True Story: What I Learned When My Father Committed Suicide

What you can learn from the hardest day of your life.

Experiencing the suicide of a parent is one of the most difficult things I have ever endured.There are so many unanswered questions that can haunt you if you let them.

Grief is a process that can take time and is very personal; we all experience it differently.

But as hard as it can be, there are many lessons and blessings that can be learned from a tragedy like this.

Here are 5 positive things that I learned when my dad committed suicide that I hope can help you with your grief and healing process.

1. Acceptance.

It’s basically impossible to not think about the “what if’s” or the “shoulda, coulda’s” when they cross your mind. I’d be lying if I said they didn’t enter my mind from time to time.

However, the only thing they ensure is more pain! If there was something we could have done to prevent my dad from committing suicide, we would have.

Many emotions surface at times like these including anger, grief, envy, and fear. It is important to sit with your emotions and not push them away. It is important to give yourself the chance to fully grieve.

Once you have grieved, you can then learn acceptance. Only then can you have some semblance of peace.

5 Crucial Things A Grieving Partner Needs You To Know

2. There Is Always a Lesson and a Gift Even in the Darkest of Circumstances.

Finding a lesson in something that feels so tragic isn’t easy.

It’s important to experience your feelings if you really want to heal. In our culture, we are told to feel a certain way when something tragic happens. We are taught that guilt and shame are part of who we are. This doesn’t have to be the case.

One way that I have found that makes any problem or tragedy easier to handle is by looking for a lesson or a gift in it.

There may never be a perfect time to start the healing, so choose to do it now.

Here’s an exercise to help:

• Think of a situation that causes you pain. That may have caused you to feel guilt, shame, or to blame others.
• Take a deep breath as you remember the person or people involved and take a step back from the situation; like you are watching a movie.
• What could possibly be learned from this situation?
• How can I live my life differently?
• How can I grow from what happened?
• Write down what you could have learned.
• Can you see how you were able to grow as a person because of this lesson? (Remember, some of the greatest personal growth comes through pain!)

3. Good Luck, Bad Luck…Who Knows?

When something painful happens, people immediately want to put a label on it. Your assumptions or judgments cause you more pain than anything else.

There is a great story about a Chinese farmer that I use with my clients to make this point:

Once there was a Chinese farmer who worked his poor farm together with his son and their horse. When the horse ran off one day, neighbors came to say, “How unfortunate for you!” The farmer replied, “Maybe yes, maybe no.”When the horse returned, followed by a herd of wild horses, the neighbors gathered around and exclaimed, “What good luck for you!” The farmer stayed calm and replied, “Maybe yes, maybe no.”

While trying to tame one of wild horses, the farmer’s son fell, and broke his leg. He had to rest up and couldn’t help with the farm chores. “How sad for you,” the neighbors cried. “Maybe yes, maybe no,” said the farmer.

Shortly thereafter, a neighboring army threatened the farmer’s village. All the young men in the village were drafted to fight the invaders. Many died. But the farmer’s son had been left out of the fighting because of his broken leg. People said to the farmer, “What a good thing your son couldn’t fight!” “Maybe yes, maybe no,” was all the farmer said.

The lesson here is acceptance, judgment and allowing divinity to make things right.

When I look back on my dad’s suicide, I know that in addition to the pain, I have received some great gifts and blessings from this tragedy.

4. Valuing Each Day and Each Breath.

I used to take life for granted

I would let myself lose days or even weeks to feeling like a victim, anger, and grief. I learned that there is a place for those things but I do not have to dwell and stay stuck.

If I choose to give my attention to drama, then I am pained. Instead, I choose to practice gratitude in my darkest moments.

9 How-To-Be-Happy Lessons EVERYONE Can Learn From The Dying

5. Finally, Don’t Let It Get Too Dark.

Sometimes it feels like society expects us to be a certain way.

Society wants you to mourn or garner revenge depending on the circumstance.

We need not garner revenge on ourselves. No matter the circumstance we did the best we could at the time with what we had.

The best thing we can do to honor ourselves and the victim is to forgive. We have two choices: we can forgive now or forgive later.

Losing a parent to suicide is tragic and sad.

But you don’t need to get stuck.

There is life on the other side.

You are allowed to experience joy. You can celebrate and talk about your friend or relative.

This guest article originally appeared on YourTango.com: 5 Things I Learned When My Dad Committed Suicide.

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Parents Don’t Understand My Mental Illness

From a teen in the U.S.: Whenever I tell my parents about my issues and me feeling suicidal, they threaten to hit me and tell me to suck it up. I have no therapist anymore due to an insurance problem. I was supposed to get a psychiatrist also but my parents refused to help me get professional help. The ironic thing is my parents both have mental illness. I love them a lot but lately they are making me more and more miserable. Please help, I don’t know how to get them to help me I really want help.

A: Thank you for writing. I understand that it is frustrating not to have your parents’ support. It may be that their own mental illness makes it hard to accept that their daughter is also struggling. Fortunately, you don’t need their help to get the help you need. At 18, you are a legal adult.

Are you sure about the insurance issues? If both parents are disabled, they may have some kind of disability insurance that covers you as well. But if not, the good news is that you live in a city that has a free clinic for people age 18 and older. See the website for the Rhode Island Free Clinic at http://ift.tt/2tuAc5m.

I wish you well.
Dr. Marie

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Parents Don’t Understand My Mental Illness

From a teen in the U.S.: Whenever I tell my parents about my issues and me feeling suicidal, they threaten to hit me and tell me to suck it up. I have no therapist anymore due to an insurance problem. I was supposed to get a psychiatrist also but my parents refused to help me get professional help. The ironic thing is my parents both have mental illness. I love them a lot but lately they are making me more and more miserable. Please help, I don’t know how to get them to help me I really want help.

A: Thank you for writing. I understand that it is frustrating not to have your parents’ support. It may be that their own mental illness makes it hard to accept that their daughter is also struggling. Fortunately, you don’t need their help to get the help you need. At 18, you are a legal adult.

Are you sure about the insurance issues? If both parents are disabled, they may have some kind of disability insurance that covers you as well. But if not, the good news is that you live in a city that has a free clinic for people age 18 and older. See the website for the Rhode Island Free Clinic at http://ift.tt/2tuAc5m.

I wish you well.
Dr. Marie

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10 People to be Wary of at Work

 

Sometimes the key to success is in knowing whom to avoid at work. Having the wrong association can be the difference between promotion and demotion. In some cases, the casualty could even be a loss of employment. So how can a person navigate through the different personality? Here are ten types of people to be wary of at work.

