down on my bed and wrote out all the reasons I wanted to commit myself to doing it and what I was looking to gain in the end.  Some of the things I wanted to gain were: A sense of pride; character, knowing I continued to do something even when it got tough; a sense of accomplishment; satisfaction, knowing I put my potential to use (something I scarcely had done); and overall betterment from working my body.

Writing it all down proved to be very important.  I got the idea from Brian Tracy, author of Accelerated Learning Techniques.  In his audiobook, he speaks about how in writing our goals down, they become more assimilated into our consciousness than they would otherwise.  Creating a physical copy of what we want to achieve makes it feel more real to us.  I recall how I felt a bit scared as well as determined while writing it all down – scared because I had never done something like this before – I had never taken it upon myself to commit to something for 30 days with no external force pushing me along.  This whole process brought up excitement as well as nervousness as it indeed became more real to me.  I concentrated on every word I wrote and recited them to myself.  I then grabbed a bunch of flash cards and made a timeline.  I drew four segments on each side of every flashcard, signifying four days worth of workouts on each side.  Every day I would write down the workouts as I did them as a sign of progress.

Keeping track of my progress and affirming my goals in this way proved invaluable.  I know I would’ve faced many more problems had I not done that.  So every day I did however many workouts I needed to do, affirming beforehand that even when I didn’t feel like working out, I would anyway.  I’d say this attitude made up about 90% of what carried me through.

I began to realize as I continued that I was gaining even more from the challenge than what I’d initially planned.  The first thing I noticed was that it was a good way to initiate conversation and connect with people.  My everyday life became a little more social because of it, and because engaging in this kind of challenge gave me a bit more confidence, I found it easier to interact with people in general.

The next thing I realized was that I was no longer only doing it for myself.  My friend and I would give each other updates through Facebook as to how we were coming along, which was a great source of motivation.  I found about halfway through the challenge that I felt totally invested in him.  At that point, even though the workouts were getting more and more intense, I simply wasn’t going to stop, because to me that would mean letting him down.  It wasn’t even an option; I was going to finish it.  Additionally, I realized that I was inspiring my mother and sister to start workout out too.  This in turn motivated me even more to continue the challenge.

Physically I felt stronger as I was able to do more workouts more easily.  When it got difficult, I would sometimes look back to the first flash card I filled out and recall the first workout day.  I would feel surprised that I needed to take 3 breaks to get through the first set of sit-ups! Seeing the progress right in front of me felt good, like I was clearly getting somewhere.

I remember during the last 10 days of the challenge how I seemed to randomly feel energized as I took out the trash.  This was abnormal for me, as I’m assuming it would be for most people.  I was literally jogging back and forth to drag the trash cans to the front of the house.  Needless to say, consistent exercise made me feel more energized.  Perhaps what is even more interesting is that I also started to feel more mentally energized and more focused.  As they say, “A body in motion is a mind in motion.”

I got to the point where I would look forward to my workout days, and on my “Rest Days,” which were every other three days, I found myself actually wanting to work out.   I think a big reason for all of this was that I had something to look forward to.

As the challenge drew to an end, I knew I wanted to continue exercising.  I believe it was the yoga master Yogi Bhajan who said that doing something consistently for 40 days will rewire parts of the brain to adapt to the new behavior; 90 days will create a new habit; 120 days will confirm the new habit; and 1000 days will master the habit.  As I continued to work out, my new goal was to do it for 40 days.  Now 51 days in, my current goal is to get to 90 days to create a new habit.

As I’ve taken up this challenge I’ve learned many things and have changed in many ways.  I know now that my fear in the beginning was one that often came up for me, and still does sometimes, but at the time I wanted to challenge myself more than I wanted to run, and so I did it.

I must give much credit to my friend who presented me with the challenge.  Had he not offered it to me, I wouldn’t have done it and probably the majority of good things that have happened to me wouldn’t have, or at least not as quickly as they did.  Thinking back to even before that, I doubt that I would have taken him up on the challenge had I not made the decision the night before to start working out again.  I probably would’ve felt too intimidated and left it up to him had I not already made that conscious choice.  Decisions are powerful.

Feeling motivated is a great thing to feel, but it is secondary, as I’ve learned.  I’ve been seeing more and more that the most important thing to do to create a new positive habit, whatever it may be, is to do it even when you don’t want to.  That is about 90% of the challenge.  You don’t even have to do it 100% correctly; what matters is that you show up.  That is what builds character and that is what will propel you forward into accomplishing your goals.

As a final thought, I feel that goal achievement is great when done for reasons that will aid in our growth, but more importantly is to be able to utilize our potential.  I hope I helped someone by writing this.


