The Behavioral Corner 

Hi, and welcome. I'm Steve Martorano. And this is the Behavioral Corner, you're invited to hang with us as we discuss the ways we live today, the choices we make, the things we do, and how they affect our health and well-being. So you're on the Corner, the Behavioral Corner, please hang around a while.

Steve Martorano 

Hey, everybody, how you doing? Welcome to the Behavioral Corner. My name is Steve Martorano and this is this spot on earth and in the internet, where we, you know, we sit on the stoop here and hope we run into interesting people and we hope they have interesting stuff to talk to us about. Which as the name implies, has everything to do with behavioral health, a very big topic, broad coverage. Basically, we take a look at the decisions we make, the choices we make, and how that affects our well being emotionally, physically, psychologically, that's what the Behavioral Corners is all about. and is underwritten by our good good partners on this Retreat Behavioral Health, there'll be more about them a little down the road. So we want to get right to it because we have a great topic, one that we sort of brushed upon for obvious reasons over the past year or so. But never more so than this past year. It's been an awful year, there's no other way to describe what the last 12 or 13 months has been like, for everybody, everyone in the world, bad across the board. On the other hand, it was good for stress. In fact, I know people have probably said this from the beginning of time, this seems to me to be the high watermark of stress. That's a human reaction. And so it's time to take a look at that because the stress is not something you can, you can take a pill for. It's something that has to be managed. And that's why we're grateful to have our guest here on the corner. This time Dr. Michele Finneran. Dr. Finneran is an author and a psychotherapist. She is in private practice in southern Florida and she provides her services to a different organizations, individuals, adolescents, adults, she has this particular interest, and has worked with a lot of first responders, which is going to become obviously important as we talk about stress management. Dr. Finneran.

Michele Finneran 

Thank you so much, Steve, thank you so much for the wonderful introduction. I appreciate it. Thank you.

Steve Martorano 

By the way, I failed to mentioned that she she is among all those other things a very strong advocate for mental health. So I want anybody to hear a howling in the background. That's very windy on the Corner here -- ordinarily so and I hope I don't fall down in here. So Dr. Finneran, did I get that right? Stress is not something you can really, although it's probably prescribed often, it's not really something you can cure with a pill.

Michele Finneran 

No, it's definitely not. It's definitely not something that you can cure with a pill. It's definitely a feeling that takes over. And the my definition of stress, like you said, it needs to be managed. Stress Management is oftentimes learned from our family of origin. There's also a genetic component to as well, your tolerance, level of stress and how you manage it. My definition of stress and overview is a kind of a condition or feeling experience when a person perceived that demands exceed their personal and social resources that the individual is able to mobilize. So basically, it's a maximization of a feeling that's overwhelming. A lot of people feel that their feelings of being overwhelmed or tapped out or recognize themselves as being stressed. And the first thing is recognizing when the stress is becoming unmanageable.

Steve Martorano 

Let's talk about some of the physical things that occur when someone is under stress. What goes on with their body?

Michele Finneran 

There could be a variety of symptoms that happen physically from migraines, to headaches to absolutely 100% complete fatigue. Like it's so much fatigue that they can't seem to get out of bed. And there's a lot of relation to gastro problems. irritable bowel syndrome, definitely syndromes and conditions physically, that manifests, particularly if you're the type of person that internalizes a lot of stress. It seems to manifest physically within the body.

Steve Martorano 

Yeah, it's kind of interesting. You mentioned that the among the many things that it can physically do to you, is exhaust you. 

Michele Finneran 

Yes. 

Steve Martorano 

Which puts you in bed, which interestingly enough, would probably most often be associated with, I don't want to say near depression, but specifically, depression. is stress often overlooked as a cause for some of these other things people are suffering from?

Michele Finneran 

Yes, yes. You know, the two main things that really stems is anxiety or depression and they kind You know, at times kind of go hand in hand, you know, when a person is overly stressed that overstressed becomes overlooked as something diagnoseable as depression or anxiety. And that is the pre something that,

Steve Martorano 

Yeah, it's a shame because you're leaping right over perhaps what's causing the depression. So it's interesting now that I think about the way stress works, it certainly works in my life, and everyone else's life is interesting in the following sense. I can manufacture my own stress, it doesn't have to be a case of a boy, I'm going to work today I know the boss is really going to be on me, or I have to drive on a treacherous road, you can make stress up out of thin air, can't you?

