BullyingWhether it takes the form of teasing, threats, violence, or other acts, bullying is a significant issue in schools and communities around the world. In the United States alone, nearly a third of students report being bullied each school year, and most who are bullied never report it. The rates of bullying are even higher among students who identify or are perceived as LGBTQ, students with disabilities, and minority students.

In addition to any physical harm that may be inflicted, bullied children can experience a variety of mental health concerns as a result of their exposure to bullying, may struggle academically, and may experience a variety of negative health effects. Bullied children are also 2.4 times more likely to report suicidal ideation than non-bullied peers.

Although awareness of bullying has grown with the Internet and social media, so, too, have opportunities for bullying. Cyber bullying may include the posting of hurtful messages, rumors, photos, or videos, and some cyber bullies have been known to create false profiles or even websites to harass their targets. Cyber bullying is compounded by the fact that what is posted online isn’t always easily erased.

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Most experts agree that if a person knows of or witnesses bullying, the best course of action is to talk to a teacher, school administrator, parent, or other trusted adult who can intervene and pursue appropriate prevention measures.

Education is a big part of the solution, of course. With that in mind, we’ve compiled a list of the 10 best online resources for bullying awareness and prevention—GoodTherapy.org excluded—in 2014. Our selections are based on quality and depth of content, presentation, and functionality.

Have a website you would like to see in our Top 10? Recommend it here.

References:

  1. Bullying Statistics. (2013). Retrieved from http://www.bullyingstatistics.org/content/facts-on-bullying.html
  2. Bullying Statistics. (n.d.). Retrieved from http://www.pacer.org/bullying/about/media-kit/stats.asp
  3. Espelage, D. L., and Holt, M. K. (2013). Suicidal ideation and school bullying experiences after controlling for depression and delinquency. Journal of Adolescent Health, 53.

Cosy mature couple lying in bed smilingPeople have it all wrong about married sex. Somehow many Americans have created a fantasy that sex in marriage should look like sex when you’re dating or sex in movies—the type of sex that is urgent, quick, spontaneous, lustful, and passionate. Sure, it can happen, and it’s wonderful when it does, but this is certainly not the norm. As a sex therapist, I see time and time again that expectations are part of the issue when it comes to low sex drive and sexless marriage. People come to my office all the time and say that when they have sex they enjoy it, but they rarely seem to desire it.

Successful couples have realistic expectations about what sex should look like. They set date nights or schedule sex so that they make time for one another. They set aside time to try to get in the mood. They make intimacy a regular part of their relationships by knowing what to expect and when to expect it.

Are you one of those people who think scheduled sex is boring or cannot be pleasurable? Allow me to persuade you that if you change your thinking, not only will you and your partner likely have more sex, but you will enjoy it more as well.

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1. You Don’t Need Desire to Precede Intimacy

Do you always feel hungry for breakfast? No, but you eat it anyway because it’s an important meal.

Are you often dirty and “in need” of a shower? Probably not. But you likely shower daily, or every other day, anyway.

Do you feel utterly exhausted every night when you go to sleep? Maybe. But you might just go to bed around the same time because you know that rest is good for your body and so you won’t be tired the next day.

Do you always feel the urge to exercise? Many people would say no, definitely not! But people do it because it’s healthy.

Well, sex is the same way! You push yourself to start sexual intimacy because it’s good for your body, your mind, your marriage, and your family.

2. Dating Is Not Spontaneous

The idea that sex when you’re dating is spontaneous is simply not accurate. When people are dating and live apart, they make time to see each other. They often dress up, do their hair, apply perfume or cologne, or wear more flattering clothes. You planned sex when you were dating, but you didn’t realize you were planning for sex because you tricked yourself into feeling like it was spontaneous. It was anything but. All these steps you took helped your brain anticipate sex at the end of the night.

3. Planning Sex May Make You Happier

Why is spontaneous good and planned bad? Do you enjoy a vacation less because you planned it and looked forward to it? According to a recent study in the Journal of Applied Research in Quality of Life, participating vacationers were happier before their trips, in anticipation. Other research shows, as well, that people derive happiness from anticipating a positive experience.

Anticipating a sexual encounter may make you more responsive in, and happy before, the actual act.

4. For Many Women, Desire Comes after Arousal

According to Rosemary Basson’s model of female sexual response, desire more commonly occurs in women after arousal. In contrast, the male model of sexual response dictates that desire generally comes before arousal. Women are not men!

If you, like many people, can enjoy sex and feel connected during intimacy but have a hard time initiating, try these steps:

If you enjoy sex with your partner but never seem to find the time or occasion to be intimate, it might be that you are waiting for the stars to align. Shift your perspective to a more functional and realistic point of view. You can have passion and desire and perhaps even orgasm, but initiation is the first step.

References:

  1. Kumar, A., Killingsworth, M.A., and Gilovich, T. (2014). Waiting for Merlot: Anticipatory Consumption of Experiential and Material Purchases. Psychological Science. Vol 25, No. 10. Pp: 1924-1931.
  2. Nawijn, J., Marchand, M.A., Veenhoven, R., and Vingerhoets, A.J. (2010). Vacationers Happier, but Most Not Happier After a Holiday. Journal of Applied Research in Quality of Life. Vol 5, Issue 1, pp: 35-47.

