Saturday 31 March 2018

The Ways We Define Recovery Can Skew Statistics

“Recovery” is not a term reserved only for those who choose and maintain the path of complete abstinence.

Inside a theatre, a stark visual appears:

“Each year, only 1% of addicts are able to kick heroin and stay clean.”

This quickly cuts to images of my former self deliberately counting syringes at the needle exchange site. I see a shadow I recognize as myself in active addiction. I can barely discern my gender, my clothing keenly styled to blend into the streets that I called home. As the lights in the theatre go on, I shift uncomfortably in my seat.

“Is that true?” my friend asks, offering me the last bit of whatever candy has melted to the bottom of the box.

“Is what true?” My mind starts spinning with whatever embarrassing section of the film I will now have to explain in great detail.

He points at the screen where the credits are finally reaching an end point. “That statistic that only one percent of heroin users get and stay clean. Is that true?” He looks genuinely concerned for me. I shrug. I accept his hand up from my seat now that the crowd has dissipated. “I don’t actually know. I mean, I don’t think so.” I didn’t have the answer.

That “statistic” stuck with me. What does that say about my chances? Many times in my 20 years of recovery, I have heard “facts” that were later revealed to be fallacies. It was extremely disheartening; with only a little over a year under my belt, what were the actual chances that I would be in that one percent?

Before I became what some call “clean” and others call “sober,” I had never known a person who effectively quit opioids. This had, in many ways, made me think such a thing was completely impossible. If there were effective ways to quit, I would surely know someone who had stopped according to my logic. However, as the weeks turned into months and months turned into years, more had been revealed to me. It was not that people did not quit, I just never saw them. It made perfect sense that any rational person who was trying to stay off the drugs was wise to avoid me while I was in active addiction. My life revolved around acquiring and injecting drugs with little room for socialization. No hobbies, no real friends, no family, no desire for anything outside of what I could fit inside a syringe.

When I began to critically examine the myths that were thrown around as facts in the recovery community, I quickly started to noticed that this “one percent” idea did not ring true. With a quick glance, I saw that the community I lived in was filled with people who had survived years of active addiction only to return to normal lives. In the initial phases of recovery, I saw those former comrades of the traveling spoon in roles such as drug counselor, the service industry, and front desk positions at halfway houses. As the years progressed, I have witnessed using buddies in a variety of professions: three nurses, one therapist, one bus driver, one phlebotomist, an IT executive, a chef, a few case managers, and one director of services for ex-offenders. How is this possible, I asked myself. There is no way this is just “one percent” of us. What does this say about our peer group? Are we just the lucky ones or is something in this “statistic” entirely flawed?

Well? Could something be entirely wrong? Find out in the rest of the original article The Other One Percent: How Definitions of Recovery Skew Statistics at The Fix.



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Book Review: Be The Parent Please

There is no arguing that parents today face considerable challenges. From safety in schools to bullying, lack of connection, and lack of empathy among kids. However, there remains one large problem that has crept in rather ominously.

“There are so many forces pushing us to give our kids technology, including the technology companies themselves, our schools, our friends, and the culture at large. It’s all happening so fast. One day we are wondering about whether an hour of Sesame Street is a good habit for a two year old and the next minute it seems we have adolescents who won’t look up from their phone for long enough to have a conversation with us” writes Naomi Schaefer Riley.

In her new book, Be The Parent Please: Strategies for Solving the REAL Parenting Problems, Riley explores what might be one of the most overlooked, and potentially insidious problems parents’ face today – screen time.

“A 2015 survey commissioned by Common Sense Media found that tweens (ages eight to twelve) are spending five hours and twelve minutes per day consuming digital media (not including listening to music and using screens at school or for homework). Teens (ages thirteen to eighteen) meanwhile, are spending eight hours and twenty minutes on digital media each day,” writes Riley.

While specialists see the trend shifting upward, parents feel it spiraling out of control. Riley quotes Jenny Pedeski, a pediatrician specializing in child development who recently ran a focus group to see how parents were using technology with their kids:

“The parents treated this as a support group instead. They thought it was so good to talk to other parents about this. They would say, ‘I don’t know what I’m doing. I don’t know how to deal with this,’” Pedeski said.

Yet the problem also works both ways. Riley points to the work of Jenny Radesky, who, after studying the interaction of parents and children in fast-food restaurants, found that when parents were on their phones more often they were not only more distracted and less likely to interact with their children, they were also more likely to be short-tempered.

Compared to years past, parents are investing more into their children — but perhaps in ways that don’t lead to desired returns. Riley notes the work of Jennifer Senior, the author of All Joy and No Fun, who describes the state of parenting today:

“Today parents pour more capital – both emotional and literal – into their children than ever before, and their spending longer, more concentrated hours with their children than they did when the workday ended at five o’clock and the vast majority of women still stayed home,” writes Senior.

On the other hand, children today are not expected to contribute economically.

“The twentieth century marked the first time in human history that having children didn’t increase your economic standing,” writes Riley.

Children today have become the receptacles of parents hopes and dreams.

“Perhaps without noticing, our parenting strategies evolved to be more geared toward ensuring that our children are never bored, uncomfortable, or at the slightest disadvantage when compared with their peers. By other measures, though, we are failing to prepare them for life as independent adults,” writes Riley.

What has occurred is a dramatic increase in attentional disorders, or what Dimitri A. Christakis of Seattle Children’s Hospital calls an “epidemic” of ADHD. He notes that an increase of one standard deviation in the number of hours of television watched at age one “is associated with a 28 percent increase in the probability of having attentional problems at age 7.”

Even in the case of educational software designed to increase readiness for school or enhance learning, there are unintended negative consequences.

“While it may seem as though our children can gain more academic skills through educational software, it is also possible that these touchscreen and button-pushing activities are inhibiting them socially and intellectually,” writes Riley.

Cell phones can also be misinterpreted by parents as necessary safety nets for their children. Riley notes the experience of one mother whose child feel asleep on the school bus with his cell phone battery dead. It wasn’t his cell phone, but the response of another concerned mother that saved him.

Riley also points to the question posed by Christine Rosen, who writes about technology and culture for the New Atlantis: “Shouldn’t we try to preserve some spaces at school for the cultivation of other valuable skills, such as face-to-face communication and socializing?”

One skill that is largely getting missed according to Riley is the ability to tolerate boredom. Children need to be constantly stimulated and the result is not just an inability to cope with distress, but a lack of creativity and imagination.

Technology is also not the economic equalizer that it is often argued to be by politicians and educators.

“What is more likely is that too much access to technology is actually exacerbating the inequality that already exists,” writes Riley.

Instead of simply removing or limiting technology, however, what parents should be doing is spending time with their children outside, exploring the natural world and engaging in human interaction. Kids learn better and become better adjusted through human interaction.

Drawing on the work of numerous research studies, Riley makes a compelling argument for rethinking our children’s relationship with screens – but perhaps more importantly, rethinking our relationship with our children.

Be The Parent Please: Strategies for Solving the REAL Parenting Problems
Naomi Schaefer Riley
Templeton press
January 2018
Softcover, 223 Pages



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Vulnerability & Therapy

I’ve been with my current therapist for a few months. They are helping me so much, I respect them, etc. Last week, our session went over an hour because my therapist didn’t have anyone else for the day. Plus she got me to dig deep, where we were not exactly at a great spot to end. But, I was afraid of this next thing happening, and it did. Today in my session, it went fine but then towards the end,my therapist got quiet, so I didn’t know if I was supposed to talk or not. When I started to, she said, okay tell me but then we have to end, because I need to be somewhere. I don’t know if she was making sure I knew last week was rare, or if she thought I disrespected her, took advantage etc. Now, MY ANXIETY IS THROUGH THE ROOF. I don’t know what to do. Should I say something to her? I respect her time, I understand of course but for some reason this hurt my feelings so much.

A. Yes, you should speak to her about this issue. You are making assumptions about what may have happened and seem to be blaming yourself. In all likelihood, it was a misinterpretation of events. If you don’t ask, then you will never know.

The more open and honest you can be with your therapist, the easier it will be to help you. She likely has no idea about your concerns. Many of these types of problems are the result of misunderstandings and miscommunications. You will likely feel a great deal of relief after this issue is resolved.

