It Isn’t Our Fault: Being in Love with a Narcissist

Note: Although I share thoughts from personal experience and refer to the narcissist as male, narcissism is not discriminatory.

Maybe you are feeling a desperate need to try and salvage a relationship you intuitively know is unhealthy and imbalanced; or maybe you are wondering why you can’t “let go” and “move on” from the loss of your relationship. It’s possible that you are in love with a narcissist, and now owning the blame for all the sudden problems or downfall. A narcissist is someone who will enter our life and consume our entire existence all for selfish benefit. Understanding the whirlwind and accepting the finality of a relationship with a narcissist will show that we possess tremendous value.

We are smart and confident, so why did we allow ourselves to fall for the narcissist?

He is too skilled to reveal any red flags when we first meet him. He is drawn to our beauty, kindness, and selfless nature because of his own emptiness. The narcissist will be attentive, generous, and impressive, at first. He will charm us with compliments on every small detail giving us attention with such intensity that we believe he is our “soul mate.”

Enchanting promises will be made that make us feel alive and invincible, and he will spend exorbitant amounts of time with us. We will quickly be mesmerized and feel so exhilarated, adored, loved, and then…

Almost instantaneously, the relationship will twist.

Time together will dwindle leaving us confused and craving any small amount of attention from him. We try to connect and share our accomplishments, but he will minimize our effort and make us feel inconsequential. We try to look beautiful for him, but the attention is gone. Intimate moments will leave us feeling used and insignificant.

The partner that once made us feel like royalty is now making us feel insecure and needy. The partner who was affectionate is now a stranger. The narcissist has taken our power to feed his own warped ego.

Why are we hanging on to this relationship?

Our emotions felt heightened so intensely and quickly, and in a blur the table turned leaving our head spinning. We now feel blindsided, angry, and betrayed. It’s almost as though our heart couldn’t catch up with our brain quick enough to understand. So, we are left constantly questioning what went wrong.

We no longer feel a connection to him and wonder if the person devoid of all emotion is the same person we love. We fear the happiness we remember was just a fabrication in our mind. The narcissist has robbed a piece of our soul and we desperately want it back. This is a deeply confusing and emotional process because intellectually, we thought we knew better.

We are assertive and attempt to resolve these relationship issues, but he is so adept at projecting and leading us to believe whatever happened is our fault.

Simply questioning the narcissist will cause him to push further away and punish us with the silent treatment. Being ignored feels so horrid that we will forget why we were upset with him and apologize emphatically to try and win his forgiveness. He preys on this kind of attention, and is incapable of recognizing any personal fault. Our self-esteem has plummeted and our self-respect has diminished.

The narcissist will not show awareness or remorse for the imposed hurt so we assume the downfall was our fault.

We have become so intertwined in making this person happy that we will exhaust and lose ourselves in the process. We start to question our own morals wondering if we deserve this abusive treatment. We start to feel obsessed with “fixing” what is broken in order to feel better, and the more our efforts are ignored, the more persistent we become. We question who this person is that we are chasing and start to feel “crazy” because nothing is changing. It’s a losing battle because after depleting all we can give he no longer has any use for us.

The inevitable downfall with a narcissist.

This relationship is bound to end when we are no longer a conquest and cannot fill the emptiness the narcissist feels inside. The ending feels so awful because we put all our energy and effort into pleasing someone who was never going to genuinely reciprocate, and is too self-absorbed to acknowledge our pain.

The partner we once trusted has completed the narcissistic cycle of abuse and needs to draw the energy and innocence from a new victim. He will end the relationship just as quickly and smoothly as it began, and the coldness and apathy leaves us feeling worthless. He will cut off contact so callously that we feel so defeated and want to curl into ball and disappear. But, this experience has not been in vein, and regardless of how painful the ending feels, it is a gift.

Accepting reality and moving on.

Being under the narcissist’s spell is not our fault and recovering from this will take time. The most important first step is to commit to “letting go.” There is nothing positive that will come from seeing him after all this inflicted damage. We need rebuild and empower ourselves from this experience.

Solicit support from trusted loved ones and make a plan for when there is temptation to reach out to him. Making this commitment will bring relief as the poison is released from our body, mind, and soul. The air will feel fresher and we will welcome healthy people and kindness into our life, slowly beginning to feel like ourselves again.

Overcoming this emotionally torturous experience will produce a stronger self and allow us to feel more attuned, perceptive, and emotionally intelligent. Let’s take the time to define our convictions, keep our heart open and full of courage, and we will find our way to the loving fulfillment we deserve.

Yeko Photo Studio/Bigstock

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Book Review: Psychoetry: Lessons in Poetic Parenting

Two wheeled bicycle

waiting to be ridden

Are you something I must try,

or fruit that is forbidden?

With thoughts of falling over,

I shake and you’re unsteady

Do I climb upon your seat,

or come back when I’m ready?

Clinging to the handlebar

I pedal up and down

Shall I smile fearlessly,

or wear a somber frown?

Reassuring adult hands

appear to comfort me

Now will I lose my balance

or defy Earth’s gravity?

– The Balancing Act, from Psychoetry by Brian Wohlmuth

This is one of over a dozen original poems in Brian Wohlmuth’s book, Psychoetry: Lessons in Poetic Parenting. This warm and insightful book offers an overview of parenting children from infancy through adolescence, each chapter accented by a poem. The book delivers a quick read — each chapter only a page or two, which may be just the right length for a busy, sleep-deprived parent. Chapter topics range from separation anxiety and trust to bullying and loss, important topics in the life of a developing child.

Wohlmuth knows what he’s writing about — he is a licensed Marriage and Family Therapist with a Master’s in Psychological Counseling, and over 25 years of experience working with families as well as specializing in children and teens with special needs. He brings this knowledge to the bear in this book, combining poetry and prose in a light but meaningful text.

The chapter Divide and Conquer begins with the poem Day One. “Amidst the tears/ you’ve dried for years/ You said, ‘Don’t cry/ Give this a try/ You’ll be alright/ out of my sight/ Do what they say/ Make friendly play/ And share the toys/ with girls and boys…/ Then as I feared/ you disappeared…” Wohlmuth uses this as an opening to discuss the challenges a child faces when beginning to separate from his or her parents and how, as parents, we can support them. He outlines the need for encouragement, companionship and also emotional containment as the child begins to individuate. He offers simple activities, such as role-playing the separation, sharing stories, and providing structure in order to facilitate this process.

Another chapter, Food for Thought, opens with the entertaining little poem Food F(l)ight. He writes, “Flying spoon to control/ this is feeding patrol/ radar spies two small lips pressing tight/ The hanger is closed/ All commands are opposed/ Captain Broccoli is not a delight;/ Using similar tact/ on a fantasy track/ locomotive with cargo are steaming/ The tunnel is blocked/ Baby teeth firmly locked…” The poem goes on like this, painting an entertaining, if rather messy, picture of feeding time with a toddler. Rather than merely see the pursed mouth as an inconvenient sign of stubbornness, Wohlmuth points out that by closing his or her mouth “your child is actually engaging in a process that will have independence as its eventual destination” and notes that, rather than a power struggle, this is an opportunity for the child to experience autonomy.

His final poem, Beyond Eighteen, reads, “Once the duckling/ now a swan/ your awkward adolescence gone/ Ever after/ flapping wings,/ responsible/ for what life brings/ Airborne over/ mountain tops/ or turbulent/ low pressure drops/ Large and legal/ free to fly,/ soar gracefully/ through adult sky.” There is no text to accompany this poem. It stands alone.

While moving in and of itself, this poem, like the rest of the book, leaves me wanting more. Many of his chapters bring up interesting and important concepts in parenting that merit further discussion. However, they feel somewhat underdeveloped, ideas that may be difficult to apply without more structure and explanation. Wohlmuth incorporates concepts that those versed in psychodynamics will pick up on — bringing up ideas such as twinship, mirroring, and optimal frustration. However, he does little more than mention these in passing, with little further explanation of their use or meaning. This feels like a lost opportunity, both for the author, who clearly has a significant breadth of knowledge on these topics that could be shared, and the reader, who would likely benefit from a more thorough explanation of these principles. In contrast, sometimes, he goes disproportionately in depth on a subject, such as an entire chapter on taking a child to the doctor.

Overall, the book is a light, easy read, but I felt it could be much more. It can easily be consumed over the course of a few afternoon nap times, which, for some, may be ideal.

Psychoetry: Lessons in Poetic Parenting
Comteq Publishing, 2014
Paperback, 76 pages
$19.95

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Scientists show that a 'Superman' disguise could actually work

Ever think it's silly that people don't recognize Clark Kent is actually Superman? Well as it turns out, glasses are actually a fairly good way to disguise yourself. In fact, researchers have shown that small alterations to a person's appearance, such as wearing glasses, can significantly hinder positive facial identification. ...

