This is the first 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.

As a therapist, I see clients with a variety of traits clustered at the high-functioning end of autism, now commonly referred to as Asperger’s syndrome, a term I will use until the DSM-5 makes it no longer accurate.

No two clients with Asperger’s syndrome exhibit the same cluster of traits, nor does any one client exhibit them all. However, there is one element that I recognize as pervasively diminished in all Asperger’s clients. This element is called “theory of mind.”

What is theory of mind? It is a person’s ability to imagine the interior life of another person. This includes understanding why someone else does something, how someone might feel in a certain circumstance, what might be important to that person: in short, it is the ability to put oneself in the mind of another person and see the world from that person’s point of view. Theory of mind means being able to create a theory about the way another person’s mind works.

Theory of mind provides the basis for empathy because if you can walk in someone else’s shoes, you also become capable, by extension, of feeling any pain or delight that person experiences. You understand motivation. You catch a glimpse of fears and dislikes. You get to know the other person from the inside out.

According to autism specialist Simon Baron-Cohen, individuals with Asperger’s syndrome typically have delayed access or no access to this phenomenon of human communication and share a problem that is called mind-blindness. Since interpersonal communication is approximately 65% nonverbal, you can quickly see that not being able to formulate a theory of mind leaves these individuals at a distinct disadvantage in relationship with others because the behavior of other people does not make sense to them.

For parents, this gap can create difficulties when they treat their son or daughter with Asperger’s with the same set of interpersonal expectations with which they treat their other children and assume intact theory of mind capabilities. This can lead to incorrect understanding of the child’s behavior as being intentionally hurtful, for example, when in fact it was based in lack of awareness.

A common test used with children suspected of being autistic is called the Sally and Anne Test:

Sally has a basket. Anne has a box. Sally has a marble. She puts the marble into her basket. Sally goes out for a walk. Anne takes the marble out of the basket and puts it into the box. Now Sally comes back. She wants to play with her marble. Where will Sally look for the marble?

Most children will answer that Sally will look in her basket, because that’s where she put it and that’s where she expects it to be when she returns from her walk. Baron-Cohen discovered that only 20% of children with autism were able to answer correctly. A full 80% answered that Sally would look in the box, because that is where the marble is.

This test is often used to demonstrate the theory of mind deficits in children with Asperger’s syndrome. They believe Sally will look in the box for her marble because they know that’s where it is. They are unable to put themselves into Sally’s mind in order to understand that from her perspective the marble should be right where she left it: in her basket. Can you imagine how unpredictable and irrational the world must appear to a child whose logic is denied in such a manner? This is the world of a child with Asperger’s syndrome.

I work with children to help them build bridges toward understanding the behavior of others, so that they can come to anticipate that their own logical view of the world may not apply in all circumstances. This is one of the primary goals of therapy with these children. It is an attempt to help them experience the world as a safer place than it appears when their logical perspective is consistently shattered by experiences that do not align with it.

Fear can be a strong motivator. People who are afraid of living in poverty may be motivated to pursue any career option in order to avoid financial destitution. In a similar way, individuals who are afraid that they may develop specific health-related problems may work tirelessly to maintain optimal physical condition. Fear often has been linked to motivation, both positively and negatively. Until recently, however, few studies examined how fear of failure affects activity-related performance.

Jocelyn J. Bélanger of the University of Maryland sought to determine how negative feedback on specific tasks affected motivation in individuals fearful of failure (obsessive) and those who were passionate about their activity but less worried about setbacks (harmonious). In a series of experiments, Bélanger found that individuals who are passionate about achieving their goal perform differently based on their style of commitment. In particular, those with obsessive passion responded with positive motivation to negative/failure cues while those with harmonious passion saw no change in performance. In fact, the harmonious passion participants maintained the same level of performance throughout the experiments, regardless of whether they received success or failure feedback.

“Obsessive passion, associated with defensiveness, predicts performance aimed at avoiding failure, whereas harmonious passion, associated with a secure self-concept, predicts stable performance,” Bélanger said. These findings suggest that fear works as a motivator for individuals with obsessive passion. Bélanger believes that people who feel their sense of self is threatened by failure of goal attainment may unconsciously respond to that threat by increasing their performance. However, those who have harmonious passion traits are less threatened and view the feedback, positive or negative, merely as information needed to continue the process of attaining their goals. The results of this study offer valuable information that could be used for the development of goal-attainment strategies in the professional, academic, and sports arenas, and could help clinicians better understand an individual’s reaction to goal-achievement outcomes.

Reference:
Bélanger, J. J., Lafrenière, M.-A. K., Vallerand, R. J., Kruglanski, A. W. (2012). Driven by fear: The effect of success and failure information on passionate individuals’ performance. Journal of Personality and Social Psychology. Advance online publication. doi: 10.1037/a0029585

Psychologists are exposed to many stressors that could cause them to have a negative outlook on their careers. Dealing with long hours, extensive paperwork, and insurance companies can lead to burnout in the mental health field. Working with difficult clients and being privy to distressing information can also place psychologists at a high risk for work-related stress and job dissatisfaction. Although most of the existing research suggests that psychologists are relatively happy with their careers, Patricia A. Rupert, associate professor of psychology at Loyola University in Chicago, wanted to explore the nuances of job satisfaction among them.

