The term “hook up” is one modern way individuals, especially young people, refer to casual-sex encounters. Teenagers who are sexually active, but not in romantic relationships, may “hook up” with other teens. But are these encounters damaging to adolescents’ sense of well-being? Research has suggested that teens who date are more likely to experience stress, depression, and emotional conflict than those who do not. However, the level of depression and stress teens experience in committed relationships has not been compared to the depression and stress in teens who “hook up.”

To address this void in research, Jane Mendle, of the Department of Human Development at Cornell University in New York, conducted a study that compared the emotional and psychological well-being of more than 1,500 pairs of siblings ranging in age from 13 to 18. She gauged whether the siblings were romantically involved with another person, engaging in sexual activity with that person, or whether they were sexually active with nonromantic partners. She found that although the teens in committed relationships did have moderately higher levels of depression than those who were single, the teens who participated in “hook-ups” had the highest levels of emotional distress and depression. This was especially pronounced in teens under the age of 15.

Mendle believes that one of the reasons for this finding could be the fact “hook-ups” often involve partners who used to date, or who may want to date each other in the future. In this sense, one of the participants may be more emotionally invested in the encounter than the other. The subsequent dismissal of a romantic relationship may bring on feelings of sadness, disappointment, and even jealousy. The findings in this study are rather robust because they are based on sibling pairs. However, this dynamic can also limit the results, and further family history should be gathered in future work. Additionally, romantic relationships, as defined by the participants, may not necessarily involve sexual intercourse but may include other intimate acts. This should also be explored in future research. “Continued exploration of how the transition to sexual maturity may be moderated by contextual factors can help clarify the particular developmental challenges and stressors of adolescence,” Mendle said.

Reference:

Mendle, J., Ferrero, J., Moore, S. R., Harden, K. P. (2012). Depression and adolescent sexual activity in romantic and nonromantic relational contexts: A genetically-informative sibling comparison. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0029816

This is the second in a series of articles designed to explore some of the issues and concerns that arise around what is currently called Asperger’s syndrome, which will soon be incorporated into the broader spectrum of autism disorder when the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) is published in 2013.

Emotional intelligence (EI) is generally understood to be a person’s ability to identify and assess his or her emotional state, as well as the emotional state of others. It is not related to the kind of intellectual capability or intelligence typically assessed by IQ tests. Rather, it corresponds to a person’s ability to relate to others, work in groups, read between the lines in conversation, and interpret behaviors and moods displayed by others. It also relates to an individual’s understanding and regulation of those qualities within. High emotional intelligence provides a sort of shorthand for smooth interpersonal relations and communication.

Emotional intelligence is related to theory of mind. (See my previous blog, titled Asperger’s Syndrome: Theory of Mind.) The better able you are to imagine the world from another person’s point of view, the more likely you are to score high on a measurement of emotional intelligence. Persons with high EI are able to anticipate what someone might do in reaction to certain circumstances or statements. They are able to empathize with unspoken sadness because they are able to interpret an event in ways another person is likely to interpret it, given what they know about that person. They are able to avoid certain topics of conversation because they can predict which subjects might be problematic for another person. They understand the concept of conversational finesse. High EI is at the very heart of diplomacy.

A person with Asperger’s syndrome experiences the world in a very different way. With a tendency to take conversations and events literally, the emotional subtext often is unseen. This can lead to behavior that appears inappropriate at best, heartless or cruel at worst.

Imagine, for example, not being able to understand why the death of a beloved pet is still a sensitive issue for your friend even several years after the pet has passed away. Imagine saying something such as, “But that cat has been dead for two years!” And then imagine the reaction of your friend, who in that moment is feeling sad about the loss, feeling it as strongly as if he or she had lost the pet yesterday. Your friend is not likely to react well. Your words might sound intentionally cold, uncaring, and thoughtless. But when your friend does not respond favorably, you are confused. What do you do now? You made a simple statement of fact, and now your friend is upset with you.

This is the experience of challenged emotional intelligence. This is commonly the experience of a person with Asperger’s. Anxiety soars as the person wonders what he or she did wrong, what he or she failed to understand, or what was missed.

