COVID – Understanding Recommendation for Face Masks

June 28, 2020

There is a tremendous amount of misinformation regarding use of face masks to decrease transmission of COVID. As with many aspects of this pandemic, mask use has become politicized. It is essential to understand that all science, including public health science, is evolving – which means information changes as data is accumulated. This means that recommendations change as new information becomes available. A new virus with limited to no prior information about it adds to the uncertainty. Understandably, all this uncertainty has caused many Americans to question the validity of recommendations to help decrease transmission of COVID – even the seriousness of this virus has been called into question. For example, initially there was a significant shortage of masks for frontline workers, which was why authorities were reluctant to recommend masks to the general public. It is understandable that people may look back at this old advice and not know what to believe now. I think we should trust the public health scientists and realize their recommendations may change as better data becomes available.


What We Know

COVID is primarily transmitted person-to-person via respiratory droplets. Washing your hands, staying away from people (social distancing) and decreasing germ transmission will all help to decrease spread. While high quality research regarding mask use is limited, all of the data to date supports that wearing masks while in public is a key public health measure to decrease viral spread.


Mask Effectiveness

The gold standard N95 mask is 95% effective at preventing inhalation of viral particles.  These masks are still best for frontline workers in high risk settings where aerosolization of viral particles occurs at a higher rate than among the general population. Surgical masks are less effective and cloth face coverings even less effective when compared to these N95 masks. However it is essential to understand that even a 50% reduction in viral transmission is statistically important.  For the general public, the reason to wear a face mask is to help protect others from you when you cough, sneeze or even talk and spray viral droplets into the air.  Many people who become infected can unknowingly spread COVID because they have few or no symptoms.  Wearing a mask is showing respect for others and is your way of helping lessen the spread of the virus. If we can slow down transmission then hospitals and medical care facilities will not get overwhelmed and will have a fighting chance to treat people.


Masks and Low Oxygen Levels

Masks absolutely do NOT decrease oxygen levels. As healthcare workers, we often wear masks all day in the hospital. The masks are designed to be breathed through and there is no evidence that low oxygen levels occur. There is also no evidence that cloth masks increase build-up of carbon dioxide – although there is some evidence that prolonged use of N95 masks in people with preexisting lung disease could cause some build-up of carbon dioxide. People with preexisting lung problems should discuss mask wearing concerns with their health care providers. There is absolutely no scientific evidence that mask wearing or physical distancing weakens the immune system.


What Should You Do?

Decreasing the severity of the pandemic is about statistics. To avoid this infection 100% you must isolate yourself completely, which is unrealistic for most people. In fact, doing this is not practical or mentally helpful for the vast majority of people. The next steps are to do things which limit the likelihood of spread from person-to-person. These things include hand-washing, social distancing and mask wearing. The further away you are from an infected person, the less likely you are to get the virus. Six feet is better than two feet (and 12 feet is probably better than six feet). At some point the distance away becomes statistically meaningless. Unfortunately, there is no absolute correct number. Airflow (indoor, outdoor, ventilation, wind, etc), temperature, humidity, viral load being produced by the infected person and the susceptibility of the uninfected person all play a role in how far apart you need to be. Masks are not 100% effective, but wearing a mask does decrease the risk of viral spread. Public health professionals believe that hand-washing, wearing a mask and social distancing are the keys to controlling the first wave and diminishing or avoiding subsequent waves of the virus. Mask wearing allows us to open the economy up faster. Not wearing a mask around others only worsens the pandemic, leads to more disease, and worsens the economic effects.


PLEASE wear a mask in public.

Coronavirus Protection: Thymosin Alpha-1 Peptide Therapy to Enhance Immunity

May 30, 2020

Thymosin alpha-1 (TA1) is a peptide originally isolated from thymus gland and identified as the compound responsible for restoring immune function. TA1 can help prevent healthy cells from being infected by viruses as well as make viral infections more visible to the body’s immune system so infected cells can be destroyed. The main mechanism of action of TA1 is to augment T-cell function.  T-cells come in two forms: natural killer cells and helper cells.


TA1 helps regulate the immune response by enhancing the Natural Killer (NK) cell system.  The NK cell system is the part of our immune system that destroys stressed cells in our body (such as tumor cells and virus-infected cells). NK cells are constantly on patrol, looking for harmful cells that diminish our health, like cancer cells and virus-infected cells. When NK-cells find these ‘invaders’, they activate other parts of the immune system. Unfortunately, NK-cell function, power, and activity fluctuate throughout our lifetime. As NK-cell function wears down, our response to foreign-invaders (like cancer, bacteria and viruses) response declines — our immune system does not attack and kill the ‘bad guys’ as vigorously as it should, leaving us more vulnerable to illness. 


TA1 also enhances the immune response by stimulating stem cells and augmenting the production of new immune cells. With these enhancements, the immune system becomes better able to kill bacterial, fungal, or viral infections and tumor cells. TA1 also improves the response to vaccines by stimulating antibody production. 


In 2009, the influenza H1N1 virus was first identified in the United States. It caused outbreaks of disease in several countries, triggering the first pandemic of the 21st century. TA1 was tested during that time as an immune enhancing peptide that potentiated the efficacy of viral vaccines especially in patients who had a weakened immune system. It has since been used in the treatment of several cancer and viral infections because of its direct influence of killing virally infected cells and cancerous cells. TA1 has proven to be useful in a wide range of clinical indications. Over 4400 subjects have been enrolled in clinical trials investigating the use of TA1, including primary treatment for subjects with acute infections, such as seen in severe sepsis, and for chronic infections including chronic hepatitis B (CHB), chronic hepatitis C (CHC), and HIV; as an adjunct treatment for cancers, including melanoma, hepatocellular carcinoma (HCC), and NSCLC; and as an enhancement to both hepatitis B and influenza vaccines in immune-depressed individuals.


