Estranged Adult Children: Understanding and Healing Relationships

Ever asked yourself why am I so angry all the time? Anger is a normal emotion everyone will experience at some point. Managing and learning how to calm down from anger effectively is crucial to maintaining healthy relationships and overall mental health well-being. For those needing help, medication may be an important component of a comprehensive anger management treatment plan. Dealing with anger can be challenging, but several medication for anger options are available to help. Read on for an anger medication list and other important information you should know if youre considering taking medication to control anger. Do Psychiatrists Prescribe Medication for Anger Issues?For some people who have anger issues, a psychiatrist might prescribe anger medication to treat extreme cases of rage when other treatments, such as therapy for anger management, lifestyle changes, self-help techniques, and other modifications, havent been effective.There are medications that can reduce the impulsivity and mood swings associated with anger issues. Medications known as mood stabilizers are the most commonly used. Talkspace psychiatrist Dr. Dion MetzgerCommon Types of Medications for Anger ManagementFor many people, therapy and lifestyle changes can be effective ways to learn to manage their types of anger. Sometimes, theyre not enough. In certain instances, medication might be part of a treatment plan to help control anger-related problems.Its important to note that anger isnt an official diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). Thus, no medication has been FDA-approved to treat anger. That said, several drugs are used off-label to treat anger (meaning theyre effective but werent developed for or FDA-approved to treat a specific condition).Its also worth noting that anger may be a symptom of or the result of a mental health condition, and the type of medication youre prescribed might depend on that diagnosis.Antidepressants for angerThe types of antidepressants are typically prescribed for depression and anxiety disorders, but they can also treat anger disorders by regulating mood and reducing intense anger.Commonly prescribed antidepressants for anger issuesResearch shows that selective serotonin reuptake inhibitors (SSRIs) might be an effective anger medication for some people. Some commonly prescribed SSRIs for rage or anger include:Citalopram (Celexa)Fluoxetine (Prozac)Sertraline (Zoloft)Potential side effects of antidepressants for anger issuesThere are some known and common side effects of SSRIs, including:IndigestionDizzinessBlurred visionDry mouthConstipationTalk to your doctor if side effects of Zoloft, Prozac, or other SSRIs worsen or start to affect your quality of life.Anxiety medications for angerSometimes your doctor might suggest anti-anxiety medication to help you control your anger. Anti-anxiety medications help keep neurotransmitter levels in the brain stable, which may help you manage angry feelings of anger or rage. Commonly prescribed anxiety meds for anger issuesBenzodiazepines are a commonly prescribed, fast-acting group of anxiety medication. Some research suggests they can be effective in reducing agitation. Common benzodiazepines include:Lorazepam (Ativan)  MidazolamPotential side effects of anxiety meds for anger issuesAnxiety medication can cause side effects, including:DizzinessDrowsinessSedationLoss of balanceMood stabilizers for angerMood stabilizers decrease abnormal brain activity that can cause agitation and anger. They can level out mood swings and balance the neurotransmitters involved in mood disturbances.Commonly prescribed mood stabilizers for anger issuesCommon mood stabilizers your doctor may prescribe to treat your uncontrolled anger include:Carbamazepine (Tegretol)LithiumValproic acidPotential side effects of mood stabilizers for anger issuesThere are some common side effects of mood stabilizers you should be aware of before starting them. They can include:Stomach cramps or nauseaThirstHeadacheFatigueMild tremorsAntipsychotics for angerAtypical antipsychotics newer versions of a drug might effectively manage extreme agitation and uncontrolled anger in some people. They can be beneficial when anger is related to health conditions, and the type of condition youre dealing with may dictate what medication your doctor prescribes. Commonly prescribed antipsychotics for anger issuesSome antipsychotics that might be prescribed to help treat anger include:Quetiapine (Seroquel)Olanzapine (Zyprexa)Risperidone (Risperdal)Potential side effects of antipsychotics for anger issuesSide effects to be aware of if you take antipsychotic medication for anger include:DizzinessDry mouthWeight gainSedationBlurred visionTremors or stiffnessFluid retentionWhat Medications Have Anger Side Effects?Almost any medication you take can have side effects. Some types of