For people who define themselves as socially awkward, the perceived risk of being seen in endlessly negative ways—inadequate, ugly, boring, stupid, anxious, depressed, empty, arrogant, fat, pathetic, etc.—is always present. When I think about people in therapy who see themselves as socially awkward, I find little correlation between how I experience each individual as a social person and how they think of themselves. Every one of them seems to have characteristics that I enjoy and admire, and they are often (but not always) in occupations of respectable social status. However, for the “socially awkward” person who supposedly “knows” how little they have to offer to the world, the facts of their occupational status or character are irrelevant.

What I have come to recognize about many people in therapy who feel severely socially awkward is that they share the belief that when they were growing up they missed out on learning the rules of social discourse. As a consequence, they are intensely anxious about how they will be responded to if they are socially off the mark. For example, Robert, an attorney, worries about phone calls and what to do after you say hello. Paula, an information technology manager, panics about being in a social situation and not knowing how to approach someone. Tanya, a college graduate, unemployed for the past year, keeps asking “what are the rules, how long do you talk with someone at a party and how do you get yourself out of a conversation?” Everyone worries about silence and eye contact.

While many of us might experience similar social concerns, a “socially awkward” person believes that their anxiety and inability to navigate these situations will be blatantly evident, and they expect to be responded to with rejection and disgust. Even when there are no evident responses that confirm their fears, such people continue to experience bad feelings about how they behaved and consequently justify their continued self-attacks and self-hate.

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Parental Expectations

A major source of the feelings of social inadequacy and the consequent self-hate that people often express is related to parental expectations. Both Tanya and Robert had parents with very high expectations. Robert talked about his parents pushing him to work harder at all the extracurricular activities they insisted he engage in: “They thought I was a virtuoso and kept pushing me to do more with the violin. My mother kept telling me what a wonderful writer I was and that I should try and get published. But she also insisted on critiquing any creative writing I tried.”

Tanya described how her parents pushed her to succeed in high school so she could get into an Ivy League school: “They would compare me to their best friends’ son and list all his achievements. On the surface, they seemed to be saying they thought I had what it took to be superior. But I never felt I could really be good enough, no matter how well I did. I upset them when I didn’t apply to Harvard, but I couldn’t bear the thought of disappointing them by not getting in.”

Paula also was negatively affected by her parents’ expectations. They wanted her to “be good.” The worst thing she could do was make anyone outside the family think any negative thoughts about her. This would shame and humiliate her parents and result in physical or verbal abuse. The most Paula could hope for from her parents was to avoid anger and criticism. She recalled: “My mother would scream and berate me if I didn’t smile the right way at a neighbor. I remember, when I was about 9, she dragged me from the Thanksgiving table at my aunt’s house because I didn’t say ‘please’ when I asked for the turkey. I was a very scared kid and never knew when I was going to get hit or criticized. I never knew what the right thing to do was. I still don’t know.”

The Importance of the Audience

Robert and Tanya needed to be high achievers so the parents could feel pleasure and ego satisfaction about their parenting. By pushing achievement on their children, the message, consciously and unconsciously, was that you must do more, be better, and shine or you will hurt and disappoint me. For all three people in therapy, the ultimate authority on how they were doing as children was the social audience their parents looked to and empowered. Most importantly, the incredible power of the “audience out there” cast the final judgment on how the parents were doing.

Without audience approval, the parents felt inadequate and humiliated and put the responsibility for these bad feelings onto their child. The parents held the child responsible for their own feelings of inadequacy, which were then attributed (projected) to the child who was designated as inadequate. The child not only felt the shame of insufficiency, but experienced the badness of having socially hurt, disappointed, and shamed the parents. It is no surprise, then, that for the humiliated, “inadequate” child, the social world would feel like a constant source of scrutiny with the mission of detecting and identifying the guilty party.

Developing Feelings of Social Adequacy

These three individuals have great certainty and strong emotional attachments to their belief that they are socially inadequate people. While they typically begin therapy with some hope that they can do something to improve their experiences, feelings of hopelessness often outweigh the hope. The journey to feeling more socially able begins with people becoming aware of the ways in which their social awkwardness has been shaped and confirmed by their early and continuing life experiences. While this provides a rational understanding of how their feelings of social inadequacy developed, it does not alter the strong emotions that arise when they find themselves in social situations.

I often hear about their intense anxiety in social situations and how they become panicked. With intense agitation, they scan faces of others to detect the expected negative reactions. If I wonder how it would be if I helped them to strategize for a social situation, the response is usually negative: “It won’t work; I’m too anxious; it’s useless.” I believe this is an expression not only of hopelessness but of the self-hate that the person feels. If I can help the person reflect about this and put his self-hate into words, it can help break through the paralysis and allow the person to agree to try and practice some new behaviors before a social situation.

Even when a person may bravely go to the party and try out a strategy, it is unusual for the person to feel that he or she has had success. As Robert told me: “It was horrible. I saw a woman standing alone near the bar and I went over to her and introduced myself and asked her name and how she came to be at the party (like we planned). I couldn’t make eye contact very well, but I tried. She did answer my questions, but then this other girl came over and started talking to the first girl and I panicked. I couldn’t say anything and left.”

The example above illustrates how, even with a strategy, it is difficult to succeed with the plan. What is even more difficult is to change the negative feelings about one’s self that influence our social behaviors. With considerable work, repeated experiences of small successes can lead to incremental but steady changes in behavior and self-perceptions.

