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Couples Therapy for Rekindling Romance

Romance fades. However, that doesn’t mean that you’re doomed to a life of the doldrums after the honeymoon phase has worn off. Instead, it means that you need to reinvent your meaning of romance. More importantly, it means getting on the same page as your partner about what romance looks like as your marriage grows. Couples counseling can provide you with a terrific space for figuring that out.

From Romance to Roommates and Back Again

Most relationships follow a common arc in that they start hot and heavy and then fade into something less lusty but steadier. However, if you’re not careful, the romance can slip so far away that it starts to feel like you’re just roommates. When that happens, one or both of you are likely to become dissatisfied.

Unfortunately, you can’t go back to before when you barely knew each other. You can finish each other’s sentences. You know exactly how to push each other’s buttons. And you can’t stop engaging in the mundane details of everyday life. However, you can still get the romance back. It just looks a little different than when you first met. There’s nothing wrong with that. In fact, it gives you the opportunity to get creative, which can be wonderful.

Is There a Problem?

Sometimes romance fades just because of circumstance. You have a few children, you get busy with your careers, you deal with illness … and the romance just kind of slips away. However, sometimes a lack of romance is a sign of an underlying issue in the relationship. Couples counseling can help you come together to communicate about exactly what’s going on. You can figure out if there’s a bigger problem at play, and if so, how you want to address it.

For example, sometimes a lack of romance is due to a series of built-up resentments that you’ve failed to deal with over time. Couples therapy can help you air those resentments, communicate about them in a healthy way, and find methods of moving forward. Once you feel more connected again, the romance issue might resolve itself. If not, couples counseling can help with that too.

Rekindle the Spark in Your Relationship

Couples therapy can also simply serve as a catalyst to rekindle romance. Simply setting aside one hour per week to talk about your relationship is a strong show of commitment. While in therapy, you can communicate about ideas that you might have to rekindle romance. Sometimes you’re shy or afraid about doing that on your own but become empowered to do so in the therapy office.

Your therapist might also offer counseling exercises, therapeutic homework, or simply suggestions for how to find ways to rekindle romance at home. You might learn new techniques for practicing mindfulness in the relationship. You might set goals that help you get romance back on track. Alternatively, you might just find that you’re more committed to date nights and weekend getaways since you feel a bit accountable for reporting back to your therapist.

Rekindling romance can be as simple as adding more handholding and deep kisses to your daily life. Or it can be much more in-depth and creative. The trick is to start somewhere. Couples counseling can help you both start on the same page.

Kathryn McNeer, LPC specializes in Couples Counseling Dallas with her sound, practical and sincere advice. Kathryn’s areas of focus include individual counseling, relationship and couples counseling Dallas. Kathryn has helped countless individuals find their way through life’s inevitable transitions; especially that tricky patch of life known as “the mid life crisis.” Kathryn’s solution-focused, no- nonsense counseling works wonders for men and women in the midst of feeling, “stuck,” or “unhappy.” Kathryn believes her fresh perspective allows her clients find the better days that are ahead. When working with couples, it is Kathryn’s direct yet non-judgmental approach that helps determine which patterns are holding them back and then helps them establish new, more productive patterns. Kathryn draws from Gottman and Cognitive behavioral therapy. When appropriate Kathryn works with couples on trust, intimacy, forgiveness, and communication.

Overcoming Fear of Flying in the Bumpy Skies

Turbulence is a natural occurrence and should be expected — not dreaded. The trick is to learn to go with the flow.

Lately, at airport gates and security lines, I’m increasingly hearing other frequent fliers share stories of spilled coffee and sudden drops on planes. Threaded through nearly every conversation are questions about whether there has been an upswing in air turbulence, and whether climate change is to blame.

Turbulence was never a concern for Ashwin Fernandes, who takes more than 200 flights per year as regional director to the Middle East, North Africa and South Asia for Quacquarelli Symonds (QS) World University Rankings, until a bad flight in 2013 left him spooked.

“We were over the Bay of Bengal during monsoon season and the plane started shaking violently and then dropped suddenly,” he recounts. “I didn’t know what to do, except wonder how much worse it would get and when it would end.”

Since then, Mr. Fernandes has followed a strict set of self-imposed rules, which includes taking daytime flights whenever possible. Red-eye flights, he says, can be more anxiety-provoking because of fatigue. But one question continues to haunt him: Is global warming making the skies less friendly?

Maybe, but only at certain altitudes, said Paul D. Williams, professor of atmospheric science at the University of Reading, who is the co-developer of a turbulence-forecasting algorithm that has helped make flight travel more comfortable by avoiding rough air and greener by reducing carbon dioxide emissions via “low turbulence” routes.

“Climate change is altering temperature patterns and wind speeds in the upper atmosphere,” he says. “The main consequence for aviation is an increase in clear-air turbulence, or in-flight bumpiness at high altitudes in regions devoid of significant cloudiness or nearby thunderstorms, as the jet stream becomes more unstable.”

But severe turbulence, the kind that causes passengers who aren’t wearing their seatbelts to defy gravity and lift up from their seats, remains a very rare occurrence.

“Only around 0.1 percent of the atmosphere at flight cruising levels contains severe turbulence, so even if that figure were to double or treble because of climate change, severe turbulence will still be very rare,” Dr. Williams says, also offering grounds for optimism. “Hopefully, a combination of improved turbulence forecasts and better technology will reduce the number of aircraft encountering turbulence in the future, despite the effects of climate change.”

The takeaway is to remain buckled throughout the flight, as is routinely instructed by the cockpit crew before takeoff. Airlines want passengers to be comfortable throughout the journey, which is the main reason for avoiding turbulence. Cargo planes, filled with packages instead of people, on the other hand, tend to stay the course even when the air is rough.

“No matter how scary it might feel, our pilots are in control and there is no question of structural integrity,” explains Rich Terry, a captain and managing director of fleet support for Delta Air Lines. “Modern aircraft are developed and tested to sustain any level of conceivable turbulence.”

Captain Terry says the easiest way to make sense of turbulence is to think about ocean waves cresting and falling. “That same movement happens in the air, so now picture those same movements throughout the atmosphere. When airplanes intersect those waves, you have turbulence.”

In other words, it’s a natural occurrence and should be expected — not dreaded. Learn to go with the flow.

“Expect, accept, allow” is the self-regulating advice offered by Martin N. Seif, a psychologist with private practices in New York and Connecticut who co-founded the Anxiety and Depression Association of America and is a co-author of “What Every Therapist Needs to Know About Anxiety Disorders” and “Overcoming Unwanted Intrusive Thoughts.”

When experiencing turbulence, Dr. Seif suggests replacing “what if” thoughts with “what is” thoughts. “Stay present,” he advises. “Anxiety is fueled by catastrophic thoughts and is maintained by attempts to avoid it.”

Ashley Nicholls, who frequently flies around the Northeast with her Vermont-based marketing and communications firm, says that when the going gets rough, she distracts herself with math — subtracting from 100 by three’s. “By the time I get to 1, the bumps are done. If they aren’t, I start over.”

What about preparing in advance for turbulence by monitoring weather reports and checking the latest phone apps for flight conditions? Both Mr. Fernandes and Ms. Nicholls believe that this may help to keep the element of surprise at bay, but Dr. Seif disagrees.

“All that stuff reinforces anxiety and puts the focus on the need to avoid turbulence,” he warns. “The best thing you can do is nothing.”

Adam Bluestein, a freelance journalist, grew weary of his worries over weather and decided to rewrite the script in his head. Previously reliant on an array of spiritual talismans — a Ganesh necklace, a tiny Buddha statue, a pouch of crystals, and 36 cents wrapped in a piece of aluminum foil as a Jewish blessing for life — Mr. Bluestein found a better way to check in and zone out.

He embarked on a cognitive behavioral therapy of his own design, which included educating himself in the laws of space and physics, and then flying to Thailand to re-establish his sense of courage. The outcome was a complete reset of his mental state. He no longer obsesses about what’s out of his control. Letting go, he knows, is the biggest obstacle for anxious fliers.

“Now I go up with a calmer state of mind. I observe what’s happening, I don’t react. When I see the wings bend, I know that’s what they are meant to do,” he says, also crediting yoga for helping him “muster of a sense of detachment” even in turbulence.

“Recently, I was on a 747 from Amsterdam, in a middle seat, when out of nowhere, the plane dropped by what seemed like 100 feet and my arms flew up,” he says. “When things like that happen now, it causes me to feel a greater calm because I’ve spent so much time working on it. I like when there’s stuff going on. It’s almost reassuring.

Ultimately, Mr. Bluestein landed on what could be the most grounding response to turbulent skies I’ve encountered: “It’s not about me.”

By Nancy Stearns Bercaw

Kin Leung is a Marriage & Family Therapist, MFT practicing in the San Francisco Bay area. Kin specializes in helping couples overcome struggles related to infidelity, intimacy, miscommunication, mistrust, and parenting. Kin’s kind, thoughtful and compassionate approach to marriage counseling San Francisco helps guide couples to a calmer and safer space to explore issues and move forward in a more productive manner.

In Search of Secure Attachment

Escaping the trap of push-and-pull relationships.

Attachment styles are formed in childhood, when the early relationship between child and parent begins to take shape. Researchers have found that attachment patterns established during childhood tend to manifest themselves again adult relationships.

In short, the attachment pattern you form with your parents is replicated later in your romantic relationships.
Ever heard that we each crave the love that we know?
Attachment styles

About 60% of people have a secure attachment style, meaning their parents represented a safe touch-base from which they set out to explore the world when they were children.

As adults, this lucky bunch is able to form secure relationships, meaning they are attuned to their partner’s needs as well as their own, and are also able to set healthy boundaries inside the relationship. Relationships between people with secure attachment styles will have their ups and downs, but those relationships are usually what we reference as healthy.
The rest of us are divided between anxious and avoidant (about 20% each).

Lisa Firestone Ph.D. explains how anxious and avoidant patterns are formed:

Anxious: “[…]when a parent is available and attuned at times and insensitive or intrusive at others, the child is more likely to experience an anxious ambivalent attachment pattern. An anxiously attached child can feel like they have to cling to their parent to get their needs met.”

In other words, an anxious attachment style is formed whenever a child’s emotional needs is not consistently met. The child is never sure about how her requests for emotional support will be received, since the response from her parents tends to be unreliable.
Avoidant: “This pattern of attachment develops when a child does not consistently feel safe, seen, or soothed by their parent and therefore becomes pseudo-independent.”

When it comes to forming an avoidant attachment pattern, the parents in this scenario are described by Dr. Lisa Firestone as “emotional deserts,” meaning they’re not very responsive. The result is a child who feels she has to either ignore her own emotional needs (since they’re inconvenient to her parents), or take care of them herself (since she can’t count on anyone else to help her with that).

The good news for those of us with a maladaptive attachment patterns (anxious or avoidant) is that it’s possible to work on changing towards secure. Therapy and self-reflection help a lot.

The bad news is that people with maladaptive attachment patterns tend to attract each other, especially when they’re not aware of which attachment pattern they have, or what that means in practical terms.

The match between someone who’s anxious and someone who’s avoidant doesn’t usually form the healthiest relationships.

How the anxious and the avoidant find each other

When they first get together, the anxious and the avoidant feel like the perfect match.

The anxious partner needs frequent validation. She needs to check with her partner constantly that he still loves her, cares for her, and considers her a priority. She sees it as investing in the relationship, as being all-in.

She blows the relationship out of proportion in her head. Love is everything, and doing everything together, texting all the time when you’re apart, and having long conversations about your feelings is what love is.

After they break up, he calls her needy.

The avoidant partner represents the other extreme. He’s too busy, he can’t be bothered. He’ll call later — maybe.

He takes care of his own emotional needs (or so he thinks), after all, so he doesn’t understand how someone could need that much reassurance that often.
After they break up, she tells her friends he was cold, self-centered, and immature.

(I’m using “him” and “her” because it reflects my personal experience, but gender doesn’t actually matter in determining anyone’s attachment pattern.)

I admit, I have first-hand experience on the (im)perfect combination between an anxious attachment style and a dismissive-avoidant attachment style.

When in a relationship, the avoidant partner’s elusiveness confirms the anxious partner’s need to push harder, to insist. The more the anxious partner insists, the more the avoidant partner feels his need for space is justified.

For a while, their characteristic behaviors justify each other, and they’re happy in their little dance — until they’re not.

My mind-blown moment

Identifying my attachment pattern as anxious-preoccupied has opened my eyes to my behavior in relationships. Understanding how someone with an avoidant attachment style can be so attractive to someone like me simply put my past relationships under a completely new light.

I can’t say it explains everything, because people are a bit more complex than their attachment styles, but I feel like it explains a lot.

I would get into relationships with a need to feel emotionally satisfied before I could do anything else — study, pursue a career, and even care for myself.

Feeling secure, to me, meant that I needed constant validation that the relationship mattered as much to my partner as it did to me. In other words, I needed to feel like it mattered more to him than anything else.

That meant that the more I needed my partner, the more he pulled away. The more he pulled away, the more I felt alone, empty, and insecure.

Whenever I fell into a relationship with an avoidant, I ended up subsisting on scraps of emotional attention, while expecting a full meal that would never come.

In the words of Dr. Lisa Firestone, the avoidant partner:

“[…] can appear to be more focused on themselves and to value their priorities above their partner’s. They can seem cool and removed, often showing annoyance or even disdain when their partner is expressing feelings or needs, believing their partner is being “childish” or “dramatic.” These reactions mimic the emotional desert in which they grew up.”

We’re not broken

Having a maladaptive attachment style doesn’t mean anyone’s broken.

It only means that some work is required in order to progress towards a secure attachment style, and to avoid the pain and heartbreak of a mismatch such as the ones I experienced.

Anxious and avoidants don’t always end up together, but knowing they are very likely to attract each other — and make each other very miserable — is reason enough to seek deeper knowledge of your attachment style.

In order to correct a maladaptive attachment style, self-awareness is the first step. By understanding your emotional needs and how you seek to fulfill them, you can make major progress in avoiding a push-and-pull type of relationship in favor of a more secure, well-balanced one.

Seeking the guidance of a qualified therapist is also an important step.

By Rae Gomes

Benu Lahiry is an Associate Marriage and Family Therapist in San Francisco specializing in Couples Counseling Pacific Heights. Her work is especially helpful for people experiencing anxiety, depression, self-doubt, lack of motivation, and for couples with intimacy issues. She is experienced in many evidence-based therapy modalities, including attachment theory, cognitive behavioral therapy, psychodynamic principles, mindfulness practices, and solution-focused therapy. Her therapeutic style is best described as warm, direct, and collaborative.

In Romantic Relationships, People Do Indeed Have a ‘Type’

Researchers show that people do indeed have a ‘type’ when it comes to dating, and that despite best intentions to date outside that type — for example, after a bad relationship — some will gravitate to similar partners.

If you’ve ever come out of a bad relationship and decided you need to date someone different from your usual “type,” you’re not alone.

However, new research by social psychologists at the University of Toronto (U of T) suggests that might be easier said than done. A study published today in Proceedings of the National Academy of Sciences shows people often look for love with the same type of person over and over again.

“It’s common that when a relationship ends, people attribute the breakup to their ex-partner’s personality and decide they need to date a different type of person,” says lead author Yoobin Park, a PhD student in the Department of Psychology in the Faculty of Arts & Science at U of T. “Our research suggests there’s a strong tendency to nevertheless continue to date a similar personality.”

Using data from an ongoing multi-year study on couples and families across several age groups, Park and co-author Geoff MacDonald, a professor in the Department of Psychology at U of T, compared the personalities of current and past partners of 332 people. Their primary finding was the existence of a significant consistency in the personalities of an individual’s romantic partners.

“The effect is more than just a tendency to date someone similar to yourself,” says Park.

Participants in the study along with a sample of current and past partners, assessed their own personality traits related to agreeableness, conscientiousness, extraversion, neuroticism, and openness to experience. They were polled on how much they identified with a series of statements such as, “I am usually modest and reserved,” “I am interested in many different kinds of things” and “I make plans and carry them out.” Respondents were asked to rate their disagreement or agreement with each statement on a five-point scale.

Park and MacDonald’s analysis of the responses showed that overall, the current partners of individuals described themselves in ways that were similar to past partners.

“The degree of consistency from one relationship to the next suggests that people may indeed have a ‘type’,” says MacDonald. “And though our data do not make clear why people’s partners exhibit similar personalities, it is noteworthy that we found partner similarity above and beyond similarity to oneself.”

By examining first-person testimonials of someone’s partners rather than relying on someone’s own description of them, the work accounts for biases found in other studies.

“Our study was particularly rigorous because we didn’t just rely on one person recalling their various partners’ personalities,” said Park. “We had reports from the partners themselves in real time.”

The researchers say the findings offer ways to keep relationships healthy and couples happy.

“In every relationship, people learn strategies for working with their partner’s personality,” says Park. “If your new partner’s personality resembles your ex-partner’s personality, transferring the skills you learned might be an effective way to start a new relationship on a good footing.”

On the other hand, Park says the strategies people learn to manage their partner’s personality can also be negative, and that more research is needed to determine how much meeting someone similar to an ex-partner is a plus, and how much it’s a minus when moving to a new relationship.

“So, if you find you’re having the same issues in relationship after relationship,” says Park, “you may want to think about how gravitating toward the same personality traits in a partner is contributing to the consistency in your problems.”

The data for the research comes from the German Family Panel study launched in 2008, an ongoing longitudinal study on couple and family dynamics with a nationally representative sample of adolescents, young adults, and midlife individuals in Germany.

Story Source:
Materials provided by University of Toronto. Note: Content may be edited for style and length.

Journal Reference:
Yoobin Park, Geoff MacDonald. Consistency between individuals’ past and current romantic partners’ own reports of their personalities. Proceedings of the National Academy of Sciences, June 10, 2019; DOI: 10.1073/pnas.1902937116

Kathryn McNeer, LPC specializes in Couples Counseling Dallas with her sound, practical and sincere advice. Kathryn’s areas of focus include individual counseling, relationship and couples counseling Dallas. Kathryn has helped countless individuals find their way through life’s inevitable transitions; especially that tricky patch of life known as “the mid life crisis.” Kathryn’s solution-focused, no- nonsense counseling works wonders for men and women in the midst of feeling, “stuck,” or “unhappy.” Kathryn believes her fresh perspective allows her clients find the better days that are ahead. When working with couples, it is Kathryn’s direct yet non-judgmental approach that helps determine which patterns are holding them back and then helps them establish new, more productive patterns. Kathryn draws from Gottman and Cognitive behavioral therapy. When appropriate Kathryn works with couples on trust, intimacy, forgiveness, and communication.

Hoarding: Symptoms and Treatment Options

Hoarding is not simply a behavior. It is a mental health condition. In fact, there are different types of hoarding disorders. Oftentimes, hoarding is a subset of OCD, which itself is an anxiety disorder.

What Is Hoarding?

Hoarding is a condition in which a person keeps things that most other people would say are not valuable. Of course, it’s true that “one’s man junk is another man’s treasure.” However, if a person collects items to the point where it interferes with their lives in some significant way, and they are still unable to get rid of those items, then they are hoarding.

Some examples of hoarding negatively impacting someone’s life include:

Their home because difficult to live in due to clutter. They may be unable to cook, shower, sleep in a bed, or move around properly.
They can’t have people in to do normal home repairs because of the “stuff.”
The hoard leads to home damage such as rotting, mold, sagging foundations, etc.
Neighbors and/or city officials complain or take action against the home because of the hoard.
Hoarding limits emergency personnel’s access to the home and its occupants.
The hoard causes physical illness due to contamination, filth, dust, etc.
Animals in the hoard aren’t receiving proper care including medical treatment.
The hoard affects the person’s relationships with loved ones.
Inability to maintain steady employment due to conditions related to the home and/or to shopping to add to the hoard.

People with hoarding disorders often become extremely distressed at the idea of losing their stuff. If someone, such as loved one, comes in and cleans, they get very anxious and angry.

Hoarding and OCD

Compulsive hoarding is a form of obsessive-compulsive disorder (OCD), which is one type of anxiety disorder. Generally speaking, people with hoarding tendencies have high levels of anxiety and the hoarding behaviors helps soothe those anxieties. It’s important to note that although compulsive hoarding is very common among people with OCD, not all hoarding before is OCD-related.