1. Blamers. The boss is fuming over a missed customer call. Mark, who is the service rep, immediately starts blaming his assistant for the oversite. When he realizes she was out sick, he shifts the blame to his cell phone, the new computer program, and lastly claims the customer is needlessly demanding. Blame shifters hate to take responsibility for any error because they believe this makes them look weak or vulnerable.
2. Complainers. Susie comes into work with a new complaint nearly every day. The traffic was bad and it made her late. The deadline was unrealistic. The bathroom is dirty. Worse yet, she criticizes any new idea or process well before it is tested or implemented. Just being around her is exhausting. Underneath the complaining is actually attention seeking behavior and a desire to be kept at the center of the discussion.
3. Hoarders. John learns about a new technique that reduces his work processing time. But he refuses to share his knowledge with his colleagues or will share only a small portion of his new method. Information hoarding is a passive aggressive way of outshining the perceived competition. Secretly, it demonstrates anger that John is able to figure out something his colleagues cannot therefore only he should benefit from the knowledge. Additionally by withholding key information, it forces others to rely on John for the missed details.
4. Guilt-trippers. Move over moms, guilt-tripping can happen even at work. Ann, a team manager, tries to encourage her team to produce more sales by saying that her job is in jeopardy if they don’t generate higher numbers. She takes it even further by pulling one person aside to say that their sales are bringing down the whole team. The use of guilt as motivation is the lazy way to inspire and shows a lack of managerial training.
5. Wisenheimers. During a team meeting, Steven can’t resist the opportunity to demonstrate his superior knowledge by cutting others off and inserting his opinion. He comes across as a know-it-all who frequently irritates others with useless details and undisputable facts. Wisenheimers are often deeply insecure people who believe their knowledge is the only way they can stand out from the crowd.
6. Braggers. Marie’s assistant comes back from a Yellowstone vacation excited about her latest adventure. But as she attempts to share her travel stories, Marie interrupts with her with a more adventurous vacation, better hotel accommodations, and prettier views. She seals the demoralization by sharing her pictures while criticizing her assistant’s photos. Braggers can’t stand to be out shown and frequently resort to belittling others.
7. Deceivers. Ken’s confidence and smile has a way of disarming just about anyone. He seems to evade blame, deflect accountability, and artfully manipulate others with the greatest of ease. When co-workers start to see through the illusion of perfection, he manages to move up the ladder to another position. A person, who looks too good to be true, probably is. Deceivers like to cover up their true intentions.
8. Close-lippers. Silence is not always golden. Beth remains silent at department meetings, refusing to offer any input even when prompted. Instead she stares at her co-workers like a tiger studying their prey. Her patience in waiting for the right moment to attack is well-thought out and happens when others least expect it. Close-lippers have learned that silence can be equally controlling as verbal bullying.
9. Big-talkers. The opposite of a close-lipper is a big-talker. Allen talks a big game to customers about how well he is connected within the community and corporation. His list of conquests grows by the minute as he overinflates his numbers to everyone. Any attempt to bring him back to reality is countered with accusations of negativity and jealousy. Big-talkers are afraid of being seen for whom they really are and use their calculated numbers to intimidate the competition.
10. Ragers. Last but not least are the ragers. Tina is furious and embarrassed that upper management called her into a private meeting to express their concerns. So she takes her anger out on her team by verbally assaulting nearly everyone in her path. Nothing is off limits including things that happened last year, personality differences, how a person dresses, and when they take breaks. Tina obviously has poor anger management skills which really is a mask for deeper personal issues.

Being able to quickly identify these types of personalities at work and avoid them as much as possible could be a job saver. Sometimes it is necessary to keep documentation of these events and report them to human resources when needed. But the timing of this should be calculated and not reactionary.

Christine Hammond is a Licensed Mental Health Counselor and a National Certified Counselor who lives in Orlando.

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How to Stop Taking Yourself So Seriously

“The one serious conviction that a man should have is that nothing is to be taken too seriously.” – Samuel Butler

Do you think of yourself as a serious person? Do you find little to laugh about or is it difficult to let yourself go and enjoy what you’re doing, who you’re with, what you must look forward to tomorrow? There’s a difference between being thoughtful and earnest and being serious. I like to think that seriousness must involve an important situation or problem, not a demeanor I want to portray on an everyday basis. Some might say that I’m too easygoing, but that’s not it, either. I simply want to take life as it comes, do the best I can, and be hopeful and positive in the process.

Looking back on my early life, when I was a kid and saw a much older person hobbling along with a mean and grouchy look on his face, I automatically thought, “What a sourpuss!” As children, we’re keenly intuitive to the emotions of others. We can read people well, even when they try to mask their feelings from us.

Yet I also know and remember that children are quick to forgive, easily able to see the joy in life, to laugh and cry and laugh again. I might have noticed the old man’s grumpy nature, but it didn’t stick with me or put a damper on my enthusiasm for life.

Somehow, however, many of us seem to lose some of this natural ability as we mature.

It doesn’t need to be this way. There are ways to turn that steamroller around. Instead of allowing negative emotions to lay waste to your life, make it a point to stop being so serious and find what’s good and true and hopeful. Then, maximize your enjoyment of it.

What about the things in life that are, well, serious? You can’t avoid those, right? While it’s true that you must deal with situations, people and things that may be unpleasant, painful, contradictory, horrendous, exasperating, even evil, there’s always the other side of that experience. You won’t be in it forever, although it may seem like it’s lasting far too long at the time.

Change your outlook first.

Perhaps the most difficult part is trying to change your own outlook from one that’s too focused on how terrible things are or how difficult it is to get through events or times to an attitude that allows for some breathing room, levity, and being able to see opportunities hidden within challenges.

If you’ve lost your job, been dumped by your spouse or partner, got hit by a speeding driver, had your identity stolen or experienced some other nasty or traumatic event, it’s hard enough to pick yourself up and go on, let alone do so without feeling dour, helpless and hopeless.

But you can do it, with the help of your friends and loved ones who support your efforts and will always be by your side no matter what. There’s joy and solace in knowing you have allies. That’s a positive and will help lift you up out of the seriousness of your current situation.

Look for the positive in every situation.

You also need to have the desire and fortitude to insist that you will look for the lighter side of life’s difficulties. It won’t just happen. If you go around with a grim face that mirrors your equally serious thoughts, you’ll keep on having the same outcome. The situations and experiences may change, but your attitude won’t. For that you need to vow to turn that ship around.

If it’s one thing I’ve learned, it’s that life is short. My wish for you is what I strive to do each day: Intend to live life to the fullest, taking every opportunity to experience joy and happiness – even amid sadness, trouble and pain.

And, lest you think that I don’t know what I’m talking about, let me assure you that I’ve experienced many tragedies and much misfortune. These included surviving a car-train crash, being broadsided by a speeding tow truck, rescued unconscious from a burning building, getting shot at, robbed at knife point, given mouth-to-mouth resuscitation after a near-drowning. I’ve lost both mother and father, stepfather, grandparents, aunts, a brother and several close friends. Cancer, concussions, burns, broken limbs, severe back injury and being diagnosed with atrial fibrillation are also part of my life experience. Then, there’s also the list of fractured relationships, lost loves, broken friendships and so on.

Still, through it all, I remain hopeful, upbeat, confident and joyful. While I may have had more unfortunate experiences than most people, I don’t consider myself unique or special. I also don’t get depressed or anxious or feel that I’m unlucky, star-crossed or cursed by fate.

One thing that has helped me overcome sadness, regain self-confidence, believe in myself and ardently pursue my dreams is counseling. Psychotherapy may not be for everyone, but for those with overwhelming problems and emotional difficulties, it can be a life-saver. Therapy also helps reaffirm what’s good and true and hopeful in life.

Tips to Live By:

Everyone likes lists. They’re quick to digest and easy to remember. At least, the short ones are. Here are some quick tips to live by when you want to stop taking yourself so seriously:

• Have a goal for each day. This gives you something to look forward to.
• Begin each day with gratitude. You have a lot to be thankful for, so express that in a silent prayer as you awake.
• Let go of grudges. They’re counter-productive and lessen your joy.
• Live in the present. Now is the only time you can act, not yesterday or tomorrow. Be conscious of this moment, fully aware and present. This helps maximize your joy of experiences and relationships.
• If you make a mistake, learn from it. You’re only human, after all, and humans make mistakes. By finding the lesson in the mistake, you add to your knowledge and increase your problem-solving ability so that you’re more confident the next time.
• Pursue your interests and dreams. Life is enriched when you go after what you passionately believe in or desire to experience.

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How to Talk to Someone Who Always Gets Defensive

Your loved one hurt your feelings or crossed a boundary. You’re trying to talk to them about it. But as soon as you start expressing yourself, they cross their arms. They look away. They start playing with their phone. They say things like: Why are you criticizing me? and I know you think I’m a terrible person. They start defending their behavior. They list a litany of reasons why you’re actually in the wrong.

In other words, they get defensive. In fact, they get defensive any time you try to have a real conversation with them.

And this defensiveness feels a lot like they don’t care. You feel like your feelings don’t matter to them. You feel like you don’t matter. According to marriage and family therapist Jennine Estes, defensiveness is actually “rarely intentional.” Rather it’s a knee-jerk reaction that shields the person from guilt and self-doubt, she said.

“People who are defensive have difficulty taking responsibility for their actions and often feel uncomfortable being ‘wrong.’ [That’s] because accepting responsibility would make them feel as if they have failed.”

Defensive behavior might stem from a tough childhood or traumatic past, which can make a person more likely to “react through a negative lens,” said Lisa Brookes Kift, MFT, a psychotherapist and founder of Love and Life Toolbox. Kids often develop this behavior as a way to cope with difficult situations, said Estes, who owns a group practice called Estes Therapy in San Diego. Then it “becomes a bad habit as an adult.” Individuals also might grow up with a sinking self-esteem and a deep belief that they’re not good enough.

