Tuesday, 31 January 2017

Childhood Sexual Abuse & Defecation Problems

I am a survivor of childhood sexual abuse. I already completed Cognitive Behavioral Therapy however I am still having issues with the feeling I get when defecating and when I have to defecate. I get uncontrollable anxiety and no one has told me how to deal with it. How do I deal with this issue? (From Japan)

A: My guess is that the abuse may be directly related to this issue. I’d strongly encourage you to get some therapy from someone who specializes in sexual abuse. This should complement the CBT work you’ve already done.

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



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Shrieking in Silence: Can Anyone Hear?

bigstock--137612942You remember the chilling Kitty Genovese case? As Kitty hysterically shrieked for help — her voice echoing through the New York night, 38 neighbors ignored her hysterical pleas. The neighbors’ blurry thought process, “Well, maybe someone else will help” or “I am not able to assist her.” Collectively, there was a diffusion of responsibility.

“What does this have to do with mind happiness?” you wonder. Let me explain.

Mind happiness is a habit — one that demands your attention. Right now. As the whirring thoughts torment, we can lament our circumstances — beseeching others to help — or even save — us. But just like in Kitty’s case, others may not be physically or emotionally available.

Here’s the unequivocal truth: You have the power to help yourself.   

Let’s take exercise. Many Americans — myself included — are in a battle with our expanding bulge. Sure exercise can be more of a chore than mowing the lawn. But as I establish an exercise routine — and attempt to maintain my overly optimistic New Year’s resolution, I empower myself to eat healthier, meet with a personal trainer, and substitute football Saturdays for, you know, actually playing football on Saturdays. The theme: take action. Decisive action. Because when you wait for others, your pleas may go unheard.

Let’s apply this to mind health treatment. In my case, the OCD thoughts have lobbed verbal grenades since adolescence. My default response: the mental equivalent of a half-hearted shrug. If I just ignore the thoughts, I reason, they will go away. Or, maybe, I could try wishing away the anxiety inducing thoughts.

Hope may be a winning political strategy; unfortunately, it isn’t a winning mind health strategy.

A half-hearted shrug is the equivalent of acquiesce. And, sadly, I cannot wish — or will away — the tormenting thoughts. In fact, inaction tightened their stranglehold. Willful blindness is just that — willful and blindness.

But here’s what you — and I — can do. When the thoughts blitzkrieg your overwhelmed mind, you define them. Each and every time. That thought about harming a loved one? Nonsense. That disturbing sexual image? Throw it in the garbage — not the recycle — bin.

As I categorize each of these thoughts for what they are, their power — miraculously — dissipates. That vice grip loosens and, in its place, something resembling tranquility appears. Even more significantly, I have empowered myself. It is futile — and arguably counterproductive — to attempt to control your mind. As mental health consumers, we know this truism better than most.

But in defining the OCD thoughts, you strike an ideal balance between resistance and acceptance. As I have consciously committed to labeling the thoughts (“OK–that is a trick thought; I can move on”), the labeling process has become semi-automatic. And, thankfully, I am now averting those once automatic sinkholes.

When the agonizing thoughts strike, my instinctive reaction has been “retreat retreat retreat.” I slink into bed or frantically call a close confidante. These are passive–even avoidance — strategies. And, sadly, they exacerbate the already writhing anxiety.

Experience has taught — and humbled — me. As my mind shrieks, I know that I am the only one who can hear. Mind health wellness is more than a spectator sport; you cannot be a disengaged witness to your own mental well-being. Innocent bystander? Like Kitty’s neighbors, you are far more culpable than you know.



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Depression: 9 Powerful New Things Research Has Found Out

Jobs with highest depression rates, herbs that beat antidepressants, the four types of depression and more...

Dr Jeremy Dean's ebooks are:



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How to Use Exercise to Overcome Abuse and Bullying and Heal Your Brain

Physical Trainer Assisting Woman With Leg ExerciseMost therapists, doctors, and mental health professionals recommend exercise to combat depression and anxiety caused by abuse and bullying. However, at no fault of their own, they rarely offer a specific plan. That is because until now it has not been out there. But that has changed recently.

For the first time, we can align exercise routines with mental health issues for recovery. We can align changes to the brain that occur with specific mental health issues with specific movements designed to heal affected brain areas and make people feel better.

In this case, we are focused only on the long-term effects of abuse and bullying on the brain and how to heal the brain using a specific exercise routine. Chronic abuse shrinks or thins out the prefrontal cortex (front brain) and medial temporal cortex (deep, center brain) regions of the brain. This causes long-term emotional, social, and cognitive impairment. People who have been abused face problems that include difficulties planning, making decisions, and moderating social behavior. This causes a lifetime battle with anxiety and depression.

The first thing for anyone who has been victimized by abuse or bullying to understand is that the changes that occurred in your brain were the direct result of what someone else did to you. These changes in your brain are not your fault nor were they under your control. They were natural defense mechanisms. But the good news is that we now know exercise positively affects these same structures (prefrontal cortex and medial temporal cortex) that abuse and bullying hurt. Regular exercise increases the thickness of these thinned brain areas, healing the brain.

But, here is the critical point — different exercises affect the brain differently and it has to be a specific type of exercise structured in a specific way to help you. To combat the effects of abuse and bullying we have to use a specific exercise plan. Outlined here is an easy program to help you get started and use for however long you would like. Follow these steps for immediate results that will add up over time.

Step #1: Choose one exercise from the list below

  • Walking, jogging, and/or running
  • Stepping
  • Bicycling
  • Elliptical training

You are probably asking, why these forms of exercise only? The reason is that they are simple, rhythmic exercises that use patterns. The abused brain needs a consistent and predictable environment to heal. Additionally, as we will see later, chaotic and high-intensity exercise produces stress chemicals that actually cause anxiety!

Step #2: Get started

Literally, just start moving. You might be uncomfortable at first. It is normal. Most everyone is, and that is because during the first two minutes of exercise your heart and body are adjusting to the exercise. During this time your brain is beginning to respond to the pattern of walking, jogging, or stepping.

Give it 10 minutes and the endorphins or feel good chemicals will kick in making it easier. By 10 minutes the oxygen-rich blood has made its way to your brain. The prefrontal cortex (one of the areas affected by abuse and bullying) relaxes, creating a controlled environment abused brains crave. You’re in the “zone” and need to stay there for about 20 minutes. This is when your brain begins to heal.

Answers to your common questions:

  1. How fast should I go? A moderate, comfortable pace. You should be able to talk, but not hold a detailed, lengthy conversation.
  2. What if I cannot complete 20 minutes at once? Stop, rest, focus on your breathing, and start again. Do not sit down!

Some of the effects of exercise are immediate. Things like the endorphin kick and the increased sense of well-being you can feel right away. You will also feel good for about two hours after exercise because your brain will be getting more blood creating euphoria and a more productive and creative environment.

But for the long-term healing to truly take place, you will need to give it three to four weeks of four to five sessions per week of 20 minutes each. And you will have to keep it up. Just as muscles begin to lose mass after 48 hours of last activity, the brain requires constant engagement too.

One final note about exercise for recovery — we have all been told that we have to work out harder and follow difficult routines to see results. That is simply NOT TRUE! In fact, the opposite is true and we have had it wrong about the value of high-intensity exercise and programs that rely on “muscle confusion”. Prolonged high intensity, chaotic exercises that use too many different movements is counterproductive. These forms of popular exercise actually increase anxiety! They stimulate the release of pain and stress chemicals that cause worry.

Having said that, that is why simple, rhythmic exercises like cycling are recommended to heal the abused brain. Just get moving — whether you take a walk outside or on a treadmill take that first step to realizing the happiness that you deserve!



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Lying: A Case of Fiction Addiction?

bigstock--164498414“If you tell the truth, you don’t have to remember anything.” – Mark Twain

“You can fool some of the people all of the time, and all of the people some of the time, but you cannot fool all of the people all of the time.” – Abraham Lincoln

Is lying a case of “fiction addiction”?  Since the idea of alternative facts and living in a post-truth world have been in the headlines of late, it seemed a good time to explore this topic.