Michele Finneran 

Absolutely. And, you know, I believe that's called internal stress. It's stress that something that you happens within your body within yourself that you develop cognitively, behaviorally, physically, it's something that happens within you. There's external stresses: Boss yelling at you, road rage, whatever the case may be outside the scope of yourself, that may cause stress, as some of those external stresses are out of our control. The internal stress that we develop within ourselves is definitely one that can be managed and in our control. So there is a distinction between internal stress and external stressors.

Steve Martorano 

Yeah, some of that external stress is, in fact valuable. We'll get into this a little later. But there's bad stress and, surprisingly enough, there's stress that's appropriate. This internal stress, though, can be real debilitating. It can stop you from doing things, right?

Michele Finneran 

Absolutely. And this is one of the things that you mentioned previously, in terms of the physical manifestation, it actually becomes, the stress becomes so internalized, and so within you, it becomes absolutely 100% paralyzing, and that word is something that I want to definitely emphasize, because it prevents you from doing. Tt interferes in your level of functioning on a day to day.

Steve Martorano 

I think an example I can think of is I've, I've, and I'm sure you have run into more people who have said, "Oh, my goodness, the idea of public speaking, so terrifies me, that I can't imagine doing it." That's kind of internal process, you're getting stressed over something that's not happening, so that you don't have to do it.

Michele Finneran 

Absolutely. When people get ready, they pre-up themselves for a stressful situation. There's something called anticipatory anxiety, when you're thinking of something that you have to do like public speaking, you anticipate stress to come your way. And so that also -- that anticipation -- interferes and prevents you from actually doing what you're supposed to be doing.

Steve Martorano 

You know, it also didn't mention blood pressure, I'm sure and heart disease all absolutely affected by stress and management. Well, as I said, it's an incredibly stressful time that we're living in. So we're grateful for your expertise here, I know a little bit, we're going to talk about your work with first responders who know a little bit more than a little bit about managing stress. One of the things that you hear a lot in behavioral therapy anyway, is that if things are not right, in the situation, you find yourself in, well, that changed the situation and see if the problem goes away. You can do that with stress, on the one hand, correct?

Michele Finneran 

Externally, yes, you can try, you can try.

Steve Martorano 

But there are situations that are stressful that you cannot change.

Michele Finneran 

Exactly. Yeah, these are stress situations that are out of your control.

Steve Martorano 

And, and and as a, as a therapist, when you are confronted with that, where do you begin trying to break that down for somebody?

Michele Finneran 

So we talked about, you know, understanding that this is something that's not in your control, and letting go of some a lot of people that try to control stress that is out of their control makes matters so much worse for themselves.

Steve Martorano 

Because that's a stressful thought.

Michele Finneran 

Absolutely.

Steve Martorano 

I can't control this, right?

Michele Finneran 

So many people they tried to, you know, try to live in that bubble, you know, they try to control of everything. And when things get outside the scope of that it becomes externally stressful. So I tried to like, let go of some of the things that you can't control. And maybe you know, let the universe like your higher power, let other entities kind of take over because you're not supposed to control everything. That's not the way it works. You can control some things and that are in your scope. But there are certain things that you're not able to control. So let's stop trying to make things that we can't control controllable, and let them just naturally and organically happen. Sometimes those situations turn out to be the best outcomes.

Steve Martorano 

Most of the cliches that we know about everything turned out to be true. otherwise it wouldn't be cliches. One of the cliches that we all grow up with is keep a pleasant thought. Technically, that really can work. I mean, someone who always goes to the dark side, their immediate default position, when confronted with some news or some situation is they go to worst case scenario. That's a bad idea, isn't it?

Michele Finneran 

Yes, I believe that people do that, because it's serving some sort of purpose for them. It's serving some sort of maladaptive purpose for them. And that's why they go there. If it's serving some type of maladaptive purpose for them to go there, then they continue to do it.

Steve Martorano 

If I go to the worst place first. When that doesn't happen, my anxiety level will go down, my stress will diminish. Is that what they're doing? Are they doing something like that? 