Defensiveness is like a spotlight, Estes said. “When you share pain with your loved one, that bright spotlight shifts from you to them. The defensiveness is a way to shift the spotlight back on to you, instead of keeping it on what really matters—the initial issue.”

We can’t control others’ reactions or actions. But we can increase the chances that they’ll listen to us by communicating in a constructive way. As Estes, said, “Relationships are like baby mobiles: If you tug on one side, the whole structure moves. If you shift your response, even just a little bit, the other person will automatically have to change their behavior.” Here’s how.

Avoid using “blame” language. Don’t start a sentence with “you,” as in “You didn’t hear me, again!” or “You just don’t care about how I feel!” said Estes, the author of Relationships in the Raw. Also, avoid using “always” and “never.” “These words give no wiggle room, and can be very critical, causing a person to defend their position.”

Start on a positive note. According to Kift, tell the other person what they mean to you, such as: “You’re a great friend and I’m telling you this because I care about you…” Also, show appreciation for what the person has done, Estes said. “If they don’t feel like their good efforts are acknowledged and only hear about how they messed up again, they will feel defeated.”

She shared this example: “I appreciate how you tried to handle our kid’s tantrum in the store. I know it wasn’t easy and I am glad I am not alone in this. You did your best. Can we talk about how we can both handle these public tantrums in the future?”

Start with some vulnerability and responsibility. Be vulnerable with the person, and take some responsibility for the situation. Estes shared this example: “I always felt as if I didn’t matter as a child. I was never seen. Now, when I talk and the TV is on, I feel like I am invisible again. You probably don’t mean to send me that message at all. I know how much you like your show. But it actually hurts and brings me back to that place of being a kid again.”

Focus on your feelings. “Beginning with an expression of how you feel is a good way to disarm defensive behavior,” Kift said. She suggested using this sentence structure: Say how you felt (your emotion) when they did what they did (their behavior). She shared this example: “I felt unimportant to you when you said we would go to dinner last night and then you canceled on me at the last minute.”

Ask meaningful questions. Estes suggested asking the other person how they’re feeling. “Be sincerely curious around their response. Deep down, it might be the little kid feeling as if they are not good enough and they need your compassion.”

For instance, according to Estes, you might say: “It seems like my question upset you. Is there something I said that makes you feel like you need to protect yourself?” or “It seems like my comment upset you. Did my comment make you feel attacked or hurt in any way?”

Don’t lose your temper. Of course, this isn’t easy to do when someone isn’t listening to you, or is listing off 20 reasons why they’re right. But losing your cool just adds fuel to the fire, Estes said. “Put down that pitchfork and stay focused on the feelings of hurt underneath it all.” Slow down, and take several deep breaths. And if you can’t calm down, tell the person you need to take a break.

Sometimes, you can do all the right things to have a constructive conversation—watch your words, be vulnerable—and the other person still gets defensive. In these cases, you can apologize and say it’s not your intention, Kift said. Remember that defensive behavior can stem from deeper issues, which have more to do with the person, than with your approach.

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What Is Thought?

Is that some sort of trick question? Everyone knows what thought is. Or do they...  My questions for you today are:

• How do you define “a thought” (yes, a single thought)? Where is the boundary from one thought to the next?

• What is “thought” more generally? Does this cognitive activity require conscious awareness? Or language? We don't want to be linguistic chauvinists, now do we, so let's assume mice have them. But how about shrimp? Or worms?

What is “a thought”?

Can you define what a discrete “thought” is?  This question was motivated by a persistent brain myth:

You have an estimated 70,000 thoughts per day.

Where did this number come from? How do you tally up 70,000 thoughts? Do some thoughts last 10 seconds, while others are finished in one tenth of a second?

Over 24 hours, one thought per second would yield 86,400 thoughts. If “thoughts” are restricted to 16 waking hours, the number would be 57,600. But we're almost certainly thinking while we're dreaming (for about two hours every night), so that would be 64,800 seconds, with an ultimate result of one thought every 0.9257 seconds, on average.

LONI_®, the Laboratory of Neuroimaging at USC, included this claim on their Brain Trivia page, so perhaps it's all their fault.¹

How many thoughts does the average person have per day?
^*70,000

^*This is still an open question (how many thoughts does the average human brain processes in 1 day). LONI faculty have done some very preliminary studies using undergraduate student volunteers and have estimated that one may expect around 60-70K thoughts per day. These results are not peer-reviewed/published. There is no generally accepted definition of what "thought" is or how it is created. In our study, we had assumed that a "thought" is a sporadic single-idea cognitive concept resulting from the act of thinking, or produced by spontaneous systems-level cognitive brain activations.

Neuroskeptic tried to find the origin of The 70,000 Thoughts Per Day Myth five years ago. He found a very bizarre post by Charlie Greer (“Helping Plumbing, HVAC, and Electrical service contractors Sell More at Higher Profits”):

Several years ago, the National Science Foundation put out some very interesting statistics. We think a thousand thoughts per hour. When we write, we think twenty-five hundred thoughts in an hour and a half. The average person thinks about twelve thousand thoughts per day. A deeper thinker, according to this report, puts forth fifty thousand thoughts daily.

If this “NSF report” exists, no one can find it (NSF is a funding agency, not a research lab). Were the LONI_® researchers funded by NSF?  No one knows...





Maybe we're approaching this in the wrong way. We shouldn't be relying on descriptions of mental events to define a thought, but rather discrete brain states.


Using this definition, “a thought” is what you can capture with your fancy new imaging technique. Therefore, a thought conveniently occupies the available temporal resolution of your method:

“A thought or a cognitive function usually lasts 30 seconds or a minute. That’s the range of what we’re hoping to be able to capture,” says Kay Tye, an assistant professor in the Department of Brain and Cognitive Sciences at MIT.

In this case, the method is FLARE, “an engineered transcription factor that drives expression of fluorescent proteins, opsins, and other genetically encoded tools only in the subset of neurons that experienced activity during a user-defined time window” (Wang et al., 2017).


But what if your method records EEG microstates, “short periods (100 ms) during which the EEG scalp topography remains quasi-stable” (Van De Ville et al., 2010). In this case, thoughts are assembled from EEG microstates:

One characteristic feature of EEG microstates is the rapid transition from one scalp field topography into another, leading to the hypothesis that they constitute the “basic building blocks of cognition” or “atoms of thought” that underlie spontaneous conscious cognitive activity.

And for good measure, studies of mind wandering, spontaneous thought, and the default mode network are flourishing. To learn more, a good place to start is Brain signatures of spontaneous thoughts, a blog post by Emilie Reas.

What is “thought”?

What is called thinking? The question sounds definite. It seems unequivocal. But even a slight reflection shows it to have more than one meaning. No sooner do we ask the question than we begin to vacillate. Indeed, the ambiguity of the question foils every attempt to push toward the answer without some further preparation.

- Martin Heidegger, What Is Called Thinking?

Philosophers have filled thousands of pages addressing this question, so clearly we're way beyond the depth and scope of this post. My focus here is more narrow, “thought” in the sense used by cognitive psychologists. Is thought different from attention? 

Once we look at the etymology and usage of the word, no wonder we're so confused...

Does Beauty Require Thought?

Speaking of philosophy, a recent study tested Kant's views on aesthetics, specifically the claim that experiencing beauty requires thought (Brielmann & Pelli, 2017).

Participants in the study rated the pleasure they felt from seeing pictures (IKEA furniture vs. beautiful images), tasting Jolly Rancher candy, and touching a soft alpaca teddy bear. In one condition, they had to perform a working memory task (an auditory 2-back task) at the same time. They listened to strings of letters and identified when the present stimulus matched the letter presented two trials ago. This is distracting, obviously, and the participants' ratings of pleasure and beauty declined. So in this context, the authors effectively defined thought as attention or working memory (Brielmann & Pelli, 2017).² 


Alternate Titles for the paper (none of which sound as exciting as the original Beauty Requires Thought)

Aesthetic Judgments and Pleasure Ratings Require Attention

Judgments of Beauty Require Working Memory and Cognitive Control

...or the especially clunky Ratings of “felt beauty” Require Attention — but only for beautiful items.


Dual task experiments are pretty popular. Concurrent performance of the n-back working memory task also disrupts the execution of decidedly non-beautiful activities, such as walking and timed ankle movements. So I guess walking and ankle movements require thought...



