Tag: stress

Five rules for approaching our feelings with greater wisdom and effectiveness.

https://www.psychologytoday.com/us/blog/supersurvivors/201911/building-emotional-intelligence-isnt-hard-you-think

David B. Feldman Ph.D.

Building Emotional Intelligence Isn’t as Hard as You Think

Pixabay
Source: Pixabay

Dozens of times a week, we ask friends, family, and even strangers, “How are you?” Given this fact alone, you’d think our society was very interested in how people feel.

But all of us know that this question generally doesn’t get an honest answer. Instead, most people reply with, “good,” “fine,” or at least, “okay.” If we’re really honest with ourselves, most of us would be a bit uncomfortable if we got a more genuine answer.

For many of us, it can feel risky to get in touch with our feelings, let alone to express them to others. I was recently speaking with a close friend who was genuinely hurt by something his father posted in a family chat room. He had been ruminating about it for days. And yet, when I suggested that he bring it up with his dad, his answer was straightforward: “No,” he told me. “We don’t talk about feelings in our family.”

Psychologist Marc Brackett, the founder of the Yale Center for Emotional Intelligence, argues that this tendency to avoid feelings, though understandable, can be a real disadvantage.

In one experiment, Brackett and his colleagues divided middle-school teachers into two groups. One group was placed in a good mood by recalling positive classroom experiences, while the other group was placed in a bad mood by recalling negative classroom experiences.

Then, they all were asked to grade the same essay. The teachers who were in a worse mood scored the essay a full letter grade lower than those in a better mood. But here’s the real kicker: Most of the teachers said they thought their mood had no influence on their grading, even though it clearly had.

Whether we like it or not, our feelings affect our thinking and behavior. Being out of touch with these feelings just means we’re at the mercy of them. So, it behooves us to get to know them better.

Our ability to understand and regulate our feelings is what psychologists often call “emotional intelligence.” Luckily, emotional intelligence isn’t a fixed commodity, but rather something we can build by learning what Brackett calls “emotion skills.”

He has developed a system, organized around the acronym R.U.L.E.R., which has been used in nearly 2,000 schools across the world to teach such skills to children and teenagers. But it can be equally applicable for helping all of us develop greater wisdom about our feelings and use them to our advantage.

Here are the five skills you can start practicing now:

R: Recognize

The first step toward productively managing any feeling is to recognize that we’re having it. Although this may sound easy, it’s equally easy to ignore our feelings. Have you ever said, “I don’t care,” about a situation when you really did? Have you ever gotten a head or neck ache, only to later realize you were actually feeling emotionally stressed?

To better recognize our feelings, Bracket suggests using a technique known as the “Mood Meter.” At its heart, this technique involves asking yourself two simple questions:

  1. How much energy does this emotion have?
  2. How pleasant is this emotion?

Emotions can be high in both, low in both, high in energy and low in pleasantness, or low in energy and high in pleasantness. Emotions high in both energy and pleasantness include joy, excitement, and optimism, while emotions low in both include sadness and depression. Anxiety, anger, and frustration are examples of feelings high in energy but low in pleasantness, whereas calmness and contentedness are examples of feelings low in energy but high in pleasantness. By at least identifying in which of these categories our feelings fall, we lay a foundation for wisely dealing with them.

U: Understand

The next emotion skill involves understanding our feelings. In short, this involves asking the question, “Why am I feeling this way?” Because this wide-open question is notoriously difficult to answer, in his book Permission to Feel, Brackett suggests some more specific questions we can ask ourselves to figure out the reasons behind our feelings. Here are a few of them:

  • What just happened? What was I doing before this happened?
  • What happened this morning, or last night, that might be involved in this?
  • What has happened before with this person that might be connected?
  • What memories do I have about the situation or place in which this emotion occurred?

Understanding the causes of our feelings can help provide clues about how to address them. If I’m feeling anxious because my new boss reminds me of a person from my past who was cruel to me, I’ll want to deal with the situation very differently than if my anxiety results from a particular managerial decision my boss just made. Of course, it could be both—so it can take serious time and introspection to really sort out what we’re experiencing and why. Be patient and keep at it.

L: Label

It’s not enough simply to recognize and understand an emotion; we also can benefit from finding the right word to describe it.

Many of us have a relatively limited emotion vocabulary. Some of us stick with two words: bad and good. Others might have three or four: happy, sad, mad, and scared. Still others may not use emotion words at all, but prefer figures of speech like, “on top of the world” or “burning up.”

But in actuality, there are thousands of words to describe emotions in the English language alone. We certainly don’t have to memorize all of them, but Brackett suggests that more accurate labels are usually better for us. In his words, “We know from neuroscience and brain imaging research that there is real, tangible truth to the proposition that ‘if you can name it, you can tame it.’”

For a start, knowing precisely what feelings we’re experiencing can give us clues about how to manage them. Although you may recognize that you’re experiencing a negative, high-energy emotion, both “stressed” and “overwhelmed” might fit that general description. But which of these labels most accurately describes our feeling really matters, because they mean different things.

“Stress” generally means we feel that what we’re trying to do or handle exceeds our capabilities, whereas “overwhelmed” means there’s just too much of it, regardless of our capabilities. If we’re feeling overwhelmed, the best approach may be to reduce our workload the best we can, whereas if we’re feeling stressed, the best approach may be to upgrade our capabilities by learning new skills or reorganizing the way we do things.

E: Express

If the R, U, and L of R.U.L.E.R. are about getting into touch with our emotions, the E and R are about what to do with them.

There are lots of reasons we hesitate to express our feelings. Especially when emotions fall on the negative end of the spectrum, we may be afraid they’re inappropriate, will embarrass us, or will somehow injure the person we express them to.

According to Brackett, however, “Hurt feelings don’t vanish on their own. They don’t heal themselves. If we don’t express our emotions, they pile up like a debt that will eventually come due.” So it’s important to express them in some way.

But this doesn’t mean we should let our emotions run wild, saying everything that’s on our minds to everyone we wish. According to Brackett, the skill of expressing our feelings “means knowing how and when to display our emotions, depending on the setting, the people we’re with, and the larger context.”

If we’re feeling hurt by something our boss said, for instance, it’s in our best interest to express this differently than if a close friend said something similar to us. Depending on the level of trust, we may make ourselves more vulnerable to our friend than our boss, expressing our feelings in greater depth or detail. If there’s a good chance we could lose our job, we may even choose not to express our hurt at all to our boss, instead confiding in and seeking support from someone else.

R: Regulate

The final emotion skill involves determining how to cope with our feelings.

Whether or not we choose to express them, feelings impact us. Regulating our emotions involves dealing with them in a way that allows us to best meet our personal and professional goals—or at least prevent our feelings from interfering with them. This certainly doesn’t mean ignoring our emotions; as already discussed, this doesn’t work well. Instead, it involves learning to accept and deal with them wisely.

Techniques for helping us cope with our feelings run the gamut, and we should strive to use ones that work for us. Relaxation videos abound on YouTube and can help us soothe strong emotions. Meditation phone apps can be used to facilitate mindfulness, which may help us accept our feelings. Physical exercise can help us to “work out” our feelings and feel more grounded in our bodies.

But emotion regulation can also be very simple. “You can’t stand your neighbor? Avoid her,” writes Brackett. “Your parents are coming to visit and you don’t want them to see some of your more outré artwork? Hide it until they leave. You’re tired? Splash some water on your face.” The important thing is to acknowledge our feelings—not avoid them—and then take productive steps toward dealing with them.

Learning to be more emotionally skilled isn’t a panacea. It won’t eliminate all our negative feelings or bring about a constant state of bliss. Such goals are probably impossible. But part of emotional intelligence is realizing that our feelings aren’t our enemies. In fact, if we approach them wisely, they can be some of our best friends. Let’s all get to know these friends a little better.

About the Author

David B. Feldman, Ph.D., is a professor in the department of counseling psychology at Santa Clara University.