The Origin of Lying

Think about the first lie documented in spiritual texts. In the Old Testament, Adam and Eve were told by God that if they ate the fruit from the tree of the knowledge of good and evil, they would die. They ate, they lived. When asked if they had munched on the apple which had them hiding their nakedness (which may be a metaphor for being revealed and vulnerable psychologically as well), Adam passed the buck to Eve who he said tempted him to eat the fruit. Eve then blamed the serpent for tricking her.  The truth is each of the players made choices and the chain of events proceeded.  Wondering if the tree was planted in plain sight so that Adam and Eve could be tested or beckoned. Consider that many people succumb to the temptation that is deliberately placed before them and expected to refrain from indulging.  This is not meant to be offensive to anyone’s spiritual beliefs, but rather an assessment of a written tale.

Why we lie can vary from person to person.

  • Fear of repercussion
  • Desire to look more impressive
  • Wanting to fit into a specific social norm or group
  • Belief that it will get us what we want
  • Habit
  • Covering over inappropriate behaviors
  • Creating a persona
  • Poor self-worth
  • Seeing what can be gotten away with
  • Wanting reality to be different than it is
  • Testing relationship boundaries
  • One-up-manship (can you top this?)
  • Rebellion against authority
  • Biding time until a justification or defense can be created
  • A passive-aggressive way of speaking up
  • Denying responsibility for choices
  • Poor self-esteem
  • Compulsion to hold power over another

Knowledge is power. When we are the keeper of information, we seem to hold power over another. Consider a partner who is unfaithful. He or she is aware of breaking the agreement of monogamy and may experience a sense of guilt and remorse. When asked if infidelity has taken place, an instinctive reaction may be to lie to cover those emotional states, protect what they fear to lose in the initial relationship or the new one. By withholding the truth, that imbalance of power can be maintained.

Set a good example. If you expect honest interaction with those in your life, it is important to be in integrity. The first of The Four Agreements, written by don Miguel Ruiz highlights the value of speaking truth.

“Be Impeccable with your Word: Speak with integrity. Say only what you mean. Avoid using the Word to speak against yourself or to gossip about others. Use the power of your Word in the direction of truth and love.”

Make your relationships a safe place for honesty. If someone tells you the truth, how do you respond? Do you accept their feelings or dismiss them? Is there room for a difference in perspective or do people need to agree with you to keep the peace?

A few examples:

Susan was married to Chris. She had grown up in a family in which truth-telling was valued and trust was a core value. When she did something that she thought, her parents wouldn’t approve of, at times she found ways to justify her actions but didn’t think of them as lies. When they found out, they expressed concern but not overt disapproval. They wanted her to make her own choices and mistakes if need be but reinforced the importance of honest reporting of her actions.  Still, she valued their approval and there were things she didn’t tell them, wanting to maintain her stellar position in their eyes. She had not yet learned the difference between secrecy and privacy.; the former is an indication of a shame-based, if-you-knew-this-about-me-you-would-disapprove-or-abandon-me paradigm and the latter reflects each person’s right to sovereignty.

Chris was raised in a family in which his safety depended on lies and power plays. His father was an actively drinking alcoholic who was unfaithful to his mother and controlling and violent with Chris. He learned that he needed to create a confident (and at times arrogant) persona to survive. When the two of them got together, Susan was determined to stay in Chris’ good graces since his anger at times took a threatening turn, so she would withhold information particularly in interactions in the business they owned together. When he discovered her fabrications, his reactions were sometimes in excess of the ‘offense’. She justified her prevarications in her own mind since she felt she didn’t have the business acumen to successfully interact with costumers in a way that elicited a win-win. He had years of experience in various businesses and expected that she would model her own actions after his since it was not her forte’. She did not possess the ability at the time to admit those shortcomings and adapt her style to suit the needs. She found herself spiraling downward as he was escalating.

Melinda was a precocious pre-teen whose concerned parents brought her in for treatment after she engaged in behavior that alarmed them and the school. Appearing far older than her stated age, she told her parents and therapist that she should be able to make her own decisions without what she perceived was her mother’s and father’s unnecessary oversight. They volleyed back that although she perceived herself as being more mature than her age would indicate, she did require their guidance since she was making poor choices and lied to them and her teacher. One such example was that she justified being lethargic in class because she drank too much caffeinated soda the night before and couldn’t get enough sleep. When called on it in the session, she admitted that she didn’t want to tell the teacher that she stayed up playing computer games.

When Lying Becomes Addictive

The American Society of Addiction Medicine, defines addiction as: “a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.”

Is lying an addiction? Pathological lying is defined as: “s a chronic behavior characterized by the habitual or compulsive telling of lies.” One who engages in this behavior has come to believe the stories they tell and often can’t differentiate between truth and fabrication.  The desire to maintain appearances and power can instill that chemical high that occurs in any addictive process; whether it is experienced as the thrill of getting away with something or protecting one’s own position.

How Do We Treat the Addiction?

The first step, as is so in any case, is to admit the problem and the impact it has on the person’s life, asking “Does it make my life unmanageable?” From that point, a cost-benefit analysis is in order. How does it serve vs. harm? Each time the temptation to lie arises, take a moment to consider a line in front of you. On one side is truth and on the other un-truth. At each instant, there is a choice about which side of the line to stand. If you find yourself crossing the line, there is always an opportunity to pull back to safety. Have an accountability partner with whom you check in. The rewards are multi-fold in terms of elevating self-esteem and enhancing relationships.



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Should I Have an Abortion?

From a young woman the U.S.: I need an opinion from women who’ve had abortions. I’m in a year long long distance relationship with a guy in New York. I’m 17 weeks along. He knows but my parents do not. My family is Mormon but I am not, and I don’t want to disappoint my parents more than I already have.

I love them both and they have done so much for me. After my first baby (whom I had because I was raped and gave him away) they were very protective and supportive. I never went to therapy and never got over the feeling of wanting to be a mother. I’m afraid that after I tell them they wont want anything to do with me and will not let me see my younger siblings.

I’m pro-choice, but for myself I wouldn’t abort a child if I have the support. My boyfriend is the same way. He’s moving out to be with me and the baby in less than 3 weeks. I called an abortion clinic not too long ago and made an appointment to get an abortion, but I’m scared and second guessing myself, mostly because I want to keep the baby, but we’re both too young and broke. I need someones opinion who’s been through something similar and just give me advise so I can decided if I should cancel the appointment, tell my parents, and keep my baby, or go through with the abortion.

A: I’m very concerned that you didn’t have some therapy after the birth and adoption of your first baby. Even when giving up the baby was the right thing to do, it is not at all uncommon for women who have surrendered a baby and not had therapy to have a “replacement baby” to ease the sense of loss and longing.

This is too big a decision for you and your boyfriend to make on your own, especially since you do not have the resources to be independent. You probably do need to involve your family. But before you do, I strongly urge you to have a few sessions with a therapist who has experience with adoption issues. Your local Planned Parenthood health center has specially trained staff who can talk with you about all of your options. (See more at: http://ift.tt/2andoLk). The therapist will help you clarify what you want to do and how best to involve your parents.

I wish you well.
Dr. Marie



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Hallucinations & Memory Issues

I have almost always had minor visual hallucinations (dark figures, geometric patterns, stationary objects look like they’re moving) in the dark (nighttime, dark room, anywhere), deep troubles identifying whether a memory is from real life or a dream, and I get deja vu a few times a week. I did not until recently realize that these could be symptoms of something concerning developing even though the hallucinations always make me very frightened/paranoid. A few years ago auditory hallucinations (muted conversations, can’t distinguish any words) developed. I have never taken any illegal/prescription drugs that could cause hallucinations. Is this simply my adhd causing memory problems and getting bored, or should I be looking into something else? (I should also mention that I suspect that I have borderline personality disorder due to emotional neglect/abuse from my parents and suddenly 4 years ago all my friends (known them for 7+ years) abandoned me. I have little sense of identity, fear of abandonment, frequent and intense mood swings, and splitting on people. However my hallucinations and confused memories are not about any of the traumatic events so I think it is something separate.)