Footnote

¹ This claim was still on their site as recently as March 2017, but it's no longer there.

² They did, however, show that working memory load on its own (a digit span task) didn't produce the same alterations in beauty/pleasure ratings.


References

Brielmann, A., & Pelli, D. (2017). Beauty Requires Thought. Current Biology, 27 (10), 1506-1513.

Van de Ville D, Britz J, Michel CM. (2010). EEG microstate sequences in healthy humans at rest reveal scale-free dynamics. Proc Natl Acad Sci 107(42):18179-84.

Wang W, Wildes CP, Pattarabanjird T, Sanchez MI, Glober GF, Matthews GA, Tye KM, Ting AY. (2017). A light- and calcium-gated transcription factor for imaging andmanipulating activated neurons. Nat Biotechnol. Jun 26.

gif from palerlotus

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Attention-Seeking Depression?

I have most of the symptoms of depression, but I’m not sure if it’s for attention. I feel that i have these symptoms and emotions but I also feel that I don’t. I think it is for attention, but I’m not neglected by my parents. I have friends that talk and socialize with me. I have 5 siblings. 2 moved out to go to college. I have a step-dad and my biological dad visits every 3 months or so. I don’t feel neglected or disconnected from anyone. People tell me that I am special in my own way and I don’t need a disorder to be special, and I know that, but I still believe I have problems and I don’t know how to think of them. I am a compulsive liar and I lie usually to try to get myself out of trouble or to impress others. I try my best but I can’t control myself and I can’t stop lying to my parents about even the stupidest things. Lying has become a habit. I believe I have some sort of anxiety disorder. I always get super weak, I breathe harder, and my heart rate increases, sweat, think of the worst outcomes, get tunnel vision, my hearing starts to get weaker, and i feel cold whenever I have to do something like perform infront of even one person like my own parents or I have to talk to someone. These symptoms happen for instance, when I have to go up to an employee just to ask things. Apart from that, I also have a very hard time getting to sleep and staying asleep. Whats happening?

A. If you are concerned about your mental health, then it’s important to seek treatment. Mental health problems can make life very difficult. Therapy would help you. Generally speaking, anxiety doesn’t get better on its own but it’s highly responsive to treatment. There’s no need to live with symptoms when treatment would help you.

You mentioned being nervous whenever you have to perform in front of people. Many people feel this way. In fact, public speaking is one of the most common fears. Counseling is the ideal solution to this problem.

Ask your parents to help you find a therapist who can help. They might start the process by speaking to your pediatrician or family physician. They can refer you to mental health professionals in the community. Counseling will help you to feel better and overcome these problems. I hope you will give it a try. Please take care.

Dr. Kristina Randle

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Attention-Seeking Depression?

I have most of the symptoms of depression, but I’m not sure if it’s for attention. I feel that i have these symptoms and emotions but I also feel that I don’t. I think it is for attention, but I’m not neglected by my parents. I have friends that talk and socialize with me. I have 5 siblings. 2 moved out to go to college. I have a step-dad and my biological dad visits every 3 months or so. I don’t feel neglected or disconnected from anyone. People tell me that I am special in my own way and I don’t need a disorder to be special, and I know that, but I still believe I have problems and I don’t know how to think of them. I am a compulsive liar and I lie usually to try to get myself out of trouble or to impress others. I try my best but I can’t control myself and I can’t stop lying to my parents about even the stupidest things. Lying has become a habit. I believe I have some sort of anxiety disorder. I always get super weak, I breathe harder, and my heart rate increases, sweat, think of the worst outcomes, get tunnel vision, my hearing starts to get weaker, and i feel cold whenever I have to do something like perform infront of even one person like my own parents or I have to talk to someone. These symptoms happen for instance, when I have to go up to an employee just to ask things. Apart from that, I also have a very hard time getting to sleep and staying asleep. Whats happening?

A. If you are concerned about your mental health, then it’s important to seek treatment. Mental health problems can make life very difficult. Therapy would help you. Generally speaking, anxiety doesn’t get better on its own but it’s highly responsive to treatment. There’s no need to live with symptoms when treatment would help you.

You mentioned being nervous whenever you have to perform in front of people. Many people feel this way. In fact, public speaking is one of the most common fears. Counseling is the ideal solution to this problem.

Ask your parents to help you find a therapist who can help. They might start the process by speaking to your pediatrician or family physician. They can refer you to mental health professionals in the community. Counseling will help you to feel better and overcome these problems. I hope you will give it a try. Please take care.

Dr. Kristina Randle

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Are Skype, FaceTime, and Google Hangouts HIPAA Compliant?

It’s been quite a while since we discussed HIPAA (see TCPR, July 2005 for our interview with Rebecca Brendel). So let’s do a quick review.

As you undoubtedly know, one of the purposes of HIPAA, a law originally passed in 1996, is to regulate the flow of protected health information (PHI). It says that you are allowed to communicate PHI in certain circumstances—like to collaborate with other doctors or to get paid by insurance companies. But it also lays out a series of safeguards that you have to take to make sure nobody outside this circle of knowing gets their hands on PHI. For example, you have to make sure you or your staff don’t talk about patients in public, you shouldn’t leave charts out where people can see them, and if you use an electronic health record (EHR), you have to make sure that it has a good protocol to prevent data breaches.

Applying HIPAA to telemedicine has proven to be pretty tricky. A decade ago, most of us believed that the only way to ensure secure videoconferencing was to pay for expensive “HIPAA-compliant” videoconferencing equipment. This severely limited telemedicine’s economic feasibility. But things are changing. There are many more free or nearly free videoconferencing platforms, and most patients and doctors are quite comfortable using them.

Unfortunately, there is no agreement on whether all the free platforms are HIPAA compliant. One source of confusion is the misconception that a specific technology can even be “HIPAA compliant.” In fact, the only entities that can be HIPAA compliant are providers themselves. The federal government requires only that we take “reasonable administrative, technical, and physical safeguards” to ensure the confidentiality of patient information. Furthermore, the HIPAA Privacy Rule is “flexible and does not prescribe any specific practices or actions that must be taken by covered entities” (see http://ift.tt/1Oq7uVA)

This means that you have to use your own judgment regarding what technologies are private enough, based on guidance provided in the HIPAA law. Instead of “HIPAA compliant,” the better term for evaluating these systems would be “HIPAA compatibility,” and there is a spectrum here. Systems can be more HIPAA compatible, or less.

There are three HIPAA guidelines that relate to telemedicine:

1. Encryption. All communication between you and your patient should be protected, and the best way to achieve this is to encrypt such information. Encryption ensures that if anybody hacks into your conversation, all they will see is gobbledygook—unless they have the encryption key. Skype, FaceTime, and Google Hangouts all encrypt their data, probably at a level that is stringent enough to meet HIPAA guidelines.

2. Business Associate Agreement (BAA). HIPAA defines a “business associate” as any company that: a) helps you run your practice, and b) has access to PHI. Business associates include your billing company, your answering service, your transcriptionist, your EHR vendor, and others. All these services require either storage of PHI or entrusting people to see the information. HIPAA requires that all of these specially defined business associate sign a contract stating that they will keep your patients’ health information secret. This is the so-called business associates agreement, or BAA.

Skype, FaceTime, and Google Hangouts do not offer such agreements (though Skype offers a paid business version that does). So they’re not HIPAA compatible, right? Probably wrong— because of a HIPAA provision called the “mere conduit” exception. If a company is not in the business of actually storing PHI, but simply helps to transmit it from point A to point B, then it doesn’t have to sign a HIPAA business agreement. The analogy often used is a mail courier service, like FedEx. FedEx transports packages from place to place, but the company does not open them. Similarly, Skype transmits encrypted information but does not look at it or store it anywhere for review.

Not everyone agrees that Skype qualifies as a “mere conduit.” A common argument is that since Skype cooperates with law enforcement to investigate criminal communication, this means that the company does have a digital “back door” that could potentially be hacked by the bad guys (though this has not happened). Because of this admittedly remote possibility, some people contend that Skype should be treated like a business associate.

We don’t agree with that argument, but we acknowledge that it is a debatable point. For us, the fact that Skype (and FaceTime and Google Hangouts) securely encrypt all transmissions makes these technologies sufficiently HIPAA compatible.

