Here’s How to Beat Narcissists at Their Own Game

Beat them at their own game.

Don’t employ these four positive character traits when you’re in love with, work for, were parented by, or are friends (frenemies) with a narcissist. These are admirable and useful traits when offered to “normal” people who don’t have the traits that typify a narcissist:

Early Warning Signs That The Person You’re In Love With Is A Narcissist

• An abundance of empathy.
• A strong desire to rescue and help.
• A willingness to try harder to make the relationship work.
• A strong sense of responsibility.

On the other end of the spectrum are the traits of a narcissist:

• Interpersonally exploitative.
• Lacking empathy: unwilling or unable to recognize the feelings and needs of others.
• Negative reaction to criticism (they can interpret us asking to have our needs met as criticism).
• Difficulty in admitting mistakes or taking responsibility for their bad behavior.
• Using fear to control people.

An example of how not to act around a narcissist comes from my long-ago narcissistic relationship:

My live-in boyfriend didn’t come until 7 AM from a “boys night out.” I was prepared to have it out with him. Get him to admit that he was cheating so I’d have the proof I needed to break up with him. Instead, he came home and grilled me. Did I call his friend Colin at 4 AM to find out where he was? (Controlling me by making me fearful I’d done something wrong.) Yes, I did call Colin.

My strong misplaced sense of responsibility kicked in. I began to doubt. Maybe it was my fault he stayed out all night because I was always trying to track him down? It’s no wonder, he said, that he couldn’t commit to a woman who behaves like “white trash.” If I could just trust him, he said, and quit trying to control him, his bad behavior would stop.

My abundance of empathy and need to try harder kicked in. I forgave him for staying out all night because maybe I was a shrew who made him want to rebel.

So, I’d just have to try harder to put up with his inconsistency, unreliability and (if I could set denial aside) his infidelities. And since he was tired from his night out he “really didn’t want to discuss our relationship right then.” (My desire to rescue and help kicked in and I let him off the hook. At least I didn’t make him breakfast!)

Unbelievable Memories Of Growing Up With A Narcissistic Mother

And don’t let passion blind you to reason! Our sexual organs often don’t care if our lover is a narcissist. So, how can you protect yourself when you’re in a relationship with someone like this? By learning how not to act around a narcissist who uses your positive character traits against you.

1. Learn all the narcissistic personality traits in a location on your body where you can see them (for me it would be my tummy).
2. Get into recovery for co-dependency (Twelve-step recovery is amazing).
3. Use emotional detachment to stop trying to manipulate, rescue, fix or people-please the narcissist.
4. Never reveal what hurts you or makes you feel vulnerable to a narcissist​​.

Dr. Athena Staik Ph.D. writes, “Expressing vulnerable emotions is vital to life balance and peace of mind, but do so only with safe others — never a narcissist. A narcissist literally uses this information to get into your mind, instilling fear to steal your sense of self, by crippling your brain’s capacity to clearly think. That means, while you’re pouring your heart and spilling your guts, the narcissist you’re talking to, like a mad scientist, listens only to gather data… to execute strategies to exploit and take possession of your mind, heart, soul for his (her) gain alone.”

This guest article originally appeared on YourTango.com: The 4 Personality Traits Narcissists Take Advantage Of (And How To Hide Them).

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Book Review: Addiction Treatment

Spanning across all socioeconomic statuses, races, cultures and ages, addiction is one of the largest and most insidious problems our society faces today. And yet, for the medical doctors who are often tasked with treating addiction, identifying and treating it is not always a straight forward process.

In his new book, Addiction Treatment, Dr. Michael Weaver, a specialist in substance abuse disorders, provides a comprehensive review of addiction, dual diagnosis, pharmaceutical treatment and clinical advice about how to work with an addict.

“People are embarrassed to admit to using drugs partly because they worry others will see it as a personal weakness or defect,” writes Weaver.

But Weaver also writes that having the right screening tools can make a big difference.

Asking non-invasive questions, such as “A lot of people have tried things like LSD or mushrooms or acid. What has been your experience?” and beginning with the more socially-accepted drugs such as caffeine and nicotine are two key steps every physician can take to more clearly diagnose a substance abuse problem. Another efficient way to assess for substance abuse is to ask open-ended questions about the consequences of use.

Though controversial, drug screens can be helpful when patients have recurrent or remote substance abuse problems or are not responding to evidence-based treatment, or if a controlled substance medication has been prescribed. Weaver offers numerous helpful tips, including which drug tests to use, the detection periods in which they must be used and even how to broach the subject with patients.

Once addiction is uncovered, the next step is choosing the right treatment.

“For a variety of economic and historical reasons, the U.S. substance use treatment system has become quite complicated, and in some cases, separated from the rest of psychiatry,” writes Weaver.

From addictions counselors, interventionists, twelve-step programs, sober houses, residential treatment, outpatient treatment and detox programs, Weaver covers the entirety of treatment options along with the American Society of Addiction Guidelines for treatment matching.

Of particular importance in treating addictions is psychotherapy, and more specifically, motivational interviewing. While motivational interviewing was first developed for treating alcohol users its purpose is to help patients become aware if their intrinsic motivations to change their problematic behaviors.

Through familiarizing themselves with the stages of change, and interventions such as the FRAMES technique – which stands for feedback, responsibility, advice, menu of options, empathy and self-efficacy – physicians can work with addicts in ways that avoid resistance and result in better outcomes. One useful technique Weaver suggests is first asking about the good things associated with drug use and then asking about the less good things.

Identifying common causes of relapse is also a fundamental skill for physicians. According to Weaver, patients relapse for a variety of reasons including overconfidence, self-medication, temptation, anger, hunger, loneliness, boredom and feeling tired.

Weaver draws on the advice of Terence Gorski, an expert on relapse prevention:

“I will often have patients write down their life and addiction history and look at why they relapsed in the past. I will then have them develop a list of early warning signs of impending relapse…We will then work together to put into place strategies for preventing relapse.”

Becoming familiar with Alcoholics Anonymous and twelve-step programs is also important for physicians who work with addicts, as Weaver notes that in a review of scientific studies, they were found to be as effective as any other interventions they were compared to. Greater meeting attendance has also been associated with better outcomes.

However, it’s important to understand that underlying most addictions is a secondary diagnosis, which often complicates addiction treatment.

“Among patients who come to your office with psychiatric issues, at least 20-50% will have a substance abuse issue, with the rate highest in schizophrenia,” writes Weaver.

As these patients will often ask for medications that are addictive in nature, understanding the different classes of addictive substances and their pharmaceutical correlates becomes vitally important.

Weaver provides a comprehensive assessment of each class of addictive substance, the effects of long-term and short-term use, as well as the many pharmaceutical treatment options available. He also covers the interplay between specific psychiatric disorders and substance issues. For example, stimulant use may cause and be confused with mania, but once the effects of the drug wear off, the diagnosis typically becomes more clear.

Drawing on motivational interviewing techniques, advising patients about unknown side effects and knowing the common forms of denial are just a few of the invaluable skills Weaver offers his readers.

As informative as it is practical, Addiction Treatment should be required reading for anyone who treats patients with addictive disorders. It is a must have practical and hands-on guide in any addiction specialist’s library.

Addiction Treatment
Michael Weaver MD
Carlat Publishing (2017)
Softcover
216 Pages

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Wife with Early Stage Alzheimer’s Doesn’t Want Help; Fear of Being Judged

My wife has been seeing the same psychiatrist for over eight years. I now accompany her since she doesn’t know why she’s still going to him and doesn’t remember what he says in the session. She has many hallmarks of early stage Alzheimer’s (about 18 months now)  but has been on Celexa for many years for depression and sees him just to be monitored. She does not want to be tested for cognitive impairment or take drugs–doesn’t see purpose. Has trouble articulating/expressing herself and really hates being “interrogated” now. She obsesses whenever I tell her her appointment is coming up. Any advice on how to lessen her fear of being questioned and/or tested? I feel pretty stuck–her psychiatrist is being ethical to monitor her Celexa dosage, but I don’t know how to help her, and he has no advice so far. She knows she has memory problems and is not in denial–she just wants to avoid doing anything about it. She has short term memory limitations and can’t be persuaded to be tested. Discussions about it go nowhere–her fears/anxiety overshadow reasoning with her. Any advice or strategies on how to deal with this? Thanks. (From the USA)

A:  It is difficult to be with a loved one who has lost their sensibilities to Alzheimer’s. She is lucky to have your warm and caring presence throughout the struggle. I think it is time for you to engage with a professional organization in your area that exclusively deals with Alzheimer’s patients. Your issues concerns, and struggles have been encountered by others before you. This association can have suggestions and resources beyond her psychiatrist that I think would be helpful: http://ift.tt/2wqcK93.

