Individuals who have avoidant attachment personalities struggle with intimacy and closeness. In romantic relationships, this type of personality can cause a partner to distance themselves from their loved one, and avoid physical closeness. “Because avoidantly-attached people feel most comfortable with distance and detachment from their partner, they may have less of the commitment-inspired inhibition that normally prevents people from showing interest in alternatives and from engaging in infidelity,” said C. Nathan DeWall of the Department of Psychology at the University of Kentucky. “Therefore, avoidant attachment may relate to a broad pattern of responses indicative of interest in alternatives and propensity to engage in infidelity, associations that should be mediated by a lack of commitment to one’s partner.” DeWall and his colleagues conducted a study to find out how avoidant attachment affected commitment in romantic relationships, and if the level of commitment would influence the desire to cheat. He said, “We focus on commitment because prior evidence suggests that commitment is the most direct mediator when predicting behaviors that relate to the persistence of one’s relationship and engagement of behaviors meant to strengthen one’s relationship, accounting for variance beyond relationship satisfaction and investment in one’s relationship.”

DeWall enlisted 42 college students in romantic relationships for his study. He conducted eight separate studies designed to evaluate both attachment style and commitment, and found that in all the studies, attachment style was directly linked to commitment and infidelity. “The first four studies showed that avoidant attachment was related to more positive attitudes toward cheating on a current relationship partner, having an attentional bias toward alternatives, and engaging in more infidelity,” said DeWall. “The final four studies showed that lower levels of commitment mediated the relationship between avoidant attachment and interest in alternatives and infidelity. He added, “Our findings suggest that chronic discomfort with closeness and intimacy, as indicated by relatively high levels of an avoidant attachment style, has direct consequences for how interested people are in alternatives to their relationship partner, their attitudes toward cheating on their partner, how committed they are, and hence how much they engage in infidelity.”

Reference:
DeWall, C. Nathan, Nathaniel M. Lambert, Erica B. Slotter, Richard S. Pond, Jr., Timothy Deckman, Eli J. Finkel, Laura B. Luchies, and Frank D. Finchman. “So Far Away From One’s Partner, Yet So Close to Romantic Alternatives: Avoidant Attachment, Interest in Alternatives, and Infidelity.” Journal of Personality and Social Psychology 101.6 (2011): 1302-316. Print.

Teachers and parents of children with ADHD know all too well how easily these special children can get distracted. The majority of research has shown that children with ADHD focus better and stay on task more when they are in an environment free from stimulation. But there is some evidence that specific stimulation can have a positive effect on these children. “Other studies have shown that background music significantly improves performance on cognitive tasks for children with ADHD but does not impact or negatively impact the performance of non-ADHD controls,” said W.E. Pelham, Jr. of the Department of Psychology at the Center for Children and Families at Florida International University, and lead author of a study on distraction among ADHD boys. “Despite these research findings, classroom teachers and the committees that revise the DSM continue to report and conclude that children with ADHD are more easily distracted than children without ADHD, and that distractors have only negative effects.”

Pelham examined how music or videos affected the attention of boys with ADHD who were non-medicated versus boys who were on methylphenidate (MPH) in a classroom environment. In three separate studies, Pelham found that the boys responded well to only musical stimulus. “Video produced significant distraction, particularly for the boys with ADHD, and MPH improved the performance of boys with ADHD across distractor conditions,” said Pelham. “In the presence or absence of music, MPH improved performance relative to placebo.” However, Pelham noted that although the video distracted all of the children, and specifically the children with ADHD, music had a beneficial effect, improving productivity in the boys with ADHD. “Thus, rather than recommending that children with ADHD perform homework in complete silence, our results suggest that listening to music while studying will not hurt most and may help some children with ADHD.” He added, “Rather than isolating a child with ADHD in a stimulus-free environment, these findings suggest that providing the child with headphones on which he or she could listen to music while working may enhance the classroom productivity of some children with ADHD.”