Rupert assessed surveys from two groups of psychologists that were part of a larger survey. The first group of 129 psychologists reported high job satisfaction levels, while the second group, consisting of 102 psychologists, reported moderate satisfaction levels. Rupert’s goal was to analyze the factors that contributed to high satisfaction versus moderate satisfaction. She looked first at whether job satisfaction correlated with growth and income opportunities as well as working environments. Secondly, Rupert identified working hours, case load, therapeutic mode, administrative responsibilities, professional improvement strategies, and negative client interactions.

The review provided evidence that several variables contribute to career satisfaction for psychologists. Specifically, Rupert found that the majority of moderately satisfied psychologists had poor professional and personal life balances and felt little sense of control in their work environments. The most satisfied participants were those with a harmonious personal/professional structure and positive work experiences. In contrast to research that suggests high rates of burnout among mental health professionals as a result of the work stressors, this research demonstrates that there are multiple nuances that influence the overall job satisfaction of therapists and psychologists. “Our results provide encouraging evidence that, despite the many challenges providers face in this evolving health care environment, practicing psychologists, as a whole, remain very satisfied with their careers,” Rupert added.

Reference:
Rupert, P. A., Miller, A. O., Hartman, E. R. T., Bryant, F. B. (2012). Predictors of career satisfaction among practicing psychologists. Professional Psychology: Research and Practice. Advance online publication. doi: 10.1037/a0029420

Next Friday, August 31, 2012, GoodTherapy.org is thrilled to welcome Dr. Laurie Moore, who will present Healing Betrayal Caused by Infidelity, a FREE CE teleconference for GoodTherapy.org members available with 1.5 CE Credits. We encourage you to join us for this exciting event, so if you have not already, register today!

Working with clients who are suffering from betrayal caused by infidelity is complex, including grieving stages, posttraumatic stress (PTSD), and additional factors. This article refers to infidelity as a breach in agreed emotional and sexual monogamy. Some couples agree to open relationships or polyamory, which is a different situation. Infidelity as defined in Wikipedia is “a breach of an expectation of sexual and or emotional exclusivity.” This involves a lie and broken promise, causing feelings of intense betrayal for many people.

Infidelity has become a common problem. Some infidelity statistics state that over 50% of both men and women engage in infidelity (Journal of Marital and Family Therapy, 2012) and others say 30% to 60% (Wikipedia, 2012).

Those suffering from infidelity betrayal commonly go through Kubler Ross’s well-known stages of grief:

1. Denial: This didn’t really happen or it’s not really as upsetting as I feel it is.
2. Anger: How could you?
3. Bargaining : If only I had communicated differently, this would not have happened.
4. Depression : I feel helpless. Nothing I can do changes this discomfort.
5. Acceptance : I have been hurt and disillusioned but I am at peace with myself.

The experience of grief due to infidelity includes additional factors that are absent from grief occurring from a death. Grief due to death is felt in a finite situation that contains an end. It is understood that the one who is gone is gone from the body permanently. Grief due to a breach in trust has no finite or predictable container. The one suffering finds him- or herself in unpredictable circumstances, which often feel very dismantling and excruciatingly unsettling.

Feelings that challenge self-confidence and worth are more common to infidelity betrayal than loss alone. Death is socially expected. Infidelity is shunned. The one who is betrayed is prone to feel guilt, shame, and embarrassment because the situation remains privately hidden or is condemned by a variety of reactions when exposed.

When death is the cause of grief, a solo journey is required. When betrayal is the cause of grief, two people are involved, so the situation is more complicated. Once one is lied to, the relationship is uncertain. This person can’t tell whether he or she is being lied to or told the truth. The one experiencing this challenge is often upset again in the aftermath of the partner relationship. This is different than the one abandoned by a death whose loss cannot re-emerge in a repeating scenario.

Clients with heartache caused by infidelity and betrayal can also go through fight-or-flight syndrome:

Fight: Arguing with, controlling, or managing the person who betrayed me will solve this.

Flight: Leaving will solve this.

Once fight or flight proves useless, a person will seek comfort in other ways. By assisting this person to fully meet the helplessness, sorrow, anger, anguish, disillusionment, and heartache that has come, peace can be found.

I have found that client-centered talk therapy, hypnotherapy, eye movement desensitization and reprocessing (EMDR), and the 12-step program are all deeply valuable for clients healing from infidelity. I also use my own Success Love Now (SLN) process effectively in these situations. Here is how and why each of these methods is valuable.

Someone who is suffering from loss and feeling isolated due to the taboo nature of this loss needs to be witnessed compassionately and caringly. This in itself helps to relieve the tremendous burden one carries from feeling alone. When being accepted within the context and emotions one is truly feeling, without being corrected or judged, peace can start to return. Acknowledging your understanding and compassion for a clients’ diverse set of feelings can be a profound help to a suffering client.

Because the shock of betrayal can be extreme, disrupting normal life in many ways, EMDR assists the hurting person to digest the deep emotions that are arising. Just getting through the day becomes a challenge for people who are betrayed. EMDR makes the healing time for this upheaval much faster in many cases.

