THE PROS AND CONS OF USING ONLINE SUPPORT GROUPS FOR ADDICTION, GRIEF, PTSD OR EATING DISORDERS

PHOTO | David Lezcano

As we enter 2019, the Internet has ushered in a new trend of online support groups. These online communities have been a game changer for some people who struggle with addictions such as alcohol, drugs, eating disorders, PTSD, anxiety, and grief. Can people reap the same benefits from online groups as they can in ‘real life,’ in person settings? We turned to Carrie Carlton LCSW at Beachway Therapy Center in Boynton Beach, Florida for answers.

Benefits of Online Support Groups

1. Members can log in any time they need help. For instance, every time you feel a strong urge to drink, you may turn to community members for immediate support. Carrie Carlton offers, “This would be impossible with traditional face-to-face meetings. 24/7 support is especially crucial in the first, most fragile phase of alcohol withdrawal.

2. “Online communities tend to be more diverse, which gives you an insight into the struggles of people from different backgrounds. At the same time, the differences such as age, ethnic background, or gender are not obvious unless disclosed, which contributes to an egalitarian atmosphere,” says Carrie Carlton.

3. People suffering from social anxiety, disabilities, autism, or illness can participate in online meetings with more ease.

4. For those who live in small towns where meetings may be far away, or sparse, online access is very convenient.

5. Online meetings protect anonymity. Carrie Carlton explains that “Even though AA and NA (Narcotics anonymous) have rules about keeping who you see and what you hear in that room private, for people who are shy, truly being “anonymous” online might be helpful.”

LIMITATIONS OF ONLINE SUPPORT GROUPS

Lack of commitment: Though easy accessibility can be an advantage, it can also make it harder to form an attachment to the group and the individuals in it. Carlton states that “Sacrificing more time and energy to get to meetings tends to build more commitment to the group and decrease the chances that an addicted individual will stop attending and relapse.”

Online bullying: Unfortunately, cyberbullying is still a large problem. It can be very easy for a bully to sign up for an online support group, get access to chat rooms and message boards, and post abusive messages or even try to trigger people into relapse. Carrie Carlton points out that, “People tend not to try this kind of thing at in-person meetings as they would have to deal with immediate consequences and would not be anonymous.”

Miscommunication: Carrie Carlton points out that, “It can be difficult to convey tone online. People tend to have significantly more misunderstandings when interacting over the Internet because they can’t hear each other’s tone of voice or see facial expressions.” This can possibly be helped by the use of video conferencing, but lag and poor picture quality can still cause problems.

Lack of True Fellowship: With groups such AA, people are able to meet face to face and often see the same members repeatedly at meetings. Group members introduce themselves by first name each time they speak. This allows other members to put a face with a name. In addition, AA and other support groups often have fellowship activities such as yoga, holiday dinners, or other group activities. It is very difficult to foster this sense of community and closeness in the virtual world.

WHAT IS THE IDEAL ANSWER TO INTERNET VERSUS “REAL LIFE MEETINGS?”

“For anyone who is a danger to themselves or others, they need a much higher level of care in a confined facility, be it a detox, rehab, or in severe cases, a psychiatric hospital. Once addicts/alcoholics are “stable” the best-case scenario is to attend meetings regularly, get a sponsor, and practice “fellowship” with others in your group,” says Carrie Carlton. Online support groups can be a helpful supplement to in-person meetings, one on one sessions with a therapist, or intensive outpatient therapy. Thanks to 21st-century technology and the prevalence of 12 step meetings, there is no reason people have to choose one method or the other.

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POSSIBLE CAUSES OF POST TRAUMATIC STRESS DISORDER

Typically, when we hear PTSD, Post-Traumatic Stress Disorder, we think of military veterans who experience vivid and often debilitating panic-inducing flashbacks of their time at war. With June 27th being National PTSD Awareness Day, a condition resulting in over 3 million cases in the US annually, we thought it best to gain some clarity. We connected with Dr. Sanam Hafeez, a PTSD expert and NYC based neuropsychologist and Teaching Faculty Member at Columbia University Teacher’s. Dr. Hafeez who shared some common causes of post-traumatic stress disorder and how to cope.

