Most people have experienced trauma at some point in time. The nature of traumatic experiences varies by severity and frequency and also differs with respect to the effect they have on survivors. Some people who have experienced violence, abuse, or disaster develop significant psychological problems and posttraumatic stress (PTSD) as a result of the trauma, while others appear to be more resilient and rebound with very few psychological problems.

Predisposition to mental health issues and stress sensitivity are two factors that have been theorized to affect risk for PTSD in trauma victims. But another factor that is less understood in relation to PTSD is intelligence. Intelligence quotient (IQ) can impact emotional regulation and reactivity and, therefore, it could be assumed that people with higher IQs may be more resilient to trauma.

To test this theory, Naomi Breslau of the Department of Epidemiology and Biostatistics at the College of Human Medicine at Michigan State University recently led a study involving 713 17-year olds. The participants were assessed for trauma history, type of trauma classified as assaultive trauma (sexual trauma, rape, life threatening trauma), or general trauma (accident, illness, disaster) and IQ taken at age 6. Breslau used this information to see how these factors affected PTSD at age 17.

She found that surprisingly, individuals of assaultive trauma were not more likely to develop PTSD than those of general trauma. However, Breslau did find a link between IQ and PTSD. “A drop of one standard deviation in IQ score measured at age 6 increased the relative risk ratio of PTSD resulting from either trauma type by approximately 50%,” she said.

This result can be interpreted in several ways. First, individuals with a lower IQ may be less able to regulate emotional reactions and thus be more vulnerable to PTSD. Second, making meaning of trauma and assigning context to a traumatic event may be easier for people with high intelligence. This can protect people from negative emotional responses and triggers, and decrease their vulnerability to negative mental health outcomes like PTSD. Although these findings clearly demonstrate a link between IQ and resiliency/vulnerability, more work should be done to determine how this link impacts younger and older individuals.

Reference:
Breslau, N., Chen, Q., Luo, Z. (2013). The role of intelligence in posttraumatic stress disorder: Does it vary by trauma severity? PLoS ONE 8(6): e65391. doi:10.1371/journal.pone.0065391

woman consoling her crying childTornado season is well underway, initiated this year by the recent tornado in Moore, Oklahoma, but severe storms and natural disasters can happen at any time. These events leave residents devastated and entire communities completely decimated. Round-the-clock news coverage tends to fade afterward, making it easy to forget about these events altogether. But for the people who survive massive disasters, the consequences last much longer than the news cycle, and extend much deeper than property damage and scrapes.

Shock

In the immediate aftermath of a natural disaster, the first reaction is often a combination of shock and denial. Sometimes this can make it challenging to take the necessary steps to begin picking up the pieces—calling insurance, assessing what property was lost, even finding temporary housing. But shock tends to give way to much stronger feelings, which can hit days, weeks, or months after a disaster strikes.

Feelings of Insecurity

Home is a place that most people spend their entire lives believing is a place of safety and refuge. But when a storm comes tearing through your house, this security can go out the window. People who have survived storms may experience nightmares, anxiety, extreme concerns about storm safety, or obsessive preparation to avoid the next disaster. The insecurity can be especially pronounced in children, who may feel constantly unsafe.

Posttraumatic Stress

Extreme stress is common in the aftermath of a storm. But when it persists for months, it can lead to posttraumatic stress (PTSD). People with PTSD may experience flashbacks to the storms, panic attacks, an extreme startle reflex, persistent avoidance of things that remind them of the storm, and anxiety and depression. PTSD can also interfere with a person’s ability to control emotions, leading to angry outbursts or crying spells, for example.

Other Mental Health Conditions

PTSD isn’t the only long-term consequence of surviving a natural disaster. For people already experiencing a mental illness, a traumatic event can make symptoms worse. And for others, a natural disaster can spark depression, extreme stress, generalized anxiety, eating and food issues, obsessive-compulsion, and a host of other problems. Sometimes these issues arise as a result of a person’s attempts to control the environment after a storm takes away control.

Effects on First Responders

Storm survivors aren’t the only people who suffer when a natural disaster hits. People who are on the scene at the time of the storm or who witness the immediate aftermath—including first responders such as police officers and fire fighters as well as the media—can also experience psychological symptoms. They could be haunted by people they were unable to save, by images of injured people, or by the massive nature of the destruction. Some witnesses may even feel guilt that someone else’s home or life was destroyed but theirs wasn’t. The symptoms for witnesses and first responders are often the same, including PTSD, depression, and other mental health conditions, and people who are present in the aftermath of a storm may need as much help and support as the victims.

References:

  1. Hellmich, N. (2013, May 21). Kids who survived tornado face emotional after-effects. USA Today. Retrieved from usatoday.com/story/news/nation/2013/05/21/psychologist-impact-kids-disasters/2346773/
  2. Pearson, C. (2013, May 21). Oklahoma tornado PTSD: How survivors are coping. The Huffington Post. Retrieved from huffingtonpost.com/2013/05/21/oklahoma-tornado-ptsd_n_3314640.html
  3. Rossi, B. (n.d.). The psychological aftermath of the Oklahoma tornados. WSJ This Morning RSS. Retrieved from blogs.wsj.com/wsjam/2013/05/22/the-psychological-aftermath-of-the-oklahoma-tornados/

It has been well established that adverse childhood experiences (ACE) result in negative outcomes. People who have experienced neglect, emotional abuse, domestic violence, childhood sexual abuse, physical abuse, or other traumatic events in childhood are at increased risk for psychological and physical illnesses.