Michele Finneran 

I think when people go to the worst case scenarios, and I've seen a lot of people do this in my practice, and even in my family and my support systems, they go to the worst case scenario, in order to it's like a defense mechanism they prepare. It hasn't happened yet. But they prepare themselves for the worst case, just in case it happens. The problem with that, though, Steve, it becomes a self fulfilling prophecy, like you manifest into the worst case scenario, because you are now they're trying to prepare for something that hasn't even happened yet. 

Steve Martorano 

Yeah, it probably works in a deeply unconscious way. The only thing it's always occurred to me about folks like that, is that no matter what the ultimate truth of this situation winds up being when you begin at the worst spot you have a longer period of time, before you realize that it's not as scary as you thought it was. I guess my my go to responses, "Hey, you can always freak out." Yeah, don't make that the first thing to do. Make it the last thing 

Michele Finneran 

Exactly. Exactly.

Steve Martorano 

Make it the last thing to do. And then there's the other side of that, where you see people who sort of like, oblivious to it all, that we often think that personality types a little weird to? What do you mean, you're not freaked out? There's a pandemic going on.

Michele Finneran 

Right. There are certain levels that people how it manifests with within them and what they do with it. It varies on so many different ways and levels, depending on the person. 

Steve Martorano 

Speaking of pandemics, what have you seen in your practice with regards to stress and how severe it is during these times?

Michele Finneran 

In my practice this past year, there are three levels of areas that are really has heightened and continue to stay at heightened throughout this pandemic. One is the rates of suicide has gone up tremendously. The rates of domestic violence has gone up significantly, and the abuse and dependency of substance abuse has risen to an ultimate high. Those three areas of behaviourally since this pandemic started has taken form. Also, people have lost the sense of having routines and functioning on no structure at all. And that is something that therapeutically, I have to reteach people how to live on a day to day basis without the structure of going to school of going to work or working remotely. You know, it's a different life that we're living right now. And so I have to reteach people and I have tried to get them to adapt and adjust to having somewhat of a structure in their lives. So they're functioning.

Steve Martorano 

There's nothing more upsetting on a day to day basis for almost anyone, then that they're well established. routine gets disrupted?

Michele Finneran 

Absolutely.

Steve Martorano 

I mean, it can cause stress, when that's just a minor disruption.

Michele Finneran 

It throws people off completely. Yeah, I feel like the person that can be a little bit flexible in their routine and adapt and adjust. They're going to have the better outcomes.

Steve Martorano 

Yeah, our guest is Dr.Michele Finneran. She's a psychotherapist in the South Florida area. She is talking to us specifically about stress management. There's a month for everything, as you know, April is in addition to whatever else is Stress Awareness Month. So we're talking to folks like Dr. Finneran about this. Talk to me about some of the techniques that you would tell somebody can help them lower their stress levels, you know, sort of get on and more even keel.

Michele Finneran 

Yes, there are several things that strategies that we have to identify. Number one, we have to recognize when they're stressed, and when there are symptoms of stress. We have to recognize that and when it becomes unbearable and unmanageable, we have to allow ourselves to ask permission for help seek out help when we are unable to manage it ourselves. We have to also be aware of our limitations where our family can do our job in our of ourselves, we have to maintain responsibility in our daily responsibilities and duties. And sometimes there are times where there is a lot going on. And we have to take an adult timeout, you know, when you tell your child, you're becoming too emotional, you're crying too much, maybe you're having a tantrum, maybe you need to take a timeout. Well, adults also need to take a timeout to kind of regroup and compose themselves a little bit when things become all encompassing. You know, put more variety in your job in your life, so you don't get mundane, and you get bored with your type of lifestyle that you're living. I would say if you can safely get out of your area, try to take a little vacation, a little getaway if you can to change up the scenery, change up your environment, safely. If you can't, that can happen. Try to change the little things that kind of gnaw at you. What you can and accommodate and adapt to just things that you cannot change. I think organizing your time to concentrate on vital tasks and admit stress is a real problem. It's a it's a big interference in people's lives. And let's not try to cover up let's try to work with it. Let's try to work so what the outcomes are not like paralyzing to you. I think it's important to distinguish what is going on that stressful in terms of your job, your home life, you know, things that you can change things you can't change, and then set some boundaries and some priorities for yourself with people that are around you with it with your partner, with your family members, with your boss, what's manageable, what things that you can do with things that are out of your scope of what you can't do, and communicate that.