Hypnotherapy allows the person who was hurt to re-find stability, meet parts of him- or herself that were hurting before the situation occurred, heal parts of him- or herself that are hurting now, and find a new basis for equanimity that is deeper than the circumstances. Taking a client into a deep, relaxed state in which the client can bring in peaceful parts of him- or herself to help the hurting parts enables a client to rebuild self-esteem and strength.

S-Anon Twelve Steps allow people to find the value in surrender, the gift in their challenge, and the support of others enduring similar pain. Twelve Steps also help the one who was betrayed to find out if addiction was involved in the betrayal, as commonly is the case. Letting your client know that S-anon is an option can be a valuable part of her or his healing process.

SLN provides a new framework for the person to feel empowered and at ease within the undesired circumstances. Encouraging the client to focus on what his/her purpose and aim are for him- or herself and gratitude for the good that is occurring within the context of the undesired happenings is beneficial. This will bring a client out of a victim mode and into a creative mode.

Of course, if the person who was betrayed plans to stay in the relationship, couples counseling and counseling for the one who was betrayed are necessary.

When working with clients who have been betrayed due to infidelity, it is important to understand the complexity of loss, mixed with PTSD, combined with humiliation–this situation causes a long period of overwhelm and readjustment. When the client is treated with compassion, the healing can go well.

Sources:

1. Infidelity statistics. (n.d.). Retrieved August 20, 2012, from http://www.statisticbrain.com/infidelity-statistics
2. Infidelity. (n.d.) Retrieved August 20, 2012, from http://en.wikipedia.org/wiki/Infidelity

Related articles:
Cheating
Can a Couple Recover From Infidelity?
In-Depth Map for Three of the Eight SUCCESS LOVE NOW Steps

Destructive parentification is a behavior in which a parent transfers the emotional or physical responsibility of parenting to their child. Some parents turn to their children for emotional support and expect their children to fill emotional voids. Other parents who engage in destructive parentification may expect their children to fulfill physical obligations such as caretaking. These behaviors diminish the appropriate boundaries between a parent and child that are necessary for a child to develop his or her own identity. Additionally, boundaries that are blurred can expose children to events and circumstances that they are emotionally and physically unprepared to handle. This type of parentification can have significantly negative outcomes for children. Research has shown that children who are the victims of parentification, which is considered a form of abuse, have higher rates of externalizing and internalizing problems in childhood and adolescence than those who do not experience parentification.

When victims of parentification become parents themselves, the risk of the cycle continuing is extremely high. However, few studies have examined how maternal behavior in adult victims of childhood parentification affects future generations. To explore the relationship between maternal behavior and childhood psychological development, Amy K. Nuttal of the Department of Psychology at the University of Notre Dame in Indiana assessed 374 pairs of mother-child participants through the first 3 years of the children’s lives. The mothers were evaluated for childhood parentification in their own families of origin and and for mixed histories of emotional abuse, sexual abuse, or physical abuse.

Nuttal found that the women with destructive parentification were less responsive to their children at 18 months than those with no history of parentification. The unresponsiveness was predictive of externalizing behaviors in the children at 36 months. When Nuttal examined the effect of the father’s presence, she discovered that the participants who maintained a relationship with the father of the child had significantly lower levels of prior parentification than those who had no relationship with the fathers. Nuttal also found that previous parentification directly predicted low levels of maternal warmth in the participants, which indirectly predicted negative developmental outcomes for the children. She added, “This finding suggests that facilitating the development of maternal contingent responsiveness among mothers with a history of destructive parentification may promote more adaptive child development in the next generation.”

Reference:
Nuttall, A. K., Valentino, K., Borkowski, J. G. (2012). Maternal history of parentification, maternal warm responsiveness, and children’s externalizing behavior. Journal of Family Psychology. Advance online publication. doi: 10.1037/a0029470

Related articles:
Welcome to Your Child’s Brain: Interview With Sandra Aamodt
Importance of Coping Skills, Part 2: Building Resilience
How to Teach Children Emotional Intelligence

According to a new study conducted by Mary Oldham of the Department of Psychology at the University of Sheffield in the United Kingdom, offering clients their choice of appointment time and providing simple reminders are two easy yet effective ways of increasing therapy attendance. Treatment refusal (TR) and premature termination (PT) are two events that can cause harm to a client and therapist. Clients who end their treatment early or refuse treatment never receive the full benefits of therapy and often continue to struggle with persistent emotional and psychological problems. Therapists who experience high rates of PT and TR may lose confidence in their abilities to provide meaningful services to their clinical population. Both of these scenarios result in negative outcomes for the clients, providers, and the community at large. Individuals who need help but do not receive it are less productive citizens and may need to rely on social services for financial aid.

Oldham examined the most effective ways to increase treatment adherence by studying 31 trials dedicated to that very topic. The trials provided data from 4,422 individuals who had a history of TR or PT. She found that interventions designed to address PT worked as well as interventions targeted at TR. The most effective strategies were the simplest. Offering clients their choice of appointment date and time and their choice of therapist reduced TR and PT. Additionally, interventions that educated and motivated clients resulted in lower rates of PT and TR. Another factor that reduced negative treatment adherence was being diagnosed with only one problem. Individuals with multiple diagnoses tended to have lower rates of treatment adherence than those with a single diagnosis. Finally, Oldham found that reminding the clients of upcoming appointments was the easiest and the most effective method for reducing PT and TR. She hopes that her results motivate clinicians and their staff members to adopt these tactics to increase treatment retention. She added, “This review indicates that attendance is a more tractable problem than previous reviews have suggested.”