Divorce, death of a parent, caregiver mental illness, and other environmental factors also place children at increased risk for negative behaviors, including smoking, drug use, and sexual risk taking. Psychological illnesses such as post-traumatic stress, depression, anxiety and even suicidal ideation are often associated with ACE.

Some research has even suggested that ACE increases the likelihood of cancer and other chronic illnesses by way of risky and maladaptive behavior and through changes in physiological and biological elements during childhood. Specifically, incidences of lung cancer and heart disease have been found to be higher in people with ACE most often as a result of smoking. However, until now, no study has looked specifically at how ACE affects risk of all cancers in childhood and adulthood.

Monique J. Brown of the Department of Family Medicine and Population Health at the Virginia Commonwealth University School of Medicine in Virginia wanted to examine whether or not ACEs increased overall risk of cancer. Brown assessed a large sample of participants and evaluated their ACE in relation to either cancer in childhood or adulthood.

She found that over 60% of all the participants had experienced at least one ACE and nearly 10% had a history of cancer. Of all the types of ACE, childhood sexual abuse was the most common in those with adult cancer, but appeared to have little impact on childhood cancer. The rate of cancer prevalence among the participants with ACE was much higher than the national average of 4.2% and suggests that ACE, and in particular, childhood sexual abuse, has a strong indirect impact on cancer risk in adulthood.

Brown was unable to find any evidence of ACE influencing childhood cancer risk, which suggests that biological and physiological effects of ACE may have less of an impact on overall health than the behavioral and emotional impacts of ACEs. Brown believes that these results reveal a particular segment of the population in need of early intervention. She added, “More research should focus on the impact of sexual abuse ACEs and adverse health outcomes.”

Reference:
Brown, M.J., Thacker, L.R., Cohen, S.A. (2013). Association between adverse childhood experiences and diagnosis of cancer. PLoS ONE 8(6): e65524. doi:10.1371/journal.pone.0065524

Indian woman wearing traditional dressA name, or identity, is a powerful thing. It is a descriptor that allows people to make quick judgments and assumptions about us. While we can understand the harm of assumptions, for the human mind it is a fast way to categorize a lot of information in a short amount of time. Assumptions also give us social context for the “rules” we need to interact with new and different people.

If you are at an event and you overhear someone talking about their upcoming church event, you might make an assumption about them. Based on that assumption you may speak differently to them. Perhaps you would avoid using curse words, for instance. Or, you may avoid interacting with them altogether.

Names and identities are our first impressions. How we dress, the way we wear our hair, how we behave, and even where we go all begins with our identity and what we call ourselves. Whether it is religion, sexuality, or gender, if it is part of an identity then it will influence how you present yourself to the world and how you interact with the world. The critical factors in creating an identity are that it describes who you are and it is self-chosen.

Identity Describes Who You Are

Our names and identities describe who we currently are. It is a present-day representation of how we perceive ourselves in this world. During my first day of high school, our gym teacher took attendance. She paused when she came to a girl who she had taught since kindergarten and asked, “Is it still Susie, or is it Susan now?” Upon the transition to high school and young adulthood the teacher recognized that the student may no longer see herself as a child and may prefer a different name to the one she previously used.

The name and identity that we have at 15 years old may be different than when we are 25 or 50 years old. As we grow, change, and have new experiences what we call ourselves may change as well.

Identity Is Self-Chosen

The second important point about our identity is that it is self-chosen. Other people may give us names (e.g. our parents) and labels (e.g. society) but an identity can only come from us. An identity represents how we perceive ourselves and how we want other people to perceive us. A label is a descriptor given to us by others based on their stereotypes of us.

My father is from Nigeria (African) and my mother is from Mississippi (African-American). I am truly African-American as a blend and product of them. There are many times when I publically call myself African-American, but I also call myself black, more privately, as that term resonates with me. For me, black describes the uniqueness of my culture: growing up American, but also as a first-generation American in many ways. Black describes the complexity of my experience in a way that African-American does not.

Depending on the situation and circumstance what we call ourselves may change. Perhaps our identity changes over time. What once resonated with us no longer does. Identity is a personal process and decision about what you call yourself. It is a process that is complex and full and fluid. It may change with time, or it may change with the environment or circumstance.

For example, I make a distinction between what I am comfortable with publicly versus privately. I am uncomfortable with some people calling me black and I use the term African-American publically. Similar to people who use familiar and formal names, different relationships have different ways of relating to each other.

Consider taking time to review your own identity. What names and identities do you have today? Is your identity based on your relationships (i.e. sister, partner, father, etc.)? Is it based on your work? Is it based on your religion? Or your sexuality?

What creates the identity that you have today? Is it different than it was 10 years ago? Do you think that it will be different 10 years from now? Share your thoughts and experiences with us; we want to hear from you!

woman-office-0624135I love my job. Love it. There are, of course, days like this one, when the 100-degree weather makes me want to bypass my office and head straight for the beach. For the most part, though, a day spent doing therapy is a day that fills me with deep satisfaction and a sense of accomplishment.

I haven’t always loved my job. In fact, for some time in college, I honestly hated it. A favorite professor recommended me for a coveted position as a psychological research assistant on a study being done at the world-renowned National Children’s Hospital. This particular study focused on how the quality of life for chronically medically ill adolescents may be improved by a part-time job at a fast-food restaurant. The position was a huge deal for an undergrad, and I was thrilled just to land a gig in my field instead of toiling at a children’s boutique, where I had been (I didn’t much love working there, either.)