Types of Hoarding

People can truly hoard almost anything. However, there are some common themes that relate to different types of hoarding. They include:

Paper Hoarding

Many hoarders have great anxiety about letting go of any little bit of paper. They worry that they will need the information on that paper and therefore can’t let it go. Their homes get overwhelmed with paper clutter. This can include:

Receipts
Bills
Invoices
Medical forms
Tax forms
Pay stubs
Printed-out copies of online conversations
Report cards
Children’s drawings
Notes, cards, and letters
Mail including coupons and junk mail
Newspapers
Magazines and books

Of course, we all keep some kind of paper clutter in our lives. However, hoarders won’t let go of anything. They often can’t find what they want in the mess. If asked to let go of something such as their child’s third grade report card, they may panic or get angry.

Animal Hoarding

There are laws in most areas limiting the number of pets a person is allowed to have. Those who go above that number may be animal hoarding. However, there’s more to it than this.

Animal hoarding means that, regardless of the law, the person has more animals than they can take care of. They physically, mentally, and financially do not have the means to provide for the animals. Therefore, the animals are undernourished and ill, often dying from unknown causes.

Despite this, the hoarder continues to believe that they love the animals and are even helping them. They don’t want to let any of them animals go to other homes. In fact, they keep acquiring more animals. They may put food out on the porch to encourage strays or even drive to various areas with traps to collect animals. They don’t spay or neuter the animals, so they breed prolifically.

Food Hoarding

Some people have a huge fear of running out of food or running out of the money to buy food. They stockpile. Their cupboards, refrigerator, freezer, pantry, and basement overflow with food and yet they keep buying more. Food hoarders rarely pay attention to expiration dates. They don’t want to throw out any food, even if it’s expired or clearly rotting.

Trash Hoarding AKA Hoarding Everything

There are some people whose hoarding is so generalized that they absolutely don’t want to get rid of anything. They’re sometimes called garbage hoarders because they keep things that other clearly consider to be trash. They don’t ever “take out the garbage.” They may see potential use in everything. Alternatively, throwing something out might just give them too much anxiety. People may keep empty containers and boxes, the plastic wrap off of opened products, or even things like toilet paper and dirty diapers if the hoarding has gotten so extreme.

Hoarding with Compulsive Shopping

People with compulsive shopping disorders don’t necessarily hoard. However, the two conditions can go hand-in-hand. The person shops impulsively and compulsively, often going into great debt but feeling unable to stop themselves. They never get rid of the items that they purchase; that’s the hoarding part. If they became unable to continue shopping because they lose all access to funds, then they may go “shop” in untraditional places such as dumpsters.

Symptoms of Hoarding

Each form of hoarding is a little bit different from the others. Individuals may experience hoarding to varying degrees. However, here are some common symptoms to look for:

The feeling that you just can’t throw something away
Justifying to others why you can’t get rid of things
High anxiety when asked to try to throw something away
Retrieving items from the trash after throwing them away
Inability to make decisions about what to keep and what to discard
Feeling overwhelmed by “stuff” but unable to do anything to change it
Stress when other people are near your things; worry that people will get rid of your items
Constant fear of not having enough, needing more, or losing something important

Of course, all of the examples described above of how hoarding can negatively impact someone’s life are also warning signs to look out for.

Treatment Options for Hoarding Disorder

Although not all compulsive hoarding is part of an OCD diagnosis, it’s often treated in the same way as OCD. Cognitive Behavioral Treatment and Exposure Response Prevention are two of the most common treatments to help people overcome hoarding. Oftentimes, the therapist will come to the individual’s home to help them work on their thoughts and behaviors in the hoarding environment.

Dr. Jeffrey Levine a Hartford Therapist Licensed Psychologist with over 40 years of clinical experience. He specializes in treating adults in individual psychotherapy, with expertise in trauma focused hypnosis, energy transformational healing and Internal Family Systems.

How the Body and Mind Talk To One Another

Have you ever been startled by someone suddenly talking to you when you thought you were alone? Even when they apologise for surprising you, your heart goes on pounding in your chest. You are very aware of this sensation. But what kind of experience is it, and what can it tell us about relations between the heart and the brain?

When considering the senses, we tend to think of sight and sound, taste, touch and smell. However, these are classified as exteroceptive senses, that is, they tell us something about the outside world. In contrast, interoception is a sense that informs us about our internal bodily sensations, such as the pounding of our heart, the flutter of butterflies in our stomach or feelings of hunger.

The brain represents, integrates and prioritises interoceptive information from the internal body. These are communicated through a set of distinct neural and humoural (ie, blood-borne) pathways. This sensing of internal states of the body is part of the interplay between body and brain: it maintains homeostasis, the physiological stability necessary for survival; it provides key motivational drivers such as hunger and thirst; it explicitly represents bodily sensations, such as bladder distension. But that is not all, and herein lies the beauty of interoception, as our feelings, thoughts and perceptions are also influenced by the dynamic interaction between body and brain.

The shaping of emotional experience through the body’s internal physiology has long been recognised. The American philosopher William James argued in 1892 that the mental aspects of emotion, the ‘feeling states’, are a product of physiology. He reversed our intuitive causality, arguing that the physiological changes themselves give rise to the emotional state: our heart does not pound because we are afraid; fear arises from our pounding heart. Contemporary experiments demonstrate the neural and mental representation of internal bodily sensations as integral for the experience of emotions; those individuals with heightened interoception tend to experience emotions with greater intensity. The anterior insula is a key brain area, processing both emotions and internal visceral signals, supporting the idea that this area is key in processing internal bodily sensations as a means to inform emotional experience. Individuals with enhanced interoception also have greater activation of the insula during interoceptive processing and enhanced grey-matter density of this area.

So what is enhanced interoception? Some people are more accurate than others at sensing their own internal bodily sensations. While most of us are perhaps aware of our pounding heart when we are startled or have just run for the bus, not everyone can accurately sense their heartbeats when at rest. Interoceptive accuracy can be tested in the lab; we monitor physiological signals and measure how accurately these can be detected. Historically, research has focused on the heart, as these are discrete signals that can easily be quantified. For example, a typical experiment might involve the presentation of a periodic external stimulus (eg, an auditory tone) that is time-locked to the heartbeat, such that each tone (‘beep’) occurs when the heart is beating, or in between heartbeats. Participants state whether this external stimulus is synchronous or asynchronous with their own heart. An individual’s interoceptive accuracy is an index of how well they are able to do this.

It is also possible to measure subjective indices of how accurate people think they are at detecting internal bodily sensations, ascertained via questionnaires and other self-report measures. My work shows that individuals can be interoceptively accurate (ie, good at these heartbeat-perception tests) without being aware that they are. In this way, interoceptive signals can guide and inform without fully penetrating conscious awareness.

Individual differences in interoception can also be investigated using brain-imaging methods, such as through brain representation of afferent signals (eg, heartbeat-evoked potentials expressed in a neural EEG signal). Functional neuroimaging (fMRI) can also be used to investigate which areas of the brain are more active when focusing on an interoceptive signal (eg, the heart) relative to an exteroceptive signal (eg, an auditory tone).

Our hearts do not beat regularly and, while we can identify that our hearts race with fear or exercise, we might not fully appreciate the complexity of the temporal structure underlying our heartbeats. For example, cardiac signatures are also associated with states such as anticipation. Waiting for something to happen can cause our heartrate to slow down: this will happen at traffic lights, when waiting for them to go green. These effects of anticipation, potentially facilitating the body and mind to adopt an action-ready-state, highlight the meaningful composition of internal bodily signals.

Internal bodily signals can be deeply informative, which is why sensing them can provide an extra channel of information to influence decision making. Gut instinct or intuition during a card game can also be guided by interoception. Bodily signatures (heart rate, skin-conductance response) can signal which cards are good (ie, more likely to be associated with a positive outcome) even in the absence of conscious knowledge that a card is good. Thus, the heart ‘knows’ what the mind does not yet realise, and access to this bodily signature can guide intuitive decision making to a better outcome. In a real-world extrapolation of this, I visited the London Stock Exchange to work with high-frequency traders. These traders claimed that their decisions were often driven by gut instinct, when faced with fast-coming information that the conscious brain could not yet fully process. My colleagues and I demonstrated that interoceptive accuracy was enhanced in those traders who were most adept at trading, potentially grounding their intuitive instincts in a capacity to sense informative changes in internal bodily signals.

An appreciation that bodily signals can guide emotion and cognition provides potential interoceptive mechanisms through which these processes can be disrupted. Alexithymia, defined as an impaired ability to detect and identify emotions, is associated with reduced interoceptive accuracy. Autistic individuals, who often have difficulty in understanding emotions, have also been shown to have impaired interoceptive accuracy. Neural representation of bodily signatures are altered in borderline personality disorder (also known as emotionally unstable personality disorder), and interventions designed to focus on the body, such as mindfulness, have been shown to reduce anxiety. Insight into the nature of these embodied mechanisms opens up potential avenues for further understanding and targeted intervention.

As well as telling us about our own emotions, our bodies respond to the joy, pain and sadness of others. Our hearts can race as loved ones experience fear, and our pupils can adopt a physiological signature of sadness in response to the sadness of others. If you pay attention to your heart and bodily responses, they can tell you how you are feeling, and allow you to share in the emotions of others. Interoception can enhance the depth of our own emotions, emotionally bind us to those around us, and guide our intuitive instincts. We are now learning just how much the way we think and feel is shaped by this dynamic interaction between body and brain.

Sarah Garfinkel is professor of neuroscience and psychiatry at the University of Sussex. Her work has been published in the Harvard Review of Psychiatry and Brain: A Journal of Neurology, among others. She lives in Brighton.

Dr. Jeffrey LevineCounseling Hartford – is a Licensed Psychologist with over 40 years of clinical experience. He specializes in treating adults in individual psychotherapy, with expertise in trauma focused hypnosis, energy transformational healing and Internal Family Systems. Therapist serving Hartford – Mansfield – Glastonbury.

The Intersection of Chronic Illness and Sex

According to the Centers for Disease Control and Prevention, chronic diseases affect 133 million Americans, representing more than 40% of the population of this country. By 2020, that number is projected to be an estimated 157 million, with 81 million having multiple conditions. Chronic illness can have profound negative effects on a relationship and sexual satisfaction. More Americans are living with not just one chronic illness, such as diabetes, heart disease or depression, but with two or more conditions. Almost a third of the population is now living with multiple chronic conditions.

Many chronic diseases can cause problems with sexual function. These conditions can include diabetes, heart and vascular diseases, neurological, and autoimmune diseases. Recent research suggests that sexual dysfunction in couples may be one of the least talked about symptoms of chronic illness.

Experiencing a chronic illness can be earth-shattering. Individuals who are chronically ill often experience emotional distress. This includes the person’s ability to engage in occupational, social, and recreational activities. But what is its impact on sex and the couple? Sex can involve a mix of feelings and emotions when battling a chronic illness. Life becomes uncertain and you both feel at a loss. Your partner feels overwhelmed because you feel shame. You may feel less attractive, less confident, and concerned about how your body works and adapts to an illness. You both become plagued with anxiety due to the worry of sexual activity, and with desire and arousal issues.

When experiencing a chronic illness, some changes may be physical, such as the changes with your body, side effects from medication, sexual dysfunction, fatigue, and pain. You may experience psychological changes such as depression and anxiety. Most of all, there is constant fear around your sexual ability and your sexual performance. We all know that physical intimacy is paramount to the quality of life, and it is still important if you are living with a chronic illness.

Your relationship as a couple can affect the development and management of a chronic illness in a variety of ways. When the both of you are at the optimal balance between intimacy and autonomy, your boundaries touch yet remains distinct. It is critical that both of you are aware of each other’s needs and emotions. Why is this so important? Because this will drive and determine the sexual intimacy in your relationship. It is important to note that your previous success in resolving sexual intimacy concerns will determine how well the both of you will cope with an illness.

Since general coping skills and sexual function are linked in the chronically ill, it is important to identify and foster strengths in your relationship that can mitigate the stress of illness. Even during an illness, relationships should not be neglected. Illness can make each partner vulnerable to fear and loss and to loneliness. Taking time to communicate and to reduce the impact of the illness on intimacy is the key to maintaining happiness despite health problems. One part of that intimacy is sexuality. What people don’t know is that with a life restricted by pain and illness, sex can be a powerful source for comfort, pleasure and intimacy. You and your partner can learn what is possible as opposed to what was once achievable by enhancing their sexual awareness, communication, and sexual styles.

Here are my tips:

Communicate your needs to your partner and have them communicate their needs. Problem-solve together by making it a team approach. State your emotional needs around sexual intimacy and the other factors in your relationship.

Consider couples psychotherapy. I recommend you see a sex therapist. I say this because they will have the knowledge and skill set in helping you and your partner with sexual problems such as the issues related to sexual functioning. They will also provide you with other suggestions to engage in if there is sexual dysfunction (i.e., desire and arousal issues, erectile dysfunction, and sexual pain).

Read up on your condition and share this with your partner. Having knowledge on the illness can bring you closer together. This can build intimacy!
Check in with each other. For the partner who does not have a chronic illness, watch for depression in them and keep an eye on their health as well. The goal here is to be lover not a caregiver, but we find at times, the partner may take on this role. They may want to seek individual counseling. This is healthy!

Acknowledge your loss and build a relationship with the illness. This can help the both of you develop the “new normal” in your relationship. With acceptance, the issue isn’t whether or not you can come to some profound insight about the nature of the illness and your experience with the illness, but rather, it is about how to live your life day to day. The ultimate goal is to accept condition and learn to live well with it. Of course, this is not easy. I watch couples experience this all the time in my practice and when they finally decide to work as a team instead of opponents or avoiders, there is this sense of hope that emerges. This hope promotes what is possible instead of what is achievable. They also report a healthier sex life.

Address stress as much as possible. I would not avoid the stress. Avoidance can make the pain worse or it cause a flare up. I see this all the time with my clients with fibromyalgia. I know this is easier said than done, but try to address the financial issues and the divisions of family responsibilities. Addressing these stressors can help promote the desire in being physically intimate.

Try to be sociable. Socially isolating is common for people with a chronic illness. Try to find a balance where you can be sociable because this can make you feel more positive about life.

Being kind is great. Doing something for your partner can build what is needed for sexual intimacy.

Resources:

Enzlin, P. (2014). Sexuality in the context of chronic illness. In Y. Binik & K. Hall (Eds), Principles and practices of sex therapy (5th ed., pp. 436-456). New York, NY: The Guilford Press.

Schover, L.R., & Jensen, S. B. (1988). Sexuality and chronic illness: A comprehensive approach. New York, NY: The Guilford Press.

By Dr. Lee Phillips

Jennifer Josey LPC LMFT CSAT of Intuitive Pathways Recovery specializes in Sex Addiction Counseling Houston Texas, love addiction, recovery for couples from sex and love addiction, trauma resolution for partners of sex addicts and group therapy. Sexual addiction is a serious problem that affects people of all socioeconomic status, educational status, both males and females and even teenagers and preadolescent children.

Common Relationship Challenges

Like most interpersonal relationships, most romantic couples experience some challenge at some point in their relationship. Some of these common challenges may include infidelity, loss of intimacy, communication difficulties, coping with stress challenges, financial pressures, boundary violations, difficulty balancing individual and couple expectations, divorce, separation and breaking up. Whatever the challenge, it is important to note that all dyadic relationships will experience some kind of distress at some point. We will examine some of the more common romantic relationship challenges below.

Infidelity

Infidelity is increasingly becoming one of the most common relationship challenges in romantic relationships. The acts of infidelity or cheating can have devastating consequences on those involved. Having been cheated on can result in anguish, depression, fury and humiliation (Brand, Markey, Mills & Hodges, 2007). It has been suggested that infidelity is one of the leading causes of divorce and romantic relationship breakdown (Brand, Markey, Mills & Hodges, 2007).

Generally, infidelity is a violation of trust by one or both members of a monogamous romantic relationship that involves a third party individual, with whom one member has an improper relationship. Zola (2007) defines infidelity as an act of emotional and/or physical betrayal characterised by behaviour that is not approved by the other partner and that has contributed to considerable ongoing distress in the non offending partner. Infidelity can be in the form of an emotional affair, a sexual affair or a combination of both. Traditionally, men are considered to be primarily interested in sexual infidelity and women are considered to be primarily interested in emotional infidelity (Zola, 2007).

Zola (2007) suggests that there has always been a greater emotional need or tie when it comes to women and affairs, while men tend to have an affair primarily for sex. One of the reasons given for women’s preference to emotional affairs is to “mate switch”. This refers to the quest of finding a partner without giving up the security derived from the current partner (Brand, Markey, Mills & Hodges, 2007). Infidelity prevalence rates vary according to gender with female incidents reported to be 10% to 15% lower than those of their male counterparts (Zola, 2007).

In resolving this matter, women are found to be more likely to forgive a sexual infidelity where as men find it the most difficult to forgive (Zola, 2007). In support for this argument, Long and Young (2007) suggest that men are more approving of affairs for sexual reasons where as women are more approving of affairs of emotional justification. It is not uncommon that couples who have experienced infidelity in their relationships experience challenges in their attempts to resolve relational problems associated with it. As such, infidelity is considered one of the most challenging issues to treat in couple therapy (Zola, 2007; Brand, Markey, Mills & Hodges, 2007).

Intimacy

The word intimacy has taken on sexual connotations. But it is much more than that. It includes all the different dimensions of our lives. It involves the physical, social, emotional, mental and spiritual aspects as well as sexual components that can enhance the feelings of togetherness between the romantic couple (Larson, Hammond & Harper, 1998). According to Sternberg’s theory of love, intimacy includes emotional bonding and feelings of connectedness. Sternberg suggests that intimacy develops during the course of the relationship and will usually include decisions of loyalty to the relationship (Long & Young, 2007).

Intimacy has also been conceptualised as a sense of self disclosure, sharing of one’s self and feeling closer to one’s partner. Intimacy is maintained by engagement in intimate conversation (Brunell, Pilkington & Webster, 2007; Kirby, Baucom & Peterman, 2005) and is considered a major part of romantic relationships. It is also an important factor for psychological wellbeing and is linked to positive and satisfying relationships (Brunell, Pilkington & Webster, 2007; Long & Young, 2007).

It is fair to assume that the quality of the romantic relationship will often be judged by the frequency of intimate interactions as perceived by each individual. It is these unmet intimacy expectations that can often affect the relationship negatively and pose challenges for the couple (Kirby, Baucom & Peterman, 2005). Therapists dealing with loss of intimacy in romantic relationships should help clients develop trust and communication skills that can help to overcome barriers to intimacy.

Conflict

Conflict is part of any interpersonal relationship and occurs as a result of differences in opinions. People differ in values, dreams, desires and perceptions. Therefore, we are all bound to encounter conflict at some point in our lives (Long & Young, 2007). Conflict can range from less serious mild disagreements to more intensely heated arguments. Previous research has found that marital conflict often stems from unmet needs, wants, and desires. From this perspective, marital conflict is defined as a process of interaction in which one or both partners feel discomfort about some aspect of their relationship and try to resolve it in some manner (Hamamci, 2005).

When one person needs or wants something badly enough, and the other person is unwilling or unable to meet that need, resentment will often grow. Then, if one were to add the power of an unruly tongue, the situation will usually become ripe for very destructive forms of conflict. To look at it pragmatically, romantic relationship conflict will often happen when one member of the couple perceives inequity or experiences an imbalance in rewards or benefits from being in the relationship whereby it is perceived by one member of the couple that the other only cares about his/ her individual needs (Long & Young, 2007).

The negative consequences of conflict are probably familiar to all of us. Conflict can cause psychological pain that manifests in withdrawal and distance, depression, anxiety and/or aggression. Not only between the couple but also with those who are living around them (Choi, 2008). However, there are also constructive outcomes to conflict in romantic relationships. For instance, people who continue to relate to one another despite their conflict may build greater trust and confidence in each another and become more apt in their ability to resolve their problems (Johnson, 2007). However, reoccurring conflict is usually a symptom of a problem in the romantic relationship and therefore should be addressed intentionally by the couple. The role of the counsellor, when dealing with couples who are experiencing conflict, is to help them identify the source of such conflict and its style to assist them in implementing skills to resolve the disagreements (Relationships Australia, 2009).

Communication

A good healthy romantic relationship is often characterised by good communication. Healthy couples speak openly and directly with congruent non verbal cues allowing them to convey the intended message accurately. Communication in romantic relationships connects and reassures partners and allows them to discuss and solve problems and share important information and views (Long & Young, 2007). Challenges occur when the messages we send to the other are misunderstood or misinterpreted.

It is not uncommon when a couple experiences problems in their relationship, communication becomes broken (Long & Young, 2007). Healthy, productive and effective communication is viewed as the binding tool for any romantic relationship. Problems and challenges in intimate relationships are often resolved through developing healthy, productive and effective communication. Therefore, the goal of enhancing communication skills may be a great starting point for the couple therapist.