Talk to your therapist. Tell her what you have just told me. Tell her you were hurt. Tell her that you would not take advantage of her generosity. And listen to her response. If you don’t like her response, if she isn’t kind and understanding, then she is not the right therapist for you. If that is the case, then this misunderstanding isn’t likely to be a rare occurrence but more likely to be just the first in a series. You are a unique individual. You’re different from your friends, and even your family. You are very unique and so is everyone else, including therapists. You would never call a department store and say to the clerk on the phone “send me out a top in size small.” Instead of that, you go to the store and look through the hundreds of tops available, so that you might find one that is suitable to you.

Not all therapists are the same, in fact they are as different as the tops hanging on the rack. Your therapist might be just fine for some people but be the worst possible match, for others. Is your therapist sensitive enough for you? Perhaps, she is a little too rough or insensitive. Some people might prefer her approach, other people certainly will not.

It’s important that you are satisfied with the top that you purchase. You might think you like the top, while at the store and the way you looked in the mirror in the fitting room. But after taking it home and trying it on again and seeing your reflection from different angles, you might then carefully repackage the top and return it to the store. Initially it seemed like it would be a good fit but with a little more time and experience with the top, you discovered that it was not a good fit after all, returned it and looked for another top.

From what you have written, it appears as if you were and are more concerned about your therapist’s feelings then she appears to be of yours. Perhaps this isn’t true. I am simply raising the possibility. Let me tell you what is true. Not all therapists are right for all people. Perhaps you have the right match and perhaps you don’t. It is not a matter of right or wrong.

When you decided that the top was not a good fit for you, it wasn’t because you thought that the designer of the top was a fool or incompetent or that the top was no good at all. You recognized that some people would just love that top and you would surely see it on someone else walking through the mall. You never blamed the top. Don’t blame yourself either. If you don’t like the top, return it and buy one that fits you better. Surely, the returned top will fit someone perfectly but just as surely, it will not fit all people and it definitely did not fit you. No one’s fault and no one is to blame.

Thank you for your question. Please take care.

Dr. Kristina Randle



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The Precise Sleep Schedule That Helps Fight Depression

Antidepressants are more effective when accompanied by the correct sleep schedule.

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How do I break my addiction to the narcissist?

Narcissists are addictive. They offer up salient brain chemicals that are hard to overcome. When people get involved in an intimate relationship with a narcissist they become hooked on the experiences the narcissist brings into their lives. Breaking an addiction to strong brain chemistry created by powerful emotional experiences is hard to do.

It involves a trauma bond. Trauma bonds with other people are stronger than typical human bonds.  Trauma bonds are created in narcissistic relationship because of the good-bad inconsistent reinforcement. When a person ends a relationship that was bonded without the added component of trauma, the pain of the separation is much less intense. Breaking a traumatic bond requires much more work.

Here are some practical steps to begin the process of breaking an addiction to a person:

  • Identify your feelings regarding your addictive relationship.
  • Identify the relationship “crazy cycle;” for instance: anticipation – encounter – momentary bliss – confusion – departure – longing – despair. Note: This is just an example; identify your own cycle within the relationship.
  • Write down what is being fulfilled in your addictive relationship (a sense of belonging, feeling wanted, etc.) Notice the temporary “fix” you encounter when you are with your person; identify the “promise” or “hope” you are temporarily fulfilling.
  • Write down the common obsessive thoughts you have regarding your person.
  • Commit to yourself to live in the truth. Addictive relationships are fantasies. You are in love with what you wish the person was.

You are addicted to the brain chemistry attached to the anticipation and traumatic bonding surrounding the relationship.  Because the relationship is so utterly unfulfilling you are left with a constant state of emptiness, which is temporarily assuaged with each encounter with your object of obsession (him or her.)

You must abstain from your addiction.

(1) Abstain from the relationship completely (no contact); this includes texts and all social media.

(2) Abstain from and emotional entanglements; this requires detachment.

This will be a very difficult part of your journey. The brain chemicals released when trying to detach are vastly different from the neurotransmitters and hormones released when you are with your loved one.

The main chemical released during times of stress (including emotional stress) is Cortisol. Any trigger (such as the loss of a loved one) releases chemicals from the noradrenergic system (which includes the release of Cortisol and norepinephrine.)

As you face another emotionally dysregulating departure from your loved one your stress system goes in to high gear, releasing stress chemicals in your body, which motivates you “to do something about this!”  As you anticipate the relief from the stress your brain releases chemicals such as Dopamine, which offer that positive feeling of anticipation.  You have entered the craving part of your addiction.

In order to break an addiction, one thing you need to realize is that you are fighting these chemical responses. This means, you will not feel very good for a while. But, rest assured, if you can abstain from responding to your brain chemistry, you can get through these tough times and your neurotransmitter system will eventually come to rest at a state of equilibrium.

Some suggestions for what to do while you are in this “craving cycle.”

  • Find a positive diversion or distraction; something to do with your craving energy – gardening, walking, meditating, or any other healthy activity.
  • Do something non-aggressively physical, such as hiking, biking, jogging, weight-lifting, etc.
  • Connect with someone healthy. Talk to a close friend and let him or her know how you really feel.
  • Write in your journal. Journaling is very effective for releasing uncomfortable emotions. Write how you feel and what you want. Encourage yourself in your journal.
  • Create positive mantras to help you get through the craving cycle. Encourage yourself and don’t allow yourself to obsess on self-defeating thoughts.
  • Write a list of all the reasons your addictive relationship/person is bad for you. It is so easy to focus on what you miss when you are experiencing feelings of emptiness; but, if you can focus on the negative aspects of your relationship you can gird yourself up with reality.

Understand that you cannot change anyone but yourself.

The best thing you can do to help yourself on your journey of healing is to be proactive and set up a plan of emotional health “bottom line behaviors” for yourself.

Here are some suggestions to help you do just that:

  • I will trust my intuition.
  • I will no longer participate in “no win” conversations.
  • I will no longer participate in “impossible situations.”
  • If I feel bad around someone I will remove myself.
  • I will no longer make every decision a crisis.
  • I will live one day at a time.
  • I will learn to “reframe” negative experiences. In other words, I will look for the “silver lining” in all situations.
  • I will learn how to manage my emotions, rather than have them control me.
  • I will take my power back.
  • I resolve to believe in myself.
  • If I feel emotionally unstable, I will connect with a safe person, not the object of my obsession.
  • I will have compassion for myself.
  • I will honor and pay attention to my feelings.

These coping methods will help you break through the addiction. In addition to developing coping skills, you also need to fill the empty space created by the lack of the narcissist in your life. Remember, narcissists bring a lot of noise, drama, and chaos. Without all that going on in your life you may feel bored and empty. To counteract this situation you must do a few things for yourself:

  1. Journal your feelings during these times. Write anything that comes up, particularly your feelings. Identifying your feelings will help you process through them and resolve them.
  2. Build a new “narc free” life. Do things for yourself that were once done by the narcissist. If he/she was exciting, then do exciting (yet safe) things for yourself. Be the person for yourself that you needed him/her to be.
  3. Avoid substance use/abuse.
  4. Get those endorphins flowing through your blood stream.
  5. Seek out a therapist, support group, and/or church group. Start working on yourself by healing the trauma you’ve undergone while in the relationship. Remind yourself that you probably have complex post-traumatic stress disorder from your unhealthy relationship.
  6. Enjoy the rest of your life. Remind yourself that you are free and life is good.

 

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

 



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Get Out of the Blame Game

If you grew up in a family where an angry “who did it?” was more important that “what did you learn?” when things got broken, disrupted, or misplaced, you may well be almost phobic about accountability. In families where there’s a constant emphasis on meting out justice in the form of blame and punishment, the kids often learn that to be accountable is to be blamed and to be blamed is dangerous.

Whether they actually did do something wrong, forgot to do something, or didn’t do something correctly, kids in such families learn a number of tactics to ward off parental anger and to reduce or eliminate their own shame: They figure out creative excuses. They create scenarios where they were the victim or at least not at fault. They may decide it’s safer not to do things than to do them and make mistakes. They take on new challenges only in secrecy. Some even figure that it’s more important to finger the other guy than to take responsibility.

Exacerbating their experience in such a family, kids today are growing up in a culture in which there always seems to be someone else to blame for what people do or don’t do. Facebook is full of posts in which politicians and celebrities make excuses for bad behavior. Although kids are often told about the importance of personal responsibility, significant role models are showing them that it’s more effective to declare innocence and get out of the situation rather than take correction and learn. For some of our most public figures, avoiding blame seems to be more important than living decently or learning from mistakes.