In Print:

Supersurvivors: The Surprising Link Between Suffering and Success
Online:

“Psychology in 10 Minutes” Podcast, Facebook

What Is Toxic Shame?

https://psychcentral.com/lib/what-is-toxic-shame

By Darlene Lancer, JD, MFT
Last updated: 23 Sep 2019

~ 2 min read

When shame becomes toxic, it can ruin our lives. Everyone experiences shame at one time another. It’s an emotion with physical symptoms like any other that come and go, but when it’s severe, it can be extremely painful.

Strong feelings of shame stimulate the sympathetic nervous system, causing a fight/flight/freeze reaction. We feel exposed and want to hide or react with rage, while feeling profoundly alienated from others and good parts of ourselves. We may not be able to think or talk clearly and be consumed with self-loathing, which is made worse because we’re unable to be rid of ourselves.

We all have our own specific triggers or tender points that produce feelings of shame. The intensity of our experience varies, too, depending upon our prior life experiences, cultural beliefs, personality, and the activating event.

Unlike ordinary shame, “internalized shame” hangs around and alters our self-image. It’s shame that has become “toxic,” a term first coined by Sylvan Tomkins in the early 1960s in his scholarly examination of human affect. For some people, toxic shame can monopolize their personality, while for others, it lies beneath their conscious awareness, but can easily be triggered.

Characteristics of Toxic Shame

Toxic shame differs from ordinary shame, which passes in a day or a few hours, in the following respects:

  • It can hide in our unconscious, so that we’re unaware that we have shame.
  • When we experience shame, it lasts much longer.
  • The feelings and pain associated with shame are of greater intensity.
  • An external event isn’t required to trigger it. Our own thoughts can bring on feelings of shame.
  • It leads to shame spirals that cause depression and feelings of hopelessness and despair.
  • It causes chronic “shame anxiety” — the fear of experiencing shame.
  • It’s accompanied by voices, images, or beliefs originating in childhood and is associated with a negative “shame story” about ourselves.
  • We needn’t recall the original source of the immediate shame, which usually originated in childhood or a prior trauma.
  • It creates deep feelings of inadequacy.

Shame-Based Beliefs

The fundamental belief underlying shame is that “I’m unlovable — not worthy of connection.” Usually, internalized shame manifests as one of the following beliefs or a variation thereof:

  • I’m stupid.
  • I’m unattractive (especially to a romantic partner).
  • I’m a failure.
  • I’m a bad person.
  • I’m a fraud or a phony.
  • I’m selfish.
  • I’m not enough (this belief can be applied to numerous areas).
  • I hate myself.
  • I don’t matter.
  • I’m defective or inadequate.
  • I shouldn’t have been born.
  • I’m unlovable.

The Cause of Toxic Shame

In most cases, shame becomes internalized or toxic from chronic or intense experiences of shame in childhood. Parents can unintentionally transfer their shame to their children through verbal messages or nonverbal behavior. For an example, a child might feel unloved in reaction to a parent’s depression, indifference, absence, or irritability or feel inadequate due to a parent’s competitiveness or over-correcting behavior. Children need to feel uniquely loved by both parents. When that connection is breached, such as when a child is scolded harshly, children feel alone and ashamed, unless the parent-child bond of love is soon repaired. However, even if shame has been internalized, it can be surmounted by later positive experiences.

If not healed, toxic shame can lead to aggression, depression, eating disorders, PTSD, and addiction. It generates low self-esteem, anxiety, irrational guilt, perfectionism, and codependency, and it limits our ability to enjoy satisfying relationships and professional success.

We can heal from toxic shame and build our self-esteem. To learn more about how to do so and the eight steps to heal, read Conquering Shame and Codependency: 8 Steps to Freeing the True You.

©Darlene Lancer 2015

Darlene Lancer, JD, MFT

Darlene Lancer is a Licensed Marriage and Family Therapist and expert on relationships and codependency. She’s the author of Conquering Shame and Codependency: 8 Steps to Freeing the True You and Codependency for Dummies and six ebooks, including: 10 Steps to Self-Esteem, How To Speak Your Mind – Become Assertive and Set Limits, Dealing with a Narcissist: 8 Steps to Raise Self-Esteem and Set Boundaries with Difficult People, and Freedom from Guilt and Blame – Finding Self-Forgiveness, available on her website and Amazon. Ms. Lancer has counseled individuals and couples for 28 years and coaches internationally. She’s a sought-after speaker in media and at professional conferences. Her articles appear in professional journals and Internet mental health websites, including on her own, where you can get a free copy of “14 Tips for Letting Go.” Find her on Youtube.com, Soundcloud, Twitter @darlenelancer, and at www.Facebook.com/codependencyrecovery.

15 Things I Learned from My Nervous Breakdown…

very good list of things to meditate on . . .

Rory

 

15 Things I Learned from My Nervous Breakdown… and How They Can Help You Live Your Best Life – Calgary’s Child Magazine.

 

15 Things I Learned from My Nervous Breakdown… and How They Can Help You Live Your Best Life

Written by Todd Patkin

I suffered a nervous breakdown at age 36 – and it turned out to be a breakthrough. Here are 15 important things about life and happiness that I have learned, and that I hope you will take to heart in the coming year.

I want you to do me a favor. Look to the upcoming year and ask yourself – realistically – what lies in store in 2012? If you’re like most people, a huge portion of your life will be spent anxiously plugging away at a job you may or may not enjoy with coworkers you may or may not like. Okay, yes, you work hard to build a better life for your family. But here’s the question: Will you have time to enjoy them? Will you be too exhausted to throw the ball with your son? And how many nights will you get home too late to tuck him in this year?

This pattern of stress and striving has to stop. We already live in uncertain and depressing times, and our lifestyles are driving us not toward new heights, but over the brink. And if you’re not careful, you may suffer the same fate I did.

When I was 36 years old, I was successfully leading my family’s auto parts business, I was well respected in my community, I had a wonderful wife and son… and I also suffered a nervous breakdown. Yes, at that point in my life, I enjoyed what I did and was truly proud of my successes, but I was also pushing myself too hard and prioritizing the wrong things, and eventually, it all caught up with me.

For months leading up to my breakdown, I suffered from a paralyzing depression and anxiety, and found it difficult to complete tasks as simple as deciding whether to order coleslaw or potato salad with my lunch. But I still consider myself to be very fortunate.

As horrific as it was, my breakdown was actually also my breakthrough. It was an in-your-face wake-up call that forced me to realize that I was driving myself too hard, and for the wrong reasons. I finally had to say, “Enough is enough! I am done destroying myself and ruining my life!” Admitting to myself that my former way of life wasn’t working was the beginning of my road to recovery and true happiness.

For the past decade, I have taken a closer look at what really makes people happy and unhappy, and I have seen most of my goals and priorities shift. In the same way, it’s in your best interests to shift your habits and focus in 2012. Call it a New Year’s resolution to simply be happy.

I have come to realize that how happy and fulfilled you are is largely under your control, and that it has less to do with success and accomplishments than you might think. I believe that most people are experiencing many – if not all – of the stressors that led to my breakdown, so please don’t wait until you, too, reach a breaking point to make changes in your life. I’m totally convinced now that true happiness is a possibility for everyone, so I’m asking you to take the lessons I have learned to heart.

If you’re ready to change the way you approach life before you drive yourself over the edge, read on for 15 life lessons that I have learned:

1. You have to choose and prioritize happiness – it doesn’t just happen. If you subscribe to the belief that your happiness is wholly dependent on what happens to you, you’ll always be dissatisfied. The truth is, your fulfillment largely depends on the choices you make: how you see the world, what you allow to influence you, what you focus on, and how you react to circumstances, regardless of whether they’re good or bad. In other words, it’s not what happens to you; it’s how you look at what happens to you.