drugs are known to increase irritability and angry feelings For this reason, its important to know which medications you might want to avoid if you struggle with maintaining and controlling your anger. Some medications that list anger as a potential side effect include:Bupropion (Wellbutrin) Levetiracetam (Keppra)Lisdexamfetamine (Vyvanse)Methylphenidate (Ritalin) Mixed amphetamine salts (Adderall)Montelukast (Singular) Testosterone replacement therapy (TRT)Varenicline (Chantix)Medications that are stimulants (Adderall, Ritalin, and Vyvanse) can have side effects of increased anger. This is why its important to only take these medications for the appropriate diagnoses and not to take higher doses than necessary. Stimulants can lead to aggressive behavior if taken incorrectly. Talkspace psychiatrist Dr. Dion MetzgerManage Your Anger Effectively at TalkspaceAnger can be a normal, healthy response to certain circumstances. However, anger that you cant control or thats increasing in frequency or severity should be addressed. If youre looking for professional mental health support to help you manage your anger, Talkspace has experienced therapists and psychiatrists ready to work with you.You dont have to let your angry outbursts control your life. Its possible to learn coping skills and techniques through in-person or online therapy, lifestyle changes, and possibly medication for anger that will help you manage symptoms of anger so you can develop and nurture fulfilling, positive, healthy relationships without anger getting the best of you.Sources:Romero-Martnez , Murciano-Mart S, Moya-Albiol L. Is sertraline a good pharmacological strategy to control anger? results of a systematic review. Behavioral Sciences. 2019;9(5):57. doi:10.3390/bs9050057. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6562745/. Accessed June 2, 2023.Amore M, DAndrea M, Fagiolini A. Treatment of agitation with Lorazepam in clinical practice: A systematic review. Frontiers in Psychiatry. 2021;12. doi:10.3389/fpsyt.2021.628965. https://www.frontiersin.org/articles/10.3389/fpsyt.2021.628965/full. Accessed June 2, 2023.Sajdeya R, Joseph V, Stetten NE, et al. Reasons for Marijuana Use and Its Perceived Effectiveness in Therapeutic and Recreational Marijuana Users Among People Living with HIV in Florida. Cannabis: Publication of the Research Society on Marijuana. 2021;4(1).  https://publications.sciences.ucf.edu/cannabis/index.php/Cannabis/article/view/75. Accessed June 2, 2023.Ansell EB, Laws HB, Roche MJ, Sinha R. Effects of marijuana use on impulsivity and hostility in daily life. Drug and Alcohol Dependence. 2015;148:136-142. doi:10.1016/j.drugalcdep.2014.12.029. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4330120/. Accessed June 2, 2023.Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

Having the right tools to know how to calm down from anger can be essential for maintaining mental health and fostering healthy relationships. Although its a natural human emotion, many types of anger can be destructive when you dont know how to manage it effectively.  When you learn how to stay calm when angry with the following methods, you can express yourself effectively without letting your anger get the best of you.   Why Do I Get Mad So Easily?Ever wondered, why am I so angry all the time? Getting mad is a natural emotion and it can happen for any number of reasons. After all, anger is an appropriate response to certain experiences. For example, you might be angry about injustice or betrayal, a fight youve had with a partner or friend, a misunderstanding, or when youre disappointed. These are all normal reasons to have an angry reaction. Sometimes, though, we realize were mad about things that may not be that big of a deal in lifes grand scheme. Everyone experiences anger. It is a typical response to a negative stimulus. The main idea is not to avoid it but to have the tools to calm down and avoid hurting ourselves or others. Talkspace therapist Cynthia Catchings, LCSW-SWhether you get mad often or its a rare occurrence, knowing how to calm down when angry can be a valuable skill to have in your arsenal. Learn nine easy, effective ways to calm down when angry emotions are getting the best of you. 9 Practical Techniques to Calm Down From AngerTry using the following tips and techniques if you want to know how to keep calm when angry.1. Use breathing exercises to control your angerResearch shows that diaphragmatic breathing triggers a relaxation response in the body which can be beneficial if youre angry. Taking long, slow, deep breaths can help calm you down and reset your brain to get you out of the fight or flight response. There are several powerful breathing exercises that are easy to use regardless of where you are. Try one of these breathing techniques the next time you want to calm down when youre angry. 