A. You mentioned emotional neglect/abuse from your parents. It’s possible that your symptoms are the result of that trauma. It’s common for people with abuse histories to describe symptoms similar to yours (i.e. mild hallucinations and memory problems).

You also said that your friends suddenly abandoned you. You had known them for seven or more years. It’s odd that they would all abandon you all at once. Something must have precipitated their leaving. I’m sure there’s more to the story. These are the types of situations that can be thoroughly examined in counseling.

I would recommend consulting a mental health professional. They can gather information about your symptoms and determine what might be wrong. Most importantly, they can design a treatment plan to address your symptoms. That plan might include medication to reduce your hallucinations.

Dialectical behavioral therapy is an effective treatment for individuals with borderline personality disorder. Consider choosing a therapist who has been trained to treat borderline personality disorder, if appropriate. Please take care.

Dr. Kristina Randle



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Best of Our Blogs: January 31, 2017

Orange candles

Are you waiting until your relative “gets” you, employer appreciates you or the political atmosphere to calm down before you feel better?

We often wait until external circumstances change to change us. But real power comes from creating our own life rafts.

Let our top posts on self-soothing and self-discovery inspire you to prepare your own self-care kit. Some things you might want to consider are a candle, journal, pair of warm socks, and an afternoon with yourself or hike with someone you love. Think of things that feel good to you and neglect the obligatory tasks for awhile.

When you are feeling ill or unwell, you can turn to this treasure trove of goodies to lift your spirits and nourish your soul. Armed with inner strength, you will feel empowered to survive anything.

5 Little Known Hallmarks of A Psychologically Healthy Person
(Childhood Emotional Neglect) – How psychologically healthy are you? These five signs will surprise you.

How Not to Cope with a Narcissist
(The Exhausted Woman) – It’s not just the narcissist that exhibits unhealthy and even toxic behavior. Find out the things you do to manage a narcissistic person in your life that does not serve you.

Clark Gable’s Daughter and Narcissistic Trigger Words
(Narcissism Meets Normalcy) – If you’ve ever received an email, text or card from a narcissistic person, you will identify with this famous daughter’s experience.

Self-Soothing During Difficult Times
(Bipolar Laid Bare) – What do you reach for during difficult times? Instead of harmful ways to relieve negative feelings, try these self-soothing techniques.

10 Questions to Ask Yourself Every Night
(Weightless) – Most of us are too busy to check in. If you’re feeling disconnected, reach for your journal and ask yourself these questions.



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S100B protein and autism continued

"Our findings showing an increase in peripheral concentrations of S100B and TNF-α provide limited support to the hypothesis about the roles of altered immune function and S100B in autism spectrum disorder (ASD)."So said the findings reported by Selin Aktan Guloksuz and colleagues [1] (open-access available here) continuing some discussions a few years back on a possible role for S100B in relation to at least some autism (see here).S100B - S100 calcium-binding protein B - is a compound involved in quite a few biological reactions not least "as a biomarker of global glial activity." Elevations of the S100B have been reported in relation to several states including that of [traumatic] brain injury. Outside of some research suggesting that elevations of S100B might also be a feature of diagnoses such as schizophrenia (see here), it has also been the topic of investigations with [some] autism in mind [2] too. The name of the game is elevations in S100B in relation to autism and more.Based on analyses of fasting blood samples from "40 unmedicated children with autism" (where autism diagnoses were confirmed by study researchers) and 35 asymptomatic control children, researchers measured levels of plasma S100B alongside various markers of immune function (cytokines). Among the suite of cytokines examined, levels of "tumor necrosis factor alpha (TNF-α), interferon gamma, interleukin (IL)-1β, IL-4, IL-6, IL-10, and IL-17A" were included. The idea of using unmedicated children with autism stems from the suggestion that at least one medication used for some autism might have the ability to elevate S100B [3].Results: as per the opening sentence to this post, levels of S100B and TNF-α were 'different' between the groups (both elevated) and this finding remained "after controlling for age, sex, and BMI [body mass index]." Researchers also reported some results looking at whether ASD symptom presentation might show any 'association' with S100B levels. On this topic they reported that: "Plasma S100B concentrations in children with severe ASD symptoms were higher than in children with mild-moderate ASD symptoms" but when again controlling for age, sex and BMI this association did not hold (significantly). As for the other cytokines outside of TNF-α... nothing came up as significant between the groups. This is interesting in light of recent work (see here) and even Guloksuz et al talk about future "prospective longitudinal studies investigating a broad set of immune markers, both in serum and CSF [cerebrospinal fluid], in large samples" and the pros- and cons of looking in CFS.Where next for this area of investigation? Well, taking into account the link between S100B and brain injury and what that could mean for cognitive processes for example, I'd be minded to suggest that more study is needed looking at the effect of S100B levels in relation to cognition and autism. Take for example the study results from Chen and colleagues [4] who reported that "serum S100B level was an independent contributor to the global cognitive dysfunctions, particularly for the speed of processing, attention/vigilance, visual learning and reasoning/problem solving subscores" in their cohort of participants with schizophrenia. Might similar correlations be present alongside S100B elevations in relation to autism? I'd also be minded to suggest looking at a possible role for comorbidities potentially accompanying a diagnosis of autism as being important for S100B elevations in light of other research on depression for example [5]. Depression (various types) and autism is very much an important area of overlap (see here for example) and might actually offer at least one way to target elevations in S100B.There is more to do on this topic.----------[1] Guloksuz SA. et al. Elevated plasma concentrations of S100 calcium-binding protein B and tumor necrosis factor alpha in children with autism spectrum disorders. Rev Bras Psiquiatr. 2017 Jan 12:0.[2] Al-Ayadhi LY. & Mostafa GA. A lack of association between elevated serum levels of S100B protein and autoimmunity in autistic children. J Neuroinflammation. 2012 Mar 16;9:54.[3] Quincozes-Santos A. et al. Effect of the atypical neuroleptic risperidone on morphology and S100B secretion in C6 astroglial lineage cells. Mol Cell Biochem. 2008 Jul;314(1-2):59-63.[4] Chen S. et al. Cognitive dysfunction correlates with elevated serum S100B concentration in drug-free acutely relapsed patients with schizophrenia. Psychiatry Res. 2017 Jan;247:6-11.[5] Rajewska-Rager A. & Pawlaczyk M. The role of S100B protein as a potential marker in affective disorders. Psychiatr Pol. 2016;50(4):849-857.----------Guloksuz SA, Abali O, Aktas Cetin E, Bilgic Gazioglu S, Deniz G, Yildirim A, Kawikova I, Guloksuz S, & Leckman JF (2017). Elevated plasma concentrations of S100 calcium-binding protein B and tumor necrosis factor alpha in children with autism spectrum disorders. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999) PMID: 28099628...

Guloksuz SA, Abali O, Aktas Cetin E, Bilgic Gazioglu S, Deniz G, Yildirim A, Kawikova I, Guloksuz S, & Leckman JF. (2017) Elevated plasma concentrations of S100 calcium-binding protein B and tumor necrosis factor alpha in children with autism spectrum disorders. Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999). PMID: 28099628  




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An individual's ultimate economic burden can be forecast in childhood

Important work from Caspi et al., who show that 20% of the population accounts for close to 80% of economic burden. This group can be predicted with high accuracy from as early as age 3.
Policymakers are interested in early-years interventions to ameliorate childhood risks. They hope for improved adult outcomes in the long run that bring a return on investment. The size of the return that can be expected partly depends on how strongly childhood risks forecast adult outcomes, but there is disagreement about whether childhood determines adulthood. We integrated multiple nationwide administrative databases and electronic medical records with the four-decade-long Dunedin birth cohort study to test child-to-adult prediction in a different way, using a population-segmentation approach. A segment comprising 22% of the cohort accounted for 36% of the cohort’s injury insurance claims; 40% of excess obese kilograms; 54% of cigarettes smoked; 57% of hospital nights; 66% of welfare benefits; 77% of fatherless child-rearing; 78% of prescription fills; and 81% of criminal convictions. Childhood risks, including poor brain health at three years of age, predicted this segment with large effect sizes. Early-years interventions that are effective for this population segment could yield very large returns on investment.