Sexual Problems

Sexual intimacy is one of the most important factors in romantic relationships. It is one of the factors that differentiate a romantic relationship from any other interpersonal relationship. Sexual problems like all other problems in romantic relationships often develop as a result of an imbalance in the partner’s styles of loving (Long & Young, 2007). In the early stages of the relationship, it is common for couples to experience intense feelings of love, affection and a strong desire for one another. As the relationship grows, external factors such as children and busy schedules can begin to have an impact on the sexual intimacy of the couple, often resulting in frustrations experienced by at least one member of the relationship. As the frustrations develop over time, problems may begin to surface.

Sometimes sexual challenges may occur as a result of sexual dysfunction. Sexual dysfunctions are characterised by psychosocial disturbances in sexual desire resulting in distress and interpersonal difficulty (APA, 2000). According to the DSM- IV-TR, some of the common sexual dysfunction disorders include sexual desire disorder, sexual arousal disorder, and orgasmic disorders. It is crucial for the therapist to differentiate sexual problems from sexual dysfunctions in order to determine the appropriate referral when necessary. If sexual problems are an issue the therapist can help clients explore options for achieving emotional and sexual intimacy in their relationships.

Substance Abuse

While substance abuse, particularly alcohol, has been associated with financial problems and health problems that contribute to relational distress, many people use it as a way of coping with the problems in their relationships. The first issue, of course, is money. Alcohol is expensive. Spending a great deal of money each day on alcoholic beverages is a serious problem that can put a great deal of strain on relationships. Alcohol can cause people to become less sensitive to the feelings of others too. Alcohol can make it difficult for people to distinguish between the other person’s emotions, and thus they may make incorrect judgments that negatively impact their relationship with their partner (Sharf, 2001).

Time is an issue as well. Drinking is not a “one and done” type of activity. It can take hours out of the day, hours that could have been spent as a couple. The imposition on couple time from excessive drinking can cause partners to emotionally drift apart often resulting in problems within the dyadic relationship. Because of these and other factors, alcohol abuse has been singled out as a contributing factor to divorce, physical abuse and lowered marital satisfaction (Long & Young, 2007).

Divorce and Breaking Up

Divorce rates are increasing at an alarming rate. In Australia, 40% of marriages end up in divorce where as in USA, 50% of marriages end up in divorce (www.divorcerates.org). For romantic relationships that continuously experience high distress, low satisfaction and low relationship quality, at some point one partner or both come to a decision to end or terminate the relationship, if such challenges are not resolved. According to ideas derived from social exchange theory, termination of marriages and romantic relationships will often occur as a result of costs exceeding rewards. If the individual perceives that they are not getting more than what they have invested in the relationship, this may lead to dissatisfaction with the relationship (Amato & Hohmann-Marriott, 2007).

Divorce and break up can be a difficult and painful experience for many. The termination of a relationship or divorce can affect an individual financially, socially, emotionally and psychologically (Long & Young, 2007). Feelings of depression, anxiety and other psychiatric disorders are often experienced during this time (Williams & Dunee-Bryant, 2006). The role of the therapist is to assist clients through this life changing transition.

References:

American Psychiatric Association, (2000). Diagnostic and Statistical Manual of Mental Disorders. (4th ed.). Text Revision. Washington, DC: American Psychiatric Association.

Brand, R.J., Markey, C.M., Mills, A., & Hodges, S.D. (2007). Sex differences in self reported infidelity and its collates. Sex Roles , 57, 101-109.

Brunell, A.B., Pilkington, C.J., & Webster, D.G. (2007). Perceptions of risk in intimacy in dating couples: conversation and relationship quality. Journal of Social and Clinical Psychology. 26, 92-119.

Choi, H. (2008). Marital Conflict, depressive symptoms and functional impairment. Journal of Marriage and Family, 70, 377-390

Hamamci, Z. ( 2005). Dysfunctional relationship beliefs in marital conflict. Journal of Relational Emotive and Cognitive Behavioural Therapy, 23, 245-261.

Kirby, J.S., Baucom, D.H., & Peterman, M.A. (2005). An investigation of unmet intimacy needs in marital relationships, Journal of Marital and Family Therapy, 31, 313-325.

Long, L.L., & Young, M.E. (2007). Couselling and Therapy for Couples. (2nd ed.). Belmont, CA: Thompson.

Johnson, S.M. (2007). The emotionally focused couples therapy. Journal of Contemporary Psychotherapy. 37, 47-52.

Zola, M.F. (2007). Beyond infidelity related impasse: an integrated, systematic approach to couples therapy. Journal of Systematic Therapies, 26, 25-41.

Source: mentalhealthacademy.com.au

Christiane Blanco-Oilar, Ph.D. offers compassionate psychological services for individuals and couples therapy Fort Lauderdale. I enjoy working with individuals and couples going through life transitions, relationship challenges or identity exploration, or those experiencing grief and loss, depression, anxiety, postpartum depression and eating disorders. My goal is to help you recognize, understand and have compassion for how you may have developed less-than-ideal ways of dealing with specific areas of your life.

Can CBD Oil Help Anxiety?

Cannabidiol is a compound derived from cannabis plants. It may help people with anxiety reduce their symptoms with few or no side effects.

Research on cannabidiol oil (CBD oil) is still in its infancy, but there is mounting evidence to suggest that some people can get relief from anxiety. In this article, we examine what CBD oil is and how it may help reduce anxiety symptoms.

What is CBD oil?

Cannabidiol is extracted from cannabis plants and can be used as an oil. CBD oil is rich in chemicals called cannabinoids that bind to specialized receptors in the brain.

The best-known cannabinoid is tetrahydrocannabinol (THC), which causes the “high” people feel after using marijuana.

THC, however, is just one of many cannabinoids. Cannabidiol also binds to these receptors but does not produce a high. Proponents argue that cannabidiol oil has many health benefits, ranging from slowing the growth of cancer to improved mental health.

CBD oil is edible and can be used as a cooking oil or added to food. People may also take it as a medication by consuming a few drops. CBD oil should not be smoked, and there is no evidence that smoking it offers any benefits.

Does CBD produce a high?
CBD oil derived from hemp will not produce a “high.” Hemp is a type of cannabis plant grown for industrial use, such as making paper and clothing. Unlike other cannabis plants, hemp has not been specially bred to produce high levels of THC.

Cannabidiol may be sold as a type of hemp oil with trace amounts of THC. So, someone using cannabidiol might still test positive for THC on a drug test, even though they will not experience any alterations of mental state after using the oil.

CBD oil and anxiety

Much of the research on cannabis products has looked at the use of marijuana rather than at CBD oil as a standalone product.

Some studies have found that cannabis might help anxiety. Others suggest that having anxiety is a risk factor for recreational marijuana use, or that using marijuana can make a person more vulnerable to anxiety.

People interested in managing their anxiety with CBD oil should look exclusively at research on cannabidiol, not generalized studies of medical marijuana. Although there are fewer studies on cannabidiol specifically, the preliminary research is promising.

A small 2010 study found that cannabidiol could reduce symptoms of social anxiety in people with social anxiety disorder (SAD). Brain scans of participants revealed changes in blood flow to the regions of the brain linked to feelings of anxiety.

In this study, cannabidiol not only made participants feel better but also changed the way their brains responded to anxiety.

A 2011 study also found that cannabidiol could reduce social anxiety. For that study, researchers looked specifically at cannabidiol to treat anxiety associated with public speaking.

Research published in 2014 found that CBD oil had anti-anxiety and antidepressant effects in an animal model.

A 2015 analysis of previous studies concluded that CBD oil is a promising treatment for numerous forms of anxiety, including social anxiety disorder, panic disorder, obsessive-compulsive disorder, generalized anxiety disorder, and post-traumatic stress disorder.

The report cautioned, however, that data on long-term use of CBD oil is limited. While research strongly points to the role of cannabidiol in treating short-term anxiety, little is known about its long-term effects, or how it can be used as a prolonged treatment.

A 2016 case study explored whether cannabidiol could reduce symptoms of post-traumatic stress disorder (PTSD) and anxiety-provoked sleep disorder in a child with a history of trauma. Researchers found that cannabidiol reduced the child’s anxiety and helped her sleep.

Considerations

Research on the use of cannabis suggests that it may have negative health effects, particularly when smoked.

Research specifically on cannabidiol, however, has found few or no negative side effects. This means CBD oil may be a good option for people who do not tolerate the side effects of other medications for anxiety, including addiction.

Not all states in the United States have specifically legalized CBD oil, although some have legalized it for only specific purposes.

A person should educate themselves about the potential risks of purchasing or using it. While CBD oil is not listed on the Controlled Substances Act (CSA), a person should consult their doctor before using it to treat anxiety.

Because CBD oil is not regulated as a medical treatment for anxiety, it is unclear what dosage a person should use, or how frequently they should use it. A person should consult a doctor who has experience with CBD oil to determine the right dosage for their needs.

By Zawn Villines

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving anxiety depression and adult ADHD. Medical Marijuana is one of the many treatments Dr. Ditzell offers to treat a variety of mental health issues.

Ketamine Used As An Antidepressant

Long used as an anaesthetic and analgesic, most people familiar with ketamine know of it for this purpose. Others know it as a party drug that can give users an out-of-body experience, leaving them completely disconnected from reality. Less well known is its growing off-label use in the USA for depression, in many cases when other options have been exhausted.

David Feifel, a professor of psychiatry at the University of California, San Diego, was one of the first clinicians to use ketamine off-label to treat depression at UCDS’s Center for Advanced Treatment of Mood and Anxiety Disorders, which he recently founded. “Currently approved medications for depression all have about the same, very limited efficacy. A large percentage of patients with depression do not get an adequate level of relief from these antidepressants even when they have tried several different ones and even when other drugs known to augment their effects are added to them”, Feifel tells The Lancet Psychiatry. “The stagnation in current antidepressant medication on the one hand, and the tremendous number of treatment-resistant patients, has propelled me to explore truly novel treatments like ketamine.”

Compelling published study results and case reports exist of patients’ depression—in some cases deeply entrenched depression that has lasted months or even years—alleviating within hours of use of ketamine. However, critics have warned that the drug has not been studied sufficiently (at least outside clinical trials), and also emphasied the cost. Patients can pay more than $1000 per session for treatment that must usually be repeated several times. That cost is rarely covered by the patient’s medical insurance.

The balance between prescribing ketamine off-label to patients with depression (who have exhausted other options) against making all patients wait until ketamine or a derivative is licensed for depression is the key ethical dilemma, says Dominic Sisti, an assistant professor in the Department of Medical Ethics and Health Policy at the Perelman School of Medicine, University of Pennsylvania, PA, USA. “I don’t think patients who have exhausted all options should have to wait, but I worry that off-label use is not being properly monitored”, says Sisti. “If patients are fully competent and informed, they should have the right to access ketamine—but we have to be sure they understand it is basically an experimental treatment. This is a vulnerable patient population.”

Another criticism is that patients who have exhausted treatment options might be willing to try anything. “This implies that patients with treatment-resistant depression (TRD) may be so desperate for relief that their ability to perform an appropriate calculation of the risks and benefits of trying ketamine is impaired. This insinuation infuriates many TRD patients in my experience”, says Feifel. “The other assumption is an implicit one that somehow using ketamine for depression is highly risky or fraught with many side effects. Both are simply wrong.”

Advocates of ketamine use in depression are excited because it has a different mechanism of action to standard antidepressants, which affect signalling by monoamine neurotransmitters such as serotonin, noradrenaline, or dopamine. Ketamine is thought to act by blocking N-methyl-d-aspartate (NMDA) receptors in the brain, which interact with the aminoacid neurotransmitter glutamate. The resultant chemical changes in the brain caused by ketamine are not yet fully understood, but could involve ketamine-induced gene expression and signalling cascades that act long after the drug has been eliminated from the body. Meanwhile, critics say that the adverse effects of the drug, including the emergence reactions (hallucinations, dreams, and out-of-body experiences) sought after by recreational users, need further study before long-term use of ketamine can be approved for depression. Feifel states that he has patients who have been receiving ketamine treatments every 2–4 weeks for long periods, some for around 3 years, and has not yet seen any safety issues arise.

Pharmaceutical companies are entering this exciting arena by attempting to develop new drugs based on ketamine without similar side-effects. Naurex, situated in Evanston, IL, USA, recently reported results from a phase 2 study of its drug GLYX-13, which reduced depression in around half of the 400 patients in the study without any psychotic side-effects. The drug is given by injection once every 1–2 weeks, and should enter phase 3 trials later in 2015. Other pharmaceutical companies are developing drugs with other modes of administration. Johnson & Johnson (New Brunswick, NJ, USA) are developing a nasal spray containing a ketamine derivative, Crecicor (Baltimore, MD, USA) is developing a once-daily oral pill, and Naurex is also developing an oral version of GLYX-13. However, Feifel dismisses the notion that the dissociative so-called trip induced by ketamine is actually an important negative side-effect. “I have not had a single patient discontinue treatment due to the dissociative psychedelic experience”, he explains. “Although I have had a couple patients have unpleasant ‘trips’, it’s exceedingly rare, usually dose related, and very transitory due to ketamine’s rapid metabolism.” Feifel says that, more often than not, patients find the trip to be positive, or even spiritual, and believe it is an important component of the antidepressant effect they experience afterwards. “There is no doubt the dissociative effect represents a logistical issue, requiring monitoring—and this should be addressed in any approval given for ketamine”, he adds.

In the UK, ketamine has been used in two clinical trials for treating depression. Rupert McShane is the lead consultant for the local electroconvulsive therapy (ECT) service based at Oxford Health NHS Foundation Trust, Oxford, UK. His clinic took part in a UK National Institute for Health Research study (REDKITE) in which ketamine was administered for TRD in a series of 28 cases. These patients were largely referred by secondary care psychiatrists, but some contacted McShane’s team following advertising or after reading about the study on the internet. Some patients had been actively looking for somewhere where they could receive ketamine treatment.

“Our team used one of the beds in the recovery bay of the ECT suite to administer ketamine during sessions where other patients—not those receiving ketamine infusions—were receiving ECT”, explains McShane. “This had the advantage of having a team present which is familiar with treating resistant depression, and also an anaesthetist. Despite evidence of the efficacy of ECT, many patients are unwilling to try it. Thus, ketamine or similar compounds may have a role in those who would otherwise have had ECT.”

McShane adds that his team is “exploring what options there may be for providing a ketamine service for people with treatment resistant depression”. He explains that intravenous infusions seemed to clearly establish whether someone was a responder or not. “Our experience was that a second infusion was necessary in order to be able to decide whether someone was a responder, but if they have not responded by then, then they will not respond to further infusions at the same dose”, explains McShane. “Its effect in those people who respond is dramatic. However, it is hardly surprising that a single dose does not usually have an enduring effect—one would not expect that of a single dose of any antidepressant.” He adds, however, that “a few people seem to have much more prolonged responses—for several months. So far, the only way we know of to create a sustained effect in someone who has a brief response is to give it repeatedly, and also through co-prescription of conventional antidepressants which may also prolong the effect. I cannot see a future in which we will not be harnessing the use of ketamine in some way.”

In terms of the safety profile of ketamine, McShane believes that adverse effects of long-term ketamine use on the bladder, which have been reported in people who misuse it recreationally, are strongly dose and frequency related, and have not occurred in the context of medical use. “The dissociative side-effects are clearly dose related. Some patients will get benefit from ketamine at doses which do not cause them, but there is likely to be a trade-off”, he explains. “Ketamine is safe enough, and there has been so much experience of it, that it is on the WHO essential drugs list. Tolerance may develop, especially if used very frequently, but this would only be problematic if ad libitum use was proposed. Routes such as intranasal, oral, intramuscular, and sublingual all have potential advantages and disadvantages in this regard. Yet whether alternative related compounds will have real safety advantages over ketamine would require formal study: it will be expensive to show that, for a dose of equivalent efficacy, their long-term safety is as good as ketamine.”

Sisti cautions that any clinicians giving ketamine for depression should be fully trained in ketamine administration. “Many are but some may not be”, he says. “Clinics should be outfitted with appropriate emergency equipment, and staff trained on its use. The FDA should set up a voluntary reporting system to track outcomes or adverse events so that some data can be gathered in the field on the safety and efficacy of ketamine for depression.”

Feifel says that it is not for him, but for his patients to decide where the balance of risks and benefits lies in trying ketamine to treat their depression. “I live in a different world from my patients and each one of them in turn lives in a different world from each other”, he explains. “We each place a different value on things, have different priorities, have differing notions of what makes life worthwhile but most importantly, unlike many of the people who come to see me, I am not experiencing the perpetual misery that makes every waking moment a struggle not to end my life. So it is much easier for me to place more weight on the unlikely negative possibilities of a treatment than the more likely potential benefits —this is the trap pundits who decry this off-label use are falling into. One could make a compelling argument that it’s unethical to withhold ketamine treatments from someone who has chronic, severe treatment resistant depression. But I know this from the patients who tell me they would not be in this world right now if it were not for the ketamine.”

Feifel concludes that it is straightforward to talk to TRD patients about ketamine. “I tell them all the relevant information. The efficacy rates, time to onset of benefits, duration limitations, alternatives, lack of insurance coverage, and other information. My job is to make sure they understand the parameters of the treatment, not to decide whether they should do it.”

By Tony Kirby for The Lancet

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving anxiety depression and adult ADHD. Ketamine for Depression is one of the many treatments Dr. Ditzell offers to treat a variety of mental health issues.

Communicating & Taking Responsibility

Your significant other is not a mind reader. Well, they’re most likely not a mind reader. Unless your significant other possesses some kind of mythical powers that allow them to tap into your deepest thoughts and feelings, if you don’t say how you feel, they really won’t have any idea. Despite the practice of proper communication being difficult at first, explicitly explaining to your partner how you’re feeling is the cornerstone of a healthy relationship.

Taking responsibility for your feelings is the best way to ensure that your needs are being met and you’re consistently happy in your relationship. Need some tips on how to make that happen? Keep reading to learn how Couples Counseling Costa Mesa can help you learn this valuable skill.

If you and your partner aren’t communicating properly, it can be a difficult, lonely and painful road to be on. By taking responsibility for your relationship and working on your communication skills, you can work towards a strong relationship built on mutual trust and respect.

Communication is a two-way street-If you and your partner are having trouble communicating; it is necessary that you both work towards a resolution. If both people in a relationship aren’t talking and listening effectively, it simply doesn’t work. Communication is also a delicate balance. Both partners need to do equal amounts of listening and speaking. Doing too much of one and too little of the other is almost as dangerous as not communicating at all.

Take responsibility

If you missed an important deadline at work could you tell your boss “I didn’t open my email so I didn’t know I should be working on something”? Probably not. Most likely, you’d never think about being so irresponsible at work, so why should it be allowed in your relationship? If you aren’t being an active participant in your relationship by listening, speaking, and being proactive, don’t be surprised if your significant other is starting to get frustrated.

Be forgiving

Strong communication is hard work, and it takes a while to master. Being (or having) a forgiving partner to encourage you along the way is incredibly important to your overall well being. Being forgiving also breaks down resentment and stops the incessant “blame game” that often occurs when commutation breaks down. Being a forgiving person also helps you forgive yourself, which is a great overall skill to master.

Know that this isn’t easy

Communicating and taking responsibility for yourself and your feelings take some getting used to and at the least, a little bit of work for both you and your partner. If you need some help to start in the right direction, Couples Counseling Costa Mesa can help. Couples Counseling Costa Mesa provides premier couples counseling services that can help your relationship flourish. I have years of experience necessary to help you work on your communication issues both now and in the future. Contact Couples Counseling Costa Mesa today and start working on your happily ever after.

Patrice Hooke, LMFT uses practical honest feedback and focus on the strengths of my clients to help them reach their goals. I believe that with honesty, compassion and understanding, we can all find healing and have a more fulfilling life. She is especially passionate about couples counseling Costa Mesa.

The Cerebral Mystique

Neuroscience gives us invaluable, wondrous knowledge about the brain – including an awareness of its limitations

More than 2,000 years ago, the semi-mythical father of medicine, Hippocrates of Kos, challenged the spiritualists of his time with a bold claim about the nature of the human mind. In response to supernatural explanations of mental phenomena, Hippocrates insisted that ‘from nothing else but the brain come joys, delights, laughter and sports, and sorrows, griefs, despondency, and lamentations’. In the modern age, Hippocrates’ words have been distilled into a Twitter-friendly pop-neuroscience slogan: ‘We are our brains.’ This message resonates with recent trends to blame criminality on the brain, to redefine mental illness as brain disease and, in futuristic-technological circles, to imagine enhancing or preserving our lives by enhancing or preserving our brains. From creativity to drug addiction, there is barely an aspect of human behaviour that has not been attributed to brain function. To many people today, the brain seems like a contemporary surrogate for the soul.