GoodTherapy | How to Build a Backbone in 3 Easy StepsDo you allow others to take advantage of you? Do you avoid speaking up for yourself? Well, now’s the time to build your backbone! One that works, doesn’t wobble, and gets stronger when used.

What is a backbone, anyway? A backbone is a symbol of strength in character, an unwillingness to be used or taken for granted, and a firm commitment to uphold one’s decisions and feelings. We’ve all seen and heard of people who have a backbone; they are the strong ones, the ones who get what they want.

How do you know if you have a backbone? Ask yourself these questions:

  1. Do you resent someone in your life?
  2. Do you feel taken advantage of?
  3. Do you often complain but nothing changes?
  4. Do you keep all of your emotions in?
  5. Do you avoid conflict?
  6. Have you said yes when you meant no?
  7. Have you allowed your anger to build up and come out in other ways?
  8. Have you compromised self-care for others-care?

If you answered yes to any of these questions, you could use a backbone adjustment!

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First, let’s understand why backbone building is so hard. Often, we’ve been hurt and have learned to give in to avoid a conflict or, worse, getting hurt even further. Another possible reason we may not use our backbone is that we lack self-esteem and confidence. But it costs us in the long run: we don’t speak up, we don’t make waves, and we allow ourselves to be treated disrespectfully in order to keep the peace.

The benefits of a backbone are many. A backbone, or confidence in our strength, allows us to feel:

We may feel a compromised sense of strength in our marriages, our parenting, our work, with our extended family, or with ourselves. In our marriages, our strength is compromised when we ignore important issues, stop communicating, and don’t speak honestly. Similarly, when we are disrespected at work or when parenting, and the issue isn’t resolved, we may feel walked on and relationships may suffer. Our extended family exposes a compromised backbone when we don’t communicate our needs properly to them, when we are available even when our schedule does not allow for it, and when others dictate our lives. We can be compromised with ourselves as well. Haven’t we all been irresponsible, ignored truths, and improperly cared for ourselves?

There are three easy steps to strengthening your backbone.

Deal, Heal, and Reveal

The first step, dealing, means observing when we are being backbone-less. Make a mental note when you shrink, when you feel lowered, and when you inappropriately compromise. Think of the consequences of speaking up, saying no, or quitting. What’s the worst that can happen? Can you deal with the discomfort? If yes, move to step two. If not, repeat step one until you feel stronger.

Step two is about healing. Using your instincts or your gut reaction, make a small decision and stand by it. Say no once. Next, make a few more decisions and say no a few more times. Do not ruminate on past mistakes and decisions. Keep going. Feel yourself getting stronger. Now you know better, and you’ll do better.

Step three is to reveal the new, updated version of you—backbone intact! Use your newfound character firmness to create a life plan with balance and reciprocity. As you gain strength and stand straighter, others will notice. You’ll be respected more, you’ll have more self-esteem, and you’ll no longer be allowing your life to be determined by others. Get out there and grow your backbone!

One woman and three men meet for coffeeJealousy can be a painful and even fatal emotion, but according to one new study, it may also help spice things up in the bedroom. According to research published in the Journal of Comparative Psychology, when heterosexual men are jealous of their partner’s male friends, couples have more sex.

Couples Have More Sex When Women Have Male Friends

It’s notoriously difficult to find out how frequently people have sex, but research suggests that many couples have much less sex than cultural norms tell them they should have. One study of more than 20,000 found that only 26% of couples have sex once per week. To explore how jealousy might affect sexual frequency, researchers relied on self-reported survey data from 393 heterosexual men in long-term relationships. The average couple had been together for 36 months. Researchers asked questions about the men’s partner’s social lives, the men’s experience of jealousy, and the frequency with which the couple had sex.

Survey results revealed that couples had more sex when the woman had more male coworkers and friends, but only when the man believed his partner was attractive to these potential male rivals. This jealousy, researchers believe, encourages men to initiate more sex with their partners. [fat_widget_left]

Perceived Sexual Rivals Inspire Jealousy

The study’s authors didn’t investigate why men were more likely to have sex with their partners when those partners evoked feelings of jealousy. They speculate this may be due to what evolutionary psychologists term “sperm competition” that occurs when sperm from two or more males “compete” to impregnate a female. This phenomenon is not uncommon among nonhuman males. The researchers argue that men who perceive their partners’ male coworkers or friends as sexual rivals may be more likely to initiate sex so that their partners are not impregnated by another man. However, the study did not test fertility, pregnancy, or sperm competition.

The study also did not evaluate the role women played in the initiation of sex, so we don’t know what their role may be in this phenomenon. They study’s authors suggest that further research is necessary to validate their findings and to explore potential causes.