Steve Martorano 

You know, because this thing is set against the backdrop of the pandemic, it's easy to make a list of the things that would cause stress and how to manage some of that. Have you in your practice or in the field in general, do you ever come up against a patient who has a sort of, I don't know, undifferentiated stress, they can't put their finger on what's making them -- what's stressing them out?

Michele Finneran 

Does that happen? Absolutely. They know something is wrong. They know something doesn't feel right. They know something's happening to them, they can't really place their finger primarily on what it may be. And with that being said, it's not like a huge, you know, outlined kind of thing that's in their face. And you know, stress can happen in so many different ways. It could be very secretly, it could be very discrete. It could be secondary, it could be you know, multiple secondary stressors, you know, that come late, you know, and collaborate together that promote some anxieties, some feelings of being overwhelmed. So there's there ways of manifests, yeah.

Steve Martorano 

Yeah, and you're an expert. So you would naturally go in those specific areas? What if the extreme case of someone for whom those triggers or potentialities don't exist? And they still feel that there's something wrong? And I'm stressed about it? Do you first have to get to the place where they got to acknowledge that that's an irrational attitude?

Michele Finneran 

Well, it may be very rational, or it might not be conscious. So the first thing I do is I assess kind of, like, when did this start happening? How long has this been going on? When it starts feeling off or not settled or not right? What was happening your life at that time? What was going on in your life circumstances or within yourself at that time? and build from that, you know, bring it to a more conscious level.

Steve Martorano 

Okay, I guess the other day can't tell anybody who's in pain, that it's not nothing. 

Michele Finneran 

Right. 

Steve Martorano 

We have more on stress management with with our guest, Dr. Michele Finneran. Here in the Behavioral Corner. But we'll pause if I may, for a little housekeeping. We have to remind folks, it's very important that you find us if you like us, please follow us, Facebook, Instagram, in your car. If you're the neighborhood, you can follow me in that as well. We are particularly interested on the Behavioral Corner in hearing back from you. And while it's true, no one likes critics, I certainly don't. We're open to any suggestions you may have about things you want to hear us talk about on the Corner of things, we're getting rights things we're not getting right. Those reviews are good, do those, I guess, Apple's iTunes, the best place to do that. So just rising to that point, hoping you'll help us get the word out about the Behavioral Corner.

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Steve Martorano 

Dr. Michelle Finneran. She's PhD, psychotherapist author, and a strong healthcare advocate. She does a lot of that as well. She's here to talk to us about stress and stress management. There are a group of people they're easily identified who seem impervious to stress. In so far as it doesn't interfere with what they have to do. The ordinary examples are up for me are those extreme sports guys, big wave surfers. I mean, not that I've been to many bull fights, or any I mean, I think of a Matador and I think how in the world, do you wind up getting into that business and not go completely crazy. And among that group of people, and we see them all the time or first responders. These are people who are expert in a responding, but doing so under stressful circumstances. These people that I've talked about who seem immune to that human expression, or fear stress, are they different than other people in some way or are they just better at handling this?

Michele Finneran 

For first responders, they are trained to see things that normal civilian people don't see, that is very traumatizing to the normal person. So they have training in which to handle what they're witnessing. And hopefully there's training for these first responders and that's what I tried to help them uncover is some of the trauma that they're exposed to. A lot of first responders see so much of it, that they become immune to it. So they know automatically how to go about responding because they see it often in their professional lives.

Steve Martorano 

They are desensitized in a sense to the harsh that they have to run into?

Michele Finneran 

I do think that they are because I think for them if they're not. And you know, they're, of course, there are certain things that catch people off guard that are first responders that are disturbing to them as well but, you know, because they have seen so much of it, they often do have to decompartmentalize. And they often have to desensitize to protect their own mental health

Steve Martorano 

Problems, though, can occur later.