This was going to look fantastic on my résumé; it was the kind of thing that would provide relevant experience and help usher me into grad school. I should have been overjoyed, and started out that way. But that soon fizzled, and instead I found myself downright miserable. The “gig” was not at all what I thought or hoped it would be. I had little to no interaction with the research participants. Instead, I spent every day hunched at the computer, matching subjects to controls, inputting boring data, and counting the slow minutes until I could head home.

According to positive psychology, we are happiest when the work we do, whether at home or on the job, allows us to use our signature strengths. Martin Seligman, the psychologist at University of Pennsylvania who pioneered the positive psychology movement, defines signature strengths as “strengths of character that a person owns, celebrates, and frequently exercises.” These are the personal traits and skills that come naturally, and that give us a sense of fulfillment and purpose when we use them.

Seligman has identified 24 unique character strengths, including fairness, curiosity, creativity, and humor. My VIA Signature Strengths survey results—which identified my top five strengths—help explain why, between my two jobs in psychology, I was woefully unhappy as a research assistant but have been blissfully content as a clinician.

My top three signature strengths are curiosity, love of learning, and perspective. Seligman and Christopher Peterson define these traits this way:

Doing therapy, I get to utilize all three of these strengths in my work. My sense of curiosity makes me truly interested in my clients and their personal stories. Because I love learning, I eat psych books like they are candy and very much enjoy attending conferences about new methods and ideas in my field, then immediately use what I learn in therapy sessions. Perspective (or wisdom) is a strength I try to employ daily by helping others look at themselves and their situations in healthy, encouraging ways.

A look at my relative weaknesses on the signature strengths survey also explains why my research assistant job didn’t work for me. The traits I seem to value least, and engage least frequently, are persistence, self-regulation, and prudence.

The research assistant job required hours of monotonous sifting through surveys and entering numbers into a statistical analysis program. This task required perseverance and discipline, two of my weaknesses. I was bored, edgy, and unfulfilled. I was impatient to learn the results of the findings, but it would be months until they were revealed. Day after day was the same—columns of numbers and the click-click-clack of computer keys. My curiosity was not satisfied, and my self-control was tested. I made regular trips to the vending machine, where in my careful scientific process I learned that I preferred Cheez-Its to Cheese Nips. I explored the wings of the hospital, discovering that the interns in the cardiology unit were better looking than those in rheumatology. I found myself daydreaming constantly.

Moreover, I became an unpopular, dissonant voice at the Adolescent Employment Readiness Center, as my unit was called. Since prudence was not one of my strengths, especially as a 20-year-old student, I made it all too clear that I did not believe that working at McDonald’s was the best use of time for a teen in remission who may not live to see his 20th birthday. As a passionate, wide-eyed kid myself, I thought our teenage subjects should be celebrating their periods of remission by sailing, surfing, seeing the world—anything but flipping burgers.

I am incredibly lucky. I was able to find a career that is in alignment with my signature strengths. Not all of us are as fortunate. Nonetheless, even in less-than-ideal situations, you can work toward finding opportunities to utilize your personal character strengths as often as possible. Research shows we are happiest when we are using our strengths regularly and in novel ways. By exploring the hospital and comparing the nuances of cheese-flavored snack foods, I engaged my curiosity and love of learning at my boring research job.

If your job or life circumstances don’t naturally engage your strengths, you can and should look for creative outlets for their expression. For example, if your strength happens to be my weakness of self-regulation, and you are in an unstructured environment, use your skills to bring order to the chaos. Help your coworkers organize their desk drawers or create a method for arranging their daily to-do list. If humor is one of your strengths, find ways to bring laughter to the board room or break room.

The most important point from the research on signature strengths is that we are happiest and most productive when we are living as an expression of our strengths rather than frantically trying to develop our weaknesses. I might look at my weaknesses and berate myself for being flighty, undisciplined, and impulsive. I could focus on these shortcomings and spend a bulk of time and energy making efforts to overcome them. To do so, according to positive psychology, is to expend precious energy swimming against the current of our most authentic selves.

It is worth investing a bit of effort to improve upon the weaknesses that handicap us and hold us back. Truth is, I do have a bit more stick-to-it-iveness and self-control now than I did in my college days. My mindfulness practice has helped me with that. Still, I am bored easily, relatively impatient, and I tend to speak my mind, so it doesn’t surprise me that persistence, self-discipline, and prudence remain my weaknesses.

Three times today I’ve abandoned writing this article to do something else. Because I’m curious and love to learn, I went to find the reference for another article, and found myself distracted by another couple of pages that popped up in my Google search. When I set out to write, I know that this will be the way things go, so I give myself the time for what will inevitably be my process. I allow and engage my strengths, and don’t beat myself up for my weaknesses. By permitting myself to work at a comfortable pace, I am able to eventually accomplish what I set out to do in a way that feels genuine to me.

Finally, I return to my signature strength of perspective/wisdom. I always enjoy sharing what I know with others, and helping them potentially gain insight, which happily propelled me to continue writing and to finish this article. I close by encouraging you to discover your own signature strengths and align your life with their expression. Become aware of your weaknesses, too, if only to learn forgiveness and a better understanding of where you may be challenged. By using your strengths creatively and consistently, you will create for yourself what positive psychologists call “the good life,” and be happier for doing so.