Reference:
Oldham, M., Kellett, S., Miles, E., Sheeran, P. (2012). Interventions to increase attendance at psychotherapy: A meta-analysis of randomized controlled trials. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0029630

Related articles:
The Healing Power of the Therapeutic Relationship
The Secret That All Clients Should Know but Few Therapists Share
Why See a Therapist When You Can Just Talk to Your Friends?

As people age, they face challenges that they may never have experienced before. Loss of friends due to death, loss of independence as a result of diminished income, and loss of physical health can all create significant stress in a person’s life. The way that people choose to cope with that stress is directly related to the skills they learned throughout their lives. Attachment styles developed in early childhood can dictate the response people have to a variety of stressors, including ones encountered in later years. Additionally, an individual’s ethnic origin influences how he or she will respond to stress at various stages. To better understand how attachment style affects coping and overall well-being in older adults and what role ethnicity plays, Eva-Maria Merz of the Netherlands Interdisciplinary Demographic Institute at The Hague in the Netherlands recently conducted a study of 1,116 older adults from varying cultural backgrounds.

The participants, which included European Americans, African Americans, Eastern European immigrants, and Caribbean immigrants, were examined to determine how attachment style affected their well-being. Specifically, Merz looked at secure or dismissive attachment styles in comparison to avoidant and fearful attachment styles. “As expected, secure attachment and dismissive attachment were associated with greater well-being, whereas ambivalent/fearful attachment was related to reduced well-being in this older cohort,” said Merz. The link between secure attachment and positive well-being was most evident among the Caribbean and African American participants and weakest among the other two groups. When she looked at avoidant/fearful attachment styles, Merz discovered that it negatively impacted well-being in all the ethnic groups with the exception of the Caribbeans.

The results of this study support previous research highlighting the importance of healthy attachment styles on well-being. This new evidence extends the existing data by demonstrating that attachment styles are especially important in later life when unique challenges arise. Further, attachment styles are influenced by ethnicity. Taken together, this information provides new insight into the underlying factors that contribute to the general physical and mental health of older adults and should be considered when implementing interventions to help older adults cope with life’s stressors.

Reference:
Merz, E.-M., Consedine, N. S. (2012). Ethnic group moderates the association between attachment and well-being in later life. Cultural Diversity and Ethnic Minority Psychology. Advance online publication. doi: 10.1037/a0029595

Related articles:
Patterns of Attachment in Adults
Individuation Issues with Elderly and Ailing Parents
The Importance of Attachment in Early Caregiving

A biography of Marilyn Monroe by Lois Banner, professor of history and gender studies at the USC Dornsife College of Letters, Arts, and Sciences, reveals a complicated woman determined to be the best at everything. Published around the fiftieth anniversary of Marilyn Monroe’s death (August 5, 1962), Marilyn: The Passion and Paradox also reveals Marilyn Monroe’s troubled psyche and tragic childhood, including her childhood experience with sexual abuse, which led to a life-long struggle with sexual addiction. In an act that continues to strike us for its bravery—especially in a society like ours that is obsessed with objectifying women—Marilyn Monroe acknowledged and spoke publicly about her struggle with the consequences of childhood sexual abuse.

Banner builds on Monroe’s own statements to create a picture of a woman battling sex addiction and seeing herself as an object to be possessed by men and women. In one particular interview she gave to the British press, she stated “I sometimes felt I was hooked on sex. I could not stop having sex with almost every man I met.” Her persona as America’s “sex symbol” speaks loudly to America’s twisted relationship to sexuality, which takes tragic self-objectification and makes it something desirable rather than identifying it as a defense to trauma that causes suffering and requires treatment.

Aside from celebrities having affairs and sometimes excusing this behavior under the guise of “sexual addiction,” our society does not talk about the topic, and therefore we do not fully understand sexual addictions. The first thing to note is, oddly enough, sex addiction is never about sex. It is about a repetition of trauma and a craving for intimacy. Sex becomes the tool a person uses in order to find love and acceptance. Of course, the aim is never satisfied because the intimacy created through frequent sexual encounters is never really intimate or loving.

Sex addiction is a byproduct of trauma coupled with loneliness, pain, and the need to be loved and accepted. It is a substitute for these needs, a counterfeit way to meet real desires. However, it always fails to meet those needs and desires and subsequently creates a greater need for more sex in order to mask what one is truly missing. In Marilyn Monroe’s case, this craving for affection probably developed early on in life as she was moved around from foster parent to foster parent. In addition, having been sexually abused by men as a child, she would likely have equated sex with attention, and attention with love.