With therapy, a person with Asperger’s can learn to decode some of what seems mysterious in the realm of emotional intelligence. It is possible to discern intellectually what may not come naturally emotionally. For example, to use the above scenario as a basis of conversation in a therapy session might help a person with Asperger’s see that there are different ways of responding to the death of a pet, and that the person’s own, seemingly logical way may not be the way others respond to something as essentially emotional as the loss of a pet.

Learning that there is such variability helps a person with Asperger’s navigate the complex emotional undertones of daily life. It also helps relieve the free-floating anxiety that can accompany conversations and events, both familiar and unfamiliar, because it broadens the range of expectations and softens the likelihood of inadvertent blunders.

Emotional intelligence is a challenge for individuals with Asperger’s, but it is also a fruitful topic for exploration in therapy because it is so central to most interactions with others, both in social and in intimate contexts.

Some of the symptoms of schizophrenia include delusions, mood fluctuations, and impaired social functioning. One of the reasons social interactions are challenging for people with schizophrenia is the way in which facial expressions are processed. Specifically, it is theorized that schizophrenia deteriorates the recognition processes of individuals and makes it more difficult for them to distinguish between familiar and unfamiliar faces. This can cause significant social struggles because accurately perceiving the facial expressions of others is how people determine their reactions to them. It is also how people decide which faces are threatening and which are safe.

Fabrice Guillaume of the Laboratory of Cognitive Psychology at Aix-Marseille University in France recently led a study that explored facial recognition in individuals with schizophrenia in order to get a better idea of impairments that occurred and why. Guillaume assessed 20 individuals with schizophrenia and 20 without as they evaluated the familiarity of facial expressions. The electrophysiological (ERP) responses of the participants were monitored as a set of faces was presented with expression changes, without expression changes, and then, finally, new faces were presented. Guillaume discovered that when the expressions changed, the participants with schizophrenia did not recognize them as familiar, even though they had seen the faces before.

The participants with schizophrenia also had a hard time distinguishing between familiar faces with new expressions and unfamiliar faces. “This result suggests that patients with schizophrenia are more sensitive to the expression change and appears to be inconsistent with studies showing spared familiarity in schizophrenia,” Guillaume said. The findings could be interpreted to indicate a broader, more global perception of faces occurs in schizophrenia, and that individuals with schizophrenia have an impaired ability to retrieve the global perception when perceptual nuances, such as expressions, occur. In sum, the results of this study reveal that people with schizophrenia can experience facial recognition deficits, which can have a dramatic impact on social interactions, even when they try to identify faces familiar to them.

Reference:
Guillaume, Fabrice, Francois Guillem, Guy Tiberghien, and Emmanuel Stip. Mismatched expressions decrease face recognition and corresponding ERP old/new effects in schizophrenia. Neuropsychology 26.5 (2012): 568-77. Print.

One of the most common methods for assessing the behavioral and emotional state of a child is a parental report. This type of evaluation usually comprises a parent’s observation and evaluation of the child’s feelings, mood states, and behaviors over a period of time. But just how accurately do parents gauge the emotional temperature of their children? That was the question at the center of a recent study conducted by C. Emily Durbin of the Department of Psychology at Michigan State University. Because parental reports can vary quite dramatically from reports obtained by other observers, such as teachers, counselors, and classmates, Durbin wanted to determine what factors, if any, skewed parents’ perceptions.

Durbin chose to focus on the effects of maternal depression on parental reports. She based her decision on the fact that other conditions, such as alcoholism, parental anxiety, and family distress, have been shown to influence maternal reports. Durbin extended the existing research and compared mothers’ reports with those of unbiased observers on a sample of 190 children ranging from 3 to 6 years old. Participants were instructed to rate levels of sadness, fear, happiness, surprise, and anger in the children after they completed 10 emotion-inducing tasks. Durbin found that the mothers with a history of depression or anxiety tended to rate their children as less happy than mothers with no such history. Additionally, these same mothers viewed their children as overly fearful, and rated girls as sadder than boys. This could be a result of maternal sensitivity to emotions such as fear and sadness. However, the outcome showed a significant disparity between observers’ ratings and those of the mothers with a psychological history. “These mothers may have greater difficulty setting aside their perceptions of the child’s typical emotional adjustment to focus solely on rating the behavior the child is currently exhibiting,” Durbin said. Although the sample size was limited to young children and did not contain a large number of mothers currently exhibiting depressive symptoms, the results warrant further investigation. Durbin believes it is essential to expand this research to include older children, comparison to other assessment tools, and evaluation of other aspects of childhood development.