The result? Blame shifting is becoming normalized. We adults are in danger of becoming inured to it. Children and teens are being regularly taught that it’s not necessary to be “right” so much as to show that someone else is “wronger.” Sadly, the avoidance skills learned in critical families and that are modeled by the less than honorable rich and famous are the very things that conspire against success as an adult.

Adults who avoid accountability often miss out on important opportunities for growth and for depth in relationships that life has to offer. Regularly finding others to blame when there’s been a mistake erodes others’ trust. Unwillingness to take corrective feedback can lead to failure in school and on the job. Feeling phobic about the possibility of blame is a very difficult way to live.

What to do to get out of the blame game:

If you are an adult who is blame-phobic, make the commitment to train yourself to be a better person than the adults who shaped you. Being an adult often means letting go of less-than-helpful strategies learned if we grew up in a family that was dysfunctional or that simply didn’t know better.

If you are a parent reading this article, please consider the importance of teaching your children these skills:  

  • If you have harmed someone, it’s important to feel the shame and make things as right as you can but it shouldn’t end there. Think about the situation long and hard with as much honesty as you can muster. Analyze your part in it and resolve to do things differently should a similar situation happen again.
  • If you’re afraid of blame, the most important thing you can tell yourself right now and often is that life is not a court of law. Life is an endless opportunity for learning. Make it a mantra. Say it until you really believe it.
  • Look boldly at mistakes. If you lie about them, deny them, or find a way to make them someone else’s fault, you’ll miss the opportunity to add to your own competence. Instead, see mistakes as an important opportunity for learning. Figure out what you can take from the experience that will help you in life.
  • If someone blames you, resist the temptation to get angry and argue. Instead, do your best to open dialogue. The world will not stop turning if you agree that you messed up. Apologize and fix the problem. If you didn’t do whatever it is that you are being blamed for, calmly present your point of view and ask for suggestions about how to move forward.
  • Catch yourself when you find yourself wanting to blame someone else for, well, anything. Ask yourself if blaming will actually make things better. Usually it doesn’t. Once we establish blame we not only still have a problem to solve but the person who is blamed is on the defensive.
  • If someone else really is responsible for a problem, do hold them accountable. But preserve the relationship by finding a way to do it that allows them to have some dignity and to participate in problem-solving.
  • Focus on what to do next instead of who is to blame. Finding out who broke the window doesn’t get it fixed. Being upset with a friend who is always late doesn’t make her be on time. When family members are in conflict, it doesn’t matter who started it. It matters that they resolve their differences so they can get along and solve the problem.

To make mistakes is only human. Sitting in blame and shame doesn’t help anyone (adult or child; you or anyone else) become a better person nor does it teach them how to make better decisions. Get out of the blame game. Growth comes from forgiveness, compassion and moving on.



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Antidepressants Have A Confusing Effect On Emotions

A little-known antidepressant side-effect on emotions and motivation.

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Finding Peace in the Face of Abuse

Aaron was deeply troubled. He finally came to the realization that he left his abusive childhood home only to recreate it as an adult. This was not his intent. He wanted more for himself and his children. The peace he longed for had never been achieved either within himself or in his environment.

His mother was an abusive alcoholic who died in a drunk driving accident. His wife didn’t drink but became addicted to Adderall after taking some of their son’s ADHD medication. Her behavior went from normal to hyper to chaotic in a short period of time. Now their whole household was in turmoil as she said and did whatever it took to keep taking the drug.

Addicts turn abusive when they feel deprived of their drug of choice. Aaron was blamed for everything that went wrong as his wife continued to spiral downward. Even though Aaron wanted to separate, he was afraid to leave the house for fear that things would get worse for his wife and kids. Instead he chose to stay and try to keep some sort of peace until his wife agreed to get help.

But how does a person find peace in the face of abuse and addiction? Here are some points.

  • The absence of conflict is not peace. Living in harmony often requires confrontation especially when there is abusive or addictive behavior. Overlooking the harmful behavior does not promote peace; rather it delays it further. Instead, a well-timed chastisement done in love and kindness is more appropriate. When his wife acted abusive, Aaron would verbally identify the behavior (“This is belittling behavior,”) reset his boundary (“Because I love you, I won’t tolerate it,”) and then deescalated the conflict by walking away.
  • The goal is to live in peace. Aaron reset his goals during this time to be intentionally focused on living in peace. This is both an inward and outward process. Inwardly, he stopped being mad at himself for recreating his childhood experience for his children. Instead, he changed his inner dialogue to one of grace and understanding. Outwardly, he often verbalized his goal of a peaceful house to his wife and kids. He set a new expectation of living peacefully together.
  • Act untroubled by harm. In the face of danger, a peaceful person acknowledges the potential for harm, works out a plan for safety, and sees it through. In this way, they appear to be untroubled by harmful behavior. This is how a person is able to be still and yet present in the face of danger. Using his wife’s past abusive behavior as an indication of what could happen in the future, Aaron thought out some scenarios in advance so he could decide ahead of time how he wanted to behave. This allowed his goal of living peacefully to be achieved.
  • Silence does not equal peace. Instead silence can be used as an illusion for peace. In the past, Aaron would remain silent during the abusive behavior. He did this because he was shocked by his wife’s reactions and triggered by his mother’s. Inside, he was deeply troubled despite his quietness. Being at peace with yourself, means the inside feelings should match the outside expression. Not that the outside expression needs to be at the same intensity as the inward feelings, but they should at least be on the same spectrum.
  • Don’t become like the abuser. At the core of abusive behavior are manipulation, deceit, dishonesty, and deception. To have peace, a person does not have to become more like the other person. This is especially true when the other person is an addict. Harmony cannot happen when a person joins in with the abusive behavior; two wrongs don’t make a right. Rather, the heart of a peaceful person begins with joy.
  • Peaceful spirit leads to a healthy body. A troubled spirit can destroy the strongest of bodies. Jealous is a perfect example of this. Jealously produces the negative effects of anxiety, stress, anger, resentment, and destruction. All of this negative energy eats away at a healthy body and spirit. As Aaron learned to release some of the negativity, he discovered that his muscles were less tense, he had fewer headaches, and his digestive system functioned better.

Aaron’s plan of creating a peaceful household worked. Eventually, his wife saw the stark contrast between his continued peacefulness and her constant discord and she sought help. After going to a rehabilitation hospital for several months, she got better and made peace her goal as well.



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Where Do I Turn for Help?

From the U.S.: I have had symptoms of depression, and formerly anxiety as well, that interfere greatly with my everyday life for upwards of seven years. Over the years I have attempted to reach out to medical professionals twice, the first time as a child, only for them to tell my parents I was totally fine, even though I was suffering from severe anxiety symptoms, depressive symptoms and self harming.

As an adult I reached out again, only to be told that maybe this is just “who I am” and that i should try coloring to cope. I am consistently sad, hopeless, fatigued, have no motivation, chronic pain, and feel as though I am just going through the motions like a zombie. It is interfering with my ability to be successful in school, and even to care for myself. People with these symptoms are always told they need to reach out for help, but what do you do once you’ve reached out and still no one is listening?

A: I’m so glad you wrote. But here’s the thing. You’ve had symptoms half your life. I’m truly, truly sorry that the two people from whom you tried to get help failed. But the failure of 2 people in 11 years does not mean that there isn’t help out there. Please take care of yourself and try again — and again.

One intake worker I know regularly told callers that finding a therapist is like finding a new pair of jeans. You might try on a dozen pair but only one fits in such a fine way that you take it home. Sometimes it takes trying on a dozen pair before you find the right one. But when you do, all the shopping and trying them on was worth it. Finding a good helper really is like that. Sometimes we have to interview several before we find the person who connects, who listens, and who offers the kind of help that resonates.

So please don’t let 2 unhelpful people determine whether you reach out again. Shop around until you find the therapist who gets you. Be honest in your interviews. Tell any new therapist about the failures and why you think they failed. It might be helpful for you to take your letter to us and this response with you on the first meeting to help you introduce the problem.

Please follow up. You deserve to get the help you want and need.

I wish you well.
Dr. Marie



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Where Do I Turn for Help?