Reference:
Pelham, Jr., William E., Daniel A. Waschbusch, Betsy Hoza, Elizabeth M. Gnagy, Andrew R. Greiner, Susan E. Sams, Gary Vallano, Antara Majumdar, and Randy L. Carter. “Music and Video as Distractors for Boys with ADHD in the Classroom: Comparison with Controls, Individual Differences, and Medication Effects.” Journal of Abnormal Child Psychology 39 (2011): 1085-098. Print.

Depression and anxiety are among the most common mood problems, regardless of age or demographics. Children and adolescents experience anxiety and depression at a significant rate, although treatment for this population brings some complicating factors. The most frequently prescribed antidepressant medications incur a small but real risk of suicide or suicidal thoughts in young people. Known as selective serotonin reuptake inhibitors (SSRIs), this class of antidepressants is otherwise well regarded for both safety and effectiveness. When parents and physicians are cautious and attentive, SSRIs can be prescribed to children with a fair degree of safety. However, other side effects appear in younger patients that do not seem to affect adults. Hyperactivity, for example, is one such side effect of SSRIs that is confined to children and adolescent patients.

A review of previous studies revealed that so-called “activation events” might be extremely common in children taking certain antidepressants. Activation events are defined by abnormal energy, hyperactivity, and disinhibition. None of these effects reaches the level of mania, however, and sometimes it’s difficult to distinguish between “normal” activity levels and hyperactivity in young children. In a clinical trial of Luvox (fluvoxamine) prescribed to children, nearly 50% of participants experienced an activation event. Age appeared to be a significant factor—younger children were more likely to experience these side effects. Blood tests also showed that children who experienced activation events had higher concentrations of Luvox in their blood, despite lowering the dosage to mitigate side effects. This suggests that the medication is metabolized differently depending on the individual.

In the case of Luvox, hyperactivity as a side effect is not typically serious enough to require a change of medication. If the side effect is accompanied by self-injurious behavior, however, then a medication change is likely the best solution. Insomnia and aggressiveness are also signs of mania beyond simple hyperactivity. In a review of published work, researchers determined that demographic or family characteristics were not predictive of activation side effects. In addition, these side effects typically diminished and did not recur once the dosage was lowered.

In summary, because of differences in metabolism and physiology, children and adolescents react differently to medications. With Luvox and other antidepressants, there is a strong possibility of hyperactive or disinhibited behavior but not to the point of mania. Physicians and parents should always monitor children taking antidepressants for signs of worsening symptoms or suicidal tendencies. The side effect of hyperactivity by itself is generally not considered to be a cause for concern.

References

  1. PubMed Health [Internet]. (n.d.). Bethesda (MD): National Library of Medicine. Fluvoxamine. National Center for Biotechnology Information. Retrieved April 4, 2012, from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000955/
  2. Reinblatt, S.P., dos Reis, S., Walkup, J.T., Riddle, M.A. (2009). Activation adverse events induced by the selective serotonin reuptake inhibitor fluvoxamine in children and adolescents. Journal of Child and Adolescent Psychopharmacology, 19(2), 119-126.

Woman sitting looking sad

Individuals who are “symptomatic” of post-traumatic stress disorder (PTSD) may seem sick, crazy, or irrational. They might appear dissociative, clinically depressed, anxious, highly reactive, or rageful (or all of the above). In addition, it’s common for an individual to cultivate a sense of self-loathing for displaying these characteristics. During treatment, both therapist and survivor may agree that these symptoms are a mark of disease, making it their goal to alleviate the symptoms. Alternatively, both may choose to believe that these symptoms are an expression of health versus illness. This could enable more directed treatment, internal compassion, decreasing fear of symptoms, and a relationship between survivor, therapist, and trauma.