Kramer, R., & Ritchie, K. (2016) Disguising Superman: How Glasses Affect Unfamiliar Face Matching. Applied Cognitive Psychology. DOI: 10.1002/acp.3261  

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Scientists show that a ‘Superman’ disguise could actually work

Ever wonder think it’s silly that people don’t recognize Clark Kent is actually Superman? Well as it turns out, glasses are actually a fairly good way to disguise yourself. In fact, researchers have shown that small alterations to a person’s appearance, such as wearing glasses, can significantly hinder positive facial identification. The research has the potential […]

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The Ironic Effect Depression Has On Managing The Emotions

The unexpected decisions depressed people make when regulating their emotions.

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Older Child Found Naked with Younger Child

From the U.S.: My wife has an 11 year old half-brother (D.), and I have a question regarding something D. did this past Thanksgiving. D. was over at his father’s house that day for the holiday. D.’s father has an adult daughter who has a four year old boy. While at his father’s house that day, D. and the 4 year old boy were playing in one of the upstairs bedrooms. Apparently, at some point, the 4 year old boy was running around naked. D. (who again, is 11 years old) decides that since this 4 year old boy got naked, he would get naked also. Eventually, the young boy’s mother found D. and the 4 year old naked in the room together.

D.’s mother was called to come pick him up, while the young boy’s mother took him to the hospital to have him checked out. A police investigation also took place. Neither the hospital personnel nor the investigation determined anything “sexual” occurred. However, the incident with D. really upset me. My wife and I have a 6 year old daughter, and after the events of Thanksgiving, I was really nervous to have D. around my daughter.

I went several months doing my best to ignore both D. and his mother when I could. Eventually, I had a long talk with D’s. mother, and things are cordial again. She told me that she gave D’ a very long talking to after the event and immediately sought help for him from a psychologist. D. has recently started seeing a different psychologist (his 1st one drop him).

So my question is this. D.’s mother recently told me that the psychologist he is now seeing stated that what D. did on Thanksgiving was normal behavior. Is an 11 year old getting naked with a 4 year old actually considered normal? I still can’t wrap my head around why he even thought to take his clothes off in the first place. I recall when I was around D.’s age, there were a few times I was in a place where younger kids (4-5 yrs. old) were running around naked for whatever reason, and I just left the room. Even though things are cordial with D. and his mother, I still get nervous at times when he is around my daughter.

A: I understand why you are concerned. It’s not usual for an 11 year old to strip just because a younger one did so. However, there may be extenuating circumstances. Kids mature at different rates. Families have different ideas about nudity. Sometimes kids aren’t “bad” but are showing bad judgment. I can’t comment on what the psychologist said about normalcy because I don’t have access to the same information she did.

The family did many things right in this situation. An investigation took place. The little boy was checked medically. D’s mother had a long talk with him and has taken him for counseling. You’ve done your best to continue to be in relationship to the family.

I think the best thing to do now is to talk carefully with your 6-year-old about what is and isn’t okay regarding nudity with anyone but her parents and doctors. Many parents find that it is helpful to tell their child that no one should see or touch any part of the body that is covered by a swimsuit. Also help her understand that she should come to you if anyone does such a thing — no matter what. Even if someone threatens her or tells her not to tell or else, she needs to come to you.

The 11-year-old is actually your daughter’s uncle. Another possibility is for his mother to talk to him about his role as “uncle” is to help to protect his niece. Being given responsibility may help him act more maturely.

Family relationships are often challenging. The tricky thing in this kind of situation is that it’s important to keep two things in mind: You want to protect your daughter, of course. It’s also important not to let a child (D) get labelled as an offender when he may have once made a bad choice.

If I were in this situation, I would try my best to normalize the relationship with the mom and her son but I would also be very vigilant for inappropriate behavior. Then take it from there.

I wish you well.
Dr. Marie

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Take Time to Be Still before a Big Change

For Floridians, hurricane threats send people scurrying around town collecting water, batteries, and can goods. The stores are flocked with people as the shelves begin to go bare. Preparations are made to homes and offices to protect landscapes, windows, and possessions. Anyone who lived through the four hurricane year of 2004, remembers the unpredictability of the path, the weeks without power, the displaced people, the intense traffic, and massive devastation that took years to recover. Nearly every part of Florida was affected by one of the storms.

But right before the storm would approach, there was an eerie stillness. Even the birds were silent as the streets of major cities became deserted, businesses and schools were shut down, homes were boarded up, and the people braced for impact. There was a peaceful deceiving look outside as even the trees were tranquil. The silence, in combination with a realization that nothing more could be done at the moment but to wait, placed serenity in the hearts of many.

That calmness was very much needed in the next few hours as each storm hit the state collectively leaving over $57 billion dollars in damage and the loss of over 3,000 lives. That was a difficult summer for nearly every Floridian contributing greatly to the economic downfall and real estate collapse two years later. The storms were a battle of sorts and those of us who lived through it pray for it never to happen again.

But there are lessons to be learned from the experience which can be applied to everyday life. The “storm” can be metaphorical for nearly anything in a person’s life. It could be a child leaving for college, a divorce, a move, change in vocation, permanent disability, significant shift in health, or the slow loss of a family member. Here are seven steps in dealing momentous change:

1. The first step is to acknowledge that something is about to change. It is important to name that change and have some understanding if the change is permanent or temporary.
2. The next is to formulate a plan for the change. This might include a time line with deadlines for completion on items to be done. Or it might be a plan of worst case scenarios.
3. Just because the change is coming does not mean that it is the right time to start on the plan. Be watchful of the early warning signs before beginning to implement the plan.
4. Now that the change is on the horizon, begin the preparation phase of the plan keeping the deadlines in mind. Strive to finish before the last deadline to allow time for the next phase.
5. This is perhaps the most important part of any change. The waiting. Taking time out to rest just before a major shift in life helps to mentally and physical readjust to the new circumstances.
6. All change brings about a period of struggle and battle. The previous steps help a person to successfully navigate the difficult time period of adjustment and tweak any necessary short-comings.
7. At the end of the process, it is good to evaluate and reflect on what worked and what needed improving. This information is invaluable for the next change in life.

The storms of life do not have to knock a person down. Rather, this can be a time for growth. But without the most important step of being still, the change can easily exhaust and overwhelm.

Christine Hammond lives in Orlando and is the award-winning author of The Exhausted Woman’s Handbook available from Amazon, Barnes & Noble and iBooks.

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Words of Hope for Anyone Struggling with Depression

One of the worst parts about depression — and there are certainly many — is that it robs you of hope. Hope that you’ll actually feel better. Hope that the darkness will lift. Hope that the emptiness will fill up and you’ll feel motivated and excited. Hope that it won’t be like this forever. Hope that you’ll get through it.

“I’ve been struggling with depression for almost 35 years,” said Douglas Cootey, who pens the award-winning blog A Splintered Mind. “In that time, I have often felt hopeless, usually during times of suicidal ideation…Depression has a way of warping our outlook so that we only notice the bleakest parts of the world.”

The darkness stops feeling like a lens that distorts your reality, and starts to become your reality, said John A. Lundin, Psy.D, a psychologist who specializes in treating depression and anxiety in adults, teens and children in San Francisco and Oakland, Calif.

“Depression often robs you of the memory of joy or happiness, so it becomes difficult to draw on happy memories to give one hope for the future,” Lundin said. Depression even makes hope seem foolish, like an illusion, he said.

Many people with depression aren’t able to articulate that they feel hopeless. Because doing so requires putting “words to an experience that just feels as real and encompassing as the air they breathe.” Saying you feel hopeless, Lundin said, can actually be a positive step. “[I]t holds the implication that hope is something that is possible.”

“Depression can be overwhelming,” said Cootey, also author of Saying No to Suicide: Coping Strategies for People Dealing with Suicidism and for the Loved Ones Who Support Them. “All those negative emotions are suffocating. This makes it difficult to believe that things will get better.”

Most of Rebecca Rabe’s clients say they’ve lost hope because they feel alone. They feel like no one understands what they’re going through. They feel like they can’t talk to anyone.

Loss of hope also might represent a loss of belief that you matter or that you can be loved, Lundin said. (This is something he works on with clients, helping them understand why they don’t feel adequate or lovable.)

What can you do when hope feels unfamiliar or impossible? What can you do when you’re in the middle of the storm?

Cootey stressed the importance of using a wide variety of coping strategies. “When I use my coping strategies to overcome depression, the next day isn’t a prison of more of the same. It’s a brand new day free of the sadness.”

Colleen King, LMFT, a psychotherapist who specializes in mood disorders and also has bipolar disorder, stressed the importance of having a treatment team and support system. This might include a therapist, doctor and several friends and family. Ask them to help you remember the times when you’ve felt better, she said. Ask them to “encourage you to be in the moment when you do experience temporary joy, even if it’s for a few minutes.”