Understanding the symptoms of PTSD

Typical symptoms of PTSD include distressing nightmares, that awaken you in a state of panic, persistent thoughts and recurring flashbacks about the traumatic experience, numbing or avoidance of memories of the trauma, triggered emotional responses and just an overall on-edge feeling. “Anyone can have PTSD symptoms and oftentimes they may feel judged for not being able to shake off something others may perceive as not being a big trauma. Many people suffer in silence,” cautions Dr. Hafeez who helps people after exposure to these traumas.

Possible Causes of Post Traumatic Stress Disorder

Motor Vehicle Accidents

One quarter of the population will be involved in automobile accidents that result in serious injuries. “For those who come seeking mental health treatment after a car accident, 60 percent are diagnosed with PTSD, it’s quite common.” Symptoms may include feelings of anxiety, increased heart rate, and a fear of driving or even being a passenger in a car. “Oftentimes people who were injured in a car accident or even perhaps witnessed a fatality will be in shock. Then over time they begin to reply the accident. This is when it’s advised to seek therapy to cope with this trauma, advises Hafeez.

Military Combat

As stated earlier PTSD is commonly associated with combat veterans with 31% diagnosed. Combat PTSD symptoms can include carrying a weapon when not necessary, seeing threats where none exist, and outbursts of physical violence. “Having these symptoms just means that you are have a reaction of stress to a nearly impossible situation,” says Dr. Hafeez.  Service animals and emotional support pets are a start. Meeting with a PTSD specialist for therapy along with self-calming activities such as meditation, deep breathing, painting or yoga are recommended.

Personal Assaults

Sexual assault, mugging or robbery are life-threatening situations that can instantly trigger post- traumatic stress disorder. When events like these occur, victims will try to avoid reminders of the trauma, always be on guard, and may have problems in daily living. “People who went through assault often report feeling unsafe and on edge as if they are expecting someone to attack them again. They also experience terrible flashbacks with disturbed sleep. Turning to alcohol or drugs isn’t uncommon which is why it’s so important to seek therapy,” explains Dr. Hafeez. Group therapy could be very helpful because there’s comfort in not feeling alone.

Natural Disasters  

Natural disasters cannot be controlled which makes it more difficult to prevent the anticipatory anxiety. Devastating life altering events such as tornadoes, earthquakes to hurricanes, and fires often put people into a survival mode for up to 18 months, studies show. Symptoms usually peak during the first year and in most cases, survivors get better with time once they have accepted the reality of the event. “When we look at natural disasters that result in loss of lives, assets, and personal property, there’s a sense of hopelessness that can be incredibly overwhelming. The best way to deal with this situation is this is through therapy which is often difficult to receive right away given people get displaced and are focused on basic survival,” says Dr. Hafeez.

Emotional Abuse

Emotional abuse is an attempt to control, it’s more about manipulation through put downs, name calling, blame shifting, instilling fear through ultimatum and threats, and making the person question their recollection of conversations and events. Typically, there is an overstepping of boundaries and the person feels as if they are walking on eggshells. Their every decision comes with doubt and anxiety as whatever they choose may upset their abuser. “Usually the PTSD begins after the relationship has ended or in the case of emotionally abusive parents, when the child leaves the home. They may feel depressed and fearful of being manipulated without knowing it. Helping people establish firm healthy boundaries and identifying “red flags,” empowers the victim,” explains Dr. Hafeez. “Emotional abuse is particularly insidious in that it’s feeds off the vulnerabilities and insecurities of its victims,” she adds.

About the Doctor:

Dr. Sanam Hafeez PsyD is a NYC based licensed clinical psychologist, teaching faculty member at the prestigious Columbia University Teacher’s College and the founder and Clinical Director of Comprehensive Consultation Psychological Services, P.C. a neuropsychological, developmental and educational center in Manhattan and Queens.

Dr. Hafeez masterfully applies her years of experience connecting psychological implications to address some of today’s common issues such as body image, social media addiction, relationships, workplace stress, parenting and psychopathology (bipolar, schizophrenia, depression, anxiety, etc…). In addition, Dr. Hafeez works with individuals who suffer from post-traumatic stress disorder (PTSD), learning disabilities, attention and memory problems, and abuse. Dr. Hafeez often shares her credible expertise to various news outlets in New York City and frequently appears on CNN and Dr.Oz.

