The world of psychiatry is full of unusual phobias. There’s symmetrophobia, the fear of symmetry, xerophobia, the fear of dryness, and ideophobia, the fear of ideas. But these phobias are exceedingly rare, and in the psychiatric interest on strange phobias, more mundane—and more dangerous—phobias are easily forgotten. Needle phobia is one such fear. There is significant evidence that fear of needles sparks physical changes in the body that can result in cardiac episodes and other health problems when a patient is exposed to needles. But needles are a part of life and are often necessary for medical treatment. Needle phobia, then, can cause a person to avoid life-saving care and, if a needle is forced upon a phobic patient, the results could be disastrous.

Needle Phobia and Cardiac Episodes
Most people dislike needles, but a true needle phobia feels overwhelming and uncontrollable to patients. People who have needle phobia may experience an extremely elevated heart rate and blood pressure immediately before a needle puncture. When the puncture occurs, the heart rate may drop precipitously. This exposes them to significant danger of heart arrhythmias and other cardiac episodes. Dr. James Hamilton, a pioneer in the treatment and study of needle phobia, reports that at least 23 deaths have been caused by a needle puncture that led to a cardiac episode.

Medical Issues
Doctors, nurses, and other people tasked with administering vaccinations and drawing blood are not typically properly educated about needle phobia. They’re accustomed to patients who dislike needles and may reassure them with promises that the puncture won’t hurt or will only take a minute. But with a true needle phobic, these reassurances don’t work. The person isn’t afraid of pain or injury: he or she is afraid of the needle itself. This poses serious obstacles to medical treatment. As many as 10% of people have some degree of needle phobia, and a significant portion of these individuals report that they would rather die than receive a needle puncture. These people tend to avoid medical care because of their fear, allowing their illnesses much more time to worsen than illnesses of nonphobic people.

Causes
Although traumatic experiences with needles such as painful blood draws or blood transfusions can cause needle phobia, people can’t typically trace the origin of the phobia. Needle phobia seems to run in families, but this does not mean the fear is genetic. Children may learn it from watching their parents show fear of needles. Restraining children during vaccinations and blood draws is strongly correlated with the later development of needle phobia. Consequently, parents should strive to ensure that their children’s early experiences with needles are positive and that children are not restrained unless the needle puncture is needed immediately to save the child’s life.

Treatment
Some people have good luck with hypnotherapy, but the most common treatment for needle phobia is counterconditioning. This process can take several years because the mere sight of a needle is sufficient to send many patients into a full-blown panic attack. Treatment providers typically start by asking the person to envision a needle, progress to showing the person a needle, and ultimately move toward getting the person to accept a needle puncture. For people who require needles for medical treatment, it may be necessary to administer general anesthesia to prevent life-threatening reactions. In less severe cases, anti-anxiety medications can lessen the symptoms of needle phobia.

Sources:

1. Hamilton, J. G. (n.d.). Needle phobia: A neglected diagnosis. Needle Phobia. Retrieved from http://needlephobia.info/pages/Hamilton-Needlephobia.pdf.
2. Emanuelson, J. (n.d.). The Needle Phobia Page – fear of needles and needle procedures. The Needle Phobia Page – Fear of Needles and Needle Procedures. Retrieved from http://www.needlephobia.com/
3. The phobia list. (n.d.). The Phobia List. Retrieved from http://phobialist.com/

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Public speaking is generally not a favorite activity of most people—in fact many people seem to fear public speaking or at least avoid it when they can. But most people are also not crippled with embarrassment or anxiety when they have to present in front of a class or when they are called on to answer a question. For students with social anxiety, being put into the spotlight occasionally during class presentations or participation is enough to make them avoid those classes altogether.

New research from the University of Plymouth and University of the West of England (UWE) Bristol looked at the impact of social anxiety in higher education, and psychologist Phil Topham estimates that “10% of university students experience significant social anxiety,” according to a news release from UWE Bristol.

Social anxiety disorder or social phobia is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as “a marked and persistent fear of social or performance situations in which embarrassment may occur.” There are several other diagnostic criteria, including that “the social or performance situation is avoided, although it is sometimes endured with dread.” People are diagnosed with the disorder only if their life is significantly negatively impacted.

Out of more than 1,500 students who were surveyed, some students experienced “frequent anxiety in learning situations that involved interacting with students and staff.” To cope with this anxiety, students would not participate in lectures and presentations or would even skip class. Other students wouldn’t take any classes that involved presenting at some point, according to the news release.

The researchers conclude that students who experience social anxiety “could be missing out on learning opportunities and may be distracted from attending to academic information by excessively focusing on their anxieties.”

Although the researchers don’t believe students should be treated as potentially fragile and coddled, there needs to be more support available for students with social anxiety without further stigmatizing these students or making them feel like their “flaws” are exposed. The researchers even give some suggestions for support in the university, including “not singling out students for questioning in lectures or setting assessed presentations in their first term,” and “sensitive appreciation of the shame and conflict caused in students by the desire to succeed and the fear of failure.”

Basically, college professors need to take into consideration the styles of all college students—some love the spotlight, others have social anxiety, so it’s best to ease students into participating and presenting during class.

Mental health experts have some tips on how to succeed in high school and college despite having social anxiety.

Nerina Garcia-Arcement, a clinical assistant professor at NYU School of Medicine and a licensed clinical psychologist, gave one major suggestion in an email to help students who are experiencing social anxiety.

“Do not avoid what you fear,” Garcia-Arcement said. “The more you avoid, you are creating evidence that it is more comfortable to not do something. Instead, if you face what you fear you can slowly prove that your worst fears will not be realized.”