Reference:
Durbin, C. Emily, and Sylvia Wilson. Convergent validity of and bias in maternal reports of child emotion. Psychological Assessment 24.3 (2012): 647-60. Print.

Children who have been victims of maltreatment can develop emotion regulation problems that affect many areas of their lives. Some survivors of abuse can experience symptoms of posttraumatic stress, anxiety, and depression throughout life. Coping and relational skills learned in childhood form the foundation from which future behaviors evolve. It has been hypothesized that women who survived maltreatment, in the form of physical or sexual abuse or neglect, will have sexual challenges in adult relationships. To test this theory, Alessandra H. Rellini of the Department of Psychology at the University of Vermont conducted a study involving 192 women ranging in age from 18 to 25.

The study focused on how emotional regulation, childhood maltreatment, sexual expression, sexual satisfaction, and relationship intimacy were associated in the context of committed adult relationships. The women in the study completed online surveys describing the type of abuse they experienced and their level of intimacy, affectionate expression, and sexual satisfaction in their current relationships. Rellini found that the more severe the childhood abuse was that the women experienced, the more unsatisfied they were in their adult relationships. This was true with respect to general and sexual relationship satisfaction. The severity of abuse also directly predicted the severity of emotional regulation impairment, which could be indirectly influential of satisfaction.

[fat_widget_right]

In contrast to Rellini’s predictions, however, the findings did not demonstrate any association between emotional regulation impairment and intimacy or emotional expression. This was rather surprising, as previous research has suggested that abuse survivors tend to have challenges sustaining emotionally healthy sexual relationships. One factor that may have contributed to these results is the broad categorization of abuse used in this study. Specifically, this study did not examine sexual abuse separately from emotional or physical abuse to determine each type of abuse’s independent effect on emotional regulation. Despite this limitation, Rellini believes her findings provide evidence of unique correlations between childhood maltreatment and adult relationships for women, but more work needs to be done. “Research is now needed to explore the stability of such findings over time in order to determine the time course and sequencing of change between the studied variables,” she said.

Reference:
Rellini, Alessandra H., Anka A. Vujanovic, Myani Gilbert, and Michael J. Svolensky. Childhood maltreatment and difficulties in emotion regulation: Associations with sexual and relationship satisfaction among young adult women. Journal of Sex Research 49.5 (2012): 434-42. Print.

Dialectical behavior therapy (DBT) is a comprehensive, evidence-based treatment approach used to treat individuals with a wide variety of issues, including relationship conflict, anxiety, depression, bipolar, self-injury, eating issues, and substance abuse. Developed in the 1980s by psychologist Marsha M. Linehan for the treatment of borderline personality disorder and chronic suicidality, this method has since been adapted and utilized to help clients with much less severe issues. The therapy can help clients who exhibit extreme emotional reactions, helping them develop self-acceptance while also learning coping skills to better regulate their emotions and handle distress. DBT uses both individual therapy sessions and group skills training, as well as telephone coaching between sessions.

The DBT model combines a behavioral therapy approach with eastern mindfulness practices. In one sense, the term dialectical refers to the goal of synthesizing the extreme opposites inherent in the rigid “black and white” thinking of many clients who have trouble regulating their emotions. “Dialectical” also applies to the core DBT principle of practicing acceptance strategies while implementing change strategies, in the process of reducing and modifying self-destructive behaviors.