4-7-8 breathing: Keeping your mouth closed, breathe through your nose, and count to 4. Hold for 7 seconds and then slowly exhale through the mouth, counting to 8. Repeat until you feel your body release the anger.Box breathing: Box breathing is a technique so effective its used by the Navy SEALs to remain calm in high-stress scenarios. To box breathe, exhale slowly, releasing all the air from your lungs. Count to 4 and inhale through your nose. Hold a deep breath for 4 seconds, then exhale for another count of 4. Repeat several times. 2. The power of visualization in calming downVisualization is a powerful way to calm down and reset your thoughts so you can let go of your anger. You can combine visualization with deep breathing for an even more effective result. Take a few deep breaths and close your eyes. Imagine yourself in a calm and peaceful place, completely relaxed and focused. Focus on the sights, smells, textures, and sounds of your imagined location. Go to a place that makes you happy and picture yourself there until you can feel that youre calming down and your anger is dissipating.3. The role of physical exercise in managing angerPhysical exercise is a great (and proven) way to manage anger and relieve tension. Frequent physical exertion can keep you feeling tranquil and resolve irritation while enhancing your overall psychological well-being.  Good exercises for anger management include:RunningYogaBikingWalkingBoxingHiking4. The importance of taking a timeoutThe next time youre feeling angry, take a break to slow your impulsive reactions and regain control over the intense emotions you might be feeling. The walk-away theory works, giving you time and space to cool off before you return to a volatile situation or conversation. Its the easiest of the methods, too. You simply, and literally, just walk away from whatevers angering you. Use the time to regroup and implement other techniques youve learned here, like deep breathing techniques or visualization. 5. How to challenge your thoughts and shift perspectiveChallenging unhealthy thought patterns can help you shift your perspective and change your emotional reaction to an event, person, or circumstance. To do it, use the following tips:Identify negative thoughts: Dont let angry feelings take over. Recognize when you have negative or unhealthy thought patterns.Analyze the evidence: Before you explode, consider whether theres any factual basis for your thoughts or if youre having irrational beliefs.Create alternative explanations: Try to come up with other possible reasons for the source of your anger. For example, someone who upsets you might not have been intentionally acting in a way that was to hurt you.Evaluate consequences: Think about how acting on your anger will affect yourself and others around you. Consider the potential repercussions of your response to determine if it will help resolve the conflict or worsen things.6. Expressing your concerns calmly and effectivelyBefore responding with frustration, think about how to release anger in a healthy way thats calm and effective. If you find this challenging, try using the strategies below. Breathe deeply: Before speaking up, take a few deep breaths to recenter your thoughts and stay calm and composed.Avoid sarcasm: Remember that sarcasm can worsen any tense situation, so try to use fact-based claims and statements.Use I statements: Express your feelings with I statements instead of using accusatory language or blaming others.Be specific: Clearly explain what has made you angry without exaggerating or generalizing the issue.Practice active listening: Give the other person an opportunity to share their perspective while maintaining eye contact and showing empathy towards their feelings.7. Identifying possible solutions to the source of angerFocusing on solutions can help you let go of your rage or at least become instrumental in your ability to reign it in. There are several techniques you can use to do this.Communicate openly: Interact calmly and openly with the person or situation causing your anger.Practice problem-solving skills: Once you identify the issue, brainstorm potential solutions.Create boundaries: Establish healthy boundaries to protect yourself, whether it be family boundaries or friendship boundaries.Avoid triggers: Recognize and minimize exposure to situations or people that provoke anger.Cultivate empathy: Try understanding the other persons perspective to resolve frustration or resentment.8. The benefits of walking away  Weve already discussed taking a timeout, but sometimes you need to do more than just take a breather. Building on the idea of setting boundaries, its important to know when it might be time to walk all-the-way away. Sometimes, relationships or situations are unhealthy for you. If youre in a toxic relationship thats causing you to be consistently angry, you might need to consider getting out.  9. Use pressure pointsSpecific pressure points in the body are associated with