According to the DSM IV (American Psychiatric Association, 1994) criteria for diagnosing PTSD includes intrusive memories, thoughts, or dreams of an event, a sense of reliving the event, and intense distress in response to both internal and external cues that resemble an event(s).  Individuals may thus avoid triggers or cues, increase isolation or have a sense of ‘waiting for the other shoe to drop’ (a foreshortened future), and detachment.  Sleep difficulties are common; mood liabiality, and hyper vigilance are also common (American Psychiatric Association[DSM-IV], 1994). When a survivor feels hopeless, confused, and self-loathing because of the manifestations of their trauma, the initial layer of treatment is frequently the unraveling of self-loathing for the expression of symptoms themselves.

To begin to evaluate trauma and develop a relationship with its influence on survivors, we can draw from the practice of narrative therapy and the concept of externalizing a problem, which recognizes that the person is not the problem; the problem is the problem (Playful approaches to serious problems: Narrative therapy with children and their families. Freeman, Jennifer C.; Epston, David; Lobovits, Dean New York, NY, US: W W Norton & Co. (1997). xvii, 321 pp.). PTSD, as a character in a survivor’s life, uses symptoms as tools to protect us, remind us of our core values, and ensure that what happened before won’t happen again. The trauma response could even correspond to the level of violation on self and values; from this perspective, a profoundly disturbing event calls for a profoundly disturbing response. Flashbacks, dreams, invasive thoughts, and triggers provide specific information about the violation the client’s event(s) infringed upon them. These also exemplify the concept of “stuck points” in Trauma-Focused Cognitive Behavior Therapy (Akin-Little, Angeleque (Ed); Little, Steven G. (Ed); Bray, Melissa A. (Ed); Kehle, Thomas J. (Ed), (2009). Behavioral interventions in schools: Evidence-based positive strategies, School Psychology (pp. 325-333). Washington, DC, US: American Psychological Association, xi, 350 pp.)

The aspect of a survivor’s past that is troublesome can be quite specific and idiosyncratic. Groups of people exposed to the same event often are disturbed by different parts of it. Interpersonal trauma such as child abuse, domestic violence, or sexual assault may render someone feeling responsible for what happened to them, feeling dirty or shameful, betrayed, foolish, unimportant, or completely exposed.  Trauma might be conveying to someone that they are at fault for an assault because it wants the individual to have a sense of mastery or agency.  Helplessness is too passive, so self-blame is an acceptable tone to assume. An individual might also begin to associate a traumatic feeling of betrayal with a feeling of foolishness, ensuring s/he does not trust people too easily and maintaining inner safety.

The way in which a survivor expresses their PTSD can vary widely and presentations can be very complex and oppressive.  It is common for survivors to blame themselves for their past experiences, and they often enter into treatment with a great deal of shame because they feel they should have “gotten over it” without help. A therapist can offer some relief from shame by viewing survivors’ symptoms as useful, even critical to their treatment.

Through the process of healing, a survivor can learn to establish trust in self to clearly identify his/her core values, to reflect his/her significance in the world, and to maintain personal safety. The character of trauma will refrain from presenting images (flashbacks and dreams) when the stuck point has been identified, and will cease making statements that the individual is culpable for what happened once there is a demonstration of mastery over the event. It will hold back on invasive, persistent thoughts once the survivor is able to look at the event rather than avoiding it.  PTSD symptoms reflect individual values and provide explicit guidance for healing; if therapist and client are willing to work with trauma, and absorb the information it has to offer, it will not invade with such rigor.

 

Depression among older adults is an often-overlooked health crisis. Studies show that more than half of all people older than 60 diagnosed with depression fail to respond to initial treatment programs. In general, a psychotropic medication such as Lexapro (escitalopram) is one option of many as a first treatment. A variety of factors, however, complicate the successful treatment of elderly depression. Comorbid conditions, such as anxiety or poor physical health, may exacerbate the symptoms of depression. For reasons not fully understood, elderly patients respond more slowly to psychotropic medications in general. The patient’s level of independence likewise contributes to the success or failure of standard treatments. Despite the well-documented difficulty of treating depression in the elderly, relatively little work has been done to find more age-appropriate solutions to the problem.