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Monday, 30 January 2017

Rebuilding Relationships After Rehab

Rebuild Family Relationships On PsychotherapyYou’ve done it. After years of denial, after suffering many losses (people, jobs, money), you finally looked at your life of addiction and said “Enough.” You went into rehab to quit the addiction and to start a new life. Give yourself enormous credit for that. Making the decision to do it took courage. Staying in the program took commitment and determination.

Now you have to meet the challenge of returning to the life you left. You have made major changes. But chances are that the home you are returning to hasn’t.

A good program will have included planning for the return home. Rehab isn’t recovery. It’s a jump-start — often an excellent one. But recovery, if it is to be real and lasting, takes a commitment to lifestyle change. And lifestyle change involves the other people in your life. How can you get the folks at home to support your recovery?

It’s important to have realistic expectations. Don’t expect them to see only the “new you”. They’ve lived with the “old you” for a very long time. They are probably happy to have you home but it makes sense that they are on guard. Let’s look at the various relationships in your life and what is reasonable to expect.

Your spouse or significant other:

Reestablishing a loving and trusting relationship with your spouse or significant other isn’t going to be easy. From her or his point of view, you’ve had an “affair” with the bottle or drugs. You’ve been more committed to your addiction than to your relationship. Anger, hurt and resentment are a natural response — even though she or he continues to love you.

You may have come home energized, excited and convinced that you are going to stay clean and sober. Your partner may not share that optimism at first. If you add disappointment in your partner’s reaction to his or her feelings of rejection and hurt, you will only grow further apart. Instead, do your best to be understanding. Be willing to talk about the damage that was done by the addiction. Apologize from the heart. Ask for compassion while you recommit to working on staying clean.

Recognize that while you’ve been doing your addiction, your partner has probably been doing double duty. He or she has been both mom and dad for your kids or may have taken on all the household chores or has been making and/or managing the money to keep the family afloat. One of the many ways to go from talk to action is to take back the chores, willingly and without complaint, certainly without looking for “credit”. Just do them and do them well and maybe your significant other will start to believe you again. If you haven’t been a good partner in making and managing money, do your share.

Your relationship with your children:

 

Things aren’t going to get “back to normal” with your children because today’s “normal” is different from when you became more interested in substances than the family. While you’ve been involved with your addiction, your kids have been growing up. They have gotten so used to being disappointed by you, they may have stopped looking to you for involvement. Take the time to observe, to listen, and to understand. As with your spouse, they will probably come around when you have been really present in their lives for enough time for them to risk believing it.

Your relationship with friends:

Your rehab program probably already included conversations about the company you’ve been keeping. It’s important to separate from people who you just know will not support your sobriety.

Healthy friendships will help keep you healthy. Find ways to spend time with those healthy folks doing healthy things. Maybe someone will be a gym buddy. Perhaps you can join in making a difference in your community by joining in a project where the focus in on doing good. You need places to go and people to see who are deeply committed to positive things.

We live in a culture where drinking is often seen as part of what makes an occasion celebratory. But you probably have more concerns about being a non-drinker than the rest of the people at the party do. As one of my clients said wryly, “When I said I just wanted a tonic and lime, the party didn’t stop like in one of those freeze frame commercials.” If you feel pressured by anyone, change the subject or have a sudden need to find the restroom. If you still get pressured, leave. Your sobriety is more important than pleasing someone who doesn’t have your best interests at heart.

Support for Change

Give it time: The only antidote to people in your life being on edge is to show them through your behavior that you really are working your program. I’m often asked how long it will take for family members to trust again. The answer is “One more day than you think it should.”  Other people are not necessarily on your timeline. But as you show folks that you have really turned over a new leaf, most will eventually come around.

Get outside support: You do need support and encouragement but you may not get it (or get enough of it) from your immediate family and friends — at least for now. For that reason, it’s important to find a support group and/or a substance abuse counselor who can meet with you regularly. Some rehab programs have a partial program or continuing care support group. If so, take advantage of it. AA works for some people, but it depends entirely on the health of the members of the particular group. If you can’t find a helpful AA group, look for other options. A therapist or counselor who specializes in substance abuse can also provide ongoing support. Equally important is that a therapist you trust she can help you regain your commitment if you start to slip.

We are all aware of celebrities for whom rehab is a revolving door. They’re in. They’re out. They’re in again. They seem to want rehab to work some kind of magic so they’ll stay clean and sober. Unfortunately, there isn’t magic to be had at even the best, most pricey or most popular program. The “magic” lies in a person’s decision to follow through. Going to rehab can be an important first step toward a better life. But it’s only a first step.



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When you have steady eye contact, it’s hard to think (even with  friends)!

In 2015, we wrote a one of our combination (“tidbit”) posts that included a bit of information on how extended eye contact can cause hallucinations. As it turns out, it also makes it hard to think (which seems reasonable if you are having hallucinations). The researchers we are covering today say that maintaining eye contact […]...




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Is the Way I Relate to My Friend Healthy?

From the U.S.: My mom is a schizophrenic and will not accept treatment. She has had absolutely no relationship with me in the last 3 years since her breakdown. Before that she did the basics of raising me, food, clothing, school, etc but was verbally and emotionally abusive and occasionally physically abusive. She had a VERY rough childhood and she actually raised me much better than what she had, so I won’t be too hard on her, but it did affect me.

I’m struggling with depression, anxiety, panic attacks, and I think bpd. Bpd explains me. :( I can also get very clingy with friends and panic if I think they are leaving me. I’ve learned to take responsibility for my actions even if I am really afraid or doing badly. Just because I’m doing badly doesn’t give me a license to not respect others boundaries, etc. But the feelings are still there. I am in therapy, possibly changing therapists as she doesn’t have time to see me very often and that makes it VERY hard for me to trust and open up.

My friend that is a mom is being there for me and she knows about my mom and my depression and anxiety, and how I get with my friends (including her) and I am really glad to have a positive figure in my life.

Is it ok if I want to call her mom? I’m too shy to say it to her, but she is “mom” when I think about her, and in my phone contacts her name is mom. She doesn’t know and I’d be shy to tell her. Is this healthy?

A: It’s not at all unusual for people who did not have a healthy relationship with their mother to find other people to fit the role. In fact, the dimensions of many female friendships have a “mothering” dimension to them. As long as there is reciprocity, it can be healthy.

Since you mention BPD as one of your issues, I do have concerns about you calling this woman “mom”. It may set up expectations that she can’t possibly meet. It may encourage a level of dependency on your part that doesn’t belong in a healthy friendship.

I suggest you work with your therapist on grieving the fact that your biological mother hasn’t been able to be the mother you needed. Then create a circle of friends who are mutually supportive. Do talk to your therapist about this exchange with me. A therapist who knows you can give you better advice.

I wish you well.
Dr. Marie



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Schizophrenia Is Improved By An Old And Popular Drug

The common drug could treat schizophrenia, ADHD, bipolar disorder, addiction and other mental health problems.

Dr Jeremy Dean's ebooks are:



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The Jung Page

The Jung Page

Carl Jung was one of the creators of modern depth psychology, which seeks to facilitate a conversation with the unconscious energies which move through each of us. He contributed many ideas which continue to inform contemporary life: complex, archetype, persona, shadow, anima and animus, personality typology, dream interpretation, individuation, and many other ideas. He had a deep appreciation of our creative life and considered spirituality a central part of the human journey. His method of interpretation of symbolic expression not only deepens our understanding of personal material, opening the psychodynamics of our personal biographies and dreams, but the deeper, collective patterns which develop within culture as well. In his memoir, Memories, Dreams, Reflections, Jung wrote that meaning comes when people feel they are living the symbolic life, that they are actors in the divine drama. That gives the only meaning to human life; everything else is banal and you can dismiss it. A career, producing of children, are all maya (illusion) compared to that one thing, that your life is meaningful.