As a bit of an aside, given the gnashing of teeth about Skype’s privacy, why don’t we ever hear worries about the simple telephone? Surely the phone, the constant victim of wiretaps in crime dramas, can’t be HIPAA compatible? Most experts seem to avoid this question—but some say that tapping a phone is actually much harder than hacking into email. That’s good enough for me!

3. Monitoring for breaches. You’re supposed to have a way of monitoring any communication you use for breaches, and the government should be able to audit it. Skype won’t provide you with a report like this. On the other hand, there have been no reports of hackers actually listening in on conversations—the main risk is that hackers could look at your call log. The bottom line is that Skype, Are FaceTime, and Google Hangouts are all encrypted video platforms that are widely adopted, easy to use, and free. Their official HIPAA compatibility is the subject of ongoing debate, but many clinicians use them anyway.

For an excellent in-depth discussion of Skype’s HIPAA issues, see the free Web article: http://ift.tt/2ur7WOC. For a good overview of HIPAA in general for psychiatrists, see the APA website: http://ift.tt/2ttfgvC (available to APA members only).

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Best of Our Blogs: June 30, 2017

I think the reason why many of us don’t take care of ourselves is not because we don’t believe it’s important. We don’t do what we need to do, because it requires us to do the hard stuff.

We’re forced to put up boundaries.

We’re forced to confront issues, people and situations we would rather deny and avoid.

Instead of running or escaping, we’re face to face with the thing, and it can either make us tough, gritty and self-confident or it can bury us deeper in self-denial and resentment.

It’s not easy to do the hard thing. Sometimes we’re just not up for it. Real positive transformation requires us to get courageous, show our true feelings, and feel the fear of being judged and do it anyway.

8 Devious Tactics of Narcissists
(Narcissism Decoded) – You feel defensive, belittled and full of shame. You’ve probably been manipulated by a narcissist.

8 Major Signs of Borderline Personality Disorder
(Caregivers, Family & Friends) – Confused about borderline personality disorder? This is what it really looks like.

How is Your Emotional Wellness? Find Out with This Emotional Wellness Quiz!
(Psychoeducation in Psychotherapy) – Think you’re pretty healthy? This may surprise you.

12 Survival Tips for Living with a Narcissist
(The Exhausted Woman) – For now, you’re stuck in a relationship with a narcissist. Here’s what you need to do to protect yourself.

Narcissists Say “Mistakes Must Not Be Made”
(Narcissism Meets Normalcy) – Are you an over-apologizer? This could explain why.

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Maybe Trump’s behavior is explained by a simple Machine Learning (A.I.) algorithm.

Burton offers an intriguing explanation for our inability to predict Donald Trump’s next move suggesting:

...that Trump doesn’t operate within conventional human cognitive constraints, but rather is a new life form, a rudimentary artificial intelligence-based learning machine. When we strip away all moral, ethical and ideological considerations from his decisions and see them strictly in the light of machine learning, his behavior makes perfect sense.

Consider how deep learning occurs in neural networks such as Google’s Deep Mind or IBM’s Deep Blue and Watson. In the beginning, each network analyzes a number of previously recorded games, and then, through trial and error, the network tests out various strategies. Connections for winning moves are enhanced; losing connections are pruned away. The network has no idea what it is doing or why one play is better than another. It isn’t saddled with any confounding principles such as what constitutes socially acceptable or unacceptable behavior or which decisions might result in negative downstream consequences.

Now up the stakes…ask a neural network to figure out the optimal strategy…for the United States presidency. In this hypothetical, let’s input and analyze all available written and spoken word — from mainstream media commentary to the most obscure one-off crank pamphlets. After running simulations of various hypotheses, the network will serve up its suggestions. It might show Trump which areas of the country are most likely to respond to personal appearances, which rallies and town hall meetings will generate the greatest photo op and TV coverage, and which publicly manifest personality traits will garner the most votes. If it determines that outrage is the only road to the presidency, it will tell Trump when and where his opinions must be scandalous and offensively polarizing.

Following the successful election, it chews on new data. When it recognizes that Obamacare won’t be easily repealed or replaced, that token intervention in Syria can’t be avoided, that NATO is a necessity and that pulling out of the Paris climate accord may create worldwide resentment, it has no qualms about changing policies and priorities. From an A.I. vantage point, the absence of a coherent agenda is entirely understandable. For example, a consistent long-term foreign policy requires a steadfastness contrary to a learning machine’s constant upgrading in response to new data.

As there are no lines of reasoning driving the network’s actions, it is not possible to reverse engineer the network to reveal the “why” of any decision. Asking why a network chose a particular action is like asking why Amazon might recommend James Ellroy and Elmore Leonard novels to someone who has just purchased “Crime and Punishment.” There is no underlying understanding of the nature of the books; the association is strictly a matter of analyzing Amazon’s click and purchase data. Without explanatory reasoning driving decision making, counterarguments become irrelevant.

Once we accept that Donald Trump represents a black-box, first-generation artificial-intelligence president driven solely by self-selected data and widely fluctuating criteria of success, we can get down to the really hard question confronting our collective future: Is there a way to affect changes in a machine devoid of the common features that bind humanity?

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How to Build a Healthy Relationship with Yourself Every Day

A healthy relationship with ourselves is multi-layered. It’s complicated. It consists of many, many parts—just like any relationship with anyone. And just like any relationship, there are important ingredients to cultivating a loving, compassionate partnership.

A healthy relationship with ourselves includes having a connected relationship with our bodies, according to Karin Lawson, Psy.D, a psychologist in private practice in Miami, Fla., who works with adults using a mind-body approach.

What does this look like?

We tune into our body’s cues and respond to them. For instance, we might notice that our jaw clenches and our stomach hurts every time we talk to a certain person. Responding to these cues might mean setting stricter, stronger boundaries or no longer spending time with them.

Stephanie Kang believes that a healthy relationship consists of making room for all of you—including your insecurities and imperfections. You have a “sense of wholeness and the feeling that you’re free to be your true self…” said Kang, a coach and counselor who guides her clients toward greater self-acceptance and personal transformation.

A healthy relationship also is based on curiosity and knowledge about our motives, intentions, needs, said Terina Lopez, a mental health counselor who specializes in eating disorders, anxiety, depression and identity development. It involves examining our actions and our whys—why do I feel the way I feel? —and making appropriate adjustments or changes.

A healthy relationship with ourselves is an ongoing process—again, just like any relationship. Below, you’ll find a list of ways to cultivate a kind, meaningful, fulfilling relationship with yourself every day.

Notice your inner chatter. Pay attention to what you regularly tell yourself. Pay attention to what you say when you’re facing a challenge or a stressful situation. “Starting to notice this is a great first step because it is often so unconscious,” Kang said. “Once we become more aware of how we relate to ourselves, we can reflect on what effect it’s having, and how we want to change.”

Use relaxation techniques to connect to your body. Lawson practices diaphragmatic breathing, progressive muscle relaxation and yoga to better hear her body. These techniques help us pay attention to subtle cues that we gloss over every day as we focus more on our tasks and to-dos. Over time, through engaging in these types of practices and taking the time to tune into your body, you’ll develop a familiar knowing.

She shared these examples: “Oh, there’s that annoying pain starting in my neck, maybe I need to go for a 5-minute walk and get some fresh air,” or “I’m feeling so numb and disconnected, I probably need to get stimulated with some aromatherapy or a call to my best friend.”

“Recognizing what’s going on physically can instigate our own care and responsiveness to our emotions, great qualities in any friendship,” Lawson said.

Check in with yourself regularly. According to Lopez, in general, “people have become so preoccupied with doing, we hardly examine how we are feeling.” However, connecting to ourselves helps us make informed decisions and actually ensure that our priorities are priorities, she said.

Lopez suggested regularly asking ourselves these questions:

• How am I taking care of myself?
• What can I do to improve my self-care practices?
• How can I make time for these practices?
• How satisfied do I feel in my personal and professional relationships?
• What changes can I make to improve the quality of these relationships?
• What is taking the most time out of my day? Am I content with the activities I’m spending the most time on? If the answer is no, what changes can I make?
• Do I feel connected to something I think is important and valuable?