But lost in the public’s romance with the brain is the most fundamental lesson neuroscience has to teach us: that the organ of our minds is a purely physical entity, conceptually and causally embedded in the natural world. Although the brain is required for almost everything we do, it never works alone. Instead, its function is inextricably linked to the body and to the environment around it. The interdependence of these factors is masked however by a cultural phenomenon I call the ‘cerebral mystique’ – a pervasive idealisation of the brain and its singular importance, which protects traditional conceptions about differences between mind and body, the freedom of will and the nature of thought itself.

The mystique is expressed in multiple forms, ranging from ubiquitous depictions of supernatural, ultra-sophisticated brains in science fiction and the popular media to more sober, scientifically supported conceptions of cognitive function that emphasise inorganic qualities or confine mental processes to neural structures. This idealisation is almost reflexively adopted by laypeople and scientists alike (including me!) and it is compatible with both materialist and spiritual world views. The cerebral mystique might help to increase enthusiasm for neuroscience – a valued consequence – but it drastically limits our ability to analyse human behaviour and address important social problems.

The widespread analogy of the brain to a computer contributes powerfully to the cerebral mystique by distancing the brain from the rest of the biology. The contrast between a machine-like brain and the wet, chaotic mess we have throughout the rest of our bodies sets up a brain-body distinction that parallels the historical mind-body distinction drawn by early philosophers such as René Descartes. In keeping with Western religious notions of the soul, Descartes in the 17th century postulated that the mind is an ethereal entity that interacts with the body but does not join with it. With his timeless axiom ‘I think, therefore I am’ Descartes placed the mind in its own universe, autonomous of the material world.

To the extent that the brain resembles a machine, we can more easily imagine removing it from our heads, preserving it for eternity, cloning it or sending it through space. The digital brain thus seems separable from the body in both its substance and causal relations, much like Descartes’s detached spirit. It might be no accident that some of the most influential inorganic analogies to the brain were introduced by physical scientists who in their later years took to the problem of consciousness in the way that elderly people sometimes take to religion. John von Neumann, the computer pioneer, was the best-known of these; he wrote the influential book The Computer and the Brain (1958) shortly before his death in 1957, inaugurating this enduring analogy at the very dawn of the digital age.

Brains are undoubtedly somewhat computer-like – computers, after all, were invented to perform brain-like functions – but brains are also much more than bundles of wiry neurons and the electrical impulses they are famous for propagating. The function of each neuroelectrical signal is to release a little flood of chemicals that helps to stimulate or suppress brain cells, in much the way that chemicals activate or suppress functions such as glucose production by liver cells or immune responses by white blood cells. Even the brain’s electrical signals themselves are the products of chemicals called ions that move in and out of cells, causing tiny ripples that can spread independently of neurons.

Also distinct from neurons are the relatively passive brain cells called glia (Greek for glue) that are roughly equal in number to the neurons but do not conduct electrical signals in the same way. Recent experiments in mice have shown that manipulating these uncharismatic cells can produce dramatic effects on behaviour. In one experiment, a research group in Japan showed that direct stimulation of glia in a brain region called the cerebellum could cause a behavioural response analogous to changes more commonly evoked by stimulation of neurons. Another remarkable study showed that transplantation of human glial cells into mouse brains boosted the animals’ performance in learning tests, again demonstrating the importance of glia in shaping brain function. Chemicals and glue are as integral to brain function as wiring and electricity. With these moist elements factored in, the brain seems much more like an organic part of the body than the idealised prosthetic many people imagine.

Stereotypes about brain complexity also contribute to the mystique of the brain and its distinction from the body. It has become a cliché to refer to the brain as ‘the most complex thing in the known Universe’. This saying is inspired by the finding that human brains contain something on the order of 100,000,000,000 neurons, each of which makes about 10,000 connections (synapses) to other neurons. The daunting nature of such numbers provides cover for people who argue that neuroscience will never decipher consciousness, or that free will lurks somehow among the billions and billions.

But the sheer number of cells in the human brain is unlikely to explain its extraordinary capabilities. Human livers have roughly the same number of cells as brains, but certainly don’t generate the same results. Brains themselves vary in size over a considerable range – by around 50 per cent in mass and likely number of brain cells. Radical removal of half of the brain is sometimes performed as a treatment for epilepsy in children. Commenting on a cohort of more than 50 patients who underwent this procedure, a team at Johns Hopkins in Baltimore wrote that they were ‘awed by the apparent retention of memory after removal of half of the brain, either half, and by the retention of the child’s personality and sense of humour’. Clearly not every brain cell is sacred.

If one looks out into the animal kingdom, vast ranges in brain size fail to correlate with apparent cognitive power at all. Some of the most perspicacious animals are the corvids – crows, ravens, and rooks – which have brains less than 1 per cent the size of a human brain, but still perform feats of cognition comparable to chimpanzees and gorillas. Behavioural studies have shown that these birds can make and use tools, and recognise people on the street, feats that even many primates are not known to achieve. Within individual orders, animals with similar characteristics also display huge differences in brain size. Among rodents, for instance, we can find the 80-gram capybara brain with 1.6 billion neurons and the 0.3-gram pygmy mouse brain with probably fewer than 60 million neurons. Despite a greater than 100-fold difference in brain size, these species live in similar habitats, display similarly social lifestyles, and do not display obvious differences in intelligence. Although neuroscience is only beginning to parse brain function even in small animals, such reference points show that it is mistaken to mystify the brain because of its sheer number of components.

Playing up the machine-like qualities of the brain or its unbelievable complexity distances it from the rest of the biological world in terms of its composition. But a related form of brain-body distinction exaggerates how the brain stands apart in terms of its autonomy from body and environment. This flavour of dualism contributes to the cerebral mystique by enhancing the brain’s reputation as a control centre, receptive to bodily and environmental input but still in charge.

Contrary to this idea, our brains themselves are perpetually influenced by torrents of sensory input. The environment shoots many megabytes of sensory data into the brain every second, enough information to disable many computers. The brain has no firewall against this onslaught. Brain-imaging studies show that even subtle sensory stimuli influence regions of the brain, ranging from low-level sensory regions where input enters the brain to parts of the frontal lobe, the high-level brain area that is expanded in humans compared with many other primates.

Many of these stimuli seem to take direct control of us. For instance, when we view illustrations, visual features often seem to grab our eyes and steer our gaze around in spatial patterns that are largely reproducible from person to person. If we see a face, our focus darts reflexively among eyes, nose and mouth, subconsciously taking in key features. When we walk down the street, our minds are similarly manipulated by stimuli in the surroundings – the honk of a car’s horn, the flashing of a neon light, the smell of pizza – each of which guides our thoughts and actions even if we don’t realise that anything has happened.

Even further below our radar are environmental features that act on a slower timescale to influence our mood and emotions. Seasonal low light levels are famous for their correlation with depression, a phenomenon first described by the South African physician Norman Rosenthal soon after he moved from sunny Johannesburg to the grey northeastern United States in the 1970s. Colours in our surroundings also affect us. Although the idea that colours have psychic power evokes New Age mysticism, careful experiments have repeatedly linked cold colours such as blue and green to positive emotional responses, and hot red hues to negative responses. In one example, researchers showed that participants performed worse on IQ tests labelled with red marks than on tests labelled with green or grey; another study found that subjects performed better on computerised creativity tests delivered on a blue background than on a red background.

Signals from within the body influence behaviour just as powerfully as influences from the environment, again usurping the brain’s command and challenging idealised conceptions of its supremacy. A particularly powerful pathway for reciprocal brain-body interactions is the so-called hypothalamic-pituitary-adrenal (HPA) axis, named for a set of structures both inside and outside the brain that together coordinate the storied fight-or-flight response. Activation of the HPA axis is often triggered by fear-related brain signals that lead to secretion of cortisol and adrenalin from a gland that sits on top of the kidneys. These hormones lead to a range of bodily changes that affect breathing, heartrate, sensory acuity and many other variables, providing feedback to the brain and closing a circuit of mutual brain-body interaction. In some cases, the HPA axis can be engaged from outside the brain, as in pregnancy, when a surge of cortisol originates on its own from the placenta.

The HPA axis provides one of the routes by which our emotional states more generally are coupled to body-wide changes that extend far beyond the brain. Monitoring of externally observable physiological parameters such as skin conductance and respiration has long supported the idea that various emotions produce distinct responses relevant to how emotions are perceived. In a 2014 study, a group of researchers led by Lauri Nummenmaa at Aalto University in Finland asked participants to describe bodily sensations that they associate with 14 distinct emotions. The result was a stunning set of ‘bodily maps’ of the emotions, revealing variegated patterns of increased and decreased sensitivity associated with feelings of anger, fear, happiness, depression, love and so on. The subjects’ ability to report their sensations emphasises that bodily changes are part of how the emotions are experienced, and not just passive, downstream consequences of emotion-related brain activity.

An amazing finding of recent years is the fact that microbes living in the intestines are also part of the physiological network that determines our emotions. Changing the gut microbial population by eating bacteria-rich foods or undergoing an off-putting procedure called a faecal transplant can alter characteristics such as anxiety and aggression. A key experiment was performed in mice, where a two-way exchange of gut microbes between the normally shy BALB/c mouse strain and the more outgoing NIH Swiss strain was enough to flip the two personalities. In human organ-transplant patients, both cognitive and emotional effects are also commonplace. Some of these have to do with correcting the medical condition that required the transplant in the first place. For instance, liver or kidney failure causes a buildup of toxins such as ammonia in the blood; this in turn causes cognitive difficulties that can be corrected by replacing the diseased organ. But even procedures such as stomach stitching, which does not cure a disease, are said to cause personality shifts in about 50 per cent of patients.

Such examples illustrate the extent to which what happens in the brain is interwoven with what goes on in the body and the environment. There is no causal or conceptual boundary between the brain and its surroundings. Aspects of the cerebral mystique – idealised views of the brain as inorganic, hypercomplex, self-contained and autonomous – fail when we look more closely at what the brain is made of and how it operates. The integrated involvement of brain, body and environment is precisely what makes having a biological mind different from having a soul, and the implications of this difference are tremendous.

Most importantly, the cerebral mystique fosters a misleading sense that the brain is the prime mover of our thoughts and actions. As we seek to understand human conduct, the mystique prompts us to think first of brain-related causes, and pay less attention to factors outside the head. This leads us to overemphasise the role of individuals and underemphasise the role of contexts across a range of cultural phenomena.

In the arena of criminal justice, for instance, some writers suggest that the perpetrator’s brain should be blamed for transgressions. This argument often invokes the case of Charles Whitman, who in 1966 committed one of the first mass shootings in the US, at the University of Texas. Whitman had reported psychological disturbances in the months leading up to the crime, and an autopsy later revealed that a large tumour had been growing near a part of his brain called the amygdala, which is involved in stress and emotional regulation. But although advocates of blaming the brain would argue that Whitman’s brain tumour might have caused his crime, the larger reality is that Whitman’s act occurred against a background of many other predisposing factors: growing up with a violent father, the recent divorce of his parents, Whitman’s repeated career rejection and court martial from the army, his substance abuse, great physical stature, and access to high-powered weaponry. Even the high temperature on the day of the crime – 99 degrees Fahrenheit (37 degrees Celsius) – might have contributed to Whitman’s aggressive behaviour on the fateful day.

Blaming the brain for criminal behaviour offers an escape from outmoded principles of morality and retribution, but it still neglects the extended network of influences likely to contribute to any given situation. In the current discussion about the causes of violence in the US, it is more important than ever to maintain a broad view of how multiple factors work together in and around each individual; mental problems, gun access, media influences and social alienation can all play their parts. In other contexts, we miss analogous factors when we attribute drug addiction or adolescent misbehaviour to the brain, or when we credit the brain for creativity and intelligence. In each case, an idealised view that simply locates good and bad personal qualities in the brain is remarkably similar to old-fashioned perspectives that assigned virtue and vice to the metaphysical soul. An updated view should instead accept that any act of brilliance or depravity arises from a combination of brain, body and environment working together.

The cerebral mystique has particular significance for the way that our society grapples with the problem of mental illness. This is because of the widespread drive to redefine mental illnesses as brain disorders. Proponents argue that doing this places psychological problems in the same category as influenza or cancer – sicknesses that don’t evoke the social stigma commonly associated with psychiatric disorders. There is some evidence that using the language of brain disorders in fact lowers the barrier for mental-health patients to seek treatment, an important benefit.

In other respects, however, reclassifying mental illnesses as brain disorders can be highly problematic. For patients, attributing mental problems to intrinsic neurological defects incurs a stigma of its own. Although people with ‘broken brains’ might not be held morally accountable or told to ‘just get over it’, the sense that they are irredeemably flawed can be just as damaging. Biological flaws can be harder to fix than moral lapses, and people with brain dysfunction can be seen as dangerous or even less than fully human. This attitude reached extremes under the Nazis, who murdered thousands of mental-health patients as part of their ‘euthanasia’ programme during the Second World War, but it persists in more subtle forms today. A large analysis of changing attitudes to mental illness in 2012 found that there was no increase in social acceptance of patients with depression or schizophrenia, despite increasing awareness of neurobiological contributions to these conditions.

Regardless of its social implications, blaming the brain for mental illnesses might be scientifically inaccurate in many cases. Although all mental problems involve the brain, the underlying causal factors can be elsewhere. In the 19th century, the sexually transmitted bacterial disease syphilis and the vitamin-B deficiency pellagra were among the greatest contributors to insane-asylum populations in Europe and the US. A more recent study estimated that as many as 20 per cent of psychiatric patients have a bodily disorder that might be producing or worsening their mental condition; the maladies include heart, lung and endocrine problems, all of which have cognitive side effects. Epidemiological surveys have found remarkable correlations between incidence of mental illness and factors such as ethnic minority status, being born in a city, and being born at certain times of year. Although these correlations are not well-explained, they emphasise the likely role of environmental factors well beyond the brain in bringing about psychiatric problems. We must be sensitive to such factors if we want effective treatment and prevention of mental disorders.

At an even deeper level, cultural conventions circumscribe the notion of mental illness in the first place. Just 50 years ago, homosexuality was classified as a pathology in the American Psychiatric Association’s authoritative compendium of mental disorders. In Soviet Russia, political dissidents were sometimes confined on the basis of psychiatric diagnoses that would horrify most observers today. Nevertheless, sexual preference or failure to bow to authority in pursuit of a righteous cause are both psychological traits for which we could imagine finding biological correlates. That does not mean that homosexuality and political dissidence are brain diseases. Society rather than neurobiology ultimately defines the bounds of normality that determine mental-health categories.

The cerebral mystique exaggerates the brain’s contribution to human behaviour, and for some it also prompts remarkable visions of the brain’s role in the future of humanity itself. In technophilic circles, there is increasing talk of ‘hacking the brain’ to improve human cognition. This notion evokes the kind of sophisticated but semi-subversive intervention one might make into a fancy smartphone or a government server, but the reality is usually more like the type of hacking one would perform with a machete. Some of the earliest brain hacks involved the purposeful destruction of parts of the brain, famously as part of the now-extinct psychosurgery procedures that inspired Ken Kesey’s novel One Flew Over the Cuckoo’s Nest (1962). The most advanced of today’s brain hacks involve surgically implanting electrodes for direct stimulation or recording of brain tissue. These interventions can restore basic function to patients with severe movement disorders or paralysis – an incredibly impressive feat, but still a world away from enhancements to normal abilities. This distance has not stopped entrepreneurs such as Elon Musk or the US defence agency DARPA from investing heavily in technology that they hope will one day routinely hardwire healthy human brains to computers.

But this exuberance is largely the product of an artificial distinction between what goes on inside versus outside the brain. The philosopher Nick Bostrom of the Future of Humanity Institute in Oxford points out that ‘most of the benefits you could imagine achieving through [brain implants] you could achieve by having the same device outside of you, and then using your natural interfaces like your eyeballs, which can project 100 million bits per second straight into your brain’. Indeed, most of us are familiar with the kind of cognitive-enhancement aids that live in our desks, pockets and handbags, boosting our memory and communication capabilities without touching a neuron. It is debatable whether connecting smartphone-like devices more directly to brains would add much except annoyance and distraction.

In the medical realm, early efforts to restore vision in blind people using brain implants quickly gave way to much less invasive approaches involving retinal prostheses, which leverage the body’s natural physiology for early processing of visual information. Cochlear implants that restore hearing in deaf patients rely on the similar strategy of interfacing with the auditory nerve in the ear, rather than the brain itself. Except in the most impaired patients, prostheses for restoring or enhancing movement also benefit from interfaces to the body. To give amputees control over mechanised artificial limbs, a technique called ‘targeted muscle reinnervation’ allows physicians to connect loose peripheral nerves from the missing original limb to new muscle groups that in turn communicate with the device. For enhancing motor function in healthy people, powered exoskeletons developed by companies such as Cyberdyne in Japan communicate with the wearer through skin-surface electrodes, also accepting input from the brain through indirect but evolutionarily honed channels. In each of these examples, the brain’s natural interactions with the body help the person use the prosthetic, leveraging rather than denying the continuity between brain and body.

The most extreme direction in futuristic brain technology is the drive to achieve immortality through the postmortem preservation of human brains. Two companies now offer to extract and preserve the brains of dying ‘clients’, who do not wish to go gentle into the good night. The organs will be stored in liquid nitrogen until technology advances to the point (now nowhere in sight) where the brain can be restored to function in some form or analysed in sufficient detail to ‘upload’ the mind into a computer. This venture takes the cerebral mystique to its logical endpoint, fully embracing the fallacy that human life is reducible to brain function and that the brain is just a physical embodiment of the soul.

Although seeking immortality through brain preservation does little harm to anything other than a few people’s bank accounts, this fringe pursuit also epitomises why demystifying the brain is so important. The more we feel that our brains encapsulate our essence as individuals, and the more we believe that our thoughts and actions simply emanate from the bundle of flesh in our heads, the less sensitive we will be to the role of the society and environment around us, and the less we will do to nurture our shared culture and resources – whether in the context of criminal behaviour, creativity, mental illness or any other aspect of human life.

The brain is special because it does not distil us to an essence, it unites us to our surroundings in a way a soul never could. If we value our own experiences, we must protect and strengthen the many factors that enrich our lives from both inside and outside, so that as many people as possible can benefit from them now and in the time to come. We must realise that we are much more than our brains.

Alan Jasanoff is professor of biological engineering, brain and cognitive sciences, and nuclear science and engineering at the Massachusetts Institute of Technology. His latest book is The Biological Mind: How Brain, Body, and Environment Collaborate to Make Us Who We Are (2018).

Besma (Bess) Benali, Clinical Social Work/Therapist, MSW, RSW, Counselling Ottawa Nepean. I am trained in Cognitive Behavioural Therapy (CBT), Brief Psychodynamic Therapy, ACT, and mindfulness. Clients come to me because they are struggling and feel like they are trapped in a darkness that no matter what they have tried (and many have tried therapy before) they can’t pull themselves out. I help my clients understand themselves in ways no one has ever taught them before allowing them to see positive changes.

Do psychotropic drugs enhance, or diminish, human agency?

From medication to recreational and spiritual substances, drugs offer us respite from pain, open opportunities for mental exploration, and escape from – or into – altered psychological states. They are our most widely available formal and informal implements for tweaking our mental condition. Consider the cold beer after a hard day at work, the joint before putting the needle on the record, the midday espresso, the proverbial cigarette break, Adderall during finals week, or painkillers to alleviate undiagnosed or chronic pain. Not to mention antidepressants to counter a sense of meaninglessness, and benzodiazepines because everything causes anxiety.

In short, drugs offer our most common path to a sense of psychological health. With a modicum of knowledge, millions of people modify their minds through chemistry every day. Considering the limited resources of time, support networks, money and patience, accepting the positivism of drugs seems more efficient and more feasible than psychodynamic therapy. This shift implies an expectation that there are quick and easy chemical levers into a wide range of mental states.

Drugs are favoured tools to foster our values and amplify or attenuate our gregariousness and productivity. They serve as release valves for labour and social relations. Socially acceptable drugs such as nicotine, caffeine and alcohol are thus embedded into common social practices in public spaces; they are aids to efficiency in coffee-shop work culture and sociability in bars. Accordingly, these practices coincide with the modern structure of the working week: in the morning we become alert, and in the evening we relax. In effect, some drugs are made highly accessible as a form of self-medication for the common self-diagnosed emotional states of stress, boredom, restlessness, anxiety, discomfort, etc.