If you want to make a dent in your stress levels, you have to make choosing happiness a priority every day. With all of the responsibilities on our plates, nothing is likely to happen unless we specifically focus on it. So make happiness one of the two or three priorities you absolutely must accomplish each day. To remind yourself, put a note where you can see it – maybe on the refrigerator or bathroom mirror. And if that sounds selfish, it’s not. If you’re extremely stressed or become depressed because of the way you’re living your life, you’re hurting many more people than just yourself. And what’s more important than teaching your kids to be happy? Always remember that children learn by example. If they see you living a harried, stressed life, that’s the pattern their lives will follow as well…and their children’s after them, and so on.

2. Striving for work/life balance is worth its weight in gold. Times are tough, and some of us are finding it necessary to work long hours to keep our jobs and livelihoods. Others have fallen into the trap of the work-ego addiction: over time, you become hooked on the “high” you feel when you accomplish something, get a promotion, etc., and you begin to spend more and more time at the office. Whatever the reason, if extremely long hours are becoming a habit for you, break it. No matter how good your intentions are, overloading on work will cause your relationships, mindset, and even health to suffer.

Prior to my breakdown, it was normal for me to work seventy- or eighty-hour weeks. In my personal dictionary, “rest” and “relaxation” were synonymous with “irresponsibility” and “slacking.” Boy, was I wrong. Working as much as I did is more than the human body is designed to take continuously. If you drive yourself that hard, you’ll eventually begin to run on fumes before you shut down entirely. Being firm about creating and maintaining a healthy work/life balance is no more selfish than prioritizing happiness – in this case, it’s about simple self-preservation! And if you’re still skeptical, remember this: no one looks back on their lives at age eighty and says, “Gee, I wish I’d spent less time with my family and friends and more time at the office.”

3. We are our own worst critics. If you’re like most people, you probably tend to focus a lot of your mental energy on the things you mess up rather than on the things you do well—even though most of us do a hundred things right for every one thing we do wrong. And although you may not realize it, focusing on that one wrong thing is very dangerous, because our thoughts are incredibly powerful. Until you give yourself permission to break free of the cycle of self-blame and negativity that causes you to be stuck demanding perfection from yourself in every situation, you’ll never have a chance to be a truly relaxed, content, and happy person.

It’s not easy to rewire your habitual thought processes, but you need to build yourself up more and beat yourself up less. I used to expect nothing less than perfection out of myself, which was delusional! We’re all human, which means that we’re going to make mistakes from time to time. That doesn’t mean that we’re in any way unworthy or undeserving of love. In fact, learning to love myself was at the core of my own happiness journey. If you aren’t satisfied with who you are, you’ll always be looking outside yourself for validation…and you’ll never be truly content. And like me, you might also push yourself beyond healthy limits in order to get accolades from other people.

4. It’s never too late to start living in the present. How often do your thoughts “live” in the present? More to the point, how often are they instead fixated on your “disappointing” or “disturbing” past or spent worrying about your future? If you are like most people, your percentage of time not spent in the present is way, way too high, and thus you’re missing out on life itself. If you’re letting what’s already happened eat away at you or fretting about what might come to pass, you’re not enjoying the blessings all around you. You’re exacerbating your anxiety and unhappiness by choosing to dwell on things you can’t change or control.

I used to spend a majority of my time rehashing my past mistakes and worrying about what might happen in the future, neither of which did anything for my peace of mind or self-esteem. In fact, these unhealthy and self-critical thoughts were a major contributor to my breakdown. Now that I’m making a conscious effort to live in the present, I’m actually enjoying all of the great things in my life instead of letting them pass me by unnoticed. Plus, I’m actually a lot more productive now that all of that mental space that used to be occupied with worries has been freed up!

5. Focusing on what you’re good at is best for everyone. If you aren’t good at something – especially if it’s work-related – chances are you’ll feel compelled to spend a lot of time and effort getting your skills up to par. It’s natural to want to shore up your weaknesses, but the fact is, this strategy tends to cause you a lot of stress for (most likely) mediocre results. Instead of trying to be good at everything, stay in your strengths as much as possible. When you’re doing what you’re good at, you’ll be happier and higher performing.

As I’ve said, I used to be a total perfectionist. I felt like I was a failure if I didn’t excel in absolutely everything I tried. It probably won’t be a surprise to hear that all I accomplished was making myself miserable when I failed to live up to my impossibly high standards. If that sounds familiar, I’d suggest focusing more time on a hobby or personal interest to start, even if you do it for only twenty minutes every other day. And if you determine that your career doesn’t utilize your strengths, start looking at online job postings or for local classes in your field of interest. It’s never too early—or too late—to start doing the things that make you happy.

6. Exercise is worth its weight in therapy. Yes, you’ve heard it (a million times) before, but exercise is one small change that yields really big, life-changing benefits. For starters, it will begin to make you feel more relaxed, stronger, and more capable of handling life’s challenges—also, it will improve your sleep, and it’s a natural anti-depressant that will help your attitude and outlook. In fact, exercise actually opens you up to future change by invigorating your mind and body.

I’m convinced that exercise is the single most important thing you can do to improve your life right now. Looking back, I believe that my breakdown occurred when it did because I had broken my feet and couldn’t work out. Before that point, exercise was essentially acting as a medication that helped to counteract the effects of the stressful lifestyle I was living, and after I recovered, it has continued to boost my energy and outlook. If working out is already a part of your life, great! If it isn’t, commit to walking just twenty minutes every other day to start out. You don’t have to join a gym, sign up for exhausting classes, and completely reorder your life to reap the benefits of this investment!

7. You need to feed your mind healthy ‘food.’ When was the last time you watched the nightly news and turned off the TV feeling positive and uplifted? If anything, hearing the headlines is more likely to be depressing and discouraging. Although many of us don’t want to admit it, the things we hear, read, and experience influence our own attitudes and outlooks, so it’s important to consciously “feed” your mind positive materials.

It may sound hokey, but over the years I’ve become a big proponent of motivational books, audio recordings, and DVDs. Whether we’re at work, talking with friends, or at home watching TV or surfing the web, most of us encounter a lot more bad news and predictions than we do good. No wonder we become negative and cynical! It’s important to seek out positive things that will counteract these influences and dispel unnecessary stress. Learn new, constructive things and expose yourself to fresh ways of thinking so that you don’t get stuck in a self-destructive rut.

8. Surround yourself with positive people. If you stop for a drink at the water cooler and find your colleagues griping about how much work they have to do and how unreasonable your boss is, you probably don’t think much of it. In fact, depending on how your own day is going, you might even join in. And although you may not realize it, your attitude will start to deteriorate. The fact is, if you spend a significant amount of time around other people who are negative, your own outlook will begin to mirror theirs.

It’s much easier for others to drag you down than it is for you to build them up. In terms of your attitude and happiness levels, you will be the average of the five people you spend the most time with, so you need to be around other people who share your commitment to happiness if you want to avoid unnecessary stress. I’m not suggesting that you completely sever relationships that aren’t entirely uplifting, but gradually, you need to gravitate more toward positive people and distance yourself from those who tend to bring you down. This might mean calling a positive friend and asking to meet up for coffee or a beer, or walking away from the water cooler when your coworkers begin to gripe and complain.

9. Invest in your relationships – especially your marriage. When we’re driving ourselves to the brink, personal relationships are usually one of the first things to suffer. After all, the more time you spend at work, the less time and energy you have to invest in friends and family. You don’t consciously realize it at first, but this gradual deterioration can leave you feeling unappreciated, angry, alone, and anxious. Remember, though, that loving, supportive relationships will majorly enhance your happiness levels, and that friends and family care about you and accept you in a way that your employer never will.