Losing a family member is one of the hardest things a person can experience. Many families pull apart and suffer extreme emotional distress after the loss of a child or parent. This is especially true if the loss is sudden and from an accident or suicide. But even anticipated deaths, like those resulting from terminal illnesses such as cancer, can cause immense emotional pain that some people cannot easily overcome.

Although research in this area is extensive, another type of loss that can have similarly negative effects has not been examined nearly enough. When a person loses a sibling, the results can be equally as devastating, and in fact, some believe even more difficult than losing a parent or other family member. Siblings often represent the longest friendship and closest relationship many people have had.

When a sibling dies, the effect can be traumatic and even life-threatening if the death is sudden. People can become easily depressed when they are overwhelmed with grief. These emotions, if not reconciled, can put someone at risk for suicide.

Mikael Rostila of the Centre for Health Equity Studies at Stockholm Univesity in Sweden wanted to see if sibling death resulted in increased suicide in surviving siblings. To assess this, Rostila looked at population data between 1981 and 2002 on over 1.7 million Swedish adults between the ages of 25 and 64.

The analysis revealed that women who lost a sibling were 1.5 times more likely to commit suicide in the two decades following the death than those who did not experience the loss of a sibling. Men were 1.28 times more likely to commit suicide. And if the sibling death was the result of a suicide, the rate increased to 3.19 times for women and 2.44 times more risk for men.

Other types of deaths, such as cancer, resulted in much lower suicide rates in surviving siblings and there were relatively no differences by gender for these suicides. Additionally, Rostila did not find any association risk for suicide based on length of time since the sibling death. This research provides new and much needed insight into the effects of a sibling death on surviving siblings. Rostila added, “The mechanisms linking the death of a sibling and completed suicide among the bereaved person need to be further investigated.”

Reference:
Rostila, M., Saarela, J., Kawachi, I. (2013). Suicide following the death of a sibling: A nationwide follow-up study from Sweden. BMJ Open 2013;3:e002618. doi:10.1136/bmjopen-2013-002618

mother-daughter-blowing-bubbles-0621136Play therapy has become a very important element of my work with families and children. In this article, I hope to give you parents some idea of how powerful play can be as an intervention as well as some ideas of how to utilize play with your own children.

Play Therapy at Work

It is Father’s Day as I write this article and I am reminded of one particular case where play therapy had a profound impact on a family. This family had a child with severe autism. They were unable to manage him at home and he was living at the residential treatment facility where I worked. The child in question was very routine-oriented, and he had an extremely restricted range of activities in which he would engage. If he wasn’t repeatedly watching small snippets of Disney videos, he wasn’t happy.

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To make matters worse, if he wasn’t happy, he tended to throw tantrums, or hit and bite those around him. As a result of these behaviors, not only could he not live at home, but the family was challenged to even have him home for short visits. They had to put the entire house on lockdown to prevent their son from wandering away, and at least one of them had to take time off of work to stay up all night to supervise their son.

When this child came onto my caseload, another therapist and I decided we wanted to work with the family to improve the quality of their interactions with their son and make their time together less stressful and challenging. We decided to use a therapy called Theraplay to accomplish this. We did several sessions with the child in which we exposed him to various new activities. We made note of what he liked, what he disliked, and what he just didn’t seem to get (but didn’t hate).

We expected to see a lot of behaviors due to the change in routine, but that wasn’t the case. We quickly found that there were a number of activities that the child seemed to enjoy. Furthermore, we found that a number of activities that he didn’t understand at first he learned and started to enjoy in subsequent sessions. Pretty soon, we had a list of about 20-or-so activities that required minimal material (about $20 of stuff from the dollar store) that he enjoyed. We could easily keep the child happily engaged for over 30 minutes at a time.

We then started doing sessions with the family at their house. First, they watched as we played with their son. Then we started showing them how to do the games. During the course of this session, we were demonstrating a modified version of catch. The child tended to want to catch the ball when thrown to him, but would then walk over and hand the ball back to us instead of throwing it. We learned that playing catch over a table got the child to actually throw the ball back.

As we were demonstrating this, he started throwing the ball to his dad and playing catch with him. Dad immediately started tearing up. He said, “This is the first time I’ve ever had a catch with my child.” There was not a dry eye in the room after that. What father doesn’t want to have a catch with his son? Imagine having to wait 17 years to make that happen. It was an unexpected, but awesome outcome of our therapy.

The Importance of Play in Development

Play is one of the fundamental ways in which children learn. Through play, they learn to how to connect or form secure attachments to others. The quality of the relationships children have growing up will impact the quality of the relationships they form as adults. So it stands to reason that good, quality play as a child can lead to quality relationships in adulthood.

Through play, children learn how to self-regulate. We get excited as we play games with each other, but then we learn how to self-calm and soothe to continue to excel at the games we play. We learn when it is appropriate to get excited and when we need to calm. In fact, I find that using play with children who have problems with regulation is a fantastic way to teach them impulse control and self-control.

Finally, through play, we learn how to socialize. We learn such things as taking turns, cooperation, and competition. We learn about rules and creativity. Through play we develop the basic skills that allow us to navigate the challenges that life presents us. Kids who don’t play are often at a great social disadvantage compared to kids who play.

Guidelines for Play

Ok, so play is important. However, the best play has some structure. To maximize the impact of play on your child’s behaviors, here are some basic guidelines to follow.