As we age, our bodies produce less TA1. This is one of the reasons why our immune systems become compromised with advancing age. Studies have also shown that individuals who are fighting infection have lower levels of thymosin alpha 1 than healthy individuals.


Pandemic or no pandemic, TA1 is a great addition to your self-care routine. But with COVID-19 in full force, TA1 can be a power protector against the virus. TA1 helps to improve cellular functions of innate and adaptive immunity.  It has been shown to exhibit:

  • antibacterial properties
  • antiviral properties
  • antifungal properties
  • Increase vaccine effectiveness
  • Enhance function of certain immune cells
  • Strengthen your immune system


March 11, 2020

Delta-sleep-inducing peptide, abbreviated DSIP, is a neuropeptide that is believed to be involved in sleep regulation due to its ability to induce slow-wave sleep.  DSIP enhances REM sleep. REM sleep is characterized by a rapid eye movement.  A number of essential physiologic functions are attributed to REM sleep. Functions include but are not limited to synchronization of biological functions, information processing, memory storage, and a variety of functions that are thought to have a role in equilibrium.Studies show that whenDSIP was given to patients with insomnia, it offered these patients better sleep and also a decrease in tension during the day and a greater tolerance to psychic stress. Patients using DSIP at night for sleep were shown to have improvements in their overall ability to cope with problems and emotions. One advantage of DSIP is that it induces sleep ‘naturally’.  Additionally, DSIP does not extend sleep beyond the normal duration nor does it impair the normal sleep architecture. These unique traits are unlike all of the synthetic hypnotic medications that tend to alter normal sleeping patterns dramatically. Studies show higher alertness and better performance while the people using DSIP are awake. DSIP has been discussed as a pharmacological intervention to fight fatigue and sleep loss in military interventions. And if DSIP could enhance military performance, could it not also enhance athletic achievement?

How does DSIP work? No one really knows. The notion of a sleep factor has never really been accepted. Sleep is made up of so many different stages and is influenced by so many factors – many of which are still unknown – that almost any biologically active compound may be related to some stage or other in sleep.

“The theory of the origin of sleep which has gained the widest credence is the one that attributes it to anemia of the brain… The idea behind this supposition has been that, as the day draws to an end, the circulatory mechanism becomes fatigued, the vasomotor center exhausted, the tone of the blood vessels deficient, and the energy of the heart diminished, and thus is the circulation to the cerebral arteries lessened.” NATURE, May 5th, 1898.

Persistent Genital Arousal Disorder (PGAD)

January 30, 2020

Persistent genital arousal disorder, or PGAD, is a condition in which a person feels repeatedly sexually aroused without provocation. The person’s arousal is NOT linked to sexual desire. Additionally, most people with PGAD experience spontaneous orgasms that do not resolve arousal. PGAD can lead to ongoing physical pain, stress, and psychological difficulties due to an inability to carry out everyday tasks. The condition can affect people of all ages. Women are more commonly affected than men. PGAD is an extremely rare and embarrassing condition. The medical community has not clinically confirmed the incidence of PGAD because as many people with the condition feel too embarrassed or ashamed to seek medical help.


Unfortunately, symptoms of PGAD can vary widely, making it more difficult to diagnose and treat.  The primary symptom is a series of ongoing and uncomfortable sensations in and around the genital tissues, including the clitoris, labia, vagina, perineum, and anus. Some people have the ‘feeling’ of an intense bladder infection — although no infection is present. Many people have other, milder bladder symptoms, like urinating frequently or urgency to urinate. Some people also have trouble defecating. Some report having orgasms every 10 seconds. Because there is no normal pattern of symptoms, it is difficult to put definite parameters around the symptoms other than saying the arousal is unwanted and distressing.  The sensations are known as dysesthesias. They can include:


  • Wetness
  • Itching
  • Pressure
  • Burning
  • Pounding
  • Pins and needles


These symptoms can lead the person with PGAD to feel consistently like they are about to experience orgasm, or the person may experience waves of spontaneous orgasms. However, as previously mentioned, these symptoms happen in the absence of sexual desire. Climaxing may temporarily alleviate symptoms, but they may return suddenly within a few hours. Episodes of intense arousal may occur several times a day for weeks, months, or even years.  Because of this, the condition can lead to psychological symptoms due to the persistent discomfort and impact on day-to-day living. These may include:


  • Anxiety
  • Panic attacks
  • Depression
  • Distress
  • Frustration
  • Guilt
  • Insomnia


People with chronic, or incurable, persistent genital arousal disorder may eventually lose their notion of sexual pleasure, because the orgasm becomes associated with relief from pain rather than an enjoyable experience. In fact, people with this disorder often avoided sex, because it can make the condition worse. A growing body of research suggests that PGAD is often missed or misdiagnosed. Though vastly more common in women, the condition is considered a version of priapism, where men have persistent and sometimes painful, sustained erections. The psychological consequences can be significant: depression and anxiety being the most common.  In addition, many people experience shame and misunderstanding of what is happening to them.