Practice self-acceptance. See the parts of yourself that you dislike as part of being human, Kang said. She suggested sharing your flaws and insecurities with a close friend, or a coach or counselor. “[O]ften this leads to a sense of relief, and even the realization that the things we are most afraid to show are often super common and relatable experiences.”

Also, imagine how you’d respond to a loved one’s flaws and insecurities, and try to apply this to yourself, she said. Finally, practice self-compassion, which is a skill you can learn.

Surround yourself with loving people. “Though building a healthy relationship with yourself is ultimately something you have to go through on your own, it can help tremendously to have a positive community,” Kang said. It’s also helpful to spend time with people who have healthy relationships with themselves, she said.

Limit negative media. According to Kang, “anything that leaves you feeling less good about yourself is something you can live without.” Think about the different things you are consuming right now, and how they influence your relationship with yourself. Be intentional about what you expose yourself to. For instance, you might decide to stop buying magazines that feature articles about losing weight and getting a “bikini body.”

Explore the obstacles. “Look at what’s getting in the way of having the relationship that you want with yourself,” Kang said. She also suggested exploring past moments and situations that have hurt your relationship with yourself. How might you heal them? How might you move on? How can you navigate these obstacles today?

Our relationship with ourselves is the foundation for everything. It is “the foundation for all other relationships in our lives,” Kang said. “And you are the only person who will be with you for your entire life.” So, it’s not an exaggeration to say that building a healthy relationship with ourselves is vital and worthwhile. Maybe even urgent.

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Registered Behavior Technician (RBT) Study Topics: Skill Acquisition (Part 1)

As mentioned in the previous RBT Study Topics posts, “The Registered Behavior Technician^TM (RBT^®) is a paraprofessional who practices under the close, ongoing supervision of a BCBA, BCaBA, or FL-CBA. The RBT is primarily responsible for the direct implementation of behavior-analytic services. The RBT does not design intervention or assessment plans.” (https://bacb.com/rbt/)

The RBT Task list is a document which describes concepts that an RBT must be familiar with in order to provide applied behavior analysis services.

There are many topics on the RBT task list including: Measurement, Assessment, Skill Acquisition, Behavior Reduction, Documentation and Reporting, and Professional Conduct and Scope of Practice. (http://ift.tt/2tpXUR6)

The Skill Acquisition category of the RBT task list includes the following concepts:

• C-01 Identify the essential components of a written skill acquisition plan
  • A skill acquisition plan is the written plan which is developed by the Behavior Analyst that contains information about behavior programming for the purposes of teaching certain skills.
  • The essential components of a skill acquisition plan include a description of the target skill being taught, materials needed for teaching, prompting strategies to be used, the consequences for correct or incorrect responding, mastery criteria, reinforcement strategies, and plan for generalization and maintenance.
• C-02 Prepare for the session as required by the skill acquisition plan.
  • To prepare for the session, have your materials and the environment set up so that you can run the plan as designed. Also, be sure to have reinforcement items easily accessible.
• C-03 Use contingencies of reinforcement (e.g., conditioned/unconditioned reinforcement,
  continuous/intermittent schedules).

• Conditioned reinforcement refers to reinforcement that gets its value by being paired with another reinforcer (It is “conditioned.”). Unconditioned reinforcement refers to reinforcement that does not need to be learned or conditioned. For example, some examples of unconditioned reinforcers may include food, drink, escape from pain, and physical attention. Conditioned reinforcement may include things such as tokens, money, praise, grades, toys, etc.
• Continuous schedules of reinforcement refers to giving reinforcement for every occurrence of the behavior while intermittent schedules of reinforcement refers to only some instances of the behavior producing reinforcement.

See the next post for more information about Skill Acquisition topics.

image credit: DeeMPhotography via Fotalia

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Introspection for Blamers and Shamers

Some people in this world are expert blamers and shamers. Perhaps you know one. It begins with the need to blame: You did something bad. How could you have done this? Then it easily slides into the need to shame: You are something bad. What is the matter with you?

When something goes wrong, it can never be an accident, a random act of nature, a simple mistake, a lack of judgment, or a moment of inattentiveness. It cannot even be a misdemeanor. No, no, no, no, no! It’s got to be a felony.

Accidents are not allowed to happen. You heard me. No accidents. Somebody has to be blamed. And, amazingly enough, the finger is always pointed outwards.

• In a traffic jam? – “This wouldn’t have happened if you were ready on time”.
• A noisy appliance? – “If you used it right, it wouldn’t be making that noise.”
• A relationship problem? – “Just get to the point and fix it instead of talking so much!”

It’s no secret that Hal is a blame-based person. A “type A” personality and perfectionist, he’s one tough guy to deal with when something goes wrong. You can count on being the target of his anger if you’re within striking distance or have anything to do with his frustration.

Hal is not the kind of guy whose anger might suggest the need for an order of protection. Indeed, he has contempt for anyone who would hit a woman or wreck a house. He is a responsible guy. Others just need to be as responsible as he is.

For him, everything is judgment. Good or bad. Right or wrong. He’s got zero tolerance for carelessness, lateness or irresponsibility. Do what you’re supposed to do, the way it should be done and on time! No excuses!

Can someone like Hal loosen up? Not right away. Yet, what may start the change process is an unpleasant encounter in which he begins to think that maybe he’s done something harsh or hurtful.

For Hal, it began when he drove Jason, his 8-year-old son, to the softball game. When they arrived, Hal saw that the game had already begun. Of course, he blamed Jason for “making him” misread the schedule, because of his fooling around. Jason rushed from the car, tears in his eyes. When his coach asked him why he was late, he shrugged, “I don’t know. I never do anything right.”

At that moment, something clicked. Hal recognized how damaging his blaming was to Jason’s self-esteem. Yes, he wanted him to be more responsible. Yes, he wanted him to be more attentive. But, he didn’t want to make his son miserable. Indeed, he wanted to build up his pride and ego.

But, a blame-based person does not easily change his ways. Seeking someone to blame was in Hal’s blood. It was his way of trying to keep the control, trying to make things right.

Over time, however, Hal learned to appreciate that when things go wrong, it’s not always necessary to blame someone. Sometimes the problem is just situational (more traffic than expected),  organizational (the mailing was late), technological (the website was down), or human nature (people make mistakes).

Still, it took Hal a while before he was willing to examine the roots of his need to blame. To reflect on why control was so important to him. To remember how he felt as a kid when he was on the receiving end of the blame.

Hal never did become an introspective person who loved to delve deep into his psyche. Indeed, that would have required a personality transplant. But there definitely was a mellowing process. A chilling out. A lighter, less blaming and shaming way of looking at life and all its myriad problems.

The result: A less intense Hal, a happier son, a more relaxed wife. Not too shabby, I would say.

©2017

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The Psychology of Addiction

People who have never used drugs or abused alcohol may wonder what could ever cause anyone to become addicted to illicit substances. Why would anyone compromise their health, safety, and finances to indulge in something that could ultimately kill them? 

In fact, addicts are often trapped by a number of psychological factors from which they cannot escape and over which they have little to no power. Despite our general reluctance to be empathetic toward someone with substance dependence issue, the reality is sober living is not always as straightforward as it may seem.

If someone you love has an addiction, discover how to help him or her by learning more about the psychology behind this growing public health crisis.

Genetics

Scientists have long believed that genetics influence people’s propensity and inclination to abuse drugs and alcohol. Indeed, addictions tend to run in families with generations of relatives falling victim to this illness.

People who have family members with drug and alcohol abuse problems are at an increased risk of becoming addicts themselves. Their brains may be inadvertently hardwired toward wanting to drink or take drugs, thus making it difficult for them to resist the temptation to abuse these substances.

Anxiety

Anxiety is another factor that contributes to many people falling prey to drug and alcohol abuse. Psychology Today reports that anxiety is a psychological reaction that triggers warning signals in people’s brains and also overwhelms their egos. To calm the alarm and to assuage their own fear and worries, they indulge in alcohol or drugs.

People who suffer from anxiety may be able to resist abusing these substances by undergoing appropriate medical or therapeutic treatment. With proper medical attention and anti-anxiety medications, these individuals may be able to hang onto their sobriety and avoid succumbing to their temptation to use drugs or alcohol.