From the U.S.: I have had symptoms of depression, and formerly anxiety as well, that interfere greatly with my everyday life for upwards of seven years. Over the years I have attempted to reach out to medical professionals twice, the first time as a child, only for them to tell my parents I was totally fine, even though I was suffering from severe anxiety symptoms, depressive symptoms and self harming.

As an adult I reached out again, only to be told that maybe this is just “who I am” and that i should try coloring to cope. I am consistently sad, hopeless, fatigued, have no motivation, chronic pain, and feel as though I am just going through the motions like a zombie. It is interfering with my ability to be successful in school, and even to care for myself. People with these symptoms are always told they need to reach out for help, but what do you do once you’ve reached out and still no one is listening?

A: I’m so glad you wrote. But here’s the thing. You’ve had symptoms half your life. I’m truly, truly sorry that the two people from whom you tried to get help failed. But the failure of 2 people in 11 years does not mean that there isn’t help out there. Please take care of yourself and try again — and again.

One intake worker I know regularly told callers that finding a therapist is like finding a new pair of jeans. You might try on a dozen pair but only one fits in such a fine way that you take it home. Sometimes it takes trying on a dozen pair before you find the right one. But when you do, all the shopping and trying them on was worth it. Finding a good helper really is like that. Sometimes we have to interview several before we find the person who connects, who listens, and who offers the kind of help that resonates.

So please don’t let 2 unhelpful people determine whether you reach out again. Shop around until you find the therapist who gets you. Be honest in your interviews. Tell any new therapist about the failures and why you think they failed. It might be helpful for you to take your letter to us and this response with you on the first meeting to help you introduce the problem.

Please follow up. You deserve to get the help you want and need.

I wish you well.
Dr. Marie



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Psychology Around the Net: March 31, 2018

This week I’m covering for Alicia and found myself with a mix bag of psychology news.

It’s a wake up call about how far we need to go when it comes to mental health stigma and being able to predict the next mass shooter. There’s also exciting research on what makes beginners overconfident and why you should think twice before using your phone in social situations.

I learned a lot of new things this week. As you’ll see, there’s something here for everybody.

Majority of people still think mental illness is a disorder like schizophrenia, OCD – A mental health study in India with 3,556 respondents from eight cities in India shows there is significant stigma and misinformation when it comes to mental illness.

There’s still no scientific way to know who will become a mass shooter – In the aftermath of mass shootings, there is a lot of pointing fingers, but also lack of understanding and research on warning signs to look out for. This article looks at possible risk factors and theories.

Research: Learning a Little About Something Makes Us Overconfident – A study in the Journal of Personality and Social Psychology has students acting as med residents in a post-apocalyptic zombie inhabited world. The results of the study showed, “beginner’s bubble,” a tendency for overconfidence to rise following initial bouts of learning a new task.

Happiness 101: Psychology course strikes chord with Yale students – One of the most popular classes at Yale is “Psychology and the Good Life.” Students learn the science behind happiness and have homework assignments such as gratitude exercises and increasing social connections.

‘Phubbing’ can threaten our basic human needs, research shows – If you’ve ever ignored someone to check your phone, you’re guilty of phubbing and as this study shows it could have negative consequences to your relationships.

‘Dark places, depression, anxiety’: Mark Rypien opens up about his mental health struggles – Former Redskins quarterback Mark Rypien shares his emotional struggles to help end the silence of mental illness.



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Friday 30 March 2018

10 Signs Your Spouse Might be Dependent

Natalie didn’t get it. She watched her sister tolerate an abusive spouse who routinely left her for another woman and then returned on a whim. Her sister knew he was an adulterer, arrogant, intolerable, demanding, condescending, cruel and controlling. She complained about him, said she wanted to leave, but then when push came to shove, she remained.

Natalie’s sister was not unintelligent; in fact, she was the top of her class. She was in upper management, beautiful, and by all outside appearances, seemed to have it all together. But then there was her husband. His narcissistic adulterous behavior was obvious to the family and they supported a separation. Yet, she didn’t leave.

Frustrated and confused, Natalie began to wonder if there was something wrong with her sister. The word “dependent” is the perfect descriptive word to summarize Dependent Personality Disorder (DPD).  DPDs need other people for all areas of emotional support and affirmation. Frequently, they are reliant on one particular person such as a spouse. Here are 10 signs of a dependent person.

  1. Intense fear of separation. The fear of separation is not the same as the fear of abandonment. Abandonment is about being rejected, deserted or having a person leave. Separation presumes a tight bond for which a person cannot seem themselves as individuals without the other person present.
  2. Difficulty making decisions. Even from a young age, Natalie’s sister had a hard time making simple decisions. She needed an excessive amount of advice from Natalie before her husband came into the picture. Even after the decision was made, her sister needed constant reassurance.
  3. Allows others to assume responsibility. Most DPDs are happier with others accepting responsibility for their finances, major decisions, and initiating projects. For a dominating spouse, this is an ideal mate because they don’t like the competition for authority. The ease with which a DPD submits to their spouse is not coming from a place of health, but rather dysfunction.
  4. Fear of confrontation. Natalie’s sister hated to be confronted and almost never challenged others. Her fear of losing the support and/or approval of her sister and husband caused her to tolerate things that she didn’t like or want.
  5. Volunteers for unpleasant activities. After seeing her sister’s frustration, Natalie asked her sister if she enjoyed helping out at their church. She said no, but felt she had no choice but to participate. It turned out that a church employee guilt-tripped her sister into volunteering because no one else would do it.
  6. Afraid to care for self. DPDs have a misconception that they are incapable of taking care of themselves and therefore constantly need someone else. Typically, they do not go very long without having an intimate relationship. Sometimes, they use their friends or family members as temporary caretakers until another person more permanent comes along.
  7. Acts passive and helpless. One of the inconsistent characteristics of Natalie’s sister was how independent and successful she was at work while being so dependent and indecisive at home. Natalie knew that her sister was able to make hard decisions and handle difficult situations but at home she acted powerless.
  8. Sensitive to criticism. While Natalie’s sister could handle constructive criticism at work, even the slightest sign of disapproval caused her to completely shut-down. She seemed unable to handle any condemnation from her husband. When her husband would disappear, she was unable to tolerate any dissatisfaction from her sister.
  9. Tolerates mistreatment and/or abuse. One of the defining characteristics of DPD is overlooking, allowing, minimizing, and/or ignoring mistreatment and abuse. Even when the manipulation is exposed, the DPD has a hard time verbalizing, internalizing, and confronting the behavior. This makes them a prime target for dominating and controlling people.
  10. Needs of caretakers are more important. Worse yet, a DPD will often forgo any self-care in favor of whatever their spouse needs or wants. They are happy to do this because to them, it shows love. Unfortunately, in the hands of the wrong person, this is very dangerous and could put them in risky situations.

Once Natalie understood that her sister was DPD and lacked common sense in interpersonal relationships, it was easier for her to communicate with her. Eventually with the consistent support of her family, Natalie’s sister was able to leave her husband. However, within a few short months, she found another relationship.



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Can You Unfriend a Person Without Demonizing Them?

Never in my six decades have I been witness to such great divide between people of various socio-political stripes. Even the Vietnam war, with its protests and the slogans spouted by the young about not trusting anyone over 30 and the older set not trusting long-haired hippies, didn’t tear relationships asunder as is the case now.

Stanford Law School professor Mugambi Jouet is the author of the provocative book Exceptional America: What Divides Americans from the World and from Each OtherIn it, he explores the polarities that exist in this country like nowhere else on the planet.  

“What’s intriguing,” he says, “is that American society is extraordinarily polarized today by both U.S. historical standards and international standards. Leaving aside a few other periods like the Civil War, for example, there are not many phases of American history where we see such a big clash over fundamental issues. Americans are routinely clashing over matters that are either not controversial or much less controversial elsewhere in the modern Western world, such as whether people should have basic rights to health care, whether special interests should be allowed to spend unlimited money on elections and lobbying, whether climate change is a hoax, a myth or scientific reality. The list goes on and on, from abortion to contraception, gay rights, gun control, theory of evolution, the death penalty, mass incarceration, even torture.”

It has become such a gut wrenchingly difficult issue for this tree hugging liberal, whose parents encouraged her to speak her mind, stand up for the underdog and be a force for good in the world. In my circles, most people share similar world-view, and some have joined in the various marches and vigils held in this shifting of rocky political ground. Many write copious amounts on social media about their distress over how things are unraveling.