I am going to list some steps that represent what happens in the therapy process that can help in altering self-defeating behaviors and feelings of self-hate and social inadequacy. To undertake these steps, with or without the help of a therapist, requires commitment to tolerate frustration and painful unwanted, and intolerable feelings. There must be a willingness to fail and try again repeatedly.

Steps to Changing Feelings of Social Inadequacy

1. Gain knowledge through self-reflection to hypothesize how your “social awkwardness” has been shaped and confirmed by your life experiences.
2. Self-talk to remind yourself of (1) positive qualities, (2) feelings that seem intolerable, and especially (3) your resilience, i.e., ability to withstand those intolerable feelings. (After all, you are still standing and functioning, and have had many encounters with those feelings, and you’re still here.)
3. Develop strategies to help manage behavior in social situations, e.g., what to say when approaching a stranger at a party or subjects to talk about on a date. (Google your questions if you can’t come up with your own strategies.)
4. Try out behaviors and be prepared to fail.
5. Learn to see failed attempts as success. This means overriding old patterns of self-attack and bad feelings and allowing yourself to feel courageous for trying.
6. Try out behaviors again and be prepared to fail again.
7. Keep trying to feel successful for trying.
8. Repeat steps 1 through 7 as long as necessary until you begin to feel more positively about yourself and more able to tolerate your unwanted feelings.
9. Come up with a new thought which reflects positive feelings about yourself.
10. Come up with a new thought about yourself as someone who is feeling a little more socially adequate.
11. Allow yourself to consider that you can change and be aware of your anxiety about change.
12. Keep repeating steps 1 through 11.
13. Never stop working on developing positive feelings about yourself.
14. Never stop working on your ability to tolerate unwanted feelings, change your behavior, and feel positive about yourself.

Note: To protect privacy, names in the preceding article have been changed and the dialogues described are a composite.

Hoarding is a serious mental health condition that can expose people who do it to dangerous living conditions, the derision of family and friends, and social isolation. About 5% of the world’s population hoards, but only about 15% of people who hoard recognize that their behavior is irrational. If you’re concerned about someone you love who hoards, you can’t force your loved one to get better. You can, however, provide a supportive environment that encourages your loved one to seek help and makes recovery possible.

Don’t Take Their Possessions

If your loved one’s house is covered in old magazines or unused clothes, it can be tempting to “cure” him or her by taking the items he or she hoards. This won’t remedy the underlying problem, though, and it can destroy your relationship with your loved one. Moreover, people who hoard can experience serious emotional distress when their possessions are taken, so your good intentions may actually harm a person you love.

Don’t Enable the Behavior

While you can’t stop someone who hoards from hoarding, you can avoid enabling the behavior. If your friend hoards antiques, don’t invite her to go antiquing. If your mother is a compulsive collector, don’t add to her collection at every birthday and holiday. Don’t offer to store hoarded items for a loved one, and if you live with someone who has been hoarding, don’t allow their possessions to overtake your home.

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Educate Yourself

To the outside observer, hoarding just doesn’t make sense. If you want to help a loved one, learn as much as you can about this condition by reading websites, consulting mental health professionals, or even attending a support group for people who want to love and help people who hoard. Once you understand the fear, loneliness, and anxiety associated with hoarding, you may be better able to offer empathy and support.

Recognize Small Victories

Particularly among people who hoard who have had the habit for years, it can take months or years to get rid of hoarded possessions and for progress with the issue to become visible. If your loved one doesn’t feel like small victories matter, he or she will have little incentive to keep trying. Help your loved one celebrate small victories by praising them for throwing away a few items or refraining from buying new ones.

Help Them Sort Their Belongings

Some people who hoard accumulate so much stuff that it fills an entire house. Even after your loved one stops hoarding, he or she may have an entire home filled with hoarded items. Volunteer to help your loved one sort through his or her items and clean out the home. Some companies specialize in helping those who have hoarding issues clean up, so if you and your loved one are daunted by a packed home, consider contacting an organization that can help.

Don’t Clean Up for Them

Although helping your loved one sort his or her possessions can be helpful, doing it for him or her is not. Likewise, you can’t expect that the person in your life who is hoarding will make progress if you force him or her into treatment. These individuals need to make independent decisions, and this might mean waiting to intervene until the person you love is ready for help.

Help Your Loved One Find Treatment

Taking the first step toward treatment can be daunting, and it’s not always easy to find a qualified therapist. Don’t force your loved one into treatment, but consider researching treatment providers so you can offer information when your loved one is ready. GoodTherapy.org can help you find a therapist who specializes in hoarding.

References:

1. Hoarding and OCD, stats, characteristics, causes, treatment and resources. (n.d.). Retrieved from http://www.namimass.org/hoarding-and-ocd-stats-characteristics-causes-treatment-and-resources
2. Hoarding: The basics. (n.d.). Retrieved from http://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/hoarding-basics
3. How to help the hoarder in your life: Some suggestions. (n.d.). Retrieved from http://www.ocfoundation.org/eo_families_of_hoarders.aspx

Thank you for this question. Handling the extroversion/introversion combination in a couple is something that many couples face. I’ve seen it quite frequently in my practice. Your “opposites attract” reference makes a lot of sense to me in understanding this dynamic. In the early days of dating, the extrovert/introvert match can create a certain ease in the interaction—the introvert can sit back, observe, and reflect on how he/she is experiencing the date while the extrovert can process his/her experience of the date by talking, sharing, asking questions, and driving the conversation. After the first couple of dates, the introvert can go home and quietly reflect and the extrovert can go home and talk about the date with friends and family.