tension. The next time youre feeling angry, try putting pressure on one of the known points that might help. Try using gentle pressure on any of the following spots:On the foot between the first and second toes, about 1 above the web of the toesBetween your eyebrows at the top of your nose bridgeInner wrist crease toward the little finger side Inside of the leg, just above the ankleLong-term Strategies for Anger ManagementImplementing long-term and consistent strategies for anger management can help you change your mindset and increase your sense of calm so you dont react in angry ways. Try regularly doing the following to keep a positive attitude so your anger doesnt take over:Working out regularlyJournaling for mental healthPracticing yogaMeditatingFocusing on healthy communication skillsHow to develop a healthier response to angerIf you want to learn how to stay calm when angry, it can help to focus on your natural response to upsetting situations. It will take work, but you can reprogram your brain so that instead of reacting with aggression, criticism, or sarcasm, you learn to calmly express yourself in ways other than anger. Identifying triggers so you can avoid them or manage your reactions is key. Talking to a behavioral professional, practicing meditation or mindfulness, and learning to recognize your triggers can help you develop a healthier response to anger. Talkspace therapist Cynthia Catchings, LCSW-SSeeking professional help for anger managementIf you have anger management issues and are struggling to get them under control on your own, it might be time to seek professional help. Therapy for anger management can be a great way to learn how to remain calm when angry, especially if your intense emotions are starting to affect relationships with others.Manage Your Anger with TalkspaceThe good news is you dont have to live in a perpetual state of anger. You can take proactive steps to overcome your anger response patterns and build healthy, mutually-rewarding relationships where joy and peace not anger are the foundations. Getting professional support from an online therapy provider like Talkspace can be a great first step. Reach out to Talkspace today to learn how to stay calm when angry emotions take over. Talkspace makes the process easy, convenient, and affordable, with therapy from the comfort of your home. Sources:Ma X, Yue Z-Q, Gong Z-Q, et al. The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in Psychology. 2017;8. doi:10.3389/fpsyg.2017.00874 . https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5455070/. Accessed June 3, 2023. Malhotra P. Exercise and its Impact on Anger Management. Acta Scientific Medical Sciences. 2019;3(4):132-137. https://actascientific.com/ASMS/pdf/ASMS-03-0278.pdf. June 3, 2023.Talkspace articles are written by experienced mental health-wellness contributors; they are grounded in scientific research and evidence-based practices. Articles are extensively reviewed by our team of clinical experts (therapists and psychiatrists of various specialties) to ensure content is accurate and on par with current industry standards.Our goal at Talkspace is to provide the most up-to-date, valuable, and objective information on mental health-related topics in order to help readers make informed decisions.Articles contain trusted third-party sources that are either directly linked to in the text or listed at the bottom to take readers directly to the source.

OverviewUpdated 08/17/23Half of all people will experience at least one form of trauma in their lifetime. About 8% of them will develop post traumatic stress disorder (PTSD) as a result, and studies show that women are twice as likely to develop PTSD than men are. Even though it typically takes longer for them to be diagnosed, PTSD symptoms in women are more likely to present for a longer duration of time, and women are more prone to have extreme sensitivity to stimuli that reminds them of the trauma they experienced.Overall, there are some major differences between PTSD symptoms in women and men. Keep reading to learn more about them, along with the signs, common causes, and how to find in-person or online therapy for PTSD in women. Recognizing the signs of post traumatic stress early on can mean an earlier diagnosis and PTSD treatment, which can improve quality of life and mental well-being.The Difference Between PTSD in Women vs. MenLike many physical and mental health conditions, PTSD in women presents differently than it does in men. This may in part, be due to the fact that women and men experience different mental health problems in general. For example, its much more common for women to be diagnosed with disorders like anxiety and depression, which are considered internalizing disorders. By contrast, men more commonly experience externalizing disorders, like substance abuse or other behavior related to poor impulse control.One known difference between