Michele Finneran 

Absolutely, if these things are not talked about or addressed, and process with a professional, particularly if your first responders, there's a high rate of divorce, there's a high rate of substance abuse, there's a high rate of suicidality, the high rate of all those numbing things.

Steve Martorano 

So these people that we talk about whether they're, you know, mundane, adrenaline freaks, who jump out of airplanes, and ski down mountains, and people who are doing life saving work like first responders, you seem to be saying that one can be trained for this kind of work, so that it's not completely crushing. And you can do it right, is that the same process, a physician goes under who, who has to open someone's chest and operate on them that would strike me as stressful for the person performing the operation and yet doctors, through their training can shut that down that stress?

Michele Finneran 

Well, it's part of their job, it's hopefully it's what they've always wanted to do, is something that they have hopefully have a passion for, in terms of saving lives. So to them, it's not as stressful as for there's certain personalities and certain people that cannot do this.

Steve Martorano 

I guess that's what I'm getting at because we almost began at this point. You mentioned that there are a number of ways one thing can become stressful. Your environment can cause your stress the way you grew up, the people you're around. You also mentioned that there might be a hereditary component here. So you believe that I've seen I guess, people who are just born better at handling stress.

Michele Finneran 

Um, I don't know about that. I definitely think that there are different temperaments. People are born with different temperaments and different tolerances. Yeah, I do feel that people are born differently, for example, and my family of origin. My oldest brother has a very calm demeanor. Okay, he's calm, he's collected, he doesn't really get too much to rattle his cage. My middle brother is a little bit more of an intense he's a competitor. He was in sports. So he has a more but intense approach. And I'm somewhere kind of in between. If I allow myself to get rattled, I can get rattled and heightened. And there are other times where I feel like I am able to reel it in and control myself. So we're from the same family but because, you know, our temperaments and our tolerances are so different. We're definitely different. individuals,

Steve Martorano 

This final point about treating and managing stress. Are the drugs used at all ever, when dealing with stress or...no.

Unknown Speaker 

Not elicit drugs? Usually, you know this, there's still DSM five diagnosis for stress, it's usually ramifications are anxiety or depression. So that has to be uncovered the anxiety and depression that may be causing some stress or reverse, and then the you get prescribed based on those disorders or those conditions.

Steve Martorano 

Yeah. So stress is, is treated as a symptom of something else.

Michele Finneran 

Yeah.

Steve Martorano 

But you mentioned just briefly there and passing. There is, of course, unfortunately, a whole range of self medication that goes on there, it's always the wrong stuff. A drink is not going to make you less stressful, much less more than one drink. But, you know, marijuana in my lifetime, you've seen it as well has gone from a drug that causes everything, every evil in imaginable to today, where it now cures everything. Just a remarkable 50 year history of the drug in this country. And in both cases, I think the claims were exaggerated, you know, you can go into these, you know, these medical marijuana dispensaries and get prescription that's specifically for something like insomnia or anxiety. Would you recommend anything like that or have you?

Michele Finneran 

No, I don't recommend marijuana as a way to relieve stress. I think it's a drug, you know, it's an illicit drug. I believe that's a form like drinking too much alcohol or drinking alcohol to relieve an intense feeling. I think these are all numbing agents. And now, you have a secondary problem. You now you have not only are you stuck with a primary stressor that you're numbing, but you also have a dependency on a substance use.

Steve Martorano 

Yes, for sure.

Michele Finneran 

Yeah. Now you have two problems.

Steve Martorano 

I'm sure many of your colleagues believe that marijuana is not a stress reducer is going to come as a shock to tens of thousands and millions of Grateful Dead fans all over the world, who seemed the least stressful people I've ever seen in my life. Dr. Finneran, I know you have a new book out, is that right?

Michele Finneran 

I do. It was published by Rutledge Taylor Brands is called Surviving Domestic Abuse: Formal and Informal Supports and Services. It's on Amazon.

Steve Martorano 

And you've got a website and people want more information from you or if they're in your area. We'll put that up on the Behavioral Corner site and they'll be able to contact you. And we hope we can get you back here under less stressful circumstances in the future.

Michele Finneran 

Absolutely, I would appreciate thank you for having me, Steve.

The Behavioral Corner 

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