There are others I know whose perspectives are a few inches apart from my own and some miles away. I have attempted to understand what shaped their values and actions. Not sure they have done the same. I acknowledge that everyone has the right to their opinion, since as my father would say, “It’s a free country.” Even so, I find it challenging to my egalitarian sensibilities.

As an active social media user, I am bombarded daily with messages that endorse the polar opposite of what I espouse. Sometimes I can shrug it off, considering the source. There are other times when I attempt to use logic, as well as my experience as a clinician who treats people whose mental health has been severely impacted by the actions taken by this administration. I too feel deep concern about the cognitive and emotional status of the occupant of the Oval Office. My expressions are sometimes dismissed as liberal lambasting and ‘fake news’ in an attempt to criticize their presidential choice.

Today I unfriended a family member over her intensely right-wing views that make me cringe. We had a brief series of interactions on line as she did her ‘what about?’ deflection when asked about what is happening in the nation’s capital that ripples out worldwide. She is an earnest cheerleader for the current administration, using jargon and slogans to rally support. What saddens me is how far she has departed from what I remember as a more open-minded upbringing.

The idea of confirmation bias and the echo chamber factor may play a role here. They describe a state of mind in which our beliefs are validated in the news pieces we choose to use as validation. It is also known as, pockets of political polarization.” I admit that I would much rather read articles about which I can cheer rather than boo, those that have me feeling nourished and not force fed verbal junk food.

Her choices of reading, listening and viewing material do indeed reinforce her adamant beliefs. When I announced my reluctant decision, my friends rallied around, supporting me in preventing myself from absorbing the negativity I could feel when seeing her posts in my thread. They too have felt a need to disconnect from certain family and friends as they went head to head over differences in opinion.

As I sit in my liberal cocoon, I imagine what it is like in the other camp. They too feel validated by their own values and see mine as threatening their sense of security. Regardless of which side of the aisle we sit, we all breathe air, drink water, have the right to safety, freedom from hate rhetoric, body sovereignty, loving who we choose, freedom of speech, freedom of the press. This administration has made it clear that those are not important to them.

Seems I am in good company as a study funded by the Pew Charitable Trust, indicates that liberals are more likely to unfriend conservatives rather than vice versa. When I do attempt to share my take on things, I am careful not to name call and cast aspersions. I don’t succumb to even the most fleeting inclination to use disparaging comments about the physical appearance of anyone in the administration. I avoid polarizing epithets. Instead, I describe direct statements made and the responses offered, as well as the impact on the state of the world by same.

In the same way, I did that very thing with the family member, responding to the dissemination of information she highlighted on her Facebook page. Now I need not do that with her. We don’t live near each other and are not likely to meet again in this lifetime. I can unfriend without demonizing her or anyone else who sees the world through the same lens. I am open to good conversation on nearly any topic. This feels like more than agreeing to disagree. Too much is at stake.



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Book Review: Making Children Mind Without Losing Yours

While most parents likely find themselves doing the tasks that they have already asked their kids to do many times, the idea that they are being masterfully manipulated might seem like a stretch. Kids, after all, are hedonistic by nature, says psychologist Kevin Leman, the author of Making Children Mind Without Losing Yours. But Leman also has a secret: Good parenting isn’t easy, but it’s simple, and doable.

The first thing parents need to know is that the world has changed. After shootings like the one in Colorado, or the recent one in Parkland, Florida, the fact that children can be gunned down in their own school yard has become a disturbing reality for most parents.

“Today’s kids are growing up faster, and they’re living in a tumultuous, dangerous jungle,” writes Leman.

He also notes that while social media gives us all access to a vast range of information, the result is that more kids are aware of sexting, cutting, and even where to score some heroin.

“Today’s kids don’t consider sexting wrong. They think nothing of taking a selfie of a body part and sending it to a boy or girl they like,” writes Leman.

To make matters worse, while most kids are media savvy, they lack discernment; they don’t realize that those pictures and statements they post remain there forever, and often with unintended consequences. In such a world, how can we create kids who make wise decisions and take responsibility for their actions?

According to Leman, it all starts with the parents. What most parents might not realize – or want to admit – is that how they were treated as kids directly influences their style of parenting. Parents often fall into two extremes: They are either authoritarian, reverting to strict rules, tight control, and dire consequences, or permissive, giving in to their children’s every desire.

“Clearly, the authoritarian parenting style — giving out edicts, controlling every aspect of your kid’s life, and barking orders about when, where, and how high to jump – doesn’t work long term,” writes Leman.

Yet clearing the path for children and never saying “no” leads to children that are incapable of making decisions for themselves or doing their own work.

“Neither parenting extreme provides what children crave — order. That desire is so strong in children that if they’re given the opportunity to do anything they want, I’ll believe they’ll eventually come back to dead center – just as the pendulum of a clock does when it winds down,” writes Leman.

A better way is to allow children to make decisions and experience real-life consequences in the safe environment of the home. This is what Leman describes as authoritative parenting.

“Authoritative parents aren’t afraid of failure. They welcome failure as part of the learning experience of life. Their self-worth isn’t based on whether their children fail or succeed in a certain area. They give their children the freedom to explore their interests, instead of controlling the direction they feel the kids should go,” writes Leman.

“Remember you are a Leman,” he reminded each of his five children before they would go out on a date. When one of his children asked what that meant, he responded, “It means that we’ve reared you with certain standards and morals, and we trust you to act within those.”

By giving children the opportunity to live up to morals and values, authoritative parents allow their children to develop a sense of confidence, and the inner radar needed to detect unscrupulous behavior. And sometimes, parents will also fail.

Parents can give their kids too much too soon, fail to follow through on consequences, make all the decisions for their kids, rescue them from their mistakes, and do everything for them.

“There’s nothing wrong with a kid being miserable for a while when she’s done wrong. It’s a good life lesson,” writes Leman.

Parents can get their children involved in giving back to the family, limit their activities to a doable amount, and allow quality time that is free from distractions and devices.

“The simple truth is what your kids want most is you. They want your time,” writes Leman.

For a parent at the end of their rope, that message likely feels tremendously reassuring. And while it may not be easy to accomplish — in Making Children Mind Without Losing Yours, Leman offers the wisdom, reassurance, and common sense strategies that have made him an internationally sought after speaker, educator and radio personality.

Making Children Mind Without Losing Yours – Revised Edition
Kevin Leman
Revell
August 2017
Softcover, 313 Pages



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Struggling with Vaginismus and Vulvodynia, Cannot Achieve Orgasm with a Partner

I’m currently in a very happy and otherwise healthy, long-term romantic relationship for the first time in my life. My boyfriend is a very caring and sensitive guy and we both love each other very much, but I’m concerned that some of my pre-existing sexual issues may cause problems down the road for our relationship. I have primary vaginismus and vulvodynia, and my first sexual experiences were very negative and traumatic. I have been to a gynecologist about these issues and went through physical therapy to try and overcome them, but even after a few years penetration is still painful and sometimes very difficult. While trusting my partner makes a big difference in reducing the amount of pain I’m in during sex, and with my current boyfriend there have been several occasions where it was virtually painless, it’s still a constant factor in my sex-life. While I do enjoy the intimacy of sex with my boyfriend despite this, I have never been able to achieve orgasm no matter what my partner tries to do or for how long. Even with assistance from vibrators it’s virtually impossible, and the only way I’ve managed to achieve orgasm is by my own intervention. I don’t understand why I have this issue, especially because I am very attracted to him. My boyfriend doesn’t complain to me about it or anything like that, but I can tell that it makes him feel self-conscious. I’ve tried explaining to him that it’s not his fault at all, but I worry that he still feels like he’s inadequate. What should I do?

A: Thank you for reaching out. Since you have already sought medical treatment, I would recommend that you consult with a sex therapist. Research indicates that both vaginismus and vulvodynia are thought of as being somewhat psychosomatic. Sex therapy can aid in addressing possible psychosomatic causes for these issues and can provide you with tools that may assist you in working through the difficulties you are experiencing. Exploring the psychological aspects of these conditions with a mental health professional will also aid you in addressing the concerns you have about your relationship with your boyfriend.