Psychological medications such as Xanax, Ritalin and aspirin help to modify undesirable behaviours, thought patterns and the perception of pain. They purport to treat the underlying chemical cause rather than the social, interpersonal or psychodynamic causes of pathology. Self-knowledge gained by introspection and dialogue are no longer our primary means for modifying psychological states. By prescribing such medication, physicians are implicitly admitting that cognitive and behavioural training is insufficient and impractical, and that ‘the brain’, of which nonspecialists have little explicit understanding, is in fact the level where errors occur. Indeed, drugs are reliable and effective because they implement the findings of neuroscience and supplement (or in many cases substitute for) our humanist discourse about self-development and agency. In using such drugs, we become transhuman hybrid beings who build tools into the regulatory plant of the body.

Recreational drugs, on the other hand, are essentially hedonic tools that allow for stress-release and the diminishment of inhibition and sense of responsibility. Avenues of escape are reached through derangement of thought and perception; many find pleasure in this transcendence of quotidian experience and transgression of social norms. There is also a Dionysian, or spiritual, purpose to recreational inebriation, which can enable revelations that enhance intimacy and the emotional need for existential reflection. Here drugs act as portals into spiritual rituals and otherwise restricted metaphysical spaces. The practice of imbibing a sacred substance is as old as ascetic and mindfulness practices but, in our times, drugs are overwhelmingly the most commonly used tool for tending to this element of the human condition.

In this historical moment, drugs fuel a culture where human nature is increasingly considered to be controllable through technology. But the essential question is this: do drugs enhance or diminish human agency, the ability to modulate one’s own thought processes?

Whether a drug boosts attention, tamps down inhibitions or deranges the senses in service of euphoria, use can become ingrained and can spiral out of control until one can be said to be addicted to the effects of the drug. The overuse of recreational drugs and socially acceptable stimulants seems to negate, distort or inflate one’s sense of agency, at which point an individual becomes dependent on drugs to cope in professional and social situations. In these cases, drugs, in the long term, are indeed counter-productive tools: they both occlude agency and compromise self-development.

Psychopharmacology implies that distinct mental illnesses are somehow natural kinds of personality formations defined by neurochemical profiles. For instance, in claiming that I have attention deficit hyperactivity disorder (ADHD) I am contextualising all my behaviours within a totalising abnormality that requires a pharmaceutical cure – a treatment beyond the capacities of my introspection and social support network. Practitioners prescribing such drugs in such a scenario are de facto technicians of the mind. They are easing our pain, but they are also dispensing cultural tools that allow us to selectively reduce or augment our sense of personal agency and power to set our own path.

One question to ask then is: How many individuals have found, through these tools, a sweet spot that blends augmentation of the will and alleviation of pain? If the number is large, then drugs fall into the same category as cars, electric guitars and mobile phones; tools that, if used judiciously, can ameliorate our quality of life. From that perspective, drugs are just one of many tools, including the tool of talk therapy, that serve to secure an appropriate sense of agency. And yet a somewhat worrisome consideration arises – maybe maintaining a sense of agency is not the best indicator of the appropriateness of a given tool. In our transhuman future, we are likely to abandon the psychodynamic tools of self-actualisation for cocktails offering the illusion of agency and escape.

Rami Gabriel is associate professor of psychology in the Department of Humanities, History, and Social Sciences at Columbia College Chicago. He is the author of Why I Buy: Self, Taste, and Consumer Society in America (2013).

Dr. Kevin Groves is a Clinical Psychologist Austin, Texas. Kevin is also a family therapist and group counselor. Dr. Groves graduated with honors in 1989 and has more than 29 years of diverse experiences.

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How to Recover From Heartbreak

Use “negative reappraisal,” and understand you have work to do—time alone may not be enough.

Melissa and J.J. met on the finish line of an obstacle course race. “We were both winded and covered in mud yet we still managed to flirt. It felt weirdly authentic,” Melissa told me in our first psychotherapy session. “He was into triathlons and obstacle courses like I was. We had very similar lifestyles.” Melissa and J.J. moved in together after eight months. A year and a half into the relationship, Melissa began raising the issue of marriage. J.J. didn’t feel ready. Soon thereafter, he broke up with her.

Melissa was a wreck. She cried for days and could barely function at work, “I’ll never find a better match for me. It was the best relationship I ever had.” Melissa came to see me after several months had passed and J.J. was still all she could think about. “Aren’t my feeling supposed to fade?” She asked me. “Why does it still feel so painful?”

We’ve been experiencing heartbreak for millennia and yet most of us still use the same coping and recovery mechanisms we did thousands of years ago, time, social support, and unfortunately, substances (e.g., alcohol, drugs, food). Despite recent advances in our scientific understanding of how we are impacted by heartbreak, little has changed in how we go about recovering from this emotionally devastating experience. As I describe in my book How to Fix a Broken Heart, the biggest mistake we make is that we go on “autopilot” and assume the only thing we can do to recover is give it time. Yes, time helps, as does social support, but new studies are verifying that there are all kinds of other steps we can and should take to soothe the emotional pain we feel and expedite our recovery.

A recent study in the Journal of Experimental Psychology examined cognitive and behavioral strategies for recovering from heartbreak. The premise of the study was that to recover from heartbreak we need to diminish our feelings of love for our ex-partner. While that might seem terribly obvious, consider that heartbreak often makes most of us do the opposite: We enact thoughts and behaviors that actually reinforce our love feelings (e.g., stalking our ex on social media, reliving our best moments, pouring over old images and video of happy times). The goal of the study was to examine three kinds of emotional regulation strategies to see which of them would help heartbroken subjects reduce their love feelings.

In the first condition, subjects focused on negative reappraisals of their ex-partner (e.g., by responding to prompts about their ex’s annoying habits). In the second condition they were asked to reframe their loving feelings as less problematic (e.g., by endorsing prompts such as ‘It’s okay to love someone I’m no longer with’). The last condition used distraction (e.g., questions about the subjects’ favorite food) to get the participants’ mind off their heartbreak. The researchers found that only negative reappraisals were truly effective in reducing love feelings. However, doing so did increase feelings of unpleasantness.

Unfortunately, it is those very feelings of “unpleasantness” that make it challenging to use negative reappraisals as a way to recover from heartbreak. We might accept, on an intellectual level, that by focusing on our ex’s faults we’re doing something important but it can still feel wrong (unpleasant), unbalanced, unfair, and even disloyal.

As a clinician, I’ve found that there are two things we can do to minimize these feelings of unpleasantness and thus feel freer to practice negative reappraisals of our ex. First, we need to frame the task differently. Specifically, we need to consider that when we are heartbroken, our mind is likely to bombard us with highly idealized snapshots, memories and thoughts both about our ex and about our relationship. We tend to remember only the best times and our ex’s best qualities. In other words, our mind is already creating unbalanced and inaccurate perceptions that are highly skewed to the positive. Therefore, our introduction of negative reappraisals does not create an imbalance, it corrects an existing one.

Second, negative reappraisals should include not just our perceptions and memories of our ex but of the relationship as well. We tend to idealize the relationship just as much as we do the person and think almost exclusively of the good times and the happy moments. We are far less likely to consider the compromises we had to make, the fights that hurt our feelings or frustrated us, or our unmet emotional needs. People often grieve both the person and the relationship itself—the experience of being a couple, having a significant other, the companionship and partnering. Therefore, it is necessary to address idealized perceptions of the relationship by introducing negative reappraisals of our couplehood, as well as of our ex as a person, in order to more effectively reduce feelings of attachment and love.

If you are trying to get over heartbreak, make a list of the person’s faults as well as of the shortcomings of the actual relationship and to keep that list on their phone. Whenever you find yourself having idealized thoughts and memoires, whip out your phone and read a few reminders in order to balance your perceptions and remind yourself that your ex was not perfect and neither was the relationship.

One crucial aspect of recovery from heartbreak that was not covered in the current study is that breakups leave all kinds of voids in our lives. Our social circle gets diminished, our activities change, our physical space changes (e.g., their ‘stuff’ is no longer there), some of the things we did as couples we no longer do, and the list goes on. A significant part of the emotional pain we feel after a breakup is related to these other losses, the ripple effects that go beyond the loss of the actual person. Finding ways to recognize these voids and fill them is an important task of recovery from heartbreak and one that is often neglected.

Heartbreak is a form of grief and loss that can cause insomnia, changes in appetite, depression, anxiety, and even suicidal thoughts and behavior and as such it should be taken very seriously, as should our efforts to recover. However, to do so, we have to assert control and consciously and willfully prevent ourselves from making mistakes that will set us back (like staying in touch or trying to be friends while we’re still heartbroken) and encourage ourselves to take steps that might feel unpleasant or counter-intuitive, but that will ultimately diminish our emotional pain and expedite our recovery.

By Guy Winch, a psychologist, speaker and author. His books have been translated into 25 languages and his two TED Talks have been viewed over 10 million times. His new book, How to Fix a Broken Heart (TED Books/Simon & Schuster, 2018), covers both pet loss and romantic heartbreak.

Christiane Blanco-Oilar, Ph.D. offers compassionate psychological services for individuals and couples therapy Fort Lauderdale. I enjoy working with individuals and couples going through life transitions, relationship challenges or identity exploration, or those experiencing grief and loss, depression, anxiety, postpartum depression and eating disorders. My goal is to help you recognize, understand and have compassion for how you may have developed less-than-ideal ways of dealing with specific areas of your life.

Sociocultural Approach

Introduction to the sociocultural approach and an exploration of how our culture influences the way in which we learn and think.

Psychology is a broad area of study with several theories and schools of thought that help us understand and make sense of human behavior. Perception, behavior, and personality are just a few aspects that psychologists study. Some psychologists choose to study abnormal behavior whilst others attempt to understand why we think the way we do and there are even those who attempt to distinguishes us as humans from other animals.

Sociocultural approach
A common method of explaining what makes and defines us as individuals is the application of sociocultural approach. This approach emphasizes the influence of the society that we living on our learning process.

According to the sociocultural approach, cultural factors such as language, art, social norms and social structures can play a significant role in the development of our cognitive abilities.1

Vygotsky: father of the sociocultural approach
A pioneer of the sociocultural approach was the Soviet psychologist Lev Semyonovich Vygotsky (1896-1934), who became interested in developmental psychology and helped to change the face of the field. He proposed that interactions made by children can shape and influence both the way in which they perceive the world and their cognitive processes. The way children learn and develop varies from culture to culture and is sometimes specific to each individual society. While the resulting cognitive processes may be unique to each culture, the way in which they are handed down from generation to generation is often similar.

Vygotsky cites three methods which are used to teach children skills. These tools are imitative learning, instructed learning, and collaborative learning.

A central tenet of Vygotsky’s studies is that children learn behavior and cognitive skills by dealing with more experienced people, such as teachers or older siblings, using one or more of these three learning methods.2

Vygotsky goes on to explain that in order for the sociocultural theory to work, you need four basic principles.

Key principles of Vygotsky’s sociocultural theory
Whilst there are more than four parts central to this theory and the approach psychologists use in studying an individual, it is easy to identify the core components that function within the theory. Development of a child is contingent upon learning. As explained, learning is a crucial part of passing down culture ideas from parents to children.

By doing so, the child also acquires cognitive skills that are specific to his or her culture.

As a result, it is simple to see the second core principle; that a person’s language is crucial to their mental development.

While animals may possess a form of rudimentary language, often consisting of more basic signals, it is humans’ linguistic abilities that distinguishes from other animals and has helped to create a society full of art and thought. Therefore, the developmental progress of a child can not be considered without also taking into consideration the child’s upbringing and social context.

If a child is reared in a creative culture, the thought process and cognitive abilities of that child will surely reflect that influence. Most interesting though, is that children are capable of creating their own knowledge through experience and cultural tools. This knowledge is then referenced later on in life.

The Zone of Proximal Development
One key element of Vygotsky’s sociocultural approach is his idea of a Zone of Proximal Development. Commonly abbreviated as ZPD, the Zone of Proximal Development is a way to gauge a child’s ability to learn and grow. Vygotsky believed that the ZPD was a far better way to gauge a child’s intelligence than through the standard academic testing, which can often fail to account for cultural differences with regards to learning.

At the core of Vygotsky’s Zone of Proximal Development, there is the area containing the cognitive abilities which we have acquired so far in life. At an earlier age, these are limited. As we travel further outwards from this core, we reach the outer reaches of the zone, which represents the potential of the human mind. This inner potential can be realized through social learning situations.

Wood, Bruner and Ross (1976) expanded on Vygotsky’s theory, adding the concept of scaffolding.3 This terms refers to the activities and environment that more knowledgeable people may provide to someone younger, in order to assist their cognitive abilities. Such people may include parents, caregivers, teachers and older siblings or peers. Scaffolding may include playing games, role playing, singing (to encourage language acquisition) and other social situations where cognitive abilities may be nurtured.

In an attempt to understand cognitive processes, several psychologist have applied Vygotsky’s work have began to look not only at an individual’s biological makeup, but also at the culture and society which surround and inform the individual.

For many years, researchers have been attempting to explain behavior, memory, and cognition in biological terms. With Vygotsky’s work as a guide, researchers are now using a dual approach to understand what makes and shapes a person’s reality and identity. Researchers are taking the social background, language, beliefs, and other cultural and social influences into consideration instead of regarding the mind as nothing more than a collection of neurons and synapses.

The Bifold Model
Many studies into memory have taken onboard the sociocultural approach. A common example of how the approach works is by comparing a human’s memory with that of an animal. An animal’s memory as we understand it is reactionary. A mouse, for example, lives in the present and only associates an object to a memory when it sees that object. An animal’s mind may be unable to unlock experiences independently of the events it is experiencing at that moment.

So, a mouse can recognize a predator when approached by one and can act accordingly, but can not recall another predator, such as a snake, if one has not been present. Language provides us with the ability to recall experiences without them having being immediately first-hand.4 An individual can see the word ‘watermelon’ and not only recall what a watermelon is, but how one tastes and maybe a pleasant memory of eating one.

Vygotsky pointed out in his book Thought and Language that children at an early age vocalize actions and thought processes, speaking out loud their reasoning. As children get older that vocalization is internalized and becomes ‘inner speech’.5 We see children talking to themselves at early ages as they carry out mundane tasks. It is believed that they are forming recall abilities, that will then be internalized later in life. Trying to remember what one did yesterday would involve a series of prompts, starting with common events such as the commute to work. This will then lead a person to recall what was on the radio and the color of the car in front of them on their morning drive.

Language is crucial for this ability to recollect information, and is also one of the major building blocks of our cultures and societies. It is language, many believe, that elevated humans from a primitive species to a one that would one day dominate the world.

With the sociocultural approach in mind, researchers have begun to look over the course of human history to see how language has shaped and defined entire societies. The results are somewhat surprising, with several anthropologists claiming that our more complex emotions, such as love and loyalty, are really learned behaviors that we have come to associate with those words, and are not ingrained behavior that is hard-wired into our brains.

Sociocultural theory on a smaller scale
In order to see how the sociocultural approach can be applied, we can look at Muzafer Sheriff’s infamous Robbers Cave Experiment.6 Two groups of boys formed different factions and cultures and were then brought together in conflict. Eventually, the groups of boys made peace with each other, but by studying their cognitive behavior during the early part of the experiment, one can use Vystogsky’s theory to study the underlying reasons why the groups felt so antagonistic towards one another. It was, after all, ingrained in their culture.

Conclusion
The sociocultural approach provides researchers and psychologists with a more informed view and understanding of the motivations which cause a person to behave in a particular way. Instead of relying on biological factors alone, the approach promises to paint a more vivid picture of the human mind through a wider understanding of how we acquire cognitive abilities at an early age. In the years since English translations popularised Vygotsky’s proposed Zone of Proximal Development, many psychologists have expanded upon his theory.

Summary
The sociocultural approach looks at how a person’s experiences, influences and culture help shape why they act the way they do.

The theory was developed by Lev Semyonovich Vygotsky in the 1930s.
Vygotsky claims that there are three cultural tools which children use to inform their cognitive abilities.

Human’s ability to recall information is a result of our understanding of complex language.
The bifold model takes into account both social and cultural influences as well as biological factors.

By Psychologist World

For the Sandwich Generation, Caregiver Support is becoming an increasingly prevalent mental health concern. Adults between the ages of 30-40 are juggling the responsibilities of children and aging parents. Erica Greenspan, LICSW of Kennedy Counseling Collective Counseling Metro DC, will work with you to navigate the burden that can come with balancing roles, while making time to care for yourself.

The Psychology of Happiness

The psychology behind happiness – how positive affect is quantified and what influences happiness.

Just how happy are you? Do you ever wish for a life that brought more moments to be joyful?

Happiness is often an elusive experience – people will go to great lengths for a fleeting moment of happiness. Even the U.S. Declaration of Independence, written in 1776, asserts the right to “Life, Liberty and the pursuit of Happiness”.

But what precisely is happiness – how can it be quantified, and is there any measurable benefit to possessing a happy mindset over that of a more stoic realist?

“Happiness is a mystery like religion, and should never be rationalized.”
G.K. Chesterton, English author (1874-1936)

Happiness is a subjective experience – what brings elation to one person will not necessarily satisfy another – but from a psychological viewpoint, we must be able to quantify this state of mind in order to understand it.

When we discuss happiness, we are referring to a person’s enjoyment or satisfaction, which may last just a few moments or extend over the period of a lifetime. Happiness does not have to be expressed in order to be enjoyed – it is an internalized experience, varying in degrees, from mild satisfaction to wild euphoria.

Psychologists often refer to happiness as positive affect – a mood or emotional state which is brought about by generally positive thoughts and feelings. Positive affect contrasts with low moods and negativity, a state of mind described as negative affect in which people take a pessimistic view of their achievements, life situation and future prospects.

Quantifying Happiness
With positive affect being subjective and relative to the individual, can happiness be measured? The United Nations seems to believe that it can, and releases the World Happiness Report, which ranks countries by the self-reported happiness of its citizens.

In 2016, the report listed Denmark as the happiest nation, followed by Switzerland and Iceland. The US was the 13th happiest country with the UK ranking 23rd. Nordic countries feature prominently as being amongst the happiest societies in the world (Helliwell, Layard and Sachs, 2016).1

The World Happiness Report measured happiness levels using the Cantril Ladder, a scale devised by U.S. psychologist Hadley Cantril (1906-1969). Participants are asked to imagine a ladder with 10 rungs, with rung number 1 representing the worst life imaginable, working upto the optimal life represented by the ladder’s highest rung. They are then asked to identify the step number that they feel reflects their life situation, either at present, in the past or how they envisage it to be in the future (Cantril, 1965).2

The four happiest countries identified by the World Happiness Report placed themselves at 7.5 or higher on the Cantril Ladder (Helliwell, Layard and Sachs, 2016).1

Given that these countries are highly developed and prosperous, it is easy to assume that positive affect is linked to wealth. A common wish in our modern age is to possess more money: wealth can signify success and increases a person’s purchasing power, giving them choices that they might not have been able to make before. But can money buy happiness?

It’s a question that troubles not only psychologists, but economists, too. Richard Easterlin, a professor of economics at the University of Southern California, noticed a strange paradox involving money and happiness. Should a positive correlation exist between the two, we might expect citizens of developed countries to be happier than those of less prosperous nations.

Easterlin discovered that this is not the case – rich people within countries tend to be happier than the poorest in the same country, but overall, more prosperous countries are no happier than their poorer counterparts. These findings, known as the Easterlin paradox, contradict popular assumptions that wealthy people enjoy happier lives.

A study of lottery winners and victims of serious accidents delved further into the link between money and happiness. The happiness of 22 winners of large lottery prizes was compared to that of both controls and 29 people who had been paralysed as a result of an accident. The level of happiness experienced by winning the lottery had numbed people to the smaller joys of everyday live – a resistance the researchers described as “habitation”, as only more significant events could bring the winners joy (Brickman, Coates, Janoff-Bulman, 1978).3

The results of these two studies suggest that money alone cannot bring people lasting happiness.

Why it Matters: Benefits of Happiness
Happiness signifies an increased enjoyment of life, which is of course beneficial in itself. But beyond this obvious advantage, are there any further gains to be had from increased happiness?

One study looked at wide-ranging research into happiness to better understand the link between happiness in successful people.

Researchers suggested that there may be a causal link between positive affect and success – that success not only brings happiness, but that a person who is happy has an higher chance of achieving success than somebody experiencing negative affect (Lyubomirsky et al, 2005).4

The findings of this research support another, earlier, study by Daubman and Nowicki (1987) which artificially induced positive affect in participants in a series of experiments by subjecting them to watching comic films and providing them with sweets.

Subjects were then timed whilst they completed an exercise in creative problem-solving. The researchers found that those in a state of positive affect were able to solve the problems quicker than those in a neutral state or those experiencing negative affect (Daubman and Nowicki, 1987).5 Positive affect prior to success, it appears, boosts our intuitive abilities and enables us to achieve more.