PGAD affects the nerves and can lead to chronic pain and discomfort.  Sexual stimulation, masturbation, anxiety, and stress can trigger PGAD. Some people find that urinating can result in such severe arousal as to be painful. The person with PGAD cannot usually identify the triggers to avoid them, and the causes of the ongoing condition are largely unknown. In some women, stress causes the onset of the disorder. Once the stress is alleviated, the condition tends to calm. Because of this, some think that PGAD may be a psychologic disorder. However, this is not the case in every presentation of PGAD. Research has implied a link between PGAD and the veins, hormone fluctuations or depletion, nervous system issues, and chemical changes after using some types of medication. Some studies suggest that PGAD can be caused by various conditions affecting the nerves that carry sensation from the genitals. One common cause is due to growths on the nerve roots near the bottom of the spine — Tarlov cysts.  Tarlov cysts are sacs filled with spinal fluid that appear on the sacral nerve root. Sacral nerves at the bottom of the spine receive electrical signals from the brain, and they relay these instructions to the bladder, colon, and genitals.  It is thought that pressure on the nerve roots cause disorder. Surgical removal of these growths, however, does not always relieve symptoms, suggesting that this is not the only etiology. Other conditions that damage lower spinal nerves, herniated disks for example, can also cause PGAD.  Other studies have also investigated whether PGAD is caused by changes in hormones or medications.  A few studies have suggested that certain antidepressants either starting a new prescription or abruptly stopping one, has led to this condition. Other research suggests that PGAD can be caused by skin infections, irritation in the genital area, or thinning of the skin due to reduced estrogen levels after menopause. Epileptic seizures and scar tissue from a trauma that puts pressure on the spinal nerves or stretches them can also be a cause. However, in many cases, the cause is unknown, which adds to the difficulty in diagnosing and treating the disorder.


It was not possible until recent years to formally diagnose PGAD.  Medical literature has only recently classed PGAD as a distinct syndrome. The Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) did not recognize PGAD as a diagnosable medical condition until recently. It was added to DSM-V.   There are currently 5 criteria for an accurate diagnosis of PGAD.


The 5 criteria are:

  • Involuntary genital and clitoral arousal that continues for an extended period of hours, days, or months
  • No cause for the persistent genital arousal can be identified
  • The genital arousal is not associated with feelings of sexual desire
  • The persistent sensations of genital arousal feel intrusive and unwanted
  • After one or more orgasms, the physical genital arousal does not go away


The above criteria are considered to be the only valid criteria established to date for a PGAD diagnosis.


The treatment of PGAD usually centers on managing symptoms, due to the often-unclear causes of the condition. Many people don’t mention it to their medical provider due to embarrassment.  Often many opt to suffer in silence. If more people were aware of this condition, the emotional consequences would certainly be diminished.  Self-harm is a major problem among people with PGAD. Surgery may treat the problem, if the cause is a Tarlov cyst, but because the cysts are seen as having no symptoms, insurance usually declines payment. To ease symptoms, many people just try to avoid triggers.  Other treatments to consider include: nerve blocks, sex therapy, steroids, and anesthetics.

Is Your Body Giving You Clues About Vitamin & Nutrient Deficiency?

December 30, 2019

Any good medical provider will tell you to stay in tune with your body.  If you notice something unusual, don’t ignore it.  Some medical conditions that can be quite serious can manifest initially in subtle ways. The sooner you address whatever is going on, the more easily the problem can be remedied.  Sometimes problems can be corrected through simple changes to diet or a dietary supplement. Here are few common things to look out for.


Do Your Joints Feel Stiff? 

Everyone know that with age we see an increase in aches & pains.  But did you know that a possible cause of joint stiffness could be low Vitamin D.  Vitamin D, known as the sunshine vitamin, helps our body absorb calcium, the main building block of bone.  If you don’t get enough Vitamin D, you can have bone density loss & soreness. How do we get more Vitamin D? There are very few foods that are rich in Vitamin D.  Salmon and egg yolks are two examples – and milk is fortified with Vitamin D.  It is difficulty to get adequate amounts of Vitamin D through diet alone. The easiest way to boost Vitamin D level is by spending time in the sun. Vitamin D produced in the skin through sunlight may last at least twice as long in the body compared to ingesting it in food or supplements.  Unfortunately, sun exposure can increase your risk for skin cancer. Using sunscreen can limit the amount of Vitamin D you produce. It is not recommended that you forgo sunscreen to increase production of Vitamin D.  Be cautious about your Vitamin D intake through supplements — too much vitamin D can lead to toxicity.  Check with your doctor before staring any Vitamin D.  If using supplementation, check levels a minimum of every 4-6 months.


Are Your Nails Peeling?

Brittle nails are typically due to external factors — like picking at polish, frequent use of hand sanitizer or wearing acrylic nails. But if you don’t do any of those things or if both your toenails & fingernails are prone to breakage, you might have a low iron level. Iron deficiency results in limited oxygen to organs, muscles & tissue. One potential side effect of reduced oxygen flow is peeling and brittle nails. This dilemma can easily be fixed by incorporating plenty of high-iron foods into your diet.  The most obvious source is red meat, but if you follow a plant-based diet, leafy greens, baked potatoes with the skin on and broccoli are also great sources. For pescatarians try: shrimp, scallops, clams & sardines. Adding Vitamin C to your meal can boost the absorption of iron. Also, cooking with cast iron can increase iron content in food being cooked in it.  Once you start these dietary changes, you should starting your nails change in a few weeks.  If you don’t, then check with a doctor to test iron levels. In cases of severe deficiency, you may need an iron supplement.   If you get prescribed an iron supplement, drink it with orange juice for optimal absorption.


