pi3: May 2020

Sunday, 31 May 2020

Day #286: On the militarization of police

The US is under attack, not by some foreign power, but by the people tasked to protect us. The police have increasingly become more militarized and as such their power to incite violence has increased exponentially alongside its budget. Notice I said incite violence, not end violence.

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The Childhood Personality Trait That Makes You Popular (M)

The trait is intrinsically rewarding.

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The Best Weight Loss Technique: Low-Fat Versus High-Fat Diets

Research reveals if low-fat diets are better for weight loss.

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My Boyfriend’s Mother Insists on Sleeping with Him

From a young woman in the U.S.: So, I recently discovered that my 27 year-old boyfriend sleeps with his mother. Now, the issue here is that it’s his mom who leaves her bedroom where she sleeps with her husband and goes to his 27-year-old son’s room to sleep with him. She says is because her husband’s snores don’t let her sleep. But they have been married for more than 20 years!

I’m just shocked that a full grown up man sleeps with his mother for whatever reason. OK. The thing is that his parents live with him, since he pays for the rent and everything else. But still, it still feels like his parents’ house and I just can’t deal with the idea that every time after I visited him (I live in another country) she goes and sleeps with him, on the same bed where I had sex with him.

I just wish to understand this situation. Because, I had to sleep with my mother too, though the last time was years ago. I tried to talk to him about this but he gets defensive. And it is not the idea of them sleeping together, but that his mother prefer to sleep with his son rather than with his husband.

One time she told me “Then where I am suppose to sleep now?” I was baffled. Was I suppose to invite her to sleep with me and her son? Is it me being weird? Or is this a weird situation? What should I do? I get mixed feelings about this because, OK, it is his mother but he is a fully-grown male. He usually wakes up with an NPT (normal erection on waking)! I know it is not sexual, but isn’t it awkward? Shouldn’t mother respect their children’s privacy?
I just don’t know what to do.

I understand why this makes you uncomfortable. I don’t understand why your boyfriend isn’t more responsive to your feelings about it. Surely, there are other ways to handle the situation.

I do sympathize with his mother’s inability to sleep with someone snoring up a storm beside her. But it puzzles me why this family hasn’t thought of other ways to handle it. Has your boyfriend’s father talked to a doctor about his snoring. It could be that he has sleep apnea, for example. If so, it can be treated so the snoring stops. If his snoring isn’t that loud, but his wife is hypersensitive to what he does, can she wear earplugs? Is there room in the house for another bed? How about a futon couch that can be made into a bed for mother, when she has to escape her husband’s snoring? Can the family afford a larger apartment so mother can have her own room to retreat to? All those are practical ideas that I hope have been explored.

If every practical solution is rejected, then I’m concerned that there may be something else going on. You didn’t mention whether there is a cultural expectation which has to be considered or whether it is possible that there are other reasons that his mother doesn’t want to be with her husband at night. If so, those issues need to be dealt with.

Regardless, what concerns me most is that your boyfriend gets “defensive” if you try to talk to him about the situation. If the two of you are serious, he needs to take your feelings seriously. And you need to find ways to approach an issue that doesn’t feel to him like an attack.

You two are in the early stages of a relationship. For it to deepen, you both need to find ways to be comfortable together when talking about uncomfortable concerns. I assure you, this won’t be the only issue where you disagree. Learning how to solve problems together is how two people learn to be a couple.

I imagine, for example, that at some point you’ll need to talk about finances and whether he can continue to support his parents and contribute to the support of a wife and young family. There are probably issues about you that he finds troublesome as well. I hope you will both find the courage and the love to start talking about the things that matter as you move forward in your relationship.

I wish you well.
Dr. Marie

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A-B-Cs for Creating Safety in Your Relationship, Especially in a Pandemic

This COVID time of uncertainty heightens… well everything! How can we stay “safe,” not just physically (by staying home), but emotionally as well?

To help people create safety through couples therapy and mediation, I’ve honed the following principles which I call the A-B-C’s. They integrate a Psychobiologic Approach to Couples Therapy (PACT)¹ with an interest-based Divorce Mediation approach.²

This integrated process begins existentially, by helping each person to articulate what is most important, and how each wishes to live his/her life. Couples therapy and divorce mediation guide both people to reach agreements, whether living under one roof or two. Especially when separated couples co-parent, these A-B-C’s can be instrumental in reaching agreements that enable their children to feel safe. Thus, whether you are partnered up or not, living together or apart, you can still create safety within your relationship.

A is for AWARENESS

To sustain successful therapy or mediation, it is important to gain a better understanding how you feel and what makes you feel that way. To feel safe, two important and related pieces of theory are relevant: your attachment style and your (brain’s) threat response.

For evolutionary survival, our brain is wired to pick up the negative — any threat! — in the environment. The giraffe at the watering hole survives when s/he interprets bushes moving from a lion, but not the wind. As human animals, we sometimes interpret the wind as a lion, and (over)react to words or actions as threats. This can lead to an “amygdala hijack”³, causing a defensive reaction, i.e. one of the 3 F’s: Fight, Flight, or Fade (play dead). Dan Siegal urges that you keep feelings and behaviors within your acceptable “Window of Tolerance.”⁴

Attachment styles frame our brain responses. These styles develop in infancy when we experience love and safety as we bond/connect to our primary care-taker. Thus, our brains encode safety or threat according to these attachment styles. Stan Tatkin describes easy-to-understand ‘island’, ‘wave’, and ‘anchor’ attachment styles.¹

B is for BEHAVIOR

The ways two people treat one another — in words and actions — is their relationship. The focus here is learning ways to improve your interactions, not just your feelings.

If another’s words or behavior trigger you into defensive mode (like the giraffe), learn to say, “I can’t talk to you right now,” then walk out of the room. Try to remember to add, “I’ll be back in… an hour (or whenever) when I calm down.” Knowing when you’ll return helps the other person not feel left, or abandoned. And you need reliably to return when you say you will.

C is for CONSIDERATION

Our words and actions contribute to how others feel and behave in return. We can learn to understand our impact on another, and anticipate it — in a word, to be considerate. We feel more safe when our words and behaviors are consistent and predictable, and we rely on others’ to be as well.

Known as Theory of Mind, this is the ability to walk around to the other side of the mountain and see from the other person’s perspective.⁵ Such a two-person paradigm is foundational for parents (together or separated) trying to be considerate of schedules and needs of both adults and kids (e.g. scheduling homework, shutting off screens, keeping a consistent bedtime).

Further, this two-person paradigm allows you to repair the inevitable ruptures that occur in any relationship. Repair happens best when you understand the other’s brain and attachment styles, thereby enhancing mutual regulation of another’s emotions. This enables you to learn to soothe him/her and head off an amygdala hijack for either of you.

While these A-B-C’s are not automatic, they are all learnable skills. Even in times of crisis, it is possible to create safety in your relationship.

References

Tatkin, S. (2011) Wired for Love: How Understanding Your Partner’s Brain and Attachment Style Can Help You Defuse Conflict and Build a Secure Relationship. Oakland, Ca., New Harbinger Publications, Inc.
Knickle, K, McNaughton, N, Downar, J (2012); Beyond winning: mediation, conflict resolution, & non-rational sources of conflict in the ICU, J. Crit Care; 16(3): 308.
“Amygdala hijack”: term coined by Daniel Goleman in (1995) Emotional Intelligence: Why It Can Matter More Than IQ, N.Y., Bantam Books.
Siegel, D. J., (2010) Mindsight: The New Science of Personal Transformation, N.Y., Bantam Book.
Fonagy, P., Gergely, G., Jurist, E.L., & Target, M. (2004) Affect Regulation, Mentalization, and the Development of the Self, N.Y., Other Press.

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Am I a Pedophile?