men and women is that signs of PTSD in women typically seem to be more intense. In fact, research on PTSD symptoms in active duty military shows that women often show more distress in almost all of the physical symptoms listed on the PTSD Checklist, Civilian Version (CPL-C). This self-reporting scale lists 17 of the key symptoms someone with PTSD might experience.Expert InsightMen may use alcohol or drugs to deal with the anxious feelings associated with PTSD, while women may live with the anxiety, which can be isolating. The signs and physical symptoms look slightly different, although some do overlap. For instance, men tend to react internally and often are quiet about their emotional turmoil. It may come out as anger or irritability. Women tend to demonstrate more emotional expression of their signs and symptoms, perhaps crying or verbalizing feelings of sadness.Licensed Clinical Social Worker (LCSW), DDKarmen SmithSigns & Symptoms of PTSD in WomenThe overall signs and symptoms of PTSD can be the same across genders. However, some symptoms are seen more often, and more severely, in women.Heres how to identify some of the most common PTSD symptoms in women:Avoidance: Some research has shown that avoidance is one of the most common symptoms of PTSD in women. The avoidance symptom is intentionally avoiding feelings or thoughts that might remind someone of the traumatic event or events they experienced that originally triggered their PTSD. Its among the most common PTSD symptoms and can include avoiding people, places, or any other environmental trigger.Re-experiencing trauma: Studies show that more women than men have the symptom of re-experiencing. Re-experiencing is another key symptom of PTSD, and it includes having unwanted or unprovoked, intrusive memories and thoughts about the traumatic experience. It can include nightmares, flashbacks, or an intense feeling that the traumatic event is happening again. This is very common in women veterans, along with male veterans.Depression or anxiety: Since PTSD symptoms in women tend to be more internalized, it makes sense that theyd experience more depression and anxiety related to their condition, as both of these are internalizing disorders.Hyperarousal: Research shows that women in the military who develop PTSD symptoms have higher scores on measures of hyperarousal than men do. Hyperarousal involves a heightened or intense state of awareness. It can result in hypervigilance, anxiety, sleep difficulties, irritability, difficulty concentrating, or panic attacks. Notably, hyperarousal is a common symptom of PTSD in the workplace; women with PTSD might fixate on trying to control their hypervigilance and struggle with the tasks theyre responsible for.Emotional numbness: Emotional numbness is yet another common PTSD symptom. It includes shutting down any feeling that might be distressing or overwhelming. It can result in a sense of detachment from others, a loss of interest in things once enjoyed, a lack of emotion, difficulty having any sort of positivity, or social isolation. Ultimately, emotional numbness is a way to avoid very painful thoughts or memories that are related to the trauma experienced.Startle response: Women with PTSD can more easily become startled than men might. Startle response is due to the body having a physical reaction to perceived or real fear. A heightened response to an intense stimulus is more evident in PTSD in women.Online therapy for PTSDGet treatment for PTSD with a trauma-informed therapist. Start therapy in days.Get startedCommon Causes of PTSD in WomenAny traumatic experience can result in PTSD. Events or experiences that are dangerous, life-threatening or violent tend to be more triggering. Common examples of causes of PTSD in women can include:CombatOther military experiencesSexual assaultPhysical assaultDomestic violenceChild sexual abuseChild physical abuseWitnessing a traumatic eventLearning about violent death, injury, or accident of a loved oneVery serious accidents like car wrecks or traumatic fallsTerrorist attacksNatural disasters like tornadoes, fires, hurricanes, earthquakes, or floodsWitnessing effects of a violent or terrible eventHow to Manage PTSD in WomenSince signs of PTSD in women are different than they are for men, its important to understand how to manage PTSD, specifically when were talking about women. Treatment options for PTSD can involve counseling or therapy, medication, or a combination of the two.Effective treatment for PTSD can include:Cognitive behavioral therapy (CBT): Cognitive behavioral therapy is a type of psychotherapy (also known as talk therapy). During sessions of CBT for PTSD, you try to identify the thoughts, behaviors, and feelings that may be interfering in daily life. It helps you develop a healthier thought process and patterns.Cognitive processing therapy (CPT): Cognitive processing therapy is a type of CBT that was