References:

  1. Montgomery, H. (n.d.). How often do ‘normal’ couples have sex? Retrieved from http://www.everydayfamily.com/how-often-do-normal-couples-have-sex/
  2. Pham, M. N., Shackelford, T. K., Holden, C. J., Zeigler-Hill, V., Hummel, A., & Memmering, S. L. (2014). Partner attractiveness moderates the relationship between number of sexual rivals and in-pair copulation frequency in humans. Journal of Comparative Psychology, 128(3), 328-331. http://dx.doi.org/10.1037/a0036602

Girl hiding beneath the tableTrauma often leaves us living in a seemingly hostile world, feeling ineffective, believing that help cannot be expected.

To some degree, the concept of limited internal power and limitless external power remains an essential component of complex trauma. Fatalism (or “learned helplessness”) is a debilitating side effect of experienced oppression. In many, the freeze response includes disengagement from life—an intentional separation from anger, power, and movement.

Internalized Oppression and the Freeze Response

The human body has a few options when threat is detected. If we look around and find physical signals of safety from another, our anxiety recedes. If support is not available, we move into fight-or-flight mode, mobilizing for self-protection. Especially for children—when physical size renders fight useless and dependence precedes flight—freeze is the next step.

Like fight or flight, freeze is a biological resource. It serves a purpose. It effectively preserves within our core what we deem most fragile and valuable, as if moving into hibernation or hiding in a safe until safety once again presents itself. We lie dormant.

While the mechanism is an effective one, the experience of life in a freeze state is not always pleasant. We still access fight and flight, often more readily than others, as if we are living on the border of that biological response. In fact, we are. As freeze is a drop after fight or flight, the experience of fight/flight becomes the wall between us and the world. Life itself becomes a protected bubble, with little action—sometimes indiscernible movement. Just breathing. Waiting. Sometimes minutes. Sometimes decades.

We live on as a sliver of our whole: eating food, maintaining, avoiding any risks that might bring us closer to whatever dreams we hold. We may carry some fantasy of being recognized or saved one day, or eventually finding courage and overcoming our self-imposed prisons. One major challenge lies in the fact the only route to freedom includes a journey through the impenetrable panic of fight/flight, and we still carry the template of our last experience there. So we end up living—or at least maintaining—in cages of our own making, feeling frustrated, depressed, powerless to escape or change.

This is a form of internalized oppression. On a macro scale, internalized oppression (also known as self-directed oppression) is when a marginalized or oppressed population begins to accept and act on stereotypes and other inaccurate beliefs related to it. On a personal level, internalized oppression happens when we impose limits on ourselves in pursuit of safety.

This is a form of internalized oppression. On a macro scale, internalized oppression (also known as self-directed oppression) is when a marginalized or oppressed population begins to accept and act on stereotypes and other inaccurate beliefs related to it. On a personal level, internalized oppression happens when we impose limits on ourselves in pursuit of safety.

Noticing Our Power

Many of us have seen the violence of power and want no part of it. We divorce from power within ourselves. We feel weak and, at the same time, fear our strength.

When we look from a distance, we see violence and oppression at a global scale. Zooming in, it becomes apparent between cultures and classes. Then, in the family unit, violence presents as abuse (physical, sexual, verbal, etc.) or neglect. Using therapeutic models such as Hakomi therapy or Internal Family Systems, we zoom in still further, witnessing the pain and “stuckness” of internal conflict and oppression.

In simple moments—maybe sitting in a garden or a counseling office—we recognize the power in ourselves. We recognize a conflict as we feel the physical sensation of shifting our awareness between the part that judges/contains and the part being contained. We notice the part contained using anger as a resource to build power, to break our own walls. We realize how dependable and valuable our own containment system has been, and may even feel gratitude noticing that part of ourselves valued us so completely. Maybe we feel the contained part in our throat, moving upward, while the other part—the tension in our shoulders—acts as the dam that holds back forbidden parts of ourselves: the precious and preserved parts.

Leaving the Island

Much like Tom Hanks in the film Cast Away, the island serves as a metaphor for our own self-containment. It is isolating, endlessly frustrating, lonely, and safe. It is a place one could live out a lifetime in the experience of nothingness. The only escape represents potential death … and simple change: the unknown. This is the experience of the freeze state. A giant ocean lies between you and the world, with no direction or guarantee of reaching that life of which you dream.

Reminders, Tips, and Tricks for Overcoming Internalized Oppression

You may notice a sense of overwhelm in considering reaching out for help for internalized oppression. I often recommend simple self-compassion and permission to take things slow. This is gradual exposure to life, building tolerance for change. Even two minutes at a time can help. Consider support groups or one-on-one counseling with a specialist in complex trauma, childhood abuse, or learned helplessness.

Thanks for your question. Six years is a long time to be living with this kind of uncertainty! And not only is this situation more common than you might realize, but the concept of certainty, or security, is often at the heart of this existential dilemma—which is something all of us want and need, though it often proves elusive.

When we begin an affair with someone who is unavailable (via marriage or otherwise), there is certainty in the fact we definitely want him or her but can’t. This creates a very specific kind of focus around the question, “Will he or she leave or not?” If the answer is “yes,” very often it seems to be “evidence” of our worthiness: that we and not the other woman (or man) is the winner. We may start to feel resentful of our lover’s spouse, thinking he or she doesn’t deserve the one we love. There may be guilt, too, or most likely a mixture of conflicting feelings and desires.