Both King and Lundin suggested participating in activities that feel nourishing to your soul, activities that you love to do when you’re not depressed. Do them even if you don’t feel like it, King said. “You will most likely alter your mood at least a little bit, and [the activity] may be a welcome distraction from depression.” Plus, it helps to “arouse glimmers of hope that you can feel whole and healthy, again.”

It often feels like depression will last forever, King said. Which is why she also suggested placing prompts at home and work to remind yourself “that you are having a depressive episode and that it’s not a permanent state of being.”

Don’t underestimate the power of small steps. Rabe, LMFT, who specializes in treating children, teens and young adults with depression, anxiety and trauma, shared this example: She worked with a woman who was struggling with depression and complained about “not being able to do anything.”

They worked on tracking small but significant accomplishments and setting small goals. “For example, she would strive to check 10 things off her list. Sometimes just getting to therapy got her these 10 checks.” After all, getting to therapy is anything but trivial. It involves getting up, showering, getting dressed, driving to the office, making the appointment on time, talking in session and driving home, among other tasks. Her client also started reaching out to supportive loved ones (instead of isolating herself); taking walks; and writing in her journal—all of which has helped to diminish her depression and create a more positive outlook.

“I’ve been through the worst my mind can throw at me. I’ve felt the pain of suicidal depression,” Cootey said. “I’ve wished and even planned for my own death, yet I learned an important truth: Depression lies to us.” This is another reason it’s helpful to surround yourself with support: These individuals can help you see through the lies, he said.

“You do have worth. You will overcome this. You won’t be sad forever.”

There is always hope for someone struggling with depression, Rabe said. “People are resilient human beings, and they can do so much more than they think they’re capable of.”

Also, remember that “how hopeless you feel does not correlate to whether you can feel better,” Lundin said. Depression is an illness that extinguishes hope. It’s the nature of the disorder.

Thankfully, therapy and medication can help. So can participating in support groups. “Some depression requires a short treatment to work, and other takes a long time. But I have never met a patient who didn’t see significant progress if they stuck with it.”

If your therapist or doctor doesn’t seem to be helping, seek out new providers, King said. “Having a trusting and caring treatment team greatly assists with creating confidence and hope for the future.”

For people who don’t respond to therapy and medication, other treatments are available, such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT), Lundin said.

With good treatment, effective and varied coping strategies and compassionate support, you can feel better. The heaviness gets lighter.  The world becomes brighter.

So no matter how hopeless you feel right now, please don’t throw away your shot. Hope and relief are not some foolish illusion. They are real. They are possible.

gor stevanovic/Bigstock

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Genograms: How to Use Them With Your Therapy Patients

Have you wanted to know how to use genograms in your practice with patients?

Monica McGoldrick describes a powerful way of employing genograms with therapy patients in her book “The Genogram Casebook.” McGoldrick bases her work upon the family systems framework of Dr. Murray Bowen, as well as a number of theorists who have followed in his footsteps.

To construct a genogram, you use a combination of lines and symbols to depict how individuals are connected to their biological and legal kinship network, as well as their informal network of friends, pets and work connections.

Aside from the basic demographic and health information of patients’ primary people (and pets) in their lives, genograms may be used to illustrate the generational wounds that have taken place, as well as a trajectory of survival, resilience and hope.

Standard Symbols

Below are a few of the standard symbols:

• Male = square; female = circle
• Horizontal lines represent marriage
• Vertical lines connect parents and children
• Separation and divorce: one or two back slashes on horizontal marriage line
• Conflicted relationship: zigzag lines
• Distant relationship: dotted lines
• Cut off/estranged: broken line
• Overly close/fused: three solid lines

In addition to using a genogram, you may wish to employ a timeline, to easily note any key events and changes your patients mention such as births, marriages, divorces, illnesses, deaths, migrations/moves and traumas. A timeline can help both you and your clients get the big picture of all the key events that have transpired in their lives.

Periodically reviewing the timeline you’ve created with your clients may also aid them in remembering past stress points that have been forgotten because of their current focus on their presenting problem.

McGoldrick emphasizes the importance of highlighting your clients’ points of resilience and strength, even within their stories of trauma, to help bolster their inner strength.

In light of the importance of the therapeutic alliance in the success of your patients’ treatment, the process of filling out a genogram must be done artfully. On the one hand, there is a need to pose questions to better understand who they are, what their concerns are and what factors may be contributing to their current situation, as well as trying to learn what strengths and resources they may draw upon to help them thrive.

On the other hand, part of the art of therapy is timing your questions to flow in as natural a manner as possible from whatever the client is discussing or concerned about.

Key Areas of Interest

Below are some of the key areas of interest to cover with your clients:

Family Make-Up (some of these questions would be naturally covered as part of your intake process with a new client)

• Relationship status
• Whether have any children (and who is the other parent of each child)
• Parents (age, education, health, residence)
• Siblings (age, education, health employment, relationship status, residence)
• Aunts, uncles and grandparents (age, education, health, residence)
• Other important people in client’s life
• Pets

History/Relationships

• What type of relationship do you have with your children/parents (and others noted in genogram)? Use appropriate symbols to depict close connection, friction, sexual abuse, physical abuse, etc.
• What painful losses or problems did family members have to face in the past?
• What are some of the strengths and assets of the family?
• What meaning do members give to their past stresses, and how may this relate to their cultural background?
• Do members seek support from others within, or outside the family? Has anyone sought a therapist’s advice? Is seeking outside guidance viewed negatively?
• What do you know about your parents, aunts, uncles and grandparents? Where did you and they grow up?

As you engage your clients around what troubles them, seek to understand their narrative of what came before their current problem, what (else) is happening and where they want to go in the future.

It is helpful to track their problem and family life cycle phase they are currently facing, through previous generations and their siblings. Typically, there will be other members who have had similar troubles at identical life cycles and bringing this to light will provide clues for how your clients may want to handle their current stresses.

Taking Power Back

Also, periodically review the genogram that you put together with your clients, to help them reconnect to who they are and see patterns in the other family members on their genogram. This practice will also give you an opportunity to emphasize to your clients that they are the experts and researchers on their lives and own families, a step that helps ensure that you maintain a healthy collaboration with your clients.

One of the goals in therapy is to help clients “take their power back” within their relationships, responding according to how they would like vs. reactively to what someone has said/done. To that end, the author recommends they avoid attacking, defending, placating or shutting down with others.

In the systemic way of viewing the world, the goal is to help your clients see their family members as individuals who had a particular story rather than as a failed or toxic member from whom it may be advisable to cut off. The process of differentiating from any parent requires learning as much as possible about him/her and this learning necessitates talking to any family members or friends who are alive who may be able to share their perspective on how a parent became that way.

As per McGoldrick, the systems prospective advocates protecting yourself as necessary from anyone who is relating in an abusive way while encouraging your willingness to open your heart if/when a relative is ready to engage in a respectful relationship.

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Book Review: It Didn’t Start With You

Shakespeare said, “The sins of the father are to be laid upon the children.” Often repeated and even more often actualized, this concept of the transference of “sins” through a generation is now supported by scientific evidence, as explained in Mark Wolynn’s It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle.

This groundbreaking work on generational trauma educates, comforts, and empowers individuals from all walks of life to both identify and disassociate from traumas that were passed down from previous generations.

Wolynn’s work is rooted in a journey he traveled to find healing from his own hang-ups and traumatic experiences. The path he took and the healing he found then became his gift to others through this book and his work with clients. Based on a mix of experiences and scientific evidence, Wolynn clearly and verifiably demonstrates the impact of generational trauma, down to the way it changes the expression of a particular gene.

Pulling on a mix of epigenetics and trauma psychology, he provides both a primer on the ancestral transmission of trauma and its symptoms and a method to recognize and deal with the lingering aftereffects. His liberal use of personal anecdotes, client testimony, and tangible examples balances the somewhat cerebral topic in a masterful way, providing an accessible and easy to understand resource for both the casual reader and the practitioner; however, the tone, style, and delivery make this an ideal tool for those seeking freedom from trauma in all its forms.

In the realm of self-help/recovery books, It Didn’t Start With You is equal parts refreshing and heavy; there is a definite weight when realizing that a family’s history can so deeply affect each member. There is also something very refreshing about realizing that there is a solution that doesn’t require years and years of therapy — it starts with taking an honest look at yourself, what you say, and what that says about you and your history. As an avid reader of these types of books, It Didn’t Start With You struck the right balance between diagnosis and prescription without falling into the self-help cliché traps of blaming parents, blaming yourself, or relying solely on positive self-talk.

The key premise of the book is found in the title: It Didn’t Start With You. By identifying core issues and the words we use to describe them, Wolynn asserts that any individual can trace back depression, suicidal tendencies, anger, and other negative emotions to ancestral issues rooted in traumas such as abandonment, detachment from the mother, deaths of either parent, and issues relating to parents as a whole. What was particularly interesting was the reality that these experiences can be translated into three generations, considering the fact that the precursor cells for the third generation are present during the first generation’s pregnancy.