It’s never a waste of time to reach out to the people who are meaningful to you and tell them how important they are to you, or to try to address any unresolved grievances and apologize for the things you may regret. And there’s one relationship you need to focus on in particular: the one with your spouse or significant other. Put more work into this relationship than you do into anything else: your house, your car, or your job, etc. Celebrate your spouse every day. Tell her (or him!) all the time how beautiful she is and how lucky you are to have her in your life. Trust me: this can make such a great difference in your emotional health, your stress levels, and your overall happiness! I truly believe that I would not be as happy as I am today without the love of my wife, and I also believe that my breakdown would have been much worse without her support.

10. Take control of what you can. If you’re reading this, chances are your life isn’t exactly stress-free. It’s practically impossible to live in the modern world without a million worries ranging from work deadlines to bills to clogged gutters. While you aren’t omnipotent, you probably can influence at least a few of the things that are causing your anxiety. Try to eliminate or minimize situations that are stressors instead of constantly dealing with their effects. Often, it’s the little things that make the biggest difference when it comes to relieving stress.

Start by identifying the two or three things that cause you the most stress on a consistent basis – maybe having a messy house is one. Often, you’ll find that there are concrete things you can do to lessen or even eliminate the pressure. For example, you might have a frank discussion with your spouse and kids regarding chores. Or, you might finally hire a cleaning person to help you once or twice a month if you can now afford it. Also, if you can’t eliminate or change a stressor, such as a job you hate but can’t afford to quit, challenge yourself to handle it differently. Specifically, decide beforehand how you will react in a more enlightened way when certain stressful situations occur – actually visualize yourself handling them with poise instead of becoming outwardly or inwardly worked up. Having a game plan in place before the “beast” rears its ugly head really can reduce your negative reactions to stressors—big time.

11. Being friendly is a good investment. In our culture, it’s become a badge of honor to stride around with an air of importance and a stony face. After all, if you’re too busy to say hello, you must be important. Yes, it’s easy to become absorbed by your responsibilities – but you’re not doing yourself any favors by shutting out the rest of the world. Even if you don’t have time to answer all of your emails, you can still smile at people in the hall and say a friendly hello to the cashier in the grocery store. Making positive connections will bring more happiness to you and to others.

Have you noticed that although our society is more and more “connected” by technology, we interact less and less with other people on a meaningful, face-to-face level than ever before? Our plugged-in lifestyles aren’t doing us as many favors as we thought they would. Even when we’re not at work, we’re likely to be glued to our smartphones or laptops, which amps up our stress. Make a conscious effort to unplug and make a friendly connection with another human – even a simple smile or hello is great. The fact is, everyone on Earth is carrying some sort of burden. You can’t make their pain, stress, or grief just magically disappear…but you can be what I call a “lamp-lighter” – someone who makes others feel just a little bit lighter and happier on their journey, even if only for five seconds. When you make friendliness a habit, you’ll attract kindness and smiles in return…and you’ll feel great about yourself for making a positive difference in the world!

12. Helping others is the soul food of life. One of the (many) negative side effects of our busy lives is that we tend to think mostly about ourselves: how much work we have left on that big presentation, how we’re going to find time to take the kids to sports practice and pick up groceries, and much, much more. No matter how busy you are now, consider helping others to be an integral part of the healthy work/life balance that will help you to avoid unhappiness. This will give you perspective, make you feel good, and will prevent you from staying in the negative me-focused cycle that was making you unhappy in the first place.

Since my breakdown, I’ve become very involved in philanthropy. I’ve found that it really is better to give than to receive, and that reaching out a helping hand to someone who isn’t as fortunate as you tends to quash selfish impulses and highlight your own blessings. Giving of yourself doesn’t have to involve money, either – remember that your time, talents, and compassion are just as valuable as cash, if not more so. Consider visiting a disabled veteran at the VA, or simply rolling your neighbor’s trashcan up the driveway! And if you have kids, you’ll be setting a wonderful example for them. I promise you, whether you’re giving time, energy, money, or encouragement, being generous will build up your self-esteem, broaden your perspective, keep you anchored in reality, and connect you to your blessings – all components of a happy life.

13. It’s important to connect with something bigger than yourself. Yes, spirituality (much like politics) is a touchy subject. But believing in something bigger than yourself is essential to developing the kind of perspective you need to be happy. Whether you consider your Higher Power to be God, Yahweh, Allah, Buddha, Krishna, the Universe, or even just Nature or another entity, being willing and able to see and feel His (or Her, if you prefer!) presence in your life will enable you to move away from self-centeredness and focus your energy and concerns on the greater community. It’ll also provide solace and give meaning to unfortunate events and troubling life circumstances.

Personally, I’ve been connected to the Jewish faith for my entire life. But it was only after my breakdown that I really allowed my faith to grow. My personal belief that God exists and cares about me has changed the way I view the world—but you don’t need to espouse my beliefs, or even join an organized religion and attend services regularly. What I do hope you’ll do is make an effort to clarify your thoughts about faith and also make an effort to connect to your Higher Power, whether it’s through prayer, meditation, writing in a journal, doing random acts of kindness, or just spending time in nature. Eventually, I hope you’ll begin to see your Higher Power as a source of inspiration, renewal, strength, guidance, and aid – as I do.

14. A grateful heart is a happy heart. It’s very easy to take things for granted: the information your coworker emailed you, the fact that your car is running, and even the food you’re eating for dinner. The fact is, most of us have gotten into the habit of ignoring all of the good things in our lives. Instead, we focus our mental energy on being upset about what’s wrong and what we don’t have. Yes, cultivating an “attitude of gratitude” might be a clichéd concept, but the humility that comes from knowing you owe so much to so many others will, in turn, spur you to give back more often to those less fortunate than yourself. Plus, studies have actually shown that thankful individuals are 25 percent healthier than their counterparts, too!

To start tapping into the power of gratitude, just say “thanks” to the people who help you out during your day. And beyond that, try to notice all of the blessings in your life. If you live in America, you have access to great education, healthcare, and the freedom to worship and work as you choose. Those are huge things to be thankful for right out of the gate! We take these “basics” and much more for granted, and we often have others—whether it’s an ancestor of ours, a veteran, or a coworker—to thank for them. It’s extremely important to be aware of all of your blessings, and to honor and thank those whom you owe.

15. Asking for help isn’t a sign of weakness. All of the things I have learned from my breakdown will help you to cut your stress levels, and they’ll also aid you in cultivating a more balanced, happier life. But it’s also important to realize that feeling anxious, overwhelmed, or depressed are all very serious, and you shouldn’t expect yourself to easily “fix” these issues on your own.

If you feel that you’re in over your head, or if your best efforts aren’t working, please reach out and ask for help. I might never have recovered after my breakdown without the help of my friends, family, and medical professionals. This is all big stuff. You shouldn’t—in fact, you can’t—make big changes in your life alone. At the very least, you’ll need the support of those who love you.

Ultimately, I’ve learned that the quality of your life is largely up to you. If you’re anything like me – and if you’re honest with yourself – you’ll have to confess that a striving, stressful lifestyle is not making you happy. I’ll admit that many of the changes I’m asking you to make in order to avoid more unhappiness (and perhaps even a breakdown) go against what society says you should do if you want to be successful. But I have found out the hard way that a “successful” yet stressed out and unhappy life is certainly not, in reality, a truly successful life at all.

Todd Patkin is the Author of Finding Happiness: One Man’s Quest to Beat Depression and Anxiety and – Finally – Let the Sunshine In (StepWise Press, 2011, ISBN: 978-0-9658261-9-8, $19.95). The book is available at bookstores nationwide, from major online booksellers, and at www.findinghappinessthebook.com.

Got Stress? Here’s a Practice You Can BET On | Mindfulness and Psychotherapy

Got Stress? Here’s a Practice You Can BET On | Mindfulness and Psychotherapy.

 

No matter what time of year it is, stress will likely be a part of it. A little stress is good, it fuels motivation, but there’s a tipping point where it starts to have diminishing returns. When that higher level of stress hits, if it’s left unchecked it can lead to anxiety, depression, chronic pain, addictive behaviors, you name it. Today I want to give you something that you can BET on anywhere, anytime to help turn the volume down on the chaotic mind and bring you back into balance.