Then one day it happens, and he or she is ours—except the imagined happy life we’d been yearning for isn’t exactly all that; it may even be more complicated, our feelings difficult to untangle. It’s common that, rather than wanting the partner to choose us, we find ourselves preoccupied with “proof” that the past will not repeat itself, that our beloved will not leave us for someone else.

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The reasons for this are varied, and some or none or all of what I’m about to say will apply to your situation. Take what you like and ignore the rest. But just know that this kind of thing happens more often than is discussed (for obvious reasons).

There is a safety (i.e., certainty) in becoming involved with someone who is unavailable; we can love while focusing on the wanting, rather than the vulnerability that comes with actual availability. I don’t think we’re to blame entirely; this arrangement usually fits a template of our early experiences where caregivers were sporadically or consistently unavailable. It is absolutely thrilling to be chosen over an “outside” person, in a reversal of what we experienced earlier, where caregivers appeared more interested in things besides us (another child or family, for instance), which of course is a terribly painful abandonment that follows us into adulthood in the form of insecurities, needs, hopes, etc. To be chosen over another appears to be a reversal of abandonment that lands us on solid relational ground at last. We can then finally create or co-create the well-founded home we have dreamed about.

But how solid is it? After all, we might then ask, “Well, if he or she left his/her spouse before, who’s to say he/she won’t do it again?” Behind or beneath this question are a slew of factors that I think may be worth some serious reflection, either alone, with a trusted friend, or with a counselor. I would suggest doing this before going to your husband to verbalize any concerns.

It can be disconcerting that certain fears never go away. We learn to live with them, tolerate them, but they can never be banished, especially if we experienced relational traumas early on, such as abandonment, neglect, or abuse. We may have felt unabandoned when he or she chose us, but the underlying fear—because it is rooted in our own histories and psyches—hasn’t been banished, leaving us to wonder if we may, in fact, be abandoned yet again. The “proof” we were seeking is not, it turns out, as iron-clad as we hoped; there are no guarantees he or she won’t leave us for someone else. (There is never such a guarantee, actually.)

The traumatized, wounded part of ourselves needs to be heard, and this is, in part, a way of announcing itself. The critical voice within may attack us (or our partner) for the “wrongness” of what happened (“how could you be so selfish or reckless,” etc); there may be guilt about how this relationship has come to be, but most often this, too, is connected to the terror of abandonment (i.e., a repetition of actual past abandonment), and our yearnings for connectedness are suddenly subject to self-doubt, and questions arise about whether we’re worthy of happiness. (“You’re not all that; you’re a cheater, too,” and so on.) Of course, certain qualities or behaviors of our partner may stoke these fears, but if we truly, at the core, did not trust this person, we would never have pursued him or her. These fears are spurred for the most part by the historical trauma I’m discussing herein. We may zoom in like a laser on possible “signs” of such abandonment happening and interpret them as such, stoking our anxieties, but the cause of it is usually a terror of yet another experience of being left behind.

It’s something of a cliché in our pop culture to believe that (as Sting once sang), “if you love someone, set them free.” But the existential truth, I believe, is that we really do have to give our partners the dignity of their choices, and your partner has chosen to be with you now. That same respect is due us, since I believe that the majority of us are not malevolent and are, in the main, doing the best we can. Why not give the relationship a chance? It probably has a better chance if you take the risk of trusting him; otherwise, it could become a self-fulfilling prophecy where fear and anxiety suffocate any chance you might have. We can’t always help who we love; the point is to understand our choices rather than simply give them the thumbs-up or -down. I think the more important question is why we choose who we choose, rather than it being “right or wrong” (which only obscures the deeper issues).

Of course, once you have a clear sense of what those underlying motives are—once you understand what “your side of the street” looks like in terms of facing your inevitable psychological demons—then you might be able to reveal your vulnerabilities to your partner and verbalize what does and doesn’t help you in your personal quest for healing. (For example, “Do you mind telling me where you’re going for the time being? I appreciate you indulging me in this as I work on myself.” As opposed to, “Where are you going? Who are you seeing? What are you up to?”) Our partners can greatly support but cannot replace that healing process. In a way, we need these types of things to show us where the healing needs to occur. The danger is in expecting that a relationship can supplant past injuries. Vulnerability is inevitable.

Paradoxically, making peace with the worst of the past seems tied to a more secure future. Thanks again for writing.

Best wishes,
Darren

A senior couple holding hands watches the seaEditor’s note: Mona Fishbane, PhD is a clinical psychologist and the author of Loving with the Brain in Mind: Neurobiology & Couple Therapy. Her continuing education presentation for GoodTherapy.org, titled Neurobiology and Couple Therapy, is scheduled for 9 a.m. PDT on December 12, 2014. This event is available at no additional cost to GoodTherapy.org members and is good for two CE credits. For details, or to register, please click here.

Falling in love is easy, and delicious. I remember the moment I fell in love with my husband—what I was wearing, how beautiful his eyes looked, the bright, cold February day. I saw the two of us in Technicolor and the rest of the world in black-and-white. It was a heady time; I was crazy in love.