These traumas appear often as what Wolynn calls “core complaints,” which are communicated via “core language.” Through a simple analysis of the two, one can identify a bridge back to an ancestral trauma that may have carried down. To illustrate this, Wolynn used examples such as grandchildren of Holocaust survivors, children of 9/11 survivors and the generations that followed the Rwandan genocide. In each case, there were core complaints and core language that traced back to the trauma experienced by an ancestor.

The final portion of the book was perhaps the most empowering section of a self-help book I’ve ever read, mainly because they provided more than rhetoric about the issue. Wolynn walks the reader through the process of identifying the core complaint, core language, and core descriptors, turning them into a core sentence, bridging the gap between the generations and finally, letting go of trauma in a positive and respectful manner.

From a holistic perspective, It Didn’t Start With You is a groundbreaking resource that provides a thorough yet understandable primer on the science behind trauma, as well as a step-by-step methodology to constructively work through the trauma.

It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle
Viking/Penguin Random House LLC, April 2016
Hardcover, 251 pages
$28.00

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Worried about Forgiveness

I come from a family history of multigenerational parental sexual and emotional abuse as well as NPD and severe depression/anxiety issues. Keeping a healthy relationship with my both my parents takes a lot of emotional energy and requires me to sometimes be the parental figure in the situation, especially with my mother. It has required years of therapy and spiritual investment to maintain a forgiving outlook.

My husband and I have been married 2 years, together for 11, and he is a huge part of my healthy mental state. We work very hard to keep our relationship as a priority.

My husband and I tend to expect that my parents would be the difficult in laws, as his family appears to be far more “normal” than mine. However, it seems that his mother has proven to be the most difficult parental relationship.

I feel guilty because my husband has always been so understanding of my family while it has been difficult for me to be forgiving of his mother. I am worried that because I am constantly dealing with my parents’ issues that I do not have emotional space left to be understanding of his mother who can act very selfishly. I also feel guilty that I have precipitated fights between my husband and his mother. I don’t consciously try to stir up animosity, but I have a tendency to point out when my mother-in-law treats my husband badly (maybe because I am always on high alert with my parents). When my husband and I were dating, I became much more aware of how my husband resolves conflict with his mother. She pushes him around, much like all of her other relationships. She can be very manipulative and never apologizes. It is always about her. They do not fight all the time by any means, but she tends to be very “me” centric and eventually my husband gets so frustrated with her selfishness that he blows up at her. Then, the rest of the fight is spent placating her without her addressing at all how she contributed to the problem.

After her actions led to several difficult situations regarding wedding planning and the wedding itself and now recently with my husband and I purchasing our first home together, I am fed up. She never apologizes! It sounds ridiculous but I am not exaggerating. How do I deal with her?

A: Thank you for asking such a thoughtful and interesting question. Dynamically, you and your husband share a familiar role in your respective families. It sounds like the narcissism has been a powerful and difficult feature each of you have had to deal with each of your mothers.

I recommend that the two of you discuss your vulnerability and needs with each other on a regular basis — not just in crisis time. (Couple therapy may be found at the ‘Find Help’ tab at the top of this page if you feel you need help in doing this.) You want to continually join forces and share the difficulty in doing that with each other. Your families are the common enemy in this regard. It is difficult to forgive (and some research shows it is best not to do so too quickly) when the person has an abusive and narcissistic feature to them.

I’d also recommend Alice Miller’s classic book: Drama Of The Gifted Child. It discusses in depth the issues of growing up with a narcissistic mother.

Finally, I’d begin to pull back significantly in the frequency and intensity of contact with both families. Your future is together with your husband, not staying in orbit around the chronically self-absorbed.

Wishing you patience and peace,
Dr. Dan
Proof Positive Blog @ PsychCentral

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The Psychology of Donald Trump & How He Speaks

Donald J. Trump will go down in American history as one of the most unusual politicians of all time. He is an enigma to everyone in the political establishment (and to much of America) as he continues his 2016 run for the American presidency.

What makes this Republican nominee tick? Why does Donald Trump speak the way he does, saying clearly outlandish things, then taking them back a day or two later? Let’s find out.

I’m not the first person who has had serious concerns about the mental health and stability of Donald Trump. Many others have commented on their concerns before me, especially about Trump’s apparent narcissism.

But I felt that these issues were best summarized in a short article to explain why these concerns exist in the first place. After all, when there’s a presidential election, a candidate’s mental health is usually not even a concern — much less the focus of the amount of media attention given to Trump during this presidential election season.

Does Trump Suffer from Narcissistic Personality Disorder?

Therapists, researchers, psychologists, and experts in mental health appear pretty consistent in their belief that Trump suffers from narcissistic traits consistent with Narcissistic Personality Disorder:

“Textbook narcissistic personality disorder,” echoed clinical psychologist Ben Michaelis. “He’s so classic that I’m archiving video clips of him to use in workshops because there’s no better example of his characteristics,” said clinical psychologist George Simon, who conducts lectures and seminars on manipulative behavior. […] “Remarkably narcissistic,” said developmental psychologist Howard Gardner, a professor at Harvard Graduate School of Education.

Maria Konnivoka, writing over at the Big Think over a year ago nicely summarized the evidence for Trump’s personality symptoms. But for a reminder, let’s look at the symptoms for this disorder one by one.

• Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  Trump does this regularly, exaggerating every achievement of his. Remember when he proudly proclaimed he “knew” and was “friends” with Russia’s President Putin, then later acknowledged he had never even met him?
• Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  Trump constantly proclaims how great everything he suggests he will do as president will be “fantastic” or “the greatest.” His entire business career appears focused on creating the impression that this is one successful, brilliant, power guy. But he’s actually been a pretty mediocre businessman according to most yardsticks.
• Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  Trump bought and refurbished the 118-room, 20 acre, multi-million dollar estate called Mar-a-Lago in Florida, allowing him to associate with only those others who can afford the $100,000 membership fee and $14,000 in annual fees.
• Requires excessive admiration
  “All of the women on The Apprentice flirted with me – consciously or unconsciously. That’s to be expected,” said Trump at one point.
• Has a very strong sense of entitlement (e.g., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations)
  “I’m running against the crooked media,” said Trump. Trump apparently wants to eviscerate the First Amendment, arguing that Congress should “open up our libel laws” (making it easier for people to sue for libel). If someone prints or says something negative about Trump, he immediately attacks back (usually with a name-calling tweet).
• Is exploitative of others (e.g., takes advantage of others to achieve his or her own ends)
  After 9/11, apparently Donald Trump — not a “small business” — took advantage of $150,000 in government funds to help small businesses. He’s also been accused of taking advantage of the tragic Orlando shooting and U.S. bankruptcy laws — exactly as you’d expect a billionaire to do.
• Lacks empathy (e.g., is unwilling to recognize or identify with the feelings and needs of others)
  When a grieving U.S. Muslim mom and dad who lost their son during the Iraq war in 2004 appeared at the Democratic national convention to berate Trump for his proposal to ban all Muslims from entering the country, this was Trump’s tangential, non-empathetic response to their grief: “His wife … if you look at his wife, she was standing there. She had nothing to say. She probably, maybe she wasn’t allowed to have anything to say. You tell me.” (Or, look at the way he mocked a person with a disability.)
• Is often envious of others or believes that others are envious of him or her
  While I’m certain Trump believes others likely envy him, there’s not as much support for this one: “One of the problems when you become successful is that jealousy and envy inevitably follow. There are people—I categorize them as life’s losers—who get their sense of accomplishment and achievement from trying to stop others” (p.59, Trump: The Art of the Deal).
• Regularly shows arrogant, haughty behaviors or attitudes
  Trump: “You know, it really doesn’t matter what (the media) write as long as you’ve got a young and beautiful piece of ass.” (Or, again, look at the way he mocked a person with a disability.)

How Trump Uses Indirect Speech

Trump is a master of speaking indirectly to whoever his audience is. This is when he doesn’t come out and explicitly say something, but rather simply implies it. Psychologists call this indirect speech and Trump excels in it.

Here are a few examples of it:

“Russia, if you’re listening, I hope you’re able to find the 30,000 emails that are missing. I think you will probably be rewarded mightily by our press.”

The implication is that Trump was asking a foreign power to intervene in a national election through illegal activity. He later walked it back — as he does nearly all of his indirect speech comments — by claiming he was “only joking.”

“Only joking” or “don’t you get sarcasm when you hear it?” are rationalizations used by others when they want to say something, but don’t want to stand up for what they said. It is the type of speech that psychologists see regularly used by cowards and bullies, not usually politicians or distinguished statesmen.

“If [Hillary Clinton] gets to pick her judges, nothing you can do, folks… Although the Second Amendment people — maybe there is, I don’t know.”