She also suggests that students follow these four steps to take control of their anxiety:

1. Stop and evaluate what you are feeling (i.e., butterflies in your stomach, sweating, trouble breathing, heart racing).
2. Stop and evaluate what are you thinking (i.e., “people will laugh at me,” “I will fail,” “I will look ridiculous.”)
3. Practice activities that will reduce the physical symptoms, such as deep breathing, muscle relaxation exercises and imagining yourself in a safe place.
4. Challenge your negative thoughts by stopping the critical belief and instead replace it with a positive thought such as “people have never laughed before,” “I can do this,” “looking silly is the point of this activity, and if I do look silly so what.”

There are effective treatment options for students who have access to a mental health professional.

“Talk therapy is extremely effective for social anxiety, especially cognitive behavioral therapy. Medication can be taken in severe cases, Garcia-Arcement said. “Learning to manage the physical anxiety symptoms and stopping and controlling the negative thoughts is essential to controlling social anxiety. Sometimes people can do it on their own, sometimes they need help with monitoring thoughts and feelings and figuring out what gets in the way of using these new skills.”

She has three other tips for students who are trying to decrease their social anxiety:

1. Practice deep breathing, meditation, yoga, and exercise. These help manage and control anxiety.
2. Ease into social activities, first with smaller groups and eventually, as you feel comfortable, with larger groups.
3. Practice what you fear in a controlled environment. First practice the presentation or talking to a stranger in front of a mirror, later practice in front of someone you trust such as a friend or parent, then go into the real situation.

Scott Carroll, a child psychiatrist who works at the University of New Mexico, said that part of the problem can be that some students don’t realize they have an issue that needs to be worked on.

“Many people with social phobia … often just think they are shy and don’t realize they may have a treatable condition,” Carroll said. “Also, if someone has been anxious their whole life, they may not realize they are significantly more anxious than other people.”

Once students do realize they have an issue, they have a variety of treatment options available to them, including individual psychotherapy (such as cognitive behavioral therapy), social skills therapy groups, and multiple types of medications.

Carroll has two other coping methods for college students who have social anxiety: positive self-talk, in which you reassure yourself that it’s OK to talk or say hello, can be helpful with milder forms; and repeated exposure, which leads to decreased anxiety, like joining Toastmasters to get comfortable with public speaking.

Jeffrey Gardere, a contributing psychologist at Healthguru.com, said in an email that it’s beneficial for students with social anxiety to have friends they can rely on to come along with them in situations that could cause more anxiety.  Sometimes self-help books can be useful as well.

“The young person with social anxiety may also want to stay away from stimulants such as energy drinks and caffeine in order to avoid becoming even more nervous,” Gardere said. “And certainly [try] to avoid liquor, marijuana or any other chemical that is a self-medication in order to feel relaxed, simply because they may be more at risk for possible addiction.”

Romantic love can be all consuming. In the beginning stages of a relationship, one or both partners may be overwhelmed with feelings of affection for the other partner. Couples may want to spend all of their waking hours together and actually crave each other’s presence when apart. These feelings are not uncommon in many budding romances. However, when they persist and lead to unhealthy behaviors, this type of love can become destructive. Much like an addiction to drugs or alcohol, people who experience love addiction pursue their drug at the expense of their friendships, careers, family members, and even self-respect.

In a recent article, Dr. David Sack, a psychiatrist and addiction specialist, explains what love addiction is. He says that people who are in addictive relationships experience limerence, a term introduced by psychologist and author Dorothy Tennov to describe love obsession and dependence. Limerence mimics new romantic love, but unlike true love that constructively develops into reciprocal, mutual affection, limerence is usually destructive. When one partner exhibits limerent behaviors, they may begin to cross emotional and physical boundaries in order to secure the attention and affection they need. Even when the feelings are not returned, the limerent partner may continue to chase after the other partner. Sack says, “Behaviors may become dangerous, such as stalking or unwanted contact, and require outpatient or residential love addiction treatment, professional counseling, and/or 12-step work.”

Limerent relationships are not all bad. Although most end with one partner being rejected and hurt, some actually grow into healthy and mutually loving unions. Individuals who display limerent behavior in one relationship may continue to do so in future relationships, creating a pattern of destruction and disappointment. Sack suggests that individuals who believe they are involved in a limerent relationship, either by their own actions or those of their partner, work with a professional to identify the negative behaviors. Understanding the cause of the limerent patterns will help an individual become aware of why they behave the way they do and give them an opportunity to transform negative patterns into more positive and promising ones.

Source:
Sack, D. (2012, June 28). Limerence and the biochemical roots of love addiction. From the Huffington Post. Retrieved from http://www.huffingtonpost.com/david-sack-md/limerence_b_1627089.html

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According to a recent article, being completely honest with your mate about infidelity might not always be the best strategy. Clinical Psychologist Bruce Stevens explained that understanding the need to be honest about the affair can help guide the decision whether to do so or not. Stevens has worked with couples for more than two decades and said that his experience has shown him that only about half of marriages survive after an affair has been revealed. He says, “After an affair is found out, it’s like a bomb has been dropped on the relationship and you cannot predict how it will go.”

When someone confesses to having an affair, it can create a sense of chaos unlike any other the relationship has ever experienced. Stevens knows that couples who put in the effort to work through the many issues that arise after the affair have a good chance of salvaging their relationship and usually have a stronger, better, healthier relationship because of it. Stevens says that many people admit to their affair in order to assuage their own guilt. He believes that this reason should not be the motivating factor for full disclosure. Stevens says there is no guarantee that both partners will be able to overcome the damage caused by the truth and thinks it’s almost like playing Russian roulette.