Now I understand the science behind what was going on in my brain back then. Neuroscientists have studied madly-in-love folks, putting them in the fMRI machine while they look at a photo of their beloved. The parts of the brain that “light up” while looking at the lover are the same brain areas activated by cocaine—the reward centers. These researchers concluded that love is like a drug. I’ve never tried cocaine, but I’ve certainly tried love, and it is indeed a high.

Mona Fishbane
Mona Fishbane, PhD

We were awash in the chemicals of early love: testosterone (the hormone fueling the sex drive in both men and women), dopamine (focusing on “that special someone”), and oxytocin (the bonding hormone/neurotransmitter). I didn’t notice my lover’s flaws, nor he mine. It turns out that in early love, the critical part of the brain goes quiet. This is the science behind “love is blind;” we see our lovers through rose-colored glasses. Perhaps this is nature’s way of helping us bond with the beloved, oblivious to the problems that lie ahead.

Waking from the Spell

Crazy in love is a temporary state; the brain can’t stand the intensity forever. At some point the critical parts of the brain come back online, and we see our partners, warts and all. The jazzed-up chemicals settle down, and our drug high gives way to a calmer brain state. Romantic love, researchers find, yields to a tamer version, called companionate love. This happens somewhere between a year and three years into a relationship. Many couples are deeply disappointed when their romance fades into a more sedate version. They crave the high of early love, dopamine and all. Some have affairs, or divorce and remarry, seeking another hit of the drug. But eventually the new relationship will become old. The challenge: How to nurture love over the long haul? 

From Crazy in Love to Lazy in Love

When the newness and the magic fade, many of us become lazy in our relationship habits. Instead of dressing up for our beloved, we wear sweats to dinner. We become lazy in our interactions, blaming our partners when upset, not giving them the benefit of the doubt.  We become reactive to the negative, and overlook the positive in our relationships. We expect unconditional love, no matter what we dish out. But adult love is not unconditional; our partners may leave us if we behave badly.

Proactive Loving vs. Passive Loving

“I still love my wife, but I’ve fallen out of love with her,” a man said to me recently. He’s missing the hit of the drug, and is thinking of looking elsewhere for that love high again. To my mind, “falling out of love” sounds so passive—like falling into a pothole! I propose a more proactive view of long-term love, in which both partners work to create a great relationship. Once the initial glow wears off, the real work of loving begins. The stakes are high; while happy relationships are associated with health and longevity, the stress of an unhappy marriage can result in illness and earlier death. [fat_widget_relationships_left]

Researchers such as John Gottman have identified the secrets to successful relationships. In longitudinal studies, he compared happy couples (he calls them the “masters”) and unhappy couples (the “disasters”). Happy long-term lovers are emotionally and socially intelligent. They nurture positivity and don’t get lost in negative reactivity with each other. They are generous, fair, and kind, practicing what I call “relational virtues.” When they hurt each other, these successful partners apologize. It turns out that love means having to say you’re sorry—a lot!

Nurturing the Positive in Your Relationship

So how can couples develop these skills of emotional and social intelligence? One of the most important skills is the ability to regulate your own emotions when you get upset. It’s so easy to “let it rip” and have a temper tantrum when your partner does something you don’t like. But staying calm in the face of stress is vital if you want to be a good lover. You also need to take responsibility for your own reaction rather than blaming your partner. As the wise Roman stoic philosopher, Seneca, said long ago, “Most powerful is the person who has himself in his own power.” Rather than getting into power struggles, each person can try to be his or her best self in interactions with one another. And partners can make room for mutual empowerment; research shows that happy relationships are more equal and respectful.

Happy couples do a lot to cultivate a positive tone in their relationship. This can be challenging, though, because our brains are biased toward the negative—better safe than sorry, so we notice an attack or danger more readily than we see the lovely things our partners may offer us. To counteract this negativity bias, many psychologists now encourage actively focusing on, noticing, and savoring the positive. One couple I know has a “Blessings Jar;” each time they notice something positive the other one does, they jot a note and put it in the jar.

For couples caught up in cycles of negativity, unable to notice the positive and having difficulty regulating their own emotions, couple therapy can be enormously helpful. Most people don’t act in nasty ways intentionally; they get triggered in interactions with their partners, and have a meltdown. And then they may blame their partners for the whole mess. Therapy can help partners take responsibility for their behavior, learn skills of emotional and social intelligence, and cultivate positivity. This is empowering, as they share the responsibility for building a relationship in which they can flourish. Rather than feeling like victims who blame each other, these couples become co-authors of their relationship.

The bottom line: To be a good long-term lover, there’s no free lunch, and there’s no free love. Love that lasts takes work. Happy couples do this work gladly, reaping the benefits in body and mind.

Stressed woman in metro station holds her head in her handsSix million Americans—almost 3% of the population—have panic disorder, a condition that causes sudden, overwhelming sensations of fear called panic attacks. Studies on twins suggest panic disorder may be partially genetic, and there’s good evidence that panic runs in families. Researchers know little about which, if any, specific genes cause the condition.