Most people took this to mean that Trump was calling for the “Second Amendment people” to “do something” about it. Later, Trump claimed he was only encouraging those folks to use their voting power, but many people took this comment to mean something more nefarious. “[…] Literally using the Second Amendment as cover to encourage people to kill someone with whom they disagree,” commented Dan Gross, the president of the Brady Campaign to Prevent Gun Violence, after he heard Trump’s comments.

Indirect speech has many benefits. By not saying what you mean, you encourage every listener to form their own opinion about what you intended. That means his supporters will hear one thing, while his detractors hear something completely different. If anything he says is taken the “wrong way” by too many people, he can simply negate it: “You misunderstood,” “Only joking,” “That was sarcasm.” It’s a perfect linguistic and psychological trick that Trump exquisitely deploys to his benefit. It allows plausible deniability for anything he says. This makes it very hard to pin him down on anything he says, much like trying to nail jello to a wall.

He’s had to walk back so many of his comments, people have lost track of the count. Just last week he claimed that President Obama and former Secretary of State Hillary Clinton, Trump’s opponent in the presidential race, were literally the “founders of ISIS,” the Islamic terrorist group that has its roots during the time of the Bush presidency:

“No, I meant he’s the founder of ISIS… I do. He was the most valuable player. I give him the most valuable player award. I give her, too, by the way, Hillary Clinton. … He was the founder. His, the way he got out of Iraq was that that was the founding of ISIS, okay?”

The next day, typical of Trump’s behavior, he took the comments back, after it became clear everyone knows he was lying about Obama’s “founding” status in ISIS. (President Obama, of course, had nothing to do with the founding of this terrorist organization based in the Middle East.)

Trump: Crafty Liar or Just Plain Bullshitter?

The other week, the Washington Post’s Fareed Zakaria had an insightful article about whether Trump’s constant lies are purposeful behavior in service of some ultimate goal, or are they simply symptoms of a “bullshit artist:”

[Princeton professor Harry] Frankfurt distinguishes crucially between lies and B.S.: “Telling a lie is an act with a sharp focus. It is designed to insert a particular falsehood at a specific point. . . . In order to invent a lie at all, [the teller of a lie] must think he knows what is true.”

But someone engaging in B.S., Frankfurt says, “is neither on the side of the true nor on the side of the false. His eye is not on the facts at all . . . except insofar as they may be pertinent to his interest in getting away with what he says.” Frankfurt writes that the B.S.-er’s “focus is panoramic rather than particular” and that he has “more spacious opportunities for improvisation, color, and imaginative play. This is less a matter of craft than of art. Hence the familiar notion of the ‘bullshit artist.’ ”

Trump — with his indirect speech patterns and ability to step back from any lie he tells — appears to be the consummate American bullshit artist.

And if he wins this presidential election, he will have shown that the American people will buy any line of B.S. it hears, as long as the person shelling it out is confident enough in the telling.

 

Reference

Lee, J. J., & Pinker, S. (2010). Rationales for indirect speech: the theory of the strategic speaker. Psychological Review, 117(3), 785.

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Filicide and autism

"The choice of the victim was in line with emerging evidence indicating that children with disabilities in general and with autism in particular are frequent victims of filicide-suicide."The case report presented by Declercq and colleagues [1] reflects yet another uncomfortable topic discussed on this blog and how the 'deliberate act of murdering ones own child' is something unfortunately not unfamiliar when it comes to the label of autism. Declercq et al provide quite a raw account of paternal filicide and how circumstances and state of mind may have been important variables in determining the eventual outcome. Not least is the intersection between "schizoid personality disorder and homicide and violence" that appears to have been linked to such an act (minus any sweeping generalisations).This is not the first time that the words 'filicide' and 'autism' have appeared together in the peer-reviewed science domain as per other examinations of media reporting of such acts [2] that have revealed a disturbing trend when it comes to "disabled children as victims of filicide-suicide." The fact that some authors have even gone as far as talking about "prevention strategies" [3] specifically with filicide in families with autistic children should tell you that despite being an uncomfortable discussion, this is not something that can be just brushed under the carpet.Having read about quite a few accounts of filicide-suicide where autism has figured down the years and the many and varied responses to such acts (see here and see here for example), it's clear that there are a number of different viewpoints when it comes to this emotive topic. Murder is murder and that point should never be forgotten; made all the more harrowing by the fact that it was a parent and a trusted caregiver who carried out such a heinous act. Irrespective of circumstances, the murdered child is the victim; let us not forget that.I also believe that it is right to research and question how and why such acts come about. In the same way that the motives of autistic people who themselves kill a parent (although rare) need to be understood, so one needs to know what might drive a parent to kill their child with autism. Such questioning does not condone such actions; neither does it or should it lessen the impact of such actions. It merely highlights the idea that to know why such acts occur can potentially prevent further instances happening in other cases. If such knowledge saves only one child, it will be worthwhile.I'm not going to venture further into the possible reasons why parents murder their children - whether with autism or not - because they are likely to be complex and variable from case to case bearing in mind that becoming a parent does not automatically make a bad person into a good person. What I will reiterate is that murder is murder and if there is even the slightest hope that science can identify factors that might place a child at risk, resources aplenty should be poured into looking.----------[1] Declercq F. et al. A Case Study of Paternal Filicide-Suicide: Personality Disorder, Motives, and Victim Choice. J Psychol. 2016 Aug 18:1-13.[2] Coorg R. & Tournay A. Filicide-suicide involving children with disabilities. J Child Neurol. 2013 Jun;28(6):745-51[3] Palermo MT. Preventing filicide in families with autistic children. Int J Offender Ther Comp Criminol. 2003 Feb;47(1):47-57.----------Declercq F, Meganck R, & Audenaert K (2016). A Case Study of Paternal Filicide-Suicide: Personality Disorder, Motives, and Victim Choice. The Journal of psychology, 1-13 PMID: 27537187...

Declercq F, Meganck R, & Audenaert K. (2016) A Case Study of Paternal Filicide-Suicide: Personality Disorder, Motives, and Victim Choice. The Journal of psychology, 1-13. PMID: 27537187  

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Climate disasters act as threat multipliers in ethnic conflicts.

Schleussner et al. offer a proof of a common assumption about the effects of climate disasters: that they drive people further apart rather than closer together:

Social and political tensions keep on fueling armed conflicts around the world. Although each conflict is the result of an individual context-specific mixture of interconnected factors, ethnicity appears to play a prominent and almost ubiquitous role in many of them. This overall state of affairs is likely to be exacerbated by anthropogenic climate change and in particular climate-related natural disasters. Ethnic divides might serve as predetermined conflict lines in case of rapidly emerging societal tensions arising from disruptive events like natural disasters. Here, we hypothesize that climate-related disaster occurrence enhances armed-conflict outbreak risk in ethnically fractionalized countries. Using event coincidence analysis, we test this hypothesis based on data on armed-conflict outbreaks and climate-related natural disasters for the period 1980–2010. Globally, we find a coincidence rate of 9% regarding armed-conflict outbreak and disaster occurrence such as heat waves or droughts. Our analysis also reveals that, during the period in question, about 23% of conflict outbreaks in ethnically highly fractionalized countries robustly coincide with climatic calamities. Although we do not report evidence that climate-related disasters act as direct triggers of armed conflicts, the disruptive nature of these events seems to play out in ethnically fractionalized societies in a particularly tragic way. This observation has important implications for future security policies as several of the world’s most conflict-prone regions, including North and Central Africa as well as Central Asia, are both exceptionally vulnerable to anthropogenic climate change and characterized by deep ethnic divides.

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Vicarious Trauma: How Much More Can We Take?

Another week, another tragedy. It’s hard to take it all in, let alone make any sense of it.

How does bad news affect us?

We can all be affected by vicarious trauma. That is the “one step removed” trauma that didn’t actually happen to us directly, but which still affects us nonetheless.

Obviously, for the victims’ friends and relatives the effects are acute, but for the onlookers (also from the news, social media and the press) these events have a profound cumulative effect.

When experiencing physical or emotional trauma first- or secondhand, our brains are affected by the perceived threat to well-being.

We are affected not only by the shock and outrage, but also by the emotional tidal wave that accompanies a significant traumatic event.

This is registered in the emotional, or limbic, part of our brain, and we then try to give it a narrative story with which to file it away. The problem is that our mental filing cabinets are already overflowing with traumatic stories.

For those of us able to feel empathy and compassion for our fellow man, we then feel compelled to act, to alleviate suffering, and to get things back to normal.

However, when we understandably feel impotent in the face of such huge national and global threats and traumatic events — whether natural or man-made, one-off or repeated — our distress becomes compounded, and we can lapse into a ‘freeze’ state of emotional overwhelm, inertia and collapse.

One way we try to minimize the threat to ourselves is to create distance from the event, by rationalizing it.