Trauma

People who witness or experience a trauma are more inclined to start using drugs or drinking. The trauma may have made such a deep impact on their psyches that they believe the only way to relieve the emotional, mental, and physical pain involves abusing illicit substances or indulging heavily in alcohol.

As they numb their pain with drugs and alcohol, they build up a resistance to these substances and thus have to continue using more and more to reach the same level of relief. In a short period of time, they find themselves addicted to their drug or drink of choice and are at risk of developing severe health problems like cirrhosis or even dying from their addictions.

Exposure

As previously mentioned, people who have relatives that drink or abuse drugs stand a greater chance of becoming addicts themselves. In this same way, people who are exposed to frequent drug abuse and alcoholism likewise are at an increased risk of falling victim to addiction.

Children in particular who witness people in their lives abuse these substances grow up believing that this behavior is entirely normal. They may even believe that they should drink or take drugs to feel accepted and like a normal part of the household or circle of friends. Their psychological attitude toward substance abuse leads to them becoming addicts themselves.

Chemical or Physical Changes in the Brain

Finally, the American Psychological Association notes that chemical and physical changes in the brain can put a person at an increased risk of becoming a drug addict or alcoholic. Any changes made to the limbic or cortical system in the brain alters the way that the brain perceives reward, motivation, memory, impulse control, and judgment. 

As such, people who suffer trauma to the brain, perhaps as the result of a car accident, stroke, or other accident or illness, may be unable to resist the temptation to use drugs or drink copious amounts of alcohol. To overcome their addictions, these individuals must undergo specialized medical care that addresses those brain changes and helps reestablish normal chemical reactions within the brain.

Addiction to drugs and alcohol is often caused by psychological factors that many people cannot avoid either because of social or lifestyle choices or their genetic makeup. By understanding these factors, people may become more sympathetic to the plight that addicts face in their struggles to regain sobriety. People also may appreciate better what it takes to guide a loved one who is addicted to these substances toward getting the proper medical and therapeutic help.

 

Sources
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Refusal to Accept Adult Responsibilities

Ever since I was a kid I have been struggling through friendships connecting to people and doing things on my own because my parents have always been strict with me . They never let me go out or anything or make friends and I reached the point where I was afraid to ask them do anything without their supervision. Today , I am a college student who struggles to make friends, has difficulty with social cues , and has a low level on knowledge in pop culture , often making it difficult for me to make relationships with anyone because I was never exposed to these things as a child. Additionally I have difficulties accepting my adult responsibilities and although my parents now pressure me to, I continue to procrastinate and refuse to take on my adult responsibilities on things that everyone else in my age group since to be taking care of. This includes things like getting a license, getting a job, making friends, or things as mundane as simply doing exercise so I could feel better about myself. A strong feeling of laziness has taken over me and whenever someone tells me I should do these things I become defensive and genuinely irritated and sometimes angry. This has turned into a destructive behavior I seem to have adapted to, and have lost many opportunities and even a relationship because of this behavior and the stress that accompanies it. Im 19 and still afraid of asking my parents if I can go out with friends. I want to change and I recognize that what I am doing isn’t healthy or helpful at all so what can I do to surpass my laziness,  my fear of doing out and things normally and assert independence from my parents ? How can I begin to move on into adulthood ? How can I work on changing this negative behavior myself ?

I would greatly appreciate it if I could get a response.

Thank You. (From the USA)

A: Working on things by yourself is only going to help up to a point. In fact, believing you can handle this on your own is one of the issues — not where the solution lies. Since your concern is with other people and taking responsibilities the resolution is taking responsibility with others. I recommend going to your university counseling center to ask them if they have group therapy. If not, ask them for help in placing you in a group. You won’t be able to avoid the issue within the structure of group therapy. You will be encouraged and supported to find new ways to connect to others, while at the same time get straight feedback about your own behavior. It is a very direct form of dealing with your issues head-on.

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

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10 Current Psychology Studies Every Parent Should Know

Whether parents are happier than non-parents, why siblings are so different, the perils of discipline, bedtimes, TV and more…

• Try one of PsyBlog's ebooks, all written by Dr Jeremy Dean:

• Activate: How To Find Joy Again By Changing What You Do (NEW)
• The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic
• Spark: 17 Steps That Will Boost Your Motivation For Anything

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How Your Smartphone Can Make You Smarter

Researchers tested how the mere presence of a smartphone affected cognitive capacity.

• Try one of PsyBlog's ebooks, all written by Dr Jeremy Dean:

• Activate: How To Find Joy Again By Changing What You Do (NEW)
• The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic
• Spark: 17 Steps That Will Boost Your Motivation For Anything

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Aging Wisely

We all have something in common. We’re getting older. While this fact might delight children who can’t wait to be “grown-ups,” it is often a source of angst for those of us who have already “grown up.” There are approximately 76 million baby boomers in the United States, and their ages range from early fifties to early seventies. It’s not surprising that this demographic is often bombarded by the media with anti-aging everything: skin creams for every part of our bodies, miracle “cures” for our wrinkles, youthful colors for our hair. They all promise to make us look younger — to fix us. Botox and facelifts have become the norm for many people (men and women), and again, there is cosmetic surgery available for almost every part of our bodies.

Well what’s wrong with that, you might ask? What’s wrong with wanting to look better (though “better” is subjective)? I get that and I know that looking good can translate into feeling good. To be perfectly honest, as someone who is well into the baby-boomer age range, I dye my hair. I’ve easily resisted all the other anti-aging remedies, but can’t seem to come to grips with having gray hair. I would look so old.

And that’s the big issue here, I believe. We as a society are resisting aging instead of embracing it. Instead of reveling in our gray hair or well-earned wrinkles, we despise them. Instead of marveling at our aging bodies and how they have stood the test of time, we are repulsed by them. Instead of recognizing and valuing the wisdom and compassion that come from age and our life experiences, we fixate on our failing memories and decreased stamina.

We focus on what we have lost, not what we have gained. And this attitude hurts us.

This study, published in 2012 in The Journal of the American Medical Association, examined the relationship between attitudes about aging and recovery from disabilities. Researchers found that seniors who have positive outlooks on aging are forty percent more likely to recover from a disability than those with negative attitudes.

So how can we feel better about aging? Is it as simple as ignoring the anti-aging ads on television? Maybe not, but it’s a start. Like so many things, it’s all about how we look at it — how we choose to view ourselves and those around us.

Surely feeling well can help us look at aging in a more positive light. Living a healthy lifestyle as we age not only benefits our bodies, but also our minds. For example, eating a healthy diet can stave off illnesses such as type 2 diabetes, heart disease, and possibly dementia. Getting enough sleep might also reduce our risk for these diseases. Exercising not only keeps us limber, but also releases those all-important endorphins which trigger positive feelings. Socializing and continuing to explore our passions are important as we age and studies have shown that those with a vibrant social circle live longer than those with few social ties.

The bottom line is we cannot change the fact that we are aging, but we can change how we view the process. When we talk with children who can’t wait to grow up, we often say, “What’s the rush? Enjoy being young. Enjoy NOW.” Well, the same outlook should apply to all of us. We can’t turn back time any more than we can fast forward it, but we can be mindful and embrace this moment we are in right now. Let’s age wisely by not trying to hold on to the past, or by dwelling on the future. Let’s live our lives in the best possible way — today.

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A Step Forward in Our Understanding of C-PTSD

The concept of Complex Post Traumatic Stress Disorder, known as C-PTSD for short, was first developed in the early 1990s. As with all scientific advances, not everyone realized its importance immediately and time was required to both refine and propagate the idea. The World Health Organization, for example, still does not recognize C-PSTD as a distinct health problem, though it may be included in the new list, scheduled for publication in 2018. The widespread slowness in recognizing C-PTSD is sometimes frustrating for those of us working in the field of psychology, trauma, and behavioral health. C-PTSD can produce severe depression, anxiety, and even psychotic episodes, which in turn can lead to serious physical symptoms. When healthcare practitioners are not aware that the problems they are dealing with are really results of C-PTSD, then treatment is much less likely to be effective.