Are Your Eyes Twitching? 

The term for this is myopenia.  There are a variety of causes including fatigue, stress, consuming too much caffeine and alcohol. But your lids might also spasm if you are low on magnesium. If low magnesium is the cause, it is relatively easy to increase your intake. Nuts and seeds — particularly pumpkin seeds — are high in magnesium. Also, look for breakfast cereal fortified with magnesium, and stick to either whole grains or white rice and bread that says “enriched” on the package.


Have You Been Feeling Out of it Lately? 

Even though you are getting plenty of rest and aren’t fighting a cold, you feel like you are dragging. Your muscles are weak and you have to force yourself out of bed in the morning. You have trouble staying on task and have been in a blah mood.Feeling depleted like this might be evidence of a Vitamin B12 deficiency. B12 is key in production of red blood cells, which transport oxygen throughout your system. Also, B vitamins are integral in neuronal function and deficiency of B vitamins can lead to depression.  If this sounds like you, infuse your diet with B12 power foods like whole grains, liver and seafood such as salmon, tuna, clams and trout. B12 deficiency is common in vegans and vegetarians, since it comes mostly from animal protein. If you don’t eat meat, ask your doctor to test your levels.


Do You Bruise Easily?

Have you bumped into your desk only to find a black-and-blue on your thigh the next morning. Or maybe you get nosebleeds for no apparent reason. Or maybe your periods have been heavier than usual. Or your gums have been bleeding when you floss.  If these things are happening, insufficient vitamin K could be the cause. Vitamin K is a coagulator that helps blood clot properly. If levels are low, it can lead to excessive bleeding and bruising. Vitamin K is found in fermented foods like sauerkraut and aged cheese, as well as greens. If eating more of those foods doesn’t do the trick, try a high-quality vitamin K2 supplement that’s natural.


Is Your Skin Super Dry?

Scales and flakes are common side effects of arid fall and winter air, but they can also be a clue that you are low on fatty acids. Omega-3s play a key role in moisture retention. Fatty acid consumption results in greater UV protection, fewer wrinkles, plumper skin and a more even complexion.  If you are low in omegas, whip up a breakfast rich in omega-3s by adding walnuts, chia seeds & flax into your cereal or oatmeal. Eat avocado toast or a can of sardines for lunch. Choose salmon instead of chicken. 

Arousal and Sexual Desire

November 30, 2019

Positive sexual anticipation a powerful aphrodisiac. Negative sexual anticipation is also powerful and can be debilitating.  Sexual desire can make or break good sex – and a good relationship. The number one reason couples in the United States stop having sex is a lack of sexual desire.


Sexual desire is, simply, the thoughts you have toward your sexual experience — good, bad or otherwise. 


The biggest speed bump many women face, especially in midlife, is the myth that if you are not walking around turned on and wanting sex, then you have “low sexual libido” and you are sexually broken.  For these women, their ‘erotic potential’ can be significant once they figure out their own key to turning themselves on.  In order to understand how to do this, it is important to be able to make the distinction between ‘spontaneous’ and ‘responsive’ arousal. It was previously assumed that sexual response is linear.  However, that is far from the truth.  Earlier theories describe low sexual desire as a lack of ‘sexual fantasies and desire for sexual activity.’ These theories place sexual desire first, as if it was the motivating factor for an individual to achieve satisfaction. In this model, desire emerges ‘spontaneously.’ Although this is not the most common pattern of sexual desire, there are definitely some people who experience desire that way — desire first, then arousal. On the contrary, many people (especially women) experience desire as responsive.  This means that desire emerges in response to, rather than in anticipation of, erotic stimulation — arousal first, then desire. Both desire styles are normal and healthy.


Unfortunately, most women skip the arousal phase (and, as a result, skip desire) in their rush to get to sexual intercourse and orgasm. Because of this, many women who have ‘responsive desire, rather than ‘spontaneous’ desire, mistakenly assume that they have ‘low desire’.  Furthermore, they become trained to think that their ability to enjoy sex with their partner is meaningless if they don’t also feel a persistent urge for it.  In short, they have been taught that they are broken, because their desire isn’t what it is ‘supposed’ to be. These women don’t need medical treatment, instead they require a thoughtful exploration of what creates desire between them and their partners. This is likely to include confidence in their bodies, feeling accepted, and explicitly erotic stimulation. Feeling judged or broken for their sexuality is exactly what they don’t need — and what will make their desire for sex shut down.


Whether you are a woman or in sexual partnership with a woman, having an understanding of responsive sexual desire and spontaneous sexual desire is fundamental to whether or not you’re going to have sex tonight. For women who have responsive sexual desire (which is the majority), it can be really important that they feel sexually desired. If the woman doesn’t feel desire, she will probably not be inspired to have sex. Women with responsive sexual desire want you to want them.  They require erotic stimulation in order to first feel arousal then desire for sex. 


This is why so many people are addicted to what is known as “New Relationship Energy.” They need to feel hot desire and the game of pursuit to access their full erotic turn on. It’s amazing how quickly a steamy love affair can fade with a woman who has responsive sexual desire, when she feels the hot desire from her lover turn to warm desire. Think back to the lust encounters of a ‘new’ relationship. Likely you couldn’t wait to see, touch, smell, and have wild sex with your new partner. Because you spent hours positively anticipating sex, you were instantly aroused by the time you actually had sex — and it was likely wonderful! Now compare that with your thoughts of sex with your partner today. For too many women, foreplay becomes days of anxiety, of her walking on egg shells wondering when sex will be initiated. When the sex is initiated, getting sexually aroused takes twice as long (if it happens at all). Women need at least 10-15 minutes of ‘warm up’ – and ironically, that’s how long the average sexual encounter lasts. Sex is suddenly over and she hasn’t had a chance to enjoy it, even if she had an orgasm, which creates an even deeper resentment towards her partner and any future sex act.