Here are some references that have helped me along:

Elliot Hulse’s YouTube Channel

Accelerated Learning Techniques by Brian Tracy (Audiobook)

Miracles Now by Gabrielle Bernstein

The Jillian Michaels Show Podcast








Why People Gain Weight, and What To Do About It

It’s well known that obesity is epidemic in this country.  Unfortunately, there doesn’t seem to be much agreement about its causes and cures.

While it might seem obvious that overeating causes overweight, a recent article in the New York Times (Always Hungry? Here’s Why) explains that one reason people overeat is because they are overweight.  Once you have excess fat cells, they start absorbing the calories you eat, leaving your bloodstream low on calories and continuing to crave more.

The authors, David Ludwig and Mark Friedman, explain what happens when fat cells store the extra calories.  The brain notices fewer calories in the bloodstream, so it tells the body to increase intake (so we feel hungry) and to save energy (so our metabolism slows down, burning calories more slowly).

Other causes of weight gain include stress, reduced physical activity (such as sitting at a computer all day), lack of sleep,  many medications including psychiatric and diabetes medicines, and genetic tendencies.

Additionally, being told you are fat (even by well-meaning parents) can actually make you gain weight.  A recent study, published in a medical journal for pediatricians (JAMA Pediatrics, “Weight Labeling and Obesity“), found  that if a child is told she is “too fat” by her family members, she is more likely to be obese by the age of 19 than is a child of similar weight who is not stigmatized by the “fat” label.

It’s pretty hard if not impossible to change these factors, so is there any hope at all for people who want to lose weight? Diet books and articles are everywhere, and many of them see m to contradict one another.  The authors of the New York Times article, Ludwig and  Friedman, who also published their findings in the Journal of the American Medical Association (“Increasing Adiposity: Consequence or Cause of Overeating?“), offer a few guiding principles.

They explain that weight gain is triggered by excess insulin, and that highly refined carbohydrates produce the most insulin.  So, they explain, it’s not true that all calories are equal.  It’s better to avoid certain kinds of calories: specifically, those from refined carbohydrates including sugar, flour, and white potatoes.

Whole grains, and certain starchy vegetables such as boiled sweet potatoes, are a better source of the carbohydrates we all crave and need as part of a balanced diet.  Surprisingly, whole wheat bread and brown rice may not be particularly lower in glycemic index (a measure of how quickly carbs are converted to glucose).  Instead, eat whole grains such as barley, millet, quinoa, wild rice, or cooked whole wheat berries.  Dr. Andrew Weil explains more about glycemic index in this article on his website.

It is likely that fat slows the absorption of the carbohydrates, which prevents a spike of insulin in the blood, leading to less of the glucose being stored in fat molecules.

Furthermore, fructose (from table sugar, honey, maple syrup, agave and high fructose corn syrup, among other sources), is even more toxic than other carbohydrates.  Fructose is metabolized down the same pathways as alcohol. Thus it, like alcohol, can cause fatty liver disease, and eventually cirrhosis of liver and liver failure.   You can hear a lecture by Dr. Robert Lustig on the dangers of sugar here.

Doctors and nutritionists all seem to agree that vegetables are good for you, especially fresh vegetables, and that protein is important, though there is room for disagreement about the value of animal proteins (meat and dairy).

And given a choice between a “low fat” product, which is likely to contain extra sugar to make up for the loss of flavor, and a full fat product with less sugar, choose the latter.  It may be that one more cause of the obesity epidemic is the spread of “low fat” processed foods over the past few decades.  Although no one advocates eating slabs of butter or deep fried foods to lose weight, we all do need some healthy fats in our diet.

It turns out that a higher fat, lower carb diet may help with weight loss.  Ludwig and Friedman point to another study showing that dieters burned about 325 more calories on a low carb diet than did others who followed a low fat diet, even though both diets involved eating the same number of calories per day.   They also cite animal research: a group of rats who were fed a diet of highly refined carbohydrates gained 71 percent more fat than did rats who ate less refined carbs – even though the  rats on the whole-grain diet consumed more calories overall.

In conclusion, what we eat is more important than how many calories we consume.   By adjusting what we eat rather than counting calories, we may be able to achieve more lasting weight loss and better health.

Yoga – A Holistic Treatment Modality

by Connie Opfell, LCSW

Yoga is for everybody

When they hear the word “yoga”, most people either think of a skinny Indian yogi sitting cross-legged in the lotus position for hours, or a svelte woman tying herself into a pretzel. Either way, they think “that’s not for me.” I’ve spent the last 15 years or so learning about this 5000-year-old philosophy and science, and one of the most interesting things I’ve learned is that yoga is really for all of us. More importantly, yoga practitioners benefit in many ways – physically, emotionally, spiritually, and energetically. And you don’t have to be able to tie yourself into a pretzel to achieve these benefits!