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

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8 Simple Ways to Give and Why Giving Is Good for You

Winston Churchill once said, “We make a living by what we get. We make a life by what we give.”

Giving feels good. We’ve all experienced that high from doing something good: donating our used books to the library, feeding the homeless at the soup kitchen, walking for AIDS or another cause, calling or visiting an older relative, or giving  someone a very personal and meaningful gift that they appreciated.

According to sociologists Christian Smith and Hilary Davidson of the Science of Generosity Initiative at the University of Notre Dame, Americans who volunteer an average of 5.8 hours per month describe themselves as “very happy,” while those who volunteer 0.6 hours say they are unhappy.

In their book The Paradox of Generosity, they also say that Americans who donate more than 10 percent of their incomes have lower depression rates than those who don’t.

But you don’t have to spend a year of your life on a mission trip or give half of our paycheck to a charity in order to give. There are so many ways to give.

Here are some, inspired by Jennifer Iacovelli’s book Simple Giving: Easy Ways to Give Every Day:

1. Spend Money on Others

Even a small gesture like buying someone a gum ball or a mint can increase your sense of happiness. A 2008 article published in Science reported on research done by social psychologist Liz Dunn of the University of British Columbia in Vancouver, Canada.

She and her colleagues surveyed more than 600 Americans and found that those who spent money on others experienced a greater level of happiness and satisfaction rather than those who spent money on themselves.

In a second research project, Dunn’s team questioned 16 employees in line for a company bonus of $3,000 to $8,000 about their level of happiness.  After they got the bonus, Dunn’s team went back to the employees and talked to them again about how happy they felt, as well as how they spent the money. The size of the bonus didn’t determine their level of happiness — but the amount spent on others or given to charity did correlate with happiness levels.

2. Spend Time with Others

Spending time with someone can be just as or more meaningful as spending money on him or her.

In her book, Iacovelli mentions a study where $10 Starbucks cards were handed out in four different ways. People were told to:

• Give the card to someone else.
• Take someone out for coffee using the card.
• Get coffee alone.
• Go for coffee with a friend but spend the gift certificate on themselves.

The group of participants who spent the gift card on someone else while spending time with that person experienced the highest happiness levels.

Our time is often worth more than our money these days, and spending it on someone with nothing to gain for ourselves (like networking opportunities) is a beautiful gift.

3. Volunteer … Untraditionally

I don’t think you need to volunteer in the traditional sense of spending several hours a week at a program or institution to reap the benefits of doing good.

Volunteering can mean visiting an elderly neighbor or running an errand for a friend. It can mean doing tax returns for a relative or walking your mom’s dog.

For persons who suffer from chronic pain and depression, volunteering (however you chose to do it) can be an important part of recovery. According to a study published in 2002 in Pain Management Nursing, nurses suffering from chronic pain experienced declines in their pain intensity and decreased levels of disability and depression when they served as peer volunteers for others also suffering from chronic pain.

“Despite encountering challenges, the rewards of this altruistic endeavor outweighed any frustrations experienced by volunteers with chronic pain,” says the abstract.

4. Be Emotionally Available

In The Paradox of Generosity,  Smith and Davidson say that another way we can give is in our relationships — by being emotionally available, generous, and hospitable.

And it has a health benefit. Those who are more giving in relationships are more likely to be in excellent health (48 percent) than those who are not (31 percent), they write.

This is perhaps the most challenging form of giving — to always be there (mind, body, and spirit) — for our spouse, our kids, our parents. When we’re sincere in this form of giving, it pays huge dividends in our lives.

5. Perform Acts of Kindness

I listed some acts of kindness under volunteering because I believe almost any kind of spending time with others is a form of volunteering that can boost your mood.

You can perform an act of kindness almost anywhere and at anytime. You can be as creative and involved as you want — devoting days to an elaborate project, or doing good in just a few seconds. Here are some acts of kindness I’m thinking of, but there are so many!

• Holding open a door for someone
• Letting someone with a few items cut in front of you at the grocery
• Smiling at a stranger and saying hello
• Counseling a friend
• Picking up your neighbor’s newspaper
• Calling an older, lonely person to chat
• Bringing your dog to a retirement home for folks to pet
• Helping an elderly person to her car
• Allowing a car to cut in front of you in traffic

6. Compliment Someone

The act of kindness I enjoy the most is complimenting people. It’s so easy, doesn’t cost anything, and always lifts my mood.

I will compliment a complete stranger on her blouse; tell the waitress she has a beautiful smile; praise the cashier at the grocery for being really fast; and commend the studious girl in my carpool for her discipline and conscientiousness. Complimenting someone takes me out of myself for a minute, which is often a relief. By making someone else feel good about themselves, I automatically feel better about myself.

7. Make Someone Laugh

Making someone laugh is the most fun way of giving and one of the very best gifts you can offer someone. As I’ve said before, laughing is one of the most potent antidepressants. It’s almost impossible to be anxious and fearful when you’re laughing.

Charlie Chaplain once said, “To truly laugh, you must be able to take your pain and play with it.” So if I can get someone to laugh — even a slight cackle — then I’m helping him or her to relieve the pain or pressure they carry. And in the process, I am helping to relieve mine as well.

8. Tell Your Story

“Stories are a communal currency of humanity,” writes Tahir Shah in Arabian Nights.

By telling your story, you are giving someone an intimate part of yourself. It’s no small gesture of generosity. We can tell our stories formally, in blogs and books and presentations. But most of the time, we tell our stories in coffee shops and hospital waiting rooms, at gyms and in churches, in grocery store aisles, and at support group meetings.

Telling your story can be immensely rewarding when it’s done sincerely and with the right person. Sometimes it can even be life-saving for you or for the person hearing your testimony.

Join Project Hope & Beyond, a depression support group.

Originally posted on Sanity Break at Everyday Health.

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A Surprising Sign Of High Intelligence

The link to intelligence is especially strong in women.

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Podcast: What Does Binge Eating Disorder Feel Like?

In this episode of the Psych Central Show, hosts Gabe Howard and Vincent M. Wales discuss Binge Eating Disorder. At his heaviest, Gabe weighed 550 pounds. He describes in detail how he went from a “normal-sized” guy to being morbidly obese, his return to being “normal-sized,” and addresses the question of whether he was, in fact, addicted to food. During the second half of the show, our hosts welcome Lisa, a woman who was with Gabe during this period of his life. She shares her experience of what it was like being with someone with binge eating disorder and how he finally confronted it.

*

Show Highlights:

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[1:13]     What is Binge Eating Disorder?

[5:27]     Is Binge Eating Disorder Really a food addiction?

[11:23]   Gabe’s Friend, Lisa, describes what Gabe was like at 550 pounds.

[12:34]   Gabe confronts binge eating disorder.

[13:45]   Gabe describes his gastric bypass surgery experience.

Listen as Our Hosts Talk About Binge Eating Disorder

“One of the things I remember very specifically about being so heavy was just the difficulty that I had doing things.” ~ Gabe Howard

Proud Sponsor of The Psych Central Show

 

About The Psych Central Show Podcast Hosts

Gabe Howard is an award-winning writer and speaker who lives with bipolar and anxiety disorders. In addition to hosting The Psych Central Show, Gabe is an associate editor for PsychCentral.com. He also runs an online Facebook community, The Positive Depression/Bipolar Happy Place, and invites you to join.  To work with Gabe, please visit his website, gabehoward.com.

 

 

Vincent M. Wales is a former suicide prevention counselor who lives with persistent depressive disorder. In addition to co-hosting The Psych Central Show, Vincent is the author of several award-winning novels and the creator of costumed hero Dynamistress. Visit his websites at http://ift.tt/2fH3c3L and www.dynamistress.com.

 

 

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Book Review: Welcome to the Jungle

Imagine that you just found out you had bipolar disorder. How might you feel?

An unexpected diagnosis often throws us for a loop. As we incorporate this new information about ourselves, we might experience fear, confusion and even denial about what our diagnosis means for our lives. But perhaps most of all, we may find ourselves asking the question: now what?

Luckily, for those diagnosed with bipolar disorder, that is the question Hilary Smith sets out to answer in her newest edition of Welcome to the Jungle with a new subtitle, Facing Bipolar Without Freaking Out.

In 2010, Smith’s blunt, insightful and witty first edition of Welcome to the Jungle offered readers a unique perspective on what it means to have bipolar disorder. Seven years later, Smith has revisited her original text with a greater sense of introspection and a more nuanced approach to her diagnosis and how best to deal with it.

“I wrote the first edition of Welcome to the Jungle when I was twenty-three…Since then, my thinking on what we call mental illness has evolved quite a bit,” writes Smith.