When you hit a ‘sex rut’, you dig yourself deeper every time you have sex. To bring the zest back into your sex life, you must build positive expectations towards sex. Unfortunately, if a couple has gone years without discussing the negative circumstance, creating positive thoughts toward sex will not happen instantaneously. Especially for women who tend to hang onto anger and allow it to linger. Luckily, fixing your situation is still doable. As sex is a team sport, it’s up to both of you to make a concerted effort to persevere and bring the fun back into your relationship. 


There are a few basic guidelines to consider to help with improve your sexual desire.  Remember, good sex starts outside the bedroom. A little intimacy, affection and touch will go a long way to help a couple easily transition into the bedroom. Look for ways to have a 10-second positive and affectionate moment every day. Talk positively about sex.  Be aware of how sex is communicated between you and your partner. Being able to inject fun, flirty chat into your daily conversation – perhaps about a future sexual encounter – is a simple way to create new, positive sex feelings. Take turns planning out fun sex.  Too many couples walk into the bedroom without a plan and have the same old sex time after time. Remember, variety is the spice of life and will do a lot to enhance your sexual desire.  Next, it is important to understand what you want out of the experience and communicate that to your partner. To help your partner plan out a fun sex evening, let them know what you would like to do. Plan an “all about your partner” evening when you spoil them. Once in a while think of something nice you can do for your partner. Spoiling your partner is definitely a win-win proposition on so many relationship levels. In a nutshell, creating positive sexual desire doesn’t have to be complicated, although it might take a little time. See for yourself how positively anticipating sex can completely turn your sex life around.


Sex Tips For Lovers With Women Who Have Responsive Sexual Desire:

  1. Women with responsive sexual desire will probably not think of sex or get “turned on” without their lover or some stimulation.
  2. Use all your ‘tools’ to show a woman that you desire her:  your words, your presence, your attention, your actions, and your body.
  3. Read chapters of erotic books to each other, or look at sexy photographs or watch erotic movies with each other before initiating sex. 
  4. Use technology to flirt and express desire to stimulate her sexual response: texting, private messages, etc. 
  5. Let her know that you love her body. Tell her this more than you think you need to. Women carry way too much body shame, and you can turn her on by supporting her in feeling beautiful in her body. Don’t just tell her that you care — show her.

Emotional Abuse – What It Looks Like

October 14, 2019

“Did it ever get physical?”


This is often the first question we ask someone we know or suspect is in an unhealthy relationship. While starting a conversation about physical abuse is essential, an issue arises when it is the ONLY question we ask. Stopping short of inquiring about other forms of abuse implies that physical violence is the defining factor of an unhealthy relationship. Even worse, it conveys the message that whatever else might be going on is not that bad. This is a huge issue, because emotional abuse is as bad – and can often be worse. 

Why don’t we hear more about emotional abuse? Many people simply aren’t sure what emotional abuse actually entails. Understanding emotional abuse is complicated for many reasons. 


Emotional abuse is any abusive behavior that is not physical, which may include (but is not limited to) verbal aggression, intimidation, manipulation and humiliation, which most often unfolds as a pattern of behavior over time that aims to diminish another person’s sense of identity, dignity and self-worth, and which often results in anxiety, depression, suicidal thoughts/behaviors, and post-traumatic stress disorder (PTSD).


Breaking It Down:

1.“…any abusive behavior that isn’t physical…”

Emotional abuse is difficult to comprehend because it encompasses so much. This list delineates some, but certainly not all, behaviors that are potentially emotionally abusive:

  • Intimidation
  • Manipulation
  • Refusal to ever be pleased
  • Blaming
  • Shaming
  • Name-calling
  • Insults
  • Put-downs
  • Sarcasm
  • Infantilization
  • Silent treatment
  • Trivializing
  • Triangulation
  • Sabotage
  • Gaslighting
  • Scapegoating
  • Blame-shifting
  • Projection
  • Ranking and comparing
  • Arbitrary and unpredictable inconsistency
  • Threatening harm
  • Forced isolation


Some of the above can be part of a healthy relationship.  However, in the context of emotional abuse, the intent is malicious and these behaviors can be extremely cutting, especially when disguised as affection or an innocent remark.


2. “ …which may include verbal aggression, intimidation, manipulation, and humiliation”

The key word here is “may.” Not only is the list of emotional abuse tactics incredibly long and dependent on context, but also the particular combination of behaviors can vary greatly from relationship to relationship. As a result, we have another layer of complexity: emotional abuse doesn’t have one specific look. For example, an emotionally abusive relationship where overt aggressing behaviors like yelling, threatening and blaming are predominantly used will look very different from a relationship where only very subtle forms of abuse like gaslighting, passive-aggressive put-downs, and minimizing are used.


3. “a pattern of behavior over time”

Emotional abuse is rarely a single event. Instead, it occurs over time as a pattern of behavior that’s sustained & repetitive.This is one of the reasons it is so complicated and so dangerous. Even if you’re the most observant person in the world, emotional abuse can be so gradual that you don’t realize what’s happening until you’re deeply entangled in its web. As a result, the abuse can go unchecked as the relationship progresses, building for months, years, even decades, especially if the abuse is more covert. In such instances, the target’s self-esteem is steadily eroded and their self-doubt becomes so paralyzing that they often have only a vague sense that something (though unsure what) is wrong.