We might say things such as ‘oh well, that’s their culture.’ ‘At least it’s not happening here in my country.’ ‘Stuff happens.’

When an atrocity affects one of us or our tribe who happens to be in a foreign land, in the wrong place at the wrong time, then that coping mechanism of distancing fails to protect us from the more personal ‘that could have been me’ impact of the trauma.

A highly significant factor which determines how much we are affected by trauma is our previous exposure to traumatic events in childhood.

If we’ve had an abusive and traumatic childhood, we then defend ourselves from the impact of further traumas by our emotional shutdown.

We needed this form of psychological self-defense years ago for our emotional and physical survival, but it limits us as adults. We’ve become overly sensitive and vulnerable to further emotional overwhelm.

Early childhood traumas will have set us up to have an oversensitive amygdala (part of our limbic brain area), which will be rapidly activated whenever the brain makes a new association with a perceived threat, physical or emotional overwhelm, or a victim/oppressor dynamic.

What can we do?

• We need downtime between major traumatic events so that we can regain our equilibrium and turn down the dial on our emotional reactivity.
• We need to convince ourselves that we are sufficiently safe and protected, which of course we never really are. The best we can hope for is ‘I’m safe right now.’
• Realize that it’s a balancing act between allowing ourselves to feel what we feel and still having our logical, rational brain functioning available to put things into context and perspective.
• Look at the statistics and probability factors which can help to reassure us. Impartial objective education also helps us to make some sense out of a traumatic event.
• If we can get a glimpse into the mindset and belief system of the perpetrator (no matter how bizarre and dysfunctional) we can at least see the ‘why’ behind their actions. Behaviors always have a reason, even if it’s hard to understand.
• We can rate the impact of an event, and use our cognitive brain functions to recalibrating our emotional brain. This rating scale would be based upon both the personal impact of a traumatic event and the wider impact upon society. The higher the impact, the more we need to self-soothe, find our inner resilience, and get ourselves ready to do something that helps our fellow man in whatever way we can.
• Share your feelings, particularly with close family and friends who will also be affected by the vicarious trauma, in a negative ripple effect.
• Grief can immobilize us and delay processing our trauma, so it’s important to talk things through with a professional if you are finding that your vicarious trauma feels overwhelming, or is reactivating your own traumatic memories from the past.

The big challenge to us all is how to feel safe in this unsafe world, and to keep ourselves calm and on an even keel in the violent storms that we must all navigate our way through.

Andrea Lea Chase/Bigstock

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Book Review: Understanding Mental Illness

As a licensed marriage and family therapist and mental health writer, I am always interested in new books about mental health and the way we treat those with mental illnesses, so it was with interest that I picked up Marianne Richards’s self-published new book, Understanding Mental Illness: Comprehensive and Jargon Free 6^th Edition. While Richards does give a comprehensive overview of the history of mental illness, the ways in which we as a society often treat it, and the defining characteristics of the most common diagnoses, I was left wondering just how this information might apply to someone who suffers from a mental illness or a professional treating this person.

Richards, who herself was diagnosed with Asperger’s years ago and experienced firsthand the stigma that those with mental illness often feel, begins with a historical look at mental illness. “Throughout history, individuals who have not conformed to the expectations of society (or their tribe) risked exclusion,” she writes. Much of this can be attributed to the difficulty society has in defining just what sanity is. While it is helpful to recognize non-conforming behavior, it is not helpful to act upon it irrationally, which is often referred to as “moral panic.”

Historically, this exclusion was most often in insane Asylums. “These were not only people with active mental illnesses but so-called social misfits whose only problem was eccentricity or minor social aberrations,” Richards writes. However, mental illness, rather than appearing in rigid categories, is better explained as existing upon a continuum, where no person remains neuro-typical throughout their life.

Much of what actually appears strange to us, Richards tells us, is not always the problem of the individual, but rather our own perception of that person. Yet because mental illness has so frequently been sensationalized, it has been given a negative image. And when those who are different experience this stigma, it often has an exponential effect. “Sometimes it’s not a matter of where you live but the society you are born into which determines your fate if you have a mental condition,” Richards writes.

It wasn’t until the Greek philosopher Hippocrates proclaimed that madness was “no more divine nor sacred than other diseases but has a natural cause,” that societal attitudes began to shift toward mental illness. The parallel is that while Hippocrates believed that mental illness was caused by imbalances in the vital fluids, psychiatrists now treat mental illness with medications to balance brain chemistry.

What also emerged out of the study of mental illness — which we can attribute to Carl Jung — was that many character constellations can be found across numerous cultures and generations. For example, the archetypes of the hero, wise man, mother, and fool have deep historical roots and are easily recognized in many different cultures. A second important finding was the value of the therapeutic relationship, which exists across the wide range of treatment modalities.

Adding to our understanding of mental illness, Richards takes a look at the Mental Health Act of 1983, which regulated the “reception, care, treatment of mentally disordered patients, the management of their property, and other related matters.” This regulation defined the ways in which patients could be removed from public places and admitted to treatment, and the need for their consent to do so, as well as the situations in which consent is overridden by concern for public safety.

Richards then explores the typical treatment modalities for mental illness and offers the following advice: “When selecting a therapist, there are two vital criteria. Therapists who have unresolved life problems will not help anyone. Therapists with a wide life experience are more likely to have a quality called empathy; good therapists possess this in spades.” However, while Richards explores both the psychotherapeutic and medical approaches to mental illness, I was left wondering how a patient with mental illness might know if their therapist has unresolved life problems.

Richards then provides “pen portraits” of therapists which I found interesting and engaging. For example, she describes Vera, a private practice counselor specializing in brief therapy, whose day consists of offering a distressed client practical problem solving skills, listening to an anxious client, helping an unhappily married man clarify his thoughts, and dealing with a passive aggressive co-worker.

Richards also explores some common mental conditions, their defining criteria, typical treatment approaches, and case histories, which again, I found interesting and informative. For example, Richards tells us that Obsessive Compulsive Disorder is often experienced as an inability to tolerate disorganization and a compulsion to make things orderly that are not under the person’s control.

Lastly, Richards offers eight keys to mental health, such as eating well, talking about feelings, learning new skills, and being creative. On the topic of stress, Richards reminds us that stress is a necessary part of life, but excessive stress results in unpleasant symptoms.

While Understanding Mental Illness is a clear and informative synopsis of the history of mental illness and the ways in which it has been treated, those who are looking for practical advice on just how to manage mental illness, or the stigma that often accompanies it, will need to look further.

Understanding Mental Illness: Comprehensive and Jargon Free 6^th Edition
CreateSpace Independent Publishing Platform, September 2015
Paperback, 169 pages
$12.99

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How 30 Minutes of Exercise Every Day Can Boost Mental Wellbeing

When we discuss the advantages of regular exercise, it’s usually the benefits to physical well-being that take centre stage, and for obvious reasons.

Most are aware that physical exertion can aid cardiovascular health and protect against a plethora of hypertensive conditions. These reasons, alongside wanting to lose weight and improve the way we look, are among the chief motivations for embarking on an exercise program.

But perhaps lesser known and lesser discussed are the benefits regular exertion can have on mental wellbeing, which are numerous. In fact, courses of regular exercise are becoming a more utilized tool in the treatment of mental health issues, for a variety of reasons.

As we’ll discuss, regular exercise needn’t constitute arduous back-to-back shifts in the gym. Just 30 minutes a day can have a range of benefits on mental health.

Mood improvement

Firstly, physical exertion is thought to stimulate the release and activity of endorphins. This process, referred to as the ‘endorphin hypothesis’ and explained by Anderson and Shivakumar as the ‘binding of [endogenous opioids] to their receptor sites in the brain’, has been explored in several analyses.

Besides their analgesic effect on physical pain, the increased activity of endorphins during exercise is also credited for improving the mood of the person practicing it. For instance, one study examining patients living with clinical depression found a convincing link between 30 minutes of aerobic exercise performed on a daily basis and “substantial” mood improvement.

Stress reduction

In addition to the stimulation of endorphins, exercise is also known to have a direct effect on the presence of cortisol and adrenaline in the body. These are natural stress hormones, often referred to as the “fight or flight” chemicals which can be triggered by a range of stimuli, including danger or emotional trauma. In persons with chronic stress or anxiety, levels of these hormones may be continually raised.

Intense physical exertion is thought to acutely increase cortisol levels, which is perhaps unsurprising due to the strain the body is being put under.

However, performing 30 minutes of low intensity exercise has been linked by one study with reduced cortisol levels.

Furthermore, regular exercise has been associated with a decreased overall presence of cortisol levels in the long term, as the body will become more used to physical exertion and not need to produce as much. So for those who make a habit of exercise, their resting levels of these stress hormones may significantly decrease.

Raised self-esteem

Another mental benefit of frequent physical activity is that it improves body image, and consequently this aids self-esteem.