– Dr. Mimi



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Research Updates in Addiction: Cannabis and Alcohol

marijuana addictionCANNABIS

Vilazodone Not Effective for Cannabis Dependence

REVIEW OF: McRae-Clark AL et al. Vilazodone for cannabis dependence: A randomized, controlled pilot trial. The American Journal on Addictions 2016;25(1):69–75

STUDY TYPE: Randomized clinical trial

Effective pharmacological treatments for cannabis dependence have eluded the field of addiction psychiatry. It’s not, however, due to a lack of trying. Theoretical connections between cannabinoids and the serotonin system have spurred a number of studies looking at the usefulness of SSRIs and buspirone. Overall, the results have been uninspiring. Recognizing that past studies have focused on either the reuptake properties of SSRIs or the partial agonism of buspirone, researchers looked at the potential of vilazodone, a combined serotonin reuptake inhibitor and partial serotonin 1A agonist.

Seventy-six adults with a diagnosis of cannabis dependence were randomized to a flexible dosing schedule of up to 40 mg (average = 32 mg) of vilazodone (n=41) or placebo (n=35). Urine screens were used to measure the primary outcome of cannabis use at baseline and over the 8-week course of the study. The Marijuana Craving Questionnaire tracked cravings, and patients were asked to keep tabs on the amount of cannabis they used over the 8 weeks. Both groups received three motivational enhancement sessions and were offered nominal financial incentives to increase engagement and compliance with treatment.

Did the combined serotonergic properties of vilazodone make a difference? Unfortunately not. Vilazodone fared no better than placebo with regard to cannabis use. Although the overall amount of cannabis use declined, it dropped equally in both groups. The vilazodone group smoked marijuana an average of 10 times per week, and the placebo group used an average of 9.9 times per week. A slight drop in cravings was noted for men in the vilazodone group, but not women. Interestingly, gender seems to have played a role in the level of cannabis use, as men racked up more overall negative urine screens than the women. This is consistent with previous research showing that women have more difficulty achieving cannabis abstinence (Cooper ZD and Haney M, Drug Alcohol Depend 2014;136:85–91) and report greater withdrawal symptoms (Copersino et al, Am J Drug Alcohol Abuse 2010;36:311–319).

CATR’S TAKE: It’s difficult to put a lot of faith into the results. Only 34% (14/41) of those originally assigned to the vilazodone group and 49% (17/35) from placebo completed the study. We know relatively little about those who dropped out and those who stayed in. The higher dropout rate of vilazodone also signals that tolerability may be an issue with the drug.

PRACTICE IMPLICATIONS: Regardless of whether the current study points to the ineffectiveness of vilazodone or leaves us wondering about the validity of the findings, nothing has changed from a practice standpoint. Psychosocial interventions should continue as first-line treatments.

ALCOHOL

Combining Alcohol With Caffeinated Energy Drinks Leads to Increased Alcohol Consumption

REVIEW OF: Marczinski C et al. Desire to drink alcohol is enhanced with high caffeine energy drink mixers. Alcoholism: Clinical and Experimental Research, 2016; ahead of publication

STUDY TYPE: Double-blind, placebo-controlled trial

Combining caffeine-based energy drinks and alcohol has become a popular practice among social drinkers over the past decade. Users say that the caffeine enhances their buzz and allows them to drink for longer periods of time. Clinicians and health officials, however, have voiced concerns that such mixed drinks reinforce unsafe alcohol use. Responding to these concerns, in late 2010, the FDA banned pre-mixed alcohol and energy drink cocktails from the market. However, the practice continues in bars, restaurants, and homes.

The FDA’s ban was based mainly on the limited evidence derived from anecdotal and case reports. That’s why researchers from Kentucky conducted a double-blind, placebo-controlled study asking the question, “Do social drinkers consume more alcohol when they drink caffeine and alcohol together, or when they drink alcohol by itself?” To answer this question, 26 social drinkers (>12 ounce beer or 5 ounce glass of wine per month) between the ages of 21 and 30 were recruited to drink 6 different concoctions during 6 separate sessions. This was not a randomized trial: All participants imbibed each of the possible beverages.

Beverages included: a) vodka + decaf soda; b) vodka + Red Bull (1:3 ratio); c) vodka + Red Bull (1:6 ratio); d) decaf soda alone; e) small Red Bull alone; and f) larger Red Bull alone. The vodka drinks contained 1.21 ml/kg of Smirnoff 40% alcohol, which amounts to about two shot glasses for the average 72-kg participant in the study.

Various strategies were used to ensure that participants were blinded to the type of drink they received. For example, in the no-alcohol conditions, a trivial, very thin layer of alcohol was poured on top of the beverage to make it smell like booze. The main outcome measure used was the “Desires-For-Drug” rating scale, which was given to the participants 10 minutes after each drink and repeated about every 20 minutes until 80 minutes had elapsed.

RESULTS: The drinks with alcohol mixed with Red Bull were the clear favorites. When participants drank either of these, they reported higher degrees of liking the drinks, feeling them, and desiring alcohol as compared to any of the other drinks, including vodka plus decaf.

CATR’S TAKE: This small study adds to the existing evidence from other studies showing that people feel more stimulated and more prone to drink more alcohol when they combine caffeine with alcohol vs. drinking alcohol alone. As the authors mention, it’s possible that any stimulant, including nicotine (very frequently consumed with drinks), would have a similar alcohol-enhancing effect.



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There Are Four Flirting Styles, Each With Its Own Tells

How to tell if someone is flirting with you.

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How Worry Takes Us Away from Our Lives — and What We Can Do About It

worried-woman

Mark Twain is quoted as saying: “I am an old man and have known a great many troubles, but most of them never happened.” The more I observe the happenings of my own mind the more I see truth in this statement.

As I am writing this I’m waiting to find out the results of an MRI on my foot, to determine whether I have a stress fracture. I’ve been worrying now for a week, since I first injured it (after a run). I love to run and be active, and the thought of having to wear an orthopedic boot and be laid up for 6 weeks is making me anxious. To have this happen during the spring (my favorite season) when the weather is finally getting nice is adding to my upset.

And therein lie the fascinating workings of the mind!  I’ve been paying attention to my thinking a lot over this past week. When I’m meditating, my mind has found its way to worrying about my foot. When I’m walking around and feel some sensation in my foot, my mind likes to wander there as well. When I’m not feeling sensation in my foot I’m wondering about whether I have a stress fracture and hoping that I don’t. It’s been taking up a lot of space in my mind lately. But here is the most interesting part: All of my upset has been because of living in some anticipated future. My irritability, my bad mood at times, my worry have nothing to do with this present moment.

Each time I find myself experiencing anxiety or upset about my foot I check in and see what’s really happening. And each time I discover that I am in some mental rehearsal in my head, envisioning how much less fun I am going to have getting through the next 6 weeks without my beloved activities.

When I stop and bring myself back to what is actually happening right NOW, it is an opportunity to awaken. Right now I might be having a quiet, peaceful space to meditate, and save for my mind pulling me into my worry thoughts I am actually quite enjoying the space of this moment. Or I am sitting with my patients engaged in helping them, or perhaps I am having a dinner with my friends and enjoying the company and connection. The reality is, I am usually not miserable or anxious about what is happening right NOW. In fact, I have many meaningful moments to fill each day if I choose to rest my attention there.

Yet worry can take us away from our lives. And often, minor worries can consume more of our days than we may realize. (My next blog will elaborate on how we can manage bigger worries).

So this minor injury has been an opportunity to remind me to practice three things:

  1. To bring compassion to myself for whatever I am experiencing — I’m human after all, and the human mind worries.
  2.  To notice how much my thoughts (especially about anticipating the future) contribute to my unhappiness.
  3. To bring my attention back to what is happening right now, and choose where I want to focus my attention (rather than let my mind wander aimlessly in unhelpful ruminations).

This foot injury is seemingly minuscule in the grand scheme of life, but it has been a great opportunity to notice up close and personal the workings of my mind. (It turns out it isn’t a stress fracture, but another injury that requires some need for rest as well). But if it wasn’t this, it could easily be some other worry creeping in. Our minds tend to wander much of the time, often to the past or future, or to self-referential thinking. In fact, neuroscientists suggest that the default setting of our brain is in this mind-wandering state much of the time. Most of our ruminations do not serve us in any helpful way because this is the kind of thinking that can’t solve anything. But it can take us away from our lives.  