Do Happier People Live Longer?
Can happiness lead to a healthier, longer life? Koopmans et al (2010) conducted a 15-year longitudinal study into the happiness of elderly people, known as the Arnhem Elderly Study. They found higher levels of happiness in those who lived longer.6

But does happiness lead to a longer life or does good health and longevity give people reason to be happier? The researchers also accounted for the participants’ levels of physical activity and found that, once exercise was accounted for, the link between happiness and life span was insignificant. This indicates that happiness may lead to increased physical activity, which in turn can be beneficial.

Indeed, a 2011 study suggested that exercise in sedentary males could be increased by first boosting their positive affect levels (Baruth, 2011).7

Encouraging Happiness
Book store shelves are awash with self-help books claiming to nurture happiness – but is positive affect something that we can nurture, or as the World Happiness Report emphasises, is influenced by our environment and life circumstances, often beyond our control?

Let’s look at some factors which can influence and encourage positive affect:

Acts of Kindness
Contradicting the idea that possessions can bring happiness, giving to others may in fact be more beneficial in terms of positive affect. Stephen Post (2005) noted that, whilst citizens in the US and Europe are more wealthy than previous generations, we are no happier as a result. Post emphasizes the personal benefit that acts of altruism – selfless giving or assistance – can provide (Post, 2005).8

The effect of selflessness on happiness was further supported by a 2008 experiment in which participants were given a gift of $5 or $20 and instructed to either spend it on themselves or on other people. Whilst the amount of money received had no notable effect on happiness, participants who gave away the money experienced elevated positive affect following the experiment (Dunn et al, 2008).9

Relationships
Familial relationships and friendships affect happiness and can also be impacted by a person’s levels of positive affect. Our ability to make friends often affects our self-esteem – unsurprisingly, people with extrovert personalities have been to found to enjoy higher levels of happiness than introverts (Argyle and Lu, 1990).10

A 20-year study of interpersonal relationships demonstrated just how important the happiness of a person’s friends and family is to their own wellbeing.

Between 1983 and 2003, James Fowler and Nicholas Christakis looked relationships between close relatives and found that the happiness of a friend or close family member who lives up to a mile away from a person can boost their prospects of happiness by around 25%.

The study also suggests that the contagiousness of happiness is not limited to direct relationships: it can influence the happiness of people by up to 3 degrees of separation from the original individual (Fowler and Christakis, 2008).11

Spousal relationships can be of particular influence on happiness levels. A study across 17 countries found that marriage does tend to lead to increased levels of happiness. Cohabiting also boosts happiness but by a lesser degree than marriage. The research emphasises the secondary effects of matrimony, such as the emotional and financial support provided by a partner, may explain this change rather than the act of marriage itself (Stack and Eshleman, 1998).12

Self-Determined Happiness
Positive affect might be influenced by external factors in our everyday life, but if people yearn for more happiness, can they bring it about themselves? Schütz et al (2013) studied the habits and happiness of people whose affect levels varied. The study observed a number of ways in which some people were able to proactively nurture their own happiness:13

The self-fulfilling participants showed significantly higher results than all other profiles on the direct attempts strategy, suggesting that in order to increase their happiness the self-fulfilling individuals are more prone to directly attempt to smile, get themselves in a happy mood, improve their social skills, and work on their self-control.

Schütz et al, 2013 via PeerJ

Pretending to be happy through outward expressions of happiness, it appears, may have led the individuals to internalise this joy.

Maintaining an optimistic mindset can also bear further benefits. Brissette and Scheier (2002)14 found that college students who started the semester with a sense of optimism were more able to cope with stressful events and felt that they had better social support even when their friendship network had not increased.

By Psychologist World

Besma (Bess) Benali, Clinical Social Work/Therapist, MSW, RSW, Counselling Ottawa Nepean. I am trained in Cognitive Behavioural Therapy (CBT), Brief Psychodynamic Therapy, ACT, and mindfulness. Clients come to me because they are struggling and feel like they are trapped in a darkness that no matter what they have tried (and many have tried therapy before) they can’t pull themselves out. I help my clients understand themselves in ways no one has ever taught them before allowing them to see positive changes.

Therapist Directory

The Characteristics of Adult Children of Alcoholics

You’ll likely identify with these traits if you grew up around alcoholism

If you grew up in an alcoholic home, you’re probably familiar with the feeling of never knowing what to expect from one day to the next. When one or both parents struggle with addiction, the home environment is predictably unpredictable. Argument, inconsistency, unreliability, and chaos tend to run rampant. Children of alcoholics don’t get many of their emotional needs met due to these challenges, often leading to skewed behaviors and difficulties in properly caring for themselves and their feelings later in life.

It’s not any wonder. If you were never given the attention and emotional support you needed during a key developmental time in your youth and instead were preoccupied with the dysfunctional behavior of a parent, how would you know how to get your needs met as an adult? Furthermore, if you lacked positive foundational relationships, it may be difficult to develop healthy, trusting interpersonal relationships later on.

Children of alcoholics often have to deny their feelings of sadness, fear, and anger in order to survive—and since unresolved feelings will always surface eventually, they often manifest during adulthood. The advantage to recognizing this is that you’re an adult now and no longer a helpless child. You can face these issues and find resolution in a way you couldn’t back then.

These Characteristics Resonate With Children of Alcoholics
Many children of alcoholics develop similar characteristics and personality traits. The late Dr. Janet G. Woititz outlined 13 characteristics of adult children in her 1983 landmark book, Adult Children of Alcoholics, which she noted often apply to other dysfunction families as well.

Dr. Jan, as she is known, was a best-selling author, lecturer, and counselor who was also married to an alcoholic. Based on her personal experience with alcoholism and its effect on her children, as well as her work with clients who were raised in dysfunctional families, she discovered that these common characteristics are prevalent not only in alcoholic families but also for those who grew up in families where there were other compulsive behaviors, such as gambling, drug abuse or overeating.

Children who experienced parents with chronic illness, strict religious attitudes, foster care and other dysfunctional systems also often identify with these characteristics, Woititz said.

  • Adult children of alcoholics guess at what normal behavior is.
  • Adult children of alcoholics have difficulty following a project through from beginning to end.
  • Adult children of alcoholics lie when it would be just as easy to tell the truth.
  • Adult children of alcoholics judge themselves without mercy.
  • Adult children of alcoholics have difficulty having fun.
  • Adult children of alcoholics take themselves very seriously.
  • Adult children of alcoholics have difficulty with intimate relationships.
  • Adult children of alcoholics overreact to changes over which they have no control.
  • Adult children of alcoholics constantly seek approval and affirmation.
  • Adult children of alcoholics usually feel that they are different from other people.
  • Adult children of alcoholics are super responsible or super irresponsible.
  • Adult children of alcoholics are extremely loyal, even in the face of evidence that the loyalty is undeserved.
  • Adult children of alcoholics are impulsive. They tend to lock themselves into a course of action without giving serious consideration to alternative behaviors or possible consequences. This impulsively leads to confusion, self-loathing and loss of control over their environment. In addition, they spend an excessive amount of energy cleaning up the mess.

Now, that doesn’t mean that everything on this list will apply to you. But it’s likely that at least some will.

The Laundry List
Before Dr. Jan’s book was published, an individual adult child of an alcoholic, Tony A., published in 1978 what he called “The Laundry List,” another list of characteristics that can seem very familiar to those who grew up in dysfunctional homes.

Tony’s list has been adopted as part of the Adult Children of Alcoholics World Service Organization’s official literature and is a basis for the article, “The Problem,” published on the group’s website.

Other Traits of an Adult Child of an Alcoholic
According to Tony A’s list, many adult children of alcoholics can:

Become isolated
Fear people and authority figures
Become approval seekers
Be frightened of angry people
Be terrified of personal criticism
Become alcoholics, marry them or both
View life as a victim
Have an overwhelming sense of responsibility
Be concerned more with others than themselves
Feel guilty when they stand up for themselves
Become addicted to excitement
Confuse love and pity
‘Love’ people who need rescuing
Stuff their feelings
Lose the ability to feel
Have low self-esteem
Judge themselves harshly
Become terrified of abandonment
Do anything to hold on to a relationship
Become “para-alcoholics” without drinking
Become reactors instead of actors

When It Comes to Relationships, ACoAs May Run Into Trouble
Many adult children of alcoholics lose themselves in their relationship with others, sometimes finding themselves attracted to alcoholics or other compulsive personalities, such as workaholics, who are emotionally unavailable.

Adult children may also form relationships with others who need their help or need to be rescued, to the extent of neglecting their own needs. If they place the focus on the overwhelming needs of someone else, they do not have to look at their own difficulties and shortcomings.

Often, adult children of alcoholics will take on the characteristics of alcoholics, even though they have never picked up a drink: Exhibiting denial, poor coping skills, poor problem solving, and forming dysfunctional relationships.

Support for Adult Children of Alcoholics
If you identify with the 13 other characteristics outlined by Dr. Woititz, or “The Laundry List” by Tony A., you might want to take the Adult Children Screening Quiz to get an idea of how much you may have been affected by growing up in a dysfunctional home. You will find more detailed descriptions of these characteristics in Dr. Jan’s book, Adult Children of Alcoholics.

Many adult children find that seeking professional treatment or counseling for insight into their feelings, behaviors, and struggles helps them achieve greater awareness of how their childhood shaped who they are today. This is often overwhelming in the beginning, but it can help you learn how to express your needs and cope with conflict in new and constructive ways.

Others have found help through mutual support groups such as Al-Anon Family Groups or Adult Children of Alcoholics. You can find a support group meeting in your area or online meetings for both Al-Anon and ACOA.

By Buddy T, Reviewed by Steven Gans, MD

Sources:
Adult Children of Alcoholics World Service Organization, “The Laundry List – 14 Traits of an Adult Child of an Alcoholic,” (Attributed to Tony A., 1978). Accessed November 2010.
Woititz, Janet G. Adult Children of Alcoholics, 2010 Expanded Edition.
Woititz, Janet G. “The 13 Characteristics of Adult Children,” The Awareness Center.

Diane Gaston utilizes an approach to therapy that emphasizes all aspects of the individual, including the psychological, emotional, spiritual, and physical. I specialize in PTSD trauma therapy long beach working with those who have affected and held back by past trauma and/or adverse life events. I also work individually and with couples who wish to improve their relationships.

Nutrition Coaching and Anxiety

How getting your health in check can also lessen the symptoms of anxiety.

Did you know that what you eat can seriously help (or hurt) your anxiety disorder? Really. The healthy functioning of your brain, central nervous system, and endocrine system is essential to maintaining healthy energy levels and a healthy mood, making it much less likely for you to feel anxious. Poor nutrition can lead to symptoms such as depression, low energy, poor sleeping patterns, diminished concentration, or addictive behaviors. Furthermore, for many people, things like caffeine and alcohol illicit negative physical and emotional responses such as nervousness, shaking, or irritability. Working to wean yourself off of these substances while working on improving your nutrition, in general, can help you reduce the above symptoms and as a result, your anxiety significantly.

So how do you eat and what do you do to make sure your anxiety stays in check?

Stabilize your blood sugar to avoid mood swings by eating smaller meals, less sugar and eating more often

Eat whole foods with mood-boosting properties such as fish, nuts, and leafy vegetables.

Choose foods with high antioxidant properties like green tea and dark chocolate as well.

Load up on calming products such as chamomile tea, lavender essential oils, or the amino acid L-lysine.

Keep a food journal focusing specifically on how different foods affect your moods.

Work on balancing your hormone levels to help support a calm and more positive mood.

Learn how caffeine, alcohol, or nicotine affect your mood and how you use them in times of stress so you can better understand how to live without these addictive substances.

Eating to maintain your overall health can be difficult depending on your knowledge of food and cooking, the amount of time you have to prepare meals and your ability to handle additional issues such as depression, work/life balance, and health problems. The best way to break through these issues and come out the other side with health and less anxiety? Hire a nutrition coach! A nutrition coach is a health expert that can help you navigate the world of eating right to stave off anxiety. They can help you choose the correct foods, monitor your calorie intake and help you understand your symptoms to ensure that you are selecting foods that work with your body. They can work in tandem with your therapist to help you with maintaining your health so you can adequately manage both the acute and long-term effects of anxiety. A nutrition coach can also make it easier to work through common symptoms of antidepressants such as fatigue or weight gain. A coach can also help you ease into a workout plan which may make it easier to cope with anxiety and live a full, healthful life.

Generally, better nutrition is often thought of as a complementary therapy when it’s being used to help treat anxiety. Getting your nutrition in check will do amazing things for your mood overall, but it shouldn’t replace medications or talk therapy unless suggested by your therapist.

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and offers nutrition coaching in the New York City area.

Hypnotherapy – A powerful tool for overcoming addiction

Can this be just what I need to live an addiction-free life?

If you or a loved one is suffering from addiction, finding the right cure may be a long and challenging journey. It may include ups and downs, successes and failures. You may experience the need to try various avenues such as medication, psychotherapy, rehab, and more. Usually, a combination of interventions is the best way to get the most comprehensive long-term addiction care. If you’re working to overcome an addiction and need some additional help, an important avenue to explore is the complementary therapy of hypnotherapy. Hypnotherapy can be an excellent way to help overcome addiction and provide you with the tools to maintain a well balanced and addiction free life. Curious to learn more? Keep reading to get a better idea of how hypnotherapy can work for you.

Hypnotherapy is a practice that guides relaxation, intense concentration, and focused attention to achieve a heightened state of awareness that is sometimes called a trance or a meditative state. The person’s attention is so focused while in this state that anything going on around them is temporarily blocked out or ignored. In this naturally occurring state, a person may focus his or her attention on specific thoughts or tasks with an end goal in mind. This practice is guided by a trained a licensed hypnotherapist that will use their expertise to help you overcome the pull of addiction. Hypnotherapy is best used as a companion therapy, working together with psychotherapy or medications to relieve symptoms and change the addiction mindset to help enact lasting change. It can help reduce anxiety, get to the root causes of addiction or even help you to perceive an awareness of pain differently; significantly reducing the uncomfortable sensations of withdraw.

Hypnotherapy is a fantastic treatment for patients with addiction for two main reasons: First, hypnotherapy is a drug-free means of wellness which is an essential consideration for anyone dealing with addiction issues. Second, it relies on relaxation, meditation, and inner strength, all incredibly important skills for those with addiction to master. Often, the desire to use a drug stems from acute stress, anxiety or overwhelm and working through these issues with the help of the positive coping mechanisms learned during hypnotherapy sessions is incredibly useful.

Clinical hypnosis is most beneficial for those who are highly motivated to overcome a problem, especially when they are paired with a professional that’s both trained in hypnosis and their specific condition. Finding a professional that can help guide you through hypnotherapy while also being trained in treating addiction can be the best way to achieve long-term wellness.

Do you think that hypnotherapy is an excellent option to help you overcome your issues with addiction? Do you think it’s the last piece of the puzzle to end your dependence for good? If so, ask your therapist if adding this practice can be just what you need to break the cycle of addiction and live a healthy well-balanced life.

By, Francis Killory, Hypnotherapist Seattle, offering Clinical Hypnotherapy, Hypnosis with Certified Medical Support. Hypnosis is a state of consciousness used by a licensed Hypnotherapist to perform Hypnotherapy and induce a hypnotic state.

Medication Management

Finding ways to make sure you’re healthy and safe both now and in the future.

Polypharmacy is the term used for taking multiple medications for different conditions. This practice is most often a need in older adults or those with complex medical conditions. No matter what medications you take, it’s imperative that you have a good handle when to take them, how to take them and how to keep track of your dosage. Due to age, a hectic schedule, advanced illness or even a medication’s side effects, keeping track of what you need to take when can be a challenge.

Mastering medication management is a necessary step towards wellness and not doing so can adversely affect your health both now and in the future. So how do you ensure that you are managing your medication properly? Continue reading to learn more.

Think practical:
Easy to implement solutions are often most effective due to their simplicity. Having trouble remembering what to take? Use a daily pill sorter so you only have to pay attention to your regimen once a week while you’re sorting them.

Forgetting to take your medicine? Set an alarm on your phone or put your pill bottle in your shoe so you can’t leave home without taking your dose. Simple strategies and repetition can be the best ways to ensure that you’re taking your medicine when you should.

Make a list:
Create and maintain an up to date medication list. A list should contain the drug name, dosage, dosing frequency, and reason for taking the drug. Bring this list with you to every doctor’s appointment or to the pharmacist when you pick up your prescriptions. Providing this information to your caregivers is imperative so they can ensure that your medication won’t cause any adverse effects or unhealthy drug interactions.

Ensure age and weight appropriate doses:
The dosage of certain medications may change with age and weight so when being prescribed a new medication, make sure that your dose is appropriate for you. Especially as you age, the way you metabolize medications changes so dosage amounts or medication time may need to change to account for this difference.

Ask for help:
If you’re having trouble managing your medications don’t feel like you have to do it alone. Ask a family member, friend or medical professional for assistance. Even having a friend send a text message to you once a day checking to make sure you took your pills may be all you need to stay on track. Get a second opinion: No two providers are alike. One may prescribe multiple medications in high doses and others may prescribe fewer. It never hurts to get a second opinion regarding your medications and your health in general, especially if you don’t feel well or are having trouble with one or many of your medications. It’s your responsibility to properly manage your (or a child or aging parent’s) medication properly. If you’re diligent, ask questions and are honest about the side effects you’ll be well on your way to leading a healthy life.

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and offers Psychiatric Consultations in the New York City area.

OCD Disorder Can help Foster Acceptance

In 2015 Target Stores released a clothing item during their Christmas season that caused a lot of controversy. The red, white and green sweater sold online and in retail locations read “OCD Obsessive Christmas Disorder.” Shortly after this item was released many people on social media reacted harshly. Some said that it was trivializing mental illness and making light of a severe condition. Others, most being those who have OCD, found it to be lighthearted and funny. The public outcry and differences in opinion show that this clothing item sparked a debate about mental disease acceptance as a whole. Ultimately, Target chose to keep the item on the shelves and continued selling it throughout the Christmas season.

This is not the first time that mental illness has been mocked in popular culture and it certainly won’t be the last. Conditions like depression, anxiety, and most often OCD are at times mocked or spoken about in a tongue-in-cheek way. We’re all bound to hear or see instances of this from time to time. Instead of getting upset and rushing to social media to profess your anger, the best way to combat the negative talk associated with mental illness is to become more knowledgeable about the subject. Keep reading below to learn more about OCD and how it affects a sufferers’ daily life.

Obsessive Compulsive Disorder (OCD) is defined as a chronic and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that they have the urge to repeat over and over. It’s not just a case of being overly organized or particular; it has to deal with habitual thoughts, rituals, or worries that interfere with everyday life. Obsessions are repeated thoughts or urges that cause anxiety. Some common symptoms include fear of germs, aggressive feelings or the need to have things in symmetrical order. Compulsions are repetitive behaviors that people feel like they need to do in response to obsessive thoughts.

Common compulsions include excessive handwashing, compulsive counting, or organizing and reordering things in a particular way. OCD is common and affects people of all ages, most being diagnosed before they turn 18. The cause of OCD is unknown, but risk factors include having a family member with OCD, abuse or trauma at a young age, or certain brain abnormalities. OCD is typically treated with medication or psychotherapy and may be seen more often in people with other mental disorders such as anxiety and depression.

OCD is a difficult disorder to have to deal with as it can affect so many parts of one’s daily life. It’s exhausting and takes a lot of work to deal with. So, the next time that you or a friend comment about how you’re “so depressed” because your favorite show is ending or how you have OCD because you like to keep your house tidy, consider the differences between being sad or particular and suffering from a mental illness. Being compassionate for others (and maybe passing on the Target shirt) is the first step to truly understanding them.

Besma (Bess) Benali, Clinical Social Work/Therapist, MSW, RSW, Counselling Ottawa Nepean. I am trained in Cognitive Behavioural Therapy (CBT), Brief Psychodynamic Therapy, ACT, and mindfulness. Clients come to me because they are struggling and feel like they are trapped in a darkness that no matter what they have tried (and many have tried therapy before) they can’t pull themselves out. I help my clients understand themselves in ways no one has ever taught them before allowing them to see positive changes.

This article about counselling Ottawa was created here.

Using Mindfulness to Help with Depression

How to use this time trusted skill to ease your depression from within.

Daily life tends to get overwhelming.Incredible demands of your time coupled with the knowledge that you should be doing more makes it easy to feel overwhelmed. If you’re dealing with depression, the stressors of daily life can quickly become too much. How do you find balance in a crazy world? How do you calm mind in a way that can help you deal with your depression? The practice of mindfulness may be the key to helping you handle it all.