The good news is that Stevens also thinks that there is significant hope for couples who can be realistic after they go through the pain of discovering an affair. If both partners are willing to accept responsibility and recognize that they are both human beings, flawed and imperfect, they have a very good chance of moving forward in their life together. Regardless of whether partners choose to come clean about their infidelity or not, Stevens reminds us that affairs are like fairytales. They are illusions that allow us to temporarily escape reality. The difference is, affairs rarely end “happily ever after.”

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The novel Fifty Shades of Gray has attracted enormous attention since its recent publication. The popularity could be attributed to the characters’ scandalous sexual trysts laid out in vivid detail. Or it could be due to the fact that women really do want more sexual pleasure in their relationships. In a recent article, clinical psychologist and sex therapist Dr. Stella Resnick explains why she believes the public has such a voracious appetite for this type of literature. Resnick practices Gestalt therapy, which integrates body and mind presence and awareness. Her experience has taught her that every form of physical contact, including touch, kissing, and even eye contact, increases overall sexual pleasure. She believes that intimate play is an integral part of a healthy sexual relationship.

Resnick has been working in her field for more than two decades and says that contrary to popular belief, men seem to lose interest in sex more quickly than women. This could be a result of the pressures men feel to provide financially and their sense of responsibility as the head of the family. The natural progression a partner makes from lover to family member can actually undermine sexual attraction and excitement for men and women alike. In fact, Resnick says that these feelings of “love” for each other can create barriers to healthy sexual fun. Resnick says that maintaining a sense of playful sexual activity is important for many reasons. “New brain research has shown that what’s essential for enhancing new learning is to keep the brain engaged and attentive and that playfulness is one of the best ways to do that,” she says. Learning about each other’s wants in and out of the bedroom helps broaden the bond between partners both physically and emotionally. Resnick suggests couples engage in conversations about sexual desires and act on them. Taking time to relax and enjoy a sexual encounter, including play, can create a sexual experience that will satisfy both partners and keep both brain and body engaged.

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Everyone occasionally has a bad case of the Mondays, but that can also go away once you start joking around with coworkers. However, what happens when you’re surrounded by negativity, people who gossip and constantly complain? If positivity is lacking in the workplace, it can be a major mood drainer. Luckily, experts do have some suggestions for conquering situations with negative coworkers. These are just some possible solutions to a negativity problem, but feel free to experiment and add your own personalized touch.

Cheryl Palmer, a certified career coach and the owner of Call to Career, said when people are placed in a negative environment, it can start to rub off on them if they don’t consciously fight against it. However, she does have a couple of tips to help workers stay positive in a potentially negative work environment:

1)    Whenever possible, surround yourself with positive people. If any of your coworkers have a positive attitude, associate yourself with them. If there are no positive people at work, then make sure you surround yourself with positive people outside of work.
2)    Physically take yourself out of that environment whenever feasible. For example, you don’t have a choice when it comes to being around negative people when you are in the office, but you can use your lunch break to get out of the office and take a breather. Going for a brief walk during your lunch break can be rejuvenating.

Workers can even attempt to bring positivity to negative coworkers, especially if they appear to be more open to changing their ways. Here are two tips for helping coworkers see their jobs in a more positive light:

1)    Focus on the positive aspects of the job and/or organization. You can usually find something positive if you look for the positive.
2)    Another way to help coworkers is to focus the conversation on positive things outside of the workplace. Instead of talking about work all the time and how bad things are, you can talk with coworkers about their families and outside interests.

Tina Tessina, a psychotherapist and author of It Ends With You: Grow Up and Out of Dysfunction, said in an email that overall negatively, especially in the workplace, can lead to worse issues.

“Negativity increases anxiety and despondency, which in turn increase stress,” Tessina said. “There are many studies that show how deleterious stress is to your health.  A negative outlook also ‘programs’ your subconscious to look for more negative things, and can easily make the situation seem gloomier than it really is.”

“When you’re complaining about what’s wrong, you’re not looking for ways to improve your situation or circumstances,” she added. “You wind up not being able to see the positive options that are there. A negative attitude can also increase the likelihood that your coworkers won’t get along. Once people start on the fault-finding path, they wind up also being negative toward each other, which creates an unpleasant, edgy atmosphere.”

She has a couple suggestions for being more positive in the workplace.

1)    Be the different voice—find something positive to say about whatever they’re complaining about; or else just ignore the negative conversation. You are not required to join in when the discussion is going downhill.
2)    No one responds well to being told what or how they should think or talk. What you can do is be the ‘Pollyanna’ in the group, searching for the positive possibilities and being a creative thinker. If you don’t follow the herd, the herd may wind up following you.

Tessina said people need to realize they have the power to take charge of their own thoughts and feelings, or they could get out of hand. This is one aspect to consider if you start giving in to negative talk at work or hear other coworkers complaining.

“Your thoughts affect your mood, and how you relate to yourself can either lift or dampen your spirits,” Tessina said. “Neuronal activity in the brain activates hormones which are synonymous with feelings. Constant self-criticism results in a ‘what’s the use’ attitude, which leads to depression. Continuous free-floating thoughts of impending doom lead to anxiety attacks. Negative self-talk creates stress.”

If you’re constantly stressed and prone to negativity, it might be a good idea to look at what types of relationships you’ve built with others, because chances are you’ve surrounded yourself with negativity and relationships that are prone to stress. It’s also beneficial to do some soul-searching and come to terms with what you want to do with your life, so that’s one less thing to become stressed about.

“What I do to help clients become aware of self-inflicted stress is first, to ask them to become aware of what they’re saying to themselves—if there is a constant stream of negativity, it will create stress—just as being followed around by someone who’s constantly carping on you would be stressful,” Tessina said.