I’m a big fan of things that are short and sweet. Something I can remember that can help me in a pinch.

Here’s a short acronym that you can BET on throughout the day:

  • B – Body – At any point, bring attention to the body. How is it feeling? Is there any tension anywhere, in this moment of awareness, can you take a breath and allow it soften?
  • E- Emotions – What emotion is there in that moment? Is it anxiety, sadness, anger, confusion, joy, calm, or maybe just a neutral feeling? How does it feel as a sensation in the body? Research shows just labeling emotions turns activity down in the emotional center of the brain.
  • T – Thoughts – What’s on your mind? Is it busy or calm? If it’s a self-judgment or a judgment of another person, ask yourself, Is it absolutely true? How does this thought make me feel? What’s another way I can see this? Practice opening your mind.

Then just refocus on what matters in the moment.

That’s it, it’s that simple.

You can BET in the morning, before a test, during a business meeting, during stressful travel, while waiting at a stop light or on hold on the phone. You can BET before you open your email, in the midst of your kid’s temper tantrum, or just while taking a nice walk outside.

If you BET a few times a day, my guess is that you’ll break out of routine and back into the wonder of everyday life.

Try it out and let your experience be your teacher.

As always, please share your thoughts, stories and questions below. Your interaction is a living wisdom we can all benefit from.

Source: Mindfulness Meditations for the Anxious Traveler: Quick Exercises to Calm Your Mind

Types of Childhood Abuse

Reposted from the blog of Darlene Barriere.

http://www.child-abuse-effects.com/types-of-emotional-abuse.html

There are six types of emotional abuse:

    »  rejecting
    »  isolating
    »  ignoring
    »  corrupting
    »  exploiting
    »  terrorizing

One type of emotional abuse that warrants a section of its own is witnessing family violence. Due to the ever-increasing statistics of family violence, I’ve treated this topic separately. You’ll find it below underterrorizing.

  Types of emotional abuse #1: Rejecting

Putting down a child or youth’s worth or putting down their needs.

    »  constant criticism
    »  name-calling
    »  telling child he/she is ugly
    »  yelling or swearing at the child
    »  frequent belittling-use of labels such as “stupid”, “idiot”
    »  constant demeaning jokes
    »  verbal humiliation
    »  constant teasing about child’s body type and/or weight
    »  expressing regret the child wasn’t born the opposite sex
    »  refusing hugs and loving gestures
    »  physical abandonment
    »  excluding child from family activities
    »  treating an adolescent like she/he is a child
    »  expelling child from family
    »  not allowing youth to make own reasonable choices

  Types of emotional abuse #2: Isolating

Keeping a child away from family and friends.

    »  leaving child in room unattended for long periods
    »  keeping child away from family
    »  not allowing child to have friends
    »  not permitting child interaction with other children
    »  keeping child away from other caregiver if separated
    »  rewarding child for withdrawing from social contact
    »  ensuring child looks and acts differently than peers
    »  isolating child in closet
    »  insisting on excessive studying and/or chores
    »  preventing youth participating in activities outside the home
    »  punishing youth for engaging in normal social experiences

FACT:  Isolated emotional child abuse has had the lowest rate of substantiation of any of the types of emotional abuse (Kairys, 20022).

  Types of emotional abuse #3: Ignoring

Failing to give any response to or interact with a child or youth at all.

    »  no response to infant’s spontaneous social behaviours
    »  not accepting the child as an offspring
    »  denying required health care
    »  denying required dental care
    »  failure to engage child in day to day activities
    »  failure to protect child
    »  not paying attention to significant events in child’s life
    »  lack of attention to schooling, etc.
    »  refusing to discuss youth’s activities and interests
    »  planning activities/vacations without adolescent

  Types of emotional abuse #4: Corrupting

Encouraging a child or youth to do things that are illegal or harmful to themselves.

    »  rewarding child for bullying and harassing behaviour
    »  teaching racism and ethnic biases
    »  encouraging violence in sporting activities
    »  inappropriate reinforcement of sexual activity
    »  rewarding child for lying and stealing
    »  rewarding child for substance abuse and sexual activity
    »  supplying child with drugs, alcohol and other illegal substances
    »  promoting illegal activities such as selling drugs
    »  teaching and promoting prostitution

  Types of emotional abuse #5: Exploiting

Giving a child or youth responsibilities that are far greater than a child/youth that age can handle. It is also using a child for profit.

    »  infants expected not to cry
    »  anger when infant fails to meet a developmental stage
    »  child expected to be ‘caregiver’ to the parent
    »  young child expected to take care of younger siblings
    »  blaming child or youth for misbehaviour of siblings
    »  unreasonable responsibilities for jobs around the house
    »  expecting youth to support family financially
    »  encouraging participation in pornography
    »  sexually abusing child or youth
    »  requiring child or youth to participate in sexual exploitation

  Types of emotional abuse #6: Terrorizing

Causing a child or youth to be terrified by the constant use of threats and/or intimidating behaviour. This includes witnessing, which is when a child or youth observes violence, hears violence, or knows that violence is taking place in the home.

    »  with infants and children, excessive teasing
    »  yelling and scaring
    »  unpredictable and extreme responses to child’s behaviour
    »  extreme verbal threats
    »  raging, alternating with periods of artificial warmth
    »  threatening abandonment
    »  beating family members in front of or in ear range of child
    »  threatening to destroy a favourite object
    »  threatening to harm a beloved pet
    »  forcing child to watch inhumane acts against animals
    »  inconsistent demands on the child
    »  displaying inconsistent emotions
    »  changing the ‘rules of the game’
    »  threatening that the child is adopted and doesn’t belong
    »  ridiculing youth in public
    »  threats to reveal intensely embarrassing traits to peers
    »  threatening to kick adolescent out of the house

FACT:  Children and youth who witness family violence experience all sixtypes of emotional abuse.

FACT:  A 1995 telephone survey identifying types of emotional abuse suggested that by the time a child was 2 years old, 90% of families had used one or more forms of psychological aggression in the previous 12 months (Straus, 20003).

Many people including parents, members of the law enforcement community and journalists, think that infants and young children who witness violence are too young to know what happened. They don’t take it in. “They won’t remember.” In fact, infants and young children can be overwhelmed by their exposure to violence, especially-as it is likely to be the case with very young children-when both victims and perpetrators are well known and emotionally important to the child and the violence occurs in or near the child’s own home.

Osofsky, 1996

Emotional Abuse – YouTube

Emotional Abuse – YouTube.

 

www.abusoemocional.com

Stop Emotional Abuse, You Deserve Better.

We all know about Sexual Abuse. We all know about Physical Abuse. But, we know very little about Emotional Abuse.

Emotional Abuse occurs when one person emotionally and psychologically abuses another person who is in need of sincere affection. This kind of abuse takes many forms…

Your partner Undermines your self-esteem. He/she delivers mixed messages: “I love you” (I hate you.)

It’s like pushing you through a cliff and running down to catch you.

Your partner can tell you the sweetest things and the most hurtful ones at the same time.

Your partner can also humilliate you by ignoring you.

He/she might contact you only when they are bored or have some spare time, or need something specific from you.

Your partner tells you that he “loves” you, or you are special, but he/she needs an open relationship.

Your partner bluffs making you believe he intends to spend time with you, even makes plans that will never happen.

Your partner tells you beautiful things he does not really mean at all, and will compensate your tolerance with small tender gifts.

Emotional abuse also occurs through financial dependency. One partner does not let the other be financially independent.

Or through intellectual and manipulative mind games. Abusers tend to play the victim or they take offense quickly.

They invariably put the blame on others, or on the world, or on their luck, or situation.

They acuse their partners of not understanding them, or not understanding their needs, creating a sense of lack of sensitivity on your part.

