What is OCD


What is Obsessive Compulsive Disorder, Symptoms of OCD

Have you ever dwelled on something that happened, to the point of feeling like you couldn’t stop thinking about it, even if you tried?

Imagine that feeling multiplied by 100.

People who struggle with Obsessive Compulsive Disorder (OCD) are quite familiar with this feeling and it becomes worse during periods of high stress. OCD is an anxiety-based disorder in which thought patterns become stuck.

For people with OCD, their behaviors can become ritualized in an effort to reduce feelings of anxiety.

These repetitive behaviors might alleviate some distress initially, but the underlying stressors remain.

The person struggling with OCD might then increase the behaviors or dwell on the thoughts even more. This cycle continues and causes disruption in the person’s life.

The most stereotypical example that we frequently hear about with OCD is hand washing.

Not all OCD is created alike.

Causes of OCD

on my website: https://www.livingwithfinesse.com/teyhousmyth/what-is-ocd/


Q&A: College and Alcohol

Teyhou Smyth LivingWithFinesse

Client: Hi Doc. I am a college student in a fraternity house. I find myself drinking heavily on weekends to keep up with my friends.  I wake up the next morning with a hangover and feel physically unwell. I have also blacked out a few times in the past which has really scared me as I don’t remember anything.  Does this mean that I have a drinking problem?


Thank you for your question.  The college years are informative years and can be challenging as one tries to keep up with the pressures of schoolwork as well as socializing with others.  

The socializing aspect of being in a fraternity does involve binge drinking behavior which can cause issues in functioning physically and mentally.  

I would encourage you to be introspective and see how your addictive behaviors are serving you and disrupting your life; paying particular attention to the consistency and frequency of your alcohol use.  If further action is needed, I would get in touch with counseling office at your university so that you may begin to talk to someone about your concerns.

One of most challenging aspects of accepting any type of addiction is the necessity to change one’s friends and support network.  Spending time with people who continue to engage in addictive behavior is a recipe of relapse and the tricky addict-brain wants what it wants an will justify behaviors that aren’t healthy with kicking the addiction cycle..


Strategies for Coping and Managing Histrionic Personality Disorder

Histrionic Personality Disorder

My last article explained what is Histrionic Personality Disorder. Here we will talk about Recognizing and Coping with this condition.

Another Form of Narcissism! Drama Queen Syndrome:

Histrionic Personality is one of four “Cluster B” personality disorders currently recognized by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM 5). It is a relatively uncommon diagnosis, with approximately 1.8 percent of the population being affected.

Often, those who deal with this disorder are known for having extreme emotional responses that can quickly change.

People who manage this disorder feel anxious if they are not receiving attention.  There is also a desire to be the center of attention in group settings, and if needed, someone with Histrionic Personality will engage in dramatized or provocative behaviors to get the attention they crave.

Sometimes this behavior manifests as sexually seductive or theatrical.

Relationships can be challenging for people struggling with Histrionic Personality Disorder.

Others may perceive the person as “fake” or overly “dramatic.” A person who deals with this disorder may also feel as if they have a closer connection to others than they actually do, which can result in feelings of rejection and loss.

These feelings feed back into the sadness that perpetuates this diagnosis, resulting in exaggerated responses and reinforcing the cycle of disconnection from others.

A person who manages Histrionic Personality Disorder may also struggle with meaningful self-expression.

Part of the struggle for someone with this disorder is the ability to use in-depth language. Often there is a reliance on vague terms that may seem shallow, instead of more descriptive ones. This style of communication may come off as disingenuous.

When this is combined with an excessive need for attention and compliment-seeking behaviors, it can indicate self-absorption, which can also make interpersonal relationships difficult.

For those managing Histrionic Personality Disorder, there is often an over-reliance on physical appearance to gain attention.

Often, appearance is a very sensitive topic for someone who struggles with this disorder. The slightest criticism or lack of needed compliments from others can be interpreted with great shame and despondency.

Follow the link to my website Coping Strategies for Managing HPD


Q&A: Recreational Drug Use

Teyhou Smyth LivingWithFinesse

Client: Hi.  I am a recreational user of cocaine on weekends and don’t feel like it it is causing me any problems but I am wondering if regular use will lead to addiction? Should I be concerned?


Thank you for your question.  The general answer will differ based on each individual’s impulse control and addictive behavior patterns.  By nature, drugs can be highly addictive due to the increased stimulation and dopamine levels which leave you feeling elated.  Dopamine reinforces the behaviors since it is a pleasure hormone of the brain.