While retaining the quirky style and delightful imagery of the first edition, Smith’s thoughtful exploration of what bipolar can mean for an individual drives this revised version of the text.

Welcome to the Jungle resists categorization. Certainly it contains a fair share of useful strategies and recommendations for individuals both newly diagnosed and those who have been living with their bipolar diagnosis for a while. Likewise, it would be a useful text for the loved ones of individuals with bipolar or anyone with an interest in the topic.

Smith’s prose is consistently engaging and accessible for readers of any background. And yet we cannot quite deem it a self-help book; Welcome to the Jungle offers more than that. It is part autobiography, part guidebook and part meditation on the nature of mental health and society.

Smith divides the book by topic, beginning with: “What Just Happened? Life Beyond the Diagnosis” and going on to explain the mechanics of addressing a diagnosis including the nature of bipolar episodes, the role of medication and mental health professionals, how to anticipate and prevent episodes and strategies for maintaining stability.

She then navigates the particular risks of bipolar disorder in Chapter 7, titled “Bugs in the Jungle: Suicide, Psych Wards, and Other Downers.” Here, Smith explores coping strategies following an episode, makes recommendations about how to approach friends and family and goes beyond traditional Western psychiatric medicine in “Hippie Sh*t That Actually Works: Herbs, Wilderness, and Other Ways to Help Yourself.”

The conclusion of Welcome to the Jungle revisits one point in Smith’s central argument: that individuals dealing with bipolar develop or innately possess unique perspectives, empathy, creativity and vision. But Smith is quick and careful not to romanticize her disorder and encourages her readers to think carefully before making significant lifestyle changes, such as discontinuing medication.

Smith clearly finds some resonance in the idea that people with bipolar have difficulty living in this particular iteration of Western society: highly mechanized, densely populated, and focused on production over the individual. In another context, she suggests they might be considered visionaries, with the capacity for more creative thought.

Skeptics of this perspective, of mindfulness and meditation, and herbal remedies will still find many useful ideas in Welcome to the Jungle. Smith’s guide is first and foremost practical, in the sense that it directly comes from practice and her personal experience. She tackles questions ignored elsewhere, such as the mechanics of dating while bipolar, navigating the many different breeds of mental health professionals and the effects of drugs and alcohol and bipolar episodes. She carefully emphasizes that, while the text may explore other options, approaches, and philosophies it is not useful to entertain these questions while in the middle of mania or depression.

First and foremost, Welcome to the Jungle provides vital resources to people who likely need them, both those diagnosed with bipolar and those who care for them. All the better, too, that they are delivered in good humor and friendly prose.

As for her other assertions, they are largely compelling—the ways we as a society treat those dealing with various mental health concerns do deserve more conversation and consideration among patients, providers and the general community. And what better way to begin that conversation than by listening to the people stigmatized for having these diagnoses? Provided, of course, there is also a liberal dose of jungle metaphors.

Welcome to the Jungle, Revised Edition: Facing Bipolar Without Freaking Out
Hilary Smith
Conari Press
224 pages, softcover

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A Twitter Diagnosis

Hypothetical tweet from @DumpTrump: “Did you see the latest Trump meltdown? How did we elect such a megalomania? No question, the guy is mentally ill.”

In a snarkily filled tweet (or, let’s say, a snarkily written 500-word column), we impugn the President’s mental stability. And we — composing that latest Facebook missive or Twitter soundbite — are not alone. From CNN to Washington Post, armchair commentators have diagnosed Trump with a buffet of mental health issues. “He is narcissistic,” the commentators scream. “No, he isn’t narcissistic; the problem is his inability to control his impulsive tendencies,” another talking head bloviates. “No, it isn’t his impulsiveness; the real problem is his bullying, disparaging treatment of, well, anyone,” the latest scribe sneers.  

Sure, Trump’s behavior is more erratic than egalitarian. For him, facts are merely speed bumps, summarily driven over or, at best, ignored. His rants and raves would make Bobby Knight cringe. As a self-respecting journalist, I shudder whenever he decries the fake news media or blasts his critics’ patriotism.  

But is he mentally ill? And, better question, are we qualified to assess his mental status?

The answer — at least to the latter question: an unequivocal no. Yes, Trump’s behavior is coarse–even threatening. From his casual footsie with Charlottesville’s torch-wielding bigots to his disdain for Constitutional checks and balances, his rhetoric is deeply disturbing. Borderline unconscionable for this unflinching Democrat.

But crazy or insane? A mental health diagnosis is more nuanced than a five minutes soundbite of a bloviating Trump. To wit, the DSM-5 lists nine symptoms of major depressive disorder. It may takes months — or even years — for a general practitioner to correctly diagnose a patient’s mental health condition. But, somehow, you and uncle Bob have pinpointed the Orange Hairpiece’s clinical diagnosis?

Really.

More than the ceaseless chatter about Trump’s mental health illness(es), there is a darker concern: the politicization of mental health issues. In our overheated times, we casually toss around pejorative mental health labels with a swift, damning ease. From Trump decrying James Comey as a “nut job” to prominent Democrats castigating Trump’s mental health–or lack thereof, the political parties have finally found a unifying message: mental health conjecture as parlor game.

This “sport” is more sinister than your standard “throw out all the bums” analysis. As we casually exchange mental health barbs, aren’t we mainstreaming–unconsciously or otherwise–the most vile of campaign tactics? Somehow it is now fair game to question a politician’s mental health in the crudest of terms? All for the sake of scoring cheap political points? This stretches political and, well, human decency. Even more concerning: its chilling effect on mental health discussions among the general public. As well-respected public figures hurl mental health invective at one another, this further stigmatizes mental health openness/transparency among the general public. But apparently for Joe Q. Public Official, this is immaterial. Mental health is now a weapon of political destruction. Consequences be damned.  

That (American) shining city on the hill? Well, it has lost a little bit of luster as politicians and surrogates spew mental health insults at one another. Forget Make America Great Again, let’s just make it civil @DumpTrump and, yes, @realDonaldTrump.  

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Do I Have the Tendencies of a Loner?

Hi, I’ve been struggling for some time now with getting in a relationship. Whenever I find someone I like, if they reciprocate the feeling I shortly lose interest in them and I no longer find see them as a ‘crush’.

I am a person who enjoys being alone and I need time with myself, such as doing things I like without getting annoyed by others. I tend to distance myself from people if they become clingy, I just cannot stand it. Even in my childhood, I used to spend time alone, didn’t have many friends. However, now when it comes to relationships I struggle, sometimes with friendships as well. I easily get sick of them and it is bothering me that I cannot commit to one person.

Is it normal to feel this way? What should I do? Thank you!

A. Effectively answering your question would require more information about the nature of your relationships. For instance, how many times have you tried beginning a relationship with someone and lost interest? How long do these relationships last? What exactly do you mean by “crush”? Having the answers to those questions would help me to ascertain the nature of your relationships and add the necessary context to your question.

You might be choosing people who you thought at first were a match but came to learn that they were not. That’s what dating is all about. Dating involves meeting (sometimes many) people and trying to determine if they are a good partner. It would be problematic if you stayed with someone that you did not like.

Dating, by its very nature, is a process of rejecting everyone who is not a match. Most of the people you date will not be someone who you continue to date. Typically, people date and choose the one person with whom they wish to spend the rest of their life. Most relationships don’t last and breaking up is the norm.

You mentioned not wanting to be around “clingy” people. That is understandable. It is an undesirable trait. You also wrote that you like to sometimes be alone. Among healthy people, that is not an unusual or unhealthy trait. Abraham Maslow, who studied psychologically healthy people, observed that they prefer solitude and privacy to a greater degree than the average person. The persons that he studied had friends but not many and did not feel compelled to be with others out of loneliness or for other similar reasons. You can read more about self-actualizing people in his books.

It’s possible that your approach to relationships is not abnormal or indicative of being a “loner.” You might consider meeting with a local therapist who can gather information about the nature of your relationships and determine if there is a problem. Therapists specialize in relationships and can advise you in making appropriate changes, if necessary. Best of luck to you.

Dr. Kristina Randle

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3 Simple Steps That Really Help Depressed People

Three steps that will help you stop brooding. Repetitive negative thoughts are at the heart of the depressive experience. There are three steps vital to reducing repetitive negative thoughts, according to Professor Hans M. Nordahl, an expert on psychological therapy. These are (1) realising that brooding is a waste of time, (2) focus on the here-and-now […]

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Book Review: Attachment-Based Yoga & Meditation for Trauma Recovery

Yoga and meditation, though they exist in many forms today, have always represented a form of healing. Through breathing, we connect more deeply to our bodies. Through mindfulness, we connect more deeply to our thoughts and minds. And through yogic philosophy, we connect more deeply with our true nature. These concepts have been drawn upon for centuries to restore health, function and vitality.