4. “aims to diminish another person’s sense of identity, dignity, and self-worth”

Regardless of how emotional abuse unfolds, the effects can be devastating. Unfortunately, these effects as well as each harmful act of abuse are largely invisible. This makes it difficult for most people to comprehend the very real risks and damage of emotional abuse. Try to picture a scene of emotional abuse, specifically someone whose self-identity has been annihilated. Can you see it? Generally, one’s mind does not know where to begin. While describing physical wounds is pretty straightforward, it is much harder to articulate emotional trauma. The parts of a person that sustained emotional abuse destroys—identity, dignity, and self-worth—are abstract and virtually impossible to picture or measure.


5. “results in anxiety, depression, suicidal thoughts or behaviors, and post-traumatic stress disorder (PTSD)”

Emotional abuse is essentially invisible, singling out the abuse as the culprit of its destructive effects is another kind of challenge and frustration. Even in cases of extreme emotional abuse, there are no bruises or gashes where the victim can point to as proof or validation.  Instead, what emotional abuse ends up looking like is a person suffering from painful yet not uncommon afflictions like anxiety or depression. It can therefore be heartbreakingly easy for anyone—whether the person inflicting the emotional abuse, a third-party observer, or even the target of the abuse—to misattribute its damage to some other cause or even blame the target who has escaped from a relationship.  In fact the abuser, tends to reach out to friends/acquaintances and even family of the victim, and devalue that person or make them appear ridiculous, insane or off-base.


The Emotional Abuser’s Typical Behavior:

Many women and men who are emotionally abused have no choice but to rescue themselves or continue to live with the abuse. Because others cannot see signs of abuse, these victims often have little or no social support.  In fact, their abuser is often quite charismatic and charming, especially to mutual friends, which is a technique often used by the abuser to further disparage their target.


Why would someone emotionally abusing you and think it’s okay? It may be a part of their behavior to control others by any means necessary to get what they want.  Certain personality disorders are common among those who emotionally abuse others. They may have an authoritarian personality – these people admit to no faults because they see themselves as right and others as wrong. If you are being emotionally abused by someone with an anti-social personality (a sociopath), you should seek immediate safety and remove yourself from the relationship, since those with an anti-social personality can become violent when they don’t get what they want. Another personality disorder in which emotional abuse may be evident is narcissism. The abuser makes everything about their own needs and desires. Narcissists may frame their actions as being helpful to their victim, but they all revolve around building their ego.


Often, abusive behavior is a direct means for the abuser to get what they want without taking responsibility for their actions. They may feel intense anxiety about losing you, so they close off your avenue of escape. Whether your abuser understands what they are doing or not, they know that they do not want you to think your own thoughts, make your own decisions, or live your own life without putting them ahead of yourself. In some way, your thoughts and behaviors are a problem for them. They do not think of you as an independent adult who can think for yourself and is entitled to your perspective. And they do not want you to think of yourself that way either. 


Techniques Used By An Emotional Abuser:

•Countering: telling you that you remember something incorrectly

•Trivializing: making you feel like your thoughts and feelings don’t matter

•Withholding: pretending they don’t understand what you’re saying

•Stonewalling: refusing to listen or engage with you in conversation

•Blocking: changing the subject

•Diverting: questioning the validity of your thoughts

•Forgetting: pretending to forget things that happened

•Denying: telling you something never happened

•Faking compassion: telling you they’re doing something harmful for your good

•Discrediting: convincing others, you’re insane or unstable

•Reframing: twisting your thoughts, behaviors, and experiences to favor their perspective


Typical Phrases Used By A Emotional Abuser:

Certain phrases come up often in relationships where someone is being emotionally abused. These phrases and others like them can convince you that your mind isn’t trustworthy. If you hear these often when you know deep inside that they’re unfair statements, it may be time to seek help:

•”I don’t want to hear that.”

•”You need to stop trying to confuse me.”

•”You’re wrong.”

•”You remember it wrong.”

•”Where did you get that crazy idea?”

•”Your imagination is getting the best of you.”

•”It didn’t happen that way.”

•”You know I’m right.”

•”You’re too sensitive.”

•”I only do it because I love you.”

•”You get angry so easily.”

•”You’re too sensitive.”

•”I have no idea what you’re talking about.”

•”You’re making that up.”

•”Calm down!”


Thoughts, Feelings, and Behaviors Associated with Being Emotionally Abused:

When someone emotionally abuses you, your thoughts, feelings, and actions may change dramatically. Where once you felt self-assured, you may now feel like you cannot trust your mind. Take some time to examine how these parts of you have changed since being with the person or in the situation. The National Domestic Violence Hotline describes what to watch for. Here is a quick checklist to guide you:

•Do you second-guess yourself often?

•Do you find yourself wondering whether you’re too sensitive?

•Do you feel confused a lot of the time?

•Do you feel like you’re ‘going crazy?’

•Do you notice that you apologize to someone often?

•Do you wonder why you can’t seem to be happy when you have so much?

•Do you make excuses for the abuser?

•Do you have an overwhelming sense that something’s wrong, even if you don’t know what it is?

•Do you often lie to avoid your partner’s, boss’s, or co-worker’s criticisms?

•Is it hard for you to make simple decisions?

•Do you feel hopeless?

•Do you feel like a loser who can’t do anything right?