The traumatologist, John Briere, was once quoted as saying, only half in jest, that “if Complex PTSD were ever given its due …. the DSM (The Diagnostic and Statistical Manual of Mental Disorders used by all mental health professionals) would shrink to the size of a thin pamphlet.” There is certainly very good evidence that C-PTSD is a much more prevalent problem than generally recognized. The C-PTSD advocacy organization, Out of the Storm, makes a strong case that there are hundreds of millions of undiagnosed cases worldwide. While the data we have is incomplete, what there is paints a picture in which, as they put it, “the numbers are staggering to contemplate”.

One obstacle, then, to giving the best help to sufferers of C-PTSD is a lack of awareness. Another is that, as a relatively new diagnosis, much still remains to be discovered about the mechanism by which C-PTSD comes about. A promising new study¹, however, may represent a major advance in our understanding of what C-PTSD is, which in turn would help us better identify and treat it.

C-PTSD and Childhood Trauma

C-PTSD differs from its better-known cousin PTSD mostly in that it is the result of a series of destabilizing incidents that happen over a period of time, even years. Each one on its own would not be sufficient to induce trauma, but their cumulative effect does. The typical case of C-PTSD involves an adult who, as a young person, was the victim of repetitive, chronic, and prolonged trauma involving harm and abandonment by a primary caregiver. Such mistreatment can include ‘passive’ slights, such as a parent withholding love or affection, or never giving praise.

It may seem intuitive that people react to such unhealthy relationships by developing the common symptoms of C-PTSD, such as, among others, shame, guilt, and an inability to regulate emotions or find enjoyment in life. This is because, unfortunately, we all know of too many examples where children of abusive parents go on to develop mental health problems. However, on reflection, this is not such an obvious result. Human beings have been forged by millions of years of evolution in order to survive, grow and procreate. Wouldn’t it make more sense for evolution to endow us with the ability to shrug off childhood traumas so that we can get on with having a successful life?

The new study suggests that C-PTSD is best understood as a learning process that has gone wrong. Part of the way we are designed for survival is that we are flexible enough to learn to thrive in very different environments. The skills you need to survive and succeed in the Savannah are very different from those you need in a modern city. During childhood, we go through a long process of learning how to avoid danger and how to deal with danger when it comes around. This is an essential part of adapting to our environment.

During this process of learning and adaptation, the relationship of the young person to his or her caregivers plays a central role. There are many dangers that a vulnerable child might face that they are unable to cope with alone. To navigate these kinds of danger and discover the appropriate way of responding, the child relies on caregivers, especially parents, for guidance and also protection. If the caregiver does not fulfill this role, or, worse, is perceived by the child as a source of danger then this process is interfered with. The child experiences dangers which he or she cannot adapt to and learns self-protective strategies that are actually deeply maladaptive in normal situations. In adult life, they are more likely to mistakenly interpret situations as dangerous and then respond in ways that are self-destructive. When a child grows up learning that the world around them is not safe, he or she takes this view of the world into adult life, with wide-ranging and damaging consequences.

Progress in Treating C-PTSD

The study suggests ways that treatment of C-PTSD can be improved. In particular, conceptualizing C-PTSD as a result of a learning process perverted through mistreatment indicates that successful treatment involves the therapist facilitating a new learning process by functioning “as a transitional attachment figure, using the therapy to generate the missing resilience-building processes of childhood.” Providing individualized treatment would mean looking closely at the ways in which the adaptive process of learning has been distorted. Some sufferers from C-PTSD will fail to process information, leaving them feeling helpless and unable to interpret the world around them. Others will err in the opposite direction and overinterpret details, which should be filtered out. To use an example given in the study, if they receive ill treatment at the hands of someone wearing a red jacket, then they will erroneously “focus on red jackets as signals of danger.”

Successful therapy is based on identifying the specific ways in which the way each individual processes information about potential and actual danger, in order to guide them to healthier thought patterns. In this way, the psychological profession can make a meaningful difference to the life of those suffering from this extremely serious, and still under-recognized condition.

References:

1. Crittenden, P. M. & Heller, M. B. (2017). The Roots of Chronic Posttraumatic Stress Disorder. Chronic Stress, 1, 1-13. doi: 10.1177/2470547016682965

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Understanding the Function of Patient Behaviors

It may seem obvious that understanding why someone does what they do should be at the heart of every approach to behavior change. Not all psychotherapeutic models are based on this notion that behavior can only be understood fully in context, but it is the basis for a framework called functional analysis, which is designed to better understand patient behaviors, thus creating a better shot at changing them.

“Seeing someone’s behavior in context is simply another way of describing empathy and understanding,” write Gareth Holman, Jonathan Kanter, Mavis Tsai and Robert Kohlenberg in their book Functional Analytic Psychotherapy Made Simple.

 Without getting into technical details, this simple statement is enough to get the point across about why it is necessary to dig around in sessions for the reasons why patients do what they do. To some extent, it involves being able to take the perspective of the patient in order to better understand what drove them to a particular behavior and what’s kept it going.

 To begin utilizing this approach in your sessions, you can start by simply looking at everything a client does (including language) as behavior, and seeking to understand the context within which that behavior occurs. Ask questions about what precludes it, what follows it, what seems to trigger it—both in terms of the individual’s inner and external experience.

 The following four steps, which have been loosely adapted from “Functional Analytic Psychotherapy Made Simple,” can be practiced in order to better understand the function of any behavior, whether it be your client’s or your own.

Tips to Practice

 1.     Identify the reason that the behavior continues to happen.

 Let’s say that a patient is struggling with letting go of an unhealthy relationship. Each time she breaks up with her boyfriend, she winds up reaching out to him again after just a few days. Why is she doing this?

 A small amount of investigation will likely get to the crux of why the client is engaging in the behavior of going back to a relationship that she knows is unhealthy. Upon being asked, she may share that she experiences thoughts of worthlessness of inadequacy—teachings that she carried with her from childhood. She may also share that she finds it difficult—if not impossible—to tolerate her feelings of grief over the relationship not turning out the way she’d hoped.

 Understanding why she continues to go back is the first step in helping her create change. 

 2.     Investigate whether or not the behavior may be related to avoiding something aversive or unpleasant.

 From the first step, it’s a short leap to knowing whether or not the whys of the behavior are at all related to avoiding something unpleasant or seemingly intolerable. In both of the hypothetical reasons for the behavior mentioned above, the client is using the behavior of going back to her boyfriend to avoid sitting with her feelings of inadequacy and/or grief.

 From there, it might make sense to target treatment accordingly; interventions could target building self-compassion for the client who struggles with letting of of the learned behavior of intense self-criticism or building distress tolerance skills for the client who never learned to regulate her emotions.

 3.     Examine the patient’s history and her history of using that particular behavior.

 With the client mentioned above, it’s important not only to investigate the history of the behavior of going back to an unhealthy relationship, but also to investigate the underlying behaviors of intense self-criticism and emotional avoidance.

 The client may have learned to berate and criticize herself from an early age through watching the behaviors of parents or from being berated or criticized by them or others directly. She may have learned to criticize herself as a way of regaining control over a situation that felt out of control such as after making a mistake, which she’d also learned somewhere along the way was unacceptable.

 Or perhaps the patient was taught early on that “negative” emotions like grief or sadness were inherently “bad,” therefore she learned to reject them and never acquired the tools to deal with them effectively. As an adult, it only makes sense that when difficult feelings emerge, she now engages in behaviors that reject and push them away. 

 4.     Identify potential longterm consequences.

 While projecting into the future about what might happen if the client continues to engage in unhealthy behaviors—such as compulsively returning to an unhealthy relationship, harsh self-criticism and emotional avoidance—may well be a difficult process, it can often help to solidify the person’s understanding of exactly why it’s in her best interest to work toward change.

 If the patient does, in fact, struggle with distress tolerance, keep in mind that any pain that may emerge while doing this exercise may be an opportunity to help her learn to better tolerate distress within the safety of the therapy room.

 “The flip side of this pain is to get in contact with what might be gained—what purpose, what meaning, what goals, what freedom—if one were to let go of the constricted problem behavior,” write the authors of  Functional Analytical Psychotherapy Made Simple.

 There are many, many ways that we learn to use behaviors and then learn to continue using them. Getting to the heart of why each client does what he or she does requires radical openness and a willingness to listen. You may have a hunch about why patients do what they do, but it’s a good idea to approach each client with the intention to have your mind changed or be proven wrong. In many ways we are all in the same boat as humans, but the variations on experience are vastly different. Always stay open.

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