In her new book, Attachment-Based Yoga & Meditation for Trauma Recovery: Simple, Safe, And Effective Practices For Therapy, Deirdre Fay demonstrates how these practices hold unique promise for trauma recovery.

“In working with trauma and attachment wounding over the past twenty plus years, it became increasingly clear that simple adages didn’t help people navigate their disorganized inner worlds. They needed, as I had needed, concrete, practical tools that pointed out ways to organize the ricocheting disruption,” writes Fay.

According to attachment theory, disruption begins very early on – from the moment we experience the world as safe or unsafe through our relationship with those who care for us. For many trauma survivors, the world has never felt safe.

“Underneath the stories and reasons our clients give us for being in therapy is the deeper, abiding, inchoate connection they are longing for – to return to their Self, their soul, their heart, while gently holding the many threads of their life so they feel put back together in a more satisfying way,” writes Fay.

From this connection – a secure base – trauma clients can begin the process of exploring the deep, painful, and possibly re-traumatizing parts of their lives. The hope is that they can find ways to relate to themselves, organize their inner world, and through their search for a sense of meaning, finds ways to process their pain.

This process begins with learning to experience the present moment.

“Most people, especially those with attachment wounding, are unknowingly flooded by the past, precluding an alive experience in the present moment,” writes Fay.

Through learning to attune to themselves, trauma clients experience a fundamental truth: the healing they want (and deserve) can only come from inside. It is only through developing an autonomous narrative that holds at its center the Self as the secure base that they can begin to break free from the hold their wounded past has on them.

While the prana, or life force can become stuck, knotted or interrupted, yogic philosophy holds that encountering these stuck and painful knots is the path. What we can do, is look for the opposites – such as love, warmth and connection – and hold these opposites along with the pain, as a way to remember and return to our true nature while also developing the consciousness that the reins of our experience are now safely in our hands.

Therapists, Fay says, are “Hope Merchants” helping clients to see, as Michelangelo saw in the beautiful yet flawed block of marble, the magnificent statue of David waiting to be expressed.

Buried under layers of shame are clients’ true, and yet undiscovered selves. Fay recounts the story of how a tribe in South Africa deals with shame:

“People would stand around the individual who had done wrong, telling them over and over again all of the things they had done right, all the wonderful qualities about them, all the good things that they are. The tribe would provide a counterpoint to the inner shame of doing something wrong, by holding up a mirror of who that person ‘really’ is.”

Making mistakes and still being loved is the work of self-compassion, and according to Fay, it can be developed. One of the lifelong practices that yogic philosophy offers are the protective characterological orientations called yamas.

Through compassion, nonviolence, truthfulness, purity, contentment, self-discipline and self-surrender, trauma clients can learn to move from the painful, isolated past toward an alternative reality – one that meets suffering with kindness.

One helpful exercise Fay offers is the Mindful Self-Compassion Break, which involves first acknowledging the pain, connecting to the reality that we all suffer, and giving ourselves a moment of kindness.

Yet the past can still interrupt the present, and especially when clients explore their pasts too quickly, or too deeply, they can become overwhelmed and dissociate. Here, Fay suggests normalizing dissociation as something that we all do, but also as a way to cope with undigested and distressing feelings. She offers exercises such as grounding to the spine to stay in the present moment; taking in small parts of difficult experiences and recycling them as more positive ones; steering the heart, body and mind toward cultivating positive experiences and identifying with how the past is intruding on the present.

The goal of attachment therapy is to experience a secure base – one of safety, comfort, and letting go. From an embodied yogic psychology perspective, secure attachment happens in reminding a client that what they long for is actually a native, natural longing for secure connection that got warped through difficult life situations. What they can learn, and what Fay so eloquently offers, is a path back toward prana – their life energy, their true Self, and the life they really want.

Attachment-Based Yoga & Meditation for Trauma Recovery: Simple, Safe, And Effective Practices For Therapy
Deirdre Fay
W.W. Norton (2017)
Hardcover
295 Pages
$39.95

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The Surprising Health Benefits of Swearing

No one needs to tell you that having a potty mouth is crass and vulgar. In fact, ever since we were little children we were told not to curse or swear excessively. While this advice seems well intentioned with respect to social decorum, science says otherwise. In fact, science reveals that a little cursing here and there can actually be a balm for our soul. How so? Let us examine how this seemingly bad habit can turn into something surprisingly comforting when the moment calls for it.

• Pain relief. Swearing activates the so-called ‘fight or flight’ response, leading to a surge of adrenaline and a subsequent pain relieving effect on our immune system. Richard Stephens of Keele University in England discovered that people who swear are able to hold their hands in ice water for twice as long. However, this only holds true for people who swear a few times a day, and not for those who swear excessively. The main reason for this is because those who swear on a constant basis are desensitized to their swearing, and as a result, are not particularly aroused by the act of swearing when they engage in it.
• Non-violent Outlet. Swearing enables us to get back at bad people or situations without having to resort to traditional violence, or something more menacing or harmful. It can be considered an act of sublimation, whereby we channel our anger by swearing instead, in what is seen as a ‘healthier’ outlet to help release our negative emotions.
• Harmless & Humorous Coping Mechanism. This coping mechanism, although far from a great one, can serve to increase our sense of self esteem, when it seems deflated, threatened or attacked. This in turn helps to build our inner resilience, and confidence in the midst of perceived tension and stress.
• Assertion of Power/Control. Swearing can give us a greater sense of power and control over a bad or negative situation. By swearing we show that we have the power to control a situation, and not have the situation control us. This usually happens, ironically, when things are spinning out of control for us, and when things are not necessarily going our way. A person need not be the actual trigger for swearing to occur, but a particular unpleasant situation can be the trigger.
• Social Bonding. Swearing can serve to show that we are not a fragmented member of a society. That’s why, cursing/swearing among friends can make you feel slightly better, when its coupled with a sense of validation from others. If done correctly, and under the right circumstances and with the right people, or group, it can also indicate that we are open, trustworthy, and fun to be around, making us appear more genuinely likable, and ‘real’ to others.
• Psychological & Physical Health. The best health benefits of swearing include increased circulation, elevated endorphin, and serotonin levels, and an overall sense of calm, control, and well-being. All of these benefits can seem intriguing if it is done in the right way, and does not become a vulgar habit.
• Outlet for Self-Expression & Creativity. Swearing can at times spark our inner creativity. Some individuals who naturally possess more of a creative flair find that they can come up with very creative words in the process of swearing, or that they muster up the energy to complete a project that has been neglected for some time.

A little swearing now and then (to yourself, or with friends) is not too terrible, and in fact may be even be good for your health by making you feel better, at least in the moment. The trick is to make sure it isn’t excessive, and that your swearing is not coupled up with anger, or another extreme negative emotion, as that can be very detrimental to your overall well being, and to others near you, possibly negating all of the potential health benefits described above.

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A Few Metaphors to Better Understand Depression

Depression is a difficult illness to understand. It’s hard to understand for the people suffering from it, but it’s downright impossible to know everything that a person who deals with depression on a daily basis goes through if you have never experienced it personally. For this reason, I have come up with a few real-life examples to help those who may not fully understand what depression is or how it functions. Of course, this will be the simplistic version. Depression is an extremely complex disease. As a person with depression myself, I have learned that it is very difficult to understand even for those who have the best intentions and the most empathy, love and support. If a person has not had personal experience, it is almost impossible to know what depression feels like.

I am writing these examples with the knowledge that some of these may strike a chord with people. They are meant to. Depression is a devastating disease, just like many of these very real examples can be devastating to many people around the world. I want to be as honest as I can, but it is also never my goal to offend anyone.

The Head Cold

You feel a cold coming on. It’s a sort of scratchiness in your throat and a foggy feeling in your head. This lasts for a few days and progresses to some more severe symptoms. Your throat is sore now and you have a high fever. There are body chills and the sweats and nausea and you just want it all to go away. It feels like this cold might never end. Finally it does. About two to three weeks later, the cold returns with a vengeance. The cycle repeats itself exactly like this for the rest of your life.

The Unemployed

You are doing well with your chosen career path. You are steadily moving up the ranks and your boss always speaks highly of you. You get along with your coworkers, not to mention you actually like what you do. Then there are cutbacks at work and you are one of them. All that you have worked so hard for seems to be lost in that moment and you wonder why it was you.

It takes you several months just to find another lower paying job to support your family and this causes you to change insurance, re-evaluate your budget and you’re not nearly as satisfied with your job. Many people have had to do it, but you didn’t think you’d be in this position until now. This causes a huge blow to your self esteem and tension in your relationship.