I am an 18-year-old transgender male, and I’m afraid I might be a pedophile. I have never touched or acted towards a child in an inappropriate way, nor do I intend to. However, I have been aroused by cartoon images of children, and I sometimes fantasize about seeing a child in a sexual way. Sometimes I view cartoon images of children online. I’ve thought about it, and I wouldn’t want to touch a child inappropriately if I had a chance. It’s only in my fantasies that that might happen. Even then the fantasies only involve a child and not myself participating in anything.
I am gay, and I am attracted to adult men as well.
My professional goal is to be a music therapist to children that have developmental disabilities, but I’m concerned that these thoughts I have might lead me one day to act inappropriately around a child. I’m not concerned I will hurt a kid, but I don’t want to touch or scare one by slipping up or indulging myself by accident. I’ve worked with many children in the past, and it hasn’t been an issue yet. Being a music therapist is the only job I can imagine for myself, and I love working with the kids. Should I abandon this professional goal to avoid any potential incidents though?
I’m also afraid to ask any medical professionals for help because I think they might see me as a danger to others and lock me up or something. I don’t want my family or friends to know about this.
I’m not sure if I’m even a pedophile either, as I am attracted to adult men as well.
Is there any advice that might help me?
Thank you.

Sexual fantasies are normal, even healthy. It’s not illegal or unusual to have fantasies. No therapist is going to report you for having sexual fantasies, no matter their nature. Fantasies are a way for you to think through something without actually having to do it. Most people never carry out their fantasies, even when presented the opportunity to do so. Fantasies are a thought process. A therapist would have to report you to the police if you were engaging in behavior that was harmful to children but that’s not what’s happening in this instance. You’re fantasizing and thus cannot get into any trouble for fantasizing.

However, there are healthy sexual fantasies and there are abnormal sexual fantasies. Another way of saying this is that there are common sexual fantasies and there are uncommon sexual fantasies. For instance, a 2014 study published in the Journal of Sexual Medicine analyzed the results of over 1,500 individuals asked about their sexual fantasies. About half of the participants were women and the other half were men. The average age of participants was about 30 years old. About 85% of the sample were heterosexual, 4% indicated that they were gay and the rest identified as being somewhere in between. The rarest of all fantasies reported was sex with a child or an animal. The vast majority of fantasies were more typical involving sex in a romantic location or receiving oral sex. The fact that you are having rare fantasies is concerning. It’s not normal to have fantasies involving children.

You asked specifically if you are a pedophile. That’s not an answer I can provide over the internet. The Diagnostic and Statistical Manual for Mental Disorders, the guidebook mental health professionals use to diagnose disorders in the United States, includes a definition of pedophilia. The latest edition of the manual, the DSM-5, says that one indicator of a pedophilia disorder is that an individual has “acted on” their sexual urges. “Acted on” means that an individual has engaged in sexual behavior involving a child. It’s also important to note that it could mean that an individual has masturbated to these fantasies or has viewed child pornography.

Based on what you have described, it does not appear as though you have “acted on” these fantasies, however, I can’t be certain based on only a short letter. You did mention fantasies, but you did not specify whether you have masturbated to them or not.

The very fact that this problem concerns you means that you should speak to a therapist. As I mentioned above, it’s not illegal to fantasize and no therapist would report you for having fantasies. A therapist would work with you to determine the problem and help to redirect your fantasies. It’s also important to note that therapists are not legally allowed to reveal confidential information about their client’s therapy unless there is an imminent threat of danger. It does not seem that this situation would fall into that category.

My suggestion is to go to counseling to address this problem, especially because you are hoping to work in a field involving children. When it comes to children, it’s imperative that you do everything in your power to ensure that you never harm a child. Therapy can help you to achieve that goal.

As for your professional goals, you might put them on hold until this issue is resolved. That way, you can ensure that no child is ever harmed by you, on purpose or accidentally. Protecting children, and ensuring that you never act inappropriately, is of the utmost importance. Good luck and please take care.

Dr. Kristina Randle

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4 Indications of a Psychopath at Work

There really isn’t any job a psychopath wouldn’t do so long as it benefits them in some way. Psychopaths can be business owners, surgeons, lawyers, data entry clerks, waste managers,...

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Saturday, 30 May 2020

Day #285: Interesting times

My Co-PI lived through the fall of the USSR. I told him that must have been an interesting time to be alive. He responded by telling me that they actually have a curse for others that goes something along the lines of, "I hope you are cursed to live through interesting times." We are living through interesting times now and I can see why that would be used as a curse.

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Five Things You May Not Realize Can Affect Your Mental Health

Did you know diabetes affects your mental health? From depression to relationship problems or mood swings, too much or too little glucose (sugar) circulating in the blood can trigger behavior and thought patterns that may seem unrelated to how much insulin is released by your pancreas. Out of control glucose levels influence how you feel and make decisions, your beliefs and, yes, your attitude, a very necessary component of your overall care.

The U.S. Centers for Disease Control and Prevention (CDC) states less than half the number of people with diabetes who have depression get treated, which leads to worsening states of mind that could include suicidal thoughts. Treatment, however — therapy, medicine, or both — is usually very effective in this group. That’s good news because diabetics are two to three times as likely to have depression that people without diabetes, and when one condition improves, the other is likely to improve, too.

My roundup of the top five crossover issues affecting mental health include the following.

Physical illnesses of all kinds can affect your mental health and behavior (and vice versa) like diabetes does because the human body works with integrated symptoms of vast complexity. You cannot make changes to one network without causing changes to the rest. Complications can range from additional stress and anxiety to reduced chances for healing or, as with diabetes, heart disease, amputations, nerve damage, or death. Cancer centers often integrate the concepts of wholeness and multidisciplinary teams of experts in scientific treatments, and mental health professionals use coping techniques that include biofeedback, meditation, soothing music and more. Treating only the symptoms or even the root cause of a disease should be partnered with a whole-body plan to help you handle every issue you might encounter.
Medications, of course, can have side effects, whether they are prescribed or bought over the counter. Reading the lists of every possible problem is daunting, but talking seriously with your doctor about the most likely ones and how to deal with them can help you make informed decisions. Other medication choices could be available, and alternative treatments might help. Make sure your doctor is aware of anything you take that did not require a prescription as drug interactions can occur. The important thing is to work with your doctor or doctors to make sure you get the best treatment possible with the least negative effect. If a medication is known to be associated with an increase in suicidal thoughts, addressing this fact helps you evaluate your course of treatment and plan how you will handle such problems. A good pharmacist can help with general questions, but always notify your doctor of any changes.
Available care might come with issues of its own. Where you live, costs, how easy your medical professionals are to work with, as well as local support options, affect your choices and can add to your worry and frustration or help your treatment work better. Stress damages the body in ways that complicate treatment, especially if it goes on long-term. One thing is certain, however. Staying calm and learning about your condition aids both you and your doctor in designing recovery or management strategies.
Harmful substances may seem to help you feel better or to improve your life initially, but illegal drugs and alcohol do far more damage than you might think. Other substances we use everyday can have chemical effects that are harmful to the brain, depending on dosage and how they are handled; these can be found in beauty products, toothpaste, pesticides, foods, and more. Consumers can check products for safety with the plethora of information available online.
Survival requirements dictate the use of common sense in most cases. Glucose, for example, cannot be eliminated totally from the diet. The body needs some (complex) carbohydrates, and your liver manufactures sugar as an important energy source. It is possible to minimize the effects of stress, but impossible to eliminate it from your life. Even positive stress has an effect. And the earth is home to all of us. What other people do will continue to affect the air we breathe, the food we eat, and the water we drink.

Far from being a hopeless situation, all this can be managed. There are many things you can do to improve your health by treating the systems that make up your wonderful body as partners in your care. Like the car you drive or the computer you use, consistent care will reward you with longevity and better quality of life. Take one issue at a time to avoid overwhelm and manage what you cannot change the best way you can. Remember, how you approach a problem is important to success.

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Psychology Around the Net: May 30, 2020

This week’s Psychology Around the Net highlights the current telehealth boom (and how some mental health professionals feel about it), ways to turn your self-criticism into self-compassion, the unique mental health challenges mission-driven work can bring, and more.

Stay well, friends!

Online Therapy Having Its Moment, Bringing Insights On How to Expand Mental Health Services Going Forward: Nicholas Joyce, a psychologist and counselor at University of South Florida, weighs in on his professional colleagues’ attitudes toward telehealth services in the past, how those attitudes are changing amid the COVID-19 pandemic, and what it would take for telehealth to work effectively long after the coronavirus crisis is over.