In the case of elderly adults with depression, behavioral therapy may be at least as important as medication. One form of therapy known as depression care management (DCM) focuses on educating the patient about depression, their treatment, and practical measures for improving mood and daily functioning. Another therapy, known as interpersonal psychotherapy (IPT), is more intense and individually targeted. IPT resembles traditional cognitive-behavioral therapy, whereas DCM is more akin to routine counseling.

In a study of elderly adults, researchers tested whether DCM alone or coupled with IPT is more beneficial for those with a history of poor response to antidepressant medication. Study participants were administered standard prescriptions for Lexapro, which was increased as needed after an initial 6 weeks. People who experienced remission with medication alone were dropped from the study. Poor responders were divided into a DCM group and a DCM plus IPT group. Eighty percent of these individuals saw some improvement, while half experienced full remission of symptoms. Interestingly, there were no significant differences between the groups. Researchers theorized that “quantity” of therapeutic attention was less important than the existence of the attention at all. Therefore, the addition of DCM alone produced benefits; adding IPT did not produce more benefits.

The study was somewhat limited because researchers did not control for external variables, other than medical conditions that might argue against the use of Lexapro. In addition, some patients might have improved simply because of increased dosages and not behavioral interventions. More investigation is necessary to answer such questions.

References
Reynolds III, C. F., Dew, M. A., Martire, L. M., Miller, M. D., Cyranowski, J. M., Lenze, E., et al. (2010). Treating depression to remission in older adults: a controlled evaluation of combined escitalopram with interpersonal psychotherapy versus escitalopram with depression care management. International Journal of Geriatric Psychiatry, 25(11), 1134-1141.

Turning points are life experiences that permanently change the course of one’s life. The death of a parent, a divorce, or even a geographical move are all examples of turning points that can have a positive or negative affect on an individual. “The most defining characteristic of a turning point, however, remains that the event is perceived as significant or life-changing to the individual,” said Royette Tavernier of the Department of Psychology at Brock University, St. Catharines in Canada, and author of a recent study. How individuals process those turning points is referred to as meaning-making and is theorized to affect well-being. “The purpose of this study was to examine whether meaning-making within turning point narratives, as well as the timing of these turning points, would be associated with psychological wellbeing among a sample of Grade 12 high school adolescents,” said Tavernier.

For their study, Tavernier and a team of colleagues analyzed the life stories of 418 12th grade students, half of whom had experienced a significant turning point in their lives. All of the students had been previously assessed for well-being while in the 9th grade, as part of another ongoing study. Tavernier discovered that although the earlier assessment of well-being did not influence meaning-making in 12th grade, those who described meaning-making as part of their turning point narrative had much higher levels of well-being than the students who did not describe using meaning-making strategies in their life stories.

“This important finding suggests that the significant positive association between meaning-making and psychological well-being was not necessarily a function of preexisting differences on this variable, prior to adolescents’ turning point experiences but instead may be related to the meaning-making process.” Tavernier added, “In conclusion, adolescents, counselors, parents, and other sources of support can benefit from the knowledge that navigating life’s unpredictable paths is not necessarily solely associated with negative affect. Although much more research in this area is needed, these findings provide some support for the possibility that when adolescents engage in a more intimate exploration of their life experiences—particularly those that cause significant change—positive consequences can emerge at the personal and relational level.”

Reference:
Tavernier, R., & Willoughby, T. (2011, November 28). Adolescent Turning Points: The Association Between Meaning-Making and Psychological Well-Being. Developmental Psychology. Advance online publication. doi: 10.1037/a0026326

Couple sitting on edge of their bed looking sadIn my neck of the woods the majority of therapists see mainly women (probably about 80% of their clients). Not so for me – more than half my clients are male, and when I work with a couple it is more often the men who initiate conjoint therapy. I think this is because many guys tend to become very uptight about their penis, what Paul Joannides (author of The Guide to Getting It On) calls “deadwood – the bummer in your pants”. Many of the men I work with are concerned about their system crashing when their pants are off!