  1. Play with your child. When engaging in play, do things that involve interaction between you and your child. It’s not enough to simply be in the room (what I call proctoring). It’s great to sit with children as they do a puzzle, but it’s better to do the puzzle with them. You want to promote that social-emotional connection with you. You want to make yourself a source of never ending reinforcement in your child’s eyes. So, do activities that promote things like touch and eye contact (something the typical child with autism might be struggling with and need practice to do or tolerate). Make the time your child spends with you silly and fun; watch how your child positively responds to you in other situations.
  2. Keep it simple and developmentally appropriate. Make sure the activities you do with your child are geared towards their mental and emotional age. In the example at the beginning of the article, even though the child was 17, he enjoyed things like holding hands, rocking, and singing “Row Your Boat.” He enjoyed the sensory nature of the rocking, as well as the familiarity of the song. Other teenagers might enjoy singing and dancing with you to music they like. Again, focus on enhancing the connection between yourself and the child.
  3. It’s ok to be silly (in fact, it’s recommended)! The games I play with my kids (at home and at work) aren’t complicated. In fact, on the face of it they are pretty silly. I find that even with more resistant, morose children, silliness draws them in. There’s something about being silly with someone else that just brings down defenses. Besides, taking time to relax, laugh, and be a little silly is FUN! It’s a marvelous way to spend some time.
  4. Inexpensive is better! It’s very easy to spend a lot of money on toys. Heck, expensive toys can be great (I adore my Xbox). but for the types of interaction I’m thinking about, expensive toys are unnecessary. Blowing a feather back and forth, blowing bubbles, playing clapping games, or playing “red light, green light” require very little in the way of materials. Be creative and see what kinds of things are sitting around your house and look to those for inspiration. Have you ever seen a young child at Christmas? They open up all their expensive presents and spend most of the time playing with wrapping paper and boxes. Tap into that instinct with your child and you will be well on your way to successful play.

Ways to Use Play Therapeutically

Here are some more ideas on how to structure play sessions with your child to get specific results.

Planned sessions to increase engagement: While my usual play style is typically to improvise with whatever is at hand and make things up as I go along, I find that planning out sessions can be helpful when trying to engage with a child. I simply make a list of 5 to 10 activities that I want to do before I do the session and try to at least get through those. I make note of what activities seemed to get the child to respond positively to me so I can use them again later. If I don’t do this, I tend to more easily get shut down by the child if he/she doesn’t immediately engage with me. I focus on activities that promote touch, eye contact, and positive sensory experiences. Good examples are singing/clapping games, blowing up a balloon while the child holds the balloon, and blowing a feather back and forth between your hands and the child’s hands.

Repeated sessions to increase skills: If I am trying to help a child acquire or improve a skill, then I want to focus on repeating activities between sessions instead of changing things up frequently. Repeated exposure is good for skill acquisition. For example, I often use play to teach deep breathing through things like blowing bubbles, singing, and a game called “monkey ride” (in which I put a stuffed monkey on the child’s belly and then have him take a deep breath in and give the monkey a “ride” up to my hand which I place a couple of inches about the monkey’s head). I will repeat these games and variations of them through several sessions until the child has mastered belly breathing.

Short sessions for planned breaks from difficult tasks (The head cooler): When a child gets upset, frustrated, or anxious during specific situations, play can be a great way to manage this. For instance, a lot of my kids have problems around homework. They get upset if there’s too much, or if they don’t understand it. Some can’t make themselves take a break before the homework is complete. These children then get so upset they couldn’t do the work even if they wanted to. The poor parents are stuck not only trying to calm an upset child, but also facing daunting task of getting the child to return to finish the dreaded homework. Hours of this every night can be a major stressor for the whole family.

To counteract this, I suggest trying many short spurts. The parent works with the child to do homework, but also watches the child for the initial signs of agitation, frustration, or upset. As soon as the parent or child notices those signs, they take a short break. During the break, they spend just a few minutes doing something fun and silly (no video games or other major distractions). The goal of the activities is to allow the child’s head to “cool off.” Once calm, the child returns to the homework with a clear head. Families that have been successful in doing this find that not only are there fewer fights and tantrums around homework, but that more homework is getting done in less time.

The bottom line is that play is important. The more challenges you face with your child, the more important it is to put time aside every day to have some positive interactions. Be silly and have fun. Please share in the comments section your ideas for play or any questions you might have. In the meantime, play more with your kids and remember to BREATHE. You’ve got this!

medfr10140Alfred Kinsey reported that men hit their sexual prime in their late teens, while women don’t get that pleasure until their mid-thirties. But does the 60-year-old research that Kinsey conducted still hold true today? Was it even true back then?

According to Dr. Bella Ellwood-Clayton, a sexual anthropologist and author, the results of Kinsey’s research probably did not consider the myriad of other factors that influence sexual peak. Even though measuring the amount of orgasms a person has is a pretty good indicator, is not the only barometer by which to gauge sexual appetite.

Ellwood-Clayton says that at the time of the study, boys were masturbating and 30-something women were probably finding their own identities in stable relationships. For the first time in their lives, they were comfortable with their own sexuality. Today, women are finding this level of comfort at even older ages that extend well into their 50s, 60s, and beyond.

Opportunity is another factor that has a big impact on libido. When the opportunity for sex is unavailable, you can lose your desire. Raising children or being in a hostile or abusive relationship can cause even blazing sexual desires to smolder to ashes. But with the peak in sexual medications and the revival of sexual promiscuity in the older generation, it appears that sexual peaks are based more on social psychology than on physical ability.