Note: This relates to the turmoil a person can go through when they are trying to find the ‘right’ antidepressant. With mental illness as opposed to most physical illnesses, it is pretty much strictly trial and error, and it can be frustrating to say the very least. You can try for months just to be disappointed in the outcome. You can also be satisfied with something you are taking for a while and eventually it may stop working.

The Breakup/Makeup

You are in a committed relationship with a partner and things are going quite well. You are happy, he/she is happy, and life is good. You are in love.

One day, you are living life as usual and your partner doesn’t come home as planned. A friend tells you that they saw your partner out with someone else. When your partner finally comes home you confront them about what your friend saw and they break down and confess everything. They have been cheating on you for weeks. They are begging you to forgive them, but you are so blindsided you can’t believe it.

The pain is gut-wrenching — it’s the most excruciating pain you’ve ever felt in your life. You cry for days, barely eating or sleeping, even wondering why you bothered to try up until this point. Finally, your partner convinces you to give them another chance. Six months later, he/she cheats on you again, and the cycle repeats itself for the rest of your life.

The College Student

You have a full-ride to your dream school, and you’re a few weeks into your sophomore year of college. Suddenly, your throat swells up like a balloon, and you start to get a sore throat like you’ve never felt before. You go to the doctor and she says you have a severe case of mono and it is contagious, you must go home for two weeks. This is devastating news, as you have a scholarship to maintain.

After the two weeks is over, you are still suffering from complications and symptoms due to the mono and it is very hard to maintain your grades. Unfortunately, it is too difficult to make up the work that you missed from the two weeks at home on top of the work you need to get done daily, not to mention you have a part time job. The scholarship is retracted and you are not allowed to attend school for the year, as financial aid has already closed and no one in the immediate family can sign for a loan. How are you ever going to pay for college now?

You are completely devastated. You planned on graduating in line with your classmates, peers and friends. You were going to get your dream career alongside your best friends and you had your entire future laid out. Plans are disrupted and your self esteem is in shambles

Note: This one is a specific example. Instead of using depression as the illness, I used mononucleosis. I did this to show that any physical illness as well as any mental illness can present itself spontaneously and throw you off course. This is what happened to me in college when my mental health deteriorated.

The Broken Down Elevator

You are riding in a crowded elevator filled with people to the top floor of an office building, in a hurry to get to your meeting, when suddenly the lights turn off and the elevator halts to a stop, jerking the unsuspecting passengers into the walls and the people around them. Suddenly everyone starts to panic and groan, because this is the last thing that they want or need.

Thoughts start to race through your mind as the walls are seemingly getting closer together. The room is getting hotter and the air is getting thinner. You look around as people start to bang on the doors and smash the emergency buttons on the key pad, but no one is coming to help. It has only been a few minutes, but it seems like you’ve been in this elevator for hours. What if this is it? What if you die in here? What about all of the things you haven’t done yet? What about your family? Your breathing starts to become labored and your chest starts to hurt. Suddenly the lights come back on and the elevator begins to move again, and there is a collective sigh of relief.

Note: This represents the anxiety that can often go hand in hand with depression. Sometimes anxiety does not always need a cause, however, such as a broken down elevator in order to be triggered. Sometimes anxiety just exists.

These metaphors only represent a fraction of what a person with depression may go through. However, I hope they may yield a clearer understanding of depression to those who may not fully understand.

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Symptoms of Mild Depersonalization?

Ever since I was young I remember having short episodes where I felt detached from myself. Everything felt sped up and unreal, and I felt like a robot. It felt like I wasn’t really “there”. I stopped getting them after puberty but very recently I have been experiencing these 10-15 min episodes again. Now when these happen I start to get panicky because I worry it’s the start of a seizure or like I’m going crazy. I have dealt with mild-moderate anxiety but nothing to severe where I felt like I needed to get help from my doctor. (From Canada)

A:  It must be a scary thing to feel this coming on. But I do think it is time to get the medical evaluation. There are several possibilities that can cause these reactions, and the best place to start is with a good general physical, letting your physician know the symptoms. He or she is standing in a very good position to make suggestions about treatment.

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

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How to Transition from Enemy to Friend

“Love is the only force capable of transforming an enemy into a friend.” – Martin Luther King

It certainly sounds like an impossibility. If you have an enemy, how can that person ever become a friend? This isn’t the recommended religious practice of turning the other cheek that we’re familiar with from the Bible, but close. Still, something about the process involved in transitioning from enemy to friend seems rather difficult.

Maybe not. Here are some examples of effectively transitioning from enemy to friend. Hint: A lot of the transformation has to do with attitude, mostly yours.

POLITICIANS

Consider politics, always an arena of intense interpersonal relationship dynamics. Even if you don’t like certain politicians because of party loyalty, personal convictions or personalities, the fact is politics is rife with enemies and friends. Sometimes it’s even difficult to tell the difference. Keeping track of the back and forth is interesting, if nothing else. That’s because in the political arena, opponents are considered enemies – until they’re not. Often, as in the case of the aftermath of political primaries, former enemies form alliances, endorse their previous opponent, and may even get named to positions within the potential administration.

Enemies turn into friends, at least, friends of an arm’s length sort. They probably won’t be erstwhile friends, those you feel you can turn to in your most dire need, but friends in contrast to enemies.

What has this to do with love? Just that it takes a bigger person to overlook enmity, to see the individual underneath the swagger and braggadocio, to separate the rhetoric from the underlying facts.

Or goodness, in the case of many.

THE EXAMPLE OF THE BULLY

Another example involves the bully. Think about the playground bully, someone bigger and stronger and seemingly out to get you. Many of us struggled to escape the attention of these mean kids in elementary school. We remember vividly how he or she pestered and tormented us or another kid, usually someone smaller, different, more vulnerable. If the targeted child continued to cower and show fear, the aggressive behavior on the part of the bully often continued and perhaps intensified. Standing up for him or herself, however, doesn’t always take the form of physical fighting. Sometimes, just a direct look – a nonthreatening, but unafraid look – will turn things in the opposite direction.

This isn’t to advocate that anyone act in a foolish manner, putting themselves or others at avoidable risk. It is, however, just an illustration that enemies can become something other than that, if not a friend, at least a non-enemy.

WORK COMPETITORS

What about the co-worker you’ve competed with for a task, coveted assignment or promotion? During the so-called contest or rivalry, you quite naturally see that individual as your enemy, someone you feel compelled or pressured to beat. After one of you wins, though, you have the option of continuing the adversarial stance separating you, opting to adopt a kind of truce, or joining forces to advance.

Who knows? You might even become friends.

While this is not love in the romantic sense, it is love in the human sense. It stands to reason that we all do better together than when we fight each other needlessly.

TRANSFORMATION: FROM ENEMY TO FRIEND

To transform an enemy into a friend requires one person to step forward and initiate the change. That’s often propelled by love, the kind of human emotion that forgives all slights, looks past harsh statements, past injustice, social pressure and aggressive actions and finds common bond.

It is also part of what resonates so strongly in Jesus’ statement during the Sermon on the Mount: “Do unto others as you would have them do unto you.”

Even if you don’t regard yourself as particularly religious, it is possible to see the wisdom in those words. Turning an enemy into a friend is how humanity learned to survive and become the dominant species.

Think about that the next time someone cuts you off on the freeway. Instead of reacting, just let them go. Call it being friends in humanity, rather than competitive adversaries.

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An essay on the real problem of consciousness.

For those of you who are consciousness mavens, I would recommend having a glance at Anil Seth’s essay, which does a clear headed description of some current ideas about what consciousness is. He summarizes the model of consciousness as an ensemble of predictive perceptions. Clips from his essay:

The classical view of perception is that the brain processes sensory information in a bottom-up or ‘outside-in’ direction: sensory signals enter through receptors (for example, the retina) and then progress deeper into the brain, with each stage recruiting increasingly sophisticated and abstract processing. In this view, the perceptual ‘heavy-lifting’ is done by these bottom-up connections. The Helmholtzian view inverts this framework, proposing that signals flowing into the brain from the outside world convey only prediction errors – the differences between what the brain expects and what it receives. Perceptual content is carried by perceptual predictions flowing in the opposite (top-down) direction, from deep inside the brain out towards the sensory surfaces. Perception involves the minimisation of prediction error simultaneously across many levels of processing within the brain’s sensory systems, by continuously updating the brain’s predictions. In this view, which is often called ‘predictive coding’ or ‘predictive processing’, perception is a controlled hallucination, in which the brain’s hypotheses are continually reined in by sensory signals arriving from the world and the body. ‘A fantasy that coincides with reality,’ as the psychologist Chris Frith eloquently put it in Making Up the Mind (2007).