April Ricchuito, a yoga/MST therapist, gave her suggestions in an email for combating negativity in the workplace:

1)    “Avoid taking anything personally. This was never about you; it’s about them. Set good, clear boundaries.”
2)    “Learn to meditate. Take three deep breaths and smile before responding, especially when you are irritated.”
3)    “Watch a few funny YouTube videos if you can. Share them with your coworkers.”
4)    “Look up a few office/desk yoga exercises you can do quickly and effortlessly to get grounded and relaxed.”
5)    “If you do choose to speak to coworkers about their outlooks, speak to them privately. Use ‘I’ statements to avoid sounding like you are attacking. Offer to help them: ‘Hey, I noticed you don’t seem as positive as usual. Is anything going on that I can help you with?’”

Denise Altman, the president of the Altman Initiative Group, Inc., said it’s important to find a job that you can look forward to and have passion for – work doesn’t have to be a place you drag yourself to. She also offers the following advice: “Start the day with a positive thought or mantra—post it on your screen saver or Post-it to your computer and think on that when others say negative things.”

Kathi Elster, an executive coach and business strategist at K Squared Enterprises, and coauthor of books like Working With You is Killing Me: Freeing Yourself From Emotional Traps At Work, gave a different suggestion to stay positive, even when you’re surrounded by negativity in the workplace. “Do whatever you need to in order to keep your positive mood in check. It might be talking to a friend that makes you laugh, keeping uplifting music on, surrounding yourself with the things that remind you how good life can be—photos, your favorite scents, humorous reminders, cartoons, jokes, etc.”

If you haven’t read the novel yet, you might be 50 shades of curious about why Fifty Shades of Grey is the most-talked-about tale in print currently.

A quick search will reveal that the romance between the main characters, Mr. Grey and Miss Steele, revolves around bondage, discipline, dominance, submission, sadism, and masochism (BDSM). In fact, Christian Grey appears to really only get satisfaction from sex when it involves inflicting pain or dominance over his partner, which, following criteria from the Diagnostic and Statistical Manual of Mental Disorders (DSM IV-TR) used by mental health professionals to make diagnoses, could be considered a mental disorder called sexual sadism.

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The DSM IV-TR states that “sexual sadism involves acts (real, not simulated) in which the individual derives sexual excitement from the psychological or physical suffering (including humiliation) of the victim.” In order to officially be diagnosed with sexual sadism, individuals must meet the following criteria:

1)    “Over a period of at least 6 months, recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving acts (real, not simulated) in which the psychological or physical suffering (including humiliation) of the victim is sexually exciting to the person.”
2)    “The person has acted on these sexual urges with a nonconsenting person, or the sexual urges or fantasies cause marked distress or interpersonal difficulty.”

In the first novel of the series, Christian Grey appears to engage in sexual sadism only with consenting participants (like Anastasia Steele, the main female character), but he openly admits to being abused (including sexual abuse) as a child and teenager and appears to be at least somewhat distressed by the fact that it’s difficult for him to have a “normal” relationship. He even explains to the character Anastasia Steele at one point that this is just the way he is, almost with sorrow. And although he does have “normal” or “vanilla” sex with Anastasia, he makes it obvious that he prefers sex that involves pain and pleasure at the same time, always with him dominating.

Anastasia also admits to herself that there is something unusual about Christian and his sexual preferences, but she lets her desire for him take over, and she hopes that she can make him want a “normal” relationship with her. She herself has issues with low self-esteem and confidence, which is perhaps why she is so drawn to the seemingly overly confident Christian. Both characters appear to function as well as the average person in their fictional world, but both have issues that could potentially need to be addressed by a professional if they lived in the real world.

So it appears that one of the main characters of Fifty Shades of Grey may have a diagnosable disorder related to sexuality, or at least has abnormal sexual preferences and a traumatic past that hasn’t been resolved yet. He has major difficulties maintaining any lasting romantic relationship, and yet the relationship between Christian and Anastasia seems to have been received in a somewhat positive light, considering the large following of readers.

The Experts Weigh In
Several mental health experts have offered their insight into the unusual relationship found in Fifty Shades of Grey (and the two other novels in the series). Reef Karim, a board-certified psychiatrist, the founder and medical director of the Control Center for Addictions, and author of Why Does He Do That? Why Does She Do That? and host of the new show Broken Minds on the Discovery channel, said that the novel is definitely making people think about normal and abnormal sexuality and possibly changing some people’s minds.

He said in an e-mail that the main question people are wondering is, “What is normal and abnormal sexual behavior, and when is aberrant sexual experimentation and behavior considered a mental health diagnosis?” “The really interesting part of psychiatric diagnoses is that many are based on a behavioral spectrum where the interruption of an individual’s social, relational, occupational, and functional life is a key factor in making the diagnosis,” Karim said. “This book has become a literary piece of pop culture that is challenging many to review their thoughts on normative and ‘out of the box’ sexual behaviors.”

He said that there could be concerns about a link between sadomasochism (S&M) and childhood abuse as well, since that is mentioned in the novel. “There is definitely a connection, but many people with no psychiatric or psychological history report enjoying BDSM primarily as a novel and alternative way to connect with each other,” Karim said.

Despite (or because of) the unusual relationship involving pain and pleasure (and emotional issues), many women appear to be captivated by the novels. Karim suggests this is because women enjoy having sexual fantasies, but that doesn’t necessarily mean they want the type of relationship found in the novel to become more than a fantasy. If anything, women might be more prone to sexually experiment during or after reading the novels.

However, he doesn’t think the novel is capable of completely changing sexual norms, so sexual sadism and sexual masochism will most likely still be considered mental disorders according to the DSM in the future. “I believe the novel opens up the conversation of BDSM, kink and sexual norms, but it’s much more in the curiosity range than actually changing research-driven professional medicine,” Karim said. “Expecting an increase in sex shop purchases is different than changing a clinical manual.”