Your AI Chatbot Therapist Isn’t Sure What It’s Doing: “How do AI-powered mental health programs compare with face-to-face treatment, or to digital therapy administered by a human? Do they answer to the same regulatory bodies as other mental health providers? Moreover, what are the risks of outsourcing something as sensitive as mental health care to Silicon Valley startups?”

Change Self-Criticism Into Self-Compassion: “You’re so fat.” “I can’t believe you’re going to wear a swimsuit in public.” “Oh, my god you look awful in those jeans.” Have you ever noticed you can easily say things to yourself you wouldn’t dare say to someone else? That you willingly bully yourself? The bottom line is that if it’s not OK to say it to someone else, it’s not OK to say it to yourself. It’s past time to replace your self-criticism with self-compassion. Here’s how.

Managing Mental Health When Working for a Mission: When you engage in mission-driven work, such as the non-profit world, you can face specific emotional challenges. Your success doesn’t always bring bonuses or accolades like it would in other career fields, and sometimes you won’t see any success or reward because the problem might be too complicated for just you or just your organization to handle. For this episode of HBR Presents, Morra Aarons-Mele talks with Poppy Jaman OBE, the CEO of City Mental Health Alliance, about what it’s like to work a mission-driven career and care for your mental health.

Designing Technologies That Interpret Your Mood From Your Skin: Skin conductance is the measure of how much someone sweats, and can indicate both emotional and physical reactions to something (technologies like lie detector tests have their roots in skin conductance). Now, researchers from Sweden and the UK have developed a way to interpret the biological signals our skin conductance produces in the form of wrist-worn sensor that could tell you about your stress levels, help you track your emotions, and more.

Getting On the Same Page About How to Discipline Your Kids: When a child’s caregivers aren’t on the same page about discipline, the child can end up pulled in all sorts of different directions without a clear idea of what’s actually “right” and “wrong.” It’s important for parents and other guardians to figure out the behaviors that need addressed, how to address them, and what the consequences will be — and to stick to it.

Photo by Danielle MacInnes on Unsplash.

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How Long Sadness Lasts After A Major Life Event (M)

The saddest events in life are health problems, bereavement and large financial losses.

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The Vitamin That Reduces COVID Risk

The vitamin plays a double role in relation to the novel COVID-19 virus.

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Attachment Trauma in the Covid-19 Era

So often, individuals who have experienced trauma have had their experiences questioned, disbelieved, and invalidated. Sadly, trauma is taking a back seat to the medical implications of COVID-19. We need...

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Friday, 29 May 2020

11 Signs You Work with a Sociopath

Usually, it is very difficult to identify a sociopath within the workplace. Because they mainly interact with others on a need basis only, they generally don’t draw attention to themselves...

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Getting Unstuck: Do You Want to Be the Agent of Change or its Victim?

Everybody changes in life. You can’t live your life without changing over time, because it’s a natural byproduct of life itself. A 1,000 year-old redwood tree doesn’t look or work much at all like a young sapling.

So that leaves you with a choice. Would you rather be the agent of your own change, or just an unwilling victim of it?

I suspect most people don’t look at life this way. They just merrily stumble along in their lives, unaware that they actually have a lot more control about things than they realize.

Sure, we’re all a product of our upbringing, our horrible (or great) parents, and our genetics. But despite all those things, everyone still has free will and the ability to exercise it whenever and however they would like. Once you’re an adult, continuing to lay blame and avoid responsibility for your choices means that you are relegating yourself to something odd — having your life determined by something other than yourself.

I know I don’t like the idea that my life is outside of my own control.

Which is good, because that is an illusion. Our lives are 100% completely within our own control. The choices we make, the hard decisions we come to, these are things within our power and our responsibility.

So Many Reasons (Excuses)

We delegate way too much control — and responsibility — for how our lives are turning out to others. We blame other people, other things, other situations — anything just as long as we don’t have to accept the responsibility for making the best out of a bad situation.

“My parents couldn’t afford the school I wanted to go to, so that’s why I’m doing so badly at college.”
“My partner doesn’t support my career choices, that’s why I’m in a dead-end job.”
“My parents never loved me, that’s why I have such a hard time with trust.”
“He didn’t want to have kids, that’s why I’m so lonely now in our relationship.”
“I never knew half the things I could do because my parents never showed me.”
“My boss hates me, I’ll never get to where I want to be in my career.”
“My siblings never helped me, that’s why I didn’t get the support I needed in my family.”
“I was an only child, so I never learned how to get along with others or do things for myself.”

Do You Want to be a Victim of Change?

But blame will only get you so far in life. If you spend so much of your energy and time blaming others, you’re not focused on change and making that change happen.

Remember, change happens whether you’re paying attention or not. But if you’re paying attention (and actually expend some effort), you can work to make the change in your life benefit you for the best.

It’s like this:

Change happens in your life, whether you want it to or not.
You can either be a hapless victim of it, letting it direct where you go in your life.
Or you can be the controlling agent of it, molding change to your needs and your will.

Which would you rather be?

Getting Unstuck: Take Back Control… And Responsibility

Taking back control of the change that occurs in your life means also taking responsibility for your decisions. Rather than relying on others to make decisions for you (or be the pawn in other people’s decisions), it means taking a proactive stance to make the decisions that will impact your life. You cannot just stand still and hope life takes care of you. It won’t.

That means figuring out what your needs are right now, in the moment, and in the near-term future. Do you need to get out of a messy relationship or a horrible roommate situation? Then maybe you need a job (or a new job), to make that happen. Figure out the pieces needed for you to get to that goal.

“But it’s really hard and I’m not sure I can change!” I hear you. Most of us have been there. And you know what helps (outside of the bended ear of a friend)? Psychotherapy. A therapist can help you make these changes in your life, some of which will not be easy. People are complex. Their situations are complex. And sometimes we all just need a little help to understand how to move forward, how to become unstuck in our lives, and get to the next stage in our development.

Change is hard, even when you want to take on the directorial role of your own change. It means examining your own thoughts and behaviors, and figuring out new thoughts and behaviors that are going to help you get to your goals. It means learning to stop bad habits, unhelpful ways of thinking, and all the other behaviors that are sabotaging those efforts.

And more often than not, it means taking one step forward and two steps back. It means learning to live with some frustration and compromise, since not everything may be achievable (at least not in the moment). It means learning to live life not only to its fullest, but also to recognize when sometimes life is just going to suck for awhile, and you’ll have to do the best you can with what you have.

If you want to be the agent of your own change, you got this! You can do it. But you need to take those first steps today, because time waits for no person. And wouldn’t you rather be that better you sooner rather than later? Good luck.

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Am I Being Overly Dramatic or Is Something Wrong?

From a young woman in the U.S.: I don’t know if there’s anything wrong with me or if I’m just over dramatic. It started when I was fourteen and went on for a couple of years. It then stoped for a while and came back and then it was gone again.

The first time, I was feeling like I was nothing, that everything was my fault. I felt that my family’s unhappiness was because of me. Because of this I hurt myself because I thought I deserved it. After about a year and a half, I learned to control whatever it was for two years.

Then when it came back, I was hyper focused on trying to be perfect and went back to my old ways of hurting myself. The only difference was that I started having anxiety attacks or panic attacks, I’m not sure which one it was. I don’t know if it qualified as a panic attack. Another thing about it coming back was that it hurt a lot more.

I remember one night when my chest hurt so much it felt like someone was squeezing my heart. I just remember thinking that I would never get through this. I don’t know any of that means anything or if I’m being over dramatic. I just don’t know what any of this is. I’m sorry if this is confusing. What’s wrong with me?

Thank you for writing. You are not being overly dramatic. You are anxious and hurt. You are even more anxious and hurt because you are anxious and hurt, which only increases the anxiety.

My guess is that you were able to stop self harm, but you didn’t get to the root of what was causing it. It may be that your insistence on perfectionism helped you feel more in control but, as you are finding, being perfect isn’t a long-term solution. As we get older, it becomes more and more difficult to keep it up — just because there are more responsibilities and more decisions to be made. You haven’t developed other skills for dealing with stressful situations.

I can’t make a diagnosis on the basis of a letter, but what you are reporting is consistent with a diagnosis of a panic disorder.