One analysis undertaken by researchers at the University of Florida found that exercise at all levels had a positive effect on the way people felt about their bodies; and their results suggested that this wasn’t limited just to those who undertake exercise on a regular basis.

However, most will know from experience that one-off episodes of physical activity aren’t enough to sustain these feelings over the long term, and a person’s positive self-image may wear off after a prolonged period of inactivity.

Frequent exercise on the other hand contributes towards higher energy levels and better overall physical health; and the better we feel, the more comfortable we are about the way we look.

Increased social interaction

One particular advantage of participating in a team sport is that it raises our level of social contact with others.

Recently, I headed an investigation into the calorie-burning value of participating in 28 different olympic activities for 30 minutes each, which celebrated in particular the role team sports can play in helping someone to maintain a regular fitness regime.

The social interaction hypothesis is a term sometimes to describe the link between physical activity in a communal setting and improved mental health. By facilitating the development of social relationships through team and communal fitness activities, exercise can help to reduce feelings of isolation and provide a supportive environment.

Regular social contact is of course more beneficial, but team sports don’t have to account for every session of someone’s entire workout routine. Participating in just one communal activity per week can contribute towards better mental health.

References:

Anderson, E. et al. ‘Effects of Exercise and Physical Activity on Anxiety.’ Frontiers in Psychiatry. 2013. http://ift.tt/1pFfaM3

Guszkowska, M. ‘Effects of exercise on anxiety, depression and mood.’ Psychiatria Polska. 2004. http://ift.tt/1JNaCrc

Dimeo, F. et al. ‘Benefits from aerobic exercise in patients with major depression: a pilot study.’ British Journal of Sports Medicine. 2001. http://ift.tt/2c6mbQf

Harvard Health Publications. ‘Exercising to Relax.’ Harvard Men’s Health Watch. 2011. http://ift.tt/1Ks9y0y  

Hill, EE. et al. ‘Exercise and circulating cortisol levels: the intensity threshold effect.’ Journal of endocrinological investigation. 2008. http://ift.tt/1h7qsTd

Hausenblas, H. et al. ‘UF study: Exercise improves body image for fit and unfit alike.’ UF News. 2009. http://ift.tt/1DWzVHt

Osborne, W. The Olympic Exercises That Burn The Most Calories. 2016. http://ift.tt/2aFSuEv

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When Your Mother is a Narcissist

Be the subject of your own life, not the object of someone else’s.

Only children of narcissists know the insidiousness of growing up with the crazy emotional mind games and conditioning they were raised with.  Children of narcissists do not realize that they are being abused and conditioned in dysfunctional ways, until years into their adulthood and often years after entering therapy.  Because a child’s vantage point is so limited, he has no idea that his upbringing is not “normal” and may even be harmful.  Even if a child does realize that something is just not right with Mom, he still doesn’t understand how it has affected him or what to do about it.

Following are a list of the types of abuse experienced by those being raised with a narcissistic mother:

• She gives silent treatments when angry.  This causes her children to feel guilty, responsible, and invisible.
• She flies into a rage over what appear to be innocuous events, causing her children to feel like they are navigating landmines.
• While getting angry over minutia, she often under-reacts over other things of monumental importance in her children’s lives, or by things that other parents would find very upsetting.  Her priorities make no common sense.
• She is more concerned with what strangers think about her than what her children think or how they feel.
• She controls the entire family, including Dad, by her outlandish and unpredictable behaviors.
• Her children serve as actors in her screenplay; as subjects in her kingdom; as roles in her script; they are not valued for their individuality or uniqueness.
• Only one person’s emotions matter in the household – Mom’s.
• Only one person is allowed to express her emotions in the family – Mom.
• She is emotionally abusive, resulting in children struggling with self-loathing, confusion, and chronic anxiety.
• She creates cognitive dissonance in her children, which results in an inability to trust one’s own reality.
• She constantly implies to her children that they have some how done something terrible to cause her to feel unhappy.
• Some narcissistic mothers pit siblings against each other, eroding one of life’s most important relationships – the one between siblings.

Children growing up in homes with narcissistic mothers learn to dissociate emotionally and try as they might to detach.  They become emotionally disengaged and learn to intellectualize their problems.  They have a type of attachment-trauma because their mother is incapable of providing healthy “attunement,” which psychologists have found is necessary for emotional health.

It is hard for children of narcissists to realize that they have been abandoned because in their minds they have had “too much” of their mother.  While it may be true that they had too much of something from their mother, it wasn’t enough of emotional nurturing, connecting, valuing, empathizing with, or role modeling that was needed.

Children of narcissists have been emotionally abandoned and neglected in important developmental ways. They grow up mainly feeling bad about themselves because they have been conditioned to believe they are internally flawed.  This is the result of their mother’s brainwashing and conditioning, which was effective in manipulating their little forming self-identities.  And since children really haven’t developed sufficient analytical capabilities nor have they had other families to grow up in to use as a standard, they don’t realize the impact of what they’ve been through.  They are stuck figuring things out themselves, and the conclusion they come up with is that it is somehow their fault.

If you live in the Southern California area, please see attached flyer for “Healing from Narcissistic Mother Abuse” Workshop: narcmotherflyer09.11.16

If you would like to receive my free monthly newsletter on the psychology of abuse, please send me your email address at: therecoveryexpert@gmail.com

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Caffeine reverts memory deficits by normalizing stress responses in the brain

A new study describes the mechanism by which caffeine counteracts age-related cognitive deficits in animals. The international teams showed that the abnormal expression of a particular receptor – the adenosine A2A, target for caffeine – in the brain of rats induces an aging-like profile namely memory impairments linked to the loss of stress controlling mechanisms. “This is part […]

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Collaborative Practice: The Good, The Bad, The Dangerous

“Sorry I’m late, I couldn’t find parking!” My 1 p.m.  patient said from the doorway clasping her hands nervously.

Emily S walked quickly into my therapy office. My initial impression was that she was anxious and then my second thought was that she had put some effort into looking well put together. However, her dress, her styled hair and artfully applied make up did not cover the pained expression on her face or the aura of distress that surrounded her. I smiled, welcoming her in.

Somewhere in the middle of the session her protective shield crumbled under my gentle encouragement and she collapsed into a miserable ball of tears. Emily had complex co occurring issues; an eating disorder hidden for 15 years and triggered by relationship problems, anxiety, depression and dependence on pain medications.

She was struggling; she was lost and very frightened.

This encounter would be a change-making experience in my practice as I had just learned that my collaborator (a coach with “expertise” in mindfulness, addiction recovery treatment and nutritional ) had breached our informal verbal agreement in several ways.

He did not have formal training in the nutritional domain. He was in partnership with four other therapists and was collecting surplus/cash fees apart from the “package” that our office charged our patients.

This individual was my first “collaborator” and he was my sister’s friend.  The expectation had been that our work would provide patients who had co occurring, difficult problems with resources and treatment that was based upon the recovery model with addiction as a core focus .

This area was not in my domain of expertise and the inclusion of a specialist within my office would meet clients’ needs for immediate and targeted help that was carefully integrated with the method of psychotherapy that I practiced.

Emily, and many other patients, needed psychotherapy for her depression and anxiety as well as coaching with nutritional input for the hidden, neglected eating disorder and help for her drug dependence.

If I referred her to outside specialists it would incur waiting for appointments and communication issues that might be too much for her to undertake in her emotionally and physically drained condition.

In this case, given the problems with my partner, I did have to refer her to outside specialists and it was a laborious process that could have been much more helpful to her.

What I learned was vitally important for the continuance of a functional and sustainable collaborative practice.

Formal Collaboration Should Be Viewed as a Business

It is important to use a business model when you engage another individual in your practice if the goals are the following;

To achieve a professional and sustainable model of practice that is based upon mutual trust and agreement upon basic ethical principles of practice

To provide clients with a full range of therapeutic strategies in a timely fashion without interruptions because of differences in practice models or breaches in agreements.

The agreement between partners should be in writing and specify the following items with more added as needed.

• The location of the sessions
• Fee schedule
• Number of clients to be taken on
• Length of time for each session
• Guidelines for emergency situations
• Need for documentation
• Schedule of review meetings between consultant and primary practitioner
• Plans for back up in the event of illness or other unexpected occurrences.

There are Positives of a Collaborative Practice. They include:

• Clients are provided with multiple resources for achieving changes and recovery
• The process may be more time efficient that benefits a client suffering from multiple sources of pain
•  Collaboration gives each partner an opportunity to discuss avenues of treatment and their own views of the patient–more objective
• Simplification:  A package option in terms of fees may reduce complexity of paying for the services

The Cons of a Collaborative Practice include:

• Sharing a client may be difficult for the solo practitioner in initial phases. There may be differences in perception of the client and their needs, in plans for intervention and in other domains. Collaboration will entail an ability to be flexible but always keeping the patients’ well being in focus.
• The issues of finances; what insurance covers and what it does not will come into play and may necessitate a blended protocol with insurance covering part of the therapy
• The client may not be familiar with the dual process and can be somewhat resistant. This reluctance will necessitate education about the benefits of this model.
• The timing of each partners’ therapies can be difficult. For example, one may tend to advance in treatment at a faster pace.  They must communicate on a frequent basis so as not to precipitously  introduce or terminate a strategy
• The roles and training levels of each provider differ and have to be clearly delineated and then explained to the client. There may be issues in regard to decision making and final responsibility that will need a full discussion prior to agreement.