Karim explains further why the novel is so appealing to women (and men), even with the dysfunctional (and sometimes even depressing) personalities of the characters. “In regards to sexual research, many women fantasize about submission, and many men fantasize about dominance,” he said. “Even though men and women are more equal than ever in regards to occupation and finances, we are still very different sexes, and definitive gender and role-based fantasies do exist,” he added. “Many people in our society have hidden (or not so hidden) fantasies involving kink, S&M, or altered sexual behavior. 50 Shades of Grey has opened up the conversation of previously hidden sexual desires and fantasies of many women.”

He said the novel could help couples become more creative in their sex lives, but going to any extremes is generally not beneficial. “The introduction of BDSM can add to a couple’s sexual tool box, but occasionally it can get out of control,” Karim said. “When extreme behavior leaves the bedroom or involves extremes in the bedroom, it can negatively impact the relationship. I’ve treated couples who use BDSM as a novel, fun experience in a healthy and intimate way, and I’ve treated other couples or individuals who became obsessed with the act or re-created a previous abuse history with a lot of painful markings.”

Overall, the BDSM series is encouraging men and women to discuss sexuality more openly with each other. “The book mentions childhood abuse and difficulties with self-esteem that contribute to the psychological make-up of these characters, but it has also found a way to tap into the S&M lifestyle curiosity shared by many men and women,” Karim said. “It may actually normalize the behavior, when done in moderation, as not something strange but perhaps just another form of sexual expression. Life isn’t always black and white; sometimes it’s fun to live with a little grey.”

Kari Tabag, a licensed clinical social worker, works with adolescents and college-age men and women and has read the series. She said the novel has passages that hint at mental health issues like posttraumatic stress, codependency, BDSM, and alcoholism.

Although she agrees that the novel can improve people’s sex lives through fantasy, role play, and experimentation, the sexual expectations people might have after reading the series might be set too high, leading to disappointment. Also, she emphasizes that the actual relationship depicted in the series is very unhealthy in many ways. “Christian and Anastasia’s relationship is not a healthy one. They are codependent and are too enmeshed with each other,” Tabag said. “A lot of women are codependent and are what I call ‘daddy hungry.’ This novel depicts two people who have abandonment along with trust issues.”
There are even more unhealthy aspects of the fictional relationship, according to Tabag:

• When Anastasia finds out that Christian only dates women with brown hair, it is a dead giveaway of his childhood abuse and abandonment. In fact, Anastasia refers to him as her “boy,” which is not healthy.
• Anastasia repeatedly feels that she is not worthy of Christian and vice versa.
• Christian is obsessed with Anastasia and even follows her to another state when she visits with her mother.
• They both are looking for someone to take care of rather than focusing on healing themselves. A healthier relationship involves two people who have their own separate, independent personas, making them well-established, well-rounded, self-reliant individuals.
• Christian wants Anastasia to give in to him and give up all control, and he lavishes her with gifts as a reward.

Although the relationship in the novel is not healthy, BDSM is not necessarily as terrible as it’s made out to be. Tabag suggests our society is not necessarily mature when it comes to accepting and understanding sexual preferences outside of ‘man on top.’”

Viewpoint From a Submissive
Kasi Alexander, the author of several books and short stories about alternative lifestyles, such as Becoming Sage and Saving Sunni, has herself been involved in the lifestyles of polyamory, BDSM, and power exchange. She currently identifies herself as a “slave,” and the partner in her polyamorous relationship is the “master”; she could also be referred to as a submissive. She said in an email that the relationship between Christian and Anastasia is not necessarily a model of the typical BDSM or power exchange relationship. The characters themselves are also not typical. For example, Christian Grey was abused as a child and became involved in BDSM at 15, and he now avoids “vanilla” sex and relationships.

“Very few people in the lifestyle immerse themselves so deeply that they have no desire for a relationship outside the parameters of power exchange,” Alexander said. “The ones who do are using the lifestyle to mask other personality defects, not the other way around. Accepting your dominant or submissive tendencies does not kill the desire for intimacy, closeness, or connection.” Also, the character of Anastasia Steele is low in self-esteem, self-worth, and confidence, which is not usual for submissives, Alexander said.

“Many people assume that submissives give up all responsibility for themselves, are doormats that cannot stand up for themselves, and so are taken advantage of by predatory dominants,” Alexander said. “That couldn’t be further from the truth. Submissives are stereotypically extremely strong, capable people. Many of them crave submission as a way to temporarily escape the huge responsibilities they take on in their “vanilla” lives.”

Alexander adds that the BDSM lifestyle can even be considered therapeutic in different ways. “In my own relationship, we have used our power exchange to work on my self-image and body issues, increase my self-confidence, and achieve many goals, including writing and publishing three books (so far),” she said. “Other kinky people that we know use sensation play as therapy or catharsis to work through feelings of inadequacy, childhood abuse issues, and various kinds of mental health issues.”

The BDSM element of 50 Shades of Grey just takes the typical romance/erotic novel a little further. “Women have a genetic inclination toward alpha males, so we love our fictional heroes to be large, powerful, and a little scary—someone who has the ability to hurt us but doesn’t,” Alexander said. “And almost all BDSM play is based on the intensification of physical experiences. So the fantasy of the physical ‘danger’ (intensity of experience) goes along with the mental domination of having a strong alpha male taking over your life. It’s erotic, even if it’s not what we want in our actual day-to-day lives.”