...instead of asking which brain regions correlate with conscious (versus unconscious) perception, we can ask: which aspects of predictive perception go along with consciousness? A number of experiments are now indicating that consciousness depends more on perceptual predictions, than on prediction errors. In 2001, Alvaro Pascual-Leone and Vincent Walsh at Harvard Medical School asked people to report the perceived direction of movement of clouds of drifting dots (so-called ‘random dot kinematograms’). They used TMS to specifically interrupt top-down signalling across the visual cortex, and they found that this abolished conscious perception of the motion, even though bottom-up signals were left intact.

More recently, in my lab, we’ve been probing the predictive mechanisms of conscious perception in more detail. In several experiments...we’ve found that people consciously see what they expect, rather than what violates their expectations. We’ve also discovered that the brain imposes its perceptual predictions at preferred points (or phases) within the so-called ‘alpha rhythm’, which is an oscillation in the EEG signal at about 10 Hz that is especially prominent over the visual areas of the brain. This is exciting because it gives us a glimpse of how the brain might actually implement something like predictive perception, and because it sheds new light on a well-known phenomenon of brain activity, the alpha rhythm, whose function so far has remained elusive.

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Book Review: Replanting Lives Uprooted By Mental Illness

In her new book, Replanting Lives Uprooted By Mental Illness: A Practical Guide For Families, Nancy Boucher explores how families can be the key to healing that a person with a mental illness needs. Boucher begins by exploring the feelings of guilt that those with a loved one mental illness often carry, ultimately reminding them that while they cannot erase mental illness, they can ease it.

While families often feel simultaneously helpless and responsible to help, Boucher writes that it is most important to treat who the person is, rather than the mental illness that they have.

One helpful exercise she offers involves taking an inventory of the person – collecting information about everything from their interests to their personality traits, stressors, things that soothe them and coping skills – followed by an inventory of their illness, which includes information about the signs, symptoms, triggers, insights about the illness and coping strategies.

Because mental illness affects the entire family and often places enormous stress on all family members, Boucher suggests that the family come together as a team to support one another and keep normal routines and traditions going.

Of particular importance is to see the person, despite the many ways that mental illness may have affected them.

“Many peoples’ views of those with mental illness remain constricted seeing the illness, not the person, and by a lack of knowledge and understanding,” writes Boucher.

When families can take the focus off of the illness and see the person, they can begin the journey of helping their loved one re-connect with a more confident version of themselves – a version that is better prepared to face mental illness.

Part of that process, Boucher writes, is understanding the purpose of both boundaries and separation. While boundaries state the tolerances and expectations of our actions toward another and his or her actions toward us, separation acknowledges the importance of individuation of each person for mature ego development. Boucher offers several helpful statements families can use, such as “I’m sorry you are not feeling well, and it’s not okay for you to take your agitation out on me.”

Communication is also a fundamental component of healing from mental illness, and one that is often challenged. Boucher shares her own experience with her son Clem, who suffered from mental illness.

“In our family’s experience, we were often worn out by communications that erupted into destabilizing conflicts, so to get by, at times we avoided saying what was in our heart and on our minds,” writes Boucher.

By expressing caring and guidance in a warm empathetic tone, Boucher says family members can help their loved ones to more independently and successfully manage their symptoms, and ultimately become more confident.

Another helpful tool Boucher offers is to use feedback loops to help build stability for the families and reduce mental illness symptoms. By checking in with a person with mental illness frequently, and providing options to reduce stress – such as taking a nap, going for a walk or sitting quietly and having a coffee – a better communication evolves, and the chances of success in staving off a breakdown increase.

Reducing sensory overload and creating new neural pathways can also help the person with mental illness find new ways of responding that don’t evoke mental illness symptoms.

“With the neuroplasticity of the brain, over time you can create optional pathways. The more often these are used, the more smoothly paved they become. Prompts, both verbal and visual can help someone try these new pathways that are healthier. Motivation is critical to establish them, and repeated use and feedback loops can help ‘set’ the new habits,” writes Boucher.

To help connect with the emotional stamina and resilience needed to establish new routines, Boucher asks her readers to recall a time when they built stamina and resilience, and then write down which actions worked best, and which did not work so well.

Also important, Boucher tells us, is to maintain a diet of healthy routines – such as leaving encouraging notes for the person with mental illness, incorporating daily routines and rest periods into the day, using feedback loops, offering reassurance and finding opportunities to complete tasks that demonstrate responsibility.

However, for any treatment to work, the person with mental illness must be engaged in the process of recovery.

“You need to identify an entry point where your loved one with an illness becomes engaged with treatment and has the opportunity for learning and growth,” writes Boucher.

While Boucher does offer many insights from her own experiences with her son’s mental illness, encouraging poems, and helpful exercises, readers may find her book lacking in both a clear definition of mental illness and the evidence-based treatments that have proven effective for the individuals and families suffering from them.

Replanting Lives Uprooted By Mental Illness: A Practical Guide For Families
Nancy Pizzo Boucher
Nancy Pizzo Boucher (2016)
Softcover, 114 Pages

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Book Review: Overcoming the Destructive Inner Voice

Overcoming the Destructive Inner Voice: True Stories of Therapy and Transformation by Robert Firestone reads like a history of case studies.

Firestone began his private practice in 1957, and first worked with schizophrenic patients in a residential center. Throughout the book, he illustrates how mental disorders are the defenses one forms and the leading cause of maladaptation later in life. A person builds defenses and resistance to pursuing a better life due to critical negative attitudes.

Firestone believes that unexpressed emotions can be the source of both physical and emotional discomfort, and identifying and releasing them is the core of his approach with clients. People struggle with destructive thought processes, or what is often called a critical inner voice, for example, which directs behavior and can limit the lives of those who struggle.

During his work, Firestone discovered the therapeutic method called Voice Therapy. This methodology allows clients to learn to identify the language of the defense system and ultimately separate their point of view from its harmful effects. Instead of personalizing the self-criticism (“I statements”), Firestone helps clients to externalize by verbalizing the thought in the second person (“you statements”).

Voice Therapy is an approach based in cognitive and behavioral therapy that brings internalized negative thought processes to the surface with accompanying emotions, which allows the client to confront unknown aspects of the personality. This confrontation allows clients to begin to identify the critical inner voice and to work more effectively with their negative thoughts. Through the identification of the critical voice, clients are better able to take action against it and begin to make rational statements about who they are and how they experience their world.

Once a person externalizes the critical voice, they are able to begin to explore how these self-criticisms have impacted their behaviors. Having this understanding begins the process of change through decreasing the self-destructive behavior and increasing positive self-talk and behaviors.

The mistakes a person may have made in the past, if acknowledged and understood, can help guide that person into taking steps to a more informed journey through their vulnerabilities. And that journey all begins with an inner look at themselves, their inner voice, and how every choice could bring them closer to their authentic self. The voice is a representation of their consciousness becoming aware of the path that lays ahead.

Firestone presents stories and case studies that show how clients’ subconscious minds are attempting to bring a feeling, idea or situation into their conscious lives. When the subconscious continually asks if they are okay, for example, there must be a part of them that is not dealing with something or that feels there is something wrong that needs to be brought to consciousness.

Firestone describes his reactions to client revelations and responses by sharing his thoughts, feelings, and reactions as the therapist sitting on the other side of the couch. His exposure of what he is thinking and feeling moves away from the traditional portrayal of a therapist taking a neutral stance and being devoid of emotions and reactions.

When comparing this book to other books using case studies, such as Irvin Yalom’s Creatures of a Day, I found Firestone’s studies self-absorbed, though the book does show the vulnerability of the individuals seeking therapy and their struggle and journey through the therapeutic process.

While this book may benefit some therapists in understanding how the critical inner voice impacts clients, I would utilize my resources on other case study models.

Overcoming the Destructive Inner Voice: True Stories of Therapy and Transformation
Robert W. Firestone                           
Prometheus Books
December 6, 2016
Softcover, 240 Pages

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The New Normal

“On a scale of 1-10, how do you feel?”

It’s a question that most psychiatrists ask when assessing mood and medication maintenance. The scale is used to monitor feelings of anxiety, depression and other mental health issues. A patient’s response is the main test used for treatment.

But if 1 means that a person feels ecstatic, and 10 means they are suicidal, what is a 6 or a 3? What happens if a patient feels like something is wrong, but nothing has happened? Or if they can’t stop crying since their dog died last week? How much of an impact do average issues have? Are they really feeling an 8 or is the magnitude of sorrow dependent on the specific moment they are experiencing at the time? The scale has problems of its own.

“Normal” is a popular word in U.S. culture. We all want to feel it, but the definition is murky. To believe in something unreal seems abnormal. For example, schizophrenia involves hallucinations or magical thinking that falls under the category of psychosis. This has no basis in reality. Religion, however, involves unexplained theories and ideologies that also may not have basis on this earth. According to the Pew Research Center, 70.6% of Americans are Christian. Are Christian’s abnormal?