New research into a so-called “suffocation alarm,” though, may shed light on panic’s genetic underpinnings. The study, published in Biological Psychiatry, suggests that the shortness of breath so common to panic attacks might be linked to the body’s suffocation prevention mechanism.

Could a Suffocation Alarm Cause Panic Disorder?

Shortness of breath and feelings of suffocation are common among people who have panic attacks. These symptoms are so terrifying that many people who experience a panic attack believe they are dying; panic attacks account for more than 20% of emergency room visits. Previous research into these sensations suggests that breathing in carbon dioxide can trigger panic attacks in people with panic disorder, but not with people who don’t have panic disorder.

Based on that research, this study’s authors theorized that panic attacks might be linked to an excessively sensitive “suffocation alarm” in the brain. Previous research on mice showed that a protein called ASIC1a helps detect carbon dioxide in the brain’s amygdala, an area that’s also linked to feelings of fear. To study the role this protein might play in humans, researchers genotyped variants of the gene in 414 people with panic disorder, then compared them to 846 controls without the disorder. They also used brain imaging and genotyping to evaluate amygdala volume in a second group of 1,048 participants, as well as amygdala function in 100 people. [fat_widget_left]

They found that people with variants of the ASIC1a gene were more likely to have panic disorder. Moreover, people whose panic attacks caused respiratory symptoms such as shortness of breath were much more likely to have the gene. The researchers also found that the ASIC1a gene can affect the size of the amygdala, as well as people’s emotional responses to threats. The effect held even among people who had the gene but who did not have panic disorder.

Avoiding suffocation is one of the many tasks associated with survival. It’s possible, the study’s authors speculate, that fundamental survival mechanisms cause panic attacks. The ASIC1a gene could be a helpful mutation in environments that pose a high risk of suffocation, but a source of panic and distress in people who have the gene and who do not regularly face suffocation dangers.

References:

  1. Facts & statistics. (n.d.). Retrieved from http://www.adaa.org/about-adaa/press-room/facts-statistics
  2. New York-Presbyterian/Weill Cornell trial is first to show effectiveness of psychodynamic psychotherapy for panic disorder. (2007, March 13). Retrieved from http://weill.cornell.edu/news/pr/2007/03/newyork-presbyterianweill-cornell-trial-is-first-to-show-effectiveness-of-psychodynamic-psychotherap.html
  3. The brain’s “suffocation alarm” – new study reports on a genetic clue to fear. (2014, December 3). Retrieved from http://www.medicalnewstoday.com/releases/286343.php

Caring FriendVictims of domestic violence will sometimes display specific behaviors or attitudes that make loved ones unsure about how they can help. Please keep in mind that victims of domestic violence are very capable and strong. Their reactions to their experiences are normal, human reactions in the face of abuse and complex emotions, including issues with children, finances, and love and attachment to the abuser, among many other complexities that accompany this type of situation.

Below are five common reactions that victims of domestic violence may exhibit and how you can respond and help.

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1. Denial

In this scenario, the victim is in denial that the abuse is happening. Even though his or her loved ones are noticing abusive behaviors, he/she pretends everything is great.

2. Defensiveness

In this scenario, the victim comes to the defense of the abuser and is not open to discussing the abuse or leaving the situation.

3. Wishy-Washiness

This is a situation in which the person goes from one extreme to the other. The victim will ask for help and either leave the relationship or express a strong desire to leave. A short time later, he or she justifies the abuser’s behavior and returns to the relationship. This can be very frustrating for loved ones; sometimes, loved ones may feel like giving up on the person.

4. Withdrawal

It is not uncommon for victims of domestic violence to become completely withdrawn and hard for loved ones to access. This could partially be due to the abuser isolating the victim to gain more control over him/her and could be compounded by depression and negative self-views, which is common in victims of domestic violence.

5. Fear

In this scenario, the victim expresses he or she wants to leave, but has fears about leaving. These fears are valid, and major barriers to leaving a violent relationship do exist. Common barriers are threats by the abuser of killing the victim and/or children if he or she leaves, harming pets or children, and financial concerns and constraints, to name only a few.

Of course, it is important to keep in mind that every situation and person is going to be different. It is not uncommon to see a combination of the above reactions. Keep in mind that these are complex situations that don’t always have simple solutions. If you suspect that someone you love is in an abusive relationship, connect with the National Domestic Violence Hotline, your local domestic violence coalition, or click here for additional suggestions and support.

Mother and daughter (8-9) doing arts and craftsChildren with attention-deficit hyperactivity (ADHD) often experience intense emotions, behavioral challenges, and low self-esteem. As a result of these experiences, children with this diagnosis may find it difficult to express their emotions and to develop the capabilities needed to control their behavior. In the short term, these issues can make it difficult for the child to have positive experiences that reinforce a sense of self-esteem and self-efficacy. Over the long term, this can have significant implications for their well-being, success, and motivation.

While standard approaches to therapy including medication and behavioral supports are integral to improving outcomes, alternative interventions such as art therapy have proven to be highly effective for addressing some of the innate challenges encountered by children with ADHD. Alternative therapies for ADHD are often overlooked by parents and educators, but there is a wealth of emerging research suggesting that these tools can be instrumental in helping children address some of the core challenges they face every day. For this reason, parents, educators, and counselors should be open to the possibility of using alternative therapies to support the needs of children with this diagnosis.