The practice of mindfulness-based stress reduction can help you learn how to calm your mind and body to help you cope depression and all of the frustrating symptoms that accompany it. When learning how to use mindfulness to help treat depression, it’s important to first understand what mindfulness is and isn’t. Being mindful isn’t “zoning out” or “turning off” but rather the act of being present in the moment. Being mindful is being able to be aware of what’s going on around you without letting your mind wander to that fact that your house is a mess or your teenager is stressing you out. Mindfulness enables you to experience the present without regretting the past or worrying about the future; actions that contribute to your overall levels of stress, anxiety and ultimately depression. Most importantly, mindfulness is intentional and active. Despite it sounding so simple, it isn’t particularly easy to achieve. It’s human nature always to be thinking ahead and planning for your next step. However, the process of mindfulness gives you the ability to live in the moment. Ultimately, you need to ensure that you’re controlling your mind, and your mind isn’t controlling you. This skill lets you handle stress better so when something is overwhelming, you’re able to process it quickly and easily.

This practice is particularly helpful as a way to help treat depression as it trains your brain to be more resilient and focused at the most important times. Another incredible benefit of mindfulness is the fact that its effects are cumulative. The same way that running gets easier the more that you do it, practicing mindfulness get easier the more you do it as well.

Not sure how to begin your mindfulness practice? Start with your next meal. Turn off the television, put your phone away and just eat. Notice how the dish looks, the way the food is placed on the plate. Note the smell of the food, the colors and the textures of what you’re eating. Pay attention to the tastes and how they change throughout the meal. Finally, notice the way the meal makes you feel. Satiated? Nostalgic? Full? Happy? Practicing mindfulness in simple ways can help you learn how to use it when you’re feeling overwhelmed or clouded by depressive thoughts.

Mindfulness is most useful when it’s being coupled with other depression mitigation techniques like Cognitive Behavioral Therapy and anti-depressant medication. Adding mindfulness to your treatment plan can help you feel in control in the most chaotic moments.

Mollie Busino, LCSW, Director of Mindful Power, Counseling Hoboken. Mollie has had extensive training in Cognitive Behavioral Therapy, Rational Emotive Therapy, and Mindfulness. Her work focuses on Anxiety, Depression, Anger Management, Career Changes, OCD, Relationship, Dating Challenges, Insomnia, & Postpartum Depression and Anxiety.

What it means to self-harm

There are over 3 million cases of self-harm each year. Learn more about what that means and how to work through it.

Self-harm defined:

Self- harm has many synonyms including deliberate self-harm, self-injury, non-suicidal self-injury or self-poisoning. It is defined as the intentional, direct injuring of the body tissue without suicidal intentions. The most common form of self-harm is using a sharp implement to cut one’s skin, but it can take many other forms. Burning, scratching, hitting body parts, interfering with wound healing (dermatillomania), hair pulling (trichotillomania) or the ingestion of toxic substances are also considered self-harm behavior. Behaviors associated with substance abuse and eating disorders usually aren’t classified as self-harm as the tissue injuries that result from these disorders usually isn’t intentional. However, the boundaries of these disorders aren’t well defined, and one ailment can creep into the other, making them hard to diagnose and treat effectively.

Suicide and Self-Harm:

Suicide isn’t the intention of self-harm, but the relationship between self-harm and suicide is a complicated one. Self-harm can be potentially life-threatening, and many of those who are suicidal also self-harm, but classifying those who self-harm as suicidal is largely inaccurate.

Who and Why:

Self-harm is a common symptom of borderline personality disorder and is also common in those with depression, anxiety disorders, substance abuse, eating disorders, and post-traumatic stress disorder. The motivations for self-harm vary widely. Some use it as an escape or coping mechanism for intense feelings of anxiety or depression. It’s often associated with trauma, including emotional or sexual abuse. Self-harm is most common between the ages of 12 and 24 and is more common in females. Adolescents between the ages of 12 and 15 are five times more likely to demonstrate self-harm activities. Unfortunately, due to societal pressures and increased stress, teens and young adults have been engaging in self-harm at a higher rate in the last decade.

Due to the prevalence of this practice in adolescents, teens and young adults, it’s important to be mindful of a child’s stress levels and coping mechanisms in order to help find healthy ways to react to stressful situations.

How to cope:

If the self-harm episodes are related to anxiety or depression, therapy, antidepression medication or stress reduction techniques can be used to help lessen the desire to self-harm. If the self-harm is related to increased societal pressures, efforts should be taken to monitor social media activity and participate in self-care.

Self-harm is a complex condition that has numerous causes and can look different in various cases. No matter what form it takes, it’s a condition that needs to be taken seriously as it can be masking other conditions or unhealthy behaviors. The most important thing to remember is that if you or someone you know is self-harming, help is available. It’s a condition that can be overcome with the help of a therapist.

Dr. Jeffrey Ditzell is a Psychiatrist in New York City and specializes in issues involving anxiety depression and adult ADHD. Ketamine Infusion Therapy is one of the many treatments Dr. Ditzell offers to treat a variety of mental health issues.

Working Through Humiliation

Everyone experiences it, no one likes it, but only the best know how to come back from it.

Whether actual or assumed, big or small, humiliation can wreak havoc on your life. Everyone at some point has been utterly humiliated for one reason or another. The feeling of humiliation is distressing, intensively painful, and frustratingly long lasting; creeping back into your stream of consciousness just as you think you’ve recovered from it. Right when it happens, humiliation can be incredibly stressful and make you feel helpless. However, there are ways to work through it and come out the other side a more resilient and self-assured individual.

How to work through humiliation:

View each crisis as an opportunity: Humiliation often stems from feelings of inadequacy or lack of preparation. Maybe you were underprepared for a job interview or utterly undertrained for the 5k you promised yourself you’d do great in. Whatever the humiliation stems from, being able to reframe it as an opportunity to do better can help you get over the feelings of distress.

Seek solace in the comfort of friends: Being able to find a support group or talk to friends about your humiliation is an incredible way to help move past it. Simply talking through your problems with trusted pals or a support group is a beautiful way to become more resilient and emotionally stable.

Look ahead: Looking past your feelings of humiliation and focusing on your opportunities ahead can help distract you and allow those distressing feelings to fade. Every situation looks better once some time has passed. Looking forward while working through humiliation can be a positive way to conquer the negative feelings associated with this emotion.

Only hide out if you need to: When something humiliating happens, its easy to want to curl up into a ball and hide away from everyone you know. Despite this sounding like a great idea, hiding out from your friends or family after a humiliating event occurs can increase feelings of regret, shame, or depression to levels that may be difficult to deal with. Lay low for awhile if you feel like you need to, but be aware that staying away from the support of your loved ones for too long can be a bad idea.

The best advice? Be kind to yourself. Any humiliating event probably feels much worse to you than anyone else who experienced it. Generally, humans are kind and are much more willing to overlook embarrassing moments than you might expect. Knowing that all humans are flawed, and you’re just like everyone else is an excellent way to help cope with any feelings of humiliation you may have. Once you realize that you’re just human and sometimes, humiliating events just “happen,” you’re much more likely to react appropriately and recover quickly.

A final note: If you’re experiencing humiliation, dread, stress, and issues regarding your self-worth it’s best to talk to a therapist about these emotions. You may have underlying anxiety or depression issues that a therapist can help you with.

Dr. Dimitra Takos is a Newport Beach Psychologist specializing in the treatment of adolescents and adults suffering from depression, anxiety, and trauma-and stressor-related disorders.

Depression – Medication Explained

Depression is not a one-size-fits all mental disorder. There are many types of depression including major depression, persistent depressive disorder, bipolar disorder, seasonal affective disorder, psychotic depression, peripartum (postpartum) depression, premenstrual dysphoric disorder and situational depression. It is impractical to expect then that one treatment plan will be effective across all types of depression. A thorough evaluation by a psychologist or psychiatrist will help pin point the specific type of depression so that a specific treatment plan may be developed.

Patients with mild depression may positively respond to strategies that do not include medication. Lifestyle changes for example, including exercising moderately three times per week, have been proven by research to diminish the symptoms of depression. Other strategies include educating oneself about the disorder and avoiding isolation by spending time with trusted friends and family. Talk therapy may also prove to be effective. While these approaches may provide gradual incremental improvement for milder forms of depression, more severe depression may require prescription medications.

Depression is a complex mental disorder and it is not fully understood. However medical science has identified several underlying causes as follows: sexual or physical abuse, grief, drug or alcohol abuse, genetics and unexpected life events. Thyroid disorders and diseases of the endocrine system (hormones) can also cause depression. Chronic illness, including heart disease, kidney disease and diabetes may also contribute to depression. Recognizing the complexity of depression is not difficult; nor is it difficult to understand that use of antidepressants for the treatment of depression must be carefully supervised by a properly trained medical professional. An understanding by the patient as to how the chemistry of antidepressants work may be helpful.

Our brains are composed of complex communication circuits and chemicals called neurotransmitters. Neurotransmitters allow the chemical transmission of signals from one nerve cell to another nerve cell. You may have heard these chemicals referred to as serotonin, dopamine or norepinephrine. Serotonin is found in the brain, bowl and blood platelets. It is believed by some medical scientists to be our body’s primary “mood regulator” and an imbalance of serotonin may lead to depression. At this time science is unsure if decreased levels of serotonin cause depression or if depression causes a decreased level of serotonin. In either case, the relationship has been established and represents the basis of how antidepressants work.

You may also have heard certain antidepressants referred to as SSRIs, selective serotonin reuptake inhibitors. SSRIs are thought to minimize depression by increasing levels of serotonin. Said another way, they enhance nerve cell function by blocking the reabsorption (reuptake) of serotonin in the brain making more serotonin available. This class of antidepressants targets (selects) serotonin and allows the buildup of serotonin between nerve cells thereby affecting emotion and depression.

Antidepressants such as SSRI’s can take two to four weeks to produce effects. They may also cause side effects which may decrease in time. A licensed psychiatrist or psychologists can explain both benefits and potential side effects. In all cases, close supervision by your treatment provider is necessary, and if you are prescribed medication, do not stop taking the medication without first consulting with your health care provider.

Carolyn Ehrlich LCSW, CGP specializes in Relationship Counseling NYC. I increase your self- awareness and help you gain more insight into your inner-life. We’ll work together so you can get more out of every day and meet any challenge life throws at you.

What Is Social Psychology?

How understanding the way couples interact can help us learn about society as a whole.

Have you ever changed the way you acted when you were in a group? Let a popular opinion change the way you thought? Or even observed the changes people experience when they’re put in positions of power? All of these topics and more are related to Social Psychology and can have a significant impact on individual and interpersonal behaviors. Taking an in-depth look at the science of social psychology can help explain why people do what they do and the implications of those actions.

Social Psychology is a researched based field that aims to explain how the thoughts and actions of individuals are influenced by the thoughts and actions of other human beings they interact with. Different people shape our experiences and the people that are around us at any given time can affect the choices we make.

Social psychology looks at a wide range of social topics, including:
Group behavior
Social perception
Leadership
Power dynamics
Nonverbal behavior
Aggression
Conformity
Prejudice
Couples Counseling

Having a better understanding of how people interact can help us understand the world in which we live.

Social Psychology vs. Sociology:

These two disciplines are often confused as they are very similar. Both Social Psychology and Sociology look at social behavior but sociology looks at it in a broader cultural level. Sociology focuses on the influence of institutions and cultures on human behavior whereas Social Psychology focuses more on interpersonal relationships and how individual people or groups of people affect social situations.

Social Psychology’s influence:

Since popular concepts such as social loafing and the crowd mind were introduced in the late 1800s, Social Psychology has shaped our understanding of how individuals interact with the world. Despite the earliest ideas of this science taking shape from the writings of Plato, Social Psychology really solidified itself after World War II. Events such as the Holocaust helped Social Psychologists understand the effects of social pressures, conformity and obedience and why people can be coerced into following orders to such an extreme level. This event coupled with a few groundbreaking social experiments were the cornerstone of Social Psychology as we know it today.

The Milgram Obedience Experiment:

One of the most well known Social Psychology experiment was organized by scientist Stanley Milgram and was conducted to help understand obedience and power dynamics. It took place in the1960s and was created to help understand why so many people would follow and support Hitler during the Holocaust. A group of men were tasked with asking their “students” questions and has to administer an electric shock when a wrong answer was given. The “students” were in on the experiment, and no actual shock was given, but they acted as if they were in pain and eventually began pleading and begging with the subjects to make the shocks stop. Each time the men paused they were urged by the study’s administrator to press on, eventually being told that “It is absolutely essential that you continue.” and “You have no other choice; you must go on.” Despite the fact that they believed that they were hurting the “students” 65% of the men consented to authority and administered the maximum shock. This was astonishing to Milgram as he believed that his authority wouldn’t have had as much influence on the subjects. This experiment was paramount in helping scientists understand the horrors of the Holocaust.

So the next time you experience “group think” in a meeting or see a teenager engage in dangerous behavior just to impress their friends, know that Social Physiology is at hand. Learning how this powerful science effects us is the cornerstone of understanding how we operate as a society.

Christy Weller, Psy.D., Couples Counseling Boulder. I bring a genuine curiosity, a kind appreciation of where you have been, and a non-judgmental stance so that you feel comfortable exploring your story and making sense of it. I tailor my work to each client and I’m trained in both short-term and long-term therapies.

Carrying and Coping with Loss

Unfortunately, loss is a part of life for everyone. Whether it’s a close friend, a relative, or even a certain situation, we’ll all have to deal with some type of loss at some point. The hard part is that we all respond to it, and deal with it differently.

There are healthy ways of coping and dealing with loss – that doesn’t necessarily mean it’s any easier for some people than others, but some people are better able to carry it with them and get through their lives. For others, loss can feel like a crushing defeat. It can take over your life and make you feel as though the walls are closing in around you.

It’s perfectly normal to grieve and feel a sense of loss when the situation is appropriate. But, when it starts to completely take over your life and feels impossible to deal with, it’s time to work on how to get through it for good.

Whether you feel angry, confused, hurt, lost, or even guilty, we can help you to focus on your future without feeling the constant weight of your personal loss. In the meantime, let’s take a look at a few helpful tips that can guide you through your grief.

Don’t Keep It Inside

One of the best ways to deal with grief is to talk to someone about it. It might sound cliché at first, and there’s a good chance you won’t want to ‘burden’ anyone with your feelings, but you can’t let yourself be held back by those thoughts. Confiding in someone can make a big difference, whether it’s a family member, friend, or even a professional in mental health.

Keep a Routine

If you already had a daily routine, try to keep it in tact. Doing ‘normal’ daily things can make coping easier and make life feel somewhat balanced again. You can also develop a new routine. Something as simple as waking up at the same time each day to go for a walk can make a difference.

Take Care of Yourself

Eating well, getting enough sleep, and even exercising can help to make the feelings of loss seem less daunting. When your mind and body are taken care of, your emotions will be, too. The stress that comes with loss can also make you feel exhausted, so don’t be afraid to fight that exhaustion by getting enough sleep.

Don’t Use Negative Substitutes

Out of the many ways to cope with loss, one of the worst things you can do is try to fill that void with something negative. Unfortunately, many people turn toward things like alcohol, gambling, or other harmful vices. Dealing with loss can take time, and there are healthy ways to get through it. Trying to find a ‘quick fix’ in order to numb the pain might work for a short period of time, but it can easily lead you down a destructive path.

Again, the best thing you can do when dealing with loss is to talk it out with someone. If you’re not comfortable sharing your feelings and emotions with friends or a family member, we can help when it comes to listening and providing guidance for the future.

Counselling Burnaby Vancouver, Via Counselling & Consulting. Burnaby Counsellor Shari Wood, M.Ed., R.C.C. dedicated to helping clients begin their personal therapeutic journey. A Clinical Counsellor, specializing in helping people overcome self-doubt and build healthy relationships.

How to Recognize and Get Past Negative Coping Mechanisms

We all cope with things like grief and stress differently. Life tends to throw a lot of things our way, and how we respond to each situation can greatly affect the next ‘chapter’ in what we do. Some negative coping mechanisms may not seem like such a big deal: Perhaps you reach for a pint of ice cream when you’re stressed out. Or, maybe you need a drink to take the edge off.

When these coping mechanisms start to turn into regular habits, or things we turn to in dependency whenever we get stressed, bigger problems can occur. Unfortunately, you may not see your coping skills as negative until they’ve already become a bigger issue. Let’s dive deeper into what negative coping actually looks like. Once you recognize the patterns, you can choose to take control of your life again and practice positive coping habits instead.

Negative Self-Talk

Getting down on yourself about things easily is an easy way to shift the blame of a problem you may be dealing with. You can almost use talking down on yourself as a type of ‘excuse’ for whatever you’re going through, but it doesn’t make the problem go away and certainly won’t make you feel better. If you find yourself criticizing the things you do, or simply the way you are, you could be falling into a poor coping habit.

Drinking, Smoking, and Drugs

If you’ve never been an avid drinker or smoker before, but you turn to these substances in times of stress or grief, it’s important to take a closer look at why. Many people who don’t want to face negative situations will look for outlets that either make them feel ‘numb,’ or as though they can avoid that particular situation for awhile. Avoidance will likely only make the problem worse, as it continues to build up and never gets resolved.

Becoming Aggressive

Stress or grief can weigh heavily on anyone. While some people’s response is sadness and proneness to depression, other people tend to act out in anger and aggression. If you find that you have a ‘short fuse’ when you’re going through a stressful time, it could be your own negative way of dealing with things. This could include anything from yelling at friends, family members, or your children, to becoming violent at times. Take stock of your aggression when you’re going through a stressful situation.

What Are Some Positive Coping Habits?

There are plenty of additional negative coping mechanisms to consider. Everything from your eating habits (overeating or undereating) to taking risks (driving too fast in your car) can come into play. They are different for everyone. The important thing is to recognize how you respond, as an individual, so you can better determine if you’re coping in a healthy way or not.

On the other side of things, there are multiple ways to cope in a healthy and positive manner.

This includes things like:
Going out with a friend
Spending time with a pet
Doing something that makes you laugh
Exercising
Meditation
Being creative

One of the best things you can do to ensure you’re coping effectively is to seek out some type of counsel if you can’t do it on your own. If negative coping mechanisms have turned into habits, getting the right kind of help can make a big difference.

We’re happy to work with you to build on the positive coping habits you can create for yourself. It can take time and a little extra effort, but by working together, we can make sure the stressful situations you deal with regularly can be handled in a healthy and appropriate manner. Not only will you start to feel better about how you handle stress, but you’ll undoubtedly notice the positive impact these changes can have on your life.

Anna M. Hickey, Counseling Macomb, works with couples and families struggling with relationship issues

Mindfulness-Based Stress Reduction (MBSR)

Everyone on the planet has felt a little out of control at times. You get angry or stressed out, tired or overwhelmed. After all, we’re all human. However, one thing as humans that we have on our side is the ability to breathe. Simply taking a deep breath and becoming aware of a moment when you feel your most stressed is profoundly helpful. The idea that breath and awareness help to cope with stress isn’t all in your head either. Pausing during stressful times to become present is an incredibly powerful practice. It’s so powerful in fact that it’s been studied, organized into a program and taught around the world. This process is called Mindfulness-Based Stress Reduction (MBSR), and it can be used to help alleviate chronic pain, reduce stress, and improve your quality of life. MBSR incorporates meditation, body awareness and yoga to help people become more mindful. It was developed at the University of Massachusetts Medical Center in the 1970s by Professor Jon Kabat-Zinn and has been used since to provide calmness and stillness to those that practice it.

Despite having roots in Eastern spiritual practices such as Buddhism and Hinduism, MBSR itself is secular and can benefit anyone that chooses to learn and practice this useful skill.

MBSR teaches participants, through in-person or online courses to be present in any given moment. Noting a definitive joy, pain, anxiety or even a particular taste or smell can help you process it easier, providing you with more fulfillment or peace at any given moment.

The beauty of this practice is that it can be useful for both positive and negative experiences. MBSR can help make you more present at joyous events just as it can help you understand what’s exactly making you anxious during periods of negativity.

Try it for yourself:
Close your eyes, sit in a comfortable position, and focus on your breath for just 2 minutes. Become aware of the way your breath feels moving through your body or the way your body feels in your chair. If a passing thought comes into your mind, acknowledge it and then recenter your focus. After the 2 minutes are over, note the way you feel. Relaxed? More centered? Better poised to tackle the rest of the day? Try to do this once a day or at least when your anxiety gets the better of you. Awareness is an incredible thing, and once you learn to use it, it’s very powerful.

Who would have thought that simply being more aware of yourself can so strongly affect your well-being? Do you think that MBSR is for you? Both online and in-person trainings are available to help you learn and thrive from this technique.