The difference between “average” and “normal” can be found in the societal connotations that ‘normal’ holds. Average is a game of numbers. If 70.6% of people in the United States believed their bodies were melting from the inside, someone concerned about their organs liquefying may be considered average. Normal, is another definition.

The Harris Poll, a survey answered by wide populations of America, reported that in 2016, American happiness was on the decline. On a scale from 1-100, the Happiness Index Number is a 31 compared to its average number in the mid thirties.

Some of the makeup of happiness involves gender, economic status, and education. Women are generally happier than men. People whose annual income is between $50,000 and $74,000 are generally more happy than people who earn between $75,000 and $99,999. People who have a college degree also find higher scores of happiness.

Splitting up these sections of people would mean the average for happiness would change. Does that mean psychiatric treatment or medication changes should be taken into consideration depending on gender, money, or location?

Aside from what is average, the reason many seek professional treatment for mental health related issues, depends on psychological distress.

Many serious causes of psychological distress can include:

• Major physical health concerns
• Bullying
• Sexual, emotional, or physical abuse
• A career transition
• Trouble with school
• Divorce and relationship issues
• Infertility

If you are unsure whether your psychological distress is causing a 3 or a 7 on your scale of mental well-being, make a check list of these symptoms to share with your doctor:

• Sudden outbursts of anger
• Intrusive thoughts that will not go away
• Weight gain or weight loss
• Audio or visual hallucinations
• Lack of sleep or too much sleep
• Delusions
• Reckless acts
• Impulsive behavior
• Feeling as if your thoughts are not your own
• Decreased sex drive
• Suicidal ideations or daydreaming

The scale for testing mental health is not perfect. Although we can usually figure out what happiness means to us, this may be particularly difficult for a teenager or a child that is receiving mental health treatment. Everything from commercials on TV to marketing on Facebook, tells us that we should be happy. America focuses on happiness as much as it does consumerism and some people believe they are tied together. It’s important to express expectations openly while keeping them in line with the current reality of life. Before starting a session with a doctor, make sure both of you are on the same page. What does he/she think about the scale? What types of behaviors, feelings, and sensations would he/she consider a 4 or an 8 and more importantly, how do you define your own normal?

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Do I Have a Mental Illness?

From Spain: I’ve been having anxiety since I was 16 (normally lasts less than a month). I’ve gone without anxiety for about a year, but now that I’m on summer vacation it has come again.

My greatest fear and obsession is to have mental illness like schizophrenia, so every time I see something in the corner of my eyes I get incredibly nervous fearing I might be hallucinating, same when I faintly hear something and I’m not able to rapidly identify where it’s coming from.

Lately this fear’s got a hold of me, so much that I’m having very troubled sleep. Not only I experience a fair bit of anxiety every night when I go to bed but I wake up at 3am ~ shaking. The first time this happened (this year) it had been so long since my last anxiety attack that I didn’t know what was going on. I though the bed was shaking and that there was an earthquake or something going on haha. But the shaking I can live with (regular panic attack), what really frightens me is the times in which I wake up in the middle of the night and keep ‘sort of’ dreaming even though I’m awake.

Like, maybe I’m dreaming that there’s a some kind of bug on my sheets and when I wake up I try to shake it off… or sometimes I wake up thinking I’m chocking on some food and run to the kitchen to quickly drink some water.

I use these examples for the sake of convenience but normally I wake up to such irrational and weird ideas I cannot begin to explain… And until a few seconds/minutes pass I’am fully convinced those things/ideas are real.

I’ve read up on it and it seems to be what’s called ‘hypnagogia’.

So, what has me worried is how much these ‘things’ happen to me lately:

– I wake up in an hypnagogic state (about 3 times last week, not much but worrying considering it almost never happened to me before)
– Sometimes I confuse objects with another/see things in the
corner of my eye and I’m incredibly nervous about it
– I forget things that happened recently
– Trouble sleeping a full night
– I’m often in a very bad mood lately though I force myself to socialize and get out of the house.

A: You are correct. The symptoms you report are consistent with hypnagogia, not a mental illness. The feelings you experience are very real. The hallucinations (both physical feelings and visual) are not. What will help is dealing with the sleep disorder directly. You need a sleep hygiene program. I can give you a brief outline here but you do need to see a therapist who specializes in sleep disorders to individualize a treatment plan.

Generally a sleep hygiene program includes the following:

• Do not drink caffeine after your morning cup.
• Eliminate other substances that interfere with sleep (alcohol or nicotine or drugs).
• Do not take naps.
• Do get some exercise every day but not after mid-afternoon.
• Set a reasonable bedtime and go to bed at the same time every night.
• Set up a safe and comfortable bedroom.
• Establish a “going to bed” routine. Something like bath, pajamas, brush teeth, meditation. Do the same thing every night.
• An hour before bedtime, get off all screens. No TV or reading in bed either. Put your phone in another room.
• If you wake during the night, don’t stay in bed longer than 10 minutes. Move to a chair and sit in the dark for awhile to settle down. You want your bed to be associated with sleep, not with tossing and turning.

It will take time to re-regulate your sleep. Establish the routine and stick with it for at least a month. I repeat: You do need to talk to a local therapist to individualize the routine for maximum help. You probably need some coaching for dealing with the anxiety disorder as well.

I wish you well.
Dr. Marie

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This Sleep Pattern Linked To Dementia

Sleep disturbance is common in dementia, but the reason is unclear.

• 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
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You’ve Got to Be Carefully Taught: How to Explain Hatred to Your Children

With world events occurring at lightning/frightening speed, adults who may be bewildered themselves, may feel at a loss to answer the questions their young ones may have about topics they see broadcast on television or hear about on the school bus. In the wake of the virulent rally in Charlottesville and those that have followed since, it is an even more important topic for parents to address. Children will ask questions and it is crucial for answers to be available and not brushed under the rug, as it might seem easier to do.

One such parent is Stefanie Nicolosi, a Philadelphia area photographer. In an article for Newsworks, she explains why she feels it is important to educate children about bigotry in order to create more caring human beings and a just society. The question remains about whether by sheltering our children from the news about what is going on in the world, we are doing them a disservice.

When the World Was Rocked in 1963

I recall vaguely when President Kennedy was assassinated (I was 5 at the time), I couldn’t understand why the adults on television were crying. My mother explained what happened in a way my pre-school age mind could absorb that someone did something bad and killed the president. I don’t remember if I asked why and I imagine my mother would have been hard pressed to have come up with an answer, but try she would have. When I look back at that November day, my child’s mind could have perceived that if the president wasn’t safe from a murderer’s bullet, then how could I be? To the best of my memory, it didn’t go there. I somehow felt protected.

I grew up in Willingboro, NJ (one of the Levitt communities built after WWII; NY and PA are the locations of the other two) which was not an overly diverse town at the time. That evolved by the time I was in high school. We were encouraged to have friends of all religious faiths and we sometimes went to church with them, even though our practice was Judaism. At our Passover table, each year were folks with different beliefs as well. Our Christmas eves were spent at the home of my mom’s BFF Miriam and as we woke up to their rainbow light and tinsel-clad tree with trains running around it, I often wondered how Santa knew to leave presents for two little Jewish girls (my sister and me). Each year my parents took us to an international festival at our local high school and we sampled food, listened to music and learned about various cultures. In 1964 and ’65, we headed to NY for the World’s Fair. There began my love affair with India, since we visited the Indian pavilion. It was the first time I had seen women wearing bindhi and smelled the delicious aroma of Nag Champa incense. Indian cuisine is among my favorites and kirtan (sacred call and response chanting in Sanskrit) part of my spiritual practice.

Why Would Anyone Teach Hatred?

One clear memory was listening to the Rogers and Hammerstein song from the musical South Pacific called “You’ve Got to Be Carefully Taught” and questioning my mom about the meaning. I was likely somewhere around 10 at the time.

You’ve got to be taught
To hate and fear,
You’ve got to be taught
From year to year,
It’s got to be drummed
In your dear little ear
You’ve got to be carefully taught.

You’ve got to be taught to be afraid
Of people whose eyes are oddly made,
And people whose skin is a diff’rent shade,
You’ve got to be carefully taught.

You’ve got to be taught before it’s too late,
Before you are six or seven or eight,
To hate all the people your relatives hate,
You’ve got to be carefully taught!

I wondered why anyone would want to teach their children to hate and fear anyone who was different. She patiently explained that some people were so afraid themselves that they passed it on to their children. Blessedly, we were taught by example to love, without regard to differences.