Yoga classes

Most people begin their experience with yoga by joining a yoga class. There are many different kinds of yoga, but most teachers or studios offer classes for beginners. You may also find classes offering “chair yoga”, and therapeutic yoga classes for people with different medical conditions. Regardless of tradition or focus, most yoga classes will include warm-ups, yoga postures, breath-work, and meditation.  These different activities correspond to different “limbs” of yoga that benefit our physical, emotional, energetic, and spiritual selves.

Yogic Breathing (Pranayama)

Through experimentation,  yogis have discovered a variety of breathing techniques designed to calm, excite, and balance our energy. By practicing these different techniques, we also become more sensitive and aware of ourselves, and of our reactions to life events – and learn to use different breathing techniques to help manage those reactions.

Abdominal Breathing and the Three Part Breath

Abdominal breathing and the Three-Part Breath are examples of yogic breathing techniques. Benefits of practicing these techniques include

  • Calming the mind
  • Releasing tension in the chest and abdomen
  • Providing a gentle massage to abdominal organs, improving digestion
  • Fully completing the exchange of air in the lungs to oxygenate the blood and remove toxins

Begin with this abdominal (belly) breathing exercise:

  1. Sit or lie so that your spine is in its natural curve, allowing your lungs room to fully expand.
  2. Gently place your hands on your belly to help you notice your breathing. Notice where your torso expands as you breathe – are you more of a chest breather, or does your abdomen expand when you inhale normally?
  3. Now exhale fully.
  4. Inhale, directing the breath to the lowest part of your lungs. Notice that when the diaphragm drops to pull air in to the bottom of the lungs, your belly expands.
  5. Exhale fully. Repeat several times.

Three Part (Dirgha) Breath

Move to the three-part breath only after you have mastered the abdominal breath.

  1. Again, sit or lie so that your spine is in its natural curve, allowing your lungs room to fully expand.
  2. Gently place your hands on your belly to help you notice your breathing.
  3. Exhale fully.
  4. Inhale, directing the breath to the lowest part of your lungs. Notice that when the diaphragm drops to pull air in to the bottom of the lungs, your belly expands.
  5. Move your hands to the sides of your rib cage, and inhale again, directing the breath to the middle of your lungs.  Notice the expansion of the rib cage.
  6. Place your fingertips on the front of your chest just below your collarbones. Inhale a third time, expanding the upper part of the chest.
  7. Exhale slowly, beginning at the top of the lungs, and gently squeezing the abdominals in at the end of the exhale to expel all the air.
  8. Repeat the cycle several times, moving your hands to help you feel how your breath is moving your body.  Focus on filling and emptying your lungs completely.
  9. Breathe normally, noticing any change – in your breath, in your energy, or in your emotional state — that has occurred.


If you are interested in learning more about yoga or yoga therapy, click on the links below.

Connie Opfell, MSW, LCSW, Certified Kripalu Yoga Teacher

Teenage Peer Pressure: It’s Not What We Thought

A series of studies have demonstrated that adolescents will tend to take more risks when they are with other teens.   The other kids don’t have to be applying pressure of any kind – simply being with other teens makes the adolescent choose riskier behavior.

Most of us have observed or experienced this phenomenon, but psychologists have shown it to be almost universal – not only among human teens, but even in adolescent mice!

In the first study, teenage volunteers were assigned to play a video driving game, either alone or with two same-age friends watching them.  Just having peers observe them made the teenagers take more risks and “crash” more often in the game.  A comparison group using adult volunteers showed that adults did not change their risk-taking in the video game just because other adults were present.

This experiment clearly reflects what real-life driving statistics consistently show – that having same-age passengers in the car substantially increases the risk of a teen driver having an accident.   The presence of passengers does not have this effect when an adult is behind the wheel.  That’s one reason why teenage drivers in many states are limited to driving with no more than one passenger.

Researchers repeated this study a number of times with similar results.  Furthermore, they learned something about the cause of this effect: the “reward centers” of adolescent brains become hyperactivated when other teens are present.  This seemed to make them more easily aroused by the possibility of a pleasurable experience, so they would pay more attention to the benefits rather than the costs of a risky choice.

But much more amazing, to me, is a  study that suggests that this “peer presence” effect may be true in the animal kingdom as well.  In this experiment, mice were given unlimited alcohol to drink.  It was observed that when adolescent mice were with other mice their age, they would actually consume more alcohol than they did if they were alone!  Full grown mice, by contrast, drank the same amount whether or not other adult mice were present.

The lead researcher, Lawrence Steinberg of Temple University, concludes that “the propensity for teenagers to do more risky things when they are with their peers — which understandably worries their parents, and which should concern those who supervise teenagers in groups — is not only real; it may be hard-wired.”