She said BDSM and power exchange have the potential to make relationships more sexually fulfilling, but just like in any relationships, it’s a matter of communicating wants and desires. And just like in other bad relationships, abuse and manipulation can happen, but that is a matter of individual personalities and relationships, not a characteristic of BDSM as a whole. She said it’s important to make a distinction between mental conditions and different sexual preferences and alternative lifestyles. “The most important aspect of the mental disorder consideration is the difference between true sadism and kinky sadism,” Alexander said. “A vast majority of ‘sadists’ in the BDSM community derive no pleasure from inflicting pain unless the recipient is enjoying the experience, whereas a true sadist is not concerned with the benefit of the other person.”

She believes that people will eventually become more accepting of these types of lifestyles and realize that they can be beneficial to people who can learn how to make them work.

“More education is needed to show people that polyamory is not cheating, BDSM is not abuse, and power exchange is not manipulation,” Alexander said. “The important thing to keep in mind is the benefit for the people involved. BDSM and power exchange can be done badly and for the wrong reasons, but they can also be used for personal, professional, and spiritual growth and for the enhancement of relationships.”

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George W. Bush created the Healthy Marriage Initiative based on research showing that healthy, strong marriages make a positive contribution to communities. The program, funded by the federal government, was designed to help unwed parents living in socioeconomically deprived neighborhoods reap the benefits of marriage. Most of the targeted families were minorities and faced challenges with keeping and maintaining employment, adequate housing, and earning enough income to supply the basic needs of their families. They also dealt with crime and safety issues. The government believed that this vulnerable group was the most in need of programs designed to help couples develop healthy marriages. The program was implemented during Bush’s administration and fully supported by Obama when he became President.

It is only recently, however, that the results of this program are coming to light and being fully analyzed. And, as outlined in a recent article, they are not encouraging. According to data gathered by Matthew D. Johnson, an associate professor of psychology at Binghamton University, the programs were based on scant research from higher income, nonminority couples. Johnson reviewed assessments from thousands of couples who participated in the program and discovered that the framework, which was based on individuals from different socioeconomic environments with fewer challenges, did not provide a relevant foundation from which minority couples could build a strong marriage. The couples that need the Healthy Marriage Initiative most do not consider marriage more important than finding employment, meeting basic needs, and ensuring the safety of their families. “When faced with a myriad of social issues, building intimate relationships is just not high on their priority lists,” says Johnson.

The Healthy Marriage Initiative costs slightly more than $9,000 per couple to implement and has become more of a burden, both economically and socially, to the very communities that it was designed to help. Johnson believes that the intention behind the program was the right one but that the whole initiative needs to be restructured in order to achieve positive results. Specifically, Johnson believes that the program should be fully examined and reformatted based on accurate research, and if it still cannot meet target goals, it should be eliminated altogether.

Most parents don’t need an expert or a study to tell them what they already know: kids get more homework now than they ever have before, with many high schoolers getting as many as seven or eight hours of homework a night. Most parents are as overwhelmed by homework as their children are and constantly struggle to create incentives for their children to complete their piles of homework. Many parents believe they’re fighting this homework battle to ensure a quality education for their children, but the truth is that there’s little evidence that excessive homework helps children learn. Indeed, evidence is rapidly amassing that overworking children interferes with their ability to learn.

Understanding Learning

Our brains are programmed to learn things that are interesting to us and relevant to our lives. You’re more likely, for example, to remember where the aggressive dog who always chases children lives than you are to remember the color pattern on your neighbor’s shirt. Children in particular are primed to learn things that help them better function in their environment. Unfortunately, homework doesn’t pass this test. The overwhelming majority of homework assignments force children to sit down and memorize facts rather than experience their world. Not only does this make information more difficult to learn; it can also decrease your child’s motivation to learn. When learning is made miserable, children associate the thing they’re learning with misery and want to avoid it. This is why tactics such as forced silent reading time or flashcards rarely help children learn math and vocabulary.

The Stressed Brain

Even when homework is well-designed and does foster learning, too much of it can be damaging. Children who have more than one hour of homework each night overwhelmingly report that they feel stressed about their ability to complete their work. Over time, this stress can create real problems for a developing brain. When we are under stress, the brain produces cortisol, which lowers immune function and processing speed. On a short-term basis, cortisol can help us deal with stress. But when the brain is constantly releasing cortisol, development and learning can slow. This is especially damaging for children, whose brains are rapidly laying down neural connections. Even more troubling, excessive doses of cortisol can damage the hippocampus, which plays an important role in memory, inhibition, and spatial reasoning.

Fewer Activities

The value of friendships, extracurricular activities, and relaxation time to children’s intellectual and emotional development has been extensively documented. When homework is overwhelming, however, children are less likely to have the opportunity to participate in these activities. Thus even a child who is left unfazed by excessive homework or who excels in school may suffer as a result of excessive homework because he’s unable to engage in the activities that can help him become a well-rounded adult.

A Better Approach to Homework

Homework can help bridge the gap between home and school, encourage independent learning, and give children who find school stressful an opportunity to learn at home. So what are the characteristics of “good” homework assignments? They include:

• Activities that encourage students to interact with their environment
• Activities that give students flexibility to focus on things they are interested in
• Activities that make learning relevant instead of flashcards and drills
• Reasonable amounts of time spent on homework—no more than one hour for young children and no more than two hours for high schoolers
• Activities that can be completed at home without substantial cost or the purchase of lots of supplies

When choosing a school or classroom for your child, ask about homework and advocate on your child’s behalf when homework becomes excessive. Your child’s stressed mind will thank you, and your child just may end up learning more.

References:

1. Gerhardt, S. (2004). Why love matters: How affection shapes a baby’s brain. New York, NY: Brunner-Routledge.
2. Harwood, R., Miller, S. A., Vasta, R. (2008). Child psychology: Development in a changing society. Hoboken, NJ: John Wiley & Sons.
3. Hirsh-Pasek, K., Golinkoff, R. M., Eyer, D. E. (2004). Einstein never used flash cards: How our children really learn–and why they need to play more and memorize less. Emmaus, PA: Rodale.