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3 Reasons You Handed that Life Coach Your Money (And Why that Doesn’t Make You Stupid)

Euro coins. Euro money. Euro currency.Coins stacked on each otheOne of humanity’s best traits is the individual’s desire to become their best self. Since way before humanistic psychology labelled this self-actualization, humans have been searching for something higher, something better; their key to happiness. Whether that search was within the realms of spirituality, for a higher understanding, or capitalism, for a higher bank balance, the seekers shared a similar motivation; to become the person that they dreamed of being, their ideal self.

With such a demand, it’s unsurprising that a huge array of coaches and self-styled gurus has sprung up to meet the need. Knowledge of humanity also makes it unsurprising that among the many undoubted experts are a large number of inexpert people claiming expert status — some from lack of understanding, some undoubtedly charlatans.

I find myself increasingly speaking to people who handed over sums of money — often large sums — to a coach, only to find that, having followed instruction to the best of their ability, they don’t get the promised result. Worse, a small minority find that the guru on whom they’ve pinned their hopes, and often their life savings or the entire capacity of their credit card, has deliberately mis-sold them, with no intention of refunding.

Sadly, the reactions of those who’ve been fooled are usually focused negatively inward — self-criticism, depression, loss of confidence. The truth is that people intentionally practicing deception understand the drives of human motivation, and how to use them against you. Here are some of the processes in play, as defined by the psychologists who researched them.

Systematic Errors – Kahneman

There are two human systems of thinking — the fast, automatic system 1 that normally controls our reactions, and the slower system 2, which jumps in where processing power is required. Usually, system 1 is in charge — and system 1 is subject to systematic biases, rules of thumb that you’ve learned to respond to automatically.

The reason you overestimated the likelihood of getting the result you want is probably the availability heuristic. We judge how often things happen by how easily they come to mind; and we remember memorable stories like those of great success. System 1 brings instances to mind, and system 2 focuses on the stories to make sense of the content. Events and marketing material all provide lots of stories of success.

We’re more susceptible to availability biases when we’re in flow state, when we’re busy, happy and most especially when we’re made to feel powerful. People who feel empowered trust their intuition more. Which is just what that event environment or long sales letter are meant to do.

Principles of Influence – Cialdini

Cialdini’s focus was on the tactics that make us buy, regardless of logic and common sense. Unsurprisingly, marketing material and events contain all or most of the six principles identified. These make you sign up, keep you signed in, even influence you to join a more expensive program. Do these sound familiar?

  • Reciprocity – giving something free to a potential client, so they feel obliged to give something back.
  • Consistency and Commitment – the need to stick by something you’ve signed up for, even when you no longer feel comfortable.
  • Social Proof – if nobody else is speaking up, you must be wrong.
  • Liking – the obligation that the person’s friendliness puts you under (even when you suspect their charm may be a little bit narcissistic).
  • Authority – the person has positioned as an “expert” and we’re conditioned to obey experts — even self-proclaimed ones.
  • Scarcity – it’s only available to 10 people. Or today. Or at this price now. Or… well, you get the picture. Sometimes the scarcity may be genuine but often it isn’t.

Cialdini recommends becoming aware of the way that these principles work, and setting yourself a mental alert. You may not stop the reaction, but you can stop yourself acting on it automatically.

Social Identity Theory – Tajfel

Social identities are based on the groups we feel part of, and significantly affect on how we see ourselves. To claim membership of a “status” group increases self-esteem and feelings of well-being. Leaving a group can be a source of anxiety and cause self-concept challenges. It’s normal to favor your own groups (ingroup) and discriminate against other groups (outgroup).

For a coach trainer who has attracted many clients into a group program, this makes it plain sailing. Many are heavily pushing the “lifestyle” aspect, inviting you into an exclusive “club”; this has the double-edged function of making you identify with the ingroup, and creating a subconscious fear of leaving and becoming a shunned “outgroup” person. You need look no further for the reason these mentors go to such lengths to prevent dissenting voices.

The moral of this? Research thoroughly. All that glitters is not gold, especially in the coaching industry. What are their qualifications and personal experience? Why do they believe they can help you?

Above all, listen to your instinct. That’s Kahneman’s system one, giving you a warning based on experience. Then apply the judgement Cialdini advises.

But please remember that to have been taken in by someone does not make you stupid. It means only that your brain is working how it’s meant to, and that you didn’t at the time have the reference material to challenge the information. And if the worst comes to the worst, you didn’t walk away from this with nothing. You walked away with a set of alarm bells to stop it happening again.

References:

Cialdini, R. B. (2007). Influence: The psychology of persuasion. New York: Collins.

Kahneman, D. (2011). Thinking, fast and slow. New York: Farrar, Straus and Giroux.

Tajfel, H., & Turner, J. C. (1986). “The social identity theory of intergroup behaviour”. In S. Worchel & W. G. Austin. Psychology of Intergroup Relations. Chicago, IL: Nelson-Hall. pp. 7–24.



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Helping Clients Improve Communication Skills 

Perhaps the most valuable life skill that leads to personal and professional success is the ability to communicate assertively. Especially in this current climate in our country, in which we are exposed everyday to more and more brashness and insensitivity, going over the basics of healthy and respectful assertive communication will help therapists and clients alike in improving their own corner of the world.

Teaching our clients how to effectively communicate and offering guidelines to differentiate between assertive, aggressive and non-assertive communication can provide skills that will improve the quality of their relationships with family, friends, co-workers, clients and others they encounter in everyday life.

I use either generic role plays that I make up, such as the case of someone being continually late for meetings or dates, or ask clients for their own real life situations. I use worksheets such as this communication handout to use as a reference in helping clients see the difference between the three types of communication.  Having handouts such as these to share with clients makes the criterion for healthy vs unhealthy communication more clear.

Most clients benefit from a mini-lesson on the three types of communication. The following are the basic three types of behavior:

Aggressive – The focus is on changing the other person and is characterized by “you” statements. Honesty is geared towards controlling or changing the other person’s mind or behavior, or “getting them to see” a point of view leading to disrespect of the other person and communication is tactless and blunt.

The Aggressive motto is “I’m OK – You’re not”  

Non-Assertive – The focus is on protecting oneself and people pleasing. Fear of disapproval or conflict ends up with tension building and later blowing up or keeping feelings in, leading to depression and anxiety. Fear and inhibition reign.

The Non-Assertive motto is “You’re OK – but I’m not unless you like me!”

Assertive – The focus is on showing respect while expressing oneself. “I” statements are spoken, focusing on only expressing oneself, not changing others.

The Assertive motto is “I’m OK – You’re OK”

Along with general informational handouts, I like to use worksheets to offer skill building practice for clients to change “You” messages into “I” messages. This worksheet geared for children offers children and adults alike a model of how to reframe you statements to “I” statements.

Handouts such as these can help clients practice assertive communication in individual as well as group settings. A group therapy setting is especially helpful to practice improving communication skills with other group members representing challenging people in their personal lives, within the support and guidance of the group setting. Use role-play regularly throughout the group’s duration, so that members get to practice new skills learned, while gaining valuable feedback and practice as they fine tune their communication skills.

Whether communication skill education is used in individual or group settings, your clients will learn valuable tips to improve their relationships with others in their lives, offering them skills to last a lifetime.