This type of therapy is very support-oriented; it helps clients identify their strengths, build new skills, and increase their self-esteem. DBT focuses on cognitive issues by indentifying destructive thought patterns and replacing them with more neutral and accepting internal dialogues. It is designed to be a nonjudgmental collaboration, with the therapist and client working together to increase emotional awareness and understanding, minimize negative thought patterns and behaviors, and develop new coping and problem-solving skills.

The four modules of dialectical behavior therapy:

• Core mindfulness: The first of the four primary modules of DBT, this concept involves learning to observe one’s emotions, describe those emotions, and fully participate in present experiences. This skill forms the foundation for the other three modules, and is derived largely from eastern practices of living in the moment.
• Interpersonal effectiveness: The second core component of DBT teaches clients assertiveness skills and strategies to ask for what they need, set boundaries and say no when appropriate, and deal more effectively with interpersonal conflict.
• Distress tolerance: The third module entails clients developing nonjudgmental acceptance of themselves as well as their current situation. The focus is on learning to accept the present reality and to tolerate crises, and making use of strategies such as distraction, self-soothing, and improving the moment. Practicing these skills will increase the client’s ability to tolerate challenging events and environments.
• Emotion regulation: The final module of DBT consists of three main goals: to understand one’s emotions, reduce emotional vulnerability, and decrease emotional suffering. With this in mind, some of the specific skills taught in DBT include identifying and labeling emotions as well as evaluating: events that prompt the emotion, interpretations that trigger the emotion, how the emotion is experienced, how the emotion is expressed behaviorally, and the aftereffects of the emotion.

In the case of adolescent treatment, Dr. Alec Miller has adapted Dr. Linehan’s model to incorporate parents attending skills training groups with their teens. There is an additional module, “walking the middle path,” which focuses on helping parents and their children understand each other’s viewpoints and reduce conflict and invalidation.

The five functions:

Dialectical behavioral therapy was designed to fulfill five primary functions:

• Enhance behavioral capabilities: DBT helps clients develop important life skills that help them regulate emotions, experience the present moment, improve interpersonal interactions, and better tolerate distressing situations.
• Improve motivation to changes: DBT supports clients’ motivation to change by tracking and reducing detrimental behaviors, thereby increasing quality of life.
• Generalize capabilities to other environments: In order for the client to make progress, the skills learned in therapy must transfer to a wide variety of situations. This is accomplished through homework assignments and practicing skills. Telephone consultations also can be valuable in helping clients utilize these skills in their daily lives.
• Support client and therapist capabilities: DBT aims to maintain and build the capabilities of therapists through continued training and consultation-team meetings.
• Enhance therapist motivation: The DBT model encourages the use of support, validation, feedback, and encouragement between therapists to avoid burnout and improve their effectiveness.

Stages of treatment:

The course of DBT generally flows through three stages:

• Stage 1: This stage is primarily focused on eliminating or reducing serious behaviors, including self-injury, suicidal thinking, and aggression. Behaviors that interfere with therapy also are addressed, such as missing appointments and not returning phone calls.
• Stage 2: The client strives to increase quality of life and experience emotions in a less intense manner. The client continues to eliminate or decrease destructive behaviors, and address other issues or situations that are interfering with daily life, such as past trauma.
• Stage 3: The client is experiencing increased feelings of completeness, self-respect, and love.

Who can benefit:

Though DBT originally was developed to treat more severe issues, such as borderline personality disorder, suicidal behaviors, and self-harm, the treatment has become a widely respected method for treating clients who exhibit the following, much milder traits and issues:

• Difficulty with emotional regulation
• A high level of reactivity, with a slow return to baseline
• Impulsiveness with a tendency toward self-destructive behaviors
• An inclination toward extreme thinking, unable to perceive a middle ground
• A lack of sense of self, tending to feel incomplete or empty
• A history of instability in relationships, and difficulty with interpersonal interactions
• Extreme sensitivity, accompanied by rapid mood swings, anxiety, and depression
• Fears of abandonment and trouble with intimate relationships

Dialectical behavior therapy has proven to be a very effective tool to help people manage intense emotions, change negative thought patterns, and decrease self-destructive behaviors. Individual therapy sessions focus on current detrimental behaviors in the client’s life, while group sessions involve learning skills from the four modules: mindfulness, interpersonal effectiveness, distress tolerance, and emotion regulation.