Women have been stereotypically defined as being more emotional than men. In popular culture, women are depicted as being more emotionally volatile, often erupting into fits of sadness, anger, despair or jealousy much more frequently than their male counterparts. But is this portrayal scientifically accurate? Research has shown that there are differences in how men and women emotionally respond to situations. However, little research has addressed the core self-conscious emotions (SCE) of men and women and how they differ. Nicole M. Else-Quest of the Department of Psychology at the University of Maryland in Baltimore sought to debunk the myth that women have less emotional regulation than men. She recently conducted a study that compared male and female levels of embarrassment, shame, guilt, and pride in data gathered from over 300 studies.

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Existing research has shown that women and men differ in their risks for some mental health issues such as depression, food and eating issues, anxiety, and self-worth. How men and women experience SCEs has a direct influence on their likelihood of developing these and other psychological problems. Else-Quest analyzed over 200,000 self-reports and found that for the most part, women and men had similar levels of SCEs. The results revealed slightly higher levels of guilt and shame in the women, but minimal differences in pride and embarrassment. Else-Quest also looked at age as a factor because men and women tend to exhibit the first signs of depression, anxiety, and low self-esteem at different ages. She found that although there were relatively few differences in SCEs in early childhood, women reported higher levels of SCEs, primarily shame and guilt, during adolescence.

Overall, Else-Quest discovered that women experienced the highest levels of guilt and shame when they were asked about sex, food and eating, body image, or the environment. Although the rates of SCEs in these areas were only slightly higher for women than men, these results support existing research regarding women’s emotional perceptions about sex, body image, and eating problems. Else-Quest concluded by saying that even though women had minimally elevated levels of guilt and shame, the men and women reported levels of pride and embarrassment that were virtually identical. She added, “These findings contribute to the literature demonstrating that blanket stereotypes about women’s greater emotionality are inaccurate.”

Reference:
Else-Quest, N. M., Higgins, A., Allison, C., Morton, L. C. (2012). Gender differences in self-conscious emotional experience: A meta-analysis. Psychological Bulletin. Advance online publication. doi: 10.1037/a0027930

For children, teens, and college students, summertime is associated with freedom from school and positive emotions. However, summer can also be a time where certain mental health issues need to be tended to even more than usual. Experts share information on what mental health problems can be present more often during summer and how to prevent certain issues.

Peter Zafirides, a psychiatrist in Ohio, said he has noticed a common mental health issue for children, teens, and students during the summer. Many evaluate whether they should still take their medication for attention deficit hyperactivity disorder (ADHD).

“Stimulants are often prescribed during the school year, but depending on the severity of the underlying ADHD, the summers may provide for some time off the medications,” Zafirides said. “But it may not always be smooth-going. The combination of unmedicated ADHD symptoms, along with the less structured days of summer can be very problematic for kids and their parents. Beyond the attention symptoms that worsen, kids can experience mood changes, including anxiety and irritability.”

School can provide a consistent schedule, which can be better for children with certain mental illnesses. “The potential unstructured nature of the summer can feed in to any underlying anxiety disorders and depression present in these kids,” he added.

For children who have ADHD, Zafirides has tips to make summer more bearable. “Children and parents may benefit from sitting down at the beginning of the summer and talking about shared goals and expectations,” Zafirides said. “Have a plan ahead of time to regularly check in with each other and, in an open, nondefensive forum, talk about any changes in behavior or concerns about mood.”

He also has other suggestions that can apply to children and teens with any type of mental illness or mental health issues. “Get outside and enjoy the summer. Try to limit the amount of time online, watching TV, or playing video games,” Zafirides said. “Be active, get plenty of sleep and exercise. If medications will continue over the summer, make sure kids are taking them regularly. Again, summer is less structured, so compliance may not be as consistent, resulting in a worsening of a mental health condition. Always speak to your medical professional before either discontinuing or reducing the dosages of medication.”

Communication is key for healthy relationships and lives. “I think the most important aspect between parents and children in the summer months is to establish clear and respectful lines of communication without either side getting defensive or feeling they are not being heard,” Zafirides said. “An occasional small discussion may be all that is needed to avoid big problems over the summer.”

John Duffy, a clinical psychologist and author of The Available Parent: Radical Optimism for Raising Teens and Tweens said in an email that depression can be more noticeable during the summer. “I have found that depression driven by loneliness often becomes more pronounced in the summer,” Duffy said. “This may be due in part to the fact that people are more obviously out, about, and social in the summertime. For many young people, summer is a far less-structured time of year than any other season.”

Anxiety issues can also come to the surface. “We often find that anxiety-based issues become apparent due in part to the lack of structure,” Duffy said. “Though most young people claim this is the time of year they most look forward to, many become listless and irritable because of a lack of structured activity.”

The solution to these issues is to provide somewhat consistent structure during the summer. “This might include participation in a sport, a play, a camp or other club, volunteer activity, or a job,” Duffy said. “Kids do better when they are part of something. They are happier, less restless, and more driven. Summer also presents a unique opportunity for young people to investigate strengths and interests, and opportunity that is less open to them during the very-structured school year.”

Adults can experience the same mental health issues as children during the summer, especially depression and anxiety. “Depressed adults are more aware, for example, of the degree to which others are socially connected during the summer, and this can serve to amplify the depression,” Duffy said. “Many adults also tell me that, though they want to be more active, limitations imposed by work and other obligations prevent them from doing so. This can contribute to feelings of depression and anxiety as well.”