Sure, men might have more testosterone than women and younger women might be a little more hormonally balanced than older women. But with hormone replacement therapy, physical health, and the right bed-fellow, people of all ages are reporting great sex drives. And there is an awful lot to be said about sexual maturity, which can add intense pleasure to sexual encounters (think Mrs. Robinson).

Overall, Ellwood-Clayton and other experts think that sexual peaks are not simply biological, but more the result of spiritual, physical, emotional, and biological components all aligning at just the right time. “Sexual prime, then, is the result of ‘sexiness.’ And that,” adds Ellwood-Clayton, “can peak at any age.”

Reference:
Ellwood-Clayton, Bella. (2013). Sexual prime: Fact or fiction. Huffington Post (n.d.): n. pag. Web http://www.huffingtonpost.com/bella-ellwoodclayton/sexual-prime_b_3424410.html

GoodTherapy | Recovering from Narcissistic Abuse, Part II: The No-Contact Rule
Back view of long hair brunette girl

In my previous article, I touched on the subject of narcissistic abuse recovery. I decided to write a second article as a follow-up for individuals who wish to explore further how to move forward through this specific healing process.

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As mentioned previously, recovery from this form of abuse can take a fair amount of months (or even years in some cases), given the insidious and covert nature of the emotional abuse (Sokol and Carter). Individuals who exhibit malignantly narcissistic behaviors are predatory in nature and seek to “conquer” targets to fuel their narcissistic supply (NS), which is the emotional sustenance which drives and fills them. These people thrive on attention (negative or positive) and will do anything in their power to ensure that their primary and secondary sources of NS are working in concert to feed the insecure ego of a broken psyche. Although by no means exhaustive of the complexity describing the individual suffering from narcissism, the DSM-IV states that people with narcissism exhibit the following traits: inflated sense of superiority, grandiosity, attention-seeking, self-absorption, arrogance, entitlement, and limited capacity to empathize and reciprocate in relationships.

Trapping a Target

It would make sense that individuals pulling away from someone like this would experience tremendous loss and trauma (Brown). Initially the person with narcissism presents as a knight in shining armor, completely in sync with the target’s emotions and dreams. The target is unaware that the individual then hones in on the target, studying the desired love object so that he or she can then act as the target’s soulmate, in essence.

This “hunting” can occur on dating websites or in the initial stages of dating (Brown). The target, who generally has the capacity for true, mature intimacy and love, is intelligent, attractive, and successful, then falls head over heels in love with the person with narcissistic tendencies. Subsequently, that individual then feigns love for the target. And the moment the target is hooked, distancing maneuvers ensue, which serve to disorient and confuse the target.

The target then becomes incredibly confused and experiences what is called cognitive dissonance, or a state of confusion. The person with narcissism had expressed love, but is now exhibiting distancing and detaching behaviors, which are not in alignment with the initial honeymoon stage (Carter and Sokol). Eventually, the individual is fully satiated on NS and then becomes bored and tired with it, because the target is merely an object or a vessel to obtain NS.

The target is devalued and discarded when the individual exhibiting narcissism no longer feels the need to court the individual who is a source of NS (Carter and Sokol). Ultimately, the target is left wondering what happened, and how someone who seemed so perfect as a soulmate completely undid everything that the target worked so hard to build. It was the target who fell in love with that individual, not the other way around. The person with narcissism purely was “feeding” on the NS, and as soon as his/her ego was full, the target was no longer considered useful (Payson).

Motivations of Narcissism

At that point, the individual with narcissism will either vanish completely or will say and do certain cruel and emotionally abusive things designed to injure the psyche of the target. He or she actually seeks to cause harm, and straddles the line of sociopathy (Brown). Ultimately, the target has no way of understanding what happened and is left with confusion, shock, disbelief, and betrayal.

Because people who tend toward narcissism always needs newer and fresher sources of supply, they have a habit of devaluing and discarding targets (Hotchkiss). They may be incapable of true love, empathy, reciprocity, kindness, and compassion. In essence, they may have broken psyches, much like a broken appliance (Hotchkiss).

Studies show that there is very limited effectiveness in treating narcissism in psychotherapy, as it can be firmly hardwired to someone’s personality due to largely environmental circumstances that occurred in his or her early childhood (Martinez-Lewi), including parental abandonment and severe abuse. It could be that they had inconsistent sources of love as children, if any at all, and to survive childhood, they had to create an outward mask to the world of the perfect individual. Underneath, these children could be empty and lacking a core sense of self, prone to depression and anxiety without NS to fill a void. Adults who are narcissistic are often referred to as developmentally stuck at age 5, when their emotional maturity ceased (Hotchkiss).

So what is a person to do if they have been crossed by this kind of toxic personality? First, I would say that though the pain is initially intense, you are blessed that the person with narcissism left. And no contact with this person will result in any form of healthy exchange.

The No-Contact Rule

Experts on narcissistic abuse recovery all agree that contact with someone like this always results in pain (Payson). Maintaining zero contact is essential for you to be able to heal and cognitively and emotionally process the mental hurricane that hit. Some clients have likened the experience to like coming off a drug; it is so painful to go through the traumatic grief work in being abandoned that these feelings are akin to withdrawals. However, as you heal, you can be empowered, stronger, wiser, and more discerning and reclaiming of your own self-worth.