I’m not comfortable diagnosing erection problems as “erectile dysfunction.” I hate labeling, and the “dys” implies failure and the overwhelming shame that goes along with it. I never click on the links that come with the numerous ads in my spam folder offering “your instant cure for impotence” (why are they sending these to ME?). Viagra can make a huge difference but masks the issues that cause the tissues to stay soft.

It’s not just men over 50 who have erection problems. They happen to men of all ages, from teens on up. Often erectile challenges crop up quite early in a sexual relationship when folks are just beginning to find their sexual rhythms together. Many guys are nervous that their performance is not up to par – they may require a few weeks or even months to find their groove. Especially when the couple moves from dating to mating in domesticity!

So gals, remember that expecting a guy to get it up straight away could be a big mistake – especially if you truly feel that he’s the man for you.

It can make for a big opportunity to look beyond sexual performance to deep bonding with each another. The danger is not the lack of an erection, but what each of you makes of it. When a woman needs her partner’s erection to validate that she’s desirable, a short term problem can quickly become long term.

Recently a 23 year old client described a typical scenario with his fiancée, with whom he has a long distance relationship. “So it’s Friday evening and we’re coming home from a romantic dinner. She says, ‘Wanna have sex when we get home?’ and I panic! I feel like all the blood is draining from my body. It’s this deep seated fear that I won’t be able to get an erection 30 minutes from now and it becomes self-fulfilling and self-defeating. How do I get control over my own body?”

He was extremely surprised when I suggested that trying to “get control” was precisely the problem. Viagra did indeed help with his attempts to stave off what he called “hydraulic failure.” But the blue pills were only part of the picture for this couple. In this kind of situation I usually sit down with both people separately as well as seeing them together. I call this my three-legged stool approach. When you eliminate one leg the stool often topples.

His fiancée had been blaming herself, “He obviously doesn’t find me attractive any more. I’ve gained some weight…” etc. Once I helped her to realize that his erection problems had nothing to do with her, it turned out that she wasn’t nearly as attached to a hard penis as he had imagined.

Viagra produced the requisite hard-ons but was no help at all when this couple couldn’t laugh together or let go of their attachment to having things go a certain way between the sheets. They needed to learn more about intimacy. Many couples require some help deepening their intimacy, and therapy can provide the tools.

Joannides again: “When it comes to making love, relationship issues trump d*** issues.”

Feelings of psychological defeat are common symptoms of many mental health problems. In some research, psychological defeat has been linked to the onset of psychosis and other challenges. “Defeat may also contribute to the development and maintenance of schizophrenia,” said Judith Johnson of the School of Psychology at the University of Birmingham in the UK and lead author of a recent study on defeat and emotion. “Perceptions of defeat have been associated with the onset and exacerbation of a range of psychiatric conditions and disorders, including depression, anxiety, and suicide,” said Johnson. “Thus, the aim of the current research was to investigate the extent to which the emotion regulation strategy of reappraisal moderated the impact of failure on perceived defeat among both a nonclinical sample and individuals diagnosed with a schizophrenia-spectrum disorder, for whom perceived defeat may be particularly important.”

For her study, Johnson focused on the effects of trait reappraisal, the frequency with which people use reappraisal. In the first part of the study, over 100 undergraduate students were evaluated for trait reappraisal as they completed tasks designed to elicit feelings of failure or success. “Specifically it was found that higher frequency of reappraisal was associated with greater increases in sadness and negative affect and greater decreases in calmness after an experience of failure,” said Johnson. In the second part, Johnson examined trait reappraisal in people diagnosed with schizophrenia and found similar results. “Supporting the prediction, it was found that reappraisal amplified the difference in defeat between individuals in the failure and success conditions. Specifically, results suggested that the highest increases in self-reported defeat were among frequent reappraisers who experienced failure,” said Johnson, noting that the findings have significant clinical implications. She added, “Frequent use of reappraisal may confer vulnerability to subjective defeat in response to stressful life events among nonclinical and clinical populations and could be an area for relapse prevention interventions to target.”