A panic attack is a reaction to intense fear from no apparent cause. The body responds as it would for any fear: Fight, flight, or freeze. Often there are physical symptoms that can feel like a heart attack. People who have experienced a panic attack often say that it can get so bad, they are sure they are dying. The fear of having another one makes them vulnerable to having more. Over time, That fear can cause a person to start limiting their life to situations where they feel they will have less stress and more control. Ironically, their attempts to stay safe can result in social anxiety and a very isolated and limited life.

Some people only have one or two panic attacks in a lifetime. Panic attacks becomes a panic disorder when they keep happening and the person continues to be afraid they’ll have another one. Symptoms include what you describe, chest pain, as well as dizziness, nausea, sweating, heart palpitations, and shaking,

The solution is to deal with the root cause — whatever is causing the anxiety — and to learn new skills for managing it. Sometimes medication is prescribed initially but it is psychotherapy that will give you long-term relief.

Cognitive Behavior Therapy (CBT) has been found to be very effective in treating anxiety. Look for a therapist who has training and experience treating panic disorder using CBT.

While you look for a therapist, you can help yourself by working your way through a workbook on managing anxiety disorders. There are several excellent workbooks available from booksellers. I also regularly recommend that my clients read “Feeling Good: The New Mood Therapy” by David Burns.

Please don’t write off your concerns. They are valid. You deserve to live a life free of such disabling symptoms.

I wish you well.

Dr. Marie

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Day #284: The things we do in the dark

Disinformation is a powerful tool. We are often taught that while previous wars had the overall and almost total support of the American people, the Vietnam war did not. You may think this had to do with the sentiment at the time or a cultural shift. However, this was most likely due to something far more innocuous, the television.

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The Improvisation Technique That Boosts Mental Health

Improvising is not just good for theatre, it is good for life.

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The First Safe COVID-19 Vaccine Passes Phase 1 Trial

The first COVID-19 vaccine is safe for phase 2 human test and could be ready in six months.

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How to Engage in Mindful Social Media During Challenging Times

How each of us carries ourselves in this world greatly affects our experience together. And with news and social media occupying such a central part of our daily activity, it’s easy to forget to investigate our own behavior. We are so impulsively quick to post and tweet about the issues of the day that we often leave love out of the equation. Why does this matter? Because there is nothing more important in human life than love.

We need to take a good look at the news and social media today. Listen to what’s dominating our conversations, even within our like-minded circles of friends. Anxiety. Worry. Fear. Anger. The love we all need is muted or missing.

It can be satisfying to call out those we do not agree with. Yet in another sense, it just perpetuates the hierarchical paradigm. In all of our social media discussions and media reporting, where is the love? Why does love take a digital back seat?

How many of us have deeply contemplated our own participation in creating a world that produces such anxiety, worry, and fear?

When fear becomes familiar, and anger so close to the surface, what can we, as individuals, do to protect both ourselves and our world? Railing against what is wrong or championing an alternative at the expense of others keeps us stuck within the same disparaging mindset that got us into this situation to begin with.

Since engaging reactively with news and social media creates polarization and precludes possibilities of personal realization that we, too, have contributed to this mighty mess we see ourselves in, we can humbly chart a new path forward. This path is led by compassion for every single human being on this earth, regardless of social standing, race, sexual identity, religion, politics, or any other variable we have used to divide us or to justify our own positions in this world.

Love can be glimpsed at times, in the social media post that shares without judging or trying to convince, or in the news story that resonates deeply in the heart, with a message that reveals beauty and harmony. Love can be found in our hearts when we manage our news intake carefully enough to be aware of what is happening in the world, but use that awareness to redirect our focus on how we are being in the world.

So when we look at the news and social media or listen to our conversations, we need to observe carefully, not just the content we are taking in, but our own inner thoughts and feelings. We need to notice our own assuming and judging. This is the starting place for cultivating a new choice on how we respond, if we really need to respond at all. For there is a healing power in taking time, not engaging, being quiet, finding calm.

Healing asks us to observe courageously and inquire within ourselves for our own inner truth and wisdom. I submit that we are perfectly capable of knowing for ourselves how to live with respect for all and, ultimately, to feel love for all in our hearts.

How each of us carries ourselves in this world greatly affects our experience together, even the physically distant experience of one another on social media.

Think about this the next time you are drawn to post, to tweet, to comment. The choice you make is a choice that can make the world a better place for others — and for yourself.

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Feeling Trapped or Abandoned: When Relationships Run Hot or Cold

By nature, humans are wired for connection. We seek out others to share our lives with, with the goal of forming lasting and intimate bonds. So feeling trapped or abandoned in an intimate relationship shouldn’t be a common thing, should it? Actually, these experiences are common for partners who wind up repeating cycles within intimate relationships that they may be unaware of. Feeling trapped or abandoned are commonly seen in the push-pull dynamic found in unhealthy relationships; both styles often represent two sides of the same coin.

Engulfment and Abandonment Defined

Fear of being engulfed, or trapped, is often indicated as feeling smothered, or in losing one’s autonomy within the relationship. People who report feeling trapped may try controlling their partner through hostile withdrawal, emotional indifference, cheating or otherwise punishing the partner, up to and including, abandoning them.

Fear of being abandoned is often indicated as being afraid to be alone, or fearing being left behind or forgotten. Those who report feelings of abandonment or perceived abandonment may use desperate measures (self-harm, alcohol or drug use, etc.) to prevent being abandoned, which often reinforces the very abandonment they fear. With this type of relationship dynamic, each partner is feeding into the other partner’s biggest fears, often at the expense of unraveling the relationship. It is common to see both partners vacillate between the two dynamics, and potentially strengthening a traumatic bond between them.

Some may seek out emotionally unavailable relationships or settle for a shallow or unfulfilling relationship because it is seen as “safe.” However, emotionally void or shallow relationships lack the very emotional intensity and dramatic flair that these personalities crave, leaving them feeling bored and aloof, and looking to find a way out of the relationship. In time, a cycle replays where feeling engulfed (trapped) or abandoned within the relationship resurfaces. Partners who were once put on a pedestal may now find themselves being devalued, held to unreasonable standards or unappreciated. For example, a partner may express that the person they’re now with is not the same person they started dating. Idealized relationships or the “The Grass is Greener Syndrome” are commonly reported, keeping them feeling trapped or fearing abandonment.

Feeling trapped or fearing abandonment has its origins in insecure attachment styles, early life trauma, PTSD, personality, and unhealthy habit formation. These push-pull dynamics are often blamed on the partner with little accountability for one’s own patterns replaying within the relationship. However, because of a lack of object constancy, projective identification or splitting, intimacy and closeness within relationships triggers feeling trapped or feeling abandoned; the resulting behavior is to abandon the relationship to prevent themselves from being abandoned.

Signs of Feeling Engulfed or Abandoned

Many times, a history of feeling trapped or abandoned in relationships is met with these key symptoms:

Fear of being alone or can’t be alone with themselves.
Confuses being alone with feelings of loneliness.
“Chasing” or “Running” from relationships; cyclic relationships.
Constantly distracted; a need to be busy all the time.
Idealization and devaluation of partner.
Denying or rationalizing a partner’s behavior.
Unable to ask for personal space when needed.
Seeks shallow or impersonal relationships to prevent being alone.
Boredom or disillusionment in relationships.
Feeling trapped or unable to leave the relationship.
Emotional volatility or emotional numbness.
Self-identity tied into the relationship or relationship roles.
Traumatic bonding within the relationship.
Feelings of emptiness, loneliness or indifference.
Cycles often repeat within relationships.

Stopping the Cycle

Getting out of the relationship is often your healthiest choice to focus on your personal goals and healing. If a partner is unwilling to address their own improvement goals, the relationship will continue the push-pull dynamic.

Take time to be alone and address core issues. Recognize the differences between being alone and feeling lonely in increasing awareness and in establishing a healthy sense of self. Work with a therapist who specializes in relationship dynamics and self-empowerment who can help create healthy habits and individual goals in fostering personal growth.

References

Pervin,T., & Eren, N. (2019). Psychodynamic formulation in borderline personality disorder: a case study. Psychiatric Nursing, 10(4), 309 – 316.