Studies show a high correlation between childhood abuse and sex addiction in adulthood. “Sixty percent of sexual addicts were abused by someone in their childhood” (Book, 1997, p 52). If your caretakers failed to protect you, or worse, inflicted the pain, you end up repeating what you know; you are attracted to the kinds of people who will fail to protect you or cause you harm. Having been sexually abused early on in life, a child grows up emotionally starved for love and mistakenly comes to equate love with sex. To bear the pain, one begins creating a fantasy where love means sex. And so, slowly, sex becomes a tool to satisfy any kind of need, whether that be loneliness, fear, anxiety, or shame. Worse, contemporary society constantly sexualizes us, especially young women, by teaching them how to become an object for someone else’s pleasure, not a participating subject. From the TV shows that we watch to the magazines that we read, we learn about sex as a performance and, for women in particular, we are taught that our bodies are a tool to be used in order to attract people. This further prevents survivors from seeking out treatment, as our society rewards unhealthy behavior and seldom teaches us how to view sexuality in a healthy way.

Sexual addiction has many different forms: compulsive masturbation, sex with people who are prostituted, anonymous and often unsafe sex with multiple partners, multiple affairs outside a committed relationship, habitual exhibitionism, habitual voyeurism, inappropriate sexual touching, repeated sexual abuse of children, abstaining from having sex altogether, or episodes of rape (Book, 1997). Addictions are quick fixes in order not to experience pain. Adult survivors of childhood sexual abuse often find it hard to trust another, to create real intimacy, to overcome feelings of shame and rejection, and to be present in intimate relationships. Sex, then, becomes a way to create a fantasy world, to tell oneself that you are sharing with another, that you are intimate and therefore present in the relationship. But, since sex addicts don’t necessarily enjoy sex with other people, and the need for intimacy is never fulfilled, one is then compelled to act out sexually—hence the addiction.

[fat_widget_sex_left]Most people who experience sex addiction do not understand why they are acting out sexually or why they have constant thoughts of either having sex with someone or masturbating. Sometimes they associate these thoughts with being in love, when love is far from the relationship. Each new sexual encounter brings relief and the promise of a new beginning. It also brings an unconscious desire to understand the pain of childhood sexual abuse. Yet as each encounter ends, and the need is not satisfied, the person feels more helpless, more alone, more ashamed. Slowly, a preoccupation with a new sexual encounter develops, and its promise for a new beginning gives rise to fantasies of intimacy, love, and affection. Perhaps the worst pain inflicted by childhood sexual abuse, which can be easily seen in the powerful and disruptive negative thoughts of someone who is addicted to sex, is the person’s lack of self-esteem, the idea of being damaged. Thus, rather than experiencing sex as a self-affirming, pleasurable activity, it is a source of pain, shame, and suffering.

Sexual addiction is a symptom of a bigger problem, and treating the symptom does not solve the problem. Underneath the symptom, one finds a codependent, wounded soul. As a young girl, Marilyn Monroe was treated as a sexual object and like many adult survivors, she became addicted to sex, suffering in silence. In treating sexual addiction, one needs to move beyond the symptoms and work with the survivor on issues regarding shame, self-esteem, and trauma. Yet therapy also needs to go a step further: In analyzing our culture’s view of women, sexuality, and relationships, we can begin to understand how ideology contributes to negative views of sexuality and women. Perhaps the greatest task for both the client and the therapist is to explore what it means to be a subject rather than an object in a relationship—to begin creating spaces where both women and men value each other and celebrate sexuality, not as a means to an end, but rather as a ground for pleasure.

By slowly peeling away the layers, Banner’s book reveals the complexity of a human being. Through Marilyn Monroe’s tragic story, we are reminded of the painful scars created by childhood sexual abuse that, when left untreated, continue to bleed throughout one’s life.

References

1. Banner, L. (2012). Marilyn: The passion and the paradox. New York: Bloomsbury Publishing.
2. Book, P. (1997). Sex & love addiction, treatment & recovery. New York: Lucerne Publishing.

I almost always suggest to clients that they learn focused abdominal breathing and practice a minimum of 5 minutes every day; for the best results, I recommend they practice 20 or more minutes per day. Sometimes they look at me funny and ask “You mean all I have to do is just breathe and everything will be better?” I tell them that no, everything is not going to magically change to exactly what you want in life, but learning and practicing focused abdominal breathing every day WILL do this for you:

1) Special breathing techniques can help reduce physical pain. Often when people are in pain, they breathe in a very shallow, disordered pattern. They also may frequently hold their breath without even realizing it. These are mostly unconscious protective reactions to pain, but they can actually increase the level of pain. Several recent scientific studies have shown that breathing at a slower rate from the diaphragm can significantly reduce sensations of pain.

2) Breathing helps to properly balance oxygen and carbon dioxide levels in the body.  Breathing properly from the diaphragm will:
•    Fuel energy production
•    Improve focus and concentration
•    Increase relaxation and calmness
•    Reduce tension and anxiety
•    Eliminate toxins
•    Strengthen the immune system
•    Improve bowel function
•    Lower blood pressure
•    Increase metabolism, aiding in digestion and weight loss

On the other hand, not breathing correctly can cause problems for a number of systems in the body, including the immune, circulatory, endocrine, and nervous systems. Improper breathing can produce various symptoms including:
•    Difficulty focusing attention
•    Dizziness
•    Numbness
•    Anxiety
•    Chest pain
•    Digestive problems
•    Irritable bowel
•    Neck and shoulder pain

3) Breathing releases emotional energy that is trapped in the body. People with anxiety and/or depression are almost always (and I mean 99.9% of the time) either breathing very shallowly or frequently holding their breath. Holding the breath is one of the most common ways that people stop emotions from coming up (think about the last time you tried not to cry, feel afraid, or get angry). Once you hold in an emotion it stays trapped in your body, until you release it. Breathing allows stifled, buried emotions to finally start to surface and be released.