Dr. Takos is a Newport Beach Psychologist specializing in the treatment of adolescents and adults suffering from depression, anxiety, and trauma-and stressor-related disorders.

Does My Child Have ADHD?

When we think about ADHD in general, we tend to label it as a disorder commonly associated with children. While the effects of this disorder can carry into adulthood if not properly treated, Attention Deficit Hyperactivity Disorder typically does show signs in younger people. It’s a mental health disorder that can affect your child’s success, relationships, and growth.

Unfortunately, symptoms can often be customary on an individual basis. It takes a doctor’s diagnosis to officially determine if a child has ADHD. Far too often, the symptoms go unnoticed and an official diagnosis is never given. Most children aren’t diagnosed officially until they are into their early teen years, even if they exhibit symptoms and behaviors earlier.

To help your child cope with the effects of ADHD, it’s important to recognize possible symptoms. Again, everyone may express these symptoms in a slightly different manner. But, knowing the overall signs can help you to determine whether or not you should take your child to a doctor to be diagnosed. Keeping your eyes open for some of these signs can be beneficial for your child if it gets them the treatment they need.

They are Only Focused on Themselves

It’s sometimes hard for children with ADHD to consider the needs of others, or think about other people’s feelings. This can lead to things like frequent interrupting during conversations, or difficulty waiting their turn. They are very self-focused and self-driven, and don’t typically understand why everything can’t be about ‘them’ all the time. Obviously, this can lead to trouble in forming friendships and healthy relationships.

They Can’t Sit Still

This is one of the most common symptoms people associate with childhood ADHD. Fidgeting, or the inability to sit still for long isn’t necessarily uncommon in most children. But, a child with this disorder will find it nearly impossible to stay in one place for any length of time, for any reason.

They Have Trouble Focusing

Another symptom people commonly associate with ADHD is a child’s inability to focus. We don’t expect our children to have extremely long attention spans, but this lack of focus is different. If they have trouble paying attention even when someone is talking directly to them, it could indicate a problem.
Furthermore, this easily distracted behavior often leads to things like daydreaming, making frequent mistakes after being given specific instructions, or even forgetting something they were just told. They may also avoid any task that requires sustained effort, mentally. This could unfortunately include things like paying attention in a classroom setting.

They Showcase Symptoms Regularly

While these are just a few of the common symptoms, it’s important to pay attention to them at home as well as school. If your child’s teacher brings up any of these signs, consider their behavior at home. A child with ADHD will show symptoms almost everywhere, not just in one specific location or during a specific circumstance. If they aren’t focused in school, are they focused at home? If not, it might be time to get an official diagnosis.

The sooner you are able to get a diagnosis, the sooner a treatment plan can be put into place to help them deal with the symptoms and inconveniences of this distracting disorder.

Marcy M. Caldwell, Psy.D. is a licensed clinical psychologist who specializes in the treatment and assessment of adult ADHD Psychologist Philadelphia.

 

Hearts Don’t Bounce, or Rebounding After a Breakup

Jumping into a new relationship too quickly after a breakup is known as “rebounding”.

It’s a fairly big word that describes an emotional quagmire in which the grieving party (or parties) find themselves when what was once pledged as “forever” turns out to be closer to 2.6 years, according to the U.S. Census Bureau.

It’s a time for sorrow. A time for regret. In some ways, it’s like mourning the death of an old friend, and no one can tell you how long you should suffer, how sad you should feel, or how quickly you ought to “just get over it and move on”.

In this time – best simply called “after” (after the love, after the dreams and plans, after a part of life ends) – you may have more than one rebound. You may also buy a Porsche, dye your hair purple, find relief in an ashram, or take up bungee jumping. It may all seem like avoidance strategy – who even wants to feel emotional pain? – but in fact you are growing up, and here’s how you can tell.

Seeing your former significant other (SO) with a new partner doesn’t kill you, because you now realize that, just because he/she wasn’t happy with you doesn’t mean they can’t be happy with anyone else. But you might want to block your Facebook page.

When rebounding lines you up with someone who thinks they were put on earth to rescue you. Don’t go there: the only person who can rescue you from impossible expectations and fantastical presumptions is you.

The truth about most rebound relationships is that they fail, and for a very obvious reason. You got into the relationship to distract yourself from your pain. But when the glow fades and the grownup games end, you’re pretty much back to square one and asking yourself the ultimate question. If you could not tolerate a certain behavior in your ex, how are you going to put up with it from your rebound?

Finally, beware the drama queens of either sex, who simply need another pair of ears to listen to their endless tale of sorrow and woe. These people really can’t stand life without crises. They have to be the center of attention, and when they aren’t they pout and take revenge in ways that suggest arrested development.

In some ways, these needy people come across as emotional refugees. In others, they skirt the edges of borderline personality disorder, or BPD. This is a serious form of mental illness characterized by instability – in moods, self-image, behavior, and relationships.

Couples Counseling Boulder, by Therapist Christy Weller, Psy.D.  Also specializing in Psychotherapy and Psychological Assessment Services.

What can therapy do for me?

Psychodynamic therapy works for at least 80 percent of individuals, including the very young and the very old.

How young, and how old? One very successful psychotherapist in California, when asked, said that his youngest patient was 9 and his oldest patient 82. In fact, psychodynamic therapy delivers a number of psychological benefits, all of them integral to the patient’s unconscious, and all of them related to the conflict between conscious and unconscious thoughts and wishes.

Therapists using the psychodynamic therapy form of psychoanalysis are responsible for teaching patients how to recognize, reveal, and correct unconscious influences over conscious behaviors. In addition to that, therapists provide a level of support not found elsewhere in the patient’s life, teaching patients how to cope with anxiety, depression, stress, self-destructive behaviors, and psychosocial dysfunction associated with borderline personality disorders.

In some instances, a therapist can even help a patient resolve a creative block stemming from the conscious suppression of unconscious desires. In fact, psychodynamic therapy in particular is strongly oriented toward reshaping the psychological underpinnings of various personality disorders.

Therapy for the real world

Individuals who do not have a major psychological disorder can also benefit from therapy. Conflicts may be as mundane as finding a home for an angry, aging parent, deciding whether to take that high-stress job offer; or how to tell an old friend that he or she is out-of-bounds when it comes to offering marital advice.

In these instances, the therapist offers a unique point of view, perhaps one that the patient never even considered. This may also lead to unexpected solutions. The best part about this, and almost every other exchange between patient and therapist, is that the therapist is bound to your privacy – unless therapy reveals ongoing child abuse, violence against another person, or a legal matter in which the patient’s mental status is involved.

For most people struggling with the ordinary trials and tribulations of life, psychodynamic therapy – which deals with the unconscious motivations of conscious behaviors – can offer insights and solutions that are not only “outside the box” but inherently life-changing. These may include revealing one’s true vocation, changing a lifelong – and self-defeating – behavior pattern, enhancing self-confidence, or helping a patient identify the childhood source of adult problems (like spending too much, eating too much or too little, or other addictions).

What if I’m managing on my own?

You have this really fantastic friend who is always there when you need him or her, listens without interrupting, and always offers the best advice you have ever had.

But if you don’t, and that is where a good therapist comes in.

Even if you have been in a loving relationship for two decades, there are some things that can’t be revealed, and you are just smart enough to know when you could use a helping hand. Or ear. In fact, psychodynamic therapy is ideal for individuals who are perceptive enough to realize when they have gotten in over their heads, psychologically speaking.

How can I tell if therapy will help?

Getting into therapy is like sailing across the Atlantic. The journey is more important than the goal. The more you immerse yourself in the process, the greater your understanding – not just of yourself, and your real needs, but also the hopes and needs of those around you.

The only time that therapy “fails” is when you go in with preconceived notions about what ought to be. As John Lennon so presciently pointed out, “Life is what happens when you are busy making other plans.”

Carolyn Ehrlich LCSW, CGP specializes in Relationship Counseling NYC

Why Communication is Key for Couples

“The greatest problem with communication is we don’t listen to understand. We listen to reply…” Roy T. Bennett wrote in his book “The Light in the Heart “.

This, perhaps more than any other facet of a relationship, is the key to staying married, staying partners, even staying friends. True listening, listening to understand, is a passive suspension of disbelief, and one of the few times when passivity is a positive response.

To achieve this passivity – this openness to impressions, opinions, and ideas – we need to do several things. First, we need to become completely calm. If we have been fighting, we need to step away from each other and find a “safe” place where we can let our heart rate drop below a certain threshold (90 beats per minute for females, 82 beats a minute for males). Anything above this and the body’s defense systems will kick in for the fight-or-flight (or freeze) response.

This reaction, also known as the acute stress response, triggers all kinds of hormones, none of them useful unless you are being attacked or inside the house when a fire starts. In fact, it is only when your heart rate drops below this threshold that you can access the logical portion of your brain – the only area worth connecting unless you want an instant argument.

It will likely take you about half an hour to access this calmer, cooler you. Once you have reached stasis, or emotional equilibrium, you are no longer in danger of having the stress function of your brain overcome the logical function. Only then can you resume communication without having to worry about saying something hurtful.

The second step is not to sweep all those negative emotions under the rug and hope they won’t crop up again, because they will – again and again, until the relationship is truly beyond repair. Instead, focus on the issue that brought on the storm. Most times you will find it is a small thing – someone forgot to turn off the alarm on the weekend, or failed to reactivate the cell phones.

Once you have identified the “trigger” issue, talk about it, but in a blameless way. Say something like “We need to have our cell phones ready at all times, in case one of us is hurt or in trouble.” Always use the word “we” and always make it a joint issue.

Once you have explained your frustrations, you can move on to other topics. Silence may be golden, but not in a relationship. On the other hand, communication doesn’t always have to be about problems. Throw in some praise, or memories of good times, to balance the more negative problem areas. Because once couples settle into a relationship, the rapture begins to unravel – as it must over the long term if that relationship is to survive.

Finally, never have a conversation when one person seems solely focused on a project, a program, or a promise. If she has a girlfriend over fitting a dress, if he is watching the NBA playoffs, or if only one half of a couple remembers the time you both agreed not to have “company” on Sunday, turn the anger off. Not every interaction requires a winner or loser. Or, as a wise woman once said: “Pick your battles, but remember. Winning the battle is not the same as winning the war.”

Written by Kin Leung, MFT, providing Couples Therapy Burlingame

Depression and Addiction – How Are They Linked?

Depression directly affects millions of people. It’s one of the most common psychiatric disorders people suffer from. Substance abuse is typically viewed as a different issue altogether. However, the two may be more connected than many people realize. Because of their close connection, we are often left with a ‘chicken or the egg’ type question, in determining what causes what: Does depression lead to addiction, or does addiction lead to depression?

Many common addictions are actually called ‘depressants,’ such as alcohol. Alcohol can trigger feelings of sadness and make you feel lethargic. However, many people use alcohol as a crutch when they are feeling low, to lift their spirits for a short time. As you can see, It’s not always easy to differentiate the two problems. They are so connected, in fact, that the Journal of Clinical Psychiatry has reported that 1 in 3 adults who struggle with some type of addiction also suffer from depression.

What are the Warning Signs of Addiction?

Depression can easily open up an individual to addiction. Again, many people who become addicted to a substance initially reach for it to stop feeling so depressed. This isn’t to say that having a glass of alcohol or trying a different substance automatically will lead to addiction, but there are some important warning signs to look out for. Some of the most common signs of addiction include things like a heavy tolerance for the substance, and withdrawals if the substance is taken away.

Withdrawals are nothing to take lightly if addiction and depression are linked. Individuals who have abused a substance for too long can actually become even more depressed if they are deprived of it. Unfortunately, the substance is often used as a ‘blanket’ to cover depression, and that psychiatric state only shows up with the substance is removed.

When these two problems are linked, it’s important to treat them both. Trying to treat one without the other typically ends in failure, and it’s not common for the individual struggling with the problems to simply ‘give up’ on the process.

Treating Depression and Addiction Together

To treat depression and addiction together first requires a dual diagnosis, which is why it’s so important to know the warning signs of addiction in the first place. The Substance Abuse and Mental Health Services Administration suggests an integrated approach to treatment of these two conditions, including things like:

  • Guiding the individual to discover the source of their depression
  • Understanding that a full recovery from both conditions is completely possible
  • Finding motivational techniques the individual can use to make changes

Changing and redirecting addictive behaviors

The most important thing to remember is that help is available. The most important resources a person struggling with addiction and depression can have are support and encouragement from friends and loved ones. A dual diagnosis is never easy, especially when you have two conditions that can depend on each other so strongly. But, with the right support, a willingness to get help, and the right techniques, beating both conditions is not impossible. If you, or someone you know, is dealing with this type of connection, know the warning signs, and know that with a dual diagnosis, it’s possible to finally find relief.

Dr. Jeffrey Ditzel is a Psychiatrist in New York City and specializes in issues involving Anxiety & Depression.

Managing Life Transitions

Life transitions are inevitable. From the moment we are born, we are transitioning mentally, emotionally and physically. Life transitions are necessary for individual and collective evolution. Here is a beautiful quote from philosopher and architect, R. Buckminster Fuller:

“I don’t know what I am. I know that I am not a category. I am not a thing – a noun. I seem to be a verb, an evolutionary process – an integral function of the universe.”

We are a fluid evolutionary process. In the midst of change, we must manage life transitions in order to maintain sound footing in the present and a watchful eye towards the future. Our mental, emotional and physical health depends upon it. Our ability to live happy productive lives depends upon the thoughtful grounded manner in which we manage life transitions.

Some people are able to successfully rise above intense crisis, see a silver lining and move towards a deeper more meaningful life. Other people unsuccessfully crumble from a minor stress. Some people seek out challenges and are invigorated and enriched from the bumps in the road that risk taking inevitably presents. Others avoid any new experience. Psychologists and researchers who study the human condition continue to seek answers as to why some people successfully manage transition while others do not.

William Bridges, PhD in his bestselling book Managing Transitions: Making the Most of Change makes a point of separating the two notions of change versus transition. Bridges explains that with change, a person focuses on the outcome that the change produces. He uses an example of moving from California to New York City; moving across the U.S. then learning to navigate in New York City. People understand the basic change and how they will be affected by it. However transition is quite different. Transition includes not only managing change from a starting point, but accepting the fact that one will have to leave the old situation behind; in other words, letting go of an old reality and embracing a new reality. Feelings of loss are surely generated in transition, and unless those feelings of loss are properly managed, change cannot successfully occur.

Self Efficacy in Changing Societies features the work of Matthias Jerusalem and Waldemar Mittag (edited by Albert Bandura). World famous psychologist Albert Bandura defined self efficacy as our personal belief in our ability to succeed in specific situations. Our sense of self-efficacy plays a major role in how we approach goals and challenges. In simpler terms, self efficacy defines how much or how little faith we have in ourselves. People with perceived high self efficacy trust their own capabilities to manage change along with new environmental demands. These people have a tendency to interpret demands and problems more as challenges instead of uncontrollable events outside their scope of control. They face stressful situations with confidence. A strong sense of self, one’s ability to navigate change and transition, buffers distress and fosters strength. Conversely, people with low perceived self efficacy are prone to self doubting and anxiety. Coping is replaced by worry, lack of self confidence and any feedback from others is interpreted as criticism of personal value. They feel more responsible for failure than for success.

When facing a significant life change, here are a few practical suggestions to make the transition more successful:
• Do not criticize yourself if you feel anxious or slightly depressed. Most likely these feelings will pass as you ground yourself in positive self regard and strength.
• Visualize your new situation with positive regard.
• Allow yourself time to let go of your old reality and see the new reality as an opportunity; a naturally positive occurrence in life’s path.
• Be realistic about the time and resources needed to adjust to your new environment.
• Most importantly, if you need help adjusting, get help. A professional licensed therapist will be able to help you navigate through change and make the most out of your new situation.

Polly Sykes, Registered Psychotherapist, MEd, RP, is a Toronto Psychotherapist with extensive post-graduate training and experience in the treatment of Trauma, and the use of Emotion-Focused Therapy for both Individuals and Couples. The support of an experienced and highly-skilled Psychotherapist can be a powerful tool to help you face the challenges of life with more hope, more self-acceptance, and stronger relational bonds.

Tallae Counseling & Wellness Center

Dwan Reed, Ph.D., LCSW, DTM

I am a certified facilitator for Prepare/Enrich (couples counseling), and a certified Anger Resolution Therapist. I am a yoga and natural health enthusiast. I have been married for twenty-five years and am the mother of two young adult children. I enjoy church ministry, traveling, playing with my pets, and watching investigative crime shows. Dwan Reed, PhD, LCSW, DTM, of Tallae Counseling & Wellness Center is a therapist specializing in Depression Counseling in Spring, TX

Tallae Counseling & Wellness Center
Dwan Reed, Ph.D., LCSW, DTM
Therapist & Prinicipal Owner
Tallae Counseling & Wellness Center
6302 Laver Love Dr.
Spring, TX 77379

832 263 1907

Psychotherapy

Sometimes life can be awfully lonely and anxious. Perhaps you don’t have the sense of fulfillment or connection in life that you want. This work is about far more than symptoms, it’s about the deeper place of who you are. It’s from this place that connection and lasting change will come. It can be vulnerable, but so very brave, to seek help. I offer a safe, comfortable space to process your feelings, and begin moving toward change. Relationships have the power to hurt us, but it is also within relationship that we can be healed.

Therapy is most effective when you feel like you can be yourself. With all the anger, melancholy, and anxiousness. It is from this place that your greatest relief and change comes from. You’re not alone in this work and it is something that we do together.

Colin B. Denney, Ph.D., Psychologist Honolulu

Colin B. Denney, Ph.D., is the Director of the Pacific Psychology Services Center in Honolulu, Hawaii, he is a Child Psychologist Honolulu.

Pacific Psychology Services Center
Honolulu, Hawaii

I provide individual and family therapy with children, adolescents, adults, families, and couples. I also have extensive training and experience with children and adolescents who are struggling in school.

Disorders with which I have particular expertise include Anxiety Disorders, Posttraumatic Stress Disorder (PTSD), Obsessive-Compulsive (OCD) and Related Disorders, Attention Deficit/Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder, Depressive Disorders, and Tic Disorders (including Tourette Syndrome).

I also have a special interest in interventions focused on parent-child relationships. I have received formal training in several well-validated treatments of this kind, including Parent-Child Interaction Therapy (PCIT), Positive Parenting Program (PPP), and Child and Adolescent Relationship Enhancement (CARE).

Drew Tillotson, PsyD., Clinical Psychologist Specializing in Sex Addiction Therapy in San Francisco

Drew Tillotson, PsyD., Clinical Psychologist Specializing in Sex Addiction Therapy in San Francisco

Drew Tillotson is a clinical psychologist with over 19 years experience in the mental health field. He is in private practice in the Lower Pacific Heights area of San Francisco and treats adults in both individual and couples therapy. He specializes in treating sex addiction therapy in San francisco and provides a safe and confidential environment for business professionals, doctors and lawyers who are looking for help. He uses a non-pathological approach to sexual behavior, helping patients understand what causes them to use sex as a way of coping with emotions, stress, fears and insecurities.

Palo Santo Sticks

Frankincense, Myrrh and apparently, Palo Santo wood. From a tree indigenous to the Americas, these burning sticks calm the senses and help you find center when modern life becomes overwhelming.

Confetti Uncut

What is it about tiny pieces of paper being thrown up in the air that makes us so happy? D. Graham Burnett dissects the ticker tape phenomenon. Now we just need something to celebrate…

Come Sunday

What makes a ‘spiritual’ a spiritual? Hundreds of years being sung in the church or maybe just the combination of Duke Ellington and Mahalia Jackson? Written by Duke for his symphony ‘Black, Brown and Biege,’ this song is at once the most mournful and most hopeful thing you’ll ever hear.

Borobudur Temple

The 9th-Century shrine to Buddha is the world’s largest Buddhist temple, but its history is shrouded in mystery. Who built it, and why, cannot be agreed on to this day.

On High

Photographer Humza Deas climbs the buildings of New York to get unbelievable images that make even the most mundane views seem otherworldly.

Mix-and-Match Spirituality

Young people are approaching religion from a highly individualistic view. What does that mean for faith and religion in the 21st Century?

The Places In Between

Rory Stewart’s incomparable memoir of his walk across Afghanistan in 2002 is at once lonely, engaging, frightening, funny, humbling and transcendent. There’s no better example of the simplicity of humanity.

Blackwork

Roxx channels something from somewhere else to create an interesting hybrid of traditional and personal art.

Top of Red Rock

Since we have found ourselves in the era of the bucket list, add Red Rocks Amphitheater to yours. The view seems to make sad songs sadder, anthems even bigger, and everything sound better.