So the next time you find yourself caught up in mental ruminations, see if you might try the following:

  1. Name what you are feeling (i.e., I notice I’m feeling anxious, worried; AND this is difficult). Send some compassion to yourself. Notice the feeling but recognize that you are not the feeling (note the difference between “I am worried” vs. “I notice that I am experiencing worry in my body”). The noticing helps us to gain a bit of distance.
  2. Check and see if your discomfort/upset is about something happening right now, or something that may (or may not) happen in the future.
  3. If it is something upsetting right now, allow yourself to be with the feelings that are arising and choose wise actions to help you cope with what is happening. Do what you can to improve the situation. Practice self-compassion.
  4. If you are stuck in ruminations or unhelpful mental anticipation, notice that and choose to direct your attention to something in THIS moment. Notice what is OK about this moment and let your mind rest there (i.e., I am having lunch outside. The sunshine is warm on my face. I am enjoying this food that I prepared). Each time your mind gets pulled away, gently direct it back and ask yourself if you are OK in this moment. Choose to rest there. Even if this moment is filled with some emotional pain or challenge, it is easier to cope with right now/this moment/today rather than with now + everything that might happen in the future.

It isn’t easy to tame our worries, but being aware of the nature of our minds is a good first step. (Stay tuned for my next blog, which will suggest some ways to manage more intense worries that may grip us.)



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Eye Movements Reveal What Memory You Are Recalling

The first time eye movements have been linked to patterns of brain activity.

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Loss of Interest

We’ve lived together for around 4yrs, known him around 19yrs, and after 2yrs of living w/him, he has seemed slowly to lose interest in me. I can attract the eye of any guy in the room but him. I can cook dinner in a sexy bat girl, school girl, German girl,ect outfit and he doesn’t even notice. Yet first chance he gets he’s online looking at half naked/naked woman. Is our relationship in trouble? Talking just angers him and makes me feel more like he doesn’t care how it makes me feel. I’m not naive enough to think he’d stop looking at other chicks online, I just want him to look at me too. It’s gotten to where I hardly sleep in the same room with him because I hate the way I feel. Our sex life is horrible. He’s always been a slightly selfish lover but now it’s pretty much always a completely selfish lover except for maybe 1 time out of 6 in a 3 moth period, and I stress the maybe. I love him and even though he’s selfish and stingy like an only child can seem to be, I know he loves me as well, other than this issue we get along rather well. We have not ever fought or argued over anything other than this. Honestly every time I try to say something about how it makes me feel, or ask if he could please act like I am someone pretty in his eyes, he clams up,and if I push it or ask how to fix it or what I’m doing wrong, he eventually blows up on me. Never saying he’s sorry for hurting me or making me feel like he is not attracted to me, he says I am in the wrong, he’s a man, what else did I expect, and things of that nature.I don’t know what to do, but I know things cannot continue on this way much longer. My heart hurts, I cry way too much for my taste, and I am losing confidence in me. I’m 37, 5’3 ,and 123 lbs, I know I’m pretty, but at the same time I don’t FEEL pretty anymore. How can I fix this please if there is anything that might help I’d like to hear what it is. Thanks for your time. (From the USA)

A: Yes, your relationship is in trouble. Let’s review what you’ve said. He would rather look at strangers on the internet than pay attention to you. When you go to talk to him about how this makes you feel the best he can do is get angry. You don’t enjoy sleeping in the same room with him because of how he makes you feel. He isn’t a good lover, is stingy, and can’t handle an intimate discussion about the relationship. His only excuse for all of this is that he is a man.

In short, here is someone who couldn’t care less about your feelings of being satisfied in the relationship, you suffer emotionally from his lack of responsiveness, and he has no desire, plan, or willingness to change. Time to move on.

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



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Best of Our Blogs: March 30, 2018

How much time do you actually spend alone in silence listening to that inner voice?

We often know more about our co-worker, best friend and even a reality star than we know ourselves.

The discomfort of hearing our thoughts usually keeps us busy. It’s the reason why the television is always on even when we’re not watching it, why we’d rather listen to a podcast or music than take a walk or run in silence.

What are you afraid of hearing? Is it possible there’s truth in the stillness and you’re afraid to know what it is?

If so, this is the perfect week to read our top posts. You’ll garner ways to get to know yourself better and declutter your mind. In doing so, you may have the clarity to decipher your relationships and discover you’re in a relationship with a narcissist.

10 Smiles and What They Mean
(Psychoanalysis Now) – Who knew there were more than one type of smile and yet it makes sense why some smiles make you feel angry and stressed.

The Narcissistic Cycle of Abuse Amongst Siblings
(The Exhausted Woman) – What does narcissism look like between siblings? You may recognize your relationship in this post.

20 Silly Prompts to Spark Self-Discovery
(Make a Mess: Everyday Creativity) – Have fun and learn something new about yourself with this creative list.

Tips for Taking Out Your Mental Trash
(Mentoring & Recovery) – It’s a way of looking at your monkey mind that you’ve never thought of before.

Love Bombing and Other Tactics from the Male Narcissist’s Handbook
(Knotted) – These tips will reveal whether you’ve been swept off your feet or just swept up by a narcissist.



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Young muscles and immune systems in aging cyclists.

I pass on the technical abstracts of two striking papers referenced by a Gretchen Reynolds article showing that the leg muscles and immune systems of 55-79 year adults who cycle approximately 400 miles/month are similar to those of young adults, suggesting that many features of immune and muscular senescence may be driven by reduced physical activity with age. By most estimates, only about 10 percent of people past the age of 65 work out regularly.

From Pollock et al.:
In this study, results are reported from the analyses of vastus lateralis muscle biopsy samples obtained from a subset (n = 90) of 125 previously phenotyped, highly active male and female cyclists aged 55-79 years in regard to age. We then subsequently attempted to uncover associations between the findings in muscle and in vivo physiological functions. Muscle fibre type and composition (ATPase histochemistry), size (morphometry), capillary density (immunohistochemistry) and mitochondrial protein content (Western blot) in relation to age were determined in the biopsy specimens. Aside from an age-related change in capillary density in males (r = -.299; p = .02), no other parameter measured in the muscle samples showed an association with age. However, in males type I fibres and capillarity (p < .05) were significantly associated with training volume, maximal oxygen uptake, oxygen uptake kinetics and ventilatory threshold. In females, the only association observed was between capillarity and training volume (p < .05). In males, both type II fibre proportion and area (p < .05) were associated with peak power during sprint cycling and with maximal rate of torque development during a maximal voluntary isometric contraction. Mitochondrial protein content was not associated with any cardiorespiratory parameter in either males or females (p > .05). We conclude in this highly active cohort, selected to mitigate most of the effects of inactivity, that there is little evidence of age-related changes in the properties of VL muscle across the age range studied. By contrast, some of these muscle characteristics were correlated with in vivo physiological indices.
and, from Duggal et al.:
It is widely accepted that aging is accompanied by remodelling of the immune system including thymic atrophy and increased frequency of senescent T cells, leading to immune compromise. However, physical activity, which influences immunity but declines dramatically with age, is not considered in this literature. We assessed immune profiles in 125 adults (55-79 years) who had maintained a high level of physical activity (cycling) for much of their adult lives, 75 age-matched older adults and 55 young adults not involved in regular exercise. The frequency of naïve T cells and recent thymic emigrants (RTE) were both higher in cyclists compared with inactive elders, and RTE frequency in cyclists was no different to young adults. Compared with their less active counterparts, the cyclists had significantly higher serum levels of the thymoprotective cytokine IL-7 and lower IL-6, which promotes thymic atrophy. Cyclists also showed additional evidence of reduced immunesenescence, namely lower Th17 polarization and higher B regulatory cell frequency than inactive elders. Physical activity did not protect against all aspects of immunesenescence: CD28-ve CD57+ve senescent CD8 T-cell frequency did not differ between cyclists and inactive elders. We conclude that many features of immunesenescence may be driven by reduced physical activity with age.



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Do Offense Specific Intervention Programs Work?

Correctional PsychiatryPunishment within the criminal justice system remains the cornerstone and is one of the primary objectives of sentencing in all western countries (Ward and Salmon 2009). As Foucault (1995) explains, the prime purpose of punishment is based around reducing the desire that makes crime attractive and to make the penalty to be feared.