In 1968, in a school in Iowa, 3rd grade teacher Jane Elliott conducted an experiment called A Class Divided which highlighted what happens when children are taught to believe that one group is superior to another by virtue of eye color.

Pro-Social Activism Is Learned

Another anecdote that reflects the values with which my mother was raised that she deeded to me came later in her life. When Barack Obama was elected for the first term, I mused with her about how amazing it was, given that I grew up in the 1960’s and witnessed the inequities that divided folks based on the color of their skin. She related that when she was 18 and her father had recently died, she and my grandmother took a bus trip from Philly to Florida. This was 1942, during WWII and the bus was filled with soldiers, sailors and marines. When the bus pulled into DC, the white bus driver yelled, “All you (and he used the N word that I won’t glorify by spelling out), get to the back of the bus.” At that, my mom stood up and said to my grandmother, “Come on, we’re moving too.” And so they did. I asked her what the driver said and she replied, “Nothing.” And, what did the other passengers say?  “Nothing,” but each time they stopped along the way, the military personnel surrounded them to protect them from potentially angry white passengers. I marvel at this anecdote and the family in which I was raised.

When I look back at the past 58 years, I can honestly say that I have not faced overt anti-Semitism. My father related stories of what he experienced as a first- generation American Jewish man in the aftermath of WWII. One was when a fellow sailor examined his hair looking for horns, since this Southern born and bred man was taught that Jews had them. He had epithets such as ‘dirty Jew’ and ‘kike’ hurled at him. I often thought it bordered on paranoia at times, as I called it ‘looking for an anti-Semite under every bed.’

My parents modeled generosity as they volunteered in the community; my mom in the local hospital and with Girl Scouts (she was a cookie mom), our homerooms and swim meets and my dad as a firefighter, in our synagogue and with a young girl in our neighborhood who had Muscular Dystrophy and he did what was then called ‘patterning.’ As a result, I became a volunteer for various organizations, including our local recycling center when I was a teenager. When my now 30 year old son Adam was in high school, he volunteered for Habitat for Humanity, and now as an adult, he put his cooking talents to work for a charity fundraiser via the company he works for.

As parents, Michael (my husband who died in 1998) and I instilled in him the importance of honoring diversity and in his teens, one of his close friends was Gay and to this day, they remain in touch and he was happy for Paul when he heard he got married to the love of his life; another man. His BFF is bi-racial and we refer to him as his “brother from another mother”. At Adam and Lauren’s recent wedding were same sex couples and friends from all over the world.

 

Family values in our home are wrapped around love, acceptance, dialog, affection, education, activism, mutual respect, service, and celebrating uniqueness.  We were carefully taught and so I taught my son. May he pass on that legacy to his children.

How to Share the News with Children

• Be informed yourself by watching, reading and listening to reputable news sources.
• Provide information in an age appropriate way, using concepts that your children will grasp.
• Assure them that you will do your best to keep them safe.
• Don’t have the news on 24/7 even if it is tempting during a crisis.
• Let your children know that there are things to do to prevent a sense of helplessness, such as getting involved in the community.
• There are signs that many families place on their lawns that read, “Hate Has No Home Here” that takes a pro-social stand.
• Speak with them openly about peaceful co-existence with people from other cultures and religious beliefs.

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Can’t Do Date Night and No Childcare? 9 Connection Builders for Couples

Having kids is a beautiful, wonderful and fulfilling adventure. But it also adds stress to your relationship. After all, extra responsibilities and resources—finite things like money and your energy—are required.

Depending on what stage your kids are in, you might feel like a zombie. You’re sleep-deprived and exhausted—and maybe even more emotional and sensitive than usual. You might be spending hours a week just on shuttling your kids to different activities.

You and your spouse are spending less and less time together. And the distance between you might be growing bigger and bigger.

“Sadly, some couples start to live parallel lives and feel like co-parents who only have their children in common,” said Clinton Power, a clinical relationship counsellor and founder of Clinton Power + Associates in Sydney, Australia. Power often sees these kinds of couples at his practice.

But it doesn’t have to be this way. And you don’t have to wait until you have a big chunk of time or can muster the energy to get dressed up and go out, said Meredith Hansen, Psy.D, a clinical psychologist who specializes in couples in Newport Beach and Laguna Niguel, Calif. Because sometimes this is tough. While a weekly date night is great, thankfully, real connection also happens in the small, daily moments—as Hansen said, by making “use of the pauses of everyday life.” Below are tips on doing just that.

Kiss and hug each other.

Do this every time you say hello and goodbye to your partner. “When you hug, I recommend a full body embrace so you’re holding each other firmly and tuning into the emotional state of your partner,” said Power. He stressed the importance of prioritizing this connection before attending to anything else—from the mail to your kids. It’s a simple but significant way to help you “feel safe, secure and connected.”

Gaze into each other’s eyes.

“Many couples can go days or weeks without truly looking into each other’s eyes,” Power said. Which is why he suggested gazing into each other’s eyes for at least 20 to 30 seconds a day. “This is a lovely way to maintain your connection, reinforce the intimacy in your relationship, and remind you what you love about each other.”

Create rituals at home.

For instance, when your kids are asleep, have a cup of tea or a glass of wine, and listen to music together, said Silvina Irwin, Ph.D, a clinical psychologist in Pasadena, Calif., who works with couples and is certified by the International Centre for Excellence in Emotionally Focused Therapy. Or have a cup of coffee together in the morning, she said.

Another important ritual is tucking each other in at night. According to Power, if your partner goes to bed earlier than you, go in with them for several minutes. “Use a gentle voice, touch your partner with affection, and kiss them good night before you leave the bedroom. Bedtime can be a vulnerable time when you’re a child, so as adults, creating a ritual around putting your partner to bed can help you feel connected before one of you drifts off to sleep.”

Make time for physical intimacy.

“Sex is an important part of relationships, and often this is the first thing to dwindle after having kids for many couples,” Irwin said. She advised against waiting until desire kicks in. Because this often happens after engaging in some sexual or intimate play. “[S]etting the stage for intimacy, touching, kissing, and being together in an intimate space can awaken desire.”

Have date night at home.

This is something you also can do after your kids go to bed. For instance, you might plan a “Taco Tuesday,” turning on music, making margaritas and cooking fajitas, Hansen said. Maybe you do dinner and a movie once a week, getting your favorite take-out and watching Netflix.

Share your appreciations.

Power suggested sharing three appreciations every night with each other. He shared these examples:

• “I really appreciated you getting off work early today to pick up the kids from school. I’ve been swamped at work lately and your offer made a big difference to me and helped me get back on track with my deadlines.”
• “I appreciate that you cook me lovely meals every night of the week. I love your cooking and it helps me feel loved and cherished when you make me a yummy meal.”
• “I appreciated you fixing the broken tire on my bike today. I didn’t even have to ask you and you did it on your own. It helps me feel loved because I know you’re thinking of me.”

Check in with each other.

It’s very easy for your conversations to sound like this: Did you get the milk and eggs? What time is the kids’ soccer game again? I have a meeting at 8 a.m. next week, so you’ll need to drop Sam off at school. Can you stop at Target? We need to pay the electric bill. Did you go to the bank?

As Irwin said, while there’s a place for reviewing the laundry list of tasks and logistics, “what gets lost so often is how each person is feeling on the inside.” Ask your partner how they’re doing. Maybe they’re sad or lonely. Maybe they’re overwhelmed with parenting. Maybe they’re excited about an upcoming project at work.

“Sharing what’s happening with each other strengthens and maintains connection. It conveys that they matter to each other; they care about their partner’s experience,” Irwin said.

Set healthy boundaries.

“A lot of the couples I work with run into problems because their children become the centerpiece of their lives, and their relationship takes second place,” Power said. Which is why setting boundaries is vital, he said.

Boundary-setting also is valuable modeling for kids, and it “helps them develop the ability to tolerate not always getting what they want.”

For instance, Power said, you might tell your child: “No, you are not doing sports four times a week, because I don’t want to spend half my week driving you to all your commitments.” You also might tell them not to come in when your door is closed, and teach them not to interrupt you when you’re having a private discussion, he said.

Look for little moments.

According to Hansen, “New parents who take their little ones out on weekly walks should use that time to connect and have more meaningful, in-depth conversations.” People tend to be more open, especially men, when walking, “because we’re not focused on the non-verbal cues.” For instance, you might talk about your feelings about being a parent or reflect on your own childhood, she said.

Another great small moment is when you’re in the car. For instance, Hansen suggested buying a “questions” book and taking turns sharing your answers.

Connecting as a couple doesn’t require grand gestures. It happens in the daily moments of our lives. A hug. A “how are you?” A sincere “thank you.” A sweet ritual of tea and your favorite songs. And a Taco Tuesday.

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