Toplu-Demirtas, E., et al. (2018). Attachment insecurity and restrictive engulfment in college student relationships: the mediating role of relationship satisfaction. Journal of Aggression, Conflict and Peace Research, 11(1), 24 – 37.

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Brain connectivity fingerprinting of complex human personality traits - another tool for the surveillance state?

A group of researchers in the Department of Radiology, Anhui Medical University, Hefei, China, find that resting-state functional connectivity patterns of whole-brain large-scale networks can effectively and reliably predict complex human personality traits, including agreeableness, openness, conscientiousness and neuroticism, at the individual level. Fascinating work, but one wonders whether this might become yet another tool that might be used by a government to assess its citizens? :

Neuroimaging studies have linked inter-individual variability in the brain to individualized personality traits. However, only one or several aspects of personality have been effectively predicted based on brain imaging features. The objective of this study was to construct a reliable prediction model of personality in a large sample by using connectome-based predictive modeling (CPM), a recently developed machine learning approach. High-quality resting-state functional magnetic resonance imaging data of 810 healthy young participants from the Human Connectome Project dataset were used to construct large-scale brain networks. Personality traits of the five-factor model (FFM) were assessed by the NEO Five Factor Inventory. We found that CPM successfully and reliably predicted all the FFM personality factors (agreeableness, openness, conscientiousness and neuroticism) other than extraversion in novel individuals. At the neural level, we found that the personality-associated functional networks mainly included brain regions within default mode, frontoparietal executive control, visual and cerebellar systems. Although different feature selection thresholds and parcellation strategies did not significantly influence the prediction results, some findings lost significance after controlling for confounds including age, gender, intelligence and head motion. Our finding of robust personality prediction from an individual’s unique functional connectome may help advance the translation of ‘brain connectivity fingerprinting’ into real-world personality psychological settings.

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Thursday, 28 May 2020

To Mothers Struggling with Addiction: You Are Not Alone

I had an idyllic childhood. I was a cheery kid with great parents, raised in a wonderful neighborhood, always cared for and never wanted for anything. When people hear this background from someone whose addiction was so strong that they planned their methamphetamine use around their pregnancy, it can be hard to reconcile. There is no blueprint for addiction; this disease has no face. Not one person in my life would have guessed I’d be homeless with multiple DUIs, totaled a number of vehicles, and would have my son taken away by authorities twice before his second birthday, but it happened. And despite how absurd it may sound, having my son taken away from me is what saved my life.

At 14, I was a high school freshman dealing with weight issues, vicious bullying and low self-esteem. This experience left me with few friends, so when the group of cool kids invited me to a party, I went. That’s when my drinking started — leading eventually to other substances and behavioral issues. I barely graduated with my class, and even though I wanted to go to college, it didn’t happen. Instead, I spent my 20s trying any substance that came my way.

Beginning in 2004, and for the next 10 years, I was in and out of treatment centers. I had periods of sobriety, but they never lasted long. During one stretch, I had a corporate job, bought a condo, and purchased a car. Everyone was thrilled for my new life. But on the inside, I was empty. None of the material things fulfilled me, and I eventually relapsed. What many don’t realize is that recovery is an inside job, meaning the want to change has to come from deep within you — and it’s so much easier said than done. When I cycled through facilities, I didn’t want to get clean, so sobriety never stuck.

In my late 30s, I found out I was pregnant which came as a complete shock. In a previous relationship, fertility treatments were not successful, and I was told pregnancy was not a possibility for me. Unfortunately, I was not sober. I tried and wanted to stop but the disease of addiction was stronger. In fact, it was so strong that my addicted brain rationalized using methamphetamine while carrying my child. I knew methamphetamine use in the first trimester can cause a cleft lip, so I waited until the second and third trimesters to use because the risks weren’t as great. That’s how much power these drugs had over me.

Fortunately, Owen was born completely healthy, which I am so grateful for, but my use continued. Six weeks after Owen’s birth, I was staying in a shelter for battered women. My substance use was reported, and the authorities came and physically took Owen from my arms. Unbeknownst to me, this was the start of a slow and painful separation from him, but the beginning of my new life.

After Owen was taken from me, I knew I had to do everything asked of me. I went to treatment and attempted to get clean. I did all the tasks required of me, but I didn’t work on myself. I kept this up for months and finally got Owen back. And then I relapsed. Owen was taken from me a second time.

When I lost my son for the second time, I was devastated. At that point, I had nothing left to lose. In the following 90 days, I was Baker Acted eight times — an involuntarily 72-hour hold in a mental health facility — overdosed twice and had two warrants out for my arrest. I was on a suicide mission. I remember thinking to myself, “I lost everything. I’ve lost my family, my soul, my career, and I’m about to lose Owen forever, the only perfect thing in my life.” It was clear I couldn’t get clean for myself, but I had to do it for him.

Fed up with my behavior, my parents stepped in and filed a Marchman Act petition, which allows family members to petition the court for mandatory assessment and treatment for those who are abusing substances and are a danger to themselves. When the petition was filed, I was relieved because my life was so unmanageable. I didn’t want to live that way anymore, so I cried out to God and begged him to do something. I prayed for something greater than me to save my life. I surrendered in that moment and entered treatment for the last time.

I entered treatment ready to succeed. Many nights I cried and questioned myself, but Owen was my North Star and guided me along the way. There were so many court battles and legal hurdles, but I had to do everything to prove that I was not the horrible person everyone thought I was. These were some of the most challenging times in my life, but anytime my faith wavered, I’d think of Owen. It took a great deal of work, but I was finally back with my son.

Today, I have full custody of Owen. He’s a happy 7-year-old and I love him beyond measure. My journey to get back to him was not easy, and unfortunately, there are mothers out there who are currently living the life I once had. For mothers still struggling with the guilt of having a disease that is out of your control, here is my advice for you:

Stop thinking you are a bad person. The disease we have, addiction, is a chronic, relapsing brain disease that affects the brain’s reward, pleasure, memory, and motivation. And like many chronic diseases, it causes spiritual, physical, and emotional sickness. The trauma, guilt, shame, fear and resentment that contributed to your addiction are the very things you have to let go of. When you set yourself free of those shackles, you’ll get to the core of who you are.
Accept your truth and interrupt the cycle. They say the truth will set you free, and in this case, it does. Not only until I was able to accept the consequences of my situation that I truly began to work on me. The past is not an easy thing to confront. It’s hard recounting some of the worst times of your life, but once you do, it’s much easier to move forward.
Use your strength. Even if you don’t believe it, you are stronger than you think, and your children deserve you. Overcoming this disease is more monumental than you realize. Addiction causes physical changes in how the brain responds to situations involving stress and self-control, and the love for your children can help you overpower it.
Seek the help you deserve. If you’re still struggling with addiction, you’re certainly not alone. There is hope and there is help. Things are not going to get better overnight, so you have to work your way toward that light at the end of the tunnel. It’s important to never give up on yourself. Work on yourself and seek guidance from professionals.

This year will mark my fifth year in recovery, and I am so thankful of where I am today. None of this would have been possible if not for Owen. He is what saved my life and guided me to the life I’ve always dreamt of living.

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Mother Is Forgetful & Accusing

I wasn’t sure how to summarize this because I’m not too sure what’s going on. My mother (now 49) had a stroke when she was roughly 22. She has always talked about the physical effects she’s endured from the stroke but not the mental effects. She may also have adhd but I am unsure if she has been diagnosed with it. We moved across the country 3 years ago and prior to this I never really saw an issue. People keep telling me it’s because I’m a teenager that “all teens hate their parents” but I just don’t think that’s the case. She is extremely accusatory, blaming everything on everyone else in the house. Today she was yelling at my father because he couldn’t remember her passwords, also she wanted him to read her a number and when she started to read it she interrupted and said that wasn’t what she wanted, then about 30 seconds later, she proceeds to yell at him telling him to hurry up and tell her the ******* number. In the past she has also accused my father of lying to her and sneaking around, which to my knowledge is not the case. Two summers ago, my father and I were visiting our home city across the country while she was at our new home in Ontario. She would video call him every day when we were there and do nothing but yell at him for whatever reason in the book. She even threatened divorce and that really upset me. Keep in mind I was not trying to eavesdrop on their conversation, she is just that loud and the entire house could hear. I have brought it up to her several times that I was hurt by her threatening divorce and accusing my father of such things but she thinks that I’m lying and says none of this ever happened. She also has turned my words around when I say things like “I love my nephew” she says “you just said you don’t love me” It’s very hard because I don’t know if I’m losing my mind or if she is. Currently I am just looking forward to moving out of this house, so there can be distance between us.
A few notes I should add: She is dependent on my father because she is physically unable to work.
I have (diagnosed) depression & anxiety (From Canada)

First of all, I am sorry that you are having to endure this while you are still in high school. Things are difficult enough nowadays without having a mother who seems to be making poor decisions and seems unable to self regulate her emotions.