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One of the most notable alternative therapies available for the treatment of ADHD is art therapy. Art therapy works in a number of different ways to lessen the impact of many of the negative consequences of ADHD. For instance, art therapy, which utilizes a number of different approaches for nonverbal creative expression, can help children with ADHD channel their intense emotions without engaging in verbal outbursts. This nonverbal form of expression provides an outlet for the child, which can quell behavioral difficulties. As the behavior of the child improves, the child may experience more positive feedback from educators, counselors, and parents. Over time, this may have a significant effect on the child’s self-esteem. As the child gains confidence, his or her behavior will improve dramatically, further reinforcing positive outcomes in all areas of development.

Art therapy has also been shown to increase attention span for children with ADHD by providing a source of focus. Art is a natural part of play in children’s development, and often children with ADHD are able to select art projects that interest them. With an art project of their choice, children with ADHD are given an outlet upon which to focus. Although the duration of attention to the project may increase over several sessions, the process is one that builds the capability of the child with ADHD to channel energy in a positive way that results in accomplishment. This also has an impact on the child’s self-esteem. Often children with ADHD are punished for their inability to pay attention or focus. By teaching this basic skill to children, art therapy can provide an important bridge for utilizing focus and attention skills in the classroom and at home.

Art therapy can also provide a foundation for the child to explore his or her identity. This can be a powerful process, as children with ADHD are often defined by labels and behaviors. For children with ADHD, labeling and attention to negative behaviors can make it difficult for the child to define himself or herself in a positive context. Art can connect the child to an inner identity that is positive and therapeutic. By providing this connection, the child can overcome much of the negativity that encompasses much of the child’s daily experience. In short, art can make a child feel good about himself or herself. Although it may take several sessions for children to experience this outcome, providing the foundation for this type of growth will be imperative for helping the child to achieve a better sense of self.

Even though art therapy is a helpful support for many children with ADHD, it is often not offered by schools or therapists. If you believe that your child may benefit from art therapy, you should ask about this intervention and see if educators or therapists working with your child can help. While art therapy will not replace more traditional forms of therapy provided to your child, it may be an important supplemental resource to help build vital social and behavioral skills that are difficult to teach in therapy. Having this additional support can help your child overcome some of the most common deficits associated with ADHD.

GoodTherapy | Breaking Bad Moods: 15 Tips for Shaking the Funk You're InWe have all had a case of the blues. You know, those times in our lives where the world looks bleak and things just don’t seem to be going in our favor. No matter how hard we try to turn things around, it seems to end up as wasted effort and all we can do is throw our hands up and ask, “Why me?” But as much as we resist our sadness, anger, frustration, or grief, it is often during these dark moments when we come to realize we have the greatest opportunity for transformation.

Finding yourself in a funk you cannot seem to shake?

Here are 15 tips to transform your bad mood and learn from it in the process:

  1. Acknowledge and accept it: You have probably heard the phrase “resistance is futile.” Fighting against negative feelings will not make them go away. If you find yourself in a dark room, you will not make it light by pretending it is not dark. You must, at some point, acknowledge that it is dark before you search for light. In order to change your mood, you must first admit to yourself how you are feeling.
  2. Reframe your bad mood: Every experience can serve as a lesson. When you experience mood changes, examine the triggers behind your emotions and try to reframe your thinking. Emotional reactions can teach us a great deal about our personal values and desires. Rather than see your bad mood as an enemy, reframe it as a friend that’s there to help you learn about yourself and grow as a person.
  3. Cultivate gratitude: When you find yourself waking up in a bad mood, try focusing on what you are grateful for. Many people tend to focus on a bad event or situation that isn’t unfolding according to plan, rather than looking at all the good things surrounding the event or situation. Taking a few moments to build a simple list of things you are thankful for each day can greatly improve your mood and change your outlook.
  4. Monitor your thoughts: If you seem to always be in a bad mood, start monitoring your thoughts for negativity. Our thoughts typically precede our emotions. If we consistently engage in negative self-talk, it is virtually impossible to feel good about ourselves. Try to remain aware of your thoughts throughout the day, or consider keeping a journal to help you shift your negative thoughts into positive affirmations.
  5. Remember, you are not your emotions: It’s easy to get so caught up in emotions that we become them. We often hear people say, “I’m angry,” rather than “I have anger.” Emotions are passing experiences. When we can become the witness consciousness—able to observe closely without reactivity or judgment—and separate ourselves from our emotions, it is easier to stay centered and at peace.
  6. Exercise: Exercising releases endorphins, which create a positive feeling in the body. Regular exercise has been shown to improve mood, alleviate symptoms of anxiety and depression, and reduce stress.
  7. Meditate: Meditation not only helps us monitor our thoughts and feelings, but it also brings us into the present moment. Many times, when you are in a bad mood, it might be over something that occurred yesterday or even last week. When we come into the present moment, we can experience a sense of freedom and peace.
  8. Try something new: The daily grind of life can start to feel mundane, and a lack of stimulation or excitement can contribute to a bad mood. Novelty awakens the senses and sparks our curiosity. Try something you’ve never done and enjoy the benefits of shaking up your routine.
  9. Talk to someone: Sometimes, simply speaking your thoughts aloud and sharing your feelings with others may help you feel better. Consider talking to someone you trust, such as a friend, family member, or qualified therapist.
  10. Get creative with your emotion: Emotions are meant to be expressed, not repressed. When you feel like you are in a bad mood, try using your favorite creative means to express your feelings. Write a poem, play an instrument, draw, paint, dance, or craft—whatever moves you.
  11. Spend time in nature: Spending time outside naturally relieves stress. Sunlight, fresh air, and living plants tend to provide us with a sense of invigoration and aliveness. Going outside also gives us a great excuse to exercise. Try going for a bike ride or a walk or hike in the woods next time you feel down in the dumps.
  12. Pay it forward: Giving evokes feelings of gratitude and promotes feelings of goodwill. Giving is also known to release oxytocin, a feel-good hormone in the brain. Shifting your focus away from yourself and onto someone you care about may help you gain perspective and feel a stronger connection to others.
  13. Focus on self-care: When you’re down in the dumps, it is easy to let your self-care regimen fall apart. Taking care of ourselves is essential to making sure that we feel good physically, emotionally, and mentally. Among other important things, make sure you’re eating a healthy diet, getting plenty of rest, and effectively managing your stress.
  14. Set attainable goals: Studies have shown that people experiencing depression often set unrealistic goals. While setting goals is a great way to motivate oneself, setting unattainable goals will only increase our feelings of dissatisfaction and hopelessness. Consider working with a life coach or therapist to help you create realistic goals and set them into action.
  15. Forgive yourself: Sometimes when we ask ourselves, “Why am in a bad mood?” we may find it is due to feelings of shame, regret, or guilt over mistakes we have made in the past. Forgiving ourselves is typically more difficult than forgiving others. Remind yourself that you are human and that life is a learning process. Let go of your mistakes and focus on how you can do better in the future.