The process of offender rehabilitation is based around two distinctive and overlapping domains within the criminal justice system and correctional intervention programs. The criminal justice system’s approach is based on punishment and risk management, while correctional treatment programs are focused on assisting people to lead more fulfilling and less harmful lives (Casey, Day, Vess and Ward, 2013).

I’ve written about risk assessment tools and theoretical frameworks that are used within correctional intervention programs to identify the level of risk, treatment targets, and clinical intervention when providing offense specific intervention.

This blog will discuss the effectiveness (if any) of using offense specific intervention programs within correctional environments.

When working within the forensic environment, it is important to have a clear understanding of the theoretical frameworks (Good Lives Model and/or Risk, Needs, Responsivity Model) when it comes to conducting clinical assessments to identify treatment targets, level or risk and the therapeutic intervention (Crighton and Towl, 2008).

Andrews and Bonta (2003) explain that to deliver effective offense specific intervention to individuals, treatment should be focused on the relevant behavioral, attitudinal, and lifestyle factors that were directly associated with the offending behavior.

Laws and Ward (2011) held a similar view, stating that to assist individuals to change their criminal dispositions a value – laden approach is necessary. This is one of the two components of rehabilitation whereby an offender has been judged to have acted wrongly and illegally, and therefore has been punished accordingly.

There is a second component of rehabilitation based on capability building. This approach is primarily focused on assisting the individual in acquiring the skills and values required to lead more fulfilling and less harmful lives. (Casey, Day, Vess and Ward, 2013).

The big question is: Do offense specific intervention programs work?

This discussion will be focused mainly towards individuals who have been convicted of a sexual offense. When it comes to reviewing the research of risk of recidivism, Gelb (2007) explains that the critical methodology that has substantial implications for interpreting how recidivism is defined are the rates of reconviction and measures such as returned to prison.

Marques (1999) acknowledges that despite the efforts of many clinicians, the effectiveness of sex offender treatment programs continues to be debated.

She reported that part of the problem is that relatively few well-designed studies pertaining to treatment effectiveness have been conducted and that opportunities for a controlled experimentation in the field are rare.

This situation is largely because of the  major investment of time and resources that follow-up studies require.

However, there has been research conducted into the effectiveness of sex offender treatment programs as reported by  Maletzky and Steinhauser (2002) who spoke of how Hall (1995) had conducted a meta-analysis and concluded that cognitive behavioral treatments were significantly effective, with community based treatment showing better effects than institutionally-based treatment (confounded by seriousness of offense history).

Higher recidivism rates were found in the majority of untreated, as opposed to treated, samples. One finding was especially optimistic that longer follow-ups led to more significant treatment effects when comparisons to control groups were available.

Low Rates?

In relation to sex offenses, Gelb (2007) advised there are low rates of reporting to police and therefore, any studies of recidivism of sexual offenses will necessarily represent an under-count of offending behavior.

According to Smallbone and Wortley (2000), there has been a growing body of literature that links sexual and other criminal offenses. They note that while incarcerated, sexual offenders are more likely to have previous convictions for non-sexual offenses than for sexual offenses and that after release from prison, these individuals are more likely to commit new non-sexual offenses than new sexual offenses.

Lievore (2004) explains that research based on both official reports of offending and self-reports of offenders shows that sex offenders typically have lower rates of recidivism than do other kinds of offenders and that these rates vary for different sub-groups of sex offender.

In relation to whether offense specific intervention programs work, it remains unclear and additional research needs to be conducted.  As Lievore (2004) explains, it is not very clear whether the low rates of sexual recidivism is because of  a lack of opportunity to re-offend, rehabilitation (or treatment), or non-detection of subsequent sex crimes.

References

Andrews D. A, and Bonta J. (2003) The Psychology of Criminal Conduct 3rd edn Cincinnati OH: Anderson Publishing Co

Casey, S. Day, A. Vess, J. & Ward, T. (2013) Foundations of Offender Rehabilitation MPG Books, Great Britain

Crighton, A. D & Towl, J, G (2003) Psychology in Prisons Blackwell Publishing, United Kingdom

Foucault, M. (1995) Discipline & Punishment – The Birth of the Prison Vintage Books A Division of Random House, INC, New York

Gelb, K. (2007) Recidivism of Sex Offenders Research Paper Sentencing Advisory Council

Laws, D.R & Ward, T. (2011) Desistance and Sexual Offending: Alternatives to Throwing Away the Key. New York, NY: Guildford Press

Lievore, D. (2004). Recidivism of Sexual Assault Offenders: Rates, Risk Factors and Treatment Efficacy. Canberra: Australian Institute of Criminology.

Maletzky, M. B. & Steinhauser, C. (2002) A 25 Year Follow-Up of Cognitive/Behavioural Therapy with 7,275 Sexual Offenders Behavioural Modification Vol. 26. No 2. April 2002 Sage Publication

Smallbone, S. & Wortley, R. (2000). Child Sexual Abuse in Queensland: Offender Characteristics & Modus Operandi. Brisbane: Queensland Crime Commission.

Marques, J. (1999) How to Answer the Question “Does Sex Offender Treatment Work?” Journal of Interpersonal Violence Vol. 14 No. 4 April 1999 Sage Publication, Inc.

Ward, T. & Salmon, K. (2009) The Ethics of Punishment: Correctional Practice Implications. Aggression and Violent Behaviour.

Tanya Jordan is an experienced Forensic Social Worker and an Accredited Mental Health Social Worker with T n J’s Consulting and Support Services.

 

 



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Thursday 29 March 2018

3 Ways Highly Successful People Handle Self-Doubt

Think about the last time you felt fear and anxiety take control of your day. Maybe it stopped you from speaking up in a meeting because you felt like your opinion wasn’t worthwhile. Perhaps a simple email took you hours to write because your inner critic kept telling you it wasn’t good enough — that you weren’t good enough.

Many high-achievers struggle with thoughts that they are a fraud and that they are incompetent, despite a track record of accomplishments.

This psychological phenomenon, known as Impostor Syndrome, can show up in many areas of our lives including at work in the form of:

  • Downplaying promotions
  • Declining new responsibilities
  • Assuming you’re not qualified enough for your job

While no one is immune from self-doubt, it actually impacts high-achievers the most and in my experience, this battle with the inner critic is one many successful people share — yet one we don’t often talk about it.

The Truth About Self-Doubt

Fear of failure is a universal human emotion, experienced by some of the world’s most successful people

Maya Angelou once admitted:

“I have written eleven books, but each time I think, “Uh-oh, they’re going to find out now. I’ve run a game on everybody, and they’re going to find me out.”

Leaders from virtually every industry have spoken about feeling undeserving of success, including Neil Gaiman, Sheryl Sandberg, Emma Watson, and even Albert Einstein.

So if you are dealing with Impostor Syndrome, know that you are not alone. While it’s true that self-doubt can be toxic, what’s more problematic is the fact that we never learn to deal with this normal, expected emotion in healthy ways.

In my TEDx talk I shared a simple two-step strategy highly successful people use to overcome self-doubt. The secret is approaching uncertainty as a skill and embracing a growth mindset that it’s something you can get better at with time and practice.

You can watch my talk for the full details, but here are a few tips to get you started.

How Highly Successful Deal with Impostor Syndrome

1. They recognize repetitive thought patterns and actively change their mindset.

Out of the 60 to 70,000 thoughts we have every day, estimates suggest 98% of them are the same. This means your inner critic is really a habit– a thought pattern you can get control of.

Start by identifying underlying beliefs (potentially rooted in childhood) that may make you feel as though you don’t deserve your success. Look for exaggerated, irrational, or unrealistic thoughts that come up again and again and practice identifying common cognitive distortions that trip you up.

2. They get curious and ask questions.

Your inner critic is really there to protect you, so do your best to practice self-compassion. Take the questions it poses at face value and use it for problem solving.

For example, if your inner critic is cautioning that you may not be ready to pursue a new career path, address its concerns constructively. Use it as an opportunity to honestly assess your skills and evaluate gaps you need to fill.

3. They don’t let fear get in the way of their purpose.

We all experience worry and confusion in the face of change and uncertainty. It’s normal to be afraid. Our inner critic will always speak up anytime we try to do big things no matter how positive we try to be. Hearing the voice of your inner critic can mean you’re about to do something brave and important to you. No one gets the luxury of living without fear–not even confident people.

So, it’s time to start viewing your emotions — the good and the “bad” — for what they are: your greatest strength and most valuable tool.



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