The Dangerous Issues in a Collaborative Practice are:

There are perils that may compromise the helping process and do harm to the patient and the psychotherapist.

• The collaborator has poor boundaries and extends his work into other realms where he or she has no expertise
• The collaborator has not been transparent about skills, certifications, fees collected
• The collaborator makes a separate commitment to the client for such things as continuing services after termination or being available during non-working hours
• The collaborator has a need for control over the process and undermines the therapist and his or her treatment and expertise.

Recognizing the positive and negative aspects of collaborative practice is a core element of homework that precedes finding that individual who fits well and becomes a strong asset.

There are several essential elements in the development of a collaborative practice between therapists and consultant. First and foremost is the need to understand the roles, skills and knowledge of each individual.

Other important factors include meeting initially to define shared authority, accountability and coordination of care and to develop mutual trust and respect. Collaboration should be viewed as an opportunity to enhance professional relationships, optimize practice and provide the structure for a  positive working relationship capable of enhancing patient care.

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Does My Wife Have BPD Lite?

From the U.K.:My wife and I have been having problems in our marriage lately. The main argument as I understand it I would like her to stop being so angry with me when I’ve done something “wrong” and her side of the argument is I should “know” that I should do the things I do.

After googling such phrases as “wife is never satisfied” “wife blames all her problems on me” I read a few different articles and some of them really sounded like my wife might have BPD.

The reason why I ask is there a “lite” version is we can go for months without an episode of unreasonability happening. Your quiz seems to indicate she doesn’t have BPD but I feel something is going on.

A: I hesitate to assign a pathology to what may be a lack of skills. This is particularly true when a problem is only episodic. It may be, for example, that your wife didn’t grow up with parents who modeled how to deal constructively with conflict. It may be that she is so anxious about being at fault that she shifts blame rather than take responsibility. Or it may even be that the two of you aren’t in agreement about your respective roles in your relationship.

I suggest you consider seeing a couples therapist to talk about how to avoid the blame game and how to instead work on problems as a team.

In the meantime, you might find this article to be helpful: 10 rules for Friendly Fighting.

I wish you well.
Dr. Marie

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A Common Vitamin Deficiency Linked to Depression in Women

Very common vitamin deficiency linked to higher levels of depression.

** Get 10% off PsyBlog's motivation ebook -- use code "10OFF" **

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Is It Withdrawal Symptoms or a Depression Relapse

Four years ago, a good friend of mine put her 10-year-old son on Prozac (fluoxetine). He had always suffered from anxiety and anger outbursts, but at age 9, his behavior turned violent, and his ruminations were keeping him up at night. My friend and her husband went to a variety of child psychologists, but the cognitive behavioral therapy wasn’t enough. Finally, they got a referral to a psychiatrist, who diagnosed the boy with attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), and generalized anxiety disorder (GAD). The doctor prescribed both Ritalin (methylphenidate) and Prozac.

The boy’s behavior was much better initially, but the drugs presented other problems: His weight dropped, and he stopped growing. Once a kid who was born with a healthy appetite and would try any food, such as chicken curry at age 1, his parents now couldn’t get him to eat anything. He went from being in the back row of his basketball photos, where the tall kids line up, to the front line, where the short kids kneel. And after six months, his old behavior returned.

The parents weaned him off the Ritalin, and the boy’s appetite returned. They tried to get him to eliminate gluten and sugar as much as possible, and have him load up on protein. They began giving him fish oil supplements, a multivitamin, and a probiotic. The dietary changes had a substantial impact on his behavior.

A few months later, they decided to try to taper him off the Prozac. He did fine initially, and the parents thought they were home free. But two months after he was off the Prozac, their son’s worrisome behavior returned — and it was worse than ever. My friend thought that they should take him back to the psychiatrist, but her husband disagreed. He had researched the half-life of Prozac and other withdrawal stories, and told her that many people go through a delayed withdrawal two to three months after taking the last pill. Unfortunately, he said, they would have to tolerate the bad behavior for a few months until the synapses in his brain made the adjustments.

The husband was right. The boy had two-and-a-half rough months, but he pulled through. Today he is eating, growing, and thriving — managing his anxiety some days better than others.

I remembered her story because I recently tapered off of one of my antidepressants. A month off, I was doing fine when all of a sudden I was hit with some acute anxiety. I wondered, “could it be a delayed withdrawal symptom?” I brought this up to my fellow depression warriors on Group Beyond Blue and ProjectBeyondBlue.com, and received confirmation: When you have tapered off an antidepressant, it is incredibly difficult to know whether you are relapsing into a depression, or if you are merely experiencing withdrawal symptoms that will go away in a few weeks or months.

My friend Margarita Tartakovsy interviewed Ross Baldessarini, MD, professor of psychiatry and neuroscience at Harvard Medical School, and director of the psychopharmacology program at McLean Hospital, for an article on Psych Central distinguishing withdrawal symptoms from depression. Dr. Baldessarini believes that when the depression re-emerges quickly, it’s easier to identify as withdrawal. If it happens weeks to months after discontinuation, then he thinks there is much more risk of its being a relapse.

But after weighing in with several of the members on both forums, I’m not so sure I agree with Baldessarini.

For example, one woman went off her antidepressant in March, and got really depressed and anxious in July. Her doctor said this is to be expected and is not unusual at all — that it’s a natural part of the brain’s readjusting process. According to her doctor, it takes a few months for the brain to realize something is missing, and to start the readjusting. The whole process can last six months to a year.

That makes a lot of sense to me. There are so many organic changes going on in the gray matter of your brain when you stop taking an antidepressant. For people like me who have a significant response to a teaspoon of sugar or three bites of pumpkin pie, think about the mayhem that’s going on inside the limbic system of my brain as it tries to reorganize all the synapses after it’s no longer getting a hefty dose of a powerful psychotropic drug. Although I don’t believe most classifications of antidepressants to be addictive — unlike benzodiazepines — I do believe your brain becomes dependent on them, so that it needs to relearn how to ride the bike again without training wheels when you go off them. Lots of skinned knees…

Of course, the withdrawal process is different for everyone. Much has to do with how long a person has been taking the medication, and at what dose. Obviously, someone who was taking 60 milligrams (mg) of Prozac for 20 years might need to wean much more slowly and endure many more withdrawal symptoms (and for much longer) than a person who was taking 10 mgs for a few months.

For some, the withdrawal symptoms are very distinct from the symptoms that they were experiencing before. They might resemble that of the flu: headaches, dizziness, nausea, or fatigue. In fact, Baldessarini discusses the “SSRI Discontinuation Syndrome” in his interview with Margarita that occurs in 20 percent of people who withdraw from antidepressants. A person may become agitated and angry more than depressed (if he or she was depressed before), or sad and lethargic more than anxious (if he or she was primarily anxious before). If a person is suddenly having crying spells after going off a medication that treated her anxiety and insomnia, chances are she is experiencing withdrawal symptoms rather than a relapse of her condition.

After reading dozens of articles on typical withdrawal times, and corresponding with dozens of folks, it seems as though three months is the average recommended time (and this begins once you start having symptoms, which could be two months after you’ve weaned off your drug) to wait to see if the symptoms clear up.

Jim Kelly, a member of my forum and a mental health advocate and speaker living in Westchester, Illinois, never agrees to a medication change without a transition plan.

“Changing medications, either starting or ending, cannot be fully assessed until two or three months in; that’s for me,” Kelly says. “And I always request some transitional medication in a small dose to ease side effects.”

Kelly has learned to be patient with the ugly process.

‪”I’m undergoing a change right now, and two weeks in I feel terrible,” he explains. “It feels like withdrawal from the old, rather than anything to do with the new…yet. I wish the two or three months would go faster, but it is what it is.”

Ultimately, I think you know yourself better than anyone and can tease apart the difference between withdrawal or relapse more easily than you think you can. After comparing my symptoms this week to the symptoms of depression I’ve had for so much of my life (for this reason, it’s important to keep a mood journal!), and assessing other things going on in my life (different diet, changes in schedule, etc.), I could recognize it was my brain just readjusting to a different chemistry, and that I’m on the right track.

Much like my friend’s son.

Join ProjectBeyondBlue.com, the new depression community.

Originally posted on Sanity Break at Everyday Health.

restyler/Bigstock

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