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Everything moves along quite smoothly until casual dating turns into a more serious relationship. At this point, some of the challenges of the introversion/extroversion combination start to become clearer. That seems to be where you and your boyfriend are now. Like most extroverts, it sounds like you thrive on having a very active social life and you want your boyfriend to be a part of that social life. But, like most introverts, he probably thrives in a quieter environment with more solitude.

Extroverts tend to have a preference for, and gain energy, by engaging in an external world of people and things. Introverts tend to have a preference for, and gain energy by, engaging in an internal world of thoughts and ideas. It’s important to understand this concept because it can help both of you avoid taking these things personally. Absent this understanding, your boyfriend might feel controlled and scheduled by your attempts to include him in your social life, and you might feel rejected by his hesitation. Another benefit of fully understanding this concept lies in the word preference—neither of you is dealing with an inability here, and that means you can both compromise. For example, when you are hosting, maybe your boyfriend can be there for an hour or two and then he can slip out and return when the gathering is over. Or perhaps there can be an agreed-upon limit on the frequency or duration of the gatherings.

I think open and honest communication is going to be the key here. If you two can develop a deeper understanding of where you are each coming from and the role that your preferences toward introversion and extroversion are playing, you’ll likely be able to come up with some compromises that feel agreeable. Working through this process together may even improve and deepen the relationship that you have with each other. If you find you are having trouble getting through these conversations on your own, consider enlisting the help of a couples therapist. I know you mentioned your boyfriend was not interested in individual therapy, but perhaps he would be agreeable to couples therapy that focused on addressing this issue in your relationship.

Best wishes,
Sarah

When a friend or loved one has been impacted by a traumatic event, it can be distressing and confusing to stand with them and watch them try to deal with the effects of such an experience. It can also feel overwhelming to the person trying to help or support when they don’t feel as if they have the tools necessary to respond to the traumatized person.

If you are wondering what you can do to be supportive to a person dealing with a recent trauma, here are some places to start:

1. Listen. Telling our stories is powerful and healing for human beings. It helps us to make sense of what has happened, to consolidate our memories of the events, and to feel heard and supported. Doing what we sometimes call “active listening” can be really important to survivors of trauma. This means devoting your attention to the act of listening carefully—without judging, interrupting, or making self-referencing comments. Asking questions is, however, an important part of active listening, as it shows that you are interested in getting the details right.
2. Don’t judge. Try to assume a stance of curiosity about the person’s story. Judgments are a heavy burden that trauma survivors become all too familiar with. Don’t add to this burden. Often, the person is struggling with internal judgments about the trauma and their reaction to it. You can help by simply supporting the person without implying that they should (or shouldn’t) have done something differently, that they did the right thing or the wrong thing, or that there was anything about the event(s) that was good or bad. The words in italics are words to avoid when discussing with a survivor the event(s) they are dealing with and/or how the person is coping in the aftermath.
3. Don’t pathologize. It is normal for human beings to feel grief, pain, rage, despair, and/or fear after a traumatic incident. Often, people will work through this on their own after a period of time, come to understand the event(s) in a way that works for them, and resume their typical engagement in everyday life. Give them a few weeks—don’t label what they are going through or make it sound like an “illness” or “disability.” As therapists, we don’t view having this response itself as problematic; we start to see a problem only if, after a couple of months, these responses are still interfering with the person’s ability to engage in daily life. In that case, you may wish to speak with the person about finding some professional support, but do so in a nonjudgmental way that is open to and hears the person’s thoughts about this.
4. Take care of yourself. Being a support person for a person dealing with deep pain can in itself be distressing and overwhelming. Sometimes this can even result in what we call “secondary traumatization”—feeling the effects of the trauma yourself. Give yourself permission to do the little things that nurture you and bring joy as you provide support to a person in distress. Be mindfully aware of your own level of distress, energy, and need for support. Learn a little bit about normal trauma responses (such as avoidance, arousal, and intrusions) so that you can understand what is happening. If you feel it might be helpful, you might consider seeking professional support for your own needs and keep yourself grounded. Give yourself permission to feel distressed, frustrated, overwhelmed, or confused, and take care of your own needs about this so that you are able to continue to be supportive when you would like to without making the trauma-affected person the target of your own pain or frustration—this can be a difficult cycle that causes more pain for everyone.

Navigating the aftermath of a traumatic event can be difficult for everyone affected—those directly involved in the event and those in the position of continuing to love and support people through their pain and grief. These tools are a place to start for those of you wondering how best to support a traumatized person. It is important to remember that being such a support person is a wonderful gift and a difficult place to be, and to give yourself the permission to struggle with it, to care for yourself and your needs during this time, and to seek your own support and care when you need it.

Traumatic brain injury (TBI) is defined as an “alteration in the function of the brain or other evidence of brain pathology caused by an external force,” according to the Brain Association of America in 2011. Defining brain injury has not been consistent in the medical research because of the complexity of the brain physiology. Improvements in technology has helped improve understanding of the brain but there still remain significant unknowns. Science journalist Carl Zimmer describes the brain as:

• an intricate network of billions of neurons
• a collaboration of neurons in constant communication
• a chemical labyrinth that senses the world inside and outside
• an organ that produces love and sorrow,
• keeps our hearts beating,
• keeps our lungs breathing,
• composes our thoughts,
• and constructs our consciousness.

Nobel Laureate Eric Kandel described the human brain as “the most complex organ in the universe.” Damage to this vital organ can cause significant limitations to a person’s ability to process the activities of daily living and function both mentally and physically. Traumatic brain injury (TBI) happens suddenly but can leave a lifetime of permanent disabilities.