Reference:
Johnson, Judith, Patricia A. Gooding, Alex M. Wood, Peter J. Taylor, and Nicholas Tarrier. “Trait Reappraisal Amplifies Subjective Defeat, Sadness, and Negative Affect in Response to Failure versus Success in Nonclinical and Psychosis Populations.”Journal of Abnormal Psychology 120.4 (2011): 922-34. Print.

A new study involving people with bipolar suggests that setting extrinsic goals may be a predictor for manic episodes. Individuals with bipolar disorder are aware that setting high goals can cause them to get overstimulated and result in a manic episode. “The reward sensitivity model has been found to be useful in predicting the course of mania; indeed, increases in mania over time have been predicted by self-reported reward sensitivity, life events involving reward, and elevations in behavior focused on attaining reward and goals,” said Sheri L. Johnson of the Department of Psychology at the University of California at Berkeley, and lead author of a recent study examining the relationship between reward sensitivity and the development of bipolar. “People with bipolar disorder appear to value goal pursuit more than do other people.”

Of particular interest to Johnson and her colleagues was the pursuit of extrinsic goals, namely fame and financial gain. “On the whole, findings regarding high aspirations for popular fame and low aspirations for friendships and family suggest that people with bipolar disorder adopt extrinsically rather than intrinsically motivated goals,” said Johnson. “Several early studies suggest that a better understanding of goal dysregulation might be relevant for treatment planning.” For her study, Johnson examined the goals of 92 people with bipolar 1 and a control group using the Willingly Approached Set of Statistically Unlikely Pursuits (WASSUP) model, and followed their pursuit of these highly ambitious aspirations over a three month period.

“Participants with bipolar disorder endorsed higher ambitions for popular fame than did controls; moreover, heightened ambitions for popular fame and financial success predicted increases in manic symptoms in those with bipolar disorder over the next three months.” Johnson added, “We have designed a mania treatment that involves techniques for modulating high goal setting. Over the course of the intervention, participants demonstrated significant decreases in WASSUP scores and interviewer ratings of manic symptom severity.” Johnson believes that insight into how goal dysregulation affects bipolar and how to manage it will help influence effective interventions for those at risk for bipolar and manic episodes.

Reference:
Johnson, S. L., Carver, C. S., & Gotlib, I. H. (2011, November 21). Elevated Ambitions for Fame Among Persons Diagnosed With Bipolar I Disorder. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0026370

GoodTherapy | When Girls Are BulliesDo you remember your first bully—the girl who called you fat, mocked your choice in clothes, or spread false rumors about you? Of course you do. It’s like a first kiss, a first drink, the first time you drove a car. Only this is a memory you wish you could forget. You may not recall her exact words, but you remember the girl, the time, the place. Did you ever wonder why she did it, what provoked her meanness, how she got to wield so much power?

Bullying is an intentional act of aggression in which the perpetrator belittles, controls, intimidates or harms another person. Attacks are often unprovoked, and exploit an individual’s vulnerabilities or weakness. Although male bullying is typically straightforward, often involving physical aggression or blatantly hostile taunts, female bullying may be more subtle, and therefore, harder to detect. For girls, bullying can be a means of gaining popularity, jockeying for power among peers, or asserting control. Since it is more covert, teachers and parents may overlook clues, or assume the behavior is just a normal part of social interactions.