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Negative Thoughts And Past, Seemingly Meaningless Events, Are Creating A Black Hole Consuming My Life

Hi! I’m 22 years old and for the past year and a half of my life I have been in a never ending cycle of self-loathing. I think firstly it is important to understand that I’m not the type of person to ask for help. I rarely do even at the most minimal of levels. So it goes without saying that this is, in a way slightly uncomfortable for me. That being said let me address the issue at hand. For the last year and a half I have been experiencing feelings that confuse me. Feelings that until now I have yet to express to any other person, including close friends and relatives. My issue is this, every single and I mean every single thing that I do that is not done to perfection I beat myself up about. I’m not talking about when it happens but in the future. I’ll be watching TV, driving a car, walking down the street and Bam! Out of nowhere a negative thought, embarrassing moment, or otherwise distasteful event will pop in my head. For the next 30 seconds to a minute it will consume me from the inside out. At best I’ll clench my fist or jaw and maybe shake my head. At worst I’ll have to lay down and take deep breaths to overcome it. Whether the event was a lie I told years ago or an awkward encounter I had with a close friend that if I asked they may not even remember. It’s a constant war in my head. On one hand I can realize that 99% of these past events just don’t matter in the bigger picture of life but on the other i’m a perfectionist and they are just unacceptable things that drive me insane. This has lead to strong anxiety to the point that If I’m having a episode in my head I may slur my words while I’m talking to someone. Furthermore it has lead to a hatred for myself and a deep sadness. I have been loved by so many people and can’t explain why I feel the way I do. But the churning in my stomach has to go. It is just to unbearable. Thank you very much for your time.

A. Negative thoughts are a scourge of the human psyche. They are common and can wreak havoc in one’s life. The good news is that they can be corrected with counseling.

Part of the problem might be your insistence on perfection. That’s not a standard that anyone can achieve. Humans are imperfect beings. It is a fact of life that perfection is not an achievable goal. People who are expecting perfection will undoubtedly experience disappointment and stress.

Researchers have indicated that people who tend toward perfectionism have a strong desire to do something well. That desire is admirable; however, the perfectionist takes things too far. They possess a deep-rooted fear of failing. The fear of making a mistake can be immobilizing. It’s possible that the anxiety and negative thoughts you have described, are directly the result of your desire for perfection.

Correcting this problem will involve altering your expectations to be more in line with reality. It will come from your realization that perfection is an unreasonable standard that you must abandon. You can learn new ways of thinking and adapting to life in counseling. Understanding reality and adapting, is the ultimate purpose of counseling.

There is no shame in consulting a professional who is trained to help people solve these types of problems. As you have experienced firsthand, thinking affects behavior. If you continue to hold yourself to impossible standards, you will continue to do things that are not in your best interest. You will suffer and nothing will change. Perfectionism is a well-known and understood problem that is easily corrected with counseling.

Finally, many people are their own worst enemies when it comes to psychological health. When they have a problem, they will often refuse to seek help because they equate the need to ask for help with personal weakness and failure. This type of thinking prevents many people from seeking treatment and thus they needlessly suffer. Don’t let that be you. Please take care.

Dr. Kristina Randle



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Negative Thoughts And Past, Seemingly Meaningless Events, Are Creating A Black Hole Consuming My Life

Hi! I’m 22 years old and for the past year and a half of my life I have been in a never ending cycle of self-loathing. I think firstly it is important to understand that I’m not the type of person to ask for help. I rarely do even at the most minimal of levels. So it goes without saying that this is, in a way slightly uncomfortable for me. That being said let me address the issue at hand. For the last year and a half I have been experiencing feelings that confuse me. Feelings that until now I have yet to express to any other person, including close friends and relatives. My issue is this, every single and I mean every single thing that I do that is not done to perfection I beat myself up about. I’m not talking about when it happens but in the future. I’ll be watching TV, driving a car, walking down the street and Bam! Out of nowhere a negative thought, embarrassing moment, or otherwise distasteful event will pop in my head. For the next 30 seconds to a minute it will consume me from the inside out. At best I’ll clench my fist or jaw and maybe shake my head. At worst I’ll have to lay down and take deep breaths to overcome it. Whether the event was a lie I told years ago or an awkward encounter I had with a close friend that if I asked they may not even remember. It’s a constant war in my head. On one hand I can realize that 99% of these past events just don’t matter in the bigger picture of life but on the other i’m a perfectionist and they are just unacceptable things that drive me insane. This has lead to strong anxiety to the point that If I’m having a episode in my head I may slur my words while I’m talking to someone. Furthermore it has lead to a hatred for myself and a deep sadness. I have been loved by so many people and can’t explain why I feel the way I do. But the churning in my stomach has to go. It is just to unbearable. Thank you very much for your time.

A. Negative thoughts are a scourge of the human psyche. They are common and can wreak havoc in one’s life. The good news is that they can be corrected with counseling.

Part of the problem might be your insistence on perfection. That’s not a standard that anyone can achieve. Humans are imperfect beings. It is a fact of life that perfection is not an achievable goal. People who are expecting perfection will undoubtedly experience disappointment and stress.

Researchers have indicated that people who tend toward perfectionism have a strong desire to do something well. That desire is admirable; however, the perfectionist takes things too far. They possess a deep-rooted fear of failing. The fear of making a mistake can be immobilizing. It’s possible that the anxiety and negative thoughts you have described, are directly the result of your desire for perfection.

Correcting this problem will involve altering your expectations to be more in line with reality. It will come from your realization that perfection is an unreasonable standard that you must abandon. You can learn new ways of thinking and adapting to life in counseling. Understanding reality and adapting, is the ultimate purpose of counseling.

There is no shame in consulting a professional who is trained to help people solve these types of problems. As you have experienced firsthand, thinking affects behavior. If you continue to hold yourself to impossible standards, you will continue to do things that are not in your best interest. You will suffer and nothing will change. Perfectionism is a well-known and understood problem that is easily corrected with counseling.

Finally, many people are their own worst enemies when it comes to psychological health. When they have a problem, they will often refuse to seek help because they equate the need to ask for help with personal weakness and failure. This type of thinking prevents many people from seeking treatment and thus they needlessly suffer. Don’t let that be you. Please take care.

Dr. Kristina Randle



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The Final Step for Couples Seeking to Survive Infidelity: Address Other Relationship Issues

Businessman tearing up sign saying trust concept for infidelity,In the aftermath of infidelity, your relationship can be saved.

Arising from the emotional devastation of one of life’s most painful betrayals, a couple can build a fresh foundation of love, support, and respect that endures a lifetime.

Doing so isn’t easy.

To stack the odds in your favor, there are 7 Survival Steps that I have identified that couples must take if they are to rebound from the ruins of infidelity. These are steps — to be followed in sequence — that when completed, offer both partners an excellent chance of sustaining and fortifying their couple.

In this article, I will discuss Step #7: Building a Healthy and Happy Relationship. To read about Steps #1 through #6, as well as my other previous Psych Central articles, visit: http://ift.tt/2igqaQ3.

The path from discovery to recovery allows no shortcuts. The journey will take as long as necessary — sometimes months or even years, and may be helped by seeing a relationship counselor.

In Steps #1 through #6, the central character is the infidelity and each partner’s response to it.

In Step #7, the spotlight turns to the broader relationship, with a close eye on problems that predate the infidelity and continue to pose a threat to the harmony of the couple.

Infidelity seldom occurs in a vacuum. Other hurtful relationship issues, although never a justification for infidelity, must be identified, examined, and addressed in order for a couple to forge a lasting, fulfilling relationship.

For example, if one or both partners felt a lack of sexual or emotional intimacy prior to the affair, now is the time to resolve the problem. The partner who strayed, who for the sake of illustration, I call “John,” must be candid if he was unfulfilled sexually.

“Sue,” the partner who was betrayed, likewise must speak up now if she felt that John had prioritized work or community involvement over spending quality time with her.

The ultimate strength and durability of John and Sue’s relationship depend on both partners finding satisfaction.

Note that “John” and “Sue,” names that I’ve applied throughout this seven-part series, are fictional amalgams of real-life men and women who I’ve seen in my counseling practice. The lessons would apply no differently if it were Sue who strayed and John who was betrayed.

Even at Step 7, and in the relationship frontiers beyond this infidelity survival guide, it may be necessary for John to accept limited penance in the immediate aftermath of his infidelity. Spending more quality time with Sue is vital, even if it means forgoing his weekly poker game with the guys or Sunday’s at the sports bar.