•Do you question whether you’re good enough for your partner or job?


How to Deal with Emotional Abuse:

People who have endured emotional abuse (no matter how long a person was exposed to it) always find it challenging to leave the relationship, have any self-confidence at all after leaving the relationship and can often struggle to have a healthy relationship with another person in the future. The real question is how to deal with emotional abuse before it reaches that point. Here are a few suggestions for dealing with emotional abuse in relationships:

  1. Study intuition and develop a strong belief in your intuition.
  2. Realize that the abuser’s manipulations have nothing to do with who you are.
  3. Understand that you can’t change someone who is abusive; you can only change yourself.

October is Domestic Violence Awareness Month

September 29, 2019



Did you know . . . .


Domestic violence is the #1 cause of injury ages 14 – 55 — more than car accidents, muggings & rapes combined  


Domestic violence is a pattern of controlling behaviors that one partner uses to get power over the other.  It includes: physical violence or threat of physical violence to get control, emotional or mental abuse and sexual abuse


Domestic violence occurs in all races, socio-economic classes, religious affiliations, occupations & educational backgrounds



Domestic violence is rarely an isolated event — tends to increase & become more violent over time


Someone is beaten by their spouse/partner every 9 seconds


On average, 24 people per minute are victims of rape, physical violence or stalking by an intimate partner in the United States


More than 12 million women and men are victims of domestic violence over the course of a year


3-4 million people are beaten in their homes each year by partners or ex-partners


85% of domestic violence victims are women


1 : 4 women and 1 : 7 men over the age of 18 will experience domestic violence in their lifetime


Women between the ages of 20 – 24 are at greatest risk of becoming victims of domestic violence


25 – 45% of all women battered are battered during pregnancy


Half of all homeless women and children in the U.S. are fleeing from domestic violence


1 : 12 women and 1 : 45 men have been stalked in their lifetime


Witnessing violence is the strongest risk factor of transmitting violence from one generation to the next


Boys who witness domestic violence are 2 times as likely to abuse their own partners and children when they become adults


In 60% to 80% of intimate partner homicides, no matter which partner was killed, the man physically abused the woman before the murder


The costs of domestic violence amount to more than $37 billion a year in law enforcement involvement, legal work, medical and mental health treatment, and lost productivity at companies


Children who witness violence are twice as likely to abuse their own partners & children as adults


30 – 60% of perpetrators of intimate partner violence also abuse children


Children of violent homes display emotional and behavioral disturbances like withdrawal, low self-esteem, nightmares, self-blame and aggression against peers, family, animals & property



Are you concerned that someone you care about is experiencing abuse?


If someone you love is being abused, it can be so difficult to know what to do. There are many reasons why people stay in abusive relationships, and leaving can be a very dangerous time for a victim.

Abuse is about power and control, so one of the most important ways you can help a person in an abusive relationship is to consider how you might empower them to make their own decisions. Offer support :


  • Acknowledge That They Are In A Very Difficulty and Scary Situation – Be Supportive and Listen
  • Be Non-Judgemental
  • If They End The Relationship, Continue To Be Supportive of Them
  • Encourage Them To Participate In Activities Outside of The Relationship with Friends & Family
  • Help Them Develop A Safety Plan
  • Encourage Them To Talk To People Who Can Provide Help & Guidance 
  • Offer To Go with Them If They Have to Go To Police, Court, Attorney, Etc.


If you need help, find a local domestic violence agency or contact the National Domestic Violence Hotline at 1-800-799-SAFE (7233) to get help.

My Quest to Communicate Effectively

August 31, 2019

Over the past few years I have realized that effective communication is KEY to having success in both personal and business endeavors.  After a handful of failed personal relationship and just as many business snafus, it became clear that I needed to hone my communication skills.  The process has been a learning experience, and I am confident that I am not even close to mastering this skill.  However, each time I am able to practice what I have learned, I CAN say that I get one step closer to better communicating with the world around me. In my pursuit, I have found four areas of that most of us would do well to improve:  listening, non-verbal communication, emotional awareness and management & questioning.


1. Learn to Listen

Communication is a two-way process. I often fall into the trap of ‘broadcasting’, where I issue a message but fail to listen to the response.  I half-heartedly listen to others in the conversation, while primarily thinking about what I was planning to say next.

Listening is not the same as hearing. Listening means paying attention to not only the words being spoken but also how they are being spoken and the non-verbal messages associated with them. That means giving full attention to the person speaking and concentrating on what he or she is saying— and, conversely, what they are NOT saying.

2. Study and Understand Non-Verbal Communication

A large portion of any message is communicated non-verbally. Non-verbal communication includes tone & pitch of voice, body movement, eye contact, posture, facial expression, and even physiological changes such as sweating. Better understand people by paying close attention to their non-verbal communication.

3. Emotional Awareness and Management

Become more aware of your own and other people’s emotions — and better manage those emotions.

It is easy to fall into the trap of thinking that everything should be logical and that emotion has no place. However, we are human and, therefore, messy and emotional. Emotion cannot be separated from communication — nor should we try to do so. An awareness and understanding of emotions, and how to master those emotions, both positive and negative, have improved my ability to effectively communicate with others.

Self-awareness and empathy are two additional areas in which I have learned to focus. Self-awareness consists of emotional awareness, accurate self-assessment and self-confidence. Empathy is the ability to ‘feel with’ others:  to share their emotions and understanding those emotions. It includes understanding and developing other human beings, service to others, valuing others and supporting their diversity,  and paying attention to and respecting their religious and political views.