Planning to move out when you finish high school is the right goal to have, and I’d put my effort into doing what you can do to become more independent. This may be going away to college, finding work and living with roommates, or finding family members you can live with until you get on your feet.

But in the time you have left at home I would encourage you to have a private conversation with your dad about your concerns with your mom.

He must be feeling some of this as well, and having an alliance with him and his understanding and help may be very important. He chose your mom as a partner and may need to hear from you how difficult it is to watch and experience her poor behavior. The fact that she had had a stroke, is angry without provocation, and fails to take responsibility for her own actions are all serious indicators that a medical evaluation may be necessary. Talk to your dad about getting your mom to see a physician.

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

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Staying Home Doesn’t Have to Mean Being Alone

While things appear to be slowly opening up again in many parts of the world, many people continue to feel hesitant to leave their homes, fearful of exposure to COVID-19. The resulting sense of isolation, depression, and anxiety are keeping mental health hotlines busy.

Without sounding too rosy, is there the possibility of extracting something positive from the turn inward that circumstances are now offering? A telephone survey of 818 Hong Kong residents of age 18-60 during the SARS epidemic in 2003 offers glimmers of hope.

Researchers have reported in the Journal of Infection (August, 2006) that over 60% of respondents cared more about their family member’s feelings. About 30-40% found their friends and family members more supportive. About 2/3 of those interviewed paid more attention to their mental health. And around 35-40% of participants in the survey reported taking more time for resting, relaxing, and exercising.

Sometimes it takes an unexpected and unwelcome jolt to remind us of what’s important in life. These findings suggest to me that one positive response to the stress and fear created by a pandemic is to avail ourselves of the rich resource of human connections, while also taking time to cultivate self-care habits.

Perhaps our lives have been so busy that we haven’t allowed ourselves to pause long enough to attend to our own — and each other’s — inner world. Now that we’re being forced (or invited) to slow down, it’s an opportunity to gently embrace what’s happening inside us, as well as to open our heart to listen to how others are experiencing the pandemic and how it’s affecting them. With the unemployment rate being so high and facing a host of uncertainties, now is a good time to avail ourselves of the support of family and/or friends. But it takes a courageous willingness to be a little vulnerable to share our feelings.

If you’re feeling pretty isolated and vulnerable right now, know that you’re not alone. As the Hong Kong survey suggests, we have an opportunity to pay more attention to our mental and emotional well-being. We can take time to gently embrace our feelings and listen deeply to others’ feelings and concerns.

This is a time when many of us are feeling rather powerless and isolated. But we do have the power make choices that help us feel less isolated. We can call, email, or video chat with a friend — or even send a nice card or letter (imagine that!) Like you, they might appreciate your checking in with them to see how they’re doing.

You might also reflect upon people who have had a meaningful impact on your life. Caught in the time-consuming rat race, it’s easy to lose touch with friends with whom we once felt a strong and supportive connection. You might consider going through your old phone book or searching social media to see if you can locate an old friend or two. I found myself “shocking” a few old friends and had some lovely and uplifting conversations recently. Perhaps we’ll stay in touch more now, but even if we don’t, there’s something rewarding for both of us to let them know I still think about them and value them.

We have the power to not just endure what is happening and whatever we’re feeling about it, but also to express our feelings and concerns to people who care about us. That won’t change the situation we find ourselves in, but don’t underestimate how communicating openly can change our inner landscape. And feeling less isolated and more connected, we might just find an inner strength that helps us consider creative ways that we might move forward in our lives.

I’ve also found myself doing more reading, while moderating how much news I absorb. It’s natural to succumb to our unbridled amygdala, which is programmed to scan for danger in order to help us survive. If we can maintain some mindfulness around what will help us feel less overwhelmed and isolated, we might find our way toward a deeper connection with ourselves and the people we care about. If we can find a spacious perspective and bring some wisdom to how we spend our time, we might find a better balance.

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The Best Hobbies To Prevent Depression (M)

Pursuing hobbies increases the chance of a depressed person recovering by 272 percent.

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Day #283: Lies the police told me

Depending on who you are and your experience in life the police are either heroes that are looked up to or they are oppressors that are feared. The truth is that they are all part of the same racist system and that inevitably makes all police bad. You may not agree, that's fine and I would bet that you are most likely white. To which I would say, it is okay not to notice the systematic racism until it is pointed out. It's normalized, so why would you notice?

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The Surprising Trait Linked To High IQ

Verbal IQ refers to being able to use language to achieve goals.

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Podcast: A National Non-Profit is Born From a Random Encounter

In today’s Psych Central Podcast, Gabe talks with Jamie Tworkowski, the founder of To Write Love on Her Arms, a non-profit movement dedicated to helping people who are struggling with addiction, depression, self-injury and suicide. Jamie shares how the idea for the non-profit was born in 2006 after he spent 5 days with his new friend Renee who’d recently been turned down for rehab. After writing about the experience and posting it on Myspace, people began to respond with their own stories, and the seeds for the non-profit were planted.

Tune in to find out how To Write Love on Her Arms helps people struggling with mental illness and addiction and how you can get involved.

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Guest information for ‘Jamie Tworkowski- To Write Love on Her Arms’ Podcast Episode

Jamie Tworkowski is the founder of To Write Love on Her Arms, a non-profit movement dedicated to presenting hope and finding help for people struggling with addiction, depression, self-injury and suicide. TWLOHA began in 2006 as Jamie’s attempt to help a friend and tell a story. Since then, the TWLOHA team has responded to more than 210,000 messages from over 100 countries, in addition to investing more than $2.5 million directly into treatment and recovery. Jamie’s TWLOHA blogs are a source of hope and encouragement for thousands, and he speaks frequently at universities, concerts and conferences. Jamie lives in Melbourne Beach, Florida. He loves surfing, music, basketball and being an uncle.

About The Psych Central Podcast Host

Gabe Howard is an award-winning writer and speaker who lives with bipolar disorder. He is the author of the popular book, Mental Illness is an Asshole and other Observations, available from Amazon; signed copies are also available directly from the author. To learn more about Gabe, please visit his website, gabehoward.com.

Computer Generated Transcript for ‘Jamie Tworkowski- To Write Love on Her Arms‘ Episode

Editor’s Note: Please be mindful that this transcript has been computer generated and therefore may contain inaccuracies and grammar errors. Thank you.

Announcer: You’re listening to the Psych Central Podcast, where guest experts in the field of psychology and mental health share thought-provoking information using plain, everyday language. Here’s your host, Gabe Howard.

Gabe Howard: Welcome, everyone, to this week’s episode of the Psych Central Podcast. Calling into the show today, we have Jamie Tworkowski. Jamie is the founder of To Write Love on Her Arms, a nonprofit movement dedicated to presenting hope and finding help for people struggling with addiction, depression, self injury and suicide. To Write Love on Her Arms began in 2006 as Jamie’s attempt to help a friend and to tell a story. Jamie, welcome to the show.

Jamie Tworkowski: Thanks for having me.

Gabe Howard: Well, it’s really excited to have you here, I’ve been aware of To Write Love on Her Arms for a long time, so it’s exciting to talk to you. I don’t want to sound like too much of a fanboy, but you’ve done excellent work out in the community and you’ve really resonated with me personally as someone who lives with bipolar disorder. So first off, thank you for all you do, and it’s an honor to meet you.

Jamie Tworkowski: Oh, man, you’re so welcome. I love that our story and our work somehow ended up on your radar. That’s really cool.