The target is capable of empathy, reciprocity, true and mature love, and growing in a relationship. People with narcissistic behaviors are generally not. They are only capable of deceptively seducing preselected targets to fill a psychological void. The same cycle may repeat every time. It is so imperative that the target understand the process of grieving the loss of the fantasy of the person who narcissistically manipulated him or her.

Those with narcissistic behaviors are usually hard-pressed to find a healthy connection in any relationship. When the masks are pulled off, they realize they cannot manipulate and seduce as they are accustomed to. Too many people have caught on and discovered who they really are.

Luckily, for those whose lives have been touched (or slightly marred), there is a path to healing. This process takes place through no contact, a compassionate and understanding psychotherapist, and a support forum (whether online or in person). Those who have been targets heal and move on to love others in healthy, mature relationships.

Resources:

  1. Saferelationshipsmagazine.com:  Sandra A. Brown, MA’s website and resources related to abuse recovery from unhealthy relationships
  2. Help! I am in Love with a Narcissist by Steven Carter and Julia Sokol
  3. Women Who Love Psychopaths: Inside the Relationships of Inevitable Harm with Psychopaths, Sociopaths and Narcissists by Sandra L. Brown
  4. Why is it Always About You? The Seven Deadly Sins of Narcissism by Sandy HotchKiss, LCSW
  5. The Wizard of Oz and Other Narcissists: Coping with the One-Way Relationship in Work, Love and Family by Eleanor Payson, MSW

Avoidance is a behavior that can be seen as both adaptive and maladaptive. In psychological research, people with anxious personalities tend to avoid social situations and use avoidance as a way to circumvent threatening environments. People with depression also engage in avoidance behaviors.

In contradiction to these theories, attentional bias toward certain stimuli is also common in certain psychological conditions. Although avoidance is not always a bad practice, people who avoid emotional stimuli may internalize feelings and increase their risk for further symptoms of depression and/or anxiety. Existing research on emotional bias and avoidance focuses mostly on children, adolescents, young adults, and middle-aged adults. But few studies have looked at how emotional avoidance and processing changes with advanced age.

To address this, Ineke Demeyer of the Department of Experimental Clinical and Health Psychology at Ghent University in Belgium recently led a study that compared 25 middle-aged adult emotional bias to attentional and emotional bias in a group of 37 older adults between the ages of 75 and 88. Demeyer also looked at how the presence of depression or anxiety affected attention bias.

The results revealed that the older participants engaged in avoidant behaviors to all of the stimuli, regardless of whether the cues were neutral, sad, or happy. The middle-aged participants did not demonstrate any attentional bias. When Demeyer looked further, it was revealed that the older adults showed avoidant behavior toward the sad and happy cues more than the neutral ones. Demeyer added, “When taking a closer look into the role of mood and affective symptoms, we found that older adults who experienced more anxiety symptoms showed more avoidance of negative stimuli.”

Demeyer believes that these findings can be interpreted in several ways. First, older individuals may have higher levels of emotional regulation, which causes them to temper their emotional responses more than younger adults. Second, because older individuals are aware of their limited life span, they may choose to avoid any negative stimuli in particular, as they would rather only expend energy on positive things. Finally, their limited energy resources may cause them to have a blunted emotional response to all stimuli in general.

In conclusion, these findings show that there are differences in how older and middle-aged adults respond to emotional stimuli. Future work should explore these variances and their overall impact on well-being in more depth.

Reference:
Demeyer, I., De Raedt, R. (2013). Attentional bias for emotional information in older adults: The role of emotion and future time perspective. PLoS ONE 8(6): e65429. doi:10.1371/journal.pone.0065429

GoodTherapy | Family Triangles: When Someone Gets Put in the Middle“Jeanette” and “Tim”—names and identifying information have been changed—have been married for seven years when they seek couples counseling. Tim complains to the therapist that each time the couple argues, Jeanette phones her mother, Barbara, to vent. Tim has become uncomfortable around his mother-in-law, feeling as though Barbara has formed a negative opinion of him as a result of these conversations. Tim also feels that the involvement of Barbara makes it more difficult for him and his wife to work on their marriage together. Jeanette insists that she has tried and failed to talk things out with her husband and that she needs her mother’s input in order to resolve her feelings.

“Kristen” is the 17-year-old “baby” in a family of three siblings. As each of her older siblings grew up and left home, Kristen sensed increasing tension in her parents’ marriage. Recently, her father began to confide in Kristen regarding the conflicts between himself and her mother. She fears that upon her graduation from high school, her parents’ marriage may dissolve and they will seek a divorce. She is worried that her father, in particular, will be extremely negatively impacted if this occurs. Kristen’s grades have dropped and she is procrastinating on completing her college applications. She is considering staying at home to work instead of attending her dream university because she is fearful of leaving her parents “alone with only each other.”

“Joe,” “Mike,” and “Eddie” are brothers in their forties. While Joe and Mike frequently argue and find fault with one another, Eddie subsequently receives phone calls from each of his brothers complaining about, blaming, and accusing one another. Eddie feels as if he is constantly being pulled into the middle of a decades-long conflict between his brothers, and spends long hours speaking to each of them in an attempt to move them toward resolution. He has begun to avoid family gatherings in anticipation of the stress of being his brothers’ referee. Eddie’s wife “Lisa” observes the stress he is under and is frustrated by the toll this family conflict has taken on her husband.

In each of these scenarios, a dyad (two-person relationship) has become taxed and communication strangled, which has resulted in the triangulation of a third party into the relationship.