4) Breathing keeps you in the present moment, instead of the past or the future. People with depression are often stuck in thoughts about the past, and people with anxiety are stuck in thoughts about the future. When you’re concentrating on your breathing, you are paying attention to your body sensations, the sound of your breath, and the process of breathing, all of which are happening RIGHT NOW. When you’re paying full attention to RIGHT NOW, you take AWAY energy and attention from the thoughts about the past or future. When you bring your attention to NOW, you automatically feel calmer.

Using the breath is a way to learn how the body and mind are connected. This is why I teach proper breathing to clients. Thoughts are directly related to feelings in the body and likewise, body sensations give rise to thought patterns in the mind. Mind and body are in a constant dance of influence, and it is important for people to learn that they have more choice and control in the matter than they thought.

Basic Instructions for Focused Abdominal Breathing
More than likely, if you are experiencing depression, anxiety, or pain, you are breathing shallowly from your upper chest. You want to train yourself to breath from your diaphragm/abdomen. Although it’s most effective to have someone teach you the process in person, here are the basic steps:

1) Sit in a comfortable upright position with your back against your chair and your feet on the ground. Keep your back straight, but let your shoulders and the rest or your body be very relaxed.

2) Place your left hand on your abdomen. Imagine that the entire area from your lower abdomen up to your chest is one large, rectangular balloon. Now, start by exhaling as completely as possible. Empty out as much air as possible. Your left hand will move inwards as the “balloon” area deflates. Now, slowly and gently, inhale, imagining that you are filling the balloon starting from the bottom, all the way up to the top. When you are breathing correctly from your abdomen, your lower abdomen will inflate, followed by your chest expanding, and your left hand will be pushed outward. Your shoulders will not go up, they will stay in place. When you inhaled did your hand move? Or did your shoulders go up instead? If your shoulders rise up when you inhale, you are breathing from your upper chest. Exhale and try again. This type of breathing may take a little practice to get the flow going. Work on this step until you can fill and empty the “balloon” completely. Then add the next steps.

3) Now that you are breathing abdominally, relax into a natural breathing rate. Your body will take over the breathing and settle into its own rate and depth. Your job is to just observe your breathing. Focus your attention on the tip of your nose and intently notice the pressure, temperature, and sensations of the air passing in and out of your nose. If it helps you to focus, you may also silently say “breathing in” on your inhalation and “breathing out” on your exhalation. Do this focusing for 5 minutes a day to start with, and work up to 20 minutes or more per day.

4) During your focused breathing session, especially when you first start practicing, you will more than likely notice that you are thinking about something else other than breathing. Thoughts have intruded into your mind and distracted your attention. When this happens, try not to react with any emotion (such as frustration). Just gently and silently allow the thoughts to drift upwards far away in to the sky like a soap bubble and then turn your attention back to your breath. At first you will find yourself re-directing your attention many, many times each session. Over time you’ll be able to maintain focus on your breathing for longer and longer periods of time and it will get easier to let go of intruding thoughts. It will even become easier to let go of unhelpful thoughts you have during the rest of the day (such as disturbing thoughts of the past or worrisome thoughts of the future). The most important thing is to keep doing the focused breathing every day, no matter what.

Open, full, unrestricted, unobstructed breathing is very important for your physical, mental and emotional health. It is something simple that can make a very big difference in your life. There are many things in life that we have no control of, so doesn’t it make sense to do the things we can have some control over? You can actively affect your own physiology and mental/emotional state just by mastering the art of breathing, focusing, and being present.

Related articles:
Deep Breathing and Guided Imagery
Alcohol and Anxiety: Not As Helpful As You Think
Managing Your Moods Through Mindfulness

You are what you eat, as the popular saying goes. And now a new study suggests that your diet as an infant may in fact determine how smart you will be when you grow older. The study, published in the European Journal of Epidemiology, found that infants who ate healthy foods had higher IQ scores by age 8 than those who ate less healthy foods. The study focused on diet at 6, 15, and 24 months of age. The researchers then followed up with subjects at age 8 years. A little over 7,000 children were included in the study.

The unhealthiest foods that led to an IQ of 1-2 points lower at all ages included “biscuits, chocolate, sweets, soda, [and] crisps,” according to the study abstract. Other types of food varied at different ages in how they impacted IQ scores. For example, at 6 months of age, a “breastfeeding pattern,” along with foods like “herbs, legumes, cheese, raw fruit and vegetables” at 15 and 24 months were linked to IQs about 1-2 points higher.