Well, maybe not real fireworks. But according to MeiMei Fox—a speaker, depth psychotherapy life coach, and author of a recent article—feeling as if fireworks are exploding is one of the 10 sure signs that you’ve found your true love. Fox, who has had her share of failed relationships, worked with her new husband to come up with 10 signs that partner is Mr. or Mrs. Right:

1. Sexual attraction: Even though fireworks may eventually smolder, sexual attraction to your partner is a must and serves as a foundation for love, honesty, and intimacy.
2. Authenticity: Partners should be comfortable with each other exactly as they are, with no pressure to act like someone they’re not.
3. Commitment: If one partner is not able to commit wholeheartedly to the relationship, it could mean they have doubts. Commitment is at the core of a true loving union.
4. Honesty: There is no place for secrets in the most important relationship of your life. “When it’s true love, you should find yourself wanting to share everything,” Fox says. “Your love is made simple and true by being honest.”
5. Unity: Each partner must put his or her needs behind those of the relationship. As the old saying goes: “There is no ‘I’ in team.” True love is about teamwork.
6. Priority No. 1: The relationship should come before anything else. The love you share with your soulmate should be the most valuable thing in both of your lives, and you should stay committed to letting nothing get in the way of working toward and sharing in its success.
7. It’s romantic: Relationships should not be all work. They should be fun, and each partner should be living in the fun of the relationship rather than talking about the relationship and its problems.
8. Your friends are happy: People sometimes worry too much about what their friends will think of a new love interest. Fox agrees that outsiders may be able to see things in your partner that you can’t. When family and friends like the person who makes you happy, it’s a good sign.
9. You want to be home: Looking forward to returning home to the arms of your partner reinforces that you’re with someone you love, value, and enjoy being with.
10. Having that lucky feeling: Fox says that she feels as if she’s won the lottery every morning she wakes up next to her husband. Although that might not happen all the time for most people, you can be pretty sure you’ve found a keeper if you feel darned lucky that he or she found you too.

Reference:
Fox, MeiMei. 10 Signs You’ve Found “The One” (n.d.): n. pag. The Huffington Post. 12 Sept. 2012. Web. 12 Sept. 2012. http://www.huffingtonpost.com/meimei-fox/10-signs-youve-found-the-_b_1870841.html

The oldest profession in the world has undergone a makeover in recent years. Although subtle, the changes to prostitution are having ripple effects. The business that used to be marketed on street corners and in seedy bars has gone high class. Escorts that provide sexual services are available as companions for outings, family gatherings, business functions and other events that are usually reserved for significant others. And the lure of having a date for these important occasions, and being guaranteed sex, is becoming irresistible for many men. However, the men who pay for sex are discovering that it is not just the sex they really want but the love and intimacy that come with it.

Researchers from George Washington University conducted an online examination of conversations between clients and escorts and found that of the 2,442 posts, many were about things other than sex. The authors believe that the transition from sex to pseudo-relationship that is emerging in the world of prostitution is due in large part to the mock dating services that escort companies provide as part of the overall package. Men enter into an agreement for companionship and sex but may soon find that the close, personal conversations and comforting presence of the escort cause them to fall in love. Christine Milrod, a sexologist and coauthor of the study, says this is especially true when a client patronizes the same escort repeatedly.

The popularity of this “girlfriend experience” of sex for hire can blur the lines between sexual satisfaction and relationship attachment. Although many of the men surveyed said that they hire sexual escorts primarily for the sex, they enjoyed the fact that the women were obligated to engage in conversations with them. They also liked being able to explore sexual fantasies that they might not otherwise have an opportunity to explore. The fact that an emotional and intimate connection may develop is merely a byproduct of this novel approach to prostitution. The authors added, “Like any other commercially packaged leisure activity, intimacy is now readily available for a price.”