Triangulation is a family therapy concept discussed most famously by multigenerational family systems theorist Murray Bowen. Bowen described dyads as being inherently unstable under stress, much like a two-legged stool. When in balance, the dyad is capable of functioning well and meeting the needs of both people in it. However, when thrown out of balance by conflict, stress, or transitions, the dyad will often pull in a third person, or “leg” of the stool, to help them stabilize the relationship.

According to Bowen, some triangulation is normal and even healthy in the course of a family’s interactions. Because dyads are inherently unstable, the involvement of a third party can assist a two-person relationship in overcoming impasses, meeting needs, and coping through stressful times. For instance, two children who are arguing over a toy may seek out a parent to help them resolve the conflict. This kind of triangulation occurs because both of the people in the dyad are looking for healthy and effective mediation. When the triangulated person gives input, it is accepted into the dyad and processed together in a way that moves the original dyad forward in their relationship. Healthy triangulation can also occur in the context of parents (or other family caregivers) who come together to meet the needs of a third member, such as a child.

Triangulation can become unhealthy in families when it causes undue stress on the third party and/or when it prevents, rather than invites, resolution of the dyad’s conflict.

In the case of Jeanette and Tim, the triangulation of Barbara is being sought by only one of the spouses. Furthermore, the input provided by Barbara is not being brought back into the marriage for joint processing by both spouses. It is being withheld by the wife for her own individual purposes. Jeanette’s conversations with her mother are essentially taking the place of the emotional process that needs to be occurring within the marriage itself in order to return the marriage to healthy functioning.

In the case of Kristen, the 17-year-old high school student, her triangulation into her parents’ marriage is both active and passive. Her father has actively placed Kristen in the role of confidant, replacing communication that should be occurring between husband and wife. Kristen has also been passively placed by her dysfunctional family system into a role in which she must sacrifice her own individuation and growth in order to serve her parents’ emotional needs. Although her mother and father may not be expressly stating this to Kristen, the message is clear: The parents are relying on Kristen’s presence in the home in order to avoid confronting the breakdown of their marriage.

Finally, in the case of brothers Joe, Mike, and Eddie, the triangulation of Eddie over the course of many years has simply become an ingrained part of the conflict-heavy dyad between Joe and Mike. Joe and Mike have become accustomed to being able to discharge the anger and tension of their dyadic relationship onto a neutral party. After they utilize Eddie to manage their emotions, they return to their battles with one another with ever-renewed energy. The triangulation in this case is a piece of the unhealthy cycle rather than an honest attempt to seek mediation. Eddie has begun to bear the symptoms of the dysfunctional relationship, and his own bonds with uninvolved family members are crumbling under the weight of his “referee” role.

It is predictable that everyone will encounter triangulation in their family relationships at some point, whether as one of the dyad seeking stability or as the third party who is being put in the middle. If you find yourself involved in a triangle, it is helpful to ask yourself a series of questions in order to determine whether this triangle will ultimately be beneficial or harmful to the family system:

If the answers to the above questions are yes, then the triangulation is likely to be of the normal type which necessarily occurs in families over time.

If the answers to the above questions are yes, then the triangulation may be the type that is unhealthy and dysfunctional in the overall family system.

If you find that unhealthy triangles are occurring in your family, there are steps you may take to counteract the negative effects of such triangles:

Conduct issues are becoming a global problem for parents, educators, and children. They usually first appear and early childhood and can be identified through behavioral and psychological screenings, such as the Strengths and Difficulties Questionnaire (SDQ). The issues that arise from conduct problems include anger, aggression, hostility, academic challenges, social problems, and other behavioral and emotional issues.

Although the SDQ has been shown to be effective at identifying symptoms of conduct disorder, it is lengthy and time consuming. Therefore, Melissa E. Duncombe of the Psychological Sciences Department at the University of Melbourne in Australia wanted to see if an alternative brief assessment would be as effective and provide results that are equal to that of the SDQ.

For her study, Duncombe used the Conduct Problems Risk Screen (CPRS), a seven-item scale, to identify conduct problems in a group of over 4,700 elementary school children. Because traits found in oppositional defiance (ODD) and attention-deficit hyperactivity (ADHD) have been shown to be precursors for later conduct problems, the CPRS was designed to reveal any specific inattentive or aggressive behaviors as well.

Parents and teachers reported their evaluations of children, and Duncombe found that although there was a much higher rating of conduct issues in the parents’ reports, the overall consistency between the two groups was high. Duncombe believes that parents may witness more behavioral problems and may also incorporate family reactions, disciplinary consequences, and other factors into their assessments when filling out the CPRS. Teachers, on the other hand, can only report on what they witness and experience during the school day.

Another strength of the CPRS is that it only takes a few minutes to administer. Unlike the lengthy SDQ, the CPRS can be completed in under two minutes, and may be viewed as more applicable tool with younger children. This can be especially important for early identification of the children at risk for later conduct, ADHD, or ODD issues. Dunscombe added, “The CPRS is a valid and reliable instrument and could be used effectively as a screening tool to identify those children at risk of developing conduct disorder.”

Reference:
Duncombe, Melissa E., Sophie S. Havighurst, Kerry A. Holland, and Emma J. Frankling. (2012). Psychometric evaluation of a brief parent- and teacher-rated screen for children at risk of conduct disorder. Australian Journal of Educational & Developmental Psychology 12 (2012): 1-11. Print.

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