Gabe Howard: Oh, very cool. So for those who don’t know, can you tell people what To Write Love on Her Arms is?

Jamie Tworkowski: Yeah. So you read the mission statement. But I tend to go back to the very beginning. Our nonprofit didn’t start as a nonprofit. It just started as an attempt to help a girl who quickly became my friend. Her name is Renee, and I met her back in 2006 when she was dealing with drug addiction, depression, a history of self injury, suicide attempts, and was denied entry into a local treatment center. And I ended up writing a story about the time we spent together getting to know her. And that story was called To Write Love on Her Arms and shared that online on social media. And I was met with a really surprising response and just learned that her story represented so many people in so many places. Initially started selling T-shirts as a way to help pay for her treatment in central Florida and then in a few weeks realized that this thing had a lot of momentum. And we were looking at the chance to do more than tell one story and do more than help one person. And we were able to over time create a 501(c)(3) and become a nonprofit and build a team and basically continue to invest in professional help in the forms of treatment and counseling. But more than anything, just to communicate a message of hope and encouragement, connect people to resources and try to break down the stigma that surrounds mental health and just let people know it’s okay to be open and it’s okay to be honest.

Gabe Howard: It sounds like Renee was the impetus for all of this, and I believe you said that you didn’t know her very well. What made you put yourself out there in really such a bold and meaningful way for someone that, if I understand correctly, you hardly knew?

Jamie Tworkowski: Yeah. I didn’t know her. So really, the story documents the five days after I met her. And people love to sort of paint me or imagine me as the hero. But I would actually say most of the credit goes to my friend David McKenna, who I was living with in Orlando. I was renting a room from him. And David has actually since passed away, but at the time was in recovery and became very much like a big brother to Renee. And after she was denied entry into this treatment center, she lived in our living room for the following five days. And so I was just staying up late and being curious and getting to know her. And we were trying to keep her safe and keep her smiling and essentially pass the time to when she would be admitted into this local treatment center. So a lot of it was just being moved by getting to know someone. And like you said, it was very much a new friendship.

Gabe Howard: I’m still hung up on, you said that she was denied access to a treatment center even though she needed treatment. I’m just having trouble wrapping my brain around how somebody who is in need of medical care would be denied medical care. Can you talk about that for a moment?

Jamie Tworkowski: Yeah, sort of the absurdity of that is highlighted. Someone just points out like you can’t get into rehab basically because you need rehab. So this particular treatment center, which actually does not exist today. They did not offer an element of detox. And I assume that was insurance-related, space-related. But their particular policy was that she was deemed too high risk in relation to the other patients who were already there. And that was because of the drugs in her system and also because of a self-inflicted wound. And that actually relates to the title of the story that I wrote and what has become the name of our organization. So the night that I met her, she ended up taking a razor blade to her forearm and wrote the word “f**k up.” And I share that not to be shocking or surprising, but simply because it’s real. It’s true. It’s what really happened. And I think it’s ultimately not about profanity, but instead about identity. And I think it really represents how stuck she felt, how sad she felt, how much regret she lived with. How much of a failure she felt like. And maybe, you know, that word might be jarring for a lot of people, but my guess is some version of that word has crossed our mind.

Jamie Tworkowski: And maybe we can relate to how did I end up here? How did my life turn out this way? Oh, my gosh. What have I done? How will I get out of this? And so I think that’s what was happening in that moment. But basically, she was denied entry because of the self-inflicted wound and the drugs that were still in her system. So all of that is the answer to why she was denied entry. And it feels important to point out that hopefully would not often be the case. And it certainly wouldn’t always be the case because this place, which, like I said, eventually went out of business, that this was not the standard entrance process for someone struggling. There are enough hurdles and barriers that keep people from getting help. Whether it’s shame, whether it’s stigma, whether it’s finances. And so the last thing we want to do is highlight another one that makes these places feel intimidating. So I think we love to highlight whether it’s in a moment like this or when I go speak somewhere, just that this would not often be the case.

Gabe Howard: Jamie, thank you so much for saying that, because you’re right, there’s an awful lot of fear in reaching out for help and feeling like you would be rejected. I can only imagine how that would feel. What was it about this friendship that impacted you so much? This wasn’t a romantic relationship. You guys are just friends. This was a friendship that led to something incredible. What was it about this collection of people at this moment in time that that made this create all of this?

Jamie Tworkowski: Yeah, I think you’re right to say it wasn’t just her and I. But it was a small group of people and it was a group of friends trying to care for someone who was really struggling, was really hurting. You know, specifically, we were looking at this five day window where we needed to get her through that so that she could step into treatment and get the help that she really needed and deserved. And actually, a movie was made about primarily the five days kind of our origin story as an organization. And then I think I had never had conversations like this and I had never had an encounter like this. And so I think I was really moved by someone who was not only struggling, not only someone who had experienced a lot of pain, but someone who was also really gifted and really unique and had a lot of life in her. And so I felt like her life was very much a picture of contrast. And I was struck by that and moved by that. And then just wondered if other people might be moved by her story being told. And she loved the idea that maybe someone else could end up getting help. And it all just kind of went from there.

Gabe Howard: Well, I think that that’s absolutely incredible, so let’s fast forward to 2020, today. We know what happened back in 2006 to start To Write Love on Her Arms. Where is the organization today? In 2020?

Jamie Tworkowski: So we’ve been able to grow, you know, in all of those years since we’ve been able to build a team. We’re still based in central Florida. I believe we have 17 full time staff members. And then we always have five or six full time interns who literally come from all over the world to live together, to work together, to work alongside our team. You know, we got our start on Myspace. So we joke that the Myspace has indeed slowed down. But social media has kind of been our heartbeat ever since it’s been sort of home base for us. And we’ve been able to make all the transitions over time, you know, to Facebook and Tumblr, Instagram. We love using social media and the Internet to meet people where they are to communicate, hope to connect people to resources. And then we love the face to face opportunities as well. Whether it’s music festivals, college campuses, we were at a high school yesterday, I think in 2020, we’ve just seen so many surprising doors into different communities open, seen doors open into Hollywood and into professional sports and into the world of gaming. And ultimately, we know that these are issues that affect people. And so we just want to try to bring hope and help to all sorts of people. But it’s been really incredible just to see folks be generous and to be welcoming and inviting us into all these different spaces. We love to do what we did initially for Renee, which is help pay for her treatment, help remove that financial barrier. So that’s a part of what we do. We have a find help tool on our website where people can come and enter their zip code and find a list of local mental health resources, including free and reduced cost services in their community. So there’s a whole bunch of things. We post blogs, we use design. We definitely value creativity. And I think more than anything are trying to move people from a place of hopelessness to hope and maybe not knowing a lot to becoming educated. And so we’re thankful that almost 14 years in, we’re going really strong.

Gabe Howard: Let’s go back to your origin story. I have so many questions about Renee. And one of them is how is she doing now?

Jamie Tworkowski: First off, she’s alive and she’s doing well. She had a baby boy about a year ago. There’s been a lot of highlights. There’s been a lot that she’s been able to pursue from music to writing a book to speaking events, ways that we’ve been able to work together on things. We sell her jewelry. She hand makes these rings that we sell and consistently sell out of in our, you know, in our online store. And then with that, I think she’d be the first to admit that it’s been really hard. It hasn’t been a fairy tale. There’s been relapses. There’s been hard seasons, hard years. But I think it’s fair to say that she’s doing well. And I think as it is for anyone who pursues sobriety and mental health, it’s one day at a time. It’s going to meetings. It’s going to counseling. It’s not trying to do the whole thing alone.

Gabe Howard: I imagine that that would be a lot. And thank you so much to her for allowing you to share. Now I’m looking at your mission statement, and one of the things that I notice in it that is different is self injury. You know, addiction, depression, suicide, that’s all commonplace. A lot of mental health charities highlight that. Can you talk about why you’re so open about self injury?