Some forms that bullying can take include:

So, why do girls resort to bullying? Reasons vary, but usually include a need for control, attention, and approval, or an outlet for anger. Girls who bully may appear threatening and commit hurtful acts, but they often harbor underlying insecurities that fuel their behaviors. Some feel lonely, inadequate, and fearful, and bully to feel powerful or hide their insecurity. Some attack first before they are attacked by others. Some are angry about problems at home and lash out at peers. Occasionally, girls who bully learn these behaviors at home due to family members who are abusive or because of a hostile neighborhood environment. Popularity is no safeguard, since often the girls who bully are those who seem to have it all. Frequently, the pretty, popular, athletic girls are the ringleaders who foster a culture of bullying, even though they may have already acquired power in the social hierarchies of their schools.

The process of bullying can develop slowly over time. Girls who are popular and charismatic may attract others into their circle of friends and make them feel special. They may then try to control these girls, expect favors, or demand that the new girls bully others as well. By controlling a group of peers, bullies achieve power in numbers and go on to terrorize teens they believe are a threat. Individual victims can be targeted at random, but are often selected because of jealousy, noticeable differences, refusal to conform to the group, or a weakness that can be exploited. Bullying also can be sparked by a sudden turn of events in a friendship, where the bully feels threatened and angry, and decides that she must retaliate.

While punches are not thrown, bullying can leave a devastating mark on its victim and engender long-lasting pain and suffering. Girls are particularly vulnerable because of how much they value friendships. Victims can become depressed, anxious, insecure, and feel they are to blame. Obsessive preoccupation with perceived flaws, physical appearance, conformity, and adhering to the bully’s rules of conduct can follow. Conversely, some girls who are bullied become isolated, withdrawn, and even drop out of school. In rare instances, victims can become so depressed and hopeless that they consider suicide as their only option.

Victims often remain silent due to embarrassment, self-blame, or fear of retaliation, so incidents of bullying may go unnoticed. Investigate whether bullying is occurring if your loved one, friend, or student is showing any of the following signs: mood swings, sudden withdrawal from friends, refusal to attend school or social events, sleep problems, academic difficulties, physical complaints, weight loss or gain, or frequent crying.

If you suspect that someone you know is being bullied, it is important to offer support. Reassure the victim that the bullying will end eventually, and that you will help her identify strategies for addressing the problem. One size does not fit all, so a variety of strategies and interventions should be considered depending on the specific situation. Useful websites with anti-bullying tips are listed below. Sometimes getting advice from a therapist or guidance counselor can help. Girls who bully also benefit from counseling, where they can learn to take responsibility for their behaviors and identify appropriate outlets for their anger and need for control.

Prevention is essential, and needs to come from both the family and community. Parents need to discuss bullying with their children, even before it occurs. Teaching girls how to respond to potentially difficult situations, before a problem develops, is critical. Helping young girls improve their self-esteem by developing strong academic, athletic or extracurricular interests, and finding friends who share similar interests (so that social standing is not as critical), may minimize their vulnerability to falling victim. Schools should offer anti-bullying initiatives, including training for staff, programs for students, and counseling services when necessary. When parents, schools, and the community promote an environment where bullying is unacceptable, perhaps fewer girls (and boys) will have to encounter that first bully.

Anti-Bullying Resources and Information:

 

MSca exercise MH900431107There are styles of thinking that are commonly related to anxiety and unhappiness. One patterned way of thinking that is identified by therapists who work with cognitions is the all-or-nothing style. It is often part of the negative body-image experience. This way of thinking can lead to a lot of unnecessary distress, but it is also a symptom of feeling overwhelmed. When the mind is faced with too much to deal with, a tactic it uses to conserve energy is to reduce its interpretation of experiences to simple categories: black or white, all or nothing, all bad or all good. In this effort to simplify and manage complex experiences, the mind protects itself in a short-term gain, long-term pain manner. Because life experiences can indeed be complex, we need to be able to tolerate the discomfort of staying open-minded as much as possible. The more we can withstand the discomfort, the more readily we can grow into new understandings, accommodating the complexity into our frame of thinking. This impacts relationships to self and others.