Medical research has not successfully discovered curative interventions to repair the brain to pre-injured status. The lack of proven effective treatments for restoring impairments means focus for interventions is on treating the symptoms associated with the multiply traumatic changes associated with brain injuries. This void in medical treatments indicates the need for psychosocial support for the TBI survivor, the spouse/partner, and family members. The main focus of therapy is 1) to help facilitate adaptation to a changed life, 2) to facilitate a quality of living with limited abilities, and 3) to create a collaborative new reality of well-being.

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Impact on Family Dynamics

Traumatic brain injury does not happen in a vacuum. It is a chronic health issue that affects the entire family. Murray Bowen’s family systems theory explains how traumatic changes to one member of the family cascades throughout the family system. In nature, this is like throwing a pebble into a pond and observing how the water ripples throw out the pond. When one family member suffers traumatic changes, the stress is felt throughout the family system. The established patterns and roles are altered, changing the entire family dynamics. The heighten changes are a major stressor and cause a negative shift in the family’s well-being.

Family members are often described as the “neglected victims” of TBI. Many marriages end in divorce after brain injuries. The loss of an intact family causes further losses for the survivor. The difficulty learning to understand and cope with the monumental changes post injury are some of the reasons there is a need to conduct therapy from a family perspective. The therapeutic process needs to address loss, grief, and adaptation to creating a new life. Maintaining and developing socializations skills as well as a strong support system of family, friends, and a spiritual leader are helpful to the healing process.

‘An Invisible Disease’

There are many challenges to traumatic brain injury that sets it apart from other chronic illnesses. First, it has been described as an “invisible disease” and a “silent epidemic.” It is estimated that 1.7 million people are diagnosed each year. However, these numbers are considered an underestimate because of the lack of visible damages and the subtleties of impairments. The extent of cognitive deficits may not be apparent until much later. The insidious nature of the impairments means family members and professionals may overestimate the abilities of the survivor.

However, trauma to the brain frequently causes pervasive cognitive dysfunction and variety of personality changes, such as impulsivity, anger, fatigue, irritability, unpredictability, and depression. Lack of critical thinking, impaired social perceptiveness, and lack of empathy are also considered hindrances for the lack of awareness the survivor has about his or her own impairments and the decrease in motivation to adapt to a new reality. These problematic issues have a negative impact on martial/couple relationship, family dynamics, and relationships in general. Yet, the research indicates that a meaningful and supportive relationship can contribute to the TBI survivor’s healing from the psychological trauma.

Including Partners and Family Members

The recommended plan of care for the injured person includes psychosocial support for the caregiver, spouse, and family members. The North American Brain Injury Society (NABIS) reports a need for more effective incorporation of family support based on the last decades of research. Marriage and family research has shown that maintaining strong and supportive relationships are integral to helping the survivor cope with challenging changes, as well as for the spouse and family members to adapt to living with a new person.

References:

1. Bowen, M. (1985). Family therapy in clinical practice. Northvale, NJ: Jason Aronson.
2. Brain Injury Association of America. (nd).http://www.biausa.org/index.htm
3. Brey, R. (2006). The silent epidemic: Traumatic brain injury’s massive impact on suffers and society. Neurology Now, 5.
4. National Institute of Mental Health (NIMH). (nd). http://www.nimh.nih.gov/health/topics/anxiety-disorders/index.shtml
5. National Institutes of Health. (2008). Traumatic brain injury: A family finds its way. National Institutes of Health: Medline Plus, 3(4), 2-7. Retrieved from NIH Medline Plus: http://www.nlm.nih.gov/medlineplus/magazine/issues/fall08/toc.html
6. Nichols, P., & Schwartz, R. (2004). Bowen family systems therapy. In Family therapy concepts and methods (pp. 119-146). Allyn & Bacon.
7. North America Brain Injury Society, NABIS. (2008). Barriers and recommendations: Addressing the challenge of brain injury in America. Washington, D.C.
8. Wood, R., Liossi, C., & Wood, L. (2005). The impact of neurobehavioural sequelae on personal relationships: Preliminary findings. Brain Injury, 19(10), 845-851.
9. Zimmerman, C. (2004). Soul made flesh: The discovery of the brain and how it changed the world. New York: Free Press.

About 11% of all children are diagnosed with attention deficit hyperactivity (ADHD) at some point, but some of these children grow into adults without ADHD. A new study suggests that these changes aren’t subjective. Instead, adults who recover from ADHD show distinct brain differences.

How Recovery from ADHD Changes the Brain

Researchers already know that, among adults and children with ADHD who aren’t focusing on a task, the brain’s posterior cingulate cortex and medial prefrontal cortex don’t synchronize their activity. The new study examined how these brain areas work together in adults who had previously been diagnosed with ADHD to see if recovery from ADHD changed the brain.

The study looked at 35 adults diagnosed with ADHD as children. Thirteen still had symptoms of the ADHD, while 22 had recovered. The researchers used resting-state functional magnetic resonance imaging (fMRI) to examine how the subjects’ brains behaved when they weren’t focused on a specific task. In a surprising twist, though, the new study found that adults who recovered from ADHD showed synchronicity between the two brain regions—a brain pattern identical to the brain patterns shown in people who have never been diagnosed with ADHD.