Reference:
Bennet-Smith, Meredith. (Sept. 4, 2012). Men who pay for sex may also be hoping to find true love, study finds. Huffington Post. Retrieved Sept. 6, 2012, from http://www.huffingtonpost.com/2012/09/04/men-paying-for-sex-may-also-looking-true-love-study_n_1854372.html

It is normal for adolescents to conflict with family members, especially parents. In fact, this transition from obedient, caring, and emotionally attached child to sometimes distant, moody, and rebellious teenager is often seen as a normal stage of development. Adolescents begin to find their own identities, their own sets of friends, and their own interests during the teen years. During this exploratory period, they begin to pull away from the safety of family and assert their own independence as they start their foray into adulthood. But even though moderate conflict is viewed as relatively normal, researchers have raised questions about the effects of conflict on social functioning. In a recent study, Katherine B. Ehrlich of the Department of Psychology at the University of Maryland took this question one step further. Using a sample of 189 adolescents, Ehrlich assessed how parental conflict and peer conflict affected social functioning independently and collectively.

The participants and their two parents, mothers and fathers, were observed as they engaged in conversations about topics that caused conflict. The adolescents were then asked to detail any conflicts in their closest peer relationships. Finally, the participants’ friends were interviewed about the level of social acceptance and general behavior of the participants while in social environments. Ehrlich discovered that although conflict with parents was linked to more aggression and risk taking, this effect was significantly amplified when peer conflicts were occurring simultaneously.

It has been suggested that conflict is a catalyst for social development and that adolescents need to experience disagreements in order to learn how to engage in problem solving and adaptive stress coping strategies. However, Ehrlich believes that when there is too much conflict present in teens’ lives, their resources may become quickly depleted, thus impairing their ability to function socially. It should be noted that the results gathered in this study were only obtained from married, heterosexual parents and were not examined independently. Future work should isolate mother-child conflict and father-child conflict to capture a more in-depth look at the individual influence of each. Additionally, single-parent environments should be examined in relation to parent-child conflict and its effect on social functioning. Ehrlich added, “We encourage researchers to continue using a multimethod approach to explore the ways in which conflict across family and friend relationship contexts influences adolescent development.”

Reference:
Ehrlich, K. B., Dykas, M. J., Cassidy, J. (2012). Tipping points in adolescent adjustment: Predicting social functioning from adolescents’ conflict with parents and friends. Journal of Family Psychology. Advance online publication. doi: 10.1037/a0029868

The pain of divorce is often unbearable. The experience can be so awful that you wonder whether it would have been easier to stay married or even to be dealing with some other horrific life event like death. The depth of pain is often surprising, particularly when you know you don’t want to be married anymore. What many people forget is that divorce is just a fancy word masking what is truly a broken attachment between two people. Divorce is more than separating assets and belongings.  It’s the severing of a very strong bond founded on deep feelings of dependency and need. Believe it or not, you developed an attachment to your partner over the course of dating and marriage that connected you on an emotional and physiological level beyond what you realized.

When two people get married they are vowing to be committed and to love one another, but they are also pledging to become “attached.” This attachment is unspoken and unknown to both, but it is the most powerful connection anyone can have to another person in a love relationship. According to author Helen Fischer in her book Why We Love, our “cuddle chemicals,” namely oxytocin and vasopressin, contribute to the sense of closeness and attachment couples feel toward each other in a love relationship. These bonding hormones promote a sense of fusion between lovers that deepens attachment and a sense of oneness. This biological phenomenon explains the depth of devastation felt when the attachment is broken and the physiological symptoms that become activated when attachments are severed. The response is often primal, leading to thoughts, feelings, and behaviors that might never surface in any other context of life.

The end of a marriage is one of the most emotionally painful human experiences. Thinking about the experience of divorce within the context of attachment generates a greater sense of empathy for what you might be feeling. It explains the levels of rage, vindictiveness, grief, and despair that so often accompany this common life transition. We too often think of divorce as a noun or a verb, but it is actually a relational trauma that has a physiological and emotional effect. You may be creating more suffering for yourself by resisting what you are feeling or telling yourself that you are overreacting.