Jamie Tworkowski: It really was not or is not a strategic thing. It literally just showed up in the life of my friend that all of this started with. And I think because we shared her story in a way that was honest, we continued to hear from people for whom that is personal, you know, and we continue to hear from people who struggle. And especially in 2006, not a lot of people were talking about it, especially in a healthy way or in a way of bringing hope and solutions to it. I think people responded and were surprised and maybe it felt inviting. And so we love to even expand beyond our mission statement and could add anxiety. You could add eating disorders. We think ultimately this is about pain and what do we do with our pain? How do we respond to pain? So we hear from all sorts of people, young and old, who deal with different things. And I think we try not to fixate too much on do you deal with this or do you deal with this? But to even zoom out and just say, hey, we it’s hard to be a person. A lot of the time we deal with grief. We deal with sadness. We deal with mental illness. It looks differently for a lot of people. But how can we quickly move to community and also to professional help?

Gabe Howard: We’ll be right back after these messages.

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Gabe Howard: We’re back discussing the nonprofit To Write Love on Her Arms with founder Jamie Tworkowski. Whenever I talk to people who have started movements and non-profits, they always have a very personal experience that usually is the impetus of all of this. Now, we’ve heard your story with Rene and how it impacted you, but you have a story personally. You’ve been very open about your own struggles with your own mental health issues. Where do you fit into all of this as a person living with a mental health issue or a mental illness?

Jamie Tworkowski: Yeah. And as you said, I’m open with the fact that I am someone who deals with depression. I’ve gone to counseling for years. I’ve been on an antidepressant for years. And I think the silver lining for me is just hopefully it allows me to relate to people. And it puts me in the boat with everyone else, you know. And so I can certainly relate to pain, to struggle with different feeling stuck or off at times. Yeah. And then I think I love that, you know, I literally went to counseling yesterday. And so to be able to speak not hypothetically about the counseling experience, but to be able to talk about how much I’ve benefited in my own life, you know, hopefully that makes it that much more real or authentic when I talk about encouraging people to take that step and, you know, even to be able to talk about meds as someone who has benefited and found stability. So, you know, I don’t wish depression on anyone, but I think I have been able to find the silver lining in my own experience.

Gabe Howard: One of the things that you say is that you realize that the biggest obstacle to mental health challenges and mental illness was the stigma associated with talking about it. How did you realize that? What’s the story surrounding that? A lot of people don’t realize how difficult it is to even say to friends and family that they’re suffering from mental illness, let alone publicly.

Jamie Tworkowski: Yeah, I think we began and I say we honestly had the time, it was just me responding to these messages. I began to see right away that the people were saying, hey, this is something I’ve never talked about. This is a question I’ve never asked. This is something I’ve kept hidden or kept secret. People talked about the shame associated with some of these topics. And I think it happened very quickly where we learned that so many people struggle and yet so many people feel alone and feel like this stuff has to live in secrecy or silence. And certainly we’ve learned over the years that two out of three people who struggle with depression don’t get help for it. And then I would add that I do think it’s getting better in terms of stigma. Certainly challenges remain. But I do think more people are writing about it, talking about it, thinking about it, being open to the conversation almost 14 years later versus when we began back in 2006.

Gabe Howard: One of the things that you want is for society to have a meaningful conversation surrounding mental health and mental illness. What do you think the most important thing that society can do to further those conversations?

Jamie Tworkowski: I think maybe it starts with learning about mental health. With realizing that it shouldn’t be treated any differently than physical health. With realizing that stigma and shame and silence that so much of that is built on lies and bad ideas and ignorance. And I think just writing, there’s such a need not only for education and wisdom, but for compassion, just for the reality that we don’t know what people are walking through, not only strangers, but at times we don’t know what our closest people are dealing with or how they’re feeling. So I think just a combination of those things, just inviting people to become educated and then to really wrestle with what does it look like to see people and to care about people? Many of whom might be dealing with something you don’t currently understand.

Gabe Howard: We’ve talked about 2006. We’ve talked about 2020. Let’s talk about 2025. Let’s talk about 2030. Where do you see your organization heading to the future?

Jamie Tworkowski: We want to continue doing what we’re doing. And obviously there’s a strategic element, but I think there’s also a big part of this where we’ve sort of always treated it like a creative project, especially early on. Just not operated from the place of a five year plan or a 10 year plan. And I think so many of our best moments, best campaigns, relationships, partnerships have been organic, have been things that we didn’t put on a whiteboard or put into a plan. So I think it’s wanting to continue to bring this conversation to as many people as we can. Different communities, different settings. There are new partnership opportunities that we’re working through. And so we continue to sort of smile at the doors that open. And I think we want to continue to be creative. I think we’ll always value writing. We’ll always value language, obviously. We started with a written story. We’ll continue to value design, whether that’s on our site, on social media, t shirts and merchandise that we create. We love to move people through the combination of words and design. And then, I think, hope to just continue to give people more and more ways to get involved, whether that’s in person, whether that’s online all over the world. More and more chances for people to be vulnerable in not only telling our story, but maybe more importantly, in sharing parts of their story and trying to invest in changing and bringing positive change to the stories that they’re connected to. So, yes, I think it’s a whole mix of things.

Gabe Howard: To our listeners who have want to connect with To Write Love on Her Arms, how would they tell their story or how would they get involved or how would they meet with you? Like we want to do something meaningful with your organization. What could they do?

Jamie Tworkowski: It’s a whole range of things. I mean, there’s individual opportunity. We see people get creative with fundraisers and creating events, sometimes benefit events or concerts. But we try to create campaigns and moments throughout the year where people can get involved. We do an annual 5K and we actually see more people do it, what we call virtually. We see more people participate in their local community than actually in person at the race in Florida. We do an annual event that’s a night of music and poetry and speakers and resources, and we see more people watch online than come to the event in Orlando. So I would just invite people to our site to follow us on social media, where we cover a lot of ground, whether it’s speaking events or different events that we get to be a part of. So we love to interact with people face to face, but we respond to the messages and the emails that we get and we’re constantly fielding partnership ideas. And so we would just encourage people to check out the site, follow us on social media. And yeah, I just know that even though our community’s small and spread thin at times, we’re open to ideas. But I think the healthy irony of what we do is we’re not trying to be everyone’s pen pal. We’re not trying to be everyone’s best friend. We have a really small team. So we’re not pointing to ourselves as the final solution. We want to connect people back into resources in their community. We hope we can give people tools to have these conversations in the places that they live. But it doesn’t have to be all about building a relationship with certainly me or even other folks on our team.

Gabe Howard: Jamie, thank you so much for starting the organization. Thank you so much for seeing a need and filling it. Thank you for everything that your organization has done in the last 14 years. And, of course, please keep it up for the future. For people who are interested in To Write Love on Her Arms, what’s your Web site? What is the best entry point for them?

Jamie Tworkowski: Well, first off, thank you for those kind words. It’s an honor and a privilege to do this work. I know our whole team feels that way and I feel like I get to bring my heart to work. And I know not everyone feels that way about their job. And so I try to remain grateful. And we are certainly going to continue to have this conversation and to invite people into it. And then to answer your question. We would love to invite people to our website. It is just our acronym, which is TWLOHA.com. It’s the same on social media. So @TWLOHA, on Instagram, on Twitter, Facebook. And there’s a whole bunch of ways to get involved. And we actually have a section of our Web site dedicated to that. And I joke that it could be as small as buying a t shirt and as big as joining our team in Florida and a whole bunch of ways in between.

Gabe Howard: Jamie, thank you so much for being here and please give a Psych Central welcome and a hug and a thank you to I know you said 17 employees, interns and of course, volunteers all over the country. I know that it’s all of them that makes your organization fantastic. And we, of course, appreciate them. Big props and a big hug as well.

Jamie Tworkowski: I’ll do that, absolutely. Thanks for that.

Gabe Howard: Oh, you’re very welcome. Listen up, everybody. After you are done checking out To Write Love on Her Arms, please, wherever you downloaded this podcast, subscribe. Give us a rating. Share us on social media. And when you share on social media, if you could, do me a solid. Use your words and tell people why they should listen. Don’t be afraid to tag them. Don’t be afraid to email them. We all have friends. When you’re at lunch or dinner or drinks or coffee with your friends, you should be talking about the Psych Central Podcast. I would consider it a personal favor. And remember, you can get one week of free, convenient, affordable, private online counseling anytime, anywhere, simply by visiting BetterHelp.com/PsychCentral. We’ll see everyone next week.

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