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Environment, Medication, and the Brain

This study might seem to suggest a biological basis for ADHD, and even a potential test for the condition. But environmental and lifestyle choices can change the brain. Carey Heller, PsyD, a GoodTherapy.org ADHD topic expert, points out that both medication and therapy can change the brain, and he emphasizes the way lifestyle choices can affect both the symptoms of ADHD and the way the disorder looks on a brain scan.

“Children have little control over their environments, but adults may be able to choose jobs, working environments, or habits that minimize their symptoms,” said Heller. Perhaps these changed brain scans are the result of a concerted effort to cope more effectively with ADHD. If that’s the case, then this research points to the importance of early interventions for helping children recover from ADHD in adulthood.

Heller is also skeptical about whether ADHD actually goes away, or just changes. “It’s unclear whether ADHD actually goes away in adulthood, or if the symptoms change,” he says. Maybe some adults with ADHD experience atypical symptoms that look different on a brain scan.

No matter how you interpret the data, though, brain differences in adults previously diagnosed with ADHD can help lead the way toward future research. The study was small, so more research is necessary to determine whether and how the adult brain changes in response to both ADHD and treatment for ADHD.

Reference:

Inside the adult ADHD brain: Differences between adults who have recovered, and those who have not. (2014, June 10). Retrieved from http://www.sciencedaily.com/releases/2014/06/140610112812.htm

That girl in your head—she was your first love, perhaps? And your first heartache too? You still have feelings for her, it seems, and I think that while she may have many wonderful features, she built a life with someone else, not you. You don’t know what her life is from the inside, so it’s easy to make it seem ideal. It may or may not be.

Also, she dumped you six weeks after you joined the military. First off, she might have dumped you anyway—you first got together in high school, a time when relationships can be flimsy and fleeting. It’s part of growing up.

Why do you wake up every day with her in your head? I’m guessing it’s not her so much as it is you and her together, the way you were 40 years ago—young, hopeful, naive, the world opening before you. You shared the exciting spirit of beginnings, but I wonder how long that would have lasted even if you hadn’t joined the military.

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The world seems closed to you now. You say no one loves you or knows you deep down. Your wife had two affairs, and you have been having a kind of fantasy mind affair with that girl, the ineffable first-time perfect girl. She stands between you and your life. You are holding her in between yourself and your life. What you had together for a short time 40 years ago stands between you and your real life, and it is taking the place of your real life. It’s time for you to dump her and live now. There’s no do-over.

Your two kids, you seem to suggest, are teenagers or young adults, and only interested in your money, not in you. Perhaps that’s true, I don’t know. I’m not sure you know, either, since you live with a curtain that blocks the reality of yourself in your life in this moment.

Why do people torture themselves with visions of a perfect past, a wonderful experience, that doesn’t exist? Why do you? Are you afraid of your life now, of looking at who and where you are now? Is it painful?

Perhaps you’re unhappy because where you are now is not where you would like to be. You can’t go back 40 years, obviously, but you can look ahead to the future and see what kind of life you would like to craft for yourself, what you need to do to make it real, to build a life for yourself—no matter your age—that is rooted in the present so it can be satisfying and genuine.

How can you do that? You can look deep inside yourself. You can go to therapy, or to group therapy, and dig hard and come alive.

I wish you luck, love, and satisfaction.

All my best,
Lynn

Most everyone has at least one traumatic memory embedded in their brains. One that still resonates for me was the time my mother left me alone when I was six years old to take the babysitter home. When I looked apprehensive, she told me not to worry. “I’ll be right back,” she said, smiling brightly, and drove off. As it got dark, I became more and more frightened that something had happened to her and she wasn’t coming back.

By the time she returned I was totally terrified. She found me standing outside wailing. She scolded me and took me inside. Years later, whenever my wife was late coming home I would become worried and anxious. My heart would begin to pound, and more than once when she was particularly late, I had a full-blown panic attack.

I know I’m not alone. Some have memories from a car accident, a rape, a natural disaster, a violent parent, a drunk husband, a hospital stay, an assault, the horrors of war. Experiences like these are more common than you might think, with an estimated 60% or more of Americans who have experienced at least one of these at some point in life. Not all of these memories cause people to experience trauma later in life, but they can cause problems for many, and for some they can be debilitating. People with posttraumatic stress (PTSD) can become hypersensitive, with nerves on a permanent state of high alert. Fear and anxiety recur without warning, and nightmares can ruin sleep.

Memories and Trauma

But now there are simple, yet effective, ways to actually erase the traumatic emotions that often accompany these memories so that they can finally be put to rest. Many people can do this work on their own. For more difficult traumatic memories, working with a therapist who specializes in healing trauma can be helpful.

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In his book Hardwiring Happiness: The New Brain Science of Contentment, Calm, and Confidence, neuropsychologist Rick Hanson says, “Your brain was wired in such a way when it evolved, it was primed to learn quickly from bad experiences but not so much from the good ones.” It’s why traumatic memories so often stick in our brains, while positive memories seem to slip away. “It’s an ancient survival mechanism that turned the brain into Velcro for the negative, but Teflon for the positive,” Hanson concludes.

Fortunately, new findings from the field of affective neuroscience can help people heal traumatic memories that can contribute to PTSD, depression, bipolar, and even Alzheimer’s. One of the things we are learning about memories is critically important: Though the brain is particularly good at recording bad memories, they are not permanently locked into the brain’s memory banks, as we once thought. Whenever we actively recall a memory, it transforms and becomes vulnerable to modification.