Know When You Need Help

[fat_widget_right]If you have tried unsuccessfully to improve your mood and nothing seems to work, consider reaching out for help. Depression and chronic bad moods can seriously affect a person’s quality of life and lead to more serious mental health issues. The great news is that depression is highly treatable, with 80% to 90% of those who seek treatment reporting relief. If mood changes persist for a long period of time or you continue to feel down, consider finding a therapist or counselor near you.

References:

  1. Public Broadcasting Service. (n.d.). Depression out of the shadows. Retrieved from http://www-tc.pbs.org/wgbh/takeonestep/depression/pdf/dep_stats.pdf
  2. Strunk, D., Lopez, H., & DeRubeis, R. (2006). Depressive symptoms are associated with unrealistic negative predictions of future life events. Behaviour Research and Therapy, 44. Retrieved November 28, 2014, from https://psychology.sas.upenn.edu/system/files/Strunk Behav Res Ther 2006 Negative Predictions.pdf
  3. Zak PJ, Stanton AA, Ahmadi S (2007). Oxytocin increases generosity in humans. PLoS ONE 2(11): doi:10.1371/journal.pone.0001128

GoodTherapy | How Much Freedom Should Parents Allow Teens to Have?Sometimes, though, being too protective and/or rigid can backfire and the teen will rebel. The key is to create a balance between dependence and independence as the adolescent slowly transitions to adulthood, typically between the ages of 10 and 25.

While many parents underestimate their teen’s readiness for certain privileges and freedoms, most teens overestimate their readiness to take on certain privileges and responsibilities. I typically tell teens that “freedom equals responsibility,” meaning that one needs to demonstrate responsible behavior before expecting to have certain freedoms. For example, if I am to have the freedom of driving a car, I need to demonstrate that I am responsible enough to follow traffic laws, have my driver’s license, car insurance, etc.

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Parents and teens often experience a push/pull in their relationships when deciding what freedoms are appropriate for the teens to have, which can create a lot of stress within the family system. The fact a teen is motivated to push for more freedom and independence and the parent’s task is to guide and protect the teen means there is often discord. This is a normal part of the process of transitioning from adolescence to adulthood. The transition is a period of regular readjustment and can intensify conflict between parents and teens.

Parents are responsible for instilling values in their children about what is right and what is wrong. Given that teens often feel a sense of entitlement to make their own decisions about issues that impact their lives, it is important for parents to have clarity about the contexts in which they will exercise their authority and in which contexts they will allow more freedom. While teens undoubtedly will make mistakes, parents need to trust them to make some of their own decisions and to learn from their missteps.

There is no way for parents to know for certain if their teen is going to make the wrong choices. The chances of a teen making the right choice are increased when parents believe in the teen’s ability to do so. That said, trust must be earned—and in order to earn trust, teens must act responsibly. In order for teens to grow up, they need to have the opportunity to experience the freedom of making their own decisions (age appropriate) and the opportunity to learn from mistakes. When parents place a certain level of trust in their teen, the teen will be more likely to respect the parents as well as their rules.

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.