Abusers are extremely possessive and jealous. They need to control other people’s lives but will never show it.

They will pretend what you do with your life is non of their business.

Abusers often have several superficial relationships with other people. They escape reality and tend to live in fantasyland.

Abusers may be described as having a dual personality: they can be either charming or exceptionally cruel.

A major characteristic of abusers is their capacity to deceive others. They can be cool, calm, charming and convincing: a true con person.

Most of the time, they also deceive themselves. They are unable or choose not to see reality as is it.

Emotional Abusers do not acknowledge the harm they cause.

Some people abuse others emotionally because that’s what they learned.
They were victims of emotional abuse and neglect themselves.

These abusers can grow out of their abusive pattern and explore healthier ways to relate to others.

Some are aware of what they do and do not intend to change.

But the worse problem about emotional abuse is the fact that many people let others abuse them.

Stop.

Think.

Are you not worth of a healthy relationship?
Are you not worth of sincere love and affection?
Are you not worth of an honest partner?

Don’t let others abuse you.
Turn your back on abuse.
Walk away from abusers.

If you are a victim of emotional abuse, seek help.

You cannot change an abuser, but maybe a professional therapist can.

Quit the game.

Don’t let an emotional abuser put you down.

Some have a hurtful way to create emotional codependency just by telling you exactly the sweet words you need to hear.

Don’t believe their words. Believe their concrete actions.

Does your partner’s words and promises match his/her actions?
Does your partner tell you he/she loves you and you are special but goes on with his life, ignoring you and ignoring your feelings?

You don’t need an abuser in your life.

You deserve someone who will love you and respect you for who you are, not for what they can get from you.

Even if it’s just attention.

Don’t fall for empty promises.
Abusers commit abuse because they know you will always give them another chance.
Don’t do it.

Choose to Love Yourself First.

Mindfulness: Attention and Attunement

Joe Loizzo, M.D., Ph.D.: Reliable Methods: The Future of Self-Transcendence.

The three decades since mindfulness meditation was first found to help with anxiety, chronic pain and depression have seen the reversal of a trend that goes back over a century. When Freud founded psychotherapy as “a middle way between philosophy and medicine,” he took pains to keep it on the scientific side of the modern gulf between science and religion. He did this in part by basing his insights on evolutionary neurobiology, and in part by distancing his psychology from its sources in the spiritual philosophy of Romanticism.

Sadly, in cutting his “new science” away from its spiritual roots, he felt a need to jettison not just myth and ritual but contemplative states and practices too. Though spiritually minded analysts like Carl Jung warned this was throwing the baby out with the bathwater, Freud’s rejection of all things spiritual came to earmark mainstream psychotherapy. Jung’s dream was that psychotherapy would not only work as a clinical art to heal mental suffering but also as a spiritual science to help build the best in our nature. The recent film, “A Dangerous Method,” dramatizes with telling accuracy Freud’s break with Jung and the rift this caused in modern psychology. 

Fast forward to the present. The more mindfulness has been proven to enhance attention, empathic attunement and neuroplasticity, the more it has found its way into traditional psychotherapy and new cognitive therapies. As this simple technique has made waves in psychotherapy, it has raised a groundswell of interest among researchers and clinicians in contemplative methods in general and Buddhist psychology in particular. 

Of course, mindfulness did not turn the anti-contemplative tide of mainstream therapy all by itself. It helped catalyze a complex reaction fueled by new findings in evolutionary biology, the neuroscience of plasticity and emotion, developmental psychology and positive psychology, all of which have converged in a new view of human nature as far more malleable and sociable than we thought. Buttressed by a growing body of research on meditation and yoga, this new consensus has begun to bridge the gulf between science and spirituality. Where the split faces of modern culture are starting to reunite is in two emerging fields for the scientific study and clinical application of humanity’s ancient contemplative traditions: contemplative neuroscience and contemplative psychotherapy. 

As clients and therapists have grown more curious about the traditional practice behind mindfulness, they’ve learned that it comes embedded in a complex psychology all its own, including integrated disciplines of cognitive self-analysis, emotional self-healing and behavioral life-change. This second wave of influence has brought mounting awareness of the scientific tradition of classical Buddhist psychology and its core disciplines. With this, the tide has shifted away from simply grafting mindfulness into conventional therapies, toward a fuller confluence of Buddhist and Western psychology.

A vibrant new field blending meditative insights and tools with current neuroscience, contemplative psychotherapy represents a turning of the modern tide away from contemplative methods. And as Buddhist contemplative science has been a catalyst in this turn thus far, it seems likely to play a more influential role in years to come. This is no accident, but reflects Buddhism’s unique bent as a religion which seeks to awaken the human spirit less by myth and ritual than by therapeutic philosophy and contemplative psychology.

Fortunately, the rise of contemplative psychotherapy also comes at a watershed moment in the history of the West’s encounter with Asian Buddhism. As neuroscientists and psychotherapists turn toward contemplative science and practice, Western and Asian scholars of Buddhism for the first time are giving us access to the long isolated Buddhism of Tibet. This most recent confluence seems likely to give rise to a third wave in the convergence of Buddhist and Western psychology, for several reasons. 

First, Tibetan civilization preserves in its final form the ancient Buddhist tradition that was most concerned with bringing contemplative tools to lay people in everyday life. This was the socially engaged tradition linked with the rise of the world’s first university at Nalanda, a world-class institution which became India’s beacon of liberative education and a think-tank for contemplative civilization throughout Asia. The second reason is that the Nalanda tradition was and is both scientifically rigorous and psychologically minded. Its core curriculum assumes that success in secular and religious life both require mastery of scientific knowledge and empirical methods, especially the insights and methods of psychology. The third reason is that this tradition is not just universal but comprehensive, enhancing mindfulness and loving kindness with a whole range of industrial-strength tools for building compassion, altruism and inspired leadership in a stress-driven world. 

Unfortunately, there’s a rub. Because it forged the religious practice of Indian yoga into a human science of spirituality, the Nalanda legacy is not only the most modern and scientific of Buddhist traditions, but ironically also the one that seems most religious! The challenge contemplative therapists face in integrating its rich archetypal imagery and transformational arts is reminiscent of those faced by analysts like Jung.

Can powerful, mind-altering contemplative states and methods be harnessed to the therapeutic work of building confident, caring and inspired new selves, while staying grounded in objective science and reproducible methods? 

Fortunately for us all, this challenge is far simpler in our day than it was only decades ago. Brain science has progressed so dramatically that we now understand how empathy and altruism, archetypal imagery and transmuting affects like joy and bliss work. And direct access to the living masters of the Nalanda tradition offers the time-tested perspective and methodology we need to make the work of reinventing ourselves for interdependence eminently safe, reliable and reproducible. Given the fast-shifting tides of science and civilization, contemplative psychotherapy seems ideally poised now to realize Jung’s dream, with a rigor that would have satisfied even Freud.

Accommodations: Illness or Excuse?

A Serious Illness or an Excuse? – WSJ.com.

By ANDREA PETERSEN

[COLLEGE11] Sally McCay

At University of Vermont, above, staff role play with students with mental health issues to prepare them to negotiate with professors.

Earlier this semester, college senior Leah Nelson emailed one of her instructors to ask for extra time to complete a paper. “I have been going through a rough patch lately and am making the decision to take care of myself this week,” Ms. Nelson wrote. Her mental health, she continued, would “take priority over everything else.”

Ms. Nelson, a 21-year-old student at the University of Connecticut in Storrs, struggles with depression. Her symptoms often flare when exams and papers pile up. She says the timing of a suicide attempt in March of 2010, when she took an overdose of Tylenol, was influenced by the pressure of the three exams and paper due she had that week.

As mental health problems become less stigmatizing, more college students are comfortable asking their professors for test extensions and excused absences due to bouts of depression and panic attacks. Andrea Petersen has details on Lunch Break.