4. Questioning Skills

Questioning is crucial to ensure you understand someone’s message correctly. It is also a good way to obtain more information or keep  a conversation going. Practicing good questioning skills has allowed me to draw additional information from others and stimulate more in-depth discussion.


Transmitting Messages

I have also learned the importance of ‘transmitting’ a message effectively. Try not to say the first thing that comes into your head. Instead take a moment and pay close attention to what you are about to say and how you are about to say it.  Focus on the meaning of what you want to communicate.

Consider how your message might be received by the other person, and tailor the way you communicate to fit your objective to help avoid misunderstandings and conflict . Avoid jargon & over-complicated language, and explain things as simply as possible. Avoid language that may cause offense. After transmitting a message, get in the habit of checking that what you said has been properly understood.  Ask the person (or group) to reflect or summarize what they have heard and understood.


Other elements that can affect how a message is both transmitted and received.

Use Humor

Laughing releases endorphins that can help relieve stress and anxiety.  Most people like to laugh and feel drawn to somebody who can make them laugh. Don’t be afraid to be funny or clever. Use your sense of humor to break the ice, to lower barriers and gain the affection of others.  

Treat People Equally

Avoid being patronizing when communicating. Do not talk about others behind their backs and try not to develop favorites:  treat people as your equal and also equal to each other so that greater trust and respect can  be built. If confidentiality is an issue, make sure its boundaries are known and ensure it is maintained.

Attempt to Resolve Conflict

Try to resolve problems and conflicts as they arise, rather than letting them fester. Try not to be biased or judgmental but instead ease the way for conflict resolution.

Maintain a Positive Attitude and Smile

Few people want to be around someone who is miserable.  Be friendly, upbeat and positive in communication with others. Maintain a positive, cheerful attitude.  Stay optimistic and learn from mistakes when things do not go as planned.

If something makes you angry or upset, wait for a few hours and calm down before taking action.  If you have something negative to say, do it calmly, try to find some positive aspects to the situation and avoid giving unnecessary criticism.


Other Things To Consider — The ‘Perception Gap’

Perhaps the most significant thing I have learned on this journey is that sometimes all of one’s focusing on more effective communication is simply not enough.

Why?  Because the intention set forth can often be misunderstood by the recipient(s).

This gap between what you mean to communicate and what is actually communicated is called ‘Perception Gap’.  Perception Gap occurs when the intention you set forth and communicate is misunderstood by your audience.  Unfortunately, this happens all the time.

Here’s why:

After doing some probing, I have become aware of at least seven different forms of communication: spatial, linguistic, intrapersonal, interpersonal, musical, bodily-kinesthetic, and logical-mathematic. Communicating a step-by-step list would work well with a logical-mathematic communicator, but a conversation of this type will likely be misunderstood by a spatial communicator, who leans heavily on interconnected ideas. Intrapersonal communicators need time & space to digest internally while interpersonal communicators prefer a group discussion.

Every person has a different primary and secondary communication form. No matter how hard you try to employ the above criteria, you will likely run into trouble when your communication style strays far from another’s.

Also, communication often fails because people often don’t see themselves as others see them — there is a disconnect between internal intention & external perception.  Becoming an effective communicator requires alignment of internal intention & external perception. You cannot effectively communicate with and influence others when you see yourself one way and others see you another. The greater the gap between internal intention & external perception, the higher your stress, frustration, and ineffectiveness.


Results of a Perception Gap

Lack of good communication is just the beginning. What comes next is the ‘domino effect’, which can be quite significant:  small misinterpretations grow into large misunderstandings, which grow into erroneous stories, which ultimately erode trust, credibility and transparency, all of which negatively impact performance and destroy relationships. It is amazing how a simple conversation can have such a negative effect. It is important for people to be aware of how they communicate, specifically in relation to whom they are communicating. Get to know different people’s communication style and aim to communicate in a manner that they are more likely to receive accurately & positively.

Ways to More Effectively Communicate:

  1. Look for patterns in your miscommunication.
  2. At the beginning of an interaction, state: ‘My intention is X.’ That way, the receiver can frame how they receive the content within the stated intentions.
  3. Ask each person you communicate with to help you bridge the gap between intention & perception. Reach out to the recipient(s) in the moment, or soon after the fact and ask, ‘Here’s how I intended that message to be understood…how did you receive it?’ This requires that you are open and ready for the answer to your question. While feedback may trigger an emotional response in you, a self-aware individual will thank the person for the feedback, accept the feedback, ask some clarifying questions & aim to minimize the gap in future interactions. Doing this not only reiterates your intention but also creates a welcoming environment for clarifying questions. 
  4. What could happen if you don’t address the gap? Asking this question will help you look towards the future and importance of the current relationship.
  5. Clarify the Perception Gap in a compassionate, non-threatening way. It is easy to make the other person ‘wrong’, saying something like, ‘What’s wrong with you that you don’t understand what I’m saying?’ It is important to remember that the person is a human being with life issues that extend outside of their current interaction with you. Approach them with openness and find out where the communication gap occurred. Then listen carefully and address the situation. It is important to be compassionate, and actively non-threatening.

A Lifelong Learning Journey

For most of us, improving our communication skills is an ongoing process. There will likely NEVER come a point at which any of us could say that we have nothing more to learn about communication or that we are ‘experts’. Just because you will never be an expert, does not mean that you should not start the process of self-improvement.  Improving your communication skills will almost certainly ease and enhance all your interpersonal relationships, both at home and at work. It is an investment of time that will definitely pay off.