Addiction can comes in many forms.  Most addictions begin as casual use and offer a soothing distraction from a difficult circumstance.  The behaviors starts as a well deserved break but somewhere along the the way it shifts from being a choice into a need.

Individual or group therapy options can be a helpful way to work on recovery from addiction.




Mental Health Insurance dilemma in America

Mental Health Insurance dilemma in America


It’s the nine-letter word that causes so many of us to cringe in anticipatory dread.

What’s your deductible? Is that provider covered under your plan? Do you need a referral from your primary doctor?

It seems we are at the mercy of our insurance plans at an increasing pace these days.

So much of what we can access for care and treatment of our illnesses depends on the whims of the insurance giants. In a money-making business such as insurance, arbitrary rules about what types of treatments and procedures are covered can make or break our overall health.

Mental health in the world of insurance is even more complex and disheartening.

Often providers of mental health services have to be mindful of their client’s coverage options, impossibly high co-pays and out of pocket coverage for those services not deemed “legitimate” by insurance companies.

Certain mental health diagnoses are highly scrutinized or outright denied by insurance companies, leaving consumers responsible for treatment that they had rightfully assumed would be covered. It seems that consumers and providers are under represented in the insurance game, and the people who are benefiting the most from these injustices are the large corporations making the rules.

Insurance companies have legal obligations and oversight, just as any public-serving entity.

Because of public concern regarding the lack of mental health coverage by insurance companies, the mental health parity law was passed in 2008 that holds insurance companies responsible for covering mental health services equal to that of physical health services. Even with this provision, many necessary services are cut short or not covered at all; it seems to be an unenforced law with good intentions.

Even services that are covered often have impractical and arbitrary time-limits imposed.

Treatments such as Cognitive Behavioral Therapy require a longer length-of-stay than many physical health treatments. This can create an “apples and oranges” comparison with which it is difficult to create true parity.

Trauma-based work is even more complex and cannot be expedited to meet the demands of an insurance company. Human emotions and the physiological components of trauma have their own timeframe. While it is understandable that certain restraints had to be placed on coverage to prevent fraudulent use of resources, there must be a happy medium that meets the needs of consumers.

The impact of the limited coverage for mental health results in negative outcomes for consumers.

With limitations on amount of coverage for services and lower rates for mental health providers in agencies than in medical settings, many mental health agencies and individual practitioners are opting to avoid becoming credentialed with certain companies. This results in limited access to services for consumers, as there are too few mental health providers offering covered services in many areas.

Teyhou Smyth is a Mental health professional in Los Angeles, London and Ireland.

Our culture is becoming more health conscious and deliberate in our efforts to care for our minds and bodies.

Increasingly, we are seeing trends toward meditation over medication and a focus on attending to the entire self as a unified entity. These trends are in line with our cultural values and insurance companies need to catch up to meet the needs of consumers and represent the shifts our society is demonstrating.

Responsible delivery of service to consumers should mean properly covering the needs of those enrolling in insurance plans.

Currently, people feel hemmed in by the limitations of their plans. Better plans are often far too expensive for the average American. Lower insurance rates mean we only have access to high deductible plans, forcing people to place their physical and mental health needs into a hierarchical and often survival-based stratum.

If financial resources are limited, which they often are for people who are forced into a high-deductible plan, this means that either physical or mental health needs get benched.

No one should be forced to choose between a healthy mind and a healthy body.

If we are truly going to embrace a preventative and proactive approach toward healthcare, it needs to be backed up by insurance plans that are effective.

Advocate for Change

It may feel futile to think about the long-standing issues of insurance coverage and the needs of the underinsured. There are ways to advocate for change and make your voice heard.

Write to your legislators:

Contact your state and federal representatives to discuss your concerns about healthcare coverage and mental health parity issues.

Reach out to disability rights advocates:

Connect with disability rights centers in your state to learn about opportunities to help with advocacy for mental health insurance coverage in your state.

Join forces with others for social justice:

Start talking to people about your concerns. Write an op/ed piece in some newspapers and start a dialogue on your social media feed. The more people talk about it, the more it takes on its own momentum and this is how revolutions begin. Be tenacious.

As much as we gripe about insurance companies, they are an important part of our access to healthcare, particularly if something catastrophic happens with our physical health.

The best thing we can do is advocate for change to ensure that our insurance companies offer adequate coverage to meet our physical and mental health needs.