When we recall a memory it becomes a little unstable and for a window of perhaps two or three hours, it’s possible to modify it before it settles down again, or “reconsolidates,” in the brain. That’s why, paradoxically, recalling bad memories can help us heal from old wounds. Reliving traumatic moments again in a condition of safety can help a person disconnect the memory from the painful “alarm” mechanisms that are the source of so much discomfort.

In the book The Archeology of Mind: Neuroevolutionary Origins of Human Emotions, Jaak Panksepp and Lucy Biven say, “Emotional memories remain forever malleable, subject to influence by future events—through a phenomenon called reconsolidation.” This is the basis of various treatment approaches for healing trauma including prolonged exposure therapy, supportive psychotherapy, emotional freedom techniques (tapping), eye movement desensitization and reprocessing (EMDR), trauma-based cognitive behavior therapy, and MDMA-assisted psychotherapy.

How to HEAL

Based on the latest in neuroscience finds Rick Hanson offers a simple, yet effective, method for rewiring the brain from the negative emotions associated with trauma to the positive emotions associated with health and wellness. In his book, he describes a four step process using the acronym HEAL.

1. Have a positive experience.

Step 1 activates a positive mental state, and steps 2, 3, and 4 install it in your brain. In step 1 we notice a positive experience that’s already present in the foreground or background of your awareness. In the example I offered at the beginning, I tuned into an experience where I felt safe and supported, and brought to mind experiences of safety and security.

2. Enrich it.

Too often we spend minutes, and sometimes hours and days, ruminating over a negative experience, but we gloss over the positive. Here we take time to deepen the positive experience. I would open myself to the feelings of support I have in my life. I would picture and my wife and friends and the many supports I have, filling my inner conscious with at least 10 to 20 seconds of positive memory.

3. Absorb it.

Here we imagine ourselves drinking in the experience. I imagine all my cells being infused with the experience. I feel it sinking into me and becoming part of my brain and all the parts of my being.

4. Link positive and negative material.

Hanson describes this as an optional step. We don’t want to become overwhelmed by the negative, but to hold the negative in consciousness while it is infused with the positive. Hanson uses the image of a garden. We imagine the beauty of beautiful flowers we are planting. We become aware of the weeds and gently pull them out so there’s room for growth. He concludes by saying, “Whenever you want, let go of all negative material and rest only in the positive. Then, to continue uprooting the negative material, a few times over the next hour be aware of only neutral or positive things that may have been associated with the negative.

I bought back the memories of being left by my mother and some of the associated experiences of getting anxious whenever someone I cared about was late. Focusing on the negative while activating positive experiences can actually “erase” the fearful feelings from the past. I still remember my mother leaving me alone and being angry with me when she returned, but it doesn’t grab me and shake me up like it used to do and I’m much less anxious when my wife is late coming home.

I describe other techniques for healing old pain in my book, Stress Relief for Men: How to Use the Revolutionary Tools of Energy Healing to Live Well. I often use them along with the ones that Dr. Hanson teaches. In this engaging TED talk Dr. Hanson describes how we can rewire the brain for joy and happiness and heal from trauma. In another show he describes how our mind can change the brain from being Velcro for the negative and Teflon for the positive.

Even when traumatic memories don’t reach a level of discomfort associated with PTSD, they can still be destructive. Hanson notes that unresolved trauma “increases inflammation, weakens your immune system, and wears on your cardiovascular system. No one has to live with traumatic memories from the past. They can truly be healed now and forever.

If you’ve ever had surgery that required anesthesia, you know the process of waking up can be a jarring one. Anesthesia induces a deep state of unconsciousness in a matter of seconds, but it can take several hours to return to normal after waking. Many people experience confusion, sleepiness, and even delirium-induced hallucinations as they awaken from surgery, but research on this waking process is limited. New research points to a complicated, meandering process through which the brain wakes up from anesthesia.

How Anesthesia Works

The state induced by anesthesia looks a lot like a deep sleep, but it’s actually quite different. Doctors rely on a variety of chemicals to induce unconsciousness, and each works slightly differently in the brain. What all general anesthesia recipes have in common is that they induce unconsciousness while preserving the body’s automatic functions, such as breathing and digestion. Anesthesia also reduces sensitivity to pain, which is why people don’t typically have dreams of being in surgery or experiencing pain when they’re under the knife.

Because a wiggly patient can quickly be injured, anesthesia also limits or eliminates your ability to move. For the one to two people out of 1,000 who briefly awaken during surgery, this paralysis can be terrifying. Fortunately, people who awake during surgery don’t typically experience pain.

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Waking from Anesthesia

Doctors have traditionally theorized that, as anesthesia is eliminated from the body, the brain’s electrical activity steadily increases until the brain returns to normal. But new research at Rockefeller University has found that the process of waking up is much more complex.

Researchers knocked rats out using a popular anesthesia called Isoflurane. As the rats awakened from the anesthesia, researchers examined electrical activity in areas of the brain believed to be associated with wakefulness. In fully awake brains, the electrical activity in neurons oscillates, but in an anesthetized or sleeping brain, electrical activity is slower.

Instead of finding a gradual increase in oscillating neurons, researchers found that oscillations occurred suddenly. While every rat’s brain eventually had oscillations in the same “hubs,” the process through which neurons became more active in each hub varied from rat to rat. Researchers believe this indicates that there’s not a single path through which the brain awakens from anesthesia. Because every rat’s brain ultimately used the same hubs, though, the research suggests that certain brain activity is a necessary prerequisite to consciousness.