People with negative body image are often throwing the baby out with the bath water. Just like people who complain of low self-esteem, they make global and categorical assessments of their worth. They are not using a logical stance to assess their strengths and areas of challenge. Their minds are locked into an all-good versus all-bad perspective. Instead of thinking of the multitude of pleasures and purposes of the body and of the complexity of the concept of attraction, they decide that they, as a whole, are unappealing. People with extremely poor body image rarely actually look at their whole selves. When they look in the mirror, they visually dissect their image into small parts which they then taint with a negative emotion. Negative feelings overall can impact what we think we are seeing. Perception is influenced by mind and emotion states. What we see can be a trick. If one who is already stressed or sad then looks only at one aspect or one piece of their physical body, the scene is ripe for negative body image. This becomes a very unhealthy habit that perpetuates itself—getting stressed and then over-focusing on one aspect of the body that brings about more negative feelings. This person may believe he or she can control that one area of the body. This sends people into very unpleasant experiences with exercising.

Categorical thinking about the body perpetuates unhealthy attitudes about wellness overall and sabotages efforts to stay fit. Instead of going to work out or enjoy sport or physical activity, the person with negative body image will sometimes resentfully engage in excessive exercise to try to manage the hated parts of the body. This usually fails, as spot-training is often a futile endeavour. Since they cannot reach their all-or-nothing goals, they often become demotivated to work out. A healthy and balanced approach to being fit in mind and body is not about spot-training or sculpting the body. A sustainable and healthy approach is one that allows a person to accept the natural ebb and flow of energy and motivation. Cherishing life, one heads to physical activity with joy, keeping in mind the goal of health, wellness, and balance itself. Self-enhancement through dedication to feeling good keeps a body well. This kind of accepting attitude leads to overall better health and fitness, which contributes greatly to relaxation and strengthened capacity to deal with emotion and stressful challenges.  Ultimately, respecting the body and the whole self, rather than trying to conquer and control it, helps to change stubborn all-or-nothing attitudes. One must humbly surrender to the emotionally provoking complexity of being human, honoring and respecting strengths and vulnerabilities in self and others. After all, life would be very boring if it was truly black and white.

Being the target of bullying can cause a child to internalize and experience a decrease in self-worth. Many children who are victims of bullying become isolated and withdrawn, and often have a limited social circle of friends. “Because many of the correlates and predictors of peer victimization are common in children with ADHD, it is not surprising that children with ADHD are at elevated risk for peer victimization,” said Stephanie L. Cardoos of the Department of Psychology at the University of California, Berkeley. “Although more is known about risk factors for victimization than about protective factors, one well-established protective factor for those at risk of victimization is friendship.” Cardoos and her colleague Stephen P. Hinshaw recently conducted a study to determine what affect friendship would have on bullying. “The overall purpose is to understand factors that may both predict and protect  against peer victimization in girls with ADHD, with a particular focus on friendship as a protective factor,” said Cardoos.

The researchers examined data from 228 girls between the ages of 6 and 12, half of whom had ADHD. The girls were evaluated by counselors at several points during a five week summer camp program and the girls listed who they considered to be their friends and which girls they did and did not like. The team found that all of the girls who were bullied exhibited similar symptoms, regardless of whether they had ADHD or not. “Our core finding was that the presence of a mutual friendship moderated the association between each behavioral risk factor and victimization, such that the presence of at least one friend reduced risk of victimization,” said Cardoos. “The current findings suggest that even for those who may be at elevated risk for deleterious peer effects, such as girls with ADHD, peers can play an important protective role.” She added, “If friends protect by intervening directly in challenging peer situations, it will be important for at-risk children to develop a friend in their natural peer group. In contrast, if friends are most important in increasing self-esteem, interventions outside of the natural peer group may be equally protective.”

Reference:
Cardoos, Stephanie L., and Stephen P. Hinshaw. “Friendship as Protection from Peer Victimization for Girls with and without ADHD.” Journal of Abnormal Child Psychology 39.3 (2011): 1035-045. Print.

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