Recognize that the end of your marriage represents much more for you than you may realize. If you were a small child and the person you depended on most was suddenly unavailable to you, there is no doubt you would have a strong reaction. The end of your marriage is no different. Give yourself the time and space to heal and repair. You are not damaged, just temporarily devastated, and the recovery will come with time. Divorce is not just a matter of the heart but an experience that impacts the whole person on a multitude of levels. 

Major depressive disorder (MDD) is a mental health problem with both psychological and physical effects. Someone diagnosed with depression may have strong feelings of sadness or a loss of interest in normal activities; physical symptoms may include lethargy, body pains, insomnia, and headaches. Despite decades of research and study, fast and effective treatment for depression remains an unfulfilled goal. Currently, the preferred approach for depression treatment begins with cognitive behavioral therapy and may include one or more psychotropic medications. 

Suicide risk is a serious complicating factor in the treatment of major depressive disorder, and choosing the appropriate drug intervention remains a haphazard procedure. Because many antidepressants are potentially linked with a heightened risk of suicidal behavior, doctors must exercise caution. Response to psychotropic drugs, particularly antidepressants, is highly individual. A period of trial and error is often necessary before doctors can identify the optimum drug or drug combination. In cases of possible suicidal thoughts and behavior, the best course of action is often observation, possibly in an inpatient facility.

A recently completed study at the New York State Psychiatric Institute promises to offer some guidance in the selection of treatment for severely depressed individuals with suicidal tendencies. The study consisted of two groups, one receiving Paxil (paroxetine) and the other receiving Wellbutrin (bupropion). The choice of these specific drugs was deliberate: Paxil belongs to the selective serotonin reuptake inhibitors (SSRI) category and is among the most frequently prescribed antidepressants; Wellbutrin is a non-SSRI medication with a different mechanism of action. However, both medications still carry the “black box” warning to notify doctors and pharmacists of potentially dangerous side effects, namely the increased suicide risk. A second aspect of the study included functional MRI scanning of each participant’s brain—once at the beginning of the 8-week trial and once more at the conclusion. Participants were given a cognitive task during the scan to assess how each of them processed sensations of reward.

The initial phase of the study is complete. Data on the 125 participants is currently being compiled and analyzed. Researchers hope that one of the drugs will reveal itself as a more effective remedy for major depression, although they may find that one of the drugs leads to a higher rate of side effects. In any event, the data from this study will help attending physicians and therapists make better choices when treating their most severely depressed patients.

References:

1. Bupropion, t. c. (n.d.). WELLBUTRIN XL® (bupropionhydrochloride extended-release tablets). DailyMed. Retrieved July 18, 2012, from http://dailymed.nlm.nih.gov/dailymed/archives/fdaDrugInfo.cfm?archiveid=14812
2. Depression (major depression). (n.d.). Mayo Clinic. Retrieved July 18, 2012, from http://www.mayoclinic.com/health/depression/DS00175
3. Paroxetine/Bupropion in Suicide Attempters/Ideators With Major Depression. (n.d.). ClinicalTrials.gov. Retrieved July 18, 2012, from http://clinicaltrials.gov/ct2/show/NCT00429169?recr=Open&intr=%22Bupropion%22&rank=16

My last piece on focusing ended with a definition of felt sensing as a “temporary wave, from the sea of being” (Madison, G.). What is meant by a temporary wave from the sea of being?

It is time to introduce Gendlin’s conception of human being. Note that I said “human being,” not “a human being.” For Gendlin, human being is “interbeing”—what we think of as an individual being is a “livings in the world, and living with” (Gendlin, 1978-79). He calls this principle Interaction First.

Gendlin conceives of human beings experientially not as separate “things” in interaction with each other. More radically, he sees our environments and us as a continuous co-creative process. We are not “inside our skins, but are our living-in the world, and living-with others” (Gendlin, 1978-79). Even our physical being is a continuous process with its inner and outer environments. Hence, in his view, it is impossible to conceive of human being as a separate entity. We are interbeing.