Foods such as “meat, cooked vegetables, [and] desserts” were found at 6 months to have a positive association with higher IQs, but this type of food style didn’t seem to have any associations with IQ at 15 and 24 months. Other types of foods seemed at first to negatively impact IQ but later appeared to increase IQ. For example, at 6 and 15 months of age, “ready-prepared baby foods” were found to negatively impact IQ to some extent, but at 24 months, “ready-to-eat foods” had a positive association with IQ.

“This study suggests that dietary patterns from 6 to 24 months may have a small but persistent effect on IQ at 8 years,” according to the study abstract.

Although lead researcher Lisa Smithers at the University of Adelaide stated in a media release that the IQ differences were not major, the study still suggests a need to put more emphasis on good nutrition at a young age.

This study is in no way isolated. Various other studies support a link between breastfeeding and IQ, as well as overall nutrition and IQ.

One 2011 study featured in a Scientific American article found that infants who were breastfed for more than 6 months had an average higher IQ of 3.8 points over infants who were bottlefed. However, the study suggests the IQ difference is not mainly due to nutrients in the milk but the closer biological interaction among infants and mothers during breastfeeding. This finding is further demonstrated by another study mentioned later in the article, where brain wave activity was recorded for bottlefed babies who fed on breast milk versus formula compared with breastfed babies. Out of the three groups, breastfed babies had different brain wave activity than both bottlefed groups, even though one bottlefed group still used breast milk.

Still more studies suggest that breastfeeding can enhance IQ. Research completed by Oxford University and Essex University “found that as little as four weeks of breastfeeding for a newborn baby has a significant effect on brain development, which persists until the child is at least 14 years old,” according to a ScienceDaily article. Researchers took into account other differences when comparing breastfed to non-breastfed children, such as mother’s age, marital status, job status, home situation, and education.

Various studies support a link between overall nutrition and IQ in children as well. For example, one study from 2011 suggests that young children who eat foods that are processed and are high in fats and sugars could have a lower IQ, whereas children who eat foods high in nutrients and vitamins tend to have a higher IQ, according to a PhysOrg article. Results seemed to show that diet was most important up until age 3 especially and that diet changes after age 3 didn’t impact IQ as much.

More research mentioned in a Mayo Clinic article links fish and omega-3 fatty acids to higher IQ in children as well. The research suggests that pregnant women with a higher intake of fish tend to have children with higher IQs, at least up until age 3. However, pregnant women also have to be aware of the mercury content in fish, because too much mercury could be harmful.

Nutrition and mental health experts have conflicting views when it comes to the newest study suggesting a link between consuming certain foods and increased IQ in infants.

Holly Stokes, a life coach and “the brain trainer,” said in an email that it’s important to take into account other factors that could have contributed to the higher IQs in the study as well. “It’s tempting to say that higher nutrition must then cause higher IQ,” Stokes said. “However, there could be other factors involved. For example, the IQ of the parents. It’s quite likely that the parents who are feeding their children better are better informed, maybe have researched on their own, and they themselves have a higher IQ than the parents who are not feeding their children as well. There is also some evidence to suggest that IQ has to do with socio-economic status as well.”

Scott Carroll, a psychiatrist with dual board certifications in adult and child and adolescent psychiatry and an assistant professor at the University of New Mexico School of Medicine, said in an email that this study brings up some important points about nutrition. “While 2 IQ points is actually within the usual standard error of most IQ tests, just the fact that you could demonstrate a statistically significant finding from rather minor dietary changes is a big deal,” Carroll said. “We certainly know that malnutrition has severe negative effects on IQ. The hard part about doing a study like this is that smarter parents often make healthier choices in food, which you have to statistically control for in this type of study.

“Statistically controlling for stuff like that often lowers the ‘effective result’ of the study,” he added. “Basically, if you took two high IQ families (IQ is highly genetic) with babies and fed them the two different diets with all other things being equal, you’d get a 2 IQ point difference on average. While that may not seem like much, as a soon to be parent (my wife is 4 months pregnant), we will be even more careful about feeding her the healthiest food possible.”

He said that since research already shows a link between a nutritious diet and good health, as well as a decrease in obesity, an increased IQ is just another benefit and does support an emphasis on certain food choices for infants. He has some suggestions about diet and lifestyle choices for parents and infants to ensure that their children have a healthy and growing IQ.

“Breastfeeding is clearly ideal for many reasons, but making sure mom is properly fed is important as well,” Carroll said. “Longer breastfeeding, up to 18 or more months even if the child does eat some solid foods, also helps. Key things for mom’s died include B vitamins, fish oil (must be mercury free since mercury is highly toxic), [and a] rich diet in terms of a variety of high quality fruits and vegetables. Limit the sugar content of their food. Personally, I strongly believe in eating organic even though the research on it is limited.”

“Other keys include having a secure attachment between the baby and primary caregiver, because insecure or disorganized attachment clearly affects the brain wiring in bad ways,” he added. “Having a stimulant-rich environment (bright colors, toys, etc.) and lots of time with parents with soothing verbal communication have also been scientifically shown to help.”

Lisa Hugh, a registered dietitian and mother of two boys under 3 years old (she breastfed both), said in an email that the IQ result alone isn’t enough to promote certain eating habits, but healthy eating has many other benefits as well.