(See Dr. Steinberg’s editorial in the New York Times here).



Mental Health Awareness Month seeks to reduce stigma

May is Mental Health Awareness month, established in an effort to help reduce the stigma that is so often still attached to the idea of having a mental illness or emotional problem.

Too many people avoid getting help because they don’t want to be seen as “weak” or because they don’t want to talk about “private matters” to anyone outside the family – or even to anyone at all.

Far, far too many people have died, taking their own lives because they didn’t believe there was anyone or anything that could help to ease their pain.   This year, it is estimated that 30,000 to 50,000 Americans will die by suicide, in addition to hundreds of thousands who will attempt to take their own lives.

Feelings of depression and hopelessness may last for hours, weeks, or months, but never last forever.  Despair is temporary.  But in the middle of the dark night of the soul, it is hard to see or remember the light that will return.

On Saturday, May 3, hundreds of people gathered at Ridley Creek State Park to walk or run 5 kilometers in support of the Delaware County Suicide Prevention and Awareness Task Force.  Among this crowd were many survivors of suicide, reminding us that while suicide may seem to end the sufferer’s pain, for those left behind, the pain may persist for a lifetime.

Like all grief, the hardest edges will eventually fade,  allowing life to go on.  But survivors are left forever wondering why they couldn’t have done more to prevent this terrible loss of life.

There is help.  Even when initial attempts at therapy and/or medication may have failed to help, there are almost always more options that have not yet been tried. There is nothing to be ashamed of.  We all need help at times.  Reach out, for you are not alone.

Ten Habits of Happy Couples

This post is borrowed from the Psychology Today blog, and was written by Mark Goulston, M.D.

What does it take to be happy in a relationship? If you’re working to improve your marriage, here are the 10 habits of happy couples.
 1. Go to bed at the same time
Remember the beginning of your relationship, when you couldn’t wait to go to bed with each other to make love? Happy couples resist the temptation to go to bed at different times. They go to bed at the same time, even if one partner wakes up later to do things while their partner sleeps. And when their skins touch it still causes each of them to tingle and unless one or both are completely exhausted to feel sexually excited.
2. Cultivate common interests
After the passion settles down, it’s common to realize that you have few interests in common. But don’t minimize the importance of activities you can do together that you both enjoy. If common interests are not present, happy couples develop them. At the same time, be sure to cultivate interests of your own; this will make you more interesting to your mate and prevent you from appearing too dependent.

3. Walk hand in hand or side by side  Rather than one partner lagging or dragging behind the other, happy couples walk comfortably hand in hand or side by side. They know it’s more important to be with their partner than to see the sights along the way.

4. Make trust and forgiveness your default mode
If and when they have a disagreement or argument, and if they can’t resolve it, happy couples default to trusting and forgiving rather than distrusting and begrudging.

5. Focus more on what your partner does right than what he or she does wrong
If you look for things your partner does wrong, you can always find something. If you look for what he or she does right, you can always find something, too. It all depends on what you want to look for. Happy couples accentuate the positive.

6. Hug each other as soon as you see each other after work
Our skin has a memory of “good touch” (loved), “bad touch” (abused) and “no touch” (neglected). Couples who say hello with a hug keep their skin bathed in the “good touch,” which can inoculate your spirit against anonymity in the world.

7. Say “I love you” and “Have a good day” every morning
This is a great way to buy some patience and tolerance as each partner sets out each day to battle traffic jams, long lines and other annoyances.

8. Say “Good night” every night, regardless of how you feel
This tells your partner that, regardless of how upset you are with him or her, you still want to be in the relationship. It says that what you and your partner have is bigger than any single upsetting incident.

9. Do a “weather” check during the day
Call your partner at home or at work to see how his or her day is going. This is a great way to adjust expectations so that you’re more in sync when you connect after work. For instance, if your partner is having an awful day, it might be unreasonable to expect him or her to be enthusiastic about something good that happened to you.

10. Be proud to be seen with your partner
Happy couples are pleased to be seen together and are often in some kind of affectionate contact — hand on hand or hand on shoulder or knee or back of neck. They are not showing off but rather just saying that they belong with each other.

Happy couples have different habits than unhappy couples. A habit is a discrete behavior that you do automatically and that takes little effort to maintain. It takes 21 days of daily repetition of a new a behavior to become a habit. So select one of the behaviors in the list above to do for 21 days and voila, it will become a habit…and make you happier as a couple. And if you fall off the wagon, don’t despair, just apologize to your partner, ask their forgiveness and recommit yourself to getting back in the habit.

If there was one key to happiness in love and life and possibly even success it would be to go into each conversation you have with this commandment to yourself front and foremost in your mind, “Just Listen” and be more interested than interesting, more fascinated than fascinating and more adoring than adorable.