What is a living body such that it has the intricacy of our situations? … With the old concepts, people might say that Focusing is “subjective.” But clearly, if the situation is carried in the body, then a felt sense is not subjective. Objective then? No, also not, since “objective” means the units and patterns to which science limits anything it studies. We could fashion a new sentence that is neither subjective, nor objective, nor both: The body IS an interaction process with the environment, and therefore the body IS its situations. The body isn’t just a sealed thing here, with an external situation over there, which it merely interprets. Rather, even before we think and speak, the living body is already one interaction process with its situation. The situation is not out there, nor inside. The external “things” and the subjective “entities” are derived from one single life-interaction process (which they always bring along with them). (Gendlin 2004)

This is a radical view and paradigm shift that is difficult to absorb. We are used to thinking about ourselves and the environment “around us” through the lens and language of a Cartesian world. We are imbued with philosophical assumptions idealizing objectivity and neutrality and a mechanistic relationship of mind over body. For example, we may have heard of such concepts as the “observer effect,” yet we go about living in a way that leaves context out of the equation.

For Gendlin, the making of meaning is a pluralistic, contextual, constructed process; it is changing and dynamic, not static and eternal (Mitchell, 1993). Our lived bodily sense of things is a function of our interbeing, and our capacity for felt sensing extends us beyond the confines of our delimited physical body.

Recall that I started my first piece by saying that you have within you—“beneath” your everyday practical use of language—another dimension, an inner language that is an imagistic dialogue between you and your immediate experiencing. It is you speaking to yourself (and listening to yourself) in your own code. Gendlin calls it the zigzag between the everyday use of language and the way we may actually hold our experiencing in a bodily felt way.

Gendlin says that this kind of processing exists preconceptually, beneath our everyday use of language and concepts and the assumptions we have about how the world works. In focusing, we find our own language and meaning that is in fact much more specific and precise than our usual use of language. We find language from the sea of our being.

A client with a traumatic history sits quietly, with eyes lowered, pausing to find a way to articulate why his time in boarding school (60 years ago!) is still so meaningful to him. His life before boarding school was consumed by his father’s collapse into psychosis. He is sensing into the situation regarding boarding school—without any explicit reference to his catastrophic childhood history. After a full few minutes of silence, he finds one word that fits: Life at boarding school was “manageable.” At the point that he says “manageable,” tears come to his eyes. He doesn’t know why, but his felt sense tells him, preconceptually, that “manageable” feels right.

The therapist, attuning to her client, takes in “manageable” and acknowledges it. As it resonates within her, she realizes how much is contained in this word “manageable” for her client. Then she drifts into her own felt sense of his childhood and finds ‘unmanageable’ experientially embedded in the world of her client’s meaning making, the therapist quietly offers the newly emerging word “unmanageable” without any reference to his history, and the client considers it.

A few moments later, the client’s full catastrophe of life with his father’s illness impacts him, but in a different way. His therapist has offered a word that touches into his world precisely and with great specificity. What is captured here in two words—manageable and unmanageable—is much more than the common meaning of these words. The client is referring to the experiential world of living-with and living-in his father’s psychosis, as well as to the emergent significance of what boarding school provided for him. The unmanageable and the manageable.

 Notice that the felt sensing came first. With “manageable,” he has begun to capture the world of his experiencing—the profound relief of finding himself for the first time in a world that he could handle (boarding school). Then “unmanageable” is intoned, and he resonates with the years of struggling with the catastrophe of his father’s psychosis. “Manageable” arose as a temporary wave from the sea of being. “Unmanageable” emerged from their shared sea of being.

And this shared moment deepens their therapeutic journey.

References

1. Gendlin. E. T. (1978-79). Befindlichkeit: Heidegger and the philosophy of psychology. Review of Existential Psychology & Psychiatry 16, 43-71.
2. Gendlin, E.T. (2004). Five philosophical talking points to communicate with colleagues who don’t yet know focusing. Staying in Focus. The Focusing Institute Newsletter, 4 (1), 5-8. From http://www.focusing.org/gendlin/docs/gol_2187.html
3. Madison, G., www.gregmadison.net.focusing_way_being.
4. Mitchell, Stephen A. (1993). Hope and dread in psychoanalysis. New York: Basic Books, pp. 285.