While research on rats isn’t always applicable to humans, rats and humans respond in similar ways to anesthesia. While anesthesia is extremely safe, a small number of people who undergo surgery don’t wake up. Among people over the age of 65, the risk is higher. By gaining a better understanding of how the brain wakes up from anesthesia, researchers may eventually find a way to reduce the risks of undergoing surgery.

References:

1. General anesthesia. (2013, January 19). Retrieved from http://www.mayoclinic.org/tests-procedures/anesthesia/basics/risks/prc-20014786
2. To recover consciousness, brain activity passes through newly detected states. (2014, June 9). Retrieved from http://newswire.rockefeller.edu/2014/06/09/to-recover-consciousness-brain-activity-passes-through-newly-detected-states/
3. WorldCrunch.com. (2011, August 4). Under the knife: Study shows rising death rates from general anesthesia. Retrieved from http://healthland.time.com/2011/08/04/under-the-knife-study-shows-rising-death-rates-from-general-anesthesia/

Parents often focus so much on their children and teens having attention-deficit hyperactivity (ADHD) that they lose sight of the specific symptoms. As a result, many parents tell their kids that they cannot do something because they have ADHD. Other parents may continually remind their children about their diagnosis. Both of these parenting tactics can lead kids over time to internalize negative perceptions of themselves. In some cases, children and teens, and even adults, may learn to use having ADHD as an excuse to avoid doing certain things or attribute negative behaviors to it.

Clearly, all of this focus on having ADHD can lead to short- and long-term negative consequences. Therefore, it is important that parents focus on specific difficulties that their child or teen has in a domain, rather than blaming everything on ADHD. For instance, if you do not want your 10-year-old to walk with his or her friends to a local convenience store after school, it is recommended that you explain your concerns instead of saying, “You can’t go because you have ADHD.” It may be that your child is not attentive to watching for traffic, so you are concerned that he or she will not be careful when crossing the street. As another example, if you do not want your 13-year-old to go to the mall with his or her friends without adult supervision, explain why. It may be that he/she is impulsive, and you worry about your teen being disruptive or otherwise getting into trouble.

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It is also important to look at ways to assist your child/teen to allow him or her to participate in age-appropriate activities. Related to this, you should also determine ways for your child or teen to prove to you that he or she is capable of participating in the desired activity without difficulty. Using the example above of the 10-year-old who wants to go to the convenience store with his or her friends, one could handle the situation in the following manner: Sit down with your child and explain your concerns about his or her ability to watch for traffic. Then, provide opportunities in a controlled environment to prove that he or she can watch for traffic. You could do this by having your child walk places with you and take the lead when crossing the street. Of course, if he or she starts darting out into traffic, stop and discuss the situation in the moment, if possible. Once you feel comfortable that your child can watch for traffic in your presence, have him or her practice crossing the street when with you and a few friends. At 10 years old, it is fairly age appropriate to be walking places with an adult.

Only use the situation with your child’s friends and you if it is deemed age appropriate. For instance, if you are having the same issue with a 17-year-old, it would be much less appropriate to make him or her practice crossing the street with you and his/her friends. Also, when helping your child practice crossing the street in this situation with friends, don’t mention to the friends that you are helping your child practice crossing the street safely. Once your child proves that he or she can cross the street safely with you and friends, consider letting him/her walk independently with friends provided that he/she does not have to cross any major intersections. After a small amount of time being able to walk independently and proving that he or she is capable of being careful, you could allow your child to walk places with friends that involve crossing busier streets.

With the examples above, the point is to explain your rationale to your child or teen if you feel uncomfortable letting him or her do something. It is important that the explanation revolve around specific skills rather than concerns about having ADHD. Furthermore, it is important to discuss ways to improve these skills and then demonstrate success with them. Taking this approach, along with other strategies, will help improve your child’s confidence and make him or her less likely to fall prey to negative self-perceptions due to having ADHD.

Hypnosis is often recognized as being used by performers in comedy or entertainment and is typically seen as fun and harmless in those situations. However, hypnosis has a broader application when used in helping practices. Essentially, there are three main platforms for hypnosis:

1. Hypnosis used for entertainment.

2. Hypnosis is used by a person trained in specialized uses, such as helping people to stop smoking, manage weight, or deal with sleeping problems.

3. Hypnosis is used by a licensed mental health practitioner (hypnotherapist) as one of the tools in the counseling/therapeutic toolbox.

Hypnosis and hypnotherapy have an extensive history as reputable methods used the therapeutic process by trained and skilled hypnotists and hypnotherapists alike. The difference between hypnosis and hypnotherapy is that hypnosis is defined as a state of mind, while hypnotherapy is the name of the therapeutic modality in which hypnosis is used.

A trained hypnotist uses hypnosis to help people with issues such as smoking cessation and weight management, but is not licensed as to practice hypnotherapy. Hypnotherapy is practiced by a hypnotherapist who is a trained, licensed, and/or certified professional. Only a hypnotherapist may use hypnotherapy to work with such mental health concerns as phobias, stage fright, eating disorders, and certain medical conditions.

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How Does Hypnosis Work?

Hypnosis is defined as a harmless altered trance state characterized by very deep relaxation, highly focused attention, and an extreme openness to suggestions which are usually positive and foster positive therapeutic changes. However, a hypnotic trance is not necessarily therapeutic on its own. For example, when someone is driving to the mall, seemingly suddenly arrives, and is not sure exactly how he or she got there so soon, he/she has experienced an altered, hypnotic state. People may also experience this altered state when they are just beginning to fall asleep and are in a dreamy and drowsy state, aware but not completely focused—just focused enough to have a simple conversation but not remember talking at all.