“I don’t think a few IQ points alone is enough evidence to support one way of feeding,” Hugh said. “However, many studies (various sources and designs) indicate that healthy eating offers many benefits: brain size, vision development, acceptance of more tastes/textures, healthy body weight, better performance in school. All of these advantages together are reason to promote healthy eating.”

She has some diet suggestions for infants in order to promote higher IQs: “[Breastfeed] for as long as possible, minimize processed foods, give foods from all food groups (except in cases of allergy, illness, food sensitivities, food intolerances, cultural preferences, etc), give kids a variety of tastes/colors/textures/cups/plates/etc. to keep meals/food interesting and to expose them to different foods,” Hugh said. “Maintain a regular daily schedule as much as possible.”

“Each child/family/parent is unique,” she added. “There is no one absolute best way of feeding a child. Parents have to do what is best given their circumstances/needs.”

Related articles:
Patterns of Attachment
Welcome to Your Child’s Brain: Interview With Sandra Aamodt
Understanding Mental Health in Children

Individuals addicted to nicotine can exhibit unique responses when they are deprived of a cigarette. Many people report being anxious, snappy, or moody when they try to quit smoking. All of these responses are common. But for people with panic disorder (PD), going without a cigarette may trigger a panic attack. According to a recent study conducted by Teresa M. Leyro of the Department of Psychiatry at the University of California in San Francisco, people with anxiety problems and a history of panic attacks in particular are more likely to smoke than people without a history of anxiety-related problems. However, few studies have looked at how nicotine cessation, an event that can cause tension and stress in individuals with no history of anxiety, affects those with a predisposition to panic.

Leyro enlisted 58 adult smokers and exposed them to bodily sensations designed to elicit fear or anxiety. The participants were comprised of individuals with and without a history of PD, and all reported smoking approximately 20 cigarettes a day. The experiment was conducted after they had gone without smoking for 12 hours to allow sufficient time for withdrawal symptoms to occur. Leyro discovered that the participants with severe PD and the most significant withdrawal had the highest rates of panic symptoms after the experiment.

These results suggest that individuals with PD may catastrophize their circumstances and be more sensitive to physical cues when in a heightened state of anxiety. Additionally, these same individuals took longer to recover from their panic than those with low withdrawal symptoms. However, Leyro also found that the participants without PD and with low levels of withdrawal had elevated panic symptoms, too. This could be due to the fact that in the absence of withdrawal symptoms, these individuals may have been overly stimulated by fearful or threatening emotions when they experienced the physical sensations. Leyro hopes that these findings open up avenues of further research. She added, “This line of inquiry can shed light on the etiology of panic psychopathology among smokers and ultimately inform the development of novel specialized interventions for this difficult-to-treat population.”

Reference:
Leyro, T. M., Zvolensky, M. J. (2012). The interaction of nicotine withdrawal and panic disorder in the prediction of panic-relevant responding to a biological challenge. Psychology of Addictive Behaviors. Advance online publication. doi: 10.1037/a0029423

Related articles:
Three Steps for Dealing with Panic Attacks
Identifying and Treating Addiction and Substance Abuse Problems

Adolescent girls are among the most vulnerable for issues that relate to body image. They are assaulted with unrealistic images and unachievable ideals from virtually every media outlet. Teen girls struggle to find their identity at a time when appearance often determines their social circle and affects their self-esteem. In fact, research shows that teen girls worry more about their bodies than they do about academics, family life, or any other stressors. Young women who develop unhealthy eating behaviors can find themselves in a lifelong battle of physical and mental distress. Eating and food issues can lead to other negative psychological problems such as depression, anxiety, or even suicidal ideation.

Kathryn E. Rayner of the Centre for Emotional Health of the Department of Psychology at Macquarie University in Australia recently led a study to explore how peer relationships affect eating and body image issues in young women. Social acceptance is critical to teens, so Rayner theorized that perhaps young women select their friends based on eating and body image similarities, or perhaps they shape their own perceptions and behaviors based on the friends in their social circle. Rayner examined selection versus socialization in a sample of 1,197 teen girls from nine separate high schools in Australia. The adolescents were assessed for bulimic and dieting patterns, body satisfaction, and peer relations over a period of three years.

The results of the study revealed some interesting trends. First, the participants tended to choose friends with similar body satisfaction/dissatisfaction levels and bulimic behaviors. However, they did not choose girls with similar dieting and eating patterns. The girls also chose to engage in friendships that were bidirectional and avoided one-sided friendships. Rayner discovered that the girls who dieted the least had more people who wanted to befriend them, while those with more depressed mood and overt dieting behaviors had fewer peers soliciting their friendship. Additionally, the girls in the study, although they selected girls with dissimilar behaviors from their own, did not change their own actions to model those of their friends. Rayner believes the results of her study shed new light on some of the factors that influence eating, dieting, and body image in girls at risk. She added, “These findings represent important building blocks in facilitating the formation of more effective prevention and intervention strategies.”

Reference:
Rayner, K. E., Schniering, C. A., Rapee, R. M., Taylor, A., Hutchinson, D. M. (2012). Adolescent girls’ friendship networks, body dissatisfaction, and disordered eating: Examining selection and socialization processes. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0029304