But for both Sue’s and John’s sake, if John is sincerely repentant and follows each of the seven steps I’ve outlined in good faith, it is in both their interest for Sue to forgive him and close the book on this troublesome chapter of their lives.

Postscript: It’s now two years since John and Sue dutifully completed the 7 Survival Steps process and forged ahead with their lives. They remain together and, in fact, are closer than they were prior to John’s betrayal.

Their life path was altered by the infidelity and its recovery process. John and Sue found it necessary to start over in a new neighborhood to avoid running into constant reminders of John’s misbehavior and to avoid a steady stream of comments or stares from others in their old neighborhood who were unwilling to forgive and forget.

Likewise, it took time, but John ultimately left his old job (where he had worked with his paramour) and landed one that turned out to pay better and be more satisfying.  

John and Sue’s couple is not perfect. They still squabble about everyday relationship issues, such as household chores and budgeting. But even those differences seem much more manageable now because John and Sue have been to the relationship abyss and managed to step back.

John and Sue concluded, rightly, that they were better off navigating life’s ups and down together than going it alone. John’s infidelity choked their love, but never extinguished it.

John came to realize that the void in his life that he attempted to address by having an affair was much better filled by Sue, right there at home. And Sue, initially hurt and bitter, realized that John is still the man she fell in love with — a man who had made a huge mistake and now has made amends. Her forgiveness was sincere.

In real life, not every story of infidelity has a happy ending. Unfortunately, many don’t.

Ideally, partners would never betray one another, and this 7 Step Guide would be unnecessary. Short of that blissful goal, it would be useful for men and women to educate themselves about the incalculable damage that infidelity causes — before they ever stray.

Too often, by the time one or both partners turn to this 7 Step Guide for direction and comfort, the infidelity has occurred and the paradigm shifts to one of damage control.

Are you or a family member struggling to cope with the aftermath of infidelity? I offer other helpful articles at SurvivingInfidelity.info.



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Can Psychologists Predict Whether Donald Trump’s Popularity With Followers Will Endure or Fade?

Perhaps the least contestable thing you can say about the unpredictable Donald Trump is that he is a polarizing politician. Clearly a lot of people love him, while it seems almost as many detest the President.

Yet no one appears to have posed the key dilemma that will surely determine the success of his reign. Will his ardent followers continue to love him for an extended period into his Presidency? Will they forgive the inevitable set-backs and disappointments? Can Donald Trump display the necessary leadership skills to retain the country’s confidence when governing isn’t going his way?

There is a recent scientific psychological study that suggests an intriguing answer to these questions.

The research was entitled, The Leader Ship Is Sinking: A Temporal Investigation of Narcissistic Leadership’ and concluded that despite enjoying a honeymoon period of leadership, the appeal and attractiveness of the narcissistic leader rapidly wanes. University students were randomly assigned to leaderless groups, enabling participants to develop and display leadership.

This study might predict that Donald Trump’s supporters could become rather rapidly disenchanted with the very trailblazer they so idolize at the moment.

The investigation, published in the prestigious academic psychology journal,‘Journal of Personality in 2016, was inspired by the so-called ‘chocolate cake’ model of narcissistic leadership.

Chocolate Cake Model

This model was first introduced by Keith Campbell, a professor of psychology at the University of Georgia, who was alluding to the fact that the first mouthful of chocolate cake is usually tasty and therefore, extremely pleasurable.

But, over time as you consume more of the confectionary, it’s the very richness of its taste that renders you increasingly nauseous. Professor Keith Campbell contended that being led by a narcissist was like eating too much chocolate cake: Narcissists are initially perceived as effective leaders, but this positive take seems to decrease over time.

Originally developed to explain love affairs with narcissists, for example, such ego-merchants are great on a first date, but tend to get tiresome further into a relationship. The ‘chocolate cake’ model also applies to leaders and their followers.

Is the psychological research on narcissistic leaders predicting that once the honeymoon is over, Donald Trump’s followers are going to live to regret their commitment following the heady ‘first date’ of the election campaign?

The authors of the latest study, from Bangor University, The University of Stirling and The University of Derby in the UK, were partly inspired by this finding that while narcissists make a better first impression than those less in love with themselves, with increasing acquaintance, their heightened arrogance begins to drag. So, almost inevitably, narcissists are inexorably found less entertaining the more you get to know them. Particularly unappealing is their tendency to swagger and overestimate their talents.

Psychologists Chin Wei Ong, Ross Roberts, Calum Arthur, Tim Woodman and Sally Akehurst, the authors of the latest study into narcissistic leadership, point out that one possible explanation for why narcissistic leaders seem great ‘on a first date’, but end up being rated poorly in the long run is that leadership ‘emergence’ and leadership ‘effectiveness’ are two different things, but are frequently confused with eachother by an electorate.

Leadership emergence is achieved by attaining high status in a group of strangers, while once you are identified as a leader, effectiveness is judged by one’s actual performance in the post.

A Rude Awakening?

Although there is no doubt Donald Trump is masterful at emerging as a front-runner, this first impression doesn’t in any way predict his future effectiveness as a leader. It is suggesting that his followers may shortly experience a rude awakening.

Another theory is that narcissists’ decision-making strategies focus on short-term gains (which makes sense when trying to get attention at the beginning of a popularity contest) but then later while being in power, this strategy comes at the expense of long-term benefits.

The authors of this latest study found that the decline in rating of leadership in those higher in narcissism is associated with a waning in the degree to which they display transformational leadership.

The researchers explain that transformational leadership is an approach that involves establishing relationships with followers through emotional and inspirational interactions, so that supporters become motivated to perform beyond their expectations.

However, given narcissists’ continual striving for self-enhancement and personal glory to the extent of exploiting others for personal gain, their transformational leadership possibilities fade over time.

A truly great transformational leader grabs your attention – but does so in a bid to get you to perform better. By everyone in the team doing better, the squad wins and rises to the top. In the end, it’s not about them – it’s about you.

Perhaps the most emblematic example is the famous quote from John F Kennedy delivered at his inauguration on January 20, 1961: ‘My fellow Americans, ask not what your country can do for you, ask what you can do for your country’.

 



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Your Private Practice Challenge for 2017



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High frequency of (self-reported) ADHD symptoms in eating disorders