Ms. Nelson is one of a growing number of college students asking for wiggle room with their academic workloads due to mental health issues.

In some cases, students make direct pleas to professors. In others, students work through their university’s disability office to receive official academic “accommodations.” These can include extra time for exams, the opportunity to take tests in a quiet room, or flexibility with class attendance and assignment deadlines.

Schools are required to extend “reasonable accommodations” for students with documented disabilities—including psychological ones—to comply with the federal Americans with Disabilities Act.

Enlarge Image


COLLEGEjp2

Brian Harkin for The Wall Street Journal

A student group devoted to reducing stigma around mental illness is on 325 campuses. A backpack, pictured, reads ‘1,100 students die by suicide each year.’

The Other College Application Process

To qualify for academic accommodations, most schools require students with mental health issues to go through a fairly extensive application process. It generally includes:

•A recent evaluation from a psychiatrist, psychologist or social worker.

•A disorder included in the DSM-IV, the primary handbook for diagnosing mental illnesses.

•A professional assessment of how the disorder affects the student academically and why specific accommodations are needed.

•There is often a deadline for applying: Some schools require applications at the beginning of the semester. Some require students to apply a certain number of days before the accommodations are necessary, say, two weeks before an exam where they’ll need more time.

But there’s hand-wringing among university administrators and faculty about how to support college students with mental health issues while making sure young adults progress academically. One of the goals of college, after all, is to prepare students for the working world. And not every boss may be OK with a blown deadline for a critical client report, no matter the reason. Professors also want to make sure they’re being fair to all students.

“There’s the danger that we take too much care and when they hit the real world that same kind of support isn’t there,” says David Cozzens, dean of students and associate vice president of student affairs at the University of Wyoming in Laramie.

Some formal accommodations, like additional test time, are fairly standard across universities and apply to students with physical and learning disabilities, too. But, schools diverge widely on formal accommodations for flexibility with assignment deadlines, class attendance and participation. Some schools leave it up to individual instructors. Others intervene more directly on students’ behalf.

Schools say they are seeing a rise in the number of students registering with their disability offices due to psychological problems. At Pace University in New York, the number of requests for accommodations from students with disabilities related to psychological disorders tripled in the last three years.

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COLLEGE

Brian Harkin for The Wall Street Journal

Leah Nelson, right, a University of Connecticut student, walks on campus with friend Kylie Angell. Ms. Nelson struggles with depression and works with professors to manage her workload.

At the University of Texas at Austin, 33% of the 1,687 students that registered with the disability services office during the spring 2011 semester listed psychological problems as their “primary” concern. In the spring of 2008, only 23% out of 1,175 did. (The increase was due, in part, to a procedural change that routed more students to the disability office.)

Colleges say they’re seeing more students on campus with psychiatric illnesses. About 11.6% of college students were diagnosed or treated for anxiety in the last year, and 10.7% were diagnosed or treated for depression, according to a survey of more than 100,000 students at 129 schools conducted by the American College Health Association. Many mental illnesses, particularly depression, bipolar disorder and schizophrenia, emerge during late adolescence.

Psychiatric disorders like depression and anxiety can have serious academic consequences because they affect concentration, sleep and cognitive processing, say mental health professionals.

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COLLEGEjp3

Associated Press

The health center at Cornell University in Ithaca, N.Y., recently stopped issuing notes students gave to professors to be excused from class.

It’s unclear why the incidence of psychiatric disorders appears to be rising among college students. Better medications and treatments are likely making it possible for more young adults with even serious mental illnesses to attend college. Many schools have launched programs to identify students with psychological problems and get them into counseling. Student-advocacy groups like Active Minds Inc., an organization with chapters on 325 campuses, are trying to reduce the stigma around having a mental illness.

Cornell University in Ithaca, N.Y., has developed an extensive suicide-prevention program and a comprehensive disability services office. But it is pulling back on how involved it gets in student-faculty negotiations not covered by the office.

Over the last several years, the counseling center has stopped issuing dated “verification of visit” notes. Too many students were making appointments just to get the notes to provide proof of why they missed class or failed to turn in an assignment, says Greg Eells, director of counseling and psychological services. (The school’s health center stopped giving notes for medical appointments, too.)

“It was just not a good use of the university’s resources,” says Mr. Eells. But professors pushed back. “The faculty wants us to be a detective to see if the student is telling the truth. That’s not our job,” he says.

If students complain of psychological problems, some faculty members will send them to the disability services office to avoid having to determine what’s a serious issue versus what’s a gloomy day. Then, “the instructor isn’t having to make decisions on something they’re not equipped to assess,” says Steven Barrett, a professor of electrical and computer engineering at the University of Wyoming.

In the fall of 2010, Amy Goodnough, now a senior at the University of Vermont, started experiencing severe insomnia and excess energy. Some mornings, she couldn’t get out of bed. Eventually diagnosed with bipolar disorder, Ms. Goodnough withdrew from one class, took an incomplete in another and appealed directly to other professors to turn in some assignments late. “It was difficult to know day to day what my energy would be like,” Ms. Goodnough, 21, says. “I kind of crawled through the end of the semester.”

Before the spring term, she registered with the university’s disability services office and received letters to take to her professors stating that she be allowed “limited” flexibility with attendance and deadlines. Without those accommodations, “I don’t think I could have stayed in school,” that semester, she says. Now getting effective treatment, Ms. Goodnough has not needed the flexibility this term and has a 3.9 grade-point average.

Schools say they can’t require faculty to adjust deadlines or attendance policies. And in some courses, like science labs and speech classes, participation is critical, but schools can push instructors to compromise with students.

Students with mental illnesses “don’t know when the symptoms will happen, when they might be incapacitated,” says Laurel Cameron, the director of ACCESS, the University of Vermont’s disability services office. Even with a letter giving a student flexibility with deadlines and attendance, students are required to negotiate with each instructor at the beginning of the semester. They need to devise a plan, for example, of when to notify faculty of an absence and a timetable for making up work.

To help students prepare for those discussions, Ms. Cameron says she and her staff will role-play with students, taking on the tone of a skeptical professor.

Kim Larrabee, a faculty member at UConn and the instructor Ms. Nelson emailed for an extension, says she has a “sense of intuition of sincerity,” when students approach her for flexibility with academic work. And she considers how committed the student has been so far to the course. She gave Ms. Nelson an extra 10 days to finish her paper.

“I think your decision to take care of your needs shows maturity and commitment,” Ms. Larrabee wrote in an email replying to Ms. Nelson’s request. Ms. Nelson got an A on the paper.

 

Rewiring the Brain to Ease Pain

Rewiring the Brain to Ease Pain – WSJ.com.

Rewiring the Brain to Ease Pain

Brain Scans Fuel Efforts to Teach Patients How to Short-Circuit Hurtful Signals

  • By MELINDA BECK          

How you think about pain can have a major impact on how it feels.

That’s the intriguing conclusion neuroscientists are reaching as scanning technologies let them see how the brain processes pain.

Alternative remedies for relief of chronic pain are getting new attention and respect these days. Melinda Beck has details on Lunch Break.

That’s also the principle behind many mind-body approaches to chronic pain that are proving surprisingly effective in clinical trials.

Some are as old as meditation, hypnosis and tai chi, while others are far more high tech. In studies at Stanford University’s Neuroscience and Pain Lab, subjects can watch their own brains react to pain in real-time and learn to control their response—much like building up a muscle. When subjects focused on something distracting instead of the pain, they had more activity in the higher-thinking parts of their brains. When they “re-evaluated” their pain emotionally—”Yes, my back hurts, but I won’t let that stop me”—they had more activity in the deep brain structures that process emotion. Either way, they were able to ease their own pain significantly, according to a study in the journal Anesthesiology last month.

While some of these therapies have been used successfully for years, “we are only now starting to understand the brain basis of how they work, and how they work differently from each other,” says Sean Mackey, chief of the division of pain management at Stanford.