Connect with her via twitter @comprehendMind or www.comprehendthemind.com

WHEN ANXIETY RISES

We loved chatting with Dr Sanam Hafeez last month in our issue as she shared tips on how to identify that you are dating a narcissist. With such great advice, we wanted to ask her about anxiety as we notice that in a lot of conversations people tend to use this word a lot when they are talking about upcoming work, making various decisions about their lives and more. We chatted to find out what anxiety is and what we mean when we say that we have it as opposed to those who have been diagnosed with an Anxiety Disorder.
 
ATHLEISURE MAG: What is anxiety?

DR. SANAM HAFEEZ: When most people say they are having or feeling anxiety they typically mean they feel out of control, pensive or worried about something in their lives. It can be an event, their career, a date, their wedding day, an important interview. Typically they deal with it, prepare and push through the situation with heightened focus. 

For those who have an Anxiety Disorder, anxiety takes a debilitating turn. 

AM: What are the symptoms of an anxiety attack and/or how do you know when one is coming on? n their mind, it's really all about them. 

DR. SH: Everyone is different. Some may feel migraines, nausea, trembling, shortness of breath, heart pounding, jittery and physically on edge.

AM: Does anxiety manifest differently in Type A vs Type B personalities? 

DR. SH: 'Type A' personalities are known to be very responsible go-getters. They focus on the end result while Type B people focus on the here and now. Type A's are typically competitive and often take on more stress in their quest to accomplish more and more. They boss around the Type B's and then the type B's have anxiety about not measuring up. Type A's and Type B's both worry about what people think of them, and have creative visual minds so they often envision worst case scenarios in a vivid manner. Type B personalities are more collaborative. These are people who don't rush to take the lead. However, some may feel anxious that they are putting their fate in someone else's hands. They also get stressed out when Type A's are behaving more aggressively and competitively. In the end both personality types can have varying levels of anxiety. Anxiety disorders can happen to anyone. 

AM: How can we overcome these feelings and what techniques can be used to maintain calm?

DR. SH: Knowing the signs of panic, what triggers you and how it presents itself in your body is important in overcoming anxiety. When you can identify what your fears are you can begin to conquer them. 

1. Deep breathing and mindfulness.

2. Focus in the moment by engaging the senses. Look at 3 things in the room (table, chair, shelf). Listen to a sound (a bird, a car, the ambient noise). Roll your tongue over your teeth. Touch something near you feel the texture. Smell something, the paper on the desk, your skin. This little exercise gets your mind off whatever thoughts are causing the anxiety and onto the present. 

3. Clear clutter! Your physical space reflects your mind. Clearing clutter will give you something to focus on and the tidy space establishes order over chaos.

4. Workout! Fitness activities that require repetitive motion such as running, walking on a treadmill, bicycling, are great because they require consistent coordination and focus. When you are focused intently on something it's difficult to simultaneously feel anxious.

5. Massage and acupuncture.

ABOUT THE DOCTOR:

Dr. Sanam Hafeez PsyD is a NYC based licensed clinical psychologist, teaching faculty member at the prestigious Columbia University Teacher’s College and the founder and Clinical Director of Comprehensive Consultation Psychological Services, P.C. a neuropsychological, developmental and educational center in Manhattan and Queens. 
 
Dr. Hafeez masterfully applies her years of experience connecting psychological implications to address some of today’s common issues such as body image, social media addiction, relationships, workplace stress, parenting and psychopathology (bipolar, schizophrenia, depression, anxiety, etc…). In addition, Dr. Hafeez works with individuals who suffer from post-traumatic stress disorder (PTSD), learning disabilities, attention and memory problems, and abuse. Dr. Hafeez often shares her credible expertise to various news outlets in New York City and frequently appears on CNN and Dr.Oz.

Connect with Dr Sanam Hafeez PsyD via twitter @comprehendMind

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Read more from the April issue and read When Anxiety Rises in mag.