When used for therapeutic approaches, specific suggestions and images given to people in a trance can alter their behavior in a positive manner. When in this state of hypnosis, you are more inclined to permanent change and more likely to be successful in making the lasting changes you desire. Almost all lasting changes happen in your subconscious mind.

Another example of how visualization in hypnosis works is when a hypnotherapist helps a person experiencing claustrophobia to visualize being in a very open space, without fear, when entering an elevator. By learning to positively visualize entering the elevator without fear, the person is often able to then do it in reality. The subconscious mind does not distinguish between a genuine experience and a suggested one. If you visualize it in a trance state, your body will react to it.

Who Can Be Hypnotized?

The simplest answer is that almost anyone can be hypnotized if they want to be. Modern research has shown that most people can be hypnotized to some degree and that the real question is how deep and to what degree they go into trance. Being able to be hypnotized is not a sign of being weak-minded, gullible, or giving up control. The ability to be hypnotized—or “hypnotizability”—is actually correlated with intelligence and the ability to have heightened awareness and focus while being in complete control.

For example, if while in a hypnotic trance you were asked to give the hypnotherapist your wallet or take off all of your clothes, you wouldn’t unless you truly wanted to. Likewise, if you were in the audience of a stage performance by a hypnotist and you were selected to participate in the show, you would quack like a duck only if you truly wanted to. In fact, the participants are usually chosen because the hypnotist believes you want to act silly and be part of the show. This is in contrast to someone who is not showing any indication he or she wants to be at the event or even have fun.

Thank you for your letter. This kind of issue comes up frequently with couples, particularly early on in one’s marriage or partnership. It often involves a topic that has potent but conflicting meanings for the people involved. A classic, somewhat stereotypical example is the guy who is a fanatic for his home team and MUST watch the game. His spouse (or partner, I use the words interchangeably here) may roll her (or his) eyes or argue or whatnot; clearly, each person sees the activity or event differently. It may be the same for a woman who just HAS to see Bruno Mars or Dave Matthews or Prince for the first or umpteenth time, or buy those Jimmy Choos at 25% off.

In this case, the symbolic “event” or activity revolves around something even more potentially charged with meaning: alcohol and drinking. Alcohol is symbolically loaded (no pun intended) for many who have complicated histories with drinking and corollary activity. I’d be interested—were I your couples counselor (and this is all conjecture, mind you)—to know the roots of your wife’s concerns. Did she have a former partner who drank too much and/or cheated on her? You say, “I don’t think she trusts me,” which to me hints that there hasn’t been a direct conversation about this. It’s striking how often couples don’t communicate directly with each other, usually because we’ve never learned how to in our own families. It helps to speak one’s concerns directly to your partner—how you feel about it—for the purpose of understanding first, before “winning” the argument. Because it has to be win-win (or else it’s lose-lose).

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Listening is, in a way, even more important than direct expression of emotion; try to “mirror” the other person’s point of view emotionally, without interjecting commentary or editorializing, which means you might say, “I hear you saying it bothers you when I do this because (fill in the blank).” “It sounds like you’re feeling worried or frustrated about (blank).” Focus on the feelings, and don’t worry just yet about finding a compromise or solution (or “proving” your point). I find that couples often find such answers organically once their heart-centered listening is in place. It sounds like she really values her connection with you (a wonderful thing) and gets anxious about whatever this activity symbolizes for her. Perhaps her best friend’s husband hit on a girl at a bar and they broke up. Perhaps her dad was a womanizer, or ignored her mom by hanging with his buddies at the pub … and so on. (Hold Me Tight by Sue Johnson is a good book on this, by the way.)

I would also encourage her to listen to you and what these evenings mean for you. Rather than get into a tug-of-war power struggle—yes I will go, no you won’t, you’re not the boss, etc.—I would first suggest you reflect on why this is important, then communicate this to your wife. It sounds like this has become a necessity for you, and that raises my curiosity. What is it about this activity that feels essential (versus, say, a round of golf or a movie)? Both you and your wife would need to understand that before it’s “taken” from you. Maybe you had a controlling ex-partner, or maybe you saw your father controlled by your mom, which created marital strife, or maybe you believe your wife is overreacting or patronizing. Most people don’t like to be told what to do—or rather, “feel” like they’re being told what to do. (Often, requests, needs, or feelings are either stated or misinterpreted as demands.) The first step would be to state these feelings to her while keeping the focus on you and your feelings, rather than, “You’re being a controlling pain when you (blank).” Then she might try reflecting this back to you, so you each “try on for size” the other’s perspective without trying to negate, shoot it down, etc.

I had a tiny niggling intuition while writing this column that maybe your wife feels like ONLY a few rounds with the lads does the trick—while she’s kept at a distance. Perhaps her anxiety about being distant leads to you somehow feeling over-controlled (the classic pursue/avoid game). Perhaps she feels excluded (while you feel controlled and perhaps criticized). My hope is that after you share your feelings, you find an activity together. Maybe your wife could join you for a round one of those nights; maybe you could have people over to your house to watch the game. The guys can watch the game while the gals either join in or do something else. Or have a weekly barbecue. Something inclusive. There’s a very either/or tone to what you’re describing and a separateness that may be at the heart of what’s bothering your wife, who obviously wants to share your experience with you—togetherness and sharing are essentials for healthy long-term relationships. You’re both right, and both points of view need to be honored to prevent corrosion to the relationship. Hope that helps! Thanks for writing!

Kind regards,
Darren