He and his colleagues were just awarded a $9 million grant to study mind-based therapies for chronic low back pain from the government’s National Center for Complementary and Alternative Medicine (NCCAM).

Some 116 million American adults—one-third of the population—struggle with chronic pain, and many are inadequately treated, according to a report by the Institute of Medicine in July.

Yet abuse of pain medication is rampant. Annual deaths due to overdoses of painkillers quadrupled, to 14,800, between 1998 and 2008, according to the Centers for Disease Control and Prevention. The painkiller Vicodin is now the most prescribed drug in the U.S.

“There is a growing recognition that drugs are only part of the solution and that people who live with chronic pain have to develop a strategy that calls upon some inner resources,” says Josephine Briggs, director of NCCAM, which has funded much of the research into alternative approaches to pain relief.

Already, neuroscientists know that how people perceive pain is highly individual, involving heredity, stress, anxiety, fear, depression, previous experience and general health. Motivation also plays a huge role—and helps explain why a gravely wounded soldier can ignore his own pain to save his buddies while someone who is depressed may feel incapacitated by a minor sprain.

“We are all walking around carrying the baggage, both good and bad, from our past experience and we use that information to make projections about what we expect to happen in the future,” says Robert Coghill, a neuroscientist at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

Dr. Coghill gives a personal example: “I’m periodically trying to get into shape—I go to the gym and work out way too much and my muscles are really sore, but I interpret that as a positive. I’m thinking, ‘I’ve really worked hard.’ ” A person with fibromyalgia might be getting similar pain signals, he says, but experience them very differently, particularly if she fears she will never get better.

Dr. Mackey says patients’ emotional states can even predict how they will respond to an illness. For example, people who are anxious are more likely to experience pain after surgery or develop lingering nerve pain after a case of shingles.

That doesn’t mean that the pain is imaginary, experts stress. In fact, brain scans show that chronic pain (defined as pain that lasts at least 12 weeks or a long time after the injury has healed) represents a malfunction in the brain’s pain processing systems. The pain signals take detours into areas of the brain involved with emotion, attention and perception of danger and can cause gray matter to atrophy. That may explain why some chronic pain sufferers lose some cognitive ability, which is often thought to be a side effect of pain medication.

The dysfunction “feeds on itself,” says Dr. Mackey. “You get into a vicious circle of more pain, more anxiety, more fear, more depression. We need to interrupt that cycle.”

One technique is attention distraction, simply directing your mind away from the pain. “It’s like having a flashlight in the dark—you choose what you want to focus on. We have that same power with our mind,” says Ravi Prasad, a pain psychologist at Stanford.

Guided imagery, in which a patient imagines, say, floating on a cloud, also works in part by diverting attention away from pain. So does mindfulness meditation. In a study in the Journal of Neuroscience in April, researchers at Wake Forest taught 15 adults how to meditate for 20 minutes a day for four days and subjected them to painful stimuli (a probe heated to 120 degrees Fahrenheit on the leg).

Brain scans before and after showed that while they were meditating, they had less activity in the primary somatosensory cortex, the part of the brain that registers where pain is coming from, and greater activity in the anterior cingulate cortex, which plays a role in handling unpleasant feelings. Subjects also reported feeling 40% less pain intensity and 57% less unpleasantness while meditating.

“Our subjects really looked at pain differently after meditating. Some said, ‘I didn’t need to say ouch,’ ” says Fadel Zeidan, the lead investigator.

Techniques that help patients “emotionally reappraise” their pain rather than ignore it are particularly helpful when patients are afraid they will suffer further injury and become sedentary, experts say.

Cognitive behavioral therapy, which is offered at many pain-management programs, teaches patients to challenge their negative thoughts about their pain and substitute more positive behaviors.

Even getting therapy by telephone for six months helped British patients with fibromyalgia, according to a study published online this week in the Archives of Internal Medicine. Nearly 30% of patients receiving the therapy reported less pain, compared with 8% of those getting conventional treatments. The study noted that in the U.K., no drugs are approved for use in fibromyalgia and access to therapy or exercise programs is limited, if available at all.

Anticipating relief also seems to make it happen, research into the placebo effect has shown. In another NCCAM-funded study, 48 subjects were given either real or simulated acupuncture and then exposed to heat stimuli.

Both groups reported similar levels of pain relief—but brain scans showed that actual acupuncture interrupted pain signals in the spinal cord while the sham version, which didn’t penetrate the skin, activated parts of the brain associated with mood and expectation, according to a 2009 study in the journal Neuroimage.

One of Dr. Mackey’s favorite pain-relieving techniques is love. He and colleagues recruited 15 Stanford undergraduates and had them bring in photos of their beloved and another friend. Then he scanned their brains while applying pain stimuli from a hot probe. On average, the subject reported feeling 44% less pain while focusing on their loved one than on their friend. Brain images showed they had strong activity in the nucleus accumbens, an area deep in the brain involved with dopamine and reward circuits.

Experts stress that much still isn’t known about pain and the brain, including whom these mind-body therapies are most appropriate for. They also say it’s important that anyone who is in pain get a thorough medical examination. “You can’t just say, ‘Go take a yoga class.’ That’s not a thoughtful approach to pain management,” says Dr. Briggs.

Write to Melinda Beck at [email protected]

 

Mindfulness Meditation: Effective as antidepressants for depression relapse

Mindfulness meditation found to be as effective as antidepressant medication in prevention of depression relapse.

TORONTO, Dec. 7 /PRNewswire/

A new study from the Centre for Addiction and Mental Health (CAMH) has found that mindfulness-based cognitive therapy — using meditation — provides equivalent protection against depressive relapse as traditional antidepressant medication.
The study published in the current issue of the Archives of General Psychiatry compared the effectiveness of pharmacotherapy with mindfulness-based cognitive therapy (MBCT) by studying people who were initially treated with an antidepressant and then, either stopped taking the medication in order to receive MBCT, or continued taking medication for 18 months.
“With the growing recognition that major depression is a recurrent disorder, patients need treatment options for preventing depression from returning to their lives.” said Dr. Zindel Segal, Head of the Cognitive Behaviour Therapy Clinic in the Clinical Research Department at CAMH. “Data from the community suggest that many depressed patients discontinue antidepressant medication far too soon, either because of side effect burden, or an unwillingness to take medicine for years. Mindfulness-based cognitive therapy is a non pharmacological approach that teaches skills in emotion regulation so that patients can monitor possible relapse triggers as well as adopt lifestyle changes conducive to sustaining mood balance.
Study participants who were diagnosed with major depressive disorder were all treated with an antidepressant until their symptoms remitted. They were then randomly assigned to come off their medication and receive MBCT; come off their medication and receive a placebo; or stay on their medication. The novelty of this design permits comparing the effectiveness of sequencing pharmacological and psychological treatments versus maintaining the same treatment – antidepressants – over time.
Participants in MBCT attended 8 weekly group sessions and practiced mindfulness as part of daily homework assignments. Clinical assessments were conducted at regular intervals, and over an 18 month period, relapse rates for patients in the MBCT group did not differ from patients receiving antidepressants (both in the 30% range), whereas patients receiving placebo relapsed at a significantly higher rate (70%). “The real world implications of these findings bear directly on the front line treatment of depression. For that sizeable group of patients who are unwilling or unable to tolerate maintenance antidepressant treatment, MBCT offers equal protection from relapse,” said Dr. Zindel Segal. “Sequential intervention — offering pharmacological and psychological interventions — may keep more patients in treatment and thereby reduce the high risk of recurrence that is characteristic of this disorder.
The Centre for Addiction and Mental Health (CAMH) is Canada’s largest mental health and addiction teaching hospital, as well as one of the world’s leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to help transform the lives of people affected by mental health and addiction issues. CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre. For more information, please visit www.camh.net.
SOURCE Centre for Addiction and Mental Health