Whether you can afford a high-end plan or are stuck with a plan that doesn’t even cover necessities, it is in our collective best interest to attend to these issues and repair the disconnect between consumer needs and what insurance companies offer.

Allowing for status quo simply perpetuates a long-standing problem that relegates mental health as an unnecessary service.

For people with depression, anxiety and other diagnoses, quality of life is negatively impacted in the absence of mental health services.

Rates of suicide, criminal involvement and other social problems arise when mental health services are not adequately provided in the community. These problems come with other price tags; some which are monetary and some of which are simply tragic.

Part of a healthy community is the ability to identify the areas of risk for people who are most in need. Insurance is an important service; it should meet us where we are with a focus on physical and mental health.

Another Form of Narcissism! Drama King-Queen Syndrome!

histrionic personality disorder

What is Histrionic Personality Disorder

Everyone enjoys being near a person with charisma. The energy they infuse into a social situation can be contagious and enigmatic.

Often seen as “the life of the party,” people with Histrionic Personality Disorder are most comfortable in this type of situation. The challenge happens when the opportunity to be center-stage is gone.

Perhaps you have met someone with Histrionic Personality Disorder. Generally, people with this condition rely heavily on their physical appearance and depend on compliments and praise to feel good.

Sometimes it can feel challenging to truly connect with someone who struggles with this disorder, as the emotional landscape can change rather quickly. When a person with HPD senses disconnection, they may express a heightened emotional response and this can feel manipulative to others.

If you care about someone with this condition, it is important for you to remember some key points about the disorder.

Full article available at:


Coping Strategies for Borderline Personality Disorder

borderline personality disorder

Another Form of Narcissism! Drama Queen Syndrome:

Earlier this week I wrote an article about what is Borderline Personality Disorder. Relationships are challenging, even in the best of circumstances. When someone you love has a diagnosis of Borderline Personality Disorder, the relationship can be even more difficult.

Borderline Personality Disorder is a condition in which individuals fear abandonment and respond in emotionally reactive ways.  It may seem as if the person with this disorder is looking for conflict, at times, but this is a conditioned response to their internal dialogue which anticipates abandonment and judgment at every turn.

If you are in a relationship with someone with Borderline Personality Disorder, whether it is a friend, family member or intimate partner, it is important to understand the disorder.

The better you understand Borderline Personality Disorder, the more you can observe the signs and symptoms and improve your relationship.

Talk to your loved one about it:

The thought of talking with a loved one about their mental disorder may feel daunting, but once you begin, it will be a relief for both of you. Ask questions about the disorder and how they feel about it. Find out how you can be supportive.

Keep your perspective:

When you care about someone with this condition, it can feel like you are walking on eggshells to avoid conflict. Try to keep your focus on the person beneath the symptoms.

Remember that some of the more trying parts of this disorder are based out of pain that stems from deeply-seated feelings of shame and low self-worth.

When someone feels they are worth nothing, their natural assumption is that you believe the same thing about them.

Establish some ground rules for yourself:

In order to avoid getting caught up in unwindable, cyclical arguments it is important to set some general rules to abide by. It may even help to write these down and refer to them during difficult periods in your relationship.

Explain your ground rules to your loved one with Borderline Personality Disorder (when they are in a good space) so that they know how you will respond to certain situations ahead of time.

It might help to think of yourself as the counterbalance to the erratic feelings or behaviors of your loved one when they are experiencing a flare up. It will be important for you to maintain a level, calm presentation and to step away from situations that feel amped up and harmful to you or them.

Create a crisis plan:

Work with your loved to develop a crisis plan. Sometimes with Borderline Personality Disorder, emotions and behaviors can escalate quickly. Be sure to include the local crisis hotline number in your plan so that you can make that call for additional help if your loved one becomes suicidal or self-injurious.

Self-Care for Loved Ones

If you have a relationship with someone with Borderline Personality Disorder, be sure you are paying attention to your own mental health needs. Invest in your own emotional health; talk to a counselor, engage in some meditation, massage or other healthy outlets.

Keep in mind that you can not (and should not) be the only person providing support to your loved one. Encourage them to establish friendships and connections with others and you should do the same. You are not going to ‘cure’ someone of this condition.

Your loved one can access specialized therapy to help manage the symptoms and this can offer dramatic improvements in functioning. You cannot ‘love’ someone out of their mental disorder, and it is important for you to keep your eye on staying within your role in their life. If you intend to stay in a relationship with someone with Borderline Personality Disorder, it is crucial that you pay attention to your own wellness and stay strong in your own knowledge of self.