specifically developed to treat PTSD. It lets you identify and then change thought patterns related to the original trauma that are upsetting or triggering, so you can confront your trauma and negative thoughts in a healthier way.Prolonged exposure therapy (PET): Prolonged exposure therapy (PET) is another form of talk therapy that helps you slowly and methodically remember a traumatic event. Over time, youll be able to confront your trauma and ideally become less sensitive to triggers.Eye movement desensitization and reprocessing (EMDR) therapy: EMDR therapy is also used to treat PTSD. During an EMDR therapy session, youll be asked to recall your trauma and talk about it as you hone in on a specific visual. Sometimes rather than looking at something, you may listen repeatedly to a certain sound, such as a repetitive beeping noise.PTSD Medication: Another treatment option is medication. There are several medications to help treat PTSD symptoms, including anti-anxiety meds and different types of antidepressants. Most often, to get the most benefit, medication is used in combination with therapy.Expert InsightMany women, especially women of Color, are told they can handle any crisis because they are strong. This can be very shaming and not helpful. By providing permission to have their feelings and negative thoughts, it validates their experience and creates a path to feeling that treatment is a viable option.Licensed Clinical Social Worker (LCSW), DDKarmen SmithFinding PTSD Treatment for WomenWhile stress or anxiety after a traumatic event is normal, if it continues for a long period of time, doesnt begin to fade within a few weeks or months, or begins interfering in daily life, it might be time to consider treatment.Treatment for PTSD can last weeks, months, or even years. Its important to figure out what will work best for you because effective PTSD treatment can look different for every woman. In addition to therapy and medication, support groups and networks are also great coping mechanisms that can help.Finally, there are self-help techniques that can be very useful in treating the symptoms of PTSD. Research has suggested that some forms of creative therapy like music-instruction programs can also be effective for PTSD.Some women have found the following to be helpful in managing their PTSD:YogaMindful meditationExerciseSetting (and enforcing) boundariesTai chiJournaling for mental healthGetting a service dogCreative outlets like gardening, painting, music, or writingExpert InsightTreatment can include bodywork such as yoga, tai chi, or aqua aerobics. We know that stress can stay in the body and needs its own therapy along with cognitive behavioral or exposure therapies.Licensed Clinical Social Worker (LCSW), DDKarmen SmithIf you or a loved one has PTSD, its important that you seek out treatment to manage it and talk with a mental health professional. With the right therapy and work, you can move past the trauma you experienced so you can get back to living a healthy and rewarding life, free from the memories that may be haunting you today. Start by learning more with a self PTSD test.See ReferencesWomen who experience trauma are twice as likely as men to develop PTSD. Heres whyFacts About Women and Trauma. Published 2017. Accessed October 29, 2021.PTSD Checklist Civilian Version (PCL-C).PTSD Checklist Civilian Version (PCL-C). Weathers, Litz, Huska, & Keane National Center for PTSD - Behavioral Science Division; 2003:1. Accessed October 29, 2021.Gender differences in the expression of PTSD symptoms among active duty military personnelHourani L, Williams J, Bray R, Kandel D. Gender differences in the expression of PTSD symptoms among active duty military personnel. J Anxiety Disord. 2015;29:101-108. doi:10.1016/j.janxdis.2014.11.007. Accessed October 29, 2021.Post-Traumatic Stress DisorderNIMH Post-Traumatic Stress Disorder. Nimh.nih.gov. Published 2019. Accessed October 29, 2021.Post-traumatic stress disorderBisson J, Cosgrove S, Lewis C, Roberts N. Post-traumatic stress disorder. BMJ. 2015:h6161. doi:10.1136/bmj.h6161. October 29, 2021.Cognitive Behavioral Therapy (CBT)Cognitive Behavioral Therapy (CBT) for Treatment of PTSD. Published 2017. Accessed October 29, 2021.Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot studyPezzin L, Larson E, Lorber W, McGinley E, Dillingham T. Music-instruction intervention for treatment of post-traumatic stress disorder: a randomized pilot study. BMC Psychol. 2018;6(1). doi:10.1186/s40359-018-0274-8. Accessed October 29, 2021.Karmen SmithDr. Karmen Smith is a board-certified Clinical Social Worker in the state of Nevada. She has worked over 20 years for Clark County Family Services with abused and neglected children in the shelter, adolescents in juvenile detention, and adults who have suffered severe trauma. Dr. Smith is a shamanic teacher and minister of metaphysics and her doctorate is in Pastoral Counseling.