The National Alliance on Mental Illness website suggests that some people can actually experience seasonal affective disorder (SAD) during the summer. SAD is characterized by depressive episodes that occur during certain times of the year (typically during the winter). In the case of seasonal affective disorder that is experienced during the summer, symptoms tend to be weight loss, minimal appetite, anxiety, irritability, and insomnia. Heat and humidity could worsen this “reverse SAD,” according to the website. Some adults with bipolar disorder are more likely to experience the mania part during spring and summer as well, he said.

William Oswald, the CEO and director of Summit Malibu, a behavioral and addiction treatment center in California, said in an email that all types of mental health issues can occur more often during the summer, such as agoraphobia, addictions and compulsions, as well as the more common depression and seasonal affective disorder.

“When people have a purpose, or curriculum in this case, their minds stay occupied, and boredom is not as prevalent of an issue,” Oswald said. “When they go from being extremely busy to having nothing to do, oftentimes this boredom results in mild, or in some cases severe, forms of depression. Once untreated, depression sets in, people (teens and college students especially) end up self-medicating with drugs or alcohol as a means to simply feel better. This is true of seasonal affective disorder as well—some may not want to be outside, and in turn isolate, resulting in isolative behaviors and a depressive state.”

Oswald has specific preventative tips for each age group during the summer:

Children: “Setting play dates with other kids or sending them to a day-care program where they do outside activities can keep their minds occupied and also help with socialization. This is key to preventing isolating behaviors later on in life.”

Teens: “Having a part-time summer job is the most important thing they can do to protect their mental health. They will learn the importance of a work ethic, earn money (which they can then spend on fun activities), and [prevent] boredom—the number one offender during summer breaks.”

College students: “Having an internship or continuing to work on their educational goals will keep them focused and driven, preventing depression and other detrimental behaviors associated with the disorder.”

Unfortunately, these suggestions will not always work, and in that case it’s best to seek a mental health professional to keep any mental health issues from worsening.

For adults, it can be unfortunate to be stuck inside working when the weather is gorgeous (at least in some places). This can be just another trigger for depression and other mental illnesses like substance-related disorders. “Adults need to utilize their vacation days properly so they have something to look forward to and get to experience summertime weather on days other than the weekend,” Oswald said. “Making time for outdoor activities on the weekend and starting an exercise program will keep one’s mood elevated.”

The word bridezilla has become an oft-used part of our lexicon, and many people who have never been married are confused by the panic and stress that seems to surround wedding planning. But a newly engaged couple quickly learns that the stress of wedding planning is not the overexaggerated fantasy of people who simply have no stress tolerance. Wedding planning is stressful for almost everyone, and yet people never stop to think about why this is. Here’s what is really going on.

Expectations vs. Reality
A wedding is a major rite of passage, and many people—especially women—have been raised to expect their wedding to be a perfect fairy tale. But nothing can be perfect, even a wedding, and the drive for perfection can be profoundly stressful and emotionally fraught. Many people use their wedding as an opportunity to take stock of their lives so far. If they can’t afford a dream wedding, they may feel like failures. Some people have a specific list of things they intended to do before they got married. No matter how unreasonable this list might have been, unfulfilled dreams can still cause stress when you’re planning a wedding.

A Stressful Engagement
The time before you get married should be one of the happiest, most romantic times in your life. Instead, many people spend this period frantically planning a wedding, stressing about finances, and fretting over guest lists. Wedding planning can cause you to pull away or turn on your future spouse, and constant planning certainly eliminates any opportunities for romantic time together. Thus some people arrive at their wedding day feeling pretty humdrum about their future marriage and pretty frustrated with the process that got them to the altar.

Finances
Disagreements about money are among the most common marital problems. When surveyed, people indicate that financial problems are one of the biggest stressors in their lives. Weddings are expensive, with the average wedding in the United States costing well over $30,000, so it’s no wonder people can be driven to a state of panic by weddings. Couples frequently must make huge sacrifices, compromise with their parents, and work extra hours to get the money to pay for their weddings, and all of this effort can take a toll.

Requests of Others
Many newlyweds report that it wasn’t the wedding planning itself that was stressful. It was the constant pressure, opinions, and criticism from other people, such as the mother who’s enraged that you’re keeping your maiden name or the father who insists on a traditional wedding ceremony. A wedding frequently puts the differences between parents and their children on full display. Many engaged couples worry about their parents making snide remarks just before their wedding, or spend the entire time they’re engaged bending over backward to please their parents, only to find out that nothing they do is enough.

Relying on Others
No matter how much you might want it to be just you and your fiancée, a wedding is a group event. From bridesmaids to florists, officiants to flower girls, you must coordinate with many people, not all of whom will be cooperative. Trying to get everyone to understand your vision for your wedding can be like herding cats. And even simple tasks such as getting your best man to finally get fitted for a tux can be extremely stressful. When people have to rely on others to get tasks done, their stress levels tend to rise. This reliance on others is made even worse by the stress most couples feel to create a perfect wedding.

So, no matter how simple you may try to keep the wedding plans, there will still be stressors that you should anticipate and plan for, just as you plan for your cake and photographer. Start thinking about the people and events that may create stress for you and your fiancé, and take steps to reduce those predictable conflicts. Acceptance of the things you can and cannot change is key, and practicing now can only help once you become a partner in a marriage.

Sources:

1. Miller, R. S. (2011). Intimate relationships. New York, NY: McGraw-Hill.
2. Reis, H. T., Rusbult, C. E. (2004). Close relationships: Key readings. New York, NY: Psychology Press.

Related articles:
The Fear of Hurting the Other and the Inhibition of Self
Embrace Conflict as a Path to Deeper Connection
Decision Making in Relationships: Three Important Values to Help you Know When to Give in or Dig in