"There is a high frequency of ADHD [attention-deficit hyperactivity disorder] symptoms in patients with binge eating/purging eating disorders that motivates further studies."That was the conclusion reached in the study by Nils Erik Svedlund and colleagues [1] (open-access) who, among other things, set out to "explore the prevalence and types of self-reported ADHD symptoms in a large, unselected group of ED [eating disorder] patients assessed in a specialized ED clinic." Participants (over 1100 of them) were "seeking help at the Stockholm Centre for Eating Disorders (SCED) from 4 February 2013 through 18 September 2015" and as well as being confirmed to have an eating disorder were also screened for ADHD-type behaviours using the WHO ADHD Self-Rating Scale for Adults (ASRS-screener). Notice the 'self-rated' part of that last sentence...Based on a ASRS screener score of 14 or above, researchers reported that some 30% of females (N=1094) self-reported 'issues' associated with a diagnosis of ADHD. Some 34% of men included for study (N=47) reported similar ADHD traits (31.3% of the total group including those diagnosed with 'Eating Disorder Not Otherwise Specified (EDNOS) type 5' were on or above the ASRS screener score of 14).Bearing in mind the presence of various types of different eating disorders in their cohort, researchers also looked at how those self-reported ADHD traits might correlate with sub-groupings. They report that: "The highest frequency of possible ADHD was found in BN [Bulimia Nervosa] and in AN-BP [Anorexia Nervosa bingeing/purging subtype], respectively." They also noted that specific symptoms of ED correlated with the ASRS-screener scores: binge eating, purging, loss of control over the eating and BMI [body mass index] > 17.5. I might add that based on responses to another schedule - the Comprehensive Psychiatric [Psychopathological] Rating Scale (CPRS) - included as part of the study, authors noted something of a link between the ASRS trait scores and "the CPRS scales for depression..., anxiety... and obsession-compulsion." But: "Psychiatric comorbidity correlated to ADHD symptoms without explaining the differences between eating disorder diagnoses."Keeping in mind that answering 6 questions on a screener questionnaire does not an ADHD diagnosis make, I am rather interested in these and other findings. I am by no means an expert on eating disorder but I have previously been interested in the suggestion that autistic traits may be 'over-represented' when it comes to ED (see here). Combined with the idea that autism and [diagnosed] ADHD might not also be unstrange diagnostic bedfellows (see here) and you can perhaps see that there is potentially more research to do in this area in these times of overlap and ESSENCE. And speaking of ESSENCE [2]...With a word or two of caution, I note the authors also talked about potential 'treatment' options given the overlap between ADHD traits (self-reported) and ED. So: "This motivates further randomized trials with stimulant treatment for bingeing/purging ED-patients with and without a concomitant ADHD diagnosis." Certain stimulants have quite a good track record when it comes to ADHD (see here) but the authors rightly note that 'appetite suppression' is a potential side-effect of such pharmacotherapy and something perhaps not ideal if someone is already underweight. More studies are indicated to disentangle what is linked to what.And while I'm on the topic, the link between autism traits and anorexia nervosa might actually be a little more tenuous that you perhaps think [3]...----------[1] Svedlund NE. et al. Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients. BMC Psychiatry. 2017; 17: 19.[2] Karjalainen L. et al. Eating disorders and eating pathology in young adult and adult patients with ESSENCE. Compr Psychiatry. 2016 Apr;66:79-86.[3] Postorino V. et al. Investigation of Autism Spectrum Disorder and Autistic Traits in an Adolescent Sample with Anorexia Nervosa. J Autism Dev Disord. 2017. Jan 24.----------Svedlund, N., Norring, C., Ginsberg, Y., & von Hausswolff-Juhlin, Y. (2017). Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among adult eating disorder patients BMC Psychiatry, 17 (1) DOI: 10.1186/s12888-016-1093-1...




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The uniformity illusion.

Otten et al. investigate a visual illusion in which the accurate and detailed vision in the center of our visual field, accomplished by the fovea, influences our perception of peripheral stimuli, making them seem more similar to the center. The open source article contains several nice examples of this illusion.
Vision in the fovea, the center of the visual field, is much more accurate and detailed than vision in the periphery. This is not in line with the rich phenomenology of peripheral vision. Here, we investigated a visual illusion that shows that detailed peripheral visual experience is partially based on a reconstruction of reality. Participants fixated on the center of a visual display in which central stimuli differed from peripheral stimuli. Over time, participants perceived that the peripheral stimuli changed to match the central stimuli, so that the display seemed uniform. We showed that a wide range of visual features, including shape, orientation, motion, luminance, pattern, and identity, are susceptible to this uniformity illusion. We argue that the uniformity illusion is the result of a reconstruction of sparse visual information (from the periphery) based on more readily available detailed visual information (from the fovea), which gives rise to a rich, but illusory, experience of peripheral vision.


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Sunday, 29 January 2017

Why Are People Mean?

Portrait Young Man Shrugging Shoulders“Friggin jerk!” Cecily screamed at the man in the blue Volvo who swerved too close for comfort. Even though her two young sons were in the car, she raged on, “What are you, a moron? Where did you learn to drive? I hope you rot.”

Cecily wanted help controlling her reactions. She knew instinctively her temper was damaging to her children and contributed to her high blood pressure. When Cecily described her road rage to me, she described herself as being angry with the man in the Blue Volvo. “Of course you were,” I validated, “After all, the driver scared the heck out of you.” But then, I explained to Cecily how she acted out that anger by yelling.

Cecily grew up in a family with lots of shouting and sometimes some hitting. Cecily naturally thought yelling and hitting WAS anger. I explained that from an emotion science standpoint, “anger” referred only to the internal experience. When her parents yelled, shouted, said mean things or hit her, they were acting out their anger. This distinction was an important one to understand.

Most people fear anger because they equate it with hurtful, scary and destructive actions. It’s an easy mistake to make. Anger happens so fast that the internal experience and the actions that follow appear to be one and the same. We have the internal experience and we act on it in an instant. 

We feel it! We act!

With a little practice, we can slow down the whole experience of being angry into the two steps it actually is.  By slowing down just a little bit, we can begin to notice a variety of things happening inside that hold the key to managing anger much more effectively. If we don’t actively slow down, however, the fuel inherent in our anger will speed us up and we will react almost immediately after the emotion is triggered in our middle brain.  

I explained to Cecily that we had to help her learn to experience her anger but NOT discharge it with yelling. I suggested, “Let’s break down your experience into two steps: 1) The internal experience of your anger and 2) the expression of your anger.

So, what does it mean to simply experience our anger (without acting it out)? 

  • First it means to just notice and validate that you are angry and what happened that just triggered it. You may sense it as a jolt to your system or a rush of energy from your core. You say to yourself something like, “I notice I am angry. I think my anger arose just after the waiter took someone else’s order even though I was next in line.”
  • Your anger is actually just a bunch of physical sensations. If you can slow down enough, you can sense the sensations of anger and describe them to yourself. And that is exactly what I teach people to do. An example of something I might say in a therapy session is, “Notice what is happening to you physically. Notice the sensations you are having and notice the flow of the energy that anger generates. Where do you notice the anger in your body? What is it like?”
  • Your anger has impulses towards the one who hurt you. The impulses of anger are aggressive by nature. Anger wants to be nasty, even though other parts of you may want to be nice or calm. You can notice the impulses your anger brings forth: wanting to yell at drivers, to say mean things to people, or to lash out physically against those who anger you.

Staying with the experience of anger without doing anything is a challenge. And that’s one reason so many people discharge their anger by yelling, insulting, blaming, hitting, or abusing others. We do those things to discharge the energy of the anger; to get rid of the bad/painful/scary/angry feelings inside of us. And it works in the moment. But there are always negative consequences to acting out.

In summary, when we react in impulsive ways as a result of our anger, we are acting out.

There is also a term called acting in. Acting in means we turn all that angry energy against our Self, causing us harm. Types of acting in include cutting, starving, binging, doing drugs, and blocking our anger with depression and anxiety. 

What helps us thrive in life is to learn to fully experience our anger but have the control of how and when we chose to act on it. When someone hurts us, we need to tune into our physical reactions and validate to our Self that we are indeed angry. We need to know who angered us, what we are angry about, and to listen to the impulse, which tells us how angry we are. The very last step is to think through the best course of action.

What are constructive courses of action? 

  • Asserting one’s needs effectively with kindness and strength. A helpful image is to imagine putting your anger in your back bone and saying something like, “It’s important to me that you help out with the housework” or “It’s important to me that when I say ‘NO’ you back off and don’t continue to try to get your way.”
  • Setting boundaries with firmness and when possible with a calm and clear tone of voice. For example, “I don’t want you criticizing me or calling me names. If something I am doing is bothering you, let’s talk about it respectfully.” Or, “I do not like it when you touch me without asking if I’m ok with it.” Or, “If you’re going to be late, please let me know.”
  • Tending to childhood wounds. Sometimes we have blocked anger from our childhood that leaks out in the present. If you suspect you have unaddressed anger that is negatively affecting your life today, it is a great idea to seek support. Many therapists, especially emotion-centered and trauma therapists are trained to help you release pent up anger in a safe way.

Noticing our internal experience is a practice honed over a lifetime. The benefit is that it enables us to listen to our anger, to be informed by our anger and not ruled by it. When we can tune into our anger before we react, and we have time to think before we react. When we can think and feel our anger at the same time, we can choose a response that is helpful and not hurtful.  

So…why are people mean?

Because people act out their anger instead of first experiencing it internally. They react from the primary impulse of the anger, which always wants to be mean and aggressive.

You do not need to be in therapy to work on your anger. You can begin practicing slowing down in the midst of your reactions and getting to know your internal experience any time you want.

What physical sensations do you have when you’re angry?

To read about a time when I did this for myself, check out a past post here.



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